Children of Somatically Ill Parents: A Methodological Review

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Abstract
The children of seriously ill parents are at risk for emotional disturbances. This review covers five former reviews, three theoretical articles, five case studies and 39 sample studies from the last 15 years. Methodological problems and shortcomings of previously published studies are discussed in detail. Based on former reviews and theoretical approaches, a developmental framework for children’s adaptation processes is elaborated. Empirical studies are analysed with a differentiation of how various results were correlated with the types of parental diseases and children’s age groups studied, as well as with various methodological designs and instruments applied. It appeared evident that children of seriously ill parents had higher scores on symptom scales than did controls, with a tendency towards internalizing symptomatology. In several studies, adolescent daughters of ill mothers appeared to be at highest risk for maladjustment. Ill parents’ subjective perception of their impairment predicted children’s symptoms better than the objective degree of severity of their disease. Although subgroups of children adjusted well, covariant protective mechanisms could not be clearly identified. In conclusion, suggestions for further research include ethical standards, a profound theoretical framework for any hypothesis to be tested, a combination of qualitative and quantitative methodology, the integration of the child’s subjective dimension by semi-structured or open interviews, and the consideration of coping as a process through longitudinal designs.