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PubMedDate not supplied

[Sibling relations between individuation and attachment: attempt at a conceptualization].

Although sibling relationships can be considered as one of the most durable and intensive relationships, not much research in developmental psychology and family research has been done on this issue. The strong focus on parents, more specifically on mothers, stood in the way of adequate conceptualization and understanding of the function and contribution of siblings to individual development and family interaction. In this contribution a conceptualization of sibling relationships is presented. Siblings as objects of aggressive and sexual feelings as well as the function of siblings in the family system, for example, as parentification and negative identity is emphasized. In addition, the different qualities of sibling relationships, for example, envy, rivalry, similarity, and difference, are emphasized. The function of siblings as love objects is stressed, and the role of siblings as support as well as teaching object is illustrated. Finally, it is emphasized that, similar to relationships between parents and child, the quality of sibling relationships changed over time and leads, for example, to a detachment between sibling relationships during adolescence.

Adolescent↗
PubMedDate not supplied

Supportive groups for siblings of pediatric oncology patients: impact on anxiety.

Childhood cancer can have a substantial emotional impact on the siblings of the sick child. In order to help these siblings adjust to the illness, supportive groups were started in 1994 at our medical center. The program is based on a model of psychosocial support; the aim of the group is to enhance control strategies and, thus, to reduce anxiety. It consists of five sessions and is offered to siblings aged 7-18. The study objective is to evaluate the effect of group participation on sibling anxiety. The State Trait Anxiety Inventory for Children was administered to 24 siblings before and after group participation. Results showed that siblings experience less anxiety after participating in the group. Before group participation, a majority of the siblings were more anxious compared with normal peers. The sibling's age and sex, whether the ill child is in treatment, survival perspective, and time since diagnosis were not related to anxiety reduction. The continuation of the group is supported by its positive impact on siblings. Results must nevertheless be interpreted cautiously, considering the small number of siblings participating in the study, the lack of a control group and the restriction to one outcome measure.

Adaptation, Psychological↗
PubMed1998

Effects of lead on sibling recognition in young herring gulls.

Lead exposure early in life affects physiology, behavior, and cognitive development in humans and other animals. In gulls, lead also disrupts parental recognition, leading to potential decreases in survival in wild populations. In this paper, young herring gulls, Larus argentatus, were used to examine the effect of lead on sibling recognition. Each of 80 one-day-old herring gull chicks was randomly assigned to either a control group or a lead treatment group that received a single dose of lead acetate solution (100 mg/kg) at day 2. Matched controls were injected with isotonic saline at the same age. At 10 days of age, there was no demonstrable sibling recognition in control chicks, but recognition was clearly developed by 15 days of age. Lead disrupted sibling recognition, and there still was no evidence of sibling recognition in lead-injected chicks by 26 days of age. Time to respond initially increased and then decreased with age in both control and lead-injected chicks. Control chicks that correctly reached their siblings did so in significantly less time than did lead-injected chicks, and they remained closer to their siblings at the end of the test. These experiments clearly demonstrate that lead disrupts sibling recognition in herring gull chicks, delays the time to respond and to reach their siblings, and increases the final distance chicks are from their calling siblings. In nature, lead-impaired chicks would be unable to use siblings as a cue enabling them to find their nests and might suffer higher mortality from territorial adults and chicks, as well as from cannibalistic adults.

Animals↗
PubMed2001

Sibling-based association study of the PPARgamma2 Pro12Ala polymorphism and metabolic variables in Chinese and Japanese hypertension families: a SAPPHIRe study. Stanford Asian-Pacific Program in Hypertension and Insulin Resistance.

The peroxisome proliferator activated receptor (PPAR) gamma2 is a transcription factor that has been shown to be involved in adipocyte differentiation, adipogenesis, and insulin sensitivity. To address the role of PPARgamma2 in glucose homeostasis and insulin sensitivity, among many other objectives, we conducted a sibling-controlled association study in a multicenter program - the Stanford Asian-Pacific Program in Hypertension and Insulin Resistance (SAPPHIRe). Approximately 2525 subjects in 734 Chinese and Japanese families have been recruited from six field centers for SAPPHIRe. In total, 1702 subjects including parents and siblings from 449 families have been genotyped for PPARgamma2, of which 328 families were Chinese and 121 Japanese. Only 88 subjects of the 1525 siblings screened for the P12A polymorphism were found to be carriers of the A variant, the most common variant of the PPARgamma2 gene. A variant frequencies of the siblings were 4.27% in Chinese and 2.72% in Japanese. A sibling-controlled association study was performed through genetically discordant sibships (i.e., P/P genotype vs. P/A + A/A genotypes). Specifically, we examined whether there were differences in metabolic variables between the discordant siblings within families. In total, 88 subjects carrying either 1 or 2 A alleles had at least one sibling who was discordant for the P12A polymorphism, yielding a total of 180 individuals from 47 families for analyses, among which 92 siblings were homozygous for wild-type P allele. Siblings with the A variant tended to have lower levels of fasting plasma glucose (OG-10), and lower glucose levels at 60 min following oral glucose loading after adjusting for age, gender, and body mass index. Using a mixed model treating family as a random effect, we found that P12A polymorphism of the PPARgamma2 gene contributes significantly to the variance in fasting plasma glucose, glucose level at 60 min, and insulin-resistance homeostasis model assessment. Our results suggest that within families siblings with the A variant in the PPARgamma2 gene may be more likely to have better glucose tolerance and insulin sensitivity independent of obesity in Chinese and Japanese populations.

Adult↗
PubMed1995

Sibling correlations of coronary heart disease risk factors in a sample of Israeli offspring with parental history of myocardial infarction.

Sibling correlations for coronary heart disease risk factors were analyzed in 731 pairs of siblings whose parents experienced a first myocardial infarction. Sibling correlations for lipids, lipoproteins and apolipoproteins ranged from 0.29 to 0.48, with limited changes on adjustment for sex, age, education and body mass index. For most lipid variables brother-brother correlation coefficients were highest and sister-brother correlation coefficients were lowest. Sib-sib correlation coefficients for lipids, lipoproteins, blood pressure and body mass index were similar to those estimated from a random sample of Jewish families. The sibling correlations were relatively low for waist to hip ratio, triceps and suprailiac skinfolds, moderate for subscapular skinfolds and body circumference measurements and high for number of cigarettes smoked by the siblings. The sibling correlations for lipid variables showed a moderate dependency on the apolipoprotein B XbaI genotypes. Siblings living in the same household tended to have higher correlation coefficients for HDL-C, apolipoprotein B and apolipoprotein AI than those living apart. The correlation coefficients for number of cigarettes and anthropometric variables tended to be heterogeneous due to the higher correlations among siblings living apart. A clear trend of decline in sib-sib correlations for apolipoprotein AI, glucose, cigarette smoking, body mass index and circumference measurements with increased spacing between sibling's ages was indicated. This temporal trend in sibling correlations for coronary heart disease risk factors suggests that genetic and/or environmental factors may have different influences at different ages.

Adult↗
PubMed1983

Respiratory frequency during sleep in siblings of sudden infant death syndrome victims. A comparison with control, normal infants.

The present study was carried out on 76 polygraphic recordings performed on 38 siblings of sudden infant death syndrome victims and on 38 control (2 days to 18 weeks old) infants. Each sibling corresponded to a control infant according to gender, gestational age at birth and postnatal age criteria. We found that in siblings as in controls, respiratory frequency (RF) was higher in active sleep (AS) compared to quiet sleep (QS) state (P less than 0.05 for 11-18 week siblings, p less than 0.01 for the other groups). During the transitional sleep (TS), RF was on an intermediate level (AS greater than TS greater than QS). There were no significant differences between RF of siblings compared to controls, except that RF during QS in 6-10 week control infants was higher than in siblings of the same age (P less than 0.05). We found a wide variability between RF of different individuals within all the age groups of siblings and of controls (P less than 0.001). However, a high correlation was usually noted between RF found in different sleep states: some infants (siblings or controls) breathed more rapidly and others more slowly in all states studied. In siblings, as previously described in other groups of normal infants, RF seems to be an individual characteristic. In addition, the present work shows that according to RF criterion, healthy siblings are similar to normal infants.

Circadian Rhythm↗
PubMed2004

Patients' sibling history was sensitive for hypertension and specific for diabetes.

OBJECTIVE: We examined the analytic validity of reported family history of hypertension and diabetes among siblings in the Seychelles. STUDY DESIGN AND SETTING: Four hundred four siblings from 73 families with at least two hypertensive persons were identified through a national hypertension register. Two gold standards were used prospectively. Sensitivity was the proportion of respondents who indicated the presence of disease in a sibling, given that the sibling reported to be affected (personal history gold standard) or was clinically affected (clinical status gold standard). Specificity was the proportion of respondents who reported an unaffected sibling, given that the sibling reported to be unaffected or was clinically unaffected. Respondents gave information on the disease status in their siblings in approximately two-thirds of instances. RESULTS: When sibling history could be obtained (n=348 for hypertension, n=404 for diabetes), the sensitivity and the specificity of the sibling history were, respectively, 90 and 55% for hypertension, and 61 and 98% for diabetes, using clinical status and, respectively, 89 and 78% for hypertension, and 53 and 98% for diabetes, using personal history. CONCLUSION: The sibling history, when available, is a useful screening test to detect hypertension, but it is less useful to detect diabetes.

Adult↗
PubMed1998

Markedly high prevalence of coronary risk factors in apparently healthy African-American and white siblings of persons with premature coronary heart disease.

Among persons with a family history of premature coronary heart disease (CHD), siblings bear an excess risk of CHD that is as high as 12 times that of the general population. Aggressive, new, national guidelines for CHD risk reduction have focused on high-risk families, yet little is known about actual remediable risk factors in siblings of persons with premature CHD. To determine the magnitude of the problem relative to the general population, we screened 846 unaffected siblings (ages 30 to 59 years) of persons with documented CHD before age 60 years and compared their risk factor values with population reference norms obtained in the Third National Health and Nutrition Examination Survey (NHANES III) and the National Health Interview Survey (NHIS). Mean levels of low-density lipoprotein cholesterol were 0.52 mmol/L (20 mg/dl) higher in siblings; the prevalence of low-density lipoprotein cholesterol > or =4.14 mmol/L (160 mg/dl) was nearly twice that of race, sex, and age-specific values from NHANES III. Levels of high-density lipoprotein cholesterol <0.91 mmol/L (35 mg/dl) were similar between siblings and NHANES III (11% and 12%, respectively). Only 4% of all siblings had triglyceride levels > or =4.52 mmol/L (400 mg/dl). Hypertension prevalence was twice as high among siblings as among the NHANES III. Current smoking was 33.9% in white siblings and 25.5% in the NHIS, whereas smoking in African-Americans was similar to that in the NHIS (31.1% vs 29.2%). A mere 13% to 29% of siblings were without any major remediable risk factors. The overwhelming need for risk factor modification in this easily identifiable high-risk population supports aggressive national guidelines and demonstrates the lack of adequate treatment of apparently healthy siblings of persons with premature CHD.

Adult↗
PubMed1995

Sibling risks of abdominal aortic aneurysm.

There is evidence that the risk of abdominal aortic aneurysm (AAA) is greater in first-degree relatives of patients with the disorder than in the same age group of the general population. We conducted a 3-year study of siblings of AAA probands and siblings of a control group (cataract surgery patients) of the same age. Genetic information was obtained by interview from 126 probands and 100 controls; another family member was present at the interview. Medical records were obtained and further information verified before a sibling (over age 50) was assigned affected status. Of 427 siblings of probands, 19 (4.4%) had probable or definite AAA, compared with five (1.1%) of 451 siblings of controls. The lifetime cumulative risks of AAA at age 83 were 11.7% (SD 3.1) and 7.5% (4.1), respectively. The risk of AAA began at an earlier age and increased more rapidly for probands' siblings than for controls' siblings (p < 0.01, log-rank test). A risk comparison, based on the results of ultrasound screening of 54 geographically accessible siblings of probands and the 100 controls showed a similar pattern. Ten (19%) siblings of probands and eight (8%) controls had AAA on ultrasound (lifetime cumulative risk 60.8% [18.9] vs 14.9% [5.1], p = 0.01). These results show that familial factors influence the age of onset of AAA. We recommend routine ultrasound examination of siblings of patients with AAA.

Age Factors↗
PubMed1999

Psychosocial impact of pediatric BMT on siblings.

Although bone marrow transplantation (BMT) has become standard therapy for many life-threatening disorders of childhood, there is little research on the psychosocial impact of BMT on siblings of children undergoing BMT. Such siblings face issues common to any family with a chronic illness. However, the psychological impact on the family is intensified because two family members, usually children, are subjected to intrusive medical procedures. Investigators had earlier noted that sibling donors may be at risk for behavioral problems and anxiety, while nondonors may experience ambivalent feelings of disappointment and relief. It was suggested that psychosocial stages of BMT may parallel the medical transplant process, with high levels of stress experienced pre-BMT, during hospitalization, and post-discharge. Our own group has recently conducted more systematic investigations on the psychosocial effects of BMT on donor vs nondonor siblings of surviving pediatric BMT patients. We found that sibling donors showed significantly more anxiety, lower self-esteem, and more adaptive skills in school than nondonors. Nondonors, on the other hand, showed significantly more school problems. One third of the siblings in each group reported a moderate level of post-traumatic stress. Taken together, our research indicates that BMT affects the life of the child at home and at school and that post-traumatic stress symptomatology is a component of the psychological reaction in siblings. The psychosocial adjustment of siblings is a critical area of investigation in BMT populations. Parents need to know that the BMT process affects every member of the family system, and both parents and professionals need to direct more emotional support and attention to siblings. Studies are needed that focus on interventions designed to reduce levels of sibling psychosocial maladjustment. The psychosocial developmental model of post- traumatic stress disorder is a viable theoretical model that may be used to guide future research.

Bone Marrow Transplantation↗
PubMed2000

Experiences of siblings of children with physical disabilities: an empirical investigation.

PURPOSE: This study aimed to investigate the experiences of Dutch siblings of children with physical disabilities (n=43). METHOD: Interviews were conducted to investigate experiences of siblings in 3 areas: the sibling relationship, the relationship with parents, and the relationship with others. The siblings also completed a coping response inventory. RESULTS: The siblings reported difficulties in undertaking activities and in communicating with their brother/sister with a disability. Most siblings worried about the future and the health of their brother/sister with a disability. The siblings reported open communication and trust as the main characteristics of the relationship with their parents. They acknowledged their parents' attempts to treat all children equally, although parents were not always successful in doing so. Having a sibling with a disability did not cause problems in the relationship with friends. The awkward reactions of strangers caused the siblings much annoyance and distress. Siblings in this sample used more approach coping strategies than avoidance strategies, t(34) = 2.37, p < 0.05. CONCLUSION: The brothers and sisters generally did not experience many significant problems, however, a minority of the children did experience problems for which they would like help. In addition, they reported joys as well as problems.

Adaptation, Psychological↗
PubMedDate not supplied

Some genetic aspects of idiopathic and symptomatic absence seizures: waking and sleep EEGs in siblings.

Epileptic activity was recorded in the waking and sleep EEG of 62.5% of 80 siblings of 38 patients with absence seizures. Epileptic discharges were noted in waking only in 8.7%, in waking as well as sleep in 28.8%, and in sleep only in 25%. Generalized, partly irregular, and slow spike-wave complexes were found, twice with lateral emphasis. Spike-wave complexes were recorded in 72% of 50 siblings of patients with idiopathic absence and in 46.7% of 30 siblings of patients with symptomatic absence. One epileptic discharge was observed every 108.6 s on the average, without striking differences between siblings of patients with idiopathic (99.7 s) and symptomatic absence (119.3 s). Without any differences between siblings of children with idiopathic and symptomatic absence, the most epileptic discharges were activated in sleep stages C and D, followed by stages A and B. The highest activation rate was observed in the 7-14-year-old group (73.5%) and to a somewhat lesser degree in the group between 15 and 20 years of age (66.7%); fewer epileptic discharges were recorded in younger (25%) and older patients (28.6%). The higher activation rates in the male sex were significant only in siblings of patients with idiopathic absence. Although only five patients (13.2%) were photosensitive, a photosensitivity was found in 24% of siblings of children with idiopathic absence and in 20% of siblings of patients with symptomatic absence. Three siblings of patients with idiopathic absence also had absence seizures; in one of them a febrile seizure occurred at an earlier age. All of them showed generalized spike wave discharges in waking as well as sleep. Occipital theta delta activity with generalization was observed more frequently in siblings of patients with idiopathic absence (82.2%) than in those of patients with symptomatic absence (63.6%). Our waking and sleep EEG recordings prove that concerning etiology-genetic factors play a striking role in idiopathic absence, but are also of considerable significance in the symptomatic types.

Adolescent↗
PubMed1992

Vesicoureteric reflux and renal scars in asymptomatic siblings of children with reflux.

The purpose of the study was to determine the incidence of vesicoureteric reflux (VUR), renal scars and hypertension in asymptomatic siblings of children with VUR. The study comprised 105 siblings of patients with VUR. Their age ranged from 4 months to 6.3 years. All had a direct radionuclide voiding cystography (DRVC) performed, and VUR was detected in 47 of 105 (45%). High grade VUR in the first year of life had an incidence of 50% compared with a 9% incidence in siblings older than 2 years, while only one of the 27 siblings with a low VUR grade was younger than 1 year. In 43 of 47 siblings with VUR, a technetium-99m dimercaptosuccinic acid (99mTc-DMSA) scan was performed and renal scars were found in 10, which presents 23% of siblings with VUR who were scanned and 10% of all siblings studied. One child had hypertension. Identifying VUR among asymptomatic siblings could possibly prevent renal damage and its consequences. Thus, the predictive value of positive family history alone in identifying VUR was 45% while 23% of siblings had renal scars. This incidence justifies the routine investigation of asymptomatic siblings, by using DRVC at an early stage.

Child↗
PubMed2000

In middle-aged siblings of patients with type 2 diabetes mellitus normal glucose tolerance is associated with insulin resistance and with increased insulin secretion. The SPIDER study.

OBJECTIVES: To evaluate the frequency of impaired glucose tolerance (IGT) and of Type 2 diabetes mellitus (Type 2 DM) in siblings of patients with Type 2 DM, and to assess insulin release and insulin sensitivity in siblings with normal glucose tolerance (NGT), compared with NGT spouses of probands without family history of Type 2 DM. DESIGN AND METHODS: We evaluated 87 families including 103 Type 2 DM patients (87 probands), and we carried out an oral glucose tolerance test (OGTT) in 130 siblings and in 60 spouses. Among NGT subjects, 12 siblings and 16 spouses underwent a low-dose insulin-glucose infusion test (LDIGIT) to evaluate C-peptide release and insulin sensitivity. RESULTS: After the OGTT, 24 siblings were classified as having Type 2 DM, 31 as IGT, and only 14 spouses as IGT (P=0.0012 vs siblings). NGT siblings (n=75) showed higher insulin levels at 120 min than NGT spouses (n=46) at OGTT, in spite of identical blood glucose levels; at LDIGIT, NGT siblings secreted more C-peptide and showed a lower insulin sensitivity than NGT spouses. CONCLUSIONS: These data indicate that middle-aged siblings of probands with Type 2 DM have a high frequency of IGT and Type 2 DM, and that NGT siblings have increased insulin resistance and increased insulin secretion when compared with adequate controls.

Blood Glucose↗
PubMedDate not supplied

Antibodies to glutamic acid decarboxylase in Syrian and Jordanian type I diabetes patients and their siblings.

BACKGROUND: Attempts to identify the earliest events in the autoimmune process in type I diabetes mellitus suggests the glutamic acid decarboxylase (GAD) is one of the first and most important autoantigens. We conducted this study to determine the prevalence of antibodies to glutamic acid decarboxylase (anti-GAD) in both Syrian and Jordanian children with Type I diabetes and their siblings. PATIENTS AND METHODS: sera were obtained from 85 Syrian patients with type I diabetes (mean age 13.6 + 5.9 years), from 45 of their siblings (mean age 11 + 6.1 years), from 78 randomly selected Syrian control subjects (mean age 9.9 + 43 years), and from 95 Jordanian patients with type I diabetes (mean age 13.9 + 65 years), from 78 of their siblings (mean age 12.3 + 7.1 years), and from 100 randomly selected Jordanian control subjects (mean age 7.8 + 4.5 years). Sera were analyzed from anti-GAD using the enzyme linked immunosorbent assay (ELISA) technique. RESULTS: Prevalence of anti-GAD was 34.1% (29/85) in Syrian type I diabetes patients, 20% (9/45) in their siblings, 1.3% (1/78) in Syrian control subjects, 49.5% (47/95) in Jordanian type I diabetes patients, 23% (18/78) in their siblings, and 2% (2/100) in Jordanian control subjects. Differences between the Syrian and Jordanian type I diabetes groups and their siblings and controls were statistically significant. In patients with less than two years of diabetes duration, the frequency was 88.8% (16/18) for both groups. There was no correlation between sex and anti-GAD levels in their Syrian and Jordanian type I diabetes patients and their siblings. The positivity of anti-GAD tended to be more frequent at the age range of 5 to 8 years in siblings. Anti-GAD titers >90 ng/ml were found in 58.8% of type I diabetes patients and in 38% of siblings who were anti-GAD positive. CONCLUSION: Syria and Jordan have prevalence rates of anti-GAD among type I diabetes patients and their siblings that are among the highest reported in the world. Therefore, anti-GAD may be valuable as an early predictive marker for type I diabetes.

Journal Article↗
PubMed1982

Parents' views of the response of siblings to a pediatric hospitalization.

In this study, parents describe siblings' adjustments to a brother's or sister's hospitalization. The families of children hospitalized for relatively usual, non-life-threatening reasons were investigated. The relationship between patterns of sibling participation and family structure and sibling response were explored. Sibling responses were studied through intensive interviews with parents. Interviews were conducted using semistructured interview guides and took place within 24 hours of the child's admission and again from 4 to 6 weeks after the child's discharge from the hospital. Families (N = 59) were divided into those in which siblings participated actively in adjusting to the hospitalization and those in which siblings were passive participants in the adjustment process. Sibling participation was discussed as a function of family structure. Parents reported few negative sibling responses to hospitalization. The quality of sibling response was related to the amount of change experienced.

Activities of Daily Living↗
PubMed1986

Sibling relationships of children with autistic, mentally retarded, and nonhandicapped brothers and sisters.

The subjects were 90 children between 6 and 15 years of age, 30 with autistic, 30 with mentally retarded, and 30 with nonhandicapped brothers or sisters. The children were questioned about their sibling relationships in an open-ended interview, and, in the case of children with handicapped siblings, they also responded to questions about particular problems they faced in regard to their brothers or sisters. In addition, mothers filled out a behavior rating scale in which they described the positive and negative aspects of their children's behavior toward the sibling. In general, children and mothers rated the sibling relationships positively. Group comparisons indicated that children with autistic and mentally retarded siblings did not differ on any self-report measures. Children with nonhandicapped siblings reported that their family relations were slightly more cohesive but otherwise did not differ in terms of their self-reports from children with handicapped siblings. Mothers of nonhandicapped children, however, rated the sibling relationships more negatively than did mothers of handicapped children. Further analyses revealed that status variables (age, gender, family size) were not as highly correlated with the quality of sibling relationships with handicapped children as were specific problem areas (e.g., perceptions of parental favoritism, coping ability, concerns about the handicapped child's future).

Adolescent↗
PubMed2005

The effects of chronic renal failure on siblings.

It is well recognised that chronic illness in children can have a significant effect upon siblings, but their viewpoints need to be sought if we are to change our practice. We conducted semi-structured interviews at home with 15 siblings (8 males) aged 8-12 years whose brother/sister were on chronic dialysis or had received or were waiting for a renal transplant. The interviews were analysed using a grounded theory approach. The children also completed the Spence Children's Anxiety Scale (SCAS), which revealed no statistically significant evidence that they were exhibiting chronic clinical anxiety. Qualitative data indicated that siblings had a variety of concerns concerning their own health and that of their siblings and worried about the effects on family routine and separation from parents. The siblings felt more protective towards their chronically ill sibling and felt that they themselves needed to be more grown up. The study has implications for our clinical practice in that our psychosocial assessment of families needs to include an assessment of sibling needs and siblings should be involved when preparing patients for chronic renal failure treatment. The importance of maintaining family routines should be emphasised, as well as trying to involve siblings in unit activities.

Anxiety↗