Sibling adaptation to childhood cancer collaborative study: Cross- cultural aspects

Cross-cultural aspects of siblings' adaptation to child-hood cancer were examined in two studies as part of a cooperative multi-institutional investigation in Israel and the United States. Study 1 compared the behavioral adaptation of Israeli siblings of patients with childhood cancer with matched clinically referred and normal Israeli children. Study 2 compared the behavioral adaptation of case-matched samples of Israeli and American siblings and assessed the contribution of family relations and parental coping to the siblings' behavioral adjustment. Israeli patients' siblings and normal samples scored significantly lower on the Child Behavior Checklist (CBCL) than the clinically referred sample did, indicating fewer behavior problems, with no differences between the sibling and normal samples. The CBCL scores of the Israeli and American samples did not differ significantly on the Externalizing and Internalizing subscales and the Total Behavior Problem score. Significant correlations were found in both the Israeli and American samples between the parental coping and family relations variables and the CBCL summary scores, indicating that greater internal family support and emotional expressiveness and lower conflict were associated with less behavior disturbance in the sibling. The authors consider cross-cultural and methodologic issues when interpreting similarities and differences among Israeli and American siblings of pediatric cancer patients.