Mediators for internalizing problems in adolescents of parents with chronic medical condition

Parents’ chronic medical condition (CMC) is related to internalizing problem behavior in adolescents. Following the transactional stress and coping (TSC) model of Hocking and Lochman, our study examines whether the effect of illness and demographic parameters on the child’s internalizing problems is mediated by the ill parent’s quality of life, family functioning, and child adaptational processes. Participants were 160 adolescents (52 % female, mean age = 15.1 years) from 100 families affected by parental CMC. Children completed a test battery including the Youth Self-Report. Family functioning was determined with the Interactional Problem Solving Inventory (marital functioning) and the Inventory of Parent and Peer Attachment (alienation from parents). Child adaptational processes were composed by cognitive processes, methods of coping, and child report of stress. Ill parents completed the Medical Outcome Study Short-Form and the Beck Depression Inventory, assessing quality of life. We used structural equation modeling to investigate the tenability of the TSC model. After a series of step-by-step modifications, the TSC model for children with parental CMC fitted the data closely. The ill parent’s quality of life, family functioning, and children’s daily hassles and stress mediated the effect of parental CMC on adolescent internalizing problems. Children’s active problem solving and social support seeking were not directly related to internalizing problems but significantly interfered with children’s self-esteem and stress. Child adaptational processes should be accorded a central role in support programs and interventions for children with parental CMC. Health practitioners and teachers are recommended to be alert for support needs in children.