Insulin dependent diabetes mellitus (IDDM) is the most common metabolic
condition in children in the United States. Research has focused on the child with IDDM
or the parents with little attention given to healthy siblings. Sibling relationships are
considered important reciprocal influences that foster cognitive and social development.
Few researchers have studied the sibling relationship, coping and/or adaptation of
children with diabetes and their siblings. The purpose of this study was to compare
perceptions of the sibling relationship, coping and adaptation in school-age children with
diabetes and their siblings. The framework that guided this study was a combination of
theoretical models developed by Stoneman and Brody (1993) for sibling relations and by
Lazarus and Folkman (1984) on coping and adaptation.
A convenient sample of 53 sibling dyads and their parents were studied using an
exploratory, cross-sectional descriptive design. Siblings were between the ages of 8 and
14 years. Subjects were recruited through mass mailings, presentations at childrens’
diabetes programs and pediatric endocrinology clinics. The families were primarily
Caucasian, intact nuclear families comprised of married, educated, professional parents,
with two or more children, and an average or above average socioeconomic status. The
siblings were similar in age, academic achievements, sports activities, hobbies and
friendships. Despite the parental perception of diabetes as a serious disease, the parents
indicated the child with diabetes had average or excellent control of the disease.
Data were collected from the siblings through the use of the Sibling Relationship
Questionnaire (Furman and Buhrmester, 1985) and the Schoolagers Coping Strategies
Inventory (Ryan-Wenger, 1990). A parent completed the Child Behavior Checklist
(Achenbach, 1991) for each child and a background information questionnaire.
Data analysis using paired t-tests revealed no significant differences between the
children in terms of their perceptions of the sibling relationship, and the number,
frequency, or effectiveness of coping strategies used. Parents perceived a significant
difference between the children in terms of total behavior, externalizing behavior and
social competency scores, but not internalizing behavior scores. The children with
diabetes had higher scores for the behaviors and lower competency scores than their
siblings. Pearson correlation coefficients indicated several significant interrelationships
for the children. The warmth factor of the SRQ was positively correlated with the number
of coping strategies used, the coping frequency score and the coping effectiveness score
and negatively correlated with the conflict factor of the SRQ for both groups of children.
The conflict subscale of the SRQ was negatively correlated with the social competency
scores for the children with diabetes and the warmth factor of the SRQ for the siblings.
These findings contribute to the knowledge of children with diabetes and their
healthy siblings. Future research needs to focus on a more heterogeneous, larger sample
of children with diabetes and their siblings.