Seligman M
CMAJ. 1987 Jun 15;136(12):1249-52.
The presence of a chronically ill or mentally handicapped child in a family can be a stress for the child's siblings, who often are ill informed about the nature and prognosis of the illness, may be uncertain what is expected of them in the caregiving role, may feel their own identities threatened, and may experience ostracism by their friends and misunderstanding at school. Although individual reactions vary widely, feelings of anger, guilt, resentment and shame are commonly reported. Excessive responsibility and concern about one's identity may add to these feelings and culminate in psychologic problems in the sibling. The physician caring for the family must be alert for symptoms of emotional disturbance or social maladjustment among the siblings of chronically ill or mentally handicapped children and should be prepared to counsel the family or refer them to a counsellor experienced in this area. In general, the first step is to be sure that the sibling is fully informed about the condition and to encourage frank discussion between the parents and the handicapped child's siblings.
家中有慢性病患儿或智障儿童，可能会给患儿的兄弟姐妹带来压力。他们往往对疾病的性质和预后了解甚少，可能不确定在照顾患儿时自己该做什么，可能觉得自己的身份受到威胁，还可能遭到朋友的排斥以及在学校被误解。尽管个体反应差异很大，但愤怒、内疚、怨恨和羞耻感是常见的表现。对自身身份的过度责任感和担忧可能会加剧这些情绪，最终导致兄弟姐妹出现心理问题。照顾这个家庭的医生必须留意慢性病患儿或智障儿童的兄弟姐妹出现情绪困扰或社会适应不良的症状，并应准备好为家庭提供咨询，或将他们转介给在该领域经验丰富的咨询师。一般来说，第一步是要确保兄弟姐妹充分了解病情，并鼓励父母与残疾儿童的兄弟姐妹进行坦诚的讨论。
