Identity formation, personality, and well-being in adolescent and emerging adult siblings of survivors of pediatric cancer

Background:
Siblings of pediatric cancer survivors are increasingly recognized as a potential vulnerable group requiring focused psychosocial support. However, little is known whether the experience of having a sibling with cancer affects their identity formation and personality traits. This study aimed to compare adolescent and emerging adult siblings of pediatric cancer survivors and control participants on identity formation, personality traits, and general well-being.

Methods:
Each sibling (n=80; mean age: 19.13 years; 49% male; age range: 14-25; mean time since diagnosis: 10.57 years) was matched on age and gender with two community youths without a history of having a chronic disease. Analysis of variance was used to assess group differences in the measures of identity formation, personality traits, and general well-being.

Results:
Siblings of pediatric cancer survivors exhibited lower levels of agreeableness, conscientiousness, openness, self-esteem, and life satisfaction compared with community youth. Gender played a significant role in identity and personality among siblings, with female siblings showing higher scores on identity confusion, neuroticism, and openness and lower scores on identity synthesis than male siblings. Other demographic or clinical variables showed no significant relationship. Siblings' self-esteem, life satisfaction, and depressive symptoms were strongly associated with their identity formation and personality traits, similar to patterns observed in the general community.

Conclusions:
Our study suggests that siblings of pediatric cancer survivors may face changes in personality traits and overall well-being, although their identity development is largely comparable with that of community youth. Not only are pediatric cancer survivors and their parents vulnerable for potential psychosocial sequelae, but so are survivors' siblings. Our results highlight the importance of assessing and targeting broader aspects of psychosocial well-being, considering both positive and negative indicators of well-being, and also aspects of identity and personality.