A psychosocial perspective. Growing up with thalassemia, a chronic disorder

Thalassemia influences individual and family psychosocial functioning. Parental reaction to diagnosis affects the parent-child relationship, parents' roles, and family resources for coping. A child frequently translates parental reactions into personal attitudes of dependency and lowered self-esteem. In coping with one child's disease, parents often sacrifice the needs of other siblings. Attainment of optimal development may be promoted or hindered. As the child's environment widens, negative attitudes may be reinforced. Poor school performance due to absenteeism, physical differences that lead to teasing, and limitations imposed by others may be interpreted by the child as personal inadequacy. Such feelings often persist through adolescence due to the individual's lag in physical growth, marginal academic record, poor self-concept, and/or pessimistic outlook on life. The central psychosocial issues of late adolescence and young adulthood--career, vocation, dating, marriage--are compounded by the perspective of institutions and potential employers. Different periods of the life cycle are vulnerable to specific psychosocial problems.