CHILDREN

 ANXIETY
 feel different from their peers and develop negative thoughts about
their life, a sense of guilt, increased anxiety, and low selfesteem; their
behavioral profile is similar to normal individuals, but many of them
may develop severe psychosocial problems because of difficulties in
complying with the painful chelation
 concerns for the future of a thalassemic child may contribute to
worsening of relationships among members, and to increase
marginalization and isolation

 DEPRESSION
 quality of life (QoL), which is defined as an individual's perception of
their position in life in the context of the culture and value systems in
which they live, and in relation to their goals, and expectations, is often
limited by the chronic illness

PARENTS

 ANXIETY
 unavailability of the blood, life and health of the child, and financing for
the treatment
 concern about their children’s’ marriage

 DISTRESSED
 grieved to see their upset child
 they expressed concern about birth of next children with thalassemia
too
 Fearing from birth of a thalassemia child, some of the mothers
underwent tubal ligations surgery which led to separation and divorce
in a number of families.
 have to spend more time for a sick child, the quality of their social,
professional and familial roles may be greatly affected
SIBLINGS

 ANXIETY & DEPRESSION

 experience differential parental treatment due to disproportionate care
for the affected child
 assigned extra care-giving and domestic responsibilities
 affected by parental distress reactions

 SOLITUDE
 siblings to be more inclined to internalize, rather than externalize their
feelings
 do not always ask for parental attention as much as they really want to
 keep their feelings to themselves to hide them from their already
overburdened parents

 DEVELOP PROSOCIAL BEHAVIORS

 stressors may also generate resilient responses and reinforce
personal assets
 experience of having resisted reinforce siblings' positive self-attributes,
such as, self-concept, self-esteem, independence and sense of
competence.

REFERENCES

https://journals.lww.com/mecpsychiatry/Fulltext/2011/10000/Psychological_m
anifestations_in_adolescents_with.9.aspx

https://www.omicsonline.org/open-access/the-burden-of-care-experiences-of-
parents-of-children-with-thalassemia-2167-1168-1000389.php?aid=88199
https://academic.oup.com/jpepsy/article/37/2/166/1746321