There really isn't a set relation with the characters. They can be cousins, step or biological. Remember, it asks you how to refer to them. I assumed it was a mother and sisters but it feels more like step now after Elizabeth's path. I definitely think these characters are not canonically related other than cousin, aunt, etc - which is still odd but legal in places like Japan.
@Grims Dungeon Of Degeneracy: I remember that the US made some taboo movies from the 80's where it was REAL family members, but I guess that is not allowed anymore, in any case they left it open for the player (aka you) to configure if it the relations was and you choise REAL sibblings and parents, )))))))))))))))))))))) there is a special place in hell for you)))))))))))))))))))
@Lucifer333: It's hard to say what the roles are supposed to be. See Summer With Mia is an adaptation of another RPG Maker game called My Summer With Mia. Yes, if is your biological sister. Lemme see what VNDB says about this one though. Strangely enough, Jessica isn't related to the MC in this one because it's a different MC than Lust Theory
@Lucifer333: Yes, canonically according to VNDB all character relations are by blood. That is supposed to be your mother and sisters. https://vndb.org/v27641
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Getting interesting... I think she drugged you and perhaps she is having memories of your activities with her...
i dont know the whole story, is it sister or stepsister?