Coparenting after marital dissolution and children's mental health: a systematic review

A call for early, effective, and scalable parent education programs for high-conflict separated/divorcing parents: A synthesized perspective from prevention science and family law

Conflict between parents is stressful and disruptive to children living in the midst of parental separation or divorce. Although some level of post-separation/divorce conflict is understandable in an emotionally-charged separation/divorce, it undermines the extent to which parents protect their children from short- and long-term problems. In this article, we weave together a synthesized perspective informed by our respective training and experience in prevention science and family law on the role of parent education programs for high-conflict separating/divorcing parents. To do so, we first describe the research on the effects of high interparental conflict on children's outcomes and then discuss current approaches and challenges to reducing these negative effects by offering parent education programs for high-conflict separating/divorcing parents. Then, we propose and describe a new model for early, effective, and scalable parent education programs with the ultimate goal of protecting children after separation/divorce.

Association Between Concussions and Suicidality in High School Students in the United States

Importance

Prior research has shown a statistically significant association between sustaining a concussion and suicidality in adolescents, but this prior research controlled for relatively few variables predictive of suicidality.

Objective

To examine whether sustaining a concussion remained a significant predictor of suicidality after controlling for relevant covariates (e.g., sexual abuse/assault, bullying, substance use, depression), hypothesizing that the relationship between concussion and suicidality would become non-significant after controlling for these variables.

Design

This study involved secondary data analysis of the 2019 Youth Risk Behavior Surveillance (YRBS) System, a national cross-sectional study of adolescents. Analyses were stratified by gender.

Setting

A national sampling of U.S. high school students.

Participants

Eleven thousand two hundred sixty-two students in the YRBS database, including 5,483 boys and 5,779 girls.

Exposure(s)

Participants included in the analyses reported whether, in the last year, they experienced a concussion and/or suicidality.

Main Outcomes and Measures

The main outcome was suicidality (i.e., ideation, planning, attempt), which was predicted by concussion in an unadjusted analysis and by concussion along with other risk factors in a multivariable analysis.

Results

The final sample included 11,262 participants with available data on concussion and suicidality in the last year (14–18 years-old; 51.3% girls; 49.0% White). Per unadjusted odds ratios with 95% confidence intervals, there was a relationship between concussion and suicidal ideation [girls: OR = 1.46 (1.24, 1.73); boys: OR = 1.69 (1.41, 2.03)], planning (girls: OR = 1.39 [1.16, 1.66]; boys: OR = 1.76 [1.44, 2.14]), and attempt [girls: OR = 1.70 (1.32, 2.19); boys: OR = 3.13, (2.37, 4.15)]. These relationships became mostly non-significant after controlling for relevant risk factors for suicidality. The adjusted odds ratios showed no relationship between concussion and suicidal ideation [girls: OR = 1.11 (0.86, 1.44); boys: OR = 1.24 (0.92, 1.69)] or planning (girls: OR = 1.07 [0.82, 1.40]; boys: OR = 1.12 [0.82, 1.55]); but a significant relationship with suicide attempts in boys [OR = 1.98 (1.28, 3.04)], but not girls [OR = 1.05 (0.74, 1.49)].

Conclusions and Relevance

There was an association between concussion and suicidality in U.S. high school students; however, after controlling for other variables (e.g., depression, sexual abuse/assault, illicit drug use), there was no association between concussion and suicidality aside from a significant relationship between concussion and attempts in boys.

Playing High School Football Is Not Associated With an Increased Risk for Suicidality in Early Adulthood

OBJECTIVE

To determine if playing high school football is associated with suicide ideation between the ages of 24 and 32 years.

DESIGN

Data were analyzed from the National Longitudinal Study of Adolescent to Adult Health. This prospective cohort study sampled nationally representative US participants at 4 time points from 1994 to 2008.

SETTING

In-home assessment.

PARTICIPANTS

There were 3147 boys (age: median = 14.9, SD = 1.8) who participated during adolescence in 1994 to 1995 (wave I), of whom 2353 were reinterviewed in 2008 (wave IV, age: median = 29.1, SD = 1.8).

ASSESSMENT OF RISK FACTORS

Football participation, history of psychological counseling, suicide ideation, and a suicide attempt in the past year during high school.

MAIN OUTCOME MEASURES

Lifetime history of depression, suicide ideation within the past year, and feeling depressed in the past 7 days at wave IV.

RESULTS

Men who played high school football, compared with those who did not, reported similar rates of lifetime diagnosis of depression, suicide ideation in the past year, and feeling depressed in the past 7 days. Those who played football reported similar rates of suicide ideation in the past year when they were in their early 20s. Individuals who underwent psychological counseling during adolescence were more likely to report a lifetime history of depression and suicide ideation in the past year.

CONCLUSIONS

Young men who played high school football are not at an increased risk for suicide ideation during both their early 20s and late 20s. By contrast, those who experienced mental health problems in high school were much more likely to experience suicide ideation during their 20s.

Dyadic coping and coparenting among couples after their child's recent autism diagnosis

LAY ABSTRACT

We investigated how couples support each other after their child's autism diagnosis and whether this affects the way they work together to raise their child. We recruited 70 couples raising a child on the autism spectrum. Both partners were asked to complete the same questionnaires measuring how they perceived the experience of having a child on the autism spectrum, how they used their relationship to support each other during stressful situations, how competent they felt completing their parenting tasks, and the coparenting relationship to explore how they worked together as a team when parenting their child. Parents participated in the study 1-36 months after their child's autism diagnosis. We used statistical techniques that allowed us to see the impact mothers and fathers had on each other. Overall, parents who felt more competent and supported by their partner worked better as a team to raise their child on the spectrum. Fathers invested in the coparenting relationship more when mothers felt more supported by fathers. Mothers invested in the coparenting relationship more when fathers felt more competent parenting their child. Further research is needed to better understand how we can support couples as their child gets older.

Importance of living arrangements and coparenting quality for young children's mental health after parental divorce: a cross-sectional parental survey

BACKGROUND

Parental separation has been associated with adverse child mental health outcomes in the literature. For school-aged children, joint physical custody (JPC), that is, spending equal time in both parents' homes after a divorce, has been associated with better health and well-being than single care arrangements. Preschool children's well-being in JPC is less studied. The aim of this study was to investigate the association of living arrangements and coparenting quality with mental health in preschool children after parental separation.

METHODS

This cross-sectional population-based study includes 12 845 three-year-old children in Sweden. Mental health was measured by parental reports of the Strength and Difficulties Questionnaire and coparenting quality with a four-item scale. The living arrangements of the 642 children in non-intact families were categorised into JPC, living mostly with one parent and living only with one parent.

RESULTS

Linear regression models, adjusted for sociodemographic confounders, showed an association between increased mental health problems and living mostly and only with one parent (B=1.18; 95% CI 0.37 to 2.00, and B=1.20; 95% CI 0.40 to 2.00, respectively), while children in intact families vs JPC did not differ significantly (B=-0.11; 95% CI -0.58 to 0.36). After adjusting the analyses for coparenting quality, differences in child mental health between the post divorce living arrangements were, however, minimal while children in intact families had more mental health problems compared with JPC (B=0.70; 95% CI 0.24 to 1.15). Factorial analysis of covariance revealed that low coparenting quality was more strongly related to mental health problems for children in intact families and JPC compared with children living mostly or only with one parent.

CONCLUSIONS

This study suggests that coparenting quality is a key determinant of mental health in preschool children and thus should be targeted in preventive interventions.

A Experiência da Coparentalidade na Guarda Compartilhada

Resumo Com o intuito de preservar o exercício da parentalidade por ambos os pais após a separação conjugal, a lei da guarda compartilhada busca favorecer o equilíbrio dos papéis parentais. Contudo, a dinâmica conflituosa do divórcio pode dificultar o exercício da responsabilização parental de forma conjunta. A partir disso, este estudo objetivou compreender a experiência da coparentalidade de pais separados que possuíam a guarda compartilhada do(s) filho(s), por meio de um estudo de casos coletivos com três duplas parentais residentes no interior do Rio Grande do Sul. Os dados obtidos por meio de um questionário sociodemográfico e de uma entrevista semiestruturada foram submetidos à Análise de Conteúdo. Mesmo no caso em que a coparentalidade foi exercida satisfatoriamente no casamento, quando a relação do casal começou a apresent ar conflitos, isso se perpetuou no pós-divórcio e influenciou a relação coparental. Entende-se que aspectos que permeiam a relação conjugal e a coparental são influenciados mutuamente e que a forma como os pais exercem a coparentalidade relaciona-se com o conhecimento e a informação que possuem sobre o assunto. Considera-se que o investimento em programas de intervenções, mediação familiar e psicoterapia podem auxiliar na melhoria do exercício coparental no pós-divórcio.

Coparentalidade e Conflito Pais-Filhos em Adolescentes Envolvidos em Práticas Restaurativas

Resumo Coparentalidade é definida como a relação estabelecida entre os cuidadores e a forma como compartilham os cuidados com seus filhos. Suas reverberações nos filhos adolescentes podem ser associadas a problemas de comportamento, condutas antissociais. Investigou-se o efeito preditor das dimensões da coparentalidade e do conflito pais-filhos em condutas antissociais de adolescentes em conflito com a lei no contexto das práticas restaurativas. Sessenta e dois adolescentes vinculados a projeto do Ministério Público no Rio Grande do Sul que responderam quatro escalas. Os resultados, a partir de regressão linear, sustentam que as variáveis - triangulação coparental familiar, intensidade e motivo de conflito com o pai são preditoras de comportamentos antissociais leves. Nos severos, o conflito coparental familiar teve o maior poder preditivo. Esses dados evidenciam a necessidade de valoração da relação familiar - coparental, instrumentalizando medidas protetivas que garantam a saúde mental do adolescente, buscando sua proteção à de condutas de risco.

Low Chronic Self-Esteem and Low Situational Self-Esteem: a literature review

OBJECTIVE

to develop a literature review about low self-esteem and components of the nursing diagnoses Low Chronic Self-Esteem and Low Situational Self-Esteem in patients with depressed mood.

METHOD

an integrative literature review carried out in the Pubmed portal and in the Scopus and Web of Science electronic bibliographic databases. Depression and self-esteem descriptors were used, resulting in 32 articles.

RESULTS

literature indicated 7 clinical indicators and 14 etiological factors for low self-esteem.

CONCLUSION

The clinical indicators Suicidal ideation and Ineffective treatment were more prevalent in the study. The etiological factors Stressful events and Stigmatization were the most frequent, both of which were suggested as new related factors for low self-esteem. Nursing diagnosis recognition can contribute to intervention strategy elaboration by the nurse, according to the urgent diagnostic and the individual's particularities.

"We also communicate through a book in the diaper bag"-Separated parents´ ways to coparent and promote adaptation of their 1-4 year olds in equal joint physical custody

Joint physical custody (JPC) refers to a practice where children with separated parents share their time between the parents’ respective homes. Studies on parents’ views of JPC for young children are scarce. The aim of this interview study was to explore parents’ perceptions on how they experience and practice equally shared JPC for their 1–4 year-olds in Sweden. Forty-six parents (18 fathers and 28 mothers) of 50 children (31 boys and 19 girls) under 5 years of age were interviewed. Parents were recruited through information in the media and represented a broad range of socioeconomic backgrounds, as well as both voluntary and court-ordered custody arrangements. The interviews were semi-structured and analyzed using systematic text condensation. Two themes emerged regarding the research question. In the first theme, Always free, never free, parents described their striving to coparent without a love relationship. While they appreciated the freedom of being a “half-time parent”, doing things one’s own way, they felt constrained by the long-term commitment to live close to and keep discussing child rearing issues with the ex-partner. Good communication was key and lessened parent’s feelings of being cut-off from half of the child’s life. When JPC was ordered by court or conflicts were intense, parents tried to have less contact and worried when the children were in the other home. The second theme, Is it right, is it good?, included descriptions of how the parents monitored the child’s responses to the living arrangement and made changes to optimize their adjustment. Adaptations included visits for the child with the other parent mid-week, shared meals or adapting schedules. In conclusion, these parents worked hard to make JPC work and cause minimal damage to their children. Most parents were pleased with the arrangements with the notable exception of couples experiencing ongoing conflict.

Clima familiar y coparentalidad en familias con ruptura de pareja

La literatura señala que el divorcio de los progenitores puede deteriorar gravemente el sistema familiar, dado que se relaciona con un empeoramiento en el apoyo familiar y en la cooperación parental. Por ello, estudiamos estas variables en familias que experimentaron la ruptura de pareja, en comparación con las que no. Se aplica el PAFAS de Sanders, Morawska, Haslam Filus y Fletcher (2013) a 80 progenitores, con al menos un hijo con edad comprendida entre 2 y 12 años. De éstos, el 50% habían experimentado la ruptura.