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INTRODUCTION

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Chronic parental discord and divorce can have profound, long-lasting effects on children. A child’s need to be loved, to be cared for, and to be a central priority of both parents is often shattered by seeing parents frequently sad, clinically depressed, unavailable (emotionally and/or physically) and preoccupied by their personal anger. If the tension leads to divorce, and especially if the discord continues after divorce, children may feel insecure, suffer diminished self-esteem, and not trust that love and attachment to others is reliable. The severity of long-term consequences may be considerably ameliorated if parents can focus on their love of the child in the midst of their own discord and loss. It is critical to remember that marriages can end, but parenting is forever.

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Family discord and divorce are common in pediatric practice, with many divorces occurring in the first 5 to 10 years of marriage. The divorce rate per thousand marriages is at the highest during child-bearing years.

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Divorce is the loss of the family unit, and its impact can be divided into 3 broad areas. One area is the child’s psychological development. Divorce makes a strong statement that relationships once thought to represent the definition of stability may be unreliable and that the expectation of a permanent family unit can be lost. The second impact relates to parental functioning. Fathers and mothers in the midst of discord and divorce often suffer depression and anger, are preoccupied for many months or years with the divorce process, and are no longer spontaneously available in the same home. The third area is financial. The same family resources are now spread over 2 households, and additional, often major, expenses accrue in lawyer fees and other unanticipated costs. Most families cannot sustain a major increase in monthly expense, and over time, mothers often suffer the more serious financial harm.

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Pediatricians should screen family functioning (“On a scale of 1 to 10, with 10 being most satisfied, rate your overall satisfaction in your marriage?” Or, “Are there ongoing tensions or arguments within your marriage or family?”) as part of every annual physical. This question will help pediatricians be aware of discord, pending divorces, changes in living circumstances and custody, and remarriages. Knowing the impact of divorce and related life changes offers opportunities to assess the risks for the child and parent and then give anticipatory guidance or, if there is intense discord, referral for mental health services.

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EXPECTED PSYCHOLOGICAL REACTIONS

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Parents may ask whether it is better to stay married for the sake of the children than to put them through a divorce. The answer depends on the intensity of the marital discord and the quality of relationships after the divorce is finalized. The tensions in discordant marriages may result in verbal or physical confrontations, compound other psychological problems such as depression or substance use, and create a bitter emotional ...

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