Medical Branch Clinic, Naval Hospital, Jacksonville, Fla.

J Am Board Fam Med. 2001;14(3) 

In This Article

Abstract and Introduction


Background: The rapidly changing nature and demographics of divorce in United States within the past 30 years has spawned an epidemic that affects more than one half of the families in the United States.
Methods: I performed a MEDLINE-assisted review of the medical literature searching with the key words "divorce" and "children." In addition, a Web search was conducted using Webferret with the same key words.
Results and Conclusions: The past view of divorce as a short-term family crisis must mature into a longitudinal view of the effects of divorce. Divorce affects children according to their coping mechanisms in their own stages of development. Many problems and concerns previously attributed to divorce have their roots in the period of family interaction before the divorce and in the ongoing conflicts in many families after the divorce itself. Because family physicians are objective observers with whom the family comes into regular contact, they must be able to assist families through the transitions of divorce and to intervene on behalf of the children to help them through this stressful life event with the fewest detrimental effects possible. Counseling, group therapy, and divorce mediation have been assessed as effective tools for intervention.


In 1972 Margaret Mead stated, "There is no society in the world where people have stayed married without enormous community pressure to do so." We know little about the effects of the great many changes that have occurred in the past 30 years. Marriage may be freely terminated in the United States for the first time in recent history. Family systems theories and views of child development are based on a society of intact families. What differences are there in divorced, separated, blended, or reconstituted families, and how can family physicians help their patients and themselves?

In the 1960s, 90% of children in the United States grew up in homes with two biological parents compared with only about 40% today.[1] The change is due to the increase in the divorce rate, society's acceptance of out-of-wedlock childbearing, and the growing acceptance of cohabitation as opposed to marriage. In 1996, 45% of marriages in the United States ended in divorce. In that year there were 1,150,000 divorces, which affected slightly more than 1,000,000 children.[1] Sixty-five percent of women and 75% of men remarry within 5 years of their divorces, and the rate of cohabitation is high for those who choose not to remarry. The divorce rate of second marriages is still higher than in first marriages.[1]

The nature of divorce itself has changed dramatically within the past 30 years. The modern quest for the quick fix has extended to many aspects of society, even to interpersonal relationships. The age of microwave ovens, Jiffy Lube, and instantaneous Internet communication has also spawned the no-fault divorce. Many states no longer require lengthy separations or a legal justification for divorce. A side effect of this change is that families no longer have the luxury of a slow transition to develop new rules under which the family will operate. Such a quick transition can result in higher levels of stress near the time of divorce than experienced in previous generations. The high rates of divorce and single parenthood have raised concerns of enduring deleterious effects on the development of children and society at large.

Twenty years ago nearly everyone subscribed to the comfortable illusion that divorce represented a short-term crisis which families would weather and from which families would recover within a couple of years.[2] Wallerstein and Blakeslee[2] studied divorced families longitudinally for more than 10 years. They followed a cohort of 116 of the original 131 study children for a full 10 years. What they found was quite different from what they expected. Divorce is not an isolated act. The divorce itself is just one step in a series of family transitions that affect the family and children. Life in the family before divorce, life in a suddenly single-parent family, and possible future marital changes, all have an impact on a child's adjustment.

The human newborn is among the most helpless in the animal kingdom. Human children need parents longer than any other species and are totally dependent on parents for food, shelter, and protection for the first several years of life. This dependency spawns a fear of abandonment. In divorce, one of the parents leaves. When one parent leaves, the children feel rejected. The loss children feel at divorce is similar to that experienced when a parent dies. Divorce might actually be harder on children because it lacks the concrete cause and finality of death.

The immediate reaction of children to divorce does not predict their long-term outcome. Some who seem crushed by the divorce will do well in life, whereas some who seem to take the divorce in stride are severely affected 5 and 10 years later. The focus for research and intervention needs to change from the time immediately surrounding divorce to a much longer view. The divorced family is not a minor variation of the intact family and deserves to be studied and researched in depth.


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