Long-term influences of parental divorce on offspring affective disorders: A systematic review and meta-analysis

Highlights

• Long-term effects of parental divorce on offspring affective disorders were investigated.

• Evidence from 29 eligible studies across the period of 35 years was synthesised.

• Parental divorce in childhood was associated with adult offspring depression.

• This effect did not decrease over time between 1980 and 2015.

• More research on parental divorce and adult offspring anxiety is needed.

Abstract

Background

The prevalence of divorce in Western countries has increased in recent decades. However, there is no recent systematic review and/or meta-analysis of studies testing for long-term effects of parental divorce on offspring affective disorders. The present study conducted a systematic review and meta-analysis of studies published since 1980 testing for the association between parental divorce and offspring depression and anxiety in adulthood.

Method

PUBMED, Science Direct, Medline, PsychInfo, and PsychArticles databases were searched for eligible studies. Random-effect meta-analyses were used to synthesize effect sizes and to test whether associations of parental divorce with offspring affective disorders differed among three publication periods (i.e., before 1996, 1996–2005, 2006–2015).

Results

In total, 29 studies were eligible for the systematic review, and 18 studies were included in the meta-analyses (depression: n=21,581; anxiety: n=2472). There was significant association between parental divorce and offspring depression (OR=1.56; 95%CI [1.31, 1.86]), but not anxiety (OR=1.16; 95%CI [0.98, 1.38]). The effect of parental divorce on offspring depression was not weaker in the reports published in more recent decades.

Limitations

There is limited research in relation to offspring anxiety in adulthood.

Conclusions

Parental divorce is associated with an increased risk of adult offspring depression, with no indication of the effect being weaker in recent publications.

Introduction

Affective disorders, such as depression and anxiety, are the most prevalent mental health problems in both children and adults (Beaumont and Lofts, 2013, Merikangas et al., 2011). A multitude of research suggests that adverse childhood experiences are a major risk factor for the development of affective disorders (Chapman et al., 2004). Parental divorce is the most common type of childhood adversity, second only to family socio-economic disadvantage (Sacks et al., 2014). Indeed, divorce prevalence rates have dramatically increased in recent decades. For example, in the UK, the estimated prevalence rate of divorce was 22% in 1972, but by 2012, it had increased to 42% (Office for National Statistics, 2012). In other Western countries, such as the USA, the estimated prevalence rate of divorce is similarly very high (43%) (National Center for Health Statistics, 2012). This means that a large number of children are at increased risk of negative consequences associated with parental divorce. Indeed, previous research (for example, see: Amato and Keith, 1991; Reid and Crisafulli, 1990) has demonstrated that children whose parents have divorced have higher levels of emotional and behavioural problems, and lower academic achievement and social functioning than do children whose parents have not divorced (Lansford, 2009).

From a developmental perspective, it is extremely important to determine whether exposure to early adversity, such as parental divorce, shows effects later in life. Two meta-analyses published more than 25 years ago (Amato and Keith, 1991, Reid and Crisafulli, 1990) posit that parental divorce is associated with a variety of negative consequences in adult offspring, including an increased risk of emotional problems. However, as noted above divorce rates have more than doubled in the last decades (Office for National Statistics, 2012). As divorce becomes more commonplace and it is associated with less stigma in a modern society, the negative associations between parental divorce and offspring mental health outcomes should have declined over time. However, few studies have examined whether the associations have remained stable over time (Sigle-Rushton et al., 2005). Moreover, there is some evidence to suggest that although divorce and separation have become more common than they once were, the impact they have on mental health has not decreased (Lacey et al., 2012). Therefore, as more studies have been published in the last 25 years, it is possible to explore the effect of publication year on the long-term association between parental divorce and offspring mental health.

In addition, study quality is likely to have changed during this time, including study design, sample size and study settings, all of which can influence the association. However, whether these study-related characteristics affect the reported results is yet to be explored.

Finally, it remains unclear whether the effects of parental divorce can differ for males and females. Some studies have shown that whilst male children of divorce demonstrate higher rates of behavioural problems in childhood and adulthood, female children of divorce demonstrate higher rates of emotional problems which usually only emerge in early adulthood (Rodgers, 1994, Wauterickx et al., 2006). Some studies have also suggested that boys are more vulnerable to the short-term effects of childhood parental divorce (Hetherington, 1997), whereas females are more vulnerable to the long-term effects, such as in late adolescence and early adulthood (Rodgers, 1994).

The present study aimed to conduct a systematic review and meta-analysis of studies published between 1980 and 2015. First, we explored the association between parental divorce in childhood and affective disorders, such as depression and anxiety, in adult offspring. Second, we tested whether the association differed for publications at different time periods and for studies of different quality, sample size and settings. Finally, we explored a possible moderation effect of sex of offspring on this association.