Centre for Health Equity Studies, Stockholm, Sweden.
Clinical Epidemiology, Department of Medicine, Karolinska Institute, Stockholm, Sweden.
BMJ Paediatr Open. 2021 May 26;5(1):e000657. doi: 10.1136/bmjpo-2020-000657. eCollection 2021.
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.
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.
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.
This study suggests that coparenting quality is a key determinant of mental health in preschool children and thus should be targeted in preventive interventions.
文献表明,父母离异与儿童心理健康不良结果有关。对于学龄儿童,即离婚后在父母双方家中平等时间生活的联合监护(JPC),与单一监护安排相比,与更好的健康和福祉有关。在 JPC 中,学龄前儿童的幸福感研究较少。本研究旨在调查父母离异后学龄前儿童的生活安排和共同养育质量与心理健康之间的关系。
本横断面基于人群的研究包括瑞典的 12845 名三岁儿童。心理健康通过父母报告的《长处与困难问卷》和共同养育质量的四项量表进行衡量。非完整家庭中 642 名儿童的生活安排分为 JPC、主要与一方父母生活和仅与一方父母生活。
调整了社会人口统计学混杂因素的线性回归模型显示,心理健康问题增加与主要和仅与一方父母生活有关(B=1.18;95%CI 0.37 至 2.00,和 B=1.20;95%CI 0.40 至 2.00),而完整家庭与 JPC 之间的儿童差异不显著(B=-0.11;95%CI-0.58 至 0.36)。然而,在调整了共同养育质量的分析后,离婚后生活安排对儿童心理健康的差异很小,而与 JPC 相比,完整家庭的儿童心理健康问题更多(B=0.70;95%CI 0.24 至 1.15)。协方差的因子分析显示,与主要或仅与一方父母生活的儿童相比,共同养育质量较低与完整家庭和 JPC 儿童的心理健康问题更密切相关。
本研究表明,共同养育质量是学龄前儿童心理健康的关键决定因素,因此应作为预防干预的目标。