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1. Adolescents from families of divorce: Vulnerability to physiological and psychological disturbances.......... 1
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Adolescents from families of divorce: Vulnerability to physiological and psychological disturbances
Author: Thompson, Paige, RN, MSN

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Abstract: Multiple factors contribute to the vulnerability of adolescents to physiological and psychological
disturbances following parental divorce. These include father absence, interparental conflict, economic distress,
multiple life stressors, parent adjustment, and short-term crisis. Clinical and societal problems manifested in
these vulnerable adolescents are discussed. Systems theory is used to explain this vulnerability of adolescents
and to identify appropriate interventions and policies to promote health in this population. Policies
recommended include required divorce mediation, early referrals for family and sibling therapy, and school
programs to identify and support those most vulnerable.
Full text: Multiple factors contribute to the vulnerability of adolescents to physiological and psychological
disturbances following parental divorce. These include father absence, interparental conflict, economic distress,
multiple life stressors, parent adjustment, and short-term crisis. Clinical and societal problems manifested in
these vulnerable adolescents are discussed. Systems theory is used to explain this vulnerability of adolescents
and to identify appropriate interventions and policies to promote health in this population. Policies
recommended include required divorce mediation, early referrals for family and sibling therapy, and school
programs to identify and support those most vulnerable.
Divorce rates have gone from fewer than 20% of all marriages in the 1960s to nearly 50% in the 1990s
(Delaney, 1995). Traditionally, the biological family serves as a haven for children from the stresses of the
world. When divorce occurs, this haven no longer exists and adolescents are unable to normally experience the
childhood events of school, sports, and family.
Although the traditional biologic family is no longer living together in divorce, the interrelationships and
interdependencies among the family members continue. However, these relationships must change and can
cause stress because of conflicts among all family members involved.
The Adjustments of Divorce
The process of divorce involves a series of transitions and reorganizations. For children, this involves coping
with changing geographical locations, changing schools, changing mental and physical health of family
members, adjusting to a single-parent household, and remarriage and the addition of new family members.
Adolescents from families of divorce not only deal with the normal developmental stages associated with this
age group, but are faced with additional stresses placed upon them by their parents' divorce. These include: (1)
father absence; (2) interparental conflict; (3) economic distress; (4) parent adjustment; (5) multiple life stressors;
and (6) short-term crisis. The result of all of these factors could be a vulnerability to both physiological and
psychosocial disturbances in this adolescent population.
Father absence
Father absence as a factor in influencing children's responses to divorce is based on the notion that boys need
a positive relationship with their father to develop a sense of masculinity, to develop controls over behavior, to
develop an appropriate conscience, and to perform up to their ability academically (Kalter, Kloner, Schreier,
&OkIa, 1989). Kalter (1987) stated that fathers are frequently responsible for setting and enforcing limits on
behavior; therefore, if the father is absent this can result in aggressive behavior. Some studies have shown that
this effect may be offset by the presence of a stepfather to fulfill this role (Amato &Keith, 1991; Hetherington,
Cox, &Cox, 1985). Wallerstein and Corbin (1989) also found that a poor father-daughter relationship was
significantly associated with poor adjustment in girls 10 years following the divorce. Amato and Keith (1991)
found some support for the parental absence perspective in their review of 23 studies related to parental
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absence. Children of divorce were found to have lower levels of well being than children who experienced
parental loss by death (Amato &Keith).
Interparental conflict
Interparental conflict stimulates anger and anxiety in children because the children love both parents (Kalter et
al., 1989). By fighting, the parents are role modeling aggressive behavior as a way of resolving conflict (Kalter et
al.). This demonstration of hostilities often continues many years after the divorce (Kalter, 1987).
Aggressive behavior is one of the common problems seen in children of divorce and may be the result of the
anger, conflicting loyalties, or learned aggression from this interparental conflict (Kalter et al., 1989). In their
evaluation of 92 studies that showed the impact of divorce on the well being of children, Amato and Keith (1991)
found support for the hypothesis that children's well being is inversely correlated with the level of postdivorce
conflict that exists between the biological parents. Wallerstein and Corbin (1989) found that parental conflict that
involved blaming the other parent for the divorce was linked to poor psychological adjustment in daughters of
divorce.
Buchanan, Maccoby, and Dornbusch (1991) found that depression, anxiety, and deviance in adolescents were
associated with a perception of "feeling caught" between parents as a result of interparental conflict. Factors
that were found to influence the perception of "feeling caught" included high discord and hostility between
parents, low cooperative communication between parents, the amount of time spent with each parent,
closeness of the parent-adolescent relationship, and age and sex of the adolescent (Buchanan et al.).
A move toward poverty
Emery and Coir (1995) reported that 29% of Caucasian women and 44% of minority women move into poverty
following a divorce. As a result, adolescents' nutrition and health may decline. Living in poverty may result in
residing in neighborhoods where health care and social services are not available, and may also stigmatize
these adolescents and result in their entry into deviant subcultures (Amato &Keith, 1991).
Aseltine (1996) found that adolescents in single-parent families with financial stresses were more vulnerable to
the effects of depression than youth in two-parent families with financial stresses. Another consequence of
economic distress following divorce is that the mother may immerse herself in work to deal with financial
pressures, with the children viewing this as a form of abandonment (Kalter, 1987).
Parental adjustment
Another factor contributing to vulnerability of adolescents following divorce is parental adjustment, especially of
the primary custodial parent (Kalter et al., 1989). Haber (1990) stated that divorce represents a significant loss
for one or both spouses and can result in temporary dysfunction. This may include alcohol or drug abuse,
depression, violence, or physical health problems (Haber, 1990). And, as mentioned, the primary custodial
parents may immerse themselves in their work to build their own self-esteem (Kalter, 1987). Kalter et al. (1989)
found positive correlations between three standardized measures of adjustment in the custodial mother and
child adjustment as assessed by parent and child report using standardized instruments. This study showed
support for the parental adjustment hypothesis.
Multiple life stresses
The multiple life stress hypothesis suggests that children of divorce are more likely to have difficulty when
multiple stresses are involved (Kalter et al., 1989). Multiple life stresses include changing geographical location
or schools, dealing with parental adjustment to the divorce, decreased financial resources, and remarriage of
the biological parents. This hypothesis, therefore, incorporates all of the factors previously discussed and adds
the influence of other common stressors that occur postdivorce.
Wallerstein and Corbin (1989) found that daughters of divorce showed signs of feeling estranged from and
rejected by their mothers. This was due either to the long hours their mothers were involved in their profession,
or to the physical and emotional exhaustion the mothers experienced when not at work. In some cases, this led
to sexual activity and drug use for these female adolescents (Wallerstein &Corbin, 1989).
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Some studies have suggested that the stress of parental absence is less when remarriage has occurred.
Aseltine (1996) showed evidence that youth in stepfamilies are significantly less depressed than youths in
single-parent families.
Short-term crisis
The short-term crisis hypothesis suggests that the initial difficulties in children following parental divorce will
decrease over time (Kalter et al., 1989). Frost and Pakiz (1990) found that both boys and girls from recently
disrupted families were described by their mothers as functioning significantly worse than adolescents from
homes that had been disrupted earlier. However, Hetherington, Cox, and Cox (1985) found that negative life
changes following divorce were associated with behavior problems in children 6 years following the divorce.
Wallerstein and Corbin (1989) found that fewer than 40% of girls who were 16 to 18 years old 10 years following
parental divorce were doing well. However, Kalter et al. (1989) found no support for the short-term crisis
hypothesis.
As shown in this review of the literature, multiple factors have been identified that contribute to both the
shortterm and long-term effects of divorce on adolescents. Most of this research has been performed on low-to-
upper-class, white populations. This does limit the application of these findings to similar populations, however,
but suggests that studies should be conducted on minority populations to determine whether the same factors
contribute to maladjustment in diverse populations.
Clinical and Societal Problems of Adolescents From Families of Divorce
Researchers have suggested many clinical and societal problems that may occur in adolescents following
divorce. Adolescents may experience regression and avoid primary developmental tasks, including a failure to
become involved in their peer groups (Kalter, 1987). Depression has also been reported in adolescents as a
result of divorce (Aseltine, 1996; Buchanan et al., 1991). This is strongly associated with family conflict, parent-
child relationship problems, financial problems, and personal and family stresses that occur along with the
divorce (Aseltine, 1996). Buchanan et al. (1991) also found high anxiety, especially in older adolescents, as a
result of feeling "caught" between their parents. In comparing adolescents from intact families with adolescents
from disrupted families, Doherty and Needle (1991) found lower self-esteem and a lower sense of mastery,
defined as perceived control over one's life, in adolescents from disrupted families.
Kalter et al. (1989) have suggested that without a regular, ongoing relationship with their father, boys may
develop an unstable sense of masculinity. Precocious sexual activity and difficulty establishing gratifying and
lasting adult heterosexual relationships have been associated with female adolescents following parental
divorce (Kalter, 1987).
Increased aggression
In addition to clinical issues that affect the individual adolescent, researchers have also identified many social
issues that may result following parental divorce. Kalter (1987) has suggested that aggression may be
stimulated in adolescents from families of divorce for three reasons: anger at being abandoned or rejected by
the parent no longer in the home; the feeling of being abandoned by a mother who now must work; and lack of
consistent limits on expression of aggression in the absence of a strong father figure. In addition, as
adolescents observe hostility between parents over the years following divorce, this behavior is learned as a
means of solving problems and coping with disagreements (Kalter).
Inadequate social skills
It has been suggested that parental absence, whether due to one parent moving from the home or work
responsibilities of the custodial parent, can result in inadequate learning of social skills such as cooperation,
negotiation, and compromise (Amato &Keith, 1991). Hetherington et al. (1985) conducted a longitudinal study
comparing children from mother-custody families with nondivorced families and found that early aggressive or
antisocial behavior was predictive of a later lack of social competence over the 6 years represented in the study.

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In their review of studies reporting influences of divorce on children, Amato and Keith (1991) found that boys
from divorced families exhibited more difficulty in adjusting socially. Delaney (1995) has suggested that the
sustained stress in children following divorce predisposes children to increased illness, resulting in absence
from school and lack of participation in school activities that can exacerbate feelings of social isolation.
Increased substance abuse
Substance abuse has also been suggested as a societal problem in adolescents from families of divorce.
Doherty and Needle (1991), in comparing children in disrupted families with those in A continuously married
families, found that substance abuse by boys in disrupted families was significantly greater -* than substance
abuse by boys in intact families and girls in disrupted families. Wallerstein and Corbin (1989) reported in their
10-year follow-up study of daughters of divorce that adolescent girls have suggested they become involved with
drugs because of the lack of discipline in the home stemming from the mother's involvement with her
profession. Frost and Pakiz (1990), in their study assessing adjustment of youth over a 10-year time span,
found significant relationships between marital disruption and adolescent reports of antisocial behaviors such as
cigarette smoking, marijuana smoking, involvement with alcohol and drugs, and appearances in juvenile court.
Theory Perspective
A theoretical model is a systematic way of looking at an issue and can be used to describe, explain, and predict
phenomena within health care. Family systems theory focuses on the interaction between family members
within a particular family and interaction of me family with other systems (Artinian, 1994). This theory will be
further described here and will be used to explain the effects of divorce on adolescents, as well as to plan
appropriate policies to promote wellness within this group.
Adjustment to stressors
A system is defined as a set of interacting elements (Artinian, 1994). A family is a group of individuals who
interact and are interdependent and, therefore, are considered to be a system. A family consists of subsystems
that include mother-famer, parent-child, and sibling-sibling. The family is also part of larger systems that include
communities, health care systems, and educational systems. Exchanges occur bom within and outside the
family system.
Family systems theory can be used to show how families adjust to changes that occur within the system. This is
based on six assumptions. The first is that the family system is different from die sum of its parts. Second, mere
are logical relationships within the subsystems and wim outside systems. Third, family systems will evolve to
promote greater adaptability to change. Fourth, family systems constantly change in response to stress from
within and outside the system. Fifth, individuals within the family are interdependent parts of the system. Sixth,
family systems function to maintain homeostasis (Artinian, 1994).
Families that adapt to change or stressors most readily are iose that are negentropic or tend to be open - both
inside and outside the family environment (Johnson, 1993). Families who are less open to the environment, or
entropie, tend to adjust poorly to change or conflict (Johnson). As already discussed, divorce can cause multiple
stresses mat influence the adjustment of adolescents. In order to better adapt, family systems should be
supported in developing openness wimin the family structure and with the outside environment.
Forchuk and Dorsay (1995) proposed mat the goal of family systems nursing is to assist families to find
solutions to problems that the families themselves have identified. In a nonjudgmental way, the nurse would
offer comments and introduce questions to family members as a way of getting those involved to view the
problem in new and more open ways (Forchuk &Dorsay).
Delaney (1995) suggested that although divorce occurs and disrupts the family system as it existed, the family
system still exists and continues to function as a family. Therefore, the goal in promoting health within the family
system must be to support openness within the family and its subsystems and openness with environmental
systems.
Vulnerability and Resilience in Adolescents
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Multiple stressors have been identified as contributing to the vulnerability of adolescents from families of
divorce. Family systems theory has been suggested as a model to be used in assisting the disrupted family
system to adapt to these multiple stressors. The literature also suggests that certain factors promote resilience
in adolescents rather man vulnerability to the effects of divorce (Rutter, 1987).
This information is useful in two respects. First, it would identify those adolescents who are most vulnerable to
the effects of divorce because mey have not been exposed to the protective mechanisms that can promote
resilience. Second, the protective mechanisms that prevent vulnerability can be used in planning policies to
promote resilience in all adolescents who have experienced the stress of parental divorce.
Protective factors to stress
Garmezy (1985) has identified dure broad sets of protective factors in stressresistant children. These include:
personality features, such as self-esteem; family cohesion and absence of discord; and the availability of
external support systems to encourage coping efforts in children. Emery and Coir (1995) suggested that a
good relationship with at least one parent and good relationships with peers can promote resilience in
adolescents following parental divorce.
Recommendations for Health Policy
As seen in me literature, me detrimental effects of divorce on adolescent children may be caused by multiple
stressors both during and after the divorce. Plans to promote health in this vulnerable population should include
prevention or alleviation of stressors, and the promotion of resilience in those who are identified as most
vulnerable. Recommendations for interventions to promote health in this population are based on the family
systems model. This model suggests that families who are both open and growth-oriented within and outside
the family system are most successful (Johnson, 1993).
Divorce mediation
One of the significant stressors identified has been interparental conflict, both at the time of divorce and many
years later. Divorce mediation is a model that focuses on the family as a system that is reorganizing and
restructuring. The role of the mediator is to act as a neutral party to assist divorcing parents in resolving conflicts
about both financial and custodial arrangements.
Dillon and Emery (1996) conducted a study involving couples who were randomly assigned to mediation or
litigation groups at the time of their divorce. Based on reports from the mothers, it was shown that parents in the
mediation group were more likely to have been communicating about the child on a weekly basis.
It was also reported by the mothers that the noncustodial parent was more likely to be involved in current
decisions about the child and more likely to have seen the child in the past month than those in the litigation
group. This study was conducted 9 years after divorce and mediation occurred, and therefore has shown long-
term benefits of the mediation process (Dillon &Emery, 1996).
Currently, some state laws require mediation; however, in most states, it is voluntary. Mediators are trained in
the process of mediation, but are not necessarily qualified in family therapy. To prevent immediate and long-
term adverse effects of divorce on adolescents, all states should pass a mandatory requirement for mediation
with a qualified mental health professional in divorces involving children. Litigation would only be pursued if the
mediator judges the parents incapable of cooperating with the process of mediation. This law would then be a
step toward promoting both open communication within the family system and collaboration regarding the
child's development in the years following divorce.
Support within the school system
The literature supports the concept that there are long-term adverse effects of divorce on children (Wallerstein,
1991). To continuously monitor vulnerability of adolescents following divorce, policies to promote identification
of vulnerable students and provide support for this group should be instituted within the school systems.
Mulholland, Watt, Philpott, and Sarlin (1991) studied academic performance in children of divorce. They found
that about a third of subjects in the divorce group were "vulnerable" in the academic domain. There was little
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evidence of immediate adjustment to divorce, but strong indications of long-term insidious and progressively
adverse consequences as the time from divorce increased (Mulholland et al.). This suggests that policies in
middle and high schools would be most appropriate in identifying vulnerable adolescents.
Adolescents often are not easily identified as vulnerable because they are often far removed from the actual
divorce event (Mulholland et al., 1991).
School nurses should take an active role in assessing adolescent students, as well as educating teachers, that
academic performance may be an indication of maladjustment postdivorce (Mulholland et al., 1991).
Because these effects are slow to develop over the years following divorce, an important indicator would be a
student who has performed well and then shows a decline in academic performance. Once these students are
identified, support through open interactions with the external system of the school should be implemented.
These interactions should include open communication between teacher and student, as well as open
interaction between peers.
Peer support groups
The formation of peer support groups within the schools can be an effective intervention (Emery &Coir, 1995).
These groups function to promote an important developmental task of adolescents, the development of
relationships outside of the family (Emery &Coir). For adolescents from families of divorce, peer support
groups can function to emphasize support, to allow identification and expression of divorce-related feelings, to
promote problem-solving and anger control skills, and to enhance selfesteem (Anable, 1991).
Conclusion
Multiple factors have been identified in the literature as contributing to vulnerability of adolescents following
divorce. These include father absence, interparental conflict, economic distress, parent adjustment, multiple life
stressors, and short-term crisis. Clinical problems associated with this vulnerable population include regression,
depression, anxiety, loss of self-esteem, an unstable sense of masculinity in boys, and precocious sexual
activity and difficulty in establishing lasting adult heterosexual relationships in girls. Societal problems
associated with this population include aggression, inadequate social skills, and antisocial behavior such as
cigarette smoking, alcohol and drug abuse, and appearances in juvenile court.
Systems theory was used to explain this phenomenon and identify appropriate interventions and policies to
promote health in those adolescents identified as most vulnerable following divorce.
Policies recommended include required divorce mediation, early referrals for family and sibling therapy, and
school programs to identify and support those most vulnerable. Nurses should actively promote development of
these policies and are well qualified to participate in the implementation.
Sidebar
Studies must - determine whether similar factors contribute to maladjustment in diverse populations.
Sidebar
As adolescents observe hostility between parents over the years following divorce, they learn this behavior as a
means of solving problems and coping with disagreements.
Sidebar
A good relationship with at least one parent and with peers can promote resilience in adolescents following
parental divorce.
Sidebar
Having a qualified mental health professional as mediator would be an initial step in identifying those children
who are most vulnerable to the effects of divorce.
Adolescents From Families of Divorce
KEYPOINTS
Adolescents From Families of Divorce: Vulnerability to Physiological and Psychological Disturbances.
Thompson, R Journal of Psychosocial Nursing and Mental Health Services 1998;36(3):34-39.
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1 Factors contributing to a vulnerability to both physiological and psychosocial disturbances include father
absence, interparental conflict, economic distress, parent adjustment, multiple life stressors, and short-term
crisis.
2 Disturbances observed include poor health and nutrition, depression, anxiety, low self-esteem, aggression,
inadquate social skills, drug and alcohol abuse, and smoking.
3 Policies recommended include required divorce mediation, early referrals for family and sibling therapy, and
school programs to identify and support these vulnerable adolescents.
References
References
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Anable, K.E. (1991). Children of divorce: Ways to heal the wounds. Clinical Nurse Specialist, 5, 133-137.
Artinian, N.T. (1994). Selecting a model to guide family assessment. Dimensions of Critical Care Nursing, 14(1),
4-13.
Aseltine, R.H. (1996). Pathways linking parental divorce with adoiescent depression. Journal of Health and
Social Behavior, 37, 133-148.
Buchanan, CM., Maccoby, E.E., &Dornbusch, S.M. (1991). Caught between parents: Adolescents' experience
in divorced homes. Child Development, 62, 1008-1029.
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effects. American Journal of Orthopsychiatry, 66, 131-140.
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and after a parental divorce. Child Development, 62, 328-337.
Emery, R.E., &Coir, MJ. (1995). Divorce: Consequences for children. Pediatrics in Review, /6.306-310.
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Journal of Orthopsychiatry, 59, 605-618.
Mulholland, D.J., Watt, N.F., Philpott, A., &Sarlin, N. (1991). Academic performance in children of divorce:
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Journal of Orthopsychiatry, 59, 593-604.
AuthorAffiliation
by Paige Thompson, RN, MSN
AuthorAffiliation
Paige Thompson, RN, MSN, is a doctoral student at Columbia University in New York, NY.
Address correspondence to Paige Thompson, RN, MSN, St. Luke's School of Nursing, 801 Ostrum St.,
Bethlehem, PA 18015.
MeSH: Adaptation, Psychological, Adolescent, Conflict (Psychology), Family Therapy, Humans, Life Change
Events, Poverty, Referral & Consultation, School Health Services, Adolescent Psychology (major), Divorce --
psychology (major), Family -- psychology (major), Health Promotion -- methods (major), Health Status (major),
Mental Health (major)
Publication title: Journal of Psychosocial Nursing & Mental Health Services
Volume: 36
Issue: 3
Pages: 34-39
Number of pages: 8
Publication year: 1998
Publication date: Mar 1998
Year: 1998
Publisher: SLACK INCORPORATED
Place of publication: Thorofare
Country of publication: United States
Publication subject: Social Services And Welfare, Medical Sciences--Psychiatry And Neurology, Medical
Sciences--Nurses And Nursing
ISSN: 02793695
Source type: Scholarly Journals
Language of publication: English
Document type: General Information
Accession number: 9547486
ProQuest document ID: 225550536
Document URL: http://search.proquest.com/docview/225550536?accountid=15859
Copyright: Copyright Slack, Incorporated Mar 1998
Last updated: 2014-04-12
Database: ProQuest Central
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