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J Pediatr (Rio J). 2016;xxx(xx):xxx---xxx
1

www.jped.com.br

REVIEW ARTICLE

2 Co-parenting after marital dissolution and children’s

3 mental health: a systematic review夽,夽夽
4 Q1 Diogo Lamela a,∗ , Bárbara Figueiredo b

a
5 Lusófona University of Porto (ULP), Porto, Portugal
b
6 University of Minho (UMINHO), Braga, Portugal

7 Received 30 July 2015; accepted 30 August 2015

8 KEYWORDS Abstract
9 Co-parenting; Objective: Research has shown that co-parenting is a vital family mechanism in predicting
10 Mental health; mental health in children and adolescents. Considering the increasing prevalence of marital
11 Divorce; dissolution in Western societies, the objective of this systematic review was to summarize the
12 Marital dissolution; key results of empirical studies that tested the association between mental health of children
13 Children; and co-parenting after marital dissolution.
14 Parenting Data source: The studies were obtained from three databases (PsycInfo, PubMed, and Web of
15 Knowledge), published between January 2000 and October 2014. The titles, abstracts, and key
16 words of the generated citations were independently reviewed by two investigators to consen-
17 sually select the articles that met the inclusion criteria. Articles that used psychometrically
18 valid tools to measure at least one mental health indicator and at least one dimension of
19 co-parenting in samples with divorced parents were included in the review.
20 Data synthesis: Of the 933 screened articles, 11 met the inclusion criteria. Significant positive
21 associations were found between co-parental conflict and behavioral problems and symptoms of
22 anxiety, depression, and somatization. Significant positive associations were also found between
23 other specific dimensions of co-parenting (co-parental support, cooperation, and agreement),
24 overall mental health, self-esteem, and academic performance.
25 Conclusions: The integrated analysis of these studies suggests that co-parenting is a key mecha-
26 nism within the family system for the prediction of child mental health after marital dissolution,

夽 Please cite this article as: Lamela D, Figueiredo B. Co-parenting after marital dissolution and children’s mental health: a systematic

review. J Pediatr (Rio J). 2016. http://dx.doi.org/10.1016/j.jped.2015.09.011

夽夽 Study carried out at Lusófona University of Porto (ULP), Porto, Portugal.
∗ Corresponding author.

E-mail: lamela@ulp.pt (D. Lamela).

http://dx.doi.org/10.1016/j.jped.2015.09.011
0021-7557/© 2016 Sociedade Brasileira de Pediatria. Published by Elsevier Editora Ltda. This is an open access article under the CC BY-NC-ND
license (http://creativecommons.org/licenses/by-nc-nd/4.0/).

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27 and thus, it is recommended that pediatricians, psychologists, and other health professionals
28 consider co-parenting as a psychosocial variable for children’s mental health assessment and
29 diagnosis.
30 © 2016 Sociedade Brasileira de Pediatria. Published by Elsevier Editora Ltda. This is an open
31 access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/
32 4.0/).

33
PALAVRAS-CHAVE Coparentalidade após a dissolução conjugal e saúde mental das crianças: Uma revisão
34
Coparentalidade; sistemática
Saúde mental;
35 Resumo
Divórcio;
36 Objetivo: A investigação tem demonstrado a coparentalidade como um dos mecanismos famil-
Dissolução conjugal;
37 iares centrais na predição da saúde mental em crianças e adolescentes. Considerando o aumento
Crianças;
38 da prevalência da dissolução conjugal nas sociedades ocidentais, o objetivo desta revisão sis-
Parentalidade
39 temática foi sumariar os resultados-chave de estudos empíricos que testaram a associação entre
40 a saúde mental das crianças e a coparentalidade pós-dissolução conjugal.
41 Fontes dos dados: Foram triados estudos de três bases de dados (PsycInfo, Pubmed e Web
42 ofKnowledge), publicados entre janeiro de 2000 e outubro de 2014. Os títulos, resumos e
43 palavras-chave das citações geradas foram independentemente analisados por dois investi-
44 gadores para selecionar consensualmente os artigos que cumpriam os critérios de inclusão.
45 Foram incluídos artigos que utilizassem instrumentos psicometricamente válidos para medir
46 pelo menos um indicador de saúde mental e pelo menos uma dimensão da coparentalidade em
47 amostras com pais divorciados.
48 Síntese dos dados: Dos 933 artigos triados, 11 cumpriram os critérios de inclusão. Foram encon-
49 tradas associações significativamente positivas entre o conflito coparental e problemas de
50 comportamento e sintomas de ansiedade, depressão e somatização. Foram também encontradas
51 associações significativamente positivas entre outras dimensões específicas da coparentalidade
52 (suporte, cooperação e acordo coparentais) saúde mental global, autoestima e rendimento
53 acadêmico.
54 Conclusões: A análise integradora destes estudos sugeriu que a coparentalidade é um
55 mecanismo-chave dentro do sistema familiar para a predição da saúde mental infantil pós-
56 dissolução conjugal, sendo recomendado que pediatras, psicólogos e outros profissionais de
57 saúde considerem a coparentalidade como uma variável psicossocial na avaliação e diagnóstico
58 da saúde mental em crianças.
59 © 2016 Sociedade Brasileira de Pediatria. Publicado por Elsevier Editora Ltda. Este é um artigo
60 Open Access sob uma licença CC BY-NC-ND license (http://creativecommons.org/licenses/by-
61 nc-nd/4.0/).

62 Introduction the adjustment levels of all family members. One of 81

the most often studied topics in psychology literature 82

63 The impact of life events on the psychological function of about families with separated parents is the impact of 83

64 human beings has aroused significant interest in psychology marital dissolution on mental health indicators and chil- 84

65 literature, as shown by the diversity of conceptual defi- dren’s psychological development. Although the association 85

66 nitions and explanatory models developed over the past between marital dissolution and problems in the psycholog- 86

67 decades.1,2 In this context, given its high prevalence in ical function of children is not linear,3---6 cross-sectional and 87

68 Western countries, the impact of marital dissolution on longitudinal results have shown that children of divorced 88

69 psychological function has been the target of systematic parents are at increased risk for maladaptive outcomes.4,5 89

70 cross-sectional and longitudinal research. The dissolution However, some authors have stated that the psycho- 90

71 of the family’s marital subsystem appears to have signifi- logical function of children after their parents’ marital 91

72 cant implications for psychological function, not only for the dissolution is not precisely associated with the end of the 92

73 adults who experience it, but also for the children. Research marital relationship itself, but with the family functioning 93

74 has attempted to describe and understand the individual, after this transition.3,7,8 Although the investigation has tradi- 94

75 family, social, and contextual variables that predict mental tionally focused on the study of how parenting and parents’ 95

76 health after marital dissolution, either in adults or in the mental health influence the mental health of children, a sys- 96

77 children whose parents ended their intimate relationship. tematic body of research has also suggested that the quality 97

78 Marital dissolution, while a family life transition char- of interaction between parents after marital dissolution --- 98

79 acterized by structural, processual, and socio-emotional either while performing joint parental responsibilities, or 99

80 reorganizations, appears to be empirically associated with as former couple --- is a strong predictor of mental health 100

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Co-parenting and children’s mental health 3

101 and psychological well-being of children living in this type developmental outcomes of family members. Teubert and 160

102 of family structure. Pinquart,9,19 in an attempt to integrate the several pro- 161

103 Although all recent co-parenting models suggest the posals for co-parenting components described in previous 162

104 effect, either direct or indirect, of co-parenting on the literature, suggested a multidimensional construct system 163

105 mental health of children,9,10 no systematic review has sum- that attempts to match and integrate the components of co- 164

106 marized the scientific studies that assessed this association parenting advocated by previous models. Therefore, these 165

107 in samples of divorced or separated parents. This article authors claim that co-parenting consists of four dimen- 166

108 aims to identify and summarize the main results of empiri- sions: cooperation, agreement in care and education of the 167

109 cal studies published in scientific journals with peer review children, conflict, and triangulation. The cooperation com- 168

110 that assessed the associations between co-parenting after ponent was defined as the degree of information exchange 169

111 marital dissolution, mental health, and social adjustment between the parents about the child, and the existence of 170

112 of children. a context of respect and mutual loyalty between them. 171

The agreement in care and education of the children 172

component refers to the extent of agreement between the 173

113 Definition of co-parenting adults in matters related to the child. In turn, the conflict 174

component reflects the degree of parenting sabotage by the 175

114 Conceptually, co-parenting focuses on inter-parental inter- other parent through the use of guilt, criticism, and belittle- 176

115 actions regarding the functions and expectations of adults ment. Finally, according to these authors, the triangulation 177

116 when performing their role as parents.11 Therefore, co- component refers to the development of coalitions between 178

117 parenting is not characterized by how each individual parent a member of the co-parental team and the child, which puts 179

118 practices childcare, but rather the dynamic synchronization the child at the center of interparental conflicts.9 180

119 of adults when caring for a particular child.12,13 McHale14

120 defined co-parenting as ‘‘a contract placed on those [that
121 are] mutually responsible for the care and upbringing of a Co-parenting and children’s mental health 181

122 child’’. In a previous contribution, Feinberg10 stated that

123 co-parenting refers to the ways parents --- and other adults Co-parenting refers to coordination of adults in the care and 182

124 who take on parental responsibilities --- interact with each education of children. This coordination is not limited to 183

125 other when performing parenting functions. merely instrumental issues in providing care. Cooperative 184

126 Co-parenting is not defined, according to this line parents give priority to the well-being of their children, as 185

127 of thought, as a substrate or ramification of the mar- they create and maintain a constructive relationship, with 186

128 ital relationship, but as an autonomous subsystem with more flexible and workable boundaries between them.10 187

129 idiosyncratic and differentiable mechanisms and character- Relying on the organization of four components of 188

130 istics from processes related to the marital and parental co-parenting, Teubert and Pinquart9 published the first 189

131 subsystems.10 While parenting conceptually describes the meta-analysis to assess the association between the quality 190

132 styles and practices that each parent individually brings of co-parenting relationships and the child’s psychologi- 191

133 in their interaction with their child, co-parenting focuses cal adjustment. This study has the specific advantage of 192

134 on interparental relational dynamics when caring for quantifying the effect of co-parenting in the explanation 193

135 children.9 In other words, parenting focuses on vertical of children’s mental health and social adjustment. Previous 194

136 exchanges (father/mother---child) between two distinct fam- studies have consistently reported a statistically significant 195

137 ily subsystems (the parental subsystem and the fraternal association between these two variables. For instance, high 196

138 subsystem), while the co-parental subsystem refers to hor- levels of co-parental conflict and low levels of interparental 197

139 izontal exchanges between two adults socially responsible cooperation predicted externalizing problems, regardless of 198

140 for the care and development of one or more children. their age range.20 The difficulties of co-parental cooperation 199

141 Throughout the article, the co-parental subsystem is consid- are also associated with internalizing problems, attentional 200

142 ered as consisting of mother and father. One should observe, difficulties, poor academic performance, and decreased 201

143 however, that the co-parental subsystem can consist of two quality of parental relationship established individually by 202

144 or more adults who undertake shared functions in the child’s each parent with the child.21 203

145 education, regardless of gender, sexual orientation, or bio- In a pioneering study on the association between the 204

146 logical ties to the child.10,14 quality of co-parenting and the health status of the children, 205

147 As this is a relatively recent construct in psychology, the Barzel and Reid22 demonstrated that the co-parental conflict 206

148 existence of an extensive number of proposals to define was associated not only with internalizing and externalizing 207

149 co-parenting as a study object is noticeable.10,15,16 How- problems, but also with worse behavior regarding the man- 208

150 ever, most of the advanced definitions by researchers seem agement of diabetes and a lower perception of quality of 209

151 to converge to a common denominator. Co-parenting is life related to this disease, in a sample of schoolchildren. 210

152 operationalized by the degree of coordination of adults Teubert and Pinquart,9 in their analysis of 59 studies, 211

153 in providing care and education to at least one child, as concluded that co-parenting predicted changes in chil- 212

154 well as the way each of the adults supports the other’s dren’s mental health and that the effect of co-parenting 213

155 parenting.10,17,18 was influenced, among other factors, by the children’s age 214

156 Thus, in the last 20 years, several researchers have pre- --- the younger the children, the higher the predictive power 215

157 sented proposals to define co-parenting, the identification of co-parenting. Each of the dimensions of co-parenting 216

158 of its components, and the analytical understanding of its individually explained 1---9% of the variance of the chil- 217

159 relevance in family dynamics and the explanation of the dren’s adjustment. Although in general the effect size of 218

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219 co-parenting was low, but significant, such effects remained parents, the nonresident father’s involvement in the chil- 276

220 statistically significant even after parenting and quality of dren’s lives, and the quality of and satisfaction with new 277

221 marital relations were controlled.9 intimate relationships. 278

Surprisingly, the empirical data on the association 279

222 Co-parenting in families with separated and between co-parenting and children’s mental health after the 280

parents’ marital dissolution appears to be reduced, when 281

223 divorced parents
compared to the available empirical data on the psycho- 282

logical function of children with married parents and even 283

224 Marital dissolution does not dissolve the family. The family
when compared to studies that focus on the impact of co- 284
225 system remains, requiring, however, a processual and struc-
parenting on mental health indicators and social adjustment 285
226 tural reorganization of the remaining family subsystems,
of parents after marital dissolution. 286
227 with implications for the individual and systemic devel-
This systematic review aimed to identify empirical stud- 287
228 opment. Over the past decades, research has consistently
ies that have assessed associations between co-parenting 288
229 shown that the quality of co-parental relationship after mar-
components in divorced parents and different areas of the 289
230 ital dissolution is one of the main predictors of children’s
children’s mental health domains, aiming to summarize 290
231 development.3,5 In other words, mental health problems in
the key findings and critically assess their implications for 291
232 children do not seem to be caused by marital dissolution
future research. Thus, this review discusses which co- 292
233 itself, but by the degree and type of interparental and co-
parenting components exercised by divorced parents have 293
234 parental conflict occurring after this family transition.
been empirically tested to explain the variation in children’s 294
235 In fact, some authors argue that co-parental conflict is
mental health indicators. 295
236 the result of diffuse boundaries between the subsystems,
237 characterized by the parent’s weak capacity to separate
238 the romantic past and the possible ensuing litigious issues Methods 296
239 from current co-parental relationships.17,23,24 More specif-
240 ically, clinical investigations suggest that the co-parental
Research strategy and data extraction 297
241 conflict may reflect the transfer of marital conflicts into the
242 co-parental relationship, which, in most cases, becomes the
In order to understand the methodological trends, objec- 298
243 only contact between parents, and the difficulty in estab-
tives, and results, the authors performed a systematic 299
244 lishing new relational boundaries between parents emerges
survey of the scientific literature from January 2000 to Octo- 300
245 as one of the main factors for the co-parental conflict.23,25
ber 2014, aiming to identify empirical studies on the target 301
246 As in families with married parents, the co-parental
variables of this review. Empirical studies that had as one 302
247 alliance is not synonymous with absence of interparental
of their research aims the assessment of the association 303
248 conflict. The co-parental alliance results from an active
between co-parenting --- or at least one of its components 304
249 commitment between parents on cooperation and sharing
--- and psychological development and/or function indica- 305
250 of childcare and education. This cooperative commitment
tors in children with divorced parents were systematically 306
251 becomes even more important in families with divorced or
reviewed. As the conceptual definition of co-parenting is 307
252 separated parents. Empirical data suggest that a positive
recent in the psychological literature, concepts that are tra- 308
253 co-parental alliance promotes greater involvement of the
ditionally used to describe the dimensions of interparental 309
254 nonresident parent in the daily lives of children and acts
coordination, both regarding decision-making in the lives 310
255 as a protective factor for the academic performance and
of their children and the children’s care, were consid- 311
256 psychosocial well-being of these children.26---31 In addition,
ered in this survey. Consequently, concepts such as parental 312
257 secure attachment, the quality of the marital relationship
alliance, interparental conflict, triangulation, and parenting 313
258 prior to its dissolution, level of education, the parents’
were considered in this review. Observe that these concepts 314
259 financial stability, parental mental health, and the existence
are not conceptually synonymous with co-parenting. Simi- 315
260 of new intimate relationships are important predictors of co-
larly, only empirical studies published in scientific journals 316
261 parental relationship quality after marital dissolution.32---37
with a peer-review system indexed to selected databases 317

were included and, therefore, empirical studies published 318

262 Co-parenting after marital dissolution and in chapters of books, doctoral theses, master’s degree 319
263 children’s mental health dissertations, and those in scientific journals without a peer- 320

review system were excluded from the analysis. 321

264 Co-parenting is a dyadic construct with a triadic manifesta- The authors searched for scientific articles indexed 322

265 tion. In other words, the conceptual models of co-parenting between January 1, 2000 and October 1, 2014 in the 323

266 defend that the co-parental subsystem structure and process PsycInfo, PubMed, and Web of Knowledge databases. 324

267 constitute a previous explanatory mechanism of individual The following keywords were used: divorce, co-parenting, 325

268 performances of each parent and each child that makes parenting alliance, interparental conflict, triangulation, 326

269 up this triadic interaction.10,14 Thus, empirical research has parenting, adjustment, mental health, and psychopathol- 327

270 focused mainly on studying the associations between the ogy. The search strategy was to individually cross the 328

271 quality of co-parenting and parenting and the psychological keyword ‘divorce’ with each of the other selected keywords. 329

272 function of each parent. Overall, the research has aimed, The literature search was restricted to articles published 330

273 over the last decade, to understand how the quality of in English, Portuguese, and Spanish. The titles, abstracts, 331

274 the co-parental alliance between parents after marital dis- and keywords of all citations generated by this search strat- 332

275 solution is associated with the psychopathology levels of egy were carefully considered, aiming to identify potentially 333

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Co-parenting and children’s mental health 5

334 eligible articles for the review. The full articles were ana- co-parenting on children’s psychological function are sum- 371

335 lyzed when it was not possible to decide upon the inclusion marized in Table 1. 372

336 or exclusion of the publication according to these indica-

337 tors. All studies that appeared to meet the criteria were Study characteristics 373
338 independently reviewed by two investigators regarding their
339 inclusion and data extraction. Disagreements between the
From the methodological point of view, the 11 selected 374
340 researchers were resolved through discussion to reach a
studies show considerable variability among them regarding 375
341 consensus.
the sample size, the children’s ages, and the tools used 376

to measure co-parenting and mental health and psycho- 377

342 Inclusion and exclusion criteria logical adjustment indicators. More specifically, the results 378

reported in the studies considered in this review were gener- 379

343 The inclusion criteria to select articles for this review were: ated from samples of children in early childhood, school age, 380

344 being a quantitative empirical study; publication in a jour- adolescence, and emerging adulthood, used cross-sectional 381

345 nal with a peer-review system; having at least one measure and longitudinal designs, evaluated co-parenting using the 382

346 of co-parenting evaluation, or one of its components or parents’ and/or children’s self-report, and assessed psycho- 383

347 associated concepts; measurement of co-parenting with logical function indicators using different tools.39---49 384

348 former spouse (parental remarriage was not considered an

349 exclusion criterion); having at least one psychometric eval- Co-parenting and overall mental health 385

350 uation measure of an indicator of the child’s mental health

351 or development, including reports of inferential statistics The results demonstrate a significant association between 386
352 (e.g., correlations, regressions, structural models) between co-parenting (or its components) and overall mental health 387
353 the co-parenting measure and mental health measure of the indicators of children, adolescents, and young adults with 388
354 children assessed in the study; and, finally, having a sample divorced parents. More specifically, some studies show that 389
355 that also included children of parents with other marital co-parenting explains a substantial proportion of the vari- 390
356 status rather than divorced and having independent data ance in the overall psychological adjustment. For instance, 391
357 for families with divorced parents regarding the considered in the study of Macie and Stolberg,40 the co-parental behav- 392
358 variables. ior explains 46% of the variance of the overall mental health 393
359 Studies that measured non-co-parental conflict between of adolescents, while Trinder, Kellet, and Swift45 showed 394
360 parents (e.g., studies evaluating the inter-adult conflict that parental concerns about the parenting skills of the 395
361 through marital conflict and/or operating scales, such as former spouse explained 31% of mental health problems of 396
362 the Conflict Tactics Scale)38 were not included. Studies that children two years after the mediation session that regulates 397
363 reported results on the same variables in the same sam- parental power. 398
364 ple were excluded, considering for inclusion only the most
365 recently published study.
Co-parenting and externalizing and internalizing 399

problems 400

366 Results
Exposure to co-parental conflict, generally defined as 401

367 The research and exclusion process is summarized in Fig. 1. expression of anger and use of reduced assertiveness strate- 402

368 Of the 933 articles identified in the selected databases, 11 gies to solve co-parental problems, appears to be the 403

369 met the inclusion criteria and were included in this review. co-parenting dimension with the most robust associations 404

370 The main results of the included studies on the impact of with externalizing problems.47 For instance, Amato et al.47 405

found that children whose parents had a conflicting co- 406

parental pattern, characterized by high levels of latent 407

Articles initially identified conflict and negative affect expression and low levels of 408
Excluded (n=519):
in the database search
– Case or qualitative studies co-parental support and agreement, had more behavioral 409
(n=933)
– Exclusive evaluation of non-coparental conflict problems in adolescence (e.g., absenteeism and school 410
Theoretical, reviews, books
– Theses, dissertations, lectures
failure, substance use, or oppositional behavior), when com- 411

– Psychometric studies pared to parents with a cooperative co-parental pattern 412

Studies selected for further
screening (n=414) (i.e., high levels of support and agreement and low lev- 413

Studies selected for
detailed assessment (n=34)
Excluded (n=380): els of negative affect and conflict expression) and parents 414
– Articles not available in English, with parallel co-parenting (i.e., low levels of conflict, co- 415
Portuguese, or Spanish
– No psychometric measure of co-parenting parental support, and agreement). 416
– No measurement of at least one indicator
of children’s mental health
Co-parenting and internalizing problems 417

Excluded (n=23):
– No data from the subsample of divorced
parentes
The co-parenting effect after marital dissolution on chil- 418
Studies included in the review
(n=11)
– Articles with the same sample dren’s internalizing symptoms appears to be little studied in 419

the literature, given that only one study shows correlational 420

Figure 1 Flowchart of the selection process of empirical stud- data between the two variables. More specifically, Macie 421

ies. and Stolberg40 found that the children’s perception about 422

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Table 1 Summary of study characteristics and main results.

Study (year) Design Participants Co-parental measurement Children’s mental health Results
Country measurement
Hilton and PCS 120 parents (60 divorced - Co-parental conflict - Externalizing problems Co-parental conflict, among other
Desrochers39 and 60 married) (Quality of Co-parental (SR-P) variables, was shown to be a mediating
(2002) M age children with Communication Scale) (Child Behavior Checklist) mechanism between the negative and
USA divorced significant association of the divorced
parents = between 7.3 parents’ marital status and children’s
and 9.6 years (SD = NA) externalizing symptoms.
Macie and PCS 68 dyads (parent---child) - Perception of parents’ - Psychological adjustment Children’s perception of parents’
Stolberg40 72% children aged co-parenting behavior (SR-P and SR-C) co-parenting behavior predicted the
(2003) between 10 and 15 (Co-parenting Behavior (Behavior Problems Index) global mental health and self-esteem of
USA years. 28% between 16 Questionnaire) - Self-esteem (SR-C) children. The co-parenting behavior

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and 17 years (Hare Self-esteem Scale) perceived by children was not
statistically associated with symptoms of
hyperactivity or symptoms of depression
and anxiety, when assessed by parents.
Dimensions of co-parenting behavior,
such as conflict, triangulation,
respect/cooperation, and
communication, are negatively and
significantly correlated with the
children’s psychological function
measures.
Fabricius and RCS 266 university students, - Co-parental conflict - Psychosomatic symptoms Overall, in a structural model, parental
Luecken41 whose parents divorced (Single question created by the (Somatization Subscale, conflict predicted greater current
(2007) before their children study authors) Symptom Checklist --- 90-R) distress about the parents’ divorce, and
USA were 16 years old in turn, the distress significantly
predicted the participants’ physical
health levels.
More specifically, a statistically
significant association of low magnitude
was found between co-parental conflict
and the current levels of psychosomatic
symptoms.
Lau42 (2007) PCS 62 dyads (resident father - Parental agreement in - Self-esteem (SR-C) The children’s overall self-esteem was

Hong-Kong and child)
M age of child = 11.6
years (SD = NA)
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Lamela D, Figueiredo B
decision making (Self-perception Profile for negative and significantly associated
(Co-parental Interaction Scale) Children Scale) with conflicted co-parenting reported by
- Co-parental support and resident parents, characterized by low

cooperation levels of co-parental agreement or

(Parenting Support Scale) support.
 Co-parenting and children’s mental health

+Model
Table 1 (Continued)

Study (year) Design Participants Co-parental measurement Children’s mental health Results
Country measurement
Schrodt and RCS 1170 young adults (484 - Triangulation and - Mental health Young adults with divorced parents had
Afifi43 (2007) with divorced parents) co-parenting sabotage (SRC) (Mental Health Subscale, significantly higher values of
USA M age total sample = 20.2 (Feeling Caught Scale) Adolescent Health Scale) triangulation and co-parenting sabotage
years (SD = 5.4) than young adults with married parents.
In the group of young individuals with
divorced parents, triangulation and
co-parenting sabotage were shown to be
a mediating variable between marital
dissatisfaction in the past and current

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mental health levels.
Gasper et al.44 PCS 389 university students - Perception of parents’ - Overall mental health In a structural model, the parents’
(2008) M age = 19.6 years co-parenting behavior (SR-C) (Brief Symptom Inventory) divorced status was related to higher
USA (SD = 2.0) (Co-parenting Behavior - Problems with intimacy co-parental hostility and lower
Questionnaire) (Fear of Intimacy Scale) co-parental cooperation which, in turn,
- Delinquency were associated with lower levels of
(Delinquency Syndrome mental health and self-esteem and
Subscale, Young Adult higher delinquency levels and problems
Self-Report) with intimacy. These results suggest the
mediating effect of these co-parenting
dimensions of the parents’ marital status
and mental health indicators of children.
Trinder et al.45 L 117 divorced fathers and - Co-parenting concerns - Emotional and behavioral Higher concerns about the quality of
(2008) mothers (moment 3 of (Parenting Concerns Scale) well-being parenting by the other parent predicted
United the evaluation) residents - Division of tasks according to (Strength and Difficulties psychological well-being (total SDQ) of
Kingdom and non-residents. High co-parenting Questionnaire [SDQ] --- the children two years after the court
litigation sample (Co-parental Decision-making parents’ version) session of mediation regulating parental
scale) power. The age and gender of the child
were not statistically significant
predictors of their psychological
well-being at the moment of the
assessment.
Altenhofen PCS 24 dyads (resident - Co-parental communication - Secure attachment No significant associations were found
et al.46 (2010) mothers and their (Quality of Co-parental (Waters’ Attachment Q-Set) between parental communication and
USA children) Communication Scale) the children’s secure attachment.
M age of child = 37
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Table 1 (Continued)

Study (year) Design Participants Co-parental measurement Children’s mental health Results
Country measurement
Amato et al.47 L 784 divorced and/or - Co-parental function - Problems with behavior, Adolescents with parents that had a
(2011) separated resident (Questions developed within use of substances, conflicted co-parenting pattern showed
USA parents, 455 children the research project context self-esteem and life more behavioral problems than
evaluated in on the division of co-parental satisfaction (Questions adolescents whose parents were
adolescence, and of tasks, support, conflicts and developed by researchers. characterized by a cooperative or
these, 296 were agreement. Questions No psychometric validity parallel co-parenting pattern.
reassessed at emerging non-subject to psychometric indicator of the items No differences were found regarding
adulthood validation) administered by telephone other mental health indicators of
M age of children at the interview is reported) children due to the parents’ co-parental
moment 2 of pattern, either in adolescence or in

ARTICLE IN PRESS
evaluation = 12.4 years emerging adulthood.
(SD = NA)
M age of children at
moment 3 = 22.7 years
(SD = NA)
Shimkowski and RCS 493 young adults (129 - Co-parental communication - Mental health When compared with young adults with
Schrodt48 with divorced parents) (SR-C) (Adolescent Health Scale married parents, young adults with
(2012) M total sample age = 20.3 (Quality of Co-parenting Subscale) divorced parents showed higher levels of
USA years (SD = 2.9) Questionnaire) antagonist co-parental communication
and lower levels of co-parental support
and mental health communication.
In a structural model, the effect of
marital conflict exercised at current
levels of the children’s mental health
was exercised through antagonistic
co-parental communication. No
multi-group differences were found
(married parents versus divorced
parents) in this model.
Yárnoz-Yaben PCS 223 divorced parents and - Willingness to co-parent - Internalizing and Willingness to co-parent and co-parental
and González49 160 of their children (SR-P) externalizing symptoms support were not significantly associated
(2012) M age of child = 11.0 (Subescala Coparentalidade, (SR-P) with of internalizing and externalizing

Lamela D, Figueiredo B
Espanha years (SD = 6.7) Cuestionario de Adaptación al (Child Behavior Checklist symptoms and total CBCL.
Divorcio-Separación) [CBCL])
- Co-parental support (SR-P)
(Cuestionario de Apoyo
JPED 387 1---12

Recibido de la Ex-pareja)

NA, not available; PCS, prospective cross-sectional; RCS, retrospective cross-sectional; L, Longitudinal; SR-P, self-report tool administered to parents; SR-C, self-report tool administered
to the children.
 +Model
ARTICLE IN PRESS
Co-parenting and children’s mental health 9

423 the co-parental behavior of parents significantly predicted Additionally, the results of studies that assessed the asso- 479

424 their symptoms of anxiety and depression, explaining 37% of ciation between co-parenting and internalizing symptoms 480

425 the variance in this internalizing indicator. Additionally, that appear to be in line with those found in studies of children 481

426 study showed that specific dimensions of co-parenting, such with married, separated, or never-married parents.57---59 In 482

427 as conflict, communication, triangulation, and co-parental turn, the study by Fabricius and Luecken,41 which showed 483

428 respect/cooperation, were associated with symptoms of that past co-parental conflict had predictive power on 484

429 anxiety and depression assessed either by the parents or by somatization levels in emerging adulthood, is in line with 485

430 the children’s self-report.40 empirical research that has consistently shown a significant 486

association between family conflict during childhood and 487

psychosomatic symptoms and/or disorders in adulthood.60,61 488

431 Co-parenting and other indicators of psychological On the other hand, contrary to what might be expected 489

432 and social adjustment from a theoretical point of view,62,63 the only study in the 490

literature about the effect of co-parenting after marital 491

433 In addition to testing the association between co-parenting dissolution on children’s attachment showed no signifi- 492

434 and levels of overall psychological adjustment and internal- cant association between the children’s secure attachment 493

435 izing and externalizing symptoms, five studies assessed the and assessed co-parenting components.46 This empirical 494

436 effect of co-parenting on other psychological health indi- information appears to corroborate previous studies of fam- 495

437 cators of children.40---42,44,46,47 In more detail, a low level ilies with married parents that systematically demonstrated 496

438 of cooperation and high co-parental hostility and conflict positive and significant associations between positive co- 497

439 were associated with lower levels of self-esteem in emerg- parenting and children’s secure attachment and between 498

440 ing adult and school-age children.42,44 In turn, the past interparental conflict and/or conflictual/non-supportive 499

441 co-parental conflict predicted levels of somatization in co-parenting and children’s insecure attachments.64---66 How- 500

442 emerging adulthood.41 ever, the results of this study, in the authors’ opinion, should 501

443 Furthermore, specific dimensions of co-parenting --- i.e., be interpreted with caution, as the absence of significant 502

444 low support and high co-parental conflict --- were associ- association values may be due to the possible decreased 503

445 ated with difficulties in establishing intimate relationships statistical power, considering the sample size (n = 24). 504

446 in emerging adulthood,44 which appears to indicate that Some of the studies, when comparing psychological func- 505

447 frequent exposure to interparental interaction patterns tion dimensions in children of divorced parents with children 506

448 characterized by reduced affective closeness, cooperation, of married parents, suggested that the effect of nega- 507

449 and relational negotiation (i.e., low co-parental support) tive co-parenting in developmental outcomes appears to 508

450 and high negative affect expression can influence the be observed in children, adolescents, and emerging adults 509

451 development of adaptive representations in the horizontal regardless of their family structure.48 Thus, future studies 510

452 relationship between adults, which is in turn reflected in the should try to replicate these results and understand whether 511

453 capacity of children to establish secure and intimate inter- co-parental processes are qualitatively influenced by the 512

454 personal relations as adults. On the other hand, Altenhofen parents’ marital status or, in contrast, through other proxy 513

455 et al.46 did not find a significant association between the variables,67 which, although not a result of marital dissolu- 514

456 quality of co-parental communication and children’s secure tion, have a higher probability of prevalence among divorced 515

457 attachment at an early age. parents. 516

458 Discussion Study limitations and future investigations 517

459 In this systematic review, empirical studies that investigated The published articles that assessed the association between 518

460 the effect of co-parenting after marital dissolution on chil- co-parenting and mental health of children with divorced 519

461 dren’s mental health were identified, aiming to summarize parents are scarce and have a set of conceptual and method- 520

462 the main results. In synopsis, the results of the investigations ological limitations that must be considered. First, none of 521

463 included in this review appear to indicate a significant asso- the articles showed the assessment of co-parenting based 522

464 ciation between co-parenting and mental health markers of on a theoretical model to guide research objectives and 523

465 the children of divorced parents. the methodological choices that were made. This aspect is 524

466 Most studies that assessed the associations between relevant regarding the selection of the co-parenting mea- 525

467 co-parenting and externalizing problems showed that co- suring tools. Although most studies measure co-parenting 526

468 parental conflict is significantly associated with increased using previously validated tools, it is clear that there is 527

469 symptoms of behavioral problems in the children. These a conceptual inaccuracy about the co-parenting construct. 528

470 results appear to be in line with empirical research that For instance, Hilton and Desrochers39 affirm they assessed 529

471 assessed the association between marital and co-parental co-parental conflict in their study; however, the scale they 530

472 conflict in married parents and the children’s externaliz- used, the Quality of Co-parental Communication,68 meas- 531

473 ing levels.9,50,51 In theory, some authors maintain that social ures the communication between co-parental partners after 532

474 learning,52,53 emotional security,54 cognitive distortion,55 marital dissolution, in which six scale items assess co- 533

475 and psychophysiological deregulation56 processes explain parental support and four items the frequency and intensity 534

476 the association between the use of aggressive techniques by of co-parental conflict. Additionally, as the measures used 535

477 parents to destructively manage conflicts and the behavioral are not based on a theoretical model that supports construct 536

478 regulation dysfunction of children. operationalization, there is no conceptual standardization 537

JPED 387 1---12

 +Model
ARTICLE IN PRESS
10 Lamela D, Figueiredo B

538 of co-parenting components in the research, which hin- that co-parenting is a multidimensional concept, it is rea- 600

539 ders the comparability of results. Second, co-parenting was sonable to hypothesize that the interactive combination of 601

540 assessed in all studies by self-report measures, without different components of co-parenting may produce different 602

541 the inclusion of other measurement tools, which, through co-parental function patterns, which may be differentially 603

542 the triangulation of data, would increase the validity of the associated with parenting and mental health levels of par- 604

543 results. ents and their children. This theoretical hypothesis has been 605

544 Third, there is an overrepresentation of studies whose tested in a recent study carried out in the United States.47 606

545 samples consist of a small number of participants (five stud- However, this study shows both conceptual (i.e., the opera- 607

546 ies with a sample size with less than 150 participants), or tionalization of co-parenting and its associations with other 608

547 participants with risk characteristics (e.g., high litigation) family subsystem is not theoretically oriented) and method- 609

548 (one study) or young adult participants in a university con- ological limitations (Table 1), which reduce the external 610

549 text (two studies). Only one study47 used a representative validity of the results. Following this line of thought, further 611

550 sample of the population; however, measures administered investigations should be carried out to replicate the results 612

551 to evaluate co-parenting and mental health were not vali- found by the authors, using a conceptual framework that 613

552 dated using a psychometric tool, which represents a marked will include the evaluation of co-parenting components and 614

553 methodological limitation. Finally, three of the studies their association with the psychological function of divorced 615

554 with larger sample sizes had retrospective characteristics, parents and their children. 616

555 instructing participants to evoke memories of marital con-

556 flict or quality of co-parenting during their childhood and/or Final considerations 617
557 adolescence.41,43,48
558 Although the results of these studies show a trend that
Traditionally, psychological research has highlighted the 618
559 is in line with those obtained in studies with longitudinal
impact of individual variables related to each parent on the 619
560 or prospective cross-sectional design, some research has
mental health of children, such as psychopathological mal- 620
561 shown, in other areas of psychology, that empirical results
adjustment, attachment patterns, personality traits, and 621
562 based on measures that require evoking past memories
exposure to adversities throughout life. However, as dis- 622
563 about potentially adverse events can show validity problems
cussed in this chapter, several studies published in the last 623
564 and suffer from the misinformation effect.69---71 Therefore,
20 years have shown that specific co-parenting dimensions 624
565 additional precautions are advised when interpreting the
(agreement/disagreement with the care and sabotage of 625
566 results of these retrospective investigations. Fifth, the
parenting) have an important explanatory weight for the 626
567 reviewed studies, except for the one by Amato et al.,47
child’s developmental results after marital dissolution. 627
568 used either tools that measured isolated components of co-
More concretely, research data have shown that co- 628
569 parenting (seven studies) or broadband tools (three studies)
parenting is a robust predictor of internalizing and 629
570 that measured co-parenting as a one-dimensional construct.
externalizing problems of children, mental health levels 630
571 Now, based on the conceptual premise that co-parenting
of parents, and processual characteristics within the fam- 631
572 is multi-dimensional, a one-dimensional evaluation of the
ily after this family transition. However, as shown in this 632
573 construct does not allow the understanding of the potential
review of the empirical literature, the scientific study of 633
574 specialized effect of the dimensions of co-parenting when
co-parenting after marital dissolution can take on clinical 634
575 predicting specific mental health problems, which can be
importance for the planning of psychological interventions 635
576 seen as a significant limitation of the current generation
in the context of primary health care, based on evidence 636
577 studies in the domain.
that promotes family and child adjustment after this family 637
578 Hence, only the study by Yárnoz-Yaben and González49
transition. More specifically, by showing which co-parenting 638
579 appears to be able to assemble a set of methodological char-
components have a differential impact on the advent of 639
580 acteristics that increase the external validity of the results,
mental health problems in children, this review may con- 640
581 as it prospectively evaluates constructs, has a sample that
tribute to the development of intervention programs that 641
582 seems to ensure adequate statistical power to test the study
focus on more specific modules for intervention targets, in 642
583 objectives, and uses measures with psychometric quality.
accordance with the principles of pediatric and psychologi- 643
584 However, the data reported by the authors are correlational,
cal practice based on empirical evidence.72---74 644
585 as the analysis of the association between co-parenting and
586 children’s psychological function was not the aim of the
587 study. Conflicts of interest 645

588 Hence, future studies in this area should respond to the

589 methodological limitations identified in previous empirical The authors declare to have no conflicts of interest. 646

590 studies. Thus, future studies using theoretically oriented co-

591 parenting assessment measures with psychometric validity, References 647
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