Marital adjustment to chronic childhood illness: a critique of the literature.

Thirty-four studies of marital adjustment were selected from the literature on family adjustment to chronic childhood illness. Studies were reviewed to determine whether divorce rates were elevated or marital adjustment was poorer compared with that of families of healthy children. Of 23 studies reporting divorce rates, only six used a group of families without a chronically ill child for comparison. These studies showed no significant differences in the divorce rates between groups. Of 23 studies of marital adjustment, 83% investigated marital distress. Four of seven studies with comparison groups showed that marital distress was increased in parents of chronically ill children. Other areas of marital adjustment, such as communication, decision-making, and role flexibility, have received almost no attention by researchers. It is questioned whether divorce or distress is an adequate indicator of marital adjustment in general. Further studies are needed to understand the relationships between divorce, distress, and other important areas of marital adjustment to chronic childhood illness.