Fifty moves a year: Is there an association between joint physical custody and psychosomatic problems in children?
Journal of Epidemiology and Community Health
Report summary
Do children living in two homes report more headaches, sleep problems, stomach aches, sadness, or stress?
Children whose parents lived together reported the fewest sleep problems, concentration difficulties, headaches, stomach aches, tension, sadness, dizziness, and appetite loss. Among children with separated parents, those in shared care reported fewer of these symptoms than children living mostly or only with one parent.
Reviews often report better average outcomes in shared care, but they increasingly emphasise that studies differ and that researchers remain uncertain about what caused the results or whether they apply equally in every country and family.
Researchers' conclusions
The authors concluded that the practical stress of moving between homes did not outweigh the advantages associated with maintaining everyday relationships and resources in both parental households in this sample.
This is a plain-language summary of the researchers' conclusion. It is not advice for an individual family.
How the report was produced
Most studies are observational. Strong interpretation therefore requires attention to selection effects, baseline differences, definitions of shared care, and the outcomes and informants used.
What this paper supports
Reasonably supports
- Rejecting an assumption that joint physical custody is inherently harmful.
- Examining prior involvement, coparenting, income, conflict, logistics, and child age alongside time allocation.
- Distinguishing average associations from the suitability of an arrangement for an individual family.
- Studying policy implementation separately from child-outcome comparisons.
Does not establish
- Claiming that shared time alone explains every observed outcome difference.
- Assuming findings dominated by school-age, higher-resource families transfer unchanged to infants or high-risk cases.
- Treating conflict as irrelevant merely because some shared-care groups fare well in its presence.
- Applying a presumption without meaningful exceptions for safety and caregiving capacity.
Important limitations
- Cross-sectional design cannot establish causation
- Swedish social conditions may limit generalization
- Family selection and pre-separation differences remain possible
- Self-reported symptoms and living arrangements
Evidence context and debate
Open the sections below for the wider research context, points of agreement, and areas that remain contested.
Why this question matters
Research shifted from broad joint-versus-sole custody comparisons toward distinguishing physical care time, legal status, family selection, conflict, income, coparenting, and children’s ages.
Shared-parenting research has accumulated a recurring average pattern: children in joint physical custody samples often show outcomes that are equal to or better than those in sole-custody samples. Bauserman’s 2002 meta-analysis, Baude and colleagues’ 2016 meta-analysis, Nielsen’s reviews, and Steinbach’s international review all identify some version of that pattern. The consistency is important, but it is not equivalent to a randomized test of a legal arrangement.
Families who practise shared care often differ before outcomes are measured. They may have higher income, more flexible work, more prior involvement by both parents, stronger coparenting, lower conflict, or greater willingness to coordinate. Statistical controls can reduce measured differences but cannot guarantee that every unmeasured selection factor has been removed. Definitions also range from roughly 25 percent of nights with each parent to near-equal time, making simple labels misleading.
A useful reading therefore separates three questions: whether shared-care samples generally fare well, whether time allocation itself contributes to that pattern, and whether a legal presumption would improve outcomes across a wider and less selected population. The first has the strongest support. The second has suggestive but nonexperimental support. The third requires policy evaluation, attention to exceptions, and evidence about implementation.
Where researchers agree and disagree
Researchers commonly agree that ongoing positive relationships with both parents can be beneficial and that family violence and serious safety risks require different analysis.
Debate concerns how much observed differences reflect the arrangement itself versus the families who select it, and whether average findings justify legal presumptions.
Comparison with other research
Bauserman, 2002
Combined 33 studies and reported better average emotional health, behaviour, self-esteem, family relationships, general wellbeing, and coping with divorce in joint-custody groups. Combining joint legal and physical custody and relying on older studies limits direct use for modern equal-time arrangements.
Baude, Pearson & Drapeau, 2016
Combined 19 studies and found a small average advantage for shared care. The amount of time with each parent was related to the size of the difference, but family choice and differences in measurement still limit the conclusion.
Nielsen, 2018
Catalogued 60 studies and emphasized how frequently joint-custody groups had equal or better outcomes. The descriptive breadth is useful; debate concerns review method, study quality weighting, and causal language.
Steinbach, 2019
Also found generally positive results, but stressed that the studies differed and that shared-care samples included many advantaged, lower-conflict families with school-age children.
Fabricius et al., 2018
Evaluated professional perceptions after Arizona’s statutory change. It informs implementation and conflict claims but does not directly estimate children’s developmental outcomes.
How the evidence developed later
Later reviews increasingly separate joint legal custody from actual residential time.
Cross-national work has widened the evidence beyond North American samples while revealing different policy and selection contexts.
Researchers now give more attention to coparenting as a possible mechanism rather than treating schedule as the only exposure.
Policy studies such as the Arizona evaluation ask how presumptions operate in practice, a different question from whether children in self-selected arrangements differ.
Read the paper and related research
This report
Malin Bergström, Emma Fransson, Bitte Modin, Marie Berlin, Per A. Gustafsson & Anders Hjern (2015). Fifty moves a year: Is there an association between joint physical custody and psychosomatic problems in children? Journal of Epidemiology and Community Health, 69(8), 769–774. https://doi.org/10.1136/jech-2014-205058
Preschool children living in joint physical custody arrangements show less psychological symptoms than those living mostly or only with one parent
See whether the same pattern appears among 3,656 preschool children using parent and teacher reports.
Record checked against the linked scholarly source. Last editorial review: 22 July 2026, as part of a batch review of the current collection.