Parents and infants: determinants of attachment in a ... - Generation R

Chapter 6
Cumulative contextual risk. We constructed a contextual risk composite variable
that has earlier been applied to predict child behavior problems in a
large community based study (Belsky & Fearon, 2002). In the current study,
this variable included 7 contextual risk factors out of 9 that were used in
the Belsky and Fearon (2002) study: ethnic minority status, low family
income (defined as below modal monthly family income in the Netherlands
i.e. 2000 € after taxes), low maternal educational level (less than 12 years
of education), single parenthood, low family functioning, high maternal
psychopathological symptoms, high parenting stress. Family functioning
was assessed with the Family Assessment Device (Epstein, Baldwin &
Bishop, 1983; Miller, Epstein, Bishop & Keitner, 1985) in the last trimester
of pregnancy. We measured maternal psychopathology at two months postpartum
with the Brief Symptom Inventory, a validated self-report measure
consisting of 53 items, which is widely used to assess psychological distress
(De Beurs, 2004; Derogatis, 1993). Parenting stress was measured at 18
months postpartum with the Nederlandse Ouderlijke Stress Index – Kort
(NOSIK, De Brock, Vermulst, Gerris, & Abidin, 1992), the Dutch version of
the Parenting Stress Index – Short Form (Abidin, 1983). Analogous with the
Belsky & Fearon (2002) approach, we defined risk status on the last three
variables as the least favorable 20% of scores within our sample.
Cumulative risk was defined as the number of risk factors that applied
to every participant divided by the number of risk factors endorsed by
the participant to achieve a weighted index of cumulative risk with values
between 0 (none of the available factors have risk status) and 1 (all available
factors have risk status). For 96% of the participants information on all seven
factors or six out of seven risk factors was available. To compare the distribution
of cumulative risk with the distribution found by Belsky and Fearon
(2002) in the NICHD sample, we created four risk groups in the same way as
they did (see Table 1): No contextual risk (49.4%), low contextual risk (0.01
- 0.15, equivalent to 1 risk factor, 22%), moderate contextual risk (0.16 - 0.25,
equivalent to 2 risk factors, 8.7%), and high contextual risk (> 0.25, equivalent
to 3 or more risk factors, 20% ). These findings were very similar to the
findings in the NICHD sample: 44% no risk, 21% low risk (1 risk factor), 13%
moderate risk (2 risk factors), and 22% high risk ( 3 risk factors). For use
in the analyses the cumulative risk scores were Z-standardized and outliers
( 3.29) were winsorized to the next highest score (3.08).
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