Defining and assessing risk and adaptation in the context of parental affective disorder : implications for future research

Abstract

The present study addresses some conceptual and methodological problems identified in the resilience research. Specifically, it focuses on the development of a rigorous and comprehensive way to measure risk and adjustment in a sample of 21 children (age 7 to 15) who share a common risk factor (i.e., parental affective disorder). A Risk Composite was developed based on a review of the literature. Forty-five potential risk factors in four broad areas (i.e., Socio-economic status, Early Development, Stressful Life Events, and Parental Psychopathology) were included in the Composite. A cumulative risk score was obtained for each child by summing across the individual risk items. Using a median split, a group of "higher" and "lower" risk children was identified. Narrative profiles of children in each group are provided to establish face validity of these risk classifications. A broad-based assessment of child adjustment was also conducted using a standardized measure of child functioning (i.e., BASC) as well as parents' ratings of the child's overall level of functioning in various contexts. Successful adaptation was defined as the absence of any "clinically significant" emotional or behavioural problems and average functioning at home, at school and with peers. Using these criteria, children in the sample were classified as "high" or "low" functioning. These classifications were validated using independent ratings of child functioning. Based on scores on the Risk Composite and the classification on the Adaptive Functioning Composite, children were placed into one of four Risk/Functioning groups. A group of "resilient" (i.e., high risk/high functioning) children were identified along with three other distinct groups who varied on level of overall risk and functioning: low risk/low functioning; low risk/high functioning; and, high risk/low functioning. Due to the sample size, statistical procedures could not be meaningfully used to examine the differences between the four groups. However, a general process for distinguishing between factors that played a protective role for children facing high adversity and factors that were resources for all children was presented. Descriptive analyses were conducted to illustrate the potential of this approach for enhancing our understanding of resilience and the factors that may contribute to better adjustment in the context of higher and lower risk.