parentingamongdepressed.pdf

Parenting Practices among Depressed
Mothers in the Child Welfare System

Patricia L. Kohl, Jacqueline Njeri Kagotho, and David Dixon

The purpose of this study was to analyze a nationally representative sample of families referred
to Child Protective Services (CPS) agencies, the National Survey of Child and Adolescent
Weil-Being, to examine the association between maternal depression and parenting practices
over a 36-month follow-up period.Three hypotheses were tested: (1) Depressed mothers are’
more likely to demonstrate harsh parenting than are nondepressed mothers; (2) depressed
mothers are more likely to demonstrate neglectful parenting than are nondepressed mothers;
and (3) depressed mothers are more likely to demonstrate emotional maltreatment than are
nondepressed mothers. The interaction between depression and time was also analyzed for
each parenting practice to determine how changes in maternal depression affected changes in
parenting. The sample for this study was 1,536 mother-child dyads in which the child was age
three to 10 years and remained in the home after a CPS investigation. Depression remained
high across time points and was associated with increased risk of emotional maltreatment and
neglect over a 36-inonth period. In addition, self-reported emotional maltreatment remained
high across time points. Implications of this work are the needs for better identification of
mental health needs for mothers entering the child welfare system and parent training to
specifically address positive parenting.

KEY WORDS: child welfare; maternal depression; National Survey
of Child and Adolescent Well-Being; parenting

M
aternal depression, a critical public
health concern, is prevalent among
mothers referred to Child Protective

Services (CPS) agencies. In fact, nearly a quarter of
adults entering the child welfare system meet the
diagnostic criteria for a major depressive episode
in the preceding 12 months (U.S. Department of
Health and Human Services, Administration on
Children.Youth and Families [HHS, ACYF], 2005),
compared with only 7% of adults in the general
population (Kessler, Chiu, Demier, & Walters, 2005).
Furthermore, w ômen have an increased likelihood
of experiencing depression compared with men
(Kessler et al., 2003), and women exposed to a
high number of chronic Stressors—as many women
referred to CPS agencies are—are three times more
likely than women with less exposure to Stressors to
experience maternal depression (Orr,James, Burns,
& Thompson, 1989). Given that women comprise
the vast majority of primary caregivers among the
child welfare population (HHS, ACYF, 2005), it is
important to understand how maternal depression
affects outcomes after a CPS referral.

The high rate of maternal depression in the child
welfare system is a concern given its influence on
parenting practices. Symptoms of depression may
impede a woman’s capacity to provide care for her
children, placing her at risk to engage in neglectful
parenting practices. For instance, depressed mothers
may lack sensitivity to their children’s physical and
emotional needs (Campbell et al., 2004; Trapolini,
Ungerer,&McMahon,2008) ormay be unavailable
or otherwise unresponsive to their children (Cum-
mings & Cicchetti, 1993).

The literature also demonstrates that maternal
depression is related to a higher risk of other
harmful parenting behaviors, including emotional
maltreatment and harsh parenting. Depressed moth-
ers are more likely than are nondepressed mothers
to have conflict-related interactions with their
children, including feeling aggravated with the
child, yelling at the child, and spanking the child
(Lyons-Ruth,Wolfe, Lyubchik, & Steingard, 2o[)2).
Maternal depression increases the likelihood of
corporal punishment toward children (Chung, Mc-
CoUum, Elo, Lee, & Culhane, 2004; Shin & Stein,

CCCCode: 1070-5309/11 $3,00 62011 National Association of Social Workers 215

2008). Using meta-analysis techniques to examine
reported findings about maternal depression and
parenting behavior across 46 studies, Lovejoy, Crac-
zyk, O’Hare, and Neunian (2000) found a moderate
effect size {d = .40) for negative parenting behav-
iors (for example, coercive, hostile, or threatening
gestures), indicating a fairly strong relation between
depression and harmful parenting.

Additional studies have shown that maternal
depression places children at risk of abuse. Longi-
tudinal analysis of the National Institute of Mental
Health’s Epidemiologie Catchment Area Survey
{N = 7,103) revealed that, among cases with no
reported abuse at baseline, depressed respondents
(parents) were more than three times as likely to
report physical abuse toward their child at wave 2
than were nondepressed parents (ChafEn, Kelleher,
& Hollenberg, 1996). Finally, symptoms of mental
illness, including depression, were associated with
higher scores on the Child Abuse Potential In-
ventory in the Women, Co-occurring Dis s
and Violence Study, indicating an elevated risk of
future abuse (N = 371) (Rinehart et al., 2005). In
summary, these studies have clearly demonstrated
that maternal depression adversely affects parent-
ing among community-based samples. The extent
to which maternal depression influences parent-
ing practices among one of the country’s most
vulnerable populations—mother and child dyads
referred to CPS agencies for allegations of abuse
or neglect—is not yet known.

The aim of child welfare intervention is to
improve the safety and well-being of children, a
goal that is adversely affected by maternal depres-
sion. There is currently a dearth of information
on the association of depression and changes in
parenting behaviors after referral to CPS agencies.
Unanswered questions remain. Do the parenting
behaviors of depressed mothers improve at similar
or different rates than do those of nondepressed
mothers? Does a change in depression status affect
parenting behaviors? Underst:anding which, if any,
parenting behaviors remain a risk will help child
welfare professionals better target limited resources
to more accurately address specific parenting be-
haviors. Furthermore, this understanding could be
used to inform policy and practice decisions about
the mental health service needs of mothers referred
to CPS agencies.

The objective of this study was to analyze a land-
mark nationally representative sample of children

and families referred to CPS agencies, the National
Survey of Child and Adolescent Well-Being (NS-
CAW),to examine the association between maternal
depression and changes in self-reported parenting
practices over a 36-month period after referral to
CPS agencies. Specifically, these three hypotheses
were tested:

1. On average, depressed mothers would be more
likely to demonstrate harsh parenting over a
36-month period than would nondepressed
mothers.

2. On average, depressed mothers would be more
likely to demonstrate neglectful parenting over
a 36-month period than would nondepressed
mothers.

3. On average, depressed mothers would be more
likely to demonstrate emotional maltreatment
over a 36-inonth period than would nonde-
pressed mothers.

In addition, we analyzed the interaction between
depression and time for each parenting practice to
determine how changes in maternal depression
between baseline and 36-month follow-up affected
changes in parenting behaviors. Finally, other child,
family, and case characteristics associated with par-
enting practices were determined.

RESEARCH METHOD
The NSCAW, a fixed-panel design with four waves
of data collection, had a stratified two-stage sample.
The primary sampling units (PSUs) were county
child welfare agencies; the secondary sampling units
were children (and their families) chosen from a list
of completed investigations at the sampled agencies.
The sample was selected from 92 PSUs located in
36 states (NSCAW Research Group, 2002). The
random sample of families within each agency
was drawn from those who underwent a complete
investigation for child maltreatment.The targeted
population was all children and families investi-
gated for child maltreatment in the United States;
however, four states that required child welfare
agency personnel to make first contact with the
family instead of the NSCAW field representative
were excluded from the study. For statistical rea-
sons, infants, sexual abuse cases, and cases receiving
ongoing services after the investigation were over-
sampled (Dowd et al., 2003). Weighting was then
performed to adjust for the unequal probability

Social Work Research VOLUME 35, NUMBER 4 DECEMBER 2011216

of selection from oversampling and nonresponse.
Cases with both substantiated and unsubstantiated
maltreatment were included in NSCAW. The ra-
tionale for inclusion of both types of cases in the
proposed project was the significant evidence that
the ultimate substantiation of a particular report
is not a good indicator of the seriousness of the
report or the likelihood of continued and serious
problems in parenting (Drake, Jonson-Reid, Way,
& Chung, 2003; Hussey et al., 2005;Jonson-Reid,
Drake, Kim, Porterfield, & Han, 2004; Kohl &
Barth, 2007; Kohl, Jonson-Reid, & Drake, 2009).
Furthermore, many states now use a differential
response system and offer voluntary services to
at-risk families whose cases were not substantiated.
Hence, substantiation status cannot be used as a
proxy for service receipt.

The NSCAW data were collected from caregiv-
ers and child welfare workers at four time points:
baseline (between October 1999 and December
2000), approximately 12 months after baseline (wave
2), approximately 18 months after baseline (wave 3),
and approximately 36 months after baseline (wave 4).
At baseline, wave 3, and wave 4, an NSCAW field
representative conducted face-to-face interviews
with the permanent caregiver of children remaining
in the home; for wave 2, the field representative con-
ducted a telephone interview with the permanent
caregiver. Child welfare workers also participated in
face-to-face interviews at baseline. If a case remained
open to child welfare services, additional worker
face-to-face interviews were completed at wave
2, wave 3, and wave 4. Wave 1, wave 3, and wave
4 included comparable measures of maternal and
child functioning and mental health that were not
included in wave 2. Data regarding service receipt
was collected from caregivers and child welfare
workers at wave 2.

Sample
The entire NSCAW sample included 5,501 children
(ages 0 to 16 years) and their families investigated
for child maltreatment. The following cases, rep-
resenting a subset of NSCAW, were included in
this study:

• The child remained in home after the index
investigation and spent no more than 5% of the
study duration in out-of-home placements.

• The child was between the ages of 3 and 10
years at baseline.

The child’s primary caregiver was identified
as his or her mother (biological, adoptive, or
step).

The child age inclusion criterion was selected
because of the potent influence of parenting duriiig
the preschool and elementary school years. NSCAW
did not capture parenting behaviors that are par-
ticularly influential during infancy and toddlerhood;
therefore, the youngest children were excluded. In
addition, parenting influences may be less powerful
during adolescence due to adaptational and matu-
rational processes (Sim &Vuchinich, 1996). ¡

With these inclusion criteria, the final sample
size was 1,536 cases. Only one child per family
was included in the NSCAW; therefore, children
were not nested within mothers. The sample was
composed of 1,536 mother—child dyads. i

Measures
Following is an overview of the manner in which
variables were measured. ¡

The dependent variables were three parenting
practices: harsh parenting, neglect, and emotional
maltreatment. These were measured with three
subscales of the Conflict Tactics Scale-Parent to
Child version (CTS-PC) (Straus, Hamby, Moore; &
Runyan, 1998) at baseline, wave 3, and wave 4.The
Physical Assault subscale assessed harsh parenting
with the following nine items: (1) spanked child on
bottom with bare hand; (2) .slapped on the hand, arhi,
or leg; (3) hit on bottom with a belt, hairbrush, stick,
or another hard object; (4) hit some other part ¡of
the body besides the bottom with a belt, hairbrush,
or stick; (5) pinched the child; (6) slapped on the
face, head, or ears; (7) hit with a fist or kicked hatd;
(8) threw or knocked down; and (9) beat up (that
is, kicked or hit the child over and over as hard as
possible) .The Neglect subscale assessed neglect with
the following five items: (1) had to leave your child
home alone, even when you thought some adult
should be with him or her; (2) were not able ¡to
make sure your child got the food he or she needed;
(3) were so drunk or high that you had a problem
taking care of your child; (4) were not able to make
sure your child got to a doctor or hospital when he
or she needed it; and (5) were so caught up with
your problems that you were not able to show br
tell your child that you loved him or her. Finally, the
Psychological Abuse subscale assessed for emotiorial
maltreatment with the following five items: (1)

K O H L , K A G O T H O , A N D D I X O N / Parenting Practices among Depressed Mothers in the ChildWelfare System 217

shouted, yelled, or screamed at child; (2) threatened
to spank or hit the child but did not actually do it;
(3) swore or cursed at child; (4) called child dumb
or lazy (or similar statement);and (5) said you would
send child away or kick child out of the house. As
recommended by the scale developers (Straus, 1991),
median scoring was used to assess the frequency of
each parenting behavior, with one incident scaled as
I, two incidents scaled as 2, three to five incidents
scaled as 4, six to 10 incidents scaled as 8,11 to 20
incidents scaled as 15, and more than 20 incidents
scaled as 25. The three parenting variables exhibited
a high degree of skewness, in large part due to the
high occurrence of 0 values (neglect: about 70%;
harsh parenting: about 90%; emotional maltreat-
ment: about 40%). Data transformations failed to
normalize these data.Thus, a natural dichotomiza-
tion at 0 versus not 0 was appropriate. Responses
on the parenting outcome measures were analyzed
as a series of individual time points (for example,
baseline, wave 3,and wave 4) in the bivariate analyses
and were analyzed as time-varying variables in the
multivariate analyses.

The primary independent variable in our analytic
models was maternal depression, which was mea-
sured as a binomial variable with the Composite
International Diagnostic Interview—Short Form
(CIDl-SF) at baseline, wave 3, and wave 4. The
CIDI-SF is a structured interview designed to screen
for common psychiatric dis s with diagnostic
criteria established in the DSM—IV (American
Psychiatric Association, 1994; Kessler, Andrews,
Mroczek, Ustun, & Wittchen, 1998). Mothers who
met the diagnostic criteria for clinical depression
were coded as 1 ; mothers who did not meet these
criteria were coded as 2. As with the parenting out-
come measures, responses on the depression measure
were analyzed as a series of individual time points in
the bivariate analyses and as a time-varying variable
in the multivariate analyses.

Control variables included in the analysis were
child gender, child age at baseline, mother race/
ethnicity, mother age at baseline, mother educa-
tional attainment, family income, urban or nonurban
status, and most serious maltreatment type of the
baseline maltreatment report. Family income was
categorized as “poor” versus “nonpoor” on the basis
of the federally defined poverty level. This measure
was calculated on the basis of procedures followed
by the U.S. Census Bureau and includes both the
family’s income level and the number of adults and

children in the household (Dalaker & U.S. Census
Bureau, 2001).The poverty measure was used as a
dichotomous variable in the analyses (at or below
poverty threshold or above poverty threshold).
Urban/nonurban status of the county was defined
consistent with U.S. Census definitions. Urban was
defined as greater than 50% of the population liv-
ing in the urban area, and twnurban was defined as
all other areas that did not meet this description
(NSCAW Research Croup, 2002) .The maltreatment
type of the official report at basehne investigation
was obtained from the child welfare worker. From
a list of 10 categories, the worker first indicated all
maltreatment types included in the report. When
multiple maltreatment types were reported, the
most serious maltreatment type was determined
by using a slight modification of the Maltreatment
Classification System (Manly, Cicchetti, & Barnett,
1994), resulting in five categories of maltreatment:
(1) physical abuse; (2) sexual abuse; (3) neglect:
failure to provide; (4) neglect: failure to supervise;
and (5) other. For purposes of our analyses, we col-
lapsed the categories into physical abuse, neglect,
and other. Physical abuse was the referent category
in our analytic models.

Data Analysis Strategy
Data were analyzed using Stata 10 data analysis
software. All analyses used the NSCAW sampling
weights; therefore, findings are nationally repre-
sentative and generalizable to child welfare cases in
which a child (between the ages of 3 and 10 years)
remained in the home with his or her mother for
at least 95% of the time in the 36 months after a
maltreatment investigation.

The data analysis strategy included univariate,
bivariate, and multivariate analysis techniques.
Frequencies were calculated to provide a general
description of the data. Chi-square tests, ( tests, and
unadjusted odds ratios were used to analyze the
bivariate relation between major depression and
the outcome and control variables. Finally, cross-
sectional and longitudinal logistic regression models
were built to analyze associations and interactions
between dependent and independent variables.
Generalized estimating equations (GEEs) were used
(Diggle, Heagerty, Liang, & Zeger, 2002).The GEE
methodology provides a method of analyzing cor-
related data that arise from longitudinal studies in
which subjects are measured at different points in
time. GEEs are most effective when the focus is on

218 Social Work Research VOLUME 35, NUMBER 4 DECEMBER 2011

estimating the average response over the population
(population-averaged effects),also referred to as the
“marginal mean model.” The resulting model re-
gression coefficients have interpretations that apply
to the population of individuals defined by fixing
the values of the other covariates in the model.The
correlated binary nature of our longitudinal inde-
pendent variable (maternal depression—yes/no) lent
itself to the GEE methodology as hkelihood-based
inference was less applicable.

The xtgee command in Stata was used for GEEs,
with the binomial specification for family to indicate
the binary dependent variables represented by the
three dichotomized parenting practice outcomes.
In addition, compound symmetry was obtained by
using exchatigeable for the correlation specification
among the binary outcomes.

To conduct the longitudinal multivariate analy-
ses, we transformed the data from a wide to a long
file. The time-varying dependent variables were
coded as follows: If wave = baseline, then the base-
line score was used; if wave = 3, then the wave 3
score was used; and if wave = 4, then the wave 4
score was used. Wave was then controlled for in all
our analytic models.Three parenting measures were
analyzed as dependent variables in separate models.
In each model, the other two parenting measures
were included as independent variables (for ex-
ample, when neglect was the dependent variable,
harsh parenting and emotional maltreatment were
included). Neglect and emotional maltreatment
were moderately correlated (a = .29, p < .001). Although this correlation is low enough to indicate that they are distinct constructs, the correlation is high enough that the relationship should be ac- counted for in the models. Both main effect and interaction models were analyzed with this approach.The interaction model included a dummy-coded interaction term of de- pression by wave.The resulting interaction term was a three-level categorical variable (no depression at baseline, no depression at wave 3, no depression at wave 4), with no depression at baseline held as the reference group across all models. To correct for missing values in the dependent variables, independent variables, and other control variables, we performed multiple imputation by chained equations. The missing values were im- puted in 10 iterations to create a simulated data set. All analyses were conducted on the simulated data set. Table 1: Description of Sample (Unweighted N = 1,536) Child gender Male Female Child age at baseline (years) 3-5 6-10 Mother's race/ethnicity Black, non-Hispanic White, non-Hispanic Hispanic Other Mother's educational attainment Less than high school High school graduate Some post-high school education Family's income At or below poverty threshold Above poverty threshold Primary maltreatment type Physical abuse Sexual abuse Neglect: Failure to provide Neglect: Failure to supervise Other Prior maltreatment reports Yes N o Urbanicity of community Nonurban Urban Child age Mother's age Number of people living in home 53.6 46.4 35.4 64.6 22,9 50,8 19.2 7.1 29.0 45.5 25.5 49.8 50.2 28,8 13,3 20,1 26,2 1 1 7 48,3 517 24,1 75.9 6.5 32.0 4,3 Note: We conducted chi-square and í tests to test for differences between cases w i t h depressed mothers at baseline and cases with nondepressed mothers at baseline for each variable reported in this table. No significant differences were found. RESULTS A description of the cases included in the sample is presented in Table 1, Slightly more than half of the children were male (53.6%).The racial and ethhic composite of the sample of mothers was 22.9% black, 50.8% white, and 19.2% Hispanic. Faniily income was evenly distributed between at or belpw the poverty threshold (49.8%>) and above the pQv-

KoHL, KAGOTHO, AND DIXON / Parenting Practices among Depressed Mothers in the Child Welfare System 219

erty threshold (50.2%).The majority of the sample
(75.9%) lived in urban areas.The mean age for the
children was 6.5 years, with 64.6% between the ages
of 6 and 10 years.The mean age of the mothers was
32.0 years. Overall, the mothers had low levels of
educational attainment; 29.0%) of the mothers re-
ported less than a high school education. Regarding
child welfare case characteristics, a slight majority
(51.7%) of the sample had no previous referrals to
CPS agencies. Neglect was most frequently identi-
fied as the most serious child maltreatment type by
child welfare workers (failure to provide: 20.2%;
failure to supervise; 26.2%).

Mothers’ self-reports of maternal depression
and parenting practices at each of the three waves
are reported in Table 2. Approximately one in
five mothers (21.1%) met the diagnostic criteria
for major depressive episode at baseline, and this
percentage was fairly stable across waves (15.5% at
wave 2, 21.5% at wave 4). More than half (59.4%)
of mothers did not report depression at any wave,
and 5.7% of mothers reported depression at all
waves; for 34.9%, the results were mixed across
waves (not shown in table). As shown in Table 2,
harsh parenting practices were highly skewed in the
direction of the absence of these behaviors across all
three waves. Nearly one out of every 10 mothers
(9.6%) reported harsh parenting practices at baseline,
whereas approximately 14% of mothers reported
harsh parenting at waves 3 and 4. Approximately
one-third (35.0%) of mothers reported neglectful
parenting behavior at baseline, whereas 30.8% and
35.2% ofmothers, respectively,reported the same at
waves 3 and 4. Finally, a higher percentage ofmothers
reported emotional maltreatment at all three time
points; 61.5%, 55.4%, and 56.1% at baseline, wave
3, and wave 4, respectively.

The association between maternal depression and
parenting behaviors reported at baseline are reported
in Table 3. The unadjusted odds of self-reporting
neglect for depressed mothers were approximately
three times those of nondepressed mothers at base-
line (odds ratio [OR] = 2.7, p < .001) and wave 3 (OR = 3.5, p < .001). In addition, the unadjusted odds of emotional maltreatment for depressed moth- ers were approximately twice those of nondepressed mothers at baseline (OR = 2.0, p < .001), wave 3 (OR = 2.3,p < .001), and wave 4 (OR = 2.6,;; < .001).The odds ofself-reported harsh parenting were not statistically significantly different for depressed and nondepressed mothers. Results of the main effects multivariate models assessing the relation between parenting and depres- sion are reported in Table 4. Consistent with the bivariate analysis, depression status and self-reported harsh parenting were unrelated.The overall model fit, however, was significant fWald)(^(17) = 145.6,/) < .001]. For this and the other models, the average Wald chi-squares for the 10 produced completed data sets are reported because Stata output did not include Wald chi-squares for analyses of the simu- lated data set. As demonstrated by the statistically significant wave variables, harsh parenting signifi- candy changed over time.The odds ofself-reported harsh parenting were significantly higher at wave 3 than at baseline (OR = 1.8, p < .05) and at wave 4 than at baseline (OR = 1.7, p < .05), with the other variables in the model controlled for. Racial and ethnic differences were found. Black and His- panic mothers were about two times more likely to self-report the use of harsh parenting practices over the 36-month study window than were white mothers (OR = 2.3,p < .001, and O R = 2 . 0 , ; J < .05, respectively). FinaUy, self-reported emotional Table 2: Frequencies of Maternal Depression and Parenting Practices Measured at Multiple Time Points (Unweighted N = 1,536) msMïus Dependent variable Maternal depression Parenting practices Harsh parenting Neglect Emotional maltreatment S5t3S 21.1 9,6 35.0 61,5 cs® 78,9 90,4 65,0 38,5 S33S 15.5 13.9 30.8 55.4 Ws 84.5 86.1 69,2 44.6 21.5 13,9 35,2 56,1 C3® 78.5 86.1 64.8 43.9 Note: All values represent weighted percentages. 220 Social Work Research VOLUME 35, NUMBER 4 DECEMBER 2011 Table 3: Odds Ratios for Maternal Depression and Parenting Practices (Unweighted N = 1,536) Harsh parenting Neglect Emotional maltreatment 1.4 2 T * * * 2 . 0 * * * 1.3 3.5*** 2.3*** 1.1 1.5 2.6' maltreatment and self-reported neglect frequently co-occurred with harsh parenting. Mothers report- ing emotional maltreatment (OR = 3.8, p < .001) and neglect (OR = 2.2,p < .001) had much higher odds of also self-reporting harsh parenting than did mothers not reporting emotional maltreatment and neglect, respectively. Depression was statistically significant in the ne- glect model [overall model fit: Wald x^(17) = 104.8, p < .001]. Depressed mothers were 1.8 times more likely to self-report neglectful parenting behaviors than were nondepressed mothers. Mothers engaging in self-reported emotional maltreatment had a higher odds (OR = 2.4, p < .001) of also self-reporting neglect than did mothers without self-reported emotional maltreatment. In addition, mothers with self-reported harsh parenting were two times more likely to self-report neglect than were mothers without self-reported emotional maltreatment (QR = 2.0,p<.01). ' The odds of emotional maltreatment were greater among depressed mothers than nondepressed mothers (OR = 1.8, p < .001).The overall motfel fit was good [Wald x7) = 142.2,;; < .001], and additional variables were associated with emotional maltreatment across the study window. Emotional maltreatment was associated with self-reported harsh parenting and neglect. For mothers reporting harsh Table 4: Multivariate Models Assessing the Relationship between Self-reported Parenting Practices and Depression (Main Effect Models) Major depression (No depression) Wave 2 ( 18-month follow-up) (Baseline) Wave 3 (36-month follow-up) (Baseline) Child gender (Male) Parent age Mother race: Non-Hispanic black (Non-Hispanic white) Mother ethnicity: Hispanic (Non-Hispanic white) Mother race: Other (Non-Hispanic white) No high school education (More than high school) High school education (More than high school) Urban/rural status (Urban) Prior reports (No prior reports) Poverty (At or below poverty threshold) Official report: Neglect (Physical abuse) Official report: Other (Physical abuse) Self-reporr: Emotional maltreatment Self-report: Harsh parenting Self-report: Neglect 1.0 1.8* 1.7* 1.1 1.0 2.3*** 2.0* 1.4 0.9 1.3 0.9 0.7 1.4 0.8 0.7 3.8*** 0.6, 1.7 1.1,2.9 1.1,2.6 0.7, 1.3 1.0, 1.0 1.3,3.3 1.2,3.3 0.7, 2.9 0.3, 1.7 0.8,2.1 0.6, 1.4 0.3, 1.1 0.9, 2.2 0.3 1.3 0.4, 1.2 2.2,6.3 1.8** 0.9 1.0 1.1 1.0 1.1 1.2 1.0 1.1 1.0 1.3 1.2 1.0 1.4 1.2 2.4*** 2.0** 1.3,2.3 0.7, 1.1 0.8, 1.3 0.8, 1.4 1.0, 1.0 0.7, 1.6 0.7, 1.6 0.6, 1.8 0.7, 1.6 0.7, 1.4 0.9, 1.7 0.9, 1.6 0.7, 1.3 1.0,2.1 0.8, 1.9 1.8,3.2 1.3,2.9 1.8*** 0.8 0.7 0.9 1.0 1.5* 0.7 0.9 0.7 0.7 0.9 1.1 1.0 0.8 0.8 3.0*** 1.3,2. 0.6, 1. 4 0 0.6, 1.0 0.8, 1.4 1.0, 1.0 1.1,2.2 0.3, 1.1 0.3, 1.7 0 . 4 , l . i l 0.3, 1.1 0.7, l.j 0.7, 1.3 0.7, 1.3 0.6, 1.2 0.5, 1.2 1.8.5.0 2.2* 1.4,3.3 Note: …