This study aimed to investigate whether a cognitive and an affective component of risk perception could be identified. Furthermore, the role of risk perception in the process of making a decision to accept or decline prenatal screening was assessed.

In a sample of 1650 pregnant women, risk perception, child-related anxiety, age, and the intention to have a prenatal test done were measured using postal questionnaires. Risk perception was measured both on a verbal scale (range: very small to very large), and on a numerical scale (range: 1 in 50000 to 1 in 10). It was hypothesized that the verbal question reflects an affective component, and numerical question reflects a cognitive component. So, the verbal question should correlate with an affective variable, and the numerical risk perception question should correlate with a cognitive variable. Child-related anxiety was used as the affective variable, and age was used as the cognitive variable (age is a proxy for the knowledge of the actual risk of having a child with Down syndrome, as this risk increases with age). Furthermore, a risk perception scale (combining the verbal and numerical question) was calculated. The role of risk perception in the decision making process was evaluated by assessing the correlation between risk perception and intention to test. For analyses of bivariate correlations, Pearson's correlation coefficient was used.

Numerical risk perception was more strongly correlated to age then to anxiety (0.40 vs. 0.16), and verbal risk perception was more strongly correlated to anxiety then to age (0.32 vs. 0.24). Correspondingly, principal component analysis revealed two components: a cognitive component (numerical risk perception and age), and an affective component (verbal risk perception and child-related anxiety). The correlation between the risk perception and intention to test was very small (0.10). All correlation coefficients were statistically significant.

From these findings it can be concluded that the perception of a risk includes both a cognitive and an affective component. This implicates that risk communication and counseling should not focus only on the correct understanding of risk figures, but also on the affective reaction to those risks. Furthermore, as the correlation between risk perception and the intention to have the test done was very small, the role of risk perception in this screening decision seemed to be limited.