Relationship between parental bonding and mood disorder in six European countries

Suicide mortality rates in Japan before and beyond the COVID-19 pandemic era

Statistical analyses from Japan reported increasing suicides in 2020, first in the world, proving the severity of the public health crisis during the COVID-19 pandemic; however, so far, international suicides have not been shown to be objectively increasing at population level. Followed studies reported the existence of a substantial heterogeneity of suicides among subgroups and time-lag impacts. Against public health crisis in Japan, policymakers, psychiatrists and public health personnel should prioritize improving suicide prevention programs following evidence-based policymaking. Understanding how/what factors relate to the COVID-19 pandemic and what other factors have shaped the increasing suicide numbers since 2020 through objectively well-controlled/fine-grained analyses of high-quality longitudinal/cross-sectional data at the individual, regional, and national levels is important for identifying the reasons for the recent trend. For this purpose, this study examined suicide statistics, statistical analysis methods, and their interpretations. Recent analyses suggest an increased suicide risk among females <50 years and males <30 years in 2020-2022. Notably, time-series analyses revealed that adolescent suicides began increasing before the pandemic, while working-age female suicides sharply increased synchronously with the pandemic outbreak. Causality analyses suggest that social issues facing Japan and recent global psychosocial and socioeconomic transformations are risk factors for suicide in high-risk groups. Finally, this report demonstrates the importance of providing appropriate support based on an objective understanding of individuals who are at risk for suicide, without being bound by traditional established knowledges.

Temporal Fluctuations of Suicide Mortality in Japan from 2009 to 2023 Using Government Databases

In Japan, suicide mortalities consistently decreased before the COVID-19 pandemic (from 2009 to 2019) but, conversely, increased after the pandemic outbreak from 2020 to 2022. To provide up-to-date suicide statistics in Japan, this study determined the temporal fluctuations of standardized suicide mortalities (SMRs), disaggregated by sex and age, by joinpoint regression analysis using the government suicide database, named the "Basic Data on Suicide in Region". From January 2009 to December 2023, three temporal fluctuation patterns of SMRs pertaining to working age and older adults were detected, such as attenuations of decreasing trends before the COVID-19 pandemic (from around the mid-2010s), a sharply increasing trend that coincided with the pandemic outbreak, and gradually decreased during the pandemic, but no changes at the end of the COVID-19 pandemic. In particular, the SMRs of working-age females sharply increased concurrently with the pandemic outbreak, whereas those of males did not change. However, before the pandemic, decreasing trends of the SMRs of working-age males diminished in the mid-2010s, but those of females consistently decreased. The SMRs of working-age males indicated non-significant but sharply increasing trends in early 2022, a trend that was not observed for females. In contrast to working-age adults, the SMRs of adolescents already began to increase in the mid-2010s and also indicated consistently increasing trends between the periods during and after the pandemic. These results suggest, contrary to our expectations, that the impacts of both the outbreak and end of the COVID-19 pandemic were limited regarding the increase in SMRs from 2020. Therefore, when revising suicide prevention programs in the post-COVID-19 era, it should be noted that focusing on pandemic-associated factors alone is not sufficient.

Sex-related differences in parental rearing patterns in young adults with bipolar disorder

The aim of this study was to examine the parenting characteristics of young patients with bipolar disorder (BD) and explore the sex differences. The parental rearing pattern of young patients with BD was measured and compared with the healthy control of young adults. The EMBU scale was used to assess parental rearing patterns. Patients with BD reported significantly higher scores in the punishment and severity index, as well as of the rejection and denial index, but lower scores in the warmth & affectionate index in the paternal rearing pattern, compared with healthy controls. In addition, patients scored higher on the punishment and severity index and rejection and patterns index in maternal rearing patterns. More importantly, we found significant sex differences in maternal rearing patterns (pBonferroni < 0.05). Specifically, in the maternal rearing patterns, male patients had higher scores on the favoring index than male controls, whereas female patients had lower scores on the warmth & affectionate index than female controls. This study shows significant differences in parental rearing patterns between patients and control subjects. Male patients were overprotective by their mothers and female patients were overlooked by their mothers during upbringing.

Sex-specific role of alexithymia in associations between parental bonding and mental health: A moderated mediation model

OBJECTIVE

This study aimed to explore the role of alexithymia and potential sex differences in the associations between perceived parental bonding and mental health.

METHODS

The sample consists of 2421 parents from the FinnBrain Birth Cohort Study who completed the parental bonding instrument, the Toronto alexithymia scale, the Edinburgh postnatal depression scale, and the anxiety subscale of the symptom checklist-90. Moderated mediation analyses were conducted to examine the possible mediating role of alexithymia and moderating role of sex in the associations between parental bonding and depressive/anxiety symptoms.

RESULTS

Alexithymia was found to be a potential mediator and sex be a moderator in the relations between perceived dysfunctional parental bonding and the psychological symptoms. Specifically, dysfunctional paternal bonding, especially paternal overprotection, had stronger indirect effects (via alexithymia) on the psychological symptoms in males.

CONCLUSIONS

This study indicates the importance of alexithymia in the parenting-related mental health impacts and highlights the significance of paternal bonding for the development of alexithymia and mental health problems in male populations. The findings improve the limited understanding of sex-related parental factors for alexithymia and mental health problems. Future studies in longitudinal designs are warranted to clarify the causal process of the mediation.

Exploring the connection between parental bonding and smartphone addiction in Chinese medical students

BACKGROUND

Smartphone addiction bodes adverse consequences, affecting different populations, including medical students. Parental bonding in childhood had been associated with addiction and recovery in later life. Therefore, this study aimed to examine the associations between parental bonding and smartphone addiction among Chinese medical students.

METHOD

Binary logistic regressions were used to investigate the associations between parental bonding with mothers and fathers, respectively, and smartphone addiction. Interaction terms of care and protection were included in the models.

RESULTS

A total of 517 medical students were included in the study. The prevalence of smartphone addiction was 48.16% (n = 249). The estimated effects of maternal and paternal parenting on smartphone addiction differed. Maternal protection was positively associated with smartphone addiction (OR, 1.046;95% CI, 1.005-1.087), and maternal care enhanced the estimated effect of protection on smartphone addiction. Paternal care was negatively associated with smartphone addiction (OR, 0.954;95% CI, 0.919-0.989).

CONCLUSIONS

Chinese medical students with overprotective mothers or with indifferent fathers tended to exhibit traits of smartphone addiction. Further studies on factors influencing the associations between parental bonding and smartphone addiction may pave the way for potential family-oriented interventions for smartphone addiction.

The effect of attachment style on long-term outcomes in psychogenic nonepileptic seizures: Results from a prospective study

INTRODUCTION

Insecure and fearful attachment styles have been reported in psychogenic nonepileptic seizures (PNES). We have investigated associations between long-term clinical outcome in PNES, parenting and attachment styles and demographic, clinical, and neuropsychiatric factors.

MATERIAL AND METHODS

Patients aged at least 16 years and with documented PNES, according to criteria from the International League Against Epilepsy, were prospectively recruited to this study. They were assessed at baseline to determine clinical characteristics, experience of attachment and perceptions of experienced parenting styles, trauma history, dissociation, and health-related quality of life. At a mean of 70.45 (SD 29.0, range 22-130) months after inclusion, participants were contacted by telephone and asked about their current medical status and psychiatric/psychological interventions.

RESULTS

Of 53 patients included in the study, 51 (96 %) provided follow-up data. Most (84.9 %) patients were female, and the mean age of PNES onset was 25.6 years. At follow-up, 20 patients (39 %) were free of PNES. Those patients that had achieved PNES freedom at follow-up had lower levels of attachment anxiety (p = 0.01) and reported to have experienced their fathers as less controlling (p = 0.02) and their mothers as more caring (p = 0.04) at baseline compared with those patients still suffering from PNES. Seizure freedom at follow-up was predicted by male gender, younger age at PNES onset, and less attachment anxiety.

CONCLUSION

In our cohort from a tertiary epilepsy center the long-term prognosis of PNES is poor. Attachment anxiety is a risk factor for persistent PNES. It may be of therapeutic relevance to assess attachment patterns in patients with PNES.

Factor structure and psychometric properties of Polish version of Parental Bonding Instrument (PBI) among adults and adolescents

Parental Bonding Instrument (PBI) by Parker et al., is a widely known and used tool in studies on the assessment of parenting behavior in adult, adolescent and child populations. This tool has had many translations and adaptations globally. In Poland, the factor structure and psychometric properties of PBI have not been studied so far. The aim of the presented research was to perform such an analysis both in the group of adults and adolescents. The data from four research projects, in which the 25-item version of the PBI translated into Polish was used, were analyzed. Data from 698 participants in total, including 473 adults and 225 adolescents were collected. Exploratory factor analyzes was performed for both mother and father version. A study of the reliability of individual factors, stability over time (test-retest) and an analysis of criterion validity were carried out. Both in the group of adults and adolescents, obtained a three-factor structure, acceptable reliability and stability over time. Moreover PBI correlated with another Polish tool in line with the adopted hypotheses, showing satisfactory criteria validity.

Parental bonding, depression, and suicidal ideation in medical students

Background

The psychological condition of university students has been the focus of research since several years. In this population, prevalence rates of depression, suicidal ideation, anxiety disorders and substance abuse are higher than those of the general population, and medical students are more likely to have mental health issues than other students.

Aims

This study deals with the psychological condition of medical students, with a focus on correlations between depression, suicidal ideation and the quality of the perceived parenting style. Gender differences were also considered.

Methods

A cross-sectional study was conducted on a population of medical students, with an online questionnaire consisting of a personal data sheet for demographic and anamnestic data, and of three self-rating scales: the Beck Depression Inventory II (BDI-II), for the screening of depressive symptoms; the Beck Hopelessness Scale (BHS), to assess suicidal ideation; the Parental Bonding Instrument (PBI), to investigate the memory of the attitude of one’s parents in the first 16 years of life. Two main affective dimensions were considered by PBI: “care” (affection and empathy) and “protection” (intrusiveness, controlling and constraint). Four different patterns of parenting styles are so evidenced: Neglectful Parenting (low care/low protection), Affectionless Control (low care/high protection), Optimal Parenting (high care/low protection), and Affectionate Constraint (high care/high protection).

Results

Overall, 671 students (182 males and 489 females) participated. Females, compared to males, experienced more distress and self-injurious behaviors, while males experienced more drugs or alcohol abuse. The BHS and BDI-II scores correlated positively with the PBI score for “protection” and negatively with that for “care.” Affectionless Control and Neglectful Parenting were associated with higher medians of BHS and BDI-II scores.

Conclusion

The study confirms that the undergraduate medical student population has higher prevalence of depression and suicidal ideation than those detectable in the general population (respectively, 50.2% and 16.7% vs. 15–18% and 9.2%) and that some specific parenting styles correlate with these two clinical variables. The impact of Affectionless Control and Neglectful Parenting on suicidal ideation and depressive symptomatology was more pronounced in females than in males. For males, the role of the father seemed to have less impact on the affective roots of suicidal thoughts and depression.

Parental Bonding and Relationships with Friends and Siblings in Adolescents with Depression

According to attachment theory, the quality of the early child-parent bond determines the child's interpersonal relationships later in life. Utilising data from The First Experimental Study of Transference Work-In Teenagers (FEST-IT), the current paper investigated the connection between the self-reported quality of bonding with mother and father and the self-reported importance of relationships with friends and siblings in adolescents with depression. The scales employed were the Parental Bonding Instrument (PBI) and the Adolescent Relationship scale (ARS). A Pearson's correlation tested the relationship between the reported levels of maternal and paternal care and control, and the reported importance of friendship and relationship with siblings. Results revealed a statistically significant negative correlation between high levels of maternal control and importance of friendship, and a statistically significant positive correlation between high levels of paternal care and importance of relationships with siblings. The results are in line with Bowlby's theory of attachment.

Mood Disorder Detection in Adolescents by Classification Trees, Random Forests and XGBoost in Presence of Missing Data

We apply tree-based classification algorithms, namely the classification trees, with the use of the rpart algorithm, random forests and XGBoost methods to detect mood disorder in a group of 2508 lower secondary school students. The dataset presents many challenges, the most important of which is many missing data as well as the being heavily unbalanced (there are few severe mood disorder cases). We find that all algorithms are specific, but only the rpart algorithm is sensitive; i.e., it is able to detect cases of real cases mood disorder. The conclusion of this paper is that this is caused by the fact that the rpart algorithm uses the surrogate variables to handle missing data. The most important social-studies-related result is that the adolescents’ relationships with their parents are the single most important factor in developing mood disorders—far more important than other factors, such as the socio-economic status or school success.

Affectionless control: A parenting style associated with obesity and binge eating disorder in adulthood

OBJECTIVE

Obesity is rising globally with a heavy health and economic burden. Early attachment experiences are relevant to the development of obesity. The purpose of this study was to investigate if parental care and attachment style experienced in childhood is associated with obesity, with or without binge eating disorder (BED), in adulthood.

METHOD

Parental style, personality traits, and psychopathology were assessed in 810 clinically referred adults with obesity, of whom 357 with BED and 453 without BED (non-BED), and 463 healthy subjects (HS). Assessments included the Parental Bonding Instrument, Temperament and Character Inventory, Eating Disorder Inventory-2, Symptom Checklist-90 and Beck Depression Inventory-II.

RESULTS

Both BED and non-BED reported lower maternal and paternal care and higher overprotection than HS. BED reported worse levels of parental care than non-BED and HS. 'Affectionless control' parenting style was more frequently reported by both BED and non-BED than HS. No significant differences in parenting style emerged between BED and non-BED.

CONCLUSIONS

Perception of parental 'affectionless control' was associated with obesity in adults, and lower quality of parental care was more frequently reported by participants with BED. Parental style may constitute an important target for early interventions to prevent obesity.

Parenting style during childhood is associated with the development of chronic pain and a patient's need for psychosomatic treatment in adulthood: A case-control study

The aim of this study is to investigate the relation between parenting style and chronic pain and the patients' need for psychosomatic treatment in adulthood.We compared 4 combinations of 2 parenting style subscales, high and low care and overprotection, among the following 4 age- and sex-matched groups: community-dwelling subjects without chronic pain (n = 100), community-dwelling subjects with chronic pain (n = 100), outpatients with chronic pain (n = 50), and inpatients with chronic pain (n = 50). Parenting style was assessed for both the mother and father by use of the Parental Bonding Instrument questionnaire. The parenting style associated with the worst outcome was defined as both low care and high overprotection, as reported in previous studies.The frequency of reported adverse parenting style was significantly higher among chronic pain patients than community-dwelling subjects without chronic pain (all P < .05). The odds ratios for an adverse parenting style significantly increased through the categories after adjusting for demographic factors and the pain visual analog scale (P for trend <.01).These findings suggest that parental low care and high overprotection during childhood contribute to the future risk of chronic pain and the patients' need for psychosomatic treatment in adulthood.

Child and Adolescent Depression: A Review of Theories, Evaluation Instruments, Prevention Programs, and Treatments

Depression is the principal cause of illness and disability in the world. Studies charting the prevalence of depression among children and adolescents report high percentages of youngsters in both groups with depressive symptoms. This review analyzes the construct and explanatory theories of depression and offers a succinct overview of the main evaluation instruments used to measure this disorder in children and adolescents, as well as the prevention programs developed for the school environment and the different types of clinical treatment provided. The analysis reveals that in mental classifications, the child depression construct is no different from the adult one, and that multiple explanatory theories must be taken into account in order to arrive at a full understanding of depression. Consequently, both treatment and prevention should also be multifactorial in nature. Although universal programs may be more appropriate due to their broad scope of application, the results are inconclusive and fail to demonstrate any solid long-term efficacy. In conclusion, we can state that: (1) There are biological factors (such as tryptophan-a building block for serotonin-depletion, for example) which strongly influence the appearance of depressive disorders; (2) Currently, negative interpersonal relations and relations with one's environment, coupled with social-cultural changes, may explain the increase observed in the prevalence of depression; (3) Many instruments can be used to evaluate depression, but it is necessary to continue to adapt tests for diagnosing the condition at an early age; (4) Prevention programs should be developed for and implemented at an early age; and (5) The majority of treatments are becoming increasingly rigorous and effective. Given that initial manifestations of depression may occur from a very early age, further and more in-depth research is required into the biological, psychological and social factors that, in an interrelated manner, may explain the appearance, development, and treatment of depression.

Family Functioning and Parental Bonding During Childhood in Adults Diagnosed With ADHD

OBJECTIVE

This work assesses family functioning, parental bonding, and the relationship between the two in adults diagnosed with ADHD.

METHOD

The study used a retrospective, ex post facto design and consisted of 100 adult participants, who were distributed into two groups: with and without diagnosis of ADHD. Two family assessment instruments were applied: the Family Adaptability and Cohesion Evaluation Scale short spanish version (FACES-20esp)) and the Parental Bonding Instrument (PBI). The diagnosis of ADHD was done by using a semistructured interview for Diagnostic and Statistical Manual of Mental Disorders (4th ed.; DSM-IV) criteria (Conners' Adult ADHD Diagnostic Interview for DSM-IV [CAADID]).

RESULTS

The results showed that higher rigidity and lower emotional connection were significantly associated with ADHD family functioning. Regarding parental bonding, the results showed significant differences only in the care dimension, with the ADHD group reporting lower care than the control group.

CONCLUSION

The results suggest that ADHD families present dysfunctional family functioning with a rigid, separated typology, and parental bonding based on control without affection.

Psychometric Validation of the Parental Bonding Instrument in a U.K. Population-Based Sample: Role of Gender and Association With Mental Health in Mid-Late Life

The factorial structure of the Parental Bonding Instrument (PBI) has been frequently studied in diverse samples but no study has examined its psychometric properties from large, population-based samples. In particular, important questions have not been addressed such as the measurement invariance properties across parental and offspring gender. We evaluated the PBI based on responses from a large, representative population-based sample, using an exploratory structural equation modeling method appropriate for categorical data. Analysis revealed a three-factor structure representing "care," "overprotection," and "autonomy" parenting styles. In terms of psychometric measurement validity, our results supported the complete invariance of the PBI ratings across sons and daughters for their mothers and fathers. The PBI ratings were also robust in relation to personality and mental health status. In terms of predictive value, paternal care showed a protective effect on mental health at age 43 in sons. The PBI is a sound instrument for capturing perceived parenting styles, and is predictive of mental health in middle adulthood.

The effects of chronic stress on the human brain: From neurotoxicity, to vulnerability, to opportunity

For the last five decades, science has managed to delineate the mechanisms by which stress hormones can impact on the human brain. Receptors for glucocorticoids are found in the hippocampus, amygdala and frontal cortex, three brain regions involved in memory processing and emotional regulation. Studies have shown that chronic exposure to stress is associated with reduced volume of the hippocampus and that chronic stress can modulate volumes of both the amygdala and frontal cortex, suggesting neurotoxic effects of stress hormones on the brain. Yet, other studies report that exposure to early adversity and/or familial/social stressors can increase vulnerability to stress in adulthood. Models have been recently developed to describe the roles that neurotoxic and vulnerability effects can have on the developing brain. These models suggest that developing early stress interventions could potentially counteract the effects of chronic stress on the brain and results going along with this hypothesis are summarized.

Perceived parenting and adolescents' adjustment

Adolescence is an important developmental period that is characterised by heightened problems of adjustment. The aim of this study is to analyse adolescents' adjustment, and to explore the typologies and dimensions of parenting, and thus to determine the relationships between these factors. The sample comprised 1285 adolescent students aged 12 to 16 from the Basque Country (Spain). The students filled out the self-report of the Behavior Assessment System for Children (BASC) and the Parental Acceptance-Rejection/Control Questionnaire, (PARQ/Control). Differences by age were found in the adolescents' school maladjustment and parenting style perception. Moreover, perceptions of little parental warmth were related to higher levels of clinical and school maladjustment, and the lower the parental control, the greater the clinical maladjustment. Finally, the results obtained revealed that the interaction between the mothers' and fathers' parenting styles was significant only for clinical maladjustment; those students with neglectful mothers and authoritative fathers presented the highest level of clinical maladjustment, followed by other combinations of neglectful mothers. Furthermore, the students from neglectful and authoritarian families presented the highest levels of school maladjustment, without differences between neglectful and authoritarian or between indulgent and authoritative families.

Parenting style and mental disorders in a nationally representative sample of US adolescents

PURPOSE

We examined associations between parenting style and past-year mental disorders in a nationally representative cross-sectional survey of US adolescents and whether the associations differed by adolescent demographic characteristics.

METHODS

The sample included 6483 adolescents aged 13-18 years who were interviewed for a full range of DSM-IV mental disorders. Parenting style was assessed by adolescent-reported maternal and paternal care and control using items from the Parental Bonding Instrument. We controlled for socio-demographics, parental history of mental disorders, stressful life events, sexual violence, inter-parental conflict, and household composition. We also tested for two-way interactions between parental care and control and adolescent age, sex, and race/ethnicity.

RESULTS

In adjusted models, high maternal care was associated with lower odds of depressive, eating, and behavioral disorders, and high maternal control was associated with greater odds of depressive, anxiety, eating, and behavioral disorders. High paternal care was associated with lower odds of social phobia and alcohol abuse/dependence. High paternal control was associated with greater odds of agoraphobia and alcohol abuse/dependence but with lower odds of attention-deficit/hyperactivity disorder. Associations of maternal and paternal control with anxiety disorders and substance abuse/dependence differed by sex. High paternal care was associated with lower odds of anxiety disorders only among Hispanics and non-Hispanic blacks.

CONCLUSIONS

Perceived parental care and control were associated with adolescent mental disorders after controlling for multiple potential confounders. Differential patterns of association were found according to adolescent sex and race/ethnicity. Findings have implications for prevention and intervention programs that incorporate familial contextual factors.

Relations among adults' remembrances of parental acceptance-rejection in childhood, self-reported psychological adjustment, and adult psychopathology

AIMS

The aim of the study was to examine relationships among recollections of maternal and paternal acceptance-rejection in childhood and the level of psychological adjustment among adults diagnosed with schizophrenia, social anxiety, and nonclinical control. The study focused primarily on adults with schizophrenia and social anxiety in comparison to nonclinical adults.

METHODS

Fifty-three adults diagnosed with schizophrenia, 51 adults with self-reported social anxiety, and 147 nonclinical controls between the ages of 18 and 62 participated in the study. Data were collected using adult versions of the Parental Acceptance-Rejection Questionnaire for mothers and for fathers, Personality Assessment Questionnaire, Brief Symptom Inventory, Liebowitz Social Anxiety Scale, and the Demographic Information Form.

RESULTS

Findings of analyses showed that participants in the schizophrenia and social anxiety groups remembered having experienced significantly more maternal rejection in childhood than did the nonclinical group. Patient with schizophrenia also reported more recollections of paternal rejection than the nonclinical group. Both clinical groups self-reported more psychological maladjustment than did the nonclinical group. Regression analysis indicated that even though the overall psychological adjustment of adults diagnosed with schizophrenia was predicted by both maternal and paternal acceptance-rejection, psychological adjustment of adults in the social anxiety group was predicted only by maternal (but not paternal) acceptance-rejection.

CONCLUSION

This study provides evidence about the long-lasting associations between adults' recollections of parental acceptance-rejection in childhood and their psychological adjustment in two mental disorders, in which genetic and environmental factors have a different weight.

Influence of Family and Childhood Memories in the Development and Manifestation of Paranoid Ideation

Several studies point out to the influence of social experiences on perceptions of the environment and others in cognitive functioning and different aspects of psychopathology. The current study aimed at studying the influence of the psychosocial risk factors in a mixed sample of participants from the general population and affected by paranoid schizophrenia. The extent to which the existence of negative life events and events that are threatening to the inner models of the self (i.e., history of maltreatment, physical, social or psychological abuse) or the memories of these traumatic events occurring during childhood are related to the existence of paranoid beliefs in adulthood was explored. Results suggested that memories of parental behaviours characterized by antipathy from both parental figures, submissiveness and bullying victimization were important predictors of paranoid ideation in adult life. This further emphasizes the need for understanding the family and social dynamics of people presenting paranoid ideations to the development of therapeutic interventions that can effectively reduce the invalidation caused by severe psychopathology, as is the case of schizophrenia. Copyright © 2015 John Wiley & Sons, Ltd.

KEY PRACTITIONER MESSAGE

Memories of family dynamics characterized by behaviours of antipathy from both parental figures, submissiveness and bullying victimization are important predictors of paranoid ideation in adult life. The study highlights the importance of exploring subjective recalls of feelings and behaviours associated with early rearing experiences, peer relationships and themes related to social rank theory in the roots of internal models of relationship with the self and others in the general sample, patients diagnosed with schizophrenia and their first-degree relatives. Our findings indicate that schizophrenic patients in active phase differ regarding memories of threat and submission and are more likely to remember childhood experiences perceived as threatening during an active phase than when in remission. It is possible that by changing these internal models and social interaction styles, patients may be able to get involved in more cooperating and affiliative interactions, disconfirming these early beliefs about others being rejecting, critical or hostile towards the self, and more effectively reducing the invalidation caused by positive and negative symptomatology of schizophrenia on social functioning.

Relation between psychotic symptoms, parental care and childhood trauma in severe mental disorders

A relation between different types of parental care, trauma in childhood and psychotic symptoms in adulthood has been proposed. The nature of this association is not clear and if it is more related to psychotic disorders per se or to a cluster of symptoms such as positive psychotic symptoms remains undefined. We have analysed the presence of childhood trauma using the CTQ scale and types of parental care using the PBI scale in three groups of subjects: borderline personality disorder patients (n=36), first psychotic episode patients (n=61) and healthy controls (n=173). Positive psychotic symptomatology was assessed with the CAPE scale. General linear models were used to study the relation between positive psychotic symptomatology and variables of interest. BPD patients had the highest rate of any kind of trauma, followed by FEP patients. We found a positive relationship between psychotic symptomatology and the existence of trauma in childhood in all groups. Moreover, an affectionless control rearing style was directly associated with the existence of trauma. Furthermore, subjects with trauma presented less probability of having an optimal parenting style in childhood. The relation between psychotic symptoms and trauma remained statistically significant after adjusting for other variables including parental rearing style. There seems to be a link between trauma in childhood and psychotic symptomatology across different populations independently of psychiatric diagnosis. Taking into account that there is an association between trauma and psychosis and that trauma is a modifiable factor, clinicians should pay special attention to these facts.

Perceived inadequate care and excessive overprotection during childhood are associated with greater risk of sleep disturbance in adulthood: the Hisayama Study

BACKGROUND

Sleep disturbance and poor sleep quality are major health problems worldwide. One potential risk factor for the development and maintenance of sleep disturbance is the parenting style experienced during childhood. However, its role in sleep disturbance in adulthood has not yet been estimated. This Japanese population study was done to clarify the relation between the parenting styles "care" and "overprotection" during childhood and sleep disturbance in adulthood.

METHODS

A total of 702 community-dwelling Japanese residents aged ≥ 40 years were assessed in 2011 for their perceptions of the parenting style of their parents by use of the Parental Bonding Instrument (PBI) and for sleep disturbance by use of the Pittsburgh Sleep Quality Index (PSQI). The odds ratio (OR) for sleep disturbance (a global PSQI score > 5) was calculated using a logistic regression model.

RESULTS

The prevalence of sleep disturbance was 29 %. After adjusting for sociodemographic, lifestyle, and physical factors in a comparison with the optimal parenting styles (high care and low overprotection), the ORs for sleep disturbance by men were significantly higher for low paternal care, by 2.49 times (95 % confidence interval [CI]: 1.21-5.09), and for high overprotection, by 2.40 times (95 % CI: 1.19-4.85), while the ORs were not significant for low maternal care and high overprotection. For women the only significant factor was high maternal overprotection, by 1.62 times (95 % CI: 1.05-2.52), while the ORs were not significant for low maternal care, low paternal care and high paternal overprotection. The association remained significant for high paternal overprotection for men after additionally controlling for depression.

CONCLUSIONS

This study suggests that parenting style, especially inadequate care and excessive overprotection during childhood, is related to sleep disturbance in adulthood and that the association is much more significant for parents of the same sex as the child.

Exploring correlation between perceived parenting styles, early maladaptive schemas, and depression among women with depressive symptoms in iran and India- role of early maladaptive schemas as mediators and moderatos

Background:

Many studies have reported that inadequate parental styles can contribute to depressive symptoms through dysfunctional cognitive styles.

Objectives:

This study aimed to investigate the association of dysfunctional schemas and parenting style with depression, as well as the role of maladaptive schemas such as moderators and mediators in Iran and India.

Patients and Methods::

The study sample was selected randomly and consisted of 200 (age group 16-60 y) depressed females (mild to moderate); 100 from Tehran (Iran) and another 100 from Pune (India). The type of the research was causal-comparative. The data collection took place in hospitals and clinics in the targeted cities. Descriptive statistic tests and hierarchical multiple regression were executed (for the purpose of analyzing data) by SPSS 17.

Results:

It was demonstrated that the association between parenting and depression was not moderated by early maladaptive schemas. On the contrary, the results supported meditational models in which parenting styles are associated with the cognitive schemas, and these in turn are related to depressive symptoms. It was also found that abandonment mediates the impacts of maternal style on depression in Iran. On the other hand, abandonment and punitiveness schemas mediated the relation between paternal style and depression in India.

Conclusions:

These findings suggest that the correlation between childhood experiences and depression in adulthood are mediated by dysfunctional schemas.

A Persian version of the parental bonding instrument: factor structure and psychometric properties

The Parental Bonding Instrument (PBI) is a widely used self-report measure for quantifying key parenting styles as perceived by the child during its first 16 years. While its development study identified two key parental dimensions, subsequent studies have variably confirmed those two or argued for one or more additional parental constructs. We developed a Persian translation of the PBI and administered it to a sample of 340 high school students. The construct validity of the Persian PBI was examined by Exploratory Factor Analysis while Confirmatory Factor Analysis was used to identify the most adequate model. Analyses of the Persian PBI favored a four-factor model for both parental forms. The Persian PBI has a factorial structure consistent with constructs identified in western cultures, as well as high internal consistency and test-retest reliability. Multivariate analyses indicated significant differences between boys and girls across some factors. The PBI appears an acceptable and appropriate measure for quantifying parent-child bonding in Iranian samples.

Do child abuse and maternal care interact to predict military sexual trauma?

OBJECTIVE

The present research tested the hypothesis that maternal care moderates the relationship between childhood sexual abuse and subsequent military sexual trauma (MST).

METHOD

Measures of childhood sexual abuse, maternal care, and MST were administered to 197 Iraq and Afghanistan war veterans.

RESULTS

After accounting for gender, age, and the main effects of maternal care and childhood sexual abuse, the maternal care x childhood sexual abuse interaction was a significant predictor of MST (odds ratio = .28, β = -1.26, 95% confidence intervals of .10, .80). As hypothesized, rates of MST were higher among veterans who reported childhood sexual abuse and low levels of maternal care (43%) compared with veterans who reported childhood sexual abuse and high levels of maternal care (11%).

CONCLUSION

These findings suggest that high levels of maternal care may act as a protective factor against future revictimization among military service members. These findings have the potential to inform both prevention and intervention efforts.

Effect of childhood maltreatment on brain structure in adult patients with major depressive disorder and healthy participants

BACKGROUND

Childhood maltreatment has been found to play a crucial role in the development of psychiatric disorders. However, whether childhood maltreatment is associated with structural brain changes described for major depressive disorder (MDD) is still a matter of debate. The aim of this study was to investigate whether patients with MDD and a history of childhood maltreatment display more structural changes than patients without childhood maltreatment or healthy controls.

METHODS

Patients with MDD and healthy controls with and without childhood maltreatment experience were investigated using high-resolution magnetic resonance imaging (MRI), and data were analyzed using voxel-based morphometry.

RESULTS

We studied 37 patients with MDD and 46 controls. Grey matter volume was significantly decreased in the hippocampus and significantly increased in the dorsomedial prefrontal cortex (DMPFC) and the orbitofrontal cortex (OFC) in participants who had experienced childhood maltreatment compared with those who had not. Patients displayed smaller left OFC and left DMPFC volumes than controls. No significant difference in hippocampal volume was evident between patients with MDD and healthy controls. In regression analyses, despite effects from depression, age and sex on the DMPFC, OFC and hippocampus, childhood maltreatment was found to independently affect these regions.

LIMITATIONS

The retrospective assessment of childhood maltreatment; the natural problem that patients experienced more childhood maltreatment than controls; and the restrictions, owing to sample size, to investigating higher order interactions among factors are discussed as limitations.

CONCLUSION

These results suggest that early childhood maltreatment is associated with brain structural changes irrespective of sex, age and a history of depression.Thus, the study highlights the importance of childhood maltreatment when investigating brain structures.

Dysfunctional parental styles perceived during childhood in outpatients with substance use disorders

People who suffer from substance use disorders (SUDs) frequently report to have undergone childhood adversity that is often associated with father or mother dysfunction, or both. Yet that issue has been barely addressed in opiate dependent patients. Therefore we sought to evaluate parent-specific dysfunctional styles perceived during childhood in a clinical sample from an outpatient addiction treatment program using the Measure Of Parental Styles (MOPS) questionnaire. DSM-IV diagnoses of substance use disorders and history of suicide attempts, family structure and changes of caregiver during childhood were obtained from 159 consecutive outpatients, along with their perception of parental bonding with the MOPS, in which mother and father scores are separate. Mother neglect dimension was significantly correlated with an earlier age at onset of several substances' use, the number of prior hospitalizations and of lifetime suicide attempts. Most of these associations remained significant in multivariate models. This was the first assessment of a representative sample of outpatients with SUDs by the MOPS questionnaire. Given its excellent acceptance and its association with several key correlates of SUDs, it should be used to design specific interventions targeted at attachment and familial management as well as in research models on gene × environment interactions.

The effects of parent-child relationships on later life mental health status in two national birth cohorts

PURPOSE

Abusive and neglectful parenting is an established determinant of adult mental illness, but longitudinal studies of the impact of less severe problems with parenting have yielded inconsistent findings. In the face of growing interest in mental health promotion, it is important to establish the impact of this potentially remediable risk factor.

PARTICIPANTS

8,405 participants in the 1958 UK birth cohort study, and 5,058 in the 1970 birth cohort study

EXPOSURES

questionnaires relating to the quality of relationships with parents completed at age 16 years.

OUTCOMES

12-item General Health Questionnaire and the Malaise Inventory collected at age 42 years (1958 cohort) and 30 years (1970 cohort). Statistical methodology: logistic regression analyses adjusting for sex, social class and teenage mental health problems.

RESULTS

1958 cohort: relationships with both mother and father predicted mental health problems in adulthood; increasingly poor relationships were associated with increasing mental health problems at age 42 years. 1970 cohort: positive items derived from the Parental Bonding Instrument predicted reduced risk of mental health problems; negative aspects predicted increased risk at age 30 years. Odds of mental health problems were increased between 20 and 80% in fully adjusted models.

CONCLUSIONS

Results support the hypothesis that problems with parent-child relationships that fall short of abuse and neglect play a part in determining adult mental health and suggest that interventions to support parenting now being implemented in many parts of the Western world may reduce the prevalence of mental illness in adulthood.

Quality of early mother-child interaction associated with depressive psychopathology in the offspring: a prospective study from infancy to adulthood

Evidence from animal research has revealed that less maternal care results in disturbed emotionality in the offspring. In the present study, the long-term impact of maternal responsiveness and stimulation during early mother-child interaction on depressive psychopathology was examined until adulthood. Data are from an epidemiological cohort study of the long-term outcome of early risk factors assessed at birth. At age 3 months, mothers and infants were videotaped during a nursing and playing situation. Maternal responsiveness and stimulation as well as infant responsiveness were evaluated by trained raters. At age 19 years, 314 participants (145 males, 169 females) were characterized on measures of depression through interview and questionnaire. In addition, measures of depression and anxiety were available from assessments in childhood. Results indicated that less maternal stimulation during early interaction was associated with a higher risk of depression in the offspring until the age of 19 years. In addition, children of less stimulating mothers showed more depressive symptoms at age 19 years and displayed more anxiety and depressive symptoms between the ages of 4.5 and 15 years. In contrast, maternal responsiveness was unrelated to children's outcome. In accordance with findings from animal research, the present study provides first longitudinal evidence in humans of a continuous and long-term influence of early maternal interaction behavior on the offspring's psychological adjustment until adulthood. The results suggest that the amount of maternally initiated contact behavior in a very early developmental stage may be crucial for children's mental health, regardless of child and maternal responsiveness.

High and low suicidality in Europe: a fine-grained comparison of France and Spain within the ESEMeD surveys

BACKGROUND

Suicidality risk-factors between countries with similar economic and religious background have been rarely compared, especially within genders.

METHODS

Lifetime prevalence of suicide ideation, plans, and attempts in the ESEMeD surveys were stratified on four separate groups: French women, Spanish women, French men, and Spanish men. Outcome odds-ratios (OR) were modelled within each group using logistic regression including demographic characteristics, lifetime mood/anxiety disorders, parental bonding, marital status, and health service-use.

RESULTS

Lifetime prevalence of suicide attempts was 3.4% in France (1.1% men, 5.4% women) and 1.5% in Spain (1.2% men, 1.7% women), with a significantly greater gender difference in France (p=0.001). Regarding risk-factors, French women reported suicide attempt more commonly with authoritarian mothers (OR=1.51; 95%CI=1.04-2.18), unlike Spanish women (OR=0.77; 95%CI=0.51-1.15) (p<0.001). Spanish men showed more than eight-times higher odds of suicide attempt with overprotecting mothers than French men (p=0.03). General practitioner-(GP)-use was significantly protective of suicide attempt among Spanish women (OR=0.08; 95%CI=0.02-0.35) with no effect in French women (OR=1.03; 95%CI=0.54-2.00) (p=0.01). No significant differences in the effect of marital status, any lifetime antidepressant use, mental disorders, or religiosity on suicide attempt were observed between France and Spain within gender-stratum.

LIMITATIONS

Parental bonding is retrospective and potentially influenced by mental state. Response rate was considerably lower in France than in Spain.

CONCLUSIONS

Suicidality risk-factors play different roles across genders between France and Spain. Parental bonding dimensions may be interpreted differently according to country, underlining cultural importance. As recommended by WHO, mental health decisions must involve GPs in conjunction with psychiatrists or psychologists.

Personality development characteristics of women with anorexia nervosa, their healthy siblings and healthy controls: What prevents and what relates to psychopathology?

This exploratory study assessed attachment and personality in anorexic women, non-affected siblings, and healthy controls, examining correlations with psychopathology. Thirty-eight anorexic subjects (31 females), thirty-one siblings (22 females), and fifty controls (35 females) participated. Personality development characteristics were assessed using the Attachment Style Questionnaire (ASQ), Temperament and Character Inventory (TCI), Eating Disorders Inventory (EDI-2), Symptom Checklist-90 (SCL-90), and other inventories for clinical assessment of EDs. Both anorexic probands and their siblings described lower maternal care and higher maternal overprotection than did controls. Healthy siblings were more similar to controls, but had lower scores than either controls or affected siblings on preoccupation with relationships (P<0.005) and higher scores than controls on self-transcendence (P<0.015) and obsessive-compulsive traits (P<0.025). Logistic regression indicated that need for approval, persistence, resourcefulness, self-transcendence, state anger, pursuit of thinness, interpersonal distrust, social insecurity, and binge eating differentiated anorexic probands from siblings. The need for approval was related to several psychopathological characteristics. Low preoccupation with relationships, low need for approval, and high self-transcendence may have protected siblings from family and environmental stressors. High need for approval was independently related to psychopathological traits in anorexic siblings. Implications for prevention and treatment are discussed.

Parenting and adolescent adjustment: the role of parental reflective function

Reflective function (RF) is the capacity to reflect on one's own mental experiences and those of others. This study examined the relationship between parental RF and adolescent adjustment. One hundred and five adolescents, aged 14-18, and their mothers and fathers were interviewed and completed questionnaires during home visits. We measured parental RF, aspects of parenting behavior, and adolescent outcomes. We found that parental RF correlated with adolescent RF and social competence. Unexpectedly, it also correlated with internalizing problems and less positive self-perception. In addition, parental RF, particularly paternal RF, interacted with aspects of parenting behavior. In the presence of higher levels of parental RF, these behavioral aspects were associated with more positive adolescent outcomes. We conclude that (a) parental RF is associated with both desirable outcomes and possible costs and (b) parental RF, particularly paternal RF, is a significant moderator of the associations between parenting behaviors and adolescent outcomes.

Chronic stress, cognitive functioning and mental health

This review aims to discuss the evidence supporting the link between chronic stress, cognitive function and mental health. Over the years, the associations between these concepts have been investigated in different populations. This review summarizes the findings that have emerged from older populations as well as from populations suffering from pathological aging, namely Mild Cognitive Impairment and Alzheimer's Disease. Although older adults are an interesting population to study in terms of chronic stress, other stress-related diseases can occur throughout the lifespan. The second section covers some of these stress-related diseases that have recently received a great deal of attention, namely burnout, depression, and post-traumatic stress disorder. Given that chronic stress contributes to the development of certain pathologies by accelerating and/or exacerbating pre-existing vulnerabilities that vary from one individual to the other, the final section summarizes data obtained on potential variables contributing to the association between chronic stress and cognition.

Parental bonding after preterm birth: child and parent perspectives in the Helsinki study of very low birth weight adults

OBJECTIVE

To examine whether parenting behavior recalled by very low birth weight (VLBW) adults or their parents differs from that of term-born control subjects or their parents.

STUDY DESIGN

A total of 164 VLBW and 172 control adults (mean age 22.5 years, SD 2.2) assessed retrospectively the parenting behavior of their parents by the Parental Bonding Instrument, which includes dimensions of care, protectiveness, and authoritarianism. A subgroup of 190 mothers and 154 fathers assessed their own parenting behavior by the Parent Behavior Inventory, which includes dimensions of supportive and hostile parenting.

RESULTS

The VLBW women assessed their mothers as more protective and authoritarian than the control women. The VLBW and control men did not differ from each other. Both mothers and fathers of the VLBW adults assessed their own parenting as more supportive than those of the control subjects.

CONCLUSIONS

Preterm birth at VLBW may promote a more protective, as well as more supportive, parenting style.

Childhood adversity and chronicity of mood disorders

To evaluate the potential impact of early childhood problems on the chronicity of mood disorders. A representative cohort from the population was prospectively studied from ages 19/20 to 39/40. Unipolar (UP) and bipolar disorders (BP) were operationally defined applying broad Zurich criteria for bipolarity. Chronicity required the presence of symptoms for more days than not over 2 years prior to an interview, or almost daily occurrence for 1 year. A family history and a history of childhood problems were taken at ages 27/28 and 29/30. Data include the first of multiple self-assessments with the Symptom-Checklist-90 R at age 19/20, and mastery and self-esteem assessed 1 year later. A factor analysis of childhood problems yielded two factors: family problems and conduct problems. Sexual trauma, which did not load on either factor, and conduct problems were unrelated to chronicity of UP or BP or both together. In contrast, childhood family problems increased the risk of chronicity by a factor of 1.7. An anxious personality in childhood and low self-esteem and mastery in early adulthood were also associated with chronicity. Childhood family problems are strong risk factors for the chronicity of mood disorders (UP and BP). The risk may be mediated partly by anxious personality traits, poor coping and low self-esteem.

Maternal rejection of the young child: present status of the clinical syndrome

This article reviews severe disorders of the mother-infant relationship involving emotional rejection of the infant in the first year of its life. Infants exposed to their mother's hatred and rage may suffer far-ranging and long-term disadvantages, and are at risk of maltreatment. Diagnosis, therapy and research have been hampered by the lack of recognition of this clinical syndrome in the classifications. The imminent revision of these classificatory systems must include them.

Parental practices predict psychological well-being in midlife: life-course associations among women in the 1946 British birth cohort

BACKGROUND

Certain parenting styles are influential in the emergence of later mental health problems, but less is known about the relationship between parenting style and later psychological well-being. Our aim was to examine the association between well-being in midlife and parental behaviour during childhood and adolescence, and the role of personality as a possible mediator of this relationship.

METHOD

Data from 984 women in the 1946 British birth cohort study were analysed using structural equation modelling. Psychological well-being was assessed at age 52 years using Ryff's scales of psychological well-being. Parenting practices were recollected at age 43 years using the Parental Bonding Instrument. Extraversion and neuroticism were assessed at age 26 years using the Maudsley Personality Inventory.

RESULTS

In this sample, three parenting style factors were identified: care; non-engagement; control. Higher levels of parental care were associated with higher psychological well-being, while higher parental non-engagement or control were associated with lower levels of psychological well-being. The effects of care and non-engagement were largely mediated by the offspring's personality, whereas control had direct effects on psychological well-being. The psychological well-being of adult women was at least as strongly linked to the parenting style of their fathers as to that of their mothers, particularly in relation to the adverse effects of non-engagement and control.

CONCLUSIONS

This study used a prospective longitudinal design to examine the effects of parenting practices on psychological well-being in midlife. The effects of parenting, both positive and negative, persisted well into mid-adulthood.

Childhood neglect and abuse as predictors of antidepressant response in adult depression

BACKGROUND

Childhood neglect and abuse are recognized as risk factors for depression, but are not often studied as predictors of treatment response in depression.

METHODS

Clinically depressed outpatients (n=195) were asked about childhood experiences before beginning a randomized antidepressant trial with either fluoxetine or nortriptyline. Three treatment outcomes were measured: Adequate trial, six-week response and two months sustained recovery.

RESULTS

Patients reporting low paternal care (paternal neglect), as measured by the Parental Bonding Instrument (PBI), were less likely to complete an adequate six-week trial of medication. Patients who reported high maternal protection (maternal overprotection) on the PBI had poorer treatment response in the short-term at six weeks, and longer term, for two months of sustained recovery. However, abuse, whether sexual, physical, or psychological in nature, did not predict treatment response.

CONCLUSIONS

The experience of having a neglectful father or an overprotective mother was more predictive of response to treatment for depression than abuse, suggesting that the quality of ongoing intra-familial relationships has a greater impact on treatment outcomes for depression than experiences of discrete abuse in childhood.

Parental care moderates the influence of MAOA-uVNTR genotype and childhood stressors on trait impulsivity and aggression in adult women

OBJECTIVES

Adverse childhood experiences are associated with poor mental health outcomes, including vulnerability to mood disorders and/or antisocial behavior. A functional polymorphism in the regulatory region of the monoamine oxidase A gene (monoamine oxidase A untranslated variable nucleotide tandem repeat, MAOA-uVNTR) may moderate the degree of risk conferred by early trauma. Experiential factors may mitigate or exacerbate the effects of trauma on individuals at genetic risk. We examined the association among MAOA-uVNTR genotype, early stress (family death, family separation, parents' divorce, physical and/or sexual abuse), quality of parental care, and disadvantageous outcomes (trait impulsivity/aggression and depression severity) in adult women.

METHODS

Diagnostic assessments were completed for 159 female participants. All were either healthy or were diagnosed with major depressive disorder or bipolar disorder. Participants were assessed for lifetime trait aggression and impulsiveness and current severity of depression, and were genotyped for the MAOA-uVNTR polymorphism. Participants rated the level of parental care they experienced, and were asked to report specific childhood stressors and abuse.

RESULTS

High perceived parental care mitigated the effect of a childhood stressor on impulsivity scores in low-expressing MAOA-uVNTR allele carriers, but level of perceived care had no effect in the group homozygous for the high-expressing MAOA-uVNTR allele. Gene-environment interactions did not influence depression severity in the mood disorder group, indicating that the effects of parenting we observed in our participants were independent of depression status.

CONCLUSION

These results suggest that gene-environment interactions influence not only disadvantageous outcomes, but also sensitivity to features of the environment that could alleviate these outcomes.

Effects of the "affectionless control" parenting style on personality traits in healthy subjects

The effects of the affectionless control (AC) parenting style on personality traits were studied in 414 Japanese healthy subjects. Perceived parental rearing was assessed by the Parental Bonding Instrument, which comprises care and protection factors, and personality traits were assessed by the Temperament and Character Inventory, which has seven dimensions. Parental rearing was classified into four types, i.e., optimal parenting (high care/low protection), affectionate constraint (high care/high protection), neglectful parenting (low care/low protection), and AC (low care/high protection). Males with maternal AC showed significantly higher harm avoidance (HA) scores and lower scores of persistence and cooperativeness than those with maternal optimal parenting. Females with maternal AC showed significantly higher HA scores and lower self-directedness scores than those with maternal optimal parenting. Paternal AC was not significantly related to any personality score. In females, the interaction between paternal rearing and maternal rearing was significant; the effect of maternal AC on HA scores was strongest when combined with paternal neglectful parenting. The present study suggests that the AC type parenting by mothers is associated with specific personality traits, especially high HA, in healthy subjects.

Early adversity in chronic depression: clinical correlates and response to pharmacotherapy

BACKGROUND

There is growing evidence suggesting that early adversity may be a marker for a distinct pathway to major depressive disorder (MDD). We examined associations between childhood adversity and a broad variety of clinical characteristics and response to pharmacotherapy in a large sample of patients with chronic forms of MDD.

METHODS

Subjects included 808 patients with chronic forms of MDD (chronic MDD, double depression, or recurrent MDD with incomplete recovery between episodes and a total continuous duration of >2 years) who were enrolled in a 12-week open-label trial of algorithm-guided pharmacotherapy. Baseline assessments included a semi-structured diagnostic interview, and clinician- and self-rated measures of depressive symptoms, social functioning, depressotypic cognitions, and personality traits, and childhood adversity. Patients were re-evaluated every 2 weeks.

RESULTS

A longer duration of illness; earlier onset; greater number of episodes, symptom severity, self-rated functional impairment, suicidality, and comorbid anxiety disorder; and higher levels of dysfunctional attitudes and self-criticism were each associated with multiple forms of childhood adversity. A history of maternal overcontrol, paternal abuse, paternal indifference, sexual abuse, and an index of clinically significant abuse each predicted a lower probability of remission. Among patients completing the 12-week trial, 32% with a history of clinically significant abuse, compared to 44% without such a history, achieved remission.

CONCLUSIONS

These findings indicate that a history of childhood adversity is associated with an especially chronic form of MDD that is less responsive to antidepressant pharmacotherapy.

Percepción sobre estilos e inconsistencia parentales en adolescentes argentinos

Se presentan avances parciales de un estudio descriptivo realizado con 214 adolescentes escolarizados de 15 y 16 años, residentes en la Ciudad de Buenos Aires, Argentina, evaluados mediante una escala autoadministrable sobre Percepción de Control y Estilos e Inconsistencia Parentales, basada en la Controlling and inconsistent parenting scale. Se verificó un grado considerable y significativo de consistencia en los niveles de Control/castigo/aceptación/perdón impartidos (r=.655**), así como en la consistencia o estabilidad temporal de tales comportamientos (r=.785**).entre los miembros de la pareja parental. Se halló, también, que el Control/castigo impartido por los padres varones resulta significativamente más elevado cuando los padres viven juntos, en tanto que cuando existe una separación o divorcio, es significativamente más bajo. El nivel educativo de ambos adultos introduce diferencias en el grado de consistencia o estabilidad temporal de las reacciones independientes, de cada uno, ante comportamientos indeseados de los hijos, y estas diferencias se dan en el mismo sentido para ambos padres: el grupo con educación primaria incompleta y completa exhibe una inconsistencia significativamente mayor que el que ha alcanzado niveles educativos medios y terciarios o universitarios. También la consistencia resulta significativamente mayor, en cada progenitor, para los casos en que el estatus económico autopercibido por el adolescente es alto.

The measurement of a major childhood risk for depression: comparison of the Parental Bonding Instrument (PBI) 'Parental Care' and the Childhood Experience of Care and Abuse (CECA) 'Parental Neglect'

BACKGROUND

Lack of adequate parental care is a consistent predictor of adult depression. Questionnaire measures that compare well with interviews are needed for large-scale studies of affective disorders in the general population. A widely used questionnaire, the Parental Bonding Instrument (PBI), was compared with a detailed standardized interview, the Childhood Experiences of Care and Abuse (CECA).

METHODS

PBI ratings of maternal and paternal care were obtained from 192 women aged 25-36, identified from primary care lists. The women were interviewed for childhood neglect using the CECA, and ratings made blind to their PBI responses.

RESULTS

The discriminative ability of PBI care scores to predict measures of neglect in the CECA were moderate to high, and the addition of paternal scores did not add to the prediction from maternal scores. Shortened forms of the PBI maternal care scales provided comparable predictions to those from the full scale, particularly three items from the maternal care scale, identified by logistic regression.

LIMITATIONS

PBI and CECA measures on the women were retrospective. Low numbers in some of the subgroups of interest limited statistical power and is reflected in wider confidence intervals. The three maternal care items identified by logistic regression need to be confirmed in other samples as being as efficient as the combined maternal and paternal care scale scores.

CONCLUSIONS

The maternal care scale of the PBI compares reasonably well as an index of overall neglect in childhood to that provided by the CECA.

Father-son attachment and sexual partner orientation in Taiwan

The topic of homosexual adjustment problems has never been explored in Taiwan. The aim of this study was to investigate the role of parental bonding in the adjustment problems of homosexuals. A total of 51 young homosexual males, 100 nonhomosexual personnel with adjustment disorder, and 124 controls were administered the Parental Bonding Instrument, the Eysenck Personality Questionnaire, and the Chinese Health Questionnaire. The final parsimonious logistic regression and structural equation modeling showed paternal attachment, especially paternal overprotection, to be a predisposing factor in the development of homosexuality. Paternal attachment, introversion, and neurotic characteristics were key factors in the development of homosexuals. In particular, paternal overprotection played the most important role in the developmental process of male homosexuals. This study can be used as a reference for clinical personnel in caring for male homosexuals.