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Are apparent associations between parental representations and psychosis risk mediated by early trauma?

Janssen I, Krabbendam L, Hanssen M, Bak M, Vollebergh W, de Graaf R, van Os J

Department of Psychiatry and Neuropsychology, South Limburg Mental Health Research Network, EURON, Maastricht University, Maastricht, the Netherlands.

OBJECTIVE: It was investigated whether the reported association between representations of parental rearing style and psychosis does not represent a main effect, but instead is a proxy indicator of the true underlying risk factor of early trauma. METHOD: In a general population sample of 4045 individuals aged 18-64 years, first ever onset of positive psychotic symptoms at 3-year follow-up was assessed using the Composite International Diagnostic Interview and clinical interviews if indicated. Representations of parental rearing style were measured with the Parental Bonding Instrument (PBI). RESULTS: Lower baseline level of PBI parental care predicted onset of psychotic symptoms 2 years later. However, when trauma was included in the equation, a strong main effect of trauma emerged at the expense of the effect size of PBI low care. CONCLUSION: The results suggest that associations between representations of parental rearing style and psychosis may be an indicator of the effect of earlier exposure to childhood trauma.

Published 14 October 2005 in Acta Psychiatr Scand, 112(5): 372-5.
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