The moderation of maternal parenting on the association of trauma, dissociation, and psychosis in depressive inpatients

Abstract

Background The effect of dissociation and parenting style on the relationship between psychological trauma and psychotic symptoms has not previously been investigated. Objective The aim of this study was to develop a moderated mediation model to assess whether the association between psychological trauma and psychotic symptoms is mediated by dissociation and moderated by parental maltreatment. Methods Inpatients with major depressive disorder (MDD) and bipolar depression (BP) were recruited. Self-reported and clinical rating scales were used to measure the level of dissociation, psychotic symptoms, history of psychological trauma and parental maltreatment. The PROCESS macro in SPSS was used to estimate path coefficients and adequacy of the moderated mediation model. High betrayal trauma (HBT), low betrayal trauma (LBT), paternal maltreatment, and maternal maltreatment were alternatively entered into the conceptual model to test the adequacy. Results A total of 91 patients (59 with MDD and 32 with BP) were recruited, with a mean age of 40.59 ± 7.5 years. After testing with different variables, the moderated mediation model showed that the association between LBT and psychotic symptoms was mediated by dissociation and moderated by maternal maltreatment. A higher level of maternal maltreatment enhanced the effect of LBT on dissociation. Conclusions Healthcare workers should be aware of the risk of developing psychotic symptoms among depressive patients with a history of LBT and maternal maltreatment.

Dissociative Symptoms and Disorders in Patients With Bipolar Disorders: A Scoping Review

“…Five studies have compared the severity of DS in patients with BD and major depressive disorder (MDD), have measured DS during depressive episodes. In four of these studies, DS were more prominent in BD than in MDD ( 22 , 26 , 30 , 38 ), while in the other, they were comparable ( 44 ). Studies comparing the severity of DS between BD and other, non-affective psychiatric disorders found that DS were significantly less in BD than in somatoform disorders and DD ( 18 , 19 , 32 ), complex post-traumatic stress disorder (PTSD) ( 32 ), atypical psychosis in adolescents ( 20 ), and borderline personality disorder ( 36 ).…”

“…DS scores have been associated with the severity of psychotic symptoms ( 42 , 44 ); both positive and null results have been reported for associations between DS and depressive symptom severity ( 31 , 41 ). DS severity has also been associated with general symptom severity across psychopathological dimensions ( 31 ), with the severity of symptoms of social anxiety, panic disorder and obsessive-compulsive disorder ( 33 , 41 ), with the presence of mixed symptoms ( 42 ), with suicide attempts ( 40 , 42 ) and with aggression ( 42 ).…”

“…Six studies have examined the association between childhood abuse or neglect and DS in BD; four of these found a positive association between childhood trauma and DS severity ( 23 , 33 , 41 , 44 ), while two failed to do so ( 37 , 43 ). A single study examined the relationship between DS and current stress related to the COVID-19 pandemic, but did not find any significant association between the two ( 43 ).…”

“…A total of 471 citations were retrieved; after removal of duplicates, 333 citations were screened; after exclusion of 226 unrelated abstracts, 107 citations were tabulated and their full text was examined for relevance. Of these, 27 were included in the final review ( 18 – 44 ). This process is illustrated through a PRISMA-ScR flow diagram in Figure 1 .…”

Erroneous Thought in Inpatients with Major Depressive Disorder: The Role of Psychological Trauma During Childhood and Adulthood

“…This study derived data from two projects which aimed to investigate the stability of self‐reported childhood interpersonal adversity and relationships among interpersonal adversity, psychiatric status, and socio-cognitive functions. 30 These investigations were approved by the Institutional Review Board of Kai-Syuan Psychiatric Hospital on 30th Dec 2014 and 1st May 2017 (KSPH-2014-34 and KSPH-2017-04) and conducted in accordance with the current revision of the Declaration of Helsinki and national legal requirements (Human Subjects Research Act, Taiwan). All participants signed written informed consent after the study had been explained in detail.…”