Maternal overprotection score of the Parental Bonding Instrument predicts the outcome of cognitive behavior therapy by trainees for depression


Correspondence: Motoshi Asano, MD, Department of Psychiatry, Social Insurance Chukyo Hospital, 1-1-10, Sanjoh, Minami-ku, Nagoya, Aichi 457-8510, Japan. Email:



The purpose of this study was to predict the outcome of cognitive behavior therapy (CBT) by trainees for major depressive disorder (MDD) based on the Parental Bonding Instrument (PBI). The hypothesis was that the higher level of care and/or lower level of overprotection score would predict a favorable outcome of CBT by trainees.


The subjects were all outpatients with MDD treated with CBT as a training case. All the subjects were asked to fill out the Japanese version of the PBI before commencing the course of psychotherapy. The difference between the first and the last Beck Depression Inventory (BDI) score was used to represent the improvement of the intensity of depression by CBT. In order to predict improvement (the difference of the BDI scores) as the objective variable, multiple regression analysis was performed using maternal overprotection score and baseline BDI score as the explanatory variables.


The multiple regression model was significant (P = 0.0026) and partial regression coefficient for the maternal overprotection score and the baseline BDI was −0.73 (P = 0.0046) and 0.88 (P = 0.0092), respectively. Therefore, when a patient's maternal overprotection score of the PBI was lower, a better outcome of CBT was expected.


The hypothesis was partially supported. This result would be useful in determining indications for CBT by trainees for patients with MDD.