Adoption, family relations and psychotic symptoms among Palauan adolescents who are genetically at risk for developing schizophrenia

Purpose This paper focuses on the role of adoption and family relations as moderators of genetic risk for psychotic disorders. Methods Participants included 184 adolescents in the Republic of Palau identified to be at genetic risk for schizophrenia and other psychotic disorders. Palau is an island nation in Micronesia with a lifetime prevalence of 1.99% for schizophrenia and 2.67% for psychotic disorders more broadly defined [ 24 ]. In Palauan culture, kinship adoption is a common cultural practice; 47 of the 184 participants had been adopted at an early age. The current study was designed to test the hypothesis that adoption would function as a protective factor among Palauan youth at genetic risk for the development of psychotic symptoms. Participants were evaluated for psychotic and other psychiatric symptoms using KSADS-PL [ 16 ]. Concurrently, the Youth Self Report [ 1 ] was used to assess the perceived quality of family relationships. Results Results indicated that adopted adolescents were more likely to develop psychotic symptoms than non-adopted adolescents. However, perceived family relations moderated the association between adoption status and psychotic symptoms, such that adopted adolescents with poorer family relations reported disproportionately higher rates of psychotic symptoms. Family relations also moderated the association between level of genetic risk and psychotic symptoms, independently of adoption status. Conclusion Consistent with previous research, adolescents at high genetic risk who reported more positive family relations also reported fewer psychotic symptoms [ 4 , 29 ].