Objective. Childhood maltreatment and familial psychopathology both lead to an increased risk of the development of posttraumatic stress disorder (PTSD) in adulthood. While family history of psychopathology has traditionally been viewed as a proxy for genetic predisposition, such pathology can also contribute to a stress-laden environment for the child. Method. Analyses were conducted to evaluate the joint effect of childhood abuse and a family history of major depressive disorder (MDD) on diagnoses of PTSD and MDD in a sample of 225 adults with DSM-IV Axis II disorders. Results. Results showed that the rate of PTSD in the presence of both childhood abuse and MDD family history was almost six-fold ( ) higher relative to the absence of both factors. In contrast, the rate of MDD in the presence of both factors was associated with a nearly three-fold risk relative to the reference group ( ). Conclusions. The results from this observational study contribute to a growing understanding of predisposing factors for the development of PTSD and suggest that joint effects of family history of MDD and childhood abuse on PTSD are greater than either factor alone. 1. Introduction Trauma exposure is a necessary condition for the development of posttraumatic stress disorder (PTSD) but there is increasing recognition that trauma exposure alone does not necessarily result in sufficient symptomatology to result in diagnosis. In fact, the observation from epidemiological samples that trauma exposure is highly prevalent but that PTSD is relatively rare [1–3] has generated research aimed at identifying environmental and genetic risk factors that can explain why only some people who are exposed to trauma will develop PTSD. Childhood maltreatment is unquestionably a potent environmental antecedent for the development of adult onset PTSD (e.g., [4, 5]), either resulting from the maltreatment itself or by increasing risk for exposure to subsequent traumatic events [6, 7]. With respect to genetic risk, it has not been obvious that molecular genetic factors are implicated in association with PTSD until recently, but there is increasing support for such a view. The genetic contribution to PTSD has been estimated at 30–40%, based on differences in concordance rates of the diagnosis between monozygotic and dizygotic twins [8–10]. And while familial psychopathology has traditionally been viewed as a proxy variable for genetic risk [11], few family studies of PTSD have been conducted. This is in part, due to the fact that the diagnosis is a relatively recent one, only appearing in the
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