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Slavin AZ, Fischer IC, Pietrzak RH. Differential associations of adverse childhood experiences and mental health outcomes in U.S. military veterans. J Psychiatr Res 2024; 172:261-265. [PMID: 38412789 DOI: 10.1016/j.jpsychires.2024.02.040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/31/2023] [Revised: 01/23/2024] [Accepted: 02/20/2024] [Indexed: 02/29/2024]
Abstract
Adverse childhood experiences (ACEs) are robustly associated with adverse mental health outcomes across the lifespan. Military veterans may be particularly vulnerable to adverse mental health effects of ACEs given their potentially higher prevalence of childhood traumas and compounding effects of military service-related traumas. To date, however, scarce research has examined the differential impact of individual ACEs on mental health outcomes in population-based samples of veterans. To address this gap, we analyzed data from the National Health and Resilience in Veterans Study (NHRVS), which surveyed a nationally representative sample of 4069 U.S. veterans, to examine the association between specific ACEs and major depressive, generalized anxiety, and posttraumatic stress disorders, and suicidal thoughts and behaviors. Results of multivariable logistic regression analyses revealed that emotional neglect and sexual abuse were most consistently associated with these outcomes, even after adjustment for the number of ACEs endorsed. Collectively, results of this study underscore the importance of assessing for specific ACEs-most notably childhood emotional neglect and sexual abuse-and treating these potentially unresolved childhood traumas in veterans.
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Affiliation(s)
- Alana Z Slavin
- Department of Psychiatry, Yale School of Medicine, New Haven, CT, USA.
| | - Ian C Fischer
- Department of Psychiatry, Yale School of Medicine, New Haven, CT, USA; U.S. Department of Veterans Affairs National Center for Posttraumatic Stress Disorder, VA Connecticut Healthcare System, West Haven, CT, USA
| | - Robert H Pietrzak
- Department of Psychiatry, Yale School of Medicine, New Haven, CT, USA; U.S. Department of Veterans Affairs National Center for Posttraumatic Stress Disorder, VA Connecticut Healthcare System, West Haven, CT, USA; Department of Social and Behavioral Sciences, Yale School of Public Health, New Haven, CT, USA
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2
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Tamman AJF, Koller D, Nagamatsu S, Cabrera-Mendoza B, Abdallah C, Krystal JH, Gelernter J, Montalvo-Ortiz JL, Polimanti R, Pietrzak RH. Psychosocial moderators of polygenic risk scores of inflammatory biomarkers in relation to GrimAge. Neuropsychopharmacology 2024; 49:699-708. [PMID: 37848731 PMCID: PMC10876568 DOI: 10.1038/s41386-023-01747-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/23/2023] [Revised: 08/25/2023] [Accepted: 09/25/2023] [Indexed: 10/19/2023]
Abstract
GrimAge acceleration has previously predicted age-related morbidities and mortality. In the current study, we sought to examine how GrimAge is associated with genetic predisposition for systemic inflammation and whether psychosocial factors moderate this association. Military veterans from the National Health and Resilience in Veterans study, which surveyed a nationally representative sample of European American male veterans, provided saliva samples for genotyping (N = 1135). We derived polygenic risk scores (PRS) from the UK Biobank as markers of genetic predisposition to inflammation. Results revealed that PRS for three inflammatory PRS markers-HDL (lower), apolipoprotein B (lower), and gamma-glutamyl transferase (higher)-were associated with accelerated GrimAge. Additionally, these PRS interacted with a range of potentially modifiable psychosocial variables, such as exercise and gratitude, previously identified as associated with accelerated GrimAge. Using gene enrichment, we identified anti-inflammatory and antihistamine drugs that perturbate pathways of genes highly represented in the inflammatory PRS, laying the groundwork for future work to evaluate the potential of these drugs in mitigating epigenetic aging.
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Affiliation(s)
- Amanda J F Tamman
- Department of Psychiatry, Baylor College of Medicine, Houston, TX, USA.
| | - Dora Koller
- Division of Human Genetics, Department of Psychiatry, Yale School of Medicine, New Haven, CT, USA
- Department of Psychiatry, Yale School of Medicine, New Haven, CT, USA
| | - Sheila Nagamatsu
- Division of Human Genetics, Department of Psychiatry, Yale School of Medicine, New Haven, CT, USA
- Department of Psychiatry, Yale School of Medicine, New Haven, CT, USA
| | - Brenda Cabrera-Mendoza
- Division of Human Genetics, Department of Psychiatry, Yale School of Medicine, New Haven, CT, USA
- Department of Psychiatry, Yale School of Medicine, New Haven, CT, USA
| | - Chadi Abdallah
- Department of Psychiatry, Baylor College of Medicine, Houston, TX, USA
- Department of Psychiatry, Yale School of Medicine, New Haven, CT, USA
| | - John H Krystal
- Department of Psychiatry, Yale School of Medicine, New Haven, CT, USA
- U.S. Department of Veterans Affairs National Center for Posttraumatic Stress Disorder, Clinical Neurosciences Division, VA Connecticut Healthcare System, West Haven, CT, USA
| | - Joel Gelernter
- Division of Human Genetics, Department of Psychiatry, Yale School of Medicine, New Haven, CT, USA
- Department of Psychiatry, Yale School of Medicine, New Haven, CT, USA
- U.S. Department of Veterans Affairs National Center for Posttraumatic Stress Disorder, Clinical Neurosciences Division, VA Connecticut Healthcare System, West Haven, CT, USA
| | - Janitza L Montalvo-Ortiz
- Division of Human Genetics, Department of Psychiatry, Yale School of Medicine, New Haven, CT, USA
- Department of Psychiatry, Yale School of Medicine, New Haven, CT, USA
- U.S. Department of Veterans Affairs National Center for Posttraumatic Stress Disorder, Clinical Neurosciences Division, VA Connecticut Healthcare System, West Haven, CT, USA
| | - Renato Polimanti
- Division of Human Genetics, Department of Psychiatry, Yale School of Medicine, New Haven, CT, USA
- Department of Psychiatry, Yale School of Medicine, New Haven, CT, USA
| | - Robert H Pietrzak
- Department of Psychiatry, Yale School of Medicine, New Haven, CT, USA
- U.S. Department of Veterans Affairs National Center for Posttraumatic Stress Disorder, Clinical Neurosciences Division, VA Connecticut Healthcare System, West Haven, CT, USA
- Department of Social and Behavioral Sciences, Yale School of Public Health, New Haven, CT, USA
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3
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Babicola L, Mancini C, Riccelli C, Di Segni M, Passeri A, Municchi D, D'Addario SL, Andolina D, Cifani C, Cabib S, Ventura R. A mouse model of the 3-hit effects of stress: Genotype controls the effects of life adversities in females. Prog Neuropsychopharmacol Biol Psychiatry 2023; 127:110842. [PMID: 37611651 DOI: 10.1016/j.pnpbp.2023.110842] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/20/2023] [Revised: 08/14/2023] [Accepted: 08/17/2023] [Indexed: 08/25/2023]
Abstract
Helplessness is a dysfunctional coping response to stressors associated with different psychiatric conditions. The present study tested the hypothesis that early and adult adversities cumulate to produce helplessness depending on the genotype (3-hit hypothesis of psychopathology). To this aim, we evaluated whether Chronic Unpredictable Stress (CUS) differently affected coping and mesoaccumbens dopamine (DA) responses to stress challenge by adult mice of the C57BL/6J (B6) and DBA/2J (D2) inbred strains depending on early life experience (Repeated Cross Fostering, RCF). Three weeks of CUS increased the helplessness expressed in the Forced Swimming Test (FST) and the Tail Suspension Test by RCF-exposed female mice of the D2 strain. Moreover, female D2 mice with both RCF and CUS experiences showed inhibition of the stress-induced extracellular DA outflow in the Nucleus Accumbens, as measured by in vivo microdialysis, during and after FST. RCF-exposed B6 mice, instead, showed reduced helplessness and increased mesoaccumbens DA release. The present results support genotype-dependent additive effects of early experiences and adult adversities on behavioral and neural responses to stress by female mice. To our knowledge, this is the first report of a 3-hit effect in an animal model. Finally, the comparative analyses of behavioral and neural phenotypes expressed by B6 and D2 mice suggest some translationally relevant hypotheses of genetic risk factors for psychiatric disorders.
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Affiliation(s)
- Lucy Babicola
- IRCCS Fondazione Santa Lucia, Rome, Italy; Dept. of Psychology and Center "Daniel Bovet", Sapienza University, Rome 00184, Italy
| | - Camilla Mancini
- University of Camerino, School of Pharmacy, Pharmacology Unit, Camerino, Italy
| | - Cristina Riccelli
- Dept. of Psychology and Center "Daniel Bovet", Sapienza University, Rome 00184, Italy
| | - Matteo Di Segni
- IRCCS Fondazione Santa Lucia, Rome, Italy; Dept. of Psychology and Center "Daniel Bovet", Sapienza University, Rome 00184, Italy
| | - Alice Passeri
- Dept. of Psychology and Center "Daniel Bovet", Sapienza University, Rome 00184, Italy
| | - Diana Municchi
- IRCCS Fondazione Santa Lucia, Rome, Italy; Dept. of Psychology and Center "Daniel Bovet", Sapienza University, Rome 00184, Italy
| | | | - Diego Andolina
- IRCCS Fondazione Santa Lucia, Rome, Italy; Dept. of Psychology and Center "Daniel Bovet", Sapienza University, Rome 00184, Italy
| | - Carlo Cifani
- University of Camerino, School of Pharmacy, Pharmacology Unit, Camerino, Italy
| | - Simona Cabib
- IRCCS Fondazione Santa Lucia, Rome, Italy; Dept. of Psychology and Center "Daniel Bovet", Sapienza University, Rome 00184, Italy.
| | - Rossella Ventura
- IRCCS Fondazione Santa Lucia, Rome, Italy; IRCCS San Raffaele, Rome, Italy.
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Maciel MR, Calsavara VF, Zylberstajn C, Mello MF, Coimbra BM, Mello AF. Changes in attachment dimensions during the treatment of acute post-traumatic stress disorder in sexually assaulted Brazilian women. Front Psychol 2023; 14:1325622. [PMID: 38130963 PMCID: PMC10734689 DOI: 10.3389/fpsyg.2023.1325622] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2023] [Accepted: 11/23/2023] [Indexed: 12/23/2023] Open
Abstract
Introduction Attachment patterns are established during early childhood; however, extreme experiences throughout life may change this structure, either toward attachment security or insecurity. We analyzed changes in attachment dimensions in women with acute post-traumatic stress disorder (PTSD) following sexual assault, that were randomized to a 14-week treatment with either the medication sertraline or Interpersonal Psychotherapy. Methods Seventy-four adult women who presented significant reduction in PTSD symptoms across the trial responded to the Revised Adult Attachment Scale at baseline, on week 8 of treatment, and at the end of the trial, on week 14. We fitted a generalized linear model to explain the attachment anxiety and avoidance scores at baseline. A generalized linear mixed model investigated how attachment dimensions changed over time. Socioeconomic data, treatment type, history of childhood trauma, and PTSD severity over the 14-week period were the considered covariates. Results At baseline, attachment anxiety was associated with a history of early trauma. Attachment anxiety remained stable during the follow-up. Attachment avoidance, on the other hand, significantly increased from baseline to week 14. Higher avoidance was observed in patients with higher total PTSD scores and on the cluster of hyperarousal symptoms. Races other than White (black, mixed-race, or Asian) and younger age were associated with higher attachment avoidance. Discussion Contrary to our expectations, attachment avoidance increased during follow-up, indicating changes in the interpersonal realm beyond the symptoms of PTSD.
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Affiliation(s)
- Mariana Rangel Maciel
- Program for Research and Care on Violence and PTSD (PROVE), Department of Psychiatry, Universidade Federal de São Paulo (UNIFESP), São Paulo, Brazil
| | | | - Cecilia Zylberstajn
- Program for Research and Care on Violence and PTSD (PROVE), Department of Psychiatry, Universidade Federal de São Paulo (UNIFESP), São Paulo, Brazil
| | - Marcelo Feijo Mello
- Program for Research and Care on Violence and PTSD (PROVE), Department of Psychiatry, Universidade Federal de São Paulo (UNIFESP), São Paulo, Brazil
| | - Bruno Messina Coimbra
- Program for Research and Care on Violence and PTSD (PROVE), Department of Psychiatry, Universidade Federal de São Paulo (UNIFESP), São Paulo, Brazil
- Department of Psychiatry, Amsterdam UMC, University of Amsterdam, Amsterdam Public Health Research Institute and Amsterdam Neuroscience Research Institute, Amsterdam, Netherlands
- Faculty of Social and Behavioural Sciences, Department of Methodology and Statistics, Utrecht University, Utrecht, Netherlands
| | - Andrea Feijo Mello
- Program for Research and Care on Violence and PTSD (PROVE), Department of Psychiatry, Universidade Federal de São Paulo (UNIFESP), São Paulo, Brazil
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Craba A, Marano G, Kotzalidis GD, Avallone C, Lisci FM, Crosta ML, Callea A, Monti L, De Berardis D, Lai C, Balocchi M, Sessa I, Harnic D, Sani G, Mazza M. Resilience and Attachment in Patients with Major Depressive Disorder and Bipolar Disorder. J Pers Med 2023; 13:969. [PMID: 37373958 DOI: 10.3390/jpm13060969] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2023] [Revised: 05/12/2023] [Accepted: 06/06/2023] [Indexed: 06/29/2023] Open
Abstract
BACKGROUND Resilience represents one of the fundamental elements of attachment and has often been investigated in mood disorders. This study aims to investigate possible correlations between attachment and resilience in patients with major depressive disorder (MDD) and bipolar disorder (BD). METHODS 106 patients (51 MDD, 55 BD) and 60 healthy controls (HCs) were administered the 21-item Hamilton Depression Rating Scale (HAM-D-21), the Hamilton Anxiety Rating Scale (HAM-A), the Young Mania Rating Scale (YMRS), the Snaith-Hamilton Pleasure Scale (SHAPS), the Barratt Impulsiveness Scale-11 (BIS-11), the Toronto Alexithymia Scale (TAS), the Connor-Davidson Resilience Scale (CD-RISC), and Experiences in Close Relationship (ECR). RESULTS MDD and BD patients did not significantly differ from each other according to the HAM-D-21, HAM-A, YMRS, SHAPS, and TAS, while they scored higher than HCs on all these scales. Patients in the clinical group scored significantly lower on CD-RISC resilience than HCs (p < 0.01). A lower proportion of secure attachment was found among patients with MDD (27.4%) and BD (18.2%) compared to HCs (90%). In both clinical groups, fearful attachment prevailed (39.2% patients with MDD; 60% BD). CONCLUSIONS Our results highlight the central role played by early life experiences and attachment in participants with mood disorders. Our study confirms the data from previous research showing a significant positive correlation between the quality of attachment and the development of resilience capacity, and supports the hypothesis that attachment constitutes a fundamental aspect of resilience capacity.
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Affiliation(s)
- Ambra Craba
- Department of Geriatrics, Neuroscience and Orthopedics, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, 00168 Rome, Italy
- Department of Psychiatry, Università Cattolica del Sacro Cuore, 00168 Rome, Italy
| | - Giuseppe Marano
- Department of Geriatrics, Neuroscience and Orthopedics, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, 00168 Rome, Italy
- Department of Psychiatry, Università Cattolica del Sacro Cuore, 00168 Rome, Italy
| | - Georgios D Kotzalidis
- Department of Geriatrics, Neuroscience and Orthopedics, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, 00168 Rome, Italy
- Department of Psychiatry, Università Cattolica del Sacro Cuore, 00168 Rome, Italy
- Department of Neurosciences, Mental Health, and Sensory Organs (NESMOS), Sapienza University of Rome, 00189 Rome, Italy
| | - Carla Avallone
- Department of Geriatrics, Neuroscience and Orthopedics, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, 00168 Rome, Italy
- Department of Psychiatry, Università Cattolica del Sacro Cuore, 00168 Rome, Italy
| | - Francesco Maria Lisci
- Department of Geriatrics, Neuroscience and Orthopedics, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, 00168 Rome, Italy
- Department of Psychiatry, Università Cattolica del Sacro Cuore, 00168 Rome, Italy
| | - Maria Luigia Crosta
- Department of Geriatrics, Neuroscience and Orthopedics, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, 00168 Rome, Italy
- Department of Psychiatry, Università Cattolica del Sacro Cuore, 00168 Rome, Italy
| | - Antonino Callea
- Department of Human Sciences, LUMSA University, 00193 Rome, Italy
| | - Laura Monti
- UOS Psicologia Clinica, Governo Clinico, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, 00168 Rome, Italy
| | | | - Carlo Lai
- Department of Dynamic, Clinical Psychology and Health Studies, Faculty of Medicine and Psychology, Sapienza University of Rome, 00185 Rome, Italy
| | - Marta Balocchi
- Department of Geriatrics, Neuroscience and Orthopedics, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, 00168 Rome, Italy
- Department of Psychiatry, Università Cattolica del Sacro Cuore, 00168 Rome, Italy
| | - Ilenia Sessa
- Department of Geriatrics, Neuroscience and Orthopedics, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, 00168 Rome, Italy
- Department of Psychiatry, Università Cattolica del Sacro Cuore, 00168 Rome, Italy
| | | | - Gabriele Sani
- Department of Geriatrics, Neuroscience and Orthopedics, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, 00168 Rome, Italy
- Department of Psychiatry, Università Cattolica del Sacro Cuore, 00168 Rome, Italy
| | - Marianna Mazza
- Department of Geriatrics, Neuroscience and Orthopedics, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, 00168 Rome, Italy
- Department of Psychiatry, Università Cattolica del Sacro Cuore, 00168 Rome, Italy
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Polimanti R, Wendt FR, Pathak GA, Tylee DS, Tcheandjieu C, Hilliard AT, Levey DF, Adhikari K, Gaziano JM, O'Donnell CJ, Assimes TL, Stein MB, Gelernter J. Understanding the comorbidity between posttraumatic stress severity and coronary artery disease using genome-wide information and electronic health records. Mol Psychiatry 2022; 27:3961-3969. [PMID: 35986173 PMCID: PMC10986859 DOI: 10.1038/s41380-022-01735-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/16/2022] [Revised: 07/29/2022] [Accepted: 08/05/2022] [Indexed: 02/07/2023]
Abstract
The association between coronary artery disease (CAD) and posttraumatic stress disorder (PTSD) contributes to the high morbidity and mortality observed for these conditions. To understand the dynamics underlying PTSD-CAD comorbidity, we investigated large-scale genome-wide association (GWA) statistics from the Million Veteran Program (MVP), the UK Biobank (UKB), the Psychiatric Genomics Consortium, and the CARDIoGRAMplusC4D Consortium. We observed a genetic correlation of CAD with PTSD case-control and quantitative outcomes, ranging from 0.18 to 0.32. To investigate possible cause-effect relationships underlying these genetic correlations, we performed a two-sample Mendelian randomization (MR) analysis, observing a significant bidirectional relationship between CAD and PTSD symptom severity. Genetically-determined PCL-17 (PTSD 17-item Checklist) total score was associated with increased CAD risk (odds ratio = 1.04; 95% confidence interval, 95% CI = 1.01-1.06). Conversely, CAD genetic liability was associated with reduced PCL-17 total score (beta = -0.42; 95% CI = -0.04 to -0.81). Because of these opposite-direction associations, we conducted a pleiotropic meta-analysis to investigate loci with concordant vs. discordant effects on PCL-17 and CAD, observing that concordant-effect loci were enriched for molecular pathways related to platelet amyloid precursor protein (beta = 1.53, p = 2.97 × 10-7) and astrocyte activation regulation (beta = 1.51, p = 2.48 × 10-6) while discordant-effect loci were enriched for biological processes related to lipid metabolism (e.g., triglyceride-rich lipoprotein particle clearance, beta = 2.32, p = 1.61 × 10-10). To follow up these results, we leveraged MVP and UKB electronic health records (EHR) to assess longitudinal changes in the association between CAD and posttraumatic stress severity. This EHR-based analysis highlighted that earlier CAD diagnosis is associated with increased PCL-total score later in life, while lower PCL total score was associated with increased risk of a later CAD diagnosis (Mann-Kendall trend test: MVP tau = 0.932, p < 2 × 10-16; UKB tau = 0.376, p = 0.005). In conclusion, both our genetically-informed analyses and our EHR-based follow-up investigation highlighted a bidirectional relationship between PTSD and CAD where multiple pleiotropic mechanisms are likely to be involved.
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Affiliation(s)
- Renato Polimanti
- Department of Psychiatry, Yale School of Medicine, West Haven, CT, USA.
- VA CT Healthcare Center, West Haven, CT, USA.
| | - Frank R Wendt
- Department of Psychiatry, Yale School of Medicine, West Haven, CT, USA
- VA CT Healthcare Center, West Haven, CT, USA
| | - Gita A Pathak
- Department of Psychiatry, Yale School of Medicine, West Haven, CT, USA
- VA CT Healthcare Center, West Haven, CT, USA
| | - Daniel S Tylee
- Department of Psychiatry, Yale School of Medicine, West Haven, CT, USA
- VA CT Healthcare Center, West Haven, CT, USA
| | | | - Austin T Hilliard
- Department of Medicine, Stanford University School of Medicine, Stanford, CA, USA
- VA Palo Alto Healthcare System, Palo Alto, CA, USA
| | - Daniel F Levey
- Department of Psychiatry, Yale School of Medicine, West Haven, CT, USA
- VA CT Healthcare Center, West Haven, CT, USA
| | - Keyrun Adhikari
- Department of Psychiatry, Yale School of Medicine, West Haven, CT, USA
- VA CT Healthcare Center, West Haven, CT, USA
| | - J Michael Gaziano
- Department of Medicine, VA Boston Healthcare System, Boston, MA, USA
- Department of Medicine, Brigham and Women's Hospital, Boston, MA, USA
- Department of Medicine, Harvard Medical School, Boston, MA, USA
| | - Christopher J O'Donnell
- Department of Medicine, VA Boston Healthcare System, Boston, MA, USA
- Department of Medicine, Brigham and Women's Hospital, Boston, MA, USA
- Department of Medicine, Harvard Medical School, Boston, MA, USA
| | - Themistocles L Assimes
- Department of Medicine, Stanford University School of Medicine, Stanford, CA, USA
- VA Palo Alto Healthcare System, Palo Alto, CA, USA
| | - Murray B Stein
- Department of Psychiatry, University of California San Diego, La Jolla, CA, USA
- VA San Diego Healthcare System, Psychiatry Service, San Diego, CA, USA
- Herbert Wertheim School of Public Health and Human Longevity Science, University of California San Diego, La Jolla, CA, USA
| | - Joel Gelernter
- Department of Psychiatry, Yale School of Medicine, West Haven, CT, USA
- VA CT Healthcare Center, West Haven, CT, USA
- Departments of Genetics and of Neuroscience, Yale School of Medicine, New Haven, CT, USA
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7
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Tamman AJF, Wendt FR, Pathak GA, Krystal JH, Southwick SM, Sippel LM, Gelernter J, Polimanti R, Pietrzak RH. Attachment Style Moderates Polygenic Risk for Incident Posttraumatic Stress in U.S. Military Veterans: A 7-Year, Nationally Representative, Prospective Cohort Study. Biol Psychiatry 2022; 91:637-646. [PMID: 34955171 DOI: 10.1016/j.biopsych.2021.09.025] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/07/2021] [Revised: 09/11/2021] [Accepted: 09/26/2021] [Indexed: 11/02/2022]
Abstract
BACKGROUND Posttraumatic stress disorder (PTSD) develops consequent to complex gene-by-environment interactions beyond the precipitating trauma. To date, however, no known study has used a prospective design to examine how polygenic risk scores (PRSs) interact with social-environmental factors such as attachment style to predict PTSD development. METHODS PRSs were derived from a genome-wide association study of PTSD symptoms (N = 186,689; Million Veteran Program cohort). We evaluated combined effects of PRS and attachment style in predicting incident PTSD in a 7-year, nationally representative cohort of trauma-exposed, European-American U.S. military veterans without PTSD (N = 1083). We also conducted multivariate gene-by-environment interaction and drug repositioning analyses to identify loci that interact with multiple environmental factors and potential pharmacotherapies that may be repurposed for this disorder. RESULTS Veterans with higher PTSD PRS were more likely to have an incident-positive screen for PTSD over 7 years. A gene-by-environment interaction was also observed, such that higher PRS only predicted incident PTSD in veterans with an insecure attachment style and not those with a secure attachment style. At an individual locus level, the strongest gene-by-environment interaction was observed for the rs4702 variant of the FURIN gene with cumulative lifetime trauma burden. Drug repositioning revealed that genes implicated in PRS are perturbated by the drug doxylamine. CONCLUSIONS Attachment style moderates polygenic risk for the development of PTSD in European-American veterans. These findings may inform PTSD prevention and treatment for veterans with high polygenic risk for PTSD and suggest a potential pharmacotherapeutic target for risk genes moderated by social-environmental factors.
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Affiliation(s)
- Amanda J F Tamman
- Department of Psychology, St John's University, Queens, New York; Mood and Anxiety Disorders Program, Baylor College of Medicine, Houston, Texas.
| | - Frank R Wendt
- Department of Psychiatry, Yale School of Medicine, New Haven, Connecticut; VA Connecticut Healthcare System, West Haven, Connecticut
| | - Gita A Pathak
- Department of Psychiatry, Yale School of Medicine, New Haven, Connecticut; VA Connecticut Healthcare System, West Haven, Connecticut
| | - John H Krystal
- Department of Psychiatry, Yale School of Medicine, New Haven, Connecticut; Clinical Neurosciences Division, National Center for PTSD, West Haven, Connecticut
| | - Steven M Southwick
- Department of Psychiatry, Yale School of Medicine, New Haven, Connecticut
| | - Lauren M Sippel
- Executive Division, National Center for PTSD, White River Junction, Vermont; Department of Psychiatry, Geisel School of Medicine at Dartmouth, Hanover, New Hampshire
| | - Joel Gelernter
- Department of Psychiatry, Yale School of Medicine, New Haven, Connecticut; VA Connecticut Healthcare System, West Haven, Connecticut
| | - Renato Polimanti
- Department of Psychiatry, Yale School of Medicine, New Haven, Connecticut; VA Connecticut Healthcare System, West Haven, Connecticut
| | - Robert H Pietrzak
- Department of Psychiatry, Yale School of Medicine, New Haven, Connecticut; Department of Social and Behavioral Sciences, Yale School of Public Health, New Haven, Connecticut; Clinical Neurosciences Division, National Center for PTSD, West Haven, Connecticut
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8
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Wendt FR, Warrier V, Pathak GA, Koenen KC, Stein MB, Krystal JH, Pietrzak RH, Gelernter J, Goldfarb EV, Baron-Cohen S, Polimanti R. Polygenic scores for empathy associate with posttraumatic stress severity in response to certain traumatic events. Neurobiol Stress 2022; 17:100439. [PMID: 35242894 PMCID: PMC8881478 DOI: 10.1016/j.ynstr.2022.100439] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2021] [Revised: 01/27/2022] [Accepted: 02/18/2022] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND Posttraumatic stress disorder (PTSD) is triggered by environmental stressors. Empathy may predispose an individual to respond to life events differently if high empathizers are emotionally more sensitive to trauma. For the first time, we test this hypothesis using genetic information. METHODS We applied polygenic scoring (PGS) to investigate the shared genetics linking empathy (measured using the Empathy Quotient (EQ), a self-report measure of empathy; N = 46,861) and PTSD symptom severity (measured using the 6-item PTSD Checklist 6-item (PCL-6)) in the UK Biobank (N = 126,219). Follow-up analyses were performed in the context of (1) experiencing any of 16 potential traumas, (2) the total number of traumas endorsed, and (3) the context of trauma. Autism, depression, generalized anxiety, and PCL-17 PGS were included as covariates to verify the specificity of the effect. RESULTS EQPGS associated with PCL-6 (R 2 = 0.012%, P = 9.35 × 10-5). This effect remained significant after accounting for autism, depression, PTSD, and anxiety PGS but was observed only in those who endorsed experiencing at least one traumatic event. EQPGS showed the strongest effect on PCL-6 (β = 2.32, s.e. = 0.762, P = 0.002) among those who endorsed childhood neglect/abuse (felt hated as a child). With respect to case status, the highest probability of PTSD was 17.93% and 10.04% for those who endorsed "feeling hated as a child" and those who did not, respectively (P diff = 0.011; Cohen's d = 1.951, 95%CI 1.70-2.20). CONCLUSIONS A genetic predisposition to higher empathy, which may index greater emotional sensitivity, predisposes an individual to more severe PTSD symptoms, especially after early-life adversity.
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Affiliation(s)
- Frank R. Wendt
- Department of Psychiatry, Yale School of Medicine, New Haven, CT, USA
- VA CT Healthcare System, West Haven, CT, USA
| | - Varun Warrier
- Autism Research Centre, Department of Psychiatry, University of Cambridge, Cambridge, UK
| | - Gita A. Pathak
- Department of Psychiatry, Yale School of Medicine, New Haven, CT, USA
- VA CT Healthcare System, West Haven, CT, USA
| | - Karestan C. Koenen
- Broad Institute of MIT and Harvard, Stanley Center for Psychiatry Research, Cambridge, MA, USA
- Massachusetts General Hospital, Psychiatry and Neurodevelopmental Genetics Unit (PNGU), Boston, MA, USA
- Harvard School of Public Health, Department of Epidemiology, Boston, MA, USA
| | - Murray B. Stein
- Department of Psychiatry, University of California San Diego, La Jolla, CA, USA
- Veterans Affairs San Diego Healthcare System, San Diego, CA, USA
- Herbert Wertheim School of Public Health and Human Longevity Science, University of California San Diego, La Jolla, CA, USA
| | - John H. Krystal
- Department of Psychiatry, Yale School of Medicine, New Haven, CT, USA
- National Center for PTSD, VA Connecticut Healthcare System, West Haven, CT, USA
| | - Robert H. Pietrzak
- Department of Psychiatry, Yale School of Medicine, New Haven, CT, USA
- National Center for PTSD, VA Connecticut Healthcare System, West Haven, CT, USA
- Department of Social and Behavioral Sciences, Yale School of Public Health, New Haven, CT, USA
| | - Joel Gelernter
- Department of Psychiatry, Yale School of Medicine, New Haven, CT, USA
- VA CT Healthcare System, West Haven, CT, USA
- Department of Genetics, Yale School of Medicine, New Haven, CT, USA
- Department of Neuroscience, Yale School of Medicine, New Haven, CT, USA
| | - Elizabeth V. Goldfarb
- Department of Psychiatry, Yale School of Medicine, New Haven, CT, USA
- Yale Stress Center, Yale University School of Medicine, New Haven, CT, USA
- Department of Psychology, Yale School of Medicine, New Haven, CT, USA
| | - Simon Baron-Cohen
- Autism Research Centre, Department of Psychiatry, University of Cambridge, Cambridge, UK
| | - Renato Polimanti
- Department of Psychiatry, Yale School of Medicine, New Haven, CT, USA
- VA CT Healthcare System, West Haven, CT, USA
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9
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Carvalho CM, Coimbra BM, Xavier G, Bugiga AVG, Fonseca T, Olff M, Polimanti R, Mello AF, Ota VK, Mello MF, Belangero SI. Shorter Telomeres Related to Posttraumatic Stress Disorder Re-experiencing Symptoms in Sexually Assaulted Civilian Women. Front Psychiatry 2022; 13:835783. [PMID: 35664481 PMCID: PMC9161278 DOI: 10.3389/fpsyt.2022.835783] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/14/2021] [Accepted: 04/19/2022] [Indexed: 12/02/2022] Open
Abstract
Telomeres are short tandem repeats of "TTAGGG" that protect the chromosome ends from deterioration or fusion of chromosomes. Their repeat length shortens with cell division acting as a biomarker of cellular aging. Traumatic stress events during adulthood or childhood have been associated with posttraumatic stress disorder (PTSD) and short leukocyte telomere length (LTL). This study investigated whether LTL was associated with PTSD in a Brazilian sample of sexually assaulted civilian women at two time points: baseline and 1-year follow-up. At baseline, we assessed 64 women with PTSD following sexual assault (cases) and 60 women with no previous history of sexual trauma or mental disorders (healthy controls - HC). At follow-up visit, 13 persistent PTSD cases, 11 HCs, and 11 PTSD remitters patients were evaluated. PTSD diagnosis and severity were assessed using Mini International Neuropsychiatric Interview (Diagnostic and Statistical Manual of Mental Disorders III/IV criteria) and Clinician-Administered PTSD Scale for DSM-5 (CAPS-5), respectively. LTL was measured using multiplex real-time polymerase chain reaction (PCR). In the baseline analysis, we observed that LTL was associated with re-experiencing symptoms (B = -0.16; confidence interval (CI) 95% = -0.027--0.005; Bonferroni-adjusted p-value = 0.02), but no association was observed between other PTSD symptoms and LTL. In the longitudinal analysis, telomere shortening was no longer observed in patients with PTSD and PTSD remitters. In conclusion, our findings indicate that shorter baseline LTL is associated with early stage of PTSD re-experiencing symptoms in recently sexually assaulted women.
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Affiliation(s)
- Carolina Muniz Carvalho
- Department of Psychiatry, Universidade Federal de São Paulo, São Paulo, Brazil.,LiNC - Laboratory of Integrative Neuroscience, Universidade Federal de São Paulo, São Paulo, Brazil
| | - Bruno Messina Coimbra
- Department of Psychiatry, Universidade Federal de São Paulo, São Paulo, Brazil.,Department of Psychiatry, University of Amsterdam, Amsterdam Public Health Research Institute and Amsterdam Neuroscience Research Institute, Amsterdam, Netherlands
| | - Gabriela Xavier
- LiNC - Laboratory of Integrative Neuroscience, Universidade Federal de São Paulo, São Paulo, Brazil.,Genetics Division of Department of Morphology, Genetics of Universidade Federal de São Paulo, São Paulo, Brazil
| | - Amanda V G Bugiga
- LiNC - Laboratory of Integrative Neuroscience, Universidade Federal de São Paulo, São Paulo, Brazil.,Genetics Division of Department of Morphology, Genetics of Universidade Federal de São Paulo, São Paulo, Brazil
| | - Tamiris Fonseca
- Department of Psychiatry, Universidade Federal de São Paulo, São Paulo, Brazil.,LiNC - Laboratory of Integrative Neuroscience, Universidade Federal de São Paulo, São Paulo, Brazil
| | - Miranda Olff
- Department of Psychiatry, University of Amsterdam, Amsterdam Public Health Research Institute and Amsterdam Neuroscience Research Institute, Amsterdam, Netherlands.,ARQ National Psychotrauma Centre, Diemen, Netherlands
| | - Renato Polimanti
- Department of Psychiatry, Yale School of Medicine, VA CT Healthcare Center, West Haven, CT, United States
| | - Andrea Feijó Mello
- Department of Psychiatry, Universidade Federal de São Paulo, São Paulo, Brazil
| | - Vanessa Kiyomi Ota
- LiNC - Laboratory of Integrative Neuroscience, Universidade Federal de São Paulo, São Paulo, Brazil.,Genetics Division of Department of Morphology, Genetics of Universidade Federal de São Paulo, São Paulo, Brazil
| | - Marcelo Feijó Mello
- Department of Psychiatry, Universidade Federal de São Paulo, São Paulo, Brazil
| | - Sintia Iole Belangero
- Department of Psychiatry, Universidade Federal de São Paulo, São Paulo, Brazil.,LiNC - Laboratory of Integrative Neuroscience, Universidade Federal de São Paulo, São Paulo, Brazil.,Genetics Division of Department of Morphology, Genetics of Universidade Federal de São Paulo, São Paulo, Brazil
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10
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Asch RH, Esterlis I, Wendt FR, Kachadourian L, Southwick SM, Gelernter J, Polimanti R, Pietrzak RH. Polygenic risk for traumatic loss-related PTSD in US military veterans: Protective effect of secure attachment style. World J Biol Psychiatry 2021; 22:792-799. [PMID: 33821766 PMCID: PMC8925016 DOI: 10.1080/15622975.2021.1907721] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/29/2020] [Revised: 12/15/2020] [Accepted: 12/28/2020] [Indexed: 12/18/2022]
Abstract
OBJECTIVES To examine whether attachment style moderates the relationship between polygenic risk scores (PRS) for posttraumatic stress disorder (PTSD) re-experiencing (PTSDREX) symptoms and the severity of and positive screen for traumatic loss-related PTSD. METHODS Data were analysed from 631 US veterans who endorsed 'unexpected death of a loved one' as their 'worst' traumatic event. Multivariable models evaluated the association between PRS for PTSDREX, attachment style, and their interaction in predicting severity and positive screen for PTSD. A gene enrichment analysis was conducted to identify possible molecular mechanisms underlying the association between PTSDREX PRS and PTSD. RESULTS PTSDREX PRS (β = 0.17; odds ratio [OR] = 1.85), attachment style (β= -0.33; OR = 0.14), and PTSDREX PRS × attachment style interaction (β= -0.12; OR = 0.53) were significant predictors of the severity and positive screen for PTSD. The most significant gene set detected was the gene ontology (GO) cellular component podosome set (GO:0002102, p < 3.95 × 10-5). CONCLUSIONS Having a secure attachment style may help mitigate polygenic risk for developing traumatic loss-related PTSD in US veterans. Podosomes, which are implicated in inflammatory and neuroplasticity processes, may contribute to the genetic liability to developing loss-related PTSD. Psychological treatments targeting attachment security may help mitigate increased polygenic risk for loss-related PTSD in this population.
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Affiliation(s)
- Ruth H. Asch
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA
| | - Irina Esterlis
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA
- Clinical Neurosciences Division, U.S. Department of Veterans Affairs National Center for Posttraumatic Stress Disorder, VA Connecticut Healthcare System, West Haven, CT, USA
| | - Frank R. Wendt
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA
- Clinical Neurosciences Division, U.S. Department of Veterans Affairs National Center for Posttraumatic Stress Disorder, VA Connecticut Healthcare System, West Haven, CT, USA
| | - Lorig Kachadourian
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA
- Clinical Neurosciences Division, U.S. Department of Veterans Affairs National Center for Posttraumatic Stress Disorder, VA Connecticut Healthcare System, West Haven, CT, USA
| | - Steven M. Southwick
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA
- Clinical Neurosciences Division, U.S. Department of Veterans Affairs National Center for Posttraumatic Stress Disorder, VA Connecticut Healthcare System, West Haven, CT, USA
| | - Joel Gelernter
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA
- Clinical Neurosciences Division, U.S. Department of Veterans Affairs National Center for Posttraumatic Stress Disorder, VA Connecticut Healthcare System, West Haven, CT, USA
| | - Renato Polimanti
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA
- Clinical Neurosciences Division, U.S. Department of Veterans Affairs National Center for Posttraumatic Stress Disorder, VA Connecticut Healthcare System, West Haven, CT, USA
| | - Robert H. Pietrzak
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA
- Clinical Neurosciences Division, U.S. Department of Veterans Affairs National Center for Posttraumatic Stress Disorder, VA Connecticut Healthcare System, West Haven, CT, USA
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11
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Muniz Carvalho C, Wendt FR, Pathak GA, Maihofer AX, Stein DJ, Sumner JA, Hemmings SM, Nievergelt CM, Koenen KC, Gelernter J, Belangero SI, Polimanti R. Disentangling sex differences in the shared genetic architecture of posttraumatic stress disorder, traumatic experiences, and social support with body size and composition. Neurobiol Stress 2021; 15:100400. [PMID: 34611531 PMCID: PMC8477211 DOI: 10.1016/j.ynstr.2021.100400] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2021] [Revised: 09/04/2021] [Accepted: 09/14/2021] [Indexed: 11/03/2022] Open
Abstract
There is a well-known association of traumatic experiences and posttraumatic stress disorder (PTSD) with body size and composition, including consistent differences between sexes. However, the biology underlying these associations is unclear. To understand the genetic underpinnings of this complex relationship, we investigated genome-wide datasets informative of African and European ancestries from the Psychiatric Genomic Consortium, the UK Biobank, the GIANT Consortium, and the Million Veteran Program. We used genome-wide association statistics to estimate sex-specific genetic correlations (r g ) of traumatic experiences, social support, and PTSD with multiple anthropometric traits. After multiple testing corrections (false discovery rate, FDR q < 0.05), we observed 58 significant r g relationships in females (e.g., childhood physical abuse and body mass index, BMI r g = 0.245, p = 3.88 × 10-10) and 21 significant r g relationships in males (e.g., been involved in combat or exposed to warzone and leg fat percentage; r g = 0.405, p = 4.42 × 10-10). We performed causal inference analyses of these genetic overlaps using Mendelian randomization and latent causal variable approaches. Multiple female-specific putative causal relationships were observed linking body composition/size with PTSD (e.g., leg fat percentage→PTSD; beta = 0.319, p = 3.13 × 10-9), traumatic experiences (e.g., childhood physical abuse→waist circumference; beta = 0.055, p = 5.07 × 10-4), and childhood neglect (e.g., "someone to take you to doctor when needed as a child"→BMI; beta = -0.594, p = 1.09 × 10-5). In males, we observed putative causal effects linking anthropometric-trait genetic liabilities to traumatic experiences (e.g., BMI→childhood physical abuse; beta = 0.028, p = 8.19 × 10-3). Some of these findings were replicated in individuals of African descent although the limited sample size available did not permit us to conduct a sex-stratified analysis in this ancestry group. In conclusion, our findings provide insights regarding sex-specific causal networks linking anthropometric traits to PTSD, traumatic experiences, and social support.
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Affiliation(s)
- Carolina Muniz Carvalho
- Department of Psychiatry, Yale School of Medicine and VA CT Healthcare Center, West Haven, CT, 06516, USA
- Department of Psychiatry, Universidade Federal de São Paulo (UNIFESP), São Paulo, SP, Brazil
| | - Frank R. Wendt
- Department of Psychiatry, Yale School of Medicine and VA CT Healthcare Center, West Haven, CT, 06516, USA
| | - Gita A. Pathak
- Department of Psychiatry, Yale School of Medicine and VA CT Healthcare Center, West Haven, CT, 06516, USA
| | - Adam X. Maihofer
- Department of Psychiatry, School of Medicine, University of California, San Diego, La Jolla, CA, USA
- Center of Excellence for Stress and Mental Health, Veterans Affairs San Diego Healthcare System, San Diego, CA, USA
| | - Dan J. Stein
- MRC Unit on Risk & Resilience in Mental Disorders, Department of Psychiatry and Neuroscience Institute, University of Cape Town, Cape Town, South Africa
| | - Jennifer A. Sumner
- Department of Psychology, University of California, Los Angeles, CA, USA
| | - Sian M.J. Hemmings
- Department of Psychiatry, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
| | - Caroline M. Nievergelt
- Department of Psychiatry, School of Medicine, University of California, San Diego, La Jolla, CA, USA
- Center of Excellence for Stress and Mental Health, Veterans Affairs San Diego Healthcare System, San Diego, CA, USA
| | - Karestan C. Koenen
- Department of Epidemiology, Harvard School of Public Health, Boston, MA, United States
| | - Joel Gelernter
- Department of Psychiatry, Yale School of Medicine and VA CT Healthcare Center, West Haven, CT, 06516, USA
- Departments of Genetics and Neuroscience, Yale University School of Medicine, New Haven, CT, 06510, USA
| | - Sintia I. Belangero
- Department of Psychiatry, Universidade Federal de São Paulo (UNIFESP), São Paulo, SP, Brazil
- Genetics Division, Department of Morphology and Genetics, Universidade Federal de São Paulo (UNIFESP), São Paulo, SP, Brazil
| | - Renato Polimanti
- Department of Psychiatry, Yale School of Medicine and VA CT Healthcare Center, West Haven, CT, 06516, USA
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12
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Abstract
Posttraumatic stress disorder (PTSD) is a complex mental disorder afflicting approximately 7% of the population. The diverse number of traumatic events and the wide array of symptom combinations leading to PTSD diagnosis contribute substantial heterogeneity to studies of the disorder. Genomic and complimentary-omic investigations have rapidly increased our understanding of the heritable risk for PTSD. In this review, we emphasize the contributions of genome-wide association, epigenome-wide association, transcriptomic, and neuroimaging studies to our understanding of PTSD etiology. We also discuss the shared risk between PTSD and other complex traits derived from studies of causal inference, co-expression, and brain morphological similarities. The investigations completed so far converge on stark contrasts in PTSD risk between sexes, partially attributed to sex-specific prevalence of traumatic experiences with high conditional risk of PTSD. To further understand PTSD biology, future studies should focus on detecting risk for PTSD while accounting for substantial cohort-level heterogeneity (e.g. civilian v. combat-exposed PTSD cases or PTSD risk among cases exposed to specific traumas), expanding ancestral diversity among study cohorts, and remaining cognizant of how these data influence social stigma associated with certain traumatic events among underrepresented minorities and/or high-risk populations.
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Affiliation(s)
- Renato Polimanti
- Department of Psychiatry, Yale University School of Medicine, West Haven, CT, USA
- Veterans Administration Connecticut Healthcare System, West Haven, CT, USA
| | - Frank R Wendt
- Department of Psychiatry, Yale University School of Medicine, West Haven, CT, USA
- Veterans Administration Connecticut Healthcare System, West Haven, CT, USA
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13
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Polygenic risk scoring to assess genetic overlap and protective factors influencing posttraumatic stress, depression, and chronic pain after motor vehicle collision trauma. Transl Psychiatry 2021; 11:359. [PMID: 34226500 PMCID: PMC8257703 DOI: 10.1038/s41398-021-01486-5] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/14/2020] [Revised: 06/07/2021] [Accepted: 06/16/2021] [Indexed: 12/16/2022] Open
Abstract
Posttraumatic stress (PTS), depressive symptoms (DS), and musculoskeletal pain (MSP) are common sequelae of trauma exposure. Although these adverse posttraumatic neuropsychiatric sequelae (APNS) are often studied separately, clinical comorbidity is high. In a cohort of European American motor vehicle collision (MVC) trauma survivors (n = 781), substantial PTS (≥33, IES-R), DS (≥26, CES-D), and MSP (≥4, 0-10 NRS) were identified via a 6-month survey. Genetic risk was estimated using polygenic risk scores (PRSs) calculated from the largest available GWAS datasets of PTSD, MDD, and back pain. We then assessed comorbidity and genetic risk influence for developing chronic PTS, DS, and MSP after MVC. Secondary analyses explored whether common social determinants of health ameliorate genetic vulnerability. We found that 6 months after MVC, nearly half 357/781 (46%) of the participants had substantial PTS, DS, and/or MSP, and overlap was common (PTS + MSP (23%), DS + MSP (18%), PTS + DS (12%)). Genetic risk predicted post-MVC outcomes. PTSD-PRSs predicted PTS and DS (R2 = 2.21% and 2.77%, padj < 0.01), MDD-PRSs predicted DS and MSP (R2 = 1.89%, padj < 0.01) and 0.79%, padj < 0.05), and back pain-PRS predicted MSP (R2 = 1.49%, padj < 0.01). Individuals in the highest quintile of PTSD-PRSs had 2.8 and 3.5 times the odds of developing PTS and DS vs. the lowest quintile (95% CI = 1.39-5.75 and 1.58-7.76). Among these high-risk individuals, those living in non-disadvantaged neighborhoods and with college education had 47% (p = 0.048) and 52% (p = 0.04) less risk of developing PTS, and those with high social support had 60% (p = 0.008) less risk of developing DS. Overall, genetic factors influence the risk of APNS after MVC, genetic risk of distinct APNS are overlapping, and specific social determinants greatly augment genetic risk of APNS development after MVC.
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14
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Wendt FR, Pathak GA, Levey DF, Nuñez YZ, Overstreet C, Tyrrell C, Adhikari K, De Angelis F, Tylee DS, Goswami A, Krystal JH, Abdallah CG, Stein MB, Kranzler HR, Gelernter J, Polimanti R. Sex-stratified gene-by-environment genome-wide interaction study of trauma, posttraumatic-stress, and suicidality. Neurobiol Stress 2021; 14:100309. [PMID: 33665242 PMCID: PMC7905234 DOI: 10.1016/j.ynstr.2021.100309] [Citation(s) in RCA: 26] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2020] [Revised: 01/20/2021] [Accepted: 02/10/2021] [Indexed: 12/27/2022] Open
Abstract
Epidemiologic studies recognize that trauma and posttraumatic stress are associated with heightened suicidal behavior severity, yet examination of these associations from a genetic perspective is limited. We performed a multivariate gene-by-environment genome-wide interaction study (GEWIS) of suicidality in 123,633 individuals using a covariance matrix based on 26 environments related to traumatic experiences, posttraumatic stress, social support, and socioeconomic status. We discovered five suicidality risk loci, including the male-associated rs2367967 (CWC22), which replicated in an independent cohort. All GEWIS-significant loci exhibited interaction effects where at least 5% of the sample had environmental profiles conferring opposite SNP effects from the majority. We identified PTSD as a primary driving environment for GxE at suicidality risk loci. The male suicidality GEWIS was enriched for three middle-temporal-gyrus inhibitory neuron transcriptomic profiles: SCUBE- and PVALB-expressing cells (β = 0.028, p = 3.74 × 10-4), OPRM1-expressing cells (β = 0.030, p = 0.001), and SPAG17-expressing cells (β = 0.029, p = 9.80 × 10-4). Combined with gene-based analyses (CNTN5 p association = 2.38 × 10-9, p interaction = 1.51 × 10-3; PSMD14 p association = 2.04 × 10-7, p interaction = 7.76 × 10-6; HEPACAM p association = 2.43 × 10-6, p interaction = 3.82 × 10-7) including information about brain chromatin interaction profiles (UBE2E3 in male neuron p = 1.07 × 10-5), our GEWIS points to extracellular matrix biology and synaptic plasticity as biological interactors with the effects of potentially modifiable lifetime traumatic experiences on genetic risk for suicidality. Characterization of molecular basis for the effects of traumatic experience and posttraumatic stress on risk of suicidal behaviors may help to identify novel targets for which more effective treatments can be developed for use in high-risk populations.
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Affiliation(s)
- Frank R. Wendt
- Department of Psychiatry, Yale School of Medicine, New Haven, CT, 06510, USA
- VA CT Healthcare System, West Haven, CT, 06520, USA
| | - Gita A. Pathak
- Department of Psychiatry, Yale School of Medicine, New Haven, CT, 06510, USA
- VA CT Healthcare System, West Haven, CT, 06520, USA
| | - Daniel F. Levey
- Department of Psychiatry, Yale School of Medicine, New Haven, CT, 06510, USA
- VA CT Healthcare System, West Haven, CT, 06520, USA
| | - Yaira Z. Nuñez
- Department of Psychiatry, Yale School of Medicine, New Haven, CT, 06510, USA
- VA CT Healthcare System, West Haven, CT, 06520, USA
| | - Cassie Overstreet
- Department of Psychiatry, Yale School of Medicine, New Haven, CT, 06510, USA
- VA CT Healthcare System, West Haven, CT, 06520, USA
- National Center for Posttraumatic Stress Disorder, Clinical Neurosciences Division, West Haven CT, 06520, USA
| | - Chelsea Tyrrell
- Department of Psychiatry, Yale School of Medicine, New Haven, CT, 06510, USA
- VA CT Healthcare System, West Haven, CT, 06520, USA
| | - Keyrun Adhikari
- Department of Psychiatry, Yale School of Medicine, New Haven, CT, 06510, USA
- VA CT Healthcare System, West Haven, CT, 06520, USA
| | - Flavio De Angelis
- Department of Psychiatry, Yale School of Medicine, New Haven, CT, 06510, USA
- VA CT Healthcare System, West Haven, CT, 06520, USA
| | - Daniel S. Tylee
- Department of Psychiatry, Yale School of Medicine, New Haven, CT, 06510, USA
- VA CT Healthcare System, West Haven, CT, 06520, USA
| | - Aranyak Goswami
- Department of Psychiatry, Yale School of Medicine, New Haven, CT, 06510, USA
- VA CT Healthcare System, West Haven, CT, 06520, USA
| | - John H. Krystal
- Department of Psychiatry, Yale School of Medicine, New Haven, CT, 06510, USA
| | - Chadi G. Abdallah
- Department of Psychiatry, Yale School of Medicine, New Haven, CT, 06510, USA
- VA CT Healthcare System, West Haven, CT, 06520, USA
| | - Murray B. Stein
- Psychiatry Service, VA San Diego Healthcare System, San Diego, CA, USA
- Departments of Psychiatry and Family Medicine & Public Health, University of California San Diego, La Jolla, CA, USA
| | - Henry R. Kranzler
- University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, 19104, USA
- Crescenz Veterans Affairs Medical Center, Philadelphia, PA, 19104, USA
| | - Joel Gelernter
- Department of Psychiatry, Yale School of Medicine, New Haven, CT, 06510, USA
- VA CT Healthcare System, West Haven, CT, 06520, USA
- Departments of Genetics and Neuroscience, Yale University School of Medicine, New Haven, CT, 06510, USA
| | - Renato Polimanti
- Department of Psychiatry, Yale School of Medicine, New Haven, CT, 06510, USA
- VA CT Healthcare System, West Haven, CT, 06520, USA
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