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Tam CC, Li L, Kosai S, Duhart Clarke SE, Ehlers CL, Karriker-Jaffe KJ. Protective effects of ethnic enclaves: Testing pathways to alcohol use and use disorders in Mexican American young adults. AMERICAN JOURNAL OF COMMUNITY PSYCHOLOGY 2024. [PMID: 38880996 DOI: 10.1002/ajcp.12756] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/28/2023] [Revised: 01/22/2024] [Accepted: 04/24/2024] [Indexed: 06/18/2024]
Abstract
Ethnic enclave residence is associated with decreased risk for drinking and related problems, but less is known about the mechanisms that explain this association. Informed by theories of social control, we used a multilevel framework to examine whether negative attitudes toward drinking mediated associations between ethnic enclave residence (i.e., neighborhood linguistic isolation) and alcohol outcomes among Mexican American young adults (N = 628) in Southern California. Model 1 assessed mediation effects in the pathways from linguistic isolation to current drinking and alcohol use disorder (AUD). Model 2 adjusted for parental drinking attitudes and neighborhood alcohol availability. There were differential associations by gender in direct effects of linguistic isolation and negative drinking attitudes on both drinking and AUD. Among women only, linguistic isolation was related to greater abstinence and decreased AUD after accounting for social control proxies of parent attitudes and alcohol availability. Young adults' own drinking attitudes did not mediate relationships between linguistic isolation and alcohol outcomes. This study offers evidence on the importance of disaggregating Hispanic national groups by gender to uncover social mechanisms within ethnic enclave settings for tailored supports in reducing risk of drinking and alcohol-related harms.
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Affiliation(s)
- Christina C Tam
- Alcohol Research Group, Public Health Institute, Emeryville, California, USA
| | - Libo Li
- Alcohol Research Group, Public Health Institute, Emeryville, California, USA
| | - Sam Kosai
- Health Practice Area, RTI International, Berkeley, California, USA
| | | | - Cindy L Ehlers
- Department of Neuroscience, Scripps Research Institute, San Diego, California, USA
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Shevorykin A, Hyland BM, Robles D, Ji M, Vantucci D, Bensch L, Thorner H, Marion M, Liskiewicz A, Carl E, Ostroff JS, Sheffer CE. Tobacco use, trauma exposure and PTSD: a systematic review. Health Psychol Rev 2024:1-32. [PMID: 38711288 DOI: 10.1080/17437199.2024.2330896] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/13/2022] [Accepted: 03/11/2024] [Indexed: 05/08/2024]
Abstract
Tobacco use remains one of the most significant preventable public health problems globally and is increasingly concentrated among vulnerable groups, including those with trauma exposure or diagnosed with PTSD. The goal of this systematic review was to update and extend previous reviews. Of the 7224 publications that met the initial criteria, 267 were included in the review. Summary topic areas include conceptual frameworks for the relation between trauma or PTSD and tobacco use; associations between trauma exposure or PTSD and tobacco use; number and type of trauma exposures and tobacco use; PTSD symptoms and tobacco use; Treatment-related studies; and the examination of causal relations. Evidence continues to indicate that individuals exposed to trauma or diagnosed with PTSD are more likely to use tobacco products, more nicotine dependent and less likely to abstain from tobacco even when provided evidence-based treatments than individuals without trauma. The most commonly cited causal association proposed was use of tobacco for self-regulation of negative affect associated with trauma. A small proportion of the studies addressed causality and mechanisms of action. Future work should incorporate methodological approaches and measures from which we can draw causal conclusions and mechanisms to support the development of viable therapeutic targets.
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Affiliation(s)
- Alina Shevorykin
- Department of Health Behavior, Roswell Park Comprehensive Cancer Center, Buffalo, NY, USA
| | - Bridget M Hyland
- Department of Health Behavior, Roswell Park Comprehensive Cancer Center, Buffalo, NY, USA
| | - Daniel Robles
- Department of Psychology, Faculty of Science, University of Alberta, Edmonton, Canada
| | - Mengjia Ji
- Department of Psychology, The City College of New York (CUNY), New York, NY, USA
| | - Darian Vantucci
- Department of Health Behavior, Roswell Park Comprehensive Cancer Center, Buffalo, NY, USA
| | - Lindsey Bensch
- Department of Health Behavior, Roswell Park Comprehensive Cancer Center, Buffalo, NY, USA
| | - Hannah Thorner
- Department of Health Behavior, Roswell Park Comprehensive Cancer Center, Buffalo, NY, USA
| | - Matthew Marion
- Department of Health Behavior, Roswell Park Comprehensive Cancer Center, Buffalo, NY, USA
| | - Amylynn Liskiewicz
- Department of Health Behavior, Roswell Park Comprehensive Cancer Center, Buffalo, NY, USA
| | - Ellen Carl
- Department of Health Behavior, Roswell Park Comprehensive Cancer Center, Buffalo, NY, USA
| | - Jamie S Ostroff
- Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Christine E Sheffer
- Department of Health Behavior, Roswell Park Comprehensive Cancer Center, Buffalo, NY, USA
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Lee CS, Nalven T, Hai A, Pinedo M, Lopez V, Morris M, Delva J, Cano M. The relationship between discrimination, alcohol use severity, and PTSD symptoms among Latinx heavy drinkers. JOURNAL OF SUBSTANCE USE AND ADDICTION TREATMENT 2024; 159:209263. [PMID: 38103830 PMCID: PMC10947868 DOI: 10.1016/j.josat.2023.209263] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/27/2023] [Revised: 11/01/2023] [Accepted: 12/11/2023] [Indexed: 12/19/2023]
Abstract
INTRODUCTION Discrimination is linked to alcohol use severity among Latinx adults, who also show high prevalence rates of PTSD compared to non-Latinx adults. We know little about whether PTSD symptoms affects the relationship between discrimination and alcohol use severity. We hypothesized that the association between discrimination and alcohol use severity might differ by level of PTSD symptom severity. METHODS This is a secondary cross-sectional analysis of data collected at baseline from a completed randomized clinical trial testing the relative efficacy of a culturally adapted motivational interview designed to address discrimination and drinking behavior against an unadapted motivational interview for Latinx adults. Eligible participants screened positive for the NIAAA Single Alcohol Screening Question for heavy drinking days, identified as Latinx, and were 18-65 years old. We assessed the Everyday Discrimination Scale, Primary Care PC-PTSD screener, Alcohol Use Disorder Identification Test, and the Short Acculturation Scale for Hispanics. The study analyzed the main and interactive effects of discrimination and PTSD symptoms on alcohol use severity, while controlling for age, sex, household income, and acculturation. RESULTS After controlling for covariates in model 2, the interaction of discrimination and PTSD symptoms was significantly related to alcohol use severity. Simple slopes analysis indicated that discrimination was positively related to alcohol use severity among those with high (1 SD above the mean) but not low (1 SD below the mean) levels of PTSD symptoms. CONCLUSIONS Evidence suggests that the experiences of discrimination were associated with alcohol use severity among those who reported more PTSD symptoms. Specifically, discrimination may have a stronger effect on alcohol use severity among Latinx adults who report more PTSD symptoms. Screening Latinx adults for heavy drinking days, discrimination, and PTSD symptoms is clinically important. Culturally adapted alcohol interventions that target discrimination may be particularly effective for Latinx individuals with more PTSD symptoms.
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Affiliation(s)
- Christina S Lee
- Boston University School of Social Work, 264 Bay State Road, Room 354, Boston, MA 02215, United States of America.
| | - Tessa Nalven
- Dept. of Psychology, University of Rhode Island, United States of America
| | - Audrey Hai
- Tulane University School of Social Work, United States of America
| | - Miguel Pinedo
- Dept of Health Sciences, University of Texas at Austin, United States of America
| | | | - Melanie Morris
- Boston University School of Social Work, United States of America
| | - Jorge Delva
- Boston University School of Social Work, United States of America
| | - Miguel Cano
- Dept. of Epidemiology, University of Texas Southwestern, United States of America
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Peng Q, Gilder DA, Bernert RA, Karriker-Jaffe KJ, Ehlers CL. Genetic factors associated with suicidal behaviors and alcohol use disorders in an American Indian population. Mol Psychiatry 2024; 29:902-913. [PMID: 38177348 PMCID: PMC11176067 DOI: 10.1038/s41380-023-02379-3] [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: 05/18/2023] [Revised: 12/12/2023] [Accepted: 12/13/2023] [Indexed: 01/06/2024]
Abstract
American Indians (AI) demonstrate the highest rates of both suicidal behaviors (SB) and alcohol use disorders (AUD) among all ethnic groups in the US. Rates of suicide and AUD vary substantially between tribal groups and across different geographical regions, underscoring a need to delineate more specific risk and resilience factors. Using data from over 740 AI living within eight contiguous reservations, we assessed genetic risk factors for SB by investigating: (1) possible genetic overlap with AUD, and (2) impacts of rare and low-frequency genomic variants. Suicidal behaviors included lifetime history of suicidal thoughts and acts, including verified suicide deaths, scored using a ranking variable for the SB phenotype (range 0-4). We identified five loci significantly associated with SB and AUD, two of which are intergenic and three intronic on genes AACSP1, ANK1, and FBXO11. Nonsynonymous rare and low-frequency mutations in four genes including SERPINF1 (PEDF), ZNF30, CD34, and SLC5A9, and non-intronic rare and low-frequency mutations in genes OPRD1, HSD17B3 and one lincRNA were significantly associated with SB. One identified pathway related to hypoxia-inducible factor (HIF) regulation, whose 83 nonsynonymous rare and low-frequency variants on 10 genes were significantly linked to SB as well. Four additional genes, and two pathways related to vasopressin-regulated water metabolism and cellular hexose transport, also were strongly associated with SB. This study represents the first investigation of genetic factors for SB in an American Indian population that has high risk for suicide. Our study suggests that bivariate association analysis between comorbid disorders can increase statistical power; and rare and low-frequency variant analysis in a high-risk population enabled by whole-genome sequencing has the potential to identify novel genetic factors. Although such findings may be population specific, rare functional mutations relating to PEDF and HIF regulation align with past reports and suggest a biological mechanism for suicide risk and a potential therapeutic target for intervention.
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Affiliation(s)
- Qian Peng
- Department of Neuroscience, The Scripps Research Institute, La Jolla, CA, USA.
| | - David A Gilder
- Department of Neuroscience, The Scripps Research Institute, La Jolla, CA, USA
| | - Rebecca A Bernert
- Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, CA, USA
| | | | - Cindy L Ehlers
- Department of Neuroscience, The Scripps Research Institute, La Jolla, CA, USA
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Johnstad PG. Unhealthy behaviors associated with mental health disorders: a systematic comparative review of diet quality, sedentary behavior, and cannabis and tobacco use. Front Public Health 2024; 11:1268339. [PMID: 38249418 PMCID: PMC10797041 DOI: 10.3389/fpubh.2023.1268339] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2023] [Accepted: 11/14/2023] [Indexed: 01/23/2024] Open
Abstract
Background There are well-established literatures documenting the associations between mental disorders and unhealthy behaviors such as poor diet quality, sedentary behavior, and cannabis and tobacco use. Few studies have attempted to understand the respective findings in light of each other, however. Objective The purpose of this review was to assemble comparable data for each behavior-disorder association and assess the associations in terms of their overall strength. The review aimed to include a representative, but not exhaustive, range of studies that would allow for explorative comparisons. Methods Eligible studies were identified via Pubmed searches and citation searching, restricted to publications no older than 2015 written in English. To obtain comparable data, only studies that reported findings as odds ratios were included, and risk of bias related to study samples, behavioral measurement disparities, and control variables was assessed via sensitivity analyses. Findings for each disorder were compared on the basis of different measures of central tendency. Results From 3,682 records, 294 studies were included. The review found evidence of associations between each of the four unhealthy behaviors and psychosis, depression, anxiety, bipolar disorder, attention-deficit/hyperactivity disorder (ADHD), and post-traumatic stress disorder (PTSD), while personality disorder was only investigated in relation to cannabis and tobacco use. In overall comparison, the associations were generally of similar strength, and only the association between cannabis use and personality disorder was exceptional in terms of being significantly stronger than its counterparts across disorders and across behaviors. Analyses of bias risk identified some influence from behavioral measurement disparities and lack of adequate statistical control, but findings were generally robust across a range of sensitivity analyses. Conclusion This explorative and comparative review found that poor diet quality, sedentary behavior, and cannabis and tobacco use are about equally strongly associated with a range of different mental disorders. Given the general nature of these associations, we should probably understand them to reflect a general and shared etiology. However, the findings in this review should be regarded as tentative until confirmed by more comprehensive investigations.
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Rosales R, Lee CS, Cortés D, Caetano R, Rohsenow DJ, Lopez SR, Colby SM. Development and Evaluation of a Measure of Drinking Behavior in Response to Acculturation Stressors for Latinx Adults Entering Alcohol Treatment. JOURNAL OF SUBSTANCE USE AND ADDICTION TREATMENT 2023; 155:208936. [PMID: 38434594 PMCID: PMC10906967 DOI: 10.1016/j.josat.2022.208936] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/05/2024]
Abstract
Introduction The current study presents the development of a scale to assess drinking behavior in response to acculturation and immigration stress. Methods The 19-item Measure of Immigration and Acculturation Stressors (MIAS) and a parallel assessment, a Measure of Drinking in Response to Immigration and Acculturation Stressors (MDRIAS), were administered at baseline, 6 months, and 12 months in a completed randomized controlled trial testing culturally adapted motivational interviewing to reduce heavy drinking and related problems in Latinx individuals who met criteria for heavy drinking (n=149). Results Exploratory factor analysis of the MIAS showed best fit for a four-factor solution (Relational Stress, Perceived Ethnic Discrimination, Attenuated Aspirations, and Sense of Alienation) with 15 items. The MIAS subscales and the four corresponding MDRIAS subscales were shown to have good reliability (i.e., internal consistency, intercorrelations, and test-retest) and criterion-related validity (i.e., concurrent, convergent, and predictive). Conclusions These findings suggest that the MIAS can be used to assess different types of immigration and acculturation stressors for Latinx adults and the MDRIAS can be used to assess drinking in response to those experiences. The MIAS and MDRIAS could be used in the future to adapt alcohol interventions to relevant stressors that contribute to Latinx adults' alcohol use.
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Affiliation(s)
- Robert Rosales
- Brown University School of Public Health, Department of Behavioral & Social Sciences, Center for Alcohol and Addictions Studies, 121 South Main Street, Providence, RI 02903
| | - Christina S Lee
- Boston University, School of Social Work, 264 Bay State Rd, Boston, MA 02215
| | - Dharma Cortés
- Health Equity Research Lab, Cambridge Health Alliance/Harvard Medical School, 1493 Cambridge Street, Cambridge, MA 02139
| | - Raul Caetano
- Pacific Institute for Research and Evaluation, Prevention Research Center, Berkeley, California
| | - Damaris J Rohsenow
- Brown University School of Public Health, Department of Behavioral & Social Sciences, Center for Alcohol and Addictions Studies, 121 South Main Street, Providence, RI 02903
| | - Steven R Lopez
- Department of Psychology, University of Southern California, SGM 501, 3620 S. McClintock Ave., Los Angeles, CA 90089
| | - Suzanne M Colby
- Brown University School of Public Health, Department of Behavioral & Social Sciences, Center for Alcohol and Addictions Studies, 121 South Main Street, Providence, RI 02903
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Ehlers CL, Gilder DA, Karriker-Jaffe KJ, Bernert R. Comorbidity of anxiety/affective, conduct/antisocial, attention deficit, and alcohol use disorders with suicidal behaviors in an American Indian community sample of adults and adolescents. J Psychiatr Res 2023; 167:63-70. [PMID: 37837862 PMCID: PMC10997741 DOI: 10.1016/j.jpsychires.2023.10.005] [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: 04/28/2023] [Revised: 09/06/2023] [Accepted: 10/05/2023] [Indexed: 10/16/2023]
Abstract
AIMS To study the associations of anxiety/affective disorders, conduct/antisocial disorders (ASPD/CD), attention deficit disorders (ADHD), and alcohol use disorders (AUD) with suicidal behaviors in an American Indian (AI) community sample of adolescents and adults. METHODS Participants were AI (360 adolescents, 925 adults) recruited from reservations who were assessed with the Semi-Structured Assessment for the Genetics of Alcoholism (SSAGA). RESULTS Among AI adults (mean age = 33 years), 17% percent reported lifetime experiences of suicidal thoughts (ideation and/or plans) and 14% reported suicidal acts (including either a suicide attempt history or verified death by suicide; n = 19 deaths). Among AI adolescents (mean age = 15 years), 20% experienced suicidal thoughts and 9% experienced suicidal acts (including 3 deaths). In logistic regression analyses, suicidal thoughts were significantly associated with lifetime diagnoses of affective disorder, CD and ADHD in adolescents, and with anxiety disorder, affective disorder, and ASPD/CD in adults. Suicidal acts were associated with affective disorder, ADHD, and alcohol drinking in adolescents and with anxiety disorder, ASPD/CD and AUD in adults. The number of comorbid disorders greatly increased the risk of both suicidal thoughts and acts among both adolescents and adults. CONCLUSIONS In addition to affective disorders, both ADHD and CD in adolescents, and ASPD in adults, demonstrated an association with suicidal thoughts. Alcohol use by adolescents and AUD among adults also were associated with suicidal attempts in this AI sample. These findings suggest need for additional research and potential integration of alcohol in screening and intervention programs focused on the prevention of suicide among AI.
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Affiliation(s)
- Cindy L Ehlers
- Neuroscience Department, The Scripps Research Institute, La Jolla, CA, USA.
| | - David A Gilder
- Neuroscience Department, The Scripps Research Institute, La Jolla, CA, USA
| | | | - Rebecca Bernert
- Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, CA, USA
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Ehlers CL, Wills D, Karriker-Jaffe KJ, Phillips E, Kim C, Gilder DA. Event-related Oscillations to Emotional Faces are Related to a History of Internalizing Disorders. Clin EEG Neurosci 2023; 54:420-433. [PMID: 35379012 PMCID: PMC9681067 DOI: 10.1177/15500594221088258] [Citation(s) in RCA: 1] [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] [Indexed: 01/31/2023]
Abstract
Event-related oscillations (EROs) may represent sensitive biomarkers or endophenotypes for disorders that underlie risk behaviors such as suicidal thoughts and actions. In this study, young adults of American Indian (AI) (n = 821) and Mexican American (MA) (n = 721) ancestry (age 18-30 yrs) were clinically assessed for internalizing and externalizing disorders, and an internalizing scale was generated by extracting core diagnostic items from 6 lifetime DSM5-compatible diagnoses (social phobia, panic disorder, agoraphobia, obsessive compulsive disorder, post-traumatic stress disorder, major depressive episode) and symptoms of suicidality. EROs were generated to sad, happy and neutral faces, and energy and phase locking of delta ERO oscillations were assessed in frontal areas. An increase in delta ERO energy was found in the frontal lead (FZ) following presentation of the sad facial expressions in those with a history of 10 or more internalizing symptoms compared to those with no symptoms. Increases in delta ERO energy in FZ were also associated with a diagnosis of major depressive disorder (MDD), but not with anxiety disorders or antisocial personality disorder/conduct disorders (ASP). Major depression was also associated with increases in cross-cortical phase-locking (FZ-PZ). A decrease in the percentage of correctly identified neutral faces also was seen among those with 10 or more internalizing symptoms compared to those without internalizing symptoms, and in those with anxiety disorders, but not in those with ASP or MDD as compared to their controls. These findings suggest ERO measures may represent important potential biomarkers of depressive disorders as well as risk indicators for suicidal behaviors.
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Affiliation(s)
- Cindy L Ehlers
- Department of Neuroscience, The Scripps Research Institute, 10550 North Torrey Pines Road, La Jolla, CA 92037, USA
| | - Derek Wills
- Department of Neuroscience, The Scripps Research Institute, 10550 North Torrey Pines Road, La Jolla, CA 92037, USA
| | | | - Evelyn Phillips
- Department of Neuroscience, The Scripps Research Institute, 10550 North Torrey Pines Road, La Jolla, CA 92037, USA
| | - Corrine Kim
- Department of Neuroscience, The Scripps Research Institute, 10550 North Torrey Pines Road, La Jolla, CA 92037, USA
| | - David A Gilder
- Department of Neuroscience, The Scripps Research Institute, 10550 North Torrey Pines Road, La Jolla, CA 92037, USA
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Gilder D, Bernert R, Karriker-Jaffe K, Ehlers C, Peng Q. Genetic Factors Associated with Suicidal Behaviors and Alcohol Use Disorders in an American Indian Population. RESEARCH SQUARE 2023:rs.3.rs-2950284. [PMID: 37398076 PMCID: PMC10312956 DOI: 10.21203/rs.3.rs-2950284/v1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/04/2023]
Abstract
American Indians (AI) demonstrate the highest rates of both suicidal behaviors (SB) and alcohol use disorders (AUD) among all ethnic groups in the US. Rates of suicide and AUD vary substantially between tribal groups and across different geographical regions, underscoring a need to delineate more specific risk and resilience factors. Using data from over 740 AI living within eight contiguous reservations, we assessed genetic risk factors for SB by investigating: (1) possible genetic overlap with AUD, and (2) impacts of rare and low frequency genomic variants. Suicidal behaviors included lifetime history of suicidal thoughts and acts, including verified suicide deaths, scored using a ranking variable for the SB phenotype (range 0-4). We identified five loci significantly associated with SB and AUD, two of which are intergenic and three intronic on genes AACSP1, ANK1, and FBXO11. Nonsynonymous rare mutations in four genes including SERPINF1 (PEDF), ZNF30, CD34, and SLC5A9, and non-intronic rare mutations in genes OPRD1, HSD17B3 and one lincRNA were significantly associated with SB. One identified pathway related to hypoxia-inducible factor (HIF) regulation, whose 83 nonsynonymous rare variants on 10 genes were significantly linked to SB as well. Four additional genes, and two pathways related to vasopressin-regulated water metabolism and cellular hexose transport, also were strongly associated with SB. This study represents the first investigation of genetic factors for SB in an American Indian population that has high risk for suicide. Our study suggests that bivariate association analysis between comorbid disorders can increase statistical power; and rare variant analysis in a high-risk population enabled by whole-genome sequencing has the potential to identify novel genetic factors. Although such findings may be population specific, rare functional mutations relating to PEDF and HIF regulation align with past reports and suggest a biological mechanism for suicide risk and a potential therapeutic target for intervention.
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10
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Ehlers CL, Yehuda R, Gilder DA, Bernert R, Karriker-Jaffe KJ. Trauma, historical trauma, PTSD and suicide in an American Indian community sample. J Psychiatr Res 2022; 156:214-220. [PMID: 36265258 PMCID: PMC9842016 DOI: 10.1016/j.jpsychires.2022.10.012] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/20/2022] [Revised: 09/20/2022] [Accepted: 10/03/2022] [Indexed: 12/12/2022]
Abstract
AIMS To study the associations between perceived historical trauma, current traumatic events, diagnoses of post-traumatic stress disorder (PTSD), and suicidal behaviors in an American Indian community sample. METHODS Participants were American Indians recruited from reservations who were assessed with the Semi-Structured Assessment for the Genetics of Alcoholism (SSAGA), as well as the Historical Loss Scale, Historical Loss Associated Symptoms Scale, and Stressful Life Events Scale. RESULTS In data from 447 American Indian adults (mean age = 33 years), twenty percent reported lifetime experiences of suicidal thoughts (ideation and/or plans) and 14% reported suicidal acts, (including either a suicide attempt history or verified death by suicide (n = 4)). Diagnosis of PTSD and experience of assaultive trauma were each significantly associated with suicidal thoughts and acts, although assaultive trauma did not remain significant in models adjusting for gender and PTSD. High endorsement of symptoms associated with historical trauma was significantly associated with suicidal acts, and this remained significant when adjusting for gender and PTSD. CONCLUSIONS PTSD and historical trauma have an association with suicide and suicidal attempts in this American Indian community. Although further research is needed to evaluate the causal nature of these relations, these findings suggest treatment and prevention programs for American Indian suicide may benefit from addressing issues related to feelings of historical losses, PTSD, and their associated symptomatology.
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Affiliation(s)
- Cindy L Ehlers
- Neuroscience Department, The Scripps Research Institute, La Jolla, CA, USA.
| | - Rachel Yehuda
- James J. Peters Bronx Medical Center and Psychiatry Department, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - David A Gilder
- Neuroscience Department, The Scripps Research Institute, La Jolla, CA, USA
| | - Rebecca Bernert
- Department of Psychiatry and Behavioral Sciences Stanford University, Stanford, CA, USA
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Hicks TA, Zaur AJ, Keeley JW, Amstadter AB. The association between recreational cannabis use and posttraumatic stress disorder: A systematic review and methodological critique of the literature. Drug Alcohol Depend 2022; 240:109623. [PMID: 36162309 PMCID: PMC9665003 DOI: 10.1016/j.drugalcdep.2022.109623] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/06/2021] [Revised: 09/02/2022] [Accepted: 09/05/2022] [Indexed: 01/06/2023]
Abstract
BACKGROUND Given recent changes in the legal status of cannabis, the risks and benefits associated with its use have become an important public health topic. A growing body of research has demonstrated that posttraumatic stress disorder (PTSD) and recreational cannabis use (RCU) frequently co-occur, yet findings are inconsistent (e.g., direction of effect) and methodological variability makes comparison across studies difficult. METHODS We conducted a comprehensive systematic review of all studies (N = 45) published before May 2020 regarding etiologic models of co-occurring RCU and PTSD, as well as provided a methodological critique to inform suggestions for future research initiatives. RESULTS Findings indicate that a majority of studies (n = 37) demonstrated a significant association between RCU and PTSD. Findings provide evidence for the self-medication and high-risk models posited to explain co-occurring RCU and PTSD despite variability in assessment of RCU, which includes commonly used non-standardized self-report questions. CONCLUSION The association between RCU and PTSD is likely bidirectional. Results inform clinicians and researchers working in the mental health and cannabis use fields how the variability in findings on the association between RCU and PTSD may be attributable, in part, to methodological issues that permeate the extant literature pertaining to RCU and PTSD.
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Affiliation(s)
- Terrell A Hicks
- Virginia Institute for Psychiatric and Behavioral Genetics, Virginia Commonwealth University, USA; Department of Psychology, Virginia Commonwealth University, USA.
| | - Angela J Zaur
- Virginia Institute for Psychiatric and Behavioral Genetics, Virginia Commonwealth University, USA
| | - Jared W Keeley
- Department of Psychology, Virginia Commonwealth University, USA
| | - Ananda B Amstadter
- Virginia Institute for Psychiatric and Behavioral Genetics, Virginia Commonwealth University, USA; Department of Psychology, Virginia Commonwealth University, USA; Department of Human and Molecular Genetics, Virginia Commonwealth University, USA
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Tam CC, Gilder DA, Li L, Karriker-Jaffe KJ, Duhart Clarke SE, Ehlers CL. Age of onset and alcohol and cannabis use disorders among Mexican American young adults: Robust substance-specific effects of early use as a risk factor. J Ethn Subst Abuse 2022:1-21. [PMID: 36093789 PMCID: PMC9998803 DOI: 10.1080/15332640.2022.2111388] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
Abstract
We investigated the substance-specific and cross-substance risk associated with early onset (before age 15) of drunkenness and cannabis use in the subsequent development of alcohol (AUD) and cannabis use disorder (CUD) in Mexican American young adults. Survival analyses employed Cox proportional hazards models for AUD and CUD, separately. In cross-risk analyses, we modeled estimates for those participants reporting lifetime use of both substances. Early onset of drunkenness and early onset of cannabis use were associated with shorter time to AUD and CUD, respectively, even after accounting for psychiatric disorders. While there were no cross-risk associations, adjusting for psychiatric disorders and early onset cannabis use attenuated the association of early drunkenness with AUD.
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Affiliation(s)
- Christina C Tam
- Alcohol Research Group, Public Health Institute, Emeryville, California
| | | | - Libo Li
- Alcohol Research Group, Public Health Institute, Emeryville, California
| | - Katherine J Karriker-Jaffe
- Center for Behavioral Health Epidemiology, Implementation, and Evaluation Research, RTI International, Berkeley, California
| | - Sarah E Duhart Clarke
- Center for Behavioral Health Epidemiology, Implementation, and Evaluation Research, RTI International, Berkeley, California
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Merghati Khoei E, Rezaei Z, Mohraz M, Brady KT, Killeen T, Korte JE, Bayat A, Yousefi H. Gender differences in post-traumatic stress disorder and depression among Iranian population with substance use disorder. JOURNAL OF SUBSTANCE USE 2022. [DOI: 10.1080/14659891.2022.2051624] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- Effat Merghati Khoei
- Iranian National Center for Addiction Studies, Tehran University of Medical Sciences, Tehran, Iran
| | - Zahed Rezaei
- Social Determinants of Health Research Center, Gonabad University of Medical Science, Gonabad, Iran
| | - Minoo Mohraz
- Iranian Research Center for HIV/AIDS, Iranian Institute for Reduction of High-Risk Behaviors, Tehran University of Medical Sciences, Tehran, Iran
| | - Kathleen T. Brady
- Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, South Carolina, USA
| | - Therese Killeen
- Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, South Carolina, USA
| | - Jeffrey E. Korte
- Department of Public Health Sciences, School of Medicine, Medical University of South Carolina, Charleston, South Carolina, USA
| | - Alireza Bayat
- Iranian National Center for Addiction Studies, Tehran University of Medical Sciences, Tehran, Iran
| | - Habib Yousefi
- Iranian National Center for Addiction Studies, Tehran University of Medical Sciences, Tehran, Iran
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Delta Event-Related Oscillations Are Related to a History of Extreme Binge Drinking in Adolescence and Lifetime Suicide Risk. Behav Sci (Basel) 2020; 10:bs10100154. [PMID: 33036364 PMCID: PMC7599813 DOI: 10.3390/bs10100154] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2020] [Revised: 09/30/2020] [Accepted: 10/02/2020] [Indexed: 11/18/2022] Open
Abstract
Alcohol exposure typically begins in adolescence, and heavy binge drinking is associated with health risk behaviors. Event-related oscillations (EROs) may represent sensitive biomarkers or endophenotypes for early alcohol exposure as well as other risk behaviors such as suicidal thoughts and actions. In this study, young adults (age 18–30 years) of American Indian (AI) (n = 479) and Mexican American (MA) (n = 705) ancestry were clinically assessed, and EROs were generated to happy, sad and neutral faces. Extreme adolescent binge drinking (10+ drinks) was common (20%) in this population of AI/MA and associated with a significantly increased risk of a lifetime history of suicidal acts (SA, suicide attempts, deaths) but not suicidal thoughts (ST, ideation, plans). ST were reported among MA participants, whereas SA were more common among AI young adults. Extreme adolescent binge drinking was also associated with errors in detection of sad and neutral faces, increases in delta ERO energy, and decreases in phase locking (PL), particularly in parietal areas. A lifetime history of ST was associated with increases in delta ERO energy and PL, whereas SA were associated with decreases in both. These studies suggest that ERO measures may represent important potential biomarkers of adolescent extreme binge drinking and risk for suicidal behaviors.
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Foroudi P, Marvi R, Kizgin H. THE OTHERS: The role of individual personality, cultural acculturation, and perceived value on towards firm’s social media and acculturation orientation. INTERNATIONAL JOURNAL OF INFORMATION MANAGEMENT 2020. [DOI: 10.1016/j.ijinfomgt.2020.102075] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Mengistu BS, Manolova G. Acculturation and mental health among adult forced migrants: a meta-narrative systematic review protocol. Syst Rev 2019; 8:184. [PMID: 31345260 PMCID: PMC6657160 DOI: 10.1186/s13643-019-1103-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/26/2018] [Accepted: 07/12/2019] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The global refugee crisis has become central to health and policy debates. There is a growing need to investigate how acculturation impacts mental health among asylum seekers and refugees. Many forced migrants have an increased risk of experiencing negative mental health outcomes, but this review will only assess the current literature on acculturation and mental health among adults. Research questions include the following: (1) How is acculturation conceptualised? (2) What are the most salient mental health outcomes? (3) How are acculturation and mental health measured and related? and (4) How do macrostructural factors affect the relationship between mental health and acculturation? METHODS We will use a meta-narrative approach to synthesise the breadth of acculturation and mental health literature from various research traditions. This review will include empirical studies measuring variations of acculturation and mental health among adult forced migrants from low- and middle-income countries residing in high-income countries. Studies will be retrieved from the following academic databases: MEDLINE, Embase, PsycINFO, Global Health, ProQuest Social Science and Web of Science. Additional studies will be collected from King's College London's online library databases and e-resources, and reference lists of eligible studies. Studies from database inception and written in English will be included. All full-text papers will undergo quality appraisal using the Mixed Methods Appraisal Tool (MMAT). Extracted data will be analysed using a conceptual framework analysis to construct overarching narratives and a framework that will describe the relationship between acculturation and mental health. DISCUSSION A meta-narrative systematic review provides a flexible and systematic approach to synthesising the heterogeneous literature on acculturation and mental health. This review will guide the development of a conceptual framework to aid future research on acculturation among adult forced migrants. As high-income countries seek to integrate forced migrants into society and improve their access to vital resources, this review has the potential to transform policies and practices that influence migrant mental health. SYSTEMATIC REVIEW REGISTRATION PROSPERO CRD42018089148.
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Affiliation(s)
- Brittney S. Mengistu
- Department of Global Health & Social Medicine, King’s College London, Bush House NE Wing, 30 Aldwych, London, WC2B 4BG UK
| | - Gergana Manolova
- Global Public Health, Migration & Ethics Research Group, Faculty of Medical Science, Anglia Ruskin University, Chelmsford, UK
- Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, UK
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17
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Ehlers CL, Phillips E, Kim C, Wills DN, Karriker-Jaffe KJ, Gilder DA. CR-19-0950: Event-related responses to alcohol-related stimuli in Mexican-American young adults: Relation to age, gender, comorbidity and "dark side" symptoms. Drug Alcohol Depend 2019; 202:76-86. [PMID: 31323376 PMCID: PMC6685752 DOI: 10.1016/j.drugalcdep.2019.06.001] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/15/2019] [Revised: 06/14/2019] [Accepted: 06/29/2019] [Indexed: 12/15/2022]
Abstract
BACKGROUND Electrophysiological variables may represent sensitive biomarkers of vulnerability to or endophenotypes for alcohol use disorders (AUD). METHODS Young adults (age 18-30 yrs, n = 580) of Mexican American heritage were assessed with the Semi-Structured Assessment for the Genetics of Alcoholism and event-related oscillations (EROs) generated in response to a task that used pictures of objects, food, and alcohol-related and non-alcohol-related drinks as stimuli. RESULTS Decreases in energy in the alpha and beta frequencies and higher phase synchrony within cortical brain areas were seen in response to the alcohol-related as compared to the non-alcohol-related stimuli. Differences in ERO energy and synchrony responses to alcohol-related stimuli were also found as a function of age, sex, AUD status and comorbidity. Age-related decreases in energy and increases in synchrony were found. Females had significantly higher energy and lower synchrony values than males. Participants with AUD had higher synchrony values specifically in the beta frequencies, whereas those with a lifetime diagnosis of conduct disorder and/or antisocial personality disorder had lower alpha power and synchrony, and those with any affective disorder had lower ERO energy in the beta frequencies. Those with substance-associated affective "dark-side" symptoms had slower reaction times to the task, lower energy in the beta frequencies, lower local synchrony in the theta frequencies, and higher long-range synchrony in the delta and beta frequencies. CONCLUSIONS These findings suggest that EROs recorded to alcohol-related stimuli may be biomarkers of comorbid risk factors, symptoms and disorders associated with AUD that also can differentiate those with "dark-side symptoms".
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Affiliation(s)
- Cindy L. Ehlers
- Neurosciences Department, The Scripps Research Institute, La Jolla, CA 92037, USA,Corresponding author: Dr. Cindy L. Ehlers, TSRI, 10550 North Torrey Pines Road, La Jolla, CA 92037 USA, Telephone: (858) 784-7058; Fax: (858) 784-7409;
| | - Evelyn Phillips
- Neurosciences Department, The Scripps Research Institute, La Jolla, CA 92037, USA
| | - Corinne Kim
- Neurosciences Department, The Scripps Research Institute, La Jolla, CA 92037, USA
| | - Derek N. Wills
- Neurosciences Department, The Scripps Research Institute, La Jolla, CA 92037, USA
| | | | - David A. Gilder
- Neurosciences Department, The Scripps Research Institute, La Jolla, CA 92037, USA
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18
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Ponicki WR, Henderson JA, Gaidus A, Gruenewald PJ, Lee JP, Moore RS, Davids S, Tilsen N. Spatial Epidemiology of Alcohol- and Drug-Related Health Problems Among Northern Plains American Indians: Nebraska and South Dakota, 2007 to 2012. Alcohol Clin Exp Res 2018; 42:578-588. [PMID: 29381219 PMCID: PMC5832572 DOI: 10.1111/acer.13580] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2017] [Accepted: 12/05/2017] [Indexed: 12/15/2022]
Abstract
BACKGROUND Despite high abstinence rates, American Indians experience elevated rates of many alcohol and other drug problems. American Indians also predominantly reside in poor and rural areas, which may explain some observed health disparities. We investigated whether geographic areas including reservations or large American Indian populations exhibited greater incidence of alcohol- and drug-related hospitalizations. METHODS We obtained inpatient hospitalization records for 2 Northern Plain states (Nebraska and South Dakota) for the years 2007 to 2012. We constructed zip code counts for 10 categories of hospitalization with diagnoses or injury causation commonly associated with alcohol or drug use. We related these to community sociodemographic characteristics using Bayesian Poisson space-time regression models and examined associations with and without controls for whether each zip code was located within an American Indian reservation. RESULTS Controlling for other demographic and economic characteristics, zip codes with greater percentage of American Indians exhibited greater incidence for all 10 substance abuse-related health outcomes (9 of 10 well supported); zip code areas within American Indian reservations had greater incidence of self-inflicted injury and drug dependence and abuse, and reduced incidence of alcohol cirrhosis and prescription opioid poisoning. However, the analyses generally demonstrated no well-supported differences in incidence associated with local residence percentages of American Indian versus African American. CONCLUSIONS In our analyses, ethnicity or heredity alone did not account for alcohol- and drug-related hospitalizations among Native populations. Aspects of social, economic, and political dimensions of Native lives must be considered in the etiology of alcohol- and drug-related problems for rural-dwelling indigenous peoples.
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Affiliation(s)
- William R. Ponicki
- Prevention Research Center, Pacific Institute for Research and Evaluation, 180 Grand Avenue, Suite 1200, Oakland, CA 94612
| | - Jeffrey A. Henderson
- Black Hills Center for American Indian Health, 701 St. Joseph Street, Suite 204, Rapid City, SD 57701
| | - Andrew Gaidus
- Prevention Research Center, Pacific Institute for Research and Evaluation, 180 Grand Avenue, Suite 1200, Oakland, CA 94612
| | - Paul J. Gruenewald
- Prevention Research Center, Pacific Institute for Research and Evaluation, 180 Grand Avenue, Suite 1200, Oakland, CA 94612
| | - Juliet P. Lee
- Prevention Research Center, Pacific Institute for Research and Evaluation, 180 Grand Avenue, Suite 1200, Oakland, CA 94612
| | - Roland S. Moore
- Prevention Research Center, Pacific Institute for Research and Evaluation, 180 Grand Avenue, Suite 1200, Oakland, CA 94612
| | - Sharice Davids
- Great Plains Local Community Development Corporation, Porcupine, SD 57772
| | - Nick Tilsen
- Great Plains Local Community Development Corporation, Porcupine, SD 57772
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Kagee A, Bantjes J, Saal W. Prevalence of Traumatic Events and Symptoms of PTSD Among South Africans Receiving an HIV Test. AIDS Behav 2017; 21:3219-3227. [PMID: 28224321 DOI: 10.1007/s10461-017-1730-9] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
We studied posttraumatic stress disorder (PTSD) among a community sample of 500 persons seeking an HIV test. The majority of participants (62.2%) indicated that they had experienced at least one index event that qualified for PTSD, even though a small proportion (5%) actually met the diagnostic criteria for the disorder. Of those who reported an index event, 25 (8.04%) met the diagnostic criteria for PTSD while 286 (91.96%) did not. On average about one-third of participants who did not meet the criteria for PTSD endorsed PTSD symptoms whereas more than three quarters of those who met the full criteria did so. No demographic factors were associated with PTSD caseness, except number of traumatic events. These results are discussed in the context of the need to address traumatic events and PTSD among persons who undergo HIV testing.
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Rivas-Drake D, Stein GL. Multicultural Developmental Experiences: Implications for Resilience in Transitional Age Youth. Child Adolesc Psychiatr Clin N Am 2017; 26:271-281. [PMID: 28314455 DOI: 10.1016/j.chc.2016.12.012] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Transitional age youth were born into a world that is becomingly increasingly diverse. Youth who are ethnic or racial minorities encounter cultural stressors, including acculturative stress and discrimination that undermine their health and mental health. Decades of research demonstrate that cultural assets can serve as risk-reducing and resilience-enhancing mechanisms among minority and immigrant youth. Cultural assets include the development of a healthy ethnic-racial identity and maintenance of cultural values. Practitioners should assess for culturally relevant stressors and incorporate cultural assets such as ethnic-racial identity and cultural values to support the mental health of these youth.
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Affiliation(s)
- Deborah Rivas-Drake
- Department of Psychology, School of Education, University of Michigan, 530 Church Street, Ann Arbor, MI 48109-1043, USA.
| | - Gabriela Livas Stein
- Department of Psychology, University of North Carolina at Greensboro, 296 Eberhart Building, Greensboro, NC 27412-5001, USA
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Genome-Wide Association Study of Post-Traumatic Stress Disorder in Two High-Risk Populations. Twin Res Hum Genet 2017; 20:197-207. [PMID: 28262088 DOI: 10.1017/thg.2017.12] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
Mexican Americans (MAs) and American Indians (AIs) constitute conspicuously understudied groups with respect to risk for post-traumatic stress disorder (PTSD), especially in light of findings showing racial/ethnic differences in trauma exposure and risk for PTSD. The purpose of this study was to examine genetic influences on PTSD in two minority cohorts. A genome-wide association study (GWAS) with sum PTSD symptoms for trauma-exposed subjects was run in each cohort. Six highly correlated variants in olfactory receptor family 11 subfamily L member 1 (OR11L1) were suggestively associated with PTSD in the MA cohort. These associations remained suggestively significant after permutation testing. A signal in a nearby olfactory receptor on chromosome 1, olfactory receptor family 2 subfamily L member 13 (OR2L13), tagged by rs151319968, was nominally associated with PTSD in the AI sample. Although no variants were significantly associated after correction for multiple testing in a meta-analysis of the two cohorts, pathway analysis of the top hits showed an enrichment cluster of terms related to sensory transduction, olfactory receptor activity, G-protein coupled receptors, and membrane. As previous studies have proposed a role for olfaction in PTSD, our results indicate this influence may be partially driven by genetic variation in the olfactory system.
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