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Zhang N, Wang C, Li Y, Chen F, Yan P. Hypothetical interventions on risk factors for depression among middle-aged and older community-dwellers in China: An application of the parametric g-formula in a longitudinal study. J Affect Disord 2023; 327:355-361. [PMID: 36754095 DOI: 10.1016/j.jad.2023.01.113] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/20/2022] [Revised: 01/22/2023] [Accepted: 01/30/2023] [Indexed: 02/09/2023]
Abstract
BACKGROUND Sleep disturbances, frailty, and body pain are widespread in middle-aged and older adults with depression, and have been identified as depression risk factors. However, there is a scarcity of research on the benefits of sleep improvement, frailty amelioration, and pain management on incident depression. METHODS A total of 8895 respondents aged above 45 years were derived from the China Health and Retirement Longitudinal Study (CHARLS) between 2011 and 2018. The parametric g-formula was used to estimate the 7-year risks of depression under independent hypothetical interventions on nighttime sleep duration (NSD), daytime napping duration (DND), perceived sleep quality (PSQ), frailty, and pain, as well as their various combinations. RESULTS The observed depression risk was 41.77 %. The independent intervention on frailty was the most effective in lowering incident depression, with a risk ratio (RR) of 0.61 (95 % CI: 0.57-0.64), followed by PSQ (RR: 0.75, 95 % CI: 0.73-0.78), pain (RR: 0.90, 95 % CI: 0.87-0.91), and NSD (RR: 0.96, 95 % CI: 0.93-0.98). In subgroup analysis, intervention on NSD was more effective in men, PSQ was more effective in middle-aged individuals, and frailty and pain were more effective in older persons. The combined intervention of NSD, PSQ, frailty, and pain lowered the risk the greatest (RR: 0.35, 95 % CI: 0.32-0.37). LIMITATIONS Generalizing our results to other populations should be possible if they have the same distribution of effect modifiers and interference patterns because of the calculation principle of the parametric g-formula. CONCLUSIONS Interventions for sleep disturbances, frailty, and body pain can minimize the risk of depression.
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Affiliation(s)
- Nan Zhang
- School of Nursing, Xinjiang Medical University, Urumqi, China
| | - Cui Wang
- School of Nursing, Peking University, Beijing, China
| | - Yuli Li
- School of Nursing and Rehabilitation, Shandong University, Jinan, China
| | - Fenghui Chen
- School of Nursing, Xinjiang Medical University, Urumqi, China
| | - Ping Yan
- School of Nursing, Xinjiang Medical University, Urumqi, China.
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McAdams TA, Rijsdijk FV, Zavos HMS, Pingault JB. Twins and Causal Inference: Leveraging Nature's Experiment. Cold Spring Harb Perspect Med 2021; 11:a039552. [PMID: 32900702 PMCID: PMC8168524 DOI: 10.1101/cshperspect.a039552] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
In this review, we discuss how samples comprising monozygotic and dizygotic twin pairs can be used for the purpose of strengthening causal inference by controlling for shared influences on exposure and outcome. We begin by briefly introducing how twin data can be used to inform the biometric decomposition of population variance into genetic, shared environmental, and nonshared environmental influences. We then discuss how extensions to this model can be used to explore whether associations between exposure and outcome survive correction for shared etiology (common causes). We review several analytical approaches that can be applied to twin data for this purpose. These include multivariate structural equation models, cotwin control methods, direction of causation models (cross-sectional and longitudinal), and extended family designs used to assess intergenerational associations. We conclude by highlighting some of the limitations and considerations that researchers should be aware of when using twin data for the purposes of interrogating causal hypotheses.
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Affiliation(s)
- Tom A McAdams
- Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London SE5 8AF, United Kingdom
- Promenta Research Centre, University of Oslo, Oslo 0373, Norway
| | - Fruhling V Rijsdijk
- Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London SE5 8AF, United Kingdom
| | - Helena M S Zavos
- Department of Psychology, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London SE5 8AF, United Kingdom
| | - Jean-Baptiste Pingault
- Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London SE5 8AF, United Kingdom
- Clinical, Educational and Health Psychology, Division of Psychology and Language Sciences, University College London, London WC1E 6BT, United Kingdom
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Abstract
BACKGROUND Test anxiety may be better thought of as a biopsychosocial process affecting academic performance during the days leading up to an exam, rather than a static appraisal of attitudes related to test taking. This was a passive observational study following students 2 days before a midterm exam and was designed to test the Sleep Anxiety Performance Process (SAPP) model in the context of a psychology statistics exam. METHODS Undergraduates (N = 167) enrolled in a statistics class, January-November 2015. Participants completed an electronic battery of measures and Sleep Mood Study Diaries (SMS) during the mornings, 2 days before a statistics exam. Instructors confirmed exam scores. RESULTS A path model showed a reciprocal bi-directional relationship between Sleep Quality and restfulness (Q&R) and test anxiety 2 days before a scheduled exam, with test anxiety measured in the morning, before the exam predicting exam performance. Prior exam performance, being a non-native English speaker (ESL), and class performance motivation also predicted exam performance. CONCLUSIONS These data support the SAPP model's premise that that sleep and anxiety feed one another, as a reciprocal process, that collectively impairs academic performance, with direct effects on academic performance, but with implications for overall student health.
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Faßbender K, Wiebe A, Bates TC. Physical and Cultural Inheritance Enhance Agency, but What are the Origins of this Concern to Establish a Legacy? A Nationally-Representative Twin Study of Erikson's Concept of Generativity. Behav Genet 2019; 49:244-257. [PMID: 30649657 PMCID: PMC6418300 DOI: 10.1007/s10519-018-9943-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2017] [Accepted: 12/11/2018] [Indexed: 01/25/2023]
Abstract
Generativity-showing concern to establish and guide future generations-has been argued to be a biological adaptation central to cumulative culture and survival, but also, in turn, to be a cultural adaptation dependent on norms. From the perspective of human agency, concern for the future has played a key role in raising agency for generations that follow by creating infrastructure and cultural inheritance. Here, in a population-representative sample of 756 twin-pairs, we present the first test of the genetic and environmental structure of generativity using the Loyola Generativity Scale (short). Genetic analysis of scale sum-scores revealed that shared environmental effects were comparable in magnitude or exceeded effects estimated for genetic differences (A = 0.30 CI95 [- 0.01, 0.61], C = 0.41 [0.25, 0.56], E = 0.86 [0.79, 0.93]). At the item level, a well-fitting genetically-informed model suggested 3 factors influencing generativity via a common-pathway structure. The first was tentatively characterized as reflecting a heritable general concern for the future. The second reflected being a valued source of advice and assistance. The third factor showed only unique environment effects and had as its strongest indicator having had a good influence on the lives of others. Replicability of this structure should be tested in the full version of the scale. Work is needed also to validate influences of generativity on vocations such as teaching and on philanthropic activity improving life for subsequent generations.
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Affiliation(s)
- Kaja Faßbender
- Department of Psychology, University of Edinburgh, 7 George Square, Edinburgh, EH8 9JZ, UK
| | - Annika Wiebe
- Department of Psychology, University of Edinburgh, 7 George Square, Edinburgh, EH8 9JZ, UK
| | - Timothy C Bates
- Department of Psychology, University of Edinburgh, 7 George Square, Edinburgh, EH8 9JZ, UK.
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Cherny SS, Freidin MB, Williams FMK, Livshits G. The analysis of causal relationships between blood lipid levels and BMD. PLoS One 2019; 14:e0212464. [PMID: 30794634 PMCID: PMC6386286 DOI: 10.1371/journal.pone.0212464] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2018] [Accepted: 02/01/2019] [Indexed: 12/11/2022] Open
Abstract
Bone mineral density (BMD) and lipid levels are two of the most extensively studied risk factors for common diseases of aging, such as cardiovascular disease (CVD) and osteoporosis (OP). These two risk factors are also correlated with each other, but little is known about the molecular mechanisms behind this correlation. Recent studies revealed that circulating levels of several metabolites involved in the biosynthesis of androsterone correlate significantly with BMD and have the capacity to affect cholesterol and lipids levels. A main aim of the present study was to investigate the hypothesis that androsterone-related metabolites could provide a link between CVD and OP, as a common cause of lipid levels and BMD. The present study employed data from the NIHR BRC TwinsUK BioResource, comprising 1909 and 1994 monozygotic and dizygotic twin pairs, respectively, to address the causal relationships among BMD and lipids, and their associated metabolites, using reciprocal causation twin modelling, as well as Mendelian randomization (MR) using large publicly-available GWAS datasets on lipids and BMD, in conjunction with TwinsUK metabolite data. While results involving the twin modelling and MR analyses with metabolites were unable to establish a causal link between metabolite levels and either lipids or BMD, MR analyses of BMD and lipids suggest that lipid levels have a causal impact on BMD, which is consistent with findings from clinical trials of lipid-lowering drugs, which have also increased BMD.
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Affiliation(s)
- Stacey S. Cherny
- Department of Anatomy and Anthropology, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
- Department of Epidemiology and Preventive Medicine, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Maxim B. Freidin
- Department of Twin Research and Genetic Epidemiology, School of Life Course Science, King’s College London, London, United Kingdom
| | - Frances M. K. Williams
- Department of Twin Research and Genetic Epidemiology, School of Life Course Science, King’s College London, London, United Kingdom
| | - Gregory Livshits
- Department of Anatomy and Anthropology, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
- Department of Twin Research and Genetic Epidemiology, School of Life Course Science, King’s College London, London, United Kingdom
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Lind MJ, Hawn SE, Sheerin CM, Aggen SH, Kirkpatrick RM, Kendler KS, Amstadter AB. An examination of the etiologic overlap between the genetic and environmental influences on insomnia and common psychopathology. Depress Anxiety 2017; 34:453-462. [PMID: 28092418 PMCID: PMC5469037 DOI: 10.1002/da.22587] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/11/2016] [Revised: 11/01/2016] [Accepted: 11/14/2016] [Indexed: 01/05/2023] Open
Abstract
BACKGROUND Insomnia is comorbid with internalizing and externalizing psychiatric disorders. However, the extent to which the etiologic influences on insomnia and common psychopathology overlap is unclear. There are limited genetically informed studies of insomnia and internalizing disorders and few studies of overlap exist with externalizing disorders. METHODS We utilized twin data from the Virginia Adult Twin Studies of Psychiatric and Substance Use Disorders (total n = 7,500). Insomnia, internalizing disorders (major depressive disorder [MDD], generalized anxiety disorder [GAD]), and alcohol abuse or dependence (AAD) were assessed at two time points, while antisocial personality disorder (ASPD) was assessed once. Cholesky decompositions were performed in OpenMx and longitudinal measurement models were run on available phenotypes to reduce measurement error. RESULTS The latent additive genetic influences on insomnia overlapped significantly (56% for females, 74% for males) with MDD and were shared completely (100%) with GAD. There was significant overlap of latent unique environmental influences, with overlap ranging from 38 to 100% across disorders. In contrast, there was less genetic overlap between insomnia and externalizing disorders, with 18% of insomnia's heritability shared with AAD and 23% with ASPD. Latent unique environmental overlap between insomnia and both externalizing disorders was negligible. CONCLUSIONS The evidence for substantial genetic overlap between insomnia and stable aspects of both internalizing disorders suggests that there may be few insomnia-specific genes and investigation into unique environmental factors is important for understanding insomnia development. The modest overlap between insomnia and externalizing disorders indicates that these disorders are genetically related, but largely etiologically distinct.
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Affiliation(s)
- Mackenzie J. Lind
- Department of Psychiatry, Virginia Institute for Psychiatric and Behavioral Genetics, Virginia Commonwealth University, Richmond, VA
| | - Sage E. Hawn
- Department of Psychiatry, Virginia Institute for Psychiatric and Behavioral Genetics, Virginia Commonwealth University, Richmond, VA
- Department of Psychology, Virginia Commonwealth University, Richmond, VA
| | - Christina M. Sheerin
- Department of Psychiatry, Virginia Institute for Psychiatric and Behavioral Genetics, Virginia Commonwealth University, Richmond, VA
| | - Steven H. Aggen
- Department of Psychiatry, Virginia Institute for Psychiatric and Behavioral Genetics, Virginia Commonwealth University, Richmond, VA
| | - Robert M. Kirkpatrick
- Department of Psychiatry, Virginia Institute for Psychiatric and Behavioral Genetics, Virginia Commonwealth University, Richmond, VA
| | - Kenneth S. Kendler
- Department of Psychiatry, Virginia Institute for Psychiatric and Behavioral Genetics, Virginia Commonwealth University, Richmond, VA
- Department of Human and Molecular Genetics, Virginia Institute for Psychiatric and Behavioral Genetics, Virginia Commonwealth University, Richmond, VA
| | - Ananda B. Amstadter
- Department of Psychiatry, Virginia Institute for Psychiatric and Behavioral Genetics, Virginia Commonwealth University, Richmond, VA
- Department of Human and Molecular Genetics, Virginia Institute for Psychiatric and Behavioral Genetics, Virginia Commonwealth University, Richmond, VA
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Gregory AM, Rijsdijk FV, Eley TC, Buysse DJ, Schneider MN, Parsons M, Barclay NL. A Longitudinal Twin and Sibling Study of Associations between Insomnia and Depression Symptoms in Young Adults. Sleep 2016; 39:1985-1992. [PMID: 27634812 DOI: 10.5665/sleep.6228] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2015] [Accepted: 07/18/2016] [Indexed: 02/01/2023] Open
Abstract
STUDY OBJECTIVES To estimate genetic and environmental influences on the associations between insomnia and depression symptoms concurrently and longitudinally. METHODS Behavioral genetic analyses were conducted on data from the British longitudinal G1219 twin/sibling study. One thousand five hundred fiftysix twins and siblings participated at Time 1 (mean age = 20.3 years, SD = 1.76). Eight hundred sixty-two participated at Time 2 (mean age = 25.2 years, SD = 1.73 years). Participants completed the Insomnia Symptoms Questionnaire and the Short Mood and Feelings Questionnaire to assess symptoms of insomnia and depression respectively. RESULTS Genetic effects accounted for 33% to 41% of the variance of the phenotypes. The phenotypic correlations were moderate (r = 0.34 to r = 0.52). The genetic correlations between the variables were high (0.73-1.00). Genetic effects accounted for a substantial proportion of the associations between variables (50% to 90%). Non-shared environmental effects explained the rest of the variance and covariance of the traits. CONCLUSIONS While genetic effects play a modest role in insomnia and depression symptoms separately, they appear to play a more central role in concurrent and longitudinal associations between these phenotypes. This should be acknowledged in theories explaining these common associations.
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Affiliation(s)
- Alice M Gregory
- Department of Psychology, Goldsmiths, University of London, London, UK
| | - Fruhling V Rijsdijk
- MRC Social, Genetic & Developmental Psychiatry Centre, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London UK
| | - Thalia C Eley
- MRC Social, Genetic & Developmental Psychiatry Centre, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London UK
| | - Daniel J Buysse
- Department of Psychiatry, School of Medicine, University of Pittsburgh
| | | | | | - Nicola L Barclay
- Sleep and Circadian Neuroscience Institute (SCNi), Nuffield Department of Clinical Neurosciences, Sir William Dunn School of Pathology, University of Oxford, UK
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Gould CE, Beaudreau SA, O'Hara R, Edelstein BA. Perceived anxiety control is associated with sleep disturbance in young and older adults. Aging Ment Health 2016; 20:856-60. [PMID: 26023761 DOI: 10.1080/13607863.2015.1043617] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
OBJECTIVE This study examined the extent to which perceived anxiety control was related to subjective sleep disturbance in young and older adults. METHOD Fifty-one young adults (18 to 30 years old) and 48 older adults (aged 65 years and older) completed questionnaires including the Pittsburgh Sleep Quality Index (PSQI) to assess sleep disturbance, Anxiety Control Questionnaire to assess perceived control over anxiety, a perceived health rating, and demographic questionnaire. Correlation and multivariable adjusted hierarchical regression analyses examined the extent to which anxiety control was associated with sleep disturbance. RESULTS Anxiety control and health status were associated with global sleep quality on the PSQI, but no age differences in PSQI scores were found. In post hoc analyses, greater anxiety control was related to shorter sleep latency. Both older age and greater anxiety control were associated with less daytime dysfunction, whereas only older age was associated with better sleep quality. DISCUSSION Although some variations in sleep quality by age were found, overall findings suggest that perceived anxiety control contributes to sleep disturbance in young and older adults. Greater anxiety control could lead to shorter sleep latency through reduced anxiety and worry symptoms at bedtime. Future studies should examine whether improved anxiety control with psychological treatments is one mechanism through which beneficial and lasting effects on sleep disturbance can be achieved.
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Affiliation(s)
- Christine E Gould
- a Department of Psychology , West Virginia University , Morgantown , WV , USA
| | - Sherry A Beaudreau
- b Sierra Pacific Mental Illness Research, Education, and Clinical Center (MIRECC), Veterans Affairs Palo Alto Health Care System , Palo Alto , CA , USA.,c Department of Psychiatry and Behavioral Sciences , Stanford University School of Medicine , Stanford , CA , USA.,d School of Psychology , University of Queensland , Brisbane , Australia
| | - Ruth O'Hara
- b Sierra Pacific Mental Illness Research, Education, and Clinical Center (MIRECC), Veterans Affairs Palo Alto Health Care System , Palo Alto , CA , USA.,c Department of Psychiatry and Behavioral Sciences , Stanford University School of Medicine , Stanford , CA , USA.,d School of Psychology , University of Queensland , Brisbane , Australia
| | - Barry A Edelstein
- a Department of Psychology , West Virginia University , Morgantown , WV , USA
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Olivares EL, Kendler KS, Neale MC, Gillespie NA. The Genetic and Environmental Association Between Parental Monitoring and Risk of Cannabis, Stimulants, and Cocaine Initiation in a Sample of Male Twins: Does Parenting Matter? Twin Res Hum Genet 2016; 19:297-305. [PMID: 27436053 PMCID: PMC4972338 DOI: 10.1017/thg.2016.52] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Our aim was to test the direction of causation between self-report parental monitoring (PM) and the liability to illicit drug initiation (DI) as indicated by cannabis, cocaine, and stimulants. We fitted a multiple indicator model to test causal and non-causal models based on a large, genetically informative cross-sectional sample of male twins. The sample comprised 1,778 males aged 24-62 years from the Virginia Adult Twin Study of Psychiatric and Substance Use Disorders. Data came from self-report measures of lifetime cannabis, stimulants, and cocaine initiation, and retrospective assessment of PM between ages 8-17 years. Multivariate modeling showed that familial aggregation in PM and DI were both explained by a combination of additive genetic and shared environmental effects. Moreover, the significant association between PM and DI was best explained by a correlated liability model versus causal models. PM has typically been assumed to be an environmental, causal risk factor for drug use and has been shown to be among the more salient environmental risk factors for illicit DI. Our data were not consistent with this causal hypothesis. Instead, a correlated liability model in which PM and risk of DI share common genetic and environmental risks provided a better fit to the data.
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Affiliation(s)
| | - Kenneth S Kendler
- Department of Psychiatry, Virginia Commonwealth University
- Department of Human Genetics, Virginia Commonwealth University
| | | | - Nathan A Gillespie
- Department of Psychiatry, Virginia Commonwealth University
- Queensland Institute of Medical Research, Brisbane, Australia
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Suarez EC, Sundy JS, Erkanli A. Depressogenic vulnerability and gender-specific patterns of neuro-immune dysregulation: What the ratio of cortisol to C-reactive protein can tell us about loss of normal regulatory control. Brain Behav Immun 2015; 44:137-47. [PMID: 25241020 PMCID: PMC4275343 DOI: 10.1016/j.bbi.2014.09.008] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/07/2014] [Revised: 08/26/2014] [Accepted: 09/07/2014] [Indexed: 12/27/2022] Open
Abstract
We examined whether the ratio of cortisol (CORT) to high-sensitivity C-reactive protein (hsCRP), an index that captures the integrity of homeostatic regulation between the hypothalamic-pituitary-adrenal (HPA) axis and inflammatory processes, is associated with vulnerability to depression in a gender specific manner and whether glucocorticoid receptor (GR) sensitivity plays a role in these associations. Fasting blood samples were collected between 08:45 and 09:15 and assayed for CORT, hsCRP, and leukocyte count in 213 healthy, medication-free men and women. The NEO-Personality Inventory was used to assess neuroticism, extraversion and anxiety. We used the Hamilton Depression Interview to assess depressive symptoms, the Buss-Perry anger subscale to measure anger, and the Pittsburgh Sleep Quality Index to evaluate subjective sleep quality and its components. Log-transformed CORT/CRP values were analyzed using multiple regression with Holms' adjusted p-values and age, body mass index (BMI), and race as covariates. GR sensitivity was estimated using the log-transformed ratio of neutrophils (N)-to-monocytes (M). The log-transformed ratio of CORT/CRP did not differ between men and women but was significantly and negatively associated with age and BMI. Severity of depressive symptoms, extraversion, anxiety, and sleep quality were associated with the CORT/CRP ratio in a gender-specific manner. For women, decreasing CORT/CRP ratios, suggestive of an insufficient release of CORT coupled with a heightened inflammatory state, were associated with increasing severity of depressive symptoms, decreasing quality of sleep, increasing frequency of sleep disturbance, and decreasing extraversion. For men, increasing frequency of daytime disturbance and levels of anxiety were associated with increasing CORT/CRP ratio, suggestive of an enhanced release of CORT relative to attenuated levels of hsCRP. For both genders, increasing anger was associated with decreasing CORT/CRP ratios. Although results suggested GR downregulation in women but not men, such differences did not mediate the observed associations. With the use of the CORT/CRP ratio, we showed that vulnerability factors for depression are associated with a loss of normal regulatory controls resulting in gender-specific patterns of neuro-immune dysregulation. That GR downregulation did not influence these associations suggests that the loss of regulatory controls in at risk individuals is primarily at the level of the hormone. Beyond the individual contribution of each component of the CORT/CRP ratio, disruption of normal neuroimmune regulatory feedback provides a plausible biological framework useful in understanding biobehavioral vulnerabilities to depression in a gender specific manner. The CORT/CRP ratio may be a viable biomarker not only for delineating risk for MDD but also progression and treatment responses among patients with MDD; possibilities that are testable in future studies.
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Affiliation(s)
- Edward C. Suarez
- Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, NC, USA
| | - John S. Sundy
- Department of Medicine, Duke University Medical Center, Durham, NC, USA
| | - Alaattin Erkanli
- Department of Biostatistics, Duke University Medical Center, Durham, NC, USA
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Goldman-Mellor S, Gregory AM, Caspi A, Harrington H, Parsons M, Poulton R, Moffitt TE. Mental health antecedents of early midlife insomnia: evidence from a four-decade longitudinal study. Sleep 2014; 37:1767-75. [PMID: 25364072 DOI: 10.5665/sleep.4168] [Citation(s) in RCA: 48] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
STUDY OBJECTIVES Insomnia is a highly prevalent condition that constitutes a major public health and economic burden. However, little is known about the developmental etiology of adulthood insomnia. DESIGN We examined whether indicators of psychological vulnerability across multiple developmental periods (psychiatric diagnoses in young adulthood and adolescence, childhood behavioral problems, and familial psychiatric history) predicted subsequent insomnia in adulthood. SETTING AND PARTICIPANTS We used data from the ongoing Dunedin Multidisciplinary Health and Development Study, a population-representative birth cohort study of 1,037 children in New Zealand who were followed prospectively from birth (1972-1973) through their fourth decade of life with a 95% retention rate. MEASUREMENTS Insomnia was diagnosed at age 38 according to DSM-IV criteria. Psychiatric diagnoses, behavioral problems, and family psychiatric histories were assessed between ages 5 and 38. RESULTS In cross-sectional analyses, insomnia was highly comorbid with multiple psychiatric disorders. After controlling for this concurrent comorbidity, our results showed that individuals who have family histories of depression or anxiety, and who manifest lifelong depression and anxiety beginning in childhood, are at uniquely high risk for age-38 insomnia. Other disorders did not predict adulthood insomnia. CONCLUSIONS The link between lifelong depression and anxiety symptoms and adulthood insomnia calls for further studies to clarify the neurophysiological systems or behavioral conditioning processes that may underlie this association.
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Affiliation(s)
- Sidra Goldman-Mellor
- Center for Developmental Science, University of North Carolina at Chapel Hill, Chapel Hill, NC ; Department of Psychology & Neuroscience, Duke University, Durham, NC ; Institute for Genome Sciences & Policy, Duke University, Durham, NC ; Department of Psychiatry & Behavioral Sciences, Duke University Medical Center, Durham, NC
| | - Alice M Gregory
- Department of Psychology, Goldsmiths, University of London, London, UK
| | - Avshalom Caspi
- Department of Psychology & Neuroscience, Duke University, Durham, NC ; Institute for Genome Sciences & Policy, Duke University, Durham, NC ; Department of Psychiatry & Behavioral Sciences, Duke University Medical Center, Durham, NC ; Social, Genetic, and Developmental Psychiatry Centre, Institute of Psychiatry, King's College, London, UK
| | - HonaLee Harrington
- Department of Psychology & Neuroscience, Duke University, Durham, NC ; Institute for Genome Sciences & Policy, Duke University, Durham, NC ; Department of Psychiatry & Behavioral Sciences, Duke University Medical Center, Durham, NC
| | - Michael Parsons
- MRC Harwell, Harwell Science and Innovation Campus, Oxfordshire, UK
| | - Richie Poulton
- Dunedin Multidisciplinary Health and Development Research Unit, Department of Preventive and Social Medicine, University of Otago, Dunedin, New Zealand
| | - Terrie E Moffitt
- Department of Psychology & Neuroscience, Duke University, Durham, NC ; Institute for Genome Sciences & Policy, Duke University, Durham, NC ; Department of Psychiatry & Behavioral Sciences, Duke University Medical Center, Durham, NC ; Social, Genetic, and Developmental Psychiatry Centre, Institute of Psychiatry, King's College, London, UK
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12
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Conroy DA. Improve Sleep during Midlife: Address Mental Health Problems Early. Sleep 2014; 37:1733-5. [DOI: 10.5665/sleep.4160] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
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Verhulst B, Hatemi PK. Gene-Environment Interplay in Twin Models. POLITICAL ANALYSIS : AN ANNUAL PUBLICATION OF THE METHODOLOGY SECTION OF THE AMERICAN POLITICAL SCIENCE ASSOCIATION 2013; 21:368-389. [PMID: 24808718 PMCID: PMC3745269 DOI: 10.1093/pan/mpt005] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
In this article, we respond to Shultziner's critique that argues that identical twins are more alike not because of genetic similarity, but because they select into more similar environments and respond to stimuli in comparable ways, and that these effects bias twin model estimates to such an extent that they are invalid. The essay further argues that the theory and methods that undergird twin models, as well as the empirical studies which rely upon them, are unaware of these potential biases. We correct this and other misunderstandings in the essay and find that gene-environment (GE) interplay is a well-articulated concept in behavior genetics and political science, operationalized as gene-environment correlation and gene-environment interaction. Both are incorporated into interpretations of the classical twin design (CTD) and estimated in numerous empirical studies through extensions of the CTD. We then conduct simulations to quantify the influence of GE interplay on estimates from the CTD. Due to the criticism's mischaracterization of the CTD and GE interplay, combined with the absence of any empirical evidence to counter what is presented in the extant literature and this article, we conclude that the critique does not enhance our understanding of the processes that drive political traits, genetic or otherwise.
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Affiliation(s)
- Brad Verhulst
- Virginia Institute for Psychiatric and Behavioral Genetics, Virginia Commonwealth University, 800 East Leigh Street, Biotech 1, Richmond, VA 23219 e-mail:
| | - Peter K Hatemi
- Department of Political Science, Microbiology and Biochemistry, Pennsylvania State University, 307 Pond Lab, University Park, PA 16802 e-mail: (corresponding author)
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Roberts RE, Duong HT. Depression and insomnia among adolescents: a prospective perspective. J Affect Disord 2013; 148:66-71. [PMID: 23261135 PMCID: PMC3644326 DOI: 10.1016/j.jad.2012.11.049] [Citation(s) in RCA: 103] [Impact Index Per Article: 9.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/09/2012] [Accepted: 11/20/2012] [Indexed: 11/27/2022]
Abstract
BACKGROUND No studies of adolescents have examined the prospective, reciprocal association between insomnia and major depression. METHODS A two-wave, community-based cohort of 3134 youths aged 11-17 at baseline. Major depression was assessed using DSM-IV criteria. Three measures of insomnia were used also following DSM-IV: P1, any symptom of insomnia; P2, any symptom plus impairment; P3, P2 with no comorbid mood, anxiety or substance use disorders. RESULTS In general, the association between insomnia and depression was stronger and more consistent for major depression than for symptoms of depression. Baseline insomnia (P1 and P2) increased subsequent risk of major depression 2-3-fold and P1 2-fold in multivariate analyses. Major depression increased risk for subsequent insomnia 2-3-fold for P1 and P2 2-fold for P2 in multivariate analyses. Results varied by measure of insomnia used. LIMITATIONS Only symptoms of insomnia were assessed, so we could not examine the effects of comorbid sleep disorders nor did we have objective or biological measures of disturbed sleep. We also did not collect data on parental reports of youth depression nor insomnia or sleep problems. CONCLUSION Our results provide the first prospective data on insomnia and major depression among adolescents indicating the two are reciprocally related. More studies are needed examining trajectories of insomnia and major depression in childhood and adolescence.
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Affiliation(s)
- Robert E. Roberts
- Correspondence to: Dr. Robert E. Roberts, UTHealth, School of Public Health, University of Texas Health Science Center, 1200 Herman Pressler Dr., E1017, Houston, TX 77030, USA Tel: (713) 500-9296; Fax: (713) 500-9406;
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Abstract
BACKGROUND Mood disorders are expressed in many heterogeneous forms, varying from anxiety to severe major clinical depression. The disorders are expressed in individual variety through manifestations governed by co-morbidities, symptom frequency, severity, and duration, and the effects of genes on phenotypes. The underlying etiologies of mood disorders consist of complex interactive operations of genetic and environmental factors. The notion of endophenotypes, which encompasses the markers of several underlying liabilities to the disorders, may facilitate efforts to detect and define, through staging, the genetic risks inherent to the extreme complexity of disease state. AIMS This review evaluates the role of genetic biomarkers in assisting clinical diagnosis, identification of risk factors, and treatment of mood disorders. METHODS Through a systematic assessment of studies investigating the epigenetic basis for mood disorders, the present review examines the interaction of genes and environment underlying the pathophysiology of these disorders. RESULTS The majority of research findings suggest that the notion of endophenotypes, which encompasses the markers of several underlying liabilities to the disorders, may facilitate efforts to detect and define, through staging, the genetic risks inherent to the extreme complexity of the disease states. Several strategies under development and refinement show the propensity for derivation of essential elements in the etiopathogenesis of the disorders affecting drug-efficacy, drug metabolism, and drug adverse effects, e.g., with regard to selective serotonin reuptake inhibitors. These include: transporter gene expression and genes encoding receptor systems, hypothalamic-pituitary-adrenal axis factors, neurotrophic factors, and inflammatory factors affecting neuroimmune function. Nevertheless, procedural considerations of pharmacogenetics presume the parallel investment of policies and regulations to withstand eventual attempts at misuse, thereby ensuring patient integrity. CONCLUSIONS Identification of genetic biomarkers facilitates choice of treatment, prediction of response, and prognosis of outcome over a wide spectrum of symptoms associated with affective states, thereby optimizing clinical practice procedures. Epigenetic regulation of primary brain signaling, e.g., serotonin and hypothalamic-pituitary-adrenal function, and factors governing their metabolism are necessary considerations. The participation of neurotrophic factors remains indispensable for neurogenesis, survival, and functional maintenance of brain systems.
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Affiliation(s)
- T Archer
- Department of Psychology, University of Gothenburg, Box 500, SE-40530 Gothenburg, Sweden
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