1
|
Nievergelt CM, Maihofer AX, Atkinson EG, Chen CY, Choi KW, Coleman JRI, Daskalakis NP, Duncan LE, Polimanti R, Aaronson C, Amstadter AB, Andersen SB, Andreassen OA, Arbisi PA, Ashley-Koch AE, Austin SB, Avdibegoviç E, Babić D, Bacanu SA, Baker DG, Batzler A, Beckham JC, Belangero S, Benjet C, Bergner C, Bierer LM, Biernacka JM, Bierut LJ, Bisson JI, Boks MP, Bolger EA, Brandolino A, Breen G, Bressan RA, Bryant RA, Bustamante AC, Bybjerg-Grauholm J, Bækvad-Hansen M, Børglum AD, Børte S, Cahn L, Calabrese JR, Caldas-de-Almeida JM, Chatzinakos C, Cheema S, Clouston SAP, Colodro-Conde L, Coombes BJ, Cruz-Fuentes CS, Dale AM, Dalvie S, Davis LK, Deckert J, Delahanty DL, Dennis MF, Desarnaud F, DiPietro CP, Disner SG, Docherty AR, Domschke K, Dyb G, Kulenović AD, Edenberg HJ, Evans A, Fabbri C, Fani N, Farrer LA, Feder A, Feeny NC, Flory JD, Forbes D, Franz CE, Galea S, Garrett ME, Gelaye B, Gelernter J, Geuze E, Gillespie CF, Goleva SB, Gordon SD, Goçi A, Grasser LR, Guindalini C, Haas M, Hagenaars S, Hauser MA, Heath AC, Hemmings SMJ, Hesselbrock V, Hickie IB, Hogan K, Hougaard DM, Huang H, Huckins LM, Hveem K, Jakovljević M, Javanbakht A, Jenkins GD, Johnson J, Jones I, Jovanovic T, Karstoft KI, Kaufman ML, Kennedy JL, Kessler RC, Khan A, Kimbrel NA, King AP, Koen N, Kotov R, Kranzler HR, Krebs K, Kremen WS, Kuan PF, Lawford BR, Lebois LAM, Lehto K, Levey DF, Lewis C, Liberzon I, Linnstaedt SD, Logue MW, Lori A, Lu Y, Luft BJ, Lupton MK, Luykx JJ, Makotkine I, Maples-Keller JL, Marchese S, Marmar C, Martin NG, Martínez-Levy GA, McAloney K, McFarlane A, McLaughlin KA, McLean SA, Medland SE, Mehta D, Meyers J, Michopoulos V, Mikita EA, Milani L, Milberg W, Miller MW, Morey RA, Morris CP, Mors O, Mortensen PB, Mufford MS, Nelson EC, Nordentoft M, Norman SB, Nugent NR, O'Donnell M, Orcutt HK, Pan PM, Panizzon MS, Pathak GA, Peters ES, Peterson AL, Peverill M, Pietrzak RH, Polusny MA, Porjesz B, Powers A, Qin XJ, Ratanatharathorn A, Risbrough VB, Roberts AL, Rothbaum AO, Rothbaum BO, Roy-Byrne P, Ruggiero KJ, Rung A, Runz H, Rutten BPF, de Viteri SS, Salum GA, Sampson L, Sanchez SE, Santoro M, Seah C, Seedat S, Seng JS, Shabalin A, Sheerin CM, Silove D, Smith AK, Smoller JW, Sponheim SR, Stein DJ, Stensland S, Stevens JS, Sumner JA, Teicher MH, Thompson WK, Tiwari AK, Trapido E, Uddin M, Ursano RJ, Valdimarsdóttir U, Van Hooff M, Vermetten E, Vinkers CH, Voisey J, Wang Y, Wang Z, Waszczuk M, Weber H, Wendt FR, Werge T, Williams MA, Williamson DE, Winsvold BS, Winternitz S, Wolf C, Wolf EJ, Xia Y, Xiong Y, Yehuda R, Young KA, Young RM, Zai CC, Zai GC, Zervas M, Zhao H, Zoellner LA, Zwart JA, deRoon-Cassini T, van Rooij SJH, van den Heuvel LL, Stein MB, Ressler KJ, Koenen KC. Genome-wide association analyses identify 95 risk loci and provide insights into the neurobiology of post-traumatic stress disorder. Nat Genet 2024:10.1038/s41588-024-01707-9. [PMID: 38637617 DOI: 10.1038/s41588-024-01707-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2023] [Accepted: 03/05/2024] [Indexed: 04/20/2024]
Abstract
Post-traumatic stress disorder (PTSD) genetics are characterized by lower discoverability than most other psychiatric disorders. The contribution to biological understanding from previous genetic studies has thus been limited. We performed a multi-ancestry meta-analysis of genome-wide association studies across 1,222,882 individuals of European ancestry (137,136 cases) and 58,051 admixed individuals with African and Native American ancestry (13,624 cases). We identified 95 genome-wide significant loci (80 new). Convergent multi-omic approaches identified 43 potential causal genes, broadly classified as neurotransmitter and ion channel synaptic modulators (for example, GRIA1, GRM8 and CACNA1E), developmental, axon guidance and transcription factors (for example, FOXP2, EFNA5 and DCC), synaptic structure and function genes (for example, PCLO, NCAM1 and PDE4B) and endocrine or immune regulators (for example, ESR1, TRAF3 and TANK). Additional top genes influence stress, immune, fear and threat-related processes, previously hypothesized to underlie PTSD neurobiology. These findings strengthen our understanding of neurobiological systems relevant to PTSD pathophysiology, while also opening new areas for investigation.
Collapse
Affiliation(s)
- Caroline M Nievergelt
- Department of Psychiatry, University of California San Diego, La Jolla, CA, USA.
- Veterans Affairs San Diego Healthcare System, Center of Excellence for Stress and Mental Health, San Diego, CA, USA.
- Veterans Affairs San Diego Healthcare System, Research Service, San Diego, CA, USA.
| | - Adam X Maihofer
- Department of Psychiatry, University of California San Diego, La Jolla, CA, USA
- Veterans Affairs San Diego Healthcare System, Center of Excellence for Stress and Mental Health, San Diego, CA, USA
- Veterans Affairs San Diego Healthcare System, Research Service, San Diego, CA, USA
| | - Elizabeth G Atkinson
- Department of Molecular and Human Genetics, Baylor College of Medicine, Houston, TX, USA
| | - Chia-Yen Chen
- Biogen Inc.,Translational Sciences, Cambridge, MA, USA
| | - Karmel W Choi
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA
- Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA
| | - Jonathan R I Coleman
- King's College London, National Institute for Health and Care Research Maudsley Biomedical Research Centre, South London and Maudsley NHS Foundation Trust, London, UK
- King's College London, Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, London, UK
| | - Nikolaos P Daskalakis
- Broad Institute of MIT and Harvard, Stanley Center for Psychiatric Research, Cambridge, MA, USA
- Department of Psychiatry, Harvard Medical School, Boston, MA, USA
- McLean Hospital, Center of Excellence in Depression and Anxiety Disorders, Belmont, MA, USA
| | - Laramie E Duncan
- Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, CA, USA
| | - Renato Polimanti
- VA Connecticut Healthcare Center, West Haven, CT, USA
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA
| | - Cindy Aaronson
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York City, NY, USA
| | - Ananda B Amstadter
- Department of Psychiatry, Virginia Institute for Psychiatric and Behavioral Genetics, Richmond, VA, USA
| | - Soren B Andersen
- The Danish Veteran Centre, Research and Knowledge Centre, Ringsted, Denmark
| | - Ole A Andreassen
- Oslo University Hospital, Division of Mental Health and Addiction, Oslo, Norway
- University of Oslo, Institute of Clinical Medicine, Oslo, Norway
| | - Paul A Arbisi
- Minneapolis VA Health Care System, Mental Health Service Line, Minneapolis, MN, USA
- Department of Psychiatry, University of Minnesota, Minneapolis, MN, USA
| | | | - S Bryn Austin
- Boston Children's Hospital, Division of Adolescent and Young Adult Medicine, Boston, MA, USA
- Department of Pediatrics, Harvard Medical School, Boston, MA, USA
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Esmina Avdibegoviç
- Department of Psychiatry, University Clinical Center of Tuzla, Tuzla, Bosnia and Herzegovina
| | - Dragan Babić
- Department of Psychiatry, University Clinical Center of Mostar, Mostar, Bosnia and Herzegovina
| | - Silviu-Alin Bacanu
- Department of Psychiatry, Virginia Commonwealth University, Richmond, VA, USA
| | - Dewleen G Baker
- Department of Psychiatry, University of California San Diego, La Jolla, CA, USA
- Veterans Affairs San Diego Healthcare System, Center of Excellence for Stress and Mental Health, San Diego, CA, USA
- Veterans Affairs San Diego Healthcare System, Psychiatry Service, San Diego, CA, USA
| | - Anthony Batzler
- Department of Quantitative Health Sciences, Mayo Clinic, Rochester, MN, USA
| | - Jean C Beckham
- Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, NC, USA
- Research, Durham VA Health Care System, Durham, NC, USA
- VA Mid-Atlantic Mental Illness Research, Education, and Clinical Center (MIRECC), Genetics Research Laboratory, Durham, NC, USA
| | - Sintia Belangero
- Department of Morphology and Genetics, Universidade Federal de São Paulo, São Paulo, Brazil
- Department of Psychiatry, Universidade Federal de São Paulo, Laboratory of Integrative Neuroscience, São Paulo, Brazil
| | - Corina Benjet
- Instituto Nacional de Psiquiatraía Ramón de la Fuente Muñiz, Center for Global Mental Health, Mexico City, Mexico
| | - Carisa Bergner
- Medical College of Wisconsin, Comprehensive Injury Center, Milwaukee, WI, USA
| | - Linda M Bierer
- Department of Psychiatry, James J. Peters VA Medical Center, Bronx, NY, USA
| | - Joanna M Biernacka
- Department of Quantitative Health Sciences, Mayo Clinic, Rochester, MN, USA
- Department of Psychiatry and Psychology, Mayo Clinic, Rochester, MN, USA
| | - Laura J Bierut
- Department of Psychiatry, Washington University in Saint Louis School of Medicine, Saint Louis, MO, USA
| | - Jonathan I Bisson
- Cardiff University, National Centre for Mental Health, MRC Centre for Psychiatric Genetics and Genomics, Cardiff, UK
| | - Marco P Boks
- Department of Psychiatry, Brain Center University Medical Center Utrecht, Utrecht, The Netherlands
| | - Elizabeth A Bolger
- Department of Psychiatry, Harvard Medical School, Boston, MA, USA
- McLean Hospital, Belmont, MA, USA
| | - Amber Brandolino
- Department of Surgery, Division of Trauma & Acute Care Surgery, Medical College of Wisconsin, Milwaukee, WI, USA
| | - Gerome Breen
- King's College London, Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, London, UK
- King's College London, NIHR Maudsley BRC, London, UK
| | - Rodrigo Affonseca Bressan
- Department of Psychiatry, Universidade Federal de São Paulo, Laboratory of Integrative Neuroscience, São Paulo, Brazil
- Department of Psychiatry, Universidade Federal de São Paulo, São Paulo, Brazil
| | - Richard A Bryant
- University of New South Wales, School of Psychology, Sydney, New South Wales, Australia
| | - Angela C Bustamante
- Department of Internal Medicine, University of Michigan Medical School, Division of Pulmonary and Critical Care Medicine, Ann Arbor, MI, USA
| | - Jonas Bybjerg-Grauholm
- Department for Congenital Disorders, Statens Serum Institut, Copenhagen, Denmark
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research, iPSYCH, Aarhus, Denmark
| | - Marie Bækvad-Hansen
- Department for Congenital Disorders, Statens Serum Institut, Copenhagen, Denmark
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research, iPSYCH, Aarhus, Denmark
| | - Anders D Børglum
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research, iPSYCH, Aarhus, Denmark
- Aarhus University, Centre for Integrative Sequencing, iSEQ, Aarhus, Denmark
- Department of Biomedicine-Human Genetics, Aarhus University, Aarhus, Denmark
| | - Sigrid Børte
- Department of Public Health and Nursing, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, K. G. Jebsen Center for Genetic Epidemiology, Trondheim, Norway
- Oslo University Hospital, Department of Research, Innovation and Education, Division of Clinical Neuroscience, Oslo, Norway
| | - Leah Cahn
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York City, NY, USA
| | - Joseph R Calabrese
- Case Western Reserve University, School of Medicine, Cleveland, OH, USA
- Department of Psychiatry, University Hospitals, Cleveland, OH, USA
| | | | - Chris Chatzinakos
- Broad Institute of MIT and Harvard, Stanley Center for Psychiatric Research, Cambridge, MA, USA
- Department of Psychiatry, Harvard Medical School, Boston, MA, USA
- McLean Hospital, Division of Depression and Anxiety Disorders, Belmont, MA, USA
| | - Sheraz Cheema
- University of Toronto, CanPath National Coordinating Center, Toronto, Ontario, Canada
| | - Sean A P Clouston
- Stony Brook University, Family, Population, and Preventive Medicine, Stony Brook, NY, USA
- Stony Brook University, Public Health, Stony Brook, NY, USA
| | - Lucía Colodro-Conde
- QIMR Berghofer Medical Research Institute, Mental Health & Neuroscience Program, Brisbane, Queensland, Australia
| | - Brandon J Coombes
- Department of Quantitative Health Sciences, Mayo Clinic, Rochester, MN, USA
| | - Carlos S Cruz-Fuentes
- Department of Genetics, Instituto Nacional de Psiquiatraía Ramón de la Fuente Muñiz, Mexico City, Mexico
| | - Anders M Dale
- Department of Radiology, Department of Neurosciences, University of California San Diego, La Jolla, CA, USA
| | - Shareefa Dalvie
- Department of Pathology, University of Cape Town, Division of Human Genetics, Cape Town, South Africa
| | - Lea K Davis
- Vanderbilt University Medical Center, Vanderbilt Genetics Institute, Nashville, TN, USA
| | - Jürgen Deckert
- University Hospital of Würzburg, Center of Mental Health, Psychiatry, Psychosomatics and Psychotherapy, Würzburg, Denmark
| | | | - Michelle F Dennis
- Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, NC, USA
- Research, Durham VA Health Care System, Durham, NC, USA
- VA Mid-Atlantic Mental Illness Research, Education, and Clinical Center (MIRECC), Genetics Research Laboratory, Durham, NC, USA
| | - Frank Desarnaud
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York City, NY, USA
| | - Christopher P DiPietro
- Broad Institute of MIT and Harvard, Stanley Center for Psychiatric Research, Cambridge, MA, USA
- McLean Hospital, Division of Depression and Anxiety Disorders, Belmont, MA, USA
| | - Seth G Disner
- Minneapolis VA Health Care System, Research Service Line, Minneapolis, MN, USA
- Department of Psychiatry & Behavioral Sciences, University of Minnesota Medical School, Minneapolis, MN, USA
| | - Anna R Docherty
- Huntsman Mental Health Institute, Salt Lake City, UT, USA
- Department of Psychiatry, University of Utah School of Medicine, Salt Lake City, UT, USA
| | - Katharina Domschke
- University of Freiburg, Faculty of Medicine, Centre for Basics in Neuromodulation, Freiburg, Denmark
- Department of Psychiatry and Psychotherapy, University of Freiburg, Faculty of Medicine, Freiburg, Denmark
| | - Grete Dyb
- University of Oslo, Institute of Clinical Medicine, Oslo, Norway
- Norwegian Centre for Violence and Traumatic Stress Studies, Oslo, Norway
| | - Alma Džubur Kulenović
- Department of Psychiatry, University Clinical Center of Sarajevo, Sarajevo, Bosnia and Herzegovina
| | - Howard J Edenberg
- Indiana University School of Medicine, Biochemistry and Molecular Biology, Indianapolis, IN, USA
- Indiana University School of Medicine, Medical and Molecular Genetics, Indianapolis, IN, USA
| | - Alexandra Evans
- Cardiff University, National Centre for Mental Health, MRC Centre for Psychiatric Genetics and Genomics, Cardiff, UK
| | - Chiara Fabbri
- King's College London, Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, London, UK
- Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy
| | - Negar Fani
- Department of Psychiatry and Behavioral Sciences, Emory University, Atlanta, GA, USA
| | - Lindsay A Farrer
- Department of Medicine (Biomedical Genetics), Boston University Chobanian & Avedisian School of Medicine, Boston, MA, USA
- Department of Neurology, Boston University Chobanian & Avedisian School of Medicine, Boston, MA, USA
- Department of Ophthalmology, Boston University Chobanian & Avedisian School of Medicine, Boston, MA, USA
- Department of Biostatistics, Boston University School of Public Health, Boston, MA, USA
- Department of Epidemiology, Boston University School of Public Health, Boston, MA, USA
| | - Adriana Feder
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York City, NY, USA
| | - Norah C Feeny
- Department of Psychological Sciences, Case Western Reserve University, Cleveland, OH, USA
| | - Janine D Flory
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York City, NY, USA
| | - David Forbes
- Department of Psychiatry, University of Melbourne, Melbourne, Victoria, Australia
| | - Carol E Franz
- Department of Psychiatry, University of California San Diego, La Jolla, CA, USA
| | - Sandro Galea
- Boston University School of Public Health, Boston, MA, USA
| | - Melanie E Garrett
- Duke University, Duke Molecular Physiology Institute, Durham, NC, USA
| | - Bizu Gelaye
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Joel Gelernter
- VA Connecticut Healthcare Center, Psychiatry Service, West Haven, CT, USA
- Department of Genetics and Neuroscience, Yale University School of Medicine, New Haven, CT, USA
| | - Elbert Geuze
- Netherlands Ministry of Defence, Brain Research and Innovation Centre, Utrecht, The Netherlands
- Department of Psychiatry, UMC Utrecht Brain Center Rudolf Magnus, Utrecht, The Netherlands
| | - Charles F Gillespie
- Department of Psychiatry and Behavioral Sciences, Emory University, Atlanta, GA, USA
| | - Slavina B Goleva
- Vanderbilt University Medical Center, Vanderbilt Genetics Institute, Nashville, TN, USA
- National Institutes of Health, National Human Genome Research Institute, Bethesda, MD, USA
| | - Scott D Gordon
- QIMR Berghofer Medical Research Institute, Mental Health & Neuroscience Program, Brisbane, Queensland, Australia
| | - Aferdita Goçi
- Department of Psychiatry, University Clinical Centre of Kosovo, Prishtina, Kosovo
| | - Lana Ruvolo Grasser
- Wayne State University School of Medicine, Psychiatry and Behavioral Neurosciencess, Detroit, MI, USA
| | - Camila Guindalini
- Gallipoli Medical Research Foundation, Greenslopes Private Hospital, Greenslopes, Queensland, Australia
| | - Magali Haas
- Cohen Veterans Bioscience, New York City, NY, USA
| | - Saskia Hagenaars
- King's College London, National Institute for Health and Care Research Maudsley Biomedical Research Centre, South London and Maudsley NHS Foundation Trust, London, UK
- King's College London, Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, London, UK
| | - Michael A Hauser
- Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, NC, USA
| | - Andrew C Heath
- Department of Genetics, Washington University in Saint Louis School of Medicine, Saint Louis, MO, USA
| | - Sian M J Hemmings
- Department of Psychiatry, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
- SAMRC Genomics of Brain Disorders Research Unit, Stellenbosch University, Cape Town, South Africa
| | - Victor Hesselbrock
- University of Connecticut School of Medicine, Psychiatry, Farmington, CT, USA
| | - Ian B Hickie
- University of Sydney, Brain and Mind Centre, Sydney, New South Wales, Australia
| | - Kelleigh Hogan
- Department of Psychiatry, University of California San Diego, La Jolla, CA, USA
- Veterans Affairs San Diego Healthcare System, Center of Excellence for Stress and Mental Health, San Diego, CA, USA
- Veterans Affairs San Diego Healthcare System, Research Service, San Diego, CA, USA
| | - David Michael Hougaard
- Department for Congenital Disorders, Statens Serum Institut, Copenhagen, Denmark
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research, iPSYCH, Aarhus, Denmark
| | - Hailiang Huang
- Broad Institute of MIT and Harvard, Stanley Center for Psychiatric Research, Cambridge, MA, USA
- Department of Medicine, Massachusetts General Hospital, Analytic and Translational Genetics Unit, Boston, MA, USA
| | - Laura M Huckins
- Department of Psychiatry, Yale University, New Haven, CT, USA
| | - Kristian Hveem
- Department of Public Health and Nursing, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, K. G. Jebsen Center for Genetic Epidemiology, Trondheim, Norway
| | - Miro Jakovljević
- Department of Psychiatry, University Hospital Center of Zagreb, Zagreb, Croatia
| | - Arash Javanbakht
- Wayne State University School of Medicine, Psychiatry and Behavioral Neurosciencess, Detroit, MI, USA
| | - Gregory D Jenkins
- Department of Quantitative Health Sciences, Mayo Clinic, Rochester, MN, USA
| | - Jessica Johnson
- Genetics and Genomic Sciences, Icahn School of Medicine at Mount Sinai, New York City, NY, USA
| | - Ian Jones
- Cardiff University, National Centre for Mental Health, Cardiff University Centre for Psychiatric Genetics and Genomics, Cardiff, UK
| | - Tanja Jovanovic
- Department of Psychiatry and Behavioral Sciences, Emory University, Atlanta, GA, USA
| | - Karen-Inge Karstoft
- The Danish Veteran Centre, Research and Knowledge Centre, Ringsted, Denmark
- Department of Psychology, University of Copenhagen, Copenhagen, Denmark
| | - Milissa L Kaufman
- Department of Psychiatry, Harvard Medical School, Boston, MA, USA
- McLean Hospital, Belmont, MA, USA
| | - James L Kennedy
- Centre for Addiction and Mental Health, Neurogenetics Section, Molecular Brain Science Department, Campbell Family Mental Health Research Institute, Toronto, Ontario, Canada
- Centre for Addiction and Mental Health, Tanenbaum Centre for Pharmacogenetics, Toronto, Ontario, Canada
- Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
- Institute of Medical Sciences, University of Toronto, Toronto, Ontario, Canada
| | - Ronald C Kessler
- Department of Health Care Policy, Harvard Medical School, Boston, MA, USA
| | - Alaptagin Khan
- Department of Psychiatry, Harvard Medical School, Boston, MA, USA
- McLean Hospital, Belmont, MA, USA
| | - Nathan A Kimbrel
- Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, NC, USA
- VA Mid-Atlantic Mental Illness Research, Education, and Clinical Center (MIRECC), Genetics Research Laboratory, Durham, NC, USA
- Durham VA Health Care System, Mental Health Service Line, Durham, NC, USA
| | - Anthony P King
- The Ohio State University, College of Medicine, Institute for Behavioral Medicine Research, Columbus, OH, USA
| | - Nastassja Koen
- University of Cape Town, Department of Psychiatry & Neuroscience Institute, SA MRC Unit on Risk & Resilience in Mental Disorders, Cape Town, South Africa
| | - Roman Kotov
- Department of Psychiatry, Stony Brook University, Stony Brook, NY, USA
| | - Henry R Kranzler
- Mental Illness Research, Education and Clinical Center, Crescenz VAMC, Philadelphia, PA, USA
- Department of Psychiatry, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA
| | - Kristi Krebs
- University of Tartu, Institute of Genomics, Estonian Genome Center, Tartu, Estonia
| | - William S Kremen
- Department of Psychiatry, University of California San Diego, La Jolla, CA, USA
| | - Pei-Fen Kuan
- Department of Applied Mathematics and Statistics, Stony Brook University, Stony Brook, NY, USA
| | - Bruce R Lawford
- Queensland University of Technology, School of Biomedical Sciences, Kelvin Grove, Queensland, Australia
| | - Lauren A M Lebois
- Department of Psychiatry, Harvard Medical School, Boston, MA, USA
- McLean Hospital, Center of Excellence in Depression and Anxiety Disorders, Belmont, MA, USA
| | - Kelli Lehto
- University of Tartu, Institute of Genomics, Estonian Genome Center, Tartu, Estonia
| | - Daniel F Levey
- VA Connecticut Healthcare Center, West Haven, CT, USA
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA
| | - Catrin Lewis
- Cardiff University, National Centre for Mental Health, MRC Centre for Psychiatric Genetics and Genomics, Cardiff, UK
| | - Israel Liberzon
- Department of Psychiatry and Behavioral Sciences, Texas A&M University College of Medicine, Bryan, TX, USA
| | - Sarah D Linnstaedt
- Department of Anesthesiology, UNC Institute for Trauma Recovery, Chapel Hill, NC, USA
| | - Mark W Logue
- Department of Biostatistics, Boston University School of Public Health, Boston, MA, USA
- Boston University School of Medicine, Psychiatry, Biomedical Genetics, Boston, MA, USA
- VA Boston Healthcare System, National Center for PTSD, Boston, MA, USA
| | - Adriana Lori
- Department of Psychiatry and Behavioral Sciences, Emory University, Atlanta, GA, USA
| | - Yi Lu
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Benjamin J Luft
- Department of Medicine, Stony Brook University, Stony Brook, NY, USA
| | - Michelle K Lupton
- QIMR Berghofer Medical Research Institute, Mental Health & Neuroscience Program, Brisbane, Queensland, Australia
| | - Jurjen J Luykx
- Department of Psychiatry, UMC Utrecht Brain Center Rudolf Magnus, Utrecht, The Netherlands
- Department of Translational Neuroscience, UMC Utrecht Brain Center Rudolf Magnus, Utrecht, The Netherlands
| | - Iouri Makotkine
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York City, NY, USA
| | | | - Shelby Marchese
- Department of Genetic and Genomic Sciences, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Charles Marmar
- New York University, Grossman School of Medicine, New York City, NY, USA
| | - Nicholas G Martin
- QIMR Berghofer Medical Research Institute, Genetics, Brisbane, Queensland, Australia
| | - Gabriela A Martínez-Levy
- Department of Genetics, Instituto Nacional de Psiquiatraía Ramón de la Fuente Muñiz, Mexico City, Mexico
| | - Kerrie McAloney
- QIMR Berghofer Medical Research Institute, Mental Health & Neuroscience Program, Brisbane, Queensland, Australia
| | - Alexander McFarlane
- University of Adelaide, Discipline of Psychiatry, Adelaide, South Australia, Australia
| | | | - Samuel A McLean
- Department of Anesthesiology, UNC Institute for Trauma Recovery, Chapel Hill, NC, USA
- Department of Emergency Medicine, UNC Institute for Trauma Recovery, Chapel Hill, NC, USA
| | - Sarah E Medland
- QIMR Berghofer Medical Research Institute, Mental Health & Neuroscience Program, Brisbane, Queensland, Australia
| | - Divya Mehta
- Queensland University of Technology, School of Biomedical Sciences, Kelvin Grove, Queensland, Australia
- Queensland University of Technology, Centre for Genomics and Personalised Health, Kelvin Grove, Queensland, Australia
| | - Jacquelyn Meyers
- Department of Psychiatry and Behavioral Sciences, SUNY Downstate Health Sciences University, Brooklyn, NY, USA
| | - Vasiliki Michopoulos
- Department of Psychiatry and Behavioral Sciences, Emory University, Atlanta, GA, USA
| | - Elizabeth A Mikita
- Department of Psychiatry, University of California San Diego, La Jolla, CA, USA
- Veterans Affairs San Diego Healthcare System, Center of Excellence for Stress and Mental Health, San Diego, CA, USA
- Veterans Affairs San Diego Healthcare System, Research Service, San Diego, CA, USA
| | - Lili Milani
- University of Tartu, Institute of Genomics, Estonian Genome Center, Tartu, Estonia
| | | | - Mark W Miller
- Boston University School of Medicine, Psychiatry, Biomedical Genetics, Boston, MA, USA
- VA Boston Healthcare System, National Center for PTSD, Boston, MA, USA
| | - Rajendra A Morey
- Duke University School of Medicine, Duke Brain Imaging and Analysis Center, Durham, NC, USA
| | - Charles Phillip Morris
- Queensland University of Technology, School of Biomedical Sciences, Kelvin Grove, Queensland, Australia
| | - Ole Mors
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research, iPSYCH, Aarhus, Denmark
- Aarhus University Hospital-Psychiatry, Psychosis Research Unit, Aarhus, Denmark
| | - Preben Bo Mortensen
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research, iPSYCH, Aarhus, Denmark
- Aarhus University, Centre for Integrative Sequencing, iSEQ, Aarhus, Denmark
- Aarhus University, Centre for Integrated Register-Based Research, Aarhus, Denmark
- Aarhus University, National Centre for Register-Based Research, Aarhus, Denmark
| | - Mary S Mufford
- Department of Pathology, University of Cape Town, Division of Human Genetics, Cape Town, South Africa
| | - Elliot C Nelson
- Department of Psychiatry, Washington University in Saint Louis School of Medicine, Saint Louis, MO, USA
| | - Merete Nordentoft
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research, iPSYCH, Aarhus, Denmark
- University of Copenhagen, Mental Health Services in the Capital Region of Denmark, Copenhagen, Denmark
| | - Sonya B Norman
- Department of Psychiatry, University of California San Diego, La Jolla, CA, USA
- Veterans Affairs San Diego Healthcare System, Center of Excellence for Stress and Mental Health, San Diego, CA, USA
- National Center for Post Traumatic Stress Disorder, Executive Division, White River Junction, VT, USA
| | - Nicole R Nugent
- Department of Emergency Medicine, Alpert Brown Medical School, Providence, RI, USA
- Department of Pediatrics, Alpert Brown Medical School, Providence, RI, USA
- Department of Psychiatry and Human Behavior, Alpert Brown Medical School, Providence, RI, USA
| | - Meaghan O'Donnell
- Department of Psychiatry, University of Melbourne, Phoenix Australia, Melbourne, Victoria, Australia
| | - Holly K Orcutt
- Department of Psychology, Northern Illinois University, DeKalb, IL, USA
| | - Pedro M Pan
- Universidade Federal de São Paulo, Psychiatry, São Paulo, Brazil
| | - Matthew S Panizzon
- Department of Psychiatry, University of California San Diego, La Jolla, CA, USA
| | - Gita A Pathak
- VA Connecticut Healthcare Center, West Haven, CT, USA
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA
| | - Edward S Peters
- University of Nebraska Medical Center, College of Public Health, Omaha, NE, USA
| | - Alan L Peterson
- South Texas Veterans Health Care System, Research and Development Service, San Antonio, TX, USA
- Department of Psychiatry and Behavioral Sciences, University of Texas Health Science Center at San Antonio, San Antonio, TX, USA
| | - Matthew Peverill
- Department of Psychology, University of Washington, Seattle, WA, USA
| | - Robert H Pietrzak
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA
- U.S. Department of Veterans Affairs National Center for Posttraumatic Stress Disorder, West Haven, CT, USA
| | - Melissa A Polusny
- Minneapolis VA Health Care System, Mental Health Service Line, Minneapolis, MN, USA
- Department of Psychiatry & Behavioral Sciences, University of Minnesota Medical School, Minneapolis, MN, USA
- Center for Care Delivery and Outcomes Research (CCDOR), Minneapolis, MN, USA
| | - Bernice Porjesz
- Department of Psychiatry and Behavioral Sciences, SUNY Downstate Health Sciences University, Brooklyn, NY, USA
| | - Abigail Powers
- Department of Psychiatry and Behavioral Sciences, Emory University, Atlanta, GA, USA
| | - Xue-Jun Qin
- Duke University, Duke Molecular Physiology Institute, Durham, NC, USA
| | - Andrew Ratanatharathorn
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA
- Department of Epidemiology, Columbia University Mailmain School of Public Health, New York City, NY, USA
| | - Victoria B Risbrough
- Department of Psychiatry, University of California San Diego, La Jolla, CA, USA
- Veterans Affairs San Diego Healthcare System, Center of Excellence for Stress and Mental Health, San Diego, CA, USA
- Veterans Affairs San Diego Healthcare System, Research Service, San Diego, CA, USA
| | - Andrea L Roberts
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Alex O Rothbaum
- Department of Psychological Sciences, Emory University, Atlanta, GA, USA
- Department of Research and Outcomes, Skyland Trail, Atlanta, GA, USA
| | - Barbara O Rothbaum
- Department of Psychiatry and Behavioral Sciences, Emory University, Atlanta, GA, USA
| | - Peter Roy-Byrne
- Department of Psychiatry, University of Washington, Seattle, WA, USA
| | - Kenneth J Ruggiero
- Department of Nursing, Department of Psychiatry, Medical University of South Carolina, Charleston, SC, USA
| | - Ariane Rung
- Department of Epidemiology, Louisiana State University Health Sciences Center, School of Public Health, New Orleans, LA, USA
| | - Heiko Runz
- Biogen Inc., Research & Development, Cambridge, MA, USA
| | - Bart P F Rutten
- Department of Psychiatry and Neuropsychology, Maastricht Universitair Medisch Centrum, School for Mental Health and Neuroscience, Maastricht, The Netherlands
| | | | - Giovanni Abrahão Salum
- Child Mind Institute, New York City, NY, USA
- Instituto Nacional de Psiquiatria de Desenvolvimento, São Paulo, Brazil
| | - Laura Sampson
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA
- Department of Epidemiology, Boston University School of Public Health, Boston, MA, USA
| | - Sixto E Sanchez
- Department of Medicine, Universidad Peruana de Ciencias Aplicadas, Lima, Peru
| | - Marcos Santoro
- Universidade Federal de São Paulo, Departamento de Bioquímica-Disciplina de Biologia Molecular, São Paulo, Brazil
| | - Carina Seah
- Department of Genetic and Genomic Sciences, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Soraya Seedat
- Department of Psychiatry, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
- Stellenbosch University, SAMRC Extramural Genomics of Brain Disorders Research Unit, Cape Town, South Africa
| | - Julia S Seng
- Department of Obstetrics and Gynecology, University of Michigan, Ann Arbor, MI, USA
- Department of Women's and Gender Studies, University of Michigan, Ann Arbor, MI, USA
- University of Michigan, Institute for Research on Women and Gender, Ann Arbor, MI, USA
- University of Michigan, School of Nursing, Ann Arbor, MI, USA
| | - Andrey Shabalin
- Department of Psychiatry, University of Utah School of Medicine, Salt Lake City, UT, USA
| | - Christina M Sheerin
- Department of Psychiatry, Virginia Institute for Psychiatric and Behavioral Genetics, Richmond, VA, USA
| | - Derrick Silove
- Department of Psychiatry, University of New South Wales, Sydney, New South Wales, Australia
| | - Alicia K Smith
- Department of Psychiatry and Behavioral Sciences, Emory University, Atlanta, GA, USA
- Department of Gynecology and Obstetrics, Department of Psychiatry and Behavioral Sciences, Department of Human Genetics, Emory University, Atlanta, GA, USA
| | - Jordan W Smoller
- Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA
- Broad Institute of MIT and Harvard, Stanley Center for Psychiatric Research, Cambridge, MA, USA
- Massachusetts General Hospital, Psychiatric and Neurodevelopmental Genetics Unit (PNGU), Boston, MA, USA
| | - Scott R Sponheim
- Minneapolis VA Health Care System, Mental Health Service Line, Minneapolis, MN, USA
- Department of Psychiatry and Behavioral Sciences, University of Minnesota Medical School, Minneapolis, MN, USA
| | - Dan J Stein
- University of Cape Town, Department of Psychiatry & Neuroscience Institute, SA MRC Unit on Risk & Resilience in Mental Disorders, Cape Town, South Africa
| | - Synne Stensland
- Oslo University Hospital, Department of Research, Innovation and Education, Division of Clinical Neuroscience, Oslo, Norway
- Norwegian Centre for Violence and Traumatic Stress Studies, Oslo, Norway
| | - Jennifer S Stevens
- Department of Psychiatry and Behavioral Sciences, Emory University, Atlanta, GA, USA
| | - Jennifer A Sumner
- Department of Psychology, University of California, Los Angeles, Los Angeles, CA, USA
| | - Martin H Teicher
- Department of Psychiatry, Harvard Medical School, Boston, MA, USA
- McLean Hospital, Developmental Biopsychiatry Research Program, Belmont, MA, USA
| | - Wesley K Thompson
- Mental Health Centre Sct. Hans, Institute of Biological Psychiatry, Roskilde, Denmark
- University of California San Diego, Herbert Wertheim School of Public Health and Human Longevity Science, La Jolla, CA, USA
| | - Arun K Tiwari
- Centre for Addiction and Mental Health, Neurogenetics Section, Molecular Brain Science Department, Campbell Family Mental Health Research Institute, Toronto, Ontario, Canada
- Centre for Addiction and Mental Health, Tanenbaum Centre for Pharmacogenetics, Toronto, Ontario, Canada
- Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
| | - Edward Trapido
- Department of Epidemiology, Louisiana State University Health Sciences Center, School of Public Health, New Orleans, LA, USA
| | - Monica Uddin
- University of South Florida College of Public Health, Genomics Program, Tampa, FL, USA
| | - Robert J Ursano
- Department of Psychiatry, Uniformed Services University, Bethesda, MD, USA
| | - Unnur Valdimarsdóttir
- Karolinska Institutet, Unit of Integrative Epidemiology, Institute of Environmental Medicine, Stockholm, Sweden
- University of Iceland, Faculty of Medicine, Center of Public Health Sciences, School of Health Sciences, Reykjavik, Iceland
| | - Miranda Van Hooff
- University of Adelaide, Adelaide Medical School, Adelaide, South Australia, Australia
| | - Eric Vermetten
- ARQ Nationaal Psychotrauma Centrum, Psychotrauma Research Expert Group, Diemen, The Netherlands
- Department of Psychiatry, Leiden University Medical Center, Leiden, The Netherlands
- Department of Psychiatry, New York University School of Medicine, New York City, NY, USA
| | - Christiaan H Vinkers
- Amsterdam Neuroscience, Mood, Anxiety, Psychosis, Sleep & Stress Program, Amsterdam, The Netherlands
- Department of Anatomy and Neurosciences, Amsterdam UMC location Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
- Department of Psychiatry, Amsterdam UMC location Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Joanne Voisey
- Queensland University of Technology, School of Biomedical Sciences, Kelvin Grove, Queensland, Australia
- Queensland University of Technology, Centre for Genomics and Personalised Health, Kelvin Grove, Queensland, Australia
| | - Yunpeng Wang
- Department of Psychology, University of Oslo, Lifespan Changes in Brain and Cognition (LCBC), Oslo, Norway
| | - Zhewu Wang
- Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, SC, USA
- Department of Mental Health, Ralph H Johnson VA Medical Center, Charleston, SC, USA
| | - Monika Waszczuk
- Department of Psychology, Rosalind Franklin University of Medicine and Science, North Chicago, IL, USA
| | - Heike Weber
- University Hospital of Würzburg, Center of Mental Health, Psychiatry, Psychosomatics and Psychotherapy, Würzburg, Denmark
| | - Frank R Wendt
- Department of Anthropology, University of Toronto, Dalla Lana School of Public Health, Toronto, Ontario, Canada
| | - Thomas Werge
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research, iPSYCH, Aarhus, Denmark
- Copenhagen University Hospital, Institute of Biological Psychiatry, Mental Health Services, Copenhagen, Denmark
- Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
- University of Copenhagen, The Globe Institute, Lundbeck Foundation Center for Geogenetics, Copenhagen, Denmark
| | - Michelle A Williams
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Douglas E Williamson
- Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, NC, USA
- Research, Durham VA Health Care System, Durham, NC, USA
| | - Bendik S Winsvold
- Department of Public Health and Nursing, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, K. G. Jebsen Center for Genetic Epidemiology, Trondheim, Norway
- Oslo University Hospital, Department of Research, Innovation and Education, Division of Clinical Neuroscience, Oslo, Norway
- Department of Neurology, Oslo University Hospital, Oslo, Norway
| | - Sherry Winternitz
- Department of Psychiatry, Harvard Medical School, Boston, MA, USA
- McLean Hospital, Belmont, MA, USA
| | - Christiane Wolf
- University Hospital of Würzburg, Center of Mental Health, Psychiatry, Psychosomatics and Psychotherapy, Würzburg, Denmark
| | - Erika J Wolf
- VA Boston Healthcare System, National Center for PTSD, Boston, MA, USA
- Department of Psychiatry, Boston University Chobanian & Avedisian School of Medicine, Boston, MA, USA
| | - Yan Xia
- Broad Institute of MIT and Harvard, Stanley Center for Psychiatric Research, Cambridge, MA, USA
- Department of Medicine, Massachusetts General Hospital, Analytic and Translational Genetics Unit, Boston, MA, USA
| | - Ying Xiong
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Rachel Yehuda
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York City, NY, USA
- Department of Mental Health, James J. Peters VA Medical Center, Bronx, NY, USA
| | - Keith A Young
- Central Texas Veterans Health Care System, Research Service, Temple, TX, USA
- Department of Psychiatry and Behavioral Sciences, Texas A&M University School of Medicine, Bryan, TX, USA
| | - Ross McD Young
- Queensland University of Technology, School of Clinical Sciences, Kelvin Grove, Queensland, Australia
- University of the Sunshine Coast, The Chancellory, Sippy Downs, Queensland, Australia
| | - Clement C Zai
- Broad Institute of MIT and Harvard, Stanley Center for Psychiatric Research, Cambridge, MA, USA
- Centre for Addiction and Mental Health, Neurogenetics Section, Molecular Brain Science Department, Campbell Family Mental Health Research Institute, Toronto, Ontario, Canada
- Centre for Addiction and Mental Health, Tanenbaum Centre for Pharmacogenetics, Toronto, Ontario, Canada
- Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
- Institute of Medical Sciences, University of Toronto, Toronto, Ontario, Canada
- Department of Laboratory Medicine and Pathology, University of Toronto, Toronto, Ontario, Canada
| | - Gwyneth C Zai
- Centre for Addiction and Mental Health, Neurogenetics Section, Molecular Brain Science Department, Campbell Family Mental Health Research Institute, Toronto, Ontario, Canada
- Centre for Addiction and Mental Health, Tanenbaum Centre for Pharmacogenetics, Toronto, Ontario, Canada
- Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
- Institute of Medical Sciences, University of Toronto, Toronto, Ontario, Canada
- Centre for Addiction and Mental Health, General Adult Psychiatry and Health Systems Division, Toronto, Ontario, Canada
| | - Mark Zervas
- Cohen Veterans Bioscience, New York City, NY, USA
| | - Hongyu Zhao
- Department of Biostatistics, Yale University, New Haven, CT, USA
| | - Lori A Zoellner
- Department of Psychology, University of Washington, Seattle, WA, USA
| | - John-Anker Zwart
- University of Oslo, Institute of Clinical Medicine, Oslo, Norway
- Department of Public Health and Nursing, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, K. G. Jebsen Center for Genetic Epidemiology, Trondheim, Norway
- Oslo University Hospital, Department of Research, Innovation and Education, Division of Clinical Neuroscience, Oslo, Norway
| | - Terri deRoon-Cassini
- Department of Surgery, Division of Trauma & Acute Care Surgery, Medical College of Wisconsin, Milwaukee, WI, USA
| | - Sanne J H van Rooij
- Department of Psychiatry and Behavioral Sciences, Emory University, Atlanta, GA, USA
| | - Leigh L van den Heuvel
- Department of Psychiatry, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
- SAMRC Genomics of Brain Disorders Research Unit, Stellenbosch University, Cape Town, South Africa
| | - Murray B Stein
- Department of Psychiatry, University of California San Diego, La Jolla, CA, USA
- Veterans Affairs San Diego Healthcare System, Psychiatry Service, San Diego, CA, USA
- University of California San Diego, School of Public Health, La Jolla, CA, USA
| | - Kerry J Ressler
- Department of Psychiatry, Harvard Medical School, Boston, MA, USA
- McLean Hospital, Belmont, MA, USA
- Department of Psychiatry and Behavioral Sciences, Emory University, Atlanta, GA, USA
| | - Karestan C Koenen
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA
- Broad Institute of MIT and Harvard, Stanley Center for Psychiatric Research, Cambridge, MA, USA
- Massachusetts General Hospital, Psychiatric and Neurodevelopmental Genetics Unit (PNGU), Boston, MA, USA
| |
Collapse
|
2
|
Cole TA, Dubuclet CM, Valentine J, Meyer EA, Orcutt HK. Assessing the mediating role of emotion regulation and experiential avoidance within a posttraumatic stress disorder and racial trauma framework. Psychol Trauma 2024; 16:254-261. [PMID: 37053407 DOI: 10.1037/tra0001487] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/15/2023]
Abstract
OBJECTIVE Theoretical and empirical evidence has begun to delineate posttraumatic stress disorder (PTSD) and racial trauma, but the degree to which individual psychological processes differ in the development of these two outcomes remains limited. Despite key distinctions in etiology and phenotypic presentations, prominent PTSD risk factors such as difficulties in emotion regulation and experiential avoidance (EA) may also contribute to the development of racial trauma. The goal of the present cross-sectional study was to investigate how difficulties in emotion regulation and EA differ in their associations with PTSD and racial trauma. METHOD For this study, racial and ethnic minority undergraduate students completed a battery of questionnaires including the Everyday Discrimination Scale, Brief Experiential Avoidance Questionnaire, Difficulties in Emotion Regulation Scale, Trauma Symptoms of Discrimination Scale, and the PTSD checklist for DSM-5. RESULTS A path model suggested emotion regulation difficulties and EA significantly mediated the relationship between perceived discrimination and PTSD symptoms. However, only emotion regulation difficulties mediated the relationship between perceived discrimination and racial trauma symptoms. Compared to racial trauma, pairwise comparisons suggested that emotion regulation difficulties and EA indirect effects were significantly greater when predicting PTSD symptoms. Additionally, the effects of emotion regulation difficulties were greater than EA when predicting PTSD symptoms and racial trauma. CONCLUSION Findings of the present study suggest individual psychological factors may play a lesser role in the development of racial trauma compared to PTSD symptoms. (PsycInfo Database Record (c) 2024 APA, all rights reserved).
Collapse
Affiliation(s)
- Travis A Cole
- Department of Psychology, Northern Illinois University
| | | | | | | | | |
Collapse
|
3
|
Ellis RA, Darnell BC, Orcutt HK. Comparing written exposure therapy delivered via telehealth to trauma-focused expressive writing in undergraduates: A proof-of-concept trial. J Trauma Stress 2023; 36:1157-1166. [PMID: 37782476 DOI: 10.1002/jts.22969] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/17/2023] [Revised: 07/17/2023] [Accepted: 07/17/2023] [Indexed: 10/03/2023]
Abstract
The literature demonstrates that posttraumatic stress disorder (PTSD) rates are estimated to be higher on college campuses compared to lifetime estimates in the general population. Written exposure therapy (WET) is a promising brief intervention for posttraumatic stress symptoms (PTSS) with a growing literature of evidence suggesting efficacy, lower drop-out rates compared to other evidence-based protocols, and long-term treatment gains. This proof-of-concept study examined the efficacy of WET delivered via telehealth compared to expressive writing (EW), the protocol from which WET was derived. The sample included non-treatment-seeking trauma-exposed undergraduate students (N = 33) with elevated PTSS. The results suggest that both WET, g = 1.26, and EW, g = 0.61, were associated with within-person decreases in PTSS. However, reliable change indices indicated that a significantly larger proportion of individuals in the WET condition (61.5%) demonstrated reliable symptom improvement compared to those who received EW (20.0%), g = 0.91. Contrary to our hypotheses, the WET and EW groups did not differ on reliable slopes of change; however, between-group effects were underpowered and should be interpreted with caution. These findings offer preliminary support for WET delivered via telehealth, including for individuals with subthreshold PTSS.
Collapse
Affiliation(s)
- Robyn A Ellis
- Department of Psychology, Northern Illinois University, DeKalb, Illinois, USA
- McLean Hospital, Belmont, Massachusetts, USA
- Department of Psychiatry, Harvard Medical School, Boston, Massachusetts, USA
| | - Benjamin C Darnell
- Massachusetts Veterans Epidemiology Research and Information Center, VA Boston Healthcare System, Boston, Massachusetts, USA
| | - Holly K Orcutt
- Department of Psychology, Northern Illinois University, DeKalb, Illinois, USA
| |
Collapse
|
4
|
Ellis RA, Orcutt HK. The Indirect Effect of Avoidant Motives for Sex on the Pathways From Childhood Maltreatment to Risky Sex Behaviors. J Interpers Violence 2023; 38:11337-11355. [PMID: 37381819 DOI: 10.1177/08862605231179726] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/30/2023]
Abstract
Literature supports a strong link between engagement in risky sex and childhood maltreatment, with engagement in risky sexual behavior proposed as a manifestation of avoidant coping. Sex motives refer to underlying motivations for engaging in sex such as increased intimacy, or peer pressure. Limited research has examined the role of sex motives on the relationship between childhood maltreatment and risky sex. This study sought to examine this path between childhood maltreatment types and later engagement in risky sex through sex motivations that seek to avoid or reduce negative affect (i.e., sex to cope and sex to affirm self-esteem). A sample of sexually active undergraduate women (n = 551) completed a series of questionnaires on childhood maltreatment, risky sexual behavior, and motivations for sexual intercourse as part of a larger parent study on revictimization. Path analysis was conducted to examine differential indirect effects of childhood maltreatment on risky sex (i.e., sex with a stranger and hookup behaviors). Results suggested sex to cope with negative affect mediated the relationship between emotional abuse, sexual abuse, physical neglect, and hookup behavior. Only an indirect path between childhood emotional abuse and sex with a stranger was identified through sex to cope. Emotional abuse was the only maltreatment to predict sex to affirm, but sex to affirm did not predict risky sex outcomes. Findings provide support for differential pathways from various forms of childhood maltreatment, specifically sexual abuse, emotional abuse, and physical neglect, to increased risky sex as a manifestation of avoidant coping. Furthermore, results support the call for more inclusion of nonsexual forms of childhood maltreatment in studies of risky sex and avoidant coping as a potential intervention target for risky sexual behavior regardless of childhood maltreatment type.
Collapse
Affiliation(s)
- Robyn A Ellis
- McLean Hospital, Belmont, MA, USA
- Department of Psychiatry, Harvard Medical School, Boston, MA, USA
| | | |
Collapse
|
5
|
Nievergelt CM, Maihofer AX, Atkinson EG, Chen CY, Choi KW, Coleman JR, Daskalakis NP, Duncan LE, Polimanti R, Aaronson C, Amstadter AB, Andersen SB, Andreassen OA, Arbisi PA, Ashley-Koch AE, Austin SB, Avdibegoviç E, Babic D, Bacanu SA, Baker DG, Batzler A, Beckham JC, Belangero S, Benjet C, Bergner C, Bierer LM, Biernacka JM, Bierut LJ, Bisson JI, Boks MP, Bolger EA, Brandolino A, Breen G, Bressan RA, Bryant RA, Bustamante AC, Bybjerg-Grauholm J, Bækvad-Hansen M, Børglum AD, Børte S, Cahn L, Calabrese JR, Caldas-de-Almeida JM, Chatzinakos C, Cheema S, Clouston SAP, Colodro-Conde L, Coombes BJ, Cruz-Fuentes CS, Dale AM, Dalvie S, Davis LK, Deckert J, Delahanty DL, Dennis MF, deRoon-Cassini T, Desarnaud F, DiPietro CP, Disner SG, Docherty AR, Domschke K, Dyb G, Kulenovic AD, Edenberg HJ, Evans A, Fabbri C, Fani N, Farrer LA, Feder A, Feeny NC, Flory JD, Forbes D, Franz CE, Galea S, Garrett ME, Gelaye B, Gelernter J, Geuze E, Gillespie CF, Goci A, Goleva SB, Gordon SD, Grasser LR, Guindalini C, Haas M, Hagenaars S, Hauser MA, Heath AC, Hemmings SM, Hesselbrock V, Hickie IB, Hogan K, Hougaard DM, Huang H, Huckins LM, Hveem K, Jakovljevic M, Javanbakht A, Jenkins GD, Johnson J, Jones I, Jovanovic T, Karstoft KI, Kaufman ML, Kennedy JL, Kessler RC, Khan A, Kimbrel NA, King AP, Koen N, Kotov R, Kranzler HR, Krebs K, Kremen WS, Kuan PF, Lawford BR, Lebois LAM, Lehto K, Levey DF, Lewis C, Liberzon I, Linnstaedt SD, Logue MW, Lori A, Lu Y, Luft BJ, Lupton MK, Luykx JJ, Makotkine I, Maples-Keller JL, Marchese S, Marmar C, Martin NG, MartÍnez-Levy GA, McAloney K, McFarlane A, McLaughlin KA, McLean SA, Medland SE, Mehta D, Meyers J, Michopoulos V, Mikita EA, Milani L, Milberg W, Miller MW, Morey RA, Morris CP, Mors O, Mortensen PB, Mufford MS, Nelson EC, Nordentoft M, Norman SB, Nugent NR, O'Donnell M, Orcutt HK, Pan PM, Panizzon MS, Pathak GA, Peters ES, Peterson AL, Peverill M, Pietrzak RH, Polusny MA, Porjesz B, Powers A, Qin XJ, Ratanatharathorn A, Risbrough VB, Roberts AL, Rothbaum BO, Rothbaum AO, Roy-Byrne P, Ruggiero KJ, Rung A, Runz H, Rutten BPF, de Viteri SS, Salum GA, Sampson L, Sanchez SE, Santoro M, Seah C, Seedat S, Seng JS, Shabalin A, Sheerin CM, Silove D, Smith AK, Smoller JW, Sponheim SR, Stein DJ, Stensland S, Stevens JS, Sumner JA, Teicher MH, Thompson WK, Tiwari AK, Trapido E, Uddin M, Ursano RJ, Valdimarsdóttir U, van den Heuvel LL, Van Hooff M, van Rooij SJ, Vermetten E, Vinkers CH, Voisey J, Wang Z, Wang Y, Waszczuk M, Weber H, Wendt FR, Werge T, Williams MA, Williamson DE, Winsvold BS, Winternitz S, Wolf EJ, Wolf C, Xia Y, Xiong Y, Yehuda R, Young RM, Young KA, Zai CC, Zai GC, Zervas M, Zhao H, Zoellner LA, Zwart JA, Stein MB, Ressler KJ, Koenen KC. Discovery of 95 PTSD loci provides insight into genetic architecture and neurobiology of trauma and stress-related disorders. medRxiv 2023:2023.08.31.23294915. [PMID: 37693460 PMCID: PMC10491375 DOI: 10.1101/2023.08.31.23294915] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/12/2023]
Abstract
Posttraumatic stress disorder (PTSD) genetics are characterized by lower discoverability than most other psychiatric disorders. The contribution to biological understanding from previous genetic studies has thus been limited. We performed a multi-ancestry meta-analysis of genome-wide association studies across 1,222,882 individuals of European ancestry (137,136 cases) and 58,051 admixed individuals with African and Native American ancestry (13,624 cases). We identified 95 genome-wide significant loci (80 novel). Convergent multi-omic approaches identified 43 potential causal genes, broadly classified as neurotransmitter and ion channel synaptic modulators (e.g., GRIA1, GRM8, CACNA1E ), developmental, axon guidance, and transcription factors (e.g., FOXP2, EFNA5, DCC ), synaptic structure and function genes (e.g., PCLO, NCAM1, PDE4B ), and endocrine or immune regulators (e.g., ESR1, TRAF3, TANK ). Additional top genes influence stress, immune, fear, and threat-related processes, previously hypothesized to underlie PTSD neurobiology. These findings strengthen our understanding of neurobiological systems relevant to PTSD pathophysiology, while also opening new areas for investigation.
Collapse
|
6
|
Maihofer AX, Engchuan W, Huguet G, Klein M, MacDonald JR, Shanta O, Thiruvahindrapuram B, Jean-Louis M, Saci Z, Jacquemont S, Scherer SW, Ketema E, Aiello AE, Amstadter AB, Avdibegović E, Babic D, Baker DG, Bisson JI, Boks MP, Bolger EA, Bryant RA, Bustamante AC, Caldas-de-Almeida JM, Cardoso G, Deckert J, Delahanty DL, Domschke K, Dunlop BW, Dzubur-Kulenovic A, Evans A, Feeny NC, Franz CE, Gautam A, Geuze E, Goci A, Hammamieh R, Jakovljevic M, Jett M, Jones I, Kaufman ML, Kessler RC, King AP, Kremen WS, Lawford BR, Lebois LAM, Lewis C, Liberzon I, Linnstaedt SD, Lugonja B, Luykx JJ, Lyons MJ, Mavissakalian MR, McLaughlin KA, McLean SA, Mehta D, Mellor R, Morris CP, Muhie S, Orcutt HK, Peverill M, Ratanatharathorn A, Risbrough VB, Rizzo A, Roberts AL, Rothbaum AO, Rothbaum BO, Roy-Byrne P, Ruggiero KJ, Rutten BPF, Schijven D, Seng JS, Sheerin CM, Sorenson MA, Teicher MH, Uddin M, Ursano RJ, Vinkers CH, Voisey J, Weber H, Winternitz S, Xavier M, Yang R, McD Young R, Zoellner LA, Salem RM, Shaffer RA, Wu T, Ressler KJ, Stein MB, Koenen KC, Sebat J, Nievergelt CM. Rare copy number variation in posttraumatic stress disorder. Mol Psychiatry 2022; 27:5062-5069. [PMID: 36131047 PMCID: PMC9763110 DOI: 10.1038/s41380-022-01776-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/25/2022] [Revised: 08/24/2022] [Accepted: 09/02/2022] [Indexed: 01/27/2023]
Abstract
Posttraumatic stress disorder (PTSD) is a heritable (h2 = 24-71%) psychiatric illness. Copy number variation (CNV) is a form of rare genetic variation that has been implicated in the etiology of psychiatric disorders, but no large-scale investigation of CNV in PTSD has been performed. We present an association study of CNV burden and PTSD symptoms in a sample of 114,383 participants (13,036 cases and 101,347 controls) of European ancestry. CNVs were called using two calling algorithms and intersected to a consensus set. Quality control was performed to remove strong outlier samples. CNVs were examined for association with PTSD within each cohort using linear or logistic regression analysis adjusted for population structure and CNV quality metrics, then inverse variance weighted meta-analyzed across cohorts. We examined the genome-wide total span of CNVs, enrichment of CNVs within specified gene-sets, and CNVs overlapping individual genes and implicated neurodevelopmental regions. The total distance covered by deletions crossing over known neurodevelopmental CNV regions was significant (beta = 0.029, SE = 0.005, P = 6.3 × 10-8). The genome-wide neurodevelopmental CNV burden identified explains 0.034% of the variation in PTSD symptoms. The 15q11.2 BP1-BP2 microdeletion region was significantly associated with PTSD (beta = 0.0206, SE = 0.0056, P = 0.0002). No individual significant genes interrupted by CNV were identified. 22 gene pathways related to the function of the nervous system and brain were significant in pathway analysis (FDR q < 0.05), but these associations were not significant once NDD regions were removed. A larger sample size, better detection methods, and annotated resources of CNV are needed to explore this relationship further.
Collapse
Affiliation(s)
- Adam X Maihofer
- Department of Psychiatry, University of California San Diego, La Jolla, CA, USA.
- Department of Family Medicine and Public Health, University of California San Diego, La Jolla, CA, USA.
- Veterans Affairs San Diego Healthcare System, Center of Excellence for Stress and Mental Health, San Diego, CA, USA.
| | - Worrawat Engchuan
- The Hospital for Sick Children, Genetics and Genome Biology, Toronto, Ontario, Canada
- The Hospital for Sick Children, The Centre for Applied Genomics, Toronto, Ontario, Canada
| | - Guillaume Huguet
- Centre Hospitalier Universitaire Sainte-Justine Centre de Recherche, Montreal, Quebec, Canada
| | - Marieke Klein
- Department of Psychiatry, University of California San Diego, La Jolla, CA, USA
| | - Jeffrey R MacDonald
- The Hospital for Sick Children, Genetics and Genome Biology, Toronto, Ontario, Canada
| | - Omar Shanta
- Bioinformatics and Systems Biology Graduate Program, University of California San Diego, La Jolla, CA, USA
| | | | - Martineau Jean-Louis
- Department of Pediatrics, Centre Hospitalier Universitaire Sainte-Justine Centre de Recherche, Montreal, Quebec, Canada
| | - Zohra Saci
- Centre Hospitalier Universitaire Sainte-Justine Centre de Recherche, Montreal, Quebec, Canada
| | - Sebastien Jacquemont
- Centre Hospitalier Universitaire Sainte-Justine Centre de Recherche, Montreal, Quebec, Canada
- Department of Genetics, Centre Hospitalier Universitaire Vaudois, Lausanne, Vaud, Switzerland
- Department of Pediatrics, University of Montreal, Montreal, Quebec, Canada
| | - Stephen W Scherer
- The Hospital for Sick Children, Genetics and Genome Biology, Toronto, Ontario, Canada
- University of Toronto, McLaughlin Centre, Toronto, Ontario, Canada
- Department of Molecular Genetics, University of Toronto, Toronto, Ontario, Canada
| | - Elizabeth Ketema
- Department of Psychiatry, University of California San Diego, La Jolla, CA, USA
- Veterans Affairs San Diego Healthcare System, Center of Excellence for Stress and Mental Health, San Diego, CA, USA
- Research Service, Veterans Affairs San Diego Healthcare System, San Diego, CA, USA
| | - Allison E Aiello
- Department of Epidemiology, Robert N Butler Columbia Aging Center, Columbia University, New York, NY, USA
| | - Ananda B Amstadter
- Department of Psychiatry, Virginia Institute for Psychiatric and Behavioral Genetics, Richmond, VA, USA
| | - Esmina Avdibegović
- Department of Psychiatry, University Clinical Center of Tuzla, Tuzla, Bosnia and Herzegovina
| | - Dragan Babic
- Department of Psychiatry, University Clinical Center of Mostar, Mostar, Bosnia and Herzegovina
| | - Dewleen G Baker
- Department of Psychiatry, University of California San Diego, La Jolla, CA, USA
- Veterans Affairs San Diego Healthcare System, Center of Excellence for Stress and Mental Health, San Diego, CA, USA
- Psychiatry Service, Veterans Affairs San Diego Healthcare System, San Diego, CA, USA
| | - Jonathan I Bisson
- MRC Centre for Psychiatric Genetics and Genomics, Cardiff University, National Centre for Mental Health, Cardiff, South Glamorgan, UK
| | - Marco P Boks
- Department of Psychiatry, UMC Utrecht Brain Center, Utrecht, the Netherlands
| | - Elizabeth A Bolger
- Department of Psychiatry, Harvard Medical School, Boston, MA, USA
- McLean Hospital, Belmont, MA, USA
| | - Richard A Bryant
- Department of Psychology, University of New South Wales, Sydney, NSW, Australia
| | - Angela C Bustamante
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, University of Michigan Medical School, Ann Arbor, MI, USA
| | | | - Graça Cardoso
- Lisbon Institute of Global Mental Health and Comprehensive Health Research Centre, Universidade Nova de Lisboa, Lisboa, Portugal
| | - Jurgen Deckert
- University Hospital of Wuerzburg, Center of Mental Health, Psychiatry, Psychosomatics and Psychotherapy, Wuerzburg, Germany
| | - Douglas L Delahanty
- Department of Psychological Sciences, Kent State University, Kent, OH, USA
- Research and Sponsored Programs, Kent State University, Kent, OH, USA
| | - Katharina Domschke
- Department of Psychiatry and Psychotherapy, Medical Center-University of Freiburg, Faculty of Medicine, Freiburg, Germany
- Faculty of Medicine, Centre for Basics in Neuromodulation, University of Freiburg, Freiburg, Germany
| | - Boadie W Dunlop
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA, USA
| | - Alma Dzubur-Kulenovic
- Department of Psychiatry, University Clinical Center of Sarajevo, Sarajevo, Bosnia and Herzegovina
| | - Alexandra Evans
- MRC Centre for Psychiatric Genetics and Genomics, Cardiff University, National Centre for Mental Health, Cardiff, South Glamorgan, UK
| | - Norah C Feeny
- Department of Psychological Sciences, Case Western Reserve University, Cleveland, OH, USA
| | - Carol E Franz
- Department of Psychiatry, University of California San Diego, La Jolla, CA, USA
| | - Aarti Gautam
- Walter Reed Army Institute of Research, Medical Readiness Systems Biology, Center for Military Psychiatry and Neuroscience, Silver Spring, MD, USA
| | - Elbert Geuze
- Netherlands Ministry of Defence, Brain Research and Innovation Centre, Utrecht, the Netherlands
- Department of Psychiatry, UMC Utrecht Brain Center Rudolf Magnus, Utrecht, the Netherlands
| | - Aferdita Goci
- Department of Psychiatry, University Clinical Centre of Kosovo, Prishtina, Kosovo
| | - Rasha Hammamieh
- Walter Reed Army Institute of Research, Medical Readiness Systems Biology, Center for Military Psychiatry and Neuroscience, Silver Spring, MD, USA
| | - Miro Jakovljevic
- Department of Psychiatry, University Hospital Center of Zagreb, Zagreb, Croatia
| | - Marti Jett
- US Medical Research & Development Comm, Fort Detrick, MD, USA
- Walter Reed Army Institute of Research, Headquarter, Silver Spring, MD, USA
| | - Ian Jones
- MRC Centre for Psychiatric Genetics and Genomics, Cardiff University, National Centre for Mental Health, Cardiff, South Glamorgan, UK
| | - Milissa L Kaufman
- Department of Psychiatry, Harvard Medical School, Boston, MA, USA
- McLean Hospital, Belmont, MA, USA
| | - Ronald C Kessler
- Department of Health Care Policy, Harvard Medical School, Boston, MA, USA
| | - Anthony P King
- Ohio State University, College of Medicine, Institute for Behavioral Medicine Research, Columbus, OH, USA
| | - William S Kremen
- Department of Psychiatry, University of California San Diego, La Jolla, CA, USA
| | - Bruce R Lawford
- School of Biomedical Sciences, Queensland University of Technology, Kelvin Grove, QLD, Australia
| | - Lauren A M Lebois
- Department of Psychiatry, Harvard Medical School, Boston, MA, USA
- McLean Hospital, Belmont, MA, USA
| | - Catrin Lewis
- MRC Centre for Psychiatric Genetics and Genomics, Cardiff University, National Centre for Mental Health, Cardiff, South Glamorgan, UK
| | - Israel Liberzon
- Department of Psychiatry and Behavioral Sciences, Texas A&M University College of Medicine, Bryan, TX, USA
| | - Sarah D Linnstaedt
- Institute for Trauma Recovery, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Bozo Lugonja
- MRC Centre for Psychiatric Genetics and Genomics, Cardiff University, National Centre for Mental Health, Cardiff, South Glamorgan, UK
| | - Jurjen J Luykx
- Department of Psychiatry, UMC Utrecht Brain Center Rudolf Magnus, Utrecht, the Netherlands
- Department of Translational Neuroscience, UMC Utrecht Brain Center Rudolf Magnus, Utrecht, the Netherlands
| | - Michael J Lyons
- Department of Psychological & Brain Sciences, Boston University, Boston, MA, USA
| | | | | | - Samuel A McLean
- Institute for Trauma Recovery, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
- Department of Emergency Medicine, UNC Institute for Trauma Recovery, Chapel Hill, NC, USA
| | - Divya Mehta
- School of Biomedical Sciences, Queensland University of Technology, Kelvin Grove, QLD, Australia
- Queensland University of Technology, Centre for Genomics and Personalised Health, Kelvin Grove, QLD, Australia
| | - Rebecca Mellor
- Gallipoli Medical Research Foundation, Greenslopes Private Hospital, Greenslopes, QLD, Australia
| | - Charles Phillip Morris
- School of Biomedical Sciences, Queensland University of Technology, Kelvin Grove, QLD, Australia
| | - Seid Muhie
- Walter Reed Army Institute of Research, Silver Spring, MD, USA
| | - Holly K Orcutt
- Department of Psychology, Northern Illinois University, DeKalb, IL, USA
| | - Matthew Peverill
- Department of Psychology, University of Washington, Seattle, WA, USA
| | - Andrew Ratanatharathorn
- Department of Epidemiology, Columbia University Mailmain School of Public Health, New York, NY, USA
- Department of Epidemiology, Harvard T. H. Chan School of Public Health, Boston, MA, USA
| | - Victoria B Risbrough
- Department of Psychiatry, University of California San Diego, La Jolla, CA, USA
- Veterans Affairs San Diego Healthcare System, Center of Excellence for Stress and Mental Health, San Diego, CA, USA
- Research Service, Veterans Affairs San Diego Healthcare System, San Diego, CA, USA
| | - Albert Rizzo
- University of Southern California, Institute for Creative Technologies, Los Angeles, CA, USA
| | - Andrea L Roberts
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Alex O Rothbaum
- Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, SC, USA
| | - Barbara O Rothbaum
- Department of Psychiatry and Behavioral Sciences, Emory University, Atlanta, GA, USA
| | - Peter Roy-Byrne
- Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, WA, USA
| | - Kenneth J Ruggiero
- Department of Nursing and Department of Psychiatry, Medical University of South Carolina, Charleston, SC, USA
| | - Bart P F Rutten
- Department of Psychiatry and Neuropsychology, Maastricht Universitair Medisch Centrum, School for Mental Health and Neuroscience, Maastricht, Limburg, the Netherlands
| | - Dick Schijven
- Department of Psychiatry, UMC Utrecht Brain Center Rudolf Magnus, Utrecht, the Netherlands
- Department of Translational Neuroscience, UMC Utrecht Brain Center Rudolf Magnus, Utrecht, the Netherlands
| | - Julia S Seng
- University of Michigan, School of Nursing, Ann Arbor, MI, USA
- Department of Obstetrics and Gynecology, University of Michigan, Ann Arbor, MI, USA
- Department of Women's and Gender Studies, University of Michigan, Ann Arbor, MI, USA
- University of Michigan, Institute for Research on Women and Gender, Ann Arbor, MI, USA
| | - Christina M Sheerin
- Department of Psychiatry, Virginia Institute for Psychiatric and Behavioral Genetics, Richmond, VA, USA
| | - Michael A Sorenson
- Department of Psychiatry, University of California San Diego, La Jolla, CA, USA
| | - Martin H Teicher
- Department of Psychiatry, Harvard Medical School, Boston, MA, USA
- Developmental Biopsychiatry Research Program, McLean Hospital, Belmont, MA, USA
| | - Monica Uddin
- Genomics Program, College of Public Health, University of South Florida, Tampa, FL, USA
| | - Robert J Ursano
- Department of Psychiatry, Uniformed Services University, Bethesda, MD, USA
| | - Christiaan H Vinkers
- Amsterdam Neuroscience, Mood, Anxiety, Psychosis, Sleep & Stress Program, Amsterdam, the Netherlands
- Department of Psychiatry, Amsterdam UMC Location Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
- Department of Anatomy and Neurosciences, Amsterdam UMC Location Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
| | - Joanne Voisey
- School of Biomedical Sciences, Queensland University of Technology, Kelvin Grove, QLD, Australia
- Queensland University of Technology, Centre for Genomics and Personalised Health, Kelvin Grove, QLD, Australia
| | - Heike Weber
- University Hospital of Wuerzburg, Center of Mental Health, Psychiatry, Psychosomatics and Psychotherapy, Wuerzburg, Germany
| | - Sherry Winternitz
- Department of Psychiatry, Harvard Medical School, Boston, MA, USA
- McLean Hospital, Belmont, MA, USA
| | - Miguel Xavier
- Universidade Nova de Lisboa, Nova Medical School, Lisboa, Portugal
| | - Ruoting Yang
- Walter Reed Army Institute of Research, Silver Spring, MD, USA
| | - Ross McD Young
- Queensland University of Technology, School of Clinical Sciences, Kelvin Grove, QLD, Australia
- University of the Sunshine Coast, The Chancellory, Sippy Downs, QLD, Australia
| | - Lori A Zoellner
- Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, WA, USA
| | - Rany M Salem
- University of California San Diego, Herbert Wertheim School of Public Health and Human Longevity Science, La Jolla, CA, USA
| | - Richard A Shaffer
- Department of Epidemiology and Health Sciences, Naval Health Research Center, San Diego, CA, USA
| | - Tianying Wu
- Division of Epidemiology and Biostatistics, San Diego State University, School of Public Health, San Diego, CA, USA
- University of California, San Diego, Moores Cancer Center, San Diego, CA, USA
| | - Kerry J Ressler
- Department of Psychiatry, Harvard Medical School, Boston, MA, USA
- McLean Hospital, Belmont, MA, USA
- Department of Psychiatry and Behavioral Sciences, Emory University, Atlanta, GA, USA
| | - Murray B Stein
- Department of Psychiatry, University of California San Diego, La Jolla, CA, USA
- Psychiatry Service, Veterans Affairs San Diego Healthcare System, San Diego, CA, USA
- University of California San Diego, School of Public Health, La Jolla, CA, USA
| | - Karestan C Koenen
- Broad Institute of MIT and Harvard, Stanley Center for Psychiatric Research, Cambridge, MA, USA
- Department of Epidemiology, Harvard T. H. School of Public Health, Boston, MA, USA
- Psychiatric and Neurodevelopmental Genetics Unit (PNGU), Massachusetts General Hospital, Boston, MA, USA
| | - Jonathan Sebat
- Department of Psychiatry, University of California San Diego, La Jolla, CA, USA
- Cold Spring Harbor Laboratory, Cold Spring Harbor, NY, USA
- Department of Cellular and Molecular Medicine, University of California San Diego, La Jolla, CA, USA
| | - Caroline M Nievergelt
- Department of Psychiatry, University of California San Diego, La Jolla, CA, USA
- Veterans Affairs San Diego Healthcare System, Center of Excellence for Stress and Mental Health, San Diego, CA, USA
- Research Service, Veterans Affairs San Diego Healthcare System, San Diego, CA, USA
| |
Collapse
|
7
|
Maihofer AX, Choi KW, Coleman JR, Daskalakis NP, Denckla CA, Ketema E, Morey RA, Polimanti R, Ratanatharathorn A, Torres K, Wingo AP, Zai CC, Aiello AE, Almli LM, Amstadter AB, Andersen SB, Andreassen OA, Arbisi PA, Ashley-Koch AE, Austin SB, Avdibegović E, Borglum AD, Babić D, Bækvad-Hansen M, Baker DG, Beckham JC, Bierut LJ, Bisson JI, Boks MP, Bolger EA, Bradley B, Brashear M, Breen G, Bryant RA, Bustamante AC, Bybjerg-Grauholm J, Calabrese JR, Caldas-de-Almeida JM, Chen CY, Dale AM, Dalvie S, Deckert J, Delahanty DL, Dennis MF, Disner SG, Domschke K, Duncan LE, Kulenović AD, Erbes CR, Evans A, Farrer LA, Feeny NC, Flory JD, Forbes D, Franz CE, Galea S, Garrett ME, Gautam A, Gelaye B, Gelernter J, Geuze E, Gillespie CF, Goçi A, Gordon SD, Guffanti G, Hammamieh R, Hauser MA, Heath AC, Hemmings SM, Hougaard DM, Jakovljević M, Jett M, Johnson EO, Jones I, Jovanovic T, Qin XJ, Karstoft KI, Kaufman ML, Kessler RC, Khan A, Kimbrel NA, King AP, Koen N, Kranzler HR, Kremen WS, Lawford BR, Lebois LA, Lewis C, Liberzon I, Linnstaedt SD, Logue MW, Lori A, Lugonja B, Luykx JJ, Lyons MJ, Maples-Keller JL, Marmar C, Martin NG, Maurer D, Mavissakalian MR, McFarlane A, McGlinchey RE, McLaughlin KA, McLean SA, Mehta D, Mellor R, Michopoulos V, Milberg W, Miller MW, Morris CP, Mors O, Mortensen PB, Nelson EC, Nordentoft M, Norman SB, O’Donnell M, Orcutt HK, Panizzon MS, Peters ES, Peterson AL, Peverill M, Pietrzak RH, Polusny MA, Rice JP, Risbrough VB, Roberts AL, Rothbaum AO, Rothbaum BO, Roy-Byrne P, Ruggiero KJ, Rung A, Rutten BP, Saccone NL, Sanchez SE, Schijven D, Seedat S, Seligowski AV, Seng JS, Sheerin CM, Silove D, Smith AK, Smoller JW, Sponheim SR, Stein DJ, Stevens JS, Teicher MH, Thompson WK, Trapido E, Uddin M, Ursano RJ, van den Heuvel LL, Van Hooff M, Vermetten E, Vinkers C, Voisey J, Wang Y, Wang Z, Werge T, Williams MA, Williamson DE, Winternitz S, Wolf C, Wolf EJ, Yehuda R, Young KA, Young RM, Zhao H, Zoellner LA, Haas M, Lasseter H, Provost AC, Salem RM, Sebat J, Shaffer RA, Wu T, Ripke S, Daly MJ, Ressler KJ, Koenen KC, Stein MB, Nievergelt CM. Enhancing Discovery of Genetic Variants for Posttraumatic Stress Disorder Through Integration of Quantitative Phenotypes and Trauma Exposure Information. Biol Psychiatry 2022; 91:626-636. [PMID: 34865855 PMCID: PMC8917986 DOI: 10.1016/j.biopsych.2021.09.020] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/28/2021] [Revised: 08/25/2021] [Accepted: 09/21/2021] [Indexed: 01/12/2023]
Abstract
BACKGROUND Posttraumatic stress disorder (PTSD) is heritable and a potential consequence of exposure to traumatic stress. Evidence suggests that a quantitative approach to PTSD phenotype measurement and incorporation of lifetime trauma exposure (LTE) information could enhance the discovery power of PTSD genome-wide association studies (GWASs). METHODS A GWAS on PTSD symptoms was performed in 51 cohorts followed by a fixed-effects meta-analysis (N = 182,199 European ancestry participants). A GWAS of LTE burden was performed in the UK Biobank cohort (N = 132,988). Genetic correlations were evaluated with linkage disequilibrium score regression. Multivariate analysis was performed using Multi-Trait Analysis of GWAS. Functional mapping and annotation of leading loci was performed with FUMA. Replication was evaluated using the Million Veteran Program GWAS of PTSD total symptoms. RESULTS GWASs of PTSD symptoms and LTE burden identified 5 and 6 independent genome-wide significant loci, respectively. There was a 72% genetic correlation between PTSD and LTE. PTSD and LTE showed largely similar patterns of genetic correlation with other traits, albeit with some distinctions. Adjusting PTSD for LTE reduced PTSD heritability by 31%. Multivariate analysis of PTSD and LTE increased the effective sample size of the PTSD GWAS by 20% and identified 4 additional loci. Four of these 9 PTSD loci were independently replicated in the Million Veteran Program. CONCLUSIONS Through using a quantitative trait measure of PTSD, we identified novel risk loci not previously identified using prior case-control analyses. PTSD and LTE have a high genetic overlap that can be leveraged to increase discovery power through multivariate methods.
Collapse
|
8
|
Reffi AN, Ellis RA, Darnell BC, Orcutt HK. Mental health service utilization following a campus mass shooting: The role of preshooting emotion dysregulation and posttraumatic cognitions. Psychol Trauma 2022; 14:151-160. [PMID: 34197171 PMCID: PMC8720105 DOI: 10.1037/tra0001036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
OBJECTIVE This study investigated preshooting emotion dysregulation and posttraumatic cognitions as predictors of mental health service utilization ([MHU]; i.e., therapy/medication) among undergraduate women following a campus mass shooting, controlling for time, age, and postshooting posttraumatic stress (PTS) and depressive symptoms. METHOD Undergraduate women (N = 483, Mage = 19.23, SD = 2.39) were engaged in a study when a mass shooting occurred on Northern Illinois University's campus. A separate, longitudinal study was then implemented to monitor postshooting adjustment among these same women. The present study examined predictors of MHU using data from the preshooting assessment and the following postshooting timepoints: 9 months (T1; n = 416); 14 months (T2; n = 416); 20 months (T3; n = 417); 26 months (T4; n = 405); and 33 months (T5; n = 397). RESULTS Multilevel models showed preshooting emotion dysregulation and postshooting PTS and depressive symptoms positively predicted increased likelihood of MHU while controlling for covariates. Posttraumatic cognitions initially predicted increased therapy utilization, but this relationship became nonsignificant after accounting for preshooting emotion dysregulation. Preshooting emotion dysregulation also weakened the positive relationship between depressive symptoms and therapy utilization and strengthened the positive relationship between age and therapy utilization. CONCLUSIONS Preshooting emotion dysregulation and postshooting mental health symptoms were the most robust predictors of increased MHU following a mass shooting. Findings suggest women exposed to a mass shooting engage in treatment when needed, but preexisting emotion dysregulation may serve as a barrier for those who go on to develop depression. (PsycInfo Database Record (c) 2022 APA, all rights reserved).
Collapse
|
9
|
Pinciotti CM, Orcutt HK. Reappraisal Bias and Sexual Victimization: Testing the Utility of a Computerized Intervention for Negative Post-Assault Support Experiences. J Cogn Psychother 2021; 35:330-347. [PMID: 35236751 DOI: 10.1891/jcpsy-d-20-00053] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
Women are at notable risk for negative reactions from others following sexual victimization which serve to intensify negative post-traumatic outcomes. The current study tested the effectiveness of cognitive bias modification-appraisal (CBM-App) training targeting post-traumatic cognitions theorized to be impacted by positive and negative social support with 45 female undergraduates, grouped by experiencing overall positive or negative post-assault support. Whereas all participants experienced improvements in post-traumatic cognitions at 1-week follow-up, a crossover effect for intrusion symptoms was found; CBM-App training reduced intrusions in participants with negative support experiences yet increased intrusions in participants with positive support experiences. While findings highlight the need for careful selection of post-trauma interventions, the study is the first to integrate findings from CBM-App, sexual assault, and social support literature. Socially relevant post-traumatic cognitions appear to be malleable and may be an important focus of treatment for survivors who experienced negative post-assault support.
Collapse
Affiliation(s)
- Caitlin M Pinciotti
- Rogers Behavioral Health System, Oconomowoc, Wisconsin
- Northern Illinois University, DeKalb, Illinois
| | | |
Collapse
|
10
|
Himmerich SJ, Orcutt HK. Examining a brief self-compassion intervention for emotion regulation in individuals with exposure to trauma. Psychol Trauma 2021; 13:907-910. [PMID: 34383520 DOI: 10.1037/tra0001110] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
OBJECTIVE Research suggests that the overuse of maladaptive emotion regulation strategies, such as avoidance, represents a vulnerability following trauma exposure. Conversely, self-compassion, which impacts emotion regulation through the acceptance of negative emotions, may be an adaptive strategy for managing posttraumatic stress (PTS). METHOD An experimental design was used to examine whether a single-session of self-compassion training improved self-compassion and decreased difficulties in emotion regulation, compared to muscle relaxation training, for trauma-exposed undergraduates. RESULTS Findings replicated previous research among these three constructs (PTS, self-compassion, and difficulties with emotion regulation), with relationships found in the expected directions. However, there was not conclusive evidence to suggest that participating in a brief self-compassion intervention was more effective for reducing difficulties with emotion regulation than participating in a muscle relaxation training intervention. CONCLUSIONS Results supported inverse associations between self-compassion and posttraumatic stress, as well as self-compassion and difficulties with emotion regulation. Future research is needed to investigate how self-compassion skills training can be best utilized to produce clinically significant and long-lasting changes in emotion regulation. (PsycInfo Database Record (c) 2021 APA, all rights reserved).
Collapse
|
11
|
Reffi AN, Pinciotti CM, Orcutt HK. Psychometric Properties of the Institutional Betrayal Questionnaire, Version 2: Evidence for a Two-Factor Model. J Interpers Violence 2021; 36:5659-5684. [PMID: 30328380 DOI: 10.1177/0886260518805771] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
Institutional betrayal reflects the failings of a trusted institution to prevent or respond appropriately to negative experiences. Following sexual assault, survivors who encounter institutional betrayal may experience greater distress and poorer functioning. The current study sought to assess the construct validity of the Institutional Betrayal Questionnaire, Version 2 (IBQ.2) and evaluate its factor structure. Survivors of sexual assault (N = 426) were recruited via Amazon Mechanical Turk and completed various questionnaires related to mental health, disclosure and assault characteristics, world beliefs, and rape myth adherence. The IBQ.2 demonstrated convergent validity with disclosure to formal support providers, assault severity, turning against reactions, and beliefs about self-control, and evidenced discriminant validity with disclosure timing, rape myth adherence, and beliefs about randomness and controllability of outcomes. Notably, the IBQ.2 was unrelated to measures of distress, including symptoms of stress, depression, anxiety, and posttraumatic stress disorder, providing mixed evidence for the IBQ.2's construct validity. Confirmatory factor analyses failed to replicate the single-factor model of institutional betrayal found in a previous study, and, instead, suggested a two-factor structure of the IBQ.2 that delineates between the promotion of and response to sexual victimization. Post hoc analyses revealed that only one of the two factors (Response to Sexual Victimization) evidenced convergent and discriminant validity largely consistent with the single-factor model. The novelty of these relationships and factor structure of the IBQ.2 found in the current study warrants replication in future research.
Collapse
|
12
|
Abstract
Institutional betrayal occurs when, following sexual victimization, institutions create hostile environments which normalize sexual violence, make it difficult to report the experience, mishandle the complaint, attempt to cover up the experience, or retaliate against survivors. These responses are not uncommon and have been linked to adverse survivor outcomes such as dissociation, anxiety, sexual dysfunction, poorer physical health, and depression, yet little is known about which survivors are most at risk for experiencing institutional betrayal. Using a sample of 404 sexual assault survivors recruited from Amazon Mechanical Turk, the current study employed logistic regression to identify risk factors for institutional betrayal. The findings indicate that institutional betrayal is more likely to be reported by survivors who identify as heterosexual, were older at the time of the assault, and endorse more severe PTSD symptoms yet, unexpectedly, less severe distress severity. Gender, race, assault characteristics, and disclosure tendencies did not significantly predict institutional betrayal risk. Although some relationships may be bidirectional, the results suggest that survivors already at risk for some negative post-assault outcomes may be particularly at risk for institutional betrayal.
Collapse
|
13
|
Ellis RA, Awada SR, Orcutt HK, Shelleby EC. Childhood Maltreatment and Risky Substance Use Behaviors: The Mediating Roles of Posttraumatic Stress Symptoms & Callous Unemotional Traits. Subst Use Misuse 2021; 56:388-395. [PMID: 33426983 DOI: 10.1080/10826084.2020.1868519] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
Background: A robust relationship has been established between childhood maltreatment and risky substance use. Posttraumatic stress symptoms and callous-unemotional (CU) traits, both of which can be consequences of childhood maltreatment, have been implicated as potential mediators of this relationship, but despite phenotypic overlap have not been examined within the same model. Objective: The current cross-sectional study examined the indirect effect of childhood maltreatment severity on risky drug and alcohol use behaviors though PTSS and CU traits. Methods: Undergraduates (n = 355, 54.4% female) with childhood maltreatment histories completed questionnaires regarding childhood maltreatment, PTSS, substance use behaviors, and CU traits. Path modeling was utilized to examine indirect effects of childhood maltreatment on risky alcohol and drug use behaviors. Results: Overall the model demonstrated good fit. PTSS and CU traits were found to fully mediate the childhood maltreatment severity to risky alcohol use behaviors, with PTSS demonstrating a trending mediational effect to risky drug usage. Results support multiple pathways to risky alcohol use for individuals with childhood maltreatment histories through PTSS and CU traits, suggesting both PTSS as well as CU traits as potential targets of intervention for alcohol misuse among individuals with childhood maltreatment experiences.
Collapse
Affiliation(s)
- Robyn A Ellis
- Psychology Department, Northern Illinois University, DeKalb, Illinois, USA
| | - Samantha R Awada
- Psychology Department, Northern Illinois University, DeKalb, Illinois, USA
| | - Holly K Orcutt
- Psychology Department, Northern Illinois University, DeKalb, Illinois, USA
| | | |
Collapse
|
14
|
Pinciotti CM, Orcutt HK. Understanding Gender Differences in Rape Victim Blaming: The Power of Social Influence and Just World Beliefs. J Interpers Violence 2021; 36:255-275. [PMID: 29294886 DOI: 10.1177/0886260517725736] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
Victims of sexual violence are frequently blamed by friends, family, or legal personnel in the aftermath of an attack, with men attributing greater blame on average than women. Victims' experiences of being blamed may generate a vicious cycle in which they are more likely to be blamed in the future. Moreover, just world beliefs (JWB) have been studied extensively as an underlying cognitive mechanism that predicts greater blame. Studies examining the influence of social support on blame have yet to examine the unique role of JWB on these attributions. The current study examined blame attribution of a fictional rape victim who received either positive, negative, or neutral support from friends and family in a sample of 383 undergraduate men and women. Individually, social support and JWB were both significant predictors of blame, and women were more influenced by social support than men; specifically, gender was a more salient predictor of blame toward the positively supported victim, suggesting that positive support received by friends and family may evoke a domino effect of support from other women. Conditional effects revealed that JWB were most influential on blame when responding to the positively supported victim. Implications and suggestions for future research are discussed.
Collapse
|
15
|
Seligowski AV, Reffi AN, Phillips KA, Orcutt HK, Auerbach RP, Pizzagalli DA, Ressler KJ. Neurophysiological responses to safety signals and the role of cardiac vagal control. Behav Brain Res 2020; 396:112914. [PMID: 32976862 DOI: 10.1016/j.bbr.2020.112914] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2020] [Revised: 09/03/2020] [Accepted: 09/10/2020] [Indexed: 01/03/2023]
Abstract
BACKGROUND Deficits in safety signal learning are well-established in fear-related disorders (e.g., PTSD, phobias). The current study used a fear conditioning paradigm to test associations among eye blink startle and event-related brain potential (ERP) latency measures of safety signal learning, as well as the role of cardiac vagal control (a measure of top-down inhibition necessary for safety learning). METHODS Participants were 49 trauma-exposed women ages 17 to 28 years. Eyeblink startle response and ERP amplitudes/latencies were derived for conditioned stimuli associated (CS+) and not associated (CS-) with an aversive unconditioned stimulus. ERPs included the P100 and late positive potential (LPP), which index early visual processing and sustained emotional encoding, respectively. Cardiac vagal control was assessed with resting heart rate variability (HRV). RESULTS P100 and LPP latencies for the CS- (safety signal stimulus) were significantly negatively associated with startle to the CS-, but not the CS + . LPP CS- latencies were significantly negatively associated with PTSD Intrusion scores, and this relationship was moderated by vagal control, such that the effect was only present among those with low HRV. CONCLUSIONS ERP-based markers of safety signal learning were associated with startle response to the CS- (but not CS+) and PTSD symptoms, indicating that these markers may have relevance for fear-related disorders. Cardiac vagal control indexed by HRV is a moderating factor in these associations and may be relevant to safety signal learning.
Collapse
Affiliation(s)
- Antonia V Seligowski
- Department of Psychiatry, Harvard Medical School, Boston, MA, USA; McLean Hospital, Belmont, MA, USA.
| | - Anthony N Reffi
- Department of Psychology, Northern Illinois University, DeKalb, IL, USA
| | | | - Holly K Orcutt
- Department of Psychology, Northern Illinois University, DeKalb, IL, USA
| | - Randy P Auerbach
- Department of Psychiatry, Columbia University, New York, NY, USA; Division of Clinical Developmental Neuroscience, Sackler Institute, New York, NY USA
| | - Diego A Pizzagalli
- Department of Psychiatry, Harvard Medical School, Boston, MA, USA; McLean Hospital, Belmont, MA, USA
| | - Kerry J Ressler
- Department of Psychiatry, Harvard Medical School, Boston, MA, USA; McLean Hospital, Belmont, MA, USA
| |
Collapse
|
16
|
Boykin DM, Dunn QT, Orcutt HK. Cumulative Trauma and Adjustment in Women Exposed to a Campus Shooting: Examining the Role of Appraisals and Social Support. J Interpers Violence 2020; 35:3601-3621. [PMID: 29294766 DOI: 10.1177/0886260517710483] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
Experiencing repeated trauma can have increasingly detrimental effects on psychosocial functioning after subsequent stressors. These effects may be intensified for victims of interpersonal traumas given that these events are often associated with heightened risk for adverse outcomes. To better understand this relationship, the present study prospectively examined the effect of pre-shooting trauma exposure (i.e., interpersonal vs. non-interpersonal trauma) on psychological functioning (i.e., posttraumatic stress symptoms, depression) following a mass campus shooting. Based on previous research, it was expected that negative appraisals and social support would mediate this relationship. A sample of 515 college women reporting prior trauma exposure was assessed at four time points following the shooting (i.e., pre-shooting, 1-month, 6-months, and 12-months post-shooting). Bootstrap analyses with bias-corrected confidence intervals were conducted. Contrary to expectation, pre-shooting trauma exposure was unrelated to 12-month post-shooting outcomes and neither negative appraisals nor social support at 6-months post-shooting emerged as mediators. Interestingly, a history of non-interpersonal trauma was associated with greater post-shooting family and friend support than a history of interpersonal trauma. Ad hoc analyses showed that pre-shooting symptom severity and level of exposure to the shooting had indirect effects on post-shooting outcomes via post-shooting negative appraisals. These findings support that cumulative trauma, regardless of type, may not have an additive effect unless individuals develop clinically significant symptoms following previous trauma. Trauma severity also appears to play a meaningful role.
Collapse
|
17
|
Hannan SM, Orcutt HK. Emotion regulation in undergraduate students with posttraumatic stress symptoms: A multimethod study. ACTA ACUST UNITED AC 2020; 12:643-650. [DOI: 10.1037/tra0000577] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
|
18
|
|
19
|
Leonard KA, Ellis RA, Orcutt HK. Experiential avoidance as a mediator in the relationship between shame and posttraumatic stress disorder: The effect of gender. Psychol Trauma 2020; 12:651-658. [PMID: 32496096 DOI: 10.1037/tra0000601] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
OBJECTIVE The current study sought to investigate whether experiential avoidance (EA) mediates the effect of shame on posttraumatic symptoms (PTS) in a population of trauma-exposed individuals. Given demonstrated gender differences in posttraumatic stress disorder (PTSD), the current cross-sectional study also sought to examine whether gender moderates this mediational proposed effect. EA has been shown to mediate shame and depression symptoms, suggesting that the unwillingness to feel and/or the attempt to control shame may be an important factor in later psychopathological symptoms. Furthermore, EA appears to influence PTS over time. METHOD Trauma-exposed undergraduates (n = 326, 68.8% male, Mage = 19.35, SD = 2.30) at a large Midwestern university completed measures of shame, EA, and PTS. RESULTS EA was found to fully mediate the relationship between shame and PTS. The role of gender was mixed as it moderated the relationship between EA and PTS such that the effect of EA is stronger for men than women; however, when analyzed with more robust methods, the effect of gender was no longer significant. A competing, flipped mediational model was run to further assess the direction of hypothesized relationships, but shame was not a significant mediator of EA and PTSD symptoms. CONCLUSIONS Results provide further evidence for the centrality of EA in maintaining PTS and suggest targeting EA rather than shame in treatment as an avenue for intervention. Future research is needed to investigate gender differences in engagement in EA. (PsycInfo Database Record (c) 2020 APA, all rights reserved).
Collapse
|
20
|
Dalvie S, Maihofer AX, Coleman JRI, Bradley B, Breen G, Brick LA, Chen CY, Choi KW, Duncan LE, Guffanti G, Haas M, Harnal S, Liberzon I, Nugent NR, Provost AC, Ressler KJ, Torres K, Amstadter AB, Bryn Austin S, Baker DG, Bolger EA, Bryant RA, Calabrese JR, Delahanty DL, Farrer LA, Feeny NC, Flory JD, Forbes D, Galea S, Gautam A, Gelernter J, Hammamieh R, Jett M, Junglen AG, Kaufman ML, Kessler RC, Khan A, Kranzler HR, Lebois LAM, Marmar C, Mavissakalian MR, McFarlane A, Donnell MO, Orcutt HK, Pietrzak RH, Risbrough VB, Roberts AL, Rothbaum AO, Roy-Byrne P, Ruggiero K, Seligowski AV, Sheerin CM, Silove D, Smoller JW, Stein MB, Teicher MH, Ursano RJ, Van Hooff M, Winternitz S, Wolff JD, Yehuda R, Zhao H, Zoellner LA, Stein DJ, Koenen KC, Nievergelt CM. Genomic influences on self-reported childhood maltreatment. Transl Psychiatry 2020; 10:38. [PMID: 32066696 PMCID: PMC7026037 DOI: 10.1038/s41398-020-0706-0] [Citation(s) in RCA: 36] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/03/2019] [Revised: 11/28/2019] [Accepted: 12/11/2019] [Indexed: 12/27/2022] Open
Abstract
Childhood maltreatment is highly prevalent and serves as a risk factor for mental and physical disorders. Self-reported childhood maltreatment appears heritable, but the specific genetic influences on this phenotype are largely unknown. The aims of this study were to (1) identify genetic variation associated with self-reported childhood maltreatment, (2) estimate SNP-based heritability (h2snp), (3) assess predictive value of polygenic risk scores (PRS) for childhood maltreatment, and (4) quantify genetic overlap of childhood maltreatment with mental and physical health-related phenotypes, and condition the top hits from our analyses when such overlap is present. Genome-wide association analysis for childhood maltreatment was undertaken, using a discovery sample from the UK Biobank (UKBB) (n = 124,000) and a replication sample from the Psychiatric Genomics Consortium-posttraumatic stress disorder group (PGC-PTSD) (n = 26,290). h2snp for childhood maltreatment and genetic correlations with mental/physical health traits were calculated using linkage disequilibrium score regression. PRS was calculated using PRSice and mtCOJO was used to perform conditional analysis. Two genome-wide significant loci associated with childhood maltreatment (rs142346759, p = 4.35 × 10-8, FOXP1; rs10262462, p = 3.24 × 10-8, FOXP2) were identified in the discovery dataset but were not replicated in PGC-PTSD. h2snp for childhood maltreatment was ~6% and the PRS derived from the UKBB was significantly predictive of childhood maltreatment in PGC-PTSD (r2 = 0.0025; p = 1.8 × 10-15). The most significant genetic correlation of childhood maltreatment was with depressive symptoms (rg = 0.70, p = 4.65 × 10-40), although we show evidence that our top hits may be specific to childhood maltreatment. This is the first large-scale genetic study to identify specific variants associated with self-reported childhood maltreatment. Speculatively, FOXP genes might influence externalizing traits and so be relevant to childhood maltreatment. Alternatively, these variants may be associated with a greater likelihood of reporting maltreatment. A clearer understanding of the genetic relationships of childhood maltreatment, including particular abuse subtypes, with a range of phenotypes, may ultimately be useful in in developing targeted treatment and prevention strategies.
Collapse
Affiliation(s)
- Shareefa Dalvie
- SA MRC Unit on Risk & Resilience in Mental Disorders, Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa.
| | - Adam X Maihofer
- Department of Psychiatry, University of California San Diego, La Jolla, CA, USA
- Veterans Affairs San Diego Healthcare System, Center of Excellence for Stress and Mental Health, San Diego, CA, USA
- Veterans Affairs San Diego Healthcare System, Research Service, San Diego, CA, USA
| | - Jonathan R I Coleman
- King's College London, Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, London, UK
- King's College London, NIHR BRC at the Maudsley, London, UK
| | - Bekh Bradley
- Atlanta VA Health Care System, Mental Health Service Line, Decatur, GA, USA
- Department of Psychiatry and Behavioral Sciences, Emory University, Atlanta, GA, USA
| | - Gerome Breen
- King's College London, Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, London, UK
- King's College London, NIHR BRC at the Maudsley, London, UK
| | - Leslie A Brick
- Alpert Medical School of Brown University, Providence, RI, USA
| | - Chia-Yen Chen
- Massachusetts General Hospital, Analytic and Translational Genetics Unit, Boston, MA, USA
- Massachusetts General Hospital, Psychiatric and Neurodevelopmental Genetics Unit (PNGU), Boston, MA, USA
- Broad Institute of MIT and Harvard, Stanley Center for Psychiatric Research, Cambridge, MA, USA
| | - Karmel W Choi
- Broad Institute of MIT and Harvard, Stanley Center for Psychiatric Research, Cambridge, MA, USA
- Harvard T.H. Chan School of Public Health, Department of Epidemiology, Boston, MA, USA
- Massachusetts General Hospital, Department of Psychiatry, Boston, MA, USA
| | - Laramie E Duncan
- Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, CA, USA
| | - Guia Guffanti
- Harvard Medical School, Department of Psychiatry, Boston, MA, USA
- McLean Hospital, Belmont, MA, USA
| | - Magali Haas
- Cohen Veterans Bioscience, Cambridge, MA, USA
| | - Supriya Harnal
- Broad Institute of MIT and Harvard, Stanley Center for Psychiatric Research, Cambridge, MA, USA
| | - Israel Liberzon
- Department of Psychiatry, University of Michigan Medical School, Ann Arbor, MI, USA
| | - Nicole R Nugent
- Alpert Medical School of Brown University, Providence, RI, USA
- Bradley/Hasbro Children's Research Center of Rhode Island Hospital, Providence, RI, USA
| | | | - Kerry J Ressler
- Department of Psychiatry and Behavioral Sciences, Emory University, Atlanta, GA, USA
- Harvard Medical School, Department of Psychiatry, Boston, MA, USA
- McLean Hospital, Belmont, MA, USA
| | - Katy Torres
- Department of Psychiatry, University of California San Diego, La Jolla, CA, USA
- Veterans Affairs San Diego Healthcare System, Center of Excellence for Stress and Mental Health, San Diego, CA, USA
- Veterans Affairs San Diego Healthcare System, Research Service, San Diego, CA, USA
| | - Ananda B Amstadter
- Virginia Institute for Psychiatric and Behavioral Genetics, Department of Psychiatry, Richmond, VA, USA
| | - S Bryn Austin
- Harvard Medical School, Department of Psychiatry, Boston, MA, USA
- Harvard School of Public Health, Department of Social and Behavioral Sciences, Boston, MA, USA
- Boston Children's Hospital, Division of Adolescent and Young Adult Medicine, Boston, MA, USA
- Brigham and Women's Hospital, Channing Division of Network Medicine, Boston, MA, USA
| | - Dewleen G Baker
- Department of Psychiatry, University of California San Diego, La Jolla, CA, USA
- Veterans Affairs San Diego Healthcare System, Center of Excellence for Stress and Mental Health, San Diego, CA, USA
- Veterans Affairs San Diego Healthcare System, Psychiatry Service, San Diego, CA, USA
| | - Elizabeth A Bolger
- Harvard Medical School, Department of Psychiatry, Boston, MA, USA
- McLean Hospital, Belmont, MA, USA
| | - Richard A Bryant
- Department of Psychology, University of New South Wales, Sydney, NSW, Australia
| | | | - Douglas L Delahanty
- Department of Psychological Sciences, Kent State University, Kent, OH, USA
- Research and Sponsored Programs, Kent State University, Kent, OH, USA
| | - Lindsay A Farrer
- Department of Medicine, Boston University School of Medicine, Boston, MA, USA
| | - Norah C Feeny
- Department of Psychological Sciences, Case Western Reserve University, Cleveland, OH, USA
| | - Janine D Flory
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - David Forbes
- Department of Psychiatry, University of Melbourne, Melbourne, VIC, Australia
| | - Sandro Galea
- Department of Psychological and Brain Sciences, Boston University, Boston, MA, USA
| | - Aarti Gautam
- US Army Medical Research and Materiel Command, Fort Detrick, MD, USA
| | - Joel Gelernter
- US Department of Veterans Affairs, Department of Psychiatry, West Haven, CT, USA
- VA Connecticut Healthcare Center, West Haven, CT, USA
- Department of Genetics and Neuroscience, Yale University School of Medicine, New Haven, CT, USA
| | - Rasha Hammamieh
- US Army Medical Research and Materiel Command, USACEHR, Fort Detrick, MD, USA
| | - Marti Jett
- US Army Medical Research and Materiel Command, USACEHR, Fort Detrick, MD, USA
| | - Angela G Junglen
- Department of Psychological Sciences, Kent State University, Kent, OH, USA
| | - Milissa L Kaufman
- Harvard Medical School, Department of Psychiatry, Boston, MA, USA
- McLean Hospital, Belmont, MA, USA
| | - Ronald C Kessler
- Harvard Medical School, Department of Health Care Policy, Boston, MA, USA
| | - Alaptagin Khan
- McLean Hospital, Belmont, MA, USA
- Harvard Medical School, Department of Health Care Policy, Boston, MA, USA
| | - Henry R Kranzler
- Department of Psychiatry, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA
- Mental Illness Research, Education and Clinical Center, Crescenz VAMC, Philadelphia, PA, USA
| | - Lauren A M Lebois
- Harvard Medical School, Department of Psychiatry, Boston, MA, USA
- McLean Hospital, Belmont, MA, USA
| | - Charles Marmar
- Department of Psychiatry, New York University School of Medicine, New York, NY, USA
| | | | - Alexander McFarlane
- University of Adelaide, Centre for Traumatic Stress Studies, Adelaide, SA, Australia
| | - Meaghan O' Donnell
- Department of Psychiatry, University of Melbourne, Melbourne, VIC, Australia
| | - Holly K Orcutt
- Department of Psychology, Northern Illinois University, DeKalb, IL, USA
| | - Robert H Pietrzak
- U.S. Department of Veterans Affairs National Center for Posttraumatic Stress Disorder, West Haven, CT, USA
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA
| | - Victoria B Risbrough
- Department of Psychiatry, University of California San Diego, La Jolla, CA, USA
- Veterans Affairs San Diego Healthcare System, Center of Excellence for Stress and Mental Health, San Diego, CA, USA
- Veterans Affairs San Diego Healthcare System, Research Service, San Diego, CA, USA
| | - Andrea L Roberts
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Alex O Rothbaum
- Department of Psychological Sciences, Case Western Reserve University, Cleveland, OH, USA
| | - Peter Roy-Byrne
- Department of Psychiatry, University of Washington, Seattle, WA, USA
| | - Ken Ruggiero
- Department of Nursing and Department of Psychiatry, Medical University of South Carolina, Charleston, SC, USA
| | - Antonia V Seligowski
- Harvard Medical School, Department of Psychiatry, Boston, MA, USA
- McLean Hospital, Belmont, MA, USA
| | - Christina M Sheerin
- Virginia Institute for Psychiatric and Behavioral Genetics, Department of Psychiatry, Richmond, VA, USA
| | - Derrick Silove
- Department of Psychiatry, University of New South Wales, Sydney, NSW, Australia
| | - Jordan W Smoller
- Massachusetts General Hospital, Analytic and Translational Genetics Unit, Boston, MA, USA
- Broad Institute of MIT and Harvard, Stanley Center for Psychiatric Research, Cambridge, MA, USA
- Massachusetts General Hospital, Department of Psychiatry, Boston, MA, USA
| | - Murray B Stein
- Department of Psychiatry, University of California San Diego, La Jolla, CA, USA
- Veterans Affairs San Diego Healthcare System, Psychiatry Service, San Diego, CA, USA
- Veterans Affairs San Diego Healthcare System, Million Veteran Program, San Diego, CA, USA
| | - Martin H Teicher
- Harvard Medical School, Department of Psychiatry, Boston, MA, USA
- McLean Hospital, Belmont, MA, USA
| | - Robert J Ursano
- Department of Psychiatry, Uniformed Services University, Bethesda, MD, USA
| | - Miranda Van Hooff
- University of Adelaide, Centre for Traumatic Stress Studies, Adelaide, SA, Australia
| | - Sherry Winternitz
- Harvard Medical School, Department of Psychiatry, Boston, MA, USA
- McLean Hospital, Belmont, MA, USA
| | | | - Rachel Yehuda
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Department of Mental Health, James J. Peters VA Medical Center, Bronx, NY, USA
| | - Hongyu Zhao
- Department of Biostatistics, Yale University, New Haven, CT, USA
| | - Lori A Zoellner
- Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, WA, USA
| | - Dan J Stein
- SA MRC Unit on Risk & Resilience in Mental Disorders, Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa
| | - Karestan C Koenen
- Massachusetts General Hospital, Psychiatric and Neurodevelopmental Genetics Unit (PNGU), Boston, MA, USA
- Broad Institute of MIT and Harvard, Stanley Center for Psychiatric Research, Cambridge, MA, USA
- Harvard School of Public Health, Department of Epidemiology, Boston, MA, USA
| | - Caroline M Nievergelt
- Department of Psychiatry, University of California San Diego, La Jolla, CA, USA
- Veterans Affairs San Diego Healthcare System, Center of Excellence for Stress and Mental Health, San Diego, CA, USA
- Veterans Affairs San Diego Healthcare System, Research Service, San Diego, CA, USA
| |
Collapse
|
21
|
Nievergelt CM, Maihofer AX, Klengel T, Atkinson EG, Chen CY, Choi KW, Coleman JRI, Dalvie S, Duncan LE, Gelernter J, Levey DF, Logue MW, Polimanti R, Provost AC, Ratanatharathorn A, Stein MB, Torres K, Aiello AE, Almli LM, Amstadter AB, Andersen SB, Andreassen OA, Arbisi PA, Ashley-Koch AE, Austin SB, Avdibegovic E, Babić D, Bækvad-Hansen M, Baker DG, Beckham JC, Bierut LJ, Bisson JI, Boks MP, Bolger EA, Børglum AD, Bradley B, Brashear M, Breen G, Bryant RA, Bustamante AC, Bybjerg-Grauholm J, Calabrese JR, Caldas-de-Almeida JM, Dale AM, Daly MJ, Daskalakis NP, Deckert J, Delahanty DL, Dennis MF, Disner SG, Domschke K, Dzubur-Kulenovic A, Erbes CR, Evans A, Farrer LA, Feeny NC, Flory JD, Forbes D, Franz CE, Galea S, Garrett ME, Gelaye B, Geuze E, Gillespie C, Uka AG, Gordon SD, Guffanti G, Hammamieh R, Harnal S, Hauser MA, Heath AC, Hemmings SMJ, Hougaard DM, Jakovljevic M, Jett M, Johnson EO, Jones I, Jovanovic T, Qin XJ, Junglen AG, Karstoft KI, Kaufman ML, Kessler RC, Khan A, Kimbrel NA, King AP, Koen N, Kranzler HR, Kremen WS, Lawford BR, Lebois LAM, Lewis CE, Linnstaedt SD, Lori A, Lugonja B, Luykx JJ, Lyons MJ, Maples-Keller J, Marmar C, Martin AR, Martin NG, Maurer D, Mavissakalian MR, McFarlane A, McGlinchey RE, McLaughlin KA, McLean SA, McLeay S, Mehta D, Milberg WP, Miller MW, Morey RA, Morris CP, Mors O, Mortensen PB, Neale BM, Nelson EC, Nordentoft M, Norman SB, O'Donnell M, Orcutt HK, Panizzon MS, Peters ES, Peterson AL, Peverill M, Pietrzak RH, Polusny MA, Rice JP, Ripke S, Risbrough VB, Roberts AL, Rothbaum AO, Rothbaum BO, Roy-Byrne P, Ruggiero K, Rung A, Rutten BPF, Saccone NL, Sanchez SE, Schijven D, Seedat S, Seligowski AV, Seng JS, Sheerin CM, Silove D, Smith AK, Smoller JW, Sponheim SR, Stein DJ, Stevens JS, Sumner JA, Teicher MH, Thompson WK, Trapido E, Uddin M, Ursano RJ, van den Heuvel LL, Van Hooff M, Vermetten E, Vinkers CH, Voisey J, Wang Y, Wang Z, Werge T, Williams MA, Williamson DE, Winternitz S, Wolf C, Wolf EJ, Wolff JD, Yehuda R, Young RM, Young KA, Zhao H, Zoellner LA, Liberzon I, Ressler KJ, Haas M, Koenen KC. International meta-analysis of PTSD genome-wide association studies identifies sex- and ancestry-specific genetic risk loci. Nat Commun 2019; 10:4558. [PMID: 31594949 PMCID: PMC6783435 DOI: 10.1038/s41467-019-12576-w] [Citation(s) in RCA: 277] [Impact Index Per Article: 55.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2019] [Accepted: 09/18/2019] [Indexed: 12/14/2022] Open
Abstract
The risk of posttraumatic stress disorder (PTSD) following trauma is heritable, but robust common variants have yet to be identified. In a multi-ethnic cohort including over 30,000 PTSD cases and 170,000 controls we conduct a genome-wide association study of PTSD. We demonstrate SNP-based heritability estimates of 5-20%, varying by sex. Three genome-wide significant loci are identified, 2 in European and 1 in African-ancestry analyses. Analyses stratified by sex implicate 3 additional loci in men. Along with other novel genes and non-coding RNAs, a Parkinson's disease gene involved in dopamine regulation, PARK2, is associated with PTSD. Finally, we demonstrate that polygenic risk for PTSD is significantly predictive of re-experiencing symptoms in the Million Veteran Program dataset, although specific loci did not replicate. These results demonstrate the role of genetic variation in the biology of risk for PTSD and highlight the necessity of conducting sex-stratified analyses and expanding GWAS beyond European ancestry populations.
Collapse
Affiliation(s)
- Caroline M Nievergelt
- University of California San Diego, Department of Psychiatry, La Jolla, CA, USA.
- Veterans Affairs San Diego Healthcare System, Center of Excellence for Stress and Mental Health, San Diego, CA, USA.
- Veterans Affairs San Diego Healthcare System, Research Service, San Diego, CA, USA.
| | - Adam X Maihofer
- University of California San Diego, Department of Psychiatry, La Jolla, CA, USA
- Veterans Affairs San Diego Healthcare System, Center of Excellence for Stress and Mental Health, San Diego, CA, USA
- Veterans Affairs San Diego Healthcare System, Research Service, San Diego, CA, USA
| | - Torsten Klengel
- Harvard Medical School, Department of Psychiatry, Boston, MA, USA
- McLean Hospital, Belmont, MA, USA
- University Medical Center Goettingen, Department of Psychiatry, Göttingen, DE, Germany
| | - Elizabeth G Atkinson
- Broad Institute of MIT and Harvard, Stanley Center for Psychiatric Research, Cambridge, MA, USA
- Massachusetts General Hospital, Analytic and Translational Genetics Unit, Boston, MA, USA
| | - Chia-Yen Chen
- Broad Institute of MIT and Harvard, Stanley Center for Psychiatric Research, Cambridge, MA, USA
- Massachusetts General Hospital, Analytic and Translational Genetics Unit, Boston, MA, USA
- Massachusetts General Hospital, Psychiatric and Neurodevelopmental Genetics Unit (PNGU), Boston, MA, USA
| | - Karmel W Choi
- Broad Institute of MIT and Harvard, Stanley Center for Psychiatric Research, Cambridge, MA, USA
- Massachusetts General Hospital, Department of Psychiatry, Boston, MA, USA
- Harvard T.H. Chan School of Public Health, Department of Epidemiology, Boston, MA, USA
| | - Jonathan R I Coleman
- King's College London, Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, London, GB, USA
- King's College London, NIHR BRC at the Maudsley, London, GB, USA
| | - Shareefa Dalvie
- University of Cape Town, SA MRC Unit on Risk & Resilience in Mental Disorders, Department of Psychiatry, Cape Town, Western Cape, ZA, USA
| | - Laramie E Duncan
- Stanford University, Department of Psychiatry and Behavioral Sciences, Stanford, CA, USA
| | - Joel Gelernter
- US Department of Veterans Affairs, Department of Psychiatry, West Haven, CT, USA
- Yale University School of Medicine, Department of Genetics and Neuroscience, New Haven, CT, USA
- VA Connecticut Healthcare Center, West Haven, CT, USA
| | - Daniel F Levey
- VA Connecticut Healthcare Center, West Haven, CT, USA
- Yale University School of Medicine, Department of Psychiatry, New Haven, CT, USA
| | - Mark W Logue
- VA Boston Healthcare System, National Center for PTSD, Boston, MA, USA
| | - Renato Polimanti
- VA Connecticut Healthcare Center, West Haven, CT, USA
- Yale University School of Medicine, Department of Psychiatry, New Haven, CT, USA
| | | | | | - Murray B Stein
- University of California San Diego, Department of Psychiatry, La Jolla, CA, USA
- Veterans Affairs San Diego Healthcare System, Million Veteran Program, San Diego, CA, USA
- Veterans Affairs San Diego Healthcare System, Psychiatry Service, San Diego, CA, USA
| | - Katy Torres
- University of California San Diego, Department of Psychiatry, La Jolla, CA, USA
- Veterans Affairs San Diego Healthcare System, Center of Excellence for Stress and Mental Health, San Diego, CA, USA
- Veterans Affairs San Diego Healthcare System, Research Service, San Diego, CA, USA
| | - Allison E Aiello
- Gillings School of Global Public Health, Department of Epidemiology, Chapel Hill, NC, USA
| | - Lynn M Almli
- Emory University, Department of Psychiatry and Behavioral Sciences, Atlanta, GA, USA
| | - Ananda B Amstadter
- Virginia Institute for Psychiatric and Behavioral Genetics, Department of Psychiatry, Richmond, VA, USA
| | - Søren B Andersen
- The Danish Veteran Centre, Research and Knowledge Centre, Ringsted, Sjaelland, Denmark
| | - Ole A Andreassen
- University of Oslo, Institute of Clinical Medicine, Oslo, NO, Norway
| | - Paul A Arbisi
- Minneapolis VA Health Care System, Mental Health Service Line, Minneapolis, MN, USA
| | | | - S Bryn Austin
- Harvard Medical School, Department of Psychiatry, Boston, MA, USA
- Boston Children's Hospital, Division of Adolescent and Young Adult Medicine, Boston, MA, USA
- Brigham and Women's Hospital, Channing Division of Network Medicine, Boston, MA, USA
- Harvard School of Public Health, Department of Social and Behavioral Sciences, Boston, MA, USA
| | - Esmina Avdibegovic
- University Clinical Center of Tuzla, Department of Psychiatry, Tuzla, BA, Bosnia and Herzegovina
| | - Dragan Babić
- University Clinical Center of Mostar, Department of Psychiatry, Mostar, BA, Bosnia and Herzegovina
| | - Marie Bækvad-Hansen
- Statens Serum Institut, Department for Congenital Disorders, Copenhagen, DK, Denmark
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research, iPSYCH, DK, Denmark
| | - Dewleen G Baker
- University of California San Diego, Department of Psychiatry, La Jolla, CA, USA
- Veterans Affairs San Diego Healthcare System, Center of Excellence for Stress and Mental Health, San Diego, CA, USA
- Veterans Affairs San Diego Healthcare System, Psychiatry Service, San Diego, CA, USA
| | - Jean C Beckham
- Durham VA Medical Center, Research, Durham, NC, USA
- Duke University, Department of Psychiatry and Behavioral Sciences, Durham, NC, USA
- VA Mid-Atlantic Mental Illness Research, Education, and Clinical Center (MIRECC), Genetics Research Laboratory, Durham, NC, USA
| | - Laura J Bierut
- Washington University in Saint Louis School of Medicine, Department of Psychiatry, Saint Louis, MO, USA
| | - Jonathan I Bisson
- Cardiff University, National Centre for Mental Health, MRC Centre for Psychiatric Genetics and Genomics, Cardiff, UK
| | - Marco P Boks
- UMC Utrecht Brain Center Rudolf Magnus, Department of Translational Neuroscience, Utrecht, Utrecht, NL, Netherlands
| | - Elizabeth A Bolger
- Harvard Medical School, Department of Psychiatry, Boston, MA, USA
- McLean Hospital, Belmont, MA, USA
| | - Anders D Børglum
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research, iPSYCH, DK, Denmark
- Aarhus University, Centre for Integrative Sequencing, iSEQ, Aarhus, DK, Denmark
- Aarhus University, Department of Biomedicine - Human Genetics, Aarhus, DK, Denmark
| | - Bekh Bradley
- Emory University, Department of Psychiatry and Behavioral Sciences, Atlanta, GA, USA
- Atlanta VA Health Care System, Mental Health Service Line, Decatur, GA, USA
| | - Megan Brashear
- Louisiana State University Health Sciences Center, School of Public Health and Department of Epidemiology, New Orleans, LA, USA
| | - Gerome Breen
- King's College London, Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, London, GB, USA
- King's College London, NIHR BRC at the Maudsley, London, GB, USA
| | - Richard A Bryant
- University of New South Wales, Department of Psychology, Sydney, NSW, Australia
| | - Angela C Bustamante
- University of Michigan Medical School, Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Ann Arbor, MI, USA
| | - Jonas Bybjerg-Grauholm
- Statens Serum Institut, Department for Congenital Disorders, Copenhagen, DK, Denmark
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research, iPSYCH, DK, Denmark
| | | | - José M Caldas-de-Almeida
- CEDOC -Chronic Diseases Research Centre, Lisbon Institute of Global Mental Health, Lisbon, PT, Portugal
| | - Anders M Dale
- University of California San Diego, Department of Radiology, Department of Neurosciences, La Jolla, CA, USA
| | - Mark J Daly
- Massachusetts General Hospital, Psychiatric and Neurodevelopmental Genetics Unit (PNGU), Boston, MA, USA
| | - Nikolaos P Daskalakis
- Harvard Medical School, Department of Psychiatry, Boston, MA, USA
- McLean Hospital, Belmont, MA, USA
- Cohen Veterans Bioscience, Cambridge, MA, USA
- Icahn School of Medicine at Mount Sinai, Department of Psychiatry, New York, NY, USA
| | - Jürgen Deckert
- University Hospital of Würzburg, Center of Mental Health, Psychiatry, Psychosomatics and Psychotherapy, Würzburg, DE, Germany
| | - Douglas L Delahanty
- Kent State University, Department of Psychological Sciences, Kent, OH, USA
- Kent State University, Research and Sponsored Programs, Kent, OH, USA
| | - Michelle F Dennis
- Durham VA Medical Center, Research, Durham, NC, USA
- Duke University, Department of Psychiatry and Behavioral Sciences, Durham, NC, USA
- VA Mid-Atlantic Mental Illness Research, Education, and Clinical Center (MIRECC), Genetics Research Laboratory, Durham, NC, USA
| | - Seth G Disner
- Minneapolis VA Health Care System, Research Service Line, Minneapolis, MN, USA
| | - Katharina Domschke
- Medical Center-University of Freiburg, Faculty of Medicine, Department of Psychiatry and Psychotherapy, Freiburg, DE, Germany
- University of Freiburg, Faculty of Medicine, Centre for Basics in Neuromodulation, Freiburg, DE, Germany
| | - Alma Dzubur-Kulenovic
- University Clinical Center of Sarajevo, Department of Psychiatry, Sarajevo, BA, Bosnia and Herzegovina
| | - Christopher R Erbes
- University of Minnesota, Department of Psychiatry, Minneapolis, MN, USA
- Minneapolis VA Health Care System, Center for Care Delivery and Outcomes Research (CCDOR), Minneapolis, MN, USA
| | - Alexandra Evans
- Cardiff University, National Centre for Mental Health, MRC Centre for Psychiatric Genetics and Genomics, Cardiff, South Glamorgan, GB, USA
| | - Lindsay A Farrer
- Boston University School of Medicine, Department of Medicine, Boston, MA, USA
| | - Norah C Feeny
- Case Western Reserve University, Department of Psychological Sciences, Cleveland, OH, USA
| | - Janine D Flory
- Icahn School of Medicine at Mount Sinai, Department of Psychiatry, New York, NY, USA
| | - David Forbes
- University of Melbourne, Department of Psychiatry, Melbourne, VIC, AU, USA
| | - Carol E Franz
- University of California San Diego, Department of Psychiatry, La Jolla, CA, USA
| | - Sandro Galea
- Boston University, Department of Psychological and Brain Sciences, Boston, MA, USA
| | - Melanie E Garrett
- Duke University, Department of Psychiatry and Behavioral Sciences, Durham, NC, USA
| | - Bizu Gelaye
- Harvard T.H. Chan School of Public Health, Department of Epidemiology, Boston, MA, USA
| | - Elbert Geuze
- Netherlands Ministry of Defence, Brain Research and Innovation Centre, Utrecht, Utrecht, NL, Netherlands
- UMC Utrecht Brain Center Rudolf Magnus, Department of Psychiatry, Utrecht, Utrecht, NL, Netherlands
| | - Charles Gillespie
- Emory University, Department of Psychiatry and Behavioral Sciences, Atlanta, GA, USA
| | - Aferdita Goci Uka
- University Clinical Centre of Kosovo, Department of Psychiatry, Prishtina, Kosovo, XK, USA
| | - Scott D Gordon
- QIMR Berghofer Medical Research Institute, Department of Genetics and Computational Biology, Brisbane, Queensland, Australia
| | - Guia Guffanti
- Harvard Medical School, Department of Psychiatry, Boston, MA, USA
- McLean Hospital, Belmont, MA, USA
| | - Rasha Hammamieh
- US Army Medical Research and Materiel Command, USACEHR, Fort Detrick, MD, USA
| | - Supriya Harnal
- Broad Institute of MIT and Harvard, Stanley Center for Psychiatric Research, Cambridge, MA, USA
| | - Michael A Hauser
- Duke University, Department of Psychiatry and Behavioral Sciences, Durham, NC, USA
| | - Andrew C Heath
- Washington University in Saint Louis School of Medicine, Department of Genetics, Saint Louis, MO, USA
| | - Sian M J Hemmings
- Stellenbosch University Faculty of Medicine and Health Sciences, Department of Psychiatry, Cape Town, Western Cape, ZA, South Africa
| | - David Michael Hougaard
- Statens Serum Institut, Department for Congenital Disorders, Copenhagen, DK, Denmark
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research, iPSYCH, DK, Denmark
| | - Miro Jakovljevic
- University Hospital Center of Zagreb, Department of Psychiatry, Zagreb, HR, USA
| | - Marti Jett
- US Army Medical Research and Materiel Command, USACEHR, Fort Detrick, MD, USA
| | - Eric Otto Johnson
- RTI International, Behavioral Health and Criminal Justice Division, Research Triangle Park, NC, USA
| | - Ian Jones
- Cardiff University, National Centre for Mental Health, MRC Centre for Psychiatric Genetics and Genomics, Cardiff, South Glamorgan, GB, USA
| | - Tanja Jovanovic
- Emory University, Department of Psychiatry and Behavioral Sciences, Atlanta, GA, USA
| | - Xue-Jun Qin
- Duke University, Duke Molecular Physiology Institute, Durham, NC, USA
| | - Angela G Junglen
- Kent State University, Department of Psychological Sciences, Kent, OH, USA
| | - Karen-Inge Karstoft
- The Danish Veteran Centre, Research and Knowledge Centre, Ringsted, Sjaelland, Denmark
- University of Copenhagen, Department of Psychology, Copenhagen, DK, Denmark
| | - Milissa L Kaufman
- Harvard Medical School, Department of Psychiatry, Boston, MA, USA
- McLean Hospital, Belmont, MA, USA
| | - Ronald C Kessler
- Harvard Medical School, Department of Psychiatry, Boston, MA, USA
| | - Alaptagin Khan
- McLean Hospital, Belmont, MA, USA
- Harvard Medical School, Department of Health Care Policy, Boston, MA, USA
| | - Nathan A Kimbrel
- Duke University, Duke Molecular Physiology Institute, Durham, NC, USA
- Durham VA Medical Center, Research, Durham, NC, USA
- VA Mid-Atlantic Mental Illness Research, Education, and Clinical Center (MIRECC), Genetics Research Laboratory, Durham, NC, USA
| | - Anthony P King
- University of Michigan Medical School, Department of Psychiatry, Ann Arbor, MI, USA
| | - Nastassja Koen
- University of Cape Town, SA MRC Unit on Risk & Resilience in Mental Disorders, Department of Psychiatry, Cape Town, Western Cape, ZA, USA
| | - Henry R Kranzler
- University of Pennsylvania Perelman School of Medicine, Department of Psychiatry, Philadelphia, PA, USA
- Mental Illness Research, Education and Clinical Center, Crescenz VAMC, Philadelphia, PA, USA
| | - William S Kremen
- University of California San Diego, Department of Psychiatry, La Jolla, CA, USA
- Veterans Affairs San Diego Healthcare System, Center of Excellence for Stress and Mental Health, San Diego, CA, USA
| | - Bruce R Lawford
- Queensland University of Technology, Institute of Health and Biomedical Innovation, Kelvin Grove, QLD, AU, Australia
- Queensland University of Technology, School of Biomedical Sciences, Kelvin Grove, QLD, AU, Australia
| | - Lauren A M Lebois
- Harvard Medical School, Department of Psychiatry, Boston, MA, USA
- McLean Hospital, Belmont, MA, USA
| | - Catrin E Lewis
- Cardiff University, National Centre for Mental Health, MRC Centre for Psychiatric Genetics and Genomics, Cardiff, South Glamorgan, GB, USA
| | - Sarah D Linnstaedt
- UNC Institute for Trauma Recovery, Department of Anesthesiology, Chapel Hill, NC, USA
| | - Adriana Lori
- Emory University, Department of Gynecology and Obstetrics, Atlanta, GA, USA
| | - Bozo Lugonja
- Cardiff University, National Centre for Mental Health, MRC Centre for Psychiatric Genetics and Genomics, Cardiff, South Glamorgan, GB, USA
| | - Jurjen J Luykx
- UMC Utrecht Brain Center Rudolf Magnus, Department of Translational Neuroscience, Utrecht, Utrecht, NL, Netherlands
- UMC Utrecht Brain Center Rudolf Magnus, Department of Psychiatry, Utrecht, Utrecht, NL, Netherlands
| | | | - Jessica Maples-Keller
- Emory University, Department of Psychiatry and Behavioral Sciences, Atlanta, GA, USA
| | - Charles Marmar
- New York University School of Medicine, Department of Psychiatry, New York, NY, USA
| | - Alicia R Martin
- Broad Institute of MIT and Harvard, Stanley Center for Psychiatric Research, Cambridge, MA, USA
- Massachusetts General Hospital, Analytic and Translational Genetics Unit, Boston, MA, USA
| | - Nicholas G Martin
- QIMR Berghofer Medical Research Institute, Department of Genetics and Computational Biology, Brisbane, Queensland, Australia
| | | | | | - Alexander McFarlane
- University of Adelaide, Department of Psychiatry, Adelaide, South Australia, AU, Australia
| | | | | | - Samuel A McLean
- UNC Institute for Trauma Recovery, Department of Anesthesiology, Chapel Hill, NC, USA
- UNC Institute for Trauma Recovery, Department of Emergency Medicine, Chapel Hill, NC, USA
| | - Sarah McLeay
- Gallipoli Medical Research Institute, PTSD Initiative, Greenslopes, Queensland, AU, Australia
| | - Divya Mehta
- Queensland University of Technology, Institute of Health and Biomedical Innovation, Kelvin Grove, QLD, AU, Australia
- Queensland University of Technology, School of Psychology and Counseling, Faculty of Health, Kelvin Grove, QLD, AU, Australia
| | | | - Mark W Miller
- VA Boston Healthcare System, National Center for PTSD, Boston, MA, USA
| | - Rajendra A Morey
- Duke University, Duke Molecular Physiology Institute, Durham, NC, USA
| | - Charles Phillip Morris
- Queensland University of Technology, Institute of Health and Biomedical Innovation, Kelvin Grove, QLD, AU, Australia
- Queensland University of Technology, School of Biomedical Sciences, Kelvin Grove, QLD, AU, Australia
| | - Ole Mors
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research, iPSYCH, DK, Denmark
- Aarhus University Hospital, Psychosis Research Unit, Risskov, DK, Denmark
| | - Preben B Mortensen
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research, iPSYCH, DK, Denmark
- Aarhus University, Centre for Integrative Sequencing, iSEQ, Aarhus, DK, Denmark
- Aarhus University, Centre for Integrated Register-based Research, Aarhus, DK, Denmark
- Aarhus University, National Centre for Register-Based Research, Aarhus, DK, Denmark
| | - Benjamin M Neale
- Broad Institute of MIT and Harvard, Stanley Center for Psychiatric Research, Cambridge, MA, USA
- Massachusetts General Hospital, Analytic and Translational Genetics Unit, Boston, MA, USA
| | - Elliot C Nelson
- Washington University in Saint Louis School of Medicine, Department of Psychiatry, Saint Louis, MO, USA
| | - Merete Nordentoft
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research, iPSYCH, DK, Denmark
- University of Copenhagen, Mental Health Services in the Capital Region of Denmark, Mental Health Center Copenhagen, Copenhagen, DK, Denmark
| | - Sonya B Norman
- University of California San Diego, Department of Psychiatry, La Jolla, CA, USA
- Veterans Affairs San Diego Healthcare System, Department of Research and Psychiatry, San Diego, CA, USA
- National Center for Post Traumatic Stress Disorder, Executive Division, White River Junction, San Diego, VT, USA
| | - Meaghan O'Donnell
- University of Melbourne, Department of Psychiatry, Melbourne, VIC, AU, USA
| | - Holly K Orcutt
- Northern Illinois University, Department of Psychology, DeKalb, IL, USA
| | - Matthew S Panizzon
- University of California San Diego, Department of Psychiatry, La Jolla, CA, USA
| | - Edward S Peters
- Louisiana State University Health Sciences Center, School of Public Health and Department of Epidemiology, New Orleans, LA, USA
| | - Alan L Peterson
- University of Texas Health Science Center at San Antonio, Department of Psychiatry, San Antonio, TX, USA
| | - Matthew Peverill
- University of Washington, Department of Psychology, Seattle, WA, USA
| | - Robert H Pietrzak
- Yale University School of Medicine, Department of Psychiatry, New Haven, CT, USA
- U.S. Department of Veterans Affairs National Center for Posttraumatic Stress Disorder, West Haven, CT, USA
| | - Melissa A Polusny
- University of Minnesota, Department of Psychiatry, Minneapolis, MN, USA
- Minneapolis VA Health Care System, Department of Mental Health, Minneapolis, MN, USA
- Minneapolis VA Health Care System, Department of Psychology, Minneapolis, MN, USA
| | - John P Rice
- Washington University in Saint Louis School of Medicine, Department of Psychiatry, Saint Louis, MO, USA
| | - Stephan Ripke
- Broad Institute of MIT and Harvard, Stanley Center for Psychiatric Research, Cambridge, MA, USA
- Massachusetts General Hospital, Psychiatric and Neurodevelopmental Genetics Unit (PNGU), Boston, MA, USA
- Charité - Universitätsmedizin, Department of Psychiatry and Psychotherapy, Berlin, GE, Germany
| | - Victoria B Risbrough
- University of California San Diego, Department of Psychiatry, La Jolla, CA, USA
- Veterans Affairs San Diego Healthcare System, Center of Excellence for Stress and Mental Health, San Diego, CA, USA
- Veterans Affairs San Diego Healthcare System, Research Service, San Diego, CA, USA
| | - Andrea L Roberts
- Harvard T.H. Chan School of Public Health, Department of Environmental Health, Boston, MA, USA
| | - Alex O Rothbaum
- Case Western Reserve University, Department of Psychological Sciences, Cleveland, OH, USA
| | - Barbara O Rothbaum
- Emory University, Department of Psychiatry and Behavioral Sciences, Atlanta, GA, USA
| | - Peter Roy-Byrne
- University of Washington, Department of Psychology, Seattle, WA, USA
| | - Ken Ruggiero
- Medical University of South Carolina, Department of Nursing and Department of Psychiatry, Charleston, SC, USA
| | - Ariane Rung
- Louisiana State University Health Sciences Center, School of Public Health and Department of Epidemiology, New Orleans, LA, USA
| | - Bart P F Rutten
- Maastricht Universitair Medisch Centrum, School for Mental Health and Neuroscience, Department of Psychiatry and Neuropsychology, Maastricht, Limburg, NL, Netherlands
| | - Nancy L Saccone
- Washington University in Saint Louis School of Medicine, Department of Psychiatry, Saint Louis, MO, USA
| | - Sixto E Sanchez
- Universidad Peruana de Ciencias Aplicadas Facultad de Ciencias de la Salud, Department of Medicine, Lima, Lima, PE, USA
| | - Dick Schijven
- UMC Utrecht Brain Center Rudolf Magnus, Department of Translational Neuroscience, Utrecht, Utrecht, NL, Netherlands
- UMC Utrecht Brain Center Rudolf Magnus, Department of Psychiatry, Utrecht, Utrecht, NL, Netherlands
| | - Soraya Seedat
- Stellenbosch University Faculty of Medicine and Health Sciences, Department of Psychiatry, Cape Town, Western Cape, ZA, South Africa
| | - Antonia V Seligowski
- Harvard Medical School, Department of Psychiatry, Boston, MA, USA
- McLean Hospital, Belmont, MA, USA
| | - Julia S Seng
- University of Michigan, School of Nursing, Ann Arbor, MI, USA
| | - Christina M Sheerin
- Virginia Institute for Psychiatric and Behavioral Genetics, Department of Psychiatry, Richmond, VA, USA
| | - Derrick Silove
- University of New South Wales, Department of Psychiatry, Sydney, NSW, AU, USA
| | - Alicia K Smith
- Emory University, Department of Psychiatry and Behavioral Sciences, Atlanta, GA, USA
- Emory University, Department of Gynecology and Obstetrics, Atlanta, GA, USA
| | - Jordan W Smoller
- Broad Institute of MIT and Harvard, Stanley Center for Psychiatric Research, Cambridge, MA, USA
- Massachusetts General Hospital, Analytic and Translational Genetics Unit, Boston, MA, USA
- Massachusetts General Hospital, Department of Psychiatry, Boston, MA, USA
| | - Scott R Sponheim
- Minneapolis VA Health Care System, Mental Health Service Line, Minneapolis, MN, USA
- University of Minnesota, Department of Psychiatry, Minneapolis, MN, USA
| | - Dan J Stein
- University of Cape Town, SA MRC Unit on Risk & Resilience in Mental Disorders, Department of Psychiatry, Cape Town, Western Cape, ZA, USA
| | - Jennifer S Stevens
- Emory University, Department of Psychiatry and Behavioral Sciences, Atlanta, GA, USA
| | - Jennifer A Sumner
- Columbia University Medical Center, Department of Medicine, New York, NY, USA
| | - Martin H Teicher
- Harvard Medical School, Department of Psychiatry, Boston, MA, USA
- McLean Hospital, Belmont, MA, USA
| | - Wesley K Thompson
- University of California San Diego, Department of Psychiatry, La Jolla, CA, USA
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research, iPSYCH, DK, Denmark
- Mental Health Centre Sct. Hans, Institute of Biological Psychiatry, Roskilde, DK, Denmark
- Oslo University Hospital, KG Jebsen Centre for Psychosis Research, Norway Division of Mental Health and Addiction, Oslo, NO, USA
| | - Edward Trapido
- Louisiana State University Health Sciences Center, School of Public Health and Department of Epidemiology, New Orleans, LA, USA
| | - Monica Uddin
- University of South Florida College of Public Health, Genomics Program, Tampa, FL, USA
| | - Robert J Ursano
- Uniformed Services University, Department of Psychiatry, Bethesda, Maryland, USA
| | - Leigh Luella van den Heuvel
- Stellenbosch University Faculty of Medicine and Health Sciences, Department of Psychiatry, Cape Town, Western Cape, ZA, South Africa
| | - Miranda Van Hooff
- University of Adelaide, Department of Psychiatry, Adelaide, South Australia, AU, Australia
| | - Eric Vermetten
- New York University School of Medicine, Department of Psychiatry, New York, NY, USA
- Arq, Psychotrauma Reseach Expert Group, Diemen, NH, Netherlands
- Leiden University Medical Center, Department of Psychiatry, Leiden, ZH, NL, Netherlands
- Netherlands Defense Department, Research Center, Utrecht, UT, Netherlands
| | - Christiaan H Vinkers
- Amsterdam UMC (location VUmc), Department of Anatomy and Neurosciences, Amsterdam, Holland, NL, Netherlands
- Amsterdam UMC (location VUmc), Department of Psychiatry, Amsterdam, Holland, NL, Netherlands
| | - Joanne Voisey
- Queensland University of Technology, Institute of Health and Biomedical Innovation, Kelvin Grove, QLD, AU, Australia
- Queensland University of Technology, School of Biomedical Sciences, Kelvin Grove, QLD, AU, Australia
| | - Yunpeng Wang
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research, iPSYCH, DK, Denmark
- Mental Health Centre Sct. Hans, Institute of Biological Psychiatry, Roskilde, DK, Denmark
- Oslo University Hospital, KG Jebsen Centre for Psychosis Research, Norway Division of Mental Health and Addiction, Oslo, NO, USA
| | - Zhewu Wang
- Ralph H Johnson VA Medical Center, Department of Mental Health, Charleston, SC, USA
- Medical University of South Carolina, Department of Psychiatry and Behavioral Sciences, Charleston, SC, USA
| | - Thomas Werge
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research, iPSYCH, DK, Denmark
- Mental Health Centre Sct. Hans, Institute of Biological Psychiatry, Roskilde, DK, Denmark
- University of Copenhagen, Department of Clinical Medicine, Copenhagen, Denmark
| | - Michelle A Williams
- Harvard T.H. Chan School of Public Health, Department of Epidemiology, Boston, MA, USA
| | - Douglas E Williamson
- Durham VA Medical Center, Research, Durham, NC, USA
- Duke University, Department of Psychiatry and Behavioral Sciences, Durham, NC, USA
| | - Sherry Winternitz
- Harvard Medical School, Department of Psychiatry, Boston, MA, USA
- McLean Hospital, Belmont, MA, USA
| | - Christiane Wolf
- University Hospital of Würzburg, Center of Mental Health, Psychiatry, Psychosomatics and Psychotherapy, Würzburg, DE, Germany
| | - Erika J Wolf
- VA Boston Healthcare System, National Center for PTSD, Boston, MA, USA
| | | | - Rachel Yehuda
- Icahn School of Medicine at Mount Sinai, Department of Psychiatry, New York, NY, USA
- James J Peters VA Medical Center, Department of Mental Health, Bronx, NY, USA
| | - Ross McD Young
- Queensland University of Technology, Institute of Health and Biomedical Innovation, Kelvin Grove, QLD, AU, Australia
- Queensland University of Technology, School of Psychology and Counseling, Faculty of Health, Kelvin Grove, QLD, AU, Australia
| | - Keith A Young
- Baylor Scott and White Central Texas, Department of Psychiatry, Temple, TX, USA
- CTVHCS, COE for Research on Returning War Veterans, Waco, TX, USA
| | - Hongyu Zhao
- Yale University, Department of Biostatistics, New Haven, CT, USA
| | - Lori A Zoellner
- University of Washington, Department of Psychiatry and Behavioral Sciences, Seattle, WA, USA
| | - Israel Liberzon
- University of Michigan Medical School, Department of Psychiatry, Ann Arbor, MI, USA
| | - Kerry J Ressler
- Harvard Medical School, Department of Psychiatry, Boston, MA, USA
- McLean Hospital, Belmont, MA, USA
- Emory University, Department of Psychiatry and Behavioral Sciences, Atlanta, GA, USA
| | - Magali Haas
- Cohen Veterans Bioscience, Cambridge, MA, USA
| | - Karestan C Koenen
- Broad Institute of MIT and Harvard, Stanley Center for Psychiatric Research, Cambridge, MA, USA
- Massachusetts General Hospital, Psychiatric and Neurodevelopmental Genetics Unit (PNGU), Boston, MA, USA
- Harvard School of Public Health, Department of Epidemiology, Boston, MA, USA
| |
Collapse
|
22
|
Himmerich SJ, Seligowski AV, Orcutt HK. The Impact of Child Abuse on Relationships between Resource Loss and Posttraumatic Stress: A Cross-Lagged Panel Analysis. J Trauma Dissociation 2019; 20:619-633. [PMID: 30932781 DOI: 10.1080/15299732.2019.1597811] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Childhood abuse is a serious and prevalent public health concern, both in the United States and around the world. The association between child abuse and adverse outcomes in adulthood is well-established, with those experiencing abuse more likely to be diagnosed with mental health disorders, including posttraumatic stress disorder (PTSD), into adulthood. One way to conceptualize the relationship between trauma and adverse mental health outcomes in adulthood is through resource loss. Previous research indicates that individuals who have experienced childhood abuse may not adequately develop resources, such as tangible (e.g., money) and intangible (e.g., emotional) support systems, with the loss of these resources associated with decreased ability to cope with distress. The current study investigated the relationship between resource loss and symptoms of posttraumatic stress longitudinally in a sample of women who had experienced both childhood abuse and a mass-shooting event. Results demonstrated that experiencing childhood physical abuse and sexual abuse predicted symptoms of posttraumatic stress after controlling for exposure to the mass-shooting event. Additionally, symptoms of posttraumatic stress and resource loss predicted each other at two time points after the shooting. Findings demonstrate the bidirectional nature of the relationship between posttraumatic stress and resource loss, as well as highlight how effects of childhood abuse can be long-standing and negatively impact psychosocial functioning in women throughout adulthood.
Collapse
Affiliation(s)
- Sara J Himmerich
- Department of Psychology, Northern Illinois University , DeKalb , Illinois , USA
| | | | - Holly K Orcutt
- Department of Psychology, Northern Illinois University , DeKalb , Illinois , USA
| |
Collapse
|
23
|
Boykin DM, Anyanwu J, Calvin K, Orcutt HK. The moderating effect of psychological flexibility on event centrality in determining trauma outcomes. Psychol Trauma 2019; 12:193-199. [PMID: 31282720 DOI: 10.1037/tra0000490] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
OBJECTIVE Emerging research shows that event centrality, or the degree to which trauma is perceived as integral to one's worldviews and personal identity, has a substantial impact on trauma recovery. Given that high centrality fosters both distress and growth, additional research on potential moderators that could better distinguish the course of adjustment is needed. This study examined whether differences in psychological flexibility (or the ability to persist in a behavior despite urges to do otherwise) impacted posttraumatic stress symptoms (PTS) and perceived posttraumatic growth (PTG) as event centrality increased. METHOD One-hundred and 25 college students (52% female) with a history of trauma exposure were recruited from a large Midwestern university. Participants completed an electronic survey for course credit. RESULTS There was a significant interaction between event centrality and psychological flexibility on PTS severity (B = 2.10, p = .003). A simple slopes analysis revealed that low psychological flexibility was associated with greater PTS severity as event centrality increased. Although event centrality and psychological flexibility independently predicted perceived PTG, no interaction effect was observed (B = -4.68, p = .080). CONCLUSION This suggests that while differences in psychological flexibility may influence PTS severity following highly centralized traumatic experiences it has a more complicated relationship with perceived PTG that requires further investigation. Clinical implications are discussed. (PsycINFO Database Record (c) 2020 APA, all rights reserved).
Collapse
Affiliation(s)
- Derrecka M Boykin
- South Central Mental Illness Research, Education, and Clinical Center (virtual center), Michael E. DeBakey VA Medical Center
| | | | | | | |
Collapse
|
24
|
Himmerich SJ, Ellis RA, Orcutt HK. Application of PTSD alcohol expectancy symptom clusters to the four-dimensional model of PTSD: Support from moderations of the association between symptoms of posttraumatic stress and alcohol use. Psychol Trauma 2019; 12:347-355. [PMID: 31246051 DOI: 10.1037/tra0000480] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
OBJECTIVE Alcohol expectancy theory, which examines beliefs about the effects of alcohol on the consumer, is especially relevant for understanding the role of alcohol use in posttraumatic stress disorder (PTSD). Previous research on the relationship between alcohol expectancies and PTSD suggests that greater endorsement of positive alcohol expectancies is positively associated with alcohol use, problem drinking, and increased PTSD symptomatology. The purpose of the current study was to investigate relationships among positive and negative PTSD alcohol expectancies, PTSD symptom clusters, and alcohol use in a sample of undergraduates. Additionally, a 4-factor structure of PTSD alcohol expectancies, based on the supported 4-domain model of PTSD, was examined. METHOD Participants included 336 undergraduates at a large Midwestern university who completed measures of trauma exposure, PTSD symptomatology, PTSD alcohol expectancies, and alcohol use. RESULTS Moderation analysis found positive alcohol expectancies influenced the relationship between posttraumatic stress (PTS) and alcohol use. Additionally, each of 4 proposed symptom clusters of PTSD alcohol expectancies moderated the association between corresponding PTSD symptom clusters and alcohol use. No support for the utility of negative alcohol expectancies was found. CONCLUSIONS The current study provides support for a PTSD symptom domain-specific approach for measuring alcohol expectancies. Though limited in generalizability, this research also provides evidence for positive PTSD alcohol expectancies as an important moderator in the relationship between symptoms of PTS and alcohol, suggesting that perceptions of alcohol's effect on PTSD symptoms confer risk for problematic drinking. (PsycInfo Database Record (c) 2020 APA, all rights reserved).
Collapse
|
25
|
Pinciotti CM, Orcutt HK. It Won't Happen to Me: An Examination of the Effectiveness of Defensive Attribution in Rape Victim Blaming. Violence Against Women 2019; 26:1059-1079. [PMID: 31226009 DOI: 10.1177/1077801219853367] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Defensive attribution posits that victim blame results from one's underlying perception of vulnerability. The resulting blame is believed to reduce perceived similarity to the victim and vulnerability to victimization, though extant research has neglected to examine its effectiveness in men and women. The current study employed multigroup analysis structural equation modeling with 618 male and female undergraduates exposed to fictional police reports of a reported rape. The theory was partially supported; among women, defensive attribution of blame effectively reduced perceived vulnerability to sexual victimization, whereas among men, blame had no effect on perceived similarity or vulnerability. Recommendations for interventions to target perceived vulnerability are discussed.
Collapse
|
26
|
Pinciotti CM, Allen CE, Milliken JM, Orcutt HK, Sasson S. Reliability and Findings From an Instrument Examining Sexual Assault Disclosure Content and Context: The Sexual Assault Inventory of Disclosure. Violence Vict 2019; 34:260-295. [PMID: 31019012 DOI: 10.1891/0886-6708.vv-d-17-00161] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
Compared to the depth of research examining the impact of sexual assault disclosure and related responses from others, little is known about the content shared during disclosures. Categorizing survivors as disclosers or nondisclosers disregards the nuanced and complex nature of disclosure. To address this gap, the current studies examined the reliability and preliminary results of the Sexual Assault Inventory of Disclosure (SAID), an inventory of content shared during disclosures and the context in which it was shared. The SAID proved reliable and preliminary findings suggest that perceptions of disclosures as positive or negative are predicted by differences in content and context, above and beyond disclosure recipients' response. The current study also explored gender differences in disclosure. Additional findings, implications, and suggestions for future studies using the SAID are discussed.
Collapse
Affiliation(s)
| | - Christy E Allen
- Department of Psychology, Northern Illinois University, DeKalb, Illinois
| | | | - Holly K Orcutt
- Department of Psychology, Northern Illinois University, DeKalb, Illinois
| | - Sapir Sasson
- Department of Psychology, Northern Illinois University, DeKalb, Illinois
| |
Collapse
|
27
|
Pinciotti CM, Reffi AN, Orcutt HK. Re-Examining the Relationship Between Avoidance and Post-Traumatic Stress Symptoms in Rape Survivors Enrolled in Self-Defense Training: The Protective Effect of Activities Self-Efficacy. Violence Vict 2019; 34:104-119. [PMID: 30808796 DOI: 10.1891/0886-6708.34.1.104] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
Although many women do not report sexual victimization as motivation for seeking self-defense training, differences in self-efficacy suggest that self-efficacy deficits may influence survivors' desire to seek training. Lower self-efficacy, thought to negatively influence perceived confidence in one's ability to engage in everyday activities, may relate to avoidance of mundane activities and cause exacerbation of post-traumatic stress symptoms (PTSS). The current study examined a three-way interaction modeling the relationships between history of rape, activities self-efficacy, activities avoidance, and PTSS in a diverse sample of 233 women enrolled in self-defense training. Results suggest that survivors who avoid everyday activities experience increased PTSS, but this effect is mitigated by perceived self-efficacy to engage in these activities. Activities self-efficacy may promote resilience in rape survivors regardless of whether they actually engage in such activities. Training that targets self-efficacy, rather than actual engagement in activities, may be sufficient to reduce PTSS in rape survivors.
Collapse
Affiliation(s)
| | - Anthony N Reffi
- Department of Psychology, Northern Illinois University, DeKalb, Illinois
| | - Holly K Orcutt
- Department of Psychology, Northern Illinois University, DeKalb, Illinois
| |
Collapse
|
28
|
Seligowski AV, Bondy E, Singleton P, Orcutt HK, Ressler KJ, Auerbach RP. Testing neurophysiological markers related to fear-potentiated startle. Psychiatry Res 2018; 267:195-200. [PMID: 29913378 DOI: 10.1016/j.psychres.2018.06.023] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/09/2018] [Revised: 06/08/2018] [Accepted: 06/10/2018] [Indexed: 11/19/2022]
Abstract
Fear-potentiated startle (FPS) paradigms provide insight into fear learning mechanisms that contribute to impairment among individuals with posttraumatic stress symptoms (PTSS). Electrophysiology also has provided insight into these mechanisms through the examination of event-related potentials (ERPs) such as the P100 and LPP. It remains unclear, however, whether the P100 and LPP may be related to fear learning processes within the FPS paradigm. To this end, we tested differences in ERP amplitudes for conditioned stimuli associated (CS+) and not associated (CS-) with an aversive unconditioned stimulus (US) during fear acquisition. Participants included 54 female undergraduate students (mean age = 20.26). The FPS response was measured via electromyography of the orbicularis oculi muscle. EEG data were collected during the FPS paradigm. While the difference between CS+ and CS- P100 amplitude was not significant, LPP amplitudes were significantly enhanced following the CS+ relative to CS-. Furthermore, the LPP difference wave (CS+ minus CS-) was associated with FPS scores for the CS- during the later portion of fear acquisition. These findings suggest that conditioned stimuli may have altered emotional encoding (LPP) during the FPS paradigm. Thus, the LPP may be a promising neurophysiological marker that is related to fear learning processes.
Collapse
Affiliation(s)
- Antonia V Seligowski
- Department of Psychiatry, Harvard Medical School, Boston, MA, USA; McLean Hospital, Belmont, MA, USA.
| | - Erin Bondy
- Department of Psychological and Brain Sciences, Washington University in St. Louis, St. Louis, MO, USA
| | - Paris Singleton
- Department of Psychiatry, Harvard Medical School, Boston, MA, USA; McLean Hospital, Belmont, MA, USA
| | - Holly K Orcutt
- Department of Psychology, Northern Illinois University, DeKalb, IL, USA
| | - Kerry J Ressler
- Department of Psychiatry, Harvard Medical School, Boston, MA, USA; McLean Hospital, Belmont, MA, USA
| | - Randy P Auerbach
- McLean Hospital, Belmont, MA, USA; Department of Psychiatry, Columbia University, New York, NY USA; Division of Clinical Developmental Neuroscience, New York, NY USA
| |
Collapse
|
29
|
Boykin DM, Orcutt HK. Treatment Use Among College Women Following a Campus Shooting. J Aggress Maltreat Trauma 2018; 28:261-280. [PMID: 31467476 PMCID: PMC6715303 DOI: 10.1080/10926771.2018.1480548] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/15/2017] [Revised: 04/20/2018] [Accepted: 05/21/2018] [Indexed: 06/10/2023]
Abstract
Despite increases in campus shootings, there is limited research on treatment utilization after these tragic events. The present study prospectively examined the prevalence and predictors of treatment use among college women following a campus shooting. Predictors included age, race/ethnicity, education level, severity of exposure to shooting, and post-shooting sequelae (i.e., social support, posttraumatic stress disorder [PTSD] severity, depression severity). Present data were obtained from 516 women on campus at the time of the shooting. They completed electronic and online surveys across three time points - pre-shooting (T1), 1-month post-shooting (T2), and 6-months post-shooting (T3). As expected, few participants (14.4%) sought any treatment. Of note, 77.5% of participants endorsed at least one risk factor for PTSD. Prevalence rates of probable PTSD significantly decreased from 51.8% of the full sample at T2 to 12.9% at T3. Results showed that a significantly higher proportion of participants with probable PTSD at T3 sought treatment than those participants at minimal to no risk for PTSD. Psychotherapy was sought at higher rates than medication or combined treatment across risk groups. No reliable predictors of treatment use were observed for at-risk participants or those with probable PTSD. Research and clinical suggestions for optimizing post-disaster recovery and improving treatment utilization among students following campus shootings are discussed.
Collapse
Affiliation(s)
- Derrecka M Boykin
- Department of Psychology, Northern Illinois University, DeKalb, Illinois, USA
| | - Holly K Orcutt
- Department of Psychology, Northern Illinois University, DeKalb, Illinois, USA
| |
Collapse
|
30
|
Boykin DM, Himmerich SJ, Pinciotti CM, Miller LM, Miron LR, Orcutt HK. Barriers to self-compassion for female survivors of childhood maltreatment: The roles of fear of self-compassion and psychological inflexibility. Child Abuse Negl 2018; 76:216-224. [PMID: 29144981 DOI: 10.1016/j.chiabu.2017.11.003] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/12/2017] [Revised: 10/25/2017] [Accepted: 11/07/2017] [Indexed: 06/07/2023]
Abstract
Preliminary evidence has demonstrated the benefits of targeting self-compassion in the treatment of posttraumatic stress disorder (PTSD). However, survivors of childhood maltreatment may present with unique challenges that compromise the effectiveness of these and other PTSD treatments. Specifically, childhood maltreatment victims often exhibit a marked fear and active resistance of self-kindness and warmth (i.e., fear of self-compassion). Victims may also attempt to control distressing internal experiences in a way that hinders engagement in value-based actions (i.e., psychological inflexibility). Research suggests that psychological inflexibility exacerbates the negative effects of fear of self-compassion. The present study expanded on previous research by examining the relations among childhood maltreatment, fear of self-compassion, psychological inflexibility, and PTSD symptom severity in 288 college women. As expected, moderate to severe levels of childhood maltreatment were associated with greater fear of self-compassion, psychological inflexibility, and PTSD symptom severity compared to minimal or no childhood maltreatment. A mediation analysis showed that childhood maltreatment had a significant indirect effect on PTSD symptom severity via fear of self-compassion, although a conditional process analysis did not support psychological inflexibility as a moderator of this indirect effect. A post hoc multiple mediator analysis showed a significant indirect effect of childhood maltreatment on PTSD symptom severity via psychological inflexibility, but not fear of self-compassion. These findings highlight the importance of addressing fear of self-compassion and psychological inflexibility as barriers to treatment for female survivors of childhood maltreatment.
Collapse
Affiliation(s)
- Derrecka M Boykin
- Northern Illinois University, Department of Psychology, DeKalb, IL, 60115, USA
| | - Sara J Himmerich
- Northern Illinois University, Department of Psychology, DeKalb, IL, 60115, USA
| | - Caitlin M Pinciotti
- Northern Illinois University, Department of Psychology, DeKalb, IL, 60115, USA
| | - Lindsay M Miller
- Northern Illinois University, Department of Psychology, DeKalb, IL, 60115, USA
| | - Lynsey R Miron
- Edward Hines, Jr. VA Hospital, 5000 5th Ave., Hines, IL, 60141, USA
| | - Holly K Orcutt
- Northern Illinois University, Department of Psychology, DeKalb, IL, 60115, USA.
| |
Collapse
|
31
|
Holzman JB, Valentiner DP, Hannan SM, Wallace DG, Orcutt HK. High dose alcohol consumption predicts less reduction in post-traumatic stress symptoms after a campus mass shooting. Anxiety Stress Coping 2017; 30:609-618. [PMID: 28697628 DOI: 10.1080/10615806.2017.1348297] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
BACKGROUND Recognizing that alcohol might affect subsequent processing of trauma-related information, this study examined whether high dose alcohol consumption (HDAC) following a campus mass shooting affected the relation between shooting exposure and post-traumatic stress symptoms (PTSS). METHODS Female participants (N = 691) recorded levels of physical exposure to the shooting event, alcohol use, and PTSS 1 month following the shooting event and 8 months later. RESULTS No evidence was found to suggest that pre-shooting HDAC moderated the relationship between trauma exposure and PTSS 1 month following the shooting. HDAC in the month following the shooting predicted less resolution of PTSS 8 months later. Specifically, at higher (but not lower) levels of HDAC, shooting exposure was associated with less reduction in PTSS from 1 to 8 months post-trauma. Several alternate explanations were ruled out. CONCLUSIONS Less reduction in PTSS seems to occur at high levels of both shooting exposure and HDAC. Theoretical implications and directions for future research are discussed.
Collapse
Affiliation(s)
- Jacob B Holzman
- a Department of Psychology , Northern Illinois University , DeKalb , IL , USA
| | - David P Valentiner
- a Department of Psychology , Northern Illinois University , DeKalb , IL , USA
| | - Susan M Hannan
- a Department of Psychology , Northern Illinois University , DeKalb , IL , USA
| | - Douglas G Wallace
- a Department of Psychology , Northern Illinois University , DeKalb , IL , USA
| | - Holly K Orcutt
- a Department of Psychology , Northern Illinois University , DeKalb , IL , USA
| |
Collapse
|
32
|
Hannan SM, Orcutt HK, Miron LR, Thompson KL. Childhood Sexual Abuse and Later Alcohol-Related Problems: Investigating the Roles of Revictimization, PTSD, and Drinking Motivations Among College Women. J Interpers Violence 2017; 32:2118-2138. [PMID: 26130681 DOI: 10.1177/0886260515591276] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
The current study sought to examine whether symptoms of posttraumatic stress disorder (PTSD), adolescent sexual assault (ASA), and drinking motivations (e.g., drinking to regulate emotional experiences) mediate the relationship between a history of childhood sexual abuse (CSA) and subsequent alcohol-related problems among college women. Participants were 579 female students at a Midwestern university. Participants were recruited as part of a larger longitudinal study that investigated risk and resiliency factors related to sexual revictimization. Using a serial mediation model, the current study found that the proposed constructs mediated the relationship between CSA and subsequent alcohol-related problems via two separate paths. In one path, CSA was associated with PTSD, which in turn predicted drinking to regulate emotional experiences, which then was related to alcohol-related problems in adulthood. In the second path, CSA was related to ASA, which in turn predicted drinking to regulate emotional experiences, which then was related to alcohol-related problems in adulthood. These results suggest that individuals with a history of CSA are more likely to experience both revictimization in adolescence and PTSD symptoms in adulthood, which may lead to alcohol-related problems via drinking to regulate emotional experiences. These findings suggest the importance of incorporating skills training in adaptive emotion regulation strategies into treatment for individuals with a history of CSA and ASA.
Collapse
|
33
|
|
34
|
|
35
|
Orcutt HK, Hannan SM, Seligowski AV, Jovanovic T, Norrholm SD, Ressler KJ, McCanne T. Fear-Potentiated Startle and Fear Extinction in a Sample of Undergraduate Women Exposed to a Campus Mass Shooting. Front Psychol 2017; 7:2031. [PMID: 28111559 PMCID: PMC5216047 DOI: 10.3389/fpsyg.2016.02031] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2016] [Accepted: 12/14/2016] [Indexed: 11/17/2022] Open
Abstract
Posttraumatic stress disorder (PTSD) is a common psychological disorder that affects a substantial minority of individuals. Previous research has suggested that PTSD can be partially explained as a disorder of impaired fear inhibition. The current study utilized a previously validated fear acquisition and extinction paradigm in a sample of 75 undergraduate women who were exposed to a campus mass shooting that occurred in 2008. We used a protocol in which conditioned fear was first acquired through the presentation of one colored shape (reinforced conditioned stimulus, CS+) that was paired with an aversive airblast to the larynx (unconditioned stimulus, US) and a different colored shape that was not paired with the airblast (non-reinforced conditioned stimulus, CS-). Fear was extinguished 10 min later through repeated presentations of the CSs without reinforcement. Number of clinically significant posttraumatic stress symptoms (PTSS) immediately following the mass shooting were positively associated with fear-potentiated startle (FPS) to the CS+ and CS- during late periods of acquisition. During early periods of fear extinction, PTSS was positively associated with FPS to the CS+. Results from the current study suggest that PTSS is related to altered fear inhibition and extinction during an FPS paradigm. In line with similar research, women with greater PTSS demonstrated a greater “fear load,” suggesting that these women experienced elevated fear to the CS+ during extinction after conditioned fear was acquired.
Collapse
Affiliation(s)
- Holly K Orcutt
- Department of Psychology, Northern Illinois University, DeKalb IL, USA
| | - Susan M Hannan
- Department of Psychology, Northern Illinois University, DeKalb IL, USA
| | | | - Tanja Jovanovic
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta GA, USA
| | - Seth D Norrholm
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, AtlantaGA, USA; Trauma Recovery Program, Atlanta Veteran Affairs Medical Center, DecaturGA, USA
| | - Kerry J Ressler
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, AtlantaGA, USA; Howard Hughes Medical Institute, Chevy ChaseMD, USA; Program in Neuroscience, Department of Psychiatry, Harvard Medical School, BostonMA, USA
| | - Thomas McCanne
- Department of Psychology, Northern Illinois University, DeKalb IL, USA
| |
Collapse
|
36
|
Pinciotti CM, Seligowski AV, Orcutt HK. Psychometric properties of the PACT Scale and relations with symptoms of PTSD. ACTA ACUST UNITED AC 2017; 9:362-369. [DOI: 10.1037/tra0000206] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
|
37
|
Bardeen JR, Fergus TA, Orcutt HK. Examining the specific dimensions of distress tolerance that prospectively predict perceived stress. Cogn Behav Ther 2016; 46:211-223. [DOI: 10.1080/16506073.2016.1233454] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
|
38
|
Seligowski AV, Lee DJ, Miron LR, Orcutt HK, Jovanovic T, Norrholm SD. Prospective Associations between Emotion Dysregulation and Fear-Potentiated Startle: The Moderating Effect of Respiratory Sinus Arrhythmia. Front Psychol 2016; 7:652. [PMID: 27199871 PMCID: PMC4858525 DOI: 10.3389/fpsyg.2016.00652] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2016] [Accepted: 04/19/2016] [Indexed: 11/24/2022] Open
Abstract
Background: Emotion dysregulation has been implicated in the negative outcomes following trauma exposure. A proposed biomarker of emotion dysregulation, respiratory sinus arrhythmia (RSA), has demonstrated associations with trauma-related phenomena, such as the fear-potentiated startle (FPS) response. The current study aimed to examine the prospective association between emotion dysregulation and RSA and FPS several years following trauma exposure. Methods: Participants were 131 women exposed to a campus mass shooting on February 14, 2008. Pre-shooting emotion dysregulation was assessed in 2006–2008. Startle response, measured by orbicularis oculi electromyography (EMG), and RSA were gathered during an FPS paradigm conducted from 2012 to 2015. Results: No significant associations among emotion dysregulation, RSA, and FPS emerged among the full sample. However, emotion dysregulation predicted FPS during both acquisition (r = 0.40, p < 0.05) and extinction (r = 0.57, p < 0.01) among individuals with high resting RSA. Conclusions: Findings suggest that pre-shooting emotion dysregulation is a potent predictor of FPS several years following potential trauma exposure, and this association varies by RSA level. Results emphasize the importance of examining autonomic regulation in the association between emotion dysregulation and recovery from trauma exposure.
Collapse
Affiliation(s)
| | - Daniel J Lee
- Department of Psychology, Auburn University Auburn, AL, USA
| | - Lynsey R Miron
- Department of Psychology, Northern Illinois University DeKalb, IL, USA
| | - Holly K Orcutt
- Department of Psychology, Northern Illinois University DeKalb, IL, USA
| | - Tanja Jovanovic
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine Atlanta, GA, USA
| | - Seth D Norrholm
- Department of Psychiatry and Behavioral Sciences, Emory University School of MedicineAtlanta, GA, USA; Trauma Recovery Program, Atlanta Veteran Affairs Medical CenterDecatur, GA, USA
| |
Collapse
|
39
|
Abstract
Research suggests that racial and ethnic minorities are more likely to attrit from longitudinal trauma studies than non-Hispanic Whites. Yet, little is known about how the loss of minority participants influences longitudinal findings as well as internal and external validity of study findings. Thus, the present study examined the effects of race/ethnicity on attrition in a longitudinal trauma study of women (minority = 223, non-Hispanic White or majority = 459) exposed to a campus shooting. Survival analyses were used to compare the attrition rates of minority participants to majority participants and assess the extent to which race/ethnicity, among other variables, predicted attrition. Minority participants were more likely to attrit than majority participants, hazard ratio (HR) = 0.69, 95% CI [0.48, 0.99], even after adjusting for study variables. A main effect was also found for age, HR = 1.06, 95% CI [1.01, 1.12]. Race/ethnicity did not interact with other study variables to influence attrition. The findings underscored the importance of assessing the effects of attrition on longitudinal findings and external validity.
Collapse
Affiliation(s)
- Derrecka M Boykin
- Department of Psychology, Northern Illinois University, DeKalb, Illinois, USA
| | - Melissa J London
- Department of Psychology, Northern Illinois University, DeKalb, Illinois, USA
| | - Holly K Orcutt
- Department of Psychology, Northern Illinois University, DeKalb, Illinois, USA
| |
Collapse
|
40
|
Abstract
OBJECTIVE Research suggests that 4-factor models of posttraumatic stress disorder (PTSD) may be improved upon by the addition of novel factors, such as Dysphoric Arousal, Externalizing Behaviors, and Anhedonia. However, a novel 7-factor hybrid model has demonstrated superior fit in veteran and undergraduate samples. The current study sought to replicate this finding in a trauma-exposed community sample and examined relations with positive (PA) and negative affect (NA). METHOD Participants included 403 adults (M(age) = 37.75) recruited through Amazon's MTurk. PTSD was measured using the PTSD Checklist-5 (PCL-5). Confirmatory factor analyses were conducted in Mplus. RESULTS The 7-factor hybrid model demonstrated good fit: CFI = .96, TLI = .95, RMSEA = .06 (90% CI [.05, .07]), SRMR = .03. This model was superior to the 5- and 6-factor models. All factors demonstrated significant relations with PA and NA, the largest of which were the Externalizing Behaviors (with NA) and Anhedonia (with PA) factors. CONCLUSION Results provide support for the 7-factor hybrid model of PTSD using the PCL-5 in a community sample. Findings replicate previous research suggesting that PTSD is highly related to NA, which has been purported as an underlying dimension of PTSD. It is recommended that future research use clinical measures to further examine the hybrid model. (PsycINFO Database Record
Collapse
|
41
|
Bardeen JR, Fergus TA, Hannan SM, Orcutt HK. Addressing Psychometric Limitations of the Difficulties in Emotion Regulation Scale Through Item Modification. J Pers Assess 2015; 98:298-309. [DOI: 10.1080/00223891.2015.1091774] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
|
42
|
|
43
|
|
44
|
Reddy MK, Seligowski AV, Rabenhorst MM, Orcutt HK. Predictors of expressive writing content and posttraumatic stress following a mass shooting. Psychol Trauma 2015; 7:286-294. [PMID: 25961120 DOI: 10.1037/a0037918] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
This study examined relations among experiential avoidance, state dissociation during writing, cognitive-emotional processing, and posttraumatic stress in the context of an expressive writing task among 58 undergraduate females who were students at a large midwestern university that had recently experienced a mass shooting. Experiential avoidance significantly predicted reported suppression during the writing task. Additionally, posttraumatic stress symptoms (PTSS) at the time of the writing task were significantly associated with state dissociation, suppression, and the use of positive emotion words during the writing. Finally, at the zero-order level, prospective PTSS were associated with state dissociation and suppression during the earlier writing task. However, in a full regression model, only experiential avoidance and PTSS at the time of the writing task significantly predicted prospective PTSS. Supplemental analyses suggest processes may operate differently across levels of exposure. Findings from the present study provide further support for the role of experiential avoidance, state dissociation during writing, and cognitive-emotional processing in predicting PTSS. Additionally, experiential avoidance may play an important role in how individuals use cognitive-emotional processing to narrate a traumatic event.
Collapse
Affiliation(s)
- Madhavi K Reddy
- Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University
| | | | | | | |
Collapse
|
45
|
Miron LR, Sherrill AM, Orcutt HK. Fear of self-compassion and psychological inflexibility interact to predict PTSD symptom severity. Journal of Contextual Behavioral Science 2015. [DOI: 10.1016/j.jcbs.2014.10.003] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
|
46
|
Abstract
Researchers have called for examinations of associations between distinct facets of distress tolerance and specific forms of psychopathology. We examined associations between five facets of distress tolerance (intolerance of uncertainty, ambiguity, frustration, negative emotion, and physical discomfort) and health anxiety using a large community sample of adults. Structural equation modeling was used to examine associations. Intolerance of uncertainty, negative emotion, and physical discomfort were the only facets of distress tolerance that shared unique associations with health anxiety after accounting for the overlap among the facets of distress tolerance. Intolerance of physical discomfort shared an especially strong unique association with health anxiety. These results highlight facets of distress tolerance that are particularly relevant to health anxiety. Conceptual and therapeutic implications are discussed.
Collapse
Affiliation(s)
- Thomas A Fergus
- Department of Psychology and Neuroscience, Baylor University, Waco, Texas
| | | | | |
Collapse
|
47
|
Howells NL, Orcutt HK. Diary study of sexual risk taking, alcohol use, and strategies for reducing negative affect in female college students. J Stud Alcohol Drugs 2014; 75:399-403. [PMID: 24766751 DOI: 10.15288/jsad.2014.75.399] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVE The goal of this study was to examine motivations for engaging in risky sexual behaviors (RSBs) and factors that may increase the likelihood of engaging in RSB. RSB was defined as not using condoms during intercourse and having intercourse with poorly known partners, which were treated separately with regard to analyses. METHOD Utilizing a weekly diary methodology, the present study examined whether using situation-specific coping strategies (e.g, using alcohol to reduce negative affect and sex to reduce negative affect) and whether subjective reports of intoxication significantly predicted if participants would engage in RSB. Female college students (N = 93) completed a weekly computerized questionnaire for 8 weeks reporting on their sexual behavior, their level of intoxication, and use of strategies (i.e., sex and alcohol) to reduce negative affect at the time of the sexual encounter. RESULTS Using hierarchical linear modeling, results indicated that level of intoxication was the sole significant main effect related to engaging in RSB; specifically, level of intoxication was positively related to sex with a poorly known partner. CONCLUSIONS Alcohol use, as opposed to motivation for intercourse, is an important area to focus on with regard to prevention of RSB.
Collapse
Affiliation(s)
- Nicolette L Howells
- The Center for Cognitive and Behavioral Therapy of Greater Columbus, Inc., Columbus, Ohio
| | - Holly K Orcutt
- Department of Psychology, Northern Illinois University, DeKalb, Illinois
| |
Collapse
|
48
|
|
49
|
Miron LR, Orcutt HK. Pathways from childhood abuse to prospective revictimization: depression, sex to reduce negative affect, and forecasted sexual behavior. Child Abuse Negl 2014; 38:1848-59. [PMID: 25455965 PMCID: PMC4254559 DOI: 10.1016/j.chiabu.2014.10.004] [Citation(s) in RCA: 47] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/31/2014] [Revised: 09/23/2014] [Accepted: 10/06/2014] [Indexed: 05/28/2023]
Abstract
Research suggests that adverse events in childhood, such as childhood physical, sexual, and emotional abuse, confer risk for later sexual assault. Psychological distress, coping strategies, and sexual behavior may help explain the path from childhood abuse to revictimization. The present study explored how the use of sex to regulate negative affect (SRNA) operates independently, and in combination with other psychosocial factors to increase college women's (N=541) risk of experiencing prospective adult sexual assault (ASA). Sequential multiple mediator models in Mplus were used to assess the effect of three different forms of childhood abuse on prospective ASA, both independently and while controlling for other forms of childhood abuse. The indirect effect of adolescent sexual assault (AdolSA), depressive symptoms, SRNA, and participants' response to a sex-related vignette was tested using bias-corrected bootstrapping. In the full path model, childhood emotional abuse and AdolSA predicted ASA, while childhood physical and sexual abuse were directly associated with AdolSA, but not ASA. Additionally, depressive symptoms and participants' estimate of their likely behavior in a sex-related vignette directly predicted prospective ASA. Results using bootstrapping revealed that a history of childhood abuse predicted prospective ASA via diverse direct and indirect paths, as well as through a similar multiple mediator path. Overall, findings suggest that a combination of affective, coping, and sexual expectancy factors contribute to risk for revictimization in adult survivors of childhood abuse. Future research directions and targets for risk-reduction programming are discussed.
Collapse
Affiliation(s)
- Lynsey R Miron
- Department of Psychology, Northern Illinois University, DeKalb, IL, USA
| | - Holly K Orcutt
- Department of Psychology, Northern Illinois University, DeKalb, IL, USA
| |
Collapse
|
50
|
Miron LR, Orcutt HK, Kumpula MJ. Differential predictors of transient stress versus posttraumatic stress disorder: evaluating risk following targeted mass violence. Behav Ther 2014; 45:791-805. [PMID: 25311288 PMCID: PMC4218730 DOI: 10.1016/j.beth.2014.07.005] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/12/2014] [Revised: 07/10/2014] [Accepted: 07/24/2014] [Indexed: 02/08/2023]
Abstract
Schools have become a common incident site for targeted mass violence, including mass shootings. Although exposure to mass violence can result in significant distress, most individuals are able to fully recover over time, while a minority develop more pervasive pathology, such as PTSD. The present study investigated how several pre- and posttrauma factors predict posttraumatic stress symptoms (PTSS) in both the acute and distal aftermath of a campus mass shooting using a sample with known levels of pretrauma functioning (N=573). Although the largest proportion of participants evidenced resilience following exposure to the event (46.1%), many reported high rates of PTSS shortly after the shooting (42.1%) and a smaller proportion (11.9%) met criteria for probable PTSD both in the acute and more distal aftermath of the event. While several preshooting factors predicted heightened PTSS after the shooting, prior trauma exposure was the only preshooting variable shown to significantly differentiate between those who experienced transient versus prolonged distress. Among postshooting predictors, individuals reporting greater emotion dysregulation and peritraumatic dissociative experiences were over four times more likely to have elevated PTSS 8months postshooting compared with those reporting less dysregulation and dissociative experiences. Individuals with less exposure to the shooting, fewer prior traumatic experiences, and greater satisfaction with social support were more likely to recover from acute distress. Overall, results suggest that, while pretrauma factors may differentiate between those who are resilient in the aftermath of a mass shooting and those who experience heightened distress, several event-level and posttrauma coping factors help distinguish between those who eventually recover and those whose PTSD symptoms persist over time.
Collapse
|