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; 56:792-808. [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] [MESH Headings] [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
|
Kimbrel NA, Aho NA, Neal LC, Bernes SA, Beaver TA, Hertzberg JA, Lutrey A, Leto F, Ostiguy W, Cammarata C, Meyer EC, Wilson SM, Dennis MF, Calhoun PS, Beckham JC, Stanley B, Gulliver SB. Development and Implementation of Web-Based Safety Planning Intervention Training for Firefighter Peer Support Specialists. Crisis 2024; 45:108-117. [PMID: 37727969 DOI: 10.1027/0227-5910/a000924] [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: 09/21/2023]
Abstract
Background: Recent findings indicate that firefighters may be at increased risk for death by suicide; however, there has been only limited suicide prevention work in fire service to date. Aim: The objective of this program evaluation project was to develop and evaluate a web-based Safety Planning Intervention (SPI) training course for firefighter peer support specialists. Method: Peer support specialists who completed the web-based SPI training were administered evaluation questionnaires before the training and then again at a 3-month follow-up assessment. Results: A total of 213 peer support specialists completed the SPI training. Most participants took 2-3 h to complete the training. Participants generally reported high levels of satisfaction with the course, with the vast majority (94.4%) indicating they would recommend it to their peers. Course completers also demonstrated significant gains in SPI knowledge and self-efficacy from baseline to 3-month follow-up (all p's < .001). Moreover, the percentage of participants who reported completing a safety plan with someone they suspected at being of risk for suicide increased approximately 7-fold from baseline (3.5%) to 3-month follow-up (25.2%; p < .001). Participants further reported that 97.6% of the safety plans that they completed resulted in a positive outcome. Limitations: This was a program evaluation project that did not include a control group. Thus, causality cannot be inferred. Conclusions: The present findings suggest that web-based SPI training is a feasible and scalable approach for training peer support specialists to deliver the SPI to at-risk individuals.
Collapse
Affiliation(s)
- Nathan A Kimbrel
- Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, NC, USA
- Durham Veterans Affairs Healthcare System, Durham, NC, USA
- VA Health Services Research and Development Center of Innovation to Accelerate Discovery and Practice Transformation, Durham, NC, USA
- VA Mid-Atlantic Mental Illness Research, Education and Clinical Center, Durham, NC, USA
| | - Natalie A Aho
- Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, NC, USA
- Durham Veterans Affairs Healthcare System, Durham, NC, USA
| | - Lydia C Neal
- Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, NC, USA
- Durham Veterans Affairs Healthcare System, Durham, NC, USA
| | - Sarah A Bernes
- International Association of Fire Fighters, Washington, DC, USA
| | - Tiffany A Beaver
- Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, NC, USA
- Durham Veterans Affairs Healthcare System, Durham, NC, USA
| | - Jeffrey A Hertzberg
- Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, NC, USA
- Durham Veterans Affairs Healthcare System, Durham, NC, USA
| | - Alice Lutrey
- International Association of Fire Fighters, Washington, DC, USA
| | - Frank Leto
- International Association of Fire Fighters, Washington, DC, USA
- Fire Department of the City of New York, NY, USA
| | - Willy Ostiguy
- International Association of Fire Fighters, Washington, DC, USA
- Boston Fire Department, Boston, MA, USA
| | - Claire Cammarata
- New York City Office of Labor Relations Employee Assistance Program, New York, NY, USA
| | - Eric C Meyer
- Department of Counseling and Behavioral Health, University of Pittsburgh, PA, USA
| | - Sarah M Wilson
- Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, NC, USA
- Durham Veterans Affairs Healthcare System, Durham, NC, USA
- VA Health Services Research and Development Center of Innovation to Accelerate Discovery and Practice Transformation, Durham, NC, USA
| | - Michelle F Dennis
- Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, NC, USA
- Durham Veterans Affairs Healthcare System, Durham, NC, USA
- VA Mid-Atlantic Mental Illness Research, Education and Clinical Center, Durham, NC, USA
| | - Patrick S Calhoun
- Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, NC, USA
- Durham Veterans Affairs Healthcare System, Durham, NC, USA
- VA Health Services Research and Development Center of Innovation to Accelerate Discovery and Practice Transformation, Durham, NC, USA
- VA Mid-Atlantic Mental Illness Research, Education and Clinical Center, Durham, NC, USA
| | - Jean C Beckham
- Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, NC, USA
- Durham Veterans Affairs Healthcare System, Durham, NC, USA
- VA Mid-Atlantic Mental Illness Research, Education and Clinical Center, Durham, NC, USA
| | - Barbara Stanley
- Department of Psychiatry, Columbia University Irving Medical Center, New York, NY, USA
- New York State Psychiatric Institute, New York, NY, USA
| | - Suzy B Gulliver
- International Association of Fire Fighters, Washington, DC, USA
- Warriors Research Institute, Waco, TX, USA
- Department of Psychiatry and Human Behavior, Texas A&M Health Science Center, Bryan, TX, USA
| |
Collapse
|
3
|
Garrett ME, Dennis MF, Bourassa KJ, Hauser MA, Kimbrel NA, Beckham JC, Ashley-Koch AE. Genome-wide DNA methylation analysis of cannabis use disorder in a veteran cohort enriched for posttraumatic stress disorder. Psychiatry Res 2024; 333:115757. [PMID: 38309009 PMCID: PMC10922626 DOI: 10.1016/j.psychres.2024.115757] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/30/2023] [Revised: 01/22/2024] [Accepted: 01/23/2024] [Indexed: 02/05/2024]
Abstract
Cannabis use has been increasing over the past decade, not only in the general US population, but particularly among military veterans. With this rise in use has come a concomitant increase in cannabis use disorder (CUD) among veterans. Here, we performed an epigenome-wide association study for lifetime CUD in an Iraq/Afghanistan era veteran cohort enriched for posttraumatic stress disorder (PTSD) comprising 2,310 total subjects (1,109 non-Hispanic black and 1,201 non-Hispanic white). We also investigated CUD interactions with current PTSD status and examined potential indirect effects of DNA methylation (DNAm) on the relationship between CUD and psychiatric diagnoses. Four CpGs were associated with lifetime CUD, even after controlling for the effects of current smoking (AHRR cg05575921, LINC00299 cg23079012, VWA7 cg22112841, and FAM70A cg08760398). Importantly, cg05575921, a CpG strongly linked to smoking, remained associated with lifetime CUD even when restricting the analysis to veterans who reported never smoking cigarettes. Moreover, CUD interacted with current PTSD to affect cg05575921 and cg23079012 such that those with both CUD and PTSD displayed significantly lower DNAm compared to the other groups. Finally, we provide preliminary evidence that AHRR cg05575921 helps explain the association between CUD and any psychiatric diagnoses, specifically mood disorders.
Collapse
Affiliation(s)
- Melanie E Garrett
- Duke Molecular Physiology Institute, Duke University Medical Center, 300N Duke St, Durham, NC 27701, USA
| | - Michelle F Dennis
- Durham Veterans Affairs (VA) Health Care System, Durham, NC, USA; VA Mid-Atlantic Mental Illness Research, Education, and Clinical Center, Durham, NC, USA; Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, NC, USA
| | - Kyle J Bourassa
- Durham Veterans Affairs (VA) Health Care System, Durham, NC, USA; VA Mid-Atlantic Mental Illness Research, Education, and Clinical Center, Durham, NC, USA; Center for the Study of Aging and Human Development, Duke University Medical Center, Durham, NC, USA
| | - Michael A Hauser
- Duke Molecular Physiology Institute, Duke University Medical Center, 300N Duke St, Durham, NC 27701, USA
| | - Nathan A Kimbrel
- Durham Veterans Affairs (VA) Health Care System, Durham, NC, USA; VA Mid-Atlantic Mental Illness Research, Education, and Clinical Center, Durham, NC, USA; Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, NC, USA
| | - Jean C Beckham
- Durham Veterans Affairs (VA) Health Care System, Durham, NC, USA; VA Mid-Atlantic Mental Illness Research, Education, and Clinical Center, Durham, NC, USA; Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, NC, USA
| | - Allison E Ashley-Koch
- Duke Molecular Physiology Institute, Duke University Medical Center, 300N Duke St, Durham, NC 27701, USA.
| |
Collapse
|
4
|
Beckham JC, Calhoun PS, Chen Z, Dennis MF, Kirby AC, Treis ET, Hertzberg JS, Hair LP, Mann AJ, Budney AJ, Kimbrel NA. Development of Mobile Contingency Management for Cannabis Use Reduction. Behav Ther 2024; 55:1-13. [PMID: 38216224 PMCID: PMC10787157 DOI: 10.1016/j.beth.2023.03.004] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/11/2022] [Revised: 03/01/2023] [Accepted: 03/07/2023] [Indexed: 01/14/2024]
Abstract
Many interventions for cannabis use disorder (CUD) are associated with decreases in frequency and quantity of use but fail to increase overall rates of sustained abstinence. It is currently unknown whether reductions in use (in the absence of sustained abstinence) result in clinically significant improvements in functioning. The objective of this study was to refine a mobile contingency management approach to reduce cannabis use to ultimately evaluate whether reductions in frequency and quantity of cannabis are related to improvements in functional and mental health status. Three cohorts of participants (n = 18 total, n = 10 women) were enrolled and completed 2 weeks of ecological momentary assessment (EMA) during a baseline ad lib cannabis use period, followed by a 6-week reduction period. Participants completed EMA assessments multiple times per day and were prompted to provide videotaped saliva cannabis testing 2-3 times daily. Data from participants who were at least 80% adherent to all EMA prompts were analyzed (13 out of 18). During the ad lib phase, participants were using cannabis on 94% of the days and reported using a mean of 1.42 grams daily. The intervention was a mobile application that participants used to record cannabis use by saliva tests to bioverify abstinence and participants completed electronic diaries to report their grams used. During the 6-week intervention phase, participants reported reducing their use days to 47% of the days with a reported mean of .61 grams daily. In the last cohort, at least 50% of the heavy users were able to reduce their cannabis use by at least 50%. The effect of cannabis reduction (versus abstinence) is largely unknown. Observations suggest that it is possible to develop a mobile intervention to reduce cannabis use among heavy users, and this paradigm can be utilized in future work to evaluate whether reductions in cannabis use among heavy users will result in improvements in functional and mental health status.
Collapse
Affiliation(s)
- Jean C Beckham
- Durham Veterans Affairs Health Care System; Veterans Affairs Mid-Atlantic Region Mental Illness Research, Education, and Clinical Center; Duke University School of Medicine.
| | - Patrick S Calhoun
- Durham Veterans Affairs Health Care System; Veterans Affairs Mid-Atlantic Region Mental Illness Research, Education, and Clinical Center; Center of Innovation to Accelerate Discovery and Practice Transformation; Duke University School of Medicine
| | | | - Michelle F Dennis
- Durham Veterans Affairs Health Care System; Veterans Affairs Mid-Atlantic Region Mental Illness Research, Education, and Clinical Center; Duke University School of Medicine
| | - Angela C Kirby
- Durham Veterans Affairs Health Care System; Veterans Affairs Mid-Atlantic Region Mental Illness Research, Education, and Clinical Center; Duke University School of Medicine
| | | | | | - Lauren P Hair
- Durham Veterans Affairs Health Care System; Veterans Affairs Mid-Atlantic Region Mental Illness Research, Education, and Clinical Center; Duke University School of Medicine
| | | | | | - Nathan A Kimbrel
- Durham Veterans Affairs Health Care System; Veterans Affairs Mid-Atlantic Region Mental Illness Research, Education, and Clinical Center; Center of Innovation to Accelerate Discovery and Practice Transformation, Durham Veterans Health Care System; Duke University School of Medicine
| |
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
|
Kimbrel NA, Garrett ME, Evans MK, Mellows C, Dennis MF, Hair LP, Hauser MA, Ashley-Koch AE, Beckham JC. Large epigenome-wide association study identifies multiple novel differentially methylated CpG sites associated with suicidal thoughts and behaviors in veterans. Front Psychiatry 2023; 14:1145375. [PMID: 37398583 PMCID: PMC10311443 DOI: 10.3389/fpsyt.2023.1145375] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/16/2023] [Accepted: 04/28/2023] [Indexed: 07/04/2023] Open
Abstract
Introduction The U.S. suicide mortality rate has steadily increased during the past two decades, particularly among military veterans; however, the epigenetic basis of suicidal thoughts and behaviors (STB) remains largely unknown. Methods To address this issue, we conducted an epigenome-wide association study of DNA methylation (DNAm) of peripheral blood samples obtained from 2,712 U.S. military veterans. Results Three DNAm probes were significantly associated with suicide attempts, surpassing the multiple testing threshold (FDR q-value <0.05), including cg13301722 on chromosome 7, which lies between the genes SLC4A2 and CDK5; cg04724646 in PDE3A; and cg04999352 in RARRES3. cg13301722 was also found to be differentially methylated in the cerebral cortex of suicide decedents in a publicly-available dataset (p = 0.03). Trait enrichment analysis revealed that the CpG sites most strongly associated with STB in the present sample were also associated with smoking, alcohol consumption, maternal smoking, and maternal alcohol consumption, whereas pathway enrichment analysis revealed significant associations with circadian rhythm, adherens junction, insulin secretion, and RAP-1 signaling, each of which was recently associated with suicide attempts in a large, independent genome-wide association study of suicide attempts of veterans. Discussion Taken together, the present findings suggest that SLC4A2, CDK5, PDE3A, and RARRES3 may play a role in STB. CDK5, a member of the cyclin-dependent kinase family that is highly expressed in the brain and essential for learning and memory, appears to be a particularly promising candidate worthy of future study; however, additional work is still needed to replicate these finding in independent samples.
Collapse
Affiliation(s)
- Nathan A. Kimbrel
- Durham Veterans Affairs (VA) Health Care System, Durham, NC, United States
- VA Mid-Atlantic Mental Illness Research, Education and Clinical Center, Durham, NC, United States
- VA Health Services Research and Development Center of Innovation to Accelerate Discovery and Practice Transformation, Durham, NC, United States
- Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, NC, United States
| | | | - Mariah K. Evans
- Durham Veterans Affairs (VA) Health Care System, Durham, NC, United States
- Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, NC, United States
| | - Clara Mellows
- Department of Psychology and Neuroscience, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States
| | - Michelle F. Dennis
- Durham Veterans Affairs (VA) Health Care System, Durham, NC, United States
- Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, NC, United States
| | - Lauren P. Hair
- Durham Veterans Affairs (VA) Health Care System, Durham, NC, United States
- Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, NC, United States
| | | | | | - Jean C. Beckham
- Durham Veterans Affairs (VA) Health Care System, Durham, NC, United States
- VA Mid-Atlantic Mental Illness Research, Education and Clinical Center, Durham, NC, United States
- Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, NC, United States
| |
Collapse
|
7
|
Watkins LL, LoSavio ST, Calhoun P, Resick PA, Sherwood A, Coffman CJ, Kirby AC, Beaver TA, Dennis MF, Beckham JC. Effect of cognitive processing therapy on markers of cardiovascular risk in posttraumatic stress disorder patients: A randomized clinical trial. J Psychosom Res 2023; 170:111351. [PMID: 37178469 DOI: 10.1016/j.jpsychores.2023.111351] [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] [Received: 12/15/2022] [Revised: 03/27/2023] [Accepted: 04/30/2023] [Indexed: 05/15/2023]
Abstract
OBJECTIVE Posttraumatic stress disorder (PTSD) is associated with elevated risk of coronary heart disease (CHD); however, the effects of PTSD treatment on CHD biomarkers is unknown. This study examined whether cognitive processing therapy (CPT) improves 24-hourheart rate variability (HRV), a predictor of CHD mortality. METHODS Individuals between the ages of 40 and 65 years with PTSD (n = 112) were randomized to receive 12 sessions of CPT or a Waiting List (WL) intervention comprised of 6 weekly telephone checks of emotional status. The primary outcome variable was 24-hour HRV estimated from the standard deviation of all normal R-R intervals (SDNN); secondary outcomes were the root mean square of successive differences between heart beats (RMSSD), low-frequency HRV (LF-HRV) and high-frequency HRV (HF-HRV). Secondary outcomes also included 24-hour urinary catecholamine excretion, plasma C-reactive protein (CRP), and flow-mediated dilation (FMD) of the brachial artery. For outcomes, linear mixed longitudinal models were used to estimate mean differences (Mdiff). RESULTS Participants randomized to the CPT group did not show improved SDNN (Mdiff = 9.8; 95%CI, -2.7 to 22.3; p = 0.12), the primary outcome variable, but showed improved RMSSD (Mdiff = 3.8; 95% CI, 0.5 to 7.1; p = 0.02), LF- HRV (Mdiff =0.3; 95% CI, 0.1 to 0.5; p = 0.01), and HF-HRV (Mdiff = 0.3; 95% CI, 0.0 to 0.6; p = 0.03) compared to WL. There were no differences between groups in catecholamine excretion, FMD, or inflammatory markers. CONCLUSION Treating PTSD may not only improve quality of life but may also help ameliorate heightened CHD risk characteristics of PTSD.
Collapse
Affiliation(s)
- Lana L Watkins
- Duke University Medical Center, Durham, NC, United States of America.
| | | | - Patrick Calhoun
- Duke University Medical Center, Durham, NC, United States of America; Durham VA Healthcare System, Durham, NC, United States of America; VA Mid-Atlantic Mental Illness Research, Education, and Clinical Center, Durham, NC, United States of America
| | - Patricia A Resick
- Duke University Medical Center, Durham, NC, United States of America
| | - Andrew Sherwood
- Duke University Medical Center, Durham, NC, United States of America
| | - Cynthia J Coffman
- Duke University Medical Center, Durham, NC, United States of America; Durham VA Healthcare System, Durham, NC, United States of America; Center of Innovation to Accelerate Discovery and Practice Transformation, Durham VA Healthcare System, United States of America
| | - Angela C Kirby
- Duke University Medical Center, Durham, NC, United States of America; Durham VA Healthcare System, Durham, NC, United States of America; VA Mid-Atlantic Mental Illness Research, Education, and Clinical Center, Durham, NC, United States of America
| | - Tiffany A Beaver
- Duke University Medical Center, Durham, NC, United States of America; Durham VA Healthcare System, Durham, NC, United States of America
| | - Michelle F Dennis
- Duke University Medical Center, Durham, NC, United States of America; Durham VA Healthcare System, Durham, NC, United States of America
| | - Jean C Beckham
- Duke University Medical Center, Durham, NC, United States of America; Durham VA Healthcare System, Durham, NC, United States of America; VA Mid-Atlantic Mental Illness Research, Education, and Clinical Center, Durham, NC, United States of America
| |
Collapse
|
8
|
Ashley-Koch AE, Kimbrel NA, Qin XJ, Lindquist JH, Garrett ME, Dennis MF, Hair LP, Huffman JE, Jacobson DA, Madduri RK, Coon H, Docherty AR, Kang J, Mullins N, Ruderfer DM, Harvey PD, McMahon BH, Oslin DW, Hauser ER, Hauser MA, Beckham JC. Genome-wide association study identifies four pan-ancestry loci for suicidal ideation in the Million Veteran Program. PLoS Genet 2023; 19:e1010623. [PMID: 36940203 PMCID: PMC10063168 DOI: 10.1371/journal.pgen.1010623] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2022] [Revised: 03/30/2023] [Accepted: 01/18/2023] [Indexed: 03/21/2023] Open
Abstract
Suicidal ideation (SI) often precedes and predicts suicide attempt and death, is the most common suicidal phenotype and is over-represented in veterans. The genetic architecture of SI in the absence of suicide attempt (SA) is unknown, yet believed to have distinct and overlapping risk with other suicidal behaviors. We performed the first GWAS of SI without SA in the Million Veteran Program (MVP), identifying 99,814 SI cases from electronic health records without a history of SA or suicide death (SD) and 512,567 controls without SI, SA or SD. GWAS was performed separately in the four largest ancestry groups, controlling for sex, age and genetic substructure. Ancestry-specific results were combined via meta-analysis to identify pan-ancestry loci. Four genome-wide significant (GWS) loci were identified in the pan-ancestry meta-analysis with loci on chromosomes 6 and 9 associated with suicide attempt in an independent sample. Pan-ancestry gene-based analysis identified GWS associations with DRD2, DCC, FBXL19, BCL7C, CTF1, ANNK1, and EXD3. Gene-set analysis implicated synaptic and startle response pathways (q's<0.05). European ancestry (EA) analysis identified GWS loci on chromosomes 6 and 9, as well as GWS gene associations in EXD3, DRD2, and DCC. No other ancestry-specific GWS results were identified, underscoring the need to increase representation of diverse individuals. The genetic correlation of SI and SA within MVP was high (rG = 0.87; p = 1.09e-50), as well as with post-traumatic stress disorder (PTSD; rG = 0.78; p = 1.98e-95) and major depressive disorder (MDD; rG = 0.78; p = 8.33e-83). Conditional analysis on PTSD and MDD attenuated most pan-ancestry and EA GWS signals for SI without SA to nominal significance, with the exception of EXD3 which remained GWS. Our novel findings support a polygenic and complex architecture for SI without SA which is largely shared with SA and overlaps with psychiatric conditions frequently comorbid with suicidal behaviors.
Collapse
Affiliation(s)
- Allison E. Ashley-Koch
- Duke Molecular Physiology Institute, Durham, North Carolina, United States of America
- Department of Medicine, Duke University Health System, Durham, North Carolina, United States of America
| | - Nathan A. Kimbrel
- Durham Veterans Affairs (VA) Health Care System, Durham, North Carolina, United States of America
- VA Mid-Atlantic Mental Illness Research, Education and Clinical Center, Durham, North Carolina, United States of America
- VA Health Services Research and Development Center of Innovation to Accelerate Discovery and Practice Transformation, Durham, North Carolina, United States of America
- Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, North Carolina, United States of America
| | - Xue J. Qin
- Duke Molecular Physiology Institute, Durham, North Carolina, United States of America
- Durham Veterans Affairs (VA) Health Care System, Durham, North Carolina, United States of America
| | - Jennifer H. Lindquist
- VA Health Services Research and Development Center of Innovation to Accelerate Discovery and Practice Transformation, Durham, North Carolina, United States of America
| | - Melanie E. Garrett
- Duke Molecular Physiology Institute, Durham, North Carolina, United States of America
| | - Michelle F. Dennis
- Durham Veterans Affairs (VA) Health Care System, Durham, North Carolina, United States of America
- Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, North Carolina, United States of America
| | - Lauren P. Hair
- Durham Veterans Affairs (VA) Health Care System, Durham, North Carolina, United States of America
- Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, North Carolina, United States of America
| | - Jennifer E. Huffman
- Massachusetts Veterans Epidemiology Research and Information Center (MAVERIC), VA Boston Healthcare System, Boston, Massachusetts, United States of America
| | - Daniel A. Jacobson
- Biosciences, Oak Ridge National Laboratory, Oak Ridge, TN, United States of America
- Bredesen Center for Interdisciplinary Research and Graduate Education, University of Tennessee Knoxville, Knoxville, Tennessee, United States of America
- Department of Psychology, NeuroNet Research Center, University of Tennessee Knoxville, Knoxville, Tennessee, United States of America
| | - Ravi K. Madduri
- Consortium for Advanced Science and Engineering, The University of Chicago, Chicago, Illinois, United States of America
- Data Science and Learning Division, Argonne National Laboratory, Lemont, Illinois, United States of America
| | - Hilary Coon
- Department of Psychiatry, Huntsman Mental Health Institute, University of Utah School of Medicine, Salt Lake City, Utah, United States of America
- Biomedical Informatics, University of Utah School of Medicine, Salt Lake City, Utah, United States of America
| | - Anna R. Docherty
- Department of Psychiatry, Huntsman Mental Health Institute, University of Utah School of Medicine, Salt Lake City, Utah, United States of America
- Department of Psychiatry, Virginia Commonwealth University, Richmond, Virginia, United States of America
| | - Jooeun Kang
- Division of Genetic Medicine, Department of Medicine, Vanderbilt Genetics Institute, Vanderbilt University Medical Center, Nashville, Tennessee, United States of America
| | - Niamh Mullins
- Department of Genetics and Genomic Sciences, Icahn School of Medicine at Mount Sinai, New York, New York, United States of America
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, New York, United States of America
| | - Douglas M. Ruderfer
- Division of Genetic Medicine, Department of Medicine, Vanderbilt Genetics Institute, Vanderbilt University Medical Center, Nashville, Tennessee, United States of America
- Department of Biomedical Informatics, Vanderbilt University Medical Center, Nashville, Tennessee, United States of America
- Department of Psychiatry and Behavioral Sciences, Vanderbilt University Medical Center, Nashville, Tennessee, United States of America
| | | | | | | | - Philip D. Harvey
- Research Service Bruce W. Carter VA Medical Center, Miami, Florida, United States of America
- Department of Psychiatry and Behavioral Sciences, University of Miami Miller School of Medicine, Miami, Florida, United States of America
| | - Benjamin H. McMahon
- Theoretical Biology and Biophysics, Los Alamos National Laboratory, Los Alamos, New Mexico, United States of America
| | - David W. Oslin
- VISN 4 Mental Illness Research, Education, and Clinical Center, Center of Excellence, Corporal Michael J. Crescenz VA Medical Center, Philadelphia, Pennsylvania, United States of America
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Pennsylvania, United States of America
| | - Elizabeth R. Hauser
- Duke Molecular Physiology Institute, Durham, North Carolina, United States of America
- Durham Veterans Affairs (VA) Health Care System, Durham, North Carolina, United States of America
- Department of Biostatistics and Bioinformatics, Duke University School of Medicine, Durham, North Carolina, United States of America
| | - Michael A. Hauser
- Duke Molecular Physiology Institute, Durham, North Carolina, United States of America
| | - Jean C. Beckham
- Durham Veterans Affairs (VA) Health Care System, Durham, North Carolina, United States of America
- VA Mid-Atlantic Mental Illness Research, Education and Clinical Center, Durham, North Carolina, United States of America
- Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, North Carolina, United States of America
| |
Collapse
|
9
|
Kimbrel NA, Ashley-Koch AE, Qin XJ, Lindquist JH, Garrett ME, Dennis MF, Hair LP, Huffman JE, Jacobson DA, Madduri RK, Trafton JA, Coon H, Docherty AR, Mullins N, Ruderfer DM, Harvey PD, McMahon BH, Oslin DW, Beckham JC, Hauser ER, Hauser MA, Ashley-Koch AE, Aslan M, Beckham JC, Begoli E, Bhattacharya T, Brown B, Calhoun PS, Cheung KH, Choudhury S, Cliff AM, Cohn JD, Crivelli S, Cuellar-Hengartner L, Deangelis HE, Dennis MF, Dhaubhadel S, Finley PD, Ganguly K, Garvin MR, Gelernter JE, Hair LP, Harvey PD, Hauser ER, Hauser MA, Hengartner NW, Jacobson DA, Jones PC, Kainer D, Kaplan AD, Katz IR, Kember RL, Kimbrel NA, Kirby AC, Ko JC, Kolade B, Lagergren JH, Lane MJ, Levey DF, Levin D, Lindquist JH, Liu X, Madduri RK, Manore C, Martins SB, McCarthy JF, McDevitt-Cashman M, McMahon BH, Miller I, Morrow D, Oslin DW, Pavicic-Venegas M, Pestian J, Pyarajan S, Qin XJ, Rajeevan N, Ramsey CM, Ribeiro R, Rodriguez A, Romero J, Santel D, Schaefferkoetter N, Shi Y, Stein MB, Sullivan K, Sun N, Tamang SR, Townsend A, Trafton JA, Walker A, Wang X, Wangia-Anderson V, Yang R, Yoon HJ, Yoo S, Zamora-Resendiz R, Zhao H, Docherty AR, Mullins N, Coleman JRI, Shabalin A, Kang J, Murnyak B, Wendt F, Adams M, Campos AI, DiBlasi E, Fullerton JM, Kranzler HR, Bakian A, Monson ET, Rentería ME, Andreassen OA, Bulik CM, Edenberg HJ, Kessler RC, Mann JJ, Nurnberger JI, Pistis G, Streit F, Ursano RJ, Awasthi S, Bergen AW, Berrettini WH, Bohus M, Brandt H, Chang X, Chen HC, Chen WJ, Christensen ED, Crawford S, Crow S, Duriez P, Edwards AC, Fernández-Aranda F, Fichter MM, Galfalvy H, Gallinger S, Gandal M, Gorwood P, Guo Y, Hafferty JD, Hakonarson H, Halmi KA, Hishimoto A, Jain S, Jamain S, Jiménez-Murcia S, Johnson C, Kaplan AS, Kaye WH, Keel PK, Kennedy JL, Kim M, Klump KL, Levey DF, Li D, Liao SC, Lieb K, Lilenfeld L, Lori A, Magistretti PJ, Marshall CR, Mitchell JE, Myers RM, Okazaki S, Otsuka I, Pinto D, Powers A, Ramoz N, Ripke S, Roepke S, Rozanov V, Scherer SW, Schmahl C, Sokolowski M, Starnawska A, Strober M, Su MH, Thornton LM, Treasure J, Ware EB, Watson HJ, Witt SH, Woodside DB, Yilmaz Z, Zillich L, Agerbo E, Børglum AD, Breen G, Demontis D, Erlangsen A, Esko T, Gelernter J, Glatt SJ, Hougaard DM, Hwu HG, Kuo PH, Lewis CM, Li QS, Liu CM, Martin NG, McIntosh AM, Medland SE, Mors O, Nordentoft M, Nurnberger JI, Olsen C, Porteous D, Smith DJ, Stahl EA, Stein MB, Wasserman D, Werge T, Whiteman DC, Willour V, Coon H, Ruderfer DM, Dedert E, Elbogen EB, Fairbank JA, Hurley RA, Kilts JD, Martindale SL, Marx CE, McDonald SD, Moore SD, Morey RA, Naylor JC, Rowland J, Shura RD, Swinkels C, Tupler LA, Van Voorhees EE, Yoash-Gantz R, Gaziano JM, Muralidhar S, Ramoni R, Chang KM, O’Donnell CJ, Tsao PS, Breeling J, Hauser E, Sun Y, Huang G, Casas JP, Moser J, Whitbourne SB, Brewer JV, Conner T, Argyres DP, Stephens B, Brophy MT, Humphries DE, Selva LE, Do N, Shayan S(A, Cho K, Churby L, Wilson P, McArdle R, Dellitalia L, Mattocks K, Harley J, Whittle J, Jacono F, Wells J, Gutierrez S, Gibson G, Hammer K, Kaminsky L, Villareal G, Kinlay S, Xu J, Hamner M, Mathew R, Bhushan S, Iruvanti P, Godschalk M, Ballas Z, Ivins D, Mastorides S, Moorman J, Gappy S, Klein J, Ratcliffe N, Florez H, Okusaga O, Murdoch M, Sriram P, Yeh SS, Tandon N, Jhala D, Liangpunsakul S, Oursler KA, Whooley M, Ahuja S, Constans J, Meyer P, Greco J, Rauchman M, Servatius R, Gaddy M, Wallbom A, Morgan T, Stapley T, Sherman S, Ross G, Strollo P, Boyko E, Meyer L, Gupta S, Huq M, Fayad J, Hung A, Lichy J, Hurley R, Robey B, Striker R. Identification of Novel, Replicable Genetic Risk Loci for Suicidal Thoughts and Behaviors Among US Military Veterans. JAMA Psychiatry 2023; 80:135-145. [PMID: 36515925 PMCID: PMC9857322 DOI: 10.1001/jamapsychiatry.2022.3896] [Citation(s) in RCA: 10] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Importance Suicide is a leading cause of death; however, the molecular genetic basis of suicidal thoughts and behaviors (SITB) remains unknown. Objective To identify novel, replicable genomic risk loci for SITB. Design, Setting, and Participants This genome-wide association study included 633 778 US military veterans with and without SITB, as identified through electronic health records. GWAS was performed separately by ancestry, controlling for sex, age, and genetic substructure. Cross-ancestry risk loci were identified through meta-analysis. Study enrollment began in 2011 and is ongoing. Data were analyzed from November 2021 to August 2022. Main Outcome and Measures SITB. Results A total of 633 778 US military veterans were included in the analysis (57 152 [9%] female; 121 118 [19.1%] African ancestry, 8285 [1.3%] Asian ancestry, 452 767 [71.4%] European ancestry, and 51 608 [8.1%] Hispanic ancestry), including 121 211 individuals with SITB (19.1%). Meta-analysis identified more than 200 GWS (P < 5 × 10-8) cross-ancestry risk single-nucleotide variants for SITB concentrated in 7 regions on chromosomes 2, 6, 9, 11, 14, 16, and 18. Top single-nucleotide variants were largely intronic in nature; 5 were independently replicated in ISGC, including rs6557168 in ESR1, rs12808482 in DRD2, rs77641763 in EXD3, rs10671545 in DCC, and rs36006172 in TRAF3. Associations for FBXL19 and AC018880.2 were not replicated. Gene-based analyses implicated 24 additional GWS cross-ancestry risk genes, including FURIN, TSNARE1, and the NCAM1-TTC12-ANKK1-DRD2 gene cluster. Cross-ancestry enrichment analyses revealed significant enrichment for expression in brain and pituitary tissue, synapse and ubiquitination processes, amphetamine addiction, parathyroid hormone synthesis, axon guidance, and dopaminergic pathways. Seven other unique European ancestry-specific GWS loci were identified, 2 of which (POM121L2 and METTL15/LINC02758) were replicated. Two additional GWS ancestry-specific loci were identified within the African ancestry (PET112/GATB) and Hispanic ancestry (intergenic locus on chromosome 4) subsets, both of which were replicated. No GWS loci were identified within the Asian ancestry subset; however, significant enrichment was observed for axon guidance, cyclic adenosine monophosphate signaling, focal adhesion, glutamatergic synapse, and oxytocin signaling pathways across all ancestries. Within the European ancestry subset, genetic correlations (r > 0.75) were observed between the SITB phenotype and a suicide attempt-only phenotype, depression, and posttraumatic stress disorder. Additionally, polygenic risk score analyses revealed that the Million Veteran Program polygenic risk score had nominally significant main effects in 2 independent samples of veterans of European and African ancestry. Conclusions and Relevance The findings of this analysis may advance understanding of the molecular genetic basis of SITB and provide evidence for ESR1, DRD2, TRAF3, and DCC as cross-ancestry candidate risk genes. More work is needed to replicate these findings and to determine if and how these genes might impact clinical care.
Collapse
Affiliation(s)
- Nathan A. Kimbrel
- Durham Veterans Affairs Health Care System, Durham, North Carolina,Veterans Affairs Mid-Atlantic Mental Illness Research, Education and Clinical Center, Durham, North Carolina,Veterans Affairs Health Services Research and Development Center of Innovation to Accelerate Discovery and Practice Transformation, Durham, North Carolina,Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, North Carolina
| | - Allison E. Ashley-Koch
- Duke Molecular Physiology Institute, Durham, North Carolina,Department of Medicine, Duke University School of Medicine, Durham, North Carolina
| | - Xue J. Qin
- Durham Veterans Affairs Health Care System, Durham, North Carolina,Duke Molecular Physiology Institute, Durham, North Carolina
| | - Jennifer H. Lindquist
- Veterans Affairs Health Services Research and Development Center of Innovation to Accelerate Discovery and Practice Transformation, Durham, North Carolina
| | | | - Michelle F. Dennis
- Durham Veterans Affairs Health Care System, Durham, North Carolina,Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, North Carolina
| | - Lauren P. Hair
- Durham Veterans Affairs Health Care System, Durham, North Carolina,Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, North Carolina
| | - Jennifer E. Huffman
- Massachusetts Veterans Epidemiology Research and Information Center, VA Boston Healthcare System, Boston, Massachusetts
| | - Daniel A. Jacobson
- Biosciences, Oak Ridge National Laboratory, Oak Ridge, Tennessee,Bredesen Center for Interdisciplinary Research and Graduate Education, University of Tennessee, Knoxville,Department of Psychology, NeuroNet Research Center, University of Tennessee Knoxville
| | - Ravi K. Madduri
- Consortium for Advanced Science and Engineering, The University of Chicago, Chicago, Illinois,Data Science and Learning Division, Argonne National Laboratory, Lemont, Illinois
| | - Jodie A. Trafton
- Program Evaluation and Resource Center, Office of Mental Health and Suicide Prevention, Veterans Affairs Palo Alto Health Care System, Menlo Park, California
| | - Hilary Coon
- Department of Psychiatry, Huntsman Mental Health Institute, University of Utah School of Medicine, Salt Lake City,Biomedical Informatics, University of Utah School of Medicine, Salt Lake City
| | - Anna R. Docherty
- Department of Psychiatry, Huntsman Mental Health Institute, University of Utah School of Medicine, Salt Lake City,Department of Psychiatry, Virginia Commonwealth University, Richmond
| | - Niamh Mullins
- Department of Genetics and Genomic Sciences, Icahn School of Medicine at Mount Sinai, New York, New York,Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Douglas M. Ruderfer
- Division of Genetic Medicine, Department of Medicine, Vanderbilt Genetics Institute, Vanderbilt University Medical Center, Nashville, Tennessee,Department of Biomedical Informatics, Vanderbilt University Medical Center, Nashville, Tennessee,Department of Psychiatry and Behavioral Sciences, Vanderbilt University Medical Center, Nashville, Tennessee
| | - Philip D. Harvey
- Department of Psychiatry and Behavioral Sciences, University of Miami Miller School of Medicine, Miami, Florida,Research Service, Bruce W. Carter VA Medical Center, Miami, Florida
| | - Benjamin H. McMahon
- Theoretical Biology and Biophysics, Los Alamos National Laboratory, Los Alamos, New Mexico
| | - David W. Oslin
- Veterans Integrated Service Networks 4 Mental Illness Research, Education, and Clinical Center, Center of Excellence, Corporal Michael J Crescenz Veterans Affairs Medical Center, Philadelphia, Pennsylvania,Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia
| | - Jean C. Beckham
- Durham Veterans Affairs Health Care System, Durham, North Carolina,Veterans Affairs Mid-Atlantic Mental Illness Research, Education and Clinical Center, Durham, North Carolina,Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, North Carolina
| | - Elizabeth R. Hauser
- Durham Veterans Affairs Health Care System, Durham, North Carolina,Duke Molecular Physiology Institute, Durham, North Carolina,Department of Biostatistics and Bioinformatics, Duke University School of Medicine, Durham, North Carolina
| | - Michael A. Hauser
- Duke Molecular Physiology Institute, Durham, North Carolina,Department of Medicine, Duke University School of Medicine, Durham, North Carolina
| | | | - Allison E. Ashley-Koch
- for the Million Veteran Program Suicide Exemplar Workgroup, the International Suicide Genetics Consortium, the Veterans Affairs Mid-Atlantic Mental Illness Research, Education, and Clinical Center Workgroup, and the Veterans Affairs Million Veteran Program
| | - Mihaela Aslan
- for the Million Veteran Program Suicide Exemplar Workgroup, the International Suicide Genetics Consortium, the Veterans Affairs Mid-Atlantic Mental Illness Research, Education, and Clinical Center Workgroup, and the Veterans Affairs Million Veteran Program
| | - Jean C. Beckham
- for the Million Veteran Program Suicide Exemplar Workgroup, the International Suicide Genetics Consortium, the Veterans Affairs Mid-Atlantic Mental Illness Research, Education, and Clinical Center Workgroup, and the Veterans Affairs Million Veteran Program
| | - Edmond Begoli
- for the Million Veteran Program Suicide Exemplar Workgroup, the International Suicide Genetics Consortium, the Veterans Affairs Mid-Atlantic Mental Illness Research, Education, and Clinical Center Workgroup, and the Veterans Affairs Million Veteran Program
| | - Tanmoy Bhattacharya
- for the Million Veteran Program Suicide Exemplar Workgroup, the International Suicide Genetics Consortium, the Veterans Affairs Mid-Atlantic Mental Illness Research, Education, and Clinical Center Workgroup, and the Veterans Affairs Million Veteran Program
| | - Ben Brown
- for the Million Veteran Program Suicide Exemplar Workgroup, the International Suicide Genetics Consortium, the Veterans Affairs Mid-Atlantic Mental Illness Research, Education, and Clinical Center Workgroup, and the Veterans Affairs Million Veteran Program
| | - Patrick S. Calhoun
- for the Million Veteran Program Suicide Exemplar Workgroup, the International Suicide Genetics Consortium, the Veterans Affairs Mid-Atlantic Mental Illness Research, Education, and Clinical Center Workgroup, and the Veterans Affairs Million Veteran Program
| | - Kei-Hoi Cheung
- for the Million Veteran Program Suicide Exemplar Workgroup, the International Suicide Genetics Consortium, the Veterans Affairs Mid-Atlantic Mental Illness Research, Education, and Clinical Center Workgroup, and the Veterans Affairs Million Veteran Program
| | - Sutanay Choudhury
- for the Million Veteran Program Suicide Exemplar Workgroup, the International Suicide Genetics Consortium, the Veterans Affairs Mid-Atlantic Mental Illness Research, Education, and Clinical Center Workgroup, and the Veterans Affairs Million Veteran Program
| | - Ashley M. Cliff
- for the Million Veteran Program Suicide Exemplar Workgroup, the International Suicide Genetics Consortium, the Veterans Affairs Mid-Atlantic Mental Illness Research, Education, and Clinical Center Workgroup, and the Veterans Affairs Million Veteran Program
| | - Judith D. Cohn
- for the Million Veteran Program Suicide Exemplar Workgroup, the International Suicide Genetics Consortium, the Veterans Affairs Mid-Atlantic Mental Illness Research, Education, and Clinical Center Workgroup, and the Veterans Affairs Million Veteran Program
| | - Silvia Crivelli
- for the Million Veteran Program Suicide Exemplar Workgroup, the International Suicide Genetics Consortium, the Veterans Affairs Mid-Atlantic Mental Illness Research, Education, and Clinical Center Workgroup, and the Veterans Affairs Million Veteran Program
| | - Leticia Cuellar-Hengartner
- for the Million Veteran Program Suicide Exemplar Workgroup, the International Suicide Genetics Consortium, the Veterans Affairs Mid-Atlantic Mental Illness Research, Education, and Clinical Center Workgroup, and the Veterans Affairs Million Veteran Program
| | - Haedi E. Deangelis
- for the Million Veteran Program Suicide Exemplar Workgroup, the International Suicide Genetics Consortium, the Veterans Affairs Mid-Atlantic Mental Illness Research, Education, and Clinical Center Workgroup, and the Veterans Affairs Million Veteran Program
| | - Michelle F. Dennis
- for the Million Veteran Program Suicide Exemplar Workgroup, the International Suicide Genetics Consortium, the Veterans Affairs Mid-Atlantic Mental Illness Research, Education, and Clinical Center Workgroup, and the Veterans Affairs Million Veteran Program
| | - Sayera Dhaubhadel
- for the Million Veteran Program Suicide Exemplar Workgroup, the International Suicide Genetics Consortium, the Veterans Affairs Mid-Atlantic Mental Illness Research, Education, and Clinical Center Workgroup, and the Veterans Affairs Million Veteran Program
| | - Patrick D. Finley
- for the Million Veteran Program Suicide Exemplar Workgroup, the International Suicide Genetics Consortium, the Veterans Affairs Mid-Atlantic Mental Illness Research, Education, and Clinical Center Workgroup, and the Veterans Affairs Million Veteran Program
| | - Kumkum Ganguly
- for the Million Veteran Program Suicide Exemplar Workgroup, the International Suicide Genetics Consortium, the Veterans Affairs Mid-Atlantic Mental Illness Research, Education, and Clinical Center Workgroup, and the Veterans Affairs Million Veteran Program
| | - Michael R. Garvin
- for the Million Veteran Program Suicide Exemplar Workgroup, the International Suicide Genetics Consortium, the Veterans Affairs Mid-Atlantic Mental Illness Research, Education, and Clinical Center Workgroup, and the Veterans Affairs Million Veteran Program
| | - Joel E. Gelernter
- for the Million Veteran Program Suicide Exemplar Workgroup, the International Suicide Genetics Consortium, the Veterans Affairs Mid-Atlantic Mental Illness Research, Education, and Clinical Center Workgroup, and the Veterans Affairs Million Veteran Program
| | - Lauren P. Hair
- for the Million Veteran Program Suicide Exemplar Workgroup, the International Suicide Genetics Consortium, the Veterans Affairs Mid-Atlantic Mental Illness Research, Education, and Clinical Center Workgroup, and the Veterans Affairs Million Veteran Program
| | - Phillip D. Harvey
- for the Million Veteran Program Suicide Exemplar Workgroup, the International Suicide Genetics Consortium, the Veterans Affairs Mid-Atlantic Mental Illness Research, Education, and Clinical Center Workgroup, and the Veterans Affairs Million Veteran Program
| | - Elizabeth R. Hauser
- for the Million Veteran Program Suicide Exemplar Workgroup, the International Suicide Genetics Consortium, the Veterans Affairs Mid-Atlantic Mental Illness Research, Education, and Clinical Center Workgroup, and the Veterans Affairs Million Veteran Program
| | - Michael A. Hauser
- for the Million Veteran Program Suicide Exemplar Workgroup, the International Suicide Genetics Consortium, the Veterans Affairs Mid-Atlantic Mental Illness Research, Education, and Clinical Center Workgroup, and the Veterans Affairs Million Veteran Program
| | - Nick W. Hengartner
- for the Million Veteran Program Suicide Exemplar Workgroup, the International Suicide Genetics Consortium, the Veterans Affairs Mid-Atlantic Mental Illness Research, Education, and Clinical Center Workgroup, and the Veterans Affairs Million Veteran Program
| | - Daniel A. Jacobson
- for the Million Veteran Program Suicide Exemplar Workgroup, the International Suicide Genetics Consortium, the Veterans Affairs Mid-Atlantic Mental Illness Research, Education, and Clinical Center Workgroup, and the Veterans Affairs Million Veteran Program
| | - Piet C. Jones
- for the Million Veteran Program Suicide Exemplar Workgroup, the International Suicide Genetics Consortium, the Veterans Affairs Mid-Atlantic Mental Illness Research, Education, and Clinical Center Workgroup, and the Veterans Affairs Million Veteran Program
| | - David Kainer
- for the Million Veteran Program Suicide Exemplar Workgroup, the International Suicide Genetics Consortium, the Veterans Affairs Mid-Atlantic Mental Illness Research, Education, and Clinical Center Workgroup, and the Veterans Affairs Million Veteran Program
| | - Alan D. Kaplan
- for the Million Veteran Program Suicide Exemplar Workgroup, the International Suicide Genetics Consortium, the Veterans Affairs Mid-Atlantic Mental Illness Research, Education, and Clinical Center Workgroup, and the Veterans Affairs Million Veteran Program
| | - Ira R. Katz
- for the Million Veteran Program Suicide Exemplar Workgroup, the International Suicide Genetics Consortium, the Veterans Affairs Mid-Atlantic Mental Illness Research, Education, and Clinical Center Workgroup, and the Veterans Affairs Million Veteran Program
| | - Rachel L. Kember
- for the Million Veteran Program Suicide Exemplar Workgroup, the International Suicide Genetics Consortium, the Veterans Affairs Mid-Atlantic Mental Illness Research, Education, and Clinical Center Workgroup, and the Veterans Affairs Million Veteran Program
| | - Nathan A. Kimbrel
- for the Million Veteran Program Suicide Exemplar Workgroup, the International Suicide Genetics Consortium, the Veterans Affairs Mid-Atlantic Mental Illness Research, Education, and Clinical Center Workgroup, and the Veterans Affairs Million Veteran Program
| | - Angela C. Kirby
- for the Million Veteran Program Suicide Exemplar Workgroup, the International Suicide Genetics Consortium, the Veterans Affairs Mid-Atlantic Mental Illness Research, Education, and Clinical Center Workgroup, and the Veterans Affairs Million Veteran Program
| | - John C. Ko
- for the Million Veteran Program Suicide Exemplar Workgroup, the International Suicide Genetics Consortium, the Veterans Affairs Mid-Atlantic Mental Illness Research, Education, and Clinical Center Workgroup, and the Veterans Affairs Million Veteran Program
| | - Beauty Kolade
- for the Million Veteran Program Suicide Exemplar Workgroup, the International Suicide Genetics Consortium, the Veterans Affairs Mid-Atlantic Mental Illness Research, Education, and Clinical Center Workgroup, and the Veterans Affairs Million Veteran Program
| | - John H. Lagergren
- for the Million Veteran Program Suicide Exemplar Workgroup, the International Suicide Genetics Consortium, the Veterans Affairs Mid-Atlantic Mental Illness Research, Education, and Clinical Center Workgroup, and the Veterans Affairs Million Veteran Program
| | - Matthew J. Lane
- for the Million Veteran Program Suicide Exemplar Workgroup, the International Suicide Genetics Consortium, the Veterans Affairs Mid-Atlantic Mental Illness Research, Education, and Clinical Center Workgroup, and the Veterans Affairs Million Veteran Program
| | - Daniel F. Levey
- for the Million Veteran Program Suicide Exemplar Workgroup, the International Suicide Genetics Consortium, the Veterans Affairs Mid-Atlantic Mental Illness Research, Education, and Clinical Center Workgroup, and the Veterans Affairs Million Veteran Program
| | - Drew Levin
- for the Million Veteran Program Suicide Exemplar Workgroup, the International Suicide Genetics Consortium, the Veterans Affairs Mid-Atlantic Mental Illness Research, Education, and Clinical Center Workgroup, and the Veterans Affairs Million Veteran Program
| | - Jennifer H. Lindquist
- for the Million Veteran Program Suicide Exemplar Workgroup, the International Suicide Genetics Consortium, the Veterans Affairs Mid-Atlantic Mental Illness Research, Education, and Clinical Center Workgroup, and the Veterans Affairs Million Veteran Program
| | - Xianlian Liu
- for the Million Veteran Program Suicide Exemplar Workgroup, the International Suicide Genetics Consortium, the Veterans Affairs Mid-Atlantic Mental Illness Research, Education, and Clinical Center Workgroup, and the Veterans Affairs Million Veteran Program
| | - Ravi K. Madduri
- for the Million Veteran Program Suicide Exemplar Workgroup, the International Suicide Genetics Consortium, the Veterans Affairs Mid-Atlantic Mental Illness Research, Education, and Clinical Center Workgroup, and the Veterans Affairs Million Veteran Program
| | - Carrie Manore
- for the Million Veteran Program Suicide Exemplar Workgroup, the International Suicide Genetics Consortium, the Veterans Affairs Mid-Atlantic Mental Illness Research, Education, and Clinical Center Workgroup, and the Veterans Affairs Million Veteran Program
| | - Susana B. Martins
- for the Million Veteran Program Suicide Exemplar Workgroup, the International Suicide Genetics Consortium, the Veterans Affairs Mid-Atlantic Mental Illness Research, Education, and Clinical Center Workgroup, and the Veterans Affairs Million Veteran Program
| | - John F. McCarthy
- for the Million Veteran Program Suicide Exemplar Workgroup, the International Suicide Genetics Consortium, the Veterans Affairs Mid-Atlantic Mental Illness Research, Education, and Clinical Center Workgroup, and the Veterans Affairs Million Veteran Program
| | - Mikaela McDevitt-Cashman
- for the Million Veteran Program Suicide Exemplar Workgroup, the International Suicide Genetics Consortium, the Veterans Affairs Mid-Atlantic Mental Illness Research, Education, and Clinical Center Workgroup, and the Veterans Affairs Million Veteran Program
| | - Benjamin H. McMahon
- for the Million Veteran Program Suicide Exemplar Workgroup, the International Suicide Genetics Consortium, the Veterans Affairs Mid-Atlantic Mental Illness Research, Education, and Clinical Center Workgroup, and the Veterans Affairs Million Veteran Program
| | - Izaak Miller
- for the Million Veteran Program Suicide Exemplar Workgroup, the International Suicide Genetics Consortium, the Veterans Affairs Mid-Atlantic Mental Illness Research, Education, and Clinical Center Workgroup, and the Veterans Affairs Million Veteran Program
| | - Destinee Morrow
- for the Million Veteran Program Suicide Exemplar Workgroup, the International Suicide Genetics Consortium, the Veterans Affairs Mid-Atlantic Mental Illness Research, Education, and Clinical Center Workgroup, and the Veterans Affairs Million Veteran Program
| | - David W. Oslin
- for the Million Veteran Program Suicide Exemplar Workgroup, the International Suicide Genetics Consortium, the Veterans Affairs Mid-Atlantic Mental Illness Research, Education, and Clinical Center Workgroup, and the Veterans Affairs Million Veteran Program
| | - Mirko Pavicic-Venegas
- for the Million Veteran Program Suicide Exemplar Workgroup, the International Suicide Genetics Consortium, the Veterans Affairs Mid-Atlantic Mental Illness Research, Education, and Clinical Center Workgroup, and the Veterans Affairs Million Veteran Program
| | - John Pestian
- for the Million Veteran Program Suicide Exemplar Workgroup, the International Suicide Genetics Consortium, the Veterans Affairs Mid-Atlantic Mental Illness Research, Education, and Clinical Center Workgroup, and the Veterans Affairs Million Veteran Program
| | - Saiju Pyarajan
- for the Million Veteran Program Suicide Exemplar Workgroup, the International Suicide Genetics Consortium, the Veterans Affairs Mid-Atlantic Mental Illness Research, Education, and Clinical Center Workgroup, and the Veterans Affairs Million Veteran Program
| | - Xue J. Qin
- for the Million Veteran Program Suicide Exemplar Workgroup, the International Suicide Genetics Consortium, the Veterans Affairs Mid-Atlantic Mental Illness Research, Education, and Clinical Center Workgroup, and the Veterans Affairs Million Veteran Program
| | - Nallakkandi Rajeevan
- for the Million Veteran Program Suicide Exemplar Workgroup, the International Suicide Genetics Consortium, the Veterans Affairs Mid-Atlantic Mental Illness Research, Education, and Clinical Center Workgroup, and the Veterans Affairs Million Veteran Program
| | - Christine M. Ramsey
- for the Million Veteran Program Suicide Exemplar Workgroup, the International Suicide Genetics Consortium, the Veterans Affairs Mid-Atlantic Mental Illness Research, Education, and Clinical Center Workgroup, and the Veterans Affairs Million Veteran Program
| | - Ruy Ribeiro
- for the Million Veteran Program Suicide Exemplar Workgroup, the International Suicide Genetics Consortium, the Veterans Affairs Mid-Atlantic Mental Illness Research, Education, and Clinical Center Workgroup, and the Veterans Affairs Million Veteran Program
| | - Alex Rodriguez
- for the Million Veteran Program Suicide Exemplar Workgroup, the International Suicide Genetics Consortium, the Veterans Affairs Mid-Atlantic Mental Illness Research, Education, and Clinical Center Workgroup, and the Veterans Affairs Million Veteran Program
| | - Jonathan Romero
- for the Million Veteran Program Suicide Exemplar Workgroup, the International Suicide Genetics Consortium, the Veterans Affairs Mid-Atlantic Mental Illness Research, Education, and Clinical Center Workgroup, and the Veterans Affairs Million Veteran Program
| | - Daniel Santel
- for the Million Veteran Program Suicide Exemplar Workgroup, the International Suicide Genetics Consortium, the Veterans Affairs Mid-Atlantic Mental Illness Research, Education, and Clinical Center Workgroup, and the Veterans Affairs Million Veteran Program
| | - Noah Schaefferkoetter
- for the Million Veteran Program Suicide Exemplar Workgroup, the International Suicide Genetics Consortium, the Veterans Affairs Mid-Atlantic Mental Illness Research, Education, and Clinical Center Workgroup, and the Veterans Affairs Million Veteran Program
| | - Yunling Shi
- for the Million Veteran Program Suicide Exemplar Workgroup, the International Suicide Genetics Consortium, the Veterans Affairs Mid-Atlantic Mental Illness Research, Education, and Clinical Center Workgroup, and the Veterans Affairs Million Veteran Program
| | - Murray B. Stein
- for the Million Veteran Program Suicide Exemplar Workgroup, the International Suicide Genetics Consortium, the Veterans Affairs Mid-Atlantic Mental Illness Research, Education, and Clinical Center Workgroup, and the Veterans Affairs Million Veteran Program
| | - Kyle Sullivan
- for the Million Veteran Program Suicide Exemplar Workgroup, the International Suicide Genetics Consortium, the Veterans Affairs Mid-Atlantic Mental Illness Research, Education, and Clinical Center Workgroup, and the Veterans Affairs Million Veteran Program
| | - Ning Sun
- for the Million Veteran Program Suicide Exemplar Workgroup, the International Suicide Genetics Consortium, the Veterans Affairs Mid-Atlantic Mental Illness Research, Education, and Clinical Center Workgroup, and the Veterans Affairs Million Veteran Program
| | - Suzanne R. Tamang
- for the Million Veteran Program Suicide Exemplar Workgroup, the International Suicide Genetics Consortium, the Veterans Affairs Mid-Atlantic Mental Illness Research, Education, and Clinical Center Workgroup, and the Veterans Affairs Million Veteran Program
| | - Alice Townsend
- for the Million Veteran Program Suicide Exemplar Workgroup, the International Suicide Genetics Consortium, the Veterans Affairs Mid-Atlantic Mental Illness Research, Education, and Clinical Center Workgroup, and the Veterans Affairs Million Veteran Program
| | - Jodie A. Trafton
- for the Million Veteran Program Suicide Exemplar Workgroup, the International Suicide Genetics Consortium, the Veterans Affairs Mid-Atlantic Mental Illness Research, Education, and Clinical Center Workgroup, and the Veterans Affairs Million Veteran Program
| | - Angelica Walker
- for the Million Veteran Program Suicide Exemplar Workgroup, the International Suicide Genetics Consortium, the Veterans Affairs Mid-Atlantic Mental Illness Research, Education, and Clinical Center Workgroup, and the Veterans Affairs Million Veteran Program
| | - Xiange Wang
- for the Million Veteran Program Suicide Exemplar Workgroup, the International Suicide Genetics Consortium, the Veterans Affairs Mid-Atlantic Mental Illness Research, Education, and Clinical Center Workgroup, and the Veterans Affairs Million Veteran Program
| | - Victoria Wangia-Anderson
- for the Million Veteran Program Suicide Exemplar Workgroup, the International Suicide Genetics Consortium, the Veterans Affairs Mid-Atlantic Mental Illness Research, Education, and Clinical Center Workgroup, and the Veterans Affairs Million Veteran Program
| | - Renji Yang
- for the Million Veteran Program Suicide Exemplar Workgroup, the International Suicide Genetics Consortium, the Veterans Affairs Mid-Atlantic Mental Illness Research, Education, and Clinical Center Workgroup, and the Veterans Affairs Million Veteran Program
| | - Hong-Jun Yoon
- for the Million Veteran Program Suicide Exemplar Workgroup, the International Suicide Genetics Consortium, the Veterans Affairs Mid-Atlantic Mental Illness Research, Education, and Clinical Center Workgroup, and the Veterans Affairs Million Veteran Program
| | - Shinjae Yoo
- for the Million Veteran Program Suicide Exemplar Workgroup, the International Suicide Genetics Consortium, the Veterans Affairs Mid-Atlantic Mental Illness Research, Education, and Clinical Center Workgroup, and the Veterans Affairs Million Veteran Program
| | - Rafael Zamora-Resendiz
- for the Million Veteran Program Suicide Exemplar Workgroup, the International Suicide Genetics Consortium, the Veterans Affairs Mid-Atlantic Mental Illness Research, Education, and Clinical Center Workgroup, and the Veterans Affairs Million Veteran Program
| | - Hongyu Zhao
- for the Million Veteran Program Suicide Exemplar Workgroup, the International Suicide Genetics Consortium, the Veterans Affairs Mid-Atlantic Mental Illness Research, Education, and Clinical Center Workgroup, and the Veterans Affairs Million Veteran Program
| | - Anna R Docherty
- for the Million Veteran Program Suicide Exemplar Workgroup, the International Suicide Genetics Consortium, the Veterans Affairs Mid-Atlantic Mental Illness Research, Education, and Clinical Center Workgroup, and the Veterans Affairs Million Veteran Program
| | - Niamh Mullins
- for the Million Veteran Program Suicide Exemplar Workgroup, the International Suicide Genetics Consortium, the Veterans Affairs Mid-Atlantic Mental Illness Research, Education, and Clinical Center Workgroup, and the Veterans Affairs Million Veteran Program
| | - Jonathan R I Coleman
- for the Million Veteran Program Suicide Exemplar Workgroup, the International Suicide Genetics Consortium, the Veterans Affairs Mid-Atlantic Mental Illness Research, Education, and Clinical Center Workgroup, and the Veterans Affairs Million Veteran Program
| | - Andrey Shabalin
- for the Million Veteran Program Suicide Exemplar Workgroup, the International Suicide Genetics Consortium, the Veterans Affairs Mid-Atlantic Mental Illness Research, Education, and Clinical Center Workgroup, and the Veterans Affairs Million Veteran Program
| | - JooEun Kang
- for the Million Veteran Program Suicide Exemplar Workgroup, the International Suicide Genetics Consortium, the Veterans Affairs Mid-Atlantic Mental Illness Research, Education, and Clinical Center Workgroup, and the Veterans Affairs Million Veteran Program
| | - Balasz Murnyak
- for the Million Veteran Program Suicide Exemplar Workgroup, the International Suicide Genetics Consortium, the Veterans Affairs Mid-Atlantic Mental Illness Research, Education, and Clinical Center Workgroup, and the Veterans Affairs Million Veteran Program
| | - Frank Wendt
- for the Million Veteran Program Suicide Exemplar Workgroup, the International Suicide Genetics Consortium, the Veterans Affairs Mid-Atlantic Mental Illness Research, Education, and Clinical Center Workgroup, and the Veterans Affairs Million Veteran Program
| | - Mark Adams
- for the Million Veteran Program Suicide Exemplar Workgroup, the International Suicide Genetics Consortium, the Veterans Affairs Mid-Atlantic Mental Illness Research, Education, and Clinical Center Workgroup, and the Veterans Affairs Million Veteran Program
| | - Adrian I Campos
- for the Million Veteran Program Suicide Exemplar Workgroup, the International Suicide Genetics Consortium, the Veterans Affairs Mid-Atlantic Mental Illness Research, Education, and Clinical Center Workgroup, and the Veterans Affairs Million Veteran Program
| | - Emily DiBlasi
- for the Million Veteran Program Suicide Exemplar Workgroup, the International Suicide Genetics Consortium, the Veterans Affairs Mid-Atlantic Mental Illness Research, Education, and Clinical Center Workgroup, and the Veterans Affairs Million Veteran Program
| | - Janice M Fullerton
- for the Million Veteran Program Suicide Exemplar Workgroup, the International Suicide Genetics Consortium, the Veterans Affairs Mid-Atlantic Mental Illness Research, Education, and Clinical Center Workgroup, and the Veterans Affairs Million Veteran Program
| | - Henry R Kranzler
- for the Million Veteran Program Suicide Exemplar Workgroup, the International Suicide Genetics Consortium, the Veterans Affairs Mid-Atlantic Mental Illness Research, Education, and Clinical Center Workgroup, and the Veterans Affairs Million Veteran Program
| | - Amanda Bakian
- for the Million Veteran Program Suicide Exemplar Workgroup, the International Suicide Genetics Consortium, the Veterans Affairs Mid-Atlantic Mental Illness Research, Education, and Clinical Center Workgroup, and the Veterans Affairs Million Veteran Program
| | - Eric T Monson
- for the Million Veteran Program Suicide Exemplar Workgroup, the International Suicide Genetics Consortium, the Veterans Affairs Mid-Atlantic Mental Illness Research, Education, and Clinical Center Workgroup, and the Veterans Affairs Million Veteran Program
| | - Miguel E Rentería
- for the Million Veteran Program Suicide Exemplar Workgroup, the International Suicide Genetics Consortium, the Veterans Affairs Mid-Atlantic Mental Illness Research, Education, and Clinical Center Workgroup, and the Veterans Affairs Million Veteran Program
| | - Ole A Andreassen
- for the Million Veteran Program Suicide Exemplar Workgroup, the International Suicide Genetics Consortium, the Veterans Affairs Mid-Atlantic Mental Illness Research, Education, and Clinical Center Workgroup, and the Veterans Affairs Million Veteran Program
| | - Cynthia M Bulik
- for the Million Veteran Program Suicide Exemplar Workgroup, the International Suicide Genetics Consortium, the Veterans Affairs Mid-Atlantic Mental Illness Research, Education, and Clinical Center Workgroup, and the Veterans Affairs Million Veteran Program
| | - Howard J Edenberg
- for the Million Veteran Program Suicide Exemplar Workgroup, the International Suicide Genetics Consortium, the Veterans Affairs Mid-Atlantic Mental Illness Research, Education, and Clinical Center Workgroup, and the Veterans Affairs Million Veteran Program
| | - Ronald C Kessler
- for the Million Veteran Program Suicide Exemplar Workgroup, the International Suicide Genetics Consortium, the Veterans Affairs Mid-Atlantic Mental Illness Research, Education, and Clinical Center Workgroup, and the Veterans Affairs Million Veteran Program
| | - J John Mann
- for the Million Veteran Program Suicide Exemplar Workgroup, the International Suicide Genetics Consortium, the Veterans Affairs Mid-Atlantic Mental Illness Research, Education, and Clinical Center Workgroup, and the Veterans Affairs Million Veteran Program
| | - John I. Nurnberger
- for the Million Veteran Program Suicide Exemplar Workgroup, the International Suicide Genetics Consortium, the Veterans Affairs Mid-Atlantic Mental Illness Research, Education, and Clinical Center Workgroup, and the Veterans Affairs Million Veteran Program
| | - Giorgio Pistis
- for the Million Veteran Program Suicide Exemplar Workgroup, the International Suicide Genetics Consortium, the Veterans Affairs Mid-Atlantic Mental Illness Research, Education, and Clinical Center Workgroup, and the Veterans Affairs Million Veteran Program
| | - Fabian Streit
- for the Million Veteran Program Suicide Exemplar Workgroup, the International Suicide Genetics Consortium, the Veterans Affairs Mid-Atlantic Mental Illness Research, Education, and Clinical Center Workgroup, and the Veterans Affairs Million Veteran Program
| | - Robert J Ursano
- for the Million Veteran Program Suicide Exemplar Workgroup, the International Suicide Genetics Consortium, the Veterans Affairs Mid-Atlantic Mental Illness Research, Education, and Clinical Center Workgroup, and the Veterans Affairs Million Veteran Program
| | - Swapnil Awasthi
- for the Million Veteran Program Suicide Exemplar Workgroup, the International Suicide Genetics Consortium, the Veterans Affairs Mid-Atlantic Mental Illness Research, Education, and Clinical Center Workgroup, and the Veterans Affairs Million Veteran Program
| | - Andrew W Bergen
- for the Million Veteran Program Suicide Exemplar Workgroup, the International Suicide Genetics Consortium, the Veterans Affairs Mid-Atlantic Mental Illness Research, Education, and Clinical Center Workgroup, and the Veterans Affairs Million Veteran Program
| | - Wade H Berrettini
- for the Million Veteran Program Suicide Exemplar Workgroup, the International Suicide Genetics Consortium, the Veterans Affairs Mid-Atlantic Mental Illness Research, Education, and Clinical Center Workgroup, and the Veterans Affairs Million Veteran Program
| | - Martin Bohus
- for the Million Veteran Program Suicide Exemplar Workgroup, the International Suicide Genetics Consortium, the Veterans Affairs Mid-Atlantic Mental Illness Research, Education, and Clinical Center Workgroup, and the Veterans Affairs Million Veteran Program
| | - Harry Brandt
- for the Million Veteran Program Suicide Exemplar Workgroup, the International Suicide Genetics Consortium, the Veterans Affairs Mid-Atlantic Mental Illness Research, Education, and Clinical Center Workgroup, and the Veterans Affairs Million Veteran Program
| | - Xiao Chang
- for the Million Veteran Program Suicide Exemplar Workgroup, the International Suicide Genetics Consortium, the Veterans Affairs Mid-Atlantic Mental Illness Research, Education, and Clinical Center Workgroup, and the Veterans Affairs Million Veteran Program
| | - Hsi-Chung Chen
- for the Million Veteran Program Suicide Exemplar Workgroup, the International Suicide Genetics Consortium, the Veterans Affairs Mid-Atlantic Mental Illness Research, Education, and Clinical Center Workgroup, and the Veterans Affairs Million Veteran Program
| | - Wei J Chen
- for the Million Veteran Program Suicide Exemplar Workgroup, the International Suicide Genetics Consortium, the Veterans Affairs Mid-Atlantic Mental Illness Research, Education, and Clinical Center Workgroup, and the Veterans Affairs Million Veteran Program
| | - Erik D Christensen
- for the Million Veteran Program Suicide Exemplar Workgroup, the International Suicide Genetics Consortium, the Veterans Affairs Mid-Atlantic Mental Illness Research, Education, and Clinical Center Workgroup, and the Veterans Affairs Million Veteran Program
| | - Steven Crawford
- for the Million Veteran Program Suicide Exemplar Workgroup, the International Suicide Genetics Consortium, the Veterans Affairs Mid-Atlantic Mental Illness Research, Education, and Clinical Center Workgroup, and the Veterans Affairs Million Veteran Program
| | - Scott Crow
- for the Million Veteran Program Suicide Exemplar Workgroup, the International Suicide Genetics Consortium, the Veterans Affairs Mid-Atlantic Mental Illness Research, Education, and Clinical Center Workgroup, and the Veterans Affairs Million Veteran Program
| | - Philibert Duriez
- for the Million Veteran Program Suicide Exemplar Workgroup, the International Suicide Genetics Consortium, the Veterans Affairs Mid-Atlantic Mental Illness Research, Education, and Clinical Center Workgroup, and the Veterans Affairs Million Veteran Program
| | - Alexis C Edwards
- for the Million Veteran Program Suicide Exemplar Workgroup, the International Suicide Genetics Consortium, the Veterans Affairs Mid-Atlantic Mental Illness Research, Education, and Clinical Center Workgroup, and the Veterans Affairs Million Veteran Program
| | - Fernando Fernández-Aranda
- for the Million Veteran Program Suicide Exemplar Workgroup, the International Suicide Genetics Consortium, the Veterans Affairs Mid-Atlantic Mental Illness Research, Education, and Clinical Center Workgroup, and the Veterans Affairs Million Veteran Program
| | - Manfred M Fichter
- for the Million Veteran Program Suicide Exemplar Workgroup, the International Suicide Genetics Consortium, the Veterans Affairs Mid-Atlantic Mental Illness Research, Education, and Clinical Center Workgroup, and the Veterans Affairs Million Veteran Program
| | - Hanga Galfalvy
- for the Million Veteran Program Suicide Exemplar Workgroup, the International Suicide Genetics Consortium, the Veterans Affairs Mid-Atlantic Mental Illness Research, Education, and Clinical Center Workgroup, and the Veterans Affairs Million Veteran Program
| | - Steven Gallinger
- for the Million Veteran Program Suicide Exemplar Workgroup, the International Suicide Genetics Consortium, the Veterans Affairs Mid-Atlantic Mental Illness Research, Education, and Clinical Center Workgroup, and the Veterans Affairs Million Veteran Program
| | - Michael Gandal
- for the Million Veteran Program Suicide Exemplar Workgroup, the International Suicide Genetics Consortium, the Veterans Affairs Mid-Atlantic Mental Illness Research, Education, and Clinical Center Workgroup, and the Veterans Affairs Million Veteran Program
| | - Philip Gorwood
- for the Million Veteran Program Suicide Exemplar Workgroup, the International Suicide Genetics Consortium, the Veterans Affairs Mid-Atlantic Mental Illness Research, Education, and Clinical Center Workgroup, and the Veterans Affairs Million Veteran Program
| | - Yiran Guo
- for the Million Veteran Program Suicide Exemplar Workgroup, the International Suicide Genetics Consortium, the Veterans Affairs Mid-Atlantic Mental Illness Research, Education, and Clinical Center Workgroup, and the Veterans Affairs Million Veteran Program
| | - Jonathan D Hafferty
- for the Million Veteran Program Suicide Exemplar Workgroup, the International Suicide Genetics Consortium, the Veterans Affairs Mid-Atlantic Mental Illness Research, Education, and Clinical Center Workgroup, and the Veterans Affairs Million Veteran Program
| | - Hakon Hakonarson
- for the Million Veteran Program Suicide Exemplar Workgroup, the International Suicide Genetics Consortium, the Veterans Affairs Mid-Atlantic Mental Illness Research, Education, and Clinical Center Workgroup, and the Veterans Affairs Million Veteran Program
| | - Katherine A Halmi
- for the Million Veteran Program Suicide Exemplar Workgroup, the International Suicide Genetics Consortium, the Veterans Affairs Mid-Atlantic Mental Illness Research, Education, and Clinical Center Workgroup, and the Veterans Affairs Million Veteran Program
| | - Akitoyo Hishimoto
- for the Million Veteran Program Suicide Exemplar Workgroup, the International Suicide Genetics Consortium, the Veterans Affairs Mid-Atlantic Mental Illness Research, Education, and Clinical Center Workgroup, and the Veterans Affairs Million Veteran Program
| | - Sonia Jain
- for the Million Veteran Program Suicide Exemplar Workgroup, the International Suicide Genetics Consortium, the Veterans Affairs Mid-Atlantic Mental Illness Research, Education, and Clinical Center Workgroup, and the Veterans Affairs Million Veteran Program
| | - Stéphane Jamain
- for the Million Veteran Program Suicide Exemplar Workgroup, the International Suicide Genetics Consortium, the Veterans Affairs Mid-Atlantic Mental Illness Research, Education, and Clinical Center Workgroup, and the Veterans Affairs Million Veteran Program
| | - Susana Jiménez-Murcia
- for the Million Veteran Program Suicide Exemplar Workgroup, the International Suicide Genetics Consortium, the Veterans Affairs Mid-Atlantic Mental Illness Research, Education, and Clinical Center Workgroup, and the Veterans Affairs Million Veteran Program
| | - Craig Johnson
- for the Million Veteran Program Suicide Exemplar Workgroup, the International Suicide Genetics Consortium, the Veterans Affairs Mid-Atlantic Mental Illness Research, Education, and Clinical Center Workgroup, and the Veterans Affairs Million Veteran Program
| | - Allan S Kaplan
- for the Million Veteran Program Suicide Exemplar Workgroup, the International Suicide Genetics Consortium, the Veterans Affairs Mid-Atlantic Mental Illness Research, Education, and Clinical Center Workgroup, and the Veterans Affairs Million Veteran Program
| | - Walter H Kaye
- for the Million Veteran Program Suicide Exemplar Workgroup, the International Suicide Genetics Consortium, the Veterans Affairs Mid-Atlantic Mental Illness Research, Education, and Clinical Center Workgroup, and the Veterans Affairs Million Veteran Program
| | - Pamela K Keel
- for the Million Veteran Program Suicide Exemplar Workgroup, the International Suicide Genetics Consortium, the Veterans Affairs Mid-Atlantic Mental Illness Research, Education, and Clinical Center Workgroup, and the Veterans Affairs Million Veteran Program
| | - James L Kennedy
- for the Million Veteran Program Suicide Exemplar Workgroup, the International Suicide Genetics Consortium, the Veterans Affairs Mid-Atlantic Mental Illness Research, Education, and Clinical Center Workgroup, and the Veterans Affairs Million Veteran Program
| | - Minsoo Kim
- for the Million Veteran Program Suicide Exemplar Workgroup, the International Suicide Genetics Consortium, the Veterans Affairs Mid-Atlantic Mental Illness Research, Education, and Clinical Center Workgroup, and the Veterans Affairs Million Veteran Program
| | - Kelly L Klump
- for the Million Veteran Program Suicide Exemplar Workgroup, the International Suicide Genetics Consortium, the Veterans Affairs Mid-Atlantic Mental Illness Research, Education, and Clinical Center Workgroup, and the Veterans Affairs Million Veteran Program
| | - Daniel F Levey
- for the Million Veteran Program Suicide Exemplar Workgroup, the International Suicide Genetics Consortium, the Veterans Affairs Mid-Atlantic Mental Illness Research, Education, and Clinical Center Workgroup, and the Veterans Affairs Million Veteran Program
| | - Dong Li
- for the Million Veteran Program Suicide Exemplar Workgroup, the International Suicide Genetics Consortium, the Veterans Affairs Mid-Atlantic Mental Illness Research, Education, and Clinical Center Workgroup, and the Veterans Affairs Million Veteran Program
| | - Shih-Cheng Liao
- for the Million Veteran Program Suicide Exemplar Workgroup, the International Suicide Genetics Consortium, the Veterans Affairs Mid-Atlantic Mental Illness Research, Education, and Clinical Center Workgroup, and the Veterans Affairs Million Veteran Program
| | - Klaus Lieb
- for the Million Veteran Program Suicide Exemplar Workgroup, the International Suicide Genetics Consortium, the Veterans Affairs Mid-Atlantic Mental Illness Research, Education, and Clinical Center Workgroup, and the Veterans Affairs Million Veteran Program
| | - Lisa Lilenfeld
- for the Million Veteran Program Suicide Exemplar Workgroup, the International Suicide Genetics Consortium, the Veterans Affairs Mid-Atlantic Mental Illness Research, Education, and Clinical Center Workgroup, and the Veterans Affairs Million Veteran Program
| | - Adriana Lori
- for the Million Veteran Program Suicide Exemplar Workgroup, the International Suicide Genetics Consortium, the Veterans Affairs Mid-Atlantic Mental Illness Research, Education, and Clinical Center Workgroup, and the Veterans Affairs Million Veteran Program
| | - Pierre J Magistretti
- for the Million Veteran Program Suicide Exemplar Workgroup, the International Suicide Genetics Consortium, the Veterans Affairs Mid-Atlantic Mental Illness Research, Education, and Clinical Center Workgroup, and the Veterans Affairs Million Veteran Program
| | - Christian R Marshall
- for the Million Veteran Program Suicide Exemplar Workgroup, the International Suicide Genetics Consortium, the Veterans Affairs Mid-Atlantic Mental Illness Research, Education, and Clinical Center Workgroup, and the Veterans Affairs Million Veteran Program
| | - James E Mitchell
- for the Million Veteran Program Suicide Exemplar Workgroup, the International Suicide Genetics Consortium, the Veterans Affairs Mid-Atlantic Mental Illness Research, Education, and Clinical Center Workgroup, and the Veterans Affairs Million Veteran Program
| | - Richard M Myers
- for the Million Veteran Program Suicide Exemplar Workgroup, the International Suicide Genetics Consortium, the Veterans Affairs Mid-Atlantic Mental Illness Research, Education, and Clinical Center Workgroup, and the Veterans Affairs Million Veteran Program
| | - Satoshi Okazaki
- for the Million Veteran Program Suicide Exemplar Workgroup, the International Suicide Genetics Consortium, the Veterans Affairs Mid-Atlantic Mental Illness Research, Education, and Clinical Center Workgroup, and the Veterans Affairs Million Veteran Program
| | - Ikuo Otsuka
- for the Million Veteran Program Suicide Exemplar Workgroup, the International Suicide Genetics Consortium, the Veterans Affairs Mid-Atlantic Mental Illness Research, Education, and Clinical Center Workgroup, and the Veterans Affairs Million Veteran Program
| | - Dalila Pinto
- for the Million Veteran Program Suicide Exemplar Workgroup, the International Suicide Genetics Consortium, the Veterans Affairs Mid-Atlantic Mental Illness Research, Education, and Clinical Center Workgroup, and the Veterans Affairs Million Veteran Program
| | - Abigail Powers
- for the Million Veteran Program Suicide Exemplar Workgroup, the International Suicide Genetics Consortium, the Veterans Affairs Mid-Atlantic Mental Illness Research, Education, and Clinical Center Workgroup, and the Veterans Affairs Million Veteran Program
| | - Nicolas Ramoz
- for the Million Veteran Program Suicide Exemplar Workgroup, the International Suicide Genetics Consortium, the Veterans Affairs Mid-Atlantic Mental Illness Research, Education, and Clinical Center Workgroup, and the Veterans Affairs Million Veteran Program
| | - Stephan Ripke
- for the Million Veteran Program Suicide Exemplar Workgroup, the International Suicide Genetics Consortium, the Veterans Affairs Mid-Atlantic Mental Illness Research, Education, and Clinical Center Workgroup, and the Veterans Affairs Million Veteran Program
| | - Stefan Roepke
- for the Million Veteran Program Suicide Exemplar Workgroup, the International Suicide Genetics Consortium, the Veterans Affairs Mid-Atlantic Mental Illness Research, Education, and Clinical Center Workgroup, and the Veterans Affairs Million Veteran Program
| | - Vsevolod Rozanov
- for the Million Veteran Program Suicide Exemplar Workgroup, the International Suicide Genetics Consortium, the Veterans Affairs Mid-Atlantic Mental Illness Research, Education, and Clinical Center Workgroup, and the Veterans Affairs Million Veteran Program
| | - Stephen W Scherer
- for the Million Veteran Program Suicide Exemplar Workgroup, the International Suicide Genetics Consortium, the Veterans Affairs Mid-Atlantic Mental Illness Research, Education, and Clinical Center Workgroup, and the Veterans Affairs Million Veteran Program
| | - Christian Schmahl
- for the Million Veteran Program Suicide Exemplar Workgroup, the International Suicide Genetics Consortium, the Veterans Affairs Mid-Atlantic Mental Illness Research, Education, and Clinical Center Workgroup, and the Veterans Affairs Million Veteran Program
| | - Marcus Sokolowski
- for the Million Veteran Program Suicide Exemplar Workgroup, the International Suicide Genetics Consortium, the Veterans Affairs Mid-Atlantic Mental Illness Research, Education, and Clinical Center Workgroup, and the Veterans Affairs Million Veteran Program
| | - Anna Starnawska
- for the Million Veteran Program Suicide Exemplar Workgroup, the International Suicide Genetics Consortium, the Veterans Affairs Mid-Atlantic Mental Illness Research, Education, and Clinical Center Workgroup, and the Veterans Affairs Million Veteran Program
| | - Michael Strober
- for the Million Veteran Program Suicide Exemplar Workgroup, the International Suicide Genetics Consortium, the Veterans Affairs Mid-Atlantic Mental Illness Research, Education, and Clinical Center Workgroup, and the Veterans Affairs Million Veteran Program
| | - Mei-Hsin Su
- for the Million Veteran Program Suicide Exemplar Workgroup, the International Suicide Genetics Consortium, the Veterans Affairs Mid-Atlantic Mental Illness Research, Education, and Clinical Center Workgroup, and the Veterans Affairs Million Veteran Program
| | - Laura M Thornton
- for the Million Veteran Program Suicide Exemplar Workgroup, the International Suicide Genetics Consortium, the Veterans Affairs Mid-Atlantic Mental Illness Research, Education, and Clinical Center Workgroup, and the Veterans Affairs Million Veteran Program
| | - Janet Treasure
- for the Million Veteran Program Suicide Exemplar Workgroup, the International Suicide Genetics Consortium, the Veterans Affairs Mid-Atlantic Mental Illness Research, Education, and Clinical Center Workgroup, and the Veterans Affairs Million Veteran Program
| | - Erin B Ware
- for the Million Veteran Program Suicide Exemplar Workgroup, the International Suicide Genetics Consortium, the Veterans Affairs Mid-Atlantic Mental Illness Research, Education, and Clinical Center Workgroup, and the Veterans Affairs Million Veteran Program
| | - Hunna J Watson
- for the Million Veteran Program Suicide Exemplar Workgroup, the International Suicide Genetics Consortium, the Veterans Affairs Mid-Atlantic Mental Illness Research, Education, and Clinical Center Workgroup, and the Veterans Affairs Million Veteran Program
| | - Stephanie H Witt
- for the Million Veteran Program Suicide Exemplar Workgroup, the International Suicide Genetics Consortium, the Veterans Affairs Mid-Atlantic Mental Illness Research, Education, and Clinical Center Workgroup, and the Veterans Affairs Million Veteran Program
| | - D Blake Woodside
- for the Million Veteran Program Suicide Exemplar Workgroup, the International Suicide Genetics Consortium, the Veterans Affairs Mid-Atlantic Mental Illness Research, Education, and Clinical Center Workgroup, and the Veterans Affairs Million Veteran Program
| | - Zeynep Yilmaz
- for the Million Veteran Program Suicide Exemplar Workgroup, the International Suicide Genetics Consortium, the Veterans Affairs Mid-Atlantic Mental Illness Research, Education, and Clinical Center Workgroup, and the Veterans Affairs Million Veteran Program
| | - Lea Zillich
- for the Million Veteran Program Suicide Exemplar Workgroup, the International Suicide Genetics Consortium, the Veterans Affairs Mid-Atlantic Mental Illness Research, Education, and Clinical Center Workgroup, and the Veterans Affairs Million Veteran Program
| | - Esben Agerbo
- for the Million Veteran Program Suicide Exemplar Workgroup, the International Suicide Genetics Consortium, the Veterans Affairs Mid-Atlantic Mental Illness Research, Education, and Clinical Center Workgroup, and the Veterans Affairs Million Veteran Program
| | - Anders D Børglum
- for the Million Veteran Program Suicide Exemplar Workgroup, the International Suicide Genetics Consortium, the Veterans Affairs Mid-Atlantic Mental Illness Research, Education, and Clinical Center Workgroup, and the Veterans Affairs Million Veteran Program
| | - Gerome Breen
- for the Million Veteran Program Suicide Exemplar Workgroup, the International Suicide Genetics Consortium, the Veterans Affairs Mid-Atlantic Mental Illness Research, Education, and Clinical Center Workgroup, and the Veterans Affairs Million Veteran Program
| | - Ditte Demontis
- for the Million Veteran Program Suicide Exemplar Workgroup, the International Suicide Genetics Consortium, the Veterans Affairs Mid-Atlantic Mental Illness Research, Education, and Clinical Center Workgroup, and the Veterans Affairs Million Veteran Program
| | - Annette Erlangsen
- for the Million Veteran Program Suicide Exemplar Workgroup, the International Suicide Genetics Consortium, the Veterans Affairs Mid-Atlantic Mental Illness Research, Education, and Clinical Center Workgroup, and the Veterans Affairs Million Veteran Program
| | - Tõnu Esko
- for the Million Veteran Program Suicide Exemplar Workgroup, the International Suicide Genetics Consortium, the Veterans Affairs Mid-Atlantic Mental Illness Research, Education, and Clinical Center Workgroup, and the Veterans Affairs Million Veteran Program
| | - Joel Gelernter
- for the Million Veteran Program Suicide Exemplar Workgroup, the International Suicide Genetics Consortium, the Veterans Affairs Mid-Atlantic Mental Illness Research, Education, and Clinical Center Workgroup, and the Veterans Affairs Million Veteran Program
| | - Stephen J Glatt
- for the Million Veteran Program Suicide Exemplar Workgroup, the International Suicide Genetics Consortium, the Veterans Affairs Mid-Atlantic Mental Illness Research, Education, and Clinical Center Workgroup, and the Veterans Affairs Million Veteran Program
| | - David M Hougaard
- for the Million Veteran Program Suicide Exemplar Workgroup, the International Suicide Genetics Consortium, the Veterans Affairs Mid-Atlantic Mental Illness Research, Education, and Clinical Center Workgroup, and the Veterans Affairs Million Veteran Program
| | - Hai-Gwo Hwu
- for the Million Veteran Program Suicide Exemplar Workgroup, the International Suicide Genetics Consortium, the Veterans Affairs Mid-Atlantic Mental Illness Research, Education, and Clinical Center Workgroup, and the Veterans Affairs Million Veteran Program
| | - Po-Hsiu Kuo
- for the Million Veteran Program Suicide Exemplar Workgroup, the International Suicide Genetics Consortium, the Veterans Affairs Mid-Atlantic Mental Illness Research, Education, and Clinical Center Workgroup, and the Veterans Affairs Million Veteran Program
| | - Cathryn M Lewis
- for the Million Veteran Program Suicide Exemplar Workgroup, the International Suicide Genetics Consortium, the Veterans Affairs Mid-Atlantic Mental Illness Research, Education, and Clinical Center Workgroup, and the Veterans Affairs Million Veteran Program
| | - Qingqin S Li
- for the Million Veteran Program Suicide Exemplar Workgroup, the International Suicide Genetics Consortium, the Veterans Affairs Mid-Atlantic Mental Illness Research, Education, and Clinical Center Workgroup, and the Veterans Affairs Million Veteran Program
| | - Chih-Min Liu
- for the Million Veteran Program Suicide Exemplar Workgroup, the International Suicide Genetics Consortium, the Veterans Affairs Mid-Atlantic Mental Illness Research, Education, and Clinical Center Workgroup, and the Veterans Affairs Million Veteran Program
| | - Nicholas G Martin
- for the Million Veteran Program Suicide Exemplar Workgroup, the International Suicide Genetics Consortium, the Veterans Affairs Mid-Atlantic Mental Illness Research, Education, and Clinical Center Workgroup, and the Veterans Affairs Million Veteran Program
| | - Andrew M McIntosh
- for the Million Veteran Program Suicide Exemplar Workgroup, the International Suicide Genetics Consortium, the Veterans Affairs Mid-Atlantic Mental Illness Research, Education, and Clinical Center Workgroup, and the Veterans Affairs Million Veteran Program
| | - Sarah E Medland
- for the Million Veteran Program Suicide Exemplar Workgroup, the International Suicide Genetics Consortium, the Veterans Affairs Mid-Atlantic Mental Illness Research, Education, and Clinical Center Workgroup, and the Veterans Affairs Million Veteran Program
| | - Ole Mors
- for the Million Veteran Program Suicide Exemplar Workgroup, the International Suicide Genetics Consortium, the Veterans Affairs Mid-Atlantic Mental Illness Research, Education, and Clinical Center Workgroup, and the Veterans Affairs Million Veteran Program
| | - Merete Nordentoft
- for the Million Veteran Program Suicide Exemplar Workgroup, the International Suicide Genetics Consortium, the Veterans Affairs Mid-Atlantic Mental Illness Research, Education, and Clinical Center Workgroup, and the Veterans Affairs Million Veteran Program
| | - John I Nurnberger
- for the Million Veteran Program Suicide Exemplar Workgroup, the International Suicide Genetics Consortium, the Veterans Affairs Mid-Atlantic Mental Illness Research, Education, and Clinical Center Workgroup, and the Veterans Affairs Million Veteran Program
| | - Catherine Olsen
- for the Million Veteran Program Suicide Exemplar Workgroup, the International Suicide Genetics Consortium, the Veterans Affairs Mid-Atlantic Mental Illness Research, Education, and Clinical Center Workgroup, and the Veterans Affairs Million Veteran Program
| | - David Porteous
- for the Million Veteran Program Suicide Exemplar Workgroup, the International Suicide Genetics Consortium, the Veterans Affairs Mid-Atlantic Mental Illness Research, Education, and Clinical Center Workgroup, and the Veterans Affairs Million Veteran Program
| | - Daniel J Smith
- for the Million Veteran Program Suicide Exemplar Workgroup, the International Suicide Genetics Consortium, the Veterans Affairs Mid-Atlantic Mental Illness Research, Education, and Clinical Center Workgroup, and the Veterans Affairs Million Veteran Program
| | - Eli A Stahl
- for the Million Veteran Program Suicide Exemplar Workgroup, the International Suicide Genetics Consortium, the Veterans Affairs Mid-Atlantic Mental Illness Research, Education, and Clinical Center Workgroup, and the Veterans Affairs Million Veteran Program
| | - Murray B Stein
- for the Million Veteran Program Suicide Exemplar Workgroup, the International Suicide Genetics Consortium, the Veterans Affairs Mid-Atlantic Mental Illness Research, Education, and Clinical Center Workgroup, and the Veterans Affairs Million Veteran Program
| | - Danuta Wasserman
- for the Million Veteran Program Suicide Exemplar Workgroup, the International Suicide Genetics Consortium, the Veterans Affairs Mid-Atlantic Mental Illness Research, Education, and Clinical Center Workgroup, and the Veterans Affairs Million Veteran Program
| | - Thomas Werge
- for the Million Veteran Program Suicide Exemplar Workgroup, the International Suicide Genetics Consortium, the Veterans Affairs Mid-Atlantic Mental Illness Research, Education, and Clinical Center Workgroup, and the Veterans Affairs Million Veteran Program
| | - David C Whiteman
- for the Million Veteran Program Suicide Exemplar Workgroup, the International Suicide Genetics Consortium, the Veterans Affairs Mid-Atlantic Mental Illness Research, Education, and Clinical Center Workgroup, and the Veterans Affairs Million Veteran Program
| | - Virginia Willour
- for the Million Veteran Program Suicide Exemplar Workgroup, the International Suicide Genetics Consortium, the Veterans Affairs Mid-Atlantic Mental Illness Research, Education, and Clinical Center Workgroup, and the Veterans Affairs Million Veteran Program
| | - Hilary Coon
- for the Million Veteran Program Suicide Exemplar Workgroup, the International Suicide Genetics Consortium, the Veterans Affairs Mid-Atlantic Mental Illness Research, Education, and Clinical Center Workgroup, and the Veterans Affairs Million Veteran Program
| | - Douglas M Ruderfer
- for the Million Veteran Program Suicide Exemplar Workgroup, the International Suicide Genetics Consortium, the Veterans Affairs Mid-Atlantic Mental Illness Research, Education, and Clinical Center Workgroup, and the Veterans Affairs Million Veteran Program
| | - Eric Dedert
- for the Million Veteran Program Suicide Exemplar Workgroup, the International Suicide Genetics Consortium, the Veterans Affairs Mid-Atlantic Mental Illness Research, Education, and Clinical Center Workgroup, and the Veterans Affairs Million Veteran Program
| | - Eric B. Elbogen
- for the Million Veteran Program Suicide Exemplar Workgroup, the International Suicide Genetics Consortium, the Veterans Affairs Mid-Atlantic Mental Illness Research, Education, and Clinical Center Workgroup, and the Veterans Affairs Million Veteran Program
| | - John A. Fairbank
- for the Million Veteran Program Suicide Exemplar Workgroup, the International Suicide Genetics Consortium, the Veterans Affairs Mid-Atlantic Mental Illness Research, Education, and Clinical Center Workgroup, and the Veterans Affairs Million Veteran Program
| | - Robin A. Hurley
- for the Million Veteran Program Suicide Exemplar Workgroup, the International Suicide Genetics Consortium, the Veterans Affairs Mid-Atlantic Mental Illness Research, Education, and Clinical Center Workgroup, and the Veterans Affairs Million Veteran Program
| | - Jason D. Kilts
- for the Million Veteran Program Suicide Exemplar Workgroup, the International Suicide Genetics Consortium, the Veterans Affairs Mid-Atlantic Mental Illness Research, Education, and Clinical Center Workgroup, and the Veterans Affairs Million Veteran Program
| | - Sarah L. Martindale
- for the Million Veteran Program Suicide Exemplar Workgroup, the International Suicide Genetics Consortium, the Veterans Affairs Mid-Atlantic Mental Illness Research, Education, and Clinical Center Workgroup, and the Veterans Affairs Million Veteran Program
| | - Christine E. Marx
- for the Million Veteran Program Suicide Exemplar Workgroup, the International Suicide Genetics Consortium, the Veterans Affairs Mid-Atlantic Mental Illness Research, Education, and Clinical Center Workgroup, and the Veterans Affairs Million Veteran Program
| | - Scott D. McDonald
- for the Million Veteran Program Suicide Exemplar Workgroup, the International Suicide Genetics Consortium, the Veterans Affairs Mid-Atlantic Mental Illness Research, Education, and Clinical Center Workgroup, and the Veterans Affairs Million Veteran Program
| | - Scott D. Moore
- for the Million Veteran Program Suicide Exemplar Workgroup, the International Suicide Genetics Consortium, the Veterans Affairs Mid-Atlantic Mental Illness Research, Education, and Clinical Center Workgroup, and the Veterans Affairs Million Veteran Program
| | - Rajendra A. Morey
- for the Million Veteran Program Suicide Exemplar Workgroup, the International Suicide Genetics Consortium, the Veterans Affairs Mid-Atlantic Mental Illness Research, Education, and Clinical Center Workgroup, and the Veterans Affairs Million Veteran Program
| | - Jennifer C. Naylor
- for the Million Veteran Program Suicide Exemplar Workgroup, the International Suicide Genetics Consortium, the Veterans Affairs Mid-Atlantic Mental Illness Research, Education, and Clinical Center Workgroup, and the Veterans Affairs Million Veteran Program
| | - Jared Rowland
- for the Million Veteran Program Suicide Exemplar Workgroup, the International Suicide Genetics Consortium, the Veterans Affairs Mid-Atlantic Mental Illness Research, Education, and Clinical Center Workgroup, and the Veterans Affairs Million Veteran Program
| | - Robert D. Shura
- for the Million Veteran Program Suicide Exemplar Workgroup, the International Suicide Genetics Consortium, the Veterans Affairs Mid-Atlantic Mental Illness Research, Education, and Clinical Center Workgroup, and the Veterans Affairs Million Veteran Program
| | - Cindy Swinkels
- for the Million Veteran Program Suicide Exemplar Workgroup, the International Suicide Genetics Consortium, the Veterans Affairs Mid-Atlantic Mental Illness Research, Education, and Clinical Center Workgroup, and the Veterans Affairs Million Veteran Program
| | - Larry A. Tupler
- for the Million Veteran Program Suicide Exemplar Workgroup, the International Suicide Genetics Consortium, the Veterans Affairs Mid-Atlantic Mental Illness Research, Education, and Clinical Center Workgroup, and the Veterans Affairs Million Veteran Program
| | - Elizabeth E. Van Voorhees
- for the Million Veteran Program Suicide Exemplar Workgroup, the International Suicide Genetics Consortium, the Veterans Affairs Mid-Atlantic Mental Illness Research, Education, and Clinical Center Workgroup, and the Veterans Affairs Million Veteran Program
| | - Ruth Yoash-Gantz
- for the Million Veteran Program Suicide Exemplar Workgroup, the International Suicide Genetics Consortium, the Veterans Affairs Mid-Atlantic Mental Illness Research, Education, and Clinical Center Workgroup, and the Veterans Affairs Million Veteran Program
| | - J. Michael Gaziano
- for the Million Veteran Program Suicide Exemplar Workgroup, the International Suicide Genetics Consortium, the Veterans Affairs Mid-Atlantic Mental Illness Research, Education, and Clinical Center Workgroup, and the Veterans Affairs Million Veteran Program
| | - Sumitra Muralidhar
- for the Million Veteran Program Suicide Exemplar Workgroup, the International Suicide Genetics Consortium, the Veterans Affairs Mid-Atlantic Mental Illness Research, Education, and Clinical Center Workgroup, and the Veterans Affairs Million Veteran Program
| | - Rachel Ramoni
- for the Million Veteran Program Suicide Exemplar Workgroup, the International Suicide Genetics Consortium, the Veterans Affairs Mid-Atlantic Mental Illness Research, Education, and Clinical Center Workgroup, and the Veterans Affairs Million Veteran Program
| | - Kyong-Mi Chang
- for the Million Veteran Program Suicide Exemplar Workgroup, the International Suicide Genetics Consortium, the Veterans Affairs Mid-Atlantic Mental Illness Research, Education, and Clinical Center Workgroup, and the Veterans Affairs Million Veteran Program
| | - Christopher J. O’Donnell
- for the Million Veteran Program Suicide Exemplar Workgroup, the International Suicide Genetics Consortium, the Veterans Affairs Mid-Atlantic Mental Illness Research, Education, and Clinical Center Workgroup, and the Veterans Affairs Million Veteran Program
| | - Philip S. Tsao
- for the Million Veteran Program Suicide Exemplar Workgroup, the International Suicide Genetics Consortium, the Veterans Affairs Mid-Atlantic Mental Illness Research, Education, and Clinical Center Workgroup, and the Veterans Affairs Million Veteran Program
| | - James Breeling
- for the Million Veteran Program Suicide Exemplar Workgroup, the International Suicide Genetics Consortium, the Veterans Affairs Mid-Atlantic Mental Illness Research, Education, and Clinical Center Workgroup, and the Veterans Affairs Million Veteran Program
| | - Elizabeth Hauser
- for the Million Veteran Program Suicide Exemplar Workgroup, the International Suicide Genetics Consortium, the Veterans Affairs Mid-Atlantic Mental Illness Research, Education, and Clinical Center Workgroup, and the Veterans Affairs Million Veteran Program
| | - Yan Sun
- for the Million Veteran Program Suicide Exemplar Workgroup, the International Suicide Genetics Consortium, the Veterans Affairs Mid-Atlantic Mental Illness Research, Education, and Clinical Center Workgroup, and the Veterans Affairs Million Veteran Program
| | - Grant Huang
- for the Million Veteran Program Suicide Exemplar Workgroup, the International Suicide Genetics Consortium, the Veterans Affairs Mid-Atlantic Mental Illness Research, Education, and Clinical Center Workgroup, and the Veterans Affairs Million Veteran Program
| | - Juan P. Casas
- for the Million Veteran Program Suicide Exemplar Workgroup, the International Suicide Genetics Consortium, the Veterans Affairs Mid-Atlantic Mental Illness Research, Education, and Clinical Center Workgroup, and the Veterans Affairs Million Veteran Program
| | - Jennifer Moser
- for the Million Veteran Program Suicide Exemplar Workgroup, the International Suicide Genetics Consortium, the Veterans Affairs Mid-Atlantic Mental Illness Research, Education, and Clinical Center Workgroup, and the Veterans Affairs Million Veteran Program
| | - Stacey B. Whitbourne
- for the Million Veteran Program Suicide Exemplar Workgroup, the International Suicide Genetics Consortium, the Veterans Affairs Mid-Atlantic Mental Illness Research, Education, and Clinical Center Workgroup, and the Veterans Affairs Million Veteran Program
| | - Jessica V. Brewer
- for the Million Veteran Program Suicide Exemplar Workgroup, the International Suicide Genetics Consortium, the Veterans Affairs Mid-Atlantic Mental Illness Research, Education, and Clinical Center Workgroup, and the Veterans Affairs Million Veteran Program
| | - Todd Conner
- for the Million Veteran Program Suicide Exemplar Workgroup, the International Suicide Genetics Consortium, the Veterans Affairs Mid-Atlantic Mental Illness Research, Education, and Clinical Center Workgroup, and the Veterans Affairs Million Veteran Program
| | - Dean P. Argyres
- for the Million Veteran Program Suicide Exemplar Workgroup, the International Suicide Genetics Consortium, the Veterans Affairs Mid-Atlantic Mental Illness Research, Education, and Clinical Center Workgroup, and the Veterans Affairs Million Veteran Program
| | - Brady Stephens
- for the Million Veteran Program Suicide Exemplar Workgroup, the International Suicide Genetics Consortium, the Veterans Affairs Mid-Atlantic Mental Illness Research, Education, and Clinical Center Workgroup, and the Veterans Affairs Million Veteran Program
| | - Mary T. Brophy
- for the Million Veteran Program Suicide Exemplar Workgroup, the International Suicide Genetics Consortium, the Veterans Affairs Mid-Atlantic Mental Illness Research, Education, and Clinical Center Workgroup, and the Veterans Affairs Million Veteran Program
| | - Donald E. Humphries
- for the Million Veteran Program Suicide Exemplar Workgroup, the International Suicide Genetics Consortium, the Veterans Affairs Mid-Atlantic Mental Illness Research, Education, and Clinical Center Workgroup, and the Veterans Affairs Million Veteran Program
| | - Luis E. Selva
- for the Million Veteran Program Suicide Exemplar Workgroup, the International Suicide Genetics Consortium, the Veterans Affairs Mid-Atlantic Mental Illness Research, Education, and Clinical Center Workgroup, and the Veterans Affairs Million Veteran Program
| | - Nhan Do
- for the Million Veteran Program Suicide Exemplar Workgroup, the International Suicide Genetics Consortium, the Veterans Affairs Mid-Atlantic Mental Illness Research, Education, and Clinical Center Workgroup, and the Veterans Affairs Million Veteran Program
| | - Shahpoor (Alex) Shayan
- for the Million Veteran Program Suicide Exemplar Workgroup, the International Suicide Genetics Consortium, the Veterans Affairs Mid-Atlantic Mental Illness Research, Education, and Clinical Center Workgroup, and the Veterans Affairs Million Veteran Program
| | - Kelly Cho
- for the Million Veteran Program Suicide Exemplar Workgroup, the International Suicide Genetics Consortium, the Veterans Affairs Mid-Atlantic Mental Illness Research, Education, and Clinical Center Workgroup, and the Veterans Affairs Million Veteran Program
| | - Lori Churby
- for the Million Veteran Program Suicide Exemplar Workgroup, the International Suicide Genetics Consortium, the Veterans Affairs Mid-Atlantic Mental Illness Research, Education, and Clinical Center Workgroup, and the Veterans Affairs Million Veteran Program
| | - Peter Wilson
- for the Million Veteran Program Suicide Exemplar Workgroup, the International Suicide Genetics Consortium, the Veterans Affairs Mid-Atlantic Mental Illness Research, Education, and Clinical Center Workgroup, and the Veterans Affairs Million Veteran Program
| | - Rachel McArdle
- for the Million Veteran Program Suicide Exemplar Workgroup, the International Suicide Genetics Consortium, the Veterans Affairs Mid-Atlantic Mental Illness Research, Education, and Clinical Center Workgroup, and the Veterans Affairs Million Veteran Program
| | - Louis Dellitalia
- for the Million Veteran Program Suicide Exemplar Workgroup, the International Suicide Genetics Consortium, the Veterans Affairs Mid-Atlantic Mental Illness Research, Education, and Clinical Center Workgroup, and the Veterans Affairs Million Veteran Program
| | - Kristin Mattocks
- for the Million Veteran Program Suicide Exemplar Workgroup, the International Suicide Genetics Consortium, the Veterans Affairs Mid-Atlantic Mental Illness Research, Education, and Clinical Center Workgroup, and the Veterans Affairs Million Veteran Program
| | - John Harley
- for the Million Veteran Program Suicide Exemplar Workgroup, the International Suicide Genetics Consortium, the Veterans Affairs Mid-Atlantic Mental Illness Research, Education, and Clinical Center Workgroup, and the Veterans Affairs Million Veteran Program
| | - Jeffrey Whittle
- for the Million Veteran Program Suicide Exemplar Workgroup, the International Suicide Genetics Consortium, the Veterans Affairs Mid-Atlantic Mental Illness Research, Education, and Clinical Center Workgroup, and the Veterans Affairs Million Veteran Program
| | - Frank Jacono
- for the Million Veteran Program Suicide Exemplar Workgroup, the International Suicide Genetics Consortium, the Veterans Affairs Mid-Atlantic Mental Illness Research, Education, and Clinical Center Workgroup, and the Veterans Affairs Million Veteran Program
| | - John Wells
- for the Million Veteran Program Suicide Exemplar Workgroup, the International Suicide Genetics Consortium, the Veterans Affairs Mid-Atlantic Mental Illness Research, Education, and Clinical Center Workgroup, and the Veterans Affairs Million Veteran Program
| | - Salvador Gutierrez
- for the Million Veteran Program Suicide Exemplar Workgroup, the International Suicide Genetics Consortium, the Veterans Affairs Mid-Atlantic Mental Illness Research, Education, and Clinical Center Workgroup, and the Veterans Affairs Million Veteran Program
| | - Gretchen Gibson
- for the Million Veteran Program Suicide Exemplar Workgroup, the International Suicide Genetics Consortium, the Veterans Affairs Mid-Atlantic Mental Illness Research, Education, and Clinical Center Workgroup, and the Veterans Affairs Million Veteran Program
| | - Kimberly Hammer
- for the Million Veteran Program Suicide Exemplar Workgroup, the International Suicide Genetics Consortium, the Veterans Affairs Mid-Atlantic Mental Illness Research, Education, and Clinical Center Workgroup, and the Veterans Affairs Million Veteran Program
| | - Laurence Kaminsky
- for the Million Veteran Program Suicide Exemplar Workgroup, the International Suicide Genetics Consortium, the Veterans Affairs Mid-Atlantic Mental Illness Research, Education, and Clinical Center Workgroup, and the Veterans Affairs Million Veteran Program
| | - Gerardo Villareal
- for the Million Veteran Program Suicide Exemplar Workgroup, the International Suicide Genetics Consortium, the Veterans Affairs Mid-Atlantic Mental Illness Research, Education, and Clinical Center Workgroup, and the Veterans Affairs Million Veteran Program
| | - Scott Kinlay
- for the Million Veteran Program Suicide Exemplar Workgroup, the International Suicide Genetics Consortium, the Veterans Affairs Mid-Atlantic Mental Illness Research, Education, and Clinical Center Workgroup, and the Veterans Affairs Million Veteran Program
| | - Junzhe Xu
- for the Million Veteran Program Suicide Exemplar Workgroup, the International Suicide Genetics Consortium, the Veterans Affairs Mid-Atlantic Mental Illness Research, Education, and Clinical Center Workgroup, and the Veterans Affairs Million Veteran Program
| | - Mark Hamner
- for the Million Veteran Program Suicide Exemplar Workgroup, the International Suicide Genetics Consortium, the Veterans Affairs Mid-Atlantic Mental Illness Research, Education, and Clinical Center Workgroup, and the Veterans Affairs Million Veteran Program
| | - Roy Mathew
- for the Million Veteran Program Suicide Exemplar Workgroup, the International Suicide Genetics Consortium, the Veterans Affairs Mid-Atlantic Mental Illness Research, Education, and Clinical Center Workgroup, and the Veterans Affairs Million Veteran Program
| | - Sujata Bhushan
- for the Million Veteran Program Suicide Exemplar Workgroup, the International Suicide Genetics Consortium, the Veterans Affairs Mid-Atlantic Mental Illness Research, Education, and Clinical Center Workgroup, and the Veterans Affairs Million Veteran Program
| | - Pran Iruvanti
- for the Million Veteran Program Suicide Exemplar Workgroup, the International Suicide Genetics Consortium, the Veterans Affairs Mid-Atlantic Mental Illness Research, Education, and Clinical Center Workgroup, and the Veterans Affairs Million Veteran Program
| | - Michael Godschalk
- for the Million Veteran Program Suicide Exemplar Workgroup, the International Suicide Genetics Consortium, the Veterans Affairs Mid-Atlantic Mental Illness Research, Education, and Clinical Center Workgroup, and the Veterans Affairs Million Veteran Program
| | - Zuhair Ballas
- for the Million Veteran Program Suicide Exemplar Workgroup, the International Suicide Genetics Consortium, the Veterans Affairs Mid-Atlantic Mental Illness Research, Education, and Clinical Center Workgroup, and the Veterans Affairs Million Veteran Program
| | - Douglas Ivins
- for the Million Veteran Program Suicide Exemplar Workgroup, the International Suicide Genetics Consortium, the Veterans Affairs Mid-Atlantic Mental Illness Research, Education, and Clinical Center Workgroup, and the Veterans Affairs Million Veteran Program
| | - Stephen Mastorides
- for the Million Veteran Program Suicide Exemplar Workgroup, the International Suicide Genetics Consortium, the Veterans Affairs Mid-Atlantic Mental Illness Research, Education, and Clinical Center Workgroup, and the Veterans Affairs Million Veteran Program
| | - Jonathan Moorman
- for the Million Veteran Program Suicide Exemplar Workgroup, the International Suicide Genetics Consortium, the Veterans Affairs Mid-Atlantic Mental Illness Research, Education, and Clinical Center Workgroup, and the Veterans Affairs Million Veteran Program
| | - Saib Gappy
- for the Million Veteran Program Suicide Exemplar Workgroup, the International Suicide Genetics Consortium, the Veterans Affairs Mid-Atlantic Mental Illness Research, Education, and Clinical Center Workgroup, and the Veterans Affairs Million Veteran Program
| | - Jon Klein
- for the Million Veteran Program Suicide Exemplar Workgroup, the International Suicide Genetics Consortium, the Veterans Affairs Mid-Atlantic Mental Illness Research, Education, and Clinical Center Workgroup, and the Veterans Affairs Million Veteran Program
| | - Nora Ratcliffe
- for the Million Veteran Program Suicide Exemplar Workgroup, the International Suicide Genetics Consortium, the Veterans Affairs Mid-Atlantic Mental Illness Research, Education, and Clinical Center Workgroup, and the Veterans Affairs Million Veteran Program
| | - Hermes Florez
- for the Million Veteran Program Suicide Exemplar Workgroup, the International Suicide Genetics Consortium, the Veterans Affairs Mid-Atlantic Mental Illness Research, Education, and Clinical Center Workgroup, and the Veterans Affairs Million Veteran Program
| | - Olaoluwa Okusaga
- for the Million Veteran Program Suicide Exemplar Workgroup, the International Suicide Genetics Consortium, the Veterans Affairs Mid-Atlantic Mental Illness Research, Education, and Clinical Center Workgroup, and the Veterans Affairs Million Veteran Program
| | - Maureen Murdoch
- for the Million Veteran Program Suicide Exemplar Workgroup, the International Suicide Genetics Consortium, the Veterans Affairs Mid-Atlantic Mental Illness Research, Education, and Clinical Center Workgroup, and the Veterans Affairs Million Veteran Program
| | - Peruvemba Sriram
- for the Million Veteran Program Suicide Exemplar Workgroup, the International Suicide Genetics Consortium, the Veterans Affairs Mid-Atlantic Mental Illness Research, Education, and Clinical Center Workgroup, and the Veterans Affairs Million Veteran Program
| | - Shing Shing Yeh
- for the Million Veteran Program Suicide Exemplar Workgroup, the International Suicide Genetics Consortium, the Veterans Affairs Mid-Atlantic Mental Illness Research, Education, and Clinical Center Workgroup, and the Veterans Affairs Million Veteran Program
| | - Neeraj Tandon
- for the Million Veteran Program Suicide Exemplar Workgroup, the International Suicide Genetics Consortium, the Veterans Affairs Mid-Atlantic Mental Illness Research, Education, and Clinical Center Workgroup, and the Veterans Affairs Million Veteran Program
| | - Darshana Jhala
- for the Million Veteran Program Suicide Exemplar Workgroup, the International Suicide Genetics Consortium, the Veterans Affairs Mid-Atlantic Mental Illness Research, Education, and Clinical Center Workgroup, and the Veterans Affairs Million Veteran Program
| | - Suthat Liangpunsakul
- for the Million Veteran Program Suicide Exemplar Workgroup, the International Suicide Genetics Consortium, the Veterans Affairs Mid-Atlantic Mental Illness Research, Education, and Clinical Center Workgroup, and the Veterans Affairs Million Veteran Program
| | - Kris Ann Oursler
- for the Million Veteran Program Suicide Exemplar Workgroup, the International Suicide Genetics Consortium, the Veterans Affairs Mid-Atlantic Mental Illness Research, Education, and Clinical Center Workgroup, and the Veterans Affairs Million Veteran Program
| | - Mary Whooley
- for the Million Veteran Program Suicide Exemplar Workgroup, the International Suicide Genetics Consortium, the Veterans Affairs Mid-Atlantic Mental Illness Research, Education, and Clinical Center Workgroup, and the Veterans Affairs Million Veteran Program
| | - Sunil Ahuja
- for the Million Veteran Program Suicide Exemplar Workgroup, the International Suicide Genetics Consortium, the Veterans Affairs Mid-Atlantic Mental Illness Research, Education, and Clinical Center Workgroup, and the Veterans Affairs Million Veteran Program
| | - Joseph Constans
- for the Million Veteran Program Suicide Exemplar Workgroup, the International Suicide Genetics Consortium, the Veterans Affairs Mid-Atlantic Mental Illness Research, Education, and Clinical Center Workgroup, and the Veterans Affairs Million Veteran Program
| | - Paul Meyer
- for the Million Veteran Program Suicide Exemplar Workgroup, the International Suicide Genetics Consortium, the Veterans Affairs Mid-Atlantic Mental Illness Research, Education, and Clinical Center Workgroup, and the Veterans Affairs Million Veteran Program
| | - Jennifer Greco
- for the Million Veteran Program Suicide Exemplar Workgroup, the International Suicide Genetics Consortium, the Veterans Affairs Mid-Atlantic Mental Illness Research, Education, and Clinical Center Workgroup, and the Veterans Affairs Million Veteran Program
| | - Michael Rauchman
- for the Million Veteran Program Suicide Exemplar Workgroup, the International Suicide Genetics Consortium, the Veterans Affairs Mid-Atlantic Mental Illness Research, Education, and Clinical Center Workgroup, and the Veterans Affairs Million Veteran Program
| | - Richard Servatius
- for the Million Veteran Program Suicide Exemplar Workgroup, the International Suicide Genetics Consortium, the Veterans Affairs Mid-Atlantic Mental Illness Research, Education, and Clinical Center Workgroup, and the Veterans Affairs Million Veteran Program
| | - Melinda Gaddy
- for the Million Veteran Program Suicide Exemplar Workgroup, the International Suicide Genetics Consortium, the Veterans Affairs Mid-Atlantic Mental Illness Research, Education, and Clinical Center Workgroup, and the Veterans Affairs Million Veteran Program
| | - Agnes Wallbom
- for the Million Veteran Program Suicide Exemplar Workgroup, the International Suicide Genetics Consortium, the Veterans Affairs Mid-Atlantic Mental Illness Research, Education, and Clinical Center Workgroup, and the Veterans Affairs Million Veteran Program
| | - Timothy Morgan
- for the Million Veteran Program Suicide Exemplar Workgroup, the International Suicide Genetics Consortium, the Veterans Affairs Mid-Atlantic Mental Illness Research, Education, and Clinical Center Workgroup, and the Veterans Affairs Million Veteran Program
| | - Todd Stapley
- for the Million Veteran Program Suicide Exemplar Workgroup, the International Suicide Genetics Consortium, the Veterans Affairs Mid-Atlantic Mental Illness Research, Education, and Clinical Center Workgroup, and the Veterans Affairs Million Veteran Program
| | - Scott Sherman
- for the Million Veteran Program Suicide Exemplar Workgroup, the International Suicide Genetics Consortium, the Veterans Affairs Mid-Atlantic Mental Illness Research, Education, and Clinical Center Workgroup, and the Veterans Affairs Million Veteran Program
| | - George Ross
- for the Million Veteran Program Suicide Exemplar Workgroup, the International Suicide Genetics Consortium, the Veterans Affairs Mid-Atlantic Mental Illness Research, Education, and Clinical Center Workgroup, and the Veterans Affairs Million Veteran Program
| | - Patrick Strollo
- for the Million Veteran Program Suicide Exemplar Workgroup, the International Suicide Genetics Consortium, the Veterans Affairs Mid-Atlantic Mental Illness Research, Education, and Clinical Center Workgroup, and the Veterans Affairs Million Veteran Program
| | - Edward Boyko
- for the Million Veteran Program Suicide Exemplar Workgroup, the International Suicide Genetics Consortium, the Veterans Affairs Mid-Atlantic Mental Illness Research, Education, and Clinical Center Workgroup, and the Veterans Affairs Million Veteran Program
| | - Laurence Meyer
- for the Million Veteran Program Suicide Exemplar Workgroup, the International Suicide Genetics Consortium, the Veterans Affairs Mid-Atlantic Mental Illness Research, Education, and Clinical Center Workgroup, and the Veterans Affairs Million Veteran Program
| | - Samir Gupta
- for the Million Veteran Program Suicide Exemplar Workgroup, the International Suicide Genetics Consortium, the Veterans Affairs Mid-Atlantic Mental Illness Research, Education, and Clinical Center Workgroup, and the Veterans Affairs Million Veteran Program
| | - Mostaqul Huq
- for the Million Veteran Program Suicide Exemplar Workgroup, the International Suicide Genetics Consortium, the Veterans Affairs Mid-Atlantic Mental Illness Research, Education, and Clinical Center Workgroup, and the Veterans Affairs Million Veteran Program
| | - Joseph Fayad
- for the Million Veteran Program Suicide Exemplar Workgroup, the International Suicide Genetics Consortium, the Veterans Affairs Mid-Atlantic Mental Illness Research, Education, and Clinical Center Workgroup, and the Veterans Affairs Million Veteran Program
| | - Adriana Hung
- for the Million Veteran Program Suicide Exemplar Workgroup, the International Suicide Genetics Consortium, the Veterans Affairs Mid-Atlantic Mental Illness Research, Education, and Clinical Center Workgroup, and the Veterans Affairs Million Veteran Program
| | - Jack Lichy
- for the Million Veteran Program Suicide Exemplar Workgroup, the International Suicide Genetics Consortium, the Veterans Affairs Mid-Atlantic Mental Illness Research, Education, and Clinical Center Workgroup, and the Veterans Affairs Million Veteran Program
| | - Robin Hurley
- for the Million Veteran Program Suicide Exemplar Workgroup, the International Suicide Genetics Consortium, the Veterans Affairs Mid-Atlantic Mental Illness Research, Education, and Clinical Center Workgroup, and the Veterans Affairs Million Veteran Program
| | - Brooks Robey
- for the Million Veteran Program Suicide Exemplar Workgroup, the International Suicide Genetics Consortium, the Veterans Affairs Mid-Atlantic Mental Illness Research, Education, and Clinical Center Workgroup, and the Veterans Affairs Million Veteran Program
| | - Robert Striker
- for the Million Veteran Program Suicide Exemplar Workgroup, the International Suicide Genetics Consortium, the Veterans Affairs Mid-Atlantic Mental Illness Research, Education, and Clinical Center Workgroup, and the Veterans Affairs Million Veteran Program
| | | |
Collapse
|
10
|
Kimbrel NA, Ashley-Koch AE, Qin XJ, Lindquist JH, Garrett ME, Dennis MF, Hair LP, Huffman JE, Jacobson DA, Madduri RK, Trafton JA, Coon H, Docherty AR, Kang J, Mullins N, Ruderfer DM, Harvey PD, McMahon BH, Oslin DW, Hauser ER, Hauser MA, Beckham JC. A genome-wide association study of suicide attempts in the million veterans program identifies evidence of pan-ancestry and ancestry-specific risk loci. Mol Psychiatry 2022; 27:2264-2272. [PMID: 35347246 PMCID: PMC9910180 DOI: 10.1038/s41380-022-01472-3] [Citation(s) in RCA: 29] [Impact Index Per Article: 14.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/21/2021] [Revised: 12/16/2021] [Accepted: 02/02/2022] [Indexed: 12/30/2022]
Abstract
To identify pan-ancestry and ancestry-specific loci associated with attempting suicide among veterans, we conducted a genome-wide association study (GWAS) of suicide attempts within a large, multi-ancestry cohort of U.S. veterans enrolled in the Million Veterans Program (MVP). Cases were defined as veterans with a documented history of suicide attempts in the electronic health record (EHR; N = 14,089) and controls were defined as veterans with no documented history of suicidal thoughts or behaviors in the EHR (N = 395,064). GWAS was performed separately in each ancestry group, controlling for sex, age and genetic substructure. Pan-ancestry risk loci were identified through meta-analysis and included two genome-wide significant loci on chromosomes 20 (p = 3.64 × 10-9) and 1 (p = 3.69 × 10-8). A strong pan-ancestry signal at the Dopamine Receptor D2 locus (p = 1.77 × 10-7) was also identified and subsequently replicated in a large, independent international civilian cohort (p = 7.97 × 10-4). Additionally, ancestry-specific genome-wide significant loci were also detected in African-Americans, European-Americans, Asian-Americans, and Hispanic-Americans. Pathway analyses suggested over-representation of many biological pathways with high clinical significance, including oxytocin signaling, glutamatergic synapse, cortisol synthesis and secretion, dopaminergic synapse, and circadian rhythm. These findings confirm that the genetic architecture underlying suicide attempt risk is complex and includes both pan-ancestry and ancestry-specific risk loci. Moreover, pathway analyses suggested many commonly impacted biological pathways that could inform development of improved therapeutics for suicide prevention.
Collapse
Affiliation(s)
- Nathan A Kimbrel
- Durham Veterans Affairs (VA) Health Care System, Durham, NC, USA.
- VA Mid-Atlantic Mental Illness Research, Education and Clinical Center, Durham, NC, USA.
- VA Health Services Research and Development Center of Innovation to Accelerate Discovery and Practice Transformation, Durham, NC, USA.
- Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, NC, USA.
| | - Allison E Ashley-Koch
- Duke Molecular Physiology Institute, Durham, NC, USA
- Department of Medicine, Duke University Health System, Durham, NC, USA
| | - Xue J Qin
- Durham Veterans Affairs (VA) Health Care System, Durham, NC, USA
- Duke Molecular Physiology Institute, Durham, NC, USA
| | - Jennifer H Lindquist
- VA Health Services Research and Development Center of Innovation to Accelerate Discovery and Practice Transformation, Durham, NC, USA
| | | | - Michelle F Dennis
- Durham Veterans Affairs (VA) Health Care System, Durham, NC, USA
- Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, NC, USA
| | - Lauren P Hair
- Durham Veterans Affairs (VA) Health Care System, Durham, NC, USA
- Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, NC, USA
| | - Jennifer E Huffman
- Massachusetts Veterans Epidemiology Research and Information Center (MAVERIC), VA Boston Healthcare System, Boston, MA, USA
| | - Daniel A Jacobson
- Biosciences, Oak Ridge National Laboratory, Oak Ridge, TN, USA
- Bredesen Center for Interdisciplinary Research and Graduate Education, University of Tennessee Knoxville, Knoxville, TN, USA
- Department of Psychology, NeuroNet Research Center, University of Tennessee Knoxville, Knoxville, TN, USA
| | - Ravi K Madduri
- Consortium for Advanced Science and Engineering, The University of Chicago, Chicago, IL, USA
- Data Science and Learning Division, Argonne National Laboratory, Lemont, IL, USA
| | - Jodie A Trafton
- Program Evaluation and Resource Center, Office of Mental Health and Suicide Prevention, VA Palo Alto Health Care System, Menlo Park, CA, USA
| | - Hilary Coon
- Department of Psychiatry, Huntsman Mental Health Institute, University of Utah School of Medicine, Salt Lake City, UT, US
- Biomedical Informatics, University of Utah School of Medicine, Salt Lake City, UT, US
| | - Anna R Docherty
- Department of Psychiatry, Huntsman Mental Health Institute, University of Utah School of Medicine, Salt Lake City, UT, US
- Department of Psychiatry, Virginia Commonwealth University, Richmond, VA, US
| | - Jooeun Kang
- Division of Genetic Medicine, Department of Medicine, Vanderbilt Genetics Institute, Vanderbilt University Medical Center, Nashville, TN, US
| | - Niamh Mullins
- Department of Genetics and Genomic Sciences, Icahn School of Medicine at Mount Sinai, New York, NY, US
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, US
| | - Douglas M Ruderfer
- Division of Genetic Medicine, Department of Medicine, Vanderbilt Genetics Institute, Vanderbilt University Medical Center, Nashville, TN, US
- Department of Biomedical Informatics, Vanderbilt University Medical Center, Nashville, TN, US
- Department of Psychiatry and Behavioral Sciences, Vanderbilt University Medical Center, Nashville, TN, US
| | - Philip D Harvey
- Department of Psychiatry and Behavioral Sciences, University of Miami Miller School of Medicine, Miami, FL, USA
- Research Service Bruce W. Carter VA Medical Center, Miami, FL, USA
| | - Benjamin H McMahon
- Theoretical Biology and Biophysics, Los Alamos National Laboratory, Los Alamos, NM, USA
| | - David W Oslin
- VISN 4 Mental Illness Research, Education, and Clinical Center, Center of Excellence, Corporal Michael J. Crescenz VA Medical Center, Philadelphia, PA, USA
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Elizabeth R Hauser
- Durham Veterans Affairs (VA) Health Care System, Durham, NC, USA
- Duke Molecular Physiology Institute, Durham, NC, USA
| | - Michael A Hauser
- Duke Molecular Physiology Institute, Durham, NC, USA
- Department of Medicine, Duke University Health System, Durham, NC, USA
| | - Jean C Beckham
- Durham Veterans Affairs (VA) Health Care System, Durham, NC, USA
- VA Mid-Atlantic Mental Illness Research, Education and Clinical Center, Durham, NC, USA
- Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, NC, USA
| |
Collapse
|
11
|
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
|
12
|
Van Voorhees EE, Dennis PA, Watkins LL, Patel TA, Calhoun PS, Dennis MF, Beckham JC. Ambulatory Heart Rate Variability Monitoring: Comparisons Between the Empatica E4 Wristband and Holter Electrocardiogram. Psychosom Med 2022; 84:210-214. [PMID: 35143136 PMCID: PMC8851683 DOI: 10.1097/psy.0000000000001010] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [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] [Indexed: 01/03/2023]
Abstract
OBJECTIVE Heart rate variability (HRV) is a useful index of psychological and physiological stress. Although several wristband devices have purported to measure HRV, none have demonstrated reliability when compared with the criterion-standard Holter monitor. We evaluated the reliability of HRV readings from the Empatica E4 wristband compared with a Holter monitor over a 24-hour period of simultaneous monitoring. METHODS Agreement between the monitors was assessed by examining correlations and intraclass correlations (ICCs) for fixed sets in 13 individuals in a treatment trial for posttraumatic stress disorder (4 women; mean [standard deviation] age = 51.92 [6.17] years). Agreement was calculated at 1-second and 5-minute intervals for interbeat intervals (IBIs) and for 5-minute intervals of the root mean square of successive differences between normal heartbeats (RMSSD) and standard deviation of all normal R-R intervals (SDNN). Agreement across the entire 24-hour observation period was also measured. Frequency-domain measures of HRV could not be calculated because of too much missing data from the E4. RESULTS Although high interdevice correlations and ICCs were observed between the E4 and Holter monitors for IBIs at 1-second (median r = 0.88; median ICC = 0.87) and 5-minute (median r = 0.94; median ICC = 0.94) intervals, reliabilities for 5-minute RMSSD (median r = -0.09; median ICC = -0.05) and 5-minute SDNN (median r = 0.48; median ICC = 0.47) were poor. Agreement between the devices on 24-hour measures of HRV was satisfactory (IBI: r = 0.97, ICC = 0.97; RMSSD: r = 0.77, IBI = 0.76; SDNN: r = 0.92, IBI = 0.89). CONCLUSIONS Findings suggest that the low reliability of Empatica E4 as compared with the Holter monitor does not justify its use in ambulatory research for the measurement of HRV over time periods of 5 minutes or less.
Collapse
Affiliation(s)
- Elizabeth E Van Voorhees
- From the Durham Veterans Affairs Medical Center (Van Voorhees, P.A. Dennis, Patel, Calhoun, M.F. Dennis, Beckham); Department of Psychiatry and Behavioral Sciences, Duke University Medical Center (Van Voorhees, P.A. Dennis, Watkins, Patel, Calhoun, M.F. Dennis, Beckham); Veterans Affairs Mid-Atlantic Region Mental Illness Research, Education, and Clinical Center (Calhoun, Beckham), Durham; and Durham Veterans Affairs Center for Health Services Research in Primary Care (Calhoun), Durham, North Carolina
| | | | | | | | | | | | | |
Collapse
|
13
|
Garrett ME, Qin XJ, Mehta D, Dennis MF, Marx CE, Grant GA, Stein MB, Kimbrel NA, Beckham JC, Hauser MA, Ashley-Koch AE. Gene Expression Analysis in Three Posttraumatic Stress Disorder Cohorts Implicates Inflammation and Innate Immunity Pathways and Uncovers Shared Genetic Risk With Major Depressive Disorder. Front Neurosci 2021; 15:678548. [PMID: 34393704 PMCID: PMC8358297 DOI: 10.3389/fnins.2021.678548] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2021] [Accepted: 07/07/2021] [Indexed: 01/09/2023] Open
Abstract
Posttraumatic stress disorder (PTSD) is a complex psychiatric disorder that can develop following exposure to traumatic events. The Psychiatric Genomics Consortium PTSD group (PGC-PTSD) has collected over 20,000 multi-ethnic PTSD cases and controls and has identified both genetic and epigenetic factors associated with PTSD risk. To further investigate biological correlates of PTSD risk, we examined three PGC-PTSD cohorts comprising 977 subjects to identify differentially expressed genes among PTSD cases and controls. Whole blood gene expression was quantified with the HumanHT-12 v4 Expression BeadChip for 726 OEF/OIF veterans from the Veterans Affairs (VA) Mental Illness Research Education and Clinical Center (MIRECC), 155 samples from the Injury and Traumatic Stress (INTRuST) Clinical Consortium, and 96 Australian Vietnam War veterans. Differential gene expression analysis was performed in each cohort separately followed by meta-analysis. In the largest cohort, we performed co-expression analysis to identify modules of genes that are associated with PTSD and MDD. We then conducted expression quantitative trait loci (eQTL) analysis and assessed the presence of eQTL interactions involving PTSD and major depressive disorder (MDD). Finally, we utilized PTSD and MDD GWAS summary statistics to identify regions that colocalize with eQTLs. Although not surpassing correction for multiple testing, the most differentially expressed genes in meta-analysis were interleukin-1 beta (IL1B), a pro-inflammatory cytokine previously associated with PTSD, and integrin-linked kinase (ILK), which is highly expressed in brain and can rescue dysregulated hippocampal neurogenesis and memory deficits. Pathway analysis revealed enrichment of toll-like receptor (TLR) and interleukin-1 receptor genes, which are integral to cellular innate immune response. Co-expression analysis identified four modules of genes associated with PTSD, two of which are also associated with MDD, demonstrating common biological pathways underlying the two conditions. Lastly, we identified four genes (UBA7, HLA-F, HSPA1B, and RERE) with high probability of a shared causal eQTL variant with PTSD and/or MDD GWAS variants, thereby providing a potential mechanism by which the GWAS variant contributes to disease risk. In summary, we provide additional evidence for genes and pathways previously reported and identified plausible novel candidates for PTSD. These data provide further insight into genetic factors and pathways involved in PTSD, as well as potential regions of pleiotropy between PTSD and MDD.
Collapse
Affiliation(s)
- Melanie E Garrett
- Duke Molecular Physiology Institute, Duke University Medical Center, Durham, NC, United States
| | - Xue Jun Qin
- Duke Molecular Physiology Institute, Duke University Medical Center, Durham, NC, United States
| | - Divya Mehta
- Queensland University of Technology, Centre for Genomics and Personalised Health, Faculty of Health, Institute of Health and Biomedical Innovation, Kelvin Grove, QLD, Australia
| | - Michelle F Dennis
- Durham Veterans Affairs Health Care System, Durham, NC, United States.,VA Mid-Atlantic Mental Illness Research, Education, and Clinical Center, Durham, NC United States.,Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, NC, United States
| | - Christine E Marx
- Durham Veterans Affairs Health Care System, Durham, NC, United States.,VA Mid-Atlantic Mental Illness Research, Education, and Clinical Center, Durham, NC United States.,Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, NC, United States
| | - Gerald A Grant
- Department of Neurosurgery, Stanford University School of Medicine, Stanford, CA, United States
| | | | | | | | | | - Murray B Stein
- Department of Psychiatry, School of Medicine, University of California, San Diego, La Jolla, CA, United States.,Herbert Wertheim School of Public Health, University of California, San Diego, La Jolla, CA, United States.,VA San Diego Healthcare System, San Diego, CA, United States
| | - Nathan A Kimbrel
- Durham Veterans Affairs Health Care System, Durham, NC, United States.,VA Mid-Atlantic Mental Illness Research, Education, and Clinical Center, Durham, NC United States.,Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, NC, United States
| | - Jean C Beckham
- Durham Veterans Affairs Health Care System, Durham, NC, United States.,VA Mid-Atlantic Mental Illness Research, Education, and Clinical Center, Durham, NC United States.,Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, NC, United States
| | - Michael A Hauser
- Duke Molecular Physiology Institute, Duke University Medical Center, Durham, NC, United States
| | - Allison E Ashley-Koch
- Duke Molecular Physiology Institute, Duke University Medical Center, Durham, NC, United States
| |
Collapse
|
14
|
Sumner JA, Maihofer AX, Michopoulos V, Rothbaum AO, Almli LM, Andreassen OA, Ashley-Koch AE, Baker DG, Beckham JC, Bradley B, Breen G, Coleman JRI, Dale AM, Dennis MF, Feeny NC, Franz CE, Garrett ME, Gillespie CF, Guffanti G, Hauser MA, Hemmings SMJ, Jovanovic T, Kimbrel NA, Kremen WS, Lawford BR, Logue MW, Lori A, Lyons MJ, Maples-Keller J, Mavissakalian MR, McGlinchey RE, Mehta D, Mellor R, Milberg W, Miller MW, Morris CP, Panizzon MS, Ressler KJ, Risbrough VB, Rothbaum BO, Roy-Byrne P, Seedat S, Smith AK, Stevens JS, van den Heuvel LL, Voisey J, Young RM, Zoellner LA, Nievergelt CM, Wolf EJ. Examining Individual and Synergistic Contributions of PTSD and Genetics to Blood Pressure: A Trans-Ethnic Meta-Analysis. Front Neurosci 2021; 15:678503. [PMID: 34248484 PMCID: PMC8262489 DOI: 10.3389/fnins.2021.678503] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [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: 03/09/2021] [Accepted: 05/10/2021] [Indexed: 11/13/2022] Open
Abstract
Growing research suggests that posttraumatic stress disorder (PTSD) may be a risk factor for poor cardiovascular health, and yet our understanding of who might be at greatest risk of adverse cardiovascular outcomes after trauma is limited. In this study, we conducted the first examination of the individual and synergistic contributions of PTSD symptoms and blood pressure genetics to continuous blood pressure levels. We harnessed the power of the Psychiatric Genomics Consortium-PTSD Physical Health Working Group and investigated these associations across 11 studies of 72,224 trauma-exposed individuals of European (n = 70,870) and African (n = 1,354) ancestry. Genetic contributions to blood pressure were modeled via polygenic scores (PGS) for systolic blood pressure (SBP) and diastolic blood pressure (DBP) that were derived from a prior trans-ethnic blood pressure genome-wide association study (GWAS). Results of trans-ethnic meta-analyses revealed significant main effects of the PGS on blood pressure levels [SBP: β = 2.83, standard error (SE) = 0.06, p < 1E-20; DBP: β = 1.32, SE = 0.04, p < 1E-20]. Significant main effects of PTSD symptoms were also detected for SBP and DBP in trans-ethnic meta-analyses, though there was significant heterogeneity in these results. When including data from the largest contributing study - United Kingdom Biobank - PTSD symptoms were negatively associated with SBP levels (β = -1.46, SE = 0.44, p = 9.8E-4) and positively associated with DBP levels (β = 0.70, SE = 0.26, p = 8.1E-3). However, when excluding the United Kingdom Biobank cohort in trans-ethnic meta-analyses, there was a nominally significant positive association between PTSD symptoms and SBP levels (β = 2.81, SE = 1.13, p = 0.01); no significant association was observed for DBP (β = 0.43, SE = 0.78, p = 0.58). Blood pressure PGS did not significantly moderate the associations between PTSD symptoms and blood pressure levels in meta-analyses. Additional research is needed to better understand the extent to which PTSD is associated with high blood pressure and how genetic as well as contextual factors may play a role in influencing cardiovascular risk.
Collapse
Affiliation(s)
- Jennifer A. Sumner
- Department of Psychology, University of California, Los Angeles, Los Angeles, CA, United States,*Correspondence: Jennifer A. Sumner,
| | - Adam X. Maihofer
- Department of Psychiatry, University of California, San Diego, San Diego, CA, United States,Veterans Affairs San Diego Healthcare System, VA Center of Excellence for Stress and Mental Health (CESAMH), San Diego, CA, United States
| | - Vasiliki Michopoulos
- Department of Psychiatry and Behavioral Sciences, Emory University, Atlanta, GA, United States,Yerkes National Primate Research Center, Atlanta, GA, United States
| | - Alex O. Rothbaum
- Department of Psychological Sciences, Case Western Reserve University, Cleveland, OH, United States
| | - Lynn M. Almli
- National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, GA, United States
| | - Ole A. Andreassen
- NORMENT, Institute of Clinical Medicine, University of Oslo, Oslo, Norway,Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway
| | | | - Dewleen G. Baker
- Department of Psychiatry, University of California, San Diego, San Diego, CA, United States,Veterans Affairs San Diego Healthcare System, VA Center of Excellence for Stress and Mental Health (CESAMH), San Diego, CA, United States
| | - Jean C. Beckham
- Durham VA Health Care System, Durham, NC, United States,Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, NC, United States,VA Mid-Atlantic Mental Illness Research, Education, and Clinical Center (MIRECC), Genetics Research Laboratory, Durham, NC, United States
| | - Bekh Bradley
- Department of Psychiatry and Behavioral Sciences, Emory University, Atlanta, GA, United States,Atlanta VA Health Care System, Decatur, GA, United States
| | - Gerome Breen
- Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology, and Neuroscience, King’s College London, London, United Kingdom,NIHR BRC at the Maudsley, King’s College London, London, United Kingdom
| | - Jonathan R. I. Coleman
- Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology, and Neuroscience, King’s College London, London, United Kingdom,NIHR BRC at the Maudsley, King’s College London, London, United Kingdom
| | - Anders M. Dale
- Department of Radiology, University of California, San Diego, San Diego, CA, United States,Department of Neurosciences, University of California, San Diego, San Diego, CA, United States
| | - Michelle F. Dennis
- Durham VA Health Care System, Durham, NC, United States,Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, NC, United States,VA Mid-Atlantic Mental Illness Research, Education, and Clinical Center (MIRECC), Genetics Research Laboratory, Durham, NC, United States
| | - Norah C. Feeny
- Department of Psychological Sciences, Case Western Reserve University, Cleveland, OH, United States
| | - Carol E. Franz
- Department of Psychiatry, University of California, San Diego, San Diego, CA, United States
| | - Melanie E. Garrett
- Duke Molecular Physiology Institute, Duke University, Durham, NC, United States
| | - Charles F. Gillespie
- Department of Psychiatry and Behavioral Sciences, Emory University, Atlanta, GA, United States
| | - Guia Guffanti
- Department of Psychiatry, Harvard Medical School, Boston, MA, United States,McLean Hospital, Belmont, MA, United States
| | - Michael A. Hauser
- Duke Molecular Physiology Institute, Duke University, Durham, NC, United States
| | - Sian M. J. Hemmings
- Department of Psychiatry, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa,South African Medical Research Council/Stellenbosch University Genomics of Brain Disorders Research Unit, Faculty of Medicine & Health Sciences, Stellenbosch University, Cape Town, South Africa
| | - Tanja Jovanovic
- Department of Psychiatry and Behavioral Neurosciences, School of Medicine, Wayne State University, Detroit, MI, United States
| | - Nathan A. Kimbrel
- Durham VA Health Care System, Durham, NC, United States,Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, NC, United States,VA Mid-Atlantic Mental Illness Research, Education, and Clinical Center (MIRECC), Genetics Research Laboratory, Durham, NC, United States
| | - William S. Kremen
- Department of Psychiatry, University of California, San Diego, San Diego, CA, United States,Veterans Affairs San Diego Healthcare System, VA Center of Excellence for Stress and Mental Health (CESAMH), San Diego, CA, United States
| | - Bruce R. Lawford
- School of Biomedical Sciences, Queensland University of Technology, Kelvin Grove, QLD, Australia
| | - Mark W. Logue
- National Center for PTSD, Behavioral Science Division, VA Boston Healthcare System, Boston, MA, United States,Department of Psychiatry, Boston University School of Medicine, Boston, MA, United States,Department of Biostatistics, Boston University School of Public Health, Boston, MA, United States,Biomedical Genetics, Boston University School of Medicine, Boston, MA, United States
| | - Adriana Lori
- Department of Gynecology and Obstetrics, Emory University, Atlanta, GA, United States
| | - Michael J. Lyons
- Department of Psychological & Brain Sciences, Boston University, Boston, MA, United States
| | - Jessica Maples-Keller
- Department of Psychiatry and Behavioral Sciences, Emory University, Atlanta, GA, United States
| | | | | | - Divya Mehta
- Center for Genomics and Personalised Health, Queensland University of Technology, Kelvin Grove, QLD, Australia
| | - Rebecca Mellor
- Gallipoli Medical Research Foundation, Greenslopes Private Hospital, Brisbane, QLD, Australia
| | - William Milberg
- GRECC/TRACTS, VA Boston Healthcare System, Boston, MA, United States
| | - Mark W. Miller
- National Center for PTSD, Behavioral Science Division, VA Boston Healthcare System, Boston, MA, United States,Department of Psychiatry, Boston University School of Medicine, Boston, MA, United States
| | - Charles Phillip Morris
- School of Biomedical Sciences, Queensland University of Technology, Kelvin Grove, QLD, Australia
| | - Matthew S. Panizzon
- Department of Psychiatry, University of California, San Diego, San Diego, CA, United States
| | - Kerry J. Ressler
- Department of Psychiatry and Behavioral Sciences, Emory University, Atlanta, GA, United States,Department of Psychiatry, Harvard Medical School, Boston, MA, United States,McLean Hospital, Belmont, MA, United States
| | - Victoria B. Risbrough
- Department of Psychiatry, University of California, San Diego, San Diego, CA, United States,Veterans Affairs San Diego Healthcare System, VA Center of Excellence for Stress and Mental Health (CESAMH), San Diego, CA, United States
| | - Barbara O. Rothbaum
- Department of Psychiatry and Behavioral Sciences, Emory University, Atlanta, GA, United States
| | - Peter Roy-Byrne
- Department of Psychology, University of Washington, Seattle, WA, United States
| | - Soraya Seedat
- Department of Psychiatry, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa,South African Medical Research Council/Stellenbosch University Genomics of Brain Disorders Research Unit, Faculty of Medicine & Health Sciences, Stellenbosch University, Cape Town, South Africa
| | - Alicia K. Smith
- Department of Psychiatry and Behavioral Sciences, Emory University, Atlanta, GA, United States,Department of Gynecology and Obstetrics, Emory University, Atlanta, GA, United States
| | - Jennifer S. Stevens
- Department of Psychiatry and Behavioral Sciences, Emory University, Atlanta, GA, United States
| | - Leigh Luella van den Heuvel
- Department of Psychiatry, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa,South African Medical Research Council/Stellenbosch University Genomics of Brain Disorders Research Unit, Faculty of Medicine & Health Sciences, Stellenbosch University, Cape Town, South Africa
| | - Joanne Voisey
- School of Biomedical Sciences, Queensland University of Technology, Kelvin Grove, QLD, Australia,Center for Genomics and Personalised Health, Queensland University of Technology, Kelvin Grove, QLD, Australia
| | - Ross McD Young
- School of Psychology and Counseling, Queensland University of Technology, Kelvin Grove, QLD, Australia
| | - Lori A. Zoellner
- Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, WA, United States
| | - Caroline M. Nievergelt
- Department of Psychiatry, University of California, San Diego, San Diego, CA, United States,Veterans Affairs San Diego Healthcare System, VA Center of Excellence for Stress and Mental Health (CESAMH), San Diego, CA, United States
| | - Erika J. Wolf
- National Center for PTSD, Behavioral Science Division, VA Boston Healthcare System, Boston, MA, United States,Department of Psychiatry, Boston University School of Medicine, Boston, MA, United States
| |
Collapse
|
15
|
LoSavio ST, Beckham JC, Wells SY, Resick PA, Sherwood A, Coffman CJ, Kirby AC, Beaver TA, Dennis MF, Watkins LL. The effect of reducing posttraumatic stress disorder symptoms on cardiovascular risk: Design and methodology of a randomized clinical trial. Contemp Clin Trials 2021; 102:106269. [PMID: 33429088 PMCID: PMC8009821 DOI: 10.1016/j.cct.2021.106269] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2020] [Revised: 11/19/2020] [Accepted: 12/31/2020] [Indexed: 12/19/2022]
Abstract
Posttraumatic stress disorder (PTSD) has been associated with accelerated progression of coronary heart disease (CHD). However, the underlying pathophysiological pathway has remained elusive and it is unclear whether there is a direct link between PTSD and CHD risk. This paper describes the methods of a randomized controlled trial developed to examine how changes in PTSD symptoms affect CHD disease pathways. One hundred twenty participants with current PTSD and who are free of known CHD will be randomized to receive either an evidence-based treatment for PTSD (Cognitive Processing Therapy; CPT) or a waitlist control (WL). Before and after CPT/WL, participants undergo assessment of CHD risk biomarkers reflecting autonomic nervous system dysregulation, systemic inflammation, and vascular endothelial dysfunction. The primary hypothesis is that individuals who show improvement in PTSD symptoms will show improvement in CHD risk biomarkers, whereas individuals who fail to improve or show worsening PTSD symptoms will have no change or worsening in CHD biomarkers. This study is expected to provide knowledge of the role of both the direct impact of PTSD symptoms on CHD risk pathways and the role of these systems as candidate mechanisms underlying the relationship between PTSD and CHD risk. Further, results will provide guidance on the utility of cognitive therapy as a tool to mitigate the accelerated progression of CHD in PTSD. Clinical Trials Registration: https://clinicaltrials.gov/ct2/show/NCT02736929; Unique identifier: NCT02736929.
Collapse
Affiliation(s)
| | - Jean C Beckham
- Duke University Medical Center, Durham, NC, USA; Durham VA Healthcare System, Durham, NC, USA
| | - Stephanie Y Wells
- Duke University Medical Center, Durham, NC, USA; Durham VA Healthcare System, Durham, NC, USA; VA Mid-Atlantic Mental Illness Research, Education, and Clinical Center, Durham, NC, United States of America
| | | | | | - Cynthia J Coffman
- VA Mid-Atlantic Mental Illness Research, Education, and Clinical Center, Durham, NC, United States of America; Center of Innovation to Accelerate Discovery and Practice Transformation, Durham VA Healthcare System, Durham, NC, United States of America
| | - Angela C Kirby
- Duke University Medical Center, Durham, NC, USA; Durham VA Healthcare System, Durham, NC, USA; VA Mid-Atlantic Mental Illness Research, Education, and Clinical Center, Durham, NC, United States of America
| | - Tiffany A Beaver
- Duke University Medical Center, Durham, NC, USA; Durham VA Healthcare System, Durham, NC, USA
| | - Michelle F Dennis
- Duke University Medical Center, Durham, NC, USA; Durham VA Healthcare System, Durham, NC, USA
| | | |
Collapse
|
16
|
Morey RA, Garrett ME, Stevens JS, Clarke EK, Haswell CC, van Rooij SJ, Fani N, Lori A, Mirecc Workgroup VMA, Kimbrel NA, Dennis MF, Marx CE, Beckham JC, McCarthy G, Hauser MA, Ashley-Koch AE. Genetic predictors of hippocampal subfield volume in PTSD cases and trauma-exposed controls. Eur J Psychotraumatol 2020; 11:1785994. [PMID: 33029326 PMCID: PMC7473168 DOI: 10.1080/20008198.2020.1785994] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/16/2020] [Accepted: 06/02/2020] [Indexed: 12/12/2022] Open
Abstract
Behavioural, structural, and functional neuroimaging have implicated the hippocampus as a critical brain region in posttraumatic stress disorder (PTSD) pathogenesis. Recent work in a normative, primarily European, sample identified 15 unique genetic loci contributing to structural variability in six hippocampal subfield volumes. We explored the relevance of these loci in two samples (Mental Illness Research Education and Clinical Centre [MIRECC] and Grady; n = 290) of trauma-exposed individuals enriched for PTSD and of diverse ancestry. Four of the previous loci demonstrated nominal evidence of replication in the MIRECC dataset, primarily within non-Hispanic whites (NHW). One locus replicated in the Grady cohort, which was composed exclusively of non-Hispanic blacks (NHB). Our data supported genetic interactions with diagnosis of lifetime PTSD and genetic interactions with childhood trauma in the MIRECC sample, but not the Grady sample. Given the racial, diagnostic, and trauma-exposure differences with the original genome-wide association study (GWAS) report, we conducted a full GWAS in the MIRECC and Grady datasets. Interactions between genetic variants and lifetime PTSD or childhood trauma were interrogated for single nucleotide polymorphisms (SNPs) with evidence of main effects. Genetic associations surpassed false discovery rate (FDR)-correction within hippocampal subfields in fimbria, subiculum, cornu ammonis-1 (CA1), and hippocampal amygdala transition area (HATA). One association was replicated in the Grady cohort (rs12880795 in TUNAR with left (L)-HATA volume). The most significant association in the MIRECC dataset was between rs6906714 in LINC02571 and right (R)-fimbria volume (p = 5.99×10-8, q = 0.0056). Interestingly, the effect of rs6906714 on R-fimbria volume increased with exposure to childhood trauma (gene*environment [G*E] interaction p = 0.022). These preliminary results argue for G*E interactions between genetic loci with PTSD and childhood trauma on hippocampal phenotypes. Our results underscore the need for larger neuroimaging-genetic studies in PTSD, trauma, and ancestrally diverse populations.
Collapse
Affiliation(s)
- Rajendra A. Morey
- VA Mid-Atlantic Mental Illness Research Education and Clinical Center, Durham VAMC, Durham, NC, USA
- Department of Psychiatry and Behavioral Sciences, Duke University, Durham, NC, USA
- Duke-UNC Brain Imaging and Analysis Center, Duke University, Durham, NC, USA
| | - Melanie E. Garrett
- VA Mid-Atlantic Mental Illness Research Education and Clinical Center, Durham VAMC, Durham, NC, USA
- Duke Molecular Physiology Institute, Duke University Medical Center, Durham, NC, USA
| | - Jennifer S. Stevens
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA, USA
| | - Emily K. Clarke
- VA Mid-Atlantic Mental Illness Research Education and Clinical Center, Durham VAMC, Durham, NC, USA
- Duke-UNC Brain Imaging and Analysis Center, Duke University, Durham, NC, USA
| | - Courtney C. Haswell
- VA Mid-Atlantic Mental Illness Research Education and Clinical Center, Durham VAMC, Durham, NC, USA
- Duke-UNC Brain Imaging and Analysis Center, Duke University, Durham, NC, USA
| | - Sanne J.H. van Rooij
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA, USA
| | - Negar Fani
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA, USA
| | - Adriana Lori
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA, USA
| | | | - Nathan A. Kimbrel
- VA Mid-Atlantic Mental Illness Research Education and Clinical Center, Durham VAMC, Durham, NC, USA
| | - Michelle F. Dennis
- VA Mid-Atlantic Mental Illness Research Education and Clinical Center, Durham VAMC, Durham, NC, USA
| | - Christine E. Marx
- VA Mid-Atlantic Mental Illness Research Education and Clinical Center, Durham VAMC, Durham, NC, USA
- Department of Psychiatry and Behavioral Sciences, Duke University, Durham, NC, USA
| | - Jean C. Beckham
- VA Mid-Atlantic Mental Illness Research Education and Clinical Center, Durham VAMC, Durham, NC, USA
| | | | - Michael A. Hauser
- VA Mid-Atlantic Mental Illness Research Education and Clinical Center, Durham VAMC, Durham, NC, USA
- Duke Molecular Physiology Institute, Duke University Medical Center, Durham, NC, USA
| | - Allison E. Ashley-Koch
- VA Mid-Atlantic Mental Illness Research Education and Clinical Center, Durham VAMC, Durham, NC, USA
- Duke Molecular Physiology Institute, Duke University Medical Center, Durham, NC, USA
| |
Collapse
|
17
|
Grasby KL, Jahanshad N, Painter JN, Colodro-Conde L, Bralten J, Hibar DP, Lind PA, Pizzagalli F, Ching CRK, McMahon MAB, Shatokhina N, Zsembik LCP, Thomopoulos SI, Zhu AH, Strike LT, Agartz I, Alhusaini S, Almeida MAA, Alnæs D, Amlien IK, Andersson M, Ard T, Armstrong NJ, Ashley-Koch A, Atkins JR, Bernard M, Brouwer RM, Buimer EEL, Bülow R, Bürger C, Cannon DM, Chakravarty M, Chen Q, Cheung JW, Couvy-Duchesne B, Dale AM, Dalvie S, de Araujo TK, de Zubicaray GI, de Zwarte SMC, den Braber A, Doan NT, Dohm K, Ehrlich S, Engelbrecht HR, Erk S, Fan CC, Fedko IO, Foley SF, Ford JM, Fukunaga M, Garrett ME, Ge T, Giddaluru S, Goldman AL, Green MJ, Groenewold NA, Grotegerd D, Gurholt TP, Gutman BA, Hansell NK, Harris MA, Harrison MB, Haswell CC, Hauser M, Herms S, Heslenfeld DJ, Ho NF, Hoehn D, Hoffmann P, Holleran L, Hoogman M, Hottenga JJ, Ikeda M, Janowitz D, Jansen IE, Jia T, Jockwitz C, Kanai R, Karama S, Kasperaviciute D, Kaufmann T, Kelly S, Kikuchi M, Klein M, Knapp M, Knodt AR, Krämer B, Lam M, Lancaster TM, Lee PH, Lett TA, Lewis LB, Lopes-Cendes I, Luciano M, Macciardi F, Marquand AF, Mathias SR, Melzer TR, Milaneschi Y, Mirza-Schreiber N, Moreira JCV, Mühleisen TW, Müller-Myhsok B, Najt P, Nakahara S, Nho K, Loohuis LMO, Orfanos DP, Pearson JF, Pitcher TL, Pütz B, Quidé Y, Ragothaman A, Rashid FM, Reay WR, Redlich R, Reinbold CS, Repple J, Richard G, Riede BC, Risacher SL, Rocha CS, Mota NR, Salminen L, Saremi A, Saykin AJ, Schlag F, Schmaal L, Schofield PR, Secolin R, Shapland CY, Shen L, Shin J, Shumskaya E, Sønderby IE, Sprooten E, Tansey KE, Teumer A, Thalamuthu A, Tordesillas-Gutiérrez D, Turner JA, Uhlmann A, Vallerga CL, van derMeer D, van Donkelaar MMJ, van Eijk L, van Erp TGM, van Haren NEM, van Rooij D, van Tol MJ, Veldink JH, Verhoef E, Walton E, Wang M, Wang Y, Wardlaw JM, Wen W, Westlye LT, Whelan CD, Witt SH, Wittfeld K, Wolf C, Wolfers T, Wu JQ, Yasuda CL, Zaremba D, Zhang Z, Zwiers MP, Artiges E, Assareh AA, Ayesa-Arriola R, Belger A, Brandt CL, Brown GG, Cichon S, Curran JE, Davies GE, Degenhardt F, Dennis MF, Dietsche B, Djurovic S, Doherty CP, Espiritu R, Garijo D, Gil Y, Gowland PA, Green RC, Häusler AN, Heindel W, Ho BC, Hoffmann WU, Holsboer F, Homuth G, Hosten N, Jack CR, Jang M, Jansen A, Kimbrel NA, Kolskår K, Koops S, Krug A, Lim KO, Luykx JJ, Mathalon DH, Mather KA, Mattay VS, Matthews S, Van Son JM, McEwen SC, Melle I, Morris DW, Mueller BA, Nauck M, Nordvik JE, Nöthen MM, O’Leary DS, Opel N, Martinot MLP, Pike GB, Preda A, Quinlan EB, Rasser PE, Ratnakar V, Reppermund S, Steen VM, Tooney PA, Torres FR, Veltman DJ, Voyvodic JT, Whelan R, White T, Yamamori H, Adams HHH, Bis JC, Debette S, Decarli C, Fornage M, Gudnason V, Hofer E, Ikram MA, Launer L, Longstreth WT, Lopez OL, Mazoyer B, Mosley TH, Roshchupkin GV, Satizabal CL, Schmidt R, Seshadri S, Yang Q, Alvim MKM, Ames D, Anderson TJ, Andreassen OA, Arias-Vasquez A, Bastin ME, Baune BT, Beckham JC, Blangero J, Boomsma DI, Brodaty H, Brunner HG, Buckner RL, Buitelaar JK, Bustillo JR, Cahn W, Cairns MJ, Calhoun V, Carr VJ, Caseras X, Caspers S, Cavalleri GL, Cendes F, Corvin A, Crespo-Facorro B, Dalrymple-Alford JC, Dannlowski U, de Geus EJC, Deary IJ, Delanty N, Depondt C, Desrivières S, Donohoe G, Espeseth T, Fernández G, Fisher SE, Flor H, Forstner AJ, Francks C, Franke B, Glahn DC, Gollub RL, Grabe HJ, Gruber O, Håberg AK, Hariri AR, Hartman CA, Hashimoto R, Heinz A, Henskens FA, Hillegers MHJ, Hoekstra PJ, Holmes AJ, Hong LE, Hopkins WD, Pol HEH, Jernigan TL, Jönsson EG, Kahn RS, Kennedy MA, Kircher TTJ, Kochunov P, Kwok JBJ, Le Hellard S, Loughland CM, Martin NG, Martinot JL, McDonald C, McMahon KL, Meyer-Lindenberg A, Michie PT, Morey RA, Mowry B, Nyberg L, Oosterlaan J, Ophoff RA, Pantelis C, Paus T, Pausova Z, Penninx BWJH, Polderman TJC, Posthuma D, Rietschel M, Roffman JL, Rowland LM, Sachdev PS, Sämann PG, Schall U, Schumann G, Scott RJ, Sim K, Sisodiya SM, Smoller JW, Sommer IE, St Pourcain B, Stein DJ, Toga AW, Trollor JN, Van der Wee NJA, van ‘t Ent D, Völzke H, Walter H, Weber B, Weinberger DR, Wright MJ, Zhou J, Stein JL, Thompson PM, Medland SE. The genetic architecture of the human cerebral cortex. Science 2020; 367:eaay6690. [PMID: 32193296 PMCID: PMC7295264 DOI: 10.1126/science.aay6690] [Citation(s) in RCA: 350] [Impact Index Per Article: 87.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2019] [Accepted: 02/10/2020] [Indexed: 12/15/2022]
Abstract
The cerebral cortex underlies our complex cognitive capabilities, yet little is known about the specific genetic loci that influence human cortical structure. To identify genetic variants that affect cortical structure, we conducted a genome-wide association meta-analysis of brain magnetic resonance imaging data from 51,665 individuals. We analyzed the surface area and average thickness of the whole cortex and 34 regions with known functional specializations. We identified 199 significant loci and found significant enrichment for loci influencing total surface area within regulatory elements that are active during prenatal cortical development, supporting the radial unit hypothesis. Loci that affect regional surface area cluster near genes in Wnt signaling pathways, which influence progenitor expansion and areal identity. Variation in cortical structure is genetically correlated with cognitive function, Parkinson's disease, insomnia, depression, neuroticism, and attention deficit hyperactivity disorder.
Collapse
Affiliation(s)
- Katrina L. Grasby
- Psychiatric Genetics, QIMR Berghofer Medical Research Institute, Brisbane, QLD, Australia
| | - Neda Jahanshad
- Imaging Genetics Center, Mark and Mary Stevens Neuroimaging and Informatics Institute, Keck School of Medicine of USC, University of Southern California, Los Angeles, CA, USA
| | - Jodie N. Painter
- Psychiatric Genetics, QIMR Berghofer Medical Research Institute, Brisbane, QLD, Australia
| | - Lucía Colodro-Conde
- Psychiatric Genetics, QIMR Berghofer Medical Research Institute, Brisbane, QLD, Australia
- School of Psychology, University of Queensland, Brisbane, QLD, Australia
- School of Biomedical Sciences, Queensland University of Technology, Brisbane, QLD, Australia
- Faculty of Psychology, University of Murcia, Murcia, Spain
| | - Janita Bralten
- Department of Human Genetics, Radboud University Medical Center, Nijmegen, Netherlands
- Donders Institute for Brain, Cognition and Behaviour, Radboud University, Nijmegen, Netherlands
| | - Derrek P. Hibar
- Imaging Genetics Center, Mark and Mary Stevens Neuroimaging and Informatics Institute, Keck School of Medicine of USC, University of Southern California, Los Angeles, CA, USA
- Personalized Healthcare, Genentech, Inc., South San Francisco, CA, USA
| | - Penelope A. Lind
- Psychiatric Genetics, QIMR Berghofer Medical Research Institute, Brisbane, QLD, Australia
- School of Biomedical Sciences, Queensland University of Technology, Brisbane, QLD, Australia
- Faculty of Medicine, University of Queensland, Brisbane, QLD, Australia
| | - Fabrizio Pizzagalli
- Imaging Genetics Center, Mark and Mary Stevens Neuroimaging and Informatics Institute, Keck School of Medicine of USC, University of Southern California, Los Angeles, CA, USA
| | - Christopher R. K. Ching
- Imaging Genetics Center, Mark and Mary Stevens Neuroimaging and Informatics Institute, Keck School of Medicine of USC, University of Southern California, Los Angeles, CA, USA
- Graduate Interdepartmental Program in Neuroscience, University of California Los Angeles, Los Angeles, CA, USA
| | - Mary Agnes B. McMahon
- Imaging Genetics Center, Mark and Mary Stevens Neuroimaging and Informatics Institute, Keck School of Medicine of USC, University of Southern California, Los Angeles, CA, USA
| | - Natalia Shatokhina
- Imaging Genetics Center, Mark and Mary Stevens Neuroimaging and Informatics Institute, Keck School of Medicine of USC, University of Southern California, Los Angeles, CA, USA
| | - Leo C. P. Zsembik
- Department of Genetics and UNC Neuroscience Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Sophia I. Thomopoulos
- Imaging Genetics Center, Mark and Mary Stevens Neuroimaging and Informatics Institute, Keck School of Medicine of USC, University of Southern California, Los Angeles, CA, USA
| | - Alyssa H. Zhu
- Imaging Genetics Center, Mark and Mary Stevens Neuroimaging and Informatics Institute, Keck School of Medicine of USC, University of Southern California, Los Angeles, CA, USA
| | - Lachlan T. Strike
- Queensland Brain Institute, University of Queensland, St Lucia, QLD, Australia
| | - Ingrid Agartz
- NORMENT-K.G. Jebsen Centre for Psychosis Research, Institute of Clinical Medicine, University of Oslo, Oslo, Norway
- Department of Psychiatric Research, Diakonhjemmet Hospital, Oslo, Norway
- Centre for Psychiatric Research, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - Saud Alhusaini
- Department of Molecular and Cellular Therapeutics, Royal College of Surgeons in Ireland, Dublin, Ireland
- Neurology Department, Yale School of Medicine, New Haven, CT, USA
| | - Marcio A. A. Almeida
- Department of Human Genetics and South Texas Diabetes and Obesity Institute, University of Texas Rio Grande Valley School of Medicine, Brownsville, TX, USA
| | - Dag Alnæs
- NORMENT-K.G. Jebsen Centre for Psychosis Research, Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway
- NORMENT-K.G. Jebsen Centre for Psychosis Research, Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Inge K. Amlien
- Centre for Lifespan Changes in Brain and Cognition, Department of Psychology, University of Oslo, Oslo, Norway
| | - Micael Andersson
- Department of Integrative Medical Biology, Umeå University, Umeå, Sweden
- Umeå Center for Functional Brain Imaging, Umeå University, Umeå, Sweden
| | - Tyler Ard
- Laboratory of Neuro Imaging, Mark and Mary Stevens Neuroimaging and Informatics Institute, Keck School of Medicine of the University of Southern California, Los Angeles, CA, USA
| | | | - Allison Ashley-Koch
- Duke Molecular Physiology Institute, Duke University Medical Center, Durham, NC, USA
| | - Joshua R. Atkins
- School of Biomedical Sciences and Pharmacy, University of Newcastle, Callaghan, NSW, Australia
- Priority Centre for Brain and Mental Health Research, University of Newcastle, Callaghan, NSW, Australia
| | - Manon Bernard
- The Hospital for Sick Children, University of Toronto, Toronto, ON, Canada
| | - Rachel M. Brouwer
- Department of Psychiatry, University Medical Center Utrecht Brain Center, University Medical Center Utrecht, Utrecht University, Utrecht, Netherlands
| | - Elizabeth E. L. Buimer
- Department of Psychiatry, University Medical Center Utrecht Brain Center, University Medical Center Utrecht, Utrecht University, Utrecht, Netherlands
| | - Robin Bülow
- Institute for Radiology and Neuroradiology, University Medicine Greifswald, Greifswald, Germany
| | - Christian Bürger
- Department of Psychiatry, University of Münster, Münster, Germany
| | - Dara M. Cannon
- Centre for Neuroimaging and Cognitive Genomics, National University of Ireland Galway, Galway, Ireland
| | - Mallar Chakravarty
- Douglas Mental Health University Institute, McGill University, Montreal, QC, Canada
- Departments of Psychiatry and Biological and Biomedical Engineering, McGill University, Montreal, QC, Canada
| | - Qiang Chen
- Lieber Institute for Brain Development, Baltimore, MD, USA
| | - Joshua W. Cheung
- Imaging Genetics Center, Mark and Mary Stevens Neuroimaging and Informatics Institute, Keck School of Medicine of USC, University of Southern California, Los Angeles, CA, USA
| | - Baptiste Couvy-Duchesne
- Queensland Brain Institute, University of Queensland, St Lucia, QLD, Australia
- Institute for Molecular Bioscience, University of Queensland, Brisbane, QLD, Australia
- Genetic Epidemiology, QIMR Berghofer Medical Research Institute, Brisbane, QLD, Australia
| | - Anders M. Dale
- Department of Neurosciences, University of California, San Diego, La Jolla, CA, USA
- Department of Radiology, University of California San Diego, San Diego, CA, USA
| | - Shareefa Dalvie
- Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa
| | - Tânia K. de Araujo
- Department of Medical Genetics and Genomic Medicine, School of Medical Sciences, University of Campinas-UNICAMP, Campinas, Brazil
- BRAINN-Brazilian Institute of Neuroscience and Neurotechnology, Campinas, Brazil
| | - Greig I. de Zubicaray
- Faculty of Health, Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, QLD, Australia
| | - Sonja M. C. de Zwarte
- Department of Psychiatry, University Medical Center Utrecht Brain Center, University Medical Center Utrecht, Utrecht University, Utrecht, Netherlands
| | - Anouk den Braber
- Department of Biological Psychology, Vrije Universiteit Amsterdam, Amsterdam, Netherlands
- Alzheimer Center Amsterdam, Department of Neurology, Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam UMC, Amsterdam, Netherlands
| | - Nhat Trung Doan
- NORMENT-K.G. Jebsen Centre for Psychosis Research, Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway
- NORMENT-K.G. Jebsen Centre for Psychosis Research, Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Katharina Dohm
- Department of Psychiatry, University of Münster, Münster, Germany
| | - Stefan Ehrlich
- Division of Psychological and Social Medicine and Developmental Neurosciences, Faculty of Medicine, Technische Universität Dresden, Dresden, Germany
| | - Hannah-Ruth Engelbrecht
- Division of Human Genetics, Institute of Infectious Disease and Molecular Medicine, University of Cape Town, Cape Town, South Africa
| | - Susanne Erk
- Division of Mind and Brain Research, Department of Psychiatry and Psychotherapy, Campus Charité Mitte, Charité Universitätsmedizin Berlin corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - Chun Chieh Fan
- Department of Cognitive Science, University of California San Diego, San Diego, CA, USA
| | - Iryna O. Fedko
- Department of Biological Psychology, Vrije Universiteit Amsterdam, Amsterdam, Netherlands
| | - Sonya F. Foley
- Cardiff University Brain Research Imaging Centre, Cardiff University, Cardiff, UK
| | - Judith M. Ford
- San Francisco Veterans Administration Medical Center, San Francisco, CA, USA
| | - Masaki Fukunaga
- Division of Cerebral Integration, National Institute for Physiological Sciences, Okazaki, Japan
| | - Melanie E. Garrett
- Duke Molecular Physiology Institute, Duke University Medical Center, Durham, NC, USA
| | - Tian Ge
- Psychiatric and Neurodevelopmental Genetics Unit, Center for Genomic Medicine, Massachusetts General Hospital, Boston, MA, USA
- Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Boston, MA, USA
| | - Sudheer Giddaluru
- NORMENT K.G. Jebsen Centre for Psychosis Research, Department of Clinical Science, University of Bergen, Bergen, Norway
| | | | - Melissa J. Green
- School of Psychiatry, University of New South Wales, Sydney, NSW, Australia
- Neuroscience Research Australia, Sydney, NSW, Australia
| | - Nynke A. Groenewold
- Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa
| | | | - Tiril P. Gurholt
- NORMENT-K.G. Jebsen Centre for Psychosis Research, Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway
- NORMENT-K.G. Jebsen Centre for Psychosis Research, Institute of Clinical Medicine, University of Oslo, Oslo, Norway
- Department of Psychiatric Research, Diakonhjemmet Hospital, Oslo, Norway
| | - Boris A. Gutman
- Imaging Genetics Center, Mark and Mary Stevens Neuroimaging and Informatics Institute, Keck School of Medicine of USC, University of Southern California, Los Angeles, CA, USA
- Department of Biomedical Engineering, Illinois Institute of Technology, Chicago, IL, USA
| | - Narelle K. Hansell
- Queensland Brain Institute, University of Queensland, St Lucia, QLD, Australia
| | - Mathew A. Harris
- Centre for Clinical Brain Sciences and Edinburgh Imaging, University of Edinburgh, Edinburgh, UK
- Division of Psychiatry, University of Edinburgh, Edinburgh, UK
| | - Marc B. Harrison
- Imaging Genetics Center, Mark and Mary Stevens Neuroimaging and Informatics Institute, Keck School of Medicine of USC, University of Southern California, Los Angeles, CA, USA
| | - Courtney C. Haswell
- Duke UNC Brain Imaging and Analysis Center, Duke University Medical Center, Durham, NC, USA
- Mental Illness Research Education and Clinical Center for Post Deployment Mental Health, Durham VA Medical Center, Durham, NC, USA
| | - Michael Hauser
- Duke Molecular Physiology Institute, Duke University Medical Center, Durham, NC, USA
| | - Stefan Herms
- Department of Biomedicine, University of Basel, Basel, Switzerland
- Institute of Medical Genetics and Pathology, University Hospital Basel, Basel, Switzerland
- Department of Genomics, Life & Brain Research Center, University of Bonn, Bonn, Germany
| | - Dirk J. Heslenfeld
- Department of Cognitive and Clinical Neuropsychology, Vrije Universiteit Amsterdam, Amsterdam, Netherlands
| | - New Fei Ho
- Research Division, Institute of Mental Health, Singapore, Singapore
| | - David Hoehn
- Max Planck Institute of Psychiatry, Munich, Germany
| | - Per Hoffmann
- Department of Biomedicine, University of Basel, Basel, Switzerland
- Institute of Medical Genetics and Pathology, University Hospital Basel, Basel, Switzerland
- Institute of Human Genetics, University of Bonn, School of Medicine and University Hospital Bonn, Bonn, Germany
| | - Laurena Holleran
- Centre for Neuroimaging and Cognitive Genomics, School of Psychology, National University of Ireland Galway, Galway, Ireland
| | - Martine Hoogman
- Department of Human Genetics, Radboud University Medical Center, Nijmegen, Netherlands
- Donders Institute for Brain, Cognition and Behaviour, Radboud University, Nijmegen, Netherlands
| | - Jouke-Jan Hottenga
- Department of Biological Psychology, Vrije Universiteit Amsterdam, Amsterdam, Netherlands
| | - Masashi Ikeda
- Department of Psychiatry, Fujita Health University School of Medicine, Toyoake, Japan
| | - Deborah Janowitz
- Department of Psychiatry and Psychotherapy, University Medicine Greifswald, Greifswald, Germany
| | - Iris E. Jansen
- Complex Trait Genetics, Center for Neurogenomics and Cognitive Research, Vrije Universiteit Amsterdam, Amsterdam, Netherlands
- Department of Neurology, Alzheimer Center, Amsterdam Neuroscience, Vrije Universiteit Medical Center, Vrije Universiteit Amsterdam, Amsterdam, Netherlands
| | - Tianye Jia
- Institute of Science and Technology for Brain-Inspired Intelligence, Fudan University, Shanghai, China
- Key Laboratory of Computational Neuroscience and BrainInspired Intelligence (Fudan University), Ministry of Education, Shanghai, China
- Centre for Population Neuroscience and Precision Medicine (PONS), Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, UK
| | - Christiane Jockwitz
- Institute of Neuroscience and Medicine (INM-1), Research Centre Jülich, Jülich, Germany
- Department of Psychiatry, Psychotherapy and Psychosomatics, Medical Faculty, RWTH Aachen University, Aachen, Germany
| | - Ryota Kanai
- Department of Neuroinformatics, Araya, Inc., Tokyo, Japan
- Sackler Centre for Consciousness Science, School of Psychology, University of Sussex, Falmer, UK
- Earth-Life Science Institute, Tokyo Institute of Technology, Tokyo, Japan
| | - Sherif Karama
- Douglas Mental Health University Institute, McGill University, Montreal, QC, Canada
- Department of Psychiatry, McGill University, Montreal, QC, Canada
- McConnell Brain Imaging Center, Montreal Neurological Institute, Montreal, QC, Canada
| | - Dalia Kasperaviciute
- Department of Clinical and Experimental Epilepsy, UCL Queen Square Institute of Neurology, London, UK
- Genomics England, Queen Mary University of London, London, UK
| | - Tobias Kaufmann
- NORMENT-K.G. Jebsen Centre for Psychosis Research, Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway
- NORMENT-K.G. Jebsen Centre for Psychosis Research, Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Sinead Kelly
- Public Psychiatry Division, Massachusetts Mental Health Center, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA
- Psychiatry Neuroimaging Laboratory, Department of Psychiatry, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, USA
| | - Masataka Kikuchi
- Department of Genome Informatics, Graduate School of Medicine, Osaka University, Suita, Japan
| | - Marieke Klein
- Department of Human Genetics, Radboud University Medical Center, Nijmegen, Netherlands
- Donders Institute for Brain, Cognition and Behaviour, Radboud University, Nijmegen, Netherlands
- Department of Psychiatry, University Medical Center Utrecht Brain Center, University Medical Center Utrecht, Utrecht University, Utrecht, Netherlands
| | - Michael Knapp
- Department of Medical Biometry, Informatics and Epidemiology, University Hospital Bonn, Bonn, Germany
| | - Annchen R. Knodt
- Department of Psychology and Neuroscience, Duke University, Durham, NC, USA
| | - Bernd Krämer
- Section for Experimental Psychopathology and Neuroimaging, Department of General Psychiatry, Heidelberg University Hospital, Heidelberg, Germany
- Centre for Translational Research in Systems Neuroscience and Psychiatry, Department of Psychiatry and Psychotherapy, University Medical Center Göttingen, Göttingen, Germany
| | - Max Lam
- Research Division, Institute of Mental Health, Singapore, Singapore
- Human Genetics, Genome Institute of Singapore, Singapore, Singapore
| | - Thomas M. Lancaster
- Cardiff University Brain Research Imaging Centre, Cardiff University, Cardiff, UK
- MRC Centre for Neuropsychiatric Genetics and Genomics, Cardiff University, Cardiff, UK
| | - Phil H. Lee
- Psychiatric and Neurodevelopmental Genetics Unit, Center for Genomic Medicine, Massachusetts General Hospital, Boston, MA, USA
- Department of Psychiatry, Harvard Medical School, Boston, MA, USA
| | - Tristram A. Lett
- Division of Mind and Brain Research, Department of Psychiatry and Psychotherapy, Campus Charité Mitte, Charité Universitätsmedizin Berlin corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - Lindsay B. Lewis
- McConnell Brain Imaging Center, Montreal Neurological Institute, Montreal, QC, Canada
- McGill Centre for Integrative Neuroscience, McGill University, Montreal, QC, Canada
| | - Iscia Lopes-Cendes
- Department of Medical Genetics and Genomic Medicine, School of Medical Sciences, University of Campinas-UNICAMP, Campinas, Brazil
- BRAINN-Brazilian Institute of Neuroscience and Neurotechnology, Campinas, Brazil
| | - Michelle Luciano
- Department of Psychology, University of Edinburgh, Edinburgh, UK
- Centre for Cognitive Ageing and Cognitive Epidemiology, University of Edinburgh, Edinburgh, UK
| | - Fabio Macciardi
- Department of Psychiatry and Human Behavior, School of Medicine University of California, Irvine, Irvine, CA, USA
| | - Andre F. Marquand
- Donders Institute for Brain, Cognition and Behaviour, Radboud University, Nijmegen, Netherlands
- Department of Cognitive Neuroscience, Radboud university medical center, Nijmegen, Netherlands
| | - Samuel R. Mathias
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA
- Olin Neuropsychiatric Research Center, Institute of Living, Hartford Hospital, Hartford, CT, USA
| | - Tracy R. Melzer
- Department of Medicine, University of Otago, Christchurch, Christchurch, New Zealand
- New Zealand Brain Research Institute, Christchurch, New Zealand
- Brain Research New Zealand-Rangahau Roro Aotearoa, Christchurch, New Zealand
| | - Yuri Milaneschi
- Department of Psychiatry, Amsterdam Public Health and Amsterdam Neuroscience, Amsterdam UMC/Vrije Universiteit and GGZ inGeest, Amsterdam, Netherlands
| | - Nazanin Mirza-Schreiber
- Max Planck Institute of Psychiatry, Munich, Germany
- Institute of Neurogenomics, Helmholtz Zentrum München, German Research Centre for Environmental Health, Neuherberg, Germany
| | - Jose C. V. Moreira
- BRAINN-Brazilian Institute of Neuroscience and Neurotechnology, Campinas, Brazil
- IC-Institute of Computing, Campinas, Brazil
| | - Thomas W. Mühleisen
- Department of Biomedicine, University of Basel, Basel, Switzerland
- Institute of Neuroscience and Medicine (INM-1), Research Centre Jülich, Jülich, Germany
- Cécile and Oskar Vogt Institute of Brain Research, Medical Faculty, Heinrich Heine University, Düsseldorf, Germany
| | - Bertram Müller-Myhsok
- Max Planck Institute of Psychiatry, Munich, Germany
- Munich Cluster for Systems Neurology (SyNergy), Munich, Germany
- Institute of Translational Medicine, Liverpool, UK
| | - Pablo Najt
- Centre for Neuroimaging and Cognitive Genomics, National University of Ireland Galway, Galway, Ireland
| | - Soichiro Nakahara
- Department of Psychiatry and Human Behavior, School of Medicine University of California, Irvine, Irvine, CA, USA
- Drug Discovery Research, Astellas Pharmaceuticals, Miyukigaoka, Tsukuba, Ibaraki , Japan
| | - Kwangsik Nho
- Department of Radiology and Imaging Sciences, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Loes M. Olde Loohuis
- Center for Neurobehavioral Genetics, University of California Los Angeles, Los Angeles, CA, USA
| | | | - John F. Pearson
- Biostatistics and Computational Biology Unit, University of Otago, Christchurch, Christchurch, New Zealand
- Department of Pathology and Biomedical Science, University of Otago, Christchurch, Christchurch, New Zealand
| | - Toni L. Pitcher
- Department of Medicine, University of Otago, Christchurch, Christchurch, New Zealand
- New Zealand Brain Research Institute, Christchurch, New Zealand
- Brain Research New Zealand-Rangahau Roro Aotearoa, Christchurch, New Zealand
| | - Benno Pütz
- Max Planck Institute of Psychiatry, Munich, Germany
| | - Yann Quidé
- School of Psychiatry, University of New South Wales, Sydney, NSW, Australia
- Neuroscience Research Australia, Sydney, NSW, Australia
| | - Anjanibhargavi Ragothaman
- Imaging Genetics Center, Mark and Mary Stevens Neuroimaging and Informatics Institute, Keck School of Medicine of USC, University of Southern California, Los Angeles, CA, USA
| | - Faisal M. Rashid
- Imaging Genetics Center, Mark and Mary Stevens Neuroimaging and Informatics Institute, Keck School of Medicine of USC, University of Southern California, Los Angeles, CA, USA
| | - William R. Reay
- School of Biomedical Sciences and Pharmacy, University of Newcastle, Callaghan, NSW, Australia
- Priority Centre for Brain and Mental Health Research, University of Newcastle, Callaghan, NSW, Australia
| | - Ronny Redlich
- Department of Psychiatry, University of Münster, Münster, Germany
| | - Céline S. Reinbold
- Centre for Lifespan Changes in Brain and Cognition, Department of Psychology, University of Oslo, Oslo, Norway
- Department of Biomedicine, University of Basel, Basel, Switzerland
- Institute of Medical Genetics and Pathology, University Hospital Basel, Basel, Switzerland
| | - Jonathan Repple
- Department of Psychiatry, University of Münster, Münster, Germany
| | - Geneviève Richard
- NORMENT-K.G. Jebsen Centre for Psychosis Research, Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway
- NORMENT-K.G. Jebsen Centre for Psychosis Research, Institute of Clinical Medicine, University of Oslo, Oslo, Norway
- Department of Psychology, University of Oslo, Oslo, Norway
- Sunnaas Rehabilitation Hospital HT, Nesodden, Norway
| | - Brandalyn C. Riede
- Queensland Brain Institute, University of Queensland, St Lucia, QLD, Australia
- Department of Radiology and Imaging Sciences, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Shannon L. Risacher
- Department of Radiology and Imaging Sciences, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Cristiane S. Rocha
- Department of Medical Genetics and Genomic Medicine, School of Medical Sciences, University of Campinas-UNICAMP, Campinas, Brazil
- BRAINN-Brazilian Institute of Neuroscience and Neurotechnology, Campinas, Brazil
| | - Nina R. Mota
- Department of Human Genetics, Radboud University Medical Center, Nijmegen, Netherlands
- Donders Institute for Brain, Cognition and Behaviour, Radboud University, Nijmegen, Netherlands
- Department of Psychiatry, Radboud university medical center, Nijmegen, Netherlands
| | - Lauren Salminen
- Imaging Genetics Center, Mark and Mary Stevens Neuroimaging and Informatics Institute, Keck School of Medicine of USC, University of Southern California, Los Angeles, CA, USA
| | - Arvin Saremi
- Imaging Genetics Center, Mark and Mary Stevens Neuroimaging and Informatics Institute, Keck School of Medicine of USC, University of Southern California, Los Angeles, CA, USA
| | - Andrew J. Saykin
- Department of Radiology and Imaging Sciences, Indiana University School of Medicine, Indianapolis, IN, USA
- Department of Medical and Molecular Genetics, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Fenja Schlag
- Language and Genetics Department, Max Planck Institute for Psycholinguistics, Nijmegen, Netherlands
| | - Lianne Schmaal
- Orygen, The National Centre of Excellence for Youth Mental Health, Melbourne, VIC, Australia
- The Centre for Youth Mental Health, University of Melbourne, Melbourne, VIC, Australia
- Department of Psychiatry, Vrije Universiteit University Medical Center, Vrije Universiteit Amsterdam, Amsterdam, Netherlands
| | - Peter R. Schofield
- Neuroscience Research Australia, Sydney, NSW, Australia
- School of Medical Sciences, University of New South Wales, Sydney, NSW, Australia
| | - Rodrigo Secolin
- Department of Medical Genetics and Genomic Medicine, School of Medical Sciences, University of Campinas-UNICAMP, Campinas, Brazil
- BRAINN-Brazilian Institute of Neuroscience and Neurotechnology, Campinas, Brazil
| | - Chin Yang Shapland
- Language and Genetics Department, Max Planck Institute for Psycholinguistics, Nijmegen, Netherlands
| | - Li Shen
- Department of Biostatistics, Epidemiology and Informatics, University of Pennsylvania, Philadelphia, PA, USA
| | - Jean Shin
- The Hospital for Sick Children, University of Toronto, Toronto, ON, Canada
- Population Neuroscience & Developmental Neuroimaging, Bloorview Research Institute, University of Toronto, East York, ON, Canada
| | - Elena Shumskaya
- Department of Human Genetics, Radboud University Medical Center, Nijmegen, Netherlands
- Donders Institute for Brain, Cognition and Behaviour, Radboud University, Nijmegen, Netherlands
- Donders Centre for Cognitive Neuroimaging, Radboud University, Nijmegen, Netherlands
| | - Ida E. Sønderby
- NORMENT-K.G. Jebsen Centre for Psychosis Research, Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway
- NORMENT-K.G. Jebsen Centre for Psychosis Research, Institute of Clinical Medicine, University of Oslo, Oslo, Norway
- Department of Medical Genetics, Oslo University Hospital, Oslo, Norway
| | - Emma Sprooten
- Donders Institute for Brain, Cognition and Behaviour, Radboud University, Nijmegen, Netherlands
| | - Katherine E. Tansey
- MRC Centre for Neuropsychiatric Genetics and Genomics, Cardiff University, Cardiff, UK
| | - Alexander Teumer
- Institute for Community Medicine, University Medicine Greifswald, Greifswald, Germany
| | - Anbupalam Thalamuthu
- Centre for Healthy Brain Ageing, University of New South Wales, Sydney, NSW, Australia
| | - Diana Tordesillas-Gutiérrez
- Neuroimaging Unit, Technological Facilities, Valdecilla Biomedical Research Institute IDIVAL, Santander, Spain
- Centro Investigacion Biomedica en Red Salud Mental, Santander, Spain
| | - Jessica A. Turner
- Department of Psychology, Georgia State University, Atlanta, GA, USA
- Mind Research Network, Albuquerque, NM, USA
| | - Anne Uhlmann
- Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa
- Department of Psychiatry, University of Vermont, Burlington, VT, USA
| | - Costanza L. Vallerga
- Institute for Molecular Bioscience, University of Queensland, Brisbane, QLD, Australia
| | - Dennis van derMeer
- NORMENT, Division of Mental Health and Addiction, Oslo University Hospital and Institute of Clinical Medicine, University of Oslo, Oslo, Norway
- School of Mental Health and Neuroscience, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, Netherlands
| | | | - Liza van Eijk
- School of Psychology, University of Queensland, Brisbane, QLD, Australia
- Queensland Brain Institute, University of Queensland, St Lucia, QLD, Australia
| | - Theo G. M. van Erp
- Department of Psychiatry and Human Behavior, School of Medicine University of California, Irvine, Irvine, CA, USA
| | - Neeltje E. M. van Haren
- Department of Psychiatry, University Medical Center Utrecht Brain Center, University Medical Center Utrecht, Utrecht University, Utrecht, Netherlands
- Department of Child and Adolescent Psychiatry/Psychology, Erasmus Medical Center-Sophia Children’s Hospital, Rotterdam, Netherlands
| | - Daan van Rooij
- Donders Institute for Brain, Cognition and Behaviour, Radboud University, Nijmegen, Netherlands
- Department of Cognitive Neuroscience, Radboud university medical center, Nijmegen, Netherlands
| | - Marie-José van Tol
- Cognitive Neuroscience Center, Department of Biomedical Sciences of Cells and Systems, University Medical Center Groningen, University of Groningen, Groningen, Netherlands
| | - Jan H. Veldink
- Department of Neurology, Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht University, Utrecht, Netherlands
| | - Ellen Verhoef
- Language and Genetics Department, Max Planck Institute for Psycholinguistics, Nijmegen, Netherlands
| | - Esther Walton
- Department of Psychology, Georgia State University, Atlanta, GA, USA
- MRC Integrative Epidemiology Unit, Department of Population Health Sciences, Bristol Medical School, Bristol, UK
- Department of Psychology, University of Bath, Bath, UK
| | - Mingyuan Wang
- Research Division, Institute of Mental Health, Singapore, Singapore
| | - Yunpeng Wang
- NORMENT-K.G. Jebsen Centre for Psychosis Research, Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway
- NORMENT-K.G. Jebsen Centre for Psychosis Research, Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Joanna M. Wardlaw
- Centre for Clinical Brain Sciences and Edinburgh Imaging, University of Edinburgh, Edinburgh, UK
- Centre for Cognitive Ageing and Cognitive Epidemiology, University of Edinburgh, Edinburgh, UK
- UK Dementia Research Institute, The University of Edinburgh, Edinburgh, UK
| | - Wei Wen
- Centre for Healthy Brain Ageing, University of New South Wales, Sydney, NSW, Australia
| | - Lars T. Westlye
- NORMENT-K.G. Jebsen Centre for Psychosis Research, Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway
- NORMENT-K.G. Jebsen Centre for Psychosis Research, Institute of Clinical Medicine, University of Oslo, Oslo, Norway
- Department of Psychology, University of Oslo, Oslo, Norway
| | - Christopher D. Whelan
- Imaging Genetics Center, Mark and Mary Stevens Neuroimaging and Informatics Institute, Keck School of Medicine of USC, University of Southern California, Los Angeles, CA, USA
- Department of Molecular and Cellular Therapeutics, Royal College of Surgeons in Ireland, Dublin, Ireland
| | - Stephanie H. Witt
- Department of Genetic Epidemiology in Psychiatry, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Katharina Wittfeld
- Department of Psychiatry and Psychotherapy, University Medicine Greifswald, Greifswald, Germany
- German Center for Neurodegenerative Diseases Rostock/Greifswald, Greifswald, Germany
| | - Christiane Wolf
- Department of Psychiatry, Psychosomatics and Psychotherapy, University of Würzburg, Würzburg, Germany
| | - Thomas Wolfers
- Department of Human Genetics, Radboud University Medical Center, Nijmegen, Netherlands
| | - Jing Qin Wu
- School of Biomedical Sciences and Pharmacy, University of Newcastle, Callaghan, NSW, Australia
| | - Clarissa L. Yasuda
- BRAINN-Brazilian Institute of Neuroscience and Neurotechnology, Campinas, Brazil
- Department of Neurology, FCM, UNICAMP, Campinas, Brazil
| | - Dario Zaremba
- Department of Psychiatry, University of Münster, Münster, Germany
| | - Zuo Zhang
- Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology & Neuroscience, King’s College London, London, UK
| | - Marcel P. Zwiers
- Donders Institute for Brain, Cognition and Behaviour, Radboud University, Nijmegen, Netherlands
- Department of Cognitive Neuroscience, Radboud university medical center, Nijmegen, Netherlands
- Donders Centre for Cognitive Neuroimaging, Radboud University, Nijmegen, Netherlands
| | - Eric Artiges
- INSERM ERL Developmental Trajectories and Psychiatry; Université Paris-Saclay, Ecole Normale Supérieure Paris-Saclay, Université de Paris, and CNRS 9010, Centre Borelli, Gif-sur-Yvette, France
| | - Amelia A. Assareh
- Centre for Healthy Brain Ageing, University of New South Wales, Sydney, NSW, Australia
| | - Rosa Ayesa-Arriola
- Centro Investigacion Biomedica en Red Salud Mental, Santander, Spain
- Department of Psychiatry, University Hospital Marqués de Valdecilla, School of Medicine, University of Cantabria–IDIVAL, Santander, Spain
| | - Aysenil Belger
- Duke UNC Brain Imaging and Analysis Center, Duke University Medical Center, Durham, NC, USA
- Department of Psychiatry and Frank Porter Graham Child Development Institute, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Christine L. Brandt
- NORMENT-K.G. Jebsen Centre for Psychosis Research, Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway
- NORMENT-K.G. Jebsen Centre for Psychosis Research, Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Gregory G. Brown
- Department of Psychiatry, University of California San Diego, San Diego, CA, USA
- VA San Diego Healthcare System, San Diego, CA, USA
| | - Sven Cichon
- Department of Biomedicine, University of Basel, Basel, Switzerland
- Institute of Medical Genetics and Pathology, University Hospital Basel, Basel, Switzerland
- Institute of Neuroscience and Medicine (INM-1), Research Centre Jülich, Jülich, Germany
| | - Joanne E. Curran
- Department of Human Genetics and South Texas Diabetes and Obesity Institute, University of Texas Rio Grande Valley School of Medicine, Brownsville, TX, USA
| | | | - Franziska Degenhardt
- Institute of Human Genetics, University of Bonn, School of Medicine and University Hospital Bonn, Bonn, Germany
| | - Michelle F. Dennis
- Mental Illness Research Education and Clinical Center for Post Deployment Mental Health, Durham VA Medical Center, Durham, NC, USA
| | - Bruno Dietsche
- Department of Psychiatry and Psychotherapy, Philipps-University Marburg, Marburg, Germany
| | - Srdjan Djurovic
- Department of Medical Genetics, Oslo University Hospital, Oslo, Norway
- NORMENT, Department of Clinical Science, University of Bergen, Bergen, Norway
| | - Colin P. Doherty
- Department of Neurology, St James’s Hospital, Dublin, Ireland
- Academic Unit of Neurology, TBSI, Dublin, Ireland
- Future Neuro, Royal College of Surgeons in Ireland, Dublin, Ireland
| | - Ryan Espiritu
- Information Sciences Institute, University of Southern California, Los Angeles, CA, USA
| | - Daniel Garijo
- Information Sciences Institute, University of Southern California, Los Angeles, CA, USA
| | - Yolanda Gil
- Information Sciences Institute, University of Southern California, Los Angeles, CA, USA
| | - Penny A. Gowland
- Sir Peter Mansfield Imaging Centre, University of Nottingham, Nottingham, UK
| | - Robert C. Green
- Brigham and Women’s Hospital, Boston, MA, USA
- The Broad Institute, Boston, MA, USA
- Harvard Medical School, Boston, MA, USA
| | - Alexander N. Häusler
- Center for Economics and Neuroscience, University of Bonn, Bonn, Germany
- Institute of Experimental Epileptology and Cognition Research, University Hospital Bonn, Germany
| | - Walter Heindel
- Department of Clinical Radiology, University of Münster, Münster, Germany
| | - Beng-Choon Ho
- Department of Psychiatry, University of Iowa College of Medicine, Iowa City, IA, USA
| | - Wolfgang U. Hoffmann
- Institute for Community Medicine, University Medicine Greifswald, Greifswald, Germany
- German Center for Neurodegenerative Diseases Rostock/Greifswald, Greifswald, Germany
| | - Florian Holsboer
- Max Planck Institute of Psychiatry, Munich, Germany
- HMNC Holding GmbH, Munich, Germany
| | - Georg Homuth
- University Medicine Greifswald, Interfaculty Institute for Genetics and Functional Genomics, Department of Functional Genomics, Greifswald, Germany
| | - Norbert Hosten
- Institute of Diagnostic Radiology and Neuroradiology, University Medicine Greifswald, Greifswald, Germany
| | | | - MiHyun Jang
- Information Sciences Institute, University of Southern California, Los Angeles, CA, USA
| | - Andreas Jansen
- Department of Psychiatry and Psychotherapy, Philipps-University Marburg, Marburg, Germany
- Core-Unit Brainimaging, Faculty of Medicine, University of Marburg, Marburg, Germany
| | - Nathan A. Kimbrel
- Mental Illness Research Education and Clinical Center for Post Deployment Mental Health, Durham VA Medical Center, Durham, NC, USA
- Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, NC, USA
| | - Knut Kolskår
- NORMENT-K.G. Jebsen Centre for Psychosis Research, Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway
- NORMENT-K.G. Jebsen Centre for Psychosis Research, Institute of Clinical Medicine, University of Oslo, Oslo, Norway
- Department of Psychology, University of Oslo, Oslo, Norway
- Sunnaas Rehabilitation Hospital HT, Nesodden, Norway
| | - Sanne Koops
- Department of Psychiatry, University Medical Center Utrecht Brain Center, University Medical Center Utrecht, Utrecht University, Utrecht, Netherlands
| | - Axel Krug
- Department of Psychiatry and Psychotherapy, Philipps-University Marburg, Marburg, Germany
| | - Kelvin O. Lim
- Department of Psychiatry, University of Minnesota, Minneapolis, MN, USA
| | - Jurjen J. Luykx
- Department of Psychiatry, University Medical Center Utrecht Brain Center, University Medical Center Utrecht, Utrecht University, Utrecht, Netherlands
- Department of Translational Neuroscience, UMC Utrecht Brain Center, University Medical Center Utrecht, Utrecht University, Utrecht, Netherlands
- GGNet Mental Health, Apeldoorn, Netherlands
| | - Daniel H. Mathalon
- Department of Psychiatry and Weill Institute for Neurosciences, University of California San Francisco, San Francisco, CA, USA
- Mental Health Service 116d, Veterans Affairs San Francisco Healthcare System, San Francisco, CA, USA
| | - Karen A. Mather
- Neuroscience Research Australia, Sydney, NSW, Australia
- Centre for Healthy Brain Ageing, University of New South Wales, Sydney, NSW, Australia
| | - Venkata S. Mattay
- Lieber Institute for Brain Development, Baltimore, MD, USA
- Department of Neurology, Johns Hopkins University, Baltimore, MD, USA
- Department of Radiology, Johns Hopkins University, Baltimore, MD, USA
| | - Sarah Matthews
- MRC Integrative Epidemiology Unit, Department of Population Health Sciences, Bristol Medical School, Bristol, UK
| | - Jaqueline Mayoral Van Son
- Centro Investigacion Biomedica en Red Salud Mental, Santander, Spain
- Department of Psychiatry, University Hospital Marqués de Valdecilla, School of Medicine, University of Cantabria–IDIVAL, Santander, Spain
| | - Sarah C. McEwen
- Pacific Brain Health Center, Santa Monica, CA, USA
- John Wayne Cancer Institute, Santa Monica, CA, USA
| | - Ingrid Melle
- NORMENT-K.G. Jebsen Centre for Psychosis Research, Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway
- NORMENT-K.G. Jebsen Centre for Psychosis Research, Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Derek W. Morris
- Centre for Neuroimaging and Cognitive Genomics, National University of Ireland Galway, Galway, Ireland
| | - Bryon A. Mueller
- Department of Psychiatry, University of Minnesota, Minneapolis, MN, USA
| | - Matthias Nauck
- Institute of Clinical Chemistry and Laboratory Medicine, University Medicine Greifswald, Greifswald, Germany
- German Centre for Cardiovascular Research (DZHK), Partner Site Greifswald, Greifswald, Germany
| | | | - Markus M. Nöthen
- Institute of Human Genetics, University of Bonn, School of Medicine and University Hospital Bonn, Bonn, Germany
| | - Daniel S. O’Leary
- Department of Psychiatry, University of Iowa College of Medicine, Iowa City, IA, USA
| | - Nils Opel
- Department of Psychiatry, University of Münster, Münster, Germany
| | - Marie-Laure Paillère Martinot
- INSERM ERL Developmental Trajectories and Psychiatry; Université Paris-Saclay, Ecole Normale Supérieure Paris-Saclay, Université de Paris, and CNRS 9010, Centre Borelli, Gif-sur-Yvette, France
- APHP.Sorbonne Université, Child and Adolescent Psychiatry Department, Pitié Salpêtrière Hospital, Paris, France
| | - G. Bruce Pike
- Radiology and Clinical Neurosciences, Hotchkiss Brain Institute, University of Calgary, Calgary, AB, Canada
| | - Adrian Preda
- School of Medicine, University of California Irvine, Irvine, CA, USA
| | - Erin B. Quinlan
- Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology & Neuroscience, King’s College London, London, UK
| | - Paul E. Rasser
- Priority Centre for Brain and Mental Health Research, University of Newcastle, Callaghan, NSW, Australia
- School of Medicine and Public Health, University of Newcastle, Callaghan, NSW, Australia
- Priority Centre for Stroke and Brain Injury, University of Newcastle, Callaghan, NSW, Australia
- Hunter Medical Research Institute, Newcastle, NSW, Australia
| | - Varun Ratnakar
- Information Sciences Institute, University of Southern California, Los Angeles, CA, USA
| | - Simone Reppermund
- Centre for Healthy Brain Ageing, University of New South Wales, Sydney, NSW, Australia
- Department of Developmental Disability Neuropsychiatry, University of New South Wales, Sydney, NSW, Australia
| | - Vidar M. Steen
- NORMENT, Department of Clinical Science, University of Bergen, Bergen, Norway
- Dr. Einar Martens Research Group for Biological Psychiatry, Center for Medical Genetics and Molecular Medicine, Haukeland University Hospital, Bergen, Norway
| | - Paul A. Tooney
- School of Biomedical Sciences and Pharmacy, University of Newcastle, Callaghan, NSW, Australia
- Hunter Medical Research Institute, Newcastle, NSW, Australia
| | - Fábio R. Torres
- Department of Medical Genetics and Genomic Medicine, School of Medical Sciences, University of Campinas-UNICAMP, Campinas, Brazil
- BRAINN-Brazilian Institute of Neuroscience and Neurotechnology, Campinas, Brazil
| | - Dick J. Veltman
- Department of Psychiatry, Amsterdam Public Health and Amsterdam Neuroscience, Amsterdam UMC/Vrije Universiteit and GGZ inGeest, Amsterdam, Netherlands
| | - James T. Voyvodic
- Duke UNC Brain Imaging and Analysis Center, Duke University Medical Center, Durham, NC, USA
| | - Robert Whelan
- School of Psychology, Trinity College Dublin, Dublin, Ireland
| | - Tonya White
- Department of Child and Adolescent Psychiatry/Psychology, Erasmus Medical Center-Sophia Children’s Hospital, Rotterdam, Netherlands
- Department of Radiology, Erasmus University Medical Centre, Rotterdam, Netherlands
| | - Hidenaga Yamamori
- Department of Psychiatry, Osaka University Graduate School of Medicine, Suita, Japan
| | - Hieab H. H. Adams
- Department of Epidemiology, Erasmus MC Medical Center, Rotterdam, Netherlands
- Department of Radiology and Nuclear Medicine, Erasmus MC Medical Center, Rotterdam, Netherlands
- Department of Clinical Genetics, Erasmus MC Medical Center, Rotterdam, Netherlands
| | - Joshua C. Bis
- Cardiovascular Health Research Unit, Department of Medicine, University of Washington, Seattle, WA, USA
| | - Stephanie Debette
- INSERM, Bordeaux Population Health Research Center, team VINTAGE, UMR 1219, University of Bordeaux, Bordeaux, France
- Department of Neurology, CHU de Bordeaux, Bordeaux, France
| | - Charles Decarli
- Department of Neurology, University of California, Davis, Sacramento, CA, USA
| | - Myriam Fornage
- Institute of Molecular Medicine, University of Texas Health Science Center at Houston, Houston, TX, USA
| | - Vilmundur Gudnason
- Icelandic Heart Association, Kopavogur, Iceland
- Faculty of Medicine, University of Iceland, Reykjavik, Iceland
| | - Edith Hofer
- Clinical Division of Neurogeriatrics, Department of Neurology, Medical University of Graz, Graz, Austria
- Institute for Medical Informatics, Statistics and Documentation, Medical University of Graz, Graz, Austria
| | - M. Arfan Ikram
- Department of Epidemiology, Erasmus MC Medical Center, Rotterdam, Netherlands
| | - Lenore Launer
- Laboratory of Epidemiology and Population Sciences, Intramural Research Program, National Institute on Aging, Bethesda, MD, USA
| | - W. T. Longstreth
- Departments of Neurology and Epidemiology, University of Washington, Seattle, WA, USA
| | - Oscar L. Lopez
- Department of Neurology, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Bernard Mazoyer
- Neurodegenerative Diseases Institute UMR 5293, CNRS, CEA, University of Bordeaux, Bordeaux, France
| | - Thomas H. Mosley
- MIND Center, University of Mississippi Medical Center, Jackson, MS, USA
| | - Gennady V. Roshchupkin
- Department of Epidemiology, Erasmus MC Medical Center, Rotterdam, Netherlands
- Department of Radiology and Nuclear Medicine, Erasmus MC Medical Center, Rotterdam, Netherlands
- Medical Informatics, Erasmus MC Medical Center, Rotterdam, Netherlands
| | - Claudia L. Satizabal
- Glenn Biggs Institute for Alzheimer’s and Neurodegenerative Diseases, University of Texas Health Sciences Center, San Antonio, TX, USA
- Department of Epidemiology & Biostatistics, University of Texas Health Sciences Center, San Antonio, TX, USA
- Department of Neurology, Boston University School of Medicine, Boston, MA, USA
| | - Reinhold Schmidt
- Clinical Division of Neurogeriatrics, Department of Neurology, Medical University of Graz, Graz, Austria
| | - Sudha Seshadri
- Glenn Biggs Institute for Alzheimer’s and Neurodegenerative Diseases, University of Texas Health Sciences Center, San Antonio, TX, USA
- Department of Neurology, Boston University School of Medicine, Boston, MA, USA
- Framingham Heart Study and Department of Neurology, Boston University School of Medicine, Boston, MA, USA
| | - Qiong Yang
- Department of Biostatistics, Boston University School of Public Health, Boston, MA, USA
| | | | | | | | | | | | | | - Marina K. M. Alvim
- BRAINN-Brazilian Institute of Neuroscience and Neurotechnology, Campinas, Brazil
- Department of Neurology, FCM, UNICAMP, Campinas, Brazil
| | - David Ames
- Academic Unit for Psychiatry of Old Age, University of Melbourne, Melbourne, VIC, Australia
- National Ageing Research Institute, Melbourne, VIC, Australia
| | - Tim J. Anderson
- Department of Medicine, University of Otago, Christchurch, Christchurch, New Zealand
- New Zealand Brain Research Institute, Christchurch, New Zealand
- Brain Research New Zealand-Rangahau Roro Aotearoa, Christchurch, New Zealand
- Department of Neurology, Canterbury District Health Board, Christchurch, New Zealand
| | - Ole A. Andreassen
- NORMENT-K.G. Jebsen Centre for Psychosis Research, Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway
- NORMENT-K.G. Jebsen Centre for Psychosis Research, Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Alejandro Arias-Vasquez
- Department of Human Genetics, Radboud University Medical Center, Nijmegen, Netherlands
- Donders Institute for Brain, Cognition and Behaviour, Radboud University, Nijmegen, Netherlands
- Department of Psychiatry, Radboud university medical center, Nijmegen, Netherlands
| | - Mark E. Bastin
- Centre for Clinical Brain Sciences and Edinburgh Imaging, University of Edinburgh, Edinburgh, UK
- Centre for Cognitive Ageing and Cognitive Epidemiology, University of Edinburgh, Edinburgh, UK
| | - Bernhard T. Baune
- Department of Psychiatry, University of Münster, Münster, Germany
- Department of Psychiatry, Melbourne Medical School, University of Melbourne, Melbourne, VIC, Australia
- Florey Institute of Neuroscience and Mental Health, University of Melbourne, Parkville, VIC, Australia
| | - Jean C. Beckham
- Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, NC, USA
- VA Mid-Atlantic Mental Illness Research Education and Clinical Center for Post Deployment Mental Health, Durham, VA Healthcare System, Durham, NC, USA
| | - John Blangero
- Department of Human Genetics and South Texas Diabetes and Obesity Institute, University of Texas Rio Grande Valley School of Medicine, Brownsville, TX, USA
| | - Dorret I. Boomsma
- Department of Biological Psychology, Vrije Universiteit Amsterdam, Amsterdam, Netherlands
| | - Henry Brodaty
- Centre for Healthy Brain Ageing, University of New South Wales, Sydney, NSW, Australia
- Dementia Centre for Research Collaboration, University of New South Wales, Sydney, NSW, Australia
| | - Han G. Brunner
- Department of Human Genetics, Radboud University Medical Center, Nijmegen, Netherlands
- Donders Institute for Brain, Cognition and Behaviour, Radboud University, Nijmegen, Netherlands
- Department of Clinical Genetics and School for Oncology and Developmental Biology (GROW), Maastricht University Medical Center, Maastricht, Netherlands
| | - Randy L. Buckner
- Department of Psychology and Center for Brain Science, Harvard University, Boston, MA, USA
- Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA
- Department of Radiology, Massachusetts General Hospital, Boston, MA, USA
| | - Jan K. Buitelaar
- Donders Institute for Brain, Cognition and Behaviour, Radboud University, Nijmegen, Netherlands
- Department of Cognitive Neuroscience, Radboud university medical center, Nijmegen, Netherlands
- Karakter Child and Adolescent Psychiatry University Center, Nijmegen, Netherlands
| | - Juan R. Bustillo
- Department of Psychiatry, University of New Mexico, Albuquerque, NM, USA
| | - Wiepke Cahn
- Department of Psychiatry, University Medical Center Utrecht, Utrecht University, Utrecht, Netherlands
| | - Murray J. Cairns
- School of Biomedical Sciences and Pharmacy, University of Newcastle, Callaghan, NSW, Australia
- Priority Centre for Brain and Mental Health Research, University of Newcastle, Callaghan, NSW, Australia
- Schizophrenia Research Institute, Randwick, NSW, Australia
| | - Vince Calhoun
- Tri-institutional Center for Translational Research in Neuroimaging and Data Science (TReNDS), Georgia State University, Georgia Institute of Technology, Emory University, Atlanta, GA, USA
| | - Vaughan J. Carr
- School of Psychiatry, University of New South Wales, Sydney, NSW, Australia
- Neuroscience Research Australia, Sydney, NSW, Australia
- Department of Psychiatry, Monash University, Clayton, VIC, Australia
| | - Xavier Caseras
- MRC Centre for Neuropsychiatric Genetics and Genomics, Cardiff University, Cardiff, UK
| | - Svenja Caspers
- Institute of Neuroscience and Medicine (INM-1), Research Centre Jülich, Jülich, Germany
- JARA-BRAIN, Jülich-Aachen Research Alliance, Jülich, Germany
- Institute for Anatomy I, Medical Faculty, Heinrich-Heine University, Düsseldorf, Germany
| | - Gianpiero L. Cavalleri
- Molecular and Cellular Therapeutics, Royal College of Surgeons in Ireland, Dublin, Ireland
- The SFI FutureNeuro Research Centre, Dublin, Ireland
| | - Fernando Cendes
- BRAINN-Brazilian Institute of Neuroscience and Neurotechnology, Campinas, Brazil
- Department of Neurology, FCM, UNICAMP, Campinas, Brazil
| | - Aiden Corvin
- Department of Psychiatry, Trinity College Dublin, Dublin, Ireland
| | - Benedicto Crespo-Facorro
- Centro Investigacion Biomedica en Red Salud Mental, Santander, Spain
- Department of Psychiatry, University Hospital Marqués de Valdecilla, School of Medicine, University of Cantabria–IDIVAL, Santander, Spain
- Hospital Universitario Virgen Del Rocio, IBiS, Universidad De Sevilla, Sevilla, Spain
| | - John C. Dalrymple-Alford
- New Zealand Brain Research Institute, Christchurch, New Zealand
- Brain Research New Zealand-Rangahau Roro Aotearoa, Christchurch, New Zealand
- School of Psychology, Speech and Hearing, University of Canterbury, Christchurch, New Zealand
| | - Udo Dannlowski
- Department of Psychiatry, University of Münster, Münster, Germany
| | - Eco J. C. de Geus
- Department of Biological Psychology, Vrije Universiteit Amsterdam, Amsterdam, Netherlands
| | - Ian J. Deary
- Department of Psychology, University of Edinburgh, Edinburgh, UK
- Centre for Cognitive Ageing and Cognitive Epidemiology, University of Edinburgh, Edinburgh, UK
| | - Norman Delanty
- Department of Molecular and Cellular Therapeutics, Royal College of Surgeons in Ireland, Dublin, Ireland
- Future Neuro, Royal College of Surgeons in Ireland, Dublin, Ireland
| | - Chantal Depondt
- Department of Neurology, Hôpital Erasme, Université Libre de Bruxelles, Brussels, Belgium
| | - Sylvane Desrivières
- Centre for Population Neuroscience and Precision Medicine (PONS), Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, UK
- Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology & Neuroscience, King’s College London, London, UK
| | - Gary Donohoe
- Centre for Neuroimaging and Cognitive Genomics, School of Psychology, National University of Ireland Galway, Galway, Ireland
| | - Thomas Espeseth
- NORMENT-K.G. Jebsen Centre for Psychosis Research, Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway
- Department of Psychology, University of Oslo, Oslo, Norway
| | - Guillén Fernández
- Donders Institute for Brain, Cognition and Behaviour, Radboud University, Nijmegen, Netherlands
- Department of Cognitive Neuroscience, Radboud university medical center, Nijmegen, Netherlands
| | - Simon E. Fisher
- Donders Institute for Brain, Cognition and Behaviour, Radboud University, Nijmegen, Netherlands
- Language and Genetics Department, Max Planck Institute for Psycholinguistics, Nijmegen, Netherlands
| | - Herta Flor
- Institute of Cognitive and Clinical Neuroscience, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Andreas J. Forstner
- Department of Biomedicine, University of Basel, Basel, Switzerland
- Institute of Medical Genetics and Pathology, University Hospital Basel, Basel, Switzerland
- Institute of Human Genetics, University of Bonn, School of Medicine and University Hospital Bonn, Bonn, Germany
- Department of Psychiatry (UPK), University of Basel, Basel, Switzerland
- Centre for Human Genetics, University of Marburg, Marburg, Germany
| | - Clyde Francks
- Donders Institute for Brain, Cognition and Behaviour, Radboud University, Nijmegen, Netherlands
- Language and Genetics Department, Max Planck Institute for Psycholinguistics, Nijmegen, Netherlands
| | - Barbara Franke
- Department of Human Genetics, Radboud University Medical Center, Nijmegen, Netherlands
- Donders Institute for Brain, Cognition and Behaviour, Radboud University, Nijmegen, Netherlands
- Department of Psychiatry, Radboud university medical center, Nijmegen, Netherlands
| | - David C. Glahn
- Olin Neuropsychiatric Research Center, Institute of Living, Hartford Hospital, Hartford, CT, USA
- Tommy Fuss Center for Neuropsychiatric Disease Research, Boston Children’s Hospital and Department of Psychiatry, Harvard Medical School, Boston, MA, USA
| | - Randy L. Gollub
- Department of Psychiatry, Harvard Medical School, Boston, MA, USA
- Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA
- Department of Radiology, Massachusetts General Hospital, Boston, MA, USA
| | - Hans J. Grabe
- Department of Psychiatry and Psychotherapy, University Medicine Greifswald, Greifswald, Germany
- German Center for Neurodegenerative Diseases Rostock/Greifswald, Greifswald, Germany
| | - Oliver Gruber
- Section for Experimental Psychopathology and Neuroimaging, Department of General Psychiatry, Heidelberg University Hospital, Heidelberg, Germany
| | - Asta K. Håberg
- Department of Neuroscience, Norwegian University of Science and Technology, Trondheim, Norway
- Department of Radiology and Nuclear Medicine, St. Olavs University Hospital, Trondheim, Norway
| | - Ahmad R. Hariri
- Department of Psychology and Neuroscience, Duke University, Durham, NC, USA
| | - Catharina A. Hartman
- University of Groningen, University Medical Center Groningen, Department of Psychiatry, Groningen, Netherlands
| | - Ryota Hashimoto
- Department of Psychiatry, Osaka University Graduate School of Medicine, Suita, Japan
- Molecular Research Center for Children’s Mental Development, United Graduate School of Child Development, Osaka University, Suita, Japan
- Department of Pathology of Mental Diseases, National Institute of Mental Health, National Center of Neurology and Psychiatry, Tokyo, Japan
| | - Andreas Heinz
- Department of Psychiatry and Psychotherapy, Charité Campus Mitte, Charité Universitätsmedizin Berlin, Berlin, Germany
| | - Frans A. Henskens
- School of Medicine and Public Health, University of Newcastle, Callaghan, NSW, Australia
- Health Behaviour Research Group, University of Newcastle, Callaghan, NSW, Australia
| | - Manon H. J. Hillegers
- Department of Child and Adolescent Psychiatry/Psychology, Erasmus Medical Center-Sophia Children’s Hospital, Rotterdam, Netherlands
- Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht University, Utrecht, Netherlands
| | - Pieter J. Hoekstra
- Department of Psychiatry, University Medical Center Groningen, University of Groningen, Groningen, Netherlands
| | - Avram J. Holmes
- Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA
- Department of Psychology, Yale University, New Haven, CT, USA
| | - L. Elliot Hong
- Maryland Psychiatry Research Center, Department of Psychiatry, University of Maryland School of Medicine, Baltimore, MD, USA
| | - William D. Hopkins
- Department of Comparative Medicine, The University of Texas MD Anderson Cancer Center, Bastrop, TX, USA
| | - Hilleke E. Hulshoff Pol
- Department of Psychiatry, University Medical Center Utrecht Brain Center, University Medical Center Utrecht, Utrecht University, Utrecht, Netherlands
| | - Terry L. Jernigan
- Department of Radiology, University of California San Diego, San Diego, CA, USA
- Department of Cognitive Science, University of California San Diego, San Diego, CA, USA
- Department of Psychiatry, University of California San Diego, San Diego, CA, USA
- Center for Human Development, University of California San Diego, La Jolla, CA, USA
| | - Erik G. Jönsson
- NORMENT-K.G. Jebsen Centre for Psychosis Research, Institute of Clinical Medicine, University of Oslo, Oslo, Norway
- Centre for Psychiatric Research, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - René S. Kahn
- Department of Psychiatry, University Medical Center Utrecht Brain Center, University Medical Center Utrecht, Utrecht University, Utrecht, Netherlands
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Martin A. Kennedy
- Department of Pathology and Biomedical Science, University of Otago, Christchurch, Christchurch, New Zealand
| | - Tilo T. J. Kircher
- Department of Psychiatry and Psychotherapy, Philipps-University Marburg, Marburg, Germany
| | - Peter Kochunov
- Maryland Psychiatry Research Center, Department of Psychiatry, University of Maryland School of Medicine, Baltimore, MD, USA
| | - John B. J. Kwok
- Neuroscience Research Australia, Sydney, NSW, Australia
- School of Medical Sciences, University of New South Wales, Sydney, NSW, Australia
- Neurogenetics and Epigenetics, Brain and Mind Centre, The University of Sydney, Sydney, NSW, Australia
| | - Stephanie Le Hellard
- NORMENT, Department of Clinical Science, University of Bergen, Bergen, Norway
- Dr. Einar Martens Research Group for Biological Psychiatry, Center for Medical Genetics and Molecular Medicine, Haukeland University Hospital, Bergen, Norway
| | - Carmel M. Loughland
- School of Medicine and Public Health, University of Newcastle, Callaghan, NSW, Australia
- Hunter New England Mental Health Service, Newcastle, NSW, Australia
| | - Nicholas G. Martin
- Genetic Epidemiology, QIMR Berghofer Medical Research Institute, Brisbane, QLD, Australia
| | - Jean-Luc Martinot
- INSERM ERL Developmental Trajectories and Psychiatry; Université Paris-Saclay, Ecole Normale Supérieure Paris-Saclay, Université de Paris, and CNRS 9010, Centre Borelli, Gif-sur-Yvette, France
| | - Colm McDonald
- Centre for Neuroimaging and Cognitive Genomics, National University of Ireland Galway, Galway, Ireland
| | - Katie L. McMahon
- Faculty of Health, Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, QLD, Australia
- Herston Imaging Research Facility, School of Clinical Sciences, Queensland University of Technology, Brisbane, QLD, Australia
| | - Andreas Meyer-Lindenberg
- Department of Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Patricia T. Michie
- School of Psychology, University of Newcastle, Callaghan, NSW, Australia
| | - Rajendra A. Morey
- Duke UNC Brain Imaging and Analysis Center, Duke University Medical Center, Durham, NC, USA
- Mental Illness Research Education and Clinical Center for Post Deployment Mental Health, Durham VA Medical Center, Durham, NC, USA
| | - Bryan Mowry
- Queensland Brain Institute, University of Queensland, St Lucia, QLD, Australia
- Queensland Centre for Mental Health Research, University of Queensland, Brisbane, QLD, Australia
| | - Lars Nyberg
- Department of Integrative Medical Biology, Umeå University, Umeå, Sweden
- Umeå Center for Functional Brain Imaging, Umeå University, Umeå, Sweden
- Department of Radiation Sciences, Umeå University, Umeå, Sweden
| | - Jaap Oosterlaan
- Emma Children’s Hospital Academic Medical Center, Amsterdam, Netherlands
- Department of Pediatrics, Vrije Universiteit Medical Center, Vrije Universiteit Amsterdam, Amsterdam, Netherlands
- Clinical Neuropsychology section, Vrije Universiteit Amsterdam, Amsterdam, Netherlands
| | - Roel A. Ophoff
- Center for Neurobehavioral Genetics, University of California Los Angeles, Los Angeles, CA, USA
| | - Christos Pantelis
- Department of Psychiatry, Melbourne Medical School, University of Melbourne, Melbourne, VIC, Australia
- Florey Institute of Neuroscience and Mental Health, University of Melbourne, Parkville, VIC, Australia
- NorthWestern Mental Health, Sunshine Hospital, St Albans, VIC, Australia
| | - Tomas Paus
- Bloorview Research Institute, University of Toronto, Toronto, ON, Canada
- Departments of Psychology and Psychiatry, University of Toronto, Toronto, ON, Canada
- Centre for Developing Brain, Child Mind Institute, New York, NY, USA
| | - Zdenka Pausova
- The Hospital for Sick Children, University of Toronto, Toronto, ON, Canada
- Department of Physiology, University of Toronto, Toronto, ON, Canada
| | - Brenda W. J. H. Penninx
- Department of Psychiatry, Amsterdam Public Health and Amsterdam Neuroscience, Amsterdam UMC/Vrije Universiteit and GGZ inGeest, Amsterdam, Netherlands
| | - Tinca J. C. Polderman
- Complex Trait Genetics, Center for Neurogenomics and Cognitive Research, Vrije Universiteit Amsterdam, Amsterdam, Netherlands
| | - Danielle Posthuma
- Complex Trait Genetics, Center for Neurogenomics and Cognitive Research, Vrije Universiteit Amsterdam, Amsterdam, Netherlands
- Department of Clinical Genetics, Vrije Universiteit Medical Centre, Vrije Universiteit Amsterdam, Amsterdam, Netherlands
| | - Marcella Rietschel
- Department of Genetic Epidemiology in Psychiatry, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Joshua L. Roffman
- Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA
| | - Laura M. Rowland
- Maryland Psychiatry Research Center, Department of Psychiatry, University of Maryland School of Medicine, Baltimore, MD, USA
| | - Perminder S. Sachdev
- Centre for Healthy Brain Ageing, University of New South Wales, Sydney, NSW, Australia
- Neuropsychiatric Institute, The Prince of Wales Hospital, Sydney, NSW, Australia
| | | | - Ulrich Schall
- Priority Centre for Brain and Mental Health Research, University of Newcastle, Callaghan, NSW, Australia
- Hunter Medical Research Institute, Newcastle, NSW, Australia
| | - Gunter Schumann
- Institute of Science and Technology for Brain-Inspired Intelligence, Fudan University, Shanghai, China
- Centre for Population Neuroscience and Precision Medicine (PONS), Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, UK
- Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology & Neuroscience, King’s College London, London, UK
- PONS Research Group, Department of Psychiatry and Psychotherapie, Charité Campus Mitte, Humboldt University Berlin, Berlin, Germany
- Leibniz Institute for Neurobiology, Magdeburg, Germany
| | - Rodney J. Scott
- School of Biomedical Sciences and Pharmacy, University of Newcastle, Callaghan, NSW, Australia
- Division of Molecular Medicine, John Hunter Hospital, New Lambton Heights, NSW, Australia
| | - Kang Sim
- General Psychiatry, Institute of Mental Health, Singapore, Singapore
| | - Sanjay M. Sisodiya
- Department of Clinical and Experimental Epilepsy, UCL Queen Square Institute of Neurology, London, UK
- Chalfont Centre for Epilepsy, ChalfontSt-Peter, UK
| | - Jordan W. Smoller
- Psychiatric and Neurodevelopmental Genetics Unit, Center for Genomic Medicine, Massachusetts General Hospital, Boston, MA, USA
- Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA
- Stanley Center for Psychiatric Research, Broad Institute, Boston, MA, USA
| | - Iris E. Sommer
- Cognitive Neuroscience Center, Department of Biomedical Sciences of Cells and Systems, University Medical Center Groningen, University of Groningen, Groningen, Netherlands
- Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht University, Utrecht, Netherlands
- Department of Psychiatry, University Medical Center Groningen, University of Groningen, Groningen, Netherlands
- Department of Medical and Biological Psychology, University of Bergen, Bergen, Norway
| | - Beate St Pourcain
- Donders Institute for Brain, Cognition and Behaviour, Radboud University, Nijmegen, Netherlands
- Language and Genetics Department, Max Planck Institute for Psycholinguistics, Nijmegen, Netherlands
- MRC Integrative Epidemiology Unit, Department of Population Health Sciences, Bristol Medical School, Bristol, UK
| | - Dan J. Stein
- Department of Psychiatry and Neuroscience Institute, University of Cape Town, Cape Town, South Africa
- SAMRC Unit on Risk & Resilience in Mental Disorders, University of Cape Town, Cape Town, South Africa
| | - Arthur W. Toga
- Laboratory of Neuro Imaging, Mark and Mary Stevens Neuroimaging and Informatics Institute, Keck School of Medicine of the University of Southern California, Los Angeles, CA, USA
| | - Julian N. Trollor
- Centre for Healthy Brain Ageing, University of New South Wales, Sydney, NSW, Australia
- Department of Developmental Disability Neuropsychiatry, University of New South Wales, Sydney, NSW, Australia
| | | | - Dennis van ‘t Ent
- Department of Biological Psychology, Vrije Universiteit Amsterdam, Amsterdam, Netherlands
| | - Henry Völzke
- Institute for Community Medicine, University Medicine Greifswald, Greifswald, Germany
| | - Henrik Walter
- Division of Mind and Brain Research, Department of Psychiatry and Psychotherapy, Campus Charité Mitte, Charité Universitätsmedizin Berlin corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - Bernd Weber
- Center for Economics and Neuroscience, University of Bonn, Bonn, Germany
- Institute of Experimental Epileptology and Cognition Research, University Hospital Bonn, Germany
| | - Daniel R. Weinberger
- Lieber Institute for Brain Development, Baltimore, MD, USA
- Psychiatry, Neurology, Neuroscience, Genetics, Johns Hopkins University, Baltimore, MD, USA
| | - Margaret J. Wright
- Queensland Brain Institute, University of Queensland, St Lucia, QLD, Australia
- Centre for Advanced Imaging, University of Queensland, Brisbane, QLD, Australia
| | - Juan Zhou
- Center for Sleep and Cognition, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Jason L. Stein
- Department of Genetics and UNC Neuroscience Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Paul M. Thompson
- Imaging Genetics Center, Mark and Mary Stevens Neuroimaging and Informatics Institute, Keck School of Medicine of USC, University of Southern California, Los Angeles, CA, USA
| | - Sarah E. Medland
- Psychiatric Genetics, QIMR Berghofer Medical Research Institute, Brisbane, QLD, Australia
- School of Psychology, University of Queensland, Brisbane, QLD, Australia
- Faculty of Medicine, University of Queensland, Brisbane, QLD, Australia
| | | |
Collapse
|
18
|
Dennis PA, Neal JM, Travis E, Watkins LL, Calhoun PS, Dennis MF, Beckham JC. Negative Affect-Related Autonomic Arousal Mediates the Association between Baroreflex Dysfunction and Insulin Resistance in Non-Diabetic Young Adults. J PSYCHOPHYSIOL 2019; 33:243-253. [PMID: 31666757 DOI: 10.1027/0269-8803/a000226] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Autonomic dysfunction, in particular under-regulation of heart rate (HR) by the baroreflex, is implicated in development of insulin resistance (IR). According to reactivity hypothesis, sympathetic response to stressors may be more sensitive at predicting IR than baroreceptor sensitivity (BRS), a baseline measure of baroreflex functioning. Using ecological momentary assessment (EMA) of negative affect coupled with minute-to-minute HR and heart-rate variability (HRV) monitoring, we examined whether negative affect (NA)-related autonomic arousal mediates the association of BRS with IR. At baseline, BRS was measured, and fasting serum glucose and insulin levels were collected from 178 young adults (18-39 years old), from which homeostasis model assessment of IR (HOMA-IR) and beta-cell functioning (HOMA %B) were derived. Participants subsequently underwent one day of Holter HR and HRV monitoring while reporting negative affect levels via EMA. Multilevel modeling was used to assess the associations of momentary negative affect with HR and low- (LF) and high-frequency (HF) HRV during the 5-minute intervals following each EMA reading. Structural equation modeling was then used to determine whether individual differences in these associations mediated the association of BRS with IR, measured by HOMA-IR, HOMA %B, and insulin levels. As predicted, BRS was negatively associated with the IR (β = -.17, p = .024). However, NA-related autonomic arousal mediated their association, accounting for 56% of the covariance between BRS and IR. Not only do these results provide support for reactivity hypothesis, they reveal a potential point of intervention in the treatment of affective dysregulation.
Collapse
Affiliation(s)
- Paul A Dennis
- Durham Veterans Affairs Medical Center, Durham, NC, 27705, USA.,Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, NC 27705, USA
| | - Julia M Neal
- Durham Veterans Affairs Medical Center, Durham, NC, 27705, USA.,Veterans Affairs Mid-Atlantic Region Mental Illness Research, Education, and Clinical Center, Durham, NC 27705, USA
| | - Emili Travis
- Durham Veterans Affairs Medical Center, Durham, NC, 27705, USA
| | - Lana L Watkins
- Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, NC 27705, USA
| | - Patrick S Calhoun
- Durham Veterans Affairs Medical Center, Durham, NC, 27705, USA.,Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, NC 27705, USA.,Veterans Affairs Mid-Atlantic Region Mental Illness Research, Education, and Clinical Center, Durham, NC 27705, USA.,Durham Veterans Affairs Center for Health Services Research in Primary Care, Durham, NC, 27705, USA
| | - Michelle F Dennis
- Durham Veterans Affairs Medical Center, Durham, NC, 27705, USA.,Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, NC 27705, USA
| | - Jean C Beckham
- Durham Veterans Affairs Medical Center, Durham, NC, 27705, USA.,Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, NC 27705, USA.,Veterans Affairs Mid-Atlantic Region Mental Illness Research, Education, and Clinical Center, Durham, NC 27705, USA
| |
Collapse
|
19
|
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
|
20
|
Adkisson K, Cunningham KC, Dedert EA, Dennis MF, Calhoun PS, Elbogen EB, Beckham JC, Kimbrel NA. Cannabis Use Disorder and Post-Deployment Suicide Attempts in Iraq/Afghanistan-Era Veterans. Arch Suicide Res 2019; 23:678-687. [PMID: 29952737 PMCID: PMC6525085 DOI: 10.1080/13811118.2018.1488638] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
The objective of the present study was to use retrospective data to test the hypothesis that cannabis dependence would be associated with an increased rate of post-deployment suicide attempts. Participants included 319 veterans who had deployed to either Iraq or Afghanistan. Study procedures involved completion of a structured clinical interview and a battery of self-report questionnaires. As expected, lifetime cannabis dependence was significantly associated with post-deployment suicide attempts, AOR = 7.963, p = .014, even after controlling for the effects of pre-deployment suicide attempts, posttraumatic stress disorder, depression, pain, non-cannabis substance use disorder, and gender. Although preliminary, our findings provide the first evidence to date that heavy cannabis use may be a unique risk factor for post-deployment suicide attempts among veterans.
Collapse
|
21
|
Kimbrel NA, Garrett ME, Dennis MF, Hauser MA, Ashley-Koch AE, Beckham JC. A genome-wide association study of suicide attempts and suicidal ideation in U.S. military veterans. Psychiatry Res 2018; 269:64-69. [PMID: 30145303 PMCID: PMC6207450 DOI: 10.1016/j.psychres.2018.07.017] [Citation(s) in RCA: 37] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/29/2018] [Revised: 06/21/2018] [Accepted: 07/08/2018] [Indexed: 12/17/2022]
Abstract
Death by suicide and suicidal behavior are major concerns among U.S. military veterans; however, no genome-wide association studies (GWAS) studies of suicidal behavior have been conducted among U.S. military veterans to date, despite the elevated rate of suicidal behavior observed within this population. Accordingly, the primary objective of the present research was to conduct the first GWAS of suicide attempts and suicidal ideation in a large and well-characterized sample of U.S. military veterans. The gene most significantly associated (p = 9.28 × 10-7) with suicide attempts was the Potassium Calcium-Activated Channel Subfamily M Regulatory Beta Subunit 2 (KCNMB2) gene, which plays a key role in neuronal excitability. In addition, replication analyses provided additional support for the potential role of the ABI Family Member 3 Binding Protein (ABI3BP) gene in the pathogenesis of suicidal behavior, as numerous nominal associations were found between this gene and both suicide attempts and suicidal ideation. Additional work aimed at replicating and extending these findings is needed.
Collapse
Affiliation(s)
- Nathan A. Kimbrel
- Durham Veterans Affairs (VA) Medical Center, Durham, NC, USA,VA Mid-Atlantic Mental Illness Research, Education, and Clinical Center, Durham, NC, USA,Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, NC, USA,Correspondence concerning this article should be sent to: Dr. Nathan A. Kimbrel, VA Mid-Atlantic Mental Illness Research, Education, and Clinical Center, 3022 Croasdaile Drive, Durham, NC, 27705,
| | | | - Michelle F. Dennis
- Durham Veterans Affairs (VA) Medical Center, Durham, NC, USA,Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, NC, USA
| | | | - Michael A. Hauser
- Duke Molecular Physiology Institute, Durham, NC, USA,Department of Medicine, Duke University Health System, Durham, NC, USA
| | - Allison E. Ashley-Koch
- Duke Molecular Physiology Institute, Durham, NC, USA,Department of Medicine, Duke University Health System, Durham, NC, USA
| | - Jean C. Beckham
- Durham Veterans Affairs (VA) Medical Center, Durham, NC, USA,VA Mid-Atlantic Mental Illness Research, Education, and Clinical Center, Durham, NC, USA,Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, NC, USA
| |
Collapse
|
22
|
Dedert EA, Dennis PA, Calhoun PS, Dennis MF, Beckham JC. A Randomized Clinical Trial of Nicotine Preloading for Smoking Cessation in People with Posttraumatic Stress Disorder. J Dual Diagn 2018; 14:148-157. [PMID: 29693495 PMCID: PMC6202285 DOI: 10.1080/15504263.2018.1468947] [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] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
OBJECTIVE The aim of this research was to determine whether augmenting standard smoking cessation treatment by wearing an active nicotine patch before the smoking quit date improves rates of smoking cessation in individuals with posttraumatic stress disorder (PTSD) and to explore mechanisms of treatment response such as decreased cigarette craving and symptom relief from smoking. METHODS This was a double-blind parallel randomized controlled trial in 81 people with PTSD who smoked cigarettes. Participants were recruited from Veterans Affairs outpatient clinics and flyers in the community. Participants provided ecological momentary assessments (EMAs) of PTSD symptoms, smoking withdrawal symptoms, and cravings before and after smoking a cigarette during one week of ad lib smoking and then three weeks of either a nicotine patch (n = 37) or placebo patch (n = 44) preceding the quit date. All participants received standard pharmacotherapy and behavioral treatment for smoking cessation after the quit date. To test the efficacy of nicotine patch preloading for engaging proposed treatment targets during the pre-quit phases, we used multilevel models to compare post-smoking changes in symptoms and cravings during the preloading phases to post-smoking changes reported during the ad lib smoking phase. RESULTS There was no significant difference in quit rates across the two conditions on the primary outcome of seven-day point prevalence smoking abstinence bioverified with breath carbon monoxide at six weeks post-quit date. In a multivariable multilevel model pre- to post-cigarette changes in PTSD symptom clusters, smoking withdrawal symptoms, and cravings, there was a significant interaction between treatment phase and condition. Relative to participants in the placebo condition, participants in the nicotine patch condition experienced diminished relief from PTSD reexperiencing symptoms, smoking withdrawal symptoms, and cigarette craving after smoking a cigarette. CONCLUSIONS Relative to placebo patch preloading, nicotine patch preloading diminished the reinforcing effects of smoking cigarettes. However, the low quit rates in both conditions suggest that nicotine patch preloading is not a sufficiently intensive treatment for achieving smoking cessation in people with PTSD. TRIAL REGISTRATION clinicaltrials.gov: NCT00625131.
Collapse
Affiliation(s)
- Eric A Dedert
- a Department of Veterans Affairs, Durham Veterans Affairs Health Care System , Durham , North Carolina , USA.,b Department of Psychiatry and Behavioral Sciences , Duke University Medical Center , Durham , North Carolina , USA.,c Veterans Affairs Mid-Atlantic Region Mental Illness Research, Education, and Clinical Center , Durham , North Carolina , USA
| | - Paul A Dennis
- a Department of Veterans Affairs, Durham Veterans Affairs Health Care System , Durham , North Carolina , USA.,b Department of Psychiatry and Behavioral Sciences , Duke University Medical Center , Durham , North Carolina , USA
| | - Patrick S Calhoun
- a Department of Veterans Affairs, Durham Veterans Affairs Health Care System , Durham , North Carolina , USA.,b Department of Psychiatry and Behavioral Sciences , Duke University Medical Center , Durham , North Carolina , USA.,c Veterans Affairs Mid-Atlantic Region Mental Illness Research, Education, and Clinical Center , Durham , North Carolina , USA
| | - Michelle F Dennis
- a Department of Veterans Affairs, Durham Veterans Affairs Health Care System , Durham , North Carolina , USA.,b Department of Psychiatry and Behavioral Sciences , Duke University Medical Center , Durham , North Carolina , USA
| | - Jean C Beckham
- a Department of Veterans Affairs, Durham Veterans Affairs Health Care System , Durham , North Carolina , USA.,b Department of Psychiatry and Behavioral Sciences , Duke University Medical Center , Durham , North Carolina , USA.,c Veterans Affairs Mid-Atlantic Region Mental Illness Research, Education, and Clinical Center , Durham , North Carolina , USA
| |
Collapse
|
23
|
Mitchell JT, McIntyre EM, English JS, Dennis MF, Beckham JC, Kollins SH. A Pilot Trial of Mindfulness Meditation Training for ADHD in Adulthood: Impact on Core Symptoms, Executive Functioning, and Emotion Dysregulation. J Atten Disord 2017; 21:1105-1120. [PMID: 24305060 PMCID: PMC4045650 DOI: 10.1177/1087054713513328] [Citation(s) in RCA: 90] [Impact Index Per Article: 12.9] [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: 11/16/2022]
Abstract
OBJECTIVE Mindfulness meditation training is garnering increasing empirical interest as an intervention for ADHD in adulthood, although no studies of mindfulness as a standalone treatment have included a sample composed entirely of adults with ADHD or a comparison group. The aim of this study was to assess the feasibility, acceptability, and preliminary efficacy of mindfulness meditation for ADHD, executive functioning (EF), and emotion dysregulation symptoms in an adult ADHD sample. METHOD Adults with ADHD were stratified by ADHD medication status and otherwise randomized into an 8-week group-based mindfulness treatment ( n = 11) or waitlist group ( n = 9). RESULTS Treatment feasibility and acceptability were positive. In addition, self-reported ADHD and EF symptoms (assessed in the laboratory and ecological momentary assessment), clinician ratings of ADHD and EF symptoms, and self-reported emotion dysregulation improved for the treatment group relative to the waitlist group over time with large effect sizes. Improvement was not observed for EF tasks. CONCLUSION Findings support preliminary treatment efficacy, though require larger trials.
Collapse
Affiliation(s)
- John T. Mitchell
- Duke University Medical Center, Department of Psychiatry and Behavioral Sciences
| | | | - Joseph S. English
- Duke University Medical Center, Department of Psychiatry and Behavioral Sciences
| | - Michelle F. Dennis
- Duke University Medical Center, Department of Psychiatry and Behavioral Sciences,Durham, NC Veterans Affairs Medical Center
| | - Jean C. Beckham
- Duke University Medical Center, Department of Psychiatry and Behavioral Sciences,Durham, NC Veterans Affairs Medical Center,Mid-Atlantic Mental Illness Research Education and Clinical Center
| | - Scott H. Kollins
- Duke University Medical Center, Department of Psychiatry and Behavioral Sciences
| |
Collapse
|
24
|
Dennis PA, Kimbrel NA, Sherwood A, Calhoun PS, Watkins LL, Dennis MF, Beckham JC. Trauma and Autonomic Dysregulation: Episodic-Versus Systemic-Negative Affect Underlying Cardiovascular Risk in Posttraumatic Stress Disorder. Psychosom Med 2017; 79:496-505. [PMID: 28570433 PMCID: PMC5466498 DOI: 10.1097/psy.0000000000000438] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [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: 01/04/2023]
Abstract
OBJECTIVE Posttraumatic stress disorder (PTSD) has been linked to elevated heart rate (HR) and reduced heart rate variability (HRV) in cross-sectional research. Recent evidence suggests that this link may be driven by individual differences in autonomic arousal associated with momentary negative affect (NA). Using ecological momentary assessment (EMA) of NA and minute-to-minute HR/HRV monitoring, we examined whether NA-related HR/HRV mediated the association of PTSD symptom severity with 24-hour HRV and endothelial functioning. METHODS One hundred ninety-seven young adults (18-39 years), 93 with PTSD, underwent 1 day of Holter monitoring while concurrently reporting NA levels via EMA. Two noninvasive measures of endothelial functioning-flow-mediated dilation and hyperemic flow-were also collected. Multilevel modeling was used to assess the associations of momentary NA with HR and low- and high-frequency HRV during the 5-minute intervals after each EMA reading. Latent variable modeling was then used to determine whether individual differences in these associations mediated the association of PTSD symptom severity with 24-hour HRV, flow-mediated dilation, and hyperemic flow. RESULTS PTSD symptom severity was positively associated with NA-related autonomic arousal (β = .21, p < .001), which significantly mediated the association of PTSD symptom severity with 24-hour HRV and hyperemic flow, accounting for 62% and 34% of their associations, respectively, while overshadowing the influence of smoking, lifetime alcohol dependence, sleep duration, mean NA, and episodes of acute NA. CONCLUSIONS Results suggest that NA-related autonomic arousal is both a primary factor driving cardiovascular risk in PTSD and a potential point of intervention.
Collapse
Affiliation(s)
- Paul A. Dennis
- Durham Veterans Affairs Medical Center, Durham, NC, 27705, USA,Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, NC 27705, USA
| | - Nathan A. Kimbrel
- Durham Veterans Affairs Medical Center, Durham, NC, 27705, USA,Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, NC 27705, USA,Veterans Affairs Mid-Atlantic Region Mental Illness Research, Education, and Clinical Center, Durham, NC 27705, USA
| | - Andrew Sherwood
- Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, NC 27705, USA
| | - Patrick S. Calhoun
- Durham Veterans Affairs Medical Center, Durham, NC, 27705, USA,Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, NC 27705, USA,Veterans Affairs Mid-Atlantic Region Mental Illness Research, Education, and Clinical Center, Durham, NC 27705, USA,Durham Veterans Affairs Center for Health Services Research in Primary Care, Durham, NC, 27705, USA
| | - Lana L. Watkins
- Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, NC 27705, USA
| | | | - Jean C. Beckham
- Durham Veterans Affairs Medical Center, Durham, NC, 27705, USA,Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, NC 27705, USA,Veterans Affairs Mid-Atlantic Region Mental Illness Research, Education, and Clinical Center, Durham, NC 27705, USA
| |
Collapse
|
25
|
Gentes EL, Schry AR, Hicks TA, Clancy CP, Collie CF, Kirby AC, Dennis MF, Hertzberg MA, Beckham JC, Calhoun PS. Prevalence and correlates of cannabis use in an outpatient VA posttraumatic stress disorder clinic. Psychol Addict Behav 2017; 30:415-21. [PMID: 27214172 DOI: 10.1037/adb0000154] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Recent research has documented high rates of comorbidity between cannabis use disorders and posttraumatic stress disorder (PTSD) in veterans. However, despite possible links between PTSD and cannabis use, relatively little is known about cannabis use in veterans who present for PTSD treatment, particularly among samples not diagnosed with a substance use disorder. This study examined the prevalence of cannabis use and the psychological and functional correlates of cannabis use among a large sample of veterans seeking treatment at a Veterans Affairs (VA) PTSD specialty clinic. Male veterans (N = 719) who presented at a VA specialty outpatient PTSD clinic completed measures of demographic variables, combat exposure, alcohol, cannabis and other drug use, and PTSD and depressive symptoms. The associations among demographic, psychological, and functional variables were estimated using logistic regressions. Overall, 14.6% of participants reported using cannabis in the past 6 months. After controlling for age, race, service era, and combat exposure, past 6-month cannabis use was associated with unmarried status, use of tobacco products, other drug use, hazardous alcohol use, PTSD severity, depressive symptom severity, and suicidality. The present findings show that cannabis use is quite prevalent among veterans seeking PTSD specialty treatment and is associated with poorer mental health and use of other substances. It may be possible to identify and treat individuals who use cannabis in specialty clinics (e.g., PTSD clinics) where they are likely to present for treatment of associated mental health issues. (PsycINFO Database Record
Collapse
Affiliation(s)
- Emily L Gentes
- VA Mid-Atlantic Mental Illness Research, Education, and Clinical Center
| | - Amie R Schry
- VA Mid-Atlantic Mental Illness Research, Education, and Clinical Center
| | - Terrell A Hicks
- Department of Psychiatry and Behavioral Sciences, Duke University
| | | | | | - Angela C Kirby
- VA Mid-Atlantic Mental Illness Research, Education, and Clinical Center
| | - Michelle F Dennis
- VA Mid-Atlantic Mental Illness Research, Education, and Clinical Center
| | | | - Jean C Beckham
- VA Mid-Atlantic Mental Illness Research, Education, and Clinical Center
| | - Patrick S Calhoun
- VA Mid-Atlantic Mental Illness Research, Education, and Clinical Center
| |
Collapse
|
26
|
Hauser MA, Garrett ME, Liu Y, Dennis MF, Kimbrel NA, Veterans Affairs Mid-Atlantic Mental Illness Research Education And Clinical Center Workgroup, Beckham JC, Ashley-Koch AE. Further evidence for a role of the ADRB2 gene in risk for posttraumatic stress disorder. J Psychiatr Res 2017; 84:59-61. [PMID: 27701011 DOI: 10.1016/j.jpsychires.2016.09.013] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [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] [Received: 03/16/2016] [Revised: 09/14/2016] [Accepted: 09/14/2016] [Indexed: 12/20/2022]
Abstract
The aim of the present study was to attempt to replicate the recently reported finding associating rs2400707 of the Adrenoceptor Beta 2, Surface (ADRB2) gene and childhood trauma on PTSD symptoms. Participants included a predominantly veteran cohort of non-Hispanic blacks (NHB; n = 949) and a pre-dominantly veteran cohort of non-Hispanic whites (NHW; n = 759). No main effects were observed for rs2400707 on PTSD diagnosis. Among the NHB participants, we observed an interaction between rs2400707 and history of childhood trauma, whereby with each additional A allele, the odds of having PTSD increased by 1.31, but only among those who had experienced childhood trauma (p = 0.038). The interaction with rs2400707 and childhood trauma was not observed among the NHW study participants (p = 0.892). Taken together, the findings from the present research provide further evidence that the adrenergic system may be an important modulator of PTSD risk; however, additional work is still needed to clarify the exact nature of the relationship between PTSD and rs2400707 of the ADRB2 gene.
Collapse
Affiliation(s)
- Michael A Hauser
- Department of Medicine, Duke University Medical Center, Durham, NC, United States; Duke Molecular Physiology Institute, Durham, NC, United States.
| | - Melanie E Garrett
- Department of Medicine, Duke University Medical Center, Durham, NC, United States; Duke Center for Human Disease Modeling, Durham, NC, United States
| | - Yutao Liu
- Department of Medicine, Duke University Medical Center, Durham, NC, United States
| | - Michelle F Dennis
- Durham Veterans Affairs Medical Center, Durham, NC, United States; The VA Mid-Atlantic Mental Illness Research, Education, and Clinical Center, Durham, NC, United States; Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, NC, United States
| | - Nathan A Kimbrel
- Durham Veterans Affairs Medical Center, Durham, NC, United States; The VA Mid-Atlantic Mental Illness Research, Education, and Clinical Center, Durham, NC, United States; Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, NC, United States
| | | | - Jean C Beckham
- Durham Veterans Affairs Medical Center, Durham, NC, United States; The VA Mid-Atlantic Mental Illness Research, Education, and Clinical Center, Durham, NC, United States; Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, NC, United States
| | - Allison E Ashley-Koch
- Department of Medicine, Duke University Medical Center, Durham, NC, United States; Duke Center for Human Disease Modeling, Durham, NC, United States
| |
Collapse
|
27
|
Rissling MB, Dennis PA, Watkins LL, Calhoun PS, Dennis MF, Beckham JC, Hayano J, Ulmer CS. Circadian Contrasts in Heart Rate Variability Associated With Posttraumatic Stress Disorder Symptoms in a Young Adult Cohort. J Trauma Stress 2016; 29:415-421. [PMID: 27603025 PMCID: PMC5108045 DOI: 10.1002/jts.22125] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/08/2015] [Revised: 04/19/2016] [Accepted: 06/06/2016] [Indexed: 11/07/2022]
Abstract
Prior research has demonstrated that individuals exposed to trauma have shown impaired autonomic function. We sought to determine if heart rate variability (HRV), a marker of impaired autonomic function, differed across periods of wake, rest, and sleep as a function of the level of symptoms of posttraumatic stress disorder (PTSD). A sample of young adults (N = 209), 95 of whom met full criteria for current PTSD based on the Clinician Administered PTSD Scale (CAPS; Blake et al., 1995), were evaluated for ≈ 24 hr using actigraphy and electrocardiogram. Actigraphy data were categorized as active, rest, or sleep. Multilevel modeling analyses showed that individuals with high PTSD symptom severity had lower high-frequency HRV than individuals with low PTSD symptom severity during periods of sleep, t(1083) = 2.20, p = .028, Cohen's d = 0.12. No differences were found during periods of activity, t(1083) = 1.34, p = .499, d = 0.05, or rest, t(1083) = 1.34, p = .180, d = 0.09. Our findings extended the import of prior studies to suggest that those with elevated PTSD symptoms may have decreased parasympathetic control during sleep. Moreover, relative to periods of wake and rest, sleep may represent a state of increased vulnerability for decreased parasympathetic cardiac control. Individuals with elevated PTSD symptoms may benefit from early screening for detection of cardiovascular disease.
Collapse
Affiliation(s)
- Michelle B. Rissling
- Veterans Affairs Mid-Atlantic Region Mental Illness Research, Education, and Clinical Center, Durham, North Carolina, USA
| | - Paul A. Dennis
- Durham Veterans Affairs Medical Center, Department of Research and Development, Durham, North Carolina, USA,Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, North Carolina, USA
| | - Lana L. Watkins
- Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, North Carolina, USA
| | - Patrick S. Calhoun
- Veterans Affairs Mid-Atlantic Region Mental Illness Research, Education, and Clinical Center, Durham, North Carolina, USA,Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, North Carolina, USA,Durham Veterans Affairs Center for Health Services Research in Primary Care, Durham, North Carolina, USA
| | - Michelle F. Dennis
- Veterans Affairs Mid-Atlantic Region Mental Illness Research, Education, and Clinical Center, Durham, North Carolina, USA,Durham Veterans Affairs Medical Center, Department of Research and Development, Durham, North Carolina, USA,Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, North Carolina, USA
| | - Jean C. Beckham
- Veterans Affairs Mid-Atlantic Region Mental Illness Research, Education, and Clinical Center, Durham, North Carolina, USA,Durham Veterans Affairs Medical Center, Department of Research and Development, Durham, North Carolina, USA,Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, North Carolina, USA
| | - Junichiro Hayano
- Department of Medical Education, Nagoya City University Graduate School of Medical Sciences, Japan
| | - Christi S. Ulmer
- Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, North Carolina, USA,Durham Veterans Affairs Center for Health Services Research in Primary Care, Durham, North Carolina, USA
| |
Collapse
|
28
|
Dennis PA, Dennis NM, Van Voorhees EE, Calhoun PS, Dennis MF, Beckham JC. Moral transgression during the Vietnam War: a path analysis of the psychological impact of veterans' involvement in wartime atrocities. Anxiety Stress Coping 2016; 30:188-201. [PMID: 27580161 DOI: 10.1080/10615806.2016.1230669] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
BACKGROUND AND OBJECTIVES Involvement in wartime combat often conveys a number of deleterious outcomes, including posttraumatic stress disorder (PTSD), depression, hostility, aggression, and suicidal ideation. Less studied is the effect of engagement in wartime atrocities, including witnessing and perpetrating abusive violence. DESIGN AND METHODS This study employed path analysis to examine the direct effects of involvement in wartime atrocities on hostility, aggression, depression, and suicidal ideation independent of combat exposure, as well as the indirect effects via guilt and PTSD symptom severity among 603 help-seeking male Vietnam War veterans. RESULTS Involvement in wartime atrocities was predictive of increased guilt, PTSD severity, hostility, aggression, depressive symptoms, and suicidal ideation after controlling for overall combat exposure. Combat-related guilt played a minor role in mediating the effect of atrocity involvement on depression and suicidal ideation. PTSD severity had a larger mediational effect. However, it still accounted for less than half of the total effect of involvement in wartime atrocities on hostility, aggression, and suicidal ideation. CONCLUSIONS These findings highlight the heightened risk conveyed by involvement in wartime atrocities and suggest that the psychological sequelae experienced following atrocity involvement may extend well beyond guilt and PTSD.
Collapse
Affiliation(s)
- Paul A Dennis
- a Durham Veterans Affairs Medical Center , Durham , NC , USA.,b Department of Psychiatry and Behavioral Sciences , Duke University Medical Center , Durham , NC , USA
| | - Nora M Dennis
- a Durham Veterans Affairs Medical Center , Durham , NC , USA.,b Department of Psychiatry and Behavioral Sciences , Duke University Medical Center , Durham , NC , USA
| | - Elizabeth E Van Voorhees
- a Durham Veterans Affairs Medical Center , Durham , NC , USA.,b Department of Psychiatry and Behavioral Sciences , Duke University Medical Center , Durham , NC , USA
| | - Patrick S Calhoun
- a Durham Veterans Affairs Medical Center , Durham , NC , USA.,b Department of Psychiatry and Behavioral Sciences , Duke University Medical Center , Durham , NC , USA.,c Veterans Affairs Mid-Atlantic Region Mental Illness Research, Education, and Clinical Center , Durham , NC , USA.,d Veterans Affairs Center for Health Services Research in Primary Care , Durham , NC , USA
| | - Michelle F Dennis
- a Durham Veterans Affairs Medical Center , Durham , NC , USA.,b Department of Psychiatry and Behavioral Sciences , Duke University Medical Center , Durham , NC , USA
| | - Jean C Beckham
- a Durham Veterans Affairs Medical Center , Durham , NC , USA.,b Department of Psychiatry and Behavioral Sciences , Duke University Medical Center , Durham , NC , USA.,c Veterans Affairs Mid-Atlantic Region Mental Illness Research, Education, and Clinical Center , Durham , NC , USA
| |
Collapse
|
29
|
Dennis PA, Weinberg JB, Calhoun PS, Watkins LL, Sherwood A, Dennis MF, Beckham JC. An investigation of vago-regulatory and health-behavior accounts for increased inflammation in posttraumatic stress disorder. J Psychosom Res 2016; 83:33-9. [PMID: 27020074 PMCID: PMC4813329 DOI: 10.1016/j.jpsychores.2016.02.008] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [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] [Received: 11/11/2015] [Revised: 02/18/2016] [Accepted: 02/24/2016] [Indexed: 12/17/2022]
Abstract
OBJECTIVE Posttraumatic stress disorder (PTSD) has been linked to chronic inflammation, a condition that poses a risk for cardiovascular disease. Attenuated vagal activity has been proposed as a potential mediator of PTSD and inflammation, although associated behavioral health risks-namely cigarette smoking and alcohol dependence-might also account for that link. METHODS Inflammation was quantified by fasting serum concentrations of C-reactive protein (CRP), tumor necrosis factor (TNF)-α, interleukin (IL)-10, and thymus- and activation-regulated chemokine (TARC)/CCL17 collected from 85 participants with PTSD and 82 without PTSD. Latent variable modeling was used to assess the relationship between PTSD symptom severity and inflammation along with potential mediators vagal activity (respiratory sinus arrhythmia; RSA), smoking status, and lifetime alcohol dependence. RESULTS PTSD symptom severity was associated with increased inflammation (β=.18, p=.02). However, this association was reduced in models that adjusted for RSA, smoking status, and lifetime alcohol dependence. Independent mediation effects were deemed significant via bootstrapping analyses. Together, RSA, smoking status, and lifetime alcohol dependence accounted for 95% of the effect of PTSD symptom severity on inflammation. CONCLUSION Although RSA accounted for a modest proportion of the association between posttraumatic stress and pro-inflammatory responses, behavioral factors-specifically cigarette smoking and alcohol dependence-proved to be larger mediators. The benefits of PTSD treatment may be enhanced by additional interventions aimed at modifying these health behaviors.
Collapse
Affiliation(s)
- Paul A. Dennis
- Durham Veterans Affairs Medical Center, Durham, NC, 27705, USA,Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, NC 27705, USA
| | - J. B. Weinberg
- Durham Veterans Affairs Medical Center, Durham, NC, 27705, USA,Department of Medicine, Duke University Medical Center, Durham, NC 27705, USA
| | - Patrick S. Calhoun
- Durham Veterans Affairs Medical Center, Durham, NC, 27705, USA,Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, NC 27705, USA,Veterans Affairs Mid-Atlantic Region Mental Illness Research, Education, and Clinical Center, Durham, NC 27705, USA,Veterans Affairs Center for Health Services Research in Primary Care, Durham, NC, 27705, USA
| | - Lana L. Watkins
- Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, NC 27705, USA
| | - Andrew Sherwood
- Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, NC 27705, USA
| | - Michelle F. Dennis
- Durham Veterans Affairs Medical Center, Durham, NC, 27705, USA,Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, NC 27705, USA
| | - Jean C. Beckham
- Durham Veterans Affairs Medical Center, Durham, NC, 27705, USA,Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, NC 27705, USA,Veterans Affairs Mid-Atlantic Region Mental Illness Research, Education, and Clinical Center, Durham, NC 27705, USA
| |
Collapse
|
30
|
Abstract
Most smokers who attempt to quit lapse within the first week and are ultimately unsuccessful in their quit attempt. Nicotine withdrawal exacerbates cognitive and attentional problems and may be one factor in smoking relapse. The startle reflex response and prepulse inhibition (PPI) of the response are sensitive to arousal and early attentional dysregulation. The current study examined whether startle response and PPI are related to early smoking lapse, and if this differs in people with and without posttraumatic stress disorder (PTSD). Participants with (N = 34) and without (N = 57) PTSD completed a startle reflex and PPI assessment during (1) ad lib smoking (2) on the first day of abstinence during a quit attempt. Most (88%) participants lapsed within the first week of the quit attempt. PTSD status predicted shorter time to lapse. Larger startle magnitude and greater PPI predicted a longer duration before smoking lapse. When diagnostic groups were examined separately, greater PPI predicted a longer successful quit attempt only in participants with a PTSD diagnosis. The startle reflex response and PPI may provide an objective, neurophysiological evaluation of regulation of arousal and early attentional processes by nicotine, which are important factors in smoking cessation success.
Collapse
Affiliation(s)
- Scott R. Vrana
- Virginia Commonwealth University, 508 Fulton St., Durham, NC, 27705
| | - Patrick S. Calhoun
- Durham VA Medical Center, 508 Fulton St., Durham, NC, 27705,MidAtlantic Research Education and Clinical Center, 508 Fulton St., Durham, NC, 27705,Duke University School of Medicine, Department of Psychiatry & Behavioral Sciences, Durham, NC, 27708
| | - Michelle F. Dennis
- Durham VA Medical Center, 508 Fulton St., Durham, NC, 27705,MidAtlantic Research Education and Clinical Center, 508 Fulton St., Durham, NC, 27705,Duke University School of Medicine, Department of Psychiatry & Behavioral Sciences, Durham, NC, 27708
| | | | - Jean C. Beckham
- Durham VA Medical Center, 508 Fulton St., Durham, NC, 27705,MidAtlantic Research Education and Clinical Center, 508 Fulton St., Durham, NC, 27705,Duke University School of Medicine, Department of Psychiatry & Behavioral Sciences, Durham, NC, 27708
| |
Collapse
|
31
|
Kimbrel NA, Garrett ME, Dennis MF, Liu Y, Patanam I, Ashley-Koc AE, Hauser MA, Beckham JC. Effect of genetic variation in the nicotinic receptor genes on risk for posttraumatic stress disorder. Psychiatry Res 2015; 229:326-31. [PMID: 26184988 PMCID: PMC4697753 DOI: 10.1016/j.psychres.2015.07.002] [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] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/21/2015] [Revised: 06/23/2015] [Accepted: 07/05/2015] [Indexed: 11/24/2022]
Abstract
The present study examined the association between genetic variation in the nicotinic receptor gene family (CHRNA2, CHRNA3, CHRNA4, CHRNA5, CHRNA6, CHRNA7, CHRNA9, CHRNA10, CHRNB2, CHRNB3, CHRNB4) and the occurrence of posttraumatic stress disorder (PTSD). Clinical interviews were used to diagnose PTSD in 925 non-Hispanic Black (NHB) and 743 non-Hispanic White (NHW) participants. Trauma history and smoking status were assessed with self-report. No significant main effects or single nucleotide polymorphism (SNP) * smoking interactions were observed among NHB participants; however, among NHW participants, a novel association between rs12898919 in the cholinergic receptor nicotinic alpha-5 (CHRNA5) gene and PTSD was observed. No other significant main effects or SNP * smoking interactions were identified among NHW participants. While preliminary, these findings provide continued support for the hypothesis that the CHRNA5 gene is associated with increased risk for PTSD. Limitations of the present study include cross-sectional design, relatively small sample sizes for genetic research, use of self-report to assess smoking status, and use of different methods to diagnose PTSD. Additional research in other samples of trauma-exposed participants is needed to identify the specific functional variant(s) responsible for the association observed between CHRNA5 and PTSD risk in the present study.
Collapse
Affiliation(s)
- Nathan A. Kimbrel
- Durham Veterans Affairs Medical Center, Durham, NC, USA, VA Mid-Atlantic Mental Illness Research, Education and Clinical Center, Durham, NC, USA, Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, NC, USA,Correspondence concerning this article should be sent to: Dr. Nathan A. Kimbrel, Durham Veterans Affairs Medical Center, 508 Fulton Street, Durham, NC, 27705. Phone: (919) 286-0411, ext. 6759.
| | - Melanie E. Garrett
- Center for Human Disease Modeling, Duke University Medical Center, Durham, NC, USA
| | - Michelle F. Dennis
- Durham Veterans Affairs Medical Center, Durham, NC, USA, VA Mid-Atlantic Mental Illness Research, Education and Clinical Center, Durham, NC, USA, Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, NC, USA
| | - Yutao Liu
- Department of Cellular Biology and Anatomy, Georgia Regents University, Augusta, GA, USA
| | - Ilyas Patanam
- Program in Computational Biology and Bioinformatics, Duke University, Durham, NC, USA
| | | | - Allison E. Ashley-Koc
- Center for Human Disease Modeling, Duke University Medical Center, Durham, NC, USA, Department of Biostatistics and Bioinformatics, Duke University Medical Center, Durham, NC, USA, Department of Medicine, Duke University Medical Center, Durham, NC, USA
| | - Michael A. Hauser
- Department of Medicine, Duke University Medical Center, Durham, NC, USA, Duke Molecular Physiology Institute, Durham, NC, USA
| | - Jean C. Beckham
- Durham Veterans Affairs Medical Center, Durham, NC, USA, VA Mid-Atlantic Mental Illness Research, Education and Clinical Center, Durham, NC, USA, Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, NC, USA
| |
Collapse
|
32
|
Ashley-Koch AE, Garrett ME, Gibson J, Liu Y, Dennis MF, Kimbrel NA, Beckham JC, Hauser MA. Genome-wide association study of posttraumatic stress disorder in a cohort of Iraq-Afghanistan era veterans. J Affect Disord 2015; 184:225-34. [PMID: 26114229 PMCID: PMC4697755 DOI: 10.1016/j.jad.2015.03.049] [Citation(s) in RCA: 74] [Impact Index Per Article: 8.2] [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] [Received: 02/10/2015] [Accepted: 03/26/2015] [Indexed: 10/23/2022]
Abstract
BACKGROUND Posttraumatic stress disorder (PTSD) is a psychiatric disorder that can develop after experiencing traumatic events. A genome-wide association study (GWAS) design was used to identify genetic risk factors for PTSD within a multi-racial sample primarily composed of U.S. veterans. METHODS Participants were recruited at multiple medical centers, and structured interviews were used to establish diagnoses. Genotypes were generated using three Illumina platforms and imputed with global reference data to create a common set of SNPs. SNPs that increased risk for PTSD were identified with logistic regression, while controlling for gender, trauma severity, and population substructure. Analyses were run separately in non-Hispanic black (NHB; n = 949) and non-Hispanic white (NHW; n = 759) participants. Meta-analysis was used to combine results from the two subsets. RESULTS SNPs within several interesting candidate genes were nominally significant. Within the NHB subset, the most significant genes were UNC13C and DSCAM. Within the NHW subset, the most significant genes were TBC1D2, SDC2 and PCDH7. In addition, PRKG1 and DDX60L were identified through meta-analysis. The top genes for the three analyses have been previously implicated in neurologic processes consistent with a role in PTSD. Pathway analysis of the top genes identified alternative splicing as the top GO term in all three analyses (FDR q < 3.5 × 10(-5)). LIMITATIONS No individual SNPs met genome-wide significance in the analyses. CONCLUSIONS This multi-racial PTSD GWAS identified biologically plausible candidate genes and suggests that post-transcriptional regulation may be important to the pathology of PTSD; however, replication of these findings is needed.
Collapse
Affiliation(s)
| | | | - Jason Gibson
- Department of Medicine, Duke University Medical Center, Durham, NC
| | - Yutao Liu
- Department of Medicine, Duke University Medical Center, Durham, NC
| | - Michelle F. Dennis
- Durham Veterans Affairs Medical Center, Durham, NC,The VA Mid-Atlantic Mental Illness Research, Education, and Clinical Center, Durham, NC,Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, NC
| | - Nathan A. Kimbrel
- Durham Veterans Affairs Medical Center, Durham, NC,The VA Mid-Atlantic Mental Illness Research, Education, and Clinical Center, Durham, NC,Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, NC
| | | | - Jean C. Beckham
- Durham Veterans Affairs Medical Center, Durham, NC,The VA Mid-Atlantic Mental Illness Research, Education, and Clinical Center, Durham, NC,Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, NC
| | | |
Collapse
|
33
|
Carpenter VL, Hertzberg JS, Kirby AC, Calhoun PS, Moore SD, Dennis MF, Dennis PA, Dedert EA, Hair LP, Beckham JC. Multicomponent smoking cessation treatment including mobile contingency management in homeless veterans. J Clin Psychiatry 2015; 76:959-64. [PMID: 25699616 PMCID: PMC4522209 DOI: 10.4088/jcp.14m09053] [Citation(s) in RCA: 47] [Impact Index Per Article: 5.2] [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] [Received: 02/08/2014] [Accepted: 07/08/2014] [Indexed: 10/24/2022]
Abstract
INTRODUCTION Smoking rates are 80% among persons who are homeless, and these smokers have decreased odds of quitting smoking. Little is known about relapse rates among homeless smokers. More information is needed regarding both quit rates and innovative methods to treat smoking cessation among homeless smokers. Web-based contingency management (CM) approaches have been found helpful in reducing smoking among other difficult-to-treat smoker populations but have been generally limited by the need for computers or frequent clinic-based carbon monoxide (CO) monitoring. This open pilot study builds on a web-based CM approach by evaluating a smartphone-based application for CM named mobile CM (mCM). The study was conducted from January 1, 2013-April 15, 2014. METHOD Following a 1-week training period, 20 homeless veteran smokers (≥ 10 cigarettes daily for 1 year or more and a CO baseline level ≥ 10 ppm) participated in a multicomponent smoking cessation intervention including 4 weeks of mCM. All smokers received 4 smoking cessation counseling sessions, nicotine replacement, and bupropion (if medically eligible). Participants could earn up to $815 ($480 for mCM, $100 for CO readings showing abstinence [ie, 6 ppm or less] at posttreatment and follow-up, and $35 for equipment return). RESULTS Mean compensation for the mCM component was $286 of a possible $480. Video transmission compliance was high during the 1-week training (97%) and the 4-week treatment period (87%). Bioverified 7-day point prevalence abstinence was 50% at 4 weeks. Follow-up bioverified single assessment point prevalence abstinence was 55% at 3 months and 45% at 6 months. CONCLUSIONS Results of this open pilot study suggest that mCM may be a useful adjunctive smoking cessation treatment component for reducing smoking among homeless veterans. TRIAL REGISTRATION ClinicalTrials.gov identifier: NCT01789710.
Collapse
Affiliation(s)
| | - Jeffrey S. Hertzberg
- Durham Veterans Affairs Medical Center, Durham, NC, 27705, USA,Institute of Medical Research, Durham, NC, 27705, USA
| | - Angela C. Kirby
- Durham Veterans Affairs Medical Center, Durham, NC, 27705, USA,Veterans Affairs Mid-Atlantic Region Mental Illness Research, Education, and Clinical Center, Durham, NC 27705, USA
| | - Patrick S. Calhoun
- Durham Veterans Affairs Medical Center, Durham, NC, 27705, USA,Veterans Affairs Mid-Atlantic Region Mental Illness Research, Education, and Clinical Center, Durham, NC 27705, USA,Veterans Affairs Center for Health Services Research in Primary Care, Durham, NC, 27705, USA,Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, NC 27705, USA
| | - Scott D. Moore
- Durham Veterans Affairs Medical Center, Durham, NC, 27705, USA,Veterans Affairs Mid-Atlantic Region Mental Illness Research, Education, and Clinical Center, Durham, NC 27705, USA,Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, NC 27705, USA
| | - Michelle F. Dennis
- Durham Veterans Affairs Medical Center, Durham, NC, 27705, USA,Veterans Affairs Mid-Atlantic Region Mental Illness Research, Education, and Clinical Center, Durham, NC 27705, USA,Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, NC 27705, USA
| | - Paul A. Dennis
- Durham Veterans Affairs Medical Center, Durham, NC, 27705, USA,Veterans Affairs Center for Health Services Research in Primary Care, Durham, NC, 27705, USA
| | - Eric A. Dedert
- Durham Veterans Affairs Medical Center, Durham, NC, 27705, USA,Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, NC 27705, USA
| | - Lauren P. Hair
- Durham Veterans Affairs Medical Center, Durham, NC, 27705, USA,Veterans Affairs Center for Health Services Research in Primary Care, Durham, NC, 27705, USA
| | - Jean C. Beckham
- Durham Veterans Affairs Medical Center, Durham, NC, 27705, USA,Veterans Affairs Mid-Atlantic Region Mental Illness Research, Education, and Clinical Center, Durham, NC 27705, USA,Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, NC 27705, USA
| |
Collapse
|
34
|
Kimbrel NA, Hauser MA, Garrett M, Ashley-Koch A, Liu Y, Dennis MF, Klein RC, Beckham JC. EFFECT OF THE APOE ε4 ALLELE AND COMBAT EXPOSURE ON PTSD AMONG IRAQ/AFGHANISTAN-ERA VETERANS. Depress Anxiety 2015; 32:307-15. [PMID: 25709077 PMCID: PMC4697754 DOI: 10.1002/da.22348] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [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] [Received: 01/21/2014] [Revised: 05/12/2014] [Accepted: 12/11/2014] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND The apolipoprotein E (APOE) ε4 allele has been implicated in a range of neuropsychiatric conditions. The present research examined if the ε4 allele of the APOE gene moderated the effect of combat exposure on posttraumatic stress disorder (PTSD) among Iraq/Afghanistan-era veterans. METHOD Participants included 765 non-Hispanic White (NHW) and 859 non-Hispanic Black (NHB) Iraq/Afghanistan-era veterans. A structured interview established psychiatric diagnoses. Combat exposure and PTSD symptom severity were assessed via self-report. RESULTS The most common lifetime diagnoses were depression (39.2%), PTSD (38.4%), and alcohol dependence (24.38%). After correcting for multiple comparisons, no significant effects were observed on any of the outcomes among the NHW sample; however, within the NHB sample, significant gene × environment (G × E) interactions were observed for lifetime PTSD (P = .0029) and PTSD symptom severity (P = .0009). In each case, the APOE ε4 allele had no effect on the outcomes when combat exposure was low; however, when combat exposure was high, an additive effect was observed such that ε4 homozygotes exposed to high levels of combat reported the highest rates of PTSD (92%) and the worst symptom severity scores on the Davidson Trauma Scale (M = 79.5). CONCLUSIONS Although preliminary, these findings suggest that the APOE ε4 allele, in conjunction with exposure to high levels of combat exposure, may increase veterans' risk for developing PTSD.
Collapse
Affiliation(s)
- Nathan A. Kimbrel
- Durham Veterans Affairs Medical Center, Durham, NC,The VA Mid-Atlantic Mental Illness Research, Education, and Clinical Center, Durham, NC,Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, NC,Correspondence concerning this article should be sent to: Dr. Nathan A. Kimbrel, Durham Veterans Affairs Medical Center, 508 Fulton Street, Durham, NC, 27705. Phone: (919) 286-0411, ext. 6759.
| | - Michael A. Hauser
- Department of Medicine, Duke University Medical Center, Durham, NC,Duke Center for Human Genetics, Durham, NC
| | - Melanie Garrett
- Department of Medicine, Duke University Medical Center, Durham, NC,Duke Center for Human Genetics, Durham, NC
| | - Allison Ashley-Koch
- Department of Medicine, Duke University Medical Center, Durham, NC,Duke Center for Human Genetics, Durham, NC
| | - Yutao Liu
- Department of Medicine, Duke University Medical Center, Durham, NC,Duke Center for Human Genetics, Durham, NC
| | - Michelle F. Dennis
- Durham Veterans Affairs Medical Center, Durham, NC,The VA Mid-Atlantic Mental Illness Research, Education, and Clinical Center, Durham, NC,Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, NC
| | - Rebecca C. Klein
- Durham Veterans Affairs Medical Center, Durham, NC,The VA Mid-Atlantic Mental Illness Research, Education, and Clinical Center, Durham, NC,Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, NC
| | | | - Jean C. Beckham
- Durham Veterans Affairs Medical Center, Durham, NC,The VA Mid-Atlantic Mental Illness Research, Education, and Clinical Center, Durham, NC,Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, NC
| |
Collapse
|
35
|
Liu Y, Garrett ME, Dennis MF, Green KT, Ashley-Koch AE, Hauser MA, Beckham JC, Kimbrel NA. An examination of the association between 5-HTTLPR, combat exposure, and PTSD diagnosis among U.S. veterans. PLoS One 2015; 10:e0119998. [PMID: 25793742 PMCID: PMC4368771 DOI: 10.1371/journal.pone.0119998] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2014] [Accepted: 01/19/2015] [Indexed: 11/19/2022] Open
Abstract
Objective To examine the association between the 5-HTTLPR polymorphism of the serotonin transporter (SLC6A4) gene, combat exposure, and posttraumatic stress disorder (PTSD) diagnosis and among two samples of combat-exposed veterans. Method The first sample included 550 non-Hispanic Black (NHB) combat-exposed veterans. The second sample included 555 non-Hispanic White (NHW) combat-exposed veterans. Participants were genotyped for the 5-HTTLPR/rs25531 variants of the SLC6A4 gene. A structured clinical interview was used to diagnose PTSD. Combat and civilian trauma exposure were assessed with validated self-report instruments. Logistic regression was used to test for main effects of 5-HTTLPR on PTSD diagnosis as well as gene x environment (GxE) interactions after adjusting for sex, ancestry proportion scores, civilian trauma exposure, and combat exposure. Results Within the NHB sample, a significant additive effect was observed for 5-HTTLPR (OR = 1.502, p = .0025), such that the odds of having a current diagnosis of PTSD increased by 1.502 for each additional S’ allele. No evidence for an association between 5-HTTLPR and PTSD was observed in the NHW sample. In addition, no evidence for combat x 5-HTTLPR effects were observed in either sample. Conclusion The present study suggests that there may be an association between 5-HTTLPR genotype and PTSD diagnosis among NHB veterans; however, no evidence for the hypothesized 5-HTTLPR x combat interaction was found.
Collapse
Affiliation(s)
- Yutao Liu
- Department of Cellular Biology and Anatomy, Georgia Regents University, Augusta, Georgia, United States of America
| | - Melanie E. Garrett
- Department of Medicine, Duke University Medical Center, Durham, North Carolina, United States of America
| | - Michelle F. Dennis
- Durham Veterans Affairs Medical Center, Durham, North Carolina, United States of America
- VA Mid-Atlantic Mental Illness Research, Education and Clinical Center, Durham, North Carolina, United States of America
- Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, North Carolina, United States of America
| | - Kimberly T. Green
- Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, North Carolina, United States of America
| | | | - Allison E. Ashley-Koch
- Department of Medicine, Duke University Medical Center, Durham, North Carolina, United States of America
| | - Michael A. Hauser
- Department of Medicine, Duke University Medical Center, Durham, North Carolina, United States of America
| | - Jean C. Beckham
- Durham Veterans Affairs Medical Center, Durham, North Carolina, United States of America
- VA Mid-Atlantic Mental Illness Research, Education and Clinical Center, Durham, North Carolina, United States of America
- Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, North Carolina, United States of America
| | - Nathan A. Kimbrel
- Durham Veterans Affairs Medical Center, Durham, North Carolina, United States of America
- VA Mid-Atlantic Mental Illness Research, Education and Clinical Center, Durham, North Carolina, United States of America
- Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, North Carolina, United States of America
- * E-mail:
| |
Collapse
|
36
|
Oddone AE, Dennis PA, Calhoun PS, Watkins LL, Sherwood A, Dedert EA, Green KT, Stein JN, Dennis MF, Beckham JC. Orthostatic hypotension in young adults with and without posttraumatic stress disorder. Psychol Trauma 2014; 7:229-33. [PMID: 25961117 DOI: 10.1037/a0036716] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
The purpose of this research is (a) to evaluate differences in orthostatic hypotension (OH) among young adults with and without posttraumatic stress disorder (PTSD) and (b) to examine whether group differences may be attributable to behavioral risk factors frequently associated with PTSD. Volunteers and U.S. veterans 18 to 39 years old (N = 222) completed a semistructured interview assessment of PTSD status. Direct measurements were obtained for supine and standing systolic and diastolic blood pressure at study visits, as well as height and weight, from which body mass index (BMI) was calculated. After controlling for use of psychotropic medications, a logistic regression model revealed that PTSD status was positively associated with OH, such that participants with PTSD were at 4.51 greater odds of having OH than control participants. Moreover, this effect was partially mediated by lifetime alcohol dependence (bootstrapped 95% confidence interval [-0.83, -0.20]). Overall, PTSD may pose a significant risk for OH among younger adults. In the present sample, this relationship was primarily driven by the disproportionately high history of alcohol dependence among individuals with PTSD. These results suggest that traditional therapy for PTSD should be coupled with treatment for alcohol dependency, when applicable, to reap both psychological and physiological benefits.
Collapse
Affiliation(s)
| | | | - Patrick S Calhoun
- Veterans Affairs Mid-Atlantic Region Mental Illness Research, Education, and Clinical Center
| | - Lana L Watkins
- Department of Psychiatry and Behavioral Sciences, Duke University Medical Center
| | - Andrew Sherwood
- Department of Psychiatry and Behavioral Sciences, Duke University Medical Center
| | | | | | | | | | - Jean C Beckham
- Veterans Affairs Mid-Atlantic Region Mental Illness Research, Education, and Clinical Center
| |
Collapse
|
37
|
Mitchell JT, Dennis MF, English JS, Dennis PA, Brightwood A, Beckham JC, Kollins SH. Ecological momentary assessment of antecedents and consequences of smoking in adults with attention-deficit/hyperactivity disorder. Subst Use Misuse 2014; 49:1446-56. [PMID: 24827866 PMCID: PMC4116432 DOI: 10.3109/10826084.2014.912229] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [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: 11/13/2022]
Abstract
The current study assessed antecedents and consequences of ad lib cigarette smoking in smokers diagnosed with attention-deficit/hyperactivity disorder (ADHD) using ecological momentary assessment (EMA). Adult smokers with ADHD (n = 17) completed 870 smoking and 622 nonsmoking electronic diary entries over a 7-day observation period of their naturalistic smoking behavior. Data collection occurred from 2011 to 2012. Generalized estimating equations indicated that ADHD smokers were more likely to smoke when urge to smoke, negative affect, boredom, stress, worry, and restlessness were elevated. In addition, participants were more likely to smoke in situations that elicited higher levels of nervousness and frustration. ADHD symptoms, in general, did not differ between smoking and nonsmoking contexts, though hyperactive-impulsive ADHD symptoms were elevated prior to smoking in frustrating situations. Additional situational antecedent variables were associated with smoking, including being in the presence of others smoking, being in a bar or restaurant, while outside, and while consuming caffeinated or alcoholic beverages. Participants also reported a significant improvement in urge to smoke, negative affect, stress, hunger, and ADHD symptoms after smoking a cigarette. Findings suggest certain contextual factors that may maintain ad lib cigarette smoking in smokers with ADHD and identify potential treatment targets in smoking cessation interventions for this at-risk group. Clinical implications and future research directions are discussed. Funding for this study was provided by the National Institute on Drug Abuse.
Collapse
Affiliation(s)
- John T Mitchell
- 1Duke University Medical Center, Durham, North Carolina, USA
| | | | | | | | | | | | | |
Collapse
|
38
|
Kimbrel NA, Johnson ME, Clancy C, Hertzberg M, Collie C, Van Voorhees EE, Dennis MF, Calhoun PS, Beckham JC. Deliberate self-harm and suicidal ideation among male Iraq/Afghanistan-era veterans seeking treatment for PTSD. J Trauma Stress 2014; 27:474-7. [PMID: 25066891 PMCID: PMC4697760 DOI: 10.1002/jts.21932] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
The objectives of the present research were to examine the prevalence of deliberate self-harm (DSH) among 214 U.S. male Iraq/Afghanistan-era veterans seeking treatment for posttraumatic stress disorder (PTSD) and to evaluate the relationship between DSH and suicidal ideation within this population. Approximately 56.5% (n = 121) reported engaging in DSH during their lifetime; 45.3% (n = 97) reported engaging in DSH during the previous 2 weeks. As hypothesized, DSH was a significant correlate of suicidal ideation among male Iraq/Afghanistan-era veterans, OR = 3.88, p < .001, along with PTSD symptom severity, OR = 1.03, p < .001, and combat exposure, OR = 0.96, p = .040. A follow-up analysis identified burning oneself, OR = 17.14, p = .017, and hitting oneself, OR = 7.93, p < .001, as the specific DSH behaviors most strongly associated with suicidal ideation. Taken together, these findings suggest that DSH is quite prevalent among male Iraq/Afghanistan-era veterans seeking treatment for PTSD and is associated with increased risk for suicidal ideation within this population. Routine assessment of DSH is recommended when working with male Iraq/Afghanistan veterans seeking treatment for PTSD.
Collapse
Affiliation(s)
- Nathan A. Kimbrel
- Durham Veterans Affairs Medical Center; Durham, North Carolina, USA,The VA Mid-Atlantic Mental Illness Research, Education, and Clinical Center; Durham, North Carolina, USA
| | - Margaret E. Johnson
- Pacific Graduate School of Psychology, Palo Alto University, Palo Alto, California, USA
| | - Carolina Clancy
- Durham Veterans Affairs Medical Center; Durham, North Carolina, USA,Department of Psychiatry and Behavioral Sciences, Duke University Medical Center; Durham, North Carolina, USA
| | - Michael Hertzberg
- Durham Veterans Affairs Medical Center; Durham, North Carolina, USA,Department of Psychiatry and Behavioral Sciences, Duke University Medical Center; Durham, North Carolina, USA
| | - Claire Collie
- Durham Veterans Affairs Medical Center; Durham, North Carolina, USA,Department of Psychiatry and Behavioral Sciences, Duke University Medical Center; Durham, North Carolina, USA
| | - Elizabeth E. Van Voorhees
- Durham Veterans Affairs Medical Center; Durham, North Carolina, USA,The VA Mid-Atlantic Mental Illness Research, Education, and Clinical Center; Durham, North Carolina, USA,Department of Psychiatry and Behavioral Sciences, Duke University Medical Center; Durham, North Carolina, USA
| | - Michelle F. Dennis
- Durham Veterans Affairs Medical Center; Durham, North Carolina, USA,Department of Psychiatry and Behavioral Sciences, Duke University Medical Center; Durham, North Carolina, USA
| | - Patrick S. Calhoun
- Durham Veterans Affairs Medical Center; Durham, North Carolina, USA,The VA Mid-Atlantic Mental Illness Research, Education, and Clinical Center; Durham, North Carolina, USA,Department of Psychiatry and Behavioral Sciences, Duke University Medical Center; Durham, North Carolina, USA,VA Center for Health Services Research in Primary Care; Durham VAMC (152), Durham, North Carolina, USA
| | - Jean C. Beckham
- Durham Veterans Affairs Medical Center; Durham, North Carolina, USA,The VA Mid-Atlantic Mental Illness Research, Education, and Clinical Center; Durham, North Carolina, USA,Department of Psychiatry and Behavioral Sciences, Duke University Medical Center; Durham, North Carolina, USA
| |
Collapse
|
39
|
Wilson SM, Dedert EA, Dennis PA, Dennis MF, Calhoun PS, Kirby AC, Beckham JC. Do ethnicity and gender moderate the influence of posttraumatic stress disorder on time to smoking lapse? Addict Behav 2014; 39:1163-7. [PMID: 24727113 PMCID: PMC4064680 DOI: 10.1016/j.addbeh.2014.03.016] [Citation(s) in RCA: 8] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2013] [Revised: 01/09/2014] [Accepted: 03/01/2014] [Indexed: 11/30/2022]
Abstract
BACKGROUND Following a smoking cessation attempt, smokers with posttraumatic stress disorder (PTSD) experience smoking relapse at a higher and faster rate. Black ethnicity and female gender are also associated with lower success rates following smoking cessation. No study to date has prospectively examined how ethnicity and gender may moderate the effect of PTSD on smoking relapse. It was hypothesized that female gender and Black ethnicity would significantly predict early lapse after quitting; further, it was predicted that ethnicity and gender would moderate the effect of PTSD on relapse rate. METHODS Smokers with PTSD (n=48) and without PTSD (n=56) completed ecological momentary assessment (EMA) the week after a quit date, and self-initiated EMA entries after smoking lapse. Smoking abstinence was biologically verified. The sample included Black (62%) and White (38%) participants, and was 50% female. Study hypotheses were tested with Cox proportional hazards regression modeling time to first smoking lapse. RESULTS Study results confirmed the main hypothesis, with a significant PTSD × Ethnicity interaction emerging. The effect of PTSD on smoking relapse was significant for White participants but not for Black participants. No significant gender moderation was found. CONCLUSION Taken together, study results support previous research, and suggest that the relationship between smoking and PTSD is stronger for White smokers than for minorities. This study has significant implications for research in smoking and mental disease, as well as for smoking cessation treatments for Black smokers.
Collapse
Affiliation(s)
- Sarah M Wilson
- Department of Psychology & Neuroscience, Duke University, Durham, NC 27705, USA; Duke Global Health Institute, Duke University, Durham, NC 27705, USA.
| | - Eric A Dedert
- Durham Veterans Affairs Medical Center, Durham, NC 27705, USA; Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, NC 27705, USA
| | - Paul A Dennis
- Durham Veterans Affairs Medical Center, Durham, NC 27705, USA
| | - Michelle F Dennis
- Durham Veterans Affairs Medical Center, Durham, NC 27705, USA; Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, NC 27705, USA
| | - Patrick S Calhoun
- Durham Veterans Affairs Medical Center, Durham, NC 27705, USA; Health Services Research and Development, Durham VA Medical Center, Durham, NC 27705, USA
| | - Angela C Kirby
- Durham Veterans Affairs Medical Center, Durham, NC 27705, USA; Veterans Affairs Mid-Atlantic Region Mental Illness Research, Education, and Clinical Center, Durham, NC 27705, USA
| | - Jean C Beckham
- Durham Veterans Affairs Medical Center, Durham, NC 27705, USA; Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, NC 27705, USA
| |
Collapse
|
40
|
Dennis PA, Ulmer CS, Calhoun PS, Sherwood A, Watkins LL, Dennis MF, Beckham JC. Behavioral health mediators of the link between posttraumatic stress disorder and dyslipidemia. J Psychosom Res 2014; 77:45-50. [PMID: 24913341 PMCID: PMC4120708 DOI: 10.1016/j.jpsychores.2014.05.001] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [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] [Received: 03/21/2014] [Revised: 05/02/2014] [Accepted: 05/04/2014] [Indexed: 10/25/2022]
Abstract
OBJECTIVES Posttraumatic stress disorder (PTSD) has been linked to dyslipidemia, which is a major risk factor for coronary artery disease. Although this link is thought to reflect response to heightened stress, behavioral health risks, including smoking, alcohol dependence, and poor sleep quality, may mediate the relationship between PTSD and dyslipidemia. METHODS To test this hypothesis, serum lipid levels were collected from 220 young adults (18-39 years old), 103 of whom were diagnosed with PTSD. RESULTS PTSD and associated depressive symptoms were negatively related to high-density lipoprotein cholesterol (HDL-C), p=.04, and positively related to triglyceride (TG) levels, p=.04. Both associations were mediated by cigarette consumption and poor sleep quality, the latter of which accounted for 83% and 93% of the effect of PTSD and depression on HDL-C and TG, respectively. CONCLUSIONS These results complement recent findings highlighting the prominence of health behaviors in linking PTSD with cardiovascular risk.
Collapse
Affiliation(s)
- Paul A. Dennis
- Durham Veterans Affairs Medical Center, Durham, NC, 27705,
USA
| | - Christi S. Ulmer
- Durham Veterans Affairs Medical Center, Durham, NC, 27705,
USA,Veterans Affairs Center for Health Services Research in
Primary Care, Durham, NC, 27705, USA,Department of Psychiatry and Behavioral Sciences, Duke
University Medical Center, Durham, NC 27705, USA
| | - Patrick S. Calhoun
- Durham Veterans Affairs Medical Center, Durham, NC, 27705,
USA,Veterans Affairs Mid-Atlantic Region Mental Illness
Research, Education, and Clinical Center, Durham, NC 27705, USA,Veterans Affairs Center for Health Services Research in
Primary Care, Durham, NC, 27705, USA
| | - Andrew Sherwood
- Department of Psychiatry and Behavioral Sciences, Duke
University Medical Center, Durham, NC 27705, USA
| | - Lana L. Watkins
- Department of Psychiatry and Behavioral Sciences, Duke
University Medical Center, Durham, NC 27705, USA
| | - Michelle F. Dennis
- Durham Veterans Affairs Medical Center, Durham, NC, 27705,
USA,Department of Psychiatry and Behavioral Sciences, Duke
University Medical Center, Durham, NC 27705, USA
| | - Jean C. Beckham
- Durham Veterans Affairs Medical Center, Durham, NC, 27705,
USA,Veterans Affairs Mid-Atlantic Region Mental Illness
Research, Education, and Clinical Center, Durham, NC 27705, USA,Department of Psychiatry and Behavioral Sciences, Duke
University Medical Center, Durham, NC 27705, USA
| |
Collapse
|
41
|
Volz AR, Dennis PA, Dennis MF, Calhoun PS, Wilson SM, Beckham JC. The role of daily hassles and distress tolerance in predicting cigarette craving during a quit attempt. Nicotine Tob Res 2014; 16:872-5. [PMID: 24474304 DOI: 10.1093/ntr/ntt286] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
INTRODUCTION Ecological momentary assessment (EMA) has shown that smoking behavior is linked to transient variables in the smoker's immediate context. Such research suggests that daily hassles (e.g., losing one's keys) may be more likely to lead to cigarette craving and eventual lapse than infrequent, large-scale stressors (e.g., death of a loved one) among individuals attempting to quit smoking. However, individual differences in distress tolerance (DT) may moderate the relationship between daily hassles and daily cigarette craving during a quit attempt. METHODS A sample of 56 veterans and community members drawn from a larger smoking-cessation study completed structured interviews and paper-and-pencil questionnaires during an initial laboratory visit and, directly following a quit attempt, were monitored via EMA. Multilevel modeling was used to examine the relationship between daily hassles and daily cigarette craving and to determine whether DT moderated this relationship. RESULTS Daily hassles were positively associated with daily cigarette craving, and this association was moderated by individual differences in DT, such that the lower one's DT, the stronger the relationship between daily hassles and daily cigarette craving. This model explained 13% of the intraindividual variability and 8% of the interindividual variability in daily cigarette craving. CONCLUSIONS Smoking-cessation interventions may be strengthened by targeting smokers' individual responses to contextual factors, such as by helping smokers develop skills to cope more effectively with distress prior to and during the quit phase.
Collapse
|
42
|
Mitchell JT, Schick RS, Hallyburton M, Dennis MF, Kollins SH, Beckham JC, McClernon FJ. Combined ecological momentary assessment and global positioning system tracking to assess smoking behavior: a proof of concept study. J Dual Diagn 2014; 10:19-29. [PMID: 24883050 PMCID: PMC4036229 DOI: 10.1080/15504263.2013.866841] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.0] [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] [Indexed: 10/25/2022]
Abstract
OBJECTIVE Ecological momentary assessment (EMA) methods have provided a rich assessment of the contextual factors associated with a wide range of behaviors including alcohol use, eating, physical activity, and smoking. Despite this rich database, this information has not been linked to specific locations in space. Such location information, which can now be easily acquired from global positioning system (GPS) tracking devices, could provide unique information regarding the space-time distribution of behaviors and new insights into their determinants. In a proof of concept study, we assessed the acceptability and feasibility of acquiring and combining EMA and GPS data from adult smokers with attention deficit hyperactivity disorder (ADHD). METHODS Participants were adults with ADHD who were enrolled in a larger EMA study on smoking and psychiatric symptoms. Among those enrolled in the latter study who were approached to participate (N = 11), 10 consented, provided daily EMA entries, and carried a GPS device with them during a 7-day assessment period to assess aspects of their smoking behavior. RESULTS The majority of those eligible to participate were willing to carry a GPS device and signed the consent (10 out of 11, 91%). Of the 10 who consented, 7 participants provided EMA entries and carried the GPS device with them daily for at least 70% of the sampling period. Data are presented on the spatial distribution of smoking episodes and ADHD symptoms on a subset of the sample to demonstrate applications of GPS data. CONCLUSIONS We conclude by discussing how EMA and GPS might be used to study the ecology of smoking and make recommendations for future research and analysis.
Collapse
Affiliation(s)
- John T Mitchell
- Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, NC 27705, USA.
| | | | | | | | | | | | | |
Collapse
|
43
|
Vrana SR, Calhoun PS, McClernon FJ, Dennis MF, Lee ST, Beckham JC. Effects of smoking on the acoustic startle response and prepulse inhibition in smokers with and without posttraumatic stress disorder. Psychopharmacology (Berl) 2013; 230:477-85. [PMID: 23828156 PMCID: PMC3830656 DOI: 10.1007/s00213-013-3181-y] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.8] [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: 03/07/2013] [Accepted: 06/03/2013] [Indexed: 11/25/2022]
Abstract
RATIONALE Cigarette smokers smoke in part because nicotine helps regulate attention. Prepulse inhibition (PPI) of the startle reflex is a measure of early attentional gating that is reduced in abstinent smokers and in groups with attention regulation difficulties. Attention difficulties are found in people with posttraumatic stress disorder (PTSD). OBJECTIVES The aim of this study is to assess whether smoking and abstinence differentially affect the startle response and PPI in smokers with and without PTSD. METHODS Startle response and PPI (prepulses at 60, 120, or 240 ms) were measured in smokers with (N = 39) and without (N = 61) PTSD, while smoking and again while abstinent. RESULTS Participants with PTSD produced both larger magnitude and faster latency startle responses than controls. Across groups, PPI was greater when smoking than when abstinent. The PTSD and control group exhibited different patterns of PPI across prepulse intervals when smoking and when abstinent. Older age was associated with reduced PPI, but only when abstinent from smoking. CONCLUSIONS The effects of PTSD on startle magnitude and of smoking on PPI replicate earlier studies. The different pattern of PPI exhibited in PTSD and control groups across prepulse intervals, while smoking and abstinent suggests that previous research on smoking and PPI has been limited by not including longer prepulse intervals, and that nicotine may affect the time course as well as increasing the level of PPI. The reduced PPI among older participants during abstinence suggests that nicotine may play a role in maintaining attention in older smokers, which may motivate continued smoking in older individuals.
Collapse
Affiliation(s)
| | - Patrick S. Calhoun
- Durham Veterans Affairs Medical Center, 508 Fulton St. (116 B), Durham, NC 27705, USA. Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham Veterans Affairs Medical Center, Durham, NC 27705, USA. Veterans Affairs Mid-Atlantic Region Mental Illness Research, Education, and Clinical Center, Durham, NC 27705, USA. Veterans Affairs Center for Health Services Research in Primary Care, Durham, NC 27705, USA
| | - F. Joseph McClernon
- Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham Veterans Affairs Medical Center, Durham, NC 27705, USA
| | - Michelle F. Dennis
- Durham Veterans Affairs Medical Center, 508 Fulton St. (116 B), Durham, NC 27705, USA. Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham Veterans Affairs Medical Center, Durham, NC 27705, USA
| | - Sherman T. Lee
- Durham Veterans Affairs Medical Center, 508 Fulton St. (116 B), Durham, NC 27705, USA
| | - Jean C. Beckham
- Durham Veterans Affairs Medical Center, 508 Fulton St. (116 B), Durham, NC 27705, USA. Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham Veterans Affairs Medical Center, Durham, NC 27705, USA. Veterans Affairs Mid-Atlantic Region Mental Illness Research, Education, and Clinical Center, Durham, NC 27705, USA
| |
Collapse
|
44
|
Dedert EA, Dennis PA, Swinkels CM, Calhoun PS, Dennis MF, Beckham JC. Ecological momentary assessment of posttraumatic stress disorder symptoms during a smoking quit attempt. Nicotine Tob Res 2013; 16:430-6. [PMID: 24191981 DOI: 10.1093/ntr/ntt167] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
INTRODUCTION Smokers with posttraumatic stress disorder (PTSD) tend to lapse more quickly following a quit attempt, which might be explained by changes in PTSD symptoms during a quit attempt. The present study examines changes in PTSD symptoms, negative affect, and craving before and during a quit attempt. METHODS Participants in this study were 52 smokers with PTSD who completed random-alarm ecological momentary assessments of PTSD symptoms, negative affect, cigarette craving, and smoking behavior throughout a prequit phase of ad hoc smoking, a phase of abstinence from smoking, and a postlapse phase. RESULTS Relative to the prequit phase, the abstinent phase was marked by decreases in PTSD reexperiencing, avoidance, and numbing clusters (ps ≤ .01). The odds of PTSD symptom or negative affect variability from one reading in the ecological momentary assessment (EMA)to the next reading was decreased in PTSD reexperiencing, avoidance, and numbing clusters (ps ≤ .02). Smoking cravings were also mildly decreased in the abstinent and postlapse phases (ps < .01), although some cravings in both phases were rated at the maximum intensity. Increased craving was predicted by the previous EMA reading of PTSD symptoms. CONCLUSIONS Results suggested that smoking abstinence is not associated with exacerbation of PTSD symptoms, but PTSD symptoms during abstinence were related to craving levels during the quit attempt.
Collapse
|
45
|
Hertzberg JS, Carpenter VL, Kirby AC, Calhoun PS, Moore SD, Dennis MF, Dennis PA, Dedert EA, Beckham JC. Mobile contingency management as an adjunctive smoking cessation treatment for smokers with posttraumatic stress disorder. Nicotine Tob Res 2013; 15:1934-8. [PMID: 23645606 DOI: 10.1093/ntr/ntt060] [Citation(s) in RCA: 85] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
INTRODUCTION Smokers with posttraumatic stress disorder (PTSD) smoke at higher prevalence rates and are more likely to relapse early in a quit attempt. Innovative methods are needed to enhance quit rates, particularly in the early quit period. Web-based contingency-management (CM) approaches have been found helpful in reducing smoking among other difficult-to-treat smoker populations but are limited by the need for computers. This pilot study builds on the web-based CM approach by evaluating a smartphone-based application for CM named mobile CM (mCM). METHODS Following a 2-week training period, 22 smokers with PTSD were randomized to a 4-week mCM condition or a yoked (i.e., noncontingent 4-week mCM condition). All smokers received 2 smoking cessation counseling sessions, nicotine replacement, and bupropion. Participants could earn up to $690 ($530 for mCM, $25.00 for assessments and office visits [up to 5], and $35.00 for equipment return). The average earned was $314.00. RESULTS Compliance was high during the 2-week training period (i.e., transmission of videos) (93%) and the 4-week treatment period (92%). Compliance rates did not differ by group assignment. Four-week quit rates (verified with CO) were 82% for the mCM and 45% for the yoked controls. Three-month self-report quit rates were 50% in the mCM and 18% in the yoked controls. CONCLUSIONS mCM may be a useful adjunctive smoking cessation treatment component for reducing smoking among smokers with PTSD, particularly early in a smoking quit attempt.
Collapse
Affiliation(s)
- Jeffrey S Hertzberg
- Research and Development Service, Durham Veterans Affairs Medical Center, Durham, NC
| | | | | | | | | | | | | | | | | |
Collapse
|
46
|
Dedert EA, Harper LA, Calhoun PS, Dennis MF, Beckham JC. The impact of race on metabolic disease risk factors in women with and without posttraumatic stress disorder. J Clin Psychol Med Settings 2013; 20:46-55. [PMID: 23179072 PMCID: PMC3608190 DOI: 10.1007/s10880-012-9305-4] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
The literature on PTSD and metabolic disease risk factors has been limited by lacking investigation of the potential influence of commonly comorbid disorders and the role of race. In this study data were provided by a sample of 134 women (63 PTSD and 71 without PTSD). Separate sets of models examining associations of psychiatric disorder classifications with metabolic disease risk factors were used. Each model included race (African American or Caucasian), psychiatric disorder, and their interaction. There was an interaction of race and PTSD on body mass index, abdominal obesity, and triglycerides. While PTSD was not generally associated with deleterious health effects in African American participants, PTSD was related to worse metabolic disease risk factors in Caucasians. MDD was associated with metabolic disease risk factors, but there were no interactions with race. Results support the importance of race in the relationship between PTSD and metabolic disease risk factors. Future research would benefit from analysis of cultural factors to explain how race might influence metabolic disease risk factors in PTSD.
Collapse
MESH Headings
- Adult
- Black or African American/psychology
- Blood Pressure/physiology
- Body Mass Index
- Cholesterol, HDL/blood
- Cholesterol, LDL/blood
- Comorbidity
- Depressive Disorder, Major/blood
- Depressive Disorder, Major/ethnology
- Depressive Disorder, Major/psychology
- Diabetes Mellitus, Type 2/blood
- Diabetes Mellitus, Type 2/ethnology
- Diabetes Mellitus, Type 2/psychology
- Female
- Humans
- Middle Aged
- Obesity, Abdominal/ethnology
- Obesity, Abdominal/psychology
- Risk Factors
- Statistics as Topic
- Stress Disorders, Post-Traumatic/blood
- Stress Disorders, Post-Traumatic/ethnology
- Stress Disorders, Post-Traumatic/psychology
- Substance-Related Disorders/blood
- Substance-Related Disorders/ethnology
- Substance-Related Disorders/psychology
- Triglycerides/blood
- Waist-Hip Ratio
- White People/psychology
Collapse
Affiliation(s)
- Eric A Dedert
- Durham Veterans Affairs Medical Center, 508 Fulton St. (116 B), Durham, NC 27705, USA.
| | | | | | | | | |
Collapse
|
47
|
Liu Y, Rimmler J, Dennis MF, Ashley-Koch AE, Hauser MA, Beckham JC. Association of Variant rs4790904 in Protein Kinase C Alpha with Posttraumatic Stress Disorder in a U.S. Caucasian and African-American Veteran Sample. ACTA ACUST UNITED AC 2013; 2:S4001. [PMID: 24839585 PMCID: PMC4021713 DOI: 10.4172/2167-1044.s4-001] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Backgound Posttraumatic stress sisorder (PTSD) is a complex anxiety disorder that can develop after traumatic event exposure. Genetic factors have been associated with PTSD risk. Recently a variant rs4790904 in the protein kinase C alpha (PRKCA) gene has been shown to be associated with PTSD risk. The objective of this study was to replicate this association in a sample of U.S. Afghanistan/Iraq era veterans. Methods The genotypes of rs4790904 were evaluated in all trauma-exposed veterans. The sample of U.S. veterans included 428 Caucasians and 533 African-Americans. The statistical analysis was conducted independently in the Caucasian and African-American subjects to evaluate the association with PTSD symptom clusters of B symptoms (re-experiencing), C symptoms (avoidance and numbing), D symptoms (hyperarousal), and with current PTSD diagnosis. Results The sample was comprised of 428 Caucasians (186 with current PTSD diagnosis, 242 trauma-exposed controls; median age, 35 years; 15% female) and 533 African-Americans (205 with current PTSD diagnosis, 328 trauma-exposed controls; median age, 41 years; 31% female). We observed a significant correlation between rs4790904 and all three PTSD symptom clusters in the Caucasian population, but no significant association with current PTSD diagnosis. However, these significant associations were with the G allele, rather than the A allele, that was previously reported by de Quervain. A significant association of this variant with current PTSD diagnosis (p=0.046) was detected in the African-American veterans. Conclusion We confirmed the correlation between rs4790904 and all three PTSD symptom clusters in the Caucasian but not the African-American population. A significant association with a current diagnosis of PTSD was found in the African-American veterans.
Collapse
Affiliation(s)
- Yutao Liu
- Center for Human Genetics, Department of Medicine, Duke University Medical Center, Durham, NC, USA
- Mid-Atlantic Mental Illness Research, Education and Clinical Center (MIRECC), USA
| | - Jacqueline Rimmler
- Center for Human Genetics, Department of Medicine, Duke University Medical Center, Durham, NC, USA
- Mid-Atlantic Mental Illness Research, Education and Clinical Center (MIRECC), USA
| | - Michelle F. Dennis
- Durham VA Medical Center, Durham, NC, USA
- Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, NC, USA
| | - Allison E. Ashley-Koch
- Center for Human Genetics, Department of Medicine, Duke University Medical Center, Durham, NC, USA
- Mid-Atlantic Mental Illness Research, Education and Clinical Center (MIRECC), USA
| | - Michael A. Hauser
- Center for Human Genetics, Department of Medicine, Duke University Medical Center, Durham, NC, USA
- Mid-Atlantic Mental Illness Research, Education and Clinical Center (MIRECC), USA
| | | | - Jean C. Beckham
- Mid-Atlantic Mental Illness Research, Education and Clinical Center (MIRECC), USA
- Durham VA Medical Center, Durham, NC, USA
- Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, NC, USA
| |
Collapse
|
48
|
Youssef NA, Green KT, Dedert EA, Hertzberg JS, Calhoun PS, Dennis MF, Beckham JC. Exploration of the influence of childhood trauma, combat exposure, and the resilience construct on depression and suicidal ideation among U.S. Iraq/Afghanistan era military personnel and veterans. Arch Suicide Res 2013; 17:106-22. [PMID: 23614484 PMCID: PMC3640796 DOI: 10.1080/13811118.2013.776445] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.0] [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: 10/26/2022]
Abstract
This study evaluated the effect of childhood trauma exposure and the role of resilience on both depressive symptoms and suicidal ideation. The study evaluated 1,488 military personnel and veterans, who served after September 2001, for depressive, suicidal, and PTSD symptoms, combat exposure, childhood trauma exposure, and resiliency. Participants were enrolled as part of an ongoing multicenter study. Outcome measures were depressive symptoms and suicidal ideation. After controlling for the effects of combat exposure and PTSD, results revealed that childhood trauma exposures were significantly associated with depressive symptoms and suicidal ideation. In addition, resilience was negatively associated with depressive symptoms and suicidal ideation, suggesting a potential protective effect. These findings suggest that evaluation of childhood trauma is important in the clinical assessment and treatment of depressive symptoms and suicidal ideation among military personnel and veterans.
Collapse
Affiliation(s)
- Nagy A Youssef
- a Durham VA Medical Center; Mid-Atlantic Mental Illness Research, Education, and Clinical Center (MIRECC), Durham VA Medical Center, USA
| | | | | | | | | | | | | | | |
Collapse
|
49
|
Calhoun PS, Hertzberg JS, Kirby AC, Dennis MF, Hair LP, Dedert EA, Beckham JC. The effect of draft DSM-V criteria on posttraumatic stress disorder prevalence. Depress Anxiety 2012; 29:1032-42. [PMID: 23109002 PMCID: PMC3514586 DOI: 10.1002/da.22012] [Citation(s) in RCA: 43] [Impact Index Per Article: 3.6] [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: 07/24/2012] [Revised: 08/23/2012] [Accepted: 09/20/2012] [Indexed: 11/07/2022] Open
Abstract
BACKGROUND This study was designed to examine the concordance of proposed DSM-V posttraumatic stress disorder (PTSD) criteria with DSM-IV classification rules and examine the impact of the proposed DSM-V PTSD criteria on prevalence. METHOD The sample (N = 185) included participants who were recruited for studies focused on trauma and health conducted at an academic medical center and VA medical center in the southeastern United States. The prevalence and concordance between DSM-IV and the proposed DSM-V classifications were calculated based on results from structured clinical interviews. Prevalence rates and diagnostic efficiency indices including sensitivity, specificity, area under the curve (AUC), and Kappa were calculated for each of the possible ways to define DSM-V PTSD. RESULTS Ninety-five percent of the sample reported an event that met both DSM-IV PTSD Criterion A1 and A2, but only 89% reported a trauma that met Criterion A on DSM-V. Results examining concordance between DSM-IV and DSM-V algorithms indicated that several of the algorithms had AUCs above 0.90. The requirement of two symptoms from both Clusters D and E provided strong concordance to DSM-IV (AUC = 0.93; Kappa = 0.86) and a greater balance between sensitivity and specificity than requiring three symptoms in both Clusters D and E. CONCLUSIONS Despite several significant changes to the diagnostic criteria for PTSD for DSM-V, several possible classification rules provided good concordance with DSM-IV. The magnitude of the impact of DSM-V decision rules on prevalence will be largely affected by the DSM-IV PTSD base rate in the population of interest.
Collapse
Affiliation(s)
- Patrick S Calhoun
- VISN-6 Mental Illness Research & Education Center, Durham, NC 27705, USA.
| | | | | | | | | | | | | |
Collapse
|
50
|
Beckham JC, Calhoun PS, Dennis MF, Wilson SM, Dedert EA. Predictors of lapse in first week of smoking abstinence in PTSD and non-PTSD smokers. Nicotine Tob Res 2012. [PMID: 23178322 DOI: 10.1093/ntr/nts252] [Citation(s) in RCA: 54] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
INTRODUCTION Retrospective research suggests smokers with posttraumatic stress disorder (PTSD) lapse more quickly after their quit date. Ecological momentary assessment (EMA) research is needed to confirm the presence of early smoking lapse in PTSD and form conceptualizations that inform intervention. METHODS Smokers with (n = 55) and without (n = 52) PTSD completed alarm-prompted EMA of situational and psychiatric variables the week before and after a quit date, and self-initiated EMA following smoking lapses. Blood samples at baseline and on the quit date allowed assessment of dehydroepiandrosterone (DHEA) and dehydroepiandrosterone sulfate (DHEA(S)). RESULTS PTSD was related to shorter time to lapse (hazard ratio [HR] = 1.677, 95% CI: 1.106-2.544). Increased smoking abstinence self-efficacy was related to longer time to lapse (HR = 0.608, 95% CI: 0.430-0.860). Analyses of participants' real-time reports revealed that smokers with PTSD were more likely to attribute first-time lapses to negative affect ( = 5.412, p = .020), and trauma reminders (Fisher's exact p = .003**). Finally, the quit date decrease in DHEA(S) was related to shorter time to lapse (HR = 1.009, 95% CI: 1.000-1.018, p < .05). CONCLUSIONS Results provide evidence of shorter time to first smoking lapse in PTSD, and add to evidence that early lapse occasions are more strongly related to trauma reminders, negative affect, and cravings in smokers with PTSD.
Collapse
Affiliation(s)
- Jean C Beckham
- Durham Veterans Affairs Medical Center, Durham, NC 27705, USA
| | | | | | | | | |
Collapse
|