Serotonin transporter 5-HTTLPR genotype is associated with intrusion and avoidance symptoms of DSM-5 posttraumatic stress disorder (PTSD) in Chinese earthquake survivors

Background and Objectives: Prior studies have found that the serotonin transporter gene-linked polymorphic region (5-HTTLPR) interacts with trauma exposure to increase general risk for Posttraumatic Stress Disorder (PTSD). However, there is little knowledge about the effects of the interaction on distinct symptom clusters of PTSD. This study aimed to investigate the relation between the interaction of 5-HTTLPR and earthquake-related exposures and a contemporary phenotypic model of DSM-5 PTSD symptoms in a traumatised adult sample from China.

Design: A cross-sectional design with gene-environment interaction (G?×?E) approach was adopted. Methods: Participants were 1131 survivors who experienced 2008 Wenchuan earthquake. PTSD symptoms were assessed with the PTSD Checklist for DSM-5 (PCL-5). The 5-HTTLPR polymorphism was genotyped with capillary electrophoresis (CE) in ABI 3730xl genetic Analyzer.

Results: Although there was no significant interaction between 5-HTTLPR and traumatic exposure on total PTSD symptoms, respondents with the LL genotype of 5-HTTLPR who were highly exposed to the earthquake experienced lower intrusion and avoidance symptoms than those with the S-allele carriers.

Conclusions: The findings suggest that the 5-HTTLPR may have an important impact on the development of PTSD and add to the extant knowledge on understanding and treating of posttraumatic psychopathology.     

Risk of future suicide attempts in adolescent psychiatric inpatients at 18-month follow-up

This study investigated potential predictors of suicidal behavior in adolescents during an 18-month follow-up period. Subjects included 60 adolescent psychiatric inpatients initially assessed in a private psychiatric hospital. Follow-up suicidality was most strongly predicted by high intake levels of hopelessness, and an increase in or persistent problems with depression during follow-up. Some family functioning variables measured at intake were predictive of suicidal behavior at the univariate level but did not add to the predictive ability of individual functioning variables. A mediational model was proposed in which the impact of family functioning on adolescent suicidality is mediated by its impact on individual functioning.     

Serotonin transporter genetic variation and biased attention for emotional word stimuli among psychiatric inpatients

The short allele in a variable repeat sequence of the promoter region of the serotonin transporter gene (5-HTTLPR) has been associated with stronger activation in brain regions critical for processing emotional stimuli. The authors examined whether variants of the 5-HTTLPR promoter polymorphism were also associated with individual differences in attentional biases for emotional stimuli. Words related to anxious and dysphoric emotional states were presented to psychiatric inpatients in a standard dot-probe reaction time task. Compared with participants with two long alleles, carriers of the short 5-HTTLPR allele exhibited a stronger attentional bias for anxious word stimuli. No genetic group difference was observed for dysphoric word stimuli. Findings from this preliminary study highlight the potential for integrating genetic and cognitive models of psychopathology.     

Dysfunctional attitudes and the serotonin transporter promoter polymorphism (5-HTTLPR)

Dysfunctional attitudes may be one phenotype by which genes increase risk for depression. Building on research demonstrating associations between serotonin abnormalities and dysfunctional attitudes, we examined the covariation between dysfunctional attitudes and the serotonin transporter gene-linked polymorphic region (5-HTTLPR). In a sample of nondepressed young adults (N = 131), people with one or two copies of the low-expressing alleles reported stronger endorsement of dysfunctional attitudes regarding performance evaluation than people who were homozygous for the high-expressing alleles; there was no association between the 5-HTTLPR polymorphism and dysfunctional attitudes regarding approval by others. These results add to the literature linking the 5-HTTLPR polymorphism and cognitive vulnerabilities for depression.     

Additive impact of childhood emotional,physical, and sexual abuse on suicide attempts among low-income African American women

This study examines the association between exposures to multiple forms of childhood abuse (emotional, physical, sexual) and adult suicidal behavior in a sample of low-income, African American women. We hypothesized a linear relation between childhood abuse and risk for making a suicide attempt, such that the more forms of childhood abuse to which a woman was exposed, the greater her risk would be to make a suicide attempt. Logistic regression analyses revealed that, compared to women who did not report any experiences of childhood abuse, women who experienced one, two, or three forms of abuse were 1.83, 2.29, or 7.75 times more likely to attempt suicide, respectively (all statistically significant). Furthermore, compared to women who reported one or two types of abuse, women who reported all three types of abuse were statistically more likely to attempt suicide. These findings have implications for clinicians working with African American women who report either childhood abuse or exhibit suicidal behavior.     

Reported childhood trauma and suicide attempts in schizophrenic patients

Childhood traumas are associated with suicidal behavior but this aspect has not been examined in relation to schizophrenia. In this study, 50 chronic schizophrenic patients who had attempted suicide were compared with 50 chronic schizophrenic patients who had never attempted suicide for their scores on the 34-item Childhood Trauma Questionnaire (CTQ). It was found that schizophrenics who had attempted suicide reported significantly higher CTQ scores for emotional abuse, physical abuse, sexual abuse, emotional neglect, and physical neglect than schizophrenics who had never attempted suicide. Therefore, childhood trauma may be a risk factor predisposing schizophrenic patients to attempt suicide.     

Suicide attempts and family history of suicide in three psychiatric populations

The influence of a family history of suicide on suicide attempt rate and characteristics in depression, schizophrenia, and opioid dependence was examined. One hundred sixty inpatients with unipolar depression, 160 inpatients with schizophrenia, and 160 opioid-dependent patients were interviewed. Overall, a family history of suicide was associated with a higher risk for suicide attempt, with high-lethality method, with repeated attempts, and with number of attempts, while the interaction between family history and diagnostic group was not significant. Thus, a positive family history of suicide was a risk factor for several suicide attempt characteristics independent of psychiatric diagnosis.     

Behavioral inhibition and triallelic genotyping of the serotonin transporter promoter (5-HTTLPR) polymorphism

To examine the genetic bases of the behavioral inhibition system (BIS) and the behavioral approach system (BAS), we evaluated the association between the BIS, the BAS, and a functional length polymorphism in the promoter of the serotonin transporter gene (5-HTTLPR) in an unscreened sample of undergraduates (N = 211); analyses were conducted using a two-variant (i.e., biallelic) genotyping and three-variant (i.e., triallelic) genotyping of the 5-HTTLPR polymorphism. People with one or two copies of the low-expressing alleles reported stronger endorsement of the BIS than people who were homozygous for the high-expressing alleles; this association was found for triallelic but not biallelic genotyping of the 5-HTTLPR polymorphism. There was no association between the 5-HTTLPR polymorphism and the BAS scales.     

Childhood physical and sexual abuse in depressed patients with single and multiple suicide attempts

Research has shown both childhood physical and sexual abuse to be associated with later suicide attempts, although some studies have not supported these findings. However, few studies have investigated differences in physical and sexual abuse histories among single and multiple suicide attempters. The goals of the current study were two-fold: (a) to replicate previous findings of associations between childhood sexual and physical abuse and suicide attempts, and (b) to explore differences in reports of childhood physical and sexual abuse among single and multiple suicide attempters. While our results supported the findings that individuals with a history of suicide attempts are more likely to report histories of childhood physical and sexual abuse, we did not find a difference in reported abuse between single and multiple suicide attempters. Implications of these findings, as well as implications for future research, are discussed.     

Associations between serotonin transporter gene promoter region (5-HTTLPR) polymorphism and gaze bias for emotional information

The serotonin transporter promoter region polymorphism (5-HTTLPR) is associated with neural response to negative images in brain regions involved in the experience of emotion. However, the behavioral implications of this sensitivity have been studied far less extensively. The current study used eye-tracking methodology to examine how individuals genotyped for the 5-HTTLPR, including the single nucleotide polymorphism (SNP) rs25531, allocated attention during prolonged (30-s) exposure to face stimuli depicting positive and negative emotion. Short 5-HTTLPR allele carriers and carriers of the long allele with guanine at the sixth nucleotide (S/LG) displayed a stronger gaze bias (total fixation time, number of fixations, mean fixation length) for positive than for sad, threat, or neutral stimuli. In contrast, those homozygous for the long 5-HTTLPR allele with adenine at the sixth nucleotide (LA) viewed the emotion stimuli in an unbiased fashion. Time course analyses indicated no initial 5-HTTLPR group differences; however, S/LG 5-HTTLPR allele carriers were more likely than LA 5-HTTLPR homozygotes to direct gaze toward happy than toward sad stimuli over time. This bias toward positive stimuli during the later stages of information processing likely reflects a strategic effort to downregulate heightened reactivity to negative stimuli among 5-HTTLPR S/LG allele carriers.     

Neuropsychological performance and suicidal behavior in adult psychiatric inpatients.

Although various studies have shown that suicidal persons exhibit greater cognitive deficiencies than both normals and other psychiatric patients, researchers as yet have been unable to account for the source(s) of the differences. Some of these differences (e.g., cognitive rigidity and impaired problem solving) hint of possible organic involvement. This study explored the relationship of neuropsychological functioning to suicidal behavior by comparing 20 suicidal and 27 nonsuicidal psychiatric inpatients on several tests of neuropsychological functioning. Although results showed no significant differences between the two groups on most measures, both groups showed evidence of notably high levels of cortical dysfunction relative to test norms. Thirty-five percent of suicidal patients and 44% of nonsuicidal patients scored in the impaired range. Implications of this high frequency of impairment for the treatment of suicidal and nonsuicidal psychiatric patients are discussed.     

Minimal brain dysfunction in adolescent and young adult psychiatric inpatients

This paper presents data on a study of 100 consecutive young adult psychiatric admissions to Horsham Hospital, to determine the incidence of minimal brain dysfunction in this population, to define the subcategories of common psychiatric presentation, and to compare these data with those from the companion study conducted by our research group of fifty consecutive adolescent psychiatric admissions, reported by Horowitz, 1981.     

Relational Security Moderates the Effect of Serotonin Transporter Gene Polymorphism (5-HTTLPR) on Stress Generation and Depression among Adolescents

Previous research demonstrates that carriers of the short allele of the serotonin transporter gene (5-HTTLPR) show both greater susceptibility to depression in response to stressful life events and higher rates of generation of stressful events in response to depression. The current study examines relational security (i.e., self-reported beliefs about attachment security) as a moderator of these effects, building on emerging research suggesting that the short allele acts as a marker of sensitivity to the social environment. Participants were 354 Caucasian adolescents oversampled for maternal depression (137 male, 217 female), assessed at ages 15 and 20. Results indicated that the short allele predicted increased stress generation at age 20 among those with low age 15 security but decreased stress generation among those with high security, and revealed a three-way interaction between age 15 depression, age 15 security, and genotype, where depression predicted stress generation only among short allele carriers with low security. Further, among boys only, security interacted with genotype to predict longitudinal changes in depression diagnosis, with the s-allele predicting relative increases in probability of depression among boys with low security but decreases among boys with high security. Results support the notion of the short allele as a marker of social reactivity, and suggest that attachment security may buffer against the genetic vulnerability introduced by the short allele, in line with predictions of the differential susceptibility theory.     

Accuracy of MMPI-A scales ACK,MAC-R,and PRO in detecting comorbid substance abuse among psychiatric inpatients

This study investigated the accuracy of various indices involving the MMPI-A scales, ACK, MAC-R, and PRO in diagnosing substance abuse in a sample of 79 psychiatric inpatients. In the full sample, 89.9% of the cases were accurately classified by at least one of the three scales. The overall accuracy of classification was similar among males, females, Caucasians, and African Americans, although there was a tendency for more false positive misclassifications among males. Profile code type moderated the accuracy of classification with greatest accuracy for code types including Scales 1, 2, 3, 5, or 0 and least accuracy for code types including Scales 4, 6, or 9. ACK, MAC-R, and PRO were better at screening out cases of substance abuse than in accurately identifying those adolescents who were using substances.     

Comparison of non-suicidal self-injurious behavior and suicide attempts in patients admitted to a psychiatric crisis unit

The aim of the current study was to examine differences in personality, coping skills, and select psychopathology symptoms in psychiatric patients with and without non-suicidal self-injury and/or suicide attempts. We collected data in a sample of 128 psychiatric patients by means of self-report questionnaires measuring self-harm, psychological symptoms, personality and coping skills. Results support a continuum of self-harm such that patients with both non-suicidal self-injury and suicide attempts exhibit significantly greater levels of psychopathology and lower levels of adaptive personality traits and coping skills. The findings point to the clinical importance of making a distinction between non-suicidal self-injury and suicide attempts, and offers additional variables to consider outside of intent when appraising suicide risk.     

Negative cognitive response to a sad mood induction: Associations with polymorphisms of the serotonin transporter (5-HTTLPR) gene

Increased negative thinking in response to sad mood states has been identified as a marker of depression risk. The present study examined whether polymorphisms of the serotonin transporter (5-HTTLPR) gene were associated with the tendency to endorse negative cognition after sad or neutral mood inductions in a healthy college student sample. Non-depressed participants were genotyped for the 5-HTTLPR and then viewed films designed to elicit a sad mood (n=30) or a neutral mood (n=23). Analyses indicated that individuals homozygous for the short 5-HTTLPR allele endorsed more negative cognition following a sad mood induction than individuals homozygous for the long 5-HTTLPR allele. Negative cognition did not vary as a function of 5-HTTLPR genetic status in the neutral mood condition. These preliminary results suggest that genetic variation of the serotonin transporter may contribute to depression vulnerability via a tendency to think more negatively in response to events that elicit sad mood.     

Affective, behavioral, and cognitive functioning in adolescents with multiple suicide attempts

The purpose of this study was to examine affective, behavioral, and cognitive functioning in adolescents with multiple suicide attempts. Forty-seven adolescents with a history of multiple suicide attempts (MA) were compared to 74 single suicide attempters (SA) on psychiatric diagnosis, depressive symptoms, affect regulation, self-mutilation, alcohol use, and hopelessness. Results revealed that the MA group was more likely to be diagnosed with a mood disorder, and reported more severe depressive symptoms and anger, in comparison to the SA group. Behaviorally, the MA group had higher rates of disruptive behavior disorders and higher levels of affect dysregulation and serious self-mutilation than the SA group. Further, greater levels of hopelessness were reported by the MA than the SA group. After controlling for a mood disorder diagnosis, only differences in anger, affect dysregulation, and serious self-mutilation remained significant. Overall, results suggest that treatment with adolescent suicide attempters might specifically target anger and affect dysregulation to reduce risk for future suicidal behavior.     

Psychometric evaluation of the symptom checklist (SCL-90) in psychiatric inpatients

The factorial validity, temporal stability and discriminatory power of the Symptom Checklist (SCL-90) were investigated in a heterogeneous sample of short-stay psychiatric inpatients (n=437). Results from a confirmatory factorial approach suggested a reduced dimensionality for the SCL-90 rather than supporting the 10 or 9 a priori symptom dimensions. From exploratory factor analyses 4 clinically interpretable and moderately intercorrelated dimensions emerged: depression, hostile-suspiciousness, somatization and phobic anxiety. Internal consistency and temporal stability coefficients of these 4 subscales and of the global scale were satisfactory. SCL-90 discriminated poorly between different clinical groups. However, the scale quite successfully discriminated patients from healthy subjects from the general population. It is concluded that SCL-90 might be a valuable instrument for the detection of potential psychiatric cases in the general population.     

Psychopathology,family functioning,and cognitive style in urban adolescents with suicide attempts

This study examined psychopathology, family functioning, and cognitive style in 121 African-American adolescents who attempted suicide. Group means suggested that these youths, when taken together, were not reporting significant psychological distress. However, after classifying the youths into three groups by level of depressive symptoms interesting findings emerged. Youth self-reports of depressive symptoms on the Children's Depression Inventory were associated with the presence of internalizing and externalizing disorders on the Youth Self-Report and Child Behavior Checklist, and with a maladaptive attributional style. Sixty-seven percent of participants classified their family types as maladaptive in terms of levels of cohesion and/or adaptability. In fact, the majority of adolescents and parents reported their families as disengaged. These findings are discussed from a culturally and developmentally sensitive framework which considers key demographic variables (race, socioeconomic status, age). Clinical implications are offered for individual and family interventions.