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The interaction between monoamine oxidase A (MAOA) and childhood maltreatment as a predictor of personality pathology in females: Emotional reactivity as a potential mediating mechanism

Published online by Cambridge University Press:  22 February 2018

Amy L. Byrd*
University of Pittsburgh
Stephen B. Manuck
University of Pittsburgh
Samuel W. Hawes
Florida International University
Tayler J. Vebares
University of Pittsburgh
Vishwajit Nimgaonkar
University of Pittsburgh
Kodavali V. Chowdari
University of Pittsburgh
Alison E. Hipwell
University of Pittsburgh
Kate Keenan
University of Chicago
Stephanie D. Stepp
University of Pittsburgh
Address correspondence and reprint requests to: Amy L. Byrd, University of Pittsburgh School of Medicine, Department of Psychiatry, Sterling Plaza, Suite 408, 201 North Craig Street, Pittsburgh, PA 15213; E-mail:


Research consistently demonstrates that common polymorphic variation in monoamine oxidase A (MAOA) moderates the influence of childhood maltreatment on later antisocial behavior, with growing evidence that the “risk” allele (high vs. low activity) differs for females. However, little is known about how this Gene × Environment interaction functions to increase risk, or if this risk pathway is specific to antisocial behavior. Using a prospectively assessed, longitudinal sample of females (n = 2,004), we examined whether changes in emotional reactivity (ER) during adolescence mediated associations between this Gene × Environment and antisocial personality disorder in early adulthood. In addition, we assessed whether this putative risk pathway also conferred risk for borderline personality disorder, a related disorder characterized by high ER. While direct associations between early maltreatment and later personality pathology did not vary by genotype, there was a significant difference in the indirect path via ER during adolescence. Consistent with hypotheses, females with high-activity MAOA genotype who experienced early maltreatment had greater increases in ER during adolescence, and higher levels of ER predicted both antisocial personality disorder and borderline personality disorder symptom severity. Taken together, findings suggest that the interaction between MAOA and early maltreatment places women at risk for a broader range of personality pathology via effects on ER.

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We are grateful to all the families who took part in this study, and to the Pittsburgh Girls Study team, which includes interviewers and their supervisors, data managers, student workers, and volunteers. This research was specifically funded by grants from the Office of Juvenile Justice and Delinquency Prevention, Office of Justice Programs, US Department of Justice (2013-JF-FX-0058); the National Institute of Mental Health (R01 MH056630); the National Institute on Drug Abuse (R01 DA012237); and by funding from the FISA Foundation and the Falk Fund. Additional funding from the National Institute of Health also supported this work (T32 MH018269 and F32 MH110077). The opinions, findings, and conclusions or recommendations expressed in this report are those of the authors and do not necessarily reflect those of the Department of Justice, National Institutes of Health, or the FISA Foundation and Falk Fund.


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