Hostname: page-component-78c5997874-94fs2 Total loading time: 0 Render date: 2024-11-18T01:16:28.124Z Has data issue: false hasContentIssue false
  • English
  • Français

A protective genetic variant for adverse environments? The role of childhood traumas and serotonin transporter gene on resilience and depressive severity in a high-risk population

Published online by Cambridge University Press:  16 April 2020

V. Carli ,
L. Mandelli ,
L. Zaninotto ,
A. Roy ,
L. Recchia ,
L. Stoppia ,
V. Gatta ,
M. Sarchiapone  and
A. Serretti
V. Carli
Affiliation:
Department of Health Sciences, University of Molise, Campobasso, Italy National Prevention of Suicide and Mental-Ill Health (NASP) at Karolinska Institutet, Stockholm, Sweden
L. Mandelli*
Affiliation:
Department of Psychiatry, Institute of Psychiatry, University of Bologna, Italy
L. Zaninotto
Affiliation:
Department of Psychiatry, Institute of Psychiatry, University of Bologna, Italy
A. Roy
Affiliation:
Psychiatry Service, Department of Veteran Affairs, New Jersey, USA
L. Recchia
Affiliation:
Department of Health Sciences, University of Molise, Campobasso, Italy
L. Stoppia
Affiliation:
Department of Biomedical Sciences, G. d’Annunzio University, Chieti-Pescara, Italy
V. Gatta
Affiliation:
Department of Biomedical Sciences, G. d’Annunzio University, Chieti-Pescara, Italy
M. Sarchiapone
Affiliation:
Department of Health Sciences, University of Molise, Campobasso, Italy
A. Serretti
Affiliation:
Department of Psychiatry, Institute of Psychiatry, University of Bologna, Italy
*
*Corresponding author. E-mail address: laura.mandelli@unibo.it (L. Mandelli).
Get access

Abstract

Genetic aspects may influence the effect of early adverse events on psychological well being in adulthood. In particular, a common polymorphism within the serotonin transporter gene (5-HTTLPR short/long) has been associated to the risk for stress-induced psychopathology. In the present study we investigated the role of childhood traumas and 5-HTTLPR on measures of psychological resilience and depression in a sample of individuals at a high risk for psychological distress (763 male prisoners). The 5-HTTLPR genotype did not influence resilience and depressive severity. However, a significant interaction was observed between 5-HTTLPR and childhood traumas on both resilience and depressive severity. In particular, among subjects exposed to severe childhood trauma only, the long-allele was associated to lower resilience scores and increased current depressive severity as compared to short/short homozygous. Sex specific effects, difference in type and duration of stressors and the specific composition of the sample may explain discrepancy with many studies reporting the short-allele as a vulnerability factor for reactivity to stress. We here speculated that in males the long-allele may confer lower resilience and therefore higher vulnerability for depressive symptoms in subjects exposed to early stress and currently living in stressful environments.

Keywords

Affective disordersStressGenetics
Type
Original article
Information
European Psychiatry , Volume 26 , Issue 8 , November 2011 , pp. 471 - 478
Copyright
Copyright © Elsevier Masson SAS 2011

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Aguilera, M, Arias, B, Wichers, M, Barrantes-Vidal, N, Moya, J, Villa, H, et al.Early adversity and 5-HTT/BDNF genes: new evidence of gene-environment interactions on depressive symptoms in a general population. Psychol Med. 2009;39(9):1425–1432.CrossRefGoogle Scholar
Alexander, DA, Klein, SKidnapping and hostage-taking: a review of effects, coping and resilience. J R Soc Med 2009;102(1):16–21.CrossRefGoogle ScholarPubMed
Andersen, HSMental health in prison populations. A review – with special emphasis on a study of Danish prisoners on remand. Acta Psychiatr Scand Suppl4242004 5–59.CrossRefGoogle ScholarPubMed
Araya, R, Hu, X, Heron, J, Enoch, MA, Evans, J, Lewis, G, et al.Effects of stressful life events, maternal depression and 5-HTTLPR genotype on emotional symptoms in pre-adolescent children. Am J Med Genet B Neuropsychiatr Genet. 150B52009 670–682.CrossRefGoogle ScholarPubMed
Arseneault, L, Cannon, M, Murray, R, Poulton, R, Caspi, A, Moffitt, TEChildhood origins of violent behaviour in adults with schizophreniform disorder. Br J Psychiatry. 2003; 183: 520–525.CrossRefGoogle ScholarPubMed
Bernstein, D, Fink, LChildhood Trauma Questionnaire. Texas: San Antonio; 1998Google Scholar
Bernstein, DP, Fink, L, Handelsman, L, Foote, J, Lovejoy, M, Wenzel, K, et al.Initial reliability and validity of a new retrospective measure of child abuse and neglect. Am J Psychiatry. 1994;151(8):1132–1136.Google ScholarPubMed
Bernstein, DP, Ahluvalia, T, Pogge, D, Handelsman, LValidity of the Childhood Trauma Questionnaire in an adolescent psychiatric population. J Am Acad Child Adolesc Psychiatry. 1997;36(3):340–348.CrossRefGoogle Scholar
Bonanno, GALoss, trauma, and human resilience: have we underestimated the human capacity to thrive after extremely aversive events? Am Psychol 2004;59(1):20–28.CrossRefGoogle ScholarPubMed
Bonanno, GA, Galea, S, Bucciarelli, A, Vlahov, DWhat predicts psychological resilience after disaster? The role of demographics, resources, and life stress. J Consult Clin Psychol. 2007;75(5):671–682.CrossRefGoogle ScholarPubMed
Brummett, BH, Boyle, SH, Siegler, IC, Kuhn, CM, Ashley-Koch, A, Jonassaint, CR, et al.Effects of environmental stress and gender on associations among symptoms of depression and the serotonin transporter gene linked polymorphic region (5-HTTLPR). Behav Genet 2008;38(1):34–43.CrossRefGoogle ScholarPubMed
Brummett, BH, Muller, CL, Collins, AL, Boyle, SH, Kuhn, CM, Siegler, IC, et al.5-HTTLPR and gender moderate changes in negative affect responses to tryptophan infusion. Behav Genet 2008;38(5):476–483.CrossRefGoogle ScholarPubMed
Bukh, JD, Bock, C, Vinberg, M, Werge, T, Gether, U, Vedel Kessing, LInteraction between genetic polymorphisms and stressful life events in first episode depression. J Affect Disord. 1191–32009 107–115.CrossRefGoogle ScholarPubMed
Butler, T, Belcher, JM, Champion, U, Kenny, D, Allerton, M, Fasher, MThe physical health status of young Australian offenders. Aust N Z J Public Health. 2008;32(1):73–80.CrossRefGoogle ScholarPubMed
Campbell-Sills, L, Forde, DR, Stein, MBDemographic and childhood environmental predictors of resilience in a community sample. J Psychiatr Res. 2009;43(12):1007–1012.CrossRefGoogle Scholar
Carli, V, Jovanovic, N, Podlesek, A, Roy, A, Rihmer, Z, Maggi, S, et al.The role of impulsivity in self-mutilators, suicide ideators and suicide attempters – a study of 1265 male incarcerated individuals. J Affect Disord. 1231–32010 116–122.CrossRefGoogle ScholarPubMed
Carli, V, Roy, A, Bevilacqua, L, Maggi, S, Cesaro, C, Sarchiapone, MInsomnia and suicidal behaviour in prisoners. Psychiatry Res. 1851–22010 141–144.CrossRefGoogle ScholarPubMed
Caspers, KM, Paradiso, S, Yucuis, R, Troutman, B, Arndt, S, Philibert, RAssociation between the serotonin transporter promoter polymorphism (5-HTTLPR) and adult unresolved attachment. Dev Psychol. 2009;45(1):64–76.CrossRefGoogle ScholarPubMed
Caspi, A, Sugden, K, Moffitt, TE, Taylor, A, Craig, IW, Harrington, H, et al.Influence of life stress on depression: moderation by a polymorphism in the 5-HTT gene. Science (New York, NY) 2003;301(5631):386–389.CrossRefGoogle ScholarPubMed
Cervilla, JA, Molina, E, Rivera, M, Torres-Gonzalez, F, Bellon, JA, Moreno, B, et al.The risk for depression conferred by stressful life events is modified by variation at the serotonin transporter 5HTTLPR genotype: evidence from the Spanish PREDICT-Gene cohort. Molecular psychiatry. 2007;12(8):748–755.CrossRefGoogle ScholarPubMed
Chapman, DP, Whitfield, CL, Felitti, VJ, Dube, SR, Edwards, VJ, Anda, RFAdverse childhood experiences and the risk of depressive disorders in adulthood. J Affect Disord. 2004;82(2):217–225.CrossRefGoogle ScholarPubMed
Charney, DSPsychobiological mechanisms of resilience and vulnerability: implications for successful adaptation to extreme stress. Am J Psychiatry. 2004;161(2):195–216.CrossRefGoogle ScholarPubMed
Chipman, P, Jorm, AF, Prior, M, Sanson, A, Smart, D, Tan, X, et al.No interaction between the serotonin transporter polymorphism (5-HTTLPR) and childhood adversity or recent stressful life events on symptoms of depression: results from two community surveys. Am J Med Genet B Neuropsychiatr Genet. 144B42007 561–565.CrossRefGoogle ScholarPubMed
Cicchetti, D, Rogosch, FAThe role of self-organization in the promotion of resilience in maltreated children. Dev Psychopathol. 1997;9(4):797–815.CrossRefGoogle ScholarPubMed
Connor, KM, Davidson, JRDevelopment of a new resilience scale: the Connor-Davidson Resilience Scale (CD-RISC). Depress Anxiety. 2003;18(2):76–82.CrossRefGoogle ScholarPubMed
Covault, J, Tennen, H, Armeli, S, Conner, TS, Herman, AI, Cillessen, AH, et al.Interactive effects of the serotonin transporter 5-HTTLPR polymorphism and stressful life events on college student drinking and drug use. Biol Psychiatry. 2007;61(5):609–616.CrossRefGoogle ScholarPubMed
Coventry, WL, James, MR, Eaves, LJ, Gordon, SD, Gillespie, NA, Ryan, L, et al.Do 5HTTLPR and stress interact in risk for depression and suicidality? Item response analyses of a large sample. Am J Med Genet B Neuropsychiatr Genet. 153B32010 757–765.Google ScholarPubMed
Cuomo, C, Sarchiapone, M, Giannantonio, MD, Mancini, M, Roy, AAggression, impulsivity, personality traits, and childhood trauma of prisoners with substance abuse and addiction. Am J Drug Alcohol Abuse 2008;34(3):339–345.CrossRefGoogle ScholarPubMed
de Vries, HG, Collee, JM, van Veldhuizen, MH, Achterhof, L, Smit Sibinga, CT, Scheffer, H, et al.Validation of the determination of deltaF508 mutations of the cystic fibrosis gene in over 11 000 mouthwashes. Hum Genet. 1996;97(3):334–336.CrossRefGoogle ScholarPubMed
Dick, DM, Plunkett, J, Hamlin, D, Nurnberger, J. Jr., Kuperman, S, Schuckit, M, et al.Association analyses of the serotonin transporter gene with lifetime depression and alcohol dependence in the Collaborative Study on the Genetics of Alcoholism (COGA) sample. Psychiatr Genet. 2007;17(1):35–38.CrossRefGoogle Scholar
Edens, JFInterpersonal characteristics of male criminal offenders: personality, psychopathological, and behavioral correlates. Psychol Assess. 2009;21(1):89–98.Google ScholarPubMed
Edmond, T, Auslander, W, Elze, D, Bowland, SSigns of resilience in sexually abused adolescent girls in the foster care system. J Child Sex Abus 2006;15(1):1–28.CrossRefGoogle ScholarPubMed
Eley, TC, Sugden, K, Corsico, A, Gregory, AM, Sham, P, McGuffin, P, et al.Gene-environment interaction analysis of serotonin system markers with adolescent depression. Molecular psychiatry. 2004;9(10):908–915.CrossRefGoogle ScholarPubMed
Fazel, S, Danesh, JSerious mental disorder in 23000 prisoners: a systematic review of 62 surveys. Lancet. 2002;359(9306):545–550.CrossRefGoogle ScholarPubMed
Feder, A, Nestler, EJ, Charney, DSPsychobiology and molecular genetics of resilience. Nat Rev Neurosci. 2009;10(6):446–457.CrossRefGoogle ScholarPubMed
Forrest, C.B, Tambor, E, Riley, AW, Ensminger, ME, Starfield, BThe health profile of incarcerated male youths. Pediatrics. 1051 Pt 32000 286–291.Google ScholarPubMed
Geschwind, N, Peeters, F, Jacobs, N, Delespaul, P, Derom, C, Thiery, E, et al.Meeting risk with resilience: high daily life reward experience preserves mental health. Acta Psychiatr Scand. 2010;122(2):129–138.CrossRefGoogle ScholarPubMed
Gillespie, NA, Whitfield, JB, Williams, B, Heath, AC, Martin, NGThe relationship between stressful life events, the serotonin transporter (5-HTTLPR) genotype and major depression. Psychol Med. 2005;35(1):101–111.CrossRefGoogle ScholarPubMed
Gillespie, CF, Phifer, J, Bradley, B, Ressler, KJRisk and resilience: genetic and environmental influences on development of the stress response. Depress Anxiety. 2009;26(11):984–992.CrossRefGoogle ScholarPubMed
Gladstone, GL, Parker, GB, Mitchell, PB, Malhi, GS, Wilhelm, K, Austin, MPImplications of childhood trauma for depressed women: an analysis of pathways from childhood sexual abuse to deliberate self-harm and revictimization. Am J Psychiatry 2004;161(8):1417–1425.CrossRefGoogle ScholarPubMed
Hamilton, MA rating scale for depression. J Neurol Neurosurg Psychiatry. 1960; 23: 56–62.CrossRefGoogle ScholarPubMed
Heils, A, Teufel, A, Petri, S, Stöber, G, Riederer, P, Bengel, D, et al.Allelic variation of human serotonin trasporter gene expression. J Neurochem. 1996;66(6):2621–2624.CrossRefGoogle Scholar
Holahan, CJ, Moos, RHLife stressors, personal and social resources, and depression: a 4-year structural model. J Abnorm Psychol 1991;100(1):31–38.CrossRefGoogle ScholarPubMed
Hu, XZ, Lipsky, RH, Zhu, G, Akhtar, LA, Taubman, J, Greenberg, BD, et al.Serotonin transporter promoter gain-of-function genotypes are linked to obsessive-compulsive disorder. Am J Hum Genet. 2006;78(5):815–826.CrossRefGoogle ScholarPubMed
Jacobs, N, Kenis, G, Peeters, F, Derom, C, Vlietinck, R, van Os, JStress-related negative affectivity and genetically altered serotonin transporter function: evidence of synergism in shaping risk of depression. Arch Gen Psychiatry. 2006;63(9):989–996.CrossRefGoogle ScholarPubMed
Jones, E, Wessely, SBritish prisoners-of-war: from resilience to psychological vulnerability: reality or perception. 20 Century Br Hist 2010;21(2):163–183.CrossRefGoogle ScholarPubMed
Karg, K, Burmeister, M, Shedden, K, Sen, SThe serotonin transporter promoter variant (5-HTTLPR), stress, and depression meta-analysis revisited: evidence of genetic moderation. Arch Gen Psychiatry 2011;68(5):444–454.CrossRefGoogle ScholarPubMed
Katerndahl, D, Burge, S, Kellogg, NPredictors of development of adult psychopathology in female victims of childhood sexual abuse. J Nerv Ment Dis. 2005;193(4):258–264.CrossRefGoogle ScholarPubMed
Kendler, KS, Kuhn, JW, Vittum, J, Prescott, CA, Riley, BThe interaction of stressful life events and a serotonin transporter polymorphism in the prediction of episodes of major depression: a replication. Arch Gen Psychiatry. 2005;62(5):529–535.CrossRefGoogle Scholar
Kim, JM, Stewart, R, Kim, SW, Yang, SJ, Shin, IS, Kim, YH, et al.Interactions between life stressors and susceptibility genes (5-HTTLPR and BDNF) on depression in Korean elders. Biol Psychiatry. 2007;62(5):423–428.CrossRefGoogle ScholarPubMed
Knutson, JFPsychological characteristics of maltreated children: putative risk factors and consequences. Annu Rev Psychol 1995; 46: 401–431.CrossRefGoogle ScholarPubMed
Laucht, M, Treutlein, J, Blomeyer, D, Buchmann, AF, Schmid, B, Becker, K, et al.Interaction between the 5-HTTLPR serotonin transporter polymorphism and environmental adversity for mood and anxiety psychopathology: evidence from a high-risk community sample of young adults. Int J Neuropsychopharmacol. 2009;12(6):737–747.CrossRefGoogle ScholarPubMed
Lesch, KP, Bengel, D, Heils, A, Sabol, SZ, Greenberg, BD, Petri, S, et al.Association of anxiety-related traits with a polymorphism in the serotonin transporter gene regulatory region. Science (New York, NY) 1996;274(5292):1527–1531.CrossRefGoogle ScholarPubMed
Lochner, C, Seedat, S, Hemmings, SM, Moolman-Smook, JC, Kidd, M, Stein, DJInvestigating the possible effects of trauma experiences and 5-HTT on the dissociative experiences of patients with OCD using path analysis and multiple regression. Neuropsychobiology. 2007;56(1):6–13.CrossRefGoogle ScholarPubMed
Luthar, SS, Cicchetti, D, Becker, BThe construct of resilience: a critical evaluation and guidelines for future work. Child Dev. 2000;71(3):543–562.Google ScholarPubMed
Mandelli, L, Serretti, A, Marino, E, Pirovano, A, Calati, R, Colombo, CInteraction between serotonin transporter gene, catechol- O -methyltransferase gene and stressful life events in mood disorders. Int J Neuropsychopharmacol. 2007;10(4):437–447.CrossRefGoogle ScholarPubMed
Masten, ASOrdinary magic. Resilience processes in development. Am Psychol 2001;56(3):227–238.CrossRefGoogle ScholarPubMed
Masten, AS, Ordinary Magic:, Lessons from research on resilience in human development. Educ Can 2009;49(5):28–32.Google Scholar
Mendlewicz, J, Massat, I, Souery, D, Del-Favero, J, Oruc, L, Nothen, MM, et al.Serotonin transporter 5HTTLPR polymorphism and affective disorders: no evidence of association in a large European multicenter study. Eur J Hum Genet 2004;12(5):377–382.CrossRefGoogle Scholar
Munafo, MR, Durrant, C, Lewis, G, Flint, JGene X environment interactions at the serotonin transporter locus. Biol Psychiatry. 2009;65(3):211–219.CrossRefGoogle ScholarPubMed
Murrell, SA, Norris, FHResources, life events, and changes in psychological states: a prospective framework. Am J Community Psychol. 1983;11(5):473–491.CrossRefGoogle ScholarPubMed
Nrugham, L, Holen, A, Sund, AMAssociations between attempted suicide, violent life events, depressive symptoms, and resilience in adolescents and young adults. J Nerv Ment Dis. 2010;198(2):131–136.CrossRefGoogle ScholarPubMed
Olsson, CA, Byrnes, GB, Lotfi-Miri, M, Collins, V, Williamson, R, Patton, C, et al.Association between 5-HTTLPR genotypes and persisting patterns of anxiety and alcohol use: results from a 10-year longitudinal study of adolescent mental health. Molecular psychiatry. 2005;10(9):868–876.CrossRefGoogle ScholarPubMed
Otte, C, McCaffery, J, Ali, S, Whooley, MAAssociation of a serotonin transporter polymorphism (5-HTTLPR) with depression, perceived stress, and norepinephrine in patients with coronary disease: the Heart and Soul Study. Am J Psychiatry. 2007;164(9):1379–1384.CrossRefGoogle ScholarPubMed
Power, T, Stewart, R, Ancelin, ML, Jaussent, I, Malafosse, A, Ritchie, K5-HTTLPR genotype, stressful life events and late-life depression: no evidence of interaction in a French population. Neurobiol Aging. 2010;31(5):886–887.CrossRefGoogle Scholar
Ressler, KJ, Bradley, B, Mercer, KB, Deveau, TC, Smith, AK, Gillespie, CF, et al.Polymorphisms in CRHR1 and the serotonin transporter loci: gene x gene x environment interactions on depressive symptoms. Am J Med Genet B Neuropsychiatr Genet. 153B32010 812–824.Google ScholarPubMed
Richardson, J, Steiger, H, Schmitz, N, Joober, R, Bruce, KR, Israel, M, et al.Relevance of the 5-HTTLPR polymorphism and childhood abuse to increased psychiatric comorbidity in women with bulimia-spectrum disorders. J Clin Psychiatry. 2008;69(6):981–990.CrossRefGoogle ScholarPubMed
Risch, N, Herrell, R, Lehner, T, Liang, KY, Eaves, L, Hoh, J, et al.Interaction between the serotonin transporter gene (5-HTTLPR), stressful life events, and risk of depression. A meta-analysis. JAMA 2009;301(23):2462–2471.CrossRefGoogle Scholar
Ritchie, K, Jaussent, I, Stewart, R, Dupuy, AM, Courtet, P, Ancelin, ML, et al.Association of adverse childhood environment with late-life depression. J Clin Psychiatry. 2009;70(9):1281–1288.CrossRefGoogle ScholarPubMed
Ritchie, K, Jaussent, I, Stewart, R, Dupuy, AM, Courtet, P, Ancelin, ML, et al.Association of adverse childhood environment and 5-HTTLPR Genotype with late-life depression. J Clin Psychiatry. 2009;70(9):1281–1288.CrossRefGoogle ScholarPubMed
Roy, A, Hu, XZ, Janal, MN, Goldman, DInteraction between childhood trauma and serotonin transporter gene variation in suicide. Neuropsychopharmacology. 2007;32(9):2046–2052.CrossRefGoogle ScholarPubMed
Rutter, MDeveloping concepts in developmental psychopathology.Hudziak, JJDevelopmental psychopathology and wellness: Genetic and environmental influences Washington, DC: American Psychiatric Publishing; 2008.3–22.Google Scholar
Scheid, JM, Holzman, CB, Jones, N, Friderici, KH, Nummy, KA, Symonds, LL, et al.Depressive symptoms in mid-pregnancy, lifetime stressors and the 5-HTTLPR genotype. Genes Brain Behav. 2007;6(5):453–464.CrossRefGoogle ScholarPubMed
Scher, CD, Stein, MBDevelopmental antecedents of anxiety sensitivity. J Anxiety Disord. 2003;17(3):253–269.CrossRefGoogle ScholarPubMed
Sheehan, DV, Lecrubier, Y, Sheehan, KH, Amorim, P, Janavs, J, Weiller, E, et al.The Mini-International Neuropsychiatric Interview (M.I.N.I.): the development and validation of a structured diagnostic psychiatric interview for DSM-IV and ICD-10. J Clin Psychiatry. 59Suppl. 201998 22–33[quiz 4–57]Google ScholarPubMed
Simeon, D, Yehuda, R, Cunill, R, Knutelska, M, Putnam, FW, Smith, LMFactors associated with resilience in healthy adults. Psychoneuroendocrinology. 328–102007 1149–1152.CrossRefGoogle ScholarPubMed
Sjoberg, RL, Nilsson, KW, Nordquist, N, Ohrvik, J, Leppert, J, Lindstrom, L, et al.Development of depression: sex and the interaction between environment and a promoter polymorphism of the serotonin transporter gene. Int J Neuropsychopharmacol. 2006;9(4):443–449.CrossRefGoogle Scholar
Steadman, HJ, Osher, FC, Robbins, PC, Case, B, Samuels, SPrevalence of serious mental illness among jail inmates. Psychiatr Serv. 2009;60(6):761–765.CrossRefGoogle ScholarPubMed
Stein, MB, Schork, NJ, Gelernter, JGene-by-environment (serotonin transporter and childhood maltreatment) interaction for anxiety sensitivity, an intermediate phenotype for anxiety disorders. Neuropsychopharmacology. 2008;33(2):312–319.CrossRefGoogle ScholarPubMed
Teicher, MH, Samson, JA, Polcari, A, McGreenery, CESticks, stones, and hurtful words: relative effects of various forms of childhood maltreatment. Am J Psychiatry. 2006;163(6):993–1000.CrossRefGoogle ScholarPubMed
Uher, R, McGuffin, PThe moderation by the serotonin transporter gene of environmental adversity in the aetiology of mental illness: review and methodological analysis. Molecular psychiatry. 2008;13(2):131–146.CrossRefGoogle ScholarPubMed
Wankerl, M, Wust, S, Otte, CCurrent developments and controversies: does the serotonin transporter gene-linked polymorphic region (5-HTTLPR) modulate the association between stress and depression? Curr Opin Psychiatry. 2010;23(6):582–587.CrossRefGoogle ScholarPubMed
Wray, NR, Coventry, WL, James, MR, Montgomery, GW, Eaves, LJ, Martin, NGUse of monozygotic twins to investigate the relationship between 5HTTLPR genotype, depression and stressful life events: an application of Item Response Theory. Novartis Found Symp. 293 2008 48–59[discussion -70]CrossRefGoogle ScholarPubMed
Xie, P, Kranzler, HR, Poling, J, Stein, MB, Anton, RF, Brady, K, et al.Interactive effect of stressful life events and the serotonin transporter 5-HTTLPR genotype on posttraumatic stress disorder diagnosis in 2 independent populations. Arch Gen Psychiatry. 2009;66(11):1201–1209.CrossRefGoogle ScholarPubMed
Zalsman, G, Huang, YY, Oquendo, MA, Burke, AK, Hu, XZ, Brent, DA, et al.Association of a triallelic serotonin transporter gene promoter region (5-HTTLPR) polymorphism with stressful life events and severity of depression. Am J Psychiatry. 2006;163(9):1588–1593.CrossRefGoogle ScholarPubMed
Zautra, AJ, Hall, JS, Murray, KSResilience: a new definition of health for people and communities.Reich, JWZautra, AJHall, JSHandbook of adult resilience New York: Guilford; 2010.3–34.Google Scholar
Submit a response

Comments

No Comments have been published for this article.