Reliability and reporting biases for perceived parental history of alcohol-related problems: agreement between twins and differences between discordant pairs

OBJECTIVE

Previous research suggests that family history of alcoholism assessments may be biased by characteristics of the informant. In this report, the reliability and potential biases in offspring reports of paternal and maternal alcohol-related problems were examined in a large community sample of adult twins.

METHOD

Subjects were volunteer participants in the Australian NH&MRC twin registry. Agreement between twin pairs on reports of paternal and maternal alcohol problems was assessed in 2,657 twin pairs (1,444 female-female pairs, 626 male-male pairs, and 587 female-male pairs). In addition, to detect systematic reporting biases, like-sex twin pairs whose paternal alcohol problems reports disagreed (n = 164) were contrasted on measures of personality, state anxiety and depression, parental rearing, alcoholism, and alcohol use.

RESULTS

Twin agreement for parental alcohol-related problems was good, with overall kappas of .66 for paternal and .58 for maternal alcohol problems. When discordant twin pairs were compared, we found that women who reported that their father had alcohol problems were significantly lower on EPQ-R Social Conformity than their twin sister who denied paternal alcohol problems: and there was a trend for men who reported that their father had alcohol problems to be higher in negative perceived parenting from father than their twin brother who denied paternal alcohol problems. Twins discordant for reporting paternal alcohol problems did not, however, differ on the major dimensions of personality, state anxiety and depression, alcoholism, or current alcohol use.

CONCLUSIONS

The results of this study bolster our confidence in using the family history method to examine characteristics of offspring of alcoholics versus offspring of nonalcoholics on self-reported measures of personality and psychopathology, but suggest that some caution should be exercised when using this method to examine differences in offspring-reported perceptions of parental rearing practices.

The control of ovulation in mothers of dizygotic twins

Dizygotic twinning is familial, suggesting that there may be an inherited abnormality of the control of ovulation that predisposes to double ovulation and, therefore, dizygotic twins. The present study examines 17 mothers of dizygotic twins (MODZT) and 8 control mothers of singletons by daily blood sampling throughout an entire menstrual cycle. Blood samples were assayed for LH, FSH, estradiol, progesterone, and inhibin. The process of follicular development was followed by transvaginal ultrasound. The pituitary LH response to iv GnRH was also assessed. Three of the 16 MODZT double ovulated during the study compared to none of the 8 control mothers (P < 0.05). The number of small follicles (<6 mm) declined significantly in control women at midcycle, but not in MODZT. There was no significant difference in serum FSH, LH, estradiol, or inhibin levels between the 2 groups at any stage of the menstrual cycle. During the follicular phase, serum progesterone levels were significantly higher in MODZT. The response to GnRH stimulation was not different between MODZT and controls. In conclusion, this study demonstrates an increased tendency to double ovulate in MODZT that may be due to a reduced rate of atresia in advanced follicles. Furthermore, the elevated progesterone levels in MODZT during the follicular phase suggest altered intrafollicular steroidogenesis that is independent of gonadotropins.

The Queensland Familial Melanoma Project: study design and characteristics of participants

Family history of melanoma is associated with an increased risk for the disease. Neither the relative contributions of genetic and shared environmental factors to familial risk nor how genetic susceptibility is mediated are known. The Queensland Familial Melanoma Project was undertaken to investigate (a) the role of genetic susceptibility as indicated by skin type, pigmentation and the prevalence of naevi and (b) exposure to solar ultraviolet radiation, and their interaction in the aetiology of familial melanoma. After obtaining doctor's consent, a brief family history questionnaire was mailed to all Queensland residents with a first primary cutaneous melanoma diagnosed between 1982 and 1990. Detailed information on melanoma history and standard melanoma risk factors was sought from all responding twins and familial cases, from a sample of non-familial cases and from cases' relatives. Medical confirmation was sought for all relatives reported to have had melanoma. The final sample comprises 15,907 persons in the 1,912 families of 2,118 melanoma cases, including 509 families in which there are two or more individuals with confirmed melanoma. Melanoma history and risk factors were obtained for 9,746 relatives, including 94 twins of cases. This is the largest family and twin study of cutaneous melanoma yet conducted in an unselected, geographically-defined population. We describe the design of the study and the characteristics of the total study population.

Social contact, social attitudes, and twin similarity

The nature of the relationship between social contact and attitude similarly between twins was investigated using longitudinal data from a sample of Australian twins. Earlier research has suggested that social attitudes are not explained solely by shared environment; rather there are both genetic and environmental components that explain variance in social attitudes. Using three types of analyses we investigated the magnitude of the relationship and the direction of causation between attitude similarity and social contact. Longitudinal analysis of within-pair variance by level of contact suggests that attitude similarity leads to contact among the females and that similarity is both genetically and environmentally based. Analyses using a crosslag regression model suggest that similarity causes contact among MZ females. Biometrical analyses indicate differences in direction of causation for males and females. Among females, both genetic and shared environmental parameter estimates could be equated across contact groups, suggesting little relationship between contact and similarity. Among males, findings of smaller estimated heritability in the high-contact group suggest that similarity causes contact. However, an increased estimate of the contribution of shared environmental variance in the high-contact males could additionally suggest that contact leads to similarity.

Genetics of educational attainment in Australian twins: sex differences and secular changes

The relative effects of genetic and environmental factors in producing individual differences in educational achievement are compared across women and men and over birth cohorts. In a large sample of Australian twin pairs, the heritability of self-reported educational attainment did not vary among women and men born before and after 1950. In a "psychometric" model of twin resemblance, based on separate self-reports in 1981 and 1989, genetic factors explained 57% of the stable variance in educational achievement, while environmental factors shared by twins accounted for 24% of the variance. Corrections for phenotypic assortative mating for educational level, however, suggested that estimated common-environmental effects could be entirely explained by the correlation between additive genetic values for mates. Taking this into account, heritability "true" educational attainment in Australia may be as high as 82% with the remaining variation being due to individual environments or experiences. Unlike previous studies in Scandinavian countries, results in Australia suggest that factors influencing educational success are comparable between women and men and for individuals born at different points during this century.

Alcohol reactions in subjects of European descent: effects on alcohol use and on physical and psychomotor responses to alcohol

Self-reports of reactions to small amounts of alcohol, obtained between 1990 and 1992, were compared with reports of alcohol use, obtained in 1990-1992 and also in 1979-1981, in twin subjects of European descent. Data on subjective, physiological, psychomotor, and metabolic responses to a test dose of alcohol, taken in 1979-1981, were also available. Alcohol reactions were more common in women than in men, and were associated with less alcohol use, both at the time that information about reactions was obtained and as recorded on average 12 years previously, in both sexes. Physiological and psychomotor responses to alcohol were similar across the reaction groups, except that deterioration in standing steadiness was greater in those who subsequently reported adverse reactions to alcohol. Contrary to expectation, skin temperature changes after alcohol were less in the subjects who reported always reacting to alcohol than in the other groups. Subjective reports of intoxication were greatest in subjects who subsequently reported alcohol reactions. The pattern of twin pair concordance for reactions suggests low heritability, so alcohol reactions in subjects of European descent are not caused by a single gene of high penetrance of the type found in the Asian alcohol flush reaction.

Genetic contribution to DZ twinning

The genetic contribution to dizygotic (DZ) twinning was investigated using 6,596 twin pairs from the Australian Twin Registry who provided information on other twins in their families. Responses were classified by the zygosity (DZ; monozygotic [MZ]) of the proband twins and by the relationship and zygosity of related twins. MZ probands and MZ twins reported by DZ probands were used as controls and assumed to be independent of any genetic influence. Significantly higher proportions of DZ twins were found in the families of DZ probands compared to the families of MZ probands for the following relationships: sibs of probands, proband mothers, offspring of sisters of proband mothers, and offspring of female probands (P < 0.001 in each case). The latter 2 relationships were used to estimate risk ratios of 1.7 for sisters of mothers of DZ twins, and 2.5 for offspring of female DZ twins. No greater tendency to DZ twinning in close relatives was found in mothers who bore DZ twins at a younger age than at an older age.

Structure of disordered eating in a twin community sample

OBJECTIVE

To describe the types of eating problems experienced by women in an Australian twin population.

METHOD

Questions assessing preoccupation with weight or shape, use of various methods of weight control, difficulties with weight control, disordered eating, or binging, were administered to a group of 3,869 female twins. Exploratory and confirmatory factor analyses were used to summarize and describe problematic eating behaviors.

RESULTS

For those women experiencing problems with eating, five groups could be identified. These were overweight women who were dissatisfied with their weight and shape, underweight women struggling with anorexic behaviors, women who were having problems with binging, women who were using more extreme methods of weight control such as vomiting, laxatives, and starvation, and overweight women who were using slimming and fluid tablets for weight control. Confirmatory factor analysis suggested that this factor model is an acceptable fit to the data and that the factor structure generalizes well across two groups viz, the first-born and second-born twins.

DISCUSSION

It was concluded that future studies aiming to develop a general description of eating problems in the community should specifically assess the purging behaviors used by women.

Seasonal changes in mood and behavior. The role of genetic factors

BACKGROUND

Seasonal rhythms in mood and behavior (seasonality) have been reported to occur in the general population. Seasonal affective disorder, a clinically diagnosed syndrome, is believed to represent the morbid extreme of a spectrum of seasonality. Two types of seasonality have been clinically described: one characterized by a winter pattern and a second by a summer pattern of depressive mood disturbance.

METHODS

By using methods of univariate and multivariate genetic analysis, we examined the relative contribution of genetic and environmental factors to the risk of seasonality symptoms that were assessed by a mailed questionnaire of 4639 adult twins from a volunteer-based registry in Australia.

RESULTS

Seasonality was associated with a winter rather than a summer pattern of mood and behavioral change. In each behavioral domain (ie, mood, energy, social activity, sleep, appetite, and weight), a significant genetic influence on the reporting of seasonal changes was found. Consistent with the hypothesis of a seasonal syndrome, genetic effects were found to exert a global influence across all behavioral changes, accounting for at least 29% of the variance in seasonality in men and women.

CONCLUSIONS

There is a tendency for seasonal changes in mood and behavior to run in families, especially seasonality of the winter type, and this is largely due to a biological predisposition. These findings support continuing efforts to understand the role of seasonality in the development of mood disorders.

Self-report psychiatric symptoms in twins and their nontwin relatives: are twins different?

While twin studies of psychiatric disorders have been conducted for over 65 years, surprisingly little is known about the comparability of psychiatric symptoms in adult twins and singletons. To address this question, we compared the means and variances of four-factor scores on the self-report Symptom Check List in twins and their relatives from the Virginia 30,000 twin-family study. The four factors were depression, panic-phobia, somatization, and insomnia. Twins had significantly higher scores on the panic-phobia factor than their relatives, by about one eighteenth of a standard deviation, and this was replicated in both subsamples. However, no consistent and significant mean differences between twins and their relatives were detected for the other three symptom factors. While some differences in variance were found between twins and their relatives, in no case were the differences replicated in both subsamples. With the possible exception of modestly elevated scores for panic-phobia, these results suggest that both the level and variability of common psychiatric symptoms reported by twins are similar to those found in the nontwin population.

A twin-family study of self-report symptoms of panic-phobia and somatization

Self-report symptoms of anxiety are widely used in mental health and social science research as an index of current psychiatric state. Previous twin studies have suggested that genetic factors account for a significant proportion of the variance in these symptoms. To replicate and extend these findings, we examined self-report symptoms of panic-phobia and somatization in the "Virginia 30,000" twin-family sample. Model fitting applied to 80 unique relationships in the twin-family pedigree produced the following major results: (i) genetic effects were significant for both symptom factors, accounting for between 25 and 49% of the total variance, with the exception of symptoms of panic-phobia in females, where they accounted for 15-16% of the variance; (ii) familial environmental effects were absent for symptoms of somatization, while for symptoms of panic-phobia they accounted for a very small proportion of variance in males (< or = 1.2%) and a modest proportion in females (6-17%); (iii) spousal correlations were present for both factors, ranging from +0.05 to +0.20; (iv) genetic factors which influenced symptoms were generally the same in males and females, although their effect was greater in males; (v) heritability estimates were lower in the population-based than in the volunteer sample; and (vi) when test-retest reliability was included in the model, results suggest that genetic factors account for at least half of the stable variance for all symptom factors, except panic-phobia in females. Our results support the validity of previous twin studies of self-report symptoms of anxiety and suggest that genetic factors significantly influence these symptoms but familial-environmental factors play little or no etiologic role.

Alcohol sensitivity and smoking history in men and women

Many studies have found genetic effects to contribute to alcoholism risk in both men and women. Based on preliminary evidence for shared genetic risk between smoking and drinking problems, a reanalysis of alcohol challenge data on 412 Australian twins was performed to explore the possibility that smoking may diminish or moderate the intoxicating effects of alcohol. We found history of smoking to be strongly associated with self-reported intoxication after alcohol challenge in women (women: r = -0.44 +/- 0.08; men: r = -0.21 +/- 0.08), comparable with self-reported average weekly consumption of alcohol, which was more strongly associated in men (women: r = -0.37 +/- 0.07; men: r = -0.54 +/- 0.06). Structural equation model-fitting indicated a strong association between heavy drinking and smoking, but the association between smoking and postalcohol intoxication remained even when the effects of heavy drinking were controlled for. These results prompt the question of whether smoking cigarettes directly influences the transition from moderate to excessive use of alcohol by diminishing feelings of alcohol intoxication.

Genetic covariance structure of incisor crown size in twins

Previous studies of tooth size in twins and their families have suggested a high degree of genetic control, although there have been difficulties separating the various genetic and environmental effects. A genetic analysis of variation in crown size of the permanent incisors of South Australian twins was carried out, with structural equation modeling used to determine the relative contributions of genetic and environmental factors. Maximum mesiodistal crown dimensions of maxillary and mandibular permanent incisors were recorded from dental models of 298 pairs of twins, including 149 monozygous (MZ) and 149 dizygous (DZ) pairs. The analysis revealed that: (i) an adequate fit required additive genetic and unique environmental components; (ii) augmenting the model with non-additive genetic variation did not lead to a significant improvement in fit; (iii) there was evidence of shared environmental influences in the upper central incisors of males; (iv) the additive genetic component constituted a general factor loading on all eight teeth, with group factors loading on antimeric pairs of teeth; (v) unique environmental effects were mostly variable-specific; (vi) most factor loadings on antimeric tooth pairs could be constrained to be equal, indicating a symmetry of genetic and environmental influences between left and right sides; and (vii) estimated heritability of the incisor mesiodistal dimensions varied from 0.81 to 0.91.

Osteoporosis in rheumatoid arthritis. A monozygotic co-twin control study

OBJECTIVE

To quantify the magnitude and distribution of osteoporosis in rheumatoid arthritis (RA).

METHODS

Bone mineral density (BMD) was measured by dual x-ray absorptiometry, in a monozygotic co-twin control study.

RESULTS

BMD was reduced at most skeletal sites in the twin with RA compared with the co-twin (lumbar spine 4.6%, femoral neck 9.7%, total body 5.7%). Differences in lean soft tissue (5.6% for total body) correlated with differences in BMD between twins at multiple sites.

CONCLUSION

Osteoporosis in RA is generalized and may be related to loss of mobility or muscle mass associated with the disease.

Is alcohol-related flushing a protective factor for alcoholism in Caucasians?

Although alcohol-related flushing seems to be a genetically influenced protective factor for alcoholism in some Asian groups, little is known about whether this is true for Caucasians. The evidence for alcohol-related flushing as a protective factor for the development of alcoholism was examined in a sample of 5831 Australian twins (2041 men, 3790 women) who were administered a structured psychiatric interview. Twin correlations for self-reported adverse alcohol reactions (e.g., "flushing or blushing" and "feeling very sleepy" after drinking 1 or 2 drinks) were modest, suggesting minimal contribution of genetic factors, but when corrected for reliability of measurement, were consistent with moderate heritabilities. In accord with studies examining Asian samples, we found that individuals who experienced adverse reactions after drinking small amounts of alcohol drank less often and slightly less per drinking occasion than those who did not experience adverse reactions. However, those who experienced adverse reactions were more likely to have symptoms of alcoholism and to report a parental history of alcohol problems. We conclude that self-reported alcohol-related flushing is not a protective factor for alcoholism in Caucasians and may be a risk factor.

Personality and the inheritance of smoking behavior: a genetic perspective

In contrast to the extensive research effort to understand the genetic contribution to alcoholism risk, there has been little research directed at understanding genetic influences on smoking behavior. Data from large twin studies in Scandinavia and Australia are consistent with a major genetic influence on the probability that an individual will become a smoker ("initiation") and will persist in the smoking habit once smoking has started ("persistence"). We use data from the 1988/1989 follow-up survey of the Australian NH&MRC twin panel to determine to what degree personality measures (Tridimensional Personality Questionnaire, Eysenck Personality Questionnaire--Revised) and attitudinal and sociodemographic variables (social and political conservatism, education, religious involvement) might account for genetic or environmental influences on smoking. While we find significant phenotypic associations between these variables and smoking, these are too modest to account for much of the genetic variance. Possible mechanisms by which this genetic variance may arise are discussed.

Heterogeneity of melanoma risk in families of melanoma patients

While it is recognized that relatives of melanoma patients are at increased risk for this disease, the source and extent of variation in melanoma risk between families of melanoma cases is unknown. Heterogeneity of familial melanoma risk was assessed among the families (comprising 7,666 first-degree relatives) of 1,149 cutaneous melanoma cases diagnosed in Queensland, Australia, between 1982 and 1987. The measure of familial melanoma risk was based on the number of cases of melanoma in the family in excess of those predicted from the age-, sex-, and birth cohort-specific cumulative incidences of melanoma among all relatives in the sample. Probands over-reported melanoma occurrence among their relatives, with a false positive reporting rate of 44.5% (216 false reports out of 485). Only medically verified cases among relatives were included in the analysis. There was statistically significant heterogeneity in family risk, with 53 (4.7%) of the total 1,116 unrelated families containing significantly more melanoma cases than expected considering the size of the family, and the age, sex, and birth cohort distributions of family members. In univariate analyses, members of the high-risk families were significantly more likely to have poor ability to tan, a propensity to sunburn, fair skin color, red hair, and many melanocytic nevi. When all variables were included simultaneously in a multiple logistic regression model, only the associations with tanning ability, skin color, and number of nevi remained significant. There were no significant differences overall between high-risk and other families in the sites and ages at diagnosis of melanoma, although melanomas on variably sun-exposed sites (trunk and legs) were diagnosed earlier in the high-risk families, independent of the stage at diagnosis.

Sources of individual differences in depressive symptoms: analysis of two samples of twins and their families

OBJECTIVE

Self-reported symptoms of depression are commonly used in mental health research to assess current psychiatric state, yet wide variation in these symptoms among individuals has been found in both clinical and epidemiologic populations. The authors sought to understand, from a genetic-epidemiologic perspective, the sources of individual differences in depressive symptoms.

METHODS

Self-reported symptoms of depression were assessed in two samples of twins and their spouses, parents, siblings, and offspring: one sample contained volunteer twins recruited through the American Association of Retired Persons and their relatives (N = 19,203 individuals) and the other contained twins from a population-based twin registry in Virginia and their relatives (N = 11,242 individuals). Model fitting by an iterative, diagonal, weighted least squares method was applied to the 80 different family relationships in the extended twin-family design.

RESULTS

Independent analyses of the two samples revealed that the level of depressive symptoms was modestly familial, and familial resemblance could be explained solely by genetic factors and spousal resemblance. The estimated heritability of depressive symptoms was between 30% and 37%. There was no evidence that the liability to depressive symptoms was environmentally transmitted from parents to offspring or was influenced by environmental factors shared either generally among siblings or specifically between twins. With correction for unreliability of measurement, genetic factors accounted for half of the stable variance in depressive symptoms.

CONCLUSIONS

Depressive symptoms in adulthood partly reflect enduring characteristics of temperament that are substantially influenced by hereditary factors but little, or not at all, by shared environmental experiences in the family of origin.

Testing a model for the genetic structure of personality: a comparison of the personality systems of Cloninger and Eysenck

Genetic analysis of data from 2,680 adult Australian twin pairs demonstrated significant genetic contributions to variation in scores on the Harm Avoidance, Novelty Seeking, and Reward Dependence scales of Cloninger's Tridimensional Personality Questionnaire (TPQ), accounting for between 54% and 61% of the stable variation in these traits. Multivariate genetic triangular decomposition models were fitted to determine the extent to which the TPQ assesses the same dimensions of heritable variation as the revised Eysenck Personality Questionnaire. These analyses demonstrated that the personality systems of Eysenck and Cloninger are not simply alternative descriptions of the same dimensions of personality, but rather each provide incomplete descriptions of the structure of heritable personality differences.

Testing a model for the genetic structure of personality: a comparison of the personality systems of Cloninger and Eysenck

Genetic analysis of data from 2,680 adult Australian twin pairs demonstrated significant genetic contributions to variation in scores on the Harm Avoidance, Novelty Seeking, and Reward Dependence scales of Cloninger's Tridimensional Personality Questionnaire (TPQ), accounting for between 54% and 61% of the stable variation in these traits. Multivariate genetic triangular decomposition models were fitted to determine the extent to which the TPQ assesses the same dimensions of heritable variation as the revised Eysenck Personality Questionnaire. These analyses demonstrated that the personality systems of Eysenck and Cloninger are not simply alternative descriptions of the same dimensions of personality, but rather each provide incomplete descriptions of the structure of heritable personality differences.

Alcohol consumption and alcohol pharmacokinetics: interactions within the normal population

We have analyzed the interrelationships between habitual alcohol consumption, peak blood alcohol concentration after a standard dose, and rate of alcohol metabolism in a group of 199 male and 213 female twins. Both peak concentration and rate of metabolism are strongly associated with alcohol consumption levels, even in the range of 0-10 g of alcohol/day. The peak concentration and rate of metabolism were strongly correlated in both men and women; this is not due to their common dependence on alcohol intake nor to experimental error. These results show that the threshold for effects of habitual consumption on alcohol pharmacokinetics is much lower than previously suspected, and that there are factors that reduce preabsorptive or first-pass metabolism but increase postabsorptive metabolism.

Comparability of naevus counts between and within examiners, and comparison with computer image analysis

In the course of an investigation of melanocytic naevus development in Queensland, Australia, whole-body naevus counts of 66 adolescents were performed separately by two nurse examiners on two occasions on average 4 weeks apart. There was good agreement between the two examiners for counts of total naevi on the whole body (intra-class correlation coefficient = 0.96) and at selected subsites (face, neck, back, upper arms, lower arms). Agreement was lower when raised naevi only were counted (0.83). Intra-examiner repeatability was high for both nurses, particularly for the more experienced examiner (intra-class correlation coefficients = 0.98 and 0.91 for total naevi on the whole body), and was consistently better when all naevi were counted rather than naevi of a particular size. Independent counts of naevi on the back using a computer imaging technique were reproducible (intra-class correlation coefficient = 0.92), but showed only moderate agreement with counts by the nurse examiners. Overall, these results demonstrate high comparability of naevus counts between and within similarly trained examiners. They do not support the common practice in epidemiological studies of restricting counts to naevi larger than 2 mm, or of counting raised naevi only.

Genetic influences on alcohol consumption patterns and problem drinking: results from the Australian NH&MRC twin panel follow-up survey

Self-report questionnaire data from 3,000 adult twin pairs participating in the 1988-1989 follow-up survey of the Australian NH&MRC twin panel were analyzed to determine (1) the contribution of genetic factors to risk of problem drinking in males and females; and (2) the magnitude of the correlation between genetic effects on problem drinking and genetic effects on alcohol consumption level. Significant genetic contributions were found both for average weekly consumption of alcohol and for problem-drinking history. For level of consumption, genetic factors accounted for approximately 58% of the variation in females and 45% of the variation in males. Heritability estimates for problem drinking, though significantly greater than zero, were variable in magnitude, ranging (under different models) from 8-44% in females and 10-50% in males. Likewise, estimates of the magnitude of the genetic correlation, whilst in all cases significantly greater than zero, ranged from 0.42-1.00 in females and 0.45-1.00 in males under different models.

Genetic influences on alcohol consumption patterns and problem drinking: results from the Australian NH&MRC twin panel follow-up survey

Self-report questionnaire data from 3,000 adult twin pairs participating in the 1988-1989 follow-up survey of the Australian NH&MRC twin panel were analyzed to determine (1) the contribution of genetic factors to risk of problem drinking in males and females; and (2) the magnitude of the correlation between genetic effects on problem drinking and genetic effects on alcohol consumption level. Significant genetic contributions were found both for average weekly consumption of alcohol and for problem-drinking history. For level of consumption, genetic factors accounted for approximately 58% of the variation in females and 45% of the variation in males. Heritability estimates for problem drinking, though significantly greater than zero, were variable in magnitude, ranging (under different models) from 8-44% in females and 10-50% in males. Likewise, estimates of the magnitude of the genetic correlation, whilst in all cases significantly greater than zero, ranged from 0.42-1.00 in females and 0.45-1.00 in males under different models.

A model system for analysis of family resemblance in extended kinships of twins

The "Virginia 30,000" comprise 29,698 subjects from the extended kinships of 5670 twin pairs. Over 80 unique correlations between relatives can be derived from these kinships, comprised of monozygotic (MZ) and dizygotic (DZ) twins and their spouses, parents, siblings, and children. This paper describes the first application of a fairly general model for family resemblance to data from the Virginia 30,000. The model assesses the contributions of additive and dominant genetic effects in the presence of vertical cultural inheritance, phenotypic assortative mating, shared twin and sibling environments, and within-family environment. The genetic and environmental effects can be dependent on sex. Assortment and cultural inheritance may be based either on the phenotype as measured or on a latent trait of which the measured phenotype is an unreliable index. The model was applied to church attendance data from this study. The results show that the contributions of genes, vertical cultural inheritance, and genotype-environment covariance are all important, but their contributions are significantly heterogeneous over sexes. Phenotypic assortative mating has a major impact on family resemblance in church attendance.

Inferring the direction of causation in cross-sectional twin data: theoretical and empirical considerations

A recent multivariate extension of the classical twin study in theory allows the inference of the direction of causation between correlated traits solely using cross-sectional data. In this paper we briefly review this model and assess its usefulness by applying it to a number of pairs of biological and psychological variables between which the nature of the causative relationship is already known. We conclude that the method has a number of biases and limitations. If a causative relationship at the phenotypic level exists between two traits, the correct direction of causation is usually identifiable, providing the reliability and validity of the measures are known. Failure to correctly specify a measurement model can lead to incorrect tests of hypotheses. Difficulties can also occur when discriminating between a direct causative relationship and a correlation due to common genetic or environmental determinants, but these occur in predictable situations. If these considerations are taken into account in interpretation of results, the true nature of the association between traits can often be correctly identified, or at least included in a subgroup of best fitting models.

Psoriasis in Australian twins

BACKGROUND

Occurrence of psoriasis has been found to be strongly genetically controlled in Northern European and U.S. twin and family studies.

OBJECTIVE

Our purpose was to assess cumulative incidence and heritability of psoriasis in the Australian population.

METHODS

Australian twins reporting psoriasis on a screening questionnaire received from 3808 pairs were mailed a detailed instrument designed to validate the diagnosis, supplemented by telephone interview and examination of medical records.

RESULTS

Only 94 of 160 subjects who screened positive were confirmed to have psoriasis. The cumulative incidence of confirmed psoriasis was 2% in 30- to 60-year-old subjects. The monozygotic twin casewise concordance for confirmed psoriasis was 35% (12 of 34 pairs), and the dizygotic twin concordance 12% (5 of 43 pairs), giving an estimated heritability of 80%, was similar to that found in a genetic reanalysis of three previous twin studies. A case-control analysis of psoriasis-discordant twin pairs found no evidence for influences of alcohol or coffee intake, overweight, birth weight, or personality in the origin of psoriasis.

CONCLUSION

Occurrence of psoriasis in the Australian population is highly heritable, but identical twins are often discordant; the factor responsible for the onset of disease in one twin and not the other is unclear.

Comparability of surrogate and self-reported information on melanoma risk factors

Surrogate reports by patients about their relatives, and vice versa, are potentially of great use in studies of the genetic and environmental causes of the familial aggregation of cancer. To assess the quality of such information in a family study of melanoma aetiology in Queensland, Australia, the authors compared surrogate reports with self-reports of standard melanoma risk factors obtained by mailed self-administered questionnaire. There was moderate agreement between surrogate reports provided by the cases and relatives' self-reports for questions on ability to tan (polychoric correlation coefficient (pc) = 0.60), skin colour (pc = 0.57), average propensity to burn (pc = 0.56), and hair colour at age 21 (kappa coefficient = 0.55), although relatives in the extreme risk factor categories were misclassified by surrogates at least half of the time. Agreement was lower for questions on degree of moliness (pc = 0.45), tendency to acute sunburn (pc = 0.42), and number of episodes of painful sunburn (pc = 0.23). The quality of relatives' surrogate reports about cases was similar to that of cases' surrogate reports about relatives. Cases who reported a family history of melanoma provided better surrogate information than did cases who indicated no family history, and female cases provided better surrogate reports than did males. Cases were better able to report for their parents and children than for their siblings. The authors conclude that when the use of surrogate reports of melanoma risk factors is unavoidable, results should be interpreted cautiously in the light of potentially high rates of misclassification. In particular, surrogate reports appear to be a comparatively poor measure of self-assessment of number of moles, the strongest known phenotypic indicator of melanoma risk, and may bias comparisons between families with and without a history of melanoma.

Genetic and environmental covariance of serum cholesterol and blood pressure in female twins

Blood pressure elevation is frequently associated with elevated cholesterol, triglyceride or low density lipoprotein (LDL-C) or low high density lipoprotein (HDL-C). The relative importance of genetic and environmental factors in these associations is unclear. We examined the relative contribution of genetic and environmental influences to the association between blood pressure and serum lipids in 75 pairs of female twins using path analysis and maximum-likelihood model fitting. Associations between systolic blood pressure and total cholesterol (r = 0.44, P < 0.001), and LDL-C (r = 0.38, P < 0.001), but not HDL-C (r = 0.05, N.S.), remained significant after age and body mass index adjustment. Univariate models suggested genetic effects contributed 60-70% to the variance of total cholesterol, LDL-C, HDL-C and systolic blood pressure. The remaining variance was explained by age and/or unique environmental influences. Using bivariate models, we demonstrated genetic (P = 0.017) and unique environmental covariance (P = 0.011) of cholesterol and systolic blood pressure. Significant genetic covariance (P = 0.038) was observed between LDL-C and systolic blood pressure. The association between blood pressure and total cholesterol in these twins results from shared genetic and similar unique environmental influences. The association between LDL-C and blood pressure is partly due to shared genetic influences. We conclude that both additive genetic and environmental factors unique to the individual are important determinants of the relationships between serum lipids and blood pressure.

Reproductive hormone genes in mothers of spontaneous dizygotic twins: an association study

There are important genetic influences on the tendency to dizygotic (DZ) twinning and it is a plausible hypothesis that these reside in one or more of the genes coding for the major reproductive hormones. We used Southern analysis of DNA from 50 young (< 32) mothers of DZ twins, who also had a family history of DZ twinning, and 50 controls, to examine allele frequencies of five restriction fragment length polymorphisms (RFLPs) in four hormone genes coding for follicle stimulating hormone beta (FSH beta), chorionic gonadotropin beta (CG beta), inhibin beta B and gonadotropin releasing hormone (GnRH). Comparison of allele frequencies revealed no significant differences between DZ twin mothers and controls. However this does not rule out the role of these genes in the hereditary tendency of multiple ovulation in humans, since absence of linkage disequilibrium does not imply absence of linkage.

Aversive reactions and alcohol use in Europeans

Two hundred subjects of European descent completed a questionnaire about alcohol use and reactions to alcohol. Eleven subjects (5.5%) reported that they always experienced unpleasant reactions after small amounts of alcohol, and these subjects reported significantly lower levels for quantity and frequency of habitual alcohol use, and fewer drinks in the preceding 7 days, than the other subjects. Reactions to alcohol, either genetic or acquired, can therefore be significant in determining alcohol use in non-Asian groups.

Genetic models for the natural history of smoking: evidence for a genetic influence on smoking persistence

We reanalyze data from the 1981 mailed questionnaire survey of the Australian twin register, to test for a genetic effect on smoking persistence (whether or not a smoker quits smoking). In the young cohort, aged 18-30 years, there are too few ex-smokers to permit resolution of genetic and non-genetic models. In the older cohort, we find a significant and substantial genetic effect on smoking persistence, accounting for 53% of the variance. This genetic effect on smoking persistence is independent of genetic effects on smoking initiation.

Risk factors for atherosclerosis in twins

We performed multivariate genetic analyses of cardiovascular risk factors from two sets of data on US and Australian female twins. Similar models for body mass index (BMI), serum low density (LDL) and high density (HDL) lipoproteins, including age as a covariate, were fitted successfully to both groups. These suggested that BMI, or genes responsible for a significant proportion of the variance of BMI, explained correlations between lipid subfractions, as well as those between blood pressure and lipid subfractions, especially HDL.

Genetic contribution to risk of smoking initiation: comparisons across birth cohorts and across cultures

Self-report data on smoking initiation (whether the respondent admitted ever having smoked) were obtained from three large adult twin samples (Australia, N = 3,808 pairs; Virginia, N = 2,145 pairs; AARP, N = 3,620 pairs). Data were broken down into birth cohorts, and genetic models were fitted to test whether the decline, in more recent birth cohorts, in the percentage of individuals becoming smokers has led to a change in the relative contributions of genes and environment to risk of becoming a smoker. Despite a marked change in the proportion of male respondents who reported ever having smoked, we found no evidence for cohort differences in genetic and environmental effects (no Genotype x Cohort interaction). Significant differences in genetic and environmental parameters were found between sexes, and between the Australian and the two U.S. samples. In the U.S. samples, estimates of the genetic contribution to risk of becoming a smoker were 60% in men, 51% in women. In the Australian sample, heritability estimates were 33% in men, but 67% in women. Significant shared environmental effects on smoking initiation also were found, accounting for 23% of the variance in U.S. men, 28% of the variance in U.S. women, 39% of the variance in Australian men, and 15% of the variance in Australian women. In models that allowed for the environmental impact of cotwin smoking on a twin's risk of smoking initiation, estimates of the direct genetic contribution to risk of smoking initiation were comparable or higher (49-58% in U.S. women and 71% in Australian women; 58-61% in U.S. men, and 37% in Australian men).

Cleft lip with or without cleft palate: associations with transforming growth factor alpha and retinoic acid receptor loci

The first association study of cleft lip with or without cleft palate (CL/P), with candidate genes, found an association with the transforming growth-factor alpha (TGFA) locus. This finding has since been replicated, in whole or in part, in three independent studies. Here we extend our original analysis of the TGFA TaqI RFLP to two other TGFA RFLPs and seven other RFLPs at five candidate genes in 117 nonsyndromic cases of CL/P and 113 controls. The other candidate genes were the retinoic acid receptor (RARA), the bcl-2 oncogene, and the homeobox genes 2F, 2G, and EN2. Significant associations with the TGFA TaqI and BamHI RFLPs were confirmed, although associations of clefting with previously reported haplotypes did not reach significance. Of particular interest, in view of the known teratogenic role of retinoic acid, was a significant association with the RARA PstI RFLP (P = .016; not corrected for multiple testing). The effect on risk of the A2 allele appears to be additive, and although the A2A2 homozygote only has an odds ratio of about 2 and recurrence risk to first-degree relatives (lambda 1) of 1.06, because it is so common it may account for as much as a third of the attributable risk of clefting. There is no evidence of interaction between the TGFA and RARA polymorphisms on risk, and jointly they appear to account for almost half the attributable risk of clefting.

Increasing incidence of cutaneous melanoma in Queensland, Australia

BACKGROUND

Queensland, Australia, had the world's highest incidence rates of invasive cutaneous melanoma in the 1970s.

PURPOSE

The purpose of this study was to monitor trends in melanoma incidence in Queensland.

METHODS

We studied two time periods in which ascertainment was comparable.

RESULTS

In the 7.5 years up to 1987, the incidence of invasive melanoma in Queensland increased by more than one half in women (to 42.89 per 100,000) and more than doubled in men (to 55.81 per 100,000), with the most dramatic increase seen in men over age 50 years. This higher increase in men is a reversal of the previously higher rates in women. In Queensland, cumulative risks of total cutaneous melanoma (in persons aged 0-74 years), including preinvasive melanoma, have increased to one in 14 in men and to one in 17 in women. There were large increases in age-standardized incidence rates of thin lesions (less than 0.75 mm) in both sexes but not of in situ lesions, and there were also increases in thicker lesions, especially on the backs of males.

CONCLUSIONS

Although increased awareness and earlier diagnosis appear to have accompanied increased incidence, increased exposure to solar UV radiation during the past 50 years appears to be the most likely explanation for the rise in incidence rates.

IMPLICATIONS

A better understanding is needed of the causes of melanoma and of the complex relationships between constitutional factors, ambient UV radiation, and sun-exposure behavior.

Pathways to hysterectomy: insights from longitudinal twin research

OBJECTIVE

We hypothesized that genetic influences act on "liability" to hysterectomy, that secular influences might differentially affect relative importance of genetic and environmental influences, and that the sources of genetic influences could be identified from reported risk factors.

STUDY DESIGN

Hysterectomy data from an Australia-wide volunteer sample of female adult monozygotic and dizygotic twins are reported. In 1980 through 1982 a mailed questionnaire was completed by 1232 monozygotic female twin pairs and 751 dizygotic female twin pairs (3966 women) from the Australian Twin Register (wave 1). The same twins were surveyed by questionnaire 8 years later (wave 2).

RESULTS

A total of 366 had undergone hysterectomy by wave 1 and a further 198 at wave 2. The twin-pair correlations for liability to hysterectomy at wave 1 (0.61 +/- 0.06 for monozygotic and 0.20 +/- 0.11 for dizygotic) and wave 2 (0.65 +/- 0.05 for monozygotic and 0.32 +/- 0.09 for monozygotic) indicated a substantial genetic contribution. Reported risk factors accounted for only 15% of total variance.

CONCLUSION

Genetic influences on liability to hysterectomy were substantial and stable across birth cohorts, but the important sources of genetic influence on liability to hysterectomy are yet to be identified.

Platelet cytosolic free calcium concentration, total plasma calcium concentration and blood pressure in human twins: a genetic analysis

1. We used path analysis and maximum-likelihood model fitting to evaluate the relative contributions of genetic and environmental factors to the relationships observed between level of blood pressure and both total plasma calcium concentration and platelet cytosolic free calcium concentration in 109 twin pairs. 2. Total plasma calcium concentration was positively associated with systolic (r = 0.26, P less than 0.001) but not diastolic blood pressure, a relationship which remained significant after adjustment for albumin, age and body mass index. A relationship between platelet cytosolic free calcium concentration and both systolic and diastolic blood pressure (r = 0.17 and r = 0.13, respectively, P less than or equal to 0.05) was no longer significant after adjustment for age and body mass index. 3. Additive genetic influences, unique environmental effects and age contributed to 60%, 30% and 10% of the variance in systolic blood pressure, respectively. Additive genetic effects explained 78% of the variance in plasma total calcium concentration and at least 48% of the variance in platelet cytosolic free calcium concentration in females and 37% in males. 4. Bivariate factor models provided evidence of genetic, but not environmental, co-variation of total plasma calcium concentration and systolic blood pressure, suggesting that a common genetic factor (or factors) contributes to their univariate relationship. In contrast, there was evidence of environmental, but not genetic, covariation of platelet cytosolic free calcium concentration and systolic blood pressure, suggesting that some of the individual experiences specific to each twin may be causing these two traits to vary together. 5. The possible confounding effects of adiposity and environmental factors should be considered in future studies investigating the role of intracellular calcium levels in the pathogenesis of hypertension.

Genetic differences in psychomotor performance decrement after alcohol: a multivariate analysis

We reanalyzed data on the decline in performance on a battery of psychomotor tests, after a standard dose of ethanol (0.75 g/kg body weight), of 206 same-sex twin pairs. Principal components analysis identified two orthogonal factors. The first factor was strongly associated with increased body sway, self-rated intoxication and unwillingness to drive, and reported low average weekly alcohol consumption, but showed a very weak association with blood alcohol concentration. The second factor had high loadings on tests assessing psychomotor coordination, was strongly associated with blood alcohol concentration, but was unrelated to willingness to drive or self-rated intoxication. Multivariate genetic analysis indicated independent genetic and environmental determination of differences in sensitivity to the effects of alcohol on these two factors.

Protease inhibitor (Pi) locus, fertility and twinning

In a sample of 160 Dutch twin pairs and their parents, we found that mothers of dizygotic twins had frequencies of the S and Z alleles at the protease inhibitor (Pi) locus that were 3 times higher than a control sample. Mothers of identical twins also had a higher frequency of S than controls. The S allele may thus both increase ovulation rate and enhance the success of multiple pregnancies. There was also an increased frequency of the S allele in fathers of dizygotic twins; however, this may be a secondary effect of assortative mating for family size (indicating by the number of siblings of the parents), for which a correlation of 0.2 was observed. Parents of dizygotic twins came from larger families than parents of monozygotic twins, but no effect of Pi type on family size was seen.

Genetic control of the renal clearance of urate: a study of twins

Although a genetic predisposition to gout has been recognised for centuries, its mechanism has never been defined. This study was designed to determine whether this factor might be the renal clearance of urate, which is an important determinant of the concentration of urate in serum. In this study the renal clearance of urate was examined in 37 pairs of normouricaemic twins to determine whether this resemblance was genetically mediated. Monozygotic twins had more similar values of urate clearance and fractional excretion of urate than dizygotic twins. The heritability of the renal clearance of urate was estimated as about 60% (95% confidence limits 40 to 100%), whereas the heritability of the fractional excretion of urate was 87% (confidence limits 45 to 100%). This study supports the hypothesis that genetic factors exert an important control on the renal clearance of urate, which determines some of the familiarity of hyperuricaemia and gout.

Fitting genetic models to Carabelli trait data in South Australian twins

This study aimed to clarify genetic and environmental contributions to Carabelli trait variation on permanent first molar teeth in a large sample of South Australian twins. Estimates of polychoric correlations were obtained between pairs of monozygous (MZ) and dizygous (DZ) twins for Carabelli data and various gene-environment models fitted by a weighted least-squares approach. The favored model included additive genetic effects together with both a general environmental component and an environmental effect specific to each side. An estimate of heritability around 90% indicated a very strong genetic contribution to observed variation. The pattern of correlations for MZ and DZ data suggested that further studies involving other types of relatives would be worthwhile for detection of possible non-additive genetic effects of dominance or epistasis.

Religion and education as mediators of attitudes: a multivariate analysis

The transmission of social attitudes has been investigated as a possible model of cultural inheritance in a sample of 3810 twin pairs from the Australian National Health and Medical Research Twin Registry. Six social attitude factors were identified and univariate genetic models fitted to scores on each factor. A joint multivariate genetic analysis of the six attitude factors, church attendance, and education indicated that the attitudes were correlated--the same genes and shared environments influenced more than one attitude factor. A current controversy regarding social attitudes is whether the significant loadings on this shared environmental component represent true cultural influences or are actually the genetic consequences of phenotypic assortative mating for church attendance and educational attainment (Martin et al., 1986). In our data, church attendance is almost entirely due to the impact of the shared environment. The large shared environmental component on church attendance also accounts for a substantial part of the family resemblance in social attitudes, suggesting that not all of the apparent cultural effects found in earlier studies can be ascribed to the genetic effects of assortative mating. However, church attendance and education do not completely account for the cultural component. Therefore, effects in addition to church attendance, education, and assortative mating for church attendance and education must be involved in the cultural component of the inheritance of attitudes.

MspI RFLP of FSHB on chromosome 11p

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NcoI RFLP of the human LHRH gene on chromosome 8p

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Excessive follicular recruitment and growth in mothers of spontaneous dizygotic twins

We wished to establish the frequency, regularity and laterality of multiple ovulation in mothers of dizygotic (DZ) twins and controls. Subjects had regular menses and were not using oral contraceptives. Ovarian ultrasound scans were taken over a number of cycles in 21 mothers of DZ twins and 18 controls (including 13 mothers of monozygotic [MZ] twins). Multiple large follicles (greater than or equal to 12 mm diameter) were seen significantly more frequently in mothers of DZ twins (13/21 mothers, 24/77 cycles, average +/- SE follicles/cycle 1.34 +/- 0.11) than controls (2/18 mothers, 3/31 cycles, average 1.10 +/- 0.08). Both ipsilateral and contralateral multiple follicles were observed. In one case a mother of DZ twins showed multiple large follicles in 7 out of 10 cycles in which she was scanned, including both ipsi- and contralateral patterns of occurrence.

The inheritance of alcohol consumption patterns in a general population twin sample: II. Determinants of consumption frequency and quantity consumed

Genetic models were fitted to self-report data on frequency of alcohol consumption and average quantity consumed when drinking, from 3,810 adult Australian twin pairs. Frequency of consumption is determined both by an abstinence dimension, which is strongly influenced by shared environmental effects but not by genetic effects, and by an independent frequency dimension, which is influenced by genetic effects in both sexes and possibly by shared environmental affects in men. Quantity of alcohol consumed is likewise determined by an environmental abstinence dimension and by an independent and partly heritable quantity dimension. The best-fitting model allowed for two routes to abstinence: those who were not abstainers by virtue of their position on the abstinence dimension could nonetheless become abstainers by their position on the second, frequency (or quantity) dimension. Heritability estimates were 66% in women and 42-75% in men, for frequency; and 57% in women and 24-61% in men, for quantity.