A Genome-Wide Test of the Differential Susceptibility Hypothesis Reveals a Genetic Predictor of Differential Response to Psychological Treatments for Child Anxiety Disorders

The role of environmental sensitivity in the mental health of Syrian refugee children: a multi-level analysis

Individuals with high environmental sensitivity have nervous systems that are disproportionately receptive to both the protective and imperilling aspects of the environment, suggesting their mental health is strongly context-dependent. However, there have been few consolidated attempts to examine putative markers of sensitivity, across different levels of analysis, within a single cohort of individuals with high-priority mental health needs. Here, we examine psychological (self-report), physiological (hair hormones) and genetic (polygenic scores) markers of sensitivity in a large cohort of 1591 Syrian refugee children across two waves of data. Child-caregiver dyads were recruited from informal tented settlements in Lebanon, and completed a battery of psychological instruments at baseline and follow-up (12 months apart). Univariate and multivariate Bayesian linear mixed models were used to examine a) the interrelationships between markers of sensitivity and b) the ability of sensitivity markers to predict anxiety, depression, post-traumatic stress disorder, and externalising behaviour. Self-reported sensitivity (using the Highly Sensitive Child Scale) significantly predicted a higher burden of all forms of mental illness across both waves, however, there were no significant cross-lagged pathways. Physiological and genetic markers were not stably predictive of self-reported sensitivity, and failed to similarly predict mental health outcomes. The measurement of environmental sensitivity may have significant implications for identifying and treating mental illness, especially amongst vulnerable populations, but clinical utility is currently limited to self-report assessment.

Genetics of environmental sensitivity to psychiatric and neurodevelopmental phenotypes: evidence from GWAS of monozygotic twins

Individual sensitivity to environmental exposures may be genetically influenced. This genotype-by-environment interplay implies differences in phenotypic variance across genotypes. However, environmental sensitivity genetic variants have proven challenging to detect. GWAS of monozygotic twin differences is a family-based variance analysis method, which is more robust to systemic biases that impact population-based methods. We combined data from up to 21,792 monozygotic twins (10,896 pairs) from 11 studies to conduct the largest GWAS meta-analysis of monozygotic phenotypic differences in children and adolescents/adults for seven psychiatric and neurodevelopmental phenotypes: attention deficit hyperactivity disorder (ADHD) symptoms, autistic traits, anxiety and depression symptoms, psychotic-like experiences, neuroticism, and wellbeing. The SNP-heritability of variance in these phenotypes were estimated (h2: 0% to 18%), but were imprecise. We identified a total of 13 genome-wide significant associations (SNP, gene, and gene-set), including genes related to stress-reactivity for depression, growth factor-related genes for autistic traits and catecholamine uptake-related genes for psychotic-like experiences. Monozygotic twins are an important new source of evidence about the genetics of environmental sensitivity.

Cumulative Genetic Scores Interact with Maternal and Paternal Parenting in Predicting Parent-Adolescent Cohesion and Conflict

Previous research concerning the interplay between genetics and parenting in the development of the parent-child relationship during adolescence has been extremely scarce, predominantly adopting single-gene designs. This limited body of work has largely overlooked the distinct effects of maternal and paternal roles, as well as potential gender differences. Additionally, existing gene-by-environment (G × E) studies have mainly concentrated on adverse environmental factors and associated negative outcomes, somewhat neglecting positive environments and outcomes. The present study examined the interactions of cumulative genetic scores (CGS, dopamine receptor D2 TaqIA and oxytocin receptor gene rs53576 polymorphisms) with both positive and negative parenting on parent-adolescent cohesion and conflict. Furthermore, this study aimed to ascertain with which gene-environment model the potential G × E interactions would align. A total of 745 Chinese Han adolescents (Mage = 13.36 ± 0.96 years; 46.8% girls) from grades 7 to 9 participated in this study. Results revealed a significant effect of CGS and negative maternal parenting on mother-adolescent conflict among males, consistent with the weak differential susceptibility model. As CGS increased, the effects of negative maternal parenting on mother-son conflict were magnified. These findings have implications for the timing and focus of interventions aimed at improving parent-adolescent relationships.

Genetics of environmental sensitivity and its association with variations in emotional problems, autistic traits, and wellbeing

Greater environmental sensitivity has been associated with increased risk of mental health problems, especially in response to stressors, and lower levels of subjective wellbeing. Conversely, sensitivity also correlates with lower risk of emotional problems in the absence of adversity, and in response to positive environmental influences. Additionally, sensitivity has been found to correlate positively with autistic traits. Individual differences in environmental sensitivity are partly heritable, but it is unknown to what extent the aetiological factors underlying sensitivity overlap with those on emotional problems (anxiety and depressive symptoms), autistic traits and wellbeing. The current study used multivariate twin models and data on sensitivity, emotional problems, autistic traits, and several indices of psychological and subjective wellbeing, from over 2800 adolescent twins in England and Wales. We found that greater overall sensitivity correlated with greater emotional problems, autistic traits, and lower subjective wellbeing. A similar pattern of correlations was found for the Excitation and Sensory factors of sensitivity, but, in contrast, the Aesthetic factor was positively correlated with psychological wellbeing, though not with emotional problems nor autistic traits. The observed correlations were largely due to overlapping genetic influences. Importantly, genetic influences underlying sensitivity explained between 2 and 12% of the variations in emotional problems, autistic traits, and subjective wellbeing, independent of trait-specific or overlapping genetic influences. These findings encourage incorporating the genetics of environmental sensitivity in future genomic studies aiming to delineate the heterogeneity in emotional problems, autistic traits, and wellbeing.

An Unhealthy Dietary Pattern during Pregnancy is Associated with Neurodevelopmental Disorders in Childhood and Adolescence

Despite the high prevalence of neurodevelopmental disorders, there are a lack of clinical studies examining the impact of pregnancy diet on child neurodevelopment. This observational clinical study examined the associations between pregnancy dietary patterns and neurodevelopmental diagnoses, as well as their symptoms, in a prospective cohort of 10-year-old children (n=508). Data-driven dietary patterns were derived from self-reported food frequency questionnaires. An Unhealthy dietary pattern in pregnancy (per SD change) was significantly associated with attention deficit hyperactivity disorder (ADHD) OR 1.66 [1.21 - 2.27], p=0.002 and autism diagnosis OR 2.22 [1.33 - 3.74], p=0.002 and associated symptoms p<0.001. Findings for ADHD were validated in two large (n=656, n=348), independent mother-child cohorts via blood metabolome modelling. Objective metabolite scores, assessed at five timepoints in mothers and children in two independent mother-child cohorts, indicated that the strongest association with ADHD was during early-to mid-pregnancy. These results provide evidence for targeted prenatal dietary interventions to prevent neurodevelopmental disorders in children.

Individual differences in environmental sensitivity: associations between cognitive emotion regulation and mental health

Introduction

Environmental sensitivity is defined as the ability to perceive and process internal and external information. Previous studies have suggested that mental health-related factors differ by sensitivity level. This study aimed to investigate whether environmental sensitivity moderates the associations between cognitive emotion regulation strategies (e.g., rumination and blaming others) and mental health.

Materials and methods

In this three-wave longitudinal study, participants (N = 1,233, 585, and 349 at Times 1, 2, and 3, respectively) completed the Cognitive Emotion Regulation Questionnaire-short and Kessler 10 scale at all the measurement points as well as the 10-item version of the Highly Sensitive Person scale and some covariates only at Time 1.

Results

Latent growth model analyses indicated that the blaming others strategy had contrastive effects on changes in mental health by sensitivity level; the increase in refocusing on planning was associated with improved mental health over time only for highly sensitive individuals; and the rumination and catastrophizing strategies were the most important risk factors for mental health problems, although their effects differed slightly by sensitivity level.

Conclusion

The associations between some of the cognitive strategies and mental health differ by environmental sensitivity level. Future investigations based on individual differences in sensitivity could provide innovative insights into practices.

The contribution of Sensory Processing Sensitivity and internalized attachment representations on emotion regulation competencies in school-age children

Introduction

As captured by the individual trait of Sensory Processing Sensitivity (SPS), highly sensitive children perceive, process, and responds more strongly to stimuli. This increased sensitivity may make more demanding the process of regulating and managing emotions. Yet, developmental psychology literature also showed that other variables, as those related to the rearing environment, are likely to contribute to the process of regulating emotions. With the current contribution, we aim to bridge two lines of research, that of attachment studies and that of SPS, by investigating the additive and interactive contribution of SPS and internal working models of attachment representations on emotion regulation competencies in school-aged children.

Method

Participants were N = 118 Italian children (mean age: 6.5, SD = 0.58 years, and 51.8% female) with their mothers. Children's positive attachment representations were rated observationally through the Manchester Child Attachment Story Task procedure during an individual session at school. Mothers reported on children SPS trait and emotion regulation competencies completing the Highly Sensitive Child Scale-parent report and the Emotion Regulation Checklist. We performed and compared a series of main and interaction effect models.

Results

SPS was not directly associated with emotion regulation but it was significantly associated with positive attachment representations in predicting emotion regulation. Highly sensitive children showed poorer emotion regulation when the internalized representations were low in maternal warmth and responsiveness. When driven by sensitive and empathic attachment representation, highly sensitive children showed better emotion regulation than less-sensitive peers, suggesting a for better and for worse effect.

Discussion

Highly sensitive children are not only more vulnerable to adversities but also show better emotion regulation competencies when supported by positive internal working models of attachment relationships. Overall, findings shed light on the link between SPS and attachment and suggest that working for promoting secure attachment relationships in parent-child dyads may promote better emotion regulation competences, particularly in highly sensitive children.

The genetic architecture of youth anxiety: a study protocol

BACKGROUND

Anxiety disorders are the most common psychiatric problems among Canadian youth and typically have an onset in childhood or adolescence. They are characterized by high rates of relapse and chronicity, often resulting in substantial impairment across the lifespan. Genetic factors play an important role in the vulnerability toward anxiety disorders. However, genetic contribution to anxiety in youth is not well understood and can change across developmental stages. Large-scale genetic studies of youth are needed with detailed assessments of symptoms of anxiety disorders and their major comorbidities to inform early intervention or preventative strategies and suggest novel targets for therapeutics and personalization of care.

METHODS

The Genetic Architecture of Youth Anxiety (GAYA) study is a Pan-Canadian effort of clinical and genetic experts with specific recruitment sites in Calgary, Halifax, Hamilton, Toronto, and Vancouver. Youth aged 10-19 (n = 13,000) will be recruited from both clinical and community settings and will provide saliva samples, complete online questionnaires on demographics, symptoms of mental health concerns, and behavioural inhibition, and complete neurocognitive tasks. A subset of youth will be offered access to a self-managed Internet-based cognitive behavioral therapy resource. Analyses will focus on the identification of novel genetic risk loci for anxiety disorders in youth and assess how much of the genetic risk for anxiety disorders is unique or shared across the life span.

DISCUSSION

Results will substantially inform early intervention or preventative strategies and suggest novel targets for therapeutics and personalization of care. Given that the GAYA study will be the biggest genomic study of anxiety disorders in youth in Canada, this project will further foster collaborations nationally and across the world.

Investigating sensitivity through the lens of parents: validation of the parent-report version of the Highly Sensitive Child scale

Children differ in their environmental sensitivity (ES), which can be measured observationally or by self-report questionnaire. A parent-report scale represents an important tool for investigating ES in younger children but has to be psychometrically robust and valid. In the current multistudy, we validated the parent-report version of the Highly Sensitive Child (HSC-PR) scale in Italian children, evaluating its factorial structure (Study 1, N = 1,857, 6.2 years, age range: 2.6-14 years) through a multigroup Confirmatory Factory Analysis in preschoolers (n = 1,066, 4.2 years) and school-age children (n = 791, 8.8 years). We then investigated the HSC-PR relationship with established temperament traits (Study 2, N = 327, 4.3 years), before exploring whether the scale moderates the effects of parenting stress on children's emotion regulation (Study 3, N = 112, 6.5 years). We found support for a bi-factor structure in both groups, though in preschoolers minor adaptations were suggested for one item. Importantly, the HSC-PR did not fully overlap with common temperament traits and moderated the effects of parenting stress on children emotion regulation. To conclude, the HSC-PR performs well and appears to capture ES in children.

Interactions between environmental sensitivity and gut microbiota are associated with biomarkers of stress-related psychiatric symptoms

BACKGROUND

Humans vary in their sensitivity to stressful and supportive environments and experiences. Such individual differences in environmental sensitivity are associated with mechanisms of stress-related psychiatric symptoms. In recent years, researchers have focused on bidirectional interactions in the brain-gut-microbiota axis as a neurophysiological pathway contributing to the mechanisms of stress-related psychiatric symptoms, and evidence is rapidly accumulating.

METHODS

Data on environmental sensitivity, gut microbiota, gut permeability (lipopolysaccharide-binding protein; LBP) and inflammation (C-reactive protein; CRP) were collected from 90 adults (50 % female; Mage = 42.1; SDage = 10.0). Environmental sensitivity was measured using a self-report questionnaire. Study participants' feces were analyzed, and observed operational taxonomic units for richness, Shannon's index for evenness, and phylogenetic diversity for biodiversity were evaluated as indicators of gut microbiota. In addition, participants' serum was analyzed for CRP and LBP. We investigated whether the interaction between environmental sensitivity and gut microbiota is associated with biomarkers of inflammation and gut permeability.

RESULTS

The interaction between environmental sensitivity and gut microbiota (excluding the Shannon's index) explained the levels of these biomarkers. Individuals with high environmental sensitivity displayed higher levels of CRP and LBP, when the richness and diversity of the gut microbiota was low. However, even highly susceptible individuals had lower levels of CRP and LBP, when the richness and diversity of the gut microbiota was high.

CONCLUSIONS

Our study indicates that high environmental sensitivity can be a risk factor for inflammation and gut permeability, when the gut microbiota diversity is low, suggesting a brain-gut-microbiota axis interaction.

Practitioner Review: Differential susceptibility theory: might it help in understanding and treating mental health problems in youth?

Diathesis-stress models conceptualise individual differences in propensity for psychopathology as an interaction between environmental risk factors and intra-individual vulnerabilities. In contrast, the differential susceptibility theory and related frameworks view intra-individual differences as variations in sensitivity to the environments rather than merely vulnerability to them. Specifically, they suggest that more sensitive individuals are more affected by the quality of their context, whether positive or negative, than others who are less sensitive. Empirical research over the last two decades has found support for this notion in that greater sensitivity is associated with a greater risk of psychopathology in adverse contexts, but also with lower risk in positive environments. However, despite growing academic and public interest in this field, it is currently unclear to what extent the differential susceptibility model is relevant, or applicable, to clinical practice. The purpose of this review is to focus on the differential susceptibility theory as an alternative explanation of individual differences in mental health and examine its relevance in the treatment of mental health problems in young people. We provide an overview of differential susceptibility and related theories, and current relevant research in the field. We identify potential implications of differential susceptibility models for understanding and treating mental health problems in young people, whilst also highlighting important gaps in research that limit their application at present. Finally, we suggest directions for future research that will assist in the translation of differential susceptibility theories into clinical practice.

Environmental susceptibility for all: A data-driven approach suggests individual differences in domain-general and domain-specific patterns of environmental susceptibility

How we are influenced by our environment is a fundamental question in developmental science. Theories and empirical research have claimed that some individuals are susceptible to environmental influences and others are much less susceptible. The present study addressed four questions: (1) Is environmental susceptibility a continuous or categorical construct? (2) Is environmental susceptibility unidimensional (i.e., domain general) or multidimensional (i.e., domain specific)? (3) Are there genetic contributions to individual differences in environmental susceptibility? (4) What are the temperamental characteristics of different environmental susceptibility patterns? We used child- and mother-report data from a sample of 11-year-old twins (N = 1,507) and applied a novel data-driven approach to assess an environmental susceptibility space, based on simultaneous associations between multiple environmental exposures (18 measures relating to parenting, parent, peer, and twin relationships) and developmental outcomes (10 measures relating to empathy, prosocial behavior, aggression, and self-esteem). The results suggest that the environmental susceptibility space we assessed is better conceptualized as continuous and multidimensional. Different children showed susceptibility to different contexts and variation in domain-general versus domain-specific patterns. A comparison of distances between monozygotic and dizygotic twins within the space demonstrated genetic contributions. Finally, susceptibility patterns could not be differentiated based on a specific temperament trait, but rather related to temperament profiles.

Prenatal programming of environmental sensitivity

According to several theories, people differ in their sensitivity to environmental influences with some more susceptible than others to both supportive and adverse contextual conditions. Such differences in environmental sensitivity have a genetic basis but are also shaped by environmental factors. Herein we narratively build on our previous work proposing that prenatal experiences contribute to the development of environmental sensitivity. This hypothesis of prenatal programming of postnatal plasticity has considerable empirical support. After presenting illustrative animal and human evidence consistent with this claim, we discuss a range of biological mechanisms likely involved in the pathway from prenatal stress exposure to postnatal environmental sensitivity. We also consider work suggesting that genetic differences, gender, as well as the timing, duration and intensity of prenatal exposures may moderate the effects of prenatal programming on postnatal environmental susceptibility or sensitivity. Before concluding, we highlight "unknowns in the prenatal programming of environmental sensitivity" and their practical implications. Ultimately, we conclude that prenatal stress does not necessarily predispose individuals to problematical development, but rather increases sensitivity to both adverse and supportive postnatal contexts. Thus, prenatal stress may actually foster positive development if paired with supportive and caring postnatal environments.

Environmental Sensitivity in Adults: Psychometric Properties of the Japanese Version of the Highly Sensitive Person Scale 10-Item Version

Environmental Sensitivity, which explains individual differences in the tendency to respond more to both positive and negative environmental influences, can be measured by the self-reported Highly Sensitive Person scale. This paper introduced psychometric properties of a brief Japanese version of a 10-item measure of sensitivity (HSP-J10) developed by four studies involving 2,388 adults. The results showed that (1) the newly created HSP-J10 supported the bifactor structure (i.e., Ease of Excitation, Low Sensory Threshold, Esthetic Sensitivity, plus General Sensitivity factor), (2) the HSP-J10 correlated with but discriminated against other personality traits and affects, (3) it had high temporal stability, and (4) participants who scored higher on the HSP-J10 showed significant increases in positive emotion from before watching a video with positive content to after, while those who scored low showed no significant change in positive emotion. It demonstrated the new scale's good psychometric properties in that it moderated outcomes as theoretically expected when the environment was experimentally manipulated. The four studies suggested that the newly created HSP-J10 might adequately measure individual differences in adults' Environmental Sensitivity.

Conduct Problems and Hair Cortisol Concentrations Decrease in School-Aged Children after VIPP-SD: A Randomized Controlled Trial in Two Twin Cohorts

The Video-feedback Intervention to promote Positive Parenting and Sensitive Discipline (VIPP-SD) is effective in increasing parental sensitivity and sensitive discipline, and aims to decrease child behavior problems. Changes in quality of parenting may be accompanied by effects on child stress levels. However, studies of VIPP-SD effects on child behavior problems have shown mixed results and there are no studies to date of the effect of the intervention on children's stress levels, as measured by hair cortisol concentration (HCC). Furthermore, differences in intervention effectiveness may be explained by differential susceptibility factors. We hypothesized that the effects of the VIPP-SD on child behavior problems might be moderated by currently available child polygenic scores of differential susceptibility (PGS-DS). In the current pre-registered trial, we randomly assigned 40% of n = 445 families with school-aged twin children to the intervention group. The VIPP-SD was successful in decreasing both children's conduct problems and HCC. Effects were not moderated by available child PGS-DS. We conclude that a brief, home-based video-feedback parenting intervention can decrease child behavior problems and affect the child's stress-related neuroendocrine system as assessed with hair cortisol. In future studies, more specific PGS-DS for externalizing behaviors should be used as well as parental PGS-DS.

The role of environmental sensitivity in the development of rumination and depressive symptoms in childhood: a longitudinal study

Some children are more affected than others by their upbringing due to their increased sensitivity to the environment. More sensitive children are at heightened risk for the development of internalizing problems, particularly when experiencing unsupportive parenting. However, little is known about how the interplay between children's sensitivity and parenting leads to higher levels of depressive symptoms. In the current study, we investigated the interaction between early parenting and children's sensitivity on levels of depressive symptomatology in middle childhood, exploring the role of rumination as a possible mediator in a community sample. Participants included 196 USA resident families, from a middle class and mostly European-American background, and their healthy children, followed up from age 3 until 9 and 12 years. Environmental sensitivity was assessed observationally when children were 3 years old. Parenting style was based on parent-report at the age of 3 years. When children were nine, they completed questionnaires on rumination and depressive symptoms (repeated at 12 years). Analyses were run applying a Bayesian approach. Children's sensitivity interacted with permissive parenting in predicting rumination at age 9. Rumination, in turn, was associated with depressive symptoms at age 9 and, to a lesser extent, at age 12. No relevant interactions emerged for authoritative and authoritarian parenting. Sensitive children may be at heightened risk for internalizing problems when exposed to a permissive parenting style. Permissive parenting was associated with increased ruminative coping strategies in sensitive children which, in turn, predicted higher levels of depression. Hence, rumination emerged as an important cognitive risk factor for the development of depressive symptoms in sensitive children.

Potential epigenetic mechanisms in psychotherapy: a pilot study on DNA methylation and mentalization change in borderline personality disorder

Genetic and early environmental factors are interwoven in the etiology of Borderline Personality Disorder (BPD). Epigenetic mechanisms offer the molecular machinery to adapt to environmental conditions. There are gaps in the knowledge about how epigenetic mechanisms are involved in the effects of early affective environment, development of BPD, and psychotherapy response. We reviewed the available evidence of the effects of psychotherapy on changes in DNA methylation and conducted a pilot study in a sample of 11 female adolescents diagnosed with BPD, exploring for changes in peripheral DNA methylation of FKBP5 gene, which encodes for a stress response protein, in relation to psychotherapy, on symptomatology and underlying psychological processes. For this purpose, measures of early trauma, borderline and depressive symptoms, psychotherapy outcome, mentalization, and emotional regulation were studied. A reduction in the average FKBP5 methylation levels was observed over time. Additionally, the decrease in FKBP5 methylation observed occurred only in those individuals who had early trauma and responded to psychotherapy. The results suggest an effect of psychotherapy on epigenetic mechanisms associated with the stress response. The finding that epigenetic changes were only observed in patients with early trauma suggests a specific molecular mechanism of recovery. The results should be taken with caution given the small sample size. Also, further research is needed to adjust for confounding factors and include endocrinological markers and therapeutic process variables.

Sensory Processing Sensitivity and Reactivity to Daily Events

Sensory processing sensitivity is an individual difference that captures the extent to which people show heightened emotional reactivity to, and increased cognitive processing of, their environment. Although central to its definition, there has been no research examining whether highly sensitive individuals display stronger reactivity to naturally occurring negative and positive events in everyday life. We addressed this gap by carrying out a 21-day online diary study with 239 participants, varying in sensory processing sensitivity, who reported their daily life-satisfaction, affective experiences, and self-esteem along with appraisals of the most negative and positive events of the day. Multilevel analyses demonstrated that individuals higher in sensory processing sensitivity showed greater reactivity to more subjectively intense negative events, but no difference in their reactivity to positive events. These findings provide initial insights into how sensory processing sensitivity manifests in daily emotional reactivity with greater reactivity to negative events in our study.

The Architecture of Happiness

Happiness is an increasingly prominent topic of interest across academia. However, relatively little attention has been paid to how it is created, especially not in a multidimensional sense. By ‘created’ we do not mean its influencing factors, for which there is extensive research, but how it actually forms in the person. The work that has been done in this arena tends to focus on physiological dynamics, which are certainly part of the puzzle. But they are not the whole picture, with psychological, phenomenological, and socio cultural processes also playing their part. As a result, this paper offers a multidimensional overview of scholarship on the ‘architecture’ of happiness, providing a stimulus for further work into this important topic.

Two Different Mismatches: Integrating the Developmental and the Evolutionary-Mismatch Hypothesis

Evolutionary psychology aims to understand the origins of the human mind, including disease. Several theories about the origins of disease have been proposed. One concerns a developmental mismatch—a mismatch might occur at the individual level between the environment experienced during childhood and the environment the adult finds herself in, possibly resulting in disease. A second theory concerns the idea of an evolutionary mismatch—humans are adapted to ancestral conditions so they might now experience a mismatch with their modern environment, possibly resulting in disease. A third theory—differential susceptibility—outlines how genetic and epigenetic differences influence the extent to which humans are susceptible to rearing, including positive and negative experiences. Because of these differences, some individuals are more prone to develop disease than others. We review empirical studies that substantiate these theories and argue that an overarching theory that integrates these three lines into one provides a more accurate understanding of disease from an evolutionary perspective.

BDNF gene polymorphisms predicting treatment response to CBT-based rehabilitation of depression: to be submitted to: European Neuropsychopharmacology

Genetic factors were shown to play a major role in both variation of treatment response and incidence of adverse effects to medication in affective disorders. Nevertheless, there is still a lack of therapygenetic studies, investigating the prediction of psychological therapy outcomes from genetic markers. Neuroplasticity and one of its mediators, brain-derived neurotrophic factor (BDNF), are potential research targets in this field. We aimed to investigate Tag SNP polymorphisms of the BDNF gene in depressed patients treated with cognitive behavioral therapy (CBT) in the context of a standardized 6-weeks outpatient rehabilitation program. Treatment response was assessed calculating the mean differences in BDI-II (Beck Depression Inventory) scores from admission to discharge. Six BDNF SNPs, including the Val66Met polymorphism (rs6265), were genotyped. Both genotypic data and BDI-II-scores at admission and discharge were available for 277 patients. Three SNPs, rs10501087 (p = 0.005, FDRp=0.015), rs11030104 (p = 0.006, FDRp=0.012), and the Val66Met polymorphism (rs6265, p<0.001, FDRp=0.006), were significantly associated with treatment response in depressed patients, even after multiple testing correction using the false discovery rate method (FDRp). We conclude that BDNF might serve as promising genetic marker for treatment response to psychological treatment in depression. However, due to our limited sample size, further studies are needed to disentangle the role of BDNF as potential therapygenetic marker.

Beyond the diathesis-stress paradigm: Effect of the environmental sensitivity × pubertal tempo interaction on depressive symptoms

Based on the Differential Susceptibility Theory, we examined whether the relationship between pubertal maturation and depressive symptoms can be moderated by individual differences in environmental sensitivity. The current article used the three-wave data collected from Japanese adolescents aged from 12 to 15 years (girls = 111, boys = 98). Consequently, a significant Sensitivity × Pubertal Development interaction was observed in 12- to 13-year-old boys, but not girls. Sensitive boys who experienced accelerated physical maturation reported decreased depressive symptoms, while those who experienced less maturation had increased depressive symptoms. The shape of the interaction supported both the Differential Susceptibility Theory and the Diathesis-Stress Model. Our findings suggest that sensitivity during early puberty among boys could be reconsidered as susceptibility rather than vulnerability.

Childhood parenting and adolescent internalizing and externalizing symptoms: Moderation by multilocus hypothalamic-pituitary-adrenal axis-related genetic variation

Genetic variants that regulate hypothalamic-pituitary-adrenal (HPA) axis function have been demonstrated to moderate the association between parenting and mental health. However, extant research has focused primarily on (i) effects of individual genes or (ii) maternal as opposed to paternal parenting. Using a multilocus genetic profile score (MGPS) approach, the current study is the first to examine the moderation effect of multilocus HPA-axis related genetic variants on the association of both maternal and paternal parenting with adolescent internalizing and externalizing symptoms. In a sample of 772 Chinese Han adolescents (Mage = 16.48 ± 1.40 years; 50.1% girls), a theory-driven MGPS was calculated using six polymorphisms within HPA-axis related genes (CRHR1, NR3C1, NR3C2, FKBP5, COMT, and HT1RA). Results showed that the MGPS interacted with both maternal and paternal parenting in the association with adolescent internalizing symptoms, but not externalizing symptoms. Consistent with the differential susceptibility model, adolescents with high versus low MGPS exhibited not only more internalizing symptoms when exposed to low quality of parenting but also less internalizing symptoms when exposed to high quality of parenting. The current findings highlight the potential value of using a multilocus approach to understanding gene-by-environment interaction (G×E) effects underlying mental health. Within such G×E effects, not only maternal but also paternal parenting should be addressed.

A neural model of vulnerability and resilience to stress-related disorders linked to differential susceptibility

Expert opinion remains divided concerning the impact of putative risk factors on vulnerability to depression and other stress-related disorders. A large body of literature has investigated gene by environment interactions, particularly between the serotonin transporter polymorphism (5-HTTLPR) and negative environments, on the risk for depression. However, fewer studies have simultaneously investigated the outcomes in both negative and positive environments, which could explain some of the inconclusive findings. This is embodied by the concept of differential susceptibility, i.e., the idea that certain common gene polymorphisms, prenatal factors, and traits make some individuals not only disproportionately more susceptible and responsive to negative, vulnerability-promoting environments, but also more sensitive and responsive to positive, resilience-enhancing environmental conditions. Although this concept from the field of developmental psychology is well accepted and supported by behavioral findings, it is striking that its implementation in neuropsychiatric research is limited and that underlying neural mechanisms are virtually unknown. Based on neuroimaging studies that examined how factors mediating differential susceptibility affect brain function, we posit that environmental sensitivity manifests in increased salience network activity, increased salience and default mode network connectivity, and increased salience and central executive network connectivity. These changes in network function may bring about automatic exogenous attention for positive and negative stimuli and flexible attentional set-shifting. We conclude with a call to action; unraveling the neural mechanisms through which differential susceptibility factors mediate vulnerability and resilience may lead us to personalized preventive interventions.

Genetic Variants Associated With Resilience in Human and Animal Studies

Resilience is broadly defined as the ability to maintain or regain functioning in the face of adversity and is influenced by both environmental and genetic factors. The identification of specific genetic factors and their biological pathways underpinning resilient functioning can help in the identification of common key factors, but heterogeneities in the operationalisation of resilience have hampered advances. We conducted a systematic review of genetic variants associated with resilience to enable the identification of general resilience mechanisms. We adopted broad inclusion criteria for the definition of resilience to capture both human and animal model studies, which use a wide range of resilience definitions and measure very different outcomes. Analyzing 158 studies, we found 71 candidate genes associated with resilience. OPRM1 (Opioid receptor mu 1), NPY (neuropeptide Y), CACNA1C (calcium voltage-gated channel subunit alpha1 C), DCC (deleted in colorectal carcinoma), and FKBP5 (FKBP prolyl isomerase 5) had both animal and human variants associated with resilience, supporting the idea of shared biological pathways. Further, for OPRM1, OXTR (oxytocin receptor), CRHR1 (corticotropin-releasing hormone receptor 1), COMT (catechol-O-methyltransferase), BDNF (brain-derived neurotrophic factor), APOE (apolipoprotein E), and SLC6A4 (solute carrier family 6 member 4), the same allele was associated with resilience across divergent resilience definitions, which suggests these genes may therefore provide a starting point for further research examining commonality in resilience pathways.

Is premature birth an environmental sensitivity factor? A scoping review protocol

INTRODUCTION

Globally, around 10% of children are born preterm and are more at risk of negative developmental outcomes. However, empirical evidences and theoretical reasoning also suggest that premature birth can be a susceptibility factor, increasing sensitivity to the environment for better and for worse. Because available findings are controversial, with the current scoping review we will explore if, based on the available literature, preterm birth can be seen as an environmental sensitivity (ES) factor. In doing so, we will consider a series of moderating variables, including the level of prematurity, the type of environment and the outcome investigated. Methodological aspects, as the type of measures used and study design, will be considered.

METHODS AND ANALYSIS

The scoping review will be conducted following the Joanna Briggs Institute Methodology guidelines. The report will follow the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews checklist. We will perform the search between 15 January 2022 and 1 February 2022. Data will be chartered by independent reviewers.

ETHICS AND DISSEMINATION

Ethical approval is not required, as primary data will not be collected. This scoping review will be the first to explore whether prematurity is associated with an increased ES. This review can have important implications for tailoring prevention and intervention programmes. Results will be published in a peer-reviewed journal.

Genome-wide stress sensitivity moderates the stress-depression relationship in a nationally representative sample of adults

We re-evaluate the findings of one of the most cited and disputed papers in gene-environment interaction (GxE) literature. In 2003, a paper was published in Science in which the authors demonstrated that the relationship between stress and depression is moderated by a polymorphism in the promoter region (5-HTTLPR) of the gene SLC6A4. Replication has been weak and led many to challenge the overall significance of GxE research. Here, we utilize data from Add Health, a large, nationally representative, and well-powered longitudinal study to re-examine the genetic determinants of stress sensitivity. We characterize environmental sensitivity using a genome-wide polygenic indicator rather than relying on one polymorphism in a single candidate gene. Our results provide support for the stress-diathesis perspective and validate the scientific contributions of the original paper.

Genetic contributions to anxiety disorders: where we are and where we are heading

Anxiety disorders are among the most common psychiatric disorders worldwide. They often onset early in life, with symptoms and consequences that can persist for decades. This makes anxiety disorders some of the most debilitating and costly disorders of our time. Although much is known about the synaptic and circuit mechanisms of fear and anxiety, research on the underlying genetics has lagged behind that of other psychiatric disorders. However, alongside the formation of the Psychiatric Genomic Consortium Anxiety workgroup, progress is rapidly advancing, offering opportunities for future research.Here we review current knowledge about the genetics of anxiety across the lifespan from genetically informative designs (i.e. twin studies and molecular genetics). We include studies of specific anxiety disorders (e.g. panic disorder, generalised anxiety disorder) as well as those using dimensional measures of trait anxiety. We particularly address findings from large-scale genome-wide association studies and show how such discoveries may provide opportunities for translation into improved or new therapeutics for affected individuals. Finally, we describe how discoveries in anxiety genetics open the door to numerous new research possibilities, such as the investigation of specific gene-environment interactions and the disentangling of causal associations with related traits and disorders.We discuss how the field of anxiety genetics is expected to move forward. In addition to the obvious need for larger sample sizes in genome-wide studies, we highlight the need for studies among young people, focusing on specific underlying dimensional traits or components of anxiety.

The clinical characterization of the adult patient with an anxiety or related disorder aimed at personalization of management

The clinical construct of "anxiety neurosis" was broad and poorly defined, so that the delineation of specific anxiety disorders in the DSM-III was an important advance. However, anxiety and related disorders are not only frequently comorbid, but each is also quite heterogeneous; thus diagnostic manuals provide only a first step towards formulating a management plan, and the development of additional decision support tools for the treatment of anxiety conditions is needed. This paper aims to describe systematically important domains that are relevant to the personalization of management of anxiety and related disorders in adults. For each domain, we summarize the available research evidence and review the relevant assessment instruments, paying special attention to their suitability for use in routine clinical practice. We emphasize areas where the available evidence allows the clinician to personalize the management of anxiety conditions, and we point out key unmet needs. Overall, the evidence suggests that we are becoming able to move from simply recommending that anxiety and related disorders be treated with selective serotonin reuptake inhibitors, cognitive-behavioral therapy, or their combination, to a more complex approach which emphasizes that the clinician has a broadening array of management modalities available, and that the treatment of anxiety and related disorders can already be personalized in a number of important respects.

Improved genetic prediction of complex traits from individual-level data or summary statistics

Most existing tools for constructing genetic prediction models begin with the assumption that all genetic variants contribute equally towards the phenotype. However, this represents a suboptimal model for how heritability is distributed across the genome. Therefore, we develop prediction tools that allow the user to specify the heritability model. We compare individual-level data prediction tools using 14 UK Biobank phenotypes; our new tool LDAK-Bolt-Predict outperforms the existing tools Lasso, BLUP, Bolt-LMM and BayesR for all 14 phenotypes. We compare summary statistic prediction tools using 225 UK Biobank phenotypes; our new tool LDAK-BayesR-SS outperforms the existing tools lassosum, sBLUP, LDpred and SBayesR for 223 of the 225 phenotypes. When we improve the heritability model, the proportion of phenotypic variance explained increases by on average 14%, which is equivalent to increasing the sample size by a quarter.

The role of epigenetics in psychological resilience

There is substantial variation in people's responses to adversity, with a considerable proportion of individuals displaying psychological resilience. Epigenetic mechanisms are hypothesised to be one molecular pathway of how adverse and traumatic events can become biologically embedded and contribute to individual differences in resilience. However, not much is known regarding the role of epigenetics in the development of psychological resilience. In this Review, we propose a new conceptual model for the different functions of epigenetic mechanisms in psychological resilience. The model considers the initial establishment of the epigenome, epigenetic modification due to adverse and protective environments, the role of protective factors in counteracting adverse influences, and genetic moderation of environmentally induced epigenetic modifications. After reviewing empirical evidence for the various components of the model, we identify research that should be prioritised and discuss practical implications of the proposed model for epigenetic research on resilience.

Stress and Learning in Pupils: Neuroscience Evidence and its Relevance for Teachers

Our understanding of how stress affects primary school children's attention and learning has developed rapidly. We know that children experience differing levels of stressors (factors that cause stress) in their environments, and that this can influence how they respond to new stressors when they occur in educational contexts. Here, we review evidence showing that stress can increase children's attention and learning capacities in some circumstances but hinder them in others. We show how children differ in their attention and learning styles, dependent on stress levels: for example, more highly stressed children may be more distracted by superficial features and may find it harder to engage in planning and voluntary control. We review intervention research on stress management techniques in children, concentrating on psychological techniques (such as mindfulness and stress reappraisal), physiological techniques (such as breathing exercises) and environmental factors (such as reducing noise). At the current time, raising teachers' awareness of pupils' differing stress responses will be an important step in accommodating the differing needs of children in their classrooms.

Highly sensitive adolescents: The relationship between weekly life events and weekly socioemotional well-being

Recent research into Person × Environment interaction has supported the view that sensitivity to environmental influences is a susceptibility factor rather than a vulnerability factor. Given this perspective, this study examined the role of the adolescent's sensory-processing sensitivity in the context of weekly life events and weekly socioemotional well-being. In the study, 114 adolescents repeatedly self-reported their sensitivity, recent life events, and recent socioemotional well-being in four surveys at one-week intervals. The results suggested the shape of Sensitivity × Life Events interaction significantly varied from week to week, which is consistent with the vantage sensitivity and diathesis-stress framework. In specific weeks, adolescents with high sensitivity are more likely to benefit from positive events than those with low sensitivity. These sensitive adolescents can be described as developmentally susceptibility rather than vulnerability.

Video-feedback promotes sensitive limit-setting in parents of twin preschoolers: a randomized controlled trial

BACKGROUND

Primary aim of the current randomized controlled trial was to test the effectiveness of the parenting intervention 'Video-feedback to promote Positive Parenting and Sensitive Discipline' (VIPP-SD) in a sample of parents of preschool-aged twins, as well as differential susceptibility to intervention efforts, that is, whether more temperamentally reactive parents would profit more from the VIPP-SD than parents with lower reactivity.

METHODS

The sample consisted of 202 families with same-sex twins [N = 404 children, mean age 45 months (SD = 6.81)]. Randomization was done at the family level in a 2:3 ratio, with 83 families (41%) randomized to the VIPP-SD group, and 119 families (59%) to the control group. After two pre-tests in year 1 and year 2 of the study, the VIPP-SD was implemented in the third year, with a post-test assessment 1 month after the five intervention sessions. Parental sensitivity was observed during structured play in which parent and child copied a drawing together in a computerized Etch-A-Sketch paradigm. Parental limit-setting was observed in a 'don't touch' task in which the parent required from the child to abstain from playing with attractive toys. Parents interacted with each of their twins in separate sessions.

RESULTS

The VIPP-SD intervention had a positive impact on the level of parents' positive limit-setting in interaction with their preschool twins, and this positive effect was most pronounced when the parents completed at least five intervention sessions. However, the intervention did not enhance parental sensitivity during structured play. Parents with higher reactivity were not more open to the impact of the intervention, thus for this temperamental marker differential susceptibility in adults was not supported.

CONCLUSIONS

The current study is unique in targeting families with twin preschoolers, providing proof of principle that coaching parents with video-feedback promotes parental sensitive limit-setting to both children. It remains to be seen whether this finding can be replicated in families with non-twin siblings, or other parental susceptibility markers. Trial registration Trial NL5172 (NTR5312), 2015-07-20.

Predicting alcohol use disorder remission: a longitudinal multimodal multi-featured machine learning approach

Predictive models for recovering from alcohol use disorder (AUD) and identifying related predisposition biomarkers can have a tremendous impact on addiction treatment outcomes and cost reduction. Our sample (N = 1376) included individuals of European (EA) and African (AA) ancestry from the Collaborative Study on the Genetics of Alcoholism (COGA) who were initially assessed as having AUD (DSM-5) and reassessed years later as either having AUD or in remission. To predict this difference in AUD recovery status, we analyzed the initial data using multimodal, multi-features machine learning applications including EEG source-level functional brain connectivity, Polygenic Risk Scores (PRS), medications, and demographic information. Sex and ancestry age-matched stratified analyses were performed with supervised linear Support Vector Machine application and were calculated twice, once when the ancestry was defined by self-report and once defined by genetic data. Multifeatured prediction models achieved higher accuracy scores than models based on a single domain and higher scores in male models when the ancestry was based on genetic data. The AA male group model with PRS, EEG functional connectivity, marital and employment status features achieved the highest accuracy of 86.04%. Several discriminative features were identified, including collections of PRS related to neuroticism, depression, aggression, years of education, and alcohol consumption phenotypes. Other discriminated features included being married, employed, medication, lower default mode network and fusiform connectivity, and higher insula connectivity. Results highlight the importance of increasing genetic homogeneity of analyzed groups, identifying sex, and ancestry-specific features to increase prediction scores revealing biomarkers related to AUD remission.

Longitudinal Links between Adolescent and Peer Conduct Problems and Moderation by a Sensitivity Genetic Index

The most extensively studied influence on adolescent conduct problem behaviors is peers, and the literature points to genetics as one source of individual differences in peer influence. The purpose of this study was to test the hypothesis that an environmental sensitivity genetic index comprised of DRD4, 5-HTTLPR, and GABRA2 variation would moderate the association between peer and adolescent conduct problems. Latent growth modeling was applied to PROSPER project longitudinal data from adolescents and their peers. Results showed the hypothesis was supported; adolescents with more copies of putative sensitivity alleles were more strongly influenced by their peers. The interaction form was consistent with differential susceptibility in follow-up analyses. Strengths and weaknesses of genetic aggregates for sensitivity research are discussed.

Genetic architecture of Environmental Sensitivity reflects multiple heritable components: a twin study with adolescents

Humans differ substantially in how strongly they respond to similar experiences. Theory suggests that such individual differences in susceptibility to environmental influences have a genetic basis. The present study investigated the genetic architecture of Environmental Sensitivity (ES) by estimating its heritability, exploring the presence of multiple heritable components and its genetic overlap with common personality traits. ES was measured with the Highly Sensitive Child (HSC) questionnaire and heritability estimates were obtained using classic twin design methodology in a sample of 2868 adolescent twins. Results indicate that the heritability of sensitivity was 0.47, and that the genetic influences underlying sensitivity to negative experiences are relatively distinct from sensitivity to more positive aspects of the environment, supporting a multi-dimensional genetic model of ES. The correlation between sensitivity, neuroticism and extraversion was largely explained by shared genetic influences, with differences between these traits mainly attributed to unique environmental influences operating on each trait.

Individual differences in sensitivity to the early environment as a function of amygdala and hippocampus volumes: An exploratory analysis in 12-year-old boys

Children differ in their response to environmental exposures, with some being more sensitive to contextual factors than others. According to theory, such variability is the result of individual differences in neurobiological sensitivity to environmental features, with some individuals generally more affected by both negative and/or positive experiences. In this exploratory study we tested whether left and right amygdala and hippocampus volumes (corrected for total brain size) account for individual differences in response to environmental influences in a sample of 62 boys. Cumulative general environmental quality, ranging from low to high, was measured across the first 9 years and child behavior was reported by teachers when boys were 12-13 years old. According to analyses, only the left amygdala volume - not any of the other brain volumes - emerged as an important brain region for sensitivity to positive environmental aspects. Boys with a larger left amygdala benefited significantly more from higher environmental quality than boys with a smaller left amygdala whilst not being more vulnerable to lower quality. Besides providing preliminary evidence for differences in environmental sensitivity due to brain structure, the results also point to the left amygdala as having a specific role regarding the response to environmental influences.

Moderators of Outcome for Youth Anxiety Treatments: Current Findings and Future Directions

Objective: To improve outcomes and create more personalized interventions, the field has sought to identify moderators of treatment response (variables that specify which treatments work for whom and under what conditions).Method: The current review examines moderators of youth anxiety treatments.Results: The majority of studies to date have examined variables of convenience, including demographics (age, sex, race, ethnicity, socioeconomic status), pretreatment youth clinical characteristics (anxiety severity, principal diagnosis, comorbidity) and pretreatment parent variables (parent psychopathology, parenting). Findings indicate few consistent moderators.Conclusions: Future directions are discussed, including (a) group to individual generalizability, (b) power considerations, and (c) updates to study design and measure selection.

Dopamine Functioning and Child Externalizing Behavior: A Longitudinal Analysis of Polygenic Susceptibility to Parenting

OBJECTIVE

This study investigated how genetic susceptibility may affect children's sensitivity to parenting practices in their development of externalizing behavior. We created a continuous polygenic index composed of 5 dopamine polymorphisms to investigate the moderating role of dopamine-related genes in shaping parent-child gene-by-environment (Gc×E) interactions. Accumulating research supports that differences in children's dopamine neurotransmission make certain children more susceptible to both negative and positive parenting practices, a "for-better and for-worse" effect.

METHODS

Data from a 3-wave longitudinal study (4 months between waves) on 190 at-risk families with children aged 4 to 8 were used to investigate whether a heightened polygenic index score amplified the associations between negative and positive parenting and later children's externalizing behavior. Parenting practices and child externalizing behavior were assessed by parent-reported questionnaires.

RESULTS

Findings were not in line with the expectation that there was a stronger association between positive and negative parenting and later externalizing behavior for children with higher scores on the polygenic susceptibility index. Rather, children with a lower score on the polygenic susceptibility index showed more later externalizing behavior in response to positive parenting behavior, whereas for children with a higher score on the polygenic index, positive parenting was predictive of relatively lower levels of later child externalizing behavior.

CONCLUSION

The results indicate that not only are children with higher but also lower scores on the polygenic index sensitive to parenting, they suggest that different phenotypical characteristics related to reward processing might underlie these genetic susceptibilities to parenting practices.

Neural and behavioral signatures of social evaluation and adaptation in childhood and adolescence: The Leiden consortium on individual development (L-CID)

The transition period between early childhood and late adolescence is characterized by pronounced changes in social competence, or the capacity for flexible social adaptation. Here, we propose that two processes, self-control and prosociality, are crucial for social adaptation following social evaluation. We present a neurobehavioral model showing commonalities in neural responses to experiences of social acceptance and rejection, and multiple pathways for responding to social context. The Leiden Consortium on Individual Development (L-CID) provides a comprehensive approach towards understanding the longitudinal developmental pathways of, and social enrichment effects on, social competence, taking into account potential differential effects of such enrichment. Using Neurosynth based brain maps we point towards the medial prefrontal cortex as an important region integrating social cognition, self-referential processing and self-control for learning to respond flexibly to changing social contexts. Based on their role in social evaluation processing, we suggest to examine medial prefrontal cortex connections with lateral prefrontal cortex and the ventral striatum as potential neural differential susceptibility markers, in addition to previously established markers of differential susceptibility.

Three phases of Gene × Environment interaction research: Theoretical assumptions underlying gene selection

Some Gene × Environment interaction (G×E) research has focused upon single candidate genes, whereas other related work has targeted multiple genes (e.g., polygenic scores). Each approach has informed efforts to identify individuals who are either especially vulnerable to the negative effects of contextual adversity (diathesis stress) or especially susceptible to both positive and negative contextual conditions (differential susceptibility). A critical step in all such molecular G×E research is the selection of genetic variants thought to moderate environmental influences, a subject that has not received a great deal of attention in critiques of G×E research (beyond the observation of small effects of individual genes). Here we conceptually distinguish three phases of G×E work based on the selection of genes presumed to moderate environmental effects and the theoretical basis of such decisions: (a) single candidate genes, (b) composited (multiple) candidate genes, and (c) GWAS-derived polygenic scores. This illustrative, not exhaustive, review makes it clear that implicit or explicit theoretical assumptions inform gene selection in ways that have not been clearly articulated or fully appreciated.

Trajectories and Predictors of Children's Early-Starting Conduct Problems: Child, Family, Genetic, and Intervention Effects

Several research teams have previously traced patterns of emerging conduct problems (CP) from early or middle childhood. The current study expands on this previous literature by using a genetically-informed, experimental, and long-term longitudinal design to examine trajectories of early-emerging conduct problems and early childhood discriminators of such patterns from the toddler period to adolescence. The sample represents a cohort of 731 toddlers and diverse families recruited based on socioeconomic, child, and family risk, varying in urbanicity and assessed on nine occasions between ages 2 and 14. In addition to examining child, family, and community level discriminators of patterns of emerging conduct problems, we were able to account for genetic susceptibility using polygenic scores and the study's experimental design to determine whether random assignment to the Family Check-Up (FCU) discriminated trajectory groups. In addition, in accord with differential susceptibility theory, we tested whether the effects of the FCU were stronger for those children with higher genetic susceptibility. Results augmented previous findings documenting the influence of child (inhibitory control [IC], gender) and family (harsh parenting, parental depression, and educational attainment) risk. In addition, children in the FCU were overrepresented in the persistent low versus persistent high CP group, but such direct effects were qualified by an interaction between the intervention and genetic susceptibility that was consistent with differential susceptibility. Implications are discussed for early identification and specifically, prevention efforts addressing early child and family risk.

Annual Research Review: Umbrella synthesis of meta-analyses on child maltreatment antecedents and interventions: differential susceptibility perspective on risk and resilience

Child maltreatment in the family context is a prevalent and pervasive phenomenon in many modern societies. The global perpetration of child abuse and neglect stands in stark contrast to its almost universal condemnation as exemplified in the United Nation's Convention on the Rights of the Child. Much work has been devoted to the task of prevention, yet a grand synthesis of the literature is missing. Focusing on two core elements of prevention, that is, antecedents for maltreatment and the effectiveness of (preventative) interventions, we performed an umbrella review of meta-analyses published between January 1, 2014, and December 17, 2018. Meta-analyses were systematically collected, assessed, and integrated following a uniform approach to allow their comparison across domains. From this analysis of thousands of studies including almost 1.5 million participants, the following risk factors were derived: parental experience of maltreatment in his or her own childhood (d = .47), low socioeconomic status of the family (d = .34), dependent and aggressive parental personality (d = .45), intimate partner violence (d = .41), and higher baseline autonomic nervous system activity (d = .24). The effect size for autonomic stress reactivity was not significant (d = -.10). The umbrella review of interventions to prevent or reduce child maltreatment showed modest intervention effectiveness (d = .23 for interventions targeting child abuse potential or families with self-reported maltreatment and d = .27 for officially reported child maltreatment cases). Despite numerous studies on child maltreatment, some large gaps in our knowledge of antecedents exist. Neurobiological antecedents should receive more research investment. Differential susceptibility theory may shed more light on questions aimed at breaking the intergenerational transmission of maltreatment and on the modest (preventive) intervention effects. In combination with family-based interaction-focused interventions, large-scale socioeconomic experiments such as cash transfer trials and experiments with vouchers to move to a lower-poverty area might be tested to prevent or reduce child maltreatment. Prevalence, antecedents, and preventive interventions of prenatal maltreatment deserve continuing scientific, clinical, and policy attention.

The Genetic Links to Anxiety and Depression (GLAD) Study: Online recruitment into the largest recontactable study of depression and anxiety

BACKGROUND

Anxiety and depression are common, debilitating and costly. These disorders are influenced by multiple risk factors, from genes to psychological vulnerabilities and environmental stressors, but research is hampered by a lack of sufficiently large comprehensive studies. We are recruiting 40,000 individuals with lifetime depression or anxiety and broad assessment of risks to facilitate future research.

METHODS

The Genetic Links to Anxiety and Depression (GLAD) Study (www.gladstudy.org.uk) recruits individuals with depression or anxiety into the NIHR Mental Health BioResource. Participants invited to join the study (via media campaigns) provide demographic, environmental and genetic data, and consent for medical record linkage and recontact.

RESULTS

Online recruitment was effective; 42,531 participants consented and 27,776 completed the questionnaire by end of July 2019. Participants' questionnaire data identified very high rates of recurrent depression, severe anxiety, and comorbidity. Participants reported high rates of treatment receipt. The age profile of the sample is biased toward young adults, with higher recruitment of females and the more educated, especially at younger ages.

DISCUSSION

This paper describes the study methodology and descriptive data for GLAD, which represents a large, recontactable resource that will enable future research into risks, outcomes, and treatment for anxiety and depression.

The effects of different rearing conditions on sexual maturation and maternal care in heterozygous mineralocorticoid receptor knockout mice

Sexual and social development is affected by a complex interplay between genetic makeup and the early-life rearing environment. While many rodent studies focused primarily on the detrimental effects of early-life stress, human literature suggests that genetic susceptibility may not be restricted to negative environments; it may also enhance the beneficial effects of positive rearing conditions. To examine this interaction in a controlled setting, heterozygous mineralocorticoid receptor knockout (MR^+/-) mice and control litter mates were exposed to a limited nesting/bedding (LN, impoverished), standard nesting (SN, control) or communal nesting (CN, enriched) paradigm from postnatal day 2-9 (P2-P9). Offspring was monitored for puberty onset between P24-P36 and, in females, maternal care-giving (i.e. as F1) during adulthood, after which basal corticosterone was measured. Different home-cage environments resulted in profound differences in received maternal care and offspring body weight. In male offspring, LN resulted in delayed puberty onset that was mediated by body weight and unpredictability of maternal care received during early development. In female offspring, rearing condition did not significantly alter sexual maturation and had little effect on their own maternal care-giving behavior. Genotype did affect maternal care: female MR^+/- offspring exhibited a less active nursing style and upregulated fragmentation during adulthood, irrespective of early life conditions. Basal corticosterone levels were highest in MR^+/- mice with a background of LN. Overall, we found a gene-by-environment interaction with respect to basal corticosterone levels, but not for sexual maturation or maternal behavior.

A genome-wide association meta-analysis of prognostic outcomes following cognitive behavioural therapy in individuals with anxiety and depressive disorders

Major depressive disorder and the anxiety disorders are highly prevalent, disabling and moderately heritable. Depression and anxiety are also highly comorbid and have a strong genetic correlation (rg ≈ 1). Cognitive behavioural therapy is a leading evidence-based treatment but has variable outcomes. Currently, there are no strong predictors of outcome. Therapygenetics research aims to identify genetic predictors of prognosis following therapy. We performed genome-wide association meta-analyses of symptoms following cognitive behavioural therapy in adults with anxiety disorders (n = 972), adults with major depressive disorder (n = 832) and children with anxiety disorders (n = 920; meta-analysis n = 2724). We estimated the variance in therapy outcomes that could be explained by common genetic variants (h2SNP) and polygenic scoring was used to examine genetic associations between therapy outcomes and psychopathology, personality and learning. No single nucleotide polymorphisms were strongly associated with treatment outcomes. No significant estimate of h2SNP could be obtained, suggesting the heritability of therapy outcome is smaller than our analysis was powered to detect. Polygenic scoring failed to detect genetic overlap between therapy outcome and psychopathology, personality or learning. This study is the largest therapygenetics study to date. Results are consistent with previous, similarly powered genome-wide association studies of complex traits.