Epistasis in neurotransmitter receptors linked to posttraumatic stress disorder and major depressive disorder comorbidity in traumatized Chinese.

Background: Posttraumatic stress disorder (PTSD) and major depressive disorder (MDD) comorbidity occurs through exposure to trauma with genetic susceptibility. Neuropeptide-Y (NPY) and dopamine are neurotransmitters associated with anxiety and stress-related psychiatry through receptors. We attempted to explore the genetic association between two neurotransmitter receptor systems and the PTSD-MDD comorbidity. Methods: Four groups were identified using latent profile analysis (LPA) to examine the patterns of PTSD and MDD comorbidity among survivors exposed to earthquake-related trauma: low symptoms, predominantly depression, predominantly PTSD, and PTSD-MDD comorbidity. NPY2R (rs4425326), NPY5R (rs11724320), DRD2 (rs1079597), and DRD3 (rs6280) were genotyped from 1,140 Chinese participants exposed to earthquake-related trauma. Main, gene-environment interaction (G × E), and gene-gene interaction (G × G) effects for low symptoms, predominantly depression, and predominantly PTSD were tested using a multinomial logistic model with PTSD-MDD comorbidity as a reference. Results: The results demonstrated that compared to PTSD-MDD comorbidity, epistasis (G × G) NPY2R-DRD2 (rs4425326 × rs1079597) affects low symptoms (ß = -0.66, OR = 0.52 [95% CI: 0.32-0.84], p = 0.008, pperm = 0.008) and predominantly PTSD (ß = -0.56, OR = 0.57 [95% CI: 0.34-0.97], p = 0.037, pperm = 0.039), while NPY2R-DRD3 (rs4425326 × rs6280) impacts low symptoms (ß = 0.82, OR = 2.27 [95% CI: 1.26-4.10], p = 0.006, pperm = 0.005) and predominantly depression (ß = 1.08, R = 2.95 [95% CI: 1.55-5.62], p = 0.001, pperm = 0.001). The two G × G effects are independent. Conclusion: NPY and dopamine receptor genes are related to the genetic etiology of PTSD-MDD comorbidity, whose specific mechanisms can be studied at multiple levels.

A latent class analysis of dissociative PTSD subtype among Chinese adolescents following the COVID-19 pandemic and lockdown.

BACKGROUND: The COVID-19 pandemic and related policies have amplified the vulnerability of adolescents to the development of posttraumatic stress disorder (PTSD) and dissociation symptoms. This study sought to explore the profile patterns and psychopathological characteristics of co-occurring PTSD and dissociation symptoms in Chinese adolescents. METHODS: A total of 57,984 junior and senior high school students in Deyang City, China were recruited between July 13 and July 19, 2020. PTSD and dissociation symptoms, risk factors, and functional impairment variables were assessed using the Global Psychotrauma Screen for Teenagers (GPS-T) instrument. Latent class analysis (LCA) was employed to examine the phenomenology and risk factors of co-occurring PTSD and dissociation symptoms. Analysis of Variance (ANOVA) was utilized to investigate differences in COVID-19 pandemic-related exposure and functional impairment across distinct symptom profiles. RESULTS: A 4-class model was selected as the optimal solution, comprising subgroups of low symptom, predominant PTSD symptom, predominant dissociation symptom, and PTSD-dissociation symptom. Class membership could be significantly predicted by other stressful experiences, social support, childhood maltreatment and psychiatric histories. The PTSD-dissociation symptom class exhibited the most severe COVID-19 pandemic-related exposure and functional impairment among all classes. LIMITATIONS: The cross-sectional design, Chinese cultural background, online survey method and oversimple measurements were the limitations. CONCLUSIONS: Our findings extend existing knowledge about the coexisting patterns of PTSD and dissociation symptoms in adolescents, which could assist in identifying high-risk youths. Furthermore, our findings offer recommendations for shaping public health policies and formulating effective clinical interventions for adolescents following the COVID-19 pandemic and lockdown.

Revealing the psychopathological pathway linking trauma to post-traumatic stress disorder: longitudinal network approach.

The present study investigated the psychopathological processes of post-traumatic stress disorder (PTSD) following the network approach to psychopathology. The directed acyclic graph model was employed to analyse a large longitudinal data-set of Chinese children and adolescents exposed to a destructive earthquake. It was found that intrusion symptoms were first activated by trauma exposure, and subsequently activated other PTSD symptoms. The data are consistent with the idea that symptoms may form a self-sustaining dynamic network by interacting with each other to promote or maintain the chronicity of PTSD. The findings advance the current understanding about the psychopathological processes of PTSD, and inform further research and clinical practices on post-traumatic psychopathology.

Anxiety and depression symptoms among healthcare workers in China after the coronavirus disease 2019 (COVID-19) epidemic eased: A cross-sectional study.

The current COVID-19 pandemic could lead to an increase in mental health problems among a range of populations, including healthcare workers involved in the pandemic. However, little is known about the lasting health effects of the pandemic after the epidemic eased. The current study was designed to investigate anxiety and depression symptoms and related predictive factors among healthcare workers in China immediately after the epidemic and lockdown eased. A total of 459 healthcare workers in the COVID-19 designated hospital (59.9% females; a mean age of 36.7 ± 9.6) completed an online survey from 14 to 23 April, 2020. The survey instruments were comprised of the Generalized Anxiety Disorder-7, the Patient Health Questionnaire-9, the Perceived Social Support Scale (PSSS), and a questionnaire assessing pandemic-related stressors and mental health needs during the pandemic. Bivariate and multivariate logistic regression analyses were conducted to identify potential predictors of mental health outcomes. The prevalence of probable anxiety and depression were 4.8% and 12.4%, respectively. Multivariable logistic regression analyses indicated that gender (OR (95% CI) = 0.26 (0.08-0.83), P < .05), mental health needs during the pandemic (OR (95% CI) = 3.06 (1.15-8.14), P < .05) and PSSS scores (OR (95% CI) = 0.93 (0.90-0.96), P < .05)were independently, and significantly associated with anxiety, while other diseases during the epidemic (OR (95% CI) = 3.47 (1.38-8.68), P < .05), mental health needs during the pandemic (OR (95% CI) = 2.89 (1.49-5.61), P < .05), and PSSS scores (OR (95% CI) = 0.94 (0.92-0.96), P < .05) were significant predictors of depression. Although the prevalence of anxiety and depression decreased among healthcare workers in China following the epidemic, further attention should be paid to the lasting effects of the epidemic on depression symptoms after the epidemic eased among this population.

A comparison of ICD-11 and DSM-5 criteria of PTSD among Chinese trauma-exposed adolescent samples.

This study aimed at comparing the prevalence and comorbidity differences of PTSD according to ICD-11 and DSM-5 definitions across two Chinese adolescent trauma-exposed samples. A total of 1,201 students exposed to earthquake and 559 students from vocational schools exposed to potentially traumatic events were included in this study. The PTSD Checklist for DSM-5 was used to measure PTSD symptoms. The MDD and GAD subscales of the Revised Children's Anxiety and Depression Scale were used to measure major depression disorder (MDD) and generalized anxiety disorder (GAD) symptoms. No significant PTSD prevalence differences between ICD-11 and DSM-5 were found across the two samples. The differences regarding comorbidities between ICD-11 and DSM-5 definitions were not significant among these two samples. The results revealed that the ICD-11 and DSM-5 provided similar prevalence of PTSD and comorbidity rates with MDD and GAD in Chinese trauma-exposed adolescent samples. This study contributes to the current understanding of the similarities and differences using different PTSD criteria and informs the organization and application of these two globally applied PTSD criteria.

The main effect and gene-environment interaction effect of the ADCYAP1R1 polymorphism rs2267735 on the course of posttraumatic stress disorder symptoms-A longitudinal analysis.

Background: Many studies have been performed to investigate the association between the ADCYAP1R1 polymorphism rs2267735 and posttraumatic stress disorder (PTSD), but the results have been inconsistent, and the way in which this gene affects the course of PTSD has not been widely investigated. Thus, a longitudinal study of the course (development trajectory) of PTSD is needed. Methods: In this study, we performed a longitudinal analysis of rs2267735 in 1017 young, trauma-exposed Chinese people (549 females and 468 males, ranging from 7 to 11 years old). At four time points after trauma exposure (2.5, 3.5, 4.5, and 5.5 years), we measured PTSD symptoms with the University of California, Los Angeles PTSD Reaction Index (PTSD-RI) for DSM-IV (Child Version). We employed a latent growth model (LGM) for the longitudinal data to test the association between rs2267735 (main and gene-environment interaction effects) and the course of PTSD symptoms. Results: The results of LGM showed that the gene-environment interaction (rs2267735 × trauma exposure) effects were associated with PTSD symptoms in girls at 2.5 years (ß = -0.291 and P = 0.013 for LGM intercept). The gene-environment interaction (rs2267735 × trauma exposure) effect was also correlated with PTSD symptoms in girls at 3.5 and 4.5 years (ß = -0.264 and P = 0.005; ß = -0.217 and P = 0.013). Conclusion: Our study revealed that the gene-environment interaction of the ADCYAP1R1 polymorphism rs2267735 is associated with PTSD symptoms in girls at 2.5 years and that the effects may be stable over time and not related to the PTSD symptom recovery rate. This is the first study to detect the how the ADCYAP1R1 gene affects the course of PTSD after trauma exposure in a longitudinal view.

DSM-5 Posttraumatic Stress Disorder Symptoms in Nonclinical Samples of Chinese and Pakistani Trauma-Exposed Adults: Factor Structure and Invariance Across Culture.

ABSTRACT: The purpose of the current study was to examine the latent structure and cross-cultural measurement validity of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) posttraumatic stress disorder (PTSD) symptoms assessed by the PTSD Checklist for DSM-5. Participants comprised trauma-exposed Chinese and Pakistani undergraduate students (N = 495 and N = 186, respectively). Confirmatory factor analysis (CFA) indicated that a seven-factor hybrid model involving intrusion, avoidance, negative affect, anhedonia, externalizing behaviors, anxious arousal, and dysphoric arousal factors provided good fit in both samples. This model fit significantly better than three alternative models including the DSM-5 four-factor model and six-factor anhedonia and externalizing behaviors models. The subsequent multigroup CFA showed that the best-fitting hybrid model demonstrated cross-cultural measurement invariance. Our findings provide further empirical support for the seven-factor PTSD hybrid model and its cross-cultural invariance, and have implications for understanding and application of DSM-5's PTSD symptoms.

Anxiety, depression, and PTSD symptoms among high school students in china in response to the COVID-19 pandemic and lockdown.

AIMS: This study aimed to investigate the prevalence of anxiety, depression and PTSD symptoms, and associated risk factors among a large-scale sample of adolescents from China after the pandemic and lockdown. METHOD: A total of 57,948 high school students took part in an online survey from July 13 to 29, 2020. The mental health outcomes included anxiety, depression and PTSD symptoms. Risk factors included negative family relationships, COVID-19 related exposure, and a lack of social support. RESULTS: The prevalence of anxiety, depression and PTSD symptoms was 7.1%, 12.8%, and 16.9%, respectively. COVID-19 related exposure significantly linked to the mental health outcomes (all p < .001). The most important predictors for the mental health outcomes were family relationship and social support (all p < .001). CONCLUSION: The pandemic may have long-term adverse mental health consequences among adolescents. Adverse family relationships and lack of social support could be the major risk factors for the post-pandemic mental health outcomes of adolescents.

Neural correlates of posttraumatic anhedonia symptoms: Decreased functional connectivity between ventral pallidum and default mode network regions.

Anhedonia is common in individuals with traumatic experience. Anhedonia symptoms play an important role in posttraumatic psychopathology, and are related to various adverse outcomes. The current study is a preliminary neuroimaging study of the neural correlates of posttraumatic anhedonia symptoms. Resting-state fMRI data were acquired from 88 Chinese earthquake survivors. Whole brain analyses and exploratory ROI-to-ROI analyses were performed to examine the relationship between posttraumatic anhedonia symptoms and resting-state functional connectivity (rsFC) of reward-related subcortical nucleus including nucleus accumbens and ventral pallidum. The rsFC between left ventral pallidum and areas of bilateral posterior cingulate cortex (PCC) and precuneus cortex were found lower in the high posttraumatic anhedonia group, after controlling for sex, age and other posttraumatic stress symptoms. The rsFC between left ventral pallidum and PCC and the rsFC between left ventral pallidum and lateral parietal cortex were significantly lower in the high anhedonia group. Our findings suggest that decreased functional connectivity between the ventral pallidum and the brain default mode network (DMN) regions could be the neural correlates of posttraumatic anhedonia symptoms.

The ADCYAP1R1 Gene Is Correlated With Posttraumatic Stress Disorder Symptoms Through Diverse Epistases in a Traumatized Chinese Population.

The adenylate cyclase activating polypeptide 1 (pituitary) receptor (ADCYAP1R1) gene is associated with the hypothalamic-pituitary-adrenal (HPA) axis, which controls stress responses. The single-nucleotide polymorphism of ADCYAP1R1, rs2267735, has been investigated in many studies to test its association with posttraumatic stress disorder (PTSD), but the results have not been consistent. It is worth systematically exploring the role of rs2267735 in PTSD development. In this study, we analyzed rs2267735 in 1,132 trauma-exposed Chinese individuals (772 females and 360 males). We utilized the PTSD checklist for DSM-5 (PCL-5) to measure the PTSD symptoms. Then, we analyzed the main, G × E (rs2267735 × trauma exposure), and G × G (with other HPA axis gene polymorphisms) effects of rs2267735 on PTSD severity (total symptoms). There were no significant main or G × E effects (P > 0.05). The G × G ADCYAP1R1-FKBP5 interaction (rs2267735 × rs1360780) was associated with PTSD severity (beta = -1.31 and P = 0.049) based on all subjects, and the G × G ADCYAP1R1-CRHR1 interaction (rs2267735 × rs242924) was correlated with PTSD severity in men (beta = -4.72 and P = 0.023). Our study indicated that the ADCYAP1R1 polymorphism rs2267735 may affect PTSD development through diverse gene-gene interactions.

Oxytocin receptor variant rs53576 genotype is associated with dysphoric arousal symptoms of DSM-5 posttraumatic stress disorder in Chinese earthquake survivors.

PURPOSE: Evidence suggests that the oxytocin receptor (OXTR) gene may be involved in the psychopathology of posttraumatic stress disorder (PTSD). This study aimed to investigate the effects of OXTR rs53576 genotype on PTSD symptoms introduced in the Diagnostic and Statistical Manual, Fifth Edition (DSM-5). METHODS: This study was a cross-sectional study conducted among 1140 adults who had personally experienced the Wenchuan earthquake. PTSD symptoms were measured with the PTSD checklist for DSM-5. A custom-by-design 2 × 48-Plex SNPscanTM Kit were used to determine the OXTR rs53576. Multiple regression models were used to analyze the independent and interactive effects of OXTR rs53576 genotype and earthquake exposure on the severity of total PTSD symptoms and different dimensions of PTSD symptoms. RESULTS: The results revealed that the rs53576 genotype could significantly predict PTSD symptoms (ß = 0.055, p = 0.045). Further analysis showed that the rs53576 genotype was only significantly associated with dysphoric arousal symptoms of PTSD (ß = 0.080, p = 0.005). The rs53576 genotype × earthquake exposure interaction had no significant effect on different symptom clusters (p > 0.05). CONCLUSION: This study showed that the rs53576 genotype was only associated with the dysphoric arousal symptoms but not with other symptom clusters of PTSD. These findings support the role of the OXTR on the psychopathology of PTSD and help us to understand the genetic basis of PTSD.

The factor structure of major depressive symptoms in a sample of Chinese earthquake survivors.

BACKGROUND: Experiencing natural disasters is associated with common mental disorders including major depressive disorder (MDD). However, the latent structure of MDD is widely debated, and few studies tested the MDD factor structure in Chinese natural disaster survivors. Therefore, the aim of the current study was to evaluate the factorial validity of the Patient Health Questionnaire-9 (PHQ-9) for DSM-5 major depressive disorder (MDD) symptoms in Chinese earthquake survivors. METHOD: Participants were 1058 Chinese earthquake survivors. Self-reported measures included the PHQ-9 and the Short-Form Health Survey (SF-36). Confirmatory factor analysis (CFA) and structural equation modelling (SEM) was used to examine the latent structure of MDD and the associations between latent factors of MDD and different domains of health-related quality of life (HRQoL), respectively. RESULTS: In the current sample, the model consisted of somatic and cognitive/affective (non-somatic) factors demonstrated significantly better fit than the other competing MDD models (χ2 = 173.89, df = 26, CFI = 0.986, TLI = 0.981, RMSEA = 0.073, BIC = 18,091.13). Further SEM analyses indicated that the non-somatic factor was significantly related to both physical (ß = - 0.362, p < .01) and psychosocial HRQoL (ß = - 0.773, p < .01), while the somatic factor was a uniquely predictor of physical HRQoL (ß = - 0.336, p < .01). Furthermore, we found the somatic factor partially mediated the relationship between the cognitive/affective factor and physical HRQoL (all ps < .05). CONCLUSIONS: The MDD symptoms was best captured by a two-factor model comprised of somatic and cognitive/affective factors in Chinese natural disaster survivors. The two MDD factors were differentially associated with physical and psychosocial HRQoL, and the cognitive/affective factor associated physical HRQoL partially through the somatic factor. The current findings increase our understanding of latent structure of MDD symptoms, and carry implications for assessment and intervention of post-disaster mental health problems.

Post-traumatic stress symptoms of children and adolescents exposed to the 2008 Wenchuan Earthquake: A longitudinal study of 5-HTTLPR genotype main effects and gene-environment interactions.

Experiencing disasters causes severe mental disorders, among which post-traumatic stress disorder (PTSD) is the most common. We conducted a longitudinal study to examine the effect of 5-hydroxyl tryptamine transporter gene-linked polymorphic region (5-HTTLPR) genotype on child and adolescent PTSD symptom course after the 2008 Wenchuan Earthquake. We genotyped 963 participants who personally experienced the earthquake. PTSD symptoms were measured by University of California, Los Angeles PTSD reaction index at 2.5, 3.5, 4.5 and 5.5 years after the earthquake, respectively. Latent growth model was utilised to examine the main effect and gene-environment interaction effect of 5-HTTLPR on PTSD's symptom course. 5-HTTLPR genotype predicted initial PTSD symptom severity (ß = 0.108, p = .019) and rates of symptom recovery (ß = -0.120, p = .031) between 2.5 and 5.5 years. Compared with L' allele carriers, those with S'S' genotype showed higher initial symptom severity but also faster recovery rate. 5-HTTLPR genotype only predicted symptom severity at 2.5 years after the earthquake, after controlling for sex, age, ethnicity and trauma severity (ß = 0.108, p = .019). This is the first evidence of the effect of 5-HTTLPR genotype on child and adolescent PTSD symptoms longitudinally, offering a novel perspective on the effect of 5-HTTLPR on PTSD symptom development following trauma exposure.

Test of the dynamic interplay between DSM-5 PTSD symptom clusters in children and adolescents.

BACKGROUND: Revealing the dynamic interplay between posttraumatic stress disorder (PTSD) symptom clusters has always been an important topic in traumatic stress studies. Based on longitudinal studies, different hypotheses have been proposed to explain PTSD symptom dynamics. But currently, no study have been conducted to test these hypotheses in children and adolescents. METHODS: Data were derived from a longitudinal study of child and adolescent traumatic event survivors of an explosion accident (N = 659). DSM-5 PTSD symptoms was measured by the PTSD Checklist-5 (PCL-5) at 4, 8, and 13 months after the disaster. Latent difference score (LDS) modeling was used to evaluate the dynamic interplay between clusters. RESULTS: The results of LDS model indicated that intrusion level positively predicted subsequent rate of increase for hyperarousal (p = .008) and negative changes in cognitions and mood symptoms (p = .036). Also, intrusion level trended to positively predict subsequent increase rate of avoidance symptoms (p = .059). CONCLUSIONS: This study expands previous knowledge of dynamic relations between symptom clusters during the maintenance and fluctuation of child and adolescent PTSD symptoms. By using new methodology, this study provided novel evidence for the hypothesis that intrusion symptom plays an important role in maintaining other PTSD symptoms.

An exploration of the DSM-5 posttraumatic stress disorder symptom latent variable network.

BACKGROUND: Both the latent variable model and the network model have been widely used to conceptualize mental disorders. However, it has been pointed out that there is no clear dichotomy between the two models, and a combination of these two model could enable a better understanding of psychopathology. The recently proposed latent network model (LNM) has provided a statistical framework to enable this combination. Evidence has shown that posttraumatic stress disorder (PTSD) could be a suitable candidate disorder to study the combined model. In the current study, we initiated the first investigation of the latent network of PTSD symptoms. METHODS: The latent network of DSM-5 PTSD symptoms was estimated in 1196 adult survivors of China's 2008 Wenchuan earthquake. Validation testing of the latent network was conducted in a replication sample of children and adolescent who experienced various trauma types. PTSD symptoms were measured by the PTSD Checklist for DSM-5 (PCL-5). The latent network was estimated using the seven-factor hybrid model of DSM-5 PTSD symptoms, analysed using the R package lvnet. RESULTS: The latent network model demonstrated good fit in both samples. A strong weighted edge between the intrusion and avoidance dimensions was identified (regularized partial correlation = 0.75). The externalizing behaviour dimension demonstrated the highest centrality in the latent network. CONCLUSIONS: This study is the first to investigate the latent network of DSM-5 PTSD symptoms. Results suggest that both latent symptom dimension and associations between the dimensions should be considered in future PTSD studies and clinical practices.

Antecedentes: tanto el modelo de variable latente como el modelo de red se han utilizado ampliamente para conceptualizar los trastornos mentales. Sin embargo, se ha señalado que no existe una dicotomía clara entre los dos modelos, y una combinación de estos dos modelos podría permitir una mejor comprensión de la psicopatología. El modelo de red latente (LNM) recientemente propuesto ha proporcionado un marco estadístico para permitir esta combinación. La evidencia ha demostrado que el trastorno de estrés postraumático (TEPT) podría ser un trastorno candidato adecuado para estudiar el modelo combinado. En el presente estudio, iniciamos la primera investigación de la red latente de síntomas de TEPT.Métodos: La red latente de síntomas del TEPT DSM-5 se estimó en 1196 adultos sobrevivientes del terremoto de Wenchuan en China en 2008. Las pruebas de validación de la red latente se realizaron en una muestra de replicación de niños y adolescentes que experimentaron varios tipos de trauma. Los síntomas de TEPT se midieron mediante la Lista de verificación de TEPT para DSM-5 (PCL-5). La red latente se estimó utilizando el modelo híbrido de siete factores de síntomas del TEPT DSM-5, analizados utilizando el paquete R lvnet.Resultados: El modelo de red latente demostró un buen ajuste en ambas muestras. Se identificó un margen ponderado fuerte entre las dimensiones de intrusión y evitación (correlación parcial regularizada = 0,75). La dimensión del comportamiento de externalización demostró la centralidad más alta en la red latente.Conclusiones: este estudio es el primero en investigar la red latente de síntomas de TEPT DSM-5. Los resultados sugieren que tanto la dimensión de los síntomas latentes como las asociaciones entre las dimensiones deben considerarse en futuros estudios de TEPT y prácticas clínicas.

A comparison of ICD- 11 and DSM-5 criteria for PTSD among a representative sample of Chinese earthquake survivors.

BACKGROUND: Striking differences regarding the diagnosis of PTSD exist between the ICD-11 and DSM-5. This study compared the prevalence and comorbidity of PTSD between the ICD-11 and DSM-5. METHODS: An epidemiological sample of 1160 Chinese adult earthquake survivors collected nine and a half years following the Wenchuan earthquake, in Sichuan province. The PTSD Checklist for DSM-5 (PCL-5), the Patient Health Questionnaire (PHQ-9), and the Generalized Anxiety Disorder-7 (GAD-7) were used to measure PTSD, depression, and anxiety symptoms. RESULTS: The ICD-11 PTSD criteria yielded higher prevalence estimates than the DSM-5 criteria. There were no significant differences in PTSD's comorbidity with major depressive disorder (MDD) or generalized anxiety disorder (GAD) between the ICD-11 and DSM-5 criteria. CONCLUSIONS: Results found that the ICD-11 and DSM-5 performed differently in assessing PTSD prevalence, but showed similar co-occurrence with MDD and GAD. This study adds to knowledge about the similarities and differences of using different PTSD criteria and carries implications for clinical and research utilization of the two widely used PTSD diagnostic criteria.

Antecedentes: Existen notables diferencias en relación al diagnóstico de TEPT entre la CIE-11 y el DSM-5. Este estudio comparó la prevalencia y la comorbilidad de TEPT según la CIE-11 y el DSM-5.Métodos: Una muestra epidemiológica de 1160 chinos adultos supervivientes a un terremoto fue seguida por nueve años y medio posterior al terremoto de Wenchuan, en la provincia Sichuan. Se utilizaron la lista de chequeo de TEPT para el DSM-5 (PCL-5 por sus siglas en inglés), el Cuestionario de Salud del Paciente (PHQ-9 por sus siglas en inglés) y la Ansiedad Generalizada-7 (GAD-7 por sus siglas en inglés) fueron usados para medir TEPT, depresión y síntomas ansiosos.Resultados: Los criterios de la CIE-11 produjeron mayor prevalencia de TEPT que los criterios del DSM-5. No hubo diferencia significativa en la comorbilidad del TEPT con episodio depresivo mayor (MDD por sus siglas en inglés) o Trastorno de Ansiedad Generalizada (GAD por sus siglas en inglés) entre los criterios de la CIE-10 y el DSM-5.Conclusiones: Los resultados concluyen que la CIE-11 y el DSM-5 se desempeñaron en forma diferente al evaluar la prevalencia de TEPT, pero mostraron similar co-ocurrencia de MDD y GAD. Este estudio aporta al conocimiento acerca de las similitudes y diferencias al usar diferentes criterios de TEPT, y conlleva implicaciones para el uso clínico y de investigación de dos criterios de TEPT ampliamente utilizados.

An Item-Based Analysis of PTSD Emotional Numbing Symptoms in Disaster-Exposed Children and Adolescents.

This study was designed to investigate the roles of numbing of positive and negative emotions in PTSD symptomology and related functional impairments. 14,465 Chinese children and adolescents who personally experienced the 2008 Wenchuan earthquake (in Sichuan province, China) took part in the study. Emotional numbing and other PTSD symptoms were assessed by the University of California-Los Angeles PTSD Reaction Index for Children. Functional impairment was measured by the Pediatric Quality of Life Inventory 4.0 Generic Core Scales. Item response theory (IRT) analysis showed that both numbing of positive and negative emotions demonstrated acceptable item response characteristics; numbing of positive emotions had better discrimination. Group comparisons revealed that participants who reported numbing of both positive and negative emotions had the highest risk of developing PTSD, most severe PTSD symptoms and functional impairments, with large effect sizes when compared with participants with no emotional numbing symptoms. Reporting only numbing of positive emotions had moderate effects, and reporting only numbing of negative emotions had smaller effects. The results revealed associations between emotional numbing patterns, posttraumatic stress symptoms and impairments in quality of life, and suggests that additional research is needed to explore generalized emotional numbing in children and adolescents in future PTSD research.

Association between the OXTR rs53576 genotype and latent profiles of post-traumatic stress disorder and depression symptoms in a representative sample of earthquake survivors.

Background and Objectives: Post-traumatic stress disorder (PTSD) and major depressive disorder are commonly experienced mental disorders among psychological trauma victims. Few studies have investigated the genetic basis for population heterogeneity of trauma-related psychopathology, including PTSD and depression. This study examined the main and interaction effects of the OXTR rs53576 genotype in distinguishing four subgroups identified by symptom profiles of PTSD and depression symptoms using latent profile analysis.Design: A cross-sectional design with a gene-environment interaction approach was adopted in the current study.Methods: This study was a secondary data analysis conducted on a sample of 1196 adult earthquake survivors. Participants completed assessments of earthquake exposure, PTSD symptoms, and depression symptoms. The rs53576 polymorphism of OXTR was genotyped using a custom-by-design 2×48-Plex SNPscanTMKit.Results: Multinomial logistic regression analyses revealed the main effects of the rs53576 genotype on symptom profiles. Specifically, G allele carriers were more likely in the combined PTSD-depression group than in the low symptom, predominantly depression, and predominantly PTSD groups. No significant interaction effects between this genotype and earthquake exposure on symptom profiles were found.Conclusions: Our findings support a genetic basis for trauma-related psychopathology heterogeneity. Furthermore, results provide preliminary evidence for the role of OXTR in PTSD/depression comorbidity.

Depicting the associations between different forms of psychopathology in trauma-exposed adolescents.

Psychiatric comorbidity in traumatized youth is prevalent, but such associations between two disorders may be confounded with other comorbid conditions. Few studies have examined the unique relationships among multiple disorders. Which disorders maximally explain the relationships between others and whether such disorders differ by sex remain largely unknown. Using a construct-level network approach, this study characterized the independent associations among nine prevalent emotional and behavioral disorders/problems evaluated by the PTSD Checklist for DSM-5, the Revised Children's Anxiety and Depression Scale, and the Youth Self-Report in a sample of 1181 disaster-exposed adolescents (53.9% girls; a mean age of 14.3 ± 0.8 years). The associations were strong among the seven internalizing problems and between the two externalizing ones, but weaker between these two spectra of psychopathology. Major depressive disorder (MDD) was most strongly connected with others, maximally accounting for the associations, especially those between the two spectra. Overall and individual association strength and the connecting role of MDD were generally equivalent across sex. These findings highlight the necessity of MDD in linking comorbid forms of psychopathology in traumatized youth, and suggest MDD as a potential intervention priority in this population.

Correlation between hypothalamic-pituitary-adrenal axis gene polymorphisms and posttraumatic stress disorder symptoms.

BACKGROUND: The hypothalamic-pituitary-adrenal (HPA) axis is the main neuroendocrine system that controls stress responses, including fear learning. To further understand the correlation between the HPA axis and stress- and fear-related symptoms in humans, the current study investigated the relationship between HPA axis gene polymorphisms and a stress- and fear-related disorder, posttraumatic stress disorder (PTSD). This is the first study that systematically investigates the correlations between HPA axis genes and distinct PTSD symptom clusters. METHODS: Participants included 1132 Chinese earthquake survivors (772 women and 360 men). PTSD symptoms were measured by the PTSD Checklist for DSM-5 (PCL-5), and the severity (total symptoms) and symptom clusters were calculated according to the hybrid seven-factor model of DSM-5 PTSD. We genotyped eight single nucleotide polymorphisms (SNPs) of three HPA axis genes, including FKBP5, CRHR1 and CRHR2. RESULTS: The main effects of the CRHR2 SNP rs2267715 were associated with PTSD severity (P = 0.0035) and all PTSD symptom clusters except dysphoric arousal (P ranging from 0.0011 to 0.048). In women, a gene-environment interaction (G × E) effect of FKBP5 (rs3800373 × trauma exposure) was correlated with PTSD severity (P = 0.038), externalizing behaviors, anxious arousal and dysphoric arousal symptoms (P ranging from 0.014 to 0.028); the G × E effect of CRHR1 (rs4458044 × trauma exposure) was associated with anxious arousal symptoms (P = 0.016). In men, a gene-gene interaction (G × G) effect of FKBP5-CRHR1 (rs9470080 × rs4458044) was associated with PTSD severity (P = 0.0091), intrusion, negative affect, externalizing behaviors and anxious arousal (P ranging 0.012-0.049). CONCLUSION: Our results systematically revealed that the main effects and G × E and G × G effects of some genetic polymorphisms of HPA axis genes are involved in the severity and distinct symptom clusters of PTSD.