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Purpose: Posttraumatic stress disorder (PTSD) often co-occurs with panic disorder (PD), with some etiological models positing a causal role of panic reactivity in PTSD onset; however, data addressing the temporal ordering of these conditions are lacking. The aim of this study was to examine the bi-directional associations between PD and PTSD in a nationally representative, epidemiologic sample of trauma-exposed adults., Methods: Participants were community-dwelling adults (62.6% women; M age  = 48.9, SD 16.3) with lifetime DSM-IV PTSD criterion A trauma exposure drawn from the 2001/2 National Epidemiologic Survey on Alcohol and Related Conditions (NESARC) and re-interviewed in 2004/5 (N = 12,467). Cox discrete-time proportional hazards models with time-varying covariates were used to investigate the bi-directional associations between lifetime PD and PTSD, accounting for demographic characteristics, trauma load, and lifetime history of major depression, generalized anxiety disorder, and social anxiety disorder., Results: PD was significantly associated with subsequent onset of PTSD (HR 1.210, 95%CI = 1.207-1.214, p < .001), and PTSD was significantly associated with onset of PD (HR 1.601, 95% CI 1.597-1.604, p < .001). The association between PTSD and subsequent PD was stronger in magnitude than that between PD and subsequent PTSD (Z = - 275.21, p < .01). Men evidenced stronger associations between PD and PTSD compared to women., Conclusions: Results were consistent with a bidirectional pathway of risk, whereby PD significantly increased risk for the development of PTSD, and PTSD significantly increased risk for PD. Given the association between PTSD and subsequent PD, particularly among men, clinicians may consider supplementing PTSD treatment with panic-specific interventions, such as interoceptive exposure, to prevent or treat this disabling comorbidity.

Alcohol consumption and interpersonal trauma (IPT) co-occur at high rates, particularly in college populations. Two non-mutually-exclusive theories of this comorbidity are the risky behavior model, suggesting that substance use increases likelihood of IPT, and the self-medication model, suggesting that individuals use substances to cope with trauma-related symptoms. Few have simultaneously tested these theories in a sample of college students. Thus, the overarching aim of this longitudinal study ( n = 1320) was to identify whether alcohol consumption and IPT are associated with one another, and if IPT and/or posttraumatic stress disorder (PTSD) impacts use of alcohol to cope with trauma-related distress. Data were collected from a longitudinal study of college students attending a large public university. Participants in the current study were on average 18.46 years old at study entry, primarily female (70%), and of diverse racial/ethnic backgrounds (e.g., 49.4% White, 19.7% Black, 17.2% Asian). Results from auto-regressive, cross-lagged models indicated that alcohol consumption preceded IPT exposure. In contrast, IPT was not prospectively associated with alcohol consumption. Those reporting probable PTSD, but not IPT, reported more use of alcohol to cope with trauma-related distress. These findings provide support for the risky behavior model, indicating that those with higher levels of alcohol consumption may be a vulnerable group in terms of likelihood of IPT. Findings also suggest that those reporting probable PTSD may be at risk for use of alcohol to cope with trauma-related distress. Implications of these findings, in light of study limitations, are discussed. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

Objective: To explore the relations between trauma exposure and anxiety and depression among college students, and to determine whether trait mindfulness may moderate these relations., Participants: Self-report survey data from 2,336 college sophomores were drawn from a larger university-wide study ("Spit for Science")., Methods: We constructed multiple linear regression models using past-year trauma exposure, trait mindfulness, and their multiplicative interaction to predict current anxiety and depressive symptom severity, while controlling for covariates., Results: Mindfulness was associated with lower levels of depression and anxiety symptom severity. Trauma was a significant predictor of anxiety, but not depression, and high levels of mindfulness attenuated the association between trauma exposure and higher anxiety symptom severity., Conclusions: These results have implications for the treatment and prevention of anxiety among trauma-exposed college students and provide a basis for further research into the mechanisms through which mindfulness may facilitate positive mental health.

Women with a history of sexual assault are at elevated risk for engaging in binge drinking. The aims of the current study are to investigate two types of drinking motives (coping and social) that potentially underlie the sexual assault-binge drinking link in a sample of female college drinkers (N = 691; 37.6% sexual assault prevalence), and to determine the extent to which the relationships between sexual assault history and each type of drinking motive depend on women's assumptions about the controllability of events. Conditional process analysis results indicated that women who experienced sexual assault (vs. those who did not) were more likely to report both coping and social drinking motives, which in turn, were both positively associated with increased binge drinking. Consistent with our hypothesis, results showed the relationship between sexual assault history and coping drinking motives was moderated by perceived controllability of events. Specifically, sexual assault victims reported high coping motives regardless of controllability of events. Nonvictims only reported high coping motives when their perceived controllability of events was low - comparable to coping motives of victims. This integrative approach affords a more comprehensive understanding of the context in which college women's binge drinking occurs, and offers insight into processes that could be targeted in interventions., (Copyright © 2018 Elsevier Ltd. All rights reserved.)

Objective: This study examined the prevalence and correlates of probable posttraumatic stress disorder (PTSD) in freshman entering college and prospective associations of probable PTSD with additional outcomes., Participants: 2,310 students with data collected from Fall 2014 through Spring 2015., Methods: Incoming freshman completed a survey assessing for relevant variables at the beginning of fall semester and during the spring semester., Results: Seventy percent of the sample endorsed experiencing at least one potentially traumatic event (PTE). 34.4% of PTE exposed individuals met criteria for probable PTSD. Female sex, higher depressive and anxiety symptoms, and interpersonal PTE count were positively associated with PTSD symptoms. Higher PTSD symptoms were associated with higher anxiety and depressive symptoms, and new-onset interpersonal PTE., Conclusions: Identification of factors contributing to risk for PTSD is essential to inform prevention and intervention efforts. Intervention efforts should be targeted to students experiencing PTSD symptoms as they enter college.

Background: Twin studies have demonstrated that both genetic and environmental factors influence risk for posttraumatic stress disorder (PTSD), and there is some evidence supporting the interplay of genes and environment (GxE). Many GxE studies within the PTSD literature have focused on genes implicated in the stress response system, such as FK506 binding protein 51 (FKBP5). Given inconsistencies across GxE literature as a whole, a meta-analysis to synthesize results is warranted., Methods: Studies were identified through PubMed and PsycINFO. A meta-analysis was conducted using a random effects model in the MAc package in R. Heterogeneity of the effect size distribution was examined with Cochran's Q statistic. A Simes procedure was used to test the gene-level GxE effect for FKBP5 interacting with trauma., Results: A significant gene-level GxE gene effect was demonstrated for FKBP5 when pooled across all four examined variants (rs1360780, rs3800373, rs9296158, rs9470080) when interacting with trauma exposure on PTSD. Significant large GxE effect sizes were also found for each independent variant. There was no evidence for heterogeneity of variance., Limitations: Limitations include reduced power for detecting variability across moderators, potential bias due to failure of meta-analyzed studies to account for two-way covariate x gene and covariate x environment influences, and a high false discovery rate that is characteristic of GxE analyses., Conclusions: This is the first study to quantify an overall gene-level effect of FKBP5 in a GxE analysis of PTSD, evidence which may be used to address current issues in the FKBP5 GxE literature (e.g., disparate variants, low sample sizes and power), as well as inform follow-up functional research., (Copyright © 2018. Published by Elsevier B.V.)

Alcohol use disorder (AUD) evidences high rates of comorbidity with a range of psychiatric disorders, particularly within high-risk populations, such as individuals exposed to physical or sexual violence. Increasing efforts are focused on understanding the role of early alcohol use (e.g., during adolescence) on emotional and psychiatric functioning over time, as well as sex differences in these associations. The aim of the current study was to evaluate patterns of association between age of initiation of regular alcohol use and posttraumatic stress disorder (PTSD), anxiety, and depressive symptoms as a function of sex. Participants were 269 college students with a history of interpersonal trauma and alcohol use who completed a battery of questionnaires regarding alcohol use and emotional health. Neither bivariate correlations nor results from structural equation models covarying for key factors showed a relationship between age of alcohol use initiation and current psychiatric symptoms among men (n = 63). Results of a structural equation model supported an association between earlier age of alcohol use initiation and greater levels of current PTSD (β = -0.14), anxiety (β = -0.15), and depression symptoms (β = -0.16) in the female sub-sample (n = 202), after controlling for covariates, as well as intercorrelations among criterion variables. Statistical support for sex as a moderator of these associations was not detected. The current study provides preliminary evidence for potential sex differences in the role of early alcohol use in the development of psychiatric symptoms and highlights the need for systematic longitudinal research., (Copyright © 2018. Published by Elsevier Ltd.)

There is a relative lack of research on distress tolerance (DT) in veteran samples. The aims of the study were to (a) evaluate convergent and discriminant validity of a behavioral measure of DT compared to theoretically similar (i.e., self-report DT, negative urgency) and dissimilar (i.e., risk-taking) constructs and (b) evaluate the concurrent validity of DT in relation to posttraumatic stress disorder (PTSD) and depressive symptoms in a veteran sample. A sample of U.S. veterans who served after the September 11, 2001 terror attacks (N = 306, 89.9% male; M age 30.2 years, SD = 4.5, range: 21-40 years) completed self-report and behavioral measures of DT, risk-taking, impulsivity, and depressive symptoms, and completed a clinical interview for PTSD. Results of a multitrait-multimethod matrix found significant yet minimal shared variance, r 2 = .01-.03, ps = .002-.055, between the self-report and behavioral measures of DT. We used a series of multiple regressions to examine the relative contribution of the behavioral and self-report DT measures in the prediction of PTSD and depressive symptoms. Self-reported, but not behavioral, DT accounted for unique variance in PTSD, r 2 = .12, p < .001, and depressive symptoms, r 2 = .23, p < .001. Participants with PTSD or higher scores on measures of depression were more likely to report greater increases in frustration and irritability after completing the behavioral task. Results indicate that DT is not a unidimensional construct and must be considered in the context of specific emotions (e.g., tolerance of irritability vs. fear) and contexts (e.g., behavioral, affective)., (© 2018 International Society for Traumatic Stress Studies.)

In the present study, we sought to replicate recent findings of Polimanti et al. (2017), who conducted a genome-wide gene-by-environment interaction study (GEWIS) and identified a gene-by-trauma interaction that predicts alcohol misuse among African Americans.  Consistent with the findings published by Polimanti and colleagues, results of the current study demonstrated an interaction effect, b = 0.41, of trauma exposure and rs1729578 in the intron of PRKG1 on alcohol misuse in a subsample of ancestral African Americans. The minor allele (rs1729578*C) was positively associated with increased alcohol use disorder symptoms in trauma-exposed subjects and negatively associated in non-trauma-exposed subjects.  This effect, however, was only significant for one out of three alcohol outcome measures we investigated, suggesting the interaction may be most salient when predicting higher severity of alcohol misuse. Additionally, the effect did not remain significant after we accounted for testing the effect on three different outcome variables. Also in line with the original study, the gene-by-environment effect was not demonstrated among the ancestral European subsample.  The findings suggest this gene variant may increase an individual's susceptibility to environmental influences, both adverse and supportive., (© 2018 International Society for Traumatic Stress Studies.)

This study investigated the use of resting-state electroencephalography (EEG) data to help differentiate posttraumatic stress disorder (PTSD) symptom factors. The sample, 147 combat-exposed OIF/OEF (Operation Iraqi Freedom/Operation Enduring Freedom) Veterans and service members, was a polytrauma population with variable PTSD and mild traumatic brain injury (mTBI) diagnoses. Participants completed the PTSD Checklist (PCL) and resting-state EEG was assessed for 10 minutes, with eyes closed. Regional averages of absolute power in alpha, beta, delta, and theta frequency bands were computed to estimate a single EEG common factor per band. An oblique 4 common-factor model was then fit to the 17 PCL items that included a residual EEG factor as an exogenous predictor with the group mean effect of mTBI on the EEG factor removed. Separate comparative model testing sequences for the alpha, beta, delta, and theta EEG factor frequency bands were conducted. An inverse relationship of delta and theta frequency bands on avoidance and numbing symptom factors (but not re-experiencing and hyperarousal) was found. Results provide evidence for possible neurobiological basis for the 4 PTSD symptom factors.

Objective: This study examined the moderating and mediating effects of perceived social support on the association between precollege sexual assault (SA) and college-onset SA., Participants: A representative sample of 6,132 undergraduates., Methods: The PLUM procedure in SPSS was used to test the moderation model, with individual regressions conducted in a hierarchical fashion. A weighted least squared mean and variance adjusted (WLSMV) mediation model was used to examine the mediating effect of social support., Results: Precollege SA significantly predicted college-onset SA. Social support significantly mediated the relation between precollege SA and college-onset SA. Social support was not a significant moderator of this relationship., Conclusions: Given the high prevalence of SA among college populations, as well as the high rates of SA revictimization, identification of factors that may be related to repeated SA (eg, low social support) within this population are essential and may inform intervention, policy, and university student services.

Background : The term resilience is applied in numerous ways in the mental health field, leading to different perspectives of what constitutes a resilient response and disparate findings regarding its prevalence following trauma. Objective : illustrate the impact of various definitions on our understanding and prevalence of resilience, we compared various resilience definitions (absence of PTSD, absence of current mental health diagnosis, absence of generalized psychological distress, and an alternative trauma load-resilience discrepancy model of the difference between actual and predicted distress given lifetime trauma exposure) within a combat-exposed military personnel and veteran sample. Method : In this combat-trauma exposed sample ( N  = 849), of which approximately half were treatment seeking, rates of resilience were determined across all models, the kappa statistic was used to determine the concordance and strength of association across models, and t -tests examined the models in relation to a self-reported resilience measure. Results : Prevalence rates were 43.7%, 30.7%, 87.4%, and 50.1% in each of the four models. Concordance analyses identified 25.7% ( n  = 218) considered resilient by all four models (kappa = .40, p  < .001). Correlations between models and self-reported resilience were strong, but did not fully overlap. Conclusions :The discussion highlights theoretical considerations regarding the impact of various definitions and methodologies on resilience classifications, links current findings to a systems-based perspective, and ends with suggestions for future research approaches on resilience.

Purpose: The goal of the Pregnancy, Race, Environment, Genes study was to understand how social and environmental determinants of health (SEDH), pregnancy-specific environments (PSE) and biological processes influence the timing of birth and account for the racial disparity in preterm birth. The study followed a racially diverse longitudinal cohort throughout pregnancy and included repeated measures of PSE and DNA methylation (DNAm) over the course of gestation and up to 1 year into the postpartum period., Participants: All women were between 18 and 40 years of age with singleton pregnancies and no diagnosis of diabetes or indication of assisted reproductive technology. Both mother and father had to self-identify as either African-American (AA) or European-American (EA). Maternal peripheral blood samples along with self-report questionnaires measuring SEDH and PSE factors were collected at four pregnancy visits, and umbilical cord blood was obtained at birth. A subset of participants returned for two additional postpartum visits, during which additional questionnaires and maternal blood samples were collected. The pregnancy and postpartum extension included n=240 (AA=126; EA=114) and n=104 (AA=50; EA=54), respectively., Findings to Date: One hundred seventy-seven women (AA=89, EA=88) met full inclusion criteria out of a total of 240 who were initially enrolled. Of the 63 participants who met exclusion criteria after enrolment, 44 (69.8%) were associated with a medical reason. Mean gestational age at birth was significantly shorter for the AA participants by 5.1 days (M=272.5 (SD=10.5) days vs M=277.6 (SD=8.3))., Future Plans: Future studies will focus on identifying key environmental factors that influence DNAm change across pregnancy and account for racial differences in preterm birth., Competing Interests: Competing interests: None declared., (© Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.)

Objective: Distress tolerance (DT; the perceived or actual ability to withstand negative internal states) has emerged as a promising transdiagnostic risk factor in clinically severe populations. However, little is known about etiological factors associated with the development of DT. We hypothesized that greater levels of childhood trauma would be associated with lower perceived and behavioral DT, beyond theoretically relevant covariates., Method: The current investigation evaluated several childhood trauma types (i.e., physical abuse, sexual abuse, emotional abuse, physical neglect, and emotional neglect) in relation to perceived (i.e., self-report) and behavioral DT in a sample of 87 trauma-exposed adults in acute-care psychiatric inpatient treatment., Results: Results of hierarchical linear regression models indicated that greater childhood physical abuse and emotional neglect were significantly associated with higher perceived DT. Greater levels of emotional abuse were associated with lower perceived DT, and greater physical neglect was associated with lower behavioral DT., Conclusions: DT may be differentially influenced by different forms of childhood trauma. (PsycINFO Database Record, ((c) 2018 APA, all rights reserved).)

Maternal prenatal stress has been linked to a variety of infant postnatal outcomes, partially through alterations in fetal HPA axis functioning; yet the underlying pathobiology remains elusive. Current literature posits DNA methylation as a candidate mechanism through which maternal prenatal stress can influence fetal HPA axis functioning. The goal of this systematic review was to summarize the literature examining the associations among maternal prenatal stress, DNA methylation of commonly studied HPA axis candidate genes, and infant HPA axis functioning. Results from the review provided evidence for a link between various maternal prenatal stressors, NR3C1 methylation, and infant stress reactivity, but findings among other genes were limited, with mixed results. An original study quality review tool revealed that a majority of studies in the review are adequate, and emphasizes the need for future research to consider study quality when interpreting research findings., (© 2018 Wiley Periodicals, Inc.)

This study examined the effect of parenting on the association between childhood sexual abuse (CSA) and psychiatric resilience in adulthood in a large female twin sample (n = 1423) assessed for severe CSA (i.e., attempted or completed intercourse before age 16). Severe CSA was associated with lower resilience to recent stressors in adulthood (defined as the difference between their internalizing symptoms and their predicted level of symptoms based on cumulative exposure to stressful life events). Subscales of the Parental Bonding Instrument were significantly associated with resilience. Specifically, parental warmth was associated with increased resilience while parental protectiveness was associated with decreased resilience. The interaction between severe CSA and parental authoritarianism was significant, such that individuals with CSA history and higher authoritarianism scores had lower resilience. Results suggest that CSA assessment remains important for therapeutic work in adulthood and that addressing parenting may be useful for interventions in children with a CSA history.

Background: To examine shared genetic and environmental risk factors across PTSD symptoms and resilience., Methods: Classical twin study of 2010-2012 survey data conducted among 3,318 male twin pairs in the Vietnam Era Twin Registry. Analyses included: (a) estimates of genetic and environmental influences on PTSD symptom severity (as measured by the PTSD Checklist) and resilience (assessed with the Connor-Davidson Resilience Scale-10); (b) development of a latent model of traumatic stress, spanning both PTSD and resilience; and (c) estimates of genetic and environmental influences on this spectrum., Results: The heritability of PTSD was 49% and of resilience was 25%. PTSD and resilience were correlated at r = -.59, and 59% of this correlation was attributable to a single genetic factor, whereas the remainder was due to a single non-shared environment factor. Resilience was also influenced by common and unique environmental factors not shared with PTSD, but there was no genetic factor specific to resilience. Confirmatory factor analysis supported the Development of a revised phenotype reflecting the broader dimension of traumatic stress, with biometric models suggesting increased heritability (66%) of this spectrum compared to PTSD or resilience individually., Conclusions: Genetic factors contribute to a single spectrum of traumatic stress reflecting resilience at one end and high symptom severity at the other. This carries implications for phenotype refinement in the search for molecular genetic markers of trauma-related psychopathology. Rather than focusing only on genetic risk for PTSD, molecular genetics research may benefit from evaluation of the broader spectrum of traumatic stress., (© 2017 Wiley Periodicals, Inc.)

Background: There remains a dearth of research examining the "buffering" effect of resilience, wherein resilience at one point in time would be expected to protect an individual against development of psychopathology following future adverse life events., Methods: Using longitudinal data from an epidemiological twin sample (N = 7463), this study tested whether resilience would act as a buffer for stressful life events (SLEs) against risk for major depressive disorder (MDD) and generalized anxiety disorder (GAD). Resilience, demographics, and psychopathology were measured at Time 1 and recent SLEs and current MDD and GAD were measured at Time 2., Results: Final models, controlling for demographic covariates and Time 1 diagnosis, examined the impact of Time 1 resilience, recent SLEs, their interaction, and a three-way interaction adding sex on MDD and GAD., Conclusions: The pattern of findings was the same for MDD and GAD, wherein main effects and two-way interactions of resilience and SLEs were significant, such that greater resilience was protective even in the context of high numbers of past-year SLEs. The three-way interaction was not significant, suggesting that the relationship between SLEs and resilience on psychopathology was the same for both men and women. Findings support the conceptualization of resilience as a buffer against the impact of future life stressors on common internalizing psychopathology. Longitudinal designs and trajectory-based studies that include recurring measures of SLEs could inform conceptualizations of resilience in the context of ongoing adversity and aid in developing interventions aimed at fostering healthy adaptation in the face of stressors., (© 2017 Wiley Periodicals, Inc.)

Individual differences in cognitive processes and coping behaviors play a role in the development and maintenance of posttraumatic stress disorder (PTSD). Given the large numbers of combat-exposed service members returning from the Operation Enduring Freedom (OEF), Operation Iraqi Freedom (OIF), and Operation New Dawn (OND) conflicts, exploring individual differences in cognitive-affective processes is important for informing our understanding of PTSD etiology and early intervention in military samples. The present study examined the unique main and interactive effects of negative posttrauma cognitions (i.e., negative beliefs about self [NS], the world [NW], and self-blame [SB]) and coping strategies (i.e., positive behavioral, positive cognitive, avoidant coping, and social and emotional coping) on PTSD diagnosis within 155 ( M age = 30.7, SD = 4.48) OEF/OIF/OND combat trauma-exposed veterans recruited from an ongoing study examining the effects of combat trauma and stress reactivity. In the final, stepwise logistic regression analysis, avoidant coping, but no other coping strategy, was significantly positively related to PTSD diagnosis in the initial step. Higher levels of NS, but not NW, were significantly associated with having a PTSD diagnosis, while SB was associated with decreased likelihood of PTSD, above and beyond coping strategies. A significant interaction effect was found between NS and positive cognitive coping, such that greater positive cognitive coping weakened the relationship between NS and PTSD. Examining and addressing coping behaviors and negative thoughts of self jointly may benefit assessment and intervention approaches in a combat-trauma population.

Low distress tolerance (DT) is related to negative mental health outcomes, particularly among trauma-exposed populations, who are at greater risk for mental health problems. However, little is known about potential etiological factors underlying the development of perceived (i.e., self-report) or behaviorally assessed DT. The present study examined associations between Big Five personality factors (i.e., openness, conscientiousness, extraversion, agreeableness, & neuroticism) and multiple measures of DT. Participants were 440 college students (71.4% women) endorsing a history of one or more potentially traumatic events. Participants completed the abbreviated Big Five Inventory (BFI), Distress Tolerance Scale (DTS), Discomfort Intolerance Scale (DIS), breath-holding task, and Paced Auditory Serial Addition Test (PASAT). Results of a series of hierarchical linear regressions indicated that higher levels of neuroticism and lower levels of conscientiousness were significantly associated with lower DTS scores, but no other DT measures. Greater extraversion was significantly associated with greater DT on the DIS and the PASAT. Lower levels of openness were associated with lower DT on the breath-holding task. Individual differences in normal personality traits account for significant variation in multiple measures of DT and may provide insight into the etiology of various forms of DT.

Background: The nature and underlying mechanisms of the observed increased vulnerability to posttraumatic stress disorder (PTSD) in women are unclear., Methods: We investigated the genetic overlap of PTSD with anthropometric traits and reproductive behaviors and functions in women. The analysis was conducted using female-specific summary statistics from large genome-wide association studies (GWAS) and a cohort of 3577 European American women (966 PTSD cases and 2611 trauma-exposed controls). We applied a high-resolution polygenic score approach and Mendelian randomization analysis to investigate genetic correlations and causal relationships., Results: We observed an inverse association of PTSD with genetically determined anthropometric traits related to body shape, independent of body mass index (BMI). The top association was related to BMI-adjusted waist circumference (WC adj ; R = -0.079, P < 0.001, Q = 0.011). We estimated a relative decrease of 64.6% (95% confidence interval = 27.5-82.7) in the risk of PTSD per 1-SD increase in WC adj . MR-Egger regression intercept analysis showed no evidence of pleiotropic effects in this association (P pleiotropy  = 0.979). We also observed associations of genetically determined WC adj with age at first sexual intercourse and number of sexual partners (P = 0.013 and P < 0.001, respectively)., Conclusions: There is a putative causal relationship between genetically determined female body shape and PTSD, which could be mediated by evolutionary mechanisms involved in human sexual behaviors.

Compelling evidence suggests that epigenetic mechanisms such as DNA methylation play a role in stress regulation and in the etiologic basis of stress related disorders such as Post traumatic Stress Disorder (PTSD). Here we describe the purpose and methods of an international consortium that was developed to study the role of epigenetics in PTSD. Inspired by the approach used in the Psychiatric Genomics Consortium, we brought together investigators representing seven cohorts with a collective sample size of N = 1147 that included detailed information on trauma exposure, PTSD symptoms, and genome-wide DNA methylation data. The objective of this consortium is to increase the analytical sample size by pooling data and combining expertise so that DNA methylation patterns associated with PTSD can be identified. Several quality control and analytical pipelines were evaluated for their control of genomic inflation and technical artifacts with a joint analysis procedure established to derive comparable data over the cohorts for meta-analysis. We propose methods to deal with ancestry population stratification and type I error inflation and discuss the advantages and disadvantages of applying robust error estimates. To evaluate our pipeline, we report results from an epigenome-wide association study (EWAS) of age, which is a well-characterized phenotype with known epigenetic associations. Overall, while EWAS are highly complex and subject to similar challenges as genome-wide association studies (GWAS), we demonstrate that an epigenetic meta-analysis with a relatively modest sample size can be well-powered to identify epigenetic associations. Our pipeline can be used as a framework for consortium efforts for EWAS., (© 2017 Wiley Periodicals, Inc.)

Despite conceptual links between disaster exposure and substance use, few studies have examined prevalence and risk factors for adolescent substance use and abuse in large, population-based samples affected by a recent natural disaster. We addressed this gap using a novel address-based sampling methodology to interview adolescents and parents who were affected by the 4th deadliest tornado outbreak in U.S., History: Postdisaster interviews were conducted with 2,000 adolescent-parent dyads living within a 5-mile radius of the spring 2011 U.S. tornadoes. In addition to descriptive analyses to estimate prevalence, hierarchical linear and logistic regression analyses were used to examine a range of protective and risk factors for substance use and abuse. Approximately 3% reported substance abuse since the tornado. Greater number of prior traumatic events and older age emerged as consistent risk factors across tobacco and alcohol use and substance abuse since the tornado. Tornado incident characteristics, namely, greater loss of services and resources after the tornado and posttraumatic stress disorder since the tornado, were associated with greater alcohol consumption. Service loss increased risk for binge drinking, whereas, for substance abuse, posttraumatic stress disorder increased risk and parent presence during the tornado decreased risk. Greater family tornado exposure was associated with a greater number of cigarettes smoked in female but not male teen participants. Both trauma and non-trauma-related factors are relevant to postdisaster substance abuse among adolescents. Future research should examine the role of broader ecological systems in heightening or curtailing substance use risk for adolescents following disaster exposure.

Recent studies point to the potential role of the (pituitary) adenylate cyclase activating polypeptide receptor 1 (ADCYAP1R1) gene, which has been implicated in stress response, in posttraumatic stress disorder (PTSD). Multiple genetic association studies have examined potential PTSD risk related to this gene, with mixed results. We conducted a meta-analysis of rs2267735 in ADCYAP1R1 in PTSD. A literature search was conducted using PubMed and PsycINFO, resulting in nine studies that met criteria for inclusion in analysis. Biostat's Comprehensive Meta-Analysis was used to conduct the main meta-analysis on the combined sex sample, as well as two subanalyses examining effects separately in female and male participants. Results indicated that the C allele of rs2267735 conferred significant risk for PTSD in the combined sex data, OR = 1.210, 95% CI [1.007, 1.454], p = .042, and in the subsample of women and girls, OR = 1.328, 95% CI [1.026, 1.719], p = .031; but not in the subsample of men and boys, OR = 0.964, 95% CI [0.733, 1.269], p = .796. These results provide evidence for an association between ADCYAP1R1 and PTSD and indicate that there may indeed be sex differences. Implications of these findings, including the role of rs2267735 as one modulator of the stress system, are discussed., (Copyright © 2017 International Society for Traumatic Stress Studies.)

Objective: Posttraumatic stress disorder (PTSD) and alcohol dependence (AD) frequently co-occur; however, epidemiologic studies of temporal associations between PTSD and AD are limited. The aims of this study were (a) to investigate the bidirectional associations between PTSD and AD and (b) to examine demographic and clinical correlates of order-of-onset among individuals with PTSD and AD., Method: Participants were 11,103 adults (60.6% women; Mage = 48.7 years, SD = 15.9) from the National Epidemiologic Survey on Alcohol and Related Conditions who endorsed lifetime alcohol consumption and DSM-IV PTSD Criterion A trauma exposure (American Psychiatric Association, 2000). Cox proportional hazards models with time-dependent covariates were used to evaluate bidirectional associations between PTSD and AD. Sex differences were assessed using stratified analyses., Results: After adjusting for demographic, trauma, and alcohol characteristics, PTSD was associated with greater likelihood of subsequent AD (hazard ratio [HR] = 1.359, 95% CI = 1.357-1.362), and AD was associated with greater likelihood of subsequent PTSD (HR = 1.274, 95% CI = 1.271-1.277). Bidirectional associations between PTSD and AD were stronger for women compared with men. Among individuals with PTSD and AD, initial onset of PTSD was associated with younger age of first potentially traumatic event. Initial onset of AD was associated with earlier initiation of alcohol use, earlier onset of heavy alcohol use, family history of alcohol problems, and history of generalized anxiety disorder and social anxiety disorder for women but not men. Initial AD was associated with lifetime panic disorder for men and women., Conclusions: Etiology of PTSD and AD is heterogeneous, and order of onset may reflect differing risk pathways. (PsycINFO Database Record, ((c) 2017 APA, all rights reserved).)

Objective: Traumatic events, particularly those that are interpersonal in nature, are associated with increased risk for co-occurring sequelae, including sleep disturbances, posttraumatic stress disorder (PTSD), and alcohol use disorder (AUD). However, the associations between these phenotypes have not been explored among college students., Methods: We examined relationships between type of potentially traumatic event (PTE) exposure (pre-college) and sleep disturbances, as well as mediating effects of lifetime PTSD and AUD symptoms on these relationships, in a large undergraduate sample (N = 1599, 64.7% female). Hierarchical linear regressions were conducted, beginning with demographics and then adding interpersonal and accidental PTEs in a stepwise regression; mediation analyses were run., Results: Within the sample, 33.7% endorsed at least one interpersonal PTE, while 64.4% endorsed at least one accidental PTE. Hierarchical regressions demonstrated that interpersonal (β = 0.202, p = 0.000), but not accidental PTE exposure significantly predicted disturbed sleep. Both PTSD and AUD symptoms significantly mediated (p values < 0.001) the relationship between interpersonal PTE exposure and sleep, with indirect effects accounting for 61% and 17% of total effects, respectively. In the correlated mediation model, both disorders remained significant mediators (p < 0.001), with indirect effects accounting for 56% (PTSD symptoms) and 14% (AUD symptoms) of total effects on sleep., Conclusions: Results suggest that interpersonal PTEs are more potent predictors of sleep problems than accidental PTEs. Further, trauma exposure psychiatric symptom sequelae (PTSD, AUD) account for part of the relationship between interpersonal PTE exposure and disturbed sleep, which both independently and jointly suggests that treating PTSD and AUD symptoms in college students may also improve sleep., (Copyright © 2017. Published by Elsevier B.V.)

Background: Insomnia is comorbid with internalizing and externalizing psychiatric disorders. However, the extent to which the etiologic influences on insomnia and common psychopathology overlap is unclear. There are limited genetically informed studies of insomnia and internalizing disorders and few studies of overlap exist with externalizing disorders., Methods: We utilized twin data from the Virginia Adult Twin Studies of Psychiatric and Substance Use Disorders (total n = 7,500). Insomnia, internalizing disorders (major depressive disorder [MDD], generalized anxiety disorder [GAD]), and alcohol abuse or dependence (AAD) were assessed at two time points, while antisocial personality disorder (ASPD) was assessed once. Cholesky decompositions were performed in OpenMx and longitudinal measurement models were run on available phenotypes to reduce measurement error., Results: The latent additive genetic influences on insomnia overlapped significantly (56% for females, 74% for males) with MDD and were shared completely (100%) with GAD. There was significant overlap of latent unique environmental influences, with overlap ranging from 38 to 100% across disorders. In contrast, there was less genetic overlap between insomnia and externalizing disorders, with 18% of insomnia's heritability shared with AAD and 23% with ASPD. Latent unique environmental overlap between insomnia and both externalizing disorders was negligible., Conclusions: The evidence for substantial genetic overlap between insomnia and stable aspects of both internalizing disorders suggests that there may be few insomnia-specific genes and investigation into unique environmental factors is important for understanding insomnia development. The modest overlap between insomnia and externalizing disorders indicates that these disorders are genetically related, but largely etiologically distinct., (© 2017 Wiley Periodicals, Inc.)

This paper provides a brief summary and commentary on the growing literature and current developments related to the genetic underpinnings of posttraumatic stress disorder (PTSD). We first briefly provide an overview of the behavioral genetic literature on PTSD, followed by a short synopsis of the substantial candidate gene literature with a focus on genes that have been meta-analyzed. We then discuss the genome-wide association studies (GWAS) that have been conducted, followed by an introduction to other molecular platforms used in PTSD genomic studies, such as epigenetic and expression approaches. We close with a discussion of developments in the field that include the creation of the PTSD workgroup of the Psychiatric Genomics Consortium, statistical advances that can be applied to GWAS data to answer questions of heritability and genetic overlap across phenotypes, and bioinformatics techniques such as gene pathway analyses which will further advance our understanding of the etiology of PTSD., (Copyright © 2016 Elsevier Ltd. All rights reserved.)

Study Objectives: Sleep disturbances are well documented in relation to trauma exposure and posttraumatic stress disorder (PTSD), but correlates of such disturbances remain understudied in veteran populations. We conducted a preliminary study of sleep disturbances in Operation Enduring Freedom, Operation Iraqi Freedom, and Operation New Dawn veterans (n = 133; mean [standard deviation] age = 29.8 [4.7] y)., Methods: Veterans were assigned to one of three groups based on responses to the Clinician Administered PTSD Scale: control (no trauma-exposure [TE] or PTSD), TE, and PTSD. Sleep disturbance was assessed using the Pittsburgh Sleep Quality Index (PSQI). Measures of resilience, trauma load, personality, coping, alcohol use, and mild traumatic brain injury were also assessed via self-report., Results: The PTSD group had significantly more disturbed sleep (PSQI global score mean = 8.94, standard deviation = 3.12) than control (mean = 5.27, standard deviation = 3.23) and TE (mean = 5.34, standard deviation = 3.17) groups, but there were no differences between TE and control. The same pattern emerged across most PSQI subscales. Results of linear regression analyses indicated that current smoking, Army (versus other military branches), neuroticism, and using substances to cope were all significant correlates of higher sleep disturbance, whereas post-deployment social support was associated with less sleep disturbance. However, when combined together into a model with PTSD status, only neuroticism and substance use coping remained significant as predictors of more disturbed sleep., Conclusions: These initial findings suggest that TE itself may not be an independent risk factor for disturbed sleep in veterans, and that neurotic personality and a tendency to cope by using substances may partially explain sleep disturbance, above and beyond a diagnosis of PTSD., (© 2017 American Academy of Sleep Medicine)

Post-traumatic stress disorder (PTSD), Major Depressive Disorder (MDD), and Substance Use Disorder (SUD) have large public health impacts. Therefore, researchers have attempted to identify those at greatest risk for these phenotypes. PTSD, MDD, and SUD are in part genetically influenced. Additionally, genes in the glutamate and gamma-aminobutyric acid (GABA) system are implicated in the encoding of emotional and fear memories, and thus may impact these phenotypes. The current study examined the associations of single nucleotide polymorphisms in GAT1 individually, and at the gene level, using a principal components (PC) approach, with PTSD, PTSD comorbid with MDD, and PTSD comorbid with SUD in 486 combat-exposed veterans.  Findings indicate that several GAT1 SNPs, as well as one of the GAT1 PCs, was associated with PTSD, with and without MDD and SUD comorbidity. The present study findings provide initial insights into one pathway by which shared genetic risk influences PTSD-MDD and PTSD-SUD comorbidities, and thus identify a high-risk group (based on genotype) on whom prevention and intervention efforts should be focused., Competing Interests: The authors declare no conflict of interest.

Objective: Impulsivity and extraversion have demonstrated associations with risky sexual behavior (RSB) and potentially traumatic events (PTEs). In addition, interpersonal trauma appears to be associated with RSB, but research on the relationship between RSB and noninterpersonal PTEs (e.g., accidental) is lacking. The current study aims to investigate the relationships between personality (i.e., impulsivity, extraversion), RSB and multiple types of PTEs (i.e., accidental, physical, or sexual)., Method: Personality and demographic characteristics were assessed during participants' (N = 970) first semester of college, past-12 month PTEs and RSB were assessed during the second semester of participants' junior year. Multiple linear regression was used to examine the relationship between PTEs, personality factors, and RSB. Analyses were also conducted to examine the potential mediating effect of interpersonal PTEs on the relationship between personality and RSB., Results: Impulsivity and extraversion were significantly positively associated with RSB. Both physical and sexual PTEs, but not accidental PTEs, were also significantly positively associated with RSB. Sexual PTEs significantly mediated the relationship between impulsivity and RSB., Conclusions: This is the first study to date to simultaneously examine the relationship between personality, RSB, and types of PTEs in a large sample of young adults. Exposure to interpersonal trauma appears to be a salient factor in the relationship between personality, specifically impulsivity, and RSB. These results indicate that college students may benefit from education regarding the potential negative outcomes of RSB, and that individuals with a history of interpersonal PTEs may be at increased risk for sexual risk taking. (PsycINFO Database Record, Competing Interests: None of the authors declare any conflict of interest., ((c) 2017 APA, all rights reserved).)

Objective: Given evidence that posttraumatic stress disorder (PTSD) is moderately heritable, a number of studies utilizing candidate gene approaches have attempted to examine the potential contributions of theoretically relevant genetic variation. Some of these studies have found sup port for a brain-derived neurotrophic factor (BDNF) variant, Val66Met, in the risk of developing PTSD, while others have failed to find this link., Methods: This study sought to reconcile these conflicting findings using a meta-analysis framework. Analyses were also used to determine whether there is significant heterogeneity in the link between this variant and PTSD. We conducted a systematic review of the literature on BDNF and PTSD from the PsycINFO and PubMed databases. A total of 11 studies were included in the analysis., Results: Findings indicate a marginally significant effect of the BDNF Val66Met variant on PTSD (p < 0.1). However, of the 11 studies included, only 2 suggested an effect with a non-zero confidence interval, one of which showed a z score of 3.31. We did not find any evidence for heterogeneity., Conclusions: Findings from this meta-analytic investigation of the published literature provide little support for the Val66Met variant of BDNF as a predictor of PTSD. Future well-powered agnostic genome-wide association studies with more refined phenotyping are needed to clarify genetic influences on PTSD., (© 2018 S. Karger AG, Basel.)

Objective: Young adult alcohol misuse is associated with numerous long-term adverse outcomes. Given the link between impulsivity and alcohol use, we examined whether three impulsivity-related traits differentially predicted number of drinks per drinking day (DDD). We also examined whether these effects varied for those with different trauma histories., Method: The current study (n=254) examined motor, non-planning, and attentional impulsivity as predictors of DDD. It also examined whether impulsivity was differentially predictive of DDD across individuals in: a control group (non-trauma exposed), a trauma exposed but non-PTSD group, and a PTSD group., Results: Regardless of group, more motor impulsivity was associated with more DDD. The effect of non-planning impulsivity varied according to trauma history. Specifically, more non-planning impulsivity predicted more DDD for those without PTSD. Finally, attentional impulsivity was not predictive of DDD., Conclusions: Young adults with high levels of motor impulsivity, regardless of trauma history, may be a particularly high-risk group in terms of propensity for alcohol use/misuse. Additionally, high levels of non-planning impulsivity may signify those at greater risk for alcohol misuse, among those without PTSD. Motor impulsivity and non-planning impulsivity may serve as useful intervention targets in alcohol misuse prevention efforts. Implications for future research in this area are discussed., (Copyright © 2016 Elsevier Ltd. All rights reserved.)

The present study aimed to utilize a Receiver Operating Characteristic (ROC) approach in order to improve clinical decision-making for adolescents at risk for the development of psychopathology in the aftermath of a natural disaster. Specifically we assessed theoretically-driven individual, interpersonal, and event-related vulnerability factors to determine which indices were most accurate in forecasting PTSD. Furthermore, we aimed to translate these etiological findings by identifying clinical cut-off recommendations for relevant vulnerability factors. Our study consisted of structured phone-based clinical interviews with 2000 adolescent-parent dyads living within a 5-mile radius of tornados that devastated Joplin, MO, and northern Alabama in Spring 2011. Demographics, tornado incident characteristics, prior trauma, mental health, and family support and conflict were assessed. A subset of youth completed two behavioral assessment tasks online to assess distress tolerance and risk-taking behavior. ROC analyses indicated four variables that significantly improved PTSD diagnostic efficiency: Lifetime depression (AUC = .90), trauma history (AUC = .76), social support (AUC = .70), and family conflict (AUC = .72). Youth were 2-3 times more likely to have PTSD if they had elevated scores on any of these variables. Of note, event-related characteristics (e.g., property damage) were not related to PTSD diagnostic status. The present study adds to the literature by making specific recommendations for empirically-based, efficient disaster-related PTSD assessment for adolescents following a natural disaster. Implications for practice and future trauma-related developmental psychopathology research are discussed.

Objective: This study examined the prevalence and correlates of precollege, college-onset, and repeat sexual assault (SA) within a representative student sample., Participants: A representative sample of 7,603 students., Methods: Incoming first-year students completed a survey about their exposure to broad SA prior to college, prior trauma, personality, relationships, and mental health. Broad SA was then reassessed each spring semester while enrolled., Results: Nearly 20% of the sample reported experiencing broad SA, with women endorsing significantly higher rates compared with males. Prior victimization before coming to college was related to a greater risk of victimization in college, and there was no statistically significant difference between males and females who reported revictimization. Correlates of college-onset broad SA were found and are discussed., Conclusions: Given the need for SA intervention and prevention on college campuses, identification of factors potentially contributing to exposure within this population is essential.

The aims were two-fold: to examine prevalence and correlates of lifetime potentially traumatic event (PTE) exposure and to explore the relationships between PTE exposure and mental health outcomes (i.e., trauma related distress, alcohol use quantity and frequency, depression symptoms, and anxiety symptoms) within a large sample of college freshmen. 6120 participants, consisting of three cohorts of incoming freshman at a large southeastern university, completed an online assessment battery measuring a multitude of factors including PTEs, personality, relationships (i.e., parental and peer), and mental health. The majority (81.8%) of participants endorsed experiencing at least one PTE within their lifetime and 39.0% reported at least one interpersonal trauma (i.e., physical assault, sexual assault, other unwanted or uncomfortable sexual situation). The average number of PTE categories endorsed was 1.71 (SD=1.30), and 8.7% of participants reported experiencing four or more separate PTE categories pre-college entry. Female gender and peer deviance were consistently associated with PTE exposure and symptoms of psychopathology. Furthermore, a history of interpersonal PTE exposure was associated with increased alcohol use (i.e., frequency and quantity), trauma related distress, depressive symptoms, and anxiety symptoms. The data demonstrate high prevalence PTE exposure among young adults and the clinical significance of a PTE history., (Copyright © 2016. Published by Elsevier Ireland Ltd.)

Posttraumatic stress disorder (PTSD) symptoms are associated with coping-motivated alcohol use in trauma-exposed samples. However, it is unclear which individuals experiencing PTSD symptoms are at greatest risk for alcohol-use problems following trauma exposure. Individuals endorsing high anxiety sensitivity, which is the fear of anxiety and related sensations, may be particularly motivated to use alcohol to cope with PTSD symptoms. In the current study, we examined the moderating role of anxiety sensitivity in the association between PTSD symptoms and coping motives in a sample of 295 young adults with a history of interpersonal trauma and current alcohol use. Participants completed measures of past 30-day alcohol consumption, trauma history, current PTSD symptoms, anxiety sensitivity, and alcohol-use motives. Results of hierarchical multiple regression analyses indicated that greater anxiety sensitivity was significantly associated with greater coping (β = .219) and conformity (β = .156) alcohol-use motives, and greater PTSD symptoms were associated with greater coping motives (β = .247), above and beyond the covariates of sex, alcohol consumption, trauma load, and noncriterion alcohol-use motives. The interaction of anxiety sensitivity and PTSD symptoms accounted for additional variance in coping motives above and beyond the main effects (β = .117), with greater PTSD symptoms being associated with greater coping motives among those high but not low in anxiety sensitivity. Assessment and treatment of PTSD symptoms and anxiety sensitivity in young adults with interpersonal trauma may be warranted as a means of decreasing alcohol-related risk in trauma-exposed young adults. (PsycINFO Database Record, ((c) 2016 APA, all rights reserved).)

Introduction: The purpose of this study was to examine predictors of risk for and the transition between acute stress disorder (ASD) and posttraumatic stress disorder (PTSD) in a longitudinal sample of youth with severe injuries admitted to the hospital. These data would assist with treatment and discharge planning., Methods: Youth were assessed for ASD during the initial hospital stay and were followed-up over an 18-month period for PTSD (n = 151). Youth were classified into four groups, including Resilient (ASD-, PTSD-), ASD Only (ASD+, PTSD-), PTSD Only (ASD-, PTSD+), and Chronic (ASD+, PTSD+). Demographic, psychiatric, social context, and injury-related factors were examined as predictors of diagnostic transition., Results: The results of multivariate analysis of variance and pairwise comparisons found that peritraumatic dissociation, gender, and socioeconomic status were significant predictors after controlling for multiple testing., Discussion: Results suggest that both within-child and contextual factors contribute to the longitudinal response to trauma in children. Clinicians should consider early screening and discharge planning, particularly for children most at risk., (Copyright © 2016 National Association of Pediatric Nurse Practitioners. Published by Elsevier Inc. All rights reserved.)

Epidemiologic studies of trauma highlight the imbalance between prevalence of psychiatric diagnoses and help seeking. We investigated prevalence and correlates of help seeking and self-medication in Norwegian adults with trauma history with a focus on common posttrauma outcomes of posttraumatic stress disorder (PTSD) and substance use disorders (alcohol or drug). Participants reporting at least 1 PTSD symptom (n = 307) were asked if they consulted with a doctor/another professional (help seeking) or used drugs/alcohol (self-medication) for trauma-related problems. PTSD, alcohol abuse or dependence (AUD), and drug use or dependence (DUD) were assessed via structured diagnostic interviews. Help seeking and self-medication were endorsed by 37.4% and 10.4% of the sample, respectively. As compared to the full sample, help seeking was endorsed at a greater rate in individuals with PTSD (χ2 = 8.59, p = .005) and at a lower rate in those with AUD (χ2 = 7.34, p < .004). Self-medication was more likely to be endorsed by individuals with PTSD than without PTSD (χ2 = 25.68, p < .001). In regression analyses, PTSD was associated with increased likelihood of self-medication (odds ratio [OR] = 4.56) and help seeking (OR = 2.29), while AUD was associated with decreased likelihood of help-seeking (OR = .29). When self-medication was included as a predictor, PTSD was no longer associated with help seeking, although AUD remained inversely associated. PTSD and AUDs have a nuanced relationship with formal help seeking as well as the use of substances to cope. Trauma-exposed individuals are likely engaging in adaptive and maladaptive coping strategies, the latter of which may be compounding distress. (PsycINFO Database Record, Competing Interests: The authors have no financial relationships or conflicts of interest to disclose, ((c) 2016 APA, all rights reserved).)

Purpose: Resilience to stressful life events (SLEs), which increase risk of psychopathology, is influenced by genetic factors. The purpose of this paper was to map the overlap of etiologic risk factors for resilience onto the broad psychopathological map. Resilience was defined as the difference between the twins' total score on a broad measure of internalizing symptoms and their predicted score based on their cumulative exposure to SLEs., Methods: Cholesky decompositions were performed with OpenMx to quantify the overlap in genetic and environmental risk factors between resilience and four phenotypes [major depression (MD), generalized anxiety disorder (GAD), alcohol abuse or dependence (AAD), and antisocial personality disorder (ASPD)]., Results: The genetic factors that influence resilience account for 42 and 61 % of the heritability of MD and GAD, respectively, and 20 and 18 % for AAD and ASPD, respectively. The latent genetic contribution to MD was shared 47 % with resilience, and for AAD, this estimate was lower (23 %). The shared environmental covariance was nominal., Conclusions: Genetic influences on resilience contribute to internalizing phenotypes to a higher degree than to externalizing phenotypes. Environmental influences can also have an enduring effect on resilience. However, virtually all of the covariance between resilience and the phenotypes was genetic.

The aims of the current study were to examine the prevalence of potentially traumatic events (PTEs), posttraumatic stress disorder (PTSD; data available in males only), and depressive symptoms in a Puerto Rican sample of 678 adult caretakers (50% female) of twins participating in the Puerto Rican Infant Twin Study. The World Health Organization Composite International Diagnostic Interview version 3.0 (CIDI 3.0) was utilized to assess rates of PTEs, PTSD, and depression among male participants while an abbreviated version of the CIDI 3.0 and the Mood and Feelings Questionnaire were administered to females to assess PTEs and depressive symptoms. Significantly more males than females reported exposure to a PTE (76.6% vs. 44.2%, χ(2) = 64.44, p < 0.001). In males, endorsement of multiple PTEs was associated with increased level of PTSD symptomatology (β = 0.33, p < 0.001). With regard to depression, a similar dose-response relationship was found in both males and females, with depressive symptoms increasing as number of PTEs increased (βs = 0.15, 0.16, ps < 0.05). Exposure to an attack with a weapon was significantly associated with increased depression symptoms in both males and females (βs = 0.24, 0.20, ps < 0.01, respectively). These findings highlight the need for identification of putative risk and resilience factors among PTE-exposed individuals in Puerto Rico.

Childhood sexual abuse (CSA) is linked to negative consequences, including insomnia. Few studies have examined the enduring effects of CSA on adult insomnia. Given the relationship between sleep and poor health, a better understanding of these effects has clinical implications. We used a representative adult twin sample. Both sexes were assessed with a broad CSA variable, with a subset of females (n = 424) given additional items capturing escalating physical contact and abuse characteristics. A sum score of past-month insomnia symptoms was calculated from the Symptom Checklist-90 (shortened version). Logistic regression was used to estimate the effects of CSA, physical contact, and incident characteristics on insomnia symptoms. Of the full sample (N = 8,184), 9.8% reported CSA. CSA significantly predicted insomnia symptoms in the female sample (n = 1,407; odds ratio [OR] = 1.67, 95% confidence interval [CI] = 1.35-2.06, p < .0001) but the continuum of physical contact did not. Individually, more than 1 perpetrator and feeling forced/threatened increased sleep risk, whereas having a male perpetrator (vs. female or multiple) decreased risk. These associations did not hold when combined. In the mixed-sex sample (n = 6,777), we replicated our CSA finding (OR = 1.65, 95% CI = 1.34-2.04, p < .0001) and found that female gender (OR = 1.16, 95% CI = 1.03-1.30, p = .0125), but not the gender*CSA interaction, was significant. CSA predicts adult insomnia symptoms decades after abuse, but the small sample size for incident characteristics (n = 424) resulted in limited conclusions about associated risk., ((c) 2016 APA, all rights reserved).)

The purpose of this paper is to determine the phenotypic relationships, and etiologic underpinnings, of cognitive/psychological traits with psychiatric resilience. Resilience was defined as the difference between the twins' total score on a broad measure of internalizing symptoms and their predicted score based on their cumulative exposure to stressful life events (SLEs). Cholesky decompositions were performed in a large twin sample (n=7,500 individuals) to quantify the overlap in genetic and environmental factors between resilience and six traits (neuroticism, optimism, self-esteem, mastery, interpersonal dependency, altruism) in bivariate analyses, and in a multivariate model. On a phenotypic level, each trait accounted for variance in resilience in univariate analyses. In the multivariate regression neuroticism accounted for the majority of the variance and attenuated the relationships between the other traits and resilience. The genetic factors that influence the traits account for between 7-60% of the heritability of resilience. In the multivariate genetic model neuroticism accounted for all of the genetic covariance between the traits and resilience; 40% of the genetic influence on resilience was independent. Neuroticism evidenced the largest phenotypic and genetic relationship with resilience, and accounted for nearly all of the phenotypic and genetic variance between resilience and the other traits.

Background: The current longitudinal study examined associations between interpersonal potentially traumatic events (PTEs; i.e., sexual or physical assault) and changes in alcohol consumption among incoming college students., Methods: 1197 students (68% female) participating in a university-wide research study were included in analyses. Assessments were administered at three time-points and included measures of alcohol use, PTEs (Life Events Checklist), and a screener for possible PTSD symptoms (abbreviated Primary Care PTSD Screen). Linear growth curve models were fit to the three repeated measures of alcohol quantity and frequency to determine the role of pre-college and college-onset interpersonal PTEs and possible PTSD symptoms on patterns of alcohol use., Results: Pre-college interpersonal PTE was associated with greater baseline alcohol use for female but not male students. College-onset interpersonal PTE predicted greater alcohol use at concurrent and future assessments for women but not men, beyond the effects of pre-college PTE. Pre-college possible PTSD symptoms did not predict baseline or change in alcohol use., Conclusions: There may be a stronger and longer-lasting impact of interpersonal PTE for college women compared to men on alcohol phenotypes, although replication in studies oversampling men endorsing interpersonal PTE is needed., (Copyright © 2015 Elsevier Ltd. All rights reserved.)

Objective: To assess the efficacy of Bounce Back Now (BBN), a modular, Web-based intervention for disaster-affected adolescents and their parents., Method: A population-based randomized controlled trial used address-based sampling to enroll 2,000 adolescents and parents from communities affected by tornadoes in Joplin, MO, and several areas in Alabama. Data collection via baseline and follow-up semi-structured telephone interviews was completed between September 2011 and August 2013. All families were invited to access the BBN study Web portal irrespective of mental health status at baseline. Families who accessed the Web portal were assigned randomly to 1 of 3 groups: BBN, which featured modules for adolescents and parents targeting adolescents' mental health symptoms; BBN plus additional modules targeting parents' mental health symptoms; or assessment only. The primary outcomes were adolescent symptoms of posttraumatic stress disorder (PTSD) and depression., Results: Nearly 50% of families accessed the Web portal. Intent-to-treat analyses revealed time × condition interactions for PTSD symptoms (B = -0.24, SE = 0.08, p < .01) and depressive symptoms (B = -0.23, SE = 0.09, p < .01). Post hoc comparisons revealed fewer PTSD and depressive symptoms for adolescents in the experimental versus control conditions at 12-month follow-up (PTSD: B = -0.36, SE = 0.19, p = .06; depressive symptoms: B = -0.42, SE = 0.19, p = 0.03). A time × condition interaction also was found that favored the BBN versus BBN + parent self-help condition for PTSD symptoms (B = 0.30, SE = 0.12, p = .02) but not depressive symptoms (B = 0.12, SE = 0.12, p = .33)., Conclusion: Results supported the feasibility and initial efficacy of BBN as a scalable disaster mental health intervention for adolescents. Technology-based solutions have tremendous potential value if found to reduce the mental health burden of disasters., Clinical Trial Registration Information: Web-based Intervention for Disaster-Affected Youth and Families; http://clinicaltrials.gov; NCT01606514., (Copyright © 2015 American Academy of Child and Adolescent Psychiatry. All rights reserved.)

The development of posttraumatic stress disorder (PTSD) is influenced by genetic factors. Although there have been some replicated candidates, the identification of risk variants for PTSD has lagged behind genetic research of other psychiatric disorders such as schizophrenia, autism, and bipolar disorder. Psychiatric genetics has moved beyond examination of specific candidate genes in favor of the genome-wide association study (GWAS) strategy of very large numbers of samples, which allows for the discovery of previously unsuspected genes and molecular pathways. The successes of genetic studies of schizophrenia and bipolar disorder have been aided by the formation of a large-scale GWAS consortium: the Psychiatric Genomics Consortium (PGC). In contrast, only a handful of GWAS of PTSD have appeared in the literature to date. Here we describe the formation of a group dedicated to large-scale study of PTSD genetics: the PGC-PTSD. The PGC-PTSD faces challenges related to the contingency on trauma exposure and the large degree of ancestral genetic diversity within and across participating studies. Using the PGC analysis pipeline supplemented by analyses tailored to address these challenges, we anticipate that our first large-scale GWAS of PTSD will comprise over 10 000 cases and 30 000 trauma-exposed controls. Following in the footsteps of our PGC forerunners, this collaboration-of a scope that is unprecedented in the field of traumatic stress-will lead the search for replicable genetic associations and new insights into the biological underpinnings of PTSD.

Objective: Twin modeling was used to conduct a genetically informative longitudinal analysis of insomnia symptoms in both sexes., Method: Data from the Virginia Adult Twin Studies of Psychiatric and Substance Use Disorders (n = 7,500) were used. Past-month insomnia symptoms were assessed at two time points with the shortened version of the Symptom Checklist-90. A composite score for the insomnia items (trouble falling asleep, restless or disturbed sleep, early morning awakenings) was computed. Twin modeling on the composite score was conducted in OpenMx to decompose the phenotypic variance, to examine the longitudinal stability of etiologic influences on insomnia symptoms, and to test for sex differences., Results: Insomnia symptoms were most commonly endorsed at a mild severity level (composite score mean = 2.24, standard deviation = 2.51). There was no evidence for sex effects in either of the univariate models, and insomnia symptoms were found to be modestly heritable (~25% at Time 1 and ~22% at Time 2). In the longitudinal measurement model, which accounts for error of measurement, the heritability for the latent factor of insomnia symptoms increased substantially, and demonstrated quantitative sex differences. The heritability of the latent insomnia factor was ~59% in females and ~38% in males., Conclusions: Genetic factors influence insomnia symptoms in adults, moreso for females than males, and these influences are largely stable over time. When taking into account measurement error, heritability estimates are substantial, but unique environmental factors continue to account for a large amount of variance in insomnia symptoms., (© 2015 Associated Professional Sleep Societies, LLC.)

Recent attention has been given to the role of emotion regulation in the development and maintenance of psychopathology, and the psychosocial literature on emotion regulation has been growing rapidly over the past decade. However, knowledge about the genetic etiology of emotion regulation facets has been slower to develop. The present paper aims to briefly introduce the various constructs that fall under the umbrella of emotion regulation; provide an overview of behavioral genetic methods; summarize the empirical studies of emotion regulation twin studies; introduce molecular genetic methods; review the recent molecular genetic studies on emotion regulation; and provide future directions for research.