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The interaction between child maltreatment, adult stressful life events and the 5-HTTLPR in major depression

Power, Robert A., Lecky-Thompson, Lucy, Fisher, Helen L., Cohen-Woods, Sarah, Hosang, Georgina M., Uher, Rudolf, Powell-Smith, Georgia, Keers, Robert, Tropeano, Maria, Korszun, Ania, Jones, Lisa, Jones, Ian, Owen, Michael John, Craddock, Nicholas John, Craig, Ian W., Farmer, Anne E. and McGuffin, Peter 2013. The interaction between child maltreatment, adult stressful life events and the 5-HTTLPR in major depression. Journal of Psychiatric Research 47 (8) , pp. 1032-1035. 10.1016/j.jpsychires.2013.03.017

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Both childhood maltreatment and adult stressful life events are established risk factors for the onset of depression in adulthood. However, the interaction between them can be viewed through two conflicting frameworks. Under a mismatch hypothesis stressful childhoods allow ‘adaptive programming’ for a stressful adulthood and so can be protective. Only when childhood and adulthood do not match is there a risk of behavioural problems. Alternatively, under the cumulative stress hypothesis we expect increased risk with each additional stressor. It has also been suggested that an individual's genetic background may determine the extent they undergo adaptive programming, and so which of these two hypotheses is relevant. In this study we test for an interaction between exposure to childhood maltreatment and adult stressful life events in a retrospective sample of 455 individuals, using major depression as the outcome. We also test whether this interaction differs by genotype at the 5-HTTLPR, a candidate for an individual's plasticity to adaptive programming. Early maltreatment and stressful life events in adulthood interacted to produce increased risk for depression over each individually (p = 0.055). This supports the cumulative stress hypothesis over the mismatch hypothesis, at least with respect to severe environmental risk factors. This effect was not altered by 5-HTTLPR allele, suggesting there was no difference by genotype in adaptive programming to these events. We suggest that the apparent additional vulnerability to stressful events of those who have experienced maltreatment has clinical relevance, highlighting the importance of providing support beyond the immediate aftermath of maltreatment into adulthood.

Item Type: Article
Date Type: Publication
Status: Published
Schools: Medicine
MRC Centre for Neuropsychiatric Genetics and Genomics (CNGG)
Neuroscience and Mental Health Research Institute (NMHRI)
Subjects: R Medicine > R Medicine (General)
Uncontrolled Keywords: Mismatch hypothesis; Stressful life events; Child maltreatment; Major depression; Gene–environment interaction; 5-HTTLPR
Publisher: Elsevier
ISSN: 0022-3956
Last Modified: 23 Dec 2017 20:33

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