Therapygenetics: predicting response to CBT in child anxiety from specific genetic markers

Thalia Eley, Jennifer Hudson, Cathy Creswell, Maria Tropeano, Kathryn Lester, Peter Cooper, Anne Farmer, Cathryn Lewis, Heidi Lyneham, Ronald Rapee, Rudolf Uher, Helena Zavos, David Collier

Research output: Contribution to journalMeeting abstractResearch

Abstract

Background: Child anxiety disorder is a chronic debilitating condition.
Cognitive Behavioural Therapy (CBT) is successful in approximately
60 % of cases, with poor response associated with greater
severity, comorbidity and parental psychopathology, implicating
genetic influence. The twin literature has shown that genetic influences
interact with both negative and positive environmental
influences, thus genes may predispose individuals to respond well
or poorly to a psychological treatment. The Serotonin Transporter
Promoter Polymorphism (5HTTLPR) has been associated with
responsivity to the environment. Specifically, the short (S) allele has
been associated with increased depression in the presence of stress,
and with better outcomes in the absence of stress, and may thus be a
marker of environmental responsivity.
Methods: We examined the role of the SS genotype in predicting
anxiety diagnosis and response to CBT in child anxiety disorders,
using a gene–environment interaction approach. Children aged 6–
13 years with a primary diagnosis of anxiety disorder undergoing
CBT provided DNA (N = 559, 357 from white European ancestry).
Results: There was an association between the 5HTTLPR and
treatment response at follow-up. Individuals with the SS genotype
were 20 % more likely than the SL/LL group, to be free of
their primary or all anxiety diagnoses by follow-up. This finding
was independent of significant influences of pre-treatment symptom
severity, and comorbid mood disorder on treatment response. Children
with the SS genotype also showed a significantly greater
reduction in symptom severity by follow-up than those with the
other genotypes.
Discussion: Treatment offers the ideal opportunity to test for gene–
environment interaction with a positive environment, and as the
timing can be predicted this design allows for pre-treatment assessment.
If replicated, these findings suggest that in time it could be
possible to predict which children are least likely to benefit from CBT
alone and would benefit from an enhanced treatment package.
LanguageEnglish
Pages932-932
Number of pages1
JournalBehavior Genetics
Volume42
Issue number6
DOIs
Publication statusPublished - Nov 2012
Event42nd Annual Meeting of the Behavior-Genetics-Association - Edinburgh
Duration: 22 Jun 201225 Jun 2012

Cite this

Eley, Thalia ; Hudson, Jennifer ; Creswell, Cathy ; Tropeano, Maria ; Lester, Kathryn ; Cooper, Peter ; Farmer, Anne ; Lewis, Cathryn ; Lyneham, Heidi ; Rapee, Ronald ; Uher, Rudolf ; Zavos, Helena ; Collier, David. / Therapygenetics : predicting response to CBT in child anxiety from specific genetic markers. In: Behavior Genetics. 2012 ; Vol. 42, No. 6. pp. 932-932.
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title = "Therapygenetics: predicting response to CBT in child anxiety from specific genetic markers",
abstract = "Background: Child anxiety disorder is a chronic debilitating condition.Cognitive Behavioural Therapy (CBT) is successful in approximately60 {\%} of cases, with poor response associated with greaterseverity, comorbidity and parental psychopathology, implicatinggenetic influence. The twin literature has shown that genetic influencesinteract with both negative and positive environmentalinfluences, thus genes may predispose individuals to respond wellor poorly to a psychological treatment. The Serotonin TransporterPromoter Polymorphism (5HTTLPR) has been associated withresponsivity to the environment. Specifically, the short (S) allele hasbeen associated with increased depression in the presence of stress,and with better outcomes in the absence of stress, and may thus be amarker of environmental responsivity.Methods: We examined the role of the SS genotype in predictinganxiety diagnosis and response to CBT in child anxiety disorders,using a gene–environment interaction approach. Children aged 6–13 years with a primary diagnosis of anxiety disorder undergoingCBT provided DNA (N = 559, 357 from white European ancestry).Results: There was an association between the 5HTTLPR andtreatment response at follow-up. Individuals with the SS genotypewere 20 {\%} more likely than the SL/LL group, to be free oftheir primary or all anxiety diagnoses by follow-up. This findingwas independent of significant influences of pre-treatment symptomseverity, and comorbid mood disorder on treatment response. Childrenwith the SS genotype also showed a significantly greaterreduction in symptom severity by follow-up than those with theother genotypes.Discussion: Treatment offers the ideal opportunity to test for gene–environment interaction with a positive environment, and as thetiming can be predicted this design allows for pre-treatment assessment.If replicated, these findings suggest that in time it could bepossible to predict which children are least likely to benefit from CBTalone and would benefit from an enhanced treatment package.",
author = "Thalia Eley and Jennifer Hudson and Cathy Creswell and Maria Tropeano and Kathryn Lester and Peter Cooper and Anne Farmer and Cathryn Lewis and Heidi Lyneham and Ronald Rapee and Rudolf Uher and Helena Zavos and David Collier",
year = "2012",
month = "11",
doi = "10.1007/s10519-012-9566-6",
language = "English",
volume = "42",
pages = "932--932",
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Eley, T, Hudson, J, Creswell, C, Tropeano, M, Lester, K, Cooper, P, Farmer, A, Lewis, C, Lyneham, H, Rapee, R, Uher, R, Zavos, H & Collier, D 2012, 'Therapygenetics: predicting response to CBT in child anxiety from specific genetic markers', Behavior Genetics, vol. 42, no. 6, pp. 932-932. https://doi.org/10.1007/s10519-012-9566-6

Therapygenetics : predicting response to CBT in child anxiety from specific genetic markers. / Eley, Thalia; Hudson, Jennifer; Creswell, Cathy; Tropeano, Maria; Lester, Kathryn; Cooper, Peter; Farmer, Anne; Lewis, Cathryn; Lyneham, Heidi; Rapee, Ronald; Uher, Rudolf; Zavos, Helena; Collier, David.

In: Behavior Genetics, Vol. 42, No. 6, 11.2012, p. 932-932.

Research output: Contribution to journalMeeting abstractResearch

TY - JOUR

T1 - Therapygenetics

T2 - Behavior Genetics

AU - Eley, Thalia

AU - Hudson, Jennifer

AU - Creswell, Cathy

AU - Tropeano, Maria

AU - Lester, Kathryn

AU - Cooper, Peter

AU - Farmer, Anne

AU - Lewis, Cathryn

AU - Lyneham, Heidi

AU - Rapee, Ronald

AU - Uher, Rudolf

AU - Zavos, Helena

AU - Collier, David

PY - 2012/11

Y1 - 2012/11

N2 - Background: Child anxiety disorder is a chronic debilitating condition.Cognitive Behavioural Therapy (CBT) is successful in approximately60 % of cases, with poor response associated with greaterseverity, comorbidity and parental psychopathology, implicatinggenetic influence. The twin literature has shown that genetic influencesinteract with both negative and positive environmentalinfluences, thus genes may predispose individuals to respond wellor poorly to a psychological treatment. The Serotonin TransporterPromoter Polymorphism (5HTTLPR) has been associated withresponsivity to the environment. Specifically, the short (S) allele hasbeen associated with increased depression in the presence of stress,and with better outcomes in the absence of stress, and may thus be amarker of environmental responsivity.Methods: We examined the role of the SS genotype in predictinganxiety diagnosis and response to CBT in child anxiety disorders,using a gene–environment interaction approach. Children aged 6–13 years with a primary diagnosis of anxiety disorder undergoingCBT provided DNA (N = 559, 357 from white European ancestry).Results: There was an association between the 5HTTLPR andtreatment response at follow-up. Individuals with the SS genotypewere 20 % more likely than the SL/LL group, to be free oftheir primary or all anxiety diagnoses by follow-up. This findingwas independent of significant influences of pre-treatment symptomseverity, and comorbid mood disorder on treatment response. Childrenwith the SS genotype also showed a significantly greaterreduction in symptom severity by follow-up than those with theother genotypes.Discussion: Treatment offers the ideal opportunity to test for gene–environment interaction with a positive environment, and as thetiming can be predicted this design allows for pre-treatment assessment.If replicated, these findings suggest that in time it could bepossible to predict which children are least likely to benefit from CBTalone and would benefit from an enhanced treatment package.

AB - Background: Child anxiety disorder is a chronic debilitating condition.Cognitive Behavioural Therapy (CBT) is successful in approximately60 % of cases, with poor response associated with greaterseverity, comorbidity and parental psychopathology, implicatinggenetic influence. The twin literature has shown that genetic influencesinteract with both negative and positive environmentalinfluences, thus genes may predispose individuals to respond wellor poorly to a psychological treatment. The Serotonin TransporterPromoter Polymorphism (5HTTLPR) has been associated withresponsivity to the environment. Specifically, the short (S) allele hasbeen associated with increased depression in the presence of stress,and with better outcomes in the absence of stress, and may thus be amarker of environmental responsivity.Methods: We examined the role of the SS genotype in predictinganxiety diagnosis and response to CBT in child anxiety disorders,using a gene–environment interaction approach. Children aged 6–13 years with a primary diagnosis of anxiety disorder undergoingCBT provided DNA (N = 559, 357 from white European ancestry).Results: There was an association between the 5HTTLPR andtreatment response at follow-up. Individuals with the SS genotypewere 20 % more likely than the SL/LL group, to be free oftheir primary or all anxiety diagnoses by follow-up. This findingwas independent of significant influences of pre-treatment symptomseverity, and comorbid mood disorder on treatment response. Childrenwith the SS genotype also showed a significantly greaterreduction in symptom severity by follow-up than those with theother genotypes.Discussion: Treatment offers the ideal opportunity to test for gene–environment interaction with a positive environment, and as thetiming can be predicted this design allows for pre-treatment assessment.If replicated, these findings suggest that in time it could bepossible to predict which children are least likely to benefit from CBTalone and would benefit from an enhanced treatment package.

U2 - 10.1007/s10519-012-9566-6

DO - 10.1007/s10519-012-9566-6

M3 - Meeting abstract

VL - 42

SP - 932

EP - 932

JO - Behavior Genetics

JF - Behavior Genetics

SN - 0001-8244

IS - 6

ER -