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.
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.
| Original language | English |
|---|---|
| Pages (from-to) | 932-932 |
| Number of pages | 1 |
| Journal | Behavior Genetics |
| Volume | 42 |
| Issue number | 6 |
| DOIs | |
| Publication status | Published - Nov 2012 |
| Event | 42nd Annual Meeting of the Behavior-Genetics-Association - Edinburgh Duration: 22 Jun 2012 → 25 Jun 2012 |