Post-traumatic stress disorder has genetic aspect, study says

CHICAGO — Groundbreaking research suggests genes help explain why some people can recover from a traumatic event while others experience post-traumatic stress disorder (PTSD).

Though preliminary, the study provides insight into a condition expected to strike increasing numbers of military veterans returning from combat in Iraq and Afghanistan, one health expert said.

Researchers found that specific variations in a stress-related gene appeared to be influenced by trauma, in this case child abuse, at a young age. That interaction strongly increased the chances for adult survivors of abuse to develop signs of PTSD, including debilitating anxiety, irritability and insomnia.

Among adult survivors of severe child abuse, those with the specific gene variations scored more than twice as high (31) on a scale of post-traumatic stress, compared with those without the variations (13).

The worse the abuse, the stronger the risk in people with those gene variations.

The study of 900 adults is among the first to show that genes can be influenced by outside, nongenetic factors to trigger signs of PTSD. It is the largest of two reports to show molecular evidence of a genetic influence on PTSD.

"We have known for over a decade, from twin studies, that genetic factors play a role in vulnerability to developing PTSD, but have had little success in identifying specific genetic variants that increase risk of the disorder," said Karestan Koenen, a Harvard psychologist doing similar research.

The results of the new study suggest there are critical periods in childhood when the brain is vulnerable "to outside influences that can shape the developing stress-response system," said Emory University researcher and study co-author Dr. Kerry Ressler.

The study appears in the new issue of the Journal of the American Medical Association. Several study authors, including Ressler, reported having financial ties to makers of psychiatric drugs.

Ressler said there are probably many other gene variants that contribute to risks for PTSD, and others may be more strongly linked to the disorder than the ones the researchers focused on.

About 250,000 Americans will develop PTSD at some point. Rates are much higher in war veterans and people living in high-crime areas.

Dr. Thomas Insel, director of the National Institute of Mental Health, said the study is valuable for the light it sheds on military veterans.

He said the results help explain differences in how two people see the same roadside bomb blast. One simply experiences it as "a bad day but goes back and is able to function." The other later develops paralyzing stress symptoms.

"This could be quite a wave that will hit us over the months and years ahead," said Insel, whose agency paid for the study.