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Initial Clinical Evidence of Genetic Contributions to Posttraumatic Stress Disorder

  • John H. Krystal
  • Linda M. Nagy
  • Ann Rasmusson
  • Andrew Morgan
  • Cheryl Cottrol
  • Steven M. Southwick
  • Dennis S. Charney
Part of the The Plenum Series on Stress and Coping book series (SSSO)

Abstract

There are few topics in the field of traumatic stress studies that clinicians approach more ambivalently than considerations of genetic factors associated with vulnerability or resistance to traumatization. Historically, individuals suffering from combat-related posttraumatic stress disorder (PTSD) received diagnoses including “soldier’s heart” or “neurocirculatory asthenia,” and were frequently viewed as possessing characteristics that cast them in a disparaging light, such as “constitutional inferiority” and “lack of virility” (Campbell, 1918; see Krystal et al., 1989). Early studies implicated race as an important factor influencing the vulnerability to psychological stress (cf. Dunn, 1942). However, these studies attempted to use flawed clinical data to support widely held societal prejudices against minority groups, similar to early misguided efforts to characterize the inheritance of intelligence (Gould, 1981). Similarly, German authorities abused genetic arguments to justify denying the claims of Jewish survivors of the Nazi concentration camps for reparation for long-term psychiatric sequelae of their traumatization (Eisler, 1963/1964, 1967; Kestenberg, 1980). The relatively greater progress made in characterizing the environmental factors that influence subsequent stress response, such as the importance of early childhood trauma (Herman, 1992; Krystal, 1988) and the impact of parental traumatization on parent—child relationships (Danieli, 1980; Oliver, 1993; Rosenheck, 1986), further compounds concerns about overestimating genetic factors associated with PTSD.

Keywords

Anxiety Disorder Panic Disorder Posttraumatic Stress Disorder Traumatic Stress Inescapable Shock 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

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References

  1. American Psychiatric Association. (1980). Diagnostic and statistical manual of mental disorders ( 3rd ed ). Washington, DC: Author.Google Scholar
  2. Andreason, N. C., Endicott, J., Spitzer, R. L. and Winokur, G. (1977). The family history method using diagnostic criteria, reliability and validity. Archives of General Psychiatry, 34, 1229–1235.CrossRefGoogle Scholar
  3. Anisman, H., Grimmer, L., Irwin, J., Remington, G., and Sklar, L. S. (1979). Escape performance after inescapable shock in selectively bred lines of mice: Response maintenance and catecholamine activity. Journal of Comparative Physiology and Psychology, 93, 229–241.CrossRefGoogle Scholar
  4. Breslau, N., Davis, G. C., Andreski, P, and Peterson, E. (1991). Traumatic events and posttraumatic stress disorder in an urban population of young adults. Archives of General Psychiatry, 48, 216–222.PubMedCrossRefGoogle Scholar
  5. Burnam, M. A., Stein, J. A., Golding, J. M., Siegel, J. M., Sorenson, S. B., Forsythe, A. B., and Telles, C. A. (1988). Sexual assault and mental disorders in a community population. Journal of Consulting Clinical Psychology, 56, 843–850.CrossRefGoogle Scholar
  6. Cadoret, R. J., O’Gorman, T. W., Troughton, E., and Hayweood, E. (1985). Alcoholism and antisocial personality: Interrelationships, genetic and environmental factors. Archives of General Psychiatry, 42, 161–167.PubMedCrossRefGoogle Scholar
  7. Campbell, C. M. (1918). The role of instinct, emotion and personality in disorders of the heart: with suggestions for a clinical record. Journal of the American Medical Association, 71, 1621–1626.CrossRefGoogle Scholar
  8. Centers for Disease Control Vietnam Experience Study. (1988). Health status of Vietnam veterans: I. Psychosocial characteristics. Journal of the American Medical Association, 259, 2701–2707.CrossRefGoogle Scholar
  9. Chapman, T. E, Mannuzza, S., Klein, D. E, and Fyer, A. J. (1994). Effects of informant mental disorder on psychiatric family history data. American Journal of Psychiatry, 151, 574–579.Google Scholar
  10. Charney, D. S., Deutch, A., Krystal, J. H., Southwick, S. M., and Davis, M. (1993). Psychobiological mechanisms of posttraumatic stress disorder. Archives of General Psychiatry, 50, 294–305.Google Scholar
  11. Charney, D. S., Woods, S. W, Krystal, J. H., Nagy, L. M., and Heninger, G. R. (1992). Noradrenergic neuronal dysregulation in panic disorder: The effects of intravenous yohimbine and clonidine in panic disorder patients. Acta Psychiatrica Scandinavia, 86, 273–282.CrossRefGoogle Scholar
  12. Cloninger, C. R. (1991). Neurogenetic adaptive mechanisms in alcoholism. Science, 236, 410–416.CrossRefGoogle Scholar
  13. Cowen, E. L., and Work, W. C. (1988). Resilient children, psychological wellness, and primary prevention. American Journal of Community Psychology, 16, 591–607.PubMedCrossRefGoogle Scholar
  14. Crowe, R. R. (1974). An adoption study of antisocial personality. Archives of General Psychiatry, 31, 785–791.PubMedCrossRefGoogle Scholar
  15. Danieli, Y. (1980). Families of survivors of the Nazi Holocaust, some long and some short term effects. In N. Milgram (Ed.), Psychological Stress and Adjustment in Time of War and Peace, Washington, DC: Hemisphere.Google Scholar
  16. Davidson, J., Smith, R., and Kudler, H. (1989). Familial psychiatric illness in chronic posttraumatic stress disorder. Comprehensive Psychiatry, 30, 345–399.Google Scholar
  17. Davidson, J., Swartz, Z., Storck, M., Krishnan, R., and Hammett, E. (1985). A diagnostic and familial study of post-traumatic stress disorder. American Journal of Psychiatry, 142, 90–93.PubMedGoogle Scholar
  18. Dunn, W. H. (1942). Emotional factors in neurocirculatory asthenia. Psychosomatic Medicine, 4, 333–354.Google Scholar
  19. Egendorf, A., Kadushin, C., Laufer, R. S., Rothbart, G., and Sloan, L. (1981). Legacies of Vietnam: Comparative adjustment of veterans and their peers. New York: Center for Research Policy.Google Scholar
  20. Eisler, K. R. (1963/1964). Die ermordung von wieveilen seiner KINDER muss ein Mensch symptomfrei ertragen können, um eine normale Konstitution zu haben? [The murder of how many of one’s children must a person be able to bear, without symptoms, in order to be considered to have a normal constitution?] Psyche,5(17), 241–291.Google Scholar
  21. Eisler, K. R. (1967). Perverted psychiatry? American Journal of Psychiatry, 123, 1352–1358.Google Scholar
  22. Farber, S. L. (1981). Identical twins reared apart: A reanalysis. New York: Basic Books.Google Scholar
  23. Garmezy, N., Masten, A. S., Tellegen, A. (1984). The study of stress and competence in children: A building block for developmental psychopathology. Child Development, 55, 97–111.PubMedCrossRefGoogle Scholar
  24. Gleser, G. C., Green, B. L., and Winget, C. (1981). Prolonged psychosocial effects of disaster: A study of Buffalo Creek. New York: Academic Press.Google Scholar
  25. Gould, S. J. (1981). The mismeasure of man. New York: Norton.Google Scholar
  26. Helzer, J. E., Robbins, L. N., and McEvoy, L. (1987). Post-traumatic stress disorder in the general population: Findings of the Epidemiologic Catchment Area Survey. New England Journal of Medicine, 317, 1630–1634.PubMedCrossRefGoogle Scholar
  27. Herman, J. L. (1992). Trauma and recovery. New York: Basic Books.Google Scholar
  28. Hyman, S. E., and Nestler, E. J., (1993). The molecular foundations of psychiatry. Washington, DC: American Psychiatric Association Press.Google Scholar
  29. Kadden, R. M., Cooney, N. L., Getter, H., and Litt, M. D. (1989). Matching alcoholics to coping skills or interactional therapies: Posttreatment results. Journal of Consulting and Clinical Psychology, 698–704.Google Scholar
  30. Kagan, J., Reznick, J. S., and Snidman, N. (1988). Biological basis of childhood shyness. Science, 240, 167–171.PubMedCrossRefGoogle Scholar
  31. Kendler, K. S., and Eaves, L. J. (1986). Models for the joint effect of genotype and environment on liability to psychiatric illness. American Journal of Psychiatry, 143, 279–289.PubMedGoogle Scholar
  32. Kendler, K. S., Kessler, R. C., Walters, E. E., MacLean, C., Neale, M. C., Heath, A. C., and Eaves, L. J. (1995). Stressful life events, genetic liability, and onset of an episode of major depression in women. American Journal of Psychiatry, 152, 833–842.PubMedGoogle Scholar
  33. Kendler, K. S., Silberg, J. L., Neale, M. C., Kessler, R. C., Heath, A. C., and Eaves, L. J. (1991). The family history method: Whose psychiatric history is measured? American Journal of Psychiatry, 148, 1501–1504.PubMedGoogle Scholar
  34. Kestenberg, M. ( 1980, August). Discriminatory aspects of the German restitution: Law and practice. Paper presented to the First World Congress of Victimology, Washington, DC.Google Scholar
  35. Kety, S. S. (1987). The significance of genetic factors in the etiology of schizophrenia: Results from the National Study of Adoptees in Denmark. Journal of Psychiatric Research, 21, 423–429.PubMedCrossRefGoogle Scholar
  36. Kilpatrick, D. G., Saunders, B. E., Amick-McMullan, A., Best, C. L., Veronen, L. J., and Resnick, H. S. (1989). Victim and crime factors associated with the development of crime-related post-traumatic stress disorder. Behavior Therapy, 20, 199–214.CrossRefGoogle Scholar
  37. Kosten, T. R., Rounsaville, B. J., Kosten, T. A., and Merikangas, K. (1991). Gender differences in the specificity of alcoholism transmission among the relatives of opioid addicts. Journal of Nervous and Mental Diseases, 179, 392–400.CrossRefGoogle Scholar
  38. Krystal, H. (1988). Integration and self-healing: Affect, trauma, alexithymia. Hillsdale, NJ: Analytic Press.Google Scholar
  39. Krystal, J. H. (1990). Animal models for post-traumatic stress disorder. In E. Giller (Ed.), The Biological Assessment and Treatment of PTSD (pp. 3–26 ). Washington, DC: American Psychiatric Association Press.Google Scholar
  40. Krystal, J. H., Kosten, T. R., Perry, B. D., Southwick, S., Mason, J. W, Giller, E. L., Jr. (1989). Neurobiological aspects of PTSD: Review of clinical and preclinical studies. Behavioral Therapy, 20, 177–198.CrossRefGoogle Scholar
  41. Kulka, R. A., Schienger, W. E., Fairbank, J. A., Hough, R. L., Jordan, B. K., Marmar, C. R., and Weiss, D. S. (1990). Trauma and the Vietnam war generation: Report of findings from the National Vietnam Veterans Readjustment Study. New York: Brunner/Maze].Google Scholar
  42. Lyons, J. A. (1991). Strategies for assessing the potential for positive adjustment following trauma. Journal of Traumatic Stress, 4, 93–111.CrossRefGoogle Scholar
  43. Lyons, M. J., Goldberg, J., Eisen, S. A., True, W., Tsuang, M. T., Meyer, J. M., and Henderson, W. G. (1993). Do genes influence exposure to trauma? A twin study of combat. American Journal of Medicinal Genetics (Neuropsychiatric Genetics), 48, 22–27.CrossRefGoogle Scholar
  44. McFarlane, A. C. (1988). The etiology of post-traumatic stress disorders following a natural disaster. British Journal of Psychiatry, 152, 116–121.PubMedCrossRefGoogle Scholar
  45. Mellman, T. A., and Davis, G. C. (1985). Combat-related flashbacks in posttraumatic stress disorder: Phenomenology and similarity to panic attacks. Journal of Clinical Psychiatry, 46, 379–382.PubMedGoogle Scholar
  46. Nagy, L. M., Morgan, C. A., III, Miller, H. L., Southwick, S. M., Merikangas, K. R., Krystal, J. H., and Charney, D. S. (in review). Genetic epidemiology of panic attacks and noradrenregic response in post-traumatic stress disorder: A family history study.Google Scholar
  47. Oliver, J. E. (1993). Intergenerational transmission of child abuse: Rates, research, and clinical implications. American Journal of Psychiatry, 150, 1315–1324.PubMedGoogle Scholar
  48. Orvaschel, J., Thompson, W D., Belanger, A., Prusoff, B. A., and Kidd, K. K. (1982). Comparison of the family history method to direct interview: Factors affecting the diagnosis of depression. Journal of Affective Disorders, 4, 49–59.PubMedCrossRefGoogle Scholar
  49. Rainey, J. M., Aleem, A., Ortiz, A., Yeragani, V, Pohl, R., and Berchou, R. (1987). A laboratory procedure for the induction of flashbacks. American Journal of Psychiatry, 144, 1317–1319.PubMedGoogle Scholar
  50. Reist, C., Kauffmann, C. D., Haier, R., Sangdahl, C., DeMet, E. M., Chicz-DeMet, A., and Nelson, J. N. (1989). A controlled trial of desipramine in 18 men with posttraumatic stress disorder. American Journal of Psychiatry, 146, 513–516.PubMedGoogle Scholar
  51. Rosenbaum, J. F., Biederman, J., Gersten, M., Hirschfeld, D. R., Meminger, S. R., Herman, J. B., Kagan, J., Reznick, J. S., and Snidman, N. (1988). Behavioral inhibition in children of parents with panic disorder and agoraphobia: A control study. Archives of General Psychiatry, 45, 463–470.PubMedCrossRefGoogle Scholar
  52. Rosenbaum, J. F., Biederman, J., Hirschfeld, D. R., Bolduc, E. A., Faraone, S. V., Kagan, J., Snidman, N., Reznick, J. S. (1991). Further evidence of an association between behavioral inhibition and anxiety disorders: Results from a family study of children from a nonclinical sample. Journal of Psychiatric Research, 25, 49–65.PubMedCrossRefGoogle Scholar
  53. Rosenheck, R. (1986). Impact of post-traumatic stress disorder of World War II on the next generation. Journal ofNervous and Mental Disease, 174, 319–327.CrossRefGoogle Scholar
  54. Shanks, N., and Anisman, H. (1989). Strain-specific effects of antidepressants on escape deficits induced by inescapable shock. Psychopharmacology, 99, 122–128.PubMedCrossRefGoogle Scholar
  55. Sierles, E S., Chen, J. J., McFarland, R. E., and Taylor, M. A. (1983). Posttraumatic stress disorder and concurrent psychiatric illness: A preliminary report. American Journal of Psychiatry, 140, 1177–1179.PubMedGoogle Scholar
  56. Skre, I., Onstad, S., Torgersen, S., Lygren, S., and Kringlen, E. (1993). A twin study of DSM-III-R anxiety disorders. Acta Psychiatrica Scandinavia, 88, 85–92.CrossRefGoogle Scholar
  57. Solomon, S. D., and Canino, G. J. (1990). Appropriateness of DSM-III-R criteria for posttraumatic stress disorder. Comprehensive Psychiatry, 31, 227–237.PubMedCrossRefGoogle Scholar
  58. Solomon, Z., Kotler, M., and Mikulincer, M. (1988). Combat-related posttraumatic stress disorder among second-generation Holocaust survivors: Preliminary findings. American Journal of Psychiatry, 145, 865–868.PubMedGoogle Scholar
  59. Southwick, S. M., Krystal, J. H., Bremner, J. D., Morgan, C. A., III, Nicolaou, A., Navy, L. M., Johnson, D. R., Heninger, G. R., Charney, D. S. (1997). Noradrenergic and serotonergic function in post-traumatic stress disorder. Archives of General Psychiatry, 54, 246–254.PubMedCrossRefGoogle Scholar
  60. Southwick, S. M., Krystal, J. H., Morgan, C. A., Johnson, D. R., Nagy, L. M., Nicolau, A., Heninger, G. R., Charney, D. S. (1993). Abnormal noradrenergic function in post traumatic stress disorder. Archives of General Psychiatry, 50, 266–274.PubMedCrossRefGoogle Scholar
  61. Speed, N., Engdahl, B., Schwartz, J., and Eberly, R. (1989). Posttraumatic stress disorder as a consequence of the POW experience. Journal of Nervous and Mental Diseases, 177, 147–153.CrossRefGoogle Scholar
  62. True, W. R., Rice, J., Eisen, S. A., Heath, A. C., Goldberg, J., Lyons, M. J., and Nowak, J. (1993). A twin study of genetic and environmental contributions to liability for posttraumatic stress symptoms. Archives of General Psychiatry, 50, 257–264.PubMedCrossRefGoogle Scholar
  63. Ursano, R. J., Wheatley, R., Sledge, W, Rahe, A., and Carlson, E. (1986). Coping and recovery styles in the Vietnam era prisoner of war. Journal of Nervous and Mental Disease, 174, 707–714.PubMedCrossRefGoogle Scholar
  64. Zacharko, R. M., Lalonde, G. T., Kasian, M., and Anisman, H. (1987). Strain-specific effects of inescapable shock on intracranial self-stimulation from nucleus accumbens. Brain Research, 426, 164–168.PubMedCrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media New York 1998

Authors and Affiliations

  • John H. Krystal
    • 1
  • Linda M. Nagy
    • 1
  • Ann Rasmusson
    • 1
  • Andrew Morgan
    • 1
  • Cheryl Cottrol
    • 1
  • Steven M. Southwick
  • Dennis S. Charney
    • 1
  1. 1.Clinical Neurosciences DivisionNational Center for PTSD, VA Connecticut Healthcare SystemWest HavenUSA

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