ABSTRACT
OBJECTIVE: This study investigated a potential interaction between the triallelic polymorphism of the serotonin transporter gene (SLC6A4) promoter and the experience of childhood trauma on the number of problem eating behaviors. METHOD: The study sample was comprised of 439 (64.7% female) Caucasian college students (mean age = 22.49, SD = 6.12). Participants completed questionnaires that assessed eating problems and experience of trauma in childhood (ages 0-12) and donated cheek cells for 5-HTTLPR and rs25531 genotyping. RESULTS: Women carrying a lower expressing allele (i.e., L(G) or S) who were exposed to higher levels of childhood trauma reported significantly higher mean numbers of eating problems (gender × genotype × trauma interaction, p = .006). DISCUSSION: These results are consistent with findings that the lower expressing alleles of the SLC6A4 promoter are associated with increased sensitivity to the negative impact of childhood stressors on adult behavioral outcomes.
Subject(s)
Adult Survivors of Child Abuse/psychology , Feeding and Eating Disorders/genetics , Feeding and Eating Disorders/psychology , Gene-Environment Interaction , Serotonin Plasma Membrane Transport Proteins/genetics , Adolescent , Adult , Alleles , Female , Gene Frequency , Genotype , Humans , Polymorphism, Genetic , Promoter Regions, Genetic , Surveys and Questionnaires , White People/genetics , WomenABSTRACT
(1) Indian Health Service (HIS) per patient funding is less than half of national per capita health spending, and declined further between 2003 and 2006. (2) Under-funding of the IHS system has led to explicit rationing of services to American Indian and Alaska Native patients, with many specialized services provided only for "life or limb threatening" conditions. (3) IHS patients report experiencing access barriers and rate the quality of care process substantially lower than do Medicaid beneficiaries, but most indicate they prefer to use IHS for their health care. (4) Options to increase the funding for American Indian and Alaska Native health care exist, but would impose higher costs on federal and state budgets and are unlikely to be feasible in the current economic environment. However, IHS might be able to make certain organizational changes that would increase efficiency and its ability to extend existing funding to cover more services.
Subject(s)
Financing, Government/organization & administration , Health Services Accessibility/economics , Quality Assurance, Health Care/economics , United States Indian Health Service/organization & administration , Adult , Child , Child Health Services , Health Care Surveys , Humans , Indians, North American , Interinstitutional Relations , Medicaid , Medicare , Patient Satisfaction , State Government , United StatesABSTRACT
The factors that influence individual differences in decision making are not yet fully characterized, but convergent evidence is accumulating that implicates serotonin (5-HT) system function. Therefore, both genes and environments that influence serotonin function are good candidates for association with risky decision making. In the present study we examined associations between common polymorphisms in the serotonin transporter gene (SLC6A4; 5-HTTLPR and rs25531), the experience of childhood trauma and decision making on the Iowa gambling task (IGT) in 391 (64.5% female) healthy Caucasian adults. Homozygosity for the 5-HTTLPR L allele was associated with riskier decision making in the first block of 20 trials (i.e., decision making under ambiguity, p = 0.004). In addition, mean IGT performance was significantly worse in blocks 3-5 (i.e., decision making under risk, p ≤ 0.05) for those participants who reported experiencing higher levels of childhood trauma. Our findings add to the growing evidence that genetic variation in the 5-HT system is associated with individual differences in decision making under ambiguity; and we report that the experience of childhood trauma is associated with relatively poor decision making under risk.