Temporal relations between alcohol use, posttraumatic stress disorder, and internalizing symptoms during the COVID-19 pandemic: An ecological momentary assessment investigation.

OBJECTIVE: COVID-19 is a collective stressor associated with both increased mental health symptoms and increased frequency of alcohol use. These increases highlight the need for investigations into the functional relationships between traumatic stress symptoms and alcohol use in the wake of the pandemic. This study sought to use ecological momentary assessment to examine the temporal association of posttraumatic stress disorder (PTSD) with alcohol use during the COVID-19 pandemic. METHOD: Participants were 21 students (Mage = 21.0; 86% female, 23.9% White) from a large, mid-Atlantic public university. Ecological momentary assessment data on PTSD symptoms, internalizing psychopathology, affect, and alcohol consumption were collected via twice daily surveys for a 14-day period. RESULTS: Increased negative affect predicted an increase in alcohol consumption at the next assessment. Increased alcohol consumption predicted increased subsequent negative affect, anxiety symptoms, and depressive symptoms. Findings did not support a relationship between PTSD symptoms and alcohol consumption in either direction. CONCLUSIONS: Results suggest a bidirectional, cyclical relationship between alcohol consumption and internalizing psychopathology broadly, rather than PTSD specifically, during the pandemic. Interventions for alcohol consumption on college campuses may benefit from targeting internalizing symptoms, such as through facilitating the development of adaptive coping strategies. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

A Narrative Commentary on the Use of a Rational Emotive Behavior Therapy-Informed Group to Address Irrational Beliefs, Posttraumatic Stress Disorder, and Comorbidities.

Irrational beliefs of Demandingness, Catastrophizing, Low Frustration Tolerance, and Depreciation have demonstrated prevalence in disparate areas of life, including psychopathology, the military, politics, religion, and education. Individuals with mental health concerns, such as Post-Traumatic Stress Disorder (PTSD), endorse elevations in such thoughts compared to the general population. This commentary describes the rationale for focusing on irrational beliefs in efforts to address PTSD and presents the Rational Emotive Behavior Therapy (REBT)-Informed Group for PTSD as a potential novel application of a well-established intervention. In support of these suggestions, we present a narrative review of the published work on irrational beliefs and REBT tenets as relevant for PTSD. We then introduce and describe the REBT-Informed Group intervention, summarize the prior preliminary research conducted by our group, and present some novel data from a re-analysis of this prior work. We end with commentary related to future directions of REBT approaches for PTSD to address limitations and expand the impact of the treatment to military and other Veteran or civilian populations.

Genetic and environmental influences on alpha amylase stress reactivity and shared genetic covariation with cortisol.

Salivary alpha amylase (sAA) is a common measure of stress reactivity, primarily reflecting sympathetic nervous system activity. Salivary cortisol is also a reliable, frequently used biomarker of stress and reflects the hypothalamic-pituitary-adrenal (HPA) axis response. This study examined heritability across varying metrics of sAA in response to a social evaluative stressor, the Trier Social Stress Test (TSST). The goal of this study was to estimate genetic and environmental influences on measurements of sAA stress reactivity. Moreover, we evaluated the shared genetic covariation between sAA and cortisol. Participants included twins aged 15-20 years (54% female). We measured alpha amylase and cortisol reactivity to the TSST via serial salivary cortisol samples collected pre- and post-TSST. Modest to moderate heritability estimates (11-64%) were observed across measures purported to capture alpha amylase stress reactivity (peak, area under the curve, baseline-to-peak change). Findings also indicate that sAA baseline and peak are primarily influenced by a shared genetic factor. There was no evidence of shared genetic influences between sAA and cortisol. These findings suggest the genetic control of the HPA and Sympathetic Adreno-Medullar axis are genetically independent of one another despite both playing a role in response to stressors.

The effect of a reduction in irrational beliefs on Posttraumatic Stress Disorder (PTSD), depression, and anxiety symptoms in a group treatment for post-9/11 Veterans.

Previous research has indicated that a Rational Emotive Behavior Therapy (REBT)-Informed Group focused on changing irrational beliefs to address comorbid depression and anxiety (as well as anger and guilt) in a combat Veteran population diagnosed with Posttraumatic Stress Disorder (PTSD) demonstrated significant reductions in depression and PTSD symptoms at posttreatment. However, mechanisms of change associated with improvement have not been evaluated. REBT theory suggests that a decline in irrational beliefs predicts a decrease in PTSD, depression, and anxiety symptoms. This study aimed to test this tenet of REBT theory in a naturalistic treatment setting. Participants (N = 86) were post-9/11 combat Veterans, engaged in the REBT-Informed Group between October 2016 and February 2020. Results of hierarchical multiple regression analyses indicated that a reduction in irrational beliefs predicted notable decreases in PTSD, depression, and anxiety symptoms controlling for several covariates. This study extends previous research demonstrating the success of the REBT-Informed Group with combat Veterans and gives support to REBT theory regarding the effect of a decline in irrational beliefs. Future directions include replication of findings with Veterans who experienced military sexual trauma (MST), pre-9/11 Veterans, those at other military or Veterans Affairs (VA) medical centers, and civilians to determine generalizability.

The longitudinal buffering effects of resilience on alcohol use outcomes.

OBJECTIVE: Traumatic events (TE) are a risk factor for alcohol use disorder (AUD). Resilience may be protective of the effects of TE exposure, but few studies have longitudinally tested the buffering hypothesis. Thus, the present study aimed to fill this gap. METHOD: Participants (N = 6,015) were from a longitudinal investigation into substance use and health outcomes at a large, urban university. Participants completed self-report measures on precollege internalizing symptoms and lifetime trauma load. Resilience was calculated as a quantitative variable. At each of the follow-up assessments, participants reported on past month consumption, AUD symptoms, and new onset TEs. Longitudinal path modeling was used to test interactions. RESULTS: Higher new onset TE load was associated with greater AUD symptoms, and higher consumption at one time-point. Results demonstrate a significant main effect of resilience at Y1S and Y3S, and a significant interaction between resilience and new onset TE at the last time-point, whereby higher levels of new onset TE were associated with higher levels of AUD symptoms at low (ß = .19, p < .001), and average (ß = .20, p = .001) levels of resilience. This effect was attenuated at high levels of resilience (ß = .07, p = .051). No significant main nor interaction effects of resilience on consumption were found. CONCLUSIONS: Findings suggest resilience as an important protective factor in relation to the development of AUD symptoms after exposure to a TE, though perhaps less so in relation to consumption. Findings are consistent with prior work demonstrating that AUD symptoms are more clinically relevant than consumption in this population. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Differences in genetic correlations between posttraumatic stress disorder and alcohol-related problems phenotypes compared to alcohol consumption-related phenotypes.

BACKGROUND: Posttraumatic Stress Disorder (PTSD) tends to co-occur with greater alcohol consumption as well as alcohol use disorder (AUD). However, it is unknown whether the same etiologic factors that underlie PTSD-alcohol-related problems comorbidity also contribute to PTSD- alcohol consumption. METHODS: We used summary statistics from large-scale genome-wide association studies (GWAS) of European-ancestry (EA) and African-ancestry (AA) participants to estimate genetic correlations between PTSD and a range of alcohol consumption-related and alcohol-related problems phenotypes. RESULTS: In EAs, there were positive genetic correlations between PTSD phenotypes and alcohol-related problems phenotypes (e.g. Alcohol Use Disorders Identification Test (AUDIT) problem score) (rGs: 0.132-0.533, all FDR adjusted p < 0.05). However, the genetic correlations between PTSD phenotypes and alcohol consumption -related phenotypes (e.g. drinks per week) were negatively associated or non-significant (rGs: -0.417 to -0.042, FDR adjusted p: <0.05-NS). For AAs, the direction of correlations was sometimes consistent and sometimes inconsistent with that in EAs, and the ranges were larger (rGs for alcohol-related problems: -0.275 to 0.266, FDR adjusted p: NS, alcohol consumption-related: 0.145-0.699, FDR adjusted p: NS). CONCLUSIONS: These findings illustrate that the genetic associations between consumption and problem alcohol phenotypes and PTSD differ in both strength and direction. Thus, the genetic factors that may lead someone to develop PTSD and high levels of alcohol consumption are not the same as those that lead someone to develop PTSD and alcohol-related problems. Discussion around needing improved methods to better estimate heritabilities and genetic correlations in diverse and admixed ancestry samples is provided.

Examining interactions between polygenic scores and interpersonal trauma exposure on alcohol consumption and use disorder in an ancestrally diverse college cohort.

Introduction: Genetic factors impact alcohol consumption and use disorder (AUD), with large-scale genome-wide association studies (GWAS) identifying numerous associated variants. Aggregate genetic methods in combination with important environmental factors (e.g., interpersonal trauma [IPT]) can be applied to expand our understanding of the ways by which genetic and environmental variables work together to influence alcohol consumption and disordered use. The present study aimed to detail the relationships between genome-wide polygenic scores (PGS) for alcohol phenotypes (i.e., alcohol consumption and AUD status) and IPT exposure as well as the interaction between them across ancestry. Methods: Data were drawn from the Spit for Science (S4S) study, a US college student population, where participants reported on IPT exposure prior to college and alcohol consumption and problems during college (N = 9,006; ancestry: 21.3% African [AFR], 12.5% Admixed Americas [AMR], 9.6% East Asian [EAS], 48.1% European [EUR], 8.6% South Asian [SAS]). Two trans-ancestry PGS were constructed, one for alcohol consumption and another for AUD, using large-scale GWAS summary statistics from multiple ancestries weighted using PRS-CSx. Regression models were applied to test for the presence of associations between alcohol-PGS and IPT main and interaction effects. Results: In the meta-analysis across ancestry groups, IPT exposure and PGS were significantly associated with alcohol consumption (ßIPT = 0.31, P IPT = 0.0002; ßPGS = 0.09, P PGS = 0.004) and AUD (ORIPT = 1.12, P IPT = 3.5 × 10-8; ORPGS = 1.02, P PGS = 0.002). No statistically significant interactions were detected between IPT and sex nor between IPT and PGS. When inspecting ancestry specific results, the alcohol consumption-PGS and AUD-PGS were only statistically significant in the EUR ancestry group (ßPGS = 0.09, P PGS = 0.04; ORPGS = 1.02, P PGS = 0.022, respectively). Discussion: IPT exposure prior to college was strongly associated with alcohol outcomes in this college-age sample, which could be used as a preventative measure to identify students at high risk for problematic alcohol use. Additionally, results add to developing evidence of polygenic score association in meta-analyzed samples, highlighting the importance of continued efforts to increase ancestral representation in genetic studies and inclusive analytic approaches to increase the generalizability of results from genetic association studies.

COVID and college: how the pandemic impacted alcohol use disorder status among students.

Objective: Alcohol consumption patterns during the COVID-19 pandemic have varied notably. Participants: We examined the acute impact of the pandemic on alcohol use disorder (AUD) in a generalizable sample of college students who were surveyed pre-pandemic and re-surveyed in May 2020. Method: Items assessed pre-pandemic included DSM-5 AUD and mental health symptoms. A COVID-19 impacts questionnaire was administered, and alcohol and mental health items re-assessed. Results: AUD symptoms decreased from pre-pandemic to during the pandemic, demonstrating a change in trajectory compared to prior cohorts. Students with persistent AUD reported greater concurrent symptoms of PTSD, depression, and alcohol consumption than those with remitted AUD (ps ≤ .02), but not increased COVID-19 impact. Persistent AUD status was predicted by higher sensation seeking and alcohol consumption. Conclusions: Students with concurrent mental health problems are at continued risk for persistent AUD. Findings highlight the impact of the college environment and social context for drinking on AUD.

Alcohol use and alcohol use disorder differ in their genetic relationships with PTSD: A genomic structural equation modelling approach.

PURPOSE: Posttraumatic Stress Disorder (PTSD) is associated with increased alcohol use and alcohol use disorder (AUD), which are all moderately heritable. Studies suggest the genetic association between PTSD and alcohol use differs from that of PTSD and AUD, but further analysis is needed. BASIC PROCEDURES: We used genomic Structural Equation Modeling (genomicSEM) to analyze summary statistics from large-scale genome-wide association studies (GWAS) of European Ancestry participants to investigate the genetic relationships between PTSD (both diagnosis and re-experiencing symptom severity) and a range of alcohol use and AUD phenotypes. MAIN FINDINGS: When we differentiated genetic factors for alcohol use and AUD we observed improved model fit relative to models with all alcohol-related indicators loading onto a single factor. The genetic correlations (rG) of PTSD were quite discrepant for the alcohol use and AUD factors. This was true when modeled as a three-correlated-factor model (PTSD-AUD rG:.36, p < .001; PTSD-alcohol use rG: -0.17, p < .001) and as a Bifactor model, in which the common and unique portions of alcohol phenotypes were pulled out into an AUD-specific factor (rG with PTSD:.40, p < .001), AU-specific factor (rG with PTSD: -0.57, p < .001), and a common alcohol factor (rG with PTSD:.16, NS). PRINCIPAL CONCLUSIONS: These results indicate the genetic architecture of alcohol use and AUD are differentially associated with PTSD. When the portions of variance unique to alcohol use and AUD are extracted, their genetic associations with PTSD vary substantially, suggesting different genetic architectures of alcohol phenotypes in people with PTSD.

Modeling the association between and predictors of two constructs of resilience.

PURPOSE: Resilience serves as a protective factor against adverse outcomes following exposure to traumatic events. The extant literature focuses on psychiatric resilience in the context of internalizing symptoms, though resilience is also important in relation to externalizing symptoms. Research is needed to clarify the predictors of resilience across contexts. The aims of the current study are twofold: 1. Determine the association between psychiatric resilience (PR) and alcohol resistance (AR) and 2. Test for differential prediction of each form of resilience by exogenous predictors. METHODS: The sample (n = 7585) was drawn from the Virginia Adult Twin Studies of Psychiatric and Substance Use Disorders (VATSPSUD). Participants completed measures of internalizing symptoms, exposure to stressful life events, DSM alcohol abuse and dependence symptoms, maximum alcohol consumption, personality variables, and social support. All cross-sectional, structural equation modeling (SEM) analyses were conducted using Mplus software version 8.2. RESULTS: A single common factor model provided adequate fits for both PR and AR. In the full measurement model the correlation between the two resilience factors was estimated (r = 0.28, SE = 0.018, p < 0.001). Neuroticism and mastery predicted AR and PR, but differentially, with a stronger effect size for PR (neuroticism: B = 0.35, p < 0.001; mastery: B = - 0.36, p < 0.001). The positive social support factor did not predict either resilience variable, while interpersonal conflict was associated with both (AR = 0.09, p < 0.001; PR = 0.07, p < 0.001). CONCLUSIONS: Findings extend the current literature on resilience in two ways. First, rigorous measurement model based definitions of two resilience variables are specified. Second, external validation of the AR and PR constructs is carried out using latent variable modeling techniques. The modest correlation suggests resilience may not be well-characterized by a single general attribute. Findings provide further evidence for predictors of resilience by way of displaying differential patterns of prediction effect sizes of PR and AR.

Diagnostic validity of the PC-PTSD screen in college students.

Objective: The purpose of this study was to test the diagnostic validity of the Primary Care PTSD screen (PC-PTSD) in a generalizable college sample and to examine potential differences in its predictive efficacy according to sex and racial/ethnic identity. An exploratory aim was to determine whether PC-PTSD symptom items differentially predicted PTSD diagnostic status. Participants: Data from 475 undergraduates were analyzed. Methods: Logistic regressions were conducted to examine the relationship between different PC-PTSD endorsement thresholds and probable PTSD among various subsamples. Follow-up tests of diagnostic accuracy were performed. Results: Results of this study indicated that the PC-PTSD identified PTSD among college students with poor accuracy. Furthermore, the PC-PTSD did not demonstrate equal predictive validity across neither sex nor racial/ethnic identity. Endorsement of reexperiencing symptoms appeared to be the strongest predictor of PTSD. Conclusions: Results highlight the clear need for a validated PTSD screener effective for a diverse college population.

Does Prior Civilian Trauma Moderate the Relationship Between Combat Trauma and Post-deployment Mental Health Symptoms?

In addition to combat trauma, childhood and adult non-military, interpersonal trauma exposures have been linked to a range of psychiatric symptoms (e.g., alcohol use problems, posttraumatic stress disorder [PTSD], depression symptoms) in veterans. However, few studies simultaneously explore the associations between these civilian and combat trauma types and mental health outcomes. Using a sample of combat-exposed veterans who were previously deployed to Iraq and Afghanistan (N = 302), this study sought to (a) understand the independent associations of civilian interpersonal trauma (i.e., childhood trauma and non-military adult trauma) and combat-related trauma with post-deployment alcohol use, PTSD symptoms, and depressive symptoms, respectively and (b) to examine the interactive effects of trauma type to test whether childhood and non-military adult trauma moderate the association of combat trauma with these outcomes. A path analytic framework was used to allow for the simultaneous prediction of these associations. In the final model non-military adult trauma and combat trauma were found to be significantly associated with PTSD symptoms and depression symptoms, but not average amount of drinks consumed per drinking day. Childhood trauma was not associated with any outcomes (i.e., PTSD symptoms, depression symptoms, average amount of drinks consumed per day). Only combat trauma was significantly associated with average amount of drinks consumed per day. Results underscore the importance of assessing multiple trauma types and considering trauma as a non-specific risk factor, as different trauma types may differentially predict various mental health outcomes other than PTSD. Further, results highlight the noteworthiness of considering co-occurring outcomes within the veteran community. Limitations, future directions, and implications of diversity are discussed.

Effectiveness of a Rational Emotive Behavior Therapy (REBT)-Informed Group for Post-9/11 Veterans with Posttraumatic Stress Disorder (PTSD).

Various treatments aimed for posttraumatic stress disorder (PTSD) have been developed for veterans, but many are not formatted for use in groups, do not address common psychiatric comorbidities, and include inherent barriers (e.g., substantial time commitment). This program evaluation study aimed to examine the effectiveness of a five-session treatment, a Rational Emotive Behavior Therapy (REBT)-Informed Group focused on changing irrational beliefs to address comorbid depression and anxiety (as well as anger and guilt) among post-9/11 veterans with PTSD. Participants (n = 47) completing the REBT-Informed Group demonstrated significant reductions at posttreatment in depression and PTSD symptoms. Compared to veterans in a ten-session treatment-as-usual group (n = 47), there was no significant difference in PTSD symptom improvement despite the reduction in number of sessions. The study demonstrates that a five-week group treatment for PTSD comorbid with depression or anxiety in post-9/11 veterans - a therapy that may be uniquely suited to a military or veteran population, but potentially generalizable to civilians as well - can lead to significant reductions in depression and PTSD symptoms. Future directions include development of a manual for dissemination and replication of findings of the REBT-Informed Group to other military or Veterans Affairs medical centers.

Potential causal effect of posttraumatic stress disorder on alcohol use disorder and alcohol consumption in individuals of European descent: A Mendelian Randomization Study.

BACKGROUND: Posttraumatic stress disorder (PTSD) often co-occurs with alcohol consumption (AC) and alcohol use disorder (AUD). However, it is unknown whether the same etiologic influences that underlie PTSD co-occurring with AUD are those that underlie PTSD and AC individually. METHODS: This study used large-scale genome-wide association study (GWAS) data to test whether PTSD and drinks per week [DPW]/AUD are causally related to one another, and, if so, whether PTSD precedes DPW/AUD and/or vice versa. We used Mendelian Randomization methods to analyze European ancestry GWAS summary statistics from the Psychiatric Genomics Consortium (PGC; PTSD), GWAS & Sequencing Consortium of Alcohol and Nicotine Use (GSCAN; DPW), and the Million Veteran Program (MVP; AUD). RESULTS: PTSD exerted a potentially causal effect on AUD (ß = 0.039, SE = 0.014, p = 0.005), but not on DPW (ß = 0.002, SE = 0.003, p = 0.414). Additionally, neither DPW (ß = 0.019, SE = 0.041, p = 0.637) nor AUD (ß = 8.87 × 10-4 , SE = 0.001, p = 0.441) exerted a causal effect on PTSD. CONCLUSIONS: These findings are consistent with the self-medication model, in which individuals misuse alcohol to cope with aversive trauma-related symptoms. These findings extend latent analysis and molecular findings of shared and correlated risk between PTSD and alcohol phenotypes. Given the health behaviors associated with these phenotypes, these findings are important in that they suggest groups to prioritize for prevention efforts. Further, they provide a rationale for future preclinical and clinical studies examining the biological mechanisms by which PTSD may impact AUD.

Longitudinal Examination of the Impact of Resilience and Stressful Life Events on Alcohol Use Disorder Outcomes.

Stressful life events (SLEs) are a risk factor for alcohol use problems, and there is a need for identification of factors that may offset this risk. Resilience is uniquely, inversely associated with alcohol use, but there remains a dearth of research examining the buffering effect of resilience toward alcohol use problems in the context of SLEs. Objectives: This study used prospective data from an epidemiological twin sample (N = 7441) to test whether resilience at Time 1 would act as a buffer for new onset SLEs (e.g. assault, marital problems) against risk for alcohol dependence (AD) symptoms at Time 2. Results: The final model, adjusted for familial relatedness and controlling for demographic covariates and Time 1 (lifetime) AD symptoms, identified significant main effects of resilience and SLEs; those with greater resilience at Time 1 reported fewer symptoms (ß=-.087, p<.001) and those with greater new-onset SLEs reported greater symptoms (ß=.116, p<.001) at Time 2. However, there was no significant interaction (ß=-.008, p>.05). Conclusions: Although findings further support the association of resilience and SLEs with AD, results do not support the conceptualization of resilience as a buffer against the impact of future life stressors on alcohol use outcomes. This suggests other factors may be more relevant for understanding protective factors for alcohol use problems or the relation between resilience and SLEs on alcohol use outcomes.

Psychiatric Resilience and Alcohol Resistance: A Twin Study of Genetic Correlation and Sex Differences.

Variability in psychiatric response following stressful/traumatic life events is frequently observed. There is also variability in propensity for alcohol use disorder (AUD) such that some can consume substantial amounts and not develop AUD symptoms whereas others develop an AUD. Our group has applied discrepancy-based approaches to capture psychiatric resilience (PR) and alcohol resistance (AR), both moderately heritable. This study sought to (1) examine the genetic and environmental correlation of these constructs and (2) model qualitative and quantitative sex effects. Data came from a large twin sample (N = 4501 twin pairs) with self-report measures and interviews assessing distress symptoms, stressful life events, alcohol use, and AUD. Correlated liability model results suggested a moderate degree of genetic correlation between PR and AR (0.54) due to the same genetic factors in males and females. Findings highlight the shared genetic predisposition of these resilience/resistance constructs while emphasizing the impact of unique environmental experiences.

Intraindividual association of PTSD symptoms with binge drinking among trauma-exposed students.

People, particularly undergraduate students, who report elevated symptoms of posttraumatic stress disorder (PTSD) are at elevated risk of binge drinking. The present study used ecological momentary assessment to (a) evaluate whether PTSD severity, specifically, or psychological distress, generally, are associated with binge drinking and (b) examine the self-medication and susceptibility models of the comorbidity of PTSD with binge drinking while accounting for shared liability (i.e., the between-person association of PTSD symptom severity with binge drinking). Within a larger study of undergraduate student mental health, for 14 days, students who reported a potentially traumatic experience (N = 276) reported nightly on use of alcohol and psychoactive substances and thrice daily on current affect, internalizing symptoms, and PTSD symptoms. Daily binge drinking, per the NIAAA definition, was analyzed using multivariate mixed effects, multilevel logistic regression. Results support the self-medication model; participants were more likely to binge drink on days marked by elevated PTSD symptoms, OR = 2.82, p < .01. Binge drinking was also more likely on weekends, OR = 4.21, p < .0001, and days marked by elevated daily positive affect, OR = 1.60, p < .001. Binge drinking was not associated with concurrent depressive or general anxiety symptoms (p > .30). PTSD symptoms were not associated with use of cannabis or other substances (p > .06). Regarding the susceptibility model, following a binge drinking episode, participants reported elevated depressive symptoms, B = 0.34, p = .04, but no change in affect, PTSD symptoms, or general anxiety symptoms (p > .16). Results suggest that, beyond understanding who is at risk for binge drinking, fluctuations in PTSD severity clarify when students engage in binge drinking. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Genetic and environmental influences on cortisol reactivity to a psychosocial stressor in adolescents and young adults.

Individuals vary in their response to psychological and physiological stressors, and this reactivity can be captured using measures of cortisol. Previous research suggests cortisol reactivity is under some degree of genetic control; however, the measures used have varied widely. This study (N = 524) examined potential differences in heritability across varying cortisol metrics of stress reactivity following the Trier Social Stress Test (TSST) and whether these measures are genetically or environmentally interrelated. Participants included twins aged 15-20 years (56% female). Cortisol reactivity to the TSST was assessed via serial salivary cortisol samples collected pre- and post-TSST. Modest to moderate heritability estimates (12% [95CI: 1-36%] - 45% [95CI: 16-69%]) were observed across measures purported to capture stress reactivity (peak, area under the curve [AUC], baseline-to-peak change). Findings also demonstrate both shared and unique genetic and environmental influences between baseline cortisol and cortisol reactivity. Minimal to no additional genetic innovations above and beyond the contributions of peak cortisol were found for other measures of cortisol reactivity such as AUC. This study is one of the largest twin-based samples to examine the heritability of cortisol reactivity, and results suggest that simpler measures of cortisol reactivity demonstrate higher heritability compared to more complex measurements.

Epigenome-Wide Study of Posttraumatic Stress Disorder Symptom Severity in a Treatment-Seeking Adolescent Sample.

Emerging research has demonstrated that psychosocial trauma exposure may elicit epigenetic changes, with downstream effects on the transcriptional regulation of genes. Epigenome-wide association studies (EWAS) offer an agnostic approach to examine DNA methylation (DNAm) associations and are a valuable tool to aid in the identification of biological pathways involved in posttraumatic stress disorder (PTSD). This study represents the first EWAS of PTSD in an adolescent sample, an important group given the significance of this developmental period regarding both DNAm changes and PTSD risk. The sample (n = 39, M age = 15.41 years, SD = 1.27, 84.6% female) comprised adolescents who experienced interpersonal trauma and were enrolled in a treatment study. Participants were assessed using the UCLA PTSD Reaction Index for DSM-IV-Adolescent Version and provided a blood sample at baseline. Genomic DNA was isolated from whole blood and assayed using the Illumina Infinium MethylationEPIC BeadChip. The primary analysis estimated the associations among individual CpG sites and PTSD symptom scores. Of the 793,575 screened probes tested, two were significant at a false discovery rate (FDR) < 10%. Hypomethylation of both sites was associated with increased PTSD symptom scores. Analysis of differentially methylated regions (DMR) identified a DMR associated with PTSD symptom scores at an FDR < 10%. Results from follow-up models are also discussed. Findings from this preliminary investigation suggest the importance of further research conducted in adolescent samples. The analytic pipeline and results are documented for use in future meta-analytic work as more such samples become available.

Precollege and New-Onset College Interpersonal Trauma as Predictors of Baseline and Changes in Alcohol Use Disorder Symptoms During College.

College is a high-risk time for interpersonal trauma (IPT) exposure (e.g., physical or sexual abuse/assault), a potent form of trauma exposure. College is also a high-risk time for alcohol misuse, as use begins and increases in adolescence and peaks in the early/mid-20s. In addition, although IPT is associated with alcohol misuse, less clear is whether distal (prior to college) or proximal (during college) IPT impacts alcohol use disorder (AUD) symptoms at the beginning of college and/or changes in symptoms during college. Data were collected from a large, longitudinal study of college students, attending a large public university in the southeast, who had reported lifetime IPT as well as lifetime alcohol use. Participants in the current study were 18.5 years old (SD = 0.46), primarily female (67.2%), and of diverse racial backgrounds (e.g., 53.4% White, 18.5% Black, 12.7% Asian, 15.4% Other). Latent change score analyses were employed to test the impact of IPT prior to college and IPT during college on initial levels of, and changes in, AUD symptoms during college. Those who experienced an IPT prior to college reported more AUD symptoms at the beginning of college and less changes in AUD symptoms during the first year of college. Those who experienced an IPT in the first 2 and last 2 years of college reported greater increases in symptoms in the first 2 and last 2 years of college, respectively. Findings suggest that prevention and intervention efforts for those who experience an IPT prior to or during college may be useful in reducing AUD symptoms during that time period.