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Extended Swedish Adoption Study of Adverse Stress Responses and Posttraumatic Stress Disorder

Amstadter, Ananda B. ; Abrahamsson, Linda LU ; Cusack, Shannon ; Sundquist, Jan LU ; Sundquist, Kristina LU and Kendler, Kenneth S. (2024) In JAMA Psychiatry 81(8). p.817-824
Abstract

IMPORTANCE Twin studies have found that posttraumatic stress disorder (PTSD) is influenced by both genetic and environmental factors within a generation. No study has used an adoption design, which can address questions about the degree and sources of cross-generational transmission of adverse stress responses (ASRs) and PTSD. OBJECTIVES To examine whether ASRs or PTSD are transmitted from parents to offspring, and to clarify the relative importance of genes and rearing. DESIGN, SETTING, AND PARTICIPANTS This cohort study used nationwide Swedish registry data from parents and offspring (n = 2 194 171, born 1960-1992) of 6 types of families (intact; had not lived with biological father; had not lived with biological mother; lived with... (More)

IMPORTANCE Twin studies have found that posttraumatic stress disorder (PTSD) is influenced by both genetic and environmental factors within a generation. No study has used an adoption design, which can address questions about the degree and sources of cross-generational transmission of adverse stress responses (ASRs) and PTSD. OBJECTIVES To examine whether ASRs or PTSD are transmitted from parents to offspring, and to clarify the relative importance of genes and rearing. DESIGN, SETTING, AND PARTICIPANTS This cohort study used nationwide Swedish registry data from parents and offspring (n = 2 194 171, born 1960-1992) of 6 types of families (intact; had not lived with biological father; had not lived with biological mother; lived with stepfather; lived with stepmother; and adoptive). Follow-up occurred on December 31, 2018, and data were analyzed from March 3, 2023, to January 16, 2024. EXPOSURES Three sources of parent-offspring resemblance: genes plus rearing, genes only, and rearing only. MAIN OUTCOMES AND MEASURES Diagnoses of ASRs or PTSD were obtained from national inpatient, outpatient, and primary care medical registries. Parent-child resemblance was assessed by tetrachoric correlation. Sensitivity analyses were conducted to control for possible shared traumatic events. RESULTS The study population included 2 194 171 individuals of 6 family types (1 146 703 [52.3%] male; median [range] age, 42 [20-63] years). The weighted tetrachoric correlations across family types were 0.15 (95% CI, 0.15-0.16) for genes plus rearing, 0.08 (95% CI, 0.06-0.11) for genes only, and 0.10 (95% CI, 0.07-0.12) for rearing only. Controlling for potential shared traumatic events, sensitivity analyses found that the correlation for rearing decreased, with the most conservative control (exclusion of parent-offspring dyads with onset of ASRs or PTSD within 1 year) suggesting equal correlations with genes and rearing. CONCLUSIONS AND RELEVANCE Diagnosis of ASRs or PTSD demonstrated cross-generational transmission, including both genetic and rearing correlations. Sensitivity analyses suggested that shared traumatic events partially accounted for the observed rearing correlations.

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author
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organization
publishing date
type
Contribution to journal
publication status
published
subject
in
JAMA Psychiatry
volume
81
issue
8
pages
8 pages
publisher
American Medical Association
external identifiers
  • pmid:38837143
  • scopus:85195847361
ISSN
2168-622X
DOI
10.1001/jamapsychiatry.2024.1140
language
English
LU publication?
yes
id
36d40a08-f544-477e-8ef9-997e5f314e43
date added to LUP
2024-09-09 09:53:22
date last changed
2024-09-10 03:00:16
@article{36d40a08-f544-477e-8ef9-997e5f314e43,
  abstract     = {{<p>IMPORTANCE Twin studies have found that posttraumatic stress disorder (PTSD) is influenced by both genetic and environmental factors within a generation. No study has used an adoption design, which can address questions about the degree and sources of cross-generational transmission of adverse stress responses (ASRs) and PTSD. OBJECTIVES To examine whether ASRs or PTSD are transmitted from parents to offspring, and to clarify the relative importance of genes and rearing. DESIGN, SETTING, AND PARTICIPANTS This cohort study used nationwide Swedish registry data from parents and offspring (n = 2 194 171, born 1960-1992) of 6 types of families (intact; had not lived with biological father; had not lived with biological mother; lived with stepfather; lived with stepmother; and adoptive). Follow-up occurred on December 31, 2018, and data were analyzed from March 3, 2023, to January 16, 2024. EXPOSURES Three sources of parent-offspring resemblance: genes plus rearing, genes only, and rearing only. MAIN OUTCOMES AND MEASURES Diagnoses of ASRs or PTSD were obtained from national inpatient, outpatient, and primary care medical registries. Parent-child resemblance was assessed by tetrachoric correlation. Sensitivity analyses were conducted to control for possible shared traumatic events. RESULTS The study population included 2 194 171 individuals of 6 family types (1 146 703 [52.3%] male; median [range] age, 42 [20-63] years). The weighted tetrachoric correlations across family types were 0.15 (95% CI, 0.15-0.16) for genes plus rearing, 0.08 (95% CI, 0.06-0.11) for genes only, and 0.10 (95% CI, 0.07-0.12) for rearing only. Controlling for potential shared traumatic events, sensitivity analyses found that the correlation for rearing decreased, with the most conservative control (exclusion of parent-offspring dyads with onset of ASRs or PTSD within 1 year) suggesting equal correlations with genes and rearing. CONCLUSIONS AND RELEVANCE Diagnosis of ASRs or PTSD demonstrated cross-generational transmission, including both genetic and rearing correlations. Sensitivity analyses suggested that shared traumatic events partially accounted for the observed rearing correlations.</p>}},
  author       = {{Amstadter, Ananda B. and Abrahamsson, Linda and Cusack, Shannon and Sundquist, Jan and Sundquist, Kristina and Kendler, Kenneth S.}},
  issn         = {{2168-622X}},
  language     = {{eng}},
  month        = {{08}},
  number       = {{8}},
  pages        = {{817--824}},
  publisher    = {{American Medical Association}},
  series       = {{JAMA Psychiatry}},
  title        = {{Extended Swedish Adoption Study of Adverse Stress Responses and Posttraumatic Stress Disorder}},
  url          = {{http://dx.doi.org/10.1001/jamapsychiatry.2024.1140}},
  doi          = {{10.1001/jamapsychiatry.2024.1140}},
  volume       = {{81}},
  year         = {{2024}},
}