JAMA：儿童期遭受虐待埋下悲伤“种子”
and child abuse measured using the traumatic events inventory and 8 SNPs spanning the FKBP5 locus.
Results Level of child abuse and non–child abuse trauma each separately predicted level of adult PTSD symptomatology (mean [SD], PTSD Symptom Scale for no child abuse, 8.03 [10.48] vs 
2 types of abuse, 20.93 [14.32]; and for no non–child abuse trauma, 3.58 [6.27] vs 4 types, 16.74 [12.90]; P < .001). Although FKBP5 SNPs did not directly predict PTSD symptom outcome or interact with level of non–child abuse trauma to predict PTSD symptom severity, 4 SNPs in the FKBP5 locus significantly interacted (rs9296158, rs3800373, rs1360780, and rs9470080; minimum P = .0004) with the severity of child abuse to predict level of adult PTSD symptoms after correcting for multiple testing. This gene x environment interaction remained significant when controlling for depression severity scores, age, sex, levels of non–child abuse trauma exposure, and genetic ancestry. This genetic interaction was also paralleled by FKBP5 genotype-dependent and PTSD-dependent effects on glucocorticoid receptor sensitivity, measured by the dexamethasone suppression test.
Conclusions Four SNPs of the FKBP5 gene interacted with severity of child abuse as a predictor of adult PTSD symptoms. There were no main effects of the SNPs on PTSD symptoms and no significant genetic interactions with level of non–child abuse trauma as predictor of adult PTSD symptoms, suggesting a potential gene-childhood environment interaction for adult PTSD.
Author Affiliations: Departments of Psychiatry and Behavioral Sciences (Drs Binder, Bradley, Liu, Gillespie, Heim, Nemeroff, Schwartz, Cubells, and Ressler, and Mr Deveau) and Human Genetics (Drs Binder, Epstein, Tang, and Cubells, and Ms Mercer), Emory University School of Medicine and Yerkes National Primate Research Center (Dr Ressler), Atlanta, Georgia; Beijing Institute of Microbiology and Epidemiology, Beijing, China (Dr Liu); Atlanta VA Medical Center, Atlanta, Georgia (Dr Bradley); and Howard Hughes Medical Institute, Chevy Chase, Maryland (Dr Ressler).
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