Association of Economic Status and Educational Attainment With Posttraumatic Stress Disorder: A Mendelian Randomization Study.

Journal: JAMA network open

Volume: 2

Issue: 5

Year of Publication: 2020

Affiliated Institutions:  Department of Psychiatry, Yale University School of Medicine, West Haven, Connecticut. Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, New York. Department of Psychiatry, School of Medicine, University of California, San Diego. Stanley Center for Psychiatric Research, Broad Institute, Cambridge, Massachusetts. Department of Psychiatry, Duke University, Durham, North Carolina. National Center for PTSD Behavioral Science Division, Veterans Affairs Boston Healthcare System, Boston, Massachusetts. South African Medical Research Council Unit on Risk and Resilience in Mental Disorders, Department of Psychiatry, University of Cape Town, Cape Town, South Africa. Department of Epidemiology, Harvard T.H. Chan School of Public Health, Harvard University, Boston, Massachusetts.

Abstract summary 

There is a well-established negative association of educational attainment (EA) and other traits related to cognitive ability with posttraumatic stress disorder (PTSD), but the underlying mechanisms are poorly understood.To investigate the association of PTSD with traits related to EA.Genetic correlation, polygenic risk scoring, and mendelian randomization (MR) were conducted including 23 185 individuals with PTSD and 151 309 control participants from the Psychiatric Genomics Consortium for PTSD and up to 1 131 881 individuals assessed for EA and related traits from UK Biobank, 23andMe, and the Social Science Genetic Association Consortium. Data were analyzed from July 3 through November 19, 2018.Genetic correlation obtained from linkage disequilibrium score regression, phenotypic variance explained by polygenic risk scores, and association estimates from MR.Summary association data from multiple genome-wide association studies were available for a total of 1 180 352 participants (634 391 [53.7%] women). Posttraumatic stress disorder showed negative genetic correlations with EA (rg = -0.26; SE = 0.05; P = 4.60 × 10-8). Mendelian randomization analysis, conducting considering a random-effects inverse-variance weighted method, indicated that EA has a negative association with PTSD (β = -0.23; 95% CI, -0.07 to -0.39; P = .004). Investigating potential mediators of the EA-PTSD association, propensity for trauma exposure and risk-taking behaviors were observed as risk factors for PTSD independent of EA (trauma exposure: β = 0.37; 95% CI, 0.19 to 0.52; P = 2.57 × 10-5; risk-taking: β = 0.76; 95% CI, 0.38 to 1.13; P = 1.13 × 10-4), while income may mediate the association of EA with PSTD (MR income: β = -0.18; 95% CI, -0.29 to -0.07; P = .001; MR EA: β = -0.23; 95% CI, -0.39 to -0.07; P = .004; multivariable MR income: β = -0.32; 95% CI, -0.57 to 0.07; P = .02; multivariable MR EA: β = -0.04; 95% CI, -0.29 to 0.21; SE, 0.13; P = .79).Large-scale genomic data sets add further evidence to the negative association of EA with PTSD, also supporting the role of economic status as a mediator in the association observed.

Authors & Co-authors:  Polimanti Renato R Ratanatharathorn Andrew A Maihofer Adam X AX Choi Karmel W KW Stein Murray B MB Morey Rajendra A RA Logue Mark W MW Nievergelt Caroline M CM Stein Dan J DJ Koenen Karestan C KC Gelernter Joel J

Study Outcome 

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Statistics
Citations :  DiGangi JA, Gomez D, Mendoza L, Jason LA, Keys CB, Koenen KC. Pretrauma risk factors for posttraumatic stress disorder: a systematic review of the literature. Clin Psychol Rev. 2013;33(6):-. doi:10.1016/j.cpr.2013.05.002
Authors :  12
Identifiers
Doi : e193447
SSN : 2574-3805
Study Population
Male,Female
Mesh Terms
Cognition
Other Terms
Study Design
Case Control Trial,Cross Sectional Study
Study Approach
Country of Study
Publication Country
United States