title: The interaction between child maltreatment, adult stressful life events and the 5-HTTLPR in major depression.
abstract: Both childhood maltreatment and adult stressful life events are established risk factors for the onset of depression in adulthood. However, the interaction between them can be viewed through two conflicting frameworks. Under a mismatch hypothesis stressful childhoods allow 'adaptive programming' for a stressful adulthood and so can be protective. Only when childhood and adulthood do not match is there a risk of behavioural problems. Alternatively, under the cumulative stress hypothesis we expect increased risk with each additional stressor. It has also been suggested that an individual's genetic background may determine the extent they undergo adaptive programming, and so which of these two hypotheses is relevant. In this study we test for an interaction between exposure to childhood maltreatment and adult stressful life events in a retrospective sample of 455 individuals, using major depression as the outcome. We also test whether this interaction differs by genotype at the 5-HTTLPR, a candidate for an individual's plasticity to adaptive programming. Early maltreatment and stressful life events in adulthood interacted to produce increased risk for depression over each individually (p = 0.055). This supports the cumulative stress hypothesis over the mismatch hypothesis, at least with respect to severe environmental risk factors. This effect was not altered by 5-HTTLPR allele, suggesting there was no difference by genotype in adaptive programming to these events. We suggest that the apparent additional vulnerability to stressful events of those who have experienced maltreatment has clinical relevance, highlighting the importance of providing support beyond the immediate aftermath of maltreatment into adulthood.
authors.affiliation: MRC Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, King's College London, London, UK. robert.r.power@kcl.ac.uk
authors.forename: Robert A
authors.initials: RA
authors.lastname: Power
authors.forename: Lucy
authors.initials: L
authors.lastname: Lecky-Thompson
authors.forename: Helen L
authors.initials: HL
authors.lastname: Fisher
authors.forename: Sarah
authors.initials: S
authors.lastname: Cohen-Woods
authors.forename: Georgina M
authors.initials: GM
authors.lastname: Hosang
authors.forename: Rudolf
authors.initials: R
authors.lastname: Uher
authors.forename: Georgia
authors.initials: G
authors.lastname: Powell-Smith
authors.forename: Robert
authors.initials: R
authors.lastname: Keers
authors.forename: Maria
authors.initials: M
authors.lastname: Tropeano
authors.forename: Ania
authors.initials: A
authors.lastname: Korszun
authors.forename: Lisa
authors.initials: L
authors.lastname: Jones
authors.forename: Ian
authors.initials: I
authors.lastname: Jones
authors.forename: Michael J
authors.initials: MJ
authors.lastname: Owen
authors.forename: Nick
authors.initials: N
authors.lastname: Craddock
authors.forename: Ian W
authors.initials: IW
authors.lastname: Craig
authors.forename: Anne E
authors.initials: AE
authors.lastname: Farmer
authors.forename: Peter
authors.initials: P
authors.lastname: McGuffin
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D002649:Child Abuse / Q000523:psychology*; D004252:DNA Mutational Analysis; D003865:Major Depressive Disorder / Q000150:complications / Q000235:genetics / Q000523:psychology; D005260:Female; D020022:Genetic Predisposition to Disease / Q000235:genetics*; D005838:Genotype; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D050486:Serotonin Plasma Membrane Transport Proteins / Q000235:genetics*; D013315:Stress, Psychological / Q000150:complications*; D011795:Surveys and Questionnaires; D055815:Young Adult
chemical_list: C493230:SLC6A4 protein, human; D050486:Serotonin Plasma Membrane Transport Proteins