title: Differential Vulnerability to Early-Life Parental Death: The Moderating Effects of Family Suicide History on Risks for Major Depression and Substance Abuse in Later Life.
abstract: Only a portion of those individuals exposed to parental death in early life (PDE) develop behavioral health disorders. We utilized demographic pedigree data from the Utah Population Database to test for differential vulnerability to PDE by creating a risk score of familial susceptibility to suicide (FS) at the population level. Using logistic panel regression models, we tested for multiplicative interactions between PDE and FS on the risks of major depressive disorder (MDD) and substance abuse (SA), measured using Medicare claims, after age 65. The final sample included 155,983 individuals (born 1886-1944), yielding 1,431,060 person-years at risk (1992-2009). Net of several potential confounders, including probability of survival to age 65, we found an FS × PDE interaction for females, in which PDE and FS as main effects had no impact but jointly increased MDD risk. No statistically significant main or interactive effects were found for SA among females or for either phenotype among males. Our findings are consistent with a differential vulnerability model for MDD in females, in which early-life stress increases the risk for poor behavioral health only among the vulnerable. Furthermore, we demonstrate how demographic and pedigree data might serve as tools for investigating differential vulnerability hypotheses.
authors.affiliation: a Department of Sociology , University of Utah , Salt Lake City , UT , USA.
authors.forename: Michael S
authors.initials: MS
authors.lastname: Hollingshaus
authors.affiliation: b Department of Psychiatry , University of Utah , Salt Lake City , UT , USA.
authors.forename: Hilary
authors.initials: H
authors.lastname: Coon
authors.affiliation: c Department of Psychology , University of Utah , Salt Lake City , UT , USA.
authors.forename: Sheila E
authors.initials: SE
authors.lastname: Crowell
authors.affiliation: b Department of Psychiatry , University of Utah , Salt Lake City , UT , USA.
authors.forename: Douglas D
authors.initials: DD
authors.lastname: Gray
authors.affiliation: d Department of Family and Preventive Medicine , University of Utah , Salt Lake City , UT , USA.
authors.forename: Heidi A
authors.initials: HA
authors.lastname: Hanson
authors.affiliation: e Population Sciences , Huntsman Cancer Institute , Salt Lake City , UT , USA.
authors.forename: Richard
authors.initials: R
authors.lastname: Pimentel
authors.affiliation: f Human Development & Family Studies , University of Utah , Salt Lake City , UT , USA.
authors.forename: Ken R
authors.initials: KR
authors.lastname: Smith
mesh_terms: D000328:Adult; D000368:Aged; D016208:Databases, Factual; D003865:Major Depressive Disorder / Q000523:psychology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D063129:Parental Death / Q000523:psychology*; D012044:Regression Analysis; D012737:Sex Factors; D013315:Stress, Psychological / Q000523:psychology*; D019966:Substance-Related Disorders / Q000523:psychology*; D013405:Suicide / Q000523:psychology* / Q000706:statistics & numerical data*; D016019:Survival Analysis; D014589:Utah; D055815:Young Adult