title: Psychological resilience and the gene regulatory impact of posttraumatic stress in Nepali child soldiers.
abstract: Adverse social conditions in early life have been linked to increased expression of proinflammatory genes and reduced expression of antiviral genes in circulating immune cells-the conserved transcriptional response to adversity (CTRA). However, it remains unclear whether such effects are specific to the Western, educated, industrialized, rich, and democratic (WEIRD) cultural environments in which previous research has been conducted. To assess the roles of early adversity and individual psychological resilience in immune system gene regulation within a non-WEIRD population, we evaluated CTRA gene-expression profiles in 254 former child soldiers and matched noncombatant civilians 5 y after the People's War in Nepal. CTRA gene expression was up-regulated in former child soldiers. These effects were linked to the degree of experienced trauma and associated distress-that is, posttraumatic stress disorder (PTSD) severity-more than to child soldier status per se. Self-perceived psychological resilience was associated with marked buffering of CTRA activation such that PTSD-affected former child soldiers with high levels of personal resilience showed molecular profiles comparable to those of PTSD-free civilians. These results suggest that CTRA responses to early life adversity are not restricted to WEIRD cultural contexts and they underscore the key role of resilience in determining the molecular impact of adverse environments.
authors.affiliation: Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, NC 27708; Duke Global Health Institute, Duke University, Durham, NC 27710; Transcultural Psychosocial Organization Nepal, Kathmandu 44616, Nepal; brandon.kohrt@duke.edu.
authors.forename: Brandon A
authors.identifier: 0000-0002-3829-4820
authors.initials: BA
authors.lastname: Kohrt
authors.affiliation: Department of Anthropology, Emory University, Atlanta, GA 30322;
authors.forename: Carol M
authors.initials: CM
authors.lastname: Worthman
authors.affiliation: Transcultural Psychosocial Organization Nepal, Kathmandu 44616, Nepal;
authors.forename: Ramesh P
authors.initials: RP
authors.lastname: Adhikari
authors.affiliation: Transcultural Psychosocial Organization Nepal, Kathmandu 44616, Nepal;
authors.forename: Nagendra P
authors.initials: NP
authors.lastname: Luitel
authors.affiliation: Division of Hematology-Oncology, Department of Medicine, University of California, Los Angeles School of Medicine, Los Angeles, CA 90095; Department of Psychiatry & Biobehavioral Sciences, University of California, Los Angeles School of Medicine, Los Angeles, CA 90095;
authors.forename: Jesusa M G
authors.initials: JM
authors.lastname: Arevalo
authors.affiliation: Division of Hematology-Oncology, Department of Medicine, University of California, Los Angeles School of Medicine, Los Angeles, CA 90095; Department of Psychiatry & Biobehavioral Sciences, University of California, Los Angeles School of Medicine, Los Angeles, CA 90095;
authors.forename: Jeffrey
authors.initials: J
authors.lastname: Ma
authors.affiliation: Division of Geriatrics, Department of Medicine, University of California, Los Angeles School of Medicine, Los Angeles, CA 90095;
authors.forename: Heather
authors.initials: H
authors.lastname: McCreath
authors.affiliation: Division of Geriatrics, Department of Medicine, University of California, Los Angeles School of Medicine, Los Angeles, CA 90095; Department of Epidemiology, University of California, Los Angeles School of Public Health, Los Angeles, CA 90095;
authors.forename: Teresa E
authors.initials: TE
authors.lastname: Seeman
authors.affiliation: Davis School of Gerontology, University of Southern California, Los Angeles, CA 90089.
authors.forename: Eileen M
authors.initials: EM
authors.lastname: Crimmins
authors.affiliation: Division of Hematology-Oncology, Department of Medicine, University of California, Los Angeles School of Medicine, Los Angeles, CA 90095; Department of Psychiatry & Biobehavioral Sciences, University of California, Los Angeles School of Medicine, Los Angeles, CA 90095;
authors.forename: Steven W
authors.initials: SW
authors.lastname: Cole
mesh_terms: D000328:Adult; D002648:Child; D006801:Humans; D008889:Military Personnel; D009390:Nepal; D055500:Resilience, Psychological; D013313:Stress Disorders, Post-Traumatic / Q000235:genetics; D013315:Stress, Psychological / Q000235:genetics*; D059467:Transcriptome; D014857:Warfare; D055815:Young Adult
keywords: biocultural anthropology; child abuse; global mental health; low-income countries; social genomics