Holly K. Orcutt

Childhood abuse and maltreatment is a worldwide problem, with prevalence rates generally reported to be around 30% of the population (e.g., Briere & Elliott, 2003), and the deleterious effects of t...

Psychiatric conditions share common genes, but mechanisms that differentiate diagnoses remain unclear. We present a multidimensional framework for functional analysis of rare copy number variants (CNVs) across 6 diagnostic categories, including schizophrenia (SCZ), autism (ASD), bipolar disorder (BD), depression (MDD), PTSD, and ADHD (N = 574,965). Using gene-set burden analysis (GSBA), we tested duplication (DUP) and deletion (DEL) burden across 2,645 functional gene sets defined by the intersections of pathways, cell types, and cortical regions. While diagnoses converge on shared pathways, mixed-effects modeling revealed divergence of pathway effects by cell type, brain region, and gene dosage. Factor analysis identified latent dimensions aligned with clinical axes. A primary factor (F1) captured reciprocal dose-dependent effects of DUP and DEL in SCZ reflecting positive and negative effects in excitatory versus inhibitory neurons and association versus sensory cortex. SCZ and ASD were both strongly aligned with F1 but with opposing directionalities. Orthogonal factors highlighted neuronal versus non-neuronal effects in mood disorders (F2) and differential spatial distributions of DEL effects in ADHD and MDD (F3). High-impact CNVs at 16p11.2 and 22q11.2 were enriched for combinations of cell-type-specific genes involved in pathways consistent with our broader findings. These results reveal molecular and cellular mechanisms that are broadly shared across psychiatric traits but differ between diagnostic categories in context and directionality.

Post-traumatic stress disorder (PTSD) genetics are characterized by lower discoverability than most other psychiatric disorders. The contribution to biological understanding from previous genetic studies has thus been limited. We performed a multi-ancestry meta-analysis of genome-wide association studies across 1,222,882 individuals of European ancestry (137,136 cases) and 58,051 admixed individuals with African and Native American ancestry (13,624 cases). We identified 95 genome-wide significant loci (80 new). Convergent multi-omic approaches identified 43 potential causal genes, broadly classified as neurotransmitter and ion channel synaptic modulators (for example, GRIA1, GRM8 and CACNA1E), developmental, axon guidance and transcription factors (for example, FOXP2, EFNA5 and DCC), synaptic structure and function genes (for example, PCLO, NCAM1 and PDE4B) and endocrine or immune regulators (for example, ESR1, TRAF3 and TANK). Additional top genes influence stress, immune, fear and threat-related processes, previously hypothesized to underlie PTSD neurobiology. These findings strengthen our understanding of neurobiological systems relevant to PTSD pathophysiology, while also opening new areas for investigation.

The literature demonstrates that posttraumatic stress disorder (PTSD) rates are estimated to be higher on college campuses compared to lifetime estimates in the general population. Written exposure therapy (WET) is a promising brief intervention for posttraumatic stress symptoms (PTSS) with a growing literature of evidence suggesting efficacy, lower drop‐out rates compared to other evidence‐based protocols, and long‐term treatment gains. This proof‐of‐concept study examined the efficacy of WET delivered via telehealth compared to expressive writing (EW), the protocol from which WET was derived. The sample included non–treatment‐seeking trauma‐exposed undergraduate students (N = 33) with elevated PTSS. The results suggest that both WET, g = 1.26, and EW, g = 0.61, were associated with within‐person decreases in PTSS. However, reliable change indices indicated that a significantly larger proportion of individuals in the WET condition (61.5%) demonstrated reliable symptom improvement compared to those who received EW (20.0%), g = 0.91. Contrary to our hypotheses, the WET and EW groups did not differ on reliable slopes of change; however, between‐group effects were underpowered and should be interpreted with caution. These findings offer preliminary support for WET delivered via telehealth, including for individuals with subthreshold PTSS.

A wealth of research has consistently identified two distinct callous unemotional (CU) variants that differ on etiological mechanisms. While the first variant has been posited to represent a genetically predisposed difference in lower emotional arousal, the secondary variant demonstrates overlap with trauma-related symptomatology. Limited research has examined whether these CU variants differ based on child maltreatment subtypes or whether symptom profiles for CU variants differ by male-identified and female-identified participants. We aimed to replicate findings that individuals in the secondary CU group demonstrate higher PTSS. In an undergraduate sample of youth ages 18 to 24 (N = 546; 55.5% female), the present study examined whether CU variants could be identified utilizing latent profile analysis including CU trait clusters (i.e., callousness, uncaring, unemotional), anxiety, and child maltreatment subtypes. We identified unique symptom profiles by male-identified and female-identified gender. CU variant groups were differentiated based on the severity of child maltreatment experiences and anxiety symptoms. The manifestation of CU symptoms differed by variant group and by gender. Additionally, PTSS was highest in secondary CU variant groups. The findings support the conceptualization of the secondary CU variant group as a trauma-based reaction and suggest potential differences in symptom profiles by gender.

This study investigated preshooting emotion dysregulation and posttraumatic cognitions as predictors of mental health service utilization ([MHU]; i.e., therapy/medication) among undergraduate women following a campus mass shooting, controlling for time, age, and postshooting posttraumatic stress (PTS) and depressive symptoms. Undergraduate women (N = 483, M_age = 19.23, SD = 2.39) were engaged in a study when a mass shooting occurred on Northern Illinois University's campus. A separate, longitudinal study was then implemented to monitor postshooting adjustment among these same women. The present study examined predictors of MHU using data from the preshooting assessment and the following postshooting timepoints: 9 months (T1; n = 416); 14 months (T2; n = 416); 20 months (T3; n = 417); 26 months (T4; n = 405); and 33 months (T5; n = 397). Multilevel models showed preshooting emotion dysregulation and postshooting PTS and depressive symptoms positively predicted increased likelihood of MHU while controlling for covariates. Posttraumatic cognitions initially predicted increased therapy utilization, but this relationship became nonsignificant after accounting for preshooting emotion dysregulation. Preshooting emotion dysregulation also weakened the positive relationship between depressive symptoms and therapy utilization and strengthened the positive relationship between age and therapy utilization. Preshooting emotion dysregulation and postshooting mental health symptoms were the most robust predictors of increased MHU following a mass shooting. Findings suggest women exposed to a mass shooting engage in treatment when needed, but preexisting emotion dysregulation may serve as a barrier for those who go on to develop depression. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Research suggests that the overuse of maladaptive emotion regulation strategies, such as avoidance, represents a vulnerability following trauma exposure. Conversely, self-compassion, which impacts emotion regulation through the acceptance of negative emotions, may be an adaptive strategy for managing posttraumatic stress (PTS). An experimental design was used to examine whether a single-session of self-compassion training improved self-compassion and decreased difficulties in emotion regulation, compared to muscle relaxation training, for trauma-exposed undergraduates. Findings replicated previous research among these three constructs (PTS, self-compassion, and difficulties with emotion regulation), with relationships found in the expected directions. However, there was not conclusive evidence to suggest that participating in a brief self-compassion intervention was more effective for reducing difficulties with emotion regulation than participating in a muscle relaxation training intervention. Results supported inverse associations between self-compassion and posttraumatic stress, as well as self-compassion and difficulties with emotion regulation. Future research is needed to investigate how self-compassion skills training can be best utilized to produce clinically significant and long-lasting changes in emotion regulation. (PsycInfo Database Record (c) 2021 APA, all rights reserved).