5HTT is associated with the phenotype psychological flexibility : results from a randomized clinical trial


Gloster, Andrew T. ; Gerlach, Alexander L. ; Hamm, Alfons O. ; Höfler, Michael ; Alpers, Georg W. ; Kircher, Tilo ; Ströhle, Andreas ; Lang, Thomas ; Wittchen, Hans-Ulrich ; Deckert, Jürgen ; Reif, Andreas



DOI: https://doi.org/10.1007/s00406-015-0575-3
URL: https://www.researchgate.net/publication/270909027...
Weitere URL: https://link.springer.com/article/10.1007%2Fs00406...
Dokumenttyp: Zeitschriftenartikel
Erscheinungsjahr: 2015
Titel einer Zeitschrift oder einer Reihe: European Archives of Psychiatry and Clinical Neuroscience
Band/Volume: 265
Heft/Issue: 5
Seitenbereich: 399-406
Ort der Veröffentlichung: Berlin ; Heidelberg ; Darmstadt
Verlag: Springer ; Steinkopff
ISSN: 0940-1334 , 1433-8491
Sprache der Veröffentlichung: Englisch
Einrichtung: Fakultät für Sozialwissenschaften > Klinische u. Biologische Psychologie u. Psychotherapie (Alpers 2010-)
Fachgebiet: 150 Psychologie
Abstract: Adaption to changing environments is evolutionarily advantageous. Studies that link genetic and phenotypic expression of flexible adjustment to one's context are largely lacking. In this study, we tested the importance of psychological flexibility, or goal-related context sensitivity, in an interaction between psychotherapy outcome for panic disorder with agoraphobia (PD/AG) and a genetic polymorphism. Given the established role of the 5HTT-LPR polymorphism in behavioral flexibility, we tested whether this polymorphism (short group vs. long group) impacted therapy response as a function of various endophenotypes (i.e., psychological flexibility, panic, agoraphobic avoidance, and anxiety sensitivity). Patients with PD/AG were recruited from a large multicenter randomized controlled clinical trial on cognitive-behavioral therapy. Pre- to post-treatment changes by 5HTT polymorphism were analyzed. 5HTT polymorphism status differentiated pre- to post-treatment changes in the endophenotype psychological flexibility (effect size difference d = 0.4, p < 0.05), but none of the specific symptom-related endophenotypes consistently for both the intent-to-treat sample (n = 228) and the treatment completers (n = 194). Based on the consistency of these findings with existing theory on behavioral flexibility, the specificity of the results across phenotypes, and the consistency of results across analyses (i.e., completer and intent to treat), we conclude that 5HTT polymorphism and the endophenotype psychological flexibility are important variables for the treatment of PD/AG. The endophenotype psychological flexibility may help bridge genetic and psychological literatures. Despite the limitation of the post hoc nature of these analyses, further study is clearly warranted.




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