This review discusses selected neurobiologic and genetic factors-including noradrenergic and hypothalamic-pituitary-adrenal axis markers, oxytocin pathways, and serotonin transporter and brain-derived neurotrophic factor gene polymorphisms-in the context of resilience to stress, with an emphasis on social support. Social support's impact on medical and psychiatric health outcomes is reviewed, and putative mediators are discussed. The reviewed literature indicates that social support is exceptionally important to maintaining good physical and psychological health in the presence of genetic, developmental, and other environmental risks. Future studies should continue to explore the neurobiologic factors associated with social support's contribution to stress resilience.
Trajectories of PTSD symptoms in WTC responders are heterogeneous and associated uniquely with pre-, peri- and post-trauma risk and protective factors. Police responders were more likely than non-traditional responders to exhibit a resistant/resilient trajectory. These results underscore the importance of prevention, screening and treatment efforts that target high-risk disaster responders, particularly those with prior psychiatric history, high levels of trauma exposure and work-related medical morbidities.
Genetic variation at the locus encoding the brain derived neurotrophic factor (BDNF) has been implicated in some neuropsychiatric disorders such as Alzheimer's disease (AD), affective disorders (AFDs), schizophrenia, and substance dependence. We therefore performed a mutation scan of the BDNF gene to identify novel gene variants and examined the association between BDNF variants and several neuropsychiatric phenotypes in European-American subjects and controls. Using dHPLC, we identified a novel variant (G-712A) in the putative promoter region. This variant and two previously reported BDNF SNPs (C270T and Val66Met) were genotyped in 295 patients with AD, 108 with AFDs, 96 with posttraumatic stress disorder (PTSD), 84 with schizophrenia, 327 with alcohol and/or drug dependence, and 250 normal control subjects. No association was found between these three BDNF gene variants and AD, AFDs, PTSD, or schizophrenia. However, there was a nominally higher frequency of the G-712A G-allele and the G/G genotype in subjects with substance dependence than in controls (Allele: χ 2 = 4.080, df = 1, P = 0.043; Genotype: χ 2 = 7.225, df = 2, P = 0.027). Although after correction for multiple testing, the findings are not considered significant (threshold P-value was set at 0.020 by the program SNPSpD), logistic regression analyses confirmed the modest association between SNP G-712A and substance dependence, when the sex and age of subjects were taken into consideration. The negative results for AFDs, PTSD and schizophrenia could be due to the low statistical power. Further study with larger samples is warranted.
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