The role of epigenetics for understanding mental health difficulties and its implications for psychotherapy research

Abstract

Many mental health difficulties have developmental origins. Understanding the mechanisms for how psychosocial experiences are biologically embedded and influence lifelong development is a key challenge for the mental health disciplines. In recent years, epigenetic processes have emerged as a potential mechanism mediating the long‐lasting vulnerability following the experience of adversity. Animal models provide evidence that early‐life adversity can produce enduring epigenetic modifications in the brain, which mediate disorder‐like behaviours, and there is emerging evidence to support that environmental factors influence epigenetic processes in humans. The investigation of DNA methylation, a chemical modification of the DNA with a role in gene regulatory processes, is becoming increasingly popular in psychological studies. A particular interest for the psychotherapy field lies in the potential for psychological interventions to influence epigenetic processes. Hence, the focus of this review will be on studies that have investigated intervention‐associated changes in DNA methylation. Results of the first few studies will be critically reviewed, and a model of how therapy‐associated changes of DNA methylation in peripheral, non‐brain tissue might be useful as epigenetic biomarkers of treatment outcome will be presented. Practitioner points Many mental health difficulties have substantial developmental origin. Epigenetic processes have emerged as a potential mechanism mediating the long‐term effects of early adversity Epigenetic refers to cellular mechanisms that control gene expression states, independent of changes to the underlying DNA sequence. The epigenome can be highly dynamic and potentially influenced by external factors A particular interest for the psychotherapy field lies in the potential for psychological interventions to influence epigenetic processes.

The social brain and heart rate variability: Implications for psychotherapy

“…An evolutionary and ‘social brain’ perspective on psychopathology and psychotherapy highlights the co‐regulating processes of emotions and motives and their impact on range of physiological systems, including genetic expression (Gilbert, 2015a; Kumsta, ). However, the contribution of psychophysiological methods is often underplayed in psychotherapy (Lehrer, ), and most psychotherapeutic approaches emphasize verbal, cognitive, and behavioural treatment and assessment procedures rather than body state assessments.…”

Targeted bisulfite sequencing: A novel tool for the assessment of DNA methylation with high sensitivity and increased coverage

“…First, given that the sensitivity of our method for this gene fragment is 0.46 %, differences in DNA methylation of 0.08 % cannot be reliably assessed. Second, DNA was extracted from saliva, which represents a heterogeneous tissue, and introduces a potential bias into the analysis (Jones et al, 2018;Kumsta, 2019). Third, individual genotype influencing individual DNA methylation signatures cannot be excluded (Gertz et al, 2011;Schroder et al, 2017).…”

“…Blood consists of multiple different cell types with their respective divergent epigenotypes. As blood cell composition can vary across time and is influenced by several factors, including inflammation, physical and/or psychosocial stress, sexual hormones etc., many differences in DNA methylation might be driven by altered blood cell composition and not by cell type-specific alterations of DNA methylation (Hummel et al, 2018;Jones et al, 2018;Kumsta, 2019). When using blood, this challenge can partly be addressed via physical isolation of cells via cell sorting or immunomagnetic isolation (Schwaiger et al, 2016), or by using blood cell counts to strip away variations in DNA methylation that can be attributed to differences in leukocyte subset composition (Jones et al, 2018).…”

Human evolution and culture in relationship to shame in the parenting role: Implications for psychology and psychotherapy

“…Early parenting has profound effects on a range of physiological and psychological maturation processes (Atzil, Gao, Fradkin, & Barrett, ; Siegel, ). These include effects on epigenetics (Cowan, Callaghan, Kan, & Richardson, ; Kumsta, ), neurophysiology (Atzil et al ., ; Belsky & de Haan, ), and a range of psychological processes such as emotion regulation (Cassidy & Shaver, ). It is well known that psychotherapists are often addressing emotional difficulties that have their roots in childhood (Holmes & Slade, ).…”