Gloster, Andrew T., Gerlach, Alexander L. ORCID: 0000-0001-6794-5349, Hamm, Alfons, Hoefler, Michael, Alpers, Georg W. ORCID: 0000-0001-9896-5158, Kircher, Tilo ORCID: 0000-0002-2514-2625, Stroehle, Andreas, Lang, Thomas, Wittchen, Hans-Ulrich ORCID: 0000-0002-6311-7711, Deckert, Juergen and Reif, Andreas (2015). 5HTT is associated with the phenotype psychological flexibility: results from a randomized clinical trial. Eur. Arch. Psych. Clin. Neurosci., 265 (5). S. 399 - 407. HEIDELBERG: SPRINGER HEIDELBERG. ISSN 1433-8491

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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.

Item Type: Journal Article
Creators:
CreatorsEmailORCIDORCID Put Code
Gloster, Andrew T.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Gerlach, Alexander L.UNSPECIFIEDorcid.org/0000-0001-6794-5349UNSPECIFIED
Hamm, AlfonsUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Hoefler, MichaelUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Alpers, Georg W.UNSPECIFIEDorcid.org/0000-0001-9896-5158UNSPECIFIED
Kircher, TiloUNSPECIFIEDorcid.org/0000-0002-2514-2625UNSPECIFIED
Stroehle, AndreasUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Lang, ThomasUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Wittchen, Hans-UlrichUNSPECIFIEDorcid.org/0000-0002-6311-7711UNSPECIFIED
Deckert, JuergenUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Reif, AndreasUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
URN: urn:nbn:de:hbz:38-398042
DOI: 10.1007/s00406-015-0575-3
Journal or Publication Title: Eur. Arch. Psych. Clin. Neurosci.
Volume: 265
Number: 5
Page Range: S. 399 - 407
Date: 2015
Publisher: SPRINGER HEIDELBERG
Place of Publication: HEIDELBERG
ISSN: 1433-8491
Language: English
Faculty: Unspecified
Divisions: Unspecified
Subjects: no entry
Uncontrolled Keywords:
KeywordsLanguage
SEROTONIN TRANSPORTER GENE; COGNITIVE-BEHAVIORAL TREATMENT; PANIC DISORDER; ENVIRONMENTAL ADVERSITY; PSYCHOMETRIC PROPERTIES; ANXIETY SENSITIVITY; MOBILITY INVENTORY; THERAPY; POLYMORPHISM; AGORAPHOBIAMultiple languages
Clinical Neurology; PsychiatryMultiple languages
URI: http://kups.ub.uni-koeln.de/id/eprint/39804

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