Polygenic risk for traumatic loss-related PTSD in US military veterans: Protective effect of secure attachment style

Abstract

Objectives

To examine whether attachment style moderates the relationship between polygenic risk scores (PRS) for posttraumatic stress disorder (PTSD) re-experiencing (PTSD_REX) symptoms and the severity of and positive screen for traumatic loss-related PTSD.

Methods

Data were analysed from 631 US veterans who endorsed ‘unexpected death of a loved one’ as their ‘worst’ traumatic event. Multivariable models evaluated the association between PRS for PTSD_REX, attachment style, and their interaction in predicting severity and positive screen for PTSD. A gene enrichment analysis was conducted to identify possible molecular mechanisms underlying the association between PTSD_REX PRS and PTSD.

Results

PTSD_REX PRS (β = 0.17; odds ratio [OR] = 1.85), attachment style (β= −0.33; OR = 0.14), and PTSD_REX PRS × attachment style interaction (β= −0.12; OR = 0.53) were significant predictors of the severity and positive screen for PTSD. The most significant gene set detected was the gene ontology (GO) cellular component podosome set (GO:0002102, p < 3.95 × 10⁻⁵).

Conclusions

Having a secure attachment style may help mitigate polygenic risk for developing traumatic loss-related PTSD in US veterans. Podosomes, which are implicated in inflammatory and neuroplasticity processes, may contribute to the genetic liability to developing loss-related PTSD. Psychological treatments targeting attachment security may help mitigate increased polygenic risk for loss-related PTSD in this population.

Keywords:

• Veterans
• posttraumatic stress disorder (PTSD)
• bereavement
• gene–environment interaction

Acknowledgements

The authors thank the veterans who participated in this study and the Ipsos staff who helped coordinate it.

Statement of interest

None to declare.

Additional information

Funding

The National Health and Resilience in Veterans Study is supported by the U.S. Department of Veterans Affairs National Center for Posttraumatic Stress Disorder. Preparation of this report was supported in part by T32 MH014276 (R. H. A.) and F32 MH122058 (F. R. W.).