Association Analysis Of Candidate Gene And Diagnostic Efficiency With The MMPI-2 For Stress Disorder

Stress disorder (SD) is abnormal psychological response caused by psychological, social and environmental factors. SD includes acute stress disorder (ASD) and posttraumatic stress disorder (PTSD) etc. SD is one of the most important diseases that threaten human health after warfare and severe disaster. Considerable attention has been devoted to SD in recent years. This is a preliminary study investigating several important risk factors and genetic susceptibility markers for patients with SD in psychiatric hospital. This study may be helpful for the screening of army man to exclude those who are susceptive to SD. Diagnostic efficiency with MMPI-2 in patients with SD was also examined to provide usefiil information for the screening and diagnosis of SD during wartime or peacetime.There were mainly three parts in our study:First, risk factors for stress disorders. Objective: To ascertain risk factors associated with SD in psychiatric hospital. Methods: forty-three patients with acute stress disorder or posttraumatic stress disorder and forty-four trauma survivors were investigated with "the questionnaire for stress", which was developed on previous epidemic studies. Results: Of the eleven items examined, significant associations were found in eight risk factors between patients and controls. Logistic regression indicated family instability, family history of alcohol abuse and introversion make significant contributions to stress disorder after controlling for family history of mental disorders. Conclusions: the results confirmed that a group of factors has muchimpact on individual's response to stress, which including pre-trauma predisposition and after-trauma supports.Second, whether susceptive candidate gene is related to genetic susceptibility of stress disorders. Objective: To investigate the association between Taq I Polymorphism of Dopamine Receptor D2 (DRD2) and genetic susceptibility for stress disorder. Methods: PCR-RFLP was used to determine the DRD2 Taq I genotypes of 37 patients with SD and 47 trauma survivors. Results: There were significant differences in Al allele frequencies and carriers between two groups. Patients carrying Al alleles showed relatively higher elevations of PK raw scores than patients who did not carry Al alleles. Conclusions: Taq I Polymorphism of DRD2 was associated with genetic susceptibility of stress disorder and carrying Al alleles may confers an increased risk to stress disorders.Third, diagnostic efficiency with the MMPI-2 in patients with SD. Objective: To investigate psychopathology and diagnostic efficiency with MMPI-2 in patients with SD. Methods: Chinese version of MMPI-2 were administered to 26 patients with ASD, 13 patients with PTSD and 42 trauma survivors. Results: Patients with SD obtained significantly higher mean scores of MMPI-2 scales F, Fb, Fp, D, Hy, Pa, Pt, Sc, Ma and PK than controls, the same with all content scales except SOD. There were significant differences in mean scores of Hs, D, Hy, ANG and TRT between patients with ASD and PTSD. 6-8-7 codetype was found as the mean profiles for SD patients. Discriminate analysis indicated that Pa and Sc were the most important variables and it successfully classified 83.9% and 72.0% respectively in training sample and cross-validation sample. Gender, types of traumatic events or types of diagnosis in patients with SD did not substantially influence PK scores. When an optimal cut-off point of 17 was utilized, sensitivity and specificity for diagnosis with PK are respectively 94.9% and 66.7%. Conclusions: MMPI-2 scales especially Pa and Sc were sensitive to posttraumatic stress symptoms. Patients with SD and trauma survivors show significantly different psychopathology. PK was moderately successful at identifying abnormal psychological responses after trauma though it produced more false-positive than false-negative errors.Our results suggest that it may be more efficient to assess risk factors such as genetic background, family environment and personality in the course of personnel selec...