Predicting PTSD using the New York Risk Score with genotype data: potential clinical and research opportunities

Joseph A Boscarino,1,2 H Lester Kirchner,3,4 Stuart N Hoffman,5 Porat M Erlich1,4 1Center for Health Research, Geisinger Clinic, Danville, 2Department of Psychiatry, Temple University School of Medicine, Philadelphia, 3Division of Medicine, Geisinger Clinic, Danville, 4Department of Medicine, Temple...

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Autores principales:	Boscarino JA, Kirchner HL, Hoffman SN, Erlich PM
Formato:	article
Lenguaje:	EN
Publicado:	Dove Medical Press 2013
Materias:	Neurosciences. Biological psychiatry. Neuropsychiatry RC321-571 Neurology. Diseases of the nervous system RC346-429
Acceso en línea:	https://doaj.org/article/04684f3219d24efba1454089d44cdfbc
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spelling	oai:doaj.org-article:04684f3219d24efba1454089d44cdfbc2021-12-02T07:29:58ZPredicting PTSD using the New York Risk Score with genotype data: potential clinical and research opportunities1176-63281178-2021https://doaj.org/article/04684f3219d24efba1454089d44cdfbc2013-04-01T00:00:00Zhttp://www.dovepress.com/predicting-ptsd-using-the-new-york-risk-score-with-genotype-data-poten-a12749https://doaj.org/toc/1176-6328https://doaj.org/toc/1178-2021Joseph A Boscarino,1,2 H Lester Kirchner,3,4 Stuart N Hoffman,5 Porat M Erlich1,4 1Center for Health Research, Geisinger Clinic, Danville, 2Department of Psychiatry, Temple University School of Medicine, Philadelphia, 3Division of Medicine, Geisinger Clinic, Danville, 4Department of Medicine, Temple University School of Medicine, Philadelphia, 5Department of Neurology, Geisinger Clinic, Danville, PA, USA Background: We previously developed a post-traumatic stress disorder (PTSD) screening instrument, ie, the New York PTSD Risk Score (NYPRS), that was effective in predicting PTSD. In the present study, we assessed a version of this risk score that also included genetic information. Methods: Utilizing diagnostic testing methods, we hierarchically examined different prediction variables identified in previous NYPRS research, including genetic risk-allele information, to assess lifetime and current PTSD status among a population of trauma-exposed adults. Results: We found that, in predicting lifetime PTSD, the area under the receiver operating characteristic curve (AUC) for the Primary Care PTSD Screen alone was 0.865. When we added psychosocial predictors from the original NYPRS to the model, including depression, sleep disturbance, and a measure of health care access, the AUC increased to 0.902, which was a significant improvement (P = 0.0021). When genetic information was added in the form of a count of PTSD risk alleles located within FKBP, COMT, CHRNA5, and CRHR1 genetic loci (coded 0–6), the AUC increased to 0.920, which was also a significant improvement (P = 0.0178). The results for current PTSD were similar. In the final model for current PTSD with the psychosocial risk factors included, genotype resulted in a prediction weight of 17 for each risk allele present, indicating that a person with six risk alleles or more would receive a PTSD risk score of 17 × 6 = 102, the highest risk score for any of the predictors studied. Conclusion: Genetic information added to the NYPRS helped improve the accuracy of prediction results for a screening instrument that already had high AUC test results. This improvement was achieved by increasing PTSD prediction specificity. Further research validation is advised. Keywords: post-traumatic stress disorder, psychological trauma, diagnostic screening, test development, genotype, single nucleotide polymorphismBoscarino JAKirchner HLHoffman SNErlich PMDove Medical PressarticleNeurosciences. Biological psychiatry. NeuropsychiatryRC321-571Neurology. Diseases of the nervous systemRC346-429ENNeuropsychiatric Disease and Treatment, Vol 2013, Iss default, Pp 517-527 (2013)
institution	DOAJ
collection	DOAJ
language	EN
topic	Neurosciences. Biological psychiatry. Neuropsychiatry RC321-571 Neurology. Diseases of the nervous system RC346-429
spellingShingle	Neurosciences. Biological psychiatry. Neuropsychiatry RC321-571 Neurology. Diseases of the nervous system RC346-429 Boscarino JA Kirchner HL Hoffman SN Erlich PM Predicting PTSD using the New York Risk Score with genotype data: potential clinical and research opportunities
description	Joseph A Boscarino,1,2 H Lester Kirchner,3,4 Stuart N Hoffman,5 Porat M Erlich1,4 1Center for Health Research, Geisinger Clinic, Danville, 2Department of Psychiatry, Temple University School of Medicine, Philadelphia, 3Division of Medicine, Geisinger Clinic, Danville, 4Department of Medicine, Temple University School of Medicine, Philadelphia, 5Department of Neurology, Geisinger Clinic, Danville, PA, USA Background: We previously developed a post-traumatic stress disorder (PTSD) screening instrument, ie, the New York PTSD Risk Score (NYPRS), that was effective in predicting PTSD. In the present study, we assessed a version of this risk score that also included genetic information. Methods: Utilizing diagnostic testing methods, we hierarchically examined different prediction variables identified in previous NYPRS research, including genetic risk-allele information, to assess lifetime and current PTSD status among a population of trauma-exposed adults. Results: We found that, in predicting lifetime PTSD, the area under the receiver operating characteristic curve (AUC) for the Primary Care PTSD Screen alone was 0.865. When we added psychosocial predictors from the original NYPRS to the model, including depression, sleep disturbance, and a measure of health care access, the AUC increased to 0.902, which was a significant improvement (P = 0.0021). When genetic information was added in the form of a count of PTSD risk alleles located within FKBP, COMT, CHRNA5, and CRHR1 genetic loci (coded 0–6), the AUC increased to 0.920, which was also a significant improvement (P = 0.0178). The results for current PTSD were similar. In the final model for current PTSD with the psychosocial risk factors included, genotype resulted in a prediction weight of 17 for each risk allele present, indicating that a person with six risk alleles or more would receive a PTSD risk score of 17 × 6 = 102, the highest risk score for any of the predictors studied. Conclusion: Genetic information added to the NYPRS helped improve the accuracy of prediction results for a screening instrument that already had high AUC test results. This improvement was achieved by increasing PTSD prediction specificity. Further research validation is advised. Keywords: post-traumatic stress disorder, psychological trauma, diagnostic screening, test development, genotype, single nucleotide polymorphism
format	article
author	Boscarino JA Kirchner HL Hoffman SN Erlich PM
author_facet	Boscarino JA Kirchner HL Hoffman SN Erlich PM
author_sort	Boscarino JA
title	Predicting PTSD using the New York Risk Score with genotype data: potential clinical and research opportunities
title_short	Predicting PTSD using the New York Risk Score with genotype data: potential clinical and research opportunities
title_full	Predicting PTSD using the New York Risk Score with genotype data: potential clinical and research opportunities
title_fullStr	Predicting PTSD using the New York Risk Score with genotype data: potential clinical and research opportunities
title_full_unstemmed	Predicting PTSD using the New York Risk Score with genotype data: potential clinical and research opportunities
title_sort	predicting ptsd using the new york risk score with genotype data: potential clinical and research opportunities
publisher	Dove Medical Press
publishDate	2013
url	https://doaj.org/article/04684f3219d24efba1454089d44cdfbc
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Predicting PTSD using the New York Risk Score with genotype data: potential clinical and research opportunities

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