Interactive Effect of Stressful Life Events and the Serotonin Transporter 5-HTTLPR Genotype on Posttraumatic Stress Disorder Diagnosis in 2 Independent Populations

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Abstract
Posttraumatic stress disorder (PTSD) is a complex and multifactorial anxiety disorder. According to the DSM-IV, it requires the presence of symptoms from each of 3 clusters, reexperiencing, avoidance, and increased arousal, that occur following exposure to a life-threatening traumatic event. While 40% to 70% of the US population have experienced high-level traumatic events,1,2 the lifetime prevalence for PTSD is 8% in adult Americans based on community epidemiological studies (DSM-IV). Several risk factors, including those that characterize the traumatic exposure as well as those that characterize traits of the individual, have been identified for PTSD. Among the former, traumatic events that involve the infliction of harm by others (eg, rape, physical assault, military combat) carry higher risks for PTSD than other traumas (eg, natural disasters).3 Female sex, preexisting psychiatric disorders, and premorbid personality characteristics such as neuroticism have also been shown to increase risk for PTSD.4,5