Do Gene-by-Environment Interactions Offer Potential Intervention Strategies in Anxiety Disorders?

Abstract

Anxiety disorders in youth are frequent, impairing, long-lasting, and recurring. The neural circuits underlying fear learning and fear extinction are relatively well understood. Cognitive Bias Modification, Cognitive Behavioral Therapy, and specific serotonin reuptake inhibitors are all effective in the treatment of anxiety disorders in youth and are thought to act through different pathways. Therefore, this may be a particularly appropriate group of disorders in which to understand how specific gene effects, environments, and gene-by-environment effects may lead to personalized medicine approaches to the treatment of these disorders. Candidate gene-based approaches have examined serotonin transporter polymorphisms, BDNF, and COMT, for gene and gene-by-environment effects in anxiety disorders with mixed results. It is likely that GWAS-based approaches with large samples will be necessary to go from genes and gene-by-environment interactions to better treatment.