Abstract
Psychosocial stress, including stress resulting from racial discrimination (RD), has been associated with elevated depressive symptoms. However, individuals vary in their reactivity to stress, with some variability resulting from genetic differences. Specifically, genetic variation within the linked promoter region of the serotonin transporter gene (5-HTTLPR) is related to heightened reactivity to emotional environmental cues. Likewise, variations within this region may interact with stressful life events (e.g., discrimination) to influence depressive symptoms, but this has not been empirically examined in prior studies. The objective of this study was to examine whether variation in the 5-HTTLPR gene interacts with RD to predict depressive symptoms among a sample of African–American adolescent females. Participants were 304 African–American adolescent females enrolled in a sexually transmitted disease prevention trial. Participants completed a baseline survey assessing psychosocial factors including RD (low vs. high) and depressive symptomatology (low vs. high) and provided a saliva sample for genotyping the risk polymorphism 5-HTTLPR (s allele present vs. not present). In a logistic regression model adjusting for psychosocial correlates of depressive symptoms, an interaction between RD and 5-HTTLPR group was significantly associated with depressive symptomatology (AOR = 3.79, 95% CI: 1.20–11.98, p = 0.02). Follow-up tests found that high RD was significantly associated with greater odds of high depressive symptoms only for participants with the s allele. RD and 5-HTTLPR status interact to differentially impact depressive symptoms among African–American adolescent females. Efforts to decrease depression among minority youth should include interventions which address RD and strengthen factors (e.g., coping, emotion regulation, building support systems) which protect youth from the psychological costs of discrimination.
Highlights
Across a wide range of health indicators, including mental health outcomes, dramatic racial and socioeconomic health disparities exist for African–American adolescents in the United States (Williams et al, 2010)
Neuroscience research suggests that carrying the s allele may prompt enhanced emotional arousal to threatening and stressful environmental events, resulting in higher levels of depressive symptoms among those with high levels of stress exposure, chronic environmental stressors (e.g., racial discrimination (RD)). These findings suggest that African–American adolescent females who experience high levels of RD AND who are predisposed toward heightened emotional reactivity to environmental events by having at least one copy of the s allele of the 5-HTTLPR should evidence greater levels of depressive symptoms than those without the genetic sensitivity or with lower levels of exposure to RD
Many of the participants were recruited from a county health department sexually transmitted disease (STD) clinic (n = 154), others were recruited from a reproductive health clinic (n = 119), and the remaining participants were recruited from an adolescent reproductive health clinic in a public hospital (n = 31)
Summary
Across a wide range of health indicators, including mental health outcomes, dramatic racial and socioeconomic health disparities exist for African–American adolescents in the United States (Williams et al, 2010). A burgeoning body of literature indicates that racial discrimination (RD) may be a key factor associated with increased risk for many negative health outcomes, including both poorer physical (e.g., coronary artery calcification, sexually transmitted infections, and low birth-weight infants) and mental health outcomes (e.g., increased rates of internalizing and externalizing conditions; Lewis et al, 2006; Brondolo et al, 2008; Dominquez et al, 2008; Pascoe and Smart Richman, 2009; Williams and Mohammed, 2009; Rosenthal et al, 2014). The primary purpose of this study was to examine the extent to which genetic variation moderates the association between RD and high levels of depressive symptomatology among a sample of adolescent African–American women. In other words, are some adolescent African–American women more affected than others by RD thereby resulting in higher levels of depressive symptoms?
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