Skip to main content

Advertisement

SpringerLink
Log in

High social support buffers the effects of 5-HTTLPR genotypes within social anxiety disorder

  • Original Paper
  • Published:
European Archives of Psychiatry and Clinical Neuroscience Aims and scope Submit manuscript

Abstract

An interaction between genetic aspects and environmental stressors has been suggested with regard to the etiology of social anxiety disorder (SAD). However, potential protective interplays which might decrease the risk of SAD have not been considered so far. Thus, we analyzed the interaction between 5-HTTLPR and differing levels of social support regarding SAD. The sample was based on participants of the Study of Health in Pomerania, Germany. We used the triallelic genotype of 5-HTTLPR and longitudinal data of social support. Final analyses were conducted in 79 individuals with SAD and 1,708 without. The diagnosis of SAD was derived from diagnostic interviews in accordance with DSM-IV. Considering the risk of SAD, a general protective effect of high social support was shown independent of variation in 5-HTTLPR genotype. In contrast, the risk of SAD was increased for both genotypes within those individuals with low social support. Additionally, the odds ratio for suffering from SAD was about two times higher for carriers of the l/l genotype compared to those with at least one short allele in those perceiving less-supportive social environments. The findings suggest that SAD is influenced by a protective and a contributing gene × environment interaction. High social support might act in a protective and low social support in an increasing manner on the risk of SAD especially within carriers of the l/l genotype. Therefore, effects of 5-HTTLPR might be buffered by high social support with respect to the risk of SAD.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1

Similar content being viewed by others

References

  1. APA (2000) Diagnostic and statistical manual of mental disorders, 4th edn. American Psychiatric Association, Washington, DC

    Google Scholar 

  2. Arbelle S, Benjamin J, Golin M, Kremer I, Belmaker RH, Ebstein RP (2003) Relation of shyness in grade school children to the genotype for the long form of the serotonin transporter promoter region polymorphism. Am J Psychiatry 160:671–676

    Article  PubMed  Google Scholar 

  3. Benjamin LS (2003) Interpersonal diagnosis and treatment of personality Disorders. Guilford Press, New York

    Google Scholar 

  4. Blom RM, Samuels JF, Riddle MA, Joseph Bienvenu O, Grados MA, Reti IM, Eaton WW, Liang K-Y, Nestadt G (2011) Association between a serotonin transporter promoter polymorphism (5HTTLPR) and personality disorder traits in a community sample. J Psychiatr Res 45:1153–1159

    Article  PubMed Central  PubMed  Google Scholar 

  5. Canli T, Lesch K-P (2007) Long story short: the serotonin transporter in emotion regulation and social cognition. Nat Neurosci 10:1103–1109

    Article  CAS  PubMed  Google Scholar 

  6. Domschke K, Stevens S, Beck B, Baffa A, Hohoff C, Deckert J, Gerlach AL (2009) Blushing propensity in social anxiety disorder: influence of serotonin transporter gene variation. J Neural Transm 116:663–666

    Article  CAS  PubMed  Google Scholar 

  7. Festa CC, Ginsburg GS (2011) Parental and peer predictors of social anxiety in youth. Child Psychiatry Hum Dev 42:291–306

    Article  PubMed Central  PubMed  Google Scholar 

  8. Furmark T, Tillfors M, Garpenstrand H, Marteinsdottir I, Långström B, Oreland L, Fredrikson M (2004) Serotonin transporter polymorphism related to amygdala excitability and symptom severity in patients with social phobia. Neurosci Lett 362:189–192

    Article  CAS  PubMed  Google Scholar 

  9. Fydrich T, Renneberg B, Schmitz B, Wittchen HU (1997) Strukturiertes klinisches interview für DSM-IV Achse II: Persönlichkeitsstörungen, interviewheft. Hogrefe, Göttingen

    Google Scholar 

  10. Fydrich T, Sommer G, Tydecks S, Brähler E (2009) Fragebogen zur sozialen unterstützung (F-SozU): normierung der Kurzform (K-14). Zeitschrift Med Psychol 18:43–48

    Google Scholar 

  11. Gingrich JA (2002) Mutational Analysis of the Serotonergic System: recent findings using knockout mice. Curr Drug Targets-CNS Neurol Disord 1:449–465

    Article  CAS  PubMed  Google Scholar 

  12. Grabe HJ, Schwahn C, Mahler J, Schulz A, Spitzer C, Fenske K, Appel K, Barnow S, Nauck M, Schomerus G, Biffar R, Rosskopf D, John U, Völzke H, Freyberger HJ (2012) Moderation of adult depression by the serotonin transporter promoter variant (5-HTTLPR), childhood abuse and adult traumatic events in a general population sample. Am J Med Genet B Neuropsychiatr Genet 159B:298–309

    Article  PubMed  Google Scholar 

  13. Heils A, Teufel A, Petri S, Stöber G, Riederer P, Bengel D, Lesch KP (1996) Allelic variation of human serotonin transporter gene expression. J Neurochem 66:2621–2624

    Article  CAS  PubMed  Google Scholar 

  14. Homberg JR, Lesch K-P (2011) Looking on the bright side of serotonin transporter gene variation. Biol Psychiatry 69:513–519

    Article  CAS  PubMed  Google Scholar 

  15. Hu X, Lipsky RH, Zhu G, Akhtar LA, Taubman J, Greenberg BD, Xu K, Arnold PD, Richter MA, Kennedy JL, Murphy DL, Goldman D (2006) Serotonin transporter promoter gain-of-function genotypes are linked to obsessive–compulsive disorder. Am J Hum Genet 78:815–826

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  16. John U, Hensel E, Lüdemann J, Piek M, Sauer S, Adam C, Born G, Alte D, Greiser E, Haertel U, Hense H-W, Haerting J, Willich S, Kessler C (2001) Study of Health in Pomerania (SHIP): a health examination survey in an east German region: objectives and design. Soc Prev Med 46:186–194

    Article  CAS  Google Scholar 

  17. Kaufman J, Yang BZ, Douglas-Palumberi H, Houshyar S, Lipschitz D, Krystal JH, Gelernter J (2004) Social supports and serotonin transporter gene moderate depression in maltreated children. Proc Natl Acad Sci USA 101:17316–17321

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  18. Knappe S, Beesdo K, Fehm L, Lieb R, Wittchen H-U (2009) Associations of familial risk factors with social fears and social phobia: evidence for the continuum hypothesis in social anxiety disorder? J Neural Transm 116:639–648

    Article  PubMed Central  PubMed  Google Scholar 

  19. Kuo JR, Goldin PR, Werner K, Heimberg RG, Gross JJ (2011) Childhood trauma and current psychological functioning in adults with social anxiety disorder. J Anxiety Disord 25:467–473

    Article  PubMed Central  PubMed  Google Scholar 

  20. La Greca AM, Harrison HM (2005) Adolescent peer relations, friendships, and romantic relationships: do they predict social anxiety and depression? J Clin Child Adolesc Psychol 34:49–61

    Article  PubMed  Google Scholar 

  21. La Greca AM, Lopez N (1998) Social anxiety among adolescents: linkages with peer relations and friendships. J Abnorm Child Psychol 26:83–94

    Article  PubMed  Google Scholar 

  22. Lesch K-P, Zeng Y, Reif A, Gutknecht L (2003) Anxiety-related traits in mice with modified genes of the serotonergic pathway. Eur J Pharmacol 480:185–204

    Article  CAS  PubMed  Google Scholar 

  23. Maffei C, Fossati A, Agostoni I, Barraco A, Bagnato M, Deborah D, Namia C, Novella L, Petrachi M (1997) Interrater reliability and internal consistency of the structured clinical interview for DSM-IV axis II personality disorders (SCID-II), version 2.0. J Pers Disord 11:279–284

    Article  CAS  PubMed  Google Scholar 

  24. Mathew SJ, Ho S (2006) Etiology and neurobiology of social anxiety disorder. J Clin Psychiatry 67(Suppl 12):9–13

    CAS  PubMed  Google Scholar 

  25. Nakamura M, Ueno S, Sano A, Tanabe H (2000) The human serotonin transporter gene linked polymorphism (5-HTTLPR) shows ten novel allelic variants. Mol Psychiatry 5:32–38

    Article  CAS  PubMed  Google Scholar 

  26. Rapee RM, Heimberg RG (1997) A cognitive-behavioral model of anxiety in social phobia. Behav Res Ther 35:741–756

    Article  CAS  PubMed  Google Scholar 

  27. Reinelt E, Stopsack M, Aldinger M, John U, Grabe HJ, Barnow S (2013) Testing the diathesis-stress model: 5-HTTLPR, childhood emotional maltreatment, and vulnerability to social anxiety disorder. Am J Med Genet B Neuropsychiatr Genet 162:253–261

    Article  CAS  Google Scholar 

  28. Rothman K (2002) Epidemiology: an introduction. University Press, New York

    Google Scholar 

  29. Schmidt L, Polak C, Spooner A (2005) Biological and environmental contributions to childhood shyness: a diathesis-stress model. In: Crozier W, Alden L (eds) The essential handbook of social anxiety for clinicians. Wiley, Chichester, pp 33–55

    Google Scholar 

  30. Sherbourne CD, Stewart AL (1991) The MOS social support survey. Soc Sci Med 32:705–714

    Article  CAS  PubMed  Google Scholar 

  31. Uher R (2009) The role of genetic variation in the causation of mental illness: an evolution-informed framework. Mol Psychiatry 14:1072–1082

    Article  CAS  PubMed  Google Scholar 

  32. Völzke H, Alte D, Schmidt CO, Radke D, Lorbeer R, Friedrich N, Aumann N, Lau K, Piontek M, Born G, Havemann C, Ittermann T, Schipf S, Haring R, Baumeister SE, Wallaschofski H, Nauck M, Frick S, Arnold A, Jünger M, Mayerle J, Kraft M, Lerch MM, Dörr M, Reffelmann T, Empen K, Felix SB, Obst A, Koch B, Gläser S, Ewert R, Fietze I, Penzel T, Dören M, Rathmann W, Haerting J, Hannemann M, Röpcke J, Schminke U, Jürgens C, Tost F, Rettig R, Kors JA, Ungerer S, Hegenscheid K, Kühn J-P, Kühn J, Hosten N, Puls R, Henke J, Gloger O, Teumer A, Homuth G, Völker U, Schwahn C, Holtfreter B, Polzer I, Kohlmann T, Grabe HJ, Rosskopf D, Kroemer HK, Kocher T, Biffar R, John U, Hoffmann W (2011) Cohort profile: the Study of Health in Pomerania. Int J Epidemiol 40:294–307

    Article  PubMed  Google Scholar 

  33. Widiger TA (1992) Generalized social phobia versus avoidant personality disorder: a commentary on three studies. J Abnorm Psychol 101:340–343

    Article  CAS  PubMed  Google Scholar 

  34. Wittchen HU, Lachner G, Wunderlich U, Pfister H (1998) Test–retest reliability of the computerized DSM-IV version of the Munich-Composite International Diagnostic Interview (M-CIDI). Soc Psychiatry Psychiatr Epidemiol 33:568–578

    Article  CAS  PubMed  Google Scholar 

Download references

Acknowledgments

Study of Health in Pomerania is a part of the Community Medicine Research net of the University of Greifswald, Germany, which is funded by the Federal Ministry of Education and Research (Grants No. 01ZZ9603, 01ZZ0103, and 01ZZ0403), the Ministry of Cultural Affairs, and the Social Ministry of the Federal State of Mecklenburg-West Pomerania. This work was also funded by the German Research Foundation (DFG: GR 1912/5-1).

Conflict of interest

Disclosure of external financial support in the past 5 years: Hans Jörgen Grabe German Research Foundation; Federal Ministry of Education and Research Germany; speakers honoraria from Bristol–Myers Squibb, Eli Lilly, Novartis, Eisai, Wyeth, Pfizer, Boehringer Ingelheim, Servier and travel funds from Janssen–Cilag, Eli Lilly, Novartis, AstraZeneca, and SALUS-Institute for Trend-Research and Therapy Evaluation in Mental Health. Ulrich John Research Grants by the European Union, the Federal Ministry of Education and Research (Germany), the Federal Ministry of Health (Germany), the Federal States of Germany, the German Cancer Aid, the German Research Foundation, the Social Ministry of the State of Mecklenburg-West Pomerania (Germany).

Author information

Authors and Affiliations

  1. Department of Clinical Psychology and Psychotherapy, Ruprecht-Karls-University, Hauptstraße 47-51, 69117, Heidelberg, Germany

    Eva Reinelt, Maren Aldinger, Malte Stopsack & Sven Barnow

  2. Unit of Oral and Systemic Diseases, Department of Prosthodontics, Gerodontology and Dental Materials, Center of Oral Health, University of Greifswald, Greifswald, Germany

    Christian Schwahn

  3. Institute of Epidemiology and Social Medicine, University Medicine Greifswald, Walther-Rathenau-Str. 48, 17475, Greifswald, Germany

    Ulrich John

  4. Institute of Community Medicine, Ernst Moritz Arndt University, Walther-Rathenau-Str. 48, Greifswald, Germany

    Sebastian E. Baumeister

  5. Department of Psychiatry and Psychotherapy, Helios Hospital Stralsund, University Medicine Greifswald, Rostocker Chaussee 70, 18437, Stralsund, Germany

    Hans Jörgen Grabe

Authors
  1. Eva Reinelt
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Maren Aldinger
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Malte Stopsack
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Christian Schwahn
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Ulrich John
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Sebastian E. Baumeister
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Hans Jörgen Grabe
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Sven Barnow
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Eva Reinelt.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Reinelt, E., Aldinger, M., Stopsack, M. et al. High social support buffers the effects of 5-HTTLPR genotypes within social anxiety disorder. Eur Arch Psychiatry Clin Neurosci 264, 433–439 (2014). https://doi.org/10.1007/s00406-013-0481-5

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00406-013-0481-5

Keywords

Search

Navigation