ABSTRACT/PROJECT SUMMARY
Substance Use Disorders (SUD, i.e., alcohol, nicotine, cannabis, opioid) and Posttraumatic Stress Disorder
(PTSD) are prevalent, highly comorbid, and associated with a high public health burden. Further, the frequent
co-occurrence of SUD and PTSD has clinical implications, including greater symptom severity, poorer treatment
prognosis, and poor physical health, compared to either disorder alone. Thus, there is a great need to understand
their etiologic underpinnings to best inform prevention and intervention efforts. SUD and PTSD are both
moderately heritable, with correlated genetic risk demonstrated by twin studies. Recent advances in statistical
genetics have produced multivariate methods well suited for comorbidity applications that expand upon genetic
correlations to examine causality (i.e., Mendalian Randomization [MR]), and to boost power for identification of
disorder-specific and shared genetic risk (i.e., genomic structural equation modeling [gSEM]). Our work thus far
has focused on the genetic relationships of PTSD with alcohol use disorder (AUD), demonstrating a significant
genetic correlation between PTSD and AUD (rG=.35), and finding a support for a causal effect of PTSD on AUD.
While these findings provide clues for the relationships between PTSD and other common SUD, the genetic
relationships between PTSD with other SUDs, especially cannabis, and opioid use disorders remain relatively
unexplored. The first aim of this project is to harness the existing large GWAS samples brought together by the
Psychiatric Genomics Consortium (PGC) SUD and PTSD workgroups, to characterize the genetic relationship
between SUDs and PTSD using state-of-the-science statistical genetic techniques. Initial GWAS in the PTSD
and SUD workgroups have largely focused on broad phenotypes that are amendable for harmonization across
cohorts. Thus, there is an unfilled need for increased data acquisition and harmonization within the workgroups
to allow for more nuanced scientific questions about the PTSD-SUD relationship to be answered. For example,
it is unknown if the nature of the PTSD-SUD genetic relationship is influenced by trauma characteristics (i.e.,
age of onset, type of trauma), differs as a function of substance use versus disorder, and how genomic risk
unfolds in comorbid PTSD-SUD cases. The second aim of this project is to interrogate these more nuanced
scientific questions by expanding phenotyping within the PGC groups. Importantly, existing research is limited
by the under-representation of individuals of African and Latinx ancestry. The third aim of this project is to
increase inclusion of diverse participants within the PTSD and SUD PGC workgroups. We will determine whether
Aim 1 findings extend to populations of African and Latinx ancestry by integrating three large and diverse existing
studies with data on SUD, PTSD, and trauma, and build additional collaborations to increase diversity in the
PGC workgroups. The overarching goal of this proposal is to understand the genetic relationships between SUD
and PTSD while increasing representation of individuals of diverse ancestry in psychiatric genetics research.