Polygenic Risk for Traumatic Loss-related PTSD in U.S. Military Veterans: Protective Effect of Secure Attachment Style

To examine whether attachment style moderates the relationship between polygenic risk scores (PRS) for posttraumatic stress disorder (PTSD) re-experiencing (PTSD_REX) symptoms and the severity of and positive screen for traumatic loss-related PTSD. Data were analyzed from 631 U.S. veterans who endorsed “unexpected death of a loved one” as their ‘worst’ traumatic event. Multivariable models evaluated the association between PRS for PTSD_REX, attachment style, and their interaction in predicting severity and positive screen for PTSD. A gene enrichment analysis was conducted to identify possible molecular mechanisms underlying the association between PTSD_REX PRS and PTSD. PTSD_REX PRS (β = 0.17; odds ratio [OR] = 1.85), attachment style (β= -0.33; OR =0.14), and PTSD_REX PRS x attachment style interaction (β= -0.12; OR =0.53) were significant predictors of the severity and positive screen for PTSD. The most significant gene set detected was the gene ontology (GO) cellular component podosome set (GO:0002102, p -5). Having a secure attachment style may help mitigate polygenic risk for developing traumatic loss-related PTSD in U.S. veterans. Podosomes, which are implicated in inflammatory and neuroplasticity processes, may contribute to the genetic liability to developing loss-related PTSD. Psychological treatments targeting attachment security may help mitigate increased polygenic risk for loss-related PTSD in this population.