Research On The Psychological Stresses In Varying Levels: Interactions Between Social-environmental Factors And Different Genes

Objective: This paper studies the influences of the stresses in different levels on thepsychological health. Tries to elaborate the process of the psychological stress anddiscuss the influential factors of stress, such as the social and environmental factors,genetic factors, etc. The study is combining and using the structural equation modeling(SEM) method and some specific statistical methods for genetic epidemiological research,such as multi-factor dimensionality reduction method, to analyze the relationshipbetween abovementioned factors and candidate gene polymorphisms, including theinteraction between the social and environmental factors and genes, and the interactionbetween different genes, to reveal the overall interaction mechanism of psychologicalstress. Method:1) A random sample and research on XinJiang Oil-field outdoor workers,who have mild psychological stresses, based on Symptom Checklist90questionnaire,Social Support Rating Scale questionnaire, Personality Trait Scale questionnaire, ChineseMaslash Burnout Survey, Occupation Stress Inventory-Revised questionnaire and usingStructure Equation Model to investigate the social and environmental factors which caninfluence the psychological stress, and the interactions between these factors.2) Aspecial-case research on the166traffic accidents, which have moderate physical andpsychological trauma and stresses, based on PCL-C (PTSD Checklist-Civilian version)questionnaire and the filter of the patients who have the positive clinical manifestation ofPTSD and using Structure Equation Model to investigate the interactions between thesesocial and environmental factors and genetic susceptibility.3) A special case-controlresearch on the patients who have severe psychological stresses normally called StressDisorders, based on the questionnaires and laboratory method and combined withLogistic Regression analysis, Multifactor Dimensionality Reduction (MDR) analysis, toinvestigate the interactions between these social and environmental factors and theinteractions between different genes. Results:1) Comparative Study between the SCL-90 scale scores of the oil-field outdoor workers and the national norm shows that: except thatthe scores of hostile factors and paranoid factors are no significant statistically, the scoresof all other factors are higher than the national norm and P＜0.05. In comparison to theSCL-90norm for occupational Han Chinese in Xinjiang region, the SCL-90scores of theXinjiang oil-field outdoor workers, such as depression factor score (1.63±0.54) andpsychosis factor score (1.48±0.44) are higher than the norm which are (1.57±0.61), and(1.41±0.50) respectively, and P＜0.05.2) The multi-factor Logistic Regression Analysisshows that the factors, which influence mild psychological stresses, are PsychologicalIntense Response (PSY), Self-health Care (SC), Nervousness (N), Psychoticism (P),Utilization of Social Support and Emotional Exhaustion.3) Using SEM to establish amulti-factor model for mild psychological stresses, the results show that the model isideal and fits the theory, proposed fitting indexes are good (RMSEA＝0.048, NFI＝0.949,GFI＝0.906). The factor loading between each index observed and the underlyingvariables is high and statistically significant.4) If the score38is set as the PCL-C criticalvalue, for the post-trauma patients caused by traffic accidents, the positive results ofscreening is15%in25cases and the PCL-C scores for25cases fall from38to52, andfor other20cases the scores fall from38to46.5) Analysis shows that a significantpositive correlation among the sum-up scores of mental health status (SCL-90) forpost-trauma patients in early stages, the scores for PTSD and each individual score fordifferent symptoms exist, and can be used to forecast and evidence the occurrence of thePTSD in the future if the mental health status in early stages after trauma is noted.Analysis also shows that Personality Trait factors such as Nervousness (N) andPsychoticism (P) are positively correlated with the sum-up score for PTSD and eachindividual score for different symptoms, and sum-up score for Utilization of SocialSupport is negatively correlated with the sum-up score for PTSD.6) Multiple LinearRegression Analysis (MLR) on the factors which influence the psychological stressesshows that, if some factors such as obsessive compulsive disorder symptoms,psychoticism (P), subjective support, interpersonal sensitiveness, extroverted andintroverted personality (E) are taken into the MLR equation, these five variables willexplain65.0%of variation of the positive PTSD occurrence degree, and the estimatedStandard Error is4.758.7) By using the SNP-SHOT method,4genes, I.E. glucocorticoidreceptor (GCCR) gene, dopamine D2receptor (DRD2) gene, five-hydroxyl-tryptamines(5-HTT) Serotonin Transporter (SLC6A4) gene and CRHR1gene, the SNPpolymorphism of10loci of these genes are tested, in which the locus rs6189of GCCR gene does not mutate, so the data for GCCR gene is not taken into the further analysis.For the other9locus, a2test and analysis is carried on and the results show that thegenotype and allele frequency distribution fits Hardy-Weinberg equilibrium law, for eachindividual P, P＞0.05, indicates that the gene frequency has reached a populationrepresentation of genetic equilibrium.8) Genetic Susceptibility analysis of thepost-trauma patients on the factors which influence the moderate psychological stresses①GCCR gene: For intrusive memory/re-experiencing (flashback) symptoms of PTSDpatients, the score for ones with mutant homozygote GG-genotype at locus rs258747ishigher than the scores for ones with heterozygote AG-genotype and wild homozygoteAA-genotype. The plasma corticosterone level for ones with mutant heterozygoteAG-genotype at locus rs10482605is higher than the levels for ones with homozygoteAG-genotype and the ones with wild homozygote AA-genotype, and the plasmacorticosterone level for ones with mutant homozygote GG-genotype at locus rs41423247is higher than the levels for ones with heterozygote GC-genotype and ones with wildhomozygote CC-genotype. The locus rs258747may be a SNP locus with very importantbiological functions, we recommend that further researches on clinical cases should becarried to verify that the individuals with G alleles who suffer from traumatic events mayhave a higher possibility to develop into PTSD, so this may be a susceptible gene andcould be used as a very important index to measure the susceptibility to PTSD relateddiseases.②DRD2gene: For intrusive memory/re-experiencing symptoms ofpost-trauma patients, the score for ones with mutant homozygote AA-genotype at locusrs1800497is higher than the scores for ones with heterozygote GA-genotype and oneswith wild homozygote GG-genotype. According to the test results of the DRD2receptorconcentration, the concentration for the post-trauma patients with mutant homozygote atlocus rs1800497is higher than the concentration for ones with heterozygote and oneswith wild homozygote. The score on Utilization of Social Support of the post-traumapatients with mutant homozygote AA-genotype at locus rs6275is lower than the scoresfor ones with heterozygote GA-genotype and ones with wild homozygote GG-genotype.The score on subjective support for ones with mutant heterozygote AC-genotype at locusrs1076560is lower than the score for ones with wild homozygote CC-genotype. And thescore for ones with mutant homozygote AA-genotype at locus rs1800497is lower thanthe ones with wild homozygote GG-genotype.③SLC6A4gene: For hyper-vigilancesymptoms of post-trauma patients, the score for ones with mutant homozygoteAA-genotype at locus rs1042173is higher than the scores for ones with heterozygote AC-genotype and ones with wild homozygote CC-genotype. The plasma concentration ofdopamine D2receptor for ones with mutant homozygote GG-genotype at locus rs242948is higher than the concentration for ones with heterozygote GT-genotype and ones withwild homozygote TT-genotype.9) Using structural equation model method to fit theinteractions between genes and social-environment to the symptoms of positive PTSGpatients, the results show that when taking into the factor of genetic susceptibility, theoverall model-fitting will be better (in contrast with the chart1-1, RMSEA＝0.041, NFI＝0.951, GFI＝0.914), the most indexes of factor loading is improved.10) A comparisonresearch on LES total score shows that the score of stress disorder group is higher thanthe score of control group, and for the negative events of life the score of stress disordergroup is higher than control group, the difference is statistically significant, P＜0.035andOR＝9.650; for the total score of Utilization of Social Support, score of subjectivesupport and the score of Utilization of Social Support between stress disorder group andcontrol group the differences are statistical significant, OR＝0.035,0.027,0.025respectively; for the negative reactions, the difference between the scores of stressdisorder group and control group is statistical significant, OR＝1.014; for personalitytraits, according to the results of T-test, the scores of P (mental quality) scalequestionnaire between stress disorder group and control group have significant difference,the score of the former is higher than the latter, a further trend chi-square test (χ2test)shows that when P scale score increases, OR value will increase significantly, the T scoreof P will exceed60and OR＝8.741.11) Analysis on the genetic factors which caninfluence the mental stress disorder:①the locus rs10482605and rs258747on GCCRgene are related to mental stress disorder (P＜0.05). the gene with G mutant alleles atlocus rs10482605has a risky factor to mental stress disorder (OR＝1.431,95%, CI＝1.186～1.999); the gene with G mutant alleles at locus rs258747is a risky factor tomental stress disorder (OR＝1.781,95%, CI＝1.567～2.0782); the gene with2haplotypes (AGC and AGG) at3different locus has a relationship with mental stressdisorder (P＜0.05), OR＝1.468,1.419respectively.②DRD2gene: the frequency ofStress disorder group with mutant homozygote AA-genotype and heterozygoteGA-genotype at locus rs1800497is higher than the frequency of control group, OR＝1.434,1.766respectively, and the gene with A mutant alleles is a risky factor to mentalstress disorder (OR＝1.211,95%, CI＝0.890～1.647), the gene with1haplotype (GAA)at3different locus has a relationship with mental stress disorder (P＜0.05), OR＝1.233.③two locus on SLC6A4gene and one locus on CRHR1gene, the gene frequencies and allele frequencies between stress disorder group and control group have no statisticaldifference (P＞0.05).12) Through MDR analysis by software, an interaction modelselecting5locus on genes is established as the best gene-gene interaction model toillustrate the influence on mental stress disorder. This gene-gene interaction model,including five SNP locus, I.E. rs10482605, rs258747, rs242948, rs1800497andrs4142324, is characterized with the best testing accuracy (67.48) and the bestcross-validation consistency (CV＝10/10).13) Gene-environment interaction research onthe Stress Mental Disorder shows that: the locus rs258747on GCCR gene and N(neuroticism) have an interactive relationship, OR＝1.304; locus rs41423247andsubjective support have an interactive relationship; locus rs1076560on DRD2gene andnegative reaction have an interactive relationship, OR＝1.320; and locus rs1800497andsubjective support have an interactive relationship, OR＝1.397. Conclusion:1) For thesocial-environmental factors which influence mild psychological stresses, they arePsychological Intense Response (PSY), Self-health Care (SC), Nervousness (N),Psychoticism (P) and Utilization of Social Support. The coincidence rate of forecast is62.7%.2) The data fitting of the mild psychological stress model is good. By usingStructural Equation Model we quantify the influence of social-environmental factors onpsychological stress, the influencing value for Job Burnout, Individual Intense Response,Social Support, and Personality Trait to psychological stress are0.165,0.139,0.077,0.189respectively.3) Mental health status in early stages post trauma (SCL-90) hasstrong positive relationship with the severeness of PTSD symptoms, those who havepersonality traits such as Nervousness (N) and Psychoticism (P) incline to be PTSDpatients and social support is kind of protective factor.4) For the social-environmentalfactors which influence moderate psychological stresses, they are obsessive-compulsivesymptoms, Psychoticism (P), subjective support, inter-personal sensitiveness, extrovertedand introverted personality (E). The coincidence rate of forecast is65.0%.5) The locusrs258747on GCCR gene and locus rs1800497on DRD2gene may be two SNP locuswith the very important biological functions, and can be used as susceptibility predictorsof Tag SNP for PTSD related diseases.6) The data fitting of the social-environmental andgenetic interaction model by SEM is good and the factor loading of the most indexes isimproved. Plasma cortisol and dopamine D2receptor have strong relationships withmental health status (SCL-90), occurrence of PTSD and severeness of PTSD symptoms,path coefficients are0.09and0.21, are good predictive indexes for PTSD.7)Hyper-stimulation of the negative events of life can increase the possibility of PTSD for about900%, social support, subjective support and utilization of supports can decease thepossibility of PTSD for about73%,75%and65%, Psychoticism (P) personality canincrease the possibility of PTSD.8) Case-control research shows that the locusrs10482605and rs258747on GCCR gene and the locus rs1800497on DRD2gene arerelated to stress disorder.9) The best of gene-gene interaction model is consisted of locusrs10482605, rs258747, rs242948, rs1800497and rs4142324of SNP.