ImportanceTwin studies have found that posttraumatic stress disorder (PTSD) is influenced by both genetic and environmental factors within a generation. No study has used an adoption design, which can address questions about the degree and sources of cross-generational transmission of adverse stress responses (ASRs) and PTSD.ObjectivesTo examine whether ASRs or PTSD are transmitted from parents to offspring, and to clarify the relative importance of genes and rearing.Design, Setting, and ParticipantsThis cohort study used nationwide Swedish registry data from parents and offspring (n = 2 194 171, born 1960-1992) of 6 types of families (intact; had not lived with biological father; had not lived with biological mother; lived with stepfather; lived with stepmother; and adoptive). Follow-up occurred on December 31, 2018, and data were analyzed from March 3, 2023, to January 16, 2024.ExposuresThree sources of parent-offspring resemblance: genes plus rearing, genes only, and rearing only.Main Outcomes and MeasuresDiagnoses of ASRs or PTSD were obtained from national inpatient, outpatient, and primary care medical registries. Parent-child resemblance was assessed by tetrachoric correlation. Sensitivity analyses were conducted to control for possible shared traumatic events.ResultsThe study population included 2 194 171 individuals of 6 family types (1 146 703 [52.3%] male; median [range] age, 42 [20-63] years). The weighted tetrachoric correlations across family types were 0.15 (95% CI, 0.15-0.16) for genes plus rearing, 0.08 (95% CI, 0.06-0.11) for genes only, and 0.10 (95% CI, 0.07-0.12) for rearing only. Controlling for potential shared traumatic events, sensitivity analyses found that the correlation for rearing decreased, with the most conservative control (exclusion of parent-offspring dyads with onset of ASRs or PTSD within 1 year) suggesting equal correlations with genes and rearing.Conclusions and RelevanceDiagnosis of ASRs or PTSD demonstrated cross-generational transmission, including both genetic and rearing correlations. Sensitivity analyses suggested that shared traumatic events partially accounted for the observed rearing correlations.

中文翻译：

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不良应激反应和创伤后应激障碍的瑞典扩展收养研究


重要性Twin 研究发现，创伤后应激障碍 （PTSD） 在一代人中受到遗传和环境因素的影响。没有研究使用采用设计，它可以解决有关不良应激反应 （ASR） 和 PTSD 跨代传播的程度和来源的问题。目的检查 ASRs 或 PTSD 是否从父母传给后代，并阐明基因和抚养的相对重要性。设计、设置和参与者该队列研究使用了来自 6 种类型家庭（完整;未与亲生父亲同住;与继母同住;与继母同住;和收养）的父母和后代（n = 2 194 171，出生于 1960-1992）的瑞典全国登记数据。随访于 2018 年 12 月 31 日进行，数据分析时间为 2023 年 3 月 3 日至 2024 年 1 月 16 日。主要结局和措施ASRs 或 PTSD 的诊断来自全国住院、门诊和初级保健医学登记处。通过四面相关评估亲子相似性。进行敏感性分析以控制可能的共同创伤事件。结果研究人群包括 6 种家庭类型的 2 194 171 人 （1 146 703 [52.3%] 男性;中位 [范围] 年龄，42 [20-63] 岁）。基因加饲养的家系类型加权四面体相关性为 0.15 （95% CI，0.15-0.16），仅基因 0.08 （95% CI，0.06-0.11），仅饲养 0.10 （95% CI，0.07-0.12）。 控制潜在的共同创伤事件，敏感性分析发现与抚养的相关性降低，最保守的对照（排除 1 年内发生 ASR 或 PTSD 的父母-后代二元组）表明与基因和抚养的相关性相等。结论和相关性ASRs 或 PTSD 的诊断表明跨代传播，包括遗传和抚养相关性。敏感性分析表明，共同的创伤事件部分解释了观察到的抚养相关性。