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Psychiatric Genetics and GenomicsReview - Psychiatric Genetics and Genomics
by Peter McGuffin, Michael J. Owen & Irving I. Gottesman (Editors)
Oxford University Press, 2002
Review by Keith S. Harris, Ph.D.
Oct 13th 2003 (Volume 7, Issue 42)

Psychiatric Genetics and Genomics is a carefully-selected compilation of chapters that give the clinician a thorough overview of the influence of recent genetic advances in a variety of areas, including mental illness, the formation of personality, the development of learning disorders, and degree of susceptibility to drug and alcohol addiction. The tailoring of drug regimens based on individual genetics is discussed, and implications for medical ethicists are considered.

The heritability (degree of genetic influence) of serious mental illnesses such as bipolar disorder and schizophrenia will be of special interest to those who work directly with such clients. One of the first questions professionals are asked by the anxious families of people recently diagnosed with a severe mental illness are, Why has this happened to us? Was it the way we treated her as a child? Were we too critical, demanding, demeaning, or rejecting? Could it have been that fall from the tree at age eleven, or that blow to the head during a ninth grade soccer match? Or the case of measles mom came down with when she was pregnant? Perhaps it's in the bloodline -- there was that other family member, a grandparent or aunt, rumored to have spent years sequestered away in a mental hospital long ago. And if this mental disorder was really caused by some genetic malfunction, should we worry about the other kids? Are they also at risk of developing a terrible illness? Is there another time bomb yet in store for the family?

Experienced clinicians are appropriately cautious in responding to these questions. The family can safely be told that not even the experts know how to fully account for or predict serious mental illnesses. There has not been much research support for those once-ubiquitous reports of the psychological damage caused by "schizophrenogenic" parents, whose emotional mistreatment of the child was thought to be the cause of schizophrenia. And as studies of identical twins show, neither can genetics alone explain the onset of serious mental illnesses. The best current understanding is that although the child may have inherited or acquired the susceptibility for these illnesses, unpredictable environmental factors also likely play a large role. So while the family can be reassured that it should not blame itself, not any more than a family should hold itself responsible when its members are victims of natural disasters, questions about heritability and environment remain.

Psychiatric Genetics and Genomics is divided into four parts. The first deals with the basic science of heredity. This section reviews what is currently known about the structure and function of DNA, chromosomal abnormalities, and the methods of quantitative genetics (such as family and twin studies), and establishes heritability and its analysis as central among the core issues of behavioral genetics. Much more compact than a college text, this section is nonetheless quite thorough and especially useful for clinicians who do not often deal with these issues at a detailed level.

The second part of this collection considers both normal and abnormal developmental issues, including personality formation, the heritability of cognitive capacities, mental retardation and learning disorders. A brief history of the quantification of personality is provided, with special consideration of what is commonly known as the Five Factor Model of personality. Although self-report questionnaires form the basis of most research into personality, twin studies using peer-rating systems have provided additional support to the (rather consistent) finding that between 40 and 50 percent of the variability in personality is heritable, and that the effects of shared environment is negligible. (The influence of non-shared environmental factors is substantial, however, accounting for as much as 50 percent of the variability of personality. The book's discussion of the importance of these non-shared environmental effects is convincing.)

Most researchers now accept the broad heritability of cognitive capacities, including those abilities that are assumed to be the basis for general intelligence, or g. "Correlations for first-degree relatives living together average 0.43 for more than 8000 parent-offspring pairs and 0.47 for more than 25,000 pairs of siblings" (p. 83). Simple cultural and environmental explanations of the correlations among related family members are unlikely to be correct, since twin studies in a wide variety of countries, regions and cultures tend to support the heritability of g. Of special interest are the studies of twins raised apart, since this permits substantial isolation of the effects of shared environment.

The third part of this book considers the possibility of genetic influences on both the mental disorders widely considered endogenous (e.g., schizophrenia and recurrent major depression) and those thought to be in large part socially created. For example, the heritability of personality factors has recently been fairly well established, and so the question of genetic underpinnings of personality disorders also arises. Many theorists and clinicians have long been assumed these disorders to be largely the result of environmental deficits or insults. For example, borderline personality disorder has been thought to result from an impaired maternal relationship during infancy and early childhood, and criminals with diagnosable antisocial personalities are often reported to have had childhood histories of abuse and neglect. While research results are mixed, this book summarizes an assortment of credible studies in the U.S. and other countries that, on the whole, suggest at least some degree of heritability in these and other personality disorders.

As pointed out above, the genetic links in major mental illnesses and vulnerability to substance abuse and misuse have long been suspected. There have of course been false starts and overly optimistic reporting in the media on some lines of promising research, but with advances in genetic research, scientists are now able to begin the process of identifying the specific genes that may be involved in the development of many of these disorders. Once these genes have been identified, animal studies can be designed to allow better-controlled experimentation on these illnesses and conditions.

The last section of the book is composed of chapters on psychopharmacogenetics, ethics related to genetics research and applied science, the counseling of people in whom genetic susceptibilities have been identified, and the future of psychiatry and psychology after the promises of genetic research have been more fully realized.

Although some sections of this book will be somewhat stiff reading for those without scientific training, most of this material should be accessible to scientists and practitioners alike.

 

2003 Keith Harris

Keith Harris, Ph.D., is a clinical psychologist and supervises the research section of the Department of Behavioral Health, San Bernardino County, California. His interests include the empirical basis for psychotherapy research (and its design), human decision-making processes, and the shaping of human nature by evolutionary forces.


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