The Neurobiology of Violence in a Psychosis Risk Cohort

大麻暴露是一个公认的精神障碍发展的环境风险因素， 这是一种高度致残的疾病，会带来重大的经济和社会成本。然而，大多数大麻 使用者不会患上精神病，遗传因素似乎在决定个人患上精神病的风险方面发挥了作用。 大麻相关性精神病（CAP）鉴于精神病遗传学的快速发展， 个性化测试可以揭示个人对精神疾病的遗传易感性水平 例如，联合呼吁程序可在不久的将来提供。将此类测试结果提供给 个人将促进积极的健康行为（例如，避免使用大麻，如果CAP易感性 升高），但基于先前的研究尚不清楚是否可能发生这种积极影响;它也是 目前还不清楚这种基因检测的效果在不同的个体之间会有什么不同， 大麻使用史及其人口特征。也有可能提供这种 测试可能具有负面影响（例如，在那些检测结果呈阴性的人中宣传这种信念， CAP的易感性，即大麻使用是无风险的）。此外，CAP遗传易感性的概念 暗示着基因与环境的相互作用--这个概念对于外行人来说是出了名的难以理解。这 提出了一种可能性，即有关CAP易感性的信息可能被宿命地误解为意味着 精神病风险仅由遗传决定，这可能会对自我效能感产生负面影响 关于健康行为。关于基因检测的潜在积极和消极影响的问题， CAP易感性具有重要的伦理和政策影响，特别是考虑到正在推动合法化 在美国各州使用大麻作为消遣。拟议补充项目的目标 是（1）调查，在一个全国代表性的个人样本的随机实验研究 年龄在18-30岁之间，关于遗传CAP风险的个性化信息在有和没有CAP风险的人群中可能产生的影响。 过去吸食大麻的历史;（2）检查受访者的人口统计变量（例如，种族和民族）， 个性化遗传信息效应的潜在调节者;（3）探索学习的潜力 关于一个人对CAP的遗传易感性被误解为指示精神病的易感性，即使在 由于遗传宿命论和未能掌握基因-环境的性质， 互动，从而减少与健康有关的机构的感觉。我们的研究结果将为 制定伦理标准和政策，指导CAP易感性基因检测的使用，包括 决定是否提供这种测试以及向谁提供。这将补充母公司R 01奖， 它的重点是更好地理解有精神病风险的个体的暴力意念， 特别是精神病和暴力的最重要的环境风险因素之一。这 在审查暴力与精神病之间的联系时，这项工作将开辟更多的研究领域。

Cannabis exposure is an established environmental risk factor for the development of psychotic disorders, which are highly disabling conditions that carry major economic and societal costs. However, most marijuana users do not develop psychosis, and genetic factors appear to play a role in determining an individual's risk of cannabis-associated psychosis (CAP). Given the rapid advancement of psychiatric genetics, it is possible that personalized testing that could reveal an individual's level of genetic susceptibility to psychiatric conditions such as CAP could become available in the near future. The goal of providing the results of such testing to individuals would be to promote positive health behaviors (e.g., avoiding cannabis use if CAP susceptibility is elevated), but based on prior research is unclear whether such positive effects are likely to occur; it is also unclear how the effects of this kind of genetic testing might differ among individuals depending upon their history of cannabis use and their demographic characteristics. It is also possible that providing this kind of testing could have negative effects (e.g., promoting the belief among those who test negative for a predisposition to CAP that cannabis use is risk-free). Additionally, the notion of genetic susceptibility to CAP implies a gene-environment interaction—a concept that is notoriously difficult for laypeople to understand. This raises the possibility that information about CAP susceptibility could be fatalistically misinterpreted as implying that psychosis risk is determined by genetics alone, which could negatively impact feelings of self-efficacy regarding health behaviors. Questions about the potential for positive and negative effects of genetic testing for CAP susceptibility have important ethical and policy implications, especially given the ongoing push to legalize recreational marijuana use in various states throughout the US. The aims of the proposed supplement project are to (1) investigate, in a randomized experimental study of a nationally representative sample of individuals aged 18-30, the likely impact of personalized information about genetic CAP risk among those with and without a past history of marijuana use; (2) examine respondent demographic variables (e.g., race and ethnicity) as potential moderators of the effect of personalized genetic information; and (3) explore the potential for learning about one's genetic predisposition to CAP to be misunderstood as indicating susceptibility to psychosis even in the absence of cannabis use, due to genetic fatalism and failure to grasp the nature of gene-environment interactions, thereby decreasing feelings of health-related agency. Our results will be informative for the development of ethical standards and policy to guide the use of genetic testing for CAP susceptibility, including decision-making about whether to offer such testing and to whom. This will complement the parent R01 award, which focuses on better understanding violent ideation in individuals at risk for psychosis, as cannabis abuse in particular is one of the most substantial environmental risk factors for both psychosis and violence. This work will open up additional areas of study when examining links between violence and psychosis.