Moderating Effects of Genes on Cognitive-Behavior Therapy for Emotional Disorders: A Meta-Analysis

Katherine A Kennedy, Fordham University


Nearly 30% people in the United States will receive a diagnosis of an anxiety or depressive disorder during their lifetime (Kessler et al., 2005). Despite the need for efficacious treatments, many patients who receive treatment do not experience symptom relief (James, Soler, & Weatherall, 2005). Few studies have examined why some patients recover when treated with cognitive-behavioral therapy, while others fail to respond or get worse (DeRubeis et al., 2005). Recent research has begun to examine genetic mechanisms underlying outcome with cognitive-behavior therapy (CBT). Identification of genetic moderators of treatment outcome would provide a greater understanding of the role of biology in psychosocial treatment. The present study is a meta-analysis of the available research on genetic moderators of CBT outcome for anxiety and depression. Empirical articles were selected from PsycINFO and PubMed databases utilizing the following main inclusion criteria: (a) administration of CBT, (b) assessment of gene(s) in evaluating outcome, and (c) diagnostic group with a known anxiety, depressive, obsessive-compulsive, trauma, or depressive disorder. Results indicated small moderating effects of the 5HTTLPR, COMT, BDNF genes on CBT outcome. These findings provide evidence for a gene by environment effect, whereby CBT represents a positive, therapeutic environment. Genes identified in this meta-analysis are associated with fear acquisition and fear learning processes and may moderate treatment outcomes by impacting extinction and habituation, core behavioral principles in CBT. Future studies with follow-up data, comparison conditions, control groups, and fidelity checks are needed in order to strengthen the research on the moderating effect of genes on CBT.

Subject Area

Mental health|Psychology

Recommended Citation

Kennedy, Katherine A, "Moderating Effects of Genes on Cognitive-Behavior Therapy for Emotional Disorders: A Meta-Analysis" (2019). ETD Collection for Fordham University. AAI10928443.