ASSESSMENT OF THE IMTACT OF STRESS FACTORS AND VARIANTS OF POLYMORPHISM OF THE 5-HTTLPR GENE OF THE SEROTONIN TRANSPORTER (SLC6A4) ON ANXIETY IN CHILDREN IN WAR CONDITIONS.

INTRODUCTION The full scale war in Ukraine has created unprecedented psychosocial stress for children, leading toincreased anxiety. An additional adverse factor may be living in radiationcontaminated areas. At the same time,individual genetic vulnerability (5-HTTLPR polymorphism of the serotonin transporter gene) can modulate theresponse to chronic stress. This study aimed to determine how war and radiation stressors affect the level of traitanxiety in children and whether this relationship is modulated by the 5HTTLPR genotype.

OBJECTIVE to assess the interaction between war related stress factors and variants of the 5-HTTLPR polymorphismof the serotonin transporter gene ( SLC6A4) on anxiety levels in schoolage children.

METHODS A crosssectional survey included 231 children aged 10-17 from three regions of Ukraine that had beenaffected by military operations (some of the participants lived in radioactively contaminated areas). The questionnaire covered data on war stressors (forced displacement, occupation, frequency of air raid alerts, etc.) and psychometric scales, in particular STAI (trait ity anxiety). Genotyping of 5-HTTLPR was performed using allelespecific PCR.The data were analysed using regression methods to assess associations and gene x environment (G x E) interactions.

RESULTS Children who experienced intense war stressors or were regularly exposed to air raid sirens had significantly higher levels of trait anxiety (p < 0.01). The strongest predictor of high anxiety was a high level of response toair raid sirens (OR ≈ 31; p < 0.001). Living in a radiation control zone had no significant effect on anxiety (p = 0.48).The effect of cumulative stress on anxiety was almost twice as strong in children carrying the S allele of 5-HTTLPRthan in those carrying the L/L genotype (G x E effect, p < 0.001).

CONCLUSIONS Chronic war stressors significantly increase children's anxiety levels, with genetically vulnerable individuals (carriers of the S allele of 5-HTTLPR) responding much more strongly to stress. The results emphasise theneed to take into account genetic factors in psychosocial assistance to children experiencing war, with a focus onthe most vulnerable (displaced persons, military families).