Evidence map›Paper›PMID 41812473›Full record

ArticlePsychiatry research2026

Disorganized attachment and identity dissociation: FKBP5 CATT as a molecular moderator.

Leonhard Kratzer, Keith Gaynor, Hans Knoblauch, Abigail Powers, Seyma Katrinli, Vasiliki Michopoulos, Negar Fani, Charles F Gillespie, Tanja Jovanovic, Kerry J Ressler and 3 more

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Article in Psychiatry research, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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1 · What the graph read from it

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2 · The registry

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3 · Its place in the literature

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4 · The record

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5 · Who and what money

Authors and funding

13 authors.

Leonhard KratzerDepartment of Psychotraumatology, Clinic St. Irmingard, Prien am Chiemsee, Germany.
Keith GaynorSchool of Psychology, University College Dublin, Dublin, Ireland.
Hans KnoblauchClinic for Psychiatry and Psychotherapy I (Weissenau), Ulm University, Ulm, Germany; Centre for Psychiatry Suedwuerttemberg, Ravensburg, Germany.
Abigail PowersDepartment of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA, USA.
Seyma KatrinliDepartment of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA, USA; Department of Gynecology and Obstetrics, Emory University School of Medicine, Atlanta, GA, USA.
Vasiliki MichopoulosDepartment of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA, USA.
Negar FaniDepartment of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA, USA.
Charles F GillespieDepartment of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA, USA.
Tanja JovanovicDepartment of Psychiatry and Behavioral Neurosciences, Wayne State University School of Medicine, Detroit, MI, USA.
Kerry J ResslerDepartment of Psychiatry, McLean Hospital, Harvard Medical School, Belmont, MA, USA.
Alicia K SmithDepartment of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA, USA; Department of Gynecology and Obstetrics, Emory University School of Medicine, Atlanta, GA, USA.
Bertram Müller-MyhsokResearch Group Statistical Genetics, Max Planck Institute of Psychiatry, Munich, Germany.
Stefan TschökeClinic for Psychiatry and Psychotherapy I (Weissenau), Ulm University, Ulm, Germany; Centre for Psychiatry Suedwuerttemberg, Ravensburg, Germany. Electronic address: stefan.tschoeke@zfp-zentrum.de.

Funding

Genetic and Trauma-Related Risk Factors for PTSDR01MH071537 · NIMH · EMORY UNIVERSITY · PI RESSLER, KERRY J. · 2005 to 2014
$8.5M
Development, Trauma, and Genotype Effects on Biomarkers of Anxiety in ChildrenR01MH100122 · NIMH · EMORY UNIVERSITY · PI JOVANOVIC, TANJA · 2013 to 2017
$1.9M
Stress-Related Psychobiology and Inflammation in Diabetic African-American WomenR01MH099211 · NIMH · EMORY UNIVERSITY · PI GILLESPIE, CHARLES FREDERICK · 2013 to 2017
$1.9M
NIMH NIH HHS R01 MH071537NIMH NIH HHS R01 MH099211NIMH NIH HHS R01 MH100122
6 · The paper itself

Abstract

backgroundChildhood maltreatment and FKBP5 CATT haplotypes increase identity dissociation risk. While maltreatment often fosters disorganized attachment, the specific role of the FKBP5 CATT haplotype within this developmental pathway remains unknown.

methodsIn 310 trauma-exposed adults, we assessed childhood maltreatment, disorganized attachment, and identity dissociation. FKBP5 CATT haplotype status was dichotomized (present/absent). Regression models were estimated to examine the pathway Childhood Maltreatment → Disorganized Attachment → Identity Dissociation, comparing two competing hypotheses: 1) The Formation Hypothesis (Maltreatment × CATT → Disorganization), and 2) The Translation Hypothesis (Disorganization × CATT → Identity Dissociation). Model fit was compared using BIC, and simple slopes were examined.

resultsDisorganized attachment predicted identity dissociation (β = 0.143, z = 3.83, p < .001), and childhood maltreatment predicted disorganization (β = 0.007, z = 4.46, p < .001). The Formation hypothesis was not supported, as the Maltreatment × CATT interaction did not predict disorganization (β = -0.004, z = -1.18, p = .24). However, the Translation hypothesis was supported by three pieces of evidence: a significant Disorganization × CATT interaction predicting identity dissociation (β = 0.133, z = 2.22, p = .027), model fit (∆BIC = 265.3), and simple slopes showing a strong effect of disorganization on identity dissociation for CATT carriers (β = 0.15, p < .001; +16.5 % per unit) but not for non-carriers (β = 0.02, p = .65).

conclusionsThe FKBP5 CATT haplotype does not promote disorganized attachment but amplifies the translation of disorganized attachment into identity dissociation. This result highlights a genetically influenced failure of identity development following disorganized attachment.

Indexed as

Dissociative DisordersObject AttachmentTacrolimus Binding ProteinsAdultFemaleGene-Environment InteractionHaplotypesHumansMalePolymorphism, Single NucleotideTacrolimus Binding Protein 5Young AdultTacrolimus Binding Protein 5Tacrolimus Binding ProteinsAttachmentChildhood maltreatmentFKBP5 haplotypesGene-environment interactionIdentity dissociation

Identifiers

PMID41812473
PMCPMC13294002

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.