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Chunk #24 — Discussion

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Informing Prevention and Intervention Policy Using Genetic Studies of Resistance.
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the “good”. A vestige of the disease era of research is the widespread existence of items, test and scales designed to measure only a small part of the liability distribution, usually most informative around the threshold between “normal” and “disease”. The recent movement to researching “domains” is an important step in the direction of observing the full range of liability, at one end capturing those at high risk for affection with disease or in the disease spectrum, and at the other, those with high resistance phenotypes. Similarly, polygenic approaches, which index tens, hundreds, or thousands of SNPs to create composite indices of genetic risk, have been developed (Maher, 2015) and it is worthwhile to consider those as part of multifactorial resistance in the same way that polygenic risk scores are used in the context of multifactorial risk. To fully inform research on resistance, an integration of biology, context and their interplay is essential. As described by Falconer, liability is a latent trait comprising effects of all factors, genetic and environmental, influencing an individual’s probability of developing a disorder (Falconer, 1965). Hence, scales developed to measure liability for sampling into prevention trials should comprise not only measures of phenotypic precursors but