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Chunk #29 — The 5-HTTLPR-by-Stressful Life Events Interaction Example

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A critical review of the first 10 years of candidate gene-by-environment interaction research in psychiatry.
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Karg et al. (39) touch on the possibility for publication bias to affect their results by calculating the fail-safe ratio. They note that 14 studies would have to have gone unpublished for every published study in order for their meta-analytic results to be nonsignificant. While this ratio is intended to seem unreachably high, a couple of points should be kept in mind. First, the fail-safe ratio speaks not to unpublished studies but rather to unpublished analyses. As discussed above, possibilities for alternative analyses (i.e., indirect cG×E replications) abound: alternative outcome, genotypic, and environmental variables can be investigated; covariates or additional moderators can be added to the model; additive, recessive, and dominant genetic models can be tested; phenotypic and environmental variables can be transformed; and the original finding can be tested in subsamples of the data. We observed each of these situations at least once among studies consistent with or replicating the original 5-HTTLPR-by-stressful life event interaction, and such indirect replications can have a high false positive rate. Second, and most importantly, Karg et al. used extremely liberal inclusion criteria, analyzing