Serotonin transporter polymorphism, depressive symptoms, and emotional impulsivity among advanced breast cancer patients

Youngmee Kim, Charles S. Carver, Joachim F. Hallmayer, Jamie M. Zeitzer, Oxana Palesh, Eric Neri, Bita Nouriani, David Spiegel

Research output: Contribution to journalArticlepeer-review

1 Scopus citations


Purpose: This study tested a theory linking a marker of low serotonergic function to both depression and impulsivity in a sample of advanced breast cancer patients, among whom elevated depressive symptoms and difficulty regulating emotions are commonly reported. Methods: A total of 95 patients provided blood samples for serotonin transporter polymorphic region of the gene (5-HTTLPR) and completed questionnaires that measured depressive symptoms and emotional impulsivity. Results: Structural equation modeling revealed that the s allele of 5-HTTLPR was related to greater depressive symptoms (β = .20, p < .042) but only marginally to greater emotional impulsivity (β = .19, p < .068). Depressive symptoms and emotional impulsivity were positively related (β = .33, p < .003). Further tests explored possible mediation from genotype to one psychological variable via the other. Results suggest that depressive symptoms, particularly perceived interpersonal rejection, may be a pathway linking genotype to emotional impulsivity. Conclusions: Findings provide the first evidence that low serotonergic function contributes to both depression and impulsivity within a clinically meaningful sample. Furthermore, the link of s allele of 5-HTTLPR to emotional impulsivity was mediated by depressive symptoms, particularly perceptions of social rejection. Findings have implications for advanced breast cancer patients’ treatment decision.

Original languageEnglish (US)
Pages (from-to)1181-1188
Number of pages8
JournalSupportive Care in Cancer
Issue number4
StatePublished - Apr 1 2018


  • Advanced breast cancer
  • Depressive symptoms
  • Emotional impulsivity
  • Serotonin transporter polymorphism (5-HTTLPR)
  • Treatment decision

ASJC Scopus subject areas

  • Oncology


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