The Role of the DRD2 A1 Allele in Mental Health: Insights for First Nations Australians and the Impact of Cultural Practices
Introduction
Scientists have long understood that our genes and gene expression can influence our mental health and behaviour. The DRD2 gene, particularly its A1 allele variant, when activated, is linked to higher risks of alcohol and drug abuse, mental health challenges such as ADHD and depression and an increase in reward seeking behaviour generally. This dopamine receptor gene allele effectively reduces the availability of dopamine able to be used in the brain and tends to be much higher in indigenous populations, however, there is limited research on how this gene affects Australian First Nations people. The impact of a reduced number of dopamine receptors can drive individuals to seek greater stimulation through activities and experiences to account for the reduced reward experienced by more neutral experiences.
DRD2 stands for Dopamine Receptor D2. It is a gene that encodes the D2 subtype of the dopamine receptor, which is a protein that interacts with the neurotransmitter dopamine in the brain. Dopamine receptors, including the D2 subtype, play a key role in many neurological processes, including movement, motivation, reward, and the regulation of mood
This article explores how the DRD2 A1 allele might impact the health and wellbeing of First Nations Australians and how their cultural practices could help reduce these genetic risks and reduce the likelihood of epigenetic. This article seeks to make the case for further genetic research to uncover if there is a genetic predisposition among first nation Australians to mental health challenges and addiction. ?A study by Blum et al. (2022) provides significant scientific evidence about the DRD2 gene's role and builds on research which began to be published in the 1990’s on this topic.
This article does not intend to oversimplify the complex social political and cultural issues that impact indigenous mental health and well-being by reducing the challenges to biological predispositions. This article looks to highlight the importance of gathering data to help build the overall picture and provide scientific evidence to support lived experiences.
Understanding the DRD2 A1 Allele
The DRD2 gene produces the D2 dopamine receptor, which is crucial for experiencing pleasure and reward. Dopamine is a chemical in the brain that plays a significant role in motivation, mood regulation, cognitive processing, and addiction. People with the A1 variant have fewer dopamine receptors, leading to a condition called hypodopaminergia. This can make them seek out rewarding activities, like harmful substances, to make up for lower dopamine activity (Noble et al., 1998; Smillie et al., 2010).
Behavioural Indicators and the DRD2 A1 Allele
The DRD2 A1 allele is linked to higher novelty-seeking behaviour, which can sometimes lead to risky actions and substance abuse. Understanding these traits is important for creating targeted interventions (Noble et al., 1998; Blum et al., 2000). For example, people with this genetic trait might be more likely to try drugs and alcohol to feel rewarded.
Reward Deficiency Syndrome
Reward Deficiency Syndrome (RDS) is when someone cannot feel satisfaction from normal activities because their brain's reward system does not work properly. The DRD2 A1 allele is a key genetic marker for RDS. People with this allele find it harder to feel pleasure from everyday activities and might turn to intense stimuli like drugs or risky behaviours to feel rewarded (Blum et al., 2000). A diagram showing the brain's reward pathway could help explain these connections.
Treatment of RDS
In exploring the impact of the DRD2 A1 allele on mental health and the resultant Reward Deficiency Syndrome (RDS), it is essential to consider the emerging treatment strategies that aim to restore dopamine homeostasis. Elizabeth Dale Gilley's research introduces a novel approach, Reward Deficiency Syndrome Solution-Focused Brief Therapy (RDS-SFBT), which bridges the gap between cutting-edge neurogenetic research and practical addiction recovery treatment. Gilley highlights that traditional treatments often fail to address the underlying dopaminergic dysfunction inherent in RDS. RDS-SFBT incorporates psycho-educational material, Rational Emotive Behavior Therapy (REBT), Reality Therapy (RT), and Motivational Interviewing (MI) to empower individuals with RDS to develop personalized recovery plans.
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By focusing on enhancing dopamine levels through natural and therapeutic interventions, this approach seeks to mitigate the drive towards harmful reward-seeking behaviours, such as substance abuse, that are often exacerbated in individuals with the DRD2 A1 allele. In comparison, traditional First Nations practices, such as "dadirri" (deep listening) and connection to land, emphasize holistic wellbeing, spirituality, and community ties, which have been shown to reduce stress and enhance mental resilience.
The integration of modern therapeutic approaches like RDS-SFBT with these cultural practices offers a promising avenue for more effective treatment. While RDS-SFBT provides structured, evidence-based techniques to directly address the neurogenetic aspects of RDS, traditional practices contribute a sense of identity, belonging, and spiritual healing that can further reinforce mental and emotional stability. This integrated model acknowledges the strengths of both modern science and ancient wisdom, potentially leading to a more comprehensive and culturally sensitive approach to mental health for First Nations Australians.
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DRD2 A1 Allele and ADHD
The DRD2 A1 allele has also been associated with Attention Deficit Hyperactivity Disorder (ADHD). Individuals with ADHD often have challenges with attention, hyperactivity, and impulsiveness. Research suggests that the DRD2 A1 allele may contribute to these symptoms by affecting dopamine regulation in the brain, leading to difficulties in maintaining attention and controlling impulses (Faraone et al., 2005). This connection highlights the broader impact of the DRD2 A1 allele on various mental health challenges beyond substance abuse. According to a study by the Australian Institute of Health and Welfare (AIHW), First Nations children are more likely to be diagnosed with ADHD, with prevalence rates estimated to be around 11% compared to 7% in non-Indigenous children (AIHW, 2020). This higher prevalence is linked to a range of factors, including genetic predispositions, social and environmental influences, and the impacts of historical trauma.
Other Mental Health Challenges
The DRD2 A1 allele is also linked to other mental health issues such as depression and anxiety. These conditions can be exacerbated by the reduced dopamine activity associated with the A1 variant. Individuals with the DRD2 A1 allele may experience lower mood and increased stress, leading to a higher risk of developing anxiety and depressive disorders (Comings & Blum, 2000). Understanding these links is crucial for developing comprehensive mental health strategies for those affected.
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Prevalence of the DRD2 A1 Allele in Different Populations
The prevalence of the DRD2 A1 allele varies among different ethnic groups:
Evolutionary Anthropology and Reward-Seeking Behaviour
Studies in evolutionary anthropology suggest that populations migrating farther from Africa – such as Australian first nations - show higher reward-seeking behaviours, which could help spread genes like the DRD2 A1 allele. Moving to new places often required risk-taking and novelty-seeking traits, helpful for finding new resources and adapting to different environments (Torney et al., 2010). These behaviours were crucial for survival and success in new territories, leading to a higher prevalence of genes associated with reward-seeking in these populations. This genetic trait, which once supported survival and resource acquisition in unfamiliar territories, now potentially contributes to the heightened susceptibility to substance abuse and mental health disorders observed in contemporary Indigenous populations.
The Gap in Literature
Many studies have looked at the DRD2 A1 allele in various populations, but there is a lack of research specifically on Australian First Nations people. Research on Taiwanese Aboriginals has linked the A1 allele to higher rates of alcoholism, suggesting similar studies on Australian First Nations could provide valuable insights (Chen et al., 1997). The study by Blum et al. (2022) adds more evidence that the DRD2 gene is important for RDS, which could be highly relevant for Indigenous Australians given their unique genetic and cultural background.
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Current State of Mental Health Issues Affecting First Nations Australians
First Nations Australians face significant mental health challenges influenced by a range of factors, including transgenerational trauma and cultural and social determinants. Statistics show far higher levels of psychological distress, suicide, and addiction compared to non-Indigenous Australians:
Cultural Determinants of Health
The integration of cultural determinants of health (CDoH) into mental health and addiction treatment is crucial for creating effective, culturally sensitive interventions for First Nations Australians. The CDoH framework, which emphasizes the importance of Indigenous knowledges, cultural practices, and connection to land, provides a holistic approach to health that aligns deeply with the traditional practices of First Nations peoples. However, as highlighted by Parter et al. (2024), systemic racism and the dominance of Western biomedical knowledge systems in policy-making have often marginalised these Indigenous perspectives, preventing their full integration into health services. To truly address the mental health challenges linked to the DRD2 A1 allele, it is imperative to embed Indigenous ways of being, knowing, and doing into health policies and practices. This approach not only respects the cultural identity and autonomy of Indigenous communities but also enhances the effectiveness of interventions by aligning them with the lived experiences and cultural strengths of First Nations Australians
These traditional ways of being and cultural practices may help mitigate the negative effects of the DRD2 A1 allele if present.
Self-Medication Tendency
The tendency for First Nations Australians to self-medicate dopamine deficiency, particularly through substance abuse, can be understood as a coping mechanism rooted in both biological and historical factors. The DRD2 A1 allele, associated with reduced dopamine receptor availability and Reward Deficiency Syndrome (RDS), drives individuals to seek out substances that temporarily elevate dopamine levels. However, this behaviour is not merely a biological response; it is also deeply intertwined with the enduring impacts of transgenerational trauma.
Historical injustices, including colonisation, displacement, and cultural loss, have inflicted profound psychological wounds on Indigenous communities, leading to heightened levels of stress, anxiety, and depression. Research shows that these traumatic experiences can be transmitted across generations, influencing the mental health of descendants through epigenetic changes (Yehuda et al., 2016). Studies have found that the stress and trauma experienced by ancestors can alter gene expression, potentially exacerbating the effects of dopamine-related deficiencies in subsequent generations (Serpeloni et al., 2017).
As a result, many Indigenous Australians may be predisposed to self-medicate in an attempt to alleviate the psychological distress inherited through both genetic and environmental pathways. This intersection of biological predisposition and historical trauma underscores the importance of culturally sensitive interventions that address both the genetic and psychosocial dimensions of substance abuse in First Nations communities.
Potential Benefits of Cultural Practices
Integrating traditional cultural practices with modern mental health and addiction treatments can create more effective, culturally sensitive interventions for Australian First Nations people. These practices enhance physical and mental wellbeing and reinforce a sense of identity and community, providing a holistic approach to health (Dudgeon et al., 2014). Daniel Amen's work also highlights the importance of spirituality and social connections in supporting brain health and mental wellbeing. Amen's studies have shown that practices promoting spirituality and social bonding can improve brain function and mental health outcomes (Amen, 2018). Successful examples of such integration include community-based programs that combine traditional healing practices with contemporary mental health services, demonstrating improved outcomes for participants.
Current Effective Treatment Models Combining First National Cultural Practices
The integration of traditional First Nations practices with modern therapeutic approaches, as demonstrated in programs like the Marumali Program, We Al-li, and Strong Spirit Strong Mind, offers a promising framework for addressing the mental health challenges associated with the DRD2 A1 allele. These programs have successfully combined cultural practices such as "dadirri" (deep listening), yarning circles, and connection to land with evidence-based therapies like cognitive-behavioral therapy (CBT) and trauma-informed care.
Given that the DRD2 A1 allele is linked to Reward Deficiency Syndrome (RDS) and heightened risks of substance abuse and mental health disorders, these integrated models can provide a holistic approach to treatment. By enhancing dopamine regulation through both cultural and modern therapeutic methods, these programs not only address the neurogenetic factors related to the DRD2 A1 allele but also strengthen cultural identity and community connections, which are crucial for long-term resilience and mental health. This combined approach could be particularly effective in reducing the adverse effects of the DRD2 A1 allele among First Nations Australians, offering a comprehensive strategy for improving overall wellbeing.
1.????? The Marumali Program is an Indigenous Australian initiative designed to support the healing of Aboriginal and Torres Strait Islander peoples who have experienced trauma, particularly those affected by the Stolen Generations. The program integrates traditional healing practices, such as "dadirri" (deep listening), with modern psychological therapies like cognitive behavioral therapy (CBT) and trauma-informed care.
One of the program's significant successes is its ability to foster a strong sense of identity and belonging among participants, which has led to improved mental health outcomes. By combining traditional practices that emphasize connection to land, culture, and community with modern therapeutic techniques, the program has seen reductions in symptoms of PTSD, depression, and anxiety among its participants.
2.????? The We Al-li Program is another Indigenous Australian initiative that integrates traditional cultural practices with Western therapeutic approaches to address trauma and promote healing. The program uses narrative therapy, group therapy, and other modern psychological methods alongside traditional storytelling, art, and cultural rituals.
Participants in the We Al-li Program have reported significant improvements in their mental health, particularly in their ability to cope with trauma and grief. The integration of cultural practices has been key to the program's success, as it provides a culturally safe space for healing, where individuals feel understood and supported in their cultural identity.
3.????? Yarning circles are a traditional Aboriginal practice where participants sit in a circle and share stories, experiences, and wisdom. This practice has been successfully integrated with modern group therapy techniques to create a culturally appropriate therapeutic environment. The combination allows for open dialogue, peer support, and collective healing.
Case Study: In a mental health program for Aboriginal men in New South Wales, yarning circles were combined with group cognitive-behavioural therapy (CBT) sessions. The program reported enhanced engagement and participation from the men, who felt more comfortable sharing their experiences in a culturally familiar format. This approach led to significant improvements in mental health indicators, including reduced levels of depression and anxiety.
4.???? Strong Spirit Strong Mind
This program, implemented in Western Australia, combines traditional cultural practices with evidence-based substance use interventions. The program emphasises the importance of cultural identity and connection to land while providing modern therapeutic support for substance abuse.
The Strong Spirit Strong Mind program has been particularly successful in reducing alcohol and drug use among Aboriginal youth. The integration of cultural practices, such as participation in cultural camps and connection to Elders, with modern addiction counselling has resulted in lower relapse rates and stronger community ties among participants.
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Conclusion
Researching the DRD2 A1 allele in Australian First Nations people provides valuable insights into the genetic foundations of mental health challenges, such as Reward Deficiency Syndrome (RDS), ADHD, and substance abuse. However, this genetic perspective is only one aspect of a much broader narrative. The intersection of biological predispositions with the profound effects of transgenerational trauma and social determinants underscores the complexity of mental health issues faced by Indigenous Australians. By acknowledging and integrating the strengths of both modern scientific approaches and traditional cultural practices, a more comprehensive and culturally sensitive strategy can be developed to support the health and resilience of First Nations communities.
The potential benefits of combining modern therapeutic methods, such as those addressing dopamine regulation, with traditional practices rooted in connection to land, community, and spirituality, are significant. Programs like the Marumali Program, We Al-li, and Strong Spirit Strong Mind exemplify how this integration can foster healing and improve mental health outcomes. Future research should continue to explore this genetic-cultural interplay, ensuring that interventions are not only effective but also culturally respectful and empowering for First Nations Australians. Through such an approach, the path to improved wellbeing is paved not only by scientific understanding but also by the rich cultural heritage that has sustained Indigenous peoples for generations.
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References
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