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Zollicoffer A, Strauss G, Luther L, Schiffman J, Sims B, Kambui H, Li H. The relationship between perceived family support and subclinical positive symptoms of psychosis among Black college students. Early Interv Psychiatry 2024. [PMID: 38769063 DOI: 10.1111/eip.13554] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/03/2023] [Revised: 01/24/2024] [Accepted: 05/09/2024] [Indexed: 05/22/2024]
Abstract
AIM Black individuals in the Unites States endure compounded and unique experiences of discrimination and structural racism that may not be as overtly evident in other countries. These distinctive forms of discrimination and racism can impact the mental health of Black individuals in the Unites States, in this case, their risk for psychosis. Adolescence and early adulthood are vulnerable periods in life where mental illness typically begins to manifest. Understanding the factors contributing to an increased likelihood of specific mental illnesses, such as psychosis, among youth in these vulnerable periods can inform intervention development. This is particularly important for those from minoritized backgrounds Unites States; this group is especially important to study given that Black American youth tend to experience higher psychosis rates and different symptom presentations than non-Black groups. METHODS This study examined the associations between perceived family support, a critical environmental factor known to be associated with full-psychosis, and attenuated positive symptoms and distress levels in a sample of 155 Black students from a Historically Black College and University (HBCU). Participants completed the Prodromal Questionnaire-Brief that assessed psychosis risk and the Family Environment Scale that assessed three dimensions of family support (family cohesion, expressiveness, and conflict). RESULTS AND CONCLUSION Positive symptom intensity (r = .30, p < .001) and distress (r = .34, p < .001) were significantly associated with higher family conflict for Black individuals in the Unites States. The findings inform novel intervention targets for psychoeducation and family therapy that have potential to reduce psychosis risk.
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Affiliation(s)
| | - Gregory Strauss
- Department of Psychology, University of Georgia, Athens, Georgia, USA
| | - Lauren Luther
- Department of Psychology, University of Georgia, Athens, Georgia, USA
| | - Jason Schiffman
- Department of Psychology, UC Irvine, Irvine, California, USA
| | - Brian Sims
- Department of Psychology, Florida A&M University, Tallahassee, Florida, USA
| | - Hasseim Kambui
- Department of Psychology, Florida A&M University, Tallahassee, Florida, USA
| | - Huijun Li
- Department of Psychology, Florida A&M University, Tallahassee, Florida, USA
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Gordon S, Mote J, Fulford D. Qualitative Analysis of Paranoia Reported in Clinical Interviews With Black and White Adults With Schizophrenia. Psychiatr Serv 2023; 74:1263-1269. [PMID: 37254507 PMCID: PMC10687302 DOI: 10.1176/appi.ps.20220089] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
Black adults in the United States are more likely to be diagnosed as having schizophrenia spectrum disorders and to report experiences of paranoia than are White adults. Cultural mistrust, or marginalized groups' adaptive skepticism toward dominant historically White institutions, is associated with paranoia among Black individuals, suggesting that experiences of paranoia may be culturally mediated. The authors aimed to explore thematic differences between Black and White adults with schizophrenia spectrum disorders in their experiences of paranoia, including potential differences in persecutory content, cultural mistrust, and related themes. The authors conducted a thematic content analysis of archival qualitative data on experiences of paranoia reported by Black and White adults with schizophrenia spectrum disorders (N=21) in a structured clinical interview. Distinct themes related to cultural mistrust and persecutory paranoia emerged among the participants, suggesting that lived experiences of persecution and discrimination may affect how Black adults with schizophrenia spectrum disorders interpret threat and express paranoia. These findings highlight the importance of culturally responsive approaches in assessment and conceptualization of clinical paranoia versus cultural mistrust.
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Affiliation(s)
- Shari Gordon
- Department of Counseling, Developmental, and Educational Psychology, Boston College, Chestnut Hill, Massachusetts (Gordon); Department of Occupational Therapy, Sargent College at Boston University, Boston (Mote, Fulford); Department of Psychological and Brain Sciences, Boston University, Boston (Fulford)
| | - Jasmine Mote
- Department of Counseling, Developmental, and Educational Psychology, Boston College, Chestnut Hill, Massachusetts (Gordon); Department of Occupational Therapy, Sargent College at Boston University, Boston (Mote, Fulford); Department of Psychological and Brain Sciences, Boston University, Boston (Fulford)
| | - Daniel Fulford
- Department of Counseling, Developmental, and Educational Psychology, Boston College, Chestnut Hill, Massachusetts (Gordon); Department of Occupational Therapy, Sargent College at Boston University, Boston (Mote, Fulford); Department of Psychological and Brain Sciences, Boston University, Boston (Fulford)
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Theisen C, Rosen M, Meisenzahl E, Koutsouleris N, Lichtenstein T, Ruhrmann S, Kambeitz J, Kambeitz-Ilankovic L, Riecher-Rössler A, Chisholm K, Upthegrove R, Antonucci LA, Bertolino A, Pigoni A, Salokangas RKR, Pantelis C, Wood SJ, Lencer R, Falkai P, Hietala J, Brambilla P, Schmidt A, Andreou C, Borgwardt S, Osman N, Schultze-Lutter F. The heterogeneity of attenuated and brief limited psychotic symptoms: association of contents with age, sex, country, religion, comorbidities, and functioning. Front Psychiatry 2023; 14:1209485. [PMID: 37484669 PMCID: PMC10361815 DOI: 10.3389/fpsyt.2023.1209485] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/20/2023] [Accepted: 06/13/2023] [Indexed: 07/25/2023] Open
Abstract
Introduction The Attenuated Psychosis Symptoms (APS) syndrome mostly represents the ultra-high-risk state of psychosis but, as does the Brief Intermittent Psychotic Symptoms (BIPS) syndrome, shows a large variance in conversion rates. This may be due to the heterogeneity of APS/BIPS that may be related to the effects of culture, sex, age, and other psychiatric morbidities. Thus, we investigated the different thematic contents of APS and their association with sex, age, country, religion, comorbidity, and functioning to gain a better understanding of the psychosis-risk syndrome. Method A sample of 232 clinical high-risk subjects according to the ultra-high risk and basic symptom criteria was recruited as part of a European study conducted in Germany, Italy, Switzerland, and Finland. Case vignettes, originally used for supervision of inclusion criteria, were investigated for APS/BIPS contents, which were compared for sex, age, country, religion, functioning, and comorbidities using chi-squared tests and regression analyses. Result We extracted 109 different contents, mainly of APS (96.8%): 63 delusional, 29 hallucinatory, and 17 speech-disorganized contents. Only 20 contents (18.3%) were present in at least 5% of the sample, with paranoid and referential ideas being the most frequent. Thirty-one (28.5%) contents, in particular, bizarre ideas and perceptual abnormalities, demonstrated an association with age, country, comorbidity, or functioning, with regression models of country and obsessive-compulsive disorders explaining most of the variance: 55.8 and 38.3%, respectively. Contents did not differ between religious groups. Conclusion Psychosis-risk patients report a wide range of different contents of APS/BIPS, underlining the psychopathological heterogeneity of this group but also revealing a potential core set of contents. Compared to earlier reports on North-American samples, our maximum prevalence rates of contents were considerably lower; this likely being related to a stricter rating of APS/BIPS and cultural influences, in particular, higher schizotypy reported in North-America. The various associations of some APS/BIPS contents with country, age, comorbidities, and functioning might moderate their clinical severity and, consequently, the related risk for psychosis and/or persistent functional disability.
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Affiliation(s)
- Christian Theisen
- Department of Psychiatry and Psychotherapy, Medical Faculty, Heinrich-Heine University, Düsseldorf, Germany
| | - Marlene Rosen
- Department of Psychiatry and Psychotherapy, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Eva Meisenzahl
- Department of Psychiatry and Psychotherapy, Medical Faculty, Heinrich-Heine University, Düsseldorf, Germany
| | - Nikolaos Koutsouleris
- Department of Psychiatry and Psychotherapy, Ludwig-Maximilian-University, Munich, Germany
- Max-Planck-Institute of Psychiatry, Munich, Germany
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom
| | - Theresa Lichtenstein
- Department of Psychiatry and Psychotherapy, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Stephan Ruhrmann
- Department of Psychiatry and Psychotherapy, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Joseph Kambeitz
- Department of Psychiatry and Psychotherapy, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
- Research Center Jülich, Institute for Cognitive Neuroscience (INM-3), Jülich, Germany
| | - Lana Kambeitz-Ilankovic
- Department of Psychiatry and Psychotherapy, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | | | - Katharine Chisholm
- Institute for Mental Health, University of Birmingham, Birmingham, United Kingdom
- Department of Psychology, Aston University, Birmingham, United Kingdom
| | - Rachel Upthegrove
- Institute for Mental Health, University of Birmingham, Birmingham, United Kingdom
| | - Linda A. Antonucci
- Department of Basic Medical Science, Neuroscience, and Sense Organs, University of Bari Aldo Moro, Bari, Italy
| | - Alessandro Bertolino
- Department of Basic Medical Science, Neuroscience, and Sense Organs, University of Bari Aldo Moro, Bari, Italy
| | - Alessandro Pigoni
- Department of Neurosciences and Mental Health, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
- MoMiLab Research Unit, IMT School for Advanced Studies Lucca, Lucca, Italy
| | | | - Christos Pantelis
- Melbourne Neuropsychiatry Centre, University of Melbourne, Melbourne, VIC, Australia
| | - Stephen J. Wood
- Institute for Mental Health, University of Birmingham, Birmingham, United Kingdom
- Orygen, The National Centre of Excellence for Youth Mental Health, Melbourne, VIC, Australia
- Centre for Youth Mental Health, University of Melbourne, Melbourne, VIC, Australia
| | - Rebekka Lencer
- Department of Psychiatry and Psychotherapy, Otto Creutzfeldt Center for Cognitive and Behavioral Neuroscience, University of Muenster, Muenster, Germany
- Department of Psychiatry and Psychotherapy, University of Lübeck, Lübeck, Germany
| | - Peter Falkai
- Department of Psychiatry and Psychotherapy, Ludwig-Maximilian-University, Munich, Germany
- Max-Planck-Institute of Psychiatry, Munich, Germany
| | - Jarmo Hietala
- Department of Psychiatry, Medical Faculty, University of Turku, Turku, Finland
| | - Paolo Brambilla
- Department of Neurosciences and Mental Health, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
- Department of Pathophysiology and Mental Health, University of Milan, Milan, Italy
| | - André Schmidt
- Department of Psychiatry, University of Basel, Basel, Switzerland
| | - Christina Andreou
- Department of Psychiatry and Psychotherapy, University of Lübeck, Lübeck, Germany
| | - Stefan Borgwardt
- Department of Psychiatry and Psychotherapy, University of Lübeck, Lübeck, Germany
| | - Naweed Osman
- Department of Psychiatry and Psychotherapy, Medical Faculty, Heinrich-Heine University, Düsseldorf, Germany
| | - Frauke Schultze-Lutter
- Department of Psychiatry and Psychotherapy, Medical Faculty, Heinrich-Heine University, Düsseldorf, Germany
- Department of Psychology, Faculty of Psychology, Airlangga University, Surabaya, Indonesia
- University Hospital of Child and Adolescent Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland
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Michaels TI, Carrión RE, Addington J, Bearden CE, Cadenhead KS, Cannon TD, Keshavan M, Mathalon DH, McGlashan TH, Perkins DO, Seidman LJ, Stone WS, Tsuang MT, Walker EF, Woods SW, Cornblatt BA. Ethnoracial discrimination and the development of suspiciousness symptoms in individuals at clinical high-risk for psychosis. Schizophr Res 2023; 254:125-132. [PMID: 36857950 PMCID: PMC10106391 DOI: 10.1016/j.schres.2023.02.021] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/07/2022] [Revised: 01/31/2023] [Accepted: 02/15/2023] [Indexed: 03/03/2023]
Abstract
BACKGROUND AND HYPOTHESIS While individuals at clinical high-risk (CHR) for psychosis experience higher levels of discrimination than healthy controls, it is unclear how these experiences contribute to the etiology of attenuated positive symptoms. The present study examined the association of perceived discrimination with positive symptoms in a cohort from the North American Prodrome Longitudinal Study (NAPLS2). It predicted that CHR individuals will report higher levels of lifetime and past year perceived discrimination related to their race and ethnicity (ethnoracial discrimination) and that this form of discrimination will be significantly associated with baseline positive symptoms. STUDY DESIGN Participants included 686 CHR and 252 healthy controls. The present study examined data from the perceived discrimination (PD) scale, the Brief Core Schema Scale, and the Scale for the Psychosis-Risk Symptoms. Structural equation modeling was employed to examine whether negative schema of self and others mediated the relation of past year ethnoracial PD to baseline suspiciousness symptoms. RESULTS CHR individuals report higher levels of past year and lifetime PD compared to healthy controls. Lifetime ethnoracial PD was associated with suspiciousness and total positive symptoms. Negative schema of self and others scores partially mediated the relation of past year ethnoracial PD to suspiciousness, one of five positive symptom criteria for CHR. CONCLUSIONS For CHR individuals, past year ethnoracial discrimination was associated with negative beliefs about themselves and others, which was associated with suspiciousness. These findings contribute to an emerging literature characterizing the mechanisms by which discrimination contributes to the positive symptoms characterizing the CHR syndrome.
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Affiliation(s)
- Timothy I Michaels
- Division of Psychiatry Research, The Zucker Hillside Hospital, Northwell Health, Glen Oaks, NY, USA; Center for Psychiatric Neuroscience, Feinstein Institute for Medical Research, Northwell Health, Manhasset, NY, USA; Department of Psychiatry, The Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY, USA.
| | - Ricardo E Carrión
- Division of Psychiatry Research, The Zucker Hillside Hospital, Northwell Health, Glen Oaks, NY, USA; Center for Psychiatric Neuroscience, Feinstein Institute for Medical Research, Northwell Health, Manhasset, NY, USA; Department of Psychiatry, The Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY, USA
| | - Jean Addington
- Department of Psychiatry, University of Calgary, Calgary, Alberta, Canada
| | - Carrie E Bearden
- Semel Institute for Neuroscience and Human Behavior, Department of Psychology, University of California, Los Angeles, Los Angeles, CA, USA
| | - Kristin S Cadenhead
- Department of Psychiatry, University of California, San Diego, La Jolla, CA, USA
| | - Tyrone D Cannon
- Department of Psychiatry, Yale University, School of Medicine, New Haven, CT, USA; Department of Psychology, Yale University, School of Medicine, New Haven, CT, USA
| | - Matcheri Keshavan
- Department of Psychiatry, Harvard Medical School at Beth Israel Deaconess Medical Center and Massachusetts Mental Health Center, Boston, MA, USA
| | - Daniel H Mathalon
- VA San Francisco Healthcare System, San Francisco, CA, USA; Department of Psychiatry and Weill Institute for Neurosciences, University of California, San Francisco, San Francisco, CA, USA
| | - Thomas H McGlashan
- Department of Psychiatry, Yale University, School of Medicine, New Haven, CT, USA
| | - Diana O Perkins
- Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Larry J Seidman
- Department of Psychiatry, Yale University, School of Medicine, New Haven, CT, USA
| | - William S Stone
- Department of Psychiatry, Harvard Medical School at Beth Israel Deaconess Medical Center and Massachusetts Mental Health Center, Boston, MA, USA
| | - Ming T Tsuang
- Department of Psychiatry, University of California, San Diego, La Jolla, CA, USA
| | - Elaine F Walker
- Department of Psychology, Emory University, Atlanta, GA, USA
| | - Scott W Woods
- Department of Psychiatry, Yale University, School of Medicine, New Haven, CT, USA
| | - Barbara A Cornblatt
- Division of Psychiatry Research, The Zucker Hillside Hospital, Northwell Health, Glen Oaks, NY, USA; Center for Psychiatric Neuroscience, Feinstein Institute for Medical Research, Northwell Health, Manhasset, NY, USA; Department of Psychiatry, The Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY, USA; Department of Molecular Medicine, The Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY, USA
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