Disparities in Psychosis Risk Symptoms for New Zealand Māori May Be Explained by Systemic Stressors and Inappropriate Conceptualization of Culturally Normative Experiences

Abstract

Background and Hypothesis Māori, the indigenous peoples of New Zealand, experience increased rates of psychotic disorders and first-episode psychosis. However, it is unclear whether they also present with increased psychosis risk symptoms, such as subclinical psychotic-like experiences (PLEs). Measurement of risk symptoms is key for early intervention. Further, it is unclear if systemic factors such as the increased rates of social adversity and discrimination or cultural biases contribute to this disparity in psychosis rates. Study Design This study surveyed 466 18- to 30-year olds in New Zealand, and compared Māori to non-Māori participant responses on the Prodromal Questionnaire Brief, alongside the history of childhood trauma, discrimination, and financial adversity. Study Results Māori reported a higher number of PLEs compared to non-Māori—however, this was not associated with increased distress related to these experiences. The increased number of psychosis-like experiences reported by Māori was likely explained by systemic factors such as childhood trauma, discrimination, and financial stress. Māori were more likely to report that the PLEs were positive. Conclusions Measurement of psychosis risk for Māori is nuanced, and increased scores on these tools may reflect pathologizing potentially normative experiences for Māori, such as spiritual encounters or discrimination, alongside the impact of increased rates of systemic discrimination, trauma, and financial stress.

Lived Experience of Health and Wellbeing Among Young People with Early Psychosis in Aotearoa New Zealand

“…In addition to creating space, improving access to appropriate resources is imperative to meet the diverse needs of rangatahi whai ora based on their identities, interests, social environments, and contextual constraints. For example, Grattan et al ( 2024 ) report that Māori face more systemic barriers, yet comparable rates of psychosis-related distress compared to non-Māori. They suggest that Māori experiences of FEP are highly nuanced and that cultural factors may be protective when interpreting psychotic experiences in some cases thus highlighting the need for culturally appropriate care.…”

Psychotic Experiences Questionnaire. Part 1

“…ПСП описаны у детей и подростков, в этом возрасте типичны незлокачественные ПСП, тем не менее, они указывают на риск психотических переживаний (ПП) в будущем, а также сопутствующих расстройств [10,11]. Характерными показателями потребности в медицинской помощи выступают дистресс, нарушения функционирования, связанные с ПСП [12], среди потенциальных факторов, разграничивающих более значимые ПСП,одновременное возникновение переживаний с интернализирующими (тревожные расстройства, навязчивые мысли и т.п.)…”