Perceived ethnic discrimination and persecutory paranoia in individuals at ultra-high risk for psychosis

Shaikh, Madiha; Ellett, Lyn; Dutt, Aparna; Day, Fern; Laing, Jennifer; Kroll, Jasmine; Petrella, Sabrina; McGuire, Philip; Valmaggia, Lucia

doi:10.1016/j.psychres.2016.05.006

Cited by 35 publications

(34 citation statements)

References 64 publications

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“…), no statistically significant relationships were found [9,37]. In case-control studies with high-risk individuals [43,52,53], results indicated that perceived discrimination was significantly more common in people reporting prodromal psychotic experiences than controls. Regarding non-clinical studies [38,42,47,49,50,55,56], most found positive associations between discrimination and experiences Not all studies reported on the gender of all participants (i.e., in some cases the gender of most but not all participants was reported) Table 1 (continued) related to psychosis.…”

Section: Do People Experiencing Psychosis Report More Discrimination?mentioning

confidence: 84%

“…A total of 35,726 participants took part in the studies included in the review (regarding overlapping samples, the studies considering the largest sample sizes were included in the total). Four of the studies involved clinical samples (n = 1017) [9,[35][36][37] and the remaining twenty recruited from non-clinical populations (n = 34,709) [11,[38][39][40][41][42][43][44][45][46][47][48][49][50][51][52][53][54][55][56]; thirteen used eight different epidemiological samples (AESOP, EMPIRIC, Fourth National Survey of Ethnic Minorities, MEDINA, NAPLS 2, NEMESIS, NSLASS and NSAL). Within the twenty studies that reported the sex of the participants, 53% were female (regarding overlapping samples, the studies considering the largest sample sizes were included in the total).…”

Section: Sample and Design Characteristics Of Eligible Studiesmentioning

confidence: 99%

“…Three examined racial/religious discrimination [47][48][49]; the remaining measured a range of discriminatory experiences requesting participants to attribute them to various factors including age, sex, sexual orientation, ethnicity, disability, skin colour, religion and appearance [50][51][52][53][54]. The clinical studies included in the review examined the impact of discrimination across the continuum of psychosis, including individuals at a clinical high risk of developing psychosis [43,52,53], first-episode psychosis [37] and people experiencing long-term psychosis [9,35,36]. Table 1 details the measures used to assess discrimination, the majority of which measured discrimination in the weeks and months prior to the study, with only a minority measuring lifetime discrimination.…”

Section: Sample and Design Characteristics Of Eligible Studiesmentioning

confidence: 99%

“…One clinical study found evidence that discrimination was associated with significantly greater severity of psychotic experiences [35], while several non-clinical [38,40,44,46,54] and one at-risk study [43] found perceived discrimination to be associated with greater frequency of prodromal/ psychotic-like symptoms (severity not investigated). In addition, Anglin et al [38] reported that people perceiving discrimination were 1.29 times more likely to experience distress as a result of non-clinical psychotic experiences.…”

Section: Is There a Relationship Between Discrimination And Severity mentioning

confidence: 99%

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Perceived discrimination and psychosis: a systematic review of the literature

Pearce

Rafiq

Simpson

et al. 2019

Soc Psychiatry Psychiatr Epidemiol

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Purpose Higher rates of psychosis have been reported in minority groups. Since individuals belonging to such groups are vulnerable to the experiences of discrimination, and in line with models proposing that social and life adversity may play a causal role in development and maintenance of psychotic experiences, it has been proposed that perceived discrimination may represent an important determinant of psychotic experiences. This paper reviews the literature examining the relationship between perceived discrimination and psychosis, examining whether discrimination is associated with an increased risk of psychosis, the severity of psychotic symptoms and whether there is an association with specific psychotic symptoms. Methods A systematic database search of PsycINFO, Embase and PubMed was conducted to identify quantitative crosssectional and prospective studies that examined the association between discrimination and psychosis. Results Twenty-four studies met the inclusion criteria, four of which used prospective designs and twenty used cross-sectional designs. The main findings indicated that discrimination may be associated with an increased risk of psychosis (too few studies to determine whether discrimination is associated with severity). Some studies found associations between discrimination and positive psychotic experiences and/or specific psychotic experiences such as paranoia. A small number of studies found that greater exposure to discrimination was associated with a greater likelihood of reporting psychotic experiences, tentatively indicating a dose-response relationship. Conclusions This review indicates that discrimination plays an important role in the experience of psychosis; however, future research is required to clarify the nature of this relationship. Avenues for further research and clinical implications are proposed.

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Section: Do People Experiencing Psychosis Report More Discrimination?mentioning

confidence: 84%

Section: Sample and Design Characteristics Of Eligible Studiesmentioning

confidence: 99%

Section: Sample and Design Characteristics Of Eligible Studiesmentioning

confidence: 99%

Section: Is There a Relationship Between Discrimination And Severity mentioning

confidence: 99%

See 2 more Smart Citations

Perceived discrimination and psychosis: a systematic review of the literature

Pearce

Rafiq

Simpson

et al. 2019

Soc Psychiatry Psychiatr Epidemiol

View full text Add to dashboard Cite

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“…Social adversity also manifests in terms of discrimination and exclusion, and people from minority ethnic backgrounds report higher levels of paranoia [9], an effect which is ameliorated as ethnic density increases [10]. Additionally, perceived discrimination is associated with paranoia in ‘ultra-high risk for psychosis' individuals [11] and mediates the association between deprivation and paranoia [12]. Increasing evidence also suggests that the subjective perception of one's relative status in the world is also an important predictor of paranoia.…”

Section: Introductionmentioning

confidence: 99%

Experimentally induced social threat increases paranoid thinking

et al. 2018

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The ability to attribute intentions to others is a hallmark of human social cognition but is altered in paranoia. Paranoia is the most common positive symptom of psychosis but is also present to varying degrees in the general population. Epidemiological models suggest that psychosis risk is associated with low social rank and minority status, but the causal effects of status and group affiliation on paranoid thinking remain unclear. We examined whether relative social status and perceived group affiliation, respectively, affect live paranoid thinking using two large-N (N = 2030), pre-registered experiments. Interacting with someone from a higher social rank or a political out-group led to an increase in paranoid attributions of harmful intent for ambiguous actions. Pre-existing paranoia predicted a general increase in harmful intent attribution, but there was no interaction with either type of social threat: highly paranoid people showed the same magnitude of increase as non-paranoid people, although from a higher baseline. We conclude social threat in the form of low social status and out-group status affects paranoid attributions, but ongoing paranoia represents a lowered threshold for detecting social threat rather than an impaired reactivity to it.

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