Update on the Social Defeat Hypothesis of Schizophrenia


Researchers from the Netherlands and Sweden seek to update the hypothesis that the five major risk factors for schizophrenia (urbanicity, migration, childhood trauma, los intelligence, and drug abuse) can be explained by sensitization of the mesolimbic dopamine system (DA) resulting from the experience of social defeat (SD). A review of the literature finds a connection between SD and schizophrenia for migration and childhood trauma, and that while evidence for mesolimbic DA sensitization is lacking (due to a lack of studies), the evidence for this in animals is strong. The study was published by Schizophrenia Bulletin.

Abstract →

Selten, J., van der Ven, E., Rutten, B., Cantor-Graae, E.; The Social Defeat Hypothesis of Schizophrenia: An Update. Schizophrenia Bulletin. Online September 23, 2013

The abstract:

According to the social defeat (SD) hypothesis, published in 2005, long-term exposure to the experience of SD may lead to sensitization of the mesolimbic dopamine (DA) system and thereby increase the risk for schizophrenia. The hypothesis posits that SD (ie, the negative experience of being excluded from the majority group) is the common denominator of 5 major schizophrenia risk factors: urban upbringing, migration, childhood trauma, low intelligence, and drug abuse. The purpose of this update of the literature since 2005 is to answer 2 questions: (1) What is the evidence that SD explains the association between schizophrenia and these risk factors? (2) What is the evidence that SD leads to sensitization of the mesolimbic DA system? The evidence for SD as the mechanism underlying the increased risk was found to be strongest for migration and childhood trauma, while the evidence for urban upbringing, low intelligence, and drug abuse is suggestive, but insufficient. Some other findings that may support the hypothesis are the association between risk for schizophrenia and African American ethnicity, unemployment, single status, hearing impairment, autism, illiteracy, short stature, Klinefelter syndrome, and, possibly, sexual minority status. While the evidence that SD in humans leads to sensitization of the mesolimbic DA system is not sufficient, due to lack of studies, the evidence for this in animals is strong. The authors argue that the SD hypothesis provides a parsimonious and plausible explanation for a number of epidemiological findings that cannot be explained solely by genetic confounding.

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Kermit Cole
Kermit Cole, MFT, founding editor of Mad in America, works in Santa Fe, New Mexico as a couples and family therapist. Inspired by Open Dialogue, he works as part of a team and consults with couples and families that have members identified as patients. His work in residential treatment — largely with severely traumatized and/or "psychotic" clients — led to an appreciation of the power and beauty of systemic philosophy and practice, as the alternative to the prevailing focus on individual pathology. A former film-maker, he has undergraduate and master's degrees in psychology from Harvard University, as well as an MFT degree from the Council for Relationships in Philadelphia. He is a doctoral candidate with the Taos Institute and the Free University of Brussels. You can reach him at [email protected].


    • I don’t know if Jani has social defeat or not.

      It seems to me like it might be fairly defeating to be the “mentally ill” daughter and have to go through all that she has gone through at a young age and not be able to find a non-sick space for oneself in the family.

      I think social defeat is more complex than this abstract indicates.

      I personally don’t think Jani has schizophrenia, either.

      (I don’t think that schizophrenia is even a valid construct, since what gets called schizophrenia can – in many cases – be explained or understood as something else, from transformation of self, to gluten reactivity, to sensory processing disorders intersecting with trauma.)

      What was happening when Jani was a kid could be explained by autism and synesthesia or other sensory integration/processing issues.

      Instead, she got pegged with schizophrenia…which is a label that itself can lead to social defeat, per stigma, confusion about self, and abusive treatment, etc.

      I wish I could talk with Jani, hang out with her, spend time with her folks.

      It’s pretty sad that they are making this “social defeat” thing loop back to the “chemical imbalance” theory…without instead addressing the structural and cultural issues that lead to social trauma.

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      • I’d agree that social defeat likely is more complex but I just couldn’t see Jani as experiencing social defeat in the given context.

        The Mind is what is so complex, really – especially in this world today: electrified, televised, transmitted, and on and on.

        In Jani’s case, her family has solidified their belief in her illness because of family history (DNA / genetics). Schizophrenia is a known diagnosis … I think on the mother’s side.

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