Younger Relative Age in School a Risk Factor for Psychosis


A study published in the journal of Psychiatry Research found that younger childhood age relative to one’s classmates may be a risk factor for adult psychotic experiences.  This research supports claims that environmental factors such as school-related difficulties and marginalization contribute to psychosis.

The lead author, Jordan DeVylder of the University of Maryland, and his fellow researchers hypothesized that children with a younger perceived age in school may have an increased risk of marginalization and social defeat.  Consistently lagging behind one’s peers in stages of development might increase the likelihood of social stressors, they write, which has previously been correlated with an increased risk of psychosis.

In 2001, Harvard medical school carried out the national NCS replication survey (NCS–R) on individuals over eighteen to assess prevalence and correlates of mental disorders in the US.  Using this data, DeVylder et al., compared respondents survey answers to questions including, “when you were in grade school, were you usually one of the younger kids in your classroom, one of the older kids, or about average in terms of age?” with self-reported psychotic experiences, such as hallucinations and delusions.

Their analysis indicated that psychotic experiences are associated with perceived relative age in school, as well as sex, and income to poverty ratio.  The association between perceived relative age and psychotic experiences was consistent across all sex, income levels, and racial and ethnic categories.

The results, they write, call attention to “the need for greater availability of generalized supportive services for individuals who are younger for their peers throughout childhood.”

The researchers conclude that “school–related risk factors for psychosis provide promising points for community–level intervention, and support the claim that environmental factors characterized by disadvantage and marginalization contribute to psychosis etiology.”



DeVylder, J. E., Oh, H. Y., Pitts, S., & Schiffman, J. (2015). Young for one׳ s grade: A risk factor for psychotic experiences among adults in the National Comorbidity Survey-Replication. Psychiatry research226(1), 352-356. (Abstract)


  1. It’s yet another piece of evidence which suggests that psychosis is a response to adverse environment in childhood and adolescence, especially chronic social stress. Other correlations show similar results for psychosis and moving schools, racial discrimination, being a child of recent migrants, sexual abuse, bullying etc.

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  2. What other scientific, implausible ridiculous stuff can they come with next? And, as usual the meaningless scientific “double-speak” to allegedly validate and act they like know something. In truth and this is what Steve McCrea is alluding to in his post; school makes you crazy. School as we know and remember it steals our childhood and thus our natural creativity and curiousity And now, after reading this published gibberish; that they actually paid these academics to perform a study about; it seems to have stolen their creativity, curoiusity and thus, their ability to think either rationally or irrationally. Irrational thought is just as valid and productive as rational thought. I see neither in this study or their conclusions. Thank you.

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    • Your read of my comment is absolutely correct. However, I do think it’s helpful for this study to be published as support of the idea that it is schooling and other institutionalized or personalized experiences that contribute to the ultimate experience of “psychosis,” rather than just faulty wiring. The suppression of any natural and spontaneous activity on the part of children appears to be central to the modern school model, and I literally mean it that it drives us crazy.

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  3. @ Someone Else- This study was conducted on adults from 2001-2003. The age distribution includes people from all of adulthood, so only a few of them would have been kids or teens in the DSM IV years of high ADHD diagnosis. I did look at the article quickly and I didn’t see an analysis that was limited to the youngest adults.

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    • Thanks, firewoman, I wasn’t able to see more than the abstract (w/o a trip to the library). It is rather odd the research was done from 2001-2003, but not published until 2015. I suppose such research showing real life events affect moods / emotions / thoughts / “psychosis” was inappropriate to publish back during the chemical imbalance lie’s hey day. Although I still think psychiatric researchers’ regular, seeming inability to control for drug use, likely results in almost all their research being fraud. And especially when it’s children being harmed, it’s truly shameful.

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    • firewoman- they started drugging kids with ritalin in the 1960’s. Plenty of time between then and 2001 to become an adult. (sez the kid who was always the youngest in his class, and whose teachers always complained about him “daydreaming,” but who never took speed till he got it from a street dealer.)

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  4. @ rebel, I am wondering what you find so ridiculous and implausible about this study. It suggests that early life social experiences are linked to psychosis. True, young age for one’s grade is just a proxy for these experiences and more research is needed to tease out what is the real underlying factor, but I think this article is a good start for looking at factors such as bullying (which sound pretty plausible linked to mental health issues down the road such as psychosis to me). And FYI, yes there are some pharma paid researchers who use their research to propagate bad science, but that is far from universal. A lot of researchers are trying to use their work to help advance programs that aim to have kids grow up in better environments and are not linked to psychiatric interventions.

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  5. I’m starting to get the impression that research is going to show that anything out of step with what is “mainstream” uniform and in perfect order can be a contributing factor to so called ‘psychosis.’ Perhaps it’s time to see past this illusion of ‘perfection,’ and for creativity and diversity to be the order of the day. Then, we can flourish and thrive as we are intended.

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  6. @alex I agree that unusual experiences, generally speaking, may be linked with psychosis in and that in and of themselves, they aren’t necessarily a problem. But what about experiences like abuse and bullying? For these types of things, I don’t feel we should just sit back and say life’s not perfect (and not try to do anything to prevent them). If you link these exposures to a “problem”, that is how to justify these exposures being worthy of action. We shouldn’t need the studies to show things like abuse and bullying are bad, but good luck getting support without them.

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    • And especially since John Read’s research into child abuse and adverse childhood experiences shows such issues are apparently the likely etiology behind 2/3’s of “schizophrenia.”

      His research also shows that 77% of children brought to a hospital with signs of abuse are declared “psychotic,” whereas only 10% (if I recall correctly, or maybe it was 11%) of non-abused children receive a “psychosis” diagnosis.

      And this is quite problematic since the “gold standard” treatment for “psychosis,” the neuroleptic drugs, are known to create both the negative symptoms of “schizophrenia,” via neuroleptic induced deficit syndrome. And this is often misdiagnosed, and rather than taking the patient off the neuroleptic, it’s treated with more neuroleptics. Which can result in the creation of they positive symptoms of “schizophrenia” via neuroleptic induced anticholinergic toxidrome.

      It is important to point out abuse or trauma can cause, or at least give the illusion of, “psychosis” – seemingly to most psychiatrists.

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    • My comment simply refers to how rigid our society can be in evaluating others, from an incredibly limited perspective, which is what gives the ‘mental health industry’ such big business, when we go by that perception, which is what I feel we are growing past now, thank goodness. I think we are seeing that this is just one big hamster wheel of judgment and projection, and not in the slightest a compassionate and fair assessment of people, just in general.

      I completely agree with you about bullying and abuse and toxic childhood family dynamics, I talk about it all the time, it’s a large part of my counseling work, and I made a film about systemic (both family system and heath and social systems) bullying and abuse via blatant stigma and discrimination.

      In fact, I think most of what we call ‘mental illness’ is caused by tormentors and gas-lighters in our life–people who blatantly deceive, thrive on being deceptive, have total disregard for whom they are ‘duping,’ and then try to make you feel ashamed, crazy, stupid, and humiliated for calling them on their deceit. They also plant seeds around the system, trying to control others’ perception. Again, more lies happen here.

      To me, that is the TRUE cause of anything we call ‘mental illness,’ because it causes total splitting of the psyche, and our trust is totally betrayed. This creates hard core paranoia.

      Most people experience this for years and years until they finally WAKE UP and start doing something about it. Some abuse is so insidious, we’re not even aware of how toxic a relationship is. Look at the Ashley Madison scandal. Lots of people are discovering how abused they’ve been, and they didn’t even know it, they believed some false illusion of ‘partnership,’ but in reality, they were being betrayed. Certainly this all traces back to what we learned as children in this sick society. So I’m in agreement with you about all that.

      However, I take issue with the word ‘psychosis,’ because of all the stigma and mythology around that particular concept. I don’t feel that is ever a fair prediction for anyone.

      I’m inclined to say that chronic childhood bullying and abuse is cause of mental distress, and people do suffer post-traumatic stress from this. A lot of acting out occurs when these issues are not resolved.

      I also believe it can heal, when we find our power, and lose the victim identity. That’s where the healing inner work comes in, shifting our self-perception away from the role of perpetual ‘victim,’ without becoming an abuser (that would be critical in this equation). That is THE transformation in healing.

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        • Alex, you speak wisely, as usual. However, I have to say that my compassion for the gaslighters is limited during the time they are doing the gaslighting. I am interested in hearing their stories, but only after I have tried to help protect their victims from further harm. Yes, they have stories, but so do most of us, and most of us choose to try and find a way not to pass it on, which is the minimum I really ask of a person who has other people in his/her charge.

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          • Great comment, Steve, I so appreciate and honor what you say here. It is hardy work to achieve this, and I’m not all there, myself. It is no easy task to remain in one’s center when either experiencing or surrounded by abuse. That would be a matter of exploring perspectives and choosing when to exercise our boundaries. Also something to learn over time, along the journey, so to speak.

            However, my growth and healing goal is always centered around increasing my capacity to love, which is no easy task given what we have to work with, here. And of course, having compassion for myself when faced with double-binding. I’ve certainly had my share of gaslighters in my life.

            Still, I have found this to be the most direct path to what I think of as healing, personal growth and, overall, supporting my desire for a grounded and joy-filled life, manifesting what I enjoy the most. Again, a work in progress, as it always is, but it’s moving forward well at this point.

            I also remember that somehow, we’re all connected and I do believe that we are, indeed, mirrors of each other, like it or not. That can lead to hard truths, but when we own them, we are free of these issues, once and for all.

            When I see through these eyes, I feel a lot clearer and centered in my truth, so the gaslighting is wasted, which tends to lead to disinterest on the part of the abuser, so they go away, which is always a relief. Although I will say that I’ve known some people who are RELENTLESS in their insistence on throwing a negative projection, regardless of anything. That’s when I just have to walk away and not look back.

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          • Afterthought: when I talk about forgiveness, compassion and unconditional love for those who are clearly violating others, I am by no means advocating being ‘understanding’ of the abuse, excusing it, and to keep going along in such a relationship. One definitely needs to GET AWAY from abusive people and environments.

            What happens is that we do take that energy with us and those thoughts and feelings can continue to torment us, leaving us feeling chronically powerless. That’s certainly a normal post-traumatic stress response to abuse, but when we make it a goal to release that anger and resentment–still seeing where the responsibility lies, and being clear about who abused whom–then we feel better. Carrying resentment is painful and not healthy to our bodies.

            I’m just saying it feels better, more relaxed, to US to feel compassion rather than hate. Although I totally understand how hard it can be to not hate some people for their horrible behavior toward others.

            Like I said, it’s hardy inner work, one has to be committed to healing their heart from all wounds. I think it’s transformational healing.

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          • Both very good comments, Alex. I agree, forgiveness is for the forgiver more than the forgiven, and it does NOT imply acceptance or tolerance of bad behavior.

            Your comments regarding abusive people are also right on. I’ve worked with domestic abuse victims a lot, and the most successful strategy I’ve recommended is not reacting to the abuse. At first, it leads to some degree of escalation, but if that doesn’t work, they change tactics, and if that doesn’t work, they become puzzled and dismayed, and ultimately bored, and start looking for other victims.

            Compassion for the gaslighters of the world is best accomplished at a safe distance!

            —- Steve

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          • Beautiful, Steve, thank you. I’m really glad to have a meeting of the minds around this particular issue. I feel it is one the most fundamental flaws in our families, communities, and society at large, these deeply entrenched ‘abuse/enabler systems’ which repeat and repeat and repeat until we ascend them, somehow, and which cause great chronic distress and illness because it can be quite difficult to detect what exactly is draining the environment, when it is not blatant but more on the clever side.

            That’s why that particular system created ‘the scapegoat,’ to keep the attention away from the abuser, who, imo, would be the one who needs healing, but would never own that. To me, that’s true narcissism, one who justifies their abusive ways, and lets another take the rap for it–insidious and sinister victimization.

            It was treacherous to experience this, and fascinating to study. Definitely an eye-opener about how we operate, as a “community system.”

            Thank you for engaging with me about this, it’s helped refine my clarity. This is the core of my counseling work. Best regards.

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          • I wrote a book that lightly touches on this very phenomenon. It’s called “Jerk Radar” and is about how to prevent abusive relationships by detecting the fake “nice” behavior of the abuser before s/he lets his/her true colors show. You might find it of interest given your studies in the area.

            —- Steve

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      • “it can heal when we find our power and lose the victim identity.” Thank you for this. I think it expresses the problem in a nutshell. I wonder if you could give me advice on how I could help my husband move away from his chronic victim identity which underlies his recurring episodes of psychosis. Each time it happens, it’s always, “they” made me crazy because “they” were doing or not doing x,y,z. Any suggested books to read on how to move beyond perpetual victim status? Ideas on how to motivate a person to take his life into his own hands? I know it’s really impossible to give general advice for specific cases, but sometimes it can still help. Thank you

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  7. Yet another glimpse into the side show freakishness that is psychiatry. Wanting so desperately for there to be a link does not create a link.
    There are far too many variables in the lives of children to make these types of connections. Psychiatry has a knack of trying to pluck one answer to plausibly explain their conclusions. I also am not fond of the age old terminology used to oppress people who do not adhere to the idea of “normal”.
    Psychiatry is a very exclusionary entity. It isn’t able to take many things into consideration long enough to see the vast range of human behavior/emotion and to understand that people operate on many different levels. They exclude information and then exclude individuals from participating fully in the world around them however they may accomplish that. They want everything explained in neat little packages and tidy solutions (usually in pill form). This would be wonderful if it were actually effective.

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  8. Operative word: perceived. They could firm that up–birth month is a good proxy for age relative to classmates.

    Remembering being small and vulnerable versus big and forceful might be influenced by how the rememberer feels in the present.

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  9. I just saw this in the newsletter and decided to have a look. I didn’t end up experiencing psychosis and was envious of those who were capable of hearing voices. But I did get psych labeled with schizoaffective, for convenience I suppose.

    I started school early and was for certain younger than the rest of the class. My parents agreed that this would be the right thing. They didn’t want me bored. I learned to speak and read at an early age. My mother told me that she was with a piano teacher friend of hers who heard me singing as a toddler and told my mother I had musical talent, that maybe she should consider music lessons for me. I believe before I was to start kindergarten, my mother took me to meet with our school principle. I recall this meeting, in fact. She showed me diagrams and asked me questions.

    I was told I was going to first grade. I was too young to ask why or understand. My mother told me that on the first day of school, while other children clung anxiously to their parents, I squealed with delight, and eagerly ran off to play with the others without looking back nor saying goodbye to my mother.

    The result? I ended up excelling academically. However, being younger, I was less mature than my peers. I was the shortest kid in the class throughout grade school. Being short means you are always looking up at others. I got used to it. Did I get teased? Oh my goodness, mercilessly! I do not find it difficult nor painful to remember this, it is simply an observation (with a bit of laughter, looking back at the tricks played on me).

    Junior high was problematic as the other girls were going after boys and I had no desire to do so. This created a dilemma for me. I didn’t like the teasing and pressure. Finally, I told myself that to get them off my back I’d tell them that yes, I did like a boy named Alex. They pressured me into giving him a note, which I placed into his hand when I saw him in the hallway. Alex’s noninterest in me led to more jeering from the girls.

    I started school young for a reason. Being “smart” led to more teasing, except when the other kids wanted the answers to the exams, when suddenly I was in demand. I never liked that, so I started dumbing down everything I did and said. I was ashamed, and hid that I was smart.

    A friend of mine who grew up in a different generation told me his experience was identical. He told me he was insulted because he was smart, and became ashamed, and eventually, hid it so that he could avoid the hostility.

    College meant I was still underage when my friends weren’t. They snuck me into the campus bars, and into the theater once to see x-rated movies. I was still the shortest in my peer group.

    Decades later, my mother told me that she and my dad regretted starting me early. She said I would have had more confidence had I been around kids of my own maturity level.

    Did any of this cause my so-called mental illness? I would say most likely not. My childhood was relatively ordinary. I’d say this is the reason:

    I WALKED INTO A SHRINK’S OFFICE. Why didn’t I go to some other type of office? It was a crapshoot. The town nutritionist was a personal friend, so I chose shrinkage.

    That, and not much more. I’d say getting labeled and living as a labeled person was the abuse that did the most harm. The rest gave me endless humorous stories to write.

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    • What a wonderful recounting of your experiences and a most honest conclusion! Nothing like a shrink to validate your negative beliefs!

      I am selfishly glad that your experiences have added your voice to the conversation. Thank you for your honesty.

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  10. Thanks. I laugh over how honesty has gotten me into far more trouble than the occasional lie I had to tell to save my hide from psych incarceration. I say this knowing we are all aware of how simplistically they think. As patients, we learned to cover our tracks. Mention of certain words, no matter how benign the statement, can for sure catapult into THEIR overreaction. “Thanks, doc, I feel terrific,” translates to mania, for instance. And if any of us are poets, we often get in trouble for our poetry, given that the #1 favorite topic for poems is death. Loving life means you can write a killer poem on the topic of death, but shrinks are in such a hurry (now that medical care is like an assembly-line) that I suspect they memorize keywords and do a mental quick-scan of what we say and then, based on no reasoning, no intuition, no common sense, decide we are hopeless nutcases.

    Does honesty pay? I believe the truth wins out…though we do have to be mighty patient and persistent.

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