Social Adversity and Crime Victimization Increase Risk of Psychotic Experiences Five Fold

Researchers parse out factors within urbanicity that leads to risk for psychotic experiences

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Research has often cited urbanicity, or dwelling in an urban setting, as a risk factor for developing the symptoms associated with psychosis. A new study, published in Schizophrenia Bulletin, examines the impact of urbanicity, adverse neighborhood conditions, and violent crime victimization on developing psychotic experiences in adolescence. The authors, led by Joanne Newbury of King’s College London, determined that adolescents raised in urban vs. rural areas were significantly more likely to report psychotic experiences and that, when combined, neighborhood social conditions and personal crime victimization were significantly associated to adolescent psychotic experiences.

“Most prior research on the emergence of adolescent psychotic experiences has focused on the individual- level risk factors and little is currently known about the potential impact of macro-level structures such as urbanicity and neighborhood-level social processes like social fragmentation and crime,” Newbury and the co-authors write.

Photo Credit: Katie McKeown, “Urban vs. Rural,” Flickr

Urbanicity is a well-accepted risk factor for psychosis. Moreover, numerous studies have confirmed higher rates of psychotic spectrum disorder in urban populations. A 2015 study found that from 1990 to 2010, rates of schizophrenia in rural areas remained stable at .36% while rates in urban areas rose to .68%. The authors of the present study point out that research has often focused on individual-level factors, discounting the potential impact of macro-level structures and neighborhood-level social processes to explain this relationship.

In their research, Newbury and team sought to parse out what it is about living in urban centers that contribute to this larger risk. Looking at data from the United Kingdom, Newbury and their colleagues sought to test their hypothesis that “one of the reasons that young people in urban settings are at increased risk for psychotic phenomena is that they experienced a greater accumulation of neighborhood-level social adversity and personal experiences of violence during upbringing.”

The authors of this study tested their hypothesis using longitudinal data of 2,063 British twins from the Environmental Risk (E-Risk) Longitudinal Twin Study. Adolescent Psychotic Phenomena were captured via a self-report measure that included items such as “I worry that my food is poisoned.” Urbanicity was determined by the family’s postcode and based on the definition provided by the Office of National Statistics (ONS) Rural-Urban Definition for Small Area Geographies. This consisted of 3 categories (rural, intermediate, and urban Neighborhood Characteristics were determined by surveys sent to nearby residents of the participants. Of particular interest were the factors: social cohesion and neighborhood disorder.

“We were interested in [these factors] because they collectively capture the neighborhood characteristics that could plausibly influence risk for psychotic phenomena, such as trust and support between neighbors and physical and social signs of threat in the neighborhood.”

Social Cohesion was captured by items assessing whether neighbors shared values, trusted, and got along with each other. Neighborhood disorder was captured by questions aimed at determining whether specific problems such as mugging, assaults, and vandalism affected their neighborhood. Information on Personal Crime Victimization was gathered through interview and using the Juvenile Victimization Questionnaire 2nd Revision (JVQ-R2). Items included: since you were 12, “did anyone hit or attack you on purpose with an object or weapon like a stick, rock, gun, knife, or anything that hurt?” Neighborhood-Level Deprivation was determined by A Classification of Residential Neighborhoods (ACORN). Categories include: “wealthy achiever (25%), urban prosperity (5.3%, comfortably off (13%), moderate means (26%), and “hard-pressed” (26%) neighborhoods. Lastly, Family and Individual-Level data were gathered and accounted for such as family socioeconomic status, family psychiatric history, and alcohol and cannabis dependence, among others.

The authors of this study found that as urban setting increased, psychotic experiences also increased. Moreover, when controlling for the potential family- and individual- level confounders (e.g., family SES, family psychiatric history), and neighborhood-level deprivation, the association remained significant.

Additionally, the results showed that psychotic experiences were more common among adolescents who had lived in neighborhoods with lower levels of social cohesion and higher levels of neighborhood disorder. Lastly, while neighborhood social adversity and crime victimization were both independently significantly associated with adolescent psychotic experiences, the combined effect was five times greater than either one alone.

 

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Newbury, J., Arseneault, L., Caspi, A., Moffitt, T. E., Odgers, C. L., & Fisher, H. L. (2017). Cumulative effects of neighborhood social adversity and personal crime victimization on adolescent psychotic experiences. Schizophrenia Bulletin, 44(2), 348-358. (Link)

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Bernalyn Ruiz
Bernalyn Ruiz
MIA Research News Team: Bernalyn Ruiz-Yu is a Postdoctoral Fellow in the Department of Psychiatry and Biobehavioral Sciences at the University of California, Los Angeles. She completed her Ph.D. in Counseling Psychology from the University of Massachusetts Boston. Dr. Ruiz-Yu has diverse clinical expertise working with individuals, families, children, and groups with a special focus on youth at risk for psychosis. Her research focuses on adolescent serious mental illness, psychosis, stigma, and the use of sport and physical activity in our mental health treatments.

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31 COMMENTS

  2. Thanks, Bernalyn, for good researched article. To me shows how strongly outside influences beyond an adolescent’s control can negatively influence this age group. Urban environments with high crime and violence, overcrowding, low employment, poverty, noise and other types of pollution are the negative aspects of living in many cities. Lack of social cohesion to me is the most important factor that I see with regards to psychosis with adolescence.

    Adolescence is all about one’s relationship with peers. It is an age of pulling away from parental influence and finding one’s identity through one’s peers. A city that provides resources including spaces and activities for adolescences with the guidance of adults that seek to mentor and provide positive supports is needed. It is well worth the funds to provide jobs and meaningful activities for this age group.

    Adolescence is when most initial encounters with the mental health system and diagnosing begins. Create opportunities for health and growth in urban areas for ages 13-22 and you will see less hospitalizations and healthy young people. Adolescents can be a difficult and challenging group but they need us adults to provide them with an environment that allows them to thrive. They are our future.

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    • I also think it’s important to recognize that the urban environment itself, which has massively increased as a result of industrialization, contributes to deterioration of people’s “mental health.” Disconnection from community, absence of green spaces, high mobility, large income differential, planning dominated by commercial interests – all of this contributes to the emergence of mental/spiritual distress, as it is not a healthy environment to live in. Adolescence itself appears to be a consequence of the industrial revolution. There is something in the very fabric of how we live that makes people “crazy,” IMHO.

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    • I agree, oldhead. It always feel that these made up diagnoses put the blame on the individual as if weak and unable to adapt to unhealthy environments. It is without a contextual framework. I truly would like to find a new lexicon for human experiences outside of the confining and damaging mental health industry.

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      • The did not made up diagnoses, the made up everything which is beyond the terms, and this is a real danger. They are using it in a wrong psychopatic way. This is false empiricism, and the only true thing in a diagnosis is a word which designate it.
        Psychosis exists, normalcy also. But the problem is that how many people are aware of the true proper human/psychological meaning ot those words ? Hillman knew , so they rejected him.

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        • Thanks, danzig666, for reference to James Hillman’s work.
          “Psychosis” means for most, a break from reality and can include auditory and visual hallucinations as well as unusual, “bizarre” thinking, making it difficult to connect with others. Psychosis can certainly be from medical/physical causes, i.e. dementia or just a UTI. I find it interesting to look at how different cultures interpret this versus Western medical disease model which just tries to stop it through antipsychotics. Being curious and being willing to look at different ways of interrupting is useful. I am saddened when professionals stop listening to the person experiencing psychosis as if they make no sense at all. Dismissing the person only adds to their disconnection.

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          • Psychosis has no universal meaning, it’s one of those terms people throw around to make it appear as though they know what they’re talking about. You seem to understand that though, based on what you said previously.

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          • How can the help? They are normal. And apollonian ego/normalcy is the least psychological archetype. They are dead to psychological world, that is why psychiatry is useless. Because it rejects all of the psychological world, and accept only their own shallow reality.And that reality is not human, it is authoritarian psychopatic reality.

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    • I agree, old head, “Psychosis is a stigmatizing term, as are all ‘mental health’ ‘diagnoses.'” And I eventually learned from reading my medical records, that today’s psychologists and psychiatrists believe dreams, gut instincts, common sense, and even legitimate concerns about the abuse of one’s child are all “psychosis.” And with such a liberal definition of “psychosis,” well, this means all human beings are “psychotic,” since we all dream.

      I have a feeling there should be a study done into the percentage of “mental health professionals” in an area, compared to the percentage of those defamed as “psychotic.” Since to my knowledge, it’s largely only the DSM debunked, highly delusional “mental health professionals” who are claiming all who dream, or have gut instincts and common sense, are “psychotic.”

      https://www.nimh.nih.gov/about/directors/thomas-insel/blog/2013/transforming-diagnosis.shtml

      And I have a theory that “neighborhood social conditions and personal crime victimization were significantly associated to adolescent psychotic experiences” is a euphemism for child abuse. And we already know the number one actual function, by design, of today’s so called “mental health professionals,” is largely according to their own medical literature, turning child abuse victims into the “mentally ill” with the psychiatric drugs.

      https://www.madinamerica.com/2016/04/heal-for-life/
      https://www.alternet.org/story/146659/are_prozac_and_other_psychiatric_drugs_causing_the_astonishing_rise_of_mental_illness_in_america
      https://en.wikipedia.org/wiki/Neuroleptic-induced_deficit_syndrome
      https://en.wikipedia.org/wiki/Toxidrome

      You “mental health professionals” currently cannot bill any insurance company for ever actually helping any child abuse victim ever, without first misdiagnosing the child abuse victim with one of your “invalid” DSM disorders.

      https://www.psychologytoday.com/us/blog/your-child-does-not-have-bipolar-disorder/201402/dsm-5-and-child-neglect-and-abuse-1

      Which has resulted in over 80% of those defamed as “depressed,” “anxious,” “bipolar,” and schizophrenic” being misdiagnosed child abuse victims. And over 90% of those labeled as “borderline” being misdiagnosed child abuse victims.

      https://www.madinamerica.com/2016/04/heal-for-life/

      I never had a problem when living in a posh intercity neighborhood of Chicago, of being defamed with a make believe DSM disorder. But I did have a problem with child rapists in a posh suburb of Chicago, and their insane “mental health professional” and “religious” friends, misdiagnosing me with an “invalid” DSM disorder, because I chose to move into a more middle class neighborhood to teach my intelligent children, whose grandfather had made millions for that religion, because I wanted my children to learn to get along with “the masses.”

      I’m pretty certain today’s “mental health industry” is all about functioning as satanic Pharmakia slaves for the self proclaimed globalist “elite,” war mongering and profiteering, fiscally irresponsible, bailout needing, globalist banksters, that our founding fathers forewarned us about. And their satanic goal of destroying the middle class of America, which will also destroy America as we know it. The psychiatric industry, as historically always, is on the wrong side.

      You are all the enemies within, since you’re on the side of the evil war mongering and profiteering, bailout needing, completely fiscally irresponsible, globalist banksters, rather than on the side of the fiscally responsible and ethical American, God fearing banking families that made America great.

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  4. Psychosis is a style of thinking/feeling which is banned, because we live in a death camp for imagination ruled by rationazism and apollonian ego hegemony. I do not think that anyone could increase sb style of thinking, it is individual kind of perception. The term is not bad, the problem is that psychiatry and other people will ridicule and demonize it. It is seen not as a psychological necessity but as sth evil to get rid of. It is not a diagnosis that hurts, but that FACT that for psychiatry it MEANS NOTHING.

    People are robbed from right to psychosis/KIND OF PERCEPTION by rational apollonianns (PSYCHIATRISTS, scientists, normal people). The problem is that psychosis is for them just an empty nominalism/insult, not a kind of human perception. Psychological man is being ridiculed and demonized by psychiatry and his traits completely lost the meaning in this shallow system, because the problem of psychiatry is that it does not recognize the human background behind every state of psyche. Nothing which is beyond normalcy, exists for them, which is illogical because they SHOULD REPRESENT THE PSYCHE, not to demonize and destroy it.
    Diagnosis are correct, the problem is that psychiatry does not see IT AS PSYCHOLOGICAL NECESSITY WHICH IS A TERRORISM OF APOLLONIAN EGO FUNDAMENTALISTS.

    It should be the obligation for psychiatrists to read the first 70 sites of James Hillman “Re – visioning psychology”. Without this knowledge and logic, diagnosis ( in today USELESS meaning), are a DEADLY DANGER FOR PEOPLE, AND PSYCHIATRY IS A DEATH CAMP FOR PSYCHE.
    There is a meaning behind every diagnosis, and every diagnosis SHOULD BE TREATED AS HUMAN PSYCHE TRAIT, NOT AS AN ENEMY of the normalcy. It is about the attitude toward the diagnosis, not the diagnosis itself, and the todays diagnosis means NADA, because psychiatrists can’t talk in human/psychological language.

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    • Psychiatrists as ego imperialists, can’t talk in humane/psychological way about psyche, so they are using pseudo medical jargon, and that is why the diagnoses are a weapon against people, not a form of understanding/empathy.

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    • Psychosis is a style of thinking/feeling which is banned, because we live in a death camp for imagination ruled by rationazism and apollonian ego hegemony.

      On the other hand, if I did need a definition for “psychosis” I like this one. 🙂

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      • Psychiatrists pretend to be the defenders and their job is to condemn psychological reality. Their hidden duty is to destroy psyche, and defend the normalcy. Psyche has got only enemies, that is why psychological man is voiceless. And the one who defend it MUST BE NOT NORMAL by definition, so he is rejected too. That is why there is no pro humane definition of psychosis. We live in a psychopatic reality.

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  5. danzig666 wrote: “Psychosis is a style of thinking/feeling which is banned…”

    Is it? I don’t think that it is. Given that’s a very specific definition.

    It’s not psychosis that is banned. It’s the troubling and troublesome acting out. Psychosis is free to rise and fall wherever and whenever it wishes. Always has and always will.

    People like me suffer through psychosis without anyone banning it (or attempting to, morelike), without any psychiatric attempt to snuff it out.

    If the drugs worked for me like they work for others I’d choose to take them, happily.

    Acting out during psychosis is where the problems begin, and you will undoubtedly start flashing on multiple radars.

    Should acting out in a troubling or troublesome way not be subject to some form of social control?

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    • I mean, they banned the truth human meaning of the psychosis, which is seen todays only as illness. There should be places for psychological hardship, but still, people are not the owners of the psychological reality. They (psychiatrists, apollonian society) should respect the things which are beyond easy and simple apollonian point of view which gave them the imitation of having control and unity and so on. Psyche is not a human property, and that is why people who do some dangeorus things in state of psychosis,they should have also more privileges. Because it is very hard to bear sth which is beyond ego control.And people paid their dues, even though they behave dangeorus. Psychiatrists should be aware of that , that apollonian reality is simple, and psychological reality beyond it, is extremely dangerous, full of pain and fear, lack of control.

      Dionisian traits, Hades traits are dangerous and complex, and apollonian are not. So apolonians paid nothing to the psychological reality, but judge and condemn those who are beyound this SIMPLE arechetype, and this is injustice. Because apollonian state of psyche is also NOT the property and the merit of those who represent it, the same as hades reality/psychosis reality. It is not a sin. We are in the psyche, we are not the owners. And sb shoul have noticed it long ago. PSYCHE IS NOT A BRAIN IT IS REALITY IN WHICH DWEEL OUR IMAGINATION. And the brain is only a tv, we are not the owners of the programm. So show some respect, you psychiatrists.

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      • That’s all a bit black and white for my tastes.

        And it doesn’t answer the question I posed: Should acting out in a troubling or troublesome way not be subject to some form of social control?

        Psychiatry is incapable of banning personal truth. I accept that some people give way to its narratives, against their own better judgement. Others eventually come to terms with the follies of their imaginations, and take some solace in psychiatric meanings. Often too people are able to hold contradictory explanatory narratives about their psychotic experiences, perhaps half-believing in their personal take on things, and half-believing in psychiatric interpretations… and moving in and out of different personal meanings. That sounds more human to me. More natural and more in keeping with how personal narratives and the self works… in that we, all that is inside of us and outside of us, are in constant flux.

        People are more subtle than you seem to be giving them credit for, they are way more sophisticated. At least that’s my view of people.

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        • Apollonian ego/authoritarian reality and psychological/Hades reality is black and white and have nothing in common. No one is able to control psychological reality and no one can buy happiness and find love in drugs, but there are people who believes they can.
          You can not control mythical powers that are beyond medical claims. This reality it is not a property of medicine or other people, it belongs to gods. We can only have balls and accept things which we can’t control.
          My vision of psyche is clear, I am not looking for remedy or help, I want a true meaning and true psychological hierarchy, which was destroyed by authoritarians and their main gods/fetish – power and money.

          There is no control over the deep psychological reality, so they invite psychiatry and they imitate the control, bu this is only brainless drugging. There’s no cure for misery and death, and people are so childish in their attitudes toward the psychological reality, they think they can cope with it with drugs. There is a cure in the illness, and the illness is the cure. But the want only to get rid of psyche, and I am not intrested in psychiatry cheap rituals of pseudo control without any repsect for psychological reality.

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  6. “Psychotic” can be a rational fear, if living in a bad neighborhood. When you can not afford to lose a dollar ( for food and rent), yes it makes you jumpy and paranoid.

    Eric Coates just wrote
    “There are even some people who consider the whole practice of modern biological psychiatry to be a form of political oppression. When your problems are blamed on your brain (PSYCHOTIC), for instance, rather than taking into account an abusive childhood or, say, living in poverty and a dangerous neighborhood, all of which might be caused (as there is more abuse in impoverished environments) by the lack of work opportunities or a decent wage that are not being supplied by the capitalist corporations that control nearly our whole economy — well, when you defocus from someone’s environment and experiences like that, and just blame their brain for their problems (which is what you are essentially doing when you persuade or force them to take chemicals rather than address the actual circumstances of their lives), you are, actually, engaging in a form of social and political oppression. By distracting from the real problems, which we could address if we wanted to — things like abuse, poverty, etc. — you are actually reinforcing the status quo. You are supporting a kind of system of abuse and a kind of system of social oppression, in other words.”

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    • marks ps2 wrote that Eric Coates wrote: “When your problems are blamed on your brain (PSYCHOTIC), for instance, rather than taking into account an abusive childhood or, say, living in poverty and a dangerous neighborhood, all of which might be caused (as there is more abuse in impoverished environments) by the lack of work opportunities or a decent wage that are not being supplied by the capitalist corporations that control nearly our whole economy”

      I wasn’t aware that Eric Coates had an abusive childhood, was living in poverty in a dangerous neighbourhood and so on. I was under the impression he had the fortune of living in a middle class milieu?

      If what you are suggesting here is true then why are the classic psychotic conditions such as schizophrenia not more prevalent in the most harsh inner city settings of the world, such as the favellas of Brazil?

      Being jumpy and paranoid is not being psychotic. It’s being jumpy and paranoid.

      A big problem I think is that these severe states of mind have been watered down in the popular imagination. Instead of being rare events they are now part of some universal experience.

      I’m not sure what has made that happen. It wouldn’t be just one thing. Psychiatry is generally blamed for this but I don’t consider that to be the full answer.

      Here’s an example. I got talking to a small group of young men recently. One of them goes to me, quite randomly: “I’m schizophrenic. I get the schizophrenic days.”

      I asks, “O, I see. You have complex delusions and sometimes complex hallucinations and such like?”

      “No, no,” he goes, “I get the schizophrenic days. Y’know, where your mind wanders a lot and you can’t keep going at stuff, and just want to go with the flow but the flow is all over the place.”

      One of his buddies kept saying, “I can’t have this conversation. My ADD keeps kicking in.”

      Puzzled me that one.

      I like the idea that you believe, or seem to be intimating, that if adverse life events were eradicated from life then psychosis would no longer manifest.

      Why do you believe this?

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