Differences in the reporting of psychotic-like experiences by children of racial and ethnic groups may be in part due to the discrimination they have experienced, suggests a study in the Journal of the Academy of Child & Adolescent Psychiatry. However, a child’s social supports may serve as a buffer against discrimination and protect against psychotic-like experiences.
“Psychotic-like experiences … are common in the general population, with approximately two-thirds of 9- to 12-year-olds reporting at least one [psychotic-like experience],” wrote Nicole R. Karcher, Ph.D., of Washington University School of Medicine and colleagues. “Results from our study indicate a strong link between self-reported [psychotic-like experiences] and factors such as [experience of discrimination], financial adversity, immigration status, English language abilities, and [adverse childhood experiences].”
The researchers analyzed data from 10,839 children aged 9 to 10 years who were participants in the Adolescent Brain Cognitive Development (ABCD) Study. Among the sample, 47.9% were female, 2.2% Asian, 13.9% Black, 19.7% Hispanic, 10.5% Multiracial/Multiethnic, and 53.8% White. (The Multiracial/Multiethnic category included Native American/Alaskan Native, Native Hawaiian or Other Pacific Islander, and those who identified as “Other.”)
As part of the ABCD Study, youth completed the Prodromal Questionnaire-Brief Child Version (PQ-BC), a 21-item questionnaire used to assess psychotic-like experiences over the past month. They also completed the Perceived Discrimination Scale, a 7-item questionnaire that asks participants how often they experienced discrimination over the past 12 months, including how often others behaved unfairly toward their racial/ethnic group and how often they felt not wanted or accepted by other Americans. Additionally, children reported on the number of close friends they had, with the total number serving as a measure of social support. (All data were collected before the COVID-19 pandemic.)
Black, Hispanic, and Multiracial/Multiethnic participants had higher scores on the PQ-BC than Asian or White participants; Black children experienced an average of 8.7 distressing psychotic-like experiences compared with 7.75 for Hispanic children, 6.24 for multiracial children, 5.06 for White children, and 4.3 for Asian children.
Black children also reported greater experiences with discrimination compared with children in every other group, and Hispanic children reported more experiences of discrimination than Asian and White children. The study also revealed that Black and Hispanic children with more social support were less likely to experience psychotic-like experiences, suggesting that social support may be a protective factor.
“Clinicians and researchers who do not consider these external influences when working with individuals from historically marginalized groups run the risk of misattributing the sources of challenges, over-pathologizing, stigmatizing, and ultimately steering clients towards inappropriate treatment,” the authors wrote. “Individual clinicians and researchers can actively seek awareness of their own potential biases.”
For related information, see the Psychiatric News article “Review Examines How Racism May Increase Psychosis Risk.”
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