Social Defeat and Psychotic Experiences in the United States: Findings from the Collaborative Psychiatric Epidemiological Surveys

• Main Author: Oh, Hans
• Language: English
• Published: 2015
• Subjects: Social service; Epidemiology
• Online Access: https://doi.org/10.7916/D8J1028R

Emerging studies have identified a specific kind of stress called social defeat, which occurs when a person is dominated, humiliated, and oppressed by another person or group. The sense of social defeat might play an important role in the development of psychosis. Meanwhile, scholars have increasingly studied the occurrence of Psychotic Experiences, which are expressions of psychosis that manifest in the general population without causing significant distress or functional impairment. Very few studies have examined the relationship between social defeat and Psychotic Experiences in the United States, and I utilize the Collaborative Psychiatric Epidemiological Surveys to examine three facets of social defeat, which are (1) everyday discrimination, (2) major discriminatory events, and (3) immigrant status, and I explore whether they predict risk for Psychotic Experiences. In the first paper, I analyzed the National Latino and Asian American Survey and the National Survey of American Life, and found that among Latino-, Asian-, and Black- Americans, everyday discrimination was associated with increased risk for Psychotic Experiences in a dose-response fashion after adjusting for demographics and socioeconomic status. Discrimination perpetrated at the interpersonal level seems to impart a profound sense of defeat that raises risk for psychosis. In the second paper, I analyzed the National Survey of American Life and found that among Black Americans, certain major discriminatory events (being denied a loan, receiving unusually bad service, and police abuse) were associated with increased risk for Psychotic Experiences after controlling for demographics and socioeconomic status. Major events seem to capture a distal source of distress stemming from the institutions and structures of society, elevating risk for psychosis among Black Americans. In the final paper, I examined the National Comorbidity Survey Replication, the National Latino and Asian American Survey, and the National Survey of American Life, and found that immigration was not associated with increased risk for Psychotic Experiences in the United States, supporting the extant literature that suggests immigrants are paradoxically healthier than native-born populations. I discuss theoretical and practical implications of my findings, and present future directions for research.