Advertisement

Psychotic experiences among ethnic majority and minority adolescents and the role of discrimination and ethnic identity

  • Saliha el Bouhaddani
  • Lieke van Domburgh
  • Barbara Schaefer
  • Theo A. H. Doreleijers
  • Wim Veling
Original Paper

Abstract

Purpose

Research shows that the prevalence of psychiatric problems is higher in ethnic minority youth compared to native youth. This school-based screening study of early adolescents’ mental health in the Netherlands examined differences in prevalence of psychotic experiences in ethnic minority youth compared to their Dutch peers. Moreover, we investigated the association between psychotic experiences, ethnic identity, and perceived discrimination.

Methods

A cohort of 1194 ethnic majority and minority adolescents (mean age 13.72, SD 0.63) filled-out questionnaires on psychotic experiences (including delusional and hallucinatory experiences), perceived group and personal discrimination, and ethnic identity.

Results

Apart from lower levels of hallucinatory experiences in Turkish–Dutch adolescents, prevalence of psychotic experiences did not differ between ethnic minority and majority adolescents. Perceived personal discrimination was associated with the presence of psychotic experiences (including delusional and hallucinatory experiences) (OR 2.30, 95% CI 1.22–4.34). This association was stronger for delusional experiences (OR 2.94, 95% CI 1.43–6.06) than for hallucinatory experiences (OR 1.65, 95% CI 0.73–3.72). No significant associations were found between perceived group discrimination and psychotic experiences. A weak ethnic identity was associated with higher risk for reporting psychotic experiences (OR 2.04, 95% CI 1.14–3.66), particularly hallucinatory experiences (OR 3.15, 95% CI 1.54–6.44). When looking at specific ethnic identity categories, marginalization, compared to separation, was associated with a threefold risk for reporting psychotic experiences (OR 3.26, 95% CI 1.33–8.03). Both marginalisation (OR 3.17, 95% CI 1.04–9.63) and assimilation (OR 3.25, 95% CI 1.30–8.13) were associated with a higher risk for hallucinatory experiences.

Conclusions

These results underline the protective effect of ethnic identity against mental health problems. Future research should focus on interventions that focus on strengthen social identity.

Keywords

Psychotic experiences Discrimination Ethnic identity Ethnic minority 

Notes

Acknowledgements

This work was supported by ZonMw (417100004). The authors gratefully acknowledge all participating children and teachers, and all research assistants involved.

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

References

  1. 1.
    Bourque F, van der Ven E, Malla A (2011) A meta-analysis of the risk for psychotic disorders among first- and second-generation immigrants. Psychol Med 41:897–910.  https://doi.org/10.1017/S0033291710001406 CrossRefGoogle Scholar
  2. 2.
    van Os J, Linscott RJ, Myin-Germeys I et al (2009) A systematic review and meta-analysis of the psychosis continuum: evidence for a psychosis proneness-persistence-impairment model of psychotic disorder. Psychol Med 39:179–195.  https://doi.org/10.1017/S0033291708003814 CrossRefGoogle Scholar
  3. 3.
    Johns LC, van Os J (2001) The continuity of psychotic experiences in the general population. Clin Psychol Rev 21:1125–1141CrossRefGoogle Scholar
  4. 4.
    Kelleher I, Connor D, Clarke MC et al (2012) Prevalence of psychotic symptoms in childhood and adolescence: a systematic review and meta-analysis of population-based studies. Psychol Med 42:1857–1863.  https://doi.org/10.1017/S0033291711002960 CrossRefGoogle Scholar
  5. 5.
    Anglin DM, Lighty Q, Greenspoon M, Ellman LM (2014) Racial discrimination is associated with distressing subthreshold positive psychotic symptoms among US urban ethnic minority young adults. Soc Psychiatry Psychiatr Epidemiol 49:1545–1555.  https://doi.org/10.1007/s00127-014-0870-8 CrossRefGoogle Scholar
  6. 6.
    Morgan C, Fisher H, Hutchinson G et al (2009) Ethnicity, social disadvantage and psychotic-like experiences in a healthy population based sample. Acta Psychiatr Scand 119:226–235.  https://doi.org/10.1111/j.1600-0447.2008.01301.x CrossRefGoogle Scholar
  7. 7.
    Oh H, Yang LH, Anglin DM, DeVylder JE (2014) Perceived discrimination and psychotic experiences across multiple ethnic groups in the United States. Schizophr Res 157:259–265.  https://doi.org/10.1016/j.schres.2014.04.036 CrossRefGoogle Scholar
  8. 8.
    Velthorst E, Nieman DH, Veling W et al (2012) Ethnicity and baseline symptomatology in patients with an at risk mental state for psychosis. Psychol Med 42:247–256.  https://doi.org/10.1017/S0033291711001486 CrossRefGoogle Scholar
  9. 9.
    Adriaanse M, van Domburgh L, Hoek HW et al (2014) Prevalence, impact and cultural context of psychotic experiences among ethnic minority youth. Psychol Med.  https://doi.org/10.1017/S0033291714001779 Google Scholar
  10. 10.
    Eilbracht L, Stevens GWJM, Wigman JTW et al (2015) Mild psychotic experiences among ethnic minority and majority adolescents and the role of ethnic density. Soc Psychiatry Psychiatr Epidemiol 50:1029–1037.  https://doi.org/10.1007/s00127-014-0939-4 CrossRefGoogle Scholar
  11. 11.
    Laurens KR, West SA, Murray RM, Hodgins S (2008) Psychotic-like experiences and other antecedents of schizophrenia in children aged 9–12 years: a comparison of ethnic and migrant groups in the United Kingdom. Psychol Med 38:1103–1111.  https://doi.org/10.1017/S0033291707001845 CrossRefGoogle Scholar
  12. 12.
    Wigman JTW, van Winkel R, Raaijmakers QAW et al (2011) Evidence for a persistent, environment-dependent and deteriorating subtype of subclinical psychotic experiences: a 6-year longitudinal general population study. Psychol Med 41:2317–2329.  https://doi.org/10.1017/S0033291711000304 CrossRefGoogle Scholar
  13. 13.
    Morgan C, Charalambides M, Hutchinson G, Murray RM (2010) Migration, ethnicity, and psychosis: toward a sociodevelopmental model. Schizophr Bull 36:655–664.  https://doi.org/10.1093/schbul/sbq051 CrossRefGoogle Scholar
  14. 14.
    Veling W, Susser E (2011) Migration and psychotic disorders. Expert Rev Neurother 11:65–76.  https://doi.org/10.1586/ern.10.91 CrossRefGoogle Scholar
  15. 15.
    Selten JP, Van Der Ven E, Rutten BPF, Cantor-Graae E (2013) The social defeat hypothesis of schizophrenia: an update. Schizophr Bull 39:1180–1186.  https://doi.org/10.1093/schbul/sbt134 CrossRefGoogle Scholar
  16. 16.
    Lewis TT, Cogburn CD, Williams DR (2015) Self-reported experiences of discrimination and health: scientific advances, ongoing controversies, and emerging issues. Annu Rev Clin Psychol.  https://doi.org/10.1146/annurev-clinpsy-032814-112728 Google Scholar
  17. 17.
    Schmitt MT, Postmes T, Branscombe NR, Garcia A (2014) The consequences of perceived discrimination for psychological well-being: a meta-analytic review. Psychol Bull 140:921–948.  https://doi.org/10.1037/a0035754 CrossRefGoogle Scholar
  18. 18.
    Selten J, Cantor-Graae E (2005) Social defeat: risk factor for schizophrenia? Br J Psychiatry. 187:101–102.  https://doi.org/10.1192/bjp.187.2.101 CrossRefGoogle Scholar
  19. 19.
    Pascoe EA, Richman LS (2009) Perceived discrimination and health: a meta-analytic review. Psychol Bull 135:531–554.  https://doi.org/10.1037/a0016059 CrossRefGoogle Scholar
  20. 20.
    Veling W, Hoek HW, Mackenbach JP (2008) Perceived discrimination and the risk of schizophrenia in ethnic minorities. Soc Psychiatry Psychiatr Epidemiol 43:953–959.  https://doi.org/10.1007/s00127-008-0381-6 CrossRefGoogle Scholar
  21. 21.
    Anglin DM, Lui F, Espinosa A et al (2016) Ethnic identity, racial discrimination and attenuated psychotic symptoms in an urban population of emerging adults. Early Interv Psychiatry.  https://doi.org/10.1111/eip.12314 Google Scholar
  22. 22.
    Anglin DM, Lui F, Espinosa A et al (2018) Ethnic identity, racial discrimination and attenuated psychotic symptoms in an urban population of emerging adults. Early Interv Psychiatry 12:380–390.  https://doi.org/10.1111/eip.12314 CrossRefGoogle Scholar
  23. 23.
    Berry JW, Sabatier C (2011) Variations in the assessment of acculturation attitudes: their relationships with psychological wellbeing. Int J Intercult Relat 35:658–669.  https://doi.org/10.1016/j.ijintrel.2011.02.002 CrossRefGoogle Scholar
  24. 24.
    Berry JW, Phinney JS, Sam DL, Vedder P (2006) Immigrant youth: acculturation, identity, and adaptation. Appl Psychol 55:303–332.  https://doi.org/10.1111/j.1464-0597.2006.00256.x CrossRefGoogle Scholar
  25. 25.
    Phinney JS, Horenczyk G, Liebkind K, Vedder P (2001) Ethnic identity, immigration, and well-being: an interactional perspective. J Soc Issues 57:493–510.  https://doi.org/10.1111/0022-4537.00225 CrossRefGoogle Scholar
  26. 26.
    Koneru VK, Weisman de Mamani AG, Flynn PM, Betancourt H (2007) Acculturation and mental health: current findings and recommendations for future research. Appl Prev Psychol 12:76–96.  https://doi.org/10.1016/J.APPSY.2007.07.016 CrossRefGoogle Scholar
  27. 27.
    Phinney JS, Cantu CL, Kurtz DA (1997) Ethnic and American identity as predictors of self-esteem among african american, latino, and white adolescents. J Youth Adolesc 26:165–185.  https://doi.org/10.1023/A:1024500514834 CrossRefGoogle Scholar
  28. 28.
    Veling W, Hoek HW, Wiersma D, MacKenbach JP (2010) Ethnic identity and the risk of schizophrenia in ethnic minorities: a case-control study. Schizophr Bull 36:1149–1156.  https://doi.org/10.1093/schbul/sbp032 CrossRefGoogle Scholar
  29. 29.
    Espinosa A, Tikhonov A, Ellman LM et al (2016) Ethnic identity and perceived stress among ethnically diverse immigrants. J Immigr Minor Health.  https://doi.org/10.1007/s10903-016-0494-z Google Scholar
  30. 30.
    Lopez CR, Antoni MH, Fekete EM, Penedo FJ (2012) Ethnic identity and perceived stress in HIV + minority women: the role of coping self-efficacy and social support. Int J Behav Med 19:23–28.  https://doi.org/10.1007/s12529-010-9121-x CrossRefGoogle Scholar
  31. 31.
    Cronin TJ, Levin S, Branscombe NR et al (2012) Ethnic identification in response to perceived discrimination protects well-being and promotes activism: a longitudinal study of Latino college students. Gr Process Intergr Relat 15:393–407.  https://doi.org/10.1177/1368430211427171 CrossRefGoogle Scholar
  32. 32.
    Romero AJ, Edwards LM, Fryberg SA, Orduña M (2014) Resilience to discrimination stress across ethnic identity stages of development. J Appl Soc Psychol 44:1–11.  https://doi.org/10.1111/jasp.12192 CrossRefGoogle Scholar
  33. 33.
    Brittian AS, Kim SY, Armenta BE et al (2015) Do dimensions of ethnic identity mediate the association between perceived ethnic group discrimination and depressive symptoms? Cult Divers Ethn Minor Psychol 21:41–53.  https://doi.org/10.1037/a0037531 CrossRefGoogle Scholar
  34. 34.
    el Bouhaddani S, van Domburgh L, Schaefer B et al (2017) Peer status in relation to psychotic experiences and psychosocial problems in adolescents: a longitudinal school-based study. Eur Child Adolesc Psychiatry.  https://doi.org/10.1007/s00787-017-1063-2 Google Scholar
  35. 35.
    Stronks K, Kulu-Glasgow I, Agyemang C (2009) The utility of ‘country of birth’ for the classification of ethnic groups in health research: the Dutch experience. Ethn Health 14:255–269.  https://doi.org/10.1080/13557850802509206 CrossRefGoogle Scholar
  36. 36.
    Ising HK, Veling W, Loewy RL et al (2012) The validity of the 16-item version of the prodromal questionnaire (PQ-16) to screen for ultra high risk of developing psychosis in the general help-seeking population. Schizophr Bull 38:1288–1296CrossRefGoogle Scholar
  37. 37.
    Loewy RL, Bearden CE, Johnson JK et al (2005) The prodromal questionnaire (PQ): preliminary validation of a self-report screening measure for prodromal and psychotic syndromes. Schizophr Res 79:117–125.  https://doi.org/10.1016/j.schres.2005.03.007 CrossRefGoogle Scholar
  38. 38.
    de Jong Y, Mulder CL, Boon AE et al (2016) Screening for psychosis risk among adolescents in child and adolescent mental health services: a description of the first step with the 16-item version of the Prodromal Questionnaire (PQ-16). Early Interv Psychiatry.  https://doi.org/10.1111/eip.12362 Google Scholar
  39. 39.
    Fusar-Poli P, Nelson B, Valmaggia L et al (2014) Comorbid depressive and anxiety disorders in 509 individuals with an at-risk mental state: impact on psychopathology and transition to psychosis. Schizophr Bull 40:120–131.  https://doi.org/10.1093/schbul/sbs136 CrossRefGoogle Scholar
  40. 40.
    Tropp LR, Erkut S, Coll CG et al (1999) Psychological acculturation: development of a new measure for Puertoricans on the U.S. mainland. Educ Psychol Meas 59:351–367.  https://doi.org/10.1177/00131649921969794 CrossRefGoogle Scholar
  41. 41.
    Stevens GWJM, Vollebergh WAM, Pels TVM, Crijnen AAM (2005) Predicting externalizing problems in Moroccan immigrant adolescents in the Netherlands. Soc Psychiatry Psychiatr Epidemiol 40:571–579.  https://doi.org/10.1007/s00127-005-0926-x CrossRefGoogle Scholar
  42. 42.
    Belhadj Kouider E, Koglin U, Petermann F (2014) Emotional and behavioral problems in migrant children and adolescents in Europe: a systematic review. Eur Child Adolesc Psychiatry 23:373–391.  https://doi.org/10.1007/s00787-013-0485-8 CrossRefGoogle Scholar
  43. 43.
    Belhadj Kouider E, Koglin U, Petermann F (2015) Emotional and behavioral problems in migrant children and adolescents in American countries: a systematic review. J Immigr Minor Heal 17:1240–1258.  https://doi.org/10.1007/s10903-014-0039-2 CrossRefGoogle Scholar
  44. 44.
    Janssen I, Krabbendam L, Bak M et al (2004) Childhood abuse as a risk factor for psychotic experiences. Acta Psychiatr Scand 109:38–45.  https://doi.org/10.1016/S0920-9964(03)80117-2 CrossRefGoogle Scholar
  45. 45.
    Wickham S, Shryane N, Lyons M et al (2014) Why does relative deprivation affect mental health? The role of justice, trust and social rank in psychological wellbeing and paranoid ideation. J Public Ment Health 13:114–126.  https://doi.org/10.1108/JPMH-06-2013-0049 CrossRefGoogle Scholar
  46. 46.
    Steele CM (1997) A threat in the air. How stereotypes shape intellectual identity and performance. Am Psychol 52:613–629CrossRefGoogle Scholar
  47. 47.
    Verkuyten M, Thijs J (2006) Ethnic discrimination and global self-worth in early adolescents: the mediating role of ethnic self-esteem. Int J Behav Dev.  https://doi.org/10.1177/0165025406063573 Google Scholar
  48. 48.
    Veling W, Selten J-P, Susser E et al (2007) Discrimination and the incidence of psychotic disorders among ethnic minorities in the Netherlands. Int J Epidemiol 36:761–768.  https://doi.org/10.1093/ije/dym085 CrossRefGoogle Scholar
  49. 49.
    McIntyre JC, Wickham S, Barr B, Bentall RP (2018) Social Identity and psychosis: associations and psychological mechanisms. Schizophr Bull 44:681–690.  https://doi.org/10.1093/schbul/sbx110 CrossRefGoogle Scholar
  50. 50.
    Branscombe NR, Schmitt MT, Harvey RD (1999) Perceiving pervasive discrimination among African Americans: Implications for group identification and well-being. J Pers Soc Psychol 77:135–149.  https://doi.org/10.1037/0022-3514.77.1.135 CrossRefGoogle Scholar
  51. 51.
    Nakash O, Nagar M, Shoshani A et al (2012) The effect of acculturation and discrimination on mental health symptoms and risk behaviors among adolescent migrants in Israel. Cult Divers Ethn Minor Psychol 18:228–238.  https://doi.org/10.1037/a0027659 CrossRefGoogle Scholar
  52. 52.
    Verkuyten M (2003) Ethnic in-group bias among minority and majority early adolescents: the perception of negative peer behaviour. Br J Dev Psychol 21:543–564.  https://doi.org/10.1348/026151003322535219 CrossRefGoogle Scholar
  53. 53.
    Schwartz SJ, Unger JB, Zamboanga BL, Szapocznik J (2010) Rethinking the concept of acculturation: implications for theory and research. Am Psychol 65:237–251.  https://doi.org/10.1037/a0019330 CrossRefGoogle Scholar
  54. 54.
    Bhatia S, Ram A (2009) Theorizing identity in transnational and diaspora cultures: a critical approach to acculturation. Int J Intercult Relat 33:140–149.  https://doi.org/10.1016/j.ijintrel.2008.12.009 CrossRefGoogle Scholar
  55. 55.
    Sellers RM, Smith MA, Shelton JN et al (1998) Multidimensional model of racial identity: a reconceptualization of African American racial identity. Pers Soc Psychol Rev 2:18–39.  https://doi.org/10.1207/s15327957pspr0201_2 CrossRefGoogle Scholar
  56. 56.
    Stevens GWJM (2004) Patterns of psychological acculturation in adult and adolescent moroccan immigrants living in the Netherlands. J Cross Cult Psychol 35:689–704.  https://doi.org/10.1177/0022022104270111 CrossRefGoogle Scholar
  57. 57.
    Özbek E, Bongers IL, Lobbestael J, van Nieuwenhuizen C (2015) Turkish and Moroccan young adults in the Netherlands: the relationship between acculturation and psychological problems. J Immigr Minor Heal 17:1687–1696.  https://doi.org/10.1007/s10903-015-0203-3 CrossRefGoogle Scholar

Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2019

Authors and Affiliations

  • Saliha el Bouhaddani
    • 1
  • Lieke van Domburgh
    • 2
    • 3
  • Barbara Schaefer
    • 1
  • Theo A. H. Doreleijers
    • 3
  • Wim Veling
    • 4
  1. 1.Parnassia AcademieCastricumThe Netherlands
  2. 2.Department of Research and DevelopmentPluryn-IntermetzoNijmegenThe Netherlands
  3. 3.Department of Child and Adolescent PsychiatryVU Medical CentreAmsterdamThe Netherlands
  4. 4.Department of Psychiatry, University Medical Centre GroningenUniversity of GroningenGroningenThe Netherlands

Personalised recommendations