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Disentangling heterogeneity of psychosis expression in the general population: sex-specific moderation effects of environmental risk factors on symptom networks.
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- Author(s): Betz, Linda T.; Penzel, Nora; Rosen, Marlene; Bhui, Kamaldeep; Upthegrove, Rachel; Kambeitz, Joseph
- Source:
Psychological Medicine. Apr2023, Vol. 53 Issue 5, p1860-1869. 10p. - Source:
- Additional Information
- Subject Terms: CANNABIS (Genus); CONFIDENCE intervals; PSYCHOSES; AGE distribution; CHILD abuse; PUBLIC health; DOMESTIC violence; RISK assessment; SEX distribution; SOCIAL isolation; PATHOLOGICAL psychology; ALCOHOL drinking; MENTAL depression; DESCRIPTIVE statistics; RESEARCH funding; STATISTICAL sampling; ANXIETY; STATISTICAL correlation; ENVIRONMENTAL exposure; BULLYING
- Abstract: Background: Psychosis expression in the general population may reflect a behavioral manifestation of the risk for psychotic disorder. It can be conceptualized as an interconnected system of psychotic and affective experiences; a so-called 'symptom network'. Differences in demographics, as well as exposure to adversities and risk factors, may produce substantial heterogeneity in symptom networks, highlighting potential etiological divergence in psychosis risk. Methods: To explore this idea in a data-driven way, we employed a novel recursive partitioning approach in the 2007 English National Survey of Psychiatric Morbidity (N = 7242). We sought to identify 'network phenotypes' by explaining heterogeneity in symptom networks through potential moderators, including age, sex, ethnicity, deprivation, childhood abuse, separation from parents, bullying, domestic violence, cannabis use, and alcohol. Results: Sex was the primary source of heterogeneity in symptom networks. Additional heterogeneity was explained by interpersonal trauma (childhood abuse and domestic violence) in women and domestic violence , cannabis use , ethnicity in men. Among women, especially those exposed to early interpersonal trauma, an affective loading within psychosis may have distinct relevance. Men, particularly those from minority ethnic groups, demonstrated a strong network connection between hallucinatory experiences and persecutory ideation. Conclusion: Symptom networks of psychosis expression in the general population are highly heterogeneous. The structure of symptom networks seems to reflect distinct sex-related adversities, etiologies, and mechanisms of symptom-expression. Disentangling the complex interplay of sex, minority ethnic group status, and other risk factors may help optimize early intervention and prevention strategies in psychosis. [ABSTRACT FROM AUTHOR]
- Abstract: Copyright of Psychological Medicine is the property of Cambridge University Press and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
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