Division of Psychiatry Research, The Zucker Hillside Hospital, Northwell Health, Glen Oaks, NY, USA; Center for Psychiatric Neuroscience, Feinstein Institute for Medical Research, Northwell Health, Manhasset, NY, USA; Department of Psychiatry, The Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY, USA.
Division of Psychiatry Research, The Zucker Hillside Hospital, Northwell Health, Glen Oaks, NY, USA; Center for Psychiatric Neuroscience, Feinstein Institute for Medical Research, Northwell Health, Manhasset, NY, USA; Department of Psychiatry, The Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY, USA.
Schizophr Res. 2023 Apr;254:125-132. doi: 10.1016/j.schres.2023.02.021. Epub 2023 Feb 27.
While individuals at clinical high-risk (CHR) for psychosis experience higher levels of discrimination than healthy controls, it is unclear how these experiences contribute to the etiology of attenuated positive symptoms. The present study examined the association of perceived discrimination with positive symptoms in a cohort from the North American Prodrome Longitudinal Study (NAPLS2). It predicted that CHR individuals will report higher levels of lifetime and past year perceived discrimination related to their race and ethnicity (ethnoracial discrimination) and that this form of discrimination will be significantly associated with baseline positive symptoms.
Participants included 686 CHR and 252 healthy controls. The present study examined data from the perceived discrimination (PD) scale, the Brief Core Schema Scale, and the Scale for the Psychosis-Risk Symptoms. Structural equation modeling was employed to examine whether negative schema of self and others mediated the relation of past year ethnoracial PD to baseline suspiciousness symptoms.
CHR individuals report higher levels of past year and lifetime PD compared to healthy controls. Lifetime ethnoracial PD was associated with suspiciousness and total positive symptoms. Negative schema of self and others scores partially mediated the relation of past year ethnoracial PD to suspiciousness, one of five positive symptom criteria for CHR.
For CHR individuals, past year ethnoracial discrimination was associated with negative beliefs about themselves and others, which was associated with suspiciousness. These findings contribute to an emerging literature characterizing the mechanisms by which discrimination contributes to the positive symptoms characterizing the CHR syndrome.
虽然处于精神病高危（CHR）状态的个体比健康对照组经历更高水平的歧视，但尚不清楚这些经历如何导致症状减轻的阳性症状的发生。本研究在北美前驱期纵向研究（NAPLS2）的队列中检查了感知歧视与阳性症状之间的关联。预测 CHR 个体将报告与他们的种族和民族（民族歧视）有关的更高水平的终生和过去一年的感知歧视，并且这种形式的歧视将与基线阳性症状显著相关。
参与者包括 686 名 CHR 和 252 名健康对照组。本研究检查了感知歧视（PD）量表、简要核心模式量表和精神病风险症状量表的数据。结构方程模型用于检查过去一年的民族歧视 PD 与基线可疑症状之间的关系是否受到自我和他人的消极模式的影响。
CHR 个体报告的过去一年和终生 PD 水平高于健康对照组。终生民族歧视 PD 与可疑性和总阳性症状有关。自我和他人的消极模式得分部分中介了过去一年民族歧视 PD 与可疑性之间的关系，可疑性是 CHR 的五个阳性症状标准之一。
对于 CHR 个体，过去一年的民族歧视与对自己和他人的消极信念有关，而这些信念与可疑性有关。这些发现有助于描述歧视导致 CHR 综合征阳性症状的机制的新兴文献。
