Psychotic experiences among ethnic majority and minority adolescents and the role of discrimination and ethnic identity
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.
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.
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.
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.
KeywordsPsychotic experiences Discrimination Ethnic identity Ethnic minority
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.
- 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
- 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
- 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
- 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
- 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