Context matters: The impact of neighborhood crime and paranoid symptoms on psychosis risk assessment
Context matters: The impact of neighborhood crime and paranoid symptoms on psychosis risk assessment
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DOI：
10.1016/j.schres.2016.01.007
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发表时间：
2016-03-01
影响因子：
4.5
通讯作者：
Schiffman, Jason
中科院分区：
文献类型：
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作者：
Wilson, Camille;Smith, Melissa Edmondson;Schiffman, Jason
精神病风险评估措施探讨偏执思维、迫害性参考观念和怀疑作为精神病风险构造的一部分。然而，在某些情况下，这些症状可能反映了对环境压力源的规范的、现实的甚至适应性的反应，而不是精神病理学。邻里特征（例如危险性）与恐惧和怀疑的程度有关，而理论上与精神病无关。尽管存在这种潜在的混淆，精神病风险评估并没有明确评估可能（适应性地）增加可疑性的邻里因素。在这种情况下，访谈者可能会将适应性怀疑误解为精神病风险症状。最终，社区因素对精神病风险评估的影响程度仍不清楚。目前的研究通过 SIPS 对居住在巴尔的摩市各个社区的主要非裔美国寻求帮助青少年 (N-57) 进行测量，探讨了社区犯罪与可疑性之间的关系。统一犯罪报告（包括巴尔的摩市的暴力和财产犯罪）被用来计算邻里犯罪的代理值。该犯罪指数与 SIPS 可疑度相关（r(55) = .32，p = .02）。多元回归分析表明，邻里犯罪增加对可疑性的预测显着高于其他 SIPS 阳性症状对可疑性预测的影响。研究结果表明，在某些情况下，邻里犯罪可能是精神病风险评估中确定的可疑性的原因，因此在评估精神病风险时，对背景因素的敏感性非常重要。 (C) 2016 Elsevier B.V. 保留所有权利。
Psychosis risk assessment measures probe for paranoid thinking, persecutory ideas of reference, and suspiciousness as part of a psychosis risk construct. However, in some cases, these symptoms may reflect a normative, realistic, and even adaptive response to environmental stressors rather than psychopathology. Neighborhood characteristics, dangerousness for instance, are linked to levels of fear and suspiciousness that can be theoretically unrelated to psychosis. Despite this potential confound, psychosis-risk assessments do not explicitly evaluate neighborhood factors that might (adaptively) increase suspiciousness. In such cases, interviewers run the risk of misinterpreting adaptive suspiciousness as a psychosis-risk symptom. Ultimately, the degree to which neighborhood factors contribute to psychosis-risk assessment remains unclear. The current study examined the relation between neighborhood crime and suspiciousness as measured by the SIPS among predominantly African American help-seeking adolescents (N-57) living in various neighborhoods in Baltimore City. Uniform Crime Reports, including violent and property crime for Baltimore City, were used to calculate a proxy of neighborhood crime. This crime index correlated with SIPS suspiciousness (r(55) = .32, p = .02). Multiple regression analyses demonstrated that increased neighborhood crime significantly predicted suspiciousness over and above the influence of the other SIPS positive symptoms in predicting suspiciousness. Findings suggest that neighborhood crime may in some cases account for suspiciousness ascertained as part of a psychosis risk assessment, and therefore sensitivity to contextual factors is important when evaluating risk for psychosis. (C) 2016 Elsevier B.V. All rights reserved.