From Womb to Neighborhood: A Racial Analysis of Social Determinants of Psychosis in the United States.
From Womb to Neighborhood: A Racial Analysis of Social Determinants of Psychosis in the United States.
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DOI：
10.1176/appi.ajp.2020.20071091
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发表时间：
2021-07
期刊：
影响因子：
--
通讯作者：
van der Ven E
中科院分区：
文献类型：
--
作者：
Anglin DM;Ereshefsky S;Klaunig MJ;Bridgwater MA;Niendam TA;Ellman LM;DeVylder J;Thayer G;Bolden K;Musket CW;Grattan RE;Lincoln SH;Schiffman J;Lipner E;Bachman P;Corcoran CM;Mota NB;van der Ven E
作者研究了美国-基于证据，将社会环境的特征与精神病连续体（从精神病经历到精神分裂症）的结果联系起来。社会的不公平的社会和经济制度通过代理人（如少数民族和移民身份）显著影响精神病风险的概念在欧洲国家得到了更广泛的研究。虽然有现有的精神病的社会决定因素的国际审查，没有作者的知识，特别是在美国的情况下的因素集中-一个遗漏，使国内的治疗发展和预防工作不完整和信息不足。在这篇评论中，作者首先描述了美国结构性种族主义的遗产如何塑造了社会梯度，突出了环境条件下的种族不平等。作者提供了一个假设的模型，通过交织的中介因素的基础上现有的理论模型和文献回顾结构性种族主义与精神病的风险。邻里因素，累积的创伤和压力，产前和围产期并发症是三个关键领域选择审查，因为它们反映了社会和环境条件，可能会影响精神病的风险，通过一个共同的途径形成的结构性种族主义。作者描述的证据表明，美国的黑人和拉丁美洲人在这三个关键领域中遭受的风险因素不成比例，这在很大程度上是种族歧视和社会劣势的结果。这种对个人和社区因素的广泛关注旨在提供一个综合的空间来审查这一不断增长的研究，并指导对美国精神病社会决定因素的持续调查。
The authors examine U.S.-based evidence that connects characteristics of the social environment with outcomes across the psychosis continuum, from psychotic experiences to schizophrenia. The notion that inequitable social and economic systems of society significantly influence psychosis risk through proxies, such as racial minority and immigrant statuses, has been studied more extensively in European countries. While there are existing international reviews of social determinants of psychosis, none to the authors’ knowledge focus on factors in the U.S. context specifically—an omission that leaves domestic treatment development and prevention efforts incomplete and underinformed. In this review, the authors first describe how a legacy of structural racism in the United States has shaped the social gradient, highlighting consequential racial inequities in environmental conditions. The authors offer a hypothesized model linking structural racism with psychosis risk through interwoven intermediary factors based on existing theoretical models and a review of the literature. Neighborhood factors, cumulative trauma and stress, and prenatal and perinatal complications were three key areas selected for review because they reflect social and environmental conditions that may affect psychosis risk through a common pathway shaped by structural racism. The authors describe evidence showing that Black and Latino people in the United States suffer disproportionately from risk factors within these three key areas, in large part as a result of racial discrimination and social disadvantage. This broad focus on individual and community factors is intended to provide a consolidated space to review this growing body of research and to guide continued inquiries into social determinants of psychosis in U.S. contexts.
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