Abstract
BackgroundExperiencing multiple types of victimization (poly-victimization) during adolescence is associated with onset of psychotic experiences. However, many poly-victimized adolescents will not develop such subclinical phenomena and the factors that protect them are unknown. This study investigated whether individual, family, or community-level characteristics were associated with an absence of psychotic experiences amongst poly-victimized adolescents.MethodsParticipants were from the Environmental Risk (E-Risk) Longitudinal Twin Study, a nationally-representative cohort of 2232 UK-born twins. Exposure to seven different types of victimization between ages 12–18 was ascertained using a modified Juvenile Victimization Questionnaire at age 18. Adolescents were also interviewed about psychotic experiences at age 18. Protective factors were measured at ages 12 and 18.ResultsExposure to poly-victimization during adolescence was associated with age-18 psychotic experiences (OR=4.62, 95% CI 3.59–5.94, P<0.001), but more than a third of the poly-victimized adolescents reported having no psychotic experiences (40.1%). Greater social support was found to be protective against adolescent psychotic experiences amongst those exposed to poly-victimization. Notably, social support was also generally associated with a reduced likelihood of age-18 psychotic experiences in the whole sample (along with engaging in physical activity and greater neighborhood social cohesion).DiscussionIncreasing social support from friends and family appears to be an important area for preventive interventions targeting adolescent psychotic experiences. Such prevention efforts would be most effectively targeted at poly-victimized adolescents who are at high-risk of developing psychotic phenomena.
Highlights
Psychotic experiences occurring during late adolescence have been found to precede the development of psychotic disorders (Dominguez et al, 2011) and a wide range of other severe mental health problems including suicide attempts (McGrath et al, 2016)
We found that engaging in physical activity, higher levels of social cohesion, and greater levels of social support were all associated with a reduced likelihood of psychotic experiences being reported at age 18 when controlling for potential confounders
Multivariate models including the above significant predictors showed that independent associations were found for engaging in physical activity (OR = 0.59, 95% CI 0.36–0.96, P = 0.035), increased social support (OR = 0.91, 95% CI 0.89–0.94, P < 0.001), and higher levels of social cohesion (OR = 0.77, 95% CI 0.60–0.98, P = 0.035)
Summary
Psychotic experiences (such as hearing voices, having visions, and feeling extremely paranoid) occurring during late adolescence have been found to precede the development of psychotic disorders (Dominguez et al, 2011) and a wide range of other severe mental health problems including suicide attempts (McGrath et al, 2016). Psychotic experiences during this developmental stage have been shown to be associated with greater psychiatric comorbidity than psychotic phenomena occurring during late childhood (Kelleher et al, 2012a). Identifying multi-level factors that are protective against the development of psychotic experiences, in this high-risk group of poly-victimized adolescents, may be especially relevant for prevention efforts
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