Sunday, January 24, 2016

Context Matters: The Impact of Neighborhood Crime & Paranoid Symptoms on Psychosis Risk Assessment

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.

Purchase full article at:

  • 1University of Maryland, Baltimore County, Department of Human Services Psychology (, 1000 Hilltop Circle, Baltimore, MD 21250, United States.
  • 2University of Maryland, School of Social Work, 525 W. Redwood St., Baltimore, MD 21201, United States.
  • 3Beth Israel Deaconess Medical Center, Department of Public Psychiatry, 75 Fenwood Road, 5th Floor, Boston, MA 02115, United States.
  • 4University of Maryland School of Medicine, 655 W. Baltimore St., Baltimore, MD 2120, United States.
  • 5University of Maryland, Baltimore County, Department of Human Services Psychology, 1000 Hilltop Circle, Baltimore, MD 21250, United States. Electronic address: 
  •  2016 Jan 14. pii: S0920-9964(16)30007-X. doi: 10.1016/j.schres.2016.01.007.

No comments:

Post a Comment