Evidence for Environmental Risk Factors and Cumulative Stress Linking Racial/Ethnic Identity and Psychotic-Like Experiences in ABCD Study Data.

OBJECTIVE: Previous work has found increased endorsement of psychotic-like experiences (PLEs) among marginalized racial and ethnic groups. According to social determinants frameworks, marginalized groups are at increased risk for exposure to socio-environmental risk factors, including systemic factors (eg, poverty and poor housing conditions) and social stressors (eg, discrimination). We examine the extent to which environmental risk factors and stress account for associations between racial/ethnic groups with PLEs. METHOD: Analyses included 11,876 young adolescents 9 to 10 years of age from the Adolescent Brain Cognitive Development (ABCD) study. Mediation models assessed whether stress at 1-year follow-up indirectly linked baseline environmental risk to later distressing PLEs at 2-year follow-up. Serial mediation models examined whether environmental risk and stress indirectly accounted for variation among racial/ethnic groups in self-reported distressing PLEs. RESULTS: Through principal component and mediation analyses, we found evidence that the link between environmental risk (eg, poverty and exposure to crime) and distressing PLEs was mediated by stress. There was also evidence that higher endorsement of distressing PLEs within the Black and Hispanic groups was serially mediated by greater environmental risk and greater stress. CONCLUSION: The analyses provide evidence that the associations between marginalized racial and ethnic identities with the endorsement of PLEs partially reflects the sequelae of systemic socio-environmental factors. Findings suggest the potential for intervening upon environmental risk factors to target the reduction of cumulative stress over time, which may in turn buffer against the development of PLEs. PLAIN LANGUAGE SUMMARY: Using longitudinal data from 11,876 young adolescents aged 9-10 from the Adolescent Brain Cognitive Development (ABCD) study, this study examined environmental (e.g., poverty) and stress-related factors (e.g., experiences of discrimination, childhood adversity) that are associated with psychotic-like experiences, and whether these factors explain racial/ethnic differences in psychotic-like experiences. The authors found evidence that the association between these environmental risk factors and psychotic-like experiences is partially explained by cumulative stress, and that differences in psychotic-like experiences across racial/ethnic groups were accounted for by both environmental risk factors and stress. Results highlight that systemic factors may explain higher levels of psychotic-like experiences among historically marginalized racial/ethnic groups. Findings suggest the potential for intervening upon modifiable risk factors to buffer against stress, and in turn, the development of psychotic-like experiences over time. DIVERSITY INCLUSION STATEMENT: We worked to ensure sex and gender balance in the recruitment of human participants. One or more of the authors of this paper self-identifies as a member of one or more historically underrepresented racial and/or ethnic groups in science. One or more of the authors of this paper self-identifies as a member of one or more historically underrepresented sexual and/or gender groups in science. We actively worked to promote sex and gender balance in our author group. We worked to ensure race, ethnic, and/or other types of diversity in the recruitment of human participants. We worked to ensure that the study questionnaires were prepared in an inclusive way.

Do Ethnic Identity, Familial, and Community Contexts Impact the Association Between Adverse Life Events and Psychopathology Among Latinx Adolescents?

OBJECTIVE: Few studies have explored the interplay of how individual identity, parental, familial, and contextual factors impact associations between Latinx adolescent adversities and psychopathology. This study aimed to examine if these factors mediate the relationship between adversities and psychopathology in Latinx youth. METHOD: Latinx youth (n=2,411) data from the Adolescent Brain Cognitive Development (ABCD) Study were used to examine path models with ACEs as the predictor and either youth- or caregiver-rated internalizing/externalizing scores over four timepoints as the outcome (age ranges: 9-13). Models examined 3 potential mediators: 1) ethnic identity, 2) familial context (comprised of parental monitoring, family conflict, and caregiver acceptance), and 3) community cohesion. Models were conducted separately for internalizing and externalizing symptoms. RESULTS: Greater adversity was associated with greater youth- and caregiver-rated internalizing/externalizing psychopathology over time. Greater adversity was associated with lower family functioning and lower ethnic identity, and greater family functioning was associated with lower psychopathology. Family functioning mediated associations between adversity and psychopathology over time (youth-reported internalizing: 95% CI= 0.012 - 0.019; youth-reported externalizing: 0.020 - 0.028). In contrast, there was not strong evidence for ethnic identity and community cohesion mediating associations between adversities and psychopathology over time. CONCLUSION: Unlike previous studies, ethnic identity did not influence the relationship between ACEs and psychopathology over time. Additional research is needed to unpack whether possible tensions rise as Latinx youth acculturate into U.S. culture and achieve optimal levels of ethnic identity formation. Providers need to assess specific Latinx parental and familial contexts that may interfere with youth identity formation.

Ethno-racial disparities in psychosis-like experiences among students in higher education: Findings from the Healthy Minds Study 2020-2021.

BACKGROUND: Ethno-racial variations of psychosis-like experiences exist in the general population; however, it is unknown whether this variation exists among emerging adults in higher education, and whether there are differences across ethnic groups within racial categories. METHODS: Using the Health Minds Study data from 2020 to 2021, we used multivariable logistic regression models to examine race/ethnicity and psychosis-like experiences, adjusting for socio-demographic characteristics (age, gender, international student status). We then adjusted for food insecurity, parental education, and social belonging. RESULTS: Black, Hispanic/Latinx, multiracial, and American Indian/Alaska Native students had greater odds of 12-month psychosis-like experiences when compared with White students. These associations attenuated and were no longer statistically significant for Black and Hispanic/Latinx students after adjusting for food insecurity and parental education. Multiracial and American Indian/Alaska Native students still had greater odds of psychosis-like experiences after further adjusting for sense of belonging. When looking at ethnic subgroups, Filipinx and multi-ethnic Asian students had significantly greater odds than East Asian students, and multi-ethnic Black students had greater odds than African Americans. CONCLUSION: Odds of psychosis-like experiences vary across and within ethno-racial categories among emerging adults in higher education. Future research may explore psychosis as a disparity impacting Native American/Alaska Native and multiracial/multi-ethnic populations.

Examining the Most Important Risk Factors for Predicting Youth Persistent and Distressing Psychotic-Like Experiences.

BACKGROUND: Persistence and distress distinguish more clinically significant psychotic-like experiences (PLEs) from those that are less likely to be associated with impairment and/or need for care. Identifying risk factors that identify clinically relevant PLEs early in development is important for improving our understanding of the etiopathogenesis of these experiences. Machine learning analyses were used to examine the most important baseline factors distinguishing persistent distressing PLEs. METHODS: Using Adolescent Brain Cognitive Development (ABCD) Study data on PLEs from 3 time points (ages 9-13 years), we created the following groups: individuals with persistent distressing PLEs (n = 305), individuals with transient distressing PLEs (n = 374), and individuals with low-level PLEs demographically matched to either the persistent distressing PLEs group (n = 305) or the transient distressing PLEs group (n = 374). Random forest classification models were trained to distinguish persistent distressing PLEs from low-level PLEs, transient distressing PLEs from low-level PLEs, and persistent distressing PLEs from transient distressing PLEs. Models were trained using identified baseline predictors as input features (i.e., cognitive, neural [cortical thickness, resting-state functional connectivity], developmental milestone delays, internalizing symptoms, adverse childhood experiences). RESULTS: The model distinguishing persistent distressing PLEs from low-level PLEs showed the highest accuracy (test sample accuracy = 69.33%; 95% CI, 61.29%-76.59%). The most important predictors included internalizing symptoms, adverse childhood experiences, and cognitive functioning. Models for distinguishing persistent PLEs from transient distressing PLEs generally performed poorly. CONCLUSIONS: Model performance metrics indicated that while most important factors overlapped across models (e.g., internalizing symptoms), adverse childhood experiences were especially important for predicting persistent distressing PLEs. Machine learning analyses proved useful for distinguishing the most clinically relevant group from the least clinically relevant group but showed limited ability to distinguish among clinically relevant groups that differed in PLE persistence.

A site-wise reliability analysis of the ABCD diffusion fractional anisotropy and cortical thickness: impact of scanner platforms.

The Adolescent Brain and Cognitive Development (ABCD) project is the largest study of adolescent brain development. ABCD longitudinally tracks 11,868 participants aged 9-10 years from 21 sites using standardized protocols for multi-site MRI data collection and analysis. While the multi-site and multi-scanner study design enhances the robustness and generalizability of analysis results, it may also introduce non-biological variances including scanner-related variations, subject motion, and deviations from protocols. ABCD imaging data were collected biennially within a period of ongoing maturation in cortical thickness and integrity of cerebral white matter. These changes can bias the classical test-retest methodologies, such as intraclass correlation coefficients (ICC). We developed a site-wise adaptive ICC (AICC) to evaluate the reliability of imaging-derived phenotypes while accounting for ongoing brain development. AICC iteratively estimates the population-level age-related brain development trajectory using a weighted mixed model and updates age-corrected site-wise reliability until convergence. We evaluated the test-retest reliability of regional fractional anisotropy (FA) measures from diffusion tensor imaging and cortical thickness (CT) from structural MRI data for each site. The mean AICC for 20 FA tracts across sites was 0.61±0.19, lower than the mean AICC for CT in 34 regions across sites, 0.76±0.12. Remarkably, sites using Siemens scanners consistently showed significantly higher AICC values compared to those using GE/Philips scanners for both FA (AICC=0.71±0.12 vs 0.46±0.17, p<0.001) and CT (AICC=0.80±0.10 vs 0.69±0.11, p<0.001). These findings demonstrate site-and-scanner related variations in data quality and underscore the necessity for meticulous data curation in subsequent association analyses.