Early traumatic experiences, perceived discrimination and conversion to psychosis in those at clinical high risk for psychosis

Soc Psychiatry Psychiatr Epidemiol. 2016 Apr;51(4):497-503. doi: 10.1007/s00127-016-1182-y. Epub 2016 Feb 6.


Purpose: There is evidence to suggest that both early traumatic experiences and perceived discrimination are associated with later onset of psychosis. Less is known about the impact these two factors may have on conversion to psychosis in those who are at clinical high risk (CHR) of developing psychosis. The purpose of this study was to determine if trauma and perceived discrimination were predictors of conversion to psychosis.

Methods: The sample consisted of 764 individuals who were at CHR of developing psychosis and 280 healthy controls. All participants were assessed on past trauma, bullying and perceived discrimination.

Results: Individuals at CHR reported significantly more trauma, bullying and perceived discrimination than healthy controls. Only perceived discrimination was a predictor of later conversion to psychosis.

Conclusions: Given that CHR individuals are reporting increased rates of trauma and perceived discrimination, these should be routinely assessed, with the possibility of offering interventions aimed at ameliorating the impact of past traumas as well as improving self-esteem and coping strategies in an attempt to reduce perceived discrimination.

Keywords: Clinical high risk; Perceived discrimination; Prodrome; Psychosis; Risk; Trauma.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Bullying*
  • Case-Control Studies
  • Female
  • Humans
  • Male
  • Psychological Trauma / epidemiology*
  • Psychotic Disorders / epidemiology*
  • Risk
  • Social Discrimination / psychology*
  • Young Adult