Review of factors resulting in systemic biases in the screening, assessment, and treatment of individuals at clinical high-risk for psychosis in the United States
BackgroundSince its inception, research in the clinical high-risk (CHR) phase of psychosis has included identifying and exploring the impact of relevant socio-demographic factors. Employing a narrative review approach and highlighting work from the United States, sociocultural and contextual factors...
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2023-03-01
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| Series: | Frontiers in Psychiatry |
| Subjects: | |
| Online Access: | https://www.frontiersin.org/articles/10.3389/fpsyt.2023.1117022/full |
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| author | Miranda A. Bridgwater Emily Petti Maksim Giljen LeeAnn Akouri-Shan Joseph S. DeLuca Pamela Rakhshan Rouhakhtar Caroline Millar Nicole R. Karcher Elizabeth A. Martin Jordan DeVylder Deidre Anglin Raquel Williams Lauren M. Ellman Vijay A. Mittal Jason Schiffman |
| author_facet | Miranda A. Bridgwater Emily Petti Maksim Giljen LeeAnn Akouri-Shan Joseph S. DeLuca Pamela Rakhshan Rouhakhtar Caroline Millar Nicole R. Karcher Elizabeth A. Martin Jordan DeVylder Deidre Anglin Raquel Williams Lauren M. Ellman Vijay A. Mittal Jason Schiffman |
| author_sort | Miranda A. Bridgwater |
| collection | DOAJ |
| description | BackgroundSince its inception, research in the clinical high-risk (CHR) phase of psychosis has included identifying and exploring the impact of relevant socio-demographic factors. Employing a narrative review approach and highlighting work from the United States, sociocultural and contextual factors potentially affecting the screening, assessment, and service utilization of youth at CHR were reviewed from the current literature.ResultsExisting literature suggests that contextual factors impact the predictive performance of widely used psychosis-risk screening tools and may introduce systemic bias and challenges to differential diagnosis in clinical assessment. Factors reviewed include racialized identity, discrimination, neighborhood context, trauma, immigration status, gender identity, sexual orientation, and age. Furthermore, racialized identity and traumatic experiences appear related to symptom severity and service utilization among this population.ConclusionsCollectively, a growing body of research from the United States and beyond suggests that considering context in psychosis-risk assessment can provide a more accurate appraisal of the nature of risk for psychosis, render more accurate results improving the field's prediction of conversion to psychosis, and enhance our understanding of psychosis-risk trajectories. More work is needed in the U.S. and across the globe to uncover how structural racism and systemic biases impact screening, assessment, treatment, and clinical and functional outcomes for those at CHR. |
| first_indexed | 2024-04-10T04:07:37Z |
| format | Article |
| id | doaj.art-bfcad9e3ed0442c98dcbc4f108a0df0e |
| institution | Directory Open Access Journal |
| issn | 1664-0640 |
| language | English |
| last_indexed | 2024-04-10T04:07:37Z |
| publishDate | 2023-03-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Psychiatry |
| spelling | doaj.art-bfcad9e3ed0442c98dcbc4f108a0df0e2023-03-13T04:40:38ZengFrontiers Media S.A.Frontiers in Psychiatry1664-06402023-03-011410.3389/fpsyt.2023.11170221117022Review of factors resulting in systemic biases in the screening, assessment, and treatment of individuals at clinical high-risk for psychosis in the United StatesMiranda A. Bridgwater0Emily Petti1Maksim Giljen2LeeAnn Akouri-Shan3Joseph S. DeLuca4Pamela Rakhshan Rouhakhtar5Caroline Millar6Nicole R. Karcher7Elizabeth A. Martin8Jordan DeVylder9Deidre Anglin10Raquel Williams11Lauren M. Ellman12Vijay A. Mittal13Jason Schiffman14Department of Psychological Science, University of California, Irvine, Irvine, CA, United StatesDepartment of Psychological Science, University of California, Irvine, Irvine, CA, United StatesDepartment of Psychological Science, University of California, Irvine, Irvine, CA, United StatesDepartment of Psychology, University of Maryland, Baltimore County, Baltimore, MD, United StatesDepartment of Psychological and Brain Sciences, Fairfield University, Fairfield, CT, United StatesDepartment of Psychology, University of Maryland, Baltimore County, Baltimore, MD, United StatesDepartment of Psychology, University of Maryland, Baltimore County, Baltimore, MD, United StatesDepartment of Psychiatry, Washington University School of Medicine, St. Louis, MO, United StatesDepartment of Psychological Science, University of California, Irvine, Irvine, CA, United StatesGraduate School of Social Service, Fordham University, New York, NY, United StatesDepartment of Psychology, The City College of New York, New York, NY, United StatesThrive Together OC, Orange, CA, United StatesDepartment of Psychology and Neuroscience, Temple University, Philadelphia, PA, United StatesDepartment of Psychology, Northwestern University, Evanston, IL, United StatesDepartment of Psychological Science, University of California, Irvine, Irvine, CA, United StatesBackgroundSince its inception, research in the clinical high-risk (CHR) phase of psychosis has included identifying and exploring the impact of relevant socio-demographic factors. Employing a narrative review approach and highlighting work from the United States, sociocultural and contextual factors potentially affecting the screening, assessment, and service utilization of youth at CHR were reviewed from the current literature.ResultsExisting literature suggests that contextual factors impact the predictive performance of widely used psychosis-risk screening tools and may introduce systemic bias and challenges to differential diagnosis in clinical assessment. Factors reviewed include racialized identity, discrimination, neighborhood context, trauma, immigration status, gender identity, sexual orientation, and age. Furthermore, racialized identity and traumatic experiences appear related to symptom severity and service utilization among this population.ConclusionsCollectively, a growing body of research from the United States and beyond suggests that considering context in psychosis-risk assessment can provide a more accurate appraisal of the nature of risk for psychosis, render more accurate results improving the field's prediction of conversion to psychosis, and enhance our understanding of psychosis-risk trajectories. More work is needed in the U.S. and across the globe to uncover how structural racism and systemic biases impact screening, assessment, treatment, and clinical and functional outcomes for those at CHR.https://www.frontiersin.org/articles/10.3389/fpsyt.2023.1117022/fullsocial determinantsclinical high-riskpsychosisscreeningsystemic bias |
| spellingShingle | Miranda A. Bridgwater Emily Petti Maksim Giljen LeeAnn Akouri-Shan Joseph S. DeLuca Pamela Rakhshan Rouhakhtar Caroline Millar Nicole R. Karcher Elizabeth A. Martin Jordan DeVylder Deidre Anglin Raquel Williams Lauren M. Ellman Vijay A. Mittal Jason Schiffman Review of factors resulting in systemic biases in the screening, assessment, and treatment of individuals at clinical high-risk for psychosis in the United States Frontiers in Psychiatry social determinants clinical high-risk psychosis screening systemic bias |
| title | Review of factors resulting in systemic biases in the screening, assessment, and treatment of individuals at clinical high-risk for psychosis in the United States |
| title_full | Review of factors resulting in systemic biases in the screening, assessment, and treatment of individuals at clinical high-risk for psychosis in the United States |
| title_fullStr | Review of factors resulting in systemic biases in the screening, assessment, and treatment of individuals at clinical high-risk for psychosis in the United States |
| title_full_unstemmed | Review of factors resulting in systemic biases in the screening, assessment, and treatment of individuals at clinical high-risk for psychosis in the United States |
| title_short | Review of factors resulting in systemic biases in the screening, assessment, and treatment of individuals at clinical high-risk for psychosis in the United States |
| title_sort | review of factors resulting in systemic biases in the screening assessment and treatment of individuals at clinical high risk for psychosis in the united states |
| topic | social determinants clinical high-risk psychosis screening systemic bias |
| url | https://www.frontiersin.org/articles/10.3389/fpsyt.2023.1117022/full |
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