Adverse Life Events by Immigrant Generational Status in a FEP Sample in Massachusetts
Emily He (1), Heather Thibeau (2), Emily Kline (2,3), Matcheri Keshavan (4,5)
1. Clark University
2. Boston Medical Center
3. Boston University School of Medicine
4. Beth Israel Deaconess Medical Center
5. Harvard Medical School
Abstract
Background: There is a higher incidence of psychosis in first-and second-generation immigrants to countries with predominantly white/European populations, this might be linked to disproportionate exposure to childhood and adult adverse experiences. This suggests that immigrant generational status may be a proxy for difficult life circumstances which contribute to an individual’s psychosis vulnerability in addition to biological and heritable risk factors. Utilizing clinician written case reports of intake interviews may provide insight to difficult life experiences for individuals experiencing early psychosis.
Methods: Research staff coded (N=70) case reports collected for a longitudinal U.S. study on outpatient psychosis specialty care specifically recruited from Boston, MA First Episode Psychosis clinics. Twenty-eight parent themes were identified with additional subthemes. The themes reflect life events related to changes in mental health status/symptomatology, pathways to care, or adverse life experiences. Frequency of the themes was analyzed by immigration status (N=36 born in the USA, N=14 1st generation, N=20 2nd generation).
Results: Frequency analysis reveals that the top common theme among the entire sample was substance misuse (51.4%). When broken up into immigration status, different themes emerged and commonly endorsed themes occurred at different frequencies.
Discussion: Identifying adverse life experiences for individuals with early psychosis can provide insight into common stressors that can contribute to psychosis development and its treatment. Adverse life experiences may further impact engagement with care and timely treatment. Additionally, identifying variation in adverse life experiences by immigrant generational status can provide context for understanding disparities that disproportionately impact those belonging to minority groups.