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In the eye of the beholder: Perceptions of neighborhood adversity and psychotic experiences in adolescence

Published online by Cambridge University Press:  22 November 2017

Joanne B. Newbury
King's College London
Louise Arseneault
King's College London
Avshalom Caspi
King's College London Duke University
Terrie E. Moffitt
King's College London Duke University
Candice L. Odgers
Duke University
Jessie R. Baldwin
King's College London
Helena M. S. Zavos
King's College London
Helen L. Fisher*
King's College London
Address correspondence and reprint requests to: Helen L. Fisher, MRC SGDP Centre, Institute of Psychiatry, Psychology & Neuroscience, King's College London, 16 De Crespigny Park, London SE5 8AF, UK; E-mail:


Adolescent psychotic experiences increase risk for schizophrenia and other severe psychopathology in adulthood. Converging evidence implicates urban and adverse neighborhood conditions in the etiology of adolescent psychotic experiences, but the role of young people's personal perceptions of disorder (i.e., physical and social signs of threat) in their neighborhood is unknown. This was examined using data from the Environmental Risk Longitudinal Twin Study, a nationally representative birth cohort of 2,232 British twins. Participants were interviewed at age 18 about psychotic phenomena and perceptions of disorder in the neighborhood. Multilevel, longitudinal, and genetically sensitive analyses investigated the association between perceptions of neighborhood disorder and adolescent psychotic experiences. Adolescents who perceived higher levels of neighborhood disorder were significantly more likely to have psychotic experiences, even after accounting for objectively/independently measured levels of crime and disorder, neighborhood- and family-level socioeconomic status, family psychiatric history, adolescent substance and mood problems, and childhood psychotic symptoms: odds ratio = 1.62, 95% confidence interval [1.27, 2.05], p < .001. The phenotypic overlap between adolescent psychotic experiences and perceptions of neighborhood disorder was explained by overlapping common environmental influences, rC = .88, 95% confidence interval [0.26, 1.00]. Findings suggest that early psychological interventions to prevent adolescent psychotic experiences should explore the role of young people's (potentially modifiable) perceptions of threatening neighborhood conditions.

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We are grateful to the study mothers and fathers, the twins, and the twins’ teachers for their participation. Our thanks to members of the E-Risk team for their dedication, hard work, and insights, and to CACI Inc. for use of their consumer lifestyle databases. We also thank Emma Hedman for geocoding assistance. The Environmental Risk (E-Risk) Longitudinal Twin Study is funded by the Medical Research Council (G1002190). Additional support was provided by National Institute of Child Health and Human Development (HD077482); the British Academy (SQ140024); and the Jacobs Foundation. Support was also provided through Multidisciplinary Studentships from the Economic and Social Research Council (ESRC; to J.B.N. and J.R.B.); a Mental Health Leadership Fellowship for the UK ESRC (to L.A.); MQ Fellows Award MQ14F40 (to H.L.F.); and a Jacobs Foundation and Canadian Institute for Advanced Research Fellowship (to C.L.O.). The last two authors are joint senior authors.


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