Violence exposure, psychotic experiences, and social disconnection in an urban community sample

Background: Psychotic experiences (PEs) occur in the general population, serving as indicators of vulnerability to psychotic disorders and other mental and physical concerns. Environmental stressors, including violence exposure and social disconnection are associated with PEs, although the exact nature of these relations is unknown. Methods: Data were drawn from an online community sample of 1,000 adults (476 male) residing in Baltimore or New York City. Binary logistic regression and mediation analyses were used to examine associations between PEs, violence exposure (adverse childhood experiences; intimate partner violence), and social disconnectedness (personal; neighborhood). Results: Personal social disconnectedness was significantly associated with delusional mood (p <.001). Neighborhood social disconnectedness was significantly associated with delusional mood (p <.01), delusions of reference and persecution (p <.001), delusions of control (p <.01), and hallucinations (p <.01). Both subtypes of violence exposure were found to have significant direct effects on PEs (p <.001). Personal social disconnectedness accounted for 6.72-7.87% of the total effect of violence exposure on PEs, whereas neighborhood social disconnectedness was found to account for 5.14-6.74% of the total effect. Discussion: The results advance understandings of prominent environmental risks for psychosis, and offer new implications for public health consideration of psychosis.