February 21, 2019

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Girls get by with help from their friends

By Dr Eloise Crush


Can early intervention that fosters social support protect victimised young women from psychosis? We asked Dr. Eloise Crush to describe the latest study results published from data from the Environmental Risk (E-Risk) Longitudinal Twin Study in the United Kingdom.


Psychotic experiences (hearing voices, having visions, and feeling paranoid) are surprisingly common among adolescents, with around 1 in 20 young people reporting them. These experiences can not only be extremely distressing but have been shown to increase the likelihood of developing severe mental ill-health, including psychotic disorders such as schizophrenia or attempting suicide, in adolescence and adulthood. Therefore, it is important we find ways to prevent psychotic experiences from emerging during this key developmental phase.

Victimisation – such as sexual and physical abuse, and bullying – is a major risk factor for developing psychotic experiences. Several studies have found that experiencing multiple types of victimisation (commonly called ‘poly-victimisation’) has an even greater risk of developing psychotic experiences. Therefore, poly-victimised adolescents are an important group to target for intervention efforts. However, a large proportion of poly-victimised adolescents do not report psychotic experiences. Through studying what protects these individuals we can begin to develop interventions to prevent other vulnerable young people from having psychotic experiences and mental ill-health in adulthood.

We used data from a sample of more than 2000 British-born children from the Environmental Risk (E-Risk) Longitudinal Twin Study, who have been followed across childhood and adolescence. Participants completed assessments of victimisation exposure, psychotic experiences, and a range of potential protective factors when they were 18 years old. We found that poly-victimised adolescents who perceived that they had more social support from friends and families were less likely to develop psychotic experiences than those who perceived themselves to have lower levels of social support. This could be because perceived social support may buffer the effects of stress, improve self-esteem, and reduce feelings of loneliness, all of which have been implicated in the development of psychotic phenomena.

When we investigated these findings further, we found that perceptions of social support from both friends and family was particularly protective for adolescent girls. We also discovered that while social support from family showed some protective influences among boys, the effects were much weaker. This gender difference is consistent with a previous clinical study  that found social support buffered against psychotic disorders specifically among women (but not men) exposed to physical abuse in childhood.

Adolescence is a critical period for mental health interventions because it constitutes the developmental phase prior to the emergence of more severe mental ill-health during early adulthood. This provides a window of opportunity for interventions, which, for practical and cost-related purposes, should be targeted at high-risk groups. Our findings suggest that interventions focused on adolescents exposed to multiple forms of victimisation might usefully involve improving their subjective perceptions of social support, and that these interventions may prove more effective for girls.

Further research is needed to replicate these findings in other cultural contexts, identify key protective factors for poly-victimised boys, and test the effectiveness of the subsequently developed interventions for psychotic experiences.


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