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Associations Between Area Deprivation and Paranoia in Serious Mental Illness.

Λεπτομέρειες βιβλιογραφικής εγγραφής
Τίτλος: Associations Between Area Deprivation and Paranoia in Serious Mental Illness.
Συγγραφείς: Berretta SA; School of Behavioral and Brain Sciences, The University of Texas at Dallas, Richardson, TX 75080, United States., Ackerman RA; School of Behavioral and Brain Sciences, The University of Texas at Dallas, Richardson, TX 75080, United States., Moore RC; Department of Psychiatry, University of California San Diego, La Jolla, CA 92093, United States., Depp CA; Department of Psychiatry, University of California San Diego, La Jolla, CA 92093, United States., Harvey PD; Department of Psychiatry, Miller School of Medicine, University of Miami, Miami, FL 33136, United States.; Research Service, Bruce W. Carter Miami VA Medical Center, Miami, FL 33125, United States., Nagendra A; Schizophrenia & Psychosis Action Alliance (S&PAA), Alexandria, VA, United States., Pinkham AE; School of Behavioral and Brain Sciences, The University of Texas at Dallas, Richardson, TX 75080, United States.
Πηγή: Schizophrenia bulletin [Schizophr Bull] 2026 Aug 20; Vol. 52 (5).
Τύπος έκδοσης: Journal Article
Γλώσσα: English
Στοιχεία περιοδικού: Publisher: Oxford University Press Country of Publication: United States NLM ID: 0236760 Publication Model: Print Cited Medium: Internet ISSN: 1745-1701 (Electronic) Linking ISSN: 05867614 NLM ISO Abbreviation: Schizophr Bull Subsets: MEDLINE
Imprint Name(s): Publication: 2005- : Cary, NC : Oxford University Press
Original Publication: [Chevy Chase, Md., For sale by the Supt. of Docs., U. S. Govt. Print. Off. Washington]
Ιατρικοί όροι (MeSH): Paranoid Disorders*/epidemiology , Paranoid Disorders*/etiology , Bipolar Disorder*/epidemiology , Schizophrenia*/epidemiology , Psychotic Disorders*/epidemiology , Hallucinations*/epidemiology , Hallucinations*/etiology , Neighborhood Characteristics*/statistics & numerical data , Residence Characteristics*/statistics & numerical data, United States/epidemiology ; Humans ; Female ; Adult ; Male ; Middle Aged ; Ecological Momentary Assessment ; Socioeconomic Disparities in Health ; Young Adult
Περίληψη: Background and Hypothesis: Though linked to paranoia in the general population and high-risk groups, neighborhood deprivation remains underexplored in serious mental illness. Paranoia also varies by demographic subgroup, potentially reflecting exposure to place-based disadvantage. Advances in the measurement of neighborhood deprivation and momentary experiences of suspiciousness could shed light on these relationships. This study uses neighborhood-level data to examine associations between area deprivation and paranoia in schizophrenia spectrum disorders (SSDs) and bipolar disorder (BD).
Study Design: Data from 293 participants with SSD (n = 148) and BD (n = 145) from three US sites were analyzed. Neighborhood disadvantage was quantified using the National Area Deprivation Index (ADI). Clinician-rated paranoia was assessed using the Positive and Negative Syndrome Scale; momentary feelings of threat/suspiciousness (MFTS) was measured across 30 days of Ecological Momentary Assessments (EMAs). Analyses examined the relationships between ADI and paranoia and tested if ADI explains observed demographic differences in paranoia. To assess specificity, hallucinations were examined in parallel.
Study Results: Greater neighborhood disadvantage was associated with higher clinician-rated paranoia and MFTS; no association was observed for hallucinations. Participants with SSD and those with racial backgrounds other than White had higher ADI scores and higher paranoia. The ADI-paranoia relationship did not differ in strength across clinical or demographic groups, nor across study sites. Area Deprivation Index significantly mediated the association between racial background and paranoia.
Conclusions: Neighborhood deprivation is associated with paranoia but not hallucinations, supporting a specific link between environment and paranoia. Improvement of neighborhood-level conditions may offer a pathway to reducing paranoia and improving functioning.
(© The Author(s) 2025. Published by Oxford University Press on behalf of the Maryland Psychiatric Research Center. All rights reserved. For commercial re-use, please contact reprints@oup.com for reprints and translation rights for reprints. All other permissions can be obtained through our RightsLink service via the Permissions link on the article page on our site—for further information please contact journals.permissions@oup.com.)
Grant Information: R01 MH112620 United States MH NIMH NIH HHS; R01 MH116902 United States MH NIMH NIH HHS; C2941 NIMH RDoC repository; R01MH112620 National Institute of Mental Health at the National Institutes of Health
Contributed Indexing: Keywords: deprivation; environment; paranoia; psychosis; suspiciousness; symptoms
Entry Date(s): Date Created: 20251030 Date Completed: 20261008 Latest Revision: 20261010
Update Code: 20261010
PubMed Central ID: PMC13645824
DOI: 10.1093/schbul/sbaf193
PMID: 41165228
Βάση Δεδομένων: MEDLINE
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  Data: Associations Between Area Deprivation and Paranoia in Serious Mental Illness.
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  Data: <searchLink fieldCode="AU" term="%22Berretta+SA%22">Berretta SA</searchLink>; School of Behavioral and Brain Sciences, The University of Texas at Dallas, Richardson, TX 75080, United States.<br /><searchLink fieldCode="AU" term="%22Ackerman+RA%22">Ackerman RA</searchLink>; School of Behavioral and Brain Sciences, The University of Texas at Dallas, Richardson, TX 75080, United States.<br /><searchLink fieldCode="AU" term="%22Moore+RC%22">Moore RC</searchLink>; Department of Psychiatry, University of California San Diego, La Jolla, CA 92093, United States.<br /><searchLink fieldCode="AU" term="%22Depp+CA%22">Depp CA</searchLink>; Department of Psychiatry, University of California San Diego, La Jolla, CA 92093, United States.<br /><searchLink fieldCode="AU" term="%22Harvey+PD%22">Harvey PD</searchLink>; Department of Psychiatry, Miller School of Medicine, University of Miami, Miami, FL 33136, United States.; Research Service, Bruce W. Carter Miami VA Medical Center, Miami, FL 33125, United States.<br /><searchLink fieldCode="AU" term="%22Nagendra+A%22">Nagendra A</searchLink>; Schizophrenia & Psychosis Action Alliance (S&PAA), Alexandria, VA, United States.<br /><searchLink fieldCode="AU" term="%22Pinkham+AE%22">Pinkham AE</searchLink>; School of Behavioral and Brain Sciences, The University of Texas at Dallas, Richardson, TX 75080, United States.
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  Data: <searchLink fieldCode="JN" term="%220236760%22">Schizophrenia bulletin</searchLink> [Schizophr Bull] 2026 Aug 20; Vol. 52 (5).
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  Data: <i>Publisher: </i><searchLink fieldCode="PB" term="%22Oxford+University+Press%22">Oxford University Press </searchLink><i>Country of Publication: </i>United States <i>NLM ID: </i>0236760 <i>Publication Model: </i>Print <i>Cited Medium: </i>Internet <i>ISSN: </i>1745-1701 (Electronic) <i>Linking ISSN: </i><searchLink fieldCode="IS" term="%2205867614%22">05867614 </searchLink><i>NLM ISO Abbreviation: </i>Schizophr Bull <i>Subsets: </i>MEDLINE
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  Data: <i>Publication</i>: 2005- : Cary, NC : Oxford University Press<br /><i>Original Publication</i>: [Chevy Chase, Md., For sale by the Supt. of Docs., U. S. Govt. Print. Off. Washington]
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  Data: <searchLink fieldCode="MM" term="%22Paranoid+Disorders%22">Paranoid Disorders*</searchLink>/<searchLink fieldCode="MM" term="%22Paranoid+Disorders+epidemiology%22">epidemiology</searchLink> <br /><searchLink fieldCode="MM" term="%22Paranoid+Disorders%22">Paranoid Disorders*</searchLink>/<searchLink fieldCode="MM" term="%22Paranoid+Disorders+etiology%22">etiology</searchLink> <br /><searchLink fieldCode="MM" term="%22Bipolar+Disorder%22">Bipolar Disorder*</searchLink>/<searchLink fieldCode="MM" term="%22Bipolar+Disorder+epidemiology%22">epidemiology</searchLink> <br /><searchLink fieldCode="MM" term="%22Schizophrenia%22">Schizophrenia*</searchLink>/<searchLink fieldCode="MM" term="%22Schizophrenia+epidemiology%22">epidemiology</searchLink> <br /><searchLink fieldCode="MM" term="%22Psychotic+Disorders%22">Psychotic Disorders*</searchLink>/<searchLink fieldCode="MM" term="%22Psychotic+Disorders+epidemiology%22">epidemiology</searchLink> <br /><searchLink fieldCode="MM" term="%22Hallucinations%22">Hallucinations*</searchLink>/<searchLink fieldCode="MM" term="%22Hallucinations+epidemiology%22">epidemiology</searchLink> <br /><searchLink fieldCode="MM" term="%22Hallucinations%22">Hallucinations*</searchLink>/<searchLink fieldCode="MM" term="%22Hallucinations+etiology%22">etiology</searchLink> <br /><searchLink fieldCode="MM" term="%22Neighborhood+Characteristics%22">Neighborhood Characteristics*</searchLink>/<searchLink fieldCode="MM" term="%22Neighborhood+Characteristics+statistics+%26+numerical+data%22">statistics & numerical data</searchLink> <br /><searchLink fieldCode="MM" term="%22Residence+Characteristics%22">Residence Characteristics*</searchLink>/<searchLink fieldCode="MM" term="%22Residence+Characteristics+statistics+%26+numerical+data%22">statistics & numerical data</searchLink><br /><searchLink fieldCode="MH" term="%22United+States%22">United States</searchLink>/<searchLink fieldCode="MH" term="%22United+States+epidemiology%22">epidemiology</searchLink> ; <searchLink fieldCode="MH" term="%22Humans%22">Humans</searchLink> ; <searchLink fieldCode="MH" term="%22Female%22">Female</searchLink> ; <searchLink fieldCode="MH" term="%22Adult%22">Adult</searchLink> ; <searchLink fieldCode="MH" term="%22Male%22">Male</searchLink> ; <searchLink fieldCode="MH" term="%22Middle+Aged%22">Middle Aged</searchLink> ; <searchLink fieldCode="MH" term="%22Ecological+Momentary+Assessment%22">Ecological Momentary Assessment</searchLink> ; <searchLink fieldCode="MH" term="%22Socioeconomic+Disparities+in+Health%22">Socioeconomic Disparities in Health</searchLink> ; <searchLink fieldCode="MH" term="%22Young+Adult%22">Young Adult</searchLink>
– Name: Abstract
  Label: Abstract
  Group: Ab
  Data: Background and Hypothesis: Though linked to paranoia in the general population and high-risk groups, neighborhood deprivation remains underexplored in serious mental illness. Paranoia also varies by demographic subgroup, potentially reflecting exposure to place-based disadvantage. Advances in the measurement of neighborhood deprivation and momentary experiences of suspiciousness could shed light on these relationships. This study uses neighborhood-level data to examine associations between area deprivation and paranoia in schizophrenia spectrum disorders (SSDs) and bipolar disorder (BD).<br />Study Design: Data from 293 participants with SSD (n = 148) and BD (n = 145) from three US sites were analyzed. Neighborhood disadvantage was quantified using the National Area Deprivation Index (ADI). Clinician-rated paranoia was assessed using the Positive and Negative Syndrome Scale; momentary feelings of threat/suspiciousness (MFTS) was measured across 30 days of Ecological Momentary Assessments (EMAs). Analyses examined the relationships between ADI and paranoia and tested if ADI explains observed demographic differences in paranoia. To assess specificity, hallucinations were examined in parallel.<br />Study Results: Greater neighborhood disadvantage was associated with higher clinician-rated paranoia and MFTS; no association was observed for hallucinations. Participants with SSD and those with racial backgrounds other than White had higher ADI scores and higher paranoia. The ADI-paranoia relationship did not differ in strength across clinical or demographic groups, nor across study sites. Area Deprivation Index significantly mediated the association between racial background and paranoia.<br />Conclusions: Neighborhood deprivation is associated with paranoia but not hallucinations, supporting a specific link between environment and paranoia. Improvement of neighborhood-level conditions may offer a pathway to reducing paranoia and improving functioning.<br /> (© The Author(s) 2025. Published by Oxford University Press on behalf of the Maryland Psychiatric Research Center. All rights reserved. For commercial re-use, please contact reprints@oup.com for reprints and translation rights for reprints. All other permissions can be obtained through our RightsLink service via the Permissions link on the article page on our site—for further information please contact journals.permissions@oup.com.)
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  Data: R01 MH112620 United States MH NIMH NIH HHS; R01 MH116902 United States MH NIMH NIH HHS; C2941 NIMH RDoC repository; R01MH112620 National Institute of Mental Health at the National Institutes of Health
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