Psychotic experiences and disability: Findings from the Collaborative Psychiatric Epidemiology Surveys | Schizophrenia Research
Hans Oh, Ai Koyanagi, Ian Kelleher, Jordan DeVylder
2017 Psychotic experiences are associated with a number of poor clinical outcomes, including multimorbid psychopathology, suicidal behavior, and poor treatment response. We wished to investigate the relationship between psychotic experiences and disability, including the following domains: cognition, mobility, self-care, social interaction, role functioning, and days out of role. We used three nationally representative and racially/ethnically diverse samples of the general US adult population: the National Comorbidity Survey Replication (NCS-R), the National Latino and Asian American Survey (NLAAS), and the National Survey of American Life (NSAL). Multi-variable logistic regression analyses were used to assess the associations between lifetime psychotic experiences (visual and auditory hallucinatory experiences and delusional ideation; WHO Composite International Diagnostic Interview psychosis screen) and 30-day impairments in functioning across disability domains (using the WHO Disability Assessment Schedule II). In all three samples, models were adjusted for socio-demographics and co-occurring psychiatric disorders. In the NCS-R, models were also adjusted for chronic health conditions. Across all three studies, our adjusted models showed that people with disability had anywhere from about 1.5 to over 3 times the odds of reporting lifetime psychotic experiences, depending on the domain. This was true for each disability domain, except self-care in the NLAAS and in the NSAL. Psychotic experiences are markers of risk for disability across a wide range of domains. This may explain the elevated rates of service utilization among individuals who report psychotic experiences and supports the need to assess for and respond to psychotic experiences even in the absence of psychotic disorder.
Effect of Police Training and Accountability on the Mental Health of African American Adults | American Journal of Public Health
Hans Oh, Jordan DeVylder, Geoffrey Hunt
2017 Seeing a police officer evokes different emotions for different people in the United States.
Psychotic Experiences in the Context of Police Victimization: Data From the Survey of Police–Public Encounters | Schizophrenia Bulletin
Jordan E DeVylder, Courtney Cogburn, Hans Y Oh, Deidre Anglin, Melissa Edmondson Smith, Tanya Sharpe, Hyun-Jin Jun, Jason Schiffman, Ellen Lukens, Bruce Link
2017 Social defeat has been proposed as the common mechanism underlying several well-replicated risk factors for sub-threshold psychotic experiences (PEs) identified in epidemiological research. Victimization by the police may likewise be socially defeating among vulnerable individuals and, therefore, may be associated with elevated risk for PEs. However, no prior studies have examined the relation between police victimization and PEs. We tested the hypothesis that exposure to police victimization (ie, physical, sexual, psychological, and neglect) would be associated with increased odds for PEs in the Survey of Police–Public Encounters data (N = 1615), a general population sample of adults from 4 US cities. Respondents who reported each type of police victimization were more likely to report PEs in logistic regression analyses (all P < .01), most of which were significant even when adjusting for demographic variables, psychological distress, and self-reported crime involvement (adjusted OR range: 1.30 to 7.16). Furthermore, the prevalence of PEs increased with greater exposure to police victimization in a linear dose-response relation, OR (95% CI) = 1.44 (1.24–1.66). These findings suggest that police victimization is a clinically important and previously unreported risk factor for PEs in the urban US population. These findings support the need for community-based outreach efforts and greater police training to reduce the prevalence of this exposure, particularly in socially disadvantaged urban communities.
Cannabis and psychotic experiences | Addiction
Hans Oh, Jordan Devylder
2017 Hamilton  outlined the past three decades of research connecting cannabis use to schizophrenia. We add to this narrative by mentioning the value of examining the relation between cannabis use and subthreshold regions of the psychosis continuum. Psychotic experiences are manifestations of psychosis that resemble frank hallucinations and delusions found in psychotic disorders, but are generally less intense, impairing or persistent . In the United States, psychotic experiences are 10 times as prevalent as schizophrenia , and these experiences are not merely prodromal signs of psychotic disorder. Some individuals who have them will develop schizophrenia, but most will not [4, 5]. Therefore, in recent years, researchers and clinicians have begun to grapple with what to make of these experiences. Studying cannabis use and psychotic experiences is useful, because it can help us make a stronger inference about causal direction. Hamilton points out that cannabis use can possibly be a form of self-medication to cope with prodromal symptoms of psychosis or the side effects of anti-psychotic medications. This is less of an issue when studying psychotic experiences, as they are often fleeting and do not necessarily cause significant distress or disruption in and of themselves; many people prove to be unfazed by psychotic experiences, depending on how the experiences are interpreted , and psychotic experiences typically do not warrant anti-psychotic medications.
Elevated Prevalence of Suicide Attempts among Victims of Police Violence in the USA | Journal of Urban Health
Jordan E DeVylder, Jodi J Frey, Courtney D Cogburn, Holly C Wilcox, Tanya L Sharpe, Hans Y Oh, Boyoung Nam, Bruce G Link
2017 Recent evidence suggests that police victimization is widespread in the USA and psychologically impactful. We hypothesized that civilian-reported police victimization, particularly assaultive victimization (i.e., physical/sexual), would be associated with a greater prevalence of suicide attempts and suicidal ideation. Data were drawn from the Survey of Police-Public Encounters, a population-based survey of adults (N = 1615) residing in four US cities. Surveys assessed lifetime exposure to police victimization based on the World Health Organization domains of violence (i.e., physical, sexual, psychological, and neglect), using the Police Practices Inventory. Logistic regression models tested for associations between police victimization and (1) past 12-month suicide attempts and (2) past 12-month suicidal ideation, adjusted for demographic factors (i.e., gender, sexual orientation, race/ethnicity, income), crime involvement, past intimate partner and sexual victimization exposure, and lifetime mental illness. Police victimization was associated with suicide attempts but not suicidal ideation in adjusted analyses. Specifically, odds of attempts were greatly increased for respondents reporting assaultive forms of victimization, including physical victimization (odds ratio = 4.5), physical victimization with a weapon (odds ratio = 10.7), and sexual victimization (odds ratio = 10.2). Assessing for police victimization and other violence exposures may be a useful component of suicide risk screening in urban US settings. Further, community-based efforts should be made to reduce the prevalence of exposure to police victimization.