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School Mobility and Prospective Pathways to Psychotic-like Symptoms in Early Adolescence: A Prospective Birth Cohort Study

https://doi.org/10.1016/j.jaac.2014.01.016Get rights and content
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Objective

Social adversity and urban upbringing increase the risk of psychosis. We tested the hypothesis that these risks may be partly attributable to school mobility and examined the potential pathways linking school mobility to psychotic-like symptoms.

Method

A community sample of 6,448 mothers and their children born between 1991 and 1992 were assessed for psychosocial adversities (i.e., ethnicity, urbanicity, family adversity) from birth to 2 years, school and residential mobility up to 9 years, and peer difficulties (i.e., bullying involvement and friendship difficulties) at 10 years. Psychotic-like symptoms were assessed at age 12 years using the Psychosis-like Symptoms Interview (PLIKSi).

Results

In regression analyses, school mobility was significantly associated with definite psychotic-like symptoms (odds ratio [OR] =1.60; 95% CI =1.07–2.38) after controlling for all confounders. Within path analyses, school mobility (probit coefficient [β] = 0.108; p = .039), involvement in bullying (β = 0.241; p < .001), urbanicity (β = 0.342; p = .016), and family adversity (β = 0.034; p < .001) were all independently associated with definite psychotic-like symptoms. School mobility was indirectly associated with definite psychotic-like symptoms via involvement in bullying (β = 0.018; p = .034).

Conclusions

School mobility is associated with increased risk of psychotic-like symptoms, both directly and indirectly. The findings highlight the potential benefit of strategies to help mobile students to establish themselves within new school environments to reduce peer difficulties and to diminish the risk of psychotic-like symptoms. Awareness of mobile students as a possible high-risk population, and routine inquiry regarding school changes and bullying experiences, may be advisable in mental health care settings.

Key Words

ALSPAC
psychotic symptoms
bullying
social defeat
school mobility

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The UK Medical Research Council (grant ref. 74882), the Wellcome Trust (grant ref. 076467), and the University of Bristol provide core support for the Avon Longitudinal Study of Parents and Children (ALSPAC). Dr. Winsper receives funding from the West Midlands Strategic Health Authority and Research and Innovation Division and the Birmingham and Solihull Mental Health Foundation Trust. Dr. Singh receives funding from the National Institute for Health Research (NIHR) Collaborations for Leadership in Applied Health Research and Care West Midlands (CLAHRC-WM) initiative. The views expressed are those of the authors and not necessarily those of the CLAHRC-WM collaborative organisations, the NIHR, or the Department of Health.

The authors are extremely grateful to all of the families who took part in this study, the midwives for their help in recruiting them, and the whole ALSPAC team, which included interviewers, computer and laboratory technicians, clerical workers, research scientists, volunteers, managers, receptionists, and nurses. The authors give special thanks to Andrea Waylen, PhD, of the University of Bristol, and Jeremy Horwood, PhD, of the University of Bristol, who helped in the conduct of the study.

Disclosure: Drs. Singh, Winsper, Wolke, and Bryson report no biomedical financial interests or potential conflicts of interest.