Social-Spatial Residence Patterns and Adolescent Mental Health: Investigating the Influences of Residential Segregation, Neighborhood Social Cohesion, and Race on Persistent, Distressing Psychotic-Like Experiences in the United States Open Access
Wade, Kirsten (Spring 2024)
Abstract
Prior work has demonstrated that living in a neighborhood where people share similar identities may be protective against experiences of psychosis, but the meaning of this association in the context of racialized residential segregation is not well understood. I investigated if the effects of evenness and exposure residential segregation on persistent, distressing psychotic-like experiences (PLEs) in young adolescents are similar across racial groups and in areas of high versus low neighborhood social cohesion in urban areas in the United States. Data from the first three years of follow-up in the Adolescent Brain Cognitive Development (ABCD) Study were used. Evenness and exposure residential segregation at the metropolitan statistical area level were measured using the Dissimilarity Index (DI) and Exposure-Interaction Index (EII), respectively. Perceived neighborhood social cohesion was measured at the individual level using the Social Cohesion subscale of the Neighborhood Collective Efficacy protocol. Multi-level generalized estimating equations were used to estimate the relative risk of PLEs among those with different exposure to each domain of residential segregation. An exploratory mediation analysis investigated potential pathways through which the effect of processes of historical racism may influence risk of PLEs; a sensitivity analysis was used to understand sensitivity of the result to duration of the exposure. In a sample of 5871 adolescents, the prevalence of PLEs was 19.8%. Evenness and exposure segregation were both individually associated with risk of PLE (DI: aRR=1.11, 95% CI 1.06-1.17; EII: aRR=0.82, 95% CI 0.78-0.87). When both domains were present in the same model, the effect of evenness, but not exposure, was attenuated (DI: aRR=0.98, 95% CI 0.92-1.05; EII: aRR=0.81, 95% 0.75-0.88). The effect of segregation on PLE risk was not meaningfully or statistically significantly different for either levels of race (p-values ranged 0.08-0.86) or levels of neighborhood social cohesion (p-values ranged 0.16-0.56). The overall result was not meaningfully altered by duration of exposure to segregation. Lower exposure to residential segregation measured through the exposure domain may be protective against risk of PLEs in young adolescents living in urban areas. This relationship appeared similar in comparisons of Black-white racial groups and high-low neighborhood social cohesion groups.
Table of Contents
Table of Contents
Chapter 1: Introduction and Literature Review………………………………………………… 1
Chapter 2: Analysis and Results……………………………………………………...…………11
Introduction………………………………………………………………...…………….11
Methods…………………………………………………………………………..………14
Results……………………………………………………………………………………20
Discussion……………………………………………………………..…………………24
Chapter 3: Expanded Discussion………………………………………………………………..29
Chapter 4: Tables and Figures…………………………………………………………………..36
References……………………………………………………………………………………….51
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