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Associations between childhood ethnoracial minority density, cortical thickness, and social engagement among minority youth at clinical high-risk for psychosis

Neuropsychopharmacology volume 48, pages 1707–1715 (2023)Cite this article

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Abstract

An ethnoracial minority density (EMD) effect in studies of psychotic spectrum disorders has been observed, whereby the risk of psychosis in ethnoracial minority group individuals is inversely related to the proportion of minorities in their area of residence. The authors investigated the relationships among area-level EMD during childhood, cortical thickness (CT), and social engagement (SE) in clinical high risk for psychosis (CHR-P) youth. Data were collected as part of the North American Prodrome Longitudinal Study. Participants included 244 ethnoracial minoritized (predominantly Hispanic, Asian and Black) CHR-P youth and ethnoracial minoritized healthy controls. Among youth at CHR-P (n = 164), lower levels of EMD during childhood were associated with reduced CT in the right fusiform gyrus (adjusted β = 0.54; 95% CI 0.17 to 0.91) and right insula (adjusted β = 0.40; 95% CI 0.05 to 0.74). The associations between EMD and CT were significantly moderated by SE: among youth with lower SE (SE at or below the median, n = 122), lower levels of EMD were significantly associated with reduced right fusiform gyrus CT (adjusted β = 0.72; 95% CI 0.29 to 1.14) and reduced right insula CT (adjusted β = 0.57; 95% CI 0.18 to 0.97). However, among those with greater SE (n = 42), the associations between EMD and right insula and fusiform gyrus CT were not significant. We found evidence that lower levels of ethnic density during childhood were associated with reduced cortical thickness in regional brain regions, but this association may be buffered by greater levels of social engagement.

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Fig. 1: Associations between childhood EMD and cortical thickness of ROIs selected a priori from The Stimulation Discrepancy Deprivation Model (n = 244).
Fig. 2

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Funding

This work was supported in part by the National Institute of Mental Health (NIMH) grants U01 MH081902 to TDC, P50 MH066286 to CEB, U01 MH081857 to BAC, U01 MH82022 to SWW, U01 MH066134 to JA, U01 MH081944 to KSC, R01 U01 MH066069 to DOP, R01 MH076989 to DHM, U01 MH081988 to EFW, and K23 MH129684 to BSK.

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Authors and Affiliations

  1. Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA, USA

    Benson S. Ku

  2. Department of Psychology, Yale University, New Haven, CT, USA

    Meghan Collins & Tyrone D. Cannon

  3. Department of Psychology, The City College of New York, City University of New York, New York, NY, USA

    Deidre M. Anglin & Kristin S. Cadenhead

  4. The Graduate Center, City University of New York, New York, NY, USA

    Deidre M. Anglin

  5. Department of Psychiatry, University of California, San Diego, CA, USA

    Anthony M. Diomino & Ming T. Tsuang

  6. Department of Psychiatry, University of Calgary, Calgary, AB, Canada

    Jean Addington & Scott W. Woods

  7. Departments of Psychiatry and Biobehavioral Sciences and Psychology, Semel Institute for Neuroscience and Human Behavior, UCLA, Los Angeles, CA, USA

    Carrie E. Bearden

  8. Department of Psychiatry, Yale University, New Haven, CT, USA

    Tyrone D. Cannon

  9. Division of Psychiatry Research, The Zucker Hillside Hospital, Northwell Health, Glen Oaks, NY, USA

    Barbara A. Cornblatt

  10. Department of Psychiatry, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY, USA

    Barbara A. Cornblatt

  11. Department of Health Policy and Management, Rollins School of Public Health, Emory University, Atlanta, GA, USA

    Benjamin G. Druss

  12. Harvard Medical School, Departments of Psychiatry at Massachusetts Mental Health Center Public Psychiatry Division, Beth Israel Deaconess Medical Center, and Massachusetts General Hospital, Boston, MA, USA

    Matcheri Keshavan & William S. Stone

  13. Department of Psychiatry, University of California, and San Francisco Veterans Affairs Medical Center, San Francisco, CA, USA

    Daniel H. Mathalon

  14. Department of Psychiatry, University of North Carolina, Chapel Hill, NC, USA

    Diana O. Perkins

  15. Department of Psychology, Emory University, Atlanta, GA, USA

    Elaine F. Walker

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The authors confirm contribution to the paper as follows: study conception and design: BK, JA, CB, KC, TC, BC, BD, MK, DM, DP, WS, MT, SW, EW; data collection: BK, JA, CB, KC, TC, BC, MK, DM, DP, WS, MT, SW, EW; analysis and interpretation of results: BK, MC, DA, AD; draft manuscript preparation: BK, MC, DA, AD, BD, EW; or revise critically for important intellectual content: JA, CB, KC, TC, BC, MK, DM, DP, WS, MT, SW. All authors reviewed the results, approved the final version of the manuscript, and agree to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.

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Correspondence to Benson S. Ku.

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Competing interests

TDC has served as a consultant for Boehringer-Ingelheim Pharmaceuticals and Lundbeck A/S. DHM has served as a consultant for Aptinyx, Boehringer-Ingelheim Pharmaceuticals, Cadent Therapeutics, and Greenwich Biosciences. DOP has served as a consultant for Sunovion and Alkermes, has received research support from Boehringer-Ingelheim, and has received royalties from American Psychiatric Association Publishing. SWW has received investigator-initiated research support from Pfizer and sponsor-initiated research support from Auspex and Teva; he has served as a consultant for Biomedisyn (unpaid), Boehringer-Ingelheim, and Merck and as an unpaid consultant to DSM-5; he has been granted a patent for a method of treating prodromal schizophrenia with glycine; and he has received royalties from Oxford University Press. The other authors report no financial relationships with commercial interests.

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Ku, B.S., Collins, M., Anglin, D.M. et al. Associations between childhood ethnoracial minority density, cortical thickness, and social engagement among minority youth at clinical high-risk for psychosis. Neuropsychopharmacol. 48, 1707–1715 (2023). https://doi.org/10.1038/s41386-023-01649-6

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