Clinical and psychosocial outcomes of Black Americans in the Recovery After an Initial Schizophrenia Episode Early Treatment Program (RAISE-ETP) study

Nagendra, Arundati; Weiss, David M.; Merritt, Carrington; Cather, Corinne; Sosoo, Effua E.; Mueser, Kim T.; Penn, David L.

doi:10.1007/s00127-022-02297-9

Cited by 8 publications

(3 citation statements)

References 82 publications

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“…Specifically, White participants were more likely to have informants that were parents or romantic partners, while Black participants had a greater variety of informants that included parents, but also staff and service providers from community care settings, who may have different perceptions of functioning relative to close family members 1 . The finding of trend-level racial differences on the participant-rated SLOF also aligns with findings from a recent study in which Black individuals with psychotic disorders self-reported less stigma and greater recovery relative to White individuals (Nagendra et al, 2022). However, this finding was only trending toward statistical significance, thus we make these interpretations cautiously.…”

Section: Discussionsupporting

confidence: 87%

Racial disparities and predictors of functioning in schizophrenia.

Merritt¹,

Halverson²,

Elliott³

et al. 2023

American Journal of Orthopsychiatry

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Black Americans are diagnosed with schizophrenia spectrum disorders at more than twice the rate of White individuals and experience significantly worse outcomes following diagnosis. Little research has examined specific factors that may contribute to worse functional outcomes among Black Americans diagnosed with schizophrenia. One approach to understanding why racial disparities emerge is to examine established predictors of functioning in this population: neurocognition, social cognition, and symptom severity. The present study aims to broaden existing literature on racial differences within these domains by (a) examining racial differences in functioning and these established predictors of functioning (i.e., neurocognition, social, and symptom severity) and (b) investigating whether cognition and symptom domains similarly predict functioning between Black and White Americans with schizophrenia. Sixty-six participants' baseline neurocognition, social cognition, symptom severity, and functioning were assessed. Black participants demonstrated lower neurocognition scores and higher levels of disorganized symptoms relative to White participants. No racial differences in functioning or social cognition were observed. Further, race did not moderate the relationship between any of these established predictors and functioning outcomes. The largely nonsignificant differences in known predictors of functioning highlight the need to explore further domains that may be more relevant for understanding racial disparities in schizophrenia. Considering that psychosocial treatments for schizophrenia spectrum disorders often focus on cognition, these results underscore the importance of identifying whether these domains or other treatment targets may be better in addressing racial disparities in functioning. Possible areas of exploration for future

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Section: Discussionsupporting

confidence: 87%

Racial disparities and predictors of functioning in schizophrenia.

Merritt¹,

Halverson²,

Elliott³

et al. 2023

American Journal of Orthopsychiatry

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“…Our study participants’ involvement in OnTrackNY, could have served a protective role, since it is a person centered, recovery oriented coordinated specialty care program for individuals with FEP. Findings from the Recovery After an Initial Schizophrenia Episode Early Treatment Program (RAISE-ETP) study found that Black participants in coordinated specialty care (NAVIGATE), a sample from a different recovery oriented program, reported reduced stigma, while participants in community care reported increased stigma ( 36 ).…”

Section: Discussionmentioning

confidence: 99%

Using focus groups to inform a brief video intervention to reduce public stigma toward Black youth living with psychosis

Jankowski,

Pope,

Smith

et al. 2023

Front. Psychiatry

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ObjectiveBlack individuals living with psychosis are at risk for stigma and marginalization due to systematic discrimination and barriers to receiving treatment. Social contact-based interventions have the potential to reduce stigma; however, interventions with elements specific to the experiences of Black youth are limited. Therefore, we aimed to gather input from Black youth living with psychosis to develop a social contact-based, brief video intervention to reduce public stigma toward Black youth with psychosis.MethodsTwo 90-min focus groups were conducted with seven young Black individuals ages 18–30 with First Episode Psychosis from OnTrackNY. Participants were asked about their experiences of stigma and racial discrimination, and their perspectives on a video intervention. Focus group transcripts were analyzed using thematic content analysis.ResultsThemes that emerged included: the salience of stigma and racial experiences for some participants and not others; the linking of religiosity and symptoms in Black communities; the importance of taking responsibility for recovery as a coping strategy to counteract stigma; and mixed views on creating a video intervention specific to Black youth.ConclusionMeaningful and empowering involvement of individuals with lived experience of psychosis is essential to create stigma reducing interventions. Input from Black youth living with psychosis assisted in developing a culturally tailored brief video-based intervention to reduce public stigma toward Black youth with psychosis that included information about the protagonist’s experience of race and mental illness, specifically family, religious, and community-based experiences.

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“…Some studies based on earlier FEP cohorts found ethnoracial group differences in trajectories of recovery, with minoritized groups more likely to demonstrate poorer functional outcome trajectories and symptom improvement over time (Hall et al 2019). A more recent study based on RAISE-ETP data suggested similar treatment outcomes between Black and White individuals receiving NAVIGATE (Nagendra et al 2023), but among those receiving regular community care, Black individuals had less psychotic symptom improvement and were less likely to be receiving individual treatment than White individuals (Oluwoye et al 2018). There were also several psychosocial baseline differences between Black and White participants in the RAISE-ETP study including lower quality of life, neurocognitive measures, and access to private insurance and greater residential stability among Black respondents (Nagendra et al 2018).…”

Section: Ethnoracial Disparities In Mental Health Treatmentmentioning

confidence: 99%

Racism and Social Determinants of Psychosis

Anglin

2023

Annu. Rev. Clin. Psychol.

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The Centers for Disease Control and Prevention has identified racism as a serious threat to public health. Structural racism is a fundamental cause of inequity within interconnected institutions and the social environments in which we live and develop. This review illustrates how these ethnoracial inequities impact risk for the extended psychosis phenotype. Black and Latinx populations are more likely than White populations to report psychotic experiences in the United States due to social determining factors such as racial discrimination, food insecurity, and police violence. Unless we dismantle these discriminatory structures, the chronic stress and biological consequences of this race-based stress and trauma will impact the next generation's risk for psychosis directly, and indirectly through Black and Latina pregnant mothers. Multidisciplinary early psychosis interventions show promise in improving prognosis, but coordinated care and other treatments still need to be more accessible and address the racism-specific adversities many Black and Latinx people face in their neighborhoods and social environments. Expected final online publication date for the Annual Review of Clinical Psychology, Volume 19 is May 2023. Please see http://www.annualreviews.org/page/journal/pubdates for revised estimates.

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Clinical and psychosocial outcomes of Black Americans in the Recovery After an Initial Schizophrenia Episode Early Treatment Program (RAISE-ETP) study

Cited by 8 publications

References 82 publications

Racial disparities and predictors of functioning in schizophrenia.

Racial disparities and predictors of functioning in schizophrenia.

Using focus groups to inform a brief video intervention to reduce public stigma toward Black youth living with psychosis

Racism and Social Determinants of Psychosis

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