Racial Differences in Psychotic-like Experiences: A Study of Schizotypy in African Americans and Caucasians

Abstract

A considerable literature has long indicated that African Americans consistently receive more clinical diagnoses of psychosis than their Caucasian counterparts although higher rates of schizophrenia in African Americans have not been reliably documented. Prior studies are limited in that while many have found elevations in psychotic symptoms and schizophrenia diagnoses in African Americans patients, it is unclear whether these race differences indicate true rates of psychosis or whether other mechanisms such as lowered medication compliance and limited access to treatment might be complicating these findings. Further, comparisons between racial groups in studies of psychosis-proneness have focused primarily on mean group differences in overall psychotic symptoms. While helpful in establishing the existence of symptom differences in racial groups, these finding do not provide more qualitative information regarding the specific nature of these differences. It can therefore be suggested that a comprehensive understanding of the role of race in schizophrenia remains elusive. The goal of the current study was to extend the available research on race differences in the experience of psychotic-like experiences by addressing the following hypotheses in a sample of putative schizotypes (social anhedonics): 1) Social anhedonics will report more psychotic-like symptoms and experiences than controls, regardless of race, 2) Psychotic-like experiences will be more prevalent in socially anhedonic African Americans compared to socially anhedonic Caucasians, and 3) socially anhedonic African Americans will report more psychotic-like experiences with religious and paranoid themes than socially anhedonic Caucasians. Possible reasons for differential symptom expression will be explored, followed by assessment and treatment implications. Finally, suggestions for future directions of study will be discussed.