Psychosis Risk & Resilience in Middle Eastern and North African (MENA) American Immigrants: A Test of the Social Defeat Theory
Rbeiz, Katrina Sofia
0000-0003-3312-9137
:
2023-07-10
Abstract
The social defeat theory (Selten et al., 2007) predicts psychosis-risk would be elevated in immigrants. The focus of this thesis is on comparing Middle Eastern and North African (MENA) populations by generational status, as well as comparing between MENA first-generation, second-generation immigrants (i.e., the “intruder”), and white non-immigrant populations (i.e., the “resident”) in the framework of the social defeat theory. To examine mental health and psychosis-risk between MENA and white populations, and within each MENA generational immigrant status group, participants completed risk (trauma and PTSD via BTQ, adverse childhood experiences via ACE, loneliness via UCLA, social defeat via SD, daily and lifetime discrimination via PDS), resilience (innate resilience via BRS, benevolent childhood experiences via BCE, sense of belonging via CSBS, ethnic identity via MEIM-R), mental health (psychosis-risk and psychosis-risk distress via PQ-16, depression/stress/anxiety via DASS-21), and demographic questionnaires. To enrich and complement the quantitative data, we also collected narratives from the participants to document their experiences of belonging, discrimination, and other facets of life challenges. MENA immigrants overall did not show increased risk for psychosis nor increased rates of depression, anxiety and stress compared with the white non-immigrant group. We observed a positive relationship between social defeat and psychosis-risk within the MENA group. MENA participants who were designated to the high-risk for psychosis group reported more social defeat experiences than the low-risk MENA participants. Within the MENA group, second-generation participants fared worse than the first-generation. We found that the MENA immigrants, especially the first generation, appeared to be remarkably resilient despite adverse experiences of immigration. Among the MENA population, the number of years spent in the U.S. was associated with increased experience of social defeat. This on-going study of mental health in the MENA population suggests that the relationship between social defeat and mental health variables is complex and that a more nuanced examination of social defeat and resilience is necessary to understand social determinants of mental health in MENA immigrant populations.