Disparities in Psychosis Risk Symptoms for New Zealand Maori May Be Explained by Systemic Stressors and Inappropriate Conceptualization of Culturally Normative Experiences

Background and Hypothesis Maori, the indigenous peoples of New Zealand, experience increased rates of psychotic disorders and first-episode psychosis. However, it is unclear whether they also present with increased psychosis risk symptoms, such as subclinical psychotic-like experiences (PLEs). Measurement of risk symptoms is key for early intervention. Further, it is unclear if systemic factors such as the increased rates of social adversity and discrimination or cultural biases contribute to this disparity in psychosis rates. Study Design This study surveyed 466 18- to 30-year olds in New Zealand, and compared Maori to non-Maori participant responses on the Prodromal Questionnaire Brief, alongside the history of childhood trauma, discrimination, and financial adversity. Study Results Maori reported a higher number of PLEs compared to non-Maori-however, this was not associated with increased distress related to these experiences. The increased number of psychosis-like experiences reported by Maori was likely explained by systemic factors such as childhood trauma, discrimination, and financial stress. Maori were more likely to report that the PLEs were positive. Conclusions Measurement of psychosis risk for Maori is nuanced, and increased scores on these tools may reflect pathologizing potentially normative experiences for Maori, such as spiritual encounters or discrimination, alongside the impact of increased rates of systemic discrimination, trauma, and financial stress.

Automated summary

Maori, the indigenous peoples of New Zealand, have higher rates of psychotic disorders. It is unclear if they also have increased risk symptoms of psychosis. This study surveyed 466 young adults in New Zealand and found that Maori reported more subclinical psychotic-like experiences, which may be influenced by systemic factors such as childhood trauma, discrimination, and financial stress.