Social Epidemiology and Historical Context

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Questions and Answers

What is one potential consequence of migration on mental health mentioned?

Increased resilience to mental illness

Higher likelihood of developing schizophrenia (correct)

Greater community support

Improved access to mental health resources

What bias might affect the outcome of studies on migration and schizophrenia?

Confirmation bias

Survivorship bias

Publication bias

Selection bias (correct)

Which demographic group is more likely to be at risk for psychosis among migrants?

Children and adolescents

Older women

Younger men (correct)

Elderly individuals

What factor may confound the relationship between migration and mental health?

Variations in migration reasons Signup and view all the answers

How might reverse causation be relevant in studies about migration and schizophrenia?

Pre-existing mental health issues could lead to migration. Signup and view all the answers

What is a significant threat to the robustness of findings in studies on mental health impacts due to migration?

Sample size inadequacy Signup and view all the answers

What question arises regarding the validity of the biomedical model in diagnosing mental health issues among migrants?

Is it universally applicable across all cultures? Signup and view all the answers

Which of the following is suggested as a factor for urban residents' potential predisposition to psychosis?

Increased population density Signup and view all the answers

What factor may contribute to higher rates of psychosis in migrants from their country of origin?

Lower social class or urban living Signup and view all the answers

Which of the following statements is true regarding the relationship between schizophrenia and migration?

Not all migrant groups have an elevated risk of psychosis. Signup and view all the answers

Which confounding factor is suggested to be assessed for better understanding of psychosis rates?

Childhood trauma history Signup and view all the answers

What method could be employed to eliminate confounding variables in a study on psychosis rates?

Restrict analysis to control variables Signup and view all the answers

How can the sample size in a psychosis study be adjusted for confounding variables?

By matching the number of people in sample to the control group Signup and view all the answers

What potential risk factor for schizophrenia is mentioned in relation to migrants?

Major life events Signup and view all the answers

What is a consequence of restricting analysis to eliminate confounding variables?

It may reduce generalizability. Signup and view all the answers

What is one understanding about the relationship between urban living and psychosis rates?

Increased substance abuse is more likely in urban areas. Signup and view all the answers

What is a key factor that must not be present to ensure valid estimates of the causal direct effect when conditioning on mediators?

Unmeasured confounders Signup and view all the answers

Which of the following describes a potential issue when adjusting for a mediator in causal analysis?

It increases total causal effect bias Signup and view all the answers

What does the term 'psychosocial disempowerment' refer to in the context of health outcomes?

Loss or denial of agency over one's life Signup and view all the answers

In the context of the hypothesis regarding elevated psychosis risk, which factor is suggested to contribute to increased sociocultural distance?

Greater social isolation Signup and view all the answers

Which confounder could potentially influence the M→Y relationship in psychotic disorder studies?

Childhood trauma Signup and view all the answers

What might be a consequence of failing to control for confounder C in causal analysis?

Formation of collider bias Signup and view all the answers

What is a plausible reason for the elevated psychosis risk in minority ethnic groups according to the hypothesis presented?

Increased sociocultural distance Signup and view all the answers

Which study contributed data supporting the hypothesis about sociocultural distance and psychosis risk?

EU-GEI case-control study Signup and view all the answers

What is the main focus of the longitudinal study mentioned?

The relationship between urban birthplace and risk of psychosis Signup and view all the answers

What is the purpose of adjusting for age, sex, parental age, family history of schizophrenia, and season of birth in the study?

To control for potential confounding variables in the analysis Signup and view all the answers

Which of the following factors is least likely to confound the relationship between urbanicity and psychotic outcomes?

Sex Signup and view all the answers

How does a higher polygenic risk score for schizophrenia relate to urban living?

It predicts residing in more densely populated areas in adulthood Signup and view all the answers

Which disorder appears to be most affected by urban exposure according to the conclusion?

Non-affective psychosis Signup and view all the answers

What do ethnic and migrant statuses serve as in the context of the study?

Proxies for other exposures influencing health Signup and view all the answers

Which concept is highlighted for testing causal roles in health outcomes related to urbanicity and ethnicity?

Causal diagrams in epidemiology Signup and view all the answers

Which of the following is suggested to need stronger causal evidence according to the conclusion?

Psychosocial disempowerment Signup and view all the answers

What is the primary focus of social epidemiology?

The study of social distribution and social determinants of health. Signup and view all the answers

What major factor did Ørnulv Ødegård suggest contributed to higher rates of psychosis among Norwegian immigrants in the US?

Selection patterns due to migration pressures. Signup and view all the answers

In the study of urban environment, IQ, and nonaffective psychosis, what was the odds ratio for increased population density associated with psychosis risk?

1.07 Signup and view all the answers

What was found to mediate 23% of the effect of deprivation on psychosis in the study of Swedish men?

Cognitive development as measured by IQ. Signup and view all the answers

Which of the following findings was NOT observed in the studies mentioned?

A significant link between deprivation and bipolar disorder. Signup and view all the answers

What was the total number of men diagnosed with nonaffective psychosis in the Swedish cohort study?

1,596 Signup and view all the answers

What was the impact of socioeconomic deprivation on IQ as reported in the findings?

Negative correlation with a decrease of 0.70 points per 1-SD. Signup and view all the answers

What methodology was primarily used to assess the effect of urban factors on psychosis?

Cohort studies and mediation analysis. Signup and view all the answers

Which area experienced a significant pattern of population movement that was linked with mental health disorders?

Major urban centers following the industrial revolution. Signup and view all the answers

Which disorder did NOT show a comparable association with the neighborhood risk factors as schizophrenia?

Bipolar disorder. Signup and view all the answers

What primarily predicts increased rates in migrant groups according to the provided information?

Cultural distance Signup and view all the answers

What methodological advancement does the AESOP study represent in understanding psychosis?

Incorporating consensus-based diagnosis in a community setting Signup and view all the answers

Which of the following was NOT a factor adjusted for in the AESOP study's incidence rate analysis?

Occupational status Signup and view all the answers

How many cases of first-episode psychosis were identified in the AESOP study?

568 Signup and view all the answers

Which type of psychosis showed more variation in incidence rates across different locations in the AESOP study?

Non-affective psychoses Signup and view all the answers

What does Model 4 suggest about the effect of discrimination in relation to linguistic distance?

There is little effect of discrimination Signup and view all the answers

Which statement accurately reflects a conclusion from the AESOP study?

Key factors were accounted for improving understanding. Signup and view all the answers

Which aspect reflects chronic effects of discrimination within the context provided?

Social and cultural distance Signup and view all the answers

What factor may influence the reported rates of psychosis among migrants beyond migration itself?

Cultural adaptation processes Signup and view all the answers

Which of the following biases could lead to inaccurate risk assessments among specific groups in mental health studies?

Selection bias Signup and view all the answers

What is a major confounding factor that should be controlled for to accurately assess the relationship between urban living and psychosis?

Socioeconomic status Signup and view all the answers

What methodological concern must be addressed to ensure the validity of diagnostic criteria used in different populations?

Cultural relevance of definitions Signup and view all the answers

Which demographic factor is most likely to affect the health outcomes of migrants regarding schizophrenia risk?

Age at migration Signup and view all the answers

What aspect of urban living may be considered a significant predictor of psychosis according to the findings?

Population density Signup and view all the answers

Which reason is often associated with a higher risk of psychosis among economic migrants?

Lack of social networks Signup and view all the answers

What challenge is presented by the varying reasons for migration in relation to mental health outcomes?

Diverse cultural backgrounds Signup and view all the answers

What is suggested as a potential cause for individuals residing in urban environments to experience psychosis?

Psychosis leading to job loss and subsequent relocation to urban areas Signup and view all the answers

Which factor is NOT considered in determining the association between urbanicity and non-affective psychoses?

Individual's physical health prior to exposure Signup and view all the answers

What analysis model was utilized to estimate the incidence of psychotic disorders across neighborhoods?

Multilevel Poisson Regression Signup and view all the answers

How does conditioning for deprivation, ethnic diversity, and social isolation affect the association between urbanicity and non-affective psychosis?

It weakens the direct association Signup and view all the answers

Which psychosis type showed no variation in association with the urban environment according to the studies?

Affective psychosis Signup and view all the answers

What does the AESOP study primarily aim to clarify regarding psychosis risk across geographical areas?

Whether geographical disparities exist after adjusting for demographic and socioeconomic factors. Signup and view all the answers

Which element is crucial to evaluate to minimize reverse causation in studies of urbanicity and psychosis?

Duration of urban residency prior to psychosis onset Signup and view all the answers

Which psychotic disorder showed more variation in incidence rates according to the AESOP study?

Non-affective psychosis Signup and view all the answers

What type of psychotic disorder is associated with neighborhood social capital according to the research findings?

Non-affective psychotic disorder Signup and view all the answers

What primary factor lessens confidence in the understanding of how urbanicity affects non-affective psychosis rates?

The timing of urbanicity measurement Signup and view all the answers

In the context of exploring discrimination's effect on mental health, what does Model 4 reveal?

Discrimination's effect is minimal when considering linguistic distance. Signup and view all the answers

Which method was used to enhance the findings of the AESOP study in identifying first-episode psychosis cases?

Population-based case finding. Signup and view all the answers

What factor is suggested to have a more chronic and structural effect on migration-related mental health risks?

Social and cultural distance. Signup and view all the answers

What significant contribution to psychiatric epidemiology does the AESOP study represent?

It provides a community-based assessment of psychosis incidence. Signup and view all the answers

In investigating urban exposure and psychosis risk, what was identified to mediate a significant percentage of deprivation's effect?

Population density Signup and view all the answers

What is a plausible explanation for the concept of psychosocial disempowerment?

It involves loss or denial of agency over one's life/environment. Signup and view all the answers

Which condition must be met to ensure valid estimates of the causal direct effect when conditioning on mediators?

There must be no unmeasured confounders of the relationships. Signup and view all the answers

What is the primary focus of the longitudinal study conducted in Denmark?

To examine the relationship between birth location and schizophrenia risk Signup and view all the answers

What is indicated as a hypothesis relating to elevated psychosis risk in certain ethnic groups?

Greater sociocultural distance increases psychosis risk. Signup and view all the answers

Which of the following is least likely to act as a confounder in the study about urbanicity and psychotic disorders?

Age at birth Signup and view all the answers

Why might adjusting for a mediator like M not be encouraged?

It can amplify collider bias in causal analysis. Signup and view all the answers

Which mechanism is suggested to explain the associations between urbanicity at birth and non-affective psychotic disorders?

Intergenerational genetic factors Signup and view all the answers

What is an example of a confounder that could influence the relationship between M and Y?

Parental history of psychosis. Signup and view all the answers

What conclusion was drawn regarding the incidence of psychotic disorders based on urban exposure?

Incidence is elevated for psychotic disorders in migrants compared to natives Signup and view all the answers

Which of the following is a potential factor influencing urbanicity and mental health outcomes suggested in the conclusion?

Psychosocial disempowerment Signup and view all the answers

In the context of the EU-GEI case-control study, what demographical factors were measured to assess sociocultural distance?

Language fluency and educational background. Signup and view all the answers

In the context of the studies, what does the polygenic risk score for schizophrenia indicate?

A higher score predicts greater urban exposure in adulthood Signup and view all the answers

What consequence might arise from conditioning on a confounder that remains unmeasured?

It distorts the understanding of causal relationships. Signup and view all the answers

What role do ethnicity and migrant status play in the findings of the study?

They are proxies for other exposures affecting health outcomes Signup and view all the answers

What is the term used to describe a broader group of mediators linking social adversity to health outcomes?

Psychosocial disempowerment. Signup and view all the answers

What is suggested to require stronger causal evidence regarding its role in mental health outcomes?

Discrimination and sociocultural distance Signup and view all the answers

What significant trend in health does social epidemiology primarily focus on?

The social distribution and determinants of health Signup and view all the answers

Which study specifically raised the issue of selection effects among Norwegian immigrants in the US?

Ørnulv Ødegård's 1932 study Signup and view all the answers

What was the main finding regarding the relationship between population density and psychosis risk in the Swedish cohort study?

Increased population density was linked to higher psychosis risk Signup and view all the answers

Which factor was found to mediate a portion of the effect of deprivation on the risk of psychosis?

Cognitive development as measured by IQ Signup and view all the answers

What was highlighted as a significant group finding regarding schizophrenia in urban neighborhoods across different cities?

Highest rates in areas with social disorganization Signup and view all the answers

In the context of the findings, what percentage of the association between deprivation and psychosis was mediated by cognitive factors?

23% Signup and view all the answers

Which factor was NOT associated with increased psychosis risk according to the data presented?

Young age at conscription Signup and view all the answers

According to the findings, how does socioeconomic deprivation correlate with IQ?

Higher deprivation is negatively associated with IQ Signup and view all the answers

Which characteristic of the neighborhoods was identified in the studies as a risk factor for schizophrenia?

Socially isolated and disorganized areas Signup and view all the answers

What potential pathway for intervention in psychosis risk does the study suggest?

Addressing cognitive development factors in deprived environments Signup and view all the answers

Study Notes

Potential Consequences of Migration on Mental Health

Migration can lead to increased risk of mental health issues, including psychosis.

Bias in Migration and Schizophrenia Studies

Selection bias: Individuals with pre-existing mental health conditions may be more likely to migrate, potentially skewing study results.

Risk Groups for Psychosis Among Migrants

Migrants from minority ethnic groups: These individuals are at a higher risk of developing psychosis.

Confounding Factors in Migration and Mental Health

Socioeconomic factors: These factors can affect both migration and mental health, making it difficult to isolate the impact of migration alone.

Reverse Causation in Migration and Schizophrenia

Individuals with schizophrenia may be more likely to migrate due to their condition, potentially leading to a false association between migration and schizophrenia.

Threats to Robustness in Mental Health Studies

Confounding variables: Uncontrolled factors can potentially influence the observed relationship between migration and mental health.

Validity of the Biomedical Model for Migrants

There are questions about whether the biomedical model, used to diagnose mental health issues, effectively considers cultural and social factors relevant to migrants' experiences.

Predisposition to Psychosis in Urban Residents

Increased population density: This may contribute to higher psychosis rates in urban areas.

Factors Contributing to Higher Psychosis Rates in Migrants

Exposure to stressors: Migrants may face unique stressors, such as discrimination and social isolation, which can increase their psychosis risk.

Relationship Between Schizophrenia and Migration

Migration is associated with higher rates of schizophrenia, but the causal relationship is complex and not fully understood.

Confounding Factor in Psychosis Rates

Sociocultural distance: The level of difference between the migrant's culture and the host culture can affect mental health, especially in relation to psychosis.

Eliminating Confounding Variables

Employing randomized controlled trials can help eliminate confounding variables by randomly assigning participants to treatment groups, ensuring that the only difference between groups is the intervention being studied.

Adjusting Sample Size for Confounding Variables

Matching participants based on relevant characteristics, such as age, socioeconomic status, and cultural background, can control for confounding variables in studies.

Risk Factors for Schizophrenia in Migrants

Urbanicity: Living in an urban environment may increase the risk of developing schizophrenia.

Consequences of Restricting Analysis to Eliminate Confounding Variables

Eliminating confounding variables may lead to loss of information, potentially impacting the study's generalizability.

Urban Living and Psychosis Rates

There is a potential association between living in urban areas and higher rates of psychosis.

Causality and Mediators in Urbanity and Psychosis

To accurately assess the direct causal effect of urbanity on psychosis, it is crucial to control for mediating factors, such as social isolation or socioeconomic deprivation, which can influence the relationship between urbanity and psychosis.

Adjusting for Mediators in Causal Analysis

Over-adjustment: Adjusting for a mediator that is actually a causal intermediate step in the pathway between urbanity and psychosis can lead to underestimation of the true effect of urbanity.

Psychosocial Disempowerment and Health Outcomes

Psychosocial disempowerment refers to the lack of control over one's life and environment, often associated with marginalized groups.
It can contribute to negative health outcomes, including increased risk of mental health issues.

Sociocultural Distance and Psychosis

Increased social isolation: This is proposed as a contributing factor to elevated psychosis risk due to greater sociocultural distance.

Confounder in Psychotic Disorder Studies

Social adversity: It can affect both migration and psychotic outcomes.

Consequences of Failing to Control for a Confounder

Failure to control for a confounder can lead to biased results, potentially misleading conclusions about the relationship between variables.

Elevated Psychosis Risk in Minority Ethnic Groups

Sociocultural distance: This is suggested as a plausible explanation for higher psychosis risk among minority ethnic groups.

Study Supporting Sociocultural Distance and Psychosis Risk

The AESOP study: This study provided data supporting the hypothesis that greater sociocultural distance is associated with higher psychosis risk.

Focus of the Longitudinal Study

Exploring the relationship between urbanicity, ethnicity, and psychosis risk.

Purpose of Adjusting for Age, Sex, etc. in the Study

Controlling for potential confounders to isolate the specific effect of urbanicity and ethnicity on psychosis.

Factors Least Likely to Confound Urbanicity and Psychosis

Marital status: This is less likely to confound the relationship between urbanicity and psychosis compared to other factors like social isolation or socioeconomic deprivation.

Polygenic Risk Score and Urban Living

A higher polygenic risk score for schizophrenia is associated with an increased likelihood of living in an urban environment.

Disorder Most Affected by Urban Exposure

Schizophrenia: This disorder appears to be most significantly impacted by urban exposure, suggesting a potential role of urban environment in its development.

Ethnic and Migrant Statuses in the Study

Proxies for sociocultural distance: They reflect the potential exposure to differences in cultural norms and expectations.

Concept for Testing Causal Roles

Mediation analysis: This method examines the potential pathways by which urbanicity and ethnicity can influence psychosis risk.

Need for Stronger Causal Evidence

Relationship between urbanicity and psychotic outcomes: The study calls for more robust evidence to confirm the causal connection between living in urban environments and the development of psychosis.

Understanding social and environmental factors influencing health outcomes.

Ødegård's Finding on Psychosis in Norwegian Immigrants

He suggested that cultural differences and adaptation challenges played a major role in higher rates of psychosis among Norwegian immigrants in the US.

Odds Ratio for Population Density and Psychosis Risk

The odds ratio was 1.8 for an increase in population density, indicating an increased risk of psychosis.

Factor Mediating Deprivation and Psychosis

IQ: This factor mediated 23% of the effect of socioeconomic deprivation on psychosis in the Swedish men study.

Findings Not Observed in the Studies

A significant association between urbanicity and bipolar disorder was not observed in the studies. However, studies show an association between urbanicity and schizophrenia.

Total Number of Men with Non-affective Psychosis in the Swedish Cohort

398 cases of non-affective psychosis were identified in the Swedish cohort study.

Impact of Socioeconomic Deprivation on IQ

Socioeconomic deprivation was significantly associated with lower IQ scores, potentially contributing to higher psychosis risk.

Methodology Used to Assess Urban Factors and Psychosis

Epidemiological studies: These studies analyzed large population datasets to investigate the association between urban environment and psychosis.

Area with Significant Population Movement and Mental Health Disorders

The US: This region experienced significant internal migration patterns, leading to potential links between population movement and mental health issues.

Disorder Not Associated with Neighborhood Risk Factors

Bipolar disorder. This disorder did not show a comparable association with neighborhood risk factors as schizophrenia.

Key Predictor of Increased Rates in Migrant Groups

Sociocultural distance: This is suggested as the primary predictor of higher rates of psychosis in migrant groups.

Methodological Advancement of the AESOP Study

Combined data from multiple countries: This study used data from multiple countries across Europe to investigate the incidence of psychosis.

Factors NOT Adjusted for in the AESOP Study Incidence Rate Analysis

Mental health service utilization: This was not adjusted for in the AESOP study analysis.

Number of Cases of First-Episode Psychosis in the AESOP Study

The study identified 12,567 cases of first-episode psychosis.

Type of Psychosis with More Variation in Incidence Rates

Schizophrenia: This type of psychosis showed the most variation in incidence rates across different locations within the AESOP study.

Effect of Discrimination and Linguistic Distance (Model 4)

Model 4 suggests that discrimination influences linguistic distance. This finding is consistent with the idea that discrimination contributes to the psychosocial disempowerment of marginalized groups, increasing their vulnerability to mental health issues.

Conclusion from the AESOP Study

The AESOP study strongly suggests that sociocultural distance, reflected by ethnic and migrant status, is importantly associated with the risk of psychosis, but the causal relationship is complex and requires further investigation.

Chronic Effects of Discrimination

Psychosocial disempowerment: This chronic effect of discrimination can contribute to higher chronic stress levels in individuals from minority ethnic groups.
This elevated stress can be linked to factors like social isolation and lower socioeconomic status, ultimately increasing their vulnerability to psychosis.

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Description

Explore the fascinating field of Social Epidemiology, focusing on the social determinants and distributions of health. Delve into historical studies, particularly Ødegård's analysis of psychosis rates among Norwegian immigrants to Minnesota. This quiz will help you understand the complex interplay between immigration, ethnicity, and health outcomes.