Differentiating kinds of systemic chronic stressors with relation to psychotic-like experiences in late childhood and early adolescence: the stimulation, discrepancy, and deprivation model of psychosis

INTRODUCTION: Chronic stress exposure occurs at the systems level, and is a key etiological factor in the development of psychotic disorders. However, conceptualizations distinguishing the impact of distinct dimensions of stress exposure are lacking; further, the magnitude of effect for differing exposures has yet to be explored. METHODS: Exploratory factor analysis was conducted to distinguish domains of environmental exposures in a nationally representative sample of 7,446 youth from the Adolescent Brain Cognitive Development (ABCD) study. Environmental exposures were associated to psychotic-like experiences (PLEs). The magnitude of associations was compared among different environmental exposures. As an exploratory aim, objective versus subjective measures of environmental risk exposure were compared. RESULTS: Six factors were defined, four of which fit theoretically with the Stimulation Discrepancy, and Deprivation (SDD) theory of developmental stress exposure and psychosis. The three domains of stimulation (high attentional demands and lack of safety), discrepancy (low social capital, social exclusion and lack of belonging), and deprivation (lack of developmentally appropriate environmental enrichment) were associated with PLEs, as predicted. Compared to exposures in other domains, exposures in the deprivation domain exhibited a significantly stronger association with PLEs. Objective and subjective measures converged in direction of association, though self-report stimulation exhibited a significantly stronger association with PLEs compared to objective stimulation domain measures. DISCUSSION: Current results suggest considering distinct environmental exposures as they relate to psychosis liability could inform putative mechanisms and degrees of vulnerability. The approach offers a valuable perspective to health policy efforts aimed at psychopathology prevention and intervention efforts. ### Competing Interest Statement The authors have declared no competing interest. ### Funding Statement Data used in the preparation of this article were obtained from the Adolescent Brain Cognitive Development (ABCD) Study (https://abcdstudy.org), held in the NIMH Data Archive (NDA). This is a multisite, longitudinal study designed to recruit more than 10,000 children age 9-10 and follow them over 10 years into early adulthood. The ABCD Study is supported by the National Institutes of Health and additional federal partners under award numbers U01DA041022, U01DA041028, U01DA041048, U01DA041089, U01DA041106, U01DA041117, U01DA041120, U01DA041134, U01DA041148, U01DA041156, U01DA041174, U24DA041123, U24DA041147, U01DA041093, and U01DA041025. A full list of supporters is available at https://abcdstudy.org/federal-partners.html. A listing of participating sites and a complete listing of the study investigators can be found at https://abcdstudy.org/Consortium_Members.pdf. ABCD consortium investigators designed and implemented the study and/or provided data but did not necessarily participate in analysis or writing of this report. This manuscript reflects the views of the authors and may not reflect the opinions or views of the NIH or ABCD consortium investigators. The ABCD data repository grows and changes over time. The ABCD data used in this report came from [NIMH Data Archive Digital Object Identifier (DOI) 10.15154/1506121]. DOIs can be found at https://nda.nih.gov/general-query.html?q=query=studies%20~and~%20orderBy=id%20~and~%20orderDirection=Ascending. ### Author Declarations I confirm all relevant ethical guidelines have been followed, and any necessary IRB and/or ethics committee approvals have been obtained. Yes The details of the IRB/oversight body that provided approval or exemption for the research described are given below: The study spans 21 sites whose respective IRBS all gave approval for data collection. All necessary patient/participant consent has been obtained and the appropriate institutional forms have been archived. Yes I understand that all clinical trials and any other prospective interventional studies must be registered with an ICMJE-approved registry, such as ClinicalTrials.gov. I confirm that any such study reported in the manuscript has been registered and the trial registration ID is provided (note: if posting a prospective study registered retrospectively, please provide a statement in the trial ID field explaining why the study was not registered in advance). Yes I have followed all appropriate research reporting guidelines and uploaded the relevant EQUATOR Network research reporting checklist(s) and other pertinent material as supplementary files, if applicable. Yes Data is publicly available and can be applied for access on nda.nih.gov