title: The impact of social deprivation on paranoia, hallucinations, mania and depression: the role of discrimination social support, stress and trust.
abstract: The negative implications of living in a socially unequal society are now well documented. However, there is poor understanding of the pathways from specific environmental risk to symptoms. Here we examine the associations between social deprivation, depression, and psychotic symptoms using the 2007 Adult Psychiatric Morbidity Survey, a cross-sectional dataset including 7,353 individuals. In addition we looked at the mediating role of stress, discrimination, trust and lack of social support. We found that the participants' neighbourhood index of multiple deprivation (IMD) significantly predicted psychosis and depression. On inspection of specific psychotic symptoms, IMD predicted paranoia, but not hallucinations or hypomania. Stress and trust partially mediated the relationship between IMD and paranoid ideation. Stress, trust and a lack of social support fully mediated the relationship between IMD and depression. Future research should focus on the role deprivation and social inequalities plays in specific manifestations of psychopathology and investigate mechanisms to explain those associations that occur. Targeting the mediating mechanisms through appropriate psychological intervention may go some way to dampen the negative consequences of living in an unjust society; ameliorating economic injustice may improve population mental health.
authors.affiliation: Institute of Psychology, Health and Society, University of Liverpool, Liverpool, Merseyside, United Kingdom.
authors.forename: Sophie
authors.initials: S
authors.lastname: Wickham
authors.affiliation: Institute of Psychology, Health and Society, University of Liverpool, Liverpool, Merseyside, United Kingdom.
authors.forename: Peter
authors.initials: P
authors.lastname: Taylor
authors.affiliation: School of Psychology, University of Ulster, Magee Campus, Londonderry, Northern Ireland, United Kingdom.
authors.forename: Mark
authors.initials: M
authors.lastname: Shevlin
authors.affiliation: Institute of Psychology, Health and Society, University of Liverpool, Liverpool, Merseyside, United Kingdom.
authors.forename: Richard P
authors.initials: RP
authors.lastname: Bentall
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001714:Bipolar Disorder / Q000191:economics / Q000453:epidemiology / Q000209:etiology / Q000523:psychology*; D003863:Depression / Q000191:economics / Q000453:epidemiology / Q000209:etiology / Q000523:psychology*; D005260:Female; D006212:Hallucinations / Q000191:economics / Q000453:epidemiology / Q000209:etiology / Q000523:psychology*; D006306:Health Surveys; D006801:Humans; D008297:Male; D008875:Middle Aged; D010259:Paranoid Disorders / Q000191:economics / Q000453:epidemiology / Q000209:etiology / Q000523:psychology*; D063508:Social Discrimination / Q000191:economics / Q000523:psychology*; D012959:Socioeconomic Factors; D013315:Stress, Psychological / Q000150:complications* / Q000191:economics / Q000453:epidemiology; D006113:United Kingdom / Q000453:epidemiology