Do they see dead people? Cultural factors and sensitivity in screening for schizophrenia spectrum disorders.
Schizophrenia spectrum disorders (SSDs), are diagnosed more frequently among African-Americans (AAs) than Caucasians. It has been suggested that cultural differences in symptom presentation and endorsement (including reporting spiritual/religious experiences) may influence this disparity. The current study investigated the relationship between endorsement of spiritual auditory and visual hallucinations and subsequent diagnosis of SSD among AA patients.



Participants (N = 471 AAs) completed the Mini International Neuropsychiatric Interview-Plus (MINI-Plus) Screening Interview as part of their intake to a HIV outpatient clinic. Endorsement of auditory or visual (A/V) hallucinations was explored with the MINI-Plus Psychotic Disorder Module and questions regarding the content of the unusual experience.



Logistic regression indicated that endorsement of A/V hallucinations significantly predicted a SSD (OR = 41.6, 95% CI 13.7-126.0, p < .001). However, when hallucinations were spiritual in nature, odds of an SSD fell dramatically (OR = 0.22, 95% CI 0.07-0.64, p < .001).



The current study indicates that not all visual and auditory hallucinations are symptomatic of a psychotic disorder in AA patients. Many of these experiences may be related to spirituality. Clinicians assessing AA patients need to query content of, meaning attributed to, and distress associated with A/V unusual experiences.
a Department of Psychology , Louisiana State University , Baton Rouge , LA , USA.
MacKenzie R
MR
Peltier
a Department of Psychology , Louisiana State University , Baton Rouge , LA , USA.
Seandra J
SJ
Cosgrove
b LSU Health Baton Rouge , Baton Rouge , LA , USA.
Kelechi
K
Ohayagha
b LSU Health Baton Rouge , Baton Rouge , LA , USA.
Kathleen A
KA
Crapanzano
a Department of Psychology , Louisiana State University , Baton Rouge , LA , USA.|b LSU Health Baton Rouge , Baton Rouge , LA , USA.
Glenn N
GN
Jones
D000328:Adult; D001741:Black or African American / Q000523:psychology*; D005260:Female; D006212:Hallucinations / Q000208:ethnology*; D006801:Humans; D016015:Logistic Models; D008297:Male; D001523:Mental Disorders / Q000175:diagnosis / Q000208:ethnology; D008875:Middle Aged; D012559:Schizophrenia / Q000175:diagnosis* / Q000208:ethnology*; D029181:Spirituality
African-American; hallucinations; religious; schizophrenia spectrum disorders; spiritual