Emerging research from New York University’s Silver School of Social Work is challenging long-held notions surrounding the onset of psychosis in young adults, particularly among marginalized communities. Traditional explanations for early psychotic episodes have predominantly centered on individual-level factors such as childhood trauma, bullying, and substance abuse. However, this novel study expands the analytical lens to include macro-social determinants — notably systemic racial inequalities and exposure to police violence — as critical contributors to the disparity observed in psychosis prevalence among low-income young people of color.
The groundbreaking study titled “Social Defeat and Psychosis in the United States,” published in Schizophrenia Bulletin, involved a comprehensive examination of data from the National Survey of Poly-Victimization and Mental Health. Its primary objective was to parse out the relative influence of both individual experiences and broader societal forces on early psychosis risk. The team, led by NYU Silver associate professor Jordan DeVylder alongside doctoral researchers Jacqueline Cosse and Brianna Amos, analyzed responses from 1,584 Americans aged 18 to 29, focusing specifically on psychotic symptomatology reported in the prior year.
Their findings are revelatory: Black, Latino, multiracial, and Indigenous young adults had a staggering 60% higher likelihood of reporting one or more psychotic episodes compared to their white counterparts. This disparity is not fully explained by classic individual-level risk factors but is significantly illuminated when considering exposure to structural violence. Among those who reported encounters with police violence, the odds of experiencing delusions or hallucinations increased by 52%, underscoring the profound psychological impacts of systemic oppression.
At the conceptual core of this research lies the “Social Defeat Hypothesis,” a theoretical framework originally developed in Northern Europe, which posits that chronic experiences of social exclusion and humiliation can precipitate neurobiological changes conducive to psychosis. For over twenty years, this hypothesis has guided psychiatric treatment approaches that focus on the individual’s subjective experience of defeat and marginalization. However, DeVylder’s team pushes this boundary by articulating the necessity of incorporating external social structures—such as systemic racism and institutional violence—into the understanding of psychosis risk.
From a neurobiological perspective, the social defeat hypothesis describes how repeated social subordination or ostracism can engender long-lasting alterations in the dopaminergic system. Dopamine dysregulation is a well-established biological marker linked to psychosis, particularly in schizophrenia-spectrum disorders. This research builds on that knowledge by suggesting that the chronic stress of racial marginalization and police brutality may act as persistent social defeats that exacerbate or even instigate these neurobiological shifts, culminating in psychotic symptoms.
The existing scholarship has often compartmentalized psychosis as an outcome primarily triggered by personal adversities like drug use or interpersonal trauma, but this study compellingly redirects attention to the sociopolitical environment. It emphasizes that the omnipresent reality of racialized social defeat experienced by many minority communities cannot be disentangled from their mental health outcomes. This is particularly critical given the U.S. context, where systemic racism manifests not just as overt discrimination but also through institutional practices, including law enforcement interactions.
Notably, the research represents a methodological advance by integrating individual-level survey data with broader analyses of structural determinants. Such an approach heralds a necessary paradigm shift away from exclusively individualized models of psychiatric risk toward multidisciplinary frameworks that include social epidemiology and justice studies. This broadened scientific inquiry may open pathways toward more effective prevention strategies that target societal factors alongside personal vulnerabilities.
The public health implications of these findings are profound. If structural stability and reductions in societal racism can lower incidence rates of psychosis, then mental health interventions may need to incorporate community-level and policy-oriented solutions rather than focusing solely on clinical therapies. As Dr. DeVylder succinctly puts it, mitigating systemic racism might offer mental health benefits comparable in magnitude to traditional psychotherapeutic interventions.
Moreover, this research implicitly critiques mental health services for insufficiently accounting for the social contexts from which many young people of color emerge. The identification of police violence as a significant correlate for psychotic episodes signals an urgent need for mental health practitioners, policymakers, and law enforcement agencies to reevaluate how systemic factors affect vulnerable populations.
Collaborative efforts behind the study further underscore its interdisciplinary depth, with contributions from social work scholars such as Lisa Fedina of the University of Michigan and NYU Silver doctoral students. Their collective expertise illustrates the power of cross-institutional partnerships in unpacking complicated public health issues that intertwine biological, psychological, and social threads.
Looking forward, the authors advocate for intensified research into societal and structural factors, particularly within low-income and racially marginalized communities. Unraveling the mechanisms by which systemic social defeats translate into neurobiological vulnerability will be pivotal in designing interventions that can reduce the disproportionate burden of psychosis faced by these populations.
The study not only realigns scientific discourse but also calls for greater societal reflection on the lived realities of oppression. It is a compelling reminder that mental illnesses such as psychosis do not occur in a vacuum and that the pervasive scars of systemic injustice wound the brain itself.
In an era increasingly attentive to the social determinants of health, this research is a timely contribution that integrates psychiatric theory, epidemiological data, and social justice frameworks. Its provocative findings underscore the necessity of addressing structural inequalities as an integral component of psychiatric research, clinical practice, and public health policy to achieve equitable mental health outcomes for all.
Subject of Research: People
Article Title: Social Defeat and Psychosis in the United States
News Publication Date: 2-Jun-2025
References: Schizophrenia Bulletin
Keywords: Mental health
