School Mobility and Prospective Pathways to Psychotic-like Symptoms in Early Adolescence: A Prospective Birth Cohort Study

Pub. Date
29 April, 2014
Social adversity and urban upbringing increase the risk of psychosis. We tested
the hypothesis that these risks may be partly attributable to school mobility and examined the
potential pathways linking school mobility to psychotic-like symptoms. Method: A community
sample of 6,448 mothers and their children born between 1991 and 1992 were assessed
for psychosocial adversities (i.e., ethnicity, urbanicity, family adversity) from birth to 2 years,
school and residential mobility up to 9 years, and peer difficulties (i.e., bullying involvement
and friendship difficulties) at 10 years. Psychotic-like symptoms were assessed at age 12 years
using the Psychosis-like Symptoms Interview (PLIKSi). Results: In regression analyses,
school mobility was significantly associated with definite psychotic-like symptoms (odds ratio
[OR] ¼1.60; 95% CI ¼1.07–2.38) after controlling for all confounders. Within path analyses,
school mobility (probit coefficient [b] ¼ 0.108; p ¼ .039), involvement in bullying (b ¼ 0.241; p <
.001), urbanicity (b ¼ 0.342; p ¼ .016), and family adversity (b ¼ 0.034; p < .001) were all
independently associated with definite psychotic-like symptoms. School mobility was indirectly
associated with definite psychotic-like symptoms via involvement in bullying (b ¼ 0.018;
p ¼ .034). Conclusions: School mobility is associated with increased risk of psychotic-like
symptoms, both directly and indirectly. The findings highlight the potential benefit of strategies
to help mobile students to establish themselves within new school environments to reduce
peer difficulties and to diminish the risk of psychotic-like symptoms. Awareness of mobile
students as a possible high-risk population, and routine inquiry regarding school changes and
bullying experiences, may be advisable in mental health care settings.