Victimization and engagement with the legal system among individuals at clinical high risk (CHR) for psychosis.

BACKGROUND

Despite findings of more victimization and legal issues in individuals with psychotic illness, little is known about this history among youth at clinical high-risk for psychosis (CHR). Further, it is unclear whether certain demographic, clinical, functional, or diagnostic patterns exist among CHR youth who report victimization and/or crime/legal engagement.

METHODS

Participants (N = 684 CHR, N = 95 healthy controls) were part of the North American Prodromal Longitudinal Study-3 (NAPLS-3). CHR participants were grouped according to whether they endorsed/did not endorse a history of being a victim of crime or being engaged with crime (committed, accused or convicted)/the legal system. Differences in clinical symptoms, functioning, diagnoses, and life-risk factors were examined in each of the groups. Follow-up binary logistic regressions were employed to assess variables associated with victimization and crime/legal engagement.

RESULTS

CHR youth were significantly more likely to report being a victim or perpetrator of crime compared to healthy controls and those with this history were more likely to have multiple risk factors for violence and comorbid mental illness. Grandiosity was significantly associated with both a history of victimization and crime/legal engagement while other symptoms were at a trend level. Age and historical risk factors were the most strongly associated with later victimization and engagement with the legal system, even when controlling for attenuated psychosis symptoms.

DISCUSSION: Risk factors among CHR youth with a legal history closely resemble those faced in the general population. These findings speak to the importance of assessment and intervention for youth with historical/environmental adversity and legal history.