Examining Psychosis Risk in Sexual Minority Youth: Increased Exposure to and Differential Impact of the Social Envirome in Early Adolescence

Background and Hypotheses: Sexual minority populations have a higher prevalence of psychotic experiences (PE), possibly due to differential experiences within the social envirome in its positive (eg, social support, parenting) and negative aspects (eg, adverse life events, bullying). This study hypothesized that (1) sexual minority adolescents experience more PE, (2) are more exposed to harmful aspects of the social envirome, and (3) may display differential sensitivity to certain aspects of the social envirome. Study Design: Data from 678 adolescents (mean age 15.6 years) were analyzed. Psychotic experiences were assessed using the Prodromal Questionnaire 16 (PQ-16). Aspects of the social envirome (childhood adversity, bullying, parenting style, and social support) were evaluated using different questionnaires. Study Results: The odds ratio of having sexual minority status (SMS) was 1.98 (95 CI%, 1.02–3.84) for participants with PE (PQ-16 ≥ 6) compared to participants without. Significant associations were found between SMS and more adverse childhood experiences (95% CI, 0.11–3.51) and parenting psychological control (95% CI, 0.11–0.53), and less parenting autonomy support (95% CI, −0.37 to −0.01). There were also significant differential effects: adverse childhood experiences were associated with PE in heterosexuals but not in sexual minorities (95% CI, −0.34 to −0.03), while less social support was associated with more PE in heterosexuals but less PE in sexual minorities (95% CI, 0.06–0.39). Conclusions: Sexual minority status is associated with a higher prevalence of PE, greater exposure to harmful factors within the social envirome, and differential effects on sexual minority and heterosexual individuals. These results emphasize the need for a fine-grained analysis of the envirome to understand the increased risk for PE in sexual minorities.