6 - (IOP 2) Exploring Minority Stress and Cognitive Symptoms in Early Psychosis

Psychosis disorders such as schizophrenia are typically accompanied by cognitive symptoms including difficulties with processing speed, memory, and executive function (McCleery & Nuechterlein 2019). However, psychosocial processes which exacerbate or alleviate cognitive symptoms are understudied. Minority stress theory (Meyer 2003) posits that among people with socially marginalized identities, discrimination experiences create hostile environments which contribute to mental health problems, including psychosis risk (Pearce et al 2019). While associations between chronic stress and cognitive impairment are well-documented (Lupien et al 2009), limited research has specifically explored the impact of minority stress and discrimination on cognition. Higher rates of cognitive impairment have been observed in LGBTQ+ older adults (Manca et al 2023) and Black older adults (Forrestor et al 2019). Despite theoretical support, the relationship between minority stress and cognitive symptoms in psychosis remains unexamined.

We recruited people enrolled in first episode psychosis programs throughout the Minneapolis-Saint Paul metropolitan area. 99 young adults (median age = 21.3 years) completed the Intersectional Discrimination Index (Scheim and Bauer 2019) and computerized cognitive tasks of processing speed, verbal memory, visual reasoning, and emotion recognition (Singh et al 2021). Of our sample, 25% of participants were LGBTQ+ (9% transgender/nonbinary, 21% LGB+), 31% were BIPOC (16% Black, 5% Asian, 10% multiracial including 8% Native American), 7% were Latine, and 31% had less than 12 years of education.

Non-parametric tests were performed due to the non-normality of data. Preliminary results showed differences in discrimination experiences based on gender identity (H(3) = 15.52, p = .001), with transgender and nonbinary people reporting higher rates of discrimination than cisgender people. Participants who were lesbian, gay, bisexual, and/or queer trended towards reporting more discrimination experiences than heterosexual people (H(2) = 5.41, p = .067). Participants did not differ in reports of discrimination experiences by race (H(2) = 0.60, p = .741) or ethnicity (H(2) = 1.54, p = .463).

Contrary to expectation, correlations did not support significant relationships between overall discrimination experiences and cognitive performance. However, anticipated discrimination trended towards a negative association with emotion recognition (rho = -0.19, p = .062); people who anticipated more future discrimination experiences had greater difficulty with emotion recognition. Future analyses will explore cognitive symptoms by diagnostic category and in relation to functional impairment to better understand protective or risk factors among people with psychosis who hold multiple marginalized identities.