Background: Higher rates of schizophrenia and related psychoses are one of the most consistent findings from decades of research into the mental health of ethnic minorities. In the UK, people of Black African and Caribbean descent are, respectively, 6 and 9 times more likely to be diagnosed with narrowly-defined schizophrenia as White British people (Morgan et al., 2006). A number of factors, including economic and social disadvantage, have been postulated as potential explanations (Morgan et al., 2009). However, the role of discrimination (particularly the role of everyday/ongoing race-based racism and discrimination) in the onset and maintenance of psychotic symptoms has not been fully explored. Additionally, the concept of racism as trauma has not been investigated. Previous research with African and Caribbean people (Edge et al., In Press) highlighted that discrimination and racism in particular featured prominently in their illness models. However, there are currently no culturally-relevant measures of discrimination that could be used to explore the mechanisms by which racism, trauma and racism as trauma might influence onset and perpetuation of psychotic symptoms.
Aims: 1) To explore the relationship between race-based discrimination, trauma and psychosis in Black African and Caribbean communities in the UK 2) To develop and validate a measure of discrimination with the potential for use in these and other populations in both clinical and research contexts.
Participants: Black African and Caribbean origin service users diagnosed with schizophrenia spectrum disorders.
Method: Mixed methods involving: i) questionnaire design and attitude measurement and ii) theory-building work on the concept of racism as trauma, including developing an understanding of the underlying mechanisms. Study design to be developed with candidate.
The candidate will receive in-house training and supervision from renowned experts in cultural adaptation of intervention/measures in ethnic minority communities (Edge and Berry), and trauma and life adversities in clinical and non-clinical individuals (Varese). Additionally, they will receive training in mixed methods research via: i) courses offered by the University of Manchester’s: i) Doctoral Academy ii) Summer School and iii) Cathie Marsh Institute for Social Research (CMIST) thereby developing the necessary skills to successfully undertake PhD research. This is likely to include: advanced qualitative and quantitative data collection and analyses, clinical assessment of psychotic symptoms and adverse experiences, questionnaire design, ethics, and research governance e.g. Good Clinical Practise.
Candidates are expected to hold (or be about to obtain) a minimum upper second class honours undergraduate degree (or equivalent) in a related area (e.g. Psychology). Candidates with experience in quantitative and/or qualitative methodology, with an interest in mixed-methodology are encouraged to apply. The project will require someone who is highly competent in statistical methods. Previous experience of developing measures is desirable. The project will involve collecting data from NHS Trusts and community settings. Ability to travel is therefore essential. University lone worker policy will be invoked.
1. Edge, D., Degnan, A., Cotterill, S., Berry, K., Drake, R., Baker, J., Barrowclough, C. Hughes-Morley, A., Grey, P., Bhugra, D., Cahoon, P., Tarrier, N., Lewis, S., & Abel, K. (2016). Culturally-adapted Family Intervention (CaFI) for African-Caribbeans diagnosed with schizophrenia and their families: A feasibility study protocol of implementation and acceptability. Pilot and Feasibility Studies, 2(1), 39. doi: http://dx.doi.org/10.1186/s40814-016-0070-2.
2. Morgan, C., Dazzan, P., Morgan, K., Jones, P., Harrison, G., Leff, J., Murray, R., & Fearon, P. (2006). First episode psychosis and ethnicity: initial findings from the AESOP study. World Psychiatry, 5(1), 40-46.
3. Morgan, C., Fisher, H., Hutchinson, G., Kirkbride, J., Craig, T. K., Morgan, K., Dazzan, P., Boydell, J., Doody, G. A., Jones, P. B., Murray, R. M., Leff, J., & Fearon, P. (2009). Ethnicity, social disadvantage and psychotic-like experiences in a healthy population based sample. Acta Psychiatrica Scandinavica, 119(3), 226-235. doi:10.1111/j.1600-0447.2008.01301.x