On this Student Spotlight during New York University Week: Structural factors can shape psychotic experiences in young adults.
Jackie Cosse, Ph.D. candidate and adjunct professor in the Silver School of Social Work, examines how.
Jacqueline (Jackie) Cosse, LMSW, is a PhD candidate and adjunct instructor at New York University’s Silver School of Social Work, with nearly a decade of experience as a psychodynamically-trained social worker. Jackie’s research explores how systems of power shape societal responses to harm and survival, with a specific focus on the criminalization of intimate partner violence (IPV) survivors under laws that mandate IPV arrest. Grounded in intersectional critical analysis, Jackie’s work examines how race, gender, and sexuality compound to influence the arrest and criminalization of survivors who are women, queer, and transgender/gender expansive people of color. Jackie’s overarching research aims to challenge dominant narratives that erase the systemic conditions that shape not only survivors’ lives, but the lives of all those rendered invisible by interlocking systems of oppression, centering the voices of those most marginalized in pursuit of a collective reimagining of systems of accountability and care.
Rethinking Social Defeat
Psychosis research has long shown that people with marginalized identities are at higher risk of developing psychosis. While this was largely understood as a direct result of identity or lived experience, Jean-Paul Selten’s theory of social defeat marked an important shift. He argued that it’s not just identity or experience that increases risk, but whether those experiences are felt as defeating or exclusionary. This reframed psychosis risk as rooted not only in how people are positioned within society, but how those positions are experienced.
While Selten’s theory offers important insights, its focus on subjective feelings of defeat can unintentionally imply that risk stems from lack of resilience rather than from the conditions that produce harm. Our research challenges that framing, focusing on how systemic factors, like racism and police violence, can shape the risk of psychotic experiences. This is critical here in the United States, where structural racism is embedded in the fabric of our institutions. From chattel slavery and slave patrols to modern-day policing and mass incarceration, this isn’t just a legacy of the past; it’s the foundation of many systems people still navigate today.
To explore this, we analyzed national survey data from over 1,500 young adults ages 18–29. As Selten’s theory suggests, marginalization was linked to greater risk of psychotic experiences. However, we also found that structural exposures played a powerful role. Participants who experienced police violence had 52% higher odds of psychotic experiences, while participants of color had 60% higher odds than white peers. Our findings highlight that psychosis risk isn’t just about individual experiences of discrimination; it’s also shaped by the systems people live in. So, to reduce that risk, we can’t just focus on individual-level factors; we must also confront the structural realities that shape people’s daily lives.
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Study citation with link:
Cosse, J.I., Amos, B., Downey, D.L., Prout, L., Kim, S. Fedina, L., DeVylder, J. (2025). Social Defeat and Psychosis in the United States: A replication and critical reconceptualization. Schizophrenia Bulletin, sbaf081. https://doi.org/10.1093/schbul/sbaf081
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