In a summary of a study from this year, it was concluded that “young city-dwellers also have 40% more chance of suffering from psychosis (hearing voices, paranoia or becoming schizophrenic in adulthood) is perhaps is less common knowledge.” The authors in the paper claim to have controlled for “a range of potential confounders including family SES, family psychiatric history, maternal psychosis, adolescent substance problems, and neighborhood-level deprivation.”
These are intriguing results, assuming that the study was successful in controlling the confounding factors and so assuming they were making a genuine comparison. Some of the features they noted for the effected urban populations were adverse neighborhood conditions and community breakdown, but I’d point out that these are increasingly found in rural areas. For example, if they further focused in on the hardest hit areas of rural Appalachia, would they find the same results? Is this really a difference between urban and rural areas? If so, that requires explaining, maybe beyond what the authors articulated.
Some of that might be caused by physical factors in urban environments.
Lead toxicity, for example, is worse in cities these days (although a century ago it was actually worse in rural areas because of heavy use of lead paint for barns). Lead toxicity has major impacts on neurocognitive development and mental illness. Also, keeping pets indoors is more common in cities. And where cats are kept as house pets, there are higher rates of toxoplasmosis which is another causal factor that alters the brain and leads to mental health issues.
Neither lead toxicity nor toxoplasmosis was mentioned in the paper. Those are two obvious confounders apparently not having been considered. That could be problematic, although not necessarily undermining the general pattern.
Other factors might have to do with crime or rather the criminal system.
There are actually lower violent crime rates in urban areas, both big and small cities, as compared to rural areas (the rural South is even worse). But it is true that specific urban communities and neighborhoods would have more crime and violence, meaning greater levels of victimization. Beyond crime itself, a major difference is that there are greater levels of policing in cities, which means more police targeting of particular populations (specifically minorities and the poor) and so more police harassment and brutality for the victimized populations. Many poor inner cities can feel like occupied territories, far from optimal conditions for normal psychological development.
Furthermore, there are more video cameras, public and private, watching the citizenry’s every move. Cities are artificial environments, highly ordered in constraining and controlling human behavior, with more walls than open spaces. In tending toward inequality and segregation, cities create divided populations that have separate life experiences. This undermines a culture of trust and makes it difficult to maintain community-based social capital. It’s understandable that all of this combined might make one feel paranoid or simply stressed and anxious. But we should be careful about our conclusions, since cities in more equal and well functioning social democracies might be far different than cities in a country like the United States.
Besides, there might be more going on than these external issues of urban environments.
Urban populations are larger and more concentrated than ever before. Maybe there are psychological changes that happen to populations under these conditions, as urbanization increases. Being in near constant close proximity to so many people has to have major impacts on human development and behavior. And this might go far beyond issues of stress alone.
This could relate to Julian Jaynes’ theory of bicameralism, as he argued that people hearing voices became more common with the emergence of the first city-states. Urban environments are atypical for the conditions under which human evolution occurred. It shouldn’t be surprising that abnormal conditions would lead to abnormal results, whatever are the specifics involved.
So, maybe it should be expected that “mental health deterioration” would follow. If the bicameral mind actually did once exist in the ancient world, I’m sure the first urban dwellers initially experienced it as negative and threatening. Any major societal change takes many generations (or centuries) to be fully assimilated, normalized, and stabilized within the social order.
But humans are so adaptable that almost anything can eventually be integrated into a culture. Recent research has shown how highly atypical is our WEIRD society (western, educated, industrialized, rich, and democratic) and yet to us it is perfectly normal. Maybe these neurocognitive changes from increased urbanization are simply our WEIRD society being pushed ever further down the path its on. The WEIRD might get ever more weird.
A new mentality could be developing, for good or ill. If our society survives the transition, something radically different would emerge. As has been noted by others, revolutions of the mind always precede revolutions of society. Before the earthquake, the tectonic plates must shift. The younger generations are standing on the faultline and, in being hit by urbanization the hardest, they will experience it like no one else. But as it goes on, none of us will escape the consequences. We better hope for a new mentality.
“News from the guinea pig grapevine suggests that whatever it is, we won’t know until it’s way too late, you see? You see that we’re all canaries in the coal mine on this one?”
~ Barris, A Scanner Darkly
* * *
Cumulative Effects of Neighborhood Social Adversity and Personal Crime Victimization on Adolescent Psychotic Experiences
by Joanne Newbury, Louise Arseneault, Avshalom Caspi, Terrie E. Moffitt1, Candice L. Odgers, & Helen L. Fishe
Does urbanicity shift the population expression of psychosis?
by Janneke Spauwen, Lydia Krabbendam, Roselind Lieb, Hans-Ulrich Wittchen, & Jim van Os
Schizophrenia and Urbanicity: A Major Environmental Influence—Conditional on Genetic Risk
by Lydia Krabbendam & Jim van Os
Brain Structure Correlates of Urban Upbringing, an Environmental Risk Factor for Schizophrenia
Leila Haddad, Axel Schäfer, Fabian Streit, Florian Lederbogen, Oliver Grimm, Stefan Wüst, by Michael Deuschle, Peter Kirsch, Heike Tost, & Andreas Meyer-Lindenberg
City living and urban upbringing affect neural social stress processing in humans
by Florian Lederbogen, Peter Kirsch, Leila Haddad, Fabian Streit, Heike Tost, Philipp Schuch, Stefan Wüst, Jens C. Pruessner, Marcella Rietschel, Michael Deuschle & Andreas Meyer-Lindenberg