An exploration of social defeat and social dominance orientation as predictors of psychosis. A secondary analysis of the COVID-19 Psychological Research Consortium (CP19RC-UK) data set

Social and economic inequalities are increasingly recognised as key determinants of mental health, shaping both the prevalence and distribution of psychological distress across societies. Over time, economic growth has improved living standards and health outcomes; however, in the wealthiest countries, these benefits have largely plateaued (Pickett & Wilkinson, 2009). Research suggests that as societies become richer, increases in income and living standards bring progressively smaller improvements in population health, a “ceiling effect” (Pickett & Wilkinson, 2009; Ray & Linden, 2018; Tibber et al., 2022). Yet, health and social inequalities remain strongly related to individual income and socioeconomic status (Islam & Jaffee, 2024). One factor contributing to this pattern is income inequality. Even in affluent societies, disparities in wealth, status, and opportunity create hierarchical social structures, leaving some groups chronically disadvantaged and marginalised. These experiences of disadvantage can have lasting effects on mental health that are independent of absolute poverty (Johnson et al., 2015). Beyond individual outcomes, economic inequality has also been linked to reduced community engagement, increased mistrust, and heightened competition within societies (Fone et al., 2014; Pickett & Wilkinson, 2010). These dynamics force some groups to compete for resources that are largely out of reach, and the resulting breakdown in social cohesion further exacerbates poor mental health outcomes (Fone et al., 2014). Although inequality establishes hierarchical social structures, individuals differ in the extent to which they endorse and legitimise these hierarchies, which may shape the psychological impact of disadvantage. Social Dominance Orientation (SDO) is a theoretical framework that captures these individual differences, reflecting the extent to which people perceive social hierarchies and inequalities as legitimate or inevitable (Sidanius & Pratto, 1999). SDO doesn’t represent a chosen ideological stance; rather is shaped by social, cultural, and contextual influences. As a result individuals may internalise hierarchical beliefs despite occupying disadvantaged positions, as a way of making sense of persistent inequality. While SDO has been extensively studied in relation to ideological and interpersonal outcomes such as prejudice and political attitudes (Nicol & Rounding, 2013; Milfont et al., 2018), its role in intrapersonal mental health outcomes remains largely underexplored. Internalising hierarchal beliefs may have psychological consequences for individuals exposed to social adversity. Whilst inequality is perceived as legitimate or justified experiences of exclusion, failure, or low status may be interpreted as personal shortcomings rather than structural outcomes, intensifying feelings of shame, defeat or marginalisation. Consequently, SDO may influence how social adversity is perceived and emotionally processed, shaping vulnerability to psychological consequences such as social defeat. With this framework, we look to emphasise the role of structural and societal factors in shaping psychological vulnerability, rather than locating it within the individual. Although SDO was initially conceptualised as a unitary construct, recent research suggests it is multidimensional, comprising two related but distinct components: SDO–Dominance (SDO-D), reflecting support for overt group-based dominance, and SDO–Egalitarianism (SDO-E), reflecting broad opposition to equality enhances policies, that challenge structural inequality (Ho et al., 2015). While correlated, these dimensions capture distinct ways in which individuals perceive and respond to hierarchy. Importantly, SDO-E may be particularly relevant to social adversity, as it reflects the internalised legitimacy of inequality and subordination, whereas SDO-D reflects dominance motivations that are less directly tied to experiences of exclusion or chronic low status. Social adversity itself is a well-established risk factor for psychosis, encompassing experiences such as trauma, minority status, bullying, social isolation, and low socioeconomic position (Bentall et al., 2014; Morgan & Gayer-Anderson, 2016; Varchmin, 2021). The social defeat hypothesis is one theory which seeks to provide a biopsychosocial understanding of these risks. Social defeat proposes that repeated social exclusion or chronic subordinate status generates a state of social defeat, which sensitises mesolimbic dopamine pathways and increases psychosis risk (Selten & Cantor-Graae, 2005). An any psychological disposition that amplifies the subjective experience of defeat may exacerbate the mental health impact of social adversity. From this perspective, It seems plausible that SDO may act as a moderating factor, shaping how individuals interpret and emotionally respond to experiences of exclusion, rejection, or failure. To our knowledge, no prior research has examined the relationship between SDO, social defeat, and psychological distress. The present study seeks to extend the literature by examining how living in unequal, hierarchical societies can create conditions for social adversity and social defeat, and how socially shaped belief systems may interact with these conditions to influence psychological vulnerability. Specifically, we highlight how internalised social beliefs formed within unequal social contexts may amplify the emotional impact of adversity and vulnerability to psychosis. 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