Elevated incidence rates of non-affective psychosis and psychotic symptoms in densely populated urban areas have been reported by many epidemiological studies. It has been proposed that social characteristics of the urban environment underlie the association with the development of psychotic disorders. Individuals at risk for psychosis may be particularly susceptible to these conditions, given that psychosis is associated with deficits in social information processing. It has been suggested that the urban environment affects the neural mechanisms for social stress processing, including the amygdala (Lederbogen et al., 2011). Increased sensitivity to social stress (negative feedback) is a key characteristic of psychosis and may further contribute to problems during social interactions (Myin-Germeys et al., 2005). Additionally, city living was associated with altered activation and modulation of brain regions involved in reward processing (Krämer et al., 2017). This functional magnetic resonance imaging (fMRI) study investigates if reduced trust in patients with psychotic disorder is associated with urban upbringing.
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