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PRS-SCZ and ES-SCZ were calculated to assess cumulative genetic and environmental (childhood adversity, cannabis use, hearing impairment, and winter births) risk for schizophrenia, respectively. The primary outcome was past-month distressing PEs at the 3-year follow-up. Secondary outcomes included distressing PEs across four yearly assessments: lifetime (\u2265\u20091 wave), repeated (\u2265\u20092 or \u2265\u20093 waves), and persisting (\u2265\u20094 waves). Sex-stratified multilevel logistic regression models were used to test the independent and joint associations of binary modes (&gt;\u200975th percentile) of PRS-SCZ (PRS-SCZ\n                      <jats:sub>75<\/jats:sub>\n                      ) and ES-SCZ (ES-SCZ\n                      <jats:sub>75<\/jats:sub>\n                      ) on the outcomes. As sensitivity analysis, the sex-stratified analyses were repeated on a randomly selected unrelated sample, and the coefficients of males and females were compared.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      PRS-SCZ\n                      <jats:sub>75<\/jats:sub>\n                      was not associated with past-month distressing PEs in either sex but significantly associated with lifetime and repeated (\u2265\u20092 waves) distressing PEs only in females. In both sexes, ES-SCZ\n                      <jats:sub>75<\/jats:sub>\n                      was significantly associated with all PE outcomes but did not additively interact with PRS-SCZ\n                      <jats:sub>75<\/jats:sub>\n                      in predicting them. Sensitivity analysis confirmed the findings and revealed a significant sex difference in the association between PRS-SCZ\n                      <jats:sub>75<\/jats:sub>\n                      and lifetime distressing PEs.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>The influence of genomic risk for schizophrenia on distressing PEs might be sex-dependent, whereas that of the exposomic risk was universal in early adolescence. Further studies in larger samples are needed.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s00737-025-01644-4","type":"journal-article","created":{"date-parts":[[2026,1,6]],"date-time":"2026-01-06T07:12:23Z","timestamp":1767683543000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Sex differences in the independent and combined effects of genomic and exposomic risks for schizophrenia on distressing psychotic experiences: insights from the ABCD study"],"prefix":"10.1007","volume":"29","author":[{"given":"Thanavadee","family":"Prachason","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Angelo","family":"Arias-Magnasco","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bochao Danae","family":"Lin","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jim","family":"van Os","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bart P. 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