Diathesis stress model

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Effects of changing loads via a development of susceptibility
Resilience depending on susceptibility

The diathesis stress model (also: vulnerability stress model) is a paradigm in clinical psychology and health psychology . It describes the interactions between diathesis ( tendency to illness) and stress . The central assumption is that both factors are necessary for the development of a mental disorder. The model is not restricted to a specific school and combines biological and psychological factors with environmental influences .

description

Under diathesis refers to the susceptibility ( disposition ) for a particular disease. This disposition can be genetic ( biological diathesis ) or learning history ( psycho-social diathesis ) and is understood as a person's tendency to react in a certain way to stress. Among the stressors is meant stressful environmental events or situations. If the loads (disposition and stressors) are too great and if they exceed a certain threshold, symptoms develop or an outbreak of disease occurs. However, this threshold is also influenced by risk and protective factors (e.g. social support).

Various authors adopted the vulnerability-stress model to explain the multifactorial psycho-socio-biological development of schizophrenia . According to this, people at risk of schizophrenia are characterized by a lack of resilience (i.e. a particular vulnerability, sensitivity or “thin skin”) which, in the worst case, in combination with stressful life history, situational-social or physical-hormonal stress , can lead to the outbreak of psychosis . (See also: double bond theory .)

Findings from research

Research results regularly show the multifactorial development of mental illnesses. Genetically determined neurobiological or biographically acquired predispositions alone usually do not explain the development of mental illnesses. Scientific evidence of psychosocial triggers exists for most mental disorders.

The influence of psychosocial stress on the hypothalamus-pituitary-adrenal cortex axis (HHNA) has been repeatedly demonstrated. The HHNA is made responsible, among other things, for the regulation of the neurotransmitter balance in the brain .

Advantages and disadvantages of the model

Advantages:

  • The diathesis stress model is able to represent complex and multifactorial causes
  • The stressors or the loads they cause can vary between and intra-individually
  • Different courses can be mapped within the model

Disadvantage:

  • This model, too, is far from providing a comprehensive explanation
  • No statement is made about the weighting of the individual factors
  • There is also no illustration of how the individual factors interact with one another

Individual evidence

  1. ^ A b Hans-Ulrich Wittchen : Clinical Psychology & Psychotherapy . Springer, 2011, ISBN 978-3-642-13017-5 , chap. 2 , p. 21-23, 833 f . ( limited preview in Google Book search).
  2. ↑ SA collar: Estrés y Psicosos. In: Vertex. Revista Argentina de Psiquiatría. Vol. 13, Suplemento 1, 2002, ISSN  0327-6139 , pp. 12-16, PMID 12122422 .
  3. ↑ KN Thompson, LJ Phillips, P. Komesaroff, HP Yuen, SJ Wood, C. Pantelis, D. Velakoulis, AR Yung, PD McGorry: Stress and HPA-axis functioning in young people at ultra high risk for psychosis. In: Journal of Psychiatric Research. Vol. 40, No. 7, 2007, ISSN  0022-3956 , pp. 561-569, doi : 10.1016 / j.jpsychires.2006.05.010 , PMID 16831447 .
  4. ↑ Gregory E. Miller, Edith Chen, Eric S. Zhou: If it goes up, must it come down? Chronic stress and the hypothalamic-pituitary-adrenocortical axis in humans. In: Psychological Bulletin. Vol. 133, No. 1, 2007, ISSN  0033-2909 , pp. 25-45, doi : 10.1037 / 0033-2909.133.1.25 , PMID 17201569 .