Diathesis–stress model

The diathesis-stress model is a psychological explanation for mental health conditions and psychological disorders, which proposes that these conditions and disorders result when a person with a preexisting physical factor is exposed to some form of emotional or physical stress. In other words, it suggests that disorders result from both a person's genetic makeup and the environment. According to the model, conditions such as depression, anxiety, obsessive-compulsive disorder, and schizophrenia are caused by this interplay between nature and nurture. It is also thought to be a factor in suicide. The model is sometimes criticized as being too limited in scope. Some experts note that these conditions result from several factors and may be caused by a few cumulative stressors, not just one.

Background

The diathesis-stress model originated in the 1960s. It was proposed by American psychologist Paul Meehl as an explanation for the development of schizophrenia. It arose as a variation of the biophysical and biopsychological models that preceded it.

Conceptions of mental health conditions and psychological disorders have evolved significantly over time. Centuries ago, conditions that modern people see as mental health conditions and psychological disorders were often thought to be the result of demonic possession, witchcraft, or punishment from a divine being. Only a few cultures, including the Greeks and some Islamic countries, accepted mental disorders in the same way as any physical condition. It was not until the eighteenth century that more people began to reconsider attitudes toward those with mental health issues. In the nineteenth century, physicians recognized that some physical conditions—most notably syphilis—could cause mental health problems.

This realization led to a biological model of psychological conditions. The biological model holds that all mental health problems result from a physical or biochemical disorder. Over the next century, several other models were developed to explain how mental health conditions and psychological disorders developed. These included the psychoanalytical model, which said that internal conflicts from past experiences caused mental health conditions and psychological disorders; the cognitive-behavioral model, which attributes mental health issues to learning abnormal ways of thinking and acting; and the biopsychosocial model, which states that mental health conditions and psychological disorders result from a combination of genetic, psychological, and social issues.

The word diathesis comes from the Greek diatithenai, which means "to arrange." The Greeks used the word diathesis to refer to a disposition. The word has been used since the seventeenth century to refer to a predisposition to, or a vulnerability to develop or have, a particular medical condition.

Overview

According to the diathesis-stress model, a person develops a mental health condition or psychological disorder because of a combination of two factors. These factors are something in a person's genetic makeup that makes them vulnerable to developing a condition and a physical or emotional stress that triggers it. The model's reliance on a combination of two factors has sometimes led to its being called the dual-risk model.

Researchers have observed that certain mental health conditions and psychological disorders tend to run in families. A person whose parents, siblings, or other close relatives have schizophrenia, depression, bipolar disorder, autism spectrum disorder, and a number of other mental health conditions and psychological disorders are more likely to develop the same condition. It is believed that certain genetic mutations may create a vulnerability, or predispose other members of the family to develop the same condition. This is called a diathesis.

However, researchers also have noted that the presence of a mental health condition or psychological disorder in a person's family is not a guarantee that every member of the family will develop one. Studies of identical twins who were not raised together have shown that while an identical twin whose sibling has a mental health condition is more likely to develop a condition than the overall population, even these twins will not automatically have the same disorders.

The diathesis-stress model says that it is exposure to some form of stress added to a genetic predisposition that leads to the development of a mental health condition. These stress triggers may arise from a single incident, such as the death of a loved one, or ongoing problems, such as an unpleasant work situation. The stress can come from an emotional source, such as the loss of a job, or from a physical source, such as chronic pain or dealing with a serious illness.

Under the diathesis-stress model, the stress needs to have occurred within one year prior to the development of the mental health issue to be considered a factor. For example, a physical or sexual assault that occurred six months earlier would be seen as a triggering event, but if the same abuse occurred during childhood several decades earlier, it would not be seen as having an effect on the recent development of depression. This is one of the key differences between this model and other models that deal with stress as a trigger or cause of mental health problems.

Not all experts consider this model inclusive enough to address the causes of mental health conditions and psychological disorders. Some psychologists note that people have different thresholds or levels of acceptance of stress. For some, a single stressful incident can trigger the onset of a mental condition. Others do not develop a problem until an accumulation of stress occurs. For instance, losing a home to a natural disaster may cause one person to become deeply depressed, while another person may be able to weather the loss of the home, financial difficulties, and a divorce before signs of depression develop. The model does not address either of these potential disparities.

On the other hand, a person who has no genetic predisposition to mental health conditions and psychological disorders can still develop one. Many experts believe that other factors, such as how people view their life circumstances, obstacles, setbacks, and the amount of social and family support they receive, also play a role in the development of mental disorders. The diathesis-stress model does not address any of these potential factors in the development of mental health conditions.

Bibliography

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