DIATHESIS STRESS AND BIOPSYCHOSOCIAL : INTEGRATIVE PARADIGMS:
THE DIATHESIS-STRESS PARADIGM:
diathesis-stress: links biological, psychological and environmental factors.
focuses on the interaction between a predisposition toward disease – the diathesis – and environmental, or
life, disturbances – the stress. Diathesis refers most precisely to a constitutional predisposition toward illness,
but the term may be extended to any characteristic or set of characteristics that increases a person’s chance of
developing a disorder.
Possessing the disorder increases a person’s risk of developing it but does not guarantee that the disorder will
develop. IT is the stress part of diathesis-stress that accounts for how a diathesis may be translated into an
psychopathology is unlikely to result from any single factor.
A genetically transmitted diathesis may be necessary for some disorders, but it is embedded in a network of
other factors that also play a part.
THE BIOPSYCHOSOCIAL PARADIGM:
biopsychosocial paradigm: biological, psychological, and social factors are conceptualized as different levels
of analysis or subsystems within the paradigm. FIGURE 2.9
The actual variables and the degree of influence of the variables from the different domains typically differ
from disorder to disorder.
Protection from risk factors, or the ability to bounce back in the face of adversity, is referred to as resilience.
Protective factors can occur within the individual (eg, perseverance and courage in a child who suffers
poverty; the ability to think and act independently in an adolescent whose parent is diagnosed with a psychiatric
disorder) but can also reside in the environment (e.g, a close relationship with one parent, support from a caring
TABLE 2.2 p.65, 2.3.
A history of maltreatment in childhood is acknowledged as a consistent and strong predictor of subsequent
A provocative study of maltreatment and subsequent aggression found that maltreated and subsequent
aggression found that maltreated children with a genotype conferring high levels of monoamine oxidase A
(MAO-A) were substantially less likely to display anti-social behaviour as adults. This is a classic example of a
Psychosocial factors: Socio-economic status And Poverty:
extreme poverty and low socio-economic status (SES) confer risk for increased rates of mental illness.
This is a tricky issue to some extent because profound mental illness . This is a tricky issue to some extent
because profound mental illness can limit socio-economic opportunities, so it is important, wherever possible,
to examine the role of SES in longitudinal research that can establish that low SES preceded the onset of mental
Further, SES might be closely related to relevant “third variables”, including job status, education, perceived
stress, neighbourhood violence and crime, social support, psysical health...
Children with higher SES have less severe internalizing and externalizing mental health symptoms. Different
etiological pathways were identified for those with low vs high SES backgrounds.
The key factor for those with low SES was chronic maternal stress during the child’s infancy. The key factor for those from a high SES was a parental history of depression along with a family history of
Cuttrona et al focused on how a poor neighbourhood escalates levels of depression. They iden