The Stress Vulnerability Model

The stress vulnerability model was proposed by Zubin and Spring (1977).It proposes that an individual has unique biological, psychological and social elements. These elements include strengths and vulnerabilities for dealing with stress.

In the diagram above person “a” has a very low vulnerability and consequently can withstand a huge amount of stress, however solitary confinement may stress the person so much that they experience psychotic symptoms. This is seen as a “normal” reaction. Person “b” in the diagram has a higher vulnerability, due to genetic predisposition for example. Person “c” also has genetic loading but also suffered the loss of mother before the age of 11 and was traumatically abused. Therefore persons “a” and “b” take more stress to become “ill”.

This model is obviously simplistic. However it does unite different approaches to psychosis. Vulnerability is not a judgmental term but an attempt to understand the variables involved. A much more sophisticated model is that of Nuechterlein and Dawson (1984).

Increasing coping skills or altering environmental factors (family, work, finance, housing etc.) and judicious use of anti-psychotic medication can reduce vulnerability and build resilience. Attending the hearing Voices group may help to build self-efficacy, self-esteem and self-acceptance all of which may be protective against relapse and forms a buffer to demoralisation (Davidson, 1999). It gives hope!