The vulnerability/stress model of schizophrenic relapse: a longitudinal study
Abstract
A tentative model for conceptualizing the interplay of vulnerability factors, stressors, and protective factors in the course of schizophrenia is discussed. A study of the initial years after a first schizophrenic episode is testing the predictive role of key factors. During an initial 1‐year period of depot antipsychotic medication, independent life events and expressed emotion were found to predict the likelihood of psychotic relapse. Initial analyses indicate that independent life events play less of a role in relapse prediction during a medication‐free period. These results suggest that maintenance antipsychotic medication raises the threshold for return of psychotic symptoms, such that relapses are less likely unless major environmental stressors occur. A low expressed emotion environment may be a protective factor.
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No trials evaluated several psychosocial interventions shown effective in high-income countries, including wellness promotion, vocational rehabilitation, and cognitive remediation.
“Lastly, no trials were found that evaluated a number of types of psychosocial interventions shown to be effective in high-income countries, such as wellness promotion,50 vocational rehabilitation51 and cognitive remediation.52,53”
From Effect of psychosocial interventions on social functioning in depression and schizophrenia: meta-analysis (2013) · cites this paper as [52]
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Stress-reactivity in psychosis: Evidence for an affective pathway to psychosis
Myin-Germeys, I., & van Os, J. (2007) · Clinical Psychology Review · doi:10.1016/j.cpr.2006.09.005 · Cited by 719 · see citing works
Alvarez-Jimenez, M., Priede, A., Hetrick, S. E., Bendall, S., Killackey, E., Parker, A. G., McGorry, P. D., & Gleeson, J. F. (2012) · Schizophrenia Research · doi:10.1016/j.schres.2012.05.007 · Cited by 511 · see citing works
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- Authors
- Nuechterlein, K. H., Dawson, M. E., Ventura, J., Gitlin, M., Subotnik, K. L., Snyder, K. S., Mintz, J., & Bartzokis, G.
- Affiliations
- University of California, Los Angeles (US)
- University of Southern California (US)
- Corresponding author
- Nuechterlein, K. H.
- Venue
- Acta Psychiatrica Scandinavica
- Publisher
- Wiley
- Published
- 1994-09
- Volume
- 89
- Issue
- s382
- Pages
- 58-64
- ISSN
- 0001-690X (ISSN-L)
- 1600-0447
- OpenAlex
- W2019144775
- Cited by
- 196
- References
- 1
- Citations by year
- 2025: 2 · 2024: 4 · 2023: 3 · 2022: 4 · 2021: 2 · 2020: 5 · 2019: 6 · 2018: 3 · 2017: 7 · 2016: 5 · 2015: 7 · 2014: 5 · 2013: 12 · 2012: 8
- FWCI
- 2.69
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Acta Psychiatrica Scandinavica (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Schizophrenia research and treatment
- Social Sciences › Psychology › Clinical Psychology › Family Caregiving in Mental Illness
- Social Sciences › Arts and Humanities › Philosophy › Mental Health and Psychiatry
- Keywords
- schizophrenia, psychotic relapse, vulnerability-stress model, protective factors, expressed emotion, recurrence prediction, environmental stressors
- MeSH terms
- Adult, Chronic Disease, Emotions, Female, Humans, Life Change Events, Longitudinal Studies, Male, Models, Psychological, Prospective Studies, Recurrence, Risk Factors, Schizophrenia, Social Environment, Stress, Psychological, Multivariate Analysis
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