The Stress-Vulnerability Model of Schizophrenia: A Conceptual Analysis and Selective Review

The stress-vulnerability model of schizophrenia is contemporary psychiatry's common explanation of how the symptoms of schizophrenia develop and evolve over time. Although the model has variants, its fundamental tenets are that the onset and course of schizophrenia result from a person's vulnerability, usually argued to be genetic, in conjunction with sufficient stress, as experienced by that person. In this paper, we conduct a conceptual analysis and selective review of problems of the stress-vulnerability model of schizophrenia as currently formulated, and we argue that the model is not sufficiently helpful – appearances to the contrary – so long as these problems are not addressed. These conceptual problems involve the subjectivity of stress, the non-specificity of vulnerability, and the unclear distinction between stress and vulnerability. We suggest solutions to these problems, and in conclusion we generalize our findings, arguing that such problems can be resolved by general methodological considerations.