Diathesis-Stress Model (Definition + Examples)

At the center of many theories in social psychology is the nature/nurture debate. Do we develop a certain personality and make certain choices because it’s in our nature? Or do our experiences alone shape who we become and how we look at the world?  I want to look at one particular model that brings both factors into play. It’s called the Diathesis Stress Model (also known as the Stress-Vulnerability Model.) This takes genetics and personal experiences into account when assessing a person’s likelihood of developing mental disorders.

Diathesis stress model graph

What Is the Diathesis-Stress Model?

The diathesis-stress model is a theory about how stress and genetics play into the manifestation of different mental disorders and conditions. High stress and high predisposition significantly increase your risk of developing said disorders. But even high stress and low predisposition can increase your risk.

History of the Diathesis Stress Model

Mental disorders are not always easy to identify. It’s not easy to pinpoint a moment where a person “became depressed.” And the causes attributed to mental illnesses have caused some pretty dramatic treatments over time.

In Ancient Rome, for example, Hippocrates connected depression to an excess of “black bile” in the kidney or spleen. A physician named Asclepiades argued against these terms, saying that depression was caused by emotions of grief or hurt. Asclepiades was pretty close, but pretty soon, his theories were thrown out. For centuries after the Ancient Romans, mental disorders were linked to interaction with the devil. Some patients with mental disorders were burned at the stake.

Hippocrates, Creator of the Diathesis Stress Model

Fast-forward to 1977. At this point, psychologists and doctors believed that more natural factors played into the development of mental disorders. Could it be genes? Could it be emotions? Maybe trauma from childhood, like Freud theorized? What if a combination could explain a disorder like schizophrenia?

How Does the Diathesis-Stress Model Explain Schizophrenia?

 Joseph Zubin, a Lithuanian-American psychologist who specialized in the study of schizophrenia, believed that relapses could be predicted using a model. On one axis was diathesis, or vulnerability. On the other axis was stress. The right combination of low vulnerability and low stress could keep a person from relapsing or showing symptoms.

Zubin’s model, the Diathesis-Stress model, has since been adapted and applied to a range of mental disorders and conditions, including addiction or depression. Let’s go over what these factors mean and how it can help anyone to keep themselves in check.

The Diathesis-Stress Model Cup Analogy

Diathesis

The first part of this model is diathesis. In regards to the diathesis-stress model, “diathesis” is often used interchangeably with “vulnerability.” If someone is more vulnerable to a mental disorder, it might not take a lot of stress for symptoms to start appearing.

Think of this like a cup. In this analogy, diathesis is the marbles in the cup. Stress is water. A cup that is ¼ full of marbles will need quite a bit of water before it starts to spill over. If the cup is ¾ full of marbles, it won’t take that much water. This is how diathesis and stress works.

So what causes diathesis? A few factors may come into play here:

  • Genes or biology
  • Cognitive factors
  • Trauma or environmental stressors early in life
  • Situational factors (living with a parent with mental illness, living in a low-income household, etc.)

Not all of these things are “nature” in the way that they are genetic. But these factors tend to stay very present in a person’s life. If a person were able to move out of a low-income household into a more affluent situation, they may be less vulnerable to certain conditions. In general, it takes a lot to move these “marbles” out of a person’s cup. It might be impossible.

Stress

Stress

Now let’s talk about stress, or the “water” in the analogy I used earlier. When stress is piled onto a person’s life, they are more likely to be “triggered” and display symptoms of a mental disorder. Stressors may be things that are generally considered stressful:

  • Divorce
  • Death in the family
  • A global pandemic

Chronic illnesses or ongoing stressors may not be a one-time event, but may continue to “fill your cup.” Stressors don’t have to be traumatic or life-altering, either. The stress of graduating high school, studying for exams, or buying a home may also “fill your cup.”

At some point, too much stress can fill anyone’s cup. You do not have to be predisposed to a specific mental disorder to develop one. You do not have to have a family of addicts to become addicted to alcohol or drugs.

It’s important to note that diathesis can cause stress or vice versa. Growing up with the knowledge that a parent has bipolar disorder can be very stressful. That early stress may remain in the body and make a person generally more vulnerable. Without addressing the issue or seeking treatment, this process can continue to cause more and more stress and vulnerability.

Protective Factors

But what about someone who is predisposed to a specific mental disorder, has a lot of stress, but still manages to go about life without showing any major symptoms?

These people are probably shielded from certain “protective factors.”

In the past 20 years, the diathesis-stress model has been adapted to include these protective factors. You may hear this version of the model referred to as the “stress-vulnerability-protective factors model.” Stressors and diathesis are still present in this model.

Protective factors make stressors easier to handle. These factors may include:

  • A positive relationship with parents or children
  • A support group
  • Help from a counselor or therapist
  • Self-awareness or emotional intelligence
  • Understanding of stress management techniques
  • A good grasp on healthy coping mechanisms or emotional regulation

Example of the Diathesis-Stress Model

An addict, for example, may be predisposed to an addiction and face stress in their marriage and career. With the help of an AA or NA group, they may be able to face those stressors and overcome them without relapsing.

What Does This Mean?

The Diathesis-Stress Model can be used to assess anyone’s risk. But if you take away one lesson about this model, it’s that stress is dangerous. Stress can be hard to avoid, like during a global pandemic or during a tragedy that is out of your control. But if you notice that more stress is coming into your life, it’s especially important to assess what protective factors are present. Do you have positive relationships that can help you through a stressful time? Are your diet and daily routine contributing to stress, or protecting you from it? The more protective factors in your life, the more confident you can be in your health and minimize risks.

How to Reduce Stress and Protect Your Mental Health

Stress can feel inevitable. In some ways, it is. Everyone goes through tough times or worries about the future. But you do not have to let that stress control your life. Take action to reduce your stress and create a healthier environment for you and the people around you.

Where Does Stress Come From?

The feeling of being stressed – sweaty palms, a tight chest, etc. – is often the result of hormones entering your bloodstream. When the brain encounters something stressful, it tells the body to release cortisol, adrenaline, and other “stress” hormones. Hormones are chemical messengers. Hormones like cortisol or adrenaline send a specific message throughout the body: we are in danger.

Your brain doesn’t have to be in actual danger to send out these hormones. You might be in front of a grizzly bear or you might just be thinking about your crush rejecting you. The response from the brain is the same. Knowing this, you can manage stress in one of two ways: prevent situations from feeling as dire as being in front of a grizzly bear, or calm your body down when the hormones start to flow through the bloodstream.

Preventing Stress

Consider Your Diet and Exercise

Diet and exercise play a big role in the production and release of stress hormones. Don’t believe me? What if I told you that 95% of serotonin is produced in the gut? Our physical and mental health are tied tighter than many people realize. If you treat your body right, you will treat your mind right – and vice versa.

Sleep!

Getting eight hours of sleep won’t just help you grow big and strong. Sleep is part of the body’s circadian rhythm. This 24-hour cycle helps the body wake up and fall asleep through the release of – you guessed it – hormones. The body releases cortisol in the morning as you get up. Improper sleep schedules mess with the body’s intended cortisol production. This can lead to a myriad of health issues, including increased appetite and high blood pressure. One of the best things you can do for your physical and mental health is get proper sleep.

Setting Boundaries

Stress often comes from feeling overwhelmed. There are only 24 hours in a day. (And hopefully, you are spending around eight of those hours sleeping.) It is okay to say “no” to responsibilities, obligations, projects, or even vacations that feel like “too much.” The easiest way to handle a stressful schedule may just be to lighten it!

Handling Stress

Journaling

Take some time to write down how you are feeling. Journaling allows you to process your emotions using different parts of your brain. As you write, you might find that you gain a new perspective on your situation and what solutions you can implement. You do not have to spend a lot of time journaling each day. Just sit down for five minutes, write about what happened in your day, and see where your words take you.

Practice Mindful Meditation

Stress can become a nasty cycle. You experience stress, so you indulge in unhealthy habits to reduce stress, and then you stress about your unhealthy habits, and you become stressed again. Break that cycle by just sitting down, closing your eyes, and meditating. Mindfulness meditation doesn’t require you to take a vow of silence or chant mantras for hours a day. You can simply be mindful by pausing and being aware of your thoughts. As you become aware of your thoughts, you may find that you are working yourself up over something silly – certainly nothing to put you in danger. Sit, breathe deeply, and remind your body that you are not in danger. You may find that your jaw unclenches, your palms start sweating, and your tense muscles loosen!

Reach Out To Your Support Groups

Belonging is listed as one of Maslow’s Hierarchy of Needs. Humans feel the desire to be part of a group that supports them. Humans also want to support other humans! If you are feeling stressed, overwhelmed, or out of control, reach out to friends. Reach out to your family. Reach out to a support group of people who are going through similar things in life. Meetups for people going through grief, who have family members that are struggling with addiction, or who are addicts themselves can help you. Don’t let your stress turn into something more severe. Get help and take care of yourself.

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Theodore T.

Theodore is a professional psychology educator with over 10 years of experience creating educational content on the internet. PracticalPsychology started as a helpful collection of psychological articles to help other students, which has expanded to a Youtube channel with over 2,000,000 subscribers and an online website with 500+ posts.