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Diathesis Stress Model: 19 Examples Of Risk and Protective Factors

Although stress is an inevitable part of a person’s life, its effect differs for different people.

Some people develop a disorder when they face major environmental stressors, while others do not.

Scientists have been trying to find out and explain what causes the differences in outcomes.

The diathesis-stress model is one plausible explanation based on scientific understanding.

What is the diathesis-stress model?

The diathesis-stress model describes how the interaction of predisposition (diathesis) and stressful situations (stress) can trigger physical or mental health disorders. It is also known as the stress-vulnerability model or stress-diathesis model.

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What is diathesis?

Diathesis is a person’s predisposition or vulnerability to a medical condition, which can be a psychological or physical disorder. This concept was first used in psychiatry to study schizophrenia and later depression, bipolar disorder, and other disorders.

Predispositions can be inherited genetically​1​, created by environmental stressors early in life, or caused by the genetics x environment interaction (GxE) ​2​.

According to the diathesis-stress theory, stresses are more likely to result in physical or mental illnesses in someone predisposed to it than in someone without the disposition ​3​.

The Dual Risk Model

The diathesis-stress model is also known as the dual risk model​4​ because the effects of stress play two roles.

The origins of predisposition can be genetic or acquired after birth.

After birth, certain early life experiences can lower an individual’s threshold for developing mental disorders and allow subsequent stressors to trigger disorders more easily. Therefore, trauma and environmental risk factors in early life can increase the likelihood of predisposition in adulthood.

Stress, therefore, plays a dual role ​5​:

  • Early stress exerts a formative influence on children increasing their underlying vulnerability to disorders.
  • Later stress exerts a precipitating or triggering influence by activating the actual onset of the disorders.

Diathesis And Stress Interaction

According to the Diathesis-Stress Model, mental health problems can be triggered by the presence of both diatheses and stress.

This is a plausible explanation for why some people develop mental disorders when facing stressful life events while others don’t.

At first glance, this model suggests that diathesis and stress are two independent qualities that could exist independently without the other. In this early version of the Diathesis-Stress Model, the interaction between vulnerability and stress was clear-cut: Stress activated the diathesis, which in turn brought about the onset of mental illness ​6​.

But in recent years, researchers have discovered several ways diathesis and stress may interact and influence each other.

Diathesis Can Cause Stress

One possible interaction between diathesis and stress is that the underlying predisposition may cause or impact the experience of stress. An association exists between having certain vulnerabilities and incurring a high level of stress.

For instance, a genetic vulnerability may cause a person to cope with life in a way that creates a stressor that normal people without the trait will not experience.

The bidirectional influences can be seen in some individuals predisposed to depressive symptoms.

These individuals may exhibit irritability, fatigue, and social withdrawal. These symptoms can cause problems in their interpersonal relationships and employment​7​. If those issues end up causing the loss of a close relationship or job, those experiences become the stressors that catalyze the onset of major depressive disorder​5​.

In this scenario, stress is not just a random event but a consequence of vulnerability.

Another type of interaction is that vulnerabilities can alter a person’s perception of stress​8​.

For example, a vulnerable person may perceive an ordinary life event as highly stressful. The vulnerabilities essentially cause high levels of psychological distress. Less stress is required to trigger a disorder. For these people, a disease may develop even without experiencing extreme stress.

Stress Can Cause Diathesis

While diathesis can lead to stress, stress can also lead to diathesis. As previously discussed, environmental stress can cause a person to develop vulnerability.

In the depression scar hypothesis, the first episode of a person’s major depression may cause them to form negative thinking patterns. These new thinking patterns become the vulnerability and lead to the emergence of depression later when further stressful events are encountered​9​.

In recent years, psychologists have found another pathway for stressful events to create a biological vulnerability. They found that some environmental factors can modify gene expression through an epigenetic process.

Such modifications are independent of the genetic makeup of a person.

That means even if a person is not born with a predisposition in their genes, certain environmental components or social factors can still alter the person’s DNA to create a biological predisposition.

Diathesis Stress Model Examples

The diathesis stress theory is a complicated psychological theory that keeps evolving as scientists gather new information. Meanwhile, this model helps to explain why some people seem to have more resilience than others.

It clarifies the roles of biological and situational factors in the development of an illness. There is no longer a debate on nature-vs-nurture. Evidence shows that a combination of nature and nurture can cause disorders.

This approach in the framework consolidates existing studies on parenting, proving that parenting matters because parents can contribute to risk and protective factors.

Examples of Risk Factors

  1. punitive parenting style​10​
  2. overprotective parenting style
  3. childhood maltreatment
  4. physical or sexual abuse​11​
  5. being a young girl​12​
  6. family history of depression​13​
  7. domestic violence​14​
  8. community violence​15​
  9. witnessing violence​16​
  10. school bullying​14​
  11. life-threatening event
  12. the traumatic loss of a parent
  13. impulsive temperament

Examples of Protective Factors

Protective factors in early life likely buffer against the onset of disorders following negative events for vulnerable children. They include:

  1. warm, responsive parenting style​17​
  2. caring adults
  3. consistent care, structure, and supervision
  4. emotionally supportive environment​18​
  5. high self-esteem​19​
  6. less “adventurous” temperament​20​


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    Swearer SM, Hymel S. Understanding the psychology of bullying: Moving toward a social-ecological diathesis–stress model. American Psychologist. Published online 2015:344-353. doi:10.1037/a0038929
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    Solberg VSH, Carlstrom AH, Howard KAS, Jones JE. Classifying At-Risk High School Youth: The Influence of Exposure to Community Violence and Protective Factors on Academic and Health Outcomes. The Career Development Quarterly. Published online June 2007:313-327. doi:10.1002/j.2161-0045.2007.tb00086.x
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    Kochanska G, Kim S. Difficult temperament moderates links between maternal responsiveness and children’s compliance and behavior problems in low-income families. Journal of Child Psychology and Psychiatry. Published online October 11, 2012:323-332. doi:10.1111/jcpp.12002
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    Yeung R, Leadbeater B. Adults make a difference: the protective effects of parent and teacher emotional support on emotional and behavioral problems of peer-victimized adolescents. J Community Psychol. Published online January 2010:80-98. doi:10.1002/jcop.20353
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    DuBois DL, Flay BR. The Healthy Pursuit of Self-Esteem: Comment on and Alternative to the Crocker and Park (2004) Formulation. Psychological Bulletin. Published online May 2004:415-420. doi:10.1037/0033-2909.130.3.415
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    Rioux C, Castellanos-Ryan N, Parent S, Séguin JR. The interaction between temperament and the family environment in adolescent substance use and externalizing behaviors: Support for diathesis–stress or differential susceptibility? Developmental Review. Published online June 2016:117-150. doi:10.1016/j.dr.2016.03.003


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