I'm currently looking at the aetiology of different mental disorders. I find it the basic model of aetiology (Margraf & Scheider, 2009) quite useful. It distinguishes between predisposing, precipitating and maintaining factors. But how clearcut is this distinction?
For example in individuals with schizophrenia it was found that they have an altered brain structure (Olabi et al., 2011) and a abnormal amount of neurotransmitter (-receptors) (Howes, McCrutcheon & Stone, 2015). But are these factors accountable for predisposing those individuals or should they be considered maintaining factors?
This is the model we were taught in school and it is a good organizational model but. like all models, it is theoretical. In real life, nothing is clear cut. The direction of correlates cannot be assumed - Mostly everything is bidirectional.
Mary V. Seeman thanks for your quick reply! I know it's never just one or the other. But especially in the case of Olabi et al., (2011), who found an altered brain structure even within high risk individuals who did not reach the diagnosis of schizophrenia, this can be more counted towards predisposing risk factors.
Howes, McCrutcheon and Stone's (2015) findings on glutamate and dopamine however could be included in both predisposing or maintaining factors, I guess.
The following literature may be useful to you.
https://link.springer.com/referenceworkentry/10.1007/978-3-319-16999-6_800-1
As Mary Seeman above pointed out, in psychiatry it is often difficult to pigeon-hole any given factor into those categories. For instance, structural or neurochemical changes in the brain could be genetically determined pre-existing conditions or a result of episodes of illness itself. Sometimes these categories are more clear cut -- a person could have strong genetic loading for alcohol use disorders (predisposing), a trauma that leads to the initiation of heavy use (precipitating), and a residence where alcohol is easily available and/or where other housemates are using (sustaining.)
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