Stress and schizophrenia: some definitional issues

Abstract

This article discusses definitional ambiguities in research on the role of stress in the etiology of schizophrenia. Implications of the change to DSM-III criteria are considered, as is the question of whether prior research samples have overincluded acute schizophrenics. It is suggested that the problem of defining schizophrenia's time of onset is one of the thorniest in this literature. Three different operational definitions of stress are examined. Stress may be considered a response involving disruption in homeostasis, or as a stimulus with objectively specifiable properties. Stress is also defined interactionally with reference to characteristics of the individual and the surrounding life context. Relative merits of the three definitions are evaluated, and an attempt is made to clarify the differentiation between formative and triggering effects of stress. Further study of the impact of remote life events on vulnerability is encouraged.