On the Brink of Disaster
Vulnerability to Mental Disorders
Keywords:
psychiatry, vulnerability, at-risk statesAbstract
The notions of at-risk and subthreshold conditions are increasingly discussed in psychiatry to describe mild, brief, or otherwise atypical syndromes that fail to meet the criteria for clinical relevance. However, the concept of vulnerability is still underexplored in philosophy of psychiatry. This article discusses psychiatric vulnerability to clarify some conceptual issues about the various factors contributing to vulnerability, the notions of risk and protection, and the idea that there are multiple ways of crossing the threshold to clinical relevance. My goal is to lay the groundwork for a finer-grained discussion on psychiatric vulnerability that reflects the complex nature of mental conditions and illustrates the kind of thinking needed in clinical practice.
References
Ajnakina, Olesya, Anthony S. David, and Robin M. Murray. 2019. “‘At Risk Mental State’ Clinics for Psychosis—an Idea Whose Time Has Come—and Gone!” Psychological Medicine 49, no. 4: 529–534. https://doi.org/10.1017/s0033291718003859.
Ajnakina, Olesya, Craig Morgan, Charlotte Gayer-Anderson, Sherifat Oduola, François Bourque, Sally Bramley, Jessica Williamson et al. 2017. “Only a Small Proportion of Patients with First Episode Psychosis Come via Prodromal Services: A Retrospective Survey of a Large UK Mental Health Programme.” BMC Psychiatry 17, no. 1: 1–9. https://doi.org/10.1186/s12888-017-1468-y.
Allen, Woody, dir. 1972. Play It Again Sam. Los Angeles: Paramount Pictures.
Allsopp, Kate, John Read, Rhiannon Corcoran, and Peter Kinderman. 2019. “Heterogeneity in Psychiatric Diagnostic Classification.” Psychiatry Research 279: 15–22. https://doi.org/10.1016/j.psychres.2019.07.005.
Bandura, Albert. 1997. Self‐Efficacy: The Exercise of Control. New York: W.H. Freeman & Company.
Barrett, Terry R. and Jane B. Etheridge. 1992. “Verbal Hallucinations in Normals, I: People Who Hear ‘Voices’.” Applied Cognitive Psychology 6, no. 5: 379–387. https://doi.org/10.1002/acp.2350060503.
Berg, Akiah O., Ingrid Melle, Jan Ivar Rossberg, Kristin Lie Romm, Sara Larsson, Trine V. Lagerberg, Ole A. Andreassen, and Edvard Hauff. 2011. “Perceived Discrimination Is Associated with Severity of Positive and Depression-Anxiety Symptoms in Immigrants with Psychosis: A Cross-Sectional Study.” BioMed Central Psychiatry 11: 77–86. https://doi.org/10.1186/1471-244X-11-77.
Bluhm, Robyn. 2012. “Vulnerability, Health, and Illness.” International Journal of Feminist Approaches to Bioethics 5, no. 2: 147–161. https://doi.org/10.2979/intjfemappbio.5.2.147.
Boldt, Joachim. 2019. “The Concept of Vulnerability in Medical Ethics and Philosophy.” Philosophy, Ethics, and Humanities in Medicine 14, no. 1: 1–8. https://doi.org/10.1186/s13010-019-0075-6.
Bolton, Derek. 2008. What Is Mental Disorder? An Essay in Philosophy, Science, and Values. Oxford: Oxford University Press.
Bourque, François, Elsje van der Ven, and Ashok Malla. 2011. “A Meta-analysis of the Risk for Psychotic Disorders among First- and Second-Generation Immigrants.” Psychological Medicine 41, no. 5: 897–910. https://doi.org/10.1017/s0033291710001406.
Broome, Matthew R., James B. Woolley, Louise C. Johns, Lucia R. Valmaggia, Paul Tabraham, Rafael Gafoor, Elvira Bramon, and Philip K. McGuire. 2005. “Outreach and Support in South London (OASIS): Implementation of a Clinical Service for Prodromal Psychosis and the At-Risk Mental State.” European Psychiatry 20, no. 5–6: 372–378. https://doi.org/10.1016/j.eurpsy.2005.03.001.
Cantor-Graae, Elizabeth and Jean-Paul Selten. 2005. “Schizophrenia and Migration: A Meta-analysis and Review.” American Journal of Psychiatry 162, no. 1: 12–24. https://doi.org/10.1176/appi.ajp.162.1.12.
Cassel, Tricia D., Daniel S. Messinger, Lisa V. Ibanez, John D. Haltigan, Susan I. Acosta, and Albert C. Buchman. 2007. “Early Social and Emotional Communication in the Infant Siblings of Children with Autism Spectrum Disorders: An Examination of the Broad Phenotype.” Journal of Autism and Developmental Disorders 37, no. 1: 122–132. https://doi.org/10.1007/s10803-006-0337-1.
Castelnovo, Anna, Simone Cavallotti, Orsola Gambini, and Armando D’Agostino. 2015. “Post-bereavement Hallucinatory Experiences: A Critical Overview of Population and Clinical Studies.” Journal of Affective Disorders 186: 266–274. https://doi.org/10.1016/j.jad.2015.07.032.
Clark, Beth and Nina Preto. 2018. “Exploring the Concept of Vulnerability in Health Care.” CMAJ 190, no. 11: E308–E309. https://doi.org/10.1503/cmaj.180242.
Collip, Dina, Inez Myin-Germeys, and Jim van Os. 2008. “Does the Concept of ‘Sensitization’ Provide a Plausible Mechanism for the Putative Link between the Environment and Schizophrenia?” Schizophrenia Bulletin 34, no. 2: 220–225. https://doi.org/10.1093/schbul/sbm163.
Constantino, John N., Clara Lajonchere, Marin Lutz, Teddi Gray, Anna Abbacchi, Kathleen McKenna, Deepti Singh, and Richard D. Todd. 2006. “Autistic Social Impairment in the Siblings of Children with Pervasive Developmental Disorders.” American Journal of Psychiatry 163, no. 2: 294–296. https://doi.org/10.1176/appi.ajp.163.2.294.
Craft, Lynette L. and Frank M. Perna. 2004. “The Benefits of Exercise for the Clinically Depressed.” Primary Care Companion to the Journal of Clinical Psychiatry 6, no. 3: 104–111. https://dx.doi.org/10.4088%2Fpcc.v06n0301.
Drożdżowicz, Anna. 2021. “Epistemic Injustice in Psychiatric Practice: Epistemic Duties and the Phenomenological Approach.” Journal of Medical Ethics. https://doi.org/10.1136/medethics-2020-106679.
Fairbrother, Nichole and Sheila R. Woody. 2008. “New Mothers’ Thoughts of Harm Related to the Newborn.” Archives of Women’s Mental Health 11, no. 3: 221–229. https://doi.org/10.1007/s00737-008-0016-7.
Fearon, Paul, James B. Kirkbride, Craig Morgan, Paola Dazzan, Kevin Morgan, Tuhina Lloyd, Gerard Hutchinson et al. 2006. “Incidence of Schizophrenia and Other Psychoses in Ethnic Minority Groups: Results from the MRC AESOP Study.” Psychological Medicine 36, no. 11: 1541–1550. https://doi.org/10.1017/s0033291706008774.
Foucault, Michel. 1961. Madness and Civilization: A History of Insanity in the Age of Reason. New York: Vintage.
Freud, Sigmund. 1905. “Jokes and Their Relation to the Unconscious.” In The Standard Edition of the Complete Psychological Works of Sigmund Freud, Vol. 8, edited and translated by James Strachey, 237–245. London: Hogarth.
———. 1913. “The Disposition to Obsessional Neurosis.” In The Standard Edition of the Complete Psychological Works of Sigmund Freud, Vol. 12, edited and translated by James Strachey, 313–327. London: Hogarth.
———. 1924. “Neurosis and Psychosis.” In The Standard Edition of the Complete Psychological Works of Sigmund Freud, Vol. 19, edited and translated by James Strachey, 149–156. London: Hogarth.
———. 1926. “Inhibitions, Symptoms and Anxiety. In The Standard Edition of the Complete Psychological Works of Sigmund Freud, Vol. 20, edited and translated by James Strachey, 77–178. New York: W.W. Norton & Company.
———. 1939. “Moses and Monotheism.” In The Standard Edition of the Complete Psychological Works of Sigmund Freud, Vol. 23, edited and translated by James Strachey, 1–38. London: Hogarth.
Fulford, K.W.M. 1989. Moral Theory and Medical Practice. Cambridge: Cambridge University Press.
Fusar-Poli, Paolo, Stefan Borgwardt, Andreas Bechdolf, Jean Addington, Anita Riecher-Rössler, Frauke Schultze-Lutter, Matcheri Keshavan et al. 2013. “The Psychosis High-Risk State: A Comprehensive State-of-the-Art Review.” JAMA Psychiatry 70, no. 1: 107–120. https://doi.org/10.1001/jamapsychiatry.2013.269.
Fusar-Poli, P., G. Rutigliano, D. Stahl, C. Davies, A. de Micheli, V. Ramella-Cravaro, I. Bonoldi, and P. McGuire. 2016. “Long-Term Validity of the At Risk Mental State (ARMS) for Predicting Psychotic and Non-psychotic Mental Disorders.” European Psychiatry 42: 49–54. https://doi.org/10.1016/j.eurpsy.2016.11.010.
Gilson, Erinn. 2011. “Vulnerability, Ignorance, and Oppression.” Hypatia 26, no. 2: 308–332. https://doi.org/10.1111/j.1527-2001.2010.01158.x.
Goldberg, L.R. 1990. “An Alternative Description of Personality: The Big-Five Factor Structure.” Journal of Personality and Social Psychology 59, no. 6: 1216–1229. https://doi.org/10.1037//0022-3514.59.6.1216.
Gross, James J. 2002. “Emotion Regulation: Affective, Cognitive, and Social Consequences.” Psychophysiology 39, no. 3: 281–291. https://doi.org/10.1017/s0048577201393198.
Hardy, Carter. 2020. “Humor and Sympathy in Medical Practice.” Medicine, Health Care and Philosophy 23, no. 2: 179–190. https://dx.doi.org/10.1007%2Fs11019-019-09928-0.
Horwitz, Alan V. and Jerome C. Wakefield. 2007. The Loss of Sadness: How Psychiatry Transformed Normal Sorrow into Depressive Disorder. New York: Oxford University Press.
Johns, Louise C., Kristiina Kompus, Melissa Connell, Clara Humpston, Tania M. Lincoln, Eleanor Longden, Antonio Preti et al. 2014. “Auditory Verbal Hallucinations in Persons with and without a Need for Care.” Schizophrenia Bulletin 40, suppl. 4: S255–S264. https://doi.org/10.1093/schbul/sbu005.
Johns, Louise C. and Jim van Os. 2001. “The Continuity of Psychotic Experiences in The General Population.” Clinical Psychology Review 21, no. 8: 1125–1141. https://doi.org/10.1016/S0272-7358(01)00103-9.
Jones, Simon R. and Charles Fernyhough. 2007. “A New Look at the Neural Diathesis–Stress Model of Schizophrenia: The Primacy of Social-Evaluative and Uncontrollable Situations.” Schizophrenia Bulletin 33, no. 5: 1171–1177. https://doi.org/10.1093/schbul/sbl058.
Kessler, Ronald C. 2003. “Epidemiology of Women and Depression.” Journal of Affective Disorders 74, no. 1: 5–13. https://doi.org/10.1016/s0165-0327(02)00426-3.
Killmister, Suzy. 2015. “The Woody Allen Puzzle: How ‘Authentic Alienation’ Complicates Autonomy.” Noûs 49, no. 4: 729–747. https://doi.org/10.1111/nous.12069.
Kingma, Elselijn. 2017. “Disease as Scientific and as Value-Laden Concept.” In Handbook of the Philosophy of Medicine, edited by T. Schramme and S. Edwards, 45–63. Dordrecht: Springer. https://doi.org/10.1007/978-94-017-8688-1_75.
Kirkbride, James B., Craig Morgan, Paul Fearon, Paola Dazzan, Robin M. Murray, and Peter B. Jones. 2007. “Neighbourhood-Level Effects on Psychoses: Re-examining the Role of Context.” Psychological Medicine 37, no. 10: 1413–1425. http://dx.doi.org/10.1017/S0033291707000499.
Kottow, Michael H. 2003. “The Vulnerable and the Susceptible.” Bioethics 17, no. 5–6: 460–471. https://doi.org/10.1111/1467-8519.00361.
Lazarus, Richard S. 1991. “Cognition and Motivation in Emotion.” American Psychologist 46, no. 4: 352–367. https://doi.org/10.1037//0003-066x.46.4.352.
Lazarus, Richard S. and Susan Folkman. 1984. Stress, Appraisal, and Coping. New York: Springer.
Lewis-Fernández, Roberto and Lawrence J. Kirmayer. 2019. “Cultural Concepts of Distress and Psychiatric Disorders: Understanding Symptom Experience and Expression in Context.” Transcultural Psychiatry 56, no. 4: 786–803. https://doi.org/10.1177/1363461519861795.
Maj, Mario. 2011. “When Does Depression Become a Mental Disorder?” British Journal of Psychiatry 199, no. 2: 85–86. https://doi.org/10.1192/bjp.bp.110.089094.
McGorry, Patrick D., Ian B. Hickie, Alison R. Yung, Christos Pantelis, and Henry J. Jackson. 2006. “Clinical Staging of Psychiatric Disorders: A Heuristic Framework for Choosing Earlier, Safer and More Effective Interventions.” Australian & New Zealand Journal of Psychiatry 40, no. 8: 616–622. https://doi.org/10.1080/j.1440-1614.2006.01860.x.
McGorry, Patrick D., Barnaby Nelson, Sherilyn Goldstone, and Alison R. Yung. 2010. “Clinical Staging: A Heuristic and Practical Strategy for New Research and Better Health and Social Outcomes for Psychotic and Related Mood Disorders.” Canadian Journal of Psychiatry 55, no. 8: 486–497. https://doi.org/10.1177/070674371005500803.
Merin, Noah, Gregory S. Young, Sally Ozonoff, and Sally J. Rogers. 2007. “Visual Fixation Patterns during Reciprocal Social Interaction Distinguish a Subgroup of 6-Month-Old Infants At-Risk for Autism from Comparison Infants.” Journal of Autism and Developmental Disorders 37, no. 1: 108–121. https://doi.org/10.1007/s10803-006-0342-4.
Misra, Supriya, Bizu Gelaye, David R. Williams, Karestan C. Koenen, Christina P.C. Borba, Diego Quattrone, Marta di Forti et al. 2021. “Perceived Major Experiences of Discrimination, Ethnic Group, and Risk of Psychosis in a Six-Country Case-Control Study.” Psychological Medicine: 1–9. https://doi.org/10.1017/s0033291721000453.
Modinos, Gemma, P. Allen, Marianna Frascarelli, Stefania Tognin, Lucia Rita Valmaggia, Lida-Alkisti Xenaki, Paul Keedwell et al. 2014. “Are We Really Mapping Psychosis Risk? Neuroanatomical Signature of Affective Disorders in Subjects at Ultra High Risk.” Psychological Medicine 44, no. 16: 1–11. http://dx.doi.org/10.1017/S0033291714000865.
Murphy, Dominic. 2006. Psychiatry in the Scientific Image. Cambridge, MA: The MIT Press.
Murray, Robin M., Anthony S. David, and Olesya Ajnakina. 2021. “Prevention of Psychosis: Moving On from the At-Risk Mental State to Universal Primary Prevention.” Psychological Medicine 51, no. 2: 223–227. https://doi.org/10.1017/s003329172000313x.
Nolen-Hoeksema, Susan, Blair E. Wisco, and Sonja Lyubomirsky. 2008. “Rethinking Rumination.” Perspectives on Psychological Science 3, no. 5: 400–424. https://doi.org/10.1111/j.1745-6924.2008.00088.x.
Nordenfelt, Lennart. 2007. “The Concepts of Health and Illness Revisited.” Medicine, Health Care and Philosophy 10, no. 1: 5–10. https://doi.org/10.1007/s11019-006-9017-3.
Ormel, Johan and Jan Neeleman. 2001. “Towards a Dynamic Stress-Vulnerability Model of Depression.” In Where Inner and Outer Worlds Meet: Psychosocial Research in the Tradition of George W. Brown, edited by Tirril Harris, 151–170. London: Routledge.
Parkes, Colin Murray. 1972. Bereavement: Studies of Grief in Adult Life. London: Tavistock Publications.
Plath, Sylvia. 1963. The Bell Jar. London: Faber & Faber.
Posey, Thomas B. and Mary E. Losch. 1983. “Auditory Hallucinations of Hearing Voices in 375 Normal Subjects.” Imagination, Cognition and Personality 3, no. 2: 99–113. https://doi.org/10.2190%2F74V5-HNXN-JEY5-DG7W.
Powell, Russell and Eric Scarffe. 2019. “Rethinking ‘Disease’: A Fresh Diagnosis and a New Philosophical Treatment.” Journal of Medical Ethics 45, no. 9: 579–588. http://doi.org/10.1136/medethics-2019-105465.
Presmanes, Alison G., Tedra A. Walden, Wendy L. Stone, and Paul J. Yoder. 2007. “Effects of Different Attentional Cues on Responding to Joint Attention in Younger Siblings of Children with Autism Spectrum Disorders.” Journal of Autism and Developmental Disorders 37, no. 1: 133–144. https://doi.org/10.1007/s10803-006-0338-0.
Rees, W. Dewi. 1971. “The Hallucinations of Widowhood.” British Medical Journal 4, no. 5778: 37–41. https://dx.doi.org/10.1136%2Fbmj.4.5778.37.
Riecher-Rössler, Anna and Erich Studerus. 2017. “Prediction of Conversion to Psychosis in Individuals with an At-Risk Mental State: A Brief Update on Recent Developments.” Current Opinion in Psychiatry 30, no. 3: 209–219. https://doi.org/10.1097/yco.0000000000000320.
Rutter, Michael. 1985. “Resilience in the Face of Adversity: Protective Factors and Resistance to Psychiatric Disorder.” British Journal of Psychiatry 147, no. 6: 598–611. https://doi.org/10.1192/bjp.147.6.598.
Saks, Elyn R. 2007. The Center Cannot Hold: My Journey through Madness. London: Hachette Books.
Schreber, Daniel Paul. 1903. Memoirs of My Nervous Illness. New York: New York Review of Books.
Serpico, Davide. 2020. “Beyond Quantitative and Qualitative Traits: Three Telling Cases in the Life Sciences.” Biology & Philosophy 35, no. 3: 1–26. https://doi.org/10.1007/s10539-020-09750-6.
Shedler, Jonathan. 2010. “The Efficacy of Psychodynamic Psychotherapy.” American Psychologist 65, no. 2: 98–109. https://doi.org/10.1037/a0018378.
Styron, William. 1991. Darkness Visible. New York: Random House.
Sucksmith, Ed, Ilona Roth, and Rosa Anna Hoekstra. 2011. “Autistic Traits below the Clinical Threshold: Re-examining the Broader Autism Phenotype in the 21st Century.” Neuropsychology Review 21, no. 4: 360–389. https://doi.org/10.1007/s11065-011-9183-9.
Szasz, Thomas S. 1960. “The Myth of Mental Illness.” American Psychologist 15, no. 2: 113–118. https://doi/10.1037/h0046535.
Tate, Andrew James Miller. 2019. “Contributory Injustice in Psychiatry.” Journal of Medical Ethics 45, no. 2: 97–100. https://dx.doi.org/10.1136%2Fmedethics-2018-104761.
Tavaglione, Nicolas, Angela K. Martin, Nathalie Mezger, Sophie Durieux‐Paillard, Anne François, Yves Jackson, and Samia A. Hurst. 2015. “Fleshing Out Vulnerability.” Bioethics 29, no. 2: 98–107. https://doi.org/10.1111/bioe.12065.
Travaglia, Joanne and Hamish Robertson. 2013. “Why Vulnerability Matters More Than Risk.” https://www.academia.edu/5846341/Why_vulnerability_matters_more_than_risk.
Turner, R. Jay and William R. Avison. 2003. “Status Variations in Stress Exposure: Implications for the Interpretation of Research on Race, Socioeconomic Status, and Gender.” Journal of Health and Social Behavior 44, no. 4: 488–505. https://doi.org/10.2307/1519795.
Turner, R. Jay and Donald A. Lloyd. 1999. “The Stress Process and the Social Distribution of Depression.” Journal of Health and Social Behavior 40, no. 4: 374–404. https://doi.org/10.2307/2676332.
Van den Bergh, Omer, Jos Brosschot, Hugo Critchley, Julian F. Thayer, and Cristina Ottaviani. 2020. “Better Safe than Sorry: A Common Signature of General Vulnerability for Psychopathology.” Perspectives on Psychological Science. https://doi.org/10.1177%2F1745691620950690.
Van Os, Jim. 2013. “The Dynamics of Subthreshold Psychopathology: Implications for Diagnosis and Treatment.” American Journal of Psychiatry 170, no. 7: 695–698. https://doi.org/10.1176/appi.ajp.2013.13040474.
Van Os, J., R.J. Linscott, I. Myin-Germeys, P. Delespaul, and L.J.P.M. Krabbendam. 2009. “A Systematic Review and Meta-analysis of the Psychosis Continuum: Evidence for a Psychosis Proneness-Persistence-Impairment Model of Psychotic Disorder.” Psychological Medicine 39, no. 2: 179–195. https://doi.org/10.1017/s0033291708003814.
Veling, Wim, Ezra Susser, Jim van Os, Johan P. Mackenbach, Jean-Paul Selten, and Hans W. Hoek. 2008. “Ethnic Density of Neighborhoods and Incidence of Psychotic Disorders among Immigrants.” American Journal of Psychiatry 165, no. 1: 66–73. https://doi.org/10.1176/appi.ajp.2007.07030423.
Vetter, Barbara. 2014. “Dispositions without Conditionals.” Mind 123, no. 489: 129–156. http://dx.doi.org/10.1093/mind/fzu032.
Williams, J.B. and R.L. Spitzer. 1982. “Research Diagnostic Criteria and DSM-III: An Annotated Comparison.” Archives of General Psychiatry 39, no. 11: 1283–1289. https://doi.org/10.1001/archpsyc.1982.04290110039007.
World Health Organization. 1992. The ICD-10 Classification of Mental and Behavioural Disorders: Clinical Descriptions and Diagnostic Guidelines. Geneva: World Health Organization.
Zachar, Peter, Michael B. First, and Kenneth S. Kendler. 2017. “The Bereavement Exclusion Debate in the DSM-5: A History.” Clinical Psychological Science 5, no. 5: 890–906. https://doi.org/10.1177%2F2167702617711284.
Zubin, Joseph and Bonnie Spring. 1977. “Vulnerability: A New View of Schizophrenia.” Journal of Abnormal Psychology 86, no. 2: 103–126. https://doi.org/10.1037//0021-843x.86.2.103.
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Funding data
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Ministerio de Ciencia, Innovación y Universidades
Grant numbers postdoctoral fellowship FJC2018-036191-I -
Agencia Estatal de Investigación
Grant numbers PGC2018-093464-B-I00 -
Eusko Jaurlaritza
Grant numbers IT1396-19 -
Euskal Herriko Unibertsitatea
Grant numbers GIU18/221