Stress and Vulnerability: A Developing Model for Suicidal Risk

Abstract

A large body of research built over the last few decades examines the interaction between stressful events and vulnerability traits to explain how a person becomes suicidal. This stress-diathesis model has been extremely fruitful to improve our understanding of suicidal behavior, but recent findings suggest that interactions could be more complex than expected. Indeed, environmental insults during pregnancy, childhood, or adolescence induce neurodevelopmental changes that increase the vulnerability for suicidal behavior in later life. In this chapter, we will outline the significance of recent neurodevelopmental findings for the stressvulnerability factors of suicidal behavior. The coherence and applicability of an integrative neurodevelopmental model of suicidal behavior will be discussed in the light of current research concerning genetics, neuroimaging, and neuropsychology, and the new classification systems. IntroductionDespite treatment and prevention advances on major psychiatric disorders, suicidal behavior still constitutes a major public health problem. Research into this behavior has increased exponentially during the last decade, and a complex network of factors, both predisposing and triggering the suicidal acts, is being unraveled. This dynamic network connects mental disorders, life experiences, social and familial interactions, physical illness, and neurobiology into what is known as the suicidal process. However, until a deeper understanding of the relationships between these factors is developed, crucial issues such as yielding an accurate prediction of future suicidal acts or determining the best treatment for suicidal patients remain distant.

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“…Within the framework of this model, experiencing many and severe SLE during childhood and throughout life can have a very negative effect on people with a trait‐like diathesis—a predisposition or persistent vulnerability, which can be described in psychological or biological terms—or susceptibility to suicidal behaviour. Lopez‐Castroman, Olié, and Courtet () point out that environmental insults during pregnancy, childhood, or adolescence induce neurodevelopmental changes that increase the vulnerability for suicidal behaviour in later life.…”

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“…Based on our expected findings, we will overcome two major limitations of relevant theories, such as (a) underspecified relationships among the constructs and (b) clinical implication to develop theory‐driven interventions through rigorously designed, descriptive longitudinal research (Millner et al, 2020 ). The stress‐vulnerability model is very simple, but it is the best one to achieve these goals between research and practice, as recommended by a previous study (Lopez‐Castroman et al, 2014 ).…”