This commentary describes the factors that influenced my scientific perspective in research on psychosis.
•An experience working with a patient who was a member of a discordant monozygotic twin-pair was the initial impetus.
•This set the stage for my view of etiology as involving interactions among pre-existing vulnerabilities and exposure to adversity.
•This view was elucidated in a neural diathesis-stress model that assumes neuromaturational processes moderate the expression of adverse exposures on the expression of vulnerabilities.
•Future research challenges include illuminating genetic and environmental determinants of vulnerability and specifying the neurobiological pathways.
AbstractIn this commentary, I describe the factors that influenced my scientific perspective and methods.
Initially, the impetus for my interest in psychosis was the life story of a schizophrenia patient who was a member of a discordant monozygotic twin-pair. This set the stage for viewing the etiology of schizophrenia and other psychoses as involving complex interactions between pre-existing vulnerabilities and exogenous factors. Over time, this crystalized in a neural diathesis-stress model that assumes neuromaturationally-moderated effects of adverse exposures on the expression of congenital vulnerabilities. Challenging issues for future research include identifying the genetic and environmental determinants of vulnerability and the neurobiological pathways mediating the effects of exposure to adversity.
KeywordsSchizophrenia
Diathesis-stress
Genetic
Nature/nurture
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