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Time to abandon the bio-bio-bio model of psychosis: Exploring the epigenetic and psychological mechanisms by which adverse life events lead to psychotic symptoms

Published online by Cambridge University Press:  11 April 2011

John Read ,
Richard P. Bentall  and
Roar Fosse
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Abstract

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Mental health services and research have been dominated for several decades by a rather simplistic, reductionistic focus on biological phenomena, with minimal consideration of the social context within which genes and brains inevitably operate. This ‘medical model’ ideology, enthusiastically supported by the pharmaceutical industry, has been particularly powerful in the field of psychosis, where it has led to unjustified and damaging pessimism about recovery. The failure to find robust evidence of a genetic predisposition for psychosis in general, or ‘schizophrenia’ in particular, can be understood in terms of recently developed knowledge about how epigenetic processes turn gene transcription on and off through mechanisms that are highly influenced by the individual's socio-environmental experiences. To understand the emerging evidence of the relationship between adverse childhood events and subsequent psychosis, it is necessary to integrate these epigenetic processes, especially those involving the stress regulating functions of the HPA axis, with research about the psychological mechanisms by which specific types of childhood trauma can lead to specific types of psychotic experiences. The implications, for research, mental health services and primary prevention, are profound.

Declaration of Interest: None of the authors have any conflicts of interest in relation to this paper.

Keywords

sexual abuse in childhoodpsychosismechanism of psychiatric symptoms
Type
Editorials
Information
Epidemiology and Psychiatric Sciences , Volume 18 , Issue 4 , December 2009 , pp. 299 - 310
Copyright
Copyright © Cambridge University Press 2010

References

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