Stress-Vulnerability Model — MRCPsych Paper B MCQ

Correct answer: A — Psychotic relapse occurs when stress interacts with personal vulnerability, while protective factors can alter the threshold.

Explanation lettering: B = shown as A · E = shown as B · D = shown as C · A = shown as D · C = shown as E

B is correct. The model proposes that psychotic relapse is neither produced by stress alone nor predetermined by genes. Each person has a level of vulnerability influenced by genetic, neurodevelopmental and experiential factors. Environmental or internal stressors can precipitate symptoms when their combined effect exceeds that person's threshold. Protective factors, including effective antipsychotic treatment, family intervention, coping or recovery skills and supportive environments, can raise the threshold or reduce stress. A and D wrongly make stress or life events sufficient by themselves. C ignores environmental contributions and the potential for modification. E is incorrect because the model is explicitly used to formulate psychosis and schizophrenia and to support collaborative psychoeducation and relapse-prevention planning.

Reference: Lecomte T, Potvin S, Samson C, et al. Predicting and preventing symptom onset and relapse in schizophrenia—A metareview of current empirical evidence. Journal of Abnormal Psychology. 2019;128(8):840–854. https://pubmed.ncbi.nlm.nih.gov/31343181/