Biological Trajectory for Psychosocial Risk Factors in Psychiatric Disorders—A Concept Based Review

DOI: 10.4236/ojpsych.2015.51002   PDF   HTML   XML   3,343 Downloads   4,079 Views  


Current understanding of mental disorders is based upon “biopsychosocial model”. Research also suggests what biological changes take place in a particular disorder as well as nature of risk which arises from psychological, social and environmental conditions. However it remains unclear how these psychosocial and environmental risk factors interact with biological factors which lead to clinical syndromes. This paper examines interrelationship of psychosocial and environmental risk and biological changes observed in mental disorders and tries to identify the possibility of a pathway of the psychopathology of psychiatric disorders. The review aims to demonstrate that significant advances in the fields of psychosocial, cultural, anthropological and neurobiological research provide novel insights into the etiology of mental disorders. There are neurochemical, functional and structural neurobiological, neurocognitive, immunological findings and findings from gene-environment interaction that appears promising. However these findings are in an isolated manner. Comprehensive studies examining major biological changes together in relation to psychosocial risk factors are lacking. Every individual reacts differently to the same environmental risk while there tends to be similarities in individual outcome in response to such stressors. The findings though robust independently, remain very preliminary to suggest a sequential trajectory for developing a clear pathway for pathogenesis. It is currently unclear whether there is a differential psychopathological impact of psychosocial stressors in different cultures despite the extensive variability both between and within major social groups and societies. Further research investigating modifiable and non-modifiable risk factors in context of prevailing socio-economic conditions is urgently needed to plan effective interventions.

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Shrivastava, A. , Boylan, J. , Bureau, Y. , Sousa, A. and Shah, N. (2015) Biological Trajectory for Psychosocial Risk Factors in Psychiatric Disorders—A Concept Based Review. Open Journal of Psychiatry, 5, 7-18. doi: 10.4236/ojpsych.2015.51002.

Conflicts of Interest

The authors declare no conflicts of interest.


[1] Bradshaw, C.P. and Garbarino, J. (2004) Social Cognition as a Mediator of the Influence of Family and Community Violence on Adolescent Development: Implications for Intervention. Annals of the New York Academy of Science, 1036, 85-105.
[2] Knafo, A. and Jaffee, S.R. (2013) Gene-Environment Correlation in Developmental Psychopathology. Development and Psychopathology, 25, 1-6.
[3] Patel, V. (2005) Social Origins, Biological Treatments: The Public Health Implications of Common Mental Health Disorders. Indian Journal of Psychiatry, 47, 15-20.
[4] Borges, S., Gayer-Anderson, C. and Mondelli, V. (2013) A Systematic Review of the Activity of the Hypothalamo-Pituitary-Adrenal Axis in First Episode Psychosis. Psychoneuroendocrinology, 38, 603-611.
[5] Radley, J.J., Kabbaj, M., Jacaobson, L., Heydendael, W., Yehuda, R. and Herman, J.P. (2011) Stress Risk Factors and Stress Related Pathology: Neuroplasticity, Epigenetics and Endophenotypes. Stress, 14, 481-497.
[6] Vogt, B. (2005) Pain and Emotion Interactions in the Subregions of the Cingulate Gyrus. Nature Review Neuroscience, 6, 533-544.
[7] McEwen, B.S. (2007) Physiology and Neurobiology of Stress and Adaptation: The Central Role of the Brain. Physiology Review, 87, 873-904.
[8] Kim, M.J., Loucks, R.A., Palmer, A.L., Brown, A.C., Solomon, K.M., Marchante, A.N. and Whalen, P.J. (2011) The Structural and Functional Connectivity of the Amygdala: From Normal Emotion to Pathological Anxiety. Behaviour and Brain Research, 223, 403-410.
[9] Shastri, P.C. (2013) Resilience: Building Immunity in Psychiatry. Indian Journal of Psychiatry, 55, 224-234.
[10] Olszewski, T.M. and Varrasse, J.F. (2005) The Neurobiology of PTSD: Implications for Nurses. Journal of Psychosocial Nursing and Mental Health Services, 43, 40-47.
[11] Rutter, M. (2012) Annual Research Review: Resilience and Its Clinical Implications. Journal of Child Psychology and Psychiatry, 54, 474-487.
[12] Feder, W.A., Cohen, H., Kim, J.J., Calderon, S., Charney, D.S. and Mathe, A.A. (2013) Understanding Resilience. Frontiers in Behavioral Neuroscience, 7, 10-19.
[13] Karatsoreos, I.N. and McEwen, B.S. (2013) The Neurology and Physiology of Resilience and Adaptation across the Life Course. Journal of Child Psychology and Psychiatry, 54, 337-347.
[14] Karatsoreos, I.N. and McEwen, B.S. (2011) Psychobiological Allostasis: Resistance, Resilience and Vulnerability. Trends in Cognitive Science, 15, 576-584.
[15] Vijaykumar, L. (2010) Indian Research on Suicide. Indian Journal of Psychiatry, 52, 291-296.
[16] Shrivastava, A.K., Johnston, M.E., Stitt, L., Thakar, M., Sakel, G., Iyer, S., Shah, N. and Bureau, Y. (2012) Reducing Treatment Delay for Early Intervention: Evaluation of a Community Based Crisis Helpline. Annals of General Psychiatry, 11, 11-20.
[17] Rutten, B.P.F., Hammels, C., Geschwind, N., Menne-Lothmann, C., Pishva, E., Schruers, K. and Wichers, M. (2013) Resilience in Mental Health: Linking Psychological and Neurobiological Perspectives. Acta Psychiatrica Scandanavica, 128, 3-20.
[18] Reiss, F. (2013) Socio-Economic Inequalities and Mental Health Problems in Children and Adolescents: A Systematic Review. Social Science and Medicine, 90, 24-31.
[19] Kumsta, R. and Heinrichs, M. (2013) Oxytocin, Stress and Social Behavior: Neurogenetics of the Human Oxytocin System. Current Opinion in Neurobiology, 23, 11-16.
[20] Hyde, L.W., Gorka, A., Manuck, S.B. and Hariri, A.R. (2011) Perceived Social Support Moderates the Link between Threat-Related Amygdala Reactivity and Trait Anxiety. Neuropsychologia, 49, 651-656.
[21] Lim, C., Chong, S.A. and Keefe, R. (2009) Psychosocial Factors in the Neurobiology of Schizophrenia: A Selective Review. Annals of the Academy of Medicine Singapore, 38, 402-406.
[22] Fisher, M.P. and Elnitsky, C. (2012) Health and Social Services Integration: A Review of Concepts and Models. Social Work and Public Health, 27, 441-468.
[23] Roberts, B. and Browne, J. (2011) A Systematic Review of Factors Influencing the Psychological Health of Conflict Affected Populations in Low and Middle Income Countries. Global Public Health, 6, 814-829.
[24] Matthews, K.A. and Gallo, L.C. (2011) Psychological Perspectives on Pathways Linking Socioeconomic Status and Physical Health. Annual Review of Psychology, 62, 501-530.
[25] Bhugra, D. (2004) Migration and Mental Health. Acta Psychiatrica Scandanavica, 109, 243-258.
[26] Liz, Z., Page, A., Martin, G. and Taylor, R. (2011) Attributable Risk of Psychiatric and Socioeconomic Factors for Suicide from Individual Level Population Based Studies: A Systematic Review. Social Science and Medicine, 72, 608-616.
[27] Nurius, P.S., Uehara, E. and Zatzick, D.F. (2013) Intersection of Stress, Social Disadvantage, and Life Course Processes: Reframing Trauma and Mental Health. American Journal of Psychiatric Rehabilitation, 16, 91-114.
[28] Nikulina, V., Widom, C.S. and Czaja, S. (2011) The Role of Childhood Neglect and Childhood Poverty in Predicting Mental Health, Academic Achievement and Crime in Adulthood. American Journal of Community Psychology, 48, 309-321.
[29] Wong, C.C., Mill, J. and Fernandes, C. (2011) Drugs and Addiction: An Introduction to Epigenetics. Addiction, 106, 480-489.
[30] Noel, X., Brevers, D. and Bechara, A. (2013) A Neurocognitive Approach to Understanding the Neurobiology of Addiction. Current Opinion in Neurobiology, 23, 632-638.
[31] Crews, F.T. (2012) Immune Function Genes, Genetics, and the Neurobiology of Addiction. Alcohol Research and Current Reviews, 34, 355-361.
[32] Shrivastava, A., Johnston, M. and Tsuang, M. (2011) Cannabis Use and Cognitive Dysfunction. Indian Journal of Psychiatry, 53, 187-191.
[33] Weaver, L.J. and Headley, C. (2009) Moving beyond Hunger and Nutrition: A Systematic Review of the Evidence Linking Food Insecurity and Mental Health in Developing Countries. Ecology, Food and Nutrition, 48, 263-284.
[34] Karasu, S.R. (2013) Psychotherapy-Lite: Obesity and the Role of the Mental Health Practitioner. American Journal of Psychotherapy, 67, 3-22.
[35] de Souza, A.S., Fernandes, F.S. and Tavares do Carmo, M.D.G. (2011) Effects of Maternal Malnutrition and Postnatal Nutritional Rehabilitation on Brain Fatty Acids, Learning, and Memory. Nutrition Review, 69, 132-144.
[36] McLaughlin, K.A., Green, J.G., Gruber, M.J., Sampson, N.A., Zaslavsky, A.M. and Kessler, R.C. (2010) Childhood Adversities and Adult Psychiatric Disorders in the National Comorbidity Survey Replication II: Association and Persistence of DSM-IV Disorders. Archives of General Psychiatry, 67, 124-132.
[37] Gould, F., Clarke, J., Heim, C., Harvey, P.D., Majer, M. and Nemeroff, C.B. (2012) The Effects of Child Abuse and Neglect on Cognitive Functioning in Adulthood. Journal of Psychiatric Research, 46, 500-506.
[38] Varghese, S., Prasad, J.H. and Jacob, K.S. (2013) Domestic Violence as a Risk Factor for Infant and Child Mortality: A Community-Based Case-Control Study from Southern India. National Medical Journal of India, 26, 142-146.
[39] Norman, R.E., Byambaa, M., De, R., Butchart, A., Scott, J. and Vos, T. (2012) The Long Term Health Consequences of Child Physical Abuse, Emotional Abuse and Neglect: A Systematic Review and Meta-Analysis. PLoS Medicine, 9, e1001349.
[40] McCrory, E., De Brito, S.A. and Viding, E. (2012) The Link between Child Abuse and Psychopathology: A Review of Neurobiological and Genetic Research. Journal of the Royal Society of Medicine, 105, 151-156.
[41] Prakash, O. and Rao, T.S.S. (2010) Sexuality Research in India: An Update. Indian Journal of Psychiatry, 52, 260-263.
[42] Papachristou, E., Frangou, S. and Reichenberg, A. (2012) Expanding Conceptual Frameworks: Life Course Risk Modelling for Mental Disorders. Psychiatry Research, 12, 545-549.
[43] Keshavan, M.S., Shrivastava, A. and Gangadhar, B.N. (2010) Early Interventions in Psychotic Disorders: Challenges and Relevance in the Indian Context. Indian Journal of Psychiatry, 52, 153-158.
[44] Engel, G.L. (1977) The Need for a New Medical Model: A Challenge for Biomedicine. Science, 196, 129-136.
[45] Cassell, J. (1974) Psychosocial Processes and Stress: Theoretical Formulation. International Journal of Health Services, 4, 471-482.
[46] Monroe, S.M. and Simons, A.D. (1991) Diathesis-Stress Theories in the Context of Life Stress Research: Implications for Depressive Disorders. Psychological Bulletin, 110, 406-425.
[47] Belsky, J. and Pluess, M. (1998) Beyond Diathesis Stress: Differential Susceptibility to Environmental Influences. Psychological Bulletin, 135, 885-908.
[48] Keshavan, M.S., Tandon, R., Boutros, N.N. and Nasrallah, H.A. (2008) Schizophrenia “Just the Facts”: What We Know in 2008 Part 3: Neurobiology. Schizophrenia Research, 106, 89-107.
[49] Shrivastava, A. (2010) Prodromal Research: Public Health Initiatives for the Prevention of Schizophrenia. Indian Journal of Psychiatry, 52, 13-16.
[50] Markham, J.A. and Koenig, J.I. (2011) Prenatal Stress: Role in Psychotic and Depressive Diseases. Psychopharmacology (Berlin), 214, 89-106.
[51] Cho, K. (2001) Chronic Jet Lag Produces Temporal Lobe Atrophy and Spatial Cognitive Deficits. Nature Neuroscience, 4, 567-568.
[52] Mar, R.A. (2011) The Neural Bases of Social Cognition and Story Comprehension. Annual Review of Psychology, 62, 103-134.
[53] Ochsner, K.N. (2004) Current Directions in Social Cognitive Neuroscience. Current Opinion in Neurobiology, 14, 254-258.
[54] Ziauddeen, H., Dibben, C., Kipps, C., Hodges, J.R. and McKenna, P.J. (2011) Negative Schizophrenic Symptoms and the Frontal Lobe Syndrome: One and the Same? European Archives of Psychiatry and Clinical Neuroscience, 261, 59-67.
[55] McEwen, B.S. (2012) Brain on Stress: How the Social Environment Gets under the Skin. Proceedings of the National Academy of Sciences of the United States of America, 109, 17180-17185.
[56] Barrett, L., Henzi, P. and Rendall, D. (2007) Social Brains, Simple Minds: Does Social Complexity Really Require Cognitive Complexity? Philosophical Transactions of the Royal Society of London B: Biological Sciences, 29, 561-575.
[57] McEwen, B.S., Eiland, L., Hunter, R.G. and Miller, M.M. (2012) Stress and Anxiety: Structural Plasticity and Epigenetic Regulation as a Consequence of Stress. Neuropharmacology, 62, 3-12.
[58] Millan, M.J., Agid, Y., Brüne, M., Bullmore, E.T., Carter, C.S., Clayton, N.S. and Young, L.J. (2012) Cognitive Dysfunction in Psychiatric Disorders: Characteristics, Causes and the Quest for Improved Therapy. Nature Review Drug Discovery, 11, 141-168.
[59] Beck, A.T. and Dozois, D.J. (2011) Cognitive Therapy: Current Status and Future Directions. Annual Review of Medicine, 62, 397-409.
[60] Snitz, B.E., McDonald, A.W. and Carter, C.S. (2006) Cognitive Deficits in Unaffected First Degree Relatives of Schizophrenia Patients: A Meta Analytic Review of Putative Endophenotypes. Schizophrenia Bulletin, 32, 179-194.
[61] Disner, S.G., Beevers, D.G., Haigh, E.A. and Beck, A.T. (2011) Neural Mechanisms of the Cognitive Model of Depression. Nature Review Neuroscience, 12, 467-477.
[62] Clarke, T.K., Nymberg, C. and Schumann, G. (2012) Genetic and Environmental Determinants of Stress Responding. Alcohol Research, 24, 484-494.
[63] Curtis, A.L., Leiser, S.C., Snyder, K. and Valentino, R.J. (2012) Predator Stress Engages Corticotropin-Releasing Factor and Opioid Systems to Alter the Operating Mode of Locus Coeruleus Norepinephrine Neurons. Neuropharmacology, 62, 1737-1745.
[64] Bangasser, D.A., Reyes, B.A.S., Piel, D., Garachh, V., Zhang, X.Y., Plona, Z.M. and Valentino, R.J. (2013) Increased Vulnerability of the Brain Norepinephrine System of Females to Corticotropin-Releasing Factor Overexpression. Molecular Psychiatry, 18, 166-173.
[65] Baumann, N. and Turpin, J.C. (2010) The Neurochemistry of Stress: An Overview. Neurochemistry Research, 35, 1875-1879.
[66] Kaufman, J., Plotsky, P.M., Nemeroff, C.B. and Charney, D.S. (2000) Effects of Early Adverse Experiences on Brain Structure and Function: Clinical Implications. Biological Psychiatry, 48, 778-790.
[67] Gayle, D.A., Beloosesky, R., Desai, M., Amidi, F., Nunez, S.E. and Ross, M.G. (2004) Maternal LPS Induces Cytokines in the Amniotic Fluid and Corticotrophin Releasing Hormone in the Fetal Rat Brain. American Journal of Physiology, 286, 1024-1029.
[68] Blackmore, S.J. and Robbins, T.W. (2012) Decision Making in the Adolescent Brain. Nature Neuroscience, 15, 1184-1191.
[69] Tanti, A. and Belzung, C. (2013) Neurogenesis along the Septo-Temporal Axis of the Hippocampus: Are Depression and the Action of Antidepressants Region-Specific? Neuroscience, 252, 234-252.
[70] Heim, C. and Nemeroff, C.B. (2001) The Role of Childhood Trauma in the Neurobiology of Mood and Anxiety Disorders: Preclinical and Clinical Studies. Biological Psychiatry, 49, 1023-1039.
[71] Chen, Y., Brunson, K.L., Adelmann, G., Bender, R.A., Frotscher, M. and Baram, T.Z. (2004) Hippocampal Corticotrophin Releasing Hormone: Pre and Post Synaptic Location and Release by Stress. Neuroscience, 126, 533-540.
[72] Mahgoub, M. and Monteggia, L.M. (2013) Epigenetics and Psychiatry. Neurotherapeutics, 10, 734-741.
[73] Kas, M.J., Krishnan, V., Gould, T.D., Collier, D.A., Olivier, B., Lesch, K.P. and Castrén, E. (2011) Advances in Multidisciplinary and Cross-Species Approaches to Examine the Neurobiology of Psychiatric Disorders. European Neuropsychopharmacology, 21, 532-544.
[74] Flint, J. and Munafo, M.R. (2007) The Endophenotype Concept in Psychiatric Genetics. Psychological Medicine, 37, 163-180.
[75] Abdolmaleky, H.M., Smith, C.L., Faraone, S.V., Shafa, R., Stone, W., Glatt, S.J. and Tsuang, M.T. (2004) Methylomics in Psychiatry: Modulation of Gene Environmental Factors May Be through DNA Methylation. American Journal of Medical Genetics, 127B, 51-59.
[76] Kato, T. (2009) Epigenomics in Psychiatry. Neuropsychobiology, 60, 2-4.
[77] Bredy, T.Y., Sun, Y.E. and Kobor, M.S. (2010) How the Epigenome Contributes to the Development of Psychiatric Disorders. Developmental Psychobiology, 52, 331-342.
[78] Wiers, C.E. (2012) Methylation and the Human Brain: Towards a New Discipline of Imaging Epigenetics. European Archives of Psychiatry and Clinical Neuroscience, 262, 271-273.
[79] Fernando, S. (2012) Race and Culture Issues in Mental Health and Some Thoughts on Ethnic Identity. Counseling Psychology Quarterly, 25, 113-123.
[80] Pyari, T.T., Kutty, R.V. and Sarma, P.S. (2012) Risk Factors in Post Traumatic Stress Disorder Survivors in Kanyakumari District in Tamil Nadu. Indian Journal of Psychiatry, 54, 48-53.
[81] Shrivastava, M.K., Sahoo, R.N., Ghotekar, L.H., Dutta, S., Danabalan, M., Dutta, T.K. and Das, A.K. (2004) Risk Factors Associated with Attempted Suicide: A Case Control Study. Indian Journal of Psychiatry, 46, 33-38.

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