29. Schizophrenia and Psychosocial Stresses

  1. Daniel R. Weinberger MD3 and
  2. Paul J. Harrison MA, BM, BCh, DM(Oxon), FRCPsych4
  1. Paul E. Bebbington MA, PhD, FRCP, FRCPsych1 and
  2. Elizabeth Kuipers BSc, MSc, PhD, FBPsS2

Published Online: 8 MAR 2011

DOI: 10.1002/9781444327298.ch29

Schizophrenia, Third Edition

Schizophrenia, Third Edition

How to Cite

Bebbington, P. E. and Kuipers, E. (2010) Schizophrenia and Psychosocial Stresses, in Schizophrenia, Third Edition (eds D. R. Weinberger and P. J. Harrison), Wiley-Blackwell, Oxford, UK. doi: 10.1002/9781444327298.ch29

Editor Information

  1. 3

    Genes, Cognition and Psychosis Program, Clinical Studies Section, Clinical Brain Disorders Branch, National Institute of Health, Bethesda, MD, USA

  2. 4

    Department of Psychiatry, University of Oxford, Warneford Hospital, Oxford, UK

Author Information

  1. 1

    University College London, London, UK

  2. 2

    Institute of Psychiatry, King's College London, London, UK

Publication History

  1. Published Online: 8 MAR 2011
  2. Published Print: 10 DEC 2010

ISBN Information

Print ISBN: 9781405176972

Online ISBN: 9781444327298



  • schizophrenia;
  • psychosis;
  • life events;
  • expressed emotion;
  • trauma;
  • sexual abuse;
  • PTSD;
  • cognitive model


It is now accepted that schizophrenia is the end result of a complex interplay between biological and psychosocial influences. This chapter summarizes recent evidence for the role of psychosocial stress in the origination of schizophrenia and the mechanisms underlying it. We review the evidence for the effect of stressful family environments, life events, and early and severe trauma. The relationship between trauma, PTSD and psychosis is used to triangulate the effects of stress. We set out the evidence for an increased vulnerability to stress in schizophrenia. Putative behavioral, psychological, and biological mechanisms for the effect of stress and severe trauma, and for increased vulnerability are described. The evidence is placed in the context of modern social–cognitive models of schizophrenia and of the conceptualization of schizophrenia as one end of a set of continuously distributed phenomena.