The permeable boundary between biological and psychological processes in the origins of psychosis

Abstract

In 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.