The author presents basic concepts and knowledge concerning psychobiological mechanisms of stress involved in the pathogenesis of mental disorders, including the role of the hypothalamic – hypophyseal-adrenal axis, as well as of the dopaminergic and noradrenergic systems. Moreover, the notion of eustress and distress is introduced and a model of "predisposition – stress" is proposed as a general psychobiological model underlying the pathogenesis of mental disorders. (Ed.)
The application of the "predisposition – stress" concept in current approaches to the pathogenesis of schizophrenia is presented. An emphasis is laid on biological mechanisms of stress and on their effect both on schizophrenic episodes triggering and on therapeutic processes – as regards both pharmacological treatment and psychosocial interventions. (Ed.)
The findings of stress research conducted in the past decade, especially in the fields of neurobiology, neuro-endocrinology, pathophysiology, immunology and genetics, as well as determinants of PTSD and ASD diagnoses (in the DSM-IV and ICD-10), invalidate the traditional views on the nature of stress. Not only the so-called non-specific character of stress reaction may be regarded as doubtful, but also the division into psychological and physiological stress, or the existence of eustress (or "good stress"). The opinion becomes to prevail that there is one stress, and that its consequences are as much psychological as biological. Stress is a natural physiological reaction with pathological consequences, to which a more friendly psychological meaning is attributed.
Sources of stress in the first schizophrenic episode in adolescence are discussed, in relation to the various systems in which the young person is functioning – such as the family system, school and peer group. Changes in the CNS occurring in adolescence are also discussed as a specific biological stressor typical of this phase of the life cycle.
The role of psychological stress preceding the onset of a psychotic episode is outlined in the paper. Stress triggering a psychotic episode may not differ from the usual life events. However, in the individual's perception it may have very specific, personality-disintegrating features. The most frequent problems underlying these events are concerned with sexuality, aggressiveness, self-worth, and a specific attitude toward the relationship with people constituting a system of psychological support to the individual.
Research findings indicate that it is usually mothers who be or the major burden of care provision to the adult child with mental disorders. The author presents a number of concepts dealing with parental, especially maternal, subjective perspective on their child's illness: – the Milliken concept of parental role re-definition, the schematic representation of experience in mothers caring for their adult mentally ill child (according to Ryan), and the typology of care provision to the adult schizophrenic child proposed by Chelsa. (Ed.)
The author presents an analysis of the notion of assertiveness and its application in the daily life. Moreover, cues are given how to differentiate between assertiveness and other types of behaviour, frequently mistaken for the farmer.