Lukoff D, Snyder K, Ventura J, Nuechterlein K H
Schizophr Bull. 1984;10(2):258-92. doi: 10.1093/schbul/10.2.258.
Recent studies have isolated some socioenvironmental factors that seem to predict the onset of schizophrenic episodes in vulnerable persons. In particular, stressful life events have been found to cluster in the 3- to 4- week period preceding a schizophrenic episode in some patients. Many persons with a schizophrenic disorder also seem to contribute to additional stressful life change events--for example, by high geographic mobility--thereby playing an active role in precipitating the onset of illness episodes. Within the family environment, hostile, critical, and emotionally overinvolved attitudes toward the patient by relatives have been found to be related to relapses. Irregularities in the communication style of parents also predict the subsequent development of schizophrenia spectrum disorders among disturbed adolescents. Many schizophrenic patients also seem to be deficient in the coping skills required to remediate the losses brought on by life events or to deal effectively with stressful relatives. Thus, they may experience greater and more prolonged stress than most others due partially to inadequate social and problem-solving skills and less supportive social networks. These findings have important implications for the design of clinical interventions as well as the development of a comprehensive vulnerability/stress model for the course of schizophrenic disorders.
最近的研究已经分离出一些社会环境因素，这些因素似乎可以预测易患精神分裂症的人群中精神分裂症发作的开始。特别是，在一些患者中，应激性生活事件被发现在精神分裂症发作前的3至4周内聚集。许多患有精神分裂症的人似乎也会导致额外的应激性生活变化事件，例如，由于频繁的地域迁移，从而在促使疾病发作方面发挥积极作用。在家庭环境中，亲属对患者的敌意、批评和情感过度投入的态度已被发现与复发有关。父母沟通方式的不规则也预示着受困扰青少年中精神分裂症谱系障碍的后续发展。许多精神分裂症患者似乎也缺乏应对生活事件带来的损失或有效应对压力大的亲属所需的应对技能。因此，他们可能会比大多数其他人经历更大、更持久的压力，部分原因是社交和解决问题的技能不足以及社会支持网络较少。这些发现对临床干预措施的设计以及精神分裂症病程的综合易感性/压力模型的开发具有重要意义。
