A vulnerability-stress framework for evaluating clinical interventions in schizophrenia.

Symptom management and prevention of psychotic relapse are major treatment concerns in schizophrenia. Research shows a relationship between psychotic symptom levels and several intrapersonal, interpersonal, and environmental factors. These determinants are incorporated into an etiologic causal model of psychotic symptoms based on a vulnerability-stress framework. Then a multifaceted intervention model to influence symptom determinants is advanced, and examples of intervention elements are specified. Finally, a research agenda to evaluate the effectiveness of the intervention model is described, and related methodologic issues are considered.