4 P's formation

Question 1

What are predisposing factors

Answer 1

Predisposing (causes vulnerability)
Usually (distal causal factors) -early life, can also be proximal (before occurrence of symptoms)

Biological - Brain injury
Low dopamine
Low or high serotonin
Sex hormones
Neurodevelopmental disorder - ASD

Psychological - Abuse
Rejection
Abandonment
Insecure / fearful attachment
Neglect

Social - Early parental divorce, unstable home life, history of trauma
Unstable home life
Parental divorce
Trauma
Peer rejection

Question 2

Precipitating factors

Answer 2

Before the occurrence of symptoms
Could also be identified as Trigger symptom

Biological - Substance use
Paradoxical effects of psychotropic medication
Recent brain injury

Psychological - Escalation of fantasies
Fantasies no longer satisfying
Inability to control impulses
Escalating anger, vengefulness

Social - LOSS:
Job
Home
Income
Relationship
Environmental instability

Question 3

What do perpetuating factors do

Answer 3

help or aid in maintenance of symptoms - prevents client from recovering

Biological - Current dose of sertraline is subtherapeutic
Ongoing alcohol use

Psychological - Her lack of adaptive coping mechanisms resulted in using self-harm to cope
Additionally, the lack of coping mechanisms leading to intense thoughts of suicide

Social - Ongoing discord in her romantic relationship Ongoing financial difficulties

Question 4

influences that modifies response to environmental stressors, making it less likely that the person will experience adverse symptoms

Answer 4

Protective factors

Biological - Medically healthy

Psychological - Previously responded well to DBT
History of being psychologically-minded and insightful
University educated

Social - Good interpersonal support from her best friend who brought her to hospital.
Has a psychiatrist that she sees every month