Kristy has a diagnosis of bipolar disorder that is well controlled despite historical childhood trauma. She holds a job and is a busy mother. During a stressful recent visit from her parents, she exhibits mania and seeks some assistance. Kristy is experiencing which component of the Stress-Vulnerability/Coping-Competence Model?

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The stress-vulnerability/coping-competence model was proposed in the 1980s to explain the occurrence and reoccurrence of psychiatric symptoms (Liberman, 1988). According to this model, increased stress in susceptible individuals can intensify symptoms and trigger a crisis (Liberman, 1988). Unfortunately, the singular application of the model's stress-vulnerability dimension resulted in people with SMI being advised by service providers to avoid engaging in activities that could potentially challenge their adaptive capabilities (Krupa et al., 2009). The pervasive disregard of this model's coping-competence dimension erroneously classified persons with SMI as fragile. This myopic perspective and the resulting harmful advice dissuaded many from pursuing meaningful activities and desired occupations, contributing to occupational disruption and deprivation (Krupa et al., 2009).
Multiple factors can contribute to a person's vulnerability. These include genetics and trauma; neurological, biological, and cognitive impairments; and physical, developmental, and substance use disorders (SAMHSA, 2010a). A lack of opportunities during childhood and adolescence to develop psychosocial skills and performance competencies can increase susceptibility to stress-related exacerbations in adulthood (Russo, Murrough, Han, Charney, & Nestle, 2012). Conversely, when stress-inducing situations are encountered and overcome during development, people acquire pro-resilience capabilities, perceived internal control, and a sense of mastery (Russo et al., 2012). The coping-competence dimension of this model recognizes the influence that development has on promoting adaptive responses to adult stress. Because this process does not always occur, the balanced application of the stress-vulnerability/coping-competence model emphasizes the development of coping skills and functional competencies throughout life. These capacities serve as protective factors to prevent symptom exacerbation and promote future resilience (Liberman, 1988; Ventura, Nuechterlein, Subotnik, Green, & Gitlin, 2004).

Kristy Has a Diagnosis of Bipolar Disorder That Is Well