The 7 – Dimension Intervention – A Holistic Diathesis-Stress Approach to Stress-Management
Developing a Systematic Psychosocial Stressor Assessment Process utilizing the 7-Dimensional Psycho-social Stressor Inventory (7D-PSI)
Can stress alone cause us to develop physical and mental disorders?
Researchers have proposed that many disorders are believed to develop when some kind of stressor affects a person who already has a vulnerability or diathesis for that disorder (Ingram & Luxton, 2005; Meehl, 1962; Monroe & Simons, 1991). The diathesis or vulnerabilty which could be a genetic predisposition or adverse childhood experience is not generally sufficient to cause the disorder itself, but it is a contributory factor. For example, a child who experiences the death of a parent would be at a higher risk to develop depression as an adult. In this case the vulnerability itself was a childhood stressor.
So then experiencing psycho-social stressors may not be a sufficient cause to develop disorders, but the two added together – genetic predisposition and/ or adverse childhood experience plus (+) current stressors are sufficient causes for the development of diseases, disorders, and abnormal behavior in general. Since vulnerabilities and stressors may exist on a continuum, for example ranging from one (1) low to ten (10) high, individuals that have high levels of vulnerabilities may only need low levels of current stressors in their life to develop disorders. Likewise, individuals with high levels of psycho-social stressors may only need low levels of diatheses (adverse childhood experiences and/ or genetic predispositions) for certain disorders to develop.
This article will introduce the 7 Dimension Intervention – a unique stress-management assessment process. It will discuss the utilization of the following three instruments – to systematically document and assist a client with visualizing their childhood vulnerabilities, current life stressors, and current positive activities that they are participating in to decrease stress, build resiliency, and improve their overall wellness to hopefully motivate them to develop and monitor a health and wellness plan for their lives:
1. Adverse Childhood Experiences (ACE) Questionnaire
2. 7 Dimensional – Psycho-social Stressor Inventory (7D-PSI)
3. 7 Dimensional – Therapeutic Activity Survey (7D-TAS)
What is the ACE Study?
The Adverse Childhood Experiences (ACE) Study is one of the largest investigations ever conducted on the links between childhood maltreatment and later-life health and well-being. As a collaboration between the Centers for Disease Control and Prevention and Kaiser Permanente’s Health Appraisal Clinic in San Diego, Health Maintenance Organization (HMO) members undergoing a comprehensive physical examination provided detailed information about their childhood experience of abuse, neglect, and family dysfunction. Over 17,000 members chose to participate. To date, over 50 scientific articles have been published and over 100 conference and workshop presentations have been made.
The ACE Study findings suggest that these experiences are major risk factors for the leading causes of illness and death as well as poor quality of life in the United States. Progress in preventing and recovering from the nation’s worst health and social problems is likely to benefit from the understanding that many of these problems arise as a consequence of adverse childhood experiences.
What’s an ACE score? Growing up experiencing any of the following conditions in the household prior to age 18 identifies your ACE score (1 point for each one):
Recurrent physical abuse
Recurrent emotional abuse
Contact sexual abuse
An alcohol and/or drug abuser in the household
An incarcerated household member
Someone who is chronically depressed, mentally ill, institutionalized, or suicidal
Mother is treated violently
One or no parents
The ACE score can be used to quantify your childhood adverse experiences and vulnerabilities, and the score can be documented on the “Wheel of Life,” to visualize a client’s stress tolerance zone.
What is the significance of the ACE study?
Because adverse childhood experiences (ACEs) are very common, and ACEs are strong predictors of health risks and disease from adolescence to adulthood – the combination of these findings makes ACEs one of the leading, if not the leading determinant of the health and social well-being of our nation.
Identifying Psych-social Stressors
“The DSM-IV-TR informs us that Axis IV is for reporting psychosocial and environmental problems that may affect the diagnosis, treatment, and prognosis of mental disorders delineated on Axes I and II. A psychosocial or environmental problem may be a negative life event, an environmental difficulty or deficiency, a familial or other interpersonal stress, an inadequacy of social support or personal resources, or other problem related to the context in which a person’s difficulties have developed. When a individual has multiple psychosocial or environmental problems, the clinician may note as many as are judged to be relevant,” (DSM-IV-TR, p. 31).
Unfortunately, clinicians rarely conduct a multi-dimensionally comprehensive systematic investigation of their client’s psychosocial stressors to document those stressors that may be significant to the diagnosis and treatment planning …