n., singular: precipitating factor
Definition: a precipitate (cause) of the onset of a problem, especially unhealthy conditions, symptoms, disease, or disorder
Table of Contents
Precipitating Factor Definition
Precipitating factors are factors that initiate or promote the onset of any illness, disease, accident, or behavioral response. Apart from the precipitating factors, other factors that are considered to have potentially caused the onset of symptoms, disorder, or disease are predisposing factors, perpetuating factors, and protective factors.
4Ps and the Biopsychosocial Formulation
The biopsychosocial model is a strategy that is applied to understand a person’s medical condition. It takes into consideration the various aspects — biological, psychological, and social, thus, the name. George Engel was the person who conceptualized the biopsychosocial model in 1977. (Biopsychosocial Model, 2013)
This model is applied to Case Formulation. Together, they are referred to as the Biopsychosocial Formulation. It takes into consideration four factors, so-called the 4Ps:
In psychology and psychiatry, Biopsychosocial Formulation is a way to comprehend the patient, more than for diagnostic purposes. For the intervention and for examining the prognosis of disease, the biopsychosocial model combines different psychological, social, and biological factors, which may further be classified into 4Ps.
- Predisposing factors. Factors or areas of susceptibility that promote the risks of the presenting problem are termed as predisposing factors. For example, exposure to alcohol of the fetus in prenatal life and any genetic predisposition of mental illness
- Precipitating factors. These are factors, events, or stressors that initiate or promote the onset of any illness, disease, accident, or behavioral response. For example, conflict about relationships, transitions, or identity
- Perpetuating factors. These are factors that maintain the disabling symptoms. Any condition or factors, either in the family or community that exaggerate the problem rather than solve it are perpetuating factors. For example, lack of education, occupation, or financial stress
- Protective factors. These are factors that take into account the person’s skill, competency, talent, or any supportive element that helps the patient in facing and overcoming the predisposing, precipitating, and perpetuating factors.
Precipitating factors, as already defined and described (above), are factors that “precipitate” the problem. It causes or sends the person suddenly into an undesirable state or condition. Biologically, they are factors that trigger the onset of a health problem or a behavioral response.
Precipitating Factors Example
- Aggressive behavior
Le’s take for example a patient showing aggressive behavior. The person would express aggression through:
- Verbal aggressive behavior includes swearing, screaming.
- Physical aggressive behavior includes kicking, biting, or throwing.
- Hostile body language includes angry gestures or dirty looks.
The aggressive behavior could have been triggered by the following precipitating factors:
- Fear, anxiety, or nervousness
- Unmet emotional (love, recognition) or physical needs (silence, hunger)
- Any physical or mental trauma
- Behavior and arrogance of peers and family members
- Uncomfortable environment (noise)
- Impaired intellectual capability (dementia or any mental illness)
- Impaired communication skill
- Lack of personal power
- Lack of self-esteem
The various factors leading to insomnia are summarized in the table below.
Table 1: Predisposing, Precipitating, and Perpetuating Factors of an Insomniac Patient
|Predisposing factors||Precipitating events||Perpetuating factors|
|Factors that promote insomnia||Factors that cause sleep disruption||The cognitive and behavioral factors that cause poor sleep over time|
|1. Any childhood or interpersonal trauma
2. Any chronic mental health conditions such as anxiety or depression
3. Chronic pain
4. The employment history of work in shifts and disturbed sleep pattern
|1. Any accident that causes physical injury
2. Divorce from the spouse
3. Death of a close friend or family member
4. Change in the employment place
5. Loss of job or transition of a new job
|1. Watching television before bedtime
2. Long naps during day time
3. Staying in bed for a long period during the day
4. Anxiety about sleep loss
(Source: Martin et al., 2018)
Watch this video for another example of precipitating factors.
Predisposing Factors of Diseases
How is precipitating factor different from a predisposing factor? Genetic predisposition is also known as genetic susceptibility. It is an increased chance of developing a specific disease or condition, which is based on the genetic makeup of the person. Genetic predisposition is the variation in the genetic makeup of the offspring, which is inherited from the parents. The alteration in the genetic makeup will cause the disease development but do not become the cause of disease directly. In the same family, some persons with the variation in genetic predisposition will get the disease while some remain healthy.
On the development of a specific disease, genetic variation either has a small or large effect. The following example explains this:
Mutation (genetic variation) in the BRCA1 or BRCA2 genes can increase the chances of breast cancer and ovarian cancer in the person. Certain mutations in the BARD1 and BRIP1 genes also increase the chances of breast cancer. The contribution of these alterations has a smaller chance of developing cancer.
In persons along with genetic predisposition, certain other factors can be risk factors for disease. They include other modified genetic factors, certain environmental or lifestyle factors. Such disease which is caused by several factors is termed multifactorial. The genetic makeup of the person cannot be modified but changes in the environment or adopting a healthy lifestyle can reduce the chances of having the disease. (Plus, 2021)
Lifestyle habits that apparently cause cancers are alcohol use and a sedentary lifestyle. They can therefore be regarded as precipitating factors that could lead to breast cancer.
Nowadays the focus of scientists is on doing such research in which they came to know about such genetic changes that although have minimal effect on developing the disease they are common as well as frequent in the overall population.
Although these variations are very minor in developing the disease, alterations in several genes will significantly increase the chances of developing the disease. Small changes in many genes will increase the chances of having certain diseases, such as obesity, cancer, cardiac disease, mental illness, diabetes, etc. Nowadays researchers are trying to find out the approximate chances of having a common or general disease based on the combination of variants in certain genes across the genome. This type of study is known as the Polygenic Risk Score. The results of this study help in making better decisions for health in the future.
Try to answer the quiz below to check what you have learned so far about precipitating factors.
- Biopsychosocial Model. (2013). Physiopedia. https://www.physio-pedia.com/Biopsychosocial_Model
- CrisisPrevention.com. (2021). Examples of Precipitating Factors. Retrieved 21 Dec, 2021, from https://www.crisisprevention.com/Blog/Causes-of-Aggressive-Behavior
- Martin, J.L, Badr, M.S., Zeineddine, S. (2018). Sleep Disorders in Women Veterans. Sleep Med Clin 13:433.
- MedlinePlus.gov. (2021). Genetic predisposition to a disease. Retrieved 20 Dec, 2021, from https://medlineplus.gov/about/using/usingcontent/
- PsychBD.com (2021). Biopsychosocial Model and Case Formulation. Retrieved 20 Dec, 2021, from https://www.psychdb.com/teaching/biopsychosocial-case-formulation
- Wright, C. D., Tiani, A. G., Billingsley, A. L., Steinman, S. A., Larkin, K. T., & McNeil, D. W. (2019). A Framework for Understanding the Role of Psychological Processes in Disease Development, Maintenance, and Treatment: The 3P-Disease Model. Frontiers in Psychology, 10. https://doi.org/10.3389/fpsyg.2019.02498
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