The nature of schizophrenia: Vulnerability and destiny.

''I feel better about myself so I don't have to be so paranoid''. Statements like this and careful observations obtained in a wide range of follow-up studies suggest that the vulnerability and destiny of people with schizophrenia are determined by the evolution of complex interactions among many factors. In such studies it is striking to see the graded transitions between normal and abnormal states, the role of subjective and objective factors in these transitions, the interactions between the person and the disorder in this process, and the central role of how the person constructs his or her view of self and the world. Viewing vulnerability and destiny from this perspective provides a beginning structure for theory, treatment, and research.