Environmental sensitivity to social environments in the prediction of mental health in adulthood: a scoping review of studies examining diathesis-stress, vantage sensitivity and differential susceptibility

Abstract Traditional literature on vulnerability to psychopathology primarily utilizes the diathesis-stress model. More recently, differential susceptibility and vantage sensitivity were proposed as alternative models. While there are numerous systematic reviews on these models in children, there is limited research addressing their applicability in adulthood. This systematic scoping review aimed to map studies conducted on these models within the environmental sensitivity framework in the prediction of adult mental health following PRISMA-ScR guidelines. A forward reference search was employed using eight foundational environmental sensitivity and differential susceptibility articles through three databases resulting in 36 studies that met inclusion criteria. A narrative synthesis revealed inconsistency in testing the diathesis-stress, vantage sensitivity, and differential susceptibility models, with most studies not following best recommended practices. All three models were supported, including 65 significant and 115 non-significant interactions. Included studies examined sensitivity factors and social environments in childhood and adulthood in the prediction of adult mental health. Childhood environments tended to show stronger support for differential susceptibility while adulthood environments showed more balanced evidence between the differential susceptibility and diathesis-stress models. Most studies focused on genotype and internalizing behaviors, resulting in a limited understanding of person-environment interactions for other individual and mental health factors. Further research is needed to test diathesis-stress, vantage sensitivity and differential susceptibility across diverse populations and broader contexts to guide developmental theory and interventions.