interactionist approach Flashcards
What is the interactionist approach
There are a range of factors that can influence the development of schizophrenia - biological, psychological ect
- Combine in a way that cant be predicted by each one separately eg interact
What is the diathesis-stress model
Schizophrenia is result of both diathesis (vulnerability) and a stressor (trigger)
- One or more underlying factors make a person particularly vulnerable to developing schizophrenia but onset is triggered by stress
Original diathesis-stress
Meehl’s model
- Diathesis is genetic - schizogene - led to schizotypic personality
- This personality is sensitive to stress
- Chronic stress eg schizophrenic mother - development of disorder
- Without schizogene, cannot develop schizophrenia no matter stress levels
Modern views of diathesis
Ripke et al - many genes - no single schizogene
Ingram and Luxton - Range of factors beyond genes are influential including psychological trauma
Read et al - proposed a neurodevelopmental model - early trauma alters the developing brain eg the hypothalamic-pituitary-adrenal system can become overactive - more vulnerable to stress
Modern views of stress
Also includes anything that risks triggering schizophrenia eg cannabis use
Cannabis - stressor - increase up to seven times according to dose - interferes with dopamine system
- People may lack the requisite vulnerability factors so do not develop schizophrenia
Treatment
Combination of antipsychotics and psychological therapies such as CBT
- Interactionist model
- Increasing practice in the UK
- Medication without accompanying psychological treatment more common in the US
EVAL - support for vulnerability and triggers
P - strength of interactionist approach to schizophrenia is evidence supporting role of both vulnerability and triggers
E - Tienari et al - impact of genetic vulnerability and psychological triggers - 19000 Finnish children whose biological bothers diagnosed - high genetic risk group compared to control of adoptees without family history in adult hood
E - adoptive child-rearing style - assessed - high levels of criticism, hostility and low levels of empathy associated but only in high genetic risk group
L - combination of genetic vulnerability and family stress can lead to increased risk
EVAL - diathesis and stress are complex
P - original model limited as argued to be oversimplified
E - multiple genes in multiple combinations influence diathesis - stress comes in many forms such as dysfunctional parenting - diathesis can also be influenced by psychological factors and stress biological factors
E - Housten et al - childhood sexual abuse - vulnerability, cannabis - trigger
L - multiple factors, both biological and psychological - supporting modern understanding of both diathesis and stress
EVAL - real-world application
P - strength is the combination of biological and psychological treatments
E - practical application - combining treatments enhances their effectiveness
E - Tarrier et al - 315 randomally allocated - (medication and CBT), (medication and counselling), (medication - control) - two combination groups showed lower symptoms following trial - no different in hospital readmission
L - clear practical advantage in interactionist approach for treatment outcomes
P - limited as one successful treatment cannot argue explanation is correct
E - Jarvis and Okami - saying that treatment for mental disorder justifies explanation - like saying alcohol reduces shyness so shyness is caused by lack of alcohol
E - this logical error is called the treatment-causation fallacy
L - cannot assume success of combined therapies means that the interactionist explanations for schizophrenia are correct
EVAL - urbanisation
- Schizophrenia - more commonly diagnosed in urban areas
E - justifies interactionist position as urban areas argued to be more stressful so city living acts as a trigger
E - however, more likely to be diagnosed in cities or people with diathesis for schizophrenia tend to migrate to cities
L - greater frequency in area cannot act as full explanation
