Interactionist approach Flashcards
(14 cards)
What is the interactionist approach?
Acknowledges that there biological, psychological and social factors in the development of schizophrenia
What is the diathesis stress model?
Diathesis - vulnerability
Stress - negative experience
Both vulnerability and stress are necessary in order to develop disorder
What was Meehls model?
Original diathesis stress model
Entirely genetic
Result of a single schizogene
Led to idea of a bioloically based schizotypic personality
Characteristic of sensitivity to stress
If person does not have schizogene, then no amount of stress would lead to schizophrenia
In carriers of gene chronic stress through childhood and adolescence could result in development of disorder
How has the diathesis model changed?
Now clear that many genes appear to increase genetic vulnerability only slightly, no single schizogene
Range of factors beyond genetic - psychological trauma
Trauma becomes the diathesis rather than the stressor
What did Read et al suggest about the updated diathesis model?
Neurodevelopmental model in which early trauma alters the developing brain
Early severe enough trauma can seriously affect many aspects of brain development
Eg. hypothalamic-pituitary-adrenal system can become overactive, making a person much more vulnerable to later stress
What is the modern understanding of stress?
Anything that risks triggering schizophrenia
Recent research into factors triggering an episode has concerned cannibis use
Cannabis is a stressor - increases risk of schizophrenia
Up to 7x according to dose
May be because cannabis interferes with the dopamine system
Most people develop schizophrenia after smoking cannabis presumably because they lack the requisite vulnerability factors
What is treatment according to the interactionist model?
Biological and psychological treatments
Combing antipsychotic medication and psychological therapies like CBT
What did Turkingtin et al point out about treatments?
Possible to believe in biological causes of schizophrenia and still practice CBT to relieve psychological symptoms
Requires adopting interactionist model
What is the interactionist model?
Not possible to adopt a purely biological approach and tell people diagnosed that their condition is purely biological
And that there is no psychological significance to symptoms and simultaneously treat them with CBT
What is the difference between treatment in US and UK?
UK - Increasingly standard practice to treat people with combination of antipyschotic drugs and CBT
US - More history of conflict between psychological and biological - may have led to slower adoption of an interactionist approach
Medication without accompanying psychological treatment is more common
What is a strength of the interactionist approach?
Evidence supporting vulnerability and triggers
Tienari et al
Large scale study
Investigated impact of both genetic vulnerability and psychological trigger
19000 finnish children
Biological mothers had been diagnosed with schizophrenia
Adulthood - high risk genetic group were compared to control group of adoptees without family history (low genetic risk)
Adoptive parents assessed for child rearing style - high levels of criticism, hostility and low levels of empathy strongly associated with development of schiz - but only in high risk group
Combination of genetic vulnerability and family stress can lead to greatly increased risk of schizophrenia
What is a limitation of the diathesis stress model?
Over simplicity
Original model said - Single schizogene and portrayed stress as schizophrenogenic parenting - very simplistic
Multiple genes in multiple combinations influence diathesis
Stress comes from many forms - not limited to dysfunctional parenting
Diathesis - Influenced by psychological factors
Stress - biological and psychological
Houston et al
Childhood sexual abuse emerged as major influence of underlying vulnerability and cannabis use major trigger
Meaning there are multiple factors affecting diathesis and stress, supporting modern understanding of both diathesis and stress
What is a strength of the interactionist approach?
Real world application
Combination of biological and psychological treatment
Combining treatments enhances effectiveness
Tarrier et al
Randomly allocated 315 participants
(1) medication + CBT
(2) medication + councelling
(3) control group - medication only
Two combination groups showed lower symptoms following trial
No difference in hospital readmission
Meaning there is clear practical advantage to adopting interactionist approach in terms of superior treatment outcomes
What is a counterpoint to the real world strength of the interactionist approach?
Jarvis and Okami
Successful treatment for mental disorder justifies a particular explanation is the logical equivalent of sating that because
Alcohol reduces shyness
Shyness is caused by lack of alcohol
Logical error - treatment-causation fallacy
We cannot automatically assume that the success of combined therapies means interactionist explanations are correct
