schizophrenia paper 3

Question 1

define schizophrenia

Answer 1

it is a psychotic mental health disorder where the person has contact with their reality and insight. An example is psychosis. Schizophrenia is where a person looses touch with their reality and has a distorted view of the world.

It is most commonly diagnosed within men than women and it is also noticed more within the cities than the countryside. In the working class rather than the middle class.

it interferes severely with everyday tasks hence why people are hospitalised or even homeless.

Question 2

define and explain one positive symptom of Schizophrenia

Answer 2

positive symptoms of schizophrenia= Atypical symptoms experienced in addition to normal experiences. This includes hallucinations and delusions.

Hallucinations= it is an unusual sensory experience and are perceptions which occur without stimuli from the external world. Some hallucinations are related to events within the environment whereas others bear no relationship to what the senses are picking from the environment. People could see distorted facial expressions or occasionally people or animals that are not there.
Types of hallucinations:
1) Auditory would involve hearing voices. The voice is usually someone persecuting, threatening or criticising.
2) Visual is where the person sees someone evil or the devil.
3) Visual and auditory occur together and are the most common.
4) sematic is where they think insects are eating away at them.

Question 3

Define and explain another positive symptom of schizophrenia

Answer 3

Delusions= it is known as a paranoia and irrational belief. Ideas and beliefs or values they believe are true but are highly unlikely to be true. People with delusions believe they are under external control and Delusions can make a person with schizophrenia behave in ways that make sense to them but are perhaps bizarre to others. Most of these individuals are not aggressive and are in fact more likely to be victims than preparators of violence some can lead to aggression.
Types of Delusions:
1)Delusion of persecution- false belief that friends, family, government or work people are plotting against them,
2)Delusions of reference= false belief that random events are meaningful patterns of events.
3)Delusions grandeur= False belief that one has special power and are famous.
4)Delusions being controlled= False belief that thoughts, feelings, and behaviours are controlled by stronger force.
Speech disorganisation:
Abnormal thoughts process where the individual has problems with organising their thoughts which would show up their speech. They may slip from one topic to another or mid- sentence and extreme cases their speech may be incoherent and sound like gibbersih.

Question 4

Define negative symptoms of schizophrenia

Answer 4

Negative symptoms of schizophrenia= Atypical experiences that represent the loss of usual experience such as clear thinking or normal levels of motivation.
Speech poverty = changes in pattern of speech and involves reduce frequency and quality of speech.
Reduction= the amount of quality speech which involves a delay in the sufferers verbal response in a conversation.
They made produce fewer words in a given time on a task of verbal frequency and they would not be able to spontaneously produce them.
Sometimes, it causes delays within people’s conversation and their responses

Question 5

define the second negative symptom of schizophrenia and an explanation

Answer 5

negative symptoms= involves the loss of usual abilities and experiences.
Avolition= This is called apathy. It involves loss of motivation to carry out tasks and results in lowered activity levels.
It can be described as finding it difficult to begin with or keep up with goal directed activity.
People with Schizophrenia have reduced motivation to carry out a range of activities.
main symptoms:
loss of energy and general loss of interest in life showing a lack of motivation.
poor hygiene and grooming
unable to finish goal/ tasks- a levels
social isolation and withdrawal

Question 6

define classification of mental disorder/ Schizophrenia

Answer 6

classification in mental disorders= the process of organising symptoms into categories based on which symptoms cluster together in people with mental disorders.
Two major systems of Classification:
1) The world health organisations international classifications of disease edition (ICD-10)
two or more negative symptoms are sufficient for diagnosis
Recognises subtypes of Schizophrenia - Catatonic
2) American psychiatric association’s diagnostic and statistical manual edition 5(DSM-V)
one of the positive symptoms are sufficient for diagnosis
Does not recognise subtypes of Schizophrenia

Question 7

define dopamine

Answer 7

a neurotransmitter that has a excitatory effect and is associated with the sensation of pleasure. Unusually high levels are associated with schizophrenia and unusually low levels are associated with Parkinson disease.

Question 8

what are the five different sub-types of schizophrenia?

Answer 8

1) Disorganised= symptoms include disorganised and vague speech bizarre behaviour absence of emotion, social withdrawal and loss of interest of everyday life activities.
2)Catatonic= excessive motor activity (repeating everything or copying movements of others) and the opposite still/silent.
3)paranoid= powerful delusions and hallucinations are common. Delusions are magnificent or persecution.
4) undifferentiated= a mixture of the symptoms above categories. Some symptoms may be a form of all categories.
5) Residual= People who have suffered from extreme or major symptoms of Schizophrenia but now display mild symptoms. Some may suffer from social withdrawal, bizarre thoughts.

Question 9

what is the evaluation of Diagnosis and Classification of Schizophrenia ?

Answer 9

Limitation= Inter-rater reliability is the extent to which different accessors agree with each other about the same assessments. In the case of diagnosis this means to the extent of two or more diagnosis for the same individuals. Ellie Cheniaux et al - two psychiatrists independently diagnose 100 patients using DSM and ICD. One psychiatrists diagnosed 26 with Schizophrenia according DSM and 44 from the ICD and the other one diagnosing 13 with DSM and 24 with ICD. This shows there is very low agreement in Diagnosis, lack inter-rater reliability and criterion validity from psychiatrists and this means it could lead to misdiagnosis.

limitation= Co-morbidity refers to the medical condition and how common it is. It also refers to that two or more condition occur together. if conditions occur together this calls in question the validity of the diagnosis and classification as there might just a single condition.
Buckley concluded that half of the patients with a diagnosis of schizophrenia also have a diagnosis of depression 50%, 47% substance abuse and 29% of ptsd and 23% with OCD. This is a limitation as patience are likely to be mis diagnosed and have the wrong treatment and which could affect recovery time and prolong health issues.
limitation= cultural bias in diagnosis
African Americans and English people of Afro- Caribbean origin are several times more likely than British people to be diagnosed with schizophrenia. One issue with positive symptoms shows that things like hearing voices in African cultures would be seen as more acceptable than British cultures or even communications exists within certain cultures. This shows the culture bias within diagnosis as shows there is a lack of validity and psychiatrists may over diagnose people as they are not familiar with cultural norms and traditions within that group and this is a limitation people who are ill are diagnosed unnecessarily.

Question 10

define genetics

Answer 10

Genes contain DNA strands. DNA produces instructions for general physical features of an organism (eye colour, height) and also specific physical features. It known as neurotransmitter levels and size of brain structures) these may impact on psychological features such intelligence and mental disorder and they are transmitted from parents or offspring.

Question 11

define neural correlates

Answer 11

patterns of structure or activity in the brain that occur in conjunctions with an experience and may be implicated in the origins of that experience.

Question 12

The Genetic basis of schizophrenia

Answer 12

Schizophrenia runs in the family and could in the genes. there are systematic investigations of the extent where there is genetic similarity between family members associated with the likelihood of both developing schizophrenia,. For example, we share 100% of our genes with an identical twin, 50% with sibling or parent. There is a strong relationship between the genetic similarity and shared risk of schziophrenia findings from Gottesman’s large scale family study.

Question 13

what are candidate gene?

Answer 13

Individual genes are believed to be associated with risk of inheritance. Because a number of genes each appear to confer a small increased risk of schizophrenia which is polygenic so it requires different combinations. Because different combinations have identified different candidate genes shows it is a heterogynous gene. Stephen Ripke et al carried out a huge study combining all previous data from genome-wide studies of schizophrenia. The genetic make-up of 37,000 people diagnosed with Schizophrenia was compared to 113,000 controls; 108 genetic variations were associated with increased risk of schizophrenia. Genes associated with increased risk included those coding for the functioning of a number of neurotransmitters including dopamine.

Question 14

what is the dopamine hypothesis?

Answer 14

neurotransmitters= the brain’s chemical messengers appear to work differently in the brain of a person with a schizophrenia. Dopamine is widely believed be involved. Dopamine is important in the functioning brain systems that may be implicated in the symptoms of schizophrenia.
Hyperdopaminergia in the subcortex= The orginial version of dopamine hypothesis focused on the possible role of high levels or activity of dopamine in the subcortex i.e the central areas of brain. For example, an excess of dopamine receptors in a Broca’s area which is responf

Answer 15

Hyperdopaminergia in the subcortex= The orginial version of dopamine hypothesis focused on the possible role of high levels or activity of dopamine in the subcortex i.e. the central areas of brain. For example, an excess of dopamine receptors in a Broca’s area which is responsible for speech production and may be associated with speech poverty or the experience of auditory hallucinations.

Question 16

Hypodopamingeria in the cortex

Answer 16

More recent versions of dopamine hypothesis have focused on abnormal dopamine systems in the brain’s cortex. Goldman Rakic have identified a role of low levels of dopamine in the prefrontal cortex (responsible for thinking or decision making in the negative symptoms of schizophrenia. It may be hyper or hypodomingeria are the right explanations for high and lows levels of dopamine affecting the regions of schizophrenia.

Question 17

what is the neural correlates of schizophrenia ?

Answer 17

Neural correlates are measurements of the structure or functions of the brain that correlate with an experience in the case of schizophrenia. Both negative and positive symptoms have neural correlates.

Question 18

what are neural correlates of negative symptoms?

Answer 18

One negative symptom avolition involves loss of motivation. Motivation involves the anticipation of a reward and regions of the brain like the ventral striatum in schizophrenia are involved in anticipation and the development of avolition. Juckel et al has measured activity levels in the ventral stratum in schizophrenia. They observed a negative correlation between activity levels in the ventral stratum.

Question 19

what is the neural correlates of positive symptoms?

Answer 19

Allen scanned the brain of people experiencing auditory hallucinations and compared them to a control group as they identified pre-recorded speech as theirs or others. Lower activation levels in superior temporal gyrus and anterior cingulate gyrus were found in the hallucination group who also made more errors than the control group and there was reduced activity in the neural correlate causing auditory hallucinations.

Question 20

what is the evaluation of biological explanations of schizophrenia?

Answer 20

strength= there is evidence with people from the gottesman study of genetic similarity and shared risk of schizophrenia. The adoption studies by peeka children that are from families of the disorder are more likely to inherent it even if they have been adopted to a family with no history of schizophrenia and Ripke showed that people who showed that some people are more vulnerable to getting disorders.

strength= sources for abnormal dopamine functioning in schizophrenia. Dopamine agonists like amphetamines that increase the level of dopamine make schizophrenia worse and produce schizophrenia like symptoms in people not diagnosed with schizophrenia. Antipsychotic drugs work by reducing dopamine activity. Both drugs were seen as important in schizophrenia. Radioactive labelling studies found chemicals needed to produce are taken up faster in the brains of people.
limitations= these brain symptom experiments leave questions unanswered like does the brain cause unusual activity in the region of the brain to cause the symptom. there may be a correlation between the levels of activity in the ventral striatum in causing negative symptoms.

Question 21

define family dsyfuntion

Answer 21

abnormal processes within a family such as a poor family communication, cold parenting and high levels of expressed emotion. These are risk factors for developing schizophrenia.

Question 22

define cognitive explanations

Answer 22

Explanations that focus on mental processes such as thinking, language and attention.

Question 23

Dysfunctional thought processing

Answer 23

A general term meaning information processing that is not functioning normally and produces undesirable consequences.

Question 24

How does Family Dysfunctional?

Answer 24

The schizophrenia mother- Reichmann proposed a psychodynamic explanation for schizophrenia based on the accounts she heard from her clients about their childhoods. Reichmann noted that many of her clients about spoke of a particular type of client- this is referred to as the Schizophrenia genic mother. She is cold, rejecting and controlling and she creates tension with a family environment. This tends to distrust that later develops into paranoid dellusions.

Question 25

Double blind theory

Answer 25

Bateson agreed that family climate is important in developing schizophrenia but the role of communication style within the family. This developing child is in situations where they fear they are doing the wrong things and get mixed signals and are unable to comment on unfair situations. when the child is believed to be wrong, they get punished by withdrawal love. It leaves them with a view of the world as dangerous and disorganised thoughts. Bateson was clear that the main type of communication in a family of Schizophrenia or the only factor.

Question 26

Expressed emotions

Answer 26

it is the level of emotion in particular negative emotion in particular negative emotion expressed towards a person with a Schizophrenia by their carers.
Expressed emotion:
-verbal criticism of the person, accompanied by violence.
-Hostility towards the person like anger
-Emotional over- involvement in the life of the person.
High levels of expressed emotion in carers directed towards the person are a serious source of stress for the patient. This is an explanation for relapse in people with Schizophrenia. it has been suggested as a source of stress that can trigger onset schizophrenia in a person who is vulnerable for example due to genetic makeup.

Question 27

what is the cognitive explanation for schziphronia?

Answer 27

It focuses on the role of mental processes.
Schizophrenia is associated with several types of abnormal information, processing and these can provide possible explanations for Schizophrenia. It is characterised by normal thought processes. There is a reduced processing in the ventral striatum- negative symptoms. Reduced processing of temporal and cingulate gyri is associated with hallucinations. This lower than usual level of information processing of information in the temporal and cingulate gyri are associated with hallucinations. This lower than usual level of information processing suggests that cognition is likely to be impaired.

Question 28

what are two kinds of dysfunctional thought processing?

Answer 28

Metrarepresentation= cognitive ability to reflect on thoughts and behaviour. It allows us to insight into our own intentions and goals. It allows to interpret the actions of others. Dysfunction in metrapresentation would disrupt our ability to recognise our own actions and thoughts as being carried out by delusions like thought insertion

Question 29

central control

Answer 29

is a cognitive ability to suppress automatic responses while we perform deliberate actions instead. Disorganised speech and thought disorder could result from the inability to suppress automatic thoughts and speech triggered by other thoughts. People with Schizophrenia experience derailment of thoughts and spoken sentences as each word trigger association.

Question 30

Evaluation

Answer 30

strength= support for family dsyfunction factor. evidence to suggest that difficult family relationships in childhood are associated with increased risk of schizophrenia in adulthood. Read reviewed 46 studies of child abuse and schizophrenia and concluded that 69% of adult women in patients with a diagnosis of schizophrenia had a history of physical abuse, sexual abuse. men= 59%. People with insecure attachment to their primary carer are more likely schizophrenia.

weakness= weak evidence for family - based explanations
there is no real support of the importance of Schizophrengic mother and the double-blind theory or double blind. As both these theories are based on clinical observation of patients ‘for making crazy characteristics’
A problem with dysfunctional family explanations for schizophrenia is that they have led historically to parent blaming. As these parents are going through trauma as they observe their child through these phrases and this can be seen as unethical.

Question 31

Define antipsychotics

Answer 31

it is drugs used to reduce the intensity of symptoms like positive symptoms of psychotic conditions of schizophrenia.

Question 32

define typical antipsychotics

Answer 32

the first generation of antipsychotic drugs having been used since the 1950s. They work as dopamine antagonists and include chlorpromazine.

Question 33

define atypical antipsychotics

Answer 33

They were developed after typical antipsychotics drugs. They are used to target a range of neurotransmitters such as dopamine and serotonin. For example, clozapine and Risperidone.

Question 34

what is the importance of antipsychotic drugs?

Answer 34

most common drug for developing schizophrenia.
it can be taken as tablets or in the form of a syrup.
they are so available as injections for those who forget to take them at home, and they are given every 2-4 weeks.
they can be required either short or long term as some patients are able to take for a short term and will not have to return but others face taking it for life.

Question 35

what is the importance of typical antipsychotics ?

Answer 35

it includes chlorpromazine which can be taken as a tablet or syrup or an injection.
the maximum dosage is 1000mg. For most patients their dosage a maximum of 400 to 800 mg. There is a strong association between the use of typical antipsychotics like chlorpromazine and the dopamine hypothesis. Typical antipsychotics like chlorpromazine work by acting as antagonist in the dopamine system. The antagonists reduce the action of neurotransmitters. Dopamine antagonists work by blocking dopamine receptors in the synapses in the brain reducing dopamine production.
when a patient begins taking chlorpromazine the dopamine production increases then reduces. The dopamine antagonist effect normalises neurotransmitters like hallucinations. chlorpromazine is used for sedation no explanation of how it sedates patients but it shown that it can taken as a syrup when patients are admitted to hospitals and are anxious but the patients do not have to be schizophrenic.

Question 36

what is the importance of atypical antipsychotics?

Answer 36

the aim in developing this drug is to maintain or improve the effectiveness of drugs suppressing the symptoms of psychosis which would minimise side effects. There is a range of atypical antipsychotic drugs, but they do not work the same way.

Question 37

what is the importance clozapine ?

Answer 37

It was withdrawn as it caused death and who developed a blood condition called agranulocytosis. it is seen to be more effective than typical antipsychotics and it was used as a treatment when other drugs failed. Patients who use this today are made to do blood testing to prevent agranulocytosis. it is not available as an injection due to its side effects and the daily dosage is lower than chlorpromazine like 300 to 450mg a day. it binds to dopamine receptors like chlorpromazine, and it acts on serotonin and glutamate receptors. This action helps to improve mood and reduce depression/anxiety in people and helps cognitive functions. The mood enhancing effects of clozapine are for patients who attempt suicide or have suicidal thoughts which is 30 to 50% of schizophrenia patients.

Question 38

what is the importance of Risperidone?

Answer 38

it is a recently developed atypical antipsychotic drug. It was developed a drug as effective as clozapine without its serious side effects. similar to chlorpromazine it can be taken in a form of tablets and syrup or in a injection that lasts around two weeks. Similar to antipsychotics it is a small dose given that builds up to a typical dose of 4-8mg and to a maximum of 12mg. Risperidone is a bind of dopamine and serotonin receptors. it binds more with dopamine than clozapine and is effective in smaller doses than antipsychotics. There is evidence to show it leads to fewer side effects than is typical antipsychotics.

Question 39

evaluation of antipsychotics drugs

Answer 39

strength= there is evidence for the effectiveness that support the idea of both atypical and typical antipsychotics are at least moderately effective in tackling symptoms of schizophrenia. Ben Thornley reviewed studies comparing the effects of chlorpromazine to control conditions in which people with schizophrenia received a placebo, so their experiences were identical to people who had taken the drug from 13 trials with a total of 1121 participants showed that chlorpromazine was associated with better overall functioning and reduced symptom severity. Data from three trails with a total of 512 participants showed that the relapse was lower than chlorpromazine. There is a benefit for atypical antipsychotics as Hebert reviewed that clozapine is more effective than typical antipsychotics and other atypical antipsychotics and it is effective 30-50% of treatment where typical antipsychotics. A number of studies have compared to the effectiveness of clozapine and other drugs like risperidone but the results show a patient responds to one drug better than the other.

limitation- serious side effects a problem of antipsychotics drugs is the side effects can be mild to serious. Typical antipsychotics are associated with a range of side effects like sleepiness or dizziness. Long term could result in tardive dyskinesia which caused by dopamine super sensitivity and manifests as involuntary facial expressions. Most serious side effects of typical antipsychotic is malignant syndrome and it is caused by a drug blocks dopamine action in system. NMS results in high temperature and delirium and coma.

Question 40

family therapy

Answer 40

a psychological therapy carried out with all or some members of a family with the aim of improving the communication and reducing the stress of living as a family.

Question 41

token economies

Answer 41

a form of behavioural therapy where desirable behaviours are encouraged by the use of selective reinforcement. people are given rewards for their behaviour.

Question 42

why are cognitive behaviour therapies important?

Answer 42

five to twenty sessions take place
it involves helping people with irrational thoughts and trying to change them. It involves helping people identify their irrational thoughts and trying to change them. It involves argument or a discussion of how likely the person’s beliefs are to be true. it does not get rid of it but helps the person cope with the schizophrenia. it helps people understand their delusions and hallucinations impact on their feelings and behaviour. Understanding where symptoms come from can be helpful for people who hear voices and afraid of their voices being demons so offering psychological advice could reduce anxiety. so when Delusions are challenged so that individual would learn that their thoughts are not based on reality.

Question 43

family therapy

Answer 43

it takes with families rather than the individual and it aims to improve the quality of communication and interactions between family members. the two approaches like double blind and the schizophrengic mother some therapists see the family as the root of the condition. Now, therapists are focused on reducing the stress within the family that might contribute to a person’ s relapse and it reduces levels of expressed emotions.

Question 44

how does family therapy help?

Answer 44

pharaoh produced a ranged of strategies by which family therapists aim to improve the functioning of family with a member experiencing schizophrenia.
forming a therapeutic alliance with all family members.
reducing the stress of a caring for a relative with schizophrenia.
improving the ability for the families to solve problems
reducing anger/guilt of family members
improving family beliefs and behaviour towards schizophrenia.
phraoah suggested this with a combination of complying with medication reduces the possiblity of relapse.

Question 45

what is token economy and how does it help?

Answer 45

Token economies are reward systems used to manage the behaviour of people with schizophrenia in particular those who have developed patterns of maladaptive behaviour through spending long periods within psychiatric hospitals. Under these circumstances it is common for people to develop bad habits so living with schizophrenia improves the person’s quality of life.
Tokens= they are given directly to patients when they carried out a desirable behaviour that has been targeted for reinforcement. For example, this may be getting dressed in the morning.
Rewards= Tokens have no value in themselves they can be swapped later for more tangible rewards. Token economies are a kind of behavioural therapy based on operant conditioning. It is a secondary reinforcer as they only have value once the patient has learned it can be used to obtain rewards.

Question 46

what is the evaluation for psychological therapies?

Answer 46

strength= there is support for the benefits of the psychological therapies for schizophrenia. Jauhar reviewed the results of 34 studies of CBT for schizophrenia. It was concluded that CBT has a significant but fairly small effect on both positive and negative symptoms.
Pharoh et al= reviewed the evidence for the effectiveness of family therapy for families of people with schizophrenia. it was concluded that family therapy reduces relapse and hospital re-admission and improves the quality of life for the individual and their family.
limitation within strength=it was also noted that the results of the different studies were inconsistent and that there were problems with the quality. The evidence of family therapy is fairly weak and the review of evidence for the token economy found only three studies where people had been randomly allocated for schizophrenia to conditions with a total of only 110 patients. Random allocation is important in controlling extraneous variables and one of the three studies showed improvement in symptoms and none yielded useful information about behaviour change.

limitation= All the psychological treatments for schizophrenia aim to make schizophrenia more manageable and, in some way, improve individuals’ life. CBT helps by allowing a person to make sense of and some cases challenge some of their symptoms. Family therapy helps by reducing the stress of people living schizophrenia in a family both for the person themselves and other family members. Token economies help by making the individuals behaviour more socially accepted so that they can be better when they are re-introduced into society. These things are all worth doing but do not cure schizophrenia and neither do biological treatments like drugs, but they reduce the severity of the symptoms.

Question 47

The interactionist approach - original diathesis- stress model

Answer 47

The diathesis-stress model says that both a vulnerability to schizophrenia and a stress-trigger are necessary in order to develop the condition
- In the original diathesis-stress model (Meehl 1962) diathesis (vulnerability) was entirely genetic, the result of a single ‘schizogene’. This led to the development of a biologically based schizotypic personality. According to Paul Meehl, if a person does not have the schizogene then no amount of stress would lead to schizophrenia. However, in carriers of the gene, chronic stress through childhood and adolescence, in particular the presence of a schizophrenogenic mother could result in the development of the condition.

Answer 48

Modern day understanding of the stressor
-it is now clear that many genes each appear to increase genetic vulnerability slightly; there is no single ‘schizogene’ (Ripke et al. 2014). Modern views of diathesis also include a range of factors beyond the genetic, including psychological trauma - so trauma becomes the diathesis rather than the stressor. Read et al. (2001) proposed a neurodevelopmental model in which early trauma alters the developing brain. Early and severe enough trauma, such as child abuse, can seriously affect many aspects of brain development. For example the hypothalamic-pituitary-adrenal (HA) system can become over-active, making the person much more vulnerable to later stress.

Modern day understanding of the stress
- In the original diathesis-stress model of schizophrenia, stress was seen as psychological in nature, in particular related to parenting. a modern definition of stress (in relation to the diathesis-stress model) includes anything that risks triggering schizophrenia (Houston et al.
2008). Much of the recent research into factors triggering an episode of schizophrenia has concerned cannabis use. In terms of the diathesis-stress model cannabis is a stressor because it increases the risk of schizophrenia by up to seven times according to dose. This is probably because cannabis interferes with the dopamine system.
However, most people do not develop schizophrenia after smoking cannabis so it seems there must also be one or more vulnerability factors.

Answer 49

the interactionist approach compatible with both biological and psychological treatments. In particular the model is associated with combining antipsychotic medication and psychological therapies, most commonly CBT.

-In Britain it is increasingly standard practice to treat patients with a combination of antipsychotic drugs and CBT. However, in the USA there is more of a history of conflict between psychological and biological models of schizophrenia. Thus medication without an accompanying psychological treatment is more common than in the UK

Answer 50

the interactionist approach compatible with both biological and psychological treatments. In particular the model is associated with combining antipsychotic medication and psychological therapies, most commonly CBT.

-In Britain it is increasingly standard practice to treat patients with a combination of antipsychotic drugs and CBT. However, in the USA there is more of a history of conflict between psychological and biological models of schizophrenia. Thus medication without an accompanying psychological treatment is more common than in the UK

Answer 51

The classic model of a single schizogene and schizophrenic parenting style as the major source of stress is now known to be very over-simple. Multiple genes increase vulnerability to schizophrenia, each having a small effect on its own; there is no single schizogene. Also stress can come in many forms, including but not limited to dysfunctional parenting. Therefore vulnerability and stress do not have one single source.
In fact it is now believed that vulnerability can be the result of early trauma as well as genetic make-up, and that stress can come in many forms including biological. In one recent study by James Houston et al. (2008) childhood sexual trauma emerged as a vulnerability factor whilst cannabis use was a trigger. This shows that the old idea of diathesis as biological and stress as psychological has turned out to be overly simple. Supports the new model but is a limitation of the old model

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27
Q
Evaluation of the interactionist approach to do with effectiveness

A
There is support for the usefulness of adopting an interactionist approach from studies comparing the effectiveness of combinations of biological and psychological treatments for schizophrenia versus biological treatments alone. As Turkington et al.
(2006) point out it is not really possible to use combination treatments without adopting an interactionist approach.
Studies show an advantage to using combinations of treatments for schizophrenia.
For example, in one study by Nicholas Tarrier et al. (2004) 315 patients were randomly allocated to a medication + CBT group, medication + supportive counselling or a control group. Patients in the two combination groups showed lower symptom levels than those in the control group (medication only) although there was no difference in rates of hospital readmission.
Studies like this show that there is a clear practical advantage to adopting an interactionist approach in the form of superior treatment outcomes, and therefore highlight the importance of taking an interactionist approach.