The interactionist approach to Schizophrenia Flashcards
(18 cards)
What is the interactionist approach?
Acknowledges biological psychological and societal factors in the development in schiz
What biological factors lead to schizophrenia?
- genetic vulnerability
- neurochemical abnormality
- neurological abnormality
What psychological factors lead to schizophrenia
- stress
- life events
- daily hassels
Outline the diathesis-stress model
diathesis=vulnerability
stress is the negative psychological experience
the model suggests that both a vulnerability to schiz and a stress trigger are necessary to develop schiz
- vulnerability + stress = schizophrenia
Outline Meehls original model
the diathesis was entirely genetic and the result of a single schizogene
this led to the development of a biologically based schiz personality characteristic of which is stress
- argues if the person doesnt have the gene no amount of stress will lead to schiz
- carriers who experience chronic stress cld develop the condition
What did Ripke et al suggest about the modern understanding of diathesis
theres no single schozogene
What did Ingram and Luxton suggest about the modern understanding of diathesis
diathesis ranges beyond genetics and includes psychological trauma
- trauma becomes the diathesis rather than the stressor
What did Read et al suggest about the modern understanding of diathesis
proposed a neurodevelopment model in which early trauma alters the brain
- early severe trauma can seriously affect aspects of the brain
What did Huston et al suggest about the modern understanding of stress?
suggested cannabis is a trigger
- it’s a stressor because it increases the risk of schiz up to 7x more because it interferes with the dopamine system
- however most ppl who smoke weed dont develop schiz so thre must be other vulnerability factors
How is schizophrenia treated according to the interactionist approach
combines antipsychotic drugs with CBT
Outline Turkington et als idea about treatments using the interactionist approach
Its possible to believe in biological causes and still practice CBT - this only works while adopting the interactionist model
What are cultural differences in the use of CBT
in Britain the use of CBT and antipsychotics is a common practice but in the US there is a history of conflict between the biological and psychological models and they are slower in the uptake of the interactionist approach
What are strengths of the interactionist approach
- supported by research (Tiernari)
- support for the effectiveness of treatments
What are limitations of the interactionist approach
- Reducitonist
- Treatment-causation fallacy
Evaluate support from Tiernari as a strength of the interactionist approach
P: evidence supports the dual role of vulnerability and stress
E: Tienari investigated the combination of genetic vulnerability and parenting style (trigger). Adopted children from 19000 Finnish mothers with szhiz were followed up. Adoptive parents were assessed for child-rearing style and rates of schiz were compared to a control group. Child rearing style characterised by high levels of criticism and low empaths was implicated in the development of this but only for children with a high genetic risk
E: suggests both genetic vulnerability and family related stress are important in the development of schiz.
Evaluate support for combinations of treatments as a strength of the interactionist approach
P: Support for the effectiveness of combinations of treatments.
E: As Turkington et al point out it is not really possible to use combination treatments without adopting an interactionist approach.
E: Studies show an advantage to using combinations of treatments for schizophrenia. For example, in one study by
Tarrier et al 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.
L: 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.
Evaluate the treatment-causation fallacy as a limitation of the interactionist approach
P: A limitation of the approach is the treatment-causation fallacy
E: Turkington et al. argue that there is a good logical fit between the interactionist approach and using combination treatments.
E: However, the fact that combined biological and psychological treatments are more effective than either on their own does not necessarily mean the interactionist approach to schizophrenia is correct. Similarly, the fact that drugs help does not mean that schizophrenia is biological in origin. This error of logic is called the treatment-causation fallacy.
L: Also, another problem with combining therapies is that we don’t know exactly how diathesis and stress work. There is
strong evidence to suggest that some sort of underlying vulnerability coupled with stress can lead to schizophrenia.
Evaluate Reductionism a limitation of the interactionist approach
P: Reductionist. The classic model of a single schizogene and schizophrenic parenting style as the major source of stress is known to be very over simple.
E: 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.
E: 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 Houston et al. (2008) childhood sexual trauma emerged as a vulnerability factor whilst cannabis use was a trigger.
L: This shows that the old idea of diathesis as biological and stress as psychological has turned out to be overly simple.
This is a problem for the old idea of diathesis-stress but not for newer models.
