7. the interactionist approach Flashcards
THE INTERACTIONIST APPROACH
Acknowledges that there are
3 factors
biological (genetic vulnerability, neurochemical / neurological abnormality), psychological (stress resulting from life events) and social factors (poor quality family interactions) in developing schizophrenia.
THE DIATHESIS-STRESS MODEL
DIATHESIS = vulnerability / STRESS = negative experience.
Both a vulnerability to schizophrenia and a stress-trigger are necessary to develop the disorder. The onset of schizophrenia is triggered by
stress
MEEHL’S MODEL
Diathesis was entirely genetic and the result of a single ‘schizogene’. He believed that
no amount of stress would make someone develop schizophrenia if they did not have the gene, however in those who carried the gene, stressors such as a stressful childhood and a schizophrenogenic mother could result in the development of schizophrenia.
MODERN UNDERSTANDING OF DIATHESIS
Many genes appear to increase genetic vulnerability and there is no single ‘schizogene’ (Ripke identified 108 genes). Modern views of diathesis also include a range of factors beyond genetics, such as psychological trauma.
Read et al.
proposed a neurodevelopmental model in which early trauma alters the developmental brain, such as severe trauma (child abuse) can seriously affect many aspects of brain development. For example, the hypothalamic-pituitary-adrenal system can become overactive, making a person much more vulnerable to later stress.
MODERN UNDERSTANDING OF STRESS
In the original model, stress was seen as psychological in nature, particularly related to parenting. Although psychological stress may still be considered important, the modern definition of stress includes anything that risks triggering schizophrenia.
Cannabis is a stressor because it
increases the risk of schizophrenia by up to 7 times according to dose, because it interferes with the dopamine system. However, most people do not develop it after smoking it because they lack the vulnerability factors.
AO3: strength of interactionist approach
SUPPORT FOR VULNERABILITY & TRIGGERS - Tienari
There is evidence supporting both vulnerability and triggers.
Tienari et al. navigated both the impact of both genetic vulnerability and a psychological trigger (dysfunctional parenting). The study followed 19,000 Finnish children whose biological mothers had been diagnosed with schizophrenia. In adulthood, this high genetic risk group were compared to a control group of adoptees without a family history of schizophrenia (low genetic risk). Adoptive parents had been assessed for child-rearing style and it was found that high levels of criticism, hostility and low levels of empathy were strongly associated with the development of schizophrenia, but only in the high-risk group.
This shows that a combination of genetic vulnerability and family stress can lead to greatly increased risk of schizophrenia.
AO3: limitation of interactionist approach
ISSUES WITH DIATHESIS-STRESS - Houston
The original diathesis-stress model is oversimplified.
It is now clear that the original model that portrayed diathesis as a single schizogene, and portrayed stress as schizophrenogenic parenting is simplistic. Houston et al. showed that diathesis can be influenced by psychological factors, and stress can be biological as well as psychological. His study showed that childhood sexual abuse emerged as the major influence on underlying vulnerability to schizophrenia and cannabis use as the major trigger.
This means that there are multiple factors, both biological and psychological, affecting both diathesis and stress, showing that Meehl’s ideas are outdated.
TREATMENT ACCORDING TO THE INTERACTIONIST MODEL
Combines antipsychotic medication with psychological therapies such as CBT.
TREATMENT
Turkington et al. point out that it is
perfectly possible to believe in biological causes of schizophrenia and to still practice CBT to relieve psychological symptoms.
In Britain it is standard practice to treat schizophrenia with a combination of drugs and CBT, whereas in the US there is a slower adaption of the interactionist approach and medication is more commonly prescribed.
AO3: strength of interactionist approach to treatment
REAL WORLD APPLICATION - Tarrier.
The combination of biological and psychological treatments is successful in treating schizophrenia.
Tarrier et al. randomly allocated 315 participants to 1. medication and CBT, 2. medication and counselling and 3. medication only (control group). Participants in the two combination groups showed significantly lower symptoms following the trial than the control group.
This means that there is a clear practical advantage to adopting an interactionist approach to schizophrenia in terms of superior treatment outcomes.
AO3: limitation of interactionist approach to treatment
COUNTERPOINT Jarvis and Okami
The argument for the interactionist approach to treatment leads to a form of circular reasoning.
Jarvis and Okami suggest that saying that a successful treatment for mental disorder justifies a particular explanation is the same as saying because alcohol reduces shyness, shyness is caused by a lack of alcohol. This logical error is called the treatment-causation fallacy.
This means that we cannot automatically assume that the success of combined therapies mean interactionist explanations are correct.
