Interactionist Approach Flashcards
What is the interactionists approach to explaining Schizophrenia
The Diathesis Stress model
What is diathesis?
- Biological vulnerabilities
- certain factors make you more vulnerable to developing sch and create a predisposition of developing the disorder. Many would suggest that the diathesis is biological
What is stress?
- Environmental factors
- certain situations, experiences, events stressors etc can trigger or activate this predisposition and cause the individual to develop sch, or cause an increase or relapse in symptoms if the individual is in remission
Describe Meehls original Diathesis stress model
diathesis (vulnerability) was entirely genetic, the result of a single ‘Schizogene’. This led to the development of a biologically based schizotypal personality, one characteristic of which is sensitivity to stress. According to Meehl, if a person doesn’t have the Schizogene then no amount of stress would lead to SCH. However in carriers of the gene, chronic stress through childhood and adolescence in particular the presence of a schizophrenic mother could result in development of the condition.
What is the modern understanding of Diathesis?
It is now clear that many genes each appear to increase genetic vulnerability slightly, there is no single Schizogene. 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. Early and severe trauma such as child abuse, can seriously effect many aspects of brain development. For example, the hypothalamic-pituitary-adrenal system can be overactive making the person much more vulnerable to later stress
What is the modern understanding of stress
Stress was seen as psychological in nature, in particular related to parenting. Although this may still be considered important, a modern definition of stress includes anything that risks triggering sch. Much of recent research into these factors has concerned cannabis use, a stressor that can increase risk of sch up to 7X, probably due to cannabis interfering with dopamine system. However most people don’t develop sch after smoking weed, so vulnerability factors are needed.
Summarise evaluations of interactionist explanation
- supported by adoption research - Tiernari
- original was oversimplified
- does not explain how the stress impacts ns to trigger the condition
- practical applications - combined therapy - Startup
- holistic
Summarise Tienari et al (2004)
- in response to interactionist evaluation
Considered genetic risks and parenting style in a huge adoption study (19,000 Finnish mothers with SCH). Biological parents were assessed for rates of SCH and adopted parents had their child-rearing styles assessed. Results showed child-rearing styles that contained high levels of criticism/conflict and low empathy were implicated in the development of SCH, but only for those at high genetic risk
What is the interactionist approaches treatment of SCH
Used a combination therapy that often involves drug therapy and psychological therapy like CBT. Drug therapy often tackles biological correlates of the condition whilst more psycho-therapeutic’ approaches simultaneously address the wider aspects of the condition. E.g. patients are given APs to help reduce psychotic symptoms which allows them to engage more fully with the demands of CBT and/or family therapy. This combined approach can deliver greater benefits to the patient e.g. reduced chance of relapse
Summarise evaluations of the interactionist approach treatments
- supporting evidence - Tarrier et al
- economic implications that could affect the NHS/economy
- Further research support - Garrett
- methodological issues - may still suffer from side effects - patients going through CBT needs to be able to self reflect etc
Summarise Tarrier et al (2004)
Used 315 SCH patients and randomly allocated them to 3 groups : APs only, APs and CBT, APs plus supportive counselling. Patients in the two combined treatment groups showed lower symptom levels than the AP only group
Summarise Garrett (2008)
CBT was successfully used to change a patients mind about taking APs, hence reducing symptoms of SCH. Therefore using CBT techniques can allow patients to be able to modify their thinking about the use of APs so by using one treatment to encourage the use of another treatment, it was a successful outcome
