INTERACTIONIST APPROACH

Question 1

• Define the interactionist approach

Answer 1

Acknowledges range of factors→ bio & psycho⇒ involved in development of schizophrenia

Question 2

What are some biological factors that it accounts for (3)

Answer 2

Genetic vulnerability, Neurochemical & neurological abnormalities

Question 3

What psychological factors does it account for

Answer 3

Stress= Life events & daily hassles eg poor quality interaction with family

Question 4

What does the interactionist approach acknowledge

Answer 4

Holistic:Identifies that patients have different triggers, genes etc. – Patients can receive different treatments for their SZ which will be more effective.

range of factors⇒ including biological, social and psychological are involved in the development of schizophrenia.

Question 5

What is the diathesis stress model

Answer 5

states that both a vulnerability to SZ and a stress trigger are necessary to develop the condition.

Question 6

What did spring et al suggest on the DSM

Answer 6

person may be born with a predisposition towards schizophrenia which is then triggered by stress in everyday life. But if they have a supportive environment and/or good coping skills the illness may not develop.

Question 7

What is evidence for DSM in twin studies

Answer 7

Concordance rates are never 100% which suggests that environmental factors must also play a role in the development of SZ. MZ twins may have the same genetic vulnerability but can be triggered by different stressors

Question 8

What did tienari et al do that supported evidence for the role of vulnerability and trigger (4) (DSM)

Answer 8

1. Investigated combination of genetic vulnerability and parenting style (trigger)
   
   2. Children adopted from 19,000 Finnish mothers with schizophrenia between 1960-79 followed up
   3. Adopted parents assessed on child rearing styles
   4. Rates of schizo compared to those in control group of adoptees without genetic risk

Question 9

What did tienari et al find that supported evidence for role of vulnerability and trigger (2) (DSM)

Answer 9

• Adopted children from families with schizophrenia had more chance of developing the illness than children from normal families. This supports a genetic link.
  
  • However, those children from families schizophrenia were less likely to develop the illness if placed in a “good” family with kind relationships, empathy, security, etc. So environment does play a part in triggering the illness

Question 10

What are two studies that support the diathesis stress model

Answer 10

• Falloon et al: stress – such as divorce or bereavement(experience of losing someone important to us. It is characterised by grief), causes the brain to be flooded with neurotransmitters which brings on the acute episode.
  
  • Brown and Birley: 50% people who had an acute schizophrenic episode had experienced a major life event in 3 weeks prior.

Question 11

• What is meehl’s model when explaining DSM

Answer 11

Original DSM

Question 12

What was the theory behind meehl’s model when explaining DSM (4)

Answer 12

• Diathesis entirely genetic→ Schizogene (single gene)
  
  • Developed biological schizotypic personality= one characteristic which is sensitive to stress
  • Said if persons did not have schizogene then no amount of stress lead to schizo
  • Carriers of gene→ chronic stress throughout childhood & adolescence + schizo mother= development of condition

Question 13

What is the modern understanding of diathesis when explaining DSM (3)

Answer 13

• Clear many genes appear to increase genetic vulnerability slightly
  
  • Range of factors beyond genes eg psychological trauma→ Truman,a echoes diathesis rather then stressor
  • read et al: neurodevelopmental model→ early alters developing Brain eg child abuse can seriously affect many aspects of brain development⇒Hypothalamic pituitary adrenal (HPA) system become over active= More vulnerable to later stress

Question 14

What is the modern understanding of stress when explaining DSM (2 + examples)

Answer 14

In original DSM= schizo stress seen as psychological in nature in particular related to parenting

Modern DSM= Includes anything that risks triggering schizo 

Example cannabis use: is a stressor bc increases risk of schizo by up to 7x according to dose→ cannabis interferes with dopamine system⇒ however most ppl do not develop schizophrenia after smoking cannabis so seems must be one or more vulnerability factors

Question 15

How is effectiveness of treatment determined (4)

Answer 15

• cost
  
  • Relapse rates
  • Degree of side effects
  • Symptom reduction

Question 16

What is the treatment using interactionist model (2)

Answer 16

Acknowledges both bio & psychological factors & treatments⇒ Combining antipsychotics and psychological therapies eg CBT

Generally treatment with antipsychotics are given first tor deuce symptoms→ then psychological treatment, so have greater effect

Question 17

Evaluate the treatment of interactionist approach causation fallacy (-ve)

Answer 17

Good logical fit between IA & using combination treatment

HOWEVER combination being better then treatment being used alone doesn’t mean the approach on explanation for schizophrenia is correct just like how drug therapy doesn’t necessarily mean schizophrenia is bio in origin

Error in logic= TCF

Question 18

Evaluate how meehls model of the original DSM on explaining schizophrenia was criticised and what is believed now in the modern DSM(3) (-ve)

Answer 18

too simplistic

- has now been revised to account for the discovery that schizophrenia is a polygenetic condition and there is no single ‘schizogene’.
- accepted that a range of factors can cause the predisposition or diathesis, and these include physical and psychological trauma that effect the developing brain.
- range of stressors that can trigger schizophrenia has been widened to include cannabis use, as it appears to increase the risk of developing schizophrenia by up to 7 times.

Question 19

Evaluate how would we know we have been cured in the interactionist approach (2) (-ve)

Answer 19

• Generalisability - patient may appear cured in controlled conditions of clinician’s place of work but relapse in the real world.
  
  • Monitoring effectiveness - who decides when a treatment is effective? Both therapist and client want to see success so may be more prone to the Type 1 error (false positive). Patient may show ‘hello-goodbye’ effect’ exaggerating their disorder at their beginning to ensure they are taken seriously and exaggerating their recovery at the end out of gratitude.