Interactionist approach Flashcards
What does the interactionist approach say about schizophrenia?
The interactionist approach acknowledges there are biological psychological and societal factors in the development of schizophrenia
When is a schizophrenic episode seen as being triggered or worsened?
When a biological vulnerability (diathesis) combines with environmental stressors (stress) - this is known as the diathesis - stress model
What does the biological part of the interactionist approach state schizophrenia comes from?
Biological = genetic vulnerability, neurochemical, abnormality and neurological
What does the psychological part of the interactionist approach state schizophrenia stems from?
Psychological = stress resulting from life events and daily hassles, including poor quality interactions in the family (family dysfunction), substance abuse and trauma
What is Meehl’s historic diathesis-stress model?
Initially it was believed that the diathesis for schizophrenia was entirely genetic; the result of a single ‘schizogene’.
This led to the development of a biologically based schizotypic personality, one characteristic is sensitivity to stress.
According to Meehl, if a person doesn’t have the schizogene then no amount of stress would lead to schizophrenia. However, in carriers of the gene, chronic stress through childhood and adolescence, particularly a schizophrenic mother could result in schizophrenia.
What are the modern views of the ‘schizogene’?
It is clear that many genes increase genetic vulnerability. There is no single ‘schizogene’.
Modern views of diathesis also include a range of factors beyond the genetic, including psychological trauma - trauma becomes the diathesis rather than the stressor.
What did Read propose?
Read (2001) proposed a neurodevelopmental model in which early development in which early trauma alters the developing brain. E.g. The hypothalamic-pituitary-adrenal system (HPA) becomes over-active and the person is more vulnerable to later stress.
How is cannabis a stressor?
Cannabis is a stressor because it increases the risk of schizophrenia 7x as it interferes with the dopamine system
Why isn’t cannabis the only vulnerability factor for schizophrenia?
However most don’t develop schizophrenia after smoking cannabis so there must be other vulnerability factors
What is the differential susceptibility hypothesis?
Extends the diathesis-stress model to include positive as well as negative environments
Explain the differential susceptibility hypothesis
An individual may have a biological vulnerability that, when combined with a stressor, leads to schizophrenia. However, the same individual, if exposed to a positive environment, such as a loving family background, could have better outcomes that reduce the chances of them becoming schizophrenic
What did Hogarty research and what were the findings?
Hogarty (1986) assessed relapse rates in 103 schizophrenics from high EE families receiving various treatments:
1st year relapse rates
Family therapy and drugs=19%
Social support and drugs=20%
Drug treatment only=41%
Family therapy and social support and drugs= 0%
What does Hogarty’s research show?
This supports the idea of combining treatments.
However, a follow up study showed that the combined treatment only delayed relapse rather than preventing it.
What did Tarrier research?
315 patients were randomly allocated to a medication and CBT group, medication and supportive counselling or a control group
Patients in the two combination groups showed lower symptom levels than control, although there were no difference in rates of hospital readmission
This and other studies show there is clear advantage to adopting an interactionist approach
