interactionist approach Flashcards
what is they key idea of the interactionist approach
- acknowledges there are biological, psychological and societal factors in development of SZ
what are the biological factors
genetic vulnerability, neurochemical and neurological abnormality
what are the psychological factors
-stress frm life events and daily hassles , including poor quality interactions in the family
what is diathesis stress model
- diathesis = vulnerability
-stress = means a negative experience to develop SZ, vulnerability and stress trigger have to be present
what does the meehl’ s model say
The original diathesis-stress model proposed that vulnerability to schizophrenia (SZ) was entirely genetic, caused by the “schizogene.” This led to a biologically based SZ-prone personality, marked by stress sensitivity. Without the schizogene, no amount of stress would cause SZ, but in carriers, chronic stress—especially from a schizophrenogenic mother—could trigger its development.
what is the modern understanding of the diathesis
many genes increase genetic vulnerability. There is no single ‘schizogene’ (Ripke et al, 2014).
range of factors beyond the genetic, including psychological trauma – trauma becomes the diathesis (vulnerability) rather than the stressor.
what did reed also propose in relation to the modern understanding
neurodevelopmental model 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.
modern understanding related to cannabis use
a modern definition of stress includes anything that risks triggering sz e.g. cannabis.
Cannabis is a stressor because it increases the risk of sz x7 as it interferes with the dopamine system.
counterpoint the cannabis use argument
However most don’t develop Schizophrenia after smoking cannabis so there must be other vulnerability factors.
equation for meehls model
Schizogene + stress = schizophrenia
equation for modern version
Combination of schizophrenia-related genes + environmental stess(ors) = higher chance of schizophrenia
treatment aspect of the approach
acknowledges both biological and psychological factors and is compatible with both types of treatment.
Model combines antipsychotics with psychological therapies such as CBT.
what does turkington et al state on treatments
it is possible to believe in biological causes of SZ and still practice CBT to relieve psychological symptoms BUT, this requires adapting an interactionist approach and not purely a biological one.
usa use of treatments
the USA there is a history of conflict between psychological and biological models of SZ which may have led to slower adaption to the interactionist approach. It is more common in USA for patients to use medication WITHOUT having psychological treatments too.
how does uk differ in use of treatment
Standard practice in UK to combine the two and is unusual to treat using psychological therapies alone but more acceptable to treat with medication alone.
strenghts of approach
(evidence for role of vulnerbaility of triggers)
Tienari (2004) studied the interaction between genetic vulnerability and parenting style in the development of schizophrenia (Sz). The research involved children adopted from 19,000 Finnish mothers with Sz. Adoptive parents were assessed for their child-rearing style, and rates of Sz in adoptees were compared to those in a control group without genetic risk. The study found that a child-rearing style characterized by high criticism, conflict, and low empathy was associated with the development of Sz, but only in genetically vulnerable children, not in the control group. This suggests that both genetic factors and family stress contribute to the development of Sz, with genetically vulnerable children being more sensitive to negative parenting behaviors. The study supports an interactionist approach to understanding Sz.
(real world app)
Tarrier (2004) conducted a study with 315 patients who were randomly assigned to three groups: medication + CBT, medication + supportive counseling, and a control group (medication only). The results showed that patients in the two combination treatment groups had lower symptom levels after the trial compared to the control group. However, there were no significant differences in hospital readmission rates. This study, along with others, suggests that combining biological and psychological treatments provides clear advantages.
(urbanisation)
Schizophrenia is more commonly diagnosed in urban than rural areas.
This is sometimes used to justify the interactionist position, as it is assumed that urban living is more stressful than rural and therefore, acts as a trigger.
limitations of apporach
(diathesis and stress are complex)
The idea of a single schizogene and dysfunctional parenting as the primary cause of schizophrenia is now considered oversimplified. It’s understood that multiple genes contribute to vulnerability, rather than a single gene. Stress can take many forms, not just dysfunctional parenting, and can include biological factors like early trauma. For example, Houston (2008) found that childhood sexual trauma could be a vulnerability factor, with cannabis acting as a trigger. This challenges the traditional view of diathesis-stress as purely biological and psychological. However, this does not pose a problem for newer models, which take a more comprehensive approach to understanding schizophrenia.
(cp real wolrd app)
Jarvis and Okami (2019) argue that claiming a successful treatment for a mental disorder justifies a particular explanation is logically flawed. They compare it to saying that because alcohol reduces shyness, shyness is caused by a lack of alcohol. This is an example of the “treatment causation fallacy.” Therefore, we cannot automatically assume that the success of combined therapies means that interactionist explanations for mental disorders are correct.
(urbanistaion)
However, it may simply by that Schizophrenia is more likely to be diagnosed in cities or that people with a diathesis for Schizophrenia tend to migrate to cities.
