Interactionist Approach In explaining and treating Sz

Question 1

what are the AO1 points for the Interactionist Approach In explaining and treating Sz

Answer 1

• Basis of Interactionist Approach
• Diathesis Stress Model
• Meehl’s Model
• Modern Understanding of DIATHESIS
• Modern Understanding of STRESS
• treatment

Question 2

what is the AO1 point, Basis of Interactionist Approach

Answer 2

• There are biological, psychological and societal factors involved in the development (and treatment) of schizophrenia
• Biological factors include genetics, neurochemical and neuroanatomical abnormality
• Psychological factors include parenting/family factors, stress and cognition.

Question 3

what is the AO1 point, Diathesis Stress Model

Answer 3

• ‘Diathesis’ means “vulnerability” and ‘Stress’ means a “negative psychological experience”
• Both a biological vulnerability and an environmental trigger are necessary to develop the condition
• Diathesis = biology, stress = environment
• Such as parents (environment) triggering a gene

Question 4

what is the AO1 point, Meehl’s Model

Answer 4

• One of the earliest interactionist theories
• He proposed that a single “schizogene” caused a “schizotypic personality”
• Without this gene, it doesn’t matter how much stress you experience in your life- you won’t develop Sz without the gene
• However if you have the gene you are very vulnerable and having a schizophrenogenic Mother may cause Sz.
• You have to have both the gene + environment
• If it’s genetic, then the parent may display symptoms - is at all the same?

Question 5

what is the AO1 point, Modern Understanding of DIATHESIS

Answer 5

• It is now clear that Sz is polygenic and is aetiologically heterogeneous.
• Furthermore, psychologists now propose that “diathesis” does not have to be biological- it could be psychological i.e. early trauma
• Read (2001) showed that early trauma (e.g. abuse) alters the developing brain (changes things biologically), making the HPA system (stress-response) over active (more vulnerable to stress).

Question 6

what is the AO1 point, Modern Understanding of STRESS

Answer 6

• Many psychologists now propose that “stress” can be triggered by non-psychological factors- especially DRUG USE.
• Cannabis use can increase the risk of developing Sz by making you 7 x more likely to develop the disorder than a non-user. This is likely due to its interference with the DOPAMINE SYSTEM in the brain.
• However, many people who use cannabis do not ever develop the disorder, highlighting the importance of a diathesis first.

Question 7

what is the AO1 point, Treatment

Answer 7

• Most typical interactionist treatment is combining anti-psychotic drugs and CBT.
• Many psychologists believe in biological causes of Sz, using drugs to treat this but psychological therapies to help MANAGE the symptoms of the disorder.
• In the Uk this is the most common treatment programme (not yet in America where drug treatments rule).
• Other interactionist treatment programmes involve anti-psychotic drugs and family therapy or use of the token economy.
• It is NOT common practise to use psychological treatments alone.

Question 8

what are the +ve AO3 points for the interactionist approach in explaining and treating schizophrenia

Answer 8

• Research Support- Tienari
• Further Support- Houston
• Support for Interactionist Treatment- Tarrier
• Further Support- Sudak

Question 9

expand on the +ve AO3 point, Research Support- Tienari, for the interactionist approach

Answer 9

• Investigated the interactionism of genetic vulnerability and parenting style
• Children adopted from 19,000 Finnish mothers with Sz between 1960 and 1979 were followed up. (longitudinal study)
• Adoptive parents were assessed for parenting style, and comparisons were made with a control group of adopted children WITHOUT genetic vulnerability
• Parenting style of high levels of criticism and conflict and low levels of empathy (i.e. Szg Mother) was found to be associated with Sz in the genetically vulnerable children ONLY. → they have the biology + stress → have the diathesis and stress
• This shows the importance of DIATHESIS and STRESS in the development of Sz- where stress in the form of poor parenting was not enough on its own to cause Sz

Question 10

expand on the +ve AO3 point, Further Support- Houston, for the interactionist approach

Answer 10

• Houston (2008) supported the theories of MODERN diathesis and stress
• In his study, childhood sexual abuse was found to be the most important DIATHESIS (and not Biology, as proposed by the early models)
• Whereas DRUG USE (cannabis) was found to be the most important STRESS in the development of Sz.
• This highlights that early models e.g. by Meehl are oversimplified and that avenues for further research should investigate open interpretations of diathesis and stress in the broadest sense.

Question 11

expand on the +ve AO3 point, Support for Interactionist Treatment- Tarrier, for the interactionist approach

Answer 11

• Tarrier found that people with schizophrenia receiving 20 sessions of CBT coupled with drug therapy did better than sufferers receiving drug therapy alone or supportive counselling with drug therapy.

Contd…

• Patients in the drugs and CBT group made the best recovery- a large proportion of them had significant decrease in psychosis and many lost ALL positive symptoms
• Treatment was less effective in the drug and counselling group
• No patients in the drugs-only group were symptom-free. → need both together as a treatment to be effective

Question 12

expand on the +ve AO3 point, Further Support- Sudak, for the interactionist approach

Answer 12

• Sudak (2011) reports that antipsychotic drug medication combined with CBT strengthens adherence to drug treatment
• The CBT gives the patient rational insight into the benefits of adhering to their drug treatment, increasing their chances of improvement, and decreasing chances of relapse.
• This illustrates the benefit of combining treatments.

Question 13

what is the -ve AO3 point for the interactionist approach in explaining and treating schizophrenia

Answer 13

• The treatment-causation Fallacy
• Just because many treatment programmes seem to be successful using both anti-psychotics and psychological treatments does not actually mean that the interactionist approach is completely CORRECT in explaining the development of Sz
• Psychologists point out that either treatment could just help manage symptoms, an OUTCOME of the disorder, not a cause. → may just be managing symptoms and not treatments
• Treating the outcome of the disorder and not the cause