Interactionist Approach In Explaining The Onset & Treatment Of SZ

Question 1

What is the interactionist approach (aka the bio social approach)

Answer 1

an approach that acknowledges that there are biological, psychological and societal factors in the development of SZ.

Question 2

Biological factors include… (4 development)

Answer 2

genetic vulnerability and neurochemical (e.g. dopamine) and neurological (brain) abnormality.

Question 3

Psychological factors include

Answer 3

stress resulting from life events and daily hassles, including poor quality interactions in the family

Question 4

What does the diathesis stress model say is necessary to develop SZ

Answer 4

A vulnerability to SZ & a stress-trigger

Question 5

When was Meehl’s model

Answer 5

1962

Question 6

Features of meehls model

Answer 6

• vulnerability seen as entirely genetic
  -> schizogene -> schizotypic personality
  -> particularly sensitive to stress
  Chronic stress through childhood could result in schizophrenia
  No schizogene = no sensitivity to stress = no schizophrenia

Question 7

Modern understanding of diathesis features

Answer 7

• Schizophrenia = polygenetic (Ripke,2014)
• vulnerability can be caused by psychological trauma too e.g. early trauma like child abuse, which can even alter the developing brain

Question 8

Modern understanding of stress

Answer 8

Originally seen as psychological in nature
-> particularly in relation to parenting
Now considered anything that risks triggering schizophrenia
-> cannabis use = 7x more likely to develop SZ found

Question 9

Supporting evidence for this model
-> Tienari et al 2004 dual role vulnerabilities & stress (genetic & parenting style)

Answer 9

Dual role of vulnerability and stress (Tienari et al., 2004)
Genetic vulnerability and parenting style.
• Children adopted from 19000 Finnish mothers with schizophrenia between 1960 and 1979)
Adoptive parents were assessed for parenting style
Compared to control group.
Child rearing style w. High levels of criticism and conflict and low levels of empathy -> implicated in the development of schizophrenia in high risk adoptees.
Suggests that genetic vulnerability and family related stress can contributed to the onset of schizophrenia.

Question 10

(-) how is the interactionist model overly simplistic

Answer 10

The idea of a single schizogene mixed with the stress of schizophrenic parenting is very simplistic.
• Polygenic (Ripke, 2014)) + stress comes in many forms and is not limited to dysfunctional parenting.
• E.g. Houston et al. (2008) - sexual abuse in childhood as a major influence on underlying vulnerability to schizophrenia and cannabis use as a major trigger.
• Supports the modern understanding of diathesis and stress.

Question 11

(+) Real World Application of this approach in its combo of treatments

Answer 11

Combination of biological and psychological treatments
Studies show that combining treatments enhance their effectiveness in the treatment of schizophrenia.
• Tarrier et al. (2004)
• 315 participants assigned to (1) Medication + CBT (2) Medication + Counselling (3) Medication only (control)
• Combination treatments showed greater reduction in symptom severity.
Clear practical advantage to adopting an interactionist approach in the treatment of schizophrenia based on the superior treatment outcomes.

Question 12

(-) limitation of the combined treatments (treatment-causation fallacy)

Answer 12

Argued the fact that biological and psychological therapies are more effective than either on their own doesn’t necessarily mean the interactionist approach to schizophrenia is correct
This error of logic is called the treatment causation effect & means that the superior outcomes of combined therapies shouldn’t be overinterpreted in terms of evidence in support of the approach

Question 13

AO1 ms points

Answer 13

• considers combined effects of biological, psychological & social factors on the development of SZ
• diathesis stress model combines effects of internal vulnerability and external stress trigger
• vulnerability (diathesis) o.g. Thought to be genetic, now includes due to childhood trauma which could affect brain development too
• stress trigger = any negative psychological experience e.g. relationship breakdown too
• treatment would include combining anti-psychotic medication with psychological therapy

Question 14

AO1 ms points

Answer 14

• considers combined effects of biological, psychological & social factors on the development of SZ
• diathesis stress model combines effects of internal vulnerability and external stress trigger
• vulnerability (diathesis) o.g. Thought to be genetic, now includes due to childhood trauma which could affect brain development too
• stress trigger = any negative psychological experience e.g. relationship breakdown too
• treatment would include combining anti-psychotic medication with psychological therapy

Question 15

AO3 ms points

Answer 15

• implications for treatment (relative effectiveness of single treatments versus multidisciplinary ones)
• revised understanding of stress trigger e.g. any risk one like substance abuse
• evidence to support efficacy of combined treatments
• revised understanding of diathesis: move from focus purely on single gene effect to polygenic one