interactionist approach to schizophrenia

Question 1

what’s the interactionist approach sometimes referred to as

Answer 1

biosocial approach

Question 2

what is the interactionist approach

Answer 2

acknowledges that there are biological psychological n societal factors in development of schiz.

Question 3

what are the biological factors

Answer 3

genetic vulnerability, neurochemical
neurological abnormality

Question 4

what r the psychological factors

Answer 4

stress
could result from life events and daily hassles
including poor quality of interactions in the family.

Question 5

what does diathesis mean

Answer 5

vulnerability

Question 6

what’s the diathesis-stress model

Answer 6

both a vulnerability to schiz and a stress stinger r nessecary in order to develop the condition.
one or more underlying factor make a person particularly vulnerable to developing schiz but the onset of the condition is triggered by stress.

Question 7

who created the original diathesis model

Answer 7

Meehl’s model 1962

Question 8

what is Meehl’s model

Answer 8

diathesis was entirely genetic, result of single ‘schizogene’.
Led to development of biologically based schizotypic personality, one characteristic is sensitivity to stress.

Question 9

According to Meehl’s model what would happen if someone doesn’t have the schizogene

Answer 9

then no amount of stress would lead to schiz.

Question 10

According to Meehl’s model what would happen if someone does carry the schizogene

Answer 10

chronic stress thru childhood n adolescence in particular schizophrenogenic mother could result in development of schiz.

Question 11

how has the modern understanding of diathesis changed

Answer 11

its now clear many genes appear to increase genetic vulnerability- no single ‘schizogene’
Ripke et al

Question 12

what did the modern diathesis become
Ingram and Buxton 2001

Answer 12

also uncured range of factors beyond genetic - psychological trauma.
trauma becomes diathesis rather then stress.

Question 13

what did Read et al devise in support for the modern diathesis

Answer 13

proposed a neurodevelopment model
which early trauma alters developing brain. child abuse can seriously affect many aspects of brain development.
example - hypothalamic-pituitary-adrenal (HPA) system can become over active making the person much more vulnerable to later stress.

Question 14

what’s HPA

Answer 14

hypothalamic-pituitary-adrenal

Question 15

what’s the modern understanding of stress
Houston et al

Answer 15

cannabis is a stressor bc it increases the risk of schiz by 7x according to dose.

Question 16

what does cannabis affect

Answer 16

cannabis interfers with dopamine system.
but most ppl don’t develop schiz after smoking so seems may be other vulnerability factors.

Question 17

what does the interactionist model combine for treatment

Answer 17

CBT snd antipsychotic drugs

Question 18

what does Douglas Tarkington et al point out in treatment

Answer 18

its perfectly possible to believe in biological causes and still practices CBT to relieve symptoms.
however requires adopting interactionist model - involving combing biological and psychological

Question 19

is it common to just use psychological therapies

Answer 19

no often those using family therapy, token economy, CBT are taking antipsychotics.

Question 20

Treatment according to interactionist model
USA and Britain

Answer 20

Britain - increasing standard practice to treat patients w combination of antipsychotics and CBT.
USA - more history of conflict between psychological n biological methods led to slower adoption to interactionist approach.

Question 21

evaluation points for the interactionist approach to schiz

Answer 21

+ evidence for the role of vulnerability and triggers
-original diathesis-stress model is oversimplified
+support for the effectiveness of combination of treatments

Question 22

what was Pekka Tienari et al evidence for the role of vulnerability triggers

Answer 22

investigated combination of genetic vulnerability and parenting style (the trigger)
Children adopted from 19,000 Finnish mothers w schiz between 1960 - 1979 were followed up.
the adoptive parents were assessed for child-rearing style and the rates of schiz were compared to a control group of adoptees without any genetic risk.
^charcterised by high levels of criticism and conflict and low levels of empathy was implicated in development of schiz but only in children w high genetic risk not control group.

Question 23

what were the conclusions/findings of Pekka Tienari research

Answer 23

suggested that both genetic vulnerability and family-related stress r importing for the development of schiz = genetically vulnerable children r more sensitive to parenting style.

this is very strong direct support for the importance of adopting the interactionist approach to schiz, including the idea poor parenting is possible source of stress.

Question 24

why is the original stress-diathesis model oversimplified

Answer 24

original- single schizogene and schizogenic parenting style as source of stress is very oversimplified.
multiple genes increase vulnrabilityeach having small effect, there is no single schizogene.
& stress can come in many forms, including dysfunctional parenting style.

Therefore vulnerability n stress do not have one single source.

Question 25

what was Houston et al other factor to stress that the original model missed

Answer 25

vulnerability result of early trauma as well as genetic makeup.
childhood sexual abuse vulnerability factor and cannibis was the trigger.

shows that old idea was oversimplified.
but this doesn’t affect the newer models.

Question 26

what was Tarrier et al 2004 study into support for effectiveness of combination of treatment

Answer 26

315 patients were ranomdly allocated to a medicine + CBT group, medicine + supportive counselling or a control group.

findings- patients in both the combined groups showed lower symptoms levels then control group. but no difference in hospital readmissions .

Question 27

what did Tarriers research show

Answer 27

show theres a clear practical advantage to adopting an interactionist approach. highlights the importance of taking this approach.