interactionist approach to schizophrenia Flashcards
what’s the interactionist approach sometimes referred to as
biosocial approach
what is the interactionist approach
acknowledges that there are biological psychological n societal factors in development of schiz.
what are the biological factors
genetic vulnerability, neurochemical
neurological abnormality
what r the psychological factors
stress
could result from life events and daily hassles
including poor quality of interactions in the family.
what does diathesis mean
vulnerability
what’s the diathesis-stress model
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.
who created the original diathesis model
Meehl’s model 1962
what is Meehl’s model
diathesis was entirely genetic, result of single ‘schizogene’.
Led to development of biologically based schizotypic personality, one characteristic is sensitivity to stress.
According to Meehl’s model what would happen if someone doesn’t have the schizogene
then no amount of stress would lead to schiz.
According to Meehl’s model what would happen if someone does carry the schizogene
chronic stress thru childhood n adolescence in particular schizophrenogenic mother could result in development of schiz.
how has the modern understanding of diathesis changed
its now clear many genes appear to increase genetic vulnerability- no single ‘schizogene’
Ripke et al
what did the modern diathesis become
Ingram and Buxton 2001
also uncured range of factors beyond genetic - psychological trauma.
trauma becomes diathesis rather then stress.
what did Read et al devise in support for the modern diathesis
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.
what’s HPA
hypothalamic-pituitary-adrenal
what’s the modern understanding of stress
Houston et al
cannabis is a stressor bc it increases the risk of schiz by 7x according to dose.
what does cannabis affect
cannabis interfers with dopamine system.
but most ppl don’t develop schiz after smoking so seems may be other vulnerability factors.
what does the interactionist model combine for treatment
CBT snd antipsychotic drugs
what does Douglas Tarkington et al point out in treatment
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
is it common to just use psychological therapies
no often those using family therapy, token economy, CBT are taking antipsychotics.
Treatment according to interactionist model
USA and Britain
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.
evaluation points for the interactionist approach to schiz
+ evidence for the role of vulnerability and triggers
-original diathesis-stress model is oversimplified
+support for the effectiveness of combination of treatments
what was Pekka Tienari et al evidence for the role of vulnerability triggers
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.
what were the conclusions/findings of Pekka Tienari research
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.
why is the original stress-diathesis model oversimplified
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.
what was Houston et al other factor to stress that the original model missed
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.
what was Tarrier et al 2004 study into support for effectiveness of combination of treatment
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 .
what did Tarriers research show
show theres a clear practical advantage to adopting an interactionist approach. highlights the importance of taking this approach.
