Interactionist approach to schizophrenia

Question 1

interactionist approach definition

Answer 1

way of explaining the development of behaviour in terms of a range of factors, including both biological and psychological ones, most importantly such factors don’t simply add together but combine in a way that can’t be predicted by each on separately (they interact)

Question 2

diathesis stress model definition

Answer 2

interactionist approach to explaining behaviour. for example, schizophrenia is explained as the result of bothe na underlying vulnerability (diathesis) and trigger (stressor), both of which are necessary for the onset of schizophrenia, in early versions of the diathesis-stress model, vulnerability was genetic and triggers were psychological. nowadays both genes and trauma are seen as diathesis, and stress can be psychological or biological in nature

Question 3

what is the interactionist approach sometimes called

Answer 3

the biosocial approach

Question 4

why is the interactionist approach sometimes called the biosocial approach

Answer 4

acknowledges that there are biological, psychological and social factors in development of schizophrenia

Question 5

what do biological factors in interactionist approach include

Answer 5

genetic vulnerability, neurochemical and neurological abnormality

Question 6

what do psychological factors in in interactionist approach include

Answer 6

stress such as from life events and daily hassles such as social factors and poor quality interactions in the family

Question 7

what is one way to present in interactionist approach

Answer 7

diathesis-stress

Question 8

what does diathesis-stress mean

Answer 8

-diathesis means vulnerability
-stress (in this context) means a negative experience

Question 9

what does the diathesis-stress model say

Answer 9

both a vulnerability to schizophrenia and a stress-trigger are necessary in order to develop the disorder. one or more underlying factors make a person particularity vulnerable to schizophrenia but the onset is triggered by stress

Question 10

who did original diathesis-stress model

Answer 10

Meehl’s

Question 11

what was Meehl’s diathesis-stress model

Answer 11

diathesis was entirely genetic, as a result of one schziogene. this led to the idea of biologically based schizotypic personality, one characteristic of which is sensitivity to stress. according to Meehl, if a person does not have the schziogene no amount of stress would lead to schizophrenia. however, in carriers of the gene, chronic stress through childhood and adolescence, in particular the presence of a schizophrenogenic mother could result in development of the disorder

Question 12

how has modern understanding of diathesis changed from Meehl’s model

Answer 12

clear that many genes each appear to increase genetic vulnerability only slightly, there is no single schziogene (Ripke et al)

Question 13

what do modern view of diathesis also include

Answer 13

a range of factors beyond the genetic, including psychological trauma (Ingram and Luxton)- so trauma becomes the diathesis rather than the stressor

Question 14

what did Read et al propose

Answer 14

neurodevelopmental model

Question 15

what was Read et al neurodevelopmental model

Answer 15

early trauma alters the developing brain. early and severe trauma, such as child abuse, can seriously affect many aspects of brain development. for example the hypothalamic-pituitary-adrenal system can become overactive, making a person much more vulnerable to later stress

Question 16

what side of the nature-nurture debate was the original (Meehl’s) model on

Answer 16

psychological in nature, in particular related to parenting

Question 17

what is the modern definition of stress

Answer 17

anything that risks triggering schizophrenia (houston et al)

Question 18

is psychological stress still important

Answer 18

yes, including that which results from parenting is still considered important, but the modern definition of stress includes anything that risks triggering schizophrenia

Question 19

what is a recently researched factor into development of schizophrenia

Answer 19

cannabis use

Question 20

role of cannabis in the diathesis-stress model

Answer 20

cannabis is a stressor as it increases the risk of schizophrenia by up to 7 times according to dose

Question 21

why does cannabis increase risk of schizophrenia

Answer 21

interferes with the dopamine system

Question 22

why do most people that smoke cannabis not develop schizophrenia

Answer 22

do not have the requisite vulnerability factors

Question 23

what types of treatments is the interactionist model compatible with

Answer 23

biological and psychological as acknowledges both biological and psychological factors

Question 24

what particular treatments are associated with the interactionist approach

Answer 24

combining antipsychotics and psychological therapies (most commonly CBT)

Question 25

what did Turkington et al point out

Answer 25

possible to believe in biological causes of schizophrenia and still practice CBT to relieve psychological symptoms. however, this does require adopting an interactionist approach- it is not possible to adopt a purely biological approach and tell people diagnosed with schizophrenia that their condition is purely biological and there is no psychological significance to symptoms, and then to simultaneously treat them with with CBT

Question 26

what is the increasingly standard practice for treating schizophrenia in britain

Answer 26

combination of antipsychotic drugs and CBT

Question 27

how is schizophrenia treated in the US

Answer 27

more of a history of conflict between psychological and biological models of schizophrenia which may have led to a slower adoption of the interactionist approach

Question 28

how does standard treatments in US and UK change treatments

Answer 28

medication without accompanying psychological treatment is more common in the US and the UK

Question 29

strength of the interactionist approach to schizophrenia - support for vulnerability and triggers

Answer 29

-evidence supporting the role of both vulnerability and triggers -in a large scale study by Tienari et al, the impact of both genetic vulnerability and psychological trigger (dysfunctional parenting) was investigated. the study followed 19000 Finnish children whose biological mothers had been diagnosed with schizophrenia. in adulthood this high genetic risk group were compared to a control group of adoptees without a family history of schizophrenia (low genetic risk). adoptive parents has been assessed for child-rearing style and it was found that high levels of criticism of schizophrenia, but only in the high genetic risk group --> shows that a combination of genetic and vulnerability and family stress can lead to greatly increased risk of schizophrenia

Question 30

limitation of the interactionist approach to schizophrenia - diathesis and stress are complicated

Answer 30

-original diathesis stress model is oversimplified -now clear that the original model that portrayed diathesis as a single schziogene and portrayed stress as schizophrenogenic parenting is hopelessly simplistic. multiple genes in multiple combinations influence diathesis. stress also comes in many forms, including but not limited to dysfunctional parenting. in facts, diathesis can also be influenced by psychological factors and stress can be biological as well as psychological. this is shown in a a study by Houston et al in which childhood vulnerability to schizophrenia and cannabis as the major trigger --> means multiple factors, both biological and psychological, affecting both diathesis and stress, supporting the modern understanding of both diathesis and stress

Question 31

strength of the interactionist approach to schizophrenia - real-world application

Answer 31

-in combination of biological and psychological treatments -practical application of acknowledging biological and psychological factors in schizophrenia has been combination of drug treatments and psychological therapies. studies show that combining treatments enhanced their effectiveness. Tarrier et al randomly allocated 315 participants to either medication + CBT, medication + counselling ot the control group of just medication. participants in two combination groups showed lower symptoms following the trail than the medication-only group, though there was no difference in hospital readmission --> means clear practical advantage to adopting an interactionist approach to schizophrenia in terms of superior treatment outcomes

Question 32

limitation of the interactionist approach to schizophrenia - counterpoint to real-world application

Answer 32

Jarvis and Okami point out that saying that a successful treatment for mental disorder justifies a particular explanation is the logical equivalent of laying that because alcohol reduces shyness, shyness is caused by a lack of alcohol. this logical error is called treatment causation fallacy --> cannot automatically assume that success of combined therapies means interactionist explanations are correct

Question 33

evaluation of the interactionist approach to schizophrenia - urbanisation

Answer 33

-schizophrenia is more commonly diagnosed in urban than rural areas. this is sometimes used to justify the interactionist position, as it assumes that urban living is more stressful than rural and therefore city living acts as a trigger -however, it may simply be that schizophrenia is more likely to be diagnosed in cities, or that people with diathesis for schizophrenia (teenagers abused as children) tend to migrate to cities