interactionist approach to schizophrenia Flashcards
what’s the interactionist approach also known as
biosocial approach
what does the interactionist approach acknowledge
there are biological, psychological & social factors in development of schizophrenia
examples of biological factors
- genetic vulnerability
- neurochemical
- neurological abnormality
examples of psychological factors
stress (eg. resulting from live events, daily hassles)
examples of social factors
poor quality interactions in the family
what is one way of presenting the interactionist approach
diathesis-stress model
what does the diathesis-stress model say
vulnerability to schizophrenia & stress-trigger are necessary to develop schizophrenia
when was the original diathesis-stress model
meehl (1962)
describe meehl (1962) original diathesis-stress model
- diathesis (vulnerability) was entirely genetic & result of single ‘schizogene’
- led to idea of biologically based schizotypic personality (one characteristic is sensitivity to stress)
- according to meehl, if someone doesn’t have schizogene then no amount of stress will lead to Sz
- although, in carriers of schizogene, chronic stress through childhood & adolescence (especially presence of schizophrenogenic mother) could result in development of Sz
describe the modern understanding of diathesis (diathesis-stress model)
- many genes which appear to increase genetic vulnerability, as no single ‘schizogene’ (ripke et al. 2014)
- diathesis refers to range of factors beyond genetic, including psychological trauma (ingram & luxton 2005) = trauma becomes diathesis rather than stressor
- read et al. (2001) proposed neurodevelopmental model where early trauma alters developing brain (eg. hypothalamic-pituitary-adrenal (HPA) system can become overactive, making someone more vulnerable to later stress)
describe the modern understanding of stress (diathesis-stress model)
original diathesis-stress model = stress seen as psychological, particularly related to parenting
- now stress is seen as anything which risks triggering schizophrenia (houston et al. 2008)
- much of recent research into factors triggering episode of Sz concerned with cannabis use = stressor as increases risk of Sz by up to 7x according to dose as likely interferes with dopamine system
- however, most don’t develop Sz after smoking cannabis as presumably lack vulnerability factors necessary
describe treatment according to interactionist model
- model acknowledges biological & psychological factors in Sz = compatible with both treatments
- combines antipsychotic medication with psychological therapies (often CBT)
- increasingly standard practice in britian to treat those with Sz diagnos with combination of antipsychotic drugs & CBT
- in US = slower adoption of interactionist approach due to history of conflict between psychological & biological models of Sz
AO3 +) evidence supporting role of vulnerability & triggers
E:
- tienari et al. (2004) conducted large-scale study & investigated impact of genetic vulnerability & psychological trigger (dysfunctional parenting)
- followed 19,000 finnish children with biological mothers diagnosed with Sz
- high genetic risk group compared to control group of adoptees without family history of Sz (low genetic risk) in adulthood
- adoptive parents assessed for child-rearing style
- found high criticism levels, hostility & low levels of empathy strongly associated with development of Sz, but only in high genetic risk group
T: shows combination of genetic vulnerability & family stress can lead to greatly increased risk of Sz
AO3 -) original diathesis-stress model is oversimplified
E:
- portrayed diathesis as single schizogene & stress as schizophrenogenic parenting
- multiple genes in multiple combinations influence diathesis
- stress arises in many forms, including dysfunctional parenting
- diathesis can be influenced by psychological factors & stress can be biological/psychological
- seen in study by houston et al. (2008) where childhood sexual abuse emerged as major influence on underlying vulnerability to Sz & cannabis use as major trigger
T: shows there’s multiple factors (including biological or psychological) affecting diathesis & stress, supporting modern understanding of diathesis & stress
AO3 +) interactionist approach has real-world application for combination of biological & psychological treatments
E:
- practical application of acknowledging biological/psychological factors in Sz is the combination of drug treatment & psychological therapies
- studies show combining treatments increases their effectiveness
- eg. tarrier et al. (2004) randomly allocated 315 participants to 1) medication/CBT, 2) medication/counselling or 3) control group (only medication)
- participants in groups 1 & 2 showed lower symptoms following trial, although no difference in hospital readmission
T: obvious practical advantage to adopting interactionist approach to Sz regarding superior treatment outcomes
HOWEVER, jarvis & okami (2019) acknowledged that saying a successful treatment for mental disorder justifies an explanation is known as the treatment-causation fallacy, meaning we cannot assume success of combined therapies means interactionist approach is correct
