interactionist approach to schz Flashcards
What is the interactionist approach?
A broad approach to explaining schizophrenia, which acknowledges that a range of factors, including biological and psychological factors, are involved in the development of schizophrenia.
Biological factors include genetic vulnerability and neurochemical abnormality. Logical factors include stress, for example, resulting from life events and daily hassles.
describe the diathesis stress model.
An Interactionist approach to explaining behaviour.
Schizophrenia is explained as a result of both an underlying vulnerability and a trigger, both of which are necessary for the onset of schizophrenia.
In early versions of the model, vulnerability was genetic and triggers for psychological. Meehl’s model - diathesis Was entirely genetic, the result of a single ‘schizogene’. This led to the development of a biologically based schizotypic personality, a characteristic of which is sensitivity to stress. if a person does not have the schizogene then no amount of stress would lead to schizophrenia.
However in carriers of the gene chronic stress the childhood and adolescence, in particular the presence of a schizophrenic mother, could result in the development of the condition.
Outline the modern understanding of diathesis.
It is now clear that many genes each appear to increase genetic vulnerability slightly; there is no single ‘schizogene’.
modern the use of diathesis also include a range of factors beyond the genetic, including psychological trauma.
Early and severe enough trauma, such as child abuse, can seriously affect many aspects of brain development.
For example, the hypothalamic-pituitary-adrenal (HPA) system can become overactive, making the person much more vulnerable to later stress.
Outline the modern understanding of stress.
In the original hotel just seen the psychological nature. Although it is still considered important, a modern definition of stress includes anything that risks triggering the schizophrenia.
for example, much of the recent research into factors triggering an episode of schizophrenia has concerned cannabis use.
In terms of the D-S model cannabis is a stressor because it increases the risk of skits for a nearby up to seven times according to dose. This is probably because cannabis interferes with the dopamine system.
Evidence for the role of vulnerability and triggers as a strength of the IA.
There is evidence to support the dual role of vulnerability and stress in the development of schizophrenia.
Tienari et al (2004) investigated the combination of genetic vulnerability and parenting style (the trigger). Children adopted from 19 000 Finnish mothers with schizophrenia between 1960 and 1979 were followed up.
Their adoptive parents were assessed for child-rearing style and the rates of schizophrenia were compared to those in a control group of adoptees without any genetic risk.
A child-rearing style characterised by high levels of criticism and conflict and low levels of of empathy was implicated in the development of schizophrenia but only for the children with high genetic risk but not in the control group.
This suggests that both genetic vulnerability and family-related stress are important in the development of schizophrenia - genetically vulnerable children are more sensitive to parenting behaviour.
This is very strong direct support for the importance of adopting an interactionist approach to schizophrenia, including hanging onto the idea that poor parenting is a possible source of stress.
Describe treatment according to the interactionist model.
I acknowledges both biological and psychological factors and schizophrenia and is therefore compatible with both biological and psychological treatments.
it is unusual to treat schizophrenia using psychological therapies alone. CBT, family therapy and the use of token economies with sufferers of schizophrenia are usually carried out with patients taking antipsychotics.
The original diathesis-stress model is over-simple as a limitation of the IA.
The classic model of a single schizogene and schizophrenic parenting style as the major source of stress is now known to be very over-simple.
Multiple genes increase vulnerability to schizophrenia, each having a small effect on its own; there is no single schizogene.
Also stress can come in many forms, including but not limited to dysfunctional parenting. Therefore vulnerability and stress do not have one single source.
In fact it is now believed that vulnerability can be the result of early trauma as well as genetic make-up, and that stress can come in many forms including biological.
In one recent study by Houston et al (2008) childhood sexual trauma emerged as a vulnerability factor whilst cannabis use was a trigger.
This shows that the old idea of diathesis as biological and stress as psychological has turned out to be overly simple.
This is a problem for the old idea of diathesis-stress but not for newer models.
Support for the effectiveness of combinations of treatments as a strength of the IA.
There is support for the usefulness of adopting an interactionist approach in treatment.
As Turkington et al (2006) pointed out, it is not really possible to use combination treatments without adopting an interactionist approach.
Studies show an advantage to using combinations of treatments for schizophrenia.
For example, in one study by Tarrier et al (2004) 315 patients were randomly allocated to a medication + CBT group, medication + supportive counselling or a control group.
Patients in the two combination groups showed lover symptom levels than those in the control group (medication only).
Studies like this show that there is a clear practical advantage to adopting an interactionist approach in the form of superior treatment outcomes, and therefore highlight the importance of taking an interactionist approach.
HOWEVER -
The fact that combined biological and psychological treatments are more effective than either on their own does not necessarily mean the interactionist approach to schizophrenia is correct.
This error of logic is called the treatment causation fallacy.
This limits of confidence in the validity of the interactionist approach to explaining schizophrenia as a condition.
