Interactionist Approach to SZ

Question 1

What does this approach acknowledge

Answer 1

That there are biological, psychological and societal factors in the development of SZ

Question 2

What are the biological factors in the development of SZ

Answer 2

Genetic vulnerability and neurochemical and neurological abnormality

Question 3

What are the psychological factors in the development of SZ

Answer 3

Stress resulting from life events and daily hassles, including poor quality interactions in the family

Question 4

What is the diathesis-stress model

Answer 4

Vulnerability to SZ and a stress-trigger are necessary to develop SZ
One or more underlying factors make a person vulnerable but the onset of the condition is triggered by stress

Question 5

What is Meehl’s 1962 Model

Answer 5

Believed diathesis was entirely genetic
Result of a single ‘schizogene’
um thats offensive to us schizos
Led to the development of a biologically based schizotypic personality: one characteristic is sensitive to stress
‘If a person doesn’t have the schizogene then no amount of stress would lead to schizophrenia’
But in carriers of the gene, chronic stress through childhood and adolescence, particularly a SZ mother could result in SZ

Question 6

What is the modern understanding of diathesis

Answer 6

Now clear that many genes increase genetic vulnerability
No single ‘schizogene’
Modern views of diathesis also include range of factors beyond genetic, including psychological trauma - trauma becomes diathesis rather than the stressor

Question 7

What neurodevelopmental model was proposed by Read et al 2001 as a different theory to Meehl

Answer 7

Early tauma alters the developing brain
e.g. Hypothalamic-pituitary-adrenal system (HPA) becomes over-active and person is more vulnerable to later stress

Question 8

Describe the original understanding of stress

Answer 8

Originally stress was seen as psychological in nature, in particular related to parenting

Question 9

Describe the modern understanding of stress

Answer 9

Psychological stress is still seen as important, a modern definition of stress includes anything that risks striggering SZ, e.g cannabis
Marryjuana is a stressor because it increases the risk of SZ by 7X as it interferes with the dopamine system
However most don’t develop SZ after smoking cannabis so there must be other vulnerability factors (Houston et al 2008)

Question 10

What treatment does the approach suggest for SZ

Answer 10

Acknowledges both bio and psych factors and therefore is compatible w both types of treatment
Model combines antipsychotics w psychological therapies like CBT
Standard practice in GB is to combine the 2
Is unusla to treat using psychological therapies alone

Question 11

What does Turkington et al 2006 say abt interactionist appraoch treatment

Answer 11

‘It is perfectly possible to beleive in biological causes and still practice CBT to relive psychological symptoms’
what an utter waste of oxygen
However treatment would need to be adapted for each individual as there is not one possible cause

Question 12

What is a +ve evaluation for this approach regarding evidence for the role of vulnerability and triggers

Answer 12

Tienari 2004 - investigated combinaton of genetic vulnerability and parenting style (the trigger)
Children adopted from 19k Finnish mothers w SZ between 1960-79
Adoptive parents assessed for child-rearing style and rates of SZ were compared to those in a control group of adoptees without any genetic risk
Child-rearing style of high levels of criticism and conflict and low levels of empathy was implicated in the development of SZ but only for the children w high genetic risk but not in the control group
Suggests both genetic vulnerability and family stress are important in development of SZ - genetically vulnerable children are more sensitive to parenting behaviour
that was fuckin long

Question 13

What is a -ve evaluation regarding the original diathesis-stress model

Answer 13

Over simplistic
Idea of a single schizogene and SZ parenting style as the major source of stress is too simple
Multiple genes increase vulnerability, there is no single gene
Stress can also cone in many forms not just dysfunctional parenting
Now believed vulnerability can be caused by early trauma as well as genetic make-up and stress can come in many forms including biological
Houston 2008 - childhood sexual trauma emerged as a vulnerability factor whilst cannabis was a trigger
Shows old idea of diathesis as biological and stress as psychological is over simplified
Problem for old idea of diathesis-stress but not for newer models

Question 14

What is a +ve evaluation regarding support for combinations of treatments

Answer 14

Tarrier 2004 - 315 patients were randomly allocated to a medication and CBT group, medication and supportive counselling or a control group
Patients in 2 combo groups showed lower symptom levels than control, altho there were no difference in rates of hospital readmission
This and other studies show there is clear advantage to adopting an interactionist approach

Question 15

How is us not knowing exactly diathesis and stress work a -ve evaluation

Answer 15

Strong evidence to suggest some sort of underlying vulnerability coupled w stress can lead to SZ
Also have well informed suggestions for how vulnerabilities and stress might lead to symptoms
However we do not yet fully understand the mechanisms by which the symptoms of SZ appear and how both vulnerability and stress produce them

Question 16

What is the treatment-causation fallacy n why is it a -ve evaluation for this approach

Answer 16

tHE pRoPHecY
Turkington et al argue that there is a good logical fit between the interactionist approach and using combining treatments
HOWEVER
Combining psych and bio treatments is more effective, but does not necessarily mean that this approach is correct