Schizophrenia- The Interactionist Approach To Schizophrenia

Question 1

The interactionist approach -

Answer 1

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.

Question 2

The diathesis-stress model -

Answer 2

An approach to explaining behaviour. For example schizophrenia is explained as the result of both an underlying vulnerability (diathesis) and a trigger, both of which are necessary for the onset of schizophrenia.

In early versions of the model, vulnerability was genetic and triggers were psychological. Nowadays both genes and trauma are seen as diatheses, and stress can be psychological or biological in nature.

Question 3

What is the interactionist approach to schizophrenia?

Answer 3

The interactionist approach, also known as the biosocial approach, considers biological, psychological, and social factors in the development of schizophrenia. Biological factors include genetic vulnerability, neurochemical, and neuroanatomical abnormalities, while psychological factors include stress from life events, daily hassles, and poor family interactions.

Question 4

What does the diathesis-stress model suggest?

Answer 4

The diathesis-stress model suggests that both a vulnerability (diathesis) to schizophrenia and a stress trigger are necessary to develop the condition.

Question 5

How does the diathesis-stress model explain the development of schizophrenia?

Answer 5

The model explains that certain underlying factors make a person more vulnerable to schizophrenia, but the condition only develops when triggered by a stress factor.

Question 6

What is Meehl’s model in the context of schizophrenia?

Answer 6

In Meehl’s original diathesis-stress model (1962), vulnerability (diathesis) is purely genetic and caused by a “schizogene.” This gene leads to a schizotypic personality, marked by sensitivity to stress.

Question 7

What role do genetic factors play in Meehl’s model?

Answer 7

According to Meehl, without the schizogene, no amount of stress would lead to schizophrenia. However, carriers of the gene exposed to chronic stress, especially from a “schizophrenogenic mother,” could develop the condition.

Question 8

How has the modern understanding of diathesis changed?

Answer 8

The modern understanding of diathesis has shifted from viewing it as a single “schizogene” to recognizing that multiple genes contribute slightly to vulnerability.

Question 9

What factors beyond genetics are now included in the modern concept of diathesis?

Answer 9

Modern views of diathesis include factors like psychological trauma, which can serve as a diathesis rather than merely a stressor.

Question 10

What did Read et al. (2001) propose about trauma and the brain?

Answer 10

Read et al. (2001) proposed a neurodevelopmental model where early trauma alters brain development, potentially making a person more vulnerable to later stress.

Question 11

How can severe early trauma impact brain development?

Answer 11

Severe early trauma, such as child abuse, can impact brain development, making systems like the hypothalamic-pituitary-adrenal (HPA) system overactive, which increases vulnerability to stress.

Question 12

What was the original view of stress in the diathesis-stress model?

Answer 12

The original diathesis-stress model viewed stress as psychological, particularly related to parenting.

Question 13

How is stress defined in the modern diathesis-stress model?

Answer 13

The modern definition of stress includes any factor that could risk triggering schizophrenia, not just psychological factors.

Question 14

What recent factor has research identified as a potential stressor for schizophrenia?

Answer 14

Recent research has identified cannabis use as a potential stressor that can increase the risk of schizophrenia by up to seven times, depending on the dose.

Question 15

Why doesn’t everyone who uses cannabis develop schizophrenia?

Answer 15

Most cannabis users do not develop schizophrenia, suggesting that additional vulnerability factors must be present for the condition to manifest.

Question 16

What does the interactionist model of schizophrenia acknowledge?

Answer 16

The interactionist model acknowledges both biological and psychological factors in schizophrenia.

Question 17

How does the interactionist model influence treatment approaches for schizophrenia?

Answer 17

The interactionist model is compatible with both biological and psychological treatments, typically combining antipsychotic medication with psychological therapies, most commonly CBT.

Question 18

What do Douglas Turkington et al. (2006) argue about the biological approach and CBT?

Answer 18

Turkington et al. (2006) argue that it’s possible to believe in biological causes of schizophrenia and still use CBT, but this requires adopting an interactionist model.

Question 19

Why is it incompatible to adopt a purely biological approach and use CBT?

Answer 19

A purely biological approach would mean viewing symptoms as only biological, without psychological significance, which contradicts the use of CBT that addresses psychological symptoms.

Question 20

What is the standard practice for treating schizophrenia in Britain?

Answer 20

In Britain, it is increasingly standard to treat patients with a combination of antipsychotic drugs and CBT.

Question 21

How does the treatment approach in the USA differ from that in Britain?

Answer 21

In the USA, there is more historical conflict between psychological and biological models of schizophrenia, leading to slower adoption of the interactionist approach, so treatment with only medication is more common.

Question 22

Why is it unusual to treat schizophrenia with only psychological therapies?

Answer 22

It’s unusual because CBT, family therapy, and token economies are usually provided alongside antipsychotic medication.

Question 23

What evidence supports the dual role of vulnerability and triggers in developing schizophrenia?

Answer 23

A study by Tienari et al. (2004) provides strong support for the interactionist approach. They examined adopted children of Finnish mothers with schizophrenia, assessing their adoptive parents’ child-rearing styles. Children at high genetic risk for schizophrenia who were raised in families with high criticism, conflict, and low empathy had higher rates of schizophrenia compared to a control group of adoptees without genetic risk. This suggests that schizophrenia development depends on both genetic vulnerability and family-related stress, emphasizing that genetically vulnerable children are more affected by adverse parenting.

Question 24

What does Tienari et al.’s study indicate about the interactionist approach?

Answer 24

Tienari et al.’s findings strongly support the interactionist approach, showing that schizophrenia may develop due to a combination of genetic vulnerability and environmental stressors like poor parenting. This study highlights the importance of an interactionist perspective that considers both biological and environmental factors in understanding schizophrenia.

Question 25

Why is the original diathesis-stress model of schizophrenia now seen as overly simplistic?

Answer 25

The original diathesis-stress model proposed that a single “schizogene” was responsible for genetic vulnerability and that dysfunctional parenting was the main stressor. This view is now considered too simple. Research shows that multiple genes contribute to schizophrenia risk, each with a small effect, and that stressors come in various forms, not limited to parenting. A study by Houston et al. (2008) found that childhood sexual trauma acted as a vulnerability factor, while cannabis use was a trigger. This indicates that vulnerability can stem from early trauma and stress can be biological, challenging the traditional view that vulnerability is strictly genetic and stress strictly psychological.

Question 26

What implications does the updated diathesis-stress model have for understanding vulnerability and stress?

Answer 26

The revised model suggests that vulnerability can include non-genetic factors, such as psychological trauma, and that stress can be broader than just environmental factors, including biological triggers like substance use. This broadens the understanding of both vulnerability and stress, making it more flexible than the original model.

Question 27

How does evidence support the use of combined biological and psychological treatments in treating schizophrenia?

Answer 27

Research indicates that combining biological and psychological treatments is often more effective than using either alone. Turkington et al. (2006) note that using combination treatments aligns well with the interactionist approach. In a study by Tarrier et al. (2004), 315 patients were randomly assigned to groups receiving either medication with CBT, medication with supportive counseling, or medication alone. Patients in the combined treatment groups showed lower symptom levels than those receiving only medication, although hospital readmission rates did not differ significantly. This supports the practical benefits of an interactionist approach, as patients showed improved symptom management with combined treatments.

Question 28

What does the Tarrier et al. study suggest about the interactionist approach to treatment?

Answer 28

Tarrier et al.’s study supports the idea that an interactionist approach, which combines biological and psychological treatments, leads to better symptom management in schizophrenia patients compared to using medication alone. This evidence underlines the value of combining treatments for improved outcomes.

Question 29

What are the limitations in understanding the mechanisms of vulnerability and stress in schizophrenia?

Answer 29

While there is strong evidence for a link between vulnerability, stress, and the development of schizophrenia, the exact processes through which symptoms appear are still unclear. Although we understand that vulnerability and stress together contribute to schizophrenia, the specific mechanisms by which these factors lead to symptoms remain poorly understood.

Question 30

What is the treatment-causation fallacy?

Answer 30

The treatment-causation fallacy is a logical error highlighted by Turkington et al., which points out that just because combined biological and psychological treatments are effective, it doesn’t necessarily confirm the interactionist model is correct. Similarly, the effectiveness of drug treatments doesn’t prove schizophrenia has a biological origin. This fallacy warns against assuming that effective treatments reveal the underlying cause of schizophrenia.