SZ - interactionist approach

Question 1

what does the interactionist approach involve

Answer 1

Diathesis stress model

Diathesis (vulnerability) + stress (trigger) = SZ

Question 2

what is Meehls model

Answer 2

Gene + stress = schizophrenia Diathesis is result of single ‘schizogene’. ‘Schizogene’ makes you vulnerable to the effects of chronic stress e.g. schizophregenic mother.

Question 3

what is the modern understanding of diathesis

Answer 3

• Diathesis is not a single ‘schizogene’. Many genes increase vulnerability a fraction, it is polygenic – Ripke et al.
• Also, early psychological trauma affects brain development, e.g. child abuse affects the hypothalamic-pituitary-adrenal (HPA) system, making a child vulnerable to stress.

Question 4

what is the modern understanding of stress

Answer 4

anything that risks triggering SZ (including psychological stress), e.g. cannabis use x7 risk.

Question 5

what is the treatment according to the interactionist approach

Answer 5

• Antipsychotic drugs + CBT. Turkington et al. says its possible to believe SZ is biological and still use psychological treatments to relieve symptoms – as long as you accept value of interactionist approach.
• In England it is usual to treat SZ using combinations of therapies. But this isn’t standard practice e.g. in Scotland and the US

Question 6

strengths for the interactionist approach

Answer 6

✓Support for dual role. Tienari et al. (2004) studied adopted children away from SZ mothers. The adoptive parents’ parenting styles were assessed and compared with a control of adoptees with no genetic risk. A child rearing style with high EE was implicated in the development of schizophrenia for those with a genetic risk

Question 7

limitations of the interactionist approach

Answer 7

• Real world application – Combination therapies have better outcomes for patients than sole treatments (Tarrier et al.). 315 patients randomly allocated to (1) medication and CBT, (2) medication and supportive counselling or (3) Medication only (Control group). Lower symptom levels for both combination approaches.
• Treatment causation fallacy – Turkington et al. Superior treatments does not necessarily mean interactionist model for schizophrenia is correct. Similarly, the fact drugs help doesn’t mean it is biological in origin. This error of logic is called a treatment-causation fallacy. Superior outcomes shouldn’t be over interpreted in terms of evidence in support of the approach