The Interactionalist Approach in Explaining and Treating Schizophrenia Flashcards
What is the interactionalist approach also known as?
The ‘biosocial approach’
Outline the interactionalist approach.
Acknowledges that there are biological, psychological and societal factors involved in the development of schizophrenia.
Biological factors include- genetic vulnerability, neurochemical and neurological abnormality
Diathesis = vulnerability.
Stress = a negative psychological experience.
Diathesis-stress model says that both a vulnerability to schizophrenia and a stress-trigger are necessary in order to develop the condition.
Outline Meehl’s interactionalist approach from 1962.
In the original diathesis-stress model, diathesis was entirely genetic, the result of a single ‘schizogene’.
This led to the development of a biologically based schizotypic personality, one characteristic of which is sensitivity to stress.
According to Meehl, if a person does not have a schizogeny then no amount of stress would lead to schizophrenia.
In carriers of the gene, chronic stress throughout childhood and adolescence (schizophrenogenic mother) = development of schizophrenia.
What are the modern understandings of diathesis?
Now it is clear that many genes appear to increase genetic vulnerability slightly; there is no single ‘schizogene’ (Ripke et al 2014).
Modern views of diathesis also include a range of factors beyond the genetic, including psychological trauma (Ingram and Luxton, 2005) - so trauma becomes the diathesis rather that the stressor.
Can trauma be a form of diathesis?
Read et al (2001) proposed a neurodevelopment model in which early trauma alters the developing brain.
Early severe enough trauma, such as child abuse, can seriously affect many aspects of brain development e.g. Hypothalamic-pituitary-adrenal (HPA) system can become over-active, making a person much more vulnerable to stress later on.
What are the modern understandings of stress?
Stress was seen as psychological in nature, in the original model-related to parenting.
Psychological stress, resulting from parenting is still considered important.
A modern definition of stress is more encompassing; it now includes anything that could trigger schizophrenia, e.g. cannabis use increases the risk of schizophrenia x7.
How does the interactional model suggest schizophrenia should be treated?
Acknowledges that both biological and psychological factors in schizophrenia .
Combining antipsychotic medication and psychological therapies, most commonly CBT.
In Britain it is increasingly standard practice to treat patients with a combination of antipsychotics and CBT.
In the USA there is more of a history of conflict between psychological and biological models of schizophrenia that has led to slower adoptions of an interactionalist approach.
It is unusual to treat schizophrenia using psychological therapies alone.
CBT, family therapy and the use of token economies are used alongside drug treatments (antipsychotic).
Outline interactionalist treatments in the USA and the UK.
In Britain it is increasingly standard practice to treat patients with a combination of antipsychotics and CBT.
In the USA there is more of a history of conflict between psychological and biological models of schizophrenia that has led to slower adoptions of an interactionalist approach.
It is unusual to treat schizophrenia using psychological therapies alone.
CBT, family therapy and the use of token economies are used alongside drug treatments (antipsychotic).
Outline Turkington et al’s study from 2006.
(Supports the interactionalist approach to schizophrenia)
Supports the interactionalist approach to schizophrenia.
This is because they stated it is perfectly possible to believe in biological causes of schizophrenia and still practice CBT to relieve symptoms that are psychological.
It is not possible to adopt a purely biological approach and tell patients that their condition is purely biological.
This suggests that interactionalism is good, but just because one works, it doesn’t mean the other is not valid.
Outline Hogarty et al’s study from 1986.
(Supports the interactionalist approach to schizophrenia)
Supports the interactionalist approach to schizophrenia.
This is because they assessed the relapse rates of 103 schizophrenics from high EE families receiving various treatments, finding first-year relapse rates of 19% for family therapy and drugs, 20% for social support therapy and drugs, and 41% for drug therapy alone, and 0% for family therapy, support therapy, and drugs.
However, a 0% relapse rate is not universal, suggesting that there are individual difference.
However, in a follow-up study, it was suggested that the combined treatment only delayed relapse rather than preventing it.
Outline the diathesis-stress model of schizophrenia.
Precursors: genetic factors.
Diathesis: vulnerability.
Stress: poor self understanding, stressful family dynamics, social stresses.
Outcome: the disorder of schizophrenia.
