the interactionist approach

Question 1

what is an interactionist approach to sz?

Answer 1

it suggests that both biological and psychological explanations and therapies should be used to explain/treat sz

Question 2

what is the diathesis-stress model?

Answer 2

according to this model, biology determines a person’s vulnerability to sz (diathesis), but sz is only triggered in response to environmental stressors (stress)

Question 3

give a practical example of the diathesis-stress model

Answer 3

• a person with high genetic predisposition towards sz may not develop the disorder, if they live in a low-stress environment
• a person with a lower genetic disposition may develop sz if exposed to enough environmental stress (family dysfunction)

Question 4

who proposed the original diathesis-stress model?

Answer 4

Meehl

Question 5

what was proposed in Meehl’s model?

Answer 5

• that there is a single schizogene, suggesting that diathesis is entirely genetic
• this caused a schizotypal personality, which eventually manifests itself into sz
• if you do not have the gene, no amount of stress will lead to sz
• if you do have the gene, chronic stress through childhood and adolescence could result in sz

Question 6

what is the modern understanding of the DSM?

Answer 6

• more recent research suggests that multiple genes contribute to the genetic risk for sz
• there is no single schizogene
• ‘stress’ in the DSM is not just the emotion, it includes anything that increases the risk of triggering sz (drug abuse, illness, sexual abuse)

Question 7

who researched multiple genes in SZ?

Answer 7

Ripke

Question 8

outline Ripke’s research

Answer 8

• carried out a meta-analysis of all genome data
• looked at 37,000 sufferers, compared to 113,000 controls
• found 108 genetic variations associated with sz sufferers

Question 9

who researched stress in the modern DSM?

Answer 9

Houston

Question 10

outline Houston’s findings

Answer 10

• Houston found that cannabis use may be considered a life style stress, which, when accompanied by childhood trauma, a biological predisposition, or chronic stress, increases the risk of developing sz by 7x

Question 11

what is the interactionist approach to sz treatment?

Answer 11

combining drugs and psychological treatments (therapy)

Question 12

what does the patient have to do in order for this to work?

Answer 12

support/ be aware of the interactionist approach

Question 13

is combination treatment more common in the US or UK?

Answer 13

UK

Question 14

what did Tarrier research?

Answer 14

interactionist approach to sz treatment (combination)

Question 15

outline Tarrier’s research

Answer 15

315 ppt’s randomly allocated to 3 groups
1. drugs + CBT
2. drugs + counselling
3. drugs (control group)
- the 2 combination groups had fewer symptoms than the control
- however, no difference in hospital re-admissions/ relapse

Question 16

evaluation: evidence for the role of vulnerability and triggers

Answer 16

ID: a strength of the interactionist approach is that there is evidence to support the dual role of vulnerability and stress in the development of sz
Q: Tienari et al studied genetic vulnerability and parenting
EV: researched children who were adopted from mothers with sz, against a control group of adoptees from mothers without sz. found that a critical parenting style led to an increase in the incidences of sz, but only in the group with a genetic risk
AN: therefore, this provides strong support for the diathesis-stress model because the findings demonstrate that a single diathesis or stressor is not enough to trigger the development of SZ, but rather a combination of the two is required.

Question 17

evaluation: original D-S is too simple

Answer 17

ID: the original diathesis-stress model can be considered as an over-simplified explanation of SZ
Q: researchers argue it may be a reflection of the outdated understanding of that disorder in the mid-twentieth century.
EV: For example, Ripke et al demonstrated that there are over 108 candidate genes, each slightly increasing the risk of SZ, and so there is no single ‘schizogene’. stress can come in many forms, such as high levels of expressed emotion, childhood trauma (Read) and the excessive use of cannabis (Houston)
AN: therefore, the diathesis is not
exclusively biological, nor is the stressor exclusively psychological. Meaning, this may also be considered a strength in the sense that our current understanding of SZ is far more accurate than the original perspective. However, questions temporal validity of original D-S

Question 18

evaluation: support for the effectiveness of combination of treatments

Answer 18

ID: there is support for usefulness of adopting an interactionist approach in comparing studies about the effectiveness of biological and psychological treatment
Q: this is evident from research carried out by Tarrier et al.
EV: for example, Tarrier studied
315 patients who were randomly allocated to one of three conditions,
1. CBT + drugs
2. counselling + drugs
3. drugs (control)
The researchers found that, after an 18-month follow-up, there were significant advantages for CBT and counselling over medication alone on symptoms, but no group difference was seen for relapse or re-hospitalisation
AN: therefore, this demonstrates clear practical advantages to adopting an interactionist approach to form superior treatment outcomes, as they can have a beneficial long-term effect on symptom reduction

Question 19

ELAB: holostic

Answer 19

rather than reducing schizophrenia to one single cause, the diathesis-stress model accounts for the multitude of factors that contribute to the disorder. this can be seen as a more complete picture of schizophrenia.