The interactionist approach

Question 1

What is the interactionist approach to schizophrenia?

Answer 1

• Explains development of behaviour in terms of a range of factors (bio, psych, social)

Question 2

What are the biological factors in the development of schizophrenia?

Answer 2

• Genetic vulnerability
• Neurochemical and neurological abnormality

Question 3

What are the psychological factors in the development of schizophrenia?

Answer 3

• Stress/life events
• Daily hassles

Question 4

What are the social factors in the development of schizophrenia?

Answer 4

• Poor quality family interactions

Question 5

What is the diathesis-stress model?

Answer 5

• Both a vulnerability to scz and a stress-trigger are necessary to developing the disorder
• One or more underlying factors make the person more vulnerable
• Diathesis= vulnerability, stress= negative experience

Question 6

What is Meehl’s model?

Answer 6

• Diathesis= entirely genetic- the result of a single schizogene
• Led to the idea of a bio based schizotypic personality (inc. sensitivity to stress)
• No schizogene= no amount of stress leads to scz
• In gene carriers, chronic stress in childhood/adolescence (especially scz mother) may result in development of scz

Question 7

What is the modern understanding diathesis?

Answer 7

• Ripke et al- many genes increase vulnerablity slightly, and there is no single schizogene
• Modern views include a range of factors: psych trauma (Ingram and Luxton), so trauma= diathesis
• Read et al- neurodevelopmental model- early trauma alters the developing brain
• Early/severe trauma can affect brain development
• E.g: hypothalamic-pituitary-adrenal system can become overactive- making people more vulnerable to later stress

Question 8

What is the modern understanding of stress?

Answer 8

• OG- stress= psych in nature, related to parenting
  Modern= stress includes anything that risks triggering scz (Houston et al)
• Cannabis= stressor, as it increases risk of scz by up to 7x according to dose
• May be because cannabis interferes with dopamine system
• Most do not develop scz after smoking cannabis as they lack requisite vulnerability factors

Question 9

What is the treatment for scz according to the interactionist approach?

Answer 9

• Compatible with bio and psych treatment- combines antipsychotics with psych therapy (i.e. CBT)
• Turkington et al- perflectly possible to believe in bio causes and still practice CBT to relieve psych symptmoms= interationist model
• Impossible to adopt purely bio approach and treat with CBT
• Britian= standard practice to treat with a combo of antipsychotics and CBT
• US= conflict, so slower adoption of interactionist approach

Question 10

Strength-
I- Support for vulnerability and triggers

Answer 10

D- Tinerai et al investigated impact of genetic vulnerability and psych trigger (dysfunctional parenting). Followed 19,000 Finnish kids, whose bio mother had scz. In adulthood, this high genetic risk group were compared to control of adoptees with no family history of scz. Adoptive parents assesses for child- rearing style, and it was found that a high level of criticism, hostility, and low levels of empathy were strongly associated with development of scz in high risk group
E- Shows a combo of genetic vulnerability and family stress can lead to greater risk of scz

Question 11

Limitation-
I- Diathesis and stress are complex

Answer 11

D- OG diathesis-stress model= oversimplified- portrays diathesis as a single schizogene and stress as schizophrenogenic parenting. Multiple genes in multiple combos influence diathesis. Stress comes in many forms, i.e. dysfunctional parenting. Diathesis may be influenced by psych factors, and stress may be bio or psych. Houston et al- childhood sexual abuse emerged as the major influence on underlying vulnerability to scz, and cannabis use= major trigger
E- Means there are multiple factors affecting both diathesis and stress

Question 12

Strength-
I- Real world application

Answer 12

D- Combo of drug treatment and psych therapy used. Tarrier et al randomly allocated 315 pps to medication + CBT, medication + counselling or medicine only (control). Pps in combination groups showed lower symptoms following the trial than control group, but no difference in hospital readmission
E- Means there is a clear practical advantage to adopting an interactionist approach to scz in terms of superior treatment outcomes

Question 13

Limitation-
I- Issues with real world application

Answer 13

D- Jarvis and Okami suggest that saying a successful treatment for mental disorder justifies a particular explanation is the logical equivilant of saying that as alcogol reduced shyness, shyness is caused by a lack of alcohol. Treatment-causation fallacy- logical error
E- Means we cannot automatically assume the success of combined therapies means interactionist explanations are correct

Question 14

Evaluation extra-
I- Urbanisation

Answer 14

D- Scz is more commonly diagnosed in urban areas- used to justify the interactionist position, assuming that urban living is more stressful than rural, due to psych (noise, crowds) and bio (pollution) factors. But, it may be that scz is more likely diagnosed in cities, or that people with a diathesis tend to migrate to cities. Greater population density in cities means more people tend to witness early symptoms and refer to a doctor and a significant number of young homeless people have moved to escape abuse
E- Means the greater chance of diagnosis in cities is not strong enough support for the interactionist approach