The interactionist approach Flashcards
intro
An approach that recognises a variety of contributing factors in the development of schizophrenia
Distress stress model
One interactionist approach is the diathesis - stress model.
• Diathesis = vulnerability
• Stress = negative experience.
• Both are needed in order to develop the condition.
DS model-Meehls model
• Vulnerability was seen as entirely genetic.
• Schizogene → Schizotypic personality.
Particularly sensitive to stress
• Chronic stress through childhood could result in schizophrenia.
• No schizogene → no sensitivity to stress → no schizophrenia.
modern understanding of DS model
The modern understanding of diathesis.
• Schizophrenia is polygenetic (multiple genes)(Ripke, 2014)
• Vulnerability (diathesis) can also be caused by psychological trauma.
-Early trauma (eg. child abuse) could even alter the developing brain (Read et al., 2001)
• E.g. HPA system (inbuilt chronic stress response) could become overactive → more vulnerable to stress.
DS model-modern understanding of stress
• Originally stress was seen as psychological in nature.
• Particularly in relation to parenting.
• Now considered anything that risks triggering schizohrenia.
• Cannabis use (Houston et al. 2008) → 7x more at developing schizophrenia.
strength-supporting evidence
• Dual role of vulnerability and stress (Tienari et al., 2004)
• Genetic vulnerability and parenting style.
• Children adopted from 19000 Finnish mothers with schizophrenia between 1960 and 1979)
• Adoptive parents were assessed for parenting style
• Compared to control group.
• Child rearing style w. High levels of criticism and conflict and low levels of empathy → implicated in the development of schizophrenia in high risk adoptees.
• Suggests that genetic vulnerability and family related stress can contributed to the onset of schizophrenia.
limitation-overly simplistic
• The idea of a single schizogene mixed with the stress of schizophrenic parenting is very simplistic.
• Polygenic (Ripke, 2014)) + stress comes in many forms and is not limited to dysfunctional parenting.
• E.g. Houston et al. (2008) - sexual abuse in childhood as a major influence on underlying vulnerability to schizophrenia and cannabis use as a major trigger.
• Supports the modern understanding of diathesis and stress.
strength-real world application
Combination of biological and psychological treatments
Studies show that combining treatments enhance their effectiveness in the treatment of schizophrenia.
• Tarrier et al. (2004)
• 315 participants assigned to (1) Medication + CBT (2) Medication + Counselling (3) Medication only (control)
• Combination treatments showed greater reduction in symptom severity.
Clear practical advantage to adopting an interactionist approach in the treatment of schizophrenia based on the superior treatment outcomes.
6 marker
The interactionist approach acknowledges that there are many factors that contribute to the development of schizophrenia, including biological, psychological and social factors.
An example of an interactionist approach is the diathesis-stress model. In this model it is suggested that mental illness comes about through the combination of an underlying vulnerability (diathesis) and a stress - trigger.
This model was originally applied to schizophrenia by Meehl (1962) who suggested that vulnerability to schizophrenia was entirely genetic, and the result of a single schizogene. According to the Meehl a combination of this schizogene and chronic stress through childhood and adolescence, for example the presence of a schizophrenogenic mother, could result in the development of the Schizophrenia.
In more recent years our understanding of both diathesis and stress has evolved. For example we now know that vulnerability doesn’t have to be caused by genes, but could also be the result of psychological trauma in childhood (Ingram and Luxton, 2005). We now also know that stress does not have to be psychological in nature, but simply refers to anything that can trigger the onset of schizophrenia.
