The Interactionist Approach Sz Flashcards
What is the interactionist approach to Sz?
Also known as the biosocial approach - sees that biological and societal factors influence Sz
Bio factors include genetic vulnerability and neurological abnormalities
Psychological include life events and the stresses of everyday life
What is the diathesis stress model?
Diathesis = vulnerability
The model states that both vulnerability to Sz and a stress trigger can make a person more vulnerable to developing Sz
What was Meehl’s model?
In the original model Meehl diathesis was genetic, the result of the Schizogene’ - this led to the Schizotypic personality
According to Meehl no amount of stress will lead to Sz if a person does not have the schizogene
In carriers of the gene, chronic stress in childhood and adolescence and with the presence of the schizophrenogenic mother could result in the condition
What is the modern understanding of diathesis?
Many genes appear to increase genetic vulnerability slightly, there is no single schizogene
Modern views consider other factors such as psychological trauma, so trauma becomes the diathesis rather than the stressor
What did Read et al provide to do with modern understanding of diathesis?
A neurodevelopmental model in which early trauma impacts on a developing brain
The hypothalamic pituitary adrenal system can become overactive, making the person more vulnerable to stress later in life
What is the modern understanding of stress?
Although psychological stress, including that resulting from parenting may still be considered important, a modern day definition includes anything that triggers Sz
What does new research to do with stress focus on and what is the research?
The use of cannabis
Cannabis is a stressor according to the model and increases the risk of Sz up to seven times - probably as cannabis interferes with the dopamine system
Childhood sexual abuse was viewed as a trigger factor into the use of cannabis
What is treatment according to the interactionist model?
Using antipsychotic drugs and psychological treatment, mostly CBT
Turkington points out that it is possible to believe in biological causes and psychological treatments
When adopting this model you cannot tell a patient their condition is purely biological and that there is no psychological significance to symptoms and then to simultaneously treat them with CBT
What treatment is used in the UK/USA?
UK = a mix
USA = there is a history of conflict between the two models and this may have led to slower adoption of the interactionist approach
It is very unusual for treatment to be psychological alone in either
What is the evidence for the role of vulnerability and triggers?
Tienari et al investigated genetic vulnerability and parenting style - children adopted from 19,000 Finnish mothers with Sz 1960-1979 were followed up. Their adoptive parents were assessed for parenting style and rates of Sz were compared with the control group of adoptees without a genetic risk.
A style that was highly critical and showed little empathy was implicated but this was only for those children who had a high genetic risk
This suggests both are important in the development of Sz, genetically vulnerable children are more sensitive to parenting behaviour - strong support for interactionist approach
How is the original model over-simple?
Multiple genes increase vulnerability to Sz, each having a small effect on its own, there is no single gene
Stress also comes in many forms (may not be family stress)
It is now believed that early trauma can impact (Houston, sexual abuse + cannabis study)
The idea of diathesis as biological and stress as psychological is outdated - new models consider this
What is a strength of the interactionist approach?
Support for the effectiveness of combinations of treatments - Tarrier et al, 315 patients randomly allocated to a medication/CBT group or med/support group - patients in combination group showed more improvement than those in control
Although there was no difference to hospital re-admissions, appears to be practical advantage of the approach
What is a key weakness of the approach?
We don’t know how diathesis and stress work - We know there is a link between vulnerability and stress that leads to symptoms but we do not fully understand the mechanism by which the symptoms of Sz appear and how vulnerability and stress produce them
What is the final weakness of the approach?
The treatment - fallacy
Turkington et al argues there is a good fit between interactionist and treatments , however, just because they work together well does not mean that the interactionist approach is correct
The fact that drugs help does not necessarily mean it is biological - treatment causes fallacy (mistaken belief)
