The interactionist approach to schizophrenia Flashcards
Diathesis stress model in schizophrenia
Often considered to be a genetic vulnerability, potentially resulting in a dopamine imbalance
Meeh’s original diathesis stress model
Diathesis was entirely the result of a single ‘schizogene’
Meehl claimed that someone without this gene should never develop schizophrenia, no matter what how much stress they were exposed to
But a person who does have the gene is vulnerable to the effects of chronic stress (schizophrenic mother)
Schizogene is necessary but not sufficient for the development of schizophrenia
Modern understanding of diathesis
- give an example
It is now clear that many genes each appear to increase genetic vulnerability slightly, there is no single schizogene.
Modern views include a range of factors beyond genetic, including psychological trauma - so trauma becomes the diathesis rather than the stressor.
Read proposed a neurodevelopmental model in which early trauma alters brain development, e.g the HPA system can become over-active = more vulnerable to stress.
Modern understanding of stress
Includes anything that risks triggering schizophrenia
- can be psychological e.g parenting
- can be biological e.g cannabis use
Cannabis use can increase risk of schizophrenia up to seven times depending on dose - probably because it interferes with the dopamine system
Turkington et al
Biological treatments appear to address the (direct) distal causes of SZ, whilst
psychological treatments appear to be more well-suited in treating the (indirect) proximal causes
What is the treatment for schizophrenia according to the interactionist model?
It combines antipsychotic medication and psychological treatments such as CBT.
In Britain it is increasingly common to treat patients with a combination of drugs and CBT, however in the USA there is more of a conflict between psychological and biological models of schizophrenia, with a slower adoption of the interactionist approach to treatment.
Two strengths of the interactionist approach to schizophrenia
Evidence for the role of vulnerability and triggers
Support for the effectiveness of the combinations of treatments
EVALUATION: Evidence for the role of vulnerability and triggers
P - One strength of the interactionist approach is evidence for the role of vulnerability and triggers
E. Tienari et al. studied adopted children whose mothers had been given a schizophrenia diagnosis. The parenting styles of the adoptive parents were assessed and compared with those of a control group of adoptees who presented no genetic risk.
E - Only children who were at a high genetic risk were found to benefit from a child-rearing style that involved a lot of criticism, conflict, and low empathy.
L - This demonstrates how a person’s vulnerability to schizophrenia is heightened by both hereditary vulnerability and family stress.
EVALUATION: Support for the effectiveness of the combinations of treatments
P - One strength is the support for the effectiveness of the combinations of treatments
EE- In Tarrier’s study 315 patients were randomly allocated to a medication and CBT group, medication and supportive counselling group or a control group (medication only).
Patients in the two combination groups showed lower symptom level than those in the control group.
L - This shows a clear practical advantage of adopting the interactionist approach in the form of superior treatment outcomes
Two limitations of the interactionist approach to schizophrenia
Diathesis stress model is oversimplistic
The treatment causes fallacy
EVALUATION: Diathesis stress model is oversimplistic
P - On the other hand one limitation claims that the stress model is oversimplistic
E - There is no schizogene; a number of genes increase vulnerability, each having no impact on its own. Different types of stress might arise, such as dysfunctional parenting.
E - Researchers now think that biological factors can contribute to stress. For instance, Houston et al. discovered that cannabis use was a trigger and childhood sexual trauma was a diathesis.
L - This indicates that a variety of biological and psychological factors influence both stress and diathesis.
EVALUATION: The treatment causes fallacy
Turkington et al. argue that combination therapy and the interactionist approach make sense. Nonetheless, this does not imply that the interactionist theory of schizophrenia is accurate, even if combined therapies work better than either one alone. The treatment-causation fallacy is the name given to this logical mistake.
EVALUATION ExTrA
- Urbanisation
Sz is more commonly diagnosed in urban than rural areas -> support interactionist position (urban living is a stressor.
However Sz may simply be more likely to be noticed in cities, or people with diathesis for Sz may migrate to cities
EVALUATION ExTrA
- Uncertainty
The fundamental mechanism by which a negative psychological event actually triggers a complex biological response resulting in symptoms is still uncertain.
Reducing confidence in the interactionist approach as a full explanation for schizophrenia
