The interactionist approach to Schizophrenia

Question 1

What is the interactionist approach?

Answer 1

Acknowledges that there are biological psychological and social factors in the development of SZ.

Question 2

What do the biological factors of SZ include?

Answer 2

-Genetic vulnerability
-Neurochemical and neurological abnormality.

Question 3

What do the psychological factors of SZ include?

Answer 3

Stress from life events and daily hassles.

Question 4

What do the social factors of SZ include?

Answer 4

Poor quality interactions in the family.

Question 5

What does diathesis mean?

Answer 5

Vulnerability.

Question 6

What is the stress? (in the context of SZ)

Answer 6

A negative experience.

Question 7

What does the diathesis-stress model say about SZ?

Answer 7

That both a vulnerability to SZ and a stress-trigger are necessary in order to develop the disorder.

Question 8

What does Meehl’s model state about SZ?

Answer 8

Diathesis was the result of a single ‘schizogene’ which led to the idea of a biologically based schizotypic personality.

Question 9

What is a characteristic of the schizotypic personality?

Answer 9

Sensitivity to stress.

Question 10

What does Meehl state about the schizogene?

Answer 10

If a person does not have the schizogene then no amount of stress would lead to SZ.

Question 11

What could result in the onset of SZ according to Meehl?

Answer 11

In carriers of he gene, chronic stress through childhood and adolescence (schizophrenogenic mother) could result in the development of the disorder.

Question 12

How has the understanding of the diathesis changed? (modern)

Answer 12

It is now clear that many genes each appear to increase genetic vulnerability only slightly, there is no single ‘schizogene’.

Question 13

What becomes the diathesis rather than the stressor in the new modern understanding?

Answer 13

Trauma becomes the diathesis rather than the stressor.

Question 14

What are the factors of the modern diathesis?

Answer 14

goes beyond just genetic and includes psychological trauma.

Question 15

What did Read et al (2001) state about the trauma?

Answer 15

He proposed a neurodevelopmental model in which early trauma alters the developing brain.

Question 16

What did Read say early and severe trauma (e.g. child abuse) can lead to?

Answer 16

The hypothalamic-Pituitary-Adrenal (HPA) system can become overactive, making a person much more vulnerable to later stress.

Question 17

What is the modern understanding of stress?

Answer 17

Includes anything that risks triggering SZ.

Question 18

What has been found via research that factors triggering a SZ episode?

Answer 18

Cannabis use acts as a trigger.

Question 19

In terms of the diathesis-stress model what is cannabis and why?

Answer 19

The stressor because it increases the risk of SZ by up to 7 times according to the dose.

Question 20

Why may people not develop SZ after smoking cannabis?

Answer 20

They presumably lack the requisite vulnerability factors.

Question 21

In regards to treatment what is the diathesis-model most associated with?

Answer 21

Combining antipsychotic medication and psychological therapies (e.g. CBT).

Question 22

What did Turkington et al (2006) state about treatment?

Answer 22

It is perfectly possible to believe in biological causes of SZ and still practice CBT to relieve psychological symptoms.
-> This requires adopting an interactionist model.

Question 23

What is Britain’s standard procedure with treatment?

Answer 23

To treat people diagnosed with SZ with a combination of antipsychotic drugs and CBT.

Question 24

What are the issues with the US and the interactionist approach?

Answer 24

There is more of a history of conflict between psychological and biological models of SZ and this may have led to slower adoption of the interactionist approach.

Question 25

What is more common in the US than the UK in regards to SZ treatment?

Answer 25

Medication without an accompanying psychological treatment is more common in the US than the UK.

Question 26

What is the research to support the combination of biological and psychological treatments?

Answer 26

Tarrier et al (2004)
- Randomly allocated 315 participants into 3 groups.
- (1) medication + CBT
- (2) medication + counselling
- (3) control group (medication only)
-> Participants in the 2 combination groups showers lower symptoms following the trial than the control group.
-> BUT there was no difference in hospital readmission.