The interactionist approach to schizophrenia Flashcards
what does diathesis and stress mean?
and what does the diathesis stress model suggest?
diathesis means vulnerability
stress in this context refers to negative experiences that trigger the vulnerability
the diathesis stress model says both a vulnerability and a trigger are needed to develop schizophrenia
individually, may not create schizophrenia - it is the interaction that is key
what did the original diathesis stress model suggest that schizophrenia was a result of?
What did Meehl argue?
in the original diathesis stress model, diathesis was entirely the result of a single ‘schizogene’
Meehl argued that someone without this gene should never develop schizophrenia - no matter how much stress they were exposed to
but a person who does have the gene is vulnerable to the effects of chronic stress (especially schizophrenogenic mother)
this schizogene is necessary but not sufficient for the development of schizophrenia
what is the modern understanding of diathesis, give an example?
it is now believed that diathesis is not due to a single ‘schizogene’ - instead it is thought that many genes increase vulnerability
also diathesis doesn’t have to be genetic - it could be early psychological trauma affecting brain development
for example, child abuse affects the hypothalamic -pituitary adrenal - HPA system - making a child very vulnerable to stress
from the modern diathesis stress model - what is considered a stress - psychological, biological and examples?
in relation to the diathesis stress model, anything that triggers schizophrenia is a definition of stress.
this can be psychological (e.g. parenting) or biological (e.g. cannabis use)
cannabis use can increase the risk of schizophrenia up to seven times depending on the dose, probably because it interferes with the dopamine system
how does the interactionist approach be used to treat schizophrenia?
antipsychotic drugs taken in combination with CBT
but this does require adopting an interactionist model - it is not possible to adopt a purely biological approach - tell patients that their condition is purely biological (no psychological significant to their symptoms) and then treat them with CBT
(Turkington)
how does Britain follow the interactionist approach and how does the US differ?
In Britain, it is increasingly standard practice to treat patients with a combination of drugs and CBT
in the US, there’s more conflict between psychological and biological models of schizophrenia and this may have led to slower adoption of the interactionist approach
A strength - support for the dual role of vulnerability and stress - Tienari (adoption)
Child rearing
Teinari studies children adopted away from mothers diagnosed with schizophrenia. the adoptive parents’ parenting styles were assessed and compared with a control group of adoptees with no genetic risk
a child -rearing style with high levels of criticism and conflict and low levels of empathy was implicated in the development of schizophrenia but only for children with a high genetic risk
this shows that a combination of genetic vulnerability and family stress leads to increased risk of schizophrenia
Limitation is original DS model is oversimplistic - where does stress come from (Houston - childhood trauma, drugs)
multiple genes increase vulnerability, each with a small effect on its own - there is no schizogene
stress comes in many forms, including dysfunctional parenting
researchers now believe stress can also include biological factors e.g. Houston found childhood sexual trauma was a diathesis and cannabis use a trigger
this means that there are multiple factors, biological and psychological , affecting both diathesis and stress
Strength - real world application - Tarrier use of medication and other treatments
Tarrier randomly allocated 315 participants to (1) medication +CBT group or (2) medication + supportive counselling group or (3) Control group (medication only)
participants in the two combination groups showed a lower symptom levels than those in the control group -but no difference in hospital readmission
means that there is a clear practical advantage to adopting and interactionist approach in the form of superior treatment outcomes
Counterpoint - Jarvis and Okami
Jarvis and Okami suggests this argument is the same as claiming that because alcohol reduces shyness, shyness is caused by a lack of alcohol - the treatment -causation fallacy
therefore we cannot automatically assume that the success of the combined therapies means interactionist explanations are correct
Extra - urban as a stressor
schizophrenia is more commonly diagnosed in urban than rural areas, may support the interactionist position (urban living is a stressor)
But, schizophrenia may simply be more likely to be noticed in cities, or people with a diathesis for schizophrenia may migrate to cities
On the balance, the greater chances of diagnosis in cities is not strong support for the interactionist approach
