The Interactionist Approach To Schizophrenia Flashcards
What is the interactionist approach to schizophrenia?
- The diathesis-stress model says that both a vulnerability to schizophrenia & a stress-trigger are necessary in order to develop the condition.
- One or more underlying factors make a person particulalry vulnerable to developing schizophrenia but the onset of the condition is triggered by stress
What did Meehl say about the original diathesis-stress model?
- Meehl (1962) proposed that schizophrenia was entirely the result of a single dominant gene he called the ‘schizogene’
- According to his model only those who inherited the schizogene would develop schizophrenia, if they encountered stress in their environment
- Particulalry stress from childhood trauma/dysfunctional family relationships
HWVR, Meehl’s model is now considered outdated because research has shown that schizophrenia is influenced by multiple genes rather than a single ‘schizogene’
What is the modern understanding of the diathesis stress model?
- Modern view of D-sm is that diathesis is not purely genetic but can include a range of biological factors such as early braini damage,birth complications & prenatal infections
- These factors may create vulnerabilities that increase the likelihood of developing schiz
What did Murray (1996) find to do with Diathesis?
- Found an 88% increased chance of developing schizophrenia in people who had been exposed to their mothers flu virus is the 2nd trimester (3-6 months) in utero than people who hadnt
- Thought to affect brain development particularly the dopamine system
- This creates a biological vulnerability later in life
What is the modern understanding of stress?
- Originally stress was thought to be soley psychological- but modern research suggests that stress includes a wide range of factors including:
- Psychological stress (e.g. childhood trauma, dysfunctional family relationships)
- Environmental stress (e.g. poverty)
- Substance abuse (cannabis use, which has been linked to increased schiz risk)
What evidence do we have for the idea that there is more than one gene for schiz?
- Stephen Ripke et al (2014)
- Combined all previous data from genome-wide studies of schizophrenia
- The genetic make up of 37000 people with a diagnosis of schiz was compared to that of 113,000 controls
- 108 seperate genetic variations were associated w a slight increased risk of schizophrenia
- This shows that there isnt just one schizogene & that schizophrenia is polygenic
Evaluate the role of vulnerability (biological) & stress (psychological) in the development of schizophrenia.
-Tienari et al (2004)
- Carried out a prospective study of 19,000 Finnish children adopted away from their biological family who had mothers diagnosed with schiz.
- They also assessed the rearing style of the adoptive family
- They compared this group with a group of children with no parent diagnosed with schiz
- After 21 yrs they found that in adoptees at high genetic risk of schiz, but not in those at low genetic risk, an adoptive family with a high level of critism & conflict was a significant predictor of schiz
- This suggests that either factor on its own does not cause schiz- they have to interact together
What treatment is best suited to treat schizophrenia according to the diathesis stress model?
- Because IM acknowledges both biological & psychological factors it is therefore compatible w both biological & psychological treatments of schiz
- In particular the model is associated w combining antipsychotic medication & psychological therapies most commonly CBT
- Turkington et al (2006)
- Pointed out that it is perfectly possible to believe in biological causes of schiz & still practise CBT to relieve psychological symptoms
- HWVR this requires adopting an interactionist model- it is not possible to adopt a purely biological approach & tell people diagnosed w schiz that their condition is purely biological & that there are no psychological significance to symptoms & then treat them w CBT
Give one strength of the interactionist approach.
- OS is the combination of biological & psychological treatments
- A practical application of acknowledging biological & psychological factors in schiz have been the combination of drug treatment & psychological therapies
- Studies show that combining treatments enhances their effectiveness E.G.
- Nicholas Tarrier et al (2004)
- Randomly allocated 315 ppts to 1. medication & CBT 2. medication & counselling or 3. control group (medication only)
- Ppts in the two combination groups showed lower symptoms following the trial than the medication only group- though there was no difference in hospital admission.
This means that there is a clear practical advantage to adopting an interactionist approach to schizophrenia in terms of superior treatment outcomes
Give another study to evaluate the interactionist approach of schizophrenia.
- Drury et al (1996):Ppts were recieving antipsychotic medication during the study
- This randomized study compared individual & group CBT sessions to recreational activities & support during & immediately after an acute psychotic episode
- Results indicated that positive symptoms diminished more rapidly & completely in the CBT group, though these benefits were not sustained over a 5yr follow up period
Give a final study to evaluate the interactionist approach of schizophrenia.
- Kuipers et al
- Ppts were stablilised outpatients (stabilised through drug therapy) experiencing distressing psychotic symptoms, this trial assigned ppts to either 20 CBT sessions over 9 months or standard treatment
- The CBT group exhibited a greater overall reduction in psychiatric symptoms & a higher improvement rate (50% vs 31%) compared to the control group
