The interactionist approach to schizophrenia Flashcards
What is the interactionist approach?
It is an approach that acknowledges there are biological, psychological and societal factors in the development of Schizophrenia.
What is the diathesis-stress model?
It says that both a vulnerability to schizophrenia and a stress-trigger (in this context a negative psychological experience) are necessary to develop the condition. One or more underlying factors make a person particularly vulnerable, but the condition is triggered by stress.
What did the original diathesis-stress model say?
Meehl
Diathesis was entirely genetic, the result of a single ‘schizogene’, which led to a sensitivity to stress. Meehl argued that if a person does not have the schizogene then no amount of stress would lead to schizophrenia. In carriers chronic stress, in particular the presence of a schizophrenogenic mother could result in the development.
What is the modern understanding of diathesis?
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.
What is the modern understanding of stress?
A modern definition of stress in the diathesis-stress model includes anything that risks triggering schizophrenia.
Recent research had looked into cannabis abuse as a trigger, in the diathesis-stress model cannabis would be a stressor as it increasing the risk of schizophrenia up to 7 times.
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.
What is the evaluation for the interactionist approach to schizophrenia?
Evidence for the role of vulnerability and triggers
The original diathesis-stress model is over-simple
Support for the effectiveness of the combinations of treatments
The treatment causation fallacy
Evaluation point for the interactionist approach to schizophrenia: Evidence for the role of vulnerability and triggers
Tienari investigated the combination of genetic vulnerability and parenting style (the trigger).
Children adopted from 19,000 Finnish mothers with schizophrenia were followed up. Their adoptive parents were assessed for child-rearing style, and the rates of schizophrenia were compared to a control group.
Style which had high levels of criticism and conflict and low levels of empathy was found to cause schizophrenia but only in those with high genetic risk.
This is strong support for the interactionist approach and diathesis-stress model.
Evaluation point for the interactionist approach to schizophrenia: The original diathesis-stress model is over-simple
A single schizogene is too simple, multiple genes increase vulnerability to schizophrenia, each having a small effect on its own. Also stress can come in many forms and is not limited to dysfunctional parenting. Therefore neither have a single source.
It is also now believed that vulnerability can be caused early trauma, and that stress can also be biological.
Houston found that childhood sexual trauma emerged as a vulnerability factor whilst cannabis use was a trigger.
This shows the old models are too simple, but not the new models.
Evaluation point for the interactionist approach to schizophrenia: Support for the effectiveness of the combinations of treatments
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.
This shows a clear practical advantage of adopting the interactionist approach.
Evaluation point for the interactionist approach to schizophrenia: The treatment causation fallacy
Turkington et al argue that there is a logical fit between the interactionist approach and combination treatments. However, the fact that combined treatments are more effective than either on their own does not necessarily mean that the interactionist approach to schizophrenia is correct. This error of logic is called the treatment-causation fallacy.
