Describe and Evaluate the Interactionist Approach to Both Explaining and Treating Schizophrenia

AO1

DIATHESIS-STRESS MODEL – ORIGINAL

  • DIATHESIS = VULNERABILITY / STRESS = NEGATIVE PSYCHOLOGICAL EXPERIENCE
  • MEEHEL’S MODEL: ENTIRELY GENETIC through a SINGLE ‘SCHIZOGENE’ = a SCHIZOTYPIC PERSONALITY which has the characteristic that it is SENSITIVE to STRESS

WITHOUT THE GENE: NO AMOUNT of STRESS can lead to SCHIZOPHRENIA

CARRIERS of the GENE: CHRONIC stress through CHILDHOOD and ADOLESENCE

DIATHESIS NOW

  • NO SINGLE GENE (RIPKE ET AL) and involves PSYCHOLOGICAL TRAUMA (INGRAM + LUXTON)
  • TRAUMA = DIATHESIS à READ ET AL: NEURODEVELOPMENT model that shows that EARLY TRAUMA ALTERS the DEVELOPING BRAIN especially CHILD ABUSE etc.

e.g. HYPOTHALAMIC-PITUITARY ADRENAL (HPA) can become OVER-ACTIVE and MORE VULNERABLE

STRESS NOW

  • ANYTHING that RISKS TRIGGERING SCHIZOPHRENIA – MOST RECENT research concerned factors such as CANNABIS = INCREASES STRESS BY 7 TIMES

TREATMENT

  • ANTI-PSYCHOTIC MEDS + PSYCHOLOGICAL THERAPIES (CBT)
  • TURKINGTON ET AL: PERFECTLY POSSIBLE to believe in BIOLOGICAL CAUSES and practice CBT BUT needs INTERACTIONALIST MODEL and is not possible with a PURELY BIOLOGICAL APPROACH
  • In BRITAIN: is standard to have a combination of the two // USA: had a CONFLICT and SLOWER ADAPTION to this approach

AO3

  • DON’T KNOW EXACTLY HOW IT WORKS: LOTS of EVIDENCE of underlying VULNERABILITY and STRESS AND know that it may lead to SYMPTOMS BUT DON’T understand the MECHANSMS by which the symptoms APPEAR
  • SUPPORT FOR THE EFFECTIVE OF TREATMENT : TARRIER ET AL: 315 patients were RANDOMLY ALLOCATED to a MEDS + CBT group, MEDS + SUPPORTIVE COUNSELLING group or a CONTROL group (just MEDS) = COMBINATIONS showed LOWER SYMPTOMS levels
  • ORIGINAL IS OVER-SIMPLE: MULTIPLE GENES = HIGHER VULNERABILITY – NO SINGLE ‘SCHIZOGENE’ and STRESS can be more than DYSFUNCTIONAL PARENTING à NEW: DIATHESIS – EARLY TRAUMA and GENES + STRESS – CANNABIS
  • EVIDENCE OF ROLE OF THE VULNERABILITY AND TRIGGERS: TIENARI ET AL: GENETIC VUL and PARENTING STYLE (trigger) – ADOPTED from 19,000 FINNISH mothers with SCHIZOPHRENIA between 1960 + 1979 – assessed CHILD REARING STYLE and tested with CONTROL without a GENETIC RISK = had HIGH CRITICISM and LOW EMPATHY within their parenting style in the GENETIC RISK GROUP