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INTERACTIONIST APPROACH IN EXPLAINING + TREATING SCHIZOPHRENIA - Coggle…
INTERACTIONIST APPROACH IN EXPLAINING + TREATING SCHIZOPHRENIA
Sz depends on biological factors (genetics, neurochemicals) + psychological factors (stress)
Stress - refers to a negative psychological experience
Diathesis model
Diathesis refers to vulnerability
Interactionist approach states that both stress + genes are needed in order to develop the condition
We must be genetically vulnerable but the onset of the condition is triggered by stress
SUPPORTING STUDY - TIENARI (2004)
Investigated 20,000 Finnish women admitted to psychiatric hospitals diagnosed with Sz + had their offspring adopted away (high risk group), these were compared with adoptees without this genetic risk (low risk)
Results = out of the 303 adoptees, 14 developed Schizophrenia + 11 were from the high risk group and being reared in a 'healthy' adoptive family had a protective effect on high risk group
This shows that genetic vulnerability + family related stress are important in the development of Sz
METHOD USED TO ASSESS ADOPTIVE FAMILY FUNCTIONING = ONLY ASSESSED AT ONE POINT IN TIME
This fails to reflect developmental changes in family functioning over time
What is also not clear is how much stress is caused by the family + how much stress is caused by the adoptee themselves
This questions the validity of the evidence that supports the interactionist approach for Sz
ORIGINAL MODEL = OVER-SIMPLIFIED
it is now understood that multiple genes increase vulnerability with each having a small effect + stress can come in many forms, not just parenting
Houston states that vulnerability can now be a result of childhood sexual abuse + cannabis is the trigger
It is clear that it is not just the diathesis being biological + stress being psychological
However, fortunately newer models have addressed this issue
' Schizogene'
Without this gene, no amount of stress would lead to Sz, however if you carried the gene, some stress in childhood (e.g. a schizophrenogenic mother) could trigger the condition
Original diathesis model states there is a 'schizogene'
Modern understanding indicates there is no one single 'schizogene' + many genes increase genetic vulnerability
It is now thought that psychological trauma in childhood e.g. sexual abuse, can also affect brain development + may therefore be a diathesis
This again indicates that both biology + environment may play a role in the condition
Stress can occur in a number of forms
E.g. childhood trauma/living in an urbanised environment
Severe trauma before the age of 16 makes you 3 times as likely to develop Sz later in life
+ the level of trauma is closely linked to severity of symptoms
Modern view of stress = not just psychological - cannabis use increases the risk of Sz 7 times according to the dose as cannabis interferes with the dopamine system
Most individuals who smoke cannabis don't develop te disorder but it is a risk factor + demonstrates once again that the onset of the disorder most likely requires stress (e.g. cannabis) but also genetic vulnerability
Genetic vulnerability
Shown in twin studies
Joseph pooled data for all Sz twin studies
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Found that concordance rates = 40.4% for monozygotic twins + only 7.4% for dizygotic twins
However, for 60% of identical twins in which one twin is diagnosed, the other never meets the diagnostic criteria for Sz
This indicates that the environment must pay a role in the development of Sz alongside genetic factors
Treatment
Interactionist because it combines biological + psychological treatments e.g. CBT + antipsychotics
Britain = interactionist approach
USA = conflict over interactionist approach with antipsychotics being the preferred choice
However, it is unusual to treat Sz only using psychological therapies + interactionist approach to treatment is often adopted successfully
SUPPORTING STUDY - TARRIER ET AL (2004)
Patients in the two combination groups shower lower symptom levels than those in the control group (medication only) - but no difference in hosptial readmission
This shows that there is a clear practical advantage to adopting an interactionist approach in the form of superior treatment outcomes
Randomly allocated 315 patients to a medication + CBT group, a medication + supportive counselling group, or a control group