an interactionist approach

• what is meant by a diathesis stress model?

  explains mental disorders as a result of an interaction between biological (the diathesis) and environmental (stress) influences
• describe the correlation between the diathesis stress model and schizophrenia

  • diathesis stress model describes schizophrenia as a result of the interaction between biological and environmental influences
  • family studies show people have varying levels of inherited genetic vulnerability to schizophrenia
  • whether the person is schizophrenic or not is partly down to this vulnerability and partly down to the level of stresses they experience in their lifetime
• evidence to support the interactionist approach according to diathesis? why can't we purely base it off diathesis?

  • support for genetic role- twin studies, identical twin of a person with schiz is more likely to develop schiz than sibling or fraternal twin, adoptive relatives experience less of a risk than biological relatives (Tienari et al)
  • However, in about 50% of identical twins, when one is diagnosed with schizophrenia, the other never meets the diagnostic criteria for it
  • indicates environmental factors are also responsible in determining whether someone actually develops schiz
• state two examples of stresses which can trigger schiz

  • urbanisation
  • early childhood trauma
• evidence for the role of childhood trauma in the development of schizophrenia?

  • Varese et al- children who experienced severe trauma before 16 yrs were three times more likely to develop schizophrenia than the general population
  • relationship between the level of trauma and the likelihood of developing schizophrenia, those severely traumatised as children are at a greater risk
• what evidence is there to support urbanisation as a stressor for schizophrenia?

  • Vassos et al meta analysis- found that the risk of schizophrenia in the most urban environments estimated to be 2.37 times higher than for rural enviros
  • could be that the unfavourable conditions of densely populated urban enviros are the reason for this
  • depends on however biological diathesis- only a tiny minority of those living in urban enviros develop schiz- need for a pre-existing genetic risk
• what is meant by additivity in terms of the diathesis stress model?

  • the diathesis and stress add together in some way to produce the disorder
  • for example, minor stressors may lead to someone who is highly vulnerable to schizophrenia developing the disorder, or major stressor low vulnerability
• describe the procedure in the study by Tienari et al which proves the existence of the diathesis stress model

  • hospital records reviewed for nearly 20,000 women admitted to psychiatric hospitals identifying those diagnosed with schiz or paranoia
  • found mothers who had offspring adopted away
  • sample of 145 adoptees (high genetic risk gr) matched with 158 adoptees without genetic risk (low risk)
  • assessed independently after median interval 12 yrs, follow-up after 21 yrs
  • family functioning in adoptive family assessed
  • blinding to status of mother (schiz/no schiz)
• describe the findings in the study by Tienari et al which proves the existence of the diathesis stress model

  • out of 303 adoptees, 14 developed schiz over the course of the study. 11 were from high risk group, 3 from low risk group
  • being reared in healthy adoptive family had protective effect even for those at high genetic risk of schiz
  • adoptees with high genetic risk of schiz, but not those at low genetic risk, adoptive-family stress was significant predictor of the development of schiz
• outline what an interactionist treatment is

  • researchers assess relative efficiency of different treatments for schiz by comparing them
  • combination treatments- more than one treatment being administered simultaneously to patients are generally most effective
  • particular combination- affected by patient's circumstances and needs
• what are combination treatments?

  more than one treatment being administered simultaneously to patients - generally more effective than stand alone treatments
• what is meant by a particular combination?

  a particular combination of treatments affected by patient's circumstances and needs
• what kind of schizophrenics is family therapy as a treatment useful for?

  suits schizophrenics that have a lot of interaction with their families and family dysfunction
• when is drug therapy given typically when treating a schizophrenic?

  antipsychotic treatment given first so psychological treatment will have greater effect, though they will still be given generally as different treatments are administered
• Evaluation of interactionist treatments?

  • 😊research support- hagerty et al- family therapy, social support and drug therapies result in lowest relapse rates
  • 😊using CBTp in congruence with drug therapies- Sudak- CBTp strengthens adherence to drug therapies so reduces relapse rates improves efficacy
  • ☹️Expensive to combine therapies
  • ☹️Drugs have side effects- enhancing hallucinations of schizophrenics about mistrusting treatments
• evaluation of interactionist approach to schizophrenia?

  • 😊research support- kids experiencing severe trauma before the age of 16 more likely to develop schizophrenia compared to the general population
  • ☹️diathesis may not be exclusively genetic- verdoux et al- schizophrenia can develop later in life for women who went through prolonged labour
  • 😊women born to schizophrenic mothers and were adopted less likely to have schiz if raised by healthy adoptive families (tienari et al)
  • 😊treatment- anti viral medicine during pregnancy prevents cytomegalovirus and therefore schizophrenia (Borglum)