Evaluation of the interactionist approach to schizophrenia

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  • evidence for vulnerability and triggers
    • Tienari et al
      • investigated 19,000 Finnish mothers with Schizophrenia, compared to a control group with no genetic risk
        • a child-rearing style with high criticism, conflict and low empathy helped trigger schizophrenia in genetic vulnerability group
          • not the same for control group
            • strong support for genetic vulnerability and family-related stress
    • Evaluation of the interactionist approach
      • the original diathesis stress is over simple
        • there is no single schizogene
          • vulnerability and stress do not have one single source
            • Houston et al found child sexual trauma was a vulnerability and cannabis was the trigger
      • Effectiveness of combination treatments
        • Tarrier et al 315 patients: medication + CBT, medication + supportive counselling, control group.
          • patients in the two combination groups showed lower symptom levels than those in the control group (medication only)
            • no difference in hospital readmission rates
              • clear practical advantage
      • evaluation extra
        • We do not yet fully understand the mechanisms by which the symptoms of schizophrenia appear and how both vulnerability and stress produce them
        • The fact that CBT works does not mean it is psychological in origin, drugs do not make it biological in origin either


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