SCHIZOPHRENIA - The Interactionist Approach to Schizophrenia

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  • The Interactionist of schizophrenia
    • Diathesis-Stress Model
      • 1. some people have psych / genetic vulnerability to have sch
        • they will not necessarily develop sch if they have a vulnerability
      • 2. they will need to have environmental stressor if they are already vulnerable
      • sch mainly develops in late adol / early adult
        • theory fits -> time is for a lot of potential stressors
          • exams
          • relationships
          • moving out
          • addiction
          • first job
      • combination treatments, drug and CBT
    • Research
      • TIENARI - looked at influence of genetics and family culture (see other resource for more details)
      • VARESE - if children suffered trauma before 16, 3 times more likely to develop schiz in later life. The more severe the trauma = greater risk
      • VASSOS - meta-analysis. 2.37 more likely to develop schiz in an urban area, but not sure why (living conditions, more stressors)
    • Evaluation (A03) of explanation
      • says schiz is caused by couple of major factors, so theory is better in 2 ways:
        • less simplistic & reductive than purely bio/psych theory.
        • less deterministic compared to bio / psych explanation
      • most accepted and treatment is most popular
      • WALKER - cortisol levsl higher immediately before onset of schiz rather than during recovery. Cortisol = trigger
      • causes may diff between individs - bio, environmental, psych and social factors
      • diff pos / neg environments in/decrease rick of developing if have bio vulnerability
      • genes do not determine outcome alone - need stressors to trigger
      • urban environment not necessarily more stressful.
        • ROMANS - CLOCKSON (1990) - found no urban-rural diffs in mental health among women in New Zealand.
    • Evaluation (A03) of treatment
      • combination behavioural & cognitive therapies - effective
      • increased cost of treatment, but cost effective long term
      • combined treat - addresses both parts
      • patients having CBT sometimes have side effects of simultaneous drug treatment (delusions) increasing distrust of further treatment
      • implications for treatment - BORGUM found women infected with cytomegalovirus during preg where more likely to have a child to develop schiz but only if they both carried a gene defect. Anti-viral meds may stop this onset

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