schizophrenia ; interactionist approach

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THE INTERACTIONIST APPROACH
DFGD
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approach that acknowledges what?
there are social / psych / bio factors in sz dev
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- explaining interactionist approach: diathesis-stress model
dgd
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what does diathesis mean?
vulnerability
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and in this context stress is?
negative psych experience
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diathesis-stress model says what?
both vulnerability to sz and stress-trigger are neccessary to dev condt
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onset of sz is triggered by?
strss
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+ meehl's model
df
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in og model, diathesis was entirely genetic and the result of one single?
schizogene
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this led to the development of biologically based?
schizotypic personality
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one characteristic of which is sensitivity to?
stress
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according to meehl no amount of stress will lead to sz if?
person doesn't posess schizogene
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howver in carriers chronic stress in childhood and adolescence specifically presence of what could lead to dev?
schizophrenogenic mother
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+ modern understanding of diathesis
dfgd
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what is one way in which our understanding of diathesis has changed?
now clear many genes each appear to increase genetic vulnerability slightly
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modern views of diathesis also include range of factors beyond genetic including?
psych trauma
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sso trauma becomes?
diathesis > stressor (*kumail nanjiani voice* yeah, i don't really get that)
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erad et al proposed a neurodevelopmental model in which?
early trauma alters developing brain
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early and severe trauma can do what?
seriously affect many aspects of brain developmnet
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for example what can become overactive and make the person much more vulnerable to later stress?
hypothalamic-pituitary-adrenal system (HPA system)
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+ modern understanding of stress
dfgd
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in original ds model stress seen psych in nature in particular rreated to?
parenting
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what is the modern definition of stress?
anything that risks triggering sz
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much recent research into factors triggering sz episode has concerned?
cannabis use
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interms of ds why can cannabis b seen a stressor?
increases risk of sz by up to 7 times acc to dose
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this is probably because cannabis refers to what system
dopamine
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however most people don't develop sz after smoking cannabis suggesting?
more than one vulnerability factos
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- treatment according to interactionist model
dfgdfg
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bc interactionist model of sz acknowledges both biological + psych factors it means?
compatible with both bio + psych treatments
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in particulr model is associated with combining?
antipsychotic meds + psych therapies
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turkington et al point out its perfectly possible to believe in bio causes and still?
practice CBT to relive psych symptoms
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this req adopting interactionist model bc its not pssible to adopt bio approach and tell patients what?
condt is purely bio and no psych significance to sumptoms
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in britain its an increasingly standard practice to treat with?
combination of drugs and cbt
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EVALUATION
DFGDF
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:) evidence for role of vulnerability and triggers
dfgdf
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evidence to support dual role of?
vulnerability and stress
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tienari et al investigated what?
combination of genetic vulnerability and parenting style
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how many children adopted from finnish mothers w/ sz from '60-'79 were followed up?
19k
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adoptive parents assessed for?
child-rearing style
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and rates of sz compared to?
ctrl grp of adpotees
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child-rearing style was characterised by high levels of?
criticism and conflict
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and low levels?
empath
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this style was implicated in dev sz but only for?
grp w/ high genetic risk
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what does this suggest about genetically vulnerable kids?
more sensitive to parenting behaviour
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this is v strong direct support for?
importance of itnerationist approach
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:( original diathesis-stress model is over-simple
egdg
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what is now known to be oversimple?
classic model of single schizogene and schizophrenic parenting style
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it is now known what about genes?
multiple genes increase vulnerability each haivng own small effect
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and stress can come in many forms including but not limited to?
dysfunctional parenting
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therefore what don't have one single cause?
vulnerability and stress
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in fact now believed vulnerability can be the result of what as well as genetic makeup?
early stress
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why?
it can alter your neural pathways + brain structures
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in recent study by houston et al what emerged as vulnerability factor?
childhood sexual trauma
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and the trigger was?
cannabis
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this shows old idea of what to be overly simple?
diathesis as biological and stress to be psychological
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this is a problem for which type of ds model?
old but not new
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:) support for effectiveness of combinations of treatments
sdgdf
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support for usefulness of adopting interactionist approach from studies comparing
effectiveness of combination treatments v bio alone
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what did turkington et al point out about combination treatments?
impossible to use w/o adopting interactionist approach
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tarrier et al studied how many patients?
315
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and randomly assigned them to what groups?
medication + CBT / medication + supportive counselling / control group
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patients in which group showed higher symptoms than other two?
medication ctrl grp
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though there was no difference in rates of?
readmission
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studies like thiss show what about interactionist approach?
clear practical advantage in form of superior treatment outcomes
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and therefore highling what?
importance of interactionist approach
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EVAL EXTRA
DGDFG
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:( don't know exactly how diathesis and stress work
dgd
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there is strong evidence for underlying vulnerability coupled with stress but we don't yet fully understand?
mechanisms by which sz symptoms appear and how vulnerability and stress produce them
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:( treatment-causation fallacy
dgs
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turkington et al argue there is a good logical fit between?
interactionist approach + combination treatments
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fact combined treatments are more effective than either alone doesn't meanwhat?
interactionist approach for causality is correct
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similarly fact drugs help doesn't mean what?
sz is biological in origin
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error of logic like this is called?
treatment-causation fallcy
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approach that acknowledges what?

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there are social / psych / bio factors in sz dev

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- explaining interactionist approach: diathesis-stress model

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what does diathesis mean?

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and in this context stress is?

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