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
3 of 73
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
71 of 73
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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Card 2

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approach that acknowledges what?

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there are social / psych / bio factors in sz dev

Card 3

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- explaining interactionist approach: diathesis-stress model

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Card 4

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what does diathesis mean?

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Card 5

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and in this context stress is?

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