The interactionist approach
The interactionist approach is a broad approach to explaining schizophrenia, which acknowledges that there are a range of factors (biological, psychological and societal factors) involved in the development of schizophrenia
What is the interactionist approach also sometimes called?
The interactionist approach is also sometimes called the ‘biosocial approach’
The interactionist approach is a broad approach to explaining schizophrenia, which acknowledges that there are a range of factors (biological, psychological and societal factors) involved in the development of schizophrenia.
What do biological factors include?
Biological factors include genetic vulnerability and neurochemical and neurological abnormality
The interactionist approach is a broad approach to explaining schizophrenia, which acknowledges that there are a range of factors (biological, psychological and societal factors) involved in the development of schizophrenia.
Biological factors include genetic vulnerability and neurochemical and neurological abnormality.
What do psychological factors include?
Psychological factors include stress, for example resulting from life events and daily hassles, including poor quality interactions in the family
What does diathesis mean?
Diathesis means vulnerability
Diathesis means vulnerability.
In the context of schizophrenia, what does stress simply mean?
In the context of schizophrenia, stress simply means a negative psychological experience
Diathesis means vulnerability.
In the context of schizophrenia, stress simply means a negative psychological experience.
The diathesis-stress model says that both what are necessary in order to develop the condition?
The diathesis-stress model says that both a vulnerability to schizophrenia and a stress-trigger are necessary in order to develop the condition
Diathesis means vulnerability.
In the context of schizophrenia, stress simply means a negative psychological experience.
The diathesis-stress model says that both a vulnerability to schizophrenia and a stress-trigger are necessary in order to develop the condition.
One or more underlying factors make a person particularly vulnerable to developing schizophrenia, but
One or more underlying factors make a person particularly vulnerable to developing schizophrenia, but the onset of the condition is triggered by stress
The diathesis-stress model
The diathesis-stress model is an interactionist approach to explaining behaviour
The diathesis-stress model is an interactionist approach to explaining behaviour.
Example
For example, schizophrenia is explained as the result of both an underlying vulnerability (diathesis) and a trigger, both of which are necessary for the onset of schizophrenia
The diathesis-stress model is an interactionist approach to explaining behaviour.
For example, schizophrenia is explained as the result of both an underlying vulnerability (diathesis) and a trigger, both of which are necessary for the onset of schizophrenia.
In early versions of the diathesis-stress model, vulnerability was genetic and triggers were psychological.
Nowadays,
Nowadays, both genes and trauma are seen as diatheses and stress can be psychological or biological in nature
In the original diathesis-stress model (who, when)
In the original diathesis-stress model (Meehl, 1962)
In the original diathesis-stress model (Meehl, 1962), diathesis (vulnerability) was
In the original diathesis-stress model (Meehl, 1962), diathesis (vulnerability) was entirely genetic
In the original diathesis-stress model (Meehl, 1962), diathesis (vulnerability) was entirely genetic, the result of what?
In the original diathesis-stress model (Meehl, 1962), diathesis (vulnerability) was entirely genetic, the result of a single ‘schizogene’
In the original diathesis-stress model (Meehl, 1962), diathesis (vulnerability) was entirely genetic, the result of a single ‘schizogene.’
What did this lead to?
This led to the development of a biologically based schizotypic personality
In the original diathesis-stress model (Meehl, 1962), diathesis (vulnerability) was entirely genetic, the result of a single ‘schizogene.’
This led to the development of a biologically based schizotypic personality, one characteristic of which is what?
This led to the development of a biologically based schizotypic personality, one characteristic of which is sensitivity to stress
In the original diathesis-stress model (Meehl, 1962), diathesis (vulnerability) was entirely genetic, the result of a single ‘schizogene.’
This led to the development of a biologically based schizotypic personality, one characteristic of which is sensitivity to stress.
According to Paul Meehl, if a person does not have the schizogene, then
According to Paul Meehl, if a person does not have the schizogene, then no amount of stress would lead to schizophrenia
In the original diathesis-stress model (Meehl, 1962), diathesis (vulnerability) was entirely genetic, the result of a single ‘schizogene.’
This led to the development of a biologically based schizotypic personality, one characteristic of which is sensitivity to stress.
According to Paul Meehl, if a person does not have the schizogene, then no amount of stress would lead to schizophrenia.
However, in carriers of the gene,
However, in carriers of the gene, chronic stress through childhood and adolescence, in particular the presence of a schizophrenogenic mother, could result in the development of the condition
The modern understanding of diathesis:
One way in which our understanding of diathesis has changed
One way in which our understanding of diathesis has changed is that it is now clear that many genes each appear to increase genetic vulnerability sightly
The modern understanding of diathesis:
One way in which our understanding of diathesis has changed is that it is now clear that many genes each appear to increase genetic vulnerability sightly - there is no
One way in which our understanding of diathesis has changed is that it is now clear that many genes each appear to increase genetic vulnerability sightly - there is no single ‘schizogene’ (Ripke et al, 2014)
The modern understanding of diathesis:
One way in which our understanding of diathesis has changed is that it is now clear that many genes each appear to increase genetic vulnerability sightly - there is no single ‘schizogene’ (Ripke et al, 2014).
What do modern views of diathesis also include?
Modern views of diathesis also include a range of factors beyond genetics, including psychological trauma (Ingram and Luxton, 2005)
The modern understanding of diathesis:
One way in which our understanding of diathesis has changed is that it is now clear that many genes each appear to increase genetic vulnerability sightly - there is no single ‘schizogene’ (Ripke et al, 2014).
Modern views of diathesis also include a range of factors beyond genetics, including psychological trauma (Ingram and Luxton, 2005) - so what?
Modern views of diathesis also include a range of factors beyond genetics, including psychological trauma (Ingram and Luxton, 2005) - so trauma becomes the diathesis, rather than the stressor
The modern understanding of diathesis:
One way in which our understanding of diathesis has changed is that it is now clear that many genes each appear to increase genetic vulnerability sightly - there is no single ‘schizogene’ (Ripke et al, 2014).
Modern views of diathesis also include a range of factors beyond genetics, including psychological trauma (Ingram and Luxton, 2005) - so trauma becomes the diathesis, rather than the stressor.
Read et al. (2001)
Read et al. (2001) proposed a neurodevelopmental model in which early trauma alters the developing brain
The modern understanding of diathesis:
One way in which our understanding of diathesis has changed is that it is now clear that many genes each appear to increase genetic vulnerability sightly - there is no single ‘schizogene’ (Ripke et al, 2014).
Modern views of diathesis also include a range of factors beyond genetics, including psychological trauma (Ingram and Luxton, 2005) - so trauma becomes the diathesis, rather than the stressor.
Read et al. (2001) proposed a neurodevelopmental model in which early trauma alters the developing brain.
Early and
Early and severe enough trauma
The modern understanding of diathesis:
One way in which our understanding of diathesis has changed is that it is now clear that many genes each appear to increase genetic vulnerability sightly - there is no single ‘schizogene’ (Ripke et al, 2014).
Modern views of diathesis also include a range of factors beyond genetics, including psychological trauma (Ingram and Luxton, 2005) - so trauma becomes the diathesis, rather than the stressor.
Read et al. (2001) proposed a neurodevelopmental model in which early trauma alters the developing brain.
What can early and severe enough trauma, such as child abuse, do?
Early and severe enough trauma, such as child abuse, can seriously affect many aspects of brain development
The modern understanding of diathesis:
One way in which our understanding of diathesis has changed is that it is now clear that many genes each appear to increase genetic vulnerability sightly - there is no single ‘schizogene’ (Ripke et al, 2014).
Modern views of diathesis also include a range of factors beyond genetics, including psychological trauma (Ingram and Luxton, 2005) - so trauma becomes the diathesis, rather than the stressor.
Read et al. (2001) proposed a neurodevelopmental model in which early trauma alters the developing brain.
Early and severe enough trauma, such as child abuse, can seriously affect many aspects of brain development.
Example
For example, the hypothalamic-pituitary-adrenal (HPA) system can become over-active
The modern understanding of diathesis:
One way in which our understanding of diathesis has changed is that it is now clear that many genes each appear to increase genetic vulnerability sightly - there is no single ‘schizogene’ (Ripke et al, 2014).
Modern views of diathesis also include a range of factors beyond genetics, including psychological trauma (Ingram and Luxton, 2005) - so trauma becomes the diathesis, rather than the stressor.
Read et al. (2001) proposed a neurodevelopmental model in which early trauma alters the developing brain.
Early and severe enough trauma, such as child abuse, can seriously affect many aspects of brain development.
For example, the hypothalamic-pituitary-adrenal (HPA) system can become over-active, doing what?
For example, the hypothalamic-pituitary-adrenal (HPA) system can become over-active, making the person much more vulnerable to later stress
The modern understanding of stress:
In the original diathesis-stress model of schizophrenia, how was stress seen?
In the original diathesis-stress model of schizophrenia, stress was seen as psychological in nature
The modern understanding of stress:
In the original diathesis-stress model of schizophrenia, stress was seen as psychological in nature, in particular related to what?
In the original diathesis-stress model of schizophrenia, stress was seen as psychological in nature, in particular related to parenting
The modern understanding of stress:
In the original diathesis-stress model of schizophrenia, stress was seen as psychological in nature, in particular related to parenting.
Although psychological stress, including that resulting from parenting, may still be considered important, what does a modern definition of stress in relation to the diathesis-stress model include?
Although psychological stress, including that resulting from parenting, may still be considered important, a modern definition of stress in relation to the diathesis-stress model includes anything that risks triggering schizophrenia (Houston et al, 2008)
The modern understanding of stress:
In the original diathesis-stress model of schizophrenia, stress was seen as psychological in nature, in particular related to parenting.
Although psychological stress, including that resulting from parenting, may still be considered important, a modern definition of stress in relation to the diathesis-stress model includes anything that risks triggering schizophrenia (Houston et al, 2008).
What has much of the recent research into factors triggering an episode of schizophrenia concerned?
Much of the recent research into factors triggering an episode of schizophrenia has concerned cannabis use
The modern understanding of stress:
In the original diathesis-stress model of schizophrenia, stress was seen as psychological in nature, in particular related to parenting.
Although psychological stress, including that resulting from parenting, may still be considered important, a modern definition of stress in relation to the diathesis-stress model includes anything that risks triggering schizophrenia (Houston et al, 2008).
Much of the recent research into factors triggering an episode of schizophrenia has concerned cannabis use.
In terms of the diathesis-stress model, what is cannabis?
In terms of the diathesis-stress model, cannabis is a stressor
The modern understanding of stress:
In the original diathesis-stress model of schizophrenia, stress was seen as psychological in nature, in particular related to parenting.
Although psychological stress, including that resulting from parenting, may still be considered important, a modern definition of stress in relation to the diathesis-stress model includes anything that risks triggering schizophrenia (Houston et al, 2008).
Much of the recent research into factors triggering an episode of schizophrenia has concerned cannabis use.
In terms of the diathesis-stress model, why is cannabis a stressor?
In terms of the diathesis-stress model, cannabis is a stressor, because it increases the risk of schizophrenia by up to 7 times according to dose
The modern understanding of stress:
In the original diathesis-stress model of schizophrenia, stress was seen as psychological in nature, in particular related to parenting.
Although psychological stress, including that resulting from parenting, may still be considered important, a modern definition of stress in relation to the diathesis-stress model includes anything that risks triggering schizophrenia (Houston et al, 2008).
Much of the recent research into factors triggering an episode of schizophrenia has concerned cannabis use.
In terms of the diathesis-stress model, cannabis is a stressor, because it increases the risk of schizophrenia by up to 7 times according to dose.
Why is this probably because?
This is probably because cannabis interferes with the dopamine system
The modern understanding of stress:
In the original diathesis-stress model of schizophrenia, stress was seen as psychological in nature, in particular related to parenting.
Although psychological stress, including that resulting from parenting, may still be considered important, a modern definition of stress in relation to the diathesis-stress model includes anything that risks triggering schizophrenia (Houston et al, 2008).
Much of the recent research into factors triggering an episode of schizophrenia has concerned cannabis use.
In terms of the diathesis-stress model, cannabis is a stressor, because it increases the risk of schizophrenia by up to 7 times according to dose.
This is probably because cannabis interferes with the dopamine system.
However,
However, most people do not develop schizophrenia after smoking cannabis, so it seems there must also be one or more vulnerability factors
The modern understanding of stress:
In the original diathesis-stress model of schizophrenia, stress was seen as psychological in nature, in particular related to parenting.
Although psychological stress, including that resulting from parenting, may still be considered important, a modern definition of stress in relation to the diathesis-stress model includes anything that risks triggering schizophrenia (Houston et al, 2008).
Much of the recent research into factors triggering an episode of schizophrenia has concerned cannabis use.
In terms of the diathesis-stress model, cannabis is a stressor, because it increases the risk of schizophrenia by up to 7 times according to dose.
This is probably because cannabis interferes with the dopamine system.
However, most people do not develop schizophrenia after smoking cannabis, so it seems there must also be one or more vulnerability factors.
Therefore, high doses of cannabis can trigger schizophrenia in people with
Therefore, high doses of cannabis can trigger schizophrenia in people with a pre-existing vulnerability
Treatment according to the interactionist model:
The interactionist model of schizophrenia acknowledges both biological and psychological factors in schizophrenia and is therefore compatible with
The interactionist model of schizophrenia acknowledges both biological and psychological factors in schizophrenia and is therefore compatible with both biological and psychological treatments
Treatment according to the interactionist model:
The interactionist model of schizophrenia acknowledges both biological and psychological factors in schizophrenia and is therefore compatible with both biological and psychological treatments.
In particular, what is the interactionist model of schizophrenia associated with?
In particular, the interactionist model of schizophrenia is associated with combining antipsychotic medication and psychological therapies, most commonly CBT
Treatment according to the interactionist model:
The interactionist model of schizophrenia acknowledges both biological and psychological factors in schizophrenia and is therefore compatible with both biological and psychological treatments.
In particular, the interactionist model of schizophrenia is associated with combining antipsychotic medication and psychological therapies, most commonly CBT.
Douglas Turkington et al. (2006)
Douglas Turkington et al. (2006) point out that it is perfectly possible to believe in biological causes of schizophrenia and still practise CBT to relieve psychological symptoms
Treatment according to the interactionist model:
The interactionist model of schizophrenia acknowledges both biological and psychological factors in schizophrenia and is therefore compatible with both biological and psychological treatments.
In particular, the interactionist model of schizophrenia is associated with combining antipsychotic medication and psychological therapies, most commonly CBT.
Douglas Turkington et al. (2006) point out that it is perfectly possible to believe in biological causes of schizophrenia and still practise CBT to relieve psychological symptoms.
However,
However, this requires adopting an interactionist model - it is not possible to:
- Adopt a purely biological approach
- Tell patients that their condition is purely biological and that there is no psychological significance to their symptoms
- Simultaneously treat them with CBT
Treatment according to the interactionist model:
In Britain, how is it increasingly standard practice to treat patients?
In Britain, it is increasingly standard practice to treat patients with a combination of antipsychotic drugs and CBT
Treatment according to the interactionist model:
In Britain, it is increasingly standard practice to treat patients with a combination of antipsychotic drugs and CBT.
In the USA,
In the USA, there is more of a history of conflict between adoption of an interactionist approach
Treatment according to the interactionist model:
In Britain, it is increasingly standard practice to treat patients with a combination of antipsychotic drugs and CBT.
In the USA, there is more of a history of conflict between adoption of an interactionist approach.
Thus,
Thus, medication without an accompanying psychological treatment is more common in the USA than in the UK
Treatment according to the interactionist model:
It is unusual to treat schizophrenia using what alone?
It is unusual to treat schizophrenia using psychological therapies alone
Treatment according to the interactionist model:
It is unusual to treat schizophrenia using psychological therapies alone.
CBT, family therapy and the use of token economies with sufferers of schizophrenia are usually carried out with patients who?
CBT, family therapy and the use of token economies with sufferers of schizophrenia are usually carried out with patients who take antipsychotics
A combination of genetic vulnerability and growing up in a dysfunctional family increases the risk of schizophrenia.
Each on their own may not be problematic, but
Each on their own may not be problematic, but they interact in such a way to produce mental health problems
The modern understanding of diathesis:
One way in which our understanding of diathesis has changed is that it is now clear that many genes each appear to increase genetic vulnerability sightly - there is no single ‘schizogene’ (Ripke et al, 2014).
Modern views of diathesis also include a range of factors beyond genetics, including psychological trauma (Ingram and Luxton, 2005) - so trauma becomes the diathesis, rather than the stressor.
Read et al. (2001) proposed a neurodevelopmental model in which early trauma alters the developing brain.
Early and severe enough trauma, such as child abuse, can seriously affect many aspects of brain development.
For example, the hypothalamic-pituitary-adrenal (HPA) system can become over-active, making the person much more vulnerable to later stress.
What is an example of early trauma?
An example of early trauma is seeing both your parents die at an early age
The modern understanding of diathesis:
One way in which our understanding of diathesis has changed is that it is now clear that many genes each appear to increase genetic vulnerability sightly - there is no single ‘schizogene’ (Ripke et al, 2014).
Modern views of diathesis also include a range of factors beyond genetics, including psychological trauma (Ingram and Luxton, 2005) - so trauma becomes the diathesis, rather than the stressor.
Read et al. (2001) proposed a neurodevelopmental model in which early trauma alters the developing brain.
Early and severe enough trauma, such as child abuse, can seriously affect many aspects of brain development.
For example, the hypothalamic-pituitary-adrenal (HPA) system can become over-active, making the person much more vulnerable to later stress.
There is lots of research that cortisol does what?
There is lots of research that cortisol inhibits growth
The modern understanding of diathesis:
One way in which our understanding of diathesis has changed is that it is now clear that many genes each appear to increase genetic vulnerability sightly - there is no single ‘schizogene’ (Ripke et al, 2014).
Modern views of diathesis also include a range of factors beyond genetics, including psychological trauma (Ingram and Luxton, 2005) - so trauma becomes the diathesis, rather than the stressor.
Read et al. (2001) proposed a neurodevelopmental model in which early trauma alters the developing brain.
Early and severe enough trauma, such as child abuse, can seriously affect many aspects of brain development.
For example, the hypothalamic-pituitary-adrenal (HPA) system can become over-active, making the person much more vulnerable to later stress.
There is lots of research that cortisol inhibits growth.
This explains why children who are neglected are often short - not because of not eating (although that may ofcourse be a factor), but because they’ve been what?
This explains why children who are neglected are often short - not because of not eating (although that may ofcourse be a factor), but because they’ve been unhappy/stressed
You’re 7 times more likely to develop schizophrenia if you smoke cannabis.
When you smoke cigarettes, what does your brain do?
When you smoke cigarettes, your brain grows receptors that want nicotine
You’re 7 times more likely to develop schizophrenia if you smoke cannabis.
When you smoke cigarettes, your brain grows receptors that want nicotine.
When you smoke cannabis, what does your brain do?
When you smoke cannabis, your brain grows receptors that want endocannabinoids
You’re 7 times more likely to develop schizophrenia if you smoke cannabis.
When you smoke cigarettes, your brain grows receptors that want nicotine.
When you smoke cannabis, your brain grows receptors that want endocannabinoids.
What does an overgrowth mean?
An overgrowth means that there is more dopamine in the brain
You’re 7 times more likely to develop schizophrenia if you smoke cannabis.
When you smoke cigarettes, your brain grows receptors that want nicotine.
When you smoke cannabis, your brain grows receptors that want endocannabinoids.
An overgrowth means that there is more dopamine in the brain.
Therefore, smoking changes your brain’s what?
Therefore, smoking changes your brain’s structure
In the original diathesis-stress model (Meehl, 1962), diathesis (vulnerability) was entirely genetic, the result of a single ‘schizogene.’
However,
However, Ripke et al. found that 108 different genetic variations were associated with increased risk of schizophrenia
Overall, it is unusual to treat schizophrenia using psychological therapies alone.
What with sufferers of schizophrenia are usually carried out with patients taking antipsychotics?
- CBT
- Family therapy
- Token economies
with sufferers of schizophrenia are usually carried out with patients taking antipsychotics