An interactionist approach

what is the interactionist approach?

it ackknowledges that nature + nurture combine, there are biological, psychological and societal factors in the development of Sz, none of these operate in isolation of the others

what is diathesis?

a pre existsing vulnerability to a condition like Sz adn it makes us more susceptible later in life

what is a biological diathesis?

genetics, neurochemical and neurological abnormality in the brain

how can birth trauma affect neurochemistry?

mothers exposure to viruses in key staged of pregnacy affecting foetal development

how does stress impact the occurance of Sz?

determines whether the vulnerablty becomes reality

what are examples of tiggers?

• psychological trauma

• chemical trauma

• urban environment

• family functioning

whats an example of psychological trauma?

• stress from shocks

• accidents

• life events

• daily hassles

how does canabis contribute to Sz?

affects dopamine system, often where dopamine is already out of balance

what has research into urbanisation and Sz found?

high level of urbanisation is associated with increased risk of developing a range of different psychoses

what were the results of Vassos’s study of urbanisation?

the risk of Sz in the most urban environments was. estimated to be 2.37 times higher than in the most rural environments

what is the diathesis stress model?

explains mental disorders are the result of an interaction between biological (the diathesis) and environmental (stress) influences

what does the diathesis stress model suggest about Sz?

a vulnerability to Sz plus a stress-trigger are neccessary to develop the disorder and teh more stress, the higher the likelihood of developing Sz

when was tienari’s study done?

2004

how many women had their hospital records reviewed?

20,000

what did the hospital records contain?

• who had been diagnosed at least once with Sz or paranoid psychoses

• able to identify those mothers who had one or more of their offspring adopted away

how many adopted away offspring were high risk?

145

how mant adopted away offspring were low risk (didn’t have genetic risk)?

158

how were adoptees assessed?

• they were assessed independently after a median interval of 12 years with a follow up study after 21 years

• also assessed using OPAS

what does the OPAS measure?

measures families on various aspects of functioning such as paretn offspring

• conflict

• lack of empathy

• insecurity

what happened in the interviews of tienari’s study?

psychatrists were kept blind as to the status of the biological mother (Sz or no Sz)

how many of the adoptees developed Sz?

• 14/303 developed sz

• 11 were high risk group

• 3 were low risk group

what were the findings from tieari’s study?

high genetic risk adoptees reared in families with low OPAS rating were significantly less likely to have developed Sz than high risk adoptees reared in families with high OPAS ratings

what did Romans-Clarkson find?

no urban-rural differences in mental health among women in New Zealand

what does Romans-Clarkson’s findings suggest?

although social adversity may well be a significant trigger for the onset of Sz the claim that social adversity and urbanisation interchangeable is likely to be an over simplification

evaluation of Interactionist approach?

• strength: supporting evidence for diathesis = Tienari

• strengths: parasitical application = combination of treatments tarrier

• strengths: Gottesman twin studies

• limitations: Clarksons urbanisation study New zealand

• limitations: treatments can become increasingly complex and expensive as a result

what did Tarrier find?

medication and CBTp group vs medication group, patients in combined group showed lower symptom levels than control

why can an interactionist approach become complex?

When considering multiple approaches, how to address these areas becomes more complex and more expensive. Providing cognitive behavioural therapy, family therapy and antipsychotic medication is costly, time-consuming, and addresses many different areas. Treatment can become increasingly complex and expensive as a result.