Hello and welcome to psychboost, in this final schizophrenia video we will be bringing together
what we have learnt about the biological approach, to explaining and treating schizophrenia and what
we know about the psychological approach to explaining and treating schizophrenia.
By bringing all of these ideas together we will be using the interactionist approach
and discussing a model called the diathesis stress response.
Understanding this section of schizophrenia is also going to help us access evaluations
that we can use when writing about the explanations and treatments covered so far. S
So let's begin.
To use an interactionist approach to explain schizophrenia is to consider how
a combination of biological, psychological and social factors work cause symptoms.
The mechanism suggested by psychologists is the diathesis stress model.
In this model people with schizophrenia are thought to have an internal vulnerability,
known as a diathesis. Now this vulnerability was originally thought to only be a combination
of genes, potentially genes that influence the dopamine system.
But now psychologists consider other potential diathesis such as pregnant mothers having
the flu late in pregnancy and very early psychological truma such as child abuse,
both of these factors may affect early brain development creating a vulnerability.
Now just because someone has a vulnerability, a diathesis,
this does not mean that they will automatically develop schizophrenia.
The schizophrenia is thought to be triggered by what is known as a stressor.
This stress trigger is a major negative psychological experience, such as
an adverse life event, a dysfunctional family relationship like those we mentioned
in the psychological explanations video, or potentially a period of intense stress like
academic pressure. Stress triggers can also include drug abuse, such as the use of cannabis.
Interestingly this interactionist approach to explaining schizophrenia
can help us expand on two evaluations we have already used in this unit and can use again here.
The Gottesman family study showed a 48% concordance rate in monozygotic twins,
so twins with 100% of the same DNA. This is highly suggestive of a genetic origin,
but if the disorder was entirely genetic then we should observe 100% concordance. These results can
be explained by the diathesis stress response, both twins with the vulnerability but only one
having the negative psychological experiences needed to actually trigger the disorder.
Also the Tienari study showing higher rates of schizophrenia for the adopted children of
biological schizophrenic mothers than the 1% of the background population,
but far higher rates in the children who were adopted into psychologically dysfunctional
families at 36.8% than the 5.8% of children adopted into psychologically healthy families.
Again highly suggestive of a biological diathesis that is triggered by psychological stressors.
So that's the interactionist explanation of how schizophrenia is caused
and supporting research studies, following on from that, it should make sense that the
interactionist way of treating schizophrenia is by combining anti-psychotic medication,
like typical or Atypical antipsychotics with a psychological talking therapies like CBT.
This should work as it is expected that with severe cases of schizophrenia
patients are unable to engage with the difficult psychological work of CBT or
family therapy. However, if medication can reduce the symptoms of schizophrenia then the person
with schizophrenia can go on to use CBT to gain the skills needed to change faulty cognitions.
And we do see with supporting research by Tarrier that there is a difference
if we give a patient routine care which is anti-psychotics,
or if we give them a combination therapy of anti-psychotics and CBT of psychosis.
It was found in the combination treatment patients showed a significant improvement
in both the severity and number of their positive symptoms. They also
spent fewer days in hospital receiving care than the anti-psychotics only group.
This is good evidence that the interactionist approach to treating schizophrenia
is more effective in treating schizophrenia than antipsychotics alone. Potentially both reducing
symptoms and giving suffers the cognitive skills needed to manage their own symptoms.
Finishing off let's consider some potential additional evaluations.
The diathesis stress response has evolved over time in response to changing evidence,
moving from understanding the diathesis as a single gene, to polygenic and even
including other vulnerabilities such Read (2001) providing evidence early
emotional trauma such as child abuse can act as a diathesis altering neueological development.
Also the understanding of risk triggers has developed to include factors such as drug abuse.
We would consider this explanation to be a holistic explanation of human behaviour,
and as it takes into consideration a complex range of causal factors,
it may be a more valid explanation of schizophrenia than reducing the
cause of schizophrenia to just certain biological or psychological factors.
The internationalist approach also takes into consideration the nature nurture debate,
carefully considering the relative importance of both hereditary and environmental influences.
However it is not all positive, the fundamental mechanism by which a negative psychological event
actually triggers a complex biological response resulting in symptoms is still uncertain
reducing confidence in the internationalist approach as a full explanation for schizophrenia.