Interactionist Explanation and Treatment

What is the interactionist approach to schizophrenia?

Suggests that the development of schizophrenia is due to the combined effects and interaction of biological and social/psychological factors

What is the diathesis stress model?

A psychological concept that a disorder is due to the interaction between a predisposed vulnerability (diathesis) and an environmental trigger later in life (trigger)

Diathesis in schizophrenia:

Diathesis in schizophrenia is often considered to be a genetic vulnerability, potentially resulting in a dopamine imbalance. Now many researchers consider non genetic diathesis such as flu in pregnant mothers and birth complications. Also very early psychological trauma such as child abuse is thought to influence brain development creating a diathesis

Stressors in schizophrenia:

Stressors in schizophrenia are later negative environmental experiences such as family dysfunction, emotional stress/anxiety or a major negative life event. This emotional event then triggers the disorder. Drug abuse is also considered a potential stressor, in particular the excessive use of cannabis has been linked to schizophrenia as it interferes with the dopamine system

Explanation AO3 - Gottesman (1991)

Reviewed cases of schizophrenia and found a concordance rate of 48% for identical twins (monozygotic/MZ) and 17% for non identical twins (dizygotic/DZ). This compares to the general population rate of 1%. This suggests a role for both biological genetic factors as the concordance rate is much higher for identical twins who share 100% of their DNA. But as the concordance rate is far less than 100% for MZ twins, this suggests there must be some psychological experience triggered in one twin but not the other

Explanation AO3 - Tienari (2004)

Studied the biological children of schizophrenic mothers who had been adopted. It was found that 5.8% of children adopted into psychologically healthy families developed schizophrenia compared to 36.8% of children raised in dysfunctional families. This research supports the influence of biological factors, due to high rate even in psychologically healthy families, but the even higher figure for dysfunctional families suggest a psychological trigger is needed

Treatment AO3 - Tarrier (1998)

Patients were randomly placed in routine care (antipsychotics) or routine care and CBT. Patients in the combined treatment had significant improvement in the severity and number of positive symptoms as well as fewer days in hospital receiving care. This suggests an interactionist approach to treating schizophrenia is more effective than the usual treatment plan of giving antipsychotics alone. Giving support to the overall interactionaist theory

What is the interactionist approach to treating schizophrenia?

• The effective treatment would combine psychological aspects such as CBT and biological drug therapies to address both causes

• In patients with severe symptoms, biological treatments allowed the reduction of symptoms so they could engage with psychological therapies. CBT then gave sufferers the cognitive skills needed to change underlying faulty cognitions

General AO3 - Read (2001)

The diathesis is no longer thought of as just a single gene, now researchers understand it is polygenic and includes vulnerabilities such as early emotional trauma like child abuse, acting as a diathesis by altering neurological development. Also understanding the risk triggers has developed to include factors such as drug abuse

General AO3 - Holistic approach

The interactionist explanation is considered to be a holistic explanation of human behaviour, 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

General AO3 - Nature nurture debate

The interactionist approach also takes into consideration the nature nurture debate, carefully considering the relative importance of both hereditary and environmental influences

General AO3 - Not a full explanation?

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 interactionist approach as a full explanation for schizophrenia