7) The Interactionist Approach

Define the interactionist approach to schizophrenia?

An approach that recognises a variety of contributing factors in the development of schizophrenia.

• Biological (genetics)

• Psychological (stress)

• Social (family)

Name an example of an interactionist model?

Diathesis stress model

Name a researcher who investigated the diathesis stress model?

Meehl

Outline Meehl’s model of the diathesis stress model?

MEEHLS MODEL:

Vulnerability was seen as entirely genetic.

• Schizogene is a candidate gene for a schizotypic personality.

  • This is a personality which is particularly sensitive to stress.

    • Chronic stress through childhood could result in schizophrenia.

• Without the schizogene, you have no sensitivity to stress and so even with a schizoprenogenic mother, schizophrenia will not be developed.

Outline the modern understanding of diathesis?

RIPKE:

Schizophrenia is polygenetic.

READ ET AL:
Vulnerability (diathesis) can also be caused by psychological trauma.

• Early trauma (such as child abuse) could even alter the developing brain.

  • e.g: the HPA system (hypothalamic-pituitary-adrenal system) could become overreactive - so they are more vulnerable to stress.

Outline the modern understanding of stress?

Originally stress was seen as psychological in nature.

• Particularly in relation to parenting.

Now, stress is considered as anything that risk triggering schizophrenia.

HOUSTON ET AL:
Cannabis use leads to 7x likely to develop schizophrenia.

• Cannabis interferes with dopamine system, however not everyone who smokes cannabis develops schizophrenia - links back to genetic vulnerability (even due to childhood trauma altering brain).

Outline interactionist treatments for schizophrenia?

Interactionist model acknowledges both biological and psychological explanations and treatments.

TURKINGTON ET AL:
Points out that it is perfectly possible to believe that biologically caused disorders can still effectively be treated through CBT as long as we accept an interactionist approach.

• The most common combination - antipsychotics and CBT.

• This is very common in the UK but not as much in the USA as there is more conflict between biological and psychological approaches historically.

However, we must believe in the relevance of all symptoms in order to use both treatments as otherwise it will not work.

Evaluate three strengths of the interactionist approach?

STRENGTH: SUPPORTING EVIDENCE

TIENARI ET AL:
Studied the dual role of vulnerability and stress.

• Children adopted from 19000 Finnish mothers with schizophrenia between 1960 and 1979.

• Adoptive parents assessed for parenting style.

• Compared to a control group.

Child rearing styles with high levels of criticism and conflict, and low levels of empathy were implicated in the development of schizophrenia in high risk adoptees.

• Suggests that genetic vulnerability and family related tress contributed to the onset of schizophrenia.

STRENGTH: REAL WORLD APPLICATION

Studies show that combining treatments enhance their effectiveness in the treatment of schizophrenia.

TARRIER ET AL:

315 participants were assigned to one of the following:
1) Medication and CBT

2) Medication and Counselling

3) Medication only ( control )

• Combination treatments showed greater reduction in symptom severity.

This is a clear practical advantage to adopting an interactionist approach in the treatment of schizophrenia based on the superior treatment outcomes.

STRENGTH: EXPLAINS URBANISATION

CHECK TEXTBOOK FOR THIS!!!!

Evaluate one limitation of the interactionist approach?

LIMITATION: OVERLY SIMPLISTIC

The idea of a single schizogene mixed with the stress of schizophrenic parenting is very simplistic.

• Firstly, the condition has been proved to be polygenic by Ripke et al, and stress comes in many forms and is not limited to dysfunctional parenting.

• Thus, disproves Meekle’s model.

HOUSTON ET AL:
Sexual abuse in childhood seen as a major influence on underlying vulnerability to schizophrenia, as well as cannabis which can be a major trigger.

• Supports the modern understanding of diathesis and stress.