Interactionist Approach

The Interactionist Approach

This approach acknowledges both the biological and the psychological factors involved in schizophrenia’s development, and therefore it is NOT reductionist. It uses the Diathesis-Stress model to explain schizophrenia. There are two developments of this model

The Diathesis-Stress Model - step by step

Diathesis (underlying vulnerability for Schizophrenia) + Stress (a trigger) —> Schizophrenia

The ORIGINAL (early) Diathesis-Stress Model - Meehl (1962)

Diathesis = entirely gene based, result of a single ‘schizogene’ which caused the development of a ‘schizotypic personality’ (this involves increased sensitivity to stress)

Stress = Chronic PSYCHOLOGICAL stress throughout childhood and adolescence can trigger schizophrenia (only in individuals with schizogene)

The MODERN Diathesis-Stress Model

Diathesis = Schizophrenic is ‘polygenic’, there are many candidate genes for the disorder, there is no single schizogene

Stress = Early PSYCHOLOGICAL trauma alters the developing brain = individuals more vulnerable to later stress. Stress can also be NON-PSYCHOLOGICAL TRIGGERS - includes anything that risks triggering disorder (eg Cannabis = 7X increased risk for people with gene)

Treatments

The interactionist approach is associated with treatments that combine anti-psychotic medication and Cognitive Behavioural Therapy (as it addresses both biological and psychological factors). Not all countries have adopted this approach (eg USA), but in places where it has been adopted (eg UK) it had shown to be most successful.

Pro - Interactionist Approach - Finnish adoptees

One strength of the interactionist approach is that there s evidence supporting its suggestions that genetic vulnerability and stress triggers must be present for schizophrenia to develop. A study using Finnish adoptees from mothers with schizophrenia recorded the parenting styles these adoptees were subject to from their new parents and the rates of schizophrenia diagnosis in the participants. This group was compared to a control group without schizophrenic mothers. The findings found that parenting styles that involved conflict, a lack of empathy and criticism were implicated with schizophrenia development, but only in the children with schizophrenic birth mothers. Therefore, this suggest diathesis and stress in childhood must both be present for schizophrenia to develop, supporting the model.

The Finnish Adoptees Study

A study followed Finnish adoptees who had been born to schizophrenic mothers and recorded the parenting styles they were subject to from their adoptive parents as well as the rates of schizophrenia diagnosis in the adoptees. This groups results were compared to a control group of adoptees without a schizophrenic mother. The study found that parenting styles involving a lack of empathy, high levels of criticism and conflict were implicated with schizophrenia’s development, however this only occurred in the adoptees with schizophrenic birth mothers.

Pro - Interactionist Approach - Treatment

One strength of the Interactionist approach is that there is evidence supporting it as successful treatments have been built from its conclusions. The approach aims to use both drug therapy and CBT in order address both the biological and psychological factors of schizophrenia. One study found that when 315 schizophrenics were randomly allocated to a group experiencing, drug therapy and CBT, drug therapy and supportive counselling or only drug therapy, the patients that received drug therapy alongside a psychological treatment had reduced symptoms compared to the patients only receiving Drug Therapy. Therefore, this suggests this approach has positive real world applications as it leads to superior treatment, meaning the IA is strong.

Con - Interactionist Approach - Incomplete

One Weakness of the interactionist approach is that, whilst there is evidence linking an underlying diathesis coupled with dress causing schizophrenia to development, the approach has no clear understanding of the mechanisms that cause schizophrenia’s symptoms, or how the diathesis and stress produce these mechanism. Therefore, this suggests the interactionist approach is not comprehensive and an incomplete explanation of schizophrenia.