interactionist approach to schizophrenia

interactionist approach

acknowledges the biological, psychological and social factors involved in development of schizophrenia
biological - genetics
psychological - stress and trauma
social - family dysfunction

Meehl's diathesis-stress model

Meehl (1962) schizophrenia diathesis result of single schizogene leading to schizotypic personality (more sensitive to stress). no schizogene means no amount of stress leads to schizophrenia, gene carriers means chronic stress could result in development

modern understanding of diathesis

many genes increase genetic vulnerability to schizophrenia, and psychological trauma seen as diathesis rather than stressor
Read et al (2001) neurodevelopmental model where early trauma alters developing brain - severe enough trauma eg child abuse can seriously affect brain development such as hypothalamic-pituitary-adrenal system becoming overactive making person more vulnerable to stress

modern understanding of stress

stress now includes anything that risks triggering schizophrenia. still includes psychological stress but also factors such as cannabis use - can increase risk of schizophrenia up to 7 times if have genetic vulnerability

treatment

combines antipsychotics with cbt
Turkington et al (2006) - can believe in biological cause and still practise cbt but need to adopt interactionist model
common in UK to treat schizophrenia with combination of drugs and cbt, but in US there is slower adoption of interactionist approach so more common to be treated with just medication

evidence supporting role of vulnerability and triggers

Tienari et al (2004) investigated impact of genetic vulnerability and a psychological trigger (dysfunctional parenting). followed 19,000 finnish children with schizophrenic bio mothers. in adulthood compared to control group with low genetic risk. high levels of criticism, hostility and low levels of empathy in adoptive parents strongly associated with development of schizophrenia but only in high genetic risk group

original diathesis-stress model too simple

single gene and stress only schizophrenogenic parenting too simple. actually combo of multiple genes influence diathesis and stress comes in many forms - diathesis and stress can be both biological and psychological

real world application of treatment

Tarrier et al (2004) randomly allocated pp with schizophrenia 1)medication+cbt, 2)medication+counselling or 3)medication only (control) pp in the two combo groups showed lower symptoms than control but no difference in hospital readmission

real world application of treatment counterpoint

Jarvis & Okami (2019) treatment-causation fallacy, saying a successful treatment for a mental disorder justifies a particular explanation is the equivalent of saying because alcohol reduces shyness, shyness is caused by lack of alcohol. can't assume that the explanation is correct just because the therapy works