The interactionist approach to schizophrenia

describe the interactionist approach of schz

acknowledgement for the biological, psychological and societal factors in the development of schz

biological factors = genetic vulnerability, neurochemical, and neurological abnormality

psychological factors = stress, poor quality, interactions with family

diathesis stress-model

define the diathesis-stress model

an interactionist approach into explaining behaviour

schz is explained as both an underlying vulnerability and a trigger

describe the diathesis-stress model

diathesis = vulnerability

stress = stress trigger

model states that both a vulnerability to schz and a stress trigger are needed to develop the disorder

Meehl (1962)

created original diathesis-stress model of schizophrenia

stated the vulnerability was always genetic = a single “schizogene“ would lead to the development of a “schizotypic“ personality, leading to them being more sensitive to stress

describe the modern understanding of diathesis

accepted that there are many genes which can increase genetic vulnerability to schz

more than just genetic factors = diathesis could be psychological trauma

Read et al (2001) proposed a neurodevelopmental model where early trauma can change the developing brain

e.g. child abuse can affect brain development = the hypothalamic-pituitary-adrenal (HPA) system can become overactive, making the person more vulnerable to later stress

describe the modern understanding of stress

stressor includes anything which triggers the risk of having of schizophrenic episode

cannabis is a stressor because it increases the risk of schz by 7x depending on dose

Varese et al (2012) found children who experienced trauma before the age of 16 were 3x more likely to develop schz in later life than the general population

Vassos et al found the risk of schz in urban area was 2.4x higher than living in rural areas

describe treatments according to the interactionist model

combining antipsychotic medication with psychological treatments (e.g. CBT)

the antipsychotic medication will reduce the activity of dopamine, while the CBT will help those with schz to identify negative thoughts and try to change them

in the UK it is standard practice to treat people with antipsychotic drugs and CBT

one strength is research support for the effectiveness of combining treatments

Tarrier et al (2004) studied 315 people with schz and randomly allocated them to groups (medication + CBT, medication + supportive counselling, medication) = found patients in the combinations groups showed lower symptom levels than those in medication alone

shows a clear practical advantage to adopting an interactionist approach as the best form of treatments = highlights the importance of taking an interactionist approach in explaining and treating schz

one strength is direct support for the diathesis-stress model

Tienaru et al (2004) investigated genetic vulnerability and parenting style, studied children adopted from 19000 Finnish mothers who had schz. adopted parents were assessed for child-rearing style and rates of schz were compared to children in a control group who were adopted (no genetic link to schz)

found a child-rearing style which was highly critical/lots of conflict/low levels of empathy were implicated in the development of schz but only for children whose bio mother had schz

suggests that both genetic vulnerability and family related stress are important in the development of schz as genetically vulnerable children are more sensitive to parenting behaviour