The interactionist approach to schiz

What is the interactionist approach

An approach that acknowledges that there are biological, psychological, ad social factors in the development of schizo

What is the diathesis-stress model

A way to present an interactionist approach. Diathesis means vulnerability. In this context stress simply means a negative experience. The diathesis-stress model says that both a vulnerability to schiz and a stress-trigger are necessary in order to develop the disorder.

What was the original diathesis-stress model

In the original diathesis-stress model (Meehl, 1962), vulnerability to schizophrenia was entirely genetic, caused by a single "schizogene." This gene was thought to create a schizotypic personality sensitive to stress. Meehl argued that without the schizogene, no amount of stress could cause schizophrenia. However, for those with the gene, chronic stress, especially from childhood or adolescence, like having a schizophrenogenic mother, could trigger the disorder

How has our understanding of diathesis changed now

Our understanding of diathesis has evolved. Instead of a single "schizogene," many genes each slightly increase genetic vulnerability (Ripke et al., 2014). Modern views also include factors beyond genetics, such as psychological trauma, which can act as the diathesis rather than just the stressor (Ingram and Luxton, 2005)

Who proposed a neurodevelopmental model where early trauma alters the developing brain and what did this say

John Read et al. For example, severe trauma can overactivate the hypothalamic-pituitary-adrenal (HPA) system, increasing vulnerability to stress later in life

How has our understanding of stress changed now

The original diathesis-stress model linked stress to psychological factors, especially parenting. While psychological stress is still relevant, modern definitions of stress include anything that can trigger schizophrenia (Houston et al., 2008). Recent research highlights cannabis use as a stressor, increasing schizophrenia risk by up to seven times depending on the dose, possibly due to its impact on the dopamine system. However, most cannabis users do not develop schizophrenia, likely because they lack the necessary vulnerability factors

What type of treatment does the interactionist model propose

The interactionist model of schizophrenia acknowledges both biological and psychological factors in schizophrenia and is therefore compatible with both biological and psychological treatments. In particular the model is associated with combining antipsychotic medication and psychological therapies, most commonly CBT

What did Douglas Turkington et al. point out

That it is perfectly possible to believe in biological causes of schizophrenia and still practise CBT to relieve psychological symptoms. However, this requires adopting an interactionist model - it is not possible to adopt a purely biological approach and tell people diagnosed with schizophrenia that their condition is purely biological and that there is no psychological significance to symptoms, and then to simultaneously treat them with CBT

What are the standard practices of schizo treatment in the UK vs US

UK: use a combo of antipsychotic drugs and CBT

US: more of a history of conflict between psychological and biological models of schizo and this may have led to slower adoption of an interactionist approach. This means meds without an accompanying psychological treatment is more common in the US than the UK

What is a strength

Evidence supporting the role of both vulnerability and triggers. Pekka Tienari et al. (2004) studied the effects of genetic vulnerability and dysfunctional parenting in 19,000 Finnish adoptees. The high-risk group, with biological mothers diagnosed with schizophrenia, was compared to a low-risk control group without a family history of the disorder. Adoptive parents were assessed, and high criticism, hostility, and low empathy were strongly linked to schizophrenia—but only in the high-risk group. This shows that genetic vulnerability combined with family stress greatly increases the risk of schizophrenia

What is a limitation of the og diathesis-stress model

It’s oversimplicity. The original diathesis-stress model, with a single "schizogene" and stress limited to schizophrenogenic parenting, is now seen as overly simplistic. Diathesis is influenced by multiple genes and psychological factors, while stress can be both biological and psychological. James Houston et al. (2008) found childhood sexual abuse to be a major factor in vulnerability to schizophrenia and cannabis use as a key trigger. This highlights the many biological and psychological factors involved in both diathesis and stress, supporting the modern understanding of the model

What is a strength

The combination of biological and psychological treatments. Acknowledging both biological and psychological factors in schizophrenia has led to combining drug treatment with psychological therapies, which studies show improves effectiveness. For example, Nicholas Tarrier et al. (2004) randomly assigned 315 participants to (1) medication + CBT, (2) medication + counseling, or (3) medication only. The combination groups had fewer symptoms than the medication-only group, though hospital readmission rates were similar

What is a counterpoint to the previous evaluation point

Matt Jarvis and Paul Okami (2019) highlight the treatment-causation fallacy, which is the mistake of assuming that a treatment's success proves the cause of a disorder. For example, saying alcohol reduces shyness doesn't mean shyness is caused by a lack of alcohol. Similarly, the success of combined therapies doesn’t automatically prove that interactionist explanations are correct