Interactionist approach- diathesis-stress model

What does the interactionist approach acknowledge?

There are biological (e.g. genetic vulnerability, neurochemical and neurological abnormality), psychological (e.g. stress, for example from life events and daily life, including family dysfunction) and societal factors in the development of schizophrenia

E.g. the diathesis-stress model

diathesis-stress model

Diathesis (vulnerability) + stress (negative psychological experience)= schizophrenia

Diathesis stress model states that both a vulnerability to schizophrenia and a stress-trigger are necessary in order to develop the condition

Original diathesis-stress model

• Diathesis= entirely genetic- thought their was one single gene that caused schizophrenia. However now many genes appear to increase genetic vulnerability slightly (Ripke)

• Stress= seen as psychological in nature, in particular relating to family dysfunction of high expressed emotion where families exhibit hostility and criticism, which can trigger schizophrenia in someone who is already vulnerable

Updated diathesis stress model

Diathesis- considers many factors beside genetic, including psychological trauma.

• So trauma became the diathesis rather than stress

• Read et al- early and severe trauma (e.g. child abuse) can seriously affect aspects of brain development e.g. the HPA system (involved in biological stress response) can become overactive - making a person more vulnerable to stress later in life

Stress= modern definitions of stress include anything that is a risk of schizophrenia e.g. family dysfunction, substance abuse, psychological trauma

Interactionist approach in treating schizophrenia

Research indicates that combination treatments are generally more effective. This is reflective of the interactionist model of using both biological and psychological treatments

AO3- appropriateness

P- can be seen as a more appropriate and complete explanation of schizophrenia

E- Tienari et al- children adopted from schizophrenic mothers. 5.8% prevalence of schizophrenia in those raised in healthy families, 36.8% in dysfunctional families.

E- higher prevalence rates in dysfunctional families (role of environment), higher prevalence rates in both groups than general population (role of biology- genes)

L- suggests that individuals with a higher genetic vulnerability to schizophrenia are more affected by environmental stressors, supporting the importance of using an interactionist approach to explain schizophrenia

AO3- useful applications for treatment

P- highlighted the necessity of combination treatment

E-

• Tarrier et al- randomly allocated 315 patients to

  • Medication and CBT group

  • Medication and supportive counselling group

  • Just medication (control)

• Patients in combination groups showed lower symptom levels than those in the control group after 18 months, although no differences in rates of hospital readmission

E- using just biological treatments alone will lead to less successful treatment outcomes compared to combination treatment.

L- demonstrates the importance of adapting an interactionist approach in order to achieve superior long term treatment outcomes

AO3- original model too simplistic

P- original diathesis-stress Model too simple

E- focused on a single gene (schizogene) as diathesis and dysfunctional parenting as the major source of stress

E- however,

• multiple genes can increase vulnerability to schizophrenia rather than a single gene.

• Research also suggests that psychological trauma can make someone vulnerable to stress triggers

• stress can come in many forms e.g. parenting, family dysfunction, substance misuse etc.

L- number of vulnerabilities and stressors that could be involved in the onset of schizophrenia. Important to adopt an interactionist approach that considers the complexity of diathesis-stress