Interactionist Approach

What does the interactionist approach suggest about Sz?

This approach acknowledges that there are biological, psychological and social factors in the development of Sz

What does the diathesis-stress model suggest about Sz?

Schizophrenia results from an interaction between genetic vulnerability and environmental stress

What was the initial understanding of diathesis from Meehl (1962)?

Meehl suggested diathesis was completely genetic, the result of a single schizogene leading to a schizotype personality who was, by nature, more sensitive to stress

Sz only develops in those with the schizogene and no amount of stress could otherwise produce it

What is the modern understanding of diathesis?

A number of genes increase diathesis as opposed to one schizogene

Factors beyond genes could increase vulnerabilty e.g trauma. Read (2001) showed how severe early trauma can actually alter a developing brain and the HPA becomes overactive making a person more susceptible to stress later in life

What is the modern understanding of stress?

Parents are no longer considered to be the sole cause of stress but just one of many potential environmental triggers

A stressor in Sz is anything that increases the risk of triggering the illness, e.g cannabis is thought to be one of the biggest stressors as Sz risk increases by 7x

What problems are there by only treating Sz with drugs?

If there are environmental triggers that are likely to bring on an episode, then as soon as the patient stops taking drugs, those triggers will continue to cause symptoms

What problems are there by only treating Sz with CBT?

There is clear evidence to show the role of excess dopamine in Sz symptoms and it is hard to see how CBT could reduce those levels, so although a patient may understand the symptoms - they will still have them

Summarise the importance of interactionism in treating Sz

If there are a combination of reasons for why someone develops Sz then it will be necessary to have a combination of therapies to treat it - biological to treat the genetic component and psychological to treat the environment

How does Tienari's investigation support the diathesis-stress model?

- she studied 19,000 children who had been adopted, including those whose biological mothers had Sz

- she assessed the adoptive parents on parenting style e.g levels of criticism, conflict and compared the children with a control group with no genetic risk

- she found that children with a genetic vulnerability were much more likely to develop Sz, but only if they were raised in a dysfunctional family environment

- this provides support for the model and also reduces the blame on parents, as poor parenting alone doesn't cause Sz without genetic vulnerability

How does Tarrier provide support for interactionist treatments?

- Tarrier showed this in his study of 315 patients who were randomly allocated to either a medication and CBT condition, medication and supportive counselling condition or a control group of medication only

- he found those patients who engaged in a combination therapy had a greater reduction in severity of symptoms than those treated only with drugs

- this clearly shows the advantage of an interactionist approach to treatment rather than solely psychological or biological treatments

How can treatment-causation fallacy weaken both biological/psychological approaches and strengthen the interactionist approach?

- treatment-causation fallacy is the assumption that because the treatment works that the cause must be whatever the treatment treats

- for example, assuming that if drugs work that Sz is caused by excess dopamine

- this is dangerous as often therapies treat the symptoms not the cause meaning the real cause of Sz may just be suppressed by drug treatment or family therapy and as soon as therapy stops the symptoms return

- diathesis-stress avoids this as a combination of treatments allows both the symptoms and the causes to be addressed in tandem and therefore likely to have a greater impact