The Interactionist Approach

• The interactionist approach


  Acknowledges that there are biological, psychological and social factors in the development of SZ.
• The interactionist approach


  Explaining the interactionist approach: The diathesis-stress model

  Says that both a vulnerability to SZ and a stress-trigger are necessary in order to develop the condition.

  In the original diathesis stress model (Meehl 1962) diathesis (vulnerability) was entirely genetic, the result of a single 'schizogene'. According to Meehl, if a person does not have the schizogene then no amount of stress would lead to schizophrenia.
• The interactionist approach


  Explaining the interactionist approach: The diathesis-stress model 2

  The modern understanding of diathesis - it is now clear that many genes each appear to increase genetic vulnerability slightly (there is no single 'schizogene'). Modern views of diathesis also include a range of factors beyond the genetic, including psychological trauma - so trauma becomes the diathesis rather than the stressor.
• The interactionist approach


  Explaining the interactionist approach: The diathesis-stress model 3

  The modern understanding of stress - Although psychological stress, including that resulting from parenting may still be considered important, a modern definition of stress includes anything that risks triggering SZ. Much of the recent research into factors triggering an episode of SZ has concerned cannabis use. Cannabis is a stressor as it increases the risk of SZ by up to 7 times according to dose which is likely because cannabis interferes w/ the dopamine system.
• The interactionist approach


  Treatment according to the interactionist model

  The model is associated w/ combining antipsychotic medication and psychological therapies, most commonly CBT. Turkington et al. (2006) pointed out that it is possible to believe in biological causes of SZ and still practice CBT to relieve psychological symptoms. However, it is not possible to adopt a purely biological approach and to simultaneously treat them w/ CBT.
• The interactionist approach - evaluation

  Studies show an advantage to using combinations of treatments for SZ. Tarrier et al. (2004) 315 people w/ SZ were randomly allocated to a medication + CBT group, medication + supportive counselling group or a control group. People in the two combination groups showed lower symptom levels than those in the control group (medication only). Shows that there is a clear practical advantage to adopting an interactionist approach in the form of superior treatment outcomes.
• The interactionist approach - evaluation 2


  There is evidence to support the dual role of vulnerability and stress in the development of SZ. In a study by Tienari et al. (2004), the adoptive parents of children from 19,000 Finnish mothers were assessed for child-rearing style. A child-rearing style characterised by high levels of criticism and conflict and low levels of empathy was implicated in the development of SZ but only for the children w/ high genetic risk. This suggests that both genetic vulnerability and family-related stress are important in the development of SZ.
• The interactionist approach - evaluation 3


  When considering multiple approaches, how to address these areas becomes more complex and more expensive. Providing cognitive behavioural therapy, family therapy, antipsychotic medication, and social support is costly, time-consuming, and addresses many different areas. Treatment can become increasingly complex and convoluted as a result.