Interactionist approach

• What does this approach recognise?

  Recognises a variety of contributing factors in the development of schizophrenia 
• What’s one interactionist approach?

  Diathesis-stress model 

  Diathesis = vulnerability 

  Stress = negative experience 

  Both are needed in order to develop the condition 
• What’s Meehl’s model (1962) ?

  -vulnerability was seen as entirely genetic 

  -schizogene - schizotypic personality 

  -particularly sensitive to stress

  -chronic stress through childhood could result in schizophrenia 

  -no schizogene - no sensitivity to stress - no schizophrenia  
• What’s the modern understanding of diathesis?

  -schizophrenia is polygenetic (Ripke,2014)

  -vulnerability (diathesis) can also be caused by psychological trauma 

  -early trauma (e.g child abuse) could even alter the developing brain (read et al,2001)

  -e.g HPA could become overactive -  more vulnerable to stress 
• modern understanding of stress (2)

  -originally stress was seen as psychological in nature 

  -particularly in relation to parenting 

  -now considered anything that risks triggering schizophrenia 

  -cannabis use (Houston et al 2008) - 7x more at developing schizophrenia 
• What does the interactionist model acknowledge?

  The interactionist model acknowledges both environmental and biological factors in schizophrenia and is therefore

  compatible with both drugs and psychological treatments.
• What did Turkington et al suggest?

  Turkington et al (2006) suggest it is possible to believe in a biological cause for schizophrenia and practice CBT to relieve psychological symptoms – provided that you adopt an interactionist model
• What’s the difference between US and Britain in treatment for schizophrenia?

  Britain: Standard practice to combine treatments (i.e. drug therapy and CBT)

  US: medication with no psychological treatment is more common
• One strength of the interactionist approach is that it can be seen as a more appropriate and complete explanation of SZ.Tienari et al found that the level of SZ diagnosed in adopted children of schizophrenic mothers was 5.8% for those adopted into healthy family environments. this increased to 36.8% for those children raised in dysfunctional families.This suggests individuals with high genetic vulnerability to SZ are more affected by environmental stressors.Therefore,supports the importance of using an interactionist approach to explain to SZ
• One strength of the interactionist approach is that it’s highlighted the necessity for combination treatments.Tarrier et al randomly allocated 315 patients to a medication+ CBT group, medication + supportive counselling group or a control group (medication only).
• necessary for combined approach support (2)

  Patients in the 2 combination groups showed lower symptom levels than those in the control group after 18 months, although there was no difference in rates of hospital readmission.suggests using just biological treatments alone will lead to less successful treatment outcomes compared to a combination of treatments.Therefore,this matters as it demonstrates the importance of adopting an interactionalist approach in order to achieve good long-term treatment outcomes.
• One limitation of the original diathesis-stress model is it’s too over simplistic.Multiple genes increase vulnerability,each with a small effect on its own,there’s no schizogene.Stress comes in many forms,including dysfunctional parenting.Researchers now believe stress can also include biological factors.For example Houston et al (2008) found childhood sexual trauma was a diathesis and cannabis use a trigger.Therefore,this matters as it suggests there are multiple factors,biological and psychological,affecting both diathesis and stress.