Interactionist approach

• Interactionists state that a range of factors can contribute to schizophrenia, these are biological, social and psychological.

  
  

  Biological includes genetic vulnerability, neurochemical and neurlogical abnormality. Psychological includes stress such as life events and daily hassles.
• Diathesis stress model

  • sees schizophrenia as the result of an underlying vulnerability (diathesis) and a trigger (stress)
  • first proposed by Meehl (1962) who suggested that the diathesis was purely genetic and the result of a single "schizogene"
  • if a person does not have the gene, they cannot develop it
  • if they do have the gene, then chronic stress such as from a schizophrenogenic mother would trigger it and result in schizophrenia
• However, nowadays both genes and trauma experienced in earlier life are seen as diathesis (early and very severe trauma can influence the brain development)

  • earlier theorists thought that a single gene was the diathesis
  • however it is now clear that there are many genes involved
  • stress can be psychological or biological in nature ; anything that risks schizophrenia can be considered a trigger, e.g. cannabis increases the risk up to 7 times. Not everyone whoo does cannabis develops schizophrenia, and according to the model, they will lack the diathesis.
• A03 - supporting evidence

  • Bruzustowicz et al
  • in their study, early trauma at 19 years or less was assosciated with the expression of schizophrenia in families that had demonstrating genetic predisposition to schizophrenia.
  • trauma is defined as a threat to physical, emotional or sexual integrity
• A03 - supporting evidence

  • Tienari et al
  • investigated the combination of genetic vulnerability and a psychological trigger (dysfunctional parenting)
  • followed 19000 Finnish children whose biological mother had been diagnosed with schizophrenia
  • compared to a group of adoptees that had a family history without schizophrenia
  • adopted parents were assessed for child rearing style
  • they found that a child rearing style with high levels of criticism, hostility and low levels of empathy were strongly assosciated with developing schizophrenia, but only for the children with high genetic risk
• Treatment according to the interactionist approach-

  • acknowledges both biological and psychological treatments in schizophrenia
  • commonly combines antipsychotics with CBT but also involves family therapy depending on an individual case
  • antipsychotics are given to reduce dopamine and then CBT to recognise thoughts and challenge them
  • research indicates that combining therapies has the most effective outcome
• A03- Strength

  • the combination of both psychological and biological treatments has resulted in a more positive outcome than drugs or therapy alone
  • many studies show that treatment is more effective if both biological and psychological treatments are combined
  • TARRIER ET AL
  • showed that combined therapy groups had lower symptoms following a drug trial than a drug therapy group alone
  • thus there are benefits of using combined treatment for schizophrenia
  • BUT there was no difference in hospital readmission between the groups