Interactionist Approach

• The Interactionist Approach acknowledges that there are biological, psychological and social factors in the development of schizophrenia
• The diathesis-stress model is one way to present an interactionist approach
• Diathesis = vulnerability

  Stress = negative experience

  Both vulnerability and a stress trigger are necessary in order to develop the disorder
• The original diathesis stress model was proposed by Meehl (62) and diathesis (vulnerability) was entirely genetic and 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
• Modern Model:

  • Many genes increase genetic vulnerability not. single gene (Ripke et al 2014)
  • Psychological trauma can become the vulnerability not the stressor
  • stress includes anything that risks triggering szp (e.g. cannabis use)
• Treatment according to the Interactionist model:

  • Combines both drug therapy and cognitive behaviour therapy
• In the UK, it is increasingly standard practice to treat people diagnosed with schizophrenia with a combination of antipsychotic drugs and CBT
• Treatment:

  • Starts with antipsychotic medication to control the symptoms
  • Followed by CBT - the patient is able to participate in CBT more successfully as drugs have already reduced some symptoms prior to CBT sessions
• Tarrier et al (2004) - found that patients (315) who were prescribed a combination of drug therapy and CBT showed reduced symptoms compared to patients only prescribed drugs
• Guo et al (2010) patients who follow interactionist regime whilst in early stages of SZP were less likely to relapse compared to drug therapy
• PEEL 1:

  Strength - Supporting research for treatment

  • Tarrier et al (04)
  • Guo et al (10)
• PEEL 2:

  Strength - Successful interactionist treatment benefit the economy

  • save money on MH services
  • get szp patients back to work
• PEEL 3:

  Limitation - Harmful side effects of drug therapy
• PEEL 4:

  Limitation - Lacks objectivity

  • some vagueness over exactly how biological, psychological and social factors interact
• PEEL 5:

  Strength - Support for DS Model

  • Tienari et al (2004) - Adoption Study
• Tienari et al (04) - Adoption Study:

  • 19,00 Finnish mothers an adoptees who suffered from SZ compared to neurotypical group of children adopted across same period (1960-79)
  • Adoptees that faced high levels of criticism and conflict and lower levels of empathy were more likely to suffer from szp (only true for children with high genetic risk and not control group).
• Tienari (04) - Conclusions:

  • provides direct support for the importance of adopting an interactionist approach to schizophrenia - poor parenting is a possible source of stress
  • Shows original DS Model is too simple