interactionist approach

• The interactionist approach is based on the assumption that biological, psychological and societal are all factors within the development of schizophrenia. Examples of biological factors may be genetic vulnerability and neurological abnormality and psychological factors include vulnerability towards coping with stress.
• The diathesis-stress model expresses that both a genetic vulnerability to schizophrenia and a stress-trigger are necessary in order to develop the condition. There are various individual differences that hinder how well somebody can cope with stress; it can be assumed that high vulnerable individuals may only have to experience a relatively minor stressor to lead to the onset of schizophrenia, whereas, those individuals with a low diathesis may require an extreme life event to trigger symptoms
• This is supported by Braden (1984) who found that stressors may trigger a schizophrenic episode which will in turn lead to the overproduction of dopamine, resulting in positive symptoms.

  To support this assumption, Meehl (1962) created the original diathesis-stress model which holds the view that schizophrenia is entirely genetic and it is a result of a single ‘schizogene’ which ultimately leads to the development of the ‘schizotypic personality’ (which is highly sensitive to stress).
• According to Meehl if the person does not have the schizogene then no amount of stress can cause them to developing schizophrenia. However, in carriers of the gene the presence of a ‘shizophrenogenic mother’ could result in the development of the condition.
• Therefore this suggests that both genetic vulnerability and family-related stress are important in the development of schizophrenia; concluding that genetically vulnerable children are more sensitive to parenting behaviour. Thus, support for the importance of adopting an interactionist approach to schizophrenia is convincing.
• One limitation of the original diathesis-stress model is that it is overly reductionist. It assumes that vulnerability to schizophrenia arises from a single ‘schizogene’ and that stress stems primarily from dysfunctional parenting, particularly the schizophrenogenic mother. This is an outdated and oversimplified view, as more recent research highlights that both genetic vulnerability and environmental stress are far more complex.
• For example, genetic risk is now understood to involve multiple genes rather than a single gene, and stress can include a range of factors such as childhood trauma, urban living, or cannabis use. The original model therefore lacks cultural and individual validity, as it cannot adequately account for the wide variability in how schizophrenia develops across different people and societies. As a result, its usefulness in explaining and treating schizophrenia is limited, reducing the overall validity of the approach.
• These limitations have caused a shift towards a more modern understanding of the diathesis-stress model in which it is now clear that many genes are responsible for genetic vulnerability rather than just one single ‘schizogene.’
• In addition, Read et al (2001) proposed the ‘neurodevelopmental model’ in which early trauma alters the developing brain. If this trauma occurs it can result in the hypothalamic-pituitary-adrenal system becoming over-active making an individual much more vulnerable to later stress, therefore suggesting that the cause of schizophrenia cannot be wholly genetic. In addition, more emphasis is now a more modern understanding of stress, for example excessive cannabis use is a stressor as it can increase the risk of schizophrenia by up to 7 times as it interferes with the dopamine system.
• As it can now be assumed that biological and psychological factors both play a role in the development of schizophrenia, research indicates that an interactionist approach towards the treatment of schizophrenia reaps the best results; a combined treatment of antipsychotic drug therapy being used with psychological therapy such as CBT is generally most effective.
• Tarrier’s et al (2004) study supports the effectiveness of combined treatments as those patients who were randomly placed in groups with a combination of medication and CBT or medication and supportive counselling showed lower symptom levels than the controlled group who were only receiving drug treatment. This furthermore shows a clear practical advantage to adopting an interactionist and holistic approach.
• Despite the effectiveness and success of combined treatments and Turkington et al arguing that it is logical to adopt the interactionist approach and the use of combined treatments, it can be argued that there is a treatment-causation fallacy. Even though strong evidence suggest biological and psychological treatments are more effective when combined than by themselves, this does not necessarily mean the interactionist approach is correct.

   
• A comparison can be drawn with the fact that even through drug therapy is effective, that does not mean schizophrenia is biological in origin. The interactionist approach is further limited by the fact that the mechanisms by which schizophrenic symptoms appear and how both vulnerability and stress produce these symptoms is not fully understood.
• One strength of the interactionist approach is that it is supported by research evidence showing the interplay between biological vulnerability and environmental stress in the development of schizophrenia. For example, Tienari et al. (2004) studied adopted children with a genetic risk of schizophrenia and found that they were more likely to develop the disorder if they were raised in a dysfunctional family environment, compared to those raised in supportive households.
• This supports the idea that neither genes nor environment alone are sufficient to cause schizophrenia, but rather the interaction between the two determines whether the disorder emerges. This increases the validity of the interactionist approach by demonstrating that it reflects the complex, multifactorial nature of schizophrenia more accurately than purely biological or psychological explanations.
• Another strength of the interactionist approach is that it has practical application in the treatment of schizophrenia. By acknowledging both biological and psychological factors, it supports the use of combination therapies, such as antipsychotic medication alongside cognitive behavioural therapy (CBT). Studies have shown that patients receiving integrated treatment tend to show better outcomes, such as fewer relapses and greater improvements in quality of life, compared to those receiving medication alone.
• This suggests that the interactionist approach leads to more holistic and effective treatment plans, which is essential for a disorder as complex and varied as schizophrenia. The ability to inform clinical practice adds real-world value to the approach and makes it more beneficial to patients.
• From an issues and debates perspective, the interactionist approach can be praised for being holistic, as it integrates both biological and psychological explanations of schizophrenia. This contrasts with reductionist approaches, such as the biological model, which may oversimplify the disorder by focusing solely on genes or neurotransmitters. By considering a range of influences, the interactionist approach can better reflect the complex reality of mental health conditions, which are rarely caused by a single factor
• . However, the approach can also be criticised for being difficult to test empirically, as it is hard to isolate and measure the interaction between genetic predispositions and life stressors. This makes it more difficult to falsify and potentially reduces its scientific credibility, despite its theoretical strength.
• Adopting this interactionist approach allows for a belief in biological causes of schizophrenia whilst relieving symptoms using psychological therapy and vice versa and it is increasingly becoming standard practice in Britain to treat patients with a combination of biological and psychological treatments / therapies.