Interactionist Approach

• why is it important to use an interactionist approach to explain schizophrenia?

  • involves taking into consideration both biological and psychological factors in the development of schizophrenia.
  • This approach acknowledges that a range of factors are involved in the illness and encompasses the diathesis stress model, where it is thought that schizophrenia is caused by a combination of biological and environmental factors.
  • Schizophrenia is seen to be triggered when environmental stress combines with a biological vulnerability
• explain the diathesis-stress model

  • many genes appear to increase vulnerability
  • diathesis now includes a range of factors such as psychological trauma in the form of child abuse.
  • It has been proposed that early psychological trauma alters an infant’s developing brain and causes vulnerability, as the hypothalamic-pituitary-adrenal (HPA) system becomes overactive, making the person more vulnerable to stress.
  • stress refers to anything that risks triggering schizophrenia
• evaluation of the interactionist approach to explaining schizophrenia (1)

  • research evidence to support the interactionist approach to explaining schizophrenia. Barlow and Durand (2009) found that a family history of schizophrenia pointed to a genetic link. When combined with a dysfunctional family the risk of developing schizophrenia increased. This supports the diathesis stress model as the increased risk was due to an interaction of genetics and stress from the family dynamic.
• evaluation of the interactionist approach to explaining schizophrenia (2)

  • The diathesis-stress model proposes that schizophrenia is caused by a combination of biology and environment. However, it is not known precisely how these risk factors i.e. how biological, environmental, psychological and social factors, contribute to the diathesis-stress interaction, as the causes may differ between individual schizophrenics. This approach is weakened as we do not fully understand the mechanisms by which the illness develops and how both vulnerability and stress produce it.
• evaluation of the interactionist approach to explaining schizophrenia (3)

  • Critics have argued that the original diathesis-stress model is over simplistic, e.g. the idea that a single gene combined with a certain parenting style causes the schizophrenia is too simplistic. Multiple genes have been found to increase the risk indicating that there is no single ‘schizogene’. Also, stress is not limited to just parenting style and family dynamics.
• why is it important to use an interactionist approach to treat schizophrenia?

  • research has found that combining both biological and psychological treatments is more effective
  • When adopting an interactionist approach to the treatment of schizophrenia, we are acknowledging the influence of diathesis and stress in causing the illness.
• evaluation of using an interactionist approach to treat schizophrenia (1)

  • There is research evidence that supports an interactionist approach to treating schizophrenia. Guo et al. (2010) found that patients who received a combination of antipsychotics and a psychological therapy whilst in the early stages of schizophrenia had improved insight and social functioning as well as being less likely to relapse when compared with patients taking antipsychotics alone. This illustrates the value of combining biological and psychological treatment
• evaluation of using an interactionist approach to treat schizophrenia (2)

  • Combining treatments does not always have a positive effect. It has been found that patients receiving CBT can sometimes interpret the side effects of their antipsychotic drugs in a delusional manner. This then led to them mistrusting and resisting any further treatment, indicating that combining treatments can cause further problems.
• evaluation of using an interactionist approach to treat schizophrenia (3)

  • Combining treatments can be cost-effective. Schizophrenia often has biological and psychological components and therefore treatment via a combination is desirable. The antipsychotics treat the biological elements, and the psychological treatments tackle the psychological elements. Although combining treatments increase the initial cost of treatment, as the effectiveness increases, the combination works out more cost effective in the long-run as both the biological and psychological elements are addressed.
• evaluation of using an interactionist approach to treat schizophrenia (4)

  • Critics argue the logic of the interactionist approach to treating schizophrenia. Turkington et al. (2006) argue that whilst research has found that combining biological and psychological treatments is more effective than them on their own, this does not necessarily support the interactionist approach. This is called the treatment-causation fallacy, as we cannot be certain whether it is the interaction of the treatments which is causing the increased efficiency.