INTERACTIONIST APPROACH

• DIATHESIS STRESS MODEL 


  Vulnerability + trigger = schizophrenia (interaction)
• INTERACTIONIST APPROACH - explaining

  An approach that acknowledges that there are a combination of factors that lead to the onset of schizophrenia, e.g. biological, psychological and societal factors in the development of schizophrenia.

  • Biological factors include genetic vulnerability, neurochemical, neurological abnormalities.
  • Psychological factors include stress, life events, daily hassles, poor quality interactions in the family, substance abuse.
• DIATHESIS STRESS MODEL 


  Diathesis means vulnerability.  The original model suggested a single gene - ‘schizogene’.  Our modern understanding has changed and there are a range of factors, e.g. brain trauma in early development, leading to the hypothalamic-pituitary-adrenal (HPA) system becoming over-active, making the individual more vulnerable or predisposition to later stress.  
• DIATHESIS STRESS MODEL 


  Stress means a negative psychological experience.  Both a vulnerability to schizophrenia and a stress-trigger are necessary in order to develop the condition.  The original model suggested stress as psychological in nature, in particular related to parenting.   The modern viewpoint includes anything that risks triggering schizophrenia, e.g. cannabis use interfering with the dopamine system, urbanisation and adverse living conditions.
• INTERACTIONIST APPROACH - treatment

  The combination of biological and psychological treatments, e.g. antipsychotic medication (e.g. drugs) and psychological therapies (e.g. CBT, FT), also management (TE).

  It is modern day practice to use a combination approach, with drugs generally providing immediate and short term gains, with psychological therapies offering long term solutions.
• INTERACTIONIST APPROACH - treatment

  The combination of treatment is based on the patients individual circumstances and needs, e.g. family therapy will only suit schizophrenics who have problems with dysfunctional family relationships and who have a great deal of contact with their families.
• (+) INTERACTIONIST 


  dual role of genetic vulnerability and stress = TIENARI = adoption study and found adopted children from a biological family with sz were more likely to develop the illness than children adopted from a biological family with no history, supporting a genetic link. (-) adopted children with biological relatives with sz were less likely to develop the illness if they had been adopted in less stressful family environment with kind relationships. This supports the idea that sz will only develop if someone with a biological predisposition is exposed to a stressful environment
• (+) INTERACTIONIST


  stressful environments can trigger sz = FARIS AND DUNHAM = positive correlation between aspects of poverty and overcrowding living in cities and levels of psychotic symptoms = there is a relationship between stress and the development of sz. (-) we cannot infer cause and effect to suggest that the stressful environment causes sz to develop
• (+) INTERACTIONIST 


  useful application = it suggests both a biological and psychological treatment in combination would be most effective = ANDERSON found a relapse rate of 40% when sz patients had drugs only compared to only 5% when family therapy was used alongside drug treatments. = it enables us to offer the most effective treatment and the lowest risk of relapse compared with using a reductionist explanation that argues it's just down to biology
• (-) INTERACTIONIST - DSM

  overly simplistic = the original theory proposed environmental stressors acted as triggers, such as loss of job, to an underlying genetic dysfunction = HOUSTON has shown that biological stressors, such as cannabis use, can also interact with genes to trigger sz.