interactionist approach to schizophrenia

• The interactionist approach - schizophrenia

  • acknowledges that here are biological psychological and social factors in development of schizophrenia
  • biological = genetic vulnerability and neurochemical and neurological abnormality
  • psychological = stress
  • social factors = poor quality interactions in family
• Interactionist approach

  A way to explain the development of behaviour in terms of a range of factors, including both biological and psychological ones. Most importantly such factors don't simply add together but combine in a way that can't be predicted by each one separately i.e. they interact.
• Diathesis-stress model

  An interactionist approach to explaining behaviour. For example schizophrenia is explained as the result of both an underlying vulnerability (diathesis) and a trigger (stressor), both of which are necessary for the onset of schizophrenia.
• Early versions of the diathesis-stress model

  • Vulnerability was genetic and triggers were psychological
• Modern diathesis-stress model

  • Both genes and trauma are seen as diatheses, and stress can be psychological or biological in nature
• the diathesis-stress model - schizophrenia

  • Meehls model -
  • diathesis entirely genetic 'schizogene'
  • schizotypic personality
  • chronic stress in childhood could result in development of disorder
  • if there is no schizogene then no amount of stress would lead to schizophrenia
• the diathesis-stress model - schizophrenia

  modern understanding of diathesis

  • many genes each appear to increase genetic vulnerability
  • psychological trauma can become diathesis
  • Read - neurodevelopmental model in which early trauma alters the developing brain
  • hypothalamic-pituitary-adrenal system - overactive and more vulnerable to stress
• the diathesis-stress model - schizophrenia

  modern understanding of stress

  • psychological stress - parenting
  • cannabis use - increases risk up to 7x - interferes with dopamine
• schizophrenia treatment - interactionist

  • combining antipsychotic medication and psychological therapies - CBT
  • UK - increasingly standard practice to treat people diagnoses with schizophrenia with a combination of antipsychotic drugs and CBT
  • less likely in the US
• AO3 - interactionist (S) - strength

  P: evidence supporting the role of both vulnerability and triggers

  E: Tineri - large-scale study investigated the impact of both genetic vulnerability and a psychological trigger - 19,000 adopted finish children whose bio mothers were diagnosed with schizophrenia

  • compared to control group
  • adoptive parents assessed for child-rearing style - high levels of criticism , hostility and low empathy - developed schizophrenia in high genetic risk group

  L: combo of genetic vulnerability and family stress leads to increased risk of schizophrenia
• AO3 - interactionist (S) - limitation

  P: oversimplicity of the original diathesis-stress model

  E: multiple genes in multiple combinations influence diathesis and stress comes in many forms

  Stress can also be biological and diathesis can also be psychological

  Houston - study on childhood sexual abuse

  L: means there are multiple factors affecting both diathesis and stress
• AO3 - interactionist (S) - strength

  P: real-world application of treatment

  E: studies show that combining treatment enhances their effectiveness

  Tarrier - randomly allocated 315 ppts to 3 groups

  medication and CBT

  Medication and counselling

  medication only

  • The two combination groups showed lower symptoms than the medication group

  L: clear practical advantage to adopting interactions approach to schizophrenia