interactionist approach to schizophrenia

• interactionist approach -

  • approach that acknowledged there are biological, psychological and social factors in development
  • biological factors - genetic vulnerability, neurochemical and neurological abnormality
  • psychological factors - stress
  • social factors - poor quality interactions in the family
• diathesis-stress model -

  • both a vulnerability to schizophrenia and a stress-trigger are necessary in order to develop the disorder
  • one or more underlying factors make a person particularly vulnerable but onset of condition is triggered by stress
• diathesis stress model: Meehl's model -

  • diathesis (vulnerability) was entirely genetic - result of a single 'schizogene'
  • led to idea of a biologically based schizotypic personality - one characteristic of which is sensitivity to stress
  • meehl - if a person doesn't have the schizogene no amount of stress would lead to schizophrenia
  • in carriers of the gene, chronic stress through childhood and adolescence in particular the presence of a schizophrenogenic mother could result in development
• diathesis stress model: moden understanding of diathesis -

  • now clear that many genes each appear to increase genetic vulnerability only slightly (no single schizogene)
  • modern views also include a range of factors beyond the genetic including psychological trauma - trauma becomes the diathesis rather than the stressor
  • read et al (2001) proposed neurodevelopmental model in which early trauma alters the developing brain - eg hypothalamic-pituitary adrenal (HPA) system can become overactive making a person much more vulnerable to later stress
• diathesis stress model: modern understanding of stress -

  • modern definition of stress (in relation to diathesis stress model) includes anything that risks triggers schizophrenia
  • research into factors triggering an episode has concerned cannabis use - cannabis is a stressor because it increases risk by up to seven times according to dose - may be because cannabis interferes with the dopamine system
  • most people don't develop schizophrenia after smoking presumably because they lack the requisite vulnerability factors
• treatment according to the interactionist model -

  • model is associated with combing antipsychotic medication and psychological therapies - most commonly CBT