Interactionist Approach

• acknowledges biological, psychological and social factors in the development of schizophrenia

  interactionist approach
• diathesis stress model


  • states that a vulnerability and stress trigger are needed to develop the condition.
  • maybe one or more factors of vulnerability but the onset is triggered by stress
• meehl's model (1962)


  original model argued the vulnerability was purely genetic and result of a schizogene. If the person doesn't have the gene then no amount of stress can trigger the illness
• modern understanding of diathesis stress model


  • clear that there may be a genetic vulnerability for developing schizophrenia but there isnt a single schizogene
  • modern views include other factors such as psychological trauma
  • trauma becomes the diathesis rather than stressor
• read (2011)


  • proposed a neurodevelopment model in which early trauma alters the development of the brain
  • this can be early child abuse
  • the hypothalamic-pituitary adrenal system can become over active making a person much more vulnerable to stress later on
• cannabis


  • triggering an episode of schizophrenia as it becomes the stressor
  • can increase risk by up to 7x as it interferes with the dopamine system
• not everyone who smokes cannabis develops schizophrenia so there must be more than one vulnerability factor
• support for the role of vulnerability and triggers

  tienari (2004)

  • investigated combination of genetic vulnerability and parenting style (children adopted from Finnish mothers w/ schizophrenia)
  • Adoptive parents addressed the child rearing style characterised by high levels of criticism and conflict increased risk of developing schizophrenia
  • BUT only children with a genetic vulnerability
• support for combining treatments

  • patients seem to fare much better when you combine treatments
  • you have to adopt an interactionist approach if you want to combine treatments
• original diathesis stress model is oversimplified(weakness)

  • there are multiple genes that leave someone vulnerable to developing schizophrenia
  • stress comes in different forms not just dysfunctional parenting
• we dont actually know how the diathesis stress model works(weakness)

  
  

  • we don't fully know how the mechanisms by which symptoms of schizophrenia appear ad how both vulnerability and stress produce them
• the treatment-causation fallacy (weakness)

  • combination of treatment makes a logical fit but it doesnt mean the interactionist approach is correct
  • doesnt mean theres a biological cause, could be environmental
• treating schizophrenia


  acknowledges both biological and psychological factors

  
  

  -uses antipsychotic drugs combined with CBT
• in britain


  its common to use both forms of treatment and have more freely adopted an interactionist approach
• in america


  more conflict between biological and psychological models

  • slower rate in adopting interactionist approach
  • drugs are used more without CBT
  • unusual to treat schizophrenia without medication; less success rate on their own (30%)
• support for combining treatments: tarrier (2004)


  215 patients allocated to conditions:

  1. medication + supportive counselling
  2. medication + CBT
  3. control group (medication on its own)

  1 & 2 showed lower levels of symptoms. shows advantage to adopting an interactionist approach