Interactionist approach

Question 1

Biosocial approach

Answer 1

• this approach acknowledges that there are psychological, biological and societal factors which may contribute to the development of schizophrenia
• biological factors: neurochemical and neurological abnormality, and genetic vulnerability
  psychological factors: stress as a result of life events

Question 2

diathesis-stress model

Answer 2

• diathesis is a vulnerability and stress is a negative psychological experience in this context
• the diathesis-stress model suggests that both a vulnerability to schizophrenia and a stress trigger are necessary to develop it
• Meehl (1962) proposed the original diathesis-stress model which suggested that the vulnerability was entirely genetic, caused by a schizogene
• Meehl argues that if a person doesn’t have the schizogeny then no amount of stress will lead to schizophrenia
• since this our understanding of the model has developed and its now clear that many genes increase genetic vulnerability, not just one schizogene
• Ripke et al. (2014) says that there are 108 genes which link to schizophrenia

Question 3

Non-biological vulnerabilities

Answer 3

• a range of factors are seen to act as a vulnerability, such as psychological trauma
• Real et al. (2001) proposed a neurodevelopment model, suggesting that early traumas could alter the developing brain
• early and serious enough trauma such as child abuse may affect multiple aspects of brain development

Question 4

Non-psychological stressors

Answer 4

• Meehl saw stress as only psychological in his model, but modern versions see stress as anything that risks triggering schizophrenia
• many recent studies have focused on drug use as a stressor, such as cannabis
• this is seen as a stressor since it increases the risk of developing schizophrenia by up to seven times
• the drug interfere with the dopamine system which is assumed to be why is has a stressor effect
• however, most people dont realise this negative effect

Question 5

Interactionist approach - treatment

Answer 5

• since the interactionist approach acknowledges both biological and psychological factors affecting schizophrenia, so does treatment
• typically a combination of antipsychotic drugs and psychological therapies e.g. CBT is used in line with the interactionist approach
• an interactionist model is needed in order to use CBT and believe that biological factors may cause schizophrenia, since it is not possible to adopt a strictly biological approach, tell patients that their condition is purely biological but then use CBT
• within the UK typically a combination of CBT and antipsychotics is used to treat people with schizophrenia

Question 6

(-) EVAL - evidence for the role of vulnerability and triggers

Answer 6

• there is evidence to support the dual role of vulnerability and stress for the development of schizophrenia
• Tienari et al. (2004P looked at a combination of genetic vulnerability and parenting style in his study
• he looked at 19,000 adopted children with schizophrenic biological parents in the 60s and 70s
• the rearing style fo the adoptive parents was assessed and the rates of schizophrenia were compared to a control group
• child rearing that involved high levels of criticism and conflict and low levels of empathy was found to be linked to the development of schizophrenia, but only In children with a high genetic risk and not the control group
• this suggests that genetic vulnerability tied with family-related stress is important in the onset of schizophrenia
• support is strong and direct

Question 7

(-) EVAL - over-simple nature of the original diathesis-stress model

Answer 7

• the original model is based on the principle that a single schizogene is the vulnerability and schizophrenic parenting styles are the major source of stress
• however, this is now seen as very over-simplistic
• many genes increase vulnerability to schizophrenia as opposed to just one gene
• stress can come in many forms as well
• vulnerability is believed to be caused by early trauma as well as genetic make-up
• Houston et al. (2008) found that childhood sexual trauma was a vulnerability factor and cannabis was a trigger

Question 8

(+) EVAL - support for the effectiveness of combinations of treatments

Answer 8

• studies comparing the effectiveness of biological-psychological treatment with just one or the other have highlighted the usefulness of taking an interactionist approach to treating schizophrenia
• Turkington et al. (2006) makes the point that without an interactionist approach it isn’t possible to use combinations of treatments
• Tarrier et al. (2004) took 315 patients and randomly allocated them to a biological and psychological treatment group, biological and societal treatment group or a control group
• patients within combination groups showed lower symptom levels that those in the control groups who only received biological treatment
• however, as for hospital re-admission rates, there was no difference between the groups
• the study and others like it show the clear practical advantage of adopting an interactionist approach to treat schizophrenics