Interactionist approach (diathesis-stress model)

Question 1

What is the interactionist approach of schizophrenia?

Answer 1

There are biological, psychological and social factors in the development in schizophrenia

Biological: Genetic vulnerability and neurochemical ad neurological abnormalities in the brain

Psychological and social: Stress from life events and daily hassles (e.g. poor quality interactions in family)

Question 2

What is the diathesis stress model?

Answer 2

The idea that both a biological vulnerability (genes and brain altering) and stress triggers are needed to develop Schizophrenia

Question 3

What is the original model of diathesis-stress model?

Answer 3

• Diathesis is entirely genetic (result of a schizogene)
• If a person hasn’t got a schizogene then no amount of stress would lead to schizophrenia
• Gene interacting with stress through childhood results in schizophrenia
• Stress was only psychological (related to parenting)

Question 4

What is the modern understanding of diathesis?

Answer 4

• Many genes that increase genetic vulnerability
• No schizogene
• Includes factors beyond genetics (e.g. early psychological trauma)
• Trauma becomes diathesis and not stress
• Read study (2001) - Early trauma alters developing brain and makes it more sensitive to stress
• BEIP found that neglect and trauma affected brain architecture

Question 5

What research supports diathesis?

Answer 5

Read (2001) looked into how trauma alters the developing brain and makes it sensitive to stress
- They found the early neglect and trauma altered the brain architecture and didn’t develop as it should

Question 6

What is the modern understanding of stress?

Answer 6

• Includes anything that risks triggering Schizophrenia
• This includes biological factors likes viruses or cannabis use

(7x risk of getting Schizophrenia if mother has influenza during pregnancy)
(Those using cannabis are 2.5x more likely to develop the condition this rises to 6x if a heavy user)

Question 7

How does this model affect treatment?

Answer 7

Supports combination of treatments (drugs and therapy) because the model acknowledges biological and psychological factors.

Question 8

What are the strengths of the diathesis model?

Answer 8

Supported by evidence

• Prospective study of adopted children
• Some had mothers with schizophrenia
• Others did not
• Those in the first group were more likely to get the condition if the family they were brought up in was rated as disturbed (e.g. high conflict, little empathy and criticism.)
• Supports that a biological vulnerability and stress is needed

Used as a basis for treatment

• 315 patients randomly allocated to 3 different groups:
  
  • medication + CBT group
  • medication + supportive counselling
  • control group
• Patients in the two combination groups showed lower symptom levels than the control group.
• Therefore there is an advantage to adopting the approach to the treatment.

Question 9

What are the limitations of the diathesis model?

Answer 9

Original model says that the diathesis is a schizogene when it may be genes and early trauma leading to the brain architecture changing.

Says that stress comes from family but now includes biological causes like cannabis.