The Interactionalist Approach

Question 1

What is an interactionist approach?

Answer 1

• A way to explain the development of behaviours in terms of a range of factors, including both biological and psychological ones. Most importantly such factors don’t simply add together but they combine in a way that can be predicted by each one separately.

Question 2

What is the interactionist approach in terms of schizophrenia?

Answer 2

• an approach which acknowledges that there are biological, psychological and social factors in the development of schizophrenia.
• biological factors included genetic vulnerability and neurochemical and neurological abnormality.
• psychological factors include stress, for example resulting from life events and daily hassles including social factors such as poor quality interactions in the family.

Question 3

What is the diathesis-stress model?

Answer 3

• an interactionist approach to explaining behaviour, for example, schizophrenia is explained as the result of both an underlying vulnerability (diathesis) and a trigger (stress).

Question 4

Who proposed the original diathesis-stress model for schizophrenia?

Answer 4

• Meehl

Question 5

In the original diathesis-stress model, what was the diathesis?

Answer 5

• the diathesis was entirely genetic, the result of a single ‘schizogene’

Question 6

According to Meehl, what happens if a person does not have the schzogene?

Answer 6

• no amount of stress would lead to schizophrenia

Question 7

What stressors did Meehl propose would result in the development of schizophrenia?

Answer 7

• in carries of the schizogene, chronic stress through childhood or adolescence, in particular the presence of a schizophrenogenic mother, could result in the development of the condition.

Question 8

How has our modern understanding of schizophrenia changed in terms of genes?

Answer 8

• it is now clear that many genes appear to increase genetic vulnerability only slightly (i.e. there is no schizogene)

Question 9

In our modern understanding of schizophrenia, what can diathesis now be?

Answer 9

• both genetics and psychological trauma

Question 10

Why can trauma become the diathesis in our modern understanding of schizophrenia?

Answer 10

• early and severe enough trauma, such as child abuse, can seriously affect many aspects of brain development.

Question 11

What is an example of how trauma may become a vulnerability for schizophrenia?

Answer 11

• the hypothalamic- pituitary- adrenal (HPA) system can become overactive, making a person much more vulnerable to stress

Question 12

In the original diathesis-stress model of schizophrenia, what was stress seen as?

Answer 12

• psychological in nature, in particular related to parenting

Question 13

What does the modern definition of stress include?

Answer 13

• anything that triggers the risk of schizophrenia, including cannabis use

Question 14

By how much does cannabis use increase the risk of schizophrenia?

Answer 14

• up to 7 times according to dose

Question 15

What does cannabis interfere with?

Answer 15

• the dopamine system

Question 16

What treatments is the interactionist approach compatible with and why?

Answer 16

• both biological and psychological treatments as it acknowledges both biological and psychological factors

Question 17

What type of therapy is the interactionist model most typically associated with?

Answer 17

• the combination of antipsychotic medication and psychological therapies (CBT)

Question 18

Evaluation- Support For Vulnerability And Triggers

Answer 18

• Strength = evidence supporting the role of both vulnerability and triggers
• Tienari et al: Large-Scale study. Investigated the impact of both genetic vulnerability and a psychological trigger (dysfunctional parenting). The study followed 19,000 Finnish children whose biological mothers had been diagnosed with schizophrenia. In adulthood, this high genetic risk group were compared to a control group of adoptees without a family history of schizophrenia. Adoptive parents had been assessed for child-rearing style and it was found that high levels of criticism, hostility and low levels of empathy were strongly associated with the development of schizophrenia but only in the high genetic risk group.

Question 19

Evaluation - Diathesis And Stress Are Complicated

Answer 19

• Limitation of original diathesis-stress model = over simplicity
• The original model portrayed diathesis as a single schizogene and portrayed stress as schizophrenogenic parenting is hopelessly simplistic.
• Multiple genes in multiple combinations influence diathesis.
• Stress also comes in many forms, including but not limited to dysfunctional parenting.
• Diathesis can be influenced by psychological factors and stress can be biological as well as psychological.
• Houston et al: study in which childhood sexual abuse emerged as the major influence on underlying vulnerability to schizophrenia and cannabis use as the major trigger.

Question 20

Evaluation - Real World Application

Answer 20

• Strength = combination of biological and psychological treatments
• Practical application of acknowledging both biological and psychological factors is the combination of drug treatment and psychological therapies.
• Studies show that combining treatments enhances their effectiveness.
• Tarrier et al: randomly allocated 315 participants to medication + CBT, medication + counselling or a control group.
• Participants in the two combination groups showed lower symptoms following the trial than the medication-only group, though there was no difference in hospital readmission.