The interactionist approach to schizophrenia Flashcards
What is the interactionist approach to schizophrenia?
The interactionist approach acknowledges that there are biological, physiological and societal factors involved in the development of schizophrenia.
What does diathesis mean?
Vulnerability.
Explain the diathesis-stress model.
The diathesis-stress model says that both a vulnerability to schizophrenia and a stress-trigger are necessary in order to develop the condition. One or more underlying factors make a person particularly vulnerable to developing the condition but the onset of schizophrenia is triggered by a stress.
Explain Meehl’s orginal diathesis-stress model.
Meehl proposed that schizophrenia was the result of one single schizogene and if a person did not carry this gene then no amount of stress could lead to schizophrenia. However, in carriers of the gene, chronic stress throughout childhood and adolescence could result in the development of schizophrenia.
What is the difference between Meehl’s understanding and the modern understanding of diathesis?
It is now clear that many genes increase genetic vulnerability and there is no single ‘schizogene’. Modern views of diathesis also include a range of factors beyond genetic, including physiological trauma.
What is the difference between Meehl’s understanding and the modern understanding of stress?
In the original diathesis-stress model, stress was seen as physiological in nature and in particular related to parenting. Although physiological stress is still considered important, modern research has considered cannabis use. Cannabis interferes with the dopamine system and can increase the risk of schizophrenia by up to seven times according to dose.
What do interactionists believe the treatment for schizophrenia should be?
The interactionist approach is compatible with both biological and psychological treatments. In particular, the approach advocates the use of antipsychotic medication alongside psychological therapy e.g CBT.
Strength of the interactionist approach to schizophrenia.
Research evidence to support the dual role of vulnerability and stress regarding schizophrenia.
Tienari et al. investigated the combination of genetic vulnerability and parenting style (the trigger). Children adopted from 19,000 Finnish mothers with schizophrenia between 1960 and 1979 were followed up. Their adoptive parents were assessed for child-rearing style and the rates of schizophrenia were compared to a control group of adoptees without any genetic risk. A child rearing style characterised by high levels of criticism and conflict and low levels of empathy was implicated in the development of schizophrenia but only for the children with high genetic risk. This did not occur in the control group.
This suggests that both genetic vulnerability and family-related stress are important in the development of schizophrenia-genetically vulnerable children are more sensitive to parenting behaviour.
Strength of the interactionist approach to schizophrenia.(comparing effectiveness of bio and psychological treatments)
There is support for the usefulness of adopting an interactionist approach from studies comparing the effectiveness of combinations of biological and psychological treatments. Studies show an advantage to using combinations of treatments for schizophrenia. Tarrier: 315 people with schizophrenia were randomly allocated to either a medication and CBT group, medication and supportive counselling group or a control group. People in the two combination groups showed lower symptom levels than those in the control group (medication only). Studies like this show that there is a clear practical advantage to adopting an interactionist approach.
Limitation of the interactionist approach to schizophrenia
The classic model of a single schizogene and schizophrenic parenting style as the major source of stress is now known to be over-simple. Multiple genes increase vulnerability to the condition. Also stress can come in many forms including dysfunctional parenting. Therefore vulnerability and stress do not just have one single source. In fact it is now believed that vulnerability can be the result of early trauma as well as genetic make-up. In one recent study by James Houston childhood sexual trauma emerged as a vulnerability factor and cannabis use was a trigger. This is a problem for old diathesis-stress models.
