The Interactionsist Approach To Schizophrenia

Question 1

What is the interactionist approach?

Answer 1

• ‘biosocial approach’ acknowledges biological, psychological and environmental factors in the development of Sz

Question 2

What is the Diathesis-stress model?

Answer 2

• Diathesis means vulnerability, stress means a negative experience
• the model suggests both a vulnerability to Sz and a stress-trigger are necessary to develop Sz

Question 3

What is Meehl’s model?

Answer 3

• original stress diathesis model. Diathesis was entirely genetic - the result of a single ‘schizogene’ led to idea of biologically based schizotypic personality
• According to Meehl is a person does not have a schizogene no amount of stress would lead to Sz
• in carriers of the gene chronic stress in childhood e.g schizophrenogenic mother could result in developing Sz

Question 4

What is the modern understanding of diathesis?

Answer 4

• Many genes appear to increase genetic vulnerability (only slightly)
• include a range of factors beyond genetic, including psychological trauma (trauma becomes the diathesis, not the stressor)
• Read et al proposed a neurodevelopmental model in which early trauma alters brain e.g child abuse can affect brain development.
• hypothalamic-pituitary-adrenal system can become overactive making a person more vulnerable to later stress

Question 5

What is the modern understanding of stress?

Answer 5

• in original stress was seen as purely psychological, especially related to parenting. Modern understanding of stress includes anything that risks triggering Sz
• Cannabis use is a stressor because it increases risk of Sz but up to 7 times. Interferes with dopamine system, most people don’t develop it due to lack of vulnerability

Question 6

What is treatment according to the interactionist model?

Answer 6

• compatible with both biological and psychological treatments e.g combining antipsychotics and CBT
• Turkington et al pointed out u can believe in biological causes and still practice CBT to relieve psychological symptoms/ However, requires interactionist model, not possible to adopt a purely biological approach an tell people no psychological significance and simultaneously treat them with CBT
• Britain it is increasingly standards practice to treat people with Sz with combo of antipsychotic drugs and CBT
• US more of a conflict between the two leading to slower adoption of interactionist approach

Question 7

What support is there for vulnerability and triggers?

Answer 7

• Tienari followed 19,000 Finnish children who’s mams had been diagnosed w Sz, in adulthood high genetic risk group compared to control group of adoptees with low genetic risk
• Adoptive parents had been assessed and it was found those that were critical with hostility and low levels of empathy were associated with development of Sz but only in the high genetic risk group compared
• shows combo

Question 8

How does the fact that diathesis and stress are complex become a weakness for the original hypothesis?

Answer 8

• It is over simplistic
• Sz is polygenic and stress also comes in many forms
• diathesis can also be influenced by psychological factors and stress can be biological as well as psychological
• Houston et al in which child sexual abuse emerged as major influence on underlying vulnerability to Sz and cannabis as the major trigger

Question 9

What is the real world application of the interactionist approach?

Answer 9

• can be very effective in developing treatments as opposed to merely just medication or therapy combining the two treats both stress and diathesis, used frequently in the NHS in the UK