SZ- Interactionist Approach

Question 1

What is the interactionist approach?

Answer 1

The interactionist approach is an approach that acknowledges that there are biological, psychological and social factors in the development of SZ.

Question 2

How does the interactionist approach explain SZ?

Answer 2

Interactionist approaches attempt to explain schizophrenia as a combination of nature (biological) and nurture (environmental) factors.

Question 3

What did Meehl originally propose?

Answer 3

• Meehl originally proposed that both a vulnerability to schizophrenia and a stress-trigger are necessary in order to develop the condition.
• Meehl suggested that the vulnerability is genetic (the result of a ‘schizogene’), causing a sensitive personality. - Chronic environmental stress, for example having a schizophrenogenic mother, results in the onset of schizophrenia.
• Those who do not have the ‘schizogene’ would not develop schizophrenia, even if they experienced a chronically stressful upbringing.
• Both aspect of diathesis-stress must be present to develop the disorder.

Question 4

What is the modern understanding of the diathesis stress model?

Answer 4

• It is now recognised that the vulnerability could be genetic or environmental. (Ingram and Luxton 2005)- trauma can be diathesis rather than a stressor . Read et al 2001 proposed a neurodevelopmental model in which early trauma alters brain development. HPA system becomes overactive making the person more vulnerable to stress
• The stress-trigger could be environmental or biological (for example, smoking cannabis is linked with schizophrenia as it interferes with dopamine system in body).
• In Meehl’s model there was only one specific gene causing schizophrenia, however now we know many genes increase genetic vulnerability rather than one single gene. (Ripke et al 2014) there is no single schizogene.

Question 5

How do we treat schizophrenia according to the diathesis stress model?

Answer 5

• In an interactionist approach, treatments will take more than one form.
• Antipsychotic medication will often be used alongside CBT, acknowledging the role that biological and psychological factors play in the disorder.
• Combining treatments is most common in the UK, although it is also sometimes used in the USA.
• Psychological therapies are very rarely used alone, but sometimes patients may just take drugs without any other therapy.

Question 6

Evaluate the interactionist approach (ADVANTAGES)

Answer 6

1) RESEARCH SUPPORT FOR DUAL ROLE OF VULNERABILITY AND STRESS
- Tienari et al (2004) found that children from adopted families who had mothers with schizophrenia were more likely to develop schizophrenia themselves, but only in those whose adopted families were assessed as having a child-rearing style which was critical and lacking in empathy.
- This supports the diathesis-stress model, as the genetic vulnerability only led to the disorder when combined with an environmental stressor (critical family).

2) USEFULNESS OF INTERACTIONIST APPROACH IN TREATMENT TO SZ
- Tarrier et al (2004) randomly allocated schizophrenic patients to 3 conditions including a control group.
- He found that patients who were treated with drug therapy and CBT showed lower symptom levels than those only taking drugs, supporting the interactionist approach in explaining schizophrenia.

Question 7

Evaluate the interactionist approach (DISADVANTAGES)

Answer 7

1) WE DON’T KNOW EXACTLY HOW DIATHESIS-STRESS WORKS
- There is a lack of understanding and explanation of how the diathesis-stress model works- it is known that both have to be present to lead to schizophrenia, but not how the mechanisms of schizophrenia symptoms develop.
- This weakens the interactionist explanation.

2) TREATMENT-CAUSATION FALLACY
- Turkington argues that the fact that combined biological and psychological therapies are effective than either on their own doesn’t mean the interactionist approach to schizophrenia is correct.
- Similarly the fact that drugs help doesn’t mean schizophrenia is biological in origin.
- This error of logic is called treatment-causation fallacy and means superior outcomes of combined therapies shouldn’t be overinterpreted.