Schizophrenia: The Interactionist Approach​

Question 1

What is the The Interactionist Approach

Answer 1

The interactionist approach acknowledges that there are biological (genetic vulnerability and neurological abnormality), psychological (stress) and societal factors in the development of schizophrenia. ​

Question 2

Meehl’s (1962) - The original diathesis-stress model​

Answer 2

Diathesis is entirely genetic: the result of a single schizogene, which led to a biologically based schizotypic personality: extremely sensitive to stress. ​

According to Meehl, no amount of stress will lead to schizophrenia if the gene is not present. ​

However chronic stress through childhood and
adolescence (schizophrenogenic mother) in someone with the gene could lead to the development of the disorder: nature and nurture interact! ​

Question 3

What is a limitation of the original version of the diathesis stress model?

Answer 3

P: A limitation is that the original version of the diathesis- stress model is over-simplified. ​

E: Houston et al. (2008) found that childhood sexual trauma emerged as a vulnerability factor whilst cannabis use was a trigger – therefore the old idea of diathesis being solely biological is overly simplified.​

C: This is a problem for the old idea of diathesis-stress but not for the newer models.

Question 4

(Ripke et al. 2014)

Answer 4

There is no longer thought to be one single ‘schizogene’ – there are many genes which appear to increase vulnerability to the illness.

Question 5

What is an example of a biological stressor for SZ?

Answer 5

Much of the recent research into the factors triggering an episode of schizophrenia has concerned cannabis use. ​

Cannabis is a biological stressor because it increases the risk of schizophrenia by up to seven times according to dose. This is because cannabis interferes with the dopamine system.​

Question 6

What did Cannon et al. (2002) find?

Answer 6

Cannon et al. (2002) found a
positive correlation between
birth complications and a later
vulnerability to developing SZ,
with some indication of damage
to hormone and
neurotransmitter systems as
well as the immune system. ​

Biological vulnerabilities
interact with later stressors to
that may trigger the disorder.​

Question 7

Murray (1996)?

Answer 7

Murray (1996) reported that children who were born after flu epidemics where their mothers had contracted the disease whilst pregnant (especially in the second trimester) had an 88% increased chance of developing SZ than children born in the same time period whose mothers had not contracted flu.​

Exposure to the flu during the second trimester is suspected of causing defects in neural development, which leads to increased vulnerability to SZ due to brain damage which has a knock on effect on dopamine functioning.

Question 8

Adoption Studies: Tienrari et al (2004)​

Answer 8

20,000 women admitted to Finnish psychiatric hospitals between 1960 and 1979, identifying those that had been diagnosed at least once with schizophrenia.​

Checked to find those mothers who had one or more of their offspring adopted away. The resulting sample of 145 adopted-away offspring (the high-risk group) was then matched with a sample of 158 adoptees without this genetic risk (low risk group). ​

Both groups of adoptees were independently assessed after an interval of 12 yrs, with a follow up after 21 yrs. The interviewing psychiatrists were kept blind as to
whether the biological mother was schizophrenic or not. ​ Of the 303 adoptees, 14
developed schizophrenia over the course of the study. 11 of these were from the high-risk group and 3 from the low-risk group.
​

Question 9

Interactionist Treatment ​

Answer 9

Although effectiveness of treatments is dependent upon factors such as cost, relapse rates, degree of side effects and symptom reduction – researchers believe that a combination therapy should be employed simultaneously between antipsychotic drugs and psychological therapies such as CBT or family therapy. ​

Generally, antipsychotics are given first so that psychological treatments will then have a greater effect.​

Combination treatments are standard practise in Britain, however in the USA biological therapies without accompanying psychological treatment is more common.​

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Question 10

What is a strength of interactionist treatments?

Answer 10

P: There is support for the usefulness of adopting an interactionist approach when comparing treatment combinations. ​

E: Tarrier et al (2004) 315 patients were randomly allocated to a medication + CBT group, medication + supportive counselling or a control group. Patients in the combination
groups showed lower symptom levels. ​

C: Studies like this show that there is a clear practical advantage to using a combination of biological and psychological treatments for SZ

Question 11

What is a strength of the interactionist approach with regards to the strength of the biological approach?

Answer 11

P: Genes cannot determine outcomes
on their own. ​

E: They need a particular environment in which to express themselves. Therefore, genes that predispose someone to have increased vulnerability to SZ cannot cause the disorder on their own, instead they need particular stressors to be present to trigger the potential of the genes to bring about the disorder.​

C: This is in-line with the diathesis- stress model, therefore supporting it as an explanation for the onset of SZ.

Question 12

What is a strength of the interactionist approach with regards to holism?

Answer 12

P: A strength of the updated diathesis-stress model is that it provides a more holistic view of the onset of SZ.​

E: Stressors that may contribute to a risk of developing SZ include biological, environmental, psychological and social factors.​

C: However, it is not known precisely how these risks contribute to the diathesis-stress interaction for any one person because specific causes of SZ may differ between individuals which creates an incomplete understanding of the diathesis – stress model.