The Use Of An Interactionist Approach In Explaining And Treating Schizophrenia

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Discuss the use of an interactionist approach in explaining and treating schizophrenia.

The interactionist approach considers the interaction between the different factors including, biological, psychological, and social, on the development of schizophrenia. The most renowned interactionist approach is the diathesis-stress model which was proposed by Meehl, who suggested that schizophrenia was caused by both a diathesis, an entirely genetic vulnerability, and a stress, an environmental stressor. He stated that if a person did not have a schizogene, a schizophrenia causing gene, they would not be able to develop schizophrenia, no matter how much stress they are exposed to from the environment. However, if one does posses a schizogene a high level of stress throughout their childhood, for example a schizophrenogenic mother, and their adulthood would trigger the gene and therefore result in the person developing schizophrenia

Meehl’s original model has been criticised for being too simplistic however, resulting in a revision of it. Since the model’s original conception, it was discovered that schizophrenia is polygenic, caused by many genes, meaning there is not a single schizogene. It is now also understood that a range of factors can cause someone to have a predisposition, diathesis, and these may include physical and psychological traumas that have effected their developing brain, for example a concussion or being emotionally abused as a child. Along with these additions, the range of stressors that can trigger schizophrenia has been widened, with previously omitted stimuli, like cannabis, now being listed, as it has been found that regular use increases the risk of developing schizophrenia by up to 700%. Evidence to support these changes come from Brzustowicz et al., who found early trauma, a term they defined as a threat to emotional, physical or sexual integrity at or younger than 19 years old, was significantly correlated with diagnoses of schizophrenia in families who showed genetic predisposition to schizophrenia.

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Research conducted by Tienari et al. further supports the interactionist approach to explaining schizophrenia. They investigated the combination of genetic vulnerabilities and parenting style in a group of children adopted from Finnish mothers who had schizophrenia. Tienari took the children who had a genetic predisposition and a control group, children who did not have predispositions, and assessed their adoptive parents parenting styles. Tienari then compared the rates of schizophrenia of the children with genetic dispositions to the control. They found that a parenting style which was highly critical, had low empathy, and high levels of criticism appeared to be associated with the development of schizophrenia, but only among those who had a ‘high genetic risk’. This research supports the interactionist explanation of schizophrenia, reinforcing the idea that both genetic vulnerabilities and stress are important in the development of schizophrenia.

The interactionist approach has sparked the creation of new treatment to schizophrenia. This treatment involves combining antipsychotic medication with psychological therapies, with Cognitive Behavioural Therapy (CBT) being the most commonly used therapy. In this therapy, the antipsychotics will reduce dopamine levels, while the CBT will help the patient identify their negative thoughts and change them. The antipsychotics will subside the positive symptoms to help the patient engage in therapy. Research which supports this therapies efficacy comes from Tarrier et al. They randomly allocated patients to either a medication plus CBT group, a medication plus supportive counselling group, or a control group, who only took medication. They found that patients who had combination therapies, CBT and medication, and, medication and supportive counselling groups, showed lower levels of symptoms that those in the control, although there was no difference in hospital readmissions. It was suggested that this was due to patients not taking their medication due to the side effects, as antipsychotics have many side effects.

This evidence suggests that taking an interactionists approach when treating those with schizophrenia is beneficial and reduces the suffering of the patients. Despite this, the fact that combining treatments reduces symptoms, does not necessary mean that this approach is completely correct. Turkington et al argue that there is a logical fit between the interactionist approach and the combination of treatments. However, the fact that combinations of treatments are more effective than one treatment on its own, does not necessarily mean that the interactionist approach is correct. They called this error of logic the treatment-causation fallacy.

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