The Interactionist Approach to Schizophrenia
“Interaction” refers to the interaction of the diathesis (an underlying vulnerability) and some
form of stress (trigger) in causing schizophrenia.
An interactionist approach takes a broader approach to explaining the cause of schizophrenia
than either the biological or psychological approaches as it recognises that a range of causal
factors are involved rather than just a biological approach or just a psychological one.
Traditionally, “diathesis” referred to biological / genetic factors and “stress” referred to
psychological/environmental factors. The diathesis-stress explanation began with Meehl’s work
in the 1960s, which argued for the existence of an as yet unidentified “schizogene” as the
diathesis and saw the presence of a schizophrenogenic mother (Fromm-Reichman) as the
stressor.
The “diathesis” in the present-day interactionist approach to schizophrenia does still include
genetic predisposition, though rather than the single “schizogene”, this would now refer to one of
the 108 gene combinations that Ripke identified that make us more vulnerable/susceptible to
developing schizophrenia, (e.g. by coding for hyperdopaminergia).
However, the modern interactionist approach to the diathesis is broader, recognising a range of
possible underlying vulnerabilities. For example, Read et al claimed that the underlying
vulnerability can be caused by sustained childhood trauma having an effect on the developing
brain.
Similarly, “stress” in the present-day interactionist approach to schizophrenia does still include
negative psychological experiences though this would now be family dysfunction or faulty
cognitions and dysfunctional information processing rather than the schizophrenogenic mother.
Again, however, the modern interactionist approach to stress is broader, recognising a range of
possible triggers. Stressors that are now believed to trigger the onset of a psychotic episode
include growing up in an urban environment (Vassos et al) and cannabis misuse (Houston et
al).
Historical development of the interactionist approach to schizophrenia:
Diathesis Stress
1) Meehl - “schizogene” (genetic Fromm Reichman – schizophrenogenic mother
predisposition)
Psychological explanations – family
2) Ripke – 108 gene combinations (genetic dysfunction (e.g. high EE) + cognitive
predisposition) explanations
3) Read – neurodevelopmental model – Vassos – living in urban areas
physical abuse in childhood)
, Houston – cannabis misuse
Diathesis-stress is still based on an additive (diathesis + stress) approach, i.e. stressors added to
an underlying vulnerability make the disorder more likely.
The assumption of the interactionist/diathesis-stress approach is that schizophrenia is caused by
an individual having both an underlying vulnerability (such as a genetic predisposition to develop
schizophrenia) and by experiencing one or more stressors (like family dysfunction).
The implication is that both elements are required for schizophrenia to develop and that an
individual with the underlying vulnerability but without the stressor, or conversely with a stressor
but without the underlying vulnerability, is less likely to develop the disorder.
Extended questions:
Extended questions on the other sections of schizophrenia will either cover explanations or
treatments. However, extended questions on the interactionist approach are likely to include
both explanations and treatments. (likely in the exam)
Implications for treatment
Given that the interactionist approach assumes that there are multiple causal factors in
schizophrenia, the logical approach to treatment is to use combination therapy. This is typically
made up of antipsychotics to treat the biological causes and a psychological treatment like
CBTp or family therapy to treat the psychological causes. (mention this briefly in 8 or 16 marker)
A03
Point Evidence Conclusion
A weakness of Meehl’s We now know that there is The fact that both aspects
original diathesis-stress no single “schizogene” of Meehl’s original
model is that it and Ripke’s study found diathesis-stress model are
oversimplifies the causes that there are no fewer than obsolete and oversimplify
of schizophrenia. 108 gene combinations the cause of schizophrenia
that increase vulnerability completely undermines its
to schizophrenia. Similarly, usefulness as an
there are clearly many explanation.
possible stressors that
can trigger a psychotic
episode rather than the
“Interaction” refers to the interaction of the diathesis (an underlying vulnerability) and some
form of stress (trigger) in causing schizophrenia.
An interactionist approach takes a broader approach to explaining the cause of schizophrenia
than either the biological or psychological approaches as it recognises that a range of causal
factors are involved rather than just a biological approach or just a psychological one.
Traditionally, “diathesis” referred to biological / genetic factors and “stress” referred to
psychological/environmental factors. The diathesis-stress explanation began with Meehl’s work
in the 1960s, which argued for the existence of an as yet unidentified “schizogene” as the
diathesis and saw the presence of a schizophrenogenic mother (Fromm-Reichman) as the
stressor.
The “diathesis” in the present-day interactionist approach to schizophrenia does still include
genetic predisposition, though rather than the single “schizogene”, this would now refer to one of
the 108 gene combinations that Ripke identified that make us more vulnerable/susceptible to
developing schizophrenia, (e.g. by coding for hyperdopaminergia).
However, the modern interactionist approach to the diathesis is broader, recognising a range of
possible underlying vulnerabilities. For example, Read et al claimed that the underlying
vulnerability can be caused by sustained childhood trauma having an effect on the developing
brain.
Similarly, “stress” in the present-day interactionist approach to schizophrenia does still include
negative psychological experiences though this would now be family dysfunction or faulty
cognitions and dysfunctional information processing rather than the schizophrenogenic mother.
Again, however, the modern interactionist approach to stress is broader, recognising a range of
possible triggers. Stressors that are now believed to trigger the onset of a psychotic episode
include growing up in an urban environment (Vassos et al) and cannabis misuse (Houston et
al).
Historical development of the interactionist approach to schizophrenia:
Diathesis Stress
1) Meehl - “schizogene” (genetic Fromm Reichman – schizophrenogenic mother
predisposition)
Psychological explanations – family
2) Ripke – 108 gene combinations (genetic dysfunction (e.g. high EE) + cognitive
predisposition) explanations
3) Read – neurodevelopmental model – Vassos – living in urban areas
physical abuse in childhood)
, Houston – cannabis misuse
Diathesis-stress is still based on an additive (diathesis + stress) approach, i.e. stressors added to
an underlying vulnerability make the disorder more likely.
The assumption of the interactionist/diathesis-stress approach is that schizophrenia is caused by
an individual having both an underlying vulnerability (such as a genetic predisposition to develop
schizophrenia) and by experiencing one or more stressors (like family dysfunction).
The implication is that both elements are required for schizophrenia to develop and that an
individual with the underlying vulnerability but without the stressor, or conversely with a stressor
but without the underlying vulnerability, is less likely to develop the disorder.
Extended questions:
Extended questions on the other sections of schizophrenia will either cover explanations or
treatments. However, extended questions on the interactionist approach are likely to include
both explanations and treatments. (likely in the exam)
Implications for treatment
Given that the interactionist approach assumes that there are multiple causal factors in
schizophrenia, the logical approach to treatment is to use combination therapy. This is typically
made up of antipsychotics to treat the biological causes and a psychological treatment like
CBTp or family therapy to treat the psychological causes. (mention this briefly in 8 or 16 marker)
A03
Point Evidence Conclusion
A weakness of Meehl’s We now know that there is The fact that both aspects
original diathesis-stress no single “schizogene” of Meehl’s original
model is that it and Ripke’s study found diathesis-stress model are
oversimplifies the causes that there are no fewer than obsolete and oversimplify
of schizophrenia. 108 gene combinations the cause of schizophrenia
that increase vulnerability completely undermines its
to schizophrenia. Similarly, usefulness as an
there are clearly many explanation.
possible stressors that
can trigger a psychotic
episode rather than the
