Biopsychosocial

Biopsychosocial Model

By:

Mimi Abesamis, Angela Alba

Loye Clamor, Milo Fagar

Kency Ferrer, Lya Gusi

Pia Mirasol, Bernadette Que

• attributes complex phenomena or events to multiple causes.

• A general model or approach that posits that biological, psychological (which entails thoughts, emotions, and behaviors), and social factors, all play a significant role in human functioning in the context of disease or illness.

• reductionistic perspective- contrast

BIOPSYCHOSOCIAL MODEL

BIOPSYCHOSOCIAL MODEL

• Health is best understood in terms of a combination of biological, psychological, and social factors rather than purely in biological terms. 

• In contrast to the traditional Biomedical Model of medicine

BIOPSYCHOSOCIAL MODEL

According to modern neuroscience:

• the brain and behavior are inextricably linked by the plasticity of the nervous system. The brain is the organ of mental function; psychological phenomena have their origin in that complex organ.

• Psychological and sociocultural phenomena are represented in the brain through memories and learning, which involve structural changes in the neurons and neuronal circuits. Y

BIOPSYCHOSOCIAL MODEL

Neuroscience does not intend to reduce all phenomena to neurotransmission or to reinterpret them in a new language of synapses, receptors, and circuits. Psychological and sociocultural events and phenomena continue to have meaning for mental health and mental illness.

Example• stressful life event: receiving the news of a diagnosis of

cancer

• A psychological event that causes immediate biological changes and later has psychological, biological, and social consequences.

• news of the cancer diagnosis—brain’s sensory cortex simultaneously registers the information– biological changes: heart to pound faster—fear of death–

escalate to anxiety or depression.

• This certainly has been established for breast cancer patients 

History

• Evidence for the application of the biopsychosocial model was found in ancient Asian (2600 B.C.) and Greek (500 B.C.) civilizations

• Model was theorized by psychiatrist George L. Engel.

George L. Engel

• Believed that to better understand and help patients, clinicians must attend simultaneously to the biological, psychological, and social dimensions of illness.

• Believed in the importance of biomedical model, but still criticized it for being too narrowed and focusing on patients as objects.

• Later on, Theodore Millon has extensively researched the Biopsychosocial model and has developed a systematic approach to understanding the clinical presentations found in many treatment settings.

Application in Medicine

• A way of looking at the mind and body of a patient as two important systems that are interlinked so the workings of the body can affect the mind, and the workings of the mind can affect the body.

• Interview process should encourage the patient to give as much information about not only the physical symptoms, but how the illness affects the patient.

Application in Medicine• Biological component: understand the cause

of illness stems from the functioning of the individual's body

• Psychological component: seeks for potential psychological causes for a health problem such lack of self-control, emotional turmoil, and negative thinking.

• Social component: investigates how different social factors such as socioeconomic status, culture, poverty, technology, and religion can influence health.

Application in Medicine

• Psychosocial factors can also cause a biological effect by predisposing the patient to risk factors.– Ex. Person with depression will drink, that

can effect to liver damage

Biological Influences on Mental Health and Mental

Illness• far-reaching biological and physical

influences on mental health and mental illness

• major categories are genes, infections, physical trauma, nutrition, hormones, and toxins

Flaws of BPS

• Critics point out this question of distinction and of determination of the roles of illness and disease

• it runs against the growing concept of the patient-doctor partnership or patient empowerment, as "biopsychosocial" becomes one more disingenuous euphemism for psychosomatic illness.

• Flawed in formulation and application

What some experts say about BPS...

Psychiatrist Hamid Tavakoli

• Unintentionally promotes an artificial distinction between biology and psychology

• Causes confusion in psychiatric assessments and training programs

• It has not helped the cause of trying to destigmatize mental health

Sociologist David Pilgrim

• It has not been properly realized despite the “scientific and ethical virtues”

Psychiatrist Niall McLaren

• Since the collapse of the 19th century models, psychiatrists were so desperate of finding a model that integrates the psyche and the soma that they settled for the “biopsychosocial model” without bothering to check its details

Models• There has been no single model but a large body of

empirical literature has identified social-cognitive (the psyho-social aspect of Engel's model) variables that appear to influence engagement in healthy behaviors and adhere to prescribed medical regimens, such as self-efficacy, in chronic diseases such as type 2 diabetes, cardiovascular disease, etc.

• These models include the  Health Belief Model, Theory of Reasoned Action and Theory of Planned Behavior, Transtheoretical Model, the Relapse Prevention Model, Gollwitzer's  implementation-intentions, the Precaution–Adoption Model, the Health Action Process Approach.

Therapy - Psycho

Multimodal therapy

-gives tools to assess a wide variety of client characteristics such as behavior, affect, sensations, imagery, cognitions, interpersonal relationships and drugs/ biology

Approach - Psycho

Existential Theory

• Helps understand how important it is for clients to determine the purpose and meaning of their lives

Gestalt Approach

• Techniques for dealing with emotional baggage

Approach - Psycho

Choice Theory

• How to help clients make and implement healthy decisions

Feminist Theory

• Fight gender discrimination and to assess role issues

Approach - SocialSystems Theory• Assess the effects of family dynamics on a

client’s issue• Help us understand that family

communication, family problem solving, family roles, and family bounderies can each have a substantial impact on issues seemingly unrelated to the client’s home life

Case StudyTheodore (Ted) John Kaczynski—AKA the Unabomber—was

born May 22, 1942 in Chicago, Illinois. The date of his first recorded attack was on May 25, 1978 when a package exploded at Northwestern University, and his last attack was on April 24, 1995 aimed at the California Forestry Association. However, before the spree of attacks—mostly targeting universities and airlines—Theodore Kaczynski’s life was marked by antisocial tendencies, flattened affectivity, and interpersonal dysfunction.

During his primary and secondary Ted played by himself and his mother encouraged socially isolated activities, such as reading.

He graduated high school one year early but was not really remembered by most of his class mates. He received his Ph.D. in 1967 from the University of Chicago and taught at the university level for several years before quitting and moving to a secluded cabin in Montana. Even though several diagnoses of psychological disorder are warranted, the diagnosis of schizoid personality disorder (SPD) best describes the particular features exhibit by the Unabomber over the course of his upbringing and adult years.

Ted exhibited a withdrawal from most social contact and had problems expressing his emotions, but unlike those with agoraphobia, he was accepting of his behavior. He was also extremely shy and aloof. He at times, did not even answer his student’s questions when he was teaching.

Even though people that suffer from SPD fantasize excessively and have odd ways of communicating there doesn’t appear to be any loss of contact with reality. Ted never indicated that he confronted anyone directly in an aggressive or violent manner. He was confrontational and aggressive at one time, but only on paper when he wrote a letter to a previous employer—Joe Visocan—where quitted & threatened to disclose illegal activity within the company if he didn’t mail his last paycheck. He never directly confronted his previous employer in person.

Ted only had one recorded attempt of suicide, in early January 1998, which failed.

The events that led to Theodore Kaczynski’s streak of violence follow a pattern of social isolation and failed interpersonal relationships. After his conviction he blamed his mother for turning him into a recluse early in life. She encouraged solitary activities, such as reading, research, and museum trips, early in childhood, which did not foster interpersonal contact with other people.

There was also a history of mild schizoid tendencies within the family—especially in his brother David. Ted also skipped two grades during his education, which put him in classes with children older than himself and was subjected to constant bullying. He also experienced a bout with allergies in infancy, during which he was not allowed social contact with his family for a time, since it was the custom back then. In addition, his brother was born when Ted was 7, which resulted in a loss of attention for him.

On a psychological level, Ted was fixated with Joseph Conrad’s novel The Secret Agent. He read it several times after secluding himself in Montana. The novel was about the bombing of an observatory as a way to strike out at a symbol of science. There are several parallels between the main character in the book and the Unabomber. Ted used the name Conrad in one of the letters he wrote after a bombing. Ted was a brilliant man who fled academics to seclude himself in a hermitage. The author of the novel had a birth name of Teodore Jozef Konrad Korzeniowski. Lastly, they both used bombs to make statements, rather than confronting the situation directly. In sum, all of these factors colluded—in addition to three failed romantic relationship—to encourage a lifestyle of introversion and social isolation, which in the end mixed with the biological predisposition already mentioned to bring about indirect violence.

Conclusion and Application

SPD is ill-suited to be examined as a simple stimulus-response interaction or from the perspective of unresolved sexual frustration centered on a parent; rather, the onset and treatment of SPD is largely concerned with the mediation and alleviation of the underlying cognitive mechanism that cause the behavioral problems. There appears to be a trend as of late in psychology—probably as a byproduct of the success of psychopharmacology—towards relying heavily on drug therapy as a way to address psychological dysfunction. Even though there is a clear genetic component to SPD, it is clear that social and psychological factors play heavily on the exhibition of schizoid behavior (Meyer, Chapman & Weaver, 2009). Clinical psychology must incorporate the mediation of the underlying cognitive dysfunction into the treatment of SPD in order to address the multifaceted factors that bring about schizoid behavior. In all, the Unabomber was brought up in a socially isolated environment that lead to maladaptive methods of mediating common stressors, and possible treatment paths must include some type of cognitive therapy that is meant to address the underlying cognitive dysfunction that led to the schizoid behavior in the first place.

References:

• http://www.cliffsnotes.com/study_guide/The-Biopsychosocial-Perspective.topicArticleId-26831,articleId-26751.html

• http://www.surgeongeneral.gov/library/mentalhealth/chapter2/sec3.html

• http://counselingoutfitters.com/vistas/vistas05/Vistas05.art03.pdf