Biopsychosocial

Question 1

What is health? WHO

Answer 1

health is a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity

Question 2

4 perspectives of medicine:

Answer 2

biomedical Psychological – ones experience of their health (e.g. cancer patients knowing they have cancer could affect their mental health) Social - Being born in a hospital vs home away from medics. Also isolating mentally ill patients in the past vs now where they’re helped more biopsychosocial

Question 3

The biomedical approach

Answer 3

Question 4

Limitations of the biomedical approach:

Answer 4

• only focuses on physical condition of body - so not reflective of WHO definition of health
• does not consider the role of a person’s mind or society in cause and treatment
• prevention of disease is overlooked - many diseases are very much dependent on people’s actions and beliefs
• does not take into account psychosocial benefits of some preventive activities
• does not consider how social factors may influence access to medical care, preventive behaviour, etc.

Question 5

illness-wellness continuum shows

Answer 5

shows difference between

• biomedical (treatment) model
• biopsychosocial (wellness) model

Question 6

Biopsychosocial approach

Answer 6

Question 7

how does personality affect health?

Answer 7

• more “conscientiousness” = lower risk of premature death – mediated by behaviour
• optimists less likely to experience same stimulus as painful - important for chronic pain

Question 8

Alcohol outcome expectancies

Answer 8

•a significant part of the “effect” of alcohol is due to expectancies - not alcohol itself

Question 9

define the placebo effect with example

Answer 9

placebo effect is measurable, observable, or felt improvement in health not attributable to treatment.

• Prozac for mild depression is largely a placebo effect

Question 10

Define the nocebo effect

Answer 10

nocebo effect occurs when inert substance produces symptoms congruent with anticipated harm

Question 11

what is the likely cause of placebo/ nocebo effects?

Answer 11

interplay of psychological and physiological mechanisms contribute to the placebo/nocebo effects

• e.g., expectancy, classical conditioning, behaviour

Question 12

Explain the psychoneuroimmunology/ psychoneuroendocrinology concepts

Answer 12

loneliness / pessimism / depression impair immune function

positive moods enhance immune function

prolonged stress impairs immunity

• stress depends on perception of situation
• perception depends on social support

Question 13

Effects of social support

Answer 13

direct effects

via positive mood and related psychosocial influences on endocrine and immune function

indirect effects

those with better social support are more likely to

• use health services
• adhere to medication

social support has beneficial effects on stress responses in immune, neuroendocrine and cardiovascular systems

better social relationships predict a lower risk of premature death

Question 14

implications of biopsychosocial model

Answer 14

holistic approach (treats whole person)

is an illness-wellness model

means that for effective treatment you need to know:

–more than just symptoms & disease

–explore patient beliefs, psychosocial circumstances & individual/family history

places responsibility for health on individuals

Question 15

Strengths and limitations of the biopsychosocial model

Answer 15

strengths:

• treats whole person
• acknowledges biographical and psychological factors
• recognises social context

a marked improvement on the biomedical model, but in practice …

• focus still tends to be the individual
• macro-level factors such as legislation, infrastructure, service provision are often ignored
• cultural factors are often overlooked