Biopsychosocial Model, Society, And Culture Flashcards
Biopsychosocial approach
A framework that illuminates the importance of psychological and sociological study for success in medical school and in practice of medicine
BPS approach expands upon the traditional biomedical approach, which focuses narrowly on the physical aspects of illness
Illness cannot be understood by only examining biological factors
1. Illness is determined by a variety of influences, rather than a single cause
2. The causes and effects of illness can be examined at multiple levels in the life of an individual. Factors that determine course of illness exist at more than one level simultaneously and no single level provides the whole picture
How does the biopsychosocial approach describe the presentation of a person’s disease or biological state?
Patients start the process of diagnosis by presenting their narrative of how the symptoms developed
Psychological processes also affect how the individual interprets and translates biological processes
An individual exists at the intersection of social and biological (a person is both the largest unit of the organism and the smallest unit of society)
In the BPS, what happens when we leave out the non-biological factors from the development of illness?
Biomedical approach leaves important variables unexplained and unexamined
How would the BPS approach affect the treatment of a patient with cirrhosis of the liver?
In a simple biomedical approach treatment would just involve the treatment of the liver through pharmaceutical or surgical means
BPS would look at the root cause of the cirrhosis, for example AUD
Patient’s alcohol consumption would need to be addressed and treatment would involve attention to related psychosocial factors (housing situation and stress level)
What are the levels of organization in the biopsychosocial model?
Biosphere > Society-Nation > Culture-Subculture > Community > Family > Two-Person > Person (experience & behavior) > Organs / Organ systems > Tissues > Cells > Organelles > Molecules > Atoms > Subatomic particles
Models
Useful representations of scientific phenomena
Never a perfect representation, and the limitations of each model must be considered
Helpful for drawing conclusions about the phenomena itself
Theories
Formed or modified to explain the results of studies and guide the design of new studies
Provides conceptual framework for understanding objects of study
Validity of a theory can be supported or undermined by the results of research
Can also be evaluated in terms of how well it contributes to development of new research and practical applications
How have models and theories in psychology changed over time?
Multiple competing viewpoints have waxed and waned in popularity and clinical acceptance over time
Psychoanalytic school of thought has declined while cognitive theories have gained popularity
Each school of thought continues to be studied and modified and no single theory dominates psychology
In what ways do the theories on social functions vary?
Major theories differ in the extent to which they assume that individuals can influence society, the level of society studied, the degree of harmony or discord in social relations, and their strengths and weaknesses
Social constructionism
Adds to the idea of scientific models as representations of reality
Human actors construct or create “reality”, rather than discovering a reality that has inherent validity
Beliefs and shared understandings of individuals create social realities
- Some believe all reality, even what some consider objective natural phenomena, has no inherent meaning beyond human beliefs
- Moderates believe two categories: brute facts and institutional facts
Brute facts: physical realities that exist outside of human input (gravity)
Institutional facts: only exist as a function of society’s structures and beliefs (gravitational force involving the larger planet bc not an observable fact)
How could social constructionism be used on the MCAT in the context of understanding illness?
Diagnosis of illness requires agreed upon set of criteria
Gap between biological or physiological reality of medical condition and societally created meaning of diagnosis
I.e. in the DSM (Diagnostic and Statistical Manual of Mentor Disorders) diagnostic categories and disorders are periodically revised according to new research and changing conceptualizations of mental illness
Symbolic Interactionism
Related to social constructionism in that it allows for social determination of shared realities
Focuses on a smaller scale of interaction between individuals and in small groups (patient-physician)
Through social interactions, individuals develop shared meanings and labels for various symbols - terms, concepts, or items that represent specific meanings by accepted convention
E.g. “drug addict” has socially determined symbolic meanings, ranging for criminal tendencies to clinical mental illness
How do shared symbols in symbolic interactionism allow for smooth societal interactions?
Permit reasonable expectations of how people will behave and what constitutes appropriate responses
Behaviors influenced by social roles can be defined through symbolic interactionism: symbols that have a large effect on behavior and identity
How does symbolic interactionism allow for change within symbolic meanings?
People actively create meaning through their social interactions, allowing for human agency in creating and changing meaning
Meaning of a symbol can change in a particular interaction where people come up with different interpretations of an environmental stimulus or social situation
What are some criticisms for symbolic interactionism?
Useful for examining social functioning at level of interpersonal interactions, but criticized for leaving out larger societal forces that undeniably have an effect on people’s lives
Functionalism
Factions of society work together to maintain stability
Claims that society is a system that consists of different components working together (think of organs working together in an organism as a metaphor)
Society contains distinct institutions that contribute to functioning and maintain equilibrium in the face of environmental demands
Disruptions: Interacting systems respond as needed to get back to previous state
Actions of individuals and groups in society can be analyzed by asking how they contribute to long-term societal stability
Conflict Theory
Views society in terms of competing groups that act according to their own self-interests, rather than according to need for societal equilibrium
Social groups naturally come into conflict as their interests collide and society changes over time due to continual competition for resources and power
Views human actions as driven by larger forces of inequality, but leaves motivations and choices of individuals unexamined
Feminist Theory
Considered a particular type of conflict theory
Examines social inequities between men and women
What are some weaknesses of functionalism?
Cannot explain social life on the micro scale
Useful perspective for considering processes that contribute to social stability, but cannot explain societal changes
- Assumes stability is the ideal
What are some weaknesses of Conflict Theory?
Cannot explain social life on the micro scale
Argues that stability is undesirable for the social groups that are oppressed by the self-interests of the powerful and that change will inevitably occur
Explains how societies change over time, but fails to recognize stability in society
Does not leave room for types of social agreement and collaboration between individuals and groups that are addressed by symbolic interactionism and functionalism
What are the two broad categories that sociological theories can be placed into?
Macrosociology: focuses on broad social structures that affect society
- Social constructionism, functionalism, conflict theory, and feminist theory
Microsociology: focuses on smaller scale of social interactions between individuals
- Symbolic interactionism
Rational Choice Theory
Assumes that people’s actions are dictated by a rational consideration of alternatives
Individuals choose action most likely to bring some type of profit
Exchange Theory
Applies basic principles of rational choice theory to social interactions
Behaviors within relationships are determined by expectations of reward or punishment
- Scale of individuals and relationships (microsociological)
Also assume that large societal structures are built from small-scale rational decisions
Cannot explain the choices of individuals that appear to be irrational or not in their best interest
Culture
All of the beliefs, assumptions, objects, behaviors, and processes that make up a shared way of life
Individuals in a culture tend to share common values, learned behaviors, and approaches to life, has pervasive effect on worldview
When immersed in culture, assume that that culture’s way of doing things is normal and natural, but can learn about own cultural assumptions through interactions with other cultures
Differing perspectives can be due to cultural differences
Culture shock
Discomfort and ensuing re-evaluation of personal cultural assumptions when first encountering a new culture which can be a catalyst for personal growth and reflection
What are the two main categories of culture?
Material culture and non-material culture
Material culture: objects involved in a certain way of life
- Includes products manufactured, tools used, art made, and every object that supports or enriches a lifestyle (all things an archaeologist might uncover and study)
Non-material culture: Encompasses elements of culture that are not physical like shared ideas, knowledge, assumptions, values, and beliefs that unify a group of people
- E.g. religions, superstitions
- Studied by living among people (ethnographers) or through language (historians)
How can culture be related to geographical area or country of origin?
Shared cultural experiences are often related to geographical area or country of origin, however can also transcend geography
Social Norms
Expectations that govern what behavior is acceptable within a group
Social interactions help to define a culture by establishing norms
Sanctions: social expressions of approval for conforming to norms or disapproval for failing to conform
- Folkways are norms governing casual interactions (helping an elderly person, good or cutting in line, bad)
- Mores are norms enforcing the moral standards of society (violations lead to serious negative sanctions such as prison)
- Taboo is most extreme end of disapproval (violation is considered immoral and repulsive, e.g. cannibalism)
Social Group
Subset of a population that maintains social interactions
Identification with social groups influences culture or cultures that a person experiences
Social group can be broad and be defined as a group identity among a set of individuals created by a collection of shared experiences (even though direct social interaction is not there)
Group identity binds people together and builds shared cultural experiences
How did humans evolve to have culture?
Humans are social animals, so they live in groups and feel the need to connect with those around them, establishing norms of behavior, social expectations, social ideas, and eventually culture
When human lineage split from apes ~8 mya, human ancestors learned tool production and manipulation of fire
Humans experienced explosion of cultural changes during last ice age and up to the present (E.g. cave art, metal working, agriculture, urban lifestyle, steam engine, internet introduced in last 40k years)
Development of symbolic culture
Symbolic culture
Type of non-material culture that consists of elements of culture that have meaning only in the mind
Based on shared system of collective beliefs in form of symbols
Meanings determined by social norms, cultural values
Includes meanings ascribed to rituals, gestures, and objects
Ritual
Formal, ceremonial behavior with specific purpose and significance
How are symbolic meanings different to different people?
Meanings people assign based on symbolic culture affect behavior and how individuals see the world
Meanings are culturally situated and determined by different experiences and social interactions
Symbolic culture provides basis for and is reinforced by symbolic interaction
What is one of the most important aspects of symbolic culture?
Language: use of symbols to represent ideas
Allow’s one person’s thoughts to be transferred to the mind of a second person through symbols, speech, or writing
Enormous milestone in evolution of human culture
Plays role in individual growth and learning by enabling transfer of shared ideas and knowledge throughout development
Society
Defined as two or more individuals living together in a community and / or sharing elements of the culture
Can sometimes encompass multiple cultures
Structures of society are social institutions
Social Institutions
Hierarchical systems that bring order to interpersonal interactions, structuring society
Address a specific purpose or set of tasks
Common examples: government & economy, education, religion, family, health & medicine
Government & Economy
Social institution
Government provides order to society through services it provides and making and enforcement of law
Economy distributes goods and services to meet the needs of society
- Both exist on local, state, national, and international level and provide framework and rules to structure society organized by power and authority
Power
Allows individuals or groups to exert their will even when they are opposed by others (according to sociologist Max Weber)
Authority
Type of power that is viewed as legitimate by the population
Can carry out its ends without resorting to force
Can be enacted through tradition, bureaucracy, or charisma
Traditional authority: Depends on a population’s respect for cultural patterns that have existed for a long time
Rational-legal authority (bureaucratic): Describes power maintained by rules and regulations (traffic laws)
Charismatic authority: Personal qualities that inspire devotion. Least stable and must eventually transform into one or a blend of the other two types
Comparative economic and political systems
Distinction between capitalism and socialism
Capitalism: resources and means to produce goods and services are privately controlled by individuals and organizations
- Desire for profit drives commercial activity
- More productive and tend to enjoy a greater degree of political freedom
Socialism: Resources and means of producing goods and services are managed collectively
- relies on government regulation to match productive output to demands of consumers
- Tend to generate less per capita income, but also have decreased wealth disparity
