Lecture 6-The biopsychosocial model

Question 1

Current Research in Human PNI

Answer 1

Wide range of ages and populations – children to elderly
Healthy participants
Clinical populations
Psychosocial factors as inputs – stress, coping, personality, locus of control, social support
Health outcomes, illness onset, progression, and survival

Examples:

1. Wound healing/surgery
2. Pregnancy and perinatal period
3. Early life adversity and health across the lifespan
4. Caregiving – elderly carers, parents as carers
5. Ageing process
6. Socioeconomic status (SES) and poverty
7. Acute stress effects in chronic conditions e.g. asthma
8. Cardiovascular disease and atherosclerosis
9. Interventions e.g. mindfulness

Question 2

Health Psychology, the Biopsychosocial Model and the field of Psychoneuroimmunology: how do they fit?

Answer 2

Health psychology is based on the biopsychosocial model and examines the contribution of psychosocial factors in “illness vulnerability, onset, exacerbation, progression and survival.”
PNI investigates the underlying “fundamental mechanisms involved in the biopsychoscial model.”

Question 3

what are the applications of the biopsychosocial model for health and well-being?

Answer 3

1. Health promotion programs to influence alcohol consumption, smoking cessation, improve diet, increase exercise, encourage safer sexual practices;
2. Stress reduction to benefit endocrine and immune functioning
3. Increase social support & coping strategies to improve psychological and physical health
4. Reduction of anxiety and depression to facilitate postoperative recovery & wound healing
5. Psychoeducational approach to cancer care – influence on quality of life & survival time (improving expression of emotion/understanding of emotion)
6. Pain reduction through psychological techniques  lots of research into pain, can help to reduce impact/experience of pain

Question 4

Implications of the Biopsychosocial Model in Health & Illness

Answer 4

A systems approach, taking into account all three levels, biological, psychological and social, needs to be given full consideration in:
Diagnosis & treatment
Doctor-patient relationship if a doctor is treating your psychological and social needs, feels nicer for patient in terms of QoL but could also increase chances of getting better sooner
Prevention & health promotion

Question 5

Systems Theory Approach (Engel, 1980 in Sarafino and Smith, 2012)

Answer 5

Hierarchical link between levels of organisation: change in one system produces change in another
Health & illness involve interrelated processes: microlevel (e.g. cellular, chemical) changes can influence macrolevel (psychosocial) processes & vice versa. Bi directional communication
Dynamic process

Question 6

Emergence of the Biopsychosocial Model (‘Holistic’ Approach)

Answer 6

Underlying premise:
Health & illness caused by multiple factors and produce multiple effects
Mind-body interaction
Health is a process achieved by attention to individual’s needs on all levels, psychological (cognition, emotion, motivation), social (relationships, support, societal values, community, culture) and biological

Question 7

What are the limitations of the biomedical model?

Answer 7

1. Reductionist
2. Single factor
3. Maintains mind-body dualism
4. Emphasis is on illness rather than health (focus is on health)
5. Fails to explain individual differences in illness susceptibility and health outcome-theyre important factors such as personality

Question 8

The Biopsychosocial Model

Answer 8

Holistic approach
Symptoms and diseases explained by a range of factors
Views health and illness as mind-body interaction
Psychological, social, cultural and biological processes combine to determine health status
Health as the absence of disease
Mechanistic & reductionist
Deals with somatic processes only i.e. mind-body Cartesian dualism
Psychosocial processes independent of disease process