Symposium on the Biopsychosocial Model Flashcards
How would you use the biopsychosocial model when the signs are slightly worse than average
Describe the balance between the biological, psychological and social aspects
Psychology
-behavior changes with strategies
Sociology
-create environments which are conducive to preventative health
Biology
-interventions rarely used unless the psychosocial elements don’t work
Psychosocial elements are dominant here
How would you use the biopsychosocial model when major disability is caused by illness
Describe the balance between the biological, psychological and social aspects
Psychology
- sustain behavior changes
- adherence to treatment
- support mental health
Sociology
-create environments which are conducive to improving health
Biology
- pharmacological intervention
- prevent/manage complications
All aspects are equal
Describe the dopaminergic/mesocorticolimbic reward pathway
How does alcohol affect this pathway
Substantia nigra (basal ganglia) => striatum (BG)
Ventral tegmental areas (MB) => nucleus accumbens (mesolimbic BG) and prefrontal cortex (mesocortical)
Involved in decision making and rewards
Alcohol enhances dopamine release by inhibiting neurones that inhibit dopamine secretion
Describe the heritability of alcoholism
25% of children of alcoholics become alcoholic
MZ generally have higher concordance for alcoholism than DZ
Describe how variants of the D2 receptor gene affects alcoholism
D2 has 1 phenotypes (A1 and A2), associated with dopamine receptor density
A1 => decreased no of dopamine binding sites
-increased chance of developing substance abuse
A2 => increased no of dopamine binding sites
-decreased chance of developing substance abuse
How would you exploit the differences in D2 receptor phenotypes in reducing alcohol cravings
Bromocriptine
-dopamine agonist => activation of nucleus accumbens
How can the RASGRF-2 gene affect the chances of developing alcoholism
Variant causes a stronger sense of reward when drinking => more likely to be a heavy drinker
How can protective signalling pathways reduce your chance of developing alcoholism
What 2 molecules are involved in this
Homeostatic pathways activated by alcohol => protected against adverse effects
As a result, won’t drink at excessive, harmful levels
- Brain Derived Neurotrophic factor
- Glial Cell line Derived Neurotrophic Factor
How can orexins affect your chances of developing alcoholism
- describe the effects of orexin receptor blockers
- what is the link between orexin and epigenetics
- what can trigger orexin release
Orexin is a neuropeptide synthesied in the hypothalamus => modulates reward seeking
Orexin blockers can make rats stop drinking freely available alcohol
Orexin receptors involved in the rewarding and motivational properties of alcohol
Orexin may be involved in withdrawal symptoms due to epigenetics
Cues associated with alcohol availability can trigger orexins
What is the link between epigenetics and alcoholism
- in adolescents
- how could you treat the changes caused by alcoholism
Alcohol exposed in adolescent rats => tighter DNA coiling due to epigenetic changes => anxiety like behavior
Epigenetic changes can be passed on
When cancer drug given associated with tightly coiled gene (needed for synapse formation) => uncoiling of gene => reduction in anxiety and alcohol intake
How can alcohol affect neuroimmune processes
- how do gut derived microbial products impact biological function
- how is crosstalk in the brain impacted
Alcohol thought to increase neuroimmune related gene and protein expression
gut derived microbial products activate innate immune system => systemic induction of inflammatory cytokines which are transported from blood => brain
Crosstalk in brain => induction of inflammatory and neuromodulatory properties of immune cells
Capability to change behavior
What 3 factors must be considered and addresses to reduce the intention to drink and increase the capability of the person to change their behaviour
Attitude to drinking
Subjective norms
-what do other people think of your drinking
Perceived behaviour control
-are you confident that you are able to stop being dependent on alcohol
By addressing these factors, you can reduce the intention to drink
Opportunities that result in excessive drinking
How can glass size influence the volume consumed
How can you use this knowledge to change drinking behaviors
May influence judgements on amount of wine consumed
Larger glasses, => increased consumption of units
By using smaller glasses, can start to control your drinking environment
How can operant conditioning lead to excess alcohol consumption
How can you use this conditioning to stop being dependent on alcohol
Stimulus, response, reward pathway reinforced in alcohol consumption
This process becomes automatic
If conscious of cues, can use if when planning to decrease consumption
What 3 factors influence motivation
Conscious voluntary processes
-capability, perceptions
Unconscious involuntary processes
-drinking cues and habits
Emotions
-depressive symptoms => increased consumption