Week 1: Biopsychosocial Model & Stress History

Question 1

True or false: Historically, beliefs about illness determine treatment:

A: True

B: False

Answer 1

A: True

Question 2

Describe illness and treatment practices in the Stone Age:

A: It was defined by evil spirits. In the Stone Age, it was thought that illness arose when evil spirits entered the head. The treatment for illness largely consisted of taking sharp tools and puncturing the skull so that the spirits could be removed (trepanation). This operation was often performed on patients who were conscious since anesthesia did not exist yet.

B: In the Stone Age, illness was believed to be caused by a natural imbalance of bodily fluids, and treatment involved restoring harmony through herbal remedies and dietary changes.

C: Stone Age communities had an advanced understanding of germ theory, and illnesses were treated using antibiotics derived from natural sources. Trepanation was never practiced during this period.

Answer 2

A: It was defined by evil spirits. In the Stone Age, it was thought that illness arose when evil spirits entered the head. The treatment for illness largely consisted of taking sharp tools and puncturing the skull so that the spirits could be removed (trepanation). This operation was often performed on patients who were conscious since anesthesia did not exist yet.

Question 3

Describe illness and treatment practices in the Middle Age:

A: In the Middle Ages, illnesses were perceived as purely physical ailments caused by imbalances in bodily humors. Treatment involved herbal remedies, bloodletting, and other natural methods to restore harmony within the body.

B: The Middle Ages saw advanced medical practices based on early scientific principles. Diseases were accurately diagnosed using sophisticated tools, and treatments involved surgical procedures and medications developed through systematic research. The notion of illnesses as punishment was absent during this period.

C: It was defined by God’s punishment. In the Middle Ages, disease was considered God’s punishment for evil. So the treatment for illness at the time consisted of torturing the patient, under the belief that they did something bad and deserved this punishment to get rid of the evil. It had nothing to do with the body and had everything to do with whether a person was “good” or bad.”

Answer 3

C: It was defined by God’s punishment. In the Middle Ages, disease was considered God’s punishment for evil. So the treatment for illness at the time consisted of torturing the patient, under the belief that they did something bad and deserved this punishment to get rid of the evil. It had nothing to do with the body and had everything to do with whether a person was “good” or bad.”

Question 4

Describe illness and treatment practices in the 1700s:

A: In the 1700s, illness was attributed to a balance of bodily humors, and treatments included herbal remedies, dietary adjustments, and purging to restore harmony within the body.

B: It was defined by capillary tension. In the 1700s, the popular belief was that all sickness was caused by capillary tension. It was believed that capillaries in the body became too tense, and so the treatment (called bloodletting) was designed to reduce this tension in the capillaries by bleeding the patient until they became unconscious. Bloodletting remained the dominant theory and treatment for Western medicine through the early 1900s.

C: During the 1700s, advanced medical understanding led to the identification of specific pathogens as the cause of illnesses. Treatments involved the use of antibiotics and vaccinations to target and eliminate these pathogens, marking a significant departure from earlier medical practices.

Answer 4

B: In the 1700s, the popular belief was that all sickness was caused by capillary tension. It was believed that capillaries in the body became too tense, and so the treatment (called bloodletting) was designed to reduce this tension in the capillaries by bleeding the patient until they became unconscious. Bloodletting remained the dominant theory and treatment for Western medicine through the early 1900s.

NOTE:
Today we still do very barbaric things like slash during surgery, burn during radiation, and poison during chemo.

Question 5

Describe illness and treatment practices in the 1800s:

A: In the 1800s, illnesses were primarily thought to be caused by supernatural forces, and treatments involved elaborate rituals and ceremonies to appease the spirits responsible for the disease.

B: During the 1800s, medical treatments focused exclusively on aggressive and invasive interventions, with the belief that more extreme measures led to better outcomes. Patients were subjected to extensive surgical procedures and harsh medications to combat various illnesses.

C: It was defined by comfort. In the 1800s, people started noticing that patients who were not treated by the medical profession were doing better than patients who were. They realized that the medical treatments were often worse than the disease. This led to about 100 years of completely non-invasive therapies, where doctors would observe and be at the bedside of patients but did not engage in actual medical treatment.

Answer 5

C: It was defined by comfort. In the 1800s, people started noticing that patients who were not treated by the medical profession were doing better than patients who were. They realized that the medical treatments were often worse than the disease. This led to about 100 years of completely non-invasive therapies, where doctors would observe and be at the bedside of patients but did not engage in actual medical treatment.

Question 6

Describe illness and treatment practices in the 1900s:

A: In the 1900s, illness was primarily attributed to the alignment of celestial bodies and their influence on the body’s energy. Treatment involved astrology-based interventions to realign these cosmic forces and restore health.

B: It was defined by the biomedical model. In the early 1900s, penicillin was discovered/invented, which changed medicine completely. Diseases that had been incurable before, like syphilis, were suddenly cured overnight with penicillin treatment. This led to the rise of the biomedical model, which reduced all illness to biological/medical factors within the body. It was really successful with acute illness but not so much with chronic illness.

C: During the 1900s, medical practices were characterized by a complete rejection of scientific advancements, and treatments were solely based on mysticism and magical rituals to ward off evil spirits causing illness.

Answer 6

B: It was defined by the biomedical model. In the early 1900s, penicillin was discovered/invented, which changed medicine completely. Diseases that had been incurable before, like syphilis, were suddenly cured overnight with penicillin treatment. This led to the rise of the biomedical model, which reduced all illness to biological/medical factors within the body. It was really successful with acute illness but not so much with chronic illness.

NOTES:
> Think medicine and vaccines
> All illness has a biomedical cause.
> Illness is based on an organ not functioning right or bio-chemicals in the body being out of balance.
> All illness can be cured with drugs if we just find the right drugs.
> Body is separate from mind.

Question 7

Describe illness and treatment practices today:

A: It is defined by the biopsychosocial model. the biopsychosocial model emerged as a new way of thinking about health and illness starting in the 1960s-1980s. It recognizes that health is determined by a combination of biological, psychological, and social factors, rather than just biological factors alone. The model was first proposed by physician George Engel in 1977. It was developed because the biomedical model was not adequately addressing chronic illnesses.

B: Today, illness is solely defined by supernatural influences, and treatment involves spiritual rituals and exorcisms to rid the body of malevolent forces causing disease.

C: In contemporary times, illness is exclusively viewed through the lens of genetics, and treatments focus solely on manipulating genes to eliminate or prevent diseases. The biopsychosocial model has no relevance in the current medical understanding.

Answer 7

A: It is defined by the biopsychosocial model. the biopsychosocial model emerged as a new way of thinking about health and illness starting in the 1960s-1980s. It recognizes that health is determined by a combination of biological, psychological, and social factors, rather than just biological factors alone. The model was first proposed by physician George Engel in 1977. It was developed because the biomedical model was not adequately addressing chronic illnesses.

Question 8

What are the 3 components of the biopsychosocial model?

A: Physiological factors, emotional factors, and environmental factors

B: Biological factors, psychological factors, and social factors

C: Organic factors, mental factors, and cultural factors

Answer 8

B: Biological factors, psychological factors, and social factors

Biological Factors: Organs, cells, tissues, biochemicals

Psychological Factors: Individuals’ motivations, beliefs, attitudes, behaviors, emotions

Social Factors: Society, culture, community, family, social class

Question 9

Why Do We Need a Biopsychosocial Model?

JUST STUDY THIS ANSWER….

Answer 9

1. Having a biomedical defect indicates disease potential, not disease existence.
2. Beliefs about illness matter.
3. Two people with the same biomedical problem may have different disease outcomes.
4. Successfully treating the biomedical problem doesn’t
   necessarily make the patient healthy.
5. Behaviors matter.

Question 10

Our overall health is composed of:

A: Psychology, social world, and biology

B: Physics, sociology, and chemistry

C: Spirituality, geography, and physiology

Answer 10

A: Psychology, social world, and biology

Question 11

Which of these behaviors kills the most people?

A: Smoking

B: Car accidents

C: Drugs

D: Alcohol

E: Sexually transmitted infections

Answer 11

A: Smoking

NOTE:
Smoking causes more preventable deaths in the US than car crashes, suicide, homicide, alcohol, and sexually transmitted diseases combined.

Question 12

What is the most common cause of death in the United State?

A: Cancer

B: Accidents

C: Cardiovascular disease.

Answer 12

C: Cardiovascular disease.

Question 13

What is stress?

A: Stress is a positive emotional experience with no impact on biochemical, physiological, cognitive, or behavioral changes.

B: Stress is solely a physiological response and has no connection to emotional experiences or cognitive changes.

C: Stress is a negative emotional experience accompanied by predictable biochemical, physiological, cognitive, and behavioral changes that are directed either toward altering the stressful event or accommodating to its effects.

Answer 13

C: Stress is a negative emotional experience accompanied by predictable biochemical, physiological, cognitive, and behavioral changes that are directed either toward altering the stressful event or accommodating to its effects.

Question 14

What four ways can you categorize stressors:

A: Physical, psychological, acute, and chronic

B: Emotional, spiritual, episodic, and long-term

C: Environmental, social, internal, and temporary

Answer 14

A: Physical, psychological, acute, and chronic

Physical: These stressors are things that all animals (human and not) might list as stressful, e.g., heat, cold, pain, fatigue, injury, hunger, and predators.

Psychological: These stressors are things that generally only humans would consider stressful, e.g., grades, job security, money, relationships, and traffic.

Acute Stressors: These stressors demand immediate attention and don’t last long. They tend to appear
suddenly. Many physical stressors are acute.

Chronic Stressors: These stressors do not require immediate attention, but last a long time and are a constant source of worry. Most psychological stressors are chronic.

Question 15

Discuss fight or flight behavior:

A: Fight or flight behavior is solely a modern concept, not associated with any historical figure, and has no relevance to the physiological responses to danger.

B: Associated with Walter Cannon. Walter Cannon was a physiologist who, way back in 1932, argued that when a person or animal experiences danger, they will either act to attack the threat or flee the threat - this is known as fight or flight. Cannon said this response is useful for dealing with danger but can disrupt normal functioning if it goes on for too long.

C: Fight or flight behavior is a passive response where individuals remain frozen and do not take any action in the face of danger.

Answer 15

B: Associated with Walter Cannon. Walter Cannon was a physiologist who, way back in 1932, argued that when a person or animal experiences danger, they will either act to attack the threat or flee the threat - this is known as fight or flight. Cannon said this response is useful for dealing with danger but can disrupt normal functioning if it goes on for too long.

NOTES:
> Stress causes physiological changes
> They help mobilize the body to fight or flee
> Useful: Helps you respond quickly
> Problem: Disrupts normal functioning

Question 16

Discuss general adaptation syndrome:

A: General adaptation syndrome is a recent concept, not associated with any historical figure, and has no basis in scientific research or experimentation.

B: Associated with Hans Selye. Hans Selye was the “father of stress.” In the 1950s, Selye published influential work on stress that came about accidentally through his experiments on rats. He observed that no matter what stressful stimuli the rats were exposed to (overexercising, electric shocks, etc.), they always showed the same set of symptoms involving enlarged adrenal glands, shrunken lymph nodes, and bleeding. Selye called this the General Adaptation Syndrome - a nonspecific response of the body to any demand placed on it. He argued it was the body’s way of trying to adapt to and deal with negative/noxious stimuli. If this response goes on for too long, the process itself can start to damage the body.

C: General adaptation syndrome is a highly specific and tailored response to each unique stressor, with no common set of symptoms observed across different stress-inducing stimuli.

Answer 16

B: Associated with Hans Selye. Hans Selye was the “father of stress.” In the 1950s, Selye published influential work on stress that came about accidentally through his experiments on rats. He observed that no matter what stressful stimuli the rats were exposed to (overexercising, electric shocks, etc.), they always showed the same set of symptoms involving enlarged adrenal glands, shrunken lymph nodes, and bleeding. Selye called this the General Adaptation Syndrome - a nonspecific response of the body to any demand placed on it. He argued it was the body’s way of trying to adapt to and deal with negative/noxious stimuli. If this response goes on for too long, the process itself can start to damage the body.

NOTES:
> Enlarged adrenal glands
> Shrunken lymph nodes
> Bleeding ulcers
> A non-specific response of the body to any demand placed upon it.
> Any stressor, any organism – all the same

Question 17

Discuss the Stressful Life Events Theory in humans:

A: The Stressful Life Events Theory is a contemporary idea that lacks historical grounding and empirical support. It proposes a connection between life events and health outcomes without the backing of established research. Unlike theories developed by reputable figures, this concept fails to provide a comprehensive understanding of the complex relationship between stressors and their impact on human health.

B: Contrary to theories crafted by influential figures in the field, the Stressful Life Events Theory is a recent and unsupported notion. It narrowly focuses on the intensity of individual stressful events, overlooking the intricate interplay of multiple stressors and their cumulative effects on health outcomes. This theory lacks the depth and nuance required for a comprehensive understanding of the dynamic nature of stress and its implications for human well-being.

C: Associated with Holmes and Rahe. Holmes and Rahe developed the “stressful life events” theory. They created a questionnaire that listed certain life events that are typically stressful, like marriage, divorce, the death of a family member, etc. They found that the more of these stressful life events a person reported experiencing, the more likely they were to have negative health outcomes or disease. This linked experiencing stressful life events to increased risk of illness. Holmes and Rahe’s stressful life events theory looked at the accumulation and number of stressful events a person experienced, rather than the intensity of each individual event. Later researchers like Lazarus criticized this theory for not taking into account the intensity of events or individual perceptions and appraisals of those events.

Answer 17

C: Associated with Holmes and Rahe. Holmes and Rahe developed the “stressful life events” theory. They created a questionnaire that listed certain life events that are typically stressful, like marriage, divorce, the death of a family member, etc. They found that the more of these stressful life events a person reported experiencing, the more likely they were to have negative health outcomes or disease. This linked experiencing stressful life events to increased risk of illness. Holmes and Rahe’s stressful life events theory looked at the accumulation and number of stressful events a person experienced, rather than the intensity of each individual event. Later researchers like Lazarus criticized this theory for not taking into account the intensity of events or individual perceptions and appraisals of those events.

Question 18

Discuss the Stress Appraisals Theory:

A: Associated with Lazarus. Lazarus and Folkman developed the stress appraisal theory. They argued that what matters isn’t just the event itself, but how a person perceives and interprets the event, which they called “appraisal.” According to Lazarus, an event only leads to a stress response if a person does a primary appraisal that judges the event as threatening, and a secondary appraisal that judges their coping abilities as insufficient to deal with the threat. This emphasizes the importance of individual cognition and perception in the stress response.

B: The Stress Appraisals Theory, a recent and unsubstantiated concept unrelated to any notable figure, proposes that the mere occurrence of an event is the sole determinant of the stress response. It neglects the crucial role of individual appraisal and perception highlighted by established theories in stress research.

C: The Stress Appraisals Theory, an antiquated notion without a recognized origin, posits that events automatically trigger stress responses without considering individuals’ cognitive processes. This simplistic view overlooks the influential work of prominent figures like Lazarus, who emphasized the critical role of appraisal and perception in shaping the stress response.

Answer 18

A: Associated with Lazarus. Lazarus and Folkman developed the stress appraisal theory. They argued that what matters isn’t just the event itself, but how a person perceives and interprets the event, which they called “appraisal.” According to Lazarus, an event only leads to a stress response if a person does a primary appraisal that judges the event as threatening, and a secondary appraisal that judges their coping abilities as insufficient to deal with the threat. This emphasizes the importance of individual cognition and perception in the stress response.

NOTES:
> Primary appraisal is when a person judges whether an event is harmful or threatening.

> Secondary appraisal is when they judge whether their coping abilities and resources are sufficient to overcome the harm or threat.

> Stress and the physiological stress response only occurs if both the primary and secondary appraisals are affirmative (i.e. the event is seen as threatening and the person feels unable to cope).

> This emphasizes how it’s not just the event itself but the cognitive appraisal of the event that determines the stress response.