DOCSLIB.ORG

The Biopsychosocial Model: Redefining Osteopathic Philosophy?

Total Page：16

File Type：pdf, Size：1020Kb

Download full-text PDF Read full-text
The Biopsychosocial Model: Redefining Osteopathic Philosophy? International Journal of Osteopathic Medicine (2013) 16,33e37 www.elsevier.com/ijos The Biopsychosocial model: Redefining osteopathic philosophy? J. Nicholas Penney Spinal Research Unit, University of Huddersfield, 30 Queen Street, Huddersfield HD1 2SP, West Yorkshire, England, UK Received 25 February 2012; revised 14 November 2012; accepted 4 December 2012 KEYWORDS Abstract The Biopsychosocial model (BPS), first proposed by Engel in 1980, can be Biopsychosocial; considered as both a philosophy of clinical care, and a practical guide to individual Osteopathic philos- patient management. The BPS model also has the benefit of extensive supportive ophy; literature. Osteopathic philosophy, however, remains poorly defined and suffers Science; from both a lack of published corroborating evidence of effectiveness, and a univer- Evidence sally accepted definition of practice. This potentially leaves the osteopathic profes- sion drifting against the tide of evidence-based practice clinging to the ‘life raft’ of what it perceives to be a distinctive philosophy, but without the evidence to support or justify swimming against the tide. As the osteopathic profession reviews its underpinning philosophy and its relevance in a fast changing evidence-based care environment, the BPS model potentially provides the answers to a number of the issues surrounding the current and future practice of osteopathy. In review- ing the accepted tenets of osteopathic philosophy in light of the BPS model, it is necessary to briefly consider aspects of science and evidence as well as the art of clinical care which all contribute to evidence-based ‘best practice’. ª 2012 Published by Elsevier Ltd. Introduction be considered as both a philosophy of clinical care for the practitioner which includes a practical The Biopsychosocial model (BPS) was first guide to individual patient management and 2 proposed by George Engel in 1980.1 The model can aspects of self appraisal for the practitioner. The model is recognized by the World Health Organi- E-mail addresses: [email protected], joe_ zation, and enshrined in many clinical practice [email protected]. guidelines such as The Australian Guide to the 1746-0689/$ - see front matter ª 2012 Published by Elsevier Ltd. http://dx.doi.org/10.1016/j.ijosm.2012.12.002 34 J.N. Penney Management of Acute Musculoskeletal Pain.3 The BPS model recognizes the complexity of mind model also informs the broadest range of clinical body interaction, aspects of circular causality practice from behavioral medicine to pre-surgical and concepts of patient centered care including screening in both primary and secondary care. compassion, empathy and consideration for the However, the evidence-based model per se is patients’ suffering. considered by some of its detractors to be The BPS model is now recognized as the pre- a philosophy of its own.4 Whilst it seems unlikely eminent scientific model central to the under- that patients would deliberately choose a treat- standing of pain in general and musculoskeletal ment that was not supported by current best pain in particular.3 The BPS model also informs evidence,4 there appears to be support for the some aspects business and health management. notion that osteopathic courses should be based The BPS model of low back pain and disability was around A.T. Still’s original concepts, and taught originally endorsed by the World Health Organiza- from the (scientifically discredited) Vitalist school tion in 2000.8 An unsupportive work place and of thought, as evidenced by a recent professional management style are associated with absen- debate in Auckland. teeism from work, and those certificated as not fit Engel’s criticism of the biomedical view should for work, and receiving wage related compensa- resonate with osteopaths, because it may be tion, are known to recover more slowly.6 considered as being broadly consistent with osteo- An extensive literature on the BPS model has pathic philosophy. Engel criticized dualistic and been published over the years since Engel first reductionist thinking, and the concept of the clini- identified the need to broaden the reductionist cian as an impartial observer to the subjective biomedical approach. The model is a combination experience of the patient.2 The idea that mind and of a number of clinical elements that contribute to body should be considered and treated separately, pain and disability, and include physical (somatic) and that every aspect of the clinical case not dysfunction, distress, ‘sickness behavior’ beliefs objectively verified should be discounted, was and coping.7 The Biopsychosocial model of low questioned by Engel although it reflected the back pain and disability was originally endorsed by biomedical view of the time. The seemingly pure the World Health Organization in 2000.8 Research biomechanical focus of some contemporary osteo- has continued to identify a large range of variables pathic education and practices may also fall into this that potentially impact on the individuals’ mental trap, which may not be consistent with osteopathic and physical health, wellbeing, and ability to philosophy or the accepted current evidence-based recover from illness and disease.9e16 model of healthcare that embraces the BPS model. Whilst the complexity of some the interactions of these factors remains elusive to individual research studies, there is a growing recognition The Biopsychosocial model that many of the functional somatic syndromes seen in osteopathic practice, such as non-specific In Engel’s model, a patient’s symptoms need to be musculoskeletal pain, gastro-intestinal disturbance conceptualized as the result of a dynamic interac- and headache, are the product of complex tion between psychological, social and pathophysi- interactions, not single precipitating incidents or ologic variables.5 Engel’s model has subsequently events. Although traditionally understood from the been described as a philosophical understanding of perspective of the ‘tissue causing symptoms,’ these how illness, disease and suffering are affected by somatic symptoms may be centrally generated and different levels of organization, from the molecular then expressed in the periphery. Whilst such disor- to societal.2 In many clinical practice guidelines, ders may not exhibit significant pathologies in such as those produced in Australia in 2003 for the the peripheral tissues, they are associated with management of Acute Low Back Pain, these levels of significant neurobiological, physiological and even organization are reflected in the flags classifica- anatomical changes in the central nervous system.17 tions. ‘Red flags’ are indicators of potential patho- physiologic compromise, ‘Yellow flags’ are potential indicators of psychosocial distress, and ‘Blue’ and Osteopathic philosophy ‘Black flags’ which represent societal organization, the rules and regulations of everyday life. The BPS The 4 basic tenants of osteopathic philosophy are model provides a framework for understanding how well known and described in terms such as: the patients’ subjective experience contributes to establishing an accurate diagnosis, negotiated The body is a unit, the person a unit of mind, outcomes and empathetic care.2 Specifically, the body, spirit The Biopsychosocial model 35 The body is capable of self regulation, healing A clinical practice that is based entirely on the and health maintenance philosophical beliefs of the practitioner may not be Structure and function are reciprocally in the best interests of the patient, and is clearly not interrelated defensible from a scientific perspective. Rational treatment based on the above18 On the other hand, an entirely scientific evidence-based approach to practice may also be Broad philosophical statements such as the above perceived as cold and uncaring by the patient, have both positive and negative attributes, in so far when the practitioner reviews only the data ob- as they make osteopathic practice difficult to tained from diagnostic testing in preference to define, while potentially allowing a broad scope of understanding the patient from within their own practice. Current osteopathic practice reflects context. Broad scientific and philosophical a somewhat mechanistic interpretation of Still’s considerations need to be integrated to achieve model of ‘holistic medicine’ which was born out of the best possible outcomes, in order to meet the the loss of 3 of his children to meningitis, and the clinical concerns of the practitioner and the medically induced morphine addiction of his expectations of the patient. brother. One interpretation of Stills’ philosophy was Scientific research is ranked by a hierarchy of that he was against the indiscriminate prescription evidence such as in the Australian Guidelines. of drugs, rather than drugs per se, whilst combining For the management of Acute Musculoskeletal principles of holistic medicine with the art of the Pain.3 The hierarchy ranges from meta-analysis bone setter.19 AT Still believed the body had its own (the highest form of evidence) through random- powers to combat disease, and likened human ized controlled trials, cohort studies to observa- anatomy to a steam engine which was susceptible to tion and expert consensus. This well established similar mechanical principals and dysfunction. This hierarchy is largely based on Bradford Hills’ dysfunction, in Still’s mind, came from the disloca- criteria which were published in 1965.20 Bradford tion of bones, abnormal ligaments and tight muscles Hills’ criteria
Load more

Recommended publications
  • The Biopsychosocial Model and Quality of Life in Persons with Active Epilepsy
    The biopsychosocial model and quality of life in persons with active epilepsy Dissertation Presented in Partial Fulfillment of the Requirements for the Degree for the Degree Doctor of Philosophy in the Graduate School of The Ohio State University By John O. Elliott, MPH Graduate Program in Social Work The Ohio State University 2012 Dissertation Committee: Virginia Richardson, Advisor Alvin Mares Bo Lu Lisa Raiz Copyright by John Ottis Elliott 2012 Abstract Persons with epilepsy (PWE), the most prevalent chronic neurological disease, view their main handicaps as psychological rather than purely physical. Despite a long recognized need in the field of the importance of the psychological and social factors in PWE there is still a paucity of research in the fields of psychology and social work. The medical community has continued to focus primarily on seizures and their treatment (the biological-biomedical model). Such an approach works to further perpetuate psychosocial disparities by excluding the patient’s subjective viewpoint. From the biopsychosocial perspective, a person’s lived experience needs to be incorporated into the understanding of health and quality of life. While the biopsychosocial model has gained notoriety over the years, it has not been studied much in epilepsy. Because the scarce research is insufficient to answer these questions further research was needed. I posed two broad questions: 1) Is quality of life in PWE better explained by the biopsychosocial model than the biological-biomedical model? and 2) Does use of mental health services (social workers/counselors and psychologists) have a moderating effect on quality of life in PWE? The study used a sample of 1,720 PWE, over the age of 12, who participated in the 2003 and 2005 Canadian Community Health Survey (CCHS).
    [Show full text]
  • The Biopsychosocial Model and Its Potential for a New Theory of Homeopathy*
    Homeopathy (20121101, 121-128 © 2012 The Faculty of Homeopathy doi:l0.1016/).homp.2012.02.001, available online at http://www.sciencedirect.com DEBATE The biopsychosocial model and its potential for a new theory of homeopathy* Josef M Schmidt* Institute of Ethics, History, and Theory of Medicine, University of Munich, Germany Since the nineteenth century the theory of conventional medicine has been developed in close alignment with the mechanistic paradigm of natural sciences. Only in the twenti­ eth century occasional attempts were made to (re)introduce the 'subject' into medical theory, as byThure von Uexküll (1908-2004) who elaborated the so-called biopsychoso­ cial model ofthe human being, trying to understand the patient as a unit of organic, men­ tal, and social dimensions of life. Although widely neglected by conventional medicine, it is one of the most coherent, significant, and up-to-date models of medicine at present. Being torn between strict adherence to Hahnemann's original conceptualization and alienation caused by contemporary scientific criticism, homeopathy today still Iacks a generally accepted, consistent, and definitive theory which would explain in scientific terms its strength, peculiarity, and principles without relapsing into biomedical reduc­ tionism. The biopsychosocial model of the human being implies great potential for a new theory of homeopathy, as may be demonstrated with some typical examples. Homeopathy (2012) 101, 121-128. Keywords: Thure von Uexküll; Jakob von Uexküll; Samuel Hahnemann; Homeopathy; Theory of medicine; Biopsychosocial model lntroduction to modern means of transportation and communication. And we are aware of the many prestigious discoveries in To suggest an option for a new theory of medicine does cosmology and atomic physics, through space exploration not necessarily mean to invalidate all previous or existing or particle accelerators.
    [Show full text]
  • The Need for a New Medical Model: a Challenge for Biomedicine
    ENGEL CLASSIC ARTICLE: A CHALLENGE FOR BIOMEDICINE CLASSIC ARTICLE The Need for a New Medical Model: A Challenge for Biomedicine George L. Engel At a recent conference on psychiatric education, many psychiatrists seemed to be saying to medicine, “Please take us back and we will never again deviate from the ‘medical model.’” For, as one critical psy- chiatrist put it, “Psychiatry has become a hodgepodge of unscientific opinions, assorted philosophies and ‘schools of thought,’ mixed meta- phors, role diffusion, propaganda, and politicking for ‘mental health’ and other esoteric goals” (1). In contrast, the rest of medicine appears neat and tidy. It has a firm base in the biological sciences, enormous technologic resources at its command, and a record of astonishing achievement in elucidating mechanisms of disease and devising new treatments. It would seem that psychiatry would do well to emulate its sister medical disciplines by finally embracing once and for all the medical model of disease. But I do not accept such a premise. Rather, I contend that all medicine is in crisis and, further, that medicine’s crisis derives from the same basic fault as psychiatry’s, namely, adherence to a model of disease no longer adequate for the scientific tasks and social responsibilities of either medicine or psychiatry. The importance of how physicians conceptualize disease derives from how such con- cepts determine what are considered the proper boundaries of pro- fessional responsibility and how they influence attitudes toward and behavior with patients. Psychiatry’s crisis revolves around the ques- tion of whether the categories of human distress with which it is con- cerned are properly considered “disease” as currently conceptualized and whether exercise of the traditional authority of the physician is Reprinted with permission.
    [Show full text]
  • The Biopsychosocial Model in Anglo-American Psychiatry: Past, Present and Future?
    Journal of Mental Health (2002) 11, 6, 585–594 The biopsychosocial model in Anglo-American psychiatry: Past, present and future? DAVID PILGRIM Lancashire Care NHS Trust & Department of Sociology, Social Policy and Social Work, University of Liverpool Abstract The biopsychosocial model in Anglo-American psychiatry is appraised. Its content and history are described and its scientific and ethical strengths noted. It is situated in relation to competing approaches in the profession, especially an older but enduring biomedical model. The tensions provoked by the latter, in relation to ‘anti-psychiatry’, the users’ movement and ‘critical psychiatry’ are explored, as a context in which the biopsychosocial model has both emerged and been constrained. At the end of the paper, reasons for the relative lack of success of the model are discussed and its future prospects assessed. Introduction He argued that for psychiatry to generate a fully scientific and inclusive account of men- This paper will appraise the current status tal disorder, bio-reductionist accounts should of the biopsychosocial model in Anglo- be superseded by ones which adhere to the American psychiatry. The term insights of general systems theory, devel- ‘biopsychosocial model’ (for brevity in most oped by the biologists Ludwig von Bertalanffy of this paper ‘BPS model’) is familiar to most and Paul Weiss. This entails accepting the mental health workers. However, its formal following assumptions: status and practical success will be exam- 1. Mental disorders (like other medical con- ined, in order to assess whether or not it ditions) emerge within individuals who remains an important organising framework are part of a whole system.
    [Show full text]
  • Explanations for Offending (Study Group on the Transitions Between Juvenile Delinquency and Adult Crime)
    The author(s) shown below used Federal funds provided by the U.S. Department of Justice and prepared the following final report: Document Title: Bulletin 3: Explanations for Offending (Study Group on the Transitions between Juvenile Delinquency and Adult Crime) Author(s): Terence P. Thornberry, Peggy C. Giordano, Christopher Uggen, Mauri Matsuda, Ann S. Masten, Erik Bulten, Andrea G. Donker, David Petechuk Document No.: 242933 Date Received: July 2013 Award Number: 2008-IJ-CX-K402 This report has not been published by the U.S. Department of Justice. To provide better customer service, NCJRS has made this Federally- funded grant report available electronically. Opinions or points of view expressed are those of the author(s) and do not necessarily reflect the official position or policies of the U.S. Department of Justice. Series: Study Group on the Transitions between Juvenile Delinquency and Adult Crime Award #2008-IJ-CX-K402 Rolf Loeber David Farrington This project was supported by Award No. #2008-IJ-CX-K402 awarded by the National Institute of Justice, Office of Justice Programs, U.S. Department of Justice. The opinions, findings, and conclusions or recommendations expressed in this publication/program/exhibition are those of the author(s) and do not necessarily reflect those of the Department of Justice. NIJ defines publications as any planned, written, visual or sound material substantively based on the project, formally prepared by the grant recipient for dissemination to the public. This document is a research report submitted to the U.S. Department of Justice. This report has not been published by the Department.
    [Show full text]
  • Biopsychosocial Model – the Integrated Approach to Health and Disease
    Coll. Antropol. 33 (2009) 1: 303–310 Professional paper Biopsychosocial Model – The Integrated Approach to Health and Disease Mladen Havelka, Jasminka Despot Lu~anin and Damir Lu~anin Department of Health Psychology, University of Applied Health Studies, Zagreb, Croatia ABSTRACT The biomedical model of health and disease dominates in current medical practice. The model attributes key role to biological determinants and explains disease as a condition caused by external pathogens or disorders in the functions of organs and body systems. Such an approach has its historic justification and has proved effective in the control of mas- sive infectious diseases. However, now that chronic non-infectious diseases prevail, its efficacy has not only become ques- tionable, but also the issue has been raised of its economic justification. The extension of biomedical approach and attri- bution of equal importance to psychosocial factors have become an imperative in the improvement of treatment efficacy and disease control, together with humanisation of relations between health staff and patients. A new biopsychosocial model has been suggested, that takes into account all relevant determinants of health and disease and that supports the integration of biological, psychological and social factors in the assessment, prevention and treatment of diseases. It does not diminish the significance of biological factors, but extends a rather narrow approach. The biopsychosocial model served as incentive for many studies o how psychological and social factors influence the development, course and out- come of a disease, giving rise to the development of interdisciplinary field – particularly the fields of health psychology and psychoneuroimmunology. Their contribution to better understanding of the impact of psychosocial factors on health stimulates greater interest of medical theory and practice in more holistic approach to a patient.
    [Show full text]
  • Relationships Between Psychological Factors, Disability, Quality of Life and Health in Chronic Pain Disorders
    Linköping University Medical Dissertations No. 1079 Relationships between Psychological Factors, Disability, Quality of Life and Health in Chronic Pain Disorders Björn Börsbo Rehabilitation Medicine, Department of Clinical and Experimental Medicine, Faculty of Health Sciences Linköping University, SE-581 85 Sweden Linköping 2008 © Björn Börsbo Cover Design: Johan Werner Printed in Sweden by LiU-Tryck, Linköping, Sweden 2008. ISBN: 978-91-7393-797-9 ISSN 0345-0082 2 To my mother Karin 3 4 CONTENTS ABSTRACT 7 ABBREVIATIONS 8 ORIGINAL PAPERS 9 INTRODUCTION 10 Defining chronic pain 10 The extent of the chronic pain problem 10 The Biopsychosocial model of pain 10 The neurobiology of chronic pain 11 Neuromatrix 12 Stress and somatic symptoms 12 ICF 14 The diathesis-stress model 15 The chronic pain conditions included in this thesis 16 Psychological factors related to chronic pain 17 Depression 17 Anxiety 17 Catastrophizing 18 Self-efficacy 18 Quality of Life and Health 18 Conclusions of the introduction 19 AIMS OF THE THESIS 20 SUBJECTS AND METHODS 22 Subjects 22 Methods 22 Data collection 22 Statistical analyses 27 RESULTS 34 Study I 34 Study II 37 Study III 42 Study IV 45 DISCUSSION 49 Methodological considerations 49 Data collection 49 Statistics 50 General discussions of the results 51 Generalization of chronic pain 51 Neurobiological mechanisms 51 Prevalence of chronic widespread pain 51 Consequences of widespread pain 52 Widespread pain in a multivariate context 52 Pain intensity and duration 53 The perception of pain intensity 53 Pain
    [Show full text]
  • “Biopsychosocial” Model in Health Psychology: Towards an Integrated Approach and a Critique of Cultural Conceptions
    Open Journal of Medical Psychology, 2012, 1, 51-62 http://dx.doi.org/10.4236/ojmp.2012.14009 Published Online October 2012 (http://www.SciRP.org/journal/ojmp) The Status of the “Biopsychosocial” Model in Health Psychology: Towards an Integrated Approach and a Critique of Cultural Conceptions Andrew R. Hatala Department of Psychology, University of Saskatchewan, Saskatoon, Canada Email: [email protected] Received July 10, 2012; revised August 20, 2012; accepted September 13, 2012 ABSTRACT The current status of the “Biopsychosocial” Model in health psychology is contested and arguably exists in a stage of infancy. Despite original goals, medical researchers have developed theoretical and empirical integrations across bio-psycho-social domains only to a limited extent. This review article addresses this issue by making connections across research findings in health psychology and related medical fields in order to strengthen the associations across bio-psycho-social domains. In particular, research in sociosomatics, neuroplasticity and psychosocial genomics are in- troduced and explored. The role of “culture” as conceived of within the Biopsychosocial Model is also ambiguous and somewhat problematic. Arthur Klienman’s conceptions of culture as what is at stake for individuals in their local social and moral worlds is adopted to offer a critique of previous perspectives of culture and question its role amidst bio-psycho-social domains. Overall, a multilevel integrative or “holistic” perspective is advanced to strengthen the Bi- opsychosocial
    [Show full text]
  • Untangling the Causal Relationships Among Biopsychosocial Variables
    Pathways to well-being: Untangling the causal relationships among biopsychosocial variables N. Karunamuni1*, I. Imayama2, D. Goonetilleke3 1Centre for Healthy Communities, School of Public Health, University of Alberta, 3-300 Edmonton Clinic Health Academy, 11405 – 87 Ave, Edmonton, Alberta, Canada. 2Division of Pulmonary, Critical Care, Sleep and Allergy, University of Illinois at Chicago, 840 S Wood St. MC719, Chicago, IL, 60612, USA 3Minnesota State University, Mankato, Department of Counseling and Student Personnel, 107 Armstrong Hall, Mankato, MN 56001, USA *Corresponding author: Nandini D. Karunamuni E-mail: [email protected] [The final format of this article is published in the journal Social Science & Medicine. Article doi: https://doi.org/10.1016/j.socscimed.2020.112846 ] 1 Introduction The biopsychosocial (BPS) model of health and illness proposed by George L. Engel (1913–1999) is a popular interdisciplinary framework (Engel, 1977) that remains influential today (Davies and Roache, 2017; Johnson and Acabchuk, 2018). This model challenged and broadened the historically dominant biomedical model by taking into consideration biological and social factors as well as an individual’s lived experiences (i.e., psychological factors relevant to an individual) that can influence health and illness (Davies and Roache, 2017; Wade and Halligan, 2017). While the BPS model currently serves as a useful clinical and teaching function in medicine and its heuristic implications appears to have reached general agreement (Davies and Roache, 2017; Wade and Halligan, 2017), a growing body of literature has been highly critical of the model for being too vague, and for not providing details as to how BPS factors interact to influence health and illness (Benning, 2015; Farre and Rapley, 2017; Ghaemi, 2010).
    [Show full text]
  • Biological, Psychological, and Social Profiles That Predict Depression
    University of Pennsylvania ScholarlyCommons Publicly Accessible Penn Dissertations 2016 Biological, Psychological, And Social Profiles That Predict Depression And/or Anxiety In Adolescents Aged 12-17 Years Identified Via Secondary Analysis Of The 2011-2012 National Survey Of Children's Health Lakeetra Mcclaine Josey University of Pennsylvania, [email protected] Follow this and additional works at: https://repository.upenn.edu/edissertations Part of the Nursing Commons Recommended Citation Josey, Lakeetra Mcclaine, "Biological, Psychological, And Social Profiles That Predict Depression And/or Anxiety In Adolescents Aged 12-17 Years Identified Via Secondary Analysis Of The 2011-2012 National Survey Of Children's Health" (2016). Publicly Accessible Penn Dissertations. 2374. https://repository.upenn.edu/edissertations/2374 This paper is posted at ScholarlyCommons. https://repository.upenn.edu/edissertations/2374 For more information, please contact [email protected]. Biological, Psychological, And Social Profiles That Predict Depression And/or Anxiety In Adolescents Aged 12-17 Years Identified Via Secondary Analysis Of The 2011-2012 National Survey Of Children's Health Abstract Depression and/or anxiety among adolescents aged 12-17 year are on the rise and increase the risk of negative outcomes that persist into adulthood. Current prevalence reports of depression in adolescents are based on dated analyses and do not include the often comorbid anxiety. The purpose of the study was to identify biological, psychological, and social factors that predict depression and/or anxiety in adolescents aged 12-17 years through a secondary analysis of data from the 2011-2012 National Survey of Children’s Health. The sample size for this study was 34,601 adolescents aged 12 – 17 of which, 2,405 had current depression and/or anxiety.
    [Show full text]
  • The Biopsychosocial Model of Addiction Monica C
    CHAPTER 6 The Biopsychosocial Model of Addiction Monica C. Skewes*, Vivian M. Gonzalez$ *University of Alaska Fairbanks, Fairbanks, AK, USA, $University of Alaska Anchorage, Anchorage, AK, USA OUTLINE Biopsychosocial vs. Biomedical Models of Addiction 61 Spouses and Intimate Partners 67 Other Individual Difference Variables that Influence Conceptual Models of Addictive Behavior 62 Substance Use 67 Biopsychosocial Model of Addiction 62 Ethnicity and Culture 67 Gender 67 Biological Factors and the Development of Environmental Influences on Substance Use 67 Addictive Behaviors 63 The Biopsychosocial Model and Addiction Psychosocial Factors and the Development of Treatment 68 Addictive Behaviors 64 Natural Recovery 68 Risk Factors in Children 64 Medication 68 Personality and Temperament 64 Classical and Operant Conditioning 64 Psychosocial Factors in the Treatment of Addiction 69 Outcome Expectancies 65 Readiness to Change 69 Self-efficacy 66 Self-efficacy 69 Social Influences on Substance Use 66 Summary 69 Families 66 Peers 66 BIOPSYCHOSOCIAL VS. BIOMEDICAL Contemporary medical disease models acknowledge the MODELS OF ADDICTION influence of social, psychological, and behavioral dimensions of addiction; however, these dimensions The biopsychosocial model of addiction posits that are viewed as relatively less important in the etiology biological/genetic, psychological, and sociocultural and treatment of addiction. The medical disease model factors contribute to substance use and all must be taken favors reductionism, whereby underlying biomedical into consideration in prevention and treatment efforts. causes for addiction are primarily implicated in the This model emerged in response to criticisms of the etiology/cause of the disorder, and mind–body dualism, biomedical model, which has historically dominated where the mind and the body are viewed as separate the field of addiction studies.
    [Show full text]
  • The Biopsychosocial Model of Medicine: Implications for the Future of Healthcare
    University of Northern Iowa UNI ScholarWorks Presidential Scholars Theses (1990 – 2006) Honors Program 2004 The biopsychosocial model of medicine: Implications for the future of healthcare Abby M. Luensmann University of Northern Iowa Let us know how access to this document benefits ouy Copyright ©2004 Abby M. Luensmann Follow this and additional works at: https://scholarworks.uni.edu/pst Part of the Medicine and Health Sciences Commons Recommended Citation Luensmann, Abby M., "The biopsychosocial model of medicine: Implications for the future of healthcare" (2004). Presidential Scholars Theses (1990 – 2006). 106. https://scholarworks.uni.edu/pst/106 This Open Access Presidential Scholars Thesis is brought to you for free and open access by the Honors Program at UNI ScholarWorks. It has been accepted for inclusion in Presidential Scholars Theses (1990 – 2006) by an authorized administrator of UNI ScholarWorks. For more information, please contact [email protected]. • The Biopsychosocial Model of Medicine: Implications for the Future of Healthcare Presidential Scholar Senior Thesis Abby M. Luensmann Advisor: Francisco Barrios, Ph.D. University of Northern Iowa • .. 2 Introduction The science of medicine is changing at an incredible rate. New treatments, technologies, and biologically-based discoveries seem to occur almost daily. In fact, the health care business has evolved into the largest service industry in the United States, grossing more than $1 trillion annually (Taylor, 2003). Despite the obvious attention paid to health-related
    [Show full text]