Biopsychosocial model

The biopsychosocial model is a concept for understanding health and illness, addressing biology, psychology, and social factors.

History

The biopsychosocial model was proposed by George L. Engel in 1977 to better reflect the development of illness through the complex interaction of biological factors (genetic, biochemical, etc), psychological factors (mood, personality, behavior, etc.), and social factors (cultural, familial, socioeconomic, medical, etc.).[1][2] The model provides a blueprint for research, a framework for teaching, and a design for action in the real world of health care.[3]

The proposal of the model was in reaction to the perceived lack of science being used in psychiatry at the time and the reductionist approach used in other medicine fields—neither of which were adequate for treating illness.[1] In developing the model, Engel noted that it needed to be equally applicable for illnesses, rather than being for either physical or psychological problems. By considering both in the same terms, it became obvious that both the inclusion of somatic and psychosocial factors were indispensable and the exclusion of either would impact on patient care.

Criticisms

There have been a number of criticisms of the biopsychosocial model. Benning summarised the arguments against the model including that it lacked philosophical coherence, was insensitive to patients' subjective experience, was unfaithful to the general systems theory that Engel claimed it be rooted in, and that it engendered an undisciplined eclecticism that provides no safeguards against either the dominance or the under-representation of any one of the three domains of bio, psycho, or social.[4] Some have argued that the approach borders on anarchy because of the suggestion that the target and focus on intervention is determined by the practitioner based on personal preference.[5] Finally, some became reductionistic about the model itself, attempting to predict small parts of one aspect to predict the functioning in one field of medicine, for example psychiatry.[6]

Application

As of 2018, the biopsychosocial model had been applied across several fields of healthcare including pain,[7] adolescent health,[8] diabetes,[9] sleepwalking,[10] gambling,[11] and hypothyroidism.[12]

See also

References

  1. 1 2 Engel, GL (8 April 1977). "The need for a new medical model: a challenge for biomedicine". Science. 196 (4286): 129–36. PMID 847460.
  2. ↑ Engel G. L. (1980). "The clinical application of the biopsychosocial model". American Journal of Psychiatry. 137 (5): 535–544. doi:10.1176/ajp.137.5.535. PMID 7369396.
  3. ↑ Engel, George L. (6 July 2009). "The Need for a New Medical Model: A Challenge for Biomedicine". Holistic Medicine. 4 (1): 37–53. doi:10.3109/13561828909043606.
  4. ↑ Benning, TB (2015). "Limitations of the biopsychosocial model in psychiatry". Advances in Medical Education and Practice. 6: 347–52. doi:10.2147/AMEP.S82937. PMC 4427076. PMID 25999775.
  5. ↑ Ghaemi, SN (July 2009). "The rise and fall of the biopsychosocial model". The British Journal of Psychiatry. 195 (1): 3–4. doi:10.1192/bjp.bp.109.063859. PMID 19567886.
  6. ↑ McLaren, N (February 1998). "A critical review of the biopsychosocial model". The Australian and New Zealand Journal of Psychiatry. 32 (1): 86–92, discussion 93–6. doi:10.3109/00048679809062712. PMID 9565189.
  7. ↑ Gatchel, RJ; Peng, YB; Peters, ML; Fuchs, PN; Turk, DC (July 2007). "The biopsychosocial approach to chronic pain: scientific advances and future directions". Psychological Bulletin. 133 (4): 581–624. doi:10.1037/0033-2909.133.4.581. hdl:10106/5000. PMID 17592957.
  8. ↑ Dodge, KA; Pettit, GS (March 2003). "A biopsychosocial model of the development of chronic conduct problems in adolescence". Developmental Psychology. 39 (2): 349–71. PMC 2755613. PMID 12661890.
  9. ↑ Peyrot, M; McMurry JF, Jr; Kruger, DF (June 1999). "A biopsychosocial model of glycemic control in diabetes: stress, coping and regimen adherence". Journal of Health and Social Behavior. 40 (2): 141–58. doi:10.2307/2676370. JSTOR 2676370. PMID 10467761.
  10. ↑ Stallman, HM; Bari, A (March 2017). "A biopsychosocial model of violence when sleepwalking: review and reconceptualisation". BJPsych Open. 3 (2): 96–101. doi:10.1192/bjpo.bp.116.004390. PMC 5405419. PMID 28446961.
  11. ↑ Sharpe, L (February 2002). "A reformulated cognitive-behavioral model of problem gambling. A biopsychosocial perspective". Clinical Psychology Review. 22 (1): 1–25. doi:10.1016/S0272-7358(00)00087-8. PMID 11793575.
  12. ↑ Brown, BT; Bonello, R; Pollard, H (12 April 2005). "The biopsychosocial model and hypothyroidism". Chiropractic & Osteopathy. 13 (1): 5. doi:10.1186/1746-1340-13-5. PMC 1151653. PMID 15967049.
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