PS1816 / 7

• What is the biomedical model of illness?

  The biomedical model only considers the biological, physical aspects of an illness and largely ignores psychological or social factors.
• Who developed the concept of psychosomatic medicine?

  Franz Alexander, a student of Freud in the early 20th century
• What did psychosomatic medicine suggest?

  Illness can have psychological causes as well as consequences
• Who formulated the biopsychosocial model?

  George Engel (1913-1999)
• What did George Engel suggest about the biopsychosocial model?

  All three levels, biological, psychological, and social, must be taken into account in every health care task
• What is the mainstream ideology in contemporary psychiatry?

  Biopsychosocial models
• What do biopsychosocial models suggest about the causes of disorders?

  Disorders (psychological and physical disorders) are caused by a combination of biological, psychological, and social factors
• How do biopsychosocial models differ from the biomedical model?

  Biopsychosocial models provide a more holistic, humanistic and pragmatic framework than the biomedical model
• What are the key differences between the biomedical and biopsychosocial models of illness?

  Biomedical Model:

  • Only considers biological, physical aspects of illness
  • Individuals are not responsible for illness
  • Treats illness by changing the physical state of the body
  • Medical profession is solely responsible for treatment

  
  

  Biopsychosocial Model:

  • Considers biological, psychological and social causes of illness
  • Individuals may have some responsibility for illness
  • Treats the whole person, not just physical changes
  • Medical profession and individual share responsibility for treatment
• What is the relationship between health and illness in the biomedical model?

  They exist on a continuum
• What is the relationship between the mind and body in the biomedical model?

  They are separate but interact
• What is the role of psychology in health and illness in the biomedical model?

  Illness can have psychological consequences but not causes
• What are the key differences between the biomedical and biopsychosocial models in terms of the relationship between health/illness, mind/body, and the role of psychology?

  Biomedical Model:

  • Health and illness exist on a continuum
  • Mind and body are separate but interact
  • Psychology can have consequences for illness but not causes

  
  

  Biopsychosocial Model:

  • Health and illness are distinct
  • Mind and body function independently
  • Psychological factors contribute to all stages of health and illness
• What are the five key factors in the biopsychosocial model of illness?

  Genes, brain, biological factors, social/environmental factors, and psychological factors
• How are the factors in the biopsychosocial model related?

  The relationships between the factors are multidirectional
• According to the biopsychosocial model, how would you research the causes of a disorder?

  You would generally increase the social component to include all environmental factors, as these can have a direct effect on biological factors
• How does the biopsychosocial model view the relationships between the different factors that contribute to illness?

  • The relationships between biological, psychological, and social factors are multidirectional
  • Each factor can interact with and influence the others
  • Research should consider the complex interplay of all three types of factors
• What are some of the advantages and disadvantages of the biopsychosocial model?

  Advantages: Allows for individualized treatment, disadvantages: can lead to therapists picking treatments based on personal opinion rather than evidence
• What is the "more is better" fallacy in relation to the biopsychosocial model?

  The belief that adding more and more perspectives will get closer to the truth, when sometimes reductionism is not wrong
• What are some of the practical difficulties in applying the biopsychosocial model?

  Difficulties include sample size, recruiting appropriate samples, and the high cost of research that looks at all biological, psychological and social factors
• What are some of the key advantages and disadvantages of the biopsychosocial model?

  Advantages:

  • Allows for individualized, eclectic treatment approaches
  • Provides a more holistic, humanistic framework than the biomedical model

  
  

  Disadvantages:

  • Can lead to therapists choosing treatments based on personal opinion rather than evidence
  • Practical difficulties in conducting research that examines all biological, psychological and social factors
  • Potential for the "more is better" fallacy - the belief that adding more perspectives will always improve understanding
• What is the diathesis-stress model of psychopathology?

  The diathesis-stress model suggests that some people have a predisposition to a mental illness, and that the occurrence of a stressor will cause the disorder to manifest
• How does the diathesis-stress model relate to the biopsychosocial model?

  The diathesis-stress model is somewhat similar to the biopsychosocial model, as it also emphasizes the interdependence of biological, psychological, and social factors
• How does the diathesis-stress model explain the development of a disorder?

  Someone with a strong predisposition (diathesis) will only require a small stressor to cause the disorder to manifest, while someone with a weaker predisposition will require a greater stressor
• How does the diathesis-stress model relate to the biopsychosocial model?

  • The diathesis-stress model is somewhat similar to the biopsychosocial model, as they both emphasize the interdependence of biological, psychological, and social factors
  • However, the diathesis-stress model specifically suggests that some people have a predisposition (diathesis) to a mental illness, which then manifests when they experience a stressor
  • This is a more specific model than the broader biopsychosocial approach
• What is the dopamine hypothesis of schizophrenia?

  The symptoms of schizophrenia are caused by an excess of dopamine in the brain
• What evidence supports the dopamine hypothesis of schizophrenia?

  Post-mortems of schizophrenics show higher than normal levels of dopamine in the limbic system, and anti-schizophrenic drugs inhibit dopamine receptors
• What are some limitations of the dopamine hypothesis of schizophrenia?

  The evidence is inconclusive, as there is no consistent difference in dopamine levels between non-clinicals and schizophrenics, and the direction of the relationship is unclear
• What is the dopamine hypothesis of schizophrenia and what are some of its limitations?

  Dopamine Hypothesis:

  • Suggests the symptoms of schizophrenia are caused by an excess of dopamine in the brain
  • Supported by evidence of higher dopamine levels in post-mortems of schizophrenics and the effects of anti-schizophrenic drugs

  
  

  Limitations:

  • Evidence is inconclusive, with no consistent differences in dopamine levels between schizophrenics and non-clinicals
  • The direction of the relationship between dopamine and schizophrenia is unclear
  • The dopamine hypothesis may only explain some forms of schizophrenia, not all
• What is the genetic theory of schizophrenia?

  Schizophrenia has heritability levels comparable to other medical conditions known to have strong genetic components
• What evidence supports the genetic theory of schizophrenia?

  Concordance studies have found that the probability of a family member developing schizophrenia depends on how closely they are related to the individual, ranging from 1% for spouses to 44% for monozygotic twins
• What is the genetic theory of schizophrenia and what evidence supports it?

  Genetic Theory of Schizophrenia:

  • Schizophrenia has heritability levels comparable to other medical conditions with strong genetic components
  • Concordance studies have found that the probability of a family member developing schizophrenia depends on how closely they are related to the individual, ranging from 1% for spouses to 44% for monozygotic twins
  • This suggests genetics play an important role in the development of schizophrenia
• What are the key psychological approaches to understanding schizophrenia?

  The cognitive approach, which focuses on dysfunctional psychological processes, and the theory of mind deficits approach
• What does the cognitive approach to schizophrenia suggest?

  Schizophrenia is caused by a breakdown in source monitoring and dysfunctional metacognitive beliefs about one's own mental processes