The Biopsychosocial Model of Health

This models looks at the biological, psychological and social factors that are associated with health and illness.

The Biopsychosocial model does not look for single causes, but starts from the assumption that health and illness has many causes, and also produces many effects.

The Biopsychosocial Model of Health

The Biopsychosocial model looks at three systems: the social system (i.e. family), the psychological system (i.e. behaviour) and the biological system (i.e. organs).

One biological system that has received a lot of attention from psychologists and physicians is the immune system, which is a collection of responses that allow the body to neutralise, eliminate or control the factors that produce disease. It seems possible that there are connections between the immune system and the experience of stress which would fit into an individual’s psychological systems. The experience of stress is also affected by the social systems an individual lives in – for example, their family.

The development of this Biopsychosocial model moves the emphasis away from traditional Western medicine and towards psychology.

Psychological Definitions For Health Psychology

Substance Misuse – is when a drug – defined as a mind-altering substance – is used in such a way that the individual’s physical and mental health is affected.

Synapse – a gap between two neurons where information can be passed from one to another.

Tolerance – where a drug user becomes used to a particular level of drug so that more and more is required to maintain the effect.

Physical Dependence – when the brain can no longer function normally without a drug supplementing the neurotransmitter level.

Psychological Dependence – a compulsion to take a drug for the pleasant effects it has, such as feeling of exhilaration or self-confidence. It may lead to misuse. This does not produce withdrawal effects.

Withdrawal – when an individual refrains from taking a drug (after becoming physically-dependent), they experience symptoms.

How Neurotransmitters Are Passed From One Neuron To Another

Communication between two neurons begins when an electrical impulse, called an action potential, travels along the axon of a presynaptic neuron towards the axon terminal. Neurotransmitters drift across the synaptic space and bind to receptors on the post-synaptic neuron. The binding of the neurotransmitter to its receptor can trigger an action potential in the post-synaptic neuron. Now that the neurotransmitter has relayed its message, it releases from the receptor into the synaptic space. Some of the neurotransmitters degrade, while others are carried back into the synaptic space (re-uptake).

Neurotransmitters passing from one neuron to the other

https://www.youtube.com/watch?v=p5zFgT4aofA

The Work Of The Health Psychologist

Health psychologists work with health professionals, such as doctors, dentists, occupational therapists and dieticians. They may carry out clinical work themselves (e.g. counselling), ore may undertake research. They are often involved in health promotion campaigns and their role is as much about prevention as cure.

When carrying out research, health psychologists use methods, such as experiments, longitudinal studies, cross-sectional studies, and case studies.

Health Psychologists deal with:

• Disease (such as heart problems)
• Substance misuse
• Social support
• Emotional state

Did You Know?

The word ‘health’ comes from an Anglo-Saxon term meaning ‘wholeness’.

Types of Neurotransmitters

Monoamine Neurotransmitters:

DOPAMINE: ——— > Pleasure

Insufficient dopamine produces the symptoms of Parkinson’s disease, while an excess amount of dopamine is associated with paranoia. It is one of the neurotransmitters related to ‘feeling good’ as a pulse of activity through the dopamine system in the brain is linked to feeling happy, even euphoric. This is called the reward system.

NORADRENALIN: ——-> ‘Fight or Flight’ Mechanism

Noradrenalin in the bloodstream is linked with adrenalin in the fight-flight mechanism. It is also found in the brain as a neurotransmitter where it boosts attention and one’s ability to focus and is also linked to mood.

SEROTONIN ——-> Emotions

This is closely linked to emotions and there is evidence that an incorrect level can make one feel depressed, angry or aggressive.

Other neurotransmitters:

ENDORPHINS

The body’s natural opiates, they have two different effects:

– They are inhibitory neurotransmitters, occupying and therefore blocking receptor sites for pain.

– Make one feel good through the stimulation of the dopamine reward system.

GABA: ——> slows everything down

This is the most important inhibitory neurotransmitter. It makes it more difficult for messages to be transmitted from one synapse to another. It slows neural activity, so is referred to as a depressant.

What Is Health Psychology?

Health psychology is the application of psychological knowledge to the promotion and maintenance of health, the avoidance, diagnosis and treatment of illness and the improvement of health care provision.

It combines the study of the biological bases of behaviour, the way cognition affects how individuals behave and the social aspects of behaviour.

Health psychology centres heavily on the BIOLOGICAL APPROACH.

Schizophrenia: The Dopamine Hypothesis

There are several explanations for the development of schizophrenia. One of these arguments originates from the Biological Approach, namely the dopamine hypothesis. This theory argues that the symptoms of schizophrenia are related to the increased level or excessive amount of dopamine neurotransmitter in the brain. For example, hallucinations (a positive symptom) may be a result of too much dopamine being active in the brain.

A strength of this explanation is provided by Grilly (2002), who proposed that when individuals who suffered from Parkinson’s disease, were given the drug L-dopa to increase the level of dopamine, they began to show psychotic symptoms. Therefore this may suggest strong evidence towards high levels of dopamine or excess dopamine in the brain, being responsible for many of the symptoms of psychosis. Post-mortem findings by Seeman and Kapur (2001) have involved an increased level of dopamine and significantly more dopamine receptors in the brains of deceased schizophrenic sufferers, especially in the limbic areas of the brain. Owen et al (1986) found the same results however in his study on post-mortems; he established that the patients had been on antipsychotic drugs for many years.

As well as the strengths of this explanation of schizophrenia, there are also weaknesses which should be considered. A major problem with the dopamine hypothesis is that it only takes into account a single neurotransmitter and therefore does not consider the interaction of other neurotransmitters. Another limitation of this explanation is that it only serves to explain the positive symptoms of schizophrenia, and so dismissing the negative symptoms. While positive symptoms are seemingly caused by an excessive amount of dopamine in the brain, it has been suggested that negative symptoms are, in fact, caused by reduced dopamine activity (Thomas, 1997). Another limitation of this argument is that, while drugs alleviate positive symptoms of schizophrenia, they are not as effective with the negative symptoms.

Schizophrenia

Schizophrenia – a topic most people wouldn’t want to approach. Edexcel, however, do not take the same view on such a disorder. They want us A-Level Psychologists to know all the ins and outs of this illness! Once you begin to learn about it, though, it becomes a rather interesting topic.

What Is Schizophrenia?

Schizophrenia is a mental illness that can affect the way someone thinks, speaks or feels to such a degree that they lose focus on reality. There are a number of ways of characterising schizophrenia, including giving first and second-rank symptoms, or positive and negative symptoms.

In the 1890’s, schizophrenia was called dementia praecox, meaning ‘senility of youth’. This was because it was thought to be a type of mental deterioration that started in adolescence. However, it is not regarded in this way any longer. Schizophrenia does not discriminate – it can affect anyone, regardless of age, gender, ethnicity or social class.

Evaluation of Cultural Issues, Diagnosis and the DSM

Strengths:

– The DSM-IV-TR takes account of cultural issues in acknowledging culture-bound syndromes

– There has been an attempt to remove focus from bizarre symptoms in schizophrenia, as it was acknowledged that such symptoms are open to interpretation and that there are cultural issues in such interpretations.

Weaknesses:

– Other feature of symptoms of schizophrenia that are listed in the DSM could lead to cultural bias. ‘First-rank’ symptoms (like ‘bizarreness’) should perhaps receive less emphasis.

– Negative symptoms of schizophrenia are more objectively measured, and so should be given greater attention. In practise, the focus is on positive symptoms.

– There might be some cultural differences in the symptoms of schizophrenia (i.e. auditory hallucinations), so these should be considered separately rather than as elements of a range of symptoms.

Source:

– Brain, C. (2009). Edexcel A2 psychology. London: Philip Allan.

Bias In Diagnosis: Gender and Ethnicity

Some have argued that diagnosis may be affected by factors, such as gender, ethnicity and social class. This means that the label attached by the psychiatrist may have been influenced by things other than the symptoms presented.

Ethnicity: The Case of Calvin

Littlewood and Lipsedge (1997) have suggested that the reason why black and Irish people in Britain are more likely than others to receive a diagnosis of serious mental disorder has more to do with bias in the system than a genuine greater vulnerability in those groups. They describe the case of Calvin, a Jamaican man arrested following an argument with the police when a post office clerk believed he was cashing a stolen postal order (an accusation which later proved to be false). The following was recorded by a British prison psychiatrist:

“This man belongs to Rastafarian – a mystical, Jamaican cult, the members of which think they are God-like. The man has ringlet hair, a straggly goatee beard and a type of turban. He appears very eccentric in his appearance and very vague in answering questions. He is an irritable character and has got arrogant behaviour.”

The aforementioned shows the ignorance within psychiatry; the suggestion is that anyone who appears different MUST have something wrong with them.

Fernando (1992) also provides an insight into diagnosis and bias:

– Over-diagnosis of schizophrenia among West Indian and Asian British. This means for the same symptoms, disproportionately more individuals from these groups were diagnosed as schizophrenic rather than any other illness.

– Excessive admission of ‘offender patients’ among West Indian British. Individuals in this group were more likely to be put into prison than in hospital.

– Excessive use of compulsory admission for West Indian British. Research in South London found that Black patients were three times more likely to be institutionalised than Whites.

It is important to emphasise that the differences are not due to differences in the prevalence of mental illness among the ethnic groups – it is a product of the bias in the mental health system.

Gender:

Similarly, this argument links to the second type of bias in the mental health system – women. Lloyd (1991) noted that women made up 4% of the prison population, but 20% of the population of the Special Psychiatric Hospitals. Women who are aggressive, addicts or living rough are more likely to be diagnosed as anti-social personality disorder than men in the same situation.