The Biopsychosocial Model Methodology and Systems of the

The Biopsychosocial Model, Methodology, and Systems of the Body 1 September 2, 2004

Overview The Emergence of Health Psychology The Biopsychosocial Model Methodology Systems of the Body • Nervous System • Endocrine System • Cardiovascular System • Respiratory System

The Emergence of Health Psychology Foundations for Contemporary Health Psychology In ancient times and the middle ages there was a belief that spiritual disturbances caused disease. The development of early Greek Medicine and the advent of the Renaissance brought about a focus on physical causes for disease. Scientific advances in microscopy and human anatomy further advanced medicine.

The Emergence of Health Psychology Foundations for Contemporary Health Psychology Psychoanalytic case studies revealed how anxiety and unconscious personality conflicts can manifest as physical symptoms. The study of psychosomatic medicine focused on diseaseprone personality types. The contemporary view focuses on the balance between physical and mental well-being in the context of the social environment.

U. S. Ten Leading Causes of Death (NVSR, 50(16), 2002) Cause of Deaths Percent of Total Deaths Diseases of the heart 710, 760 29. 6 Malignant Neoplasms 553, 091 23. 0 Cerebrovascular Diseases 167, 661 7. 0 CLRD 122, 009 5. 1 Accidents (unintentional injuries) 97, 900 4. 1 Diabetes 69, 301 2. 9 Influenza & Pneumonia 65, 313 2. 7 Alzheimer’s Disease 49, 558 2. 1 Kidney Disease 37, 251 1. 5 Septicemia 31, 224 1. 3 Total 2, 403, 351 100. 0

The Emergence of Health Psychology The Modern Problem Patterns of illness are changing. People are less likely to die from acute disorders and communicable disease (with the exception of AIDS). People are living longer with chronic diseases Chronic diseases: • Generally can be managed, not cured • Related to health behaviors and compliance with medical regimen • Living with chronic diseases has social and psychological consequences

The Emergence of Health Psychology Technological Advances Genetic counseling • Coping with potential health risks Patient counseling regarding life-sustaining measures Research in health psychology identifies risk-factors

The Emergence of Health Psychology Health Care Services • Health care is the largest service industry in the United States. • Prevention can reduce health care costs. • Most people in the U. S. are recipients of health care services. • Research on satisfaction with health care • Health psychologists are becoming more integrated into the medical context.

The Biopsychosocial Model Health and illness are consequences of the interplay of biological, psychological, and social factors. Systems Theory All levels of organization in any entity are linked hierarchically. Change at one level influences change in other levels • Changes on the microlevel can have macrolevel effects and vice versa.

The Biomedical Model • Dominant model for the past 300 years • All illness can be explained on the basis of aberrant somatic processes. Liabilities of the Biomedical Model • Reductionism – Illness is reduced to microlevel processes i. e. chemical imbalances. • Single-factor model – Illness is due to one factor: a biological malfunction. • Mind-body dualism – The mind and the body are separate entities. • Emphasis on illness over health

Advantages of the Biopsychosocial Model Health is determined by both microlevel and macrolevel processes (psychological and social factors). Multiple factors – a variety of factors are involved in health and illness. The mind and body are not separated when considering matters of health and illness. Emphasis on both health and illness.

Clinical Applications of the Biopsychosocial Model The process of diagnosis must consider the interaction of biological, psychological, and social factors. • Treatment recommendations must take these factors into account. The relationship between the patient and the health care practitioner has an impact on the effectiveness of care.

Areas of Focus In Health Psychology Health Promotion and Maintenance Prevention and Treatment of Illness Etiology (causes) and Correlates of Health and Illness Health Policy and Health Care Service Delivery

Contributions of Health Psychology Short-term behavioral interventions have been effective in helping patients to: • • Manage pain Modify bad health habits (such as smoking) Manage side effects and treatment effects when coping with chronic illness. Psychologists help ease the adjustment process for patients.

Methodology Experiments Randomized Clinical Trials Correlational Studies Comparing changes in variables Prospective Designs Looking forward, longitudinal research Retrospective Research Looking backward

Methodology Experiment A study where there is random assignment to treatment groups in an intervention focused on exercise and weight loss Correlation A study of the relationship between cultural identity and physical symptoms Prospective A study following the physical and mental health indicators outcomes of cancer patients 6 months, 1 year, and 2 years after chemotherapy Retrospective A study examining the past coping strategies of cardiac patients

Methodology Epidemiology The study of the frequency, distribution, and causes of infectious and noninfectious disease in a population based on an investigation of the physical and social environment

Methodology Morbidity refers to the number of cases of a disease that exist at some given point in time. • Incidence: the number of new cases • Prevalence: the total number of existing cases Mortality refers to the number of deaths due to a particular cause.

The Nervous System Central Nervous System • Brain and Spinal Cord • The brain is the command center Peripheral Nervous System • Somatic Nervous System • Autonomic Nervous System • Sympathetic Nervous System • Prepares the body to respond to emergencies • Plays an important role in reactions to stress • Is concerned with the mobilization of energy. A catabolic system • Parasympathetic Nervous System • Acts antagonistically with the sympathetic nervous system. • Restores the body to a normal state.

The Nervous System Neurotransmitters Chemicals that regulate nervous system functioning. • Catecholamines - the neurotransmitters, epinephrine and norepinephrine, that promote sympathetic nervous system activity. • The catecholamines are released in substantial quantities during stressful times.

The Nervous System Disorders of the Nervous System • Affect 25 million Americans • 12% of deaths are from nervous system disorders. • Epilepsy • Cerebral Palsy • Parkinson's Disease • Multiple Sclerosis • Huntington’s disease • Polio • Paraplegia, quadriplegia

The Endocrine System • Complements the nervous system in controlling bodily activities. • Make up of ductless glands which secrete hormones into the blood. • Governs slow-acting responses of long duration • Regulated by the hypothalamus and the pituitary gland

The Endocrine System Disorders Diabetes • Third most common chronic disorder in the U. S. • Body cannot manufacture and properly use insulin. • Primary forms of diabetes: • • Type I (juvenile diabetes) – insulin dependent, partly genetic Type II – lifestyle, especially obesity and stress, plays a major role, onset after age 40.

The Endocrine System • Diabetes is associated with: • Thickening of the arteries, leading to high rates of coronary heart disease. • Blindness, and is the leading cause of blindness in adults. • Kidney failure • Nervous system damage leading to pain and loss of sensation.

The Cardiovascular System • System consists of the heart, blood vessels and blood. • Arteries carry blood from the heart to other organs and tissues. • Veins return the blood to the heart after the oxygen has been used up.

The Cardiovascular System The Heart • Cardiac Cycle - Rhythmic phases of contraction and relaxation. • Systole Cycle - Blood is pumped out of the heart and so blood pressure inside the vessels increases. • Diastole Cycle - Blood pressure drops as the heart muscle relaxes and blood is taken into the heart.

The Cardiovascular System Disorders • Congenital Defects (present at birth) • Disorders Due to Infections • Lifestyle • • Diet Exercise Smoking Stress Exposure

The Cardiovascular System Disorders • Atherosclerosis – deposits of plaque in the arteries • Angina Pectoris (chest pain) • Myocardial infarction (heart attack) • Hypertension – chronically high blood pressure

The Cardiovascular System • Disorders Related to White Cell Production • Leukemia, leukopenia, leukocytosis • Disorders Related to Red Cell Production • Anemia, erythrocytosis, sickle-cell anemia • Clotting Disorders • Hemophilia, Clots (Thromboses) in blood vessels • Coronary thromboses, cerebral thromboses • Embolus (A clot that becomes detached)

The Respiratory System Functions of Respiration 1. To take in oxygen 2. To excrete carbon dioxide 3. To regulate the composition of the blood Organs Involved • Nose, mouth, pharynx, trachea, diaphragm, abdominal muscles, and lungs. • Inspiration is active; expiration is passive.

The Respiratory System Disorders • Asphyxia –lack of O 2, excess of CO 2 • Anoxia – lack of O 2 • Hyperventilation – excess of O 2 , lack of excess of CO 2 • Hay Fever – seasonal allergic reaction in which irritants enter the lungs prompting the body to produce histamines. • Asthma – more severe allergic reaction that may produce bronchial spasms and hyperventilation.

The Respiratory System Disorders • Viral Infections – Common cold, influenza • Bacterial Infections – Strep throat, whooping cough, diphtheria. • Pneumonia and Emphysema • Tuberculosis and Pleurisy • Lung Cancer