Biomedical model

Biopsychosocial model
PSY – 375

Adapted from Health Psychology: Understanding the Mind-Body Connection (3rd ed) by
Catherine A. Sanderson. (2019) Publisher: SAGE Publications, Inc
Ogden, J. (2012) Health Psychology , Open University Press;
Taylor, S. (2018). Health Psychology 10th e. McGraw-Hill Education
 Past Conceptualizations of Health

Evolving view
of Medical Model
Health/Disease

Biopsychosocial Approach
Biomedical Model
 Mind Body Dualism
 Concept of dualism originates in 17th century work Rene
Descartes
 Considered mind and body as separate
 Was revolutionary at it’s time
 Still a foundation of medicine today
 Single cause
 Physical treatment
 Cause of disease was not yet known

First demonstrations of heart and circulation of blood

17th Century Discovery of bacteria/viruses

Medicine
Average life span 35-45 years

Treatments included bloodletting, trepanation

Many now treatable diseases were thought to have supernatural

causes, viewed as mental illnesses or as the result of moral vice.
 What causes illness?

Biomedical
Model
Biological factors as the primary and only cause of
illness.

Chemical Genetic Hormonal

Viruses Bacteria
Imbalances Predisposition Imbalances
 How should illness be treated?

Biomedical
Model
Treatments which change the physical state of the
body

Vaccinations Surgery Chemotherapy Medications

 Illness arises from biological factors beyond
Biomedical individuals’ control
Model
Individuals thus are not responsible for illness
(passive)
Who is
responsible for External Locus of control (external causes)
illness?
Important implication: The individual has no role
in the onset or progression of his/her illness.
Biomedical Model
Mind and body are separate
What is the
relationship between
the mind and body?
Dualistic view

Mind cannot influence our physical

state
Biomedical Model
Illness has psychological consequences
What is the role of
psychology in health
and illness?
Psychological factors do not cause illness

E.g. You may feel anxious because you have

diabetes, but anxiety is not seen as related
to the onset or progression of your diabetes
 Psychosomatic Medicine
 Twentieth century
 Origins with Sigmund Freud
 Described “hysterical paralysis” – actual conversion disorder
Specific unconscious conflicts produce physical disturbances
symbolizing repressed psychological conflicts
 Patients had paralyzed limbs but no obvious physical cause
 Argued repressed feelings responsible.
Biopsychosocia
l Model of
Health
Health Psychology

SOURCE: Adapted from Engel, 1977, 1980

Health/ Illness
 What causes illness?

Biopsychosocia
l Model
Illness can be caused by biological, psychological,
social factors, or the interactions thereof.
Psychology (eg. Social (eg. workplace
Biology (eg. viruses,
health behaviors, stress, socio-
bacteria, genetics)
stress, health beliefs) economic status)
Biopsychosocia Both external and internal
l Model factors influence illness

Who is
responsible for
illness? Individuals have some
responsibility in the onset,
progression and treatment of
illness.
 Mind and body are not viewed as
Biopsychosocia separate
l Model
Our physical and mental state
What is the influence each other
relationship
between the There is an interaction between the
mind and body? mind and the body

Whole person approach

 What is the role of psychology
in health and illness?

Biopsychosocia
l Model

Psychological factors are both

a cause and consequence of
health and illness
 Each model carries different implications
for the ……
Summary:
Biomedical vs
Biopsychosocia • Prevention of disease
l Model • Etiology (cause) of health and disease
• Treatment of health and disease
 Summary: Biomedical model
What causes illness?
Who is responsible for illness?
How should illness be treated?
Who treats illness?
Symptoms
What is the role of psychology?
• Chemical imbalances, bacteria, viruses, genetic
predisposition
• No one – an individual is a victim of an external force
• External locus of control
• Medications, surgery
• Physician as expert
• Amount of sx is concordant with degree of pathology
• A consequence but not a cause
 Summary: Biopsychosocial Model
What causes illness? • Biological, psychological and social factors

• An individual may be seen as responsible

Who is responsible for illness? • Internal locus of control

How should illness be treated? • By treating the whole person

Who treats illness? • Patient physician partnership

Symptoms • May be modified by psychogical and social factors

What is the role of psychology in • A contributing factor and a consequence

illness?
 Higher probability for outcome success

ADVANTAGE
S of
Biopsychosocia Patient/client satisfaction
l Model

(understanding Lower cost in the long run (focuses on

prevention)
of health and
illness)
Involves an integrated care team rather than
just the physician
 Time-consuming
DISADVANTAG
ES of
Biopsychosocial
Model
Costly in the short term
(understanding of
health and
illness)
Lower number of patients per
physician
 Engle’s biopsychosocial model of health and disease adapted for this study

Habtewold, T.D., Islam, M.A., Radie, Y.T., & Tegegne, B.S. (2016). Comorbidity of depression and diabetes: an application
of biopsychosocial model. International Journal of Mental Health Systems.
Psychological factors influence
health/illness both directly and
indirectly

Health psychology focuses on two

The direct
pathways between psychological
factors and illness
and indirect
pathways
The dual process model
• The direct pathway (eg stress causes illness)
• The indirect pathway (eg. Stress causes
smoking which causes illness)
Dual Pathway Model:

Direct
relationship
Psychological Physical
Processes Health

re I n d c t p
la i r r e h i
tio ec d i ns
ns t In tio
hi la
p e
r
Behaviour
Direct and
indirect
pathways
© Open University Press, 2012
Questions?
Class activities –
week 2
PSY375