Biopsychosocial Model

1. What is the World Health Organization's definition of health?

"Health is a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity."

"Heath is being able to think clearly, having good self-esteem, and enjoying a general feeling of well-being."

"Health is having good interpersonal skills, meaningful relationships with friends and family, and social support in times of crisis."

"Health is the absence of aberrant somatic processes, such as biochemical imbalances, viruses, or injuries."

Correct. [Preamble to the Constitution of the World Health Organization as adopted by the International Health Conference, New York, 19 June - 22 July 1946; signed on 22 July 1946 by the representatives of 61 States (Official Records of the World Health Organization, no. 2, p. 100) and entered into force on 7 April 1948.]

Explanation

Correct. [Preamble to the Constitution of the World Health Organization as adopted by the International Health Conference, New York, 19 June - 22 July 1946; signed on 22 July 1946 by the representatives of 61 States (Official Records of the World Health Organization, no. 2, p. 100) and entered into force on 7 April 1948.]

2. The biopsychosocial model suggests that:

Psychological factors play an unimportant role in the treatment of chronic diseases.

A person's health behaviours are an automatic consequence of a given social context.

A person's health are determined by the interaction of biological, psychological and social processes.

A healthy body is one that is free of diseases.

Pathogens and other biological factors are unimportant when considering a person's health.

The biopsychosocial model suggests that a person's health is determined by the interaction of biological, psychological, and social processes. This means that factors such as genetics, mental and emotional well-being, and social environment all play a role in determining a person's overall health. It recognizes that health is not solely determined by biological factors or the absence of disease, but rather a complex interplay of various factors.

Explanation

The biopsychosocial model suggests that a person's health is determined by the interaction of biological, psychological, and social processes. This means that factors such as genetics, mental and emotional well-being, and social environment all play a role in determining a person's overall health. It recognizes that health is not solely determined by biological factors or the absence of disease, but rather a complex interplay of various factors.

3. In January 2008, the National Aboriginal Health Organization made the following statement:

"For Indigenous Peoples living in Canada and around the world, the inter-relationships between the physical, mental, spiritual, and emotional aspects of being are integral to individual and community health."

Although the comparison is imperfect, this holistic perspective has some similarities to the:

Behavioral model

Birth cohort perspective

Biomedical model

The placebo effect

Biopsychosocial model

The statement made by the National Aboriginal Health Organization emphasizes the inter-relationships between various aspects of being, such as physical, mental, spiritual, and emotional, which are all integral to individual and community health. This holistic perspective aligns with the biopsychosocial model, which also recognizes the interconnectedness of biological, psychological, and social factors in determining health outcomes. Both perspectives go beyond a narrow focus on purely physical or biomedical aspects and acknowledge the importance of considering the whole person and their social context in understanding and promoting health.

Explanation

The statement made by the National Aboriginal Health Organization emphasizes the inter-relationships between various aspects of being, such as physical, mental, spiritual, and emotional, which are all integral to individual and community health. This holistic perspective aligns with the biopsychosocial model, which also recognizes the interconnectedness of biological, psychological, and social factors in determining health outcomes. Both perspectives go beyond a narrow focus on purely physical or biomedical aspects and acknowledge the importance of considering the whole person and their social context in understanding and promoting health.

4. "The interpersonal relationship between a patient and a health professional will affect the efficacy of a given treatment."

Please infer which theory or model could best incorporate this statement.

Phrenologic theory

Humoral theory

Biomedical model

Biopsychosocial model

Psychosomatic theory

The biopsychosocial model is the best theory or model that can incorporate the statement "The interpersonal relationship between a patient and a health professional will affect the efficacy of a given treatment." This model takes into account the biological, psychological, and social factors that influence a person's health and well-being. It recognizes that a patient's relationship with their healthcare provider, including factors such as trust, communication, and empathy, can play a significant role in the success of a treatment. By considering the holistic aspects of a person's health, the biopsychosocial model emphasizes the importance of the patient-provider relationship in achieving positive treatment outcomes.

Explanation

The biopsychosocial model is the best theory or model that can incorporate the statement "The interpersonal relationship between a patient and a health professional will affect the efficacy of a given treatment." This model takes into account the biological, psychological, and social factors that influence a person's health and well-being. It recognizes that a patient's relationship with their healthcare provider, including factors such as trust, communication, and empathy, can play a significant role in the success of a treatment. By considering the holistic aspects of a person's health, the biopsychosocial model emphasizes the importance of the patient-provider relationship in achieving positive treatment outcomes.

5. An article from Princeton University found that students felt more stressful during the final exam period when compared with 5 days before and 14 days afterwards. Also, their concentrations of S-IgA were lower during the exam period, especially in students who reported less adequate social support during the pre-exam period. Given this information, which one of the following statements is true?

The students' immune systems were stronger during the exam period.

The biomedical model can easily identify a pathogen to explain this change in S-IgA concentrations.

The differences in S-IgA concentrations are arguably because of seasonal variances.

The biopsychosocial model would not be able to account for these observations.

The influence of social and psychological factors in this situation is consistent with the interrelationships suggested by the biopsychosocial model.

See: Jemmott, J.B., III, & Magliore, K. (1988). Academic stress, social support, and secretory immunoglobulin A. Journal of Personality and Social Psychology, 55, 803-810.

Explanation

See: Jemmott, J.B., III, & Magliore, K. (1988). Academic stress, social support, and secretory immunoglobulin A. Journal of Personality and Social Psychology, 55, 803-810.

6. Which of the following issues does the biopsychosocial model accommodate for that the biomedical model does not?

That a particular biochemical alteration does not always translate directly into a illness.

Why modern surgeons use the term "craniotomy" instead of "trepanation."

Pathogens can cause illnesses and health problems.

Antibiotics can be used to treat tuberculosis.

Aseptic (germ-free) surgical procedures will reduce the risk of complications.

The biopsychosocial model considers that a particular biochemical alteration does not always result in an illness. This means that even if there is a change in the biochemical makeup of an individual, it may not necessarily lead to the development of an illness. The model recognizes that various factors such as psychological and social factors also play a role in determining an individual's health. This is in contrast to the biomedical model, which primarily focuses on the biological aspects of illness and may overlook the influence of psychological and social factors.

Explanation

The biopsychosocial model considers that a particular biochemical alteration does not always result in an illness. This means that even if there is a change in the biochemical makeup of an individual, it may not necessarily lead to the development of an illness. The model recognizes that various factors such as psychological and social factors also play a role in determining an individual's health. This is in contrast to the biomedical model, which primarily focuses on the biological aspects of illness and may overlook the influence of psychological and social factors.

7. Pasteur's germ theory of disease suggests that pathogens invade body cells and cause disease. How the biomedical model incorporated this theory was especially relevant during the early 20th century because:

Health care costs greatly increased per capita as more citizens started driving automobiles and causing accidents.

Infectious diseases such as influenza, pneumonia, and consumption (tuberculosis) were among the leading causes of death.

The placebo effect had not yet been discovered.

Non-communicable "lifestyle diseases" such as diabetes and heart disease were not preventable in the early 20th century.

The biomedical model soon became out-dated once antibiotics were discovered.

During the early 20th century, the biomedical model incorporated Pasteur's germ theory of disease because infectious diseases like influenza, pneumonia, and tuberculosis were major causes of death. This theory helped in understanding that pathogens invade body cells and cause diseases, leading to the development of medical interventions to prevent and treat these infectious diseases. This was particularly relevant at that time due to the high mortality rates associated with these diseases and the need for effective healthcare strategies to combat them.

Explanation

During the early 20th century, the biomedical model incorporated Pasteur's germ theory of disease because infectious diseases like influenza, pneumonia, and tuberculosis were major causes of death. This theory helped in understanding that pathogens invade body cells and cause diseases, leading to the development of medical interventions to prevent and treat these infectious diseases. This was particularly relevant at that time due to the high mortality rates associated with these diseases and the need for effective healthcare strategies to combat them.

8. Bitton et al (2008) examined the biopsychosocial model and its implication in predicting relapse in Crohn's disease. Which of the following factors reduced the chance of relapse in their patients?

Low stress levels

Low psychological distress

Having an effective coping strategy

All of the above

None of the above

Bitton, A., Dobkin, P.L., Edwardes, M.D., Sewhich, M.J., Meddings, J.B., Rawal, S., et al. (2008) Predicting relapse in Crohn’s disease: a biopsychosocial model. Gut, 57.

Explanation

Bitton, A., Dobkin, P.L., Edwardes, M.D., Sewhich, M.J., Meddings, J.B., Rawal, S., et al. (2008) Predicting relapse in Crohn’s disease: a biopsychosocial model. Gut, 57.

9. What problem does the placebo effect pose to the biomedical model?

The biomedical model has difficulty explaining the biological basis for how a person's beliefs influence the efficacy of a treatment.

There are ethical problems when assigning patients to placebo treatments.

It counteracts the biomedical model's concept of the "nocebo effect," where a person attaches negative expectations to a treatment.

Placebos are considered to be best kept to the realm of science experiments and out of the health care system.

The placebo effect poses a problem to the biomedical model because it challenges its ability to explain how a person's beliefs can impact the effectiveness of a treatment. The biomedical model focuses on the biological basis of diseases and treatments, but the placebo effect suggests that psychological factors can also play a role in healing. This raises questions about the comprehensive understanding of the biomedical model and its limitations in accounting for the mind-body connection in healthcare.

Explanation

The placebo effect poses a problem to the biomedical model because it challenges its ability to explain how a person's beliefs can impact the effectiveness of a treatment. The biomedical model focuses on the biological basis of diseases and treatments, but the placebo effect suggests that psychological factors can also play a role in healing. This raises questions about the comprehensive understanding of the biomedical model and its limitations in accounting for the mind-body connection in healthcare.

10. The biomedical model is considered to be a reductionist model. What does a reductionist viewpoint mean in context of the biomedical model?

Health professionals focus on investigating factors that promote physical, psychological and social health.

Health is nothing more than the absence of disease.

Disease can always be reduced to an underlying biological cause, such as a pathogen.

A single psychological problem is sufficient to trigger disease.

The reductionist viewpoint in the context of the biomedical model means that disease is believed to always have an underlying biological cause, such as a pathogen. This viewpoint suggests that health professionals primarily focus on investigating and treating the biological factors that contribute to physical, psychological, and social health. It implies that the complexity of disease can be simplified and understood by identifying and targeting the specific biological cause. This reductionist approach often overlooks the influence of other factors, such as psychological or social determinants of health, in the development and treatment of disease.

Explanation

The reductionist viewpoint in the context of the biomedical model means that disease is believed to always have an underlying biological cause, such as a pathogen. This viewpoint suggests that health professionals primarily focus on investigating and treating the biological factors that contribute to physical, psychological, and social health. It implies that the complexity of disease can be simplified and understood by identifying and targeting the specific biological cause. This reductionist approach often overlooks the influence of other factors, such as psychological or social determinants of health, in the development and treatment of disease.

11. Which of the following statements about the biopsychosocial model is true?

A: When using the biopsychosocial model, an assessment of a person's medical problems would not include his or her illness.

B: A patient's genetics are unimportant within the context of the biopsychosocial model.

C: The levels in the hierarchy of natural systems are not weighted equally in all situations.

Options A and B are true.

Options A, B, and C are true.

See Epstien, R.M., and Borrell-Carrio, F. (2005). The Biopsychosocial Model: Exploring Six Impossible Things. Families, Systems, & Health, 23(4), 426-431.

Explanation

See Epstien, R.M., and Borrell-Carrio, F. (2005). The Biopsychosocial Model: Exploring Six Impossible Things. Families, Systems, & Health, 23(4), 426-431.

12. Select the perspective that would most likely describe a patient as being "a case of acute myocardial infarction with ventricular fibrillation."

Reductionist

Epidemiological

Psychosomatic

Systematist

Behaviorist

his example is from Engel, G.L. (1978). The biopsychosocial model and the education of health professionals. Annals of the New York Academy of Sciences, 310, 169-181.

Explanation

his example is from Engel, G.L. (1978). The biopsychosocial model and the education of health professionals. Annals of the New York Academy of Sciences, 310, 169-181.

13. Among other things, scoring highly on the Type A Cognitive Questionnaire (TACQ) means you are more at risk for:

Death

Cancer

Depression

Having less social support (quantitatively)

A sedentary lifestyle

Watkins, P.L., Ward, C.H., Southard, D.R., Fisher E.B. Jr. (1992). The Type A Belief System: Relationships to Hostility, Social Support, and Life Stress. Behavioural Medicine, 18(1), 27-31.

Explanation

Watkins, P.L., Ward, C.H., Southard, D.R., Fisher E.B. Jr. (1992). The Type A Belief System: Relationships to Hostility, Social Support, and Life Stress. Behavioural Medicine, 18(1), 27-31.

14. Engel based the biopsychosocial model on systems theory. This can be understood as:

B: A hierarchy of systems in which each system is simultaneously part of a larger system and contains smaller subsystems.

C: A linear cause-effect model that can attribute a single sociological, psychological or biological basis for a given disease.

Options A and B are true.

Options A, B and C are true.

The biopsychosocial model, developed by Engel, is based on systems theory. This means that it views health as a result of interactions between various systems. Option A correctly explains that these interactions can influence higher and lower systems, and that complexity theory can help understand their emergent properties on a person's health. Option B also accurately describes the model as a hierarchy of systems, where each system is part of a larger system and contains smaller subsystems. Option C, on the other hand, is incorrect as it suggests a linear cause-effect model, which contradicts the biopsychosocial approach. Therefore, the correct answer is that options A and B are true.

Explanation

The biopsychosocial model, developed by Engel, is based on systems theory. This means that it views health as a result of interactions between various systems. Option A correctly explains that these interactions can influence higher and lower systems, and that complexity theory can help understand their emergent properties on a person's health. Option B also accurately describes the model as a hierarchy of systems, where each system is part of a larger system and contains smaller subsystems. Option C, on the other hand, is incorrect as it suggests a linear cause-effect model, which contradicts the biopsychosocial approach. Therefore, the correct answer is that options A and B are true.

15. Suls and Rothman (2004) propose that the biopsychosocial model be examined closely in a number of areas to make practical use of the model more effective. Which of the following areas IS NOT mentioned in their article?

Including the new category of spiritualism discovered in recent research

Defining linkages of the subsystems of the model

Look at representative samples on a broader level

Policymaking that includes the model in treatment/prevention

Communicating between policy makers, practitioners and researchers

Suls, J. & Rothman, A. (2004). Evolution of the Biopsychosocial Model: Prospects and Challenges for Health Psychology. Health Psychology, 23(2), 119-125

Explanation

Suls, J. & Rothman, A. (2004). Evolution of the Biopsychosocial Model: Prospects and Challenges for Health Psychology. Health Psychology, 23(2), 119-125

16. Which of these examples of placebo analgesia would Price et al (2005) attribute to external factors?

A physician reducing pain by verbally suggesting that analgesia will take place

A patient distorts their memory of recent pain

A patient records their expectancy of pain

A physician offers a placebo in place of an anti-inflammatory

MRI technician shows a patient has reduced activation in the rostral anterior cingulate cortex

Price, D.D., Chung, S.K., Robinson, M.E. (2005). Conditioning, Expectation, and Desire for Relief in Placebo Analgesia. Semin Pain Med. 3, 15-21.

Explanation

Price, D.D., Chung, S.K., Robinson, M.E. (2005). Conditioning, Expectation, and Desire for Relief in Placebo Analgesia. Semin Pain Med. 3, 15-21.

17. As suggested by Engel, please identify the logical fault in a person's position that "I would rather have a physician who has the most up-to-date biomedical knowledge and techniques than one who understands my psyche."

The statement assumes a false dicotomy; that competence in one area precludes competence in the other area.

The statement uses emotional reasoning; this is when a person uses their feelings as a substitute for the objective truth.

The statement is mentally filtering out the influence of social factors on a person's health.

The statement creates an inappropriate generalisation; perhaps the physician who is out-of-date with medical knowledge is better.

The correct answer is that the statement assumes a false dichotomy; that competence in one area precludes competence in the other area. This means that the person is assuming that a physician cannot possess both up-to-date biomedical knowledge and an understanding of their psyche. However, it is possible for a physician to have expertise in both areas, as they are not mutually exclusive.

Explanation

The correct answer is that the statement assumes a false dichotomy; that competence in one area precludes competence in the other area. This means that the person is assuming that a physician cannot possess both up-to-date biomedical knowledge and an understanding of their psyche. However, it is possible for a physician to have expertise in both areas, as they are not mutually exclusive.

18. Covic et al (2003) examined a biopsychosocial approach to rheumatoid arthritis in their study. What was the most significant predictor of pain levels and depression in their patients?

Physical disability

Feelings of helplessness

Coping mechanisms

Satisfaction of care

Social support

Covic, T., Adamson, B., Spencer, D., Howe, G. (2003). A biopsychosocial model of pain and depression in rheumatoid arthritis: a 12-month longitudinal study. Rheumatology, 42, 1287-1294

Explanation

Covic, T., Adamson, B., Spencer, D., Howe, G. (2003). A biopsychosocial model of pain and depression in rheumatoid arthritis: a 12-month longitudinal study. Rheumatology, 42, 1287-1294

19. Which of the following are not components of a diagnosis of a Somatoform Disorder?

Experiential

Cognitive

Behavioural

Biological

All of the above are components of a Somatoform Disorder

The question asks for components of a diagnosis of a Somatoform Disorder. The options provided are Experiential, Cognitive, Behavioural, and Biological. The correct answer is Biological because biological factors are not considered components of a diagnosis of a Somatoform Disorder. Somatoform Disorders are characterized by physical symptoms that cannot be explained by a medical condition, and the focus is on psychological and emotional factors rather than biological factors. Therefore, biological factors are not included in the diagnosis of a Somatoform Disorder.

Explanation

The question asks for components of a diagnosis of a Somatoform Disorder. The options provided are Experiential, Cognitive, Behavioural, and Biological. The correct answer is Biological because biological factors are not considered components of a diagnosis of a Somatoform Disorder. Somatoform Disorders are characterized by physical symptoms that cannot be explained by a medical condition, and the focus is on psychological and emotional factors rather than biological factors. Therefore, biological factors are not included in the diagnosis of a Somatoform Disorder.

20. According to Weiner (2008), which of these is not a problem associated with the biopsychosocial model?

Surges in correlations between outcomes and psychosocial factors

Theory is difficult to test

Healthy patients are difficult to accurately distinguish from unhealthy ones

Treatment based on the model requires a large number of specialists

Specialists are using the theory as a scapegoat for difficult to diagnose patients

Weiner, BK. (2008). The Biopsychosocial Model and Spine Care. Spine. 23(2), 219-223

Explanation

Weiner, BK. (2008). The Biopsychosocial Model and Spine Care. Spine. 23(2), 219-223

21. Select the perspective that would most likely describe a patient as being "a middle-aged real estate salesman with an acute myocardial infarction developed ventricular fibrillation while the intern was attempting an arterial puncture."

Reductionist

Epidemiological

Psychosomatic

Systematist

Behaviorist

This example is from Engel, G.L. (1978). The biopsychosocial model and the education of health professionals. Annals of the New York Academy of Sciences, 310, 169-181.

Explanation

This example is from Engel, G.L. (1978). The biopsychosocial model and the education of health professionals. Annals of the New York Academy of Sciences, 310, 169-181.