The Biopsychosocial Model: “Reports of My Death Have Been Greatly Exaggerated”

Searight, H. Russell

doi:10.1007/s11013-015-9471-6

Cited by 4 publications

(3 citation statements)

References 32 publications

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“…We conceived the patient’s QoL as an outcome, rather than a process, and the application of the WHOQOL-BREF was intended to screen and to monitor progress in individual patient care; different applications of QoL-related instruments need to be distinguished because instruments that work very well for one purpose need not necessarily be helpful when used in another context [ 69 ]. Finally, recent literature has discussed the difficulty in applying the biopsychosocial model to some clinical conditions and the need for a re-formulation [ 70 , 71 ].…”

Section: Discussionmentioning

confidence: 99%

Quality of life of patients with rheumatic diseases during the COVID-19 pandemic: The biopsychosocial path

et al. 2022

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Background Previous models that assess quality-of-Life (QoL) in patients with rheumatic diseases have a strong biomedical focus. We evaluated the impact of COVID-19 related-health care interruption (HCI) on the physical, psychological, social relationships and environment QoL-dimensions, and explored factors associated with QoL when patients were reincorporated to the outpatient clinic, and after six-month follow-up. Patients and methods Study phase-1 consisted of a COVID-19 survey administered from June 24th-October 31st 2020, to outpatients with rheumatic diseases who had face-to-face consultation at outpatient clinic reopening. Study phase-2 consisted of 3 consecutive assessments of patient´s QoL (WHOQOL-BREF), disease activity/severity (RAPID-3), and psychological comorbidity/trauma (DASS-21 and IES-R) to patients from phase-1 randomly selected. Sociodemographic, disease and treatment-related information, and comorbidities were obtained. Multiple linear regression analysis identified factors associated with the score assigned to each WHOQOL-BREF dimension. Results Patients included (670 for phase-1 and 276 for phase-2), had primarily SLE and RA (44.2% and 34.1%, respectively), and all the dimensions of their WHOQOL-BREF were affected. There were 145 patients (52.5%) who referred HCI, and they had significantly lower dimensions scores (but the environment dimension score). Psycho-emotional factors (primarily feeling confused, depression and anxiety), sociodemographic factors (age, COVID-19 negative economic impact, years of scholarship, HCI and having a job), and biomedical factors (RAPID-3 score and corticosteroid use) were associated with baseline QoL dimensions scores. Psycho-emotional factors showed the strongest magnitude on dimensions scores. Most consistent predictor of six-month follow-up QoL dimensions scores was each corresponding baseline dimension score, while social determinants (years of scholarship and having a job), emotional factors (feeling bored), and biomedical aspects (RAPID 3) had an additional impact. Conclusions HCI impacted the majority of patient´s QoL dimensions. Psycho-emotional, sociodemographic and biomedical factors were consistently associated with QoL dimensions scores, and these consistently predicted the QoL trajectory.

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Section: Discussionmentioning

confidence: 99%

Quality of life of patients with rheumatic diseases during the COVID-19 pandemic: The biopsychosocial path

et al. 2022

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“…Some authors noted that the model focuses on the need to elicit biopsychosocial information without providing any methodological guidance to assist this process [ 17 ]. Within this, critics have also pointed out that the model does not indicate what level of analysis (biological, psychological, or social) to prioritise or when [ 19 ], and, since it is often not known which factor might be the ultimate responsible for a given condition, all levels of analysis routinely co-exist and clinicians are left to choose the level that seems to work best [ 22 ], without a shared rationale as to why a given clinician heads in one direction or the other [ 23 ].…”

Section: The Biopsychosocial Model In Medicine: Key Controversies mentioning

confidence: 99%

The New Old (and Old New) Medical Model: Four Decades Navigating the Biomedical and Psychosocial Understandings of Health and Illness

2017

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The importance of how disease and illness are conceptualised lies in the fact that such definition is paramount to understand the boundaries and scope of responsibility associated with medical work. In this paper, we aim to provide an overview of the interplay of these understandings in shaping the nature of medical work, philosophically, and in practice. We first discuss the emergence of the biopsychosocial model as an attempt to both challenge and broaden the traditional biomedical model. Then, we outline the main criticisms associated with the biopsychosocial model and note a range of contributions addressing the shortcomings of the model as initially formulated. Despite recurrent criticisms and uneven uptake, the biopsychosocial model has gone on to influence core aspects of medical practice, education, and research across many areas of medicine. One of these areas is adolescent medicine, which provides a particularly good exemplar to examine the contemporary challenges associated with the practical application of the biopsychosocial model. We conclude that a more optimal use of existing bodies of evidence, bringing together evidence-based methodological advances of the biopsychosocial model and existing evidence on the psychosocial needs associated with specific conditions/populations, can help to bridge the gap between philosophy and practice.

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“…Although there is a large and growing body of psychophysiological research on stress, the field lacks an accepted overarching framework to integrate psychophysiological stress research findings into stress interventions. The biopsychosocial model is frequently used as a general model to conceptualize the interactions between biological, psychological, and social factors in health (Searight, 2016 ; Smith, 2021 ). The biopsychosocial approach, however, has focused only on general concepts and has not provided a specific framework for integrating information across factors.…”

Section: Introductionmentioning

confidence: 99%

Using the Research Domain Criteria as a framework to integrate psychophysiological findings into stress management and psychotherapy interventions

Steffen

2023

Front. Neuroergonomics

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Research on the psychophysiology of stress is expanding rapidly, but the field lacks a clear integrative framework to help translate research findings into empirically supported stress interventions. The Research Domain Criteria (RDoC) is an excellent candidate to explore as a framework to integrate stress research. The RDoC framework is a dimensional, multi-modal approach to psychopathology proposed as an alternative to categorical approaches used by the International Classification of Diseases (ICD) and the Diagnostic and Statistical Manual (DSM). The goal of this paper is to explore the RDoC as a framework to integrate psychophysiology research into therapeutic interventions for stress. The RDoC consists of six domains: negative valence systems, positive valence systems, cognitive systems, social processes systems, arousal/regulatory systems, and sensorimotor systems, and provides an excellent structure for integrating information from multiple levels of functioning including physiology, behavior, and self-report, as well as genes, molecules, cells, and brain circuits. Integrating psychophysiological research on stress using the RDoC framework can direct and amplify stress management and psychotherapeutic interventions. First, the RDoC provides a clear foundation for conceptualizing the stress response in terms of important concepts such as allostasis and adaptation. In this perspective, the terms “allostatic response” or “adaptation response” are more descriptive terms than “stress response” in understanding bodily responses to life threats and challenges. Second, psychophysiological approaches can be used in the context of modalities such as biofeedback and mindfulness to both collect psychophysiological data and then integrate that data into a broader therapeutic framework. Heart rate variability (HRV) biofeedback is being used more frequently as part of a therapeutic intervention package with stress management and psychotherapy, and HRV data is also used to provide outcome evidence on the efficacy of treatment. Mindfulness practices are commonly used in combination with stress management and psychotherapy, and psychophysiological data (HRV, EEG, blood pressure, etc.) is often collected to explore and understand mind/body relationships. In conclusion, the lack of a clear framework to assess and understand mind/body functioning limits current stress research and interventions. The RDoC provides a strong framework to assess and integrate physiological and psychological data and improve stress interventions.

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The Biopsychosocial Model: “Reports of My Death Have Been Greatly Exaggerated”

Cited by 4 publications

References 32 publications

Quality of life of patients with rheumatic diseases during the COVID-19 pandemic: The biopsychosocial path

Quality of life of patients with rheumatic diseases during the COVID-19 pandemic: The biopsychosocial path

The New Old (and Old New) Medical Model: Four Decades Navigating the Biomedical and Psychosocial Understandings of Health and Illness

Using the Research Domain Criteria as a framework to integrate psychophysiological findings into stress management and psychotherapy interventions

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