hello and welcome to shorts in psychology in this video we'll be discussing the biopsychosocial model what it is and how it can be applied to understand the dynamic interaction between biological psychological and social factors in overall health since the mid 20th century healthcare in industrialized societies was dominated by the biomedical model in other words clinicians believe the illness is as a result of a biochemical alteration therefore when assessing patients emphasis was placed on disease and its associated biological components including signs and symptoms and the use of laboratory tests for diagnosis this limited treatment of a person's poor health almost exclusively to medicinal remedies as a result the biomedical approach has many limitations the main one being that it is a very linear and reductionist model of the cause of disease this narrow focus subsequently led clinicians to regard patients as objects and ignore the possibility that the subjective experience of the patient was worth studying george engel believed that to understand and respond adequately to patients suffering and to give them a sense of being understood clinicians must attend simultaneously to the biological psychological and social dimensions of illness he offered a holistic alternative that tried to reverse the dehumanization of medicine and disempowerment of patients engel argued that any one factor such as biology is not sufficient it is the interplay between people's biology psychology and social and cultural context that determines the course of their health-related outcomes rather than nature vs nurture engel said that it is a dynamic and interactional mutual influence of mind and body what affects the body will often affect the mind and vice versa what affects the mind will also often end up affecting the body wellness or illness is not simply a matter of someone's physical state but is also influenced by that person's psychological and social status as well his model struck a resonant chord with those sectors of the medical profession that wish to bring more empathy and compassion into medical practice engel's new model came to be known as the bio-psychosocial model the biopsychosocial model bio for physiological pathology psycho for psychological including thoughts emotions and behaviors and social for the social environmental and cultural aspects such as work issues family circumstances and socio-economic status again angle iterated that any one factor alone is not sufficient it is the interplay between people's genetic makeup mental health and behavior and social and cultural context that determines the course of their health related outcomes let's deep dive into each of these components and what they encompass biological influences on health include an individual's genetic makeup many disorders have an inherited genetic vulnerability the greatest single risk factor for developing schizophrenia for example is having a first degree relative with the disease physical health and whether the individual has a disability or history of physical trauma or infection can also play a role neurochemistry so the levels of certain neurotransmitters or hormones also play a key role in health other examples of biological influences on health include drug effects diet and lifestyle the immune and stress responses as emotions involve a physiological response they can also be considered a biological influence the psychological component of the virus psychosocial model seeks to find a psychological foundation for a particular symptom or array of symptoms there are a wide range of possible psychological influences some of the main ones include the individual's personality perceptions self-esteem attitudes and beliefs emotions such as irritability and overwhelming sadness could also play a role other examples of psychological influences include coping skills social skills grief and trauma social factors include socio-economic status work school and interpersonal relationships for instance losing one's job or ending a romantic relationship may place one at risk of stress and illness such life events may predispose an individual to developing depression which may in turn contribute to physical health problems peer group lifestyle and societal norms can also have a big impact for example the fashion industry and the media promote an unhealthy standard of beauty that emphasizes thinness over health this exerts social pressure to attain this ideal body image despite the obvious health risks and could lead an individual to develop an eating disorder also included in the social domain are cultural factors for instance differences in the circumstances expectations and belief systems of different cultural groups contribute to different prevalence rates and symptom expression of disorders for example anorexia is less common in non-western cultures because they put less emphasis on thinness in women culture can vary across a small geographic range such as from lower income to higher income areas and rates of disease and illness differ across these communities accordingly there are many other social factors that can influence overall health some others include education family circumstances abuse and neglect this diagram shows how biological psychological and sociological factors overlap to determine overall health for example individuals with a genetic vulnerability may be more likely to display negative thinking that puts them at risk for depression alternatively psychological factors may exacerbate a biological predisposition by putting a genetically vulnerable person at risk for other risk behaviors for example depression on its own may not cause liver problems but a person with depression may be more likely to abuse alcohol and therefore develop liver damage increased risk taking leads to an increased likelihood of disease let's now examine a specific psychological disorder using the bio-psychosocial model the example we use is depression biological influences could include genetic inheritability as depression can run in families research is also being conducted to identify genes that contribute to depression low levels of neurotransmitters such as dopamine and serotonin also contribute to depression in some people dopamine creates positive feelings associated with reward and reinforcement and serotonin is the feel-good chemical in the brain many antidepressant medications aim to increase serotonin levels in the brain having a disability particularly if the individual is lacking social support and poor physical health whether it is a chronic illness or a condition like obesity can also contribute to depression another biological factor is substance abuse psychological factors influencing depression include personality some people have a more general lifelong tendency to experience unpleasant emotions and anxiety in response to stress psychologists use terms like neuroticism and negative effectivity to refer to this tendency and people who have it are also more likely to experience major depression other psychological factors include characteristic negative patterns of thinking low self-esteem deficits in coping skills judgment problems and impaired emotional intelligence the ability to perceive understand and express emotions that depressed people tend to exhibit to some degree these psychological factors can be influenced by biology people's innate temperament or their biologically based personality characteristics can influence whether they're more or less likely to act in ways characteristic of depression and by social factors such as what coping behaviours are modeled for people for example by their parents and teachers as they're growing up people can also come depressed as a result of social factors such as experiencing traumatic situations early separation lack of social support or harassment research has shown that stressful social events are capable of serving as triggers for turning genes on and off causing changes in brain functioning by this path a social stressor can trigger a physical cause of depression environmental and social causes of depression can also be far more subtle than actual trauma it is not necessary for people to have been abused as children to grow up feeling negatively about themselves or their prospects because of how they learned to think about their self-worth or their ability to successfully respond to this tasks and stresses present in daily living low socioeconomic status and work environment can also contribute to depression work environment could contribute in a variety of ways including due to stress workplace bullying lack of stability in the form of short-term or casual contracts or even unemployment social norms relating to expectations of achievement sexual preference marital status and other stereotypes could also be a contributing factor furthermore the stigma surrounding mental illness and the perception that sufferers are weak lazy or inadequate could prevent someone suffering from depression from seeking help or speaking to others of their condition similarly cultural beliefs and expectations could also contribute to depression for example if the individual doesn't meet these expectations the biopsychosocial model suggests and the scientific evidence has tended to confirm that these inter interdependent factors all end up influencing each other depression can be caused by any number of factors that could appear to be independent from one another but are really related as one factor tends to influence the other factors it is possible to have a body reaction to social or mental stress the opposite is also true where you can have a social or mental reaction to a bodily problem the way that the various causes of depression affect one another make it very important that all factors be taken into account when trying to form a complete explanation of depression recognizing and understanding and responding to all factors that affect health requires the health care provider to integrate the biological aspects of the disease with the psychological and social aspects of the patient if this occurs the patient is more likely to engage in health-promoting behaviors like taking medication proper diet or nutrition and engaging in physical activity ultimately the goal of the biopsychosocial model is to develop a patient-centered care plan that is realistic in order to achieve the best possible health outcomes for example if the model was used to develop a treatment plan for chronic pain it might encompass a variety of approaches at each level including patient education biological treatment such as medication and acupuncture as well as psychological interventions such as cognitive behavioral therapy and mindfulness while there are limitations to engel's model its enduring contribution is that it has changed the way illness suffering and healing are viewed by clinicians i hope this video has helped you to gain a better understanding of the biopsychosocial model and how it can be used to examine some of the influencing factors in overall health and develop a comprehensive treatment plan thanks for listening