Sober living

Understanding the Biopsychosocial Model of Health

Negative affective states during the period after substance consumption are an important part of the withdrawal-craving cascade (path J). It has been shown that in the absence of the substance, negative moods (e.g., depression, anxiety) coupled with enhanced sensitivity to stress eventually Top 5 Advantages of Staying in a Sober Living House create obsession-like preoccupation (brain becomes “hi-jacked”), a loss of executive functioning, and then relapse, reinitiating the cycle again (89). In Figure 1 the preoccupation-craving feedback loop converges with the neuroeconomics construct (see section Neuroeconomics).

The Informants

The current paradigm for OUD treatment is typically centered on psychotherapy in individual and group settings, in addition to psychiatry. Skills for distress tolerance and managing negative affect appear to be critical for maintaining sobriety. Other treatment approaches which consider neuroscience may lead to targeted treatments and better outcomes. Meanwhile, a purely medical approach to treatment (e.g., MAT alone) often fails to consider the importance of the patient-clinician relationship in the recovery process (195). Targeted treatments for individuals who are at heightened psychosocial and biological risk may benefit from the inclusion of enhanced treatment protocols such as gut-focused nutrition therapy.

the biopsychosocial model of addiction

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Such an assessment of the BPSM’s place in contemporary medicine is arguably overstated (Wade and Halligan 2017). The BPSM is also increasingly taught in medical schools and healthcare trainings (Barron et al. 2021; Bolton and Gillett 2019). While the biopsychosocial model has its place in the healthcare and mental healthcare systems, individuals might also implement tenants of this model in their own lives. This means being aware of how environmental factors impact their mental and physical health, as well as how their genetics and medical history in turn influence behaviors, thoughts, and emotions. A biopsychosocial approach to healthcare understands that these systems overlap and interact to impact each individual’s well-being and risk for illness, and understanding these systems can lead to more effective treatment. It also recognizes the importance of patient self-awareness, relationships with providers in the healthcare system, and individual life context.

the biopsychosocial model of addiction

Sociodemographic variables and factors

  • Similarly, the physician must know how to recognize and when to express his or her own emotions, sometimes setting limits and boundaries in the interest of preserving a functional relationship.
  • The SMH proposes a mechanism where emotion guides or significantly influences behaviour, particularly decision-making.
  • McLaren, Ghaemi, and others have argued that the BPSM is vague and/or devoid of meaningful scientific content (Bolton and Gillett 2019; Ghaemi 2009; McLaren 1998; Van Oudenhove and Cuypers 2014; Weiner 2008).
  • A relatively new class of theories known as ‘embodied mind’, ‘embodied cognition’, or ‘4E cognition’, explicitly overturns dualism and are, therefore, potentially relevant to a revitalized BPSM.
  • The first clinical trials of psychological therapies appeared in the 1970s, heralding what has become a very large-scale research program of developing and evaluating psychological interventions for a wide range of health conditions and their complications.
  • This reification of TMD helps explain why it seems plausible to say that “TMD,” despite never having been properly validated, is a disease that causes the symptoms by which it is actually defined.

This is one path to follow for new opportunities for treatment and intervention directed toward prevention. Accordingly, an analysis of the ethical, legal and social issues around other problems of addiction, such as prescription opiate misuse for pain management, may also be examined within the context of our proposed framework. Hunt (2004) takes the rights-based notion further and identifies and characterizes two ethics of harm reduction. First, he describes a “weak” rights ethic, wherein individuals have the right to access good healthcare.

  • So, should researchers aggregate disparate presentations to capture the fundamental “complexity” of TMD or disaggregate them to produce groupings that are more scientifically and clinically meaningful (i.e., valid in the normal sense of the term)?
  • Equally, it can be added, cognitive psychological models of specific systems such as memory and attention, need a wider, person-level framework to theorize how lowered function affects the person, for example, or typically, by compromising agency.

How the Biopsychosocial Model Impacts Mental Health

One explanation for this trend is that the toxic stress from trauma leads to a dysregulated stress response. An individual’s stress hormones (cortisol and adrenaline) are chronically elevated (Burke Harris, 2018; van der Kolk, 2014). Nothing in the relevant literature indicates this occurred (Bair et al. 2013; Slade et al. 2016).

Rather, in embracing Systems Theory,2 Engel recognized that mental and social phenomena depended upon but could not necessarily be reduced to (ie, explained in terms of) more basic physical phenomena given our current state of knowledge. He endorsed what would now be considered a complexity view,9 in which different levels of the biopsychosocial hierarchy could interact, but the rules of interaction might not be directly derived from the rules of the higher and lower rungs of the biopsychosocial ladder. As current interventions are inadequately addressing the multidimensional and far-reaching nature of the opioid epidemic [5, 6], some scholars have suggested developing more tailored approaches to reach specific, underrepresented populations [7]. Non-Hispanic whites, for instance, have become the primary focus for multiple prevention programs and strategies as they have been found to misuse opioid at greater rates [8,9,10]. However, multiple racial/ethnic groups have been found to be at differential risk, as well as differentially affected by opioid misuse [8,9,10].

Examples of wayward BPSM discourse

Despite their flaws, Engel’s concept-shifting arguments have become a part of the wider BPSM discourse. For example, as discussed in this article’s online Appendix, Maltzman argues that, due in part to “developments in biopsychosocial medicine,” a disease can be defined as a syndrome or cluster of biological and psychosocial problems; on this basis, “alcoholism is a disease” (Maltzman 1994, 13–15). The Appendix’s discussions of alcoholism, chronic pain, and chronic fatigue syndrome provide further examples of BPSM researchers using concept-shifting arguments to frame these maladies as diseases or disease equivalents. To our knowledge, this is the first US population-level study to comprehensively address risk profiles of opioid misuse using the latest national survey data available. These data are subject to the individual participant’s bias, truthfulness, recollection, and knowledge. Second, although the data are nationally representative, the survey is cross-sectional, and it excludes some subsets of the population.

the biopsychosocial model of addiction

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