This comprehensive paper examines multiple dimensions of health and disease through contrasting theoretical frameworks and applied case studies. It begins by comparing the traditional biomedical model with the modern biopsychosocial model, demonstrating how the latter better accounts for social, psychological, and environmental influences on health outcomes. The paper then analyzes risk and resilience factors using a case study, develops an HIV prevention plan for women in Franklin County, explores the psychological mechanisms underlying drug addiction, examines eating disorders as a mental health concern, and reviews the psychology of addiction including learning theory and evidence-based treatments. Throughout, the paper emphasizes how integrated, multifactorial approaches—rooted in the biopsychosocial perspective—offer superior frameworks for understanding and treating complex health and behavioral conditions.
Prior to 1977, the biomedical model was the key model used by physicians to explain the causes of illness and disease. It postulates that illness is a consequence of abnormalities or malfunctions in physiological body processes, and that social and psychological factors are not in any way related to the disease process (Taylor, 2009). In addition to this single-cause aspect, the biomedical model was driven by three other major assumptions: (i) the mechanical metaphor—that the body works as a machine; (ii) mind-body dualism—that our values, beliefs, and ideas, which are matters of the mind, play a significant role in the physiological and biological processes of the body; and (iii) the discounting emotion factor—that physicians could not rely on the patient's opinion when making a diagnosis because patients are likely to be biased about their health.
The biopsychosocial model, on the other hand, recognizes disease as a consequence of the interaction of various social, psychological, and biological factors (Taylor, 2009). It takes into account the entire scope of a patient's well-being and recognizes the effect of such factors as strain and stress, emotion, and environmental surroundings on the occurrence of illness and disease (Taylor, 2009).
The biomedical model is the traditional model of health and offers a number of crucial benefits in the study of illness and disease, particularly in relation to the effect of germs on biological processes. However, it also had its own share of liabilities, and it is these liabilities that led scientists to develop the new biopsychosocial model of health. To begin with, its assumption of mind-body dualism wrongly portrayed the body and the mind as two separate entities. Additionally, the model appeared to place more emphasis on the causes of illness as opposed to the conditions that promote health (Taylor, 2009). Moreover, its body-as-machine approach was thought to be a wrong oversimplification of reality that failed to recognize the fact that factors external to the human body such as inadequate food supply, domestic abuse, and dangerous neighborhoods also had an effect on a person's health (Taylor, 2009).
Of crucial significance, however, was its emphasis on the single-cause aspect of illness and disease. The model assumed that disease was caused solely by germs; however, this assumption began to gradually lose relevance after it was established that most modern illnesses are largely associated with lifestyle factors and stress and cannot be attributed to a single cause (Taylor, 2009).
The biopsychosocial model of health essentially addresses the shortcomings of the biomedical model. First, by recognizing the possible effect of external environmental factors on biological processes, the model is able to explain why, for instance, out of ten people who are exposed to measles, only five would actually develop the disease (Taylor, 2009). Moreover, by appreciating the effect of somatic factors, the model provides a more realistic framework for explaining the leading causes of death in modern society, including diabetes, cardiovascular diseases, and high blood pressure, which are largely associated with lifestyle factors. Further, the model is able to clearly explain how social and psychological factors influence the effectiveness of treatment (Taylor, 2009). It is because of these relative strengths that the biopsychosocial model has been increasingly adopted by practitioners and researchers.
Under the biomedical model, physicians were expected to make diagnoses by considering only the effect of biological factors such as biochemical imbalances, and how these could have contributed to the reported malfunctions. In contrast, the biopsychosocial model requires physicians to "consider the interacting role of biological, psychological, and social factors in assessing an individual's health or illness" (Taylor, 2009, p. 7). Moreover, a physician must ensure that treatment recommendations involve all three factor sets, and that consequently, target therapy is designed to fit the unique health statuses of individual patients and to deal appropriately with multiple health problems (Taylor, 2009).
The case of Max illustrates the multiple risk factors that predispose individuals to stress and disease. Job stress is a primary concern: he works in an auto parts factory, where he is exposed to unfavorable levels of noise, hostile working conditions that he has very little control over, and a demanding work schedule that requires him to work in the evenings and on weekends. He has very little time to rest, and the fact that his body is constantly in a state of activation predisposes his biological systems to higher levels of wear and tear. Ultimately, the risk of disease increases as the body becomes increasingly fatigued, and its ability to repair damaged tissues and defend itself from harm is seriously compromised.
Relationship problems compound this stress. He is unable to negotiate higher wages given that he has little control over the terms of his employment. As a result, he faces financial constraints and is under constant pressure from his wife, who perhaps feels that he is not giving enough in terms of time and finances to support his family. He also faces the pressure of being a good employee and, at the same time, a family man. The combined effect of these pressures places him at very high risk of suffering a psychological breakdown.
Smoking and unhealthy eating habits further increase his disease risk. His frequent intake of fatty diets increases the levels of cholesterol in his blood and causes plaque buildup in his coronary arteries, placing him at high risk of cardiovascular disease. Smoking increases this risk, as well as that of lung cancer.
Unfavorable surroundings and neighborhoods present additional stressors. He lives in a crime-prone neighborhood and is under intense pressure to protect his hard-earned assets. He also faces additional pressure from not having enough time to guide his children away from engaging in crime. These factors make him more predisposed to stress and mental disease.
Resilience factors enhance Max's ability to cope with the aforementioned risk factors. A strong social network of caring family members and good friends offers assistance in the form of financial and friendly advice, essentially helping him deal with his financial constraints and psychological pressures. Regular exercise helps him burn excess cholesterol and boost his levels of good cholesterol, minimizing the risk of heart disease. Further, regular exercise reduces the risk of psychological breakdown as it provides an emotional lift, making one feel happier and more confident.
The Centers for Disease Control and Prevention (CDC) estimates that approximately 29 percent of persons living with HIV in America today are women (Morokoff, et al., 2011). It is further estimated that women have a 12 percent likelihood of getting infected through heterosexual contact, whereas men have a 4 percent risk of exposure to the same (Morokoff, et al., 2011). Injection drug use has been found to be the greatest cause of HIV infection among women, with approximately 46 percent of the current population of women living with AIDS having been exposed through this medium (Morokoff, et al., 2011). Moreover, 38 percent of this population was exposed through unprotected intercourse with an infected person.
This plan seeks to reduce the rates of HIV infection among women in Franklin County, New York. The CDC recently named New York as the second-leading state in terms of HIV infections among women. The plan will focus on educating women in Franklin on how to reduce their exposure to HIV. It will emphasize three major areas: infections through injected drug use, infections through sexual behavior, and mother-child transmissions during birth and breastfeeding.
The CDC identifies amphetamines, cocaine, and heroin as the most commonly injected substances among women. Sharing of injection paraphernalia such as needles exposes women to the risk of HIV infection. This infection could also occur through water used to unclog equipment, cotton used for drug filtration, and drug cookers for melting heroin, all of which come into contact with blood at some point during the injection process (Morokoff, et al., 2011). The majority of women who get infected with HIV through this medium do so from a relational context—sharing injection equipment with their injection drug-using sex partners.
This form of transmission can be prevented through educating women on how to use bleach to clean their drug injection paraphernalia. Further, needle exchange programs (NEPs) can be initiated. However, unlike in other programs where women are required to travel physically to the distribution center to exchange their equipment for new ones, this program will emphasize a door-to-door distribution mechanism so that child care responsibilities do not bar women from benefiting from the program.
Although the rate of women-to-women transmission is not as high as that of men-to-men, the CDC estimates that homosexual sexual behavior still accounts for a significant percentage of HIV transmission among women (Morokoff, et al., 2011). Oral sex is the most common form of transmission in this regard. Condoms have been found to be an effective mechanism for preventing sexually transmitted disease transmission during sexual activity.
To reduce the rates of transmission between heterosexual partners, this plan, unlike past programs which have focused on educating women on how to use and obtain condoms, will teach women how to "be sexually assertive with respect to declining unwanted sex or initiating condom use" (Morokoff, et al., 2011, p. 276). Specific strategies will include empowering women to gain control over sexual activity through the use of the female condom, as the male condom has been found to be largely male-controlled.
Under the proposed plan, counseling will be offered in all settings that offer care facilities to women, including drug abuse treatment facilities, mental health clinics, sexually transmitted disease clinics, prenatal clinics, family planning clinics, and primary care facilities. Practitioners will be trained on how to provide voluntary testing programs as well as universal counseling services. Further, care and information providers will be educated on how to use sensitive strategies to assess patients' exposure risks by, for instance, examining their drug use and sexual risk behaviors (Walker, 2003).
They will be taught how to design their strategies so that they are client-centered, linguistically-specific, developmentally-appropriate, sensitive to sexual identity issues, culturally-competent, and confidential. Women will be educated on, among other things, "how the administration of zidovudine (ZDV) early in pregnancy can substantially reduce the rate of perinatal HIV transmission" (Morokoff, et al., 2011).
Based on effective implementation of these strategies, it is estimated that the plan could reduce the rates of HIV transmission among women in Franklin County by more than 3 percent annually.
Traditionally, psychologists held that drug use can best be explained through the reinforcement effect—that with repeated use, drugs and substances affect the dopamine system of the brain, making it unable to regulate emotional responses without the drug (American Psychology Association, 2001). Continued use is then seen as the only way to acquire that emotional reinforcement or reward that was initially provided by the dopamine system (APA, 2001).
Studies have, however, shown that drug use and addiction are more complex processes that go beyond the brain's ability to regulate emotion. Accordingly, psychologists have increasingly adopted the explanation that repeated substance abuse causes damage to the frontal cortex of the brain, which is responsible for regulating both emotional activities and cognitive activities such as response-inhibition and decision-making (APA, 2001). In this regard, drug use is taken to have an effect on both the emotion-regulating system and the cognitive-regulating system of the brain. It is, therefore, regarded as both a behavioral and a pharmacological disease; and consequently, treatment for addiction has to focus on both aspects (APA, 2001).
This model of drug use provides a clearer framework for explaining why, although many people use drugs such as alcohol and cocaine, only a small proportion becomes addicted (APA, 2001). According to Dr. Herb Weingartner of the National Institute on Drug Abuse (NIDA), whether or not one becomes addicted depends primarily on the degree to which the individual's ability to control cognitive operations has been compromised (APA, 2001). Media influences, such as advertisements for the drug or public campaigns against the drug, therefore, have a negligible effect on drug use and addiction. This basically means that if an individual still has relatively strong control over their cognitive operations, no amount of advertising for the drug can drive them to compromise the same.
Drugs are psychoactive substances capable of altering behavior, cognition, and mood. They are classified into three major groups, depending on their effect on the central nervous system (CNS): (i) depressants such as heroin and alcohol, which slow down CNS activity, creating feelings of reduced anxiety as well as relaxation; (ii) stimulants such as cocaine and caffeine, which speed up CNS activity, causing paranoia as well as increased feelings of well-being, confidence, and energy; and (iii) hallucinogens, such as ketamine and PCP, which cause alterations in the perception of time and sensory experiences.
This discussion focuses on the depressants category, which are associated with a number of health hazards, including the risk of permanent brain damage and sustained mental confusion; strokes and seizures; liver damage or failure; abdominal pain and vomiting; and a weakened immune system that is highly susceptible to infections.
Addiction to drugs in the depressant category (alcohol and heroin) is treatable using psychological techniques, particularly because thoughts play a significant role in an individual's decision to engage in substance use. Cognitive-behavioral therapy can be used to alter the way an individual thinks about these drugs. Through such therapy, the individual would be able to anticipate health problems associated with drug use and to consequently develop appropriate coping mechanisms. Specific treatment techniques would include exploring the consequences of continued substance abuse and initiating self-monitoring strategies for recognizing and dealing with cravings and risk factors.
"Clinical recognition and therapeutic intervention for bulimia nervosa"
"Theoretical frameworks and evidence-based treatment approaches"
You’re 60% through this paper. Sign up to read the remaining 2 sections.
Sign Up Now — Instant Access Already a member? Log inAlways verify citation format against your institution’s current style guide requirements.