This approach is called holistic because it posits that separate issues are often related. The course of a physical illness could influence social interaction or psychological function, or a social and familial background might have an impact on a biological or psychological problem. By asking a series of questions that may establish the most important elements in each of these spheres, a better treatment plan may be derived.
The Biopsychosocial Approach The biopsychosocial model has led to the development of the most therapeutic and cost-effective interdisciplinary pain management programs and makes it far more likely for the chronic pain patient to regain function and experience vast improvements in quality of life.
The study also revealed that one-fifth of adults over the age of 65 reported pain that lasted more than 24 hours, with three-fifths of these older adults reporting that their pain had lasted for more than one year. Although pain research has traditionally focused on the sensory modalities and the neurological transmissions identified solely on a biological level, more recent theories integrating the body, mind, and society have been developed.
The most heuristic perspective is known as the biopsychosocial model, with pain viewed as a dynamic interaction among and within the biological, psychological, and social factors unique to each individual. Indeed, as reported Bio psycho social Gatchel,4 Figure 1 presents a conceptual model of these interactive processes involved in health and illness.
In this paper, we will also examine the following: Evolution of the Biopsychosocial Model of Pain The earliest theories of pain had focused primarily on the understanding of the biological or pathophysiological component of pain.
Cartesian Dualism, or separation of the mind and the body, dates back to the 17th century when Rene Descartes conceptualized pain as an exclusive process within the sensory nervous system.
Even without empirical evidence, it was Bio psycho social that the experience of pain was conveyed directly to the brain from the skin, without any psychosocial interplay. Termed biomedical reductionism, this point of view remained constant through the late 19th century.
During the late s, two additional theories arose, providing a clearer conceptualization of the biological view of pain.
The specificity theory of pain, put forth by Maximilian von Frey inproposed that there were subcutaneous receptors unique to the different types of sensory input. Although this theory helped to explain incidences of phantom limb pain, which is described as experiencing pain after the termination of the input, the pattern theory of pain disregards receptor and fiber evidence which has come to fruition in recent developments.
Today, there is much more known about the different types and functions of receptors, such that mechanoreceptors respond to touch and pressure, while thermoreceptors activate in response to changes in temperature.
Nociceptors are associated with pain perception and, depending on the specific fiber A, d or C of the nociceptor type mechanical, thermo-mechanical, or polymodal that is stimulated, the perception of pain can range from sharp and prickly, to burning or freezing.
The lack of adequate explanations for pain and suffering spurred the next advance in our understanding of nociception and the individual experience of pain. Although the underlying mechanisms of this proposed theory are often debated, the implications that there is an interaction between the psychosocial and physiological processes have been widely accepted.
Melzack and Wall8 claimed that this gate-like function modulated the amount of afferent impulses from the periphery to the transmission cells T-cells of the dorsal horn through inhibitory processes at the neuronal level, and thereby controlling the quantity and intensity of the signals to the central nervous system.
Furthermore, it was posited that higher cortical functions contribute to this gating mechanism. This allows for psychological phenomena to directly affect the subjective experience of pain.
From a clinical perspective, Gatchel5 suggests that the psychosocial component in the gate control theory contributes a great deal in treating patients with pain. By promoting positive health behaviors, proactive choices can be factors in lessening the perception of pain.
Compared to the earlier dualistic approaches to understanding pain, the gate control theory can be viewed as the first mind-body perspective to introduce the integration of the central nervous system with cognitive processes. An extension to this theory, termed the Neuromatrix Model of Pain, was proposed by Melzack in The neuromatrix theory incorporates the stress component into the pain equation.
Based on the original work put forth by Selye,9 stress serves as a mechanism of adaptation, such that the body will respond to challenging or dangerous situations in an attempt to lessen any problematic consequences.
The two neuroendocrine systems, the sympathetic-adrenomedullary system and the hypothalamic-pituitary-adrenocortical axis HPAserve to activate this fight or flight system. When dealing with chronic pain, individuals experiencing elevated levels of stress may actually exacerbate the pain experience.
As stress intensifies pain, the increased level of pain, in turn, inevitably becomes a stressor that continues to threaten homeostasis.
This approach views a physical disorder as the result of an intricate and dynamic interaction among biological, psychological, and social factors that can often antagonize the pain condition.
Individuals tend to express variability in their pain experiences due to the range and interaction of these factors that modulate the interpretation of symptoms.
Subsequently, Loeser,14 applied this model to pain see Figure 2. From this perspective, there were four dimensions related to the idea of pain: While nociception and pain provide methods of communication to the central nervous system, suffering and pain behavior, on the other hand, are described as reactions to those signals that can be influenced by both previous experiences and anticipation of potential consequences.The biopsychosocial model seems to be the most adequate for the study of trauma-related disorders, while in therapy the specific shaping of psychotherapy seems to be crucial.
Biopsychosocial model The biopsychosocial model (abbreviated "BPS") is a general model or approach positing that biological, psychological (which entails thoughts, emotions, and behaviors), and social (socio-economical, socio-environmental, and cultural) factors, all play a significant role in human functioning in the context of disease or.
CONFIDENTIAL CARE Rev.
07/25/ Page 1 of 7 1. abstract of dissertation exploring biopsychosocial (bps) facets of chronic obstructive pulmonary disease (copd) in patients in an acute inpatient.
In fact, the dominant theoretical framework in addiction science today is the biopsychosocial framework, which recognizes the complex interactions between biology, behavior, and environment. biopsychosocial approach recognizes that different clinical scenarios may be most usefully understood scientifically at several levels of the natural systems continuum.
To apply the biopsychosocial approach to clinical practice, the clinician should.