Biopsychosocial Model

The biopsychosocial model views health and illness behaviours as products of biological characteristics (such as genes), behavioural factors (such as lifestyle, stress, and health beliefs), and social conditions (such as cultural influences, family relationships, and social support).

The biopsychosocial model of health and illness is a framework developed by George Engel that states that interactions between biological, psychological, and social factors determine the cause, manifestation, and outcome of wellness and disease.

Biopsychosocial Model

The psychological component of the biopsychosocial model seeks to find a psychological foundation for a particular symptom or array of symptoms.

Social and cultural factors are conceptualised as a particular set of stressful events that may differently impact the mental health of people from different social environments and histories.

Despite its usefulness, there are issues with the biopsychosocial model, including the degree of influence that each factor has, the degree of interaction between factors, and variation across individuals and life spans.

PSCEBSM Model for Taking Biopsychosocial History

Pain type

Clinical identification and differentiation of the dominant pain mechanism:

  • nociceptive pain
  • neuropathic pain
  • non-neuropathic pain of central sensitization

Somatic and medical factors

  • comorbidities
  • modified movement patterns
  • exercise capacity
  • neurodynamics
  • strength
  • coordination

Cognitive factors

  • cognitions and perceptions about the physical and mental aspects of pain
  • expectations regarding care, prognosis, and emotional representation of pain
  • catastrophizing
  • perceived injustice or harm

Emotional factors

  • anxiety, anger, fear, depression and post-traumatic stress
  • fear of movement (kinesiophobia), avoidance behaviours
  • psychological issues related to work, family, finances, or social issues

Behavioural factors

Behavioural adaptations to pain:

  • healthy response
  • fear avoidance
  • pain persistence

Social factors

  • housing/living situation
  • social environment
  • work
  • relationships
  • prior treatments and attitudes towards prior/other healthcare providers
  • social support

Motivation

  • readiness to change
  • perceptions about the cause of pain and treatment expectations
  • psychological flexibility
  • state of change
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