Unlike, say, the Henle-Koch postulates or Evans’ criteria for causality (Evans 1976), the BPSM does not articulate epistemic principles that would allow researchers to distinguish true cause-effect relationships from spurious correlations. Furthermore, because the BPSM is really an atheoretical model (Brendel 2003; Sober House Ghaemi 2011; Skarmeta et al. 2019), it obviously cannot establish which explanations make theoretical sense. Thus, although the BPSM tells us we can list a huge array of factors as disease causes (see Fig. 1), the model itself does not tell us how to determine which factors play a causal role in any given case.
1. Socrates, Plato, Aristotle and the origin of knowledge
- Since this information will help us understand the claims made about OPPERA, I will briefly summarize it in this paragraph and the next.
- This study provides the most recent and comprehensive risk assessment of possible biopsychosocial characteristics indicative of opioid misuse.
- Substances such as alcohol and legal or illegal drugs have been used for recreation, celebration, and coping with difficult life situations and health problems [37].
- “I believe that [the biopsychosocial model] could enhance their self-awareness and understanding of themselves, along with broadening their personal sense of what issues or challenges may be going on with them,” says Dr. Marsh.
- Our study used a comprehensive approach to understand how multiple biopsychosocial characteristics relate, in context, to opioid misuse and/or use disorder.
Invoking the BPSM and writings of Paolo Freire, they argue that gun violence disease can be attributed to an underlying “disease of oppression” embedded in “our violent society.” “Public health,” they write, “has a role to address the disease of oppression” (Kohlbeck and Nelson 2020, 3). Instead of merely providing public education, health professionals should engage directly in the “dismantling of violent structures of power” and in fostering “liberation” https://thefremontdigest.com/top-5-advantages-of-staying-in-a-sober-living-house/ (Kohlbeck and Nelson 2020, 4–5). This effort would entail helping to redistribute resources in society to eradicate the perceived root causes of violence and steering public discourse on violence to align with the authors’ own views (Kohlbeck and Nelson 2020, 4–5). Thus, Kohlbeck and Nelson would have health professionals working to restructure society and manipulate the parameters of public debate as forms of disease control and prevention.
- However, since Engel makes these claims while still in the epistemically-uncharted territory of “illness” and “human experience,” there is nothing internal to the discussion itself that clearly rules them out.
- For instance, they have established that the genetic underpinnings of alcohol addiction only partially overlap with those for alcohol consumption, underscoring the genetic distinction between pathological and nonpathological drinking behaviors [50].
- A premise of our argument is that any useful conceptualization of addiction requires an understanding both of the brains involved, and of environmental factors that interact with those brains [9].
- At times they appear to argue that the diverse problems manifested by patients (“abundant variables,” “appreciable variability”) mean that the TMD construct17 is good.
Whole Person Healthcare The Biopsychosocial Spiritual Model of Medicine. By Doodle Med.(
Finally, the individual in recovery is encouraged to “make amends” to those harmed, expanding the social network beyond the support group so that new metacontingencies can be established in novel environments. These practices borrowed from 12-step programs are just a few of the turn-key strategies that can be employed when developing new metacontingency- and network-based interventions for drug addiction. For instance, medications designed specifically for substance use disorders target the central nervous system in ways to minimize the effectiveness of the addictive substance (e.g., buprenorphine/naloxone for opioid use disorder). Other medications impact the nervous system to decrease the influence of comorbid psychiatric conditions that drive addictive behavior (e.g., antidepressants, anxiolytics). In similar ways, psychotherapy addresses past traumatic experiences (e.g., childhood abuse) and current psychological stressors (e.g., loss of job) that are determinants of both drug use and pathological relationships with other individuals in the social environment. Policy interventions influence the external environment to make drugs more expensive, less available, and less socially desirable in ways that impact both the individual and the drug using community.
Theorizing personal, interpersonal, and institutional factors in clinical care
All characteristics tested with exception of residence at some level were found to be a significant factor predictive of opioid misuse. In dismissing the relevance of genetic risk for addiction, Hall writes that “a large number of alleles are involved in the genetic susceptibility to addiction and individually these alleles might very weakly predict a risk of addiction”. He goes on to conclude that “generally, genetic prediction of the risk of disease (even with whole-genome sequencing data) is unlikely to be informative for most people who have a so-called average risk of developing an addiction disorder” [7]. It is true that a large number of risk alleles are involved, and that the explanatory power of currently available polygenic risk scores for addictive disorders lags behind those for e.g., schizophrenia or major depression [47, 48]. The only implication of this, however, is that low average effect sizes of risk alleles in addiction necessitate larger study samples to construct polygenic scores that account for a large proportion of the known heritability.
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