Feb. 15, biopsychsocial model

Feb. 15, Biopsychsocial Model
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February 15: Biopsychosocial Model Biopsychosocial unified approach - no single aspect can fully explain the complexity of psychological disorders - each causal factor is interacting with the other How did these factors interact to produce THIS disorder in THIS person at THIS time? Example: Judy, a 16-year-old, was referred to an anxiety clinic after increasing episodes of fainting. About 2 years earlier, in her biology class, the teacher showed a graphic film of a frog dissection, with vivid images of blood, tissue, and muscle. About halfway through, Judy felt lightheaded and left the room. But the images didn’t leave her. She continued to be bothered by them and occasionally felt queasy. She began to avoid situation where she might see blood or injury. She stopped looking at magazines that might have gory pictures, and found it difficult to look at raw meat, or even Band-Aids. It got so ba that she felt lightheaded when her friend exclaimed, “Cut it out!” She fainted anytime she unavoidably encountered blood. Each time, her parents or friends rushed to her side, but were unable to help. By the time of referral, Judy was fainting 5-10 times a week, often in class. Because her physician could find nothing wrong with her, Judy’s principal concluded that she was being manipulative and suspended her from school, even though she was an honors student. Multiple, interacting influences that contribute to Judy’s phobia: Psychological - classical conditioning and stimulus generalization - generalizes her reaction to a US to include anything related to the US—has a conditioned response to anything related to blood - negative thoughts and avoidance maintain fear (negative reinforcement) - she cannot habituate to her fear, so her conditioned response is maintained - fear triggers more intense physiological response Cognitive - a cognitive psychologist would look for some sort of irrational interpretations (such as Judy’s interpretation of band-aids) - Ellis would say that Judy is having catastrophic thoughts (like “Blood will cause me to faint and hit my head and die” or “It will cause terrible social humiliation) - becomes a self-fulfilling prophecy Psychodynamic - repression or denial of a previous traumatic event, such as a bloody car accident - her mind is naturally protecting her by fainting, so she can avoid dealing with the trauma Social - social attention (positive reinforcer) may increase symptoms, because she likes the attention - rejection and adversity can worsen mental disorders Biological - oversensitive sinoaortic baroreflex arc —how the body reacts to elevations in blood pressure - the experience of disgust causes her to have a sudden increase in blood pressure, and her body overcompensates activating the parasympathetic nervous system to maintain homeostasis—the overcompensation leads to less blood flow to the brain, so she faints - this oversensitivity seems to be inherited - vasovagal syncope - if medicine solves the problem, then Judy will become dependent on medicine—she never cognitively
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