UNIT 2 - TOPIC 3

Biopsychosocial approach

it promotes a holistic, three-pronged, collaborative approach to understanding, assessing and treating psychological disorders. It offered a holistic alternative to the traditional biomedical model, which separated mind and body.

Who and when was the biopsychosocial approach developed?

George Engel in 1977

How do biological factors help with the biopsychosocial approach

helps us understand how physical health and brain function can impact a person’s mental health and behaviour.

• Focuses on how the body affects behaviour.

• Looks at the brain, nervous system,
  chemicals in the brain, and inherited traits
  (genetics).

• Explains behaviour using physical and
  biological processes.

Biological factors included in biopsychosocial approach

body and physical health - physiology, anatomy, neurology, genetics, gender, age, and ethnicity.

How do psychological factors help with the biopsychosocial approach

helps us understand how a person’s mental
processes and emotional traits influence their behaviour and wellbeing.

Psychological factors included in biopsychosocial approach

mind and emotions - personal perceptions (their individual opinions based on past experiences), personality traits, cognition (how they think, learn etc.), attention (what they focus/ignore), motivation (what drives them?) and behaviours (are they aware of their actions and how it affects others?).

How do social factors help with the biopsychosocial approach

highlights how a person’s social surroundings and support systems affect their health and recovery.

• These factors can help build resilience or
  contribute to poor health.

• Strong social support networks are just as
  important as medical care for recovery.

• A caring, professional relationship
  between the patient and clinician is
  essential for better outcomes.

Social factors included in biopsychosocial approach

people, environment, and social conditions - school or work pressures, level of education, access to medical/support services, socioeconomic status, cultural background and values

Risk factors

conditions or factors that increase the likelihood of a person developing a disorder/condition or experiencing a relapse (getting worse after getting better) They often interact, and their impact depends on their number, type, and persistence.

Biological risk factors for psychological disorders

can make someone more vulnerable to mental illness. It includes genes, medication, sleep and substance abuse.

Genes as a biological factor

it is the genetic vulnerability to specific disorders. It increases the risk of developing psychological disorders. Genes influence how proteins are made in the body, but genetic mutations can result in abnormal protein function such as neurotransmitter imbalances. This does not guarantee a disorder, it only increases susceptibility.

Medication as a biological factor

it is poor response to medication due to genetic factors. Genetics can affect the effectiveness and dosage needs of the medication.

Sleep as a biological factor

sleep and mental health can influence each other. Common disorders include anxiety, depression, ADHD, and bipolar disorder. Sleep deprivation can impair emotional regulation, making individuals react more intensely to negative emotions. Mental dysregulation from lack of sleep can increase vulnerability to mental illnesses. Benzodiazepines can treat sleep problems by enhancing GABA, which helps with relaxation and emotional control. Long-term use of benzodiazepine can cause worsening depression and dependence.

Substance abuse as a biological factor

it is linked to various psychological disorders. Addictive substances can alter brain function by interfering with neurotransmission. It can also worsen existing mental health conditions or trigger symptoms in genetically vulnerable individuals.

Psychological risk factors for psychological disorders

affects how someone handles stress or trauma. It includes rumination, impaired reasoning and memory and stress.

Rumination as a psychological factor

obsessive thinking and worrying about negative past, present, or future situations. It can harm mental health if the cycle is not broken, preventing the ability to generate solutions or shift focus. The more long-term the rumination, it becomes a cognitive habit and becomes more harder to break. It is the brain’s tendency to link related memories - negative thoughts trigger more negative memories. This process involves neural networking, where brain areas for negative thinking become more active.

Impaired reasoning and memory as a psychological factor

difficulties in thinking clearly and remembering information. It interferes with everyday life, work and relationships.

What disorders does impaired reasoning and memory occur in?

schizophrenia, depression, dementia, bipolar disorder and PTSD

Stress as a psychological factor

causes the body to release hormones (cortisol). Too much stress that is ignored can harm the mind and body.

Social risk factors for psychological disorders

impacts a person’s emotional wellbeing and support system. It includes disorganised attachment and significant relationships.

Disorganised attachment as a social factor

People with disorganised attachment struggle to express feelings and connect with others. This makes it harder for people to cope with life’s challenges in a healthy way, increasing their chances of developing psychological disorders.

Significant relationships as a social factor

relationships that are considered highly important, such as with family, friends, romantic partners, or housemates. They often involve love and affection. The loss of a significant relationship can lead to gried. Prolonged grief can lead to psychological disorders such as anxiety or depression.

Grief relating to loss of a significant relationship

a multi-faceted response to loss that activates the limbic system - physical, emotional, cognitive, behavioural and spiritual. It can even cause risky behaviours such as substance use, complicated bereavement disorder (in severe cases) etc.

Two examples of anxiety disorders

GAD and specific phobias

Prevalence of specific phobias

affect about 11% of Australians, with children being the most commonly affected group. It's normal for children to have fears at different ages, and most grow out of them. The age of onset varies depending on the type of phobia, but most begin in childhood. If a specific phobia persists into adulthood, it usually does not go away without treatment.

Symptoms of specific phobias

there is four broad categories of symptoms - healthy, reacting, injured and disorder. Disorder symptoms include excessive anxiety and fear, inability to fall or stay asleep, isolation and inability to perform duties.

Perceived causes of specific phobias

refer to the factors believed to contribute to the development of phobias. These causes are not always the same for everyone, but they usually fall into the biopsychosocial approach (biological, psychological and social/environmental factors).

Biological causes of specific phobias

genetics, brain function, and flight-fight-freeze response.

Psychological causes of specific phobias

classical conditioning (a direct experience causing a general phobia - association), observational learning and cognitive biases.

Social/environmental causes of specific phobias

parenting styles, life experiences (traumatic general events often out of person’s control) and cultural influences.

Generalised Anxiety Disorder (GAD)

involves constant, excessive worrying that affects daily life for at least six months. Unlike specific phobias, GAD’s anxiety is not tied to a particular situation and can cover worries about work, school, health, family, finances, and more. Worries often shift from one topic to another, causing ongoing distress.

Prevalence of GAD

Anxiety disorders affect about 17.2% of Australians aged 16–85. Women are more affected (21.1%) than men (13.3%). From this same sample, around 3.8% of Australians have GAD (higher in women by 2 percent - 4.8% in women and 2.8% in male). GAD often occurs alongside other disorders like depression, complicating diagnosis and treatment. In Australia, about 6.9% of young people (4-17 years old) have an anxiety disorder, with 2.2% having GAD.

Symptoms of GAD

persistent worrying that is hard to control, restlessness, muscle tension, fatigue, difficulty participating in everyday activities. In children, they may show perfectionism traits and often seeking constant approval from others and asking “what if…?” questions.

Perceived causes of GAD

falls into the biopsychosocial approach (biological, psychological and social/environmental factors).

Biological causes of GAD

flight-fight-freeze response, the neurotransmitters GABA (calming) and glutamate (excitatory), and genetic predisposition and inherited vulnerabilities.

Psychological causes of GAD

Individual perceptions such as behavioural factors, how behaviour is influenced by the environment; and cognitive factors, how thought processes influence feelings and behaviours. Thoughts and beliefs play a MAJOR role.

Social/environmental causes of GAD

environmental triggers (life events, substances, exposure), parental modelling (children observing parents) and transmission of threat information (e.g. people mentioning threats frequently).

Stigma

Stigma is the negative label or judgment society attaches to mental illness. It can be public stigma (others holding stereotypes, e.g., “weak” or “dangerous”), self-stigma (when the person internalises those stereotypes), or institutional stigma. This leads to discrimination, disapproval or exclusion of a person because of a mental illness - causing them to feel ashamed, isolated and rejected. It prevents them from seeking help or receiving proper support by hiding symptoms or losing trust in treatment.

What are the main types of treatment for psychological disorders?

psychotherapy, pharmacotherapy, electroconvulsive therapy (ECT) and psychosurgery.

What is psychotherapy?

a type of psychological disorder treatment. It is the use of psychological techniques (like CBT, psychodynamic, and systematic desensitisation) by trained professionals to change thoughts, emotions, and behaviours.

What disorders is psychotherapy used for?

It’s used for a range of disorders

What is the effectiveness of psychotherapy?

It is effective for many people and often improves quality of life and emotional functioning.

Side effects of psychotherapy

they are minimal but may involve emotional discomfort when exploring distressing thoughts.

Is psychotherapy used alone or in combination?

It can be used alone or combined with medication (pharmacotherapy), especially for moderate to severe conditions.

What is pharmacotherapy?

a type of psychological disorder treatment. involves treating mental health disorders with medication, such as antidepressants (SSRIs), antipsychotics (e.g. clozapine), or medication for substance use (e.g. methadone).

What disorders is pharmacotherapy used for?

It’s used for depression, anxiety, schizophrenia, and addiction.

What is the effectiveness of pharmacotherapy?

It is effective at reducing or managing symptoms but may not fully cure the disorder.

Side effects of pharmacotherapy

dependency, physical effects (like weight gain), and possible non-compliance.

Is pharmacotherapy used alone or in combination?

It can be used alone, but is often more effective when combined with psychotherapy.

What is electroconvulsive therapy (ECT)?

a type of psychological disorder treatment. it is a medical treatment where seizures are electrically induced in the brain to relieve severe mental health symptoms

What disorders is ECT used for?

It’s used especially for depression and bipolar disorder

What is the effectiveness of ECT?

It is highly effective, with 50–80% remission in some cases, and works quickly.

Side effects of ECT

confusion and memory loss, particularly around the time of treatment.

Is ECT used alone or in combination?

It is usually only used when other treatments like psychotherapy and pharmacotherapy have failed, or when fast relief is needed (e.g. in suicidal depression).

What is psychosurgery?

a type of psychological disorder treatment. it involves physically altering the brain (e.g. removing brain tissue or using Deep Brain Stimulation)

What disorders is psychosurgery used for?

It’s used rarely, for severe, treatment-resistant disorders like OCD, depression, and schizophrenia.

What is the effectiveness of psychosurgery?

Its effectiveness is limited — fewer than half of patients significantly improve — but DBS (deep brain stimulation) is more precise and less damaging than older traditional surgeries.

Side effects of psychosurgery

serious side effects like memory loss, personality changes, brain bleeding, and death.

Is psychosurgery used alone or in combination?

It is only used when all other treatments have failed, and is not combined with other therapies during the procedure, but some patients still take medication before or after.

Placebo effect in treatment

a psychological and physiological phenomenon where a person experiences a real improvement in their condition after receiving a treatment that has no active therapeutic effect. So, if someone is given a fake treatment (like a sugar pill) but believes it's real medicine, they may start to feel better— not because of the treatment itself, but because they expect it to work.

How does placebo effect even work (science)

The placebo is the fake treatment — it could be a sugar pill, saline injection, or even a sham procedure. The effect comes from the person’s belief that they are receiving a real treatment. It’s not “just in their head” — the brain can release chemicals (like endorphins or dopamine) that produce realphysical effects.

Why is the placebo effect important?

Researchers use placebo-controlled studies to test whether a new treatment works better than a placebo — helping to separate the actual effectiveness of a treatment from the effects of belief and expectation.