Biopsychosocial model

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The biopsychosocial model ("BPS model") looks at biological, psychological and social factors to explain why disorders occur and is a tool used by psychologists to examine how psychological disorders develop.[1]

History[edit]

In a 1977 article in Science,[2] psychiatrist George L. Engel called for "the need for a new medical model."

Controversy[edit]

Inappropriately used to explain biological disorders that cannot yet be explained by medical science. Myalgic encephalomyelitis and Chronic Fatigue Syndrome, (ME/CFS), and Fibromyalgia are now believed to have a biological cause. This incorrect view has led to the PACE trial with Graded Exercise Therapy (GET) and Cognitive behavioral therapy (CBT) being utilized for treatment of ME/CFS.

We have been attacked by gremlins[edit]

A 1994 study by Pawlikowska, Trudie Chalder and Simon Wessely, looking at general fatigue and psychological distress, found that women are more likely to complain of fatigue; and that the commonest reasons for fatigue were work, family, and lifestyle ('psychosocial', 40% of patients). Their conclusion was that fatigue is closely associated with 'psychological morbidity'.[3]

  • A 2000 response by Martin Bland, a professor of mathematical statistics, questioned the seemingly impossible statistical results of that study, and some other statistical errors.[4].
  • A response from Chalder and Wessely admitted the error and said:
'Somewhere between the analysis and the printed copy we have been attacked by gremlins. Sadly, the passage of time, theft of a computer containing the original draft, and the fact that none of us can find the proofs anymore, mean that we have no idea when this happened.'[5]
  • David Marchevsky, a consultant psychiatrist, responded on the dangers of 'unsupported conclusions derived from faulty analyses', especially when 'this doctor was an important key figure in a Cochrane collaboration group.'[6]
  • Jon Håvard Loge wrote that he had a copy of the original 1993 manuscript submitted for review, which did not include the errors, and he suggested that 'The gremlins seem to have attacked somewhere in the production line because the referees at the BMJ reviewed a manuscript with correct means.'[7]
"Missing proofs, theft of a computer and passage of time might seem like poor excuses and indicate unreliable researchers."
  • Simon Wessely replied, reaffirming that the BMJ was attacked by gremlins.[8]
  • Anthony Pelosi, who reviewed the original manuscript, responded that he had told the authors of a number of statistical errors, and suggestions to fix them.[9]
  • Richard Smith, the editor of the BMJ, replied that the errors were "ultimately unimportant", and suggested a dinner be held.[10]

Notable studies[edit]

References[edit]

  1. What is the Biopsychosocial Model? - Definition & Example - Study.com Chapter 4, Lesson 15 - Instructor, Gina Mitchell
  2. JSTOR - Science, Apr 8, 1977, Volume 196 Number 4286
  3. Pawlikowska, T; Chalder, T; Hirsch, SR; Wallace, P; Wright, DJ; Wessely, SC (1994-03-19), "Population based study of fatigue and psychological distress", BMJ : British Medical Journal, 308 (6931): 763–766, PMID 7908238 
  4. Bland, Martin (2000-02-19), "Fatigue and psychological distress - Statistics are improbable", BMJ, 320 (7233): 515, PMID 10678880, doi:10.1136/bmj.320.7233.515/a 
  5. Chalder, T; Wessely, SC (2000-02-19), "Fatigue and psychological distress - Statistics are improbable (author's response)", BMJ, 320 (7233): 515, PMID 10678880, doi:10.1136/bmj.320.7233.515/a 
  6. Marchevsky, David (2000-02-29), "Twists in the tale of impossible means - In which a copy of the original manuscript is found safe in Norway", BMJ, 320 (7233): 515, PMID 10678880, doi:10.1136/bmj.320.7233.515/a 
  7. Loge, Jon Håvard (2000-05-13), "Twists in the tale of impossible means - In which a copy of the original manuscript is found safe in Norway", BMJ, 320 (7233): 515, PMID 10885930 
  8. Wessely, SC (2000-05-13), "Twists in the tale of impossible means - Gremlins at the BMJ, not Kings", BMJ, 320 (7233): 515, PMID 10885930 
  9. Pelosi, Anthony (2000-05-13), "Twists in the tale of impossible means - The reviewer shows that the gremlins might have attacked on several fronts", BMJ, 320 (7233): 515, PMID 10885933 
  10. Smith, Richard (2000-05-13), "Twists in the tale of impossible means - and the editor invites everyone to dinner", BMJ, 320 (7233): 515, PMID 10885933 


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From MEpedia, a crowd-sourced encyclopedia of ME and CFS science and history