Author Topic: Biopsychosocial Model for the Mind  (Read 703 times)

Lorenzo

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Biopsychosocial Model for the Mind
« on: July 04, 2013, 11:06:11 PM »
Written by: A. L. Lucino Jr, M.D., M.A., Ph.D-c
Doctoral Research Paper
Historical Systems in Psychopathology Research




Since the famous case of Phineas Gage in 1848, who was a British industrial worker who experienced profound personality change after his life altering accident that resulted in a metal rod that damaged his central nervous system (Hergenhahn, 2009), there has been considerable research and interest on how behavior can be affected if there is organic damage to the central nervous system, which is primarily composed of the brain and the spinal cord (Sadock and Sadock, 2007). A phenomenon has occurred recently in the late 20th century and continues to this present time where there is an interest in understanding how disease manifestation happens. This need to understand how disease occurs and what factors influence this led to the birth of the Biopsychosocial model, which has stated that there are many factors that influence an individual’s mental and physical well-being and Engel called this the Biopsychosocial model (Suls, Krantz and Williams, 2013).





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Lorenzo

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Re: Biopsychosocial Model for the Mind
« Reply #1 on: July 04, 2013, 11:07:03 PM »
What the Biopsychosocial model stated was that biological, psychological and social factors influence human functioning especially in regards to disease and illness (Suls et al, 2013). In the analysis of the biopsychosocial model of the mind in explaining how disease manifests, one has to understand that this process of thinking was influenced by Galton’s concept of Nature Vs. Nurture, which, according to Galton, influenced the personality and the very persona of the individual. Nature represented the physical make-up of the individual and that individual’s natural mental capacity for thinking and learning, whereas nurture represented the influences that affected the individual after birth (Hergenhahn, 2009). The use of the biopsychosocial model can be used to analyze specific types of mental disorders and one in particular is schizophrenia.

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Lorenzo

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Re: Biopsychosocial Model for the Mind
« Reply #2 on: July 04, 2013, 11:07:16 PM »
Schizophrenia is a psychopathology that is characterized with problems in patient’s cognitive abilities, emotional stability, perception of reality, and overall abnormality in behavior. The disorder is associated with the first rank and second rank symptoms that clinical psychologists and medical psychiatrists can observe. The first rank symptoms include audible thoughts, voice arguments, or observable discussion with self, passive somatic experiences, withdrawal in thought, broadcasting of thought and delusion. The second rank symptoms include sudden delusion; perplex character, depression and then subsequent euphoria (Sadock and Sadock, 2007).

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Lorenzo

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Re: Biopsychosocial Model for the Mind
« Reply #3 on: July 04, 2013, 11:07:30 PM »
   Through the use of modern medicine and evaluative tools such as the positron emission tomography and magnetic resonance imaging, physicians are now able to visualize the organic changes to the brain in terms of activity and physical size in patients with schizophrenia. There was a research conducted by Karabay, Oniz, Gokcay, Alptekin, Hugdahl and Ozgoren (2013) which wanted to enlighten the relationship with mental illness and the morphology of the brain and the use of this relationship as a possible biomarker for patients suffering with schizophrenia. Karabay et al (2013) conducted a study to observe the Prefrontal Cortex and the Heschel’s Gyrus in terms of changes in size and function and its relationship to patietns’ cognitive ability as well as and other psychiatric implications for patients suffering with schizophrenia. Karabay et al (2013) documented that in medical studies that there have been profound changes in the morphology of patients suffering from schizophrenia such as the dysplastic changes of the ventromedial temporal lobe, changes in the limbic system’s subcortical nucleus, in the profrontal cortex and in the main cerebral cortex, which is responsible for memory and executive functions.

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Lorenzo

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Re: Biopsychosocial Model for the Mind
« Reply #4 on: July 04, 2013, 11:07:46 PM »
   Schizophrenia’s classical signs and symptoms, especially incoherent speech, delusional disorders, somatic passivity, thought withdrawal and audition of thoughts can be explained through the organic changes of the brain. Karabay et al (2013) noted that there were profound changes in the integrity of the white matter of the brain, especially in the reduction of the corpus callosum, which is responsible for connecting the right and left hemispheres and thus functions in the communication. The research conducted by Karabay et al (2013) indicated that the corpus collosum was actually reduced in size or was destroyed in some schizophrenic patients as compared to normal individuals without schizophrenia. This severance of the corpus callosum was debated as a possible cause of the lack of coherence in thought and speech. Patients with schizophrenia also have damage in the Heschel’s gyrus, which is associated with auditory input and information conceptualization, and thus also plays a major role in the processing of speech. The damage of the Heschl’s gyrus correlates to schizophrenic patients’ inability to effect proper speech or speech that is coherent in thought and suggestion.

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Lorenzo

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Re: Biopsychosocial Model for the Mind
« Reply #5 on: July 04, 2013, 11:07:58 PM »
Since the Heschl’s gyrus plays a role in auditory perception and the processing of language, the reduction of the volume of the Heschl’s gyrus is associated with the cognitive dysfunction in schizophrenic patients. There was, unfortunately, a decreased overall size in brain volume in patients with schizophrenia as compared to individuals who do not have schizophrenia (Karabay et al, 2013). To augment the current research’s understanding of how organic changes in the brain is associated with cognitive changes in schizophrenia patients, Nickl-Jockschat, Schneider, Pagel, Laird, Fox and Eickhoff (2011) conducted a study to observe the correlation with the reduction in grey matter size and duration of schizophrenia. The results of the study showed that morphological changes of the grey matter and white matter in areas of the brain that were associated with auditory and language perception of stimuli and response processes were significantly affected.

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Re: Biopsychosocial Model for the Mind
« Reply #6 on: July 04, 2013, 11:08:10 PM »
There is some kind of genetic link with schizophrenia. Sadock and Sadock (2007) state that in the United States alone, there was a prevalence for schizophrenia in 1 percent of the American population, which means that for every 100 people in the United States, there will be 1 individual who will develop schizophrenia. There seems to be some kind of genetic link to schizophrenia. Schizophrenia and schizophrenia-related disorders such as paranoid personality disorders, schizoid disorders, schizotypal disorders tend to occur with high rates in blood relatives of schizophrenic patients. The proclivity for schizophrenia tends to be higher for persons who are more genetically closer to an individual with schizophrenia, this means that there is a discrimination for first degree relatives as compared to second degree, third degree, etc (Sadock and Sadock, 2007). To illustrate the genetic link of schizophrenia, a study was conducted by Bener, Dafeeah, Samson (2012) to study how consanguinity increased the risk of patients developing schizophrenia. The results of the study showed that individuals who had schizophrenia had parents who had schizophrenia and that their parents were also related by blood. The study illustrated that there were higher risk of individuals who committed consanguineous marriages to produce schizophrenic children as compared to individuals who did not have consanguineous marriages, thus reducing the risk of schizophrenia (Bener et al, 2012).

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Re: Biopsychosocial Model for the Mind
« Reply #7 on: July 04, 2013, 11:08:23 PM »
When one studies schizophrenia, one has to also understand the environmental factors in the onset of this disorder. Despite the genetic and the congenital factors for the explanation of the disorder, there are also environmental factors that could contribute to the manifestation of schizophrenia. In a study conducted by Van Os, Kenis and Rutten (2010) it was identified through twin-twin studies and through heritability studies that there is increased risk for schizophrenia for patients who live in an urban environment, for patients who are in a social-economic disadvantaged minority group such as African American or Latino-American group, patients who are regular users for cannabis, and for those who have experienced developmental trauma. Van Os et al (2010) emphasize the importance of gene-environmental analysis for schizophrenia and schizotypal disorders as a way to understand how disorders can be identified, and help aid in the treatment and management process (Richard and Brahm, 2012).

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Re: Biopsychosocial Model for the Mind
« Reply #8 on: July 04, 2013, 11:08:36 PM »
The psychopathology known as schizophrenia definitely has some implications for the mental health field and for research, however, through the lens of the biopsychosocial model of research in the mental health field, we have a better understanding of how mental disorders are not merely a result of some kind of chemical or congenital malformation, but is influenced by a plethora of factors, mostly through morphological changes in the biology of the brain, through genetic factors, and environmental factors such as ethnicity and race as well as location of living in an urban, suburban or rural environment. We see how nature and nurture can not only influence the development of human personality, but how it can also be used to analyze how disease processes manifest in patient populations.

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Re: Biopsychosocial Model for the Mind
« Reply #9 on: July 04, 2013, 11:10:14 PM »
Research Methods and Results

We (Lucino et al, 2013)conducted a study to observe changes in the brain morphometry occurred in patients with schizophrenia, the specific areas of the brain that was analyzed and observed was the prefrontal cortex as well as the heschel’s gyrus. The researchers hypothesized that there would be dramatic changes in the heschl’s gyrus asn prefrontal cortex in schizophrenic patients as compared to patients that are not suffering from schizophrenia. The study took 29 patients suffering from schizophrenia and were evaluated to have schizophrenia through DSM-IV diagnosis. These said 29 patients were then studied through magnetic resonance imaging and their prefrontal cortex and heschl’s gyrus volumes were measured through proper tracing procedures. When the data was analyzed, they observed how brain volume sizes changed as the disease progressed in its nefarious stages. The results of the study showed how there was indeed a decrease in the heschl gyrus volumes in both the right and left hemispheres, as well as a decrease in white matter and grey matter sizes in both left and right hemispheres of the brain. It was observed that in relation to the left heschl’s gryus volume, the spearman rho was at -0.48, with a p < 0.01 with a curve estimation at p < 0.05. The decrease in size of the heschl’s gyrus and prefrontal cortex of patients with schizophrenia has been associated with the loss of neuronal dendrites, decrease in conduction, as well as the loss of axonal myelin and even apoptosis of neurons.

The presentation of the information was rather didactic and thorough with biomedical graphing used to illustrated the morphological changes of the brain, specifically the heschl’s gyrus and the prefrontal cortex. This provides psychologists and neurophysiologists an biological feedback and point of view of how organic changes influence cognition.

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