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The bio-psycho-social model: Understanding health and illness
Posted on
21.8.2024
Edited on
20.8.2024
Contents
Health and illness are influenced by many factors. The biopsychosocial model is a holistic approach to understanding health and illness. It looks at the complex interactions between biological, psychological and social factors.
The biopsychosocial model can be applied to various health issues.These include chronic pain, mental disorders and other complex medical problems.The biopsychosocial model was first conceptualised by George Engel in 1977. It is considered an interdisciplinary alternative to the traditional ‘biomedical model’, which focussed mainly on isolated biological factors.This article presents the factors influencing health in terms of the bio-psycho-social model.Advantages and challenges for practice are explained.
Biological factors in the bio-psycho-social model
In the bio-psycho-social model, the biological factors relate to the physical level. These include age, gender, predisposition, physical processes, nutritional status, illnesses and injuries.
Age & gender
Susceptibility to diseases and the likelihood of contracting certain diseases is influenced by gender and age. For example, degenerative rheumatic diseases tend to occur with increasing age.
Statistically, three times as many women are affected by MS than men.
Genetic predispositions
Genetic predispositions describe human predispositions. They influence various processes in the human body and can influence the probability of certain diseases. For example, some diseases are considered hereditary diseases, others can be inherited indirectly. In the latter case, a predisposition may be inherited which is a risk factor for the disease but does not necessarily predict an onset of the disease.
Physical processes
Physical processes describe all processes that take place in the body. These include metabolic processes, hormonal processes and the function of the immune system. Physical processes are also known as physiological processes. If these processes run incorrectly, these diseases can trigger or influence them.
Pathogens
Pathogens are biological factors that can cause infections in the human organism. For example, the Sars-CoV-2 virus can trigger a coronavirus infection that can lead to long Covid. Bacteria can also cause infections or pollutants can cause diseases.
Injuries
Accidents or other events that result in physical injury also fall into this category.
Nutritional status
Nutrition provides the body with energy, vitamins, minerals and trace elements. Supplying the body with nutrients is essential for health.
Musculature
Exercise and sport are generally considered to be beneficial to health.
Well-trained muscles are regarded as a protective factor on a biological level, as they can prevent overloading, among other things.
Biological factors influence health and illness as well as the symptoms that occur.However, biological factors are not considered individually, but in constant interaction with psychological and social factors.
The biopsychosocial model emphasises that health and illness are the result of complex interactions between all these factors.
Psychological factors in the biopsychosocial model
In the biopsychosocial model, psychological factors refer to the cognitive, mental and emotional levels of a person.
Not only the basic attitudes towards health, illness and treatments are taken into account. Psychological factors also include personality traits that influence thinking and behaviour, as well as feelings, self-care and self-efficacy.
Thinking
Cognitive processes, beliefs and thought patterns play an important role. For example, a positive attitude to life can have a positive effect on health and illness.
Feeling
Emotions and emotional states can also influence health. This applies to positive emotions such as joy or happiness, as well as negative emotions such as fear or sadness.
Behaviours
Behaviour and reactions to different situations can also influence health.For example, a healthy and balanced diet can support health. Coping strategies and mechanisms can help to deal with emotional and health challenges.
Stress management
The way a person deals with stress can have a significant impact on their health. Effective stress management strategies can help to minimise negative health effects.
Motivation and goals
Motivation to stay healthy and achieve personal health goals can have a major impact on a person's behaviour and health. Clear goals and intrinsic motivation often promote healthier lifestyle habits.
Learning experiences and conditioning
Previous learning experiences and conditioning influence how people react to certain stimuli and situations. Negative learning experiences can lead to anxiety disorders, for example, while positive experiences can strengthen self-confidence.
Self-respect
Self-care, also known as self-care or self-awareness, is the ability to be attentive and aware of one's own needs, feelings and boundaries and to actively ensure that these needs are met.
Self-Efficacy
Self-Efficacy describes confidence in their own abilities to successfully complete specific tasks or challenges. Self-Efficacy influences how people think, feel, motivate and act.
Psychological factors are in constant interaction with biological and social factors. They influence how a person perceives and deals with health and illness and what impact this has on their well-being. The biopsychosocial model emphasises that psychological factors can have a significant influence on the state of health and the course of illness.
Social factors in the biopsychosocial model
In the biopsychosocial model, social factors refer to a person's environment and living conditions.
These include the private and professional environment, but also cultural and social factors.
Private & professional environment
The quality of relationships within the family and family support play an important role. A reliable social network can also act as a protective factor. Friends and family not only form a social network during health. In the event of worries, problems or illness, they can also provide day-to-day support and mental support.
The working environment also has an influence on health. For example, the working environment, job satisfaction, relationships with colleagues and occupational stress are all influencing factors. For example, persistent excessive demands or chronic stress can have a negative impact on health. Shift work can also affect health, as the sleep rhythm is irregular.
Cultural and social factors
Social expectations as well as cultural practices and habits can influence health behaviour. These include diet, physical activity and the consumption of various substances, such as regular alcohol consumption.
Health literacy and access to basic medical care also influence health. Health literacy describes the knowledge of health-related topics. Access to healthcare describes the ability to utilise medical and preventative services.
These social factors are in constant interaction with the biological and psychological factors. The biopsychosocial model emphasises that a person's health cannot be viewed in isolation, but is the result of complex interactions between all three levels.
Understanding health and illness holistically — advantages of the biopsychosocial model
The biopsychosocial model is an interdisciplinary approach that takes into account biological, psychological and social factors influencing health and illness. It views health and illness as the result of complex interactions between these factors, rather than isolated biological phenomena.
Along the way, the model illustrates individual, complex influences on health, but also on illness.
As a result, the bio-psycho-social model promotes the active participation of patients in their own healthcare and decision-making processes.
The model also requires collaboration between different health professionals to consider all aspects of a patient's health.
The biopsychosocial model has found broad acceptance in practice. It is considered a comprehensive approach to healthcare that involves patients, doctors and therapists alike. The focus is on the patient with their physical and mental health as well as the social and cultural environment.
The holistic view of health is very complex and poses challenges for therapists in particular. The views of clinicians can differ greatly from that of patients, making it difficult to communicate and understand symptoms.
However, patients can start this themselves and document symptoms and influencing factors themselves. Symptom diaries or apps such as the Fimo Health app can be used for this purpose.
Despite these challenges, the biopsychosocial model continues to influence medical education, clinical practice, and research and offers a more holistic and patient-focused approach to healthcare.
The biopsychosocial model is a holistic approach to explaining health and illness. It takes into account biological, psychological and social factors. The model was proposed by George Engel in 1977 as an alternative to the traditional biomedical model, which only considers biological factors.
Biological factors include genetic predispositions, physical processes and nutritional status. Psychological factors relate to cognitive processes, emotions, behaviour and self-efficacy. Social factors include the social environment, working conditions and cultural influences. The biopsychosocial model emphasises the interactions between these levels and promotes interdisciplinary cooperation in healthcare.
[1] George L. Engel: The need for a new medical model: a challenge for biomedicine. In: Science. Band 196, Nr. 4286, 8. April 1977, S. 129–136, PMID 847460.
[2] Springer Medizin – Das biopsychosoziale Modell von Krankheit und Gesundheit, abgerufen am 05.07.2024
[3] Lexikon der Psychologie – biopsychosoziales Krankheitsmodell, abgerufen am 05.07.2024
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