Understanding the Biopsychosocial Model of Health

This may involve reckless behaviour that is often incomprehensible to other people and may lead to stigma and shame [16, 18, 48]. Mental health problems, such as anxiety and depression, may increase [29], and it may be difficult to maintain social relationships, everyday parenting responsibilities and work routines [18, 34]. The hard work of obtaining, paying for, and using substances becomes all-consuming [37, 47]. Most people who develop SUD either manage their substance-induced life problems adequately or are able to quit on their own or with help from family and friends [42]. For a smaller group of people, substances have too many negative consequences, and they need help and treatment from professionals.

What Exactly Is the Biopsychosocial Model of Addiction?

  • This is in line with former research on recovery, which emphasised the importance of social relationships during a recovery-process [22, 31, 35, 43, 44].
  • Yet when neurogenetic attributions are made entirely irrespective of their social context, individuals with mental health problems are viewed as less responsible (Mehta and Farina 1997), and the individuals themselves may perceive a limited control over their actions (Shiloh, Rashuk-Rosenthal, and Benyamini 2002).
  • For instance, cocaine and methamphetamine block dopamine reuptake, which leads to increased dopaminergic activity from the VTA to the NAcc (Niehaus, Murali, & Kauer, 2010).
  • Critically, it is now generally accepted that illness and health are the result of an interaction between biological, psychological, and social factors.
  • The internal homunculus is a fallacy – it has no role in either the production or evaluation of behavior or its consequences.

The BMM would predict scientific-explanatory reduction to primary biological causes only across the whole of health, like the biomedical models of infectious diseases (or of effects of lesions or of genes of major effect). Translating the principals of social learning theory into actionable practices for addiction does not mean that inpatient treatment should cease – indeed, some components of inpatient treatment are absolutely critical (e.g., detoxification). It also does not mean that the solution for addiction is already at hand in the church basements and community centers across the country where 12-step programs meet. Rather, successful translation of social learning principals into clinical practice involves creating treatments that are socially and environmentally invasive – in much the same way that new treatments for pancreatic cancer and valvular heart disease are physiologically invasive. Borrowing from Bandura’s model, “drug use” can be considered the critical behavior of interest.

  • If Descartes cracked open the door of causal determinism, then an argument could be made that Thomas Hobbes blew it off its hinges.
  • Our affinity for this inebriant was such that humans throughout most parts of the world had mastered the techniques of creating wine, beer, and distilled spirits 2000 years ago.
  • Changes to the functional relationships between the three components of the model can occur at any point within the model, leading to continually evolving functional relationships between personal factors, the environment, and behavior.

Communicating Clinical Evidence

biopsychosocial theory of addiction

The opponent-process approach (Solomon & Corbit, 1974) suggests that the shift from substance use to substance abuse is generated by the transition from positive to negative reinforcement processes motivating continued substance use. From the perspective of incentive sensitization (Robinson & Berridge, 1993), the shift reflects an associative learning process mediated by a neurobiological sensitization to substance-related cues. Taken together, and according to incentive-learning principles (Bouton & Nelson, 1998), it is possible that before drug-related cues become meaningful enough to ‘incentivize’ drug use, they first need to be paired with the consequences of drug-use via repetition and reinforcement.

Interpretations, Language, and Causality

Addiction professionals tend to partition complex phenomena according to their own self-interests – the neuroscientist sees only neuropathology, the psychologist sees only broken relationships, the bureaucrat sees only ineffective laws and regulations. All of these individuals are correct in their observations, but they are only seeing part of the picture – a picture that is exceedingly complex because it’s in a constant state of motion. Placing addiction at the center of this model reveals how addiction is greater than the sum of its parts. The factors that have causal influences on addictive behavior do not operate independently but are part of a complex network that both directly and indirectly influence addictive behavior ad infinitum. Once these factors begin to set the occasion for addictive behavior, a series of interdependent events begin to unfold, with each event further increasing drug intake, and making the other events all the more effective at increasing drug use further.

Understanding the Impact of Close Relationships

Rates of substance use and dependence vary across, and even within, cultural and social groups (Wallace 1999; Wallace, Bachman, O’Malley et al. 2002). Factors such as availability and peer modeling account for the inter- and intra-group disparities (Thomas 2007). These factors may indicate a certain level of group risk for problematic substance use, but cannot verify either the likelihood of substance use occurring within the group or which individuals within the group are more likely to be affected. These factors are not inherent in the composition of the social structure, are neither stable nor persistent, but are governed by the social values and norms of that social system or group (Bunge 2003).

biopsychosocial theory of addiction

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