The biopsychosocial context of ADHD.

attention-deficit/hyperactivity disorder (adhd) represents adaptation to defective neurotransmission – an adaptation seldom with benefit. the resulting behavioural style not only increases vulnerability to adverse experiences, but also creates a context in which encountering adversity is more likely. furthermore, the fact that adhd is a highly heritable condition increases the probability of a child with a compromised neurobiological disposition being raised by caregivers with suboptimal resources

Beyond Theoretical Orientations: The Emergence of a Unified Scientific Framework in Professional Psychology

Psychology has been remarkably successful as both a basic and applied science despite serious and persistent conflict between its many theoretical camps and schools of thought. By far the most influential approaches to conceptualizing clinical practice in psychology have been the traditional theoretical orientations, even though they are widely viewed as inadequate and incomplete. This article reviews the underlying reasons for these conflicts and then discusses the emergence of a unified scientific framework that moves the profession beyond these problems. Outmoded conceptual frameworks are not appropriate for a science-based profession, and professional psychology needs to consider making a systematic transition to a comprehensive scientific approach to understanding human development, functioning, and behavior change

The substrate of the biopsychosocial influences in the carcinogenesis of the digestive tract

Digestive cancer represents a severe public health problem, being one of the main causes of death. It is considered a multifactorial disease, with hereditary predisposition, environmental factors, and other factors involved in carcinogenesis. Both the evolution and the pathogenesis of digestive neoplasms remain incompletely elucidated. As a multifactorial disease, it can be approached by taking into account the biopsychosocial influences via enteric nervous system. Many peptides and non-peptides having a neurotransmitter role can be found in the enteric nervous system, which can influence the neoplastic process directly or indirectly by affecting some angiogenic, growth, and metastasis factors. However, neurotransmitters can also cause directly, through intercellular signalizing, the angiogenesis, the proliferation, and the digestive neoplasms’ metastasis. This new approach to neoplasms of the digestive tube assumes broader psychosocial factors can play an important role in the understanding the ethiopathogenie, the evolution of the disease, and determination of possible molecular targeted therapies; it also suggests that behavioral strategies may be important for maintaining a healthy state with respect to the digestive tract

Case management training needs to support vocational rehabilitation for case managers and general practitioners: a survey study

<b>Background</b><p></p> The use of the biopsychosocial model of health and case management for effective vocational rehabilitation (VR) has been confirmed for many health conditions. While Case and Condition Managers (CCMPs) use this approach in their everyday work, little is known about their views on training needs. A review of the training curriculum for General Practitioners’ (GPs) revealed little training in VR and the biopsychosocial model of care. This study aims to identify Case and Condition Managers and GPs perceptions of their training needs in relation to employability and VR.<p></p> <b>Methods</b><p></p> 80 Case and Condition Managers and 304 GPs working in NHS Lanarkshire, providing a comparison group, were invited to participate in this study. A self-completion questionnaire was developed and circulated for online completion with a second round of hardcopy questionnaires distributed.<p></p> <b>Results</b><p></p> In total 45 responses were obtained from CCMPs, 5 from occupational health nurses (62% response rate) and 60 from GPs (20% response rate). CCMPs and the nursing group expressed a need for training but to a lesser extent than GP’s. The GP responses demonstrated a need for high levels of training in case/condition management, the biopsychosocial model, legal and ethical issues associated with employment and VR, and management training.<p></p> <b>Conclusions</b><p></p> This survey confirms a need for further training of CCMPs and that respondent GPs in one health board are not fully equipped to deal with patients employability and vocational needs. GPs also reported a lack of understanding about the role of Case and Condition managers. Training for these professional groups and others involved in multidisciplinary VR could improve competencies and mutual understanding among those advising patients on return-to-work

Examining the Content of Mental Health Intake Assessments From a Biopsychosocial Perspective

Psychotherapists’ approach to intake assessment has a major impact on mental health case conceptualization and treatment. Despite the importance of this issue, very little is known about the actual intake assessment practices of therapists providing mental health care in the community. This appears to be the first study that has investigated which aspects of biological, psychological, and sociocultural functioning are documented by therapists in their client intake assessments, how thoroughly these issues are assessed, and how well the information collected is then integrated into the assessment findings and case conceptualization. The examination of 163 client files from 3 mental health clinics found that therapists were regularly collecting client information regarding a wide range of biopsychosocial issues, though not in a detailed or comprehensive manner. There was also little evidence that the information was being integrated in a manner designed to maximize treatment effectiveness. These findings have major implications for training and practice in mental health assessment

Blaming the victim, all over again: Waddell and Aylward's biopsychosocial (BPS) model of disability

The biopsychosocial (BPS) model of mental distress, originally conceived by the American psychiatrist George Engel in the 1970s and commonly used in psychiatry and psychology, has been adapted by Gordon Waddell and Mansell Aylward to form the theoretical basis for current UK Government thinking on disability. Most importantly, the Waddell and Aylward version of the BPS has played a key role as the Government has sought to reform spending on out-of- work disability benefits. This paper presents a critique of Waddell and Aylward’s model, examining its origins, its claims and the evidence it employs. We will argue that its potential for genuine inter-disciplinary cooperation and the holistic and humanistic benefits for disabled people as envisaged by Engel are not now, if they ever have been, fully realized. Any potential benefit it may have offered has been eclipsed by its role in Coalition/Conservative government social welfare policies that have blamed the victim and justified restriction of entitlements

The growing need for a unified biopsychosocial approach in mental health care

Psychology has been remarkably successful as a scientific discipline and field of clinical practice. Despite its remarkable growth, however, the field has also experienced substantial conflict and controversy. There has been great diversity in the approaches counselors and psychologists have used to understand development, psychopathology, and the goals and processes of psychotherapy. This has led to large numbers of conflicts and controversies that have distracted the field from its primary purposes. A biopsychosocial approach has the potential to bring the field together around a unified science-based framework for understanding mental health practice that will avoid these conflicts

Changes in pain-related beliefs, coping, and catastrophizing predict changes in pain intensity, pain interference, and psychological functioning in individuals with myotonic muscular dystrophy and facioscapulohumeral dystrophy

The primary aim of this study was to test hypothesized associations between changes in psychological variables (i.e., pain beliefs, catastrophizing and coping strategies) and changes in pain intensity and related adjustment (i.e., pain interference and psychological functioning) in individuals with Myotonic Muscular Dystrophy (MMD) and Facioscapulohumeral Muscular Dystrophy (FSHD). Methods: A sample of 107 adults with a diagnosis of MMD or FSHD, reporting pain in the past three months, completed assessments at two time-points, separated by about 24 months. Results showed that changes in pain-related psychological variables were significantly associated with changes in psychological functioning, pain intensity and pain interference. Specifically, increases in the belief that emotion influences pain, and catastrophizing were associated with decreases in psychological functioning. Increases in the coping strategies of asking for assistance and resting, and the increases of catastrophizing were associated with increases in pain intensity. Finally, increases in pain intensity and asking for assistance were associated with increases in pain interference. Discussion: The results support the utility of the biopsychosocial model of pain for understanding pain and its impact in individuals with MMD or FSHD. These findings may inform the design and implementation of psychosocial pain treatments for people with muscular dystrophy and chronic pain

Management of work-relevant upper limb disorders: a review

Background Upper limb disorders (ULDs) are clinically challenging and responsible for considerable work loss. There is a need to determine effective approaches for their management. Aim To determine evidence-based management strategies for work-relevant ULDs and explore whether a biopsychosocial approach is appropriate. Methods Literature review using a best evidence synthesis. Data from articles identified through systematic searching of electronic databases and citation tracking were extracted into evidence tables. The information was synthesized into high-level evidence statements, which were ordered into themes covering classification/diagnosis, epidemiology, associations/risks and management/treatment, focusing on return to work or work retention and taking account of distinctions between non-specific complaints and specific diagnoses. Results Neither biomedical treatment nor ergonomic workplace interventions alone offer an optimal solution; rather, multimodal interventions show considerable promise, particularly for occupational outcomes. Early return to work, or work retention, is an important goal for most cases and may be facilitated, where necessary, by transitional work arrangements. The emergent evidence indicates that successful management strategies require all the players to be onside and acting in a coordinated fashion; this requires engaging employers and workers to participate. Conclusions The biopsychosocial model applies: biological considerations should not be ignored, but psychosocial factors are more influential for occupational outcomes. Implementation of interventions that address the full range of psychosocial issues will require a cultural shift in the way the relationship between upper limb complaints and work is conceived and handled. Dissemination of evidence-based messages can contribute to the needed cultural shift