Skip to main content Accessibility help

We use cookies to distinguish you from other users and to provide you with a better experience on our websites. Close this message to accept cookies or find out how to manage your cookie settings.

Close cookie message
×
Hostname: page-component-76fb5796d-dfsvx Total loading time: 0 Render date: 2024-04-28T12:15:50.043Z Has data issue: false hasContentIssue false

Chapter 3 - The Biopsychosocial Assessment

from Part I - Approach to Wellness

Published online by Cambridge University Press:  18 September 2020

By
Lubna Somjee  and
Sabrina A. Esbitt
Edited by
Waguih William IsHak
Waguih William IsHak
Affiliation:
Cedars-Sinai Medical Center and David Geffen School of Medicine, University of California Los Angeles (UCLA)
Get access

Summary

In the past few decades we have seen incredible advances in healthcare with respect to technology, research, and interventions. As we continue to research health and healthcare, we have uncovered that the traditional focus on the biomedical model (BM) exclusively has been reductionistic and not robust in assessing and treating patients. Accordingly, it is critical that our work with patients, including the assessment process, needs to reflect these advances in healthcare. This includes a biopsychosocial (BPS) approach to working with patients [1].

Traditionally, the dominant approach to health focused on the body and the ways medicine can assess and intervene. This is the BM model. This model posits that illness is determined by biologically based defects. This approach was incredibly helpful for illnesses like tuberculosis, and other infectious diseases. However, in the twentieth century, people were more likely to die of chronic diseases including – but not limited to – heart disease, cancer, and so forth [2].

Type
Chapter
Information
The Handbook of Wellness Medicine , pp. 23 - 36
Publisher: Cambridge University Press
Print publication year: 2020

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Engel, GL. The biopsychosocial model and the education of health professionals. Ann N Y Acad Sci 1978; 310: 169–181.CrossRefGoogle ScholarPubMed
Fuller, J. The new medical model: a renewed challenge for biomedicine. CMAJ 2017; 189: E640–E641.Google Scholar
Engel, GL. The need for a new medical model: a challenge for biomedicine. Science 1977; 196: 129–136.Google Scholar
Smith, RC. The biopsychosocial revolution: interviewing and provider–patient relationships becoming key issues for primary care. J Gen Int Med 2002; 17: 309–310.CrossRefGoogle Scholar
Phillips, A, Frank, A, Loftin, C, et al. A detailed review of systems: an educational feature. J Nurse Pract 2017; 13: 681–686.CrossRefGoogle Scholar
Behforouz, HL, Drain, PK, Rhatigan, JJ, et al. Rethinking the social history. N Engl J Med 2014; 371: 1277–1279.Google Scholar
McDaniel, S, Campbell, TI, Seaburn, DB. Family-Oriented Primary Care: A Manual for Medical Providers. New York, Springer-Verlag; 1989.Google Scholar
Wu, B. History taking in reverse: beginning with the social history. Consultant 2013; 53: 34–36.Google Scholar
Haidet, P, Paterniti, DA. “Building” a history rather than “taking” one. Arch Intern Med 2003; 163(10): 1134.Google Scholar
Berk, ML, Monheit, AC. The concentration of healthcare expenditures, revisited. Health Affairs 2001; 20(2): 9–18.CrossRefGoogle ScholarPubMed
Schoenman, JA. NIHCM Foundation data brief: the concentration of healthcare spending. 2012. www.nihcm.org/pdf/DataBrief3%20Final.pdf.Google Scholar
Kessler, RC, Demler, O, Frank, RG, et al. Prevalence and treatment of mental disorders, 1990 to 2003. N Engl J Med 352: 2515–2523.Google Scholar
U.S. Preventive Services Task Force. Final recommendation statement: depression in adults: screening. 2016. www.uspreventiveservicestaskforce.org/Page/Document/RecommendationStatementFinal/depression-in-adults-screening1.Google Scholar
Kroenke, K, Spitzer, RL, Williams, JBW. The PHQ-9. J Gen Intern Med 2001;16(9): 606–613.Google Scholar
Parmelee, PA, Katz, IR. Geriatric Depression Scale. J Am Geriatr Soc 1990; 38(12): 1379.CrossRefGoogle ScholarPubMed
Spitzer, RL, Kroenke, K, Williams, JBW, Löwe, B. A brief measure for assessing generalized anxiety disorder. Arch Intern Med 2006; 166(10): 1092.Google Scholar
Prins, A, Bovin, MJ, Kimerling, R, et al. The Primary Care PTSD Screen for DSM-5 (PC-PTSD-5). 2015 [Measurement instrument].Google Scholar
Prins, A, Bovin, MJ, Smolenski, DJ, et al. The Primary Care PTSD Screen for DSM-5 (PC-PTSD-5): development and evaluation within a veteran primary care sample. J Gen Intern Med 2016; 31(10): 1206–1211.CrossRefGoogle ScholarPubMed
Weathers, FW, Litz, BT, Keane, TM, et al. PTSD. 2018. www.ptsd.va.gov/professional/assessment/adult-sr/ptsd-checklist.asp.Google Scholar
Blevins, CA, Weathers, FW, Davis, MT, Witte, TK, Domino, JL. The Posttraumatic Stress Disorder Checklist for DSM-5 (PCL-5): development and initial psychometric evaluation. J Trauma Stress 2015; 28: 489–498.CrossRefGoogle ScholarPubMed
Brown, RL, Rounds, LA. Conjoint screening questionnaires for alcohol and other drug abuse: criterion validity in a primary care practice. Wis Med J 1995; 94(3): 135–140.Google Scholar
Levinson, W. Patient-centred communication: a sophisticated procedure. BMJ Qual Saf 2011; 20(10): 823–825.CrossRefGoogle ScholarPubMed
Burg, MM, Abrams, D. Depression in chronic medical illness: the case of coronary heart disease. J Clin Psychol 2001; 57(11): 1323–1337.Google Scholar
Uchino, BN, Bowen, K, Kent de Grey, R, Mikel, J, Fisher, EB. Social support and physical health: models, mechanisms, and opportunities. In: Fisher, E, Cameron, L, Christensen, A, et al., eds., Principles and Concepts of Behavioral Medicine. New York, Springer; 2018; 341–372.Google Scholar
Williams, DR, Priest, N, Anderson, NB. Understanding associations among race, socioeconomic status, and health: patterns and prospects. Health Psychol 2016; 35(4): 407–411.Google Scholar
Goh, J, Pfeffer, J, Zenios, SA. The relationship between workplace stressors and mortality and health costs in the United States. Manage Sci 2016; 62(2): 608–628.CrossRefGoogle Scholar
Moortel, DD, Vandenheede, H, Muntaner, C, Vanroelen, C. Structural and intermediary determinants of social inequalities in the mental well-being of European workers: a relational approach. BMC Public Health 2014; 14(1).CrossRefGoogle ScholarPubMed
Lifestyle Management: Standards of Medical Care in Diabetes – 2019. Diabetes Care 2018; 42(Supplement 1).Google Scholar
Wegman, HL, Stetler, C. A meta-analytic review of the effects of childhood abuse on medical outcomes in adulthood. Psychosom Med 2009; 71(8): 805–812.CrossRefGoogle ScholarPubMed
American Academy of Pediatrics. Adverse childhood experiences and the lifelong consequences of trauma. www.aap.org/en-us/Documents/ttb_aces_consequences.pdf.Google Scholar
Leeb, RT, Paulozzi, LJ, Melanson, C, Simon, TR, Arias, I. Child maltreatment surveillance: uniform definitions for public health and recommended data elements 2008. www.cdc.gov/violenceprevention/pdf/cm_surveillance-a.pdf.Google Scholar
Wegman, HL, Stetler, C. A meta-analytic review of the effects of childhood abuse on medical outcomes in adulthood. Psychosom Med 2009; 71(8): 805–812.CrossRefGoogle ScholarPubMed
Merrick, MT, Ports, KA, Ford, DC, et al. Unpacking the impact of adverse childhood experiences on adult mental health. Child Abuse Negl 2017; 69: 10–19.CrossRefGoogle ScholarPubMed
Robert Wood Johnson Foundation. Race, racism and health. www.rwjf.org/en/library/collections/racism-and-health.html.Google Scholar
Smedley, BD, Stith, AY, Nelson, AR. Unequal treatment: confronting racial and ethnic disparities in health care. 2003. www.nap.edu/read/12875/chapter/1.Google Scholar
Adler, NE, Rehkopf, DH. U.S. disparities in health: descriptions, causes, and mechanisms. Annu Rev Public Health 2008; 29(1): 235–252.CrossRefGoogle ScholarPubMed
Hasnain-Wynia, R, Baker, DW. Obtaining data on patient race, ethnicity, and primary language in health care organizations: current challenges and proposed solutions. Health Serv Research 2006; 41(4 Pt 1): 1501–1518.CrossRefGoogle ScholarPubMed
Koenig, HG. Religion, spirituality, and health: the research and clinical implications. ISRN Psychiatry 2012; 2012: 1–33.Google Scholar
Powell, A, ed. Proceedings from Harvard Chan School of Public Health: Health in the LGBTQ Community: Improving Care and Confronting Discrimination. 2018. https://news.harvard.edu/gazette/story/2018/03/health-care-providers-need-better-understanding-of-lgbtq-patients-harvard-forum-says.Google Scholar
Institute of Medicine (US) Board on the Health of Select Populations. Collecting Sexual Orientation and Gender Identity Data in Electronic Health Records: Workshop Summary. Washington, DC, National Academies Press; 2013.Google Scholar
Sabin, JA, Riskind, RG, Nosek, BA. Health care providers’ implicit and explicit attitudes toward lesbian women and gay men. Am J Public Health 2015; 105(9): 1831–1841.Google Scholar
KW Counseling services. What does LGBTQ+ mean? https://ok2bme.ca/resources/kids-teens/what-does-lgbtq-mean.Google Scholar
Office of Disease Prevention and Health Promotion. Lesbian, gay, bisexual, and transgender health. www.healthypeople.gov/2020/topics-objectives/topic/lesbian-gay-bisexual-and-transgender-health.Google Scholar
Mazer, LM, Storage, T, Bereknyei, S, Chi, J, Skeff, K. A pilot study of the chronology of present illness: restructuring the HPI to improve physician cognition and communication. J Gen Intern Med 2016; 32(2): 182–188.Google Scholar
Singh Ospina, N, Phillips, KA, Rodriguez-Gutierrez, R, et al. Eliciting the patient’s agenda: secondary analysis of recorded clinical encounters. J Gen Intern Med 2019; 4(1): 36–40.Google Scholar
Hashim, J. Patient-centered communication: basic skills. J Am Fam Phys 2017; 95(1): 29–34.Google Scholar
Stewart, M, Brown, JB, Donner, A, et al. The impact of patient-centered care on outcomes. Fam Pract 2000; 49(9),796–804.Google Scholar
Bickley, LS. Bates’ Guide to Physical Examination and History Taking (12th ed.). Philadelphia, PA, Lippincott, Williams & Wilkins; 2017.Google Scholar

Save book to Kindle

To save this book to your Kindle, first ensure coreplatform@cambridge.org is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about saving to your Kindle.

Note you can select to save to either the @free.kindle.com or @kindle.com variations. ‘@free.kindle.com’ emails are free but can only be saved to your device when it is connected to wi-fi. ‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.

Find out more about the Kindle Personal Document Service.

Available formats
×

Save book to Dropbox

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Dropbox.

Available formats
×

Save book to Google Drive

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Google Drive.

Available formats
×