• Sleep is an incredibly important contributor to maintaining physical and psychological health; positive body image may be difficult to achieve if you are sleep-deprived.

• Substance use – from drinking alcohol to vaping – may seem fairly common, but can be incredibly detrimental to your health. Being body positive includes treating your body well and not using substances.

• Our bodies change with age; this is completely normal even if it is sometimes very uncomfortable.

• Many of us will experience health concerns and even chronic health conditions as we age. This makes it extra important to take good care of our bodies and approach them with acceptance.

Although many people will experience a mental health reaction to major incidents and pandemics, only a minority of people affected are likely to require mental healthcare. Most people will not develop a mental disorder, but common conditions will be precipitated, such as adjustment disorders, anxiety disorders, depressive disorders, post-traumatic stress disorder (PTSD), and substance use disorders. Other conditions include complex PTSD, prolonged grief disorder, psychosis, somatic symptom disorders, and neuropsychiatric consequences of infection in pandemics. The evidence for the prevention of mental disorders through formal interventions is very limited, and contrasts with strong evidence for effective treatments. In order to provide optimal care following major incidents and pandemics a biopsychosocial framework is appropriate, with mental health service provision being part of a whole system approach. A seamless, person-centred mental healthcare pathway for those affected would probably involve first responders, primary care, secondary physical care, the third sector, and social care.

This chapter frames problems that reflect the split between biological psychiatry and psychotherapy, and promotes a biopsychosocial model of etiology for most mental disorders. Findings with regard to genetics, neurotransmitters, and imaging methods are reviewed, and their limitations are highlighted. A similar critical review is applied to purely psychosocial interpretations of etiology with a focus on post-traumatic theories of mental disorders. The chapter emphasizes that constructs in science which have some applicability are often expanded into what can be called “concept creep.”

Psychological care is endorsed in DSD medicine. Psychosocial research has been on the increase. But these positive moves have not given psychological practice the kind of collective focus that is enjoyed by the biomedical disciplines. However, psychological care providers have a wide variety of thinking tools and practice techniques to draw on, if to work in an ad hoc way at times. These tools and techniques do not change, but some are more useful and relevant than others for this service context. In Chapter 7, the author discusses the strengths and weaknesses of key theoretical frameworks in healthcare psychology. A major weakness of the individualistic models is their lack of capacity to address structural inequalities in psychological wellness and distress. The author introduces aspects of the Power Threat Meaning Framework and describes how to draw from its theoretical richness to think systemically about what sex variations pose to individuals and families in the social context and how they are responded to. The Framework provides the theoretical backbone for some of the practice vignettes in the final section of the book (Chapters 9–14).

The currently dominant model of health and disease in psychiatry and medicine is Engel’s biopsychosocial (BPS) model, proposed in the 1970s to advance reductionistic biomedicine by integrating psychological and social factors. Although the BPS model represented progress, its scientific and philosophical foundations remain questionable and it cannot be considered complete or sufficient. In this chapter, we provide a historical and conceptual analysis of the BPS model before showing that the integration of evolutionary theory can provide a suitable next step from the BPS model, much as the BPS model was a step forward from the biomedical approach. Evolutionary theory justifies and enhances the BPS model’s recognition of multiple levels of causation and expands it by recognising both ultimate and proximate causation. It allows a clearer distinction of biological function from dysfunction and encourages a phylogenetic perspective on biology, which can guide research in new directions. In connecting the model of health with the most fundamental theory of biology, this approach provides the philosophical and scientific coherence that the BPS model sorely lacked.

The core principle that should guide any health professional caring for older adults and their families is that the “secret of caring for the patient is in caring for the patient” (Peabody). Practitioners must understand the most up-to-date biomedical and psychosocial aspects of aging, health, wellness, and disease, and strive to support the older adult to remain as active, functional, and engaged as possible. At the same time, practitioners must recognize and help patients and families understand when a palliative approach will be most effective at meeting their goals. The Choosing Wisely campaign launched by the American Board of Internal Medicine provides targeted guidance to clinicians to provide care that is effective and efficient, consistent with the essential principles. Also, the 4Ms (what Matters, Medication, Mentation, and Mobility) proposed by The John A. Hartford Foundation and Institute for Healthcare Improvement provide a framework for an Age-Friendly Health System through which practitioners can deliver optimal care for older adults.

Cognitive failure and the fear of losing control over one’s life has occupied mankind for centuries. In our chapter we describe the conceptual history of dementia starting with the first written traces from the twenty-fourth century BCE, relating the story of an Egyptian officer who not only developed the inability to remember yesterday but also became more and more childish. Subsequently, we summarize medical discoveries that have allowed cognitive, psychological and behavioral symptoms of dementia to be viewed as a result of brain disease rather than, for instance, witchcraft or ill will. In the context of growing awareness of neuro-pathophysiological mechanisms underlying dementia, associated with postmortem brain research in the late ninettenth century, Alzheimer’s disease became the ‘face’ of dementia for some time. We discuss further developments in the discovery and in the treatment of different types of dementia, also focusing on psychosocial aspects of the disease. These became an important topic of research as pharmacological treatments aimed at curing the neurodegenerative causes of dementia as yet do not exist. AWe compare how different cultures and societies deal with dementia. Finally, the political and societal attempts to promote social inclusion and empowerment of individuals with dementia are summarized.

Psychogenic nonepileptic seizures (PNES) are paroxysms of altered sensory, cognitive, and/or motor manifestations with or without alteration of consciousness that may resemble epileptic seizures, but do not originate from epileptiform brain activity. One framework conceives PNES as arising from a biopsychosocial, multifactorial etiologic model. An unexpectedly high co-occurrence rate of PNES and mild traumatic brain injury (mTBI) has been reported. A causal relationship may be possible in many cases. In applying the biopsychosocial framework, this review discusses how TBI may subserve contributing roles as Predisposing, Precipitating, and Perpetuating factors in the development of PNES.

Either side of the Second World War, social psychiatry had emerged in the United States, influenced by Adolf Meyer’s work, the ecological wing of the Chicago School of sociology and subsequently the development of the biopsychosocial model by George Engel. The sociological imagination in British social psychiatry was sparse but not always absent. Most of the work in UK is derived from the Institute of Psychiatry in London, augmented by a minority of studies from Scotland and the English provinces. By the turn of this century, the taken-for-granted diagnostic categories used by social psychiatrists were subject to critical questioning. The weak construct validity of schizophrenia was conceded and a broader notion of psychosis as the medical codification of madness (i.e. socially unintelligible conduct) emerged. No discipline has a monopoly of understanding about this topic and so the interdisciplinary potential of social psychiatry, broadly conceived, remains an opportunity for all. However, for its potential to be realised, the principle of interdisciplinarity needs to be fully respected by all.

Health psychology and behavioral medicine are founded on the biopsychosocial model, in which health and disease reflect reciprocal influences among biological, psychosocial, and sociocultural processes. As a result, research methods in these fields draw on concepts and methods from several disciplines and often require their integration. Health psychology and behavioral medicine include three major topics: health behavior and risk reduction; psychosocial aspects of medical illness and medical care; and psychosocial and psychobiological influences on disease. This chapter emphasizes methodological challenges in the third topic, although the issues discussed are broadly relevant to the others. Conceptualization and measurement of health endpoints presents evolving challenges in which measured outcomes must capture specific and well-defined aspects of health and disease. In the identification of psychosocial predictors of health outcomes, psychosocial epidemiology research must address a variety of challenges, including the conceptualization, measurement, and analysis of overlapping risk factors. In research on the psychobiological mechanisms linking risk and resilience factors with health outcomes, theory-driven research should consider a broad range of interrelated physiological processes and multiple sources of pathogenic physiological activation. Across the various research topics, clear ties to conceptual models, consideration of developmental issues across the lifespan, the need to examine both between- and within-person associations in many research questions, and the importance of health disparities and related aspects of ethnic and cultural diversity are important in measurement, design, and analysis of biopsychosocial research.