The past,present, and future of the biopsychosocial model: A review of The Biopsychosocial Model of Health and Disease: New philosophical and scientific developments by Derek Bolton and Grant Gillett

Health psychology is a growing field generating exciting advances in theory, research, and applications that significantly improve the lives of individuals, shape the medical profession, and inform global public policy. For over 40 years, the field has been guided by the biopsychosocial model (Engel, 1977), an interdisciplinary and multifaceted model that posits the interrelations among the biological, psychological, and socio-environmental influences on health and disease. The theoretical implications and empirical research that it has generated have been vast. In The Biopsychosocial Model of Health and Disease: New philosophical and scientific developments, Derek Bolton and Grant Gillett (2019) present a summary of four decades of scholarship. They conclude that the model has fallen short clinically, scientifically, and philosophically. Although their book is timely, well-written, thought-provoking, and designed to highlight weaknesses that could drive science and practice forward, their criticisms are not fully convincing and are open to debate. The contributions this book could make may be to challenge a new generation of scholars and scientists to demonstrate that the biopsychosocial model is more relevant than ever, especially as areas such as social genomics, psychoneuroimmunology, health disparities, and global health become more important. Despite interesting philosophical challenges presented by Bolton and Gillett, theory, research, and practice focused on health, disability, illness, and wellness should remain grounded in the biopsychosocial model.     

An information - expectation framework for decisions under uncertainty

Despite being in existence for many decades, normative decision theory has not become a commonly used tool for real-world decisions. This paper considers the reasons for this situation and suggestions for circumventing them. The main suggestion involves a two-stage framework in terms of the information available to the decision maker and his/her expectations under the available acts. This framework is well suited for decisions with incomplete structure, which is typical of real decision situations. Within this framework a specific multiplicative model is also discussed.     

Publishing in Journals Outside the Box: Attaining Mainstream Prominence Requires Demonstrations of Mainstream Relevance

Primary pediatric medical care is as mainstream as any major cultural practice in the USA. Thus, publishing behavior analytic papers that pertain to problems that present in pediatric settings in pediatric medical journals is one route to mainstream relevance. With sufficient numbers of such papers, it could even lead to prominence. This article describes examples of publishing in pediatric journals and some lessons I learned from the experience. For example, (1) all child behavior problems that present in pediatric settings are of social importance but most are high-frequency, low-intensity problems that are not necessarily exotic or representative of serious pathology, and they usually respond to straightforward behavioral applications; (2) it is usually best to use a “colloquialized version of learning theory” when writing for and speaking to pediatric providers (and the families for whom they provide care); (3) pediatricians often have limited knowledge about behavior analytic research designs; and (4) when submissions are rejected by pediatric journals, the rejection can be exploited as an opportunity to educate pediatric editors and reviewers.     

Idiographic outcome analyses of the clinical significance of two interventions for patients with musculoskeletal pain

This study adopted a perspective of the individual to define domains of everyday life for the analysis of clinically meaningful change. The purpose was to compare the clinical significance of two interventions for patients with musculoskeletal pain, applying an idiographic outcome measure, The Patient Goal Priority Questionnaire, in combination with the Jacobson and Truax methodology [(1991). Clinical significance: A statistical approach to defining meaningful change in psychotherapy research. Journal of Consulting and Clinical Psychology, 67 (3), 300-307] for determination of clinical significance. The concurrent validity of the outcome variables behavioral performance, satisfaction with behavioral performance, and fulfilled pre-treatment expectations was also studied. Eighty-two patients, randomized to either individually tailored behavioral medicine treatment (experimental group) or physical exercise therapy (control group) were evaluated at baseline and 3 months post-treatment regarding behavioral treatment goals. The experimental intervention had high impact on participants' performance of their highest ranked everyday life activities, and resulted in larger proportions of clinically significant outcomes compared with controls. The concurrent validity of the outcomes was high for those reporting clinically significant changes, but more generally, there was a moderate agreement across outcome categories. The individual should be the unit for analyses of clinical significance to enhance the ecological validity of the construct. Further development of idiographic outcome measures is necessary, as is the inclusion in pain intervention research.     

医学伦理审查如何适应转化医学的要求

随着转化医学的兴起,医学伦理审查面临前所未有的机遇与挑战.如何使医学伦理审查工作更好地适应转化医学发展的需要,提高审查质量,成为亟需解决的问题.在分析当前我国医学伦理审查工作现状和主要问题的基础上,进一步探讨了可行的解决方法,如进一步明确和强化管理部门服务功能、保证伦理委员会成员多样性和重视伦理审查多视角、强化伦理委员会后续跟踪审查、规范伦理审查委员的培训与继续教育等,为我国医学伦理审查工作的规范化发展和医学伦理审查质量的进一步提高提供参考.     

Cognitive styles in the context of modern psychology: toward an integrated framework of cognitive style

The goals of this article are to elucidate trends and perspectives in the field of cognitive style research and to propose an integrated framework to guide future research. This is accomplished by means of a comprehensive literature review of the major advances and the theoretical and experimental problems that have accumulated over the years and by a discussion of the promising theoretical models that can be further developed, in part, with modern neuroscience techniques and with research from different psychological fields. On the basis of the research reviewed in this article, the author suggests that cognitive styles represent heuristics that individuals use to process information about their environment. These heuristics can be identified at multiple levels of information processing, from perceptual to metacognitive, and they can be grouped according to the type of regulatory function they exert on processes ranging from automatic data encoding to conscious executive allocation of cognitive resources.     

How to manage the evolution of a computerized information system

Existing computerized fiscal and patient information systems do not seem well suited for the mental health field. To design its own system, an institution would do better to form an information system staff rather than to use an outside software house, because doing it externally is less responsive, slower, and, for some tasks, simply impossible. The in-house staff must be selected to be competent generalists, at ease with computer technology. Working in close and friendly cooperation with various user groups, the systems evolve out of small beginnings. As the users gain working experience with early versions of a system, they are able to refine their goals, with the result that the final system meets their needs well, even though it may seem to be different from what was originally expected.     

Opportunity recognition and the tendency to be an entrepreneur: A bivariate genetics perspective

We applied quantitative genetics techniques to a sample of 851 pairs of monozygotic and 855 pairs of dizygotic female twins to examine the influence of genetic factors on the variation across people in opportunity recognition. We also examined the extent to which the same genetic factors contribute to both opportunity recognition and the tendency to be an entrepreneur. We found substantial heritability for opportunity recognition (0.45), with no influence of the shared environment. Moreover, we found that 53% of the phenotypic correlation between opportunity recognition and the tendency to be an entrepreneur had a common genetic aetiology.     

如何提高临床医学生与患者之间沟通的能力

正常有序的医疗活动应以良好的医患沟通为基础,要从根本上处理好医患关,首先要从培养临床医学生与患者之间的沟通能力入手,多数医学生在进入临床实习时都因紧张而不知道应该如何与患者沟通,因此培养医学生与患者间良好的沟通能力是当前迫切需要解决的问题。     

How many fidgets in a pretty much: A critique of behavior rating scales for identifying students with ADHD

The school psychologist's role and responsibilities for meeting the needs of students with Attention-Deficit Hyperactivity Disorder (ADHD) have been expanding in recent years. Students with this disorder present refractory problems that may involve the school psychologist in the assessment and diagnosis of ADHD. Rating scales commonly are used, sometimes in conjunction with other techniques, for assessing and diagnosing ADHD. They often are presented as an objective way to quantify the severity of a child's behavior in comparison with a normative standard. Because rating scales have become such an integral component in the identification of children with ADHD, school psychologists should understand the limitations associated with this methodology. In this article we first describe behavior rating scales and difficulties in the use of cutoff scores to identify students as ADHD. Second, we describe how problems with interobserver agreement hamper the validity of rating scales and the subsequent conclusions that can be drawn about students' behavior. Finally, we present recommendations for obtaining more reliable and valid information from rating scales.     

From Poisson shot noise to the integrated Ornstein-Uhlenbeck process: Neurally principled models of information accumulation in decision-making and response time

In the diffusion model of decision-making, evidence is accumulated by a Wiener diffusion process. A neurally motivated account of diffusive evidence accumulation is given, in which diffusive accumulation arises from an interaction between neural integration processes operating on short and long time scales. The short time scale process is modeled as a Poisson shot noise process with exponential decay. Stimulus information is coded by excitatory-inhibitory shot noise pairs. The long time scale process is modeled as algebraic integration, possibly implemented as a first-order autoregressive process realized by recurrent connections within a population of neurons. At high intensities, an excitatory-inhibitory shot noise pair converges weakly to an Ornstein-Uhlenbeck (OU) velocity process. The integrated OU process, or OU displacement process, obtained by integrating the velocity process over time, is indistinguishable at long times from the Wiener process. Diffusive information accumulation may therefore be characterized as an integrated OU process whose properties mimic those of the Wiener process.     

Specificity of cognitive and behavioral variables to Positive and Negative Affect

The Tripartite Model proposes that a combination of greater Negative Affect (NA) and reduced Positive Affect (PA) contributes to depressive symptoms. The purpose of this study was to test a model of affective experience in which cognitive variables (i.e., negative cognitions and appraisals) are uniquely related to NA but not PA, and in which behavioral variables (i.e., activity participation) are uniquely associated with PA but not NA. Participants included 88 spousal Alzheimer caregivers (mean age = 74 years). Multiple regression models, in which negative cognitions (i.e., helplessness, blames self, and negative appraisals) and activity participation (i.e., frequency of engaging in social and recreational activities) were used to predict depressive symptoms, PA and NA. Results indicated that while helplessness, blaming oneself, negative appraisals, and activity participation all significantly predicted depressive symptoms, only negative cognitive variables significantly predicted NA, and only activity participation significantly predicted PA. These data confirm that depressive experience consists of two relatively independent components - increased Negative Affect and reduced Positive Affect - which have unique correlates in negative cognitions and activity participation. If confirmed, the findings suggest the utility of focusing interventions on each of these components in the management of depressive symptoms.     

An integrative framework on the impact of allies: How identity-based needs influence intergroup solidarity and social movements

What impact do advantaged group allies have within social movements? Although solidarity between advantaged and disadvantaged group members is often encouraged to achieve long-term social change, allies run the risk of being ineffective or counterproductive, therefore making it important to shift our focus towards understanding the impact of allies. We propose an integrative theoretical framework describing the positive and negative impact of allies based on their distinct identity-based needs: advantaged group members’ need for moral acceptance and disadvantaged group members’ need for empowerment and respect. By consolidating extant literature and identifying gaps in prior research, we propose a set of hypotheses concerning (a) tensions that arise within intergroup solidarity efforts for social change between advantaged group allies and disadvantaged group members, and (b) the role of allies in influencing broader public opinion to advance the psychology of social change.     

How to prove the existence of God: an argument for conjoined panentheism

International Journal for Philosophy of Religion - This article offers an argument for a form of panentheism in which the divine is conceived as both ‘God the World’ and ‘God the...     

Science and the Art of Healing: A Contribution to the History of Life Science

In conventional medicine, healing is effected mainly by treating the symptoms of the physical body disease, while in mind–body medicine the cure is performed by the mind itself (thoughts and emotions). In fact, the holographic mind theory claims that the mind could be either the healer or the slayer. Thus, this article is a contribution toward a more in-depth study of this theme of conventional medicine versus mind–body medicine, particularly to understand the gifts of quantum physics to life science and the art of healing, so that we might find an integrative medicine model (a holistic approach to health) that could explain some “incurable” diseases.     

Sneaking in through the back door: How category-based stereotype suppression leads to rebound in feature-based effects

Given the dramatic shifts in societal norms to curb overt stereotyping and prejudice, these biases may leak out in more subtle ways than were apparent in the past. Accordingly, we examined how the suppression of stereotypes might affect post-suppression category-based stereotyping and the more subtle feature-based stereotyping. In support of our proposition, participants in the suppression condition used more feature-based, but less category-based stereotypes in their post-suppression task than participants in the control condition. Furthermore, a relation between post-suppression category-based and feature-based stereotyping existed in the suppression condition such that decreases in category-based stereotyping were associated with increases in feature-based stereotyping. Findings as a whole suggest that norms against the expression of stereotypic biases may ironically lead people to be more vulnerable to biases as a function of within-category features.