Have you ever wondered what it would be like to get a peek inside a doctor's mind? How do they think through illnesses and other body problems? Is there a certain perspective they tend to use as they make decisions and choose treatments? The answer is yes, and it is the medical model!
- Let's begin by understanding the medical model definition.
- Then, what is the medical model of mental health?
- What is the medical model in psychology?
- As we continue, let's look at Gottesman et al. (2010), an important medical model example.
- Finally, we'll discuss the pros and cons of the medical model.
The Medical Model
Psychiatrist Laing coined the medical model. The medical model suggests that illnesses should be diagnosed based on a systematic process accepted by the majority. The systematic approach should identify how the condition differs from 'typical' behaviour and describe and observe if the symptoms match the description of the illness in question.
Medical Model Psychology Definition
Just like a broken leg can be identified through an x-ray and treated through physical means, so can mental illnesses such as depression (using different identification techniques, of course).
The medical model is a school of thought in psychology that explains mental illness as a result of a physical cause.
The medical model is how mental and emotional issues are related to biological causes and problems. The model suggests they can be identified, treated, and monitored by observing and identifying physiological signs. Examples include abnormal blood levels, damaged cells, and abnormal gene expression.
For example, a mental illness can be caused by irregular neurotransmitter levels. Psychiatrists, rather than psychologists, typically accept this school of thought.
Medical Model Use in Psychology
So how is the medical model used in psychology? Psychiatrists/psychologists apply the medical model of mental health theory to treat and diagnose patients. They focus on using the approaches we discussed above:
- The biochemical.
- The genetic.
- Brain abnormality explanation of mental illness.
To diagnose and treat a patient, they use these approaches to assess the situation. Typically, psychiatrists assess the patient's symptoms.
Psychiatrists try to use multiple methods to assess symptoms. These include clinical interviews, brain imaging techniques, observations, medical history (their and their families), and psychometric tests.
After assessing the symptoms, established diagnostic criteria are to match the patient's symptoms with a psychological illness.
If the patient's symptoms are hallucinations, delusions, or disorganised speech, the clinician will likely diagnose the patient with schizophrenia.
Once a patient has been diagnosed with an illness, the psychiatrist decides on the best treatment. Various treatments exist for the medical model, including drug therapies. An old, outdated model is Electroconvulsive therapy (ECT), now a largely abandoned treatment because of some severe risks. Also, the treatment method is still not fully understood.
Research has found that people diagnosed with mental illnesses may have brain abnormalities. These include:
Lesions.
Smaller brain regions
Poor blood flow.
Medical Model of Mental Health
Let's examine the biochemical, genetic, and brain abnormalities theories used to diagnose and treat patients. These explanations are models of how mental health illness is understood.
Medical Model: Neural Explanation of Mental Illness
This explanation considers that atypical neurotransmitter activity is a cause of mental illness. Neurotransmitters are chemical messengers within the brain which allow communication between neurons. Neurotransmitters can contribute to mental illnesses in several ways.
'Atypical' neurotransmitter activity is thought to cause mental illness. When there is a low level of neurotransmitters, it makes it difficult for the neurons in the brain to send signals. This can cause dysfunctional behaviour or the symptoms of mental illnesses. Similarly, abnormally high levels of neurotransmitters can lead to brain dysfunction, as it upsets the balance.
Research has linked low serotonin and norepinephrine (neurotransmitters) to manic depression and bipolar disorder. And abnormally high dopamine levels in particular brain regions to the positive symptoms of schizophrenia.
Serotonin is the 'happy' neurotransmitter; it passes along 'happy' messages to neurons.
Fig. 1 Dug therapy affects neurotransmitter abundance in the synapse and can be used to treat mental illnesses.
A psychiatrist who accepts the medical model school of thought may choose to treat a patient using drug therapy. Drug therapy targets receptors, which affect the abundance of neurotransmitters in the synapses.
Take depression, for example. The typical type of drug used for this treatment is selective serotonin reuptake inhibitors (SSRIs).
As mentioned, depression is linked to low levels of serotonin. SSRIs work by blocking the reuptake (absorption) of serotonin. This means there are higher serotonin levels, as they are not being re-absorbed at the same rate.
Medical Model: Genetic Explanation of Mental Illness
The genetic explanation of mental illness focuses on how our genes affect the development of certain diseases within the brain.
Humans inherit 50 per cent of their genes from their mothers and the other 50 per cent from their fathers.
Scientists have identified that there are variants of genes that are associated with specific mental illnesses. Some biopsychologists argue that these variants are predispositions for mental illnesses.
Predispositions refer to a person's increased likelihood of developing a mental illness or disease, depending on their genes.
This predisposition, combined with environmental factors such as childhood trauma, can lead to the onset of mental illnesses.
McGuffin et al. (1996) investigated the contribution of genes to the development of major depression (classified using the Diagnostic and Statistical Manual of Mental Disorders, specifically the DSM-IV). They studied 177 twins with major depression and found that monozygotic twins (MZ) who share 100 per cent of their DNA had a concordance rate of 46 per cent.
In contrast, dizygotic twins (DZ) who share 50 per cent of their genes had a concordance rate of 20 per cent, concluding there was a significant difference between them. This supports the idea that depression has a certain degree of inheritability, alluding to a genetic component.
Medical Model: The Cognitive Neuroscience Explanation of Mental Illness
Cognitive neuroscientists explain mental illness in terms of dysfunction in brain areas. Psychologists generally agree that certain brain regions are responsible for specific jobs.
Cognitive neuroscientists propose that mental illnesses are caused by damage to brain regions or disruptions that influence brain function.
The cognitive neuroscience explanations of mental illness are usually supported by research from brain imaging techniques. This means that the research theories and evidence are empirical and highly valid.
There are, however, limitations to using brain imaging techniques. For example, magnetic resonance imaging (MRI) cannot give information on the timing of brain activity. To deal with this, researchers may have to use multiple imaging methods; this can be costly and time-consuming.
Medical Model Example
Gottesman et al. (2010) provided supportive evidence of the genetic explanation by calculating the risk levels of children inheriting mental illnesses from their biological parents. The study was a natural experiment and a national register-based cohort study based in Denmark and offers a great medical model example.
The variables investigated were:
The comparison groups were:
Both parents were diagnosed with schizophrenia.
Both parents were diagnosed with bipolar.
One parent was diagnosed with schizophrenia.
One parent was diagnosed with bipolar.
Parents with no diagnosed mental illness.
The table shows how many parents were diagnosed with schizophrenia or bipolar disorder and the percentage of their children diagnosed with mental illnesses by 52 years old.
| No parent diagnosed with either disorder | One parent with schizophrenia | Both parents had schizophrenia | One parent with bipolar disorder | Both parents with bipolar disorder |
| Schizophrenia in offspring | 0.86% | 7% | 27.3% | - | - |
| Bipolar disorder in offspring | 0.48% | - | 10.8% | 4.4% | 24.95% |
When one parent had been diagnosed with schizophrenia and the other with bipolar, the percentage of offspring diagnosed with schizophrenia was 15.6, and bipolar was 11.7.
This research suggests that genetics is a significant contributor to mental illnesses.
The more offspring are predisposed to a genetic vulnerability; the more likely the child will be diagnosed with a mental illness. If both parents have been diagnosed with the respective disorder, the higher the child's chances are of developing the disorder.
Pros and Cons of the Medical Model
The medical model has a vital role in psychology as it is a widely accepted school of thought for treating mental illnesses. This indicates that the model's views are widely applied to the psychological services available.
However, there are cons to the medical model that should be considered when applying the model for diagnosing and treating mental illnesses.
Pros of the Medical Model
Let us consider the following strengths of the medical model:
Fig. 2 Psychologists who accept the medical model use various sources to make diagnoses, increasing the likelihood of a correct diagnosis. Cons of the Medical Model
One of the major causes of schizophrenia is high levels of dopamine. The drug treatment of schizophrenia typically blocks dopamine receptors (stops high levels of dopamine released). This has been found to reduce positive symptoms of schizophrenia but has no or little effect on negative symptoms. This suggests that the biochemical approach partially explains mental illnesses and ignores other factors (reductionist).
The treatments in the medical model do not try to get to the root of the problem. Instead, it tries to combat the symptoms. There are also certain debates the medical model tends to fall into in psychology overall:
Reductionist versus holism - the model only considers biological explanations of mental illnesses whilst ignoring other cognitive, psychodynamic, and humanistic factors. This suggests that the model over-simplifies the complex nature of mental illnesses by ignoring important factors (reductionist).
Medical Model - Key takeaways
- The medical model definition is the concept of how mental and emotional issues are related to biological causes and problems.
- The medical model use in psychology is to help with the diagnosis and treatment of mental illnesses.
- The medical model of mental health explains mental illnesses as a result of brain abnormalities, genetic predispositions and biochemical irregularities.
- Gottesman et al. (2010) provided supportive evidence of the genetic explanation by calculating the risk levels of children inheriting mental illnesses from their biological parents; this is a research medical model example.
- There are pros and cons of the medical model, e.g. it is supported by empirical, reliable and valid research, but it is often criticised as reductionist and deterministic.
Explanations 
Exams 
Magazine 
