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Medical Model

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Medical Model

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!

Medical Model Definition

The medical model is a school of thought in psychology that explains mental illness as a result of a physical cause. 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 identifications techniques, of course).

The medical model is the concept that formulates how mental and emotional issues are related to biological causes and problems. 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, lab equipment presenting biological research, StudySmarter

Biological research, freepik.com/Freepik

The components of the medical model theory

Psychiatrists/psychologists apply the medical model theory to treat patients. They focus on a few main components: the biochemical, genetic, and brain abnormality explanation of mental illness. To diagnose and treat a patient, they use the above approaches to assess the situation, focusing on the above three components. 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 used to match the patient's symptoms with a psychological illness.

If the patients' symptoms are hallucinations, delusions, or disorganised speech, the clinician is likely to 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 An old, outdated model is Electroconvulsive therapy (ECT), a largely abandoned treatment because of some severe risks. Also, the treatment method is still not fully understood.

Medical Model Use in Psychology

Psychiatrists apply the medical model to diagnose patients with mental illnesses. The biochemical, genetic, and brain abnormalities theories are models of how mental health illness is understood.

The biochemical 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.

  1. Neurotransmitters send chemical signals between neurons or neurons and muscles. Before a signal can be transmitted between neurons, it must cross the synapse (the gap between two neurons).
  2. '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.

Low serotonin and norepinephrine (neurotransmitters) have been linked to manic depression and bipolar disorder. Abnormally high levels of dopamine have been linked to schizophrenia.

Medical Model, chemical formula of serotonin, StudySmarter

The chemical formula of serotonin, Wikimedia.com

The genetic explanation of mental illness focuses on how our genes affect the development of certain diseases within the brain. Humans inherit 50 percent of their genes from their mothers and the other 50 percent from their fathers, and it is well understood now that diseases can be inherited through genes.

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. This, 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 percent of their DNA had a concordance rate of 46 percent.

In contrast, dizygotic twins (DZ) who share 50 percent of their genes had a concordance rate of 20 percent, concluding there was a significant difference between the two. This supports the idea that depression has a certain degree of inheritability, alluding to a genetic component.

Gottesman et al. (2010) provided supportive evidence of the genetic explanation. To calculate 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. The study used a register available in Denmark to see how many parents and their offspring did and did not have mental illnesses.

The variables investigated were:

  • Independent variable: whether the parent had been diagnosed with bipolar or schizophrenia

  • Dependent variable: child diagnosed with mental illness (using the ICD)

The comparison groups were:

  1. Both parents were diagnosed with schizophrenia
  2. Both parents were diagnosed with bipolar
  3. One parent diagnosed with schizophrenia
  4. One parent diagnosed with bipolar
  5. Parents with no diagnosed mental illness

Results

The table shows how many parents were diagnosed with schizophrenia or bipolar disorder and the percentage of their children diagnosed with the mental illnesses by 52 years old.

No parent diagnosed with either disorderOne parent with schizophreniaBoth parents had schizophreniaOne parent with bipolar disorderBoth parents with bipolar disorder
Schizophrenia in offspring0.86%7%27.3%--
Bipolar Disorder in offspring0.48%-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.

Conclusion

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 of developing the disorder.

This study is key research in the OCR A level specification, so be sure to learn it!

Medical Model of Mental Health: Brain Abnormality Explanation of Mental Illness

Research has found that people diagnosed with mental illnesses may have brain abnormalities. These include:

  • Lesions - damaged brain regions can disrupt the functioning of that brain region and cause mental illnesses/symptoms. Lesions are parts of the brain that have been damaged because of an illness or physical trauma.
  • Smaller brain regions - research has shown that patients with mental health illnesses sometimes have a lower grey matter volume in the areas associated with the illness/symptoms.
  • Poor blood flow in specific brain regions has been found to contribute to the onset of mental illnesses

Research has found a smaller volume of grey matter in the frontal lobe and parts of the temporal lobe in patients with major depressive disorder versus healthy controls (Shad, Muddasani & Rao, 2012). Consider Coffey et al. (1993). This study observed cerebral anatomy in depressed patients using magnetic resonance imaging (MRI).

48 patients with severe depression were referred for ECT and compared to 76 control subjects. They found that the mean total frontal lobe volume was seven percent smaller in depressed patients when compared to normal subjects. This demonstrates how mental illness may be related to brain abnormalities.

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 of the medical model that should be considered when applying the model for the diagnosis and treatment of mental illnesses.

Practical application of the medical model for the treatment of depression

A psychiatrist who accepts the medical model school of thought could treat a patient with depression using drug treatment. The typical type of drug used for this treatment is called selective serotonin reuptake inhibitors (SSRIs).

Depression is associated with low serotonin levels (although more recent research suggests there's more to it than just low levels of this particular neurotransmitter). SSRIs work by blocking the reuptake (absorption) of serotonin. This means that there are higher serotonin levels, as they are not being reabsorbed at the same rate.

Serotonin is the 'happy' neurotransmitter; it passes along 'happy' messages to neurons.

Pros of the medical model

Let us consider the following strengths of the medical model:

  • The approach tends to be objective and follows an empirical approach to diagnosing and treating mental illnesses.
  • There is research evidence such as Gottesman et al. (2010) that shows a genetic and biological component to mental illnesses.
  • The medical model has real-life practical applications. For example, it describes how people with mental illnesses should be diagnosed and treated.
  • The treatment methods used nowadays are widely available, relatively easy to administer, and effective

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 given in the medical model do not try to get to the root of the problem, and instead, it tries to combat the symptoms. There are also certain debates the medical model tends to fall into in psychology overall:

  • Nature versus nurture - believes that genetic makeup (nature) is the root of mental illnesses and ignores other factors that may cause them. For example, it ignores the role of the environment (nurture).
  • Reductionist versus holism - the model only considers biological explanations of mental illnesses whilst ignoring other factors such as cognitive, psychodynamic, and humanistic. This suggests that the model over-simplifies the complex nature of mental illnesses by ignoring important factors (reductionist).
  • Determinism versus free will - the model suggests that people have no free will over their well-being. For instance, the model indicates that their genetic make-up determines mental illness. This implies that you are helpless against developing certain mental illnesses and acting a certain way.

Medical Model - Key takeaways

  • The medical model is the concept that mental and emotional issues are related to biological causes and problems.
  • The medical model typically explains mental illnesses in terms of biological explanations.
  • The medical model uses treatment types that influence the biology of humans.
  • The medical model is usually objective, uses empirical evidence, and has research evidence to support it for all three explanations discussed above. Treatments based on the model are effective and reliable.
  • However, the medical model has issues with reductionism, treating symptoms but not addressing the root cause of the disorders, and is somewhat deterministic.

Frequently Asked Questions about Medical Model

The medical model is the concept that formulates how mental and emotional issues are related to biological causes and problems. They can be identified, treated, and monitored by observing and identifying physiological signs. Examples include abnormal blood levels, damaged cells, and abnormal gene expression. Treatments alter the biology of humans. 

The components of the medical model are:

  • the biochemical explanation of mental illness
  • the genetic explanation of mental illness 
  • the brain abnormality explanation of mental illness 

The strengths of the medical model are:

  • the approach takes an empirical and objective approach to understanding mental illness
  • the model has practical applications for its use in the diagnosis and treatment of mental illnesses 
  • the treatment theories suggested are widely available, relatively easy to administer and effective for many mental illnesses
  • supporting evidence has been found of the biological component of explaining mental illnesses (Gottesman et al. 2010)

The limitations of the medical model are:

  • the treatment of schizophrenia (blocking dopamine) only combats positive and not negative symptoms of schizophrenia. Therefore, the treatment is not entirely effective 
  • raises issues, such as:
    • only considers the nature side of the nature versus nurture debate 
    • reductionist 
    • deterministic 

The medical model provides an empirical and objective framework to understand, diagnose and treat mental illnesses. This is needed in social services to make sure that vulnerable people have access to proper treatment.  

Final Medical Model Quiz

Question

Which of the following is the most accurate description of the medical model? 

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Answer

School of thought

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Question

Which approach does the medical approach consider?

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Answer

Biological 

Show question

Question

Which biological treatment is widely abandoned nowadays? 

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Answer

Drug treatment

Show question

Question

What are the strengths of the medical model? 

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Answer

The strengths of the medical model are:

  • the approach takes an empirical and objective approach to understanding mental illness
  • the model has practical applications for its use for the diagnosis and treatment of mental illnesses 
  • the treatment theories suggested are widely available, relatively easy to administer, and effective for many mental illnesses
  • supporting evidence has been found of the biological component of explaining mental illnesses

Show question

Question

What are the cons of the medical model? 

Show answer

Answer

The limitations of the medical model are:

  • the treatment of schizophrenia (blocking dopamine) only combats positive and not negative symptoms of schizophrenia. Therefore, the treatment is not entirely effective 
  • raises issues, such as:
    • only considers the nature side of the nature versus nurture debate 
    • reductionist 
    • deterministic 

Show question

Question

How is the medical model reductionist? 

Show answer

Answer

The model is reductionist because it only considers biological explanations of mental illnesses. Whilst ignoring other factors such as cognitive, psychodynamic, humanistic. This suggests that the model over-simplifies the complex nature of mental illnesses by ignoring important factors.

Show question

Question

Which component of the medical model does Gottesman et al. (2010) provide supporting evidence for? 

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Answer

Genetic component 

Show question

Question

What is the practical application of the medical model for the treatment of depression?


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Answer

A psychiatrist who accepts the medical model school of thought could treat a patient with depression using drug treatment. The typical type of drug used for this treatment is called selective serotonin re-uptake inhibitors (SSRIs). Depression is associated with low levels of depression, SSRIs work by blocking the re-uptake (absorption) of serotonin. This means that there are higher levels of serotonin.  

Show question

Question

Can the following statement be regarded as true or false based on Gottesman et al. (2010) findings? "Children, who have two parents with the same mental illness are more likely to be diagnosed with it than if only one parent has been diagnosed with it".

Show answer

Answer

True 

Show question

Question

Which neurotransmitters have been linked to manic depression? 

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Answer

Low levels of serotonin and norepinephrine (neurotransmitters) have been linked to manic depression and bipolar disorder.  

Show question

Question

How can neurotransmitters cause mental illnesses and their symptoms? 

Show answer

Answer

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.  

Show question

Question

How is the medical model used in psychology? 

Show answer

Answer

The medical model is used typically by psychiatrists to diagnose patients with mental illnesses. 

Show question

Question

Why are ECTs no longer a treatment that is widely used? 

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Answer

ECT is a largely abandoned treatment because of the serious risks involved and because the treatment method is still not fully understood. 

Show question

Question

What are the typical methods psychiatrists use for the diagnosis of mental illnesses?

Show answer

Answer

Psychiatrists try to use multiple methods to assess symptoms. These include clinical interviews, brain imaging techniques, observations, medical history (their own and their families), and psychometric tests. 

Show question

Question

How does the medical model explain mental illnesses? 

Show answer

Answer

The medical model explains mental illness to be a result of a physical cause. For example, the onset of mental illnesses is because of irregular neurotransmitter levels. 

Show question

Question

What did Szazs think of mental illnesses? 

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Answer

They are a myth

Show question

Question

Which theories take an interactionist approach in the nature versus nurture debate? 

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Answer

Cognitive

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Question

Which theory criticises the cognitive approach for not measuring phenomena that are directly observable? 

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Answer

Behavioural 

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Question

Which type of reinforcement is used to encourage 'healthy' behaviour in behaviour modification therapy? 

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Answer

Positive reinforcement 

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Question

Which type of reinforcement is used to discourage 'unhealthy' behaviour in behaviour modification therapy? 

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Answer

Negative reinforcement 

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Question

What is a strength of the psychodynamic approach to explaining mental illness?

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Answer

The psychodynamic theory highlights the importance of childhood experiences such as trauma, relationships and how they shape later life. 

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Question

How does the classical conditioning theory explain mental illnesses and apply this to our understanding of phobias? 

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Answer

The classical conditioning theory describes that mental illnesses are learned when people form associations between a conditional stimulus and response. For example, someone may form a phobia of enclosed spaces after associating it with panic attacks they have when in small spaces.   

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Question

Which theory has some commonalities with the medical model? 

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Answer

Cognitive 

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Question

How do cognitive neuroscience and the medical model differ in terms of explaining mental illnesses? 

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Answer

Cognitive neuroscience and the medical model differ as cognitive neuroscientists do not place as much emphasis on diagnostic criterias as the medical model does.

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Question

Which theories emphasise the role of experiences shaping mental illnesses? 

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Answer

Behavioural 

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Question

Is the following statement true or false, "the medical model and the humanistic approach take opposing stances in the free will versus determinism debate"?

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Answer

True

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Question

How did Beck's theory explain depression? 

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Answer

Beck formed the negative triad theory to explain depression. People with a negative triad tend to see the world, their current and future selves negatively. Therefore, people with depression continuously see events negatively. This feeds into their depression as they continuously feel low (this is known as the vicious cycle). 

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