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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!
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.
Biological research, freepik.com/Freepik
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 An old, outdated model is Electroconvulsive therapy (ECT), a largely abandoned treatment because of some severe risks.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.
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.
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.
Low serotonin and norepinephrine (neurotransmitters) have been linked to manic depression and bipolar disorder. Abnormally high levels of dopamine have been linked to schizophrenia.
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:
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 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 of developing the disorder.
This study is key research in the OCR A level specification, so be sure to learn it!
Research has found that people diagnosed with mental illnesses may have brain abnormalities. These include:
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.
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.
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.
Let us consider the following strengths 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:
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 strengths of the medical model are:
The limitations of the medical model are:
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.
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