The Experts below are selected from a list of 9003 Experts worldwide ranked by ideXlab platform
Douglas A Drossman - One of the best experts on this subject based on the ideXlab platform.
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Biopsychosocial Model of irritable bowel syndrome
Journal of Neurogastroenterology and Motility, 2011Co-Authors: Yukari Tanaka, Motoyori Kanazawa, Shin Fukudo, Douglas A DrossmanAbstract:Irritable bowel syndrome (IBS) is a common chronic disorder seen in gastroenterology and primary care practice. It is characterized by recurrent abdominal pain or discomfort associated with disturbed bowel function. It is a heterogeneous disorder with varying treatments, and in this regard physicians sometimes struggle with finding the optimal approach to management of patients with IBS. This disorder induces high health care costs and variably reduces health-related quality of life. IBS is in the class of functional gastrointestinal disorders, and results from dysregulation of central and enteric nervous system interactions. Psychosocial factors are closely related to their gut physiology, associated cognitions, symptom manifestations and illness behavior. Therefore, it is important for the physician to recognize the psychosocial issues of patients with IBS and in addition to build a good patient-physician relationship in order to optimize treatment. This review focuses on the interaction between psychological and physiological factors associated with IBS by using a Biopsychosocial Model. In this article, we describe (1) the predisposing psychological features seen in early life; (2) the psychological factors associated with life stress, the symptom presentation, and their associated coping patterns; (3) gut pathophysiology with emphasis on disturbances in motility, visceral hypersensitivity and brain-gut interactions; and finally (4) the clinical outcomes and effective treatments including psychotherapeutic methods.
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presidential address gastrointestinal illness and the Biopsychosocial Model
Psychosomatic Medicine, 1998Co-Authors: Douglas A DrossmanAbstract:OBJECTIVE To review the evidence supporting the Biopsychosocial Model in understanding patients with gastrointestinal disorders (GI). METHOD Essay of personal experience and review of related literature through a MEDLINE search. RESULTS Through clinical examples of three common gastrointestinal disorders, a case is made to refocus our understanding from a biomedical or disease-based Model of illness to a Biopsychosocial Model. With the latter Model, the psychosocial and biological predeterminants are seen to interact in the clinical expression of illness and disease. With gastroesophageal reflux disease, the evidence shows that stress can lead to amplification of heartburn symptoms that is independent of the degree of reflux. Functional gastrointestinal pain is "an illness without disease," where structural or physiological disturbance of the GI system does not exist. Rather, the symptoms are understood in terms of visceral hypersensitivity as modulated by central nervous system activity. With the Crohn's disease example, the clinical expression of the disorder is not explained by the degree of disease activity. Rather, the symptoms and impaired quality of life relate to preexisting psychosocial determinants. The observed association of stress with disease activation in Crohn's disease is explained by stress-related alterations in psychoimmunological function via the hypothalamic-pituitary-adrenal axis. CONCLUSIONS Gastrointestinal disorders, as a Model for other medical conditions, exemplify the important role of an integrated, Biopsychosocial Model of illness.
Deirdre E Logan - One of the best experts on this subject based on the ideXlab platform.
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the Biopsychosocial Model of pain in the context of pediatric burn injuries
European Journal of Pain, 2019Co-Authors: Sarah Nelson, Caitlin Conroy, Deirdre E LoganAbstract:Background Burns are a common and traumatic source of childhood injury in the United States. The treatment and recovery from burn injuries can be significantly painful and may lead to chronic or persistent pain for years following the initial incident. Further, burn injuries in youth have been found to increase the potential for significant psychosocial (e.g., anxiety, depression, PTSD) and physical (e.g., decreased mobility) impairment. Relatedly, the general experience and processing of pain in youth can also be associated with greater psychosocial (e.g., anxiety, depression) impairment and functional disability over time. However, the phenomenology and associated characteristics of the pain experience following burn injury and, in particular, the potential for combined impact on physical and psychosocial outcomes in youth with severe and/or prolonged pain and a history of burn injury is poorly understood. Methods A review of the literature was performed in the areas of burn injuries and outcomes associated with both acute and chronic pain with youth and adult populations. Results The current review highlights current gaps in the literature in important areas of function in youth with a history of burn injuries using the Biopsychosocial Model of pain. Future research and considerations for practice are also outlined. Conclusions Gaining a greater understanding of the relationship between pain, physical impairment, and psychosocial functioning in these youth is significantly important in order to provide greater preventative and treatment-related intervention going forward. Significance Using a Biopsychosocial framework, this review highlights the need for a greater understanding of pain processing and the long-term potential for persistent pain and pain-related impairment (e.g., functional disability) in youth with a history of burn injuries.
Christine Miaskowski - One of the best experts on this subject based on the ideXlab platform.
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a Biopsychosocial Model of chronic pain for older adults
Pain Medicine, 2020Co-Authors: Christine Miaskowski, Fiona M Blyth, Francesca M Nicosia, Mary N Haan, Frances Keefe, Alexander K Smith, Christine S RitchieAbstract:Population Comprehensive evaluation of chronic pain in older adults is multifaceted. Objective and methods Research on chronic pain in older adults needs to be guided by sound conceptual Models. The purpose of this paper is to describe an adaptation of the Biopsychosocial Model (BPS) of Chronic Pain for older adults. The extant literature was reviewed, and selected research findings that provide the empiric foundation for this adaptation of the BPS Model of chronic pain are summarized. The paper concludes with a discussion of specific recommendations for how this adapted Model can be used to guide future research. Conclusions This adaptation of the BPS Model of chronic pain for older adults provides a comprehensive framework to guide future research in this vulnerable population.
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adaption of the Biopsychosocial Model of chronic noncancer pain in veterans
Pain Medicine, 2019Co-Authors: Ariel M Baria, Sanjog Pangarkar, Gary W Abrams, Christine MiaskowskiAbstract:Population Veterans with chronic noncancer pain (CNCP) are a vulnerable population whose care remains a challenge for clinicians, policy-makers, and researchers. As a result of military experience, veterans are exposed to high rates of musculoskeletal injuries, trauma, psychological stressors (e.g., post-traumatic stress disorder, depression, anxiety, substance abuse), and social factors (e.g., homelessness, social isolation, disability, decreased access to medical care) that contribute to the magnitude and impact of CNCP. In the veteran population, sound theoretical Models are needed to understand the specific physiological, psychological, and social factors that influence this unique experience. Objective This paper describes an adaption of Gatchel and colleagues' Biopsychosocial Model of CNCP to veterans and summarizes research findings that support each component of the revised Model. The paper concludes with a discussion of important implications for the use of this revised Model in clinical practice and future directions for research. Conclusions The adaption of the Biopsychosocial Model of CNCP for veterans provides a useful and relevant conceptual framework that can be used to guide future research and improve clinical care in this vulnerable population.
Keith Geraghty - One of the best experts on this subject based on the ideXlab platform.
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myalgic encephalomyelitis chronic fatigue syndrome and the Biopsychosocial Model a review of patient harm and distress in the medical encounter
Disability and Rehabilitation, 2019Co-Authors: Keith Geraghty, Charlotte BleaseAbstract:AbstractObjective: Despite the growing evidence of physiological and cellular abnormalities in myalgic encephalomyelitis (ME)/chronic fatigue syndrome (CFS), there has been a strong impetus to tackle the illness utilizing a Biopsychosocial Model. However, many sufferers of this disabling condition report distress and dissatisfaction following medical encounters. This review seeks to account for this discord.Methods: A narrative review methodology is employed to synthesize the evidence for potential iatrogenesis.Results: We identify seven potential modalities of iatrogenesis or harm reported by patients:difficulties in reaching an acceptable diagnosis;misdiagnosis, including of other medical and psychological conditions;difficulties in accessing the sick role, medical care and social support;high levels of patient dissatisfaction with the quality of medical care;negative responses to controversial therapies (cognitive behavioral therapy and graded exercise therapy);challenges to the patient narrative and e...
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chronic fatigue syndrome is the Biopsychosocial Model responsible for patient dissatisfaction and harm
British Journal of General Practice, 2016Co-Authors: Keith Geraghty, Aneez EsmailAbstract:In 1977 George Engel wrote about the need for an ‘integrated approach’ in medicine that moved the focus beyond biological mechanisms of disease to include all pertinent aspects of illness presentation, setting out a ‘Biopsychosocial Model’.1 Around the same time, McEvedy and Beard asserted that the disease ‘ benign myalgic encephalomyelitis ’, described by Ramsay at the Royal Free Hospital, London, was nothing more than a case of ‘mass hysteria’.2 In the 1980s, doctors combined theories of neurasthenia, hysteria, and somatoform illness, to reconstitute ME as ‘ chronic fatigue syndrome ’. Psychiatrists argued that CFS was best understood using a Biopsychosocial (BPS) framework, being perhaps triggered by viral illness (biology), but maintained by certain personality traits (psychology) and social conditions (sociology).3 Although the BPS Model holds much utility in understanding ‘illness’ in a wider context, many sufferers of CFS reject the notion that their illness is psychologically or socially derived. Significant numbers of patients report difficult interactions with doctors that leave them feeling dissatisfied, disbelieved, and distressed. In this article, we question whether or not the BPS Model generates ‘harms’ for CFS patients, and we ask if other, alternative approaches might be more preferable to both patients and GPs. GPs are increasingly encouraged to apply Biopsychosocial principles in the clinical assessment of patients with medically unexplained symptoms, particularly CFS.3,4 There is a general argument put forward in the BPS literature that patients with CFS have higher rates of depression and anxiety, are combative, and seek unnecessary investigations in an effort to maintain sick role status and avail of social benefits.3 GPs are encouraged …
Christine S Ritchie - One of the best experts on this subject based on the ideXlab platform.
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a Biopsychosocial Model of chronic pain for older adults
Pain Medicine, 2020Co-Authors: Christine Miaskowski, Fiona M Blyth, Francesca M Nicosia, Mary N Haan, Frances Keefe, Alexander K Smith, Christine S RitchieAbstract:Population Comprehensive evaluation of chronic pain in older adults is multifaceted. Objective and methods Research on chronic pain in older adults needs to be guided by sound conceptual Models. The purpose of this paper is to describe an adaptation of the Biopsychosocial Model (BPS) of Chronic Pain for older adults. The extant literature was reviewed, and selected research findings that provide the empiric foundation for this adaptation of the BPS Model of chronic pain are summarized. The paper concludes with a discussion of specific recommendations for how this adapted Model can be used to guide future research. Conclusions This adaptation of the BPS Model of chronic pain for older adults provides a comprehensive framework to guide future research in this vulnerable population.