THE BIOPSYCHOLOGICAL MODEL 1

The Usefulness of the Biopsychosocial Model for Understanding the Causes of Rheumatic Heart

Disease.

Student’s Name

Institutional Affiliation
THE BIOPSYCHOLOGICAL MODEL 2

The Usefulness of the Biopsychosocial Model for Understanding the Causes of Rheumatic Heart

Disease.

Rheumatic heart disease (RHD) is one of the most common health issues that account for

high morbidity and death rates among people living in third world countries. The cardiovascular

is said to be more common in children than in adults. RHD is described as a health condition

that leads to permanent destruction of heart valves due to Rheumatic fever (Marijon, Mirabel,

Celermajer & Jouven, 2012). The damage of the heart valves is triggered by under-treated and

untreated infection of the streptococcus. In most cases, strep throat is the major streptococcal

infection that triggers heart valves damage as it causes an inflammatory condition during the

body’s immune response to the condition (Jaine, Baker & Venugopal, 2008). Children are

considered to be the most vulnerable to RHD because they are highly likely to suffer from strep

throat. Rheumatic fever is described as an inflammatory illness that is triggered by untreated

strep throat. Subsequently, strep throat entails an infection of bacterial origin that leads to a sore

feeling in the throat or a scratchy throat. If not treated, the condition leads to rheumatic fever

which in turn leads to RHD (Jaine, Baker & Venugopal, 2011). Thus, there is a close relationship

between RHD, rheumatic fever, and strep throat.

The prevalence of RHD in developing countries is mostly linked to poor economic status

in such countries. It is considered rare in developed economies having been almost eliminated in

the countries in the 20th century (Jaine et al., 2011). Global estimates indicate that there 62-78

million individuals who might be suffering from RHD and out of the people, about 1.4 million

are at a higher risk of succumbing to the condition or its complications (Talwar & Gupta, 2016).

Studies suggest that individuals with RHD are more likely to suffer from other conditions such

as heart failure among other complications of the heart. In New Zealand, RHD is mostly
THE BIOPSYCHOLOGICAL MODEL 3

common in high-risk populations especially children between the ages of 5 and 14 of the Pacific

and Maori (Ordunez et al., 2019). It is estimated that 80% of RHD cases are reported among

people in this age group.

As some of the diseases such as RHD continue to cause wreak havoc in society, it is

important to have models that help in the understanding of various health problems. In essence,

some several theories and concepts have been developed in the past to promote clinical practice

and prevention of diseases (Adler, 2009). These concepts and models are instrumental in the

diagnosis, development, and execution of interventions. In medical practice, disease prevention

and health promotion usually borrow knowledge from one or more models or theories. The

biopsychosocial model is among the models that have successfully been used in the prevention

of diseases and to support health. The concept was developed by George Engel (Adler, 2009).

The psychologist argued that an illness is not only determined by biological influences but also

social and psychological factors. Biopsychosocial model is mostly recommended in the

conditions that pertain to chronic pain on the assumption that pain represents a

psychophysiological pattern that is characterized by social, biological, and psychological factors.

The Biopsychosocial model follows a practical guide that is instrumental in the medical

evaluation of a patient's data. It uses the PSCEBSM approach that stands for Pain, Somatic,

Cognitive, Emotional, Behavioral, Social, and Motivational factors (Suls & Martin, 2011). The

main contribution of this model to clinical practice is that it enables a physiotherapist to

understand all the underlying factors that lead to a patient's condition of health. The

Biopsychosocial model is subdivided into three major components that influence the health of an

individual which include psychological influences, biological factors as well as social issues.
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The three major components of the Biopsychosocial model are key in the promotion and

prevention of health. The biological component is composed of three major processes which

include growth, development, and aging (Adler, 2009). In these three processes of biological

factors, the most important determinants of human health are genetic composition, internal and

external agencies as well as aging. In terms of genetic composition, human diseases are blamed

for the presence of faulty genes. Subsequently, internal agencies entail factors such as lifestyle

choices which act as risk factors to diseases while external agencies include viruses and bacteria.

Moreover, aging tends to cause a gradual weakening of physical and mental health of an

individual. Next, psychological component involves mental conditions that lead to a disease such

as depression, perception, anxiety, and emotional status of a person (Suls & Martin, 2011). These

mental factors are highly likely to influence an individual's decision on daily activities to

undertake some of which may expose an individual to the risk of contracting a disease such as

smoking and excessive drinking. Finally, the social element of the Biopsychosocial model

includes issues such as cultural norms, values, and economic status of an individual. These

factors may affect a person's healthcare choices or serve as barriers to accessing healthcare

services such as low economic status. The direct impact of social factors is mortality and

morbidity (Suls & Martin, 2011). Thus, it is important for medical practitioners considers all the

three components of the Biopsychosocial model while trying to address various health condition

to ensure better health outcomes.

The Biopsychosocial model helps in understanding the causes of different diseases

through examining the reciprocal influences of social factors, behavioral, psychology and

biology on health and illnesses. For instance: pain is a symptom of most human diseases. The

Biopsychosocial model helps physicians establish the cause of the pain by examining the factors
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outside the patient’s health that may affect their perception of pain. The biopsychological model

posits that biological, social, cultural and psychological components and explanations for a

health condition are not enough to cause illness each on its own. It, therefore, examines the

interactions between the various components to establish the cause of disease and the course of

its development. This approach has been proved to be effective when studying the causes of

mental illnesses and lifestyle diseases (Suls & Martin, 2011). Health literature on the

Biopsychosocial model proposes that examining how the workings of the environment, mind and

body deeply interrelate and affect each other helps understand the physical activity, nutrition and

health promotion behaviors of a patient.

The biological matrix of RHD states that the disease is thought to be a result of an

autoimmune response with unclear pathogenesis. RHD results are secondary to rheumatic fever.

It is caused by a permanent heart valve damage. The damage is caused by primary illnesses such

as pericarditis, valvulitis and myocarditis. Such underlying illnesses are characteristic in people

with rheumatic fever. As such diseases progress, they narrow the mitral valve causing mitral

stenosis (Ordunez et al., 2019). From a biopsychosocial context, the valve damages caused by a

biological factor are mild and may not be enough to cause a RHD unless when coupled with

psychological and sociological factors.

RHD is highly prevalent among people living in certain sociological environments.

Findings from several research studies reveal that people overcrowding, illiteracy, low

socioeconomic status and poor hygiene are the major risk factors of rheumatoid heart disease.

Besides, individuals living in urban areas are more likely to develop the disease compared to

people in the countryside. (Jaine et al., 2011). According to Beg, Younas & Asma (2016),

children who attend highly populated nursery schools have a higher risk of contracting RHD
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compared to those who attend the less populated private schools. Moreover, cases of RHD are

more likely to be reported in households with large family size. In such cases, children are

affected more than the parents. Literate people in highly skilled professions report fewer cases of

RHD compared to the unskilled and illiterate people working in harsh conditions (Beg et al.,

2016). The sociological aspect of RHD is highly related to overpopulation, awareness and

hygiene.

Based on the biopsychological model, there is a known relationship between

psychological trauma and physical illnesses such as Rheumatoid Heart Disease. According to

Suls & Martin (2011), emotional tension and trauma are common among patients with RHD

before the onset of symptoms. In all cardiac diseases, psychological factors account for 75% of

all reported cases. Anxiety and depression are highly related to RHD both as a cause and an

effect (Suls & Martin, 2011). The two conditions lead to difficulties in managing various aspects

of life.

In conclusion, RHD is among the common illnesses that have high rates of mortality and

morbidity. The disease involves permanent destruction of heart valves. The high prevalence of

RHD in developing countries if attributed to poor economic status. The biopsychological model

incorporates biological, social and psychological components to establish the causes of RHD and

develop the appropriate clinical intervention. The biological component is composed of three

major processes which include growth, development, and aging. The psychological factors

influence an individual’s decision on daily activities. Lastly, the social element of the model

includes the economic status, cultural norms and values of an individual. Findings from research

studies on the causes of RHD reveal that all the three components of the Biopsychosocial model
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interact to cause RHD. This creates the need for medical practitioners to consider all three

components of the Biopsychosocial model when addressing various health conditions.

The Biopsychological model is useful in understanding the causes of RHD because it

explores all the aspects of the patient to not only establish the cause of the illness but also

develop effective treatment methods that would alleviate the chances of the disease recurring. It

is evident that psychological, social and biological factors play are responsible for the

development of RHD.
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References

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Psychosomatic Research, 67(6), 607–611.

https://doi.org/10.1016/j.jpsychores.2009.08.008.

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Jaine, R., Baker, M., & Venugopal, K. (2008). Epidemiology of acute rheumatic fever in New

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