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Revisiting the Biopsychosocial Formulation: Neuroscience, Social Science, and the Patient’s Subjective Experience

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References

  1. McHugh PR, Slavney PR. The perspectives of psychiatry. 2nd ed. Baltimore: Johns Hopkins University Press; 1998.

    Google Scholar 

  2. Kendler KS. The structure of psychiatric science. Am J Psychiatry. 2014;171:931–8.

    Article  PubMed  Google Scholar 

  3. Engel G. The need for a new medical model: a challenge for biomedicine. Science. 1977;196:129–36.

    Article  CAS  PubMed  Google Scholar 

  4. Fava GA, Sonino N. The biopsychososcial model thirty years later. Psychother Psychosom. 2008;77:1–2.

    Article  PubMed  Google Scholar 

  5. Ghaemi SN. The rise and fall of the ‘biopsychosocial model. Br J Psychiatry. 2009;195:3–4.

    Article  PubMed  Google Scholar 

  6. Insel TR, Quirion R. Psychiatry as a clinical neuroscience discipline. JAMA. 2005;294:2221–4.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  7. Ross D, Travis M, Arbuckle M. The future of psychiatry as clinical neuroscience: why not now? JAMA Psychiatry. 2015;72:413–4.

    Article  PubMed  Google Scholar 

  8. Reynolds CF, Lewis DA, Detre T, et al. The future of psychiatry as clinical neuroscience. Acad Med. 2009;84:446–50.

    Article  PubMed  PubMed Central  Google Scholar 

  9. Rubin EH, Zorumski CF. Upcoming paradigm shifts in psychiatry in clinical care, research, and education. Acad Med. 2012;87:261–5.

    Article  PubMed  Google Scholar 

  10. Psychiatry Milestone Group (Thomas C, Benjamin S, Bentman AL et al: http://acgme.org/acgmeweb/Portals/0/PDFs/Milestones/PsychiatryMilestones.pdf. Patient care 2: psychiatric formulation and differential diagnosis. March 14, 2016.

  11. Heim C, Shugart M, Craighead WE, Nemeroff CB. Neurobiological and psychiatric consequences of child abuse and neglect. Dev Psychobiol. 2010;52:671–90.

    Article  PubMed  Google Scholar 

  12. Psychiatry Milestone Group (Thomas C, Benjamin S, Bentman AL et al: http://acgme.org/acgmeweb/Portals/0/PDFs/Milestones/PsychiatryMilestones.pdf. Medical knowledge 1: development through the life cycle. March 14, 2016.

  13. Dvir Y, Denietolis B, Frazier J. Childhood trauma and psychosis. Child Adolesc Psychiatric Clin N Am. 2013;22:629–41.

    Article  Google Scholar 

  14. Varese F, Smeets F, Drukker M, et al. Childhood adversities increase the risk of psychosis: a meta-analysis of patient control prospective and cross-sectional cohort studies. Schizoph Bull. 2012.

  15. Nestler E. Epigenetic mechanisms of depression. JAMA Psychiatry. 2014;71:454–6.

    Article  PubMed  PubMed Central  Google Scholar 

  16. Rutten B, Mill J. Epigenetic mediation of environmental influences in major psychotic disorders. Schizophr Bull. 2009;35:1045–56.

    Article  PubMed  PubMed Central  Google Scholar 

  17. Vialou V, Feng J, Robison A, Nestler E. Epigenetic mechanisms of depression and antidepressant action. Annu Rev Pharmacol Toxicol. 2013;53:59–87.

    Article  CAS  PubMed  Google Scholar 

  18. Roth TL, Lubin FD, Funk AJ, Sweat JD. Lasting epigenetic influence of early life adversity on the BDNF gene. Biol Psychiatry. 2009;65:760–9.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  19. Ivy AS, Brunson KL, Sandman C, Baram TZ. Dysfunctional nurturing behavior in rat dams with limited access to nesting material: a clinically relevant model for early-life stress. Neurosci. 2008;154:1132–42.

    Article  CAS  Google Scholar 

  20. Psychiatry Milestone Group (Thomas C, Benjamin S, Bentman AL et al: http://acgme.org/acgmeweb/Portals/0/PDFs/Milestones/PsychiatryMilestones.pdf. Medical knowledge 3: clinical neuroscience. March 14, 2016.

  21. Neigh GN, Gillespie CF, Nemeroff CB. The neurobiological toll of child abuse and neglect. Trauma Violence Abuse. 2009;10:389–410.

    Article  PubMed  Google Scholar 

  22. Champagne FA. Epigenetic influence of social experiences across the lifespan. Dev Psychobiol. 2010;54:299–311.

    Article  Google Scholar 

  23. Franklin TB, Russig H, Weiss IC, et al. Epigenetic transmission of the impact of early stress across generations. Biol Psychiatry. 2010.

  24. Luhrmann TM. Beyond the brain. Summer: Wilson Quarterly; 2012. p. 28–34.

    Google Scholar 

  25. Shim RS, Compton MT, Manseau MW, et al. Overview of the social determinants of mental health. In: Compton MT, Shim RS, editors. The Social Determinants of Mental Health. Arlington: American Psychiatric Publishing; 2015. p. 1–22.

    Google Scholar 

  26. Sareen J, Afifi TO, McMillan K, Asmundson G. Relationship between household income and mental disorders findings from a population-based longitudinal study. Arch Gen Psychiatry. 2011;68(4):419–27.

    Article  PubMed  Google Scholar 

  27. Manseau MW. Economic inequality, poverty, and neighborhood deprivation. In: Compton MT, Shim RS, editors. The Social Determinants of Mental Health. Arlington: American Psychiatric Publishing; 2015. p. 121–44.

    Google Scholar 

  28. McGregor BS, Holden KB. Unemployment, underemployment, and job insecurity. In: Compton MT, Shim RS, editors. The Social Determinants of Mental Health. Arlington: American Psychiatric Publishing; 2015. p. 99–119.

    Google Scholar 

  29. Ehrenreich B. Nickel and dimed: on not getting by in America. New York: Henry Holt and Company, Ltd.; 2001.

    Google Scholar 

  30. Van Nierop M, Van Os J, Gunther N, et al. Does social defeat mediate the association between childhood trauma and psychosis? Evidence from the NEMESIS-2 study. Acta Psychiatr Scand. 2014;129:467–76.

    Article  PubMed  Google Scholar 

  31. Bhugra D. Severe mental illness across cultures. Acta Psychiatr Scand. 2006;113:17–23.

    Article  Google Scholar 

  32. Luhrmann TM. Social defeat and the culture of chronicity: or, why schizophrenia does so well over there and so badly here. Cult Med Psychiatry. 2007;31:135–72.

    Article  CAS  PubMed  Google Scholar 

  33. Chu JA. Rebuilding shattered lives: treating complex PTSD and dissociative disorders. Hoboken: John Wiley and Sons, Inc.; 2011.

    Book  Google Scholar 

  34. Herman J. Trauma and recovery. NYC: Basic Books; 1997.

    Google Scholar 

  35. Arseneault L, Bowes L, Shakoor S. Bullying victimization in youths and mental health problems: ‘much ado about nothing’? Psychol Med. 2010;40:717–29.

    Article  CAS  PubMed  Google Scholar 

  36. Vreeman RC, Carroll AE. A systematic review of school based interventions to prevent bullying. Arch Pediatr Adolesc Med. 2007;161:78–88.

    Article  PubMed  Google Scholar 

  37. Sadler JZ. Stigma, conscience, and science in psychiatry: past, present, and future. Acad Med. 2009;84:413–7.

    Article  PubMed  Google Scholar 

  38. Kleinman A. Concepts and a model for the comparison of medical systems as cultural systems. Soc Sci Med. 1978;12:85–93.

    Article  CAS  PubMed  Google Scholar 

  39. Lawrence D, Kisely S. Review: inequalities in healthcare provision for people with severe mental illness. J Psychopharmacol. 2010;24:61–8.

    Article  PubMed  PubMed Central  Google Scholar 

  40. Phelps EA, O’Connor KJ, Cunningham WA, et al. Performance on indirect measures of race evaluation predicts amygdala activation. J Cogn Neurosci. 2000;12:729–38.

    Article  CAS  PubMed  Google Scholar 

  41. Volz KG. In group as part of the self: in group favoritism is mediated by medial prefrontal cortex activation. Soc Neurosci. 2009;4:244–60.

    Article  PubMed  Google Scholar 

  42. Harris LT, Fiske ST. Dehumanizing the lowest of the low: neuroimaging responses to extreme out-groups. Psychol Sci. 2006;17:847–53.

    Article  PubMed  Google Scholar 

  43. Fiske ST. From dehumanization and objectification to rehumanization: neuroimaging studies on the building blocks of empathy. Ann NY Acad Sci. 2009;1167:31–4.

    Article  PubMed  PubMed Central  Google Scholar 

  44. Stanley D, Phelps E, Banaji M. The neural basis of implicit attitudes. Curr Dir Psychol Sci. 2008;17:164–70.

    Article  Google Scholar 

  45. Eisenberger NI, Lieberman MD, Williams KD. Does rejection hurt? An fMRI study of social exclusion. Science. 2003;302:290–2.

    Article  CAS  PubMed  Google Scholar 

  46. Corrigan PW, Watson A. Stop the stigma: call mental illness a brain disease. Schizophr Bull. 2004;30:477–9.

    Article  PubMed  Google Scholar 

  47. Satcher D, Shim RS. A call to action: addressing the social determinants of mental health. In: Compton MT, Shim RS, editors. The Social Determinants of Mental Health. Arlington: American Psychiatric Publishing; 2015. p. 235–54.

    Google Scholar 

  48. http://acgme.org/acgmeweb/Portals/0/PDFs/Milestones/PsychiatryMilestones.pdf. Medical knowledge 6: practice of psychiatry.

  49. Kendler KS. Toward a philosophic structure for psychiatry. Am J Psychiatry. 2005;162:433–40.

    Article  PubMed  Google Scholar 

  50. Kandel ER. A new intellectual framework for psychiatry. Am J Psychiatry. 1998;155:457–69.

    Article  CAS  PubMed  Google Scholar 

  51. Stahl S. Psychotherapy as an epigenetic ‘drug’: psychiatric therapeutics target symptoms linked to malfunctioning brain circuits with psychotherapy as with drugs. J Clin Pharm Ther. 2012;37:249–53.

    Article  CAS  PubMed  Google Scholar 

  52. http://acgme.org/acgmeweb/Portals/0/PDFs/Milestones/PsychiatryMilestones.pdf. Patient care 4: psychotherapy.

  53. Krishnan V, Nestler E. Linking molecules to mood: new insight into the biology of depression. Am J Psychiatry. 2010;167:1305–20.

    Article  PubMed  PubMed Central  Google Scholar 

  54. Tyrka AR, Burgers DE, Philip NS, et al. The neurobiological correlates of childhood adversity and implications for treatment. Acta Psychiatr Scand. 2013;128:434–47.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  55. http://acgme.org/acgmeweb/Portals/0/PDFs/Milestones/PsychiatryMilestones.pdf. Patient care 3: treatment planning and management.

  56. Beauregard M. Mind does really matter: evidence from neuroimaging studies of emotional self-regulation, psychotherapy, and placebo effect. Prog Neurobiol. 2007;81:218–36.

    Article  PubMed  Google Scholar 

  57. Kendler KS, Gardner CO. A longitudinal etiologic model for symptoms of anxiety and depression in women. Psychol Med. 2011;41:2035–45.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  58. Wigney T, Parker G. Factors encouraging medical students to a career in psychiatry: a qualitative analysis. Aust N Z J Psychiatry. 2008;42:520–5.

    Article  PubMed  Google Scholar 

  59. Haidet P, Dains JE, Paterniti DA, et al. Medical student attitudes toward the doctor-patient relationship. Med Educ. 2002;36:568–74.

    Article  PubMed  Google Scholar 

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Acknowledgments

The author gratefully acknowledges the numerous critical readings and invaluable edits provided by Amy Brenner.

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  1. University of Texas Southwestern Medical Center, Dallas, TX, USA

    Adam M. Brenner

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  1. Adam M. Brenner
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Correspondence to Adam M. Brenner.

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Brenner, A.M. Revisiting the Biopsychosocial Formulation: Neuroscience, Social Science, and the Patient’s Subjective Experience. Acad Psychiatry 40, 740–746 (2016). https://doi.org/10.1007/s40596-016-0542-y

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