Model Answer Example (DP IB Psychology)

The biopsychosocial model of health and well-being (BPS model) was developed by psychiatrist George Engel in 1977 to replace the biomedical model that he viewed as too reductionist. Instead of just seeing health as related to our physiology, the biopsychosocial model argues that health is dependent on an interaction between physiological, psychological and social/environmental factors. Supporters of the BPS model assert that a health approach that considers this interaction between factors should lead to improved explanation of health behaviour and better understanding, diagnosis and treatment of illnesses. This essay will discuss the BPS model explanation for the correlation between job stress and heart problems, through Marmot et al.’s (1997) investigation of civil service employees.

The wording of the exam question is used which shows Focus on the question. There is an explanation of the biopsychosocial model which shows Knowledge & Understanding. The command term is referred to explicitly which tells the examiner that the student has understood what is required of them (Focus). Relevant Research is cited so that the examiner knows what to expect in the essay plus the student has identified the biopsychosocial model’s approach to stress (Focus; Knowledge & Understanding). The paragraph is clear, coherent and grammatical (Clarity & Organisation) with effective use of terminology.

Marmot et al (1997) took the BPS approach to investigating whether employees in lower position jobs who had little control over their work environment would develop heart problems over five years. This research was part of an ongoing prospective longitudinal study into civil service employees. Medical checks were carried out (biological factors), and then a standardised self-report questionnaire was sent to their homes at yearly intervals for the next five years. The questionnaire asked for demographic data (social factors), but also asked about their environmental stressors, such as neighbourhood problems, loneliness and social support (a mixture of social and psychological  factors). Any self-reported health problems were verified by hospital records. Job specifications and responsibilities were also measured through independent assessments of the work environment by personnel managers. In this way, a holistic approach was taken to the employees’ health.

The biopsychosocial approach is explained (Focus) in relation to the study (Knowledge & Understanding and Use of Research). The command term is referred to (indirectly) in the final sentence of the paragraph (Focus). The paragraph is clear, coherent and grammatical (Clarity & Organisation) with effective use of terminology.

The results showed that the rate of heart problems for those in the lowest level jobs was 1.5 times the rate in the highest levels. The most significant risk factor for developing heart disease over the five years of the study was the degree of control that participants felt they had in the work environment. This was correlated with the control they actually had through the personnel managers’ independent assessments, showing that the employees’ perception of their lack of control was accurate. Therefore, those with low control over their day-to-day working life were more likely to develop heart disease. This use of the BPS model to explain the psychological and social correlates of job stress increases the possibility of addressing these problems and so reducing the incidence of heart disease. It connects the biological with the social and psychological in an explanation of health and well-being.

The Research is used effectively to demonstrate the biopsychosocial model and the question is addressed directly i.e. the use of the biopsychosocial model is explained (Knowledge & Understanding). The command term is implicitly addressed at the end of the paragraph (Focus). The paragraph is clear, coherent and grammatical (Clarity & Organisation) with effective use of terminology.

Marmot et al.’s research used standardised questionnaires, objective health measures and correlational analysis, meaning that the results have a high degree of reliability. The longitudinal design means that the data from this study can be compared with data from previous and future research, allowing for a trend to be identified. However, although the methods used to gather the data were standardised and easily replicable, self-report questionnaires are subject to participant bias in several different ways, which can reduce the internal validity of the results. One of the main problems is the social desirability effect, as participants may under-report their own health problems in an effort to appear healthy. Questions are also open to individual interpretation and forced choices in closed-ended questions may not match the participants’ preferred answers. As the questionnaires are about health, fear that confidentiality may not be maintained may have led to untruthful answers or some questions not being answered. Finally, a correlation can only suggest association rather than cause-and-effect so it cannot conclusively show what the source of the stress was in each participant’s life. However, the correlation between lack of control in one’s job and heart problems is maintained over the five years of the study, supporting the BPS model’s explanation for health.

The use of Research to support the use of biopsychosocial model’s explanation of the relationship between work stress and heart problems is expanded upon.  (Knowledge & Understanding). Critical Thinking is used to challenge the extent of the validity and reliability of the findings. The paragraph is clear, coherent and grammatical (Clarity & Organisation) with effective use of terminology. Focus is maintained, with the reference to the terms in the question at the end of the paragraph. 

Supporters of the BPS model argue that it should lead to improved diagnosis and better predictions about treatment and follow-up. However, health professionals should not just explore each factor on its own, and then combine all the knowledge at the end, but understand how each affects and is affected by the others. For example, once an employee with little job control begins to suffer from chronic stress, their social life may diminish as their immune system is compromised and they are in the earlier stages of heart disease. This leads to exhaustion and no time for anything except work, and then loneliness can become a social factor in their ill-health.This interaction between the factors needs to be considered in order to engage effectively with prevention and treatment. The BPS model has been criticised for the complexity of this relationship and the resulting difficulty of isolating variables to identify just what is causing ill-health.

More knowledge shown of how the BPS model works (Knowledge & Understanding). Critical Thinking is used to discuss the interactionist nature and the complexity of the model. All of this is discussion, so meeting the command term requirements  (Focus). The paragraph is clear, coherent and grammatical (Clarity & Organisation) with effective use of terminology.

Given this difficulty, Suls and Rothman (2004) suspected the BPS model was not being implemented as intended. They assessed the extent to which health psychologists used the BPS model effectively in an interactionist way. Their meta-analysis of studies showed  that psychological factors were measured in over 94% of the studies being assessed, but biological and social factors appeared in only about half of the studies. They concluded that while health psychologists have acknowledged the BPS model enough to reference it in their research, their studies are not focused on the links between the different factors, and research exploring interaction between biological and social factors were especially limited. However, we have to consider that health psychologists, by the nature of their work, are more likely to favour psychological factors when researching health. Moreover, the study was carried out between 2001 and 2002, so it is over twenty years old and the findings therefore lack some temporal validity, and the frequency of use of the BPS model by medical practitioners may well have increased.

The student shows Critical Thinking which also includes wider Knowledge & Understanding of the topic and cites another piece of Research. The command term is implicitly addressed (Focus). The paragraph is clear, coherent and grammatical (Clarity & Organisation) with effective use of terminology.

To conclude, the BPS model provides a reliable explanation for ill-health by looking at the relationship between a person’s physiology, psychology and social conditions (environment). However, any discussion of the BPS model has to acknowledge its complexity. In order to be effective, it needs to be used in the way intended, with the interaction between all three factors looked at to create a holistic explanation of health and well-being. The difficulty with this is that it is difficult to see how the factors interact, but also challenging to isolate the different factors and determine which may play the most significant role in stress for most people. But, given the complexity of many health problems, the BPS model would be insufficient if it was reductionist and simplistic. 1058 words

The essay comes to a conclusion, reflecting on what has been covered and returning to the demands of the question (Focus). Critical Thinking explores the limitations of the use of the BPS, and of the model itself. The question is explicitly addressed (Focus). The paragraph is clear, coherent and grammatical (Clarity & Organisation) with effective use of terminology.

Why would an examiner give this model answer top marks?

• It is fully focused on the question at all times

• It does not go ‘off on a tangent’ by including off-topic, irrelevant or superfluous detail

• It is concise, there is no ‘waffle’ and it uses key terminology throughout

• Research is used in a way which adds value to the response i.e. it is not a ‘shopping list’ of ‘everything I know about this topic/theory/study’ (what some teachers call a ‘knowledge vomit’, sorry for the gross imagery!)

• It selects key critical thinking/evaluation points

• Critical thinking is not simply an evaluation of research, it is an appraisal of the model as a whole

• Each paragraph is composed of a topic sentence which is then expanded on, with examples