(a) Discuss the biopsychosocial model of health. Suggest relevant actions to prevent illness. (15 marks) (b) Explain the…

(a) The biopsychosocial model of health and actions to prevent illness

Engel (1977) proposed the biopsychosocial model as an alternative to the purely biomedical model, which sees disease as a biological fault alone. Health and illness arise from the interaction of three sets of factors: Biological: genes, immunity, neurochemistry, infection and nutrition. Psychological: stress, emotions, beliefs, coping style and health behaviours such as smoking or exercise. Social: poverty, family support, work, education, culture and access to care. These interact. For example, hypertension involves inherited risk, chronic stress and a salt-rich diet, and also low income and poor access to treatment. Treatment and prevention must therefore address all three. Prevention: Primary (before disease): immunisation, a healthy diet and exercise, tobacco and alcohol control, stress management, sanitation, health education in schools, and safe workplaces and roads. Secondary (early detection): screening for hypertension, diabetes and cancer, which India provides at Ayushman Arogya Mandirs (formerly health and wellness centres), and mental-health screening. Tertiary (limiting disability): rehabilitation, adherence support, self-management and family counselling. Psychologists contribute through health-behaviour change (health belief model), stress and coping training, and community programmes.

(b) Assumptions of behaviour therapy and its techniques for phobia

Assumptions: behaviour, normal or abnormal, is largely learned through classical conditioning, operant conditioning and observational learning; maladaptive behaviour is itself the problem, and not just a symptom of unconscious conflict; what is learned can be unlearned or replaced; therapy is present-centred, goal-oriented and based on observable, measurable behaviour; and techniques should be tested empirically. Techniques for phobia (a conditioned fear with avoidance): Systematic desensitisation (Wolpe, 1958): the client learns deep muscle relaxation, builds a hierarchy of feared situations, and imagines each step while relaxed. By reciprocal inhibition, relaxation replaces anxiety. Graded in vivo exposure: the client meets the real feared object stepwise without escape; this is the most effective approach, and one-session treatment is possible for specific phobias (Öst). Flooding and implosion: prolonged exposure to the most feared stimulus at full intensity until anxiety extinguishes, with response prevention. Modelling (Bandura): the client watches a fearless model deal with the object, and then takes part with the therapist's help. Virtual-reality exposure delivers controlled exposure for fears such as heights and flying. All rest on extinction of the conditioned fear and a reduction of avoidance.

(c) Standardised psychological tests: characteristics and limitations

A standardised test is a systematic, objective sample of behaviour, administered and scored under uniform conditions, with established norms. Characteristics: Standardisation: fixed instructions, time limits, materials and scoring, so that every examinee takes the test under the same conditions. Objectivity: scoring that does not depend on the scorer's judgement. Norms: scores are interpreted against data from a representative sample (percentiles, standard scores), so an individual's score has a meaning. Reliability: consistency across time (test-retest), items (split-half, Cronbach's alpha) and scorers. Validity: the test measures what it claims to (content, criterion-related and construct validity). Practicability: reasonable length, cost and ease of use. Limitations: Cultural and linguistic bias: tests developed in the West may not fit Indian samples, and need local norms and adaptation (for example the Malin's Intelligence Scale for Indian Children, adapted from the Wechsler scale for children). Limited sampling: a test samples only some behaviour and gives a snapshot, subject to measurement error. Response bias and test conditions: faking, social desirability, test anxiety, motivation and coaching affect scores. Outdated norms: scores drift over time (the Flynn effect). Labelling and misuse: scores can stigmatise, and interpretation by untrained persons gives harmful decisions. Tests should be used by trained professionals, together with interviews and history.