Biopsychosocial Behaviour Model means behaviour influenced by biological, psychological and social factors which collectively play a significant role in humans experiencing some disease and/or some illness and/or some Chronic Pain  - such Chronic Pain may be due to 'inter alia' degeneration or trauma accident.

The Biopsychosocial Behaviour Model identifies the experience of some disease, illness, and Chronic Pain and its impact in terms of an interaction between three main factors:

           biological changes (eg. trauma injury) can lead to psychological effects (eg. Chronic Pain) which, in turn, can affect the body and mind through behaviour such as fear, reduced self-confidence, reduced Self-esteem, avoiding a regular activity (which may lead to deconditioning, as well as Depression) which all negatively impact social behaviour.

Interactions develop between the musculature, the nervous system and a person’s psychological state, which collectively act to perpetuate the problems experienced by a person experiencing for example disabling Chronic Pain bring on -
*         REDUCED ACTIVITY,
*         UNHELPFUL BELIEFS & THOUGHTS,
*         REPEATED TREATMENT FAILURES,
*         LONG-TERM USE OF ANALGESIC,
*         SEDATIVE DRUGS,
*         LOSS OF JOB,
*         FINANCIAL DIFFICULTIES,
*         FAMILY STRESS,
*         PHYSICAL DETERIORATION (eg. muscle wasting, joint stiffness),
*         FEELINGS OF DEPRESSION associated HELPLESSNESS and IRRITABILITY SIDE EFFECTS (eg. stomach problems lethargy, constipation).

The Biopsychosocial Behaviour Model was theorised by psychiatrist George L. Engel at the University of Rochester, and purportedly discussed in a 1977 article in Science, where Engel posited "the need for a new medical model.  No single definitive, irreducible model has been published.  However, the general biological, psychological and social factors model has guided formulation and testing of models within each professional field.

In a philosophical sense, the Biopsychosocial Behaviour Model identifies a direct interaction between mind and body as well as indirect effects through intermediate factors, whereupon it states that the -

*           workings of the body can affect the mind, and

*           negative/positive workings of the mind can negatively/positively affect the body.

The Biopsychosocial Behaviour Model presumes that it is important to handle the biological, psychological and social factors together, as a growing body of literature suggests that patient perceptions of health and threat of disease, as well as barriers in a patient's social or cultural environment, appears to influence the likelihood that a patient will engage in health-promoting or treatment behaviours, such as medication taking, proper diet, engaging in physical activity.

The Biopsychosocial Behaviour Model has been a general framework to guide theoretical and empirical exploration, which has amassed considerable research since George Engel's 1977 article.  One of the areas that has been greatly influenced is the formulation and testing of social-cognitive models of health behaviour over the past 30 years.  While no single model has taken precedence, a large body of empirical literature has identified social-cognitive (the psyho-social aspect of Engel's model) variables that appear to influence engagement in healthy behaviours and adhere to prescribed medical regimens, such as self-efficacy, in chronic diseases such as type 2 diabetes, cardiovascular disease, etc.   These models include the Health Belief Model, Theory of Reasoned Action and Theory of Planned Behavior, Transtheortical Model, the Relapse Prevention Model, Gollwitzer's implementation-intentions, the Precaution-Adoption Model, the Health Action Process Approach, etc.  This model has become widely recognised as currently the most useful perspective for both explaining and treating with Cognitive Behaviour Therapy some disease, illness, and Chronic Pain.  Although rarely primary causes of Chronic Pain, psychological and environmental factors often play a critical role in the maintenance of Chronic Pain and associated disability with Cognitive Behaviour Therapy. The combination of central nervous system physiological changes, psychological and environmental changes has been described as a ‘disease entity’ (Siddall and Cousins, 2004).  In other words, the processes of living with Chronic Pain become the principal problem.

Suffers of lower back pain, in particular, can get into a vicious cycle from 'Fear Avoidance Behaviour' (developing a rigidity in the lower back for fear of aggravating the injury), whereupon because of inflexibility, suffers may experience increased pain due to "turning off" associated stabilizing muscles.  The experience of pain may give rise to hyperactivity of the long muscles, at the expense of the short muscles that are required to stabilise the skeleton.  Some people who have injured their lower back then experience shoulder and/or neck pain due to abnormal stabilisation of the shoulders and spine.  Normalising skeletal muscle behaviours by learning the best exercises to calm down the nervous system may well restore a more normal demand on the nervous system and reduce central sensitisation.

Many suffers of Chronic Pain can do little things often each day to experience a more conducive and comfortable environment provided they identify their own limitations.  It is vital that suffers of Chronic Pain who introduce an exercise programme then monitor muscle soreness which often will take much longer to pass away than someone who is not experiencing Chronic Pain.  Long-term pain sufferers may take 4 to 6 days to overcome new exercise loading patterns than a non-suffer would recover from in half these days.

There is accumulating evidence that persistent pain cannot be regarded as merely a passive warning signal of an underlying disease process.  Continuing nociceptive inputs result in a multitude of consequences that impact on the individual, ranging from changes in receptor function to mood dysfunction, inappropriate cognitions, and social disruption.  These changes that occur as a consequence of continuing nociceptive inputs support persistent pain being regarded as a disease.  As with any disease, the extent of these changes is largely determined by the internal and external environments in which they occur.  Thus genetic, psychological and social factors may all contribute to the perception and expression of persistent pain.  Hence, optimal outcomes in the management of persistent pain may be optimised by addressing both the contributors and consequences of Chronic Pain.

With regard to addressing "social factors", the Hypothesis explains that the Second Basic Component Of CBT can treat some diseases, some illnesses, and some types of Chronic Pain through:

2.     Providing coping skills training across a wide variety of cognitive and behavioural pain coping strategies. 
Progressive relaxation and cue-controlled brief relaxation exercises are used to decrease muscle tension, reduce emotional distress, and divert attention from pain. 
Activity pacing and 'pleasant activity scheduling' are used to help patients increase the level and range of their activities.
Training in 'distraction techniques' such as pleasant imagery, counting methods, and use of a focal point helps patients learn to divert attention away from severe pain episodes. Cognitive restructuring is used to help patients identify and challenge overly negative pain-related thoughts and to replace these thoughts with more adaptive, coping thoughts.

 

Section 16(c) asserts that scope exists to include amongst the 50 Volunteers in the 10 Months Tenure Of Primary Research Programme some adults who are experiencing some types of Chronic Pain because the Second Basic Component Of CBT under the Biopsychosocial Behaviour Model are in accord with the primary characteristics evident in the 10 Months Tenure Of Primary Research Programme because Volunteers which are experiencing Chronic Pain are under the Supervision and Administration of a Research Programme Team of 4 clinicians/sports therapists with health physiology  expertise.

Hence, by garnering currently non-profiled Australian adult Volunteers who are determined to re-introduce Recreational Road Cycling into their Lifestyle Behaviour following a serious trauma accident or illness, which has caused Chronic Pain cannot only provide an enormous fillip to the RTV Promotion to show the Power of Positive Thinking under the Supervision and Administration of a Research Programme Team of 4 clinicians/sports therapists with health physiology expertise.  More importantly, such inclusion of some Chronic Pain suffers can extend current research of CBT, in particular the Second Basic Component Of CBT to achieve medical recognition of the YELP  Primary Research Programme.   Powerful reasoning is explained at "Include amongst the 50 Volunteers some Volunteers who are enduring Chronic Pain" in Section 16(c).

Refer "The high price of pain:  the economic impact of persistent pain in Australia - November 2007" by Access Economics Pty Limited for MBF Foundation, Chronic Pain; CBT; and Second Basic Component Of CBT.