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Biopsychosocial Approach
(George Engle, 1960s) (Biological (Regulatory…
Biopsychosocial Approach
(George Engle, 1960s)
Biological
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Antenatal exposure, maternal stress or drugs etc
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Psychological
Developmental Processes #
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WILLIAM: Hyperactivity
Impulsivity
Aggression
Defiance at home, pre-school and in social situations
Low frustration tolerance
Self-harming behaviours - biting
Delayed language development
Low self-worth
Inability to engage with peers/play with others
Slow to reach developmental milestones
Parents recognise that “he is a good kid, sometimes’”
He can make friends (he just can't sustain the relationship)
Social
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text 
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harsh, controlling parenting and the
emergence of childhood externalizing problems, including aggression, oppositional behavior,
and conduct problems.
factors that moderate parenting, including characteristics
of the child, such as temperament and biological vulnerability
parental psychopathology and impaired parent–child relationships are
among the primary risk factors for compromised child emotional and behavioral health
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WILLIAM:
MOTHER;Care worker
Previous recreational drug use
Smoker
Long shifts prevent her spending more time with the children. FATHER; Unemployed
History of drug misuse
Currently on methodone programm.
History of depression
Main caregiver – often overwhelmed by the children‘s demands
RELATIONSHIPS; Significant family history for depression, anxiety and substance abuse on both sides of the family.
Marriage is under significant strain .
No family support network in Scotland
Financial difficulties
Sibling rivalry
WILLIAM:
Experienced ECE teachers and staff
SEIT for learning support
Parents and sibling in the home
Mother’s extended family have contact
Positive previous experience with CAMHS
Input from Social Services (Social Worker, Health Visitor)
Probabilistic Epigenesis: genes initiate developmental pathways that are
receptive to influences that occur from the cellular to the social contextual level, and all are
candidates for developmental interactions that may influence pathways to particular outcomes
for children.
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children who are considered more reactive have been identified as being more
susceptible to the negative effects of environmental adversity as well as the positive effects of
environmental support as compared to less-reactive children.
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WILLIAM:
Father’s history of abuse and lack of positive parenting experience.
Mother’s shift work and consequent absence
Parents’ behaviour modelling - lack of coping strategies and ‘shouting’
Experience of Dad’s traumatic incident/overdose
Criticism the focus on individual genetic biomarkers has received criticism for being a continued
form of biomedical reductionism, with critics highlighting that individual differences are the
result of the interaction of multiple, rather than single, genetic biomarkers and multilayered
complex environments