University of Wyoming, Department of Psychology, Dept. 3415, 1000 E. University Ave., Laramie, WY 82071, USA.
Clin Psychol Rev. 2013 Nov;33(7):846-61. doi: 10.1016/j.cpr.2012.09.007. Epub 2013 Apr 8.
The biomedical model posits that mental disorders are brain diseases and emphasizes pharmacological treatment to target presumed biological abnormalities. A biologically-focused approach to science, policy, and practice has dominated the American healthcare system for more than three decades. During this time, the use of psychiatric medications has sharply increased and mental disorders have become commonly regarded as brain diseases caused by chemical imbalances that are corrected with disease-specific drugs. However, despite widespread faith in the potential of neuroscience to revolutionize mental health practice, the biomedical model era has been characterized by a broad lack of clinical innovation and poor mental health outcomes. In addition, the biomedical paradigm has profoundly affected clinical psychology via the adoption of drug trial methodology in psychotherapy research. Although this approach has spurred the development of empirically supported psychological treatments for numerous mental disorders, it has neglected treatment process, inhibited treatment innovation and dissemination, and divided the field along scientist and practitioner lines. The neglected biopsychosocial model represents an appealing alternative to the biomedical approach, and an honest and public dialog about the validity and utility of the biomedical paradigm is urgently needed.
生物医学模式假设精神障碍是脑部疾病，并强调采用药理学治疗方法来针对假定的生物学异常。这种以生物学为重点的科学、政策和实践方法主导了美国医疗保健系统三十多年。在此期间，精神药物的使用急剧增加，精神障碍通常被认为是由化学失衡引起的脑部疾病，可以用特定于疾病的药物来纠正。然而，尽管人们普遍相信神经科学有可能彻底改变精神健康实践，但生物医学模式时代的特点是临床创新广泛缺乏，精神健康结果不佳。此外，生物医学范式通过在心理治疗研究中采用药物试验方法，对临床心理学产生了深远的影响。尽管这种方法促进了针对许多精神障碍的循证心理治疗的发展，但它忽略了治疗过程，抑制了治疗创新和传播，并在科学家和从业者之间划分了领域。被忽视的生物心理社会模式代表了对生物医学方法的一个有吸引力的替代方案，迫切需要就生物医学范式的有效性和实用性进行诚实和公开的对话。
