​​​​​​​​​​​​​​​​​​​​​​From Brain to Behavior: Rethinking Health with the NBPS Model

​​​​​​​​​​

The neural-biopsychosocial (NBPS) represents a significant advancement over the traditional biopsychosocial model by incorporating neurological factors as a distinct and crucial component in understanding health and illness. While the biopsychosocial model, introduced by George Engel in 1977, provided a more holistic approach to healthcare by considering biological, psychological, and social factors, the NBPS model further refines this perspective by explicitly recognizing the role of the brain and nervous system.​

​​​​​​​​​​​
This enhanced model acknowledges that neurological processes play a fundamental role in mediating the interactions between biological, psychological, and social factors. By incorporating the "neural" component, the NBPS model offers a more comprehensive framework for understanding the intricate interplay of factors that influence an individual's health and well-being.

The NBPS model's inclusion of neurological factors enables a deeper understanding of how brain function and neural pathways contribute to health outcomes, providing new insights into diagnosis, treatment, and prevention strategies. This expanded approach enables healthcare providers to develop more targeted and effective interventions that address the full spectrum of influences on a patient's condition.

​

1. Neurological Influences

 

The brain is the central hub of our overall health, profoundly affecting our physical, mental, and social well-being. As the body's master regulator, the brain oversees vital functions and influences our responses to stress and illness, playing a key role in our overall physical well-being. It is the seat of our thoughts and emotions, shaping our cognitive abilities and regulating our mood, underscoring its essential influence on psychological well-being. The brain drives our social interactions, influencing our ability to connect, empathize, and feel a sense of belonging. This highlights our need for meaningful relationships, which have a profound impact on both mental and physical well-being. The brain is the core that integrates these different dimensions of the human experience. Therefore, understanding the brain and its interconnected influence on physical, mental, and social aspects is key to promoting overall health.

​

2. Biological Influences

​​

A mix of biological and environmental factors shapes our health. Biological factors include our genes and past experiences with illness or injury. For example, a family history can increase the risk for heart disease, certain cancers, or even conditions like type 2 diabetes. Additionally, past infections, such as a severe case of the flu or an autoimmune disorder, can have long-lasting effects on our health. Our genetic makeup can also influence how we respond to medications or how efficiently our bodies process nutrients. However, these biological factors are not the only influences. Environmental factors, such as access to healthy food, clean water, and stress levels, are also key in shaping our health.​

​

3. Psychological Influences

 

Our thoughts, feelings, and behaviors—our psychological state—play a significant role in our health, sometimes independently of our biology. For example, constant stress from work or relationships can cause headaches or weaken your immune system, even without an apparent biological reason. Negative thinking and feelings of loneliness can lead to depression and physical problems. Similarly, suppressing emotions can increase tension and the risk of high blood pressure. Our mental state can have a profound impact on our physical health, even in the absence of a direct biological link. Therefore, considering these psychological factors is necessary to understand overall well-being. Our thoughts and feelings can have a direct impact on our physical health.​

 

4. Social Influences

​

Social factors profoundly shape health through interconnected influences. Major life changes and societal pressures create stress, increasing risks for both mental and physical issues. Unsafe environments, limited access to resources, discrimination, and lack of support all contribute to poorer health outcomes and inequities. It's clear these social elements are potent determinants of well-being, making addressing them necessary for promoting health and equity.​​

​​

Application of the Neural-biopsychosocial Model

 

The neural-biopsychosocial (NBPS) model proposes that the interconnected workings of the biological systems (including the brain and nervous system), the psychological (mind and emotions), and social (environment and cultural contexts) all influence each other. According to this model, none of these components is sufficient to determine health or illness; rather, the deep interrelation of all aspects of a person's life is key in shaping health outcomes.

​

Effective health promotion, therefore, must address all of these components. A growing body of research demonstrates that health status, perceptions of health, and sociocultural factors that create barriers to accessing health care collectively influence an individual’s likelihood of engaging in health-promoting behaviors, such as medication adherence, proper nutrition, and physical activity. Understanding these complex interactions is necessary for supporting overall well-being.

​​

​​​​​​​​​​Case Study: Applying the Neural-biopsychosocial Model to Post-Traumatic Stress Disorder (PTSD)

 

To illustrate the practical application of the Neural-biopsychosocial  Model, let's consider a case study of PTSD treatment using EEG-guided neurofeedback.

 

Background​

 

A 35-year-old military veteran presented with symptoms of PTSD, including intrusive memories, nightmares, and hypervigilance. These symptoms significantly impacted his daily life, relationships, and overall well-being.

​

Application of the Neural-biopsychosocial Model

​

​Brain Function Component: EEG-guided neurofeedback was employed to address the neurological aspects of PTSD. This technique harnesses the brain's neuroplasticity, allowing the patient to actively participate in reshaping his brain's activity patterns. The neurofeedback sessions focused on regulating brain wave patterns associated with PTSD symptoms.

 

Biological Component: The treatment plan thoroughly evaluated the patient's physical health, including hormone levels and sleep patterns. Sleep quality was monitored and improved through a combination of neurofeedback and behavioral interventions. For example, as his sleep improved through neurofeedback and behavioral techniques, he also reported increased energy levels and improved focus during the day.

 

Psychological Component: Cognitive-behavioral therapy (CBT) was integrated into the treatment plan to address the psychological aspects of PTSD. This helped the patient develop coping strategies and reframe traumatic memories. The improved focus from the biological interventions helped enhance the effectiveness of CBT, allowing him to engage more deeply with the therapy process.

 

Social Component: The treatment approach included family therapy sessions and support group participation to address the social aspects of recovery. This helped improve the patient's relationships, for example, his ability to communicate more openly and calmly with his spouse. This resulted in him feeling more supported and connected.

 

Outcome

 

By addressing all components of the neural-biopsychosocial model, the patient experienced significant improvement in PTSD symptoms. The EEG-guided neurofeedback helped regulate brain activity, while the comprehensive approach as a whole ensured that all aspects of the patient's health and well-being were addressed.

 

Conclusion

 

The Neural-biopsychosocial (NBPS) Model represents a paradigm shift in how we understand and approach health. By explicitly integrating neurological function into the biopsychosocial framework, it empowers clinicians, researchers, and educators to see the full picture of human well-being. This model not only enhances diagnostic precision and therapeutic effectiveness but also reinforces the importance of treating individuals, not just symptoms. As healthcare continues to evolve, the NBPS Model stands as a guiding framework for personalized, integrative, and compassionate care—where brain, body, mind, and society are all part of the healing equation.

 

The future of healthcare lies in embracing such integrative models that recognize the complexity of human health and behavior. As our understanding of neuroplasticity and brain health continues to evolve, the neural-biopsychosocial model will likely play an increasingly important role in developing innovative and effective treatments for various conditions. Addressing each component is necessary for overall health.