Academic journal article Journal of Marriage and Family

Toward a Biopsychosocial Model of Domestic Violence

Academic journal article Journal of Marriage and Family

Toward a Biopsychosocial Model of Domestic Violence

Article excerpt

It is widely accepted that the etiology of family violence is a multifaceted phenomenon that can best be understood from a multidisciplinary perspective. No single theory or discipline has been adequate in thoroughly explaining spouse abuse (Gelles & Loeske, 1993; Hotaling & Sugarman, 1986; Howell & Pugliesi, 1988). Reviews of the literature on domestic violence typically have utilized three groupings of theories to account for the separate contributions of biological, psychological, and sociological perspectives (e.g., Steinmetz, 1987; Van Hasslet, Morrison, Bellack, & Hersen, 1988). However, to date, no studies have attempted to integrate these perspectives into what is commonly referred to as a biopsychosocial perspective.

THE BIOPSYCHOSOCIAL PERSPECTIVE

The biopsychosocial perspective is an attempt to understand health and illness through an appreciation of how biological, psychological, and social elements persist in affiliation with one another. Engel's (1977, 1980) innovative work within this perspective has served to highlight the limitations of reducing explanations of dysfunction to any one of its three major components (biological considerations, psychological variables, or social context factors), and to emphasize the great benefits derived from their simultaneous inclusion. From the standpoint of a physician, Engel (1977) wrote:

The boundaries between health and disease, between well and sick, are far from clear and never will be clear, for they are diffused by cultural, social, and psychological considerations. ... By evaluating all of the factors contributing to both illness and patienthood, rather than giving primacy to biological factors alone, a biopsychosocial model would make it possible to explain why some individuals experience as "illness" conditions that others would regard merely as "problems of living," be they emotional reactions to life circumstances or somatic symptoms (pp. 132-133).

A more recent formulation of this perspective is presented by McDaniel, Hepworth, and Doherty (1992), who utilized the term biopsychosocial systems model to highlight the interactive nature of biological, psychological, and social phenomena regarding health and illness. According to this model, such phenomena are seen as not only existing in an arranged hierarchical ordering, but also as having a consistent and reciprocal impact on one another. Here, biological system factors are thought to exist in and interact with psychological system factors, both of which are hypothesized to exist in and interact with family and other social system factors. Hence, descriptions that result within this framework are not simply summative but rather assert multiplicative relationships among these factors.

From this perspective, all theoretical, empirical, and clinical efforts must account for the complex interplay of biological, psychological, and social facets of a given intrapsychic or interpersonal dysfunction. Hence, psychiatry and associated medical models, schools of psychology, various family systems theories, and sociological models all contain their own unique limitations because of their disciplinary viewpoint on dysfunction. In addition, those who subscribe in principle to a biopsychosocial model often note how difficult the model is to carry out in practice, as exemplified in literature emanating from a variety of contexts such as pediatric illness (Wood, 1993), medical education (Engel, 1982), family medicine (Doherty, Baird, & Becker, 1986), psychiatry (Amchin, 1991), and family psychoeducational approaches (Moltz, 1993).

In the area of interpersonal violence, some theoretical work has been done that attempts to integrate the biopsychosocial aspects of interpersonal violence. Dutton (1985) utilized a variety of theoretical frameworks in presenting an ecologically nested theory of interpersonal violence, including factors related to genetic predisposition, physiological arousal, emotional labeling, power issues, neighborhood influences, unemployment, and the effect of cultural and societal characteristics. …

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