(078) HOW HAS THE BIOPSYCHOSOCIAL MODEL FAIRED IN SEXUAL MEDICINE/SEXUAL THERAPY AND RECOMMENDATIONS FOR THE FUTURE
Bibliographic record
Abstract
Abstract Introduction Engel’s (1977) introduction of the biopsychosocial model emphasized multiple etiological determinants and upended traditional medical views of disease and its treatments. Evidence gradually accumulated that a combined biomedical and psychotherapeutic approaches were the most effective treatment for most sexual conditions. Urologists were late to this realization, in part because of sildenafil’s successful launch (1998), which catalyzed urology’s ascendancy over other specialties (psychiatry, psychology, and gynecology) which previously had managed sexual issues. The educational efforts of sexual medicine societies (ISSM, ISSWSH, SMSNA, SSTAR, etc.) in the early 21st century helped rebalance appreciation for multidisciplinary expertise and multidimensional understanding. Subsequently, most sex therapy and sexual medicine experts have adopted a biopsychosocial model. Objective The biopsychosocial model’s path to its current predominance is reviewed, including the specifics of how its underlying factors’ can determine sexual disorder etiology and treatment. Given the biopsychosocial model’s importance to sexual medicine and sex therapy, the need for periodic re-examination is encouraged in order to optimize the models’ strengths and minimize misapplication. The authors encourage sexual health professionals to embrace a broadened recognition of all facets of the model, not merely those emphasized by their profession of origin disciplines. Methods The author searched relevant terms using databases, including PubMed, Google Scholar, https://clinicaltrials.gov, etc. Co-authors reviewed the articles, offering additional references and expert opinions. Authored by an intentionally recruited diverse expert group from different disciplines, geography, gender, and opinion, their view has substantial merit. However, it lacks the rigorous process used by professional societies’ methodologies when producing guidelines. Results The biopsychosocial model is used productively, but many secondary to their discipline’s training have limited focus with insufficient awareness of alternative etiologic factors. Clinicians support a multidisciplinary approach, but siloed thinking remains. Collegial respect is increasing, but perspectives remain separated. Sex therapists are aware of psychosocial nuances, but many are ignorant regarding the impact of biomedical advances in diagnosis and treatment that impact sexuality. Reciprocally, too many physicians are insufficiently aware of the cognitive, emotional, behavioral, social and cultural factors contributing to sexual disorders. Physicians preferring broader assessment often find office time limitations negating multilayered engagement. Conclusions The necessity of fully embracing the comprehensive scope of the biopsychosocial model for sexual health professionals cannot be overstated. Biopsychosocial must stand for all the predisposing, precipitating, and maintaining biological, medical/surgical, cognitive, behavioral, emotional, social, and cultural factors involved in the etiology and management of sexual disorders. These components are best understood at a granular detail level that recognizes multiple proportional factor contributions. Having disciplines spending more time training together would enhance understanding of each other’s strengths and contributions. We must train the next generation of sexual medicine and sex therapy/sexology experts to have an appreciation of all the contributory and mutually influential factors that underlie sexual disorder etiology and treatment to best serve their patients. Furthermore, it is incumbent upon all of us to mindfully seek continuing education opportunities (offered by our professional societies, etc.) to fill in our own gaps in both knowledge and expertise. Disclosure Any of the authors act as a consultant, employee or shareholder of an industry for: None of the relationships to industry are relevant to this presentation’s content. If the presentation is selected and if detailed information regarding the above question is required, all 8 authors would be happy to detail all industry relationships they have, despite their clear lack of relavance to the presentation.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.005 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.000 | 0.001 |
| Science and technology studies | 0.001 | 0.003 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".