The following case illustration demonstrates and highlights the biopsychosocial model as it depicts the elements contributing to the client’s well-being.
Kisha’s Case
Kisha is a 28-year-old Caucasian female presenting with symptoms of possible depression and anxiety. Kisha reports that her boyfriend, Jack, asked her to marry him 2 months ago, but she has not yet accepted the proposal. Ever since, she has been feeling anxious, overeating, and sleeping 10 to 12 hours at a time. Kisha has been withdrawn from her friends because she knows that they do not support her relationship with Jack, as they believe that he is an alcoholic and has abused her. She also lacks interest in her work, has been taking numerous days off, and has demonstrated very low performance on her job duties. Kisha grew up in a very rigid and religious family. She states that her parents are very supportive of her, but they were always very critical toward her while she was growing up. Her father is very authoritative, and he is also a heavy drinker. While drunk, he often exhibits extremely violent and abusive behavior toward his wife and Kisha. Kisha’s relationship with her mother is strained because she is critical of her father’s behavior and often voices her disapproval of her father’s actions toward her mother. Kisha reports that her relationship with Jack has been rocky, with multiple breakups and a history of heated augments. Jack becomes extremely violent when intoxicated, and it reminds her of her father’s behavior and how that affected her family. Kisha’s religious beliefs cause her to feel guilt over her father and Jack’s drinking problems. She reports having a few good friends whom she sees “from time to time.” She expresses that she can “rely on them to vent her frustrations” but has recently “pulled back from them” because they do not approve of her relationship with Jack. Kisha and Jack have a history of domestic violence. She reported one incident of domestic violence to the police, in which Jack was arrested and referred to participate in anger management counseling. Although there has not been an incident since then, Kisha is worried that he might do it again when he drinks. Kisha reports no homicidal ideation, plan, or intent to do so. She also denies any personal alcohol or substance abuse.
In summary, Kisha is presenting symptoms of depression and anxiety. The symptoms and findings are prominent and clinically significant: oversleeping, overeating, isolative behavior, and feelings of anxiety. The symptoms are relatively acute. Protective factors include a supportive mother and friends, as well as Kisha’s insight and motivation for treatment. Significant biopsychosocial stressors include absences from work and her relationship with her supervisor and coworkers. Other stressors include her relationship with her boyfriend, Jack, and her traumatic experience while growing up with an abusive alcoholic father, a demanding mother, and also a history of domestic violence with her father and her boyfriend.
Reference Article (Nature vs Nurture): Reference this article with the case study in completing the discussion.
Link: https://www.verywellmind.com/what-is-nature-versus-nurture-2795392
Questions

• What are the differences between nature and nurture? How do nature and nurture contribute to human development?
• As you read the case illustration, identify the biopsychosocial variables due to biological or environmental factors that you feel contribute to Kisha’s depression, anxiety, and other concerns. Discuss your observations and reference to the nature vs nurture article.