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4.2 General Concepts of the Relationship between Medical and Behavioral Issues
ОглавлениеTo provide optimal medical care for any animal, it is imperative that we first move beyond the paradigm where we attempt to separate “medical” conditions from “behavioral” conditions. All medical conditions will result in some behavioral change (American Psychiatric Association 2013). Many of these are the most basic of signs and symptoms that all veterinarians are taught to look for, such as the lethargy and anorexia associated with many illnesses. In addition, every behavior is a result of neurochemical action at the molecular level in the nervous system and thus cannot ever be completely separated from the physiological (see Figure 4.1). While some behavioral changes can be associated with organic diseases, such as space‐occupying masses in the central nervous system or the changes that occur as a result of infection and/or inflammation, other behaviors can result from dysregulation at the neurophysiological or neurochemical level—problems that we still have much to learn about. It is hoped that with advancing technology, our understanding of the neurophysiologic basis of behavior will continue to improve.
Using a medical model approach to problem behaviors can improve communications between caregivers, shelter staff, and the rest of the health care team. This approach broadly categorizes behavior problems using terminology similar to that used in human mental health. However, these categories are purely descriptive and often attempt to assign a motivation to the unwanted behavior. This terminology does not necessarily reflect a knowledge of the cause, mechanism, or neurobiology underlying the behavior (American Psychiatric Association 2013). Some behaviors may reflect a dysregulation or disruption of the neurological system and may thus be considered truly malfunctional, as the medical model suggests. Other behaviors may represent an animal’s attempt to adapt to an environment to which adaption is not completely possible and should be considered maladaptive (Mills 2003). Having a thorough understanding of normal species‐typical behaviors for the animal in question is critical to developing a management and/or treatment plan for the individual exhibiting maladaptive or malfunctional behaviors. A third category that will not be covered in this chapter is the normal adaptive behaviors of animals that are simply inconvenient or problematic for their caretakers. See Chapters 12 and 18 for more information on training and behavior modification.
Figure 4.1 This diagram depicts how genetics, the environment, and medical conditions/disease processes all contribute to behavior. The relationship and interconnectedness of all of these components will be reflected in the overall health and welfare of the individual.
A variety of different disease processes can cause and/or contribute to the worsening of both maladaptive and malfunctional behaviors. Many individuals will simply differ in how readily they react to stimuli, the degree to which they respond, and how long they stay emotionally aroused. These differences often represent normal individual variations in temperament and are also affected by an individual’s experience during development.