Chapter Five Health Compromising Behaviors Copyright 2015 Mc

Chapter Five: Health. Compromising Behaviors Copyright © 2015 Mc. Graw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of Mc. Graw-Hill Education.

• Characteristics of health-compromising behaviors • Obesity • Eating disorders • Alcoholism and problem drinking • What is substance dependence? • Smoking Copyright © 2015 Mc. Graw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of Mc. Graw-Hill Education. 2

• Habitual and addictive • Window of vulnerability in adolescence • Influenced by peer pressure • Pleasurable and helps to cope with stress • Develop gradually • Have similar causative factors • Common in the lower social classes Copyright © 2015 Mc. Graw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of Mc. Graw-Hill Education. 3

• Excessive accumulation of body fat • Risks • Contributes to: • Death rates for all cancers and cardiovascular disease • Atherosclerosis, hypertension, Type II diabetes, and heart failure • Increases risks in surgery, anesthesia administration, and childbearing Copyright © 2015 Mc. Graw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of Mc. Graw-Hill Education. 4

• Major cause of disability • Lowers the drive to exercise • Difficulty performing basic tasks • Poor cognitive functioning • Associated with early mortality • Can cause psychological, social, and economic stress Copyright © 2015 Mc. Graw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of Mc. Graw-Hill Education. 5

• Causes • Genetics • Forceful feeding style • Sedentary lifestyle • Depends on the number and size of an individual’s fat cells Copyright © 2015 Mc. Graw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of Mc. Graw-Hill Education. 6

• Factors that influence obesity • Social status and culture • Depression • High neuroticism, extraversion, and impulsivity • Social networks • Siblings and friends who are obese Copyright © 2015 Mc. Graw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of Mc. Graw-Hill Education. 7

• Yo-yo dieting: Successive cycles of dieting and weight gain • Enhances the efficiency of food use • Lowers metabolic rate • Set point theory of weight: Each individual has an ideal biological weight, which cannot be greatly modified Copyright © 2015 Mc. Graw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of Mc. Graw-Hill Education. 8

• Affects eating habits of different people in different ways • Can disinhibit food consumption • Stress eating: Practice of eating in response to stress • Tied to anxiety and depression Copyright © 2015 Mc. Graw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of Mc. Graw-Hill Education. 9

• Dieting • Surgery • Cognitive behavioral therapy (CBT) • Screening • Self-monitoring • Stimulus control • Controlling eating Copyright © 2015 Mc. Graw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of Mc. Graw-Hill Education. 10

• Self reinforcement • Controlling self-talk • Adding exercise • Stress management • Social support • Relapse prevention Copyright © 2015 Mc. Graw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of Mc. Graw-Hill Education. 11

• Training parents on sensible meal-planning and eating habits • Changing lifestyles at an young age • School-based interventions • Social engineering strategies Copyright © 2015 Mc. Graw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of Mc. Graw-Hill Education. 12

• Developed due to the pursuit of thinness • Highest disability and mortality rates of all behavioral disorders • Lead to: • Depression and anxiety • Low self esteem and a poor sense of mastery Copyright © 2015 Mc. Graw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of Mc. Graw-Hill Education. 13

Obsessive disorder amounting to self-starvation • Body weight is well below optimum level Causes • Genetic factors - Genes involving the serotonin, dopamine, and estrogen systems • Interactions between genetic and environmental factors • Dysregulated biological stress systems • Personality characteristics • Family interaction patterns Copyright © 2015 Mc. Graw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of Mc. Graw-Hill Education. 14

• Therapy • Cognitive-behavioral approaches • Family therapy • Prevention • Addressing social norms • Addressing the health risks of eating disorders • Urging symptomatic individuals to accept treatments Copyright © 2015 Mc. Graw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of Mc. Graw-Hill Education. 15

• Characterized by alternating cycles of binge eating and purging • People with binge eating disorders are characterized by: • Excessive concern with body and weight • Preoccupation with dieting • History of depression, psychopathology, and alcohol or drug abuse Copyright © 2015 Mc. Graw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of Mc. Graw-Hill Education. 16

• Difficulties with managing work and social settings • Causes • Different stress responses • Higher cortisol levels • Large body mass • Depression and substance abuse • Genetics and hormonal dysfunctions Copyright © 2015 Mc. Graw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of Mc. Graw-Hill Education. 17

• Family values • Low leptin functioning • Hypothalamic dysfunction • Food allergies • Disordered taste responsivity • Disorder of the endogenous opioid system • Neurological disorder Copyright © 2015 Mc. Graw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of Mc. Graw-Hill Education. 18

• Convincing bulimics about the seriousness of the disease • Combination of medication and cognitivebehavioral therapy • Using relapse prevention techniques Copyright © 2015 Mc. Graw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of Mc. Graw-Hill Education. 19

Associated with: • • • High blood pressure Stroke Cirrhosis of the liver Certain forms of cancer Brain atrophy Sleep disorders Leads to: • Economic loss • Social problems Copyright © 2015 Mc. Graw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of Mc. Graw-Hill Education. 20

• Repeatedly self-administering substances • Physical dependence: Body adjusts to substance and incorporates its use into normal functioning of the body’s tissues • Tolerance: Body increasingly adapts to the use of a substance • Craving: Strong desire to engage in a behavior or consume a substance Copyright © 2015 Mc. Graw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of Mc. Graw-Hill Education. 21

• Addiction: Person becomes physically or psychologically dependent on a substance following repeated use over time • Withdrawal: Unpleasant symptoms experienced by people when they stop using the dependent substance • Causes anxiety, irritability, intense cravings for the substance, nausea, headaches, tremors, and hallucinations Copyright © 2015 Mc. Graw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of Mc. Graw-Hill Education. 22

• Patterns of behaviors • Inability to cut down on drinking • Repeated efforts to control drinking • Binge drinking • Occasional consumption of large quantities • Loss of memory while intoxicated Copyright © 2015 Mc. Graw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of Mc. Graw-Hill Education. 23

• Drinking despite health problems • Drinking of nonbeverage alcohol • Physical addiction • Withdrawal symptoms • High tolerance for alcohol Copyright © 2015 Mc. Graw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of Mc. Graw-Hill Education. 24

• Causes • Genetics • Socio demographic factors • Stress - Financial and social • Low social support • Unemployment • Depression Copyright © 2015 Mc. Graw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of Mc. Graw-Hill Education. 25

Cognitive-behavioral modification programs Providing employment opportunities and social support Treatment programs • Detoxification: Conducted in a carefully supervised and monitored medical setting for hard-core alcoholics Relapse prevention Copyright © 2015 Mc. Graw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of Mc. Graw-Hill Education. 26

• Factors associated with successful alcohol treatment programs • Environmental factors • Moderate length of participation • Involvement of family and employers • Social engineering approaches are required to complement formal intervention efforts Copyright © 2015 Mc. Graw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of Mc. Graw-Hill Education. 27

• Inducing adolescents to not drink or to keep it under control • Promoting social influence programs in schools • Enhances adolescents’ self-efficacy • Changes social norms • Low-cost option for low-income areas Copyright © 2015 Mc. Graw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of Mc. Graw-Hill Education. 28

• Results in thousands of vehicular fatalities each year • Can be controlled by: • Programs such as MADD (Mothers Against Drunk Driving) • Adopting self-regulatory techniques Copyright © 2015 Mc. Graw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of Mc. Graw-Hill Education. 29

• Single greatest cause of preventable death • Increases the risk of many diseases and disorders • Coworkers and family members of smokers are affected by secondhand smoke Copyright © 2015 Mc. Graw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of Mc. Graw-Hill Education. 30

• Boosts the damaging effects of other risk factors • Stress and smoking interact in dangerous ways • In men - Increase heart rate reactivity to stress • In women - Reduce heart rate but increase blood pressure as a response to stress Copyright © 2015 Mc. Graw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of Mc. Graw-Hill Education. 31

• Weight and smoking can interact to increase mortality • Smoking and depression can interact to substantially increase the risk for cancer • Related to anxiety in adolescence Copyright © 2015 Mc. Graw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of Mc. Graw-Hill Education. 32

• Initial experimentation • Peer pressure • Interacting with other smokers • Lack of discipline and monitoring in schools • Familial attitude and influence • Socio economic status Copyright © 2015 Mc. Graw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of Mc. Graw-Hill Education. 33

• Increase in stress • Depression • Mass media influence • Low self-esteem • Dependency • Feelings of powerlessness • Social isolation Copyright © 2015 Mc. Graw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of Mc. Graw-Hill Education. 34

• Associated with pleasurable activities • Highly individualized • Leads to short-term unpleasant withdrawal symptoms when stopped abruptly • Elevates mood • Keeps weight down • Benefits of being abstinent is not known Copyright © 2015 Mc. Graw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of Mc. Graw-Hill Education. 35

• Changing attitudes toward smoking • Therapeutic approach to the problem • Nicotine replacement therapy • Interventions • Social support and stress management • Interventions with adolescents • Relapse prevention Copyright © 2015 Mc. Graw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of Mc. Graw-Hill Education. 36

• Evaluation of interventions • Brief interventions • Workplace interventions • Commercial programs and self-help • Self-help aids: Encourages smokers to quit the habit Copyright © 2015 Mc. Graw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of Mc. Graw-Hill Education. 37

• Catch potential smokers early and attack the underlying motivations that lead to smoking • Implemented in schools • Emphasize the negative effects of smoking • Convey a positive image of the nonsmoker • Peer groups are used to foster non smoking Copyright © 2015 Mc. Graw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of Mc. Graw-Hill Education. 38