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

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

3. Copyright © 2015 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. 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 3

4. Copyright © 2015 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. 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 4

5. Copyright © 2015 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. 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 5

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

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

8. Copyright © 2015 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. 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 8

9. Copyright © 2015 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. 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 9

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

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

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

13. Copyright © 2015 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. 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 13

14. Copyright © 2015 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. Body weight is well below optimum level Obsessive disorder amounting to self-starvation 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 Causes 14

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

16. Copyright © 2015 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. 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 16

17. Copyright © 2015 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. 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 17

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

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

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

21. Copyright © 2015 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. 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 21

22. Copyright © 2015 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. 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 22

23. Copyright © 2015 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. 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 23

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

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

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

27. Copyright © 2015 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. 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 27

28. Copyright © 2015 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. 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 28

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

30. Copyright © 2015 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. 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 30

31. Copyright © 2015 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. 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 31

32. Copyright © 2015 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. 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 32

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

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

35. Copyright © 2015 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. 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 35

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

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

38. Copyright © 2015 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. 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 38