Post on 22-Dec-2015
© 2012 McGraw-Hill Companies, Inc. All rights reserved.McGraw-Hill/Irwin © 2012 McGraw-Hill Companies, Inc. All rights reserved.
Health Psychology 8th edition
Shelley E. Taylor
Chapter Five:
Health-Compromising Behaviors: Alcoholism and
Smoking
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Characteristics of Health-Compromising Behaviors
Many of these behaviors share a window of vulnerability in adolescence:- drinking to excess
- smoking
- using illicit drugs
- having unsafe sex
- using risk-taking behaviors
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Health-Compromising Behavior (cont.)
- behaviors are tied to the peer culture- image of these behaviors as “cool”- behaviors, though dangerous, are pleasurable- behaviors develop gradually- substance abuse of all kinds is predicted by
some of the same factors- most problem behaviors more common in
lower SEC individuals
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Substance DependencePhysical dependence:
- body adjusts to substance and incorporates its use into normal functioning of the body’s tissues
Tolerance:
- larger doses needed to produce same effects
Craving:
- conditioning process is involved so that environmental cues trigger intense desire
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Substance Dependence (cont.)
Addiction:- person has become physically or psychologically
dependent on a substance following use over a period of time
Withdrawal:- unpleasant symptoms, both physical and
psychological, that people experience when
they stop using a substance on which theyhave become dependent
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Alcoholism and Problem Drinking
Scope of the problem:- third leading cause of preventable death- more than 20% of Americans drink at levels that
exceed government recommendations- alcohol consumption is linked to high blood
pressure, stroke, cirrhosis of the liver, fetalalcohol syndrome and some cancers
- 41% of traffic-related deaths related to alcohol- many drinkers keep their problem hidden
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Alcoholism and Problem Drinking (cont.)
Alcoholism:- physical addition to alcohol
- withdrawal symptoms when abstaining from alcohol
- high tolerance for alcohol
- little ability to control drinking
Problem drinking:- may not have all symptoms listed above, but do have
substantial social, psychological and medical
problems resulting from alcohol
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Alcoholism and Problem Drinking (cont.)
Origins of alcoholism and problem drinking:- genetic, gender, physiological, behavioral
and sociocultural factors are involvedDrinking and stress:
- drinking buffers stress, reduces negative emotions, lowers anxiety
Social origins of drinking:- two windows of vulnerability:
- dependence starting between 12 and 21 years
- late middle age
- depression and alcoholism may be linked
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Alcoholism and Problem Drinking (cont.)
Treatment of alcohol abuse:- 10 to 20% of alcoholics stop drinking on their
own
- 32% of alcoholics can stop with minimal help
- some use of cognitive-behavioral modification
- without employment or social support, prospects
for recovery are dim
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Alcoholism and Problem Drinking (cont.)
Treatment programs:- self-help groups such as AA (Alcoholics
Anonymous)
- inpatient/outpatient programs:
- detoxification
- short-term, inpatient therapy
- continuing outpatient treatment
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Alcoholism and Problem Drinking (cont.)
Treatment programs (cont.):- cognitive-behavioral treatments:
- self-monitoring
- contingency contracting
- motivational enhancement
- medications
- stress management techniques
- family therapy and group counseling
- relapse prevention
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Alcoholism and Problem Drinking (cont.)
Evaluation of alcohol treatment programs:- success involves environmental factors,
outpatient services, family/social support
- minimal interventions:
- can make a dent in drinking-related problems
- social engineering
- banning alcohol advertising
- raising the legal drinking age
- strictly penalizing drunk driving
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Alcoholism and Problem Drinking (cont.)
Can recovered alcoholics ever drink again?
- Alcoholics Anonymous philosophy:
An alcoholic is an alcoholic for life
- Drinking in moderation seems possible for:
- young, employed problem drinkers
- those who have not been drinking for long
- those who live in supportive environments
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Alcoholism and Problem Drinking (cont.)
Preventive approaches to alcohol abuse:- appealing to adolescents to avoid drinking- social engineering programs
Drinking and driving:- pressure state and local governments for tougher alcohol control measures- hosts/hostesses/friends intervening to recognize those too drunk to drive- need for stiffer penalties- designated drivers
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Alcoholism and Problem Drinking (cont.)
Is modest alcohol consumption a health behavior?- modest alcohol intake (1-2 drinks/day) may add to
a long life- coronary artery disease may be reduced
- HDL (“good” cholesterol) may increase- fewer strokes
- moderate drinking among younger adults may enhance risks of death, probably due to alcohol-related injuries
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Smoking- single greatest cause of preventable death- in the U.S., accounts for about 1 in 5 deaths- increases the risk of many diseases and disorders- smokers are generally less health-conscious than
non-smokers- dangers not confined to the smoker; hazards of
secondhand smoke- may lower cognitive performance in adolescents
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Smoking (cont.)Synergistic effects of smoking:
- smoking enhances the impact of other risk factors in compromising health:
- smoking and stress can interact in dangerous ways- weight and smoking can interact to increase
mortality- smokers engage in less physical activity- smoking is considered a potential cause of
depression, especially among youth- smoking is related to an increase in anxiety among
adolescents
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Smoking (cont.)A brief history of the smoking problem:
- considered sophisticated and a “manly” habit- 1940s
- large numbers of women smoke- 1955 – 53% of the adult male population was smoking - 1964
- first U.S. Surgeon General’s warning is issued- 2008 – 20% of adults smoke
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Smoking (cont.)Why do people smoke?
- genetics: smoking runs in families
- Factors associated with smoking in adolescents:- 22% of high school students already
smoke- peer and family influences- self-identity and smoking- Nicotine addiction and smoking
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Smoking (cont.)Interventions to reduce smoking:
- changing attitudes toward smoking
- the therapeutic approach to the smoking problem:
- Nicotine replacement therapy
- multimodal interventions
- social support and stress management
- interventions with adolescents
- maintenance
- relapse prevention
- evaluation of interventions
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Smoking (cont.)
Brief interventions:
- work-site
- commercial programs and self-help
- public health approach
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Smoking (cont.)
Smoking prevention:- advantages of smoking prevention programs:
- potentially effective, cost-effective and
easily implemented
- social influence interventions:
- modeling
- McGuire’s behavioral inoculation
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Smoking (cont.)Evaluation of social influence programs:
- can reduce smoking rates for as long as 4years
The life-skills training approach:- encourage self-esteem and coping
enhancement as well as social skills in adolescents
- has shown success in the reduction of smoking onset over time
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Smoking (cont.)
Social engineering and smoking:
- liability litigation
- regulation of access of tobacco by the Food and Drug Administration
- heavy taxation
- restricting smoking to particular places
- the perils of secondhand smoke