Chapter 5 - Health Compromising Behaviors Lecture Notes PDF

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Health Psychology 306 lecture notes with professor Rachel McIntyre. ...

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Health-Compromising Behaviors ● Health compromising behaviors ○ Behaviors practice by people that are undermine or harm current or future health ■ Habitual or addictive such as smoking which make them hard to break. However can be modified with right interventions ● Obesity ○ Excessive accumulation of body fat ○ Contributions of society ■ Increasing availability of high fat and high energy foods ● Portion sizes increased ● Soda consumption skyrocketed ■ Low levels of physical activity ■ Genetic factors ■ 200+ daily caloric increase from 1970s to 1990s ● Risk of obesity ○ Cancer ○ Cardiovascular disease ○ Type 2 diabetes ○ Heart failure ○ Poor cognitive functioning ○ Disability ● Psychological impact of obesity ○ Weight stigma ■ Difficulty finding clothes ■ Treated as if they do not fit ■ Disability that is considered one's own fault ■ Even physicians can demonstrate negative weight stereotypes ○ Social ■ Alienation and teasing ○ Obesity increases the risk of depression. Trigger to obesity ○ Connection between childhood obesity and depression often comes at a young age and continues into adulthood

● Obesity in childhood ○ 37% of kids are overweight or obese ○ Sedentary lifestyle and overeating habits ■ tv/video games ○ Being overweight in childhood predicts risk for heart disease in adulthood ○ Family dog- obesity in families extend to all members of a family including the dog. How they treat everyone ○ Fat cells- obesity depends on the number and size of fat cells ● Factors associated with obesity ○ The eating habits we develop in childhood can keep with us as adults ○ Style of eating ■ Eating between meals ■ Greater convenience for prepared food ■ Does not take much to gain weight ○ Family history (genetic and dietary) ○ SES for women ■ Socioeconomic status. Women looked at as less ○ Social network ● Dieting and obesity ○ High insulin levels which promote overeating ■ Large fat cells=store more fat than smaller fat cells ■ Many people with high insulin have obesity ○ Yo-yo dieting ■ When restrict food and lose weight then start to gain the weight back because the body is thinking the metabolism is efficient ----- decrease in metabolism ○ Set point theory ■ No matter what we do, our body uses as much energy as needed to get to our set point weight ■ Obese people have a higher set point which makes it harder to lose weight ● Stress and eating ○ 50% of people eat more when they are under stress; 50% eat

less ○ Stress may ■ Suppress hunger cues ■ Loss of self control ○ Men stress eat less than women ○ Stress influences what food is consumed ● Interventions ○ Difficult to treat and risk of relapse ○ Exercise- can also prevent other health disorders ○ Sleep- managed weight ○ Diet ■ Don't diet ● Hypothesis ○ Diets fail because of stress and increased cortisol ■ Lifestyle changed instead: incorporating health foods and exercise ● Can't expect dramatic weight loss right away ● Weight control interventions ○ Cognitive-behavior therapy (CBT) combats maladaptive eating behaviors through ■ Screening ● Random control traits to have an intervention of change model ■ Self-monitoring ● To know/understand dimensions of our behavior and what causes it

■ Stimulus control ● Changing environment around- pack lunch to reduce restaurants ■ Controlling eating ● Food log- take a break after every bite, manage meals and make modifications

■ Self-reinforcement ● Adding rewards (cheat days ■ Controlling self talk ● Don't be so hard on yourself ■ Adding exercise ● Start slow so they can progress more later ■ Stress management ● Give something else to help stress ■ Increasing social support ● Group interventions so they aren't alone ■ Preventing relapse ● Be okay with yourself if you don't follow techniques ● Eating disorders ○ Obesity is not an eating disorder ○ Disordered eating behaviors: (typically happens after overeating) ■ Restriction ■ Binge eating (overeating and losing control) ■ Purging ■ Laxative/diuretic use-expelling food from body ■ Over-exercise ○ Women ages 15-24 are most vulnerable but that is expanding! ○ Appearance idea ○ Eating disorders have the highest disability and mortality rates of all behavioral disorders

● Anorexia ○ Extreme dieting and exercise ○ Factors associated with anorexia ■ Genetics- predisposed, early stressors or traumatic events ■ Personality factors- need for approval, out of control (family environment) ■ Distorted body image- body dysmorphia

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■ Family background- influences ○ Treating anorexia ■ Johns hopkins treatment for anorexia ■ Avoid glamorizing or normalizing disorder Bulimia ○ Alternating cycles of binge eating and compensatory behaviors ○ Typically normal weight or overweight ○ Cortisol levels (stress hormone) may be higher ○ Treating bulimia ■ Self monitoring ■ Meds and CBT (cognitive behavioral treatment) ● Delay binges, monitor triggers, change environment for eating Binge eating disorder ○ Recurrent binge eating ○ Binge eating: eating large amounts of food, eating past fullness ○ Recent disorder ○ Many do not seek treatment, but CBT is effective Alcohol use ○ Third leading cause of preventable death in the US- 79,000 deaths ○ Links to high blood pressure, stroke, cirrhosis of the liver and some cancers, deterioration of cognitive functioning when excessive ○ Alcohol has huge economic impact ■ $184 billion for alcohol use and related consequences ● Missing work, medical complications, psych ○ Impacts aggression and impulsivity ■ Criminal justice system ○ Beer- 12 oz ○ Liquor- 1.5 oz ○ Wine- 4.5 oz Substance dependence ○ Physical dependence ■ The body has adjusted to the substance and incorporates

its use into the normal functioning of its tissues ■ Tolerance: body adapts to the use of a substance, requiring larger and larger doses for an effect ■ Higher tolerance means you aren't being harmed by alcohol? FALSE ■ Higher tolerance means your body gets rid of alcohol at a faster rate than others? TRUE AND FALSE ○ Craving: desire to engage in a behavior or consume a substance ○ Addiction: occurs when a person has become dependent on a substance ○ Withdrawal: symptoms people experience after they stop using a drug when they have become dependent ■ Anxiety ■ Irritability ■ Intense cravings ■ Nausea ■ Headaches ■ Tremors ■ Hallucinations ● Origins of alcoholism ○ genetics*- alcoholism in family shows kids will be alcoholics too ■ Men at greater risk ○ Low income- factor of alcoholism because they don't have money and are stressed about it ○ Stress ■ Negative life events- losing a job ■ Chronic stressors- illness, being a caretaker, financial issues ■ Little social support- divorce=loss of support ○ Increase positive emotions ■ Associated with immediate positive feelings ■ Popularity ○ Social influences ● Preventions of alcohol problems: harm reduction approach

○ Reduce the risk of negative consequences ○ Does not require abstinence ○ CBT ■ Motivational interviewing ■ Client-focused ○ Protective behavioral strategies ● Treatment for substance use disorder ○ Some stop or reduce drinking on their own 32 ■ Maturing out of drinking/ natural recovery ○ Step 1: detoxification ○ Step 2: cognitive behavioral treatment ○ Focus on environmental factors ○ Enhance coping skills ○ Involve family/friends ○ Alcoholics anonymous (AA) ■ Self help program ■ Religious conversion type experience ■ 90 meetings in 90 days ■ Social reinforcement ● Prospective new members talk with longtime members ● Having a sponsor ■ Alcoholism is a disease that is incurable but can be managed ■ Cost effective ● Recovery and alcohol ○ Can recovered alcoholics ever drink again ○ AA ■ Alcoholism is a disease that is incurable ■ Can never drink again ○ CBT ■ Harm reduction ■ Relapsing is part of process ■ Drinking moderation ● Smoking

○ Chief cause of death in developed countries ○ Increases risk for ■ Heart disease ■ Lung cancer ■ Chronic bronchitis ■ Emphysema ■ Respiratory disorders ■ Lower birth weight in offspring ■ Erectile dysfunction ○ Drinking and smoking ● Synergistic effects on smoking ○ Smoking and cholesterol interact to produce higher rates of morbidity ○ Stress and smoking ■ For men: nicotine can increase magnitude of heart rate reactivity to stress ■ For women: smoking can reduce heart rate but increase blood pressure responses ■ Most common- those that are depressed or have anxiety ○ Exercise and smoking ■ Smokers engage in less physical activity ■ After quitting, activity level increases ○ Smoking puts women at 4x greater risk of getting breast cancer ○ More likely among people who are depressed ○ Increases anxiety ● Why do people smoke? ○ Social ties in adolescents ○ Smoking in the family ■ Having family members who smoke reduced the perception that smoking is harmful ○ Genetic influences ○ Maladaptive coping styles ● Why is smoking so hard to change ○ Tobacco industry targets adolescents, african americans, and low SES

■ Stop profiling ○ Smoking patterns are individualized ■ Hard for interventions to target all smoking motives ○ Unpleasant withdrawal symptoms ○ Mood elevating ○ Keeps weight down ○ Other tobacco product use ■ cigars ● Nicotine addiction ○ More addictive than heroin ○ Chippers ■ No signs of addictions ○ Increases alertness ○ FTND to assess nicotine dependence ● Smoking interventions ○ Changing attitudes about smoking ■ Anti smoking media messages ○ Nicotine replacement therapy ○ CBT interventions ■ Stages of change ○ Brief interventions ○ Self help aid ■ Quitlines ○ Cold turkey ● Smoking prevention ○ Catch potential smokers early and attack underlying motivations that lead people to smoke ○ Advantages ■ Cost effective ■ Easily implemented through school system ○ Social influence interventions ○ Life skills training approach ■ Training in social skills, self esteem, and coping skills ■ Won't feel the need to bolster their self image by smoking ○ Social engineering

■ Heavy taxation ■ Restricting it to particular places (not in public places)...