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109 Cards in this Set
- Front
- Back
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1. What are the three major complications that result from cigarette smoking?
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1. Heart disease
2. Lung Cancer 3. COPD |
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2. What are the harmful components of cigarette smoke and what do they cause?
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1. Nicotine -> addiction
2. Tars -> contain 60+ carcinogens 3. Carbon monoxide -> displaces O2 4. Irritants, e.g. formaldehyde causes cell damage |
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3. What is smoking's triple whammy on the heart?
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1. Nicotine makes the heart work harder Can increase HR 30%
-Occurs even in long-term smokers 2. Carbon monoxide reduces oxygen capacity of the blood 3. Plaque build-up narrows blood vessels -HDLP/LDLP (i.e., good/bad) cholesterol tends to be lower in smokers -Makes blood more “sticky” (increases clotting factors: platelets, fibrinogen) |
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4. How does smoking affect the lungs?
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COPD
Bronchitis – bronchi inflamed and mucus-filled Emphysema – bronchioles less elastic Destroys alveolar sacs, which normally allow gas exchange Affects the capillaries ability to bring oxygen-carrying blood to the alveoli |
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5. What are the diseases caused by tobacco use?
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Cigarette smoking increases the risk of:
Cardiovascular disease Coronary heart disease Peripheral vascular disease Cerebrovascular disease Cancers of the lung, larynx, mouth, esophagus, bladder, pancreas, kidney, and cervix Chronic obstructive pulmonary disease Low-birth weight babies, miscarriage, SIDS Cataracts, macular degeneration, hip fractures Peptic ulcer disease |
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6. What are some other risks of smoking?
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Periodontal disease
Diminished physical strength Increased susceptibility to the colds Problems with cognitive functioning Accelerated wrinkles – aging Decreased bone density in women Sexual impotence |
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7. What about light/low tar cigarettes?
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The lower tar and nicotine numbers on light cigarette packs and in ads are misleading
Light cigarettes trick the smoking machines so that they record artificially low tar and nicotine levels Light cigarettes provide no benefit to smokers’ health |
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8. What about involuntary smoking? i.e. environmental tobacco smoke?
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Related to:
Lung cancer (causes ~3000 deaths/year) Coronary heart disease (causes ~35000 deaths/year) Respiratory infections (bronchitis, pneumonia) Asthma SIDS |
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9. How about other forms of tobacco, i.e. smokeless, cigars?
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Smokeless tobacco causes:
Oral Cancer Oral leukoplakia (precancerous lesion on tongue or cheek) Tooth decay (possibly) Cigars cause: Cancers of the mouth, larynx, and lung Coronary heart disease COPD |
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10. What are the trends regarding adolescent smoking?
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Rates of adolescent (> age 18) smoking remained unchanged throughout the 1990s.
Rates among adolescents, especially females, have increased since 1990s. However, most recent data suggests a decline. European American adolescents have highest rates |
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11. What was the point of the Warren et al (2006) article?
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The difference in current cigarette smoking between boys and girls is narrower than expected in many regions of the world.
Use of tobacco other than cigarettes by students is as high as cigarette smoking in many regions. Almost 1/5 never-smokers reported they were susceptible to smoking in the next year. Student exposure to secondhand smoke was high both at home (more than 4/10) and in public places (more than 5/10). Never-smokers were significantly less likely than current smokers to be exposed to secondhand smoke at home High exposure to secondhand smoke suggests a need for countries to pass strong and effective smoke-free policies. |
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12. Why do people start smoking?
Nine reasons... |
1. Optimistic bias
2. Image 3. Oriented to the present 4. Control tension 5. Social pressure 6. Modeling peer/parents 7. Rebelliousness 8. Weight control 9. Alcohol |
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13. What was the point of the Chassin et al (2000) article?
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After removing 2 groups (abstainers and erratics), the
authors empirically identified 4 trajectory groups---early stable smokers, late stable smokers, experimenters, and quitters---and psychosocial variables from adolescence and young adulthood were significantly distinguished among them. Given recent advances in quantitative methods, it is now feasible to consider subgroups of trajectories within an overall longitudinal design. |
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14. What are some reasons for why people continue to smoke?
Four reasons... |
1. Positive reinforcement
2. Negative reinforcement 3. Habit 4. Addiction |
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15. What did Dr. Philip Morris from a large tobacco company state about the efficiency of nicotine delivery in cigarettes?
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"Smoke is beyond question the most optimized vehicle of nicotine and the cigarette the most optimized dispenser of smoke.”
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16. What is addiction?
Regular definition... |
Addiction is a behavioral pattern of compulsive drug use characterized by overwhelming involvement with the use of a drug, the securing of its supply, and a high tendency to relapse after discontinuance.
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17. What is addiction?
DSM-IV definition: |
DSM-IV (Nicotine dependence)
3 or more of the following criteria: Tolerance Withdrawal Persistent desire or unsuccessful attempts to cut down or control use Used in larger amount or for a longer time than intended Important social, occupational, or recreational activities are given up or reduced because of use Great deal of time spent to obtain, use or recover Continued use despite physical or psychological problems |
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18. What is physical dependence?
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Addiction is possible in the absence of physical dependence.
Physical dependence is a state in which as a consequence of exposure to a drug, the presence of that drug is required for normal function. Associated with drug tolerance and characterized by the onset of a withdrawal syndrome after discontinuance. |
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19. What are the withdrawal symptoms like with nicotine?
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Physical:
Headaches Decreased heart rate Behavioral/Affective: Craving Tension Irritability Difficulty concentrating Drowsiness Trouble sleeping Increased appetite Weight gain |
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20. What is alcohol and what does it do?
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Alcohol is a psychoactive drug that is a CNS depressant
Increases activity of the major inhibitory neurotransmitter (GABA) Decreases activity at glutamate receptors |
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21. What is the relationship between the effects of EtOH and BAC?
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.02 - mellow feeling. Slight body warmth. Less inhibited.
.05 - noticeable relaxation. Less alert. Less self-focused. Coordination impairment begins. .08 - drunk driving limit. Definite impairment in coordination and judgment. .10 - noisy. Possible embarrassing behavior. Mood swings. Reduction in reaction time. .15 -Impaired balance and movement. Clearly drunk. .30 - .50 most lose consciousness; breathing stops. Many die. |
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22. How do other factors affect BAC?
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BAC produced depends on the:
Presence of food in the stomach slows absorption Rate of alcohol consumption -About 0.015% cleared per hour Concentration of alcohol -Beer vs. wine vs. hard liquor -Standard drink ~ 12 vs. 5 vs. 1.5 ounces Drinker’s body composition -Higher body fat -> increased BAC -Alcohol dissolves in water, not fat. So the more fat the less water and the higher the concentration of alcohol Women are more sensitive to the effects of alcohol than men even after controlling for body weight |
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23. How is alcohol metabolized?
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90% in liver:
Alcohol dehydrogenase: ADH converts alcohol into acetaldehyde, which is then converted to carbon dioxide and water. Aldehyde dehydrogenase: enzyme that converts aldehyde to acetic acid |
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24. What are the specific effects of alcohol in low to moderate doses?
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Low to moderate doses
Interfere with motor activity, reflexes and coordination Disinhibition Social setting and mental state Euphoric, friendly, talkative Aggressive and hostile |
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25. What is the relationship between alcohol and aggression?
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Drinking during crime
-up to 86 percent of homicide offenders -37 percent of assault offenders -60 percent of sexual offenders -up to 57 percent of men and 27 percent of women involved in marital violence -13 percent of child abusers Big problem in college (NIAAA, 2005) 600,000 assaulted by student drinking -70,000 victims of alcohol-related sexual assault -Increased risk if high trait anger |
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26. Why might alcohol cause aggression?
Two main factors... |
Direct effects (e.g., disinhibition, misjudge social cues due to impaired information processing, inaccurate assessment of risk due to “myopia”)
Social/cultural expectancies (balanced placebo design) |
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27. What are the effects of alcohol in moderate quantities?
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Moderate quantities:
Slightly increases heart rate Slightly dilates blood vessels in arms, legs, skin Moderately lowers blood pressure Stimulates appetite Increases production of gastric secretions Increases urine output |
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28. What about at higher doses of alcohol?
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At higher doses:
Difficulty in walking, talking, and thinking Induces drowsiness and causes sleep In large amounts -- severe depression of the brain and motor control area of the brain Lack of coordination, confusion & disorientation Stupor, anesthesia, coma, and even death Lethal level of alcohol is between 0.4 and 0.6% by volume in the blood About 1400 deaths related to alcohol poisoning each year more likely to occur when alcohol is combined with other drugs of abuse (e.g., sedatives) |
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29. What are some chronic effects of alcohol consumption on the liver?
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Light or moderate drinking does little permanent harm
Heavy drinking is the most common cause of liver disease Damaging metabolic bi-products: Fatty deposits in liver (1st) Alcoholic hepatitis (2nd) Cirrhosis (3rd) |
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30. What about chronic alcohol consumption and brain damage?
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Alcoholics have smaller, shrunken brains, especially in frontal lobe (cognitive deficits)
The vulnerability to this frontal lobe shrinkage increases with age. Repeated imaging of a group of alcoholics who continued drinking over a 5-year period showed progressive brain shrinkage that significantly exceeded normal age-related shrinkage. Moreover, the rate of shrinkage correlated with the amount of alcohol consumed. Korsakoff’s syndrome -Thiamine (Vitamin B1) deficiency -Memory loss (especially for things occurring after the onset of the condition) |
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31. What are some other effects of heavy drinking?
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Lowered resistance to pneumonia and other infectious diseases
Increase risk of heart disease (increased fatty acids, abnormal contractions, increased systolic blood pressure) Increased risk for certain types of cancer Irritated stomach lining and bleeding from stomach ulcers Epilepsy |
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32. What are the withdrawal symptoms from alcohol?
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Physical:
Headache Sweating Rapid heart rate Fever Dilated pupils Tremors Delirium tremens Behavioral/Affective: Anxiety Irritability Depression Fatigue Loss of appetite Insomnia |
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33. Why do people drink?
Two schools of thought... |
1. The disease model
2. Cognitive physiological theories |
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34. What is the disease model?
What are its limitations? |
Physical properties of alcohol are cause
Like disease model for other medical disorders (e.g., bacteria and infection) Does not allow for “choice” to use Limitations: Disease model doesn’t account for cognitive, environmental or emotional factors |
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35. What is alcohol dependency syndrome?
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Central feature is “impaired control”
Narrowing of drinking repertoire Salience of drink-seeking behavior Increased tolerance Withdrawal Avoidance of withdrawal Subjective awareness of compulsion Reinstatement of dependence after abstinence |
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36. What is the tension-reduction hypothesis?
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Under most circumstances, alcohol consumption will reduce stress
In times of stress, people will be especially motivated to drink alcohol |
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37. What are some limitations of the tension-reduction hypothesis?
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Mixed support
Alcohol consumption reduced stress in some studies, did not affect stress responses in others, and exacerbated stress in still other investigations -Stress-response-dampening effect Expectancies are important determinant -People who do experience tension reduction after alcohol also tend to experience it after placebo -Situational factors and individual differences may also be important -e.g., greater stress-response dampening in social/relaxing situations and in children of alcoholics |
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38. What is alcohol myopia?
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Alcohol myopia refers to the tendency of alcohol to increase a person's concentration upon immediate events and reduce awareness of events which are distant (hence the reference to myopia which is nearsightedness).
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39. What is the purpose of the digestive system?
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Purpose: Convert the food we ingest into proteins, carbohydrates, lipids for our body to use
Absorbed particles travel through bloodstream for all body cells to use The body then uses these digested particles for physical activity, growth, maintenance and repair. The particles not used for these functions are excreted as waste. |
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40. What is the purpose of the mouth, of swallowing, and of peristalsis?
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Mouth:
Grinds up food Mix with saliva Starches begin to break down Swallowing: Epiglottis folds back to block passage of food into the larynx Pushes food through pharynx into esophagus Peristalsis: Propels food through esophagus and into stomach |
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41. What does the stomach do and what enzyme is used there?
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Contractions mix food with gastric juices
Contains pepsin – enzyme that digests protein in the stomach |
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42. What about the small intestines?
Purpose? What about the upper, middle and lower 1/3 of the small intestines? |
It's where most nutrients from food are absorbed
Pancreatic juices -Reduce acidity -Aid in digestion of carbohydrates and fats Upper 1/3 – carbs & protein Middle 1/3 – fats -Bile salts produced by the liver break down fats Lower 1/3 – reabsorb bile salts |
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43. What about the large intestine? What happens here?
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Vitamins B & K are manufactured and absorbed in the large intestine, and there the fluid volume of the mixture is decreased.
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44. What is the role of the hypothalamus?
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Controls hunger and eating
Damage to lateral hypothalamus – decreases eating Damage to ventromedial hypothalamus is related to weight gain |
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45. What is leptin?
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Hormone produced by adipose tissue (proportional to the amount of adipose tissue), travels to hypothalamus
Reduces appetite and leads to weight loss through decreasing food intake and increasing activity (in mice) Mutant mice lacking this hormone become obese Small population of humans lack this hormone – eat constantly and are morbidly obese Low-levels signal low fat stores which promote eating and weight gain |
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46. Leptin levels are high in obese individuals... if leptin reduces appetite why don't they lose weight?
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Although leptin is a circulating signal that reduces appetite, in general, obese people have an unusually high circulating concentration of leptin.
These people are said to be resistant to the effects of leptin, in much the same way that people with type 2 diabetes are resistant to the effects of insulin. |
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47. What is ghrelin?
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Produced in stomach, acts on the hypothalamus
Rises before eating and falls after Stimulates eating |
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48. What is Cholecystokinin (CCK)?
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Hormone secreted by small intestines
Causes release of pancreatic enzymes and bile salts Suppresses hunger -Short-term regulator, may be part of signaling system that terminates a meal |
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49. What happened in the starvation experiment (Keys et al., 1950)?
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Men volunteered to be in a study of starvation to avoid draft (WWII)
Cut calorie intake in half for 6 months, goal to reduce 25% of body weight Initial weight loss rapid, then harder – metabolic rate slowed -Were forced to consume fewer and fewer calories for weight loss to continue When allowed to eat, regained weight quickly, many heavier and remained obsessed by food |
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50. What were some side effects of this starvation experiment?
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Men became irritable and aggressive
-Fought amongst each other Became very apathetic, avoided physical activity Neglected to care for themselves and their living space Finally, major obsession with food, eating -Lasted through the weight regaining phase -Resulted in many eating up to five large meals per day -Many of the men exceeded their pre-experimental weight |
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51. What about the overeating experiment (Sims et al., 1976)
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Prisoners volunteered to gain 20-30 lbs
Offered great food, and discouraged from physical activity At first men gained weight, then found overeating increasingly unpleasant and weight gain difficult Metabolic rate sped up Had to increase calories to 5,000+ to continue gaining After study all but two of men had no trouble losing the weight of obesity -These two men had family history of obesity -Normal weight people have difficulty maintaining the increased weight |
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52. What are the three models that we use to explain maintenance of metabolism?
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Setpoint Model
Genetic Explanations Positive Incentive Model |
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53. What is the setpoint model?
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Weight is regulated around a ‘setpoint’
-Acts as an internal thermostat If fat levels fall below or above a certain point, physiological and psychological mechanisms are activated -These mechanism encourage return to setpoint When fat levels fall below setpoint, body takes action to preserve its fat stores When fat levels were above setpoint, body took actions to stop eating |
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54. What are the genetic explanations for metabolism maintenance?
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1. Thrifty gene
2. Obesity tends to run in families |
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55. What is the thrifty gene?
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Thrifty gene: tends to store fat for times of famine
No longer an issue in industrialized world Instead people become obese due to predisposition to store fat ex: Pima Indians |
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56. What about obesity in families?
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Obesity tends to run in families suggesting a genetic component
However, families tend to eat together Evidence from adopted children, weight was more similar to biological parents (Stunkard et al., 1986) Recent study of twins found high degree of heritability for BMI and fat distribution (Schoesboe et al., 2004) However, rapid increases around the world in the past 30 years mean something environmental is occurring |
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57. What is the positive incentive model?
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Formulated from the shortcomings of setpoint and genetic theories
Positive reinforcers of eating have important consequences for weight maintenance |
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58. What are three different types of motivations for eating?
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1. Personal pleasure: people enjoy food
2. Social context: a cultural experience -Eat more in a social setting -Culture tells you what to eat and when 3. Biological factors: Length of time since eating and blood glucose levels. |
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59. So...how does the positive incentive model work with predicting one's body weight?
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Predicts a variety of body weights depending on…
Food availability -Even if food is available people must overeat to become obese -Variety of foods Individual experiences with food Cultural encouragement to eat certain foods -Food industry encourages people to eat through advertising Cultural ideal for body weight |
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60. About how much of the US population is now obese?
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About 60 million adults, or 30 percent of the adult population, are now obese, which represents a doubling of the rate since 1980.
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61. What are some health risks of obesity?
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Cardiovascular disease
Hypertension, high cholesterol Type 2 Diabetes Liver and gall bladder disease Migraine headaches Kidney Stones Lung function impairment Cancer Endocrine problems Joint trauma |
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62. What about the relationship between mortality and weight?
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For older people, weight is unrelated to all-cause mortality, and weight loss after age 50 actually increases health risks.
U shaped relationship between weight and poor health. Very thinnest and very heaviest are at greatest risk for all-cause mortality. |
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63. About how much does obesity cost in terms of health care?
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Accounts for $50-70 billion annually in health care costs
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64. What about age and weight?
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For young and middle aged adults, being obese is a risk factor for all-cause mortality
After age 65, this relationship no longer exists -weight loss after age 50 actually increases health risks. Some research suggests that gaining or losing weight is riskier than maintaining a stable weight. |
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65. What about ethnicity and weight?
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For African-American men and women, the healthiest BMI levels were around 27 which is considered overweight
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66. What are some approaches to losing weight?
Five ways... What are the similarities in all these methods? |
1) Reduce portion size…an especially big problem in the US
2) Restrict types of food 3) Increase exercise 4) Rely on drastic medical procedures 5) Combination of the above *** all diets that prompt weight loss do so through restriction of calories |
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67. What about reducing portion size?
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Maintain a diet with a variety of foods with smaller portions
Weight Watchers was found to be most effective weight loss and low drop-out People find it difficult to simply eat less |
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68. What about low carb or low fat diets?
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Low carbohydrate:
Atkins, the Zone, South Beach -May develop depression or fatigue -Most relapse and eat carbs Low fat: -May be vegetarian or vegetarian modified -Eat more food since carbs have less calories than fats -Feel deprived of certain foods and drop out |
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69. What are some drastic measures for losing weight?
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1. Diet pills
2. Fasting, purging, and very low calorie diets 3. Surgery |
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70. How about getting me some diet pills...eh?
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During 1950s amphetamines were prescribed to increase activity nervous system and increase metabolism
Today, sibutramine (Meridia) and orlistat (Xenical) Offer some weight loss but can only take them for a year Usually weight returns |
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71. OK, how about surgery then...?
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Gastric banding: placing a band around the stomach
Gastric bypass: routing food around most of the stomach and part of the intestines -Have a BMI over 35 to qualify -Number increased 600% from 1990-200 Liposuction: remove adipose tissue…recontouring of fat deposits rather than overall weight loss |
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72. About how long does the average weight loss program last?
Whats the amount of weight lost? |
Today, average program lasts over 20 weeks, yielding weight loss of about 20 lbs initially, and regain of about 1/3 of this over the course of following year
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73. What is the best predictor of maintaining one's weight?
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Exercise is best predictor of maintenance
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74. What about childhood obesity?
CHUNKY BEEFY!!! |
16% of children between 6-19 years old are overweight
-Approximately 9 million kids Overweight kids have a 70% chance of becoming overweight or obese adults. -increases to 80 percent if one or more parent is overweight or obese Obesity-associated hospital costs for children has more than tripled over two decades -Rising from 35 million to 127 million |
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75. Why are children so chunky???
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Experts agree that inactivity and poor eating habits contribute to obesity. While national guidelines recommend 150 minutes of physical activity each week for elementary children and 225 minutes for older children, only Illinois has a statewide requirement for daily physical education.
Nearly one-third of U.S. Children aged 4 to 19 eat fast food every day, resulting in approximately six extra pounds per year, per child. Fast food consumption has increased fivefold among children since 1970. |
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76. What are some ethnic differences in obese children?
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Among boys, the highest prevalence of obesity is observed in Hispanics
Among girls, the highest prevalence is observed in African Americans. According to the CDC, black (21%) and Mexican-American adolescents (23 %) ages 12-19 were more likely to be overweight than non-Hispanic white adolescents (14 %). |
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77. What are some important risks with childhood chunkiness?
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Lifetime risk of being diagnosed with Type 2 diabetes at some point in their lives is
30 % for boys and 40% for girls. Approx 60% of obese kids 5-10 years had at least one CVD risk factor including elevated total cholesterol, triglycerides, insulin or blood pressure -25 percent had 2+ risk factors. |
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78. What about diabetes and childhood chunkiness?
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Type 2 diabetes accounted for 8-45% of all new pediatric cases of diabetes
-Compared to fewer than 4% before the 1990s Inpatient diabetes cases in children's hospitals have increased approx. 12 % between 2002 and 2004 |
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79. What are some health benefits of exercise?
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Aerobic exercise:
-Increases amount of oxygen available during strenuous activity -Increases amount of blood pumped by the heart -Therefore, your cardiovascular system is more efficient! Lowers LDLs and increases HDLs Ratio becomes more favorable and risk for CVD disease Lowers blood pressure -Reduces body fat which is associated with high blood pressure Dose-response – the more kilocaloeries you burn in physical exercise the more you reduce your risk of an MI (~50% at 2-3000 kcal). Above 2-3000 kcall the gain levels off |
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80. What are some more health benefits of exercise?
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Cancer
-Exercise reduces risk of all-type cancer death -Relationship to colon is particularly strong -May also protect against breast and lung cancer --Women with high activity levels survived longer after a diagnosis of breast cancer Osteoporosis -History of exercise associated with increased bone density -May both promote bone formation and prevent loss |
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81. What are even more health benefits of exercise?
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Obesity:
-Reduce body fat and improve body’s ability to use calories Type 2 diabetes -Controls weight and therefore can help control diabetes Psychological effects -Exercise causes a lift in mood and also changes the way you feel about yourself Depression -RCT with older depressed adults found those in the weight-lifting group had lower depression scores (Singh, 2001) Anxiety -Can reduce state anxiety Buffering stress |
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82. What are some hazards of physical activity?
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Injuries
-Mostly from irregular exercisers (weekenders) -Musculoskeletal Dying during exercising -If you get your heart pumping and BP up, doesn’t that put you are risk for sudden death? YES If healthy: 16 times greater risk; but benefits outweigh risk |
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83. What about addiction to exercise?
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Like those with alcohol or drug dependence
-Strong emotional attachment to exercise -Exhibit withdrawal symptoms (anxiety, depression) -Make changes in life so they can exercise Obligatory Exercisers -Continue a behavior that is harmful or self-destructive -Body image obsession -More likely to suffer from an eating disorder too |
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84. How much exercise in enough?
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Recommended:
30 minutes of moderate physical activity/day CV health: walking 3 hr/week or 6 miles can reduce a woman’s risk for heart attack by 30% However, only 25% of adults meet these requirements People who participate in exercise regimes have dropout rates similar to those of alcohol and smoking cessation programs |
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85. What was the importance of the study by Vandewater et al (2004)?
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Results indicated that while television use was not related to children’s weight status, video game use was. Children with higher weight status played moderate amounts of electronic games, while children with lower weight status played either very little or a lot of electronic games. Interaction analyses revealed that this curvilinear relationship applied to children under age 8 and that girls, but not boys, with higher weight status played more video games. Children ages 9–12 with lower weight
status used the computer (non-game) for moderate amounts of time, while those with higher weight status used the computer either very little or a lot. Results also indicated that children with higher weight status spent more time in sedentary activities than those with lower weight status. |
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86. What was the importance of the study by Cartwright (2003)?
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Baseline data from the Health and Behavior in Teenagers Study (HABITS) were used to investigate associations between stress and dietary practices in 4,320 schoolchildren. They completed questionnaire measures of stress and 4 aspects of dietary practice (fatty food intake, fruit and vegetable intake, snacking, and breakfast consumption) and also provided demographic and anthropometric
data. Results revealed that greater stress was associated with more fatty food intake, less fruit and vegetable intake, more snacking, and a reduced likelihood of daily breakfast consumption. These effects were independent of individual (gender, weight) and social (socioeconomic status, ethnicity) factors. Stress may contribute to long-term disease risk by steering the diet in a more unhealthy direction. |
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39. What was the importance of the study by Mukamal et al., (2003)?
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Studied the association of alcohol consumption with the risk of myocardial infarction
among male health professionals They assessed the consumption of beer, red wine, white wine, and liquor. During 12 years of follow-up, there were 1,418 cases of myocardial infarction. As compared with men who consumed alcohol less than once per week, men who consumed alcohol three to four or five to seven days per week had decreased risks of myocardial infarction. Among men, consumption of alcohol at least three to four days per week was inversely associated with the risk of myocardial infarction. Neither the type of beverage nor the proportion consumed with meals substantially altered this association. Men who increased their alcohol consumption by a moderate amount during follow-up had a decreased risk of myocardial infarction. |
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87. What about modifiable lifestyle factors and death?
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50% of deaths from the 10 leading causes of death in this country are due to modifiable lifestyle factors
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88. What are health behaviors?
What are health habits? |
Health behaviors:
Behaviors that enhance or maintain health Health Habits: Health-related behavior that is established and often performed automatically, without awareness |
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89. What did the Alameda County Study (Belloc & Breslow, 1972) find?
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More good health habits were associated with
-Less illness in prior 12 months -Feeling better -Less disability 9 ½ year follow-up: Mortality rate 28% lower in men who practiced all 7 as compared to men who practiced 0-3. Mortality rate 43% lower in women who practiced all 7 as compared to women who practiced 0-3. |
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90. What are some characteristics of educational approaches to changing health behaviors?
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Colorful/vivid
Case histories Communicator –expert, likable, trustworthy, similar to target audience Important arguments at beginning and end of message Clear, short, concise Emphasize consequences of not acting Both sides of issue (depends on stage) |
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91. What are some limitations of these educational approaches?
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Informational approaches have only limited effects
Informational appeals alone are often insufficient to produce behavioral change Information sometimes processed defensively (optimistic bias) |
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92. Remember the health belief model? What the f*ck is it???
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To understand why people practice a behavior need to know:
1. Belief in threat -General health values -Beliefs about vulnerability to a disease -Beliefs about consequences of the disease 2. Perception that changing health behavior will reduce the threat. -Effective? -Does cost exceed benefit? |
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93. Apply this health belief model to a smoker with a desire to quit...
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1. Belief in threat
-General health values: (Concerned about health) -Specific beliefs about vulnerability: (I could get lung cancer) -Beliefs about severity of disorder: (I would die if I developed lung cancer) 2. Belief that specific behavior can reduce the threat. -Can change be effective: (If I stop smoking now, I will not develop lung cancer) -Belief that benefits exceed costs: (Even though it is hard to stop smoking, it is worth it to reduce risk of cancer?) |
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94. What is self efficacy?
Why is it important? |
Belief that one is able to control one’s practice of a particular behavior
Important determinant of the practice of health behaviors |
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95. What is the theory of planned behavior by Fishbein & Ajzen (1975)?
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Health behavior->
Behavioral intention Behavioral intention comes from : 1. Attitudes 2. Subjective Norms 3. Perceived Control |
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96. What are problems with health messages?
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They evoke defensive processes
-Perceive threat as less relevant than it is -See themselves as less vulnerable than others -Unlike those who have become sick. Negative mood – hopelessness May change attitude and motivation, but does not help with behavioral change |
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97. What was the importance of the study by Antoni et. al., (1991)?
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Forty-seven asymptomatic, healthy gay men were randomly assigned to a cognitive-behavioral
stress management (CBSM) condition or an assessment-only control group 5 weeks before being notified of their HIV-1 antibody status. Control subjects showed significant increases in depression, but only slight decrements in mitogen responsivity and lymphocyte cell counts pre- to postnotification of seropositivity. Seropositive CBSMSs did not show significant pre-post changes in depression, but did reveal significant increases in helper-inducer (CD4) and natural killer (CD56) cell counts as well as a slight increment in proliferative responses to phytohemagglutinin (PHA). Analyses suggest that the psychological buffering and immunomodulating effects of the CBSM manipulation may be attributable, in part, to relaxation skills learned and practiced or to a general willingness to comply with the intervention guidelines. |
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98. What is cognitive behavioral therapy (CBT)?
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Set of practices grounded in behavioral science, especially learning theory.
Focus is on target behavior – the conditions that elicit and maintain it and the factors that reinforce it Focus also on cognitions -- beliefs that a person has |
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99. What are stimulus controls in interventions?
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Discriminative stimulus – cues in environment that signal that a positive reinforcement will occur
Stimulus-control interventions avoid/remove discriminative stimuli that evoke problem behavior Crate new discriminative stimuli that signal new response that will be reinforced |
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100. What is maintenance?
What is generalization? |
Maintenance:
Learning the persistence of behavior over time. Generalization: Learning the persistence of behavior across settings. |
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101. What is contingency management?
What does it have to do with contracting? |
Changing behavior by controlling its consequences
Involves contracting – contract formed with another for behavioral change |
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102. What is cognitive restructuring?
Is it brain-washing...??? |
Internal dialogues “I need a cigarette--“smoking causes cancer”
Recognize and *restructure* cognitive distortions Adaptive self talk |
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103. What about relaxation interventions? What do they involve?
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Progressive muscle relaxation
Guided imagery Hypnosis Deep breathing Biofeedback |
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104. What was the importance of the study by Jain et al. (2007)?
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This randomized controlled trial examines the effects of a 1-month mindfulness meditation versus somatic relaxation training as compared to a
control group in 83 students reporting stress. The data suggest that compared with a no-treatment control, brief training in mindfulness meditation or somatic relaxation reduces distress and improves positive mood states. However, mindfulness meditation may be specific in its ability to reduce distractive and ruminative thoughts and behaviors, and this ability may provide a unique mechanism by which mindfulness meditation reduces distress. |
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105. Again, what is CBT?
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Combining multiple behavior change techniques:
Self-monitoring Stimulus control Education/modeling/behavioral rehearsal Self-reinforcement Feedback |
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106. What about relapse prevention?
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Relapse is a problem – 50-90%
Relapse prevention is an important component of treatment Coping skills given to help avoid relapse -Booster sessions -Add more training -Consider abstinence a lifelong process- e.g., AA |
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107. What are the five stages of behavior change according to Prochaska (1994)?
Hint...Transtheoretical model |
Transtheoretical model of behavior change
Proposes stages people go through in attempting to change behavior 1. Precontemplation 2. Contemplation 3. Preparation 4. Action 5. Maintenance |
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108. What was the importance of the study by Farrelly et al., (2005)?
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They studied the impact of the "Truth" campaign on national
smoking rates among US youths (students in grades 8, 10, and 12). Findings indicate that the campaign accounted for a significant portion of the recent decline in youth smoking prevalence. They found that smoking prevalence among all students declined from 25.3% to 18.0% between 1999 and 2002 and that the campaign accounted for approximately 22% of this decline. This study showed that the campaign was associated with substantial declines in youth smoking and has accelerated recent declines in youth smoking prevalence. |
