PSY333 MAY 30.docx

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University of Toronto St. George
Nevena Simic

PSY333 MAY 30, 2012 HEALTH COMPRIMISING BEHAVIOURS CHAPTER 5 Hcb – behaviours practive by people that undermine or harm current or futre health – abusing aclogol, smoking, illicit drug use, unsafe sex, risk tasking behavior Substance dependecen - Dependent – on a substqnce if repeadeltyself administer it resulting in tolerance withdrawl compulsive behavior - Physical dependence – state that occurs when body adjust to taking a substance and incorpaates the use of it into normal function of body tissues – often involves tolerance meaning body increasingly adapts to use of substance requiring increased doses to achieve same effect – craving meaning strong desire to engage in a beh or consume a substance Contd Addiction – occurs when a person becomes phy or psych dependent on a substance following use over time - psy dependet – phys is body requires it and psych is mind requires (cognitive) Withdrawl – unpleasant symptoms experience when stop taking substance on which one has become dependent – anxiety, irritability, intense cravings, nausea, headaches, shaking, hallucinations Costs - 2002 canada costs - 39.8 billion health care resources, law enforcement, loss of producutivty at work/home - Smoking accounted for most of this cost 37% - Substance abuse 20% - Harmreduction – intercention stragety - Meaning – - Public health response to substance abuse problem - Approach that focuses on the risks and consequences of substance use rather than on the use itself - Ex – methadone clinics, needle exchange programs Substance abuse vs dependence - According to dsm - A maladaptive behavior pattern of substance ise leading to clinically sig impairment or distress as manifested by one or more of the following occurring within a 12 month period (clinically sig by doctor) - 1. Recurrent substance use resulting in a failure to fulfill major role obligations at work school home e- for some can meet some but not others like work but social life is suffering , - examples repeatd absence or poor work performance related to substance use - Substance related absences or suspensions or expulsions from school - Neglect of children or household - 2. Recurrent sunstance use in sits in which it is physically hazardous - Examples driving an automobile or operating a machine whrn impaired by substance use - 3. Recurrent substance related drug problems - Example arrests for substance related disorderly conduct - 4. Continued sub use despite having persistent or recurrent social or interpersonal problems caused or exacerbated by the effects of the substance - Example argument with spuse about consequences of intox - Physical fights Dependence – a maladaptive pattern 1. Tolerance as defined by wither of the following - A need for increase amounts of the subs to aachive intox or desired effect - Diminished effect with cont use of the same amount fo subs 2. Withdrawl 0 as manifested by either of the following - The characterisc withdrawl syndrome for the substance - The same or closely related substance is taken to releve the or avoid withdrawl symps 3. Sub taken in larger amounts or more time then intended 4. Persistenat unsucces efforts to cut down on control substance use 5. A great deal of time is spent on activites to obtain use or recover from –substance 6. Important socua occ recreational activites are given up or reduced bc of sub use 7. Sub is used despite knowledge of having persistent physical or psych problem link casued or exacerbated by subs – such as drink despite recognition that ulcer made worde by it 8. Abuse not have to be dependet but depednet abuse it Alcoholism How does aa comprime health - Alacholhol related deaths 8000 per year resulting from motor vehicle - Linked to a number od disorders – high bp, stroke cirrhosis or liver, some forms of cancer, fasd, major sleep disorders, cognitive impairments (irresivlae often) - Fas – physical and cognitive and social - Economically cost canadaians 14.6 billion in loss of prodcutity treatments acient fire and crime 463 dollars per candian per year - 20 percent of candians drink at levels that exceed gov recommendations Low risk drinking guidelines - Maximize life minimize risk - 0 xero drinks lowest risk of alchol related probles - Camh - 2 no more then 2 drinks standard a day - 9 women up to 9 drinks a week - 14 men up to 14 - One standard drink = 13.6 grams of alcohol - 142 of wine 12 percent - 43 of 40 percent - 341 of 5 percent (ml0 - PROBLEM – hard to gage a what a drink is Contd - Origins – genetic factors (twin studies) M more then F more for 100 then 50% – sociodemo factors low SES - Overall a gradual process invoolvingg process involving physiological behavioural and soci cultural variables indices alcohol use (parents perrs shape behaviours) stress buffer – social event =learned early) - Appears to be 2 windows of vuln - Chem. Dep starts 12 and 21 peaks 18 to 25 - Late middle age coping method for managing stress - Late is death Treatment - 10 to 20 percent of alc stop drinking on theor own – cold turkey - 32 pecent stop sith minimal ass – maturing out – later years of life - Cb mod programs – but 60 percent dropout - Alcho from high ses and are highly socially stable env do better in treatment programs 68 vs 18 pecent - Numbers 2 things still work to be done and know low ses greater risk so how do we figure out tech and needs of low ses soci unstable areas Pine river inst - A res treatment center outdooe leadership experience for youth 13 to 19 who are in crisis largely as a result of addictive behavior - Unique holistic treatment and edu model based on the developmentl needs of the adolescents and frounded in best practives for substance abuse treatmnr for youth - Family centered indi and offers felx length stay with average between 9 to 12 monts - Developmenat inmatureity – behviur, social, dependence Contd - 4 phases - 1. Outdoor leadership exper – alqonquin park – students live and work in nature – detoxing and from cues removed - 2. Residence - Live at pine river comapus - 4 hrs academics - 2 hrs phys act - 2 hrs group therapy - 1 hr expressive art - Free time and chores - No contact with family in 1 2 stage - 3. Pine river camp and home - Trans phase week on cam weekends at home - 4. Aftercare at home – extends to family - Finally grad and checkins - Some is subsidized but most from pockets of indi Smoking is single greatest cause of preventative death Smoking - Causes more deaths then combining aids coke heroine alc auto acc dires homicides and suicides Hwo ocmprimis health - 45000 deaths per year – many cardiovascular problems - Accounts for at least 30 percent of all cancer deaths - Linked to number of disorders – bladder, mouth, eso, lar and phar, Synergistic effects of smoking - Synergistic – enhances the detrimental effects of other risk factors compromising health - Smoking and ccholesteral – nicotine stims free fatty acids ---- inc synthesis of triglyxerides --- dec hdl good chol production - Smoking plus stress - Men – nicotine --- inc heate rate reactivity to stress - Women – nicotine --- inc blood pressure - 4x inc in risk of breast cnaser after menopause - Genes that interfere with break down of cig chemical --- more chemicals in bloodstream Percent of Canadian men women and teens who smoke in 65 – 2006 - Trend few people then before men more before but all the same - Increase and for teens some points Smoking cessation - Why? – physiologicall addictive and habit becomes ass with most daily activities, ingrained in lives - Treatment - 5 fold - Nicotine add - Smoking and quit history - Medical history comorbid psychological issue - Motivation, sekf effeicay, readiness to quit Addiction Dsm 4 nictotine related disorders - Nicotine dependence and nic withrdrawl no nic abuse Nic dep dis - 3 of 7 withibn last 12 monts - Tolerance - Withdrawl - Substance used in larger amounts loonger period then intended - Persistent desire or unsuccessful efforts to cut down or control - Great deal of time used to obtain or use - Imortatn activies given up or reduced
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