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Chapter 5

Chapter 5 Risky Health Behaviours.docx

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Psychology 2036A/B
Sarah Khan

Chapter 5 Risky Health Behaviours Section I Unintentional Injury and Violence Motor Vehicle Accidents - Why do adolescents have higher accident rates? Factors: inexperience, driver’s age, distraction Nighttime Driving - Driving hazards are poorly illuminated when dark - The US and Canada have adopted a graduated license law (GDL) that issues first-time adolescent drivers a provisional driving license – limits adolescents to driving only under specific conditions o i.e. Prohibition from driving at night or with other teenage passengers - The provisional license provides a test period, an opportunity for the new driver to establish an accident/incident-free driving record - Current finding show that the provisional or graduated license have helped reduce adolescent automobile accidents and other driving-related incidences by 9%-41% Seat Belts - Seat belt use reduces the number of fatal injured due to automobile accidents - Before the seat belt legislation (1999), 54% of adults in automobile accidents died after reaching the hospital - After the legislation, the fatality rate associated with automobile accidents dropped by 17% after hospitalization - Requiring individuals to use seat belts as a matter of law requires them to adopt a behaviour that improves this health outcomes in the event of an auto accident Type of Motor Vehicle - Motorcycles o No seat belt o Structure of motorcycle  little protections against other vehicles o Riding without helmet - Fatal motor vehicle injury rates are higher for motorcycle riders than for all other forms of motorized travel - Motorcyclists referred to as “organ donors” by many ER physicians Violence - Homicide – killing another person - Physical assault – physical confrontation with another person that could include hitting, shoving, kicking, or other physically aggressive behaviours - Violence can also be defined more broadly as the intentional use of force against another person, a community, or even against oneself o According to this definition, suicide is also an act of violence - The psychological impact of living in a violent or potentially violent environment leads some adolescents to carry tools that may increase the chances of violent confrontation o E.g. teenagers carrying weapons (i.e. guns) to school to protect them from unwanted confrontations - The CDC Youth Risk Behaviour study also revealed a gender difference in the likelihood of carrying weapons to school o Males were much more likely to carry weapons/guns than females o To date, all initiators of high school or college mass shootings have been males o 6% of students in the survey stated that when concerned about their safety at school, they chose to be absent - Both these behaviours demonstrate fear or apprehension of violent encounters regardless of whether a person has firsthand exposure to violence - Both can lead to emotional or psychological health problems as a result of exposure to or fear of injury due to violence Domestic Violence - Def: actions by one person in a relationship intended to control or dominate another. The actions can be physical, sexual, or emotional and may include acts of intimidations or threats - The term is used to describe abusive relationships between family members, or others sharing a living space - Includes: o Elder abuse – physical or emotional maltreatment of older persons o Child abuse – physical mistreatment of a child by an adults o Emotional abuse – psychological intimidation and trauma that can include physical acts - Several studies show that children and adolescence exposed to (although no the target of) domestic violence in the home experience psychological trauma due to witnessing the violence. They are also at greater risk for physical violence later in life at the hands of an abusive partner - Another group of studies points to the likelihood of children who, when abused by their parents, become abusive themselves o Even when a child is not raised in an abusive environment, researchers suggest that a pattern of aggressive behaviour in childhood is predictive of aggressive behaviour in adulthood - For males, childhood aggression represents a stable behavioural style that links male peer aggressive behaviour to violence toward their spouse and children Dating Violence - Def: aggressive and abusive behaviour between individuals who are not in committed relationships - For many who experience acts of physical or psychological aggression, domestic abuse is an embarrassing experience. The victim’s shame often prevents him or her from disclosing the experience; others fear the threats of retaliation by their abuser in the event that they reveal the truth  statistics are only based on severe underreporting - Increased media attention to domestic violence through television, radio, and print ads provides information and tangible assistance to people exposed to domestic abuse o Confidential hotlines o Counseling services o Domestic violence shelters - Many hospital emergency departments screen for and identify patients whose injuries were obtained as a result of domestic violence Suicide - Thethost widely recognized form of self-injury is (attempted) suicide - 11 leading cause of death in the US - Gender: o The CDC reports that deaths due to suicide are more prevalent among males than females – 8 leading cause for males but 16 for females o Among adults, the highest suicide rates are recorded for men 75 years of age or older  Older males commit suicide at a rate of 37.4/100,000 people  The highest suicide rate for women is 8.0/100,000 and occurs among the 40-50 year old age groups o Studies find that physical and mental health problems, SES problems4, or family and individual crises all contribute to high male suicide rates both in the US and globally - Age: o The suicide rates for older adults are considerably higher than for younger adults o 65y/o+: 1 of 4 attempts is successful o Young adults: 1 of 100-200 attempts is successful - Ethnic groups: o Prevalence for suicide among Native American and Alaskan Natives is almost twice as high as for other ethnicities  Primarily ages 15-34 o Leading cause appears to be societal problems; i.e. extreme poverty, poor education, lack of employment, social isolation and cultural marginalization - Suicide and self-injury is a form of violence that affects more than just the individual o Affects families and entire communities o Can cause psychological or emotional health problems for the victim’s social network o The impact of the act has residual effects on others - Suicide is a global health issue o Pronounced differences in suicide prevalence rates between developed vs. developing countries o Suicide rates are highest in western and eastern Europe, the Soviet Union, China, and Japan o Rates are lowest in Africa and the Southern Pacific o Rates suggest that a country’s SES, individual factors and societal factors are important determinants of suicide rates Section II Substance Use and Abuse: Influence of Culture, Age and Gender Cigarettes - Smoking was the primary or contributing cause of death for over 440,000 adults in the US (2000) - It remains the leading preventable cause of death and the leading cause of death due to disease in the US - Smoking causes more deaths than AIDS, alcohol, automobile accidents, cocaine, fires, heroin, homicides and suicides combined Social Norms and Environmental Factors - Product manufacturers are skilled in promoting and selling their products to their intended audiences - Advertisements promote smoking as socially normative behaviour – behaviour widely accepted by society o Sometimes these ads specifically target children by using cartoon characters, smoking logos and items with cigarette logos o i.e. Joe Camel - The Joe Camel campaign was so successful that Camel product manufacturers saw a 31% increase in their share of the illegal children’s cigarette market - Factor of early initiation of adolescents into smoking: direct and indirect marketing to young audiences Social Role Models - Research suggests that smoking on “the silver screen” has a direct and indirect effect on adolescent smoking - Indirect effect - smoking behaviour that is influenced or mediated by a secondary factor o i.e. peers who smoke - Studies suggest that teens exposed to smoking by actors in movies are more likely to associated with peers who smoke - Teens who associate with other teens who smokes are themselves likely to begin smoking - Research also suggests that teen smoking rates increase when the on-screen smoking is done by an adolescent’s favourite movie star o Among adolescent girls who never smoked, the on-screen smoking behaviour of their favourite actor strongly predicted smoking initiation o Nonsmoking boys were not as affected by the actions of their favourite on-screen actors - Effective marketing may have encouraged children and adolescents to view smoking as a desirable or even an expected behaviour - Additionally, studies suggest that adolescent smoking behaviour can be encouraged by exposure to individuals who model smoking behaviours o i.e. Movie stars/peers Culture and Gender - Adolescents also credit their family members as smoking models - Many adolescent report that their first experience with cigarettes usually occurred in the presence of friends or older siblings who smoke - Cultural practices can also influence smoking patterns – China and India are homes to the largest number of tobacco consumers o China and India are nations in which smoking is a common or normative behaviour - Extensive health promotion campaigns in the US, designed to decrease smoking rates over the past 30 years, have changed the culture of smoking in the US - Hispanic and African American males and white females were most likely to smoke - Researchers contend that ethnic differences in smoking reflects an acculturation process – an effort to change one’s attitudes, values, or behaviours to adopt the attitudes, values, and behaviours of a dominant ethnic group - In sum, perceived social norms, culture, and gender influence smoking initiation and general smoking behaviours Theories of Substance Abuse - Research on substance use behaviour tends to focus on adolescents - Examining early onset of such behaviours helps to identify and assess the factors that contribute to substance abuse behaviours in the short and long term - Studies suggest that environmental, social, and cultural factors all contribute to adolescent smoking patterns - Cognitive-Affective Theories o Propose that three factors influence the likelihood of substance abuse:  An adolescent’s positive attitudes about substance use  The endorsement of substance use by others  An individual’s decision that the benefits of substance use outweigh the costs o Include Azjen’s theory of reasoned action and theory of planned behaviour and Rosenstock’s health belief model - Social Learning Theories o Includes Bandura’s social cognitive theory and Akers’ social learning theory o Substance use is explained as a behaviour rooted in the attitudes and beliefs of the adolescent’s role models, close friends, and parents o By observing the context in which role models use substances and the consequences of use, adolescents form attitudes about smoking and the perceived likely consequence of their decision to use - Conventional Commitment Theories o View adolescents’ level of attachment to conventional social institutions (family, school, religious institutions) as buffers against substance use o Buffers are the factors that protect an adolescent from initiating substance use behaviours o Conventional commitment theorists claim that weak bonds to structured systems will lead to a lack of commitment to the social norms of the institutions that help guide behaviour  Weak bonds lead to a greater likelihood of involvement with other adolescents with similar weak ties, which can lead to “deviant” behaviours o According to conventional commitment theorists, the adolescent’s behaviour is not brought about by a desire to rebel, but rather by an absence of close personal ties to the institution - Personality Trait Theories o Individual characteristics of the adolescents and their social settings may influence the timing and occurrence of substance use o Generalized stress and generalized low self-esteem may explain more about the likelihood of substance use than conventional commitment or social normative beliefs o Trait theorists hold that an individual’s methods of coping with highly stressful environments may shape the decision to use - Integration Theories o Include elements of the 4 other categories of theories o Includes the problem-behaviour theory  Examines early substance use behaviour in the context of other problem behaviours that may occur o Adolescents who exhibit one problem behaviour, such as substance use, are prone to engage in other problem behaviours also o Peer cluster theory  Focuses on the role of peers in influencing substance use, and the model of vulnerability, which suggests a genetic or biological determinant of substance use Alcohol - Some studies suggest that moderate consumption of alcohol can be beneficial to one’s health o Example: red win contains plant phenolics (chemical compounds that serve as antioxidants) that protect against some forms of CV disease and cancer - Alcohol is not the problem – excessive consumption or alcohol abuse is the problem Excessive Consrdption of Alcohol - The 3 leading cause of preventable deaths in the US – approx. 75,000 people in the US - CDC: a standard drink of alcohol is defined as one that contains approx. 0.5 ounces (1.2 tbs) of pure alcohol - Excessive alcohol consumption can be characterized by heavy drinking or binge drinking - Heavy drinking is defined by consuming five or more drinks in a day - Binge drinking is defined by consuming five or more drinks in a single sitting or within two hours - Excessive drinking poses serious health risks to the consumer and to others o Consumer: GI problems, heart disease, strokes, cancer of mouth, throat, liver, and prostate - Cirrhosis – scarring and inflammation of the liver - Can also contribute to neurological and psychiatric problems and greater likelihood of involvement in other risky behaviours such as risky sexual behaviours - Alcohol abuse also affects family members, friends, and communities o Excessive drinking exposes family members to increased risk of violence – intimate partner violence and child abuse - Alcohol abuse in pregnant mother can cause fetal alcohol syndrome – causing physical and mental abnormalities in the developing fetus o Abnormal facial features, growth deficiencies, and problems with the CNS - Studies shows higher alcohol consumption is associated with speci
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