PSYC 3170 Chapter Notes - Chapter 5: Harm Reduction, Cognitive Therapy, Peer Pressure

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24 Apr 2012
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Health Psychology Chapter 5
Health Compromising Behaviours
o Many and several including smoking are addictive; difficult habits to ever break
Characteristics of health compromising behaviours:
o 1.Window of vulnerability in adolescence
Drinking in excess/smoking/drugs/sex/risk taking behaviours
Obesity though; usually in early childhood
o 2.Many behaviours tied to peer culture, as children learn from peers they like/admire
Self presentation process: young adults efforts to appear ‘’with it’’/socially hip
o 3.Many of these behaviours are pleasurable, enhance coping with stress, thrill seeking
o 4. Occur gradually: exposure to and susceptible behaviour, experiments, engages,
regulates
Not acquired all at one
o 5.Abuse Predicted by same factors:
Conflict with family, Poor self control,
Behaviours to cope and manage stressful life
Adolescents who have deviant behaviours, low self esteem, family problems
very likely to practice these behaviours
Long hours of employment tied with school creates high risk for high use of
substances
Poor school performance: Family problems, deviance, low esteem explain this
relationship
o 6. Problem behaviours are related to larger social structure in which they occur:
More common abuse in low class
Common in less health conscientious households
Lower class provides stress; hence abuse
Substance Dependence:
o Repeated self-administered substance; tolerance; withdrawal; compulsive behaviour
o Physical dependence: when body has adjusted to substance and incorporates the use
substance into normal functioning of body tissues
Involves tolerance-process which the body adapts to substances; requires more
n more
Craving: strong desire to engage in a behaviour or consume a substance
Paired with many environmental cues; triggers desire
Addiction: physically or psychologically dependant on substance
Withdrawal: unpleasant symptoms both physical/psychological ppl experience
when stop use of substance which they were dependent on
o Substance Costs:
40 bill in 2002
Smoking 43% of this
o Harm reduction:
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Strategy for dealing with substance abuse
Approach focuses on risk/consequences rather than use itself
Better focus on reducing for reduction of harm as opposed to unrealistic
elimination
Harm reduction most often used in a community level program
Ex: injections risk of hiv/aids
Most problematic in large cities
Some facility “” insite” show that 70% less likely to share if visit
How do they compromise health:
o Disorders associated:
Blood pressure, stroke, cirrhosis of liver, cancer
Sleep disorder
Immune alterations
Elevated infection risks
Cognitive impairments
Driving offences declining though
Disinhibits aggression; many suicides homicides under alcohol’s influence
More impulsive sexuality; probably rape related
Alcoholism/problem drinking:
o Alcoholic:
Physically addicted to alcohol
Show withdrawal symptoms
High tolerance for alc
Little self control
o Problem drinkers:
Substantial social/psychological, medical problems resulting from alcohol
o Both have seen some loss of memory
o Difficulty in performing ones job
o Legal encounters; convictions
Origins of alcoholism:
o `genetic factors appear implicated
o Younger women and women employed outside home catching up to men who have
higher rates/risks for alcoholism
o Socio-demographic factors of low income affect it too
Stress:
o Use to buffer impact of stress
o High rates in laid off workers
o Many drinking to enhance positive emotions and reduce negatives
o Lowers anxiety and improves self esteem temporarily
o Psychological rewards in drinking
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Social origins:
o Pleasant occasion drinking, socially
o 2 windows of vulnerability:
Age of 12-21
Middle age as coping method for stress
Depression:
o Social isolation
o Lack of employment
o Women who suffered violence and abuse; use
Treatment for alcoholism:
o Con be modified; 10-20 % stop on their own
o 32% can stop with minimal help
o Can be treated with cognitive-behavioural modification
o High dropout rates; 60% return to alcohol
o Heavily dependent on social environment
High socially do well in treatment
68%
Low socially do poorly in treatment
18%
Programs:
o AA: alcoholics anonymous most common source
o Treatment usually use a broad spectrum cognitive therapy to treat
biological/environmental factors in the problem
o Goals:
Decrease reinforcements of alcohol
Teach new behaviour inconsistent with alc abuse
Modify environment to include reinforcements to activities not involving alc
Coping techniques
o Hardcore’s: use detoxification
Short term intensive inpatient treatment followed by outpatient
Cognitive behavioural treatments:
o Self monitoring phase:
Understand situation of drinking and targets
o Contingency contracting: costly outcomes to drink
o Motivational enhancement included in many cognitive approaches
o Some programs use drugs:
Naltrexone: prevent relapse
Blocks opiod receptors in brain weakening rewards of drinking
Acamprosate(Campral): maintains abstinence
Modifying GABA neurotransmitters
o Many have tied stress-management into it; since its tied into drinking
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