health chapter 16: human adjustment john w. santrock mcgraw-hill © 2006 by the mcgraw-hill...
TRANSCRIPT
Health
Chapter 16:
Human AdjustmentJohn W. Santrock
McGraw-Hill © 2006 by The McGraw-Hill Companies, Inc. All rights reserved.
McGraw-Hill ©2006 by the McGraw-Hill Companies, Inc. All rights reserved.
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Chapter Outline
Explaining Health and Illness
Nutrition and Eating
Exercise
Drugs and Addiction
The Patient and the Health-Care Setting
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Learning Goals
1. Describe some key factors in health and illness
2. Discuss nutrition, eating behavior, and eating problems
3. Summarize the role of exercise in health
4. Explain drug use and addiction
5. Characterize some important aspects of the patient and the health-care setting
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EXPLAINING HEALTH AND ILLNESS
The Bio-Psycho-Social Model
Psychological Factors in Health and Illness
Social Factors in Health and Illness
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The Bio-Psycho-Social Model
Bio-psycho-social model - health is best understood in terms of a combination of biological, psychological, and social factors
Biological
Psychological
Social
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Psychological Factors in Health and Illness
Psychological factors proposed as causes of health problems include:– lack of self-control
–emotional turmoil
–negative thinking
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Psychological Factors in Health and Illness
Positive emotional states are associated with health patterns of physiological functioning in cardiovascular system and immune system–Positive emotions linked with release of secretory
immunoglobin A, antibody defense for common cold
Mood also influences people’s beliefs about their ability to carry out health-promoting behaviors
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Social Factors in Health and Illness
Frequency and intensity of health problems vary across cultures
Variations linked to cultural differences:– social
–economic
– technological
– religious
–poor health care
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Social Factors in Health and Illness
Social factors that influence health:– frequency of daily stressors
–unhealthy lifestyles
–poor health care
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Review - Learning Goal 1
–How is the bio-psycho-social model of health defined?
–What are some psychological influences on health?
–What are some social influences on health?
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NUTRITION AND EATING
Nutrition and Eating Behavior
Eating Problems
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The Food Guide Pyramid
The Food Guide Pyramid consists of recommended daily servings of food, with an emphasis on consuming more bread, cereals, rice, pasta, and vegetables than milk, meats, fats, oils, and sweets–The Food Guide is being revised by U.S. Department of
Agriculture
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16-13Adjustment Strategies for Eating Right
1. Study the Food Guide Pyramid and monitor proposed changes in it
2. Follow a diet low in fat, saturated fat, and cholesterol
3. Substitute plenty of vegetables, fruits, and grain products for unhealthy food
4. Use sugar only in moderation
5. Use sodium in moderation
6. Drink plenty of water
7. Eat breakfast every day
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Nutrition and Eating Behavior
–Cross-cultural study of women found strong correlation between fat consumption and death rates from breast cancer
–Food restriction in laboratory animals can increase the animal’s lifespan
–Whether low-calorie diets can increase human lifespan is not known
–Recent research suggests the possibility that some vitamin supplements help slow the aging process and improve health of older adults
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Obesity
Obesity is a serious and pervasive health problem for many individuals–Prevalence of obesity in U.S. adults is 25 percent
–Obesity is linked to increased risk of hypertension, diabetes, and cardiovascular disease
Body mass index - measure of weight in relation to height, used to determine whether an individual is underweight, healthy weight, overweight, or obese
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Obesity
Factors likely involved in obesity include:–heredity
– leptin
– set point and metabolism
–environmental factors
–ethnicity
–gender
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Heredity and Obesity
Some individuals inherit a tendency to be overweight Animals can be inbred to be obese Human twins have similar weights, even when they are
reared apart
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Leptin
Leptin acts as an anti-obesity hormone
Leptin = protein involved in satiety (condition of being full to satisfaction) and released by cells resulting in decreased food intake and increased energy expenditure
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Leptin
In humans, leptin concentrations have been linked with:–weight
–percentage of body fat
–weight loss in a single diet episode
– cumulative percentage of weight loss in all diet episodes
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Set Point and Metabolism
Set point - weight maintained when no effort is made to gain or lose weight
Fat is stored in adipose cells
When people gain weight, the number of their fat cells increases–Some scientists suggest these fat cells do not decrease
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Set Point and Metabolism
Basal metabolism rate (BMR) - minimal amount of energy an individual uses in a resting state–BMR decreases gradually during adulthood
Weight gain can be due to declining basal metabolism rate
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Environmental Factors in Obesity
Our earliest ancestors probably developed preference for sweets because ripe fruit was accessible
The dramatic increase in rate of obesity in the United States is likely due to greater availability of food, energy-saving devices, and declining physical activity
Sociocultural factors are involved in obesity, which is six times more prevalent among women with low incomes
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Dieting and Obesity
Many Americans are obsessed with dieting Restrained eaters - individuals who chronically restrict
food intake to control their weight–Restrained eaters are often on diets, very conscious of what
they eat, and feel guilty after splurging on sweets
Many Americans regularly start diets, but few are successful in keeping weight off
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Dieting and Obesity
Current hot trend is low-carbohydrate diet promoted by Robert Atkins
Short-term - individuals on low-carbohydrate diet do lose weight
Long-term - studies not yet done–Atkins diet may pose health risks - foods high in fats
increase risk of heart disease and cancer-food restricted reduce heart disease, cancer and other diseases
Weight cycling (yo-yo dieting) is linked with some chronic diseases
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Adjustment Strategies for Losing Weight
1. Exercise regularly2. Keep a food diary3. Shop from a list and don’t shop when hungry4. Minimize exposure to food cues5. Use smaller plate with smaller servings6. Eat at the table with the TV off7. At restaurants, eat only half your meal8. Don’t starve yourself all day and then eat one big meal in the evening9. Seek support from family and friends10. Be realistic about weight loss goals
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Anorexia Nervosa
Anorexia typically begins in teenage years Ten times more likely to affect females
Anorexia nervosa = eating disorder that involves relentless pursuit of thinness through starvation
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Anorexia Nervosa
Characteristics of anorexia nervosa include:–weighing less than 85% of what is considered normal
–having intense fear of gaining weight
–having a distorted image of body
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Bulimia Nervosa
A Bulimic goes on an eating binge and then purges by self-induced vomiting or use of a laxative–90% of bulimics are women
Bulimia nervosa = eating disorder in which individual consistently follows a binge-and-purge eating pattern
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Bulimia Nervosa
Most bulimics are:–preoccupied with food
–have strong fear of becoming overweight
–are depressed or anxious
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Review - Learning Goal 2
–What is the Food Guide Pyramid and how is it changing? What are some cultural variations in eating behavior? What are some links between nutrition and longevity?
–What characterizes obesity and dieting? What are anorexia nervosa and bulimia nervosa?
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EXERCISE
The Benefits of Exercise
Exercise and Longevity
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The Benefits of Exercise
Exercise helps to prevent heart disease
Aerobic exercise = sustained exercise that stimulates heart and lung activity
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The Benefits of Exercise
Regardless of other risk factors (smoking, high blood pressure, overweight, heredity), if you exercise enough to burn over 2,000 calories a week you can cut risk of heart attack by two-thirds
Health experts recommend at least 30 minutes of moderate-intensity physical activity a day
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The Benefits of Exercise
Exercise also benefits mental health:– improves self-concept
– reduces anxiety
– reduces depression
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Exercise and Longevity
Regular exercise can lead to healthier life as a middle-aged and older adult and increase longevity
Gerontologists recommend strength training in addition to aerobic activity and stretching for older adults–Weight-lifting can preserve and
possibly increase muscle mass in older adults
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Exercising and Aging
Conclusions on exercise and aging:– can influence physiological changes in brain tissue
associated with aging– can optimize body composition– is related to prevention of chronic diseases– is associated with improvement in many diseases– is related to prevention of disability– can be used to counteract side-effects of standard medical
care– is linked to increased longevity
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16-37Adjustment Strategies for Exercising Regularly
1. Consult with your doctor and get a physical exam
2. Make exercise a high priority in your life
3. Reduce TV time
4. Chart your progress
5. Get rid of excuses
6. Learn more about exercise
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Review - Learning Goal 3
–What is aerobic exercise? What are the benefits of exercise?
–What is the connection between exercise and longevity?
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DRUGS AND ADDICTION
Psychoactive Drugs
Addiction
Alcohol
Smoking
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Psychoactive Drugs
Psychoactive drugs = substances that act on the nervous system to alter states of consciousness, modify perceptions, and change moods
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Psychoactive Drugs
Psychoactive drugs have been classified into three main categories:–Depressants - drugs that slow down the nervous system,
body functions, and behaviors
–Stimulants - drugs that increase activity of the nervous system
–Hallucinogens - drugs that modify an individual’s perceptual experiences and produce hallucinations
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Addiction
Psychological dependence = person is preoccupied with a drug for emotional reasons (such as reduction of stress)
Physical dependence = discontinuing use of a drug creates unpleasant, significant changes in physical functioning and behavior
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Addiction
Withdrawal changes can include:– insomnia– tremors–nausea– vomiting– cramps–elevation of heart rate and blood pressure– convulsions–anxiety–depression
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Models of Addiction
Disease model of addiction - addictions are biologically based, lifelong diseases that involve loss of control over behavior and require medical and/or spiritual treatment for recovery
–Disease model supported by medical profession and Alcoholics Anonymous (AA)
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Models of Addiction
Life-process model of addiction - addiction is a habitual response and a source of gratification or security that can be understood best in the context of social relationships and experiences
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Alcohol
Alcohol acts on the body as a depressant
Approximately 1.4 million people in United States are alcoholics
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16-47Drinking in College Students and Young Adults
Almost half of college binge drinkers reported problems that include:–missing classes
–physical injuries
– trouble with police
Rate of binge drinking is about 44 percent
By the time individuals reach mid-20s, many have reduced their use of alcohol
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Alcoholism
Alcoholism = disorder that involves long-term, repeated, uncontrolled, compulsive, and excessive use of alcoholic beverages and that impairs the drinker’s health and social relationships
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Alcoholism
Both genetic and environmental factors play a role in alcoholism–Heredity likely plays a role in half of the cases of alcoholism
About one-third of alcoholics recover
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16-50Adjustment Strategies for Curbing Alcohol Use
1. Admit you have a problem
2. Write down your reasons for cutting down your drinking
3. Set a drinking goal and keep a diary
4. Don’t ignore what others are saying to you
5. Don’t go out with others who make you feel uncomfortable if you are not drinking
6. Don’t keep beer, wine, or hard liquor at home
7. Seek help for your problem
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Smoking
Smoking is linked to–30% of cancer deaths
–21% of heart disease deaths
–82% of chronic pulmonary disease deaths
Most adult smokers would like to quit, but their addiction to nicotine makes quitting a challenge
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16-52Adjustment Strategies for Quitting Smoking
1. Develop a strong self-motivation to quit
2. Use a substitute source of nicotine
3. Take the antidepressant Bupropion ST (Zyban)
4. Control stimuli associated with smoking
5. Undergo aversive conditioning
6. Go “cold turkey”
7. Stay smoke-free
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Review - Learning Goal 4
–What are psychoactive drugs? What are the three main classifications of psychoactive drugs?
–What is addiction? What are two models of addiction?
–What is the effect of alcohol use, and how extensive is it? What is alcoholism?
–What are the effects of smoking cigarettes, and how extensive is cigarette smoking in the United States? How effective are strategies for quitting smoking?
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16-54THE PATIENT AND THE HEALTH-CARE SETTING
Recognizing and Interpreting Symptoms
Seeking Treatment
The Patient’s Role
Adherence to Medical Advice and Treatment
Socioeconomic Status and Ethnicity
Gender
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Recognizing and Interpreting Symptoms
Many people are not very accurate at recognizing they have symptoms of an illness–People are better at recognizing symptoms of illnesses they
are familiar with than illnesses they are less familiar with
We use schemas (organized ways of looking at things that influence our expectations) to interpret information about ourselves in our world–Prior experience is often used to interpret
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Seeking Treatment
Whether or not we seek treatment for symptoms depends on our perception of their severity and of the likelihood that medical treatment will relieve or eliminate them
When people direct their attention outward, they are less likely to notice symptoms than when they direct their attention inward–Belief systems influence our response to symptoms
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The Patient’s Role
Shelley Taylor (1979) identified two general types of patient roles:– “good patient” role - patient who is passive and
unquestioning and behaves properly
– “bad patient” role - patient who complains to staff, demands attention, disobeys staff orders, and generally misbehaves
Realistic expectations about the hospital experience, predictable events, and social support reduce the stress of hospitalization
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16-58Adherence to Medical Advice and Treatment
One-third of patients fail to follow recommended treatments–Adherence depends on the disorder and the
recommendation
Success or failure in treatment may depend on whether the doctor can convince patients that a valid, believable danger exists and can offer an effective, concrete strategy for coping with the problem
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Socioeconomic Status and Ethnicity
Individuals from low socioeconomic status backgrounds use medical services less than individuals from middle and high socioeconomic status backgrounds–Many individuals living in poverty do not receive regular
medical care
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Socioeconomic Status and Ethnicity
Language is often a barrier for unacculturated Latinos in doctor-patient communication
Depending on the degree of acculturation to Western society, Chinese Americans might go to either a folk healer or a Western doctor for care
Mexican Americans rely on family members to make decisions, and cannot make a quick decision when asked by a doctor
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Socioeconomic Status and Ethnicity
Health-care professionals can increase effectiveness with ethnic minority patients by: – improving their knowledge of patients’ attitudes, beliefs, and
folk practices regarding health and disease
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Gender
Special concerns about women’s health focus on:–unintended and unwanted pregnancy–abuse and violence–AIDS– role of poverty in women’s health–eating disorders–drug abuse–breast diseases– reproductive health–discrimination of medical establishment against women
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Gender
In one study, physicians described men and women patients differently: –men - characterized as direct, logical, good decision
makers, and rarely emotional
–women - characterized as excitable in minor crises, more easily influenced, less adventurous, less independent, and illogical
Most medical research has been done with men, and results generalized to women without justification
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Review - Learning Goal 5
–How good are individuals at recognizing and interpreting symptoms?
–What factors influence whether individuals seek treatment?
–What are “good patient” and “bad patient” roles?
–To what extent do individuals adhere to medical advice and treatment?
–What roles do socioeconomic status and ethnicity play in health care?
–How is gender involved in the health-care system?
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End of Chapter 16