314 - MT2 Flashcards
cost effectiveness of healthy lifestyles
- occurs through…
less costly than treatment of disease
- occurs through indiv efforts, interaction (env shapes behav) w medical syst, mass media and legislation
Health enhancing vs health compromising behaviours
Health enhancing: exercise, eating healthy, sleep»_space; promote health
Health compromising; excessive drinking, smoking, drug use, unsafe sex, risk-taking behaviours»_space; undermine or harm current/future health
health and behaviour factors
- disease pattern change?
- deaths
- most preventable cause of death
- patterns of disease in North America have changed from acute infectious disorders to “preventable” disorders
- half of deaths are caused by preventable behaviours
- obesity/lack of exercise»_space; about to overtake tobacco as most preventable cause of death
obesity
- BMI + risk
- 1994 to 2013 change
- biological links?
- countries involved?
- age/gender
- eating disorders
- overweight if BMI is 25+, obese if body mass index (BMI) is 30 or higher»_space; measure of adult’s weight in relation to height»_space; disease risk increases as BMI increases beyond normal level
- age adjusted prevalence of obesity and diagnosed diabetes among US adults»_space; went from 14% in 1994 to more than 26% in 2013 (very high!)
- correlation is not causation! but there are biological links
- obesity not limited to the US»_space; rates are high in US/Mexico, medium in Canada (nearly 1/3 of CAD are obese!) /European countries, and low in Asian countries
- age also plays a role»_space; mostly 55-64yo are obese compared to other age groups
- more men obese than women
- eating disorders are also prevalent (BMI < 18.5)
health advocates (3)
- want calorie counts on menus (became part of legislation in Ontario, 2017)
- advocate for tax on sugary drinks (did not pass, but normal sales tax was added)
- want to take vending machines away
Health habits (3)
- change?
- how do they happen?
- when are they developed?
- predictors
- attitude/beliefs
- health-related behaviour»_space; firmly established, stable, but can change over time
- often automatic»_space; occurs outside awareness
- often developed in childhood»_space; typically stabilize around age 11-12
- health behaviours are not strongly tied to each other»_space; doing one does not predict doing others
- health behaviours are not governed by single set of attitudes or beliefs
eg. social encouragement: dieting, seat belts
eg. people changing: experience, peer pressure
socialization influences early health habits (3)
- window of vulnerability
- parents: model»_space; brushing teeth, wearing seatbelt
- social institutions: increase physical activity required, encourages healthy snacks at school
- peers
Window of Vulnerability: adolescents may ignore early training
- adolescents are particularly vulnerable (body changes = feeling awk = less exercise)
- poor diet, smoking, alcohol/drug use, risky sexual behaviour, low phys activity
Targeting at risk ppl
- prognosis
- tailoring
- problems (3)
- early identification may benefit prognosis
- knowledge helps monitoring»_space; tailor to high risk ppl
problems:
- most ppl don’t always perceive risk correctly
- most ppl are unrealistically optimistic ( difficult to target those who are at risk because they think it won’t happen to them)
- stress»_space; don’t stress out the ppl ur trying to help by scaring them!
teachable moment
2 examples
certain moments are better than others for teaching particular health practices
eg. emphasize teeth brushing at dentist visit
eg. stopping smoking during pregnancy
percentage of death
- 1960s vs now
- why?
in the 1960s it was mostly (50.6%) CVD»_space; heart disease, stroke»_space; now its mostly cancer (28%)
- result of behaviour risk factor modifications/medial treatment
health behaviour
- well behaviour
- symptom-based behaviour
- sick-role behaviour
- breast cancer health behaviour
- any activity trying to maintain/improve health, regardless of if it works
well behaviour: maintain/improve health or avoid illness
- depends on motivational factors»_space; perception of threat of disease (if you’re not sick you won’t try to be especially healthy»_space; good diet, exercise, etc)
symptom behaviour: ill person tries to determine and fix problem»_space; complaining, seeking help
sick role behaviour: treat illness»_space; adjust lifestyle
- sick ppl have a special “role”»_space; exempt from obligations/tasks»_space; stay home from school/work to recover
breast cancer health behaviour: women ages of 50-69 should get mammogram every 2 years (self/physician check not effective)
Illness prevention
- clean teeth example
- primary, secondary, tertiary prevention
Example: having clean teeth
- behavioural influence (brush teeth)
- environmental measures (put fluoride in the water supply)
- preventative medical efforts (repair cavities)
- primary prevention: actions to avoid disease/injury
- secondary prevention: actions to identify/treat illness or injury»_space; stop/reverse problem
- symptom-based behaviour
eg. physical examinations yearly - tertiary prevention: actions to contain damage done by serious injury/progressed disease»_space; prevent disability/reoccurrence + rehab
problems in promoting wellness
- individual (3)
- interpersonal
- community (+ problems)
Individual: health behaviours are less appealing and less convenient than unhealthy behav
- little incentive to change immediately, especially if healthy
- hard to change habits, need knowledge, planning skills and self-efficacy
- being sick/on drugs affects mood/energy/cog resources/motivation
Interpersonal: social factors»_space; marriage partners adopt each other’s behaviours»_space; family dynamics may get interrupted (eg. they go eat out when you’re on diet)
Community: more likely to do if gov’t/healthcare systems encourage
problems: insufficient funds for research, hard to adjust to diff age/sociocultural backgrounds, lacking safe spaces for exercise, fast food restaurant, health insurance
Reinforcement
+/-
Extinction
results in desirable state of affairs
- positive reinforcement: reward added
- negative reinforcement: bad thing removed
extinction: if consequence of behaviour is eliminated, response tendency is weakened gradually
modeling and antecedents
modeling: learning vicariously (observational learning)
antecedents: internal/external stimuli that precede and set occasion
for behaviour»_space; habits
eg. coffee with cigarette after breakfast
conscientiousness association
dutiful, organized»_space; associated with practicing health behaviours (fitness, healthy diet, taking prescribed meds, etc)
optimistic beliefs
- ppl who partake in health behaviours
- health professionals
- ppl have feelings of invulnerability at all ages
- ppl with health behaviours feel less at risk for health problems»_space; unrealistically optimistic»_space; unlikely to take preventative action
- health professionals implement programs to make ppl see risks realistically
A. Health belief model
- definition
- barrier examples (3)
- perceived threat factors (3)
- sum
- shortcomings (3)
taking preventive action depends on assessment of threat to person and weight pros(benefits to health)/cons (barriers»_space; perceived costs) of taking action
eg. financial, psychological (embarrassing), or physical (distance to doctor’s office too far)
perceived threat factors:
- perceived seriousness (if left untreated)
- perceived susceptibility (likelihood of development)
- cues to action (reminders)
sum = benefits - barriers: extent to which taking action is more beneficial than not
Shortcomings:
- does not take into account habitual health behaviours (eg. brushing teeth)
- no standard way of measuring components
- perceived susceptibility/seriousness
- diff surveys used to measure - assumes that ppl think about risks in a detailed manner
B. Theory of Planned Behaviour
- intention (barriers, env, health goals)
- attitude
- subjective norm
- perceived behavioural control
- support for theory
- shortcomings (4)
ppl decide their intention in advance»_space; intentions are the best predictors of what ppl will do (goals make it much more likely)»_space; linking attitudes and intentions directly to behaviour
intention: do I intend to change my behaviour?»_space; just intention alone may not be enough
- barriers (like time, other business) get in the way
- environmental factors (eg. weather/seasonal effects)
- health goals are especially hard since you have to change complex habitual behaviour
- attitude regarding the behaviour (is it a good thing to do?)
- based on the outcome, and whether it would be rewarding (what will happen if I change my behaviour?) - subjective norm (impact of social pressure/behaviour’s appropriateness»_space; based on other’s opinions (env) and motivation to comply
- perceived behavioural control (self-efficacy)»_space; expectation of success
- judgements combine to form intention»_space; leads to performance
- If you have all 3 it will likely result in the intended behaviour!
support: empirical evidence for ToPB across a broad spectrum of health behaviours: flossing, phys activity, fruit/veg consumption, seat-belt use, and breast self-examination»_space; all based on separate long-term longitudinal studies and clinical trials with N>100 participants
shortcomings:
- intentions and behaviour are not strongly correlated»_space; ppl don’t always do what they claim to decide »_space; intentions can change
- incomplete»_space; does not take experiences with the behaviour into account»_space; more likely to do again if done before
- assumes that ppl think about risks in a detailed manner
- does not account for habitual health behaviours
Theory of planned behaviour
- planning»_space; mental simulation
a) action plans
b) coping plans
planning: the bridge between goals (recommendations»_space; in order to maintain/see it through) and behaviour»_space; key variable in health behaviour
- beyond intention
- a mental simulation commits the indiv to perform a behaviour once the critical situation is encountered
a) action plans: plans regarding the initiation of behaviour (when, where, how structure)»_space; break it down into actionable units
b) coping plans: plans regarding the maintenance of behav in the face of barriers»_space; plan B instead of dropping behaviour
C. Stages of Change Model
- what does it do?
- 5 stages
- importance of timing
readiness to change
- help people advance: describe in detail how to carry out change, plan for problems that may arise»_space; provides a framework for a wide range of potential interactions by health promoters (if they have a negative response, you need to talk to them about their failures/obstacles)
- the model identifies a number of stages which a person can go through during the process of behav change
stages:
- precontemplation: not considering changing»_space; refuse/not thought about it
- motivational enhancement strategies - contemplation: aware that a problem exists»_space; considering changing, not ready
- assessment and treatment matching - preparation: plan to pursue behaviour goal
- action: active efforts to change behav
- maintenance: maintain successful changes
- relapse prevention/management
- important to know where they are at so that you can tailor the message to suit their needs
eg. if theyre already committed you dont want to bore them by trying to convince them
eg. if you try talking about obstacle management but they don’t even know the risks yet, you will miss the opportunity to bring them in
gender and health
- who lives longer?
why?
- hormones (stress, estrogen)
- health compromising behaviours
- work
- consulting
- women tend to live a few years longer than men, but women have higher rates of acute diseases
- physiological reactivity (blood pressure/stress hormones) affect men more
- estrogen delays CVD»_space; reduces cholesterol
- men smoke, drink, do drugs, eat unhealthily, become overweight and partake in risky sexual behaviours more than women
- work env for men is more hazardous»_space; more fatalities
- women more likely to consult a physician
Sociocultural factors and health
- relevance
- social status
- immigrants
- biological factors
- cognitive/linguistic factors
- social and emotional factors
relevant on national and international levels
- social status: lower SES (eg. minority groups) = poorer health habits
- immigrants: adopt health behaviours of new culture (acculturation)
- biological factors: differ in physiological processes/stress reactivity
- cognitive/linguistic factors: diff ideas of illness causes, diff pain perception, language difference impairs ability to communicate
- social and emotional factors: differ in stress experienced (physiological reactivity) and coping; social support differs
Methods for promoting health
- providing info (3)
- features to enhance motivation (4)
- motivational interviewing»_space; decisions
- behavioural/cognitive methods»_space; prevention
Providing info: what to do, when, how, where
- mass media»_space; negative consequences
- internet»_space; websites
- medical settings»_space; Dr office»_space; advantages (once a year, respect for professionals) and disadvantages (tight scheduling, lack of expertise, dr may be intruding on personal life)
Features to enhance motivation:
- use tailored content»_space; specific to indiv
- educational appeals»_space; non-tailored, general info
- fear appeal»_space; motivated by fear to protect health
- message framing»_space; emphasize physical/social consequences , provide instructions
Motivational interviewing: resolve ambivalence in changing behav»_space; decisional balance and personalized feedback
Behavioural and cognitive methods: enhance ppls performance of preventive act»_space; manage antecedents and consequences»_space; enhance self-efficacy
HIV infection
- leads to?
- how does it spread?
- gender?
- circumcision?
human immunodeficiency virus: leads to AIDS (acquired immune deficiency syndrome)»_space; there is no vaccine
- spreads through contact of bodily fluids (eg. sex, drug needles)
- more common in males (75% of new cases)
- circumcised = much less risk of infection
Sleep facts
- who does not get recommended amt of sleep?
- why worsening?
- younger?
- 1/3 Canadians do not get the recommended 7 hours of sleep (worsening over time»_space; sleep durations have decreased over the past decade»_space; could be due to changes in technology use
- when ppl are younger (children/adolescents) they need more sleep
why is good sleep important?
- benefits of sleep (4)
- problems with lack of sleep (4)
sleep = the final frontier; not as studied as the other things such as diet/exercise
Benefits:
- reduces disease risk: CVD, cancer, hyperT, diabetes, pain, obesity, depn
- helps conserve energy
- helps consolidate memory and increase brain plasticity
- eliminate toxins and repair tissues
Problems with lack of sleep:
- attention, learning and memory (cognitive function): risk of accidents and impulsive/risky behaviour
- mood/psychological functioning (dep/anx): having psych issues puts at risk for sleep disorders like chronic insomnia
- interpersonal relationships strained»_space; less marital satisfaction
- quality of life is lower
Define good sleep S A T E D
are you SATED?
Satisfaction: self reported sleep quality
Alertness: day time functioning; how refreshing was your sleep?
Timing: bed time + wake time»_space; how consistent?
- at risk for metabolic problems if lacking consistency
Efficiency: time spent asleep divided by the time spent in bed (ideally 85-95%)
Duration: amount of time asleep (total sleep time)
- recommended adults get 7H of sleep every 24H
Two Process Model
- Process S (3 pts)
- Process C (4 pts)
- Factors (9)
- light
for normal sleep (in a typical adult)
- Homeostatic sleep drive: Process S (balance)
- need for sleep (pressure) increases the longer you are awake
- caused by accumulation of sleep-inducing substances (melatonin)
- homeostatic sleep drive is strongest around 10pm (when you normally sleep) - Circadian rhythm: Process C (pressure)
- internal biological clock that regulates periods of sleepiness/wakefulness throughout the day
- internal clock located in the suprachiasmatic nucleus (SCN), which is within the hypothalamus
- dips around 2-4am, and 1-3pm in adults
SCN synchronized by environmental cues (light exposure)»_space; makes you more awake and sets SCN pattern
- circ rhythm at its peak around 9pm»_space; keeping you awake despite process S
Factors: light (most important), food, temp, meds, substance use, meal times, naps, exercise, daily schedule»_space; direct or non-direct effects
Light: photosensitive retinal ganglion cells in the eyes sense brightness and send info to the SCN
SCN
- what is it
- full dark?
- light conditions (3)
- who does this affect most? (2)
master clock that determines continuous cycle of physiological changes within cells (hormones for waking/sleeping)
- when kept entirely in the dark circ rhythm barely changes
- too much/too little light/seeing light at wrong time of day can mess up internal clock
- problem for ppl who work at hight/ppl with sleep disorders and ppl with visual impairments (cant reach ganglion cells)
Disruptions to circadian rhythms
- jet lag (2)
- work
- timing
- light conditions (2)
- jet lag: body stuck in a diff time zone
- social jet lag: sleeping in on weekends
- working night shifts: especially irregular shifts»_space; metabolic problems
- irregular sleep/wake times
- too little light during day
- too much light at night
recommended amt of sleep for healthy adult
- consensus recommendation (age and amount)
- based on what?
- when is it appropriate to sleep 9+ hours?
consensus recommendation (experts >> Sleep Research Society and American Academy of Sleep Medicine) say that adults (18-60 yrs) should sleep 7+ hours per night on a regular basis to promote optimal health - based on studies of disease, cognition and safety
when is it appropriate to sleep 9+ hours?
- younger adults, ppl recovering from sleep debt (not sleeping enough for a long time), ppl with illnesses
- some ppl say too much sleep is bad
How did experts come up with 7+ hours for 18-60yo?
- studies (number, based on?)
- voting + statement
- which does not have a clear recommendation?
- reviewed >5k studies»_space; scientific evidence»_space; based on how good the studies were rated
- went through several rounds of voting»_space; for each hour range of sleep, each expert rated their agreement to the statement “based on the available evidence, [X] hours of sleep is associated with optimal health with the [X] subcategory in the [X] category (eg heart disease)
*only breast cancer doesn’t have a clear sleep rec
Sleep architecture
stage 1, 2, 3/4 and REM
tend to cycle through stages (if healthy sleep)»_space; 4-5 cycles
stage 1: 7 mins, light sleep
stage 2: light sleep, sleep spindles (bursts of brain activity/waves)»_space; HR and metabolism slow, body prepping for deep sleep
stage 3/4: SWS, deep sleep (delta waves)
- if woken from deep sleep you are disconnected
- SWS is most restorative»_space; repairs muscle/tissue/growth and devel/boosts immune fxn/build up energy for next day
- less time spent in deep sleep as you age»_space; impaired (major health complaint)
REM: rapid eye movement»_space; brain is active/dreaming»_space; similar to when awake»_space; important for memory consolidation (short to long term)
- tends to decrease as you get older
- occurs abt 90 mins after you fall asleep (10 mins long)»_space; inc duration as night goes on
sleep latency
- min/max times
- age factor
time it takes to fall asleep»_space; 10-15 mins in healthy adults
- if it takes less time you’re probs sleep deprived, but if it takes more than 30 mins = sign of insomnia
- as you get older it takes longer to fall asleep
WASO
- definition
- sign of insomnia?
wake after sleep onset
- how much time you’re awake during the night after you have fallen asleep the first time (tossing and turning)
- more than 30 mins = sign of insomnia»_space; inc w age
Study: metabolic consequences of sleep and circadian disruption
- research question
- methods (sample size, environment, 1 week, 3 weeks, 9 days)
- results (2)
Research Question: does prolonged sleep restriction w circadian disruption impair glucose regulation and metabolism in humans?
Methods:
- 21 participants (younger/older adults)
- stayed in controlled lab env for almost 6 weeks (light, food, temp and activities all controlled)
- 1 week of sleep saturation 10-16hrs»_space; make sure nobody is sleep deprived; get used to env
- 3 weeks of sleep restriction (5.6 hours per day) and disrupted circadian rhythms (sleep period staggered each day)
- after 3 weeks of disruption, had recovery period (9 days)»_space; 10-16hrs»_space; went back to normal (not permanent)»_space; both younger and older
Results: after 3 weeks of sleep restriction (reduced time in bed) and circadian disruption (disrupt inner clock)
- resting metabolic rate decreased
- insufficient insulin response after a meal»_space; resulting in too much glucose in blood
Insulin controls blood glucose levels
- insulin
- after eating
- what does insulin do?
- no insulin (2)
insulin: hormone made by pancreas»_space; allows body to use glucose (sugar) from food
- after eating, blood sugar is high
> pancreatic cells release insulin to bloodstream
> insulin signals fat cells to absorb sugar»_space; used for energy - insulin keeps blood sugar from getting too high (hyperglycemia) or too low (hypoglycemia)
- if there’s not enough insulin or body becomes resistant to insulin»_space; leads to metabolic problems (at risk for diabetes)
Study: younger adults vs older adults
- younger and older
- what else did they measure?
- effect?
younger adults: after disruption, glucose levels (at pre-diabetic level) are much higher than normal»_space; not mounting a sufficiently high insulin response
older adults: same as younger
- also measured resting metabolic rate»_space; oxygen consumption
- hint to metabolism»_space; changes in metabolic rate
- BIG effect on obesity/diabetes in the long term! (even tho this was only 3 weeks)
chronic insomnia
- definition
- causes
- statistics
3P model
- perpetuating behaviours
- precipitating situations
- predisposing factors
Definitions: pre-morbid, acute, early development, chronic
difficulty falling asleep, staying asleep, or getting refreshing sleep at least 3 times a week for past 3 months
- caused by increased arousal»_space; closely tied to stress/emotional issues/age
- in US, 1/10 adults have chronic insomnia, and 1/3 ppl experience 1 of the symptoms
3P model
- Perpetuating: behaviours that lead insomnia to continue over long term (chronic)»_space; caused by controllable behaviours such as poor sleeping habits, working (blue light)/worrying before bed (inc tension/cog arousal), medication/caffeine (stimulants which activate SNS)
- Precipitating: situations such as a new job/job stress, fam stress (caring for newborns, disabled ppl), illness/injury (brain injury/depression/chronic pain)
- can push you over the edge and cause early/acute insomnia - Predisposing: factors such as personality (neuroticism), hyperarousal, genetics, chronotype (night owls at greater risk for insomnia)
- not enough on its own to cause insomnia itself
pre-morbid = before insomnia acute = temporary symptoms early = early devel chronic = long term (3mo)
variability in sleep patterns
- mean
- more variability =? (6)
- depression
- pain conditions
- cross sectional data
- even if you’re getting a mean 7h of sleep (some days lots, some days little) and you don’t have any insomnia symptoms, you are at greater risk of health problems
- more night to night variability in sleep measures is associated w worse mental and physical health»_space; inflammation, depression, gastrointestinal and breathing problems (asthma), pain (arthritis, migraines), neurological diseases
- ppl who have depression have difficulty in regulation of sleep»_space; leads to variability
- pain conditions can disrupt sleep»_space; more inconsistent
- this is a correlation! not causation!»_space; cross sectional research = no directionality since you measure both at the same time
Promoting good sleep behaviours
- example + 2 reasons
- limit the amt of time awake in bed»_space; designed to decondition pre-sleep arousal (if you stay there and worry/be tense, it will be harder to sleep), and to re-associate bed with rapid onset, well-consolidated sleep
Typical instructions for sleep problems include… (6)
- keep a fixed wake time 7 days a week
- use bed for sleep and intimacy only»_space; dont do work in bed»_space; stress
- sleep nowhere else except bedroom
- if still awake after 15 min, leave bedroom and do something relaxing and return when sleepy
- keep naps <30 mins and before 3pm
- bright light in the morning (>30 mins)
addiction
- definition
Physical dependence
- tolerance
- withdrawal
Psychological dependence
- dependence potential
condition produced by repeated consumption of a psychoactive substance»_space; physical and psychological dependence
Physical dependence: body adjusted to substance»_space; becomes part of normal bodily functioning
- tolerance: body adapts»_space; requires larger doses to get same effect
- withdrawal: phys/psych symptoms when you stop/reduce substance use»_space; results in anxiety, instability, cravings, nausea, headaches, hallucinations and tremors
Psychological dependence: feel compelled to use substance for the effect even if they arent physically dependent
*dependence potential is high for cocaine/heroin, moderate for marijuana, and low for LSD
substance use disorder
- DSM-5»_space; symptoms (6)
- mild, moderate and severe disorders
Dagnostic and Statistical Manual of Mental Disorders (DSM-5)»_space; published by APA
Symptoms:
- great deal of time spent trying to obtain substance/recovering from use
- showing tolerance»_space; inc doses to attain same effect
- strong cravings
- failing to fulfill important obligations (eg. absence from work)
- repeated risks taken for phys injury (eg. drunk driving)
- substance-related legal difficulties (eg. arrested for disorderly conduct)
- having 2 is mild, 4-5 is moderate, and 6+ is a severe disorder
Remission: no longer meeting diagnostic criteria for dependency
Processes leading to dependence
- Reinforcement (positive/negative)
- avoiding withdrawal
- substance-related cues
- expectancies
- personality and emotional factors
- genetics
- smoking vs drinking
- adolescence vs adulthood
- environment
- Reinforcement
- positive reinforcement: feeling a rush/buzz
- negative reinforcement: stop cravings/dull pain/cope with stress - Avoiding withdrawal
- substance-related cues: associating substance use with internal or env stimuli that are regularly present
eg. smell of cig smoke (conditioned stimulus) is paired with the buzz feeling (unconditioned stimulus) you get after smoking - expectancies: from your own experiences/from watching others
eg. drinking is fun/sociable/grown up - Personality and emotional factors: impulsive, high-risk taking, sensation-seeking, low self-regulation ppl are more susceptible
- being depressed/anxious increases risk for substance abuse - Genetics: heredity influences addiction
- MZ twins are more likely to have similar behaviour in substance abuse than DZ twins»_space; specific genes involved
- genes for smoking not the same as genes for drinking
- substance use strongly influenced by social factors in adolescence, and more by genetics in adulthood
- high parental involvement can counteract genetic risk
- epigenetics important (env)
incentive-sensitization theory of addiction
dopamine (NT) enhances prominence of stimuli associate w substance use»_space; cues become increasingly powerful in directing behaviour
smoking tobacco
- 60s
- prevalence
- teens
- habit begins
- statistics (4»_space; gender, sociocultural diff, indig, SES)
- antismoking ads
decreased in the 60s once govt began sending reports of health effects
»_space; currently 20-40yo smoke the most (prevalence)
- teens not going to college more likely to try smoking
- habit starts in early 20s
- 75% of smokers are men (1 billion men, 250 mil women)»_space; mostly Europe
- 80% of smokers are from developing countries»_space; sociocultural difference
- indigenous ppl 2x more likely to smoke
- % of smokers declines w increase in education, income, and job prestige
*antismoking ads work! proves that ppl can be persuaded to avoid/quit
starting to smoke
- first time
- modelling/pressure
usually unpleasant»_space; coughing, bad smell, nausea
modelling/peer pressure: peer encouragement or env (from fam/friends smoking)
Becoming a regular smoker
- time?
- Factors (5)
- susceptibility
- insula
takes years»_space; faster if first exp is pleasant
Factors:
- parents/siblings/friends who smoked or are unconcerned/encourage smoking
- rebellious/thrill-seeking, low school motivation
- tobacco ads, peer pressure, positive attitude to smoking
- don’t think smoking will harm them, or think they can quit if they want
- negative feelings (depression)
*most susceptible during preparation phase (having the intention to smoke)
insula: part of brain that may control desire to smoke
- stroke to the area = loss of desire to smoke
chemicals in cigarettes
- CO
- tars
- nicotine
carbon monoxide: easily absorbed into blood»_space; affects physiological functioning»_space; reduces O2 carrying capacity
Tars: particles in smoke»_space; carcinogen (cause cancer), no evidence for addiction
Nicotine: addictive, physiological effects»_space; only in tobacco»_space; quickly absorbed by alveoli»_space; enters blood in seconds»_space; affects CNS/SNS»_space; in alertness, HR, BP
Nicotine regulation model
- definition
- limits (2)
- maintenance
smokers keep smoking to maintain lv of nicotine in their bodies»_space; avoid withdrawal
Limits:
- ppl still crave, even after nic is gone from their body
- some ppl don’t show tolerance/withdrawal
*maintenance of smoking behav involves interplay btwn biological, psychological and social factors
Smoking and health
- deaths
- life expectancy
- affect on respiratory system
- 6 mil die each year due to smoking illnesses
- reduces life expectancy and quality of life in elder years»_space; deadliest cancer currently
- smoke passes through branchial tubes and irritates the lining»_space; inc number of cells»_space; cilia (which normally clear the lungs of foreign particles) stop moving/disappear»_space; devel smokers cough (body trying to clear)»_space; cause of lung cancer
Passive smoking
- why ban
breathing secondhand smoke
- ban smoking in public places»_space; can aggravate acute symptoms of ppl w CVDs or respiratory problems
CVD
- CHD
- reactivity
- nicotine effect
- e-cigarettes
leading cause of death worldwide»_space; 25% in CAD
- risk of devel CHD is twice as high in smokers»_space; aggravated by stress»_space; heightened reactivity from smoking inc risk
- nicotine constricts blood vessels»_space; inc HR»_space; atherosclerosis (plaques)
- e-cigs may help with lung cancer, but bad for CVD
COPD
- stat
- examples
- causes
- tar
- marijuana
chronic obstructive pulmonary diseases»_space; 80% of cases caused by smoking
eg. emphysema, chronic bronchitis
- permanently reduced airflow
- more damage if there is more tar
- marijuana can also damage resp system
Alcohol use
- binge drinking
- occasional drinkers
- heavy drinkers
- effect of sex/age
- high vs low class
- social factors
- negative consequences
- cues
Factors (5)
binge drinking: 5+ drinks on a single occasion in a 30 day period
- 70% of Canadians (15+) drink occasionally
- 19% (12+) are heavy drinkers
- alcohol abuse more common in males, most likely to develop btwn ages 18-24 of both sexes»_space; phys dependence/addiction
- large numbers of alcoholics come from higher classes (although low class more at risk)
- role of social factors increases over time
- experiencing negative consequences (black outs/regretted sex) may lead to continued heavy drinking
- heavy drinkers form strong substance-related cues»_space; heightened physiological reaction and positive feelings to alcohol-related stimuli (seeing or smelling liquor)
Factors: heredity and abuse (stronger affect before 25yo), family history (tolerance), gene pattern»_space; stronger cravings, high genetic risk = greater feeling of reward
Drinking and Health
- drinking causes… (3)
- fetal alcohol syndrome (3)
- drunk driving
- cirrhosis
- high blood pressure
- heart/brain damage (CNS»_space; memory functions)
- impaired immune function
fetal alcohol syndrome:
- slow growth after birth
- intellectual defects»_space; impared NS devel + cog/phys defects
- facial characteristics (small eye openings)
drunk driving: impairs cognitive, perceptual and motor performance for several hours»_space; degree varies
cirrhosis: liver cells die»_space; non-functional scar tissue»_space; liver unable to cleanse blood
drinking misconceptions (3)
all of these are myths:
- full stomach prevents you from getting drunk
- beer/wine have lower impact than mixed drinks
- super-size “one-drink”»_space; count it by drinks, and then judge intoxication by “number of drinks”
is moderate drinking good for health?
if you control for ppl who are non-drinkers because of some illness/condition, there is no difference between moderate drinkers (glass or 2 of wine a day)
Types of Drugs and Effects
- causes
- examples
- side effects
- stimulants
- depressants
- hallucinogens
- narcotics
- stimulants: physiological/psychological arousal
- amphetamines, caffeine, cocaine
- causes mental confusion, exhaustion, physical (except cocaine)/psychological dependence; withdrawal causes anx, depn, fatigue and headaches - depressants: decrease arousal, inc relaxation»_space; reduce anx, induce sleep
- alcohol, benzodiazepines (valium), barbiturates
- interferes w emotional stability, phys/psych dependence - hallucinogens: perceptual distortions
- marijuana, LSD, PCP»_space; exhiliration
- causes psychological dependence, and only marijuana has physical dependence - Narcotics: opiates»_space; sedatives (relieve pain)»_space; euphoric/relaxed
- morphine, heroin
- causes intense psychological/phys dependency
Drug use
- factors (3)
- prevalence (3)
- when does it devel?
- other drug use (2)
factors: genetic (parents), psychological (personality), and env factors (especially social factors like peers, parents and celebrities) are involved
- low worldwide prevalence
- 40% of CAD report using MJ
- prevalence greater in men than women
- more likely to devel in adolescence (like smoking and drinking)
- other drugs tend to be used later due to greater risks and low availability
- less serious substance use tends to precede serious use (correlational! not causational)
polysubstance use (2)
more than one substance
- sociocultural variables (marginalized groups more likely)
- co-occurring mental disorders (ADHD) or abused or indig or LGBTQ+ youth more likely (especially if they are disapproved of»_space; same for smoking)
Drug use and Health
- not well documented
- pregnancy
- meth/cocaine effects
- snorting/smoking affects
- ODing crisis
- menthol cigs
- ppl unwilling to admit since it is a criminal offense»_space; not well documented
- BAD during pregnancy»_space; bb affected too
- use meth/cocaine inc BP, HR, blood vessels constrict»_space; can cause heart attack/stroke = death
- snorting cocaine can cause major damage to nose/lungs (so can marijuana)
- deaths from ODing (on opioids like fentanyl) reaching epidemic levels»_space; 2mg can kill a person
- harder to quit menthol cigs (which slow the metabolism of nic) than regular ones
Prevention
- interventions
- social influence approaches
- life skills training approaches - inc prices
- prevention programs
- decriminalization
- interventions (family involvement)
- social influence approaches: resist social pressures»_space; watch videos, modelling, role playing, refusal skills
- life skills training approaches: social/cog/coping skills»_space; improve personal skills»_space; critical thinking/decision-making/coping with anx/social skills»_space; assertiveness/convo skills - inc price of alc/cigs by taxation ; restrict age
- prevention programs
* decriminalization (MJ) does not inc use of substance
ppl can quit on their own (without therapy) if… (7)
- they are ready to quit
- confident in success
- feel less cravings/dependency
- willing to try again if they don’t succeed
- smoke less than a pack a day
- experience less stress
- less severe/fewer withdrawal symptoms
*quitting cold turkey without use of substitutes»_space; more success
A. Cognitive-behavioural approach to remission
- self-efficacy, bolstering, +/- reinforcement, cue exposure
cognitive behavioural methods are one of the most effective psychosocial approaches for reducing problem drinking, drug use, and cig smoking
self-efficacy: critical for initiating efforts to change
bolstering: from fam/friends/physicians/therapists»_space; must have the desire and readiness to change
positive reinforcement: stopping or reducing use»_space; more successful than no reinforcement
eg. monetary-based»_space; earn vouchers for lottery opportunities
reduce negative reinforcement: find other ways to cope with stress
eg. muscle relaxation, mediation, cognitive restructuring
cue exposure: decrease impact of cues (reduce classical conditioning effects)
B. Behavioural methods for remission
- definition
- self monitoring
- stimulus control
- competing response
- behavioural contracting
- scheduled reduction
change the behaviour, its antecedents, and consequences (rewards/penalties)
- self monitoring: record info»_space; gather data»_space; self-management
- stimulus control: address antecedents»_space; alter env cues
- competing response: rewarding behav that is incompatible w problem behaviour
- behavioural contracting: physically writing out conditions/consequences»_space; specify reinforcement/punishment
- scheduled reduction: use only at regular specified intervals»_space; get longer over time
Alcoholics Anonymous (AA)
believe that ppl who abuse alc are alcoholics for life even if they abstain»_space; commit to goal of total abstinence
C. chemical methods for remission
- disulfiram
- gum/lozenges
- methadone
- naltrexone
- drugs (disulfiram)»_space; react with alc»_space; unpleasant (nausea/vomiting)
- smokers can use gum/lozenges of nicotine»_space; curb cravings
- drug users»_space; methadone»_space; prevents effects of opiates (euphoria)
- naltrexone blocks effects of euphoria in alc/drugs
lapse
- caused by?
relapse
- occurrence
- why does it happen?
abstinence-violation effect
lapse: backslide»_space; expected»_space; not a failure
- caused by cravings (if you stay abstinent, cravings will decrease)
relapse: going back to original pattern
- very high change of occurring in first few months
- less satisfaction with results = more likely to relapse
abstinence-violation effect: lapse = personal failure
Factors that can lead to relapse (6)
- low self-efficacy: lose confidence due to a lapse»_space; abstinence-violation effect
- negative emotions/poor coping
- high craving
- expectation of reinforcement via the substance
- low motivation
- interpersonal issues (lacking social support, or env promotes it)
Relapse prevention method (3)
- learn to ID high-risk situations»_space; descriptions, antecedents»_space; when lapses are likely
- acquire competent and specific coping skills»_space; deal with high-risk situations and avoid lapses
- practice effective coping skills in high-risk situations
Canada’s official food rules (1942)
- based on?
- milk, fruit/veg, cereal/bread, meat/fish, eggs, Vit D
based on food scarcity
- 1 pint milk (more for children)
- fruits 2, veggies 2
- cereal 1, bread 4-6 slices
- meat/fish 1
- eggs 3-4 weekly
- source of Vit D (esp children)
Canada’s food guide
- slogan»_space; based on
- mindful of…
- warnings
- proportions
- eat well, live well»_space; based on nutritional balance»_space; big change from 1942
- mindful of eating habits, cook more often, enjoy, eat with others (cultural diff)
- read labels, limit high salt/sugar/fat foods (first time advocating!), beware marketing (social and psychological contours!)
- should have fruit/veg/gains»_space; proteins smaller aspect
Optimizing health through movement
- guidelines (3)
24h movement guidelines (18-64yos)
- move more (150+ mins per week) + hours of light exercise (including standing»_space; dont have to go to gym, there are diff ways)
- reduce sedentary time (<8H a day)»_space; less than 3 hours of recreational screen time
- sleep well (7-9h)
Physical activity benefits
- pill?
- increases?
- improves?
- decreases?
- yet…
- there is no pill that can replace this
- inc CV fitness and endurance
- improve psych well-being/cog functioning (esp older adults)
- dec risk of chronic disease (diabetes»_space; inc longevity)
- yet the majority of CAD dont meet guidelines
avg minutes of phys activity
- kids vs adults
sedentary behaviour
- definition
- sitting… increases…
- CAD
- kids are more active than adults»_space; adults barely move
sedentary behav = any waking behaviour characterized by an energy expenditure < 1.5 METs (v small) while in a sitting/reclining posture
- sitting is the new smoking»_space; increases chronic diseases
- Canadians spend approx 9.7H per day sedentary
Health impact of sedentary behaviour
- sedentary lifestyle vs phys activity
- associated with (4)
- sedentary promotes?
- reduction causes?
- sedentary lifestyle = independent risk factor
independently from physical activity, sedentary behaviour is associated w
- all cause mortality
- CVD/hyperT/type 2 diabetes
- metabolic syndrome
- some forms of cancer
modern sedentary activities may promote overconsumption of food
*reduce sitting to less than 3hr per day can result in a 2 yr inc in life expectancy
Health care costs
- phys inactivity vs smoking
smoking one whole pack of cigs a week has similar health costs as physical inactivity
What can you do to prevent sedentary lifestyle? (4)
- 20-30 mins phys activity a day»_space; good, but not enough
- stand up and stretch every 30-40 mins
- use a standing desk
- stretch, roll shoulders, lift feet
role of less rational processes
a) motivational factors
b) false hope and willingness
c) emotional factors
- conflict theory
- hypervigilance
- vigilance
a) motivational factors: motivated reasoning»_space; prefer a particular conclusion»_space; use biased cognitive processes»_space; search for acceptable reasons/info and discount disconfirming info»_space; seems “reasonable” even if logic is faulty
b) false hope and willingness: believing without rational basis that they will succeed»_space; misinterpret failures (did succeed for a while…)
- willingness to engage in risky behav depends on positive subjective normal/attitudes towards behaviour and being engaged in the behaviour/having favourable social image of the person who would perform the behaviour
c) emotional factors: high stress = less health promotion info retention
- perceptions depend on risk, hope, and adequate time
- conflict theory: model to account for rational/irrational decision-making»_space; stress is important (threat vs opportunity appraisal)
- hypervigilance: see risk in current and alternative behaviour»_space; feel like you’re running out of time»_space; high stress (may choose alternative hastily)
- vigilance: perceive serious risks and possibilities, but feel they might find better solution with time»_space; moderate levels of stress»_space; search carefully»_space; rational choices
Study: Intentions, Planning and Exercise»_space; Theory of Planned Behaviour
- sample size
- assessments
- study focus
Findings
- intentions
- coping planning
- difference
empirical evidence
- issues (2)
- 484 ppl with CVD
- 3 assessments (during rehab, after 2 mo, 4 mo
- behavioural intentions, actions planning, coping planning, and physical exercise»_space; continuation of plans learned in rehab
- behavioural intentions were associated with exercise at baseline (helps ppl get going)
- coping planning became a more important predictor of exercise over time in study (adherence)
*predicted difference aspects in long term process
empirical evidence: of pre- and post-intentional processes across a number of health promoting behaviours
BUT:
- social behaviours do not occur in a social vacuum»_space; studies usually only focus on indiv (social component forgotten)
- people differ in their state of readiness for change
Health behaviours studied in silos
- silo?
- problem
professionals often zoom in on specific health behaviours
Problem: people are typically told to engage in multiple health behaviours by separate professionals»_space; left up to the patient to integrate them together
- a lot of the time patients think as long as they do one it is fine
Study: cross behaviour cognitions
- sample size
- main focuses (2)
- findings (2)
- detection?
co-regulation of multiple health behaviours
- cross-sectional online survey with N = 767 participants
Main focuses:
- does one serve as a gateway to the other (doing one makes it easier to do others)
- health action process approach variables PLUS transfer cognitions
eg. if I am physically active, its easier to eat healthy - compensatory health beliefs
- healthy behaviours compensate for unhealthy ones
eg. if i am eating healthy, I can afford to exercise less
Findings:
- yes, it is a gateway»_space; makes it easier
- but also there is evidence of compensatory behaviours too!
*these co-regulations go undetected because professionals tend to study only one field»_space; silos
social context in ToPB
“takes 2 to tango”
- ppl will take into consideration food preferences of others»_space; if they don’t know about what doctor said, its a missed opportunity
- cooking/eating together often means sharing dietary restrictions
- if you live with someone who likes to go for walks vs someone who wants to sit and read books there will be a very different affect on you
study of physical activity synchrony btwn spouses
- study of?
- aims
- sample size
T1 Methods - how measured? - what measured? - data collected how often?
Findings
the extent of equivalent activity levels among dyad members during a certain time period, independent of their location
aims: investigate synchrony patterns btwn partners in moderate to vigorous physical activity (MVPA) and sedentary behaviour on an hourly time resolution
- 114 heterosexual, older community-dwelling couples from Vancouver»_space; social units who live together»_space; share a lot of env
T1: entry interview»_space; ambulatory assessment»_space; exit interview
Methods: measure of physical activity
- hip-worn ActiGraph GT3X accelerometers (captures movement) during waking hours
- minutes spent in sedentary behav per hour
- data aggregated on hour-level (n = 17,554 hrs from 114 couples)
Findings:
- significant association btwn spouses MVPA
- phys activity and sedentary-ness occurred similarly
- there were a few that had almost opposite MVPA patterns tho!
components of food
- carbohydrates
- lipids
- proteins
- vitamins
- minerals
- fiber
- antioxidants
- carbohydrates: simple (glucose, fructose)/complex sugars (sucrose, lactose, starch)»_space; major sources of energy for body
- lipids: fats»_space; provide energy»_space; saturated(bad)/polyunsaturated(good) and cholesterol (diet shouldnt contain more than 30% or less than 10% calories from fat)
- Proteins: important to body synthesis of new cell material (amino acids)
- Vitamins: organic chemicals»_space; regulate metabolism/body fxns»_space; used to convert nutrients to energy, produce hormones, and break down waste/toxins
- some are fat-soluble and stored in fat (A, D, E, K)
- some are water soluble and are difficult to store»_space; excreted as waste - Minerals: inorganic chemicals»_space; calcium, phosphorous, potassium, sodium, iron, iodine, zinc»_space; important to body devel/fxn (eg. Ca and P important for teeth, K and Na involved in nerve transmission, Fe helps O2 blood transport)
Fiber: not a nutrient but still important»_space; needed for digestion but not metabolized
antioxidants: vitamin A (eg. carotene in carrots) , C and E»_space; reduce metabolic damage to cells (oxidation)»_space; vit A reduces risk of several diseases (cancers, CVDs, eye diseases)
taking vitamins is helpful, but too much can be a hazard»_space; affect liver (A) and kidneys (D)
What people eat
- sex
- healthy changes
- unhealth changes
- women tend to eat less fat, and eat more fruit and fiber than men
Healthy changes: consumption of red meat and whole milk has decreased, and poultry, rice, skim milk, and vegetables increased
Unhealthy changes: intake of sugars, soft drinks, cheese, cream and fasts/oils has increased
why do people eat what they eat?
- inborn processes
- environment and experience (5)
inborn processes: newborns like sweet tastes and avoid bitter tastes
env/exp: affects preference for dairy/starch
- newborns can learn to eat foods they avoid
- food exposure
- fast food availability
- observational learning (eg. seeing on TV ppl enjoy a food)
- portions are supersized
atherosclerosis
- main culprit»_space; causes?
- LDL vs HDL
- risk factors of CVDs
- statin
- cholesterol is the main dietary culprit of fatty plaques in blood vessels»_space; depends on presence of lipoproteins (low density and high density lipoproteins»_space; LDL/HDL)
- LDL related to increases plaques»_space; carries “bad cholesterol”»_space; mixed w other substances
- HDL decreases likelihood of plaque buildup»_space; carries “good cholesterol”»_space; carries LDL away to be removed by liver
Risk Factors:
- age (45+ for men, 55+ for women)
- diet (eggs, milk, fatty meats contain high conc of chol)
- cigarette smoking»_space; inc LDL and dec HDL
- HBP
- Low “good” cholesterol (HDL <40mg)
- Family history of early CVD
Statin: drug that greatly reduces LDL and raises HDL levels»_space; dec LDL can reduce CVD
dietary fats (3) - ban
Dietary Fats:
- triglycerides»_space; inc heart disease
- omega-3 FAs»_space; in fish»_space; reduce 3Glyc and inc HDL
- trans-FAs»_space; in oils»_space; inc LDL and dec HDL
*artificial trans-fats banned in commercial food
Hypertension
- BP
- strongest role?
- diet
hypertension = BP exceeding 140/90 diastolic
- sodium has strongest role »_space; inc BP and reactivity when stressed
- hypertensive ppl get put on low-sodium diets»_space; can lower BP by reducing sodium and increasing potassium (counteracts sodium)
- also decreases risk of heart disease
diet and cancer
high fat, low fiber/fish diets associated w cancer devel (colon/prostate esp)
Multiple Risk Factor Intervention Trial (MRFIT)
- modifying diets of thousands of men over 6 yrs
- at risk of coronary heart disease because of high cholesterol levels, high blood pressure, and cigarette smoking
becoming overweight
- add fat
- heredity (3)
- active
add fat to body by consuming more calories than you burn through metabolism»_space; excess fat stored in adipose tissue
- physical activity and metabolism decline with age
- heredity plays a role»_space; if obese child has obese parents, risk of obesity after age 30 doubles (could also be learned habits)
- – twin studies (genetic obesity link)
- – epigenetics/env factors
- – specific genes linked to obesity
*however, being physically active can counter genetic predisposition
set-point theory
- definition
- what happens when weight leave set point?
- rapid changes
- limitation
each person’s body has a certain or “set” weight that it strives to maintain via hypothalamus
- when weight leave set pt, body changes metabolism/eating to return to set pt
- rapid changes initially if you drastically change, but eventually will show slower changes»_space; reach limit»_space; will return to original weight if you stop diet
does not explain ppl who lose a lot of weight and manage to keep it off
hypothalamus
- ghrelin»_space; secreted when
- leptin»_space; regulates?
- insulin»_space; regulates?
- hyperinsulinemia
- fat-cell hyperplasia
monitors blood for hormone levels
ghrelin: secreted when energy intake is low/stomach empty
- increase w stress (negative emotions can induce eating)
leptin: regulates stimulation/inhibition of eating/metabolism»_space; depends on body fat levels
insulin: produced by pancreas»_space; regulates glucose in blood, conversion of glucose into fat, and storage of fat in adipose tissue»_space; depends on body fat levels
hyperinsulinemia: obese ppl tend to have high lvs of insulin»_space; inc hunger
fat-cell hyperplasia: ppl w too many fat cells»_space; may be doomed to struggle against a high set-point for the rest of their lives (enlarged fat cells will shrink, hunger will inc and metabolism will dec)
*once a person’s set point becomes established, change is difficult
weight gain, obesity and health (3 factors)
- central adiposity
- degree of being overweight
- fitness
- distribution of fat
- men tend to gather fat on abdomen, women on their hips, thighs and butts
central adiposity: waist to hip ratio»_space; high ratio = higher risk for CVD/diabetes
avoid getting child overweight (6)
- encourage regular physical activity and restrict TV watching
- dont use unhealthy food rewards»_space; use praise instead
- decrease buying high-chol/sugary foods; avoid fast food restaurants
- use fruits, nuts, and other healthy foods as regular desserts»_space; unhealthy desserts for special occasions
- make sure child eats healthy breakfast (eggs) everyday, no highcal snacks at night (metabolism dec later in day)
- monitor BMI
health halo effect
tendency to judge an entire food item as healthier based on a narrow attribute that is perceived as healthy
celiac disease
- definition
- effects
a disorder in which the surface of the small intestine is damaged by gluten»_space; gluten-free diet is essential to maintaining health
effects: anemia, fatigue, and neurological problems
social stigma against overweight ppl
- being overweight is inconsistent with socially prescribed ideal body types, particularly for women
- many people blame heavy individuals for their condition, believing they simply lack willpower
Treatments to lose weight
- exercise
- interventions + techniques (5 + 2)
exercise: inc metabolism»_space; burn calories
interventions (behav/cog): control antecedents and consequences to maintain eating patterns
Techniques:
- nutrition and exercise counselling
- self-monitoring
- stimulus control
- alter act of eating (chew thoroughly)
- behavioural contracting (rewards system)
- motivational interviewing (inc commitment and self-efficacy)
- problem solving training (strategies to deal with everyday difficulties)
Medically supervised approaches (4)
- orlistat: dec intestinal absorption of fat
- protein-sparing modified fast regimen: less than 800 cal/day»_space; short term!
- bariatric surgery: change structure of stomach/intestines»_space; restrict holding capacity or modify absorption (surgical risk!)»_space; limited to ppl w severely high BMI = 40
- liposuction: suck out adipose tissue»_space; cosmetic function only (body sculpting)
diet relapse reasons (3)
hard to keep off weight
- biological: hormones keep signaling for food for at least a year
- lack of reinforcement
- food cues»_space; restaurants, negative emotions, boredom,
Eating disorders
- anorexia nervosa
- BMI
- leads to
- deaths? - bulimia nervosa
- tendency
- psychotherapy
- anorexia nervosa: drastic reduction in food intake and an unhealthy loss of weight, BMI < 18.5, intense fear of gaining weight, and distorted idea of body shape
- can lead to kidney failure, cardiac arrest, extremely low blood pressure, or cardiac arrhythmias (due to low levels of electrolytes, such as potassium)
- death 3x higher in ppl w anorexia than bulimia - bulimia nervosa: recurrent episodes of binge eating + purging (vomiting, laxatives or excessive exercise)
- tend to be self-critical and depressed after an episode
- psychotherapy more effective for bulimia than anorexia»_space; behavioural and cognitive methods
Why do people develop eating disorders?
- genetic and physiological links (MZ twins»_space; likely for BOTH to have if one has)»_space; NT processes are abnormal in eating-disorder indivs
- cultural factors»_space; high in white females»_space; beauty standards
Exercise
- Isotonic exercise
- Isometric exercise
- Isokinetic exercise
- aerobic exercise
- Isotonic exercise: builds strength and endurance by having the person move a heavy object, exerting most of the muscle force in one direction»_space; weight lifting/pushups
- Isometric exercise: builds mainly strength rather than endurance—the person exerts muscle force against an immovable object
- Isokinetic exercise: builds strength and endurance—the person exerts muscle force to move an object in more than one direction (back and fourth)
- aerobic exercise: to energetic physical activity that requires high levels of oxygen over an extended time (eg. 20min)»_space; dancing, jogging, swimming etc»_space; increases the body’s ability to extract oxygen from the blood and burn fatty acids and glucose
Psychosocial (2) and immune (2) benefits of exercise
Psychosocial:
- lowers stress/anx
- improve cog processes (better memory)
- no cause-effect! correlational!
Immune:
- less risk of breast/colon cancer
- increases killer T cell number and function
How fitness protects CV health
- blood pressure, lipids/inflammation, reactivity
Blood pressure: lowers BP, less likely to devel hyperT
Lipids and inflammation: improves serum lipid levels (raises HDL and lowers LDL/
3glyc) and reduces inflammation
Reactivity to stress: lower HR/BP reactivity to stress
anabolic steroids
- definition
- effects
- related to?
- male hormones»_space; build tissue/muscle + inc strength
- raises LDL, reduces HDL
- related to kidney tumors, heart attacks/strokes
Beliefs influencing exercise (5)
- underestimate enjoyment of exercising by focusing on negative aspects at the beginning
- low vs high self-efficacy
- perceived susceptibility to illness can spur ppl to exercise
- perceived barriers»_space; personal, environmental, etc
- past success vs failure
Strategies to promote exercising (7)
- preassessment: purpose for exercising + benefits
- exercise selection: tailored to indiv
- Exercise conditions: when + where + equipment needed
- Goals: specific written sequence»_space; small to large
- Consequences: reinforcement (either for phys activity or dec sedentary behav)
- Social influence: encouragement
- Record keeping: weight + performance»_space; see progress
*deal with setbacks constructively»_space; attribute to temporary factors
Accidents
- 5th most frequent cause of death in canada
- leading cause of death in indiv under 45
- responsible for over 20% of all deaths of children 1-14yrs of age
- nearly 3.9 million ppl die from unintentional injuries worldwide each year
preventing accidents
- reduce driver errors, study reaction time
2. 4x more likely to get into accident during or shortly after using a phone/hands-free device
