Health Psych Final

Alzheimer’s disease

• Degenerative disease of the brain

• Early-onset: occurs before 60; rare; genetic component

• Late-onset: occurs after 60; more common; may have genetic component but lifestyle factors may also play a role

Strongest risk factor for Alzheimer’s

Age - by age 85, 50% of individuals show signs

Asthma

• Inflammatory disease that causes constriction of the bronchial tubes, preventing air to pass freely

• Children have highest rates

Risk factors for asthma

• More common in developed countries

• In urban areas

• Common among Black and African Americans

• Sedentary lifestyle and obesity linked to risk

Diathesis-stress model for asthma

• Genetic variability

• Respond with an allergic reaction to certain substances in the environment

Hygiene hypothesis

asthma results from the cleanliness that is common in modern societies

Treatment for asthma

• Minimizing attacks

• Requires medication

Diabetes

disorder caused by insulin deficiency

Type 1: Insulin-dependent

• Autoimmune disorder

• Caused mainly by genetic factors

• occurs usually before age of 30

• cannot produce insulin

• no cure

• non-Hispanic white individuals

• No longer called “juvenile-onset diabetes” because older adults can still get it  

Type 2: Non-insulin dependent

• More common

• Mainly caused by lifestyle factors

• Ethnic minorities (Hispanics, Nativ Americans, and Black people)

• No longer called “Adult-onset” diabetes because more juvenile kids are getting it

risk for Type 1 and Type 2 diabetes between ethnic groups

Type 1: non-Hispanic white individuals

Type 2: Ethnic minorities (Hispanics, Native Americans, and Black people)

Pima Indian groups in Mexico vs. the United States

• Pima Indian groups in Mexico

  • Rate of diabetes was 6.9%

• Pima Indian groups in United States

  • The rate of diabetes was 38%

• Why?

  • Pima Indians also have much higher rates of obesity

  • Pima Indians thought to have “thrifty gene” that increases risk of diabetes

  • U.S. Pima Indians farm and grow most of their own food

  • have low levels of occupational physical activity

  • Even with genetic predisposition, rates of diabetes largely influenced by environment and are preventable

leading cause of death for Type 1 and Type 2

Type 1: renal disease

Type 2: cardiovascular disease

HIV

human immunodeficiency virus; causes the development of AIDS

AIDS

• acquired immune deficiency syndrome; the immune system loses effectiveness

• HIV’s Relation to it: Sexual contact & drug use

main risk groups for HIV

Overall, Black/African American people account for the largest number of estimated new HIV infections

Primary prevention

• changing behavior to decrease transmission of HIV

  • Limiting # of sexual partners

  • Use condoms

  • Don’t share needles

Secondary prevention

• helping people live with infection

  • Encouraging HIV testing

  • Coping with HIV diagnosis

  • Tailoring interventions to person’s specific situation

  • Finding meaning

History of drinking habits

• In colonial America drinking was much more common than it is today.

• In 1920, the sale of alcoholic beverages was outlawed (prohibition) which lowered per capita consumption

• When this amendment was repealed in 1934, consumption rose sharply.

• About ⅔ of U.S. adults classified as current drinkers currently

Beer

12 fl oz

Wine

 5 fl oz

Malt liquor

8-9 fl oz

Gin, rum, tequila, vodka, whiskey, etc

1.5 fl oz (40% alcohol)

Who has the highest rate of drinking?

Adults age 25-44

What gender is more likely to drink?

Men

Education and drinking

People with more education are more likely to drink, but those without high school education more likely to develop drinking problems, and second lowest for any consumption in the last month

Race and drinking

Asians are the lowest for binge drinking and heavy drinking

Body composition

• In women, a greater percentage of body mass is fat compared to men

• Result: The concentration of alcohol is increased in the female bloodstream (muscle has more blood supply)

Stomach ADH

• Women have less of this enzyme compared to men

• Result: Women do not metabolize alcohol before it gets out of the stomach. Therefore the blood alcohol concentration (BAC) is higher for women

Liver ADH

• Women have a less active form of this enzyme than do men.

• Result: Women do not metabolize alcohol as efficiently, thereby increasing BAC

Tolerance

The more you use a drug, the more of that drug you will need to get the same effects

Dependence

The body becomes so reliant on a drug that it needs that drug in order to function “normally”

Direct hazards of alcohol use

harmful physical effect of alcohol itself

Indirect hazards of alcohol use

Consequences resulting from psychological and physiological impairments produced by alcohol

the amount of alcohol consumed and mortality

• J-shaped curve

• Non-drinkers and heavy drinkers are at increased risk of mortality and number of drinks per day

• Light to moderate drinkers have the best prospects for good health

Alcohol and heart disease

• Heavy drinking related to heart disease and stroke

• Light moderate drinking may lower heart disease deaths

Disease model

• People with problem drinking have the disease of alcoholism

• Strongly influenced the medical community

• Two most common types of alcoholism: Gamma - loss of control once drinking begins & Delta - Inability to abstain

Tension Reduction model

• People drink alcohol as a means of coping with tension

• Sedative, so capable of producing physiological relaxation

• Effect varies across people and is influenced by expectancy (expect to get drunk then you might)

Alcohol Myopia Model

• People drink because it makes them feel better about themselves and alters their thought process

• Effects include: Self-inflation, Relief from worry, Increased aggression, Increased friendliness, Exaggerated sexual behaviors

Social Learning Model

• Drinking is a learned behavior and is acquired in the same way as other learned behaviors

• Positive Reinforcement (like the taste)

• Negative Reinforcement (to escape from an unpleasant situation)

• Modeling (learning to drink through others)

Alcoholics Anonymous

• Alcohol prevention class

• Follows the disease model

• If deemed an alcoholic, then always an alcoholic (sustained effort)

• Focused on abstinence from alcohol

Stimulants

• produce alertness, elevate mood, decrease appetite

  • Caffeine

  • Cocaine

  • Amphetamines

  • Nicotine

Sedatives/depressants

• induce relaxation by lowering activity of the brain, muscles, heart

  • Barbiturates

  • Tranquilizers

  • Opiates

  • Alcohol

Hallucinogens

• Serotonin is involved in feelings of well-being and perceptual distortions

  • Ecstasy (MDMA)

  • LSD

Abuse

frequent, heavy consumption that results in damage to one’s health

Treatment to drug abuse

• Goal is total abstinence

• Narcotics Anonymous

• Treatments are similar to alcohol treatments

• Relapse programs that are individualized may be especially helpful

Positive Reinforcement

They enjoy the taste and its positive effects

Negative Reinforcement

Drinking allows escape from an unpleasant situation

Leptin

a protein, signals when more food is needed

Insulin

a hormone, helps the hypothalamus understand when we have eaten enough food

Ghrelin

a hormone, stimulates appetite and decreases metabolism

Two things for your body to maintain

• Stable weight occurs when calories eaten equal those expended for body metabolism and physical exercise

• Metabolic rates differ from person to person

Obesity Stigma

• Obese people are viewed as less attractive, socially adept, intelligent and productive than their peers.

• Standard model is 5’11 and 110 pounds

  • 7 inches taller and 55 lbs lighter than average US woman

experimental starvation

• Key’s WWII study

• Physical Effects of human starvation

• During WWII - severely restricted diet for 6 months instead of war

• Drastic weight loss over short period leads to irritability, aggression, and preoccupation with food

experimental overeating

• Sim’s Vermont Prison study

• Incarcerated individuals at a prison in Vermont volunteered to gain 20 to 30 lbs by overeating

• Not as miserable as those drastically undereating, but started to find food unpleasant, having to force themselves to eat

• Differences in difficulty returning to starting weight - family history of obesity for those with more difficulty

Biological Influences on weight

• As weight fluctuates, hormones stimulate changes in metabolism and appetite

• Body is preparing for scarcity for food

• A woman who drops from 200 to 130 lbs has to eat fewer calories to maintain that weight than a woman whose weight was steady at 130

Environmental/Societal Influences on weight

• Portion size increases

• Americans consume about 200 calories more per day than 30 years ago

• Fast food items are 2-5x larger than in the 1980s

• New editions of cookbooks have larger portions for same recipes – 43.7% increase in Joy of Cooking

Body Mass Index

• a common way to talk about the range between underweight and obesity

Healthy range

18,5 - 24,9 

Underweight

<18,5

Obese

30 - 34,9

weight and health

• Overweight people (BMI 25-30) had LOWER mortality than people with BMIs of <25

• Slightly obese people (BMIs < 35) did not have greater mortality than those with BMIs < 25

• People with BMIs > 35 had higher mortality

Associations with obesity

• Use of medical care, chance of developing Type 2 diabetes, high blood pressure, heart disease, stroke

• Risk of migraine headaches, sleep apnea, colon cancer

Effective strategies for maintaining weight loss

1. Eating low calorie, low fat diet, eating breakfast (not low carb)

2. Exercise

3. Frequent self-monitoring

Low-carbohydrate diet

Atkins had more initial weight loss, but was no more effective at the end

Low-fat diet

• Average of 1381 calories / day

• Eat 4.87 times per day

• Eat at fast food restaurants once per week and other restaurants 2.5 times per week

• Greater avoidance of fried foods

• 78% eat breakfast every day

Anorexia

• Emphasis on caloric restriction through low intake of foods or intake of only voluminous foods

• Concern about nutrition facts, calories, ingredients, etc

• Debilitating fear of weight gain

• Going long periods of time without eating

Bulimia

• episodes of binge eating followed by compulsive purging

• Feelings of losing control, shame, disgust

• Eating well past the signs of fullness

Binge Eating

• Episodes of Binge Eating, typically no purging afterwards

• Purging behaviors include vomiting, use of laxatives or diuretics, excessive exercise, fasting

• Physical Signs of Vomiting: Callused hands, dental

Well-year

is a completely well year; void of ill-being or health-related problems

Health expectancy

the expected number of years a person is free from disability

Health disparity

• African Americans and Native Americans have a shorter life and lower health expectancy than European Americans

• Hispanics do not show poorer health rates as much as African Americans do

• Asian Americans have lower infant mortality, longer life expectancy than other ethnic groups

34th

the US ranking in health expectancy

ethnic groups and  health expectancy and life Expectancy

• African Americans have a shorter life and lower health expectancy than European Americans

• Native Americans also have a shorter life expectancy than European Americans

• Overall, Hispanics do not show poorer health rates as much as African Americans do

• Asian Americans have longest life expectancy and best health of any ethnic group in the US

 challenges for health care

• Helping older people achieve and maintain healthy and productive lifestyles and adjust to chronic illness diagnoses

• Increasing diversity within the health care system to help reduce disparities

Factors that contribute to high costs

• Expensive technology

• Specialists

• Administrative costs

• Inappropriate treatments

• Profit-oriented system

Primary prevention

• avoids the development of a disease

  • Immunizations

  • Lifestyle changes

    • Diet

    • Exercise

    • Stress management

    • Alcohol and drug use

    • Risky behavior

    • Happiness and positive emotions

Secondary prevention

• aims at early disease detection,

  • Regular physical exams and cancer screening

  • Cholesterol and blood pressure testing