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.

16-2

Chapter Outline

Explaining Health and Illness

Nutrition and Eating

Exercise

Drugs and Addiction

The Patient and the Health-Care Setting

McGraw-Hill ©2006 by the McGraw-Hill Companies, Inc. All rights reserved.

16-3

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

McGraw-Hill ©2006 by the McGraw-Hill Companies, Inc. All rights reserved.

16-4

EXPLAINING HEALTH AND ILLNESS

The Bio-Psycho-Social Model

Psychological Factors in Health and Illness

Social Factors in Health and Illness

McGraw-Hill ©2006 by the McGraw-Hill Companies, Inc. All rights reserved.

16-5

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

McGraw-Hill ©2006 by the McGraw-Hill Companies, Inc. All rights reserved.

16-6

Psychological Factors in Health and Illness

Psychological factors proposed as causes of health problems include:– lack of self-control

–emotional turmoil

–negative thinking

McGraw-Hill ©2006 by the McGraw-Hill Companies, Inc. All rights reserved.

16-7

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

McGraw-Hill ©2006 by the McGraw-Hill Companies, Inc. All rights reserved.

16-8

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

McGraw-Hill ©2006 by the McGraw-Hill Companies, Inc. All rights reserved.

16-9

Social Factors in Health and Illness

Social factors that influence health:– frequency of daily stressors

–unhealthy lifestyles

–poor health care

McGraw-Hill ©2006 by the McGraw-Hill Companies, Inc. All rights reserved.

16-10

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?

McGraw-Hill ©2006 by the McGraw-Hill Companies, Inc. All rights reserved.

16-11

NUTRITION AND EATING

Nutrition and Eating Behavior

Eating Problems

McGraw-Hill ©2006 by the McGraw-Hill Companies, Inc. All rights reserved.

16-12

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

McGraw-Hill ©2006 by the McGraw-Hill Companies, Inc. All rights reserved.

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

McGraw-Hill ©2006 by the McGraw-Hill Companies, Inc. All rights reserved.

16-14

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

McGraw-Hill ©2006 by the McGraw-Hill Companies, Inc. All rights reserved.

16-15

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

McGraw-Hill ©2006 by the McGraw-Hill Companies, Inc. All rights reserved.

16-16

Obesity

Factors likely involved in obesity include:–heredity

– leptin

– set point and metabolism

–environmental factors

–ethnicity

–gender

McGraw-Hill ©2006 by the McGraw-Hill Companies, Inc. All rights reserved.

16-17

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

McGraw-Hill ©2006 by the McGraw-Hill Companies, Inc. All rights reserved.

16-18

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

McGraw-Hill ©2006 by the McGraw-Hill Companies, Inc. All rights reserved.

16-19

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

McGraw-Hill ©2006 by the McGraw-Hill Companies, Inc. All rights reserved.

16-20

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

McGraw-Hill ©2006 by the McGraw-Hill Companies, Inc. All rights reserved.

16-21

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

McGraw-Hill ©2006 by the McGraw-Hill Companies, Inc. All rights reserved.

16-22

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

McGraw-Hill ©2006 by the McGraw-Hill Companies, Inc. All rights reserved.

16-23

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

McGraw-Hill ©2006 by the McGraw-Hill Companies, Inc. All rights reserved.

16-24

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

McGraw-Hill ©2006 by the McGraw-Hill Companies, Inc. All rights reserved.

16-25

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

McGraw-Hill ©2006 by the McGraw-Hill Companies, Inc. All rights reserved.

16-26

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

McGraw-Hill ©2006 by the McGraw-Hill Companies, Inc. All rights reserved.

16-27

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

McGraw-Hill ©2006 by the McGraw-Hill Companies, Inc. All rights reserved.

16-28

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

McGraw-Hill ©2006 by the McGraw-Hill Companies, Inc. All rights reserved.

16-29

Bulimia Nervosa

Most bulimics are:–preoccupied with food

–have strong fear of becoming overweight

–are depressed or anxious

McGraw-Hill ©2006 by the McGraw-Hill Companies, Inc. All rights reserved.

16-30

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?

McGraw-Hill ©2006 by the McGraw-Hill Companies, Inc. All rights reserved.

16-31

EXERCISE

The Benefits of Exercise

Exercise and Longevity

McGraw-Hill ©2006 by the McGraw-Hill Companies, Inc. All rights reserved.

16-32

The Benefits of Exercise

Exercise helps to prevent heart disease

Aerobic exercise = sustained exercise that stimulates heart and lung activity

McGraw-Hill ©2006 by the McGraw-Hill Companies, Inc. All rights reserved.

16-33

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

McGraw-Hill ©2006 by the McGraw-Hill Companies, Inc. All rights reserved.

16-34

The Benefits of Exercise

Exercise also benefits mental health:– improves self-concept

– reduces anxiety

– reduces depression

McGraw-Hill ©2006 by the McGraw-Hill Companies, Inc. All rights reserved.

16-35

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

McGraw-Hill ©2006 by the McGraw-Hill Companies, Inc. All rights reserved.

16-36

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

McGraw-Hill ©2006 by the McGraw-Hill Companies, Inc. All rights reserved.

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

McGraw-Hill ©2006 by the McGraw-Hill Companies, Inc. All rights reserved.

16-38

Review - Learning Goal 3

–What is aerobic exercise? What are the benefits of exercise?

–What is the connection between exercise and longevity?

McGraw-Hill ©2006 by the McGraw-Hill Companies, Inc. All rights reserved.

16-39

DRUGS AND ADDICTION

Psychoactive Drugs

Addiction

Alcohol

Smoking

McGraw-Hill ©2006 by the McGraw-Hill Companies, Inc. All rights reserved.

16-40

Psychoactive Drugs

Psychoactive drugs = substances that act on the nervous system to alter states of consciousness, modify perceptions, and change moods

McGraw-Hill ©2006 by the McGraw-Hill Companies, Inc. All rights reserved.

16-41

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

McGraw-Hill ©2006 by the McGraw-Hill Companies, Inc. All rights reserved.

16-42

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

McGraw-Hill ©2006 by the McGraw-Hill Companies, Inc. All rights reserved.

16-43

Addiction

Withdrawal changes can include:– insomnia– tremors–nausea– vomiting– cramps–elevation of heart rate and blood pressure– convulsions–anxiety–depression

McGraw-Hill ©2006 by the McGraw-Hill Companies, Inc. All rights reserved.

16-44

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)

McGraw-Hill ©2006 by the McGraw-Hill Companies, Inc. All rights reserved.

16-45

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

McGraw-Hill ©2006 by the McGraw-Hill Companies, Inc. All rights reserved.

16-46

Alcohol

Alcohol acts on the body as a depressant

Approximately 1.4 million people in United States are alcoholics

McGraw-Hill ©2006 by the McGraw-Hill Companies, Inc. All rights reserved.

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

McGraw-Hill ©2006 by the McGraw-Hill Companies, Inc. All rights reserved.

16-48

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

McGraw-Hill ©2006 by the McGraw-Hill Companies, Inc. All rights reserved.

16-49

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

McGraw-Hill ©2006 by the McGraw-Hill Companies, Inc. All rights reserved.

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

McGraw-Hill ©2006 by the McGraw-Hill Companies, Inc. All rights reserved.

16-51

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

McGraw-Hill ©2006 by the McGraw-Hill Companies, Inc. All rights reserved.

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

McGraw-Hill ©2006 by the McGraw-Hill Companies, Inc. All rights reserved.

16-53

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?

McGraw-Hill ©2006 by the McGraw-Hill Companies, Inc. All rights reserved.

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

McGraw-Hill ©2006 by the McGraw-Hill Companies, Inc. All rights reserved.

16-55

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

McGraw-Hill ©2006 by the McGraw-Hill Companies, Inc. All rights reserved.

16-56

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

McGraw-Hill ©2006 by the McGraw-Hill Companies, Inc. All rights reserved.

16-57

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

McGraw-Hill ©2006 by the McGraw-Hill Companies, Inc. All rights reserved.

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

McGraw-Hill ©2006 by the McGraw-Hill Companies, Inc. All rights reserved.

16-59

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

McGraw-Hill ©2006 by the McGraw-Hill Companies, Inc. All rights reserved.

16-60

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

McGraw-Hill ©2006 by the McGraw-Hill Companies, Inc. All rights reserved.

16-61

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

McGraw-Hill ©2006 by the McGraw-Hill Companies, Inc. All rights reserved.

16-62

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

McGraw-Hill ©2006 by the McGraw-Hill Companies, Inc. All rights reserved.

16-63

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

McGraw-Hill ©2006 by the McGraw-Hill Companies, Inc. All rights reserved.

16-64

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?

McGraw-Hill ©2006 by the McGraw-Hill Companies, Inc. All rights reserved.

16-65

End of Chapter 16