Treatments of Addiction
Chemotherapy: Naltrexone used to target & block dopamine receptors (reward) substitute drugs as replacement therapy: cigarettes replaced with Nicorette gum/ patches, breaks cycle. Heroine is replaced with methadone, illegal but obtained through doctor’s, dose cut down over a time. Addicts in contol but may develop reliance. UK statistics Authority figures show that methadone was responsible for over 300 deaths in the UK in 2007.
Behavioural: learning. Aversion therapy: Antabuse & alcoholics, association between drinking alcohol & being sick as Antabuse 10X worse effects. 2 outcomes: stop drinking all together or they can refuse. Cardiac, pulmonary problems may experience worse symptoms & aggression.
Reinforcement: Sindelar et al 2007, p's randomly chosen reward/ no reward & recieve equal care. Rewards given money, negative urine samples 60% higher than control works. Doesn't attack root cause 7 addicts may engage in a different type of addictive behaviour instead.
CBT: chang how you think & what you do, correct - thinking patterns. Attacks root cause. Ladouceur et al 2001 randomly allocated 66 pathological gamblers either to cognitive therapy or to a waiting list, 86% completed treatment no longer fulfilled the DSM criteria for addictive gambling & had better perception of control over their problem improvements mainitained after 1 year follow up.
state of mental or emotional strain or tension resulting from adverse or demanding circumstances e.g. fight or flight’ & GAS
Lazarus’ cognitive appraisal: stressor: prevent the experience of stress is to deal with the situation that triggers stress. Systematic desensitisation: perceived threat from stressor. Stree inooculation added by Meichenbaum. Conceptualisation, analyse diff features of situation. Skills training, real life application. EVAL: gain confidence but £ and time.
CBT: encourages participants to be realistic on ability to cope, considering alternative assumptions. Clark in 1999 looked at effectiveness of briefer (cost effective CBT form) p's had panic disorders FCT & BCT. Both significantly better than contol but no diff between 2 groups. Hardiness training: example of management, uses CBT. Assesses stress amount & hardiness of attitudes. Focusing: patients are trained to stop stress signs & identify stressors. Analyse these stressful situations & think of resolutions. Challenges to show how they cope.
US military personnel were assessed before combat. Experienced life threatening situations had higher hardiness levels = less likely to develop PTSD. Sample Bias & Ethics
Physiological: Beta-blockers, high BP BZ's enhances action of natural brain chemical, GABA excitatory NT reduced & p calmer. £ & work quick, addictive & SE, attack root cause?
Factors affecting Health
Age: childhood SLT. Ross 87, weight affected by parents’ exercise habits. Klesges et al 93 children can own decisions, TV viewing partly controlled important factor of weight gain, children are capable of making informed decisions but impact later life.
Adolescence: own decisions & social factors. Eiser (1997) estimated 50% adolescent illnesses & deaths preventable due to negative health behaviours e.g. substance abuse. 'invincibility fable’- where they believe it won’t happen to them. Adulthood: Greendale et al 95 retrospective study 1700 men and women to rate exercise levels as teenagers, at 30 and then at 50. Both sexes with highest activity levels had higher bone mineral density. remembered accurately? Elderly: Fiatarone 94 after 10 weeks, frail nursing home residents 72-98 resistance training 3 times a week were able to walk faster & increased stair-climbing ability by 28%.
S/E status: low paid & long hours. Warren & Schwartz 03 BP was lower in normal 9- 5 Generalise? Wealth = better HC. Blair 93 language is important, doctors of high SES more likely to be incomprehensible to patients of low SES status. Reliable?
Gender: Arber 1999 men 15-44, 3x higher mortality rate than women from accidents& suicide. Women mental health problems 'carer' provision focus on reproductive roles. Arber 1999 US females less likely to receive kidney transplants than men in the UK women are less likely to be offered a coronary heart bypass. Ethnocentric. 1994 statistics show that 15% of women over 65 suffered disabilities that needed daily help compared to 8.5% of men aged 65+
Issues in Health Promotion
process of enabling people to increase control & improve health. Moves beyond focus on individual behav towards range of S&En interventions.
Yale’s MoC, 1950's. Research programme set up as a response to increasing role of mass communication in £, P & S spheres. Hovland 1953: communicator - credibility source. communication - persuade someone their health is a risk, frighten people = more likely behaviour change, majority of health promotions contain element of fear arousal = ego defence mechanisms to cope = reduce chance of chane. audience = susceptible to persuasion ethics?
HBM) (Rosenstock 1966, Becker & Rosenstock 1984) helps to predict and explain people’s health behaviour. Influencing factors - internal = pains, external = health campaigns & social pressures. Beliefs of threat of illness & preventative action. Actions: action to prevent illness depending on both factors & beliefs. Specific. E.g. education on a population would be more beneficial for targeting certain perceptions, medical procedures (Reminders for screening tests) and barriers to use (challenge the social embarrassment to promote condom use) easily applied: Marks et al 2000 found only 10% accounted variance in behav when V & behav combined, only predict & purely a cognitive
Issues in Health Promotion 2
Locus of control Ajzen 1991, self-efficacy & perceived behavioural control the same. Povey (2000) argued that perceived control is made up of two components Bandura’s self-efficacy & perceived control over the behaviour. Wallston et al (1978) scale specifically designed to measure the extent to which people perceive their state of health as being under internal or external control. Multidimensional health locus of control scale (MHLC)
Internal Health locus of control: strong IHLC feels responsible for their health. . Powerful others health locus of control others are responsible for your own state of health, strong PHLC are less likely to take personal responsibility for changing. Chance health locus of control less likely to take responsibility for looking after their own health
Bandura 1977 self-efficacy: “belief in ones capabilities” 4 sources contribute to type of locus of control we have: social modelling (others succeed = motivation to do well) Mastery experiences (being able to successfully preform a task) social persuasion and our psychological responses.
Townsend 1993 adolescents 13-17, smokers and/or drinkers. Regular smokers = smoked at least 1 cigarette a week. Those who had lower internal locus of control were regular smokers & drinkers had low scores compared to powerful locus of control. Teenage smokers have lower belief in the ability to control their own health & as a result to strengthen self-efficacy could reduce smoking levels preventing issues in later life. Hard to generalise