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  1. 1. Chapter OutlinePlease note that much of this information is quoted from the text.I. HEALTH, ILLNESS, AND DISEASE A.Children’s Health • Prevention is administered through immunizations and safety precautions. • Poverty is related to poor health status of about 11 million preschool children who suffer from malnutrition. B. Adolescents’ Health • Adolescence is a critical juncture in the adoption of behaviors relevant to health. Many things associated with poor health habits and early deaths in adulthood begin during adolescence. • Social contexts, including families, peers, and schools influence adolescent health. Parents and older siblings can be important models of health-enhancing behaviors. Research has shown that youth who do not eat dinner with a parent five or more days a week have dramatically higher rates of smoking, using marijuana, getting into fights, and initiating sexual activity. Peer pressure can lead to unhealthy behaviors. Teachers can serve as important health role models. Improving adolescent health involves reducing adolescents’ health –compromising behaviors and increasing health-enhancing behaviors. C. Emerging and Young Adults’ Health • Emerging adults have more than twice the mortality rate of adolescents. • Although emerging adults have a higher death rate than adolescents, emerging adults have few chronic health problems, and they have fewer colds and respiratory problems than when they were children. • Most college students know about preventing illnesses, but few apply it to themselves. • Few emerging adults stop to think about how their personal lifestyles will affect their health later in life. • The peak of performance in young adulthood disguises the abuse done to their bodies. D. Health and Aging • Chronic disorders are characterized by a slow onset and long duration and vary in middle age for females and males. — Females: arthritis, hypertension, and sinus problems — Males: hypertension, arthritis, hearing impairments, and heart disease — Men have a higher incidence of fatal chronic condition, while women have a higher incidence of non-fatal chronic conditions. — Over age 65: conditions associated with the greatest limitation on work are heart conditions, diabetes, asthma, and arthritis. — Low income is strongly related to health problems in late adulthood. — Osteoporosis is an aging disorder that involves an extensive loss of bone tissue, especially in postmenopausal women who are thin and small boned. — Prevention requires calcium, vitamin D, exercise, and no smoking. • Diversity in Life-Span Development: Culture and Health – Culture plays an important role in health. • When people migrate to another culture, their health practices are likely to change while their genetic predispositions to certain disorders remain constant. • One study found that Japanese men living in Japan have had the lowest rate of coronary heart disease, those living in Honolulu have had an intermediate rate, and those living in San Francisco have had the highest rate. • Dementia: a global term for any neurological disorder causing mental deterioration. • It is estimated that 20% of individuals over the age of 80 have dementia.
  2. 2. • Alzheimer’s disease (AD): a progressive, irreversible brain disorder characterized by a gradual deterioration of memory, reasoning, language, and eventually, physical function. — Affects about 5.2 million people in the United States and may reach 10 million as the Baby Boomers age. — Alzheimer’s can be categorized as early-onset (initially occurring in individuals less than 65 years of age) or late-onset (initially occurring in individuals 65 years of age and older). — Involves a deficiency in acetylcholine, a neurotransmitter involved in memory. — The brain shrinks and deteriorates and AD progresses. — Tangles and plaques in the brain tissue are pervasive in AD. — The cause of AD is unknown, although age and genetic predisposition appear to play a role. The number of people with AD doubles every five years after 65 years. — A protein called apolipoprotein E could play a role in as many as one-third of the cases of AD. — The apoE gene appears to lower the age of onset. — It is possible to lower the risk for AD with a healthy diet, exercise, and weight control. — Mild cognitive impairment (MCI) represents a transitional state between the cognitive changes of normal aging and very early AD and other dementias. — MCI is increasingly recognized as a risk factor for AD. — Early detection is sometimes possible with brain scans such as MRIs. — Although there is no cure for AD, there are drugs that can improve cognitive functions and slow down the progression of the disease. These drugs are approved for only the mild to moderate stages of AD. — Care of AD patients is stressful and puts a strain on caregivers, usually the family. Respite care has been developed to ease the strain on caregivers. — Research in Life-Span Development: The Stress of Caring for an Alzheimer patient at home — Researchers have recently found that the stress of caring for an Alzheimer patient at home can prematurely age the immune system, putting caregivers at risk for developing age-related diseases. • Parkinson’s Disease Another type of dementia, chronic and progressive, is Parkinson’s Disease (PD). PD is characterized by muscle tremors, slowing of movement, and partial facial paralysis. The degeneration of dopamine-producing neurons causes Parkinson’s disease. It is not clear why these neurons degenerate, but treatment involves administering drugs that enhance the effect of dopamine (in the early stages of the disease) and the drug L- Dopa in later stages (this drug is converted into dopamine in the brain). Some problems with L-Dopa are that it is difficult to determine the appropriate dose and it loses its effectiveness over time. • Health Treatment in Older Adults — The development of alternative home and community-based care has decreased the percentage of older adults who live in nursing homes. — The quality of nursing homes and other extended-care facilities varies widely and is a national concern, with more than one-third falling below federally mandated standards. — Alternatives include home health care, elder-care centers, and preventive medicine clinics. — Currently, there is an increased demand for but shortage of home care workers because of the increase in population of older adults and their preference to stay out of nursing homes. — Nursing home residents that feel in control and a sense of self-determination experience better health.II. NUTRITION AND EATING BEHAVIOR A. Infancy
  3. 3.  From birth to 1 year of age, human infants triple their weight and increase their length by 50 percent. 1. Breast-Feeding Versus Bottle Feeding • For the first 4 to 6 months of life, human milk or an alternative formula is the baby’s source of nutrients and energy. • The American Pediatric Association and the American Dietetic Association strongly endorse breast-feeding throughout the first year of life. • There are several benefits to the child when breastfed: • Lower gastrointestinal infections • Lower respiratory tract infections • Protects against wheezing • Less ear infections • Less atopic dermatitis • Less likely to become overweight or obese throughout life • Less likely to develop diabetes • Less likely to experience SIDS • There are several benefits to the mother who breastfeeds: • Lower incidence of breast cancer • Reduction in ovarian cancer • Small reduction in type 2 diabetes • Lower incidence of metabolic syndrome in midlife • Women should not breast-feed if they have AIDS or some other infectious disease transmittable via breast milk, have TB, or is taking any drug that would be unsafe for the infant. • Caution is warranted in interpreting research on the benefits of breastfeeding. Correlation does not imply causality. 2. Malnutrition in Infancy • Marasmus—a wasting away of body tissues in the infant’s first year caused by severe protein-calorie deficiency. • Kwashiorkor—a condition caused by a protein deficiency, in which the child’s face, legs, and abdomen swell with water and the vital organs collect the nutrients that are present and deprive other parts of the body of them. • Severe and lengthy malnutrition is detrimental to physical, cognitive, and social development.B. Childhood 1.Malnutrition • Malnutrition and starvation continues to be a major threat to millions during the childhood years. • Poor nutrition is a special concern for children from low-income families. • There is a correlation between SES and use of fresh vs. canned fruits and vegetables. • WIC is a program that supports healthy eating. 2.Eating Behavior and Parental Feeding Styles • In most children in the United States insufficient food is not a key problem. • Receiving poor nutrition as a result of unhealthy eating habits and being overweight threatens American children. 3.Parental Feeding Styles • Children’s eating behavior is strongly influenced by their caregivers’ behavior. • Children’s eating behavior improves when caregivers eat with children on a predictable schedule, model eating healthy food, make meal times pleasant occasions, and limit distractions. 4.Overweight Children •Body mass index (BMI) is used to establish categories for being overweight.
  4. 4. • Children and adolescents at or above the 95th percentile of BMI are included in the overweight category, and those at or above the 85th percentile are included in the at risk category for being overweight. • 11% of children and adolescents are obese, 16% are overweight, and 38% are at risk for being overweight. • The trend towards an increase in the percentage of children that are overweight is occurring worldwide. • Being overweight in childhood is linked to being overweight in adulthood. • High BMI in childhood increases the risk for metabolic syndrome in adulthood. •Many parents do not realize that their children are overweight. 5.Heredity and Environment • Both heredity and environment influence whether children will become overweight. • Environmental factors that influence whether children become overweight or not include the greater availability of food, energy saving devices, declining physical activity, parental monitoring of children’s eating habits, the context in which a child eats, and heavy TV watching. 6.Consequences of Obesity • Childhood obesity is a risk factor for high blood pressure, diabetes, elevated blood cholesterol, pulmonary problems, hip problems, low self-esteem, depression, and exclusion from peer groups. • Overweight and obese children are more likely than normal-weight children to be both the victims and perpetrators of bullying. 7. Treatment of Obesity • Many experts recommend a program that includes a combination of diet, exercise, and behavior modification to help children lose weight. • Schools and parents both play a role in combating obesity.C.Adolescence  Proper nutrition and being overweight are also problems in adolescence.  Teenagers in the United States eat more junk food than do teenagers in most other countries.  Adolescents are more likely to eat fruits and vegetables if they are available in the home and the parents’ model eating them.  The percentage of overweight adolescents has been increasing and around 17%.  Obesity during adolescence is a risk factor for obesity in adulthood.  African American girls have an especially high risk of being overweight during adolescence.  A combination of caloric restriction, exercise, reduction of sedentary activity, and behavioral therapy are moderately effective in helping adolescents lose weight. 1. Anorexia Nervosa • An eating disorder that involves the relentless pursuit of thinness through starvation, which can lead to death. • Characteristics: Weighing less than 85 percent of what is considered normal, an intense fear of gaining weight, and a distorted image of body shape. • Most anorexics are young adult females from well-educated, middle- and upper-income homes, and are competitive and high achievers. • The “thin is beautiful” image contributes to the incidence of anorexia. 2. Bulimia Nervosa • An eating disorder in which the individual consistently follows a binge-and-purge eating pattern. • Most bulimics are females in their late teens or early 20s, are preoccupied with food, and are depressed or anxious.D. Adult Development and Aging 1. Obesity • Approximately 60% of Americans are obese or overweight. • Obesity is linked with increased risk of hypertension, diabetes, and cardiovascular disease.
  5. 5. • Obesity rates are increasing faster for women than men. • Most research suggests there is a hereditary component in obesity. • Evolution gave use a “sweet tooth” that is no longer adaptive. • Environmental factors include greater availability of (high-fat) food, energy-saving devices, and declining physical activity. 2. Exercise and Dieting • The most effective programs for losing weight include exercise. • Even when diets do produce weight loss, they can place the dieter at risk for other health problems. • When overweight people diet and maintain their weight loss, they become less depressed and reduce their risk for a number of health-impairing disorders. 3. Calorie Restriction (CR) and Longevity • Considerable evidence exists that food restriction can increase the life span of laboratory animals. • Diet restriction also delays chronic problems like increased cholesterol and kidney disease. • Some scientists believe CR may lower the level of free radicals and reduce oxidative stress in cells, slowing the aging process. 4. The Growing Controversy Over Vitamins and Aging  Antioxidants may help to slow the aging process (by counteracting the cell damage caused by free radicals) and improve the health of older adults.  There is no evidence that antioxidants can increase the human life span, but some aging and health experts argue that Vitamin C and beta-carotene may reduce a person’s risk of becoming frail and sick in the later adult years.  Taking B vitamins is positively related to cognitive performance in older adults.III. EXERCISE • Exercise is linked with many aspects of being physically and mentally healthy. A. Childhood and Adolescence • American children and adolescents are not getting enough exercise. • Children need daily exercise. • TV viewing and computer use may place children at risk for reduced physical activity and weight gain. • Preschools provide an important setting to promote physical activity. • Physical activity in childhood decreases body fat, increases muscle strength, and improves planning skills. • Individuals become less active as they reach and progress through adolescence. • Ethnic differences in exercise participation rates also occur and these rates vary by gender. • Only 33percent of high school students take daily PE classes. • Ways to help children and adolescents exercise more include improving PE classes in schools, offering more physical activity programs, having children plan community and school exercise activities that interest them, encourage families to focus on physical activity and challenge parents to exercise more. B.Adulthood • Both moderate and intense exercise appears to produce physical and psychological benefits. • One of the primary health benefits of exercise is prevention of heart disease. Recent research also shows that exercise is linked with a reduced risk of developing colon and rectal cancer. • Many health experts recommend aerobic exercise—sustained activity that stimulates heart and lung functioning. • If you exercise enough to burn more than 2,000 calories a week, you can reduce your risk of a heart attack by two-thirds.
  6. 6. • Exercise benefits mental health, improves self-esteem, and reduces anxiety and depression. • Applications in Life-Span Development: Exercise • Strategies for building exercise in to your life include reducing TV time, charting your progress, getting rid of excuses, imagining the alternatives, and learning more about exercise. C. Aging and Longevity • Regular exercise can lead to a healthier life in middle and late adulthood and can increase longevity. • Gerontologists recommend strength training in addition to aerobic activity and stretching for older adults. • Exercise is an excellent way to maintain health. • Research have found that exercise is correlated with increased longevity, prevention of common chronic diseases, improvement in the treatment of many diseases, improvement in older adults’ cellular functioning, optimization of body composition, reduction in the decline of motor skills, and improvement of mental health and cognitive functioning. • Despite the power of exercise on the aging process, older adults have only slightly increased their exercise levels in recent years. • Possible explanations of why older adults fail to increase their amount of exercise include such factors as chronic illnesses, life crises that disrupt exercise schedules, embarrassment of being around others who are in better shape, and the “why bother?” factor.IV. SUBSTANCE USE A. Adolescence and Emerging Adulthood • Cigarette smoking generally begins in childhood and adolescence and many alcoholics establish their drinking habits during secondary school or college. • Drug use poses a special hazard to development when adolescents and emerging adults use drugs as a way of coping with stress. • Drug use in early adolescence has more detrimental long-term effects on development of responsible, competent behavior than drug use in late adolescence. 1. Trends in Adolescent Drug Use a. The United States has one of the highest rates of adolescent drug use of any industrialized nation. b. Illicit drug use by 8th–12th grades had been declining since the late 1990s. c. There has been a decline in U.S. adolescent alcohol use in recent years. d. Cigarette smoking among U.S. adolescents has been gradually declining since the late 1990s. e. Cigarette smoking is one of the most serious yet preventable health problems. f. Risk factors for becoming a regular smoker in adolescence include having a friend who smokes, a weak academic orientation, and low parental support. g. An alarming trend is use of prescription painkillers by adolescents. 2. The Roles of Development, Parents, Peers, and Educational Success a. A special concern involves adolescents who begin to use drugs early in adolescence or even in childhood. b. Parents, peers, and social support can play important roles in preventing adolescent drug abuse. c. Positive relationships, parental control and monitoring, family meals, having friends all help decrease the risk of drug use in adolescence. d. Educational success is a strong buffer for the emergence of drug problems in adolescence. 3. Emerging Adults’ Drug Use a. The transition from high school to college may be a critical transition in alcohol abuse.
  7. 7. b. Approximately 40% of U.S. college students report that they drink heavily. c. Binge drinking is related to missing classes, physical injuries, troubles with police, and having unprotected sex. d. Many individuals reduce their use of alcohol and drugs by their mid-20s. e. Cigarette smoking peaks in emerging adulthood.B. Substance Abuse in Older Adults Binge drinking peaks between the ages of 18–24 and declines throughout adulthood. While binge drinking and overall drug use declines in adulthood, substance use and abuse is still of concern across the adult years. The majority of adults over 65 years in the United States completely abstain from alcohol. The Substance Abuse and Mental Health Services Administration has identified substance abuse among older adults as the “invisible epidemic” in the U.S. There is concern about the abuse of both illicit and prescription drugs. The consequences of abuse—such as depression, inadequate nutrition, congestive heart failure, and frequent fall—may erroneously be attributed to other medical or psychological conditions. Many older adults are taking multiple drugs, which poses an increased risk for substance abuse. Despite the concerns about substance abuse in adulthood, moderate alcohol use in older adults appears to provide a protective effect, especially red wine.