Risk behaviors in contracting diseases Smoking -Public enemy number 1 in bringing prejudice to human health millions of deaths caused

d by this genuine vice Main disease groups: - Cancer over 90% of cancer pacients are smokers - Cardio-vascular afflictions(MI and strokes) - Respiratory disorders (acute bronchitis, pulmonary emphysema) - Pregnancy disorders (low weight or higher mortality rate at birth) - Early aging of the skin after the age of 50 The noxious effect of smoking on the non-smokers passive smoking There are approximately 4000 substances in total that are released through pyrolysis, from which the following have the major pathological effect: nicotine, tar, carbon monoxide. Effects: Respiratory System:
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Drying of nasal and buccopharyngeal mucosa Increased sensibility to superior airways infections High incidence of middle otitis and asthma in children whom parents are smokers

Cardio-vascular System MI ACV Obliterative chronic arteriopathy by favoring atherosclerosis

Dogestive System: High incidence of ulcers Low healing capacity High recurrence rate

Neoplastic afflictions: Pulmonary, laryngeal, esophageal, gastric, biliary, pancreatic, breast and cervical cancer.

Pregnancy: Cognitive deficits and developmental problems in childhood

Other effects: Vitamin B and C deficiency Epidermal alterations (wrinkles, yellow fingers) Decreased visual acuity and memory Decreased sexual function and fertility

Psychological and conjunctural causes: It installs based on a mimic process. Literature data accentuates the role of the external factors: distress, depression, fatigue, negative moods induced by conflictive or aversive events or by loss, etc. But a high number of smokers present obsessive-compulsive features and a high level of anxiety. The causes of resisting to stop smoking are the state of well being, relaxation and also conditioned reflexes. Psychological approach of the smoker: 1. Problems with therapeutical compliance because blaming and the stigmatization of smokers is lesser than of the alcohol consumers; the last ones comply much easier with medical and social interdictions Although smokers motivation is high, it gets stroked by the resistance induced by objective factors hipocompliance inducers which are: Physical and psychological nicotine addinction Psychosocial distress act indirectly by strenghtening the conditioned reflexes Entourage influence

But also subjective factors: The lack of will Showing off

Fear of obesity

2. Psychologists methods of intervention:

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Quitting smoking imply the amplification of the subjects motivation in that direction, meant to annihilate all the other motivations in favor of this vice Increase of motivation for quitting smoking by:

Self contracting Making lists of goods that could be bought with the saved money Announcing the family, friends, colleagues Making diaries in which to analyze why they couldnt keep himself from smoking that day

Cognitive-behavioral coercive schemes: Avoiding smoking places or situations Aversive conditions (smoking place near the dumpster) Trying substitutive methods (holding a pencil between the fingers) Joining non-smoker groups

Planning and gradually reducing the cigarettes Reducing the number of cigarettes gradually Reaching the limit of 10-12 cigarettes Association with tranquilizers Family support

Nicotine substitutes Helpful behaviours: candy, chewing gum etc Maintaining the stability of the withdrawal

Supportive psychotropic medication

Alcohol

The psychological and somatic effects of the alcohol

Most people consider alcohol as a stimulant, but the pharmacologists classify it among inhibitory substances. Moderate consume does not attract psychological or somatic disorders. High doses of alcohol cause alcohol intoxication, but can go up to coma or death. In case of chronic consumption, pathological manifestations occur, characterizing alcohol chronic intoxication.

Alcohol chronic intoxication

1. Phase of excitation, since the beginning of alcohol ingestion: euphoria, verbose, disinhibition 2. The inebriated phase with speech disorders, uncontrolled moves, unbalanced walk 3. Sleep almost impossible to avoid 4. Ethylic coma

The acute ethylic intoxication creates reversible psychological changes and does not leave traces if the degree of intoxication was moderate especially if is not repeated frequently. Particularly euphoria, created by regular alcohol consumption, has effect over the subject making him a chronic alcohol consumer, a truly alcoholic.

Chronic alcoholism

High alcohol consumption leads to a decrease of the mental and somatic health, which is underlined by deviant behavior often with antisocial nature.

Steps taken by chronic drinker: 1. 2. Occasional chronic ethylic intoxications The alcohol abuse as a chronic consumption: with disease risk (35-49 UA - M and 14-35 UA - W) high disease risk (over 53 UA W and 50 UA M), with somatic pathological effects (gastroduodenitis, pancreatitis, arterial hypertension, chronic hepatitis, ) but also psychological ( insomnia, daytime sleepiness, memory loss, ) 3. Physiological dependence with local somatic and neuropsychological damages. Abstinence syndrome According to DSMIV: 1. autonomic hyperactivity 2. severe tremor of the extremities 3. insomnia 4. nausea and vomiting 5. visual hallucinations 6. psychomotor restlessness 7. anxiety 8. grand-male crises The behavior of the alcoholic:

1. 2. 3. 4. 5.

constant need for alcohol egocentrism unseriousness (lies, not keeping any promise) violence, irascibility frequent remorse, suicide attempts ( CAGE Formula)

C cut down A annoyed G guilty E eye opener

6. antisocial conflicts: marital/familial

7. absenteeism, major infractions Neuropsychological symptoms in alcoholism

1. Cognitive disorders: loss of attention, memory, delirium, hallucinations, dementia 2. Affective disorders: anxiety, irritability, affects (ample, brutal, short-timed emotional status: e.g. screams, crying) 3. Behavioral disorders: sleepiness, insomnia, exacerbated sexuality initially or diminished (chronic), psychomotor agitation leading to abstinence syndrome with delirium tremens. 4. Neurological disorders: tremor of the extremities. Diseases and disorders caused by alcohol:

1. gastrointestinal system 2. nutrition 3. central nervous system 4. immune system 5. endocrine system 6. liver 7. heart 8. muscles 9. blood 10. breast, pancreas 11. lung Types of alcoholics: 1. the argumentative drinker: with physical addiction to alcohol, undisciplined drinker behavior but without loss of control 2. occasionally: without addiction but forced to consume alcohol on occasion 3. addicted: physical and somatic dependence with loss of control when reaching abstinence 4. in mirror highly accentuated alcohol dependence, not capable of being abstinent but keeping control even in case of high doses tolerance syndrome 5. episodic with psychological dependence and loss of control but with increased capacity of abstinence

Treatment

1. Rehab medication plus supportive and cognitive psychotherapy Prevention by raising patients motivation for keeping being abstinent

Prophylactic and therapeutic intervention:

1. finding the subpopulation with high risk 2. detailed information over the nature of the risks ( bad behavior and social stigma, diseases, mental disorder) 3. open communication style: emphatic, without paternalistic attitude, without labels and aggression 4. main content of recommendations: - limit the number of cups consumed daily - self-monitoring behavior of consumption - change of the consume rhythm - assertive learning of the drink refusal - initiating a system of awards - learning alternative coping styles Drug abuse and addiction Causes General psychosocial factors - curiosity or experimentation - pressure from the group or wish to be part of a group - experiencing a pleasant feeling of relaxation and euphoria - anesthetic effect which helps to relieve physical or emotional pain Biological factors - genetic factors

- unspecified vulnerability Learning and conditioning - positive reinforcement - nice effects - negative reinforcement - withdrawal Environmental and social factors - cultural factors - group behavior - law - cost - availability of drug Family factors - drug addiction to several generations of one family - high incidence of lack of a parent through divorce, abandonment, death or incarceration - highprotection or excessive control - distant father, uncarry or absent - children with behavioural problems Symptoms: 1. Physical Symptoms:fatigue, multiple somatic complaints, red eye or hazy, cough 2.Emotional Symptoms: changes of personality, mood, low self-esteem, irritability, irresponsible behavior, poor judgment, depression, lack of general interest 3.Family:argue person, not respecting the rules, away from family 4. At school: low interest, negative attitude, absences, discipline problems, reduced performance 5. Social issues: anti-social, changes in their clothing, new friends, etc.. Prevention: Areas of intervention 1. intrafamilial relationships 2. Relationship of the group,of the community 3. school environment Preventive strategies: 1. active involvement of family 2. educating young people to recognize peer pressure and advertising industry tricks and effects of drugs 3. providing alternatives to drug use

Treatment Combine pharmacotherapeutic and psychosocial interventions

Obesity Pathological consequences of obesity - the somatic 1.cardiomyopathy 2. HTA 3. type II diabetes 4.hypercholesterolemia 5.cancer: colorectal cancer and prostate,utero.ovarian, bile and breast cancer 6. osteoarthritis 7.digestive diseases (gallstones, gastroesophageal reflux) 8.respiratory failure 9.heart failure 10.skin diseases

In terms of psychosocial 1.inferiority complex 2.social discrimination Etiology Decrease in metabolism Genetic obesity Pathological causes Physiological causes Behavioral causes - Malnutrition - Decrease in physical activity -Feeding behavior induced by psychosocial factors includes: -Increased appetite -Tahifagiapredilecie for sweets

-Compulsive ingestion -Habit to pick -Frequent association of alcohol -Predilection for spices -Devastating psychological reactions

Types of psychogenic obesity 1. developing obesity - childhood, communication disorders, extended requests. atmosphere of coercion, psihotraumatized major events 2. reactive obesity related to triggered situations to high-stress value, beginning of installation that is linked to stress - stress hipercortizolemy. - adipogenetic effects of this hormone Hyperphagia food behavior 1. Binge - eating (food orgy) - attacks of bulimia 2. Fits of nocturnal hyperphagia 3. Hyperphagia behavior generated by eustress 4. Compulsive intake - food automatism The psychological profile of obese Obese Type genial - optimisticattitude with hedonistic teint Obese type tense - with affective disorder wich generate the compensating need of food Obese type complexed -with physical and mental handicap Patients become obese because of medical treatments

Principles of psychological approach Simple supportive psychotherapy - information - encouraging - Purchase of relaxation times Specific psychotherapies 1. cognitive-behavioral 2. hypnotherapy 3. directed imagery Four. relaxation techniques and hypnosis.

Arama Oana, Silaghi Razvan Andrei, Nicolae Cristina Grupa 33, Seria 3