HEALTH COMPROMISING
BEHAVIOR
HIRA KHAWAR
WHAT ARE THE CHARACTERISTICS OF HEALTH-COMPROMISING BEHAVIORS?
• Many health-compromising behaviours—such as excessive drinking,
smoking, drug use, disordered eating, unsafe sex, and risk-taking—often
begin in adolescence and share several key characteristics:
• Adolescent Vulnerability: These behaviours typically start during
adolescence and may cluster together as part of a broader pattern of
problem behaviours.
• Peer Influence & Self-Presentation: Teens often adopt these
behaviours to fit in with peers or to appear cool, mature, or attractive.
• Pleasure & Stress Relief: These behaviours can be pleasurable or help
cope with stress, despite being risky and linked to major health problems.
• Gradual Development: Engagement usually progresses from
exposure to experimentation and then regular use.
• Common Risk Factors: Poor family relationships, low self-
esteem, deviance, and poor self-control are common predictors.
• Socioeconomic Influence: These behaviours are more common
among lower social classes due to stress, hardship, and lower
health awareness.
• Overall, these shared traits help explain why such behaviours are
challenging to prevent and change.
SUBSTANCE USE DISORDER
• According to DSM-5, a substance use disorder arises when an individual
uses a substance repeatedly, which in turn causes the individual to
experience functional or clinical impairment, such as psychopathology,
physical health problems, and/or not being able to meet important
obligations at home, school, or work. Given that a diagnosis of substance
use disorder is centred on a pathological use of a substance, DSM-5
considers four basic criteria sets when determining whether a substance
use disorder is present: risky use, impaired control, social impairment,
and pharmacological effects (American Psychiatric Association, 2013).
RISKY USE
• Risky use of a substance refers to using a substance despite
experiencing problems associated with its use —for example,
continuing to consume alcohol even when experiencing
health problems directly attributable to alcohol use (e.g., liver
disease).
IMPAIRED CONTROL
• Impaired control includes not only using a substance in larger quantities or
more frequently than originally intended, but also craving.
Craving
• Craving is traditionally defined as powerful desires and urges to consume
a substance and is clinically significant because it is predictive of future
substance use and relapse (Drummond, Litten, Lowman, & Hunt, 2000;
Schlauch, Rice, Connors, & Lang, 2015).
SOCIAL IMPAIRMENT
• Individuals may not meet important work or family
obligations due to their substance use or may abandon
important recreational, occupational, or social events.
PHARMACOLOGICAL EFFECTS
• Tolerance is the process by which the body increasingly adapts to the use
of a substance, requiring larger and larger doses of it to obtain the same
effects, eventually reaching a plateau.
• Withdrawal refers to the unpleasant symptoms, both physical and
psychological, that people experience when they stop using a substance
on which they have become dependent. Although the symptoms vary,
they may include anxiety, irritability, intense cravings for the substance,
nausea, headaches, shaking, and hallucinations.
ADDICTION
• Addiction occurs when a person has become physically (i.e.,
presence of withdrawal symptoms when the drug is not
taken) or psychologically (i.e., drug becomes central to a
person’s thoughts, emotions, and activities) dependent on a
substance following use over time.
HARM REDUCTION
• Approach that focuses on the risks and consequences of
substance use rather than on the use itself (Poulin, 2006).
SMOKING
• Less unconscious
• Drinking and smoking side by side
• Smokers have more accidents
• Injuries at work
• More sick leaves
SYNERGISTIC EFFECTS OF SMOKING
• Smoking increases the detrimental effects of other risk
factors.
• Smoking + cholesterol = higher risk of morbidity and
mortality.
• Stress + smoking = higher heart rate reactivity.
•
THE THERAPEUTIC APPROACH TO THE
SMOKING PROBLEM
• Nicotine Replacement therapy
• Multimodel intervention
• Social support and stress management
• Maintenance
• Relapse prevention
• Commercial programs and self help
• Public health approach
EATING DISORDER
• Anorexia Nervosa: Anorexia nervosa is an obsessive disorder
amounting to self-starvation, in which an individual diets and
exercises to the point that body weight is grossly below
optimum level, threatening health and potentially leading to
death. Most sufferers are young women.
BULIMIA NERVOSA
• Bulimia is an eating syndrome characterized by alternating cycles of binge
eating and purging through techniques such as vomiting, laxative abuse,
extreme dieting or fasting, and drug or alcohol abuse (American Psychiatric
Association, DSM-5 Task Force, 2013). A related eating disorder, termed “binge
eating disorder,” describes the many individuals who engage in recurrent
binge eating but do not engage in the compensatory purging behaviour to
avoid weight gain (Spitzer et al., 1993). Binge eating usually occurs when the
individual is alone; bingeing may be triggered by negative emotions produced
by stressful experiences (Telch & Agras, 1996). About half the people
diagnosed with anorexia nervosa are also bulimic.
