Transcript Diathesis/Personality/Stress: Smoking

Health Effects of Drinking




75,000 deaths excessive consumption of
alchohol
2.3 million years of life lost
STDs, unintended pregnancy, acute
myocardial infarction, motor vehicle crashes
(14 600 deaths from a mvc in 2003; alcohol is
associated with half of automobile-related
deaths and major injuries)
4% of global burden of disease (only slightly
less than that of tobacco and high blood
pressure)
Drinking and Violence







Homicide (28 – 86%)
Assault (24 –37%)
Robbery (7-72%)
Sexual offenses (13-60%)
Drug/alcohol use by partners is assoc with 10-15
fold increase in physical violence against
partners
Within ED, patients with blood alcohol of .08 g/dL
were more than 3.2 time more likely to experience
a violent injury than patients with an
unintentional injury
Slight dose response relationship between
amount of alcohol consumed and risk of violent
injury
Health Effects and Smoking





The Leading Cause of Preventable Death
Dying from lung cancer is more than 22 times higher
among men who smoke cigarettes, and about 12
times higher among women who smoke cigarettes
compared with never smokers;
There are significantly greater respiratory effects
and cardiovascular effects;
Risk for stroke is doubled and individuals are 10
times more likely to develop peripheral vascular
disease;
Exposure to environmental tobacco smoke
continues to be a problem particularly for vulnerable
populations (I.e., children and lower socioeconomic
groups)
Comorbidity of SUDs



41-65.5% of individuals with a LT
addictive disorder also have a lifetime
hx of at least one other mental disorder
Of those with a LT mental disorder
50.9% also have a LT history of at least
one addictive disorder
Comorbidity affects course, treatment,
and prognosis
Diathesis/Personality/Stress:
Alcohol
Diathesis
Male
In younger groups,
white>black, reversed
trend in older groups
>Native American
Personality
Stressor
Type 1: <sensation,
>anxiety, >
dependence; drinks to
reduce anxeity
Type 1 more
likely to have a
stress precipitant
Type 2: >sensation,
fearless, autonomous;
drinks to reduce
inhibition
>stressors may be
assoc w/relapse
>Type 2
Males display traits
early, prealcoholic
<beta endorphin; <
serotonin
Females display
anxiety and
belligerence
> Tolerance in COAs
>antisocial
> Sensation
seeking
>parental
antagonism
Fa alcoholic
Diathesis/Personality/Stress:
Smoking
Stressor
Diathesis
Age < 25 for
Daily Smoking
Personality
< problemsolving
Risk taking
>stress via
withdrawal
< education
>history of
childhood trauma
experiences
<employment
>depression
<self-esteem
>anxiety dx
>impulsivity
Black Smokers <
White
Neuroticism