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After reading this chapter, you will be able to:

  1. Conceptualize negative behaviors as occurring on a continuum that ranges from no use through addiction.

  2. List the four most-common characteristics of addiction.

  3. Describe several of the criteria for the diagnosis of substance-use disorders.

  4. Understand the basic structure and function of the brain's reward pathways and explain how these appear to be related to substance dependency and addictive behaviors.

  5. Explain several biological, psychological, and social/environmental risk factors for the development of substance-use disorders and addictive behaviors.

  6. Describe some of the ways that public-health efforts attempt to prevent and address negative health behaviors, such as tobacco use.

  7. Discuss some of the factors one should consider when working with people trying to change negative health behaviors.

  8. Summarize evidence-based approaches for changing negative health behaviors.


image Kim teaches group exercise classes, conducts personal training sessions, and is assistant manager of the fitness facility at a large community center. One evening, as she is preparing to lead her popular dance-exercise class, one of her longtime participants, Hope, arrives with a friend. Her friend, Eliza, looks like she has been crying, with her eyes red and a little swollen. She is smiling shyly at the moment, however. Hope explains that Eliza quit smoking two days ago and is a wreck. Eliza stops smiling and sighs, "I feel like I have lost my best friend." Hope explains that maybe getting out of the house and doing things in the evening will help Eliza get through the hard early days of quitting. Kim acknowledges that this is a great idea, and she gives Eliza a brochure featuring the variety of activities available at the community center. "Exercise doubles the success rate of people trying to quit smoking," Kim tells Eliza. Eliza picks up the steps quickly and manages to stay for the entire class. Kim praises her efforts and encourages her to sign up for the class. Eliza confesses that she is terrified of gaining weight and is hoping exercise will not only help her through nicotine withdrawal but also prevent weight gain as well. Kim asks Eliza to arrive 10 minutes early for the next class so that she can give her some materials on quitting smoking.image

Negative health behaviors are behaviors likely to cause harm. They may cause harm to a person's health, as when the use of tobacco products causes cancer, or when binge eating disorder leads to obesity and the litany of health problems linked to excess body fat. Negative health behaviors may also interfere with a person's life in other ways. For example, alcohol abuse may interfere with social relationships as well as academic and job performance. Illegal behavior, such as underage drinking, driving under the influence, or use of illegal substances, can result in punishments such as suspension from school, job termination, loss of one's driving privileges, ...

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