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50-641: Behavioral medicine is especially relevant in recent days, where many of the health problems are primarily viewed as behavioral in nature, as opposed to medical. For example, smoking, leading a sedentary lifestyle , and alcohol use disorder or other substance use disorder are all factors in the leading causes of death in the modern society. Practitioners of behavioral medicine include appropriately qualified nurses , social workers , psychologists , and physicians (including medical students and residents), and these professionals often act as behavioral change agents, even in their medical roles. Behavioral medicine uses

100-457: A meta-analysis of RP techniques in the treatment of alcohol, tobacco, cocaine, and polysubstance use , and upon reviewing 26 studies, concluded that RP was successful in reducing substance use and improving psychosocial adjustment. RP seemed to be most effective for individuals with alcohol problems, suggesting that certain characteristics of alcohol use are amenable to the RP. Miller et al. (1996) found

150-500: A cognitive component to pain, leading to the gate control theory and the discovery of the placebo effect. Psychological factors that affect pain include self-efficacy , anxiety, fear, abuse, life stressors, and pain catastrophizing, which is particularly responsive to behavioral interventions. In addition, one's genetic predisposition to psychological distress and pain sensitivity will affect pain management. Finally, social factors such as socioeconomic status, race, and ethnicity also play

200-422: A large shift from manual labor jobs (e.g. farming, manufacturing, building) to office jobs which is due to many contributing factors including globalization, outsourcing of jobs and technological advances (specifically internet and computers). In 1960, there was a decline of jobs requiring moderate physical activity from 50% to 20%, and one in two Americans had a physically demanding job, while in 2011 this ratio

250-441: A malpractice framework or not. Our modern-day culture involves many acute, microstressors that add up to a large amount of chronic stress over time, leading to disease and illness. According to Hans Selye, the body's stress response is designed to heal and involves three phases of his General Adaptation Syndrome: alarm, resistance, and exhaustion. An example of how to apply the biopsychosocial model that behavioral medicine utilizes

300-502: A negative association between exposure to an existing urban motorway and moderate to vigorous physical activity. The proportion of physically active individuals was higher in high- versus low- walkability neighborhoods. Rising rates of being overweight, obesity, and physical inactivity in China's rapidly growing cities and urban populations have been due to urban development practices and policies. Occupational sedentary behaviour accounts for

350-472: A primary structural protein in tendons and ligaments, tends to harden when not regularly stretched and mobilized, which leads to decreased flexibility and increased risk of injury in the back. Physical inactivity reduces the efficiency of the cardiovascular system. Sluggish blood flow allows for the accumulation of fatty acids and lipids in the blood vessels. These deposits can adhere to the vessel walls, forming plaques ( atherosclerosis ), which eventually narrow

400-518: A risk factor for: Extended periods of sitting reduce overall blood circulation. This diminished blood flow leads to reduced oxygen delivery to the brain ( cerebral hypoxia ), impairing cognitive functions such as concentration and alertness. The brain relies heavily on a continuous supply of oxygen and glucose for optimal performance; decreased circulation hampers this supply, resulting in cognitive sluggishness and decreased mental sharpness. Sitting, particularly with poor posture, often involves craning

450-784: A role in the experience of pain. Behavioral medicine involves examining all of the many factors associated with illness, instead of just the biomedical aspect, and heals disease by including a component of behavioral change on the part of the patient. In a review published 2011 Fisher et al. illustrates how a behavior medical approach can be applied on a number of common diseases and risk factors such as cardiovascular disease/diabetes, cancer, HIV/AIDS and tobacco use, poor diet, physical inactivity and excessive alcohol consumption. Evidence indicates that behavioral interventions are cost effectiveness and add in terms of quality of life. Importantly behavioral interventions can have broad effects and benefits on prevention, disease management, and well-being across

500-479: A significant proportion of sitting time for many adults. Some workplaces have implemented exercise classes at lunch, walking challenges among coworkers, or allowing employees to stand rather than sit at their desks during work. Workplace interventions such as alternative activity workstations, sit-stand desks, and promotion of stair use are among measures implemented to counter the harms of a sedentary workplace. A 2018 Cochrane review concluded that "At present there

550-429: A sitting, reclining or lying posture". Spending most waking hours sitting does not necessarily mean that an individual is sedentary, though sitting and lying down most frequently are sedentary behaviors. Esmonde-White defines a sedentary lifestyle as a lifestyle that involves "longer than six hours a day" of sedentary behavior. Effects of a sedentary work life or lifestyle can be either direct or indirect. One of

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600-578: A strong predictor of relapse. Relapse prevention techniques can include having booster sessions with a therapist, being vigilant for and trying to prevent or avoid high risk situations, and being ready to re-apply previously used therapies if a disturbance does occur. Carroll et al . conducted a review of 24 other trials and concluded that RP was more effective than no treatment and was equally effective as other active treatments such as supportive psychotherapy and interpersonal therapy in improving substance use outcomes. Irvin and colleagues also conducted

650-540: A system for certification of Relapse Prevention Specialists (CRPS). Relapse prevention is a specific intervention modality in the treatment of substance use disorder that focuses on developing skills and cognitive-behavioral techniques to help patients and their clinicians identify and manage situations that increase the risk of relapse. These situations can include both internal experiences, such as automatic thoughts related to substance use, and external cues, like people or places that are associated with substance use. In

700-426: Is a cognitive-behavioral approach to relapse with the goal of identifying and preventing high-risk situations such as unhealthy substance use , obsessive-compulsive behavior, sexual offending, obesity , and depression. It is an important component in the treatment process for alcohol use disorder , or alcohol dependence . This model founding is attributed to Terence Gorski's 1986 book Staying Sober . Relapse

750-423: Is a term for the amount of time a person spends looking at a screen such as a television, computer monitor, or mobile device. Excessive screen time is linked to negative health consequences. Sedentary behavior is not the same as physical inactivity : sedentary behavior is defined as "any waking behavior characterized by an energy expenditure less than or equal to 1.5 metabolic equivalents (METs), while in

800-499: Is among its academic forebears, albeit, it is now obsolete as an psychological discipline. In the form in which it is generally understood today, the field dates back to the 1970s. The earliest uses of the term were in the title of a book by Lee Birk ( Biofeedback: Behavioral Medicine ), published in 1973; and in the names of two clinical research units, the Center for Behavioral Medicine, founded by Ovide F. Pomerleau and John Paul Brady at

850-571: Is characterized by feelings, thoughts, and actions that ultimately lead to the individual's returning to their old behavior. Relapse is thought to be multi-determined, especially by self-efficacy, outcome expectancies, craving, motivation, coping, emotional states, and interpersonal factors. In particular, high self-efficacy , negative outcome expectancies , potent availability of coping skills following treatment, positive affect , and functional social support are expected to predict positive outcome. Craving has not historically been shown to serve as

900-594: Is commonly used and was found to be effective in preventing relapse, especially in patients with more pronounced residual symptoms. Another approach often used in patients who wish to taper down antidepressant medication is preventive cognitive therapy, an 8-week psychological intervention program delivered in individual or group sessions that focuses on changing dysfunctional attitudes, enhancing memories of positive experiences and helping patients to develop personal relapse prevention strategies. Preventive cognitive therapy has been found to be equally effective in preventing

950-818: Is important for doctors to make meaningful connections and relationships with their patients, instead of simply having interactions with them, which often occurs in a system that relies heavily on specialist care. For this reason, behavioral medicine emphasizes honest and clear communication between the doctor and the patient in the successful treatment of any illness, and also in the maintenance of an optimal level of physical and mental health. Obstacles to effective communication include power dynamics, vulnerability, and feelings of helplessness or fear. Doctors and other healthcare providers also struggle with interviewing difficult or uncooperative patients, as well as giving undesirable medical news to patients and their families. The field has placed increasing emphasis on working towards sharing

1000-482: Is low‐quality evidence that sit‐stand desks may reduce sitting at work in the first year of their use. However, the effects are likely to reduce with time. There is generally insufficient evidence to draw conclusions about such effects for other types of interventions and for the effectiveness of reducing workplace sitting over periods longer than one year." An intervention to encourage office workers to stand and move reduced their sitting time by 22 minutes after 1 year;

1050-401: Is seen as both an outcome and a transgression in the process of behavior change. An initial setback or lapse may translate into either a return to the previous problematic behavior, known as relapse, or the individual turning again towards positive change, called prolapse. A relapse often occurs in the following stages: emotional relapse, mental relapse, and finally, physical relapse. Each stage

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1100-556: Is shown to be a risk factor on its own independent of hard exercise and BMI . People that sit still more than four hours per day have a 40 percent higher risk than those that sit fewer than four hours per day. However, those that exercise at least four hours per week are as healthy as those that sit fewer than four hours per day. Indirectly, an increased BMI due to a sedentary lifestyle can lead to decreased productivity and increased absenteeism from necessary activities like work. A sedentary lifestyle contributes to or can be

1150-404: Is through chronic pain management. Before this model was adopted, physicians were unable to explain why certain patients did not experience pain despite experiencing significant tissue damage, which led them to see the purely biomedical model of disease as inadequate. However, increasing damage to body parts and tissues is generally associated with increasing levels of pain. Doctors started including

1200-453: The biopsychosocial model of illness instead of the medical model . This model incorporates biological, psychological, and social elements into its approach to disease instead of relying only on a biological deviation from the standard or normal functioning. Writings from the earliest civilizations have alluded to the relationship between mind and body, the fundamental concept underlying behavioral medicine. The field of psychosomatic medicine

1250-614: The Behavioral Medicine Study Section to encourage and facilitate collaborative research across disciplines. The 1977 Yale Conference on Behavioral Medicine and a meeting of the National Academy of Sciences were explicitly aimed at defining and delineating the field in the hopes of helping to guide future research. Based on deliberations at the Yale conference, Schwartz and Weiss proposed the biopsychosocial model, emphasizing

1300-577: The GORSKI/CENAPS relapse warning signs to be a good predictor of the occurrence of relapse on the AWARE scale ( r = .42, p < .001). Some theorists, including Katie Witkiewitz and G. Alan Marlatt , borrowing ideas from systems theory , conceptualize relapse as a multidimensional, complex system . Such a nonlinear dynamical system is believed to be able to best predict the data witnessed, which commonly includes cases where small changes introduced into

1350-648: The International Society of Behavioral Medicine was founded to provide, through its many daughter societies and through its own peer-reviewed journal (the International Journal of Behavioral Medicine ), an international focus for professional and academic development. Many chronic diseases have a behavioral component, but the following illnesses can be significantly and directly modified by behavior, as opposed to using pharmacological treatment alone: Medications work best for controlling chronic illness when

1400-587: The US population, prevalence of sitting watching television or videos at least 2 h/d was high in 2015-2016 (ranging from 59% to 65%); the estimated prevalence of computer use outside school or work for at least 1 h/d increased from 2001 to 2016 (from 43% to 56% for children, from 53% to 57% among adolescents, and from 29% to 50% for adults); and estimated total sitting time increased from 2007 to 2016 (from 7.0 to 8.2 h/d among adolescents and from 5.5 to 6.4 h/d among adults). Relapse prevention Relapse prevention ( RP )

1450-651: The University of Pennsylvania in 1973, and the Laboratory for the Study of Behavioral Medicine, founded by William Stewart Agras at Stanford University in 1974. Subsequently, the field burgeoned, and inquiry into behavioral, physiological, and biochemical interactions with health and illness gained prominence under the rubric of behavioral medicine. In 1976, in recognition of this trend, the National Institutes of Health created

1500-513: The amount of time spent sitting or lying down and positively affect the intention to be active physically. Recent innovations in AI technology have led to the development of exercise prescription systems designed to reduce sedentary behavior. These systems deliver personalized exercise plans by analyzing individual health metrics, potentially decreasing the prevalence of a sedentary lifestyle and its associated health risks. Some evidence has been found of

1550-597: The arteries and restrict blood flow. This condition increases the risk of coronary artery disease and heart attacks as the heart struggles to receive adequate oxygen and nutrients. One study found that interrupting sitting with 20 minutes of light-intensity walking each hour significantly reduced systolic and diastolic blood pressure in healthy participants or 3 minutes of light intensity walking every 30 minutes. A sedentary lifestyle contributes to decreased muscle activity, which affects glucose metabolism . Reduced muscle activity leads to lower insulin sensitivity , prompting

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1600-441: The clinical applications of learning principles such as reinforcement, avoidance, generalisation, and discrimination, and of cognitive-social learning models as well, such as the cognitive-social learning model of relapse prevention by Marlatt. Learning can be defined as a relatively permanent change in a behavioral tendency occurring as a result of reinforced practice. A behavior is significantly more likely to occur again in

1650-453: The day . A sedentary lifestyle contributes to poor health quality, diseases as well as many preventable causes of death . Sitting time is a common measure of a sedentary lifestyle. A global review representing 47% of the global adult population found that the average person sits down for 4.7 to 6.5 hours a day with the average going up every year. The CDC found that 25.3% of all American adults are physically inactive. Screen time

1700-643: The effect was 3-times greater when the intervention included a sit-to-stand desk. The intervention also led to small improvements in stress, wellbeing and vigor. The majority of time children are in a classroom, they are seated (60% of the time). Children who regularly engage in physical activity are more likely to become healthy adults; children benefit both physically and mentally when they replace sedentary behavior with active behavior. Despite this knowledge and due in part to an increase in sedentary behaviors, children have 8 fewer hours of free play each week than they did 20 years ago. Several studies have examined

1750-520: The effects of adding height-adjustable standing desks to classrooms, which have reduced the time spent sitting. However, associating the reduction in sitting with health effects is challenging. In one study conducted on Australian school children, known as the Transform-Us! study, interventions reduced the amount of time children spent sitting in the classroom, which was associated with lower body mass index and waist circumference. The interventions used in

1800-463: The equation seem to have large effects. The model also introduces concepts of self-organization, feedback loops, timing/context effects, and the interplay between tonic and phasic processes. Rami Jumnoodoo and Patrick Coyne, in London UK, have been working with National Health Service users and carers over the past ten years to transfer RP theory into the field of adult mental health. The uniqueness of

1850-724: The field. Additional developments during this period of growth and ferment included the establishment of learned societies (the Society of Behavioral Medicine and the Academy of Behavioral Medicine Research, both in 1978) and of journals (the Journal of Behavioral Medicine in 1977 and the Annals of Behavioral Medicine in 1979). In 1990, at the International Congress of Behavioral Medicine in Sweden,

1900-636: The future as a result of learning, making learning important in acquiring maladaptive physiological responses that can lead to psychosomatic disease. This also implies that patients can change their unhealthy behaviors in order to improve their diagnoses or health, especially in treating addictions and phobias. The three primary theories of learning are: Other areas include correcting perceptual bias in diagnostic behavior; remediating clinicians' attitudes that impinge negatively upon patient treatment; and addressing clinicians' behaviors that promote disease development and illness maintenance in patients, whether within

1950-401: The life span. Sedentary lifestyle Sedentary lifestyle is a lifestyle type, in which one is physically inactive and does little or no physical movement and/or exercise. A person living a sedentary lifestyle is often sitting or lying down while engaged in an activity like socializing , watching TV , playing video games , reading or using a mobile phone or computer for much of

2000-545: The model is the sustainment of change by developing service users and carers as 'experts' – following RP as an educational process and graduating as Relapse Prevention Practitioners. The work has won many national awards, been presented at many conferences, and has resulted in many publications. Terence Gorski MA has developed the CENAPS (Center for Applied Science) model for relapse prevention including Relapse Prevention Counseling (Gorski, Counseling For Relapse Prevention, 1983) and

2050-425: The most prominent direct effect of a sedentary lifestyle is an increased BMI leading to obesity. A lack of physical activity is one of the leading causes of preventable death worldwide. At least 300,000 premature deaths, and $ 90 billion in direct healthcare costs are caused by obesity and sedentary lifestyle per year in the US alone. The risk is higher among those that sit still more than five hours per day. It

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2100-568: The neck forward to look at screens or documents. Such forward head posture puts excessive strain on the cervical vertebrae , leading to muscle tension and pain in the neck and shoulders. Over time, this can cause the cervical vertebrae to become misaligned permanently, leading to chronic neck pain and potential nerve impingement. The intervertebral discs , which act as cushions between the vertebrae, are subjected to constant pressure when sitting for prolonged periods. This compression can lead to disc degeneration and herniation. Additionally, collagen,

2150-414: The new field's interdisciplinary roots and calling for the integration of knowledge and techniques broadly derived from behavioral and biomedical science. Shortly after, Pomerleau and Brady published a book entitled Behavioral Medicine: Theory and Practice , in which they offered an alternative definition focusing more closely on the particular contribution of the experimental analysis of behavior in shaping

2200-502: The pancreas to produce more insulin to maintain normal blood glucose levels ( metabolic syndrome ). Chronic overproduction of insulin can exhaust the pancreas and contribute to insulin resistance, a precursor to type 2 diabetes . Prolonged sitting impedes venous return from the legs to the heart, leading to venous stasis (slow blood flow in the veins). This can cause fluid to pool in the lower extremities, resulting in swelling (edema) and varicose veins. Also, sluggish blood flow increases

2250-585: The patients use them as prescribed and do not deviate from the physician's instructions. This is true for both physiological and mental illnesses. However, in order for the patient to adhere to a treatment regimen, the physician must provide accurate information about the regimen, an adequate explanation of what the patient must do, and should also offer more frequent reinforcement of appropriate compliance. Patients with strong social support systems, particularly through marriages and families, typically exhibit better compliance with their treatment regimen. Examples: It

2300-573: The power in the relationship, as well as training the doctor to empower the patient to make their own behavioral changes. More recently, behavioral medicine has expanded its area of practice to interventions with providers of medical services, in recognition of the fact that the behavior of providers can have a determinative effect on patient outcomes. Objectives include maintaining professional conduct, productivity, and altruism, in addition to preventing burnout, depression, and job dissatisfaction among practitioners. Behavioral medicine includes understanding

2350-512: The relapse prevention model, patients and clinicians work together to develop strategies that target these high-risk situations, using both cognitive and behavioral techniques. By increasing coping skills and confidence, patients learn to handle challenging situations without turning to alcohol. or drugs, thus increasing their self-efficacy. For the prevention of relapse in major depressive disorder , several approaches and intervention programs have been proposed. Mindfulness-based cognitive therapy

2400-419: The risk of clot formation, potentially leading to deep vein thrombosis (DVT), a condition where blood clots form in the deep veins, which can travel to the lungs and cause a life-threatening pulmonary embolism . Adults and children spend long amounts of time sitting in a workplace or at a school, which is why interventions have been focused in these two areas. Mass media campaigns might also be able to reduce

2450-471: The study included stand-up desks and easels, the use of timers, and sport and circus equipment in the classroom. Teachers also made lessons more active, and added breaks to lessons to promote active time. In the US, another intervention for children is promoting the use of active transportation to and from school, such as through the Safe Routes to School program. Over the last hundred years, there has been

2500-520: Was one in five. From 1990 to 2016, there was a decrease of about one third in manual labor jobs/employment. In 2008, the United States American National Health Interview Survey found that 36% of adults were inactive, and 59% of adult respondents never participated in vigorous physical activity lasting more than 10 minutes per week. According to a 2018 study, office based workers typically spend 70-85% sitting. In

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