Mental and behavioral health ELIZABETH C. KATz, EUGENE M. DUNNE, SAMANTHA LOOKATCH AND JOSHUA S CAMINS CHAPTER OUTLINE work, school, home). Within the broader category of mental MENTAL HEALTH/BEHAVIORAL DISORDERS AND SUICIDE 252 A. Definitions 252 gnostic categories. The most prevalent of the emotional disorders, and therefore the most costly to individua B. Epidemiology 253 C. Costs 254 and society, are depression and anxiety. Table 21-1 outlines mood(depressive), anxiety, and trauma disorders, the mental IL. RISK AND PROTECTIVE FACTORS 255 health disorders that are the focus of this chapter. A, Biologic Risk Factors 255 B. Psychological Risk Factors 256 C. Social risk factors 256 BEHAVIORAL DISORDERS D. Environmental Risk Factors 256 Behavioral disorders involve substance use or participation E. Culture/Diversity 257 n non-drug-related risky behaviors (e.g, gambling, overeat Protective Factors 257 ng), also known as behavioral addictions, to such an extent III PREVENTION AND HEALTH PROMOTION that they appear compulsive ("out of control" of the indi- STRATEGIES 257 vidual) and pose serious threats to the participant's health A. Theoretical Framework 257 and well-being. Behavioral disorders represent extreme cases B. Public Policy 258 of typical behaviors(e.g, alcohol dependence; overeat C. Media Campaign point of obesity) D. Screening 258 Substance use, both licit(e.g, alcohol, tobacco)and illicit E. Psychosocial Interventions 259 (e, g,, cocaine, heroin), varies along a continuum(Fig. 21-1 ef Interventions 259 Misuse of a substance is often indicative of a risk for more 2. Longer-Term pathological use. Pathological use may be characterized by macologic Interventions 260 IV. SUMMARY 261 HIV infection, incarceration ), tolerance(need to take n 8. continued substance use despite serious consequences of REVIEW QUESTIONS, ANSWERS, AND EXPLANATION experience It withdrawal whether other beh ors, such as overeating, excessive video game or Internet use, and sexual behavior, may be considered behavioral addic- Depression, anxiety, schizophrenia, and substance abuse tions. The following arguments favor the behavioral addic- prominent among the mental health and behavioral disor- tion concept ders. Affecting more than 450 million people worldwide and associated with substantial morbidity and mortality, these Such behaviors often appear compulsive (outside the individual's control). disorders are critical targets for prevention efforts because of Participation is continued despite experiencer their toll on individuals and socie egative consequences. y resp addiction is also involved in excessive pursuit of these MENTAL HEALTH/BEHAVIORAL DISORDERS AND SUICIDE Research also suggests that substance and behavioral orbid. Although strong evidenc A. Definitions upports the inclusion of pathological gambling and exces MENTAL HEALTH DISORDER sive Internet use within the broader of addictive disorders, evidence supporting other behavioral addictions Mental health disorder is a broad term that refers to a set of (e.g,, kleptomania, sexual addiction)is less compelling emotions, cognitions, and behaviors that cause distress to However, others consider the evidence in support of the food individuals or others are abnormal from the bective of addiction concept, specifically as it relates to compulsive the society or culture, and result in harm to self or others overeating and bulimia, to be compelling. Obesity is dis- in functional impairment in one or more domains (i.e, cussed in Chapter 19