Chapter 13: Health-Related and Substance-Use Disorders

Sleep-wake disorders including insomnia, narcolepsy, sleep terrors, and sleepwalking disrupt cognitive functioning and emotional regulation by compromising prefrontal cortex activity, which results in concentration difficulties, impulse control deficits, and mood dysregulation. Treatment involves behavioral restructuring such as establishing consistent sleep hygiene protocols and, when necessary, pharmacological intervention. Elimination disorders encompassing enuresis and encopresis stem from developmental lags, medical factors, or psychological stressors and respond to behavioral reinforcement techniques combined with medical management and family-centered approaches. Chronic pediatric illnesses such as diabetes, asthma, and cancer create multifaceted challenges affecting physical well-being alongside psychological adjustment, with affected children experiencing elevated rates of anxiety and depression that impair academic success. Pediatric health psychology addresses these comorbid conditions through coping skill development, family-based interventions, and stress reduction strategies. Adolescent substance-use disorders represent a critical public health concern, with early substance initiation producing neurotoxic effects on the developing brain particularly regarding dopamine system functioning and prefrontal executive capacities. Contributing factors include genetic vulnerability, peer influence, family relationship quality, and cultural attitudes toward substance use. Evidence-based interventions employ multisystemic therapy models that target family dynamics, cognitive-behavioral approaches that address maladaptive thinking patterns and behavioral triggers, and school-based prevention initiatives that reduce risk factors and build protective mechanisms. Understanding the developmental trajectory of these disorders and implementing developmentally sensitive interventions across multiple ecological systems enhances treatment efficacy and long-term prognosis.