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Children with chronic illnesses often experience sleep problems as a result of disease symptoms (e.g., itching, wheezing) or nighttime disease management (e.g., blood glucose monitoring). Poor sleep has negative implications for daytime functioning, including academic performance and quality of life. As asthma and allergic diseases (e.g., allergic rhinitis) are the most common chronic diseases in childhood, associations between sleep and these chronic conditions are of particular concern for researchers and health care providers. Disease-specific factors associated with asthma and allergic disease (e.g., severity, treatment adherence), as well as factors associated with cultural background and the family context (e.g., urban poverty, sleep practices, caregiver functioning) can affect child sleep patterns. Given the consequences of poor sleep on child functioning, clinical recommendations and interventions for children with asthma and allergic disease should focus not only on disease management, but also on family and environmental factors that may impact child sleep.

Body image disturbances are common among women in the general population. Less is known about their prevalence and impact during pregnancy. This chapter examines the history of body image theory and research. Next, we examine issues related to body image during pregnancy, such as pregravid weight, gestational weight gain, and the unique ways women think about the changes to their body during pregnancy. The role of physical activity, mood, and eating disorders in relation to peripartum body image disturbance is also discussed. Finally, assessment of body image disturbance and existing treatments are presented. Future research is needed to develop peripartum-specific body image assessment tools and to assess the impact of psychosocial interventions during and after pregnancy on body image dissatisfaction.

Perinatal experiences during a critical developmental period program brain structure and function “for life,” thereby determining vulnerability to psychopathology and cognition in adulthood. Although these functional consequences are associated with alterations in HPA-axis activity and hippocampal structure and function, the underlying mechanisms remain unclear. The parent-offspring relationship (i.e., sensory and nutritional inputs by the mother) is key in mediating these lasting effects. This chapter discusses how early-life events, for example, the amount of maternal care, stress, and nutrition, can affect emotional and cognitive functions later in life. Interestingly, effects of perinatal malnutrition resemble the perinatal stress-induced long-term deficits. Because stress and nutrition are closely interrelated, it proposes that altered stress hormones and changes in specific key nutrients during critical developmental periods act synergistically to program brain structure and function, possibly via epigenetic mechanisms. Understanding how the adult brain is shaped by early experiences is essential to develop behavioural and nutritional preventive therapy.

Health-related quality of life (HRQL) is a multidimensional subcomponent of quality of life involving subjective appraisal of various dimensions of one's life that can be affected by health or health-related interventions. There is a growing consensus that HRQL is an integral indicant of treatment efficacy across a wide variety of therapeutic interventions. Consistent with this position, interest in delineating the effects of exercise on HRQL has increased considerably in the past 20 years. Results from studies in the physical activity, psychology, medical, and behavioral medicine literatures demonstrate that exercise results in meaningful improvements in an array of HRQL outcomes. The primary objectives of the present chapter are to summarize the empirical evidence addressing the effects of exercise on HRQL, address issues in the conceptualization and measurement of HRQL outcomes, and underscore persisting research considerations that will aid in developing a more comprehensive understanding of the exercise–HRQL relationship.

Contemporary theories of exercise behavior have been the products of the so-called cognitive revolution, which has shaped the dominant paradigm in psychology over the past several decades. Cognitive theories rely on the assumption that, in making behavioral decisions, humans collect relevant information and make their selections on the basis of a more-or-less rational analysis of this information. Although the dominance of cognitive theories in the field of exercise psychology is unquestionable, evidence suggests that they leave most of the variance in exercise behavior unaccounted and interventions based on them are of limited effectiveness in changing exercise behavior. This chapter reviews the history and evaluates the potential of an alternative approach, namely the hedonic theory of motivation. This idea, long neglected due the fascination of psychologists with information-processing models of the mind, attributes a substantial portion of the variance in decision-making to affective processes. Modern iterations of the idea emerging from the fields of neurology and behavioral economics reaffirm the ancient thesis that, in the long run, humans tend to repeat what makes them feel better and tend to avoid what makes them feel worse. Evidence from studies in the context of exercise suggests that affective responses to exercise vary greatly between individuals. Furthermore, despite a still-evolving methodological platform, preliminary studies show that affective responses to exercise predict subsequent exercise behavior. This line of research and theorizing offers a novel and intriguing perspective on the mechanisms underlying behavioral decision-making in the context of exercise. The literature reviewed in this chapter highlights the need for further research on the motivational implications of affective processes and lays the foundation for the development of a hedonic theory of exercise behavior.

Although much has been learned about global adolescence and especially global adolescent health over the past decade, research has focused more on minority than majority world adolescents. Furthermore, more attention to adolescents has been paid by global policy and practice organizations than by researchers. Young people aged 10–24 years constitute 25% of the global population and demand our best research efforts. Although significant, global statistics fail to convey the importance of cultural and social contexts for their roles in shaping adolescent health and development. This chapter attempts to summarize what is known from global research and complements this relatively disembedded information with culturally embedded knowledge from India.

In medical settings such as hospitals, play has become more common in recent decades, deployed to help children deal with treatment. Similarly, at specialized camps for ill children, peers are observed to actively, without adult suggestion, draw from imaginal ways of coping, ranging from irreverent song lyrics or skits, to wordless silly mockery of medical implements, to ghost stories about wheezing apparitions said to visit an asthma facility. At home, ongoing treatment of a condition also benefits from children coping through subjunctive pretense, as is suggested both by ethnographic studies and a small-scale experiment assessing a play enhanced asthma inhaler. Such uses of play can become routinized as a family ritual, and can serve as a way of making sense and sharing meaning in the midst of stressful experience. Resilience is a capacity that gains flexible, tensile strength from play, even in the face of exceptional suffering.

This chapter provides a cross-cultural exploration of antisocial behavior, substance use, and sexual behavior in relation to health among emerging and young adults. By summarizing what is known about these risk behaviors and health in Sweden, Japan, and Turkey, the authors discuss differences and commonalities between countries in terms of proximal causes and the relations between risk behaviors and disease. Finally, the authors discuss the importance of the development of theories that have the potential to bridge the not-so-distal connection between cultural resources, developmental processes, and health. The chapter ends with an examination of selected themes across the respective nations and recommendations for how to advance future research on risk and health in emerging and young adults.

The formation of an attachment bond to a parent or caregiver is a key developmental milestone that occurs during the first year of a child’s life. In this chapter, we examine the relation between maternal psychopathology and the development of the young child’s attachment relationship with his or her mother. In general, the identified direction of effects from research points to greater risk for child insecure or disorganized attachment when the mother is psychiatrically ill, yet the research is equivocal, and findings suggest that other risk factors, as well as resiliency factors, must be considered for their influences of attachment relationship formation in the context of maternal psychopathology. Studies have begun to elucidate some of the mediating and moderating factors, yet much work remains to be done in order to understand the complex relation between maternal mental health and the quality of attachment.

Nocturnal enuresis (bedwetting) is one of the most well-studied sleep disorders of childhood. This common condition occurs in up to 20% of school children. Although most children will outgrow their problem, nocturnal enuresis can persist into adulthood. Nocturnal enuresis is considered one of the parasomnias and is diagnosed when the night wetting persists beyond the age of 5 in a child who has attained daytime continence.

The etiology of nocturnal enuresis is multifactorial and occurs when the child is unable to arouse from sleep in response to a full bladder sensation, with excessive nocturnal urine production and/or reduced nocturnal bladder capacity commonly being a feature. An understanding of the physiology of sleep and the relationship between sleep arousal and nocturnal enuresis is a first step to understanding how treatments work. It will enable clinicians to identify the most appropriate treatment for each individual and appreciate why some children fail treatment.

Obstructive sleep apnea (OSA) in children is a sleep disorder where the movement of air through the upper airway (nose, mouth, trachea) is decreased due to an obstruction that is most commonly caused by enlarged adenoids and tonsils. It results in disturbed and fragmented sleep and decreased levels of blood oxygenation. In turn, children with OSA can experience enuresis, growth retardation, and cognitive and behavioral difficulties. Treatment of pediatric OSA focuses on the removal of adenoid and tonsil tissues where applicable. Secondary treatment of OSA is continuous positive airway pressure (CPAP), which has a series of issues regarding adherence and use that could be addressed by cognitive-behavioral therapies or group therapy. Children with special medical conditions such as Trisomy 21, other genetic syndromes, and psychiatric illness are at increased risk for the development of OSA and should be closely monitored for the presence of the disease. Future directions include delving deeper into an understanding of how CPAP effectively treats OSA in children and strategies to improve adherence to CPAP therapy in the pediatric population.

Becoming pregnant and giving birth can lead to considerable psychological, behavioral, and cognitive transformation. The nature and scope of change varies a great deal from woman to woman. This chapter summarizes qualitative and quantitative research on normal psychological adaptation to pregnancy, including recognition and acceptance of the pregnant state, experience of the boundary between self and fetus, and body image changes. It reviews research on internal representations of the fetus and fetal and neonatal attachment. Perinatal changes in stress reactivity and coping style are reviewed. The chapter explains the influence of women’s prenatal expectations about labor and delivery on subsequent experiences and reactions and describes normative postpartum mood reactivity. Perinatal effects on sleep, physical activity, sexual activity, and eating patterns are described. Controversies about the effects of pregnancy on cognition are examined. The chapter also covers topics related to the transition to motherhood, including influences on maternal self-esteem and self-efficacy.

Because many childhood sleep disturbances can be effectively treated by behavioral sleep medicine providers, understanding when and how to refer children for such services is essential to assist families in obtaining the right treatment. A stepped care model of service delivery is an appropriate model, particularly given the high prevalence of behavioral sleep disturbance in childhood and the limited number of trained pediatric behavioral sleep medicine providers. Securing appropriate referrals requires understanding physicians’ educational needs with regard to assessment for sleep disturbances and referrals to behavioral sleep medicine providers. The goal of the field of pediatric behavioral sleep medicine, then, is to determine which patients are in greatest need of referrals, match interventions accordingly, and effectively communicate this to physician referral sources.

Using a positive youth development approach, we comprehensively review the literature on social, psychological, and physical outcomes of children's participation in sport and physical activity. Organizing topical areas around the Five Cs (Lerner & Lerner, 2006 ), we first discuss robust findings on social assets, including social relationships and competencies (parents, peers, coaches) and moral development. Second, we review the knowledge base on psychological assets, including self-perceptions (global self-worth, perceived competence), emotional outcomes (primarily enjoyment and anxiety), and motivational orientations and behaviors. Third, we discuss the unique set of physical assets that are possible from engaging in physical activity–based youth development programs, such as motor skill development, physical fitness, and physical health. Finally, we offer several avenues for future research studies that will provide even more definitive evidence of physical activity as a context for promoting positive youth development.

Over the past several years, there has been considerable interest in the association between children’s sleep duration and obesity risk. Mounting epidemiological evidence suggests that short sleep is associated with concurrent and prospective risk of obesity during childhood. Studies have further suggested plausible mediators for the sleep–weight association, including hormones and eating and activity behaviors. Despite the convincing data, no pediatric experimental or treatment studies targeted at changing sleep length have been published. Thus, whether short sleep causes weight gain or changes in children’s weight status remains unknown. Beyond sleep duration, there is also evidence for an association between obesity and sleep disordered breathing (SDB) in children with some evidence that weight loss may improve SDB symptoms. The present chapter reviews the extant literature on the association between pediatric sleep duration and obesity risk, the association between pediatric obesity and SDB, and concludes with suggestions for future research.