Symptoms of the disease - violations of the emotionally volitional sphere. Violation of emotionally volitional sphere Violation of emotionally volitional sphere of man treatment

Birth in the family of a child with certain deviations from normal development - always stress for both parents. It is very good when they help them cope with the problem of relatives, friends or specialists in psychological rehabilitation.

The first signs of violation of the emotional-volitional sphere begin to appear in the period of active communication in the team of peers, which is why you should not ignore any deviations in the behavior of the child. These disorders are rarely noted as an independent disease, often they are precursors or constituent of quite serious mental abnormalities:

Schizophrenia;

Depression;

Manic syndrome;

Psychopathy;

Autism.

The reduction in intellectual activity in children is manifested in the form of not fully regulating emotions, inadequate behavior, reducing morality, low level of emotional color of speech. The mental retardation in such patients can be veiled in inadequate behavior in the extreme expression - apathy, irritability, euphoria, etc.

Classification of disorders in the emotional-volitional sphere

Among the violations in the field of an emotional-volitional expression of the individual in adults are distinguished:

1. Hypobulia is a decrease in will. Patients with such a violation do not have absolutely no need to communicate with the surrounding people, they are annoying the presence of a number of extraneous, they are not capable and do not want to support a conversation, they can be in an empty dark room for hours.

2. Hyperbulia - increased attraction in all spheres of human life, more often this violation is expressed in strengthening appetite, continuous communication and attention.

3. Abulia is a sharp decline in volitional deposits. In case of schizophrenia, this disorder is included in a single symptom complex "Apatico-abulic".

4. Compulsive attraction is an irresistible need for something, com else. This feeling is commensurate with an animal instinct and makes a person perform actions, which, in most cases, criminal off.

5. An obsessive desire - the emergence of obsessive desires that the patient cannot independently control. Not satisfied with the desire leads to the deep sufferings of the patient, all his thoughts are filled with ideas about his incarnation.

The main deviations in the emotional and volitional sphere in children are:

1. Emotional hypermatability.

2. Increased impressionability, fears.

3. Motor inhibition or hyperactivity.

4. Apathy and indifference, indifference to others, the lack of compassion.

5. Aggressiveness.

6. Increased suggestibility, non-independence.

Soft correction of emotionally-volitional disorders

The hippotherapy around the world received a lot of positive feedback both with the rehabilitation of adults and when the rehabilitation of children. Communication with a horse delivers great pleasure to children and their parents. This rehabilitation method helps to unwind the family, strengthen the emotional connection between generations, build a trusting relationship.

Thanks to adults, children and adolescents, the processes of excitation and braking in the cerebral cortex are normalized, motivation to achieve their goals increases, self-assessment and vital tone increases.

With the help of horse riding, each rider can learn how to manage its emotions smoothly and without donoma from the psyche. In the course of classes, the severity of fears is gradually decreasing, confidence appears in the fact that communication with animals is necessary to both participants in the process, their own significance increases in closed persons.

Trained and all understanding a horse helps children and adults to cope with the goals, acquire new skills and knowledge, become more open to society. In addition, the hippotherapy develops the highest nervous activity: thinking, memory, concentration of attention.

The constant voltage of the muscles of the entire body and the maximum collence in riding lessons improves the balance, coordination of movements, self-confidence even among those students who cannot accept any solution without the help of outsiders.

Different types of hippotherapy help reduce anxiety and depressive mood, to forget about negative experiences and increase the vigor of the Spirit. When achieving his goals in classes, it allows you to develop will and endurance and break the internal barriers to your insolvency.

Some disciples are so much like to communicate with animals that they are glad to be engaged in horse-out at school for disabled. In the process of training and at competitions, the volitional sphere is developing perfectly. They become more assertive, purposeful, improved self-control and endurance.

Pretty often parental care is mainly concentrated on the physical health of his child, while the emotional component remains almost no attention. This is due to the fact that most parents consider the early manifest symptoms of emotional disorders, as temporary, and therefore non-hazardous.

The place of emotional disorders in the mental development of the child is one of the key aspects of his life, due to the fact that these violations affect its attitudes towards their parents and to the surrounding, in general. To date, there is a tendency to an increase in emotional violations in children, in the form of reduced social adaptation and inclinations towards aggressive behavior.

There are many reasons for the emergence of emotional disorders in a child, so parents should be particularly attentive in the manifestation of various pathological signs. As a rule, specialists establish a final diagnosis when registering 3 signs of emotional instability.

The most common causes of emotional disorders are as follows:

• Physical characteristics, taking into account the suffering diseases in the infant period;
• Braking mental and mental development;
• Improper education of the child in the pre-school period;
• Improper nutrition, namely the lack of admission of necessary substances, which significantly affects the development of the baby;

Also data above the causes are subdivided into two large groups:

1. Biological.

This caused group includes the characteristic type of nervous system. For example, if there is a deficit deficit syndrome, a child may later have a pathological process in the brain, forming as a result of a severe course of pregnancy and childbirth.

1. Social

This group determines the process of interaction between the child with other people and the surrounding environment. For example, if a child already has experience in communicating with the age group of people, with their peers and the group-family primary for him, in some cases such socialization can also harm him.

If the child is constantly denied by adults, it unconsciously begins to force out the information received, which comes from the environment.

The emergence of new experiences that do not coincide with its conceptual structure, begin to be perceived by them negatively, which in the end form a certain stress for it.

In the absence of an understanding of the peers in the child, emotional experiences are formed (rage, insult, disappointment), which are characterized by sharpness and duration. Also permanent conflicts in the family, child demands, the lack of understanding of his interests, also causes emotional violations in the mental development of the child.

Classification of emotional disorders and their symptoms

The complexity in identifying emotional-volitional disorders led to the fact that a number of psychologists have formed various views on these types of violations. For example, a psychologist's scientist G. Sukhareva noted that emotional violations in the younger school age are often observed in children suffering from neurasthenia, which has allocated its excessive excitability.

Another idea of \u200b\u200bthese violations had a psychologist Y. Milanich. He found that 3 groups of emotional disorders include emotionally volitional disorders;

• Acute emotional reactions that are characterized by staining certain conflict situations, which manifested itself in aggression, hysteria, fear reactions or resentment;
• The state of high tension is anxiety, fearness, reduced mood.
• Dysfunction of emotional state, which manifested itself in a sharp transition from positive emotional phenomena to negative and also in reverse order.

However, the most detailed clinical picture of emotional disorders was N.I. Caterina. It divides emotional disorders into 2 large groups, which are characterized by an increase in the level of emotionality and its decrease, respectively.

The first group includes such conditions as:

• Euphoria, which is characterized by an inadequate increase in mood. The child in this state, as a rule, has increased impulsiveness, impatient and desire for dominance.
• Dysphoria is the opposite form of euphoria characterized by the manifestation of such emotions as: malice, irritability, aggressiveness. It is a kind of depressive syndrome.
• Depression is a pathological condition characterized by manifestation of negative emotions and behavioral passivity. The child in this state feels the depressed and dreary mood.
• Anxiety syndrome is a condition in which the child feels unfortunate concern and pronounced nervous tension. It is expressed in the constant change of mood, the plasticity, the absence of appetite, high sensitivity. Often this syndrome develops into a phobia.
• Apathy is a serious condition in which the child feels indifference to everything that happens around, and is also characterized by a sharp decrease in initiative functions. Most psychologists claim that the loss of emotional reactions is combined with a decrease or complete loss of volitional motives.
• Patami - a characteristic disorder of an emotionally background, in which the experience of one particular emotion is accompanied by external manifestations of absolutely opposite emotions. Often marked in children suffering from schizophrenia.

The second group includes:

• Hyperactivity syndrome and attention deficit, stand out by such symptoms as a motor disorientation, impulsiveness. It follows from this that the key features of this syndrome are distractions and excessive motor activity.
• Aggression. This emotional manifestation is formed as part of character traits or as a reaction to environmental impacts. In any case, the above disorders need correction. However, before adjusting pathological manifestations, primarily the main causes of diseases.

Diagnosis of violations

For subsequent impaired therapy and its effectiveness, the timely diagnosis of the emotional development of the child and its violations is very important. There are many special techniques and tests that assess the development and psychological condition of the child, taking into account its age characteristics.

Diagnosis of preschool children includes:

• Diagnostics of the level of anxiety and its evaluation;
• Study of psycho-emotional state;
• Color Test Lucher;
• Study of self-assessment and personal characteristics of the child;
• Studying the development of volitional qualities.

Appeal for psychological help is necessary if the child is experiencing certain difficulties in studying, communicating with peers, behavior or it has certain phobias.

Also, parents should pay attention if the child is experiencing any emotional experiences, feelings, and also if its condition is characterized as depressed.

Methods for correcting emotional disorders

A number of domestic and foreign scientists in the field of psychology allocate a number of techniques that allow you to adjust emotionally volitional violations in children. These methods are taken to divide on 2 main groups: individual and group, however, such division does not reflect the main goal of the correction of mental disorders.

The mental correction of affective disorders in children is an organized system of psychological impacts. This correction is mainly aimed at:

• Mitigating emotional discomfort,
• Increase active activities and independence
• Suppression of secondary personal reactions (aggressiveness, excessive excitability, anxiety, etc.).
• Self-assessment correction;
• Formation of emotional stability.

World psychology includes 2 main approaches to the psychological correction of the child, namely:

• Psychodynamic approach. He advocated the creation of conditions that allow suppressing external social barriers, with the help of such methods as psychoanalysis, game therapy and artherapy.
• Behavioral approach. This approach allows you to encourage the child to master new reactions aimed at the formation of adaptive behavioral forms and, on the contrary, suppresses non-adaptive forms of behavior, if any. Includes such impact methods as behavioral and psychoregulating trainings that allow the baby to consolidate the learned reactions.

When choosing a method of psychological correction of emotional disorders, it should be processed from the specifics of the violation that determines the deterioration of the emotional state. If the child has intrapersonal disorders, there will be an excellent way to use game therapy (not computer), and the method of family psychocorrection is well established well.

If the prevalence of interpersonal conflicts is observed using a group psychocorrection that allows you to optimize interpersonal relationships. When choosing any method, the severity of the emotional instability of the child is taken into account.

Such methods of psychological correction as a game manager, talentherapy, etc. Effectively work if they correspond to the psychic features of the child and the doctor's physician.

The child's age of up to 6 years (pre-school period) is the most important period of its development, since it was at the given period that the child forms personal foundations, volitional qualities, and the emotional sphere is developing rapidly.

Village qualities are developing mainly due to conscious behavior control, while maintaining certain behavioral rules in the memory.

The development of these qualities is characterized as the general development of the personality, that is, mainly forming the will, emotions and feelings.

Consequently, for the prosperous emotional-volitional education of the child, parents and teachers are necessary in particular to pay attention to the creation of a positive atmosphere of mutual understanding. Therefore, many experts recommend parents to form the following criteria for their child:

• In communicating with the child, it is necessary to respect absolute calm and show its goodwill in every way;
• You should try more often to communicate with the child, ask him about anything, empathize, and interested in his hobbies;
• Joint physical work, game, drawing etc. It will safely affect the state of the child, so try to give him as much attention as possible.
• It is necessary to ensure that the child does not watch movies and did not play games with elements of violence, as it will only aggravate its emotional state;
• Complete the child in every way and help him form confidence in myself and in your abilities.

Emotions - This is one of the most important mechanisms of mental activity that produces a sensually painted subjective total assessment of incoming signals, well-being of the internal state of the person and the current external situation.

The overall favorable assessment of the present situation and the prospects are expressed in positive emotions - joy, pleasure, tranquility, love, comfort. The overall perception of the situation as unfavorable or dangerous is manifested by negative emotions - sadness, longing, fear, anxiety, hatred, malice, discomfort. Thus, the quantitative characteristic of emotions should be carried out not by one, but on two axes: strong - weak, positive - negative. For example, the term "depression" means strong negative emotions, and the term "apathy" indicates weakness or complete absence of emotions (indifference). In some cases, a person does not have sufficient information to assess one or another stimulus - this can cause uncertain emotions of surprise, bewilderment. He is rarely healthy, but conflicting feelings arise: love and hatred at the same time.

Emotion (feeling) - internally subjective experience, inaccessible to direct observation. The doctor judges the emotional state of man Affect (In the broad sense of this term), i.e. According to the external expression of emotions: facial expressions, gestures, intonation, vegetative reactions. In this sense, the terms "affective" and "emotional" in psychiatry are used as synonyms. Often, it is necessary to deal with the inconsistency between the content of the patient's speech and the expression of the face, the tone of the statement. Mimic and intonation in this case allow us to evaluate the true attitude to the above. The statements of patients of love for relatives, a desire to get a job in combination with the monotony of speech, the absence of proper affects indicate the vote of allegations, the predominance of indifference and laziness.

Emotions are characterized by some dynamic signs. Continuous emotional states the term " mood", Which in a healthy person is quite moving and depends on the combination of many circumstances - external (luck or defeat, the presence of an insurmountable obstacle or waiting for the result) and internal (physical unhealthy, natural seasonal activity fluctuations). Changing the situation in a favorable side should determine the improvement of mood. At the same time, it is characterized by a certain inertia, so the joyful news against the background of sorrowful experiences cannot cause immediate responses from us. Along with sustainable emotional states, short-term stormy emotional reactions occur - the state of the affect (in the narrow sense of the word).

You can select several main Emotion functions.The first of them, signalallows you to quickly estimate the situation - earlier than a detailed logical analysis will be carried out. Such an assessment based on a general impression is not quite perfect, but allows not to spend extra time on the logical analysis of irrelevant incentives. Emotions generally signal to us about the presence of any need: we will learn about the desire to eat in the feeling of hunger; About the thirst for entertainment - by feeling boredom. The second important function of emotions - communicative.Emotionality helps us to communicate and act together. The collective activity of people involves such emotions as sympathy, empathy (mutual understanding), distrust. Violation of the emotional sphere in mental illness naturally entails a violation of contacts with others, closure, misunderstanding. Finally, one of the most important functions of emotions is formation of behaviorman. It is emotions that make it possible to appreciate the importance of this or that human needs and serve as an impetus for its implementation. So, the feeling of hunger encourages us to look for food, suffocation - open the window, shame - hide from the audience, country ha-flee. It is important to take into account that emotion does not always accurately reflect the true state of the internal homeosta, and the peculiarities of the external situation. Therefore, a person, experiencing hunger, may have more than necessary for the body, experiencing fear, he avoids the situation, in reality is not dangerous. On the other hand, an artificially caused by the help of drugs a sense of pleasure and satisfaction (euphoria) deprives a person of the need to act despite the essential violation of his homeostasis. The loss of the ability to experience emotions in the mental illness naturally leads to inaction. Such a person does not read books and does not watch TV, because it does not feel boredom, does not follow the clothes and the cleanliness of the body, because it does not feel shame.

On the effect on the behavior of emotions are divided into SHENIFICAL(prompting to action, activating, exciting) and Asthenic(depriving activity and strength paralyzing will). The same psychotrauming situation can have different people to cause excitement, flight, frenzy, or, on the contrary, a stupor ("from fear of legs ran"), so, emotions give the necessary impetus to perform actions. Direct conscious planning of behavior and the implementation of behavioral acts makes the will.

Will is the main regulatory mechanism of behavior, allowing you to consciously plan to operate, overcome obstacles, meet the needs (desection) in the form that contributes to greater adaptation.

The attraction is the state of the specific need of a person, the need for certain conditions of existence, dependence on their presence. Conscious attractions we call desires.It is practically unrealistic to list all the likely kinds of needs: each person's set is unique, subjective, however, you should specify some of the most important needs for most people. These are physiological needs for food, security (self-preservation instinct), sexual attraction. In addition, a person as a social being often needs to communicate (affilative need), and also seeks to take care of loved ones (parental instinct).

A person has always at the same time there are several relevant for him, competing needs. The choice of the most important of them on the basis of an emotional assessment is carried out by the will. Thus, it allows you to realize or suppress existing deductions, focusing on an individual scale of values \u200b\u200b- The motif hierarchy.Suppression of the need does not mean reducing its relevance. Lack of ability to implement a relevant need for a person causes an emotionally unpleasant feeling - frustration.Trying to avoid her, a person is forced to either satisfy his need later, when conditions change to more favorable (for example, it comes to a patient with alcoholism, when it receives a long-awaited salary), or attempt to change the relationship to the need, i.e. Apply Mechanisms of psychological protection(See Section 1.1.4).

Will's weakness as a personality property or as a manifestation of a mental illness, on the one hand, does not allow a person to be systematically satisfied with his needs, and on the other hand, leads to the immediate implementation of any desire in the form that contradicts the norms of society and causing disadaptation.

Although in most cases it is impossible to associate mental functions with any particular nervous structure, it should be mentioned that the experiments indicate the presence of certain pleasure centers in the brain (a number of areas of the limbic system and the septal region) and avoidance. In addition, it was noticed that the defeat of the frontal bark and paths leading to the frontal shares (for example, during the operation of lobotomy), often leads to the loss of emotions, indifference and passivity. In recent years, the problem of the functional asymmetry of the brain is discussed. It is assumed that an emotional assessment of the situation mainly occurs in a non-permanent (right hemisphere), with the activation of which bind states of longing, depression, while in the activation of the dominant (left) hemisphere more often there is an increase in mood.

8.1. Symptoms of emotional disorders

Emotion disorders are an excessive expression of human emotions (hypertimia, hypothymia, dysphoria, etc.) or violation of their dynamics (lability or rigidity). The pathology of the emotional sphere should be said when emotional manifestations deform the behavior of the patient as a whole, cause serious disadaptation.

Hypothimia - resistant painful decrease in mood. The concept of hypothymia corresponds to sadness, longing, depression. In contrast to the natural feeling of sorrow, due to the unfavorable situation, hypothymia in mental illness is distinguished by amazing resistance. Regardless of the momentary situation, patients extremely pessimistically evaluate their current state and existing perspectives. It is important to note that this is not only a strong feeling of longing, but also the inability to experience joy. Therefore, a person in a similar state cannot cheer or a witty joke, nor a pleasant news. Depending on the severity of the disease, hypothymia can take a form from light sadness, pessimism to a deep physical (vital) feeling experienced as "mental pain", "Streking in the chest", "Stone on the heart". Such a feeling is called vital (atrial) longing,it is accompanied by a sense of catastrophe, hopelessness, collapse.

Hypothymia as a manifestation of strong emotions refer to productive psychopathological disorders. This symptom is not specific and may be observed in the exacerbation of any mental illness, it is often encountered in severe somatic pathology (for example, with malignant tumors), and also included in the structure of obsessive-phobic, hypochondriac and dysfolical syndromes. However, first of all, this symptom is associated with the concept depressive syndrome,for which hypotimia is the main syndrome-forming disorder.

Hyperthy - resistant painful increase in mood. With this term bind bright positive emotions - joy, fun, delight. Unlike situationally caused joy, hypertimia is characterized by persistence. For weeks and months, patients constantly retain amazing optimism, a feeling of happiness. They are full of energy, in all show the initiative, interest. Neither sad news, nor obstacles on the path of implementation are not disturbed by their common joyful attitude. Hyperthythmia - characteristic manifestation manic syndrome.The most acute psychosis is expressed by particularly strong exalted feelings reaching degrees. Ecstasy.Such a state may indicate the formation of an onairoid permanent of consciousness (see section 10.2.3).

Special option of hyperthythmia is the state Euphoria, this should be considered not as much as the expression of joy and happiness, as as complacently-careless affect. Patients do not show initiatives, are inactive, prone to empty conversations. Euphoria is a sign of a variety of exogenous and somatogenic brain lesions (intoxication, hypoxia, brain tumors and extensive disintegrating neosomy-forming, severe damage to hepatic and renal function, myocardial infarction, etc.) and may be accompanied by delusional ideas of magnitude (with paradens syndrome, patients with progressive paralysis).

Term Moria.indicate foolish careless letteen, laughter, unproductive excitation from deeply weakly patients.

Dzithoria they call suddenly emerging attacks of anger, malice, irritation, discontent with others. In this state, patients are capable of cruel, aggressive actions, cynical insults, rough sarcasm and bullying. Paroxysmal flow of this disorder indicates the epileptiform nature of symptoms. With epilepsy, the dysphoria is observed either as an independent type of seizures, or enters the structure of the aura and twilight permanent of consciousness. Dysphoria is one of the manifestations of psychoorganic syndrome (see section 13.3.2). Disprooric episodes are often observed in the exposive (excitable) psychopathy and in patients with alcoholism and drug addiction during the period of abstinence.

Anxiety - the most important emotion of a person, closely related to the need for safety, expressed by a sense of impending indefinite threat, internal excitement. Anxiety - Flying emotion: accompanied by throwing, nonsense, anxiety, muscle tension. As an important signal of unfavorable can occur in the initial period of any mental illness. In neurosis of obsessive states and psychstore, anxiety serves as one of the main manifestations of the disease. In recent years, suddenly emerging (often on the background of a psychotrauming situation) are distinguished as an independent disorder), which are manifested by acute anxiety attacks. Powerful, deprived of all means a feeling of anxiety is one of the early symptoms of a starting acute delusional psychosis.

With acute delusional psychosis (acute sensual sensory syndrome), anxiety is expressed extremely and often reaches a degree. confusionwhile combined with uncertainty, misunderstanding of the situation, violation of the perception of the surrounding world (Derealization and depersonalization). Patients are looking for support and explanations, their eyes expresses surprise ( affect bewilderment).As well as the state of ecstasy, such a disorder indicates the formation of onairoid.

Ambivalence - simultaneous coexistence of 2 mutually exclusive emotions (love and hatred, attachment and squeamishness). In mental illness, ambivalence causes significant suffering to patients, disorganizes their behavior, leads to contradictory, inconsistent actions ( ambyteracy). The Swiss psychiatrist E. Bleiler (1857-1939) considered ambivalence as one of the most typical manifestations of schizophrenia. At present, most psychiatrists consider this state by a non-specific symptom observed, in addition to schizophrenia, with schizoid psychopathy and (in a less pronounced form) in healthy people inclined to self-analysis (reflection).

Apathy - No or sharp decrease in the severity of emotions, indifference, indifference. Patients lose interest in close and friends, indifferent to the events in the world, indifferent to their health and appearance. The speech of patients becomes boring and monotonous, they do not show no interest in conversation, Mimica monotoned. The words of those surrounding do not cause them from their resentment, nor embarrassment, no wonder. They may argue that they are tested for parents, but when you meet with loved ones, it remains indifferent, do not ask questions and silently eat food-brought them. Especially brightly, the emotionalness of the patients is manifested in a situation requiring an emotional choice ("What kind of food do you like most?", "Who do you like more: dad or mom?"). The absence of feelings does not allow them to express any preference.

Apathy refers to negative (deficient) symptoms. Often it serves as a manifestation of finite states during schizophrenia. It should be borne in mind that apathy in schizophrenia patients constantly increases, passing a number of stages that differ in the severity of the emotional defect: smoothness (leveling) of emotional reactions, emotional coldness, Emotional stupidity.Another reason for the occurrence of apathy is the defeat of the frontal shares of the brain (injuries, tumors, partial atrophy).

From apathy should be distinguished by a symptom Painful mental insension (AnaesthesiaSychicadolorosa, sorrowful insension). The main manifestation of this symptom is not the lack of emotions as such, but a painful sense of their own immersion in selfish experiences, the consciousness of the inability to think about someone else, often combined with delirium self-evidence. Often there is a phenomenon of hypasshesia (see section 4.1). Patients complain, / which became "like a tree" that they have "not a heart, but an empty canning bank"; They crush that there are no alarms for young children, are not interested in their success in school. The bright emotion of suffering testifies to the state's severity, on the reversible productive nature of the disorders.anaesthesiapsychicadolorosa- typical manifestation of depressive syndrome.

Symptoms of violation of the dynamics of emotions include emotional lability and emotional rigidity.

Emotional lability - This is an emergency mobility, instability, ease of emergence and change of emotions. Patients easily switch from tears to laughter, from a fracture to careless relaxation. Emotional lability is one of the important characteristics of patients with hysterical neurosis and hysterical psychopathy. Such a condition may also be observed in the syndromes of the permanent of consciousness (delirium, onseyroid).

One of the emotional lability options is weak (emotional weakness).For this symptom, not only a quick change in the mood, but also the inability to control the external manifestations of emotions. This leads to the fact that each (even unimportant) event experiences brightly, often causes tears arising not only with sad experiences, but expressing and lunizing, delight. Weak - typical manifestation of vascular diseases of the brain (cerebral atherosclerosis), but can meet both personality feature (sensitivity, vulnerability).

Patient 69 years old, diabetes and pronounced memory disorders, is brightly experiencing his helplessness: "Oh, doctor, I was a teacher. I disciples, open the mouth, listened. And now Quash's quasher. That daughter will not say - I remember anything, everyone has to record. The legs do not go at all, I barely crawl around the apartment ... ". All this is a patient pronounces, constantly wiping his eyes. On the question of the doctor who still lives with her in the apartment, answers: "Oh, we have full house to the people! Sorry, the dead man did not live. My son-in-law is thoughtful. The granddaughter is wise: and dances, and draws, and in her ... And the grandson will go to the institute for next year - he has such a special school! ". The last phrases of the patient utters with a triumphant face, but tears continue to flow, and she constantly wipes them with her hand.

Emotional rigidity - Tugaway, stuck emotions, a tendency to a long experience of feelings (especially emotionally unpleasant). Emotional rigidity expressions are maliciousness, stubbornness, perseverance. In speech, emotional rigidity is manifested by a circumstance (viscosity). The patient cannot move to the discussion of another topic until the question of interest is completely invited. Emotional rigidity is a manifestation of the overall trapidity of mental processes observed in epilepsy. Psychopathic characters are also isolated with a tendency to jam (paranoid, epileptoid).

8.2. Symptoms of Will and Verification Disorders

Disorders of will and deposits are manifested in clinical practice of violations of behavior. It is necessary to take into account that the statements of patients do not always accurately reflect the nature of the existing disorders, since patients often hide their pathological attractions, they are ashamed to confess to others, for example, in their laziness. Therefore, the conclusion about the presence of violations of the will and impulses should be done not on the basis of declared intentions, but based on the analysis of the actions performed. Thus, the statement of the patient about the desire to get a job looks like an unfounded, if he has not been working for several years and does not make an employment attempt. It should not be perceived as an adequate statement of the patient that he likes to read if he read the last book a few years ago.

Allocate quantitative changes and perversions of impulse.

Hyperbulia - The overall increase in will and deposits affecting all the main attitudes of a person. An increase in appetite leads to the fact that patients, being in the department, immediately eat the transmission brought by him and sometimes cannot resist not to take products from someone else's bedside table. Hypersexuality is manifested by increased attention to the opposite sex, courtships, immodest compliments. Patients try to attract attention to bright cosmetics, throwing clothes, stand for a long time with a mirror, leading to the hair in order, can enter into numerous random sex. There is a pronounced thrust for communication: every conversation of the surrounding becomes interesting for the sick, they are trying to turn on in the conversations of foreign. Such people seek to provide patronage to any person, distribute their belongings and money, make expensive gifts, get involved in a fight, wanting to protect the weak (in their opinion). It is important to take into account that the simultaneous increase in impulse and will, as a rule, does not allow patients with obviously dangerous and rude unlawful actions, sexual violence. Although such people usually do not pose a danger, they can interfere with their obsessiveness, fussy, behave carelessly, misconcellious property. Hyperbulia - characteristic manifestation manic syndrome.

Typobulia - A general decline in will and deposits. It should be borne in mind that patients with hylogulia are suppressed all the main attractions, including physiological ones. There is a decrease in appetite. The doctor can convince the patient as needed, but he takes food reluctantly and in small quantities. A decrease in sexual attraction is manifested not only by falling interest in the opposite sex, but also the lack of attention to its own appearance. The patients do not have the need for communication, they are presented by the presence of foreign and the need to support the conversation, asking to leave them alone. Patients are shipped to the world of their own suffering and cannot take care of loved ones (the behavior of the mother with postpartum depression looks particularly surprising, which is unable to force himself to take care of the newborn). Suppression of self-preservation instinct is expressed in suicidal attempts. It is characteristic of the feeling of shame for their inaction and helplessness. Hypolasses is a manifestation Depressive syndrome.Suppression of deposits during depression is temporary, transient disorder. The binding of the attack of depression leads to the resumption of interest in life, activity.

For Abulia it is usually not observed to suppress physiological impulses, the disorder is limited to a sharp decrease in will. Laziness and the notionlessness of persons with Abulia are combined with a normal need for food, a distinct sexual activation, which are satisfied with the most simplest, not always socially acceptable ways. So, a patient experiencing hunger, instead of going to the store and buy the products you need, asks the neighbors to feed it. Sexual attraction of the patient satisfies continuous masturbation or drawn with ridiculous attractions to the mother and sister. In patients suffering from Abulia, the highest social needs disappear, they do not need communication, in entertainment, can conduct in idle all days, are not interested in the events in the family and in the world. In the department, they do not communicate with neighbors around the ward, do not know their names, the names of doctors and nurses.

Abulia is a persistent negative disorder, together with Apatia is one Apatico-abulic syndrome,characteristic for end states during schizophrenia. With preventive diseases, doctors can observe the rise of the phenomena of Abulia - from light laziness, misinterpretation, inability to overcome obstacles to gross passivity.

The patient of 31 years, the turner by profession, after the undergoing attack of Schizophrenia left a job in the workshop, since he considered it too heavy for himself. I asked him to take it by a photographer in the city newspaper, as I used to have been engaged in a photo. Once, on behalf of the editorial board, a report on the work of collective farmers was to report. I came to the village in urban shoes and, so as not to be staining the boot, did not approach the tractors in the field, and did only a few pictures from the car. From the editorial office was dismissed for laziness and misintermettiness. It did not get on another job. The house refused to deal with any economic affairs. I stopped to care for the aquarium, which I made my hands before the disease. For all day later, lay in bed and dreamed of moving to America, where everything is easy and accessible. I did not object when relatives appealed to psychiatrians with a request to arrange disabilities.

A lot of symptoms are described Perversion of impulse (para- bulb). The manifestations of mental disorders may be perverted appetite, sexual attraction, the desire for asocial agencies (theft, alcoholization, vagrancy), self-injunction. Table 8.1 shows the main terms indicating the disorders of the deposits on the ICD-10.

Parabulia is not considered independent diseases, but are only a symptom. Reasons

Table 8.1. Clinical options for deposits

Cipher on μb-10	Name of disorder	Character of manifestation
	Pathological
	passion for gambling
	games
	Pyromania	The desire to commit airsfish
	Kleptomania	Pathological steam
	Trichothylomania	Attraction for pulling W. Himself
	Piccismism (peak)	The desire to eat invalid
	"Children	(as a variety, coprof-
		gia - Nedania excrement)
	Dipcomania	Attraction to alcohol
	Domomania	The desire for vagrancy
	Homicidomania	Snowless desire of SO
		left murder
	Suicidomania	Attraction to suicide
	Oniomania	Attraction to shop (often
		unnecessary)
	Nervous anorexia	Desire to limit yourself in
		food, lose weight
	Bulimia	Attacks of overeating
	Transsexualism	The desire to change the floor
	Transvestism	Desire to wear clothes about
		floor
	Paraffilia	Sexual disorders
	including:	respect
	fetishism	Getting sexual satisfaction
		imaging from contemplation
		metals of intimate garard
	exhibitionism	Passion for expulsion
	voyeurism	Passion for peeping for about
		nailed
	pedophilia	Attraction to minors
		in adults
	sadomasochism	Achieving sexual satisfaction
		aligning by causing
		pain or moral suffering
	homosexuality	Attraction to the persons your own

Note. The terms for which the cipher is not included are not included in the ICD-10.

the pathological impositions are gross disorders of intelligence (oligophrenia, total dementia), various forms of schizophrenia (both in the initial period and at the final stage with the so-called schizophrenic dementia), as well as psychopathy (persistent disharmony of personality). In addition, deposit disorders are a manifestation of metabolic disorders (for example, eating inedible with anemia or pregnancy), as well as endocrine diseases (increase in appetite in diabetes, hyperactivity in hyperthyroidism, abulia in hypothyroidism, violation of sexual behavior with sexual hormone imbalances).

Each of the pathological deposits can be expressed in varying degrees. There are 3 clinical variants of pathological deposits - obsessive and compulsive attractions, as well as impulsive actions.

Observatory (obsessive) attraction ensures the occurrence of desires that the patient can control according to the situation. Inquiries, clearly diverged with the requirements of ethics, morality and legality, in this case are never implemented and suppressed as unacceptable. However, the refusal to satisfy the attraction gives rise to severe experiences in patients; In addition to the will, thoughts on unfulfilled need are constantly in the head. If it does not carry an explicit antisocial nature, the patient carries it to the first opportunity. So, a person with an obsessive fear of pollution keeps the attraction to the washing of hands for a short time, but it will definitely be carefully wooing them when strangers do not look at him, because all the time he suffers, he constantly painfully thinks about his need. The obsessive attractions are included in the structure of the obsessive-phobic syndrome. In addition, they are a manifestation of mental dependence on psychotropic drugs (alcohol, tobacco, hashish, etc.).

Compulsive attraction - more powerful feeling, because it is in force, it is comparable to such life needs, like hunger, thirst, self-preservation instinct. Patients are aware of the perverted nature of the attraction, trying to restrain themselves, but with unmet need, an unbearable sense of physical discomfort arises. The pathological need occupies such a dominant position that a person quickly stops the inner struggle and satisfies its attraction, even if it is associated with rude asocial agencies and the possibility of subsequent punishment. Compulsive attraction can be the cause of repeated violence and serial killings. A bright example of compulctural attraction is the desire for drugs under an abstineent syndrome in suffering from alcoholism and drug addiction (physical dependence syndrome). Combulsive attractions are also a manifestation of psychopathies.

Impulsive deeds a man is committed immediately as soon as a painful attraction arises, without the previous struggle of motives and without a decision of the decision. Patients can only think about their actions after their commit. At the moment of action, there is often an affectively narrowed consciousness, which can be judged by subsequent partial amnesia. Among the impulsive deeds are dominated, devoid of any meaning. Often patients subsequently cannot explain the goals of the deed. Impulsive deeds are a frequent manifestation of epileptiform paroxysms. Patients with catatonic syndrome are also inclined to perform impulsive actions.

From disorders should be distinguished by acts due to the pathology of other spheres of the psyche. Thus, the rejection of food is caused not only by a decrease in appetite, but also the presence of nonsense of poisoning, imperative hallucinations prohibiting the patient, as well as a coarse disorder of the motor sphere - a catatonic stupor (see section 9.1). Acts that lead patients with their own death, do not always express the desire to end with themselves, but are also due to imperative hallucinations or permanent consciousness (so, the patient in a state of delirium, fleeing from imaginary persecutors, jumps out of the window, belonging to the door).

8.3. Emotional-Wall Disorders Syndrome

The most striking manifestations of the disorder of the affective sphere are depressive and manic syndromes (Table8.2).

8.3.1. Depressive syndrome

The clinical picture is typical Depressive syndrome it is customary to describe the symptoms in the form of a triad: reduce mood (hypothymia), slowdown in thinking (associative inhibition) and motor inhibition. It should, however, take into account that it is a decline in the mood is the main syndrome-forming sign of depression. Hypothymia can be expressed in the complaints of longing, depression, sadness. Unlike the natural reaction of the sorrow, in response to a sad event, the longing of the depression is deprived of communication with the surrounding environment; Patients do not show reactions to either joyful news or new blows of fate. Depending on the severity of the depressive condition, hypothymia can manifest itself with feelings of various intensity - from light pessimism and sadness to a heavy, almost physical sensation of "Heart Stone" ( vital longing).

Maniacal syndrome

Table 8.2. Symptoms of manic and depressive syndromes

Depressive syndrome

Depressive Triad: Mood Reducing Ideacher Motor Insurance

Reduced self-esteem,

pessimism

Nonsense, self-relocations, and hypochondria

Deposit suppression: decrease in appetite Reduction of libido avoiding contacts, closedness depreciation of life, striving for suicide

Sleep disorders: reduction of duration Early awakening lack of feeling sleep

Somatic disorders: dry skin, reduction of its turbine, hair lone and nails, lack of tears constipation

tachycardia and an increase in blood pressure Extension of the pupil (MIDRIAZ) Body Mass Reduction

Manicard triad: improving the mood acceleration of thinking psychomotor arousal

Overestimated self-esteem, optimism

Brad magnifies

Redestoming of the Inspection: An increase in appetite Hypersexuality The desire for communication need to assume surrounding, altruism

Sleep disorder: reduction of sleep duration, not causing fatigue

Somatic disorders are not characteristic. Sick complaints do not impose, look young; an increase in blood pressure corresponds to the high activity of patients; body weight decreases with a pronounced psychomotor excitation

Slowing thinking in easy cases is expressed by a slow monowing speech, longly thinking about the answer. In more severe cases, patients with difficulty comprehend the assigned question are unable to cope with the solution of the simplest logical tasks. Silence, spontaneous speech is absent, but complete mutism (silence) does not usually happen. Motor inhibition is detected in stiffness, slowness, and hardness, with severe depression, can reach the degree of stupor (depressive stupor). Posses of spooring patients are pretty natural: lying on his back with elongated hands and legs or sitting, bowing his head, leaning on his knees.

The statements of depressive patients are discovered sharply understated self-esteem: they describe themselves as insignificant, worthless people devoid of talents. Surprised that the doctor

it gives one time such a minor person. Pessimistically estimated not only their real state, but also the past and future. They say that they could not do anything in this life that they brought a lot of troubles with their family, were not joy for parents. They build the most sad forecasts; As a rule, they do not believe in the possibility of recovery. With severe depression, the delusional ideas of self-evidence and self-relocating. Patients consider themselves deeply sinful before God, which are mounted in the death of elderly parents, in the country occurring in the country. Often blame yourself in loss of ability to empathize others (AnaesthesiaSychicadolorosa). There may also be the emergence of hypochondriad nonsense ideas. Patients believe that hopelessly sick, perhaps a shameful disease; fear to infect loved ones.

Suppression of the deposits is usually expressed by a closedness, a decrease in appetite (less often bulimia attacks). Lack of interest in the opposite sex is accompanied by distinct changes in physiological functions. Men often experience impotence and put it in guilt. Fryricted women often accompany the menstrual cycle violations and even a long-lasting amenorrhea. The patients avoid any communication, among people they feel awkward, inappropriate, someone else's laughter only emphasizes their suffering. Patients are so shipped into their experiences that unable to take care of someone. Women cease to household classes, can not care for young children, do not pay any attention to their appearance. Men do not cope with their favorite work, not able to get out of bed in the morning, gather and go to the service, lie all day without sleep. Patients are not available entertainment, they do not read and do not watch TV.

The greatest danger of depression is a predisposition to suicide. Among mental disorders, depression is the most common cause of suicide. Although thoughts on leaving life are inherent in almost all suffering depressions, the real danger occurs when a combination of severe depression with sufficient patient activity. With a pronounced stupor, the implementation of such intentions is difficult. There are cases of expanded suicide when a person kills his children to "save them from the coming MUK."

One of the most painful experiences at depression is stubborn insomnia. Patients sleep badly at night and can not relax in the afternoon. It is especially characteristic of awakening in the early morning clock (sometimes at 3 or 4 h), after which patients do not fall asleep anymore. Sometimes patients persistently claim that at night they did not sleep for a minute, never closed the eyes, although relatives and medical staff were seen by their sleeping ( no sleep feeling).

Depression is usually accompanied by a diverse somadegital symptom. As a reflection of the state of sharpness, peripheral sympathicotonium is more often observed. The characteristic triad of symptoms is described: Tachycardia, expansion of pupil and constipation ( triad Protopopova).The appearance of the patients is drawn attention. Skin surfaces dry, pale, peeling. The decrease in the secretory function of the glands is expressed in the absence of tears ("All eyes flushed"). Often celebrate hair loss and nail fragility. The decrease in the turgorate of the skin is manifested in the fact that wrinkles are deepened and patients look older than their age. An atypical domestic eyebrows may be observed. The fluctuations of blood pressure with a tendency to increase are recorded. The disorders of the gastrointestinal tract are manifested not only by constipation, but also a deterioration of digestion. As a rule, the mass of the body is noticeably reduced. Frections are a variety of pain (head, heartfelt, in the stomach, in the joints).

Patient 36 years has been translated into a psychiatric hospital from the therapeutic department, where for 2 weeks was examined due to permanent pains in the right hypochondrium. During the examination of the pathology, they did not reveal, but the man assured that he was sick, and admitted to the doctor in his intention to commit suicide. Did not mind the translation into a psychiatric hospital. Upon arrival, it is responsible for questions. He declares that he is "all the same!". In the department, it does not communicate with anyone, most of the time lies in bed, almost nothing eats, constantly complains of the lack of sleep, although the staff reports that the patient sleeps every night, at least until 5 hours in the morning. Once, in the morning inspection, a stagnation groove on the neck of the patient was found. With persistent abrasion admitted that in the morning, when the staff fell asleep, he tried, lying in bed, strangle himself a loop associated from 2-nasal headscarves. After treatment, antidepressants disappeared with painful thoughts and all the unpleasant feelings in the right hypochondrium.

Somatic symptoms of depression in some patients (especially with the first attack of the disease) can act as the main complaint. This is due to their appeal to the therapist and long-term, unsuccessful treatment over the "ischemic heart disease", "hypertension", "dyskinesia of the biliary ways", "vegetative dystonia" and others. In this case, they are talking about masked (licorned) depression,in more detail described in Chapter 12.

The brightness of emotional experiences, the presence of delusional ideas, signs of hyperactivity of vegetative systems make it possible to consider depression as a syndrome of productive disorders (see Table 3.1). This is confirmed by the characteristic dynamics of depressive states. In most cases, depression lasts several months. However, it is always reversible. Before the introduction into the medical practice of antidepressants and electrical sound therapy, the doctors often observed a spontaneous output from this state.

Above the most typical depression symptoms were described. In each individual case, their set can differ significantly, but always prevails the depressed, dreary mood. Depressed syndrome is considered as a psychotic level disorder. The severity of the state shows the presence of delusional ideas, the absence of criticism, active suicidal behavior, a pronounced stupor, suppressing all basic deposits. Soft, non-psychotic depression option denote as subdepress.During scientific research for measuring the severity of depression, special standardized scales (Hamilton, Tsung, etc.) are used.

The depressive syndrome is not specific and may be a manifestation of various mental illness: manic-depressive psychosis, schizophrenia, organic lesions of the brain and psychogeneration. For depression due to endogenous disease (TIR and schizophrenia), pronounced satellite disorders are more characteristic, an important feature of the endogenous depression is the particular daily dynamics of the state with an increase in longing in the morning and some weakening of experiences in the evening. It is the morning hours regarded as a period associated with the greatest risk of suicide. Another marker of endogenous depression is considered a positive dexamethasone test (see Section 1.1.2).

In addition to typical depressive syndrome, a number of atypical depression options are described.

Anxious (armed) depressionit is distinguished by the lack of pronounced stiffness and passivity. A rack affect anxiety causes patients to fuss, constantly turn to others with a request to moor or demanding to stop their flour, help them leave life. The premonition of an imminent catastrophe does not give sick to sleep, they can attempt to end with them in front of others. At times, the excitation of patients reaches the degree of fury (melancholic raptus, raptusmelancholicus), when they torn clothes on themselves, make scary screams, fight their heads about the wall. Anxious depression is more often observed in an involutionary age.

Depressive-delusional syndrome,in addition to the dreary mood, it is manifested by such fabuns of nonsense as nonsense prosecution, drawing, exposure. Patients are confident in serious punishment for perfect misconduct; "Notice" permanent monitoring. They fear that their fault will entail the oppression, punishment or even the murder of their relatives. Patients are restless, constantly ask about the fate of their relatives, trying to justify, swear that there will be no mistake in the future. Such atypical delusional symptoms is more characteristic not for TIR, but for an acute attack of schizophrenia (schizoaffective psychosis in terms of ICD-10).

Apathetic depressioncombines affects of longing and apathy. Patients are not interested in their future, they are inactive, do not express any complaints. The only desire their desire is to be left alone. From apatico-abulic syndrome, this condition is distinguished by inflexibility, reversibility. The whole apathetic depression is observed with schizophrenia suffering.

8.3.2. Maniacal syndrome

It manifests itself primarily by improving the mood, accelerating thinking and psychomotor excitation. Hypertimia at this condition is expressed by constant optimism, disregard for difficulties. Denies the presence of any problems. Patients are constantly smiling, no complaints are presented, do not consider themselves sick. The acceleration of thinking is noticeable in the fast, jumping speech, increased distracted ™, the surfaceness of associations. With pronounced mania, it is so disorganized, which resembles a "verbal okros." Speech head is so great that patients lose their voice in the corners of the mouth, whipped saliva foam. Their activity is chaotic, unproductive. They can not sit in place, seek to leave home, ask to let go from the hospital.

There is an overvaluation of its own abilities. Patients consider themselves surprisingly charming and attractive, constantly praise the allegedly existing ones with them with Lanta. They are trying to write poems, demonstrate their vocal data to others. A sign of extremely pronounced Mania is nonsense.

It is characterized by an increase in all basic deposits. Appetite increases sharply, sometimes there is a tendency to alcoholization. Patients cannot be alone and constantly looking for communication. In a conversation with doctors, they do not always follow the necessary distance, referring to easily - "Battle!". Patients pay a lot of attention to their appearance, try to decorate themselves with icons and medals, women are excessively bright cosmetics, clothing are trying to emphasize their sexuality. Increased interest in the opposite sex is expressed in compliments, immodest proposals, confessions in love. Patients are ready to help and patronize everyone around. In this case, it is often that on its own family simply lacks time. They are tagging money, make unnecessary purchases. With excessive activity, it fails to be completed by none of the cases, since each time new ideas occur. Attempts to prevent the realization of their deposits cause the reaction of irritation, indignation ( angry mania).

For manic syndrome, a sharp decrease in the duration of night sleep is characteristic. Patients refuse to lie down in the bed while continuing to fuss and at night. In the morning you wake up very early and immediately turn on in active activity, but never complain about fatigue, claim that they sleep quite enough. Such patients are usually caused by many inconveniences, they harm their material and social status, but the immediate threat to the life and health of other people, as a rule, do not represent. Soft subsycotic increase in mood ( goloman)unlike heavy mania, it may be accompanied by consciousness of the unnaturalness of the state; Brad is not observed. Patients can produce a favorable impression by their ingenuity and wit.

In physically, the mania sufferers look healthy, somewhat thinned. With pronounced psychomotor excitation, they lose weight, despite the wolf appetite. With hypologia, a significant weight gain can be observed.

Patient 42 years old, suffering from 25 years old attacks inadequately increased mood, the first of them emerged during the graduate studies at the Department of Political Economy. By that time, the woman was already married and had a 5-year-old son. In a state of psychosis, he felt very feminine, accused her husband in a not enough attitude towards her. Not more than 4 hours per day slept, and he was engaged in scientific work, he paid little attention to his son and home care. I felt a passionate attraction to my supervisor. She sent him a secret bouquet of flowers. I visited all his lectures for students. Once in the presence of all employees, the tribes at the knees asked him to take her to his wife. It was hospitalized. Upon completion of the attack, it was not able to finish work on the dissertation. During the next attack fell in love with a young actor. She went to all his performances, gave flowers, secretly invited him to the cottage from her husband. I bought a lot of wine to drink a lover and thereby overcome his resistance, herself very much and often drank. On the underwent questions of the husband with heat in everything admitted. After hospitalization and treatment married a lover, went to work towards him to the theater. In the interconcenetary period calm, alcohol is rare. With warmth, responds about the former husband, a little regrets about divorce.

Maniacal syndrome is most often manifestation of TIR and schizophrenia. Occasionally there are maniacal states caused by organic brain damage or intoxication (phenamine, cocaine, cimetidine, corticoide, cyclosporine, teturas, hallucinogens, etc.). Mania is a sign of acute psychosis. The presence of bright productive symptoms allows you to count on the full reduction of painful disorders. Although individual attacks can be sufficiently long (up to several months), they are still often shorter than attacks of depression.

Along with typical mania, atypical syndromes of a complex structure are often found. Manico-delusional syndrome,in addition to the affect of happiness, accompanied by non-systematized delusted ideas of persecution, staging, meticomanic delusions of greatness ( acute paraffrenation).The patients say that "save the whole world" are designed, which are endowed with incredible abilities, for example, "the main weapon against the mafia" and the criminals are trying to destroy them. A similar disorder with TIR does not occur and most often indicates a acute attack of schizophrenia. At the height of the manic-delusional attack, there may be an onaireoid permanent of consciousness.

8.3.3. Apatico-abulic syndrome

Manifested by a pronounced emotionally volitional deed. Indifference and indifference make patients quite calm. They are poorly in the department, spend a lot of time in bed or sitting alone, can also be at the TV. It turns out that they did not remember any viewed transmission. Laziness schorates in all their behavior: they are not waving, do not clean their teeth, refuse to go into the shower and cut hair. Land dressed in bed, because they are too lazy to shoot and wear clothes. They cannot be attracted to activities by calling for responsibility and a sense of duty, because they do not have shame. The conversation does not cause patients of interest. They say they are monotonously, often refuse to conversation, stating that they are tired. If a doctor manages to insist on the need for a dialogue, it is often that the patient can talk for a long time without showing signs of fatigue. In the conversation, it turns out that patients do not feel any suffering, do not feel sick, no complaints are presented.

The symptomatic described is often combined with the development of the simplest deposits (voraciousness, hypersexuality, etc.). At the same time, the lack of shame leads them to attempts to realize their needs in the simplest, not always socially acceptable form: for example, they can urinate and straighten right in bed, because they are too lazy to walk to the toilet.

Apatico-abutic syndrome serves as a manifestation of negative (deficient) symptoms and does not have trends towards reverse development. Most often, the cause of apathy and Abulia is the final states in schizophrenia, in which the emotional-volitional defect increases gradually - from light indifference and passivity to states of emotional stupidity. Another reason for the occurrence of apatico-abylic syndrome is an organic lesion of the frontal brain shares (injury, tumor, atrophy, etc.).

8.4. Physiological and pathological affect

The reaction to a psychotrauming event may proceed very differently depending on the individual significance of the stressful event and the characteristics of the human emotional response. In some cases, the form of manifestation of the affect is surprisingly frantic and even dangerous to others. Cases of the murder of a spouse on the soil of jealousy, cruel fights between football fans, violent disputes between political leaders. A gross asocial manifestation of an affect can be promoted by a psychopathic personality warehouse (excited psychopathy - see section 22.2.4). Nevertheless, it is necessary to recognize that in most cases such aggressive actions are committed consciously: participants can tell about their feelings at the time of the arrival of the act, repent of incontinence, are trying to smooth the bad impression, appealing to the severity of an insult. Whatever the perfect crime, in such cases it is considered as Physiological affect and entails judicial responsibility.

Pathological affect call short-term psychosis, which arises suddenly after the action of a psychotrauma and accompanied by the permanent of consciousness with the subsequent amnesia of the entire period of psychosis. The paroxysmal nature of the occurrence of the pathological affect indicates that the psychotrauming event becomes a starting point to the implementation of the existing epileptiform activity. Often, patients have a history of head injuries or signs of organic dysfunction since childhood. The perisage of consciousness at the moment of psychosis is manifested by rapidness, amazing cruelty of perfect violence (dozens of heavy wounds, numerous blows, each of which can be fatal). The surrounding unable to correct the actions of the patient, since he does not hear them. Psychosis lasts a few minutes and ends with heavy exhaustion: the patients suddenly fall without strength, sometimes fall into deep sleep. Upon comes from psychosis, they cannot remember any of the happening, are extremely surprised, having heard that they did not believe others. It should be recognized that disorders in pathological affect only can be attributed to the circle of emotional violations, since the most important expression of this psychosis is Twilight permanent consciousness(See section 10.2.4). The pathological affect serves as the basis for the recognition of the patient with invisible and exemption from responsibility for the crime committed.

BIBLIOGRAPHY

Isard K. Man's emotions. - M.: Publishing House of Moscow State University, 1980.

Numer Yu.L., Mikhalenko I.N. Affective psychosis. - L.: Medicine, 1988. - 264 p.

Psychiatric Diagnosis / Repellsky I.Ya., Blaikher V.M., Kruk I.V., Revlyanskaya L.I. - Kiev: School School, 1989.

Psychology emotions. Texts / Ed. V.K.Vilyunas, Yu.B.gippen-Reuteter. - M.: MSU, 1984. - 288 p.

Psychosomatic Disorders for cyclotem and cyclote-like states. - Works MIP., T.87. - ON ed. S.F. Semenov. - M.: 1979. - 148 p.

Reikovsky I. Experimental psychology of emotions. - M.: Progress, 1979.

Sinitsky V.N. Depressive states (pathophysiological characteristics, clinic, treatment, prevention). - Kiev: Nookova Dumka, 1986.

The kids in this period are very difficult to fall asleep. They become restless at night, often wake up. A child can botherly react to any stimuli, especially if he is in an unfamiliar atmosphere for him.

Adults are also largely dependent on their mood, which can change according to the unknown, seemingly reasons. Why does it happen and what is important about this to know?

Definition of the emotional-volition sphere

For appropriate development in society, as well as normal life, an emotional-volitional sphere is important. It depends a lot of it. And this applies not only to family relationships, but also professional activities.

The process itself is very complex. Various factors affect its origin. It can be both social conditions for a person and his heredity. This area begins to develop at an early age and continues to form before adolescence.

The person from birth overcomes such types of development:

Emotions are different ...

Like their manifestations in life

What reasons are the failure?

There are a number of reasons that are able to affect the development of this process and cause emotionally volitional disorders. The main factors include:

Along with this, you can call any other reasons that are able to cause internal discomfort and the feeling of inferiority. At the same time, the child will be able to develop harmoniously and correctly only if he has confidential relations with his relatives.

Spectrum of Violations of Will and Emotions

Emotionally volve violations include:

• hyperbulia;
• hystoculia;
• abulia;
• observatory-compulsive disorder.

With a general increase in the will, a hyperbulia is developing, which is capable of affecting all the main attractions. This manifestation is considered characteristic of manic syndrome. So, for example, a person will increase appetite if it is in the department, it will immediately eat food that he brought him.

Reduced both will and descending at hystobulia. In this case, a person does not need communication, its outsiders who are nearby. It is easier for him alone. Such patients prefer to immerse themselves in their own world of suffering. They do not want to take care of their relatives.

When the will is reduced, this indicates Abulia. Such a disorder is considered persistent, and in conjunction with apathy is composed of an apatico-abulic syndrome, which, as a rule, manifests itself during the period of the final state of schizophrenia.

In case of obsessive deposits, the patient has desires that it is capable of monitoring. But when he begins to give up his impulses, it gives rise to serious experience in it. He is pursued by the thoughts of the need that was not quenched. For example, if a person has fear of pollution, he will try not so often to wash his hands, as he wants, however it will force him to think about his own needs. And when no one will look at him, it will wash them carefully.

More powerful feelings include a compulsive attraction. It is so strong that is compared with instincts. The need becomes pathological. Its position is dominant, so the internal struggle ceases very quickly and the person immediately satisfies his desire. It may be a gross asocial act, followed by punishment.

Village disorders

The will is the mental activity of the person, which is aimed at a certain purpose or overcoming obstacles. Without this, a person will not be able to realize his intentions or solve life tasks. The volitional disorders include hystobulia and abulia. In the first case, the volitional activity will be weakened, and in the second - absent at all.

If a person faces a hyperbulia that combines with distractions, it can talk about a manic state or a delusional disorder.

The attraction to food and self-preservation is disturbed in the case of parabula, that is, with the perversion of the volitional act. The patient, refusing to normal products, begin eating inedible. In some cases, pathological voraciousness is observed. When a sense of self-preservation is disturbed, then the patient can apply a heavy injury. This includes sexual perversions, in particular, masochism, exhibitionism.

Spectrum of volitional qualities

Disorders of the emotional sphere

Emotions are different. They characterize the relationship of people to the world around the world and to themselves. There are many emotional disorders, but some of them are considered an urgent reason to visit a specialist. Among them:

• depressed, dreary mood, repeating, protracted;
• constant change of emotions, without serious reasons;
• uncontrollable emotional states, affects;
• chronic anxiety;
• stiffness, uncertainty, timidity;
• high emotional susceptibility;
• phobia.

The following pathological deviations include violations of the emotional sphere:

1. Apathy resembles emotional paralysis. The person is completely indifferent to the whole surrounding. This is accompanied by inactive.
2. Hypothimia at which the mood is reduced, and a person feels depression, longing, hopelessness, so fixes its attention only on negative events.
3. For depression, such a triad is characterized as hypothymia, slowdown in thinking, motor inhibition. At the same time, the patient is a melancholic mood, he feels deep sadness, heaviness in the heart and all body. Early in the morning, well-being deteriorated significantly. During this period, there is a high probability of suicide.
4. In the case of a dysphoria, the mood is also reduced, but it has a stress-angry nature. This is a short-term deviation. As a rule, there are people suffering from epilepsy.
5. Do not protracted and distortium. It passes for a relatively short period of time. This condition is characterized by mood disorder. A person feels despondency, anxiety, anger.
6. The opposite of the above deviations is considered hypertimia, in which a person is overly cheerful, he is glad and cheerful, energetic and overestimates his own capabilities.
7. A person in the state of Euphoria is complacted and is careless, but it is characterized by passivity. This often occurs in the case of organic brain disease.
8. During the ecstasy, the patient is immersed in itself, he is experiencing delight, extraordinary happiness. Sometimes this condition is associated with visual hallucination of positive content.

When the child is excessively aggressive or closed

Disruption of the emotionally volitional sphere, which are most pronounced in children:

1. Aggressiveness. Almost every child can show aggression, however, it is worth paying attention to the degree of reaction, its duration and nature of the reasons.
2. Emotional dismissal. In this case, there is too stormy reaction to everything. Such children, if they cry, do it loudly and defiantly.
3. Anxiety. With such a violation, the child will be shy to express his emotions to vividly, he does not tell his problems, he feels discomfort when attention is paid to him.

In addition, the violation is with enhanced emotionality and reduced. In the first case, this applies to Euphoria, depression, anxiety syndrome, dysphoria, fears. At low, apathy develops.

The violation of the emotionally volitional sphere and the disorder of behavior is observed in a hyperactive child, which is experiencing motor anxiety, suffers from nonsense, impulsiveness. It cannot concentrate attention.

Modern look at the correction

Hippotherapy is isolated as one of the main methods of soft correction. It provides for communication with horses. This procedure is suitable not only for children, but also adults.

It can be used for the whole family, which will help you rally, improve trusting relationships. This treatment will allow to spread with depressive mood, negative experiences, reduce anxiety.

If we are talking about the correction of violations in the child, then a variety of psychological methods can be used for this. Among them should be allocated:

• a game manager that provides for the application of the game (this method is particularly effective for preschoolers);
• bodily-oriented therapy, dance;
• fairy-therapy;
• art therapy, which is divided into two types: perception of finished material or independent drawing;
• music therapy in which music is activated in any form.

Any disease or deviation is better to try to prevent. In order to prevent disorders of the emotionally volitional sphere, it is worth listening to such ordinary advice:

• if an adult or child is emotionally injured, then located nearby, must be calm, show their benevolence;
• people need to share their experiences as often as possible;
• need to do physical labor or draw;
• watch out for the day of the day;
• try to avoid stressful situations, unnecessary experience.

It is important to understand that much depends on those who are near. It is not necessary to share your experiences with all others, but it is necessary to have such a person who will help in a difficult situation will support and listen. In turn, parents must be patient, care and limitless love. This will retain the mental health of the baby.

Emotionally volitional violations

Human emotions act as a special class mental state, which are reflected in the form of a positive or negative attitude towards the world around the world, other people and above all. Emotional experiences are determined by the relevant properties and qualities formed from objects and phenomena of reality, as well as certain needs and human needs.

The role of emotions in human life

The term "emotions" comes from the Latin name Emovere, which means movement, excitement and excitement. The key functional component of emotions is to encourage activity, as a result, the emotional scope is differently called emotional-volitional.

At the moment, emotions perform a significant role in ensuring the interaction of the body and the environment.

Negative emotions are manifested as a result of the deficit, it is necessary to provide information to meet a number of needs, and positive emotions are characterized by the complete availability of all necessary information.

Today, emotions are divided into 3 main parts:

1. Affect, characterized by a sharp experience of a certain event, emotional voltage and excitation;
2. Cognition (awareness of its condition, his verbal designation and evaluation of further prospects for satisfying needs);
3. Expression, which is characterized by an external bodily motorcy or behavior.

The relatively sustainable emotional state of a person is called mood. The sphere of human needs includes the social needs and emotions that arise on the basis of social and cultural needs, which later received the name of the senses.

Allocate 2 emotional groups:

1. Primary (anger, sadness, anxiety, shame, surprise);
2. Secondary, which include recycled primary emotions. For example, pride is joy.

Clinical picture of emotional-volitional disorders

The main external manifestations of violations of the emotionally volitional sphere include:

• Emotional tension. With increased emotional tensions, disorganization of mental activity and reducing activity arises.
• Rapid mental fatigue (in a child). It is expressed by the fact that the child is not able to focus, is also characterized by a sharp negative response to certain situations where the demonstration of its mental qualities is necessary.
• The alarm state, which expresses the fact that a person in every way avoid any contacts with other people and do not strive to communicate with them.
• Increased aggressiveness. Most often occurs in childhood when the child defiantly disappoints adults, experiencing a constant physical and verbal aggression. Such aggression can be expressed not only in relation to others, but also to itself, thereby causing harm to their own health.
• The absence of the ability to feel and comprehend the emotions of other people, empathize. This feature is usually accompanied by increased anxiety and is the cause of mental disorder and mental delay.
• Lack of desire to overcome vital difficulties. In this case, the child is in constantly sluggish condition, he does not have a desire to communicate with adults. The extreme manifestations of this disorder are expressed in full ignoring parents and other adults.
• Lack of motivation to success. The main factor of low motivation is the desire to avoid possible failures, as a result of which a person refuses to take on to fulfill new tasks and is trying to avoid situations where even the slightest doubts arise in final success.
• Severe distrust of other people. Often accompanied by such a sign as hostility towards others.
• Increased impulsiveness in childhood. It is expressed by such signs as the lack of self-control and awareness of their actions.

Violation of the emotional sphere in adult patients stand out by such features as:

• Hypolasses or lowering volitional qualities. In patients with this violation there is no need for communicating with other people, irritability arises in the presence of a number of extraneous, the lack of ability or desire to support the conversation.
• Hyperbulia. It is characterized by increased activation in all spheres of life, it is often expressed in strengthening appetite and needs for constant communication and attention.
• Abulia. It is highlighted by the fact that the person sharply decreases the volitional desection.
• Compulsive attraction is an irresistible need for anything or com else. This disorder is often compared with animal instinct, when a person is significantly suppressed by the ability of its awareness of its actions.
• An obsessive attraction is the manifestation of obsessive desires that the patient is not able to control independently. The dissatisfaction of such desires leads to the depression and the deep suffering of the patient, and his thoughts are filled with the idea of \u200b\u200btheir implementation.

Emotional-Wall Disorders Syndrome

The most common forms of emotional disorders acts depressive and manic syndromes.

The clinical picture of the depressive syndrome is described by 3 main signs, such as:

• Hypotomy characterized by a decrease in mood;
• Associative inhibition (mental inhibition);
• Motor inhibition.

It is worth noting that it is the first item above is the key feature of the depressive state. Hypotomy can be expressed in the fact that a person is constantly whining, it feels depression and sadness. Unlike the established reaction, when sadness arises due to the experience of a sad event, then when depressed, a person is deprived of communication with the surrounding environment. That is, in this case, the patient does not show reactions to joyful and other events.

Thinking inhibition in its light manifestations is expressed in the form of a slowdown in one-room speech and long overducting the answer. The difficult course is characterized by the inability to understand the given questions and solving a number of simplest logical tasks.

Motor inhibition manifests itself in the form of stiffness and slowness of movements. In case of severe depression, there is a risk of a depressive stupor (the state of complete depression).

Often, manic syndrome is manifested in the framework of affective bipolar disorder. In this case, the flow of this syndrome is characterized by the attackness, in the form of separate episodes with certain stages of development. The symptomatic picture released in the structure of a manic episode is characterized by variability in one patient, depending on the development stage of pathology.

Such a pathological condition as a manic syndrome, as well as depressive, stand out 3 main signs:

• Hypertime in hyperthythmia;
• Mental excitability in the form of accelerated thinking processes and speech (tachips);
• Motor excitation;

Anomalous improved mood is characterized by the fact that the patient does not feel such manifestations as longing, anxiety and a number of other signs characteristic of depressive syndrome.

The mental excitability with the accelerated process of thinking arises until the jump of ideas, that is, in this case, the patient's speech becomes incomplete, due to excessive distractions, although the patient itself is aware of the logic of his words. Also highlights the fact that the patient has the ideas of their own greatness and denial of guilt and responsibility of other people.

Increased motor activity with this syndrome, is characterized by the discharging of this activity in order to obtain pleasure. Consequently, with manic syndrome, patients usually consume a large amount of alcohol and narcotic substances.

For manic syndrome, such emotional disorders are also characteristic as:

• Strengthening instincts (increase in appetite, sexuality);
• Increased distraction;
• Revaluation of personal qualities.

Methods for correction of emotional disorders

Features of the correction of emotional disorders in children and adults are based on the use of a number of effective techniques that can almost completely normalize their emotional state. As a rule, emotional correction against children is to apply gaming therapy.

There is another therapeutic approach, namely psychodunic, which is based on the method of psychoanalysis, aimed at permitting the patient's internal conflict, awareness of its needs and the experience gained from life.

The psychodynamic method also includes:

These specific impacts have proven itself not only for children, but also adults. They allow patients to liberate, show creative fantasy and present emotional disorders as a certain image. The psychodynamic approach is also highlighted by ease and ease.

Also, the common methods include ethnofunctional psychotherapy, which allows you to artificially form the division of the subject, in order to realize your personal and emotional problems, as if focusing your side view. In this case, the assistance of the psychotherapist allows patients to transfer their emotional problems to an ethnic projection, to work out them, realize and skip through themselves in order to finalize them.

Prevention of emotional disorders

The main purpose of the prevention of violations of the emotionally volitional sphere is the formation of dynamic equilibrium and a certain stock of the strength of the CNS. This state is determined by the absence of internal conflicts and a stable optimistic attitude.

Stable optimistic motivation makes it possible to move to the target target, overcoming various difficulties. As a result, a person learns to make decisions, based on a large number of information, which reduces the likelihood of error. That is, the key to an emotionally stable nervous system is the movement of a person along the development path.

what is an emotional and volitional disorder?

All of the above is it ... Does not arise, herself. And as a rule, accompanies the following diseases:

True, sometimes .. We whisper that there are all special techniques, exposure and suppression ...

And 1% of cases - yes, exist .. But the rest, of course - the provincial theater.)

The task of the doctors in that is that ... Everyone was alive and healthy .. And those who are unhealthy - extremely, facilitate existence ... True, the question is asked in the "Psychology" category. But what a psychologist - does not dream known ... doctor.)

Unwillingness to engage in familiar activities

Emotionally volitional disorders

Birth in the family of a child with certain deviations from normal development - always stress for both parents. It is very good when they help them cope with the problem of relatives, friends or specialists in psychological rehabilitation.

The first signs of violation of the emotional-volitional sphere begin to appear in the period of active communication in the team of peers, which is why you should not ignore any deviations in the behavior of the child. These disorders are rarely noted as an independent disease, often they are precursors or constituent of quite serious mental abnormalities:

The reduction in intellectual activity in children is manifested in the form of not fully regulating emotions, inadequate behavior, reducing morality, low level of emotional color of speech. The mental retardation in such patients can be veiled in inadequate behavior in the extreme expression - apathy, irritability, euphoria, etc.

Classification of disorders in the emotional-volitional sphere

Among the violations in the field of an emotional-volitional expression of the individual in adults are distinguished:

1. Hypobulia - a decrease in will. Patients with such a violation do not have absolutely no need to communicate with the surrounding people, they are annoying the presence of a number of extraneous, they are not capable and do not want to support a conversation, they can be in an empty dark room for hours.

2. Hyperbulia - increased attraction in all spheres of human life, more often this violation is expressed in strengthening appetite, needs for constant communication and attention.

3. Abulia - a sharp decline in volitional deposits. In case of schizophrenia, this disorder is included in a single symptom complex "Apatico-abulic".

4. Compulsive attraction is an irresistible need for something, com else. This feeling is commensurate with an animal instinct and makes a person perform actions, which, in most cases, criminal off.

5. An obsessive desires - the emergence of obsessive desires that the patient cannot independently control. Not satisfied with the desire leads to the deep sufferings of the patient, all his thoughts are filled with ideas about his incarnation.

The main deviations in the emotional and volitional sphere in children are:

1. Emotional hyperoportability.

2. Increased impressionability, fears.

3. Motor inhibition or hyperactivity.

4. Apathy and indifference, indifference to others, the lack of compassion.

6. Increased inspiration, non-independence.

Soft correction of emotionally-volitional disorders

The hippotherapy around the world received a lot of positive feedback both with the rehabilitation of adults and when the rehabilitation of children. Communication with a horse delivers great pleasure to children and their parents. This rehabilitation method helps to unwind the family, strengthen the emotional connection between generations, build a trusting relationship.

Thanks to the classes of hippotherapy in adults, children and adolescents, the processes of excitation and braking in the cerebral cortex are normalized, motivation to achieve their goals increases, self-assessment and vital tone increases.

With the help of horse riding, each rider can learn how to manage its emotions smoothly and without donoma from the psyche. In the course of classes, the severity of fears is gradually decreasing, confidence appears in the fact that communication with animals is necessary to both participants in the process, their own significance increases in closed persons.

Trained and all understanding a horse helps children and adults to cope with the goals, acquire new skills and knowledge, become more open to society. In addition, the hippotherapy develops the highest nervous activity: thinking, memory, concentration of attention.

The constant voltage of the muscles of the entire body and the maximum collence in riding lessons improves the balance, coordination of movements, self-confidence even among those students who cannot accept any solution without the help of outsiders.

Different types of hippotherapy help reduce anxiety and depressive mood, to forget about negative experiences and increase the vigor of the Spirit. When achieving his goals in classes, it allows you to develop will and endurance and break the internal barriers to your insolvency.

Some disciples are so much like to communicate with animals that they are glad to be engaged in horse-out at school for disabled. In the process of training and at competitions, the volitional sphere is developing perfectly. They become more assertive, purposeful, improved self-control and endurance.

Violation of the emotionally volition sphere

General

For normal life and development in society, the emotional-volitional sphere of personality is of great importance. Emotions and feelings play an important role in human life.

The will of a person is responsible for the ability, which manifests itself during the regulation of its activities. From birth, she does not possess it, since, mostly, all his actions are based on intuition. As life experience accumulates, volitional actions begin to appear, which becomes more and more difficult. It is important that a person does not just recognize the world, but he tries to somehow adjust it to himself. This is the volitional actions that are very important indicators in life.

The volitional sphere of personality is most often manifested when various difficulties and tests are found on the life path. The last stage in the formation of will is the actions that must be made to overcome external and internal obstacles. If we talk about history, then the volitional solutions at different times were formed thanks to certain work.

Under what diseases there is a violation of the emotional-volitional sphere:

External stimuli can include certain social conditions, and to internal, heredity. Development occurs, starting from an early age to the adolescent period.

Characteristics of the volitional sphere of personality

Volosses can be divided into two groups:

Simple actions (do not require the cost of certain forces and an additional organization).

Complicated actions (imply a certain concentration, perseverance and skill).

In order to understand the essence of such actions, it is necessary to understand the structure. The volitional act consists of their such elements:

method and means of activity;

Violations of the emotional volition sphere

Hyperbulia, general increase in will and deposits affecting all the basic directions of man. For example, an increase in appetite leads to the fact that patients, being in the department, immediately eat food-brought them. Hyperbulia is a characteristic manifestation of manic syndrome.

Disorders of the mature personality and behavior in adults (psychopathy)

Disorders of a mature personality and behavior in adults (psychopathy) - anomaly for the development of a person with a predominant deficiency in the emotional-volitional sphere, persistent violations of adaptation in behavior, starting with children's and adolescent age and continuing during the subsequent life. Of this abnormal character leading in the personality structure, according to PB Gannushkin, characteristic of the triad: the totality of disorders, their durability and severity to the level of social deadaption. At the same time, the person with a disharmonious personality warehouse and people surrounding him suffer. Subjects with personal disorders are usually prone to refusal of psychiatric care and denial of violations observing them.

With the identity disorders, the subjects are not exempt from criminal liability (in forensic psychiatric examination), they are recognized as unfit to the service in the army, there are restrictions on their choice of profession.

According to reports, the prevalence of these disorders is 2-5% among the adult population, 4-5% among hospitalized psychiatric hospitals, the predominance among men's psychopathic personality compared with women (2: 1-3: 1).

The reasons

The emergence of mature personality disorders and behavior in adults predispose genetic, biochemical and social factors.

Genetic factors. Among monosigital twins, the concordancy for personal disorders is marked several times greater than for dialing. Features of temperament (character), manifested from childhood, more clearly traced in adolescence: Children who are afraid in nature may be detected by the behavior of avoidance. Small violations of the organic nature on the part of the central nervous system in children are subsequently most frequent in antisocial and border personalities.

Biochemical factors. Persons with impulsive features often marked the level of hormone levels - 17-estradiol and estron. The low level of the enzyme monoami-non-oxidase of platelets to a certain extent correlates with social activity. Dopaminergic and serotoninergic systems have an activating effect on psychophysical activity. The high level of endorphins, contributing to the suppression of the activation reaction, is found in passive, phlegmatic subjects.

Social factors. In particular, the discrepancy between the temperament (character) of the mother, which has the features of anxiety, and the educational approach leads to the development of increased anxiety in a child, greater exposure to his personal disorders than in the case of raising his calm mother.

Symptoms

The disharmony of personality and behavior is manifested in several areas: in the cognitive (providing cognitive activity of a person) - the nature of the perception of the surrounding and himself changes; in emotional - the range, the intensity and adequacy of emotional reactions (their social acceptability) changes; in the area of \u200b\u200bcontrol of impulse and satisfaction of needs; In the field of interpersonal relations - in resolving conflict situations, the type of behavior significantly evades the culture norm, manifests itself in the absence of flexibility, insufficient adaptability in various situations. If in childhood there are pathocharacterological radicals (excess excitability, aggressiveness, tendency to shoots and vagrancy, etc.), then in adolescence there may be their transformation into the Patoocterological formation of the individual, then in adulthood in psychopathy. Here, the diagnosis of personality disorder can be exposed from 17 years.

Character accentuation is the extreme options for the norm, in which individual traits are excessively reinforced. At the same time, there is a selective vulnerability for certain mental impacts with good and even increased resistance to others. At least 50% of the population of developed countries has accentuated traits. The severity of personality disorders (severe, pronounced, moderate) is determined by the degree of severity of compensatory mechanisms. Among the types of disorders of a mature personality and behavior in adults are allocated as follows.

Schizoid disorder of personality In addition to the general diagnostic criteria of psychopathy is characterized by an Agedonia, when little is enjoyable, emotional coldness, inability to show warm feelings or anger towards other people, a weak response to praise and criticism, minor interest in sexual contacts with another person, increased interest. Concern to fantasies, constant preference for solitary activities, ignoring social norms dominant in society and conventions, the lack of close friends and trust ties.

Emotional-unstable personality disorder is characterized by a pronounced tendency to act impulsively, without taking into account the consequences, along with the instability of the mood. Two varieties of this personal disorder are distinguished: impulsive type with outbreaks of cruelty and threatening behavior, especially in response to condemnation by others; Border type, which is characteristic of a chronic feeling of devastation, disorder and uncertainty of the image I, intentions and internal preferences, including sexual (factor risk of the formation of sexual perversions), the inclination of involvement in intensive and unstable relationships, excessive efforts to avoid privacy. If such persons remain alone, there may be suicidal threats or acts of self-injunction due to the insignificant subjective value of life.

The hysterical disorder of the individual is characterized by theatricality of behavior, an exaggerated expression of emotions, increased impetibility, superficiality and lability of emotions, a tendency to the mood drops, a constant desire for activities in which an individual is in the center of attention, inadequate seduction in appearance and behavior, increased concern about its physical appeal.

Annaya (obsessive-compulsive) personality disorder manifests itself an excessive tendency to doubt and caution, concern to details, rules, lists, order, organization or charts; the desire for perfection that prevents the completion of the tasks; excessive conscientiousness; scrupulsiness and inadequate concern about productivity to the detriment of pleasure and interpersonal relations; increased pedantype and commitment to social standards (conservatism); rigidity and stubbornness; not sufficiently reasonable, according to the persistent requirements for others to do so, as it seems correctly by Anankast; The appearance of persistent and unwanted thoughts and impositions.

Anxious (evading) personality disorder is characterized by a constant overall sense of tension and severe premonitions and ideas about their own social inaptability, personal unattractiveness, in relation to others; increased concern criticism in its address, its reluctance to enter into relations without guarantees to please limited lifefriend due to the need for physical security; Evasion from social or professional activities due to fear to be criticized or rejected.

The dependent personality disorder is characterized by active or passive shift in other majority of solutions in their lives; subordination of their own needs needs of other people on whom the patient and inadequate compliance with their desires depends; unwillingness to impose even reasonable requirements to people from which the patient is dependent on; The feeling of inconvenience or helplessness alone due to excessive fear of inability to independent life; The fear of being an abandoned person with which there is a close relationship, and stayed by itself; Limited ability to make everyday solutions without enhanced councils and encouragement from other persons.

Dissocial personality disorder (antisocial psychopathy - according to PB Gannushkina, "Type of congenital criminal" - for Lombrosovo) is manifested by heartless indifference to the feelings of others; Rough and resistant position of irresponsibility and neglect of social rules and responsibilities; inability to maintain relationships in the absence of difficulties in their formation; extremely low tolerance for frustrations, as well as a low threshold for aggression, including violence; failure to experience guilt and benefit from life experience, especially punishment; A pronounced tendency to accuse others or to nominate gullible explanations to their behavior, leading a subject to conflict with society.

Paranoid personality disorder characterize: excessive sensitivity to failures and failures; The tendency to constantly be dissatisfied with someone; suspicion; militant and scrupulous attitude to issues related to personal rights, which does not correspond to the actual situation; renewable unjustified suspicions regarding the sexual loyalty of the spouse or sexual partner; The trend towards the experiences of its increased importance, which is manifested by the constant attribution of what is happening to its account, increasing the "regular" interpretations of events taking place with a given personality.

Diagnostics

It is raised on the basis of dynamic observation of the behavior of the subject and the results of psychological testing.

Treatment

Various methods of psychotherapy, in a state of decompensation. Biological methods of therapy (neuroleptics, antidepressants, tranquilizers).

Psycho Patavoharactericity of the formation of a person in children and adolescents, which take attention due to social significance and relative frequency. In its appearance, they are associated with a chronic psychotrambulating situation in a microcrine and improper education. With an unfavorable coating of circumstances, the PatoCharacterological formation of a person may lead to the formation of "acquired" psychopathy by the 17-18 years. At the same time, there is a fixing of personal reactions (protest, refusal, imitation, hypercompensation and other characteristic and pathocharacterological reactions arising in response to psycho-traumatic impacts) and direct stimulation of incorrect education of undesirable character traits (excitability, timidity, incontinence, etc.). Allocate (in V.V. Kovalev) the following options: 1) affectively excitable; 2) brake; 3) Exteroid and 4) unstable.

Children and adolescents with an affective excitable embodiment of psychogenic pathocharacterological formation of the personality are characterized by a tendency to affective discharges (irritation, anger) with aggressive actions, inability to restrain itself, angiveness, opposition attitude to adults, increased readiness for conflicts with others. These character traits are particularly often formed and secured under conditions of hypoopective or neglect (incomplete family, alcohol or narcotic dependence of parents), with a long conflict situation in a microcrin (family, school children's team, etc.). Accelerates the formation of pathological traits of the nature of microocial and pedagogical nestry, due to care from school, at home, passing classes.

For the braking option, uncertainty in itself, timidity, syradiability, tendency to asthenic reactions. Cancellation is also possible, falsity, dreaminess. This option is formed in conditions of improper education of the type of "hyperophek" with the despotism of parents, humiliation of the child, the use of permanent prohibitions and restrictions, physical punishment.

The exteroid is manifested by demonstration, the desire to attract attention to itself, the egoistic installation. It is more often formed in families with the only child in the conditions of upbringing on the type of "idol family." Most of the following children with signs of mental immaturity.

An unstable option is characterized by the lack of volitional delays, the dependence of behavior from momentary desires, an increased subordination of the unauthorized influence, the reluctance to overcome the slightest difficulties, the absence of skill and interest in labor. Promotes its formation of "greenhouse education" when a child from early childhood is fencing from independent overcoming difficulties, fulfill all the duties (care for personal belongings, cooking lessons, cleaning bed, etc.). Due to the immaturity of emotional-volitional properties, there is an increased tendency to imitation of negative forms of the behavior of others (leaving the school, small theft, drinking alcohol, psychoactive substances, etc.) when the phenomena of microocial and pedagogical neglence are attached. As a result - the path to offenses.

The following stages of the dynamics of pathocharacterological formations of the personality are distinguished: 1) of characterological and pathocharacterological reactions (younger school age); 2) the leading pathocharacterological syndrome (prepubertal age 10-12 years); 3) puberty polymorphism; 4) postpubertatual dynamics. At the last stage, the formation of a psychopathic personality structure is either completed, or a tendency to smooth pathological traits (deposicopatization) is detected.

The permission of a psychotrauming situation, the emergence of new interests (educational, professional, sexual, etc.), related to the approach of physical, mental and social maturity, comes from a negative educational influence of the family, the emergence of more mature self-consciousness, critical assessment of their actions, contributes to a beneficial dynamics. Directed correctional pedagogical impacts.

Emotional-Volve Sphere Disorders

Emotions are one of the most important mechanisms of mental activity. It is emotions that produce a sensually painted total estimate of the incoming information from the inside and outside. In other words, we estimate the external situation and our own internal state. Evaluation of emotions should be carried out on two axes: strong and weak and negative-positive.

Emotion - feeling, internally subjective experience, inaccessible to direct supervision. But even this deeply subjective form of manifestation may have violations called emotional-volitional disorders.

Emotional-grade disorders

The peculiarity of these disorders is that they combine two psychological mechanism in themselves: emotions and will.

Emotions have an external expression: Mimic, gesturing, intonation, etc. According to the external manifestation of emotions, doctors are judged by the inner state of a person. A long emotional state is characterized by a term "mood". The mood of a person is quite moving and depends on several factors:

• external: luck, lesion, obstacle, conflicts, etc.;
• internal: Health, manifestation of activity.

Will is a mechanism for regulating behavior that allows you to plan activities, satisfy the needs, overcome difficulties. The needs contributing to adaptation is made to call "inclusion." The attraction is a special state of human needs under certain conditions. Conscious attraction is customary to be called desires. A person always has several relevant and competing needs. If a person has no opportunity to implement its needs, then an unpleasant condition called frustration.

Symptoms of emotional and volitional disorders

Directly disorders of emotions are an excessive manifestation of natural emotions:

• Hypothimia is a persistent painful decrease in mood. Hypothimia corresponds to longing, depression, sadness. Unlike the feeling of sadness, hypothymia has high resistance, but it can have a different high-quality expression: from easy sadness to severe "spiritual pain."
• Hypertimia -Bole-plated increased mood. Bright positive emotions are associated with this concept: fun, delight, joy. For several weeks and even months, patients retain optimism and sensation of happiness. People are usually very energetic, manifest an initiative and interest. At the same time, a common raised mood cannot spoil neither sad events or difficulties. Hyperthythmia is a characteristic manifestation of manic syndrome. The hypertimia variant is an euphoria, which is considered not so much as an expression of joy and happiness, but also as a complacent and careless affect. Patients are absolutely inactive. All their conversations are empty.
• Dysphoria - sudden attacks of anger, irritation and malice. In this state, people are capable of cruel aggressive deeds, sarcasm, insults and bullying.
• Anxiety is an emotion associated with the need for security. Anxiety is expressed by a sense of impending indefinite threat, excitement, throwing, anxiety, muscle tension.
• Ambivalence is the simultaneous joint existence of two opposite emotions: love and hatred, attachment and squeamishness, etc.
• Apathy - a decrease in the severity of emotions, indifference, indifference to everything. Patients lose interest in friends, do not respond to events in the world, are not interested in their own appearance and health status.
• Emotional lability is the extraordinary mood of the mood, which is characterized by ease of the occurrence of mood changes: from laughter to tears, from relaxation to active fussiness, etc.

Will and Wheel Disorders

In the clinical practice of the disorder of the will and deposits, violations of behavior are manifested:

• Hyperbulia is an increase in impulse and will that affect all the basic needs: increased appetite, hypersexuality, etc.
• Hypolasses - decline in impulse and will. In patients with all major needs, including physiological ones.
• Abulia is a state at which a sharp decline in will is observed. At the same time, certain needs remain normal.
• The perversion of the impositions is a changed manifestation of ordinary needs: appetite, sexual attraction, the desire for asocial actions (theft, alcoholism, etc.).
• An obsessive (obsessive) attraction is the occurrence of desires that diverging with the norms of morality, but controlled by the efforts of the will. In this case, a person is able to suppress desires as unacceptable. However, the refusal to satisfy the impulse is able to cause strong experiences, and the idea of \u200b\u200bunfulfilled need is in the head.
• Compulsive attraction is a powerful feeling comparable to life needs (hunger, thirst, self-preservation instinct).
• Impulsive deeds are made immediately in the manifestation of painful attraction, while there are absolute stages of the struggle of motives and decision-making.

Emotional and volitional disorders need treatment. Often effective is medication therapy in combination with psychotherapy. For productive treatment, the choice of a specialist plays a decisive role. Trust only real professionals.

Chapter 8. Disorders of the Emotional-Volve Sphere

Emotions- This is one of the most important mechanisms of mental activity that produces a sensually painted subjective total assessment of incoming signals, well-being of the internal state of the person and the current external situation.

The overall favorable assessment of the present situation and the prospects are expressed in positive emotions - joy, pleasure, tranquility, love, comfort. The overall perception of the situation as unfavorable or dangerous is manifested by negative emotions - sadness, longing, fear, anxiety, hatred, malice, discomfort. Thus, the quantitative characteristic of emotions should be carried out not by one, but on two axes: strong - weak, positive - negative. For example, the term "depression" means strong negative emotions, and the term "apathy" indicates weakness or complete absence of emotions (indifference). In some cases, a person does not have sufficient information to assess one or another stimulus - this can cause uncertain emotions of surprise, bewilderment. He is rarely healthy, but conflicting feelings arise: love and hatred at the same time.

Emotion (feeling) - internally subjective experience, inaccessible to direct observation. The doctor judges the emotional state of man Affect(In the broad sense of this term), i.e. According to the external expression of emotions: facial expressions, gestures, intonation, vegetative reactions. In this sense, the terms "affective" and "emotional" in psychiatry are used as synonyms. Often, it is necessary to deal with the inconsistency between the content of the patient's speech and the expression of the face, the tone of the statement. Mimic and intonation in this case allow us to evaluate the true attitude to the above. The statements of patients of love for relatives, a desire to get a job in combination with the monotony of speech, the absence of proper affects indicate the vote of allegations, the predominance of indifference and laziness.

Emotions are characterized by some dynamic signs. Continuous emotional states the term " mood", Which in a healthy person is quite moving and depends on the combination of many circumstances - external (luck or defeat, the presence of an insurmountable obstacle or waiting for the result) and internal (physical unhealthy, natural seasonal activity fluctuations). Changing the situation in a favorable side should determine the improvement of mood. At the same time, it is characterized by a certain inertia, so the joyful news against the background of sorrowful experiences cannot cause immediate responses from us. Along with sustainable emotional states, short-term stormy emotional reactions occur - the state of the affect (in the narrow sense of the word).

You can select several main emotion functions.The first of them, signalallows you to quickly estimate the situation - earlier than a detailed logical analysis will be carried out. Such an assessment based on a general impression is not quite perfect, but allows not to spend extra time on the logical analysis of irrelevant incentives. Emotions generally signal to us about the presence of any need: we will learn about the desire to eat in the feeling of hunger; About the thirst for entertainment - by feeling boredom. The second important function of emotions - communicative.Emotionality helps us to communicate and act together. The collective activity of people involves such emotions as sympathy, empathy (mutual understanding), distrust. Violation of the emotional sphere in mental illness naturally entails a violation of contacts with others, closure, misunderstanding. Finally, one of the most important functions of emotions is formation of behaviorman. It is emotions that make it possible to appreciate the importance of this or that human needs and serve as an impetus for its implementation. So, the feeling of hunger encourages us to look for food, suffocation - open the window, shame - hide from the audience, country ha-flee. It is important to take into account that emotion does not always accurately reflect the true state of the internal homeosta, and the peculiarities of the external situation. Therefore, a person, experiencing hunger, may have more than necessary for the body, experiencing fear, he avoids the situation, in reality is not dangerous. On the other hand, an artificially caused by the help of drugs a sense of pleasure and satisfaction (euphoria) deprives a person of the need to act despite the essential violation of his homeostasis. The loss of the ability to experience emotions in the mental illness naturally leads to inaction. Such a person does not read books and does not watch TV, because it does not feel boredom, does not follow the clothes and the cleanliness of the body, because it does not feel shame.

On the effect on the behavior of emotions are divided into sHENIFICAL(prompting to action, activating, exciting) and asthenic(depriving activity and strength paralyzing will). The same psychotrauming situation can have different people to cause excitement, flight, frenzy, or, on the contrary, a stupor ("from fear of legs ran"), so, emotions give the necessary impetus to perform actions. Direct conscious planning of behavior and the implementation of behavioral acts makes the will.

Will is the main regulatory mechanism of behavior, allowing you to consciously plan to operate, overcome obstacles, meet the needs (desection) in the form that contributes to greater adaptation.

The attraction is the state of the specific need of a person, the need for certain conditions of existence, dependence on their presence. Conscious attractions we call desires.It is practically unrealistic to list all the likely kinds of needs: each person's set is unique, subjective, however, you should specify some of the most important needs for most people. These are physiological needs for food, security (self-preservation instinct), sexual attraction. In addition, a person as a social being often needs to communicate (affilative need), and also seeks to take care of loved ones (parental instinct).

A person has always at the same time there are several relevant for him, competing needs. The choice of the most important of them on the basis of an emotional assessment is carried out by the will. Thus, it allows you to realize or suppress existing deductions, focusing on an individual scale of values \u200b\u200b- the motif hierarchy.Suppression of the need does not mean reducing its relevance. Lack of ability to implement a relevant need for a person causes an emotionally unpleasant feeling - frustration. Trying to avoid her, a person is forced to either satisfy his need later, when conditions change to more favorable (for example, it comes to a patient with alcoholism, when it receives a long-awaited salary), or attempt to change the relationship to the need, i.e. Apply mechanisms of psychological protection(See Section 1.1.4).

Will's weakness as a personality property or as a manifestation of a mental illness, on the one hand, does not allow a person to be systematically satisfied with his needs, and on the other hand, leads to the immediate implementation of any desire in the form that contradicts the norms of society and causing disadaptation.

Although in most cases it is impossible to associate mental functions with any particular nervous structure, it should be mentioned that the experiments indicate the presence of certain pleasure centers in the brain (a number of areas of the limbic system and the septal region) and avoidance. In addition, it was noticed that the defeat of the frontal bark and paths leading to the frontal shares (for example, during the operation of lobotomy), often leads to the loss of emotions, indifference and passivity. In recent years, the problem of the functional asymmetry of the brain is discussed. It is assumed that an emotional assessment of the situation mainly occurs in a non-permanent (right hemisphere), with the activation of which bind states of longing, depression, while in the activation of the dominant (left) hemisphere more often there is an increase in mood.

8.1. Symptoms of emotional disorders

Emotion disorders are an excessive expression of human emotions (hypertimia, hypothymia, dysphoria, etc.) or violation of their dynamics (lability or rigidity). The pathology of the emotional sphere should be said when emotional manifestations deform the behavior of the patient as a whole, cause serious disadaptation.

Hypothimia -resistant painful decrease in mood. The concept of hypothymia corresponds to sadness, longing, depression. In contrast to the natural feeling of sorrow, due to the unfavorable situation, hypothymia in mental illness is distinguished by amazing resistance. Regardless of the momentary situation, patients extremely pessimistically evaluate their current state and existing perspectives. It is important to note that this is not only a strong feeling of longing, but also the inability to experience joy. Therefore, a person in a similar state cannot cheer or a witty joke, nor a pleasant news. Depending on the severity of the disease, hypothymia can take a form from light sadness, pessimism to a deep physical (vital) feeling experienced as "mental pain", "Streking in the chest", "Stone on the heart". Such a feeling is called vital (atrial) longing,it is accompanied by a sense of catastrophe, hopelessness, collapse.

Hypothymia as a manifestation of strong emotions refer to productive psychopathological disorders. This symptom is not specific and may be observed in the exacerbation of any mental illness, it is often encountered in severe somatic pathology (for example, with malignant tumors), and also included in the structure of obsessive-phobic, hypochondriac and dysfolical syndromes. However, first of all, this symptom is associated with the concept depressive syndrome,for which hypotimia is the main syndrome-forming disorder.

Hyperthy -resistant painful increase in mood. With this term bind bright positive emotions - joy, fun, delight. Unlike situationally caused joy, hypertimia is characterized by persistence. For weeks and months, patients constantly retain amazing optimism, a feeling of happiness. They are full of energy, in all show the initiative, interest. Neither sad news, nor obstacles on the path of implementation are not disturbed by their common joyful attitude. Hyperthythmia - characteristic manifestation manic syndrome.The most acute psychosis is expressed by particularly strong exalted feelings reaching degrees. ecstasy.Such a state may indicate the formation of an onairoid permanent of consciousness (see section 10.2.3).

Special option of hyperthythmia is the state Euphoria,this should be considered not as much as the expression of joy and happiness, as as complacently-careless affect. Patients do not show initiatives, are inactive, prone to empty conversations. Euphoria is a sign of a variety of exogenous and somatogenic brain lesions (intoxication, hypoxia, brain tumors and extensive disintegrating neosomy-forming, severe damage to hepatic and renal function, myocardial infarction, etc.) and may be accompanied by delusional ideas of magnitude (with paradens syndrome, patients with progressive paralysis).

Term moria.indicate foolish careless letteen, laughter, unproductive excitation from deeply weakly patients.

Dzithoriathey call suddenly emerging attacks of anger, malice, irritation, discontent with others. In this state, patients are capable of cruel, aggressive actions, cynical insults, rough sarcasm and bullying. Paroxysmal flow of this disorder indicates the epileptiform nature of symptoms. With epilepsy, the dysphoria is observed either as an independent type of seizures, or enters the structure of the aura and twilight permanent of consciousness. Dysphoria is one of the manifestations of psychoorganic syndrome (see section 13.3.2). Disprooric episodes are often observed in the exposive (excitable) psychopathy and in patients with alcoholism and drug addiction during the period of abstinence.

Anxiety -the most important emotion of a person, closely related to the need for safety, expressed by a sense of impending indefinite threat, internal excitement. Anxiety - Flying emotion: accompanied by throwing, nonsense, anxiety, muscle tension. As an important signal of unfavorable can occur in the initial period of any mental illness. In neurosis of obsessive states and psychstore, anxiety serves as one of the main manifestations of the disease. In recent years, suddenly emerging (often on the background of a psychotrauming situation) are distinguished as an independent disorder), which are manifested by acute anxiety attacks. Powerful, deprived of all means a feeling of anxiety is one of the early symptoms of a starting acute delusional psychosis.

With acute delusional psychosis (acute sensual sensory syndrome), anxiety is expressed extremely and often reaches a degree. confusionwhile combined with uncertainty, misunderstanding of the situation, violation of the perception of the surrounding world (Derealization and depersonalization). Patients are looking for support and explanations, their eyes expresses surprise ( affect bewilderment).As well as the state of ecstasy, such a disorder indicates the formation of onairoid.

Ambivalence -simultaneous coexistence of 2 mutually exclusive emotions (love and hatred, attachment and squeamishness). In mental illness, ambivalence causes significant suffering to patients, disorganizes their behavior, leads to contradictory, inconsistent actions ( ambyteracy). The Swiss psychiatrist E. Bleiler (1857-1939) considered ambivalence as one of the most typical manifestations of schizophrenia. At present, most psychiatrists consider this state by a non-specific symptom observed, in addition to schizophrenia, with schizoid psychopathy and (in a less pronounced form) in healthy people inclined to self-analysis (reflection).

Apathy- No or sharp decrease in the severity of emotions, indifference, indifference. Patients lose interest in close and friends, indifferent to the events in the world, indifferent to their health and appearance. The speech of patients becomes boring and monotonous, they do not show no interest in conversation, Mimica monotoned. The words of those surrounding do not cause them from their resentment, nor embarrassment, no wonder. They may argue that they are tested for parents, but when you meet with loved ones, it remains indifferent, do not ask questions and silently eat food-brought them. Especially brightly, the emotionalness of the patients is manifested in a situation requiring an emotional choice ("What kind of food do you like most?", "Who do you like more: dad or mom?"). The absence of feelings does not allow them to express any preference.

Apathy refers to negative (deficient) symptoms. Often it serves as a manifestation of finite states during schizophrenia. It should be borne in mind that apathy in schizophrenia patients constantly increases, passing a number of stages that differ in the severity of the emotional defect: smoothness (leveling) of emotional reactions, emotional coldness, emotional stupidity.Another reason for the occurrence of apathy is the defeat of the frontal shares of the brain (injuries, tumors, partial atrophy).

From apathy should be distinguished by a symptom Painful mental insension(AnaesthesiaSychicadolorosa, sorrowful insension). The main manifestation of this symptom is not the lack of emotions as such, but a painful sense of their own immersion in selfish experiences, the consciousness of the inability to think about someone else, often combined with delirium self-evidence. Often there is a phenomenon of hypasshesia (see section 4.1). Patients complain, / which became "like a tree" that they have "not a heart, but an empty canning bank"; They crush that there are no alarms for young children, are not interested in their success in school. The bright emotion of suffering testifies to the state's severity, on the reversible productive nature of the disorders.anaesthesiapsychicadolorosa- typical manifestation of depressive syndrome.

Symptoms of violation of the dynamics of emotions include emotional lability and emotional rigidity.

Emotional lability- This is an emergency mobility, instability, ease of emergence and change of emotions. Patients easily switch from tears to laughter, from a fracture to careless relaxation. Emotional lability is one of the important characteristics of patients with hysterical neurosis and hysterical psychopathy. Such a condition may also be observed in the syndromes of the permanent of consciousness (delirium, onseyroid).

One of the emotional lability options is weak (emotional weakness).For this symptom, not only a quick change in the mood, but also the inability to control the external manifestations of emotions. This leads to the fact that each (even unimportant) event experiences brightly, often causes tears arising not only with sad experiences, but expressing and lunizing, delight. Weak - typical manifestation of vascular diseases of the brain (cerebral atherosclerosis), but can meet both personality feature (sensitivity, vulnerability).

Patient 69 years old, diabetes and pronounced memory disorders, is brightly experiencing his helplessness: "Oh, doctor, I was a teacher. I disciples, open the mouth, listened. And now Quash's quasher. That daughter will not say - I remember anything, everyone has to record. The legs do not go at all, in the apartment barely crawling. " All this is a patient pronounces, constantly wiping his eyes. On the question of the doctor who still lives with her in the apartment, answers: "Oh, we have full house to the people! Sorry, the dead man did not live. My son-in-law is thoughtful. The granddaughter is wise: and dances, and draws, and English. And the grandson will go to the institute for next year - he has such a special school! " The last phrases of the patient utters with a triumphant face, but tears continue to flow, and she constantly wipes them with her hand.

Emotional rigidity- Tugaway, stuck emotions, a tendency to a long experience of feelings (especially emotionally unpleasant). Emotional rigidity expressions are maliciousness, stubbornness, perseverance. In speech, emotional rigidity is manifested by a circumstance (viscosity). The patient cannot move to the discussion of another topic until the question of interest is completely invited. Emotional rigidity is a manifestation of the overall trapidity of mental processes observed in epilepsy. Psychopathic characters are also isolated with a tendency to jam (paranoid, epileptoid).

8.2. Symptoms of Will and Verification Disorders

Disorders of will and deposits are manifested in clinical practice of violations of behavior. It is necessary to take into account that the statements of patients do not always accurately reflect the nature of the existing disorders, since patients often hide their pathological attractions, they are ashamed to confess to others, for example, in their laziness. Therefore, the conclusion about the presence of violations of the will and impulses should be done not on the basis of declared intentions, but based on the analysis of the actions performed. Thus, the statement of the patient about the desire to get a job looks like an unfounded, if he has not been working for several years and does not make an employment attempt. It should not be perceived as an adequate statement of the patient that he likes to read if he read the last book a few years ago.

Allocate quantitative changes and perversions of impulse.

Hyperbulia- The overall increase in will and deposits affecting all the main attitudes of a person. An increase in appetite leads to the fact that patients, being in the department, immediately eat the transmission brought by him and sometimes cannot resist not to take products from someone else's bedside table. Hypersexuality is manifested by increased attention to the opposite sex, courtships, immodest compliments. Patients try to attract attention to bright cosmetics, throwing clothes, stand for a long time with a mirror, leading to the hair in order, can enter into numerous random sex. There is a pronounced thrust for communication: every conversation of the surrounding becomes interesting for the sick, they are trying to turn on in the conversations of foreign. Such people seek to provide patronage to any person, distribute their belongings and money, make expensive gifts, get involved in a fight, wanting to protect the weak (in their opinion). It is important to take into account that the simultaneous increase in impulse and will, as a rule, does not allow patients with obviously dangerous and rude unlawful actions, sexual violence. Although such people usually do not pose a danger, they can interfere with their obsessiveness, fussy, behave carelessly, misconcellious property. Hyperbulia - characteristic manifestation manic syndrome.

Typobulia- A general decline in will and deposits. It should be borne in mind that patients with hylogulia are suppressed all the main attractions, including physiological ones. There is a decrease in appetite. The doctor can convince the patient as needed, but he takes food reluctantly and in small quantities. A decrease in sexual attraction is manifested not only by falling interest in the opposite sex, but also the lack of attention to its own appearance. The patients do not have the need for communication, they are presented by the presence of foreign and the need to support the conversation, asking to leave them alone. Patients are shipped to the world of their own suffering and cannot take care of loved ones (the behavior of the mother with postpartum depression looks particularly surprising, which is unable to force himself to take care of the newborn). Suppression of self-preservation instinct is expressed in suicidal attempts. It is characteristic of the feeling of shame for their inaction and helplessness. Hypolasses is a manifestation depressive syndrome.Suppression of deposits during depression is temporary, transient disorder. The binding of the attack of depression leads to the resumption of interest in life, activity.

For Abuliait is usually not observed to suppress physiological impulses, the disorder is limited to a sharp decrease in will. Laziness and the notionlessness of persons with Abulia are combined with a normal need for food, a distinct sexual activation, which are satisfied with the most simplest, not always socially acceptable ways. So, a patient experiencing hunger, instead of going to the store and buy the products you need, asks the neighbors to feed it. Sexual attraction of the patient satisfies continuous masturbation or drawn with ridiculous attractions to the mother and sister. In patients suffering from Abulia, the highest social needs disappear, they do not need communication, in entertainment, can conduct in idle all days, are not interested in the events in the family and in the world. In the department, they do not communicate with neighbors around the ward, do not know their names, the names of doctors and nurses.

Abulia is a persistent negative disorder, together with Apatia is one apatico-abulic syndrome, Characteristic for end states during schizophrenia. With preventive diseases, doctors can observe the rise of the phenomena of Abulia - from light laziness, misinterpretation, inability to overcome obstacles to gross passivity.

The patient of 31 years, the turner by profession, after the undergoing attack of Schizophrenia left a job in the workshop, since he considered it too heavy for himself. I asked him to take it by a photographer in the city newspaper, as I used to have been engaged in a photo. Once, on behalf of the editorial board, a report on the work of collective farmers was to report. I came to the village in urban shoes and, so as not to be staining the boot, did not approach the tractors in the field, and did only a few pictures from the car. From the editorial office was dismissed for laziness and misintermettiness. It did not get on another job. The house refused to deal with any economic affairs. I stopped to care for the aquarium, which I made my hands before the disease. For all day later, lay in bed and dreamed of moving to America, where everything is easy and accessible. I did not object when relatives appealed to psychiatrians with a request to arrange disabilities.

A lot of symptoms are described Perversion of impulse (para- bulb).The manifestations of mental disorders may be perverted appetite, sexual attraction, the desire for asocial agencies (theft, alcoholization, vagrancy), self-injunction. Table 8.1 shows the main terms indicating the disorders of the deposits on the ICD-10.

Parabulia is not considered independent diseases, but are only a symptom. Reasons

Table 8.1. Clinical options for deposits

Human emotions act as a special class mental state, which are reflected in the form of a positive or negative attitude towards the world around the world, other people and above all. Emotional experiences are determined by the relevant properties and qualities formed from objects and phenomena of reality, as well as certain needs and human needs.

The term "emotions" comes from the Latin name Emovere, which means movement, excitement and excitement. The key functional component of emotions is to encourage activity, as a result, the emotional scope is differently called emotional-volitional.

At the moment, emotions perform a significant role in ensuring the interaction of the body and the environment.

Emotions This is mainly the result of reflection of human needs and assess the likelihood of their satisfaction, which are based on personal and genetic experience.

As far as it acts expresses the emotional state of a person, depends on the importance of the needs and lack of necessary information.

Negative emotions are manifested as a result of the deficit, it is necessary to provide information to meet a number of needs, and positive emotions are characterized by the complete availability of all necessary information.

Today, emotions are divided into 3 main parts:

1. Affect, characterized by a sharp experience of a certain event, emotional voltage and excitation;
2. Cognition (awareness of its condition, his verbal designation and evaluation of further prospects for satisfying needs);
3. Expression, which is characterized by an external bodily motorcy or behavior.

The relatively sustainable emotional state of a person is called mood. The sphere of human needs includes social, which arise on the basis of cultural needs, which subsequently received the name of the senses.

Allocate 2 emotional groups:

1. Primary (anger, sadness, anxiety, shame, surprise);
2. Secondary, which include recycled primary emotions. For example, pride is joy.

Clinical picture of emotional-volitional disorders

The main external manifestations of violations of the emotionally volitional sphere include:

• Emotional tension. With increased emotional tensions, disorganization of mental activity and reducing activity arises.
• Rapid mental fatigue (in a child). It is expressed by the fact that the child is not able to focus, is also characterized by a sharp negative response to certain situations where the demonstration of its mental qualities is necessary.
• The alarm state, which expresses the fact that a person in every way avoid any contacts with other people and do not strive to communicate with them.
• Increased aggressiveness. Most often occurs in childhood when the child defiantly disappoints adults, experiencing a constant physical and verbal aggression. Such aggression can be expressed not only in relation to others, but also to itself, thereby causing harm to their own health.
• The absence of the ability to feel and comprehend the emotions of other people, empathize. This feature is usually accompanied by increased anxiety and is the cause of mental disorder and mental delay.
• Lack of desire to overcome vital difficulties. In this case, the child is in constantly sluggish condition, he does not have a desire to communicate with adults. The extreme manifestations of this disorder are expressed in full ignoring parents and other adults.
• Lack of motivation to success. The main factor of low motivation is the desire to avoid possible failures, as a result of which a person refuses to take on to fulfill new tasks and is trying to avoid situations where even the slightest doubts arise in final success.
• Severe distrust of other people. Often accompanied by such a sign as hostility towards others.
• Increased impulsiveness in childhood. It is expressed by such signs as the lack of self-control and awareness of their actions.

Classification of disorders in the emotional-volitional sphere

Violation of the emotional sphere in adult patients stand out by such features as:

• Hypolasses or lowering volitional qualities. In patients with this violation there is no need for communicating with other people, irritability arises in the presence of a number of extraneous, the lack of ability or desire to support the conversation.
• Hyperbulia. It is characterized by increased activation in all spheres of life, it is often expressed in strengthening appetite and needs for constant communication and attention.
• Abulia. It is highlighted by the fact that the person sharply decreases the volitional desection.
• Compulsive attraction is an irresistible need for anything or com else. This disorder is often compared with animal instinct, when a person is significantly suppressed by the ability of its awareness of its actions.
• An obsessive attraction is the manifestation of obsessive desires that the patient is not able to control independently. The dissatisfaction of such desires leads to the depression and the deep suffering of the patient, and his thoughts are filled with the idea of \u200b\u200btheir implementation.

Emotional-Wall Disorders Syndrome

The most common forms of emotional disorders acts depressive and manic syndromes.

1. Depressive syndrome

The clinical picture of the depressive syndrome is described by 3 main signs, such as:

• Hypotomy characterized by a decrease in mood;
• Associative inhibition (mental inhibition);
• Motor inhibition.

It is worth noting that it is the first item above is the key feature of the depressive state. Hypotomy can be expressed in the fact that a person is constantly whining, it feels depression and sadness. Unlike the established reaction, when sadness arises due to the experience of a sad event, then when depressed, a person is deprived of communication with the surrounding environment. That is, in this case, the patient does not show reactions to joyful and other events.

Depending on the severity of the state, hypotomy may occur with different intensity.

Thinking inhibition in its light manifestations is expressed in the form of a slowdown in one-room speech and long overducting the answer. The difficult course is characterized by the inability to understand the given questions and solving a number of simplest logical tasks.

Motor inhibition manifests itself in the form of stiffness and slowness of movements. In case of severe depression, there is a risk of a depressive stupor (the state of complete depression).

1. Maniacal syndrome

Often, manic syndrome is manifested in the framework of affective bipolar disorder. In this case, the flow of this syndrome is characterized by the attackness, in the form of separate episodes with certain stages of development. The symptomatic picture released in the structure of a manic episode is characterized by variability in one patient, depending on the development stage of pathology.

Such a pathological condition as a manic syndrome, as well as depressive, stand out 3 main signs:

• Hypertime in hyperthythmia;
• Mental excitability in the form of accelerated thinking processes and speech (tachips);
• Motor excitation;

Anomalous improved mood is characterized by the fact that the patient does not feel such manifestations as longing, anxiety and a number of other signs characteristic of depressive syndrome.

The mental excitability with the accelerated process of thinking arises until the jump of ideas, that is, in this case, the patient's speech becomes incomplete, due to excessive distractions, although the patient itself is aware of the logic of his words. Also highlights the fact that the patient has the ideas of their own greatness and denial of guilt and responsibility of other people.

Increased motor activity with this syndrome, is characterized by the discharging of this activity in order to obtain pleasure. Consequently, with manic syndrome, patients usually consume a large amount of alcohol and narcotic substances.

For manic syndrome, such emotional disorders are also characteristic as:

• Strengthening instincts (increase in appetite, sexuality);
• Increased distraction;
• Revaluation of personal qualities.

Methods for correction of emotional disorders

Features of the correction of emotional disorders in children and adults are based on the use of a number of effective techniques that can almost completely normalize their emotional state. As a rule, emotional correction against children is to apply gaming therapy.

Often in childhood, emotional disorders are determined by the shortage of the gameplay, which significantly slows down mental and mental development.

The systematic motor and speech factor of the game allows you to reveal the possibilities of a child and feel positive emotions from the gameplay. The study of various situations from life in gaming therapy allows the child to adapt to real living conditions much faster.

There is another therapeutic approach, namely psychodunic, which is based on the method of psychoanalysis, aimed at permitting the patient's internal conflict, awareness of its needs and the experience gained from life.

The psychodynamic method also includes:

• Artherapy;
• Indirect game therapy;
• Fairy-therapy.

These specific impacts have proven itself not only for children, but also adults. They allow patients to liberate, show creative fantasy and present emotional disorders as a certain image. The psychodynamic approach is also highlighted by ease and ease.

Also, the common methods include ethnofunctional psychotherapy, which allows you to artificially form the division of the subject, in order to realize your personal and emotional problems, as if focusing your side view. In this case, the assistance of the psychotherapist allows patients to transfer their emotional problems to an ethnic projection, to work out them, realize and skip through themselves in order to finalize them.

Prevention of emotional disorders

The main purpose of the prevention of violations of the emotionally volitional sphere is the formation of dynamic equilibrium and a certain stock of the strength of the CNS. This state is determined by the absence of internal conflicts and a stable optimistic attitude.

Stable optimistic motivation makes it possible to move to the target target, overcoming various difficulties. As a result, a person learns to make decisions, based on a large number of information, which reduces the likelihood of error. That is, the key to an emotionally stable nervous system is the movement of a person along the development path.