Emotions are mental states reflecting the body's reaction to the change in the surrounding world, himself or other people.
The biological role of emotions is informative-adaptive. The amount of emotions over the interval is called mood. And bright expressions of emotions with a distinct motor component are called affect.
Pathology of emotions:
1 group - symptoms of reduced mood.
Hypothimia is a decrease in mood.
Yearning - Experience of hopelessness, loss of life tone. This condition begins in the morning. Wake up usually before, five hours, and you lie with your eyes open. Scary longing and stone on the chest. You need to get up, but I do not want, it seems terrible that ahead is a huge day. At work, too, nothing good, I want to score in the corner. Tosca literally paralyzes, and the whole world seems gray and dim, as if visible through a dirty glass. All the meaning is lost and there is nothing good in the future.
Dysphoria - states of unmotivated evilness and irritability, sometimes aggressiveness aimed at all without exception. Typical for organic disorders and epilepsy. Usually, after some time after the attacks there are whole days when you are angry at all just like that. Whatever anyone say, I want to argue, protest. Right want to rush on the one who objects or did not look so. It happens that we specifically provoke, but it does not make relief. Irritate sounds and bright lights, clothes and transport. In these black days, all the time I get into different stories.
Distimia - Reducing the mood with the predominance of irritation.
Anxiety - Experiment of confusion, danger in the near future with an increase in motor activity, sometimes tremor, palipital, trembling, tachycardia, an increase in blood pressure. The alarm is supported by the following cognitive chains: the heart can stop, it beats too - I can have an attack anywhere - as a result of the attack, I will die - enhance the alarm and repetition of the stereotypical circle.
Fear - Experiencing direct concrete threat. Among the fears in humans in the next place are worth it: the fear of outsiders, which for the first time appears in a child aged about 1.5 years; The fear of becoming incredible disease (infected); Fear of unpredictable situations; fear of death; Social loss; child and love; familiar stereotypes; And finally, the fear of loss of the meaning of life, which in the hierarchy takes the highest place.
2 group. Symptoms of increased mood.
Hypertimia - Increased mood. There is nothing better than this period in the fall, usually it begins in September. Work a lot, but do not get tired. Ideas immediately carry out, only they appear. Everywhere I spend and always at the height. I notice that I can drink anymore and not toxicate, eat, I don't even notice that, but always with appetite. There are many friends and girlfriends, money sometimes go on one day. One disadvantage is an increase in the number of debts.
Euphoria - The state of serenity with the desire for contemplation, but often with active actions that are characterized by carelessness. Characteristic to use psychoactive substances.
Moria. - Euphoria with the lack of targeted activity and foolishness is characteristic of lesions of the frontal fraction of the brain.
Ecstasy - Extremely raised, elevated mood with a presentation of the exit of its own body and merging with others, such as nature. Orgasm equivalent. It may be observed as a special type of epileptic paroxy.
3 group. Symptoms of instability of the emotional sphere.
Incontinence of affect - inability to control the behavior that accompanies emotions; It is often expressed in aggressiveness in relation to the weak stimulus of the offense. Characteristic for organic disorders and some anomalies of the person.
Emotional lability - Fast mood change, rapidly emerging tears of dignity, irritability. Typical for vascular disorders.
Emotional coldness (weak) - indifference, inability to empathy, extension, formal reaction to the emotions of other people and even family members. But it is all capable of telling about their feelings and mood, a significant number of patients uses poor and colorless expressions to describe them, this phenomenon is called alexitimia.
4 group. Symptoms of high-quality emotion distortion.
Emotional stupidity (flattening) - loss of ability to delicate and adequate emotional reactions and the impossibility of their appearance at all. The introduction of exciting drugs leads to a temporary impregnable motor excitation, but not to the appearance of feelings or contact. For example, a patient, for many years, suffering from a simple form of schizophrenia, in recent years, according to her husband, "he became insensitive, does not look at anything." In the stationary branch of the dispensary for three months of staying have never been observed any manifestations of emotional activities. On dates with her husband and children, never once could not be noted the appearance of feelings in the patient: she sat with her hands and the missing facial expression, did not answer any question. Looking aside, removing the children hugging her, despite their tears and her husband's requests, independently interrupted a date.
Apathy - Lack of encouraging to activities and loss of interest in others, but there is an emotional response.
Emotional cloister - loss of ability to fine and adequate emotional reactions.
Emotional paradoxicality - the weakening of adequate emotional contacts on important events while bringing reactions to concomitant minor circumstances simultaneously. PTSD.
Ambivalence (duality) - Simultaneous emergence and coexistence of two mutually opposite feelings (for example, love and hatred).
Will - The ability to active conscious and targeted activities. The physiological basis are instincts.
Violations:
Abulia - Lack of volitional motives. With a schizophrenic identity defect and with organic lesions of frontal fractions.
Hymanobulia - Weakening of volitional motives. With depressive and asthenic conditions.
Hyperbulia - Strengthening volitional motives. When addiction to amphetamines, psychomimetics. Manic states.
Parabulia - Qualitative perversion of volitional motives (in psychopathy-self-injury).
Holistic changes in volitional activity are manifested in the hyperbulia, hystobulia, parabula and abulia, but separate changes in the spheres of instinct are described depending on the type of instinct.
teenage
Curriculum.
Typology of violations in the development of the emotional-volitional sphere.
Psychological and pedagogical characteristics of children and teenagers with violations
emotional-volitional sphere.
Psychopathy in children and adolescents.
Character accentuation as a factor contributing to the emergence of emotionally-volitional disorders.
Children with early autism (RDA).
The conceptualization of the emotional-volitional sphere in defectologies is determined by neuropsychiatric disorders (mainly light and moderate severity). *
The main types of violations in the development of the emotional-volitional sphere in children and adolescents include reactive states (hyperactivity syndrome), conflict experiences, psychstakes and psychopathy (psychopathic forms of behavior), early children's autism.
As is known, the identity of the child is formed under the influence of hereditary deterministic (due) qualities and factors of the external (primarily social) environment. Since the development process largely depends on the external environment factors, it is obvious that adverse environmental impacts may cause temporary behavioral violations that, entrusted, can lead to an abnormal (distorted) personality development.
As for normal somatic development, an appropriate amount of calories, proteins, minerals and vitamins and vitamins and normal mental development require the presence of certain emotional psychological factors. These include, first of all, the love of neighbor, the sense of security (provided by the care of parents), the upbringing of proper self-assessment, as well as along with the development of independence and behavior) the leadership of adults, including, in addition to love and care, a certain set of prohibitions. Only with the right ratio of attention and prohibitions are formed the corresponding links between the "I" of the child and the outside world, and a small person, while maintaining its individuality, develops into a person who will definitely find its place in society.
The versatility of the emotional needs that ensure the development of the child is already due to the possibility of a significant number of adverse factors of the external (social) environment, which may cause violations in the development of the emotional-volitional sphere and deviations in the behavior of children.
Reactive statesdefined in special psychology as neuropsychiatric disorders caused by unfavorable situations (conditions of development) and not related to organic damage to the central nervous system. The most striking manifestation of reactive states (PC) is hyperactivity syndrome, speaking against the background of a "prolonged" state of general mental excitability and psychomotor disbursement. The causes of the PC can be diverse. Thus, such a psycho-physiological disorder as enuresis (night incontinence of urine, persistent or often repeated after the 3rd year of life), to the injury to the child's injuration of the child as an interlentine (Night incontinence of urine), which is often observed in somatically weakened and nervous children. Enurperse may occur after a heavy nervous shock, fright, after the depleting organism of the somatic disease. In the emergence of Enurrawa, such reasons are also noted as conflict situations in the family, excessive severity of parents, too deep sleep, and others. Exacerbate the reactive conditions with enuresque ridicule, the punishment of the unfair attitude of those surrounding the child.
A reactive state may result in a child of certain physical and psychophysiological defects (strabismus, strains of limbs, the presence of chromium, severe scoliosis, etc.), especially with incorrect relationships.
The frequent cause of psychogenic reactions in young children is a sudden strong irritation of a frightening nature (fire, an evil dog attack, etc.). Increased susceptibility to mental injury is observed in children with residual phenomena after suffering infections and injuries, in children of excitable, weakened, emotionally unstable. Children relating to the weak type of higher nervous activity, easily excited children are most susceptible to mental injury.
The main distinguishing feature of the PC is inadequate (excessively pronounced) personal reactions on the impact of the surrounding (primarily social) environment. For reactive conditions, the state is characteristic psychological tensionand discomfort. RS can manifest in the form of depression (dreary, depressed state). In other cases, the main symptoms of the PC are: psychomotor arousal, disbursement, the commission of inadequate actions and actions.
In severe cases, a disorder of consciousness may be observed (acknowledgment of consciousness, orientation violation in the surrounding), anonymonized fear, a temporary "loss" of some functions (deafness, mutism).
Despite the difference in manifestations, a general symptom that connects all cases of reactive states is a heavy, oppressive psycho-emotional state that causes overvoltage of nervous processes and a violation of their mobility. This largely determines an increased tendency to affective reactions.
Mental Development Disorders may be associated with severe internal conflict experiencesWhen in the mind of the child, opposite attitudes towards loved ones or to a social situation that has a great personal value for a child. Conflict experiences (as a psychopathological disorder) are long, socially determined; They acquire dominantthe value in the child's mental life and sharply negatively reflect on its characteristic features and behavioral reactions. The causes of conflict experiences are most often: the unfavorable position of the child in the family (conflicts in the family, the disintegration of the family, the appearance of the stepmother or the stepfather, the alcoholism of the parents, etc.). Conflict experiences may arise in children left by parents adopted in other cases. Another reason for persistent conflict experiences may be the above disadvantages of psychophysical development, in particular, stuttering.
Manifestations of heavy conflict experiences are most often closed, irritability, negativism (in many forms of its manifestation, including speech negativism), depressive states; In some cases, the consequence of conflict experiences becomes a delay in the cognitive development of the child.
Resistant conflict experiences are often accompanied by disorders ( deviations) behavior. Quite often, the cause of behavioral violations in this category of children is the incorrect education of the child (excessive guardianship, excessive freedom or, on the contrary, the lack of love, excessive severity and unreasonable demand, without taking into account its personal - intellectual and psychophysical capabilities determined by the age development stage). A particularly serious mistake in the education of a child is the constant derogatory comparison of it with children with better abilities and the desire to achieve from a child who does not have pronounced intellectual accuracy of great achievements. The child whose dignity is humiliated and whom is often punished, a sense of inferiority, a reaction of fear, robust, crosses and hatred can develop. In those who are in constant tension of children, ENUSCH often occurs, headaches, fast fatigue, etc. At an older age, such children can rebel against the dominant authority of adults, which is one of the causes of antisocial behavior.
Conflict experiences may be due and psychotrauming situations in the school team. Of course, the occurrence and degree of severity of conflict situations is influenced by the individual personality and psychological features of children (the state of the nervous system, personal claims, the circle of interests, impressionability, etc.), as well as the conditions of upbringing and development.
Also a rather complicated neuropsychiatric disorder is psychasthenia- Violation of mental and intellectual activity, determined by weakness and violation of the dynamics of the processes of higher nervous activity, the general weakening of neuropsychic and cognitive processes. The reasons for the psychstage may be severe breach of somatic health, violations of general constitutional development (due to dystrophy, violations of metabolic processes in the body, hormonal disorders, etc.). At the same time, the factors of hereditary conditioning, violation of the functions of the central nervous system of various genesis, the presence of minimal brain dysfunction, play a major role in the occurrence of psychstore.
The main manifestations of psychoze are: a decrease in total mental activity, slowness and fast depletion of mental and intellectual activity, decrease in performance, phenomena of mental inhibition and inertness, increased fatigue in psychological loads. Psycho-bearing children are extremely slowly included in the training work and are very quickly tired when performing tasks related to the implementation of mental and mesmerous actions.
Children of this category are characterized by such specific features of character, as an indecision, an increased impressionability, a tendency to constant doubt, timidity, constancy, anxiety. Often, the symptoms of the psychstay are also the state of depression and autistic manifestations. Psychopathic development by psychiathenictype in childhood is manifested in highlightedness, in obsessive fears, in anxiety. At an older age, obsessive doubts, fears, hypochondriadity, increased imperidity are observed.
3. Psychopathy(from Greek. - psyche.- soul, pathos.- disease) is determined in special psychology as pathological warehouse charactermanifested in impassional behavior, poor adaptability to changing environmental conditions, inability to obey external requirements, increased reactivity. Psychopathy is a distorted version of the formation of a person, this is a disharmonic personality development with sufficient (usually) intelligence preservation. Research of domestic scientists (V.A. Gilyarovsky, V.R.Myssishchev, G.E. Sukhareva, V.V. Kovalev, etc.) showed the dialectical interaction of social and biological factors in the origin of psychopathy. Most of the psychopathies are due to external pathological factors operating in the intrauterine or early childhood. The most frequent causes of psychopathy are: infections - general and brain, cranial and brain injuries - intrauterine, generic and acquired in the first years of life; Toxic factors (for example, chronic gastrointestinal diseases), disorders of intrauterine development due to alcohol intoxication, the impact of radiation, etc. It also plays a certain role in the formation of psychopathy and pathological heredity.
However, for the development of psychopathy, along with the main ( predisposing) The reason that causes innate or early acquired insufficiency of the nervous system is necessary, the presence of another factor is necessary - the unfavorable social environment and the lack of corrective impacts in raising the child.
The targeted positive environmental impact may be more or less corrected by the child's existing deviations, whereas with adverse conditions of education and development, even light deviations in mental development can transform into a severe form of psychopathy (G. Sukhareva, 1954, etc.). In this regard, biological factors are considered as source Minds,prerequisitesmay cause psychopathic personality development; The crucial role is acquired social factors, mainly conditions of the education and development of the child.
Psychopathy is very diverse on its manifestations, so in the clinic allocate its various forms (organic psychopathy, epileptoid psychopathy, etc.). Common for all forms of psychopathy is the violation of the development of the emotional-volitional sphere, specific abnormalities of character. For the psychopathic development of the personality characteristic: the weakness of the will, the impulsivity of actions, coarse affective reactions. The underdevelopment of the emotional-volitional sphere is also manifested in a certain decline in performance related to the inability to focus, overcome the difficulties encountered when performing tasks.
The most distinct disorders of the emotional-volitional sphere are expressed at organic Psychopathy, which is based on organic lesion of subcortical brain systems. Clinical manifestations of organic psychopathy are different. In some cases, the first manifestations of mental disorder are found already at an early age. In the history of these children there is a sharply pronounced bugness, fear of sharp sounds, bright light, unfamiliar subjects, people. This is accompanied by an intense and long cry and crying. In early and preschool age, psychomotor concern is at the forefront, increased sensory and motor excitability. In the younger school age, psychopathic behavior manifests itself in the form of an unbridled, protest against the rules of social behavior, all regime, in the form of affective outbreaks (proceeding, running, noise, and later - school absenteeism, tendency to vagrancy, etc.).
In other cases, the following feature of the behavioral reactions of children is drawn to organic psychopathy, sharply distinguishing them from peers already in preschool age. Native and educators note the extreme unevenness of their mood; Along with the increased excitability, excessive mobility in these children and adolescents, a reduced, sullen-irritable mood is often marked. Children of senior pre-school and younger school age are often complaining of indefinite pain, refuse food, sleep well, often quarreled and fighting with peers. Increased irritability, negativism in various forms of its manifestation, an unfavorable attitude towards others, the aggressiveness in relation to them is formed by the pronounced psychopathological symptoms of organic psychopathy. Especially distinctly specified manifestations are expressed in an older age, in the pubertal period. Often they are accompanied by a slow motion of intellectual activity, reduced memory, increased fatigue. In some cases, organic psychopathy is combined with a delay in the psychomotor development of the child.
G.E. Sukhareva highlights two main groups of organic psychopathy: nearprime (exposive) and restorindose.
At first (exclude)type There are unmotivated mood oscillations in the form dysphoria. In response to the lowest places in children and adolescents there are rapid protest reactions, leaving homes, schools.
For organic psychopaths on neglect type, elevated background of mood, euphoria, noncriticality. All this is a favorable background for the formation of pathology of impulse, tendency to vagrancy.
With the hereditary burden of epilepsy in children, personality features, peculiar epileptoid psychopathy.This form of psychopathy is characterized by the fact that in children, with the primary preserved intelligence and the absence of typical signs of epilepsy (seizures, etc.), the following behaviors and nature features are noted: irritability, hot temper, poor switching from one type of activity on another, "jam" on His experiences, aggressiveness, egocentrism. Along with this, carefulness and perseverance are characterized by learning tasks. The specified positive features must be used as a support in the process of correctional work.
In the hereditary burden of schizophrenia in children, schizoid personalities can be formed. For these children, it is characteristic: the poverty of emotions (often underdevelopment of higher emotions: feelings of empathy, compassion, appreciation, etc.), the lack of children's immediacy and cheerfulness, a small need for communicating with others. The nuclear property of their personality is egocentrism and autistic manifestations. It is characterized by a peculiar asynchrony of mental development from early childhood. The development of the speech overtakes the development of Motoriki, and therefore, self-service skills are often inconsigned in children. In games, children prefer loneliness or communication with adults and older children. In some cases, the uniqueness of the motor sphere is noted - clumsiness, motor awkwardness, invisibility to perform practical activities. General emotional lethargy, which is found in children from early age, the lack of need for communication (autistic manifestations), lack of interest in practical activity, and later - closedness, insecurity, despite a fairly high level of intellectual development, create considerable difficulties in education and learning this category of children.
Hystericalpsychopathic development is most often found in childhood than other forms. It is manifested in pronounced egocentrism, in high sustainability, in demonstrative behavior. The basis of this embodiment is based on psychopathic development. It manifests itself in the thirst for recognition, in the inability of a child and a teenager to the volitional effort, which is the essence of the psychic disharmony.
Specific features estroid psychopathythey manifest themselves in pronounced egocentrism, in the constant demanding of increased attention to themselves, in the desire in any way to achieve the desired one. In social communication, there is a tendency to conflict, to lies. In a collision with life difficulties, hysterical reactions arise. Children are very capricious, love to play a team role in the team of peers and exhibit aggressiveness if it fails. There is an extreme instability (lability) of mood.
Psychopathic development by unstablethe type can be observed in children with psychophysical infantilism. They are distinguished by immaturity of interests, surface, instability of attachments, impulsiveness. Such children have difficulty in long focusing activities, they are characterized by irresponsibility, the inconsistency of moral principles, socio-negative forms of behavior. This option of psychopathic development can be both constitutional gene and organic.
In practical special psychology, a certain dependence has been established between incorrect approaches to raising children, pedagogical errors and the formation of psychopathic character traits. Thus, the characteristic features of excitable psychopaths often occur with the so-called "hypoophec" or direct neglect. The formation of the "brake psychopaths" favorably favors or even the cruelty of others when the child does not see caress, is subjected to humiliation and insults (Social phenomenon "Cinderella"). The hysterical features of the personality are most often formed in the conditions of "Hyperopheki", in the situation of permanent adoration and admiration, when any of his desires and whims are played by a close child (the "Kumir family" phenomenon).
4. B. adolescencethere is an intensive conversion of the psyche of a teenager. Significant shifts are observed in the formation of intellectual activity, which manifests itself to the quest for the formation of abstract thinking, in a creative approach to solving problems. The volitional processes are intensively formed. The teenager is peculiar to perseverance, perseverance in achieving the goal, the ability to targeted volitional activities. Consciousness is actively formed. This age is characterized by disharmony of mental development, which is often manifested in accentuatednosta character. According to A.E. Persian, accentuating (pointedness) of individual character traits in students from different types of schools varies from 32 to 68% of the general contingent of schoolchildren (A.E. Pershko, 1983).
Character accentuation – these are the extreme variants of a normal nature, but in, then, the same time they can be a predisposing factor for the development of neurosis, neurotic, pathocharacterological and psychopathic disorders.
In numerous studies of psychologists, it is shown that the degree of disharmonicity in adolescents is different, and the character accentuating character itself has different qualitative features and is manifested in different ways in the peculiarities of adolescents. The main variants of character accentuations include the following.
Distimic type of personality.The peculiarities of this type of accentuation are periodic oscillations of mood and life tone in adolescents. In the period of lifting the mood of adolescents of this type of sociable, active. During the residence of the mood, they are few, pessimistic, begin to be a noisy society, become sad, lose their appetite, they suffer from insomnia.
Teens of this type of accentuation conformally feel among the small range of close people who understand them and provide support. Important for them is the presence of long, stable attachments, hobbies.
Emotive type of personality.Teens of this type are characterized by variability of moods, depth of experiences, increased sensitivity. Emotative adolescents have developed intuition, sensitive to those surrounding. They conformally feel the Circle of Family, understanding and caring adults, constantly strive for trusting communicating with great adults and peers for them.
Alarm typeDashible feature of this type of accentuation is alarming imperidity, constant fear for itself and its loved ones. In childhood, adolescent-type adolescents often observe a symbiotic relationship with mother or other relatives. Teens are experiencing strong fear of new people (teachers, neighbors, etc.). They need warm, caring relationships. The confidence of the adolescent, that he will support support, help in an unexpected, non-standard situation, contributes to the development of the initiative, activity.
Introvert type. In children and adolescents of this type there is a tendency to emotional dedication, closets. They, as a rule, there is no desire to establish close, friendly relations with others. They prefer individual activities. They have a weak expressiveness, the desire for loneliness filled with reading books, fantasizing, of various hobbies. These children need warm, caring relationships from loved ones. Their psychological comfort increases with adults and support their most unexpected hobbies.
Excitable type. At the same time, the type of character accentuation in adolescents there is an imbalance between the excitatory and braking processes. Teens of excitable type, as a rule, are in a state of dysphoria, which is manifested in depression with the threat of aggressiveness in relation to the entire external world. In this state, an excitable teenager is suspicious, inhibited, rigidid, is inclined to affective quick-temperedness, impulsiveness, unmotivated cruelty in relation to loved ones. Excientable teenagers need warm emotional relations with others.
Demonstrative type.Teens of this type are distinguished by pronounced egocentrism, constant desire to be the center of attention, the desire to "make an impression." It is characterized by communicability, high intuition, the ability to adapt. Under favorable conditions, when the "demonstrative" teenager turns out to be in the spotlight and adopted by others, it adapts well, capable of productive, creative activity. In the absence of such conditions, the disharmony of personal properties on the exteroidal type is observed - attracting special attention to the demonstrative behavior, the tendency towards lies and fantasy as a protective mechanism.
Pedantic Type. As emphasizes E.I. Leongard, pedantic as an accentuated character trait manifests itself in the behavior of the person. The behavior of the pedantic person does not go beyond the limits of reasonable, and in these cases often affect the advantages associated with the tendency to the rootality, clarity, completeness. The main features of this type of character accentuation in adolescence are indecision, a tendency to resonation. Such adolescents are very accurate, conscientious, rational, responsible. However, in some adolescents, at elevated anxiety, indecision is observed in the decision-making situation. Their behavior is characterized by some rigidity, emotional restraint. Such adolescents are characterized by increased fixation on their health.
Unstable type.The main characteristic of this type is the pronounced weakness of the volitional components of the individual. Briefless manifests itself, first of all, in the educational or labor activity of the teenager. However, in the process of entertainment, such adolescents may exercise high activity. In unstable adolescents, there is also an increased suggestibility, and therefore their social behavior largely depends on the environment. Increased immaturity and impulsiveness Against the background of the immaturity of the highest forms of volitional activities, often contributes to the formation of a tendency to additive (dependent behavior): alcoholism, drug addiction, computer dependence, etc. Unstable accentuation is already manifested in primary schools. The child has a completely lack of desire to learn, unstable behavior is observed. In the personality structure, unstable adolescents there are inadequate self-esteem, which is manifested in the inability to the self-analysis corresponding to the assessment of its actions. Unstable teenagers are prone to intelligent activities, which makes it possible under favorable conditions to form socially acceptable forms of behavior.
Affective-labile type. An important feature of this type is the extreme variability of mood. Frequent mood changes are combined with a significant depth of their experiences. From the mood of this moment depends well-being of a teenager, its ability to work. Against the background of mood fluctuations, conflicts with peers and adults, short-term and affective flashes are possible, but then the rapid remorse. During a period of good mood, labile teenagers are sociable, easily adapt to the new setting, responsive to the request. They have a well-developed intuition, they are distinguished by the sincerity and depth of attachment to relatives, close, friends, deeply experiencing rejection from emotionally significant individuals. With a friendly attitude, from teachers and surrounding such teenagers feel comfortable, show activity.
It should be noted that the manifestations of psychopathic development are not always ends with complete formation of psychopathy. With all the forms of psychopathic behavior, provided early targetedcorrectional impact in combination (if necessary) with therapeutic measures can be achieved significant successes in compensation for the deviationing development in this category of children.
3. Children with early child autism syndrome.
Early Children's Autism (RDA)it is one of the most complex violations of mental development. This syndrome is formed in its full form to a three-year-old age. RDA is manifested in the following clinical and psychological signs:
violation of the ability to establish emotional contact;
stereotype of behavior. It is characterized by the presence in the behavior of a child of monotonous actions - motor (swinging, jumps, tapping), speech (uttering of the same sounds, words or phrases), stereotypical manipulations by any object; Monotonous games, stereotypical interests.
specific violations of speech development ( mutism, Echolalia, speech stamps, stereotypical monologues, the absence of first person pronouncements, etc.), leading to a violation of speech communication.
In early childhood autism, it is also characteristic:
Increased sensitivity to sensory stimuli. In the first year of life, there is a tendency to sensory discomfort (most often on intense household sounds and tactile irritation), as well as focusing on unpleasant impressions. With insufficient activity aimed at examining the surrounding world, and restriction of various sensory contact with it, there is a pronounced "capture", the charm of certain certain impressions - tactile, visual, auditory, vestibular, which the child seeks to receive again and again. For example, a favorite occupation of a child for six months and more can be a fluffy of a cellophane package, monitoring the shadow movement on the wall; The strongest impression may be the light of the lamp, etc. It is a fundamental difference in autism is the fact that it is almost never possible to engage in the actions that the child "is enchanted".
Violation of self-preservation feeling is celebrated in most cases up to a year. It manifests itself both in oveucasure, and in the absence of a sense of danger.
Disruption of affective contact with the nearest environment is expressed:
in the peculiarities of the relationship to the hands of the mother. Many autistic children are missing anticypidpose (pulling the handles towards an adult when the child looks at him). On the hands of Mother, such a child may also not feel comfortable: either "hanging a bag", or is excessively tense, resists caresses and others;
features of fixing a look at the mother's face. Normally, the child early detects interest in the human face. Communication with the help of the view is the basis for the development of subsequent forms of communicative behavior. For autistic children, the avoidance of the eye contact is characterized (a look past the face or "through" the face of an adult);
the features of the early smile. The timely appearance of a smile and her orientation is near - a sign of the prosperous effective development of the child. The first smile in most autistic children is not addressed to a person, but rather, in response to a pleasant sensory stimulation (torment, the bright color of the mother's clothing, etc.).
the features of the formation of attachment to a near person. Normally, they manifest themselves as an obvious preference for one of the people who caregoing for the child, most often - the mother, in the experiences of separation from it. An autistic child most often does not use positive emotional reactions to express affection;
in difficulties in expressing a request. Many children are normal at an early stage of development formed a directional look and gesture - stretching the hand in the right direction, which in subsequent stages transformed into index. At the autistic child and at the later stages of development, such a gesture transformation does not occur. Even at the older age, when expressing his desire, an autistic child takes the hand of an adult and puts on the desired object;
the difficulties of an arbitrary organization of a child who can be expressed in the following trends:
the absence of or inconstancy of the toddle's response to appeal to the adult, to its own name;
lack of leakage view of an adult looking, ignoring his index gesture;
inexpressiveness of imitative reactions, and more often their absence; the difficulty in organizing autistic children to simple games requiring imitation and display ("Ladushka");
great dependence of the child from the influences of the surrounding "mental field". If parents show great perseverance and activity, trying to attract attention, then an autistic child either protests or leaves contact.
Violation of contact with others related to the features of the development of the forms of child's appeal to adult is finding an expression in the complexity of expressing their own emotional state. Normally, the ability to express its emotional state, share it with adults - one of the earliest adaptive achievements of the child. It usually appears after two months. Mother perfectly understands the mood of his child and therefore can manage it: console the child, remove discomfort, calm down. Mothers of autistic children often experience difficulties even in understanding the emotional state of their kids.
The will is conscious targeted mental activity. THEM. Sechens in the work of "brain reflexes" (1866) indicated that the mechanism of arbitrary movements is reflexive, which is based on nervous excitement. In the process of socio-historical development, people developed more complex and accurate forms of adaptive reactions, expressed by highly differentiated conventional reflex reactions. The volitional sphere is closely related to instincts (congenital reflexes) and entrepreneurs.
Instincts are congenital reflexes that have been inherited by His ancestors. Instincts include: food, defensive, sex, parent. A person can regulate his instincts and suppress them. If several contradictory desires arise at the same time, then there is a struggle of motives. Motive - This is an act of comprehension, i.e., a critical attitude towards desire in accordance with the real possibilities. As a result of the struggle of motives, a person takes a certain decision. Will, volitional action -this is one of the sides of the psyche, which, as any mental activity, is causally due to the laws of the existing world. Wallave activities are an action aimed at implementing a consciously set target, targeted mental activities.
Volosses can manifest themselves in accordance with the laws of this environment and then they talk about the right upbringing and behavior of a person. In the volitional sphere disorders, it is possible to distinguish an increase or decrease in mental activity, the perversion of volitional action.
The volitional processes may violate in various types and is characterized by a variety of manifestations.
In patients with manic-depressive syndrome, there is an increase in volitional activity, which manifests itself in increased activities, tirelessness, multi-mercy, increased good mood. The decrease in volitional activity is accompanied by a volatility, apathy, a sharp decrease in motor activity and is observed in some mental disorders (reactive and endogenous psychosis).
Emotional-volitional and motor-volitional actions are formed in the course of life, their deviations can manifest themselves at a certain age and in some psycho-neurological disorders.
The weakening of the volitional activity, and with them and the manifestation of impulse, is often found in a psychiatric clinic.
Inquiries are phylogenetically old, inherited, complex unconditional reflex (instinctive) vital reactions aimed at preserving the genus and extension of the species. They are characteristic of man and animal. Persons, unlike animals, are subordinated to social and labor activities. Training and upbringing contribute to the braking of impulse. Under some lesions of the cortex of the brain, the degrees may be rapidly.
Instinct and Verification Disordersthey can manifest themselves in their strengthening, decreasing, disappearing or high-quality perversions.
Violation of food instinct.Inquiring to food is observed in the form of strengthening of food instinct (voraciousness, greed). Such states are observed in patients who have suffered encephalitis, and are called bulimia.Most often have to face food inlet. Persistent refusal of food eating ( anorexia) leads to the depletion of the patient. Persistent rejection of food may be associated with the delusional tune (delusional ideas of poisoning, etc.) or belief that food is made of poor-quality products. Symptom of Pick - eating inedible objects. Coprophagia - eating feces. Food refusal can be observed with various forms of stupor, under the states of depression, during hysteria. In some cases, anorexia is a protective physiological mechanism by which the body adapts to the new conditions of the external and internal environment.
In the first hours after birth, the food reflex is manifested with innate. Normally born baby with a good weight smacks lips and looking for a nipple, sucks enough milk. Children who born weak, with a small weight or having suffered a generic brain injury, differ in a weak food reflex, little and poorly eaten, jerk, they often have a dyspeptic (disturbance of the gastrointestinal tract) phenomena. Subsequently, they eat little, selectively. They often manifest polydipsy(increased fluid consumption). In physical development, these children of low food are often sick, they easily show themselves various neurotic reactions.
When strengthening the edible reflex, children from an early age draw attention to high appetite, good fatty fatness. With age, they eat a lot, especially flour and carbohydrate food. Mothers are often complaining that children get out of the castle forbidden food and all eat. They quickly gain in growth and weight and pay attention to increased fatty fatness ( endocrinopathy). Children tell that they have an incredible attraction for food ( bulimia), they all the time hungry, eat a lot ( polyphagia) and can not be satisfied ( acrira), Although they are well fed enough.
Along with the weakening or strengthening of the edible reflex, the perversion of the impulse can be observed under certain states: pregnancy, in patients who have moved brain concussion, some psychosis. The perversion of the edible reflex is manifested in the desire to use one food or abandon another. Sometimes patients use inedible food with a shortage of some substances in the body, for example, chalk during pregnancy or excrement during idiotia.
FROM defensive reflex related methods of education. Parents and teachers teach children to treat well and help his comrade, prohibit fighting. Some children are absorbed by this principle and behave correctly in the team, others have different deviations.
In children easily excitable, who suffered a generic crank-brain-brain or lifelby injury, there are often affective flashes, they easily come into conflict. In adolescents, these states are exacerbated under the influence of alcohol, drugs, asocial conditions.
In physically weakened children, the defensive reflex is not formed. They are offended, plaxive, they all offend them, they can not protect themselves. Educators of preschool and school institutions should be especially attentive to physically weakened children, prevent conflict situations.
This group of pathology belongs disorder of attraction for self-save,which can manifest in the form exacerbationsattractions to self-preservation (distrust of everything new, change, unfamiliar objects, commitment to stereotypical order), weakeningattractions to self-preservation (lack of protective reactions, indifferent attitude towards others), perversioninclusion to self-preservation (autoagression).
Feartakes the pathological form of attraction to self-preservation. This is a deep life experience, completely unworthy, usually nothing motivated and emergency intensity. The manifestation of it is different: in a stupor (discharge) or turbulent motor concern (hysterical reactions).
Attraction for suicide ( suicide about Mania) It is usually associated with mental disorders and is observed in adolescents and young people with reactive psychosis, drug addiction, alcoholism. Mentally sick people often show greater ingenuity and perseverance in the implementation of their suicidal intentions. Close to the impulse to deprive itself of life is attracted to self-suicide, it is often impulsively. Often it happens against the background of delusional and hallucinatory experiences.
In a psychiatric clinic, a noticeable place occupy violations sexidation: increased or reduced sexually excitability, sexual perversions that may be observed with various mental illness and states.
Increased sexual excitability - hypersexualityexpressed in adolescents in the form of frequent and long erections, erotic fantasies, masturbation. Such states are observed with a sharp increase in the secretion of androgens due to accelerated pubertate development, under the influence of endocrine disorders or organic lesions of the hypothalamolymbic region.
Hydosxuality - Lowering sexual entry, manifested in adolescents, in the absence of interest in the opposite sex. These disorders arise in the delay in psychosexual development.
The most frequent form of violation of sexual entraints is homosexuality(attraction to the people of the same name). In the history of homosexuals, the peculiarities of disorders from childhood are often noted, the most clearly manifested in adolescent and young age (interest in specific games, decorations, girls' clothes and the opposite). In the mental state of homosexuals, the features related to the pathology of their impulses are often a sense of social rejection, isolation, often heavy experiences associated with the consciousness of their inferiority.
To the number of other forms of violation refers transvereticismpathological attraction to dressing in the opposite sex, as well as interest in the opposite sex.
The object of sexual attraction may also be small children ( pedophilia), sex intercourse with animals ( zoophilia), attraction to the statues ( pygmalion)other. There are long known deviations as sadism and masochism. Sadism -it is characterized by the desire to hurt another person in order to achieve sexual satisfaction. Masochism - Getting sexual satisfaction or pleasure from the caused pain or humiliation delivered by a partner.
The opposite state is to reduce the sexual activity due to temperament, the possibility of a volitional management of its instincts, moral level of personality, and experienced stress. Often falls potencyin chronic alcoholics.
Given that sexual instinct is formed in childhood, the task of parents and educators is to influence the children of the right understanding of the relationship between boys and girls, respect for them.
He applied for the advice of her grandmother about his grandson of 6 years. Having come home from a kindergarten, a boy spends a lot of time near the mirror, puts on his shoes and a mother's dress, her jewelry, paints his lips and reincarnate into a woman. This interest in women's clothing worries her grandmother. Question to grandmother: What do parents do the parents of the house? Grandmother's answer: Dad reads a newspaper and watching TV, mother considers his new fashionable things or talks with friends about the update. No one is engaged in the child, he is granted to himself and lives in a circle of permanent conversations about things, toilets, women's jewelry, fashion. Naturally, his female interests are formed. In this regard, the Council to parents: the child's father to engage in male work in the house and physical culture together with her son and teach a child to work. Otherwise, the child has various pathological features of the person.
Parental instinctformed from childhood. The girl is more often a ribs in the hands of a doll, shakes, bathes and putting it up, imitating mother. During life, the girl turns out to be closer to the doll, and then to the child. The boy prefers opposing games: in war, football or plays with cars, designer, soldiers. Currently, boys and girls are fond of computer games. Parental instinct is formed in the process of living a child with parents, care about them and is expressed in healthy, the right upbringing of his child. But various deviations may be observed in the form of hyperteks or hypoopects, which is manifested in strengthening or weakening the parental instinct.
For hyperophecloving parents are trying to do everything for their child: it grows unsuitable for home work, the need to help parents. Most often, the hyperopka goes from the mother, she clothes and shoes a child, advises him to sit at the table with whom to be friends and what to say. In these cases, the child does nothing independently, does not solve his problems. This provision (suppression of the initiative) is preserved in school and in adolescence. The child is formed a certain personality warehouse, which is defined as mental. In difficult everyday conditions, these people are not prepared for independent solutions of any tasks and in difficult cases show a severe stress reaction.
In cases hypoophekiwhen parents pay a little attention to their children for various reasons: they work a lot, abuse alcohol and spend free time in entertainment. Children grow under the influence of the upbringing of other people's people, not always prosperous. In these cases, children go out of the house, they are engaged in vagabilities and theft. Depending on the age, many of them fall into boarding schools, orphanages or a crime in prison.
In some cases, mothers are observed directly after childbirth, even disgust with respect to their children. This may be an early sign of a mental illness ( symptomatic postpartum psychosis, aggravation of the schizophrenic process).
Inclosures are formed on the basis of instincts. However, the attraction is a broader concept that not only implies certain forms of behavior, but also means experiencing a certain biological need. Thus, the attraction is a state that encourages to seek or avoid those vital situations in which it could be resolved by instinctive movement. Inquiries are formed in the process of life, but may be changed under the influence of the environment. Inquiries periodically arise and disappear, their intensity changes. Forms of the manifestation of impulses are different and often depend on their satisfaction or volitional action.
In psychiatry describe a large number impulsive impulse: attraction to vagrancy ( domomania), arson ( pyromania), theft ( kleptomania). Most impulsive deposits represent complex formations in genetic, and in structural terms. In contrast to obsessive states, impulsive attractions are acute encouraging and aspirations, submitting to themselves all the consciousness and behavior of the patient. Impulsive actions occur with a deeper impaired mental activity compared with impulsive attractions. They are characterized by meaninglessness and arise without any occasion. The patient can impulsively perform an aggressive act or cause damage to suicide (A.A. Portnov). Such states are observed in schizophrenia and psychopathy.
Pathophysiological mechanisms of emotional-volitional disorders are diverse and have genetic and social roots, are observed with many mental and neurotic painful states. In these cases, children and adolescents need good, attentive and caring attitude, attracting educational and employment activities.
Disorders of effector functions (engine-volitional)
Along with emotionally-volitional disorders in a psychiatric clinic, engine-volitional disorders are also described.
The mechanism of the emergence of motor-volitional disorders is the factor of the predominance of excitation or brake processes in the cerebral cortex. In these cases, volitional activity is weakened or increases.
To the motor-volitional disorders with the predominance of the excitatory process refers hyperbulia - an increase in volitional activity associated with the enhancement of impulse. May manifest in shape:
Manic excitationin which the patient is constantly in operation: without finishing one job, he starts another, while he says a lot, the mood of fun, appetite is increased. In such patients, hypersexuality can be observed, aggression, disbursement of behavior. The person in such a state does not feel fatigue and can work up to 20 hours a day, leaving for a few hours.
Such a state of manic excitation is observed within two or three weeks, then gradually calms down until the next attack or go to its opposite state - braking. The disease of the manic-depressive psychosis (TIR) \u200b\u200bpasses with separate cycles.
Ktathonic excitationwhich, unlike manic excitation, is not focused and is expressed by stereotypical movements, chaotic, stripping. Patients are in constant motion, pulsely jump from bed and goofly walk out of the corner in the angle, shout separate words. For this state, echolalia (repeating words) is characterized, echopraxia (repetition of movements), echomymia (repetition of the expression). These changes in patient behavior are characteristic of schizophrenia.
Goebafrenic excitationwhich is characterized by manneriness, foolish behavior, abundance of ridiculous poses, jumps, jumps, luggles. In adolescence, symptoms is supplemented by deflecting lower deposits. Patients say a lot, philosophy (barren philosophical wise, residement). These states are observed during schizophrenia.
Hysterical excitementemerging after fright. A person runs without regard to and long can not stop, understand what happened. The shape of hysterical excitation also refers a hysterical attack.
Motor-volitional disorders with the predominance of the brake process include all forms characterized by the weakening of volitional activities ( hymanobulia) or stop action - stupor:
Depressive stuporin which the patient is long in the same position, says quietly, with difficulty picks up words, moves it slowed down and committed with difficulty. A constant sign of depressive stupor is the oppressed state, the predominance of the feeling of longing, fear, anxiety. It is characteristic of the sufferer, frozen facial expressions. Such states may be observed with manic-depressive psychosis in the depression phase, with senile depression.
Catatonic stuporit is characterized by immobility and mutism (refusal of conversation, silence). There is a state of wax flexibility ( catalepsy) - You can give any pose to the patient and it does not change it for a long time, for example, the hand raised does not omit until it sicks. Such states are observed during schizophrenia.
Gebafrenic stuporit is characterized by splitting (splitting) of activity, negativism, expressed in the fact that patients perform the action opposite to those as they ask. These states are observed during schizophrenia.
Hysterical, or psychogenic, stuporarrives after mental injuries: when fright, sudden grief, natural disaster. The external manifestation is the overall inhibition until a complete discharge. Sometimes a person freezes and cannot budge, can not say words ( mutism). In these cases, there is a disassembled braking in the cerebral cortex.
Such states may be observed in children and adults. In children after fright, accompanied by the phenomena of mutism, neurotic stuttering can develop.
The various symptoms of psychopathological disorders considered by us show a variety of options for painful states that may be observed in children's and adolescence. It is important that the need for early detection of volitional disorders in children and adolescents, studying the reasons for their causing, the right organization of pedagogical work, compliance with the mental and physical activity regime, attracting children to physical education, creativity, education of moral qualities and artistic and aesthetic taste. Deviations in the emotional-volitional sphere against the background of mental illness causes the need for medical and psychological and pedagogical counseling.
Questions for independent work:
1. What is emotions? What do they differ from feelings?
2. What are the features of the formation of the emotional sphere?
3. Describe the types of emotional disorders.
4. How is the emotional-volitional sphere in childhood?
5. What is the attraction? What types of pathology of attraction do you know?
6. What types of violations of the engine-volitional sphere do you know?
7. What features of emotional disorders may be observed in childhood?
8. How do you imagine "negativism" and its meaning in the educational process?
9. Name the differences in the hystobulia and stupor.
10. What is sadism and masochism?
11. Features of the work of the educator and the teacher with children suffering from affective and effector disorders.
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 syndromesDepressive 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.
Often, the care of parents is mainly concentrated in the field of children's physical health, when there is no appropriate attention to the emotional state of the child, and some early disturbing symptoms of disorders in the emotional-volitional sphere are perceived as temporary, characteristic of age, and therefore non-hazardous.
Emotions play a significant role from the very beginning of the life of the baby, and serve as an indicator of his attitudes towards parents and to the fact that he surrounds. Currently, along with general health problems in children, specialists with concern are noted the growth of emotionally-volitional disorders, which are poured into more serious problems in the form of low social adaptation, inclinations for asocial behavior, learning difficulties.
External manifestations of violations of the emotional-volitional sphere in childhood
Despite the fact that it is not necessary to independently put not only medical diagnoses, but also diagnoses in the field of psychological health, and it is better to entrust it to professionals, there are a number of signs of violations of the emotional-volitional sphere, the presence of which should cause access to specialists.
Violations in the emotional-volitional sector of the child's personality have the characteristic features of age-related manifestations. For example, if adults are systematically noted at their baby at an early age such behavioral characteristics, such as excessive aggressiveness or passivity, plasticity, "jam" on a certain emotion, then it is possible that this is an early manifestation of emotional disorders.
At the preschool age to the above symptoms, it may be added to the inability to follow the norms and rules of behavior, the insufficient development of independence. At school age, these deviations, along with those listed, can be combined with uncertainty in themselves, violation of social interaction, decrease in purposefulness, inadequacy of self-esteem.
It is important to understand that the existence of violations should be judged not by the presence of a single sign, which can be a reaction of a child to a specific situation, but for the aggregate of several characteristic symptoms.
Basic external manifestations look like this:
Emotional tension. With increased emotional tensions, besides well-known manifestations, it can also be pronounced difficulties in organizing mental activities, a decrease in gaming activity characteristic of a specific age.
- The rapid mental fatigue of the child compared to peers or with earlier behavior is expressed in the fact that the child is difficult to focus, it can demonstrate a clear negative attitude towards situations where the manifestation of mental, intellectual qualities is necessary.
- Increased anxiety. Increased anxiety, except known signs, can be expressed in avoiding social contacts, reducing the desire for communication.
- Aggressiveness. Manifestations can be in the form of demonstrative disobedience of adults, physical aggression and verbal aggression. Also, its aggression can be directed at himself, he can hurt. The child becomes naughty and with great difficulty given for educational influences of adults.
- Lack of empathy. Empathy - the ability to feel and understand the emotions of another person, empathize. With violations of the emotional-volitional sphere, this feature is usually accompanied by increased anxiety. The disability of empathy can also be an alarming sign of mental disorder or delay of intellectual development.
- Nootability and reluctance to overcome difficulties. The child is sluggish, with displeasure contact with adults. The extreme manifestations in behavior may look like a complete ignoring of parents or other adults - in certain situations, the child can pretend that he does not hear an adult.
- Low motivation to success. A characteristic sign of low motivation to success is the desire to avoid hypothetical failures, so the child with displeasure is taken for new tasks, trying to avoid situations where there are even the slightest doubts as a result. It is very difficult to persuade him to try something. A frequent answer in this situation is: "It will not work," "I do not know how." Parents will mistakenly interpret as manifestations of laziness.
- Severe distrust of others. It can manifest as hostility, often conjugate to the federation, children of school age can exercise this as an excessive criticality to the statements and actions of both peers and those surrounding adults.
- The excessive impulsiveness of the child is usually expressed in the weak self-control and insufficient awareness of its actions.
- Avoiding close contacts with surrounding people. The child can repel the surrounding comments expressing contempt or impatience, daring, etc.
Formation of the emotional-volitional sphere of the child
The manifestation of emotions Parents are watching the child from the very beginning of the life of the child, with their help there is communication with their parents, so the baby shows that he is good, or he experiences unpleasant sensations.
In the future, in the process of growing, before the child there are problems that he has to solve with varying degrees of independence. Attitude towards a problem or situation causes a certain emotional response, and attempts to influence the problem are additional emotions. In other words, if the child has to show arbitrariness in the implementation of any actions, where the fundamental motive will not "want", and "necessary", that is, the problem will require a volitional effort, in fact it will mean the implementation of a volitional act.
As we grow, emotions also undergo certain changes, develop. Children at this age learn to feel and are able to demonstrate more complex manifestations of emotions. The main feature of the correct emotional-ski development of the child is the increasing ability to control the manifestation of emotions.
The main causes of violations of the emotional and volitional sphere of the child
Children's psychologists have a special emphasis on approval that the development of the personality of the child can harmoniously occur only with sufficient trustful communication with close adults.
The main causes of violations are:
- transferred stress;
- lag in intellectual development;
- insufficiency of emotional contacts with close adults;
- social and domestic reasons;
- films and computer games that are not intended for its age;
- a number of other reasons causing the child internal discomfort and a sense of inferiority.
Disorders of the children's emotional sphere are manifested much more often and brighter during periods, so-called age crises. Bright examples of such points of adult may be the crises of "I myself" at the age of three years and the "transitional crisis" in the adolescence.
Diagnosis of violations
To correct disorders, it is important to timely and correct diagnostics, taking into account the reasons for the development of deviations. In the arsenal of psychologists, a number of special techniques and tests for assessing the development and psychological state of the child, taking into account its age characteristics.
For preschoolers, as a rule, projective diagnostic techniques are applied:
- test for drawing;
- color Test Lucher;
- back anxiety scale;
- questionnaire "Wellness, Activity, Mood" (San);
- filipsy school anxiety test and many others.
Correction of violations of the emotional-volitional sphere in childhood
What to do if the behavior of the baby makes it assume the presence of such a disorder? First of all, it is important to understand that these violations can and need to be corrected. It is not necessary to observe only specialists, the role of parents in the correction of the behavioral characteristics of the child's character is very important.
An important point that allows you to lay the foundation to safely resolve this problem is the installation of contact and trust relationships of parents with a child. In communication, critical estimates should be avoided, show a benevolent attitude, to maintain peace of mind, to praise adequate manifestations of feelings more, should be sincerely interested in his feelings and empathize.
Appeal to psychologist
To eliminate violations of the emotional sphere, you should contact a children's psychologist who, with special classes, will help learn how to react correctly when stressful situations arise and control their feelings. Also an important point is the work of a psychologist with the parents themselves.
Psychology has currently described many ways to correct children's violations in the form of gaming therapy. As you know, the best learning occurs with the involvement of positive emotions. Learning proper behavior is no exception.
The value of a number of methods is that they can successfully apply not only specialists themselves, but also parents interested in the organic development of their baby.
Practical correction methods
Such, in particular, the methods of talented therapy and dumplings. Their basic principle is the identification of a child with a character of fairy tales or his beloved toy during the game. The child projects his problem on the main character, the toy and, in the process of the game, the plot allows them.
Of course, all these methods imply the mandatory immediate involvement of adults in the game process itself.
If the parents in the process of education are given sufficient and due attention to such parties to the development of a childhood personality, as an emotional-volitional sphere, then in the future this will make it much easier to survive the period of adolescence of the personality, which, as well as many, can make a number of serious deviations in the behavior of a child.
The experience gained by psychologists shows that not only accounting for the peculiarities of age development, a solid selection of diagnostic techniques and techniques of psychological correction, allows specialists to successfully solve the problems of violation of the harmonious development of a childhood personality, a decisive factor in this area will always be parents, patience, care and love will always be .
Psychologist, psychotherapist, specialist in personal well-being
Svetlana Beech
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Question:
Hello! Our child diagnosed violation of the emotional-volitional sphere. What to do? He is in grade 7, I am afraid if you will send for training at home, it will become even worse.
Answer:
Hello, dear mommy!A child with a violation of the emotional-volitional sphere can be longing, depression, sadness or painfully increased mood up to euphoria, anger or anxiety attacks. And all this within a single diagnosis.
A competent psychotherapist works not with a diagnosis, but with a specific child, with its individual symptoms and the situation.
First of all, you are important to align your condition. Fears and fears of parents negatively affect any child.
And to make a correction, solve the problem. Translation for home learning is only an adaptation to the problem (that is, a way to somehow live with it). To solve, it is necessary together with medical care to come to the reception and to a psychologist-psychotherapist.
Question:
Hello. I am a mother. My son is 4 years old. We first set the STD, yesterday, this diagnosis was removed by a neuropathologist and set the "emotional sphere disorder against the background of the formation of the emotional sphere." What should I do? How to adjust? And what literature will advise for the correction of behavior. My name is Marina.
Answer:
Hello, Marina!
Imagine that you somehow do not work smartphone or TV.
Will someone comes to start repairing these devices on books or recommendations of specialists (take the soldering iron and replace the transistor 673 and resistor 576). A man's psyche is much more difficult.
Here you need versatile classes with a psychologist-psychotherapist, a speech therapist, a defectologist, a psychiatrist.
And than at an earlier age, the classes will begin, the more effective there will be a correction.Question:
What are the diagnostic techniques for identifying violations in the emotional and volitional sector of children 6 - 8 years?Answer:
Classification M. Bleyher and L.F. Barlachuk:
1) observation and methods close to it (study of the biography, clinical conversation, etc.)
2) Special experimental methods (modeling certain types of activities, situations, some hardware techniques, etc.)
3) Personal questionnaires (methods based on self-esteem)
4) projective methods.Question:
Hello Svetlana.
Violations of the children's emotional sphere, described in this article, I observed about many children about 90% - the aggressiveness, the lack of empathy, the unwillingness to overcome the difficulties, the unwillingness to listen to the other (the headphones are very often helped) this is the most frequent. The rest are less common. I am not a psychologist and maybe I am mistaken in observations therefore I want to ask: is it true that 90% are disturbed by the emotional-volitional sphere?Answer:
Hello, dear reader!
Thank you for your interest in the topic and the question.
The manifestations they have noticed are aggressiveness, the lack of empathy, the unwillingness to overcome the difficulties, the unwillingness to listen to the other is only signs. They can serve as a reason to appeal to a specialist. And their presence is not a reason for formulation of a "violation of the emotional-volitional sphere". In one way or another, each child is trying to experience aggressiveness, for example.
And in this sense, your observations are true - most children have the above-mentioned signs from time to time.Question:
Hello Svetlana!
I would like to consult you about the behavior of my son. We have a family from grandparents, son and me (moms). Son of 3.5 years. With my father, I divorced, with him we broke up when the child was a little more than a year. Now we do not see. The son was diagnosed with dysarthria, intellectual development is normal, very active and sociable, but in the emotional-volitional sphere there are serious disorders.
For example, it happens that he pronounces (in the garden one boy began to do so) sometimes some syllable or sound is repeated and monotonously, and when he is told to stop doing so, it can start doing something else, for example, to sneak the face ( How he was forbidden to do so). At the same time, in a calm tone, we explained that the boys or the "bad" boys do that so they do. First, he begins to laugh, and after another explanation and reminders that it can be fraught with any punishment, especially when the adult is broken and increases the tone, it begins crying, which is dramatically replaced by laughter (definitely, already unhealthy), and so laughter and cry can Change for minutes several times.
Also in the behavior of the son, we see that he can throw toys (often (in the sense for a month or two), breaks the car or toys, sharply throwing and breaking it. At the same time, he is very naughty (hears, but does not listen), often every day Bring close people.
We all love him very much and want him to be a healthy and happy boy. Tell me, please, how to be in such a situation when he does something called? What methods of conflict resolution do you advise? How to learn from the habit of pronounce these "self-regulatory sounds"?
Grandma with grandfather - intelligent people, I have the education of a teacher, economist, educator. We referred to a psychologist about a year ago, when such a picture was just started. The psychologist explained that these are signs of crisis. But, having a diagnosis of Dyslight, we are forced to explain his behavior otherwise, which, by the way, was not corrected, despite our fulfillment of the councils of a psychologist, but worsened.
Thanks in advance
Sincerely, SvetlanaAnswer:
Hello Svetlana!I recommend that you come to consult.
You can pre-contact Skype or phone.
The child is important to switch, distract to some interesting occupation at such moments.
Punishment, explanations and tone increases are not effective.
You write "Despite our fulfillment of the tips of the psychologist," what exactly did you do?
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