Disturbing frustration at children – group of the affective violations which are characterized by emotional pressure, concern, fears. In the center of experiences of the child – negative expectations and presentiments of rather own life, health, the relations in a family and school. Sometimes uneasiness takes the form of the notions of compulsion, compulsive actions, phobias, the panic attacks, nightmares. The main methods of diagnostics – collecting the anamnesis, a conversation, observation. The psychodiagnostics is in addition used. A widespread method of treatment is the cognitive and behavioral psychotherapy in combination with reception of antidepressants and anksiolitik.
Disturbing frustration at children
Disturbing frustration at children concern to wide group of emotional violations of children's age. Their prevalence constantly grows, now pathology takes the second place among mental diseases in the childhood and a podrostnichestvo (after behavioural deviations). Active researches of the last 20 years allowed to reveal new nosological units which are included in MKB-10 and DSM-IV now – official qualifiers of diseases. Epidemiological indicators fluctuate from 4 to 15% in various age groups. Preschool children and younger school students are most subject to disturbing symptoms. At girls options of frustration with the expressed emotional component, at boys – with somatic prevail (violations of digestion and a dream, abdominal and headaches).
The reasons of disturbing frustration at children
The alarm is the natural reaction which is increasing concentration of attention and making active mechanisms of fight or flight in a threat situation. At its strengthening adaptation process is broken, constant psychophysiological tension leads to exhaustion. In such cases speak about disturbing frustration. At children its reasons can become:
- Congenital factors. Results of twin researches prove that tendency to intensive alarm is descended. It can be caused by features of humoral regulation and functioning of nervous system. Also in risk group there are children having prenatal and natal defeats of TsNS.
- Style of education. Symptoms of alarm are formed as a result of a certain attitude of parents towards the child. Development of frustration is promoted by psikhastenichesky lines of mother (more rare – the father), hyper guardianship, directive methods of education.
- The psychoinjuring event. Uneasiness of the child can be provoked by experience of a disease, separation from the loved one, sharp deterioration in material resources of a family, accidents, natural and military-political cataclysms. Single influence of a psychotrauma is transferred by children more simply, repeated episodes form neurotic violations.
Periodic manifestation of alarm is normal reaction of an organism, serves as a motivational component of behavior, providing the high level of vigilance, commitment and readiness to use the efforts for achievement of result. However frequent, uncontrollable fears negatively influence ability to adequately assess a situation and to work purposefully, and in hard cases distort perception of daily events. The disturbing state is always focused on the future and is shown by fear in relation to what can occur. What stronger expressed frustration, especially a wide range of events which are regarded as dangerous.
At the physiological level high uneasiness is connected with dysfunctions in the departments of limbic system and a hippocampus responsible for regulation of emotions. I. P. Pavlov considered fear and alarm as options of manifestation of a passive and defensive reflex. At the heart of these emotions – the self-preservation instinct which is making active all systems of an organism for flight or fight. And if excitement and braking of TsNS are normal it is balanced, the natural defensive reflex is replaced by relaxation, then at frustration of disturbing type there is a rigidnost of neural processes – the emotion which became irrelevant is experienced again and again.
There is a set of types of the children's disturbing frustration differing with symptomatology. Their general manifestation – the long concern inadequate to the existing situation which negatively influences everyday life of the child reduces feeling of psychological comfort. Taking into account features of a clinical picture allocate:
- General disturbing frustration. Children constantly worry about various spheres of life – about health, safety, the relations with peers and parents, success of study. From all options of the future negative it seems to the most probable.
- Obsessivno-kompulsivnoye frustration. The alarm is shown by persuasive actions and thoughts. Rituals for short time provide feeling of tranquility.
- Phobias. The presentiment of danger can be issued in steady fear of certain objects and situations. Often children are afraid of height, of the dark, the invented monsters, social contacts.
- Panic attacks. The intensive alarm is sometimes shown by increase of vegetative symptoms – dizziness, heartbeat increase, a respiratory spasm, an overstrain of muscles. The child begins to avoid the events capable to provoke panic.
- Post-traumatic stressful frustration. This option of alarm arises as result of experience of the traumatic event which is not fitting into a framework of habitual experience. It is shown by sudden flow of memoirs and nightmares.
Symptoms of disturbing frustration at children
The main symptom – the strong, expressed concern. Patients feel emotionally intense, cannot distract with negative experiences and relax. Because of alarm they experience difficulties with concentration of attention, teenagers report "emptiness in the head" about feeling. The increased nervousness is shown by irritability, tearfulness, fearfulness. Start at unexpected sharp sounds, illumination change, sudden touches is characteristic. The behavior becomes avoiding (restrictive): children refuse communication, walks, active games, travel, the use of some products.
Among physical symptoms of disturbing frustration the causeless fatigue and a bystry exhaustion prevails. Patients complain of dizziness, weakness, head and muscular pains, discomfortable feelings in a stomach and a breast. The increased perspiration, especially in stressful situations, tachycardia, the complicated breath, a tremor and a shiver, feeling of a lump in a throat, heat inflows, a fever can be noted. Appetite is more often reduced, but gluttony with the subsequent nausea and vomiting sometimes develops. Sleep disorders include difficulties of falling asleep, awakening in the middle of the night, nightmares.
Symptoms of fobichesky frustration are steady fears. Fear of situations which actually do not pose a threat is formed or can be dangerous only under certain conditions. Kids of early age are afraid of the dark, heights, maternal separations. At preschool children the imagination actively develops, fears are connected with the fantastic or invented monsters – dragons, dinosaurs, the recovered skeletons, the zombie, werewolves. School students to the forefront have social phobias – fear of communication, acquaintance, a public statement. Teenagers feel fear of loss of control, death, madness, experience of a shame. The alarm after experience of a psychotrauma is characterized by "fleshbeka" – uncontrollable frightening flows of memoirs, nightmares at night.
At obsessivno-compulsive frustration uneasiness is followed by formation of persuasive representations of frightening character. Children mentally lose negative options of succession of events, feeling at the same time fear. Ritual actions – kompulsiya help to cope with emotional pressure to them partly. The most widespread – frequent washing of hands, shuffle of edge of clothes, an obkusyvaniye of nails, circulation on room perimeter. At the panic attacks the alarm arises for no apparent reason and instantly increases, being shown by vegetative symptoms. The health worsens – there is dizziness, darkening in eyes, feeling of estrangement of own personality, unreality of objects and events. The fear of the next panic attack, the avoiding behavior is again formed.
Emotional frustration quite often lead to complications as children are incapable to understand and to critically estimate own experiences. They do not report about the quashed mood and constant feeling of alarm therefore diagnostics is carried out out of time. Teenagers do not tell about the disturbing thoughts, being afraid of misunderstanding and condemnations from people around. The long course of frustration without adequate therapy is complicated by a depression, autichesky changes of behavior. Patients are inclined to self-accusation, feel loneliness, become isolated, avoid communication. The risk of social disadaptation, suicide attempts against the background of a depression increases.
The main examination is conducted by the psychiatrist: talking to parents and the child, he collects kliniko-anamnestichesky data, finds out existence of somatic diseases, congenital pathologies of TsNS, specifies conditions of accommodation, feature of adaptation in kindergarten, school. At prevalence of complaints to a condition of physical health the doctor directs to consultation to the pediatrician, the children's neurologist for performing differential diagnostics. Treat special methods of a research:
- Conversation. During easy communication with the child the expert quite often manages to define the alarm reason – fears, destructive relationship at school and a family, problems with study, memories of a psychotrauma. At the expressed uneasiness children are passive, but become more open at establishment of confidential contact and discussion of the urgent, disturbing subjects.
- Observation. The doctor estimates emotions and behavior of the child. Emotional and motive constraint, hyper reactions to unexpected irritants is characteristic of a disturbing state (noise behind a door, an entrance without the prevention of strangers). Kids often do not want to depart from mother, are afraid to look in the face.
- Questionnaires. Teenagers are offered to answer questions of the standardized techniques for identification of the increased alarm. Spilbergera-Khanin's scale, the test of school uneasiness of Phillips, the test for determination of level of uneasiness of Beck is used.
- Projective tests. The techniques revealing the extramental dominating emotions (fear, concern) and problems in the interpersonal relations are applied to inspection of children of preschool and younger school age. Widespread instruments of diagnostics are pictural tests (the drawing of the person, a family, a nonexistent animal) and projective test "Choose the person" (R. Temml, M. Dorki, V. Amen).
Treatment of disturbing frustration at children
Therapeutic help to children is given by psychiatrists and psychotherapists, but successful rehabilitation requires connection of mother, father and other close relatives. The volume of medical procedures is defined individually: at easy forms of frustration there are enough one psychotherapy course and support of parents, at a heavy current long drug treatment and periodic meetings with the psychologist is necessary. The general scheme of treatment looks as follows:
- Cognitive and behavioural therapy. On sessions the psychotherapist corrects destructive installations, replaces negative judgments positive, trains in skills of management of emotions and solutions of problems. As a result the child learns independently to resolve difficult situations, to resist to influence of stressful influences. If the alarm is based on fears or phobias, technology of systematic desensitization is applied.
- Family psychotherapy. Correction of the increased uneasiness of parents and the problem family relations – factors of development and maintenance of frustration is necessary for elimination of alarm of the child. Interacting with a family, the psychotherapist uses technicians of cognitive psychotherapy, gestalt therapy. It adjusts normal communication between all family members, trains parents better to understand the child, to control emotions, to avoid the situations provoking alarm at the son or the daughter.
- Medicinal therapy. The medicamentous help is shown at moderate and heavy symptoms of alarm. For long-term therapy antidepressants are used. Medicines of the choice are the selective inhibitors of the return capture of serotonin (SIRCS). Application of anksiolitik aged up to 18 years is justified in exceptional cases when there are sharp symptoms. Benzodiazepines are for this purpose used, therapy is carried out in short term.
Forecast and prevention
The probability of recovery in many respects is defined by timeliness of an initiation of treatment and readiness of family members to help the child to cope with emotional problems. At the early address to experts the forecast favorable. Prevention of disturbing frustration is based on the confidential family relation, the correct ways of education which are based on love and respect without hyper guardianship and authoritarianism. It is important to show sincerity, openness in communication, to impart own positive experience of overcoming uncertainty and fears. It is necessary to give support in difficult situations, at failures – to analyze the got experience, to teach the child to draw conclusions.