Diagnosis of a behavioral disorder in a child. Ways to correct children's behavior

Arson, theft, destructive tendencies;

Constant absenteeism of lessons, leaving home, vagrancy;

Tendency to lie, frequent, uncontrollable outbursts of anger;

Defiant behavior, outright disobedience.

Chapter 17 AND TEENAGERS

The behavior of some children and adolescents draws attention to itself as a violation of norms, inconsistency with the advice and recommendations received, differs from the behavior of those who fit into the requirements of the family, the school regime and the morality of society.

“Conduct disorders are characterized by a persistent type of dissocial, aggressive, or defiant behavior. This behavior is at its most extreme goes to the point of marked violation of age-appropriate social norms and is therefore more severe than the usual childish malice or adolescent rebelliousness. Isolated dissocial or criminal acts are not in themselves grounds for a diagnosis of a permanent pattern of behavior” (ICD-10). If a behavioral disorder occurs as a manifestation of other neuropsychiatric disorders, then it is diagnosed within these disorders and coded accordingly.

The diagnosis of conduct disorder can only be made based on the age of the child. In early preschool age, outbursts of anger with appropriate behavior are not a deviation. Violations of civil and property rights by children of preschool age also cannot be grounds for evaluating them as behavioral deviations. The diagnosis of disturbed behavior is made on the basis of excessive pugnacity, hooliganism, cruelty, destructive actions, arson, theft, lying, absenteeism from school, leaving home, unusually frequent and violent outbursts of anger, causing provocative behavior, outright disobedience. Usually, the duration of the described deviations, which is 6 months or more, serves as the basis for an appropriate assessment of behavior. Behavior characterized by a deviation from accepted moral and, in some cases, legal norms is called deviant. It can include anti-disciplinary, anti-social, delinquent (illegal), and auto-aggressive (suicidal and self-injurious) acts. By their origin, they can be caused by various deviations in the development of the personality (dissocial personality disorder, P60.2) and its response. More often, this behavior is the reaction of children and adolescents to difficult life circumstances. It is on the verge of norm and disease and therefore should be evaluated not only by a teacher, but also by a psychologist (doctor). If deviant behavior occurs in children with impaired personality formation or in the process of pathological situational reactions, then it refers to neuropsychiatric pathology. The possibility of deviations in behavior is also associated with the characteristics of physical, psychological development, conditions of education and social environment.

Prevalence. Among psychoneurological disorders of childhood, the prevalence of behavioral disorders is high, an accurate judgment about their number is difficult because the definitions of this concept are formulated differently by different specialists. Among rural children (10-11 years old) it is 4%, and among urban children of the same age it is 2 times higher. In boys, behavioral disorders are 3 times more common than in girls. Of the children who come to the reception in outpatient institutions, from 1/2 to 1/3 - with aggressiveness, behavioral deviations and antisocial behavior.

Systematics. Behavioral deviations in children are classified differently depending on the criteria and ideas about the etiology. G. E. Sukhareva (1959) systematizes behavioral disorders within the framework of psychogenic reactive states based on the severity and intensity of psychotrauma, the ratio of situational and personal moments. V. V. Kovalev (1995) understands behavioral disorders as a kind of psychogenic characterological and pathocharacterological reactions and divides them into reactions of protest, refusal, imitation, compensation and hypercompensation, emancipation, grouping, passion. Here is a description of behavioral disorders in accordance with this taxonomy.

A characterological reaction is a transient, situationally determined change in the child's behavior, which manifests itself mainly under certain circumstances. It is psychologically directed, does not lead to violations of social adaptation and is not accompanied by somatic disorders.

Pathocharacterological reaction - a psychogenic personal reaction, manifested by deviations in the child's behavior; it leads to violations of social and personal adaptation and is accompanied by somatovegetative disorders. Usually it develops on the basis of character, but in the presence of an unfavorable background (accentuation of character, organic insufficiency, disharmonious age crisis) |. immediately takes on pathological forms. An indicator of the transition to a pathocharacterological reaction is behavioral disturbances that appear outside the situation in which they initially

arose, a partial loss of psychological understanding of their occurrence, a greater severity of affective disorders and obvious somatovegetative disorders. As a rule, pathocharacterological reactions violate the adaptation of children to the conditions of family life, the children's team, upset relationships with adults and peers. They become a reason for seeking advice from a specialist (psychologist, doctor).

Conduct disorders in children

Behavioral disorders in children are syndromes characterized by a persistent inability to plan and control behavior, to build it in accordance with social norms and rules. It is manifested by unsociableness, aggressiveness, disobedience, indiscipline, pugnacity, cruelty, severe damage to property, theft, deceit, running away from home. The diagnosis is made by the clinical method, the data are supplemented by the results of psychodiagnostics. Treatment consists of sessions of behavioral, group, family psychotherapy, medication.

Conduct disorders in children

The term "conduct disorder" (BD) is used to refer to repetitive behavior patterns that persist for more than 6 months and do not conform to social norms. RP is the most common diagnosis in child psychiatry. Epidemiology among children is about 5%. There is a gender dependence - boys are more prone to behavioral disorders. In children, the ratio is 4:1, in adolescents - 2.5:1. The decrease in the difference as they grow older is explained by the late debut in girls - years. In boys, the peak incidence occurs at 8-9 years of age.

Causes of conduct disorder in children

Development behavioral disorders is determined by the realization of biological inclinations and the influence of the environment. Studies confirm that the leading role belongs to education, and heredity, psychophysiological characteristics are risk factors. Among the causes of behavioral disorders in children can be identified:

Physiological processes. An imbalance of hormones, excitation-inhibition processes, metabolic disorders contribute to the development of RP. Epilepsy, cerebral palsy are associated with increased risk disobedience, irritability.
Psychological features. The formation of RP is facilitated by emotional instability, low self-esteem, depressed mood, a distorted perception of causal relationships, manifested by a tendency to blame events, other people for their own failures.
Family relationships. Behavioral syndromes in a child are formed with pathological styles of education, frequent conflicts between parents. These reasons are most relevant for families where one or both parents suffer mental illness, lead an immoral lifestyle, are involved in criminal activities, have pathological addictions (drug, alcohol). Intra-family relations are characterized by hostility, coldness, severe discipline or its complete absence, lack of love, participation.
Social interactions. Prevalence behavioral disorders higher in kindergartens, schools with poor organization of the educational process, low moral principles of teachers, high staff turnover, hostile relations between classmates (classmates). The broader influences of society are relations in the territory of residence. In areas with national, ethnic, political fragmentation, there is a high probability of behavioral deviations.

Pathogenesis

The physiological prerequisites for the formation of behavioral disorders in children are changes in the activity of neurotransmitters, an excess of testosterone, and metabolic changes. As a result, the purposefulness of nerve transmission is disrupted, an imbalance in the processes of inhibition and excitation develops. The child is excited for a long time after frustration or is unable to activate volitional functions (directed attention, memorization, thinking). With proper upbringing, a benevolent environment, physiological characteristics are leveled. Frequent conflicts, lack of close trusting relationships, stress become triggers for the realization of biological characteristics and the development of RP.

Classification

IN International classification diseases 10 (ICD-10) conduct disorders are highlighted as a separate heading. It includes:

RP limited to the family. It is characterized by dissocial, aggressive behavior, realized within the home, relationships with mother, father, household. In the yard, kindergarten, school, deviations are extremely rare or absent.
Unsocialized conduct disorder. Manifested by aggressive actions, actions towards other children (classmates, classmates).
Socialized conduct disorder. Aggressive, antisocial acts are committed as part of a group. There are no difficulties in intragroup adaptation. Includes group offenses, truancy, stealing with other children.
Defiant oppositional disorder. Typical for children younger age, is manifested by pronounced disobedience, the desire to break off relations. Aggressive, dissocial acts, offenses are absent.

Symptoms of conduct disorder in children

Behavioral disorders have three main manifestations: unwillingness to obey adults, aggressiveness, antisocial orientation - activity that violates the rights of others, causing harm to property and personality. It is important to consider that these manifestations are possible as a variant of the norm, disobedience is determined in most children, characteristic of crisis stages of development. The disorder is evidenced by a persistent (from six months) and excessive manifestation of symptoms.

Children with behavioral disorders often argue with adults, get angry, do not control emotions, tend to transfer the blame to another person, are touchy, do not obey the rules and requirements, purposefully annoy others, take revenge. Often there is a desire to destroy, damage other people's things. Possible threats, intimidation of peers, adults. Adolescents with RP provoke fights, fights with the use of weapons, enter other people's cars, apartments, set fires, show cruelty towards people, animals, wander, skip school.

Clinical symptoms include depressed, dysphoric mood, hyperactivity manifested by decreased attention, restlessness, and impulsivity. Sometimes depressive states develop, suicide attempts are made, self-harm is inflicted. Destructive behavior negatively affects academic performance, cognitive interest falls. The popularity of the child in the group is low, there are no permanent friends. Due to the problems of accepting the rules, he does not participate in games, sporting events. Social maladjustment exacerbates conduct disorder.

Complications

Complications of conduct disorders develop in adults. Adolescents who have not received treatment are aggressive, prone to violence, an antisocial lifestyle, often have alcohol, drug addiction are involved in criminal gangs or commit offenses on their own. In girls, aggressiveness, antisociality are replaced by emotional and personality disorders: neurosis, psychopathy. In both cases, socialization is violated: there is no education, profession, there are difficulties with employment, maintaining marital relations.

Diagnostics

A child psychiatrist deals with the diagnosis of behavioral disorders in children. The research is based on the clinical method. To objectify the data, psychodiagnostics is additionally carried out, extracts from examinations are collected narrow specialists(neurologist, ophthalmologist), characteristics of educators, teachers, representatives of law enforcement agencies. A comprehensive examination of a child includes the following steps:

Clinical conversation. The psychiatrist finds out the severity, frequency and duration of aggressive, antisocial acts. Clarifies their character, focus, motivation. Talks with the parent about the emotional state of the child: the predominance of sadness, depression, euphoria, dysphoria. Asks about school performance, features of socialization.
observation. In parallel with the conversation, the doctor observes the behavior of the child, the peculiarities of the relationship between him and the parent. Reactions to praise, condemnation are taken into account, it is assessed how relevant behavior is adequate to the situation. The specialist draws attention to the sensitivity of the parent to the mood of the child, the tendency to exaggerate the symptoms, the emotional mood of the participants in the conversation. Taking an anamnesis, monitoring intra-family relationships makes it possible to determine the proportion of biological and social factors in the formation of the disorder.
Psychodiagnostics. Projective Methods, questionnaires are used additionally. They make it possible to identify the state of maladjustment, emotional and personal characteristics, such as aggressiveness, hostility, a tendency to impulsive actions, depression, anger.

Differential diagnosis of behavioral disorders involves distinguishing them from adjustment disorder, hyperactivity syndrome, subcultural deviations, autism spectrum disorders, and a variant of the norm. To do this, the examination takes into account the presence of recent stress, the intentionality of deviant actions, adherence to subcultural groups, the presence of autism, and the development of cognitive functions.

Treatment of conduct disorders in children

Treatment is carried out by methods of child psychotherapy. For severe behavioral disorders that do not allow contact, medications are used. An integrated approach to the elimination of RP involves:

behavioral methods. Based on learning theory, conditioning principles. Techniques are aimed at eliminating unwanted forms of behavior, developing useful skills. A structured, directive approach is used: behavior is analyzed, correction stages are determined, new behavioral programs are trained. The child's compliance with the therapist's requirements is reinforced.
Group psychological trainings. Used after behavioral therapy. Designed to promote the socialization of the child. Conducted in a playful way, aimed at developing the skills of interpersonal interaction, problem solving.
Medical treatment. Preference is given sedatives plant origin. Concomitant emotional disorders, somatovegetative disorders are corrected with benzodiazepine tranquilizers with a vegetative-stabilizing effect. Antipsychotics (small dosages) are individually prescribed.

The child's treatment should be supplemented by family counseling and social rehabilitation measures. Work with parents is aimed at improving the family microclimate, establishing cooperative relations with a clear indication of the boundaries of what is permitted. In the form of training, the correct style of parenting is taught, which involves focusing on the desired behavior of the child, improving self-management skills, and coping in conflict situations.

Forecast and prevention

The prognosis of behavioral disorders in children is favorable with systematic psychotherapeutic assistance. It must be understood that the treatment process is unlimited in time, takes several years, and requires periodic medical supervision. Most often, a positive outcome is observed in the presence of deviant behavior according to one characteristic, for example, aggressiveness, while maintaining normal socialization and academic performance. The prognosis is unfavorable with an early onset of the disorder, a wide range of symptoms, and an unfavorable family environment.

Preventive measures - a favorable intra-family environment, respectful, friendly attitude towards the child, the creation of comfortable material and living conditions. It is necessary to promptly diagnose and treat neurological, endocrine diseases, maintain physical health by organizing regular activity (sections, walks), rational nutrition.

Behavioral disorders in children - treatment in Moscow

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Hyperkinetic conduct disorder.

It is characterized by a lack of persistence in activities requiring mental exertion, a tendency to jump from one activity to another without completing any of them, along with loosely regulated and excessive activity. This can be combined with recklessness, impulsiveness, a tendency to get into accidents, receive disciplinary action due to a thoughtless or defiant violation of the rules. In relationships with adults, they do not feel distance, children do not like them, they refuse to play with them.

Conduct disorder limited to the family.

It includes antisocial or aggressive behavior (protesting, rude), which manifests itself only at home in relationships with parents and relatives. There may be theft from the house, destruction of things, cruelty towards them, arson of the house.

Unsocialized conduct disorder.

It is characterized by a combination of persistent antisocial or aggressive behavior with violation of social norms and with significant violations of relationships with other children. It is characterized by a lack of productive communication with peers and manifests itself in isolation from them, rejection by them or unpopularity, as well as in the absence of friends or empathic mutual bonds with peers. In relation to adults, they show disagreement, cruelty and indignation, less often the relationship is good, but without due trust. There may be associated emotional disturbances. Usually the child or teenager is lonely. Typical behaviors include pugnacity, disorderly conduct, extortion or assault with violence and cruelty, disobedience, rudeness, individualism and resistance to authority, severe outbursts of anger and uncontrollable rage, destructive acts, arson,

Socialized conduct disorder.

It differs in that persistent antisocial (stealing, lying, skipping school, leaving home, extortion, rudeness) or aggressive behavior occurs in sociable children and adolescents. Often they are part of a group of antisocial peers, but they can also be part of a non-delinquent company. Relations with adults representing power are bad.

Mixed, behavioral and emotional disorders combination persistently

aggressive antisocial or defiant behavior with pronounced

symptoms of depression or anxiety. In some cases, the above disorders are combined with persistent depression, manifested by severe

suffering, loss of interest, loss of pleasure from lively, emotional games and activities, self-accusations and hopelessness. In others, behavioral disorders are accompanied by anxiety, timidity, fears, obsessions or worries about their health.

Delinquent behavior.

Misdemeanors are implied, petty offenses that do not reach the degree

crime punishable in judicial order. It manifests itself in the form of absenteeism from classes, communication with anti-social companies, hooliganism, mockery of the small and weak, extortion of money, theft of bicycles and motorcycles. Often there are fraud, speculation, home theft. The reasons are social - the shortcomings of education. 30% -80% of delinquent children have an incomplete family, 70% of adolescents have serious character disorders, 66% are accentuators. Among hospital patients without psychosis, 40% have delinquent behavior. In half of them, it was combined with psychopathy. Runaways from home and vagrancy in a third of cases are combined with delinquency. A quarter of those hospitalized - with shoots.

The first shoots occur in fear of punishment or as a reaction to protest, and

then they turn into a conditioned reflex stereotype. Escapes occur:

As a result of insufficient supervision;

For entertainment purposes;

As a protest reaction to excessive demands in the family;

As a reaction to insufficient attention from loved ones;

As a reaction of anxiety and fear of punishment;

Due to fantasy and reverie;

To get rid of the guardianship of parents or caregivers;

As a consequence of mistreatment by comrades;

Like an unmotivated craving for a change of scenery, which

preceded by boredom, melancholy.

Early alcoholization and narcotization (addictive behavior).

It's the teenage equivalent domestic drunkenness adults and the onset of addiction. In half of the cases, alcoholization and drug addiction begin in

adolescence. More than a third of delinquent adolescents abuse alcohol and are familiar with drugs. Motives for use - to be one's own in the company, curiosity, the desire to become an adult or change one's mental state. In the future, they drink, take drugs for a cheerful mood, for greater looseness, self-confidence, etc. Addictive behavior can be judged first by the appearance of mental (the desire to survive the rise, oblivion) dependence, and then physical dependence (when the body cannot function without alcohol or drugs). The emergence of group mental dependence (the desire to get drunk at every meeting) is a threatening precursor to alcoholism.

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Conduct disorder in children - the content of the medical history

Conduct disorder refers to a set of problematic behaviors exhibited by children and adolescents, which may include a person violating their rights or property. It is characterized by aggression and sometimes delinquency.

This disorder is one of a group of behavioral disorders called disruptive behavior disorders, which include oppositional- defiant disorder(OVD) and Attention Deficit Hyperactivity Disorder (ADHD). Early intervention and treatment is important because children with untreated conduct disorder are at increased risk of developing a range of problems in adulthood, including substance use, personality disorders, and mental illness.

Characteristics of conduct disorder

Some typical behaviors of a child with a disorder may include:

Refusal to obey parents or other authority figures
absenteeism
Addiction to drug use, including tobacco and alcohol, at a very early age
Lack of empathy for others
Vicious and vindictive behavior
Aggression towards animals
Aggression towards people, including intimidation and physical or sexual abuse
Tendency to hang out in gangs
Tendency to fight
Using weapons in fights
Violent behavior - theft, intentional fires, sexual assault and vandalism.
Tendency to run away
Learning difficulties
Low self-esteem
Suicidal tendencies.

A child who develops this disorder is usually irritable and has a difficult temperament in infancy - although most difficult children do not develop conduct disorders.

About a third of children with OAD also have attention deficit hyperactivity disorder (ADHD). Every fifth child at risk is depressed. Behavioral disorder (BCD) is usually diagnosed when a child is between 10 and 16 years old, boys tend to be diagnosed at an earlier age than girls.

Family influence and case history content

The reasons for the non-constructive behavior of the disorder are unknown, but the researchers found that although not all children have family difficulties, the influence of the family on the development of the problem is very significant. Some of the factors that increase a child's risk of getting sick include:

Parents do not set limits on the child's behavior
Parents who do not follow through with the consequences of inappropriate behavior (for example, a parent may threaten to turn off the TV at night but then fail to do so when the child's behavior does not change)
Lack of parental control of a child or teenager
Poverty
big families
Aggressive parents, especially the father
Marital conflicts
Violence in family
Parents with mental health problems
Parents who are involved in breaking the law
Child abuse

Other factors that may contribute to the onset or worsening of a behavioral disorder include:

Gender – boys are twice as likely to get sick than girls
Negative peer group
Alcohol or drug abuse
Mood disorders
Learning difficulties
Post Traumatic Stress Disorder (PTSD)
Depression
Oppositional defiant disorder
Attention Deficit Hyperactivity Disorder (ADHD)
Brain damage.

Without treatment, some of the possible consequences in adulthood for children with a behavioral disorder include:

Mental health problems, including personality disorders
depression
Alcoholism
drug addiction

Behavioral disorder is very similar to other similar disorders such as attention deficit hyperactivity disorder and oppositional defiant disorder, and this makes it difficult to diagnose.

Only a child psychiatrist or pediatrician who specializes in conduct disorder should diagnose a child or adolescent with a conduct disorder.

The professional will make his assessment based on his observations and conversations with parents, peers and teachers.

One of the biggest challenges in treating a child with a behavioral disorder is overcoming distrust of others, especially authority figures. The unwillingness of the child to comply with any rules should also be taken into account. It may take some time to unravel the various factors that contribute to a child's behavior and take appropriate action.

Treatment depends on the individual, but may include:

behavior therapy
cognitive behavioral therapy
Anger management
stress management
social skills
Special educational programs
family therapy
An integrated approach to the family, teachers and other educators
Managing any associated issues
Medications (in case of coexisting depression or ADHD).

Your doctor (he will carefully study the contents of the medical history, make an initial examination and conclusion, and give a referral)
Child or adolescent psychologist
Child psychiatrist

P.S. Download right now here our free guide "How to choose a good doctor" and save yourself from negligent diagnoses and wrong treatment!

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Conduct disorder in children

What is Conduct Disorder in Children -

Conduct disorder is a syndrome that manifests itself in a persistent inability to control behavior, adjusting it to the norms and rules accepted in a given society. In child psychiatry, this problem is the most common, as can be seen from epidemiological studies.

Often, conduct disorder in children is stable, which negatively affects the people around them. It is believed that this syndrome is incurable. It manifests itself in behavioral problems: open disobedience to parents, teachers, educators; aggression and antisocial behavior. Not all disobedience can be attributed to a conduct disorder, these are normal parts of a child's development, and as a child grows up, such behavior fades away (with the right upbringing). The diagnosis is made only when the behavior is both persistent and excessive.

Conduct disorder can vary in severity and is treated through the so-called measured approach. The question of whether conduct disorder is a psychiatric problem has not yet been definitely resolved.

What provokes / Causes of Conduct disorders in children:

The influence of biological parents, according to research, is less than the influence of adoptive parents. Among the risk factors are a natural tendency to a difficult temperament and an unfavorable environment. In the development of antisocial personality and delinquency in adults, genetic influences play a large role.

Provokes behavioral disorders in children the immediate environment and the wider environment.

Surrounding environment

Mental disorder of father or mother
Delinquent Parents
Child education

Disagreements between parents, hostility directed at the baby, lack of warmth, attention and participation affect the formation of a conduct disorder in a child. This can be both a response to the child's behavior that parents do not like, and the cause of such behavior. Inconsistent discipline and lack of supervision also play a role in what the child fails to learn. social rules and obey them. The opposite aspect is also important - too severe discipline - when the child is not given the right to vote and the right to choose, they are punished for the slightest misconduct.

Patterns of Parent-Child Interaction

A fine-grained analysis by Patterson (1994) found that a child's destructive behavior is exacerbated if it gives him the opportunity to get more attention, avoid unpleasant demands, or have his own way more often.

Badly organized and unfriendly teams, low moral principles of teachers, high staff turnover negatively affect the child, causing a disorder of conduct.

It is still not clear whether overcrowding, poor housing, and area poverty are causal factors or markers of other family or socioeconomic variables. Conduct disorders in children and adolescents occur more often in areas where they receive honor and fame for stealing, carrying weapons, skipping classes, where violence used against the weaker and younger is quoted.

Pathogenesis (what happens?) during conduct disorder in children:

Child-specific mechanisms

1. Constitutional characteristics

Suggestions include neurotransmitter imbalances, excess hormones (especially testosterone), and metabolic changes such as low cholesterol. This includes the inability to calm down after frustration - an abnormal form of arousal. Some children with conduct disorder have a lower heart rate and a lower level of arousal in general.

Yet infants whose temperament is classified as "difficult" are more likely to be referred to a doctor later because of problems associated with aggression. Children with neurodevelopmental disorders such as cerebral palsy and epilepsy are more likely to have defiance and irritability problems, but they are no more at risk of severe antisocial behavior than other children.

2. Psychological processes

Aggressive children in frequent situations take neutral words and actions of others as hostile. They react accordingly, which is why the child is increasingly shunned in companies. This entails only aggravation of the negative perception of the actions of others. Social skills are at an extremely low level. Until now, the emotional processes in children with conduct disorder have been little studied. But it is known that they often have low self-esteem, because such children are often sad.

Symptoms of behavioral disorders in children:

The symptoms of conduct disorder syndrome in children change as they get older. Those who are younger show signs of oppositional defiant disorder. These signs are extremely rare in children who do not have conduct disorder.

DSM-IV Criteria for Oppositional Defiant Disorder

Within six months, at least 4 of the following symptoms should appear:

The child often argues with adults
The child often loses his temper
The child often transfers the blame to another person
The child is often offended
The child often refuses to obey the rules and comply with the requirements of adults
The child often displays resentment or anger
The child often deliberately annoys others
The child is often vengeful or spiteful

DSM-IV conduct disorder criteria

During the year, a child with a conduct disorder has at least 3 of the following:

Destroys other people's things or any other property
Threatening, bullying, or intimidating other children and adults
Often provokes fights and brawls
Penetrated into other people's homes or cars
Used serious weapons in fights
Lies and deceives others
Shows physical cruelty towards people
Shows physical cruelty towards animals
Often does not appear at home at night without warning anyone
Participates in thefts with the use of physical force
Ran away from home with an overnight stay twice
Incited someone to engage in sexual activity
Frequently skips school from age 13
Set fire to something with the intent to harm another person

Associated features

Combination of inattention, restlessness, general overactivity, impulsivity.

In 1/3 of children with conduct disorder, unhappiness, sadness and similar emotional symptoms are recorded. Often this leads to depression, intentional self-harm, and suicide attempts.

Many children with conduct disorder have low grades in school, low grades in their level of work. There are often specific learning deficits. Testing has shown that 1/3 of children with conduct disorder have a specific reading disorder. Conversely, about 1/3 of children with a specific reading disorder have a conduct disorder. Three reasons for such regularities were found:

destructive behavior can be negatively associated with the learning process
children who are unable to understand tasks and participate in activities may become destructive as a result of frustration.
both destructiveness in a child and problems with reading may be the result of hyperactivity or non-supportive malevolent parenting or other third factors.

Bad interpersonal relationships

Destructive children often have low popularity in peer groups, often they do not have permanent friends. Such children show poor social skills - not only with peers, but also with adults. It is difficult for them to become full-fledged participants in the game and accept all its rules. Poor peer relationships indicate a poor outcome. According to the International Classification of Diseases ICD-10, conduct disorder can be of two types: socialized and unsocialized. They are divided depending on whether the child has relationships with other children or not.

There is a small percentage of children with conduct disorder who have permanent friends, have altruistic thoughts and actions, are able to feel remorse and guilt, and are able to care for other children and adults. Such children are classified as socialized conduct disorder, they are less involved in antisocial actions: taking alcoholic beverages, absenteeism, theft, fights, etc.

Diagnosis of behavioral disorders in children:

When diagnosing, it is important to obtain information from several sources. Because behavioral problems can only occur in one environment - at home or at school.

The differential diagnosis requires distinguishing conduct disorder in children from such diagnoses:

Symptoms of this diagnosis appear immediately after the child has experienced stress, such as bereavement (death of a relative, for example), parental divorce, adoption, abuse, or severe mutilation. Symptoms last less than six months after the end stressful situation or its consequences.

Hyperactivity is often confused with conduct disorder in a child. Hyperactive children do not show open disobedience, intentional antisocial behavior, aggression towards other people and objects.

Small deviations from the norms accepted in society - indicators normal development child. It's just that educators and parents may have high expectations in relation to the baby.

Some children and adolescents are considered anti-social, but do not show much aggression, the behavior is not too defiant. In subcultures (for example, groups of young people where smoking or carrying weapons are approved) are well adapted.

Often these disorders resolve with destructive behavior and outbursts of anger.

Grade

Specialists find out in detail the severity and frequency of defiant, aggressive and antisocial acts over the past 30 days or so. They also find out from parents about the attention and activity of the child, as well as about his impulsiveness. Although impulsivity may also indicate hyperactivity or normal behavior problems in a normal child. Collect data on emotional symptoms, especially sadness and unhappiness. Often sadness can be due to circumstances that are often repeated - such as the lack of appreciation of the child by the mother, for example. Therefore, the reasons can be reached by interviewing the child face to face.

Consideration should be given to the sensitivity of mom and dad in relation to the moods and needs of the child, whether they take them into account, and to what extent they take them into account. They also record the emotional mood of the parents and their attitude towards the child. An assessment from teachers is also important: is the child able to concentrate, how diligent is he, what kind of relationship with classmates and other children, etc.

Treatment of Behavioral Disorders in Children:

Behavior modification can be very effective in changing one or two specific species antisocial behavior, but usually does not cover all behavior.

Individual psychotherapy sessions

Social skills training

Problem Solving Training

Drug treatment, special diet

Parent management training (high performance)

Exodus

In 40% of children with behavioral disorders, problems and relationship disorders continue in the future. 90% of young adult delinquents had a conduct disorder in childhood.

A bad outcome is predicted if:

Behavior problems had an early onset

There are a lot of symptoms

Behavior is sustainable at home, school, and other environments

Has associated hyperactivity

Mom or dad has a mental disorder

There are criminals in the family

There is strong hostility and discord in the family, which affects the child.

Which doctors should you contact if you have Conductive Disorder in Children:

Are you worried about something? Do you want to know more detailed information about Conduct disorders in children, its causes, symptoms, methods of treatment and prevention, the course of the disease and diet after it? Or do you need an inspection? You can make an appointment with a doctor - the Eurolab clinic is always at your service! The best doctors examine you, study the external signs and help identify the disease by symptoms, advise you and provide needed help and make a diagnosis. You can also call a doctor at home. The Eurolab clinic is open for you around the clock.

The phone number of our clinic in Kiev: (+3 (multi-channel). The clinic secretary will select a convenient day and hour for you to visit the doctor. Our coordinates and directions are listed here. Look in more detail about all the services of the clinic on its personal page.

If you have previously performed any studies, be sure to take their results for a consultation with a doctor. If the studies have not been completed, we will do everything necessary in our clinic or with our colleagues in other clinics.

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If you want to ask a doctor a question, use the online consultation section, perhaps you will find answers to your questions there and read tips on self-care. If you are interested in reviews about clinics and doctors, try to find the information you need in the All Medicine section. Also, register on the Eurolab medical portal to be constantly up to date with the latest news and information updates on the site, which will be automatically sent to you by mail.

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Many behaviors of children or adolescents are of concern to parents or other adults. Behavioral disturbances or individual behaviors become clinically significant if they are frequently repeated or observed consistently and are inappropriate (eg, affect emotional maturation or social or cognitive function). Severe behavioral disorders can be classified as mental disorders(eg, defiant oppositional disorder or conduct disorder). Prevalence may vary depending on how behavioral disorders are defined and evaluated.

Survey

The diagnosis includes a multi-stage behavioral assessment. Problems that occur in children in their first years of life usually relate to functions such as eating, defecation, sleep, while in older children and adolescents, problems are mainly noted in the area of interpersonal communication and behavior (eg, activity level, disobedience, aggression).

Identification of the violation. Behavioral disturbance may appear suddenly as a single episode (eg, arson, school fight). More often, signs appear gradually and information must be collected over time. It is best to evaluate the child's behavior in the context of his mental and mental development, general health, temperament (eg, difficult, carefree), and relationships with parents and others around the child.

Direct observation of the relationship between the child and parents during a visit to the doctor provides valuable information, including the reaction of parents to the actions of the child. These observations are supplemented, if possible, by information from relatives, teachers, caregivers and school nurses.

When talking with parents or caregivers, you can find out routine child's day. Parents are asked to give examples of events that precede and follow certain actions or behaviors of the child. Also, parents are asked about their interpretation of age-specific behaviors, expectations from the child, the level of parental interest in the child, the availability of support (for example, social, emotional, financial) in fulfilling their role as parents, and the nature of relationships with other family members.

Problem interpretation. Some "problems" represent inadequate parental expectations (for example, that a 2-year-old child will assemble toys by himself without any help). Parents misunderstand certain age-specific behaviors as violations (for example, defiant behavior in a 2-year-old child, i.e. the child refuses to follow the rules or requirements of adults).

The child's history may include looking for factors that are thought to increase the likelihood of developing behavioral problems, such as exposure to toxins, complications during pregnancy, or severe illness in a family member. Low level Parent-child interactions (eg, indifferent parents) lead to subsequent behavioral problems. Benevolent reactions of parents to the problem can worsen it (for example, parents overprotect a timid child who does not leave them a single step, or follow the lead of a child who manipulates them).

In young children, some problems develop through the mechanism vicious circle when the parent's negative reaction to the child's behavior leads to the child's negative reaction, which in turn leads to continued negative parental reaction. With this mechanism of behavior, children are more likely to respond to stress and emotional discomfort with stubbornness, sharp objections, aggressiveness, outbursts of irritation, rather than crying. In the most common mechanism of behavior of the type of a vicious circle, parents in response to the aggressive and stubborn behavior of the child scold him, scream and may spank him; after that, the child provokes the parents even more by doing the actions that caused such a reaction of the parents, and in response they react to this more strongly than initially.

In older children and adolescents, behavioral problems may be a manifestation of a desire for independence from parental rules and supervision. Such problems should be distinguished from random errors in judgment.

Treatment of behavioral disorders and problems in children

Once a problem is identified and its etiology determined, early intervention is preferable because the longer the problem exists, the more difficult it is to correct.

The physician must reassure the parents that there is nothing physically wrong with their child (for example, that a behavioral disorder is not a sign of a physical illness). By identifying parental frustration and pointing out the prevalence of various behavioral disorders, a clinician can often reduce parental guilt and make it easier to find possible sources of the problem and ways to treat it. For simple violations, it is often enough to educate the parents, reassure them, as well as a few specific tips. Parents should also be reminded of the importance of spending at least 15-20 minutes a day in enjoyable interaction with their child. Parents should also be advised to regularly spend time away from their child. For some problems, however, it is useful to apply additional methods to discipline the child and modify his behavior.

The doctor may advise parents to limit the child's search for independence, as well as his manipulative behavior, which allows you to restore mutual respect in the family. The desired as well as unacceptable behavior of the child should be clearly defined. It is necessary to establish permanent rules and restrictions, parents must constantly monitor their observance, providing due rewards for their successful implementation and consequences for inappropriate behavior. Positive reinforcement of conforming behavior is a powerful tool that has no negative effects. Parents should try to minimize anger by insisting that rules be followed and increase positive contact with the child (“praise the child when he is good”).

Ineffective punishments can lead to behavioral problems. Scream or physical punishment capable of a short time control the child's behavior, but can ultimately reduce the child's sense of security and self-esteem. Threats to abandon the child or send him away are traumatic for him.

A good way to influence the child's unacceptable behavior is the "time out" technique, in which the child has to sit for a short period of time alone in a sparsely occupied boring place (corner or room, other than the child's bedroom, which does not have a TV and toys, but which should not be dark or scary). Time-outs are a learning process for a child and are best used for one or few misbehavior at a time.

The vicious circle mechanism can be interrupted if parents ignore the child's actions that do not interfere with others (for example, refusing to eat), and distract attention or temporarily isolate the child if his behavior cannot be ignored (public tantrums, temper tantrums).

If the behavior does not change within 3-4 months, it is necessary to re-examine such a child, evaluating the problem; an evaluation of his mental health may be shown.

"Time out" method

This disciplinary method is best applied when the child realizes that his behavior is wrong or unacceptable; usually this method is not used in children under 2 years of age. Care should be taken to use this technique in a children's group, for example in a kindergarten, as this can lead to the fact that the child will feel humiliated.

This method is used when the child knows that his behavior is leading to a "time out", but still does not correct it.

The child is explained the reasons for the punishment and is told to go sit in the "time out chair" or, if necessary, take them there themselves.

The child should sit on a chair for 1 minute per year of life (maximum 5 minutes).

If the child gets up from the chair before the allotted time, he is returned to his place and the time is recorded again. If the child immediately rises from the chair, it may be necessary to hold him (but not on his knees). At the same time, conversations with the child and eye-to-eye contact are avoided.

If the child remains sitting on the chair, but does not calm down for all the allotted time, the time is recorded again.

When the time-out expires, the child is asked about the reason for the punishment, avoiding anger and irritation. If the child cannot name it, he is briefly reminded of the correct reason.

Shortly after the time-out, the child should be praised for good behavior, which is easier to achieve if the child is engaged in a different activity than the one in which he was punished.

References

Neonatology - A.K. Tkachenko, A.A. Ustinovich, A.V. Sukalo, A.V. Solntseva, L.V. Grak, E.K. Khrustalev. 2009
Clinical neonatology - Khazanov A.I. 2009
Neonatal Resuscitation - Kattwinkel J. 2007
Neonatology - R. Rooz, O. Genzel-Borovichi, G. Prokitte - Practical recommendations. 2010

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Introduction

Bibliography

Introduction

Behavior is the way a person expresses himself in Everyday life. Behavior is defined as a set of actions in relation to objects of animate and inanimate nature, to an individual person or society, mediated by external (motor) and internal (mental) activity of a person.

Various shortcomings in the behavior of school-age children hinder the formation of arbitrariness - an important personality trait, disrupt educational activities, make it difficult to master, and negatively affect the child's relationship with adults and peers. To a greater extent, this is characteristic of children at risk. Therefore, correcting shortcomings in the behavior of children at risk is an important component of the education and development of these children in the system of correctional and developmental education.

By school age, in the process of communicating with adults (and then with peers), the child develops a certain behavioral repertoire, in which “favorite” behavioral reactions and actions are necessarily present. According to E. Berne, the mechanism here is as follows: in difficult situations, the child experiments using various behaviors, and discovers “that some of them are found in his family with indifference or disapproval, while others bear fruit. Having understood this, the child decides what behavior he will cultivate.

The younger student, while maintaining the old forms of communication with adults, learns business cooperation and management of his behavior already in educational activities. Thus, managing one's behavior is the most important neoplasm of senior preschool and primary school age.

What factors largely determine the arbitrariness of a child's behavior? These are self-esteem, self-control, the level of claims, value orientations, motives, ideals, personality orientation, etc.

1. Causes of deviations in behavior

The causes of deviations in behavior are varied, but they can all be classified into 4 groups:

* In some cases, behavioral disorders have a primary conditionality, i.e. are determined by individual characteristics, including the neurodynamic properties of the child:

* Instability of mental processes,

* Psychomotor retardation or vice versa.

* Psychomotor disinhibition.

These and other neurodynamic disorders manifest themselves mainly in hyperexcitable behavior with emotional instability characteristic of such behavior, ease of transition from increased activity to passivity and, conversely, from complete inactivity to disordered activity.

2. In other cases, behavioral disorders are the result of an inadequate (defensive) response of the child to certain difficulties in school life or to a style of relationship with adults and peers that does not satisfy the child. The behavior of the child in this case is characterized by indecision, passivity or negativism, stubbornness, aggression. It seems that children with such behavior do not want to behave well, they deliberately violate discipline. However, this impression is erroneous. The child is really not able to cope with his experiences. The presence of negative experiences and affects inevitably leads to breakdowns in behavior, is the reason for the emergence of conflicts with peers and adults.

3. Often, bad behavior occurs not because the child specifically wanted to break discipline or something prompted him to do so, but from idleness and boredom, in an educational environment that is not sufficiently saturated with various types of activities.

4. Violations of conduct are also possible due to ignorance of the rules of conduct.

2. Typical Violations behavior

Hyperactive behavior (due, as already mentioned, mainly to neurodynamic personality traits).

Perhaps, the hyperactive behavior of children, like no other, causes complaints and complaints from parents, educators, and teachers.

These children have an increased need for movement. When this need is blocked by the rules of behavior, the norms of the school routine (i.e., in situations in which it is required to control, arbitrarily regulate one’s motor activity), the child’s muscle tension, attention worsens, working capacity decreases, fatigue sets in. Following this emotional release is a protective physiological reaction of the body to excessive overvoltage and is expressed by uncontrolled restlessness, disinhibition, qualifying as disciplinary offenses.

The main signs of a hyperactive child are - physical activity, impulsiveness, distractibility, inattention. The child makes restless movements with the hands and feet; sitting on a chair, writhing, wriggling; easily distracted by extraneous stimuli; hardly waits for his turn during games, classes, in other situations; often answers questions without hesitation, without listening to the end; has difficulty maintaining attention when performing tasks or during games; often jumps from one unfinished action to another; cannot play quietly, often interfere with the games and activities of other children.

demonstrative behavior. With demonstrative behavior, there is a deliberate and conscious violation accepted norms, rules of conduct. Internally and externally, this behavior is addressed to adults.

One of the options for demonstrative behavior is childish antics, which has the following features:

* the child makes faces only in the presence of adults and only when they pay attention to him;

* when adults show the child that they do not approve of his behavior, the antics not only do not decrease, but even increase.

What prompts the child to use demonstrative behavior?

Often this is a way to attract the attention of adults. Children make such a choice in those cases when parents communicate with them little or formally (the child does not receive the love, affection, warmth that he needs in the process of communication), and also if they communicate exclusively in situations where the child behaves badly and he should be scolded , punish. Having no acceptable forms of contact with adults, the child uses a paradoxical, but the only form available to him - a demonstrative trick, which is immediately followed by punishment. That. "communication" took place. But there are also cases of antics in families where parents communicate with children quite a lot. In this case, the antics, the very blackening of the child “I am bad” is a way to get out of the power of adults, not to obey their norms and not give them the opportunity to condemn (since condemnation - self-condemnation - has already taken place). Such demonstrative behavior is predominantly common in families (groups, classes) with an authoritarian style of educator, authoritarian parents, educator, teacher, where children are constantly condemned.

One of the options for demonstrative behavior is whims - crying for no particular reason, unreasonable masterful antics in order to assert themselves, to attract attention to "take over" adults. Whims are accompanied by motor excitement, rolling on the floor, scattering toys and things. Occasionally, whims can occur as a result of overwork, overexcitation nervous system child with strong and varied impressions, as well as a sign or consequence of an onset of the disease.

From episodic whims, it is necessary to distinguish entrenched whims that have turned into a habitual form of behavior. The main reason for such whims is improper upbringing (spoiltness or excessive severity on the part of adults).

Protest behavior:

Forms of protest behavior of children - negativism, obstinacy, stubbornness.

Negativism is the behavior of a child when he does not want to do something just because he was asked about it; this is the reaction of the child not to the content of the action, but to the proposal itself, which comes from adults.

Typical manifestations of children's negativism are unreasonable tears, rudeness, insolence or isolation, alienation, touchiness. "Passive" negativism is expressed in a silent refusal to fulfill instructions, demands from adults. With “active” negativism, children perform actions opposite to those required, strive to insist on their own at all costs. In both cases, children become uncontrollable: neither threats nor requests have any effect on them. They steadfastly refuse to do what until recently they performed unquestioningly. The reason for this behavior often lies in the fact that the child accumulates an emotionally negative attitude towards the demands of adults, which impede the satisfaction of the child's need for independence. Thus, negativism is often the result of improper upbringing, a consequence of the child's protest against the violence committed against him.

“Stubbornness is such a reaction of a child when he insists on something, not because he really wants it, but because he demanded it ... the motive of stubbornness is that the child is bound by his original decision” (L.S. Vygotsky)

The reasons for stubbornness are varied:

* this may be a consequence of an irresolvable conflict between adults;

* stubbornness may be due to general overexcitability, when the child cannot be consistent in the perception of an excessively large number of advice and restrictions from adults;

* and may be the cause of stubbornness for a long time emotional conflict, stress that cannot be resolved by the child on their own.

Obstinacy differs from negativism and stubbornness in that it is impersonal, i.e. directed not so much against a specific leading adult, but against the norms of upbringing, against the way of life imposed on the child.

Aggressive behavior is purposeful destructive behavior, the child contradicts the norms and rules of people's life in society, harms the “objects of attack” (animation and inanimateness), causes physical damage to people and causes them psychological discomfort (negative experiences, a state of mental tension, depression, fear).

Aggressive actions of the child can act as:

* means to achieve a meaningful goal for him;

* as a way of psychological relaxation;

* replacement of a blocked, unmet need;

* as an end in itself, satisfying the need for self-realization and self-affirmation.

The reasons for aggressive behavior are varied:

* a dramatic event or need for the attention of adults, other children,

* an unsatisfied need to feel strong, or a desire to make up for one's own grievances,

* problems that appear in children as a result of learning,

* a decrease in emotional sensitivity to violence and an increase in the likelihood of the formation of hostility, suspicion, envy, anxiety - feelings that provoke aggressive behavior due to exposure to drugs mass media(systematic viewing of films with scenes of cruelty);

* deformation of the value system in family relations;

* disharmonious relationships between parents, aggressive behavior of parents towards other people.

infantile behaviour.

Infantile behavior is said to be in the case when the child's behavior retains features inherent in an earlier age.

Often, during a lesson, such a child, disconnecting from the educational process, imperceptibly begins to play (rolls a typewriter around the map, launches airplanes). Such a child is unable to independently make a decision, perform some action, feels a sense of insecurity, demands heightened attention to one's own person and the constant care of others about oneself; He has low self-criticism.

Conformal behavior - such behavior is completely subordinate external conditions the requirements of other people. These are super-disciplined children deprived of freedom of choice, independence, initiative, creative skills (because they have to act on the instructions of an adult, because adults always do everything for the child), acquire negative personality traits. In particular, they have a tendency to change their self-esteem and value orientations, their interests, motives under the influence of another person or group they are included in, significant to them. Psychological basis conformity are high suggestibility, involuntary imitation, "infection".

Conformal behavior is largely due to incorrect, in particular authoritarian or hyper-protective, parenting style.

symptomatic behavior.

A symptom is a sign of a disease, some painful (destructible, negative, disturbing) phenomenon. As a rule, the child's symptomatic behavior is a sign of trouble in his family, at school, it is a kind of alarm signal that warns that the current situation is further unbearable for the child. For example, a 7-year-old girl came from school, scattered books and notebooks around the room, after a while she collected them and sat down for lessons. Or, vomiting - as a rejection of an unpleasant, painful situation at school, or a temperature on the day when the test should take place.

If adults make mistakes in interpreting children's behavior, remain indifferent to the child's experiences, then the child's conflicts are driven deeper. And the child unconsciously begins to cultivate a disease in himself, as it gives him the right to demand increased attention to himself. Making such a “flight into illness”, the child, as a rule, “chooses” exactly that illness, that behavior (sometimes both at the same time) that will cause the most extreme, most acute reaction from adults.

3. Pedagogical correction of typical deviations in the behavior of children

behavior children deviation correction

Overcoming the shortcomings of personal development, the behavior of children is possible if 3 main factors are observed:

1 - preventive work which involves as early as possible the identification and correction of negative phenomena in the behavior and personal development of children;

2 - not a superficial explanation of actions, but a deep pedagogical analysis (identifying the real reasons, differentiated approach for elimination);

3 - not the use of a separate isolated methodology, technology, but a change in the entire organization of the child's life (i.e., a change in the entire system of relationships between the child and his social environment). BUT! The effective construction of such a system is possible only as a result of the joint efforts of both the child himself and parents, educators, and teachers.

Depending on the identified difficulties in the personal development of the child, the tactics of correctional and developmental work are chosen.

General rules that must be observed when working with children who have certain behavioral deficiencies.

1. Focus on the behavior, not the personality of the child.

Those. the adult's reaction to the child's unacceptable behavior should demonstrate that "You are good and can be even better, but your behavior is terrible now."

2. When explaining to a child why his behavior is unacceptable and upsets adults, avoid the words “stupid”, “wrong”, “bad”, etc. because subjective evaluative words only cause offense in the child, increase the irritation of adults and, as a result, lead away from solving the problem.

3. When analyzing the child's behavior, limit yourself to a discussion of what happened now. turning to a negative past or a hopeless future leads both the child and the adult to the idea that today's incident is something inevitable and irreparable.

4. Reduce rather than increase the tension of the situation. The following common mistakes should be avoided:

* have the last word

* evaluate the character of the child,

* use physical strength

* involve other people who are not involved in the conflict,

* make generalizations like: "You always do this",

* compare one child with another.

5. Demonstrate to children models of desirable behavior.

6. Throughout the entire educational and correctional work, it is necessary to maintain systematic contact with parents.

Bibliography

1. Belkin A.S. The theory of pedagogical diagnostics and prevention of deviations in the behavior of schoolchildren. /Abstract. dis. doc. ped. Sciences. - M.: 2003. - 36 p.

2. Varga A.Ya. Psychodiagnostics of deviant behavior of a child without anomalies mental development/ The psychological status of the individual in various social conditions: development, diagnosis and correction. - M.: MGPI. - 2002. - S. 142-160.

3. Vygotsky L.S. Pedagogical psychology / Ed. V.V.Davydova.- M.: Pedagogy-Press, 2002.- S. 263-269.

4. Levitov N.D. Mental condition aggression // Vopr. Psychology, No. 6, 1972.- S. 168-173.

5. Lesgaft P.F. Family education of the child and its significance./P.F. Lesgaft - M.: Pedagogy, 1991. - S. 10-86.

6. Lichko A.E. Psychopathies and character accentuations in adolescents.// Vopr. psychology, N 3, 2003. - S.116-125.

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Behavioral disorders in children

Manifestations of physical cruelty, outbursts of anger, deliberate destruction of someone else's property, infliction of pain, humiliation, often started fights - these symptoms are directly related to one of the topical and debatable problems of psychology - the phenomenon of personality aggressiveness. The manifestation of aggression in children and educational institutions is an issue of increasing concern to educators and parents. Interest in the declared topic is explained by the growing attention to it from researchers of various specialties - psychologists, sociologists, thereby reflecting the social demands of a society that is experiencing an increased impact of violence and cruelty. The relevance of the chosen topic is also determined by the importance of aggressiveness in the structure of a person's personality, its influence on the formation of certain forms of behavior, constructive, socially approved or, conversely, destructive, giving actions an asocial character.

Today it is no longer possible to imagine a newspaper, a magazine or a radio or television news program where there would not be a single report of any act of aggression or violence. Statistics convincingly testify to the frequency with which people injure and kill each other, inflict pain and suffering on their loved ones. However, records of manifestations of violence in other times and places suggest that there is nothing out of the ordinary in the cruelty and violence that reigns in our world.

Of course, even when people maim and kill each other with spears, bows, arrows and other primitive weapons, their actions are destructive and lead to unnecessary suffering. However, earlier such battles, as a rule, took place in a limited area and did not pose a threat to humanity as a whole. The use of modern, incomparably more powerful types of weapons can lead to a global catastrophe...

In the light of these trends, it is impossible not to recognize that violence and conflict are among the most serious problems facing humanity today. Questions arise: why do people act aggressively and what measures should be taken in order to prevent or control such destructive behavior?

These questions occupied the best minds of mankind for many centuries and were considered from various positions - from the point of view of philosophy, poetry and religion. However, only in our century this problem has become the subject of systematic scientific research. The tense, unstable social, economic, ecological, ideological situation that has currently developed in our society causes the growth of various deviations in the personal development and behavior of the younger generation. Among them, not only the progressive alienation, increased anxiety, and spiritual emptiness of children, but also their cynicism, cruelty, and aggressiveness are of particular concern. Moreover, the problem of the aggressiveness of children, which affects society as a whole, causes both a deep concern of teachers and parents, and an acute scientific and practical interest of researchers. However, attempts to explain the aggressive actions of children are hampered by the fact that not only in everyday consciousness, but also in professional circles and in many theoretical concepts, the phenomenon of aggression receives very contradictory interpretations, limiting both its understanding and the possibility of influencing the leveling of aggressiveness.

Of particular concern to both parents and specialists are models of aggression shown on television, videos used in computer games. And this is no coincidence, because both verbal and physical aggression on our television screens are not at all uncommon. So, according to the results of special studies, in the most popular television programs for every hour of broadcasting, there are on average about nine acts of physical and eight acts of verbal aggression. Thus, a child who spends only two hours watching TV, for example, sees on average more than 17 acts of aggression per day. But even the announcements of TV programs are not free from showing sex and violence; foreign researchers report, for example, that sex and violence, one way or another, appear in more than 60% of prime-time television announcements. This statistic, unfortunately, is also recognizable in our Russian reality.

Because children are so often exposed to violence in the media, many people express concern that such a "video diet" may increase children's propensity for aggressive behavior. And it is no coincidence that this topic, which is of particular interest to psychological science and has a high social significance, has recently attracted more and more close attention of researchers.

Behavioral disorders associated with manifestations of aggressiveness and cruelty can be considered in the context of deviant development, deviant behavior and psychopathological personality traits.

N.Ya. Semago and M.M. Semago under the term « deviant development" understand any deviation of a separate function or system of mental functions from the “development program”, regardless of the sign of this change “+” or “-” (advance or delay), which goes beyond the socio-psychological standard determined for a given educational, socio-cultural or ethnic situation and given age of the child. A child showing such phenomena should be classified as a developmentally deviant child.

So, asynchronous development characterized by a violation of the basic principle of development (heterochrony), when there are complex combinations of underdevelopment, accelerated (accelerative) development, distorted development of both individual mental functions and the structure of their basic components (with a predominant violation of the basic affective component). At the same time, it should be noted that the asynchrony of development is also inherent in various categories of other distinguished development groups, i.e. is not absolutely specific for this group of deviant development.

Children demonstrating various behavioral disorders are classified as a subgroup of disharmonious development (one of the variants of asynchrony). The nature of the affective response of children of the extrapunitive type of disharmonious development is associated with elements of negativistic and protest forms of behavior, and sometimes with demonstrative negativity. Children of this type may demonstrate aggressive and protest reactions against the background of fatigue. They are extremely demanding of others (like a “little monster” in the family), they may consciously demonstrate reactions characteristic of a younger age, or, conversely, demand recognition as a leader, even without factual grounds. They are often irritable, easily moving from dysphoria to euphoria. Under unfavorable conditions of development, the authors point out, the emergence of asocial forms of behavior, as a rule, of a group character, is likely. The most typical diagnoses of other specialists for children and adolescents of this type of development are: "personality formation according to the hysterical type", "neurosis-like reactions", "excitable type psychopathy", "hysterical neurosis", "pathological personality formation", "conduct disorder" (F91 ), in particular, causing oppositional disorder "(F91.3) according to ICD-10.

The International Classification of Mental and Behavioral Disorders, 10th Revision (ICD-10), under the code F91 "Behavioral Disorders" in children and adolescents, describes in detail the symptoms when there is repetitive and persistent behavior that violates the rights of others or the most important age-appropriate social norms or rules. Such behavior must be observed for at least 6 months and include the following manifestations:

unusually frequent outbursts of anger for his age;
often argues with adults;
often actively refuses to comply with the demands of adults;
often deliberately does things that annoy other people;
often touchy and easily annoyed;
often angry and indignant;
often vicious and vengeful;
often starts fights;
used a weapon that is capable of causing serious harm to other people (for example, a brick, a club, a broken bottle, a knife);
shows physical cruelty towards other people and animals;
deliberately destroys another's property;
deliberately starts a fire with the risk or desire to cause serious damage;
commits crimes in front of the victim;
frequent manifestations of bullying behavior (for example, deliberate infliction of pain, humiliation, torment), etc.

By the manifestation of certain symptoms, a conclusion is made about unsocialized and socialized behavioral disorders, oppositional defiant behavior and unspecified behavioral disorders of childhood and adolescence.

Deviant behavior is called such behavior, in which deviations from social norms are steadily manifested: cultural, moral, legal. Family dysfunctionality is considered to be the main factor that plays a role in the development of deviant behavior. There are deviations:

- selfish type- offenses and actions with the aim of illegally obtaining material, monetary and property benefits (theft, bribes, theft, etc.);

- aggressive type- are manifested in actions directed against a person (insults, beatings, murders);

- socially passive type - refusal from active life, from their civic duties (deviation from work, study, use of alcohol, drugs, toxic drugs; the extreme manifestation is suicide), social roles.

V.D. Mendelevich reveals the following types deviant behavior:

delinquent- deviant behavior, in its extreme manifestations representing a criminally punishable act;

addictive- one of the forms of deviant behavior with the formation of a desire to escape from reality by artificially changing one's mental state;

pathocharacterological- this type is understood as behavior due to pathological changes in character, formed in the process of education;

psychopathic- is based on psychopathological symptoms and syndromes that are a manifestation of certain mental illnesses.

Deviant behavior is the result of unfavorable psychosocial development and disruption of the socialization process, which are expressed in various forms of child and adolescent maladjustment at an early age, for example, in the assimilation of social roles, curricula, norms, requirements. Depending on the nature and nature of maladaptation, pathogenic, psychosocial and social maladaptation are distinguished. Each can be both separately and in a complex combination.

Pathogenic disadaptation is caused by deviations and pathologies of mental development and neuropsychiatric diseases, the cause of which is functional-organic lesions of the central nervous system.

Psychosocial maladaptation is associated with the age and sex and individual psychological characteristics of the child, adolescent. By their nature and character, various forms of psychosocial maladjustment are divided into stable and temporary, unstable forms. Sustainable forms can arise due to character accentuations, inadequate self-esteem, violations of the emotional-volitional and emotional-communicative sphere (insufficient empathy, disinhibition or pathological shyness, etc.).

Social maladjustment is manifested in violation of the forms of morality and law, in asocial forms of behavior and deformation of the system of internal regulation, social attitudes. Two stages of social maladaptation of adolescents can be distinguished - pedagogical and social neglect.

So, describing the signs of social maladaptation of children and adolescents associated with "deformities" of character, N.M. Iovchuk as an illustration hysterical psychopathy gives examples of high conflict, seizures and protest reactions (rudeness, aggression, auto-aggression, refusal to attend school, etc.) in children and adolescents. At excitable (explosive) psychopathy typical manifestations of capriciousness, resentment, cruelty and gloom, unmotivated malice in communication with peers, parents. For the most insignificant reasons, such children may experience bouts of anger, rage, inadequate screaming, anger and active protest. At school age, they demonstrate antisocial and illegal behavior (fights, departures, the desire to do "out of spite"). epileptoid psychopathy, although it is characterized by viscosity, getting stuck in emotionality and in thinking, it can combine attacks of anger, affective discharges with aggressiveness, cruelty, a sadistic desire to hurt oneself and others. Such children are conflicted, suspicious, unfriendly, suspicious and picky. Their adaptation at school, behavior at home remain difficult due to vindictiveness, petty nitpicking, periods of discontented-angry mood and outbursts of rage. In the absence of proper upbringing, school maladjustment, leading to refusal to attend school, can develop in the clinic. psychopathy of an unstable circle. Disobedience, restlessness, ease of mastering negative forms of behavior, petty offenses, a tendency to deceit and absenteeism, alcohol and drug use often lead such children to asocial groups, they can enter the criminal path early . A group of "emotionally dumb" individuals includes manifestations of this type of psychopathy from an early age: deceit, cruelty, underdevelopment of higher moral feelings. Such children bully the younger ones, torture animals, are hostile even to their parents, swear at school, fight, start stealing and wandering early, and embark on a criminal path.

Compensation for personality anomalies involves a complex of social, environmental, medical, psychological and pedagogical influences. Important corrective factors are: improvement of the environment, isolation of the child from persons with antisocial behavior, psychotherapeutic work with the child and family, assistance in adaptation and emotional support adults, drug treatment prescribed by a psychiatrist.

Considering the clinical and dynamic signs of various types of aggression, Yu.B. Mozhginsky describes the signs of various variants of aggression associated with psychopathological personality traits within the framework of mental illness.

impulsive-sadistic aggression is a psychopathological variant of aggressive actions related to manifestations of disorders of the morbid-psychotic level. It combines a sadistic complex and automated actions. Committed with particular cruelty, often serial murders include an impulsive component in the form of stereotypical multiple knife blows, sudden arousal against the background of a change in consciousness, followed by amnesia. These violations are associated with a sadistic complex.

At overvalued aggression the motivation for violent actions is formed on the basis of pathological overvalued ideas of persecution, revenge, and murder. This option may include states in which these ideas reach the level of delusions with separate hallucinatory experiences. There may also be cases with deep mental disorders, when the ideas of revenge are associated with specific circumstances, have a psychologically understandable causal relationship with the situation and do not contain such psychotic symptoms like hallucinations.

hallmark defensive aggression is the presence of a real, immediate threat to life and health, for the preservation of which appropriate violent actions are taken. These actions can sometimes contain signs of both impulsive-sadistic and overvalued aggression.

Signs of the formation of aggressiveness can be found throughout the development of personality. Absolutely unreasonable mood swings, periods of anger, all-encompassing diffuse fear and suspicion, unmotivated cheerfulness, sudden, abrupt, unrelated changes in character and behavior discovered by others or relatives can be manifestations of the main dynamics of aggressiveness. Staged manifestations of aggressiveness are represented by psychologically more understandable manifestations: in childhood - disinhibition, pugnacity, sadistic actions, theft, the desire to hurt peers or helpless people; later, during puberty, stage syndromes are found in the form of departures from home, opposition to close circle, the use of intoxicants .

Thus, each aggressive action that has a pathological nature is included in the structure of certain psychopathological aggressive symptom complexes with its own dynamics of development. Studies of cases of severe aggressive acts lead to the discovery of the origins of this pathology in early childhood and in different periods late childhood and adolescence. This area of manifestations of aggression belongs to the field of activity of psychiatrists, medical psychologists, and a child demonstrating such behavior needs mandatory consultation with specialist doctors and the help of psychologists. It should be noted that only a systematic approach to the problem of preventing and correcting behavioral disorders and aggression in children and adolescents can be an effective means of helping this category of children. The system of psychological assistance should include a targeted impact on the entire socially significant environment of the child, including parents and teachers.

Behavioral disorders, manifestations of aggression in children's and educational institutions are a problem that worries teachers and parents more and more. The emergence of a large amount of literature by domestic and foreign psychologists on the problems of behavioral disorders, aggressiveness and methods of prevention, correction of these conditions is determined by the growing attention to it from researchers of various specialties - psychologists, sociologists, thereby reflecting the social demands of a society that is experiencing an increased impact of violence. and cruelty.

However, in our opinion, it is much easier to prevent the problem of behavioral disorders in children and adolescents than to work with already formed and stable aggressive tendencies, defensive aggression and oppositional defiant disorders in childhood and adolescence.

Bibliography

Baron R., Richardson D. Aggression. SPb., 1997. 336 p.
Mendelevich V.D.. Clinical and Medical Psychology: A Practical Guide. M., 1998. 592 p.
Mozhginsky Yu.B. Adolescent aggression: Emotional and crisis mechanism. SPb., 1999. 128 p.
Parens G. Aggression of our children / Per. from English. M., 1997. 160 p.
Semago N.Ya., Semago M.M. Problem children: the basics of diagnostic and corrective work of a psychologist. M., 2001. 208 p.
Sokolova E.V. Deviant development: causes, factors, conditions for overcoming. Novosibirsk, 2003. 288 p.
Sokolova E.V., Gulyaeva K.Yu. Prevention and correction of behavioral disorders in children. Novosibirsk, 2003. 118 p.
Social psychology of personality in questions and answers: Proc. allowance / Ed. prof . V.A. Labunskaya. M., 1999. 397 p.

Psychopaths. A reliable story about people without pity, without conscience, without remorse Kil Kent A.

Diagnosis of conduct disorder in children

Personality disorders are, by definition, permanent patterns of thought, experience, and behavior that are relatively stable over a long period of time. In children and adolescents, symptoms of personality disorders should be present for a significant period (usually more than six months), and not just be a reaction to the social environment. The Diagnostic and Statistical Manual of Mental Disorders (DSM-IV-TR) of the American Psychiatric Association uses terms such as "conduct disorder" and "oppositional defiant disorder" to describe children and adolescents with severe disruptive behavior problems. The DSM-IV-TR symptoms of these disorders are listed in Box 3.

BOX 3

Conduct disorder and oppositional defiant disorder are based on the following criteria:

CONDUCT DISORDERS

A. recurring and sustainable scheme behavior in which the basic rights of other people or the basic norms and rules of behavior for a given age are violated, while three (or more) of the following criteria have been observed in the last 12 months and at least one criterion has been observed in the last 6 months:

Aggression towards people and animals

1) the child often bullies, intimidates or threatens others

2) often provokes fights

3) uses weapons capable of causing serious physical harm (for example, a baseball bat, a stone, a broken bottle, a knife, a gun)

4) shows physical cruelty to people

5) shows physical cruelty to animals

6) commits theft in personal contact with the victim (that is, he was engaged in robbery or robbery, pulled out bags, extorted money)

7) force someone to have sex

Vandalism

8) knowingly participates in arson with the intent to cause serious damage

9) deliberately destroys someone else's property (other than arson)

Fraud or theft

10) breaks into other people's houses or cars

11) often lies to get things or services or to avoid responsibility (that is, manipulates others)

12) steals relatively expensive items without personal contact with the victim (for example, shoplifting, but without burglary; forgery)

Serious offenses

13) often stayed out late, despite parental prohibition, starting at the age of under 13

14) spent the night away from home at least twice when living with parents or in foster family(or once, but several nights)

15) often skipped school until the age of 13

B. Conduct disorder results in clinically significant impairments in social, academic, or occupational functioning.

IN. If the individual is 18 years of age or older, the criteria for antisocial personality disorder do not apply.

Disorder code by age of onset

312.81 Conduct disorder, childhood onset: at least one criterion for conduct disorder presenting before the age of 10 years

312.82 Conduct disorder, onset in adolescence: no criteria specific to conduct disorder before age 10 years

312.83 Conduct disorder, onset undetermined: age of onset unknown

Severity of the disorder

Weak: Behavioral problems beyond those required for diagnosis are few or absent; behavioral problems cause only minor harm to others (i.e. lying, absenteeism, staying out late without permission)

Moderate: the number of behavioral problems and their impact on others varies between mild and severe (i.e. stealing without personal contact with the victim, vandalism)

Severe: Many behavioral problems beyond those required for a diagnosis, or behavioral problems cause significant harm to others (i.e. rape, physical abuse, use of a weapon, robbery, breaking and entering)

OPPOSITIONAL DEFENDER DISORDER

A. A pattern of negativistic, hostile, and defiant behavior lasting at least 6 months, during which four (or more) of the following criteria are observed:

1) the child often loses his temper

2) often argues with adults

3) often behaves defiantly or refuses to follow the instructions of adults and the rules established by them

4) often deliberately annoying others

5) often reproaches others for his own misdeeds and mistakes

6) often touchy and easily irritated

7) often angry and indignant

8) often vicious or vengeful

Note: a child meets the criterion only if the behavior occurs more frequently than usual in children and adolescents of a similar age and developmental level.

B. Behavioral problems lead to clinically significant impairments in social, academic, or occupational functioning.

IN. Behavior is not exclusive to psychosis or affective disorder.

G. The patient does not meet the criteria for conduct disorder or, if the patient is 18 years of age or older, the criteria for antisocial personality disorder do not apply.

The current definition of conduct disorder was first included in the DSM-III, and since then the criteria for the disorder have varied considerably. At first conduct disorder was defined as behavioral tendencies in which the rights of others are violated, including physical aggression towards people and things. DSM-III has been significantly influenced by behavioral theory, and because of this, environmental exposure has taken on a large role in defining two subtypes: socialized and unsocialized.

The unsocialized type includes children who are incapable of attachment, empathy, social and romantic ties with others of the usual degree and quality. The socialized type, on the other hand, may experience ordinary affection for other people, but still constantly gets into trouble. This division is based on taking into account all the symptoms of problem children and the so-called factor analysis, which statistically separates symptoms into two categories.

The DSM-IV abandoned the distinction between unsocialized and socialized subtypes. Now the unsocialized group is the group started at an early age. Weak parental controls also began to play important role in assessing conduct disorder. Research shows that for children and adolescents with severe interpersonal problems at an early age, as well as other psychological factors risk (that is, bad parents) are characterized by more stable antisocial traits in maturity.

The DSM-IV lists four general categories of conduct disorder: aggression towards humans and animals, vandalism, lying and theft, serious breach rules. To be diagnosed with this disease, a child or adolescent must have had at least three of the fifteen symptoms for at least 12 months.

Looking at the known facts of Brian and Eric's lives, we see that Brian and Eric meet the criteria severe behavioral disorders with onset in childhood. And since they meet the criteria for this more severe disorder, psychologists will not give them a milder diagnosis of oppositional defiant disorder (even if they meet all the criteria).

What does a conduct disorder diagnosis mean? Will the patient become a psychopath when he grows up? Well, in fact, everything is not so clear-cut. The diagnosis of conduct disorder is based solely on observed behavior; it does not assess the emotional, interpersonal, and affective traits associated with psychopathy. In fact, the DSM-IV conduct disorder diagnosis does not mention a lack of empathy, guilt, and remorse, or a paucity of emotion. Many scientists believe that the omission of the diagnosis of such traits as callousness And indifference, greatly limits its usefulness. There are other criticisms of the conduct disorder diagnosis. Nearly 80 percent of children who receive this diagnosis do not develop a personality disorder or psychopathy in adulthood. That is, it can be assumed that a conduct disorder is not really a disorder. In other words, the diagnosis does not predict what children will experience for the rest of their lives. personality problems and which will exhibit antisocial behavior or psychopathy.

Perhaps the most scathing criticism of this diagnosis is the former president of the American Psychological Association, director of the Yale University Child Behavior Clinic, and author of more than seven hundred peer-reviewed journal articles and forty books by Dr. Alan Kazdin. Dr. Kazdin noted that there are 32,647 combinations of symptoms that can be present in a child or adolescent, leading to a diagnosis of conduct disorder (52). In fact, the symptoms of the disorder are independent of each other; in other words, there are over 32,000 different types of children with conduct disorder. This is a real nightmare of a clinical psychologist. The diagnosis lacks sensitivity and specificity. With such criteria, it can be put to a huge number of very different children. And he does not allow to draw any conclusions. This is nothing more than a hodgepodge of symptoms with very little practical applicability.

Within the juvenile correctional facilities where I've done research, doctors often don't even evaluate them for conduct disorder, since virtually any teenager, youth, meets the criteria. Diagnosis simply does not help distinguish one juvenile prisoner from another. Thus, it has many of the same shortcomings as the adult diagnosis of antisocial personality disorder (which we discussed in Chapter 2).

But this picture is starting to change. For about the past twenty years, a number of scientists have been hard at work developing ways to assess and measure traits of callousness and indifference in children and adolescents. Psychologists believe that looking at these two traits in addition to the antisocial and impulsive traits in children and adolescents will help identify those at highest risk of becoming a true adult psychopath.

From the book Moral Animal author Wright Robert

Darwin's Diagnosis Darwin saw it all. He didn't know anything about genes, but he certainly knew about the concept of heredity and was a materialist scientist; he didn't think any non-physical forces were needed to explain human behavior or anything else in the natural world.

From the book Conversations on the New Immunology author Petrov Rem Viktorovich

Before treatment, you need to make a diagnosis. - How to treat immunodeficiencies? - To do this, you first need to find out exactly which link of the immune machine is defective. - How do you know? - Designed for accurate diagnosis special methods

From the book Diagnosis and Correction of Deviant Behavior in Dogs author Nikolskaya Anastasia Vsevolodovna

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From the book The Human Genome [Encyclopedia written in four letters] author Tarantul Vyacheslav Zalmanovich

3.5. Characterological disorders (excitable, hysterical, anankastic, paranoid type) Currently, in psychiatry, the generally accepted point of view is to attribute disorders of this circle to the group of polyetiological diseases of the biopsychosocial

From the book Brain, Mind and Behavior the author Bloom Floyd E

3.6. Endogenous mental disorders Considering endogenous mental disorders in the context of this work, it is advisable to refer to the description of schizophrenia in children (G. Kaplan, B. Saddock, 2002). As a rule, it is indicated that in children the clinical picture is dominated by

From the book Sensuality and Sexuality by Burbo Liz

4.1.5. Mood disorders The animal understands the task well, but may switch to another activity (hyperactivity) or refuse to perform (depression, lack of motivation). The performance of tasks is accompanied by increased vocalization (barking in case

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From the author's book

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Brain Diseases and Behavioral Disorders It is important that we distinguish between "disease" and "disorder" when considering specific brain anomalies and their impact on thinking and behavior. At first glance, it may seem that the disease is a more serious condition in terms of

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Part 7. Diseases and Disorders I have had sex so often that I have wasted all my strength and now I practically do not have an erection. Can this be fixed? Perhaps the lack of erection has nothing to do with the intensity of the sexual life that you led in the past. Communication can

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Influence of suggestion on pathological disorders ... Based on my personal observations, I can say that hypnotic suggestions have a decisive effect on very many nervous disorders that are not caused by organic lesions, such as, for example,

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Recognition of reality as a hallucinatory experience as one of the manifestations of a mental disorder painful conditions when patients in the form of hallucinations are reproduced

Diagnosis of a behavioral disorder in a child. Ways to correct children's behavior

Chapter 17 AND TEENAGERS

Conduct disorders in children

Conduct disorders in children

Causes of conduct disorder in children

Pathogenesis

Classification

Symptoms of conduct disorder in children

Complications

Diagnostics

Treatment of conduct disorders in children

Forecast and prevention

Behavioral disorders in children - treatment in Moscow

Directory of Diseases

Childhood diseases

Last news

Hyperkinetic conduct disorder.

Conduct disorder limited to the family.

Unsocialized conduct disorder.

Socialized conduct disorder.

Delinquent behavior.

Conduct disorder in children - the content of the medical history

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