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Mental disorders are risk factors. Mental Health Factors

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“Formation of a healthy lifestyle of the younger generation

through the creation of a single health-saving area of the district"

The topic of experimental work at the Novo-Peredelkino CPMSS:

"Transdisciplinary approach in creating

adaptive environment in an educational institution"

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Mental Health: Risk Factors for Impairment

and optimal conditions for its formation.

In 1979, the World Health Organization coined the term "mental health". It can be defined as “a state of mental activity, which is characterized by the determinism of mental phenomena, the harmonious relationship between the reflection of the circumstances of reality and the attitude of the individual towards it, the adequacy of the body's reactions to social, psychological and physical conditions of life, thanks to the ability of the individual to control his behavior, plan and implement his life path in the micro- and macro-social environment”. Unlike the concept of "mental health", the term "mental health" is not yet common.The emergence of this term is associated with the development of the humanitarian methodology of human cognition. It was named among the basic concepts of a new branch of psychological research - humanistic psychology, an alternative to the mechanistic approach to man transferred from the natural sciences.

Today, the problem of psychological health is relevant and is being developed by a number of researchers (V.A. Ananiev, B. S. Bratus, I. N. Gurvich, N. G. Garanyan, A. N. Leontiev, V. E. Pakhalyan, A. M. Stepanov, A.B. Kholmogorova and others). The problem of children's psychological health is discussed in the works of I.V. Dubrovina, V.V. Davydov, O.V. Khukhlaeva, G.S. Nikiforov, D.B. Elkonin, etc.).

R. Assagioli described psychological health as a balance between various aspects of a person's personality; S. Freiberg - between the needs of the individual and society; N.G. Garanyan, A.B. Kholmogorova - as a process of a person's life, in which reflex, reflexive, emotional, intellectual, communicative, behavioral aspects are balanced. The understanding of psychological health within the framework of the adaptive approach is widespread (O.V. Khukhlaeva, G.S. Nikiforov).

In the concept of modernizing the education system, an important role is given to health-saving technologies, psychological support for children in educational institutions, and the preservation and strengthening of mental health. Today, children still remain outside the field of vision and positive intervention, whose condition can be described as borderline relative to the norm and qualified as "not mentally ill, but psychologically no longer healthy."

Psychological health is a state that characterizes the process and result of the normal development of subjective reality within an individual life; the maxim of psychological health is the unity of the viability and humanity of the individual.

"Psychological health" characterizes the personality as a whole (in contrast to "mental health", which is related to individual mental processes and mechanisms), is in direct connection with the manifestations of the human spirit and allows you to highlight the actual psychological aspect of the problem of mental health.

Psychological health is a necessary condition for the full functioning and development of a person in the process of his life. Thus, on the one hand, it is a condition for a person to adequately fulfill his age, social and cultural roles, on the other hand, it provides a person with the opportunity for continuous development throughout his life.

In other words, the "key" concept for describing psychological health is "harmony". And above all, it is the harmony between the various components of the person himself: emotional and intellectual, bodily and mental, etc. But it is also the harmony between the person and the surrounding people, nature. At the same time, harmony is considered not as a static state, but as a process. Accordingly, we can say that “psychological health is a dynamic set of mental properties of a person that ensures harmony between the needs of the individual and society, which is a prerequisite for the orientation of the individual to fulfill his life task” (O.V. Khukhlaeva).

At the same time, the psychological health of a person is closely related to physical health, because. the very use of the term “mental health” emphasizes the inseparability of the physical and mental in a person, the need for both for full functioning. Moreover, such a new scientific direction as health psychology has recently emerged - “the science of the psychological causes of health, the methods and means of its preservation, strengthening and development” (V.A. Ananiev).

The next point that needs to be considered for the meaningful filling of the concept of psychological health is its relationship with spirituality. I.V. Dubrovina argues that psychological health should be considered from the point of view of the wealth of personality development, i.e. to include in psychological health a spiritual principle, an orientation towards absolute values: Truth, Beauty, Goodness. Thus, if a person does not have an ethical system, then it is impossible to talk about his psychological health. And one can fully agree with this position.

Having understood what mental health is, it is also necessary to pay attention to the factorsrisk of mental health problems. They can be conditionally divided into two groups: objective, or environmental factors, and subjective, due to individual personality characteristics. Environmental factors (for children) are understood as family unfavorable factors and unfavorable factors associated with children's institutions. In turn, family adverse factors can be divided into risk factors emanating from:

type of parent-child relationship (lack of communication between parents and the child, overstimulation of the child, overprotection, alternation of overstimulation with the emptiness of relationships, formal communication, etc.),
family system (interaction of the type “the child is the idol of the family”, the absence of one of the parents or conflict relations between them).

At primary school age (from 6–7 to 10 years old), relationships with parents begin to be mediated by the school, because for the first time, a child enters a situation of socially evaluated activity, gets the opportunity to objectively compare his own activity with the activities of others, which can lead to a significant decrease in children's self-esteem. In addition, if a child perceives the results of learning as the only criteria of his own value, while sacrificing imagination, play, he acquires a limited identity, according to E. Erickson - "I am only what I can do." It becomes possible to form a feeling of inferiority, which can negatively affect both the current situation of the child and the formation of his life scenario.

But if we consider the development of psychological health only from the point of view of risk factors, questions arise why not all children “break down” in adverse conditions, but, on the contrary, sometimes achieve success in life, and why we often encounter children who grew up in a comfortable external environment, but at the same time needing some kind of psychological help. Therefore, it is necessary to take into account the optimal conditions for the formation of a person’s psychological health:

the presence in the life of a child of difficult situations that cause tension corresponding to the age and individual capabilities of children. At the same time, the task of adults is not to help in overcoming difficult situations, but to help in finding their meaning and educational impact;
the presence of a positive mood background in the child (the student's mental balance, i.e., the ability in various situations to come to a state of inner peace, optimism and the child's ability to be happy). A good mood increases the effectiveness of a person solving certain problems and overcoming difficult situations;
the presence of a constant fixation of the child on progress, positive changes that relate to both the field of educational and extracurricular activities;
the presence of social interest (the ability to be interested in other people and take part in them).

But it is important that the selected conditions can be considered only in terms of probabilities. With a high degree of probability, the child will grow up psychologically healthy in such conditions, in the absence of them - with certain mental health disorders.

Thus, summarizing all of the above, we get a "portrait" of a psychologically healthy person. “A psychologically healthy person is, first of all, a spontaneous and creative person, cheerful and cheerful, open and knowing himself and the world around him not only with his mind, but also with feelings, intuition. He fully accepts himself and at the same time recognizes the value and uniqueness of the people around him. Such a person places responsibility for his life primarily on himself and learns from adverse situations. His life is filled with meaning, although he does not always formulate it for himself. He is in constant development and, of course, contributes to the development of other people. His life path may not be entirely easy, and sometimes quite difficult, but he adapts perfectly to rapidly changing living conditions. And what is important - he knows how to be in a situation of uncertainty, trusting what will happen to him tomorrow ”(O.V. Khukhlaeva).

In general, we can conclude that psychological health is formed by the interaction of external and internal factors, and not only external factors can be refracted through internal ones, but also internal factors can modify external influences. And once again it must be emphasized that for a psychologically healthy person, experience of a struggle that is crowned with success is necessary.

Health and wellness is influenced by many factors, and those that cause ill health, disability, disease, or death are known as risk factors. is a property, condition, or behavior that increases the occurrence of illness or injury. Often talk about individual risk factors, but in practice they do not occur separately. They often coexist and interact. For example, physical inactivity will eventually cause weight gain, high blood pressure, and high blood cholesterol levels. These factors combine to increase the likelihood of chronic heart disease and other health problems. Population aging and increased life expectancy have led to an increase in long-term (chronic) diseases and disorders that require expensive treatment.

Demand for medical care is increasing and the industry's budget is under increasing pressure that it cannot always sustain. It is important that we, as members of society and users of health systems, understand the causes and risk factors for disease and actively participate in affordable, cost-saving prevention and treatment programs.

In general, risk factors can be divided into the following:

behavioral,
physiological,
demographic,
related to the environment
genetic.

Let's consider them in more detail.

Types of risk factors

Behavioral risk factors

Behavioral risk factors usually refer to actions that a person takes on their own. Therefore, such factors can be eliminated or reduced by changing lifestyle or behavioral habits. Examples include

tobacco smoking,
alcohol abuse,
food image,
lack of physical activity;
prolonged exposure to the sun without proper protection,
the absence of a series of vaccinations,
unprotected sex.

Physiological risk factors

Physiological risk factors are associated with the body or biological characteristics of a person. They can be influenced by heredity, lifestyle and many other factors. Examples include

overweight or obesity,
high blood pressure,
high blood cholesterol,
high levels of sugar (glucose) in the blood.

Demographic risk factors

Demographic factors refer to the population as a whole. Examples include

age,
population subgroups based on occupation, religion or income.

Environmental risk factors

Environmental risk factors cover a wide range of phenomena such as social, economic, cultural and political factors, as well as factors of a physical, chemical and biological nature. Examples include

access to clean water and sanitation,
Risk is the likelihood of harm or injury resulting from treatment in clinical practice or research. Harm or injury can be physical, but also psychological, social or economic. Risks include developing side effects of treatment or taking a drug that is less effective than standard treatment (as part of a trial). When testing a new medicine, there may be side effects or other risks not anticipated by the researchers. This situation is most typical for the initial stages of clinical trials.

Conducting any clinical trial involves risks. Participants should be informed about possible benefits and risks before deciding to participate (see definition of informed consent).
" target="_blank">risks in the workplace,
air pollution,
social environment.

Genetic risk factors

Genetic risk factors are linked to a person's genes. A number of diseases, such as cystic fibrosis and muscular dystrophy, are caused by the "genetic makeup" of the body. Many other diseases, such as asthma or diabetes, reflect the interplay of human genes and environmental factors. Some diseases, such as sickle cell anemia, are more common in certain population subgroups.

Global Mortality Risks and Demographic Factors

In 2004, the number of deaths from any cause worldwide was 59 million.

The table below lists the ten most common risk factors that caused the most deaths in 2004 according to the World Health Organization (WHO). All six of the leading risk factors at the top of this ranking are associated with the potential development of long-term conditions such as heart disease, diabetes and cancer.

Table: WHO data on the top 10 risk factors for mortality, 2004

Place	risk factor	% of total deaths
1	High blood pressure	12.8
2	Tobacco smoking	8.7
3	High blood glucose.	5.8
4	Lack of physical activity	5.5
5	Overweight and obesity	4.8
6	high cholesterol	4.5
7	unprotected sex	4.0
8	Alcohol consumption	3.8
9	Underweight in children	3.8
10	Smoke in the premises as a result of the use of solid fuels	3.0

The factors in the above table rank differently when income and other demographic factors are taken into account.

Income

For high- and middle-income countries, the most important risk factors are those associated with long-term illness, while in low-income countries risk factors such as malnutrition in children and unprotected sex are much more common.

Age

Health risk factors also change with age. A number of risk factors, such as malnutrition and indoor smoke from solid fuels, affect almost exclusively children. Risk factors affecting adults also change markedly with age.

Unprotected sex and addictive substances (alcohol and tobacco) are the causes of most diseases in young people.
Risk factors that cause long-term illness and oncology affect mainly people of a more mature age.

Floor

Health risk factors manifest themselves differently in men and women. For example, men are at greater risk of suffering from factors associated with addictive substances. Women often suffer from iron deficiency during pregnancy.

Reducing exposure to risk factors

Reducing existing risk factors and their impact can significantly improve health and increase life expectancy for many years. This would reduce health care costs. The fact sheet of the SCORE project can be seen as an example of how significant the impact of existing risk factors on people's health and life expectancy can be.

Reference literature

World Health Organization (2009). Global health risks: Mortality and burden of disease attributable to selected major risks. Geneva: World Health Organization.Available from: http://www.who.int/healthinfo/global_burden_disease/global_health_risks/en/
Australian Institute of Health and Welfare (2015). risk factors to health. Retrieved June 23, 2015, from http://www.aihw.gov.au/risk-factors/

Applications

Newsletter Project SCORE
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This fact sheet takes the SCORE project as an example of how significant the impact of risk factors on people's health and life expectancy is, and what proactive steps a person can take to reduce the impact of these risk factors on their health and well-being.

Risk factors for health and disease
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Learn more about risk factors for health and disease.

Environmental factors: family unfavorable factors and unfavorable factors associated with children's institutions, professional activities, the socio-economic situation in the country. It is well known that the most significant factor in the normal development of an infant's personality is communication with the mother, and a lack of communication can lead to various kinds of developmental disorders in the child. However, in addition to the lack of communication, other, less obvious types of interaction between the mother and the baby can be distinguished, which adversely affect his psychological health. Thus, the opposite of a lack of communication is 1. the pathology of an overabundance of communication, leading to overexcitation and overstimulation of the child. 2. Alternation of overstimulation with the emptiness of relationships, i.e. structural disorganization, disorder. 3. Formal communication, i.e. communication, devoid of erotic manifestations necessary for the normal development of the child. This type can be implemented by a mother who seeks to completely build child care according to books, doctor's advice, or a mother who is next to the child, but for one reason or another (for example, conflicts with the father) is not emotionally included in the care process. Unfavorable types of mother-child interaction include: a) too abrupt and rapid separation, which may be the result of the mother going to work, placing the child in a nursery, the birth of a second child, etc .; b) continuation of constant custody of the child, which is often shown by an anxious mother. An important role in the development of psychological health is played by how the upbringing of a child's neatness is carried out. This is the "basic stage" where the struggle for self-determination is played out: the mother insists on the observance of the rules - the child defends his right to do what he wants. Therefore, a risk factor can be considered an overly strict and quick accustoming to neatness of a small child. A place of relationship with the father for the development of the autonomy of the child. The father must be physically and emotionally available to the child, because: a) he gives the child an example of relations with the mother - relations between autonomous subjects; b) acts as a prototype of the external world, i.e., liberation from the mother becomes not a departure to nowhere, but a departure to someone; c) is less of a conflict object than the mother and becomes a source of protection. Preschool age (from 3 to 6-7 years) is so significant for the formation of a child’s psychological health and is so multifaceted that it is difficult to claim an unambiguous description of risk factors for intra-family relationships, especially since it is already difficult to consider a separate interaction of a mother or father with a child, but it is necessary Discuss risk factors coming from the family system. The most significant risk factor in the family system is the interaction of the "child - the idol of the family" type, when the satisfaction of the child's needs prevails over the satisfaction of the needs of other family members. The next risk factor is the absence of one of the parents or a conflict relationship between them. It causes a deep internal conflict in a child, can lead to violations of gender identity or, moreover, cause the development of neurotic symptoms: enuresis, hysterical attacks of fear and phobias. In some children, it leads to characteristic changes in behavior: a strongly pronounced general readiness to respond, timidity and timidity, submissiveness, a tendency to depressive moods, insufficient ability to affect and fantasize. But, as G. Figdor notes, most often changes in the behavior of children attract attention only when they develop into school difficulties. The next phenomenon of parental programming, which can affect it ambiguously. On the one hand, through the phenomenon of parental programming, there is an assimilation of moral culture - the prerequisites for spirituality. On the other hand, due to an extremely pronounced need for parental love, the child tends to adapt his behavior to meet their expectations. School may be the most significant risk factor for mental health problems. Conventionally, the following stages can be distinguished in the process of reducing self-esteem. First, the child is aware of his school inability as the inability to "be good." But at this stage, the child retains the belief that he can become good in the future. Then faith disappears, but the child still wants to be good. In a situation of persistent long-term failure, the child may not only realize his inability to "become good", but already lose the desire for this, which means a persistent deprivation of the claim to recognition. Adolescence (from 10-11 to 15-16 years). This is the most important period for the formation of independence. In many ways, the success of achieving independence is determined by family factors, or rather, by how the process of separating the adolescent from the family is carried out. therefore, it is important that parents are able to provide the teenager with the rights and freedoms that he can dispose of without endangering his psychological and physical health. Bodrov three main characteristics of sustainability: control, self-esteem and criticality. In this case, control is defined as a locus of control. In their opinion, externals who see most events as the result of chance and do not associate them with personal involvement are more prone to stress. Internals, on the other hand, have greater internal control, more successfully cope with stress. Self-esteem here is a sense of one's own destiny and one's own abilities. First, people with low self-esteem have a higher level of fear or anxiety. Second, they perceive themselves as having insufficient ability to face the threat.

Mental health is a state of well-being in which a person can realize their own potential, cope with the normal stresses of life, work productively and productively, and contribute to their community. In this positive sense, mental health is the foundation of well-being and effective functioning for the individual and for the community. Mental health is a set of attitudes, qualities and functional abilities that allow an individual to adapt to the environment. A person who deviates significantly from the standards of his community runs the risk of being recognized as mentally ill. At the same time, ideas about mental illness vary across cultures and at different times within each culture. An example of the former is the fact that many Indian tribes, unlike most other Americans, consider hallucinations to be normal; an example of the second is the change in attitudes towards homosexuality, which was once regarded as a crime, then as a mental illness, and now as a variant of sexual adaptation. Regardless of social or ethnic origin, an individual living in a technological, urbanized society must have a set of certain psychological traits that ensure social adaptation, i.e. successful functioning in this society.

According to severity, these mental disorders can be divided into psychotic and non-psychotic.

Psychosis is a disease that can impair mental functioning so much that a person loses the ability to cope with the elementary requirements of everyday life. The perception of reality can be seriously disturbed, delirium and hallucinations may occur. A typical example of psychosis is schizophrenia; in its severe form, very deep disturbances are observed. Syndromes of organic disorders of the brain, ranging from mild to extremely severe, are diseases associated with physiological damage to the central nervous system. Damage can be caused genetically or by birth or any other trauma, infection, as well as metabolic disorders. Since organic disorders are caused by disease or injury, the direction of prevention programs is fairly clear. Mental health programs also deal with problems such as alcoholism, the prevention of industrial accidents and lead poisoning.

Non-psychotic disorders are characterized by less disorientation and loss of contact with reality, and a greater likelihood of improvement. The most common non-psychotic disorders are neuroses, personality disorders, behavioral disorders in children and adolescents, and some syndromes of organic brain disorders. Neurosis is considered the result of a conflict in thoughts and feelings that a person cannot adequately cope with. Anxiety and depression are the most characteristic manifestations of neuroses. Personality disorders, manifested by the formation of a paranoid, schizoid, hysterical or asocial personality, are deeply rooted maladaptive behaviors. Behavioral disorders such as excessive shyness, timidity, aggressiveness, and delinquency are less deeply rooted, but also persistent. The causes of psychogenic, or inorganic, disorders are less clear. As a rule, they are considered the result of the interaction of constitutional and family influences, as well as environmental influences. The main psychotherapeutic schools differ significantly in their views on the causes, and, therefore, on the prevention of neuroses and personality disorders. Nevertheless, they all agree that a child born with a healthy mental and physical heredity and raised by mentally healthy parents has the greatest chance of growing up mentally healthy. The child should be loved, accepted as an independent person and respected, cared for and nourished, emotionally and intellectually stimulated, protected from severe stress associated with poverty, physical and emotional trauma, overly strict parenting or a rigid family life style. A balance between what is permitted and what is controlled is important for development, as well as forms of community support such as good schools, opportunities to play and decent housing.

Factors that influence mental health:

1) predisposing

2) provoking

3) supporting.

Predisposing factors increase a person's susceptibility to mental illness and increase the likelihood of developing it when exposed to provoking factors. Types of predisposing factors:

1) genetically determined - depend on personal characteristics and genetic heritage (schizophrenia, some forms of dementia, affective disorders, epilepsy)

2) biological (sex and age)

3) psychological

4) social - are divided into socio-environmental, socio-economic, socio-political, environmental (problems related to family, work, housing, dissatisfaction with social status, social disasters and wars, natural disasters)

The judgment about the mental health of an individual should be correlated with the stage of his development, and at certain age periods, a person becomes more vulnerable in stressful situations. These periods include: primary school age, in which there is a high prevalence of fears; adolescence (12-18 years), which is characterized by increased emotional sensitivity and instability, behavioral disorders, including drug use, acts of self-harm and suicide attempts; the period of involution - with characteristic personality changes and a decrease in reactivity to the effects of psychological and socio-environmental factors. Age not only affects the frequency of development of mental disorders, but also gives a kind of "age" coloring to their manifestations. For childhood, fears of the dark, animals, fairy-tale characters are characteristic. Mental disorders of old age (delusions, hallucinations) often reflect everyday experiences - damage, poisoning, exposure and all sorts of tricks to "get rid of them, old people." Gender also to some extent determines the frequency and nature of mental disorders. Men are more likely than women to suffer from schizophrenia, alcoholism, drug addiction. But in women, the abuse of alcohol and psychotropic substances leads to the development of drug addiction faster and the disease is more malignant than in men. The hierarchy of social values in women and men is different. For a woman, family and children are more important; for men - his prestige, work. Therefore, a common cause of the development of neurosis in women is trouble in the family, personal problems, and in men - a conflict at work or dismissal.

Provoking factors - cause the development of the disease. Some people with increased susceptibility to a mental disorder, however, never get sick or stay sick for a very long time. Usually provoking factors act non-specifically. The time of onset of the disease depends on them, but not the nature of the disease itself. Types of provoking factors:

1) physical - somatic diseases and injuries (brain tumor, traumatic brain injury or loss of a limb), cat. can be in the nature of psychological trauma and cause mental illness (neurosis)

2) socio-psychological - painful experiences, obsessive fears that are associated with reality (speedophobia, radiophobia) or come from the distant past (fears of corruption, witchcraft, obsession).

supporting factors. The duration of the disease after its onset depends on them. When planning treatment and social work with the patient, it is especially important to give them due attention. When the initial predisposing and provoking factors have already ceased their influence, supporting factors exist and can be corrected. In the early stages, many mental illnesses lead to secondary demoralization and social withdrawal, which in turn prolongs the original disorder. The social worker must take steps to correct these secondary personality factors and eliminate the social consequences of the disease.

Prevention programs developed in the field of mental health have three main goals:

1) preventing or reducing the frequency of mental illness;

2) relief of their severity or reduction in duration;

3) reducing their impact on work capacity.

The main methods of treatment used individually or in various combinations:

1) psychotherapy

2) drug therapy

3) shock therapy and environment therapy.

Psychotherapy. Most psychotherapeutic approaches can be attributed to one of two schools - psychoanalysis by Z. Freud or behavioral therapy based on the theories of learning and conditioned reflexes B. Skinner and I.P. Pavlov. In psychoanalytically oriented therapy, the patient's maladaptive forms of behavior and symptoms of his disease are considered as the result of deep, unconscious conflicts in thinking, feelings and motives. Liberation from the disease in such therapy occurs due to the awareness and resolution of internal conflicts, as well as the identification of their sources (as a rule, dating back to childhood). The goal of behavioral psychotherapy is to eliminate maladaptive forms of behavior and teach new, more productive ones.

Drug therapy - treatment with psychotropic drugs (tranquilizers, stimulants, antidepressants, and anticonvulsants), shock therapy, and environmental therapy, which includes occupational therapy, group discussion, collaborative planning, self-help and self-control skills, and is widely used to avoid a complete withdrawal of the patient from life during hospitalization.

Preservation of mental health and the prevention of mental disorders is a much less understood task than the prevention of infectious diseases, which are prevented by vaccination and treated with antibiotics; no such measures exist in the field of mental illness. Around the world, drug addiction and alcoholism have led to a mental health crisis. As a result of the formation of addiction, the psyche of tens of millions of men, women and children suffers. Child abuse is also a worldwide phenomenon. As a factor in the occurrence of mental illness, it deserves much more attention than it currently receives. In recent years, such violence has been seen as the primary cause of multiple personality syndrome.

They can be conditionally divided into two groups: objective, or environmental factors, and subjective, due to individual personality characteristics.

Let us first discuss the influence of environmental factors. They are usually understood as family unfavorable factors and unfavorable factors associated with children's institutions, professional activities, and the socio-economic situation in the country. It is clear that environmental factors are most significant for the psychological health of children and adolescents, so we will reveal them in more detail.

Quite often, the difficulties of the child originate in infancy (from birth to a year). It is well known that the most significant factor in the normal development of an infant's personality is communication with the mother, and a lack of communication can lead to various kinds of developmental disorders in the child. However, in addition to the lack of communication, other, less obvious types of interaction between the mother and the baby can be distinguished, which adversely affect his psychological health. Thus, the pathology of an overabundance of communication, which leads to overexcitation and overstimulation of the child, is opposite to the lack of communication. It is this kind of upbringing that is quite typical for many modern families, but it is it that is traditionally regarded as favorable and is not considered as a risk factor either by the parents themselves or even by psychologists, so we will describe it in more detail. Overexcitation and overstimulation of the child can be observed in the case of maternal overprotection with the removal of the father, when the child plays the role of an "emotional crutch of the mother" and is in a symbiotic relationship with her. Such a mother constantly stays with the child, does not leave him for a minute, because she feels good with him, because without a child she feels emptiness and loneliness. Another option is continuous excitation, selectively directed to one of the functional areas: nutrition or bowel movements. As a rule, this variant of interaction is implemented by an anxious mother, who is madly worried about whether the child has eaten the prescribed grams of milk, whether and how regularly she has emptied her intestines. Usually she is well acquainted with all the norms of child development. For example, she carefully monitors whether the child began to roll over from his back to his stomach in time. And if he is delayed with the coup for several days, he is very worried and runs to the doctor.

The next type of pathological relationships is the alternation of overstimulation with the emptiness of relationships, i.e. structural disorganization, disorder, discontinuity, anarchy of the child's life rhythms. In Russia, this type is most often realized by a student mother, i.e., who does not have the opportunity to constantly care for the child, but then tries to make amends for her guilt with continuous caresses.

And the last type is formal communication, that is, communication devoid of erotic manifestations necessary for the normal development of the child. This type can be implemented by a mother who seeks to completely build child care according to books, doctor's advice, or a mother who is next to the child, but for one reason or another (for example, conflicts with the father) is not emotionally included in the care process.

Disturbances in the interaction of the child with the mother can lead to the formation of such negative personality formations as anxious attachment and distrust of the world around them instead of normal attachment and basic trust (M. Ainsworth, E. Erickson). It should be noted that these negative formations are stable, persist until primary school age and beyond, however, in the process of child development, they acquire various forms, “colored” by age and individual characteristics. As examples of the actualization of anxious attachment at primary school age, one can name an increased dependence on adult assessments, the desire to do homework only with mom. And distrust of the world around is often manifested in younger students as destructive aggressiveness or strong unmotivated fears, and both of them, as a rule, are combined with increased anxiety.

It should also be noted the role of infancy in the occurrence of psychosomatic disorders. As many authors note, it is with the help of psychosomatic symptoms (gastric colic, sleep disturbances, etc.) that the child reports that the maternal function is performed unsatisfactorily. Due to the plasticity of the child's psyche, it is possible to completely free him from psychosomatic disorders, but the variant of the continuity of somatic pathology from early childhood to adulthood is not excluded. With the preservation of the psychosomatic language of reaction in some younger schoolchildren, the school psychologist often has to meet.

At an early age (from 1 to 3 years), the relationship with the mother also remains important, but the relationship with the father also becomes important for the following reasons.

Early age is especially significant for the formation of the "I" of the child. It must free itself from the support that the "I" of the mother provided to it in order to achieve separation from her and awareness of itself as a separate "I". Thus, the result of development at an early age should be the formation of autonomy, independence, and for this, the mother needs to let the child go to the distance that he himself wants to move away. But choosing the distance to release the child, and the pace at which this should be done, is usually quite difficult.

Thus, unfavorable types of mother-child interaction include: a) too abrupt and rapid separation, which may be the result of the mother going to work, placing the child in a nursery, the birth of a second child, etc.; b) continuation of constant custody of the child, which is often shown by an anxious mother.

In addition, since early age is a period of ambivalent attitude of the child to the mother and aggression is the most important form of child activity, an absolute ban on the manifestation of aggressiveness may become a risk factor, which may result in the complete displacement of aggressiveness. Thus, an always kind and obedient child who is never naughty is the “pride of a mother” and everyone’s favorite often pays for everyone’s love at a rather high price - a violation of their psychological health.

It should also be noted that an important role in the development of psychological health is played by how the upbringing of a child's neatness is carried out. This is the "basic scene" where the struggle for self-determination is played out: the mother insists on following the rules - the child defends his right to do what he wants. Therefore, a risk factor can be considered an overly strict and quick accustoming to neatness of a small child. It is curious that researchers of traditional children's folklore believe that fears of punishment for untidiness are reflected in children's scary tales, which usually begin with the appearance of a "black hand" or "dark spot": - a black spot on the walls, and the ceiling falls all the time and kills everyone ... ".

Let us now determine the place of the relationship with the father for the development of the autonomy of the child. According to G. Figdor, the father at this age should be physically and emotionally available to the child, because: a) sets the child an example of relations with the mother - relations between autonomous subjects; b) acts as a prototype of the external world, i.e., liberation from the mother becomes not a departure to nowhere, but a departure to someone; c) is less of a conflict object than the mother and becomes a source of protection. But how rarely in modern Russia does a father want and how rarely does he have the opportunity to be near a child! Thus, the relationship with the father most often adversely affects the formation of autonomy and independence of the child.

But we need to be very clear that the unformed independence of the child at an early age can be the source of many difficulties for the younger student and, above all, the source of the problem of expressing anger and the problem of insecurity. Educators and parents often mistakenly believe that a child with an anger expression problem is one who fights, spits, and swears. It is worth reminding them that the problem can have different symptoms. In particular, one can observe the repression of anger, which is expressed in one child as a fear of growing up and depressive manifestations, in another as excessive obesity, in a third as sharp unreasonable outbursts of aggressiveness with a pronounced desire to be a good, decent boy. Quite often, repression of anger takes the form of intense self-doubt. But even more clearly unformed independence can manifest itself in the problems of adolescence. A teenager will either achieve independence with protest reactions that are not always adequate to the situation, perhaps even to the detriment of himself, or continue to remain "behind his mother's back", "paying" for this with certain psychosomatic manifestations.

Preschool age (from 3 to 6-7 years) is so significant for the formation of a child’s psychological health and is so multifaceted that it is difficult to claim an unambiguous description of risk factors for intra-family relationships, especially since it is already difficult to consider a separate interaction of a mother or father with a child, but it is necessary Discuss risk factors coming from the family system.

The most significant risk factor in the family system is the interaction of the “child is the idol of the family” type, when the satisfaction of the child’s needs prevails over the satisfaction of the needs of other family members.

The consequence of this type of family interaction may be a violation in the development of such an important neoplasm of preschool age as emotional decentration - the child's ability to perceive and take into account in his behavior the states, desires and interests of other people. A child with unformed emotional decentration sees the world only from the standpoint of his own interests and desires, does not know how to communicate with peers, understand the requirements of adults. It is these children, often well-intellectually developed, who cannot successfully adapt to school.

The next risk factor is the absence of one of the parents or a conflict relationship between them. And if the influence of an incomplete family on the development of a child has been studied quite well, then the role of conflict relationships is often underestimated. The latter cause a deep internal conflict in the child, which can lead to violations of gender identity or, moreover, cause the development of neurotic symptoms: enuresis, hysterical attacks of fear and phobias. In some children, it leads to characteristic changes in behavior: a strongly pronounced general readiness to respond, timidity and timidity, submissiveness, a tendency to depressive moods, insufficient ability to affect and fantasize. But, as G. Figdor notes, most often changes in the behavior of children attract attention only when they develop into school difficulties.

The next phenomenon that needs to be discussed within the framework of the problem of the formation of the psychological health of a preschooler is the phenomenon of parental programming, which can influence him ambiguously. On the one hand, through the phenomenon of parental programming, the assimilation of moral culture occurs - the prerequisites for spirituality. On the other hand, due to the extremely expressed need for parents' love, the child tends to adapt his behavior to meet their expectations, based on their verbal and non-verbal signals. According to E. Berne's terminology, an "adapted child" is being formed, which functions by reducing its ability to feel, to show curiosity towards the world, and in the worst case, due to living a life other than its own. We believe that the formation of an "adapted child" can be associated with education according to the type of dominant hyperprotection described by E. G. Eidemiller, when the family pays a lot of attention to the child, but at the same time interferes with his independence. On the whole, it seems to us that it is the "adapted child", so convenient for parents and other adults, who will show the absence of the most important neoplasm of preschool age - initiative (E. Erickson), which does not always fall into the field both at primary school age and in adolescence. attention not only of parents, but also of school psychologists. The “adapted child” at school most often does not show external signs of maladaptation: learning and behavioral disorders. But upon closer examination, such a child most often demonstrates increased anxiety, self-doubt, and sometimes expressed fears.

So, we have considered family unfavorable factors in the process of child development, which can determine the violations of the psychological health of a child crossing the threshold of school. The next group of factors, as we have already mentioned, is related to children's institutions.

It should be noted the meeting in the kindergarten of the child with the first foreign significant adult - the educator, which will largely determine his subsequent interaction with significant adults. With the teacher, the child receives the first experience of polyadic (instead of dyadic - with parents) communication. Studies have shown that the educator usually does not notice about 50% of the appeals of children directed to her. And this can lead to an increase in the child's independence, a decrease in his egocentrism, or maybe to a dissatisfaction with the need for security, the development of anxiety, and psychosomatization of the child.

In addition, in kindergarten, a child may have a serious internal conflict in case of conflict relations with peers. Internal conflict is caused by contradictions between the requirements of other people and the child's capabilities, disrupts emotional comfort, and hinders the formation of personality.

Summing up the objective risk factors for a violation of the psychological health of a child entering school, we can conclude that certain intra-family factors are predominant, but the child's stay in kindergarten can also have a negative impact.

Junior school age (from 6–7 to 10 years). Here, relationships with parents begin to be mediated by the school. As A. I. Lunkov notes, if parents understand the essence of changes in the child, then the status of the child in the family rises and the child is included in new relationships. But more often conflict in the family increases for the following reasons. Parents can actualize their own fears of the school. The roots of these fears lie in the collective unconscious, for the appearance of teachers in the social arena in antiquity was a sign that parents are not omnipotent and their influence is limited. In addition, conditions are created in which it is possible to strengthen the projection of the parental desire for superiority over their own child. As K. Jung noted, the father is busy with work, and the mother wants to embody her social ambition in the child. Accordingly, the child must be successful in order to fulfill the expectations of the mother. Such a child can be recognized by his clothes: he is dressed like a doll. It turns out that he is forced to live by the desires of his parents, and not his own. But the most difficult situation is when the demands made by parents do not correspond to the capabilities of the child. Its consequences may be different, but always represent a risk factor for psychological disorders.

However, the school may be the most significant risk factor for mental health problems. Indeed, at school, for the first time, a child finds himself in a situation of socially assessed activity, i.e., his skills must correspond to the norms of reading, writing, and counting established in society. In addition, for the first time, the child gets the opportunity to objectively compare his activities with the activities of others (through assessments - points or pictures: “clouds”, “suns”, etc.). As a consequence of this, he realizes for the first time his "non-omnipotence". Accordingly, the dependence on the assessments of adults, especially teachers, increases. But it is especially important that for the first time the child's self-awareness and self-esteem receive strict criteria for his development: academic success and school behavior. Accordingly, the younger schoolchild learns himself only in these areas and builds his self-esteem on the same foundations. However, due to the limited criteria, situations of failure can lead to a significant decrease in children's self-esteem.

Conventionally, the following stages can be distinguished in the process of reducing self-esteem. First, the child is aware of his school inability as the inability to "be good." But at this stage, the child retains the belief that he can become good in the future. Then faith disappears, but the child still wants to be good. In a situation of persistent long-term failure, the child may not only realize his inability to "become good", but already lose the desire for this, which means a persistent deprivation of the claim to recognition.

Deprivation of the claim to recognition in younger schoolchildren can manifest itself not only in a decrease in self-esteem, but also in the formation of inadequate defensive response options. At the same time, the active variant of behavior usually includes various manifestations of aggression towards animate and inanimate objects, compensation in other activities. The passive option is a manifestation of insecurity, shyness, laziness, apathy, withdrawal into fantasy or illness.

In addition, if a child perceives the results of learning as the only criteria of his own value, while sacrificing imagination, play, he acquires a limited identity, according to E. Erickson - "I am only what I can do." It becomes possible to form a feeling of inferiority, which can negatively affect both the current situation of the child and the formation of his life scenario.

Adolescence (from 10-11 to 15-16 years). This is the most important period for the formation of independence. In many ways, the success of achieving independence is determined by family factors, or rather, by how the process of separating the adolescent from the family is carried out. The separation of a teenager from a family is usually understood as building a new type of relationship between a teenager and his family, based no longer on guardianship, but on partnership. This is a rather difficult process both for the teenager himself and for his family, since the family is not always ready to let the teenager go. A teenager is not always able to adequately dispose of their independence. However, the consequences of an incomplete separation from the family - the inability to take responsibility for one's life - can be observed not only in youth, but also in adulthood, and even in old age. Therefore, it is so important that parents know how to provide a teenager with such rights and freedoms that he can dispose of without threatening his psychological and physical health.

A teenager differs from a younger student in that the school no longer affects his psychological health through the implementation or deprivation of the claim to recognition in educational activities. Rather, the school can be seen as a place where one of the most important psychosocial conflicts of growing up takes place, also aimed at achieving independence and self-reliance.

As can be seen, the influence of external environmental factors on psychological health decreases from infancy to adolescence. Therefore, the influence of these factors on an adult is difficult to describe. A psychologically healthy adult, as we said earlier, should be able to adequately adapt to any risk factors without compromising health. Therefore, we turn to the consideration of internal factors.

As we have already said, psychological health implies resilience to stressful situations, so it is necessary to discuss those psychological characteristics that cause reduced resilience to stress. Let's look at temperament first. Let's start with the classic experiments of A. Thomas, who singled out the properties of temperament, which he called "difficult": irregularity, low adaptive ability, tendency to avoid, the prevalence of bad mood, fear of new situations, excessive stubbornness, excessive distractibility, increased or decreased activity. The difficulty of this temperament lies in the increased risk of conduct disorders. However, these disorders, and it is important to note, are caused not by the properties themselves, but by their special interaction with the child's environment. Thus, the difficulty of temperament lies in the fact that it is difficult for adults to perceive its properties, it is difficult to apply educational influences adequate to them.

Quite interestingly, the individual properties of temperament in terms of the risk of mental health disorders were described by J. Strelyau. In view of the special importance of his position, let us consider it in more detail. J. Strelyau believed that temperament is a set of relatively stable characteristics of behavior, manifested in the energy level of behavior and in the temporal parameters of reactions.

Since, as noted above, temperament modifies the educational influences of the environment, J. Strelyau and his colleagues conducted research on the relationship between the properties of temperament and some personality traits. It turned out that such a connection is most pronounced in relation to one of the characteristics of the energy level of behavior - reactivity. In this case, reactivity is understood as the ratio of the strength of the reaction to the stimulus that caused it. Accordingly, highly reactive children are those who react strongly even to small stimuli, while weakly reactive children are those with a weak intensity of reactions. Highly reactive and low reactive children can be distinguished by their reactions to the remarks of teachers. Weakly reactive comments from teachers or bad grades will make you behave better or write cleaner, i.e. improve their performance. In highly reactive children, on the contrary, there may be a deterioration in activity. For them, a strict look is enough to understand the dissatisfaction of the teacher.

Interestingly, according to research results, highly reactive children are most often characterized by increased anxiety. They also have a reduced threshold for fear, reduced performance. A passive level of self-regulation is characteristic, i.e., weak perseverance, low efficiency of actions, poor adaptation of one's goals to the real state of affairs. Another dependence was also found: the inadequacy of the level of claims (unrealistically low or high). These studies allow us to conclude that the properties of temperament are not sources of psychological health disorders, but a significant risk factor that cannot be ignored.

Now let's see how the reduced resistance to stress is associated with any personality factors. There are no clearly defined positions on this issue today. But we are ready to agree with V. A. Bodrov, who, following S. Kobasa, believes that cheerful people are the most psychologically stable, respectively, people with a low mood background are less stable. In addition, they identify three more main characteristics of sustainability: control, self-esteem and criticality. In this case, control is defined as a locus of control. In their opinion, externals who see most events as the result of chance and do not associate them with personal involvement are more prone to stress. Internals, on the other hand, have greater internal control, more successfully cope with stress. Self-esteem here is a sense of one's own destiny and one's own capabilities. Difficulties with coping with stress in people with low self-esteem come from two types of negative self-perceptions. First, people with low self-esteem have higher levels of fear or anxiety. Second, they perceive themselves as having insufficient ability to face the threat. Accordingly, they are less energetic in taking preventive measures, they strive to avoid difficulties, because they are convinced that they will not cope with them. If people rate themselves highly enough, then it is unlikely that they will interpret many events as emotionally difficult or stressful. In addition, if stress arises, they show greater initiative and therefore cope with it more successfully. The next necessary quality is criticality. It reflects the degree of importance for a person of security, stability and predictability of life events. It is optimal for a person to have a balance between the desire for risk and security, for change and for maintaining stability, for accepting uncertainty and controlling events. Only such a balance will allow a person to develop, change, on the one hand, and prevent self-destruction, on the other. As you can see, the personal prerequisites for stress resistance described by V. A. Bodrov echo the structural components of psychological health that we identified earlier: self-acceptance, reflection and self-development, which once again proves their necessity. Accordingly, negative self-attitude, insufficiently developed reflection and lack of desire for growth and development can be called personal prerequisites for reduced resistance to stress.

So, we looked at the risk factors for mental health disorders. However, let's try to dream up: what if the child grows up in an absolutely comfortable environment? Probably, he will be absolutely psychologically healthy? What kind of personality will we get in the event of a complete absence of external stress factors? Let us cite the point of view of S. Freiberg on this score. As S. Freiberg says, “recently, it has been customary to consider mental health as a product of a special “diet”, which includes appropriate portions of love and security, constructive toys, healthy peers, excellent sex education, control and release of emotions; all this together forms a balanced and healthy menu. Reminiscent of boiled vegetables, which, although nutritious, do not cause appetite. The product of such a "diet" will become a well-oiled boring person.

In addition, if we consider the formation of psychological health only from the point of view of risk factors, it becomes incomprehensible why not all children “break down” in adverse conditions, but, on the contrary, sometimes achieve success in life, moreover, their successes are socially significant. It is also not clear why we often encounter children who grew up in a comfortable external environment, but at the same time need one or another psychological help.

Therefore, consider the following question: what are the optimal conditions for the formation of a person's psychological health.