What are Childhood-Specific Emotional Disorders?
The diagnosis of emotional (neurotic) disorder is widely used in child psychiatry. In frequency of occurrence, it is second only to behavioral disorders.
Causes of Child-Specific Emotional Disorders
In some cases, these disorders develop if the child has a tendency to over-react to everyday stressors. It is assumed that such features are inherent in character and genetically determined. Sometimes such disorders occur as a reaction to constantly worrying and hyper-custody parents.
Prevalence
It is 2.5% among both girls and boys.
Symptoms of Childhood-Specific Emotional Disorders
Childhood Phobic Anxiety Disorder (F93.1).
Minor phobias are usually typical in childhood. Emerging fears relate to animals, insects, darkness, death. Their prevalence and severity varies by age. With this pathology, the presence of pronounced fears characteristic of a certain phase of development, for example, fear of animals in the preschool period, is noted.
Diagnostics
A diagnosis is made if: a) the onset of fears corresponds to a certain age period; b) the degree of anxiety is clinically pathological; c) anxiety is not part of a generalized disorder.
Therapy
Most childhood phobias go away without specific treatment, provided that the parents take a consistent approach, supporting and encouraging the child. Simple behavioral therapy with desensitization of situations that cause fear is effective.
Social Anxiety Disorder (F93.2).
Caution before strangers is normal for children aged 8-12 months. This disorder is characterized by persistent, excessive avoidance of contacts with strangers and peers, interfering with social interaction, lasting more than 6 months. and combined with a clear desire to communicate only with family members or individuals whom the child knows well.
Etiology and pathogenesis
There is a genetically determined predisposition to this disorder. In families of children with this disorder, similar symptoms were observed in mothers. Psychotrauma, physical damage in early childhood can contribute to the development of the disorder. Differences in temperament lead to a predisposition to this disorder, especially if the parents support the modesty, shyness and isolation of the child.
Prevalence
Social anxiety disorder is not common, mainly observed in boys. It can develop from 2.5 years after a period of normal development or a state of minor anxiety.
Clinic
A child with social anxiety disorder has a constant recurring fear and / or avoidance of strangers. This fear occurs both among adults and in the company of peers, combined with normal attachment to parents and other relatives. Avoidance and fear go beyond the age criteria and combine with the problems of social functioning. Such children avoid contact for a long time even after meeting. They slowly thaw out; usually natural only in a home environment. Such children are characterized by redness of the skin, difficulty speaking, slight embarrassment. Fundamental disturbances in communication and intellectual decline are not observed. Sometimes shyness and shyness complicate the learning process. True abilities of a child can manifest themselves only under extremely favorable conditions of education.
Diagnostics
The diagnosis is made on the basis of excessive avoidance of contacts with strangers for 6 months. and more, interfering with social activity and relationships with peers. The desire to deal only with familiar people (family members or peers whom the child knows well), a warm attitude towards family members is characteristic. The age of the manifestation of the disorder is not earlier than 2.5 years, when the phase of normal anxiety in relation to strangers passes.
Differential diagnosis
A differential diagnosis is made with an adaptation disorder that is characterized by a clear association with recent stress. With anxiety due to separation, symptoms appear in relation to persons who are subjects of affection, and not that it is necessary to communicate with strangers. In severe depression and dysthymia, isolation is observed in relation to all persons, including acquaintances.
Therapy
Psychotherapy is preferred. Effectively developing communication skills in dancing, singing, music lessons. Parents are explained the need for restructuring relationships with the need to stimulate the child to expand contacts. Anxiolytics are prescribed in short courses to overcome avoidance behavior.
Disorder of sibling rivalry (F93.3).
It is characterized by the appearance of emotional disorders in young children after the birth of a younger sibling.
Clinic
Rivalry and jealousy can be seen in a noticeable competition between children in order to receive the attention or love of their parents. This disorder must be combined with an unusual degree of negative feelings. In more severe cases, this may be accompanied by open cruelty or physical trauma of the youngest child, humiliation and anger towards him. In milder cases, the disorder manifests itself in the form of an unwillingness to share anything, a lack of attention, and friendly interactions with the youngest child. Emotional manifestations take various forms in the form of a certain regression with the loss of previously acquired skills (control of bowel and bladder function), a tendency to infant behavior. Often such a child copies the behavior of the baby in order to attract more attention of parents. Confrontation with parents, unmotivated outbursts of anger, dysphoria, severe anxiety or social exclusion are often noted. Sometimes sleep is disturbed, the demand for attention of parents is often increased, especially at night.
Diagnostics
Sibling rivalry is characterized by a combination of:
- evidence of the existence of sibling rivalry and / or jealousy;
- the beginning within the months following the birth of the youngest (usually the next) child;
- emotional disorders that are abnormal in degree and / or persistence and combined with psychosocial problems.
Therapy
An effective combination of individual rational and family psychotherapy. It is aimed at easing stressful effects, normalizing the situation. It is important to encourage the child to discuss relevant issues. Often, thanks to such techniques, the symptoms of the disorders soften and disappear. For the treatment of emotional disorders, antidepressants are sometimes used taking into account individual indications and in minimum dosages, anxiolytics with short courses to facilitate psychotherapeutic measures. General strengthening and bio-stimulating treatment is important.
Treatment of Emotional Disorders Specific to Children
No specific treatment has been identified to date. Some types of psychotherapy and working with families are effective. With most forms of emotional disturbance, the prognosis is favorable. Even severe disorders gradually subside and, over time, go away without treatment, leaving no residual symptoms. However, if an emotional disorder that began in childhood continues into adulthood, then it more often takes the form of a neurotic syndrome or an affective disorder.