Depression and depression
Recently, the terms "depression" and "depression" have appeared more and more often on the pages of various publications and sounded from the lips of different people. Many people understand depression and depression as simply bad moods caused by negative factors, but this is far from the case.
Depression is a mental disorder that usually occurs after negative events in a person's life, but often develops without any visible reason.
In the diagnostic sense, the term "depression" refers to a mental illness, the main criterion of which are emotional disorders. In addition, we should not forget that depression is associated with a large number of mental illness with different origins. In this regard, the famous scientist Freud's opinion that there are complementary causes and factors of depression, including hereditary and physiological, constitutional. Based on this, the key to understanding depression lies in a set of various neurophysiological and psychological studies conducted after in-depth clinical diagnosis. As a concomitant symptom of depression, they differ significantly, so they may be different in neuroses, schizophrenia, borderline and cyclotymic pathologies.
The main difference between mental disorder and just depressed mood is that there is a pathological physical and mental process that threatens the health and life of the patient.
The increase in the number of people suffering from depression on the planet is due to the way of life of modern civilization: accelerated pace of life, stress, increased demands on workers, social and political instability, unfavorable economic situation, migration, uncertainty of people in their future.
As a mental illness, depression is well curable, in more than 80% of cases there is a full recovery, however, nowadays it is the most widespread mental illness. Often, a person suffering from depression begins to abuse alcohol (or other drugs that affect the central nervous system).
The main symptoms of depression include: depressed mood, independent of circumstances, anhedonia - loss of interest or pleasure from previously pleasant activities, expressed fatigue, pessimism, guilt, uselessness, anxiety and/or fear, low self-esteem, inability to concentrate and make decisions, thoughts of death or suicide, unstable appetite, marked decrease or gain in weight, sleep disorders, etc. Depression is also accompanied by increased attention to one's own inner world and decreased interest in the events of the outside world. The patient is often convinced that certain components and qualities of his personality, are defective, incomplete, unhealthy (hypochondria). Sometimes expressed hypochondrial anxiety, which is sometimes primary.
Among the behavioral manifestations of depression are passivity, difficulty of involvement in targeted activities, avoiding contacts. In the intellectual and volitional sphere, there are difficulties in decision making and slow thinking.
From the psychoanalyst's point of view, one of the most common symptoms of depression is a disorder of self-esteem regulation. Victims of depression are patients with unstable self-esteem, who have no external support that supports the self-image.
It is sometimes quite difficult to find out the causes of depression. It can be both physiological sources, such as brain tumors, brain injury, endocrine disorders, and psychological: traumatic, stressful situations.
Violations of self-esteem regulation and subsequent depression may be caused by the loss of an object (a significant person) - its death, repulsion or disappointment in it.
Other good reasons for depression include the collapse of hopes, illusions, loss of ideals, the lack of conformity of lifestyle with the Ya-ideal, the feeling of helplessness, helplessness.
Normally, the sadness caused by the loss of an object is usually not accompanied by a decrease in self-esteem or self-examination. Neurotic melancholy (pathological depression) occurs as a reaction to the loss of an object, when this object has a personal value for a person (that is, has features that coincide with certain aspects of the vulnerable self of an individual).
Thus, psychology today studies depression as a disease caused by a set of different factors: biological, psychological and social. Some scientists propose a hypothesis about the psychosomatic nature of depression, as it is often expressed in a vegetative way, in the form of sleep disorders, eating disorders, reduced sexual desire.
There are several types of depression: primarily endogenous (i.e., mainly caused by genetic causes) and psychogenic (primarily caused by a specific stress event) depression, as well as classical, neurotic, postnatal, circular.
This classification is based on the causes of the disorder and the nature of its course. Thus, psychogenic depression develops in a situation of loss of vital values for the person (loss or death of a loved one, severe stress at work, etc.).
Individuals suffering from such depression are characterized by hypersensitivity and mood swings.
Endogenous depression is not caused by stress, loss, and traumatic situations, but by the innate features of the body. It comes from genetic, biochemical and hormonal abnormalities.
Classical depression is just a state of mind, experienced as sadness, depression, anxiety, anhedonia. Its mandatory symptoms also include external impotence, slow motion and slow thinking (a depressive triad).
Neurotic depression is the result of a long-term psychologically traumatic situation. Such depression is most often found among people with certain personality traits, such as straightforwardness, uncompromising combined with uncertainty, indecision in certain situations.
We can also distinguish such types of depression as dreary, anxious, apathetic, asthenic and others. More often, they are associated with other mental illness. Tawdry depression is more common in manic-depressive psychosis, while anxious and apathetic depression is more common in schizophrenia. Anxious, dreary and apathetic components in the form of permanent or episodic inclusions were defined in all types of depressive states.
Major depression or major depressive disorder, manic-depressive psychosis (bipolar affective disorder) and depressive neuroses are considered separately. These include not only depression, but also its combination with other mental disorders such as manic and gender identity disorders.
The disease begins with a decrease in mood with tearfulness and ideas of unfair treatment of oneself. Such depression is also characterized by: difficulty falling asleep, anxious awakening, weakness, brokenness, headaches in the morning, low blood pressure, constipation and sexual disorders.
The state of psychogenic depression develops within a short period of time. Often there is a fixation on the loss, internal tension and anxiety for their fate, and the fate of loved ones. Patients complain of longing and thinking retardation, express ideas of their own low value, pessimistically assess their past, present and future. They perceive suicide as the only way out of the painful situation.
Postpartum depression develops in young mothers in the first month after delivery. Since the birth of a child is an important stage and partly a critical period in a woman's life, the body at this time is most vulnerable. Such depression manifests itself in emotional instability, fatigue, sleep disorders, increased anxiety, and a feeling of rejection of the child.
The peculiarity of cyclical depression is daily, seasonal or other variants of mood swings. Among the vegetative signs are rapid heart rate, dizziness, nausea. Panic disorder is possible.
Depression in children is less common than in adults. Symptoms in children are also slightly different; these are mainly loss of appetite, sleep problems, nightmares, study problems that have not been observed before, poor performance, emotional isolation, distrust, aggression. In adolescents, drug or alcohol use may also be one of the indicators.
A child's depression may develop based on rejection and emotional coldness of their parents, especially their mother. A child does not develop internal psychological structures capable of regulating his or her self-esteem; he or she needs constant external psychological support. In adolescence, unfavorable family situations, stress at school, in the peer group, and emotional instability can add up. From the moment a child moves to school, the main causes of depression are problems with school and classroom staff (change of teacher or classmates, lagging behind other students, insulting teachers).
For child depression, the division between psychogenic and endogenous depression is mainly also fair. Depression is most pronounced in adolescence. Feelings of sadness, sadness are combined with thoughts of their own lameness and inferiority, unattractiveness for classmates, painfulness. Outwardly, adolescent depression manifests itself in different ways: lethargy, apathy, rudeness, impudence or disobedience, anxious conversations about their health or appearance. Weakening of volitional qualities and loss of energy can be expressed in constant inactivity, a long stay in front of the TV, rereading familiar books, returning to the games of early childhood. A pupil can not take up the lessons, while grumbling at laziness and helplessness. In case of problems with grades the pupil tries to avoid unpleasant situations: he misses classes, runs away from classes, can completely leave education at school.
During the depression a teenager reacts to any comments roughly, in a sharp form, shows aggression, under one hour physical. His behavior is dominated by conflict, cockiness, intolerance. In the circle of relatives, the teenager is unfriendly and hidden, especially in relation to those relatives who show toughness and straightforwardness.
As a rule, childhood depression is prolonged. Usually, it lasts 1-3 months, and rarely runs quickly and briefly. The intensity of manifestation of childhood and adolescent depression varies and depends on the family environment, the physical condition of the child, his temperament and character traits.
The main psychological protection during depression, which is most often used by patients, is an introection. From the psychiatry point of view, the introection is a very important mental process, which allows to diagnose and treat depression. Introduction is the attraction to the inner world of the personality of the views, attitudes and motivation of other individuals, it is also the basis for self-identification. As a result of this process, what happens in the outside world may manifest itself to the patient as internal processes. In case of positive application of the introduction, it helps to carry out the simplest identification of oneself with other significant personalities.
However, "depression" and "depression" are not the same concepts. Depression is a disease, while depression is a personality trait. Depression is a persistent, lasting at least 2 weeks, a decrease in mood, depression completely absorbs the person, he becomes less active, the desire to do something disappears. And depression is a character trait.
However, in depressed individuals under unfavorable conditions, fear of loneliness prevails and may develop the following, already painful, conditions:
- Modesty and timidity - as an inhibition of the ability to assert oneself;
- propensity for comfort, passive waiting, undemanding for life;
- apathy, idleness, drug abuse.
Otherwise, depression is called depressive personality accentuation. This is what we will look at in more detail.
Depressive personality accentuation
Emphasis on character - excessive reinforcement of individual character traits and their combinations, representing the extremes of the norm. They tend to develop socially positive and socially negative depending on the impact of the environment and education. This term was first used by the character emphasis researcher Carl Leongard, a German psychologist and psychiatrist.
For people with depressive (dim or hypothetical) accentuation of personality are characterized by depression, negative perception of the world around them. Constant negative emotions and lack of joyful experiences reduce the activity of these people. Also characterized by increased anxiety, sensitivity to unpleasant situations.
Even rare moments of joy are overshadowed by the belief that it is transient, and that in fact everything is negative. An individual with depression in a moment of joy carries himself into the future with gloomy perspectives.
Therefore, distemperous people are closed, uncommunicative, but this is not a manifestation of autism or other pathology. They remain responsive, but can be frank only with some people they know well. If they show trust in the person, they also become attached and psychologically dependent on the person. They are more in need of love, understanding, friendship, empathy. People with depressive character emphasis need support, positive evaluation, reassurance about their value and need, uniqueness, and social weight.
However, distimists are aware of their isolation, self-deepness, negative emotions. And this prevents them from living normally. In what they have to do, people with depressive accentuation of character find only bad sides. They can not withstand prolonged willpower tension, indecisive and timid. In their behavior, they are slow because they are dominated by inhibition processes supported by melancholic temperament. There are headaches and dizziness, constipation, sleep disorders, sleepiness, poor appetite.
Children with this accentuation are tearful, thoughtful. They also have psychotic occurrences (manic or depressive outbreaks). Similar features are present in psychasthenics. In their professional activities, hypothyms are characterized by responsibility and reliability. In the mechanism of overcompensation, boldness and excitability may arise, while the degree of excitability depends on anxiety.
We can state a good development of thinking in people with depression, while thinking mainly verbal. In case of stress, stop reactions and activity blocking occur. In the form of protection, there is a shift from self-actualization and increased control of consciousness.
According to E. Zhilina's research, distal accentuation of character is not characteristic of adolescence and youth, at least without associated physical deviations. The connection between depression and depression is determined by the fact that in stressful and traumatic situations, dystymics easily fall into depression. Therefore, children and adolescents with depressive character accentuation may develop long-term depression in adverse psychological or physical conditions, exacerbated by neuroses, anxiety, or phobias. For example, dystymymics have a propensity for sociophobia and obsessive-compulsive neuroses. They may experience negative social experience or other situations assessed as negative for a long time.
Emotional stress and resistance to stress
Emotional stress is a non-specific (general) reaction of a living organism's tension to any strong impact on it.
The existing stress factors can be divided into the following groups:
- Stressors of active activity: their impact on the body is carried out in the process of a person performing a targeted act. They can not only disrupt the course of the activity, but also strengthen and mobilize it. They can be:
- extreme stressors: participation in hostilities and all other situations of risk;
- industrial stressors - work with a high level of responsibility, time constraints, etc.
- psychosocial stressors - various kinds of competitions and contests.
- Assessment stressors: they are characterized by the emotional coloring of the present or upcoming activity. Assessment stressors can act on a person long or immediately before the activity, immediately after the end or after a long period of time after the action. Thus, many adults remember offensive nicknames that teachers gave them at school. This includes also:
- starting and memory stressors - upcoming contests, diploma defense, a concert performance, and a sudden memory of a grief they had experienced.
- Stressers, victories and defeats - successes in career, art and sports. Love, marriage, birth of a child, defeats, failures, non-recognition in activity, illness of a loved one.
- spectacle stressors - sports spectacles, films, theater performances, fine arts, etc.
- Stressors of misalignment of activities:
- Disagreement stressors: conflict situations, threat, unexpected but significant news, etc.
- Restriction stressors - psychosocial and physiological: diseases that limit normal areas of activity, isolation, discomfort, sexual disharmony, hunger, thirst, etc.
- Physical and natural stressors:
- muscle strain, surgery, medical procedures, injuries, darkness, bright light, strong unpleasant sound, vibration, rocking, height, cold, heat, earthquakes, etc.
Stress can be divided into two types - eustress and distress. We also distinguish between nervous and mental, social, thermal, light and other stresses, as well as positive and negative forms of stress.
Eustress manifests itself as a positive impact on the psyche and the human body, as it mobilizes them, increases concentration, improves reaction and mental activity in general. It also has a positive impact on the adaptive properties of the body.
Distress - pathological stress, which has a negative impact on the psyche and human health, worsens mental activity, deforms behavior, sometimes leading to complete disorganization. It is accompanied by hyperactivation of neurohumoral systems, which may become a pathogenic source for all systems and organs in the body. Distress may cause or exacerbate neurotic, psychosomatic and physiological diseases. The formation of this or that type of stress is dependent on all factors of the stress situation: health, both mental and physical, personality traits, the usual way of life and response to stress, the mechanism of individual psychological protection, the degree of psychological and social support.
Nervous psychological stress appears due to incompatibility of individuals in the group, a large concentration of individuals of the same species, constant noise, etc.
Social stress is a social tension that requires multiple adaptive reactions, complex balancing in systems of social behavior, interaction, etc.
In stress, it highlights the main phases:
- The phase of anxiety - mobilization of protective forces;
- the phase of resistance - adaptation to a complex, stressful situation;
- the phase of exhaustion, which under severe, prolonged stress can provoke illness or even death.
The manifestation of distress is manifold, but there are also some common symptoms. One of the main signs is anxiety. Each person is characterized by a different level of anxiety, which is optimal and allows you to continue normal activities. But in case of distress, unlike eustress, the level of anxiety increases several times, and the alarm turns into its unproductive destructive form.
This leads to disorders of cognitive and vegetative processes. Attention, memory, reduced performance, increased emotional irritation, excessive muscle strain, poor appetite and sleep.
Also, stress takes part in the emergence of psycho-vegetative disorders. The vegetative disorders caused by distress are manifold and affect all body systems. They can often be masked as symptoms of various physiological pathologies.
In the work of the cardiovascular system there is an increase in heart rate, pulsation, instability of blood pressure, its increase or decrease, exposure to lipotic conditions: fainting, pre-fainting sensations.
In the respiratory system, distress manifests itself as breathing, a feeling of lack of air, the presence of hyperventilation syndrome.
Often there are hiccups, nausea, vomiting, poor appetite, diarrhea or constipation, flatulence, desbacteriosis, gastrointestinal spasms.
Other vegetative disorders may be observed in distress: increased sweating, a feeling of heat or cold, chills, nervous shivering, dizziness, frequent urination.
It is confirmed the involvement of emotional stress in the emergence of panic attacks and vegetative crises. The most striking feature of psychovegetative syndrome is panic attack, including a large number of vegetative disorders and emotional expression in the form of panic.
Panic attacks can cause many stressful situations: life changes - a prolonged illness or death of a native person, separation, divorce of spouses. Or situations related to their own state of health: severe physical stress, starvation, pregnancy and its termination, childbirth, surgical operations, somatic illness and, finally, stress-induced exacerbation of conflict situations. Most often the cause of stress and panic attacks are family conflicts.
As a consequence of emotional stress, pain syndromes are exacerbated: headaches, migrainous attacks, menstrual pain, myofascial pain syndromes. This comes from the increased muscle tension observed in distress. This tension also accompanies anxious and depressed people. During stress, muscular tension is known as tension in the muscles of the neck, face, especially the forehead, and jaws, clenched teeth, fingers on all limbs, discontented facial expressions, frowning, gestures, motor hyperactivity, excessive blinking, sharpness in statements and judgments.
The psychological literature actively discusses the concepts of stress availability and stress resistance, as they largely determine whether a person will experience distress in response to a certain event.
A person's stress resistance is the ability to overcome difficulties, suppress their emotions, understand human moods by showing restraint and tact.
Stress resistance is defined by a set of personal qualities that allow a person to endure significant intellectual, volitional and emotional stress caused by the peculiarities of professional activity, without special harmful consequences for the activity, others and their health.
Stress availability - personal qualities that prevent a person from overcoming emotional stress.
Stress tolerance is typical for physically healthy, emotionally stable individuals with an active life position, with low anxiety and adequate self-esteem. Stress tolerance is mainly characteristic of passive, dependent, highly anxious or depressed and hypochondriacal individuals, dystymics and hypothymists. It reveals a connection between depression and stress resistance.
Stress tolerance increases with lack of sleep, physical or mental exhaustion, after the disease, etc.
Undoubtedly, the strength and duration of the stress exposure itself play a role.
Children are more exposed to stress than adults. They are more strongly affected at an early age by physical and natural stressors, and in teenagers - by stressors.
We can talk about reduced stress resistance in children, especially if it is accompanied by distemporal character accentuation, vegetative or physical disorders.
As in adults, stress in children is characteristic and individual for each of them. Not every child is stressed at the same time. One child can easily pass through the days of school without any effort, getting high scores without the slightest effort, but for another child rivalry at school seems so frightening that he begins to have stomach cramps and headaches even at the sight of the school bus approaching the stop.
In addition, children that experience significant stress react differently to it. Some small children may return to infant behaviors such as holding their thumb in their mouth or urinating in bed.
Older children show signs of depression, become silent and withdrawn, and avoid friends. Others show stress in difficult behaviors such as fits of irritation or outbursts of rage that show that they lose control of themselves.
It is not unusual for children to become nervous under the influence of stress or to have a ticking, flashing, twitching, winding hair on their fingers, or frequent swallowing, which will be discussed in more detail.
Symptoms and factors of tycosis hyperkinesis occurrence
One of the most frequent neuropsychiatric disorders in childhood is tycosis hyperkinesis, which is a sudden involuntary, violent, jerky, repetitive, varying in intensity of movement, covering different muscle groups. According to various literature sources, tics are found in 4-7% of children.
When motor ticks occur, genetic and immune mechanisms, perinatal pathology (pathology of a child's development a couple of weeks before and after birth), and psychosocial factors play an important role. One should always keep in mind the possibility of exposure to several factors that affect each other.
In 90% of cases, tics begin at the age of 3 to 15 years. They most often appear at the age of 6-8 years and may be transitional from early childhood to adolescence. Many studies show that in 8.5% of cases the disease occurs after the first days of school ("tics of September 1"). A child's going to school coincides with the fourth age crisis - the crisis of 7 years. A common stressful situation that requires a child to adapt is a change of team, the need to get used to new environments and activities, the transition from kindergarten to school, or from one school to another.
The disease reaches its peak at the age of 10 years. In 50% of cases ticks disappear by the age of 14. They can also appear in adulthood, although there are often indications of episodes of the disease in childhood in the patient's anamnesis (a survey of the patient's history and life). Among patients with ticks 4-6 times dominated by men.
Ticks are significantly increased under the influence of emotional stimuli - anxiety, fear, embarrassment. The disease is wave-like with periods of improvement and exacerbation. In children, for example, a period of improvement can be observed during the vacations.
A distinctive feature of ticks is their irresistible nature. According to patients: "Trying to prevent ticks is like trying to stop sneezing. Any attempt to suppress them with willpower always leads to increased tension and anxiety, and the violent implementation of the desired motor reaction brings immediate relief.
Children's tics are classified according to etiology (primary, secondary, cryptogenic), clinical manifestations (local, common, generalized - Tourette's syndrome, severity (single, serial status), current (transiting, rehearsing, stationary), and stage.
Secondary ticks are associated with taking medicines (antiepileptic drugs, neuroleptics and other antidopaminergic drugs, levodopa drugs, psychostimulants), encephalitis, vascular diseases, carbon monoxide poisoning, birth pathology.
In terms of frequency, the ticks are in descending order from the upper face to lower extremities, and the most common is blinking, followed by the ticks of the lower face, neck and shoulders, and then the torso.
Stress as one of the causes of motor ticks
According to the general opinion of most psychologists and psychiatrists, the main factor of ticks in children and adolescents is stress. A similar cause is observed in 64% of cases of tycosis hyperkinesis, including motor (motor ticks). Adaptation stress in school can be called the dominant one. Also among the significant stressful situations are unfavorable family circumstances, separation from father or mother after the parents' divorce, and sudden fear. Tics may also occur after respiratory infectious diseases, especially after bronchitis, tonsillitis, otitis, or rhinitis. Primary and repetitive ticks may occur as a result of prolonged mental or nervous tension, acting under the influence of evaluation stressors. Also the basis for the development of tycosis hyperkinesis may be a traumatic brain injury.
In addition, ticoses are caused by long work at a personal computer, excessive watching of TV, emotional experiences. Ticks are more often exacerbated in the evening or seasonally: in autumn and winter. In half of the cases, the ticks are reduced during medical examination, and may disappear in contrast to the home environment. Facial ticks are more often manifested in a quiet environment.
It means that adolescents with low stress resistance are more susceptible to tick-borne hyperkinesis, which in turn can be caused by depression. But there is also a feedback when motor ticks provoke uncertainty in children, creating a predisposition for distemporal accentuation of character and development of depression.
Children's tics can be one of the symptoms of childhood depression, and depression is a consequence and concomitant tick disorder.
Emotional state of the child and development of motor ticks
Ticosal hyperkinesis has a negative impact on the mental and emotional state of the child. Approximately half of patients with Tourette's syndrome develop obsessional syndrome in adolescence and youth, which manifests itself through haunting thoughts, memories, unfounded fears, which are often accompanied by obsessive actions, sometimes taking the character of a complex ritual. In school years, many patients are often marked by slowness, distraction (hyperactivity disorder and attention deficit). Sometimes aggression, inclination to self-harm, depression, negativism are observed.
From the medical point of view, tics are the result of errors in the extrapyramid system (brain departments responsible for the organization of movement, posture and regulation of muscle tone). But from the psychological point of view, tics, especially neurotic ones, have a psychological component. A tick is a certain desire, emotion, feelings that are suppressed and cannot be expressed. Often, a child feels sad feelings and is shy about a tick, considering it a manifestation of its inferiority. Peer mockery is especially hard to bear. Therefore, a child suffering from a tick tries to have less contact with other children; he or she is withdrawn, hidden, crying or irritable.
Ticks can be attributed to psychological, rather than neurological disorders, as they are easily provoked and eliminated, can appear suddenly and proceed very quickly, disappearing in a state of sleep. Rhythmicity distinguishes ticks from stereotypical repetitive actions, typical for autism or mental retardation. Unlike compulsive movements, ticks are not defined by a conscious goal.
In most cases, ticks are of psychogenic origin: they often accompany emotional disorders and mental development delays. Therefore, in each individual case, a complete diagnosis of the child's mental and physical condition is necessary to determine the cause and specificity of thikosis.
Children aged 4-5 years may have transient ticks, which in itself is not a disorder, but an extreme variant of the age norm of development. Chronic ticks that disrupt the process of human social interaction can be considered pathological. They are the ones that reduce children's stress resistance and provoke the development of depression.
Based on all the above, we can propose a hypothesis that adolescents suffering from motor ticks have increased depression and reduced stress resistance, which is both the cause and consequence of tycosis hyperkinesis. We will be able to confirm or refute this theory in practical research. At the same time, it is necessary to analyze the results of the study and make recommendations to reduce depression and increase stress resistance in adolescents with motor ticks.
Characteristics of the research subject
Our study surveyed 30 adolescents aged 11 to 18 of both sexes with different motor ticks. The entire group of children surveyed is divided into two subgroups: 15 girls and 15 boys each. Children of the same age are represented by two individuals of both sexes with different clinical patterns of ticks. Only 18-year-olds are represented by only two people: one girl and one boy, because tickosa hyperkinesis is less common at this age. The names of the children under study have been changed and are a common combination of Russian names and surnames. The study is planned to be conducted over a two-day period, with anonymity and non-disclosure of data.
The children's anamnesis is studied in advance: interviews are conducted with them, their parents and teachers to paint a picture of the course of the disease, possible causes of ticks, and personal characteristics of the teenagers involved in the study. All data are recorded in special lists.
To analyze and understand the results obtained, it is necessary to provide a brief description of each of the teenagers with motor ticks.
The first in the list of tested girls is Yulia Abramova, 11 years old. The girl has a pronounced local tick: twitching muscles of the face, lips, nose, eyes and cheeks. With breaks lasts a year. Yulia is a pupil of the 5th grade, has good academic performance, lives with her parents, but conflicts are often observed in the family. She has a younger brother. The inclination to respiratory diseases. The temperature is melancholic.
Next child is Olga Andreeva, also 11 years old. Suffers from a common tick, which manifests itself in facial tick, involuntary movements of shoulders and neck. Studying in the 4th grade of the school, performance is average. She lives with her mother and has no father. She often complains about dizziness. In general, the girl's well-being is characterized by asthenic manifestations. The prognosis gives an idea that the tick first appeared at the age of 4 and appeared periodically, appearing again after the treatment. Phlegmatic.
Bogdanova Katerina at the age of 12 has Turret's syndrome: rapid blinking is supplemented by speech disorders. The girl is studying at home because of chronic diseases of the musculoskeletal system. In the classes she shows assiduity, likes to study, but suffers from lack of communication with peers. Ticosis hyperkinesis appeared relatively recently - 8 months ago, and two months later began to show speech disorders. Katerina lives with parents, who show a dominant hyperprotection - excessive petty control in her upbringing. The temperature is melancholic.
She suffers from local tic Borisov Svetlana, 12 years old. Fast flashing is observed. Lives alternately with her father and mother: parents are divorced. Studying in the 6th grade of school, academic performance is average. She complains about vegetative displays: headaches, sweating of hands and feet, rapid heartbeat. The girl is not painful, there are no expressed physical pathologies. The temperature is choleric.
Volkova Tatiana 13 years old has symptoms of a common motor tick: the institution of gaze, body curvature, sometimes accompanied by bouncing. Lives in a family of foster parents. She was excommunicated from her real parents seven years ago due to the family's poor state of health and was subjected to harsh treatment. The first signs of tycosis hyperkinesis appeared when she was 5-6 years old, and then it became worse. Studying at a specialized school for children with nervous disorders, Volkova was previously diagnosed with neurotic conditions. Propensity to respiratory diseases. The temperature is choleric.
Volkova's age - Anna Vladimirova with a local tick: involuntarily tilting her head. She lives with her parents and has a sister. Studying in the 6th grade of school, she studies in various clubs, obviously parents are too demanding, there is a role-playing disorder in the family: the girl is given the image of a "prodigy". She shows good grades, but quickly gets tired. Hysterical seizures are frequent, there are disorders of sleep and digestive system. Ticks have been observed for two years now. The temperature is melancholic.
Alla Gordeev is 14 years old and has been affected by the local motor tick. Her tick is characterized by involuntary nose twitches. She lives with her parents. Studying in the 7th grade of gymnasium, succeeding well. No physical or mental pathologies noted. But shows increased shyness, has problems in communicating with peers. Signs of a tick periodically return, starting from the age of 4. The temperature is phlegmatic.
Eugenia Grigorieva - 14 years old, suffers from a widespread tick, abdominal muscles are supported, spasms of leg muscles are observed, sometimes involuntary movements of the hands. She lives with her parents, has a brother and sister. Studying in the 7th grade of general education school. Achievement is good. No physical or mental deviations have been observed before. Tick first appeared at the age of 7, but quickly passed. Then from the age of 12 there were temporary attacks. Reasons of its occurrence are unknown. The temperature is choleric.
Another teenager Oksana Dmitrieva, 15, was diagnosed with local motor tick: twitching of the corners of the mouth. Oksana lives with her father, the girl's mother died. She is studying in the 8th grade and is doing well. The tick started after a craniocerebral injury three years ago; at the same time, a school psychologist diagnosed depression two years ago. There was a course of psychotherapy. Melancholic.
Another girl under test - Irina Zinovieva, aged 15, has Turret's syndrome. Along with flexion of fingers there are speech disorders. The girl is brought up by her grandmother, as her parents are abroad. Studying in the 8th grade, she does not find any special success in studies, shows a lack of discipline. She tried to run away from home. The first signs of the syndrome appeared at the age of 7. There are no physical deviations. The temperature is choleric.
Kondratyeva Elena is 16 years old. Symptoms of local tick on the face: head turns. Lives with her parents and brother. Studying in 9th grade. Achievement is good. Ticks began to appear two years ago during exams. During the vacations they pass. In childhood, was operated on for heart failure. The temperature is phlegmatic with some sanguine features.
Kovaleva Vika, also 16 years old, shows signs of a common tick: the movement of shoulders, fingers, spasms of the diaphragm muscles. Lives with his parents. Studying in the first year of technical school. Ticosal hyperkinesis began to show recently, since the end of school. In general, the girl is painful: she tends to have respiratory and infectious diseases. The temperature is choleric.
The representative of the older part of the subjects, 17-year-old Maria Leonidova, has a local tick, expressed in jerking facial muscles. She lives with her parents and brother. Pupil of the 10th grade, studies well. This jerking occurred periodically from the age of 14, was observed against the background of emotional experiences: associated with the mother's disease. General physical condition is satisfactory. Choleric.
Leontief Valentina, 17, unlike the previous girl, shudders, involuntarily raises her arms, which reveals a common tick. She lives separately from her parents and has finished school and does not continue her education yet. The tick appeared periodically from the age of 5, according to the mother, it was the first time when she was frightened. It was last resumed after separation from the young man and emotional experiences. He suffers from kidney disease. Phlegmatic.
Closes the list of female researchers - Lesya Makarova, 18 years old. The girl's local tick manifests itself in the form of involuntary facial muscle movements. She lives with her mother, her parents are divorced. First-year student in one of the universities. The tick manifested itself a year ago at the end of school, since then it lasts with different intensity, depending on the mental tension in study. It is accompanied by somnambulism. No physical pathologies have been identified. The temperature is choleric.
Description of the male subjects we will start with Andrey Avdeev - 11 years old. The boy suffers from local tic: obsessive uncontrollable shoulder movements. Lives with a divorced mother. Studying in the 4th grade. Achievement is low. The first attacks of tycosis hyperkinesis appeared at the age of 6. Later they disappeared and renewed with different intensity. General health condition is satisfactory. The temperature is choleric.
His peer Oleg Alexandrov has Turret's syndrome. In the beginning, three years ago, the disease manifested itself as a local tick of the facial muscles, then it went into the phase of a common tick with fluttering, and was supplemented with speech disorder, which is characteristic of Turret's syndrome. He lives with his grandmother, because his parents died. Studying in 5th grade, performance is mediocre. Has problems with discipline, in remission periods attended a sports club. There are no physical pathologies, but in early childhood we observed enuresis and sleep disorders. The temperature is choleric.
12-year-old Belikov Sergey involuntarily twitches his arms, squats, which confirms the diagnosis of common motor tic. He lives with his mother and sister. Studying in the 6th grade. His success rate is bad. In class, shy, quiet, often cries. Mother chose an authoritarian style of upbringing, often breaks down on her son, which she herself realizes. Tick first appeared at age 3, first as a local tickosis hyperkinesis. He is prone to respiratory diseases, had a lung operation. Melancholic.
Igor Varlamov - 12 years old suffers from local tick: the boy has a nose wings flinching. He lives with his parents and two brothers. Studying in the 5th grade, progress is good. The tick appeared relatively recently after the death of the grandmother to whom the child was attached. His physical health is satisfactory. The temperature is sanguine.
The list of investigated teenagers is continued by Nikolay Glebov, age - 13 years. He lives with his mother and his parents have recently divorced. Studying in the 6th grade of the grammar school, attending circles. He has an average academic performance, but likes to do creative work. Tick first appeared at the age of 7, then passed and resumed after the parents divorce. He suffers from childhood diabetes. The temperature is phlegmatic.
Dorofeev Mikhail is 13 years old, bending his hands involuntarily, shuddering. Lives with his parents and sister. For the first time the widespread motor tick has made itself known at the age of 10. The boy began to study worse, to skip classes. Now in the 7th grade the study load is higher and his academic performance has deteriorated. He is sick and inclined to respiratory diseases and neuroses, including sleep neuroses. The temperature is choleric.
A boy at the age of 14, named Alexander Yeremeyev, is prone to twitching corners of the mouth, involuntary smile, which is evidence of local tic. He lives with his father and sister. Studying in the 7th grade, he shows average performance and has problems with discipline. The tick has appeared recently, about six months. The exact causes of tick-borne hyperkinesis are unknown, the child is closed and has no proper contact with the father. The temperature is choleric.
Boris Zhdanov, also 14 years old, has symptoms of common motor tic. The teenager blinks fast, moves the neck and bent the torso. Lives with his mother. Studying at school for children with nervous and mental disabilities. He was diagnosed with mental retardation. Tick manifests itself from the age of 5. There are no physical pathologies. Phlegmatic.
Ivan Klimov, 15, is one of the other children who participated in the research. Turret's syndrome is expressed: facial tick and hand movements are supported by speech disorders. He lives with his parents and three brothers and sisters. Studying in the 8th grade, good academic performance. Often takes care of younger brothers and sisters. Physically healthy. A possible cause of motor tick in a teenager is physical and psychological stress that does not correspond to age. The tick first appeared at the age of 8. The temperature is melancholic.
Ivan's age-mate - Kostin Peter is subject to involuntary head tilts, movement of arms and legs. He lives with his parents, in the family conflicts are not uncommon. Studying in the 8th grade, assiduous, his progress is good, but dispersed. He is uncommunicative and worried about his tick. For the first time it manifested itself at the age of 9. The temperature is choleric.
16-year-old Pavel Matveev often blinks, which is typical for a local tick. He lives with his mother. Studying in the 9th grade of school. Her success rate is bad, problems with discipline turn into hooliganism. Tick appeared for the first time in 12 years. Hasn't stopped almost since then. There is a speech defect. Physical indicators are good. The temperature is choleric.
Maxim Markov, 16, he has head and shoulder movements, flinching, sometimes muscle spasms, general muscle tension. The exact moment of the beginning of the disease is not determined. He is brought up in an orphanage, at the same time studying in a vocational school, as he has completed only 9 classes. Achievement is low, relations with peers are difficult. Painful, inclined to infectious diseases. Phlegmatic.
Eyelid twitching and blinking are typical for 17-year-old Vladimir Nikonov. He lives with his parents and sister. Studying in 10th grade, good academic performance. Had polio in childhood. Studying in the 10th grade of school, grades are average. For the first time the tick appeared at the age of 3. In general, the boy is sick, it is manifested as a consequence of previous illness. Melancholic with phlegmatic features.
Alexey Nazarov, also 17, shows symptoms of a common tick: movement of arms, torso and legs, tremors. He lives with his parents, there are also frequent conflicts in the family. Studying in 10th grade of school. Success is good. The tick started at the age of 13. Physical condition is satisfactory. The temperature is choleric.
The most adult - Dmitry Osipov - 18 years. He has a facial tick, eyebrows movement. The boy lives separately from his parents, works. He developed tycosis hyperkinesis at the age of 7. Over time, he periodically underwent treatment, and then renewed in stressful situations. There are no mental or physical pathologies. The temperature is choleric.
In addition, a similar study will be conducted for a group of healthy adolescents of 30 people (equal group will simplify statistical calculations). For convenience, each child will be conditionally called by letters of Russian - for girls or Latin alphabet for boys. Their detailed description is not given - the main criterion is that none of them has suffered or suffers from tycosis hyperkinesis.
Thus, by describing the general anamnesis and psychological profile of each teenager with a tick that is the subject of our study, we can begin a direct study of their depression and stress resistance.
Diagnosis of teenagers' depression by Beck and Zhmurov methods
Beck's depression diagnosis allows us to find out with the help of the survey that depression prevails in a teenager, as an accent of character or depression, as a pathological mental process.
The questionnaire contains 13 question choices, four questions each (only the eighth question contains three answer choices). The teenager is invited to answer by choosing the most appropriate option for all 13 questions. The variants of answers are adapted for teenagers.
After, when processing the questionnaires for each answer there are points: for each answer A there are 0 points, answer B - 1 point, B - 2 points, D - 3 points. After that, the total score is calculated. If it does not exceed 10, a child is not inclined to be depressed; if it is from 10 to 19, then depression may occur. If it is between 19 and 24 points, then the teenager may suffer from beginning depression. If it is above 24, then the child needs antidepressant therapy because he or she suffers from moderate to severe depression.
Before starting the diagnosis of depression of teenagers using the Beck method, all teenagers are given questionnaires and explained how to fill them out. When the group of surveyed children is ready, they start filling in the questionnaire on command. It takes 40 minutes to fill in the questionnaire. If any of the tested children finish early, they are allowed to quietly leave the classroom.
An example of points calculation is given in the completed Andrey Avdeev's questionnaire.
The Beck Depression Scale (BDI) allows to reveal not only depression and degree of depression in adolescents, but also to study cognitive and somatic manifestations of depression. The cognitive-effective, i.e., intellectual-emotional sphere of children is characterized by statements number 1-5, 7, 9, 11, and 13. Somatic manifestation can be identified by statements 6, 8, 10, and 12.
After undergoing the Beck method of depression diagnosis, adolescents undergo a differential diagnosis of depression using the V.A. Zhmurov method. The method adapted for adolescents is, like the previous one, a test questionnaire consisting of 39 statements with four variants of answers. These statements determine the presence and degree of depression (mainly dull or melancholic depression). It also provides an opportunity to determine the severity of a depressive condition at the time of testing and to distinguish between depression and depression. Each statement is scored on a 3-point scale. In this case, the answers marked with the letter a - get 0 points, the letter b - 1 point, c - 2 points, d - 3 points. The higher the number of points, the more pronounced the depressive state is:
- 1-9 - no depression;
- 10-24 - there is a depressive accentuation of character;
- 25-44 - initial degree of depression;
- 45-67 - average degree of depression;
- 68-87 - major depression;
- 88-87 - major depression; 88-87 - depression requiring emergency treatment.
An example of score calculation is given in the questionnaire of the same Andrey Avdeev.
Both methods are similar in many ways, so the first one is used as a forming experiment, and the second one as a controlling experiment. After both surveys have been conducted and scores have been counted for each questionnaire, summary sheets are made for the whole group of adolescents with motor ticks in the study. A similar summary list is also provided for healthy children.
Zhmurov's method also makes it possible to consider cognitive and somatic manifestations of depression separately, since finding a general score alone is not enough to classify a depressive state and understand its nature.
Diagnosis of adolescent stress resistance by Holmes-Raget and Kettell methods
American scientists Holmes and Raghe have devoted a long time to studying the dependence of mental and physical diseases of different origins on stressful situations. In the course of research they interviewed and examined more than five thousand people. As a result Holmes and Raghe came to a conclusion that mental and physical diseases (including thikosis hyperkinesis) are often preceded by serious events and changes in human life. Based on their work, they have created a scale where each event in a person's life has its own stressfulness score.
When the scores are summed up, it is possible to find out how high the probability of illness and a person is, and what is their degree of resistance to stress. The second one is the one we are most interested in. Teenagers are given a questionnaire with Holmes-Raget test adapted for children. The test contains 43 events. Opposite to each of them, the teenager under study sets a mark, and then the points are summed up during the processing of questionnaires. The higher the number of points, the higher is the stress tolerance. However, too many scores are also evidence of susceptibility to nervous disease:
- 150-199 points - high stress resistance;
- 200-299 points - Threshold of stress resistance;
- 300 or more points - low stress resistance (vulnerability). An example in Avdeev's questionnaire.
The Kettel survey is one of the most popular questionnaire methods for assessing individual psychological characteristics of a person both abroad and in our country. It was developed under the guidance of R.B. Kettel and is intended for writing a wide range of individual-personal relations.
A distinctive feature of this questionnaire is its focus on identifying relatively independent 16 factors (scales, primary traits) of personality. This quality has been identified through factor analysis from the largest number of surface personality traits originally identified by Kettel. Each factor forms several superficial traits grouped around one central trait.
There are 4 forms of questionnaires: A and B (187 questions) and C and D (105 questions). In Russia, forms A and C, adapted by E. S. Chugunova, are most commonly used.
From 105 questions, we choose only, we will describe only 24 questions describing emotional characteristics of the personality of teenagers with motor ticks, including stress resistance. Since the questions in the Kettel test are grouped according to their content around certain traits that eventually come out to some or other factors.
The results are processed using a special key with question numbers and the number of points that are given a, b, c in each question. In the cells with a letter indicating the factor, the number of points is zero. Thus, for each answer the subject may get 2, 1 or 0 points. The number of points for each factor is summed up and recorded on the answer sheet, thus, we obtain a personality profile by the stress tolerance criterion in raw scores. These scores are translated into standard (wall) scores. Then, it is determined whether this factor has developed: low, medium or high. As a result, we can judge about the severity of certain personal qualities.
Thus, Avdeev's factors C are low (1 point on a standard score), factors O are high (8 points), factors Q 3 are average (5 points), and factors Q 4 are high (7 points). In general, this confirms the low stress resistance identified during the Holmes-Raghet diagnosis, but has other more detailed indicators.
The teenager shows genetic emotional instability (biological dependence), plasticity of nervous system, however - high self-regulation, control of emotions and behavior, stress resistance.
The data on stress resistance of both tests are recorded in special lists. In addition, the 16-factor Kettel Interviewer provides a better understanding of each child's intellectual and communication abilities. We do not provide detailed questionnaires in the survey, limiting ourselves to the final list of the results of personal diagnosis of teenagers using the Kettel method. Where: B - general level of intellect; M - level of imagination development; C - stress resistance; O - degree of anxiety; Q 3 - presence of internal tensions; Q 4 - level of self-control development; G - degree of social normality and organization; A - openness, isolation; H - courage; L - attitude to people; E - degree of dominance - subordination; Q 2 - dependence on the group.
Processing and interpretation of data
So, after conducting direct research, we compare the data. For starters, we compare depression rates on the Beck and Zhmurov scales. The data are almost identical. The only difference is that Zhmurov's diagnosis is more differentiated, and that Beck's depression is considered the highest degree of depressive character accentuation, the Zhmurov scale classifies as beginning depression. This gradation is fair if we take into account the fact that distigmatism under unfavorable conditions (which are in fact tycosis hyperkinesis and its causes) leads to the development of depression. Therefore, we do not use additional mathematical tools to compare the samples.
As a result, we can say that adolescents with motor ticks very often have depressive character accentuation: 60% (18 people) on the Beck scale and 53% (16 people) on the Zhmurov scale. Dystigma becomes depressed in 27% (8 people) on the Beck scale and 43% (13 people) on the Zhmurov scale. And, only 4-13% (3-4 persons) of children with tycosis hyperkinesis lack depression and depression.
At the same time, we can also examine the sex and age dynamics of depression in the study adolescents. Among girls, depression is found in 11 and 7 cases respectively. Among boys there are 7 and 9 cases. At first glance, the ratio seems to be approximately equal. But in such a small sample it is necessary to use statistical and mathematical methods of comparing depression by sexual group.
To do this, we will use the null hypothesis method. Our null hypothesis is based on the fact that among girls and boys with thikose hyperkinesis at the age of 11 to 18 years of depression is spread approximately the same. To do this, we must find the significance coefficient and degree of freedom in the group of girls and boys. We roughly equate Beck and Zhmurov's scales with a common three-point scale, where 0-point means no depression in a teenager, 1-point depression, and 2-point depression, regardless of its degree.
Having done this, we begin to calculate the significance level coefficient.
Thus, the significance level coefficient is 2.7, and the permissible degree of freedom for groups is 28. According to the table of significance levels t Student, we find that in a sample with a significance level of 0.99 (this means that calculations based on mathematical probability theory suggest that in the same studies 99% of cases, the same result will be obtained, perhaps, only with minor deviations) and degree of freedom 28 should be the coefficient of 2.7633. The coefficient we found is 2.7, i.e. it differs only by 0.633. This confirms the null hypothesis and proves that the distribution of depression among girls and boys is almost the same.
A study of the stress resistance of adolescents with motor ticks gives us a similar picture of diagnostics using Holmes-Raget and Kettel methods. For the group of girls, the data is completely similar for the two tests, while for boys there is a difference in the estimates of three subjects. This discrepancy may also be due to a deeper differentiation in the Kettel test. As in the first case, there is no need to prove the identity of the outcome of the two tests. In general, the majority of adolescents who participated in the study showed high stress tolerance: 70% (21 people) on the Holmes-Raghet scale and 67% (20 people) on the Kettel scale. Average resistance to stress was observed in 23 and 20% respectively. Low stress resistance bordering on painful vulnerability was observed in 7-13% of adolescents with motor ticks. At the same time, only boys are among them.
We cannot tell the difference in stress resistance by gender groups visually. Therefore, we also use the null hypothesis method. It again consists in the fact that the stress resistance of girls and boys is approximately equally distributed. Holmes-Raget and Kettel scales we result in a common 3-point scale: 0 - high stress resistance, 1 - medium and 2 - low. And according to formulas 1 and 2, we find the coefficient of significance level and allowed freedom of sampling.
Thus, the significance level coefficient is 28.3, which is much higher than the reference significance level of 2.7633 from the Student table. It means that our null hypothesis is not confirmed - the samples differ significantly by gender.
In order to consider this statistics, we will make a table of conjugation by gender based on Holmes-Raget test results.
Conjunction coefficient shows the relationship between the variables in the conjugation table, it is always less than one, but the closer it is to zero, the less relationship between the variables. As in our case, the relationship between gender and stress tolerance is small, but it does occur. In principle, girls are less susceptible to tycosis hyperkinesis, probably because their stress resistance is always higher than that of male adolescents.
The age dynamics of stress resistance practically does not differ between the results of two tests: teenagers with motor ticks from 15 years old have the highest stress tolerance rates, and children aged 12-13 years old are the most susceptible to stressors. In other words, we can say that the age of 12-14 years is critical for adolescents with motor ticks in terms of depression and stress resistance.
Consequently, our hypothesis is only partially confirmed in the course of processing the study data: adolescents with motor ticks are susceptible to depression, but most of them have high stress tolerance. Depression and low stress tolerance are less common and are associated with each other. Girls are less affected by them than boys.
In the end, we move on to comparing depression and stress resistance in children who have motor ticks with healthy children. We do not have a definite hypothesis regarding the ratio of depression to stress resistance in children with ticks and healthy children. However, we can assume that the psychological state of healthy children is more favorable and that they are less likely to have distemper character accentuation and higher stress resistance. If this assumption is confirmed, we will only support our basic hypothesis that children with motor ticks are more susceptible to depression, depression, and reduced stress resistance.
We have already had the opportunity to review summary sheets of healthy adolescents testing using Beck and Zhmurov's methods, as well as Holmes-Raget and the Kettel questionnaire. At first glance, we can see that healthy children are not depressed and that depression is much rarer. Their stress resistance is also somewhat higher; there are no cases of very low stress resistance. At the same time, healthy girls also have slightly better indicators than boys. Depression is found only in 3 girls, and among boys in 5 (on the Beck scale). High stress resistance is typical for 9 girls and 6 boys (Holmes-Raghet scale).
If we consider all factors in the Kettel survey, we can note that almost all indicators in healthy children are significantly higher. They have a more developed social normality, positive attitude towards people, and less anxiety.
However, even a visual presentation of the results of healthy children's testing cannot give us reliable confirmation or denial that indicators of depression and stress resistance in healthy and tick children are different.
Therefore, we will use the Student method to compare the two groups. This is a parametric method used to test hypotheses about the validity of differences in mean values when analyzing quantitative data on populations with normal distribution and with the same variant. The Student method is different for independent and dependent samples. In our case, the groups of children we study can be referred to as dependent samples because they are affected by an independent variable - absence or presence of disease.
Because for the degree of freedom 30-1=29 and level of reliability 0.999 (99.9 out of 100 cases), the Student's t-student's tabular value is 3.8494.
So, if our t-Student score for the Beck scale is greater than the table value, then the difference in depression scores between healthy and tick teenagers is significant. And we statistically confirmed that healthy children are less depressed and depressed than their tick-borne peers.
On Zhmurov's scale, the t-Student's score will be: 6,7 > 3,8494
Therefore, the difference in depression rates on the Zhmurov scale in groups of healthy and teak-affected adolescents is also reliable.
Further, we compare the stress resistance of teenagers on the Holmes-Raget and Kettel scales according to the developed scheme.
The t-Student score for Holmes-Raget teenagers is: 0.72 < 3.8494.
We conclude that the difference in stress resistance indices on the Holmes-Raghe scale in groups of healthy and teak-affected adolescents is not reliable. And, we cannot say that in 9.99 cases out of 100 children with tics are less resilient than healthy peers.
Let us test this relationship again using the Kettel scale: 4.82 > 3.8494.
It turns out that the results of Kettel's questionnaire testing show that the difference between stress resistance indices in groups of healthy and tick teenagers is reliable, although not very high.
The question arises about the difference in reliability between Holmes-Raget and Kettel scales. Probably, the difference arises from the fact that the Holmes-Raget technique is specifically designed for diagnosing stress resistance, and the 16-factor Kettel Scoreboard is designed for complex personality diagnosticians, and its stress resistance scale may have errors. Holmes-Raget's diagnosis also considers not so much the child's resilience as the presence and character of her stressful situations. In any case, both healthy and tick children may be equally affected by stress, but in children suffering from tics the nervous system peculiarities provoke the development of ticose hyperkinesis. While children with strong and stable nervous systems, temperamentally stable children do not experience ticks, even at moderate levels of stress tolerance.
Thus, we confirmed the assumption that children with motor ticks are more susceptible to depression, depressive states. Stress tolerance is not always related to the presence or absence of tickosa hyperkinesis, although in children with motor ticks it is still more likely to be underreported. Comparison with a group of healthy children was a kind of control and final stage of the study, which finally supported a partial confirmation of the working hypothesis.
Recommendations based on results obtained
So, during the practical part we found out that teenagers of both sexes suffering from motor ticks at the age of 11 to 18 years are characterized by depression or distemporal character accentuation. Under unfavorable conditions, it leads to depression and often prevents children from leading normal lifestyles typical of their age.36 More often, all these disorders develop against the background of choleric and melancholic temperament types. The most important thing for such children is to create a favorable psychological environment at home and in educational institutions, and to communicate with peers. As time goes by, any accentuation of character can be smoothed. In some cases, correction methods are needed.
Assuming that tycosis hyperkinesis is close to neurotic disorders, there is an inconsistency between the communicative and emotional spheres of adolescents, which significantly affects the system of interpersonal relations. Therefore, it is necessary to make a psychologically corrective impact in order to harmonize the communicative sphere and reduce personal anxiety and depression. It is possible to use methods of rational psychotherapy and symbolrams. Rational psychotherapy is a logically substantiated explanatory psychotherapy, the purpose of which is to re-evaluate a teenager suffering from depression or excessive depression, his or her current situation and tasks, his or her condition and compensatory possibilities (known reorientation of the personality with change of emotional attitude to certain facts and search for a reasonable way out of the created situation with refusal of unattainable aspirations and some forms of behavior).
Symboldrama (catatom-imaginative psychotherapy, catatomized experience of images) is one of the directions of psychotherapy based on the principles of deep psychology, which uses a special method of working with the imagination (if the level of ravitos of the adolescent's imagination allows it) in order to make clear the unconscious desires of the child, his or her fantasies, conflicts and protection mechanisms, as well as the transfer relations and resistance.
Psycho-corrective work should consist in identifying the neurotic conflict that is the cause of the motor tick, its awareness of the child's personality, and rebuilding the child's system of relationships to himself/herself and to the traumatic situation.
In the process of corrective action, as a rule, the dynamics of the communicative sphere of personality, harmonization of interpersonal relations are noted. The difference between the images of the Self (real and ideal) is minimized. Reduced nervous and psychological tension in the correction work contributes to the reduction of personal anxiety and increased stress resistance.
The stress resistance of the overwhelming majority of teenagers proved to be satisfactory. However, some male teenagers are susceptible to vulnerability. Probably, it was low stress resistance combined with distigmatism that led to the appearance of tycosis hyperkinesis. Most often, it happens in single-parent families. For example, Andrey Avdeev and Sergey Belikov, who were brought up without a father, are prone to depression and have low stress resistance. For this purpose, we can recommend the following method of increasing stress resistance:
- The most typical stressful situations are highlighted;
- Each situation is modeled in a game or training form;
- Each situation is lost or rehearsed until success is achieved.
For example, if a teenager has difficulties in new acquaintance, in communicating with peers, model all situations, fixing them with a positive ending. It is communication stress resistance that is relevant for adolescents with motor ticks aged 12-14 years. There are two main manifestations of communicative stress resistance. The first is the ability to communicate effectively against the background of stress, so to speak, despite the stress. For example, in conditions of lack of time, fatigue, poor health, against the background of interferences, etc. And the second manifestation is the ability not to lose effectiveness under the influence of stressors inherent to communication.
When considering the depression and stress resistance of a child, one should also pay attention to other aspects of his or her personality. For example, according to the results of Kettel's 16-factor questionnaire, we can conclude that against the background of depression and lack of stress resistance, Sergei Volkova and Belikov have strong secrecy, underdeveloped intellect, high degree of subordination, poor social normality, weak imagination and high internal tension. Therefore, a comprehensive approach is needed to eliminate all negative trends in their personality development. In this case, family therapy may be necessary.
For all teenagers suffering from tycosis hyperkinesis, it is important to adhere to the hygiene of the nervous system: more rest, spend time in the fresh air, maintain sleep and nutrition, normalized physical activity.
By: Alexandra Dimant