Childhood social dysfunction
Introduction
Introduction to childhood social dysfunction Childhood social dysfunction is a group of social dysfunctions that begin in the development process, but unlike generalized developmental disorders, there is no obvious functional social incompetence or defect in all areas as a primary feature, and the living environment is considered It plays a key role in the pathogenesis. There was no significant gender difference in incidence. These include selective silence, child-responsive attachment disorders, oppositional defiant disorders, and computer addiction behavior. basic knowledge The proportion of sickness: 0.003%-0.005% (more common in single children) Susceptible people: children Mode of infection: non-infectious complication:
Cause
Childhood social dysfunction
(1) Causes of the disease
The cause of selective silence:
Children with this disease have certain personality characteristics, such as timidity, solitude, quietness, sensitivity, shame, sentimentality and other personality foundations. On this basis, mental factors such as fear, fear, and anger are easy to cause illness.
The cause of children's reactive attachment disorder:
Mainly related to serious parenting methods, such as children's psychological or physical abuse or emotional long-term neglect.
The cause of the opposite defiant disorder:
Since ODD is considered as part of the conduct disorder in previous studies, although the separate diagnosis of ODD has been listed in the classification, the cause of ODD research is still very few, and most scholars believe that there are many links with conduct disorder. Lahey et al. (1990) systematically observed behavioral disorders and ODD children and found that both types of children have an abnormal family environment, and there are more antisocial personality disorder among family members. Loeber (1991) believes that ODD and conduct disorder There is a great connection, and if there is a family background of anti-social behavior, it will develop into more serious destructive behavior.
At present, the addictive behavior of computers cannot be called a medical problem, because it is more of a sociological problem or a social behavior. The phenomenon of excessive investment in time, energy, money and emotion is commonly called × × fans, such as watching TV for a long time called "television fans", keen on football wins and losses called "football fans", like to listen to music as "music fans", other sociologists and behavioralists do put this phenomenon Called addictive behavior, so you can see the symptoms of addiction from these actors, rely too much on the computer, and when you do not have the opportunity to use the computer, there will be withdrawal symptoms, such as emotional irritability , depression, irritability, etc., the above-mentioned addiction symptoms and withdrawal symptoms at the same time exist in line with the basic rules of addictive behavior.
(two) pathogenesis
Due to the complex causes of this type of disease, most of them contain sociological problems, and the profound pathogenesis remains to be studied.
Prevention
Childhood social dysfunction prevention
Because in this type of disorder, the living environment of the child is considered to play a key role in the pathogenesis factor, it is essential to prevent and reduce childhood social dysfunction and establish a good child rearing style in the coming year, too harsh or blindly Care and love are not the right way to raise. Most parents always want their children to be the best. However, many parents ignore or simply dont know the direct impact of their behavior, their health and The logical consequences that may arise in the future, in the current family of one-child children in China, should vigorously advocate the correct way of raising children, and the moral, intellectual, and physical development.
Complication
Childhood social dysfunction complications Complication
Social disorders, emotional disorders.
Symptom
Childhood social dysfunction symptoms common symptoms mental disorder mutism irritability anxiety depression place fear
1. Selective silent clinical manifestations
Speaking for a long time in one or more specific social situations, silently speaking; while speaking on another occasion, normal or near normal, its speech comprehension and expression ability is normal, the symptoms can last for more than 1 month, but not included Admission, the first month of enrollment, the child's silence is not a developmental disorder of language function, and should exclude extensive developmental disorders and other psychiatric disorders.
2. Clinical manifestations of children with reactive attachment disorders
(1) Children show excessive depression in social relationships, excessive vigilance, obvious contradictory reactions (such as children with closeness, indifference, avoidance and defiance at the same time), or lack of emotional reactions, withdrawal, emotional disorders, An attack response to the pain of yourself or others, or a fearful over-alert.
(2) Sometimes there is a certain social response and responsiveness in dealing with normal adults.
(3) The children showed the above symptoms on most occasions, and the social relationship was obviously obstructed. The symptoms started more than 1 month before the age of 5 years, and the children's reaction can be made after the mental retardation is excluded and the general developmental disorder is removed. Diagnosis of sexual attachment disorders.
3. The clinical manifestation of opposing defiant disorder
Oppositional defiant disorder mainly manifests as negative, hostile, antagonistic and defiant behavior, quarreling with adults, losing temper, swearing, complaining and dissatisfied with people around, often blaming others for their mistakes or faults, deliberately confronting or rejecting adults. At the request of (she), there is retaliation. Most of the above behaviors occur in the family environment. Most of the defying objects are parents or other family members. Of course, they can also occur in schools. Defiance of teachers and peers can be accompanied by attention deficit hyperactivity. Obstacles can be manifested as decreased self-esteem, emotional instability, and age-related substance abuse, smoking, drinking, etc. A small number of patients develop passive-aggressive personality disorder in adulthood. Symptoms often occur before the age of 10, and men are significantly more In women, there are generally no mental retardation and mental symptoms.
4. Children and adolescent computer addicts
There are more and more times when you use the computer with the following characteristics. You can get a certain degree of satisfaction from it; when you don't use it, you will have withdrawal symptoms such as depression, irritability, and emotional irritability; actually using the computer is more than planning to use the computer. Long time; attempted to stop or reduce the number of computer use, but unsuccessful; spent too much time on computer-related activities; in order to achieve the purpose of using computers, can reduce important social, work and entertainment activities; One way or another, you still can't give up using computers. Personally, computer addicts have personality characteristics that show their personal advantages. They want to show themselves in terms of computer technology and interpersonal communication.
Examine
Childhood social dysfunction check
There is currently no specific laboratory test for this disease. When other conditions, such as infection, occur, laboratory tests show positive results from other conditions.
Diagnosis
Diagnosis and identification of childhood social dysfunction
diagnosis
Selective mutism
The main feature of this obstacle is that the speech has obvious selectivity and is restricted by emotions. It is silent in certain occasions (such as schools or strangers), but speaks freely in other environments, and the speech comprehension and expression ability are normal. At times, often accompanied by anxiety, withdrawal, defiance and other emotions, the diagnosis should pay attention to the above symptoms for at least 1 month (excluding the first month of initial admission), and need to exclude speech skills development disorders, extensive developmental disorders, schizophrenia And other psychiatric disorders.
2. Children's reactive attachment disorder
This disorder is a child's mental disorder characterized by long-term social relationship disorders, and children's long-term inappropriate behaviors such as excessive inhibition, excessive vigilance, or obvious contradictory reactions (such as appeasement of the caregiver and closeness , indifference, avoidance and defiance), or lack of emotional reactions, withdrawal, emotional disorders, but also an attack or horror over-vigilance against the pain of oneself or others, poor communication with peers, often self-injury, wounding, sorrow and Depressed, some cases have stopped growing and developing. In the process of interaction with normal adults, sometimes there is a certain social response and reaction ability. The onset is about 5 years old. The diagnosis should exclude mental retardation and extensive developmental disorders.
3. Discussion on CCMD-3
Many normal children have insecure feelings, which are characterized by selective attachment to both parents, but should not be confused with reactive attachment disorders. The key to identification is that this disorder is characterized by unusual insecurity, which is manifested in normal children. The apparently contradictory social reaction, which extends to various social situations, is not limited to the relationship between the child and the dependent, and does not respond to comfort, with apathy, pain or fear. Affective disorder, the patient's reactive attachment disorder is more obvious when parting and reuniting, may avoid eye contact when coming to the person, and try to look elsewhere when being held, can be close to the supporter, avoid and refuse caress Contradictory reactions, emotional disorders can be manifested as obvious distress, lack of emotional response and performance retreat (such as shrinking on the ground), or attacking the pain of oneself or others, some children have caress do not work Fear and excessive alertness, but most of them are interested in peer-to-peer interactions. Unfortunately, the negative emotional reactions of distress hinder their social activities. The occurrence of reactive attachment disorders is almost always associated with severe child malnutrition, which can be psychological abuse or neglect (such as harsh punishment, disregard of the child's opinion or apparently stupid parents), or physical abuse or neglect (eg Long-term inattention to the child's basic physiological needs, repeated intentional injury or not provide adequate nutrition), attachment disorders such as accompanied by physical growth hindered and damaged, should be diagnosed in parallel.
Differential diagnosis
The disease should be differentiated from extensive developmental disorders:
1. Children with this disease have normal social interaction and responsiveness, while children with extensive developmental disorders have no.
2. The child with this disease has an abnormal social reaction at the beginning, which becomes a behavioral characteristic in various occasions. However, if the child is placed in another normal environment that can be given continuous care, there will be a significant improvement. It does not occur in children with extensive developmental disorders.
3. Although children with reactive attachment disorders may have speech and language development impairment, there will be no abnormalities in the nature of autism.
4. Persistence and stereotypes of behavior, interest and activity patterns are not the characteristics of this disease but autism.
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