Periods of individual development in psychiatry
The study in the comparative age of the parameters of normal development of the psyche and the preference for the emergence of syndromes of neuropsychic disorders in children and adolescents led to the creation of a number of classifications of the periodization of mental development. According to V. V. Kovalev, the pathogenetic basis of the predominant manifestations of psychiatric disorders for different age periods is the mechanism of the replacement of qualitatively different levels of the pathological neuropsychic response to certain harmful events. The researcher identified four basic age levels of neuropsychic response.
1. For somatovegetative response level (0-3 years), various variants of neuropathic syndrome (excitability, propensity to digestion disorders, nutrition, sleep, tidiness, etc.) are characteristic . The predominantly somatovegetative level of response in young children finds an explanation in the earlier completion of the regulation of autonomic functions in ontogeny, which significantly outstrips the formation of regulation of motor functions.
2. To psychomotor response level (4-10 years) include manifestations of hyperdynamic syndrome, systemic neurotic and neurosis-like motor disorders - tics, stuttering, mutism, etc. The isolation of this level corresponds to the data of age morphology and physiology, indicating the most intensive differentiation of the functions of the motor analysor at this age.
3. The affective response level (7-12 years) is characterized by fear syndromes, increased affective excitability, withdrawal and vagrancy.
4. Emotional-ideator the level of response (12-16 years) is already manifested by supervalued formations such as pathocharacter reactions (protest, emancipation, etc.), dysmorphophobia, mental anorexia, philosophical intoxication and the like.
The symptomatology inherent in each subsequent level does not exclude the manifestation of previous levels of response, but pushes them to the background and somehow modifies them.
The most systematic development of the systematics of the child's mental development, proposed by the famous child psychiatrist GK Ushakov. The formation of the child's psyche, he also divides into four periods: motor (up to 1 year), sensorimotor (1-3 years), affective (3-12 years) and ideator (12-14 years).
The motor stage of development of the psyche is very short (up to 1 year), although the improvement of motor skills and its differentiation occur throughout the life of the individual. The reactions of the child in the first months of life are in fact rudiments of subsequent psychic reactions.
On external stimuli the child responds with diffuse motor reactions (screaming, crying, motor anxiety). Even the so-called reaction of the newborn's fear represents two types of movements: with the predominance of the reaction of flexors or extensors (extensor muscles). To catch the difference between the "reaction of fear and the reflex of Moreau (reflex girth) in the newborn often fails.
The sensomotor stage of the development of the psyche (from one year to three years). From six months to six to seven years, the importance of the forming motor reactions continues to be the leading, however they lose their purely motor character and become more complex "sensorimotor acts" (later, improving, they will become psychomotor, that is, they will have an informed character).
Sensomotor reactions are distinguished by the mastery of purposeful movements, which in the future leads to willful actions. Sensory organs develop, attention is formed, thinking is formed, ideas about the present and the past, the primary consciousness "I" (an element of self-awareness, three to three and a half years). The clearest sign of the final completion of the sensorimotor developmental period is the formation in the child of the representation of the "body scheme" (by 6-7 years).
Affective stage of development of the psyche (from 3 to 12 years). Higher (epicritic) affects, unlike simple (organic), never arise without an image, representation, and later without a concept, i.e. involvement in the experience of the ideal (rational, cognitive) sphere. The affective stage begins to form in the form of an epicritic emotionality from three years: emotional reactions of protest, negativism, demonstrative behavior, excessive affectation or taciturn are being mastered. By 6-7 years, children's immediacy changes its qualities. She increasingly receives an expression in the affective coloring of certain forms of the child's activity. In 10-11 years, the lability of affect, good nature and childlike enthusiasm become less pronounced. Affectiveness acquires a constantly individual character, and two types of behavioral reactions can be clearly identified. Some children have extroversion features, and they are more sociable. In others, introvertedness predominates, and they are more silent.
The ideatorial stage of the development of the psyche begins even in the depths of the sensorimotor stage, but its true origin must be dated 11-12 years. Since then, the child usually has the opportunity to build complex conclusions and strengthens the phenomenon of "doubling reality". The latter means the child's skill to operate with objects of external reality, on the one hand, and subjective reality (conceivable, represented) on the other. Both these realities interpenetrate each other.
In adolescence (12-16 years), the ability to reason is available, consistently discussing facts and revealing patterns. The teenager claims himself by opposing himself to others. It often acquires the character of its opinion, concept. He realizes himself as a person, and this generates unprecedented opportunities for reflection. Consciousness of the individual begins to acquire the character of consciousness of the collective, social. In the emotional sphere, aesthetic, ethical and intellectual feelings are formed.
Mental disorders in children have different qualities depending on the age and extent of the lesion. Violation of mental functioning in the early stages of postnatal ontogeny can not cause those types of disorders that require a certain degree of maturity of the affective and ideational levels of development of the psyche. For a person of mature age, the following trend becomes the rule: the greater the amount of damage, the more deeply the psyche levels, all other things being equal, turn out to be damaged.
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