رفتار درمانی کودک

نویسنده
حسین مطیع
مترجم
---------------
تعداد صفحات
224 صفحه
سال نشر
1397
قطع
رقعی
ناشر
بوکتاب
شابک
978-964-2775-97-2
قیمت
200000 ریال

رفتار درمانی کودک

Child Behavior Therapy

نشانه‎های افسردگی در کودکان

یکی از اختلال‌های دوران کودکی، اضطراب و افسردگی‌ست که اگر به‌موقع، تشخیص داده شود، قابل درمان می‌باشد.

ترس و تشویش، شیوع اضطراب در کودکان را پایه‌ریزی می‌کند و در صورتی‌که این ترس‌ها، بیمارگونه نباشد، به‌صورت طبیعی خود را نشان‌می‌دهد. خجالتی و گوشه‌گیر بودن، جزو شایع‌ترین اضطراب‌های اجتماعی کودکان است که می‌تواند زندگی آنان را مختل کند. کودکان، ترس و اضطراب را از راه شرطی‌‌شدن فرامی‌گیرند. بروز ترس‌ها در کودکان، قابل پیش‌بینی نیست و در تمام سنین، یکسان نمی‌باشد.

نقش خانواده به‌عنوان عاملی در ایجاد اختلال اضطراب کودکان، همیشه مورد توجه قرارگرفته است. انتقال اضطراب از پدر و مادر به کودک، بر اثر مشاهده و الگوسازی رفتارها صورت‌می‌گیرد.

ارزیابی اضطراب در کودکان، از طریق مصاحبه و گزارش شخصی و درجه‌بندی نوع اضطراب و درنهایت تجویز دارو انجام می‌شود. به‌همین منظور باید دو مصاحبه‌ی جداگانه، یکی با کودک و دیگری با پدر و مادر صورت‌گیردتا میزان آشفتگی هیجانی در بروز اضطراب، مشخص شود.

کودکان می‌توانند برای مقابله با اضطراب و ناکامی، از روش‌های دفاعی مانند کناره‌گیری، انکارکردن، سرکوبی و فرافکنی استفاده کنند. کودک یاد گرفته همیشه از موقعیت‌ها و شرایط ناراحت‌کننده و محرک‌های آزاردهنده، کناره‌گیری کند تا در آرامش باشد. مکیدن انگشتان و شب‌ادراری، از علائم اضطراب است که حتی در سنین نوجوانی هم اتفاق می‌افتد. درواقع وقتی کودک نتواند راه‌هایی را برای مقابله با اضطراب بجوید، مجبور می‌شود به زمان خردسالی برگردد. در مرحله‌ی انکار، منکر واقعیت است و آن‌چه اتفاق افتاده را به‌نوعی سرپوش می‌گذارد. در مرحله‌ی سرکوبی، تلاش او در جریان فراموشی حالت‌های اضطراب، به‌کار می‌رود تا به‌تدریج آن‌را از ذهن خودآگاهش دور سازد اما در مرحله‌ی فرافکنی، هر حادثه و اتفاقی که در زندگی‌اش رخ‌می‌دهد را به دیگران نسبت‌می‌دهد. درنتیجه کودکانی که تمایل شدید به استفاده از مکانیسم‌های دفاعی در برابر اضطراب دارند، نمی‌توانند از روابط سالم عاطفی و ذهنی برخوردار باشند.امروزه اضطراب‌های اجتماعی کودکان، بیش‌تر به‌چشم می‌آید و عامل فرار کودک از اجتماع، مردم، دوستان، مجالس و میهمانی‌هایی‌ست که درواقع، با اضطراب‌های اجتماعی، بدنی، فکری و رفتاری روبه‌روست.

نشانه‌های اضطراب کودک در بعد جسمی (فیزیولوژیک) هم‌چون بزرگسالان، با تنفس تند، لرزش دست و پا، گرم شدن و سرخی صورت، گرفتگی صدا و تپش قلب، همراه استکه با آرام‌ساختن، قابل اصلاح می‌باشد و در بعد فکری (شناخت‌درمانی) تلاش کودک بر این است که دیگران از او راضی باشند، تأییدش کنند، طردش نکنند و مهم باشد و اگر غیر از این شود، برایش ناخوشایند است.

در بعد رفتاری که (با رفتاردرمانی قابل اصلاح است)، کودک یاد می‌گیرد خانه برایش مکانی امن است، نیاز به دوست ندارد، از جمع، گریزان و در کوچه و خیابان همیشه سرش پایین است و ترس از نگاه دیگران دارد. به‌خوبی نمی‌تواند سؤال کند و جواب دهد و احساس ناامنی می‌نماید.

کودکان در طول دوره‌ی زندگی‌شان، ممکن است افسردگی را تجربه کنند که این اختلال با افزایش سن، در دختران، بیش‌تر از پسران دیده می‌شود. افسردگی، زمانی در کودک ایجاد می‌شود که احساس و تصور بدی از خود داشته باشد و این احساس، زمانی‌که به اوج خود برسد، تبدیل به یک بیماری می‌شود.

عوامل خانوادگی و زیستی، بیش‌ از عوامل دیگر در بروز افسردگی نقش دارند.افسردگی کودکی، پیامدهای منفی بسیاری را به‌همراه دارد ازجمله افسردگی‌ در ادوار آینده، عدم سازگاری‌های اجتماعی، مشکلات تحصیلی و در برخی مواقع حتی اقدام به خودکشی.

نشانه‌های افسردگی کودکان عبارتند از:

۱- نشانه‌های عاطفی: ناامیدی، خشم، درماندگی، اضطراب، نوسانات خلقی، احساس گناه و غمگین بودن

۲- نشانه‌های جسمی: به‌هم خوردن ساعات خواب، بی‌اشتهایی و یا خوردن افراطی، یبوست، افزایش و کاهش وزن

۳- نشانه‌های رفتاری: بدون دلیل گریه‌کردن، کناره‌گیری از دوستان، سریع خشمگین شدن و کاهش انگیزه

۴- نشانه‌های تخریب‌گرایانه: خود را سرزنش‌کردن، احساس بازنده بودن، امیدوار نبودن به آینده و بلاتکلیفی

این اختلال‌ها در بزرگسالان، با طیف وسیع‌تر و پیچیده‌تری خود را نشان‌می‌دهند. عده‌ای معتقدند سوابق خانوادگی و وراثت، در افسردگی نقش تعیین‌کننده‌ای دارد. شروع افسردگی زودرس در کودکان، بیش‌تر تحت‌تأثیر عوامل خانوادگی و وراثت است. با وجود این، ازهم‌گسیختگی خانوادگی، ارتباط تنگاتنگی با افسردگی کودکان دارد. ازهم‌گسیختگی خانوادگی را می‌توانیم در رفتار سرد و بی‌روح و منفی روابط متقابل کودک و پدر و مادر به‌وضوح ببینیم.

شناخت‌درمانی رفتاری برای کودکان افسرده، نویدبخش می‌باشد اما در مورد کودکان و نوجوانان با افسردگی و استرس شدیدتر، احتمال بهبودی با این روش، کم‌تر است و باید با مشورت پزشک، از دارو استفاده نمود.

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