Obsessive-compulsive disorder is a psychological disorder. The following is what I arranged for children with obsessive-compulsive disorder. Let's have a look.

Representative cases

Xiao Wu is a timid, cautious and perfectionist. He always feels uneasy when he finishes his homework, so he checks it again and again. The teacher asked him to publish the blackboard newspaper in class, but he always felt dissatisfied, so he wiped and daubed it. The first time I wrote a letter to my classmates, I tore it up and rewritten it after just writing a few words, tearing more than a dozen pages repeatedly; After writing the letter, put it in the envelope and open it to see if there is anything wrong. When I go home to do my homework every day, the desk lamp is high. I felt that the illumination was not enough, so I put it down. I'm afraid that too strong light will damage my eyesight. He repeatedly raised and lowered the desk lamp. ...

Obsessive-compulsive disorder (OCD) is a psychological disorder with obsessive-compulsive ideas and behaviors as the main symptoms. Symptoms of obsessive-compulsive disorder refer to thoughts, emotions and behaviors that are repeatedly presented under the condition of knowing that they are unnecessary. Domestic investigation shows that the prevalence rate of this disease is 0.30‰.

Symptoms of obsessive-compulsive disorder in children

The peak incidence was at 2 years old and 7-8 years old, and there was no significant difference between men and women. A normal child may have mild obsessive-compulsive behavior in the early stage of development. For example, some children like to touch the telephone poles by the roadside when walking, some children like to kick pebbles with their feet when walking, some children like to count the number of window bars or balcony railings repeatedly, and so on. This behavior is not accompanied by any emotional disorder, and will disappear with the child's age.

If they are not allowed to repeat these actions, they will feel anxious and even lose their temper. If they are allowed to do these actions repeatedly, they will not have obvious inner contradictions and anxiety like adult obsessive-compulsive patients. Generally speaking, children don't feel distressed and sad about their compulsive behavior, but just repeat it rigidly.

A child with obsessive-compulsive disorder often has other obsessive-compulsive symptoms, such as obsessive-compulsive concept, compulsive intention and compulsive behavior. The concept of coercion includes:

Forced memory: I repeatedly recall what I have done or even unimportant things, or I am eager to recall past experiences. Although I know it has no practical significance, I still can't help but recall;

Forced doubt: Unnecessary doubt about the correctness of one's actions. If you doubt whether your answer is correct, you always feel that you have miscalculated; After going out, I suspect that the lock of the house door is not locked well; Suspect that the letter was not stamped after it was sent; Suspect that the homework is wrong; Wait a minute. A common feature is that doubt is accompanied by anxiety, which drives patients to check again and again;

Compulsive exhaustion: Most people repeatedly think about the causes of natural phenomena or daily life events. Patients know that this idea is meaningless, unnecessary and even absurd, but it is difficult to control. For example, thinking repeatedly about "why is a day 24 hours", "why do people have two legs" and "whether the chicken lays eggs or the egg lays chickens" and so on;

Compulsive opposition thought: I can't get rid of the ideological entanglement opposite to my own understanding and feel distressed. For example, when I hear the teacher talk about "peace" and "friendship" in class, I immediately think of relative concepts such as "war" and "hostility".

Forced intention and action include forced intention: often entangled in an intention that is contrary to the will at that time, knowing that it is unreasonable and unnecessary, but can not get rid of it. For example, if you meet a good friend or something you love, you want to take a bite or pinch it, and you want to tear it when you get it. This compulsive intention is not accompanied by corresponding actions, but with anxiety and fear, which drives patients to avoid such occasions or take other countermeasures;

Forced hand washing: when the patient's hands or body come into contact with objects that he thinks are dirty or things that others have used, such as pencils, erasers, money, rice, boxes, meal tickets, or shake hands with others, it is impossible to control hand washing or even clean the whole body;

Forced counting: patients can't help counting something, such as counting involuntarily whenever they see poles, steps, etc. Force them to remember the license plates of passing cars, kick stones while walking, count how many times they kicked, and so on.

Forced ritual movements: often repeated-a set of rigid movements. To enter the classroom door, you must first take your left foot; Sometimes take two steps forward and one step back; If someone else does what you want to do, you must do it again. Do a "crazy" exercise before doing your homework; Take off your clothes and shoes in the prescribed order before going to bed, and then circle the bed before going to sleep, otherwise you will feel uneasy; Wait a minute.

Causes of obsessive-compulsive disorder in children

Regarding the causes of children's obsessive-compulsive disorder, psychoanalyst Freud believes that obsessive-compulsive disorder patients have an "anal personality" tendency. The characteristics of obsessive-compulsive personality can be summarized as "imperfection", "insecurity" and "uncertainty". As long as one of the "three noes" is very prominent, it is a typical obsessive-compulsive personality.

It is generally believed that children's innate quality, personality foundation, the influence of parents' bad personality and improper educational methods are all related to the occurrence of this disease. According to statistics, about 2/3 patients with obsessive-compulsive disorder have obsessive-compulsive personality characteristics before they get sick. Such as formality, hesitation, deliberation, poor self-control or timidity, indecision; Lack of self-confidence, conformism, dull living habits, like to think carefully about problems, love to get into a dead end; Do things carefully, strive for accuracy, lack flexibility, be too strict with yourself, and demand perfection in everything; Love neatness, cleanliness, organization and order.

Children's parents are often timid, too cautious, lack of self-confidence, indecision, repeated inspection afterwards, too self-restraint, rigid, lack of hobbies and other bad personality characteristics. Parents demand too much from their children, for example, too much from cleanliness and rigid life, which may be the cause of this disease.

Children's serious illness, trauma, mental trauma caused by sudden severe punishment, or long-term excessive mental stress and mental burden. , can be induced factors, prompting the symptoms of this disease. There are more parents or siblings with obsessive-compulsive personality characteristics and obsessive-compulsive disorder than the control group. Genetic factors have a certain influence on the pathogenesis of this disease.

The intense emotional experience such as anxiety and uneasiness caused by the increase of tasks and the objective requirement to improve the adaptability and flexibility to the environment make the process of cerebral cortex excitement or inhibition excessively tense or conflict with each other, forming pathological inert excitement focus.

Therefore, some people think that obsessive-compulsive disorder has social and psychological inducing factors, and normal people also have obsessive-compulsive concepts, but they are not lasting; Obsessive-compulsive disorder is often the result of being strengthened under the influence of social and psychological factors. For example, sudden change of environment (such as transfer), sudden increase of responsibilities or tasks (such as becoming a student cadre or teacher's workload), too strict requirements of teachers and parents, difficult situation (faced with dropping out of school or often being harassed by bad people), family discord (parents divorced to let their children choose who to go with), and sudden fright. Make children hesitate, think repeatedly and worry, which leads to obsessive-compulsive disorder.

Children with obsessive-compulsive disorder need to actively correct those distressing thoughts, intentions and behaviors through repeated training and practice. Attention should be paid to the following points during calibration:

First, build confidence.

For children with obsessive-compulsive disorder, parents should help them consciously understand and overcome their own personality weaknesses, guide them to deal with problems decisively, help them make suggestions and find ways to overcome the weakness of indecision. Let children know that people will inevitably encounter all kinds of things in their lives, and it is impossible to handle everything properly and comprehensively. Some setbacks are always inevitable. Children should be encouraged to have a correct evaluation of themselves, see their own strength and establish confidence in overcoming diseases. We should create conditions in many ways to make children successful and help them improve their self-confidence. We should also pay attention to enriching children's spare time, distracting children's attention and reducing their unnecessary doubts.

Second, create a harmonious living environment.

Help children arrange a regular life and work, and don't let children live in conflicts and contradictions.

Three, organize children to participate in collective entertainment activities and a certain amount of intense physical labor.

Divert children's intentional attention to symptoms from interesting activities and let them gradually get rid of obsessive-compulsive symptoms.

Fourth, give understanding and sympathy.

Children with severe obsessive-compulsive disorder may feel pessimistic or even world-weary because of their uncontrollable compulsive behavior, so we should give more understanding and sympathy and do patient and meticulous work to avoid accidents.

Five, the concept of training

When a child has uncontrollable compulsive behavior, parents and teachers should help the child to fight it with ideas, relax the child's nervousness and fear, and tell the child that this behavior is meaningless to distract attention.

Sixth, cultivate hobbies.

Parents should encourage their children to participate in group activities, get in touch with the outside world and cultivate their children's hobbies, such as singing, dancing, listening to music, playing ball games and running. So as to establish a new brain excitation focus to suppress the excitation focus of obsessive-compulsive symptoms and divert their high attention to obsessive-compulsive symptoms.

Seven, give rewards

Children whose conditions have improved should be encouraged and given appropriate spiritual or material rewards.

Eight, correct parents' personality deviation.

If the parents of OCD children have different personalities, such as being very clean, too cautious, too rigid, indecisive, indecisive, etc., they should be corrected, otherwise it will affect the rehabilitation of OCD children and be detrimental to their future psychological development. This is very important.

Nine, psychological counseling therapy

Explain, eliminate children's unnecessary doubts, and establish confidence in overcoming the disease.

Morita therapy

Ask children to "let nature take its course and go its own way", instead of suppressing symptoms, and adopt an attitude of not being afraid, ignoring or confronting, so that symptoms gradually fade from consciousness or even disappear. This therapy has a good effect on obsessive-compulsive disorder.

Xi。 behavior therapy

Systematic desensitization (also called interactive inhibition), thinking block, catharsis therapy and imitation learning in behavioral therapy have good curative effects on obsessive-compulsive disorder symptoms.

Behavioral antagonism therapy can be used to help correct obsessive-compulsive disorder that can't be countered by thinking alone. Behavioral antagonism therapy is basically an operational conditioned reflex process, which combines antagonistic stimulation with compulsive behavior repeatedly to form a new conditioned reflex, which makes it oppose the original compulsive behavior and eliminates the original wrong behavior.

The specific method is: instruct children to put a rubber band consisting of three strands of rubber bands on their right wrists, and once there is an irresistible compulsion, such as repeated counting and repeated inspection, immediately pull the rubber band on their right wrists to counter the compulsion. The elastic force of the rubber band should be slightly painful when it acts on the wrist skin, and the times of elastic pulling and the duration of compulsion are calculated. At first, you need to pull 20 ~ 30 times to resist compulsion. After a period of repeated training, when you can resist the compulsion by pulling the rubber band for 3 ~ 5 times, you can take off the rubber band, and when there is compulsion again in the future, you can immediately think of the antagonism of the rubber band to the wrist and dilute the compulsion desire with your own thoughts.

Twelve, drug therapy

The drugs used to treat obsessive-compulsive disorder in children mainly include anti-anxiety drugs and antipsychotics, such as lorazepam, diazepam, chlorpromazine and perphenazine.

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