Abstract | Cilj ovog rada je prikazati eksternalizirane poremećaje u djece i adolescenata, a to su deficit pažnje/hiperaktivni poremećaj, poremećaji ophođenja i poremećaj s prkošenjem i suprotstavljanjem. Iako se razlikuju po svojim manifestacijama, zajedničko za sve ove poremećaje jest nedovoljna kontrola i usmjerenost prema okolini, za razliku od internaliziranih poremećaja koji su obilježeni pretjeranom kontrolom i usmjerenosti prema sebi. S obzirom na to da ovi poremećaji uključuju značajnu impulzivnost, a nerijetko i agresiju, značajno remete odnose s vršnjacima i odraslim osobama uz često pogrešno tumačenje djetetovog ponašanja kao zločestog što određuje i reakcije okoline koje mogu biti održavajući čimbenik za poremećaj. Zbog toga je važno prepoznati ove poremećaje kako bi se izbjeglo postupke koji mogu pridonijeti održavanju simptoma pa čak i njihovu produbljivanju i pravodobno interveniralo. Dodatni problem predstavljaju komorbidni poremećaji koji su razmjerno česti i neprepoznati u ove djece. Brojni su biološki i psihosocijalni rizični čimbenici za ove poremećaje pa su izuzetno važna djelovanja u pravcu prevencije. Poseban naglasak stavljen je na ADHD kao biološki uvjetovani poremećaj, a koji je obilježen poteškoćama u akademskom, radnom i socijalnom okruženju. Poremećaj ophođenja definiran je kao trajni model ponašanja u kojem se povređuju temeljna prava drugih ili važne društvene norme. Poremećaj s prkošenjem i suprotstavljanjem je obilježen dječjim negativističkim, neprijateljskim i prkosnim ponašanjem prema starijima i autoritetima. Opisane su različite razine prevencije, uključujući primarnu, sekundarnu i tercijarnu, uz poseban osvrt na postupak prema ovoj djeci u odgojno-obrazovnim ustanovama. |
Abstract (english) | The aim of this paper is to present externalized disorders in children and adolescents, namely attention deficit/hyperactivity disorder, conduct disorders, and oppositional defiant disorder. While they differ in their manifestations, what is common to all of these disorders is insufficient control and orientation towards the environment, in contrast to internalized disorders characterized by excessive self-control and self-orientation. Given that these disorders often involve significant impulsivity and aggression, they substantially disrupt relationships with peers and adults, often leading to misinterpretation of the child's behavior as being naughty, which in turn influences the reactions of the environment and may serve as a maintaining factor for the disorder. Therefore, it is important to recognize these disorders in order to avoid actions that can contribute to the maintenance or even exacerbation of symptoms and to intervene in a timely manner. A further problem is presented by comorbid disorders, which are relatively common but often go unrecognized in these children. Numerous biological and psychosocial risk factors are associated with these disorders, making preventive measures of utmost importance. Special emphasis is placed on ADHD as a biologically conditioned disorder, the manifestations of which can be influenced by psychosocial factors. ADHD is characterized by difficulties in academic, occupational, and social settings. Conduct disorder is defined as a persistent pattern of behavior in which the basic rights of others or important social norms are violated. Oppositional defiant disorder is characterized by a child's negative, hostile, and defiant behavior towards adults and authorities. Various levels of prevention are described, including primary, secondary, and tertiary prevention, with a special focus on the approach to these children in educational institutions. |