Disorders of adaptation of children to emotional and physical stresses associated with learning: A modern view of the problem and treatment options. A review
- 作者: Kotova O.V.1,2,3, Akarachkova E.S.2,4
-
隶属关系:
- Peoples' Friendship University of Russia named after Patrice Lumumba
- International Society for the Study of Stress "Stress Under Control"
- Vladimirsky Moscow Regional Research Clinical Institute
- Rehaline Rehabilitation Center
- 期: 编号 3 (2025)
- 页面: 208-213
- 栏目: Articles
- URL: https://pediatria.orscience.ru/2658-6630/article/view/691228
- DOI: https://doi.org/10.26442/26586630.2025.3.203456
- ID: 691228
如何引用文章
全文:
详细
Abstract
School adaptation disorders are a common multifactorial problem in pediatric and neurological practice, exacerbated in recent years by new psychosocial stressors. Early diagnosis and comprehensive treatment of this condition are key factors in the prevention of severe anxiety and depressive disorders in the future. The review highlights current views on the etiology, neurobiological mechanisms, and comprehensive approaches to addressing adaptation disorders to school stress in children. A review of modern Russian and foreign literature data on the problem of school stress, maladaptation, and the role of emotional competence and executive functions in the adaptation process was conducted. The root cause of school maladaptation is a complex of stress factors (significant life changes, academic stress, social difficulties, and environmental exposures). The development of emotional competence (the ability to recognize and regulate emotions) and executive functions (inhibition control, working memory, cognitive flexibility), which are closely interrelated, play a key role in successful adaptation. A practical care approach should include both non-pharmacological methods (such as psychological and pedagogical interventions, as well as work with the child's family) and adequate pharmacotherapy. The nootropic agent nicotinoyl γ-aminobutyric acid (Picamilon), which has a complex, autonomous, stabilizing, anxiolytic, vasoactive, and neurometabolic effect, is considered a pathogenetically justified and safe pharmacological option. The importance of timely detection of school maladjustment signs and the use of an integrated approach combining psychological support and, if necessary, modern nootropic agents with a favorable safety profile is emphasized. It enhances children's ability to adapt to school and improves their long-term mental health outcomes.
全文:

作者简介
Olga Kotova
Peoples' Friendship University of Russia named after Patrice Lumumba; International Society for the Study of Stress "Stress Under Control"; Vladimirsky Moscow Regional Research Clinical Institute
编辑信件的主要联系方式.
Email: ol_kotova@mail.ru
ORCID iD: 0000-0002-3908-0381
Cand. Sci. (Med.)
俄罗斯联邦, Moscow; Moscow; MoscowElena Akarachkova
International Society for the Study of Stress "Stress Under Control"; Rehaline Rehabilitation Center
Email: ol_kotova@mail.ru
ORCID iD: 0000-0002-7629-3773
D. Sci. (Med.)
俄罗斯联邦, Moscow; Krasnogorsk参考
- Акарачкова Е.С., Байдаулетова А.И., Беляев А.А., и др. Стресс: причины и последствия, лечение и профилактика. Клинические рекомендации. СПб.: Скифия-принт; М.: Профмедпресс, 2020 [Akarachkova ES, Baidauletova AI, Beliaev AA, et al. Stress: prichiny i posledstviia, lechenie i profilaktika. Klinicheskie rekomendatsii. Saint Petersburg: Skifiia-print; Moscow: Profmedpress, 2020 (in Russian)].
- Sharma S. Adjustment: process, achievement, characteristics, measurement and dimensions. Int J Acad Res. 2016;3(1(2)):42-5.
- Катунова В.В. Практико-ориентированный подход к типологии школьной дизадаптации. Клиническая и специальная психология. 2019;8(3):19-39 [Katunova VV. A practice-oriented approach to the typology of school maladjustment. Clinical Psychology and Special Education. 2019;8(3):19-39 (in Russian)]. doi: 10.17759/psyclin.2019080302
- Гущина К.А. Школьная дезадаптация как трудная жизненная ситуация, требующая совладающего поведения. Вопросы науки и образования. 2017;6(7):155-9 [Gushchina KA. Shkolnaia dezadaptatsiia kak trudnaia zhiznennaia situatsiia, trebuiushchaia sovladaiushchego povedeniia. Voprosy Nauki i Obrazovaniia. 2017;6(7):155-9 (in Russian)].
- Заваденко Н.Н. Школьная дезадаптация в педиатрической практике. Лечащий врач. 2005;1. Режим доступа: https://www.lvrach.ru/2005/01/4531954. Ссылка активна на 14.06.2025 [Zavadenko NN. Shkolnaia dezadaptatsiia v pediatricheskoi praktike. Lechashchii vrach. 2005;1. Available at: https://www.lvrach.ru/2005/01/4531954. Accessed: 14.06.2025 (in Russian)].
- Захарова И.Н., Творогова Т.М., Пшеничникова И.И., Сгибнева А.И. Астенический синдром у школьников: от риска развития до диагностики и лечения. Педиатрия. Consilium Medicum. 2021;(1):76-83 [Zakharova IN, Tvorogova TM, Pshenichnikova II, Sgibneva AI. Asthenic syndrome in schoolchildren: from the risk of development to diagnosis and treatment. Pediatrics. Consilium Medicum. 2021;(1):76-83 (in Russian)]. doi: 10.26442/26586630.2021.1.200713
- Литвиненко Н.В. Школьная тревожность как показатель нарушения адаптации школьников к образовательной среде. Современные проблемы науки и образования. 2014;5 [Litvinenko NV. School Anxiety as Anindication of Adaptationdisorder of Pupils to Educational Environment. Modern Problems of Science and Education. 2014;5 (in Russian)].
- Шарипов А.Т., Эргашева Н.О., Нурмаматова К.Ч. Особенности нервной системы и проявления энуреза у детей. Вестник НДМЦ. 2022;2:100-2 [Sharipov AT, Ergasheva NO, Nurmamatova KCh. Osobennosti nervnoi sistemy i proiavleniia enureza u detei. Vestnik NDMTs. 2022;2:100-2 (in Russian)].
- Заиров Н.М., Садыкова Г.К. Особенности школьной дезадаптации детей начальных классов. Вестник КазНМУ. 2015;2:376-8 [Zairov NM, Sadykov GK. Features of school exclusion of children of primary school. Vestnik KazNMU. 2015;2:376-8 (in Russian)].
- Чутко Л.С., Корнишина Т.Л., Сурушкина С.Ю., и др. Синдром вегетативной дисфункции у детей и подростков. Журнал неврологии и психиатрии им. С.С. Корсакова. 2018;118(1):43-9 [Chutko LS, Kornishina TL, Surushkina SYu. Syndrome of autonomic dysfunction in children and adolescents. Zhurnal nevrologii i psikhiatrii im. S.S. Korsakova. 2018;118(1):43-9 (in Russian)]. doi: 10.17116/jnevro20181181143-49
- Акарачкова Е.С., Блинов Д.В., Котова О.В., и др. Стресс у детей: как активировать адаптационные резервы у ребенка. РМЖ. 2018;26(9):45-51 [Akarachkova ES, Blinov DV, Kotova OV, et al. Stress u detei: kak aktivirovat adaptatsionnye rezervy u rebenka. RMZh. 2018;26(9):45-51 (in Russian)].
- Акарачкова Е.С., Байдаулетова А.И., Блинов Д.В., и др. Cтресс у детей и подростков: причины и последствия, лечение и профилактика. Клиническое руководство. СПб.: Скифия-принт; М.: Профмедпресс, 2022 [Akarachkova ES, Baidauletova AI, Blinov DV, et al. Ctress u detei i podrostkov: prichiny i posledstviia, lechenie i profilaktika. Klinicheskoe rukovodstvo. Saint Petersburg: Skifiia-print; Moscow: Profmedpress, 2022 (in Russian)].
- Акарачкова Е.С., Климов Л.В., Котова О.В. 21 век: от пандемии COVID-19 к новым психосоциальным стрессам. Клиническое руководство. М.: Перо, 2022 [Akarachkova ES, Klimov LV, Kotova OV. 21st century: from COVID-19 pandemic to new psychosocial stress. Clinical guidelines. Moscow: Pero, 2022 (in Russian)]
- Рачин А.П., Котова О.В., Демьяновская Е.Г., и др. COVID-19 и постковидный синдром. Руководство для невролога. М., 2023 [Rachin AP, Kotova OV, Demianovskaia EG, et al. COVID-19 i postkovidnyi sindrom. Rukovodstvo dlia nevrologa. Moscow, 2023 (in Russian)].
- Котова О.В., Захаров В.В., Акарачкова Е.С., и др. Стресс и расстройства, связанные с ним. Поведенческая неврология. 2024;(1):30-6 [Kotova OV, Zakharov VV, Akarachkova ES. Stress and stress-related disorders. Behavioural Brain Research. 2024;(1):30-6 (in Russian)]. doi: 10.46393/27129675_2024_1_30
- Акарачкова Е.С., Блинов Д.В., Климов Л.В., и др. Стресс и стресс-связанные расстройства у детей. Медицинский совет. 2023;(12):210-20 [Akarachkova ES, Blinov DV, Klimov LV. Stress and stress-associated disorders in children. Medical Council. 2023;(12):210-20 (in Russian)]. doi: 10.21518/ms2022-016
- Котова О.В., Бородулина И.В. Боль у детей и подростков. Клинический разбор в общей медицине. 2024;5(8):79-83 [Kotova OV, Borodulina IV. Pain in children and adolescents. Clinical Review for General Practice. 2024;5(8):79-83 (in Russian)]. doi: 10.47407/kr2024.5.8.00463
- Ato E, Fernandez-Vilar MA, Galian MD. Relation Between Temperament and School Adjustment in Spanish Children: A Person-Centered Approach. Front Psychol. 2020;11:250. doi: 10.3389/fpsyg.2020.00250
- Cicchetti D, Valentino K. An ecological-transactional perspective on child maltreatment: Failure of the average expectable environment and its influence on child development. Development and Psychopathology. 2006;3:2.
- Li Q, Liu P, Yan N, Feng T. Executive Function Training Improves Emotional Competence for Preschool Children: The Roles of Inhibition Control and Working Memory. Front Psychol. 2020;11:347. doi: 10.3389/fpsyg.2020.00347
- Lahaye M, Fantinihauwel C, Van BN, et al. Emotional competence and quality of life of children with asthma: the mediating effect of coping strategies. Psychol Health. 2011;26(12):1678-95. doi: 10.1080/08870446.2011.562606
- Riquelme E, Montero I. Improving emotional competence through mediated reading: short term effects of a children’s literature program. Mind Cult Act. 2013;20(3):226-39. doi: 10.1080/10749039.2013.781185
- Pons F, Lawson J, Harris PL, De RM. Individual differences in children’s emotion understanding: effects of age and language. Scand J Psychol. 2003;44(4):347-53. doi: 10.1111/1467-9450.00354
- Wardiesielski EF, Limowski AR, Kreper SN, Mcdermott MJ. Relationships between treatment attitudes, psychological symptoms, emotional competence, and help seeking intentions. J Counsel Dev. 2019;97:250-9. doi: 10.1002/jcad.12265
- Oh S, Lewis C. Korean preschoolers’ advanced inhibitory control and its relation to other executive skills and mental state understanding. Child Dev. 2008;79(1):80-99. doi: 10.1111/j.1467-8624.2007.01112.x
- Healy SA, Im-Bolter N, Olds J. Executive function and emotional, behavioral, and social competence problems in children with epilepsy. J Child Family Stud. 2018;27(8):2430-40. doi: 10.1007/s10826-018-1079-3
- Zelazo PD, Carlson SM. Hot and cool executive function in childhood and adolescence: development and plasticity. Child Dev Perspect. 2012;6(4):354-60. doi: 10.1111/j.1750-8606.2012.00246.x
- Silkenbeumer J, Schiller EM, Holodynski M, Kärtner J. The role of co-regulation for the development of social-emotional competence. J Self Regul Regul. 2016;2:17-32. doi: 10.11588/josar.2016.2.34351
- Liew J. Effortful control, executive functions, and education: bringing self-regulatory and social-emotional competencies to the table. Child Dev Perspect. 2012;6(2):105-11. doi: 10.1111/j.1750-8606.2011.00196.x
- Rhoades BL, Greenberg MT, Domitrovich CE. The contribution of inhibitory control to preschoolers’ social-emotional competence. J Appl Dev Psychol. 2009;30(3):310-20. doi: 10.1016/j.appdev.2008.12.012
- Nakamichi K. Differences in young children’s peer preference by inhibitory control and emotion regulation. Psychol Rep. 2017;120(5):805-23. doi: 10.1177/0033294117709260
- Fox NA, Henderson HA, Rubin KH, et al. Continuity and discontinuity of behavioral inhibition and exuberance: psychophysiological and behavioral influences across the first four years of life. Child Dev. 2001;72(1):1-21. doi: 10.1111/1467-8624.00262
- Garcia-Andres E, Huertas-Martinez JA, Ardura A, Fernandez-Alcaraz C. Emotional regulation and executive function profiles of functioning related to the social development of children. Procedia Soc Behav Sci. 2010;5:2077-81. doi: 10.1016/j.sbspro.2010.07.416
- Carlson SM, Wang TS. Inhibitory control and emotion regulation in preschool children. Cogn Dev. 2007;22:489-510. doi: 10.1016/j.cogdev.2007.08.002
- Penela EC, Walker OL, Degnan KA, et al. Early behavioral inhibition and emotion regulation: pathways toward social competence in middle childhood. Child Dev. 2015;86(4):1227-40. doi: 10.1111/cdev.12384
- Baddeley A. Working memory and emotion: ruminations on a theory of depression. Rev Gen Psychol. 2013;17(1):20-7. doi: 10.1037/a0030029
- Mitchell RLC. fMRI delineation of working memory for emotional prosody in the brain: Commonalities with the lexico-semantic emotion network. NeuroImage. 2007;36(3):1015-25. doi: 10.1016/j.neuroimage.2007.03.016
- Morey RA, Dolcos F, Petty CM, et al. The role of trauma-related distractors on neural systems for working memory and emotion processing in posttraumatic stress disorder. J Psychiatr Res. 2009;43(8):809-17. doi: 10.1016/j.jpsychires.2008.10.014
- Mutter B, Alcorn MB, Welsh M. Theory of mind and executive function: working-memory capacity and inhibitory control as predictors of false-belief task performance. Percept Mot Skills. 2006;102(3):819-35. doi: 10.2466/pms.102.3.819-835
- Morra S, Parrella I, Camba R. The role of working memory in the development of emotion comprehension. Br J Dev Psychol. 2011;29(Pt. 4):744-64. doi: 10.1348/2044-835x.002006
- Батышева Т.Т., Климов Ю.А., Платонова А.Н., и др. Комплексная коррекция легких когнитивных и сопутствующих им эмоциональных нарушений у детей и подростков. Детская и подростковая реабилитация. 2017;(4):22-30 [Batysheva TT, Klimov UA, Platonova AN. Complex correction of easy cognitive and emotional disorders of children and adolescents. Detskaia i Podrostkovaia Reabilitatsiia. 2017;(4):22-30 (in Russian)]. EDN:UOQIIJ
- Чекалова С.А., Карпович Е.И. Школьная дезадаптация в практике детского невролога. Русский журнал детской неврологии. 2025;20(2):61-70 [Chekalova SA, Karpovich EI. School maladjustment in the practice of a pediatric neurologist. Russkii Zhurnal Detskoi Nevrologii. 2025;20(2):61-70 (in Russian)]. doi: 10.17650/2073-8803-2025-20-2-61-70
- Немкова С.А., Болдырев В.Г. Когнитивные нарушения у детей: современные подходы к диагностике и коррекции. Нервные болезни. 2025;1:22-3 [Nemkova SA, Boldyrev VG. Cognitive impairment in children: modern approaches to diagnostics and correction. Nervnye bolezni = Nervous Diseases. 2025;1:22-3 (in Russian)]. doi: 10.24412/2226-0757-2025-13238
- Батышева Т.Т., Квасова О.В., Быкова О.В., и др. Роль нейротрофической терапии в практике детского невролога. Методические рекомендации Департамента здравоохранения г. Москвы. 2015 [Batysheva TT, Kvasova OV, Bykova OV, et al. Rol neirotroficheskoi terapii v praktike detskogo nevrologa. Metodicheskie rekomendatsii Departamenta zdravookhraneniia g. Moskvy. 2015 (in Russian)]. EDN:ZIXXZF
- Кузенкова Л.М., Маслова О.И., Намазова-Баранова Л.С. Ноотропы в когнитивной неврологии детского возраста. Пособие для врачей. М., 2010 [Kuzenkova LM, Maslova OI, Namazova-Baranova LS, et al. Nootropics in cognitive neurology of childhood. Manual for doctors. Moscow, 2010 (in Russian)].
- Митрохин К.В., Баранишин А.А. Классификация и краткое описание лекарственных препаратов – аналогов производных гамма-аминомасляной кислоты и токсических веществ, влияющих на ГАМКергическую связь. Анестезиология и реаниматология. 2018;6:22-30 [Mitrohin KV, Baranishin AA. Klassifikaciya i kratkoe opisanie lekarstvennyh preparatov – analogov proizvodnyh gamma-aminomaslyanoj kisloty I toksicheskih veshchestv, vliyayushchih na GAMK-ergicheskuyu svyaz. Russian Journal of Anesthesiology and Reanimatology. 2018;6:22-30 (in Russian)]. doi: 10.17116/anaesthesiology201806122
- Силкина И.В., Ганьшина Т.С., Середенин С.Б., Мирзоян Р.С. ГАМКергический механизм цереброваскулярного и нейропротекторного эффектов Афобазола и Пикамилона. Экспериментальная и клиническая фармакология. 2005;1(68):20-4 [Silkina IV, Ganshina TS, Seredenin SB, Mirzoyan RS. GAMK-ergicheskii mekhanizm tserebrovaskuliarnogo i neiroprotektornogo effektov Afobazola i Pikamilona. Eksperimentalnaya i Klinicheskaya Farmakologiya. 2005;1(68):20-4 (in Russian)]. doi: 10.30906/0869-2092-2005-68-1-20-24
- Данилов А.Б., Шиндряева Н.Н., Бородулина И.В., Лунегов Т.Д. Интегративная оценка эффективности и безопасности амбулаторного применения препарата Пикамилон. Журнал неврологии и психиатрии им. С.С. Корсакова. 2024;124(7):119-30 [Danilov AB, Shindryaeva NN, Borodulina IV. Integrative assessment of the effectiveness and safety of outpatient use of Picamilon. Zhurnal nevrologii i psikhiatrii im. S.S. Korsakova. 2024;124(7):119-30 (in Russian)]. doi: 10.17116/jnevro2024124071119
- Kalueff A, Nutt DJ. Role of GABA in memory and anxiety. Depress Anxiety. 1996-1997; 4(3):100-10. doi: 10.1002/(SICI)1520-6394(1996)4:3<100::AID-DA2>3.0.CO;2-K
- Быкова О.В., Богдан И.Я., Алексеева М.В. Дисфункция нижних мочевыводящих путей у детей в психоневрологической практике. Медицинский совет. 2025;(11):212-8 [Bykova OV, Bogdan IYa, Alekseeva MV. Lower urinary tract dysfunction in children in neuropsychiatric practice. Medical Council. 2025;(11):212-8 (in Russian)]. doi: 10.21518/ms2025-258
- Белоусова И.С., Сухоруков В.С. Применение метаболических препаратов в лечении детей с гиперактивным мочевым пузырем. Вопросы современной педиатрии. 2005;4(6):22-7 [Belousova IS, Sukhorukov VS. The use of metabolic drugs in treating children with hyperactive urinary bladder. Voprosy sovremennoi pediatrii. 2005;4(6):22-7 (in Russian)]. EDN:PCLNWL
- Маслова О.И., Борисова С.А., Артюхина С.В., Зоркин С.Н. Влияние производных нейромедиаторных аминокислот на уродинамические показатели детей с нейрогенной дисфункцией мочевого пузыря. Лечащий врач. 2011;1:61 [Maslova OI, Borisova SA, Artiukhina SV, Zorkin SN. Vliianie proizvodnykh neiromediatornykh aminokislot na urodinamicheskie pokazateli detei s neirogennoi disfunktsiei mochevogo puzyria. Lechashchii vrach. 2011;1:61 (in Russian)]. EDN:SGGIID
- Энурез. Клинические рекомендации. Министерство здравоохранения Российской Федерации, 2024. Режим доступа: https://cr.minzdrav.gov.ru/preview-cr/835_1. Ссылка активна на 14.06.2025 [Enurez. Klinicheskie rekomendatsii. Ministerstvo zdravookhraneniia Rossiiskoi Federatsii, 2024. Available at: https://cr.minzdrav.gov.ru/preview-cr/835_1. Accessed: 14.06.2025 (in Russian)].
- Мазаева Н.А., Головина А.Г. Типология, динамика и коррекция фобических синдромов в структуре психической патологии у подростков. Методическое пособие для врачей. М.: Цифровичок, 2014 [Mazaeva NA, Golovina AG. Tipologiia, dinamika i korrektsiia fobicheskikh sindromov v strukture psikhicheskoi patologii u podrostkov. Metodicheskoe posobie dlia vrachei. Moscow: Tsifrovichok, 2014 (in Russian)].
- Котова О.В., Беляев А.А., Акарачкова Е.С. Современные методы диагностики и лечения тревожных и депрессивных расстройств. РМЖ. Медицинское обозрение. 2021;5(10):648-53 [Kotova OV, Beliaev AA, Akarachkova ES. Sovremennye metody diagnostiki i lecheniia trevozhnykh i depressivnykh rasstroistv. RMZh. Meditsinskoe obozrenie. 2021;5(10):648-53 (in Russian)].
补充文件
