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INTERVENTIONAL PSYCHODIAGNOSIS IN PRESCHOOL INSOMNIA
Complains of insomnia in preschool children is very common in pediatric offices. When their causes are not organic, we should evaluate their possible psychological causes,in view of this stage of development. These include external factors such as: birth of a sibling, entry into school, separation or tension between parents, maternal depression or loss of a loved one or pet. Among the intra-psychic factors, which may or may not relate to external events, we find the typical childhood fantasies of this phase as: ambivalence between good and evil; love and hatred; voracity, omnipotence and persecutory anguish arising from an incipient and cruel superego, symbolized by fairy tales.
To evaluate the effectiveness of interventional psychodiagnosis in children with complaints of insomnia in this age group.
Thirty-six preschool children, between two and six years old, between 2015 and 2017, ( 19 girls and 17 boys), with initial and intermediate insomnia complaints were evaluated. The method used was interventional psychodiagnosis, which is characterized by seeking diagnostic understanding in the psychodynamic aspect and at the same time, briefly intervening in a model of therapeutic consultations. Two to three interviews with parents were conducted, and two to four consultations with children (with or without parental presence). The instruments used were: semi-directed interviews with parents, with specific interventions. Playful observations and other projective techniques, such as story drawings, with timely interventions focused on sleep quality. Feedback interviews are included in this process.
Of the 36 children, we obtained positive responses and improved insomnia in 90% of the subjects, according to their parents' feedbacks, after two months of psychological intervention.
The onset of insomnia in this age group is very common, however, even if transient, it is a symptom that generates great family stress and if not well managed, can condition a poor quality sleep for a long time. Interventional psychodiagnosis proves to be a quick and effective instrument for listening and welcoming the anxieties and parental conflicts and the child himself. It allows the understanding of each family dynamics and the child's own, and because it is interventional, punctuates, discriminates and guides the impeding aspects of a peaceful sleep for the child and their parents.
infant insomnia; preschool sleep; interventional psychodiagnosis; sleep psychology
CARMEN SYLVIA ALCÂNTARA, Luiza Elena Ribeiro do Valle