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Objective: Behavioral disorders (in particular increased aggressiveness of children) are one of the most serious problems not only for doctors, teachers and psychologists, but also for society as a whole. Behavioral disorders in children suffering from severe somatic diseases, including cancer, are of particular importance because they make it difficult to adapt during long-term treatment of cancer.
Methods: We carried out a clinical examination of 143 patients treated in a scientific research institute of Pediatric Oncology and Hematology with various forms of cancer. The age of onset of cancer was in the range from 3 to 17 year-old, the youngest age group of 3 to 12 years (81 patients), adolescents from 12 to 17 (62 patients). Behavioral disorders were noted in 22 cases (15%). The study used the method of clinical observation, psychological tests to identify aggression in children, including projective techniques.
Results: Behavioral disorders were components of the reactive formation; they were observed more frequently in the younger age group. Behavioral disorders in the younger group (16 patients) were manifest in different kinds of hysterical, hysteria-demonstrative reactions, rudeness, and episodes of “verbal” and “physical” aggression. The aggressive actions of children were of reactive “protective” character when the children were trying to avoid the situation that frightened them. The aggression often was “instrumental” (6 patients): It had the aim to manipulate and it made it possible to achieve the desired result. In rare cases, the children’s aggressive actions can be attributed to “target-aggression”, which were determined by the features of forming constitution (the propensity for violence) due to inadequate education and heredity (7 patients). The aggressive displays were much rarer (6 patients) in the group of adolescents (12 to 17 years). “Verbal” aggression was more common. Teens had a tendency to blame parents for wishing to restrict their freedom, humiliated them, cursed and insulted. Direct aggressive action took the form of self-aggression (2 patients). Teenagers smoked “to spite”, ate food contraindicated for them, drank alcohol, violated the regimen, or even refuse treatment. Some of them voluntarily left the clinic, ignored the doctor’s demands, demonstratively skipping the necessary medical appointments.
Conclusion: Aggressive behavior of both children and adolescents has always led to significant adjustment disorders. Behavioral disturbances in children with cancer could act as a reaction component of adjustment disorders and it also arises due to changes in the affective background. The motives of aggressive behavior were different and depended on age. Adolescents’ behavioral disorders were protective-psychological reactions of protest against disease. The turbulent emotional manifestations in children were due to the desire to change the current situation of frustration. Appointment of anti-anxiety medications reduces the severity of aggression in children, indicating that they have anxiety as the main emotional background.