Citation

Akitani S. J. Jpn. Pediatr. Assn. 2020; 60: 77-81.

Vernacular Title

不安に寄り添うことで緘黙症状の改善を認めた場面緘黙13歳女児例

Copyright

(Copyright © 2020, Nihon Shonika Ikai)

DOI

10.34584/ikaihou.60.0_77

PMID

unavailable

Abstract

Selective mutism is a condition in which there is almost no problem with speaking ability, but in certain situations it is not possible to speak aloud for more than a month. According to the diagnostic criteria of the US Diagnostic and Statistical Manual of Mental Disorders (5th ed.), DSM IV-TR 1) (Diagnostic and Statistical Manual of Mental Disorders (4th-TR )) It was defined as one of the social anxiety group / anxiety disorder group from the "disorders usually first diagnosed in early childhood / childhood or adolescence" in ed.)). The fact that a girl who has been diagnosed with selective mutism "cannot speak in kindergarten or school" is regarded as "behind anxiety", and the surroundings accept symptoms such as selective mutism to give a sense of security and respond to anxiety. By doing this, the symptoms improved and good self-esteem could be formed.

選択性緘黙（以下，場面緘黙）とは，話す能力にはほぼ問題がないのに，特定の状況では1カ月以上声を出して話すことができないことが続く状態である。米国の精神障害の診断・統計マニュアルDSM-V（Diagnostic and Statistical Manual of Mental Disorders (5th ed.)）の診断基準においては，DSM IV-TR1）（Diagnostic and Statistical Manual of Mental Disorders (4th-TR ed.)）の「通常，幼児期・小児期または青年期に初めて診断される障害」分類から社交不安症群／不安障害群の一つと定義された。場面緘黙と診断した女児の「幼稚園や学校などで話せない」ことを「不安が背景にある」ととらえ，緘黙を始めとした症状を周囲が受け入れることで安心感を与え，不安に寄り添った対応をすることで症状が改善し良好な自尊感情を形成できた。

Language: ja

Keywords

SMQ-R（Selective Mutism questionnaire-Revised）; 場面緘黙; 社交不安症; 自尊感情; 選択性緘黙