Fear and Anxiety in the Children Suffering from Infantile Cerebral Palsy and Raised in Families with Various Parental Subsystems

The education of the special needs children has been in the very focus of attention in our country in recent years. The inclusive education concept got a vast popularity and has already started to be intensively implemented into the Russian upbringing process. Though, it is necessary to take into account plenty of various nuances. The challenge of psychological peculiarities of the special needs children is one among the above mentioned. The present article is dedicated to the children suffering from infantile cerebral palsy (ICP), whereas this disease is something special within the classification of the muscular-skeletal system disorders in children. It is a multi-factorial disease that combines different variants of mental developmental disabilities. Primary school age coincides with the first perception of one's disability. The history of illness complicates, the situational behavioral disorders are closely interconnected with psychoorganic ones; cerebroasthenic, apathy-adynamic and hyperdynamic types are the most often among them. The necessity of accommodation and socialization among the schoolmates are added hereto together with study load, etc. On the basis thereof, the hypothesis was developed that the ICP primary schoolchildren have a high level of anxiety and fears. For proving that and also in order to reveal the peculiarities of the anxiety and fears, if any in such children, the present research has been performed. It has been also fixed that the ICP children are brought up in the families with various parental subsystems, as a part of this study. To that end, the parallel was drawn between the anxiety level, fears peculiarities and family structure, where the child is brought up.

Anxiety is one of few psychological phenomena, which significance is at the same time valued as extremely high and quite specifically, even in the functional context.On the one hand, it is "a core problem of the contemporary civilization" (May, 1950;Erikson, 1996), as the most important characteristics of our epoch: "The 21 st century is the age of disturbance".It is estimated as the principal "vital feeling of contemporaneity" (Gottwald & Howland, 1992).On the other hand, it is a mental state caused by special experimental condition or situation (competitive, examination anxiety).
The psychological literature offers various visions of these concepts.According to V. K. Villyunas, "Anxiety is the proneness of an individual to experiencing worry, which is characterized with a low threshold of the worry reaction emergence: one of the main parameters of individual differences (Villyunas, 1997).
In psychological research, several lines of anxiety understanding can be identified.The whole diversity of the anxiety definitions can be narrowed to a few conceptual approaches (Eysenck, 2001): 1. Anxiety is understood as special feature of the sensual-emotional field, which includes the asthenic negative emotions with the unrealized causes of their occurrence (May, 1996).
2. Anxiety is treated as a personal property, which is prone to the reaction in the form of worry in various situations, which objectively are safe (Spielberger, 1970;Eysenck, 2001;Cattell, 1972).
The modern vision of the anxiety's influence upon the development of personality is mainly based upon the results obtained from clinical tests, including those conducted in cases of the borderline disorders.Besides, the connections between anxiety and other personal traits that are stated in course of empirical studies are interpreted in this way exactly, e.g. between anxiety and level of aspiration (Atkinson, 1950(Atkinson, , 1965;;Reykovsky, 1979), anxiety and types of accentuation (Zakharova et al., 1994).Certainly, the exactly opposite interpretation of the obtained connections is also widespread, when the anxiety is treated as secondary as for these personal traits.
Anxiety is strongly predictive to become stable as a personal trait.It can be believed that the Ego-conflict leads to backlog of needs, and their tension together with multi-directionality cause anxiety.In the following the latter becomes stable and turns into a separate trait, gains its own logics of development.If possessing enough motivation force, anxiety starts to function as a motive for communication, stimulation for success, etc.In other words, it sets place among principal personal traits.
The correlation between the notions of anxiety and fear also causes some significant issues.The differentiation between anxiety and fear fixed in the corresponding concepts (Ger.: Angst, En.: anxiety, Fr.: angiosse means "uprush, blank terror, or depression", opposite to Ger.: Furcht, En.: fear that means "certain, empirical, experimental dread, or peril") was made at the beginning of the 19 th century only by S. Kierkegaard who systematically differs the certain fear (Furcht) from the indefinite, blank terror (Angst).Before that everything that we contemporary treat as either anxiety, or fear was described and discussed as general concept of "dread" from the point of view both physiological and biochemical parameters (Cattell, 1972).Some explorers treat fear as a basic emotion, while anxiety -as a more complicated emotional formation, secondary-formed at the basis of the former, often in combination with other basic emotions (Izard, 1980;Levitov, 1969).Thus, following the differentiated emotions theory (Izard & Tomkins), fear is a basic emotions, and anxiety is a stable set formed in the result of combination of fear with other basic emotions: "Anxiety... consists of the predominant emotion of fear and interactions of this very fear with one or several other basic emotions, especially with misery, anger, guilty, shame and interest" (Izard, 1980, p. 331).This point of view is of local nature and so is not very popular beyond the mentioned theory, especially as concerning the cases when it touches upon studying the stable kinds of anxiety.I. G. Sarason differentiates anxiety from fear on the assumption of direction of attention: in fear the individual's attention is directed outside, while in anxiety -inside.The human-being fixes himself to his inner state.However, fear and anxiety are ordinary used as permutable notions.
In this very thesis anxiety is treated as a multi-object ruefulness (i.e., the plenty of subjects bear threat, all aspects of polysemic and indefinite reality) after I. A. Musina's approach.When anxiety fixes to any peculiar object -all the rest frees from it.Thus, fear appears.To some degree, anxiety can be characterized as a subjective experience, while fear -as an objective manifestation.

Research Management
The issue of causes for frank stable anxiety belongs to the most important ones.In the present thesis the connection between anxiety, fear and parental subsystem, wherein a child is being brought up, has been studied.The parental subsystem joins all family members whose interactions are connected to the parental functioning.In respect to the differentiation of the kind the following types of families were marked: 1. Couple families -children are brought up by both a father and a mother; The research was performed in the boarding-school #4 for the children with muscular-skeletal system disorders and secondary school #167.The exploration surveyed 56 primary schoolchildren.The experimental group (EG) included 28 children suffering from various in type and severity infantile cerebral palsies and studying at the special school.The control group (CG) consisted of other 28 children who have never suffered from any muscular-skeletal disorders and attend secondary school.

Methods of Research
The research was performed in two stages.In the first stage the children with higher level of anxiety were detected by means of such techniques, as: • Anxiety Test (R. Tammle, M. Dorkey, & V. Amen); • Imaginary Animal Drawing (after A. P. Wenger).In accordance with the findings of the first stage, the children demonstrating higher level of anxiety and fears were selected for the participation in the second stage of the exploration applying the following technique: Children's Apperception Test (САТ, L. Bellack).
Furthermore, proceeding from the result obtained from the Imaginary Animal Picture Technique (after A. P. Wenger) and Children's Apperception Test (САТ, L. Bellack, S. Bellack), the attempt to reveal the peculiarities of experiencing fear and anxiety in each group of the surveyed children who were separated according to the parental subsystem, wherein the children are brought up, has been made.

Results of Research
Primarily, for the sake of revealing the abundance of anxiety and fear among the EG and KG children the Anxiety Test's (R. Tammle, M. Dorkey, V. Amen) results were analyzed.The obtained results are given in Table 1.Subsequently, the drawings of the imaginary animal were analyzed.In course of their interpretation not only the children's drawing were studied, but also the peculiar features of accompanying story-telling were taken into account for complex and all-sided analysis.The most frequent signs of emotional disorders in children were selected (see Table 2).Thus, the findings obtained at the first stage of the present exploration allowed to state that the high level of anxiety is in the families with both the ancestral and unrelated guardianships, except for the families with both of these two types of guardianship, where the largest number of selected children were the ones from CG (it should be mentioned that in the families with unrelated guardianship only one child was tested initially).Some qualitative differences in the symptom complexes of different groups of children and family types were also detected.Those data will be taken into account during the interpretation of the second stage's findings and making conclusions.
The aim of the second stage was to reveal causes of fears and anxiety in EG and CG, also to find out the peculiarities (if any) of the essence of fears in the children suffering from ICP brought up in couple, incomplete and foster families.For that purpose the Children's Apperception Test (САТ, L. Bellack) was applied.In data processing only the peculiarities of interpretative importance among all found in the children's stories were taken into account.The interpretation of the findings obtained using this very technique was performed with a glance to the H. Murray's system of needs (Sokolova, 1980), while the personal theory developed by this very scholar is the theoretical justification of the Thematic Apperception Test (TAT), whereas CAT is the variation of the former method.The needs typical for the primary schoolchildren in a greater or lesser degree and most often in the surveyed children's stories told within this very exploration were taken from the 20 general needs appointed by the author of the technique for the TAT stories interpretation.

Discussion
It was concluded that the parental subsystem of the family was significant for the determination of peculiarities of fear and anxiety in both the EG and CG children.Owing to the revealed peculiarities, the fear and anxiety's symptom complexes in these groups of children were built up.However, it would be improper to claim against this very background that the children suffering from the muscular-skeletal disorders experience the specific fear of any kind and demonstrate persistently high level of anxiety caused by their disabilities.The specific symptoms mainly typical for the EG children only (such as, asthenization, anxiety as for health status, disturbance of vision of body constitution) were detected.No essential tendencies were revealed as concerning the parental subsystems, as the patterns are either stopped, or amplified by both the upbringing model and the personality of the child.The only specificity is the presence of ostentation, wish to attract notice and hysteric traits in characters of the children from both the ancestral and unrelated guardianship families.It is reasonable to collate the obtained data with the new information about the types of relations between parents and children in each particular family and also about their influence upon the findings being in place.
The obtained results coincide with the standpoints of modern scholars that the ICP children, despite the deviation in their development, are able to achieve the same results as the normally developed ones, though the former should spend more mental and physiological forces and energy (Akhmetzyanova, 2012;2013;Alexeeva, 2008).Despite the fact that the children suffering from ICP are more psychologically and physiologically incurred to fear appearance and permanent anxiety, they can avoid these states by means of working over obviously problem areas (Gredyushko & Khusainova, 2012;Gurov & Metelkina, 2006).There are some peculiarities in upbringing in couple, incomplete families, also in cases of either ancestral or unrelated guardianship.However, there are some other factors, at that: the personality of parents/fosterers, the nature of family relations, the type of upbringing, the position of a child within the family structure.All mentioned above can have either compensatory, or malforming significance in any type of the families, depending on their nature (Akhmetzyanova, 2014a(Akhmetzyanova, , 2014b)).

Conclusion
The anxiety level and specificity of fears were failed to be coincided with pertain of a child either to CG, or EG.
The anxiety in the EG children could certainly be referred to their constitutional peculiarities.Though, it would be incorrect to claim that these very specificities are of exact significance, because in the process of children's symptom complexes it was concluded that the nature of this anxiety and the fears emerging are greatly various.Age-related, social factors and tendencies could be also relevant.
The regard to the parental subsystems allowed to elicit some consistencies (e.g., fear of condemnation, ostentation in both EG and CG children brought up in unrelated guardianship families).However, the exposure of the peculiarities that appear on the back of other parental subsystems attracted attention to the multifactor causes of fears and anxiety in the children from these groups.The nature of the obtained data and their sources' analysis make it reasonable to hazard a conjecture about the key importance of the upbringing type, family climate and interrelations between a child and "educator/s".It means, despite the fact of the muscular-skeletal disorders in a child, the family type -either both biological, or foster-parents, the upbringing type, properly adjusted to the child's personal traits and corresponding merciful educational and social environment can release a child from excessive anxiety and fears.And conversely, the improper upbringing type can midwife anxiety and fears, while the muscular-skeletal disorders and parental subsystem type will become the aggravating factors only.

Research Restrictions and Perspectives
Going forward, the survey of the examined children should be enlarged for the sake of more statistically significant data.The family upbringing style should be also researched: that will allow to elicit the causes of permanent anxiety and fears.
The children suffering from ICP are able to achieve the same results and characteristic values as the normally developed ones, but the former should spend more psycho physiological energy.This leads to an increase in nerve and psychic tension in such children and can causes the cerebrospinal overstress that will be spontaneously manifested in anxiety raise, obsessive fears formation and other signs of mental instability.Thus, the further updating of fears and anxiety causes, the complete detection of factor influencing upon their occurrence, also revealing the peculiarities of the disorders of the kind will allow to perform the prevention against such recurrent extraneous features.
2. Incomplete families -children are brought up by a single parent (a mother) only;3.Ancestral guardianship -the parents are substituted with other relatives, grandmothers and grandfathers, first of all; 4. Unrelated guardianship -children are brought up by foster-parents.

Table 1 .
Anxiety levels comparative analysis

Table 2 .
Symptom complexes severity comparative analysis (Imaginary Animal Drawing)