№ 85 (2023)
Psychotherapy
Comparison of clinical and psychological characteristics in patients with neurotic disorders who chose active versus passive role in psychotherapy. Part 2
Аннотация
The relevance is determined by the need to solve one of the most difficult methodological problems in evidence-based psychotherapy – assessment of clinical, medicaland clinical-psychological changes in patients during psychotherapy in order to increase its effectiveness and simultaneously reduce its duration.
The objective is to perform comparative analysis of clinical and psychological characteristics of patients with neurotic disorders who actively choose psychotherapeutic treatment and passively participate in psychotherapy.
Methods. Clinical and clinical-psychological methods were used. The dynamics of clinical and psychological characteristics of 82 patients with neurotic disorders aged 18 to 55 years is presented. Forty five persons (54.9 %) actively chose psychotherapy and 37 persons (45.1 %) – passively. These groups were homogeneous in terms of gender, age and other socio-demographic characteristics. Here Part 2 of the article is presented revealing the treatment effectiveness in patients who have chosen psychotherapy passively.
Results and discussion. The results of the study showed that the greater efficiency of psychotherapy was observed in Group 1 patients. Group 2 patients, despite a decrease in neurotic symptomatology and improvement of some clinical and psychological characteristics, had a decrease in the level of “constructive aggression,” which contributed to a decrease in the desire to openly express their emotional experiences, to form and implement their life goals, there was an increase in neurotic symptomatology, which increased interpersonal isolation, and a decrease in the level of internalism in the relationship to health and illness.
Conclusion. The data obtained indicate the specificity of the dynamics of clinical and clinical and psychological characteristics and give reason to assume positive effects of the active choice of psychotherapy on the effectiveness of psychotherapy.
5-14
Outstanding Russian medical scientists and academicians I.P. Pavlov and V.M. Bekhterev and their contribution to academic and practical advances in hypnosis, hypnotherapy, and psychotherapy in Russia
Аннотация
Relevance. The paper is a brief historical and analytical overview of works of I.P. Pavlov and V.M. Bekhterev regarding theory, methods, and practice of hypnosis, hypnotherapy, and psychotherapy; the authors evaluate the prospective influence of these scientists on further developments in the theory, methods and practice of hypnosis, hypnotherapy, psychotherapy and behaviorism in the 20th century Russia.
The objective is to retrospectively analyze works by I.P. Pavlov and V.M. Bekhterev and evaluate their impact on theory, methods, and practice of hypnosis, hypnotherapy, and psychotherapy.
Methodology. The paper analyzes lifetime editions of works by I.P. Pavlov and V.M. Bekhterev, as well as publications evaluating their contribution to the history of Russian hypnology and psychotherapy in the late 19th early–20th centuries.
Results and Discussion. The paper outlines the contribution made by I.P. Pavlov and his school to advance theories and practices of suggestion, hypnosis and hypnotherapy in shaping the concept of higher nervous activity. The finding consider the Pavlovian logic of suggestive and hypnotic phenomena based on reflexology, combined inhibition and excitation cortical processes; efficiency of linking hypnotic and extra-hypnotic suggestions according to (Pavlovian) typology of higher nervous activity; a consistent transition from animal models and therapy frameworks in experimental studies and hypnosis, to clinical and therapeutic studies of hypnotherapy and suggestive psychotherapy in the treatment of human neuroses. The review highlights the impact of Pavlov’s doctrine on understanding higher nervous activity, theories of hypnosis and suggestion in the development of Russian hypnotherapy, and – more broadly – the medical model of the Soviet psychotherapy. I.P. Pavlov’s contribution to the development of behaviorism is also emphasized. Analysis of theoretical, methodological, and clinical heritage by V.M. Bekhterev and its influence on hypnotherapy and psychotherapy was carried out in line with his milestone multifaceted scientific contribution to neuromorphology, neurophysiology, neurology, psychiatry, psychology (including developmental psychology), pedagogy, and sociology. V.M. Bekhterev’s contribution to the theory of hypnosis, methods and practices of hypnotherapy and psychotherapy relies on comprehensive advances in an array of human sciences (neuromorphology, neurophysiology, psychiatry, objective (psychology), collective reflexology (sociology)), driven by his own extensive research, as well as creative transformations and contemporary achievements in national reflexology, global hypnology, hypnotherapy, psychotherapy, psychoanalysis, psychiatry, psychology, sociology. Bechterev’s unique research, methods, and practical activities have become a profound foundation for subsequent developments in Russian hypnology and psychotherapy of the 20th century, and became an incentive for the development of behaviorism.
15-27
Medical psychology
Psychological aspects of adaptive response in changed living conditions
Аннотация
Relevance. In early 2020, following the WHO declaration on the COVID-19 pandemic, the population of Russian Federation faced a major change in lifestyle. Quarantine became the main measure to combat the new coronavirus infection COVID-19. As a result, many people, including students, found themselves in conditions of social deprivation and limitation of habitual forms of activity. Such conditions were created for the corrosive tests of the psychic adaptation of astronaut in the 1970s by O.N. Kuznetsov and V.I. Lebedev. Interest in these phenomena has been heightened again by the obvious and significant transformation of the socio-cultural situation resulting from the widespread introduction of digital communication.
The aim of this study was to analyze changes in the mental state of young people (university students) during adaptation to quarantine and distance learning.
Methodology. The study involved 132 students aged 17 to 26 years. Students were asked to fill out a questionnaire, which contained a number of socio-demographic characteristics of the respondents, such as: gender, age, living conditions, form of employment, etc. The semantic differential method was used to assess the experience of one’s own “Self ” in a comprehensive study of the adaptation of young students in conditions of quarantine, and the SAN method was used to assess the functional state of the respondent in his manifestations of well-being, activity and mood. For mathematical data processing, Student’s t-test was used.
Results and Discussion. As a result of the analysis, it was revealed that the meaning of “Self ” in respondents significantly changes with deterioration of the functional state. Some groups of subjects such as: female subjects, subjects from 17 to 22 years old, subjects who have a negative attitude to distant education, subjects who often have a negative attitude towards others, subjects who live with friends, were found to experience more difficulties during quarantine. There is a greater distance in the semantic space between the meanings of the concepts of I before the pandemic and I during the pandemic. Thus, we can say that these groups are more susceptible to the change of their own “Self ”.
Conclusion. The data obtained can be used to create a prevention program, which is necessary to prevent a traumatic situation during anti-epidemic measures.
28-36
Strategies and personal resources of coping in mental adaptation of women with facial skin cosmetic problems
Аннотация
Relevance. Facial skin cosmetic problems are associated with a high level of stress [21; 34; 5]. Coping strategies and personal resources represent the mechanisms of psychological adaptation to stress [1; 16] in the general framework of person’s mental (biological, psychological and social) adaptation [3]. In national literature there are no screening data on the level of mental adaptation/ desadaptation and peculiarities of stress-overcoming behavior in female patients treated at the cosmetology clinic.
Objective. The aim is to study strategies and personal coping resources of cosmetology clinic patients with different levels of mental adaptation.
Methods. We examined 161 patients admitted to the cosmetology clinic with an average age of (39.5 ± 0.9) years. The patients were split into two groups: group 1 (n = 74, or 45.9 %) did not reveal any disorders of psychological adaptation; group 2 (n = 87, or 54.1 %) revealed a reduced level of psychological adaptation. The groups were not significantly different according to sociodemographic and clinical characteristics. Using psychological methods, the groups were compared in terms of perceived stress, social frustration, frequency of psychic and traumatic situations, coping strategies and personal coping resources. We used statistical data analysis methods (Pearson’s χ2 and ANOVA included in the statistical package SPSS 25.0).
Results and discussion. The indicators of perceived stress and social frustration, as well as frequency of traumatizing situations was significantly higher in the group 2 compared to group 1. The indicators for the “Escape & Avoidance” (p = 0.001), “Distancing” (p = 0.014), “Self-Control” (p = 0.061) and “Responsibility Acceptance” (p = 0.006) strategies were significantly higher in Group 2 compared to Group 1. Individual coping resources, i.e. life and sense orientations related to the evaluation of one’s past, present and future, as well as the level of internalization, were significantly higher (p = 0.001) in group 1 compared to group 2.
Conclusion. The decrease in psychic adaptation level in cosmetology clinic patients is related to emotionally oriented coping strategies of care (evasion), strategies caused by anxiety, guilt or own insolvency, as well as the external locus of control. Limitations and perspectives of studying psychological characteristics of cosmetology clinic patients are provided.
37-50
Task-oriented training in rehabilitation after stroke
Аннотация
Relevance. After a stroke, patients encounter problems to adapt to living conditions and perform self-care. Moreover, they have to accept a new social role, as well as develop new attitudes to transformed value orientations and the meaning of life, which compels practitioners to develop a psychological assistance program to develop coping behaviors.
The objective is to study dynamics of self-attitude, as well as attitudes to the disease and treatment in patients after a stroke in the course of task-oriented group training.
Methodology. We studied 110 stroke patients (50 men and 60 women) aged 40 to 75 years with mild post-stroke cognitive impairment who underwent comprehensive post-stroke rehabilitation in a rehabilitation hospital before and after group training. The Spielberger-Khanin Personality and Reactive Anxiety Scale, as well as Hospital Anxiety and Depression Scale (HADS) were used; in addition, patients were rated on Mini-Mental Status Examination (MMSE), Barthel Self-Service Scale, Quality of Life (QoL) scale, and the scale of attitudes towards illness and treatment.
Results and analysis. Psychological modification training raised patients’ awareness regarding the importance of their own efforts in the treatment process and acceptance of a new social role. This helped to increase control over emotions, relieve fear of disease recurrence, resolve depression and resentment and boost self-care efforts to adjust the rate physical and neuropsychic stress. Having completed the training program, patients demonstrated significantly decreased reactive and personal anxiety, as well as decreased anxiety and depression according to HADS, together with improved QoL, Barthel Self-Service and MMSE score. The results of cluster analysis indicate a shift in selfesteem emphasis towards self-centeredness, holistic self-perception, and self-sufficiency from social frustration before the training; improved outcomes after training also include perception of health as a value (self-caring attitudes) and restructured hierarchy of life values.
Conclusion. Task-oriented training at later stages of post-stroke rehabilitation can help to strengthen compliance and positive self-attitude.
51-59
Physical, sexual, emotional abuse in childhood – prerequisites for the development of borderline personality disorders in adolescents (review foreign studies)
Аннотация
Relevance. According to a study by the University of Manchester, people with borderline personality disorder (BPD) are 13 times more likely to report childhood trauma than people without any mental health problems. An analysis of data from 42 international studies involving more than 5,000 people showed that 71.1% of people diagnosed with a personality disorder reported at least one traumatic experience during childhood.
Intention. To identify the current state of the problem of studying physical, sexual, emotional abuse in childhood as a possible factor in the development of borderline symptoms in adolescence.
Methodology. The object of the study was scientific articles and meta-reviews on the problem presented in the abstract-bibliographic databases MEDLINE, PubMed and eLibrary.ru for the last 5 years.
Results and Discussion. Based on this analysis, there is a lot of evidence that traumatic experience in the early period of development increases the likelihood of developing borderline disorders. Studies on the effects of childhood trauma on adolescent mental health show that it is much more likely associated with BPD than with mood disorders, psychosis, and other personality disorders. The most common adverse experience in people with BPD was physical neglect, followed by emotional abuse, physical abuse, sexual abuse, and last but not least emotional neglect.
Conclusion. The results showed that childhood traumatic experiences may be a predictor of BPD symptoms at a later age. It should be noted that childhood emotional abuse and neglect has the most significant influence on the formation of BPD in adolescents.
60-69
Individual and personal characteristics of patients taking synthetic cathinones at the stage of remission
Аннотация
Relevance. The systematic use of any psychoactive substance, as a rule, contributes to personality changes and deterioration of social functioning. Research on the impact of synthetic cathinones (SC) on the mental health of their consumers is currently relatively small, and their results sometimes contradict each other. It is especially important to study the stage of the formation of remission in patients with dependence, since at this moment the formation of a setting for abstinence from taking a narcotic substance takes place.
The aim is to study the individual and personal characteristics of patients taking synthetic cathinones at the stage of remission formation.
Methodology. The study involved 186 patients who were in rehabilitation due to the use of PAS. The 1st group consisted of 109 patients with dependence on synthetic cathinones. The second group consisted of 37 patients who occasionally took synthetic cathinones. The third group consisted of 40 patients dependent on alcohol. The main research method was clinical and psychopathological,
in addition to which experimental psychological (abbreviated method of personality examination “SMOL”, “Personal aggressiveness and conflict-ness” method and psychometric (self-assessment scale of social adaptation (SASS)) methods were used.
Results and their analysis. The study showed that in patients of the main group (addicted to SC) characterological changes were more often detected than in individuals from other groups of the study. At the same time, excitable-type accentuation prevailed in the groups with developed dependence; it occurred significantly more often than in patients with episodic SC use. The manifestations of leading accentuations in patients of the main study group were studied. It was also found that in patients dependent on SC, in comparison with patients from the group of episodic use of these surfactants, personality disorders were more often observed. It was found that the average level of assessment of social adaptation in patients in the main group was significantly lower than in patients in the comparison groups (episodic use of SK and alcohol dependence).
Conclusion. The identified individual and personal characteristics of patients with dependence on SC will allow a differentiated approach to their treatment and resocialization through the development of personalized rehabilitation programs.
70-80
Fear of relapse and mental traumatization in parents of childhood cancer patients
Аннотация
Relevance. Fear of child disease relapse in parents is the result of mental trauma and by itself is a traumatizing factor.
The objective is to study fear of disease relapse in parents of childhood cancer survivors.
Methods. We examined 29 parents of childhood cancer survivors. Group 1 consisted of 14 (48 %) parents with children undergoing in-patient treatment for cancer; group 2 included 15 (52 %) parents of childhood cancer survivors who were in remission. Clinical, psychological and experimental methods and techniques encompassed the Hospital Anxiety and Depression Scale (HADS), a measure of an individual’s tolerance to ambiguity (MSTAT-1) and specific measures for child-parent emotional interaction.
Results and Discussion. Fear of child’s cancer relapse is identified in parents at the stage of child’s disease treatment, as well as remission; however, the triggers of parental fear of relapse are different. Severity of the parental fear of relapse depends on the parent’s individual personality, in particular susceptibility to anxiety and tolerance to ambiguity. Parents of childhood cancer patients show impaired self-esteem, which is especially evident by the Accepting Oneself as a Parent parameter.
Conclusion. Psychological assistance is required by both the parent and their ailing child. Professional psychological assistance should be available to parents throughout the child’s treatment, as well as during follow-up after discharge.
81-91
Risk factors for the development of anxiety disorders
Аннотация
Relevance. The article studies risk factors of anxiety disorders. The relevance and significance of the research topic is justified by the need to preserve the knowledge accumulated within the outgoing clinical and psychological paradigm (with regard to the transition to ICD-11), generalize and systemize earlier obtained results, as well as supplement them with trends that manifest themselves in the transition to an updated understanding of borderline personality disorders.
The objective of the article is to clarify the totality (groups) of risk factors for anxiety disorders related and unrelated to social events on a global scale. The novelty of the study is an attempt to identify risk factors for the formation of anxiety disorders in connection with such social events as the COVID-19 pandemic and the geopolitical conflict caused by the beginning of the military special operation of the Russian Federation in Ukraine.
Methods. General scientific (dialectical, analysis and synthesis, comparison and analogy, annotation, annotation and abstraction), special (systematic, comparative analysis, etc.), research (analysis of Russian and foreign literature on the problem of research, results of empirical research, social surveys, etc.) are among the priority research methods.
Results and discussion. As a result of our research, the author arrived at the following conclusions: firstly, the risk groups for the development of anxiety disorders, caused by social events of global scale or without direct motivation, include intrasocial, extrasocial, economic, and political reasons; secondly, the risk groups for the development of directly dominant anxiety disorders associated with global social events include epidemiological and geopolitical impacts; thirdly, all these events shift the emphasis towards specific components of the enlisted groups, thus forming a situationrelated set of risk factors impregnated with the development of such anxiety disorders, that most evidently produce various types of borderline personality disorders and antisocial behavior in the social micro and macro scale.
Conclusion. The study eventually allowed to identify the risk groups for the formation of anxiety disorders, including borderline personality disorders.
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