ARTICLES ARCHIVE

The aim of the work was to study the individual psychological features of combatants with various forms of post−stress psychiatric disorders. The study used the methods of observation, psychodiagnostic and mathematical−statistical. As a result of the study, it was shown that the combatants with post−stress psychiatric disorders are characterized by emotional disturbances of various type and severity, accentuated personality traits, behavioral disorders, transformation of the system of basic beliefs and auto−perception of psychological well−being. Typical emotional disorders are manifested in the form of severe anxiety and depression, emotional coldness and detachment, feelings of guilt, presence of suspicion, hostility and impulsiveness, aggressive and autoaggressive tendencies, alcoholization. In general, they have an insufficient level of psychological well−being, low self−esteem, insufficient personal autonomy, low ability to integrate new experiences, significant dissatisfaction with the circumstances of their own lives, inability to maintain emotionally favorable relationships with others, and a decrease in adaptive capacity in general. With the increase in the manifestations of post−stress mental disorders, the combatants have an increased presence of emotional and behavioral disorders, personality changes, a subjective assessment of psychological well−being and tolerance to uncertainty decreases, and the system of basic beliefs changes.

Anxiety disorders are the most common mental illness in children and adolescents. They negatively affect all aspects of the child's life, disrupting its normal functioning at home and at school. Manifestations of anxiety in childhood often become predictors of anxiety−depressive disorders in adulthood. Anxiety−phobic conditions in children and adolescents occur much more often than they are diagnosed, acting in an atypical, «masking» form. In order to determine the regularities of forming such a pathology on the basis of the study of socio−psychological, hereditary, biological factors, patients with anxiety disorders were examined: children aged 7−14 and adolescents aged 15 and older. The study used structured interviews, questionnaire SCL−90, Spielberger's scale, the scale «Multidimensional Assessment of Child Anxiety»; color selection method; Quettel's questionnaire «Personality Features», etc. The results of the study showed that psychopathological symptoms of anxiety disorders in children were heterogeneous and had age−related differences. Four clusters of syndromic complexes were distinguished: emotional, somatic, cognitive and behavioral, which, depending on the age, had different constellations: for children, somatic and cognitive, for adolescents −− emotional and behavioral. Fears were registered in all subjects: multiple phobia −− in children, isolated −− in adolescents. The gender features in children were determined: anxiety and phobic disorder was significantly more common in boys, and anxiety and depression −− in girls. In formation of anxiety disorder in children, the factor of family upbringing is important. The interrelation of a number of social, psychological, and biological factors of the formation of anxiety disorders in children and adolescents is emphasized.

The problems of family health, family interaction and family structure are analyzed. Family interaction is defined as an integral concept in family psychology and its essential features. It is emphasized that the central element of the most part of family crises, conflict situations, destructive reactions of family members are problems related to violation of family interaction, that is, deformed and destructive interaction is congruent with the notion of «family crisis». The interrelation of the state of family interaction and the level of the family crisis is grounded; the components of the system of family interaction are defined: psychoemotional, individual−psychological, behavioral, psycho−physiological, partner. Diagnostic markers which are also targets of psychological correction are shown: self−actualization (support, value orientations, self−esteem, spontaneity, acceptance of aggression, contactness, self−acceptance, flexibility of behavior, sensitivity, creativity, competence in time), internality (general, in the field of achievements, family and industrial relations), sexual looseness (sexual libido, impersonal sex, permissibility, pornography, masculinity−femininity) and relationships in sex (sex physical excitement, physical sex, sexual aversion, sexual neuroticism), family relationships (understanding, emotional attraction, authority, satisfaction with marriage), psychological defense, behavior in conflict situations. The results of the work both in the field of theoretical research, and in the field of practical life, psychological counseling, psychotherapy in the context of women's self−fulfillment are of great importance.

In the recent years, the increasing concern of physicians is caused by additions to social networks and the specific negative effects of such an addiction, especially those related to the impact of social networks on the emotional state of the users. With the purpose to investigate the features of the effects of hyperbolized self−reflection and introspection in individuals with the signs of addiction to social networks at the present stage of the Internet development, 52 persons with the mean ae of 10 years were examined. Content analysis, clinical anamnestic, psychopathological, psycho−diagnostic, statistical methods were used. It is noted that one of the main prerequisites of hyperbolized self−reflection and introspection is leveling of depersonalization of the Internet users in social networks and acquisition of the character of mainstream of publications containing an outright description of emotionally saturated experiences, which leads to induction of fixation of attention on their own psychic experiences. More popularity of descriptions of negatively colored experiences causes concentration of the users of social networks on the emotions of this circle. It was established that these individuals are characterized by the publication in social networks of personal information, including description of their own emotional experiences, dominated by negatively colored experiences; progressive increase in episodes of self−reflection and introspection as social networks are used; a tendency to self−inducing self−reflection and introspection under the influence of the third−party records of similar content; less self−therapy ability to verbalize and publish description of negatively colored experiences. The characteristic self−therapy mechanisms when publishing descriptions of negative−stained experiences are catharsis and the effect of «imaginary life in advance»; the tendency to publish descriptions of negative−stained experiences, even in the presence of destructive influence on the mental state of such actions; obsessive check of the availability of answers to published descriptions of their own experiences and worsening mental status in the absence of such responses from other users.

Following the emergence of a mental disorder that can be regarded as a life crisis, a person faces the problem of re−adaptation, a return to society in a new incarnation of its existence. At the forefront is the need to find those components of the personality that have not been affected by the disease and on the basis of which it is possible to build rehabilitation measures. The intrapersonal factors of re−adaptation of individuals include abilities −− the personality traits that enable them to successfully perform various activities. Professional, communicative, creative and reflexive abilities in their development in the activity ensure the expansion of ways adaptive behavior and coping strategies. To study the peculiarities of the subjective picture of the adaptive abilities of women with schizophrenia, a study was carried out using M. Kuhn−T. McPartland «Test of 20 Definitions» and Methodology for studying the dynamics of abilities of O. L. Muzyka. Its results show that women with schizophrenia have an average and high level of reflection. The patients are able to reflect changes that occurred in their personality, but they are not always associated with the progression of the disease. It is characteristic that the answers often contain manifestations of the symptoms of illness (delirious ideas, mannered language, neologisms). The patients are not always critical of their illness, describe characteristics that are not true or have occurred in the distant past, often exaggerate their own abilities, have a predisposition to multitasking, express their hopes for complete recovery, describe mainly knowledge, skills and skills related to the housekeeping, hobbies and leisure. In the description of individual−personality characteristics the women did not report communicative and professionally important qualities. Analysis of true and potential abilities indicates a weak motivation for success, an orientation towards internal self−development. Development of abilities in activity will enable to provide opportunities for active inclusion in social processes and improve the quality of life.

The presence of the maxillofacial defect and the need to seek surgical help in this regard are accompanied by a complex set of pathological personality reactions, experiences, significant increase in psychoemotional load, an increase in the level of neuroticism and worsens the life quality. To develop a system of medical and psychological support for persons who underwent maxillofacial surgical interventions, a prospective study was performed. Clinical−anamnestic, psychodiagnostic methods were used. Surgical and medical−psychological characteristics of various variants of lesions of the maxillofacial area were analyzed. The basic surgical and psychological risks of the surgical treatment were determined in patients with traumatic lesions of the maxillofacial area of various localization, including fracture of the mandible, alveolar process, upper jaw, zygomatic bone, and nose bones, which are reduced to three types of surgical defects: aesthetic, functional and odontological. The findings of the investigation allowed to develop the technique of combined use of reconstructive surgical intervention and medical−psychological support of patients in the postoperative period, which is made as a 4−stage protocol the purpose of which is prevention of psychological disorders in the patients.

Formed as a result of the crises of the recent decade (military actions, socio−economic upheavals) a difficult political, socio−economic state has a negative impact on the psychological state of the population. Children, as the most defenseless part of the population, are in the most difficult situation, and the primary task of the state is to protect the physical and psychological health of the younger generation. It is known that psychotrauma and stress can cause a delay in the mental development of children, and in some cases have an adverse effect on the physiological activity, which in the future can lead to development of chronic diseases. The problem of neurosomatic relationships of gastroenterological patients attracts the attention of researchers and doctors because of their high prevalence and socio−medical significance. The nervous system in the diseases of the gastrointestinal tract is primarily involved at the beginning of formation of somatic pathology, determining neurosomatic mechanisms and as a manifestation of somatoneurological disorders. It is very important that the primary psychological help in any form chosen by the specialist be provided immediately after the injury in order to strengthen the victim's level of awareness of what happened. In other words, psychotherapeutic intervention is aimed at realizing what has happened and allows «shifting» fears from the lower parts of the brain directly to the cerebral cortex, which makes them (fears) more flexible for further psychocorrection.

To date, the mechanisms for preventing development of both psychosomatic diseases and neurotic disorders have not been identified. Gastroenterological patients belong to the group of persons with classical psychosomatism: somatic pathology develops against a background of the mental pathology. If, moreover, the necessity of surgical treatment is added, the degree of the patient neurotization increases. To study the clinical structure of nonpsychotic mental disorders in patients at the preoperative stage, gastroenterological patients were examined depending on the type of planned surgical intervention. The patients were divided into groups depending on the type of the forthcoming surgical intervention (traditional, laparoscopic), as well as the inclusion of psycho−rehabilitation measures in the complex treatment of patients at the pre− and postoperative stages. The examination was carried out using a clinical−psychopathological method. As a result of the study, it was revealed that in patients with planned laparoscopic intervention, nonpsychotic mental disorders of neurasthenic and somatoform structure, as well as reactions to stress, were more reliably diagnosed. In patients with a planned traditional surgical intervention, nonpsychotic mental disorders of anxious−phobic, conversion and obsessive−compulsive structure were significantly more frequent. This should be taken into account when organizing the psychocorrective work with the gastroenterological patients at the preoperative stage.

The question of the relationship between cognitive deficits and the level of social adaptation of patients with anxiety disorders is extremely important, since the application point of the efforts of many psychiatrists is not only a decrease in the severity of anxiety symptoms. The ambiguity of the influence of anxiety as a symptom on cognitive functioning is stressed, and some of the cognitive impairments are considered a proper risk factor for the development of both depression and anxiety, while the other part is just a correlate of clinical psychopathological disorders or a marker of predisposition and a marker of the condition. Early detection and effective treatment of the first episodes of depression reduces the severity of the depressive process, smooths out the phenomena of cognitive deficits, facilitates the onset of remission and the social recovery of patients. In order to determine the peculiarities of the cognitive functioning of children with anxiety disorders, taking into account the characteristics of their motivational and personal sphere, a study of 108 children aged 7−18 with anxious and phobic disorders was conducted using complex clinical, psychopathological and pathopsychological methods. In the course of the study, three variants of syndrome complexes of anxiety disorder in children were identified: with the predominance of symptoms of secondary anxiety with cognitive (vector out) and emotional component; personality−dependent states; and vital. In formation of effective therapy programs and psychological intervention, it is necessary to take into account the degree of impairment of the cognitive functions of children with anxiety disorders. Cognitive dysfunction in children with anxiety disorders allows to determine the strategy of therapeutic intervention, the program of medical and psychological support at further stages of ontogenetic development of the child.

In order to investigate the factors of social frustration and personality peculiarities in servicemen of the Armed Forces of Ukraine (AFU) with the diagnosis of posttraumatic stress disorder, servicemen of AFU, who participated in military operations in Eastern Ukraine with different PTSD variants (dysphoric, anxious, asthenic and hypochondriac). The complex of methods of investigation included Leonhard−Schmieschek Characterological Questionnaire, method for diagnosis of the levels of frustration of L. I. Wasserman (modified by V. V. Boiko), as well as methods of mathematical statistics. The findings of the investigation demonstrated that the persons with excited and affective−rigid types of accentuation predominated among the patients with dysphoric variant, anxious and emotive types prevailed in anxious variant, dysthymic and affective−exaltation types prevailed in asthenic variant, and pedantic and anxious variants of accentuation predominated in PTSD HV. The investigation of factors of a social frustration showed that in patients with hypochondriac variant. The study of social frustration factors testifies that in patients with a dysphoric variant the main factor of social frustration is dissatisfaction with: relations with colleagues, commanders and other subjects of military service; position in society, material condition, housing and living conditions; the situation in the society and the state; sphere of services; household and medical services; leisure and vacation. The servicemen with anxiety variant are dissatisfied with: relations with colleagues, commanders and other subjects of military service; relations with the spouse, children, parents, friends and acquaintances; sphere of services; household and medical services; leisure and vacation. The servicemen with asthenic variant are dissatisfied with: mutual relations with colleagues, commanders and other subjects of military service; sphere of services; household and medical services; way of life in general. The servicemen with hypochondriac variant are dissatisfied with: mutual relations with colleagues, commanders and other subjects of military service; the content of service in combat conditions, the conditions of professional activity of a serviceman; sphere of services; household and medical services; leisure and vacation. The obtained data should be taken into account at diagnosis and treatment of posttraumatic stress disorder.

The problem of maintaining the mental health of servicemen and timely diagnosis of psychopathological manifestations that arise in military personnel as a result of participation in combat operations, correct nosological and syndromic classification of these disorders and their treatment in the modern world is permanently relevant. Particular attention in this context is given to psychopathological disorders from a group of combat stress reaction. The purpose of the study was to conduct a descriptive analysis, to establish clinical features, to determine the pathogenesis and to systematize the diagnostic criteria for the delayed post−combat response (tension) syndrome among servicemen who participated in combat operations in the ATO zone in Ukraine. The study involved 142 servicemen who participated in combat operations in the ATO zone in Ukraine and who showed the signs of psychopathological disorders. The methods of research included clinical history taking, clinico−psychopathological, psychodiagnostic, catamnestic, analytical, statistical. The study revealed a specific stable set of psychopathological symptoms, combined by a single pathogenetic mechanism, peculiarities of the debut and dynamics manifested in the military personnel of Ukraine who participated in combat operations in the zone of the ATO in Ukraine. This condition was called «delayed post−combat response (tension) syndrome». The features of the debut, clinical filling and dynamics of а delayed post−combat response (tension) syndrome was established and described; its etiopathogenesis was determined; diagnostic criteria were formulated. The revealed delayed post−combat response (tension) syndrome requires further study in order to clarify its structural components, dynamics, duration, medical and social consequences and the choice of optimal preventive and rehabilitation tactics.

Among a wide range of psychopathological aspects of involvement of persons with addiction in substitution treatment programs with synthetic opioids, one of the most pressing problems is the diagnosis of psychopathological disorders that mimic neurotic spectrum disorders. The purpose of the study was to establish the relationship between the comorbid psychopathological nonpsychotic signs in persons on the programs of substitution treatment with synthetic opioids. In the course of the study psychodiagnostic, clinical−psychopathological (including the Symptomatic questionnaire SCL−90−R and the Clinical questionnaire for detection and evaluation of neurotic states) and clinical−statistical methods were used. It was found that anxiety, as a pathological condition, is observed in 94 % of the examined, manifestations of neurotic depression −− in 97 %, manifestations of asthenic syndrome −− in 77 %, hysterical type of response and obsessive−phobic manifestations had an absolute representation, and psycho−vegetative disorders were detected in 90 % of the examined persons. The analysis of the correlation between individual groups of psychopathological symptoms and the index of the overall level of psychopathological disorders indicates the presence of high or very high correlations with all groups of psychopathological symptoms except for a group of somatic distress symptoms. According to the results of the study, the following can be concluded: in the studied group, a system of mutual influence between individual groups of symptoms has developed; when they are divided into 2 classes, namely: pseudoneurotic and psychoorganic symptoms, it is evident that there are direct correlation links in the anxiety group and the phobic group symptoms with symptom groups of the psychoorganic class; the hypothesis of pseudoneurotic origin of the comorbid psychopathological nonpsychotic level symptomatology in persons undergoing substitution treatment programs with synthetic opioids was confirmed.

Until recently, the opposition of somatic and hypochondriac symptoms has been generally accepted, according to the criterion of the presence or absence of an objective basis for the existence of the disorder. With the purpose to develop a hypothesis that hypochondriac symptoms in patients with cardiovascular pathology are not homogeneous and can be represented by clusters of manifestations with different origin and development mechanisms, a prospective clinical psychological study of 100 patients with the history of vascular «catastrophes» was performed. Clinical−anamnestic and psychodiagnostic methods were used. Differences in introspective perception of the own state: «primary» hypochondria, associated with spontaneous development of hypochondriac symptoms as a consequence of specific personal readiness and nosogenic factors of psychotraumatism and «secondary» hypochondria, induced by psychogenic factors of the social and therapeutic circle, were determined. Two types of hypochondriac symptoms were distinguished in the study population. Attributes of these types of disturbances were described: typical onset of the manifestations relative to the underlying disease, internal or external causation of the disorder, its syntonic or dystonic character, the character of the behavior transformation. An original questionnaire was designed to systematize the attributes of «primary» and «secondary» hypochondria in the patients.

Today, the study of adaptation disorders in Ukraine is a very topical issue, especially for the families of forced migrants from the east of the country where armed conflict continues. Using the «Life Style Index» methodology, the indicators of psychological protection were investigated in children with adaptation disorders who are brought up in the families of internally displaced persons. It was determined that in the children and adolescents aged 7−18 almost all the indicators of protective mechanisms exceeded the norms, and therefore they demonstrated aversion to adequate criticism and rejection of the aspects of external reality that caused them to recall the psychotraumatic situation. They manifested subconscious unacceptable desires, thoughts and feelings that can cause feelings of anxiety with the preservation of their emotional and psycho−vegetative components (anxiety, fear, difficulty in forming new acquaintances). A tendency to stereotyped behavioral reactions with persistence, irritability, capriciousness, unreasonable anxiety, aggression and a feeling of anger because of any small things, propensity to suicide were noted. In migrant children with adjustment disorders, there was a tendency to «experience» of negative feelings and thoughts in oneself, without «carrying them out», the lack of schematization, rational reasoning and understanding the conflict, the presence of constant manifestations of anxiety, an illogical and unreasonable way to overcome conflicts or frustrating situation with manifestations of puritanism, dysmorphomania and dysmorphophobia. As a result of the study, conclusions were drawn on the need to take into account the obtained data when creating a complex of psycho−corrective measures in this category of patients.

Drug addiction remains dominant in the structure of other forms of psychoactive substances addiction and is one of the most acute problems of modern society. Theoretical generalization of the phenomenon of «Self» in addicts showed underdevelopment, immaturity of structures «Self», its blurred boundaries, which significantly updates and confirms the need to study it. To study the features of the «Self»−concept of a drug addict as an important resource to overcome the life−difficulties of drug addicts 55 patients with drug addiction (opium addiction), aged were investigated. The method of diagnosis of interpersonal relations (interpersonal diagnosis of T. Leary), methodology of 20 definitions of M. Kuhn and T. McParland «Who am I?» was used. The study of the phenomenon of «Self»−concept in drug addicts showed that it is based on the background of authoritarianism, aggressiveness and at the same time the pursuit of social acceptance and acceptance, sacrifice of their own interests, an attempt to help others at their own expense, to be positive for the society. The positive qualities of the «Self»−concept of drug addicts are of an imaginary nature and are an «external mask» of crowding out the fact of the marginality of drug addiction. In drug addicts, the leading pattern of the «Self»−concept is the emotional−polar type of personality, resulting in a distorted motivational sphere; semantic accents are shifted and are largely determined by the relationship with the surrounding world. Drug addicts are closed to new experiences and centered on negative experiences.

A comprehensive program of family reconstructive psychological correction of tobacco addiction aimed at restructuring the family system, optimizing family interaction and psychocorrection of destructive behavioral patterns was developed. To test and analyze its effectiveness, a study was conducted in which the experimental group, smokers and members of their families, whose program was conducted in full, and the comparison group, smokers who underwent psychological correction by cognitive behavioral methods participated. To evaluate the effectiveness of the psychocorrection program, psychodiagnostic methods FACES−3 and «Motivation for smoking cessation» were used. The program included the preparatory, main, final and supporting stages. The obtained results indicate that systemic family reconstructive psychocorrection makes it possible to transform the dysfunctional family system characteristic of tobacco addiction by the type of chaotic disunited in a balanced, flexible divided type. Psychocorrection work with smokers with cognitive behavioral methods only does not lead to reliable changes in the indicators of family functioning. After the implementation of the psychocorrection program in full, the motivation for smoking cessation becomes autonomous. Introjected and external motivation for cessation dominated in the smokers of the comparison group, thus their predictive success is determined by the measure of the individual's desire to meet the standards of society and the stability of influence of anti−tobacco factors. The proposed psychocorrection program can be used in the complex therapy of tobacco addiction.

The situation regarding abuse of alcohol and alcoholic substances among the CIS countries at the moment should be considered dangerous and extraordinary. The frequency of chronic alcohol abuse in the world community varies from 3.0 % to 10.0 %. Excessive alcohol abuse leads to significant functional and morphological changes in most brain structures. The degree of disturbances of the central nervous system varies from minimal brain deficits to gross focal symptoms or sharp cognitive shifts. One of the most common complications of chronic alcohol abuse is development of alcoholic encephalopathy, which is difficult to treat, but when the treatment is absent, the prognosis is considerably unfavorable. The research on the definition of clinical and therapeutic, socio−demographic and other features of alcoholic encephalopathy is rather significant and relevant. Obtaining specific data on the prevalence of pathology among various age−sex and social groups of the population, identification of personality characteristics and socio−psychological prognostic features of this pathology will allow more adequate and purposeful planning and implementation of the follow−up measures. It was emphasized that for a more in−depth study of the problem of alcoholic encephalopathy and alcohol abuse of the general population, only medical approach is insufficient, further clinical and psychopathological, psycho−neurological and medical−social studies, scientific developments and developments are needed.