Auto-aggressive Behavior Research Articles

Aggressive and Autoaggressive Behaviors in Patients with Autism Spectrum Disorder in Correlation with Middle Cerebral Artery Flow Velocity.

Background/Objectives The purpose of this study was to see whether there is a correlation between the behavior of autism spectrum disorder patients and brain abnormalities based on the velocity of blood flow in the MCA (middle cerebral artery). Methods: The use of HAP (High Altitude Protection) suits, which are used in aviation, to treat patients with ASD (autism spectrum disorder) causes significant changes in their functioning and physiological processes. These changes are not only noted in psychological tests but are observed in cerebral blood flow using transcranial Doppler ultrasound of the MCA. Results The results of this study made it possible to distinguish two groups with different flow velocities, which can be characterized as flows of less than 80 cm/s and flows of more than 80 cm/s. In addition, it was shown that in patients with elevated blood flow velocity, aggressive behaviors account for 86.96%, while self-aggressive behaviors account for 65.2%. On the other hand, in the case of patients with reduced flow velocity, i.e., less than 80 cm/s, the rate of aggressive behavior is 20% and that of self-aggressive behavior is 50%. The experiment showed that after therapy, there is a normalization of blood flow, which increased in the case of patients with a reduced flow rate below 80 cm/s and, in the case of elevated blood velocity after therapy, decreased towards normal levels. Conclusions The observed rate of normalization of flow velocities in the MCA translated into significant changes in the behavior and functioning of patients in the neurotypical direction, which was noticeable in the psychological tests conducted.

Clinical features of auto-aggressive behavior in borderline personality disorder: a review of current research

Borderline personality disorder (BPD) is a common psychiatric disorder characterized by severe auto-aggression (AA) in the form of suicide attempts (SA) and non-suicidal self-injury (NSSI). The purpose of this review was to describe the current knowledge about the clinical features of self-harming behavior in borderline personality disorder. Materials and methods: The eLibrary, PubMed, CNKI, and Google Scholar databases were searched for articles on the relevant search query for the last 11 years. As a result, 28 articles were selected and summarized (a total of 7,284 BPD patients and 134 controls were included). Results: Suicidal attempts occur in 75 % of BPD patients, and NSSIs — in 90 %. AA behavior varies with age: adolescents tend to NSSIs, while adults more often undertake SAs. Depending on the type of clinical dynamics, AA in BPD may be impulsive, demonstrative, associated with comorbid addiction, or occur in the context of depersonalization. Among BPD symptoms, feelings of chronic emptiness, avoidance of abandonment, emotional instability, and identity disturbance are most commonly associated with auto-aggression. Risk factors for self-harming behavior in BPD include traumatic childhood events, especially physical and sexual abuse, and stress caused by microsocial conflict. Men with BPD and AA more often have comorbid narcissistic, antisocial, paranoid, and schizotypal personality disorders, as well as substance use disorders. Women with borderline personality disorder and AA tend to suffer more from addictive and obsessive-compulsive personality disorders, as well as eating disorders, particularly bulimia nervosa. In conclusion, self-harming behavior in BPD has many clinical features and can manifest in different forms. It is always necessary to study the predominant clinical manifestations, risk factors, and comorbid disorders to be able to assess the severity of AA.

Я-концепция старших подростков, склонных к аутоагрессивному поведению

<p style="text-align: justify;">The work is devoted to the study of the characteristics of the self-concept of older adolescents prone to auto-aggressive behavior. A study was conducted using the questionnaire “Auto- and het-ero-aggressions” by E.P. Ilyin among 150 adolescents aged 15-16 years living in the city of Gelendzhik. Based on the results of the study, a sample of 56 adolescents with a tendency to auto-aggressive behavior and 94 adolescents with a tendency to hetero-aggressive behavior was com-piled. Further, the study also used the following methods: “Studying the tendency of adolescents to suicidal behavior” by M.V. Gorskаya, methodology for studying self-attitude by S.R. Pantileev. The results of the study showed that the tendency to auto-aggression, despite the often unconscious nature of the manifestation, can influence the idea of one’s own “I”, the level of self-esteem and the tendency to suicidal behavior in of older adolescents. The tendency to suicidal behavior of adolescents demonstrating auto-aggressive beh</p>

ОСОБЛИВОСТІ ВЗАЄМОЗВ’ЯЗКУ РІВНЯ СУЇЦИДАЛЬНОГО РИЗИКУ ТА ЕМОЦІЙНОГО ВИГОРАННЯ У ВІЙСЬКОВОСЛУЖБОВЦІВ

The article presents the results of a theoretical analysis and an empirical study of the features of the relationship between emotional burnout and suicidal risk in military personnel. The analysis of the psychological literature on the problem showed that the activities of the military take place in special, extreme conditions associated with a threat to people’s lives and health. It makes higher demands on the personality of the military man, his moral-willed, emotional, intellectual qualities, which creates an increased load on the specialist’s adaptive systems. Over time, there is an accumulation of negative states, which leads to the development of various professional deformations and destructions. One of the manifestations is the syndrome of emotional burnout, the consequence of which can be the appearance of suicidal thoughts and behavior. The purpose of the study is to determine the characteristics of the relationship between emotional burnout and suicidal risk in military personnel. Scientific novelty. The conducted research revealed that all symptoms of emotional burnout in military personnel are in the stage of formation. Among suicidal motivation, the most pronounced complexes are: anesthetic, anemic, altruistic and autopunitive. The least pronounced are instrumental and heteropunitic. The most pronounced anti-suicidal motivational complexes are: final uncertainty, ethical complex, moral and salutary. The least expressed are aesthetic, narcissistic and religious. The most pronounced diagnostic concepts of suicidal risk are: anti-suicidal factor, demonstrativeness, social pessimism and maximalism. The least pronounced is the breaking of cultural barriers. Conclusions. The analysis of the features of the relationship between emotional burnout and suicidal risk showed that the formation of emotional burnout syndrome significantly increases the level of suicidal risk in military personnel. Psychologists need to develop effective means of preventing emotional burnout in military personnel. Key words: emotional burnout, autoaggressive behavior, suicidal behavior, military personnel.

Clinical features of suicidal behaviouг in youth with borderline personality disorder

IntroductionBorderline personality disorder (BPD) in youth has the greatest spectrum of psychopathology and is strictly associated with nonsuicidal self-injury (NSSI) and suicidal behaviour [Guile et al. Adolesc Health Med Ther 2018; 9 199-210; Paris Med. 2019; 55(6):223]. The formation of autoaggressive behaviour and suicidal activity is due to the psychopathological features of BPD, which include affective instability, impulsivity and impaired self-identity.ObjectivesThe aim of the study was to investigate the psychopathological features of suicidal behaviour in BPD in youth.MethodsClinical and psychopathological examination with assessment of suicidal behaviour at the time of, 6 and 12 months later. For additional psychometric examination of patients we used: SCID-II questionnaires, Barratt Impulsiveness Scale (BIS-11), Toronto Alexithymic Scale (TAS), Columbia Suicide Severity Rating Scale (C-SSRS). Sample: N=62 male and female youth males and females in two equal groups of 31, respectively, with an established diagnosis of BPD and the presence of suicidal behaviour. The mean age of first referral in both groups was 19.1±2.2 years.ResultsThis study defined 2 variants of suicidal behaviour in patients with BPD in youth: 1) Expansive - with predominance of impulsiveness (BIS-11 70±3), affective instability, associated with psychosocial factors as a trigger of suicidal activity. Suicidal attempts were made at the height of psychoemotional stress. These patients were characterised by moderately high scores of the C-SSRS scale 2±1, in which patients noted the absence of a plan and specific intentions before the attempt, and a lower incidence of repeated attempts after 6 ((N=6 (19.4%) and 12 months N=10 (32.2%). 2) Rationalistic variant of suicidal behaviour was found in patients with predominance of self-identification disorders, dissociative disorders and high level of alexithymia TAS 81±4.2 in the clinical picture. Suicidal ideation was revealed in all patients, often throughout the entire youth period, and attempts were characterised by thoughtfulness and led to severe consequences, including fatal outcome. Patients with rationalistic variant of suicidal activity had higher C-SSRS scale scores of 4±1, with the presence of suicidal intentions and high frequency of attempt recurrence after 6 (N=11 (35.5%) and 12 months (N=17 (54.8%)).ConclusionsThe variant of suicidal behaviour depended on the degree of severity and correlation of the psychopathological structure of BPD in youth. Less favourable prognosis was characteristic of the rationalistic variant due to the high frequency of repeated attempts. The results obtained require further analysis and contribute to the development of differentiated therapeutic strategies.Disclosure of InterestNone Declared

Clinical features of depressive states in eating disorders

IntroductionEating disorders (ED) are one of the most pressing problems of modern society. Eating disorders, due to their heterogeneity, can be considered both an independent form of mental disorders and as part of the manifestations of other mental illnesses. In the vast majority of cases within these pathologies, eating disorder coexists with depressive symptoms, which significantly worsens the prognosis of the disease.ObjectivesIdentification of the association of depressive disorders with eating disorders to improve the criteria for nosological diagnosis, prognosis and therapeutic approaches.MethodsA total of 74 patients aged from 15 to 25 years old (all female, average age 16.2), who were on outpatient and inpatient observation of the clinic were studied.ResultsThe study made it possible to establish the characteristics of depressive disorders and the nature of the current course of depression associated with eating disorders. In eating disorders with a predominance of anorexia nervosa, the structure of depression was more dominated by the asthenia radical with symptoms of apathy, melancholia, anhedonia, irritability, episodes of anxiety after eating, and sleep disturbances. Patients noted a decrease in performance, mental activity, and a narrowing of their range of interests and communication. Depression became severe as exhaustion progressed. For eating disorders with bulimia nervosa. depressive states varied in the severity and polymorphism of their manifestations. Their structure was largely dominated by the apatho-adynamic radical of affect, along with asthenia and anxiety, which often reached the level of panic states. Often, along with this, there were pronounced a guilt feeling and low self-esteem ideas with self-deprecation and self-hatred, which led to the manifestation of auto-aggressive behavior (both non-suicidal and suicidal). Depression reached a severe degree as exhaustion progressed, as well as against the background of more frequent attacks of overeating and vomiting.ConclusionsThe identified associations between depressive disorders and eating disorders allow us to form a clearer picture of the expected course of psychiatric disease and optimize therapeutic intervention algorithms.Disclosure of InterestNone Declared

Evaluation of COVID-19 Effect on Mental Health, Self-Harm, and Suicidal Behaviors in Children and Adolescents Population

Objectives: The impact of the COVID-19 pandemic on the psychological state of the under-18 population includes an increased risk of psychopathological symptoms development and exacerbation of already present psychiatric disorders. This study aimed to assess the prevalence of mental health problems in Polish children and adolescents with a focus on suicidal and self-harm behavior with the impact of the pandemic. Methods: The questionnaire collected demographic data, information regarding mental states and psychopathological symptoms, history of self-harm and suicidal behaviors, as well as the experience of psychological, and physical violence, and suicidal self-harm behaviors before and during the COVID-19 pandemic. Results: In the final analysis, 782 responses were included. Self-evaluation of general and mental health scores was significantly lower during the pandemic among children (both p < 0.001) and adolescents (both p < 0.001). Moreover, general and mental health scores were lower among adolescents compared to children before (both p < 0.001) and during (both p < 0.001) the pandemic. The frequency of seeking help because of mental health problems increased during the pandemic among children and adolescents, while no changes were observed in the prevalence of psychiatric hospitalizations in either of the populations (p = 0.317 and p = 1.00, respectively). Out of autoregressive behaviors among children during the pandemic period, only the frequency of thinking about death increased (p = 0.038). No suicidal attempts were undertaken by children in either of the evaluated time periods. The presence of all autoaggressive behaviors was greater among adolescents compared to children both before and during the COVID-19 pandemic (all p<0.05). Conclusions: A subjective decrease in psychophysical well-being, an increase in the frequency of seeking mental health help during the pandemic, as well as an increased prevalence of depressive and anxiety symptoms were observed in the under-18 population as a potential consequence of the COVID-19 pandemic and related socioeconomic changes. The marked increase in self-harm behavior in the adolescent population (age > 12) and the marked increase in the frequency of death thinking in children (age ≤ 12) suggests the need for greater awareness and easier access to professional help from mental health specialists, particularly in a time of unprecedented stress and social isolation.

Отношение представителей молодежи к смерти и феномену скулшутинга

<p style="text-align: justify;">An analysis of differences in psychological attitudes to the phenomenon of school shooting among young people who are knowledgeable and uninformed about school shootings was carried out through studying its relationship with attitudes towards death in a sample of 98 people (48 men and 50 women, the average age was 22.7 years). It is shown that there is a difference in the assessment and perception of the specific terminology of school shootings «natural selection», «reb’n’vodka», «trench coat mafia», «wrath» in groups knowledgeable and uninformed about school shootings: common terms are more positively evaluated by those who were previously familiar with the concept of «school shootings». It is concluded that for respondents familiar with school shootings, their own death and the death of another are close in meaning and emotional burden. The group of people who are knowledgeable on school shootings demonstrates the presence of a suicidal risk. Death is viewed by them approvingly and positively, since it entails a liberation from suffering, adversity and difficulties. The results obtained reflect the diagnostic possibilities of studying the implicit attitude towards school shootings by studying the attitude towards death. The promising task of this study is to analyze the differences in the psychological attitude towards the phenomenon of school shootings in people with autoaggressive behavior, who are knowledgeable and uninformed of school shootings, by studying the attitude towards death.</p>

НЕКОТОРЫЕ ВОПРОСЫ ПСИХОЛОГИЧЕСКОЙ РАБОТЫ С ЭМОЦИОНАЛЬНОЙ СФЕРОЙ ОСУЖДЕННЫХ, СКЛОННЫХ К СУИЦИДУ

The article discusses the possible causes of the formation of suicidal manifestations in persons in conditions of social isolation. The statistical data of the Federal Penitentiary Service of Russia are presented, indicating the importance and timeliness of solving penitentiary tasks related to the identification of suicidal intentions in convicts, as well as actual factors of suicidal risk. It is proposed to discuss the problem of the influence of the emotional sphere of the individual on the commission of suicidal acts, taking into account the specific circumstances of serving a criminal sentence. The results of an empirical study of the emotional sphere of convicts with autoaggressive behavior using valid psychodiagnostic tools are presented. The conclusion is formulated that the instability of the emotional properties of the individual affects the increase in the level of suicidal risk. The importance of conducting comprehensive psychological work with suicidal convicts in institutions executing criminal penalties is emphasized. The question is raised about the need to improve the professional competencies of the staff of the penitentiary system to reduce the risk of suicide and improve the mental state of convicts

Dokonywanie samouszkodzeń przez osadzonych. Wybrane problemy

The auto-aggressive behavior of prisoners is a challenge for prison administration, warders and health service, responsible for safety in the penitentiary. Self-aggressive acts of prisoners have been monitored in Polish prisons and detention centers not only recently, but for years. The number of auto-aggressive acts does not increase. The article discusses the problems of health service in prisons in relation to prisoner’s self-injury.

The epidemiology of non-suicidal self-injurious behavior, a non-systematic narrative review

Non-suicidal self-injury, as a type of auto-aggression, is a widespread behavioral problem among adolescents. Researchers have noted an increase in the number of self-harm in recent years. The aim of the work: to conduct a narrative review of the scientific literature on the epidemiology of auto-aggression and non-suicidal self-injurious behavior. Method: the article presents a narrative review of domestic and foreign literature on the epidemiology of non-suicidal self-injurious behavior (NSSI). Articles were selected and analyzed in the databases MEDLINE/PubMed, Elibrary.ru, Scopus. To obtain basic information, publications from 2015 to 2022 were used, in international medical journals, as well as relevant references in the reference lists of the analyzed sources. At the same time, early publications on the subject were included for general information, definitions, and historical hindsight. The search was conducted using various variations of the specified keywords.Results: NSSI is most common in adolescents and young adults, and the age of onset has been reported to be most common between 12 and 14 years of age. There is no unambiguously accurate estimate of the prevalence of NSSI, when studying the literature, the prevalence is estimated to be in a wide range from 7.5 to 46.5% among adolescents. According to foreign meta-analyses, at present the average percentage of adolescents who have resorted to self-harm is from 16.9% to 19.5% and tends to increase. The prevalence of the phenomenon has increased greatly with the onset of the Covid-19 pandemic. Conclusion: Auto-aggressive behavior, self-injurious behavior, and non-suicidal self-harm are now common among adolescents. It should be noted that the prevalence rates of this phenomenon remain insufficiently studied and are presented by studies for Western countries, there is still a lack of data in studies of the adolescent population of the Russian Federation due to the low level of knowledge of the phenomenon in the country.

Interdepartmental cooperation in prevention auto- and heteroaggressive behavior of minors

The growing trend in the number of shootings cases in schools determines the need to take preventive measures to identify minors at risk of committing socially dangerous acts. The purpose is to determine approaches for interdepartmental interaction between specialized medical organizations and educational organizations in the aspect of minors auto- and heteroaggressive behavior preventing. Materials and methods. Behavioral indicators and psychological characteristics of adolescents who planned or committed attacks on educational institutions, minors with autoaggressive behavior who underwent complex forensic psychological and psychiatric examinations at the FSBI “NMIC PN named after V.P. Serbsky” of the Ministry of Health of Russia are analyzed. Results. In 2022, a new version of the «Methodological materials on the signs of deviations, the actions of education system specialists in situations of social risks and prevention of deviant behavior of students» was introduced into the educational process (methodological development “Prevention Navigator”). One of the new aspects is a block dedicated to identifying the risk of an attack on an educational organization (signs of the risk of committing a particularly dangerous act and a special algorithm of actions). The article describes aspects of the interaction of educational organizations with specialized medical institutions in the context of identifying such students and preventing socially dangerous behavior of minors. Conclusion. The current system of interaction between educational institutions and medical organizations specializing in the field of mental health of children and adolescents requires improvement and legal support

Auto-aggressive Behavior as a Medical and Social Problem of Our Time: Definitions, Concepts, and Retrospective of Research by Russian Authors, Narrative Review

Background: The study of autoaggression is one of the main areas of research work in psychiatry, suicidology, and psychology. Suicidal behavior remains one of the most dangerous forms of autoaggressive behavior. In recent years, both in Russia, and around the world, there has been an increased interest in the problem of non-suicidal injuries. Objective: This review aims to analyze, summarize, and present definitions of autoaggression, suicidal behavior, and self-harm that are relevant among Russian authors, as well as present long-term results of dissertation research by Russian authors on this topic. Methods: A non-systematic narrative review is presented. In the first section, a search was made for Russian-language, and English-language sources in the databases: ELibrary.ru, PubMed, and the “google scholar” search system. Articles were searched by keywords: SelfInjurious Behavior Suicide Suicidal Ideation Suicide, Attempted, autoaggression, self-harm, and adolescents. In the second section, a search and analysis of dissertation research by Russian authors from 2000 to 2020 are carried out using the database of the Russian State Library. On this topic, a total of 86 papers were found, of which 66 theses directly study these issues, 8 theses have information on this topic in the results and conclusions, and 12 theses were excluded from the results as not relevant. The story is arranged in chronological order from oldest to newest. Abstracts of dissertations are used for citation. Results: The behavior of an autoaggressive nature, self-injurious behavior, and non-suicidal self-harm is currently a phenomenon that is widespread among adolescents. Currently, NSSI is an urgent problem of mental health among adolescents.

Психологические ресурсы и личностные дефициты у выпускников организаций для детей-сирот

<p><span lang="EN-US">The article presents the results of a study of psychological resources and personal deficits of graduates of organizations for orphans, in which 164 people participated: 106 (average age 15.96+1.01) expected to graduate from the organization soon, 58 (average age 13.4+0.76) were far from graduation. The groups did not differ by gender (c2=1.467 at p=0.147). It is established that the psychological resources of graduates are social skills, emotional intelligence and some constructive coping strategies. In girls, the degree of severity of these parameters is slightly lower than in boys. And the graduates-boys — are lower than the boys of the younger group. It was found that the severity of constructive coping among respondents has a reduced character even in comparison with groups with congenital and acquired disabilities. It is shown that the cause of personality deficits in pupils is psychotraumatization. Psychological traumas are more often associated with withdrawal from the family, especially among graduates, and more often among girls who have been brought up in the organization for more than 3-5 years. A characteristic shift in the fixation of the time of a traumatic event is highlighted. At the same time, girls feel more traumatized and react less constructively to trauma. It has been established that informants are characterized by a situational predisposition to delinquent, dependent, aggressive and autoaggressive behavior, which indicates a mild degree of socio-psychological maladaptation. Graduates have a higher propensity for dependent behavior. They are also more likely to use unconstructive coping strategies when coping with stress.</span></p>

Suicidal behavior as a result of maladjustment of servicemen to the conditions of military service in Ukraine

Introduction and aim. The purpose of the article is to analyze the peculiarities of suicidal behavior as a result of maladjustment of servicemen to the conditions of military service in Ukraine. The tasks of the article are to identify among militaries: 1) the most significant risk factors for autoregressive and suicidal behavior; 2) the psychological peculiarities of adaptive disorders that may lead to suicide; 3) protective factors against autoregressive and suicidal behavior. Material and methods. To solve the problem of our research, a set of methods was used: theoretical methods – theoretical and methodological analysis of scientific sources, their systematization, classification, generalization; empirical methods – the observation, the interview, a questionnaire, testing, the method of expert assessments. In general 420 militaries were participated in our research. The participants of the 1 st stage of the study were 240 militaries in the age 18-25 years old with suicidal and auto-aggressive behavior in anamnesis and one or more attempts of suicide. These militaries were treated in the psychiatric hospital No 1 in Kyiv (Ukraine). At the 2 nd stage of the study 180 militaries were participated. They were treated in the Main Military Clinical Hospital (the Center), Kyiv, Ukraine. The research was organized during May–November, 2021. Results. We investigated that 120 militaries had various forms of post-suicidal encephalopathy, such as acute affective, non-psychotic state. The number of patients with residual psychoorganic pathology was 41 people (34.16%); after poisoning there were 37 people, the number of patients with toxic encephalopathy – 33 people (27.5%); after self-arson – 9 people, there were 4 patients (3.33%) with burn encephalopathy. We identified the following clinical variants of depressive reactions as a result of maladjustment and suicidal attempts: 1) the reaction of disadaptation in combination with neurosis-like disorders (48.9%); 2) the reaction of maladjustment including hypochondriacal inclusions (in 23.4% of cases of respondents); 3) maladaptive reactions with an anxious component were observed in 28.6% of cases. Conclusion. It was shown that the suicidal behavior of soldiers depended on many external and internal risk factors. We showed protective factors against autoregressive and suicidal behavior.

ELECTROCONVULSIVE THERAPY FOR AGITATION IN LEWY BODIES DEMENTIA

IntroductionDementia with Lewy Bodies (DLB) is a primary degenerative dementing syndrome characterized by visual hallucinations, fluctuation in cognition, depressive symptoms and parkinsonism. Literature has shown the utility of electroconvulsive therapy (ECT) in demented patients regarding depressive symptoms and agitation. Nevertheless, the majority of cases described include patients with vascular dementia and Alzheimer’s disease. There are no cases informed concerning ECT in DLB patients with agitation and aggressive behaviors.ObjectivesEvaluate the impact of electroconvulsive therapy (ECT) for agitation in a patient with diagnosis of Lewy Bodies Dementia (DLB).MethodsCase report. 68-year-old male, with no prior neuropsychiatric history, was present for psychiatric evaluation for 5 year history of progressive dementia with fluctuations in cognition, complex visual hallucinations, delusional beliefs, depressive mood, anhedonia, irritability, associated to parkinsonism and increasing autoaggressive behaviors and agitation.An extensive neurologic workup including neuroimaging, EEG and laboratory studies failed to reveal a specific etiology. Neuropsychological testing reveals frontal, attentional, and visuospatial dysfunction. A presumptive diagnosis of DLB was made.Medication trials including donepezil, memantine, lamotrigine, sertraline, quetiapine, risperidone and melatonin failed to manage his depressive, psychotic and behavioral disturbances.ResultsConsidering past medication failures and prominent behavioral disturbances family consented for an acute course of ECT.Initial acute phase consisted of 6 sessions of right unilateral, brief pulse width (0.3 ms) ECT tri-weekly utilizing Mecta Spectrum. Anesthesia was induced with propofol, and received succinylcholine for muscle relaxation. Initial charge was 115 mC (6x seizure threshold), then raised to 192 mC. Seizure duration averaged in 22 seconds. No adverse reactions reported.Clinical outcomes were measured with the CGI-Efficacy Index. Pre-ECT CGI-SI score was 6 (severely ill) and post-ECT CGI-I was 3 (minimally improved).ConclusionsMood and behavioral disturbances are a frequent primary motive consultations in DLB patients. The treatment is challenging due to the sensitivity to antidopaminergic medications evidenced in this type of patients. This case suggests that ECT has an impact in the treatment of agitation and aggression in DLB patients, although further investigation is needed.Disclosure of InterestNone Declared

ВПЛИВ ТРАВМ НА ПСИХІКУ І ЖИТТЯ ЛЮДИНИ ТА ОСОБЛИВОСТІ СТАНОВЛЕННЯ ЗДОРОВОЇ ВРІВНОВАЖЕНОЇ ОСОБИСТОСТІ ЗА МЕТОДОМ МЕРИЛІН МЮРРЕЙ

Background. The article reveals the topical issues of the impact of adverse experiences on the human psyche (psychological trauma, all types of violence, emotional deprivation). Emphasis is placed on the tendencies towards abuse of psychoactive substances, various types of addictions, destructive and auto-aggressive behavior, and maladaptations. It is noted about the effectiveness of using the Murray Method in overcoming the consequences of all types of psychological injuries of any severity, which covers almost all aspects of working with a person: from his inner experiences to interaction with other people. The program of rehabilitation of persons according to the Murray method reveals the process of trauma, violence, contempt, as well as the protective mechanisms of a person on the distortion of a person's mental perception and emotional response, which affects the health and behavior of a person. The result of the application of the rehabilitation program based on the Murray method is "the development of a healthy balanced personality" through the conscious and complete explanation of the consequences of the pain experienced in childhood, and the acquisition of knowledge and the development of skills for healthy behavior patterns in the present and future. Methods. Theoretical and methodological analysis of primary sources. Results. According to the Murray method, five groups of dysfunctions are distinguished for a person who was forced to experience trauma and did not process it: addictions, codependency, the state of the victim, manifestations of narcissistic traits, active and passive aggression. It is they who are an obstacle on the way to a full-fledged life of persons affected by injuries, and the subject of work in the rehabilitation program. Marilyn Murray's psychotherapeutic method is aimed at the formation of a healthy, balanced personality by overcoming psychological trauma, violence and deprivation. One of the basic concepts of M. Murray's concept is the "Original feeling child", which has talents and gifts, intelligence, creative abilities, healthy sexuality, spirituality, it is characteristic for her to harmoniously feel and express all feelings. Under the influence of adverse external factors, such as contempt, illness, injury, insult, etc., the essential integrity of the " Original feeling child " is destroyed – the "Sobbing hurting child" appears. The painful experiences that the "Original feeling child" felt during the trauma created her "Pool of Pain", where helplessness, fear, loneliness, sadness, anger, resentment, etc. accumulate – precisely such feelings that a person is not trained to express during trauma. A "Controlling Child" is added to protect the "Sobbing hurting child". A person becomes dependent on what helps them to avoid experiencing pain (drugs, food, alcohol, gambling, nicotine, sex, caffeine, work, constant employment, codependency, etc.). A harmonious combination of the strengths of the "Original feeling child", "Sobbing hurting child", and "Controlling Child" is a "Healthy balanced person". Сonclusions. M. Murray's therapeutic approach is based on sufficiently strong immersion in the "Pool of Pain" and its "devastation" in an atmosphere of support and love, reducing the role of the protective mechanism as a result of working with images, manifesting, talking about painful emotions, analyzing traumatic experiences, as well as searching and formation of personal talents, formation of a healthy, balanced personality, able to sympathize, show empathy, protect oneself without harming others, enjoy life.

Psychopathological correlates of depression with non-suicidal self-harm in non-psychotic mental illnesses of adolescence

To determine the main clinical and psychopathological features of the relationship between depressive states and non-suicidal self-injury (NSSI) in mental illnesses of the non-psychotic register in adolescence. Clinical data of 128 patients (77 males and 51 females), who presented with depressive states and NSSI in non-psychotic mental disorders during adolescence, were analyzed. The patients were examined at the Clinic of the Mental Health Research Center during the period 2020-2023. The mean age of the patients was 19±4.1 years. Based on the data from studying depression and NSSI in adolescence, we developed a typology, identifying three variants of affect and auto-aggressive activity interactions. The affect-dominant type (25.8%) was characterized by a predominance of affective pathology (p<.05), with the occurrence of impulsive NSSI (45.5%) and demonstrative NSSI (30.3%) (p<0.05). The personality-dominant type (43.0%) was based on pathocharacterological abnormalities (60.0%), where NSSI were represented by impulsive (25.5%), depersonalizing (27.3%), and addictive variants (32.7%) (p<0.05). The reciprocal type (31.3%) exhibited pronounced polymorphism, combining high affect variability with a tendency towards auto-aggressive behavior of varying severity and manifestations of NSSI (p<0.05). In terms of nosological distribution, schizotypal disorder predominated (45.0%) followed by predominantly borderline personality disorder (30.0%) and bipolar affective disorder (25.0%) (p<0.05). In terms of nosological distribution, schizotypal disorder predominated (45.0%), followed by predominantly borderline personality disorder (30.0%) and bipolar affective disorder (25.0%) (p<0.05). Three types of correlation between depression and NSSI were identified, the formation of which was due to the pathoplastic influence of the age factor, nosological affiliation and a certain, including pathological personality structure. Statistically significant regularities between variants of NSSI and types of their interrelation were revealed. The results can be considered as differential diagnostic and prognostic markers of their further trajectories and, therefore, contribute to the creation of new therapeutic strategies, timely diagnosis and earlier intervention.

Dynamics of autoagressive behavior in youth in the trajectory of borderline personality disorder

Objective: to determinate the clinical and psychopathological characteristics of autoagressive behavior (AB) in youth in the trajectory of borderline personality disorder (BPD) with determinate relathionship between each other, further dynamics and prognosis. Material and methods. Clinical-psychopathological (61 patients), follow-up (55 patients), retrospectively and psychometric methods, 116 patients males and females with autoagressive behavior (AB) in youth in the trajectory of BPD were clinically observed in outpatiently and psychiatric hospital. Patients with AB were divided into three equal groups: 1 — Non-suicidal self injurance (NSSI); 2- suicidal attempts (SA); 3- NSSI with SA. Results. Correlations have been established between the original typology of BPD and AB: in the clinical group — impulsivity (64%) and demonstrative (24 %) AB of BPD type I (“affective storm”), addictive (44.4 %) in type II (“addictive adrenalin addiction”) — depersonalization (51,9%) and self-torturing (11,1 %) in type III (“cognitive distortions and disorders of self-identification”). In the follow-up group was noted transformation of main variants AB towards addictive behavior (56,4 %). Conclusion and findings. The formation of auto-aggressive behavior in adolescence and in the trajectory of BPD is due to the interaction of the age factor with the main personality traits of BPD — impulsivity, affective instability, impaired identification, alexithymia and leading psychopathological syndromes. A high association of NSSI with suicidal activity was confirmed, and high suicidal risk for BPD was revealed not only in adolescence, but also after it has passed. The data obtained will contribute to the future study of autoagressive behavoir in personality disorder and for the creation of new therapeutic and social models of patients.

The suicidal activity and comorbid mental pathology in persons with gender dystrophia

According to foreign publications, 58% of patients with gender disorders had additional psychiatric diagnosis, 39.3% had at least one suicide attempt. The data of suicidal activity and mental comorbidity in Russian population of transgenders are absent.Purpose of the study is to assess suicidal activity and mental comorbidity in persons with gender disorders.The retrospective analysis of records of patients applied with complains on gender disorders from January 2014 to April 2021 was applied. The demographic characteristics, life anamnesis, comorbid mental pathology at time of appliance, frequency of suicidal attempts, suicidal thoughts and auto-aggressive behavior were examined. The data of 926 patients with gender disorders were included: FtM 515 (55.7%), MtF 411 (44.3%). The median age of patients applied for care appliance was 24 years (13-65 years). In group of transgender patients 75.2% had no mental illness, except gender disorders. At that, there was high prevalence of comorbid mental pathology (24.8% on average). Usually, it was background mental illnesses and reversible mental disorders, which were not causes of gender disorders. The suicide rate in transgender group was 12.5%. For 1 patient with suicidal experience, there were 1.3 suicidal attempts (from 1 to 5). The significant dependence of increased suicidal activity, depression, auto-aggressive behavior and rate of comorbid mental pathology on age of debut of gender disorders was established. The transgender patients with debut of gender dysphoria in puberty age are most vulnerable to development of any mental pathology. The suicidal activity of patients with gender disorders depends on both social causes and presence of comorbid mental pathology. A number of modifiable risk factors for suicidal behavior were identified: support of relatives, external correspondence to associated gender, early steps to "change gender", earlier apply for medical care, background compensated mental illnesses.