Borderline States Research Articles

Social Stress Disorders as a Social Problem

The institutional transformations that took place in Russia in the 1990s brought not only new patterns of behavior to different spheres of society but also a new system of value orientations. New values - the values of individualism, personal freedom, enrichment, moral relativism - are not characteristic of the Russian sociocultural tradition. Such an invasion of the value system led to a disruption in the social adaptation of a significant part of the population, which in turn provoked an increase in the number of social stress disorders, borderline states of the psyche of people between the norm and the disease (Professor Iu. A. Aleksandrovskii). Studies by Russian and foreign authors indicate the influence of affective reactions of a negative nature, depression on the development of not only addictive behavior (alcoholism, gambling, Internet addiction, etc.), but also somatic diseases (cardiovascular, diabetes, etc.). The analysis of statistical indicators revealed an increase in the deviate, addictive behavior, mortality rate in Russia, since the 1990s. The data of opinion polls show a high level of Russian depression, according to this indicator Russia ranks third among European countries. According to a number of researchers, psychopathology in the coming years will become the main cause of disability for people of active age. The scientific community considers the spread of social-stress disorders as a social problem; methods for the prevention and overcoming of stressful and depressive conditions are created and applied. The article provides an example of the Program for the Prevention of Social Stress Disorders of the candidate of psychological sciences S.M. Lady-Rus (Peunovoi), based on mastering the skills of self-regulation of the emotional state.

Between a suffering body and a body in a state of need: Aulagnier’s theory of discourses on the body applied to primitive mental states

ABSTRACTIn her theory of discourses on the body, Aulagnier makes the comparison of the concept of ‘a suffering body’ and the concept of ‘a body in a state of need’. The last type is what she thinks is often found in addiction, anorexia and in borderline states, conditions marked by a radical negativity. On the other hand, ‘a suffering body’ is a concept that indicates a relation and two bodies, mother’s and child’s, that communicate. Suffering and infantile sexuality is a first attempt to accept separation by weaving a net of fantasy over the abyss of lack and separation. If pleasure and suffering are lacking as representations, the sensory reactions may exist physiologically but without psychical existence. The concepts of ‘a suffering body’ and 'a body in a state of need' will enable us to think about important structural differences between neurotic-, borderline- and psychotic conditions. As a foundation for her concepts lies a metapsychological elaborations of three kinds of processes for representation: the primal-, the primary- and the secondary process.

Immersion in the Mother: Lacanian Perspectives on Borderline States.

Borderline states have received comparatively little attention in Lacanian psychoanalysis due to the lower incidence of borderline pathology in France as well as Lacanian analysts' dismissal of the diagnosis. As Lacanian analysis has grown in North America, Lacanians have increasingly theorized about borderline states. This article provides a brief review of Lacanian literature on borderline states, emphasizing the works of Lucie Cantin, Raul Moncayo, and Jean-Pierre Lebrun. Their views are contrasted, and the author proposes that a new subjective structure is warranted for cases in which the mother plays a dominating role. This structure is similar to perversion, includes a disavowal of access to the Name-of-the-Father, and may be aptly referred to as "immersion."

Педагогическая значимость постижения трансформационных музыкальных практик народов мира в современном образовании

Nowadays the Russian education is living a raw of system changes, where formation of student’s personal agency, of skill for learning and for self-development during the whole life, for elaborating the way of actualization of their own intentions are becoming the main tasks of the learning process. The abilities for self-understanding, self-development and self-actualization are connected with a category of personal transformation. The keys for its understanding could be found in the experience of traditional cultures that despite their bent for constancy are full of transformational motifs. The important role in this process belongs to “symbols of transformation”. One of the most effective between them is music that accompanies all the important events of human life in the context of traditional culture. The main mechanism for personal transformation is activity of musical experiencing. The comparative study of traditional cultures gives possibility to offer the following typology of transformational practices of work with musical experiencing: 1. Musical practices for passing the borderline states between dream and wakefulness. 2. Rites of passage and initiation. 3. Practices of individual and joint intoning of experiencing. 4. Healing practices. 5. Transformational practices of storytelling sessions. 6. Rituals of spiritual renovation. 7. Spiritual musical practices in education. 8. Dance transformational practices. In all of them music takes on the role: of internal subjective experience; of “live sound” that influences the whole human organism but not only the acoustic analyzer; of means for symbolization of experiencing; of a way of internal “growing” – from concentration in point of painful experiencing into the wide, endless “Self”; of marker of internal changes; of a metaphor of experiencing activity for transformation of internal world. The study of transformational musical practices in modern education helps to achieve the deeper level in world culture study, to understand the variety, typology and mechanisms of musical influence on a human in different traditions; widens the range of methods for work with musical experiencing; forms pedagogical tools for modern developmental, psychotherapeutic and educational practices; reveals the role of music as means for symbolization of experiencing; shows spiritual foundations of musical traditions of different peoples that form emotional and axiological attitude to them; enriches with wide range of cultural symbols for understanding and composing person’s own life.

«ЧЕРВОНА» ОДЕСА ОЧАМИ Н. КАЗАНДЗАКІСА: ДОКУМЕНТАЛЬНО-ХУДОЖНІЙ ДВОСВІТ АВТОРА (на матеріалі тревелогу «Подорожуючи: Русія»)

The article explores the features of documentary works of art, in particular letters, articles, travel notes, newspaper publications, photo and video materials, which formed the basis of the travelogue «Travelling: Russia» by the Greek writer Nikos Kazantzakis. It describes his trips to the Soviet Union in the 20s of the XX century. A complex of themes and motives typical of travelogue, topos is considered, topographic plots focused on the presentation of facts and situations are highlighted. The subject of the image in travel notes and feature articles by N. Kazantzakis is practically everything that he sees and realizes / perceives and, of course, describes: topographic environment, the beauty of nature, mode of life, social relations and the psychology of people. The wandering figure, breaking away from usual life, overcoming the barrier of existence, which forces the author and readers to experience borderline states, ask extreme questions, seek for the answers, fulfilling the mission of the travelogue. Getting into other, unfamiliar conditions, the traveller either gets used to them, or evaluates them, transforming them for himself and for the others. Travelogue N. Kazantzakis «Traveling: Russia» does not always adequately reflect the real space of travel. The repeating routes of Greece – Odesa – Kiev trips by sea and further by rail receive different irradiation depending on optimistic (at the beginning of his philosophical and religious journey) or catastrophic with a touch of disappointment (at the end of his ideological search) premonitions of the author. So, the construction of the travelogue of the Greek writer was greatly influenced by previous trips to the same places. Nikos Kazantzakis often refers reader to facts of history, to cultural codes, to ideological oppositions, to personal memory. Oppositions Europe/Greece – Russia, Vienna – Odesa, Greeks – Russians / Ukrainians – Jews are interpreted nominally in the article, the main task of the writer seems to be a way out to the existential principles of the structure and transformation of person.

Scale of Personal Problems in Everyday Life: Conceptual Justification and Psychometric Development

Introduction. Theoretical and methodological issues of psychology of personal problem solving in everyday life have been underrepresented in Russian research literature. For the first time, the authors develop, pilot-test, and validate a new technique for diagnosing personal problems of everyday life.
 Methods. The sample was comprised of 506 individual participants (aged 17-67 years) from general population and of 43 patients of the psycho-neurological department and the department of borderline states (aged 18-50 years). The study used the following techniques for construct validation of the pilot version of the Scale: (a) Life Satisfaction Scale; (b) Positive and Negative Affect Scale; (c) Five-Factor Personality Inventory; (d) Life Orientation Test (Russian modification); and (e) Hardiness Survey (Russian modification).
 Results and Discussion. This section (a) describes the procedure of developing the Scale and eliminating non-valid items, (b) examines the factor structure of the questionnaire, (c) determines its construct, structural, and differential validity, and (d) discusses the results of studying age, gender, social, and demographic differences in the general level of problematization of life and the manifestation of specific types of everyday problems. The authors compared the findings obtained in pilot testing with those described in previous studies and demonstrated their similarity. The study provides diagnostic norms for the Scale scores. The proposed technique has great potential for further research (collecting empirical data in various subject areas of psychology) and psychodiagnostic (supporting the consultative and psychotherapeutic process and clinical practice) applications.
 Conclusion. The authors draw the conclusion that the developed technique manifests relevant measurement properties and can be recommended for use in psychological research and practice. Further psychometric development of the Scale will involve determining test-retest reliability, assessing the impact of social desirability on the results, as well as differentiating and specifying test norms on larger samples.

Preconception management of thyroid dysfunction.

Uncorrected thyroid dysfunction in pregnancy has well-recognized deleterious effects on foetal and maternal health. The early gestation period is one of the critical foetal vulnerability during which maternal thyroid dysfunction may have lasting repercussions. Accordingly, a pragmatic preconception strategy is key for ensuring optimal thyroid disease outcomes in pregnancy. Preconception planning in women with hypothyroidism should pre-empt and mirror the adaptive changes in the thyroid gland by careful levothyroxine dose adjustments to ensure adequate foetal thyroid hormone delivery in pregnancy. In hyperthyroidism, the goal of preconception therapy is to control hyperthyroidism while curtailing the unwanted side effects of foetal and maternal exposure to antithyroid drugs. Thus, pregnancy should be deferred until a stable euthyroid state is achieved, and definitive therapy with radioiodine or surgery should be considered in women with Graves' disease planning future pregnancy. Women with active disease who are imminently trying to conceive should be switched to propylthiouracil either preconception or at conception in order to minimize the risk of birth defects from carbimazole or methimazole exposure. Optimal strategies for women with borderline states of thyroid dysfunction namely subclinical hypothyroidism, isolated hypothyroxinaemia and thyroid autoimmunity remain uncertain due to the dearth of controlled interventional trials. Future trial designs should aspire to recruit and initiate therapy before conception or as early as possible in pregnancy.

Sleep Association With Borderline Diabetes Hypertension: A Cross-sectional Analysis

Abstract Short and long sleep ( 9 hours) are associated with increased odds ratio for diabetes and hypertension and depend on race. However, less is known about the relationships when diabetes and hypertension are in their borderline states. A cross-sectional study using the 2013-2014 National Health Interview Survey and NHANES datasets showed associations between non-midrange sleep duration and borderline disease status that differ from the full-disease associations. Advanced practice providers may use these results to include sleep duration assessment and possible sleep disorder screening in care plans for borderline diabetic and hypertensive patients.

Факторы риска в современном фитнесе

Objective: to identify the dominant groups of risk factors when practicing fitness physical activities. Materials and methods: analysis of 110 websites of local fitness centres, workout facilities, sports clubs, wellness studios, dancing schools, fight clubs, Yoga centres etc. Results: the analysis revealed that modern fitness industry involves a wide range of additional risk factors (scarcely ever considered) in addition to conventional reasons for potential medical problems with enhanced physical activity. The focus points are as follows: lack of medical permission to participation in sports activities; specific motivation of fitness-goers in the vast majority of cases; progressive convergence of strength fitness programs with particular strength sports; wide use of a variety of means and methods (typically in strength programs) classified as doping; exercise loads along with health-promoting activities (each characterized by distinct physiological price); frequent combination of physical exercise with pathogenic nutrition and water consumption violation; etc. Conclusions: only a few trends of the analyzed fitness programs were considered to be actually health-improving ones (with correct biomechanics and competent dosing of exercises). Realization of other programs may have a number of negative consequences, especially for persons with border-line states of health. Some of trends in fitness are in greatest possible convergence with professional commercial sport where health of athletes occupies one of the last places in the list of priorities. Consideration of the identified risk factors dictates the need for a broad range of measures to prevent emergencies and sudden deaths in amateur athletes.

The screening of the risk of autism spectrum disorders in children aged 16–24 months in Russia, 2015

IntroductionImproving the mental health diagnosis in young children is the high-priority problem in reducing the rate of child disability due to mental illnesses. In 2015, the Ministry of Healthcare (Russia) introduced the pilot project – the total screening of the paediatric population at an early age, detecting autism spectrum disorders (ASD) risk group.ObjectivesTo determine the broad range of mental disorders: from minor borderline states (states of risk) to serious mental disorders, with an emphasis on determination of ASD in children aged 16–24 months in general population.MethodsThe survey was conducted by the total screening in primary health care institutions (in the three largest regions of Russia: Volgograd, Novosibirsk, Chelyabinsk regions). The screening tool: checklist for parents aimed at detection of risk of occurrence of ASD in early children, for screening in general population.Results and conclusionsDuring 2015, 34,770 parents of children aged 16–24 were questioned. Of these 4102 children or 11.8% (118:1000) formed the risk group in ASD. By the risk group in ASD predisposition (diathesis) is understood, that does not correspond fully to the clinical criteria of illness. This state of predisposition may last for several years and pass either to illness or to health.The part of the children of the risk group in ASD were consulted by psychiatrist on a voluntary basis (2774 cases). Fifteen children (0.4:1000) were diagnosed with prominent clinical disorders in ICD-10 (F84). This prevalence rate cannot be extrapolated on the general population of the children at the considered age.Disclosure of interestThe authors have not supplied their declaration of competing interest.

Women with hysterical manifestations: Menopause, gender and mental health

IntroductionAging and menopause as a medico-social determinant of female gender influence on mental health. Female gender in the period of menopause is associated with the end of fertility that affects adaptation to changed conditions, decreases intellectual and physical possibilities, narrows role positions, leads to non-psychotic mental disorders (NPMD).ObjectiveTo identify influence of the age, menopause, female sex, sociodemographic parameters on hysterical symptoms in structure of NPMD.MaterialIn the borderline states department, 93 female patients with hysterical manifestations in structure of NPMD were treated.MethodsPsychopathological, clinical-dynamic, clinical-catamnestic, psychometric, psychological and statistical.ResultsIn 100%, the hysterical symptoms in the puberty leveled at reproductive age, intensified in climax: 72.04% - pre-menopause (P < 0.05), meno-, postmenopause - 13.98% each. Sociodemographic characteristics (marital status, social status, place of living, education, family composition, family relations) were not interrelated with frequency of hysterical manifestations in the structure of NPMD (P > 0.05). There were more married (68.82%) than divorced (15.05%), widowed (10.75%), single (5.38%); more working (70.97%) than pensioners (22.58%), unemployed (6.45%); more living with husband (51.61%) than with husband and children (17.21%), living alone (15.05%), with adult children (16.13%); more townswomen (80.65%) than villagers (19.35%); education more often secondary (51.61%), high (45.16%) than elementary (3.23%); disharmonic family relations more often (70.97%) than harmonic (13.98%), indifferent (15.05%).ConclusionsAge, menopause, female sex are reliably (P < 0.05) connected with intensification of hysterical symptoms in the structure of NPMD in difference from sociodemographic parameters not associated with frequency of hysterical manifestations.Disclosure of interestThe authors have not supplied their declaration of competing interest.

Excursionismo internacional y secuestros en la frontera de México, 1997 - 2016

Los últimos años han estado marcados por una fuerte tendencia positiva en la llegada de turistas internacionales a México, lo que se ha reflejado en los listados internacionales, en los que dicha nación se ha situado entre los diez países más importantes en la recepción de turistas. Sin embargo, la recepción de excursionistas internacionales en la frontera se ha visto fuertemente reducida, tal tendencia negativa, si bien tuvo su inicio con los atentados terroristas acontecidos en la ciudad de Nueva York en septiembre de 2001, se profundizó a partir del incremento de los secuestros registrados en los estados fronterizos. Debido a lo anterior, en este trabajo se analiza la relación entre los secuestros y los excursionistas en la zona fronteriza de México, el estudio se lleva a cabo a través de un Modelo Estructural de Vectores Autorregresivos, que considera los secuestros en estados fronterizos, los excursionistas en frontera y el PIB de EE. UU. Los resultados obtenidos son congruentes con la teoría del turismo, ya que muestra que el crecimiento de los secuestros provoca contracciones en la llegada de excursionistas, mientras que el crecimiento de la economía estadounidense tiene el efecto contrario

THE INFLUENCE OF HYPOBARIC HYPOXIC TRAINING ON PHYSICAL PERFORMANCE

The expansion of tasks, being carried out by military personnel in different climatic and geographical conditions, needs introduction of effective medical provision into the system of military training aimed at maintenance of high level of military efficiency in case of negative factors of the environment. At present the application of hypoxic factor is widely used in sports. In a number of Russian and foreign studies a high effectiveness of hypobaric hypoxia was shown for the correction of borderline functional states, enhancement of organism tolerance of pilots to flight factors, medical rehabilitation, therapy and prophylaxis of a number of diseases and so on. A research has been carried out that included the analysis of in- fluence of physical performance by volunteers in the course of a session of hypobaric hypoxia on factors of physical working capacity. Hypoxia was modelled in pressure chamber by means of barometric pressure decrease to the level equivalent to 3500 m altitude. In the time of presence «at the altitude» (30 min) physical activity was modelled by squatting performed by volunteers (30 squattings every 5 min) and stepping test performed throughout lift motion. Before hypoxic exposure, in the course of test trials and after its accomplishment the heart rate was assessed in volunteers. Also the results of functional probe performance (Shtange, Gench and Ruffier tests) and load testing on a treadmill («Running on the treadmill) were assessed. In the result of this study it was shown that the course of lift actions in pressure chamber leads to the increase of spare capacity of cardiorespiratory system and the development of human adaptation to the influence of moderate hypoxia levels. The most evident effect was observed at simultaneous impact of lift actions in pressure chambers and graduated exercise on the organisms of healthy volunteers.

Possibilities of increasing the effectiveness of medical and psychological rehabilitation taking into account the prevailing part of the autonomic nervous system in specialists of EMERCOM of Russia

Relevance. Specialists of EMERCOM of Russia are engaged in hazardous activities and, therefore, are at risk of mental and physical health disorders. Further measures are required to recover their borderline functional states, preserve and restore mental and physical health, thus increasing the body’s resistance to adverse occupational factors. Intention. To analyze possible effects of the prevailing part of autonomous (vegetative) nervous system on the effectiveness of rehabilitation measures, the choice of the course duration and content of the proposed programs. Methods. The object of research is a long-term medical and psychological rehabilitation, the subject – functional indices reflecting the state of somatic and mental health. The techniques of detailed psychophysiological research are described. Results and Discussion. The results obtained indicate the need to consider the predominant activity of the autonomic nervous system in specialists of EMERCOM of Russia (sympatheticotonia, normotonia, parasympatheticotonia) when implementing rehabilitation programs. Recommendations were made for adapting the basic standard health-promoting long-term program to the current vegetative status of the Russia EMERCOM specialists in order to normalize neurohumoral regulation and increase adaptive reserves. The results indicate the feasibility of correction techniques in parasympatheticotonia (activating regimen to enhance sympathetic and reduce parasympathetic tone) as well as increased number and intensity of rehabilitation measures. In sympatheticotonia, a light regimen was indicated (to reduce sympathetic activity and increase parasympathetic tone); the number and intensity of rehabilitation measures were also decreased. Conclusion. Knowledge of prevailing activity of the autonomic nervous system in Russia EMERCOM specialists helps to predict the risk of psychosomatic diseases and to develop and implement personalized measures for mastering self-control and coping skills.

EVALUATION OF EXPRESSION OF 4 MIRNAS IN CYTOLOGICAL SAMPLES AS AN ADDITIONAL METHOD OF CERVICAL CANCER DIAGNOSIS

Introduction. Cervical cancer is the 4th most common cancer among women. The main screening method for cervical cancer is cytological examination of the cervical epithelium. This method allows to evaluate the level of cervical dysplasia (malignant potential) but it has several limitations and flaws. Development and implementation of new methods of molecular and genetic analysis in clinical practice can increase informational value of the traditional cytological examination and therefore objectivity in choosing treatment options. Objective is to develop and verify a new method of differential diagnosis of severe intraepithelial dysplasia and invasive cervical cancer. Materials and methods . The method is based on analysis of small non-coding RNA molecules (miRNAs) extracted from the material of traditional Pap smears. Based on literature search, 18 “marker” microRNA molecules were chosen and their expression levels were estimated in 166 samples of Pap smears from cervical canals with different cytological diagnoses. The analysis was performed using reverse transcription polymerase chain reaction. Results . Estimation of ratios between expression levels of miRNA pairs: 126/375; 20а/375; 126/145 allows to differentiate with high confidence borderline states of severe intraepithelial dysplasia and invasive cervical carcinoma (coefficients of quantitative interpretation of the error curve were 0.8, 0.75, 0.72, respectively). Conclusions . Analysis of miRNAs in Pap smear samples is a promising additional method of cervical cancer diagnosis. The method is objective and can be proposed as a supporting technique in cases when cytological examination doesn’t allow to differentiate between borderline pathological states of the cervical epithelium. Implementation of the method in clinical practice requires methodological optimization and additional validation using more clinical material.

Prenosological approach to attaining the objectives of aviation medical expert assessment

Early diagnosis of diseases and conditions undesirable in terms of flight safety in senior pilots is tightly linked with the evaluation of disease risks. Prenosological diagnostics is focused on borderline states that may pass from health to disease (prenosology and premorbidity) and, vice versa, from disease to recovery (post-nosology). Regarding health as a vital adaptation reserve, prenosology diagnostics is concerned with the ability of the body to adapt to the environment rather than develop a disease. A constant drain of adaptation reserves may become the reason for increased risks of disease. Heart rate variability analysis is one of the instruments of prenosological diagnostics. The paper discusses the applicability of the space-medicine oriented probabilistic approach to the evaluation of adaptation risks by medical expert assessment boards certifying civil pilots. The results of two series of investigations showed increased adaptation risks and reduced functional reserves in pilots found unfit to continue their careers.

My subdued ego: A psychodynamic case study of borderline personality disorder following relational trauma

Recent advances in the conceptualisation of borderline personality disorder (BPD) have highlighted the role of relational trauma as central to the onset of the disorder, whilst observing deficits in the structure of the self-concept as a result of developmental adversity. Understanding borderline states within a psychiatric framework alone has attracted significant criticism due to the lack of the medical model’s explanatory properties, which fail to account for the complexity and variation of borderline symptomatology. A reliance on psychodynamic formulation instead, can provide an aetiological framework where BPD can be understood as a disorder of the sense of self, originating in the client’s relational matrix. The purpose of the current paper is to discuss a borderline case study with a focus on formulation rather than diagnosis, in an attempt to shed light on the relational and unconscious processes underpinning the disorder and thus inform treatment interventions.

The Causes of Borderline States from the Standpoint of Reliability Theory

The Causes of Borderline States from the Standpoint of Reliability Theory

Working in the borderland: early relational trauma and Fordham's analysis of 'K'.

This paper outlines a view of early relational trauma as underlying borderline states of mind, and argues that Knox's paper on internal working models and the complex provides a basis for understanding such states of mind. The author argues that in addition to internal working models, the complex also embodies and contains primitive defences of the core self. He outlines how these apply on the objective, subjective, transference and archetypal levels, and in direct and reversed forms and applies this to the account of Fordham's analysis of his patient 'K', which ended in impasse. The paper explores the dynamic that emerged in that analysis and suggests that it could be helpfully accounted for in terms of the co-construction and re-construction of early relational trauma in the analytic relationship.

Statelessness and the poetry of the borderline: André Green, W.H. Auden and Yousif M. Qasmiyeh

Every conflict brings its refugees, but the wars of the twentieth century produced population movements on a new scale. The peace of these wars was almost as bad as the fighting: for every border re-drawn, every treaty signed, millions shifted. They shift still. Traumatic testimony has long been the life-writing genre of choice for those wanting to give voice to the dispossessed. But can trauma really capture the complexity of this territorial violence? There are many ways of moving across a border, or, as is the case for millions today, living on a border. In his 1976 essay, ‘The Borderline Concept’, the psychoanalyst, André Green wrote: ‘I can be a citizen or heimatlos (homeless), but to “be” borderline – that is difficult for me to imagine'. This article takes Green's writing on the borderline as a starting point for reflecting on the condition of statelessness. For Green, to think seriously about the borderline is to risk an imagination adequate to its shifting geographies – frequently, he compares the task of imagining borderline states to the writing and reading of poetry. How might we describe a poetry of the borderline? And how might such descriptions help us think again about the geographies of modern writing? The second part of this article turns to two poets from different ends of the same history of exile and displacement: Auden, whose voluntary 1939 departure from England coincided with the first convulsions of national frontiers in Europe, its colonies, protectorates and mandates, and the Oxford-based Palestinian, Yousif M. Qasmiyeh, whose writing captures the reality of borderline existence with a particular clarity.