Psychotraumatic Events Research Articles

The role of stressful traumatic events, personality traits and psychiatric disorders in the formation of chronic pain syndromes

BACKGROUND: Chronic pain syndrome is a highly prevalent condition that negatively affects the ability to work and quality of life, as well as worsening the prognosis of the disease and increasing the risk of early death. One of the most important scientific and practical medical tasks is the identification of risk factors for the transition of acute pain to chronic pain, which in the future will allow to develop mechanisms for preventing the development of chronic pain. It has been established that various psychological and psychopathological factors, in particular, personality traits and mental disorders, psychotraumatic events, make a significant contribution to the perpetuation of pain, but these data require clarification. AIM: To determine the contribution of stressful events, personality profile and comorbid psychiatric disorders to the formation of chronic pain syndromes. MATERIALS AND METHODS: The study included 105 patients aged 18 to 70 years with unexplained somatic or neurological pain syndrome that existed for more than 6 months and served as a reason for hospitalization. All patients underwent clinical-anamnestic and psychometric examination, statistical processing of the results was performed using SPSS Statistics v22. RESULTS: In the course of the study, 4 groups of patients with psychiatric disorders comorbid with chronic pain were formed: 1 — chronic pain within the framework of prolonged reaction to stress\exhaustion disorder, 42 observations (12 men, 30 women); 2 — chronic pain within the framework of prolonged masked depressive episodes, 41 observations (6 men, 35 women); 3 — chronic pain as part of hypochondriacal spectrum disorders (limited hypochondria), 15 observations (8 men, 7 women); 4 — chronic pain as part of constitutional anomalies with a tendency to experience pain (pain prone personality), 7 observations (5 men, 2 women). CONCLUSION: A significant association of chronic pain syndromes with stressful events has been established.

Resource-Based Psychotherapy Model Application in the Treatment of Psychological Trauma Consequences.

The ongoing war in Ukraine significantly affects the mental and emotional well-being of its citizens. Consequently, there is an urgent need to explore the use of the resource psychotherapy model to develop effective support methods for trauma victims. The research aims to enrich the understanding of resource-based psychotherapy as an effective tool for supporting people who have experienced psychological trauma and improving their psychological well-being and quality of life. The analytical method, generalization, and systematization were used in this research. A clinical case of psychotherapy of a military man according to the 7-step model of working with the consequences of a psychotraumatic event is considered, which ultimately showed the effectiveness of its application. The study found that the resource psychotherapy model has significant potential for improving the psychological state of victims of trauma, as this approach allows the active use of internal resources of the individual to overcome the consequences of traumatic experiences and restore mental well-being. The results of the study indicate the effectiveness and deep potential of resource-based psychotherapy in working with people facing psychological trauma, helping them to build positive adaptation strategies and strengthen their psychological state. The results of this study may be useful for psychologists and psychotherapists working with people who have experienced traumatic experiences to improve the quality of psychological support and assistance to such people.

Analysis of stressoprotective properties of progesterone on an animal model of post­traumatic stress disorder

Relevance. Sex steroid hormones play a fundamental role not only in reproductive biology, regulation of emotions and mood, but also participate in maintaining proper ho-meostasis of the nervous system, acting as trophic factors and neurotransmitters, while steroids are also synthesized de novo in both central and peripheral nervous system. One of the main neurosteroids is progesterone, and its two important metabolites, namely allopregnanolone (3a,5a-tetrahydroP4) and 3a,5a-tetrahydrodeoxycorti-costerone, which due to a combination of genomic and non-genomic effects, have a wide range impact on neural cells. Aim. To analyze the stress-protective properties of progesterone on an animal model of post-traumatic stress disorder. Materials and methods. 40 white mongrel male rats were taken for the purpose of investigation. They were divided into several investigation groups: Con — group of animals receiving intraperitoneal injection of solvent (n=10); PS — group of animals exposed to vital stress (n=10); PS+P — a group of animals exposed to vital stress and receiving an intraperitoneal oil solution of progeste-rone in a dose of 8 mg/kg (n=10) for 10 days before a stress exposure; PS+S — a group of animals exposed to vital stress receiving an intraperitoneal solution of sulpir-ide in a dose of 10 mg/kg (n=10). To simulate a psycho-traumatic event, the classical method of imaging a pred-ator was used. To record the changes in emotional-motor patterns among the control and experimental groups a battery of behavioral tests was used, Elevated Cruciform Maze, Open Field, and Porsolt test. Results. Changes in behavioral patterns were observed after administration of progesterone to animals that had been exposed to a psychotraumatic event. The impact on the “emotionali-ty” zone was characterized by a reliable increase in the number of sniffing (p≤0.05), and a significant increase of locomotor activity was also observed (p≤0.05). In the Ele-vated Cruciform Maze test, the anxiolytic effect of proges-terone was demonstrated, which consisted of a decrease in the time experimental animals spent in the closed arm of the installation and, accordingly, of an increase in the time ani mals stay in the open arm, which may indicate a decrease in the level of anxiety. Porsolt test demon-strates that the antidepressant effect of progesterone is to normalize the timing of behavioral patterns in animals exposed to a stressor. Conclusion. As a whole, the results of our study demonstrate that intraperitoneal administra-tion of an oily progesterone solution at a dose of 8 mg/kg has pronounced anxiolytic and antidepressant effects according to the results of a series of behavioral tests in the predator presentation stress model

Лікування ПТСР та розладів адаптації у учасників та ветеранів бойових дій за допомогою терапії прийняття та відповідальності (ACT): Тези до майбутьного дослiдження

Ukraine faced numerous challenges accompanied by an increased level of psychotraumatic events in society. Historical events, including war, the annexation of Crimea, and other socio-political transformations, have contributed to an increase in the number of individuals who may exhibit symptoms of post-traumatic stress disorder (PTSD) and adjustment disorders. The growing need for qualified psychotherapy services and PTSD treatment programs in the country is urgent. However, the existing services are not yet sufficiently developed to satisfy this need at an adequate level. Increasing awareness and education in mental health issues in society actualizes the need for further scientific research and development of effective and economically justified methods of treatment. ACT (Acceptance and Commitment Therapy) is a progressive approach that helps people with PTSD change their attitudes about their memories and feelings through acceptance rather than avoidance. This method is actively studied and used in countries with developed medical science, for example, in the USA, Canada and Great Britain. In the context of Ukraine, where the topic may be less researched, the need to develop an adapted ACT model, conduct clinical trials, educate professionals, and develop supportive resources for patients and their families is urgent. Such measures will contribute to more effective treatment of PTSD and adjustment disorders in Ukrainian society.

PSYCHOLOGICAL INTERVENTIONS IN THE TIME OF CRISIS

Psychological interventions may improve patients’ motivation and adherence to various therapies, including those alleviating pain, depression, and fatigue. Evaluating patients’ psychological status and choosing the most appropriate intervention may improve combined treatment outcomes, particularly in the elderly and other vulnerable groups. Exposure to psychotraumatic events such as violence, torture, and limb amputation should be appropriately assessed to choose a psychotherapy method. Narrative exposure therapy and cognitive behavioural therapy are commonly used psychological interventions with variable level of evidence. Training first-contact health professionals and psychologists to use the most efficient evidence-based psychological interventions is thus becoming critical at the current stage.

SOCIAL NETWORKS AND SUPPORT FOR WOMEN SURVIVING THE LOSS OF A SPOUSE

Aim. To discuss the results of the study on the effectiveness of psychological assistance to women experiencing the loss of a spouse in the form of social networks support groups.Methodology. The study used the comparison method of the results of psychodiagnostics of two groups of women who participated and did not participate in a psychological assistance program in the VK (social network) support groups. The research also relies on a number of psychodiagnostic techniques aimed at studying psychological characteristics of women. To process the data obtained, methods of qualitative and quantitative analysis, methods of mathematical data processing were used.Results. The study proves the effectiveness of the proposed psychological program of assistance to women experiencing the loss of a spouse, implemented through a social network community. It was determined that women who have completed the program tend to experience reduced impact of a psychotraumatic event on their general psychological state, as well as a decrease in the level of psychological stress and depressive symptoms manifestations. Emerging models of coping behavior and strategies for coping with stress tend to be optimized in terms of getting out of social “isolation”, making social contact and seeking social support.Research implication. The results obtained and the materials presented in this article, as well as the proposed organizational and methodological recommendations for the program, expand the possibilities of providing psychological assistance to people facing the loss, and allow the material to be used by practicing psychologists working with the above-mentioned problem.

Impact of psychogenic factors on the dynamics of suicidal behavior in patients of a psychiatric hospital who have committed suicide or a suicidal attempt

The article presents an attempt to assess the impact of individual psychotraumatic events in the life of patients of a psychiatric hospital, including the strength of the psychotraumatic effect, subjective significance, duration, and impact of its resolution on the severity of suicidal risk (under the control of the Beck Scale for Suicide Ideation and the Montgomery — Åsberg Depression Rating Scale). The ideas of psychiatrists about suicidal risks have been studied. The data obtained can be used to assess suicidal risk during treatment in a psychiatric hospital and in the early stages after discharge.

PEDAGOGICAL PROCESS AND INTERDEPARTMENTAL COOPERATION: FOSTERING A HOLISTIC UNDERSTANDING OF STRESS-RELATED DISORDERS AMONG STUDENTS

The World Health Organization estimates that one in every five individuals affected by war is at risk of developing mental illness. In Ukraine, this approximately approaches to 8.5 million people. According to the Ministry of Health’s predictions for the beginning of 2023, over 15 million Ukrainians will require psychological assistance due to the aftermath of war, with approximately 3.4 million requiring medical treatment. This review presents theoretical viewpoints and practical developments on the peculiarities of the pedagogical process and interdepartmental cooperation in fostering a comprehensive theoretical and clinical understanding of stress-related disorders among students by teams from the Department of Pathophysiology, Psychiatry, Narcology, and Medical Psychology of Poltava State Medical University.
 Stress-related disorders herein defined as a set of symptoms of varying degrees of severity caused by a significant subjectively perceived psychotraumatic event are classified into three groups by their manifestations: emotional disorders, cognitive disorders, and vegetative and somatic symptoms. To effectively prevent, diagnose, treat, and rehabilitate patients with stress-related disorders, students must receive interdisciplinary knowledge and training. Physiology and biochemistry of stress are introduced to students in the first year of their studies, and pathophysiology is taught through practical and experimental approaches. Medical psychology and psychiatry equip students with the skills and knowledge required to manage psychological responses to stress and evaluate clinical symptoms of stress-related disorders. Other clinical departments also provide relevant training on this subject.
 Therefore, a systematic approach to training students in diagnosis, therapy, and rehabilitation of patients with stress-related disorders is crucial. This requires a step-by-step, interdisciplinary integration of this issue, which is well reflected in the educational and professional programs of the second level of higher education.

Experience of traumatic situations and symptoms of post-traumatic stress in men with experience of sports injury

The purpose of this study is to analyze the experience of traumatic events and symptoms of post-traumatic stress in men involved in amateur sports. The participants of the study were men aged 20-30 years (n = 60), who have been engaged in various types of martial arts at the amateur level for 5 years, and do not have sports qualifications. Martial arts as a sport means combat without the use of weapons. This sport is a dangerous injury, characterized by injuries of various localization. The study involved athletes who had no experience of a sports injury (n = 30) and survived the experience of minor injuries (fractures, facial injuries, bruises, dislocations, etc.), without surgical intervention (n = 30). It is shown that, regardless of life experience, the most traumatic events for the respondents are the events of death, illness and injury of a loved one; become an eyewitness or participant in the death, injuring someone. Injuries, diseases associated with the subject himself, as psycho-traumatic events are noted only by men with experience of a sports injury. They are also characterized by a higher level of post-traumatic stress and the corresponding symptoms of obsessive repetition and negative changes in the cognitive-emotional sphere.

Genesis and psychological role of self-purification and grooming gestures in human pantomimic production

The article proposes a classification of gestures when hiding information from the persons involved. Pantomimic production with fear of exposure has an unconscious origin. It is differentiated into resource gestures that restore the body's homeostasis and adaptive body movements, which refer to the self-preservation reactions of the limbic system to a dangerous stimulus. Gestures - manipulators, as actions that cleanse the body, were singled out by the American psychologist, psychiatrist P. Ekman. According to the authors, the pantomimic production described by P. Ekman has the nature of grooming. The paper considers examples of the cleansing pattern and gestures in primates and humans. Grooming, as a regressive behavior, refers to a psychological defense mechanism, reduces anxiety and neuropsychic stress in case of psychological trauma. In mentally ill patients, self-purification is a marker of dysontogenesis, a manifestation of primitive thinking and behavior in pathology. In healthy individuals, redirection and substitution for scratching the body, pinching, shaking off ‟invisible dust”, pulling clothes, under which negative emotions are disguised, predominate. In instrumental lie detection (verification), gestures - self-cleansing are an indirect marker of deception, if another unconscious pantomime is jointly produced in the external pattern of the interviewed person's behavior. On neutral topics, they signal unformed rapport, situational anxiety, and maladaptation to testing. The appearance of grooming on control topics is the “target” of experienced psychotraumatic events in the subject.

CONSIDERATIONS ABOUT THE IMPACT OF PERMACRISIS ON PEOPLE LIVING IN ROMANIA

The current global context, characterized by the Covid 19 pandemic, wars in various parts of the world, theclosest of which is in the proximity of our country (neighbouring Ukraine), the growing energy crisis andthe imminence of a global economic one, significantly impacts the way each person manages daily activityin terms of emotions and behaviour, resorting to their own coping mechanisms. The present analysisexpresses some considerations regarding the management of the current psycho-traumatic events byRomanian people, and some possible explanations, based on day to day observations and currentreflections in the media.

ПОСТТРАВМАТИЧНЕ ЗРОСТАННЯ УКРАЇНЦІВ В УМОВАХ ВІЙНИ

In the article the problem of psychological health of Ukrainians who experienced traumatic events was studied. Post-traumatic stress disorder is one of these problems. However, recent research has increasingly shown that stressful or psycho-traumatic events can lead to positive personality changes, a phenomenon known as post-traumatic growth. The purpose of this article is to identify and analyze key indicators of post-traumatic growth among Ukrainians during the war. The research methodology includes the questionnaire on post-traumatic growth developed by R. Tedeschi & L. Calhoun and adapted by M. Magomed-Eminov. Key indicators of post-traumatic growth measured by five scales (personal strength, attitude toward others, life values, new opportunities, and spiritual changes) were identified and analyzed. The research category is presented as a case study of post-traumatic growth among Ukrainian educators and students, affected by the war against Ukraine, treacherously started by russia on February 24, 2022, based on their voluntary self-assessment. As a result of the conducted quantitative and qualitative analysis, it was found that post-traumatic growth is not only related to positive changes in attitude to life and understanding of personal priorities. It is essential for individuals to have the ability to create mutually supportive relationships with others and to restore emotional balance. Unfortunately, many Ukrainians do not have these qualities. The increase in the value of life and attitude toward others is directly related to age. The interaction of indicators of personality strength and vision of new opportunities in a stressful situation becomes more complex with age Special attention should be paid to the study of the concept of spirituality in modern Ukrainian culture. We assume that it is connected to a lesser extent with religiosity, and to a greater extent with the sense of self-worth and the defense of the nation's right to independence and freedom. The category of spirituality and its development as a result of stressful situations and their overcoming requires a separate theoretical justification, modern research tools that correspond to the mentality of Ukrainians and, accordingly, in-depth research.

Psychological care for combatants psychotraumatized by armed conflict

The treatment of psychotrauma is based on two main aspects, pharmacological and psychotherapeutic, in accordance with national and international recommendations on psychotherapy, which recommend the use of different techniques, depending on the time frame ofthe psychotraumatic event or events. The principles of psychological support are based onthree phases: immediate, post-medical and long-term. Therapeutic patient education brings added value to the psychological care of psychotraumatized people.

Childhood Trauma as a Risk Factor for High Risk Behaviors in Adolescents with Borderline Personality Disorder.

Objective: Childhood trauma is associated with many major short-term and lifelong consequences, such as deterioration of mental health, higher frequency of affective dysregulation, changes in consciousness and attention, personality disorders, etc. Therefore, this study aims to examine childhood trauma as a possible factor in the incidence of high risk behaviors in adolescents with borderline personality disorder (BPD). Method : 120 individuals aged 12-18 years were selected based on purposive sampling and included in the research group (including 60 BPD adolescents and 60 non-BPD adolescents). After receiving ethical approval from official institutions, data was collected from the participants through demographic, childhood trauma, sexual addiction screening, eating attitudes, RAFFT, and suicidal behavior questionnaires. The collected data was analyzed using chi-square test, independent t-test, prevalence, odds ratio and correlation analyses using the SPSS V21.0 software. Results: All adolescents with BPD had experienced some forms of psychotraumatic events in childhood. The BPD group experienced more traumatic events than the non-BPD group (P < 0.05). After controlling for gender, age and years of education, all differences remained significant. Furthermore, statistically significant correlations were found between the scores of the emotional abuse and eating disorders scales in the group of girls with BPD (r = 0.788, P < 0.01). Moderate correlations were discovered between emotional abuse and suicidal behaviors in boys with BPD (r = 0.641, P < 0.01). Moreover, it was found that the most significant factors in the formation of addictive behaviors among adolescents with BPD were emotional abuse (r = 0.527) and emotional neglect (r = 0.513, P < 0.05). Conclusion: These findings reinforce the role of childhood trauma in the formation of BPD symptoms during adolescence. Successful detection of the earliest risk factors in the form of childhood trauma and its different forms can provide specific high risk behavior targets for early intervention.

Динамика симптомов посттравматического стресса у сотрудников полиции, выполнявших оперативно-служебные задачи в особых условиях

The article features of dynamics of post-traumatic symptoms and displays of personal desadaptation of the police officers who have carried out operational and service tasks in special conditions are considered. The empirical study involved 195 police officers aged from 26 to 32 years. Techniques: the standardized multifactorial method of research of the personality (L.N. Sobchik), the questionnaire of traumatic stress I.O. Kotenev. As a result of research it is established, that over time, changes of personal features, posttraumatic symptoms often proceed latently in the form of progredient (towards increase or decrease) or "wave-like" orientation (with alternation of periods of improvement and deterioration of a condition). Symptoms of "intrusion", "avoidance" and physiological hyperexcitability increase from the moment of performance of operational and service tasks in special conditions, and stabilize after three years. Neurotic control, pessimism and social introversion increase linearly. Optimism, distress and flashbacks of psychotraumatic events decrease progrediently. In the post-traumatic period from 1.5 to 3 years, the number of persons with signs of emotional lability, rigidity, non-productive tension and chronic fatigue grows. After 4 years, impulsiveness and aggravation increase, and the ability to withstand emotional stresses decreases. Practical recommendations for psychological rehabilitation of the specified negative manifestations are offered.

OVERCOMING MENTAL TRAUMA IN CHILDREN USING FAIRYTALE THERAPY

The article deals with the problem of psychological help to children who suffered as a result of crisistraumatic events in Ukraine. These threats usually cause intense fear in situations where children witness or possibly become victims of brutal violence in their habitual living, witness the destruction of property (homes) and are forced to flee in panic. Psychotherapeutic work with a child who has experienced psychotraumatic events involves helping him to restore a sense of security, which is largely ensured by the appropriate construction of a psychotherapeutic relationship, and is also strengthened in connection with the opportunities that the child receives in the process of creating a safe environment with the help of visual materials . The article discusses typical behavioral reactions of children to mental trauma. One of the most effective means of preventing and overcoming mental trauma is the use of art therapy methods, among which fairy-tale therapy plays an important role. Fairytale therapy helps children get rid of complexes, find a way out of a difficult situation, not to lose their strength of spirit and faith in good, because evil is always defeated. Fairy tales cause an intense emotional reaction. Thanks to fairy-tale therapy, the child will be able to survive difficult psycho-emotional states and experience the process of observing military actions, forced escape from home, adaptation to a new place of living. The materials presented in the article are addressed to psychological and pedagogical workers and parents who work with children of preschool and primary school age or raise their own. An algorithm for creating a therapeutic fairy tale is provided, thanks to which specialists will be able to compose therapeutic fairy tales themselves and provide assistance to children. Informational material will help adults find the right words when communicating with a child to describe their feelings, explain some difficult things, and, most importantly, restore strength and resources for further feelings of peace, stability and joy.

Post Traumatic Stress Disorder : Clinical description of 101 children

IntroductionPost traumatic stress disorder (PTSD) is a mental health condition that’s triggered by a psychotraumatic event .ObjectivesThe aim of our study was to investigate the clinical manifestations of PTSD in the pediatric population.MethodsThis is a descriptive cross-sectional study carried out on children over the age of 7 and victims of a traumatic event that had occurred at least one month before. They were recruited from August 2020 to April 2021, in child psychiatry department. The clinical manifestations were evaluated using the Clinician Administered PTSD Scale Child and Adolescent version for DSM 5 (CAPS CA5) in Tunisian dialect. The statistical processing of these data was carried out using SPSS 26 software.ResultsWe recruited 101 children who had experienced a traumatic event which was in 35.6% physical assault, 47.5% sexual assault and in 16.8 % exposure to death. The mean age was 10.7 years at the onset of traumatic event and 11.74 years at the interview. We noted in our patients a female predominance at 64.4%. Diagnosis of PTSD according to the diagnostic criteria of the DSM5 was retained in 54.5% of cases. Intrusive symptoms were present in 81.2%, with 66.3% of involuntary, intrusive memories. Persistent avoidance of stimuli was noted in 80.2%. 71.3% of cases suffered from negative cognition and mood. We found in 66.3% marked alterations in trauma-related arousal and reactivity. Resulting in clinicialy significant distress in71.3%.ConclusionsRecognizing PTSD symptoms is essential for diagnosis to initiate specialized care and reduce impairment at this critical age.DisclosureNo significant relationships.

Psychological Correction of Individual Neurotic Problems

The article conducts a theoretical analysis of the features of the neurotic response to uncertain situations as an important component and trigger of individual problems. In this regard, the issue of psychological correction of individual neurotic problems in uncertain situations at the theoretical, methodological and practical levels has been studied in the article. The neurotic experience of psychotraumatic events is due to internal conflicts. Effective methods of corrective work with neurotic reactions as prevention of persistent neurotic states are indicated here too. The neuropsychological content of psychotherapeutic techniques that can prevent neurotic development of an individual is revealed. It is presented the model of psychological correction of individual neurotic problems, which is capable to carry out effective corrective influence of the personal sphere on emotional, cognitive, motivational and behavioral levels. Important principles and conditions are noted regarding the psychological correction of such neurotic nature. The neuropsychological content of the body-oriented model of psychological correction of an individual in combination with psychotherapeutic methods is considered in detail.

Взаимосвязь бодимодификаций и самоповреждающего поведения с психологическими травмами, пережитыми в детском возрасте

This article presents the results of empirical research on the relationship between body modification and self-harming behavior on the one hand and psychological trauma in childhood on the other hand. The problem appears to be topical due to the frequent occurrence of self-harming behavior and the increasing popularity of body modification. The hypotheses of the study were as follows: the extent of body modifi-cation and self-harm are positively associated with psychological traumas experienced in childhood; psy-chological traumas associated with violence experienced in childhood show a stronger correlation with body modification and self-harm in adulthood, compared with other types of psychological traumas. The study involved 105 women and 71 men aged 16 to 50 years (the average age of women was 21.5, the av-erage age of men was 25.2). The survey and subjective scaling methods were used. The analysis of rela-tionships between the variables was carried out with the help of nonparametric methods. The nonparamet-ric Spearman coefficient was used to study the correlation. The intergroup comparison of scale estimates was performed using a one-factor analysis of variance. We obtained statistically significant weak positive correlations between the number of body modifications and the overall indicator of adverse life events. The number of body modifications is significantly positively associated with the experience of family psycho-traumatic events and violence. The self-harm rate is significantly positively associated with the overall indicator of adverse life situations, experience of family psycho-traumatic situations and violence. The coefficients of correlation between self-harm and adverse life situations turned out to be slightly higher compared to the correlation between body modifications and adverse childhood experiences. Cor-relation analysis showed a weak but significant positive relationship between self-harm and the number of body modifications. Significant differences in the indicator of psycho-traumatic events were found be-tween subgroups of respondents with and without piercings. Respondents with piercings demonstrate sig-nificantly higher rates on the general scale of adverse life events, on the scale of family psycho-traumatic situations, and the scale of psycho-traumatic events related to violence, compared with respondents with-out piercings. Regression analysis showed a significant correlation between the coefficient of self-harm and the gender factor, the factor of family psycho-traumatic events and psycho-traumatic events related to violence. This model explained 16.2% of the variance of the self-injury coefficient. The number of body modifications was significantly related only to the gender factor and the factor of psycho-traumatic events related to violence, which explained only 7.4% of the variance in the number of body modifications.

PSYCHOTHERAPEUTIC PRINCIPLES OF WORKING WITH CLIENTS AT DIFFERENT STAGES OF INJURY

The article discusses the psychotherapeutic principles of working with clients at various stages of trauma. A definition of a psychotraumatic event or situation is provided. A distinction is made between extraordinary and extreme psychotherapeutic situations and events. The signs of traumatic situations and events are grouped together, the impact they have on a person is described. The factors that cause differences in reactions and the strength of the impact of a traumatic event on a person are considered. The definition of psychotrauma, its causes, and the duration of its course are proposed. Ways of receiving an injury and signs of a person experiencing psychotrauma are highlighted. The rules and principles of the psychotherapist's work at the stage of the client's experience of trauma are proposed. It was emphasized that the main task at the stage of living with the injury is the stabilization of the client's mental state. After the stage of experiencing the trauma, the stage of the traumatic process, which is accompanied by a stress disorder, is highlighted. At this stage, attempts are made to integrate the traumatic experience. The mental processes that occur at the stage of the traumatic process are given: adaptation, displacement of the traumatic experience and its constant invasion. The signs and rules of the psychotherapist's work at the stage of the traumatic process have been elaborated. The stages of a psychotherapist's work with a client who has experienced a traumatic experience and turned in at the stage of the traumatic process are given. A scheme of the development of the injury process depending on the level of stress and time has been developed. The stages of trauma and the corresponding psychological states are given. The signs of the third stage of trauma – the post-traumatic process have been analyzed. It was found that this stage is accompanied by post-traumatic stress disorder. Definition of the concept and diagnostic criteria of post-traumatic stress disorder are proposed. It is emphasized that the main task of the psychotherapist at this stage of trauma is the integration of the client's traumatic experience and his return to his usual life.