Abdriakhimov R. Post-stress psychological disadaptation in combat eye trauma with partial loss of vision (phenomenology, mechanisms of psychogenesis, medical-psychological support)

The dissertation is devoted to the substantiation concept of appearance and development of post-stress psychological disadaptation in combatants, and its transformation after influencing additional personality stress factors related to combat trauma of the eyes with partial vision loss. In order to identify and evaluate psychological manifestations and mechanisms of formation post-stress psychological disadaptation in combatants with eye trauma that caused partial vision loss, and to develop a system of their medical-psychological support, 191 combat personnel (including 103 participants with traumas and 88 persons without somatic combat injuries), and 59 men with partially vision disorders caused by household injury were comprehensively examined. The study found that participants with combat trauma and partial loss of vision had a higher level of disadaptation disorders, and clinical-psychological manifestations of maladaptation were specific, compared with people after combat stress or household injury. Neurotic response to the combination of mental and somatic combat traumas results in two scenarios: as a diffuse specific psychological disadaptation (systemic variant), or psychopathological symptomatology with mosaic inclusions of pre-nosological signs post-traumatic stress disorder that formed clinical picture of post-traumatic syndrome (personal variant), aggravated psychopathological response on somatic trauma. Grounded pathogenetic structural-dynamic model of development and functioning of maladaptive disorders in combatants with combat eye trauma that caused partial vision loss on the background of diffuse specific disadaptation or discrete manifestations of posttraumatic stress syndrome, as a continuum of post-traumatic stress disadaptation, that confirmed its transformation as pathological response on the existential threat. Based on the data obtained, developed a system of medical-psychological support for combatants with combat eye trauma and partial loss of vision, which consists of such stages as psychodiagnostic, psychocorrection and psychological support. The aim of the psychodiagnostic stage is to determine the clinical-psychological variant of post-stress psychological disadaptation, and to evaluate the factors each of the psychogenesis domains of post-stress psychological maladaptation. The aim of the clinical-psychological block of the psychocorrectional stage is the reduction and leveling of psychopathological manifestations, the de-actualization of post-traumatic manifestations and the normalization of emotional and vegetative signs of post-stress psychological disadaptation, and the tasks of reconstructive-personal block is to positively changed factors that formed predispositional, provocative and pathoplatical domains of their psychogenesis. The evaluation of the effectiveness, carried out after the end of active psycho-corrective measures, proved the effectiveness of the created system in relation to reduction sychopathological symptoms, as well as improving adaptive personal resources and improving the quality of life of combatants.