The results are based on a comprehensive survey of 109 people who experienced psychosocial stress in a military conflict: 6 wives of fallen servicemen; 71 persons from among the mothers, fathers and wives of the UBD who were not injured, 32 persons from among the internally displaced persons - internally displaced persons.
In the course of work: the peculiarities of clinical and psychopathological symptoms were studied, the severity of depressive manifestations was studied, the features of stress-relieving behaviour were established, the quality of life was assessed, post-traumatic stress affected civilians who experienced psychosocial stress in military conflict.
The study had a three-stage structure. At the first stage, the study was prepared, its methodology was formed, the survey map and program were developed, and the contingent of the study was selected. At the second stage, a clinical and diagnostic examination was performed. In the third stage, a comparative analysis of the results of our proposed comprehensive system of personalized medical and rehabilitation care for people with adaptation disorders who experienced psychosocial stress in military conflict, and traditional treatment and rehabilitation approaches based on the evaluation of results in the intervention group and comparison group.
It has been established that the leading psychopathological construct in civilians who have experienced psychosocial stress in the context of military conflict is depressive, anxiety-depressive and dissomnic psychopathological symptoms. Differentiation of psychopathological symptoms depending on a certain social group was also determined, with the predominance of obsessive-compulsive symptoms in the relatives of killed combatants, depression in relatives of unaffected combatants, and somatization and anxiety on the part of IDPs in general. and its greatest quantitative expression in IDPs. It was found that the most vulnerable social group in terms of depression are IDPs and relatives of victims of hostilities, who showed signs of mild depression.
The predominance of civilians who have experienced psychosocial stress in the context of military conflict, a constructive coping strategy for planning the problem of differentiation of coping behaviour in certain social groups using coping strategies of positive reassessment and confrontational coping among relatives of combatants, self-control strategies and positive reassessment of the relatives of unaffected combatants; and strategies for seeking social support, distancing, and self-control from IDPs.
Civilians who have experienced psychosocial stress during a military conflict have a moderate quality of life, with the lowest quality of life in most areas among IDPs and the highest among relatives of unaffected combatants, which may be explained by differences in social psychological perception of these categories, a significant difference in material security and positions of state institutions in relation to each of these categories of civilians.
The highest incidence of post-traumatic stress of IDPs with a predominance of symptoms of avoidance and excitability, and relatives of the killed participants in hostilities - symptoms of invasion.
Based on the obtained data, a system of multi-vector assessment in the areas of clinical and psychopathological condition and psychosocial response and functioning is substantiated and developed, a forecast assessment of the risk of complications is formed both in individual areas and in a complex interaction of clinical and socio-psychological factors.
A scale for screening examination was developed to identify potential contingents for further in-depth clinical and psychopathological examination, based on indicators of post-traumatic stress according to the Mississippi scale of post-traumatic stress disorder, and standards and measures for each risk group were determined.
Based on the research data, a comprehensive system of personalized medical and rehabilitation care for civilians with adaptive disorders who have experienced psychosocial stress in military conflict, based on the principles of individual orientation, complexity and systemic treatment, has been scientifically substantiated, developed and implemented in health care practice. rehabilitation measures, a clear sequence and stages of treatment and rehabilitation measures, a description of the content and content of the stages of the system: psychodiagnostic, therapeutic, rehabilitation and prevention; the efficiency of the proposed system in accordance with the principles of evidence-based medicine is proved.
Keywords: civilians, adaptation disorders, psychosocial stress, military conflict, relatives of combatants, IDPs.
