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The study comprised 38 patients diagnosed with PTSD (F43.1) according to the ICD-10, who received treatment at the Regional Mental Health Care Institution for the Protection of the Armed Forces. All patients provided informed consent to participate in the study. \nA structured clinical diagnostic interview known as CAPS-DX was applied in this study. Developed based on the DSM-IV, this interview assesses the symptoms of posttraumatic stress disorder (PTSD), the duration of the disorder, and the degree of impairment of social functioning. The CAPS-DX scale provided insights into the presence of PTSD symptoms both currently and throughout the individual's life following psychotrauma. To diagnose psychosocial maladjustment and its characteristics, we employed the Psychosocial Maladjustment Scale by L. Herasymenko (2018). \nClinical and anamnestic examinations revealed that 86% of servicemen had experienced multiple traumatic events, indicating a history of several psychotraumas. 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引用次数: 0

摘要

在战争背景下,创伤后应激障碍(PTSD)成为最常见的心理疾病之一,特别是在部署在战区的军人中。军人创伤后应激障碍的主要诱因通常包括失去战友或必须使用致命武器,从而导致重大后果。要表现出创伤后应激障碍,个人必须经历超过正常人压力水平的创伤经历并导致痛苦。本研究的目的是调查经历过激烈战斗行动的军人的创伤后应激障碍病程,并探讨其适应不良表现。研究对象包括 38 名根据国际疾病分类-10 被诊断为创伤后应激障碍(F43.1)的患者,他们都在保护武装部队的地区心理保健机构接受了治疗。所有患者都在知情同意的情况下参与了研究。本研究采用了名为 CAPS-DX 的结构化临床诊断访谈。该访谈是根据 DSM-IV 编制的,用于评估创伤后应激障碍(PTSD)的症状、持续时间和社会功能受损程度。通过 CAPS-DX 量表,可以了解创伤后应激障碍症状的存在情况,包括当前症状和精神创伤后的终生症状。为了诊断心理社会适应不良及其特征,我们采用了 L. Herasymenko(2018 年)的心理社会适应不良量表。临床和肛门检查显示,86%的军人经历过多次创伤事件,表明他们有多次精神创伤史。研究发现,创伤后应激障碍的主要精神病理表现与该疾病的传统病程并无显著差异,但在这一军人群体中更为强烈和明显。研究表明,有战斗经历和创伤后应激障碍的军人表现出社会心理适应水平下降。他们的适应资源和能力以及神经心理的稳定性都明显减弱,沟通能力也有所下降。根据社会和心理适应的总体水平和质量,与战斗有关的创伤后应激障碍患者的适应/不适应程度分为三个等级:充分适应、部分适应或不适应。值得注意的是,适应水平与焦虑的严重程度相关。适应充分的军人通常表现出较低程度的焦虑,而部分适应的军人表现出一般程度的焦虑,适应不良的军人则表现出较高程度的焦虑。研究揭示了处于战区的军人的一系列精神病理学表现,从类似恐慌发作的符号综合症到精神性催眠。此外,研究还发现,有战斗经验和创伤后应激障碍的军人的社会心理适应水平较低,这与焦虑的严重程度有关。
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PECULIARITIES OF ADAPTATION AND COURSE OF POST-TRAUMATIC STRESS DISORDER IN SERVICEMEN DEPLOYED TO INTENSE COMBAT ZONES
In the context of war, post-traumatic stress disorder (PTSD) emerges as one of the most prevalent psychological conditions, particularly among military personnel deployed in combat zones. The primary triggers for PTSD in military personnel often include the loss of comrades or the necessity to use lethal weapons, resulting in significant consequences. For PTSD to manifest, individuals must undergo a traumatic experience that exceeds normal human stress levels and leads to distress. The aim of this study is to investigate the course of PTSD in military personnel who have been exposed to intense combat operations and to explore their maladaptive manifestations. The study comprised 38 patients diagnosed with PTSD (F43.1) according to the ICD-10, who received treatment at the Regional Mental Health Care Institution for the Protection of the Armed Forces. All patients provided informed consent to participate in the study. A structured clinical diagnostic interview known as CAPS-DX was applied in this study. Developed based on the DSM-IV, this interview assesses the symptoms of posttraumatic stress disorder (PTSD), the duration of the disorder, and the degree of impairment of social functioning. The CAPS-DX scale provided insights into the presence of PTSD symptoms both currently and throughout the individual's life following psychotrauma. To diagnose psychosocial maladjustment and its characteristics, we employed the Psychosocial Maladjustment Scale by L. Herasymenko (2018). Clinical and anamnestic examinations revealed that 86% of servicemen had experienced multiple traumatic events, indicating a history of several psychotraumas. The study identified that the primary psychopathological manifestations of PTSD did not differ significantly from the traditional course of the disorder, but they were more intense and pronounced in this group of servicemen. The study has demonstrated that servicemen with combat experience and PTSD exhibited reduced levels of psychosocial adaptation. Their adaptive resources and capabilities, as well as their neuropsychological stability, were significantly diminished, along with a decrease in their communication abilities. Based on the overall level and quality of social and psychological adaptation, three levels of adaptation/maladaptation were distinguished among servicemen with combat-related PTSD: sufficient, partial, or maladaptation. It should be noted that the levels of adaptation were correlated with the severity of anxiety. Servicemen with sufficient adaptation typically exhibited low levels of anxiety, while those with partial adaptation showed an average level, and those with maladaptation displayed high levels of anxiety. The study revealed a spectrum of psychopathological manifestations in servicemen who were in the combat zone, ranging from semiotic complexes resembling panic attacks to psychogenic catalepsy. Furthermore, it was found that servicemen with combat experience and post-traumatic stress disorder had reduced levels of psychosocial adaptation, which correlated with the severity of anxiety.
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