Affective syndromes. Affective disorders Affective disorders history of study main theoretical models

25.11.2019 -

Face and body care

Ministry of Health of the Russian Federation Far Eastern State Medical University

Department of Psychiatry, Narcology and Neurology FPKiPPS

Test for the course: “Nursing in Psychiatry”

Topic: “Affective syndromes”

Khabarovsk, 2008

Plan

INTRODUCTION

1. History

2. Epidemiology

3. Etiology

4. Clinical signs and symptoms

5. Nursing process and features of caring for patients with affective syndromes

Conclusion

Bibliography

Vveating

Mood characterizes internal emotional condition subject; affect is its external expression. There are a number of pathological disorders of mood and affect, the most serious of which are the mood disorders depression and mania. In the DSM-111 classification, depression and mania were called mood disorders. In DSM-111-R they are grouped under the name mood disorders.

The mood can be normal, elated or depressed. The normal range of mood fluctuations is very large. A healthy person has a wide range of ways to express the effect and feels able to control his mood and affects. Mood disorders are a group of clinical conditions characterized by disturbances in mood, loss of ability to control affect, and a subjective feeling of severe distress.

1. Story

Information about depression has been preserved since ancient times, and descriptions of cases that are now called affective disorders can be found in many ancient documents. The story of King Saul in the Old Testament contains a description of depressive syndrome, as does the story of Ajax's suicide in Homer's Iliad. Around 450 BC, Hippocrates used the terms mania and melancholia to describe mental disorders. Cornelius Celsus in his work "Medicine" around 100 AD. wrote that melancholy is depression caused by black bile. The term continued to be used by other authors, including Aratheus (120-18 AD), Galen (129-199 AD). In the Middle Ages, medicine existed in Muslim countries; Avicenna and the Jewish physician Maimonides believed that melancholy was a painful essence. In 1686, Bonet described a mental illness that he called manic melancholicus.

In 1854, Jules Falret described a condition called Folie circulaire, in which the patient suffered from alternating depression and mania. Around the same time, another French psychiatrist, Jules Baillarger, described the state of Folie a double, in which the patient fell into deep depression and then into a stuporous state, from which he eventually had difficulty emerging. In 1882, German psychiatrist Karl Kahlbaum, using the term “cyclothymia,” described mania and depression as stages of the same disease.

Emil Kraepelin in 1896, based on the knowledge of French and German psychiatrists of the past, created the concept of manic-depressive psychosis, including criteria, most of which are used by psychiatrists today to determine the diagnosis. The absence of dementia and malignancy in manic-depressive psychoses made it possible to differentiate them from schizophrenia. Kraepelin also described a type of depression that occurs in women after menopause and in men in adulthood, which was called involutional melancholia.

2. Epidemiology

Mood disorders, especially depression, are the most common mental disorders in adults. The lifetime chance of developing depression is 20% for women and 10% for men. Despite the fact that most patients with affective disorders see a doctor sooner or later, it has been found that only 20-25% of patients with depression in its main form, which meets the criteria for this disease, receive treatment.

Depression occurs twice as often in women as in men. Although the reasons for this difference are unknown, it is not the result of special factors affecting the physician's performance. Causes may include various stresses, childbirth, helplessness and hormonal influences.

Depression can begin at any age, but in 50% of patients it begins between the ages of 20 and 50; The average age of onset is about 40 years.

The prevalence of mood disorders is not associated with race.

More often, depression occurs in people who do not have close interpersonal ties, in divorced or separated spouses.

3. Etiology

Etiological theories of mood disorders include biological (including genetic) and psychosocial hypotheses.

Biological aspects.

Biogenic amines. Norepinephrine and serotonin are two neurotransmitters that are most responsible for the pathophysiological manifestations of mood disorders. Animal models have shown that effective biological treatment with antidepressants is always associated with inhibition of the sensitivity of postsynaptic β-adrenergic and 5 HT-2 receptors after a long course of therapy. These delayed receptor changes in animals correlate with the 1-3 weeks in clinical improvement typically observed in patients. This may be consistent with decreased serotonin receptor function following chronic exposure to antidepressants, which reduces the number of serotonin reuptake sites, and increased serotonin concentrations found in the brains of suicide patients. It has also been described that in some individuals suffering from depression, the binding of 3H-imipramine to blood platelets is reduced. There is evidence to suggest that dopaminergic activity may be reduced in depression and increased in mania. There is also evidence to support dysregulation of acetylcholine in mood disorders. One study described an increase in the number of muscarinic receptors on tissue culture of fibrinogens (eg, 5-HIAA, HVA, MHPG) in blood, urine and cerebrospinal fluid in patients with mood disorders. The data described are most consistent with the hypothesis that mood disorders are associated with heterogeneous dysregulation of the biogenic amine system.

Other neurochemical features. There is some evidence that neurotransmitters (especially GABA0 and neuroactive peptides (especially vasopressin and endogenous opioids) are involved in the pathophysiological mechanisms of some depressive disorders, although this issue cannot yet be considered completely resolved. Some researchers have suggested that secondary regulatory systems, such as adenylate cyclase, phosphatidyl inositol, or calcium regulatory system may also be an etiological factor.

Neuroendocrine regulation. A number of neuroendocrine regulation disorders have been described in patients with mood disorders. Although these disorders may be one of the primary etiological factors of brain disorders, neuroendocrine testing is now better viewed as a “window” into the brain. Most likely, deviations in the neuroendocrine sphere reflect a dysregulation of the entry of biogenic amines into the hypothalamus.

Sleep disturbance. Disturbance in sleep patterns is one of the strongest markers of depression. The main disorders consist of a decrease in the latent period of the REM sleep phase (REM) (the time between falling asleep and the first period of REM sleep), which is observed in 2/3 of depressed patients, an increase in the duration of the first period of REM sleep and an increase in the volume of REM sleep in the first phase of sleep. There is also an increase in early morning awakenings and interrupted sleep with multiple awakenings in the middle of the night.

Other biological data. Disturbances in immunological function are observed in both depression and mania. It has also been suggested that depression is a disorder of chronobiological regulation.

Live brain imaging studies to date have yielded modest results. CT scans have shown that some patients with mania or depression have enlarged cerebral ventricles; positron emission tomography scans indicate decreased cerebral metabolism, and other studies find decreased cerebral blood flow in depression, especially to the basal ganglia.

Psychosocial hypotheses.

Life events and stress. Most American clinicians suggest a connection between stress in the patient’s life and clinical depression. Often, when reviewing medical records, it is possible to identify stress, especially those associated with events preceding the onset of depressive episodes. It is assumed that life events play an important role in the onset of depression, which is reflected in statements such as “Depression began in connection with ....” and “Depression has worsened due to...” Some clinicians believe that life events play a primary or fundamental role in depression, others are more conservative, believing that the connection between depression and life events is expressed only in the fact that they determine the time of occurrence and determine the duration of an already existing episode. However, the research data cited to support this connection is inconclusive. The strongest evidence for this association is between the loss of a parent at age 11 and the loss of a spouse at the time of illness onset and the development of severe depression.

Premorbid personality factors. It is not possible to identify any character traits or any specific personality type that would be signs indicating a predisposition to depression. All people, regardless of personality, can and do become depressed under certain circumstances; however, different individuals exhibit different features diseases: suggestible individuals become impulsive-compulsive, hysterical individuals are more at risk of becoming depressive than antisocial, paranoid and others who use projection and other externalizing defense mechanisms.

Psychoanalytic factors. Karl Abraham believed that the periods of manifestation of the disease are accelerated by the loss of the libidinal object, which leads to a regressive process in which it passes from its natural functional state to a state in which the infantile trauma of the oral-sadistic stage of libidinal development dominates due to the fixation of the process in early childhood.

According to Freud's structural theory, ambivalent introjection of a lost object into the ego leads to the development of typical depressive symptoms, assessed as a loss of energy available to the ego. The superego, unable to respond to the loss of energy in external expression, attacks the psychic representation of the lost subject, which is now internalized in the ego as an introject. When this conquers or merges into the superego, there is a release of energy previously bound in depressive symptoms, resulting in mania with its typical symptoms of excess.

Developed feeling of helplessness. In experiments in which animals were repeatedly exposed to shocks electric current and which could not be got rid of, they eventually "gave in" and made no attempt at all to avoid further blows. A similar state of helplessness can be found in people who are depressed. According to learning theory, depression can be reduced if the doctor can instill in the patient a sense of control over the situation and the ability to cope with it. Behaviorist techniques, including reward and positive reinforcement, are used in these attempts.

Cognitive theories. According to this theory, negative life events, negative self-esteem, pessimism and helplessness contribute to misunderstandings of the situation.

4. Clinical signs and symptoms

The most common affective syndrome is mild depression, reminiscent of neurotic reactions in its vague emotional discomfort. With this type of depression, patients complain of a certain feeling of discomfort, lack of energy, boredom, and a desire to change places. Favorite words of patients: laziness, powerlessness, lethargy, colorlessness, restlessness, a feeling of slow passage of time, lack of interests, etc.

If these manifestations are accompanied by some somatic ailments, such as headaches, loss of appetite, insomnia, then the syndrome becomes similar to neurotic conditions psychogenic nature. This similarity is enhanced when patients have a tendency to obsessions of the catathymic type. The thoughts that health has deteriorated alarmingly, that the work begun is unlikely to ever be completed, that there is not enough time to raise a child, strengthens the similarity of this mild depression with neurotic depression. Feelings of melancholy and anxiety here do not yet occupy a leading place in the structure; they arise only as minor overshadowing episodes. “Suddenly it became melancholy,” “the soul became dreary,” “a cloud of anxiety ran through” - this is how patients usually characterize these transient affective states.

Usually this kind of depression is of an undulating nature. They appear suddenly and disappear just as suddenly. It is noteworthy that patients can cope with them to a certain extent, continue to work and live in the family.

Some people successfully hide their depression by turning to doctors for help with headaches and insomnia. general practice.

It is not easy to distinguish mild endogenous depression from neurotic depression or a neurotic asthenic reaction. The main thing you need to pay attention to is the presence of structural elements of axial endoform syndrome - a decrease in the level of personality, which form the background of this depression. Without identifying these structural elements, this kind of depression should be interpreted as either cyclothymic or psychogenic.

It should also be noted that psychogenic depression often occurs in connection with some unfavorable situations, breaking a habitual stereotype. Although this kind of situation cannot be excluded in the case of endoform depression under consideration, it is the absence of psychogenesis, not entirely clear, indeducible from the life situation that serves as the main diagnostic factor in clinical assessment. Diagnosis is complicated by the symptom of boredom, which is the most common type of submental state of our contemporaries. In everyday life, the sources of boredom are satiety, lack of employment, inability to rationally use leisure time, insufficient cultural level, which gives rise to a painful feeling of boredom with its inherent experience of the slow passage of time.

More severe registers of affective disorders include anxious depression. With this type of depressive syndrome, the general emotional background is an anxious or sad mood. Patients complain of a painful, painful state of health. The melancholy they experience is vital in nature, localized in the region of the heart, intensifies in the morning, decreases in the evening. With this type of depression, patients find themselves at the mercy of catathic thoughts. It seems to them that they have done something wrong, that their physical health is threatened by illness, that their mental strength and psyche are on the verge of disaster. Concern about one's health and moral discomfort create themes for hypochondriacal fixations on bodily sensations and ideas of self-blame. As a rule, with this type of depression, there is a feeling of slowing down the passage of time, a feeling of general heaviness, and such a deep concentration on one’s own inner world that everything around begins to play the role of a kind of neutral, amorphous background. Patients become restless.

In some cases, anxiety becomes the dominant affect in these depressions. At first this is a vague feeling, but gradually it acquires the features of reality. At the same time, patients show fears for the fate of loved ones and express thoughts that the family is in danger. At the same time, they complain about the loss of love and affection for loved ones. Often anxiety takes on a hypochondriacal orientation, and then patients claim that they are developing severe physical illness(cancer, hypertension, sclerosis, heart attack), that the danger of death is imminent.

Weakening of vital impulses, melancholy and anxiety, apathy and hypochondria, a feeling of general numbness or dullness for some time does not obscure a critical attitude towards one’s condition. At the same time, the ability to compare with what happened before the illness is still retained. In the end, this ability is lost, and then experiences of fear and horror appear. Delusional ideas of persecution are also formed, spreading even to relatives and acquaintances.

In the picture of anxious depression, depersonalization phenomena are also possible. Patients claim, for example, that their body takes on a deathly hue, senile flabbiness, that their mental abilities have become dull and will never be restored. Some exhibit depersonalization of a different kind: they suffer from the fact that the colors of the surrounding world have faded, people’s faces have acquired mysterious, frightening expressions, moving people and cars seem to make very strange, alarming movements.

There are two types of anxious depression. One type is accompanied by motor activity. At the same time, patients are in constant motion, sigh loudly and deeply, wring their hands, pull out their hair, fussily sort through the folds of their clothes, and continually turn to the staff with anxious requests. Another type is inhibited depression. In this case, there is a lack of motor skills, a frozen expression of suffering on the face, slow and quiet speech, and significant pauses when answering questions. In some cases, inhibition can reach the point of stupor.

With less frequency, but no less severity, affective disorders of the opposite type are observed - manic syndromes.

Hypomanic syndrome is more common. In some cases, this is an acute state of unbridledness, increased playfulness, playfulness, intemperance, and disinhibition of drives. A variant of pathological playfulness, or petulence, is more often observed in cases of nuclear schizophrenia, both slowly occurring and characterized by a rapid course (psychopathic form. Hebephrenia). Another variant of the hypomanic syndrome is the state of letitia, which manifests itself in episodes of pathological gaiety, causeless jubilation, an indomitable desire to bring joy to others, to brag, to brag. Laetitia is usually accompanied by ideas of reassessing one’s own personality. For example, a woman begins to boast about the slenderness of her legs, claims that she has the most fashionable bust in the world, that many noble men are crazy about her, that she is invited to film shoots, to modeling houses, etc. Men often begin to claim that they are capable of great feats, can set world records in sports, organize a big business; they also boast about their physical characteristics, sexual success, etc. Patients make it clear that they have decent and powerful connections, that they are included in the “spheres”, enjoy enviable success with colleagues, with women, that they could, if they wanted, make a business, writing, scientific career, etc. P.

A more serious disorder is simple mania. An elevated mood with expansiveness and irritability is a criterion for this condition. Elevated mood is characterized by euphoria and is often contagious in nature; this sometimes makes it difficult for an inexperienced doctor to correctly diagnose the transition of the disease to the opposite phase. Although persons communicating with the patient may not recognize of an unusual nature his mood, people who know this person well can easily distinguish unusual changes in his mood. The patient's mood may sometimes be irritable, especially if his extremely ambitious plans are interfered with. There is often a change in the dominant mood - from euphoria at the onset of the disease to irritability observed in further period its development.

Keeping manic patients on an inpatient basis is made difficult by the fact that they violate hospital rules, seek to shift responsibility for their misdeeds to others, take advantage of the weakness of others and seek to quarrel with staff. Manic patients often drink alcohol excessively, perhaps in an attempt to help themselves. The lack of inhibition, characteristic of these patients, is manifested in numerous telephone conversations, especially in calls to people living far away in the early morning. The urge to gamble, which becomes pathological, the need to be naked in public places, to wear clothes and jewelry in bright colors and unexpected combinations and inattention to small details (for example, they forget to put the telephone receiver back) are also typical manifestations of this disorder. The impulsive nature of many of the patients' actions is combined with a sense of inner conviction and determination. The patient is often overwhelmed by religious, political, financial, sexual or persecutory ideas, which may become part of a delusional complex.

In some cases, simple manic syndrome also contains disorders that fall into the category of obsessive, violent and overvalued ideas. An example of obsession is the seemingly deliberate philosophizing characteristic of a number of patients. It manifests itself both in the desire to give one’s speech a thoughtful, aphoristic character, and in meaningless reflection of a reasoning nature. So, for example, some patients constantly turned to others with questions of a naive and far-fetched nature: what will happen if the sun rises not from the east, but from the west, what will happen if the phenomenon of magnetism at the North Pole disappears, how can you teach a chicken to swim, etc. . Despite the fact that such patients understand the meaninglessness of these questions, their inappropriateness, they nevertheless turn to doctors and patients with them at the most inopportune moment.

As a rule, there are overvalued ideas that have the nature of unbridled bragging and boasting, going beyond the limits of reason.

5. Nursing processand featurescaring for patients with affectiveAndsyndromesAnd

A negative prejudice has formed in society regarding psychiatry. There are big differences between mental and physical illnesses. Therefore, patients and their relatives are often ashamed of the disease and hide the fact of visiting a psychiatrist. Often others, even medical workers, treat people with mental disorders in an unnatural way: with excessive apprehension (even fear), with emphasized pity or condescension. This attitude can make it difficult nursing process at all its stages.

The best help for mental patients is provided when their condition is perceived by others only as an illness. This helps patients maintain the self-awareness necessary for their healing.

Caregivers should not perceive the patient's personality, with its needs, desires and fears, only in terms of the diagnosis of the disease. Holistic care covers the person, illness, profession, family, relationships, etc. A mentally ill person is not only an object for care. Actively involve the patient in solving his health problems - the main task caring staff. In this sense, caring for a patient means not only performing the necessary medical procedures, it means much more: accompaniment, explanation, encouragement to action and attention to the patient's problems.

The care process is carried out in stages as follows: collecting information, making a nursing diagnosis, identifying the patient’s problems (in case of affective states, the problems will be the following: for depression: depressed mood - hypothymia, decreased volitional activity - hypobulia, motor retardation, slowing of the thought process, for mania: increased mood - euphoria, increased volitional and motor activity, acceleration of the thought process, cheerfulness, carelessness, etc.), determining the goals of care, planning care, providing care and evaluating results. Assessment of the effectiveness of care is based on the results of repeated collection of information about the patient's condition and makes it possible to monitor and make necessary adjustments in the care process.

Quality care is possible through a partnership between the patient and the caregiver. Such interaction can only be achieved by establishing a relationship of trust between the patient and the caring staff. Therefore, the nurse must have communication skills, knowledge of medical psychology and certain personal qualities: respect for the individual, the ability to empathize, endurance, etc.

When communicating with mental patients, you must not raise your voice, order anything, disdain their requests, ignore their requests or complaints. Any harsh, disrespectful treatment of patients can provoke agitation, aggressive actions, attempts to escape, and suicide. You should refrain from discussing with patients the condition and behavior of other patients, and express your point of view on the correctness of treatment and regimen. It is necessary to regulate the behavior of patients, if such a need arises, very correctly. Conversations with patients should concern only treatment issues and be aimed at reducing their anxiety and anxiety.

Nurses and junior medical staff on duty must wear a strict medical gown and a medical cap. Flashy jewelry, demonstrative hairstyles, bright makeup, and anything that might attract increased attention from patients are inappropriate. The pockets of the robe should not contain sharp objects, keys to the department, or cabinets with medicines. The loss of keys requires taking urgent measures to find them, as this may lead to patients escaping from the department.

Therapeutic manipulations (dispensing medications, injections and other procedures) are carried out according to doctor’s prescriptions within the specified time frame. It is necessary to monitor whether patients are taking pills. Distributing medications without monitoring their intake is not allowed, so patients take medications only in the presence of a nurse.

Mental patients require supervision, which comes in three forms. Strict supervision prescribed to depressed patients with suicidal tendencies. In the ward where such patients are located, there is a medical post around the clock, the ward is constantly illuminated, and there should be nothing in it except beds. Patients can leave the ward only with accompanying persons. Any change in the behavior of patients is reported immediately to the doctor. Enhanced Surveillance is prescribed in cases where it is necessary to clarify the characteristics of painful manifestations (character of sleep, mood). General observation is prescribed to those patients who do not pose a danger to themselves and others. They can move freely in the department, go for walks, and are actively involved in work processes (which is typical for manic patients).

Depressed patients may make suicidal attempts, so the nurse should monitor their attempts to get ropes, laces, cutting objects, and medications. Such patients should not be left unattended. If an attempt is made, it is necessary to take emergency medical care measures and notify the doctor. Depressed patients may also refuse to eat. The nurse needs to understand the reasons for refusing to eat. In some cases, psychotherapeutic methods, persuasion, and explanation are effective. To stimulate appetite, it is possible to prescribe small doses of insulin (4-8 units) subcutaneously. If attempts to feed the patient are unsuccessful within 3-4 days, you can resort to artificial feeding through a tube or parenteral feeding by intravenous administration of nutrient solutions.

Patients with manic syndrome often do not want to voluntarily undergo treatment in a clinic, so they have to be forced. They do not have such a deep understanding of their illness, and hospital treatment seems to them utter absurdity. The nurse must be able to convince the patient of the need to stay in the hospital and take medications. Manic patients are often aggressive and conflict-ridden; medical personnel should remember this and try not to enter into conflict with such patients.

Conclusion

Affective syndromes include polar emotional disorders - depression and mania. Depressive syndrome characterized by painfully low mood, melancholy, which are sometimes accompanied by a physically painful feeling of pressure or heaviness in the area chest, intellectual and motor inhibition (difficulty in the flow of thoughts, loss of interest in professional activities, slowing of movements up to complete immobility - depressive stupor). A pessimistic worldview in depression is accompanied by anxiety, feelings of guilt, ideas of low value, which in severe cases acquire the character of delusions of self-blame or sinfulness, suicidal ideas and tendencies.

Manic syndrome is characterized by a painfully elevated mood, combined with unreasonable optimism, accelerated thinking and excessive activity. Patients are characterized by feelings of joy, happiness, and an overestimation of their own capabilities, sometimes reaching the level of ideas of greatness. There is verbosity and a desire to constantly expand the scope of activity and contacts. In this case, increased irritability and conflict (angry mania) are often detected.

When caring for such patients, it is necessary to monitor changes in condition and immediately report these changes to the doctor. The nurse should be aware of all depressed patients with suicidal intentions, be attentive to the patients’ statements, and monitor their attempts to obtain items that could harm the patient. You should not enter into a conflict situation with manic patients, you should not raise your voice at them, order anything, neglect their requests, ignore their requests or complaints.

Listliterature used

1. Zharikov N.M., Ursova L.G., Khritinin D.B., Psychiatry (textbook for students of medical institutes). M., 1998.

2. Kaplan G.I., Sadok B.D. Clinical psychiatry in 2 volumes. T. 1. 1998, - M.: Medicine.

3. Portnov A.A. General psychopathology: study. allowance. - M.: Medicine, 2004.

4. Ritter S. Guide to nursing work in psychiatric clinic. Principles and techniques. - Publishing house "Sfera", Kyiv, 1997.

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As a manuscript

Kholmogorova Alla Borisovna

THEORETICAL AND EMPIRICAL BASES

INTEGRATIVE PSYCHOTHERAPY

AFFECTIVE SPECTRUM DISORDERS

19.00.04 – Medical psychology

dissertations for an academic degree

Doctor of Psychology

Moscow – 2006

The work was carried out at the Federal State Institution “Moscow Research Institute of Psychiatry of the Federal Agency for Health and Social Development”

Scientific consultant- Doctor of Medical Sciences,

Professor Krasnov V.N.

Official opponents– Doctor of Psychology,

Professor Nikolaeva V.V.

Doctor of Psychology

Dozortseva E.G.

Doctor of Medical Sciences,

Professor Eidemiller E.G.

Lead institution- St. Petersburg psychoneurological

Institute named after V.M. Bekhtereva

The defense will take place on December 27, 2006 at 14:00 at a meeting of the Dissertation Academic Council D 208.044.01 at the Moscow Research Institute of Psychiatry of the Federal Agency for Health and Social Development at the address: 107076, Moscow, st. Poteshnaya, 3

The dissertation can be found at the Moscow Research Institute of Psychiatry of the Federal Agency for Health and Social Development

Scientific Secretary

Dissertation Council

Candidate of Medical Sciences Dovzhenko T.V.

GENERAL DESCRIPTION OF WORK

Relevance. The relevance of the topic is associated with a significant increase in the number of affective spectrum disorders in the general population, among which depressive, anxiety and somatoform disorders are the most epidemiologically significant. In terms of prevalence, they are the undisputed leaders among other mental disorders. According to various sources, they affect up to 30% of people visiting clinics and from 10 to 20% of people in the general population (J.M.Chignon, 1991, W.Rief, W.Hiller, 1998; P.S.Kessler, 1994; B.T.Ustun, N. Sartorius, 1995; H.W. Wittchen, 2005; A.B. Smulevich, 2003). The economic burden associated with their treatment and disability constitutes a significant part of the budget in the health care system of different countries (R. Carson, J. Butcher, S. Mineka, 2000; E.B. Lyubov, G.B. Sargsyan, 2006; H.W. Wittchen, 2005). Depressive, anxiety and somatoform disorders are important risk factors for the emergence of various forms of chemical dependence (H.W. Wittchen, 1988; A.G. Goffman, 2003) and, to a large extent, complicate the course of concomitant somatic diseases (O.P. Vertogradova, 1988; Yu.A. Vasyuk, T.V. Dovzhenko, E.N. Yushchuk, E.L. Shkolnik, 2004; V.N. Krasnov, 2000; E.T. Sokolova, V.V. Nikolaeva, 1995)

Finally, depressive and anxiety disorders are the main risk factor for suicide, in terms of the number of which our country ranks among the first (V.V. Voitsekh, 2006; Starshenbaum, 2005). Against the backdrop of socio-economic instability in recent decades in Russia, there has been a significant increase in the number of affective disorders and suicides among young people, elderly people, and able-bodied males (V.V. Voitsekh, 2006; Yu.I. Polishchuk, 2006). There is also an increase in subclinical emotional disorders, which are included within the boundaries of affective spectrum disorders (H.S. Akiskal et al., 1980, 1983; J. Angst et al, 1988, 1997) and have a pronounced negative impact on quality of life and social adaptation.

The criteria for identifying different variants of affective spectrum disorders, the boundaries between them, the factors of their occurrence and chronicity, targets and methods of assistance are still debatable (G. Winokur, 1973; W. Rief, W. Hiller, 1998; A. E. Bobrov, 1990; O.P.Vertogradova, 1980, 1985; V.N.Krasnov, 2003; G.P.Panteleeva, 1998; 2003). Most researchers point to the importance of an integrated approach and the effectiveness of a combination of drug therapy and psychotherapy in the treatment of these disorders (O.P. Vertogradova, 1985; A.E. Bobrov, 1998; A.Sh. Tkhostov, 1997; M. Perrez, U. Baumann , 2005; W. Senf, M. Broda, 1996, etc.). At the same time, in different areas of psychotherapy and clinical psychology, various factors of the mentioned disorders are analyzed and specific targets and tasks of psychotherapeutic work are identified (B.D. Karvasarsky, 2000; M. Perret, U. Bauman, 2002; F.E. Vasilyuk, 2003, etc. .).

All the mentioned factors of occurrence and the resulting targets of psychotherapy for affective spectrum disorders do not exclude, but complement each other, which necessitates the integration of various approaches when solving practical problems of providing psychological assistance. Although the task of integration is increasingly coming to the fore in modern psychotherapy, its solution is hampered by significant differences in theoretical approaches (M. Perrez, U. Baumann, 2005; B. A. Alford, A. T. Beck, 1997; K. Crave, 1998; A. J. Rush, M. Thase, 2001; W. Senf, M. Broda, 1996; A. Lazarus, 2001; E. T. Sokolova, 2002), which makes it relevant to develop theoretical foundations for the synthesis of accumulated knowledge. It should also be noted that there is a lack of comprehensive objective empirical research confirming the importance of various factors and the resulting targets of assistance (S.J.Blatt, 1995; K.S.Kendler, R.S.Kessler, 1995; R.Kellner, 1990; T.S.Brugha, 1995, etc.). Finding ways to overcome these obstacles is an important independent scientific task, the solution of which involves the development of methodological means of integration, conducting comprehensive empirical studies of the psychological factors of affective spectrum disorders and the development of scientifically based integrative methods of psychotherapy for these disorders.

Purpose of the study. Development of theoretical and methodological foundations for the synthesis of knowledge accumulated in different traditions of clinical psychology and psychotherapy, a comprehensive empirical study of the system of psychological factors of affective spectrum disorders with the identification of targets and the development of principles of integrative psychotherapy and psychoprevention of depressive, anxiety and somatoform disorders.

Research objectives.

Theoretical and methodological analysis of models of occurrence and methods of treatment of affective spectrum disorders in the main psychological traditions; justification of the need and possibility of their integration.
Development of methodological foundations for the synthesis of knowledge and integration of methods of psychotherapy for affective spectrum disorders.
Analysis and systematization of existing empirical studies of psychological factors of depressive, anxiety and somatoform disorders based on the multifactorial psycho-social model of affective spectrum disorders and the four-aspect model of the family system.
Development of a methodological complex aimed at the systematic study of macrosocial, family, personal and interpersonal factors of emotional disorders and affective spectrum disorders.
Conducting an empirical study of patients with depressive, anxiety and somatoform disorders and a control group of healthy subjects based on a multifactorial psycho-social model of affective spectrum disorders.
Conducting a population-based empirical study aimed at studying macrosocial factors of emotional disorders and identifying high-risk groups among children and youth.
Comparative analysis of the results of studies of various population and clinical groups, as well as healthy subjects, analysis of connections between macrosocial, family, personal and interpersonal factors.
Identification and description of the system of targets for psychotherapy for affective spectrum disorders, based on data from theoretical and methodological analysis and empirical research.
Formulation of the basic principles, objectives and stages of integrative psychotherapy for affective spectrum disorders.
Determination of the main tasks of psychoprophylaxis of emotional disorders in children at risk.

Theoretical and methodological foundations of the work. The methodological basis of the study is the systemic and activity-based approaches in psychology (B.F. Lomov, A.N. Leontiev, A.V. Petrovsky, M.G. Yaroshevsky), the bio-psycho-social model of mental disorders, according to which the emergence and in the course of mental disorders, biological, psychological and social factors are involved (G. Engel, H. S. Akiskal, G. Gabbard, Z. Lipowsky, M. Perrez, Yu. A. Aleksandrovsky, I. Ya. Gurovich, B. D. Karvasarsky, V. N. Krasnov), ideas about non-classical science as focused on solving practical problems and integrating knowledge from the point of view of these problems (L.S. Vygotsky, V.G. Gorokhov, V.S. Stepin, E.G. Yudin, N. L.G. Alekseev, V.K. Zaretsky), cultural and historical concept of mental development by L.S. Vygotsky, concept of mediation by B.V. Zeigarnik, ideas about the mechanisms of reflexive regulation in normal and pathological conditions (N.G. Alekseev, V. K. Zaretsky, B.V. Zeigarnik, V.V. Nikolaeva, A.B. Kholmogorova), a two-level model of cognitive processes developed in cognitive psychotherapy by A. Beck.

Object of study. Models and factors of mental norm and pathology and methods of psychological assistance for affective spectrum disorders.

Subject of study. Theoretical and empirical foundations for the integration of various models of the occurrence and methods of psychotherapy for affective spectrum disorders.

Research hypotheses.

Different models of the emergence and methods of psychotherapy for affective spectrum disorders focus on different factors; the importance of their comprehensive consideration in psychotherapeutic practice necessitates the development of integrative models of psychotherapy.
The developed multifactorial psycho-social model of affective spectrum disorders and the four-aspect model of the family system allow us to consider and study macrosocial, family, personal and interpersonal factors as a system and can serve as a means of integrating various theoretical models and empirical studies of affective spectrum disorders.
Macrosocial factors such as social norms and values (the cult of restraint, success and perfection, gender role stereotypes) affect the emotional well-being of people and can contribute to the occurrence of emotional disorders.
There are general and specific psychological factors of depressive, anxiety and somatoform disorders associated with different levels (family, personal, interpersonal).
The developed model of integrative psychotherapy for affective spectrum disorders is an effective means of psychological assistance for these disorders.

Research methods.

1. Theoretical and methodological analysis – reconstruction of conceptual schemes for studying affective spectrum disorders in various psychological traditions.

2. Clinical-psychological – study of clinical groups using psychological techniques.

3. Population - study of groups from the general population using psychological techniques.

4. Hermeneutic - qualitative analysis of interview data and essays.

5. Statistical - the use of mathematical statistics methods (when comparing groups, the Mann-Whitney test was used for independent samples and the Wilcoxon T-test for dependent samples; to establish correlations, the Spearman correlation coefficient was used; to validate methods - factor analysis, test-retest, coefficient - Cronbach's, Guttman Split-half coefficient; multiple regression analysis was used to analyze the influence of variables). For statistical analysis, the software package SPSS for Windows, Standard Version 11.5, Copyright © SPSS Inc., 2002, was used.

6. Method of expert assessments – independent expert assessments of interview data and essays; expert assessments of the characteristics of the family system by psychotherapists.

7. Follow-up method - collecting information about patients after treatment.

The developed methodological complex includes the following blocks of methods in accordance with the levels of research:

1) family level – family emotional communications questionnaire (FEC, developed by A.B. Kholmogorova together with S.V. Volikova); structured interviews “Scale of stressful events in family history” (developed by A.B. Kholmogorova together with N.G. Garanyan) and “Parental criticism and expectations” (RKO, developed by A.B. Kholmogorova together with S.V. Volikova), test family system (FAST, developed by T.M.Gehring); essay for parents “My Child”;

2) personal level – questionnaire of prohibition of expressing feelings (ZVCh, developed by V.K. Zaretsky together with A.B. Kholmogorova and N.G. Garanyan), Toronto Alexithymia Scale (TAS, developed by G.J. Taylor, adaptation by D.B. Eresko , G.L. Isurina et al.), emotional vocabulary test for children (developed by J.H. Krystal), emotion recognition test (developed by A.I. Toom, modified by N.S. Kurek), emotional vocabulary test for adults ( developed by N.G. Garanyan), perfectionism questionnaire (developed by N.G. Garanyan together with A.B. Kholmogorova and T.Yu. Yudeeva); physical perfectionism scale (developed by A.B. Kholmogorova together with A.A. Dadeko); hostility questionnaire (developed by N.G. Garanyan together with A.B. Kholmogorova);

interpersonal level – social support questionnaire (F-SOZU-22, developed by G.Sommer, T.Fydrich); structured interview “Moscow Integrative Social Network Questionnaire” (developed by A.B. Kholmogorova together with N.G. Garanyan and G.A. Petrova); test for the type of attachment in interpersonal relationships (developed by C. Hazan, P. Shaver).

To study psychopathological symptoms, we used the severity of psychopathological symptoms questionnaire SCL-90-R (developed by L.R. Derogatis, adapted by N.V. Tarabrina), the depression questionnaire (BDI, developed by A.T. Beck et al., adapted by N.V. Tarabrina), the anxiety questionnaire ( BAI, developed by A.T.Beck and R.A.Steer), Childhood Depression Inventory (CDI, developed by M.Kovacs), Personal Anxiety Scale (developed by A.M. Prikhozhan). To analyze factors at the macrosocial level when studying risk groups from the general population, the above methods were selectively used. Some of the methods were developed specifically for this study and were validated in the laboratory of clinical psychology and psychotherapy of the Moscow Research Institute of Psychiatry of the Russian Health Service.

Characteristics of the examined groups.

The clinical sample consisted of three experimental groups of patients: 97 patients with depressive disorders , 90 patients with anxiety disorders, 52 patients with somatoform disorders; two control groups of healthy subjects included 90 people; groups of parents of patients with affective spectrum disorders and healthy subjects included 85 people; samples of subjects from the general population included 684 school-age children, 66 parents of schoolchildren and 650 adult subjects; The additional groups included in the study to validate the questionnaires included 115 people. A total of 1929 subjects were examined.

The study involved employees of the laboratory of clinical psychology and psychotherapy of the Moscow Research Institute of Psychiatry of the Russian Health Service: Ph.D. leading researcher N.G. Garanyan, researchers S.V. Volikova, G.A. Petrova, T.Yu. Yudeeva, as well as students of the department of the same name of the Faculty of Psychological Counseling of the Moscow City Psychological and Pedagogical University A.M. Galkina, A. A. Dadeko, D. Yu. Kuznetsova. A clinical assessment of the patients’ condition in accordance with ICD-10 criteria was carried out by a leading researcher at the Moscow Research Institute of Psychiatry of the Russian Healthcare Ministry, Ph.D. T.V. Dovzhenko. A course of psychotherapy was prescribed to patients according to indications in combination with drug treatment. Statistical processing of the data was carried out with the participation of Doctor of Pedagogical Sciences, Ph.D. M.G. Sorokova and Candidate of Chemical Sciences O.G. Kalina.

Reliability of results is ensured by a large volume of survey samples; using a set of methods, including questionnaires, interviews and tests, which made it possible to verify the results obtained using individual methods; using methods that have undergone validation and standardization procedures; processing the obtained data using methods of mathematical statistics.

Basic provisions submitted for defense

1. In existing areas of psychotherapy and clinical psychology, different factors are emphasized and different targets for working with affective spectrum disorders are identified. The current stage of development of psychotherapy is characterized by trends towards more complex models of mental pathology and the integration of accumulated knowledge based on a systematic approach. The theoretical basis for integrating existing approaches and research and identifying on this basis a system of targets and principles of psychotherapy are the multifactorial psycho-social model of affective spectrum disorders and the four-aspect model of family system analysis.

1.1. The multifactorial model of affective spectrum disorders includes macrosocial, family, personal and interpersonal levels. At the macrosocial level, factors such as pathogenic cultural values and social stress are highlighted; at the family level - dysfunction of the structure, microdynamics, macrodynamics and ideology of the family system; at the personal level - disorders of the affective-cognitive sphere, dysfunctional beliefs and behavioral strategies; at the interpersonal level - the size of the social network, the presence of close trusting relationships, the degree of social integration, emotional and instrumental support.

Part I. Theoretical models, empirical research and treatment methods for affective spectrum disorders: the problem of knowledge synthesis.

Chapter 1. Affective spectrum disorders: epidemiology, classification, problem of comorbidity.

1.1 Depressive disorders.

1.2.Anxiety disorders.

1.3. Somatoform disorders.

Chapter 2. Psychological models and methods of psychotherapy for affective spectrum disorders.

2.1. Psychodynamic tradition - focusing on past traumatic experiences and internal conflicts.

2.2. Cognitive-behavioral tradition - focus on dysfunctional thoughts and behavioral strategies.

2.3. Cognitive psychotherapy and domestic psychology of thinking

Focus on the development of reflexive regulation.

2.4. Existential-humanistic tradition - focusing on feelings and inner experience.

2.5. Family and interpersonal-focused approaches.

2.6. General development trends: from mechanistic models to systemic ones, from opposition to integration, from influence to cooperation.

Chapter 3. Theoretical and methodological means of synthesis of knowledge in the sciences of mental health.

3.1. Systemic bio-psycho-social models as a means of synthesizing knowledge accumulated in the mental health sciences.

3.2. The problem of knowledge integration in psychotherapy as a non-classical science. P

3.3. Multifactorial psychosocial model of affective spectrum disorders as a means of synthesizing theoretical models and systematizing empirical research.

3.4. The four-aspect model of the family system as a means of synthesizing knowledge accumulated in system-oriented family psychotherapy.

Chapter 4. Systematization of empirical psychological studies of affective spectrum disorders based on a multifactorial psycho-social model.

4.1. Macrosocial factors.

4.2. Family factors.

4.3. Personal factors.

4.4. Interpersonal factors.

Part II. Results of an empirical study of psychological factors of affective spectrum disorders based on a multifactorial psycho-social model.

Chapter 1. Organization of the study.

1.1. The purpose of the study: substantiation of hypotheses and general characteristics of the surveyed groups.

1.2 Characteristics of the methodological complex.

Chapter 2. The influence of macrosocial factors on emotional well-being: a population study.

2.1. Prevalence of emotional disorders in children and youth.

2.2. Social orphanhood as a factor of emotional disorders in children.

2.3. The cult of social success and perfectionistic educational standards as a factor of emotional disturbances in children studying in advanced programs.

2.4. The cult of physical perfection as a factor in emotional disorders in young people.

2.5. Gender-role stereotypes of emotional behavior as a factor of emotional disorders in women and men.

Chapter 3. Empirical research on anxiety and depressive disorders.

3.1. Characteristics of groups, hypotheses and research methods.

3.2.Family factors.

3.3. Personal factors.

3.4. Interpersonal factors.

3.5. Analysis and discussion of results.

Chapter 4. Empirical study of somatoform disorders.

4.1. Characteristics of groups, hypotheses and research methods.

4.2.Family factors.

4.3 Personal factors.

4.4. Interpersonal factors.

4.5. Analysis and discussion of results.

Part III. Integrative psychotherapy and prevention of affective spectrum disorders.

Chapter 1. Empirical basis for identifying a system of targets for psychotherapy and psychoprophylaxis of affective spectrum disorders.

1.1. Comparative analysis of data from empirical studies of clinical and population groups.

1.2. Correlation of the obtained results with existing theoretical models and empirical studies of affective spectrum disorders and identification of targets for psychotherapy.

Chapter 2. Main tasks and stages of integrative psychotherapy for affective spectrum disorders and the possibilities of their psychoprevention.

2.1. Main stages and tasks of integrative psychotherapy for affective spectrum disorders.

2.2. The main stages and tasks of integrative psychotherapy for affective spectrum disorders with severe somatization.

2.3. The role of psychotherapy in increasing compliance with drug treatment.

2.4. Objectives of psychoprophylaxis for affective spectrum disorders in selected risk groups.

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Introduction of the dissertation (part of the abstract) on the topic “Theoretical and empirical foundations of integrative psychotherapy for affective spectrum disorder”

Relevance. The relevance of the topic is associated with a significant increase in the number of affective spectrum disorders in the general population, among which depressive, anxiety and somatoform disorders are the most epidemiologically significant. In terms of prevalence, they are the undisputed leaders among other mental disorders. According to various sources, they affect up to 30% of people visiting clinics and from 10 to 20% of people in the general population (J.M.Chignon, 1991, W.Rief, W.Hiller, 1998; P.S.Kessler, 1994; B.T.Ustun, N. Sartorius, 1995; H.W. Wittchen, 2005; A.B. Smulevich, 2003). The economic burden associated with their treatment and disability constitutes a significant part of the budget in the health care system of different countries (R. Carson, J. Butcher, S. Mineka, 2000; E.B. Lyubov, G.B. Sargsyan, 2006; H.W. Wittchen, 2005). Depressive, anxiety and somatoform disorders are important risk factors for the emergence of various forms of chemical dependence (H.W. Wittchen, 1988; A.G. Goffman, 2003) and, to a large extent, complicate the course of concomitant somatic diseases (O.P. Vertogradova, 1988; Yu.A. Vasyuk, T.V. Dovzhenko, E.N. Yushchuk, E.L. Shkolnik, 2004; V.N. Krasnov, 2000; E.T. Sokolova, V.V. Nikolaeva, 1995) Finally, Depressive and anxiety disorders are the main risk factor for suicide, in terms of the number of which our country ranks among the first (V.V. Voitsekh, 2006; Starshenbaum, 2005). Against the backdrop of socio-economic instability in recent decades in Russia, there has been a significant increase in the number of affective disorders and suicides among young people, elderly people, and able-bodied males (V.V. Voitsekh, 2006; Yu.I. Polishchuk, 2006). There is also an increase in subclinical emotional disorders, which are included within the boundaries of affective spectrum disorders (H.S. Akiskal et al., 1980, 1983; J. Angst et al, 1988, 1997) and have a pronounced negative impact on the quality of life and social “adaptation.”

Within the framework of attachment theory, system-oriented family and dynamic psychotherapy, disruption of family relationships is indicated as an important factor in the emergence and course of affective spectrum disorders (S. Arietti, J. Bemporad, 1983; D. Bowlby, 1980, 1980; M. Bowen, 2005 ; E.G.Eidemiller, Yustitskis, 2000; E.T.Sokolova, 2002, etc.). The cognitive-behavioral approach emphasizes skill deficits, disturbances in information processing processes and dysfunctional personal attitudes (A.T. Vesk, 1976; N.G. Garanyan, 1996; A.B. Kholmogorova, 2001). Within the framework of social psychoanalysis and dynamically oriented interpersonal psychotherapy, the importance of disrupting interpersonal contacts is emphasized (K. Horney, 1993; G. Klerman et al., 1997). Representatives of the existential-humanistic tradition highlight the violation of contact with one’s internal emotional experience, the difficulties of its awareness and expression (K. Rogers, 1997). All the mentioned factors of occurrence and the resulting targets of psychotherapy for affective spectrum disorders do not exclude, but complement each other, which necessitates the integration of various approaches when solving practical problems of providing psychological assistance. Although the task of integration is increasingly coming to the fore in modern psychotherapy, its solution is hampered by significant differences in theoretical approaches (M. Perrez, U. Baumann, 2005; B. A. AIford, A. T. Beck, 1997; K. Crave, 1998; A. J. Rush, M. Thase, 2001; W. Senf, M. Broda, 1996; A. Lazarus, 2001; E. T. Sokolova, 2002), which makes it relevant to develop theoretical foundations for the synthesis of accumulated knowledge. It should also be noted that there is a lack of comprehensive objective empirical research confirming the importance of various factors and the resulting targets of assistance (S.J.Blatt, 1995; K.S.Kendler, R.S.Kessler, 1995; R.Kellner, 1990; T.S.Brugha, 1995, etc.). Finding ways to overcome these obstacles is an important independent scientific task, the solution of which involves the development of methodological means of integration, conducting comprehensive empirical studies of the psychological factors of affective spectrum disorders and the development of scientifically based integrative methods of psychotherapy for these disorders.

Purpose of the study. Development of theoretical and methodological foundations for the synthesis of knowledge accumulated in different traditions of clinical psychology and psychotherapy, a comprehensive empirical study of the system of psychological factors of affective spectrum disorders with the identification of targets and the development of principles of integrative psychotherapy and psychoprevention of depressive, anxiety and somatoform disorders. Research objectives.

1. Theoretical and methodological analysis of models of occurrence and methods of treatment of affective spectrum disorders in the main psychological traditions; justification of the need and possibility of their integration.

2. Development of methodological foundations for the synthesis of knowledge and integration of methods of psychotherapy for affective spectrum disorders.

3. Analysis and systematization of existing empirical studies of psychological factors of depressive, anxiety and somatoform disorders based on the multifactorial psycho-social model of affective spectrum disorders and the four-aspect model of the family system.

4. Development of a methodological complex aimed at the systematic study of macrosocial, family, personal and interpersonal factors of emotional disorders and affective spectrum disorders.

5. Conducting an empirical study of patients with depressive, anxiety and somatoform disorders and a control group of healthy subjects based on a multifactorial psycho-social model of affective spectrum disorders.

6. Conducting a population-based empirical study aimed at studying macrosocial factors of emotional disorders and identifying high-risk groups among children and youth.

7. Comparative analysis of the results of studies of various population and clinical groups, as well as healthy subjects, analysis of connections between macrosocial, family, personal and interpersonal factors.

8. Identification and description of the system of targets for psychotherapy for affective spectrum disorders, based on data from theoretical and methodological analysis and empirical research.

9. Formulation of the basic principles, objectives and stages of integrative psychotherapy for affective spectrum disorders.

10. Determination of the main tasks of psychoprophylaxis of emotional disorders in children at risk.

Theoretical and methodological foundations of the work. The methodological basis of the study is the systemic and activity-based approaches in psychology (B.F. Lomov, A.N. Leontiev, A.V. Petrovsky, M.G. Yaroshevsky), the bio-psycho-social model of mental disorders, according to which the emergence and in the course of mental disorders, biological, psychological and social factors are involved (G. Engel, H. S. Akiskal, G. Gabbard, Z. Lipowsky, M. Perrez, Yu. A. Aleksandrovsky, I. Ya. Gurovich, B. D. Karvasarsky, V. N. Krasnov), ideas about non-classical science as focused on solving practical problems and integrating knowledge from the point of view of these problems (L.S. Vygotsky, V.G. Gorokhov, V.S. Stepin, E.G. Yudin, N. L.G. Alekseev, V.K. Zaretsky), cultural and historical concept of mental development by L.S. Vygotsky, concept of mediation by B.V. Zeigarnik, ideas about the mechanisms of reflexive regulation in normal and pathological conditions (N.G. Alekseev, V. K. Zaretsky, B.V. Zeigarnik, V.V. Nikolaeva, A.B. Kholmogorova), a two-level model of cognitive processes developed in cognitive psychotherapy by A. Beck. Object of study. Models and factors of mental norm and pathology and methods of psychological assistance for affective spectrum disorders.

Subject of study. Theoretical and empirical foundations for the integration of various models of the occurrence and methods of psychotherapy for affective spectrum disorders. Research hypotheses.

1. Various models of the occurrence and methods of psychotherapy for affective spectrum disorders are focused on different factors; the importance of their comprehensive consideration in psychotherapeutic practice necessitates the development of integrative models of psychotherapy.

2. The developed multifactorial psycho-social model of affective spectrum disorders and the four-aspect model of the family system allow us to consider and study macrosocial, family, personal and interpersonal factors as a system and can serve as a means of integrating various theoretical models and empirical studies of affective spectrum disorders.

3. Macrosocial factors such as social norms and values (the cult of restraint, success and perfection, gender role stereotypes) affect the emotional well-being of people and can contribute to the occurrence of emotional disorders.

4. There are general and specific psychological factors of depressive, anxiety and somatoform disorders associated with various levels (family, personal, interpersonal).

5. The developed model of integrative psychotherapy for affective spectrum disorders is an effective means of psychological assistance for these disorders.

Research methods.

1. Theoretical and methodological analysis - reconstruction of conceptual schemes for studying affective spectrum disorders in various psychological traditions.

2. Clinical-psychological - study of clinical groups using psychological techniques.

3. Population - study of groups from the general population using psychological techniques.

4. Hermeneutic - qualitative analysis of interview data and essays.

5. Statistical - the use of mathematical statistics methods (when comparing groups, the Mann-Whitney test was used for independent samples and the Wilcoxon T-test for dependent samples; to establish correlations, the Spearman correlation coefficient was used; to validate methods - factor analysis, test-retest, coefficient a - Cronbach's, Guttman Split-half coefficient; multiple regression analysis was used to analyze the influence of variables). For statistical analysis, the software package SPSS for Windows, Standard Version 11.5, Copyright © SPSS Inc., 2002, was used.

6. Method of expert assessments - independent expert assessments of interview data and essays; expert assessments of the characteristics of the family system by psychotherapists.

7. Follow-up method - collecting information about patients after treatment.

The developed methodological complex includes the following blocks of methods in accordance with the levels of research:

1) family level - the questionnaire “Family Emotional Communications” (FEC, developed by A.B. Kholmogorova together with S.V. Volikova); structured interviews “Scale of stressful events in family history” (developed by A.B. Kholmogorova together with N.G. Garanyan) and “Parental criticism and expectations” (RKO, developed by A.B. Kholmogorova together with S.V. Volikova), test family system (FAST, developed by T.M.Gehring); essay for parents “My Child”;

2) personal level - questionnaire of prohibition of expressing feelings (ZVCh, developed by V.K. Zaretsky together with A.B. Kholmogorova and N.G. Garanyan), Toronto Alexithymia Scale (TAS, developed by G.J. Taylor, adaptation by D.B. Eresko , G.L. Isurina et al.), emotional vocabulary test for children (developed by J.H. Krystal), emotion recognition test (developed by A.I. Toom, modified by N.S. Kurek), emotional vocabulary test for adults ( developed by N.G. Garanyan), perfectionism questionnaire (developed by N.G. Garanyan together with A.B. Kholmogorova and T.Yu. Yudeeva); physical perfectionism scale (developed by A.B. Kholmogorova together with A.A. Dadeko); hostility questionnaire (developed by N.G. Garanyan together with A.B. Kholmogorova);

3) interpersonal level - social support questionnaire (F-SOZU-22, developed by G.Sommer, T.Fydrich); structured interview “Moscow Integrative Social Network Questionnaire” (developed by A.B. Kholmogorova together with N.G. Garanyan and G.A. Petrova); test for the type of attachment in interpersonal relationships (developed by C. Hazan, P. Shaver).

To study psychopathological symptoms, we used the severity of psychopathological symptoms questionnaire SCL-90-R (developed by L.R. Derogatis, adapted by N.V. Tarabrina), the depression questionnaire (BDI, developed by A.T. Vesk et al., adapted by N.V. Tarabrina), anxiety questionnaire (BAI, developed by A.T. Vesk and R.A. Steer), childhood depression questionnaire (CDI, developed by M. Kovacs), personal anxiety scale (developed by A.M. Prikhozhan). To analyze factors at the macrosocial level when studying risk groups from the general population, the above methods were selectively used. Some of the methods were developed specifically for this study and were validated in the laboratory of clinical psychology and psychotherapy of the Moscow Research Institute of Psychiatry of the Russian Health Service. Characteristics of the examined groups.

The clinical sample consisted of three experimental groups of patients: 97 patients with depressive disorders, 90 patients with anxiety disorders, 52 patients with somatoform disorders; two control groups of healthy subjects included 90 people; groups of parents of patients with affective spectrum disorders and healthy subjects included 85 people; samples of subjects from the general population included 684 school-age children, 66 parents of schoolchildren and 650 adult subjects; The additional groups included in the study to validate the questionnaires included 115 people. A total of 1929 subjects were examined.

Basic provisions submitted for defense

I. In existing areas of psychotherapy and clinical psychology, different factors are emphasized and different targets for working with affective spectrum disorders are identified. The current stage of development of psychotherapy is characterized by trends towards more complex models of mental pathology and the integration of accumulated knowledge based on a systematic approach. The theoretical basis for integrating existing approaches and research and identifying on this basis a system of targets and principles of psychotherapy are the multifactorial psycho-social model of affective spectrum disorders and the four-aspect model of family system analysis.

1.2. The four-aspect model of family system analysis includes the structure of the family system (degree of closeness, hierarchy between members, intergenerational boundaries, boundaries with the outside world); microdynamics of the family system (daily functioning of the family, primarily communication processes); macrodynamics (family history in three generations); ideology (family norms, rules, values).

2. The empirical basis for psychotherapy of affective spectrum disorders is a complex of psychological factors of these disorders, substantiated by the results of a multi-level study of three clinical, two control and ten population groups.

2.1. In the modern cultural situation, there are a number of macrosocial factors of affective spectrum disorders: 1) increased stress on a person’s emotional sphere as a result of a high level of stress in life (pace, competition, difficulties in choosing and planning); 2) the cult of restraint, strength, success and perfection, leading to negative attitudes towards emotions, difficulties in processing emotional stress and receiving social support; 3) a wave of social orphanhood against the background of alcoholism and family breakdown.

2.2. In accordance with the levels of research, the following psychological factors of depressive, anxiety and somatoform disorders have been identified: 1) at the family level - disturbances in structure (symbioses, coalitions, disunity, closed borders), microdynamics (high level of parental criticism and violence in the family), macrodynamics (accumulation stressful events and reproduction of family dysfunctions in three generations) ideology (perfectionistic standards, distrust of others, suppression of initiative) of the family system; 2) at the personal level - dysfunctional beliefs and disorders of the cognitive-affective sphere; 3) at the interpersonal level - a pronounced deficit of trusting interpersonal relationships and emotional support. The most pronounced dysfunctions at the family and interpersonal levels are observed in patients with depressive disorders. Patients with somatoform disorders have severe impairments in the ability to verbalize and recognize emotions.

3. The theoretical and empirical research conducted are the basis for the integration of psychotherapeutic approaches and the identification of a system of targets for psychotherapy for affective spectrum disorders. The model of integrative psychotherapy developed on these grounds synthesizes the tasks and principles of cognitive-behavioral and psychodynamic approaches, as well as a number of developments in Russian psychology (concepts of internalization, reflection, mediation) and systemic family psychotherapy.

3.1. The objectives of integrative psychotherapy and prevention of affective spectrum disorders are: 1) at the macrosocial level: debunking pathogenic cultural values (the cult of restraint, success and perfection); 2) at the personal level: development of emotional self-regulation skills through the gradual formation of reflexive ability in the form of stopping, fixing, objectifying (analysis) and modifying dysfunctional automatic thoughts; transformation of dysfunctional personal attitudes and beliefs (hostile picture of the world, unrealistic perfectionist standards, prohibition on expressing feelings); 3) at the family level: working through (comprehension and response) traumatic life experience and family history events; work with current dysfunctions of the structure, microdynamics, macrodynamics and ideology of the family system; 4) at the interpersonal level: practicing deficient social skills, developing the ability to form close, trusting relationships, expanding the system of interpersonal connections.

3.2. Somatoform disorders are characterized by fixation on the physiological manifestations of emotions, a pronounced narrowing of the emotional vocabulary and difficulties in recognizing and verbalizing feelings, which determines a certain specificity of integrative psychotherapy for disorders with pronounced somatization in the form of an additional task of developing mental hygiene skills of emotional life. Novelty and theoretical significance of the study. For the first time, theoretical foundations have been developed for the synthesis of knowledge about affective spectrum disorders obtained in different traditions of clinical psychology and psychotherapy - a multifactorial psycho-social model of affective spectrum disorders and a four-aspect model of family system analysis.

For the first time, based on these models, a theoretical and methodological analysis of various traditions was carried out, existing theoretical and empirical studies of affective spectrum disorders were systematized, and the need for their integration was substantiated.

For the first time, based on the developed models, a comprehensive experimental psychological study of the psychological factors of affective spectrum disorders was carried out, as a result of which macrosocial, family, and interpersonal factors of affective spectrum disorders were studied and described.

For the first time, based on a comprehensive study of the psychological factors of affective spectrum disorders and theoretical and methodological analysis of various traditions, a system of targets for psychotherapy has been identified and described and an original model of integrative psychotherapy for affective spectrum disorders has been developed.

Original questionnaires have been developed to study family emotional communications (FEC), prohibition on the expression of feelings (TE), and physical perfectionism. Structured interviews have been developed: a scale of stressful events in family history and the Moscow Integrative Social Network Questionnaire, which tests the main parameters of a social network. For the first time, a tool for studying social support - the Sommer, Fudrik Social Support Questionnaire (SOZU-22) - has been adapted and validated in Russian. Practical significance of the study. The main psychological factors of affective spectrum disorders and scientifically based targets of psychological assistance are identified, which must be taken into account by specialists working with patients suffering from these disorders. Diagnostic methods have been developed, validated and adapted, allowing specialists to identify factors of emotional disorders and identify targets for psychological help. A model of psychotherapy for affective spectrum disorders has been developed that integrates knowledge accumulated in various traditions of psychotherapy and empirical research. The objectives of psychoprophylaxis of affective spectrum disorders for children at risk, their families and specialists from educational and educational institutions are formulated. The results of the study are implemented:

In the practice of the clinics of the Moscow Research Institute of Psychiatry of the Russian Health Service, the Scientific Center for Mental Health of the Russian Academy of Medical Sciences, State Clinical Hospital No. 4 named after. Gannushkina and the City Clinical Hospital No. 13 of Moscow, into the practice of the Regional Psychotherapeutic Center at the Regional Psychotherapeutic Center at the Regional Clinical Clinical Hospital No. 2 of Orenburg and the Consultative and Diagnostic Center for the Mental Health of Children and Adolescents in Novgorod.

The results of the study are used in the educational process of the Faculty of Psychological Counseling and the Faculty of Advanced Training of the Moscow City Psychological and Pedagogical University, the Faculty of Psychology of Moscow State University. M.V. Lomonosov, Faculty of Clinical Psychology

Siberian State Medical University, Department of Pedagogy and Psychology of Chechen State University. Approbation of the study. The main provisions and results of the work were presented by the author at the international conference “Synthesis of Psychopharmacology and Psychotherapy” (Jerusalem, 1997); at the Russian national symposiums “Man and Medicine” (1998, 1999, 2000); at the First Russian-American Conference on Cognitive Behavioral Psychotherapy (St. Petersburg, 1998); at international educational seminars “Depression in the primary medical network” (Novosibirsk, 1999; Tomsk, 1999); at sectional sessions of the XIII and XIV Congresses of the Russian Society of Psychiatrists (2000, 2005); at the Russian-American symposium “Identification and treatment of depression in the primary medical network” (2000); at the First International Conference in Memory of B.V. Zeigarnik (Moscow, 2001); at the plenum of the board of the Russian Society of Psychiatrists within the framework of the Russian conference “Affective and schizoaffective disorders” (Moscow, 2003); at the conference “Psychology: modern trends interdisciplinary research”, dedicated to the memory of corresponding member. RAS A.V.Brushlinsky (Moscow, 2002); at the Russian conference “Modern trends in the organization of psychiatric care: clinical and social aspects"(Moscow, 2004); at the conference with international participation “Psychotherapy in the system of medical sciences in the period of its formation” evidence-based medicine"(St. Petersburg, 2006).

The dissertation was discussed at meetings of the Academic Council of the Moscow Research Institute of Psychiatry (2006), the Problem Commission of the Academic Council of the Moscow Research Institute of Psychiatry (2006) and the Academic Council of the Faculty of Psychological Counseling of the Moscow State University of Psychology and Education (2006).

Structure of the dissertation. The text of the dissertation is presented in 465 units, consists of an introduction, three parts, ten chapters, a conclusion, conclusions, a list of references (450 titles), an appendix, includes 74 tables, 7 figures.

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Conclusion of the dissertation on the topic “Medical Psychology”, Kholmogorova, Alla Borisovna

1. In various traditions of clinical psychology and psychotherapy, theoretical concepts have been developed and empirical data have been accumulated on the factors of mental pathology, including affective spectrum disorders, which complement each other, which necessitates the synthesis of knowledge and the tendency towards their integration at the present stage.

2. The methodological basis for the synthesis of knowledge in modern psychotherapy is a systematic approach and ideas about non-classical scientific disciplines, which involve the organization of various factors into blocks and levels, as well as the integration of knowledge based on the practical tasks of providing psychological assistance. Effective means of synthesizing knowledge about the psychological factors of affective spectrum disorders are a multifactorial psycho-social model of affective spectrum disorders, including macrosocial, family, personal and interpersonal levels and a four-aspect model of the family system, including structure, microdynamics, macrodynamics and ideology.

3. At the macrosocial level, there are two differently directed trends in the life of a modern person: an increase in the stressfulness of life and stress on the emotional sphere of a person, on the one hand, maladaptive values in the form of the cult of success, strength, well-being and perfection, which make it difficult to process negative emotions, on the other. These trends are expressed in a number of macrosocial processes leading to a significant prevalence of affective spectrum disorders and the emergence of risk groups in the general population.

3.1. A wave of social orphanhood against the background of alcoholism and family breakdown leads to pronounced emotional disturbances in children from dysfunctional families and social orphans, and the level of disturbances is higher in the latter;

3.2. An increase in the number of educational institutions with increased academic loads and perfectionistic educational standards leads to an increase in the number of emotional disorders in students (in these institutions their frequency is higher than in regular schools)

3.3. Promoted in media mass media perfectionistic standards of appearance (low weight and specific standards of proportions and body shapes) lead to physical perfectionism and emotional disorders in young people.

3.4. Gender-role stereotypes of emotional behavior in the form of a ban on the expression of asthenic emotions (anxiety and sadness) in men lead to difficulties in seeking help and receiving social support, which may be one of the reasons for secondary alcoholism and high rates of completed suicide in males.

4. General and specific psychological factors of depressive, anxiety and somatoform disorders can be systematized on the basis of a multifactorial model of affective spectrum disorders and a four-aspect model of the family system.

4.1. Family level. 1) structure: all groups are characterized by dysfunctions of the parental subsystem and the peripheral position of the father; for depressed people - disunity, for anxious ones - symbiotic relationships with the mother, for somatoforms - symbiotic relationships and coalitions; 2) microdynamics: all groups are characterized by a high level of conflicts, parental criticism and other forms of inducing negative emotions; for the depressed - the predominance of criticism over praise from both parents and communication paradoxes from the mother; for the anxious - less criticism and more support from the mother; for families of patients with somatoform disorders - elimination of emotions; 3) macrodynamics: all groups are characterized by the accumulation of stressful events in family history in the form of severe hardships in the lives of parents, alcoholism and serious illnesses of close relatives, presence at their illness or death, abuse and fights; in patients with somatoform disorders, early deaths of relatives are added to the increased frequency of these events. 4) ideology: all groups are characterized by the family value of external well-being and a hostile picture of the world; for depressed and anxious groups - a cult of achievements and perfectionistic standards. The most pronounced family dysfunctions are observed in patients with depressive disorders.

4.2. Personal level. Patients with affective spectrum disorders have high rates of prohibition on expressing feelings. Patients with somatoform disorders are characterized by a high level of alexithymia, a narrowed emotional vocabulary, and difficulties in recognizing emotions. For patients with anxiety and depressive disorders, there is a high level of perfectionism and hostility.

4.3. Interpersonal level. Interpersonal relationships of patients with affective spectrum disorders are characterized by a narrowing of the social network, a lack of close trusting relationships, low level emotional support and social integration in the form of identifying oneself as a member of a certain reference group. In patients with somatoform disorders, in contrast to anxiety and depressive disorders, there is no significant decrease in the level of instrumental support; the lowest rates of social support are in patients with depressive disorders.

4.4. Data from correlation and regression analysis indicate the mutual influence and systemic relationships of dysfunctions at the family, personal and interpersonal levels, as well as the severity of psychopathological symptoms, which indicates the need for their comprehensive consideration in the process of psychotherapy. The most destructive influence on the interpersonal relationships of adults is exerted by the pattern of eliminating emotions in the parental family, combined with the induction of anxiety and distrust of people.

5. Tested foreign methods: social support questionnaire (F-SOZU-22 G.Sommer, T.Fydrich), family system test (FAST, T.Ghering) and developed original questionnaires “Family Emotional Communications” (FEC), “Prohibition of Expression” feelings" (SHF), structured interviews "Stressful Events in Family History Scale", "Parental Criticism and Expectation" (RCE) and "Moscow Integrative Social Network Questionnaire" are effective tools for diagnosing dysfunctions at the family, personal and interpersonal levels, as well as identifying targets for psychotherapy .

6. The objectives of providing psychological assistance to patients with affective spectrum disorders, substantiated by theoretical analysis and empirical research, involve work at different levels - macrosocial, family, personal, interpersonal. In accordance with the means accumulated to solve these problems in different approaches, integration is carried out based on cognitive-behavioral and psychodynamic approaches, as well as a number of developments in domestic psychology (concepts of internalization, reflection, mediation) and systemic family psychotherapy. The basis for the integration of cognitive-behavioral and psychodynamic approaches is a two-level cognitive model developed in cognitive therapy by A. Beck.

6.1. In accordance with different tasks, two stages of integrative psychotherapy are distinguished: 1) development of emotional self-regulation skills; 2) work with the family context and interpersonal relationships. At the first stage, cognitive tasks dominate, at the second - dynamic ones. The transition from one stage to another involves the development of reflexive regulation in the form of the ability to stop, fix and objectify one’s automatic thoughts. Thus, a new organization of thinking is formed, which significantly facilitates and speeds up the work at the second stage.

6.2. The objectives of integrative psychotherapy and prevention of affective spectrum disorders are: 1) at the macrosocial level, debunking pathogenic cultural values (the cult of restraint, success and perfection); 2) at the personal level, developing emotional self-regulation skills through the gradual formation of reflexive ability; transformation of dysfunctional personal attitudes and beliefs - a hostile picture of the world, unrealistic perfectionist standards, a ban on the expression of feelings; 3) at the family level: working through (comprehension and response) traumatic life experiences and events in family history; work with current dysfunctions of the structure, microdynamics, macrodynamics and ideology of the family system; 4) at the interpersonal level", training of deficient social skills, development of the ability for close, trusting relationships, expansion of interpersonal connections.

6.3. Somatoform disorders are characterized by fixation on the physiological manifestations of emotions, a pronounced narrowing of the emotional vocabulary and difficulties in recognizing and verbalizing feelings, which determines the specificity of integrative psychotherapy for disorders with pronounced somatization in the form of an additional task of developing mental hygiene skills of emotional life.

6.4. Analysis of follow-up data of patients with affective spectrum disorders proves the effectiveness of the developed model of integrative psychotherapy (a significant improvement in social functioning and the absence of repeated visits to the doctor is noted in 76% of patients who completed a course of integrative psychotherapy in combination with drug treatment).

7. Risk groups for the occurrence of affective spectrum disorders in the child population include children from socially disadvantaged families, orphans and children studying in educational institutions with an increased educational load. Psychoprophylaxis in these groups involves solving a number of problems.

7.1. For children from disadvantaged families - social and psychological work on family rehabilitation and the development of emotional mental hygiene skills.

7.2. For orphans - social and psychological work on organizing family life with mandatory psychological support for the family and the child in order to process his traumatic experience in his birth family and successfully integrate into the new family system;

7.3. For children from educational institutions with an increased academic load - educational and advisory work with parents, teachers and children, aimed at correcting perfectionist beliefs, inflated demands and competitive attitudes, freeing up time for communication and establishing friendly relationships of support and cooperation with peers.

Conclusion

The data obtained contribute to clarifying the nature and status of affective spectrum disorders, which are the subject of heated debate among specialists. The high figures for comorbidity of depressive, anxiety and somatoform disorders presented in the first chapter indicate their common roots. Currently, an increasing number of studies confirm the complex multifactorial nature of these disorders and most leading experts adhere to systemic bio-psycho-social models, according to which, along with genetic and other biological factors, psychological and social play an important role.

The data obtained confirm the observations of specialists and empirical research data on the common psychological factors of these disorders: the important role of family traumatic experience, various family dysfunctions in the form of a high level of parental criticism and other types of induction of negative emotions. Based on the data from the study, we can talk not only about the traumatization of the patients themselves, but about the accumulation of stressful events in their family history. Many of the patients' parents had to endure severe hardships, there were alcoholic family scenarios, and psychological and physical violence was practiced in families.

The study of family factors in affective spectrum disorders also revealed many similarities in the structure, communication, family history, norms and values of the three clinical groups studied. Communication in such families is characterized by the induction of negative emotions through fixation on negative experiences and a high level of criticism. Accumulated negative emotions cannot be processed effectively, since another characteristic feature communication between family members is the elimination of emotions - a ban on open expression of feelings. It can be assumed that families develop certain compensatory strategies to process traumatic experiences. Closed boundaries, distrust of people, the cult of strength and restraint in the family form perfectionistic standards and high levels of hostility in children, which lead to various cognitive distortions that make an important contribution to the induction of negative affect.

These studies indicate the important role of traumatic experiences in family relationships in the genesis of affective spectrum disorders and their reproduction in subsequent generations. From this follows two most important goals of psychological work - processing this traumatic experience, on the one hand, and assistance in building a new system of relationships both in the family and with other people. The main defect of these relationships is the inability to have close, confidential contact. Such contact requires a culture of emotional self-expression and the ability to understand the emotions and experiences of other people. According to regression analysis data, it is the elimination of emotions in the parental family that makes the greatest contribution to violations of interpersonal relationships in adulthood. This leads to another important goal of working with these patients - the development of emotional psychohygiene skills, the ability to self-understanding, emotional self-regulation and trusting, close relationships. The identified targets determined the need to integrate different approaches.

I would like to especially emphasize the data regarding the peripheral role of the father in the modern family. Almost half of healthy people and the same percentage of patients rated their fathers as taking virtually no part in upbringing. In patients, these data are supplemented by a fairly high percentage of families where the father is aggressive and critical of the children. These data relate to another problem area of modern culture - the role of the father figure in raising children. Families of patients with affective disorders are characterized by profound violations of the parental subsystem - the relationship between parents.

So, the data obtained point to common psychological roots and testify in favor of a unitary approach to the status of depressive, anxiety and somatoform disorders, which is adhered to by many domestic specialists (Vertogradova, 1985; Krasnov, 2003; Smulevich, 2003). However, they also make it possible to identify certain specifics of these disorders and outline differentiated targets for psychotherapy.

The tendency to somatization and fixation on anxiety about health was associated with traumas related to damage to health - being present at the death or illness of loved ones, early deaths and serious illnesses. Somatization can be considered as a strategy for obtaining help - the level of instrumental support in these patients does not differ from healthy subjects. This may be an important reinforcer of somatization due to certain benefits associated with it. Disorders with severe somatization, including anxiety and depression, require a special psychotherapeutic approach aimed at overcoming the alexithymic barrier and developing emotional mental hygiene skills.

The most severe traumatic experience associated with a particularly high level of criticism and a ban on the expression of feelings, which often came from both parents, a large number of various stresses in the family history turned out to be characteristic of patients prone to depressive reactions. Depressed patients also suffer from deficits in social support and emotional intimacy more than patients in the other two groups. Patients with anxiety disorders were more likely to have symbiotic relationships and report more support from their mother.

Considering the ongoing wave of social orphanhood in Russia and the significant number of children deprived of parental care and experiencing violence and abuse, we can expect a rapid increase in the number of patients with severe depressive and personality disorders.

However, material security and external well-being of the family are not a guarantee of mental well-being. The percentage of children at risk with emotional disorders in elite gymnasiums is equal to that among social orphans. Perfectionistic standards and competition lead to the development of perfectionism as a personality trait and prevent the establishment of trusting relationships.

All identified macrosocial, family, personal and interpersonal factors represent a complex system of targets that require consideration in practical work. It is precisely the practical tasks of assistance that the integration of approaches should be subordinated to. The integration of psychotherapy methods, subordinated to practical tasks and built on theoretically and empirically substantiated targets of assistance, is evidence-based psychotherapy in accordance with the modern understanding of the status of non-classical scientific disciplines (Yudin, 1997; Shvyrev, 2004; Zaretsky, 1989). The integration of cognitive and dynamic approaches with the developments of Russian psychology on the role of reflection in the development of emotional self-regulation seems constructive for psychotherapy of affective spectrum disorders (Alekseev, 2002, Zaretsky, 1984, Zeigarnik, Kholmogorova, Mazur, 1989; Sokolova, Nikolaeva, 1995).

An important task for further research is to study the influence of the identified factors on the course of the disease and the process of treatment, both medicinal and psychotherapeutic. Particularly important is the need for further research into personality factors of affective spectrum disorders and further search for their specificity for anxiety, depressive and somatoform disorders.

List of references for dissertation research Doctor of Psychological Sciences Kholmogorova, Alla Borisovna, 2006

1. Ababkov V.A., Perret M. Adaptation to stress. Fundamentals of theory, diagnosis, therapy. St. Petersburg: Rech, 2004. - 166 p.

2. Averbukh E.S. Depressive states. L.: Medicine, 1962.

3. Adler A. Individual psychology, its hypotheses and results // Collection: Practice and theory of individual psychology. M.: Progress, 1995. - P. 18-38.

4. Aleksandrovsky Yu.A. On a systematic approach to understanding the pathogenesis of non-psychotic mental disorders and the substantiation of rational therapy for patients with borderline states // J. Therapy of mental disorders.-M.: Academy. 2006. - No. 1.-S. 5-10

5. Alekseev N.G. Cognitive activity in the formation of conscious problem solving // Author's abstract. diss. Ph.D. Psychol.Sc. M., 1975.

6. Alekseev N.G. Designing conditions for the development of reflective thinking // Diss. doc. psycho. Sci. M., 2002.

7. Alekseev N.G., Zaretsky V.K. Conceptual foundations for the synthesis of knowledge and methods in ergonomic support of activities // Ergonomics. M.: VNIITE, 1989. - No. 37. - P. 21-32.

8. Bannikov G.S. The role of personal characteristics in the formation of the structure of depression and maladaptation reactions // Abstract of thesis. diss. . Ph.D. honey. Sci. M., 1999.

9. Batagina G.Z. Depressive disorders as a cause of school maladaptation in adolescence // Abstract of thesis. diss. . Ph.D. honey. Sci. -M., 1996.

10. Bateson G., Jackson D., Haley J., Weakland J. Towards a theory of schizophrenia // Moscow. psychotherapeutic journal. -1993. No. 1. - P.5-24.

11. Beck A., Rush A., Shaw B., Emery G. Cognitive therapy for depression. -SPb.: Peter, 2003.-304 p.

12. Bobrov A.E. A combination of psycho- and pharmacotherapeutic approaches in the treatment of anxiety disorders // Materials of the international. conf. psychiatrists, February 16-18, 1998 - M.: Farmedinfo, 1998. - P. 201.

13. Bobrov A.E., Belyanchikova M.A. Prevalence and structure of mental disorders in families of women suffering from heart defects (longitudinal study) // Journal of Neuropathology and Psychiatry. -1999.-T. 99.-S. 52-55.

14. Bowlby J. Creation and destruction of emotional connections. M.: Academic project, 2004. - 232 p.

15. Bowen M. Theories of family systems. M.: Kogito-Center, 2005. - 496 p.

16. Varga A.Ya. Systemic family psychotherapy. St. Petersburg: Rech, 2001. -144 p.

17. Vasilyuk F.E. Methodological analysis in psychology. M.: Smysl, 2003.-240 p.

18. Wasserman L.I., Berebin. M.A., Kosenkov N.I. On a systematic approach to assessing mental adaptation // Review of Psychiatry and Medical Psychology named after. V.M. Bekhterev. 1994. -No. 3. - P. 16-25.

19. Vasyuk Yu.A., Dovzhenko T.V., Yushchuk E.N., Shkolnik E.JI. Diagnosis and treatment of depression in cardiovascular pathology. M.: GOUVUNMTs, 2004.-50 p.

20. Vein A.M., Dyukova G.M., Popova O.P. Psychotherapy in the treatment of vegetative crises (panic attacks) and psychophysiological correlates of its effectiveness // Social and clinical psychiatry. 1993. - No. 4. -S. 98-108.

21. Veltishchev D.Yu., Gurevich Yu.M. The importance of personal and situational factors in the development of depressive spectrum disorders // Methodological recommendations / Ed. Krasnova V.N. M., 1994. - 12 p.

22. Vertogradova O.P. Possible approaches to the typology of depression // Depression (psychopathology, pathogenesis). Proceedings of the Moscow Research Institute of Psychiatry. ed. ed.-M., 1980.-T. 91.-S. 9-16.

23. Vertogradova O.P. On the relationship between psychosomatic and affective disorders // Abstracts of reports to the V All-Russian. Congress of Neuropathologists and Psychiatrists. M., 1985. - T. 3. - P. 26-27.

24. Vertogradova O.P. Psychosomatic disorders and depression (structural-dynamic relationships) // Abstracts of reports for the VIII All-Russian. Congress of neurologists, psychiatrists and narcologists. M., 1988. - T. 3. - P. 226228.

25. Vertogradova O.P., Dovzhenko T.V., Vasyuk Yu.A. Cardiophobic syndrome (clinic, dynamics, therapy) // Collection: Mental disorders and cardiovascular pathology / Ed. Smulevich A.B. 1994. - pp. 19-28.

26. Vertogradova O.P. Anxiety-phobic disorders and depression // Anxiety and obsessions. M.: RAMN NCPZ, 1998. - P. 113 - 131.

27. View V.D. Parameters of the psychotherapeutic process and results of psychotherapy // Review of Psychiatry and Medical Psychology named after. V.M. Bekhtereva. 1994.-№2.-S. 19-26.

28. Voytsekh V.F. Dynamics and structure of suicides in Russia // Social and clinical psychiatry. 2006. - T. 16, No. 3. - pp. 22-28.

29. Volikova S.V. Systemic psychological characteristics of parental families of patients with depressive and anxiety disorders // Author's abstract. diss. Ph.D. psycho. Sci. M., 2005.

30. Volikova S.V., Kholmogorova A.B. Galkina A.M. Parental perfectionism is a factor in the development of emotional disorders in children studying in complex programs // Questions of psychology. - 2006. -№5.-S. 23-31.

31. Volovik V.M. Study of families of mentally ill people and family problems in mental disorders. // Clinical and organizational basis for the rehabilitation of mentally ill patients. M., 1980. -S. 223-257.

32. Volovik V.M. On the functional diagnosis of mental illnesses // New in the theory and practice of rehabilitation of mentally ill patients.-L., 1985.-P.26-32.

33. Vygotsky L.S. Historical meaning of the psychological crisis // Collection. op. in 6 volumes. M.: Pedagogy, 1982 a. - T.1. Questions of theory and history of psychology. - P. 291-436.

34. Vygotsky L.S. Consciousness as a problem in the psychology of behavior // Collection. op. in 6 volumes - M.: Pedagogy, 1982 b. T.1. Questions of theory and history of psychology. - P. 63-77.

35. Vygotsky JT.C. Problem mental retardation// Collection op. in 6 volumes - M.: Pedagogika, 1983. T. 5. Fundamentals of defectology. - pp. 231-256.

36. Galperin P.Ya. Development of research on the formation of mental actions // Psychological science in the USSR. M., 1959. - T. 1.

37. Garanyan N.G. Practical aspects of cognitive psychotherapy // Moscow Psychotherapeutic Journal. 1996. - No. 3. - P. 29-48.

38. Garanyan N.G. Perfectionism and mental disorders (review of foreign empirical studies) // Therapy of mental disorders. M.: Academy, 2006. -No. 1.-S. 31-41.

39. Garanyan N.G., Kholmogorova A.B., Integrative psychotherapy for anxiety and depressive disorders // Moscow Psychotherapeutic Journal. 1996.-No.3.-S. 141-163.

40. Garanyan N.G. Kholmogorova A.B., The effectiveness of the integrative cognitive-dynamic model of affective spectrum disorders // Social and clinical psychiatry. 2000. - No. 4. - P. 45-50.

41. Garanyan N.G. Kholmogorova A.B. The concept of alexithymia (review of foreign studies) // Social and clinical psychiatry. 2003. -№ i.-c. 128-145

42. Garanyan N.G., Kholmogorova A.B., Yudeeva T.Yu. Perfectionism, depression and anxiety // Moscow Psychotherapeutic Journal. 2001. -№4.-S. 18-48.

43. Garanyan N.G., Kholmogorova A.B., Yudeeva T.Yu. Hostility as personal factor depression and anxiety // Collection: Psychology: modern directions of interdisciplinary research. M.: Institute of Psychology of the Russian Academy of Sciences, 2003. -P.100-113.

44. Gorokhov V.G. Knowing to Do: The History of the Engineering Profession and Its Role in Modern Culture. M.: Knowledge, 1987. - 176 p.

45. Goffman A.G. Clinical narcology. M.: Miklos, 2003. - 215 p.

46. Gurovich I.Ya., Shmukler A.B., Storozhakova Ya.A. Psychosocial therapy and psychosocial rehabilitation in psychiatry. M., 2004. - 491 p.

47. Dozortseva E.G. Mental trauma and social functioning in adolescent girls with delinquent behavior // Russian Psychiatric Journal. 2006. - No. 4.- P. 12-16

48. Eresko D.B., Isurina G.L., Kaidanovskaya E.V., Karvasarsky B.D., Karpova E.B. and others. Alexithymia and methods for its determination in borderline psychosomatic disorders // Methodological manual. St. Petersburg, 1994.

49. Zaretsky V.K. Dynamics of level organization of thinking when solving creative problems // Author's abstract. diss. Ph.D. psycho. Sci. M., 1984.

50. Zaretsky V.K. Ergonomics in the system of scientific knowledge and engineering activities // Ergonomics. M.: VNIITE, 1989. - No. 37. - P. 8-21.

51. Zaretsky V.K., Kholmogorova A.B. Semantic regulation of solving creative problems // Study of problems in the psychology of creativity. M.: Nauka, 1983.-P.62-101

52. Zaretsky V.K., Dubrovskaya M.O., Oslon V.N., Kholmogorova A.B. Ways to solve the problem of orphanhood in Russia. M., LLC “Questions of Psychology”, 2002.-205 p.

53. Zakharov A.I. Neuroses in children and adolescents. L.: Medicine, 1988. -248 p.

54. Zeigarnik B.V. Pathopsychology. M., Moscow University Publishing House, 1986. - 280 p.

55. Zeigarnik B.V., Kholmogorova A.B. Violation of self-regulation of cognitive activity in patients with schizophrenia // Journal of Neuropathology and Psychiatry named after. S.S. Korsakov. 1985.-No. 12.-S. 1813-1819.

56. Zeigarnik B.V., Kholmogorova A.B., Mazur E.S. Self-regulation of behavior in normal and pathological conditions // Psychol. magazine. 1989. -No. 2.- P. 122-132

57. Iovchuk N.M. Child and adolescent mental disorders. M.: NTSENAS, 2003.-80 p.

58. Isurina G.L. Group psychotherapy for neuroses (methods, psychological mechanisms therapeutic effect, dynamics of individual psychological characteristics). // Author's abstract. diss. . Ph.D. psycho. Sci. L., 1984.

59. Isurina G.L., Karvasarsky B.D., Tashlykov V.A., Tupitsyn Yu.Ya. Development of the pathogenetic concept of neuroses and psychotherapy by V.N. Myasishcheva at the present stage // Theory and practice of medical psychology and psychotherapy. St. Petersburg, 1994. - pp. 109-100.

60. Kabanov M.M. Psychosocial rehabilitation and social psychiatry. St. Petersburg, 1998. - 255 s.

61. Kalinin V.V., Maksimova M.A. Modern ideas about phenomenology, pathogenesis and therapy anxiety states// Journal of Neuropathology and Psychiatry named after. S.S. Korsakov. 1994. - T. 94, No. 3. - P. 100-107.

62. Kannabikh Yu. V. History of psychiatry. - M., TsTR IGP VOS, 1994. - 528 p.

63. Karvasarsky B.D. Psychotherapy. SPb. - M. - Kharkov - Minsk: Peter, 2000.-536 p.

64. Karvasarsky B.D., Ababkov V.A., Isurina G.L., Kaidanovskaya E.V., Melik-Parsadanov M.Yu., Poltorak S.V., Stepanova N.G., Chekhlaty E.I. . The relationship between long-term and short-term psychotherapy methods for neuroses. / Manual for doctors. St. Petersburg, 2000. 10 p.

65. Carson R., Butcher J., Mineka S. Abnormal psychology. St. Petersburg: Peter, 2004.- 1167 p.

66. Kim L.V. Cross-cultural study of depression among adolescents of ethnic Koreans - residents of Uzbekistan and the Republic of Korea // Author's abstract. diss. . Ph.D. honey. Sci. - M.: Moscow Research Institute of Psychiatry, Ministry of Health of the Russian Federation, 1997.

67. Kornetov N.A. On the typology of initial manifestations of mono and bipolar affective disorders // Abstracts of reports. scientific conf. "Endogenous depression (clinic, pathogenesis)." Irkutsk, September 15-17 1992. -Irkutsk, 1992.-S. 50-52.

68. Kornetov N.A. Depressive disorders. Diagnostics, systematics, semiotics, therapy. Tomsk: Tomsk University Publishing House, 2000.

69. Korobeinikov I.A. Features of socialization of children with mild forms of mental underdevelopment // Author's abstract. diss. . doc. psycho. Sci. -M. 1997.

70. Krasnov V.N. On the issue of predicting the effectiveness of depression therapy // Collection: Early diagnosis and prognosis of depression. M.: Moscow Research Institute of Psychiatry, Ministry of Health of the Russian Federation, 1990.-90-95 p.

71. Krasnov V.N. Program "Identification and treatment of depression in the primary medical network" // Social and clinical psychiatry. 2000. - No. 1. -S. 5-9.

72. Krasnov V.N. Organizational issues of helping patients with depression //Psychiatrist and psychopharmacist.-2001a.-T. 3.-No.5.-P.152-154

73. Krasnov V.N. Psychiatric disorders in general medical practice. Russian Medical Journal, 20016, No. 25, pp. 1187-1191.

74. Krasnov V.N. The place of affective spectrum disorders in modern classification // Materials of Ross. conf. "Affective and schizoaffective disorders." M., 2003. - pp. 63-64.

75. Kryukova T.L. Psychology of coping behavior // Monograph. -Kostroma: Avantitul, 2004.- 343 p.

76. Kurek N.S. Study of the emotional sphere of patients with schizophrenia (using the model of recognition of emotions by non-verbal expression) // Journal of Neuropathology and Psychiatry named after. S.S. Korsakov. -1985.- No. 2.- P. 70-75.

77. Kurek N.S. Deficit of mental activity: personality passivity and illness. Moscow, 1996.- 245 p.

78. Lazarus A. Short-term multimodal psychotherapy. St. Petersburg: Rech, 2001.-256 p.

79. Langmeier J., Matejczyk 3. Mental deprivation in childhood. Prague, Avicenum, 1984. - 336 p.

80. Lebedinsky M.S., Myasishchev V.N. Introduction to medical psychology. L.: Medicine, 1966. - 430 p.

81. Leontyev A.N. Activity. Consciousness. Personality. M., 1975. - 95 p.

82. Lomov B. F. On the systems approach in psychology // Questions of psychology. 1975. - No. 2. - P. 32-45.

83. Lyubov E.B., Sarkisyan G.B. Depressive disorders: pharmacoepidemiological and clinical-economic aspects // Social and clinical psychiatry. 2006. - T. 16, No. 2. -P.93-103.

84. WHO materials. Mental health: new understanding, new hope // World Health Report / WHO. 2001.

85. International classification of diseases (10th revision). Class V = Mental and behavioral disorders (F00-F99) (adapted for use in the Russian Federation) (part 1). Rostov-on-Don: LRRC "Phoenix", 1999.

86. Möller-Leimküller A.M. Stress in society and stress-related disorders in the aspect of gender differences // Social and clinical psychiatry. 2004. - T. 14. - No. 4. - P. 5-12.

87. Minukhin S., Fishman Ch. Family therapy techniques. -M.: Class, 1998 -304 p.

88. Mosolov S.N. Clinical use of modern antidepressants. St. Petersburg: Medical Information Agency, 1,995,568 p.

89. Mosolov S.N. Resistance to psychopharmacotherapy and methods of overcoming it // Psychiatrist and psychopharmacist, 2002. No. 4. - With. 132 - 136.

90. Munipov V.M., Alekseev N.G., Semenov I.N. The emergence of ergonomics as scientific discipline// Ergonomics. M.: VNIITE, 1979. - No. 17. -from 2867.

91. May R. The meaning of anxiety. M.: Klass, 2001. - 384 p.

92. Myasishchev V.N. Personality and neuroses. L., 1960.

93. Nemtsov A.V. Alcohol mortality in Russia 1980-90s. m 2001.- S.

94. Nikolaeva V.V. On the psychological nature of alexithymia // Human corporeality: interdisciplinary research. - M., 1991. pp. 80-89.

95. Nuller Yu.L. Depression and depersonalization. L., 1981. - 207 p.

96. Obukhova L.F. Age-related psychology. M., 1996, - 460 p.

97. Oslon V.N., Kholmogorova A.B. Professional foster family as one of the most effective models for solving the problem of orphanhood in Russia // Questions of psychology. 2001 a - No. 3. - P.64-77.

98. Oslon V.N., Kholmogorova A.B. Psychological support for a substitute professional family // Questions of psychology. 20О 1 b. - No. 4. - P.39-52.

99. Oslon V.N. Replacement professional family as a condition for compensation of deprivation disorders in orphans. // Author's abstract. diss. . Ph.D. psycho. Sci. M. - 2002.

100. Palazzoli M., Boscolo L., Cequin D., Prata D. Paradox and counter-paradox: A new model for therapy of families involved in schizophrenic interaction. M.: Cogito-Center, 2002. - 204 p.

101. Pervin L., John O. Personality psychology: theory and research. -M.: AspectPress, 2001. 607 p.

102. Perret M., Bauman U. Clinical psychology. 2nd int. ed. - St. Petersburg: Peter, 2002.- 1312 p.

103. Podolsky A.I., Idobaeva O.A., Heymans P. Diagnosis of adolescent depression. St. Petersburg: Peter, 2004. - 202 p.

104. Polishchuk Yu.I. Current issues in borderline gerontopsychiatry // Social and clinical psychiatry. 2006.- T. 16, No. 3.- P. 12-17.

105. Parishioners A.M. Anxiety in children and adolescents: psychological nature and age dynamics. M.: MPSI, 2000. - 304 p.

106. Parishioner A.M., Tolstykh N.N. Psychology of orphanhood. 2nd ed. - St. Petersburg: Peter, 2005.-400 p.

107. Bubbles A.A. Psychology. Psychotechnics. Psychogogy. M.: Smysl, 2005.-488 p.

108. Rogers K.R. Client-centered therapy. M.: Wakler, 1997. -320 p.

109. Rotshtein V.G., Bogdan M.N., Suetin M.E. Theoretical aspect of the epidemiology of anxiety and affective disorders // Psychiatry and psychopharmacotherapy. J-l for psychiatrists and general practitioners. M.: NCPZ RAMS, PND No. 11, 2005. - T. 7, No. 2. - P.94-95

110. Samukina N.V. Symbiotic aspects of the relationship between mother and child // Questions of psychology. 2000. - No. 3.- P. 67-81.

111. Safuanov F.S. Features of the regulation of the activities of psychopathic individuals by semantic (motivational) attitudes // Journal of neuropathology. and psychiatrist, named after. S.S. Korsakov. 1985. - V.12. - S. 1847-1852.

112. Semenov I.N. Systematic study of thinking in solving creative problems // Author's abstract. diss. Ph.D. psycho. Sci. M, 1980.

113. Semke V.Ya. Preventive psychiatry. Tomsk, 1999. - 403 p.

114. Skärderud F. Anxiety. A journey into yourself. Samara: Publishing house. house "Bahram-M", 2003.

115. Smulevich A.B. Depression in somatic and mental illnesses. M.: Medical Information Agency, 2003. - 425 p.

116. Smulevich A.B., Dubnitskaya E.B., Tkhostov A.Sh. et al. Psychopathology of depression (towards the construction of a typological model) // Depression and comorbid disorders. M., 1997. - P. 28-54

117. Smulevich A.B., Rotshtein V.G., Kozyrev V.N. and others. Epidemiological characteristics of patients with anxiety-phobic disorders // Anxiety and obsessions. M.: RAMN NCPZ, 1998. - P.54 - 66

118. Sokolova E.T. Self-awareness and self-esteem in personality anomalies. -M., 1989.

119. Sokolova E.T. Psychotherapy theory and practice. M.: Academy, 2002. -366 p.

120. Sokolova E.T., Nikolaeva V.V. Personality features in borderline disorders and somatic diseases. M.: SvR - Argus, 1995.-360 p.

121. Spivakovskaya A.S. Prevention of childhood neuroses. - M.: MSU, 1988. -200 p.

122. Starshenbaum G.V. Suicidology and crisis psychotherapy. M.: Kogito-Center, 2005. - 375 p.

123. Stepin B.C. The formation of scientific theory. Minsk: BSU. - 1976.

124. Tarabrina N.V. Workshop on the psychology of post-traumatic stress. Moscow: “Cogito-Center”, 2001. - 268 p.

125. Tashlykov V.A. Interior picture diseases in neuroses and its significance for therapy and prognosis. // Author's abstract. diss. . doc. honey. Sci. JI, 1986.

126. Tiganov A.S. Endogenous depression: issues of classification and systematics. In: Depression and comorbid disorders. - M., 1997. P.12-26.

127. Tiganov A.S. Affective disorders and syndrome formation // Journal of neurology. and psychiatrist. - 1999. No. 1, pp. 8-10.

128. Tikhonravov Yu.V. Existential psychology. M.: JSC "Business School" Intel-Sintez", 1998. - 238 p.

129. Tukaev R.D. Mental trauma and suicidal behavior. Analytical review of literature from 1986 to 2001 // Social and clinical psychiatry. - 2003. No. 1, p. 151-163

130. Tkhostov A.Sh. Depression and psychology of emotions // Collection: Depression and comorbid disorders. M.: RAMN NCPZ, 1997. - P. 180 - 200.

131. Tkhostov A.Sh. Psychology of physicality. M.: Smysl, 2002.-287 p.

132. Fenichel O. Psychoanalytic theory of neuroses. M: Academic Project, 2004. - 848 p.

133. Frankl V. The will to meaning. M.: April-Press - EKSMO-Press, 2000. -368 p.

134. Freud 3. Sadness and melancholy // Collection: Drives and their fate. M.: EKSMO-Press, 1999. - 151-177 p.

135. Heim E., Blaser A., Ringer X., Tommen M. Problem-oriented psychotherapy. Integrative approach. M., Klass, 1998.

136. Kholmogorova A.B. Education and health // Possibilities for the rehabilitation of children with mental and physical disabilities through education / Ed. V.I. Slobodchikova. M.: ILI RAO, 1995. -S. 288-296.

137. Kholmogorova A.B. The influence of emotional communication mechanisms in the family on development and health // Approaches to the rehabilitation of children with special needs through education / Ed.

138. V.I.Slobodchikova.-M.: ILI RAO, 1996.-P. 148-153.

139. Kholmogorova A.B. Health and family: a model for analyzing the family as a system // Development and education of special children / Ed. V.I. Slobodchikova. -M.: ILI RAO, 1999. P. 49-54.

140. Kholmogorova A.B. Methodological problems of modern psychotherapy // Bulletin of psychoanalysis. 2000. - No. 2. - P. 83-89.

141. Kholmogorova A.B. Cognitive psychotherapy and prospects for its development in Russia // Moscow Psychotherapeutic Journal. 2001 a. -No. 4.-S. 6-17.

142. Kholmogorova A.B. Cognitive psychotherapy and domestic psychology of thinking // Moscow Psychotherapeutic Journal. 2001 b. - No. 4.- P. 165-181.

143. Kholmogorova A.B. Scientific foundations and practical tasks of family psychotherapy // Moscow Psychotherapeutic Journal. 2002 a. - No. 1.1. P.93-119.

144. Kholmogorova A.B. Scientific foundations and practical tasks of family psychotherapy (continued) // Moscow Psychotherapeutic Journal. -2002 b. No. 2. - pp. 65-86.

145. Kholmogorova A.B. Bio-psycho-social model as a methodological basis for research into mental disorders // Social and clinical psychiatry. 2002 c. - No. 3.

146. Kholmogorova A.B. Personality disorders and magical thinking // Moscow Psychotherapeutic Journal. 2002 - No. 4. - P. 80-90.

147. Kholmogorova A.B. Multifactorial psychosocial model as the basis for integrative psychotherapy of affective spectrum disorders // Materials of the XIV Congress of Psychiatrists of Russia, November 15-18, 2005. M., 2005. -P. 429

148. Kholmogorova A.B., Bochkareva A.V. Gender factors of depressive disorders // Materials of the XIV Congress of Psychiatrists of Russia, November 15-18, 2005-M., 2005.-P. 389.

149. Kholmogorova A.B., Volikova S.V. Emotional communications in families of patients with somatoform disorders // Social and clinical psychiatry. 2000 a. - No. 4. - P. 5-9.

150. Kholmogorova A.B., Volikova S.V. Features of families of somatoform patients // Materials of the XIII Congress of Psychiatrists of Russia, October 10-13, 2000 - M., 2000 b.-S. 291.

151. Kholmogorova A.B., Volikova S.V. Family sources of negative cognitive schema in emotional disorders (using the example of anxiety, depressive and somatoform disorders) // Moscow Psychotherapeutic Journal. - 2001. No. 4. - P. 49-60.

152. Kholmogorova A.B., Volikova S.V. Family context of affective spectrum disorders // Social and clinical psychiatry. 2004. - No. 4.-S. 11-20.

153. Kholmogorova A.B., Volikova S.V., Polkunova E.V. Family factors of depression // Questions of psychology. 2005. - No. 6. - P. 63-71

154. Kholmogorova A.B., Garanyan N.G. Group psychotherapy for neuroses with somatic masks(part 1). Theoretical and experimental substantiation of the approach // Moscow Psychotherapeutic Journal. 1994. -No. 2. - P. 29-50.

155. Kholmogorova A.B., Garanyan N.G. Group psychotherapy of neuroses with somatic masks, (part 2). Targets, stages and techniques of psychotherapy of neuroses with somatic masks // Moscow Psychotherapeutic Journal. - 1996 a. No. 1. - pp. 59-73.

156. Kholmogorova A.B., Garanyan N.G. Integration of cognitive and dynamic approaches using the example of psychotherapy for somatoform disorders //MPZh. 1996 b. - No. 3. - P. 141-163.

157. Kholmogorova A.B., Garanyan N.G. Multifactorial model of depressive, anxiety and somatoform disorders // Social and clinical psychiatry. 1998 a. -No. 1. - P. 94-102.

158. Kholmogorova A.B., Garanyan N.G. The use of self-regulation in affective spectrum disorders. Methodological recommendations No. 97/151. M: Ministry of Health of the Russian Federation, 1998 b. - 22 s.

159. Kholmogorova A.B., Garanyan N.G. Culture, emotions and mental health// Questions of psychology. 1999 a. - No. 2. - P. 61-74.

160. Kholmogorova A.B., Garanyan N.G. Emotional disorders in modern culture // Moscow Psychotherapeutic Journal. 1999 b.-№2.-S. 19-42.

161. Kholmogorova A.B., Garanyan N.G. Cognitive-behavioral psychotherapy // Main directions of modern psychotherapy. // Uch. allowance / Ed. A.M. Bokovikov. M., "Cogito-Center", 2000. - P. 224267.

162. Kholmogorova A.B., Garanyan N.G. Principles and skills of mental hygiene of emotional life // Psychology of motivation and emotions. (Series: Reader on Psychology) / Ed. Yu.B. Gippenreiter and M.V. Falikman. -M., 2002.-S. 548-556.

163. Kholmogorova A.B., Garanyan N.G. Psychological help people who have experienced traumatic stress. -M.: Unesco. MGPPU, 2006. 112 p.

164. Kholmogorova A.B., Garanyan N.G., Dovzhenko T.V., Volikova S.V., Petrova G.A., Yudeeva T.Yu. Concepts of somatization: history and current state // Social and clinical psychiatry. 2000. - No. 4. - P. 81-97.

165. Kholmogorova A.B., Garanyan N.G., Dovzhenko T.V., Krasnov V.N. The role of psychotherapy in the complex treatment of depression in the primary medical network // Materials of Ross. conf. "Affective and schizoaffective disorders", October 1-3, 2003. -M., 2003. P. 171.

166. Kholmogorova A.B., Garanyan N.G., Petrova G.A. Social support as a subject of scientific study and its impairment in patients with affective spectrum disorders // Social and clinical psychiatry. 2003. - No. 2.-S. 15-23.

167. Kholmogorova A.B., Garanyan N.G., Petrova G.A., Yudeeva T.Yu. Short-term cognitive-behavioral psychotherapy for depression in the primary medical network // Materials of the XIII Congress of Psychiatrists of Russia, October 10-13, 2000. M., 2000. - P. 292.

168. Kholmogorova A.B., Dovzhenko T.V., Garanyan N.G., Volikova S.V., Petrova G.A., Yudeeva T.Yu. Interaction of team specialists in the complex treatment of mental disorders // Social and clinical psychiatry. 2002. - No. 4.-S. 61-65.

169. Kholmogorova A.B., Drozdova S.G. Suicidal behavior in the student population // Materials of the XIV Congress of Psychiatrists of Russia, November 15-18, 2005. M., 2005. - P. 396.

170. Horney K. Neurotic personality of our time. M.: Progress - Univers, 1993.-480 p.

171. Horney K. Our internal conflicts. Neurosis and personality development // Collected works in 3 volumes. M.: Smysl, 1997. - T. 3. - 696 p.

172. Chernikov A.V. Integrative model of systemic family psychotherapeutic diagnostics // Family psychology and family therapy (thematic application). M., 1997. - 160 p.

173. Shvyrev V.S. Rationality as a philosophical problem. // In: Pruzhinin B.I., Shvyrev B.S. (ed.). Rationality as a subject of philosophical research. M., 1995. - P.3-20

174. Chignon J.M. Epidemiology and basic principles of therapy for anxiety disorders // Synapse. -1991. No. 1. - pp. 15-30.

175. Shmaonova JI.M. Neuroses // Handbook of psychiatry, 2nd ed., revised. and additional / Ed. A.V. Snezhnevsky. - M.: Medicine, 1985. - P.226-233.

176. Eidemiller E.G., Justitskis V. Psychology and psychotherapy of the family. - St. Petersburg: Peter, 2000.-656 p.

177. Yudeeva T.Yu., Petrova G.A., Dovzhenko T.V., Kholmogorova A.B. Derogatis scale (SCL-90) in the diagnosis of somatoform disorders // Social and clinical psychiatry. 2000. - T. 10, No. 4. -WITH. 10-16.

178. Yudin E.G. Systematic approach and operating principle. Methodological problems modern science. M.: Nauka, 1978. - 391 p.

179. Yudin E.G. Methodology of science. Systematicity. Activity. M.: Editorial URSS, 1997. - 444 p.

180. Abraham K. Notes on the psycho-analytic investigation and treatment of manic-depressive insanity and allied conditions // In: Selected Papers on PsychoAnalysis. London: Hogarth Press and Institute of Psycho-Analysis, 1911.

181. Akiskal H., Hirschfeild R.M., Yerevanian V.: The relationship of personality to affective disorders: a critical review // Arch. Gen. Psychiat. 1983. - Vol. 40 - P. 801-810.

182. Akiskal H., McKinney W. Overview of recent research in depression: integration of ten conceptual models into a comprehensive clinical frame // Arch. Gen. Psychiat. 1975. - Vol. 32, No. 2. - P. 285-305.

183. Akiskal H., Rosenthal T., Haykal R., et al. Characterological depressions: clinical and sleep EEG findings separating “subaffective dysthymias” from character-spectrum” disorders // Arch. Gen. Psychiat. 1980 - Vol. 37. - P. 777783.

184. Alford B.A., Beck A.T. The integrative power of cognitive therapy. New York-London: The Gilford Press, 1997.- P.197.

185. Allgulander C., Burroughs T., Rice J.P., Allebeck P. Antecedents of Neurosis in a Cohort of 30,344 Twins in Sweden // Anxiety. -1994/1995. Vol. 1. -P. 175-179.

186. Angst J., Ernst C. Geschlechtunterschiede in der Psychiatrie // Weibliche Identitaet im Wandel. Studium Generate 1989/1990. Ruprecht-Karls-Universitaet Heidelberg, 1990. - S. 69-84.

187. Angst J., Merikangas K.R., Preisig M. Subthreshold syndromes of depression and anxiety in the community // J. Clin. Psychiatry. 1997. - Vol. 58, Suppl. 8. - P. 6-40.

188. Apley J. The Child With Abdominal Pains. Blackwell: Oxford, 1975.

189. Arietti S., Bemporad J. Depression. Stuttgart: Klett-Cotta, 1983. - 505 P.

190. Arkowitz H. Integrative theories of therapy. History of Psychotherapy. / In D.K. Freedhein (ed.). Washington: American Psychiatric Association, 1992. - P. 261-303.

191. Bandura A.A. Self-efficacy: Toward a unifying theory of behavior change // Psychological Review. 1977. - Vol. 84. - P. 191-215.

192. Barlow D.H. Anxiety and its disorders: The nature and treatment of anxiety and panic. N.Y.: Guiford. - 1988.

193. Barlow D.H. & Cerny J.A. Psychological treatment of panic: Treatment manuals for practitioners. N.Y.: Guilford. - 1988.

194. Barsky A.J., Coeytaux R.R., Sarnie M.K. & Cleary P.D. Hypochondriacal patients beliefs about good health // American Journal of Psychiatry. 1993. -Vol. 150.-P.1085-1089

195. Barsky, A. J., Geringer E. & Wool C. A. A cognitive-educational treatment for hypochondriasis // General hospital Psychiatry. 1988. - Vol. 10. - P. 322327.

196. Barsky A.J., Wyshak G.L. Hypochodriasis and somatosensoiy amplification // Brit. Jornal of Psychiatry 1990. - Vol.157. - P.404-409

197. Beck A.T. Cognitive therapy and emotional disorders. New York: American books, 1976.

198. Beck A.T., Emery G. Anxiety disorders and phobias. A cognitive perspective. New York: Basic books, 1985.

199. Beck A., Rush A., Shaw V., Emery G. Cognitive therapy of depression. -New York: Guilford, 1979.

200. Beck A., Rush A., Shaw V., Emery G. Cognitive therapy for depression. -Weinheim: BeltzPVU, 1992.

201. Beck A.T., Steer R.A. Beck Anxiety Inventory. San Antonio: The Psychological Cooperation, 1993.

202. Berenbaum H., James T. Correlates and retrospectively reported antecedents of alexithymia // Psychosom. Med. 1994. - Vol. 56. - P. 363-359.

203. Bibring E. The mechanism of depression. / In: Greenacre, P. (Ed.). Affective disorders. N.Y.: International Univ. Press, 1953.

204. Bifulco A., Brown G.W., Adler Z. Early sexual abuse and clinical depression in adult life // British Journal of Psychiatry. -1991. Vol. 159. - P. 115122.

205. Blatt S.J. The destructiveness of perfectionism // American Psychologist. -1995.- Vol.50.- P. 1003-1020.

206. Blatt S. & Felsen I. Different kinds of folks may need different kinds of strokes: The effect of patient's characteristics on therapeutic process and outcome // Psychotherapy Research. 1993. - Vol. 3. - P. 245-259 .

207. Blatt S.J., Homann E. Parent-child interaction in the etiology of dependent and self-critical depression // Clinical Psychology Review. 1992. - Vol. 12. - P. 47-91.

208. Blatt S., Wein S. Parental representation and depression in normal young adults // J-l Abnorm. Psychol. 1979. - Vol. 88, No. 4. - P. 388-397.

209. Bleichmar H.B. Some subtypes of depression and their implications for psychoanalytic treatment // Int. Psycho-Anal. 1996. - Vol. 77. - P. 935-960.

210. Blumer D. & Heilbronn M. The pain prone disorder: a clinical and psychological profile // Psychosomatics. -1981. Vol. 22.

211. Bohmann M., Cloninger R., Knorring von A.-L. & Sigvardsson S. An adoption study of somatoform disorders. Cross-fistering analysis and genetic relationship to alcoholism and criminality // Arch. Gen. Psychiat. 1984. - Vol. 41.-P. 872-878.

212. Bowen M. Family therapy in clinical practice. New York: Jason Aronson, 1978.

213. Bowlby J. Maternal Care and Mental Health. Geneva: World Health Organization, 1951.

214. Bowlby J. Attachment and loss: Separation: anxiety and anger. New York: Basic Books, 1973. - Vol. 2. - P.270.

215. Bowlby J. Attachment and loss: Loss, sadness and depression. New York: Basic Books, 1980. - Vol. 3. - P. 472.

216. Bradley B.P., Mogg K.M., Millar N. & White J. Selective processing of negative information: Effects of clinical anxiety, concurrent depression and awareness // J. of Abnormal Psychology. 1995. - Vol. 104, No. 3. - P. 532-536.

217. Brooks R.B., Baltazar P.L. and Munjack D.J. Co-occurrence of personality disorders with panic disorder, social phobia and generalized anxiety disorder: A review of the literature //J. of Anxiety Disorders. 1989. - Vol. 1. - P. 132-135.

218. Brown G.W., Harris T.O. Social origins of depression. London: Free Press, 1978.

219. Brown G.W., Harris T.O. Loss of parent in childhood and adult psychiatric disorder a tentative overall model // Development and Psychopathology. 1990. -Vol. 2.-P. 311-328.

220. Brown G.W., Harris T.O., Bifulco A. Long-term effects of early loss of parenthood./ In: Depression in young people: developmental and clinical perspectives. -New York: The Guilford Press, 1986.

221. Brown G.W., Harris T.O., Eales M.J. Atiology of anxiety and depressive disorders in an inner-city population. Comorbidity and adversity // Psychological Med. 1993. - Vol. 23. - P. 155-165.

222. Brown G.W., Morgan P. Clinical and psychosocial origins of chronic depressive episodes // British Journal of Psychiatry. 1994. - Vol. 165. - P. 447456.

223. Brugha T. Social support // Current Opinion in Psychiatry. 1988. - Vol. 1. -P. 206-211.

224. Brugha T. Social support and psychiatric disorders: overview of evidence./ In: Social support and psychiatric disorders. Cambridge: University Press, 1995.

225. Burns D. The spouse who is a perfectionist. // Medical aspects of human sexuality. 1983. - Vol. 17. - P. 219-230.

226. Caplan G. Support Systems // Support Systems and Community Mental Health / Ed. by G. Caplan. N.Y.: Basic Books, 1974.

227. Cassel J. The contribution of the social environment to host resistance // American Journal of Epidemiology. 1976. - Vol. 104.-P. 115-127.

228. Cathebras P.J., Robbins J.M. & Haiton B.C. Fatigue in primary care: prevalence, psychiatric comorbidity, illness behavior, and outcome // Journal Gen Intern Med.-1992.-vol.7.

229. Champion L.A., Goodall G.M. , Rutter M. Behavior problems in childhood and acute and chronic stressors in early adult life: I. A twenty year follow-up study // Psychological Medicine. 1995. - P. 66 - 70.

230. Clark D.A., Beck A.T. & Alford B.A. Cognitive theory and therapy of depression. New York: Wiely, 1999.

231. Clark L., Watson D. Tripartite model of anxiety and depression: Psychometric evidence and taxonomic implications // Journal of Abnormal Psychology. -1991.-Vol. 100.-P. 316-336.

232. Cloninger C.R. A systematic method for clinical description and classification of personality variants // Arch. Gen. Psychiat. 1987. - Vol. 44. - P. 573-588.

233. Compton A. A study of the psychoanalytic theory of anxiety. I. Developments in the theory of anxiety // J. Am. Psychoanal. Assoc. 1972 a. -Vol. 20.-P. 3-44.

234. Compton A. A study of the psychoanalytic theory of anxiety. II. Developments in the theory of anxiety since 1926 // J. Am. Psychoanal. Assoc. -1972 b.-Vol. 20.-P. 341-394.

235. Cottraux J., Mollard E., Clinical therapy for phobias. In: Cognitive psychotherapy. Theory and practice. /Ed. by C. Perris. New York: Springer Verlag, 1988.-P. 179-197.

236. Crook T., Eliot J. Parental death during childhood and adult depression // Psychological Bulletin. 1980. - Vol. 87. - P. 252-259.

237. Dattilio F.M., Salas-Auvert J.A. Panic disorder: assessment and treatment through a wide-angle lens. Phoenix: Zeig, Tucker & Co. Inc. - 2000. - P. 313.

238. Declan Sh. Dyads and triads of abuse, bereavement and separation: a survey in children attending a child and family center // Irish Journal Psychol. Med. -1998.- Vol. 15.- No. 4.- P. 131-134.

239. DeRubies R. J. & Crits-Chistoph P. Empirically supported individual and group psychological treatments for adult mental disorders // J. of Consulting and Clinical Psychology. 1998. - Vol. 66. - P. 17-52.

240. Doctor R.M. Major results of a large-scale pre-treatment survey of agoraphobics. Phobia: a comprehensive survey of modern treatments. /In R.L. Dupont (ed.). N.Y.: Brunner/Mazel, 1982.

241. Dodge K.A. Social cognition and children's aggressive behavior. // Child Development. 1980. - Vol. 1. - P. 162-170.

242. Dohrenwend B.S., Dohrenwend B.R. Overview and prospects for research on stressful life events. /Ed. by B.S. Dohrenwend & B.R. 1974. - P. 310.

243. Duggan C, Sham P et al. Family history as a predictor of poor long term outcome in depression // British Journal of Psychiatry. - 2000. - Vol. 157. - P. 185-191.

244. Durssen A.M. Die "Cognitive Wende" in der Verhaltenstherapie eine Brucke zur Psychoanalyse //Nervenarzt. - 1985. - B. 56. - S. 479-485.

245. Dworkin S.F. et al. Multiple pains and psychiatric disturbance // Arch. Gen. Psychiat. 1990. - Vol. 47. - P. 239 - 244.

246. Easburg M.G., Jonson W.B. Shyness and perceptions of parental behavior // Psychological Reports. 1990. - Vol. 66. - P. 915-921.

247. Eaton J.W. & Weil R.J. Culture and mental disorders: A comparative study of the Hutterites and other populations. Glencoe, Free Press, 1955.

248. Ellis A. A note on the treatment of agoraphobic's with cognitive modification versus prolong exposure in vivo. // Behavior. Research and Therapy. 1979.-Vol. 17.-P. 162-164.

249. Engel G.L. "Psychogenic" pain and the pain-prone patient // Amer. J. Med. -1959.-Vol.26.

250. Engel G.L. Die Notwendigkeit eines neuen medizinischen Modells: Eine Herausforderung der Biomedizin. / In: H. Keupp (Hrsg.). Normalitaet und Abweichung.- Munchen: Urban & Schwarzenberg, 1979. S. 63-85.

251. Engel G.L. The clinical application of the biopsychosocial model // American J. of Psychiatry. 1980. - Vol. 137. - P. 535-544.

252. Engel G.L. & Schmale A.H. Eine psychoanylitische Theorie der somatischen Stoerung // Psyche. 1967. - Vol. 23. - P. 241-261.

253. Enns M.W., Cox B. Personality dimensions and depression: Review and Commentary // Canadian J. Psychiatry. 1997. - Vol. 42, No. 3. - P. 1-15.

254. Enns M.W., Cox B.J., Lassen D.K. Perceptions of parental bonding and symptom severity in adults with depression: mediation by personality dimensions // Canadian Journal of Psychiatry. 2000. - Vol. 45. - P. 263-268.

255. Epstein N., Schlesinger S., Dryden W. Cognitive-behavioral therapy with families. New York: Brunner-Mazel, 1988.

256. Escobar J.I., M.A. Burnam, M. Karno, A. Forythe, J.M. Golding, Somatization in the connunity // Archives of General Psychiatry. 1987. - Vol. 44. -P. 713-718.

257. Escobar J.I., G. Canino. Unexplained physical complaints. Psychopathology and epidemiological correlates // British Journal of Psychiatry. 1980. - Vol. 154. -P. 24-27.

258. Fava M. Anger attacks in unipolar depression. Part 1: Clinical correlates and response to fluoxetine treatment // Am J Psychiatry. 1993. - Vol. 150, No. 9. - P. 1158.

259. Fonagy P., Steele M., Steele H., Mogan G.S., Higgit A.C. The capacity for understanding mental states: the reflective self in parent and child and its significance for security of attachment. Infant Mental Health. -1991. Vol. 13. - P. 200-216.

260. Frances A. Categorical and dimensional systems of personality diagnosis: a comparison // Compr. Psychiatry. 1992. - Vol. 23. - P. 516-527.

261. Frances A., Miele G.M., Widger T.A., Pincus H.D., Manning D., Davis W.W. The classificatiom of panic disorders: from Freud to DSM-IV // J. Psychiat. Res. 1993. - Vol. 27, Suppl. 1. - P. 3-10.

262. Frank E., Kupfer D.J., Jakob M., Jarrett D. Personality features and response to acute treatment in recurrent depression // J. Personal Disord. 1987. -Vol. l.-P. 14-26.

263. Frost R., Heinberg R., Holt C., Mattia J., Neubauer A. A comparison of two measures of perfectionism // Pers. Individual Differences. 1993. - Vol. 14. - P. 119126.

264. Frued S. How anxiety originates. Standard Edition. London: Hogarth Press, 1966.-Vol. l.-P. 189-195.

265. Gehring T.M., Debry M., Smith P.K. The Family system test FAST: theory and application. Brunner-Routledge -Taylor & Francis Group, 2001. - P. 293.

266. Gloaguen V., Cottraux J., Cucherat M. & Blachburn I.M. A meta-analysis of the effects of cognitive therapy in depressed patients // J. of Consulting and Clinical Psychology. 1998. - Vol. 66. - P. 59-72.

267. Goldstein A.P., Stein N. Prescriptive psychotherapies. N.Y.: Pergamon, 1976.

268. Gonda T.A. The relation between pain complaints and family size // J. Neurol. Neurosurg. Psychiat. 1962. - Vol. 25.

269. Gotlib J.H., Mount J. et al. Depression and perception of early parenting: a longitudinal investigation // British Journal of Psychiatry. 1988. - Vol. 152. - P. 24-27.

270. Grawe K. Psychologische Therapie. Gottingen: Hogrefe, 1998.P.773

271. Grawe K., Donati R. & Bernauer F. Psychotherapy in Wandel. Von der Confession zur Profession. Gottingen: Hogrefe, 1994.

272. Greenblatt M., Becerra R.M., Serafetinides E.A. Social networks and mental health: an overview // American Journal of Psychiatry. 1982. - Vol. 139. - P.77-84.

273. Grogan S. Body Image. Understanding Body dissatisfaction in Men, Women and Children. London and New York: Routledge, 1999.

274. Gross R., Doerr H., Caldirola G. & Ripley H. Boderline syndrome and incest in chronic pelvic pain patients // Int. J. Psychiatr. Med. 1980/1981. - Vol. 10. - P. 79-96.

275. Guidano V.F. A system process-oriented approach to cognitive therapy // Handbook of cognitive-behavioral therapies. /Ed. K. Dobson. 1988. - N.Y.: Guildford press. - P. 214-272.

276. Harvey R., Salih W., Read A. Organic and functional disorders in 2000 gastroenterology outpatients. // Lancet. 1983. - P. 632-634.

277. Hautzinger M., Meyer T.D. Diagnostik Affektiver Storungen. Gottingen: Hogrefe, 2002.

278. Hawton K. Sex and suicide. Gender differences in suicidal behavior // Br. J. Psychiatry. 2000. - Vol. 177. - P. 484-485.

279. Hazan C., Shaver P. Love and work: an attachment-theoretical perspective. // J. of Personality and Social Psychology. 1990. - Vol.59. - P.270-280

280. Hecht H. et al. Anxiety and depression in a community sample // J. Affect. Disord.-1990.-Vol. 18.-P. 13877-1394.

281. Heim C., Owens M. Role of early adverse life events in the pathogenesis of depression. WPA Bulletin on Depression. 2001. - Vol. 5 - P. 3-7.

282. Henderson S. Personal networks and schizophrenias // Australian and New Zealand Journal of Psychiatry. 1980. - Vol. 14. - P. 255-259.

283. Hewitt P., Flett G. Perfectionism and depression: a multidimensional study // J. Soc Behavior Pers. 1990. - Vol. 5, No. 5. - P. 423-438.

284. Hill J., Pickles A. et al. Child sexual abuse, poor parental care and adult depression: evidence for different mechanisms // British Journal of Psychiatry. -2001.-Vol. 179.- P. 104-109.

285. Hill L. & Blendis L., Physical and psychological evaluation of “non-organic” abdominal pain // Gut. 1967. - Vol. 8. - P.221-229

286. Hirschfield R. Does personality influence the course of depression? // WPA Bulletin on Depression. 1998. - Vol. 4. - No. 15. - P. 6-8.

287. Hirschfield R.M. WPA. Teaching Bulletin in Depression. 2000. - Vol. 4. -P. 7-10.

288. Hudgens A. The social worker's role in a behavioral management approach to chronic pain // Soc. Work Health Care. 1977. - Vol. 3. - P.77-85

289. Hudhes M. Recurrent abdominal pain and childhood depression: clinical observation of 23 children and their families // Amer. Journal Orthopsychiat. -1984. Vol. 54. - P. 146-155.

290. Hudson J., Pope Y. Affective spectrum disorder // Am J Psychiatry. 1994. -Vol. 147, No. 5.-P. 552-564.

291. Hughes M. & Zimin R. Children with psychogenic abdominal pain and their families // Clin. Pediat. 1978. - Vol. 17. - P. 569-573

292. Ingram R.E. Self-focused attention in clinical disorders: Review and conceptual model // Psychological Bulletin. 1990. - Vol. 107. - P. 156-176.

293. Ingram R.E., Hamilton N.A. Evaluating precision in the social psychological assessment of depression: Methodological considerations, issues, and recommendations // Journal of social and clinical psychology. 1999. - Vol. 18. -P. 160-168.

294. Joyce P.R., Mulder R.T., Cloninger C.R. Temperament predicts clomipramine and desipramine response in major depression // J. Affect Disord. -1994.-Vol. 30.-P. 35-46.

295. Kadushin A. Children in Foster Families and Institutions. Social Service Research: Review of Studies. / In: Here Maas (Ed.) Washington, D.S.: National Association of Social Workers, 1978.

296. Kagan J., Reznick J.S., Gibbons J. Inhibited and uninhibited type of children //ChildDev.- 1989.- Vol.60. P. 838-845.

297. Kandel D.B., Davies M. Adult sequel of adolescent depressive symptoms // Arch. Gen. Psych. 1986. - Vol. 43.- P. 225-262.

298. Katon W. Depression: Relation to somatization and chronic medical illness. //Journal Clin.Psychiatry.- 1984.-Vol. 45, No. 3.- P.4-11.

299. Katon W. Improving antidepressant treatment of patients with major depression in primary care. WPA Bulletin on Depression. 1998. - Vol. 4, No. 16. -P. 6-8.

300. Kazdin A.E. Integration of psychodynamic and behavioral psychotherapies: Conceptual Versus Empirical Synthesis. / In H. Arkowitz & B. Messer (Eds.).

301. Psychoanalytic therapy and behavior therapy: Is integration possible? - New York: Basic, 1984.

302. Kazdin A.E. Combined and multimodal treatment in child and adolescent psychotherapy: Issues, challenges and research directions. // Clinical Psychology: Science and Practice. 1996. - Vol. 133. - P. 69-100.

303. Kellner R. Somatization. Theories and Research // Journal of Nervous and Mental Disease. 1990. - Vol. 3. - P. 150-160.

304. Kendell P.C., Holmbeck G. & Verduin T. Methodology, design and evaluation in psychotherapy research. /In M.J. Lambert (Ed.). Bergin and Garfield's handbook of psychotherapy and behavior change, 5th edn. New York: Wiley, 2004.-P. 16-43.

305. Kendell R.E. Die Diagnosis in der Psychiatrie. Stuttgart: Enke, 1978.

306. Kendler K.S., Kessler R.C. et al. Stressful life events, genetic liability and onset of an episode of major depression // American Journal of Psychiatry. 1995. -Vol. 152.- P. 833-842.

307. Kendler K.S., Kuhn J., Prescott C.A. The interrelationship of neuroticism, sex, and stressful life events in the prediction of episodes of major depression // Am J Psychiatry. 2004. - Vol. 161. - P. 631 - 636.

308. Kendler S., Gardner C., Prescott C. Toward a comprehensive developmental model for major depression in women // Am J-l Psychiatry. 2002. - Vol. 159. -No. 7.-P. 1133-1145.

309. Kessler R. S., Conagle K. A., Zhao S. et al. Life-time and 12 month prevalence of DSM-III-R psychiatric disorder in the United States: results from the National Comorbidity Survey // Arch.Gen. Psychiat. 1994. - Vol. 51. - P. 8-19.

310. Kessler R.S., Frank R.G. The impact of psychiatric disorders on work loss day // Psychol.Med. 1997.-Vol. 27. - P. 861-863.

311. Kholmogorova A.B., Garanian N.G. Integration of cognitive and psychodynamic approaches in the psychotherapy of somatoform disorders // Journal of Russian and East European Psychology. 1997. - Vol. 35. - NO. 6. - P. 29-54.

312. Kholmogorova A.B., Garanian N.G. Vernupfung kognitiver und psychodynamisher Komponenten in der Psychotherapie somatoformer Erkrankungen // Psychother. Psychosom. Med. Psychol. 2000. - Vol. 51. - P. 212-218.

313. Kholmogorova A.B., Garanian N.G., Dovgenko T.V. Combined therapy for anxiety disorders // Conference "The Synthesis between psychopharmacology and psychotherapy". Jerusalem, November 16-21. 1997. - P. 66.

314. Kholmogorova A.B., Volikova S.V. Familiarer Context bei Depression und Angstoerungen // European psychiatry, The Journal of the association of European psychiatrists, Standards of Psychiatry. Copenhagen, 20-24 September. - 1998. -P. 273.

315. Klein D.F. Delineation of two drug-responsive anxiety-syndromes // Psychofarmacologia. 1964. - Vol. 5. - P. 397-402.

316. Kleinberg J. Working with the alexithymic patient in groups // Psychoanalysis and Psychotherapy. 1996. - Vol. 13. - P. 1.-12

317. Klerman G.L., Weissman M.M., B.J. Rounsaville, E.S. Chevron P. Interpersonal psychotherapy of depression. North vale-New Jersey-London: Lason Aronson inc. - 1997. - P. 253.

318. Kortlander E., Kendall P.C., Panichelli-Mindel S.M. Maternal expectations and attribution about coping in anxious children // Journal of Anxiety Disorders. -1997.-Vol. 11.-P. 297-315.

319. Kovacs M. Akiskal H.S., Gatsonic C. Childhood onset dysthymic disorder: Clinical features and prospective outcome. // Archives of General Psychiatry. -1994.-Vol. 51.-P. 365-374.

320. Kreitman N., Sainsbury P., Pearce K. & Costain W. Hypochondriasis and depression in out-patients at a general hospital // Brit. J. Psychiat. 1965. - No. 3. -P. 607-615.

321. Krystal J.H. Integration and self-healing. Affect, trauma and alexithymia. -Hillsdale. New Jersey: Analytic Press, 1988.

322. Lambert M.J. Psychotherapy outcome research: Implications for integrative and eclectic therapies. Handbook of psychotherapy integration. / In J.C. Norcross & M. R. Goldfried (Eds.). New York: Basic, 1992.

323. Lecrubier Y. Depression in medical practice // WPA Bull. On depression. -1993.-Vol. l.-P. 1.

324. Leff J. Culture and differentiation of emotional states // Br. Journal of Psychiatry. 1973. - Vol. 123. - P. 299-306.

325. Lewinsohn P.M., Rosenbaum M. Recall of parental behavior by acute depressives, remitted depressives and non-depressives // Journal Pers. Soc. Psychology. 1987.-Vol. 52.-P. 137-152.

326. Lipowski Z. J. Holistic Medical Foundations of American Psychiatry: A Bicentennial // Am. J. Psychiatry. - 1981. - Vol. 138:7, July - P. 1415-1426.

327. Lipowsky J. Somatization, the concept and its clinical application // Am. Journal of Psychiatry. 1988.-Vol. 145.-P. 1358-1368.

328. Lipowsky J. Somatisation: its definition and concept // American Journal of Psychiatry. 1989. - Vol. 147:7. - P. 521-527.

329. Luborsky L., Singer V., Luborsky L. Comparative studies of psychotherapy // Archives of General Psychiatry. 1975. - Vol. 32. - P. 995-1008.

330. Lydiard R. B. Comorbidity of panic, social phobia disorder and major depression // Controversies and convention in panic disorder: AEP Symp. 1994. - P. 12-14.

331. Maddux J.E. Self-efficacy. / Handbook of social and clinical psychology. /In C.R. Snyder & D.R. Forsyth (Eds.). New York: Pergamon, 1991. - P. 57-78.

332. Mahler M. Sadness and grief in childhood. // Psychoanalytic study of the child. 1961. - Vol.15. - P. 332-351

333. Mailer R.G & Reiss S. Anxiety sensitivity in 1984 and panic attacks in 1987 // Journal of Anxiety Disorders. 1992. - Vol. 6. - P. 241-247.

334. Mangweth V., Pope H.G., Kemmler G., Ebenbichler C., Hausmann A., C. De Col, Kreutner V., Kinzl J., Biebl W. Body Image and Psychopathology in Male Bodybuilders // Psychotherapy and Psychosomatics. 2001.- Vol.7. - P.32-39

335. Martems M. & Petzold H. Perspektiven der Psychotherapieforshung and Ansatze fur integrative Orientierungen (Psychotherapy research and integrative orientations) // Integrative Therapie. 1995. - Vol.1.- P. 3-7.

336. Maughan B. Growing up in the inner city: findings from the inner London longitudinal study. // Pediatric and Perinatal Epidemiology. 1989. - Vol. 3.- P. 195-215.

337. Mayou R., Bryant V., Forfar C. & Clark D. Non-cardiac chest pain and palpitation in the cardiac clinic // Br. Heart J. 1994. - Vol. 72. - P.548-573.

338. Merskey H. & Boud D. Emotional adjustment and chronic pain // Pain. -1978. -No. 5.-P. 173-178.

339. Millaney J.A., Trippet C.J. Alcohol dependence and phobia, clinical description and relevance // Brit.J. Psychiatry. 1979. - Vol. 135. - P. 565-573.

340. Mohamed S.N., Weisz G.M. & Waring E.M. The relationship of chronic pain to depression, marital adjustment, and family dynamics // Pain. 1978. -Vol. 5.-P. 285-295.

341. Mulder M. Personality pathology and treatment outcome in. major depression: a review // Am J-l Psychiatry. 2002. - Vol. 159. - No. 3. - P. 359-369.

342. Neale M. C., Walters E. et al. Depression and parental bonding: cause, consequence or genetic covariance? // Genetic Epidemiology. 1994. - Vol. 11.-P. 503-522.

343. Nemiah & Sifneos. Affect and fantasy in patients with psychosomatic disorders. Modern trends in psychosomatic medicine. / In: Hill O.W. (Ed.). -London: Butterworth, 1970.

344. Nickel R., Egle U. Somatoforme Stoerungen. Psychoanalytische Therapie. / In Praxis der Psychotherapy. Ein integratives Lehrbuch. Senf W. & Broda M. (Eds.) - Stuttgart New-York: Georg Thieme Verlag, 1999. - S. 418-424

345. Norcross J.C. The movement toward integrating the psychotherapy: An overview // American J. of psychiatry. 1989. - Vol. 146. - P. 138-147.

346. Norcross J.C Psychotherapy-Integration in den USA. Uberblick uber eine Metamorphose (Psychotherapy integration in the USA: An overview of a metamorphosis) // Integrative Therapie. 1995. - Vol. 1. - P. 45-62.

347. Parker G. Parental reports of depression: an investigation of several explanations // Journal of Affective Disorder. -1981. Vol. 3. - P. 131-140.

348. Parker G. Parental style and parental loss. In Handbook of Social Psychiatry. /Ed. A.S. Henderson and G.D. Burrous. - Amsterdam: Elsevier, 1988.

349. Parker G. Parental rearing style: examining for links with personality vulnerability factors for depression // Soc. Psychiatry Psychiatry Epidemiology. - 1993.-Vol. 28.-P. 97-100.

350. Parker G., Hadzi-Pavlovic D. Parental representation of melancholic and non-melancholic depressives: examining for specificity to depressive type and prevention of additive effects // Psychological Medicine. 1992. - Vol. 22. - P. 657-665.

351. Parker S. Eskimo psychopathology in the context of Eskimo personality and culture // American Anthropologist. 1962. - Vol. 64. - S. 76-96.

352. Paykel E. Personal impact of depression: disability // WPA Bulletin on Depression. 1998. - Vol. 4, No. 16. - P. 8-10.

353. Paykel E.S., Brugha T., Fryers T. Size and burden of depressive disorder in Europe // European Neuropsychopharmacology. 2005. - No. 15. - P. 411-423.

354. Payne V., Norfleet M. Chronic Pain and the Family: a Review // Pain. -1986.-Vol. 26.-P. 1-22.

355. Perrez M., Baumann U. Lehrbuch: Klinische Psychologie Psychotherapie (3 Auflage). - Bern: Verlag Hans Huber-Hogrefe AG, 2005. - 1222 s.

356. Perris C., Arrindell W.A., Perris H. et al. Perceived depriving parental rearing and depression // British Journal of Psychiatry. 1986. - Vol. 148. - P . 170-175.

357. Phillips K., Gunderson J. Review of depressive personality // Am. J. Psychiatry. 1990. - Vol. 147: 7. - P. 830-837.

358. Pike A., Plomin R. Importance of nonshared environmental factors for childhood and adolescent psychopathology // J. Am. Acad. Child Adolescence Psychiatry. 1996. - Vol. 35. - P. 560-570.

359. Plantes M.M., Prusoff B.A., Brennan J., Parker G. Parental representations of depressed outpatients from an USA sample // Journal of Affective Disorder. -1988. Vol. 15. -P. 149-155.

360. Plomin R., Daniels A. Why are children in the same family so different from one another? // Behavioral and Brain Sciences. 1987. - Vol. 10. - P. 1-16.

361. Rado S. The problem of melancholia./ In: S. Rado: Collected papers. 1956. - Band I. - Yew York: Grune & Stratton.

362. Rapee R.M. Differential response to hyperventilation in panic disorder and generalized anxiety disorder // J. of Abnormal Psychology. 1986. - Vol. 95:1. - P. 24-28.

363. Rapee R.M. Potential role of childrearing practices in the development of anxiety and depression // Clinical Psychological Review. 1997. - Vol. 17. - P. 47-67.

364. Rasmussen S. A., Tsuang M. T. Epidemiology of obsessive-compulsive disorder // Journal of Clinical Psychiatry. - 1984. - Vol. 45. - P. 450-457.

365. Regier D.A., Rae D.S., Narrow W.E. et al. Prevalence of anxiety disorders and their comorbidity with mood and addictive disorders // Br. J. Psychiatry. -1998. Vol. 34, SuppL - P. 24-28.

366. Reich J.H., Green A.L. Effect of personality disorders on outcome of treatment //Journal of Nervous and Mental Disease. 1991. - Vol. 179. - P. 74-83.

367. Reiss D., Hetherington E. M., Plomin R. et al. Genetic questions for environmental studies: differential parenting and psychopathology in adolescence // Arch. Gen. Psychiat. 1995. - Vol. 52. - P. 925-936.

368. Reiss S. Expectancy model of fear, anxiety and panic // Clinical Psychology Review. -1991.-Vol. 11.-P. 141-153.

369. Rice D.P., Miller L.S., The economic burden of affective disorders // Br. J. Psychiatry. 1995. - Vol. 166, Suppl. 27. - P. 34-42.

370. Richwood D.J., Braitwaite V.A. Social-psychological factors affecting help-seeking for emotional problems // Soc. Science & Med. 1994. - Vol. 39. - P. 563572.

371. Rief W. Somatoforme und dissoziative Storungen (Konversionsstorungen): Atiologie/Bedingungesanalyse./ In Lehrbuh: Klinische Psychologie -Psychotherapie (3 Auflage). Perrez M., Baumann U. Bern: Verlag Hans Huber-Hogrefe AG, 2005. - S. 947-956.

372. Rief W., Bleichhardt G. & Timmer B. Gruppentherapie fur somatoforme Storungen Behandlungsleitfaden, Akzeptanz und Prozessqualitat // Verhaltenstherapie. - 2002. -Vol. 12.-P. 183-191.

373. Rief W., Hiller W. Somatisierungsstoerung und Hypochodrie. Goettingen-Bern-Toronto-Seattle: Hogrefe, Verlag flier Psychologie, 1998.

374. Roy R. Marital and family issues in patient with chronic pain // Psychother. Psychosom. 1982. - Vol. 37.

375. Ruhmland M. & Magraf J. Effektivitat psychologischer Therapien von Generalisierter Angststorung und sozialer Phobie: Meta-Analysen auf Storungsebene. 2001. - Vol. 11. - P. 27-40.

376. Rutter M, Cox A, Tupling C et al. Attachment and adjustment in two geographical areas. I. The prevalence of psychiatric disorder // British Journal of Psychiatry. 1975. - Vol. 126. - P. 493-509.

377. Salkovskis P.M. Somatic problems. Cognitive behavior therapy for psychiatric problems: a practical guide. / In: Havton K.E., Salkovskis P.M., Kirk J., Clark D.M. (Eds). Oxford: Oxford University Press, 1989.

378. Salkovskis P.fyl. Effective treatment of severe health anxiety (Hypochondrias). Copenhagen: World Congress of Behavioral & Cognitive Therapies, 1995.

379. Sanderson W.C., Wetzler S., Beck A.T., Betz F. Prevalence of personality disorders among patients with major depression and dysthymia // Psychiatry Research. 1992. - Vol. 42. - P. 93-99.

380. Sandler J., Joffe W.G. Notes on childhood depression // International J. of Psychoanalysis. 1965. - Vol. 46. - S. 88-96.

381. Sartorius N. Depression in different cultures (WHO collaborative materials), ed. -1990.

382. Schaffer D., Donlon P. & Bittle R. Chronic pain and depression: a clinical and family history survey // Amer. J. Psychiat. 1980. - V. 137. - P.l 18-120

383. Scott J., Barher W.A., Eccleston D. The new castle chronic depression study. Patient characteristics and factors associated with chronicity // British Journal of Psychiatry. 1998. - Vol. 152. - P. 28-33.

384. Senf W., Broda M. Praxis der Psychotherapie: Ein integratives Lehrbuch fur Psychoanalyse und Verhaltenstherapie. Stuttgart-New York: Georg Theieme Verlag. - 1996.- 595 s.

385. Shawcross C.R., Tyrer P. Influence of personality on response to monoamine oxidase inhibitors and tricyclic antidepressant // J. Psychiatr Res. -1985.-Vol. 19.-P. 557-562.

386. Sheehan D.V., Carr D.B., Fishman S.M., Walsh M.M. & Peltier-Saxe D. Lactate infusion in anxiety research: Its evolution and practice // J. of Clinical Psychiatry. 1985. - Vol. 46. - P. 158-165.

387. Shimoda M. Uber den premorbiden Charakter des manish-depressive Irrseins//Psychiat. Neurol. Jap. -1941. Bd. 45. - S. 101-102.

388. Sifneos P. et al. The phenomenon of alexithymia observations in neurotic and psychosom. patients // Psychother. Psychosom. 1977. - Vol. 28:1-4. - P.45-57

389. Skolnick A. Early attachment and personal relationships across the life course. In: Life-span Development and Behavior. /Ed. P.B. Baltes, D. L. Featherman & R.M. Lerner. Hillsdale, N.J.: Lawrence Erlbaum, 1986. - Vol. 7. -P. 174-206.

390. Sommer G., Fydrich T. Soziale Unterstuetzung. Diagnostik, Kozepte, F-SOZU. Materialie No. 22. Dt. Ges. fuer Verhaltenstherapy. Tuebingen, 1989. -60 s.

391. Speierer G.W. Die differentielle Inkongruenzmodell (DIM). Heidelberg: Asanger-Verlag, 1994.

392. Spitzer R.L., Williams J.B.W., Gibbon M., First M.B. Structured Clinical Interview for DSM-III-R Personality Disorders (SCID-II, Version 1.0). -Washington, DC: American Psychiatric Press, 1990.

393. Stavrakaki S., Vargo B. The Relationship of anxiety and depression: A Review of literature // Br. J. Psychiatry. 1986. - Vol. 149. - P. 7-16.

394. Stein M.B. et al. Enhanced dexamethason suppression of plasma Cortisol in an adult women traumatized by childhood sexual abuse // Biological Psychiatry. -1997.- Vol. 42.-P. 680-686.

395. Swanson D. Chronic pain as a third pathologic emotion // Amer. J. Psychiat. 1984.-Vol. 141.

396. Swildens H. Agorophobie mit Panickattaken und Depression // Praxis der Gespraechstherapie. / In: Eckert J., Hoeger D., Linster H.W. (Hrsg.). Stuttgart: Kohlhammer. - 1997. - S. 19-30.

397. Taylor G.J. Alexithymia: concept, measurement and implications for treatment // Am. J. Psychiat. 1984. - Vol. 141. - P. 725-732.

398. Tellenbach R. Typologische Untersuchungen zur premorbiden Persoenlichkeit von Psychotikern unter besonderer Beruecksichtigung Manisch-depressiver//Confina psychiat. Basel, 1975.-Bd. 18.-No.1.-S. 1-15.

399. Teusch L., Finke J. Die Grundlagen eines Manuals fuer die gespraechstherapeutische Behandlung der Panik und Agorophobie. Psychotherapeut. 1995. - Vol. 40. - S. 88-95.

400. Teusch L., Gastpar T. Psychotherapie und Pharmakotherapie // Praxis der Psychotherapie: Ein integratives Lehrbuch fur Psychoanalyse und Verhaltenstherapie. / In W. Senf, M. Broda (Hrsg.). Stuttgart - New York: Georg Theieme Verlag, 1996. - S. 250-254.

401. Thase M.E., Greenhouse J.B., Frank E., Reynolds C.F., Pilkonis P.A., Hurley K. Treatment of major depression with psychotherapy or psychotherapy-pharmacotherapy combinations // Arch. Gen. Psychiat. 1997. - Vol. 54. - P. 10091015.

402. Thase M.E., Rush A.J. When at first you don't succeed, sequential strategies for antidepressants non-responders // Journal of Clinical Psychiatry. 1997. - Vol. 58.-P. 23-29.

403. Thompson R.A., Lamb M.E., Estes D. Stability of infant-mother attachment and its relationship to changing life circumstances in an unselected middle-class sample. Child Development. 1982. - Vol. 5. - P. 144-148.

404. Tobis D. Moving from Residential Institutions to Community Based Services in Eastern Europe the Former Soviet Union. Paper prepared for the international Bank for Reconstruction and Development, 1999.

405. Torgerson S. Genetic factors in moderately severe and mild affective disorders //Arch. Gen. Psychiat. 1986 a. - Vol. 43. - P. 222-226.

406. Torgerson S. Genetic of somatoform disorders // Arch. Gen. Psychiat. -1986 b.-Vol. 43.-P. 502-505.

407. Turkat I. & Rock D. Parental influences of illness behavior development in chronic pain and healthy individuals // Pain. 1984. - Suppl. 2. - P. 15

408. Tyrer P., Seiverwright N., Ferguson V., Tyrer J. The general neurotic syndrome: A coaxial diagnosis of anxiety, depression and personality disorder // Acta Psychiatrica Scand. 1992. - Vol. 85. - P. 565-572.

409. Uexkuel T. Psychosomatische Medizin, Urban & Schwarzenberg. -Muenchen-Wien-Baltimore, 1996. 1478 s.

410. Ulusahin A., Ulug B. Clinical and personality correlates of outcome in depressive disorders in a Turkish sample // J. Affect. Discord. 1997. - Vol. 42. -P. 1-8.

411. Ustun T., Sartorius N. Mental illness in general health practice // An international study. 1995. - Vol.4. - P. 219-231.

412. Van Hemert A.M. Hengeveld M.W., Bolk J.H., Rooijmans H.G.M. & Vandenbroucke J.P. Psychiatric disorders in relation to medical illness among patients of a general medical out-patient clinic // Psychol. Med. 1993. - Vol. 23. -P. 167-173

413. Vaughn C., Leff J.P. The Influence of Family and Social Factors on the Course of Psychiatric Illness // British Journal of Psychiatry. 1976. - Vol. 129. -P. 125-137.

414. Violon A., The onset of facial pain // Psychother. Psychosom. 1980. - Vol. 34.-P. 11-16

415. Wahl R. Interpersonelle Psychotherapie und Kognitive Verhaltenstherapie bei depressiven Erkrankungen im Vergleich. Wiesbaden: Westdeutscher Verlag, 1994.

416. Warr P., Perry G. Paid employment and women's psychological well-being // Psychological Bulletin. 1982. - Vol. 91. - P. 493-516.

417. Warren S.L. et al. Behavioral genetic analyzes of self-reported anxiety at 7 years of age // Journal American Academia Child Adolescence Psychiatry. 1999. -Vol. 39.-P. 1403-1408.

418. Watson D., Clark, L.A. & Tellegen,A. Development and validation of brief measures of positive and negative affect: The PANAS scales // Journal of Personality and Social Psychology. 1988. - Vol. 54. - P. 1063-1070.

419. Weinberger J. Common factors aren't so common: the common factors dilemma // Clinical Psychology. 1995. - Vol. 2. - P. 45-69.

420. Wells K., Stewart A., Haynes R. The functioning and well-being of depressed patients: results from the Medical Outcomes Study. JAMA. 1989. - No. 262.-P. 914-919.

421. Westling B.E. & Ost L. Cognitive bias in panic disorder patients and changes after cognitive-behavioral treatments // Behavior Research and Therapy.1995. Vol. 33, No. 5. - P. 585-588.

422. WHO (World Health Organization). Choosing interventions: effectiveness, quality, costs, gender, and ethics (EQC). Global program on evidence for health policy (GPE). Geneva: WHO, 2000.

423. Winokur G. The types of affective disorders // J. Nerv. Ment. Dis. - 1973. -Vol. 156, No. 2.-P. 82-96.

424. Winokur G. Unipolar depression is it divisible into autonomous subtypes? //Arch. Gen. Psychiat. - 1979. - Vol. 25. - P. 47-52.

425. Wittchen H.U., Essau S.A. Epidemiology of panic disorder: progress and unresolved issues // J. Psychiatr. Res. 1993. - Vol. 27, Suppl. - P. 47-68.

426. Wittchen H.U., Vossen A. Implication von komorbiditat bei Angststoerungen ein kritischer Uebersicht. // Verhaltenstherapy. - 1995. -Vol.5. - S. 120-133.

427. Wittchen H.U., Zerssen D. Verlaeufe behandelter und unbehandelter Depressionen und Angststoerungen // Eine klinisch psychiatrische und epidemiologische Verlaufsuntersuchung. Berlin: Springer, 1987.

428. Wright J.N., Thase M.E., Sensky T. Cognitive and biological Therapies: A combined approach. Cognitive therapy with inpatients. / Wright J.H., Thase M.E., Beck A.T., Ludgate J.W. (Eds.). N.Y. - London: Guilford Press, 1993. - P. 193247.

429. Zimmerman M., Mattia J.I. Differences between clinical and research practices in diagnosing borderline personality disorder // Am J Psychiatry. 1999. -Vol. 156.-P. 1570- 1574.1. As a manuscript

430. Presidium of the Higher Attestation Commission of the Ministry of Education and Science of Russia (decision from< ЛМ- 20Q&г» с /решил выдать диплом ДОКТОРАнаук1. Начальник отдела/

431. Kholmogorova Alla Borisovna

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"clinical psychology"
on this topic:
Psychological Models of Affective Disorders

Performed:
Second year student d/o
Migunova M.Yu.

Moscow 2011

1. Brief characteristics of affective disorders
2. Factors in the development of mood disorders
* Genetic
*Biological

3. Psychological models of affective disorders
* Psychoanalytic model
* Behaviorist model
*Cognitive model
4. Conclusion
5. References

Brief characteristics of affective disorders

Affective disorder (Mood disorder) is a mental disorder associated with disturbances in the emotional sphere. The contribution of biological factors to the development of affective disorder is approximately equal to the contribution of psychological ones, which makes it interesting to study from the point of view of both medicine and psychology, and in particular clinical psychology.
The number of people suffering from mood disorders is increasing every year. So, if in the 1970s the prevalence of people who had at least one depressive episode throughout their lives was only 0.4 - 0.8%, in the 1990s it was already 5-10%, in the 2000s - 10-20%, according to various researchers. In addition, one should take into account people who have not applied to specialized medical institutions and these data were not included in the results.
The prevalence of affective spectrum disorders among men and women is approximately equal, which suggests that such disorders are not related to differences in hormonal levels. When talking about mood disorders, they highlight depressive states, mania, as well as mixed affective states.
Depression refers to depressed mood, which can sometimes include anxiety or irritability; the concept of depression in the sense of a clinical syndrome covers, along with these signs of emotional disorder, a whole range of symptoms in the cognitive-motivational sphere (negative self-esteem, impaired concentration, loss of interest in life, etc.), in the behavioral sphere (passive-inhibited or anxious-agitated behavior, reduction in social contacts, etc.) and in the somatic sphere (sleep and appetite disorders, fatigue, etc.). Whether there are smooth transitions between subclinical symptoms of depressed mood and clinical depressive disorders continues to be debated (Grove & Andreasen, 1992, Costello, 1993).
Manic episodes are characterized by:
a) exaggerated euphoric emotions (or excessive anger and irritability);
b) motivational disorders in the form of overmotivation, impulsivity and hyperactivity;
c) decreased need for sleep.
At manic states, a state of euphoria (or irritability) and hyperactivity occurs. Euphoric joy is seen here as the basis of excessive motivation, which in turn leads to frantic, often poorly coordinated activity. Despite the frequent lack of positive results from actions, the euphoric mood during manic phases most often persists, since negative results are interpreted as positive and do not contribute to the assessment of opportunities for future actions. Thus, cognitions and reality are separated, which means that such emotions are not adequate to reality.
The main forms of affective disorders according to ICD-10 are:
1. Bipolar disorder
2. Depressive episode3. Manic episode
4. Recurrent depressive disorder
5. Chronic affective disorder (dysthymia, cyclothymia)

Factors in the development of mood disorders

In addition to psychogenic influences, genetic and biological factors can be identified that influence the occurrence and development of affective spectrum disorders in an individual.
Genetic factors
Can...

Topic 1.1 Concepts of norm and pathology in the psychodynamic tradition.

Topic 1.2 Concepts of norm and pathology in the cognitive-behavioral tradition.

Topic 1.3 Concepts of norm and pathology in the existential-humanistic tradition.

*Zhdan A.N. History of psychology. M., 1999. Ch. Descriptive psychology. P.355-361.

Topic 1.4 Concepts of norm and pathology in Russian psychology.

Topic 1.5. System-oriented concepts of norm and pathology, centered on the family.

Section 2. Theoretical models and empirical studies of major mental disorders

Topic 2.1. Multifactorial models and modern classification of mental disorders.

Topic 2.2. Schizophrenia: history of study, main theoretical models and empirical studies.

Topic 2.3. Personality disorders: history of study, major theoretical models and empirical research.

Topic 2.4. Depressive and anxiety disorders: history of research, major theoretical models and empirical studies.

4.List of sample test questions and tasks for independent work.

Section 1. Basic psychological concepts of norm and pathology.

Topic 1.1 Concepts of norm and pathology in the psychodynamic tradition.

Topic 1.2 Concepts of norm and pathology in the cognitive-behavioral tradition.

Topic 1.3 Concepts of norm and pathology in the existential-humanistic tradition.

Topic 1.4 Concepts of norm and pathology in Russian psychology.

Topic 1.5. System-oriented concepts of norm and pathology, centered on the family.

Section 2. Theoretical models and empirical studies of major mental disorders

Topic 2.1. Multifactorial models and modern classification of mental disorders

Topic 2.1. Schizophrenia: history of study, theoretical models and empirical studies.

Topic 2.3. Personality disorders: history of research, theoretical models and empirical research.

Topic 2.3. Affective spectrum disorders: history of study, theoretical models and empirical research.

5. Approximate topics of abstracts and reports

Section 1. Basic psychological concepts of norm and pathology.

Topic 1.1 Concepts of norm and pathology in the psychodynamic tradition.

Topic 1.2 Concepts of norm and pathology in the cognitive-behavioral tradition.

Topic 1.3 Concepts of norm and pathology in the existential-humanistic tradition.

Topic 2.3. Personality disorders: history of research, theoretical models and empirical research.

Topic 2.4. Affective spectrum disorders: history of study, theoretical models and empirical studies.

6. An approximate list of questions to assess the quality of mastering the discipline

III. Forms of control

Appendix Guidelines for students

Section 1. Basic psychological concepts of norm and pathology.

Topic 1.1 Concepts of norm and pathology in the psychodynamic tradition.

Topic 1.2 Concepts of norm and pathology in the cognitive-behavioral tradition.

Topic 1.3 Concepts of norm and pathology in the existential-humanistic tradition -6 hours.

Topic 1.4 Concepts of norm and pathology in Russian psychology.

Topic 1.5. System-oriented concepts of norm and pathology, centered on the family.

Section 2. Theoretical models and empirical studies of major mental disorders

Topic 2.1. Multifactorial models and modern classification of mental disorders.

Topic 2.2. Schizophrenia: history of study, theoretical models and empirical studies.

Topic 2.3. Personality disorders: history of study, theoretical models, empirical studies.

Topic 2.4. Affective spectrum disorders: history of study, theoretical models and empirical research.

Topic 2.3. Personality disorders: history of research, theoretical models and empirical research.

Characteristics of primitive personal defenses.

Characteristics of the borderline personality structure according to N. McWilliams.

Stages of development of object relations according to H. Hartmann and M. Mahler.

Structural characteristics of a healthy personality according to O. Kernberg.

The main diagnostic headings contained in the “Personality Disorders” cluster according to ICD-10 and DSM-4.

Healthy and pathological narcissism.

Teaching about the characters of E. Kretschmer.

Parametric model of personality pathology by K. Jung.

Cognitive-behavioral model of personality disorders.

Topic 2.4. Affective spectrum disorders: history of study, theoretical models and empirical studies.

Cognitive model of panic disorder.

Stages in the development of S. Freud's views on anxiety disorder. The case of the village girl and the case of little Hans.

Mechanisms of anxiety formation in psychodynamic (S. Freud) and behavioral (J. Watson, D. Wolpe) approaches.

Bio-psycho-social model of anxiety disorders.

The existential meaning of anxiety (L. Binswanger, R. May)

6. An approximate list of questions to assess the quality of mastering the discipline

Diathesis-stress-buffering model of mental disorders. Types of stressors. Vulnerability factors and buffering factors.

Modeling ideas about the determinants of normal development in the psychodynamic tradition.

Modeling ideas about the structural-dynamic characteristics of the psyche in the psychodynamic tradition.

Modeling ideas about mental pathology in classical psychoanalysis: model of trauma, model of conflict, model of fixation at different stages of psycho-sexual development.

Modeling ideas about mental norm and pathology in neo-Freudianism (individual psychology of A. Adler, analytical psychology of C. Jung, social psychoanalysis of G. Sullivan, K. Horney and E. Fromm).

Modeling ideas about mental norm and pathology in post-classical psychoanalysis (psychology of the “I”, theory of object relations, psychology of the self by H. Kohut).

A brief history of the formation and basic theoretical and methodological principles of the psychodynamic tradition.

Basic research rules and procedures and their transformation in the psychodynamic tradition.

Modeling ideas about normal mental development and the mechanisms of deviation from it in radical behaviorism. Characteristics of the main models of learning in radical behaviorism.

Studies of mental pathology in radical behaviorism.

Characteristics of basic research rules and procedures in the cognitive-behavioral tradition.

Research rules and procedures in psychoanalysis and behaviorism. Hermeneutics and operationalism.

Research rules and procedures in behaviorism and existential-humanistic traditions. Operationalism and phenomenological method.

Modeling ideas about normal mental development and mechanisms of deviation from it in methodological behaviorism and information approach (concepts of A. Bandura, D. Rotter, A. Lazarus, the concept of attributive style).

Characteristics of the main models of mental pathology within the framework of an integrative cognitive approach (A. Ellis; A. Beck).

Modeling ideas about normal mental development and the mechanisms of mental pathology in the concept of C. Rogers.

Modeling ideas about normal mental development and the mechanisms of mental pathology in the concepts of W. Frankl and L. Binswanger.

The phenomenological method and two approaches to its understanding in the existential-humanistic tradition.

A brief history of the formation and basic theoretical and methodological principles of the existential-humanistic tradition.

Basic principles of modern classification of diseases

A brief history of the study of schizophrenia. Views of E. Kraepelin. Basic disorders in schizophrenia according to E. Bleuler.

Analytical models of schizophrenia. The classical psychoanalytic approach is the model of M. Seshe. A model of schizophrenia within the framework of the interpersonal approach and within the framework of object relations theory.

Existential approach to schizophrenia (R. Lang, G. Benedetti).

Models of thinking disorders in schizophrenia by K. Goldstein and N. Cameron. The concept of central psychological deficit in schizophrenia within the framework of the cognitive approach.

Domestic studies of thinking disorders in schizophrenia. Violation of the motivational-dynamic side of thinking.

The concept of anhedonia by S. Rado and domestic research on anhedonia.

Research into the family context of schizophrenia. The concept of "double bond" by G. Bateson.

Research on emotional expressivity. Features of social networks of patients with schizophrenia.

General criteria and main types of personality disorders in modern classifications.

History of the study of personality disorders within the framework of psychiatry and psychoanalysis.

Understanding the term “borderline” in Russian psychiatry and modern psychoanalysis.

Three levels of personality organization in modern psychoanalysis.

Characteristics of primitive defense mechanisms in modern psychoanalysis.

Characteristics of parametric and typological models of personality disorders.

Basic parametric models of personality disorders within the framework of clinical psychology (E. Kretschmer, K. Jung, G. Eysenck, T. Leary, “Big Five”).

The study of personality disorders within the framework of object relations theory.

Object representations: definition and basic characteristics.

The theory of normal and pathological narcissism by H. Kohut.

Bio-psycho-social model of personality disorders.

Mood disorders in the form of depression according to ICD-10. Basic criteria for a mild depressive episode.

Personality factors of depression and their research (perfectionism, hostility, neuroticism, dependence).

Analytical models of depression.

Cognitive model of depression.

Behavioral model of depression (Saligman's theory of “learned helplessness”).

Bio-psycho-social model of depression.

Anxiety, anxiety and anxiety disorders. Types of anxiety disorders according to ICD-10.

Analytical models of anxiety.

Cognitive model of anxiety. Cognitive mechanisms of panic attack.

Bio-psycho-social model of anxiety.

Affective syndromes. Affective disorders Affective disorders history of study main theoretical models

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Topic 2.3. Personality disorders: history of research, theoretical models and empirical research.

Topic 2.4. Affective spectrum disorders: history of study, theoretical models and empirical studies.

6. An approximate list of questions to assess the quality of mastering the discipline

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