Pathopsychology, like neuropsychology, can rightfully be considered a domestic branch of clinical psychology, at the origins of which were L. S. Vygotsky, B. V. Zeigarnik and S. Ya. Rubinshtein. Pathology began its development in the 1930s, during the years of the Great Patriotic War(1941-1945) and post-war years when it turned out to be in demand, like neuropsychology, for the restoration of mental functions in patients with military trauma. Pathopsychology, along with somatopsychology and neuropsychology, is an integral part of clinical psychology and therefore bears all the main features inherent in clinical psychology as a whole. Pathopsychology refers to the borderline branches of science that have arisen at the intersection of disciplines that are similar in object and research issues. If clinical psychology is an area bordering between psychology and medicine in general, then pathopsychology is most closely bordered by a special section of clinical science and practice - psychiatry. It can be said that pathopsychology- this is a special section of clinical psychology, in particular, studying the nature of the course and structural features of mental processes leading to disorders observed in the clinic

Psychiatry- describes, investigates and systematizes MANIFESTATIONS of disturbed mental functions, i.e. explores the disturbed phenomenon

Object of study- mental disorders

Subject of study- regularities of the decay of mental activity and personality traits in comparison with the regularities of the formation and course of mental processes in the norm

Tasks- psychodiagnostics in order to clarify the medical diagnosis and justify treatment, in particular psychotherapy and occupational therapy

Thus, psychopathology studies the causes, manifestations, course, treatment and prevention of various mental disorders.

2) tasks of pathopsychology

Pathopsychology is aimed at providing specific practical assistance to clinicians dealing with mental disorders in a variety of mental disorders.

The main tasks of pathopsychological research include the following six:

1. Obtaining data for diagnostics.
2. Study of the dynamics of mental disorders in connection with the ongoing therapy.
3. Participation in expert work.
4. Participation in rehabilitation work.
5. Participation in psychotherapy.
6. A study of understudied mental illnesses.

Obtaining additional data on the mental state of the patient(about the features cognitive activity, emotional-volitional sphere and personality as a whole) is one of the most important tasks of practical pathopsychology

Study of the dynamics of mental disorders in connection with the therapy is also an important task implemented by the pathopsychologist in the clinic.

Another important task of the pathopsychologist is participation in expert work. Pathopsychological studies play an important role in the conduct of forensic psychiatric, military and labor examinations. At the same time, the psychologist not only provides data that facilitates the solution of diagnostic issues, but also objectively establishes the severity of the mental defect.

Participation in rehabilitation work is currently acquiring special meaning. Modern psychiatry pays much attention to the problems of rehabilitation and resocialization of patients. The provision of medical care to mentally ill people involves not only active and supportive therapy, but also the implementation of measures to restore their social status. The prevention of disability also depends on properly constructed rehabilitation measures.

Participation in psychocorrection, as well as carrying out rehabilitation measures, should be carried out by a psychologist under the guidance and at the request of a psychiatrist. IN Lately there has been a trend of active inclusion of psychologists in the conduct of psychotherapy.

Less often, the pathopsychologist has to solve the problem research on understudied mental illnesses. As a rule, such studies are carried out in clinics operating on the basis of research institutes. The purpose of such scientific research is the analysis of still insufficiently studied psychopathological manifestations of certain mental illnesses. At the same time, a study of large groups of patients with similar psychopathological symptoms is carried out. Here, the statistical reliability of the data obtained acquires a special role. Moreover, the solution of this problem differs significantly from pathopsychological research aimed at solving issues of a clinical and practical nature.

3) methods and techniques of pathopsychology

In assessing the mental state, conversation and observation still occupy the main place, while the somatic state of the patient is studied by a variety of modern laboratory and experimental methods. Meanwhile, when analyzing the pathology of the psyche, the methods of questioning and observation must necessarily be supplemented by experiment, since it is the experimental method that allows one to move from describing the phenomenon to analyzing the causes and mechanisms of symptom formation.

Pathopsychology, being a branch of psychology, uses the entire arsenal psychological methods, and among them the experiment occupies a leading place. Due to the specifics of the subject and the practical problems it solves, we can say that pathopsychology is an experimental science.

4) violations of sensations and perception in psychiatry and pathopsychology

In pathopsychology, the emphasis is not on describing symptoms and syndromes, but on revealing their psychological mechanisms and patterns of formation.

DISTURBANCE OF PERCEPTION

agnosia- violation of the semantic side of perception, that is, the patient can describe the object, but cannot name it, cannot say why it is needed

pseudoagnosia in dementia- violation of not only semantic but also structural components. Patients snatch out individual parts of the image and cannot catch this image as a whole.

deception of the senses- hallucinations, cases of difficult concentration on the source, increased orienting activity of the analyzers, contribute to the occurrence of hallucinations. The main role in the occurrence of hallucinations is played by a change in the activity of external and internal analyzers, the presence of subthreshold (unconscious) stimuli that cause an overload of these analyzers.

motivational component- (the motivation of perception is not set; the study of the imagination; the study of mental capabilities)

healthy- interest in tasks varied depending on the "motive of expertise"

schizophrenia- no interest in the task, no motive for expertise, only own motive for perception

epilepsy- too much big interest to the task

A change in the motivational component leads to a change in perceptual activity; accordingly, some perception disorders are a manifestation of a violation of the motivational sphere

MEMORY DISTURBANCES

-impaired immediate memory

Violation of remembering images

1. Korsakov's syndrome is a violation of immediate memory for current events. violation of the reproduction of events, and not the imprinting of traces. Missing memories can be replaced by fictional events (confabulations)
2. progressive amnesia - impaired memory for current events and events from the past. The disturbance spreads gradually, the earliest memories being the last to be cut. Patients confuse the past and the present, lose their orientation in time and space. Repeated repetition of the material does not improve its memorization, the total amount of memorization is reduced.

- mediated memory impairment

violation of remembering the image with the help of any symbols denoting this image (mediated image)

Pictograms of Luria

Patients cannot establish a conditional connection adequate to the content of the task
Epileptics could not independently choose one of the many options.
Schizophrenics make overly formal connections, such as sound
May be too detailed

Due to such disturbances in thinking, patients remember material worse if they resort to mediation, unlike healthy people.
In case of violation of mediated memory, the playback process does not go as indicated in the scheme of A.N. Leontiev A-X-A, it can be A-X-X or even A-X-Y

Depending on the disease and the structure of the impairment of activity specific to each disease, there is a specific impairment of mediated memory (that is, it is impaired differently in different patients)

- violation of the dynamics of mnestic activity

Violation of the efficiency of memorization and reproduction depending on time (today is good, tomorrow is bad), usually associated with similar disorders in all forms of their activity, their cognitive and affective-emotional sphere.

Accordingly, a violation of the dynamics of memory is an indicator of the instability of mental performance in general.

Violations of the dynamics of mnestic activity can also be associated with affective-emotional instability or effective capture of patients. Affective disorganization of patients, often found in organic brain diseases of various origins, can manifest itself in forgetfulness, inaccuracy in assimilation, processing and reproduction of material. Effective capture of patients, excessive focus on the mandatory success of activities can also lead to forgetting intentions, undifferentiated perception and retention of material.

- violation of the motivational component of memory

In patients with a disturbed motivational sphere, memorization and reproduction is at a lower level than in healthy people, which is explained by the lack of desire for proper memorization and reproduction.

DISTURBANCE OF THOUGHT

Violation of thinking - a violation of the components included in its structure

1) operational side of thinking

1. the decrease in the level of generalization lies in the fact that direct ideas about objects and phenomena dominate in the judgments of patients. Operating with general features is replaced by the establishment of purely specific relationships between objects. That is, objects are combined on the basis of secondary and particular features. The book and the sofa will be combined because the book is convenient to read on the sofa, and the ball and tomato because they are red. In particularly severe cases, patients may lack the ability to classify objects. A narrow circle of connections, few associations.
2. the distortion of the level of generalization consists in reflecting only the random aspects of phenomena, while the essential relationships between objects are little taken into account, the subject content of things and phenomena is often not taken into account. For example, when performing a task on the classification of objects, patients are guided by excessively general features that are inadequate to the real relationships between objects. So, the patient combines a fork, a table and a shovel into one group according to the principle of "hardness". There are a lot of associations, but they are incorrect and reflect only excessively general connections.

2) the dynamics of thinking

1. The lability of thinking is characterized by the instability of the way the task is performed, that is, by the alternation of adequate and inadequate solutions. The level of generalization of patients generally may not suffer, patients are able to correctly generalize the material, they do not violate the operations of comparison, transfer. However, the adequate character of judgments can be unstable.
2. inertia of thought. In these cases, there is a pronounced difficulty in switching from one mode of work to another. Patients cannot change the course of their judgments, switch from one type of activity to another. Patients with such a disorder hardly change their behavior model, algorithm of actions, the way of solving when changing activities, changing the task.

3) personal component of thinking

Violation of the motivational component, thinking is tied to motives and needs that are different in patients from those accepted in society. When classifying objects, healthy people rely both on personally significant meanings based on personal experience and feelings, and on socially accepted ones, based on a developed body of knowledge about the subject.

1. diversity. Patients with such a violation in the process of performing one task rely either on adequate knowledge about the subjects, or on personal experiences associated with these subjects. The judgments of such patients about some phenomenon proceed in different planes.
2. reasoning. fruitless sophistication, unproductive long-winded reasoning. the reasoning reasoning of the patient is determined not so much by a violation of his intellectual operations, but by increased affectivity, inadequate attitude, the desire to bring any, even an insignificant phenomenon, under some kind of concept. Reasoning is expressed in the patient's pretentious and evaluative position and a tendency to generalize more in relation to the small object of judgments. Affectivity is manifested in the very form of the statement: significant, with inappropriate pathos. Grammar speech reflects the emotional features of reasoning: the syntax is peculiar, the vocabulary of reasoning statements, inversions and introductory words are often used.

Diversity and reasoning are reflected in speech, which acquires the character of "disintegration". Its main characteristics:

1. in the rather lengthy utterances of the patients there is no reasoning;
2. in the speech of patients it is impossible to detect a specific object of thought;
3. patients are not interested in the attention of the interlocutor; they do not express in their speech any relation to other people.

Thus, the "torn" speech of patients is devoid of the main features characteristic of human speech. It is neither an instrument of thought nor a means of communication between people.

4) violation of critical thinking

Critical thinking in this case is the deliberateness of actions, their verification and correction in accordance with objective conditions.

Patients show critical thinking in different ways, some are ready to correct mistakes on their own, others do it only under external pressure, and still others stubbornly defend their point of view. Worst of all, errors related to the diversity of judgments lend themselves to correction, i.e. with a violation of the motivational component of thinking

PERSONALITY DISTURBANCES

1) violation of the structure of the hierarchy of motives

The most obvious examples are dependency generation.
Motives become less mediated, correspondingly less controllable. Gradually, the leading motive - the satisfaction of a need (dependence) subjugates the entire personality of a person.

This is the transformation of a social need into a pathological attraction that subjugates all human activity.

2) the formation of pathological needs and motives

Initially, an adequate motive as a result of some events (trauma, stress, illness, lifestyle change) becomes dominant in a person’s life. The hierarchy of motives changes, the actions necessary to satisfy the need themselves become a motive, and all human activity begins to be built around the satisfaction of this need, this need becomes pathological.

3) violation of meaning formation

1. the weakening of the meaning-forming function of the motive, the motive becomes simply known. "paradoxical stabilization of some circle of semantic formations" (Kochenov)
2. the narrowing of the circle of semantic formations, that is, the motive, while retaining the motivating force, began to direct it to a smaller number of phenomena than before the disease. As a result, the motivating force of the motive decreased

Such patients are not included in common system relationships of people. Therefore, one of the most important measures of psychocorrection is the inclusion of patients in labor activity.

4) Violation of self-regulation and mediation

Mediation occurs at the level of operations

A sign is a means of mastering behavior, mastering behavior is an indirect process

By mediating his behavior, a person gets the opportunity to develop new ways of acting, activity, new motives. Human behavior becomes more arbitrary and conscious

In patients with organic diseases of the brain, the inability to operate with a sign is part of a wider pathology - a violation of mediation, regulation of one's actions

Mediated behavior is a "path" to the goals that a person sets for himself, while realizing not only his actions, but also the motives behind them. The ability to make knowledge and experiences about the situation and their capabilities in it the object of their consciousness. The process of meaning formation is possible only in the presence of mediation.

Self-regulation is awareness of the situation, setting goals.

In patients, due to impaired mechanisms of mediation and self-regulation, the process of meaning formation is disrupted, despite the understanding of the need to perform some actions, the motivating force of the motive may not be enough for them to begin to perform these actions.

5) Violation of criticality and spontaneity of behavior

If the critical controlled attitude to oneself and to the environment is violated, it becomes impossible to realize the kaleidoscope of impressions of the surrounding patient, the ability to resist these impressions is lost. The actions of patients cease to be dictated by internal motives and needs. A person begins to act on the basis of the situation around him, without relying on motivation, a new object that appears in the field of attention can easily force the patient to change activities. This phenomenon is called aspontaneity. The loss of the ability to evaluate oneself and others leads to the loss of motives, goals, awareness of actions and judgments. Such patients have anosognosia not only in relation to the disease, but also in relation to their behavior.

6) Violation of the formation of characterological features of the personality

The character of a person, both healthy and sick, is formed in vivo depending on the conditions, the disease creates conditions leading to anomalies of motives.

PATHOPSYCHOLOGICAL SYNDROMES

In pathopsychology, as in psychiatry, a syndrome is understood as a pathogenetically determined community of symptoms, signs of mental disorders, internally interdependent, interrelated. This is the greater diagnostic significance of syndromes compared with symptoms. In the diagnostic thinking of a doctor, the correct qualification of the syndrome is an approach to determining the nosological affiliation of the disease. Each of the pathopsychological syndromes includes a number of symptoms. The set of symptoms is a symptom complex (syndrome). A syndrome (symptom complex) is a stable combination of interrelated positive and negative symptoms due to a common pathogenesis.

Symptoms and syndromes are the material from which the clinical picture of the disease is created. Syndromes and their dynamics manifest the pathogenesis of the disease, the sequence of its stages. When recognizing a mental illness (nosological form), one should focus not only on the currently dominant psychopathological syndrome in the patient’s condition, but mainly on the entire context of the disease: how this syndrome is related to other symptoms and syndromes, what is their dynamics, how it affected the safety of the patient's personality, that is, what are the depth and dimensions of the lesion, the degree of involvement of the mental sphere in the painful process.

According to the peculiarities of origin, all psychopathological symptoms with a certain degree of conventionality can be divided into positive and negative. Positive symptoms (productive, plus symptoms) arise in connection with the pathological production of the psyche. This includes hallucinations, delusions, obsessions, overvalued ideas and other pathological formations. Negative symptoms (deficient, minus symptoms) are a sign of persistent loss of mental functions, a consequence of gender, loss or underdevelopment of some links of mental activity. The manifestations of a mental defect are memory loss, dementia, dementia, a decrease in the level of personality, etc. It is generally accepted that positive symptoms are more dynamic than negative ones; it is changeable, capable of becoming more complex and, in principle, reversible. Deficiency phenomena are stable, they are highly resistant to therapeutic effects.

Isolation of positive and negative symptoms in the patient's condition corresponds to the clinical reality. Since the time of the neurologist J. Jackson, who proposed the concept of productive and deficient symptoms in the first half of the 19th century (within the framework of the theory of a single psychosis), many concepts have accumulated to clarify the term "deficiency" in the mental sphere. Deficiency is not only an irreversible defect, loss of mental function, but also its inhibition, temporary shutdown. The clearer the destruction of the brain, the weaker the mental reaction, the more clearly the signs of deficiency appear, which are most pronounced in organic dementia.

Productive (positive) psychopathological syndromes are an indicator of the depth and generalization of damage to mental activity. Positive psychopathological syndromes include neurotic, affective, depersonalization-de-realization, confusion syndrome, hallucinatory-delusional syndromes, syndromes of movement disorders, clouding of consciousness, eyleptiform and psychoorganic.

As a result of the identification of pathopsychological syndromes, it becomes possible to assess the features of the structure and course of the mental processes themselves, leading to clinical manifestations - psychopathological syndromes. The pathopsychologist directs his research to the disclosure and analysis of certain components of brain activity, its links and factors, the loss of which is the cause of the formation of symptoms observed in the clinic.

The following pathopsychological register-syndromes are distinguished (I.A. Kudryavtsev):

• schizophrenic
• affective-endogenous
• oligophrenic
• exogenous organic
• endogenous-organic
• personality abnormal
• psychogenic-psychotic
• psychogenic-neurotic

The schizophrenic syndrome complex consists of such personality-motivational disorders as: a change in the structure and hierarchy of motives, a disorder of mental activity that violates the purposefulness of thinking and meaning formation (reasoning, slipping, diversity, pathological polysemanticism) while maintaining the operating side, emotional disorders (simplification, dissociation of emotional manifestations, sign paradoxicality), changes in self-esteem and self-awareness (autism, sensitivity, alienation and increased reflection).

The psychopathic (personality-abnormal) symptom complex includes: emotional-volitional disorders, violations of the structure and hierarchy of motives, inadequacy of self-esteem and the level of claims, impaired thinking in the form of "relative affective dementia", impaired prediction and reliance on past experience.
The organic (exo- and endogenous) symptom complex is characterized by such signs as: a general decrease in intelligence, the collapse of existing information and knowledge, mnestic disorders affecting both long-term and operative memory, impaired attention and mental performance, impaired operational side and purposefulness of thinking, changes in emotional spheres with affective lability, violation of critical abilities and self-control.
The oligophrenic symptom complex includes such manifestations as: inability to learn and form concepts, lack of intelligence, lack of general information and knowledge, primitiveness and concreteness of thinking, inability to abstract, increased suggestibility, emotional disorders.

REASONING

Reasoning is a type of thinking characterized by a tendency to empty, fruitless reasoning based on superficial, formal analogies. It manifests itself in philosophizing, verbosity and banality of judgments that are inadequate to the real situation. At the same time, the goal mental task relegated to the background, and the patient's desire for "reasoning" comes to the fore.

The psychological structure of resonant thinking was revealed by T. I. Tepenitsyna (1965, 1968, 1979). The author found that reasoning is not associated with any particular type of error in the implementation of the mental operations. It is due to the peculiarities of the personal-motivational sphere of patients. This variant of the patient's personal position is defined as an excessive need for "self-expression" and "self-affirmation". This explains such typical features of resonant thinking as the exaggerated pretentious and evaluative position of the patient, the affective inadequacy of the choice of the subject of discussion, the latter’s inconsistency with the methods of evidence and reasoning, the tendency to “overgeneralize” on a trifling matter, insufficient self-criticism, a peculiar manner of speech (floridity, a tendency to meaningful intonations, the use in excess of concepts that are often completely inappropriate for the subject of discussion, verbosity)

Recently, the sciences have ceased to have strict distinctions, today the names "biochemistry" and "biophysics" no longer surprise anyone, but it turns out that the process of erasing the boundaries has begun a long time ago. In the 1930s, at the junction of psychology and psychiatry, a new scientific discipline- pathopsychology. What is included in the sphere of interests of this science, we have to find out.

How did the science of pathopsychology appear?

As a science, pathopsychology began its development in the 1930s, during the Second World War and the post-war period, when many people with war injuries appeared, whose mental functions needed to be restored. But science reaches rapid development by the 1970s. It was then that the foundations of domestic pathopsychology were outlined in the works of the first practical psychologists in our country. Finally, the disputes around the tasks, subject and place of pathopsychology ended by the 80s of the last century. Today there is a process of dividing science into separate areas, for example, today the direction of forensic pathopsychology has taken shape.

Subject and object of pathopsychology

Pathopsychology studies disorders of mental processes and states using psychological methods. At the same time, an analysis of pathological changes is made on the basis of a comparison with the course and nature of the formation of mental processes and states in individuals whose mental indicators correspond to the norm. Based on the definition, we can say that pathopsychology is a practical branch of medical psychology, the subject of which is the study of the patterns of formation of psychopathologies, and as an object, anomalies and disorders of mental activity are considered, different in manifestations, but similar in severity, that is, bordering on normal ( healthy) states.

The leading direction of clinical psychology should be considered pathopsychology. Pathopsychology emerged at the turn of the twentieth century. Its founder is considered to be V.M. Bekhterev, who, together with his students, revealed the qualitative and quantitative features of the neuropsychic activity of individual patients, as well as the dynamics of mental disorders depending on various external factors. The development of this area of ​​clinical psychology was significantly influenced by A.F. Lazursky, G.I. Rossolimo, B.V. Zeigarnik and other scientists.

Pathopsychology is a branch of clinical psychology that studies the patterns of disintegration of mental activity and personality traits when compared with normally formed and ongoing mental processes. N.L. Belopolskaya notes that within the framework of pathopsychology, issues of abnormal mental development are being developed, defects in individual mental functions, as well as involutional and destructive mental states are being studied. The author points out that pathopsychology provides the material necessary for understanding the essence of the concept of "normal mental development", and because of this, it has a significant impact on the solution of many fundamental problems of general psychology. However, pathopsychology has its own subject and methods, while being an applied discipline. Pathopsychology is closely interconnected with other sections psychological science. For example, the study of the patterns of functioning of various mental processes is carried out in more detail if there is data on their possible violations. The mechanisms of mental activity, normally often hidden from the researcher, can be studied and analyzed much more easily in case of their disintegration or violation.

V.A. Kulganov and others offer a distinction between pathopsychology and psychopathology. Psychopathology as a science differs from pathopsychology in that it describes the signs of a mental illness in the course of an illness, in dynamics. If pathopsychology operates largely in psychological terms, then psychopathology operates in medical clinical terms (etiology, pathogenesis, symptom, syndrome). The author calls the main tasks of pathopsychology the following:

1. Obtaining data for pathogenetic and differential diagnosis.

2. Study of the dynamics of mental disorders in connection with the ongoing therapy - an assessment of the effectiveness of the treatment process.

3. Participation in expert work (military, medical and social, judicial, psychological, medical and pedagogical expertise).

4. Participation in rehabilitation work.

Thus, pathopsychology as a subject considers not just the human psyche, but the psyche against the background of some kind of violation. B.V. Zeigarnik described the subject of pathopsychology in the most detailed way: “pathopsychology as a psychological discipline proceeds from the laws of development and structure of the psyche in the norm. It studies the laws of the decay of mental activity and personality traits in comparison with the laws of the formation and course of mental processes in the norm, it studies the laws of distortion of the reflective activity of the brain ". Summarizing the above, we can conclude that pathopsychology studies mental activity against the background of various disorders. In this regard, it should be noted that the most popular concept in pathopsychology is the concept of mental disorder. This concept, in accordance with the International Classification of Diseases, is interpreted as a disease state with psychopathological or behavioral manifestations associated with impaired functioning of the body as a result of exposure to biological, social, psychological, genetic or chemical factors. In other words, this concept means deviation from the norm. From the point of view of N.L. Belopolskaya, a deviation from the norm is a condition in which the following aspects are detected:

1) inadequacy emotional reactions, actions, speech statements, facial expressions, gestures and behavior in general;

2) reduction or lack of criticality to their actions, physical and mental state;

3) unproductive activity.

The opposite concept in pathopsychology is the concept of mental health. The term " mental health" was first introduced by the World Health Organization in 1979. In foreign countries(USA, UK) the concept of "mental health" is considered as the successful performance of mental functions, resulting in productive activity, establishing relationships with other people and the ability to adapt to changes and cope with troubles. The essence of mental health lies in the fact that it is the basis of intellectual activity and communication skills, learning, emotional growth, resilience and self-esteem.

From the point of view of many authors (SM Grombakh, N. Sartorius), mental health is an integral characteristic of the full value of the individual's mental functioning, including an understanding of the nature and mechanisms of its maintenance. The basis of mental health is the full development of higher mental functions, mental processes and mechanisms at all stages of ontogenesis.

IN domestic psychology the term "mental health" defines the state of mental well-being, in which there are no painful mental manifestations, adequate regulation of behavior and activity is ensured. In other words, the mental health of an individual is characterized by the integrity and coordinated activity of all the mental functions of the body, which contributes to a certain level of comfort, the formation of adequate forms of behavior. The main features of mental health are mental processes and states, as well as personality traits. The most complete criteria for mental health are described by N.D. Lakosina and G.K. Ushakov:

Permanence of habitat

Correspondence of age and maturity of feelings,

Lifestyle,

Correspondence of reactions to external stimuli and their adequacy,

A sense of responsibility for offspring,

Changing your own behavior depending on life situations,

Self-affirmation in the team.

Thus, mental health as a set of criteria is an acute problem today. modern society. To study it in order to maintain a favorable state in the framework of clinical psychology, various studies are being carried out.

V.A. Kulganov et al. note that the following problems are being investigated within the framework of pathopsychology:

1. Violations of mental processes in patients:

Sensations, perceptions (visual, auditory, tactile (tactile), olfactory and gustatory disorders, as well as disturbances in the level of perception: agnosia, illusions, hallucinations, etc.),

Violations of voluntary movements and actions (motor disorders, including tics, hyperactivity, etc.),

Speech disorders (specific disorder of speech articulation; disorder of expressive, impressive speech; stuttering), communication and learning skills,

Memory disorders (dysmnesia - amnesia, hypermnesia, hypomnesia; paramnesia - pseudo-reminiscences, cryptomnesia, echomnesia, confabulation),

Thinking disorders (impairments of the operational side of thinking, the dynamics of thinking, the personal component of thinking),

Emotional disturbances. Disorders of the emotional sphere consist in painful experiences of certain emotional states. The main violation is to change emotional state towards oppression or uplift. Disturbances in the emotional sphere include hypothymia, hyperthymia, parathymia, as well as disturbances in the dynamics of emotions,

Mood disorders (depressive disorders and bipolar affective disorder),

Disturbances of consciousness (detachment from outside world, stunned state of consciousness, twilight state of consciousness, etc.).

2. Psychosomatic and psychogenic disorders in various diseases (cardiovascular, gastrointestinal, skin, etc.). As part of this direction neuroses, their manifestations, factors of occurrence, etc. are also studied in detail.

Thus, pathopsychology studies the characteristics of the psyche of a sick person, his personality changes in situations of mental disorders. This direction helps to collect medical and psychological data about what mental changes occur with a sick person in order to determine the most favorable treatment option. Pathopsychology provides information to other areas for the formation of an optimal psychotherapeutic and correctional program. Therefore, the significance of this direction is fundamental for other areas of clinical psychology.

Pathopsychology studies the regularities of disorders of mental activity in comparison with the course of mental processes in the norm.

Pathopsychology is a section that explores mental disorders using experimental methods.

Psychopathology is a branch of clinical psychiatry that is devoted to the description of mental symptoms and syndromes (talk and observation).

According to its goals and practical tasks to be solved, pathopsychology is aimed at providing specific practical assistance to clinicians dealing with mental disorders in various mental disorders.

Pathopsychology, like any other branch of psychology, studying the psyche, has its own specifics, since its subject is not just the psyche, but the psyche, disturbed by one or another mental disorder. The most complete and accurate definition of the subject of pathopsychology was given by B. V. Zeigarnik: “Pathopsychology as a psychological discipline proceeds from the patterns of development and structure of the psyche in the norm. She studies the regularities of the disintegration of mental activity and personality traits in comparison with the regularities of the formation and course of mental processes in the norm, she studies the regularities of distortions of the reflective activity of the brain.

Pathopsychology, considering mental disorders, qualifies psychopathological phenomena in terms of modern psychology, using a categorical apparatus common to all branches of psychology. Pathopsychology, being a branch of psychology, uses the entire arsenal of methods accumulated by psychological science, and experiment occupies a leading place among them. Due to the specifics of the subject and the practical problems it solves, we can say that pathopsychology is an experimental science. In pathopsychology accumulated great experience experimental study of the psyche of patients, and this experience is very useful for psychopathology.

Modern systems approach to the study of mental disorders requires their comprehensive consideration, so the data of the clinical analysis should be supplemented by the data of the pathopsychological study. Therefore, in recent years, there has been a clearer trend towards the convergence of the practice of studying mental disorders in psychology and psychopathology: clinicians are increasingly using psychological experimental methods of research, and in pathopsychology (and clinical psychology in general) a significant role is assigned to the descriptive approach.

Pathopsychological examination is aimed at solving the following tasks:

1. Dif. Diagnosis of mental illness (observation, conversation, anamnesis ...) diagnosis has extremely serious consequences for the individual.

differential methods. Diagnostics: in 99% according to the results of the implementation of experimental methods aimed at studying cognitive processes. Rarely personality questionnaires and questionnaires (they lie, suffer from cognitive disorders). Sometimes projective methods are used

1. Assessment of the severity of cognitive and emotional disorders.
2. Evaluation of the dynamics of cognitive and emotional disorders in the process of treatment and rehabilitation.
3. Solving the problems of forensic-psychological and medical-labor examination.

2. History of the development of pathopsychology

The history of pathopsychology is connected with the development of psychiatry, neurology and experimental psychology.

IN late XIX V. psychology began to gradually lose the character of a speculative science, in its research methods of natural science began to be used. The experimental methods of W. Wundt and his students penetrated into psychiatric clinics - into the clinic of E. Kraepelin, into the largest psychiatric clinic in France in the Salpêtrière, where P. Janet held the position of head of the laboratory for more than 50 years; experimental psychological laboratories were also opened in psychiatric clinics in Russia - in the laboratory of V. M. Bekhterev in Kazan, then in the laboratory of V. F. Chizh in Yuryev, I. A. Sikorsky in Kiev, etc.

Pathopsychology as an independent branch of psychological science began to take shape at the beginning of the 20th century. So, in 1904, V. M. Bekhterev wrote that the latest advances in psychiatry were largely due to the clinical study of the patient’s mental disorders and formed the basis of a special branch of knowledge - pathological psychology; She has already helped solve many psychological problems and is likely to be even more helpful in the future.

It was in the works of V. M. Bekhterev that the most clear ideas about the subject and tasks of pathopsychology at the initial stages of its formation were contained, namely, the study of abnormal manifestations of the mental sphere, since they illuminate the tasks facing the psychology of normal people. Courses in general psychopathology and pathological psychology were taught at the Psychoneurological Institute organized by V. M. Bekhterev. In the literature of those years, it is referred to as "pathological psychology."

In one of the first generalizing works on pathopsychology, Psychopathology as Applied to Psychology, the Swiss psychiatrist G. Sterring wrote that a change in one or another constituent element of mental life as a result of an illness makes it possible to find out in which processes it takes part and what significance it has for phenomena. , which include.

In the 20s. 20th century there are works on medical psychology by famous foreign psychiatrists: "Medical psychology" by E. Kretschmer, which interprets the problems of decay and development from the standpoint of constitutionalism, and "Medical psychology" by P. Janet, in which the author dwells on the problems of psychotherapy.

The development of domestic pathopsychology was distinguished by the presence of strong natural science traditions. I. M. Sechenov attached great importance convergence of psychology and psychiatry. However, the founder of the pathopsychological trend in Russia was not I. M. Sechenov, but V. M. Bekhterev, who organized extensive experimental psychological studies of mental disorders.

The representative of the reflex concept, V. M. Bekhterev, expelled introspection from the sphere of science, declaring the objective method the only scientific one.

In the works of the school of V. M. Bekhterev, rich concrete material was obtained on the features of associative activity, thinking, speech, attention, mental performance in different categories patients compared with healthy people of the appropriate age, sex and education.

The principle of qualitative analysis of violations of psychological activity, adopted at the school of V. M. Bekhterev, has become a tradition in Russian psychology.

V. M. Bekhterev, S. D. Vladychko, V. Ya. Anifimov and other representatives of the school developed many methods of experimental psychological research of the mentally ill, some of them (the method of comparing concepts, defining concepts) were among the most used in Soviet pathopsychology .

retained their value for modern science requirements for methods formulated by V. M. Bekhterev and S. D. Vladychko:

Simplicity (to solve experimental problems, subjects should not have special knowledge and skills);

Portability (the ability to study directly at the patient's bedside, outside the laboratory environment);

Preliminary testing of the method for in large numbers healthy people of the appropriate age, gender, education.

A prominent role in determining the direction of domestic experimental psychology was played by a student of V. M. Bekhterev - A. F. Lazursky, head of the psychological laboratory at the Psychoneurological Institute founded by V. M. Bekhterev, organizer of his own psychological school.

The scientist made a great contribution to the development of the methodology of pathopsychology. A natural experiment developed by him for the needs of pedagogical psychology was introduced into the clinic. It was used in organizing the leisure of patients, their occupations and work activities.

A significant stage in the development of pathopsychology was the work of G. I. Rossolimo "Psychological profiles. The method of quantitative research psychological processes in normal and pathological states", which became widely known in Russia and abroad. This was one of the first attempts at test research: a system was proposed for examining mental processes and evaluating them on a 10-point scale

In 1911, a book by A. N. Bernshtein was published, devoted to the description of the methods of experimental psychological research; in the same year, F. E. Rybakov published his Atlas for the Experimental Psychological Study of Personality. Thus, by the 20s. 20th century a new field of knowledge began to take shape - experimental pathopsychology.

The development of ideas about pathopsychology in the post-revolutionary period

An important role in the development of pathopsychology as a specific field of knowledge was played by the ideas of L. S. Vygotsky on objective activity, which were later developed in general psychology by his students and colleagues: A. N. Leontiev, A. R. Luria, P. Ya. Galperin , L. I. Bozhovich, A. V. Zaporozhets and others.

L. S. Vygotsky expressed the thesis that:

The human brain has different principles of organization than the animal brain;

The development of higher mental functions is not predetermined by the morphological structure of the brain alone; mental processes do not arise as a result of the mere maturation of brain structures, they are formed in vivo as a result of training, education, communication and appropriation of the experience of mankind;

The defeat of the same areas of the cortex has different meaning at different stages of mental development.

L. S. Vygotsky with his experimental studies laid the foundation for the study of the disintegration of thought.

Following the tradition of V. M. Bekhterev, V. N. Myasishchev strove for a combination of psychiatry and psychology and the introduction of objective methods for examining patients in psychiatric clinics. Techniques for objective registration of the emotional components of a person's mental activity were developed; The electrocutaneous characteristic of a person (ECC) recorded with a galvanometer was used as an objective indicator.

A number of works were devoted to the analysis of the structure of the labor activity of patients. Based on these studies, V. N. Myasishchev put forward the thesis that a violation of working capacity should be considered as the main manifestation of a person’s mental illness and that the indicator of working capacity serves as one of the criteria for the patient’s mental state.

During the Great Patriotic War, pathopsychologists were involved in rehabilitation work in the neurosurgical hospital. Disorders of mental activity and their recovery become the subject of pathopsychological research.

The data of S. Ya. Rubinshtein, B. V. Zeigarnik, A. R. Luria on the structure of reading, writing, and thinking disorders in patients with vascular pathology, Alzheimer's disease, and the consequences of brain injury made it possible to substantiate the following point of view: mental illness proceeds according to biological patterns that cannot repeat patterns of development. Even in those cases when the disease affects the youngest, specifically human parts of the brain, the psyche of a sick person does not acquire the structure of the psyche of a child at an early stage of his development. The fact that the patient cannot think and reason in high level, indicates the loss of complex forms of behavior and cognition, but does not mean a return to the stage of childhood. That is, the disintegration of the psyche is not a negative of its development. Different types pathologies lead to qualitatively different decay patterns.

The most important ideas of L. S. Vygotsky were developed in the works of A. N. Leontiev, who was especially careful in developing the problem of activity. He formulated the following basic principle: internal mental activity arises in the process of interiorization of external practical activity and has the same structure as practical activity. Thus, by studying practical activity, we learn the patterns of mental activity. This provision played a huge role in the development of the methodology of pathopsychology. B.V. Zeigarnik repeatedly pointed out that it is possible to understand the patterns of mental activity disorders only by studying the practical activity of the patient, and to correct mental activity disorders by managing the organization of practical activity.

Another theory that played an important role in the development of pathopsychology is the theory of relations by V. N. Myasishchev, according to which a person's personality is a system of relationships with the outside world. These complex relationships are expressed in his mental activity. Human relations in a developed form are a system of individual, selective, conscious connections of a person with various aspects of objective reality.

Mental illness changes and destroys the existing system of relationships, and violations in the system of personality relationships, in turn, can lead to illness. It was through such contradictory relationships that V. N. Myasishchev considered neuroses.

The development of ideas about pathopsychology in the modern period

One of the leading problems in the field of pathopsychology is the problem of the decay of cognitive activity. Work in this area is carried out in different directions: changes in the personality component in the structure of disorders are being studied. cognitive processes, the question of the relationship of violations of cognitive processes with the process of updating knowledge is being developed. Another line of research is aimed at the psychological analysis of personality disorders observed in a psychiatric clinic.

Recently, pathopsychological research in experimental practice has expanded significantly: forensic psychiatric and labor.

The problem of labor and social rehabilitation now attracts the attention of representatives of various specialties; the network of laboratories for the restoration of both individual dysfunctions and the working capacity of sick people is expanding. The participation of psychologists is becoming not only necessary, but often the leading factor in both the rehabilitation sphere and the prevention of mental illness.

Pathopsychological research in children's neuropsychiatric institutions has received particular development. Techniques are being developed to facilitate the early diagnosis of mental retardation; analysis of complex pictures of dementia and underdevelopment in childhood is carried out in order to search for additional differential diagnostic signs and symptoms; on the basis of L. S. Vygotsky’s position on the zone of proximal development, a number of teaching experiment methods are being developed aimed at identifying prognostic important signs of children’s learning ability (psychological laboratory of the neuropsychiatric hospital No. 6).

Along with research work, a lot of work is being done to develop and test research methods. The growth of research and practical work in the field of experimental pathopsychology, it also manifests itself in the fact that scientific societies of both psychologists and psychiatrists and neuropathologists have sections that unite and coordinate research in the field of pathopsychology. At the all-Union congresses of psychologists, the reports of pathopsychologists were widely presented, which concentrated around the following problems:

The value of pathopsychology for the theory of general psychology;

Compensation problem;

The problem of pathopsychology of thinking and personality.

important role in the development of pathopsychological research in different years played by M. M. Kabanov, Yu. F. Polyakov, V. V. Nikolaeva, V. M. Kogan. Pathopsychological research in children's neuropsychiatric institutions has received particular development. Techniques are being developed that contribute to the early diagnosis of intellectual disorders, the identification of additional differential diagnostic signs of mental illness in children, methods of psycho-correctional work (S. Ya. Rubinshtein, V. V. Lebedinsky, I. Λ. Korobeinikov, Λ. Ya. Ivanova, A. S. Spivakovskaya).

3. The main problems hindering the development of domestic pathopsychology at the present stage

1. An outdated psychodiagnostic tool (developed in the 30-60s of the XX century). extreme conservatism of the psychiatric system
2. Lack of integration with foreign clinical psychology: methodological and ideological differences
3. Lack of introduction of modern cognitive sciences into neurophysiology (?)

pathopsychology engaged in the study of painful changes in the psyche. Engaged in the study of patterns of change and decay of the psyche. Is an integral part clinical psychology. Pathopsychology borders on psychiatry, in particular, on psychopathology. Although the names of these disciplines consist of the same ancient Greek roots, however, despite the common “object” of research (which is mental disorders), there are significant differences between them. In pathopsychology, ideas about pathopsychological syndromes violations of the cognitive, motivational-volitional and personal spheres.

Pathopsychological disorders

Pathopsychological disorders can be the following:

Dissociative symptom complex. It consists of such personality-motivational disorders as a change in the structure of the hierarchy of motives, a violation of the purposefulness of thinking; emotional-volitional disorders, changes in self-esteem and self-awareness.

Organic symptom complexes. Decreased intelligence, the collapse of the system of previous knowledge and experience, impaired memory, attention, and the operational side of thinking; instability of emotions; decrease in critical abilities.

Psychopathic symptom complex. It consists of emotional and volitional disorders, changes in the structure of the hierarchy of motives, inadequacy of the level of claims and self-esteem, impaired thinking of the catatim type, impaired forecasting and reliance on past experience (in the clinic - accentuated and psychopathic personalities and psychogenic reactions largely due to abnormal soil).

Oligophrenic symptom complex. Inability to learn, form concepts, abstract, lack of general information and knowledge, primitive and concrete thinking, increased suggestibility and emotional disorders.

Mental disorder in psychopathology This is a state of mind that is different from the standard. It is quite difficult to draw a clear line between a healthy and unhealthy psyche. It is difficult to decide what to consider as a standard, since many people have some mental disorders associated with character traits and personality. A change in the social mentality has a serious impact on psychopathology - to consider this or that deviation as a disease or not.

social phobia

From contemporary examples can be called social phobia. social phobia it is a stubborn irrational fear of performing any social action (for example, public speaking), or actions accompanied by attention from outsiders (fear of the looks of passers-by on the street, the inability to do anything when observed from the side). Previously, people suffering from this disorder were considered quite normal, simply possessing such character traits as timidity, shyness, and lack of communication skills.

Attitudes towards homosexuality have changed in the opposite direction - a few decades ago it was considered a mental disorder requiring treatment. Now the opinion has been established, according to which sexual orientation in itself is not a mental disorder. Psychopathology, studying mental disorders, uses a number of qualifications. In particular, stand out:

Organic disorders, i.e. caused organic disorders;

personality disorders;

Behavioral disorders;

Affective, they are emotional, disorders;

Disorders caused by the use of various psychoactive substances;

post-traumatic disorders.

In practice, these groups of disorders often overlap with each other.

It was said above that it is quite difficult to separate a healthy mental state from a pathological one. Meanwhile, such a task exists (not only in medicine, but also in jurisprudence). Therefore, a set of criteria for mental ill health is generally recognized:

Violation of self-identification;

Inconstancy of experiences in the same type of situations;

Lack of a critical attitude towards oneself and the results of one's mental state;

Inconsistency of mental reactions with the strength and frequency of external influences;

antisocial behavior;

Inability to plan their activities and put plans into practice;

Lack of ability to change one's behavior when external circumstances change.

Mental disorders are divided into two groups:

exogenous (caused external factors);

endogenous (their cause is internal factors).

The first factors include drugs, alcohol, traumatic brain injury, the second - gene and hereditary diseases, chromosomal disorders.

Treatment of pathopsychological disorders

The manifestation of mental disorders is closely related to the socio-cultural background in which a person lives. For example, if mental disorders are not accepted, condemned by society, then they often manifest themselves in the form of physical ailments (psychosomatics), in particular, depression leads to diseases of the internal organs. In countries with the opposite mentality, the same depression is perceived as a state of apathy, loss of energy, lack of emotion.

If we turn from the practical aspects of psychopathology to its scientific component, then it should be noted that this science is still in its infancy. Until now, the questions of what is its subject, how it is connected with other branches of psychology, etc., have not been finally resolved. The problem of separating pathological and non-pathological is acute.

It is generally accepted that the syndrome is the basic structural unit of psychopathology. It is understood as a set of signs of mental illness. Knowing the syndrome, the doctor can correctly diagnose the disease. Syndromes are divided into positive and negative. The former can be characterized as associated with the defeat (of varying degrees of depth) of mental activity, and the latter denote the exhaustion of mental activity. For example, affective syndromes, hallucinatory, states of clouding of consciousness are considered positive. Dementia, regression of mental activity - negative.

feature historical development psychopathology is its susceptibility to external influences from society, politics, philosophy. Often, theorists of psychopathology tried to use it to solve problems that go beyond the scope of science, fulfilling an ideological order.

In the future, psychopathology will be strengthened as a science aimed at conducting objective research, the results of which will help in the treatment of the mentally ill, as well as in the study of the nature of mental disorders.