Home Mushrooms Formation of a comfortable environment for people with a violation of the musculoskeletal system. Topic18. Formation of a comfortable environment for people with disorders of the musculoskeletal system Psychological characteristics of a person with a musculoskeletal system

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Formation of a comfortable environment for people with a violation of the musculoskeletal system. Topic18. Formation of a comfortable environment for people with disorders of the musculoskeletal system Psychological characteristics of a person with a musculoskeletal system

2.2 Personal characteristics of people with disorders of the musculoskeletal system

The problem of the correlation of mental and somatic pathology is an integral part of a holistic approach to the patient (Perozhok I.L., Zharikov N.M., 1986) and the subject of a psychosomatic direction. The historical aspect of this issue is sufficiently covered in the domestic literature (Nikolaeva V.V., 1987, Isaev D.N., 1994). Domestic authors considered the idea of psychosomatic unity (Gilyarovsky V.A., 1957), autoplastic picture of the disease (Luriya R.A., 1935), somatognosia (Kvasenko A.V., Zubarev Yu.G., 1980) and neurotic disorder of internal organs (Kavasarsky B.D., Prostomolotov V.F., 1988).

The term "rheumatic diseases" combines pathological pictures, the common characteristic and leading symptoms of which are pain in the musculoskeletal system.

This symptomatic concept includes etiologically, pathologically and clinically-nosologically different syndromes. It is necessary to distinguish at least three main groups of rheumatic diseases: inflammatory processes of the joints and spine, degenerative diseases of the joints and spine, and rheumatic lesions of soft tissues. The fourth group should be the so-called pararheumatic diseases, in which pain in the tissue structures of the musculoskeletal system is a sign of another disease.

According to I.G. Malkina-Pykh, with rheumatic lesions of soft tissues (fibromiralgia), patients have clearly expressed feelings of fear and depression. Patients are little inclined to hypercompensated behavior. Their latent or explicit desires, worries and addiction tendencies are pronounced, the tendency to self-sacrifice and dependence is clearly defined.

The patient's frozen and exaggerated position in life is striking. They often exhibit heightened self-control and a desire for perfectionism. They cannot afford healthy aggressive impulses, they try to compensate for disappointment and resentment with “internal stamina”. Characteristic for them is a tendency to self-sacrifice and an exaggerated willingness to help, which manifests itself not spontaneously, but by internal compulsion.

Blocked aggressive impulses of patients are expressed in increased muscle tension and, finally, in localized or localized pain.

Bweck (1971) describes such a patient as one who, after the onset of the disease, is addictive and develops strong needs for surrender and a desire for outside care. relatively often manifest neurotic symptoms develop, especially states of fear, depression and psychosomatic symptoms in the form of functional cardiac, gastric disorders, headaches, asthenic pictures.

In patients with rheumatoid arthritis in the remote stages of the condition, their tolerance and undemandingness are striking. Their patient unpretentiousness is in conflict with the objective data on the disease.

In premorbid patients are characterized as quiet, inconspicuous people. They are diligent and conscientious. Their altruistic behavior is often noticeable, which, combined with energy and thirst for activity, makes them consummate mothers and tireless nurses. Patients pay very little attention to their physicality, characterized by poor self-perception and reduced self-knowledge. Their patience probably corresponds to an internal prohibition against the open expression of residual aggressive impulses.

The specificity of the "rheumatic personality" is to increase self-restraint in life relationships, in one's own self, in one's own body and in the communicative sphere, including in social behavior. The foregoing can be attributed to motor aggressive impulses, which, starting from early childhood, are described as a problematic area. In general, we can talk about an unsuccessful balance of the poles of softness and hardness.

In all patients with rheumatoid arthritis, three character traits occur with sufficient constancy:

1. Persistent manifestations of over-conscientiousness, commitment and external compliance, combined with a tendency to suppress all aggressive and hostile impulses, such as anger or rage.

2. Masochistic-depressive manifestations with a strong need for self-sacrifice and an excessive desire to provide assistance, combined with supermoral behavior and a tendency to depressive mood disorders.

3. A pronounced need for physical activity before the development of the disease (professional sports, intensive housework, gardening, etc.). .

The aforementioned character traits are, moreover, hypercompensatory defenses against underlying conflict. Over-conscientiousness, refusal to express one's feelings and self-sacrifice create a protective barrier for a possible breakthrough of aggressive impulses and allow one to get rid of hostile feelings. Obsessive and depressive-masochistic manifestations are regarded as protective structures against a destructively experienced production. Often described are a kind of tolerance, resignation to fate, liveliness, despite limited mobility and pain, which, according to psychoanalytic views, has a dual interpretation.

Patients with primary chronic polyarthritis are experienced patients with whom there is little trouble. They are modest and undemanding, often to the point of indifference. They are almost never obviously depressive, although fate limits the possibilities of their activity: they almost never grumble, are not unbearable and caustic, do not fall into despair or anger. Their patience and moderation are in sharp contrast to the catastrophe that occurs in their destiny.

According to B. Luban-Plozza, poise, modesty and undemanding are the result of the fact that these patients do not fully appreciate all the symptoms of the disease and the severity of its consequences. Patients perceive their deformed hands not so much as a sick part of the body, but as an annoying nuisance. You can be surprised to see what actions they perform with these hands. Contrary to expectations, diseased hands are not excluded from the body schema; patients do not spare them, do not isolate them, but perceive them as although reduced and "inhibited", but quite usable organs and use them accordingly. Their world of self-perception shows a certain limitation, due to the reduction of their consciousness on their bodily sphere. The patient is then unpretentious, modest and patient when he perceives himself, his illness and the diseased state of his body parts in a “reduced” way. Modesty is a kind of escape from the truth.

Most of the patients with primary chronic polyarthritis before the disease were especially active and active. Their indefatigability in caring for loved ones is noteworthy. These are people who help in need and for years can play the role of an assistant without any posture, free of charge and without claims of gratitude. This is selflessness of service and tirelessness, later (after illness) selflessness and undemanding and modesty. Both qualities - pseudo-altruistic asceticism and patiently resigned self-denial - the outcome of premorbid and for the disease - this is the process of self-disclosure, the reduction of self-perception, that dominates throughout the life of a patient with polyarthritis.

There are many classifications of types of personal response of the patient to his disease. However, all classifications can be conditionally divided into three groups: medical-psychological, psychological-psychiatric and socio-psychological.

Medico-psychological classifications are guided by everyday practical medical activities and describe the types of attitude to the disease, more bearing in mind the nature of the interaction that develops between the doctor and patients (Reinvald N.I., 1969; Stepanov A.D., 1975; Lezhepekova L.N. ., Yakubov P.Ya., 1977, etc.)

According to B.A. Yakubov (1982) the following types of response to the disease can be distinguished:

Friendly response. This reaction is typical for people with a developed intellect. It is as if from the first days of the disease they become the “assistant” of the doctor, demonstrating not only obedience, but also rare punctuality, attention, and goodwill. They have unlimited trust in their doctor and are grateful for his help.

Calm reaction. Such a reaction is typical for persons with stable emotional-volitional processes. They are punctual, adequately respond to all the instructions of the doctor, accurately perform medical and recreational activities. They are not just calm, but even appear “solid” and “sedate”, they easily come into contact with medical personnel. They may sometimes not be aware of their illness, which prevents the doctor from identifying the influence of the psyche on the disease.

unconscious reaction. Such a reaction, having a pathological basis, in some cases plays the role of psychological protection, and this form of protection should not always be eliminated, especially in severe diseases with an unfavorable outcome.

follow-up reaction. Patients are in the power of prejudice, tendentiousness. They are suspicious. Distrustful. With difficulty they come into contact with the attending physician, do not attach serious importance to his instructions and advice. They often have conflict with medical personnel. Despite their mental health, they sometimes exhibit the so-called "double reorientation".

panic reaction. Patients are in the grip of fear, easily suggestible, often inconsistent, treated simultaneously in different medical institutions, as if checking one doctor with another doctor. Often treated by healers. Their actions are inadequate, erroneous, affective instability is characteristic.

destructive reaction. Patients behave adequately, carelessly, ignoring all the instructions of the attending physician. Such persons do not want to change their usual way of life, professional workload. This is accompanied by a refusal to take medications, from inpatient treatment. The consequences of such a reaction are often unfavorable.

In the typology of N.D. Lakosina and G.K. Ushakov (1976) as a criterion taken as the basis for the classification of types, a system of needs that are frustrated by the disease is distinguished: vital, social and professional, ethical or related to intimate life. Other authors (Burn DG, 1982) believe that the reaction to the disease is largely determined by the prognosis of the disease.

Psychological and psychiatric classifications describe personal reactions to a person's illness. Many believe that it is the premorbid psychological characteristics of a person that can largely explain the preference for the appearance of certain forms of response in patients to their disease, since the content of the internal picture of the disease reflects not only the life situation (the situation of the disease), but also the inherent features of a person’s personality, including character and temperament. Traditionally, there are three main types of the patient's reaction to the disease: sthenic, asthenic and rational. With an active life position of the patient in relation to treatment and examination, they speak of a sthenic reaction to the disease. There is, however, a negative side to this behavior, since the patient may be weakly capable of fulfilling the necessary restrictions on the stereotype of life imposed by the disease. With an asthenic reaction to a disease, patients have a tendency to pessimism and suspiciousness, but they are relatively easier than patients with a sthenic reaction to psychologically adapt to the disease. With a rational type of reaction, there is a real assessment of the situation and a rational escape from frustration. Pathological forms of response to the disease (experiencing the disease) are often described by researchers in psychiatric terms and concepts: depressive, phobic, hysterical, hypochondriacal, euphoric-anisognosic and other options (Shevalev E.A., 1936; Rokhlin L.L., 1971; Kovalev V.V., 1972; Kvasenko A.V., Zubarev Yu.G., 1980, etc.). In this aspect, the classification of types of attitude to the disease, proposed by A.E. Lichko and N.Ya. Ivanov (1980).

1. Harmonic - a correct, sober assessment of the state, unwillingness to burden others with the burdens of self-care.

2. Ergopathic - “leaving the disease in work, the desire to maintain working capacity.

3. Anisognosic - active rejection of the thought of the disease, "it will cost."

4. Anxious - continuous anxiety and suspiciousness, belief in signs and rituals

5. Hypochodriacal - behavior of the type of "irritable weakness". Impatience and outbursts of irritation at the first comer (especially with pain), then - tears and remorse.

7. Melancholic - disbelief in recovery, dejection by illness, depression (danger of suicide).

8. Apathetic - complete indifference to one's illness, passive obedience to procedures and treatment.

9. Sensitive - sensitive to interpersonal relationships, full of fears that those around him are avoiding him due to illness, fear of becoming a burden for loved ones.

10. Egocentric - "going into illness" with flaunting one's suffering, demanding a special attitude towards oneself.

11. Paranoid - the belief that the disease is the result of someone's malicious intent, and complications during the course are the result of the negligence of medical personnel.

12. Dysphoric - dominated by a gloomy embittered mood, envy and hatred of healthy people. Outbursts of anger demanding pleasing from loved ones in everything.

Socio-psychological classifications of a personal reaction to a disease focus on the social consequences of the disease, the patient's relationship with his microsocial environment and society as a whole. Here it is important to take into account the ambivalence of the patient's attitude to his illness. The traditional understanding of the disease is associated with its negative side. However, the observations of psychologists show that there is a positive side of the disease. The "advantages" of the disease are clear in places of detention. But even in everyday life, the disease can “remove” the patient from the need to make any decisions in the service or at home, helps to get rid of certain difficulties, give certain advantages (psychological, social) over other people, can serve to compensate for feelings of inferiority.

According to Z.D. Lipowski (1983), psychosocial responses to illness are made up of responses to information about the illness, emotional responses (such as anxiety, grief, depression, shame, guilt) and coping responses. Reactions to information about the disease depend on the "significance of the disease" for the patient:

1) the disease is a threat or a challenge, and the type of reactions is opposition, anxiety, withdrawal or struggle (sometimes paranoid).

2) illness - loss, and the corresponding types of reactions - depression or hypochondria, confusion, grief, an attempt to attract attention, violation of the regime.

3) disease - gain or deliverance, and the types of reactions in this case are indifference, cheerfulness, violation, hostility towards the doctor.

4) illness is a punishment, and at the same time, reactions such as depression, shame, anger arise. Reactions to overcome the disease are differentiated by the predominance of their components: cognitive (downplaying the personal significance of the disease or close attention to all its manifestations) or behavioral (active resistance or capitulation and attempts to "avoid" the disease). So, at present, several types of a person's attitude to the disease can be distinguished: medical-psychological, psychological-psychiatric and socio-psychological. Each of them captures the peculiarities of a person's attitude to his disease from different positions and the psychological changes that the disease imposes on a person. From this point of view, we can distinguish, first of all, an adequate perception of the disease and pathological attitudes towards it.

Based on the analysis of psychological studies, it can be concluded that people with diseases of the musculoskeletal system have the following psychological characteristics: the presence of fears, a tendency to depression, suppression of aggressive impulses, unpretentiousness, which indicates that the disease leaves its mark on the personality a person and entails a change in self-esteem, emotional states and social relationships.

3. Studies of the characteristics of the emotional sphere of women of mature age with a violation of the musculoskeletal system

3.1 Research agenda

The study was conducted in the Khakass regional public organization of the All-Russian Society of Disabled People at the address: Vyatkina 16, Abakan, and in the Department of Social Support for the Population of the Municipal Formation of Abakan.

The study involved 30 women with musculoskeletal disorders and 30 women without musculoskeletal disorders.

Abilities are a complex of various manifestations of a person in a certain motor activity, which is based on the concept of "strength". The tasks of developing strength abilities in step-aerobics classes with middle-aged women. The first task is the general harmonious development of all muscle groups of the musculoskeletal system of women. The second task is the versatile development of strength abilities ...

From SSSR. If necessary, they contact colleagues and the administration of the institutions where the child enters. The experience of creating and operating the SSSR in Pskov has shown that the work of accompanying a family raising a child with developmental disabilities is in demand. For a year and a half of the Service's work, 48 families living in the city of Pskov and in the Pskov region have used its services. All applied families...

Rheumatism led to a significant decrease in the incidence - up to 0.8 per 1000 children. Domestic pediatricians V.I. Molchanov, A.A. Kisel, M.A. Skvortsov, A.B. Volovik, V.P. Bisyarina, A.V. A connection has been established between the onset of the disease and the transferred streptococcal infection, mainly in ...

The modern need for social protection and rehabilitation of people with special needs is a response to the exacerbation of social problems of various categories of these citizens in the difficult conditions of the formation of a new society. The decline in social guarantees, impoverishment, unemployment, discrimination, unfortunately, is especially acute for those citizens who previously lived difficultly due to health limitations, impaired motor functions, orientation, perception and intellectual abilities.

Many countries have successfully overcome the path of recognizing the rights of persons with disabilities on an equal basis with healthy people. Russia is also confidently moving in this direction. Declaring the European choice, our country is obliged to start creating standards for a decent life for these people as well. There are a number of public organizations of the disabled in the country, which are in the leading positions in Russia in the development and implementation of European and global approaches to solving problems of inferiority. But the goal of public administration in this general area is, first of all, to create prerequisites for the dynamic development of a system of services, activities and conditions that would guarantee people with disabilities a gradual progress towards European living standards.

This can be achieved through the rehabilitation and integration of children, youth and adults with special needs, the introduction of non-institutional forms of residence and care based in society, the organization of progressive forms of education, employment, leisure and sports for the disabled, the adaptation of institutions, urban infrastructure, transport and information to the needs people with disabilities. At the same time, a significant share of responsibility and funding can be delegated through social contracting to non-state actors.

The problems that appear before people with functional limitations in society are based on low self-esteem, discrimination. This affects even in the initial period through a high level of abortions with unfavorable prenatal diagnosis. In the postnatal period of development of a disabled person, this is manifested through: the parents' refusal from the child; branding with a medical diagnosis (hoax); lack of equal opportunities in education, as well as in personal growth; inequality in the labor market; general isolation in the social environment.

Under modern conditions, there is a tendency to increase attention to the socialization, social rehabilitation and adaptation of disabled people, which include both material and spiritual psychological and pedagogical assistance.

Abroad, where such activities have a fairly long history of development - both practice and theory, it is customary to distinguish between the concept of habilitation and rehabilitation.

Habilitation is a set of actions aimed at the formation of new and mobilization of existing resources and opportunities for the social, mental and physical development of a disabled person. Rehabilitation in international practice is the renewal of abilities lost as a result of illness or injury. Adaptation, therefore, acts as a concept that combines habilitation and rehabilitation.

The personality of a person with functional limitations develops in full accordance with the general human laws of personality development. Defective conditions or diseases are the causes of derivative symptoms that arise indirectly under the influence of abnormal social development through the non-perception of a person with functional limitations on the part of society.

The concept of "equal opportunities" should be understood as a situation, as a result of which various social institutions and the material environment are available to everyone with the satisfaction of all their needs.

The term "normalization" develops the content of the previous concept and concerns the life of a disabled person in all areas of the normalized life of society. The content of this concept includes the usual daily routine, appropriate confidentiality, normalized involvement of the disabled person in social, emotional and sexual relationships with others, opportunities for personal development, work, participation in decision-making regarding one's own life.

"Integration" is the final concept in the process of deploying the content of the socialization of disabled people. It manifests itself through the tendency to teach children with functional limitations in ordinary schools, the creation of integrated groups in higher educational institutions, etc. First of all, this contributes to the demystification, destigmatization of disability in the eyes of the "ordinary" population. Integration is promising in terms of raising self-esteem and self-expectation of children and young people with special needs, they get the opportunity to build relationships with "ordinary" people, peers, who, in turn, learn to treat people with functional limitations with understanding, distinguishing them from their own. flaws.

In line with the implementation of this trend in Russia, for example, the Concept of Early Social Rehabilitation of Disabled Children was adopted, which defines the essence and main directions of the process of social rehabilitation of a disabled child.

The main goal of early socialization of children with disabilities is to provide an opportunity to:

· children with disabilities overcome developmental difficulties, learn everyday life and social skills, develop their abilities, fully or partially integrate into the social life of society;

parents to realize the essence of their children's problems, master the methodology for implementing individual rehabilitation programs, become an active participant in the rehabilitation process and, on this basis, achieve progress in overcoming the shortcomings of the child, in integrating it into the children's team and society.

The study of the problems of people with special needs is quite voluminous. Let us highlight one of the latest studies published in the collection "Social Rehabilitation of Youth with Disabilities". It traces the trend in the development of social rehabilitation and adaptation of young people with disabilities in the direction of increasing attention to socio-psychological rehabilitation and adaptation.

The organization of social assistance to children and young people who are deprived of the opportunity to adhere to a full-fledged lifestyle as a result of physical development defects needs, first of all, to change the attitude of society towards the disabled and the problem of disability in Russia in general. Through the restriction in communication, self-service, movement, the development of these children largely depends on the satisfaction of their needs by other people, and this is a multifaceted process of socio-pedagogical rehabilitation.

The problem of disability is traditionally considered as, first of all, medical, and then economic, that is, the problem of meeting the material needs of a disabled person. But the problem of disability is not limited to these important aspects. The socio-psychological factor, the self-perception of a disabled person in society is another painful point. A person with disabilities has problems not just as a result of illness, injury or innate limitations, but also through the inability of the social environment to its specific needs, the superstitions of society, the clichés of mass psychology. The trend in changing the attitude of mankind towards the problem of disabled people can be traced on the basis of a comparative analysis of international legislative acts designed to protect the rights of disabled people. So, in 1971, the UN General Assembly adopted the Declaration on the Rights of Mentally Retarded Persons, which focuses on medical and economic support for the disabled, proclaims the "right to patronage for the development of their capabilities" and the opportunity to "work productively."

Eighteen years later, that is, in 1989, the UN General Assembly adopted the Convention on the Rights of the Child. It enshrined the right of children with developmental disabilities to lead a full and dignified life in conditions that allow them to maintain self-esteem, self-confidence, and facilitate active participation in public life. The purpose of creating such conditions is the fullest possible inclusion of a disabled person in social life and the comprehensive development of his personality.

Such changes are predetermined by the general trend in the development of mankind in the direction of maximum informatization, the creation of a post-industrial society in which the ability for normal communication becomes the leading factor in normal life.

An integrated legal document that defines social requirements for the normalization of the situation of persons with disabilities and reflects the tendency for society to adapt to people with disabilities, and not vice versa, as it was before, is the "Standard Rules for Ensuring Equal Opportunities for Persons with Disabilities" adopted by the UN General Assembly on 12/20/93. For example, Rule No. 5 recommends that all States develop and implement programs of action to make the physical environment accessible to persons with disabilities and take steps to ensure that they have access to information and communications.

In modern conditions of economic instability, people with disabilities have become one of the most vulnerable segments of the population. The main problem that needs to be addressed immediately is overcoming the social exclusion of the disabled. This problem is formulated approximately as follows: structural disorders, either pronounced, or those that are diagnosed with the help of medical equipment, can lead to the loss or imperfection of the skills necessary for certain types of activity, as a result of which "limited opportunities" for life are formed; this, in turn, under appropriate conditions, will lead to social maladjustment, slow socialization.

In our time, helping people with impaired legal capacity is becoming an increasingly important social task.

The social protection of young people with limited legal capacity is becoming more profound, that is, society is striving to satisfy an ever wider range of their needs, to bring their living conditions closer to those of healthy youth.

Gradually, the opportunities for disabled people to receive education, acquire a profession, and exercise personal self-assertion are expanding. National and international exhibitions of creativity of the disabled are organized, sports competitions, which include the Olympic Games for this category of people - Paralympic.

Unfortunately, in modern conditions of searching for different ways of effective socialization and rehabilitation of people with physical disabilities, the use of some traditional approaches in relation to people with disabilities is carried out without taking into account all possible negative consequences. We are talking about the activities of some centers of social adaptation in the direction of "spiritual rehabilitation". Proclaiming quite correctly the supra-confessional nature of spiritual values, some centers are guided by patronage relations with Orthodox dioceses. In any case, this is not evil or a mistake, but, in addition to interfaith tensions in Orthodoxy, which poses a certain danger to spiritual development, the traditional Christian model of attitude towards persons with physical defects itself has certain features that are often not taken into account when working with such people. The fact is that the Orthodox, generally Christian religious culture has traditionally considered people who have physical or mental limitations for life as "possessed" or as such, who are marked by "God's providence." "Poor" is the status of a disabled person in society that is as sharply different from the normal as the status of an "inferior" member of society. Undoubtedly, a much more humane attitude towards a disabled person as "wretched" is better than no attention at all. But such an attitude does not solve the main socio-pedagogical problem - creating a feeling of a full-fledged, just an ordinary member of society. Preservation of a sense of difference, even if for the better, from others on the basis of one's physical limitations is stored, namely, society should help to overcome it.

Summing up, it should be noted first of all that "spiritual" rehabilitation should have a two-sided character. For the most part, its object is considered to be a person with special needs, which must be adapted to society. Now we need to develop the opposite aspect of the problem - to adapt society to the point that more and more of its members have functional limitations.

To determine the third group of disability, the criterion is social insufficiency requiring social protection or assistance, due to a health disorder with persistent slight or moderately pronounced disorders of body functions caused by diseases, the consequences of injuries or defects, leading to a mild or moderately pronounced limitation of one of the categories of life activity or their combination. Indications for the establishment of 3 groups of disability:

ability to self-service with the use of assistive devices;

the ability to move independently with a longer expenditure of time, fragmentation of performance and a reduction in distance;

the ability to study in educational institutions of a general type, subject to a special regime of the educational process and (or) using auxiliary means, with the help of other persons (except for teaching staff);

the ability to perform labor activity under the condition of a decrease in qualification or a decrease in the volume of production activity, the impossibility of performing work in one's profession;

the ability to orientate in time and space, subject to the use of auxiliary means;

the ability to communicate, characterized by a decrease in speed, a decrease in the amount of assimilation, receipt and transmission of information.

(http://103-law.org.ua/Article.aspx?a=33)

2. Classification of disabled people depending on nosological signs (disabled by sight, hearing, speech, musculoskeletal system, intelligence, etc.)

visual impairment refers to the main types of violations of body functions (disturbance of sensory functions). In this regard, if the function of vision is lost, a person may be recognized as visually impaired.

Distinguish patients with the following visual impairments.

Blind - people with a complete lack of visual sensations or light perception (they do not see the outlines of objects, but have only a sense of light). In turn, there are two degrees of vision loss in visually impaired people: 1st - total loss of vision; 2nd - practical blindness, when there is light perception, the ability to determine the contour of an object. The visually impaired are people whose visual acuity allows them to distinguish objects whose outlines they see indistinctly.

In violation of the function of vision, there is a violation of spatial images, self-control and self-regulation, coordination and accuracy of movements. There are also violations of posture, flat feet, weakness of the respiratory muscles. Concomitant diseases include neurosis, diseases of the respiratory system, cardiovascular system, and metabolism. As well as general underdevelopment of speech, cerebral palsy, minimal brain dysfunction (MMD), there may be hearing loss and fatigue.

Patients with hearing loss can be: deaf (hearing loss) and hard of hearing. Deaf people without speech are people who have become deaf early or have a congenital lack of hearing. Deaf people who have retained speech to one degree or another are late deaf. The consequences of congenital deafness include: violations of the vestibular apparatus, a delay in the formation of upright posture, violations of spatial orientation, violations of posture, deafness. Against the background of these disorders, changes in the psyche are observed for the second time: problems with communication, a lag in the development of thinking, poor memory, and poverty of emotions. Hearing impaired - people with partial hearing loss who have retained their speech. Their intellect does not suffer.

Impairment of the intellect

This form of mental dysontogenesis is based on the underdevelopment of all aspects of the psyche: cognitive processes, the emotional-volitional sphere, the need-motivational sphere, etc. The leading role in the structure of general mental underdevelopment belongs to the underdevelopment of cognitive activity. A typical model of mental underdevelopment is mental retardation.

Mental retardation is a state of delayed or incomplete development of the psyche, which is primarily characterized by impaired abilities that appear during maturation and provide a general level of intelligence, that is, cognitive, speech, motor and social abilities.

People with intellectual disabilities have cognitive impairment. The strength and mobility of nervous processes decreases. There is a violation of higher mental functions, analytical and synthetic activity of the central nervous system. There is also dysplasia; violation of ossification, posture, deformity of the foot, spine, disharmony of physical development; impaired coordination of movements.

Congenital heart defects, diseases of the internal organs, endocrine disorders, sensory abnormalities - all this is observed in people with intellectual disabilities.

ODA violation

Types of disorders of the musculoskeletal system

1. Diseases of the nervous system: cerebral palsy, poliomyelitis.

2. Congenital pathology of the musculoskeletal system: congenital dislocation of the hip, torticollis, clubfoot and other deformities of the feet, developmental anomalies and defects of the limbs, anomalies in the development of the fingers, arthrogryposis (congenital deformity).

3. Acquired diseases and injuries of the musculoskeletal system; traumatic injuries of the spinal cord, brain and limbs; polyarthritis, limb disease, systemic diseases of the skeleton.

In people with a violation of the musculoskeletal system, the leading defect is a motor defect (underdevelopment, impairment or loss of motor functions).

With the defeat of the ODA cerebral genesis there is a violation of support ability, balance, vertical posture, orientation in space, coordination, micro- and macromotor skills. Osteochondrosis, muscular hypotrophy, osteoporosis, contractures, disharmony of physical development are observed. Concomitant diseases include disorders of the cardiovascular and respiratory systems, diseases of internal organs. As well as impaired hearing, vision, intelligence. Low performance.

With the defeat of the ODA spinal genesis there is a complete or partial loss of movement, sensitivity, dysfunction of the pelvic organs.

There is a violation of vegetative functions, bedsores appear. characterized by osteoporosis. With a high (cervical) spinal lesion, breathing is disturbed, orthostatic disorders appear. With flaccid paralysis - muscle atrophy. With spastic - stiffness of the joints, contractures, spasticity.

In case of damage to the musculoskeletal system due to amputation or congenital malformation impaired support and walking (with amputation of the lower extremities), coordination of movements, posture, vertical posture; there is also a decrease in body weight and vascular bed.

There are violations of regulatory mechanisms, degenerative changes in neuromuscular and bone tissue, contractures. Violated the functions of blood circulation, respiration, digestion, metabolic processes. General performance decreases, phantom pains appear.

Speech disorder

Speech is the most important function of a person, therefore, cortical speech zones located in the dominant hemisphere (Brock and Wernicke centers), motor, kinetic, auditory and visual areas, as well as conducting afferent and efferent pathways related to the pyramidal and extrapyramidal systems take part in its implementation. , analyzers of sensitivity, hearing, vision, bulbar parts of the brain, visual, oculomotor, facial, auditory, glossopharyngeal, vagus and hypoglossal nerves.

In the implementation of the speech function, as well as writing and reading, visual, auditory, motor and kinesthetic analyzers take part. Of great importance are the preservation of the innervation of the muscles of the tongue, larynx, soft palate, the state of the paranasal sinuses and the oral cavity, which play the role of resonator cavities. In addition, coordination of breathing and pronunciation of sounds is important.

For normal speech activity, the coordinated functioning of the entire brain and other parts of the nervous system is necessary. Speech mechanisms have a complex and multi-stage organization.

Causes of speech disorders: intrauterine pathology; hereditary predisposition and genetic abnormalities; adverse births and their consequences, diseases suffered by the child in the first years of life.

Types of speech disorders:

Violation of oral speech;

Writing disorders.

(http://kokarevala.narod.ru/index/0-38)

Yes, at visual impairment, there is a general underdevelopment of speech of different levels, accompanied by various types of dysarthria, underdevelopment of written speech of a mixed nature (various types of dysphagia).

At hearing loss, the main components of speech are violated: phonetic-phonemic, lexical, grammatical; both the pronunciation and the semantic aspects of speech are insufficiently formed.

At intellectual disability, all the functions of speech suffer, to one degree or another. From various forms of speech impairment, one can judge the degree of mental retardation! (http://iamtiptop.ru/p/iam_13190.html)

At violation of the ODA, a speech disorder in the form of dysarthria (impaired pronunciation of sounds) is characteristic, due to the fact that such persons have difficulty feeling the position of the tongue and lips. (Solntseva V.A., Belova T.V. Psychological characteristics of persons with impaired motor development (impaired functions of the musculoskeletal system) // Handbook on the organization and conduct of career guidance - M .: Center for New Technologies LLC, 2012. - pp. 97–99.).

Children cannot distinguish sounds by ear, repeat syllables, highlight sounds in words. Vocabulary increases slowly, does not correspond to age, abstract concepts, spatio-temporal relations, sentence construction, perception of the shape and volume of the body are very difficult to form. In connection with violations of vocabulary, the grammatical structure of speech is not sufficiently developed. Violation of phonetic-phonemic development limits the accumulation of grammatical means.

Clinical manifestations of speech disorders in cerebral palsy:

Dysarthria - a violation of the pronunciation of sounds due to pathological innervation of the speech muscles, damage to the speech motor mechanisms of the central nervous system;

Alalia - systemic underdevelopment of speech as a result of damage to the cortical speech zones (it occurs both as motor alalia and sensory alalia);

Dyslexia, dysgraphia - violations of written speech due to dysfunction of speech zones;

Neurosis-like speech disorders, like stuttering, due to impaired motor speech function;

Anartria is the absence of speech. (p.234 textbook)

The term "rheumatic diseases" combines pathological pictures, the common characteristic and leading symptoms of which are pain in the musculoskeletal system.

Blocked aggressive impulses of patients are expressed in increased muscle tension and, finally, in localized or localized pain.

In all patients with rheumatoid arthritis, three character traits occur with sufficient constancy:

1. Persistent manifestations of over-conscientiousness, commitment and external compliance, combined with a tendency to suppress all aggressive and hostile impulses, such as anger or rage.

It is interesting:

Analysis of the results of the study
The hypothesis of our study was that the level of empathy of spouses and the degree of conflict in the family are inversely proportional: the higher the level of empathy of spouses, the lower the degree of conflict in the family, and...

Methods for correcting child-parent relationships.
Methods of counseling and correction of the family consider the problematic relationship between parents and children. The specifics of the work varies from what age group of children it is carried out with, with small children, teenagers or with an adult ...

Theoretical aspects of the study of the emotional sphere of personality in psychology. The study of the emotional sphere in foreign and domestic psychology
A lot has been written about emotions both in fiction and in scientific literature; they are of interest to philosophers, physiologists, psychologists, and clinicians. It suffices to refer to the systematic reviews of their experimental study in the works ...

Federal Agency for Education

State Educational Institution of Higher Professional Education "Khakass State University named after V.I. N.F. Katanov"

Medical-Psychological-Social Institute

Department of General and Clinical Psychology

Features of the emotional sphere of women of mature age with a violation of the musculoskeletal system

Graduate work

Specialty 030301- Psychology

Scientific adviser:

Yakotsuts Olga Leonidovna, Ph.D.

"Admit to the defense"

Head Department of General and Clinical

psychology MPSI

Fotekova Tatyana Anatolyevna, Doctor of Psychology

Abakan 2008

Introduction

1. Theoretical aspects of the study of the emotional sphere of personality in psychology

1.1 The study of the emotional sphere in foreign and domestic psychology

1.2 Mechanisms of development of the emotional sphere in case of damage to the musculoskeletal system

2. Psychological characteristics of women of mature age

2.1 Factors and conditions of personality development in adulthood

2.2 Personal characteristics of people with disorders of the musculoskeletal system

3. Study of the characteristics of the emotional sphere of mature women with musculoskeletal disorders

3.1 Research agenda

3.2 Analysis and interpretation of study results

Bibliography

Introduction

Due to the fact that at the beginning of the 21st century a number of federal programs were adopted, the main directions of which were the improvement of the nation and the optimization of its emotional well-being: the “Program for medical examination of the population of Russia”, in the interests of a number of population groups, social issues related to demographic progress became priority , improvement of psychophysiological health, in particular, restrictions were introduced in various types of activity of women, as potentially dangerous, causing overload of the female body and inability to produce healthy offspring.

Factors of a sharp increase in the likelihood of developing various diseases of the musculoskeletal system, congenital and acquired human movement disorders were taken into account, which was found in 12% of the population in Russia.

In conditions of social and economic instability, there is also an increase in the forms of unstable emotional states, which is an essential element of public consciousness. In critical situations, there is a need for psycho-emotional safety of people with a violation of the musculoskeletal system, which is expressed in anxiety, mood swings, emotional anxiety. Changes in the emotional sphere is one of the most common causes of deviations in mental development, creating a significant amount of difficulties in the process of life.

Based on this, the problem of studying the characteristics of the emotional sphere of women of mature age with a violation of the musculoskeletal system is relevant and requires detailed study.

Object of study: emotional realm.

Subject of study: features of the emotional sphere of women of mature age with a violation of the musculoskeletal system.

Purpose of the study: to identify the psychological characteristics of the emotional sphere of women of mature age with a violation of the musculoskeletal system.

In accordance with the purpose of the work, the following tasks:

1. Analyze the literature on the problem of studying the emotional sphere of the personality;

2. To identify the features of the emotional sphere of women of mature age with a violation of the musculoskeletal system;

3. To identify the features of the emotional sphere of women of mature age with the norm of activity;

4. Compare the features of the emotional sphere of women of mature age with a violation of the musculoskeletal system and with the norm of activity.

Research hypothesis: we assume that a group of women of mature age with disorders of the musculoskeletal system have features in the emotional sphere, which is manifested in a high level of anxiety and instability of emotional processes.

Methodological basis for writing this work were:

Concepts about the nature of emotions E.P. Ilyin, I. Izard; a holistic, integrative approach to mental and emotional health reflecting the works of B.G. Ananiev and L.S. Vygotsky.

Research methods:theoretical methods: analysis of literature on the problem of the study of the emotional sphere of personality; empirical methods: psychodiagnostic methods: diagnostics of the state of stress; Taylor's anxiety level measurement technique adapted by T.A. Nemchinova; method of differential diagnosis of depressive states V.A. Zhmurova; Eysenck method - EPQ; methodology for determining stress resistance and social adaptation of Holmes and Rage; method of diagnostic type of emotional reaction to the impact of environmental stimuli V.V. Boyko; interpretive methods(Pearson; Mann-Whitney)

Theoretical significance the thesis is that the conducted experimental study will expand and deepen knowledge about the emotional sphere of mature women with impaired musculoskeletal system and without pathologies, consider the features of emotional response, emotional control, level of anxiety and depression.

Practical significance This work consists in the fact that the data obtained from the results of the study on the characteristics of the emotional sphere of women with a violation of the musculoskeletal system and without pathologies can be used by specialists in working with this category of women.

Reliability and reliability of data, obtained in the course of the study were provided by the use of a wide range of methods adequate to the purpose and object of the study, qualitative and quantitative analysis of the experimental material using the methods of mathematical statistics.

Research base: Khakass Regional Public Organization of the All-Russian Society of the Disabled. Address: Vyatkina 16, Abakan.

The structure of the thesis: The work consists of an introduction, three chapters, a conclusion and a list of references.

1. Theoretical aspects of the study of the emotional sphere of personality in psychology

1.1 The study of the emotional sphere in foreign and domestic psychology

A lot has been written about emotions both in fiction and in scientific literature; they are of interest to philosophers, physiologists, psychologists, and clinicians. It suffices to refer to the systematic reviews of their experimental study in the works of R. Woodswords (1950), D. Lindsley (1960), P. Fress (1975), J. Reikovsky (1979), K. Izard (2000), translated into Russian, as well as domestic authors: P.M. Yakobson (1958), V.K. Vilyunas (1973), B.I. Dodonova (1987), P.V. Simonova (1962. 1975, 1981, 1987), L.I. Kulikova (1997). However, the problem of emotions is still mysterious and largely unclear.

The role of emotions in managing human behavior is great, and it is no coincidence that almost all authors writing about emotions note their motivating role, associate emotions with needs and their satisfaction (Freud, 1894, Vilyuna, 1990, Dodonov, 1987, Izard, 1980, Leontiev, 1982, Fress, 1975, Reikovsky, 1979, Simonov et al.).

Emotion (from the Latin emovere - to excite, excite) is usually understood as an experience, emotional excitement.

Dictionary of Psychology, edited by A.V. Petrovsky and M.G. Yaroshevsky characterizes emotions as "a psychic reflection in the form of a direct biased experience of the vital meaning of phenomena and situations, due to the relationship of their objective properties to the needs of the subject" .

In the process of evolution, emotions arose as a means that allows living beings to determine the biological significance of the state of the body and external influences. The simplest form of emotions - the so-called emotional tone of sensations - direct experiences that accompany individual vital influences (for example, taste, temperature) and encourage the subject to preserve or eliminate them. In extreme conditions, when the subject cannot cope with the situation that has arisen, affects develop.

VC. Viliunas rightly notes that “much of what is traditionally called the word “theory” in the teaching of emotions is, in essence, rather separate fragments, only as a whole approaching an ideally exhaustive theory. We can distinguish such approaches to understanding emotions as physiological, psychoanalytic, cognitive, socio-cultural, etc.

Psychoanalytic theory of emotions. Z. Freud based his understanding of affect on the theory of drives and, in fact, identified both affect and drive with motivation. Freud and his followers considered only negative emotions arising from conflicting drives. Therefore, they single out three aspects in the affect: the energy component of the instinctive drive (the "charge" of the affect), the process of "discharge" and the perception of the final discharge, the feeling, or experience of emotion.

Vascular theory of emotional expression I. Wenbaum. At the beginning of the 20th century I. Wenbaum noted the close interaction between the facial muscles and cerebral blood flow, from which he suggested that the muscles of the face regulate blood flow. By acting oppositely on the veins and arteries, they increase the inflow or outflow of blood to the brain.

Biological theory of emotions P.K. Anokhin builds his understanding of emotions as a biological product of evolution, an adaptive factor in the life of animals. The emergence of needs leads, according to P.A. Anokhin, to the emergence of negative emotions that play a mobilizing role, contributing to the most rapid satisfaction of needs in the best way. When feedback confirms that the programmed result has been achieved, i.e. needs are satisfied, positive emotions arise. It acts as the ultimate reinforcing factor.

Cognitive and cultural approaches. One of the earliest cognitive theories of emotion in psychology was that of Magda Arnold, who closely viewed the emotional process as a sequence beginning with the perception of a stimulus, immediately followed by an act of appreciation, which in turn activates an emotional response. Arnold defined perception as the immediate direct understanding of a stimulus, and evaluation as a decision as to whether the stimulus is good or bad. It is the assessment of the stimulus that contributes to the emergence of emotion in relation to an object, person or event, and emotion - the development of a behavioral response of achievement (if the object is assessed as likely useful) or avoidance (if the object is assessed as potentially harmful). Neutral incentives are simply ignored.

According to this theory, the emotional reaction is mainly determined by the individual's memory of the experience of interacting with a particular phenomenon, object, or idea of a stimulus. Like Freud, Arnold sees the evaluation process as direct, immediate, and intuitive, rather than conscious, planned, and deliberate: “Sequence—“perception—evaluation—emotion” is so tightly bound that our daily experiences are never rigorous objective knowledge of the subject. , they always look like knowledge and liking or knowledge and antipathy.

Some socio-psychological theories have been formulated to explain emotional processes in adulthood, and a number of scientists, such as Arnold and Schechner, have viewed emotion as closely dependent on cognition. In his two-factor theory, Schechner argues that emotions are built on the basis of a cognitive interpretation of arousal in a social context. The same undifferentiated state of arousal is taken as the basis of all emotions, which are felt differently due to different interpretations of it.

Other social psychologists, such as Lazarus and Tomkins, have rejected the reduction of emotional experience to cognitive interpretations of various types. Lazarus proposed a more complete cognitive-motivational theory, according to which emotions are complex multicomponent processes. The components are seen as independent, but one component is not enough to explain emotions.

As already noted, emotions in the narrow sense of the word are a direct, temporary experience of some kind of feeling. From the point of view of influence on human activity, emotions are divided into sthenic and asthenic. Sthenic emotions stimulate activity, increase the energy and tension of a person, induce him to actions, statements. And, conversely, sometimes experiences are characterized by a kind of stiffness, passivity, then they talk about asthenic emotions. Therefore, depending on the situation and individual characteristics, emotions can affect behavior in different ways. So, in a person experiencing a feeling of fear, an increase in muscular strength is possible and he can rush towards danger. The same feeling of fear can cause a complete breakdown, from fear his knees can bend. Grief can cause apathy, inactivity in a weak person, while a strong person doubles his energy, finding solace in work and creativity.

Various scientists describe emotions as a source of energy for thought, as who, what cognition serves and what is a window to consciousness, as a means of social contacts and a link in human relations, as a unifying principle for the integrity and coherence of the human "I" and as something that colors our experience and gives meaning to our lives. Both organizing and potentially disorganizing effects of emotions are noted.

Emotions play an important role in understanding the environment and adaptive response to it. In humans, they perform a guiding function that provides a function provided by the instincts in many animals, which gives the behavior the flexibility that distinguishes us as a species.

Emotion also plays a major role in defining psychopathology. Every major psychiatric illness is primarily characterized by the expression or regulation of emotions. Reduced efficiency, inadequate or unrestrained emotion - all these are signs of pathology. In disorders ranging from the split between thought and emotion in schizophrenia to apathy in some personality disorders and rampant anger in rebellious children, emotional disturbances are central.

Emotions play an important role in developmental psychology in general. Indeed, without understanding emotions, it is impossible to fully understand human development. Similarly, without understanding development as a whole, one cannot understand emotional life. Emotional life is based on perception, cognition and social experience. At the same time, changes in emotional life reflect changes in cognitive and social development, and in turn, emotional experiences unify and drive progress in these areas. Such is the role of emotions in human behavior.

Emotions play a big role in people's lives. So, today no one denies the connection of emotions with the characteristics of the vital activity of the organism. It is well known that under the influence of emotions the activity of the organs of blood circulation, respiration, digestion, glands of internal and external secretion, etc. changes. Excessive intensity and duration of experiences can cause disturbances in the body. M.I. Astvatsaturov wrote that the heart is more often affected by fear, the liver by anger, and the stomach by apathy and depression. The emergence of these processes is based on changes occurring in the external world, but affects the activity of the whole organism.

Under the influence of negative emotional states in a person, the formation of prerequisites for the development of various diseases can occur. Conversely, there are a significant number of examples when, under the influence of an emotional state, the healing process is accelerated. It is no coincidence that it is believed that the word also heals. This means that, first of all, the verbal impact of the psychotherapist on the emotional state of the patient. This is the regulatory function of emotions and feelings.

In addition to the fact that emotions perform the function of regulating the state of the body, they are also involved in the regulation of human behavior in general. This became possible because human feelings and emotions have a long history of phylogenetic development, during which they began to perform a number of specific functions that are unique to them. First of all, such functions should include the reflective function of feelings, which is expressed in a generalized assessment of events.

The evaluative or reflective function of emotions is directly related to the motivating or stimulating function. For example, in a traffic situation, a person, experiencing fear of an approaching car, accelerates his movement across the road. S.L. Rubinstein pointed out that “emotion in itself contains attraction, desire, aspiration directed towards or away from an object”. Thus, emotions contribute to determining the direction of the search, as a result of which the satisfaction of the need that has arisen is achieved or the task facing the person is solved.

The switching function of emotions is especially clearly revealed in the competition of motives, as a result of which the dominant need is determined. Thus, a contradiction may arise between the instinct of self-preservation natural for a person and the social need to follow a certain ethical norm, which, in fact, is realized in the struggle between fear and a sense of duty, fear and shame. The attractiveness of the motive, its closeness to personal attitudes directs a person's activity in one direction or another.

Another function of emotions is adaptive. According to Charles Darwin, emotions arose as a means by which living beings establish the significance of certain conditions to meet their actual needs. Thanks to the feeling that has arisen in time, the body has the ability to effectively adapt to environmental conditions.

There is also a communicative function of feelings. Mimic and pantomimic movements allow a person to convey their experiences to other people, to inform them about their attitude to objects and phenomena of the surrounding reality. Facial expressions, gestures, postures, expressive sighs, changes in intonation are the "language of human feelings", a means of communicating not so much thoughts as emotions.

Significant individual differences are also observed in the emotional excitability of people. There are people who are emotionally a little sensitive, in whom only some extraordinary events evoke pronounced emotions. Such people do not so much feel when they find themselves in a particular life situation, as they are aware of it with their minds. There is another category of people - emotionally excitable, in whom the slightest trifle can cause strong emotions. Even an unimportant event causes them to rise or fall in mood.

One of the most significant differences between people lies in how emotions are reflected in their activities. So, for some people, emotions are of an effective nature, they encourage action, for others everything is limited to the feeling itself, which does not cause any changes in behavior.

Thus, emotions are a mental reflection in the form of a direct biased experience of the vital meaning of phenomena and situations, due to the relationship of their objective properties to the needs of the subject. In psychology, there are theories of emotions that point to the dependence of emotions on the physiological state of a person, which allows us to say that the mechanisms of the emotional development of a healthy person may differ from the emotional development of a person with physical defects and pathologies.

1.2 Mechanisms of development of the emotional sphere in case of damage to the musculoskeletal system

In the twentieth century, in connection with the development of transport services and an increase in the number of personal vehicles, the lifestyle of an individual becomes more and more sedentary. As a result, a person walks a short distance from home to transport and from transport to the workplace. Of course, this is not enough to keep the musculoskeletal system in good shape, therefore, as a result of this lifestyle, its functionality decreases. Together with the peculiarities of nutrition and a number of other factors, the likelihood of developing various diseases of the musculoskeletal system increases dramatically, which we can observe in developed countries. Congenital and acquired diseases of the musculoskeletal system are observed in 12% of the population worldwide.

Skeleton and muscles, plus what binds these components together: ligaments and joints - all together form the musculoskeletal system. The functions of this apparatus are clear from the name - support and movement.

The musculoskeletal system consists of bones, ligaments, cartilage and tendons. It provides the structural strength of the body, vertical position, protects the internal organs from damage. The musculoskeletal system is a repository of minerals. Bones are long (in the arms and legs), short (patella, ankle, wrist), flat (skull, ribs, chest, shoulder blades). The strength of the musculoskeletal system is reduced due to poor nutrition, the use of large amounts of sugar, and the lack of proper physical activity. It also contributes to hormonal imbalance. The use of coffee and drinks with a high content of phosphoric acid leads to the loss of calcium and the formation of osteoporosis, in which the rate of resorption (resorption) of bone minerals increases.

Depending on the number of components of the musculoskeletal system, there is a wide variety of its diseases.

Since ancient times, the spine has been considered the focus of human life force, the energy core. In accordance with ancient Indian ideas about life, the main energy channels run along the spine, and the centers of the human body (chakras) are located, in which energy of different levels is accumulated.
Correct posture (and correct outlook) contributes to the unimpeded flow of energy in the human biomagnetic field. The physiological curves of the spine symbolize the stress that a person experiences when taking responsibility for the implementation of a certain part of his life program.
The fluid contained in the core of the disc is a symbol of the emotional nature of man. The properties of ligaments reflect the degree of flexibility in the relationship. Muscles - the ability to manage life circumstances. The blood supply of the spinal cord is the bodily equivalent of a person's connection with the outside world. Accordingly, the lack of flexibility, a rigid worldview, the inability to implement one's aspirations and organize work are the psychosomatic causes of osteochondrosis.

Connective tissue symbolizes the ability to interact with people. And the joints are the ability to manage these interactions. Autoimmune reactions are an analogue of pronounced internal contradictions, prohibitions on the natural manifestations of the inner "I", as well as the desire to control people. Violation in one link of the mechanism inevitably causes changes in the entire system. The body tries to adapt to the changed conditions, to compensate for the lack or dysfunction.

Violation of the functions of the musculoskeletal system can be both congenital and acquired. The following types of pathologies of the musculoskeletal system are noted.

1. Disease of the nervous system: cerebral palsy: poliomyelitis;

2. Congenital pathology of the musculoskeletal system: congenital dislocation of the hip; torticollis; clubfoot and other foot deformities; anomalies in the development of the spine (scoliosis); underdevelopment and defects of the limbs; anomalies in the development of the fingers; arthrogryposis (congenital deformity).

3. Acquired diseases and injuries of the musculoskeletal system: traumatic injuries of the spinal cord, brain and limbs; polyarthritis; skeletal diseases (tuberculosis, bone tumors, osteomyelitis); systemic diseases of the skeleton (chodrodystrophy, rickets)

All diseases of the musculoskeletal system are divided into independent and secondary, which occur as a complication of another pathological process occurring in the body. In turn, independent diseases are divided into two main groups: arthritis and arthrosis. Their main difference lies in the cause of the disease. Arthritis is caused by inflammatory processes, while arthrosis is associated with a degenerative process in the joints.

The most common disease of the musculoskeletal system is belonging to the group of arthrosis - osteochondrosis. Intervertebral osteochondrosis is caused by wear or deformation of the intervertebral disc, accompanied by a significant decrease in its height. The onset of the disease is usually associated with premature wear of the disc due to high physical activity, with injuries preceding the disease, and age-related changes. The defeat of the spinal column also occurs in Bechterew's disease (ankylosing spondylitis). With Bechterew's disease, an inflammatory lesion of the intervertebral joints and spinal ligaments develops, which is accompanied by the development of pain syndrome. The pain is widespread, along the entire length of the spine or in the projection of the affected section, is characterized by constancy, intensifies after prolonged rest, depends on weather conditions. The pain is often associated with stiffness in the area of the affected area and is more pronounced in the morning. A radicular syndrome may develop when the roots of the spinal nerves are infringed as a result of the convergence of the vertebral bodies. With the progression of the disease, there is a deformation of the spine and a change in the posture of the patient: either the “posture of the petitioner” or the “board-like back” is formed.

Herniated disc- this is an extreme manifestation of a disease such as osteochondrosis, as a result of which degenerative changes in the intervertebral discs occur. The process of formation of an intervertebral hernia can be triggered by many factors: osteochondrosis, trauma, weak back muscle corset, poor posture, metabolic disorders, age-related changes, hereditary causes, heavy physical exertion, infection.

The onset of the disease occurs due to a rupture of the intervertebral disc, as a result of which the nucleus pulposus comes out of it and an intervertebral hernia is formed. If it is directed towards the spinal cord and its nerve endings, puts pressure on the ligamentous apparatus of the spine, then this causes acute pain. The pressure of the hernia on the nerve root causes inflammation, which is accompanied by swelling.

The most common hernia of the lumbar spine. This is due to the fact that the main load falls on the lower back, especially when lifting weights or in the wrong position, when performing some work. With a hernia of the lumbar region, the following symptoms are observed: pain in the leg, most often along its back surface from the thigh to the foot or heel; pain in the lumbar region of a permanent and prolonged (over three months) nature; isolated pain in the foot or numbness of the toes; numbness in the groin area.

Cervical hernia accompanied by headaches in combination with pressure surges and dizziness, pain radiating to the shoulder or arm, numbness of the fingers. With this type of hernia, cerebral circulation is disturbed and headaches, dizziness and memory impairment are caused by the fact that the parts of the brain responsible for coordination do not receive enough blood.

Osteochondrosis can develop at any age, but more often men aged 40-60 suffer from it. Women are much more susceptible to another disease of this group - osteoarthritis. Unlike osteochondrosis, osteoarthritis affects the hip, knee and hand joints. Only occasionally, with the development of polyosteoarthritis, can it spread beyond these limits. The cause of osteoarthritis is premature aging of the articular cartilage due to permanent injuries (for example, professional ones), impaired normal blood circulation, and genetic predisposition.

Osteoarthritis manifests itself in the form of constant small pains and gradually developing joint deformities. Deformities are not associated with inflammatory processes, therefore, as a rule, they are not painful. However, if a piece of cartilage is pinched between the joints, there may be sudden sharp pain and the inability to move in the affected joint, which does not last long.

Symptoms of osteoarthritis of different joints can also vary. So, deforming arthrosis of the hip joint is accompanied by pain at the time of leaning on the leg, lameness. If the disease is not treated, over time there will be significant restrictions on all movements in the joint, shortening of the limb due to constant subluxation of the femoral head. Deforming arthrosis of the knee joint is characterized by dull pain when descending the stairs, periodically occurring swelling of the affected joint.

In menopausal women, deforming arthrosis of the distal interphalangeal joints often occurs. Its first signs are the occurrence of seals in the joints, sometimes their soreness.

In children aged 6-14 years, there is a deforming endemic arthrosis. The reason for its occurrence gives rise to a lot of controversy among scientists and has not yet been clarified exactly. As options are called fungus infection of cereals and an underestimated calcium content in water and soil, and, consequently, its insufficient intake into the child's body. The disease manifests itself in progressive deformation of the joints, a significant slowdown in growth, and short fingers. In this case, pain, as a rule, is absent or slightly expressed. Sometimes there is a so-called "blockade" of the joint - a sharp onset of its immobility for a short period of time. It is believed that it is impossible to stop the course of deforming endemic arthrosis, but it is possible to slow down the development of the disease with physiotherapy individually selected for the patient and special preparations containing phosphorus and calcium.

Back pain is most often interpreted as the first signs of osteochondrosis, but they can be caused by various diseases, including Bechterew's disease (ankylosing spondylitis). This disease is caused by an inflammatory process, most often a sluggish urogenital infection, and occurs in men aged 20-40 years. Bechterew's disease affects the small joints of the spine and sacroiliac joint. The disease leads to gradual ankylosing of the joints, ossification of the intervertebral discs and, as a result, absolute immobility of the spine.

Another disease that affects the joints is rheumatoid arthritis is a chronic systemic immune-inflammatory disease of the connective tissue, in which erosive-destructive polyarthritis develops, affecting mainly the small joints of the hand and foot. The etiology of the disease is unknown. At an early stage of the disease, a symmetrical polyarthritis of the small joints of the indicated localization develops. Much later and not in all cases, large joints are involved in the process. The least affected are the hip and shoulder joints, sometimes the temporomandibular and atlanto-axial joints. Pain in the joints is pronounced, aching, constant, more pronounced at night and in the morning, aggravated by active and passive movements, may subside during the day. Outwardly, there is swelling of the joints, possibly limited mobility in the joint, due to pain. A characteristic symptom of rheumatoid arthritis is morning stiffness throughout the body or only in the affected joints. This state lasts at least half an hour and passes after active movements. With further progression of the disease, atrophy of the muscles adjacent to the affected joints joins. The disease is characterized by steady progression and the development of seasonal exacerbations, in which temperature rises, an increase in inflammatory changes and pain in the affected joints, and the involvement of new joints in the process are possible. As the disease progresses, the joints become deformed, persistent contractures develop, and significant limitation of mobility develops. The most characteristic is the deformation of the hand in the form of walrus flippers. Perhaps the formation of instability in the joints and subluxations.

Among metabolic diseases leading to joint damage, the most significant is gout. The disease is much more common in men over 40 years of age than in other age and sex groups. This disease is characterized by a violation of the metabolism of uric acid, which accumulates in the form of microcrystals of sodium monourate in the joint cavity. The course of the disease is crisis, the exacerbation of the disease is called "gouty attack" and is due to the formation of new monourate crystals in the joint cavity. A gouty attack often begins at night, on the eve of possible overeating of meat, stress, trauma, alcohol abuse. In typical cases, the disease begins with acute arthritis of the first metatarsophalangeal joint. Within a few hours, a pronounced swelling of the joint develops, redness, the skin becomes glossy, hot to the touch, tense. There is a burning excruciating pain. Fever and deterioration of health develops. The duration of the attack is from several hours to several days. The subsidence of the attack occurs faster when taking non-steroidal anti-inflammatory drugs. Over the years, the frequency of attacks may increase, new joints are involved in the pathological process. The long and severe course of the disease is characterized by generalization of gouty changes with spread to the spine, sternoclavicular joints, tendons. Gradually, the pain becomes permanent, contractures occur, the joints become deformed. Changes in the joints of the hand may resemble changes in rheumatoid arthritis. The distinction between these diseases is carried out according to the features of the clinical picture.

Knowledge of the psychological characteristics of the personality of people with various diseases is very important, since in most cases it is not so much the type and degree of the defect that is of decisive importance, but the circumstance who has the defect, who suffers from the defect, i.e. what is the personality of this person.

The term "defect" means a deficiency, violation or damage that has the character of a serious and relatively stable defect; loss or absence of any function or organ. M. Sovak divides defects into organic and functional.

BUT) organic defect- this is a violation, absence or deficiency of any organ (generalized defect) or part of it (isolated defect).

The causes of organic defects can be:

Hereditary or congenital (congenital) insufficiency, affecting both the organ as a whole and its parts.

A disease that leads to significant consequences in the activity of certain organs, for example, paralysis of muscle groups, chronic tissue changes, heart disease, etc.

Trauma, i.e. damage to the body, one-time or chronically recurring, and the consequence of the injury is the deformation of certain organs. An injury can be caused by mechanical influences (for example, an operation), the effects of radiation (for example, atomic radiation), a lack of any substances in food, etc.

b) functional defect is a violation of the function of an organ or a violation of the general functions of the whole organism without any violation of the tissue of the organ or organic system. These include organ neuroses (for example, cardiac, venous, and other neuroses), psychoneuroses, behavioral disorders, psychopathy, psychosis, and the like. Functional defects are most often caused by intrapsychic disturbances or disturbances in the individual's social connections.

According to the physiological theory of emotions, the emergence of emotions is due to changes caused by external influences both in the voluntary motor sphere and in the sphere of involuntary acts, for example, the activity of the cardiovascular system. The sensations associated with these changes are emotional experiences. It is organic changes that are the root causes of emotions. Reflected in the human psyche through a feedback system, they generate an emotional experience of the corresponding modality. According to this point of view, first, under the influence of external stimuli, the changes characteristic of emotions occur in the body, and only then, as a result of them, does the emotion itself arise. Based on this, one should consider the human body as a whole and take into account the interconnection of all its systems. The problem of the relationship between a defect and emotional development can be approached from the standpoint of theoretical principles developed by the Russian psychologist L.S. Vygotsky and Austrian psychologist A. Adler in relation to the development of abnormal children and adolescents.

A. Adler and his school consider the doctrine of defective organs and functions, the insufficiency of which constantly stimulates increased development, to be the basis of their psychological system. As a psychoanalyst, A. Adler believed that the main driving force behind a person’s mental development is the need to realize an innate “social feeling”, or “sense of community”, consisting in a person’s desire to find and take a worthy place in his social whole.

A great place in his works L.S. Vygotsky devotes himself to the question of the possibility of compensating for a defect. He writes: “Any bodily defect - be it blindness, deafness or congenital dementia - not only changes a person's attitude to the world, but, above all, affects relationships with other people. An organic defect or vice is realized as a social abnormality of behavior. A.R. Luria significantly contributed to the formation of the modern understanding of the sense organs as a single system. The fact that the disturbed analyzer is an integral part of a single functional system means that it includes the activities of other members of the system and establishes a certain relationship both between individual parts and between parts and the system as a whole. Thus, the law of compensation can be applied to both normal and defective development.

Thus, it can be concluded that a defect is a deficiency, violation or damage that has the character of a serious and relatively stable defect; loss or absence of any function or organ. Defects can be organic and functional properties. From the point of view of A. Adler and L.S. Vygotsky, the defect has a dual nature - on the one hand, it is a minus, limitation, weakness, but on the other hand, it stimulates forward development, which allows us to speak of its compensatory functions.

Diseases of the musculoskeletal system include:

Diseases of the nervous system: cerebral palsy: poliomyelitis;

Congenital pathologies of the musculoskeletal system: congenital hip dislocation; torticollis; clubfoot and other foot deformities; anomalies in the development of the spine (scoliosis); underdevelopment and defects of the limbs; anomalies in the development of the fingers; arthrogryposis (congenital deformity);

Acquired diseases and injuries of the musculoskeletal system: traumatic injuries of the spinal cord, brain and limbs; polyarthritis; skeletal diseases (tuberculosis, bone tumors, osteomyelitis); systemic diseases of the skeleton (chodrodystrophy, rickets), various arthrosis and arthritis.

Thus, considering the human body as a complex formation, we can say that a violation of the musculoskeletal system entails changes in the emotional sphere of the individual.

2. Psychological characteristics of women of mature age

2.1 Factors and conditions of personality development in adulthood

Maturity is the longest period of life for most people. Its upper limit is defined differently by different authors: from 50-55 to 65-70 years. According to E. Erickson, maturity covers the time from 25 to 65 years, i.e. 40 years of life.

Maturity is considered to be the time of the full flowering of the personality, when a person can realize his full potential, achieve the greatest success in all areas of life. This is the time of fulfillment of one's human destiny - both in professional or social activities, and in terms of the continuity of generations.

The lower and upper limits of maturity do not match in the classifications of different authors. D. Birren identifies early maturity (17-25 years old), maturity as such (25-50 years old) and late maturity (50-75 years old). D. Bromley distinguishes four periods of maturity, which he calls adulthood: early adulthood (21-25 years old), middle adulthood (25-40 years old), late (40-55 years old), pre-retirement age (55-65 years old).

There is no consensus on the lower and upper limits of the age periods identified by the authors and on early and late maturity. One author considers the beginning of early maturity at 17 years, the other - 25. The difference is 4 years. The period of early maturity ends at the age of 25 according to one classification, and at 40 according to another. The difference is 15 years.

The inconsistency in the definition of age limits, upper and lower, is explained by different principles for constructing classifications of age periods: physiological, anthropological, demographic, psychological. It should be agreed that the psychological and physiological indicators of development in time may not coincide, which is reflected in the age characteristics. As for the large coverage of ages in the age period, this can most likely be explained by the fact that the authors of the classifications do not have sufficient experimental material. However, despite different approaches to the construction of the age periodization of an adult, one should pay attention to the fact that all authors note the heterogeneity of maturity, phases in the development of an adult throughout life.

Most researchers attribute the beginning of the period of adulthood to the end of adolescence - to 18-19 years, and the end - to the age of 55-60 years (Bodalev A.A., 1999). In this range, a number of stages are distinguished: 1) early adulthood (18-30 years old); 2) middle adulthood (30-45 years); 3) late adulthood (45-55 years); 4) pre-retirement age (50-55 years for women: 55-60 years for men). At the same time, at each stage, characteristic features are noted for it.

At the stage of early adulthood, mastering the role of an adult, obtaining the right to vote, full legal and economic responsibility is characteristic. Most have their own family, the first child is born. Completion of higher education. At work, professional roles are mastered, a social circle is formed, which is based on the chosen profession.

Middle adulthood is a period of perfection in the performance of a professional role and seniority, and sometimes leadership among workmates, relative material independence and a relatively wide range of social ties, as well as the presence and satisfaction of interests outside the framework of professional activity.

Late adulthood is characterized by highly qualified fulfillment of professional and social roles chosen in youth and, as a rule, reaching a peak in official status, as well as some decrease in social activity. In many cases, in these cases, there is a departure from the family of grown children.

Pre-retirement age - there is a noticeable decrease in physical and mental functions, but at the same time - these are years favorable for occupying a prominent social position. In the main area of work, there is a decline in professional aspirations, there are significant changes in the entire motivational sphere in connection with the preparation for the upcoming retirement lifestyle.

One of the most interesting foreign concepts included in the scientific "arsenal" of modern developmental psychology is the theory of the American psychologist E. Erickson about eight stages of personality development. In the psychology of adults, he identified three main stages: early (25-35 years old), middle (35-45 years old) and late (45-60 years old) maturity.

Early maturity (25-35 years). The main psychological point of this age is the establishment of intimacy in close personal relationships with another person. If a person fails in intimate communication, then a sense of isolation from people can form and grow in him with a feeling that he can rely only on himself in everything.

Twenty-year-olds usually deal with choosing a spouse and career, setting life goals and starting to achieve them. Later, about thirty years, many come to reevaluate their previous choices of spouse, career, life goals: sometimes it comes to divorce and change of profession. Finally, the first years after thirty, as a rule, is a time of getting used to new or reaffirmed elections.

Average maturity (35-45 years). This period is a period of a kind of reassessment of personal goals and aspirations and is often accompanied by a sudden feeling and realization that half of life has already been lived - a "mid-life crisis" (Jacks, 1965). The mid-life crisis is a normative, age-related event; this is the time when people critically analyze and evaluate their lives. Some may be satisfied with it, believing that they have reached the peak of their abilities. For others, the analysis of past years can be a painful process.

Mid-life crisis is usually defined by the gap between dreams, youth goals, actual results, achieved results. Since the dreams of youth are often not very real, but the assessment of what has been achieved also often turns out to be negative and colored with negative emotions. A person begins to pessimistically evaluate his future as well - “you won’t have time”, and it’s too late to change anything ..”.

The decline in physical strength and attractiveness is one of the many problems that a person faces during the years of the midlife crisis and thereafter. For those who previously relied on their physical qualities and attractiveness, middle age can become a period of severe depression. Many people simply begin to complain that they are starting to get more tired - they cannot, for example, as in their student years, go several days without sleep if an important matter required it. Although a well thought out program of daily exercise and an appropriate diet has its positive effect. Most people in middle age begin to rely not on "muscles" but on "brains". They find new advantages in knowledge, accumulated life experience, acquire wisdom.

The position in society among adults is higher than among young people: life experience has already been accumulated, there are knowledge and skills that are acquired only with age. An adult is able to make independent decisions and, most importantly, to be responsible for the choice made, to be the master of his own destiny. He has an established (but not ossified) system of life values, principles and beliefs, which he embodies in practice. On this basis, his individual lifestyle and philosophy of life are formed. An adult strives and knows how to be himself, appreciates his originality.

According to A.A. Reana, with age, a person becomes more psychologically stable, because he has a fairly stable self-esteem, knows himself and his own capabilities well, has survived the crises and difficulties of previous ages. Feeling his advantage, he seeks to support those around him, to take care of helping the weaker and more dependent. It is important for him to feel needed for others, to be able to influence the world around him. At the same time, people with rich life experience have a philosophical attitude to life, accepting it as it is. They show great tolerance for human weaknesses and shortcomings, they are able to forgive themselves and others failures and mistakes.

After 35 years, many evaluate the previous life period as a fairly calm phase of life. Regardless of external events, most people felt inner balance and self-confidence at this time. Closer to 40 years, such confidence gradually disappears. An adult enters the most critical period of life - the "decade of the fatal line" (35-45 years). Spirituality must take the place of rationality. It is then that the manifestation of the Self of a person - his true "I" takes place. As Gail Sheehy writes, “Regardless of what we have done so far, there is something in us that we have been repressing and now it is bursting forth.” Therefore, it happens that at the age of about 40 people change their family, profession, lifestyle and start everything from scratch.

Women who until now have given all their strength to the family, at this time feel a great need to take care of themselves or their careers, regarding this as the last chance to catch up.

In maturity, as in youth, the main aspects of life are professional activities and family relationships. But if in youth it included mastering the chosen profession and choosing a life partner, then in maturity it is the realization of oneself, the full disclosure of one's potential in professional activities and family relationships.

E. Erickson considers the choice between productivity and inertia to be the main problem of maturity.

The concept of productivity according to E. Erickson is creative, professional productivity, as well as a contribution to education and affirmation in the life of the next generation. According to E. Erickson, productivity is associated with caring for “people, results and ideas in which a person is interested.” Inertia leads to preoccupation with oneself, one's own needs.

The most important feature of maturity is the awareness of responsibility for the content of one's life to oneself and to other people.

The development of the personality of a mature person requires getting rid of unjustified maximalism, characteristic of youth and partly youth, a balanced and versatility approach to life problems, including questions of one's professional activity. The accumulated experience, knowledge, and skills are of great value to a person, but they can also create difficulties for him in perceiving new professional ideas, hinder the growth of his creative abilities. Past experience, in the absence of reasonable flexibility and versatility, can become a source of conservatism, rigidity, rejection of everything that does not come from oneself.

Some people live another "unscheduled crisis" for 40 years (sometimes earlier and later). This is like a repetition of the crisis of 30 years, the crisis of the meaning of life, if the crisis of 30 years did not lead to a proper solution of problems. The crisis of 40 years is often caused by the aggravation of family relations. Children, as a rule, grow up and begin to live their lives, some close relatives and relatives of the older generation die. The loss of direct participation in the lives of children contributes to the final understanding of the nature of the marital relationship. It often happens that apart from the children of the spouses, nothing significant for both of them connects. In the event of a crisis of 40 years, a person again has to rebuild his life plan, develop a new "I - concept". This crisis can seriously change a person's life up to a change of profession and the creation of a new family.

If in youth, family relations, including motherhood and fatherhood and professional competence, are the central age-related neoplasm, then in maturity, a united education appears on their basis. It integrates the results of the development of both neoplasms of the previous period and is called productivity.

The crisis of 40 years speaks of another important new formation of maturity: adjustments in the life plan and related changes in the "I - concept."

The Swiss psychologist E. Claparede believed that reaching the peak of his professional productivity in maturity, a person stops his development, stops in improving his professional skills, creativity, etc. Then comes a decline, a gradual decrease in professional productivity: all the best that a person could do in his life is left behind, on the already traveled segment of the path.

From the point of view of E. Erickson, this stage of development is characterized by universal humanity - the ability to be interested in the fate of people outside the family circle, to think about the life of future generations, the forms of the future society and the structure of the future world. To do this, it is not necessary to have your own children, it is important to actively take care of young people and make it easier for people to live and work in the future.

Those who have not developed a sense of belonging to humanity focus on themselves, and their main concern becomes the satisfaction of their needs, their own comfort, self-absorption.

Later, pre-retirement age, is characterized by a decrease in the speed of reaction, a weakening of memory, thinking. Psychologists-gerontologists note such a feature of older people as introversion, i.e. focus on oneself - on one's own health, feelings, problems, lack of interest in external events. This property is fraught with the danger of egocentrism, isolation in one's own world. And at the same time, it can induce a genuine immersion into the depths of the inner world, a departure from everyday bustle to the heights of the spirit.

Studies show that with age, life position changes from active to passive. After 60 years, people perceive the world around them as more dangerous and complex than in their youth, and they believe that any actions are useless, because they cannot change anything in it. Hence the characteristic features of the elderly: conservatism, caution in expressing judgments, the desire to avoid risk, legibility.

Thus, in maturity as the longest age stage, several stages can be distinguished: early (25-35 years), middle (35-45 years) and late (45-60 years) maturity. The early and middle periods are characterized by psychological and social stability, the development of intellectual and physical strength, but the later - pre-retirement period is characterized by a decline in activity, a decrease in physical strength, susceptibility to depressive moods, deterioration in well-being, which negatively affects the general background of mood and emotional state.

2.2 Personal characteristics of people with disorders of the musculoskeletal system

The term "rheumatic diseases" combines pathological pictures, the common characteristic and leading symptoms of which are pain in the musculoskeletal system.

Blocked aggressive impulses of patients are expressed in increased muscle tension and, finally, in localized or localized pain.

In all patients with rheumatoid arthritis, three character traits occur with sufficient constancy:

1. Persistent manifestations of over-conscientiousness, commitment and external compliance, combined with a tendency to suppress all aggressive and hostile impulses, such as anger or rage.

3. A pronounced need for physical activity before the development of the disease (professional sports, intensive housework, gardening, etc.). .

Medico-psychological classifications they are guided by everyday practical medical activities and describe the types of attitude to the disease, more referring to the nature of the interaction that develops between the doctor and patients (Reinvald N.I., 1969; Stepanov A.D., 1975; Lezhepekova L.N., Yakubov P .Ya., 1977, etc.)

According to B.A. Yakubov (1982) the following types of response to the disease can be distinguished:

Friendly reaction. This reaction is typical for people with a developed intellect. It is as if from the first days of the disease they become the “assistant” of the doctor, demonstrating not only obedience, but also rare punctuality, attention, and goodwill. They have unlimited trust in their doctor and are grateful for his help.

Calm reaction. Such a reaction is typical for persons with stable emotional-volitional processes. They are punctual, adequately respond to all the instructions of the doctor, accurately perform medical and recreational activities. They are not just calm, but even appear “solid” and “sedate”, they easily come into contact with medical personnel. They may sometimes not be aware of their illness, which prevents the doctor from identifying the influence of the psyche on the disease.

unconscious reaction. Such a reaction, having a pathological basis, in some cases plays the role of psychological protection, and this form of protection should not always be eliminated, especially in severe diseases with an unfavorable outcome.

trace reaction. Patients are in the power of prejudice, tendentiousness. They are suspicious. Distrustful. With difficulty they come into contact with the attending physician, do not attach serious importance to his instructions and advice. They often have conflict with medical personnel. Despite their mental health, they sometimes exhibit the so-called "double reorientation".

panic reaction. Patients are in the grip of fear, easily suggestible, often inconsistent, treated simultaneously in different medical institutions, as if checking one doctor with another doctor. Often treated by healers. Their actions are inadequate, erroneous, affective instability is characteristic.

Destructive reaction. Patients behave adequately, carelessly, ignoring all the instructions of the attending physician. Such persons do not want to change their usual way of life, professional workload. This is accompanied by a refusal to take medications, from inpatient treatment. The consequences of such a reaction are often unfavorable.

Psychological and psychiatric classifications describe personal reactions to a person's disease. Many believe that it is the premorbid psychological characteristics of a person that can largely explain the preference for the appearance of certain forms of response in patients to their disease, since the content of the internal picture of the disease reflects not only the life situation (the situation of the disease), but also the inherent features of a person’s personality, including character and temperament. Traditionally, there are three main types of the patient's reaction to the disease: sthenic, asthenic and rational. With an active life position of the patient in relation to treatment and examination, they speak of a sthenic reaction to the disease. There is, however, a negative side to this behavior, since the patient may be weakly capable of fulfilling the necessary restrictions on the stereotype of life imposed by the disease. With an asthenic reaction to a disease, patients have a tendency to pessimism and suspiciousness, but they are relatively easier than patients with a sthenic reaction to psychologically adapt to the disease. With a rational type of reaction, there is a real assessment of the situation and a rational escape from frustration. Pathological forms of response to the disease (experiencing the disease) are often described by researchers in psychiatric terms and concepts: depressive, phobic, hysterical, hypochondriacal, euphoric-anisognosic and other options (Shevalev E.A., 1936; Rokhlin L.L., 1971; Kovalev V.V., 1972; Kvasenko A.V., Zubarev Yu.G., 1980, etc.). In this aspect, the classification of types of attitude to the disease, proposed by A.E. Lichko and N.Ya. Ivanov (1980).