The choice of research methods used by a clinical psychologist is determined by the tasks that arise before him in the performance of his professional duties. The diagnostic function dictates the use of psychological methods (batteries of tests, questionnaires, etc.) that can assess both the activity of individual mental functions, individual psychological characteristics, and differentiate psychological phenomena and psychopathological symptoms and syndromes. The psycho-correctional function implies the use of various scales, on the basis of which it is possible to analyze the effectiveness of psycho-correctional and psychotherapeutic methods. The selection of the necessary methods is carried out depending on the goals of the psychological examination; individual characteristics of the mental, as well as the somatic state of the subject; his age; profession and level of education; time and place of the study. All kinds of research methods in clinical psychology can be divided into three groups: 1) clinical interviewing, 2) experimental psychological research methods, 3) evaluation of the effectiveness of psycho-correctional influence. Let's dwell on them in more detail.

Clinical interview

We are aware of how difficult the unification and schematization of the creative process is, and yet interviewing can rightly be called creativity. In this regard, we are aware of the limits of our capabilities and do not pretend to find the ultimate truth. Each psychologist has the right to choose from a variety of existing ones the most suitable for him (his character, interests, preferences, level of sociability, worldview, culture, etc.) method of interviewing a client (patient). Therefore, the proposed text and the thoughts embodied in it should be considered as another possibility, another option that can satisfy the discerning reader and lead to the application of the provisions of this particular guide in practice.

If the information is capable of causing rejection, then it is up to the reader to continue searching for the most appropriate guide to clinical method in clinical psychology.

One of main goals of clinical interviewing is the assessment of the individual psychological characteristics of the client or patient, the ranking of the identified features in terms of quality, strength and severity, their assignment to psychological phenomena or psychopathological symptoms.

The term "interview" has entered the lexicon of clinical psychologists recently. More often they talk about a clinical questioning or conversation, the description of which in scientific works is overwhelmingly descriptive, sententious. Recommendations, as a rule, are given in an imperative tone and are aimed at forming undoubtedly important moral qualities of a diagnostician. In well-known publications and monographs, a clinical method for assessing a person’s mental state and diagnosing mental deviations in him is given without describing the actual methodology (principles and procedures) of questioning, which takes the recommendations given beyond the scope of scientific ones and available for effective reproduction. It turns out a paradoxical situation: it is possible to learn clinical examination and diagnostics only experimentally, participating as an observer-student in conversations with clients of well-known and recognized authorities in the field of diagnostics and interviewing.

Digressing from the main topic, I would like to note that, unfortunately, in the field of diagnostics there is and has a lot of fans even among professionals in diagnosing mental disorders without interviewing. That is, the diagnosis is made in absentia, without a direct meeting of the doctor with the alleged patient. This practice is becoming fashionable in our time. Diagnoses of mental illness based on an analysis of human actions known to the doctor by hearsay or from the lips of non-specialists, psychopathological interpretations of the texts of the “suspects” (letters, poems, prose, once abandoned phrases) only discredit the clinical method.

Another distinctive feature of modern practical psychology has become the belief in the omnipotence of experimental psychological methods in the diagnostic plan. A large army of psychologists is convinced that they are able to identify mental abnormalities and delimit the norm from pathology with the help of various tests. Such a widespread misconception leads to the fact that the psychologist often turns himself into a fortune-teller, into a conjurer, from whom others expect to demonstrate a miracle and solve miracles.

True diagnostics of both mental deviations and individual psychological characteristics of a person must necessarily combine diagnostics in the narrow sense of the term and direct examination by a psychologist of a client (patient), i.e. interviewing.

Currently, the diagnostic process is completely at the mercy of psychiatrists. This cannot be considered fair, since the doctor, first of all, is aimed at finding a symptom, and not at the actual differentiation of a symptom and a phenomenon. In addition, due to tradition, the psychiatrist is little aware of the manifestations of healthy mental activity. It is precisely because of these features that it can be considered reasonable to involve a clinical psychologist in the diagnostic process in the form of interviews to assess the mental state of the subjects.

A clinical interview is a method of obtaining information about the individual psychological properties of a person, psychological phenomena and psychopathological symptoms and syndromes, the internal picture of the patient's illness and the structure of the client's problem, as well as a method of psychological impact on a person, produced directly on the basis of personal contact between the psychologist and the client.

The interview differs from the usual questioning in that it is aimed not only at complaints actively presented by a person, but also at revealing the hidden motives of a person’s behavior and helping him to realize the true (internal) grounds for an altered mental state. The psychological support of the client (patient) is also considered essential for the interview.

Interview Features in clinical psychology are: diagnostic and therapeutic. They should be carried out in parallel, since only their combination can lead to the desired result for the psychologist - the recovery and rehabilitation of the patient. In this respect, the practice of clinical questioning, ignoring the psychotherapeutic function, turns the doctor or psychologist into an extra, whose role could be successfully performed by a computer.

Clients and patients often cannot accurately describe their condition and formulate complaints and problems. That is why the ability to listen to the presentation of a person's problems is only part of the interview, the second is the ability to tactfully help him formulate his problem, to let him understand the origins of psychological discomfort - to crystallize the problem. “Speech is given to a person in order to better understand himself,” wrote L. Vygotsky, and this understanding through verbalization in the process of a clinical interview can be considered essential and fundamental.

Principles of the clinical interview are: unambiguity, accuracy and accessibility of wording-questions; adequacy, consistency (algorithmicity); flexibility, impartiality of the survey; verifiability of the received information.

Under the principle uniqueness and precision within the framework of a clinical interview, the correct, correct and precise formulation of questions is understood. An example of ambiguity is such a question addressed to the patient: “Do you experience a mental impact on yourself?” An affirmative answer to this question does not give the diagnostician practically anything, since it can be interpreted in various ways. The patient could mean by "impact" both ordinary human experiences, events, people around him, and, for example, "energy vampirism", the impact of aliens, etc. This question is inaccurate and ambiguous, therefore uninformative and redundant.

Principle accessibility is based on several parameters: vocabulary (linguistic), educational, cultural, cultural, linguistic, national, ethnic and other factors. The speech addressed to the patient must be understandable to him, must coincide with his speech practice, based on many traditions. The diagnostician asked: “Do you have hallucinations?” - may be misunderstood by a person who encounters such a scientific term for the first time. On the other hand, if a patient is asked if he hears voices, then his understanding of the word “voices” may be fundamentally different from the doctor’s understanding of the same term. Availability is based on an accurate assessment by the diagnostician of the patient's status, the level of his knowledge; vocabulary, subcultural features, jargon practice.

One of the important parameters of the interview is algorithmic (sequence) questioning, based on the knowledge of the diagnostician in the field of compatibility of psychological phenomena and psychopathological symptoms and syndromes; endogenous, psychogenic and exogenous types of response; psychotic and non-psychotic levels of mental disorders. A clinical psychologist must know hundreds of psychopathological symptoms. But if he asks about the presence of every symptom known to him, then this, on the one hand, will take a lot of time and will be tedious for both the patient and the researcher; on the other hand, it will reflect the incompetence of the diagnostician. The sequence is based on the well-known algorithm of psychogenesis: on the basis of the presentation of the first complaints by patients, the story of his relatives, acquaintances, or on the basis of direct observation of his behavior, the first group of phenomena or symptoms is formed. Further, the survey covers the identification of phenomena, symptoms and syndromes that are traditionally combined with those already identified, then the questions should be aimed at assessing the type of response (endogenous, psychogenic or exogenous), the level of disorders and etiological factors. For example, if the presence of auditory hallucinations is the first to be detected, then further questioning is built according to the following algorithm scheme: assessment of the nature of hallucinatory images (the number of "voices", their awareness and criticality, speech features, determining the location of the sound source according to the patient, the time of appearance etc.) - the degree of emotional involvement - the degree of criticality of the patient to hallucinatory manifestations - the presence of thinking disorders (delusional interpretations of "voices") and Further, depending on the qualification of the described phenomena, confirmation of exogenous, endogenous or psychogenic types of response using a survey on the presence , for example, disorders of consciousness, psychosensory disorders and other manifestations of a certain range of disorders. In addition to the above, the principle of sequence implies a detailed questioning in a longitudinal section: the order in which mental experiences appear and their connection with real circumstances. At the same time, every detail of the story is important, the context of events, experiences, interpretations is important.

The most significant are the principles verifiability and adequacy psychological interview, when, in order to clarify the congruence of concepts and exclude incorrect interpretation of answers, the diagnostician asks questions like: “What do you understand by the word“ voices ”that you hear?” or “Give an example of the ‘voices’ being tested. If necessary, the patient is asked to specify the description of his own experiences.

Principle impartiality- the basic principle of a phenomenologically oriented psychologist-diagnostician. Imposing on the patient his own idea that he has psychopathological symptoms on the basis of a biased or carelessly conducted interview can occur both due to a conscious attitude, and on the basis of ignorance of the principles of the interview or blind adherence to one of the scientific schools.

Considering the burden of responsibility, primarily moral and ethical, lying on the diagnostician in the process of psychological interview, it seems appropriate for us to cite the main ethical provisions of the American Psychological Association regarding counseling and interviewing:

1. Adhere to confidentiality: respect the rights of the client and his privacy. Do not discuss what he said during interviews with other clients. If you cannot comply with the confidentiality requirements, then you must inform the client about this before the conversation; let him decide for himself whether it is possible to go for it. If information is shared with you that contains information about a danger that threatens a client or society, then ethical regulations allow you to violate confidentiality for the sake of safety. However, one must always remember that, be that as it may, the psychologist's responsibility to the client who trusts him is always primary.

2. Realize the limits of your competence. There is a kind of intoxication that occurs after the psychologist has learned the first few techniques. Beginning psychologists immediately try to delve deeply into the souls of their friends and their clients. This is potentially dangerous. A novice psychologist should work under the supervision of a professional; Seek advice and suggestions to improve your work style. The first step to professionalism is knowing your limits.

3. Avoid asking about irrelevant details. The aspiring psychologist is mesmerized by the details and "important stories" of his clients. Sometimes he asks very intimate questions about sex life. It is common for a novice or inept psychologist to place great importance on the details of the client's life and at the same time miss what the client feels and thinks. Consulting is intended primarily for the benefit of the client, and not to increase your volume of information.

4. Treat the client the way you would like to be treated. Put yourself in the client's shoes. Everyone wants to be treated with respect, sparing his self-esteem. A deep relationship and a heart-to-heart conversation begins after the client has understood that his thoughts and experiences are close to you. A relationship of trust develops from the client's and counselor's ability to be honest.

5. Be aware of individual and cultural differences. It is safe to say that the practice of therapy and counseling, regardless of what cultural group you are dealing with, cannot be called an ethical practice at all. Are you prepared enough to work with people who are different from you?

The current situation in society allows us to talk about potentially or clearly existing conflicts in the field of communication. The clinical interview is no exception in this regard. Potential psychological difficulties in conducting interviews are possible at different levels - yesterday they covered one area; today - the second; tomorrow - may spread yes third. Without a trusting atmosphere, therapeutic empathy between a psychologist and a patient, qualified interviewing, diagnosis and psychotherapeutic effect are impossible.

Jacques Lacan's theory suggests that an interview is not just a relationship between two people physically present in a session. It is also the relationship of cultures. That is, at least four people are involved in the counseling process, and what we took for a conversation between a therapist and a client may turn out to be a process of interaction between their cultural and historical roots. The following figure illustrates the point of view of J. Lacan:

Figure 2.

Note that counseling is a more complex subject than just giving recommendations to a client. Cultural affiliation must always be considered. In the figure above, the therapist and the client are what we see and hear during the interview process. “But no one can get away from their cultural heritage. Some-

Some psychological theories tend to be anti-historic and underestimate the influence of cultural identity on the client. They focus mainly on the client-psychologist relationship, omitting more interesting facts of their interaction” (J. Lacan).

Schneiderman argued that "whoever seeks to erase cultural differences and create a society in which alienness does not exist, is moving towards alienation ... The moral denial of alienness is racism, one can hardly doubt it."

Empathy requires that we understand both the personal uniqueness and the “foreignness” (cultural-historical factor) of our client. Historically, empathy has focused on personal uniqueness, and the second aspect has been forgotten. For example, psychologists in the United States and Canada expect that all clients, regardless of their cultural background, will respond in the same way to the same treatment. Based on the concept of J. Lacan, then such therapy looks like this:

Figure 3

Thus, the cultural-historical influence is reflected in this interview, but the client and the psychologist are not aware of these problems, they are disconnected from them. In this example, the client is aware of the specifics of their cultural identity and takes it into account in their plans for the future. The psychologist, however, proceeds from a theory based on individual empathy and does not pay attention to this important circumstance. In addition, the client sees only a cultural stereotype in the consultant, “This example is by no means an exception to the rule, and many non-white clients who have tried to get counseling from an unqualified white psychotherapist will readily confirm this” (A. Ivey).

Ideally, both - the psychologist and the client - are aware of and use the cultural-historical aspect. Empathy, on the other hand, cannot be considered a necessary and sufficient condition if one does not pay attention to the cultural aspect as well.

J. Lacan's model gives an additional impetus to building a certain level of empathy. Sometimes the client and the psychologist think that they are talking to each other, when in fact they are only passive observers of how two cultural settings interact.

In the course of a clinical interview, as experience shows and confirms the theory of J. Lacan, such components of historical and cultural bases psychologist (doctor) and client (patient) as: gender, age, religious beliefs and religion, racial characteristics (in modern conditions - nationality); sexual orientation preferences. The effectiveness of the interview in these cases will depend on how the psychologist and the patient with different beliefs and characteristics will find a common language, what style of communication the diagnostician will offer to create an atmosphere of trust. Today we face relatively new problems in the field of therapeutic interaction. Patients conceived do not trust doctors, and doctors do not trust patients only on the basis of differences in national, religious, sexual (hetero-, homosexual) characteristics. A doctor (as well as a psychologist) should be guided by the current situation in the field of ethnocultural relations and choose a flexible communication tactic that avoids discussing acute global and non-medical problems, in particular national, religious ones, and even more so not to impose his point of view on these issues.

The described principles of the clinical interview reflect the basic knowledge, the theoretical platform on which the entire interviewing process is built. However, principles not supported by practical procedures will remain unused.

There are various methodological approaches to conducting interviews. It's believed that by duration first interview should be about 50 minutes. Subsequent interviews with the same client (patient) are somewhat shorter. The following model (structure) of a clinical interview can be proposed:

Stage I: Establishing a "confidence distance". Situational support, provision of confidentiality guarantees; determining the dominant motives for conducting an interview.

Stage II: Identification of complaints (passive and active interviews), assessment of the internal picture - the concept of the disease; problem structuring,

Stage III: Evaluation of the desired outcome of the interview and therapy; determination of the patient's subjective model of health and preferred mental status.

IV stage: Assessment of the patient's anticipatory abilities; discussion of probable outcomes of the disease (if it is detected) and therapy; anticipation training.

The above stages of a clinical psychological interview give an idea of ​​the essential points discussed during the meeting between the psychologist and the patient. This scheme can be used for each conversation, but it should be remembered that the specific weight - the time and effort allocated to one or another stage - varies depending on the order of meetings, the effectiveness of therapy, the level of observed mental disorders, and some other parameters. It is clear that during the first interview, the first three stages should be predominant, and during subsequent interviews, the fourth. Particular attention should be paid to the level of mental disorders of the patient (psychotic - non-psychotic); voluntariness or compulsory interview; criticality of the patient; intellectual features and abilities, as well as the real situation surrounding him.

First stage clinical interview ("establishing a confidence distance") can be defined as an active interview. "It is the most important and difficult. The first impression of the patient can decide the further course of the interview, his desire to continue the conversation, go to the disclosure of intimate details. not from the boring formal “What are you complaining about?”, but from situational support.The interviewer takes the thread of the conversation into his own hands and, mentally putting himself in the place of a patient who first turned to a doctor (especially if he was in a psychiatric hospital), feeling the drama situations, the fear of the applicant being recognized as mentally ill or misunderstood or put on record helps him start a conversation.

In addition, at the first stage, the psychologist must identify the dominant motives for contacting him, make a first impression of the level of criticality of the interviewee to himself and psychological manifestations. This goal is achieved with the help of questions like: “Who initiated your appeal to a specialist?”, “Is your coming to talk with me your own desire or did you do it to reassure relatives (acquaintances, parents, children, bosses)?” ; “Does anyone know that you were going to see a specialist?”

Even when interviewing a patient with a psychotic level of disorder, it is advisable to begin the interview by providing assurances of confidentiality. Often effective for further conversation with such patients are phrases like: “You probably know that you can refuse to talk to me as a psychologist and psychiatrist?” In the vast majority of cases, this phrase does not cause a desire to leave the doctor's office, but rather turns out to be a pleasant revelation for the patient, who begins to feel free to dispose of information about himself and at the same time becomes more open to communication.

The active role of the doctor (psychologist) is interrupted at this point and begins passive interview. The patient (client) is given time and opportunity to present complaints in the sequence and with those details and comments that he considers necessary and important. At the same time, the doctor or psychologist plays the role of an attentive listener, only clarifying the features of the manifestations of the patient's disease. Most often, the listening technique includes the following methods (Table 1).

The questions asked by the diagnostician are aimed at assessing the internal picture and concept of the disease, i.e. identifying the patient's ideas about the causes and reasons for the occurrence of certain symptoms in him. At the same time, the problem is structured, which remains frustrating at the time of the interview. Here

Table 1

The main stages of diagnostic listening (according to A-Ivn)

Methodology	Description	Function during the interview
Open questions	"What?" - reveals the facts; "How?" - the senses; "Why?" - the reasons; "Is it possible?" - big picture	Used to clarify basic facts and facilitate conversation
Closed questions	Usually include the particle “li”, they can be answered briefly	Gives the opportunity to reveal special facts, shorten too long monologues
Promotion (support)	Repetition of several key phrases of the client	Encourages detailed development of specific words and meanings
reflection of feeling	Draws attention to the emotional content of the interview	Clarifies the emotional background of key facts, helps to open feelings
retelling	Repetition of the essence of words client and his thoughts, using his keywords	Activates discussion, shows level of understanding
	Succinctly repeats key facts* and feelings of the client	It is useful to repeat periodically during the interview. Required at the end of the meeting.

the diagnostician asks all sorts of questions regarding analysis and mental state, based on known diagnostic algorithms. In addition to listening, the psychologist should also use elements of influence during the interview.

Methods of influence in the interview process (according to A. Ivey)

table 2

Method	Description		Function during the interview
Interpretation	Sets a new framework in which the client can see the situation		An attempt to enable the client to see the situation in a new way - an alternative perception of reality, which contributes to a change in views, thoughts, moods and behavior
Directive (indication)	Tells the client what action to take. It can be just a wish or a technique.	Clearly shows the client what action the psychologist expects from him.
(information)	Gives wishes, general ideas, homework, advice on how to act, think, behave.,	Moderately used tips provide the client with useful information.
Self-disclosure	The psychologist shares personal experiences and experiences, or shares the feelings of the client.	Closely related to the reception of feedback, built on "I-sentences". Helps build rapport.
Feedback	Gives the client the opportunity to understand how the psychologist perceives him, as well as those around him.	Gives specific data that helps the client understand how to understand him, how others perceive his behavior and thinking style, which creates the possibility of self-perception.
logical subsequence	Explains to the client the logical consequences of his thinking and behavior. "If...then."	Gives the client a different point of reference. This method helps people anticipate the results of their actions.
Impact Resume	Often used at the end of a conversation to formulate the psychologist's judgments. Often used in combination with a client's resume.	Clarifies what the psychologist and client achieved during the conversation. Summarizes what the therapist said. Designed to help the client transfer these generalizations from the interview to real life.

Essential at this stage of the interview is the collection of the so-called psychological and medical anamnesis - the history of life and illness. The task of the psychological anamnesis is to obtain information from the patient to assess his personality as an established system of attitudes towards himself and, in particular, attitudes towards the disease and assess how much the disease has changed this entire system. Important are the data on the course of the disease and the life path, which are designed to reveal how the disease is reflected in the subjective world of the patient, how it affects his behavior, on the entire system of personal relationships. Outwardly, the medical and psychological history as research methods are very similar - the questioning could go according to a single plan, but their purpose and the use of the data obtained are completely different (V.M. Smirnov, T.N. Reznikova).

Next (III) stage The clinical interview aims to identify the patient's ideas about the possible and desired outcomes of the interview and therapy. The patient is asked: “Which of what you told me would you like to get rid of first of all? How did you imagine our conversation before coming to me and what do you expect from it? How do you think I could help you?"

The last question aims to identify the patient's preferred mode of therapy. After all, it is not uncommon for a patient, after presenting complaints (often diverse and subjectively severe) to a doctor, to refuse treatment, referring to the fact that he does not take any medications in principle, is skeptical about psychotherapy, or does not trust doctors at all. Such situations indicate the desired psychotherapeutic effect from the interview itself, from the opportunity to speak out, to be heard and understood.

In some cases, this turns out to be sufficient for a certain part of those who seek advice from a doctor or psychologist. Indeed, often a person comes to a doctor (especially a psychiatrist) not for a diagnosis, but in order to get confirmation of his own beliefs about his mental health and balance.

On the fourth final stage clinical interview again active role passes to the interviewer. Based on the identified symptoms, having the patient's understanding of the concept of the disease, knowing what the patient expects from treatment, the interviewer-psychologist directs the interview into the mainstream of anticipatory training. As a rule, a neurotic is afraid to think and even discuss with anyone the possible sad outcomes of the conflict situations that exist for him, which caused him to go to the doctor and get sick.

Anticipatory training, which is based on the anticipatory concept of neurogenesis (V.D. Mendelevich), is aimed, first of all, at the patient's thinking out the most negative consequences of his illness and life. For example, when analyzing a phobic syndrome within the framework of a neurotic register, it is advisable to ask questions in the following sequence: “What exactly are you afraid of? - Something bad must happen. - How do you suppose and feel with whom this bad thing should happen: with you or with your loved ones? - I think with me. - What exactly do you think? - I'm afraid to die. - What does death mean to you? Why is she terrible? - I do not know. - I understand that it is an unpleasant occupation to think about death, but I ask you to think about what exactly you are afraid of in death? I will try to help you. For one person, death is non-existence, for another, it is not death itself that is terrible, but the suffering and pain associated with it; for the third - it means that children and loved ones will be helpless in the event of death and etc. What is your opinion about this? - ...-»

Such a technique within the framework of a clinical interview performs both the function of a more accurate diagnosis of the patient's condition, penetration into the secret secrets of his illness and personality, and a therapeutic function. We call this technique anticipatory training. It can be considered a pathogenetic method for the treatment of neurotic disorders. The use of this method when interviewing patients with psychotic disorders performs one of the functions of the interview - it clarifies the diagnostic horizons to a greater extent, and this has a therapeutic effect.

The clinical interview consists of verbal (described above) and non-verbal methods, especially in the second stage. Along with questioning the patient and analyzing his answers, the doctor can recognize a lot of important information that is not dressed in verbal form.

The language of facial expressions and gestures is the foundation on which counseling and interviewing are based (Harper, Wiens, Matarazzo, A. Ivey). Non-verbal language, according to the last author, functions at three levels:

Terms of interaction: for example, the time and place of the conversation, the design of the office, clothing and other important details, pain

most of which affect the nature of the relationship between two people;

Information flow: for example, important information often comes to us in the form of non-verbal communication, but much more often non-verbal communication modifies meaning and rearranges emphasis in a verbal context;

Interpretation: Each individual, from any culture, has vastly different ways of interpreting non-verbal communication. What one perceives from non-verbal language may be fundamentally different from what another understands.

Extensive research in Western psychological science on the study of listening skills has shown that the standards of eye contact, torso tilt, medium timbre of the voice may be completely unsuitable in communicating with some clients. When a clinician is working with a depressed patient or someone who is talking about sensitive matters, eye contact during the interaction may be inappropriate. Sometimes it is wise to look away from the speaker.

visual contact . Without forgetting cultural differences, it should still be noted the importance of when and why an individual stops making eye contact with you. “It is the movement of the eyes that is the key to what is happening in the client's head,” says A. Ivey. “Usually, visual contact stops when a person speaks on a sensitive topic. For example, a young woman may not make eye contact when she talks about her partner's impotence, but not when she talks about her solicitousness. This may be a real sign that she would like to maintain a relationship with her lover. However, more than one conversation is required to accurately calculate the meaning of a change in non-verbal behavior or visual contact, otherwise there is a high risk of drawing erroneous conclusions.

Language of the body . Representatives of different cultures naturally differ in this parameter. Different groups put different content into the same gestures. It is believed that the most informative in body language is the change in torso tilt. The client may sit naturally and then, for no apparent reason, clench their hands, cross their legs, or sit on the edge of a chair. Often these seemingly minor changes are indicators of conflict in the person.

intonation and tempo of speech. The intonation and pace of a person's speech can say as much about him, especially about his emotional state, as verbal information. How loudly or quietly sentences are spoken can serve as an indicator of the strength of feelings. Rapid speech is usually associated with a state of nervousness and hyperactivity; while slow speech may indicate lethargy and depression.

Following AAivy and his colleagues, we note the importance of such parameters as the construction of speech in the interview process. According to these authors, the way people construct sentences is an important key to understanding their perception of the world. For example, it is proposed to answer the question: “What will you tell the controller when he starts checking the availability of tickets, and you find yourself in a difficult situation?”: a) The ticket is torn, b) I tore the ticket, c) The car tore the ticket, or d) Something what happened?

Explaining even such an insignificant event can serve as a key to understanding how a person perceives himself and the world around him. Each of the above sentences is true, but each illustrates a different worldview. The first sentence is just a description of what happened; the second - demonstrates a person who takes responsibility and indicates an internal locus of control; the third represents external control, or "I didn't do it," and the fourth indicates a fatalistic, even mystical, outlook.

Analyzing the structure of sentences, we can come to an important conclusion regarding the psychotherapeutic process: the words that a person uses when describing events often give more information about him than the event itself. The grammatical structure of sentences is also an indicator of personal worldview.

The research and observations of Richard Bandler and John Grinder, the founders of neurolinguistic programming, focused the attention of psychologists and psychotherapists on the linguistic aspects of diagnosis and therapy. For the first time, the significance of the words used by the patient (client) and the construction of phrases in the process of understanding the structure of his mental activity, and hence personal characteristics, was noted. Scientists have noticed that people talk differently about similar phenomena. One, for example, will say that he “sees” how his spouse treats him badly; another will use the word "know"; the third - "feel" or "feel"; the fourth - will say that the spouse does not "listen" to his opinion. Such a speech strategy indicates the predominance of certain representational systems, the presence of which must be taken into account in order to “connect” to the patient and create true mutual understanding within the interview.

According to D. Grinder and R. Bandler, there are three types of mismatches in the structure of the interviewee's speech, which can serve to study the deep structure of a person: deletion, distortion and overgeneralization. Crossing out can appear in sentences such as "I'm afraid." To questions like “Who or what are you afraid of?”, “For what reason?”, “In what situations?”, “Do you feel fear now?”, “Is this fear real or its causes are unreal?” - There are usually no responses. The task of the psychologist is to "expand" a brief statement about fear, to develop a complete representative picture of the difficulties. During this "filling in the crossed out" process, new surface structures may appear. Distortion can be defined as an unconstructive or incorrect proposal. These proposals distort the real picture of what is happening. A classic example of this would be a sentence like, "He's making me crazy," while the truth is that a person who "makes another crazy" is only responsible for his own behavior. A more correct statement would be: "I get very angry when he does this." In this case, the client takes responsibility for his behavior and begins to control the direction of his actions. Distortions often develop from strikeouts on the surface structure of a sentence. At a deeper level, a close examination of the client's life situation reveals many distortions of reality that exist in his mind. Overgeneralization occurs when the client draws far-reaching conclusions without having sufficient evidence for this. Overgeneralization is often accompanied by distortions. The words accompanying overgeneralizations are usually the following: "all people", "everyone in general", "always", "never", "the same", "always", "forever" and others.

The use of verbal and non-verbal communication contributes to a more accurate understanding of the patient's problems and allows you to create a mutually beneficial situation during the clinical interview.

Methods (techniques) for the study of personality

Personality is the most complex mental construct in which many social and biological factors are closely intertwined. A change in even one of these factors significantly affects its relationship with other factors and the personality as a whole. This is connected with the variety of approaches to the study of personality - various aspects of the study of personality come from different concepts, they differ methodologically according to the object of which science is the study of personality.

In recent years, there has been a significant increase in interest in research on the personality characteristics of mentally ill patients, both in pathopsychology and in clinical psychiatry. This is due to a number of circumstances: firstly, personality changes have, to a certain extent, nosological specificity and can be used to resolve issues of differential diagnosis; secondly, the analysis of premorbid personality traits can be useful in establishing the possible causes of the origin of a number of diseases (and not only mental, but also somatic, for example, peptic ulcer, diseases of the cardiovascular system); thirdly, the characterization of personality changes during the course of the disease enriches our understanding of its pathogenetic mechanisms; fourthly, taking into account the characteristics of the individual is very important for the rational construction of a complex of rehabilitation measures.

Given the complexity of the concept of personality, we should immediately agree that there is no single method of its study, no matter how complete and versatile it may seem to us, which can give a holistic description of personality. With the help of experimental research, we obtain only a partial characterization of the personality, which satisfies us insofar as it evaluates certain personality manifestations that are important for solving a specific problem.

Currently, there are many experimental psychological techniques, methods, techniques aimed at studying personality. They, as already mentioned, differ in the peculiarities of the approach to the problem itself (we are talking about a fundamental, methodological difference), the diversity of the interests of researchers (personality is studied in educational psychology, in labor psychology, in social and pathological psychology, etc.) and focus on various manifestations of personality. Of course, the interests of researchers and the tasks facing them often coincide, and this explains why the methods of studying personality in social psychology are adopted by pathopsychologists, and the methods of pathopsychology are borrowed by specialists working in the field of labor psychology.

There is not even any clear, much less generally accepted classification of methods used to study personality. We (V. M. Bleikher, L. F. Burlachu k, 1978) proposed the following classification of personality research methods as a conditional:

• 1) observation and methods close to it (studying biographies, clinical conversation, analysis of subjective and objective anamnesis, etc.);
• 2) special experimental methods (simulation of certain types of activities, situations, some instrumental techniques, etc.);
• 3) personality questionnaires and other methods based on assessment and self-assessment; 4) projective methods.

As will be seen from what follows, the distinction between these 4 groups of methods is very conditional and can be used mainly for pragmatic and didactic purposes.

K. Leonhard (1968) considered observation to be one of the most important methods for diagnosing personality, preferring it over methods such as personality questionnaires. At the same time, he attaches particular importance to the opportunity to observe a person directly, to study his behavior at work and at home, in the family, among friends and acquaintances, in a narrow circle and with a large number of people gathered. The special importance of observing facial expressions, gestures and intonations of the subject, which are often more objective criteria of personality manifestations than words, is emphasized. Observation should not be passive-contemplative. In the process of observation, the pathopsychologist analyzes the phenomena that he sees from the point of view of the patient's activity in a certain situation, and for this purpose exerts a certain influence on the situation in order to stimulate certain behavioral reactions of the subject. Observation is a deliberate and purposeful perception, due to the task of activity (MS Rogovin, 1979). In a clinical conversation, the features of the patient's biography, the features of personal reactions inherent in him, his attitude to his own character, and the behavior of the subject in specific situations are analyzed. K. Leonhard considered the latter as the most important methodological point in the analysis of personality. MS Lebedinsky (1971) paid special attention in the study of the patient's personality to the study of diaries and autobiographies compiled by him at the request of the doctor, or conducted before.

For the study of personality in the process of activity, special methods are used, which will be discussed below. It should only be noted that for an experienced pathopsychologist such material is provided by any psychological methods aimed at studying cognitive activity. For example, according to the results of a test for memorizing 10 words, one can judge the presence of apathetic changes in a patient with schizophrenia (a memorization curve of the “plateau” type), an overestimated or underestimated level of claims, etc.

Significant methodological and methodological difficulties arise before the pathopsychologist in connection with the use of personality questionnaires. Personal characteristics obtained in terms of self-assessment are of great interest to the pathopsychologist, but the need to compare self-assessment data with indicators that objectively represent personality is often overlooked. Of the most commonly used personality questionnaires, only MMP1 has satisfactory rating scales that allow one to judge the adequacy of the self-assessment of the subject. A disadvantage of the design of many personality questionnaires should be considered their obvious purposefulness for the subject. This primarily applies to monothematic questionnaires such as the anxiety scale. Thus, the information obtained with the help of personality questionnaires can be adequately assessed only by comparing it with the data of an objective assessment of the personality, as well as by supplementing it with the results of personality research in the process of activity, by projective methods. The selection of methods that complement one or another personal questionnaire is determined in many respects by the task of the study. For example, when studying the "internal picture" of a disease, the patient's position in relation to his disease is significantly refined by introducing techniques such as unfinished sentences into the experiment.

By projective, we mean such methods of mediated study of personality, which are based on the construction of a specific, plastic situation that, due to the activity of the perception process, creates the most favorable conditions for the manifestation of tendencies, attitudes, emotional states and other personality traits (V. M. Bleikher, L. F. Burlachuk, 1976, 1978). E. T. Sokolova (1980) believes that the projective method, focused on the study of unconscious or not quite conscious forms of motivation, is almost the only proper psychological method of penetrating into the most intimate area of ​​the human psyche. If the majority of psychological techniques, E. T. Sokolova believes, are aimed at studying how and due to what the objective nature of a person’s reflection of the outside world is achieved, then projective techniques aim to identify peculiar “subjective deviations”, personal “interpretations”, and the latter far from always objective, not always, as a rule, personally significant.

It should be remembered that the range of projective techniques is much wider than the list of methodological techniques that are traditionally included in this group of techniques (V. M. Bleikher, L. I. Zavilyanskaya, 1970, 1976). Elements of projectivity can be found in most pathopsychological methods and techniques. Moreover, there is reason to believe that a conversation with the subject, directed in a special way, may contain elements of projectivity. In particular, this can be achieved by discussing with the patient certain life conflicts or works of art containing a deep subtext, phenomena of social life.

Pathopsychological methods in the aspect of the problem of projectivity were analyzed by V. E. Renge (1976). At the same time, it was found that a number of methods (pictograms, a study of self-esteem, a level of claims, etc.) are based on stimulation that is not identical for the patient and does not limit the scope of the “choice” of answers. The possibility of obtaining a relatively large number of responses of the subject largely depends on the characteristics of the pathopsychological experiment. An important factor in this is, according to V. E. Renge, the subject’s unawareness of the true goals of applying the techniques. This circumstance, for example, was taken into account in the modification of the TAT method by H. K. Kiyashchenko (1965). According to our observations, the principle of projectivity is inherent in the classification technique to a large extent. In this regard, one should agree with V. E. Renge that there are no methods for studying only personal characteristics or only cognitive processes. The main role is played by the creation of the most favorable conditions for the actualization of the projectivity factor in the process of performing the task, which to a certain extent is determined not only by the knowledge and skill of the psychologist, but is also a special art.

The study of the level of claims. The concept of the level of claims was developed by psychologists of the school of K. Lewin. In particular, F. Norre's (1930) method of experimental research of the level of claims was created. The experiment found that the level of claims depends on how successfully the subject performs experimental tasks. V. N. Myasishchev (1935) distinguished two sides of the level of claims - the objective-principled and the subjective-personal. The latter is closely related to self-esteem, a sense of inferiority, a tendency to self-affirmation and the desire to see a decrease or increase in working capacity in terms of one's performance. Further, the author pointed out that the ratio of these moments determines the level of claims of patients, especially with psychogenic diseases.

The level of claims is not an unambiguous, stable personal characteristic (B. V. Zeigarnik, 1969, 1972; V. S. Merlin, 1970). It is possible to distinguish the initial level of claims, which is determined by the degree of difficulty of tasks that a person considers feasible for himself, corresponding to his capabilities. Further, we can talk about the known dynamics of the level of claims in accordance with how the level of claims turned out to be adequate to the level of achievements. As a result of human activity (this also applies to the conditions of the experimental situation), finally, a certain level of claims typical of a given individual is established. In shaping the level of claims, an important role is played by the compliance of the activity of the subject with his assumptions about the degree of complexity of the tasks, the fulfillment of which would bring him satisfaction. V. S. Merlin (1970) attached great importance to social factors, believing that in the same activity there are different social standards of achievement for different social categories, depending on the position, specialty, and qualifications of the individual. This factor also plays a certain role in the conditions of an experimental study of the level of claims - even the correct performance of experimental tasks with a certain self-assessment of the subject may not be perceived by him as successful. From this follows the principle of the importance of the selection of experimental tasks.

The nature of the subject's reaction to success or failure is primarily determined by how stable his self-esteem is. Analyzing the dynamics of the level of claims, V. S. Merliy found that the ease or difficulty of adapting a person to activity by changing the level of claims depends on the properties of temperament (anxiety, extra or introversion, emotionality) and on such purely personal properties as the initial level of claims, the adequacy or inadequacy of self-esteem, the degree of its stability, the motives of self-affirmation.

In addition to self-assessment, in the dynamics of the level of claims, such moments as the attitude of the subject to the situation of the experiment and the researcher, the assessment of the activity of the subject by the experimenter, who registers success or failure during the experiment, the nature of the experimental tasks, play a significant role.

In the laboratory of B. V. Zeigarnik, a version of the methodology for studying the level of claims was developed (B. I. Bezhani-shvili, 1967). In front of the patient, two rows are laid out with the reverse side up 24 cards. In each row (from 1 to 12 and from 1, but to 12, a) the cards contain questions of increasing complexity.

The subject is informed that in each row the cards are arranged according to the increasing degree of task complexity, that in parallel in two rows there are cards of the same difficulty. Then he is offered, according to his abilities, to choose tasks of one or another complexity and complete them. The subject is warned that a certain time is allotted for each task, but they do not tell him what time. By turning on the stopwatch every time the subject takes a new card, the researcher, if desired, can tell the subject that he did not meet the allotted time and therefore the task is considered failed. This allows the researcher to artificially create "failure".

The experience is carefully recorded. Attention is drawn to how the level of the patient's claims corresponds to his capabilities (intellectual level, education) and how he reacts to success or failure. Some patients, after successfully completing, for example, the 3rd task, immediately take the 8th or 9th card, while others, on the contrary, are extremely careful - having correctly completed the task, they take a card either of the same degree of complexity or the next one. The same is the case with failure - some subjects take a card of the same complexity or slightly less difficult, while others, having not completed the 9th task, go to the 2nd or 3rd, which indicates the extreme fragility of their level of claims. It is also possible that the patient's behavior is such that, despite failure, he continues to choose tasks that are more and more difficult. This indicates a lack of critical thinking.

N. K. Kalita (1971) found that the questions used in the variant of B. I. Bezhanishvili, aimed at identifying the general educational level, are difficult to rank. The degree of their difficulty is determined not only by the volume of life knowledge and the level of education of the subject, but also largely depends on the circle of his interests. In search of more objective criteria for establishing the degree of complexity of tasks, N.K. Kalita suggested using pictures that differ from each other in the number of elements. Here, the complexity criterion is the number of differences between the compared pictures. In addition, control examinations can establish the time spent by healthy people to complete tasks of varying degrees of complexity. Otherwise, the study of the level of claims in the modification of N.K. Kalita has not changed.

To conduct the study, tasks of a different kind can also be used, in the selection of which it is possible to relatively objectively establish their gradation in terms of complexity: Koos cubes, one of the series of Reiven tables. For each of the tasks, it is necessary to select a parallel one, approximately equal in degree of difficulty.

The results of the study can be presented for greater clarity and facilitate their analysis in the form of a graph.

It is of interest to study the level of claims with the assessment of some quantitative indicators. Such a study may be important for an objective characterization of the degree of mental defect of the subject. An attempt to modify the methodology for studying the level of claims was made by V.K. Gorbachevsky (1969), who used all the subtests of the Wechsler scale (WAIS) for this. However, the modification of V.K. Gerbachevsky seems to us difficult for pathopsychological research, and therefore we have somewhat modified the version of the Zeigarnik-Bezhanishvili technique.

According to the instructions, the subject must choose 11 out of 24 cards containing questions of varying difficulty according to their abilities (of which the first 10 are taken into account). The response time is not regulated, i.e., it is important to take into account the actual completion of tasks, however, the subject is advised, if it is impossible to answer the question, immediately say so. Considering the well-known increase in the difficulty of the questions contained in the cards, the answers are respectively evaluated in points, for example, the correct answer to cards No. 1 and No. 1, and in 1 point, No. 2 and Zh2, e- in 2 points, No. points, etc. At the same time, just as according to V.K. Gorbachevsky, the value of the level of claims (the total score of the selected cards) and the level of achievements (the sum of the points scored) are determined.

In addition, an average score is calculated that determines the trend of activity after a successful or unsuccessful response. For example, if the subject answered 7 out of 10 questions, the sum of points for the cards selected after a successful answer is calculated separately and divided by 7. Similarly, the average activity trend after 3 unsuccessful answers is determined. To assess the choice of cards after the last answer, the subject is offered an unaccounted 11th task.

The methodology for studying the level of claims, as practical experience shows, makes it possible to detect the personal characteristics of patients with schizophrenia, circular psychosis, epilepsy, psychopathy, cerebral atherosclerosis, organic brain lesions that occur with characterological changes.

The study of self-esteem by the method of Dembo - Rubinshtein. The technique was proposed by S. Ya. Rubinshtein (1970) for the study of self-esteem. It uses the approach

T. Dembo, with the help of which the subject's ideas about his happiness were discovered.

S. Ya. Rubinshtein significantly changed this technique, expanded it, introduced instead of 1 reference scale 4 (health, mental development, character and happiness). It should be noted that the use of a reference scale to characterize any personal property helps to identify the position of the subject much more than the use of alternative methods such as the polarity profile and the list of adjectives, when the patient is offered a set of definitions (confident - timid, healthy - sick) and asked to indicate his state (H. Heimann, 1967). In the Dembo-Rubinshtein method, the subject is given the opportunity to determine his condition according to the scales chosen for self-assessment, taking into account a number of nuances that reflect the degree of severity of a particular personal property.

The technique is extremely simple. A vertical line is drawn on a sheet of paper, about which the subject is told that it means happiness, with the upper pole corresponding to a state of complete happiness, and the lower one occupied by the most unhappy people. The subject is asked to mark his place on this line with a line or a circle. The same vertical lines are drawn to express the patient's self-esteem on the scales of health, mental development, and character.

Then they start a conversation with the patient, in which they find out his idea of ​​\u200b\u200bhappiness and unhappiness, health and ill health, good and bad character, etc. It turns out why the patient made a mark in a certain place on the scale to indicate his characteristics. For example, what prompted him to put a mark in this place on the health scale, whether he considers himself healthy or sick, if sick, with what disease, whom does he consider sick.

A peculiar version of the technique is described by T. M. Gabriel (1972) using each of the scales with 7 categories, for example: the most sick, very sick, more or less sick, moderately sick, more or less healthy, very healthy, most healthy. The use of scales with such gradation, according to the author's observation, provides more subtle differences in identifying the position of the subjects.

Depending on the specific task facing the researcher, other scales can be introduced into the methodology. So, when examining patients with alcoholism, we use scales of mood, family well-being and service achievements. When examining patients in a depressed state, mood scales, ideas about the future (optimistic or pessimistic), anxiety, self-confidence, etc. are introduced.

In the analysis of the obtained results, S. Ya. Rubinshtein focuses not so much on the location of the marks on the scales as on the discussion of these marks. Mentally healthy people, according to the observations of S. Ya. Rubinshtein, tend to determine their place on all scales with a point “slightly above the middle”.

In mental patients, there is a tendency to refer the points of marks to the poles of the lines and the “positional” attitude towards the researcher disappears, which, according to S. Ya. .

The data obtained using this technique are of particular interest when compared with the results of the examination in this patient of the features of thinking and the emotional-volitional sphere.

At the same time, a violation of self-criticism, depressive self-esteem, and euphoria can be detected. Comparison of data on self-esteem with objective indicators for a number of experimental psychological techniques to a certain extent allows us to judge the patient's inherent level of claims, the degree of its adequacy. One might think that self-esteem in some mental illnesses does not remain constant, and its nature depends not only on the specificity of psychopathological manifestations, but also on the stage of the disease.

The Eysenck personality questionnaire is a variant created by the author (H. J. Eysenck, 1964) in the process of revising the Maudsley questionnaire proposed by him (1952) and, like the previous one, is aimed at studying the factors of extra-, introversion and neuroticism.

The concepts of extra-, introversion were created by psychoanalysts.

S.Jung distinguished between extra- and introverted rational (thinking and emotional) and irrational (sensory and intuitive) psychological types. According to K. Leonhard (1970), the criteria for distinguishing between extra- and introversion of S. Jung were mainly reduced to the subjectivity and objectivity of thinking. H. J. Eysenck (1964) connects extra- and introversion with the degree of excitation and inhibition in the central nervous system, considering this factor, which is largely innate, as a result of the balance of the processes of excitation and inhibition. In this case, a special role is given to the influence of the state of the reticular formation on the ratio of the main nervous processes. H. J. Eysenck also points to the importance of biological factors in this: some drugs introvert a person, while antidepressants extrovert him. Typical extrovert and introvert are considered by H. J. Eysenck as opposite personalities, the edges of the continuum, to which different people approach in one way or another.

According to H. J. Eysenck, an extrovert is sociable, likes to party, has many friends, needs people to talk to them, does not like to read and study on his own. He craves excitement, takes risks, acts on the spur of the moment, impulsive. An extrovert loves tricky jokes, does not go into his pocket for a word, usually loves change. He is carefree, good-naturedly cheerful, optimistic, likes to laugh, prefers movement and action, tends to be aggressive, quick-tempered. His emotions and feelings are not strictly controlled, and he cannot always be relied upon.

In contrast to the extrovert, the introvert is calm, shy, introspective. He prefers reading books to communicating with people. Restrained and distant from everyone except close friends. Plans his actions in advance. Distrusts sudden urges. Serious about making decisions, likes everything in order. Controls his feelings, rarely acts aggressively, does not lose his temper. You can rely on an introvert. He is somewhat pessimistic, highly values ​​ethical standards.

H. J. Eysenck himself believes that the characteristic of the intro- and extrovert described by him only resembles that described by S. Jung, but is not identical to it. K. Leonhard believed that the description of H. J. Eysenck as an extrovert corresponds to the picture of a hypomanic state and believes that the extra- and introversion factor cannot be associated with temperamental traits. According to K. Leonhard, the concepts of introversion of extraversion represent their own mental sphere, and for the extravert, the world of sensations has a determining influence, and for the introvert, the world of ideas, so that one is stimulated and controlled more from the outside, and the other more from the inside.

It should be noted that the point of view of K. Leonhard largely corresponds to the views of V. N. Myasishchev (1926), who defined these types of personality, from a clinical and psychological point of view, as expansive and impressive, and from a neurophysiological point of view - excitable and inhibited.

J. Gray (1968) raises the question of the identity of the parameters of the strength of the nervous system and intro- and extraversion, and the pole of weakness of the nervous system corresponds to the pole of introversion. At the same time, J. Gray considers the parameter of the strength of the nervous system in terms of activation levels - he considers a weak nervous system as a system of a higher level of reaction compared to a strong nervous system, provided that they are subjected to objectively identical physical stimuli.

J. Strelau (1970) found that extraversion is positively related to the strength of the excitation process and the mobility of nervous processes. At the same time, there is no connection between extraversion and the force of inhibition (in the typology of I.P. Pavlov, the force of inhibition is set exclusively for conditioned inhibition, in the concept of J. Strelau we are talking about “temporary” inhibition, consisting of conditioned and protective, i.e. of two different types of braking). All three properties of the nervous system (strength of excitation, strength of inhibition and mobility of nervous processes), according to J. Strelau, are negatively associated with the parameter of neuroticism. All this testifies to the illegitimacy of comparing the personality typology according to H. J. Eysenck with the types of higher nervous activity according to I. P. Pavlov.

The factor of neuroticism (or neuroticism) indicates, according to H. J. Eysenck, emotional and psychological stability or instability, stability - instability and is considered in connection with the congenital lability of the autonomic nervous system. In this scale of personality traits, opposite tendencies are expressed by discordance and concordance. At the same time, a person of the “external norm” turns out to be at one pole, behind which lies the susceptibility to all kinds of psychological perturbations, leading to an imbalance in neuropsychic activity. At the other extreme are individuals who are psychologically stable and adapt well to the surrounding social micro-environment.

The neuroticism factor plays an extremely important role in the diathesis-stress hypothesis of the etiopathogenesis of neuroses created by H. J. Eysenck, according to which neurosis is considered as a consequence of a constellation of stress and a predisposition to neurosis. Neuroticism reflects a predisposition to neurosis, a predisposition. With severe neuroticism, according to H. J. Eysenck, a slight stress is sufficient, and, conversely, with a low rate of neuroticism, severe stress is required for the onset of neurosis to develop neurosis.

In addition, a control scale (lie scale) was introduced into the Eysenck questionnaire. It serves to identify subjects with a "desirable reactive set", that is, with a tendency to respond to questions in such a way that the results desired for the subject are obtained.

The questionnaire was developed in 2 parallel forms (A and B), allowing for a second study after any experimental procedures. Questions differ, in comparison with MMP1, in the simplicity of wording. It is important that the correlation between the scales of extraversion and neuroticism is reduced to zero.

The questionnaire consists of 57 questions, of which 24 are on the extraversion scale, 24 are on the neuroticism scale, and 9 are on the lie scale.

The study is preceded by an instruction that indicates that personality traits are being investigated, and not mental abilities. It is proposed to answer the questions without hesitation, immediately, since the first reaction of the subject to the question is important. Questions can only be answered with “yes” or “no” and cannot be skipped.

Then questions are presented either in a special notebook (this facilitates assessment, as it allows the use of a key in the form of a stencil with specially cut windows), or printed on cards with appropriately cut corners (for subsequent recording). Here are some typical questions.

So, the following questions testify to extroversion (the corresponding answer is noted in brackets, with the opposite nature of the answer, it is counted as an indicator of introversion):

Do you like the revival and bustle around you? (Yes). Are you one of those people who do not go into their pocket for words? (Yes). Do you usually keep a low profile at parties or in companies? (No). Do you prefer to work alone? (No).

The maximum score on the extraversion scale in this version of the Eysenck questionnaire was 24 points. An indicator above 12 points indicates extraversion. With an indicator below 12 points, they speak of introversion. Questions typical of the neuroticism scale:

Do you feel sometimes happy and sometimes sad for no reason? (On the scale of neuroticism, only positive responses are taken into account). Do you sometimes have a bad mood? Are you easily swayed by mood swings? Have you often lost sleep due to feelings of anxiety?

Neuroticism is indicated by an indicator exceeding 12 points in this scale. Examples of questions on the lie scale:

Do you always do immediately and resignedly what you are ordered to do? (Yes).

Do you sometimes laugh at indecent jokes? (No). Do you brag sometimes? (No). Do you always reply to emails immediately after reading them? (Yes).

An indicator of 4-5 points on the lie scale is already considered critical. A high score on this scale indicates the subject's tendency to give "good" answers. This trend also manifests itself in answers to questions on other scales, however, the lie scale was conceived as a kind of indicator of demonstrativeness in the behavior of the subject.

It should be noted that the scale of lies in the Eisenck questionnaire does not always contribute to the solution of the task. The indicators for it are first of all corrected with the intellectual level of the subject. Often, persons with pronounced hysterical traits and a tendency to demonstrative behavior, but with good intelligence, immediately determine the direction of the questions contained in this scale and, considering them negatively characterizing the subject, give the minimum indicators on this scale. Thus, obviously, the scale of lies is more indicative of personal primitiveness than demonstrativeness in the answers.

According to H. J. Eysenck (1964, 1968), dysthymic symptoms are observed in introverts, hysterical and psychopathic in extroverts. Patients with neurosis differ only in the index of extraversion. According to the index of neuroticism, healthy and neurotic patients (psychopaths) are at the extreme poles. Patients with schizophrenia have a low rate of neuroticism, while patients in a depressed state have a high rate. With age, there was a tendency to decrease in the indicators of neuroticism and extraversion.

These data of H. J. Eysenck need to be clarified. In particular, in cases of psychopathy, the study using a questionnaire reveals a known difference in indicators. So, schizoid and psychasthenic psychopaths, according to our observations, often show introversion. Different forms of neurosis also differ not only in terms of extraversion. Patients with hysteria are often characterized by a high rate of lies and an exaggeratedly high rate of neuroticism, often not corresponding to an objectively observed clinical picture.

In the latest versions of the Eysenck questionnaire (1968, 1975), questions were introduced on the scale of psychotism. The factor of psychotism is understood as a tendency to deviations from the mental norm, as it were, a predisposition to psychosis. The total number of questions is from 78 to 101. According to S. Eysenck and H. J. Eysenck (1969), the indicators on the psychotism scale depend on the gender and age of the subjects, they are lower in women, higher in adolescents and the elderly. They also depend on the socio-economic status of the surveyed. However, the most significant difference in the factor of psychotism turned out to be when comparing healthy subjects with sick psychoses, that is, with more severe neuroses, as well as with persons in prison.

There is also a personal questionnaire S. Eysenck (1965), adapted to examine children from the age of 7. It contains 60 age-appropriate questions interpreted on scales of extra- and introversion, neuroticism, and lying.

The questionnaire for the study of accentuated personality traits was developed by H. Schmieschek (1970) based on the concept of accentuated personalities by K. Le-onhard (1964, 1968). According to her, there are personality traits (accentuated), which in themselves are not yet pathological, but can, under certain conditions, develop in positive and negative directions. These features are, as it were, a sharpening of some unique, individual properties inherent in each person, an extreme version of the norm. In psychopaths, these traits are especially pronounced. According to the observations of K. Le-onhard, neuroses, as a rule, occur in accentuated individuals. E. Ya. Sternberg (1970) draws an analogy between the concepts of "accentuated personality" by K. Leonhard and "schizothymia" by E. Kretschmer. Identification of a group of accentuated personalities can be fruitful for developing clinical and etiopathogenesis issues in borderline psychiatry, including the study of somatopsychic correlates in some somatic diseases, in the origin of which the personality characteristics of the patient play a prominent role. According to E. Ya. Sternberg, the concept of accentuated personalities may also be useful for studying the personality traits of relatives of the mentally ill.

K. Leonhard distinguished 10 main types of accentuation.

• 1. Hyperthymic personalities, characterized by a tendency to high mood.
• 2. "Stuck" personalities, with a tendency to delay, "stuck" affect and delusional (paranoid) reactions.
• 3. Emotive, affectively labile personalities.
• 4. Pedantic personality, with a predominance of features of rigidity, low mobility of nervous processes, pedantry.
• 5. Anxious personalities, with a predominance of anxiety traits in the character.
• 6. Cyclothymic personalities, with a tendency to phase mood swings.
• 7. Demonstrative personality, with hysterical character traits.
• 8. Excitable personalities, with a tendency to increased, impulsive reactivity in the sphere of inclinations.
• 9. Dithymic personality, with a tendency to mood disorders, subdepressive.
• 10. Exalted personalities prone to affective exaltation.

All these groups of accentuated personalities are united by K. Leonhard according to the principle of accentuation of character traits or temperament. The accentuation of character traits, “features of aspirations” include demonstrativeness (in pathology - psychopathy of the hysterical circle), pedantry (in pathology - ananastic psychopathy), a tendency to “get stuck” (in pathology - paranoid psychopaths) and excitability (in pathology - epileptoid psychopaths) . The remaining types of accentuation K. Leonhard refers to the features of temperament, they reflect the pace and depth of affective reactions.

Shishek's questionnaire consists of 88 questions. Here are some typical questions.

To detect hyperthymia: Are you enterprising? (Yes).

Can you entertain society, be the soul of the company? (Yes).

To identify the tendency to "get stuck": Do you vigorously defend your interests when injustice is allowed towards you? (Yes).

Do you stand up for people who have been treated injustice? (Yes).

Do you persist in achieving your goal if there are many obstacles along the way? (Yes). To identify pedantry:

• - Do you have doubts about the quality of its execution after the completion of some work and do you resort to checking whether everything was done correctly? (Yes).
• - Does it annoy you if the curtain or tablecloth hangs unevenly, do you try to fix it? (Yes). To identify anxiety:
• - Were you afraid of thunderstorms, dogs in your childhood? (Yes).
• - Do you worry about the need to go down into a dark cellar, to enter an empty, unlit room? (Yes). To detect cyclothymism:
• - Do you have transitions from a cheerful mood to a very dreary one? (Yes)
• - Does it happen to you that, going to bed in an excellent mood, in the morning you get up in a bad mood, which lasts for several hours? (Yes). To identify demonstrativeness:
• - Have you ever sobbed while experiencing a severe nervous shock? (Yes).
• - Willingly you recited poems at school? (Yes).
• - Is it difficult for you to perform on stage or from the pulpit in front of a large audience? (No). To detect excitability:
• - Do you get angry easily? (Yes).
• - Can you, angry with someone, use your hands? (Yes).
• - Do you do sudden, impulsive acts under the influence of alcohol? (Yes).

To identify dysthymia:

• - Are you capable of being playfully cheerful? (No).
• - Do you like to be in society? (No). To identify exaltation:
• - Do you have states when you are full of happiness? (Yes).
• - Can you fall into despair under the influence of disappointment? (yes).

Answers to questions are entered into the registration sheet, and then, using specially prepared keys, an indicator is calculated for each type of personal accentuation. The use of appropriate coefficients makes these indicators comparable. The maximum score for each type of accentuation is 24 points. A sign of accentuation is an indicator that exceeds 12 points. The results can be expressed graphically as a personality accentuation profile. You can also calculate the average accentuation index, equal to the quotient of dividing the sum of all indicators for individual types of accentuation by 10. Shmishek's technique was also adapted for the study of children and adolescents, taking into account their age characteristics and interests (I. V. Kruk, 1975).

One of the variants of the Shmishek questionnaire is the Litman-Shmishek questionnaire (E. Littmann, K. G. Schmieschek, 1982). It includes 9 scales from the Shmishek questionnaire (exaltation scale is excluded) with the addition of scales of extra-introversion and sincerity (lie) according to H. J. Eysenck. This questionnaire was adapted and standardized by us (V. M. Bleikher, N. B. Feldman, 1985). The questionnaire consists of 114 questions. The responses are evaluated using special coefficients. The results on individual scales from 1 to 6 points are considered as the norm, 7 points - as a tendency to accentuation, 8-9 points - as a manifestation of a clear personal accentuation.

To determine the reliability of the results, their reliability in a statistically significant group of patients, the examination was carried out according to a questionnaire and with the help of standards - maps containing a list of the main features of types of accentuation. The selection of standards was made by people close to the patient. In this case, a match was found in 95% of cases. This result indicates sufficient accuracy of the questionnaire.

The total number of accentuated personalities among healthy subjects was 39%. According to K. Leonhard, accentuation is observed in about half of healthy people.

According to a study of healthy people by the twin method (V. M. Bleikher, N. B. Feldman, 1986), a significant heritability of types of personality accentuation, their significant genetic determinism, was found.

Toronto alexithymic scale. The term "alexithymia" was introduced in 1972 by P. E. Sifneos to refer to certain personal characteristics of patients with psychosomatic disorders - the difficulty of finding suitable words to describe one's own feelings, impoverishment of fantasy, a utilitarian way of thinking, a tendency to use actions in conflict and stressful situations. In a literal translation, the term "alexity-mia" means: "there are no words for feelings." In the future, this term took a strong position in the specialized literature, and the concept of alexithymia became widespread and creatively developed.

J. Ruesch (1948), P. Marty and de M. M "uzan (1963) found that patients suffering from classic psychosomatic diseases often show difficulties in verbal and symbolic expression of emotions. Currently, alexithymia is determined by the following cognitive-affective psychological features: 1) difficulty in defining (identifying) and describing one's own feelings; 2) difficulty in distinguishing between feelings and bodily sensations; 3) a decrease in the ability to symbolize (poverty of fantasy and other manifestations of the imagination); 4) focus (it is more on external events than on inner experiences.

"As clinical experience shows, in the majority of patients with psychosomatic disorders, alexithymia-11Nicheskie manifestations are irreversible, despite long-term and intensive psychotherapy. In addition to patients with psychosomatic disorders, alexithymia can also occur in healthy people. enough numerous methods for measuring alexithymia in the Russian-speaking contingent, only one is adapted - the Toronto alexithymic scale of the Central Psychoneurological Institute named after V. M. Bekhterev, "1994). It was created by G. J. Tayior et al. in 1985 using a concept-driven, factor-based approach. In its modern form, the scale consists of 26 statements, with the help of which the subject can characterize himself, using five gradations of answers: “completely disagree”, “rather disagree”, “neither, nor 1zfugoe”, “rather agree”, “ totally agree." Examples of scale statements: 1. When I cry, I always know 1 why. 8. I find it difficult to find the right words for my feelings. 18. I rarely dream. 21. It is very important to be able to understand emotions.

In the course of the study, the subject is asked to choose for each of the statements the most appropriate answer for i of the proposed answers; in this case, the numerical designation of the answer is the number of points scored by the subject according to this statement in the case of the so-called 1-1st positive points of the scale. The scale also contains 10 negative points, in order to obtain a final score in points for which it is necessary to put down the opposite score for these points, rated in a negative way: for example, score 1 gets 5 points, 2-4, 3-3, 4-2, 5- -one. The total sum of positive and negative points is calculated.

According to the staff of the Psychoneurological Institute. V. M. Bekhtereva (D. B. Eresko, G. L. Isurina, E. V. Kaidanovskaya, B. D. Karvassarsky et al., 1994), who adapted the methodology in Russian, healthy individuals have indicators according to this method 59 ,3 + 1.3 points. Patients with psychosomatic diseases (patients with hypertension, bronchial asthma, peptic ulcer) had an average score of 72.09 + 0.82, and no significant differences were found within this group. Patients with neurosis (neurasthenia, hysteria, obsessive-phobic neurosis) had an indicator on a scale of 70.1 + 1.3, not significantly different from the group of patients with psychosomatic diseases. Thus, using the Toronto alexithymic scale, one can only diagnose a “combined” group of neuroses and psychosomatic diseases; its differentiation requires further targeted clinical and psychological research.

Methodology "Type of behavioral activity" (TBA). Proposed in 1979 by K. D. Jenkins et al. (Jenkins C. D. et al.). In the USSR, it was adapted by A. A. Goshtautas (1982) in the Department of Medical Psychology of the Kaunas Research Institute of Cardiology.

The theoretical basis of the methodology is the concept of behavioral type A (Friedman M., Rosenman R. H., 1959), which is characteristic of individuals with an increased tendency to coronary atherosclerosis: chronic and excessive struggle to obtain an unlimited number of results, extreme competitiveness and aggressiveness, chronic anxiety . In individuals with such behavioral characteristics, biochemical changes that contribute to the development of coronary artery disease were significantly more often observed.

The methodology consists of 61 statements relating to various aspects of everyday human behavior, for example:

• 1. Do you find it difficult to choose the time to go to the hairdresser?
• 2. Do you have a job that “cheers up” (encourages, excites)?
• 3. How often do your family and friends notice that you are inattentive if you are told something in too much detail?
• 4. Do you sometimes rush to your destination even though there is still enough time?
• 36. Do you determine the deadlines for completing work at work and at home? etc.

Each statement provides from 2 to 5 answers, one of which is offered to the subject to choose.

When processing the results of the study by key, the total number of points scored by the subjects is calculated.

Evaluation of the results of the study: up to 167 points and a pronounced type of behavioral activity A is diagnosed with a high probability,

• 168-335 points - a certain tendency to type A behavioral activity is diagnosed,
• 336-459 points - an intermediate transitional) type of personal activity AB is diagnosed,
• 460-626 points - a certain tendency to behavioral activity of type B is diagnosed, - 627 points and above - a pronounced behavioral type of personal activity B is diagnosed with a high probability (type B is opposite to type A and is characterized by excessive slowness, balance and rationality in work and other areas activity, reliability and predictability in behavior, over-commitment, etc.).

In the laboratory of clinical psychology of the Psychoneurological Institute. V. M. Bekhtereva (St. Petersburg) developed a computer version of the TPA questionnaire.

The TPA questionnaire is widely used in studies on cardiology, psychosomatics, to identify individuals with behavioral type A (indirectly - risk groups for the development of coronary artery disease), primary and secondary prevention of coronary artery disease.

S. D. Polozhentsev and D. A. Rudnev (1990) showed the possibility of psychological correction of the behavioral activity of patients with IHD with a change in the type of behavior A to B, which can significantly improve the prognosis and outcomes of IHD.

The pathocharacterological diagnostic questionnaire (PDO) was developed by N. Ya. Ivanov and A. E. Lichko (1976, 1981) and is intended to study characterological deviations in adolescents with psychopathy and character accentuations.

Unlike K. Leonhard, A.E. Lichko (1977) considers accentuation not in personal terms, but correlates it with character, since personality is a broader concept that includes, in addition to character and temperament, intelligence, abilities, worldview and etc. The author considers character as the basis of personality. In addition, according to A.E. Lichko, the fact that the character is formed mainly in adolescence, the personality as a whole - already when growing up is of significant importance. According to quantitative indicators (severity, duration and frequency of decompensations and phases, psychogenic reactions, the correspondence of these reactions to the strength and characteristics of pathogenic factors, the severity of extreme forms of behavioral disorders, the assessment of social disadaptation, the depth of self-esteem disorders), various degrees of severity of psychopathy and character accentuation are distinguished: severe , pronounced and moderate psychopathy, overt and covert accentuation.

A. E. Lichko draws attention to the fact that in the classification of K. Leonhard there are no unstable and conformal types that are quite common in adolescence, as well as an asthenoneurotic type. At the same time, according to his observations, dysthymic and stuck types (respectively, constitutionally depressive and paranoid according to P. B. Gannushkin, 1933) practically do not occur in adolescence.

PDO is intended to determine in adolescence (14-18 years) character types in constitutional and organic psychopathy, psychopathic developments and character accentuations.

In accordance with the concept of the psychology of relations by A. F. Lazursky (1912) and V. N. Myasishchev (1949, 1953, 1960), the questionnaire includes the main problems of relevance to adolescents: well-being, mood, sleep and dreams, awakening, appetite and attitude to clothes, money, to parents and friends, to people around and strangers, to loneliness, future, new, failures, adventures and risks, leadership, criticism and objections, guardianship and instructions, rules and laws, self-assessment in childhood , attitude to school, self-assessment at the moment.

Each problem in the PDO corresponds to from 10 to 20 sentences, from which, at the first stage of the study, the teenager must choose one or more (up to 3) statements. He is also allowed to refuse selection on several issues. At the second stage of the study, the teenager is asked to choose the most inappropriate, rejected answers. This freedom of choice is seen as preferable to the yes and no alternative responses commonly used in most personality questionnaires. Each statement gives from 1 to 3 points for the corresponding type of accentuation. The rating system allows you to find out how the subject himself sees his character (subjective rating scale) and what type of accentuation he actually belongs to (objective rating scale). In addition, the type of accentuation is considered indeterminate if a specially developed indicator (minimum diagnostic number) is not reached on the scale of objective assessment for any of the types.

In the new version of PDO (1981), decoding on a scale of subjective assessment is usually not carried out, except in cases where the researcher specifically sets himself the goal of characterizing how the adolescent sees himself or would like to see himself. Basically, the processing of the results begins with decoding on a scale of objective assessment. For this purpose, a graph is constructed in which the scores obtained at both stages of the study are plotted vertically, respectively, for each type of accentuation. The graph is evaluated in the following order: the degree of conformity, the indicator of negative attitude to the examination, the possible tendency to dissimulation, the degree of frankness, the possibility of the organic nature of psychopathy or accentuation, the reflection in self-assessment of the tendency to emancipation reaction, the psychological tendency to delinquent behavior and alcoholism are determined.

In practice, pathopsychologists often extend the age range for the use of PDO from 10 to 25 years. In childhood, the possibilities of using PDO are limited, especially for examining preschool children. In these cases, the type of accentuation is determined mainly by interviewing the child and his parents. In mass studies, a method was proposed for determining the type of character accentuation using standards (I. V. Kruk, 1983). The standards are cards containing descriptions of the types of accentuation, compiled taking into account the interests and behavioral characteristics of preschool children. Standard cards are presented for review to parents and, at their choice, the type of accentuation of the child's character is determined.

The Minnesota Multidisciplinary Personality Questionnaire (MMP1) was developed by S. R. Hathaway and J. Mckinley (1943) and is based on an analysis of the personality traits of the mentally ill. It consists of 550 statements (in the main version) relating to the general well-being of the subject, the functioning of certain systems of internal organs, his relationships with others, the presence of psychopathological symptoms, the characteristics of his self-esteem, etc.

For each statement, the subject chooses one of three answer options: “true”, “false”, “I can’t say”. The questionnaire is used for both individual and group research. American researchers recommend using a questionnaire to examine people aged 16 to 55 with an IQ (according to Wexler) of at least 80.

The answers to the statements contained in the questionnaire are distributed according to 3 evaluation and 10 main (clinical) scales. In addition to the main ones, there are many additional scales (alcoholism, maturity, anxiety, control, dissimulation, emotional immaturity, hostility control, leadership, etc.) based on the same 550 statements. 16 repeated statements were added to the questionnaire - a retesting scale, indicating the absence of inconsistency in the answers to the same statements. Evaluation scales characterize the attitude of the subject to the very fact of the study and, to a certain extent, indicate the reliability of the results. These scales significantly distinguish MMP1 from all other questionnaires.

The lie scale (L) indicates the subject's tendency to present himself in the most favorable light in accordance with generally accepted social norms. High scores on this scale are more common in primitive individuals.

Statement examples:

• - I do not always tell the truth (a negative answer is taken into account).
• - Sometimes I put off until tomorrow what I have to do today (no answer).

The validity scale (F) when high indicators are detected indicates the unreliability of the results obtained. Such an increase can be observed in clearly psychotic states, when the subject does not understand the statements contained in the questionnaire, as well as when the results are deliberately distorted.

Statement examples:

• - It would be better if all laws were canceled (yes).
• - Sometimes I feel like I have to hurt myself or someone else (yes).

The correction scale (K) serves to identify the tendency of the subject to hide or downplay his psychopathological phenomena, or, conversely, reveals his excessive frankness.

Statement examples:

• - I don't care what others say about me (no).
• - I am against giving alms (no).

The scale registers the number of statements that the subject could not answer. The indicators on these scales are evaluated not only individually, but also in aggregate and in relation to the indicators of clinical scales. With indicators on rating scales over 70 T-points, the personality profile is considered doubtful, and over 80 - unreliable. However, even with high scores on these scales, the personality profile can be analyzed by an experienced psychologist with constant comparison of the results with the clinic. A high positive F-K index indicates a tendency for the subjects to exaggerate their disease state, aggravation, simulation. A high negative F-K indicator is a sign of dissimulation, the desire of the subject to demonstrate compliance with social norms of behavior. However, these indicators should also be constantly correlated with clinical factors, with observational data. For example, in forensic practice, we often observe a high positive F-K index, although the psychologist does not see the phenomena of aggravation or simulation either in the behavior or in the performance of tasks by the subject according to methods aimed at studying cognitive processes. Obviously, in these cases we are talking about a kind of psychological defense mechanism, which can be designated as pre-simulation. Whether or not the simulation develops in the future depends on how the situation develops.

The evaluation of the obtained results is carried out according to the following main scales.

1 - the scale of hypochondria (overcontrol, somatization of anxiety) measures the degree of fixation of the subject on his somatic functions. A high score on this scale indicates the frequency and uncertainty of somatic complaints, the desire to arouse sympathy from others.

Statement examples:

• - Several times a week I have heartburn (yes).
• - I often feel like my head is wrapped in a hoop (yes).

The scale of depression (anxiety and depressive tendencies) indicates the predominance of depressive mood, pessimism, and dissatisfaction.

Statement examples:

• - The work is given to me at the cost of considerable stress (yes).
• - I have intermittent and restless sleep (yes).
• - At times I am sure of my own uselessness (yes).

III - scale of hysteria (emotional lability, repression of anxiety-causing factors). High rates for it are typical for hysteroid personalities prone to psychological defense mechanisms of the type of displacement.

Statement examples:

• - I like to read about crimes and mysterious adventures (no).
• - I never fainted (no).

In the scale of hysteria, two subscales are distinguished (D. N. Wienez, 1948) - clear, obvious and "subtle" manifestations.

• - I often feel a “lump” in my throat (yes).
• - I suffer from nausea and vomiting (yes). Examples of statements on the second subscale (they refer to a personal assessment of social situations or to the peculiarities of the subject's perception of his environment and himself):
• - It's safer not to trust anyone (no)
• - I think that many people exaggerate their misfortunes in order to get help and sympathy from others (no).

"Subtle" manifestations of hysteria show that the subject strengthens, exaggerates ideas about the socially positive traits of his personality. This is considered characteristic of patients with hysteria, ignoring the complex psychological problems that arise in front of them, forcing them out, and is considered not as a conscious tendency, but as unconscious attitudes of the personality due to its social and mental immaturity (W. Sanocki, 1978).

IV - scale of psychopathy (impulsivity, the realization of emotional tension in direct behavior).

Statement examples:

• - At times I really wanted to leave the house (yes).
• - At school, I was called to the director for absenteeism (yes).

V - scale of masculinity - femininity (severity of male and female character traits).

Statement examples:

• - I love poetry.
• - I think I would like the work of a forester.
• - I really like hunting.

VI - scale of paranoia (rigidity, rigidity of affect). High rates are typical for people with a gradual accumulation and stagnation of affect, rancor, stubbornness, slow mood swings, stiffness of thought processes, and increased suspicion.

Statement examples:

If people didn't intrigue against me, I would

much more (yes).

It's not always easy to fix a broken mood with something interesting (yes).

In the scale of paranoia, there are (D. N. Wiener, L. A. Nag-mon, 1946) subscales of obvious and “subtle” manifestations.

Examples of statements on the first subscale:

• - At times I am in the grip of some evil force (yes).
• - I think I'm being followed (yes). Examples of "subtle" manifestations:
• - At times, such thoughts come into my head that about them

It's better not to tell anyone (yeah)

Most people are honest only because they are afraid of punishment (no).

VII - scale of psychasthenia (anxiety, fixation of anxiety and restrictive behavior). Reflects inclination

to reactions of anxiety and fear, sensitivity, self-doubt.

Statement examples:

• - I'm worried about the fear of going crazy (yes).
• - In my school years, it was difficult for me to speak in front of the whole class (yes).

VIII - scale of schizophrenia (individual alisticity, autism). It is aimed at identifying schizoid personality traits, isolation from the environment, autism. Also includes statements related to productive psychopathological symptoms (delusions, hallucinations).

Statement examples:

• - When there is no one around, I hear strange things (yes).
• - Surrounding me often seems unreal (yes).
• - Most of the time I feel alone, even when I'm around people (yes).

IX - hypomania scale (optimism and activity, denial of anxiety).

Statement examples:

• - I am a significant person (yes).
• - Sometimes my thoughts flow faster than I have time to express them (yes).

O - scale of social introversion (introversion - extraversion, social contacts). It is aimed at establishing the degree of extroversion - introversion in thinking, emotional sphere and social life.

Statement examples:

• - I am a sociable person (no).
• - If they make fun of me, I take it lightly (no).
• - Criticism and remarks terribly offend and hurt me (yes).

Recently, some authors quite correctly point out that the former names of clinical scales, derived on the basis of a survey of the corresponding contingents of mentally ill patients, do not correspond well to the results obtained in the examination of mentally healthy people or those suffering from borderline neuropsychiatric disorders (F. B. Berezin, M. P. Miroshnikov, R. V. Rozhanets, 1976; L. N. Sobchik, 1978). In this regard, new, psychological designations of the main scales are proposed. With this in mind, we have given both psychiatric and psychological designations above.

After processing the results obtained for all assessment and main scales and transferring these indicators from “raw” scores to standardized T-scores, a profile is drawn that outlines the structure of personality traits, the severity of various tendencies or symptoms.

The interpretation of the personality profile in MMP1 is covered in special manuals. We will only point out that when interpreting the results, the presence of individual peaks on the profile, its height, the prevalence of the left (neurotic) or right (psychotic) part of the profile, and combinations of indicators on certain scales are taken into account.

The conditional norm of the personality profile according to MMP1 is within 30-70 T-points (R. Hathaway, P. E. Meehl, 1951). Average data for the normative group corresponds to 50 T-scores. F. B. Berezin and co-authors (1976) consider indicators located between 60 and 70 T-scores as a manifestation of personal accentuation.

A low-lying (“drowned”) personality profile is most often observed when the subject tries to present himself in a favorable light, during dissimulation. It often corresponds to high scores on the lie and correction scales. In some patients, a profile can be observed that is a variant of the norm, although the clinic does not raise doubts about obvious mental disorders. Such a "false-negative" profile is typical for patients with schizophrenia in the stage of a pronounced mental defect and indicates a pronounced emotional flattening.

Great importance is attached to the slope of the profile. A positive slope, i.e., the presence of higher scores on the psychotic tetrad scales (4th, 6th, 8th and 9th), is a sign of a psychotic state and indicates a violation of contacts with reality, disorientation, confusion. A negative slope, i.e., the predominance of high scores on the scales of the neurotic triad (1st, 2nd, and 3rd), in the presence of a general high rise in the entire profile, is a sign of an acute affective disorder.

Like all other personality questionnaires, MMP1 does not provide a nosological and diagnostic assessment. The personality profile obtained in the study using this technique characterizes only the characteristics of the personality at the time of the study. Therefore, it cannot be evaluated as a "diagnostic label" (FB Berezin et al., 1976). However, the characteristic of the patient's personal properties obtained in such a study significantly complements the picture of the pathopsychological register syndrome. So, a code characterized by an increase in indicators on scales 6 and 8 (paranoid thinking) was observed by us not only in paranoid schizophrenia, but also in other delusional psychoses, in particular, in temporal lobe epilepsy, which occurs with chronic delusional (schizoform) syndrome. .

The data obtained using MMP1 should be constantly correlated with clinical symptoms, materials of observation of a pathopsychologist regarding the characteristics of the performance of tasks by the subject according to methods aimed at studying cognitive activity, with the results of the study using other personal methods.

The MMP1 questionnaire is used by psychologists in all countries of the world with its mandatory adaptation and standardization in accordance with the socio-cultural characteristics of the population. In Russian, several variants of the questionnaire for a multilateral study of personality have also been developed. Of these, the main ones are: adaptation and modification of the MMP1 questionnaire by the laboratory of medical psychology of the Leningrad Research Psychoneurological Institute named after I.I. V. M. Bekhtereva (1974), variant F. B. BerezinaiM. P. Miroshnikova (1969, 1976), development of MMP1 by L.N. Sobchik (1971), later called the Standardized Personality Research Method (SMIL).

Sometimes only one of the scales of the MMP1 questionnaire is used for the study. This allows you to shorten the study and, as it were, purposefully direct it (to the detriment of the general assessment of the personality of the subject). An example is the use of the so-called personality anxiety scale (J. Teylor, 1953).

Taylor's questionnaire consists of 50 statements. For ease of use, each statement is offered to the subject on a separate card. According to the instructions, the subject puts cards to the right and left, depending on whether he agrees or disagrees with the statements contained in them. These statements are included in MMP1 as an additional scale. Poll-Nick Taylor adapted by T. A. Nemchin (1966).

Here are examples of typical questions from the anxiety scale (in parentheses is the answer taken into account when determining the indicator of anxiety):

• - During work, I have to strain a lot (yes).
• - It's hard for me to focus on anything (yes).
• - Potential trouble always makes me anxious-IY (yes).

~ - I often feel embarrassed, and I don't like it when others notice it (yes).

• - Heartbeat doesn't bother me (no).
• - My sleep is intermittent and restless (yes).
• - Often I have bouts of fear (yes).
• - Usually I am calm and it is not easy to upset me (no).
• - Waiting always makes me nervous (yes).
• - The state of my health worries me (yes).
• - I'm always afraid of meeting difficulties (yes).

Evaluation of the results of the study according to the Taylor questionnaire is made by counting the number of responses of the subject, indicating anxiety. Each such answer is worth 1 point. A total score of 40-50 points is considered as an indicator of a very high level of anxiety, 25-40 points indicate a high level of anxiety, 15-25 points - about the average (with a tendency to high) level, 5-15 points - about the average (with a tendency to low) level and 0-5 points - about a low level of anxiety.

With the help of factor analysis in the Taylor scale, 4 factors were identified: factor A - chronic fear associated with anxiety, sensitivity, self-doubt; factor B - lability of the autonomic nervous system in threatening situations; factor C - sleep disorders associated with general internal stress; factor D - a sense of inferiority.

The isolated use of one of the scales of the MMP1 questionnaire can lead to insufficiently reliable results, an adequate assessment of which by the researcher is impossible due to the lack of rating scales. Any mono-thematically directed questionnaire, as it were, induces the subject and helps to identify his conscious or unconscious tendencies and attitudes. In this regard, it is not enough to supplement the questionnaire to determine the level of anxiety with a lie scale, as suggested by V. G. No-rakidze (1975), especially since the latter does not always allow one to judge demonstrativeness, insincerity in answers, high rates for it often testify more about personal primitiveness.

Questionnaires for screening neuroses. This group of methods includes questionnaires designed to identify and tentative syndromic definition of neuroses. These quite numerous questionnaires serve for the preliminary, pre-medical, diagnosis of neuroses. When compiling and testing them, such criteria as efficiency, simplicity, budget in differentiating healthy and sick people, corresponding correlations with other tests intended for such studies are taken into account. Usually these questionnaires are also used for epidemiological studies.

We give as an example the characteristics of the three most typical questionnaires for screening neuroses.

Questionnaire Heck - Hess (K. Hock, H. Hess, 1975), or scale of complaints (BFB). It is standardized for patients aged 16 to 60 years.

When creating it, the authors proceeded from the fact that the complaints of patients with neurosis are of a specific nature and, in contrast to patients with organic somatic pathology, indications of vegetative disorders and mental complaints predominate in them.

The subject is given a sheet with a list of bodily (visual impairments, double vision, asthma attacks, tachycardia, heart palpitations, hand tremors, etc.) and mental (speech disorders, stuttering, contact difficulties, lethargy, fear of being alone, etc.). n.) complaints. In total, 63 symptoms of neuroses appear in the complaints. Responses are interpreted in quantitative terms, taking into account gender, and for women, age. There are 3 types of total assessments: norm, presumptive diagnosis of neurosis, neurosis.

According to the indicators, an index of emotionality is also calculated, reflecting a pronounced vegetative irritation characteristic of psychosomatic diseases, or the predominance of purely psychoneurotic disorders. The authors attach importance to this indicator in the choice of psychotherapy methods. The analysis of complaints characteristic of the subject is made taking into account the following factors: excessive autonomic excitability (sympathicotonia), apathy, phobias, vagotonia, asthenia, hypersensitivity, sensorimotor disturbances, schizoid reactions, fears.

The questionnaire is extremely simple, the duration of the study with its help is 5-10 minutes, the "raw" scores are calculated using the key, then the "raw" scores are converted using a special scale into standard ones.

The neurotic-depressive questionnaire of T. Tashev (1968) was developed for screening diagnostics of neuroses in mass studies and for the purpose of preliminary, pre-medical, diagnostics. It consists of 77 questions, the answers to which characterize the patient's condition in accordance with the following scales: general neurotic, depression, autonomic disorders, hysteria, obsessive-phobic symptoms. The answer to the question is worth 1 point. A total score of up to 9 points corresponds to the norm, from 9 to 18 points - neurotic tendencies and over 20 points - severe neurosis. The ratio of indicators on different scales is estimated. Thus, high scores on the scales of general neurotic and vegetative disorders indicate neurasthenia or an asthenic condition of another origin. In the presence of elevated indicators on many scales, the syndromic design of the disease state is judged on a scale with a predominant indicator. In the presence of high rates on two scales, we are talking about the complex nature of the neurotic syndrome.

The evaluation is performed using a special key. Distinguish negative, doubtful and positive results (on all, on one or several scales). According to the total assessment, three possible categories are distinguished: the norm, mildly pronounced neurotic or neurosis-like tendencies, pronounced neuroses or neurosis-like states.

Persons who give a negative result during the study fall out of the contingent subject to further observation and research. Those who give a positive result are sent for further examination to a doctor. With a doubtful result, the question of the need for further research is decided individually. The test, according to the author, has a high diagnostic capability. Thus, neurosis with the help of this test was diagnosed in 88.2% of cases. The results obtained using the A. Kokoshkarova questionnaire correlate to a high degree with the data obtained using the Heck-Hess questionnaire. The author herself notes the dependence of the results of the study on the position of the subject and points out that with a negative attitude towards the study or fear of disclosing the results, unreliable data are obtained.

According to A. Kokoshkarova (1983), screening polls essentially reveal the factor of neuroticism and give a syndromic description of the disease state. They are uninformative and practically unsuitable for the purposes of nosological diagnostics, for example, for distinguishing between a neurosis and a neurosis-like state.

Spiel-Werther's reactive and personal anxiety scale (C. D. Spielberger, 1970, 1972) distinguishes between the concept of anxiety as a state and anxiety as a trait, a property of Dyancy. Anxiety is characterized by different intensity, variability in time, the presence of conscious unpleasant experiences of tension, concern, anxiety, fear, pronounced activation of the autonomic nervous system. Anxiety arises as a person's reaction to various stresses, more often of a psychogenic, socio-psychological nature.

The author considers personal anxiety as the properties of an individual, it is a constitutional feature, it refers to a predisposition. Personal anxiety is a relatively constant property of a person to see a threat to their well-being in a variety of situations. Personal anxiety is a pre-disposition that facilitates the occurrence of anxiety reactions. The Taylor Anxiety Scale is essentially aimed at measuring personal anxiety rather than states of reactive anxiety.

The Spielberger scale takes into account the differentiation of factors of personal anxiety and reactive anxiety. It is a questionnaire consisting of two subscales. The subscale of personal anxiety includes 20 statements that the subject must evaluate on a 4-point system: “almost never”, “sometimes”, “often”, “almost always”. Examples of statements on this subscale: I worry too much about trifles; I try to avoid critical situations and difficulties.

The reactive anxiety subscale also consists of 20 items. Of these, 10 state, and 10 deny the existence of anxiety. Evaluation of statements: “no, this is not at all true”, “perhaps so”, “true”, “absolutely true”. Examples of statements on the subscale of reactive anxiety: I do not find a place for myself; nothing threatens me.

The Spielberger scale is extremely simple, it belongs to express methods, and its application requires very little time. In the USSR, the Spielberger scale was modified, adapted and standardized by Yu. L. Khanin (1976, 1978). He also received indicative standards: a low level of anxiety - 20-34 points, an average level - 35-44 points, a high level - 46 points and above. The total scores are obtained by counting the results using a key that takes into account the inverted statements. The technique may be of interest for examining patients with depressive and anxiety-depressive conditions of various origins.

Beckmann-Richter method. Developed by D. Beckmann and H. E. Richter (1972) for the study of personality and the analysis of social relations, especially relations in small groups. The test gives an idea of ​​how the subjects see themselves, how they would like to see themselves, how they see others, how others see them, what, in their opinion, should be the ideal representative of a particular group.

The test is standardized on persons aged 18-60 years and includes 3 variants of the same 40 bipolar statements ("I", "He", "She"). The questionnaire has 6 main scales and 2 trend scales.

1. Scale of social resonance (from negative to positive). The negative pole is characterized by unattractiveness, little interest in one's appearance, disrespect for others, their dislike. Accordingly, at the positive pole there are attractive faces, able to stand up for themselves, respected and valued by other people. So, in the first scale, the question of the relationship with the environment, a certain aspect of the social role, is studied. Statement example:

I think that for me... 3210123 .. .it is rather easy to win the sympathy of other people rather difficult.

II. Scale of dominance (compliance). On one pole - people who easily enter into disputes, wayward, impatient, prone to dominance, on the other - compliant, rarely enter into disputes, patient.

III. Scale of control (not controlling themselves enough - ordered, with a high level of self-control). The former are characterized by disorder, inconstancy, a tendency to pranks, frivolous acts, inability to manage money. The “over-controlling” are characterized by pronounced orderliness, diligence, truthfulness to the point of fanaticism, inability to pranks and carefree behavior. Statement example:

I find myself 3210123 ...very easy to be difficult to be laid-back. at ease...

IV. Dominant mood scale (hypomanic - depressive). At the extreme poles of this scale are: rarely depressed, little prone to introspection, almost non-self-critical, not hiding irritation, often dejected, prone to excessive introspection, self-critical, not showing irritation. Sample statements: I think that I rarely... 3210123... .reproach myself very often.

V. The scale of openness - isolation. Persons demonstrating high rates on this scale are characterized at one extreme by gullibility, openness to other people, and a need for love; on the other - isolation, distrust, detachment from other people, a tendency to hide their own need for love. Statement example:

It seems to me that I 321012 ...rather closeness to feel rather other people. aloofness...

VI. Scale of social opportunities (socially weak - socially strong). Social weakness, according to the authors, is characterized by lack of sociability, a weak ability to give of oneself, an inability for long-term attachments, and poor imagination. And, conversely, the opposite pole - people who love to be in society, prone to self-giving and long-term attachment, with a rich imagination. Statement example:

It seems to me that according to 3210123 ... rather unsociable, my character is rather closed. sociable...

Two additional scales are based on the count of zeros crossed out by the subject and triples crossed out. In the first case, a high indicator is considered as a manifestation of emotional indifference to the task being performed, in the second, it indicates, for example, an excited state, low self-control. These scales play the role of evaluative ones, they characterize the attitude of the individual to the research situation, in each individual case, an increase in the number of such answers requires careful analysis.

For each statement, the subject notes his personal position. The sum of these "raw" estimates is transferred to the protocol form using a special key. At the top of the protocol form, the standard units corresponding to the “raw” estimates are indicated. In group studies, when there is no need to draw individual profiles, the conversion of estimates into standard ones is carried out using a table.

The authors subjected the results of the study to psychoanalytic interpretation, but they point out that such an interpretation of the data is not necessary, the diagnostic profile itself does not require any conceptual interpretations, it simply represents a chain of relationships between individual signs confirmed by mathematical analysis.

When the test is repeated in the course of psychotherapy, one can be convinced of a change in the relationship between the doctor and the patient. So, with the success of the treatment, the patient's self-esteem will increasingly approach the evaluation of his doctor and, conversely, will increasingly differ if the therapy does not bring relief to the patient. The doctor's assessment of patients contains expectations and attitudes determined by social and socio-psychological factors. In the course of treatment, this assessment may also change.

This possibility of using the Beckmann-Richter test was convincingly shown by H. Goza Leon (1982), who conducted a study of the relationship between a doctor and a patient in the clinic of some psychosomatic diseases. He examined patients suffering, according to M. Bleuler, from true psychosomatosis - peptic ulcer of the stomach and duodenum, coronary heart disease, bronchial asthma. As the main research methods, the author used the Beckman-Richter test and the method of evaluative construction previously used by V. A. Tashlykov (1974), in which a personality characteristic is recreated by evaluating it according to a standard set of personal properties. Research by X. Goza Leon showed a high degree of correlation between these techniques. The analysis of the data obtained allowed the author to identify two images of the attending physician - empathic and emotionally neutral. Of these, the first is an ideal image of the attending physician, and the second is undesirable. Accordingly, the main types of emotional contact between the doctor and the patient and the forms of role behavior of the doctor (leadership, partnership, leadership - partnership) were identified. The author showed that the system of relationships between the doctor and the patient in the course of treatment is not stable, it is an extremely mobile process, reflecting the role of many factors and of great importance for the effectiveness of treatment, especially psychotherapy. Similar data were obtained by V. A. Tashlykov (1974, 1978), who studied the relationship between a psychotherapist and neurotic patients.

The importance of such studies lies in the fact that knowledge of the patient's attitudes towards the attending physician, his illness and its treatment allows the doctor to manage the process of establishing optimal emotional contact, develop and implement rehabilitation measures.

Rorschach method. The stimulus material of the Rorschach method (H. Rorschach, 1921) consists of 10 tables with polychrome and one-color symmetrical images, "spots". Each image is shown to the subject sequentially, while he is asked to answer the questions: “What can it be? What does it look like?" During the study, the subject does not receive any additional information. All questions of interest to the experimenter can be asked only after the end of the study.

The received answers-interpretations are recorded verbatim. Formalization of interpretations is carried out according to the following five counting categories.

• 1. Localization feature of interpretation. This registers whether the submitted response was holistic, i.e. covering the entire image (W), or related to some detail (D, Dd).
• 2. Determinants, or characteristics of the "quality" of the answer. When creating an image, the subject can give preference to the shape of the image (F) or highlight the color, which can be in various combinations with the shape (FC, CF, C), semitones (c, c), see movement in the created image (M).
• 3. Form sign. The shape is evaluated with a positive (+) or negative sign (-), which shows how adequately the shape of the spot, its contours are reflected in the created image. As a criterion, healthy interpretations of the corresponding images and their details are used.
• 4. Accounting for the content of the interpretation, which can be very diverse. For example, the image is interpreted as a person (H), an animal (A), fire (Fi), etc.
• 5. Additional factors. First of all, the originality (Og) or popularity (P) of the interpretation can be noted here, and then those factors that do not have a specially developed system of notation, representing important qualitative characteristics of the answer (for example, perseverations, description instead of interpretation, etc. .).

The indicator of originality of answers differs depending on the clarity of the form. When answering in form and color and purely color, the indicator of originality is indicated by the sign (-) and indicates not the originality of thinking or fantasy, but the pathological disorganization of thinking. Accounting for additional factors makes it possible to obtain valuable data, especially when examining mental patients.

Thus, each interpretation of the subject receives a certain formalized form, for example: Table. II - "two people shaking hands." The answer takes the form: WM + H, i.e. the image is interpreted as a whole (W), the subject sees human beings in motion (M), the sign of the form is positive, since most of the subjects see here two people, according to the content - a person (H).

In numerous studies, a certain psychological characteristic of the indicators of the Rorschach method has been developed. Consider the psychological significance of some indicators.

First of all, about what represents the different approach of the subject to the interpretation of images (the choice of the whole or the details). A significant number of holistic interpretations with a positive sign indicates the richness of the imagination, the ability to synthesize, the criticality of the mind. If holistic interpretations appear with a negative sign of the form, this is considered as a violation in the synthesis, a lack of criticality.

The choice of an image detail for constructing an image is the most frequent and indicates (in the presence of a positive form) a specific intellectual activity of the subject. Small fractional details (Dd) with a negative form appear mainly in the mentally ill, they are uncharacteristic for healthy people.

As already mentioned, the determinants are the most important categories of calculation, the basic information about the individual, according to H. Rorschach, can only be obtained by carefully studying the "quality" of the answers.

Most often in research protocols, according to H. Rorschach, the form determinant appears. The perceptual activity of the subject in the process of finding "similarity" is associated with the involvement of data from past experience. It is also necessary to have a critical approach to the actualized images, the choice of the most appropriate form of the image. In this regard, the percentage of positive forms acts as a kind of indicator of "clearness of perception", which is considered as reflecting some of the intellectual characteristics of the individual.

Kinesthetic interpretations (M), according to the literature, characterize the degree of internal activity, creative imagination, testify to the deepest and most individual tendencies of the personality.

One can fully agree with this, because here, in addition to establishing similarity, removing uncertainty, which in itself requires a certain level of activity, a qualitatively new element appears - internal activity, not caused by external factors, since the image does not contain movement as such.

Interpretations that take into account the color of the image relate to the evaluation of the emotional sphere, with the degree of participation of the form indicating various types of control on the part of the intellect.

Less often, answers appear in the protocols taking into account different shades and density of gray (s, s). This type of answers includes the definition of surfaces (rough, smooth, etc.), accounting for light and shade (X-rays, smoke, etc.). The interpretation of these indicators is perhaps the least developed.In general, we can say that these responses are considered as indicating anxiety, anxiety.

When evaluating the content of the interpretation (N, A, etc.), perseverative tendencies, preferred themes, and a number of other personality traits can be revealed.

The diagnostic value of individual indicators of the method, despite their importance, is small. The currently existing diagnostic schemes provide for the accounting and analysis of a holistic picture, all indicators are studied in conjunction. Thus, the need for a comprehensive review of a number of indicators (WF + M and Og) was shown to assess the intellectual capabilities of the subject (V. A. Wysocki, 1957).

The determining factor in diagnostics, according to H. Rorschach, is the establishment of the type of personality experience. Here we must touch on the ideas of H. Rorschach about the structure of personality. As already noted (V. N. Myasishev, I. G. Bespalko, I. N. Gilyasheva, B. D. Karvassarsky, T. A. Nemchin, 1969), the general psychological assumptions put forward by H. Rorschach are so few and simple that do not contradict one or another theory of personality. H. Rorschach proceeded from the position that human activity is determined by both internal and external motives. In connection with such an understanding of the activity in which the personality is expressed, the more clearly the less stereotyped (“structured”) the stimuli causing it, the concepts of introversion and extratension were introduced by the author. Each of these concepts corresponds to a set of certain personality traits associated with the predominant type of activity.

In the experiment, sensitivity to internal urges is represented by kinesthetic interpretations, to external - by color ones. According to their ratio (M:S), the “type of experience” is established.

The Rorschach typology represents a qualitatively new stage in the understanding of introversion and extraversion. In contrast to S. Jung with his understanding of introversion as a state, N. Rorschach presents introversion both as a process and as a flexible possibility of withdrawing into oneself, depending on the circumstances and environmental conditions. Only the rigid predominance of introversion tendencies allows us to speak of introversion as a pathological condition, which H. Rorschach repeatedly emphasizes.

Further, H. Rorschach notes that the concept of introversion in the usual sense is opposed to the concept of extraversion, however, according to the author, the use of such terminology creates the inconvenience that a conclusion can be drawn about the real opposite of extraversion and introversion. Due to these circumstances, the concept of "extratension" is introduced.

The ambiequal type of experience, according to H. Rorschach, is characterized by the possibility of detecting an alternation of introversion and extra-intense tendencies in the same person. Periods of focus on their own experiences in such people alternate with periods of turning to activity in the outside world.

The coartive type is characterized by the absence or paucity of both kinesthetic and color responses. H. Rorschach distinguished between coarted (OM n OS) and coartative (IM and 1C, IM and OS, OM and 1C) types of experience, depending on the number of responses in color and kinesthetic, but this division is not of great practical importance, and both of these types of experience are combined into the concept of "coartive type" (L.F. Burlachu k, 1979).

Thus, we must conclude that H. Rorschach's approach to the study of personality is characterized by dynamism. The meaning of typing, according to H. Rorschach, lies not so much in the academic classification of people as in its clinical significance (V. N. Myasishev, I. G. Bespalko, I. N. Gilyasheva, 1969).

Currently, in domestic pathopsychology, there is an increasing use of the Rorschach method to solve some theoretical and practical problems. This involves overcoming a number of difficulties. So, I. G. Bespalko (1978) refers to the weaknesses of the method a relatively large subjectivity in the generalizing interpretation of experimental data. E. T. Sokolova (1980) points to the empiricism of correlating individual indicators with certain personality parameters. She also considers the debatable question of what the Rorschach test reveals - personality structure or private individual characteristics.

The wider use of the Rorschach method in our country should be preceded by a serious study of it in terms of practical use, with mandatory comparison with data obtained using other methods, and the theoretical development of its methodological foundations.

In this regard, we can point to works whose authors reported the results obtained using the Rorschach method in the study of reactive states (N. N. Stanishevskaya, 1970, 1971), epilepsy (V. M. Bleikher, L. F. Burlachuk, 1971 ; L. F. Burlachuk, 1972; I. I. Belaya, 1978; I. I. Belaya, V. A. Torba, 1978), in the pathology of the limbic-reticular complex (A. M. Wein, P. I Vlasova, O. A. Kolosova, 1971).

A significant contribution to the development of the theoretical and practical foundations of the Rorschach method, contributing to its practical application, is the monograph by L. F. Burlachuk (1979) and the methodological manual by I. I. Belaya (1978).

An analysis of the problem gives reason to think that the Rorschach method in pathopsychology will be useful mainly in terms of diagnosing individual personality traits, especially in psychotherapeutic and rehabilitation work. Using it for the purposes of nosological diagnostics seems to us less promising, however, here, too, the data obtained using the Rorschach method in combination with other experimental psychological methods and techniques significantly complement the picture of the pathopsychological syndrome. Thematic Apperception Test (TAT) proposed

The task of the subject is to compose a small coherent story for each of the presented pictures (based on an average of 5 minutes per picture). When conducting research on the TAT, they usually warn that it is a study of the imagination or the features of literary creativity. In reality, the main thing that attention is drawn to in the stories of the subject is who and what he will talk about, what situations he will create, how he will resolve conflicts in the content of the stories, and if they exist, will a certain typical, repeatedly repeated situation come to light in the stories.

In the process of research, depending on the goals, the subject may be asked questions like: “What is this person thinking about now?”, “What is his profession?” etc. In general, as a rule, the task of the subject includes a condition that requires highlighting three main points in the story: what led to the situation depicted in the picture, what is happening at the moment, how will this situation end?

The stories of the subject are recorded verbatim, with fixation of pauses, intonations and other expressive movements. Usually they resort to a transcript or a hidden tape recorder, sometimes the subject himself writes down his story.

Before proceeding with the interpretation of the totality of stories, the experimenter must have all possible information about the subject (marital status, profession, age, etc.). If the subject is mentally ill, a thorough study of the anamnesis and medical history is necessary.

According to one of the authors of this method, the famous American psychologist N. A. Miggeu, the diagnostic value of TAT is based on the recognition of the existence of two distinct tendencies in the human psyche. The first of them is expressed in the desire to interpret every multi-valued situation that a person encounters in accordance with his past.

experience and personal needs. The second tendency of offiowr is that in any literary work the author relies on his own experiences and consciously or unconsciously depicts his own needs, feelings in the personalities and characters of fictional characters.

The theoretical construction of N. A. Mshteu is aimed primarily at a detailed disclosure of the motivational aspect of personality. In this regard, the author singles out (warning that he does not consider this classification perfect and complete) 44 variables corresponding to the hypothetical dominant processes in the psyche. These include 20 explicit needs, 8 hidden needs, 4 needs related to internal states, and finally 12 general traits that can characterize individuals. The selection of these variables and their subsequent interpretation (“aggression”, “exhibitionism”, etc.) was undoubtedly influenced most significantly by psychoanalytic concepts. To characterize individual needs, the author gives in his work a description of persons who have these needs to a high degree.

The analysis of the data obtained with the use of TAT is constructed as follows: the first stage is the selection of a “hero” with whom the subject identifies himself (if this takes place at all). To resolve this issue, the author of the method proposes a number of criteria (gender, status, role, etc.). The first task of the researcher is to consider in detail what the "hero" feels, thinks or does, establishing what is unique in some way. Each manifestation of a variable is evaluated on a 5-point scale.

The next stage is the study of the “pressures” of the medium, the strength of each of them is also subject to a quantitative assessment. Next comes a comparative assessment of the forces emanating from the "hero" and the forces emanating from the environment. Interests and feelings are treated separately in leadership. Of particular importance are the positive and negative assessments of the persons acting in the story.

B. V. Zeigarnik, V. V. Nikolaeva, L. V. Filonov (1972) give the following main categories of analysis of the stories of the subjects.

"Leaving" - evasion of the subject from the task. Either a description is given, sometimes even too detailed, or the plot is built formally, while there is no specific content, or the subject replaces the need for his own construction of the plot with a presentation of ready-made material taken from literary works, films, etc., or the subject gives a branched version of the plot, easily moving from one storyline to another, considering them as equivalent, equally possible. "Leaving" in all the paintings is seen as a manifestation of fear of testing or difficulties in communication. It can also be the result of intellectual insufficiency. “Leaving” in cases of describing individual paintings means either rejection of the depicted situation due to complete ignorance of the features of life collisions of this kind (alien environment), or the special significance of the situation for the subject.

The position of the characters can be active, passive, contemplative or aggressive. All these types reflect the corresponding tendencies of the individual and have their own qualitative characteristics. For example, an effective position is characterized by the prevalence of verbs in the present tense, reflecting the desire to change the existing situation by operating with one's own capabilities, emphasizing a good forecast.

The category of solidarity is considered as a manifestation of understanding of one of the characters, sharing his views, sympathy for him. According to the features of solidarization, the system of interpersonal relations inherent in the patient is judged.

Deviation from the storyline is characterized by a sudden transition from one direction of the story to another. Digressions are reference, indicating resonant tendencies, and memorial, which are indicators of egocentricity. Frequent digressions are characterized by the authors as a manifestation of a "leap of ideas".

Perception errors (but not confabulations) are a manifestation of imbalance between external and internal factors of perception, with the dominance of the latter.

The number of details indicates the behavior of the subject in the experimental situation. For example, a small number of details is a manifestation of the independence of the subject, his independence and some disregard for the environment.

The total time of the story characterizes the sphere of consciousness of the subject, the richness of ideas inherent in it, the ease of associations. A long story about one of the paintings indicates interest, long pauses - about affective reactions.

E. T. Sokolova (1980), analyzing the possibilities of practical use of the method, believes that it finds the greatest application in the clinic of neuroses and other borderline conditions to identify affective conflicts and spontaneously, often unconsciously, the patient's ways of resolving them. At the same time, such features of the affective sphere of the personality, diagnosed using TAT, as determining the leading motives, relationships, values, detecting affective conflicts, psychological defense mechanisms characteristic of the patient, characterizing a number of individual personality traits (impulsiveness - controllability, emotional stability - lability, emotional maturity - infantilism), self-esteem of the subject (correlation between the "I" ideal and real, the degree of self-acceptance).

B. D. Karvassarsky (1982) sees a significant drawback of TAT in the existing level of interpretation technology, which still does not provide sufficient reliability of the conclusion, its complete independence from the researcher. The circumstance emphasized by E. T. Sokolova is extremely important, without taking into account which it is impossible to use TAT in practice: all patterns revealed by this technique are nothing more than potential opportunities, tendencies, attitudes of the individual. Therefore, the direct transfer of TAT data to the characteristics of the personality and behavior of the patient is illegal.

In pathopsychological practice, it seems to us that the possibilities of using TAT are not limited to psychogenic diseases. With the help of the method, we obtain interesting personal characteristics in affective psychosis, alcohol degradation of the personality. The significance of the method for assessing the affective sphere of patients with schizophrenia is shown (N. K. Kiyashchenko, 1965; T. N. Boyarshinova, 1975): Theoretical and practical aspects of the use of TAT in pathopsychology were developed by I. N. Gilyasheva (1967), S. V. Tsuladze (1969).

Verbal projective test (VPT). The technique was proposed in 1991 by V. M. Bleikher and S. N. Bokov. Refers to the methods of the TAT series. Unlike all currently existing projective methods of this group, the stimulus material of the EP is verbal in nature, which makes it possible to avoid one of the stages of stimulus apperception - the internalization of stimulus material into inner speech, and this, in turn, significantly shortens and facilitates the process of perceiving the stimulus. The second feature of the VPT is its great readiness to work with groups of subjects with various mental and emotional disorders. This is due to the fact that the perception of the semantic and emotional meaning of words in many pathopsychological conditions is significantly impaired. This is especially true for schizophrenia. Thus, VPT provides the clinician with great opportunities for the timely diagnosis of disorders of emotionality and thinking, which in turn entails more timely measures for treatment and rehabilitation. Finally, another feature and important advantage of the VPT is its almost timeless nature, since the process of language aging is much slower than the change in the attributes of people's material life. Moreover, even in the case of obsolescence of some lexical units of the stimulus material of the methodology, their replacement will not be associated with such serious difficulties as, most likely, the replacement of TAT stimulus tables may be associated with. True, it is precisely this feature of the VPT that makes it necessary to carry out this technique only in persons who are fluent in the language in which the stimulus cards are drawn up.

The stimulus material of the VPT consists of two series of cards - the main one and for conducting a parallel study.

Each series contains 19 proposals and 1 white card. In addition, each series contains male and female variants that differ from each other in personal pronouns and personal verb endings.

All proposals of the VPT meet the following basic requirements: 1) unstructured, their vagueness in terms of plot, 2) pronounced emotional richness, 3) brevity. The proposals are printed on rectangular cards measuring 18 x 3 cm. On the reverse side of each card is its serial number in the set. Each card number corresponds to a specific, theoretically substantiated theme, reflecting one or another aspect of the functioning of the individual. These topics are as follows: 1) attitude to duty, 2) depressive, suicidal tendencies, 3) family relationships, 4) attitude to success, luck, 5) attitude to mother, 6) attitude to the loss of an object of love, 7) aggressive tendencies, 8 ) attitude to authorities, higher persons, 9) experience of joy, pleasure, 10) attitude to the future, II) relationships between men (women), 12) relationships between mother and son (daughter), 13) fears, anxiety, 14) sexual attitudes, conflict, 15) attitude towards death, 16) relationship between father and son (daughter), 17) expectations regarding some difficult situation, 18) fears and fears (to danger from outside), 19) white card - actual experiences and problems, 20) feelings of loneliness, fears. Examples of stimulus sentences (male version): 1) the thought of the promised tormented him, 3) petrified, he went to meet his family, 6) he lost all support with her, 10) he thought about the trip with bated breath, 13) an anxious thrill ran through his body, 15) he went up the hill to the dug graves, 18) he shuddered, noticing shadows stirring in the ruins, 20) fences, boarded up windows, lanterns, corners stretched. The research technique is similar to that of the classical TAT technique. It is especially necessary to emphasize again that it is always necessary to conduct an individual study with recording the stories of the subject by the researcher; cases where the subjects write down their stories themselves are possible only as an extreme exception.

If the subject speaks too quickly, so that it is very difficult to write down after him, then one should (in no case interrupting him) begin to repeat aloud what he says. As a rule, in such cases, the rate of speech of the subject slows down. When the subject makes up several stories in one sentence, they are all written down, then they are asked to choose the one that he considers the most significant.

The survey of the subject in connection with the VPT is carried out twice. First, before starting the technique, detailed information is collected about the subject. Then, already having them, they carry out the VPT. After carrying out the technique, some points of interest to the researcher that are found during its implementation are clarified. This order makes it possible to optimally approach the assessment of the personal characteristics of the subject and, as a rule, is very positively perceived by him, as it shows, in his opinion, a more complete complicity of the doctor or psychologist in solving the patient's problems.

The interpretation of the results of the study is carried out within the framework traditional for the methods of the TAT series. The following key points stand out:

• 1) “moment” (“present”) - its presence is spoken of when the situation of the sentence itself is reflected in the plot of the story;
• 2) "past" - the source of the situation displayed in the plot of the story in its connection with the present;
• 3) "future" - the outcome of the situation depicted in the plot in its connection with the present;
• 4) "thoughts" - reflect the thoughts, plans of the hero of the story;
• 5) "feelings" - reflect the experiences, emotions of the hero of the story;
• 6) "identification" and "solidarity" - two very closely interacting and interconnected categories. The concept of "solidarization" is somewhat broader and allows us to judge which of the characters in the story is closest to the subject, whom he prefers, whom he would like to be like;
• 7) "spheres" - intimate, sexual, family, professional, moral and ethical, socio-political, personal, religious and mystical;
• 8) "position" - can be active, passive, indefinite and ambivalent;
• 9) "conflict" - can be external, internal and so-called general type (existential);
• 10) "value system" - self-confidence; courage, daring; success in the service; calm; courage, pride; proper upbringing of children; the joy of motherhood; willingness to help; kindness; human participation; self-importance, giftedness; rationality; public prestige; tact, subtlety; decency; spiritual intimacy in marriage; love; altruism, sensitivity, attention to people, etc.;

II) "general mood background" - must be determined at the time of the study;

• 12) "comments" - are subdivided into evaluation, reference and memorial;
• 13) “puberty themes” - characterized by mention of long-distance travels, description or mention of exotic places, exotic professions, names, etc., negative characteristics of older people in age and position (“evil”, “inert”, etc. ) and testify to the emotional immaturity of the personality, its infantilism, hysteria;
• 14) "special topics" - a manifestation of deep personal disharmony. The following topics are classified as special: death, suicide, symptoms of somatic chronic, incurable diseases, symptoms of mental disorders;
• 15) "transfer to conventionality" - a nosologically non-specific pathopsychological expression of irrationality in thinking;
• 16) "re-qualifications" - all proper names, days of the week, numbers, nationality, etc.;
• 17) "symbolization" - it can be personal (not pathological) and pathological;
• 18) “violations of logic” - they represent a combined group of various related phenomena and are divided into obvious violations of logic; hidden violations of logic; logic violations that need to be checked; departure from the plot; non-perception of the emotional overtones of the stimulus offer;
• 19) "pathology of speech";
• 20) "reminiscences";
• 21) "stamps";
• 22) “assessments for representatives of the sexes”;
• 23) "antisocial manifestations in stories";
• 24) "a detailed description of external and internal suffering";

25) "protection" - reflects the provision of the most convenient and effective way of action by the subjects.

In addition to the detailed points of the content analysis of the results of the subjects' implementation of the methodology, a lexical and grammatical analysis of their stories can also be undertaken in order to clarify the characteristics of the subjects' speech, which is of great diagnostic value. However, such a psycholinguistic approach is currently used mainly for purely scientific purposes, requiring special knowledge that goes beyond the scope covered in this manual.

When analyzing the results of the subjects' implementation of the methodology in detail, for each of the above points, each of the stories is evaluated, and then a summary complex characteristic of the identified personality-motivational features of a particular subject is compiled.

The experience of using the PPT technique in a psychiatric clinic for the purpose of diagnosing various neuropathopsychological disorders for five years allows us to draw the following conclusions:

• 1) the technique successfully functions as a new projective technique for studying personality;
• 2) the technique has a special sensitivity to the detection of emotional disorders, allows diagnosing their nature and severity, which makes it possible to use HT in various disorders of the emotional sphere, especially for differential diagnostic purposes.

Children's Apperception Test (CAT). Proposed by L. Bellak and S. Bellak in 1949 (L. Bellak, S. Bellak). It is a related technique for the study of personality TAT and is intended for the examination of children aged 3 to 10 years. For the first time, the idea of ​​creating a methodology was put forward by E. Criss, who believed that children identify themselves with animals much easier and better than with people. In accordance with these ideas, V. Lamont created pictures with images of various animals, and some of them contain images of animals in an anthropomorphic style, the other part - as they are in nature. The stimulus material of the method is represented by 10 black-and-white drawings. All of them are made in a manner typical for children's books. The content of the drawings is as follows:

According to the authors of the methodology, each of the paintings corresponds to a specific theme. These are: 1 - the problem of nutrition, satisfaction or frustration; 2 - the problem of fighting fear, accompanied by aggression; 3 - the problem of relationships with the father, power, aggression; 4 - the problem of relationships with the mother, children among themselves, the topics of nutrition, feeding; 5 - the theme of conjectures, observations, embarrassment, interaction and mutual exploration by children of each other; 6 - the problem of jealousy, relations between parents; 7 - the theme of fear of aggression and ways to prevent it, the ability to avoid aggression; 8 - the problem of the place of the child in the system of family relations; 9 - the theme of fear of the dark, fear of being alone, parental care, curiosity; 10 - the theme of moral relations, the ability to take care of yourself.

The technique of carrying out the technique is close to the technique of carrying out the classical TAT. It is necessary to establish a good emotional connection with the child before starting the study. However, this is not always easy, especially if the child is small or has various developmental disabilities. It is better when it is possible to present the study in the form of a kind of game. In the instruction, the child is asked to tell what is happening in the picture, what the animals are doing at the moment, what preceded this situation and what will happen later. It is advisable to encourage the child during the study. When conducting a study, all pictures that are not directly involved in the work should be out of sight of the child. It is necessary to present the pictures in strict sequence, in accordance with their numbering.

All stories of the child are recorded either by the researcher himself, or with the help of a hidden microphone on a tape recorder.

Unlike the TAT technique and related techniques in adults, the child can be interrupted in the case of CAT, unless, of course, this is an emergency.

The interpretation of SAT has its own characteristics. This, first of all, concerns the fact that in the first place, when interpreting SAT, the topic updated by the child is singled out - it is necessary to understand why he composes such and not another story. It is necessary to trace whether similar themes are repeated from story to story. Next, the main character of the story is singled out; there are cases when the subjects identify themselves with the characters of the opposite sex, which may indirectly indicate violations of gender role orientation. Establish the main needs and motivations of the hero. The authors of the technique also suggest paying attention to the reflection of self-imagination in the child's stories, by which they mean the subject's idea of ​​his appearance, his body and his social role. The next strong points in the interpretation of stories are the analysis of the representation of persons, objects, circumstances in them; missed persons, objects and to establish with whom the child identifies himself, in what way he reacts to others, what major conflicts he actualizes in his stories. Find out the nature of anxiety and anxiety and the main means of protection used by the child.

Experience with SAT over a long period of time and specially conducted studies have shown that the initial hypothesis that the child identifies better with animals than with people has not been confirmed. This served as the basis for the creation by the authors of the technique in 1966 of a new version of SAT with images of people (SAT-H).

The children's apperception test can be used in determining which dynamic factors determine the child's behavior in various situations, in scientific research, as a game technique.

The method for studying frustration tolerance was first described by S. Rosenzweig (1954) under the title "Painting Frustration Method"*. Later, a special guide was published on the use of this method with the corresponding standardized norms (S. Rosenzweig, E. Hemming, H Clark, 1947), which still remains the main one.

As can be seen from the name of the method, its task is to study a special aspect of personality, reactions to frustration. As a stimulus material, drawings are used that depict the most frequently occurring conflict situations, situations that can frustrate a person. Gender, age and field of activity are not decisive for the occurrence of these situations.

In contrast to the TAT pictures, the pictures offered here are quite uniform in nature and, most importantly, serve to get relatively simple answers from the subject, limited in content and size. Thus, the present method retains some of the objective advantages of the word association test and at the same time approaches the possible disclosure of those aspects of personality that researchers are trying to identify with the TAT.

The material of the methodology consists of 24 drawings depicting persons in a transitory type of frustration situation. In each drawing, the character on the left is depicted speaking words that describe the frustration of one's own or that of another individual. There is an empty square above the character on the right, in which the subject must enter his own answer. The features and facial expressions of the characters from the drawings have been eliminated.

Those situations that are present in the methodology can be divided into two main groups. The first is situations of obstacles, yali, according to the terminology of S. Rosenzweig, “ego-blocking”. In these situations, any obstacle operating in the situation discourages, confuses, frustrates the subject in any direct way. There are 16 situations of this type (for example, 1, 3, 6, 8, etc.). The second is the situation of accusation, or "super-ego-blocking". Here the subject is the object of the accusation (for example, 2, 5, 7, etc.).

During the experiment, the subject is given a series of drawings and the following instructions are offered: “Each of the drawings depicts two or more faces. One is always shown speaking certain words. Imagine what the other person would say and write down the first answer that comes to mind. Do not try to get away with a joke and act as quickly as possible. The subject, using the example of the first picture, is shown how he should give an answer. The test can be used for both individual and group experiments.

Each response of the subject is evaluated in terms of two criteria: direction and type of reaction of the individual. According to the direction, 1) extrapunitive reactions are distinguished - external obstacles or persons who caused trouble in the subject are blamed; at the same time, sometimes someone is charged with the duty to resolve the situation; 2) intrapunitive reactions - blaming oneself; the subject takes responsibility for correcting the situation or perceives the frustration situation as favorable for himself; 3) impulsive reactions - the subject avoids reproaches to other people and considers the situation in a conciliatory way, as something that can be corrected, one has only to wait and think.

According to the type of reaction, they are divided into: 1) obstructive-dominant - in the response of the subject, the obstacle that caused frustration is emphasized in every possible way (this obstacle is presented as unfavorable, favorable or insignificant); 2) self-protective - the main role in the response of the subject is played by the method of protecting the "I", the subject condemns someone, admits his guilt, denies responsibility in general; 3) necessarily-persistent - the emphasis is on the need to resolve the situation that has arisen, the subject requires help from other people, he takes on the solution of the problem himself or believes that time and the course of events will lead to its correction.

From the combination of these 6 categories, each of which receives its own symbol, 9 possible evaluation factors (and 2 additional options) are obtained.

When evaluating the results, the answers of the subject are compared with the standard ones. Mismatched answers do not receive a score, and matching answers are evaluated at 1 or 0.5 points (the latter, if the answer contains a double score, and only one of them matches the standard one). Based on the responses, profiles of numerical data are compiled, and according to them - three main samples and one additional one.

In the process of research, the subject often changes the trend of answers. To account for this, trends are analyzed. During interpretation, attention is drawn to the study of the social adaptation of the subject, the frequency of his conflicts with others, the factors of the profile table are assessed, patterns and trends are studied. Attention is drawn to how the subject understands his reactions. In mentally healthy people, extrapunitive reactions are the most frequent, followed by impunity, and intrapunitive reactions are less common. Thus, a healthy person in most cases either directs his reactions to the external environment and blames external causes for the obstacles, or avoids reproaching both other people and himself, that is, he considers the frustrating situation in a conciliatory way. Establishing an indicator on the basis of which one can judge the degree of social adaptation of an individual is possible with the availability of average group data. However, the standards available in foreign literature cannot be borrowed for this purpose.

Consideration of the method devoted to the study of frustration as a personal characteristic makes us turn to some theoretical aspects of the problem of frustration in general.

Interest in frustration as one of the real life problems arose in the 30s of our century and, undoubtedly, the work of S. Freud served as an impetus for this. But the psychologists who dealt with this problem quickly discovered that accepting Freudian principles was one side of the matter, and using them as a basis for experimental research was something else. This was the impetus for the development of frustration theories.

Currently, we can talk about the following main theories of frustration in modern foreign psychology: the theory of frustration fixation (N. K. Maier, 1949); the theory of frustration regression (K. Barker, T. Dembo, K. Lewin, 1943); the theory of frustration aggression (J. Dollard, 1939); heuristic frustration theory (S. Rosenzweig, 1949). The heuristic theory of frustration created by S. Rosenzweig seems to us the most complete and interesting. According to this theory, frustration occurs when the organism encounters more or less insurmountable obstacles on the way to the satisfaction of some vital need. Frustration, according to S. Rosenzweig, is the ability to adapt to a stressful situation, a characteristic way of behavior.

Protection of the body is carried out, according to this theory, at three levels: cellular (protection is based on the action of phagocytes, antibodies, etc., in other words, protection from infectious influences); autonomous - protection of the body as a whole from physical "aggressions" (corresponds psychologically to states of fear, suffering, physiologically - to changes that occur in the body during stress); cortical-psychological level. At this level, the theory of frustration is mainly built, the selection of appropriate criteria in terms of the direction and type of reaction of the individual, which we spoke about earlier.

This distinction is schematic and emphasizes that, in a broad sense, frustration theory includes all three levels as interpenetrating. Thus, we can conclude that frustration is interpreted extremely broadly (although the method developed by S. Rosenzweig is intended to study the third level of protection), it includes the concept of stress, and is not limited to studying only the realization of this phenomenon at the mental level.

In this regard, it seems to us more psychological is the definition of N. D. Levitov (1967), who understands frustration as a state of a person, expressed in the characteristic features of experiences in behavior and caused by objectively insurmountable (or subjectively understood) difficulties that arise on the way to achieving goals or problem solving.

The method of researching frustration can and should play a role in pathopsychological research. The study of frustration reactions helps to understand the origin of neuroses, to contribute to the correct organization of psychotherapy. The problem of frustration is directly related to the problem of psychopathy and psychogeny. In domestic studies, the possibility of using it for the differential diagnosis of neuroses (N. V. Tarabrina, G. V. Sheryakov, V. D. Dmitriev, 1971) and neurosis-like states (L. I. Zavilyanskaya, G. S. Grigorova, 1976) is noted .

Methods of diagnosing interpersonal (shterperso-valny) relationships T. Lirn. Increasing attention to the methods of studying interpersonal relations in psychodiagnostics is primarily associated with the approval in science of such theories of personality, in which interpersonal relations are attributed the importance of its main components. First of all, these are theories of personality created by H. S. Sullivan (1953) and V. N. Myasishchev (1960).

H. S. Sullivan points out that the assessments and opinions of those around him that are significant to him play an extremely important role; it is under the influence of these assessments in opinions that the personification of the individual takes place, his personality is formed. In the process of interaction with the environment, a person manifests himself in the style of interpersonal relations, striving to constantly adjust his behavior to the assessments of others significant to him.

These provisions were the basis for the development of T. Li-ri (Leary T., 1956) methods for diagnosing interpersonal relationships. It is a list of 128 simple characteristics, to which the subject must answer whether this characteristic fits him (“yes”, “true”) or does not fit (“no”, “false”). In the classical version of the methodology, the researcher is offered to self-assess his actual "I" (his real "I", that is, his idea of ​​himself at the time of the study); the technique also allows you to study the ideal "I" of the subject (how he wants to see himself), as well as the widest range of actual (real) and ideal ideas of the subject about the people around him (relatives, colleagues, acquaintances, etc.). Examples of characteristics-epithets of the questionnaire:

1. Likeable, 6. Independent, 16. Often disappointed, 24. Seeking approval, 100. Despotic, 111. Stubborn, etc.

During the implementation of the methodology, the subject in a specially proposed answer sheet crosses out, in agreement with him, the serial number of the corresponding statement; the numbers of those characteristics that reflect the missing properties of the test property remain uncrossed out. According to a special key, points are calculated for 8 variants of interpersonal interaction identified by T. Leary. It is also possible to calculate the vectors of dominance (V) and goodwill (G) on the basis of the digital values ​​obtained for 8 octants, but these data are not very informative.

The assessment of the results of the study is based on T. Leary's ideas that there are two main axes in interpersonal relations: dominance - submission and friendliness - aggressiveness. According to these axes, eight psychological tendencies (octants) are grouped, the degree of expression of which reflects certain personal modalities - from positive to negative. These octants are as follows:

1. Leadership-imperiousness-despotism. With moderately expressed scores, it reveals self-confidence, the ability to be a good adviser, mentor, organizer, leader. At high rates - intolerance to criticism, overestimation of one's own capabilities, then - traits of despotism, imperative need to command others, didactic style of statements.

II. Self-confidence-self-confidence-narcissism. With moderate indicators - confidence, independence, desire for rivalry, then - complacency, narcissism, a pronounced sense of superiority over others, a tendency to have a dissenting opinion that is different from the opinion of the majority, to take a separate position in the group.

III. Demandingness-intransigence-cruelty.

Depending on the degree of severity, it reveals sincerity, spontaneity, straightforwardness, perseverance in achieving the goal, excessive perseverance, unfriendliness, intemperance, irascibility.

IV. Skepticism-stubbornness-negativism. Moderate indicators - realistic judgments and actions, skepticism, non-conformity, then - extreme touchiness, distrust of others, a pronounced tendency to criticism, dissatisfaction with others and suspicion.

V. Compliance-meekness-passive obedience. It reflects such interpersonal features as modesty, shyness, a tendency to take on other people's duties, then - complete humility, increased guilt, self-abasement.

VI. Credulity-obedience-dependence. Moderate indicators - the need for help and trust from others, in their recognition. At high rates - over-conformity, complete dependence on the opinions of others.

VII. Kindness-dependence-excessive conformity. Diagnoses the style of interpersonal relationships, characteristic of persons seeking close cooperation with the reference group, friendly relations with others. With high scores - compromise behavior, intemperance in outpourings of one's friendliness towards others, the desire to emphasize one's involvement in the interests of the majority.

VIII. Responsiveness-selflessness-sacrifice. With moderate scores - a pronounced willingness to help others, a developed sense of responsibility. High scores reveal soft-heartedness, overcommitment, hypersocial attitudes, emphasized altruism.

Characteristics that do not go beyond 8 points are characteristic of harmonious personalities. Indicators exceeding 8 points and up to 14 points are an indication of sharpening, accentuation of the properties revealed by this octant. Indicators from 14 to 16 points are evidence of pronounced difficulties in social adaptation. Low scores - from 0 to 4 points - for all octants may be evidence of the secrecy and lack of frankness of the subjects.

T. Leary's method of studying interpersonal relationships can be used to solve the widest range of diagnostic, treatment and rehabilitation tasks in patients with various forms of mental disorders.

The method of unfinished sentences has been used in experimental psychological practice for a long time. SD Vladychko (1931) indicates that it was developed and used by H. Ebbirghaus and Th. Ziehen. In the experimental psychological laboratory of the clinic of V. M. Bekhterev, the method of unfinished sentences was used to study the imagination (V. V. Abramov, 1911, S. D. Vladychko, 1931). There are many variants of it.

In educational psychology, a variant of the method of unfinished sentences by A. Myerson (1919) was used to determine the type of personal orientation. It was distinguished by a relatively high regulation - the subject had to choose the end of the sentence from several offered to him. According to N. D. Levitov (1969), this variant was close to collision tests. The regulation of the activity of the subject to a large extent reduces the significance of the Meyerson method as a projective one. An example from the Meyerson technique:

A person who leads a righteous (good) life... misses an opportunity to have fun, gains universal respect, walks a hard path in life, will be deceived by swindlers.

In the variant of A. F. Raupe and A. Rohde, the subject is offered 66 unfinished sentences, which he must complete. The instruction contains an indication of the need to do this as quickly as possible, without thinking, without missing any of the proposals presented. Based on the analysis and interpretation of the data obtained, the researcher makes a conclusion about the peculiarities of the attitude of the subject to others, members of the same or opposite sex, friends, teachers, people in general, what is his attitude towards himself, his future, money, laws, upbringing

etc. In this case, the presence of hypochondria, suicidal thoughts, excessive suspiciousness can be revealed. According to T. Bilikiewicz (1960), this method is applicable for both individual and group studies and helps to reveal the experiences hidden by the patient or even not realized by him. Therefore, the author writes about the importance of the method of incomplete sentences for the construction of psychotherapeutic and psychoprophylactic work, as well as for solving a number of social issues related to the arrangement of mentally ill people in society. Here are examples of unfinished sentences in A. F. Raupe and A. Rohde:

There is also a variant of the method of incomplete sentences by J. M. Sacks and S. Levy. It includes 60 unfinished sentences, additions to them are somewhat more determined by the channel of the beginning of the phrase than in the variant of A. F. Raupe and A. Rohde. These proposals can be divided into 15 groups, characterizing to some extent the system of relations of the subject to the family, to representatives of the same or opposite sex, to sexual life, to superiors and subordinates. Some groups of sentences are related to the patient's fears and fears, to his sense of guilt, testify to his attitude to the past and future, affect relationships with parents and friends, life goals.

It should be noted that some questions of this option are unpleasant for the subjects, as they relate to the intimate side of their lives. Therefore, G. G. Rumyantsev (1969) recommends informing the patient in the instructions that the study is being carried out in order to train memory or attention.

Quantitative assessment facilitates the identification of a disharmonious system of relations in the subject, however, a qualitative study of supplemented sentences, carried out taking into account anamnestic data, is more promising.

Many patients, especially those who consider research as an undesirable procedure for them and who seek to hide the world of their deep feelings, give formal conditional answers that do not reflect the system of their personal relationships. Research by the method of unfinished sentences must be preceded by the establishment of contact between the researcher and the free, based on trust.

According to GG Rumyantsev (1969), with the help of the method of unfinished sentences, changes in the system of personal relations characteristic of patients with schizophrenia are revealed. We used this method to examine patients with epilepsy (I. V. Kruk, 1981) and in neurosis-like states in order to form groups for collective psychotherapy. B. D. Karvassarsky (1982) notes that the method gives positive results in express diagnostics of the system of personality relations, which is of interest to the practitioner in his daily activities, allowing much brighter and more complete coverage of the overall picture of the violation of personality relations, the patient's life attitudes, its tendencies (conscious and unconscious). Therefore, the method of unfinished sentences, which is extremely simple and easy to interpret, can be especially useful in borderline neuropsychiatric, including psychosomatic, diseases.

Wartegg method. E. Wartegg (1963) considers the proposed sign (reflex-graphic) test as a psychodiagnostic test, consisting in a graphic continuation of systematically varied visual graphic stimuli.

The subject is offered a sheet of paper with white planes on a black background for drawing. There are 8 such squares-planes in total. Each square contains stimulus signs: a dot, a wavy line, line segments in different positions, a shaded square, a semicircle, a dotted semicircle.

The researcher invites the patient to continue the signs already entered into the square, considering them as the initial lines and an integral element of the drawing. The sequence of filling in the squares and the time required for this are not regulated. Pencils are placed in front of the subject - simple and colored. According to most researchers, the Wartegg test should be classified as a projective method. R. Meili (1969) draws a parallel between the methods of Wartegg and Rorschach based on the fact that both of them are based on the processing and interpretation of given stimuli.

The theory created by E. Wartegg to explain the data obtained by this method seems to us eclectic and controversial. The author tried to harmonize the results of his research with the principles of pathophysiology of higher nervous activity of IP Pavlov. So, diffuse blackness of the drawing, asymmetric and crowded perseveration of the sign, scribbles are considered by him as a manifestation of the predominance of the excitation process in the cerebral cortex, while perseverative strokes at the edge of the drawing field, symmetrical repetition of signs or strokes should indicate the dominance of cortical inhibition. The dissociation between the content of the picture and its interpretation is regarded as a manifestation of violations of the relationship between signal systems. Based on this kind of analysis, E. Wartegg builds a “reflexographic profile” supposedly inherent in every patient. Even more doubtful is the construction of a "characterological profile" based on a rather arbitrary assessment of the participation of certain signs in the drawing. Signs-irritants are attributed to known characterological properties. So, drawings by the second sign (wavy line) are analyzed in terms of characterizing such properties of the subject as affectivity, contact; on the third sign (three consecutively increasing straight vertical lines) - purposefulness. It seems to us that the arbitrariness of this symbolism to a certain extent resembles the constructions of psychoanalysts.

Without accepting the theoretical “superstructure”, we tested in our laboratory (A. G. Cherednichenko, 1985) the Wartegg method in examining patients with epilepsy and schizophrenia. A convincing difference was found in the data obtained in patients of both groups. the nature of the drawing (realism, symbolism, a tendency to detail), the choice of color, the introduction of graphic-verbal components into the drawing, the "standard" drawing, its interpretation by the subjects.

The Luscher color selection test was developed by the Swiss psychologist M. Luscher (1947) and is considered as a projective method aimed at indirectly studying personality. The full version of the test uses 73 color cards in 25 different colors and shades.

An abbreviated set consisting of 8 color cards is more commonly used. Four colors - blue (dark blue), yellow, red and green are considered the main, basic, "psychological primary elements". Violet (a mixture of red and blue), brown (a mixture of yellow-red and black), neutral gray, which does not contain any color and therefore supposedly does not have any significant effect on the subject, and black, which is considered as "color negation", are additional colors.

Cards are laid out in front of the subject on a white background in a semicircle and he is asked to choose one of them, painted in the most pleasant color for him. At the same time, the subject is warned that neither his taste, nor the dominant color in fashion, nor the color of the interior should influence the choice. The card chosen by the subject is turned over and put aside, after which he is asked to again choose the most pleasant card for him from the remaining ones. Thus, the study is carried out to the end, and as a result, the researcher gets the opportunity to fix the resulting color range.

This color range sets the ranking of cards in descending order.

The interpretation of the results is made taking into account the categories of function and color structure. Under the function of color M. Luscher understands the subjective attitude of the subject to the color, due to his emotional state at the time of the study. The structure of color opre ~ It is given to supposedly objective knowledge of color, its psycho-logical content. In accordance with the function and structure of color, with the help of special tables, standard characteristics of the personal properties of the subject are obtained.

We give as an example an abbreviated psychological description of the structural meaning of one of the basic colors: for example, the blue color symbolizes the depth of passion and is concentric (i.e., occupied with the subjective sphere), passive, reunifying, heteronomous, sensitive, its affective components are calm, contentment, tenderness, love affection. Thus, the author highlights the factors that control a person. At night (dark 1 "blue color) human activity stops and, conversely, 1" mouth, during the day (bright yellow color) human activity, its agvality is stimulated. These heteronomous colors are considered by M. Luscher as beyond human control. The other two basic colors are red and green - are considered as autonomous, self-regulating.

At the same time, red symbolizes attack, and green - protection.

Beyond the hetero- and autonomy criteria. M. Luscher also uses the factors of activity and passivity. Blue is heteronomously passive, yellow is heteronomously active, red is autonomously active, green is autonomously passive. Thus, colors are associated with human life and the functioning of the individual. The choice of color within the primary colors refers to the conscious sphere of the psyche, within the complementary colors and shades, it is associated with the unconscious sphere.

The question of the possibilities of using the Luscher test in pathopsychology seems to us controversial and its solution cannot be unambiguous. The situation of color choice created in the course of the study is very specific and cannot be identified with the behavioral reaction of the subject in any situation at all. This broad interpretation is completely wrong. Moreover, it is difficult to evaluate the act of choice itself. The choice of color is a complex form of activity, depending on a number of essential points, variables that are important when taken individually and in various combinations. R. Meili (1961) rightly points out that at the present time we still cannot fully assess the choice reaction. Referring to the studies of M. Luscher and M. Pfister himself, R. Meili says that the choice in situations modeled using the Luscher and Pfister tests (color pyramid test) depends not only on the reaction to color. It is influenced by the situation in which it occurs. The choice of color essentially depends on the motives of the activity (whether something needs to be done with a color card or not), on how many color cards the subject makes a choice of - from two or more. It can only be argued, says R. Meili, that there is a dependence of the choice of color on the mood. V. P. Urvantsev (1981) writes that too many factors influence the preference for one or another color, including both the characteristics of the color stimulus and the individual typological characteristics of a person. Thus, the author refers to the features of the stimulus the influence of fatigue and adaptation on the emotional evaluation of color, the size of a color sample, affective contrast when considering a series of chromatic samples that differ in affective value, background color, saturation and brightness of a color sample. The features of color perception, depending on the subject, according to L.P. Urvantsev, include individual affective sensitivity to color, age, socio-cultural characteristics, gender, emotional state at the time of the study (for example, a calm state or mental tension). Most of these factors are not taken into account in the Luscher test, which in no way is compensated by its strict standardization.

Even more dubious are the theoretical justifications for the Luscher test. Like all other authoritative experts in the field of psychodiagnostics, R. Meili writes that a necessary condition for using the test in practice is a thorough scientific development of its foundations. The Luscher test is not based on any serious scientific theory.

The above arguments of M. Luscher regarding the structure of primary colors are based on purely mythological symbolism and can be considered as speculative. J. De Zeeuw (1957), analyzing the Luscher test, "writes that some empirical data, especially those obtained in the mental illness clinic W. Furrer (1953), seem valuable, interesting, but M. Luscher's theory is mostly part is acceptable; and the test and the interpretation of the data obtained with its help need to be objectified.

The above is not a reason for the complete rejection of the Luscher test. Denying the possibility of using it to obtain any complete, detailed characteristics of the personality, it should be confirmed that it can be used to assess the emotional sphere of the personality. In this regard, indicators of the color function, reflecting the subjective perception of color by the subject, are of particular interest. This approach opens up quite interesting prospects for using the Luscher test in pathopsychology to compare different affective states in individual and especially group studies. Here, the Luscher test can objectively show the dynamics of the patient's emotional state and, possibly, its depth.

In recent years, experimental work based on a scientific clinical-psychological approach has appeared, in which the Luscher color selection test was used. So, S. N. Bokov (1988) applied the Luscher technique to study the affectivity of patients with paranoid schizophrenia. He showed the possibility of using this technique for diagnosing the dynamics of motivational disorders in patients and found an increase in motivational disorganization (amotivation) as the duration of the disease increased. Similar results were obtained somewhat earlier by V. A. Moskvin (1987), who applied the Luscher test in patients with continuous-progressive schizophrenia and excitable psychopathic personalities and showed the possibility of using the technique for diagnosing violations of goal formation, however, in his work, in contrast from the first, no dynamic approach to the evaluation of results was applied.

NV Agazade (1988) Luscher's technique was applied to identify suicidal tendencies. The author points out that in healthy subjects without auto-aggressive experiences, the color pair of standards

Nos. 3 and 4 (red and yellow) are quite rare in the second half of the layout (4-10%), while with suicidal phenomena - in more than half of the subjects. In addition, a pronounced negative emotional reaction was often observed when choosing most of the color standards with statements about the unpleasantness of all the colors offered.

T. A. Ayvazyan and I. A. Taravkova (1990), using the Luscher color test in a comprehensive psychological and diagnostic examination of patients with hypertension, conclude that it can be used as a screening test to identify a group of patients with a higher level of neuroticism, anxiety, most in need of psychotherapeutic intervention. At the same time, the authors point out the need for further work on the validation of the methodology.

L. N. Sobchik (1990), based on the Luscher test, proposed the method of color choices (MCV). The substantiation of the method is detailed in the second issue of the series "Methods of psychological diagnostics" (1990). An attempt was made to identify, with the help of MCV, primarily a hyper- or hyposthenic type of response. Recommendations for determining the level of anxiety using MCV are of practical value. If the primary colors, to which the first four belong, occupy one of the last three positions of the series, this indicates the dissatisfaction of a particular need, which becomes a source of dissatisfaction. By whether the primary colors are located in the last positions, anxiety is assessed. The indicator of anxiety is also affected by the appearance of additional colors (6, 7, 0) in one of the first three positions. Anxiety is calculated in points according to a special scheme, its maximum indicator is -12 points. A combination of 2, 3 and 4 colors (in any order) is called a "working group", its placement at the beginning of the row reveals good performance. A "broken" working group indicates a decrease in efficiency.

Of interest are the data obtained with the help of MCV by Yu. A. Aleksandrovsky, L. N. Sobchik (1993) in the study of healthy individuals with a harmonious personality, accentuated personalities, patients with neuroses and neurosis-like (pathocharacterological) developments. For healthy people, preference for primary colors and the absence of indicators of anxiety were characteristic. Accentuated personalities and persons with painful emotional tension are characterized by the arrangement of colors 6, 0, 5 or 7 in the first positions, the shift of the working group to the right. In neurotic states, colors 6,0,7,6,0 or 6, 7 are in the first positions. The working group is divided, the main colors are in the last positions. With pathological developments, a combination of achromatic and primary colors is observed in the first positions, the working group is not fully assembled, the primary colors may be in the indifferent zone (5th-6th positions).

Summing up the results of studies on MCV in patients with schizophrenia and borderline mental disorders, LN Sobchik concludes that the methodology cannot be considered standardized.

V. M. Bleikher, S. N. Bokov (1994) used an abbreviated (eight-color) version of the Luscher test to study the relationship between the functional state of the autonomic nervous system and the choice of color. The results of their study allow us to conclude that there is a definite relationship between the predominant functional state of the various parts of the ANS and the choice of color: with the predominance of parasympathetic influences, preference is given to green more often, sympathetic to yellow.

Determining the degree of pleasantness of individual chromatic colors. The technique was proposed by K. A. Ramul (1958, 1966) and belongs to the group of “impression methods”. The material of the study is the experiences of the subject, caused by any irritations or impressions. The technique is aimed at studying the emotional sphere of a person. It is based on the determination by the subject of the degree of pleasantness of the color cards shown to him, painted in the main chromatic colors.

Several methods are possible. In one of the options, colored cards are presented simultaneously, being located on the same front sheet. The subject must choose the most pleasant color for him. Sometimes the task consists in choosing color combinations that are pleasing to the subjects. This option comes close to the Luscher test, since in essence a situation of choice is created for the subject.

In the second variant, the method does not include color selection elements, although a comparison of individual colors, not provided for by the researcher's instructions, is also available here. The subject is shown color cards separately and is offered to evaluate each chromatic color according to the following system: very pleasant (+3), pleasant (+2), slightly pleasant (+1), indifferent (0), slightly unpleasant (-1 ), moderately unpleasant (-2), very unpleasant (-3).

The study is carried out using a special set of maps (a colored square on a white background). The assessment is quantitative.

The technique is suitable for studies of both individual patients and groups of patients. For each patient, a characteristic color range can be established. Comparison of these series in dynamics, with a change in the emotional state of the patient, is of considerable interest,

As an additional variant of the technique, we used the technique of correlating colors and shades. To do this, standards are made, that is, cards painted in the primary colors of the spectrum and having the shape of a circle. Accordingly, for each color, the subject is presented with three more square cards, of which one is completely identical in color to the standard, the second is colored with a more saturated color, and the third is a less saturated color. The instruction provides for the need to select for each reference card “the most suitable square card for it”, the mode of activity and the selection criterion are not specified. The features of the motivational orientation of search activity and the accuracy of registering the identity of colors and shades when comparing them are studied.

The choice of methods is closely related to the tasks that the clinical psychologist sets himself. Various research methods are divided into 3 groups:

· Clinical interviewing

· Experimental-psychological methods

Evaluation of the effectiveness of psycho-correctional influence

The examination takes into account the patient's somatic condition, age, gender, profession and level of education, time and place of the study.

Clinical interview (conversation)

This is a creative process and largely depends on the personality of the psychologist. One of the main goals of a clinical conversation is to assess the individual psychological characteristics of the client, ranking them according to quality, strength and severity, as well as classifying them as psychological phenomena or psychopathological symptoms. True diagnosis must necessarily combine conversation.

A clinical interview is a method of obtaining information about the individual psychological properties of a person, psychological phenomena, psychopathological symptoms, the internal picture of the disease, the structure of the patient's problems, as well as a method of psychological impact on a person that occurs during the interview. It differs from the usual questioning in that it is aimed not only at identifying complaints, but also at identifying the hidden motives of a person’s behavior and helping him to understand the true reasons for existing problems. Customer (patient) support is essential.

Interview features- diagnostic and therapeutic.

Interview principles:

· Unambiguity and Precision- correct, correct formulation of questions.

· Availability- taking into account educational, language, national and other factors.

· Interrogation sequence- after revealing the first complaint, - the formation of the 1st group of phenomena or symptoms, etc. It is also important to ask the patient about the order in which mental experiences appear, especially in the context of events.

· Verifiability and adequacy- clarifying questions are important here.

· The principle of impartiality– neutral position of the psychologist, observance of ethical norms, creation of a trusting atmosphere, therapeutic empathy.

There are different approaches to interviews in terms of duration, it is considered that the 1st interview is about 50 minutes, the subsequent interview with the same client is shorter.

Experimental psychological research methods

The main task of these methods is to detect changes in the functioning of individual mental functions and to identify pathopsychological syndromes (this is a pathogenetically determined community of symptoms, signs of mental disorders, internally interdependent and interconnected).

Methods of examination in clinical psychology is an extensive set of methods for assessing the activity of the brain. It is impossible to master all methods - it is important to be able to choose the necessary method and be able to interpret its data.

The sphere of mental activity in which violations are noted	Pathopsychological technique
Attention disorders	Schulte tables Correction test Kraepelin count Münsterberg method
Memory disorders	Ten Word Quiz Pictogram
Perceptual disorders	Sensory excitability Ashafenburg test Reichardt test Lipman test
Thinking disorders	Tests for classification, exclusion, syllogisms, analogy, generalization Associative experiment Everier problem Pictogram
Emotional disorders	Spielberger test Luscher color choice method
Intellectual Disorders	Raven test Wexler test

Evaluation of the effectiveness of psychocorrectional and psychotherapeutic effects.

One of the important methodological problems of clinical psychology is the problem of evaluating the effectiveness of psychological influence, for this purpose clinical scale for evaluating the effectiveness of psychotherapy (B.D. Karvasarsky), it includes 4 criteria:

criterion for symptomatic improvement

the degree of awareness of the psychological mechanisms of the disease

the degree of change in disturbed personality relationships

degree of improvement in social functioning.

Along with this clinical scale, indicators of the dynamics of mental

the state of patients according to various psychological tests. More often than others

MMPI and the Luscher color selection method are used.

PRACTICE 1

Task 1. Analyze the various definitions of the concept of "clinical psychology", highlight the general content, the specifics of domestic and foreign views on clinical psychology as a field of science and practice.

Task 2. Select the object field of clinical psychology.

Task 3. Define the subject of clinical psychology. Describe the characteristics that, in your opinion, may enter the subject of clinical psychology in the next 50 years.

Task 4. Distinguish between the concepts of "clinical" and "medical psychology".

Task 5. Give arguments in favor of each of the positions: “clinical psychology is a branch of psychology”, “clinical psychology is a branch of medicine”, “clinical psychology is an interdisciplinary field of research”.

Task 6. Analyze the relationship between clinical psychology and psychology in medicine.

Basic literature on the topic:

1. Bulletin of Clinical Psychology / Ed. S.L. Solovyov. - St. Petersburg, 2004.

2. Zalevsky G.V. On the history, state and problems of modern clinical psychology // Siberian psychological journal. –1999, issue 10, pp.53-56.

3. Karvasarsky B.D. Clinical psychology. 4th ed. - St. Petersburg, 2010.

4. Mendelevich V.D. Clinical and medical psychology. Practical guide. - M., 2008.

5. Perret M., Bauman W. (eds.) Clinical psychology. 2nd ed., - St. Petersburg - M., 2003.

Similar information.

Methodology and methods of clinical psychology

Methodology is a system of principles and methods for organizing and constructing theoretical and practical activities, united by the doctrine of this system. It has different levels: philosophical, general scientific, concrete scientific, which are interconnected and should be considered systematically. Methodology is closely related to the worldview, since its system involves a worldview interpretation of the foundations of the study and its results. The methodology of clinical psychology itself is determined by the specific scientific level and is associated with the worldview of the researcher (for example, focused on a dynamic, cognitive-behavioral, humanistic or dialectical-materialistic understanding of personality, behavior, psychopathology).

The methodology includes specific scientific methods of research: observation, experiment, modeling, etc. They, in turn, are implemented in special procedures - methods for obtaining scientific data. As a psychological discipline, clinical psychology relies on the methodology and methods of general psychology. Methods, that is, the ways of cognition, are the ways by which the subject of science is known.

Methodology in psychology is implemented through the following provisions (principles).

1. The psyche, consciousness are studied in the unity of internal and external manifestations. The relationship between the psyche and behavior, consciousness and activity in its specific, changing forms is not only an object, but also a means of psychological research.

2. The solution of a psychophysical problem affirms the unity, but not the identity, of the mental and the physical; therefore, psychological research presupposes and often includes a physiological analysis of psychological (psychophysiological) processes.

3. The methodology of psychological research should be based on a socio-historical analysis of human activity.

4. The purpose of psychological research should be to reveal specific psychological patterns (principle of individualization of research).

5. Psychological patterns are revealed in the process of development (genetic principle).

6. The principle of pedagogization of the psychological study of the child. It does not mean the rejection of experimental research in favor of pedagogical practice, but the inclusion of the principles of pedagogical work in the experiment itself.

7. The use of products of activity in the methodology of psychological research, since the conscious activity of a person materializes in them (the principle of studying a specific person in a specific situation).

According to Platonov, for medical (clinical) psychology, principles similar to those presented above are of the greatest importance: determinism, unity of consciousness and activity, reflex, historicism, development, structurality, personal approach. Probably only a few of them require explanation, in particular the last three principles.

development principle. In clinical psychology, this principle can be concretized as the etiology and pathogenesis of psychopathological disorders in their direct (disease development) and reverse (remission, recovery) development. Specific is a special category - the pathological development of personality.

The principle of structure. In philosophy, structure is understood as the unity of elements, their connections and integrity. In general psychology, the structures of consciousness, activity, personality, etc. are studied. Pavlov gave the following definition of the method of structural analysis: “The method of studying the human system is the same as any other system: decomposition into parts, studying the meaning of each part, studying the parts, environment and understanding on the basis of all this its general work and management of it, if it is in the means of man. The task of clinical psychology is to bring various psychopathological phenomena into a single system of particular structures and to harmonize it with the general structure of a healthy and sick person.

The principle of personal approach. In clinical psychology, a personal approach means treating the patient or the person being studied as a whole person, taking into account all its complexity and all individual characteristics. It is necessary to distinguish between personal and individual approaches. The latter is taking into account the specific features inherent in a given person in given conditions. It can be realized as a personal approach or as a study of individual psychological or somatic qualities.

Methods of medical (clinical) psychology are divided into:

Clinical and psychological methods of personality research:

2) Interview

3) Anamnestic method

4) Observation

5) Study of products of activity

Experimental-psychological methods:

1) Non-standardized (qualitative methods) - represented primarily by a set of so-called pathopsychological methods (Zeigarnik, S. Ya. Rubinshtein, Polyakov), are distinguished by their “targeting”, focus on certain types of mental pathology, and their choice is carried out individually for a particular subject. These methods are being created to study specific types of mental disorders. Under the conditions of a psychological experiment, they are selectively used to identify the features of mental processes in accordance with the task, in particular, differential diagnosis. The psychological conclusion is based not so much on taking into account the final result (effect) of the patient’s activity, but on a qualitative, meaningful analysis of the methods of activity that are characteristic features of the process of performing the work as a whole, and not individual tasks. It is important to take into account the attitude of the patient to the study, the dependence of the form of presenting the task on the state of the subject and the level of his development. Only with such a design of the experiment can the requirement for psychological research be fully realized - the identification and comparison of the structure of both altered and remaining intact forms of mental activity.

2) Standardized (quantitative) - In this case, groups of suitably selected and structured tasks are presented in the same form to each subject in order to compare the method and level of their performance by the subjects and other persons. Standardized methods can be defined as broadly understood tests, including tests for the study of mental processes, mental states and personality. In the case of standardized methods, the method of analyzing the results of each individual method is based mainly on a quantitative assessment, which is compared with the estimates obtained previously from the corresponding sample of patients and from healthy subjects. Standardized methods are inferior in their diagnostic value to non-standardized ones; their use in the clinic usually has an auxiliary value, more often as a supplement to non-standardized methods. Their use is adequate for mass examinations, if necessary, a group assessment of the subjects, for indicative express diagnostics in conditions of time pressure.

Projective Methods- addressed to the unconscious psyche. Disguised testing, the subject does not know what the study is aimed at and therefore cannot distort the results. The only proper psychological method of research. Projection is a normal psychological process of assimilation

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RESEARCH METHODS IN CLINICAL PSYCHOLOGY

The choice of research methods used by a clinical psychologist is determined by the tasks that arise before him in the performance of his professional duties. The diagnostic function dictates the use of psychological methods (batteries of tests, questionnaires, etc.) that can assess both the activity of individual mental functions, individual psychological characteristics, and differentiate psychological phenomena and psychopathological symptoms and syndromes. The psycho-corrective function implies the use of various scales, on the basis of which it is possible to analyze the effectiveness of psycho-corrective and psychotherapeutic methods. The selection of the necessary methods is carried out depending on the goals of the psychological examination; individual characteristics of the mental, as well as the somatic state of the subject; his age; profession and level of education; time and place of the study. All kinds of research methods in clinical psychology can be divided into three groups: 1) clinical interviewing, 2) experimental psychological research methods, 3) evaluation of the effectiveness of psycho-correctional influence. Let's dwell on them in more detail.

Clinical interview

We are aware of how difficult the unification and schematization of the creative process is, and yet interviewing can rightly be called creativity. In this regard, we are aware of the limits of our capabilities and do not pretend to find the ultimate truth. Each psychologist has the right to choose from a variety of existing ones the most suitable for him (his character, interests, preferences, level of sociability, worldview, culture, etc.) method of interviewing a client (patient). Therefore, the proposed text and the thoughts embodied in it should be considered as another possibility, another option that can satisfy the discerning reader and lead to the application of the provisions of this particular guide in practice.

If the information is capable of causing rejection, then it is up to the reader to continue searching for the most appropriate guide to clinical method in clinical psychology.

One of the main goals of clinical interviewing is to assess the individual psychological characteristics of a client or patient, to rank the identified features in terms of quality, strength and severity, and to classify them as psychological phenomena or psychopathological symptoms.

The term "interview" has entered the lexicon of clinical psychologists recently. More often they talk about a clinical questioning or conversation, the description of which in scientific works is overwhelmingly descriptive, sententious. Recommendations, as a rule, are given in an imperative tone and are aimed at forming undoubtedly important moral qualities of a diagnostician. In well-known publications and monographs, a clinical method for assessing a person’s mental state and diagnosing mental deviations in him is given without describing the actual methodology (principles and procedures) of questioning, which takes the recommendations given beyond the scope of scientific ones and available for effective reproduction. It turns out a paradoxical situation: it is possible to learn clinical examination and diagnostics only experimentally, participating as an observer-student in conversations with clients of well-known and recognized authorities in the field of diagnostics and interviewing.

Digressing from the main topic, I would like to note that, unfortunately, in the field of diagnostics there is and has a lot of fans even among professionals in diagnosing mental disorders without interviewing. That is, the diagnosis is made in absentia, without a direct meeting of the doctor with the alleged patient. This practice is becoming fashionable in our time. Diagnoses of mental illness based on an analysis of human actions known to the doctor by hearsay or from the lips of non-specialists, psychopathological interpretations of the texts of the “suspects” (letters, poems, prose, once abandoned phrases) only discredit the clinical method.

Another distinctive feature of modern practical psychology has become the belief in the omnipotence of experimental psychological methods in the diagnostic plan. A large army of psychologists is convinced that they are able to identify mental abnormalities and delimit the norm from pathology with the help of various tests. Such a widespread misconception leads to the fact that the psychologist often turns himself into a fortune-teller, into a conjurer, from whom others expect to demonstrate a miracle and solve miracles.

True diagnostics of both mental deviations and individual psychological characteristics of a person must necessarily combine diagnostics in the narrow sense of the term and direct examination by a psychologist of a client (patient), i.e. interviewing.

Currently, the diagnostic process is completely at the mercy of psychiatrists. This cannot be considered fair, since the doctor, first of all, is aimed at finding a symptom, and not at the actual differentiation of a symptom and a phenomenon. In addition, due to tradition, the psychiatrist is little aware of the manifestations of healthy mental activity. It is precisely because of these features that it can be considered reasonable to involve a clinical psychologist in the diagnostic process in the form of interviews to assess the mental state of the subjects.

A clinical interview is a method of obtaining information about the individual psychological properties of a person, psychological phenomena and psychopathological symptoms and syndromes, the internal picture of the patient's illness and the structure of the client's problem, as well as a method of psychological impact on a person, produced directly on the basis of personal contact between the psychologist and the client.

The interview differs from the usual questioning in that it is aimed not only at complaints actively presented by a person, but also at revealing the hidden motives of a person’s behavior and helping him to realize the true (internal) grounds for an altered mental state. The psychological support of the client (patient) is also considered essential for the interview.

The functions of the interview in clinical psychology are: diagnostic and therapeutic. They should be carried out in parallel, since only their combination can lead to the desired result for the psychologist - the recovery and rehabilitation of the patient. In this respect, the practice of clinical questioning, ignoring the psychotherapeutic function, turns the doctor or psychologist into an extra, whose role could be successfully performed by a computer.

Clients and patients often cannot accurately describe their condition and formulate complaints and problems. That is why the ability to listen to the presentation of a person's problems is only part of the interview, the second is the ability to tactfully help him formulate his problem, make him understand the origins of psychological discomfort - crystallize the problem. “Speech is given to a person in order to better understand himself,” wrote L. Vygotsky, and this understanding through verbalization in the process of a clinical interview can be considered essential and fundamental.

The principles of a clinical interview are: unambiguity, accuracy and accessibility of wording questions; adequacy, consistency (algorithmicity); flexibility, impartiality of the survey; verifiability of the received information.

The principle of unambiguity and accuracy in the framework of a clinical interview is understood as the correct, correct and precise formulation of questions. An example of ambiguity is such a question addressed to the patient: “Do you experience a mental impact on yourself?” An affirmative answer to this question does not give the diagnostician practically anything, since it can be interpreted in various ways. The patient could mean by "impact" both ordinary human experiences, events, people around him, and, for example, "energy vampirism", the impact of aliens, etc. This question is inaccurate and ambiguous, therefore uninformative and redundant.

The principle of accessibility is based on several parameters: vocabulary (linguistic), educational, cultural, cultural, linguistic, national, ethnic and other factors. The speech addressed to the patient must be understandable to him, must coincide with his speech practice, based on many traditions. The diagnostician asked: “Do you have hallucinations?” -- may be misunderstood by a person who encounters such a scientific term for the first time. On the other hand, if a patient is asked if he hears voices, then his understanding of the word “voices” may be fundamentally different from the doctor’s understanding of the same term. Availability is based on an accurate assessment by the diagnostician of the patient's status, the level of his knowledge; vocabulary, subcultural features, jargon practice.

One of the important parameters of the interview is the algorithmization (sequence) of the questioning, based on the knowledge of the diagnostician in the field of compatibility of psychological phenomena and psychopathological symptoms and syndromes; endogenous, psychogenic and exogenous types of response; psychotic and non-psychotic levels of mental disorders. A clinical psychologist must know hundreds of psychopathological symptoms. But if he asks about the presence of every symptom known to him, then this, on the one hand, will take a lot of time and will be tedious for both the patient and the researcher; on the other hand, it will reflect the incompetence of the diagnostician. The sequence is based on the well-known algorithm of psychogenesis: on the basis of the presentation of the first complaints by patients, the story of his relatives, acquaintances, or on the basis of direct observation of his behavior, the first group of phenomena or symptoms is formed. Further, the survey covers the identification of phenomena, symptoms and syndromes that are traditionally combined with those already identified, then the questions should be aimed at assessing the type of response (endogenous, psychogenic or exogenous), the level of disorders and etiological factors. For example, if the presence of auditory hallucinations is the first to be detected, then further questioning is built according to the following algorithm scheme: assessment of the nature of hallucinatory images (the number of "voices", their awareness and criticality, speech features, determining the location of the sound source according to the patient, the time of appearance etc.) - the degree of emotional involvement - the degree of criticality of the patient to hallucinatory manifestations - the presence of thinking disorders (delusional interpretations of "voices") and Further, depending on the qualification of the described phenomena, confirmation of exogenous, endogenous or psychogenic types of response with the help of a survey about the presence of, for example, disorders of consciousness, psychosensory disorders and other manifestations of a certain range of disorders. In addition to the above, the principle of sequence implies a detailed questioning in a longitudinal section: the order in which mental experiences appear and their connection with real circumstances. At the same time, every detail of the story is important, the context of events, experiences, interpretations is important.

The most significant are the principles of verifiability and adequacy of a psychological interview, when, in order to clarify the congruence of concepts and exclude incorrect interpretation of answers, the diagnostician asks questions like: “What do you understand by the word“ voices ”that you hear?” or “Give an example of the ‘voices’ being tested. If necessary, the patient is asked to specify the description of his own experiences.

The principle of impartiality is the basic principle of a phenomenologically oriented psychologist-diagnostician. Imposing on the patient his own idea that he has psychopathological symptoms on the basis of a biased or carelessly conducted interview can occur both due to a conscious attitude, and on the basis of ignorance of the principles of the interview or blind adherence to one of the scientific schools.

Considering the burden of responsibility, primarily moral and ethical, lying on the diagnostician in the process of psychological interview, it seems appropriate for us to cite the main ethical provisions of the American Psychological Association regarding counseling and interviewing:

1. Adhere to confidentiality: respect the rights of the client and his privacy. Do not discuss what he said during interviews with other clients. If you cannot comply with the confidentiality requirements, then you must inform the client about this before the conversation; let him decide for himself whether it is possible to go for it. If information is shared with you that contains information about a danger that threatens a client or society, then ethical regulations allow you to violate confidentiality for the sake of safety. However, one must always remember that, be that as it may, the psychologist's responsibility to the client who trusts him is always primary.

2. Realize the limits of your competence. There is a kind of intoxication that occurs after the psychologist has learned the first few techniques. Beginning psychologists immediately try to delve deeply into the souls of their friends and their clients. This is potentially dangerous. A novice psychologist should work under the supervision of a professional; Seek advice and suggestions to improve your work style. The first step to professionalism is knowing your limits.

3. Avoid asking about irrelevant details. The aspiring psychologist is mesmerized by the details and "important stories" of his clients. Sometimes he asks very intimate questions about sex life. It is common for a novice or inept psychologist to place great importance on the details of the client's life and at the same time miss what the client feels and thinks. Consulting is intended primarily for the benefit of the client, and not to increase your volume of information.

4. Treat the client the way you would like to be treated. Put yourself in the client's shoes. Everyone wants to be treated with respect, sparing his self-esteem. A deep relationship and a heart-to-heart conversation begins after the client has understood that his thoughts and experiences are close to you. A relationship of trust develops from the client's and counselor's ability to be honest.

5. Be aware of individual and cultural differences. It is safe to say that the practice of therapy and counseling, regardless of what cultural group you are dealing with, cannot be called an ethical practice at all. Are you prepared enough to work with people who are different from you?

The current situation in society allows us to talk about potentially or clearly existing conflicts in the field of communication. The clinical interview is no exception in this regard. Potential psychological difficulties in conducting interviews are possible at different levels - yesterday they covered one area; today - the second; tomorrow they may spread and a third. Without a trusting atmosphere, therapeutic empathy between a psychologist and a patient, qualified interviewing, diagnosis and psychotherapeutic effect are impossible.

Jacques Lacan's theory suggests that an interview is not just a relationship between two people physically present in a session. It is also the relationship of cultures. That is, at least four people are involved in the counseling process, and what we took for a conversation between a therapist and a client may turn out to be a process of interaction between their cultural and historical roots. The following figure illustrates the point of view of J. Lacan:

Figure 2.

Note that counseling is a more complex subject than simply giving advice to a client. Cultural affiliation must always be considered. In the figure above, the therapist and the client are what we see and hear during the interview. “But no one can get away from their cultural heritage. Some psychological theories tend to be anti-historic and underestimate the impact of cultural identity on the client. They focus mainly on the client-psychologist relationship, omitting more interesting facts of their interaction” (J. Lacan).

Schneiderman argued that "whoever seeks to erase cultural differences and create a society in which alienness does not exist, is moving towards alienation ... The moral denial of alienness is racism, one can hardly doubt it."

Empathy requires that we understand both the personal uniqueness and the “foreignness” (cultural-historical factor) of our client. Historically, empathy has focused on personal uniqueness, and the second aspect has been forgotten. For example, psychologists in the United States and Canada expect that all clients, regardless of their cultural background, will respond in the same way to the same treatment. Based on the concept of J. Lacan, then such therapy looks like this:

Figure 3

Thus, the cultural-historical influence is reflected in this interview, but the client and the psychologist are not aware of these problems, they are disconnected from them. In this example, the client is aware of the specifics of their cultural identity and takes it into account in their plans for the future. The psychologist, however, proceeds from a theory based on individual empathy and does not pay attention to this important circumstance. In addition, the client sees only a cultural stereotype in the counselor. “Such an example is by no means an exception to the rule, and many non-white clients who have tried to get counseling from an unqualified white therapist will readily confirm this” (A. Ivey).

Ideally, both - the psychologist and the client - are aware of and use the cultural-historical aspect. Empathy, on the other hand, cannot be considered a necessary and sufficient condition if one does not pay attention to the cultural aspect as well.

J. Lacan's model gives an additional impetus to building a certain level of empathy. Sometimes the client and the psychologist think that they are talking to each other, when in fact they are only passive observers of how two cultural settings interact.

In the process of a clinical interview, as experience shows and confirms the theory of J. Lacan, such components of the historical and cultural bases of a psychologist (doctor) and a client (patient) as: gender, age, religious beliefs and religion, racial characteristics (in modern conditions - - nationality); sexual orientation preferences. The effectiveness of the interview in these cases will depend on how the psychologist and the patient with different beliefs and characteristics will find a common language, what style of communication the diagnostician will offer to create an atmosphere of trust. Today we face relatively new problems in the field of therapeutic interaction. Patients conceived do not trust doctors, and doctors do not trust patients only on the basis of differences in national, religious, sexual (hetero-, homosexual) characteristics. A doctor (as well as a psychologist) should be guided by the current situation in the field of ethnocultural relations and choose a flexible communication tactic that avoids discussing acute global and non-medical problems, in particular national, religious ones, and even more so not to impose his point of view on these issues.

The described principles of the clinical interview reflect the basic knowledge, the theoretical platform on which the entire interviewing process is built. However, principles not supported by practical procedures will remain unused.

There are various methodological approaches to conducting interviews. It is believed that the duration of the first interview should be about 50 minutes. Subsequent interviews with the same client (patient) are somewhat shorter. The following model (structure) of a clinical interview can be proposed:

Stage I: Establishment of a "confidence distance". Situational support, provision of confidentiality guarantees; determining the dominant motives for conducting an interview.

Stage II: Identification of complaints (passive and active interviews), assessment of the internal picture - the concept of the disease; problem structuring,

Stage III: Evaluation of the desired outcome of the interview and therapy; determination of the patient's subjective model of health and preferred mental status.

Stage IV: Assessment of the patient's anticipatory abilities; discussion of probable outcomes of the disease (if it is detected) and therapy; anticipation training.

The above stages of a clinical psychological interview give an idea of ​​the essential points discussed during the meeting between the psychologist and the patient. This scheme can be used in each conversation, but it should be remembered that the specific weight - the time and effort allocated to one or another stage - varies depending on the order of meetings, the effectiveness of therapy, the level of observed mental disorders, and some other parameters. It is clear that during the first interview, the first three stages should be predominant, and during subsequent interviews, the fourth. Particular attention should be paid to the level of mental disorders of the patient (psychotic - non-psychotic); voluntariness or compulsory interview; criticality of the patient; intellectual features and abilities, as well as the real situation surrounding him.

The first stage of a clinical interview (“establishing a confidence distance”) can be defined as an active interview.” It is the most important and difficult. the patient does not begin with a formal one that has set the teeth on edge; “What are you complaining about?”, But with situational support. The interviewer takes the thread of the conversation into his own hands and, mentally putting himself in the place of a patient who first turned to a doctor (especially if he is in a psychiatric hospital), having felt the drama of the situation, the fear of the applicant being recognized as mentally ill or misunderstood or put on record helps him start a conversation.

In addition, at the first stage, the psychologist must identify the dominant motives for contacting him, make a first impression of the level of criticality of the interviewee to himself and psychological manifestations. This goal is achieved with the help of questions like: “Who initiated your appeal to a specialist?”, “Is your coming to talk with me your own desire or did you do it to calm relatives (acquaintances, parents, children, bosses)? »; “Does anyone know that you were going to see a specialist?”

Even when interviewing a patient with a psychotic level of disorder, it is advisable to begin the interview by providing assurances of confidentiality. Often effective for further conversation with such patients are phrases like: “You probably know that you can refuse to talk to me as a psychologist and psychiatrist?” In the vast majority of cases, this phrase does not cause a desire to leave the doctor's office, but rather turns out to be a pleasant revelation for the patient, who begins to feel free to dispose of information about himself and at the same time becomes more open to communication.

The active role of the doctor (psychologist) is interrupted at this point and the stage of the passive interview begins. The patient (client) is given time and opportunity to present complaints in the sequence and with those details and comments that he considers necessary and important. At the same time, the doctor or psychologist plays the role of an attentive listener, only clarifying the features of the manifestations of the patient's disease. Most often, the listening technique includes the following methods (Table 1).

The questions asked by the diagnostician are aimed at assessing the internal picture and concept of the disease, i.e. identifying the patient's ideas about the causes and reasons for the occurrence of certain symptoms in him. At the same time, the problem is structured, which remains frustrating at the time of the interview.

Table 1

The main stages of diagnostic listening (according to A-Ivn)

Methodology	Description	Function during the interview
Open questions	"What?" - reveals the facts; "How?" -- the senses; "Why?" -- the reasons; "Is it possible?" - big picture	Used to clarify basic facts and facilitate conversation
Closed questions	Usually include the particle “li”, they can be answered briefly	Gives the opportunity to reveal special facts, shorten too long monologues
Promotion (support)	Repetition of several key phrases of the client	Encourages detailed development of specific words and meanings
reflection of feeling	Draws attention to the emotional content of the interview	Clarifies the emotional background of key facts, helps to open feelings
retelling	Repetition of the essence of words client and his thoughts, using his keywords	Activates discussion, shows level of understanding
	Succinctly repeats key facts* and feelings of the client	It is useful to repeat periodically during the interview. Required at the end of the meeting.

Here, the diagnostician asks all sorts of questions regarding analysis and mental state, based on known diagnostic algorithms. In addition to listening, the psychologist should also use elements of influence during the interview.

Methods of influence in the interview process (according to A. Ivey)

table 2

	Description	Function during the interview
Interpretation	Sets a new framework in which the client can see the situation	An attempt to enable the client to see the situation in a new way - an alternative perception of reality, which contributes to a change in attitudes, thoughts, moods and behaviors
Directive (indication)	Tells the client what action to take. It can be just a wish or a technique.	Clearly shows the client what action the psychologist expects from him.
(information)	Gives wishes, general ideas, homework, advice on how to act, think, behave.,	Moderately used tips provide the client with useful information.
Self-disclosure	The psychologist shares personal experiences and experiences, or shares the feelings of the client.	Closely related to the reception of feedback, built on "I-sentences". Helps build rapport.
Feedback	Gives the client the opportunity to understand how the psychologist perceives him, as well as those around him.	Gives specific data that helps the client understand how to understand him, how others perceive his behavior and thinking style, which creates the possibility of self-perception.
logical subsequence	Explains to the client the logical consequences of his thinking and behavior. "If...then."	Gives the client a different point of reference. This method helps people anticipate the results of their actions.
Impact Resume	Often used at the end of a conversation to formulate the psychologist's judgments. Often used in combination with a client's resume.	Clarifies what the psychologist and client achieved during the conversation. Summarizes what the therapist said. Designed to help the client transfer these generalizations from the interview to real life.

Essential at this stage of the interview is the collection of the so-called psychological and medical anamnesis - the history of life and illness. The task of the psychological anamnesis is to obtain information from the patient to assess his personality as an established system of attitudes towards himself and, in particular, attitudes towards the disease and assess how much the disease has changed this entire system. Important are the data on the course of the disease and the life path, which are designed to reveal how the disease is reflected in the subjective world of the patient, how it affects his behavior, on the entire system of personal relationships. Outwardly, the medical and psychological history as research methods are very similar - the questioning could go according to a single plan, but their purpose and the use of the data obtained are completely different (V.M. Smirnov, T.N. Reznikova).

The next (III) stage of the clinical interview is aimed at identifying the patient's ideas about the possible and desired results of the interview and therapy. The patient is asked: “Which of what you told me would you like to get rid of first of all? How did you imagine our conversation before coming to me and what do you expect from it? How do you think I could help you?"

The last question aims to identify the patient's preferred mode of therapy. After all, it is not uncommon for a patient, after presenting complaints (often diverse and subjectively severe) to a doctor, to refuse treatment, referring to the fact that he does not take any medications in principle, is skeptical about psychotherapy, or does not trust doctors at all. Such situations indicate the desired psychotherapeutic effect from the interview itself, from the opportunity to speak out, to be heard and understood.

In some cases, this turns out to be sufficient for a certain part of those who seek advice from a doctor or psychologist. Indeed, often a person comes to a doctor (especially a psychiatrist) not for a diagnosis, but in order to get confirmation of his own beliefs about his mental health and balance.

At the fourth and final stage of the clinical interview, the interviewer takes on an active role again. Based on the identified symptoms, having the patient's understanding of the concept of the disease, knowing what the patient expects from treatment, the interviewer-psychologist directs the interview into the mainstream of anticipatory training. As a rule, a neurotic is afraid to think and even discuss with anyone the possible sad outcomes of the conflict situations that exist for him, which caused him to go to the doctor and get sick.

Anticipatory training, which is based on the anticipatory concept of neurogenesis (V.D. Mendelevich), is aimed, first of all, at the patient's thinking out the most negative consequences of his illness and life. For example, when analyzing a phobic syndrome within the framework of a neurotic register, it is advisable to ask questions in the following sequence: “What exactly are you afraid of? “Something bad is about to happen. - How do you suppose and feel with whom this bad thing should happen: with you or with your loved ones? - I think with me. - What exactly do you think? - I'm afraid to die. What does death mean to you? Why is she terrible? -- I do not know. - I understand that it is an unpleasant occupation to think about death, but I ask you to think about what exactly you are afraid of in death? I will try to help you. For one person, death is non-existence, for another, it is not death itself that is terrible, but the suffering and pain associated with it; for the third, it means that children and loved ones will be helpless in the event of death, etc. What is your opinion about this? -- ...--»

Such a technique within the framework of a clinical interview performs both the function of a more accurate diagnosis of the patient's condition, penetration into the secret secrets of his illness and personality, and a therapeutic function. We call this technique anticipatory training. It can be considered a pathogenetic method for the treatment of neurotic disorders. The use of this method when interviewing patients with psychotic disorders performs one of the functions of the interview - it clarifies the diagnostic horizons to a greater extent, and this has a therapeutic effect.

The clinical interview consists of verbal (described above) and non-verbal methods, especially in the second stage. Along with questioning the patient and analyzing his answers, the doctor can recognize a lot of important information that is not dressed in verbal form.

The language of facial expressions and gestures is the foundation on which counseling and interviewing are based (Harper, Wiens, Matarazzo, A. Ivey). Non-verbal language, according to the last author, functions at three levels:

* Terms of interaction: for example, the time and place of the conversation, the design of the office, clothing and other important details, most of which affect the nature of the relationship between two people;

* Information flow: for example, important information often comes to us in the form of non-verbal communication, but much more often non-verbal communication modifies the meaning and rearranges the accents in the verbal context;

* Interpretation: Each individual, belonging to any culture, has completely different ways of interpreting non-verbal communication. What one perceives from non-verbal language may be fundamentally different from what another understands.

Extensive research in Western psychological science on the study of listening skills has shown that the standards of eye contact, torso tilt, medium timbre of the voice may be completely unsuitable in communicating with some clients. When a clinician is working with a depressed patient or someone who is talking about sensitive matters, eye contact during the interaction may be inappropriate. Sometimes it is wise to look away from the speaker.

visual contact. Without forgetting cultural differences, it should still be noted the importance of when and why an individual stops making eye contact with you. “It is the movement of the eyes that is the key to what is happening in the client's head,” says A. Ivey, “Usually, visual contact stops when a person speaks on a sensitive topic. For example, a young woman may not make eye contact when she talks about her partner's impotence, but not when she talks about her solicitousness. This may be a real sign that she would like to maintain a relationship with her lover. However, more than one conversation is required to accurately calculate the meaning of a change in non-verbal behavior or visual contact, otherwise there is a high risk of drawing erroneous conclusions.

Language of the body. Representatives of different cultures naturally differ in this parameter. Different groups put different content into the same gestures. It is believed that the most informative in body language is the change in torso tilt. The client may sit naturally and then, for no apparent reason, clench their hands, cross their legs, or sit on the edge of a chair. Often these seemingly minor changes are indicators of conflict in the person.

intonation and tempo of speech. The intonation and pace of a person's speech can say as much about him, especially about his emotional state, as verbal information. How loudly or quietly sentences are spoken can serve as an indicator of the strength of feelings. Rapid speech is usually associated with a state of nervousness and hyperactivity; while slow speech may indicate lethargy and depression.

Following AAivy and his colleagues, we note the importance of such parameters as the construction of speech in the interview process. According to these authors, the way people construct sentences is an important key to understanding their perception of the world. For example, it is proposed to answer the question: “What will you tell the controller when he starts checking the availability of tickets, and you find yourself in a difficult situation?”: a) The ticket is torn, b) I tore the ticket, c) The car tore the ticket, or d) Something what happened?

Explaining even such an insignificant event can serve as a key to understanding how a person perceives himself and the world around him. Each of the above sentences is true, but each illustrates a different worldview. The first sentence is just a description of what happened; the second - demonstrates a person who takes responsibility and indicates an internal locus of control; the third represents external control, or "I didn't do it," and the fourth indicates a fatalistic, even mystical, outlook.

Analyzing the structure of sentences, we can come to an important conclusion regarding the psychotherapeutic process: the words that a person uses when describing events often give more information about him than the event itself. The grammatical structure of sentences is also an indicator of personal worldview.

The research and observations of Richard Bandler and John Grinder, the founders of neurolinguistic programming, focused the attention of psychologists and psychotherapists on the linguistic aspects of diagnosis and therapy. For the first time, the significance of the words used by the patient (client) and the construction of phrases in the process of understanding the structure of his mental activity, and hence personal characteristics, was noted. Scientists have noticed that people talk differently about similar phenomena. One, for example, will say that he “sees” how his spouse treats him badly; another will use the word "know"; the third is "I feel" or "feel"; the fourth - will say that the spouse does not "listen" to his opinion. Such a speech strategy indicates the predominance of certain representational systems, the presence of which must be taken into account in order to “connect” to the patient and create true mutual understanding within the interview.

According to D. Grinder and R. Bandler, there are three types of mismatches in the structure of the interviewee's speech, which can serve to study the deep structure of a person: deletion, distortion and overgeneralization. Crossing out can appear in sentences such as "I'm afraid." To questions like “Who or what are you afraid of?”, “For what reason?”, “In what situations?”, “Do you feel fear now?”, “Is this fear real or its causes are unreal?” -- usually no responses. The task of the psychologist is to "expand" a brief statement about fear, to develop a complete representative picture of the difficulties. During this "filling in the crossed out" process, new surface structures may appear. Distortion can be defined as an unconstructive or incorrect proposal. These proposals distort the real picture of what is happening. A classic example of this would be a sentence like, "He's making me crazy," while the truth is that a person who "makes another crazy" is only responsible for his own behavior. A more correct statement would be: "I get very angry when he does this." In this case, the client takes responsibility for his behavior and begins to control the direction of his actions. Distortions often develop from strikeouts on the surface structure of a sentence. At a deeper level, a close examination of the client's life situation reveals many distortions of reality that exist in his mind. Overgeneralization occurs when the client draws far-reaching conclusions without having sufficient evidence for this. Overgeneralization is often accompanied by distortions. The words accompanying overgeneralizations are usually the following: "all people", "everyone in general", "always", "never", "the same", "always", "forever" and others.

The use of verbal and non-verbal communication contributes to a more accurate understanding of the patient's problems and allows you to create a mutually beneficial situation during the clinical interview.

Experimental-psychological (patho- and neuropsychological) research methods

Pathopsychological research methods.

Under pathopsychological studies (experiments) in modern psychology is understood the use of any diagnostic procedure in order to model an integral system of cognitive processes, motives and "personal relations" (B.V. Zeigarnik).

The main tasks of paraclinical methods in clinical psychology are the detection of changes in the functioning of individual mental functions and the identification of pathopsychological syndromes. A pathopsychological syndrome is understood as a pathogenetically determined community of symptoms, signs of mental disorders, internally interdependent and interconnected (V.M. Bleikher). Pathopsychological syndromes include a set of behavioral, motivational and cognitive features of the mental activity of patients, expressed in psychological terms (V.V. Nikolaeva, E.T. Sokolova, A.S. Pivakovskaya). It is believed that the pathopsychological syndrome reflects violations of various levels of functioning of the central nervous system. According to A.Rluriya, Yu.F.Polyakov, in the system of hierarchy of brain processes, such levels are distinguished as: and neuropsychological (which are characterized by a violation of the course of mental processes and the properties of the psyche associated with them), psychopathological (manifested by clinical symptoms and syndromes of mental pathology).

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

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

* schizophrenic

* affective-endogenous

* oligophrenic

* exogenous-organic

* endogenous-organic

* personality-abnormal

* psychogenic-psychotic

* psychogenic-neurotic

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

The psychopathic (personality-abnormal) symptom complex includes: emotional-volitional disorders, violations of the structure and hierarchy of motives, inadequacy of self-esteem and the level of claims, impaired thinking in the form of "relative affective dementia", impaired prediction and reliance on past experience.

The organic (exo- and endogenous) symptom complex is characterized by such signs as: a general decrease in intelligence, the collapse of existing information and knowledge, mnestic disorders affecting both long-term and operative memory, impaired attention and mental performance, impaired operational side and purposefulness of thinking, changes in emotional spheres with affective lability, violation of critical abilities and self-control.

The oligophrenic symptom complex includes such manifestations as: inability to learn and form concepts, lack of intelligence, lack of general information and knowledge, primitive and concrete thinking, inability to abstract, increased suggestibility, emotional disorders.

Identification of pathopsychological register-syndromes allows the clinical psychologist not only to fix disorders in various areas of mental activity, but also to rank them according to the mechanisms of occurrence. In addition, the correct qualification of the pathopsychological syndrome allows the clinician to verify the nosological diagnosis and direct corrective and therapeutic work in the right direction. To a greater extent, register syndromes are significant for pathopsychological studies in a psychiatric clinic, to a lesser extent - in a somatic clinic.

Paraclinical research methods in clinical psychology represent an extensive set of methods for assessing brain activity. Each of them represents the tools of any field of science. As a result, the development of all paraclinical methods and diagnostic methods is not within the competence of clinical psychologists. But the ability to select paraclinical methods necessary for a specific clinically identified pathology, to justify the need for their use, to correctly interpret the results obtained with their help is considered an integral part of the activity of a clinical psychologist.

Table 3

The main methods of pathopsychological diagnostics for violations of certain areas of mental activity

The sphere of mental activity in which violations are noted	Pathopsychological technique
Attention disorders	Schulte tables correction test Kraepelin account Munsterberg method
Memory disorders	test ten words pictogram
Perceptual disorders	sensory excitability of the Aschaffenburg, Reichardt, Lipman tests
Thinking disorders	tests for classification, exclusion, syllogisms, analogies, generalization associative experiment Everrier problem, pictogram test of discrimination of properties of concepts
Emotional disorders	Spielberger test Luscher color selection method
Intellectual Disorders	Raven test Wexler test

Pathopsychological diagnostics uses a battery of experimental psychological test methods, with the help of which

it is possible to evaluate the functioning of both individual spheres of mental activity and integrative formations - types of temperament, character traits, personal qualities.

The choice of specific methods and methods of pathopsychological diagnostics in clinical psychology is based on the identification of cardinal psychopathological deviations in various types of mental response in certain areas of mental activity. Table 3 presents the indications for the use of certain methods of pathopsychological diagnostics.

Pathopsychological assessment of attention disorders

To confirm the clinically detected attention disorders, the most adequate pathopsychological methods are the evaluation of attention according to the Schulte tables, the results of thinning the correction test and the Kraepelin count.

Schulte tables are a set of numbers (from 1 to 25) not placed in random order in the cells. The subject must show and name in a given sequence (as a rule, increasing from one to twenty-five) all the numbers. The subject is offered four or five non-identical Schulte tables in a row, in which the numbers are arranged in a different order. The psychologist records the time spent by the subject on showing and naming the entire series of numbers in each table separately. The following indicators are noted: 1) exceeding the standard (40-50 seconds) time spent on pointing and naming a series of numbers in the tables; 2) the dynamics of temporal indicators during the survey process for all five tables.

Schulte tables. one.

According to the results of this test, the following conclusions about the characteristics of the attention of the subject are possible:

Attention is concentrated enough - if the subject spends time corresponding to the standard on each of the Schulte tables.

Attention is not concentrated enough - in the event that the subject spends time exceeding the standard on each of the Schulte tables.

Attention is stable - if there are no significant time differences when counting the numbers in each of the four to five tables.

Attention is unstable - if there are significant fluctuations in the results according to the tables without a tendency to increase the time spent on each subsequent table.

Attention depleted - if there is a tendency to increase the time spent by the subject on each next table.

The Kraepelin score technique is used to study fatigue. The subject is asked to add in his mind a series of single-digit numbers written in a column. The results are evaluated by the number of numbers added in a certain period of time and errors made.

When conducting a correction test, special forms are used, on which a series of letters are shown, arranged in a random order. The instruction provides for the test subject to cross out one or two letters at the choice of the researcher. At the same time, every 30 or 60 seconds, the researcher makes marks in the place of the table where the subject's pencil is at that time, and also registers the time spent on the entire task.

The interpretation is the same as when evaluating the results according to the Schulte tables. Normative data on the correction test: 6-8 minutes with 15 errors.

The Munsterberg technique is designed to determine the selectivity of attention. It is a literal text, among which there are words. The task of the subject as quickly as possible reading the text, underline these words. You have two minutes to work. The number of selected words and the number of errors (missing or incorrectly highlighted words) are recorded.

Münsterberg technique

bsopnceevtrgschofionzshchnoeost

sukengshizhwafyuropdbloveavyfrplshd

bkyuradostwufciejdlorrgshrodshljhashshchgiernk

zhdorlvfuyuvfbcompetitionfnguvskaprpersonality

eprppvaniedptyuzbyttrdshschnprkkukom

janvtdmjgftasenplaboratorygsh

Attention disorders are not specific to any mental illness, types of mental response, levels of mental disorders. However, it is possible to note the specifics of their changes in various mental pathologies. So, they are most clearly represented in the structure of the exogenously organic type of mental response, manifesting themselves as impaired concentration and stability of attention, rapid exhaustion, and difficulties in switching attention. Similar disorders are found in neuroses. Within the framework of the endogenous type of mental response, attention disorders are not decisive (as a rule, they are either absent or secondary to other psychopathological phenomena). Despite this, there is evidence (E.Krepelin) that in schizophrenia, violations of active attention are characteristic, while passive attention is preserved. This distinguishes patients with schizophrenia from patients with exogenous organic and neurotic mental disorders.

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