medical psychology

Clinical psychologists can work with adults or children individually, with couples and families, and with groups, as shown in the illustration.

Clinical psychology- an extensive section of applied psychology (at the junction with psychiatry), which studies individual characteristics in terms of related medical reactions and phenomena.

The field of clinical psychology includes the assessment of mental health, the organization and conduct of scientific research to understand mental problems, and the development, implementation and evaluation of psychological correction and assistance (psychotherapy). Psychotherapeutic methods of clinical psychology: counseling, individual psychotherapy, family psychotherapy, family counseling and various forms of support for people experiencing adaptation problems.

The term "clinical psychology" was coined by the American psychologist Lightner Whitmer (1867-1956), who narrowly defined it as the study of individuals through observation or experiment with the intention of producing change. According to the American Psychological Association's modern definition:

The field of clinical psychology integrates science, theory, and practice to understand, predict, and alleviate maladjustment, disability, and discomfort, as well as promote adaptation, adjustment, and personal development. Clinical psychology focuses on the intellectual, emotional, biological, psychological, social, and behavioral aspects of human functioning throughout life, across cultures, and at all socioeconomic levels.

Subject of Clinical Psychology

Clinical psychology is a broad specialty that has an intersectoral character and is involved in solving a set of problems in the healthcare system, public education and social assistance to the population. The work of a clinical psychologist is aimed at increasing the psychological resources and adaptive capabilities of a person, harmonizing mental development, protecting health, preventing and overcoming illnesses, and psychological rehabilitation.

In Russia, the term " medical psychology”, which defines the same field of activity. In the 1990s, as part of bringing the Russian educational program to international standards, the specialty "clinical psychology" was introduced in Russia. Unlike Russia, in which medical psychology and clinical psychology often actually represent the same area of ​​psychology, in international practice, medical psychology usually means a narrow sphere of psychology of the relationship between a doctor or therapist and a patient and a number of other highly specific issues, while time, as clinical psychology is a holistic scientific and practical psychological discipline.

The subject of clinical psychology as a scientific and practical discipline:

• Mental manifestations of various disorders.
• The role of the psyche in the occurrence, course and prevention of disorders.
• The impact of various disorders on the psyche.
• Developmental disorders of the psyche.
• Development of principles and methods of research in the clinic.
• Psychotherapy, conducting and developing methods.
• Creation of psychological methods of influencing the human psyche for therapeutic and prophylactic purposes.

Clinical psychologists are engaged in the study of general psychological problems, as well as the problem of determining the norm and pathology, determining the relationship between the social and biological in a person and the role of the conscious and the unconscious, as well as solving problems of the development and decay of the psyche.

History of clinical psychology in Russia

The prerequisites for the emergence of clinical psychology were laid by the psychological research of French and Russian psychiatrists at the end of the 19th century. In France, R. Ribot, I. Taine, J.-M. Charcot, P. Janet. In Russia, pathopsychological studies were conducted by S. S. Korsakov, I. A. Sikorsky, V. M. Bekhterev, V. Kh. Kandinsky and other psychiatrists. The first psychological laboratory in our country was founded by V. M. Bekhterev in the city at the psychiatric clinic of Kazan University. In the 20th century, numerous studies were carried out on the base.
An important role in the development of clinical psychology as a science was played by the ideas of L. S. Vygotsky, which were further developed in general psychology by his students and colleagues A. N. Leontiev, A. R. Luria, P. Ya. Galperin, and others.
The development of clinical psychology in Russia was seriously promoted by such outstanding domestic scientists as V. P. Osipov, G. N. Vyrubov, I. P. Pavlov, V. N. Myasishchev. A significant scientific and organizational contribution to the development of clinical psychology in Russia in recent years has been made by Myasishchev's student B. D. Karvasarsky.

Sections of clinical psychology

Pathopsychology and clinical pathopsychology

Pathopsychology deals with the issues of human mental disorders, disorders of adequate perception of the world due to lesions of the central nervous system. Pathopsychology studies the patterns of disintegration of mental processes in various disorders (diseases), as well as factors that contribute to the creation of effective corrective methods of treatment.

The practical tasks of pathopsychology include the analysis of the structure of mental disorders, the establishment of the degree of decrease in mental functions, differential diagnosis, the study of personality characteristics and the study of the effectiveness of therapeutic interventions.

There is a difference between pathopsychology, or the consideration of the human mental sphere from the point of view of the methods of psychology, and psychopathology, which considers the human psyche from the point of view of nosology and psychiatry. Clinical psychopathology investigates, reveals, describes and systematizes the manifestations of disturbed mental functions, pathopsychology, on the other hand, reveals by psychological methods the nature of the course and structural features of mental processes leading to disorders observed in the clinic.

B. V. Zeigarnik and S. Ya. Rubinshtein are considered the founders of Russian pathopsychology.

Neuropsychology

Neuropsychology is a broad scientific discipline that studies the role of the brain and the central nervous system in mental processes, touching on issues of both psychiatry and neurology, as well as philosophy of mind, cognitive science, and artificial neural networks.

The Soviet school of neuropsychology was mainly concerned with the study of causal relationships between brain lesions, their localization, and changes in mental processes. Its tasks included the study of impaired mental functions as a result of brain damage, the study of the localization of the lesion and the restoration of impaired mental functions, as well as the development of theoretical and methodological problems of general and clinical psychology.

The leading role in the creation of neuropsychology as an independent discipline was played by Soviet scientists A. R. Luria and L. S. Vygotsky, whose research has received worldwide recognition.

Psychosomatics

Psychosomatics explores the problems of patients with somatic disorders, in the origin and course of which the psychological factor plays an important role. The scope of psychosomatics includes issues related to oncological and other serious diseases (diagnosis notification, psychological assistance, preparation for surgery, rehabilitation, etc.) and psychosomatic disorders (when experiencing acute and chronic mental trauma; problems include symptoms of coronary heart disease, peptic ulcer diseases, hypertension, neurodermatitis, psoriasis and bronchial asthma).

Psychological correction and psychotherapy

Psychological correction, or psychocorrection, is associated with the peculiarities of helping a sick person. Within the framework of this section, the development of the psychological foundations of psychotherapy, psychological rehabilitation as a systemic medical and psychological activity aimed at restoring personal social status through various medical, psychological, social and pedagogical measures, mental hygiene as a science of maintaining and maintaining mental health, psychoprophylaxis, or a combination measures to prevent mental disorders, as well as medical and psychological examination (examination of working capacity, forensic psychological examination, military psychological examination).

Clinical Psychology and Psychiatry

Although clinical psychologists and psychiatrists share a common fundamental goal - the treatment of mental disorders - their training, views and methodologies are often very different. Perhaps the most important difference is that psychiatrists are medical doctors with at least 4-5 years of medical training and a few more years of internship, during which they can often choose to specialize (eg, working with children or the disabled). A consequence of this is that psychiatrists tend to use the medical model to evaluate psychological problems (i.e., they treat clients as patients with illnesses), and their treatment is often based on the use of psychotropic drugs as the main method of achieving a therapeutic effect (although many psychiatrists and use psychotherapy in their activities). Their medical training allows them to make full use of all the medical equipment of a modern clinic.

Clinical psychologists, on the other hand, generally do not prescribe drugs, although in recent years there has been a move in some US states to allow psychologists to prescribe drugs with some restrictions. To do this, they need to undergo additional special training, and medications are mainly limited to psychotropic drugs. Typically, however, many clinical psychologists work in collaboration with psychiatrists to meet all their therapeutic needs.

Methods of clinical psychology

In clinical psychology, many methods are used to objectify, differentiate and qualify various variants of the norm and pathology. The choice of technique depends on the task facing the psychologist, the mental state of the patient, the education of the patient, the degree of complexity of the mental disorder. There are the following methods:

• Psychophysiological methods (for example, EEG)
• Exploring the products of creativity
• Anamnestic method (collection of information about the treatment, course and causes of the disorder)
• Experimental psychological method (standardized and non-standardized methods)

Psychotherapy

Psychotherapy is the main method of psychological correction carried out by a clinical psychologist, in general terms, it is a set of techniques and methods used by a psychotherapist to change a person’s psycho-emotional state, his behavior and communication patterns, improve his well-being and improve his ability to adapt in society. Psychotherapy is carried out both individually and in groups.

There are many different areas of psychotherapy: psychodynamic psychotherapy, cognitive psychotherapy, humanistic psychotherapy, family psychotherapy, Gestalt psychotherapy, body-oriented psychotherapy; in recent decades, there has also been an emergence of transpersonal types of psychotherapy, as well as gradual recognition of NLP psychotherapy.

The problem of mental norm and pathology

Clinical psychology deals with the problem of determining what is a mental norm and pathology. Within the framework of the nosological approach, it is customary to distinguish two states of a person - health and illness.

Typical signs health the structural and physical safety of the nervous system and human organs, individual adaptability to the physical and social environment, the preservation of a stable habitual state of health are considered.

Disease characterized by a general or partial decrease in adaptability, while the following possible outcomes of the disease are distinguished: complete recovery, recovery with the presence of residual effects, disability (obtaining a defect) and death.

Also allocate pathological mental state, due to the etiology of the process and having no outcome.

The issue of determining the norm and pathology is extremely complex and affects various areas of human activity - from medicine and psychology to philosophy and sociology. A number of attempts were made to derive the criteria for a mental norm, which included maturity of feelings corresponding to a person’s age, an adequate perception of reality, the presence of harmony between the perception of phenomena and an emotional attitude towards them, the ability to get along with oneself and the social environment, flexibility of behavior, a critical approach to life circumstances , the presence of a sense of identity, the ability to plan and evaluate life prospects. In many cases, the mental norm determines how much an individual is adapted to life in a social environment, how productive and critical he is in life.

When making a diagnosis, psychiatrists and clinical psychologists use both personal experience and general recommendations, as well as the International Classification of Diseases (ICD) and the Diagnostic and Statistical Handbook of Mental Disorders (

Notes

see also

Wikimedia Foundation. 2010 .

medical psychology science

Medical psychology, includes the following sections:

1.) Pathopsychology, a branch of psychology that studies the patterns of disorders of mental activity and personality traits based on comparison with the patterns of their formation and course in the norm.

The development of pathopsychology is closely intertwined with the development of psychiatry. The first experimental psychological laboratories in neuropsychiatric institutions were created at the end of the 19th century. German psychologist W. Wundt, Russian psychoneurologists V.M. Bekhterev and S.S. Korsakov.

At the beginning of the 20th century the first manuals on the use of experimental psychological methods for the study of mental patients began to be published. In the development of pathopsychology in Russia, the ideas of L.S. Vygotsky.

Pathopsychological research is of great importance for a number of general methodological problems of psychology, for example, for resolving the issue of the relationship between biological and social in development. psyche. The data of these studies show that a violation of the personality does not mean the "release" of its biological instincts and needs, but is characterized, first of all, by a change in the very human motives and needs. It is also established that the regularities of the disintegration of the psyche do not repeat the stages of its development in reverse order.

The data of pathopsychological studies are used in psychiatry: as diagnostic criteria; when establishing the degree of intellectual decline; during the examination (judicial, labor, military); when taking into account the effectiveness of treatment, especially when using psychopharmacological agents; in the analysis of violations of mental activity in the case of harmful working conditions; when deciding on the restoration of lost performance.

Pathopsychology uses experimental research methods, the main principle of which is a qualitative analysis of mental disorders as a mediated and motivated activity. The pathopsychological experiment provides an opportunity to update not only mental operations, but also the motives of a sick person. The pathopsychology of childhood received particular development, in which, on the basis of Vygotsky's position on the "zone of proximal development", special methods were developed, in particular the method of a teaching experiment.

Methods of medical psychology, not differing in principle from the methods of general psychology, are specified depending on the nature of the disease. Particular attention is paid to medical psychology history- analysis of the patient's past experiences from infancy to the moment of illness.

2). Anamnesis (Greek anamnesis - recollection), information about the patient's living conditions that preceded this disease, as well as the entire history of the development of the disease.

Anamnesis is an integral part of every medical examination, often giving the necessary indications for the diagnosis of the disease. Distinguish between a general history and anamnesis of the disease. The general history includes answers to the following groups of questions: diseases of parents and close relatives (hereditary diseases, malignant tumors, mental illness, tuberculosis, syphilis, etc.); previous diseases and operations, lifestyle (marital status, nutritional conditions), habits (alcohol consumption, smoking), sexual life, working conditions, all living conditions.

The anamnesis of this disease concerns the onset of the disease, the course and treatment of it until the day of the study. The anamnesis is collected from the story of the patient himself or those around him.

In veterinary practice, anamnesis is collected by interviewing animal caregivers, studying documentary data (case histories, etc.). The origin of the animal and the state of health of its parents, the presence of diseases in the farm to which the animal belongs, the conditions of care and maintenance (characteristics of feeding, watering, premises for the animal, operating conditions) are established. They find out previous diseases, the time of occurrence of this disease, its signs, cases of a similar disease in the household, information about the treatment used.

3). The painful nature of the experience, the insolubility of the pathogenic situation, the duration of the psychotraumatic stress- all these factors can be understood and explained only taking into account the individual characteristics of the personality and character of the patient.

Stress (from English stress - pressure, pressure, tension),

• 1) in technology - an external force applied to an object and causing its deformation.
• 2) in psychology, physiology and medicine - a state of mental stress that occurs in a person during activities in difficult conditions (both in everyday life and in specific circumstances, for example, during space flight). The concept of stress was introduced by the Canadian physiologist G. Selye(1936) when describing adaptation syndrome.

Stress can have both positive and negative effects on activity, up to its complete disorganization, which sets the task of studying a person’s adaptation to difficult (so-called extreme) conditions, as well as predicting his behavior, especially in such conditions.

Further development of medical psychology leads to the allocation of such branches as clinical psychophysiology (clinical psychosomatology) and clinical psychology. neuropsychology, psychological problems of defectology and pathology. Medical psychology is the foundation psychotherapy and mental hygiene.

4) Neuropsychology, a branch of psychology that studies the brain basis of mental processes and their relationship with individual systems brain; developed as a division neurology.

For centuries, idealistic psychology proceeded from the idea of ​​the parallelism of brain (physiological) and conscious (mental) processes or from the idea of ​​the interaction between these two areas, which were considered independent.

Only in the second half of the 19th century. in connection with the success of the study of the brain and the development of clinical neurology, the question was raised about the role of individual parts cerebral cortex in mental activity. Pointing out that when certain areas of the cortex of the left (leading) hemisphere are affected, individual mental processes (vision, hearing, speech, writing, reading, counting) are disturbed, neurologists suggested that these areas of the cerebral cortex are the centers of the corresponding mental processes and that "mental functions" are localized in certain limited areas of the brain. This is how the doctrine of the localization of mental functions in the cortex was created. However, this teaching, which bore a "psychomorphological" character, was simplified.

Modern neuropsychology proceeds from the position that the complex forms of mental activity that have formed in the process of social development and represent the highest forms of conscious reflection of reality are not localized in narrowly limited areas ("centers") of the cortex, but represent complex functional systems, in the existence of which the complex takes part. working areas of the brain. Each part of the brain makes a specific contribution to the construction of this functional system. Thus, brain stem regions and reticular formation provide energy tone of the cortex and are involved in maintaining wakefulness. The temporal, parietal and occipital regions of the cerebral cortex are an apparatus that provides the receipt, processing and storage of modal-specific (auditory, tactile, visual) information that enters the primary sections of each zone of the cortex, is processed in more complex "secondary" sections of these zones and combines, is synthesized in the "tertiary" zones (or "overlap zones"), especially developed in humans. The frontal, premotor and motor areas of the cortex are an apparatus that ensures the formation of complex intentions, plans and programs of activity, implements them in a system of corresponding movements and makes it possible to exercise constant control over their course.

Thus, the entire brain is involved in the performance of complex forms of mental activity.

Neuropsychology is essential for understanding the mechanisms of mental processes. At the same time, by analyzing mental disorders that occur with local brain lesions, neuropsychology helps to clarify the diagnosis of local brain lesions (tumors, hemorrhages, injuries), and also serves as the basis for the psychological qualification of the resulting defect and for restorative education, which is used in neuropathology and neurosurgery.

In Russia, problems of neuropsychology are dealt with at the Department of Neuropsychology, Faculty of Psychology, Moscow State University, in a number of laboratories and neurological clinics. A great contribution to the development of neuropsychology was made by scientists from other countries: Kh.L. Teuber and K. Pribram (USA), B. Milner (Canada), O. Zangwill (Great Britain), A. Ekaen (France), E. Weigl (GDR). The special journals "Neuropsychologia" (Oxf., since 1963) are devoted to the problems of neuropsychology. Cortex (Mil., since 1964) and others. There is an international society for neuropsychology.

5) Psychotherapy (from psycho... and Greek therapia - treatment), a system of mental influences aimed at treating the patient. The goal of psychotherapy is to eliminate painful deviations, to change the patient's attitude towards himself, his condition and the environment. The ability to influence the human psyche was noticed in antiquity. The formation of the scientific began in the 40s. 19th century (the work of the English physician J. Brad, who explained the effectiveness of mental influence by the functional features of the human nervous system). The theoretical substantiation and practical development of special methods of psychotherapy are associated with the activities of Zh.M. Charcot, V.M. Bekhterev and many others. A certain influence on the development of psychotherapy was exerted by the method psychoanalysis increased attention to the world of internal human experiences, to the role they play in the origin and development of diseases; but Freudianism(and earlier - in the first half of the 19th century - the school of "psychics" who considered mental illness as a result of the "oppression of sin") an irrational approach to understanding the nature of mental illness is inherent. Psychotherapy in the USSR is based on data from medical psychology and physiology higher nervous activity, clinical and experimental research method.

There are general and private, or special, psychotherapy. General psychotherapy is understood as a complex of psychological influences that strengthen the patient's strength in the fight against the disease (the relationship between the doctor and the patient, the optimal psychological climate in the institution, which excludes mental trauma and iatrogenic diseases, prevention and timely elimination of secondary neurotic layers that can be caused by the underlying disease). General psychotherapy is a necessary component of the treatment process for all forms of diseases. Private psychotherapy is a method of treating patients with the so-called borderline forms of neuropsychiatric disorders ( neuroses, psychopathy etc.), using special methods of psychotherapeutic influence: rational (explaining) psychotherapy, suggestion in the waking state and hypnosis distraction psychotherapy, autogenic training, collective psychotherapy, etc. (in combination with medication and other methods of treatment). Psychotherapy is impossible without positive emotional contact with the patient.

6) Mental hygiene, a section of hygiene that studies the measures and means of forming, maintaining and strengthening the mental health of people and preventing mental illness. Theoretical basis Psychohygiene - social and general psychology, psychotherapy, social psychiatry and physiology higher nervous activity. The first special work "Hygiene of Passions, or Moral Hygiene" belongs to Galena. The original idea for Psychohygiene of the dependence of people's mental health on the conditions of their social life was put forward by J.Zh. Cabanis. The founder of Psychohygiene in Russia, I. P. Merzheevsky, saw the most important means of preserving mental health and increasing the productivity of activity in the high aspirations and interests of the individual. Psychohygiene in Russia is characterized by predominant attention to such social measures as improving working and living conditions, the consistent formation of active socially valuable attitudes in adolescents, professional orientation that contributes to the implementation of these attitudes, as well as to psychohygienic education and training in special methods of managing one's own mental state. and well-being. An Important Method of Mental Hygiene-- clinical examination persons with neuropsychiatric disorders. The actual tasks of P. include the prevention of mental trauma in children and the development of ways to rationalize the learning process in secondary and higher schools (in order to prevent neuropsychic overload). In connection with the consequences of the scientific and technological revolution, the importance of managing the psychological climate in large and small social groups, as well as methods of increasing the mental stability of workers in professions of increased complexity, is growing. Sections of Psychohygiene: industrial (Psychological occupational hygiene), mental work, sexual life and family relations, children and adolescents, the elderly.

medical psychology

(from lat. medicus - medical, medical) - a branch of psychology that studies the psychological aspects of hygiene, prevention, diagnosis, treatment, examination and rehabilitation of patients. The field of study of M. p. includes a wide range of psychological patterns associated with the occurrence and course of diseases, the influence of certain diseases on the human psyche, providing an optimal system of health effects, the nature of the relationship of a sick person with a microsocial environment. The M.'s structure of the item includes a number of the sections focused on researches in concrete areas of a medical science and practical health care. The most common of these is including pathopsychology, neuropsychology and somatopsychology. Intensively developing are the branches of mental health related to psycho-correctional work: , , , .

Brief psychological dictionary. - Rostov-on-Don: PHOENIX. L.A. Karpenko, A.V. Petrovsky, M. G. Yaroshevsky. 1998 .

medical psychology Etymology.

Comes from the Greek. psyche - soul, logos - teaching.

Category.

Section of psychology.

Specificity.

It is devoted to the study of the influence of mental factors on the occurrence and course of diseases, the diagnosis of pathological conditions, psychoprophylaxis and psychocorrection of diseases. Based on the data obtained in medical psychology, productive hypotheses can be constructed about the process of normal development of the psyche.

Kinds.

It is customary to distinguish two main areas of application of medical psychology: neuropsychiatric and somatic diseases.

Psychological Dictionary. THEM. Kondakov. 2000 .

MEDICAL PSYCHOLOGY

(English) medical psychology) is a branch of psychological science aimed at solving theoretical and practical problems related to the psychoprophylaxis of diseases, the diagnosis of diseases and pathological conditions, psychocorrectional forms of influence on the recovery process, with the solution of various expert issues, with the social and labor rehabilitation of patients. M. p. studies the influence of mental factors on the occurrence and course of diseases, and on the process of people's recovery.

Modern M. p. is divided into 2 main areas. One is related to the use of psychology in the clinic of neuropsychiatric diseases, where the main problem is to study the effect on the patient's psyche of changes in the structure and functioning of the brain, caused by lifelong acquired pathology, or determined by congenital, in particular genetic, anomalies. Dr. the area of ​​​​M. p. is associated with its use in the clinic of somatic diseases, where the main problem is the influence of mental states (factors) on somatic processes (see. ).

The first area of ​​mental psychology received the deepest development in domestic psychology, which was manifested in the emergence of 2 scientific disciplines: neuropsychology(Luria A.R.) and experimental pathopsychology(Zeigarnik B.AT.). Development within these scientific disciplines of fundamental theoretical problems - brain organization higher mental functions, the ratio of the development and decay of mental activity, etc. - made it possible to lay the scientific foundations for the active participation of M. p. in solving diagnostic, experimental and rehabilitation problems.

The 2nd area of ​​mental health is less developed, which is primarily due to insufficient scientific development of issues related to the nature and mechanisms of interaction between somatic (bodily) and mental processes. Among the most important is also the problem of studying the relationship between the doctor and the patient. At present, the efforts of psychologists, physiologists, doctors, biologists, and others are united in the development of problems in this area of ​​mental health.

L. p. plays an important role in the development of psychological science itself, since in pathology m. often reveals what is often hidden in the norm. M. p. - the most important area of ​​practical application of psychological science, one of the sources of new psychological knowledge. Cm. . (Yu. F. Polyakov.)

Big psychological dictionary. - M.: Prime-EVROZNAK. Ed. B.G. Meshcheryakova, acad. V.P. Zinchenko. 2003 .

See what "medical psychology" is in other dictionaries:

Medical Psychology- a section of psychology devoted to the study of the influence of mental factors on the occurrence and course of diseases, the diagnosis of pathological conditions, psychoprophylaxis and psychocorrection of diseases. It is customary to distinguish two main areas of application ... ... Psychological Dictionary

medical psychology- Clinical psychologists can work individually with adults or children, with couples and whole families, as well as with groups, as shown in the illustration. Clinical psychology is an extensive section of applied psychology (at the junction with ... ... Wikipedia

medical psychology- a branch of psychology that studies the role of the psyche in the occurrence, manifestations and course of human diseases and the restoration of his health. The first attempt to substantiate M. p. belongs to the German psychologist and philosopher of the 19th century R. G. Lotze. Most… … Great Soviet Encyclopedia

MEDICAL PSYCHOLOGY- the field of psychological research and knowledge related to the diagnosis, prevention and treatment of various diseases, as well as the scientific description of psychological and behavioral disorders that occur in humans with various diseases ... Glossary of terms for psychological counseling

PSYCHOLOGY- PSYCHOLOGY, the science of the psyche, personality processes and their specifically human forms: perception and thinking, consciousness and character, speech and behavior. Soviet P. builds its own understanding of the subject of P. on the basis of the development of the ideological heritage of Marx ... ... Big Medical Encyclopedia

A branch of psychology that studies the psychological aspects of hygiene, prevention, diagnosis, treatment, examination and rehabilitation of patients. Defines the specifics of the relationship between the doctor and the patient. Substantiates the procedures for diagnosis, treatment, prevention ... Great Psychological Encyclopedia

PSYCHOLOGY- (from psycho ... and ... ology) the science of the patterns, mechanism and facts of the mental life of humans and animals. The main theme of the psychological thought of antiquity and the Middle Ages is the problem of the soul (Aristotle, On the Soul, etc.). In the 17th and 18th centuries based… … Big Encyclopedic Dictionary

PSYCHOLOGY- (from psycho ... and ... ology), the science of the laws, mechanisms and facts of the mental life of humans and animals. The main theme of the psychological thought of antiquity and the Middle Ages is the problem of the soul (On the soul of Aristotle, etc.). In the 17th and 18th centuries based… … Modern Encyclopedia

Psychology- (from psycho ... and ... ology), the science of the laws, mechanisms and facts of the mental life of humans and animals. The main theme of the psychological thought of antiquity and the Middle Ages is the problem of the soul (“On the Soul” by Aristotle and others). In the 17th and 18th centuries based… … Illustrated Encyclopedic Dictionary

The subject of study of medical psychology are pathological mental states and processes, psychological factors influencing the occurrence and course of diseases, the personality of the patient in connection with his illness or health and the social microenvironment, the personality of a medical worker and the system of relations in a medical institution, the role of the psyche in promoting health and preventing diseases.

Consequently, the main task of medical psychology is the study of the patient's psyche in various conditions.

General medical psychology studies:
1. The main laws of the psychology of a sick person (criteria for a normal, temporarily altered and painful psyche); the psychology of a health worker, the psychology of communication between a health worker and a patient, the psychological climate of relationships.
2. Psychosomatic and somatopsychological relationships, i.e. psychological factors affecting the disease, changes in mental processes and the psychological make-up of the personality under the influence of the disease, the influence of mental processes and personality characteristics on the onset and course of the disease.
3. Individual characteristics of a person (temperament, character, personality) and their changes in the process of life and illness.
4. Medical deontology (medical debt, medical ethics, medical secrecy).
5. Psychohygiene and psychoprophylaxis, i.e. the role of the psyche in health promotion and disease prevention.

Private medical psychology studies:
1. Features of the psychology of specific patients with certain forms of diseases.
2. Psychology of patients in the preparation, conduction of diagnostic and surgical interventions.
3. Medico-psychological aspects of labor, pedagogical, military and judicial expertise.

It is possible to single out specific clinics where the knowledge of the relevant sections of medical psychology finds practical application: in a psychiatric clinic - pathopsychology; in neurological - neuropsychology; in the somatic - psychosomatics.

Pathopsychology studies, according to the definition of B. V. Zeigarnik, the structure of disorders of mental activity, the patterns of disintegration of the psyche in their comparison with the norm. At the same time, pathopsychology uses psychological methods, operates with the concepts of modern psychology. Pathopsychology can consider the tasks of both general medical psychology (when the laws of the disintegration of the psyche, changes in the personality of mental patients are studied), and private (when mental disorders of a particular patient are studied to clarify the diagnosis, conduct a labor, judicial or military examination).

Close to pathopsychology is neuropsychology, the object of study of which are diseases of the central nervous system (central nervous system), mainly local focal lesions of the brain.

Psychosomatics studies the influence of the psyche on the occurrence of somatic manifestations.

Of the entire volume of medical psychology in this manual, the main attention will be paid to pathopsychology. Pathopsychology should be distinguished from psychopathology. The latter is a part of psychiatry and studies the symptoms of mental illness by clinical methods, using medical concepts: diagnosis, etiology, pathogenesis, symptom, syndrome, etc. The main method of psychopathology is clinical and descriptive.

WORKBOOK

FOR INDEPENDENT WORK OF STUDENTS

MEDICAL FACULTY

Copying for distribution in any form of part or in full is possible only with the permission of the authors of the tutorial.

Medical psychology: guidelines for independent work of students of the medical faculty // A.M. Kozhina, V.L. Gavenko, G.A. Samardakova, V.M. Sinaiko, T.P. .V.Gavenko, L.M. Gaichuk, M.N. Khaustov, I.N. Strelnikova, A.A. Cherkasova, I.M. Sokolova - Kharkov, 2014. - 122 p.

SUBJECT, OBJECTIVES OF MEDICAL PSYCHOLOGY AND METHODS OF STUDYING HUMAN MENTAL STATE.

THE CONCEPT OF MENTAL HEALTH

Psychology is the science of the laws of origin, development and manifestations of the psyche. Psychology is divided into general, individual and social. From general psychology, age, medical, engineering, space, military, etc. are distinguished. Psychology is directly related to philosophy and other human sciences, plays a significant role in the scientific knowledge of the patterns of personality formation, its ideological, moral, ethical and aesthetic attitudes and values.

General psychology is the science of the patterns of formation and practical implementation of mental functions (perception, memory, attention, thinking, emotions, effector-volitional sphere, consciousness) separately and in their interaction, which makes up the personality. It gives the doctor methods that allow you to notice minor changes in the mental state of the patient, to observe the course of the disease step by step, noting the positive or negative effect of the methods of treatment.

medical psychology- This is a field of psychology that studies the laws of the functioning of the psyche in the conditions of the onset and course of the disease, the treatment of sick people and the use of psychological factors in the treatment process, preventive and hygienic work of medical personnel.

Medical psychology is aimed at solving theoretical and practical problems related to strengthening and maintaining the psychological health of the population, preventing diseases, diagnosing pathological conditions, psycho-correctional forms of influence on the recovery process, addressing issues of expertise, social and labor rehabilitation of healthy and sick people, as well as the study of the psychological characteristics of the professional activity of a medical worker.

The place of medical psychology in clinical medicine is determined by the object of study of these sciences - a sick person who, with any disease, has an altered psyche. Psychological features of the behavior of a doctor in a particular disease, correction of the psyche in the process of treating a patient, psychotherapeutic influence on the patient are the main points of contact between these sciences. Medical psychology is associated with all medical specialties (therapy, surgery, obstetrics and gynecology, pediatrics, hygiene, etc.), while it has some specific approaches, and, accordingly, plays an important role in the training of doctors of any profile.

The main tasks of medical psychology:

Psychological assessment of the individual characteristics of the patient, changes in his mental functions under the influence of various mental and somatic diseases

Study of the influence of various mental and somato-neurological diseases on the mental sphere of children and adults

Assessment of the role of mental influences in the occurrence, course and prevention of psychosomatic diseases, their psychopathological complications

Analysis of individual and professional psychological characteristics of the behavior and work with patients of a doctor and other medical workers

The study of the psychology of the relationship between the patient and medical workers in the implementation of the treatment and diagnostic process

Development of principles and methods of experimental psychological research in the clinic, methods of correction and psychotherapeutic support of diagnostic and therapeutic processes.

In Ukraine, psychology is developing as an integral part of the world psychological science. At the beginning of the XX century. scientific schools were formed: Kyiv (G.I. Chelpanov, I.A. Sikorsky, S.A. Ananin), Odessa (I.M. Sechenov, I.I. Mechnikov, M.M. Lange, S. L. Rubinstein ). One of the most important centers for the development of experimental psychology in the 20-30s of the twentieth century was Kharkov. The history of the development of medical psychology is also associated with such famous scientists as A.R. Luria, L.S. Vygotsky, N.A. Bernshtein, O.V. Zaporozhets, A.Ya. Anfimov, K.K. Platonov, O. M. Leontiev, V. P. Protopopov, P. I. Zinchenko, L. I. Bozhovich and others.

So, Alexander Romanovich Luria was the founder of neuropsychology in the USSR, his research was devoted to the problems of localization of higher mental functions and their disorders in brain damage. Lev Semenovich Vygotsky dealt with the problems of the development of mental functions, developed the concept of "psychological systems", which implied functional connections between various mental functions, proposed a hypothesis about the localization of mental functions as structural units of the brain. The works of L.S. Vygotsky enriched psychiatry, defectology, and other human sciences. Nikolai Alekseevich Bernshtein developed research methods - kymocyclography and cyclogrammetry, with the help of which human movements were studied in the norm and in patients with pathology of the nervous system, when using prosthetic limbs. The results obtained by him made it possible to clarify the idea of ​​the localization of functions in the nervous system, to suggest effective methods for restoring disturbed functions. Petr Kuzmich Anokhin developed the theory of functional systems, which is one of the most important in psychophysiology. Bluma Vulfovna Zeigarnik stood at the origins of the formation of pathopsychology, was engaged in the development of a cultural-historical theory in relation to the study of the problems of the pathology of various mental processes. Leonid Fokich Burlachuk dealt with the methodology of psychological research, the principles of psychodiagnostics, and the development of concepts about the levels of mental health. Vadim Moiseevich Bleikher paid great attention to the development of the principles of pathopsychological diagnostics for various mental illnesses.

Before proceeding to a description of the methods that are used in medical psychology, we should dwell on the main stages of experimental psychological examination.

At the preparatory stage, a question (hypothesis) is formulated, to which it is necessary to find an answer. Most often, this is a question about differential diagnosis, about the causes or factors that determine the specifics of the course of a particular disease, about establishing the individual psychological characteristics of the patient's personality.

Psychodiagnostic research includes the following steps:

Preparatory (statement of a hypothesis, selection of methods)

Proper experimental

Quantitative data processing study

Interpretation of the received data, writing a conclusion

After the problem is formulated, it is possible, by sorting through all possible phenomena, to establish how and to what extent they influence the event that interests the researcher. Such a preliminary answer to the question about the nature of the connection between events is a hypothesis. The main requirement for a hypothesis is the possibility of its verification. Often, when planning a study, several equally probable hypotheses may arise, then they are tested sequentially.

Psychological diagnosis is the identification of hidden causes of apparent trouble (L.F. Burlachuk).

In medical psychology, the following methods are used:

1 - method of clinical directed conversation,

2 - observation method

3 - experiment

4 - psychodiagnostic examination

Clinical conversation and observation are the main methods used in the daily practical work of a doctor and a medical psychologist.

Method of clinical conversation, (interview). The conversation provides for the identification of relationships of interest to the researcher based on empirical data obtained in real two-way communication with the researcher. This is a method of obtaining information about the individual psychological properties of a person, psychological phenomena and psychopathological symptoms, the internal picture of the disease and the structure of the patient's problem, as well as a method of psychological influence on a person, developed directly on the basis of personal contact between a doctor, psychologist and patient.

The principles of clinical conversation are: unambiguousness, accuracy and availability of formulations, adequacy, consistency; flexibility, impartiality of the survey, verification of the information received. The success of the conversation depends on the qualifications of the researcher, which provides for the ability to establish contact with the subject, to give the opportunity to express their thoughts as freely as possible.

In the course of a clinical conversation, anamnestic information is collected and the patient's complaints are questioned. The materials of the anamnesis make it possible to judge the nature of the disease, the causes and circumstances of its occurrence, the features of the course and clinical manifestations. Collecting anamnestic information, the doctor can assess the patient's neuropsychic state in the period preceding the disease, find out if the patient was previously treated and in which departments, how effective the treatment was. The anamnesis enables the doctor to determine the patient's attitude to his disease, the features of psychological reactions to the disease. When interviewing a patient, the doctor not only evaluates the actual material, but also has the opportunity to determine the psychological characteristics of the patient. It is necessary to give the patient the opportunity to independently talk about his disease, his life, but the conversation with the patient should be directed by the doctor. It is very important to ask questions to the patient correctly, in a certain order and form, it is impossible to inspire the patient with certain sensations with questions (for example, sometimes it is enough to ask the patient if he has pain in the heart area, and he begins to experience them). With special delicacy, the most intimate issues of the patient's life should be touched upon. The doctor must take into account how attentively and thoughtfully the patient listens to his questions.

However, patients, suffering from discomfort and pain, may think that either the doctor inattentively examined him, or the disease is very serious and incurable. In addition, some tend to remain in the position of the patient, although recovery has come, they are afraid to return to their previous healthy lifestyle. In this case, we can talk about setting on the disease. Often, patients underestimate the severity of their disease state and either do not express complaints at all, or soften the degree of their severity.

Clinical conversation is an important method not only for studying the patient, but also for the interaction of the doctor with the patient, for influencing the patient.

observation method. One of the most typical ways a researcher works is to observe an object (a person, a group) in the expectation that the phenomena of interest to the researcher will manifest themselves in such a way that they can be recorded and described. With the help of this method, mental processes, states and properties are studied in healthy and sick people. The study of the psyche is carried out in natural living conditions and differs from a natural experiment in that the doctor or psychologist is a passive observer and is forced to wait until he can see the phenomena that interest him a second time.

The advantage of this method is that during the observation the natural course of mental phenomena is not disturbed. The disadvantage of the method of observation is that it does not make it possible to establish with absolute accuracy the cause of a particular mental phenomenon, since in the process of observation it is impossible to take into account all the relationships of a mental phenomenon. Observation is carried out in normal conditions of life: in the family, in the process of work, play, training, in the hospital ward. Independent activity, observation, features of the patient's reactions to what is happening, his relationship with others are taken into account. Observation must be directional, i.e. pursue certain goals. In medical practice, it makes it possible to assess the patient's sleep, his appetite, mood, mental activity, etc.

Experiment. Experiment differs from observation in that it provides for the organization of the research situation, which allows one to carry out what is impossible in observation - relatively complete control of variables. A variable is a reality that can be changed in an experimental situation. Manipulation of variables is one of the important advantages of the experimenter over the observer.

If the researcher is interested in any connection between phenomena, then in the experiment it is possible, having created a certain situation, to introduce a new element and determine whether this or that change will occur in the situation as a result of the change he created. When observing, the researcher is forced to wait for the occurrence of a change that may not occur. There are 4 types of experiment: laboratory, natural, ascertaining, forming.

The disadvantage of the method is that it is difficult to organize it in such a way that the subject does not know what is happening to him. Therefore, the subject may exhibit stiffness, uncertainty, conscious and unconscious anxiety, etc.

Psychodiagnostic examination. On the basis of a psychodiagnostic study, hypotheses about dependencies between different psychological characteristics are tested. Having found their features in a sufficient number of subjects, it becomes possible, on the basis of appropriate mathematical procedures, to establish their relationship. The requirements for a psychodiagnostic study are the same as for an experiment - the control of variables. Psychodiagnostics, in addition, is an independent field of psychology and, in this case, the researcher focuses not on research, but on examination. Psychodiagnostics as a field of psychology is focused on measuring the personality-psychological properties of a person.

Psychodiagnostics is the science and practice of establishing a psychological diagnosis. Diagnosis as the main goal of diagnosis can be established at different levels.

Level 1 - symptomatic or empirical. At this level, the diagnosis is limited to the statement of features or symptoms (signs)

Level 2 - etiological, which takes into account not only the presence of characteristics, but also the reasons for their occurrence.

Level 3 - the level of typological diagnosis, which consists in determining the place and significance of the identified characteristics in the overall picture of a person's mental life.

Methods of psychodiagnostics. The main methods of psychodiagnostics are testing and questioning, the methodical implementation of which is, respectively, tests and questionnaires, which are also called methods. Methods allow collecting diagnostic information in a relatively short time, provide information about a person in general, and specifically about one or another of its features (about intelligence, anxiety, etc.), allows for a qualitative and quantitative comparison of an individual with other people. The information obtained with the help of psychodiagnostic techniques is useful in terms of choosing the means of intervention, predicting its effectiveness, as well as predicting the development, communication, and effectiveness of one or another activity of the individual.

Testing. A test is a test, a task or a system of tasks that make it possible to quickly assess the mental state or level of intellectual development of the subject.

Psychological diagnostics uses a number of experimental psychological methods - tests, with the help of which it is possible to assess the functioning of both individual areas of mental activity and integrative formations - types of temperament, character traits, personal qualities.

There are verbal (linguistic) and non-verbal (drawing) tests. There are mainly two groups of tests - standardized and projective (projective).

An assessment-oriented test is called a standardized test (tests of intelligence, special abilities, to measure creativity).

However, there are tests that are oriented towards something else: they do not determine the estimated indicators (for example, the level of development of a certain property), but the qualitative characteristics of the personality. Projective methods belong to this group of tests. They are based on the fact that in various manifestations of the individual, his personality is embodied, including hidden, unconscious needs, conflicts, experiences. That is, the main thing is the subjective content and attitude that the test will cause in the subject, which allows you to draw conclusions about personality traits.

Questionnaires are called methods that contain a set of questions to which the subject must answer whether he agrees with this statement or not. There are questionnaires of "open" type (answers are given in any form) and "closed" type (the answer is chosen from the options that are presented in the questionnaire). In addition, there are questionnaires-questionnaires and personality questionnaires. Questionnaires-questionnaires provide an opportunity to obtain such information about the subject, which does not directly reflect his personal characteristics. For example, biographical, questionnaires of interests, attitudes.

Personality questionnaires for measuring personality traits are divided into several groups:

a) typological questionnaires developed on the basis of determining personality types and allow us to attribute the subjects to one or another type, which is distinguished by qualitatively peculiar manifestations;

b) a questionnaire of personality traits that determine the severity of traits - persistent personality traits;

c) questionnaire of motives;

d) questionnaire of values;

e) attitude questionnaire;

f) interest questionnaires;

Methods of psychological research are not isolated, they can be part of one another.

Basic psychodiagnostic methods:

Sphere of mental activity	Psychodiagnostic technique
Perception	Sensory excitability Samples of Aschaffenburg, Rehardt, Lipman
	Ten Word Test Memorizing numbers Replay stories
Attention	Schulte tables Correction test Account according to Kraepelin
Thinking	Tests for classification, exclusion of concepts, syllogisms, analogies, generalization, interpretation of proverbs association experiment Pictogram
Intelligence	Raven test, Wechsler test
	Spielberger test Luscher color selection method Hospital Anxiety and Depression Scale (HADS)
Personality	Rorschach test SAN, TRANS Eysenck questionnaire "Unfinished Offers" Dembo-Rubinshtein Self-Assessment Methodology

The last stage of experimental psychological research necessarily includes writing a conclusion on the results obtained.

One of the most important in medical psychology is the concept of mental health. According to the WHO Constitution, health is defined as a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity.

There are components of health: 1) physical (physical activity, physical well-being, physical limitations); 2) mental (mental well-being, control of behavior and emotional reactions, functioning of cognitive processes); 3) social (interpersonal communication); 4) role-playing (freedom in performing ordinary roles at home, at work); 5) general self-assessment of health.

Three interrelated aspects of health are described - somatic, mental and spiritual, which are based on the corresponding levels of personality, the consideration of which is necessary for the correct planning of valeological events. The spiritual (moral) aspect of health is the motivation for a healthy lifestyle, setting for a long and fulfilling life, the absence of a dependent attitude to medicine, independent activity in the formation and strengthening of one's own health, a careful attitude to the life and health of others.

According to WHO criteria, under mental health understand: a) the absence of severe mental disorders; b) a certain reserve of human strength, thanks to which he can overcome unexpected stresses, difficulties that arise in exceptional circumstances; c) the state of balance between a person and the surrounding world, harmony between him and society, the coexistence of the ideas of an individual with the ideas of other people about "objective reality".

Mental health is the absence of mental illness, normal mental development and a favorable functional state of the higher parts of the central nervous system. For children, this is the presence of normal abilities to acquire knowledge and skills, the ability to fulfill all the requirements of school life, and the observance of norms of behavior in relationships with peers and teachers. Normal development - harmonious, age-appropriate, with a normal functional state and normal mental performance, with a positive emotional state.

It is generally recognized that there are 5 health groups:

Healthy with normal development and a normal level of function.

Healthy, but with functional or some morphological abnormalities, as well as reduced resistance to acute and chronic diseases.

Patients with chronic diseases are in a state of compensation with preserved functionality of the body.

Patients with chronic diseases in a state of subcompensation, with reduced functionality.

Patients with chronic diseases in a state of decompensation with significantly reduced functionality of the body.

Important in medical psychology is the concept of psychological adaptation of a person, i.e. the ability to change structural relationships to preserve functions and ensure the existence of a person in a changed environment. Adaptation can include both physiological and behavioral responses. There are several types of adaptation states:

The state of "physiological adaptation" is the usual existence of a person in changing environmental conditions with the optimal mode of all functional systems.

A state of intense adaptation - when there is a need for restructuring, changing existing parameters of activity that require a certain tension in the work of the corresponding functional systems.

The state of pathological adaptation that occurs when the reserve capacity of the body is exceeded, which can lead to the complete depletion of adaptive mechanisms and the development of maladjustment.

test questions

Specify the principles of constructing a purposeful psychological conversation.

2. Psychology is:

A. The science of human behavior

B. The science of the laws of origin, development and manifestations of the psyche

C. The branch of science that studies the level of human intellectual development

D. Science directed towards the development of adequate methods of treatment of the mentally ill

E. All of the above

3. Medical psychology is:

A. A branch of psychiatry that studies the main symptoms and syndromes of mental pathology

B. A branch of psychology that studies the basic patterns of the functioning of the psyche in the event of a disease

C. The science of methods for determining the level of human intellectual development

D. The branch of human knowledge aimed at using the achievements of modern medicine in the study of the psychological characteristics of a person

E. All of the above

4. Medical psychology is associated with specialties:

A. Pediatrics

B. Obstetrics and gynecology

C. Surgery

D. Psychiatry

E. All of the above

5. The technique "Correction test" is used to study:

A. Sensations and perceptions

C. Psychological properties of personality

D. Thinking

E. Attentions

6. A 17-year-old teenager is seeing a psychologist, who has an inadequacy of emotions. What methods can be used to clarify the emotional characteristics of a patient?

A. Aschaffenburg test

B. Luscher Method

C. Kraepelin score

D. Test 10 words

E. All of the above

7. Relatives of a 35-year-old patient who suffered a traumatic brain injury several years ago began to notice that he had difficulty in mental activity. What research method is most appropriate for assessing the intellectual state of the patient:

A. Storytelling

B. Kraepelin score

C. Wechsler test

D. Pictogram methodology