Types of psychopathy and their characteristic features. Symptoms of various forms of psychopathy

MILITARY UNIVERSITY .

TEST

Subject: “Psychopathic levels of personality disorder. types of psychopathy.

Executor

MOSCOW 1998

INTRODUCTION:

Personality disorders in international and American classifications mean pronounced and persistent violations of character and behavior that impede social adaptation. In our country, for these cases, the term "psychopathy", proposed by V.M. Bekhterev back in 1886. Psychopathies are characterized by: - ​​the severity of pathological properties to the extent of impaired adaptation; - the totality of psychopathological features that determine the entire mental appearance of the individual;

Relative stability, low reversibility;

A set of personality, behavioral, affective and neurotic disorders of a certain clinical structure, with the exception of the mosaic type;

The presence of predominantly the same type of psychopathic response; ambiguous psychogenic effects;

The appearance of dynamic shifts in the form of a "psychopathic cycle" (according to O.V. Kerbikov): dysphoria - conflict - reaction to it - deepening of the psychopathic properties of the personality;

Separation of the emerging pathocharacterological properties of the personality from the root cause.

In the process of forming a psychopathic structure, the significance of each of these parameters becomes more and more obvious, but until the totality of their majority, which determines a specific type of psychopathy, is determined with sufficient clarity, it is advisable to regard the condition of a child or adolescent as prepsychopathic.

The genesis in most specific observations is ambiguous: the cause can be pathological heredity (alcoholic, schizophrenic, psychopathic, etc.), and various kinds of exogenous organic influences (light TBI and other mild brain damage under the age of 3.5 years). and inadequate upbringing, i.e., not meeting the requirements that this child or adolescent makes, and psychogenic trauma - acute or chronic.

In the variant where only one of the influences takes place, nuclear, organic or marginal psychopathy is stated, respectively.

If the latter owe their appearance to inadequate education, and the period of their formation is called pathocharacterological development, then when it comes to the consequences of a protracted neurosis, reactive state or chronically affecting psychogenies, they speak of neurotic, post-reactive or psychogenic development of the personality.

Not one of the types of psychopathy is not detected ready-made in early childhood, although it is from this time, especially in the group of "nuclear" psychopathy, that their formation begins under the influence of external influences (exo-, psycho- and somatogeny, environmental and upbringing factors). The process of formation of psychopathy occurs in childhood and adolescence, and sometimes continues in adolescence, distorting the normal ontogenetic development and maturation of the psyche (psychopathic dysontogenesis).

At the 1st stage, the clinical manifestations of psychopathy in childhood are practically exhausted by individual elementary manifestations of excitable, hysterical, or unstable types. The clinical picture at this time is undifferentiated, fragmentary and mobile.

At the 2nd stage of the formation of psychopathy, the mosaic pattern of the clinical picture is clearly manifested, mainly due to the predominance of the symptoms of the negative phase of puberty. At this time, not only the labile interchangeability of psychopathic syndromes is noted, but also the variety of exaggerated age-related features of the psyche (the desire for self-affirmation, self-centeredness, infantilism, reactions of opposition, imitation, refusal, etc.), psychoendocrine manifestations and often signs of pedagogical neglect. In the same period, there may be a tendency to polymorphic overvalued formations.

At the 3rd stage, the formation of psychopathy is completed, all its clinical characteristics that fit into the framework of one of the psychopathic syndromes (types) are formed. Knowledge of the stages of the formation of psychopathy is necessary for the correct collection of anamnesis, the establishment of an accurate diagnosis and the exclusion of conditions that are only superficially similar to psychopathy.

Diagnostic criteria for adult personality disorder are:

1) noticeable disharmony in personal positions and behavior, usually covering several areas of functioning (affectivity, excitability, impulse control, processes of perception and thinking, etc.);

2) the chronic nature of the abnormal style of behavior that arose long ago and is not limited to episodes of mental illness;

3) an anomalous style of behavior that is comprehensive and disrupts adaptation to a wide range of personal and social situations;

4) the disorder leads to significant personal distress;

5) usually, but not always, the disorder is accompanied by a significant deterioration in professional and social productivity (ICD - 10). In this case, we are talking about conditions that are not directly related to extensive damage or disease of the brain or other mental disorder.

1 . A look at psychopathy from the point of view of psychiatry.

Psychopathy- an anomaly of character, which, according to the outstanding Moscow psychiatrist P.B. Ganushkin, determines the mental appearance, leaving an imperious imprint on the entire mental warehouse, does not undergo any drastic changes during life and prevents one from adapting to the environment. Later, these signs of O.V. Kerbikov laid the foundation for the diagnostic criteria for psychopathy:

1) the totality of pathological character traits; they manifest themselves everywhere - at home and at work, at work and at rest, in everyday conditions and during emotional stress;

2) stability of pathological character traits; they persist throughout life, although they are first detected at different ages, most often in adolescence, sometimes in childhood, less often when growing up;

3) social maladjustment is a consequence of pathological character traits, and is not due to an unfavorable environment.

There are the following types of formation of psychopathy:

Constitutional (nuclear) psychopathies. They are due to heredity and appear even under the most favorable conditions of the immediate social environment. Usually, parents or other blood relatives manage to trace similar manifestations.

Psychopathic development ("acquired psychopathy"). They are the result of improper upbringing or prolonged bad influence of the environment, especially if it falls on adolescence - the period of formation of character. However, not everyone develops psychopathic development under the influence of the same psychogenic chronic factors. At the same time, not just any long-term adverse socio-psychological impact is necessary, but one that is addressed to the “place of least resistance” of this type of accentuation.

Organic psychopathy. They are the result of prenatal, notal and early postnatal (the first 2-3 years of life) harmful effects on the developing brain. These harmful effects can be severe toxicosis of pregnancy, trauma to the fetus during pregnancy and childbirth, intrauterine and early brain infections, long-term debilitating somatic diseases from the first months of life. Organic psychopathy manifests itself from childhood, but as they grow older they can be smoothed out.

Personality disorders, especially constitutional psychopathy, are characterized by stability: pathological character traits that are revealed at a certain age persist for life. However, these features are either sharpened or softened. This gave rise to P.B. Ganushkin to develop the doctrine of the dynamics of psychopathy. Dynamic shifts included age-related crises, compensations and decompensations, psychopathic phases, transformation of psychopathy types.

Age crises - pubertal and menopausal - due mainly to biological factors. The period of puberty more strongly reveals and sharpens the pathological traits of character in boys, the climacteric period has a strong effect on women in this respect.

Compensation- temporary mitigation of psychopathic features by changing the "microenvironment" to one where these features do not interfere in the best way to adapt (a solitary lifestyle and engaging in a favorite hobby in schizoid disorder). Less commonly, compensation is carried out through the active development of psychological defense mechanisms, lifestyle, and behavior.

Decompensation- sharpening of psychopathic traits, usually accompanied by behavioral disorders and social maladaptation. It occurs more often under the influence of unfavorable environmental factors, however, it is quite tolerable by healthy individuals. It happens that psychopaths themselves create a traumatic environment around themselves, which then leads to decompensation.

Psychopathic phases - periodic, without any reason, sharp deterioration, also passing on their own after a while - are found only in certain types of psychopathy.

Transformation of types of personality disorders occurs both due to endogenous mechanisms, for example, with age, and under the influence of adverse environmental conditions. Paranoid development usually begins in 30-40 years, but it may be preceded by schizoid disorder or epileptic character accentuation.

P.B. Ganushkin believed that the doctrine of psychopathy was the result of an in-depth clinical development of the field of so-called borderline states - borderline between "mental" and "nervous" diseases, on the one hand, and between mental illness and mental health, on the other.

This includes mild abortive forms of psychosis - processes with a certain moment of onset of the disease, and phenomena observed throughout life in improperly organized, disharmonic personalities. The former always represent something alien to the main trend that guides the development of a given personality. With them, some factor that causes a shift necessarily intervenes in the course of life processes, and the development of phenomena begins, which, being alien to the body and the whole personality, lead it in whole or in part to change and destruction. It is fundamentally unimportant whether in these cases the morbid process is manifested by sharp, bright or only extremely weak phenomena, whether it proceeds quickly or slowly, whether it stops in its course, or whether it progresses all the time.

The situation is quite different in relation to those cases where abnormal phenomena do not represent the result of the intervention of a foreign process, but turn out to be innate, inherent in the very essence of the personality and developing only within the limits in which its normal life development or the conditions of its relationship with the environment require it. . To refer to this kind of forms, the term "constitutional psychopathy" is used. Accordingly, from the point of view of P.B. Ganushkin, individuals are called psychopathic, from youth, from the moment of formation, representing a number of features that distinguish them from the so-called normal people and prevent them from painlessly for themselves and others to adapt to the environment. The pathological properties inherent in them are permanent, innate properties of the personality, which, although they may intensify or develop in a certain direction during life, usually do not undergo drastic changes. It should be added that we are talking about such traits and features that more or less determine the entire mental appearance of the individual, imposing their authoritative imprint on his entire mental structure, because the existence in the psyche of a particular subject in general of any individual elementary irregularities and deviations has not yet been gives reason to classify him as a psychopath

Thus, psychopathy are forms that have neither beginning nor end; some psychiatrists define psychopathic personalities, those permanent residents of the borderline between mental health and mental illness, as unfortunate biological variations, as deviations too far away from a certain average level or normal type. In addition, for the vast majority of psychopathy, a sign of insufficiency, defectiveness, inferiority in the broad sense of the word is characteristic, while deviations in the direction of strengthening the positive properties of the personality, although they sometimes place the subject outside the normal average person, in no case still give the right to classify him to psychopaths.

It must be added that the boundaries between individual psychopathies are as vague and indefinite as the general framework of this entire area to be studied. The forms that are distinguished are, for the most part, an artificial product of a schematic processing of what is observed in reality; in fact, pure forms of psychopathy in the form in which they are usually described are rare: mixed forms predominate in life - hence the extraordinary diversity and great instability of individual symptoms.

In Russian psychiatry, one of the first P.B. Ganushkin (1933) compiled a classification of psychopathy, describing several groups.

Cycloid group. The composition includes: constitutionally depressive, constitutionally excited, cyclothymic, emotively labile. They differ in the features of the dominant mood - constantly depressed, elevated, periodically or often changing.

Asthenic group. The composition includes: neurasthenics, "extremely impressionable", psychasthenics. It combines a tendency to be easily exhausted and "irritable weakness".

In addition, he singled out groups of schizoids, paranoids, epileptoids, hysterical and unstable psychopaths, and others, most of which are included in the ICD-10 under the same or other names.

The classification and views on the accentuation and psychopathy of the personality of the German psychiatrist K. Leonhard are interesting and noteworthy.

To understand the essence of a person, it is necessary to look closely at the various features of mental spheres characteristic of him. Neither observations nor conversations with people help to unambiguously describe and determine the various variations in the characteristics of the psyche.

It is not always easy to draw a clear line between the traits that form an accentuated personality and the traits that determine the variations in a person's personality. Fluctuations here are defined in two directions. First of all, features stuck, or pedantic or hypomanic personalities can be expressed in a person so insignificantly that accentuation as such does not take place, one can only state a deviation from a certain pattern. Accentuation always generally implies an increase in the degree of a certain feature. This personality trait thus becomes accentuated.

Many features are difficult to differentiate. For example, if we talk about ambition, then it should be determined whether it belongs to the sphere of interests and inclinations or is a feature of accentuated stuckness. The last definition is possible with a pronounced expression of this trait: stubborn, blind careerism. In addition, stuckness is never manifested by ambition alone, it is joined by an increased sensitivity to resentment and a pronounced vindictiveness.

We encounter a similar situation when we observe vivid manifestations of a sense of duty. It can be attributed to the orientation of interests and inclinations, but one can also see in it a trait inherent in anancastam (pedantic personalities) . They have a sense of duty associated with anxiety, constant questions about whether he acts selflessly enough.

It is very interesting from a psychological point of view that stuck personalities reveal manifestations of selfish feelings, and pedantic ones - a manifestation of altruistic ones, in particular a sense of duty. It should be emphasized that the traits of getting stuck are mainly interconnected with egoistic feelings, and the traits of doubt, constant fluctuations (anankastic) - with feelings of an altruistic order. The more a person hesitates in his decisions, the more altruistic feelings affect decision making.

An even greater contrast is evident when comparing the anankastic personality with the hysterical personality, since hysterics are more prone to selfishness. They often make rash decisions, rarely weigh their actions, remaining in the selfish circle of interests that is closer to them.

A highly developed area of ​​emotions in a person activates altruistic feelings - a sense of compassion, joy for someone else's luck, a sense of duty. To a much lesser extent, in such cases, the desire for power, greed and self-interest, indignation, anger in connection with the infringement of pride are developed. For an emotive nature, such a property as sympathy is especially characteristic, but it can also develop on other grounds.

Does not reveal a single genetic basis and such a personality trait as anxiety (fearfulness). In a normal degree, timidity is characteristic of many people, but it can become dominant, leaving its mark on all human behavior.

Accentuated features are far from being as numerous as varying individual ones. Accentuation is, in essence, the same individual traits, but with a tendency to move into a pathological state. Anankastic, paranoid, and hysterical traits may be inherent in any person to some extent, but their manifestations are so insignificant that they elude observation. With greater severity, they leave an imprint on the personality as such and can acquire a pathological character, destroying the structure of the personality.

Personalities labeled as accentuated are not pathological. With a different interpretation, the conclusion suggests itself that only an average person can be considered normal, and any deviation from such an average should be recognized as pathology. This would force those who, with their originality, stand out clearly against the background of the average level, to go beyond the norm. This category would also include the category of people about whom they speak of “personality” in a positive sense, emphasizing that they have a pronounced original mental warehouse. If a person does not exhibit properties that in "high doses" give a paranoid, anankastic, hysterical, hypomanic or subdepressive picture, then such an average person can be unconditionally considered normal. Such a person does not expect the uneven life path of a sickly creature with the oddities of a loser, but it is also unlikely that he will excel in a positive respect. In accentuated personalities, both the possibilities of socially positive achievements and the socially negative charge are potentially laid down. Some accentuated personalities appear in a negative light, since life circumstances did not favor them, but it is quite possible that under the influence of other circumstances they would become extraordinary people.

stuck personality under unfavorable circumstances, he can become an intractable, unrepentant debater, but if circumstances favor such a person, it is possible that he will turn out to be a purposeful and tireless worker.

Pedantic personality under unfavorable circumstances, she may develop obsessive-compulsive disorder; under favorable circumstances, she will become an exemplary worker with a sense of duty for the task assigned.

Demonstrative personality can act out a neurosis, under other circumstances it is capable of outstanding creative achievements.

In general, with a negative picture, there is a tendency to see psychopathy, with a positive picture, it is rather an accentuation of the personality.

The designation "pathological personality" should be used only in relation to people who deviate from the standard, and when external circumstances that impede the normal course of life are excluded. But we should not forget that there is no hard border between normal, average and accentuated people. You should not approach this concept too narrowly, i.e. it would not be right, on the basis of some minor peculiarity of a person, to immediately see in him a deviation from the norm. But even with a fairly broad approach to what qualities can be called standard, normal, not conspicuous, there are still quite a few people who have to be attributed to accentuated personalities.

Speaking of variants of accentuated personalities, K. Leonhard had in mind various traits of character and temperament that form a person as a person in those cases when he represents a deviation from a certain standard.

Since Karl Leonhard, unlike many of his colleagues, was convinced that there are basic features of human personality and that science should strive to describe them, he created one of the first classifications of personality accentuation, which is presented below with the main distinguishing features.

demonstrative personalities. The peculiarity of demonstrative reactions is that their beginning is associated with a conscious desire for something. People with this accentuation have a great need for recognition by others, they try to attract attention to themselves in any way, they are prone to verbal self-praise. In addition, this type of personality has a pronounced tendency to self-pity. They believe that others are often not fair to them. that they undeservedly suffered a blow of fate.

Pedantic personalities. A feature of this type of personality is indecision, delay in making a decision.

Stuck personalities. Its essence lies in the pathological persistence of affect.

excitable(a weakened analogue of epileptoid psychopathy) - drives, instincts, uncontrollable impulses play a decisive role in life and behavior.

Hyperthymic(weakened degree of hypomanic states) - with inadequately elevated mood, the possibility of violation of ethical standards, the transformation of excessive thirst for activity into fruitless scattering.

dysthymic(a weakened version of subdepressive) - with a pessimistic attitude.

Affectively labile(a weakened version of cycloid psychopathy) - a characteristic change in hyperthymic and dysthymic states.

Affectively exalted- there is a great ease of development of an enthusiastic state during joyful events and despair - during sad ones.

Anxious(fearful) - humility, timidity, fearfulness.

emotive- sensitivity and deep reactions in the field of subtle emotions.

extroverted- a greater focus on perception than representation.

introverted- the tendency to live not so much with one's perceptions and sensations as with ideas.

Another classification of character accentuations was proposed by the Russian psychiatrist Lichko A.E. He combined the systematics of psychopathy and character accentuations, describing the same types that are either variants of the norm (accentuations) or have reached a pathological level of deviation (psychopathy).

When diagnosing psychopathy in adolescents, it is necessary to focus on the criteria for psychopathy indicated by O.V. Kerbikov (see above).

The totality of pathological character traits appears at this age especially brightly. A teenager endowed with psychopathy discovers his type of character in the family and at school, with peers and elders, in school and on vacation, in everyday and familiar conditions, and in emergency situations. Everywhere and always hyperthymic teen is full of energy schizoid fenced off from the environment by an invisible veil, and hysterical wants to get attention.

Speaking of relative stability However, three things should be taken into account:

1) Adolescence is a critical period for psychopathy, the features of most types at this age are exacerbated.

2) Each type of psychopathy has its own age of formation. Schizoid can be seen from the first years of life - such children prefer to play alone. Psychasthenic traits often bloom in the first grades of school, when a carefree childhood is replaced by demands for a sense of responsibility. Unstable type betrays itself either from entering school with the impending need to change the pleasure of games to educational work, or from puberty, when spontaneously formed groups of peers make it possible to escape from parental care. Hyperthymic features become especially bright from adolescence. Cycloid, especially in girls, can be detected from the moment of puberty. sensitive psychopathy develops at the age of 16-19 years, during the period of entry into an independent life with its burden on interpersonal relationships. paranoid psychopathy is extremely rare in adolescents, the maximum of its development occurs in 30-40 years.

3) There are some regular transformations of character types in adolescence. With the onset of puberty, the hyperthymic features observed in childhood can be replaced by obvious cycloidism, astheno-neurotic features - by a psychasthenic or sensitive type, etc. All transformations can occur both due to biological and social reasons.

Psychopathies are painful personality changes, with impaired emotional sphere, volitional disorders, pathological experiences and bouts of inappropriate behavior. People suffering from these types of disorders may retain intellectual ability but often lose them. The development of psychopathy gradually leads to the fact that patients develop inappropriate behavior in society, the ability to normal social adaptation is lost. Psychopathic manifestations are especially difficult if painful changes begin in childhood.

The representative of the German school of psychiatry, K. Schneider, argued that the personality of a psychopath exposes both himself and the people around him to suffering. Psychopathic manifestations can undergo dynamic changes with the age and development of a person. Especially clinical symptoms increase in adolescence and in the elderly.

Causes of psychopathy

Note:severe diseases can become provoking factors for the development of pathological changes internal organs, strong stressful situations. According to official data, up to 5% of the population suffers from psychopathy.

Despite the prevalence of this pathology, its causal factors have not been studied enough. Scientists differ both in some questions of classification, and in the mechanisms of development of painful changes.

In a separate large group of causes of psychopathy, brain lesions are identified, which are caused by:

• environmental pollution;
• severe infectious diseases;
• traumatic head injuries;
• poisoning;
• elevated .

The listed groups of harmful effects lead to painful changes in the brain, nervous system, and as a result, severe changes occur in the psyche.

Also in the development of pathology great importance have social factors: the atmosphere in the family, school, work teams, etc. Especially these conditions play a role in childhood.

The hereditary nature of the transmission of psychopathy is of no small importance.

The main classifications of psychopathy

The problem of psychopathy was of interest to many world-class scientists. This has led to the creation of many classifications. We will consider the most common, most commonly used in clinical medicine.

According to the main groups (O.V. Kebrikov), the following are distinguished:

• nuclear psychopathy(depending on the constitutional type of a person, in which the main role is assigned to heredity);
• marginal psychopathy(arising from problems of a biological nature and social causes);
• organic psychopathy(caused by organic lesions of the brain, and manifested at the stage of personality development, at the age of 6-10 years).

An additional role in the development of psychopathic traits is played by:

• separation of the child from parents, family;
• overprotectiveness, developing a painful self-importance;
• lack or complete absence attention to their children;
• "Cinderella" syndrome - relegation to the background of the adopted child, or the formation of a complex in children due to increased parental attention paid to one child at the expense of others;
• the “idol” phenomenon is a painful perception of caring for other children by a child – the “favorite” of the family society.

Note:the existing psychopathic character traits can clearly manifest themselves with defects in upbringing and give painful emotional reactions and pathological behavior.

The main medical classification of psychopathy divides the disease according to the leading psychopathological syndrome.

In practical medicine, psychopathy is distinguished:

• asthenic;
• psychasthenic;
• schizoid"
• hysterical;
• epileptoid;
• paranoid;
• excitable;
• affective;
• heboid;
• with sexual disorders and perversions

Symptoms of the main clinical forms of psychopathy

The main manifestations of psychopathy depend on developing species diseases

Symptoms of asthenic psychopathy

This form is characteristic of people of a weak psychophysical type, prone to increased vulnerability, hypersensitivity, quickly exhausted during strong nervous and physical stress. They are characterized by excessive anxiety (fearfulness), cowardly actions, frequent indecision, if necessary, to take responsibility for themselves.

Deep and prolonged experiences lead to a permanently depressed mood. Over time, an excessive tendency to take care of one's health appears, develop.

Asthenic psychopath is constantly tired, good health for him - an extreme rarity. Excessive pedantry, acrimony prevail in character traits, there is a certain life algorithm, it is very difficult for the patient to go beyond the boundaries of which.

This form is also characteristic of a weak type of nervous system. The main feature of patients is the predominance of the second signaling system. It is characteristic of people of the mental type. The behavior of these psychopaths is dominated by corrosiveness and excessive analysis of events and actions, especially their own. The patient is concerned about abstract, unimportant questions. For example, the color of the shirt in which you need to go out. Arguments about whether it is worth going in these clothes right now can lead a person to a dead end, and he will not go to the place he needs at all. Among the main symptoms of psychasthenic psychopathy are painful doubts (“mental chewing gum”) that arise for any, the most insignificant reason. Psychasthenics are characterized by pettiness and pedantry, which reach the level of obsessive states to an extreme degree.

Psychasthenics are constantly engaged in self-reexamination. Intrusive thoughts distract patients from real life. The insufficiency of the first signaling system makes patients emotionally narrowed, "flat" and indifferent.

Patients with this form of the disease look closed, avoid people and communication, are prone to self-immersion (pronounced introverts) . Thoughts and ideas of patients are obscure to others, very peculiar. Appearance, hobbies are unusual. There is a detachment from the interests of the outside world.

They say about such people that they are “not of this world”, eccentric and indifferent to themselves and others. Often they have developed intellectual abilities. . According to I.V. Chess allocate: sthenic a type of schizoid psychopathy (with symptoms of withdrawal, emotional dullness, rigidity and coldness) and asthenic type (closedness is noticeable, accompanied by daydreaming, anxiety and combined with strange hobbies - “freaks”).

Typology of a person with a predominance of the first signal system. Characteristic for the artistic type nervous activity. Vivid emotions come to the fore in the life of this category of patients. , that are prone to rapid polar changes . This leads to mood swings, unstable behavior.

Patients suffering from this form are very proud, self-centered, with a characteristic feature - to be constantly in the center of attention (demonstrative behavior). These patients are characterized by inventing stories, a tendency to fantasize and embellish facts, sometimes they “lie” so much that they themselves begin to believe in their writings. This form of psychopathy often develops symptoms .

People suffering from this type of mental disorder have viscous thinking, obsession with details, and extreme pedantry. Their thinking is stiff, hard "swaying". Among the main symptoms are pettiness, scrupulousness and excessive prudence. .

In behavior, there are sharp changes in attitude towards people: from sugary obsequiousness to outbursts of anger and intransigence. One of the features of the type is the inability and unwillingness to forgive. Epileptoid psychopaths can harbor anger and resentment all their lives, and at the slightest opportunity resort to revenge. Outbursts of anger are strong and prolonged. Patients of this form of the disease often exhibit sadistic tendencies.

Patients of this group are prone to one-sided and obsessive thinking, are prone to the formation of overvalued ideas that can completely take over their volitional and emotional sphere. The most common manifestation of this morbid quality is suspicion.

A paranoid psychopath can find in each of his acquaintances the features of an intruder who is watching him. Often, patients attribute envy towards themselves to people around them. It seems to the patient that everyone wants to harm him, even doctors. Painful symptoms of paranoid psychopathy often manifest themselves in ideas of jealousy, fanatical thoughts, constant complaints. It is quite natural that the relationship of this category of psychopaths with other people is conflicting.

This group of patients is more prone to uncontrolled outbursts of anger, inappropriate actions, attacks of unmotivated and pronounced aggression. Psychopaths are overly demanding of other people, too touchy and selfish. They have little interest in the opinions of outsiders.

At the same time, patients with excitable psychopathy may show symptoms of depressive states, despair. The most often excitable type is inherent in alcoholics, drug addicts, socially pathological personalities (thieves, bandits). Among them is the largest percentage of offenders and persons who are examined by forensic medical examinations.

This type of mental disorder occurs in the form hyperthymia- a condition in which patients are constantly elevated mood with a sense of carelessness and activity. This type of patient is inclined to take on all the cases in a row, but not one of them is able to complete. There is frivolity, increased talkativeness, importunity and leadership tendencies. Affective psychopaths quickly find a common language with everyone and no less quickly get bored with their “stickiness”. They have a tendency to get into difficult, conflict situations.

The second type of disorder hypothymia, is the opposite of hyperthymia. Patients diagnosed with "affective psychopathy" are in a depressed state. They tend to see negative aspects in everything, express dissatisfaction with themselves and others, they often have hypochondriacal symptoms, and extreme degrees of pessimism are observed. They are closed and feel a sense of their own guilt in front of everyone, consider themselves guilty of everything that happens. At the same time, hypothymics expressed resentment. Any word can deeply hurt the patient.

type of it pathological process contains deviations in the sphere of the concepts of duty, honor, conscience. Sick of a cruel disposition, merciless and selfish, with an atrophied concept of shame. General human norms do not exist for them. This type of psychopathy always proceeds in a severe form. Geboid psychopaths are characterized by sadism and indifference to the suffering of other people.

Symptoms of psychopathies with sexual perversions and disorders

The clinic of these disorders proceeds in combination with other types of psychopathy. Sexual perversions include pedophilia, sado-masochism, bestiality, transvestism and transsexualism. The forms of these deviations are constantly reviewed by specialists in order to determine the line between the symptoms of the disease and the variant of behavior within the framework of the mental norm.

Psychopathies run in cycles. Periods of improvement are replaced by exacerbations of the disease process. Psychopathies must be distinguished from personality accentuations (extreme degrees of manifestation of character).

Note:accentuations are not a pathology, although their manifestations may resemble psychopathy. Only a qualified psychiatrist can distinguish psychopathy from accentuation.

Treatment of psychopathy

Therapy of psychopathy begins with the elimination of the cause that triggered the development of clinical manifestations (infectious diseases, injuries, stress, diseases of internal organs, etc.)

Medical treatment includes:

• fortifying agents: vitamins, antioxidants, immunomodulators;
• sedatives (soothing in mild forms of pathology);
• tranquilizers (to stabilize the emotional background with constant overexcitation);
• neuroleptics (with affective forms);
• antidepressants (in cases of depression);
• sleeping pills (for stabilization in excitable forms of the disease);
• symptomatic (with problems with the heart, liver, kidneys).

Treatment of psychopathy must be accompanied by psychotherapy (hypnosis, waking suggestion, rational psychotherapy). Acupuncture, physiotherapy, especially electrosleep are widely used.

Prevention of psychopathy

Prevention of this group of diseases is possible only with large-scale measures at the state level, including the solution of socio-economic issues, the early detection of abnormal types of behavior in children and the creation of favorable conditions for their development, with gradual adaptation in society.

The task of medicine is to effectively treat somatic diseases.

Educational institutions should instill in children a healthy lifestyle, raise the cultural and educational level.

You will receive more detailed information about the course of psychopathy, methods of their diagnosis and treatment by watching this video review:

Lotin Alexander, medical columnist

The most controversial issue in modern psychology is what a psychopath is. There is no such diagnosis in the qualification of mental illness. Often this term is understood as a sociopath. Disputes on this topic and research are ongoing, and opinions are expressed diametrically opposed. From the complete denial of such a thing as psychopathy, to advanced tomographic studies with the establishment of typical brain activities in sociopaths. You can see what kind of brain a psychopath has. The photo below clearly demonstrates this.

The brain of a psychopath

The psychopath's brain is characterized by reduced functionality in the frontal and temporal regions. These areas are responsible for control and empathy. Empathy is defined as the ability to sense the emotions of others. Psychopaths can be figuratively defined as intraspecific predators that prey on their own kind and use their resources and energy for their own well-being.

For many people who live with psychopaths and don't know it, one understanding is that close person sick, brings relief. They understand that emotional exhaustion and neuroses are not their personal problem. A psychopath is a person who, due to illness, can bring the whole family to nervous breakdowns.

Who is this?

Psychopath - who is this? It's hard to answer in a nutshell. The symptoms must be acute, cumulative and continuous. long period time. Each person has certain inclinations and weaknesses of character, all people, not necessarily sick, face neuroses and nervous breakdowns, especially if there are reasons that cause emotional outbursts. It is important to realize that such drastic changes in life, which are accompanied by the death of a loved one, loss of a job, betrayal of a companion and naturally suggest a certain reaction of a person to stress, cannot be taken as a pathology. Often, it is these reactions that can be mistaken for a personality disorder. But if all the features of deviation from the norm are present in a complex and systematically without visible external causes, we can already draw some conclusions.

The presence of signs of psychopathy does not give us the right to label a person, especially in public. This information should only help us personally make decisions about continuing to communicate with a person.

How to spot a psychopath

How do you know who a psychopath is? Symptoms and signs are below:

• Loquaciousness and superficial charm. Often these are friendly, talkative people, using gestures, artistic. Others consider such people cute and charming. If you listen to what such a person says, it turns out that all the information given out is very superficial, this is a conversation for the sake of a conversation.
• The need for mental stimulation. These people often get bored when nothing happens, when everything is quiet and calm. They cannot occupy and entertain themselves, so they definitely need to arrange something - a feast, a scandal, some kind of trip, call people home. They are adrenaline addicts, and if everything is calm, they become uncomfortable.
• Even if they work, they look for a job where they can do nothing. Ideally, he does nothing at all, lives off his husband, wife, children, parents, etc. psychopath.
• This disease involves poor behavioral control. They cannot control themselves, easily explode, get irritated.
• Promiscuous sex, but not always.

Personalities of psychopaths

What a psychopath has This is important to know in order to protect your emotional health.

• Emotional superficiality. They do not have deep feelings, no deep fear, anxiety, love, affection. All emotions are formal and superficial. They never think about anything for a long time, they are indifferent to difficulties, whatever they may be - financial, social, emotional, physical, etc. The feeling of love is not characteristic of them. They may experience sexual feelings, an obsessive thought about controlling a person or manipulating his life, and this is perceived by them as love.
• The ability to manipulate. Such people will bring loved ones to tears, force them to do what they need. Everyone in the family will follow along. Manipulate psychopaths with the help of screaming, bad mood, feeling unwell, blackmail and threats (disinherit).
• Deceit. Sociopaths tell a variety of stories that didn't exist, passing it off as the truth. When they deny them, they claim that they did not say such a thing.
• Lack of compassion and empathy, heartlessness. Nothing can evoke any kind of sympathetic reaction in them - neither illness of loved ones, nor death, nor poverty, nor abandoned animals or homeless children.
• Inability to regret and repentance. Even if the guilt is obvious, these people will shift it to another. They are not ashamed, they will never say: "What a pity that I did this." They feel no remorse. You won't get an apology from them.
• Egocentricity.

Beware the psychopath!

A psychopath is a person who, due to his own inadequacy, is able to humiliate others, endanger them, cause pain and suffering, and not once or twice, but systematically. Sociopaths are extremely deceitful, and given their effective abilities (flat effect), their lies are very difficult to determine. Even experienced verifiers and profilers often make mistakes when working with them. When defining a lie, experts often ask themselves at the very beginning whether the person in front of me is healthy or not.

You won’t immediately understand who a psychopath is, these people have a superficial charm and are excellently disguised, causing others to (justify the actions of a person who causes suffering).

Varieties of psychopathy

Is the interpretation of the term limited by sociopathy? What can be a psychopath? Varieties are described in the book of P. B. Galushkin. He proposes such a classification.

• Cycloids - the life regime changes abruptly, intervals of complete inactivity - to hyper-efficiency. Characterized by cyclical ups and downs of mood for no reason.
• Asthenics are people who are characterized by anxiety, suspiciousness and the possibility of developing nervous obsessive states. The main feelings are “what if something happens”, “I said something correctly or not”, “what if I get sick”. Create predictable safety spaces around them, avoid unpredictable situations.
• Schizoids - they leave the world, do nothing, close themselves in a shell and refuse to interact with people, limiting the circle of contacts.
• Hysterical characters - do not refuse contact with the world, but on the contrary, they try to demonstrate themselves, surprise everyone, throw tantrums.
• Paranoids are people who are overly suspicious for no reason and have no sense of humor. They sacredly believe in their delusional conjectures and ideas, there is no need to convince such a person - it will not work.
• Epileptoids (they do not suffer from epilepsy) - structure the reality around them, they know what lies where, the house is always perfectly clean. Everything should lie strictly in its place, everything should happen at a strictly appointed time and in a certain order. Resentful, everyone can remember. They can be identified by handwriting or signature. They usually have a very beautiful, complex signature, very clear and unchanging. They are suitable for work that requires accuracy, stereotyping, accuracy, they enjoy it.
• Unstable psychopaths - cannot strain in terms of study, work or stressful situations, tend to live under someone's guardianship. They do not deny themselves anything, so there may be problems with alcohol, drugs, and a promiscuous sex life.
• An antisocial psychopath is a complete lack of interest in others, including family. They have no friends, they do not know how to empathize. They lie shamelessly, are prone to cheating, act impulsively and do not plan far. They often criticize others, but not themselves.
• Constitutionally stupid - sweet, sociable personalities, good interlocutors. Disorderly, extremely sloppy and lazy. They feel good only thanks to a strong hand and leadership.

Varieties of personalities

The following disorders can also be classified as psychopathic.

• Narcissistic Personalities - They love attention and will do anything to get it. All for me and all the attention on me. And if this does not happen, the person becomes aggressive. It becomes common behavior to extract both material and emotional resources from the family for their own personal goals, to maintain their external position in society. Half of such a person's salary is spent on expensive suits, ties and watches, and he sees nothing unusual in this, although the family saves on food for children, hoping that the husband will climb career ladder, will bring more money. But the family will not get anything, even if the narcissistic psychopath gets rich. It's a disease, but that doesn't make it any easier. The absolute self-centeredness of such psychopaths seems somewhat childish and infantile. In fact, it is: this is a big narcissistic child who plays with toys and will never stop. When deciding to establish a relationship with such a person, you need to understand that if you don’t put him on a pedestal, he will behave aggressively, and in the opposite case, he will pull all the resources out of his loved one. There is no "no" for him. sexual relations, he does not stop, but continues harassment. In the company of such a person there is a high risk of rape, he considers the other as a thing to support his own ego.
• Emotionally Unstable - jumping on all spectrums of feelings, from extremely positive to extremely negative mood. At work or in some public place, they can be charming, being on an emotional upsurge, and at home the smallest difficulty, any unpleasant information will lead them to the very bottom of the negative emotional spectrum. Home will have to pull them out of there, acting as a lifeguard. Those who associate closely with such people pay an emotional tribute for life, so tired that they are completely exhausted, depriving themselves of the opportunity to lead a normal life. Sometimes such psychopaths are figuratively called energy vampires. Such people can move from one person to another, and then back, waiting until the old partner has a rest, forgets the emotional fatigue from their relationship and can be used again. Such multiple connections are one of the characteristics of such psychopaths. In attempts to get emotional support, they are extremely manipulative, their typical threat is suicide. It must be treated realistically, it is best to persuade a person to visit a psychotherapist. But still you need to leave, these relationships are destructive by definition. Interestingly, one of the signs of such a disorder is self-harm, for example, multiple healed skin cuts. Seeing such scars, you can prepare forces for emotional support or leave immediately.
• paranoid. The motto of such people: "trust no one, and you will not be offended." They see the whole world through the prism of threat. The first sign is distrust in relationships, constant monitoring, surveillance, checking the phone and e-mail. If there is no evidence of infidelity, the tension only grows. Paranoid psychopaths consider themselves very logical and are able to convince everyone of the correctness of their picture of the world. As soon as words are heard about a conspiracy, a world government, or just about colleagues at work who are making cunning plans to fire him, it is worth considering, even if everything looks logical and truthful. Paranoids are consumed by irrational distrust and fear, tend to collect threats, and if they see no support, write off the person in the category of "enemies".

Predators are people in the presence of which many experience a literal physical malaise, the so-called social discomfort. This applies not only ordinary people, but also trained specialists, psychotherapists, polygraph examiners. It often takes several hours, or even days, to recover after communicating with such a person. This is not always the case, predators often have to deceive people, for a very long time they can seem quite nice. This category includes pedophiles, rapists, brutal robbers, human traffickers. A typical situation: the mother is in love and lives with a charming male predator who systematically intimidates and rapes her adopted daughter, and the mother turns a blind eye to this and does not believe her daughter. It is difficult for a predator to express emotions, he literally peers into the expression on a person’s face and tries to understand how to react and how to adapt.

Is the disease curable?

Can a psychopath be healed? The symptoms and treatment of this disease is largely a mystery even to doctors. Such violations are difficult to correct. If the psychopath himself is aware of his own problem and wants to treat it, he has a chance to correct his behavior. Unfortunately, this awareness is available to few, and the possibility of pushing a psychopath into treatment seems unlikely.

Before treatment, you need to make a diagnosis with a specialist psychotherapist. To do this, a conversation is held with a person, his behavior is observed, and a tomography may be needed.

Usually drugs are not prescribed, you can only maintain a stable state with the help of antidepressants. To begin with, they are prescribed in small doses, gradually increasing, but it is extremely difficult to convince a person to take something. Basically, they try to treat the side effects of psychopathy - drug addiction, alcoholism and other types of addictions.

Also, a course of psychotherapy is carried out with such people, conducting conversations and directing the patient's behavior in the right direction, eliminating negative painful stereotypes of thinking.

What do diagnoses sound like?

Who is a psychopath? Signs in women and men are almost identical. The diagnosis may include:

• Paranoia.
• Hysteria.
• Schizoid psychopathy.
• Psychoasthenia.
• Excitable psychopathy.
• Unstable psychopathy.
• Sociopathy.

So we found out who a psychopath is. Signs in men and women are very similar, but men are more susceptible to such diseases and are more likely to show aggression. Maybe that's why alcoholism is a problem, rather, of the stronger sex.

In old age, dementia is added to personality disorders, especially if the pensioner stops social and social activities and does not use his brain actively. serials from morning to evening, a narrow circle of contacts - all this aggravates the situation.

How common are mental illnesses?

According to the US National Institute of Mental Health, 26% of Americans over the age of 18 suffer from some form of diagnosable personality disorder. Perhaps in Russia the figures are different, but there are no prerequisites to expect a significant decrease in this percentage.

More than 30% of the subjects felt something similar to a mental disorder throughout the year. About 50% suffered from this kind of dysfunction during their adulthood. According to a deeper analysis of the research materials, mental disorders accounts for 23% of all years lost due to incapacity. Nearly a quarter of people who become incapacitated for a year lose it due to mental illness. These diseases easily compete with neurological diseases and injuries of the musculoskeletal system by prevalence.

And perhaps Viktor Tsoi was right: “And I don’t know what the percentage of crazy people is at this hour, but if you believe your eyes and ears, it’s several times more.”

Until recently (more precisely, until the tenth revision of the classifier of diseases), both neuroses and psychopathy were considered within the framework of borderline mental disorders.

In the latest International Classification of Diseases, the usual boundary categories were replaced by the collective term "personality disorders". Pathological personality traits of a particular individual, bringing suffering to himself or to the society in which he resides, are referred to as psychopathies. notice, that we are talking about anomalies, not about character traits.

Psychopathy is an unsanctioned name for a condition of a specific anomaly human nature. Psychopaths are often referred to as excitable people who react inappropriately to unpleasant events for them, who are not always able or willing to control their behavior. They cannot critically evaluate their not always adequate actions and look at them from the perspective of other people. However, such behavior can be the result of serious errors in education and in a completely healthy person.

Psychopathy is a disease or a character?

For a long time, psychiatry ignored antisocial disorders, they were dealt with by criminologists and the judiciary. Psychopaths who did not break the law were considered people with a difficult character.

The term "psychopathy" itself means "disease of the mind", however, most specialists do not consider it as a common mental disorder.

Psychopaths think rationally and are well oriented, their actions are sane, they know very well what they are doing, however, such actions are incompatible from the point of view of an ordinary person with a sound mind.

The French psychiatrist F. Pinel, two centuries ago, describing the behavioral model of a psychopathic personality, called psychopathy "a mental illness without insanity."

To perceive psychopathy as a disease of the soul began long ago, back in ancient times, but to study seriously - in the second half of the last century, and with the advent of new diagnostic methods that allow scanning the brain, the development of genetics and neurobiology, it became possible to study the biological background of antisocial behavior.

With psychopathy, mental retardation does not progress, psychotherapist sessions allow patients to hone their abilities to manipulate people. Psychopaths can perfectly hide their main anomaly of the psyche - lack of empathy and absolute egocentrism, and do not dwell on it. Psychopathy is more difficult to recognize than other mental disorders. So far, these people have not been judged, in general, rightly believing that they are able to be aware of their actions.

Currently, personality disorders are classified as mental illness, however, the line between illness and the norm is very thin. It is believed that they are based on some distortion in the development of the central nervous system, often not obvious, which was influenced by the influence of unfavorable external stimuli.

Some pedagogical errors are not enough for the formation of psychopathy. Explosive temperament and antisocial behavior are not grounds for enrolling a person in the ranks of psychopaths. For accentuated individuals, whose deviations from the norm are sufficiently compensated and do not reach a pathological level, the diagnosis of a psychotic disorder is also considered inappropriate.

So psychopathy is a disorder of higher nervous activity, which means that it is still a disease that usually manifests itself in an imbalance between the processes of excitation and inhibition, a pronounced predominance of one of them.

Psychopathies are a whole group of personality disorders, there are many options for the behavior of patients, depending on which different types of diseases are distinguished. The development of psychopathy usually occurs under the influence of external factors in people with hereditary or impaired activity of the central nervous system at an early age.

Among psychopaths there are many people who have a good education, successful career growth, they are called socialized. A specific feature of psychopaths is considered to be intellectual safety and the lack of the ability to empathize with both negative and positive emotions of another person. This painful condition is not characterized by a progressive course with the degradation of the personality and the development of dementia. However, the normal intellect of a psychopath under the influence of adverse external factors is dissonant with his emotional and volitional sphere, which leads to social maladaptation, and acute mental trauma fraught with serious violations of social foundations.

Psychopaths make up a significant detachment of people with criminal inclinations, which is facilitated by their one-sided perception of reality from the point of view of their own expectations and the absence of higher moral qualities. Such categories as empathy, repentance, affection, love are unknown to them. Although at favorable conditions psychotic disorders are practically not manifested, which is confirmed by the story of the American neuroscientist J. Fallon. But any deviation from the expected, the appearance of any problems often leads the patient to an emotional breakdown.

Epidemiology

Statistical information on the frequency of occurrence of psychopathy has significant discrepancies due to the lack of a unified approach among different authors to isolate this disease.

Using the evaluation criteria of the International Classification of Diseases Tenth Edition, on average, about 5% of the world's population suffers from various types of personality disorders. Another 10% have separate psychopathic features, however, they do not reach the diagnosis of psychopathy.

Psychiatrists give slightly different figures. They believe that approximately 1% of the world's population meets the clinical criteria for psychopathy, and the higher figures of 3 to 5% reflect their prevalence in the business world, where psychopathic personality traits are much more common.

Among patients receiving psychiatric care on an outpatient basis, the proportion of psychopaths ranges from 20 to 40%, in hospitals - half of patients with personality disorders.

In places of deprivation of liberty, psychopathy is detected in 78% of male prisoners and in half of female prisoners, in other sources the figures are 20-30% and 15%, respectively.

It is believed that there are much more psychopaths among men than among women, which is also confirmed in terms of genetics. The gene for increased aggressiveness (MAO-A), located on the X chromosome, inherited from the mother by a man, manifests itself at 100%. Among psychopaths, 4/5 are men.

Carrying this gene is much more common in nationalities where aggressiveness and militancy among males are encouraged. Among the inhabitants of Africa, the rage gene is found in 59% of the population, the indigenous inhabitants of New Zealand (56%) and the inhabitants of China (54%) are almost not far behind. In the modern civilized world, aggressiveness has lost its high status - slightly more than a third of the representatives of the Caucasian race (34%) are carriers of the MAO-A gene.

Causes of psychopathy

There are several assumptions about the etiology of the formation of a psychopathological personality. Unity is achieved in that the main impact of hypothetical causes refers to the early period of development.

Among the reasons considered: the conception of an embryo with a hereditary predisposition; genetic modifications during this period; the influence of negative factors on intrauterine development; injuries received during childbirth or the early postnatal period, infections or intoxications that provoked the inferiority of the central nervous system.

Researchers of this problem associate the strongest impact of external factors with critical periods of early development - the moment of conception, the third and fourth weeks of pregnancy, the moment of childbirth and the so-called "fourth trimester" - the first three months after birth. For example, the mother is an alcoholic, a drug addict, or she is in constant stress due to intra-family conflicts; a child left by the mother in the care of the state, and similar situations.

Then, according to experts, the susceptibility to adverse external factors decreases somewhat, however, before the child reaches the age of three, complex adaptive behavioral skills are formed. Therefore, the stress factors acting at this stage of development disrupt the formation of a normal standard of behavior.

The psychodynamic concept, common in the UK and the US, is based on the teachings of Sigmund Freud. The leading role in the development of psychopathy is assigned to a violation of the relationship between parents (guardians) and the child at the earliest stages of its development (again, up to three years), which provokes the formation of pathological complexes in the child, which are predominantly sexual in color. Psychopathy in this case is considered as a protective reaction of the body. The disadvantages of this concept are the impossibility of experimentally confirming this version, as well as a one-sided view of the problem. It does not take into account the influence of the social environment, that is, relations within the family are analyzed in isolation.

Back in the 19th century, when the concept of “psychopathy” began to be widely used, doctors began to notice that members of the same family often had similar traits of a psychopathic personality, expressed in varying degrees. Even then, scientists were interested in whether psychopathy is inherited. Studies of identical twins, even separated in early childhood and living with different parents, said that hereditary predisposition still takes place.

However, only the development of genetics made it possible to identify a specific type of genes encoding monoamine oxidase A, a catalyst for the biotransformation of neurotransmitters (adrenaline, norepinephrine, serotonin, melatonin, histamine, dopamine) that regulate mood and behavior. They are also called the “rage gene” or “warrior gene”, as well as the psychopathy gene, its carriers are distinguished by natural cruelty, selfishness, aggressiveness, and lack of empathy.

A person with such a genetic set will not necessarily grow up to be a psychopath, however, the atmosphere of cruelty and violence surrounding him from early childhood will complete the process of the formation of psychopathy. But children, even with an unfavorable hereditary predisposition, who grew up in a warm family environment, where all family members love and care for each other, and parents strictly control the child's behavior, become full-fledged members of society.

Canadian professor R. Hare notes that the processing of the emotional component in the brain of a psychopath, as shown by physiological MRI, is not the same as in a healthy person. The deficit of his perception concerns the entire emotional sphere, positive and negative. The area of ​​the brain responsible for emotions simply does not activate.

Currently, psychopathy by origin are divided into three main groups.

Congenital psychopathy (nuclear, constitutional) is due to hereditary predisposition. In these cases, one of the blood relatives has character anomalies characteristic of psychopaths. Hypothetically, such qualities are inherited by daughters from both parents and sons from mothers, although the exact mechanisms for the transmission of genetic information have not been identified. The MAO-A gene is located on the X chromosome, so males get it from their mother, and since this chromosome is unpaired, its influence is fully felt.

Women have a pair of X chromosomes. Having inherited the psychopathy gene from one of the parents, paired with a “clean” one, the woman practically does not feel its effects. The presence of the aggression gene on both chromosomes has not yet been investigated.

Acquired psychopathies are subdivided, in turn, into organic and marginal. The first, as the name implies, are the result of a deficiency of cerebral organs caused by the damaging effect of infectious agents, intoxications or brain injuries during fetal development, infancy or early childhood.

The second type is acquired as a result of prolonged exposure to a very unfavorable pedagogical atmosphere that surrounds the child in childhood and adolescence. “Unloved”, emotionally rejected children acquire asthenic character traits, total control and hypertrophied care leads to the development of psychoasthenia, permissiveness and unconditional admiration for the “family idol” form hysterical traits in the child, lack of control and reasonable restrictions, combined with parental indifference, contributes to the development of increased excitability . Regional acquired psychopathy develops in more late age than constitutional and organic, they are considered less stable and deep.

In the overwhelming majority of cases, it is not possible to attribute this antisocial personality disorder to any specific form of psychopathy, since the formation of abnormal personality characteristics occurs under the influence of a combination of a number of various unfavorable causes.

Risk factors

Studies of patients with psychopathological traits, and scientists usually look at individuals with extreme psychopathy who are imprisoned after committing criminal acts, suggest that the likelihood of developing psychopathy increases in people:

• with a certain genetic set;
• with reduced activity in the temporal and frontal sectors of the meninges, responsible for the ability to empathize, adherence to ethical standards and social values;
• with intrauterine damage;
• injured during childbirth;
• suffered brain damage at an early age (from birth to three years);
• pedagogically neglected, neglected or brought up in an atmosphere of permissiveness;
• exposed to a negative social environment.

The risk factors for the birth of a psychopathic child are considered to be the presence of a family history of syphilis, drug addiction, and alcoholism.

Substance abuse, in addition to other factors, accelerates manifestation and exacerbates the course of a personality disorder. Psychopathy and alcoholism are closely related, even the gene responsible for aggressive behavior is activated in the body of its carrier under the influence of alcohol. The activation of this gene is facilitated by the abuse of the child himself or by bullying and violence, which he has witnessed.

During age-related crises (periods of formation and involution), hormonal changes (puberty, pregnancy, menstruation, postpartum period), the likelihood of increased psychopathic manifestations increases.

Psychopathies are classified as multifactorial pathologies, the development mechanism of which is different in origin.

Pathogenesis

To date, a single and generally accepted concept of the formation of a psychopathic personality does not exist.

But all scientists recognize the importance early period development, including the moment of conception, when an unborn child can inherit a set of genes with a tendency to psychopathy, an unfavorable course of pregnancy in his mother, a difficult birth, and external interference in the natural gene adaptation program for the formation of behavior that is normal from a universal point of view, disrupting its course. The mechanism is implemented in the first three years of a child's life, when adverse external influences stimulate the consolidation of certain forms of behavior, which are distinguished by constancy and persist throughout the life of the individual.

For example, there is a noticeable lag in the development of children who were brought up from birth to two years in children's boarding schools (orphanages), next to which from the moment of birth there was no key figure of attachment - the mother or the person who replaced her. The antisocial behavior of the mother, her indifference to the child or, conversely, excessive guardianship also increases the likelihood of primary mental personality disorders. In children with a hereditary predisposition, psychopathy sometimes manifests itself very early - at two or three years.

An important pathogenetic link is social factor. Its independent role in the formation of regional psychopathy is also recognized. Also, against the background of adverse conditions, psychopathy is decompensated, while a favorable background contributes to the normalization of the individual's behavior.

Age and hormonal crises contribute to the growth of psychopathic symptoms. The use of psychoactive substances provokes the activation of the MAO-A gene.

The neurophysiological side of the mechanism of development of psychopathy is revealed in the concept of I.P. Pavlov about the types of higher nervous activity, from these positions it was considered by both Russian and Canadian scientists. Various types of psychopathological personality disorders stem from pathological misalignment nervous processes, signaling systems, the interaction of the subcortex and the cerebral cortex. The basis for the formation of excitable type psychopathy is the absence of inhibition processes, the psychoasthenic form develops with the predominant influence of the second signaling system over the first and the weakness of the subcortex of the brain, and the hysteroid form, on the contrary, when the first prevails over the second, as well as the cerebral cortex over the subcortex. The pathophysiological basis of the asthenic form of the disease lies in the weakness of higher nervous activity, paranoid - in the tendency to form foci of stagnation in the second signal system.

A number of already known and not yet studied factors influence the pathogenesis of psychopathy, and the result will depend on the degree of pathogenicity of each of them.

Symptoms of psychopathy

The first signs of psychopathy with a hereditary predisposition appear from childhood, sometimes quite early at two or three years. When a child is raised in a benevolent environment, pathological character traits are smoothed out. Compensated psychopathy is a completely acceptable phenomenon in society, although an individual's tendency to unusual, often shocking behavior, causeless mood swings, some hardness of heart and recklessness is noticed. However, socialized psychopaths find their place in society, often have families, children, friends who evaluate them positively enough.

Behavior in psychopathy varies depending on its form and accentuation. However, experts from different conceptual areas identify three main features that are characteristic of all types of psychopathy, expressed to varying degrees:

• fearlessness, audacity - psychopaths have a reduced sense of fear and danger, combined with high stress resistance, they are confident in their own abilities, have great perseverance and try to dominate society;
• disinhibition - impulsive, easily impulsive, have a need to satisfy their desires "here and now", without thinking about the consequences and not limited to generally accepted behavioral norms;
• meanness and heartlessness - they are not capable of empathy, they use any means up to violence to get what they want immediately, they are prone to exploitation, disobedience, and manipulation of other people.

Such a triarchic model of behavior (the triad of psychopathy) is characteristic of people with a psychopathic personality.

Other researchers highlight the tendency of psychopaths to narcissism, noting that they are almost always very pleased with themselves. Communication with other people comes down to their exploitation, manipulative actions, ignoring other people's interests and feelings. Disobedience to a psychopath can cause a very violent aggressive reaction.

Such personality traits as psychopathy, narcissism, and a complete lack of principles, called the dark triad, have many general characteristics. To these negative traits is often added a tendency to sadism.

Psychopathies in the psychiatric hierarchy occupy an intermediate place, delimiting the extreme version of the norm, called character accentuation, which implies some more pronounced traits of a person’s character, manifested in connection with traumatic situations for a short time in the form of psychosis or neurosis, and progressive mental pathologies.

Psychopathy of the personality does not fit into the general boundaries of the description of mental illness, therefore, for a long time it was attributed to borderline painful conditions, not recognizing it as a disease, but you cannot call a psychopath a healthy personality either. Accentuation of character and personality psychopathy are separated from each other by a ghostly feature that even experienced psychiatrists cannot always discern. The main difference is the constancy of psychopathy, it accompanies a person all his life, while accentuation looks like accents on some character traits that stand out more than others, and therefore dissonant against the general background. These accents do not appear constantly, but under the influence of certain psycho-traumatic situations. Emphasizing some features does not prevent a person from leading a normal life in society.

The average psychological portrait of a psychopath looks something like this: at first glance, this is an enterprising, energetic, charming person who does not suffer from an inferiority complex; later, traits such as cunning and the ability to manipulate others, deceit, callousness and callousness emerge. This person never repents of his actions, does not feel guilty and does not regret anything.

In institutions and organizations, psychopaths, as a rule, are charming and dutiful in front of superiors, however, they are rude, offensive and aggressive towards employees below them in the hierarchical ladder. Their business qualities are usually highly valued. Courage, the ability to take risks and make quick decisions, sometimes non-trivial, from the point of view of an ordinary person, mostly bring good dividends to psychopaths, manipulative abilities allow you to achieve a lot from employees and lead them along. Although their unscrupulousness and lack of morality are assessed rather negatively, it is believed that the harm brought by a psychopath occupying a high leadership level is much greater than its benefits.

Psychopathy in the family

Working with a psychopath isn't easy, but it's much worse when the psychopath happens to be a family member. There are no recipes, the best remedy is not to create a family with psychopathic personalities. A psychopathic husband will sincerely consider his wife and children his property, and much in the development of further events will depend on the conditions in which he grew up. A socialized psychopath will fulfill his duties, raise children, support a family, simply because it is easier, more comfortable and convenient for him, and not because he loves his wife and children or feels responsible for them. However, even in this case, no one can guarantee that he will not break loose, you cannot rely on this person. And his wife will have to put up with many oddities of her husband.

A psychopathic wife is also not a gift, and in this case there is a connection with her upbringing. She will not love her husband and children, because she cannot, she will not have responsibility to them either. But a socialized psychopath can easily pass for a caring mother - to do homework with children, take them to extra classes, play games, and also play the role of a devoted wife, especially if the husband lives up to her expectations.

Psychopaths, wealthy and socialized, prefer to communicate with older children, small children who require hourly care and presence simply annoy them. If possible, such parents will try to shift the care of young children to a nanny, grandmothers or other relatives. Fathers who are “burning” at work usually cause respect, mothers, business women, careerists, also in modern world- Not unusual.

Much worse are antisocial psychopaths who grew up in an unfavorable environment, had an unsuccessful start in life and an unstable financial situation. AT best case they will be indifferent to the child, will not pay attention to him, at worst, which happens much more often, they can mock him physically and morally, even involve him in illegal actions.

Psychopathy in men is better studied, since there are much more of them among psychopathic personalities, and also - they are in prisons, where, basically, research is carried out.

The symptomatology of psychopathy does not depend on gender, and the difference in manifestations is determined by its type, as well as differences in society's assessment of the behavior of men and women.

For example, if many authors, describing female psychopaths, call them sexually promiscuous, then when talking about men, they mention a lot of relationships, marriages or broken hearts, which actually characterizes psychopaths of any gender as sexually active and, in their own way, attractive. , as well as irresponsible and soulless manipulators who know how to get what they want at all costs, without thinking about the future.

And, you see, a female tramp and / or alcoholic also causes a slightly different reaction in society than a man leading the same lifestyle.

Psychopathy in women is characterized by less aggressiveness and the use of physical violence, which is simply characteristic of the female sex in general. They are much less likely to commit criminal acts in a state of passion, among them there are often kleptomaniacs, but in terms of psychological sadism, a female psychopath will give any man a hundred points ahead. In general, some experts believe that in fact there are no fewer female psychopaths, they just need to be evaluated differently.

Psychopaths of any gender are egocentric, they are all guided only by their momentary desires, ignoring the interests of those around them and even those closest to them. A psychopathic mother in most cases poses a serious threat to the mental health of her children, much more than a psychopathic father, because children, especially small ones, in most families spend most of the time with their mother.

It is almost always noted that a psychopath husband is a huge mental trauma for his wife, and often Great chance physical bullying.

Psychopathic women are also uncontrollable in family life. Lack of self-control, long-term goals, callousness and addiction to substance abuse, deceit and meanness can ruin the life of any normal man.

The first signs of inherited psychopathy appear as early as two or three years. Young children are emotionally unstable, they lack a sense of pity for animals, peers and relatives, it is difficult to get sympathy and remorse for cruel acts from them. Basically, the first thing parents pay attention to is cruelty towards other children and / or animals, the desire to dominate, command other children, and use force against those who disagree.

Psychopathy before school age diagnosed by S. Scott (Institute of Psychiatry, London) on the following grounds:

• frequent insults to others (regardless of faces and kinship);
• regular attempts to hurt any living beings (prick, pinch, press, pull), older children try to exert a moral influence;
• total disobedience, attempts to escape in order to disobey the rules;
• the child never feels guilty;
• it is possible to achieve adequate perception only with the help of reward;
• in any failure, the child blames others, never himself;
• does not respond to comments and is not afraid of punishment.

It is worth considering if children of senior preschool and primary school age constantly fight, take other people's things without asking, try to set fire to something or blow it up.

A real flurry falls on parents when children reach adolescence. They are rude, run away from home, do not want to obey, they cannot be intimidated by any threats. Adolescents do not feel their guilt and responsibility, reacting violently to punishment. Psychopaths are not interested in the feelings of other people at any age.

It is teenagers who most often start having problems with the law, they can start drinking, taking drugs, and commit crimes.

Psychopathy in adolescents is severe, this is a critical age hormonal adjustment and the development of personality. It is during this period that parents find it most difficult to cope with a psychopathic child. Basically, of course, such children are characterized by increased excitability, stubbornness, there may be sharp transitions from fun to a depressed state, hysteria, tearfulness, and even fainting.

The transition to adolescence can be marked by the so-called metaphysical intoxication - attempts to solve any complex insoluble problems and thus make humanity happy.

At the age of about 20 years, compensation usually occurs, in successful psychopaths the mood stabilizes and adaptation takes place in society.

stages

Despite the fact that psychopathy is not characterized by progredientity, like other mental illnesses and illnesses in general, it has its own dynamics. It is not a static state, it is evolving, and it has certain stages of development.

The prepsychotic stage takes quite a long time. Constitutional (nuclear) psychopaths go through the formation of psychopathic character traits in childhood and adolescence, the pathology acquired in adulthood also goes through the prepsychotic (subclinical) stage, in which the clinical symptoms are not yet sufficiently pronounced.

Psychopaths have two states: compensated, when the individual is at peace with society (usually achieved due to the comfortable conditions of his existence), and decompensated, when a pathological psychogenic reaction develops (decompensation most often occurs with adverse external influences). For each type of psychopathy, various factors have a decompensating effect. And the reactions can also be unambiguous to the type of psychopathy, such do not last long - sometimes a few hours, sometimes a few days. After very significant mental trauma, decompensation may occur, manifesting itself in the form of a reaction that did not previously dominate in this individual, for example, asthenia in an excitable psychopath or, conversely, a depressive one will show an explosive temperament.

Ambiguous structural shifts in the character of a psychopath are usually longer, but still reversible when the causes that caused this state are eliminated. The symptomatology of such shifts is not represented by psychotic symptoms, but by characterological reactions - for some time an individual can be swallowed up by some kind of passion, he may experience a state of unmotivated aggression, hopeless longing, a desire to commit suicide. If the traumatic situation is not resolved, the reaction can take on a protracted character, gain a foothold, and over time, severe psychopathy will develop.

Regardless of the type of psychopathy, they develop according to the same cyclic scenario. Personal anomalies of a psychopath lead to the creation of a conflict situation, as a result of which the patient develops a psychopathic reaction that lasts for a more or less long time. After its completion, aggravation of psychopathy is noted.

Complications and consequences

The danger to society and the psychopath himself is the decompensation of psychopathy, leading to an increase in personality anomalies that prevent natural adaptation in society.
The clinical course of decompensation looks like an exacerbation of the individual's abnormal personality traits specific to a particular type of psychopathy - hysterical seizures, affective antics, depression, hypochondria, acute delusional syndromes, reformism, litigation.

Psychopathy develops throughout a person's life, the impact of society is of great importance in its dynamics. Favorable - helps to smooth out psychopathic manifestations, their compensation. On the contrary, under the influence of many constant adverse factors, an antisocial personality is formed, which can bring significant damage to society.

Complications of a personality disorder do not exist - a person will live with him all his life. However, over time, it can both smooth out and worsen. Frequent decompensation aggravates the course of psychopathy, which can greatly worsen the quality of life of the individual himself, become a specific threat to his life or the people around him. Often found different forms attacks of aggression and antisocial behavioral reactions on the part of psychopaths, some are quite harmless, others can pose a real danger. It is not for nothing that psychopaths in prisons make up from a third to a half of all prisoners.

fluctuations hormonal background- adolescence, pregnancy, menstruation, menopause, as well as - crisis age stages contribute to the decompensation of the disease and the aggravation of its course.

Adolescence is considered especially dangerous, when, in addition to changes in the hormonal background, growing up and the formation of personality occur. During this period, stubbornness, unwillingness to obey, and impulsiveness increase in individuals with psychopathic traits. Teenagers are characterized by emotional instability - unmotivated transitions from bursts of fun to tearfulness, depressive state, sadness; outbursts of rage or aggression without any reason, tantrums, tearfulness, fainting. Teenagers often run away from home, begin to wander, lead an antisocial lifestyle.

Stormy puberty is often replaced by philosophizing, reflection, metaphysical searches. After 20-23 years, successful psychopathic personalities usually have a period of compensation, the personality socializes and the character becomes more balanced.

During the period of extinction of sexual function, psychopathic personality traits become aggravated again, emotional balance is disturbed, the individual becomes more impulsive, angry, irritable and / or whiny. When involution coincides with a change in lifestyle, for example, retirement, the decompensation of psychopathy can worsen: anxiety, depression, depression appear in combination with hypochondria and hysteria, litigation and conflict intensify.

Diagnosis of psychopathy

Research methods for patients with personality disorders include a variety of studies. Firstly, socially maladjusted individuals usually fall into the field of view of specialists in the field of psychiatry. Socialized psychopaths who do not have problems with adaptation in society are quite satisfied with themselves, and they themselves and their families never seek medical help. Long-term decompensated psychopathy attracts attention, but in order to establish a diagnosis of a personality disorder, it is necessary to exclude general somatic causes of mental disorders.

For this, laboratory analyzes are carried out, giving an idea of general condition of the patient's health, some specific tests may be ordered.

Neurophysiological research includes encephalography - magnetic, electrical, neuroradiographic - different types of tomography, the most informative and modern of them is functional magnetic resonance imaging, which allows to assess not only the structure of the brain, but also the course of metabolic processes, blood flow.

The diagnosis of psychopathy is made on the basis of conversations with the patient, in which psychiatrists and psychologists, using a set of certain techniques and methods, identify violations of the human psyche.

Psychiatrists conduct a clinical discussion and are guided by the criteria for the latest edition of the classifier of diseases to make a diagnosis.

A medical psychologist uses various tests and interviews in his work to identify a symptom complex - a stable combination of positive and negative features of the psyche that exist as a whole.

When diagnosing a personality disorder, the Minnesota multidimensional personality test is used; in the post-Soviet space, its adapted version, the Standardized Multifactorial Personality Test, is popular. These questionnaires have clinical scores, which allow you to establish the type of personality disorder - to identify the patient's proximity to a certain type of personality (paranoid, asthenic, schizoid), the degree of gender identification, anxiety and a tendency to antisocial actions. Additional scales allow you to assess the sincerity of the patient, as well as correct his unreliable answers.

The Psychopathy (Sociopathy) Scale - Fourth on the Minnesota Multidimensional Personality Test assesses the test-taker and his similarity to antisocial personality disorder. The high scores scored on the questions of this scale indicate the inability of the individual to live in a society of his own kind. They characterize the tested as impulsive, angry, conflict, not observing the moral and ethical rules adopted in human society. Their mood is subject to fluctuations, they are very susceptible to resentment, reacting aggressively to the offender and losing control over their behavior.

R. Hare's test for psychopathy is very popular; the questionnaire includes twenty basic character traits of a psychopath. Each item is worth a maximum of three points, if the subject receives more than 30 points, he is predisposed to psychopathy. The questionnaire is accompanied by an interview in which the test-taker sets out his biography: talks about education, places of work, describes marital status and possible friction with the law. Since psychopaths are notorious liars, interview data must be documented. The R. Hare test was designed to detect psychopathy in criminal offenders, although it can be used in other cases.

AT psychiatric practice different assessment methods are used to determine the patient's self-esteem, the quality of his relationships with other people, cognitive functions, the level of perception, attention, memory are examined.

The basis for recognizing a person as a psychopath are the following criteria for Gannushkin's psychopathy:

• stability (stability) of abnormal character traits, that is, they accompany the patient all his life.
• the psychopathic feature is comprehensive, that is, it completely determines the characterological structure of the individual (totality);
• pathological anomalies of character are so noticeable that it makes it difficult, if not completely impossible, for the individual to adapt to life in society.

The same P.B. Gannushkin notes that psychopathy is characterized by a certain dynamics (strengthening or weakening of a personality disorder). And the environment has the greatest influence on dynamic processes.

In general, the diagnosis of psychopathy is quite complicated, people are examined using different methods, because psychopathic symptoms can be observed after brain injuries and intoxications, with endocrine disorders, and also - manifestations of decompensated psychopathy resemble obsessive-compulsive disorders, schizophrenia, psychoses. Only an experienced doctor can differentiate psychopathy from other pathologies.

For self-diagnosis of persons who suspect psychopathy in themselves or their loved ones, but have not yet violated the law and have not consulted a doctor, you can be tested, for example, using the M. Levenson psychopathy questionnaire. Questionnaire items represent different statements, and the test person evaluates his attitude to them on a four-point scale. Primary psychopathy is interpreted as a lack of empathy for other people (heartlessness), secondary - as an impulsive reaction to events.

The Internet is also requesting a Dante test for psychopathy. It does not specifically answer whether you have a mental disorder. And other tests for self-diagnosis cannot replace a trip to the doctor.

Differential Diagnosis

Pathological anomalies in psychopathy should be of a total and stable nature, and individual, albeit noticeably pronounced, character anomalies that do not reach the level of pathology are referred to as accentuated character traits. The types of accentuations correspond to the types of psychopathy, however, accentuations usually appear temporarily, under the influence of a traumatic factor, during growing up, later they are smoothed out and do not lead to maladaptation in society. The differences between accentuation and psychopathy, according to many authors, are precisely quantitative in nature and lie in their dosage, which is not perceived as a pathology.

Differentiation of a personality disorder is carried out with psychopathic states after a brain injury, infections and intoxications with damage to the central nervous system, endocrinopathies and other diseases. One of the criteria for the difference is the fact that before the appearance of a psychopathic state in diseases or injuries, the personality developed quite normally.

They also differentiate constitutional or nuclear psychopathy with marginal, that is, psychogenic and pathocharacterological developments that can occur at any age under the influence of psychotrauma. They are distinguished from congenital ones by a clear onset; in the first case, a personality disorder is noticed from early childhood. The anomalous personality traits of a psychopath are distinguished by their constant presence.

Sociopathy is also distinguished as the result of the influence of adverse living conditions and is differentiated from the nuclear forms of psychopathy, leading to the development of antisocial attitudes in the individual.

Affective psychosis and some of its manifestations resemble decompensated affective psychopathy, however, at the end of the affect phase, patients experience an intermission of psychosis and that's it. mental functions are normalized. Whereas the psychopathic personality traits are not completely smoothed out during the period of compensation. Affective phases - depressive, manic, manic-depressive last no less than one or two weeks (sometimes several years), occur periodically and spontaneously, completely disrupt the patient's lifestyle and cause the need to seek medical help.

Intellectual deficiency and psychopathy have many common features, in particular, in their pathogenesis there is an underdevelopment of the frontal and temporal lobes, in manifestations - infantilism of thinking. Both those and others belong to the border states. However, in patients with personality disorders, cognitive functions are not impaired, and according to the Wechsler test, the intellectual level is often even above average. The most difficult thing is to differentiate psychopathy from intellectual insufficiency caused by pedagogical neglect. In such individuals, intellectual deficiency may well be combined with psychopathic personality traits.

Mild paranoia is considered modern psychiatry like paranoid personality disorder, the symptoms in this case are no different. With the progression of the disease and the transition to delirium with impaired rational activity, accompanied by hallucinations, the condition is interpreted as a delusional isolated disorder. The main clinical criterion for differentiation is the time of onset of the disease. Paranoid psychopathy is usually constitutional and the first signs of anomalies appear at an early age, for a progressive endogenous disease late manifestation is characteristic (often after 40 years).

Narcissism as a character trait is inherent in psychopaths in general, their egocentrism, narcissism, high self-esteem, and often sexual deviation is considered in the symptom complex of psychopathy. However, by itself it is not enough for diagnosis. Character accentuation can be narcissistic. Psychiatrists distinguish normal and pathological or grandiose narcissism, it is the latter that is considered the prerogative of psychopathic personalities.

Empathy is the ability to determine the mood of another person, sympathize with his experiences, “tune in” to the same wave with him. It is believed that this property is unknown to psychopaths, this is one of the main characteristics of psychopathy. People can have different levels of empathy, and in psychopathic personalities this ability is absent, with any kind of psychopathy. Cyclothymics or affective psychopaths, able to feel the mood of others, in the new classifier already belong to patients with mild forms of manic-depressive psychosis. They are no longer classified as psychopaths.

Schizophrenia is characterized by the presence of mania, delusions, hallucinations, auditory and visual. Schizophrenics have incoherent speech, poor emotions, slovenly appearance, inadequate reactions and actions. However, such symptoms are characteristic of severe schizophrenia. And the sluggish process is practically indistinguishable from schizoid psychopathy. The progressive course and, as a rule, later manifestation of schizophrenia will be its main difference from schizoid personality disorder.

Neurosis, like psychopathy, was previously considered as a borderline state between the norm and mental illness. In modern American classifiers, this term has already been abolished.

P.B. Gannushkin believed that neuroses and psychopathy are mutually related, their symptoms and causes overlap with each other. In decompensation, the leading role is assigned to psychogenic causes, there is no progression of dementia, delirium and hallucinations. Both disorders are reversible.

In neurosis, there is usually a close connection with the stress factor and the appearance of neurosis. Before this event, the patient was absolutely normal, while the psychopath always showed oddities. Timely treatment of neurosis contributes to the normalization of the patient's condition, whose personality structure is normalized.

Psychasthenia or in a modern reading - obsessive-compulsive or anxiety disorder(ICD-10) defines a mentally weak personality type with an intellectual mindset.

Psychoasthenic psychopathy mainly manifests itself at an early age and accompanies a person all his life, and acquired disorders manifest themselves after a psychotrauma, and after treatment the patient's nervous system usually recovers.

Psychopathy treatment

Psychopathies in the stage of decompensation are almost always accompanied by social and personal maladaptation. It is during such periods that it is necessary to help the patient find stable ground under his feet.

The preferred method is the provision of psychotherapeutic assistance. Psychotherapy of psychopathy is carried out with the aim of correcting the personality attitudes of the individual and compensating for abnormal characterological deviations, shaping his understanding of the need to comply with moral norms and rules in relations with other people, as well as activating aspirations for productive activity.

Compensation for psychopathy

The doctor selects the method of working with the patient individually, based on the type of personality disorder and the degree of decompensation. They begin the course with individual lessons with a predominance of activation of rational attitudes. Classes are held in the form of explanations and discussions.

Methods based on suggestion (hypnotic sessions, auto-training, and others) are used with great success in the treatment of the hysterical form of psychopathy, although in this case the improvement is short-lived.

From individual lessons they move on to group sessions - where patients learn to build relationships on the principles of universal morality, establish contacts with each other, and participate in role-playing games.

Family sessions are held to help normalize relations between family members, find compromise solutions, and reach mutual understanding.

Treatment with medicines is not welcome, however, in some cases it is indispensable, with severe and deep personality disorders there is a need to take drugs constantly to avoid decompensation.

Medicines are also selected individually, taking into account the type of disorder and their selective action.

So, antidepressants are used to compensate for inhibited psychopathy. In a state of subdepression, Amitriptyline, a tricyclic antidepressant that blocks the cholinergic receptors of the central and peripheral nervous system, can be prescribed, due to which the patient's mood improves, anxiety and anxiety disappear. The daily dose of the drug is approximately 75-100 mg.

Maprotiline is a fairly powerful drug with a tetracyclic structure. It is used in patients with a hypertrophied sense of their own guilt. It has a noticeable thymonoanaleptic effect, eliminates melancholy, lethargy, stops bursts of excitement. It is allowed to use the drug in pediatrics. As a rule, no more than 75 mg per day is prescribed.

These drugs are contraindicated in post-infection patients with decompensated hypertension and insufficiency of the heart muscle, men with a benign prostate tumor, pregnant and lactating women.

In the case of the development of hypomanic syndrome, the antipsychotic Clozapine (Leponex) is prescribed, which is characterized by a powerful and rapid sedative effect. In patients taking the drug, the number of suicide attempts is reduced. However, long-term use can significantly affect the composition of the blood.

Finlepsin (at a daily dose of 0.4-0.6 g) or Haloperidol drops (at a daily dose of 10-15 mg) can become an alternative to Clozapine.

In hysterical forms of psychopathy, the same Finlepsin (0.2-0.6 mg), Neuleptil (10-20 mg) or Propazine (100-125 mg) are used to compensate for the patient's condition - daily doses are indicated.

Patients are usually treated on an outpatient basis. During a course of psychotropic medicines it is necessary to completely abandon the use of alcohol, since these drugs are incompatible with alcohol. This combination is fraught with the development negative effects up to death. Also, during treatment, it is not recommended to drive a car and perform other work that requires concentration.

Indication for emergency hospitalization in the hospital of a psychiatric clinic (without the consent of the patient) are severe stages of psychopathy, decompensation in the form of psychoses. For example, twilight consciousness in hysteroids, psychoses with delusions in paranoids, dysphoric disorders in epileptoids, in addition, cases of aggressive behavior that pose a danger to others or suicide attempts, self-harm.

It is impossible to cure psychopathy, especially congenital psychopathy, however, it is quite likely to achieve long-term compensation for the individual's condition.

Treatment of psychopathy with folk remedies

Psychotropic drug therapy has many side effects, often reminiscent of the mental disorder itself, and also - affects the work gastrointestinal tract and the cardiovascular system, changes the composition of the blood.

Traditional medicines have less detrimental effect on the body, although they can also lead to side effects, one of them is a variety of allergic reactions. But the severity of side effects from herbal preparations not comparable with the undesirable consequences of taking medications. In addition, most psychoactive drugs are addictive, and psychopathic individuals are already prone to substance abuse.

Therefore, resorting to treatment with folk remedies, especially after consulting first with a doctor or herbalist, may not be the worst idea.

Hyperactive personality traits can be somewhat corrected with the help of soothing herbs: motherwort, evading peony, valerian root, marsh cudweed, dandelion, mint, lemon balm and other herbs. Each herb can be brewed separately, or you can make herbal mixtures. In this case, the effect will be stronger.

With infusions of soothing herbs, you can take baths or use essential oils of the same plants.

For example, some fragrances are believed to promote calm concentration, greater concentration and perseverance. These are essential oils of sandalwood, eucalyptus and jasmine.

Aromas of juniper and ylang-ylang are set up for productive activity.

Excitable personalities are contraindicated in the aromas of cloves, nutmeg, thyme, cinnamon.

Inhibited psychopaths, in particular, individuals of the asthenic type, are recommended infusions of ginseng, echinacea, licorice, calamus, elecampane, angelica.

Aromatherapy with oils of oregano, mimosa, lemon balm, mint, valerian, iris, anise, coriander, geranium will first strengthen the nervous system, then you can apply stimulating aromas: orange, basil, cloves and cinnamon.

Depressive reactions to stressful situations are stopped by such herbs as chamomile, peppermint, lemon balm, soapwort, valerian.

Aromatherapy helps to cope with bouts of anger or despondency, eliminate Bad mood, excessive excitement, activate the intellect, clarify the mind and even strengthen spirituality. Such properties are endowed with sandalwood, rose, juniper, cedar oil, myrrh and frankincense.

Mix at least three oils and spray the fragrance in the room, the composition of the oils sometimes needs to be changed.

The oil of geranium, lavender, chamomile, tuberose will help calm down excitable psychopaths; distract from depression and improve mood with depressive ones - jasmine, ylang-ylang, angelica herbs.

Hyperthymics are recommended to reduce the emotional background and normalize their mood with geranium, chamomile and rose oils, replacing them with a composition of clary sage, thyme and ylang-ylang.

Anxiety and anxiety, self-doubt are stopped by the aromas of sage, fern, rosemary, oregano. Strong fatigue will go away from the aromatic composition of sage, clove and marjoram oils. Also for hypothymics and psychasthenics (asthenics), the vitality and mood are raised by the aromas of fern, sage, oregano, rosemary oils.

Juniper, marjoram, ginger, clove, cinnamon oils restore lost strength and vitality.

Everyone is good at fighting psychopathy alternative means: yoga therapy (preferably under the guidance of an experienced yoga therapist, at least at the beginning), meditation, mineral therapy, color resonance therapy and others.

Prevention

It is important for any child to grow up in a supportive environment, and especially for children with constitutionally determined psychopathic personality traits.

Adults need to strive for the absence of negative external influences that provoke the emergence of antisocial character traits, especially at the age when behavioral norms and moral principles accepted in society are being formed.

At the initial stages of personality development, the most important role in the prevention of psychopathy is assigned to pedagogical influence, then social adaptation and professional orientation, taking into account individual characteristics, join it.

Forecast

There are cases when, in a favorable environment, from persons genetically prone to psychopathy, quite socially adapted and respectable citizens grew up.

The most unfavorable prognosis is given by specialists in hysterical psychopathy, although suitable conditions of existence lead to adulthood to sustainable compensation. Hysteroids can socialize and acquire some skills for productive activities. Pathological liars practically do not adapt from this group of psychopaths.

Psychopaths are responsible for their illegal actions and are not considered disabled. Psychopathy and disability are incompatible concepts, at least in modern society. Perhaps in the future, when this phenomenon will be better studied and explained, they will be included in the disabled population. With severe decompensation, a sick leave certificate can be issued, certifying the temporary lack of ability to work.

When persistent signs of mental illness appear on the basis of long-term decompensation, then the VTEK can recognize the psychopath as a disabled person of group III with certain recommendations for organizing his work regime.

Cinematic heroes-psychopaths, according to R. Heyer, one of the leading experts on psychopathy, are far from real characters, although, of course, such developments are also possible. Films that play on psychopathy as a phenomenon do not claim to be scientific approach and filmed for the box office. Their heroes are more like members of the "club of the elite" than typical characters.

Psychopathy (Greek psyche - soul and pathos - suffering) - borderline violation of personality development, characterized by disharmony in the emotional and volitional spheres. This is an incorrect, painful, development of character, an anomaly of character, from which both the person himself and society suffer (“ugliness of character”). Psychopathy is not a mental illness, but it is not a variant of the norm, not health.

Psychopathy is characterized by 3 main features established by the Russian psychiatrist P.B. Gannushkin:

1. The totality of pathological character traits that manifest themselves always and everywhere, in any conditions.

Stability of pathological character traits - they first appear in childhood or adolescence, less often in adults, and persist throughout a person's life; periodically they increase (decompensation) or weaken (compensation), but do not completely disappear.

Violation of social adaptation is precisely due to pathological character traits, and not because of adverse external influences.

Psychopathies are formed when a combination of congenital or acquired in early childhood (in the first 2-3 years) inferiority of the nervous system with the adverse effects of the environment (but at the core is precisely the biological inferiority of the child's nervous system).

There are many causes of psychopathy, the main ones are the following:

hereditary factors - psychopath parents most often give birth to children with a similar pathology (these are the so-called constitutional, genuine psychopathy - the most unfavorable option, they cannot be corrected even with proper upbringing);

alcoholism and drug addiction in parents;

various factors that negatively affect the fetus in the prenatal period of development (alcohol, nicotine, drug intoxication of the mother, medication, poisoning with something, mental trauma and infectious diseases, especially viral ones, malnutrition, severe toxicosis of pregnancy, the threat of abortion, placental abruption and etc.);

birth trauma, asphyxia during childbirth, prolonged difficult labor, forceps, etc.;

traumatic brain injury, brain infections (meningitis, encephalitis), severe poisoning in the first 3 years of a child's life;

prolonged debilitating diseases in the first 3 years of life;

disadvantages of education (atmosphere of scandals, drunkenness, incomplete family, permissiveness, etc.)

Psychopathy should be distinguished from character accentuation.

character accentuation(Latin accentus - stress and Greek charakter - trait, feature) - these are mild deviations of character, sharpening of certain personality traits. This is not a disease, but one of the variants of the norm.

The concept of accentuated personalities was developed by K. Leonhard.

With character accentuation (as opposed to psychopathy):

social adaptation is not broken (or the violation of adaptation is insignificant and temporary);

features of accentuation do not appear everywhere and not always;

a person is aware of his shortcomings and tries to avoid situations that offend him, and with psychopathy, there is an uncritical attitude towards himself and his own behavior.

Both psychopathy and character accentuations with similar manifestations are called the same.

Manifestations of psychopathy are diverse. Despite the rarity of pure types and the predominance of mixed forms, it is customary to distinguish the following classic types of psychopathy:

Explosive (excitable) psychopathy . From early childhood, the child is noted for loudness, slight excitability, restlessness, light sleep with frequent awakenings, twitches. Then the following main pathological features appear:

1. irritability and irascibility, incontinence,

   fits of uncontrollable rage,

   mood disorders (sadness, anger, fear),

   aggressiveness, vindictiveness, despotism,

   tendency to quarrels and fights (aggressive reaction of the type of short circuit “irritant - reaction”),

   the desire to assert itself at the expense of the weak,

   self-centeredness, cruelty, etc.

Behavior at school is uncontrollable, such a child cannot be disciplined. Does not show interest in studies, studies poorly, does not feel the distance between himself and an adult. Most have been drinking alcohol since adolescence, and their pathological character traits are even more pronounced (this is the group with the highest risk of developing alcoholism). They can be energetic and active. Among them are gamblers (as a rule, this takes on a painful character). Conflicts with others go through their whole life and cause a violation of social adaptation: they are intolerant at school, family, in the army, at work.

With excitable psychopathy, others suffer more than the psychopath himself (although he gets it in fights).

Hysterical psychopathy . The first personality deviations appear in children at 2-3 years of age or at preschool age. Children are capricious, touchy, mobile, prone to loin, mimic adults, imitate them; easily remember poems, jokes, anecdotes overheard from adults; they are impressionable and emotional, often the idols of the family. They have high self-esteem.

Hysterical psychopathy is characterized by:

the desire to appear larger than it actually is;

the desire to be the center of attention;

unquenchable thirst for recognition;

selfishness (life at the expense of others), selfishness, indifference to others;

posturing, acts calculated for an external effect;

tendency to lie, fantasize;

the importance of assessing others;

ability to build trust

Such children and adults usually have a good memory, relaxed thinking, quickly master a new profession, but they are not characterized by perseverance and diligence. They only like things that come easy. They prefer professions where they can be seen. They have big problems with honesty and decency (they should never be trusted to manage money). Like all weak personalities, they are cowards, they will betray and sell everyone, because. More than anything in the world, they love themselves. Prone to alcohol abuse.

Unstable psychopathy , in which there is blatant irresponsibility, the absence of permanent attachments; people with such a character easily marry, leave easily, often change their place of work, place of residence (“tumbleweed”), these are people who live in one minute.

4. Asthenic psychopathy . Its main features are:

timidity, shyness, fearfulness;

lack of self-confidence;

lethargy, decreased activity;

vulnerability, mimoznost;

increased fatigue, by the end of the lesson their attention is scattered, they are unable to perceive new material.

Asthenik at home must necessarily rest for a long time before doing homework. Usually such children do not have friends, they cannot call and learn lessons or are embarrassed to do so. Parents should constantly help them with the preparation of homework. They are very worried before any important event - an exam, a speech, etc. A slight complication of the life situation causes neurotic reactions such as neurasthenia in them. They cannot carry out assignments, occupy positions associated with great responsibility and the need to lead other people. Moreover, failures in such cases are very painfully experienced.

5.Psychasthenic psychopathy . S.A. Sukhanov called psychasthenics anxious people. Their main features:

indecision, suspiciousness;

tendency to doubt, difficulty in making a decision;

tendency to introspection, mental chewing gum;

a feeling of inferiority, but at the same time expressed pride and increased appreciation;

touchiness;

communication difficulties

From childhood, such people are shy, impressionable and anxious, they are distinguished by low physical activity. At school age, anxiety intensifies, they painfully endure reprimands, repeatedly check the correctness of solving problems, in the classroom they take the longest to complete tests (recheck!). however, most of them are of a thinking type and have a good intellect. They have an inquiring mind, a desire to get to the bottom of things meticulously, they are excellent performers, they ask a lot of questions (but only to their people), but the call to the board is painful. The “weakest” point is the need to make a quick decision or complete work in a short time .

Psychasthenic psychopathy is the option when the person himself, and not society, suffers the most (they spend their whole lives in a heroic struggle with themselves).

6.paranoid psychopathy . Its distinctive features are

suspiciousness, suspiciousness;

a high degree of readiness for the formation of overvalued ideas (most often the ideas of jealousy, litigation, invention);

selfishness, self-confidence, lack of doubt;

faith in one's infallibility;

intransigence, activity in defending one's idea

heightened self-esteem.

Schizoid psychopathy differs in the following features:

lack of sociability, isolation, isolation, secrecy;

phlegm, but also the ability to explode emotions;

emotional coldness, dryness;

lack of empathy;

greater proximity to nature and books than to peers (such people are always aloof, often lonely);

in friendship - constancy, importunity, jealousy;

one-sidedness inflexibility of judgments (a person can be boring, corrosive)

Cycloid psychopathy, the main symptom of which is a constant change of mood (either high or low) with cycles from several hours to several months.

Pathological drives , which include kleptomania, pyromania, sexual psychopathy (in which sexual satisfaction is achieved only in a perverted way), including:

homosexuality (attraction to people of the same sex);

sadism (satisfaction of sexual feelings when causing pain to a partner);

masochism (satisfaction of sexual feelings when pain is caused by a partner);

pedophilia (sexual attraction to children);

sodomy, bestiality (sexual attraction to animals);

exhibitionism (satisfaction of sexual feelings when the genitals are exposed in front of the opposite sex) and others.

Various psychopathic personalities quite often come into conflict with others. By creating conflict situations themselves, they make themselves even worse, because. during the conflict, an additional psychogenic effect arises and a psychopathic reaction may develop with an aggravation of abnormal character traits (the teacher must take this into account). A psychopathic reaction occurs suddenly, in response to events of little significance (for a normal person) (for example, someone accidentally touched it while passing by), as a rule, it is inadequate, most often expressed in the form of protest, indignation, anger, anger, rage, and even aggression.

3. Neuroses and neurotic states in children and adolescents

Neurosis is the most common group of neuropsychiatric diseases in children. The manifestations of neurosis in them are very diverse.

The cause of neuroses is interpersonal conflicts (neurotic conflict). Neurosis is a form of mental adaptation (with the manifestation of signs of maladaptation). It is always constitutionally conditioned, connected with the peculiarities of the psyche, and not with the nature of the traumatic situation. The form of neurosis in a person does not change throughout life. The neurotic form of response is laid in childhood as a manifestation of overcompensation of some quality in violation of significant relationships with the microenvironment and has a childish connotation. There are no organic changes in the brain during pregnancy.

An important feature of neurosis is that a person is aware of his illness and strives to overcome it. The ability to adapt to the environment remains.

There are three main forms of neurosis:

Neurasthenia (asthenic neurosis) - the most common form of neurosis. In the development of neurosis in children and adolescents, the main role belongs to stress or chronic psychotrauma , most often associated with conflicts in the family (quarrels between parents, alcoholism, their divorce, a conflict situation due to the lack of work of spouses, a sense of social injustice - the inaccessibility of much that other peers have) or protracted school conflicts. Has the meaning and the wrong approach to education (excessive requirements, unnecessary restrictions), as well as weakening health child due to frequent illnesses, contributes to the development of impotence overloading the child with various activities , primarily intellectual (increased teaching load in specialized schools, additional classes in circles, etc.). However, in itself, the factor of intellectual (as well as physical) overload in childhood and adolescence, although it can cause overwork and asthenia of the nervous system, in the absence of a traumatic situation, it usually does not lead to the development of asthenic neurosis.

Asthenic neurosis in an expanded form occurs only in children of school age and adolescents (in children of early, preschool and primary school age, initial and atypical asthenic reactions are observed).

The main manifestation of neurasthenia is a condition irritable weakness, characterized, one side, increased incontinence, a tendency to affective discharges of discontent, irritability and even anger, often aggression (excessive response to an insignificant occasion), and with another- in mental exhaustion, tearfulness, intolerance to any mental stress, fatigue. Passive defense reactions are excessively expressed. At the same time, volitional activity is reduced, a feeling of hopelessness arises against the background of super-responsibility, the mood is depressed, dissatisfaction with oneself and everyone around is noted, depression is a strong melancholy, accompanied by a feeling of despair and anxiety, there may be suicide attempts (suicide).

With neurasthenia, vegetative disorders are always present: palpitations, a feeling of sinking heart or interruptions, pain in the region of the heart, a tendency to vascular syncope (with a rapid change in body position), a decrease or increase in blood pressure, shortness of breath, increased gag reflex, decreased appetite, superficial sleep, cold snap hands, feet, sweating (hyperhidrosis), which contributes to the child's colds, which in turn aggravate the course of asthenic neurosis.

Hysteria (Greek hystera - uterus) - ranks second in frequency after neurasthenia. It occurs in infantile, hysterical personalities with poor mental adaptation (often with a pyknotic somatic constitution), often in a traumatic situation associated with a contradiction between what is desired and what is actually achievable (poor academic performance, inattention from peers, etc.), with infringed pride, dissatisfied with their position in the team. Its forms are diverse and often disguised as various diseases (“big liar”, “big monkey” - this is how this type of neurosis is figuratively called). Its forms reflect two known animal (and children’s) types of response in the face of danger - “ imaginary death" (fading) and "motor storm" (frightening, avoidance, attack) - seizures (like epilepsy). A hysterical fit usually occurs in the presence of spectators and is aimed at attracting their attention. Partial fixation can be manifested by functional paralysis and paresis, disorders of pain sensitivity, coordination of movements, speech disorders (stuttering, soundlessness up to complete dumbness), asthmatic attacks, etc. "Escape to illness" plays the role of a kind of pathological protection of the individual from difficult situations, justify a child's underachievement or eliminate the need to go to school.

Obsessional neurosis. It occurs more often in asthenics, people of a melancholic warehouse. It is believed that a well-defined obsessive-compulsive disorder cannot arise before the age of 10. This is due to the achievement of a certain degree of maturity of the self-consciousness of the child's personality and the formation of an anxious and suspicious background of the psyche, on the basis of which obsessive phenomena arise. Children have more early age it is expedient to speak not of neurosis, but of neurotic reactions in the form of obsessive states.

There are two types of neurosis:

- neurosis of obsessive fears(phobias). Their content depends on the age of the child. In younger children, obsessive fears of infection and pollution, sharp objects, enclosed spaces predominate. In older children and adolescents, fears associated with the consciousness of their physical "I" dominate. For example, obsessive fears of illness and death, fear of blushing (ereutophobia), obsessive fear speech in stutterers (logophobia). A special type of phobic neurosis in adolescents is unbearable waiting, which is characterized by anxious anticipation and fear of failure when performing some habitual action (for example, fear of verbal answers to the class, despite being well prepared), as well as violation of it when trying to perform.

- obsessional neurosis. However, obsessive-compulsive states of a mixed nature are often encountered. At the same time, the mood tends to decrease, vegetative disorders occur.

Children often have systemic neuroses :

- neurotic stuttering - violation of the rhythm, pace and fluency of speech associated with convulsions of the muscles involved in the speech act. It occurs more frequently in boys than in girls.

- Mutism ( lat. mutus - silence) is a disorder predominantly of school age (in adults - rarely), because the emerging speech of the child is the youngest function of the psyche, therefore it often breaks down under the influence of a wide variety of harmful factors.

Children with mutism need to be treated with care - do not punish, do not ridicule, do not insult, do not put them up to the board "until they speak."

- neurotic tics– various automated elementary movements (blinking, lip licking, twitching of the head, shoulders, various movements of the limbs, torso), as well as coughing, “grunting”, “grunting” sounds (the so-called respirator tics), which arise as a result of the fixation of one or another protective action. Most often observed between the ages of 7 and 12 years. Tics can become obsessive, then they are a manifestation of obsessive-compulsive disorder ;

- anorexia nervosa- refusal to eat;

- neurotic sleep disorder - sleep disturbance, sleep depth with nocturnal awakenings, night terrors, as well as sleepwalking (somnambulism) and sleep-talking.

- neurotic enuresis - unconscious urinary incontinence, predominantly during nocturnal sleep ;

- neurotic encopresis - involuntary excretion of bowel movements that occurs in the absence of disorders and diseases lower section intestines. As a rule, the child does not feel the urge to defecate, at first does not notice the presence of bowel movements, and only after some time feels an unpleasant odor. Most often occurs at the age of 7-9 years, in boys more often.

Treatment methods for neuroses are based on a combination of pharmacological therapy with various types of psychotherapy.

Buyanov M.I. Conversations about child psychiatry. - M.: Enlightenment, 1992

Buyanov M.I. Fundamentals of psychotherapy for children and adolescents.- M .: Education, 1998

Doroshkevich M.P. Neuroses and neurotic conditions in children and adolescents: Textbook for students of pedagogical specialties of higher educational institutions / - Minsk: Belarus, 2004

Enikeeva D.D. Border states in children and adolescents: fundamentals of psychiatric knowledge. Allowance for students. Higher Ped. Educational institutions.-M.: 1998

Fundamentals of psychological knowledge - Uch.posobie. Author-compiler G.V. Shchekin - Kyiv, 1999

list the most common signs of violations of cognitive activity, emotional and volitional activity.

name borderline mental states in children.

explain the need for knowledge about such states for the teacher.

describe different types of psychopathy

after analyzing the causes of psychopathy, to give recommendations for their prevention.

give the concept of neurosis.

talk about the types of neuroses and their prevention.

Questions submitted for independent study:

1. Factors of the risk of mental illness in the era of scientific and technological revolution: urbanization, hypodynamia, informational overwhelm.

Weiner E.N. Valeology: a textbook for universities. - M .: Flinta: Science, 2002. - pp. 68-74; 197-201.

Additional block of information.

The living conditions of modern man are significantly different from those in which his formation as a biosocial being took place. In the early stages of the existence of Homo sapiens, he led a lifestyle close to natural. In particular, he was characterized by a high level of physical activity, which in itself corresponded to the neuropsychic tension necessary in the struggle for existence. People lived in small communities, lived in an ecologically clean natural environment, which could be replaced (but not changed) by the whole community if it became unsuitable for life.

The development of civilization went in the direction of property stratification and professional specialization of people, necessary for mastering new tools of labor, increasing the duration of training and gradually lengthening the period of specialization of a part of the population. From the point of view of the life of one generation, all these changes occurred rather slowly, against the background of relatively slow changes in habitat, low population density, and while maintaining high level motor activity. All this did not represent any special requirements for the human psyche that went beyond the evolutionary requirements.

The situation began to change from the beginning of the development of capitalism and progressive urbanization, and most radically - in the second half of the 20th century, when the way of life of a person began to change rapidly.

Urbanization(lat. urbanus - urban) - socio-demographic process, which consists in the growth of the urban population, the number and size of cities, which is associated with the concentration and intensification of technogenic functions, the spread of a changed urban lifestyle

Urban population growth is sharp increased the density of human-to-human contacts.. The increased speed of human movement causes an increasing number of interpersonal contacts, and to a large extent - with strangers. From the point of view of the psyche, these contacts are often unpleasant for a person (danger of developing distress). On the contrary, family relationships are beneficial, if, of course, relations between family members are good. However, unfortunately, favorable family relationships occupy only 20-30 minutes a day in the family, according to statistics. Often there is a violation of traditional family ties.

The undoubted influence on the psyche of modern man is exerted by some factors of a markedly changed external environment. So, the noise level has increased significantly in the city, where it significantly exceeds the permissible norms (busy highway). Poor sound insulation, included in your own apartment or neighbors TV, radio, etc. make the effect of noise almost constant. They, unlike natural ones (wind noise, etc.), have a negative effect on the entire body and on the psyche in particular: the respiratory rate and blood pressure change, sleep and the nature of dreams are disturbed, insomnia and other adverse symptoms develop. Such factors have a particularly strong impact on the growing children's body, and the level of fear increases more clearly in children.

Special place in a violation of the mental state of a person is played by radioactive contamination(the nervous system is very sensitive to its effects), electromagnetic pollution in the form of radiation from the plexus of wires, electrical appliances (makes a person more aggressive). On the emotional sphere of a person some forms of rock music are extremely unfavorable. which are characterized by a monotonous rhythm, emphasized emotionally intense coloring of the soloists' voices, increased loudness above the norm and a special spectrum of sound.

It should be taken into account that the person himself is a source of weak electromagnetic and other physical fields. Perhaps a large crowd of people (and this is typical for a city) generates electromagnetic waves of various characteristics, which, at an unconscious level, can have a negative effect on the brain.

An indirect effect on the state of the brain, mental health has and chemical pollution of the atmosphere(increase carbon monoxide in the inhaled air impairs gas exchange in the brain tissue and reduces its functional characteristics, etc.).

Destruction of the natural human environment(which itself is a particle of nature), replacing it with an artificial environment made of stone and concrete containing isolated spaces, etc. deforms the human psyche, especially the emotional component, disrupts perception, reduces the health potential.

The scientific and technological revolution led to a decrease in the share of physical labor, that is, to decrease in the level of physical activity(development of hypodynamia). This circumstance violated the natural biological mechanisms, in which the latter was the final link in life, therefore, the nature of the flow of life processes in the body changed and, ultimately, the stock of human adaptive capabilities, its functional reserves, decreased.

According to Academician Berg, over the past century, energy consumption for muscle activity in humans has decreased from 94% to 1%. And this indicates that the reserves of the body have decreased by 94 times. Physical inactivity is especially unfavorable in children during the maturation of the body, when energy deficiency limits not only physical development, but also psychological (including intellectual). There may be a need for doping, first psychological, then medicinal and, quite possibly, narcotic.

Hypodynamia turns off the final link of the stress reaction - movement. This leads to stress on the central nervous system, which, in conditions of already high information and social overload of a modern person, naturally leads to the transition of stress into distress, reduces physical and mental performance, and disrupts the normal functioning of the brain.

Modern life is associated with an exceptionally large flow of diverse information, which a person receives, processes and assimilates. According to some data, every 10-12 years the amount of newly received information in the world corresponds to that which has been accumulated over the entire previous history of mankind. And this means that modern children need to learn at least 4 times more information than their parents at the same age, and 16 times more than their grandparents. But the brain of modern man has remained almost the same as it was 100 and 10,000 years ago. This creates the prerequisites for information overload. In addition, a reduction in the time for processing new information increases neuropsychic stress, which often causes negative reactions and conditions leading to disruptions in normal mental activity. At the same time, the brain tries to protect itself from excessive and unfavorable information, which makes a person emotionally less sensitive, emotionally "stupid", less responsive to the problems of loved ones, insensitive to cruelty, and then to kindness, aggressive. In some cases, this is already observed in young children.

The considered risk factors, which are typical for most cities, are associated with the so-called diseases of civilization - diseases that are widespread among economically developed countries: hypertension, coronary heart disease, stomach ulcers, diabetes, metabolic diseases, bronchial asthma, neuroses, mental disorders, etc. .

List the main health risk factors associated with the scientific and technological revolution.

Explain the negative impact of urbanization on human mental health.

Describe the relationship between hypodynamia and human mental health

Describe the effect of excess information on the human psyche.

Give the concept of diseases of civilization.