Given that cognitive hazard assessment are the first link in an alarm condition, and Cogne – tive reassessment determines the intensity of these comprising – Nij and their stability over time, the prevalence of moderate level of reactive anxiety in 64.0% of patients with HIV-infection indicates a low cognitive assessment stressful situations that lead to a state of distress .
Significant predominance of high trait anxiety in 60.0% of HIV-infected patients is caused by the fact that patients tend to take most of the situations as threatening and react to alarm state, which is a negative color emotio – nal state, including a sense of tension, fearing – Niya and anxiety …
The distribution of patients with HIV infection depending on the level of anxiety is presented in Table 2.
|Low –up to 30 points||Moderate –31- 45 points||Tall –46 points and above|
|abs . number||one||6||96||54||53||90|
– RT – reactive anxiety
– LT – personal anxiety
The predominance of a moderate level of reactive and high level of personal anxiety in HIV-infected patients shows that this category of patients more susceptible to the influence of stress and prone to worry comprising – Niya anxiety greater intensity and more often than individuals with low levels of anxiety.
Research on depression in HIV-infected patients
In 51.4% of HIV-infected patients, indicators of moderate depression ( Me = 63.0) prevail in the form of depression and melancholy, sleep disturbances, weight loss, constipation, heart palpitations, anxiety and irritability.
Significantly significant relationship between indicators of depression, reactive (r = 0.26; p < 0.05) and personal (r = 0.62; p <0.05) anxiety in patients with HIV infection determines the low stress resistance of this category of patients; disorders in unstable mental adaptation are expressed by a combination of anxiety, subdepressive or depressive reactions.
The majority of HIV-infected patients in the structure of the mental state of depressed mood is determined by background, level of activity, performance, motivation and ability to hell – suitable approach to emotional response, accompanied by a lack of experience of the value of the self; a pessimistic estimate of per – prospects for, psychasthenic difficulties in situations of decision-making and interpersonal – the first interaction. Disturbance of mental adaptation of HIV-infected patients with different phenomenological – Skim symptoms of major depressive tendencies.
Based on the position of the subject-active approach, the results of the comprehensive study show that an HIV-infected subject is characterized by such personal characteristics as: a tendency to authoritarian and conflicting behavior, isolation, isolation, the desire to blame others for mistakes, self-doubt. In the process of communication, patients with HIV infection behave distrustfully and impulsively, characterized by: low normality of behavior, a tendency to inconstancy, susceptibility to the influence of feelings, lack of agreement with generally accepted moral rules and standards, as well as a tendency to antisocial behavior. An increased readiness to take risks is revealed.
By virtue of its nesamostoya – telnosti, dependence and attachment to a group of patients with HIV need constant support, the support of approx – Rouge because they lack initiative and courage in choosing a GSS – stvennoj line behavior.
Under high stress load of HIV infection, which manifests itself in life breaking stereotypes, social exclusion and isolation, puff – rudnenii employment, fear of disclosure Diagne – for infection and family members of patients revealed a low tolerance for frustration. At the same time, the structure of the HIV-infected patients with a mental condition identified: a tendency to perceive the majority of situations as threatening and react to anxiety, sense of tension, anxiety, pessimistic assessment lane – prospects for, difficulties in situations of decision-making and interpersonal – the first interaction.
The indicators of psychosocial adaptation of HIV-infected patients are the mechanisms of psychological defense and coping strategies.
Studies of psychological defense mechanisms of HIV-infected patients show a high tension mechanisms, “Denial”, “Wipe”, “compensation” and “regression”, which testify to the denial frustrating circum – ments and those aspects of external reality, are not recognized very personally – Stu; displacement of unacceptable desires, thoughts and feelings that cause anxiety; about trying to find a suitable replacement in D – real or imagined lack of other quality, with the aim to stop the alarm by use of a simple and familiar behavior patterns, as well as by suppressing emotions. For the studied patients are characterized by low capacity to neutralize the feelings caused by uncomfortable or unpleasant subjectively – acceptability of the situation with the help of logical units and manipulation, as well as the imperfection of “intellectual” way to overcome the conflict, or ( frustrating ) situation.
As a result of our study obtained correlations between the mechanisms of coping with stress and mechanisms of psychological protection as an important component of psychological ADAPT – tion of HIV-infected patients; explore and develop the structure of individual psychological personality factors (emotional, intellectual, communicative – al, behavioral) in patients with HIV infection, levels of anxiety and depression were studied as a mental adaptation parameters of patients.
For the first time, in our study used an integrated approach to the study of the psychological status of the individual HIV-infected patients, the study of coping -strategy, psychological defense mechanisms, structure of individual psychological factors of personality, performance anxiety and depression as a component of psychological ADAPT – tion of patients with HIV infection.
An integrated approach is promising because allows to carry out early psychodiagnostics of typical ways of coping with stress and to outline the directions of psychocorrective , psychotherapeutic work not only in HIV-infected patients, but also in people with addictive forms of behavior.
1. Individual psychological characteristics of the personality of patients with HIV infection who are in conditions of constantly existing and growing social stress factors that cause the destruction of the connection between the subject and his activities (professional, family), are characterized by a violation of the social style of behavior (instability, impulsivity, irritability, diffidence); violation of emotional reactions with a tendency of HIV-infected patients to aggressive ( auto-aggressive ), authoritarian and conflictual behavior.
2. The structure of the mental status of HIV-infected patients the prevalence of high levels of trait anxiety, characterized by the tendency of patients to perceive the majority of situations as threatening and react to an alarm condition in the form of voltage feelings, anxiety, feelings of insufficient value of self, a pessimistic assessment of per – prospects for, which causes a high level of frustration tension and impaired mental adaptation and, accordingly, the risk of adaptive disorders in patients with HIV infection.
3. Mechanisms of coping with stress, as well as psychological mechanisms of protection are important components ADAPT psychological – tion and are interconnected in a close relationship, in which are formed – vanie certain coping -strategy correlates with the severity of certain types of psychological protection.
4. Koping -strategy used by HIV-infected patients is not – camping nozospefitsicheskimi and, for the most part, are characteristic for healthy people ( Konfrontativny coping , distancing , self-control, social support search, Taking responsibility, Escape – avoidance, problem solving Planning , Positive reappraisal) ways of coping with stress. At the same time frame – tuar coping -strategy in patients with HIV infection has its own characteristics, for – consists in more frequent use of certain coping strategies ( Distancing , Escape-avoidance and Konfrontativny coping ) and the deficit of the other (Planning solution to the problem, positive reappraisal, Search Social support, Self-Control, “Taking responsibility), in the search for social support , control of their feelings and actions, as well as recognition of their role in the problem with trying to solve it.
5. It is extremely unfavorable ways of coping with stress, negative – but it affects the functioning of patients with HIV infection are the strategies for the avoidance of problem solving, as well as strategy, expressed in a desire aimed at the separation of the situation and reduce its importance. A strategy that manifests itself in confrontation indicates the presence of aggressive tendencies aimed at changing the situation. This mechanism of coping with stress involves a certain degree of hostility and willingness to take risks, and is extremely maladaptive for patients with HIV infection.
6. The expression in the structure of the individual HIV-infected patients defense mechanisms distort, deny and falsify Sun – acceptance of reality, open source software – a proper formation of the passive, maladaptive variants of coping -strategy, including mental aspiration and behavioral efforts to escape from solving the problem, as well as cognitive efforts to break away from the situation and the decrease in its value, which contributes to the development in patients of low resistance to stress and leads to the existence d ezadaptivnogo , dysfunctional coping -povedeniya.
7. The successful functioning – tion of the individual patients with HIV in different social spheres involves the formation and conduct of individual and group training psychotherapeutic programs, which should be based training appropriate mechanisms to respond to stress, expanding the repertoire of ways to cope with difficult life – GOVERNMENTAL situations and consolidate the positive experience problem solving that optimizes the social recovery of patients.