The article describes the main psychotherapeutic targets and individual psychological characteristicsof cancer patients with comorbid post-traumatic stress disorder (PTSD), using the example of breast cancer, prostate cancer, and rectal cancer patients in remission following surgery (mastectomy, prostatectomy, and colostomy). The study was carried out at N. N. Petrov Research Institute of Oncology. The experimental group consisted of 40 patients with breast cancer, 32 patients with prostate cancer, and 19 patients with rectal cancer, in accordance with the selection criteria and based on a specialized questionnaire designed to detect symptoms of post-traumatic stress disorder (Trauma Screening Questionnaire). A control group, for comparison, was comprised of 51 women with breast cancer, 53 patients with prostate cancer, and 22 patients with rectal cancer who showed signs of constructively coping with cancer. The assessment of individual psychological characteristics of patients in these nosological groups was carried out using a battery of experimental psychological techniques. In order to enhance the adaptive capacity of the personality in patients with oncological diseases, to prevent the likelihood of developing PTSD, and develop the effectiveness of treatment, the following general psychotherapeutic targets were identified: intrapsychic maladaptive type of response to the disease, excessive fixation on the disease and care during illness; low risk tolerance manifested by patients’ reluctance to act in the absence of reliable guarantees of success; destructive and deficient personality functions; shortage of positive cognitive representations of the world and themselves; destructive guilt associated with the illness and family relationships; excessive desire for autonomy and independence that reduces the possibility of receiving social support.

The aim of the work is to develop a construct of the internal picture of the disease (IPD) in case of neurotic disorders (ND) as the main personality factor that determines the use of environmental resources and adherence to treatment under stressful conditions of the disease; based on the assessment of the structure and mechanisms of the IPD, the determination of the basic emotional, cognitive and behavioral components in connection with the tasks of optimization of medical and psychological rehabilitation. Methods. A multivariate cohort analytical observational study of 1,262 patients with ND was performed. Clinical, experimental-psychological and statistical methods were used. Results. Four main types of IPD were singled out: depressive somatocentric (DS), depressive psychocentric (DP), phobic somatocentric (FS) and phobic psychocentric (AF) with the prevalence of the latter (p = 0.036). Individuals with ND were more characterized by "depressed" types of IPD (p = 0.028), with anxiety-phobic disorders - "phobic" (p = 0.032), with dissociative, s a wide variation in the representation of IPD types: DP - 35.9 %, DS - 26, 0 %, AF - 25.0 %, FS - 13.1 % was observed. The disharmony of the interpersonal sphere in ND was shown: a clear prepotence to conflict and dominance (dominance factor V 1.17 ± 0.45) over the tendency to cooperate and subjection (benevolence factor G -0.10 ± 0.41). Regardless of the type of IPD in HP there was a mistuning of the concepts "I-real" and "I-ideal", which manifested in a low degree of self-acceptance and the presence of a conflict attitude to oneself. The peculiarity of self-esteem in patients with "depressed" types of IPD was expressed in emphasizing weakness in emotional experience and at the same time reflecting traits of confidence, independence, perseverance in self-ideal; with "phobic" - alertness and straightforwardness in relations with others. Conclusions: the developed concept of IPD in case of HP was an emotional-cognitive-behavioral construct of personality adaptation to a disease as the basis for a psychological strategy in therapy and medical-psychological rehabilitation aimed at increasing the level of psychological resource reserve of patients.

The paper presents the results of a clinical-psychopathological and experimental psychological study carried out on 91 women with breast cancer (aged 35—65, mean age 55.8±11.08 years). The sample was divided into two groups, 51 women with a diagnosed posttraumatic stress disorder (PTSD) developed as a result of their illness and 40 stress-resistant women. The author’s semi-structured anamnestic interview was used to study the clinical and socio-psychological characteristics of patients. Methods: Trauma Screening Questionnaire (Brewin et al., 2002), Impact of Event Scale (Tarabrina, 2001), Type of Attitude to the Disease measure (Vasserman et al., 2014), G. Ammon’s Ego Structure Test (Tupitsyn et al., 1998), Mental Health Assessment measure (Bocharov, Tupitsyn, 1999), The Personal Views Survey III- R (Leontiev, Rasskazova, 2006), Experiences in Close Relationships (Kazantseva, 2008). Results: In patients with PTSD, low parameters of resilience, the dominance of maladaptive types of attitude to the disease, and deficient and destructive personality structures (aggression, anxiety, deficient external and internal boundaries of the self, and destructive narcissism and sexuality) were revealed.

The establishment of psychotherapy and clinical psychology in a Russia is a very complicated and contradictive process. B. D. Karvassarsky has played an essential, key role in the psychotherapy formation as a science and distinct discipline. The article describes the crucial points of this discipline development, presents the main key studies of this mental health field. The Leningrad-Saint-Petersburg psychotherapy school maid a serious impact in the modern Russian neurosology cornerstone issues, that allowed to consider the multidimensional aspects of this pathology. This publication emphasizes the recent research results in this field, makes a deep analysis of the target phenomena understanding in different approaches, other methods integration in personality oriented reconstructive psychotherapy, elaboration of the nosocentric target oriented psychotherapy algorithms and strategies, and also different psychotherapy interventions research.