Dynamics of the development of post-traumatic stress disorder (PTSD) in combat participants after combat brain injury

Abstract

Topicality. Participation in hostilities strongly affects all participants and is the cause of various not only neurological, but also mental and psychological disorders. According to official data, fewer servicemen die during hostilities than veterans of the war after its end due to the effects of mental trauma. Post-traumatic stress disorders occupy a significant place in the structure of mental pathology of combatants - delayed long-term reactions to extreme events not associated with organic brain damage are observed over a long period of time and can cause significant changes in personality and behavior. The purpose of the study was to determine the factors that traumatize the psyche of combatants during a long stay in a specific state of «combat stress», which has a positive effect during the battle, and after its end, as a rule, negatively. Materials and methods. Veterans and participants in hostilities in the ATO-OSO- zone were examined and treated on the department of neurological at the base of the Regional hospital for war veterans, Kharkiv from 2014 to 2021. To conduct the study, patients were divided into groups depending on the severity of the disease. received combat wound, representative by age and sex. Group I - 100 men (25-45 years old) with mild TBI (brain concussion), Group II - 100 men (25-45 years old) with TBI of medium severity (brain contusion combined with acubarotrauma), Group III - 80 men (25-45 years old) with severe TBI (contusion and compression of the brain, formation of intracranial hematomas). Psychological measures used by hospital psychologists in their work: 1. Individual work: consultations, psychoeducation, psychotherapy, psychocorrection, behavior correction, awareness and assimilation of new experience, body-oriented therapy (TRE, TTT, Brainspotting, Soma-system, synchronization of cerebral hemispheres, stabilization of emotional state), art. therapy, psychodiagnostics, post-induction, reframing (correction of attitudes); formation of state control skills, breathing exercises, formation of self-reflection skills. 2. Group work: group psychotherapy (only with veterans and only in small groups), group body-oriented therapy and group art therapy. Conclusions. It can be said that the medical, social and socio-economic consequences of stress factors caused by the unstable sociopolitical situation and the conduct of anti-terrorist operations are spread both to individuals and to the entire population of our country. Veterans and combatants and their entourage (family, friends, work colleagues, etc.) suffer the most from these processes. At the state level, there are a number of regulatory and legal acts that contribute to the social adaptation of these categories of the population and the provision of medical and psychological assistance to them. The organizational structure of institutions and specialists who provide medical and psychological assistance to combatants and members of their families is represented by rehabilitation centers for ATO-OSO participants, full-time psychologists of health care institutions, various volunteer and public organizations; state bodies are additionally involved in issues of social adaptation of social services