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The parameters and effectiveness of biofeedback training in the complex treatment of neurotic disorders at the hospital stage and psychological correction at the sanatorium stages of rehabilitation of military personnel were assessed. We examined 40 mentally healthy military personnel who participated in combat operations and 36 military personnel who participated in combat operations and suffered from stress-associated neurotic disorders and who were undergoing inpatient treatment in the S.M. Kirov Military Medical Academy clinics. In identifying possible negative psychological consequences of combat stress in a group of mentally healthy military personnel, a medical and psychological examination was performed using the military version of the Mississippi scale for assessing post-traumatic reactions, Neurotic Disorders-Symptomatic Questionnaire, and Quality of Life Questionnaire-12. The military personnel underwent stress testing according to a specially developed scenario using a biofeedback hardware software complex to assess individual changes in physiological parameters in response to emotionally significant stimuli. In the military personnel who participated in combat operations and suffered from neurotic disorders, a medical and psychological examination was performed using the Neurotic Disorders-Symptomatic Questionnaire and Quality of Life Questionnaire-12 upon admission to the hospital and on the eve of discharge, and stress testing was conducted upon admission to the hospital. The therapeutic effectiveness of biofeedback training in the treatment of neurotic disorders was evaluated by comparing the results of treatment between two groups of 18 individuals each. One group received only drug therapy, whereas the other group, in addition to drug therapy, underwent biofeedback training on the amplitude of the systolic wave. The level of stress-associated psychogenic damage was found to be correlated with the amplitude of the systolic wave according to the digital photoplethysmogram. Moreover, the physiological indicators of the circulatory and respiratory systems, used in foreign studies for psychophysiological training in the treatment of post-stress disorders, were not associated with the level of psychogenic damage, indicating their lack of involvement in pathogenesis and the ineffectiveness of their use. The addition of biofeedback training on the amplitude of the systolic wave to the complex therapy of neurotic disorders leveled astheno-neurotic symptoms and improved quality of life. Therefore, when treating astheno-neurotic disorders in military personnel participating in combat operations, it is critical to include biofeedback training on the amplitude of the systolic wave; this reduces severity of neurotic symptoms, improves quality of life, and forms preventive skill of conscious control of excessive physiological reactions of combat stress. Furthermore, the correlation between the magnitude of the decrease in the amplitude of the systolic wave and level of mental damage in combatants, revealed during stress testing, indicates the importance of biofeedback training on the amplitude of the systolic wave in sanatorium-resort organizations and military clinical hospitals of the Russian Ministry of Defense for the medical and psychological rehabilitation of military personnel exhibiting negative symptoms and those suffering from psychological consequences of combat stress.
The parameters and effectiveness of biofeedback training in the complex treatment of neurotic disorders at the hospital stage and psychological correction at the sanatorium stages of rehabilitation of military personnel were assessed. We examined 40 mentally healthy military personnel who participated in combat operations and 36 military personnel who participated in combat operations and suffered from stress-associated neurotic disorders and who were undergoing inpatient treatment in the S.M. Kirov Military Medical Academy clinics. In identifying possible negative psychological consequences of combat stress in a group of mentally healthy military personnel, a medical and psychological examination was performed using the military version of the Mississippi scale for assessing post-traumatic reactions, Neurotic Disorders-Symptomatic Questionnaire, and Quality of Life Questionnaire-12. The military personnel underwent stress testing according to a specially developed scenario using a biofeedback hardware software complex to assess individual changes in physiological parameters in response to emotionally significant stimuli. In the military personnel who participated in combat operations and suffered from neurotic disorders, a medical and psychological examination was performed using the Neurotic Disorders-Symptomatic Questionnaire and Quality of Life Questionnaire-12 upon admission to the hospital and on the eve of discharge, and stress testing was conducted upon admission to the hospital. The therapeutic effectiveness of biofeedback training in the treatment of neurotic disorders was evaluated by comparing the results of treatment between two groups of 18 individuals each. One group received only drug therapy, whereas the other group, in addition to drug therapy, underwent biofeedback training on the amplitude of the systolic wave. The level of stress-associated psychogenic damage was found to be correlated with the amplitude of the systolic wave according to the digital photoplethysmogram. Moreover, the physiological indicators of the circulatory and respiratory systems, used in foreign studies for psychophysiological training in the treatment of post-stress disorders, were not associated with the level of psychogenic damage, indicating their lack of involvement in pathogenesis and the ineffectiveness of their use. The addition of biofeedback training on the amplitude of the systolic wave to the complex therapy of neurotic disorders leveled astheno-neurotic symptoms and improved quality of life. Therefore, when treating astheno-neurotic disorders in military personnel participating in combat operations, it is critical to include biofeedback training on the amplitude of the systolic wave; this reduces severity of neurotic symptoms, improves quality of life, and forms preventive skill of conscious control of excessive physiological reactions of combat stress. Furthermore, the correlation between the magnitude of the decrease in the amplitude of the systolic wave and level of mental damage in combatants, revealed during stress testing, indicates the importance of biofeedback training on the amplitude of the systolic wave in sanatorium-resort organizations and military clinical hospitals of the Russian Ministry of Defense for the medical and psychological rehabilitation of military personnel exhibiting negative symptoms and those suffering from psychological consequences of combat stress.
BACKGROUND: Currently, the issues of restoring the somatic and mental health of combatants undergoing treatment and rehabilitation in hospital conditions are becoming particularly relevant. AIM: To examine and compare the mental states and psychological consequences of combat trauma at the hospital stage of rehabilitation of combatants. MATERIALS AND METHODS: The study involved 97 combatants with various wounds and injuries that were hospitalized in the clinical units of the surgical and therapeutic profile of the Military Medical Academy. Of these, 44 people were examined in 2014 and 53 people in 2022. RESULTS: Comparison of independent samples of combatants in 2014 and 2022 at the stage of treatment and rehabilitation showed a statistically significant twofold decrease in asthenic manifestations from 38.6% in 2014 to 20% in 2022 (p 0.05). The relative number of combatants with negative psychological consequences of combat trauma in the form of manifestations of post-traumatic stress disorder in 2014 and 2022 was similar and amounted to 15.9% and 17%, respectively, which is apparently due to the homogeneity of the sample and the similarity of factors causing these stress-reactive changes. Uncompensated negative psychological consequences of combat trauma can be fixed in the form of combatant accentuation and chronic, irreversible personality change. These stress-reactive changes reduce both the professional qualities of the combatants and their quality of life. CONCLUSION: The clinical and psychological characteristics of patients indicate the need for psychological assistance, starting from the moment of injury and continuing throughout the wound disease.
Modern concepts about the dynamics of states of servicemen following combat mental trauma are presented. Psychological mechanisms of the development of post-traumatic stress disorder are described. The results of psychological examination of servicemen-combatants are briefly summarized. It is shown that 40% of them have negative psychological consequences of combat stress in the form of signs of partial post-traumatic stress disorder, which correlate with manifestations of neurotic disorders. Signs of partial post-traumatic stress disorder in healthy military combatants reduce the self-assessment of the quality of life, but do not significantly affect the professional aspect of social functioning in favorable conditions, that does not allow to identify the presence of negative psychological consequences of combat stress by commander expert assessment. In addition to the psychological examination, the servicemen underwent stress testing on the Rehacor hardware psychophysiological software complex, which consisted in the fact that the subject was alternately presented with stress stimuli consisting of video and audio sequences on the monitor screen and in headphones in accordance with a pre-compiled scenario. In the course of stress testing the physiological parameters of the subject were recorded. In military personnel with signs of partial post-traumatic stress disorder, a decrease in the threshold of sensitivity to stress was found, which in combat conditions can lead to the development of acute stress-induced mental disorders and to be the reason for the growth of violations, mistakes, the adoption of incorrect operational and tactical decisions, the demoralization of personnel, the growth of sanitary and irretrievable losses and losses of military equipment and weapons. Based on the physiological parameters obtained during stress testing, a method for diagnosing signs of partial post-traumatic disorder has been developed. This method makes it possible to objectify the identification of the negative psychological consequences of combat stress and can be used in the interests of psychological and psychiatric intelligence.
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