Objective. Factors of the environment, society, as well as internal personal psychological factors and personal experience, affect the formation of mental disorders. Society and stressors determine which behavioral scenarios of the individual will be relevant. Personality characteristics through behavioral responses determine which of the many potential stressors are significant and what impact they will have on the individual.
Modern understanding of the genesis of PTSD shows that the individual's overcoming of traumatic stressors of the combat situation depends on three groups of factors: the nature of traumatic events, individual psychological characteristics of veterans, and the conditions in which the demobilized falls after returning from war. The interaction of these factors with the process of cognitive processing of psycho-traumatic experience leads to an increase in mental stress or to the gradual assimilation of psycho-traumatic experience. As a result, it is possible to expect mental "restabilization" or the emergence of PTSD. The presence of additional bio-psycho-social stressors (e.g., substance abuse, family instability, concomitant medical comorbidity) significantly increases the likelihood of developing PTSD in veterans and the degree of social maladaptation in PTSD. The comorbidity of PTSD and TBI further increases the likelihood of social maladaptation in demobilized servicemen.
The relevance of studying the impact of life problems on social adaptation in veterans with PTSD and TBI is determined by the need to develop an adequate set of medical and psychological interventions and socio-psychological rehabilitation.Purpose: to investigate medical and anamnestic features and to conduct a modal analysis of life problems of veterans with PTSD and mTBI.
Methods and materials. 329 combatants (members of the Armed Forces, the National Guard, and "volunteer battalions") in eastern Ukraine who suffered from PTSD and mTBI were examined.The socio-demographic and medical-anamnestic examination was performed using the Unified map of patient research developed by us. Modal analysis of existing problems was carried out on the basis of ICD-10, their presence was assessed by diagnostic headings: Z55 - Z73.
Results. Antisocial traits and increased social conflict in veterans with PTSD and mTBI correlated with marital/sexual and parental problems, as well as insufficient family support, problematic alcohol/drug use, and inadequate social skills. and conflicting perceptions of their own social status.
Conclusions. The negative factors influencing the course of PTSD and mTBI identified by us became the material for the formation of targets of psychosocial therapy and optimization of pharmacological treatment.
Full-text of the article is available for this locale: Українська.
- Bohomolets OV. Optymizatsiia pidkhodiv do nadannia psykhiatrychnoi dopomohy vidpovidno do suchasnykh potreb uchasnykiv boiovykh dii. Kyiv: Metodychni rekomendatsii; 2014:46.
- Chaban OS, Bezsheyko VH, Khaustova OO, Burlaka OV, Ryvak TB, Kyrylyuk SS. Gender-related differences of stress reactions in Ukrainian combatants. Farmatsiia. 2018;65(2):3-10.
- Voloshyn PV. Diahnostyka, terapiia ta profilaktyka medyko-psykholohichnykh naslidkiv boiovykh dii v suchasnykh umovakh. Kharkiv: Metod Rekomendatsii; 2014.
- Khaustova OO, Smashna OY. Clinical features of PTSD in patients with TBI. European Psychiatry. 2017;41(1):474-5.
- Kiselov AF, Ziuzin VO, Tsebrzhynskyi OI, Rudenko AO, Yermilov VS, Zinchenko TM. Sotsialno-ekonomichni ta ekolohichni aspekty hromadskoho zdorov’ia naselennia Mykolaivshchyny. Ekolohiia. 2012;167:103-6.
- Matiash MM, Khudenko LI. Social stress disorders in the structure of ukrainian syndrome. UMJ. URL: https://www.umj.com.ua/wp/wp-content/uploads/2016/06/4489.pdf?upload=
- Mezentseva NI, Batychenko SP, Mezentsev KV. Zakhvoriuvanist i zdorov’ia naselennia v Ukraini: suspilno-heohrafichnyi vymir. Kyiv: «Print Servis»; 2018:136.
- Smashna OY, Khaustova OO. Features posttraumatic stress disorder diagnosis in patients with mild traumatic brain injury. Arkhiv psykhiatrii. 2017;4(91):225-32. URL: http://ndips.org/assets/%D0%B0%D0%BF_4_2017_%D1%84%D0%B8%D0%BD%D0%B0%D0%BB.pdf
- Smashna OY. Cognitive-behavioral therapy of insomnia in posttraumatic stress disorders. Arkhiv psykhiatrii. 2014;4(79):91-95. URL: http://ndips.org/assets/a%D0%BF_4_2014.pdf
- Soshenko T, Habinska A. Efektyvnist psykhoterapii ta farmakoterapii v likuvanni PTSR u viiskovosluzhbovtsiv i veteraniv. Psykhosomatychna medytsyna ta zahalna praktyka. 2018;3(96):32-6.
- Duncan LE, Cooper BN, Shen H. Robust Findings From 25 Years of PTSD Genetics Research. Curr Psychiatry Rep. 2018;20(12):115. DOI: https://doi.org/10.1007/s11920-018-0980-1 PMID: https://pubmed.ncbi.nlm.nih.gov/30350223
- Bufka LF, Wright CV, Halfond RW. Casebook to the APA Clinical Practice Guideline for the Treatment of PTSD. Washington: American Psychological Association; 2020:91-122. DOI: https://doi.org/10.1037/0000196-005 URL: https://www.apa.org/pubs/books/casebook-apa-clinical-practice-guideline-treatment-ptsd-sample-chapter.pdf
- Garton AL, Sisti JA, Gupta VP, Christophe BR, Connolly ES. Poststroke post-traumatic stress disorder: A review. Stroke. 2017;48(2):507-12. DOI: https://doi.org/10.1161/strokeaha.116.015234 PMID: https://pubmed.ncbi.nlm.nih.gov/27932604
- Goldstein RB, Smith SM, Chou SP, et al. The epidemiology of DSM-5 posttraumatic stress disorder in the United States: results from the National Epidemiologic Survey on Alcohol and Related Conditions-III. Soc Psychiatry Psychiatr Epidemiol. 2016;51(8):1137-48. DOI: https://doi.org/10.1007/s00127-016-1208-5 PMID: https://pubmed.ncbi.nlm.nih.gov/27106853
- Judkins JL, Moore BA, Collette TL, Hale WJ, Peterson AL, Morissette SB. Incidence Rates of Posttraumatic Stress Disorder Over a 17-Year Period in Active Duty Military Service Members. J Trauma Stress. 2020;33(6):994-1006. DOI: https://doi.org/10.1002/jts.22558 PMID: https://pubmed.ncbi.nlm.nih.gov/32598575/
- Koenen KC, Ratanatharathorn A, Ng L, et al. Posttraumatic stress disorder in the World Mental Health Surveys. Psychol Med. 2017;47(13):2260-74. DOI: https://doi.org/10.1017/s0033291717000708 PMID: https://pubmed.ncbi.nlm.nih.gov/28385165/
- Nagamine M, Giltay EJ, Shigemura J, et al. Assessment of Factors Associated With Long-term Posttraumatic Stress Symptoms Among 56 388 First Responders After the 2011 Great East Japan Earthquake. JAMA Netw Open. 2020;3(9):e2018339. DOI: https://doi.org/10.1001/jamanetworkopen.2020.18339 PMID: https://pubmed.ncbi.nlm.nih.gov/32990742/
- Nichter B, Norman S, Haller M, Pietrzak RH. Psychological burden of PTSD, depression, and their comorbidity in the US veteran population: suicidality, functioning, and service utilization. J Affect Disord. 2019;256:633-40. DOI: https://doi.org/10.1016/j.jad.2019.06.072 PMID: https://pubmed.ncbi.nlm.nih.gov/31299445/
- Richardson LK, Frueh BC, Acierno R. Prevalence Estimates of Combat-Related PTSD: A Critical Review. Aust N Z J Psychiatry. 2010;44 (1):4-19. DOI: https://doi.org/10.3109/00048670903393597 PMID: https://pubmed.ncbi.nlm.nih.gov/20073563/
- Smashna OY, Khaustova OO. Diagnostic Approach to the Mild Traumatic Brain Injury Verification in Patients with Posttraumatic Stress Disorder. Psychiatry, psychotherapy and clinical psychology. 2019;3:408-16.
- Sommer JL, Mota N, Edmondson D, El-Gabalawy R. Comorbidity in illness-induced posttraumatic stress disorder versus posttraumatic stress disorder due to external events in a nationally representative study. Gen Hosp Psychiatry. 2018;53:88-94. DOI: https://doi.org/10.1016/j.genhosppsych.2018.02.004 PMID: https://pubmed.ncbi.nlm.nih.gov/29776731/
- Zhang Y, Weed JG, Ren R, et al. Prevalence of obstructive sleep apnea in patients with posttraumatic stress disorder and its impact on adherence to continuous positive airway pressure therapy: a meta-analysis. Sleep Med. 2017;36:125-32. DOI: https://doi.org/10.1016/j.sleep.2017.04.020 PMID: https://pubmed.ncbi.nlm.nih.gov/28735910/
- Gelernter J, Sun N, Polimanti R, et al. Genome-wide association study of post-traumatic stress disorder reexperiencing symptoms in >165,000 US veterans. Nat Neurosci. 2019;22(9):1394-401. DOI: https://doi.org/10.1038/s41593-019-0447-7 PMID: https://pubmed.ncbi.nlm.nih.gov/31358989/
- Eidhof MB, Ter Heide FJJ, van Der Aa N, et al. The Dissociative Subtype of PTSD Interview (DSP-I): Development and Psychometric Properties. J Trauma Dissociation. 2019;20(5):564-81. DOI: https://doi.org/10.1080/15299732.2019.1597806 PMID: https://pubmed.ncbi.nlm.nih.gov/31132959
- Howard JT, Sosnov JA, Janak JC, et al. Associations of Initial Injury Severity and Posttraumatic Stress Disorder Diagnoses With Long-Term Hypertension Risk After Combat Injury. Hypertension. 2018;71(5):824-832. DOI: https://doi.org/10.1161/HYPERTENSIONAHA.117.10496 PMID: https://pubmed.ncbi.nlm.nih.gov/29555664
- Song H, Fang F, Tomasson G, et al. Association of Stress-Related Disorders With Subsequent Autoimmune Disease. JAMA. 2018;319(23):2388-400. DOI: https://doi.org/10.1001/jama.2018.7028 PMID: https://pubmed.ncbi.nlm.nih.gov/29922828
- Jak AJ, Jurick S, Crocker LD, et al. SMART-CPT for veterans with comorbid post-traumatic stress disorder and history of traumatic brain injury: a randomised controlled trial. // J Neurol Neurosurg Psychiatry. 2019;90(3):333-341. DOI: https://doi.org/10.1136/jnnp-2018-319315 PMID: https://pubmed.ncbi.nlm.nih.gov/30554135