Аннотация:
Introduction. According to the data of domestic and foreign studies, a violation of self-awareness is characteristic of all non-psychotic disorders. However, depending on the type of non-psychotic disorder (neurosis or personality disorder), self-awareness is violated at different levels and in varying degrees of severity.
Aim: to study the features of impaired self-consciousness in persons suffering from alcoholism with different types of comorbid non-psychotic disorders in order to identify targets in the use of subsequent psychocorrectional and psychotherapeutic programs, which, in turn, can ensure not only the full functioning of the personality, but also prevent the appearance of various kinds of addictive states and personality disorders.
Methods. The theoretical basis of the work was the study of self-consciousness, both domestic (V.V. Stolin, A.G. Spirkin, L.I. Bozhovich, I.I. Chesnokova, I.S. Kon, M.I. Lisina, etc.) and foreign authors (W. James, E. Erickson, K. Rogers, R. Burns, etc.). The basis of the theoretical approach was the concept of I.S. Kohn and the three-component model of personality self-consciousness proposed by him, on the basis of which the choice of the methodological base was made and the further course of the study was determined. An experimental psychological study was conducted using a multi-level personality questionnaire «Adaptiveness» (MLO-AM) by A.G. Maklakova and S.V. Chermyanin, test-questionnaire of self-attitude (V.V. Stolin, R.S. Pantileev) for studying the cognitive component of self-consciousness, the test «Who am I?» Kuhn to study the affective component of self-consciousness and the methodology «Meaningful orientations» by D.A. Leontiev for the analysis of the behavioral component of self-consciousness.
Results. For patients with alcohol dependence and neurotic disorders, the most characteristic is a violation of the affective component of self-awareness; one can speak of their self-esteem as internally contradictory, disharmonious, in connection with which some experts speak of high, while others speak of low self-esteem in neuroses. Patients with personality disorders, most often, have violations of self-awareness at the level of cognitive and behavioral components. The presence of a non-psychotic disorder and the impairment of self-awareness it causes increases the risk of alcoholism. It was found that in the presence of alcohol dependence, a violation of the cognitive component of self-awareness occurs in all types of comorbid non-psychotic disorders. In patients with alcoholism with comorbid personality disorders, the cognitive component of self-consciousness is impaired to a greater extent than in neurotic disorders. Violation of the affective and behavioral components of self-awareness is also characteristic of those suffering from alcoholism with comorbid neurotic disorders.
Conclusions. The obtained conclusions about the influence of non-psychotic pathology on the violation of self-consciousness in alcoholism allow us to develop a plan of psycho-correctional work for each type of comorbid non-psychotic disorder. As a result of the work carried out, psychocorrectional programs were developed for alcoholics with comorbid personality disorders and neurotic disorders based on data on the features of self-consciousness disorders in alcoholics with comorbid disorders of a non-psychotic nature and take into account information about which components of self-consciousness are violated in a particular type of disorder. Practical recommendations developed on the basis of this knowledge are designed to increase the effectiveness of the treatment of patients with alcoholism.
Ключевые слова:
alcoholism, comorbid non-psychotic disorders, neurotic disorders, personality disorders, self-awareness.