Clinical and Health Psychology

The article has discussed the Leningrad Siege (1941-1944), focusing on the individual and collective memories of survivors who had lived through that trauma during their childhood. Thus far there has been no psychological investigation of the feelings of extreme deprivation caused by that Siege, despite the reams of material published on Leningrad under siege. To deal with this shortfall, the critique has considered the effect of that experience on the future lives of the people concerned. The basic methodology, the paper maintains, combined quantitative and qualitative approaches and involved a comparison of two equal-sized groups: the experimental group, comprising 60 war survivors who lived through the Siege; and the control group, comprising 60 war survivors who were evacuated from Leningrad during the Siege and consequently did not experience the trauma. The review related that the groups were matched by age and by gender distribution. Data for the Interpretative Phenomenological Analysis-based qualitative analysis (QA) were collected according to psychometric measures (containing scales for depression, general satisfaction with life, and stress) applied in semi-structured interviews. The QA, for its part, used methods such as correlation, factor- and cluster-analysis to measure data segments. The nature of the suffering and the persistence of the human threat (past and present) were reconstructed within the framework of the psychological experiences (under extreme conditions) faced by the experimental group. The report, in conclusion, has stated that these experiences were evaluated via psychoanalytic tools dealing with child development, mourning and symbolization of traumatic events. These enabled it to identify psychological phenomena such as child grief and the impact of trauma on the adult life of the former Siege victims.

The article aims to demonstrate a high efficiency of the methodological means suggested by psychological syndrome analysis approach (Vygotsky-Luria school) for solving theoretical and applied issues in contemporary person-centered medicine. 

This is achieved through an example of empirical study meant to construct a psychosomatic syndrome for 290 patients with mitral valve prolapse (MVP). Analysis of all collected data was based on psychological syndrome analysis concept (Vygotsky–Luria school) and A.R. Luria’s principles for psychological factors (causes) selection, which determine the logic and structure of a neuropsychological syndrome. It demonstrated the association between characteristics of emotional experiences and clinical symptoms manifested in MVP patients. This correlation was statistically verified. The results proved that the most important syndrome-establishment factor (radical) is a specific emotionality and dysfunction of emotion regulation and emotional control in MVP patients (excessive emotional repression with insufficient reflection of emotional experiences). Features of the motivation sphere of MVP patients appear as a second psychological syndrome-establishment factor: these are domination of the motive of failure avoidance and unsatisfied self-approval need. 

We argue that psychological syndrome analysis can be used as a means to approach not only diagnostic but also prognostic tasks both in clinical psychology and medicine, as well as for the development and implementation of the person-centered integrative diagnosis model. 

We maintained that this approach, applied in theoretical and practical fields of clinical psychology and mental health care is highly efficient at the current stage of the science evolution due to prospects revealed by s new methodological context of postnonclassical model of rationality and a comprehensive character of the cultural-historical concept regarding an individual and his mind as a self-developing open systems.

The article analyzes certain socio-cultural and personal predispositions, which determine the modern diversity of subjective uncertainty and ambiguity manifestations. It stresses that for the creation of ‘realistic’ clinical psychology (in terms of A.R. Luria) one needs to retrace the relations between the resourceful and the psychopathological aspects of the ambiguity phenomenon and the cultural environment with its destructive ideals and mythologems, manipulative media-technologies and all-pervading idea of ‘deconstruction’. Methods for modeling the experiences of ambiguity in experimental settings, in pathopsychological examination and in projective psychological diagnostics are put in comparison. The arguments are adduced for the interpretation of deficient manifestations of subjective uncertainty as a criterion for diagnostics of the severity of personality disorder.