N. Maruta, H. Kalens’ka, V. Fedchenko, T. Pan’ko, O. Maruta
State Institution “Institute of Neurology, Psychiatry and Narcology of the National Academy of Medical Sciences of Ukraine”
Introduction. Today, the problem of internally displaced persons is one of the most acute for Ukraine. Due to the prolonged military conflict in the Donbass, the occupation of parts of the Donetsk and Lugansk regions and the annexation of Crimea, about 1 500 000 Ukrainians were forced to leave their homes and move to other cities. At the present stage, a powerful influence of psychological factors on the subjective well-being of a person is noted, especially if he/she is undergoing a crisis of adaptation, an unstable situation in his/her life, for example, a cardinal change in life, moving, migration. The adaptation process in a migration situation, as well as experiences of migration as a vital event, depends on the circumstances of the migration process, the motivation and desirability of this change in human life. During migration, habitual activity is disrupted, which can be an impetus for the occurrence of mental disorders.
The aim of the study. To identify psychological risk factors for mental disorders in internally displaced persons.
Materials and methods. The study involved 213 internally displaced persons (105 women (49.29 %) and 108 men (50.71 %) aged 18 to 69 years) who took part in comprehensive psycho-diagnostic examination, which included the diagnosis of copy-strategies, the dominant mental state and severity viability indicators. All the examined were divided into 3 comparison groups: 94 internally displaced persons from the general population were included in I group (without signs of mental disorders) (54.25 % of women, 45.75 % of men aged 18-39), 68 people (47.05 % of women, 52.94 % of men aged 40-59 years), in whom certain symptoms (signs) of psychopathological disorders were identified, were included in II group (risk groups) and 51 people (41.17 % of women, 58.82 % of men aged 50-69) who sought medical help were included in III group.
Results. It was established that the internally displaced persons is heterogeneous and 3 categories of people should be distinguished among them: the first group of internally displaced persons that do not have signs of mental disorders (44.13 %), the second group of internally displaced persons that have individual symptoms of mental disorders (risk group) (31.92 %) and group III of internally displaced persons with established mental disorders (23.95 %).
Healthy internally displaced persons were inclined to use adaptive coping strategies (44.68 %): problem analysis, setting one’s own value, optimism, protest, appeal and distraction; relatively adaptive (38.24 %) and non-adaptive (32.35 %) coping strategies prevailed in the risk group: religiosity, ignoring, self-blaming, protest, active avoidance and distraction; non-adaptive coping strategies prevailed among patients (45.10 %): confusion, humility, self-accusations, active avoidance and treatment.
The characteristics of the mental state of internally displaced persons were determined: healthy internally displaced persons were characterized by increased indicators of an active attitude to life situations (58.67 %), increased tone (57.36 %), average indicators of emotional stability (51.15 %) and life satisfaction (55.42 %). An increase in indicators of an active attitude to a life situation (55.13 %), average indicators of emotional stability (48.03 %), and a decreased tone (54.76%) were determined in the risk group. Passivity (39.17 %), inertia (40.11 %), emotional instability (38.17 %), and dissatisfaction with life in general (37.86 %) were observed among the patients.
The psychological risk factors for the occurrence of mental disorders in internally displaced persons were determined, which included the updating of mainly non-adaptive coping strategies (DK = 3.97), passive life position (t = 3.384), reduced level of vitality (DK = 4.97), emotional lability (t = 2.689) and dissatisfaction with life (t = 3.683).
It has been established that the adaptation mechanism that determines the mental health of internally displaced persons is associated with the peculiarities of updating adaptive coping strategies, emotional stability and an active lifestyle, which can be considered as goals of psychocorrection intervention in case of violations of the adaptation process in malware.
Conclusions. The psychological risk factors for the occurrence of mental disorders in internally displaced persons were determined, which included updating mainly non-adaptive coping strategies, passive life position, reduced level of vitality, emotional lability and dissatisfaction with life.
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