Mechanisms of the formation and the system of psychotherapeutic correction of states of maladaptation of students of higher educational medical institution

Abstract

In order to achieve this aim, in compliance with the principles of bioethics and deontology, 412 students of the 2-5 academic years of the Kharkiv National Medical University, of both sexes, at the age of 17-22 years, were examined. All the surveyed people were divided into three groups: Group 1 included 215 students-inhabitants of the Eastern Ukraine; Group 2 consisted of 87 students-residents of Luhansk and Donetsk regions, who entered the study at the KhNMU before the ATO; Group 3 consisted of 110 students-migrants from the ATO zone. As the results of the study indicated, students- migrants have a higher level of adaptation disorders, compared with the students of the first and second groups. It was established that the structure of adaptation disorders is represented by depressive, neurasthenic, anxious and dissociative syndrome complexes. The elements of pathogenetic significance in the formation of maladaptive states among medical students are the change of life stereotype, difficult educational material, imperfection of mechanisms of psychological protection, lack of self-regulation skills, non-constructive coping strategies, and situations of prolonged mental stress. For nonresident students, an emotionally stressful factor is the need for adaptation in the new conditions and the status of a forced migrant. Prognostically significant elements in the formation of adaptation disorders are excitability and imbalance, proneness to conflicts in relationships, disturbing confidence, disorganization of behavior, failure to self-regulation, inability to successfully overcome stressful situations, act in conditions of uncertainty, rigidity, and focusing on traumatic and negative feelings. The basis for the development of students' maladaptation is the high levels of somatization, depression and anxiety according to the SCL-90-R scale; prevalence of severe depressive and anxiety episodes according to the Hamilton scale; clinical manifestations in accordance with the hospital scale of anxiety and depression, predominance of the inversive and extensive psychological stress. Based on the data obtained, we have a system of medical and psychological support of a medical student during the period of study, which involves the use of integrated psychotherapeutic, psychoeducational and psychoprophylactic influences and proved its effectiveness.