bekhterevОбозрение психиатрии и медицинской психологии имени В.М.БехтереваV.M. BEKHTEREV REVIEW OF PSYCHIATRY AND MEDICAL PSYCHOLOGY2313-70532713-055XV. M. BEKHTEREV NATIONAL RESEARCH MEDICAL CENTER FOR PSYCHIATRY AND NEUROLOGY OF THE RUSSIAN FEDERATION MINISTRY OF HEALTH10.31363/2313-7053-2022-4-77-84bekhterev-751Research ArticleИССЛЕДОВАНИЯINVESTIGATIONSДинамика аутоагрессивного поведения в юности в траектории пограничного расстройства личностиDynamics of autoagressive behavior in youth in the trajectory of borderline personality disorderhttps://orcid.org/0000-0002-2288-202XКулешовА. А.KuleshovA. A.

Алексей Андреевич Кулешов, аспирант

Москва

Alexey A. Kuleshov

Moscow

kuleshovaleksei.ncpz@gmail.comhttps://orcid.org/0000-0002-6644-5454КрыловаЕ. С.KrylovaE. S.

Елена Сергеевна Крылова,  к. м. н.

Москва

Elena S. Krylova

Moscow

krylovaes@gmail.comhttps://orcid.org/0000-0002-1209-1443БебуришвилиА. А.BeburishviliA. A.

Анастасия Андреевна Бебуришвили, к. м. н.

Москва

Anastasiya A. Beburishvili

Moscow

beburishvili@gmail.comhttps://orcid.org/0000-0002-1209-1443КаледаВ. Г.KaledaV. G.

Василий Глебович Каледа, д. м. н.

Москва

Vasilij G. Kaleda

Moscow

kaleda-vg@yandex.ruНаучный центр психического здоровьяРоссияMental Health Research CenterRussian Federation2022181220225647784Copyright © Кулешов А.А., Крылова Е.С., Бебуришвили А.А., Каледа В.Г., 20222022Кулешов А.А., Крылова Е.С., Бебуришвили А.А., Каледа В.Г.Kuleshov A.A., Krylova E.S., Beburishvili A.A., Kaleda V.G.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.bekhterevreview.com/jour/article/view/751

   Цель: выявление клинико-психопатологических особенностей аутоагрессивного поведения в юношеском возрасте в траектории пограничного расстройства личности с определением их взаимосвязи, дальнейшей динамики и прогноза.   Материал и методы. Клинико-психопатологически (61 пациент), катамнестически (55 пациентов), ретроспективно и психометрически амбулаторно и в психиатрическом стационаре обследовано 116 больных мужского и женского пола с аутоагрессивным поведением (АП) при ПРЛ в юности. Пациенты с АП были разделены на три группы: 1 — с несуицидальными самоповреждениями (НССП); 2- с суицидальными попытками (СП); 3- с НССП вместе с СП.   Результаты. Установлены корреляции между оригинальной типологией ПРЛ и АП: в клинической группе преобладание импульсивного (64 %) и демонстративного (24 %) варианта при ПРЛ I типа («аффективный шторм»), аддиктивного (44,4 %) при II типе («аддиктивная адреналиномания») — и деперсонализационного — (51,9 %) и самоистязающего — (11,1 %) при III типе («когнитивные искажения и нарушения самоиндентификации»). В катамнестической группе отмечена трансформация основных вариантов аутоагрессивного поведения в сторону аддиктивного (56,4 %).   Заключение и выводы. Формирование аутоагрессивного поведения в юности и в траектории ПРЛ обусловлено взаимодействием возрастного фактора с основными личностными чертами ПРЛ — импульсивность, аффективная нестабильность, нарушение идентификации, алекситимия и ведущими психопатологическими синдромами. Подтверждена высокая сопряженность НССП с суицидальной активностью и выявлен высокий суицидальный риск для ПРЛ не только в юношеском возрасте, но и по его миновании. Полученные данные будут способствовать дальнейшему изучению аутоагрессивного поведения при различных типах личностной патологии и созданию новых моделей терапевтической и социо-реабилитационной помощи этого сложного контингента больных.

   Objective: to determinate the clinical and psychopathological characteristics of autoagressive behavior (AB) in youth in the trajectory of borderline personality disorder (BPD) with determinate relathionship between each other, further dynamics and prognosis.   Material and methods. Clinical-psychopathological (61 patients), follow-up (55 patients), retrospectively and psychometric methods, 116 patients males and females with autoagressive behavior (AB) in youth in the trajectory of BPD were clinically observed in outpatiently and psychiatric hospital. Patients with AB were divided into three equal groups: 1 — Non-suicidal self injurance (NSSI); 2- suicidal attempts (SA); 3- NSSI with SA.   Results. Correlations have been established between the original typology of BPD and AB: in the clinical group — impulsivity (64%) and demonstrative (24 %) AB of BPD type I (“affective storm”), addictive (44.4 %) in type II (“addictive adrenalin addiction”) — depersonalization (51,9%) and self-torturing (11,1 %) in type III (“cognitive distortions and disorders of self-identification”). In the follow-up group was noted transformation of main variants AB towards addictive behavior (56,4 %).   Conclusion and findings. The formation of auto-aggressive behavior in adolescence and in the trajectory of BPD is due to the interaction of the age factor with the main personality traits of BPD — impulsivity, affective instability, impaired identification, alexithymia and leading psychopathological syndromes. A high association of NSSI with suicidal activity was confirmed, and high suicidal risk for BPD was revealed not only in adolescence, but also after it has passed. The data obtained will contribute to the future study of autoagressive behavoir in personality disorder and for the creation of new therapeutic and social models of patients.

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The authors declare that there are no conflicts of interest present.