Research Areas of the Department of Medical Psychology and Psychophysiology of Saint Petersburg State University

Archives of Psychiatry and Psychotherapy, 2017; 1: 56–61

DOI: 10.12740/APP/67330

Research areas of the Department of Medical Psychology and Psychophysiology of Saint Petersburg State University

Olga Y. Shchelkova, Irina V. Grandilevskaya, Ekaterina A. Burina, Piotr K. Trabczynski

Summary This article represents primary aspects of Saint Petersburg School of Clinical Psychology and briefly describes its history, as well as the main research goals pursued at the Department of Medical Psychology and Psycho- physiology at Saint Petersburg State University, Russia. The main key areas of research presented in the article are the following: studies in the field of theory and methodology of clinical psychology, psychological research in clinical and preventive medicine, research in the field of pediatric and perinatal clinical psychology, research on the theory and practice of psychotherapy, research in psychophysiology, and development of methods for clinical psychodiagnostics.

research / medical psychology / psychophysiology / St. Petersburg School of Clinical Psychology

INTRODUCTION tinued by V.N. Myasischev, his disciples and fol- lowers, and formed the basis of the Leningrad St. Petersburg School of Clinical (previously – school of medical psychology. pathological) Psychology was formed on the The methodology of clinical and psycholog- basis of psychoneurology influenced by the ical research, developed in the 1950s to 1970s works and with personal participation of out- by domestic psychologists, representatives of standing Russian psychiatrist, neurologist and V.N. Myasischev’s Leningrad school of medi- psychologist, V.M. Bekhterev. The works of cal psychology, due to the new life conditions V.M. Bekhterev and his associates, A.F. Lazurs- was being significantly supplemented by for- kiy, M.Y. Basov and S.L. Frank, started the tradi- eign approaches. The integration processes typ- tion of a humanistic and holistic approach to the ical at the time led to the emergence of a new study of the patient’s psyche, integrating all as- psychological specialty, clinical psychology. Ac- pects of the patient’s life functioning in the face cording to modern concepts, it is a specialty of of illness and treatment. This tradition was con- a broad profile characterized by interdiscipli- nary features and one that participates in solving complex psychological problems in med- Olga Y. Shchelkova1, Irina V. Grandilevskaya1, Ekaterina A. Buri- icine, public health, education, social care and 1 1 1 na , Piotr K. Trabczynski : Saint Petersburg State University, Saint other social areas. Petersburg, Russia. Correspondence address: Ekaterina A. Burina, Nab. Makarova 6, Saint-Petersburg, 199034, Russia, The first cohort of clinical psychology majors Correspondence address: [email protected] graduated in 2004, trained at the Department Research areas of the Department of Medical Psychology and Psychophysiology of Saint Petersburg... 57 of Medical Psychology and Psychophysiology, highlighted: biochemical, physiological and psy- the Faculty of Psychology of St. Petersburg State chological. The concept of mental adaptation in- University. The Department was established on tegrates these research areas and considers ad- the basis of the medical psychology specialisa- aptation as an integrated, multi-level (including tion at the Faculty in 1966 at the initiative of V.N. biological, psychological and social levels) and Myasischev [1]. The concept is based on the ide- self-governing functional system aimed at main- as of the founders of the psychological school at taining a stable interaction of the individual with Leningrad University. Staff of the St. Petersburg the environment [2]. Institute of Neuropsychiatry named after V.M. Bekhterev played a major role in the creation of the Department. The concept of stress and coping A personal approach to the patient in conjunc- tion with the study of the role of the neurophys- The study of mental adaptation processes iological processes in the mechanisms of psychic marked an interest shift from the study of un- conscious intrapsychic defense mechanisms to phenomena, the nature of the psychosomatic in- the study of stress coping, i.e. coping which im- teraction mechanisms of mental adaptation and plies strategies implemented for the most part compensation in the face of illness, and condi- consciously and actively in order to overcome tions that threaten the development of the dis- negative feelings and dealing with problems [3]. ease, constitute the basic research directions of Domestic studies stress the importance of total the Department of Medical Psychology and Psy- situation parameters faced by the subject. Cop- chophysiology. However, it should be noted that ing is treated as an individual way of interact- the discussion in this article does not exhaust the ing with the situation according to its own log- whole variety of problems of clinical psycholo- ic, significance in the person’s life and their psy- gy explored at the Faculty of Psychology of St. chological resources [4]. It is obvious that such Petersburg State University. an interpretation of coping with stress behavior is more appropriate for research in clinical psychology. Research in the field of clinical psychology: theory and methodology The concept of health-related quality of life One of the key areas of research in the field of clinical psychology is to further develop a sys- The recent intensified focus on research of tematic approach to understanding health and health-related quality of life is noticeable all over disease. A systematic approach identifies a shift the world. As a result of these studies the idea from the study of an abstract construct – disease of health-related quality of life was formed as – to a holistic study of a specific person, the per- a complex system concept. In many studies, sig- son who exists in terms of disease, “pre-disease” nificance is given to the subjective component or psychological maladjustment. The concepts of quality of life. It is largely determined by an of mental adaptation and health-related quality attitude towards health as a life value, and un- of life, as well as a systematic approach to psy- derstanding and recognition that come with the chodiagnostics, are currently being rapidly de- disease [2]. veloped.

System approach in psychodiagnostics System concept of mental adaptation and maladjustment According to the modern concepts of psychology, human psyche is a system of mental func- At present, the concept of mental adaptation and tions and conditions. It is obvious therefore that maladjustment receives special attention in con- in psyche research it is necessary to use the sys- nection with the revival of interest in the theo- tem-situational approach, which was developed ry of stress, in which several research areas are in clinical psychodiagnostics in recent years [5].

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This approach contrasts with the traditional in- search for differential diagnostic criteria; pre- tegrated approach [6]. It involves the study of dicting the effectiveness of rehabilitation treat- the nature of the system (integrated) interaction ment; the study of the social environment and of individual functions, processes and mental social position of patients. states, as well as taking into account situational and contextual influences on human behavior. Areas of research in the somatic clinic

Development of the main provision of theoretical The introduction of the tenets and methods of psychology clinical psychology at the medical illnesses clinic occurs rapidly and is associated with a grow- Looking at the fundamental research of recent ing understanding of the role that patient per- years, it is necessary to highlight work related sonality and socio-psychological factors play in to the creation of a new field of psychology – the development of disease and the treatment theoretical psychology, uniting and systematiz- process. Equally important is the study of the ing methodological principles, categories, laws changes that the disease brings to the current of psychology, as well as the stages of psycho- mental state of the patient and their social func- logical research [7]. The development of the ba- tioning. In this regard, current approaches to as- sic concepts of theoretical psychology is in its fi- sessing the results of treatment consider thera- nal stage; a new monograph on the topic is ex- peutic dynamics in three areas: somatic, psycho- pected in the near future. logical and social. Main research interests focus on the study of: changes in the mental health of patients with somatic diseases; psychological ad- Psychological research in clinical medicine aptation to the disease; patients’ quality of life (in particular, the internal picture of the disease, The term “clinical psychology” (from Greek kline – bed, hospital bed), although it has a much psychological defense mechanisms and coping, broader meaning, is often used in the tradition- quality of life); and the role of psychological fac- al, historically acquired sense: the psychology tors in the occurrence and progression of psy- of the sick person. It is also understood that its chosomatic diseases. practical value is determined by the immediate needs of clinical medicine. The subject of clinical psychology is presented by the features of Psychological research in preventive medicine the patient’s mental activity in their implications A significant role plays research aimed at sec- for pathogenesis and differential diagnosis of ondary psychoprophylaxis in post-traumatic the disease, to optimize its treatment, second- stress disorder, and in treatment and rehabilita- ary prevention and patient social rehabilitation. tion of survivors of extreme and crisis situations. Of particular importance is clinic-psychological Areas of research in the psychiatric clinic research in children and adolescents for the prevention of deviant and self-destructive behav- In psychiatry, the traditional tasks of applied re- ior, as well as targeted family research. These search are search problems of increasingly nar- research areas are gaining greater social signifi- row and reliable criteria for the differential clin- cance due to a substantial increase in the dynam- ical diagnosis, determining the level and struc- ics and tension of everyday life in recent years. ture of the intellectual, emotional and volitional Mental maladjustment risk factors identified in defect, as well as adjusting patient behavior in preventive research can be both subjective and various areas of expertise (judicial, military, em- objective in nature (i.e. defined as the individual ployment), and an evaluation of the dynamics of characteristics of emotional responses, volition- a mental disorder following therapy. In the cur- al control, coping and social factors in the envi- rent circumstances, these objectives remain val- ronment, professional activities, etc.). Research id, but are filled with new content, including: methodology in the field of mental health risks

Archives of Psychiatry and Psychotherapy, 2017; 1: 56–61 Research areas of the Department of Medical Psychology and Psychophysiology of Saint Petersburg... 59 is primarily based on screening, monitoring the cases, research and development in the field of state of health of professional groups or popula- psychotherapy further the pathogenetic concept tion groups, united by general conditions of life. of neuroses and psychotherapy of V.N. Myasis- chev [11]. The main task of pathogenetic psychotherapy of neuroses is to reconstruct and restore Research in the field of pediatric and perinatal clinical the broken system of patient relations. The basis psychology for this is an awareness of the patient’s own personality characteristics and system of relations, One of the key areas of research in child clinical as well as the relationship between these char- psychology is the study of abnormalities of men- acteristics and disease. tal development in children, the structure of dif- With the development of group personality- ferent types of dysontogenesis [8]. oriented (reconstructive) psychotherapy the full- Due to a sharp increase in the number of psy- est realization of its basic tasks became possi- chosomatic and somatoform disorders in chil- ble. The particular task was achieving positive dren and adolescents the amount of research change in various aspects of attitude to self. This in recent years has increased. The studies are change represents the beginning of more pro- aimed at the difficult connection between men- found positive improvements in the relations tal and physical aspects of child development. system in general. Another direction is no less relevant in modern The Department of Medical Psychology and socio-economic conditions: the study of children Psychophysiology has for many years conducted and adolescents with mental and social depriva- research, in collaboration with a number of med- tion, which is held in connection with the task ical institutions (primarily – the V.M. Bekhterev of determining the basic principles and meth- Research Institute), on the effectiveness of differ- ods of psychological assistance to this catego- ent types and forms of therapy, focusing on the ry of children. dynamics of a variety of psychological parame- Preventative line of research in child clini- ters: self-esteem, coping mechanisms, intrapsy- cal psychology is represented by work related chic and interpersonal conflicts, basic beliefs and mainly to the study of the parent–child relation- irrational attitudes, and so on. ship as a factor promoting and at the same time In recent years, increased attention has been blocking the harmonious development of the paid to short-term forms of psychotherapy, both child and his/her successful social adaptation. individual and group therapy. At the same time, A separate area of research and psychologi- short-term clinical and psychological interven- cal practice is perinatal psychology (in its clini- tions are becoming more common. These types cal and preventive aspects). The greatest number of intervention, in contrast to short-term psycho- of studies in this area is dedicated to the devel- therapy that lasts about 15–20 sessions, are lim- opment and evaluation of programs of psycho- ited to 1–2 meetings. They are used most often logical support for pregnant women [9]. A num- in order to create a healthy lifestyle or motiva- ber of studies focus on issues around the birth of tion for treatment (i.e. in patients with alcohol a sick child, and psychological assistance needed addiction, in fetal alcohol syndrome prevention by families in these situations, the study of fam- [12-13]. ilies who have lost their unborn child, as well as psychological support for families at risk of hav- ing small children [10]. Research in psychophysiology

The overall theme of research carried out at the Research on the theory and practice of psychotherapy laboratory of psychophysiology of the Faculty of Psychology of St. Petersburg State University One of the main areas of practice and research is an exploration of physiological mechanisms activity of clinical psychologists, who were of psychic phenomena. Consequently, the basic trained in the psychological traditions of the St. research is related to mental phenomena mod- Petersburg school, is psychotherapy. In many eling. In the context of understanding the ori-

Archives of Psychiatry and Psychotherapy, 2017; 1: 56–61 60 Olga Y. Shchelkova et al. gin of the psyche as a natural phenomenon, Russian: Coping Strategies Questionnaire [24], the physiological mechanisms of consciousness the Toronto Alexithymia Scale [2], the Sympto- [14], emotions [15] and speech [16] were stud- matic Questionnaire of Neurotic Disorders [18] ied. Mathematical modeling was applied in the and others. processes of interaction of the modules of the An important area is the development and nervous system and the formation of the sim- improvement of tests for monitoring men- plest of psychic phenomena on the basis of this tal health and early diagnosis of mental disor- interaction; performance testing and optimiza- ders [25] as well as addictive and suicidal be- tion of a mathematical model of a neural net- havior [26]. Among the new developments are work was conducted, describing how brain cent- creative methods of determining psychological ers interact [17]. The new directions of this scien- traits based on situational speech and texts [16], tific work are applied cognitive and clinical psy- and the validity of psychological testing based chophysiology. on psychophysiological criteria [27]. At the moment it becomes obvious that one of the possible directions in the development of Development of methods for clinical psychodiagnostics clinical psychodiagnostic methods is connected with the opportunities offered by the continu- A broad spectrum of methods of experimental ous development of computer and information and clinical-psychological research are availa- technology. A particularly valuable develop- ble to study the scientific and practical problems ment concerns the psychodiagnostic informa- of clinical psychology [18]. However, the devel- tion expert systems, based on a holistic cover- opment of their own research methods for the age of various aspects of psychodiagnostics and study of IQ is a priority, and of great importance the psychological characteristics studied. in the practical work of a clinical psychologist, especially in expert practice. Among the new developments in the field of CONCLUSION IQ diagnostics is an adapted method called the “test of intellectual potential”, which is a mon- Currently, research in the field of clinical psy- omeric tool for a rapid assessment of non-ver- chology practice is in demand. Clinical psychol- bal intelligence, and the potential for its devel- ogy is increasingly establishing itself as an inde- opment in school-age children and adolescents pendent professional activity of psychologists, [19]. With regulatory assessment, another test, a study of the whole of the human personality developed at the national sample, the Intellectu- and its role in the occurrence, course, preven- al Potential Test, can be effective in solving var- tion and treatment of a variety of diseases and ious problems of clinical and educational (cor- conditions of mental maladjustment, both con- rectional) psychology. With regard to the field of ventional and related to the new stage of pro- adult cognitive deficits a re-standardized tech- gress. The scientific research of the Department nique called “Complex Figure Rey – Osterreith” of Medical Psychology and Psychophysiology, is notable [20]. St. Petersburg State University, has made signif- For the purpose of personal diagnostics, in re- icant contributions in this area. cent years the V.M. Bekhterev Research Institute, in collaboration with the Laboratory of Clinical REFERENCES Psychology, developed a number of original psychometric tests, scales and methods, such as 1. Serebryakova RO. Actual problems of clinical psychology the Neurotic Personality Traits Questionnaire and psychophysiology. Ananievskie Chtenia Conference, [21], The Level of Social Frustration method [2], Saint Petersburg. Saint Petersburg State University Publi- The Level of Neurotic Asthenia Questionnaire cation; 2004: 268–272. [2], Attitudes to Disease method [22], and the Se- 2. Wasserman LI, Trifonova EA, Schelkova OJ. Psychological mantic Differential of Time method [23]. Wide- diagnostics and correction in somatic clinic: practical tutori- ly used in clinical and preventive medicine are al. Saint Petersburg: Rech; 2011: 271. tests created in other countries and adapted for

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