ADAPTIVE POTENTIAL OF PATIENTS WITH MENTAL DISORDERS

The work is devoted to studying the peculiarities of personal adaptive potential in mental disorders of different genesis. The analysis of the structure of adaptation potential, hierarchy of its elements, qualitative diversity of its internal and external relations can reflect the dynamics of adaptation process prognosis, be an effective component of psychological support programs in forming adaptive strategies of co-adaptive behavior, providing personalized psychological correction assistance. A total of 105 patients with mental disorders of various genesis aged 19 to 67 years participated in the study. Among them there were 35 patients with mental disorders of neurotic, 35 - endogenous, 35-with organic genesis. The comparison group consisted of 35 persons without signs of psychopathology. In case of mental disorders there is a decrease in personal adaptive potential. This reflects a reduction in the ability to respond adequately and productively to a complex of adverse factors under stressful loads, disproportionate use of functional reserves, which in turn affects the prevention of premorbid conditions. The structure of adaptation possibilities of patients with mental disorders testifies to the prevalence of neuropsychological stability as a leading adaptation mechanism in this category of patients, along with much less pronounced communication abilities and moral standards. Among patients with mental disorders of various genesis the highest adaptive potential was noted in the group of patients with organic disorders, which reflects their ability to adequately regulate the functional state of the organism in various living and activity conditions. Also this category of patients had the highest indices of neuropsychic resistance. Patients with neurotic disorders, as a leading way of adaptation, most often used communication skills, which prevailed in comparison with other nosological groups, and the lowest indicators for all components of coping behavior resources were observed in patients with endogenous disorders.

Problem statement. The urgency of studying mental disorders is caused not only by the prevalence of psychogenic factors and low mental adaptation of the population, but also by the prevalence of chronic recurrent, resistant forms in the structure of psychopathology, which significantly reduce social functioning and quality of life of the population. Under these conditions, the study of personalized mechanisms of disease genesis, which make it possible to identify a person's "vulnerability" to the development of pathogenic influences, acquires not only theoretical but also important practical significance.
Problem analysis. The instability of modern life (social and political crises, terrorism, armed conflicts, migration) places increased demands on adaptive personal mechanisms and increases the risk of mental disorders, which is confirmed by the results of epidemiological studies. It has been shown that a characteristic feature of interaction in the 'human environment' system is that a person acts as its active side, modeling various adaptation strategies, using both genetically fixed and acquired mechanisms of adaptive behavior (Lazareva, 2012, Soroko, 2012. It is possible to designate that adaptation is defined as a process of interaction between a person and the environment, as a result of which he or she has models and strategies of behavior that are adequate to the conditions changing in this environment (Bulan, 2008, Shestopalova, 2002.
The level of development of this property defines the interval of change of conditions and character of activity within which adaptation for a concrete individual is possible (Ng, Jeffery, 2003). Turning to the role of the individual in adaptation, it has been revealed that an individual's adaptive abilities largely depend on psychological features of the individual, which determine the possibility of adequate regulation of the functional state of the organism in various conditions of life and activity (Tolstyh, 2011). The more significant are adaptation abilities, the higher is the probability of normal functioning of the organism and effective activity at the increase of intensity of influence of psychogenic factors of external environment (Trifonova, 2013, Schroder, 2004.
The mental component of adaptive capacity is provided by latent and real human mental capabilities, which allow reflecting the objective reality in all its diversity and regulating various relationships with it and with oneself, preserving one's own integrity, self-realization and selftransformation (Romanov, 2012, Bogomolov, 2008.
By adaptation we mean the process of not only preservation of physiological, but also mental homeostasis; optimal constant interaction of a person with the environment and establishment of the most effective correspondence between physiological and psychological factors, as a result of formation of relatively stable psychophysiological relations (Chikhachev M.V. 2016, Nikolaev, 2013. The adaptive potential of the individual is inextricably linked to the social and psychological well-being of the individual and productivity in life activities (Maruta, Fedchenko, 2019). Destructive mechanisms of desadaptation lead to the formation of various forms of deviations. Therefore, our task is to respond to the problem in a timely manner, correctly diagnose the adaptive potential and provide professional assistance (Ovcharenko, 2020).
The aim of this research was to investigate the peculiarities of adaptive potential in patients with mental disorders of different etiologies, as well as its structural differences depending on the genesis of the disease.
Configuration and research methods. Psychological research was conducted at the Department of Medical Psychology of the National Academy of Medical Sciences of Ukraine. A total of 105 patients with mental disorders of various genesis aged 19 to 67 years (mean age 32.57±9.84 years), including 33 (31.41%) men and 72 (68.58%) women, participated in the study. Among them there were 35 patients with mental disorders of neurotic (F41, F43, F44, F48), 35endogenous (F34.0, F34.1, F33), 35-with organic genesis (F06.4, F06.5, F06.6). The comparison group consisted of 35 persons without signs of psychopathology. In general, the main sociodemographic features of the main group and the control group were identical.
In order to realize the set goal, the method of the "Adaptivity" personal questionnaire was used (Raygorodsky 2001). Statistical processing of empirical data was carried out with the help of the method of establishing the reliability of sample differences (by t -Student's criterion, φ -Fisher's criterion of reliability of differences).
Statement of the main material. The analysis of the research results showed that a decrease in personal adaptive potential (PAP) is observed at mental disorders (4,89±0,14 standart ten). This reflects a reduction in the ability to respond adequately and productively to a complex of adverse factors under stressful loads, disproportionately involve functional reserves, which in turn negatively affects the prevention of pre-morbid conditions. The study of the structure of adaptation possibilities of patients with mental disorders testifies to the prevalence of neuropsychological stability (NPS) as a leading adaptation mechanism (5,35±0,26 standart ten), along with much less expressed communicative abilities (CA) and moral normality (MN) (4,79±0,09 standart ten and 4,89±0,14 standart ten, p<0,05). This reflects the relative productivity of the specificity of the motivational and consumer sphere, which determines the vector and intensity of individual activity, the mechanisms through which the processes of goal setting and choice of means to achieve the goals.
In patients with neurotic disorders a satisfactory level of adaptation was noted (4,97±0,04 standart ten), in the structure of which the prevalence of communicative ways of coincidence was expressed (6,71±0,16 standart ten). Thus, high and average levels of CA were observed in 45,71% and 40% of patients respectively, and low -in 14,29% (Fig.1). The indices of neuropsychological resistance in patients with neurotic disorders were satisfactory (5.11±0.29 standart ten). At the same time the majority of subjects had average level of NPS (54,28%), high resistance indices were 34,29%, and low -11,43%.

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In the case of neurotic disorders, there was a significant decrease in moral normality as an adaptation resource of the individual (4.97±0.04 standart ten, p<0.05). In this group only 8,57% of subjects had a high level of observance of generally accepted norms and rules of behaviour, 60% adhered to the rules irregularly, depending on external environment conditions, and 31,43% had a low level of MN.
In the group of patients with mental disorders of endogenous genesis the level of personal adaptive potential was rather low (3.88±0.08). The most significant in the structure of the co-operative resource was NPS (4,6±0,17 standart ten, p<0,05), which high and medium level was in 37,4% and 34,29% of the subjects respectively (Fig.2). Low level of behavioral regulation and lack of adequate self-esteem were demonstrated by 28,57% of patients. In endogenous mental disorders,CA were observed at a low level (3.31±0.03 standart ten). Patients of this group had difficulties in building productive communications, interaction with others, and were inclined to use an inflexible system of interpersonal relations: the average and low CA indices were recorded in 42.86% and 37.14% of the subjects, respectively, while the ease of contact and nonconflictiveness was shown only in 20% of cases.
Also in patients with endogenous disorders in the structure of adaptation mechanisms a decrease in MN was observed (3.74±0.05 standart ten). Only 22,86% of subjects adhered to behavioral norms and regular evaluation of moral and ethical principles, while average and low MN levels were observed in 45,71% and 31,43% of patients respectively. In case of organic mental disorders, relatively high PAP indices (5.83±0.17 standart ten) were registered. In the structure of resource potential the MN reliably prevailed (6,8±0,12 standart ten), high and medium level of adherence to moral and social norms were demonstrated by 54,29% and 37,14% of the subjects, respectively, while intolerance to moral aspects was observed only in 8,57% of patients with this pathology (Fig.3). In patients with mental disorders of organic genesis the adaptive component of NPS was also expressed (6.34±0.32 standart ten, p<0.05). A high and average level of resistance to stress was noted in 42.86% and 40% of respondents respectively. Low level of behavioral regulation was registered in 17,14% of subjects.
The lowest indices in the group of patients with organic pathology were observed for CA factor (4,37±0,08 standart ten, p<0,05). It was shown that 45,72% of patients had difficulties in communication, establishing contacts with others and deep emotional connections. In this group, only 25.71% of the respondents had adaptive communication skills, while 28.57% had the average structural indicator of the CA.
Comparative analysis of the study data of patients with mental disorders showed that a significantly higher adaptive potential was observed in the group of patients with organic disorders (p<0,005), which reflects their ability to adequately regulate the functional state of the body in a variety of living and activity conditions (Fig. 4). Also, this category of patients had the highest rates of NPS.
Patients with neurotic disorders were more likely to use communication skills as a leading way of adaptation than other nosological groups (p<0.005). This indicates a propensity of this category of patients to use interpersonal interaction as a way of avoiding in difficult life circumstances, reluctance to accept responsibility by transferring negative emotions to external objects and a desire to replace the process of cognitive experience processing.
A study of the structure of adaptive capacity in patients with mental disorders showed that the lowest rates for all components of coping resources were observed in patients with endogenous disorders (p<0.05). Such distribution is characterized by low level of behavioral regulation, Medical Psychology certain propensity for neuropsychiatric breakdowns, lack of adequate self-esteem and real perception of reality, low level of development of communicative abilities, difficulties in building contacts with others, manifestation of aggressiveness, increased conflict, inability to adequately evaluate one's place and role in the team, lack of aspiration to observe generally accepted norms of behavior.
To determine the significance of adaptation potential indicators by identifying and diagnosing criteria of mental disorders, the structure of resource potential in subjects without signs of psychopathology was analyzed (Fig. 5). The study showed that in the comparison group LAP was significantly higher than in the presence of mental disorders (7.36±0.25 standart tens, p<0.005). The leading adaptation mechanism was CA (8.11±0.29 standart tens, p<0.05), while NPS and MN were expressed less (7.23±0.14 and 6.47±0.31 standart tens, respectively), while being within the framework of high normative indicators. Thus, this group was distinguished by a high level of neuropsychological stability and behavioral regulation, high adequate self-esteem and real perception of reality, developed communication abilities, ease of establishing contacts with others, reduced conflict, a real assessment of its role in the team, orientation on compliance with generally accepted norms of behavior.
Conclusions 1. In case of mental disorders there is a decrease in personal adaptive potential. This reflects a reduction in the ability to respond adequately and productively to a complex of adverse factors under stressful loads, disproportionate use of functional reserves, which in turn affects the prevention of premorbid conditions.
2. The structure of adaptation possibilities of patients with mental disorders testifies to the prevalence of neuropsychological stability as a leading adaptation mechanism in this category of patients, along with much less pronounced communication abilities and moral standards.
3. Among patients with mental disorders of various genesis the highest adaptive potential was noted in the group of patients with organic disorders, which reflects their ability to adequately regulate the functional state of the organism in various living and activity conditions. Also, this category of patients had the highest indices of neuropsychic resistance. Patients with neurotic disorders, as a leading way of adaptation, most often used communication skills, which prevailed in comparison with other nosological groups, and the lowest indicators for all components of coping behavior resources were observed in patients with endogenous disorders.
The prospect of further research on this issue is to study the extent to which adaptation resources influence the formation of pathopsychological symptomatology, variability, severity, duration and peculiarities of the course of mental disorders of different etiologies.
The analysis of the structure of adaptation potential, hierarchy of its elements, qualitative diversity of its internal and external relations can reflect the dynamics of adaptation process prognosis, be an effective component of psychological support programs in forming adaptive strategies of co-adaptive behavior, providing personalized psychological correction assistance.