RU2291720C1 - Method for estimating human emotional state - Google Patents

Abstract

FIELD: medicine.

SUBSTANCE: method involves showing four groups of verbal characteristics reflecting different emotional states and their expression degree. Then, verbal characteristics selected by testee as ones reflecting his/her emotional state are analyzed with assigning scores. Four adjective groups reflecting the following four basic personality requirements like safety, independence, success, unity-intimacy. To estimate basic personality requirements for safety, the following score and adjective system is used. 0 score assigned to calmed, pacified, placid. Score 1 is given to vigilant, anxious, agitated. Score 2 is given to alarmed, frightened, scared. Score 3 is given to martyred, tortured, desperate. To estimate basic personality requirements for independence, the following scores and adjective system is used. 0 score assigned to relieved, free, emancipated. Score 1 is given to excited, indignant, angry. Score 2 is given to preoccupied, overloaded, overstressed. Score 3 is given to depressed, suppressed, constrained. To estimate basic personality requirements for success, the following scores and adjective system is used. 0 score assigned to glad, joyful, proud. Score 1 is given to moody, inspired, enthusiastic. Score 2 is given to overexcited, frantic, nervy. Score 3 is given to exhausted, devastated, indifferent. To estimate basic personality requirements for unity, the following scores and adjective system is used. 0 score assigned to charmed, gratified, well-to-do. Score 1 is given to interested, animated, admired. Score 2 is given to upset, hurt, disappointed. Score 3 is given to lost, single, grieving. To study each kind of basic personality requirements, circular scale is used. It is divided into four quadrants with two perpendicular straight line segments intersecting in the center and arranged at an angle of 45° to horizontal line. Three adjectives, reflecting the degree the basic personality requirements are satisfied, are placed at each point of intersection of these straight line segments with the circular scale circle boundary. If words, describing patient state, have been selected by the patient, position is marked on the circular scale at the point the word group is disposed or, when two different word groups being selected, on the circle or on the segment connecting two different word groups. The score values sum related to each of four basic personality requirements are determined depending on mark position. A mark being found on the boundary separating quadrants, maximum of two value is assigned to it. The mark being placed in the circle center, it is excluded from the study. Mean score value corresponding to each kind of basic personality requirements. The value is interpreted in terms of personal emotional adaptation disorder as follows. 0 points shows lack of emotional adaptation disorder as physiologic relaxation. 1 point shows lightly expressed emotional adaptation disorder as physiologic stress. 2 points show moderately expressed emotional adaptation disorder as pathologic stress. 3 points show severe emotional adaptation disorder as pathologic relaxation.

EFFECT: exact quantitative estimate enabling testee to become conscious of nature of his/her emotional experience; enhanced effectiveness in training self-control and self-regulation of psychic state.

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Description

The present invention relates to medical and clinical-psychological diagnosis and can be used for timely assessment of the emotional state of patients with neurological and somatic pathology.

Assessing the emotional state of patients is important in neurological and therapeutic practice due to the significant influence of emotional stress on the clinical manifestations and nature of the course of many neurological and somatic diseases (Carson A.J. et al., 2000). Increasing attention is being paid to daily monitoring of the patient’s emotional state, which allows optimizing the psychological assistance to patients (Whalen C.K. et al., 2001; Bolger N. et al., 2003).

Of clinical interest is both the diagnosis of the level of emotional maladaptation, and the determination of the nature of the emotions experienced by the patient, contributing to an understanding of the personal causes of stress. Determining the degree of emotional maladaptation in clinical practice is most often carried out by assessing the symptoms of anxiety-depressive disorders, recognized as clinical correlates of mental stress. Most often, verbal questionnaires are used for this purpose, such as Zung Self-Rating Depression Scale, Beck Questionnaire, Wakefield Self-Assessment Depression Inventory, Hospital Anxiety and Depression Scale, Hamilton Rating Scale for Depression, Spilberger Anxiety Inventory, etc. ( Masur H. et al., 2004).

Such scales have proven themselves in diagnosing the level of chronic stress. However, their drawback is the limitation of the characteristics of the emotional sphere to only the area of anxiety and depression, while the spectrum of human emotions is much wider. Meanwhile, clarification of the patient's range of experiences is essential for understanding the psychological causes of his emotional discomfort associated with the violation of certain biopsychosocial needs. In addition, the components of such approval scales (for example: “I do not monitor my appearance”) characterize a relatively stable state of a person. In this regard, these scales do not allow observing the dynamics of a person’s emotional state over short periods of time calculated in hours or one day.

A dynamic assessment of the level of mental stress can be given by the scale “The Affect Adjective Check List” developed by Zuckerman and his collaborators in the 1960s (cited by G. Breslav, 2004). According to this technique, the subject is presented with a list of 21 adjectives reflecting the presence of experiences of anxiety or its absence, and it is proposed to evaluate the severity of each of these experiences “here and now” and “usually” on a 5-point scale. At the same time, this technique also limits the diagnosis of a person’s emotional state to only determining the level of his mental stress, leaving a range of feelings experienced by a person beyond the scope of the analysis, the analysis of which is significant insofar as it allows to find out the source of this mental stress.

A number of projective techniques also make it possible to assess the severity of emotional stress, of which the Luscher test is most often used for this purpose. The severity of emotional stress ("anxiety") is determined in points by a special rating system, determined by the location of various color standards in a number of preferences of the subject. A number of studies have confirmed the existence of correlations between the preference of a particular color standard and the actual emotional state of the subject (Kuznetsov ON, et al., 1990). At the same time, the Luscher test, like the verbal scales of anxiety and depression described above, allows you to identify only the general level of mental stress, without indicating the specificity of the emotions experienced by a person.

Diagnosis of the nature of emotions experienced by a person is possible using methods based on the assessment of facial expression. However, methods of identifying a person’s current emotional state by facial expressions and pantomimics are mainly used for experimental purposes and have not been widely used in clinical practice due to their laboriousness (Breslav G., 2004). Diagnostics of the emotional state is also described by the characteristics of speech (loudness and pitch, tempo and intonation of statements). So, Mehl M.R. et al. (2001), for dynamic observation of the subject’s affective sphere, suggested using an electronic portable device that provides periodic (repeated every 12 minutes) 30-second audio recordings of the subject’s speech and sounds of his environment. It is proved that such a record allows you to get an accurate dynamic description of the psychological state of a person during the observation. The disadvantages of the method include the need to use expensive electronic equipment, as well as the complexity of the analysis and interpretation of the data obtained.

There are also verbal methods for diagnosing the nature of emotions experienced by a person. So, Matthews K.A. et al. (2000) developed a method for assessing the emotional state based on the choice of the verbal characteristics of the emotions experienced by the subjects. According to the technique, the subject is presented with a list of 17 words denoting various emotions, after which they are asked to indicate the degree of experience at the time of examining each of these emotions on a four-point scale (1 point - I do not feel at all, 4 points - I feel very much). At the stage of the method development, the authors identified three mood options - “negative”, “positive” and “bored”. The words “intense”, “irritable”, “angry”, “indignant / offended”, “excited”, “restless”, “impatient” and “sad” served as characteristics of negative mood. Signs of a positive mood were considered to be emotions, indicated by the words “satisfied”, “joyful”, “satisfied”, “energetic”, “controlling oneself”, “interested / involved”. The signs of a bored mood included emotions, indicated by the words "tired", "indifferent" and "tired." Based on the results of a factor analysis of the data obtained by the authors, each of the 17 emotions listed was assigned its own “weight” depending on the degree to which it reflected the corresponding mood. The severity of each of the indicated mood variants for a particular subject was evaluated by “weighing” and summing up the points assigned to them by emotions corresponding to this mood.

The disadvantage of this method include ignoring information about the degree of mental stress experienced by the patient. Another drawback is the need to repeat the factor analysis and determine the "weight" coefficients that indicate the emotions of words when conducting research on samples belonging to new populations. All this complicates the method and complicates its application in clinical practice.

As a prototype of the proposed method, we have chosen the method proposed by A. Wessman and D. Ricks “Self-assessment of emotional states” (cited in: Psychological tests / Edited by A.A. Karelin. - M .: Humanit. Ed. Center VLADOS, 1999 - In 2 vols. - M.: Humanitarian Publishing Center VLADOS, 1999. - T.1 - S.241-244). The test subject is offered 40 statements combined in four sections (ten statements each).

1 set of judgments

1. Completely distraught with fear. I lost my mind. Scared by insoluble difficulties.

2. Huge anxiety, concern. Exhausted by fear.

3. Significant uncertainty. Extremely traumatized by uncertainty. Scary.

4. I'm experiencing some concern, fear, anxiety, or uncertainty. Nervous, worried, annoyed.

5. A little worried, feel constrained, a little alarmed.

6. Nothing bothers me much. I feel more or less at ease.

7. Generally confident and free from anxiety.

8. The feeling of complete well-being. Confident and feel at ease.

9. Extremely cold-blooded, extremely confident and not worried.

10. Perfect calm. Unshakably self-confident.

2 set of judgments

1. Absolutely exhausted. Not capable of even the smallest effort.

2. Terribly tired. Almost exhausted and practically incapable of action. Almost no energy left.

3. Great fatigue. Sluggish. Scanty energy resources.

4. Pretty tired. There is not much energy in stock.

5. Slightly tired. Laziness. There is not enough energy.

6. I feel pretty fresh, moderately awake.

7. I feel fresh, in stock significant energy.

8. A lot of energy, a strong need for action.

9. Overflowing vitality, tremendous energy, a strong desire for action.

10. An impulse that knows no barriers. Life force spills over the edge.

3 set of judgments

1. Extreme depression and despondency. Depressed. Everything is black and gray.

2. Very depressed. I feel just awful.

3. Oppressed and feel very depressed. The mood is definitely dull.

4. The mood is depressed and somewhat dull.

5. I feel a little depressed, "so-so."

6. I feel pretty good, "fine."

7. I feel very well. Cheerful.

8. Excited, in good mood.

9. Excited, in high condition. Enthusiasm.

10. Strong lift, enthusiastic fun.

4 set of judgments

1. A pressing feeling of weakness and futility of effort. I can’t do anything.

2. I feel miserable and miserable. Tired of my incompetence.

3. Depressed by his weakness and lack of ability.

4. I feel rather incapable.

5. I feel that my skills and abilities are somewhat limited.

6. I feel pretty competent.

7. I feel that my abilities are enough and my prospects are good.

8. Very confident in their abilities.

9. I feel a lot of self-confidence. Confident of his future accomplishments.

10. For me, nothing is impossible. I can do whatever I want.

The first section contains statements that reflect the state of the subject on the scale of “Calmness - anxiety”, the second - on the scale of “Energy - fatigue”, the third - on the scale of “Elevation - depression” and the fourth - on the scale of “Feeling self-confidence - a feeling of helplessness”. The sequence number of the statement in each section reflects the severity of the described condition. The subject is asked to choose from the proposed sets of judgments the one that best describes his condition at the time of the examination. The sum of the numbers of judgments selected for each of the sections is an integral indicator of the emotional state of the subject. This indicator reflects the severity, degree of emotional uplift / exhaustion of the subject.

The disadvantages of the above methods include the following:

1) The statements included in sections 1-3 describe the emotional state of a person only in the range of concepts “anxiety / calmness” and “rise / depression”, not reflecting the severity of other emotions, such as anger, resentment, disappointment, pride and other

2) The statements that make up Section 4 characterize mainly the cognitive sphere (a person's beliefs regarding his capabilities), and not the sphere of emotions.

3) The difference in the system of evaluating statements that make up four different sections of the methodology draws attention. Thus, an increase in the ratings assigned to the statements of Section 1 reflects an increase in the degree of mental adaptation of the subject, while the highest rating in this section indicates the highest level of mental adaptation. However, in sections 2 and 3, the highest values are assigned to such statements (“An impulse that does not know obstacles, life force spills over the edge” and “Strong rise, enthusiastic fun”), which reflect not so much a state of mental adaptation as a pathological hypomanic state. In this regard, the general scale obtained by summing the estimates for all four sections seems non-linear: while low values of the integral indicator indicate a pronounced mental maladaptation, high values of the integral indicator cannot be interpreted so unambiguously. In other words, the integral indicator of this technique is more sensitive to the state of mental maladaptation than to the state of adaptation.

The objective of the invention is the expansion of the diagnostic capabilities of the method by providing the ability to determine both the degree of mental maladaptation and the nature of the emotions experienced by a person, reflecting the intrapersonal causes of emotional stress. Also, the task is to ensure the possibility of dynamic monitoring of the emotional state of a person over relatively short periods of time calculated in hours or days.

The task is achieved by the fact that a person is presented with four groups of adjectives, reflecting various degrees of satisfaction of the following four basic personal needs: in safety; regardless; in achievement; in unity (proximity); to study each basic personality need, a circular scale is used, divided into four equal quadrants by two straight lines intersecting at its center at two degrees perpendicular and located at an angle of 45 ° to the horizontal, with three adjectives at each intersection point of these straight lines with a circle of a circular scale. reflecting a certain degree of satisfaction of the investigated basic personality needs; when the patient selects the words corresponding to his condition at a given time, a mark is made on the dial either at the point where the group of words is located, or when two different groups of words are selected - on a circle or a segment between two different groups of words; depending on the location of this mark, determine the number of points scored by a person for each of the four basic personal needs; then determine the average score for all four basic personality needs, and judging by this average score, the degree of emotional maladaptation is judged as follows:

0 points - lack of emotional maladaptation (physiological relaxation),

1 point - mild emotional maladaptation (physiological stress),

2 - moderate emotional maladaptation (pathological stress),

3 - pronounced emotional maladaptation (pathological relaxation).

To assess the degree of satisfaction of the basic personal security needs in a circular scale, use the following system of adjectives and points:

“Calm, peaceful, serene” - 0 points;

“Guarded, worried, excited” - 1 point;

“Alarmed, frightened, frightened” - 2 points;

“Tormented, tormented, desperate” - 3 points.

To assess the degree of satisfaction of the basic personal need for independence in a circular scale, use the following system of adjectives and points:

“Lite, liberated, liberated” - 0 points;

“Heated, indignant, angry” - 1 point;

“Preoccupied, overloaded, overstrained” - 2 points;

“Depressed, oppressed, shackled” - 3 points.

To assess the degree of satisfaction of the basic personal need for achievement in a circular scale, use the following system of adjectives and points:

“Pleased, joyful, proud” - 0 points;

“Tuned, inspired, inspired” - 1 point;

“Overexcited, frenzied, inflated” - 2 points;

"Exhausted, devastated, indifferent" - 3 points.

To assess the degree of satisfaction of the basic personal need for unity (closeness) in a circular scale, use the following system of adjectives and points:

“Delighted, pleased, prosperous” - 0 points;

“Interested, enthusiastic, admired” - 1 point;

“Upset, wounded, disappointed” - 2 points;

“Abandoned, lonely, yearning” - 3 points.

The determination of the points scored by a person when choosing different groups of words is carried out as follows: if the mark is located on the border between the quadrants, the highest of two values is assigned to it; if the mark is located in the very center of the circle, it is excluded from the analysis of the results.

Figures 1-4 show dials for four basic personality needs. Figure 1 shows a dial for a personal need for security, Figure 2 - for a personal need for independence, Figure 3 - for a personal need for achievement, and Figure 4 - dial for a personal need for unity (proximity) . Figure 5 shows the marks made on the above four scales by the patient during her examination using the proposed method (see clinical example).

The proposed method is as follows: the subject is presented with four patterns, each of which shows a circle divided into four equal parts by two mutually perpendicular intersecting in its center and straight lines at an angle of 45 degrees to the horizontal, and four groups of words located outside the circle next to the points of intersection of its indicated segments (see Figure 1-4).

The test subject is asked to select one or two groups of words in the first figure that are most suitable for describing his condition at the present time, and if one group of words is enough to describe his condition, put a cross right on its pointer. If the subject chose two groups of words, he is asked to put a cross between them on a circle line or on a straight line, placing the cross closer to the group of words that describes his condition better than the other. Then they also ask to put a cross on the second, third and fourth figures.

When a mark is found in the lower right quadrant of the circle, it is assigned a value of zero points, in the region of the upper right quadrant - 1 point, in the region of the upper left quadrant - 2 points and in the region of the lower left quadrant - 3 points. If the mark is located on the border between the quadrants, the highest of the two values is assigned to it. When the mark is located in the very center of the circle, it is excluded from the analysis of the results.

A quantitative assessment of the results consists in determining the arithmetic mean of all scores e, taken as an integral indicator of the degree of emotional maladaptation (PSED) of the subject. The value of PSED, obtained by rounding it to integers, equal to 0 points, indicates the absence of signs of emotional maladaptation, equal to 1 point - about slight emotional maladaptation, equal to 2 points - about moderate emotional maladaptation, equal to 3 points - about pronounced emotional maladaptation.

A qualitative assessment is based on the verbal choice of the subject himself and includes the corresponding verbal characterization of the emotions experienced by him, reflecting the degree of satisfaction of such four basic personal needs as the need for security; independence; achievement and unity (closeness).

This method is aimed at assessing both the quality (nature) of emotions and their strength (degree of emotional stress).

Its theoretical basis in many respects was the provision of the information-information theory of emotions (Simonov P.V., 1987; Sudakov K.V., 1998), according to which the quality and strength (tension) of emotions are determined by the actualized human need and predicting the probability of its satisfaction. In other words, the quantitative and qualitative characteristics of emotions experienced by a person are determined by the likelihood of achieving the desired result of interaction with a positively or negatively evaluated object. This probability, in turn, is interconnected with the dynamics of the spatial characteristics of this interaction (for example, the probability of the desired connection with a positively evaluated object is much higher when the subject approaches the object than when moving away from it). This provision is consistent with the model of cybernetic control of actions, according to which human emotions depend on the characteristics of the subject's movement towards his intended goal (Carver C.S., Scheier M.F., 1990). This position also corresponds to the cognitive-motivational theory of emotions and the transactional stress model of R. Lazarus, according to which emotions arise in the course of personal-environmental interaction, including the subjective perception of an external signal, an assessment of its significance, a response, mental and behavioral response and the achievement of a certain final result of the interaction ( Lazarus RS, 1991; Van Egeren LF, 2000). The emergence of emotions is primarily associated with an unconscious and conscious assessment of the significance of the signal, mediating the transition from its sensory perception to the motor response, aimed at eliminating or approximating the source of this signal (Rolls ET, 1996).

Thus, the strength and nature of emotions are closely related to the spatial characteristics of the real or imaginary interaction of the subject with a significant (positive / negatively assessed by him) object. M. Arnold also drew attention to this regularity, which in 1960 in its classification of emotions of “struggle” took into account the subject’s tendencies to action in drawing closer to or disconnecting from a “useful” or “harmful” object (cited from: Breslav G., 2004 )

The achievement of a comfortable state of the subject is facilitated by the elimination of the negatively evaluated or the acquisition of a positively evaluated object. Possible options for disengaging from the object are its removal, destruction, bestowal, loss, etc. The actions aimed at rapprochement with the object include retention, absorption, receiving, finding, achieving, etc.

Various actualized human needs can be conditionally correlated with various spatially dynamic characteristics of the subject-object interaction (for example, the need for independence - with the removal of a negatively evaluated object, the need for achievement - with approaching a positively evaluated goal, etc.).

1. In view of the foregoing, to describe the nature of emotions experienced by a person, we very widely used verbal adjectives (denoting an object’s attribute by its (non) exposure to action or (in) ability to perform an action), including those that reflect the direction of the action. Adjectives were combined into separate groups that describe emotions that arise when satisfying / dissatisfying such four basic needs of a person as the need for security, independence, achievement and unity (closeness, attention to oneself).

So, for example, interaction aimed at satisfying the subject’s need for unity (love, closeness) and attracting a positively evaluated object to himself may be accompanied by a wide variety of emotions, depending on the degree of satisfaction of this need and the spatially dynamic characteristics of the subject-object interaction. These emotions can be conveyed with words such as “pleasure”, “pleasure” (upon successful completion of the action), or as “enthusiasm”, “admiration” (in the process of action, when predicting its successful completion), or as “vulnerability”, “disappointment” "(In the process of action when predicting its failure), or as" abandonment "," loneliness "(with the unsuccessful completion of the action).

The method intentionally does not include the diagnosis of "social" emotions (such as shame, guilt, embarrassment, empathy, gratitude, envy, jealousy). Their identification (awareness), as a rule, is painful for a person and poses a threat to his usual self-image (Breslav G., 2004), which often leads to insincerity in answers to questions concerning these emotions.

To indicate the nature of emotional states, we did not use abstract (abstract) nouns based on the ideas of the cognitive-evolutionary model of awareness of emotional experience Lane R.D. et al. (1990) and data on a significant incidence of alexithymia in patients with diseases of the nervous system.

So, according to the cognitive-evolutionary model of awareness of emotional experience, a person’s ability to verbally represent his and others’s emotional experience (awareness of emotions) is a cognitive process and undergoes certain evolutionary and ontogenetic stages of development. Five different levels of awareness of emotions correspond to these stages, each of which may prevail in a particular person.

So, the level “0” includes the use of words denoting not feelings, but human thoughts. Level “1” is determined using words that reflect the awareness of physiological signals (“I feel tired”). Level “2” includes the use of words used in other contexts, but also used to express relatively undifferentiated emotions (“I feel bad”) or the use of the word “feel” to convey sensations from the action (“I feel like breaking through a wall "). Level “3” is characterized by the use of one abstract noun denoting a particular emotion (sadness, anger, disgust, fear, surprise, joy, etc.). Level “4” is characterized by the use of two or more words of the third level, providing a more accurate differentiation of emotions.

It has been established that a significant proportion of patients with pathology of the nervous system show signs of alexithymia and a predominance of 1-2 levels of awareness of emotions (Lane R. et al., 2000; Bydlowski S. et al., 2002). In this regard, when testing such patients, we abandoned the use of abstract nouns (such as joy, happiness, grief, love, etc.), and anonymous adjectives.

2. The theoretical basis for assessing the severity of emotions was the provision according to which emotional stress can arise on the basis of actualization of the most varied needs of a person, and emotions of the same intensity can qualitatively vary (Sidorova OA, 2001). In other words, when realizing the most diverse needs, one can single out the same degree of satisfaction / dissatisfaction and emotional stress. Similarly, in the process of subject-object interactions of the most diverse orientations, the development of the same levels of psychophysiological adaptation / maladaptation is possible.

In identifying the levels of emotional stress, we proceeded from the assumption that the patterns of emotional response in a person’s interaction with the outside world or himself can be correlated with the patterns of the formation of physiological reactions that arise in the process of organismic-environmental interaction. Organizational-environmental interaction, in turn, can be represented as consisting of two phases - the stress phase and the relaxation phase. The phase of tension is energy-intensive catabolic reactions that occur in response to stimulating stimuli. They are accompanied by the mobilization of internal resources, the growth of psychophysiological stress and an active change in the relationship of the organism with its environment. The relaxation phase is comprised of anabolic reactions induced by relaxing signals coming from an altered environment. These reactions are accompanied by psychophysiological relaxation, the assimilation of external energy and the restoration of homeostasis. The change of response phases occurs gradually, with a decrease in the stimulating and soothing effects of environmental influences.

We have identified two types of organism-environment interactions, the first of which (self-healing interactions) is characterized by a harmonious combination of phases of physiological (productive) stress and physiological (productive) relaxation, leading to the restoration of homeostasis. At the psychological level, the second phase of such interaction corresponds to a state of human satisfaction of their biopsychosocial needs and the achievement of an emotionally comfortable state.

The second type of organism-environment interaction (auto-exhausting interactions) is characterized by a combination of phases of pathological (destructive) stress and pathological (destructive) relaxation. The second phase of such interaction at the psychological level corresponds to a state of emotional overstrain, fatigue and “burnout”.

The listed states of physiological (productive) relaxation, physiological (productive) stress, pathological (destructive) stress and pathological (destructive) relaxation at the psychological level correspond to different degrees of emotional maladaptation.

These ideas are largely consistent with the views of T.A. Pearl (1983), who distinguished four degrees (stages) of neuropsychic stress: weak (normal indicators of psychomotor activity and central hemodynamics), moderate (activation of mental activity with an increase in its productivity), excessive (accompanied by disorganization of psychomotor activity and central hemodynamics) and pathological (pathological condition, accompanied by the development of psychosomatic diseases) stress. These degrees of emotional stress also correspond to different levels of psychophysiological maladaptation, highlighted by domestic physiologists (Kositsky G.I., 1977) and clinicians (Aleksandrovsky Yu.A., 2000). In our work, we prefer to use the term “emotional maladaptation” rather than “emotional stress” to avoid terminological differences with other authors, since we correlate the extreme degree of psychophysiological maladaptation with “pathological relaxation” and not with “pathological stress” (from our point of view vision, an increase in the level of maladaptation corresponds to an increase in mental stress only to a certain extent, while at the last stage the psychophysiological stress drops).

These psychophysiological conditions most often do not have clear distinctions between themselves. It is more justified to speak only about the predominance of one or another emotion or the correlation of probabilities (chance) of experiencing one, and not another, emotion. So, for example, as the subject successfully implements the actions directed by him to achieve the desired result, the replacement of external stimulating influences (“repulsive-exciting” or “attracting-exciting”) with comfortable, relaxing environmental influences gradually arises, which leads to the transition of the body from state of tension in a state of relaxation and emotional comfort. Regardless of whether a successful completion of self-healing interaction is described as disconnection with a negatively evaluated object or as approaching a positively evaluated object, it manifests itself in a gradual transition from a state of productive stress to a comfortable psychophysiological state of productive relaxation. At the psychological level, the completion of such an interaction corresponds to the satisfaction of the biopsychosocial needs of the individual through the implementation of specific behavioral programs. And, on the contrary, unsuccessful, self-depleting organism-environment interaction, described as approaching to a negatively evaluated object or disconnection from a positively evaluated object, manifests itself in a gradual change of the phase of destructive stress with the phase of destructive relaxation. At the psychological level, such an interaction corresponds to a state of violation of the biopsychosocial needs of the individual.

The idea of the absence of clear distinctions between emotions that correspond to states of productive and destructive stress, productive and destructive relaxation served as the basis for choosing a circular shape of the scale. Its vertical axis can be denoted by the physiological terms “relaxation - stress” of the subject, and the horizontal axis by the terms “inefficiency-effectiveness” of the subject-object interaction.

Images of these axes are absent in the figures presented to the test subject, however, when evaluating the test results, they are reproduced.

Axes such as “pleasure-displeasure”, “calming-excitement”, “tension-resolution” were previously used by various authors in schematic models of emotions. These axes were present in the three-component model of W. Wundt’s sense system, which he created at the beginning of the 20th century, and two perpendicular axes of “pleasure-displeasure” and “acceptance-repulsion” formed the basis of the circular model of emotions proposed by Woodworth and Schlosberg in 1954 (cit by: Y. Reykovsky, 1979; Shadrikov V.D., 2002). However, these models did not find their application in clinical practice and were not included in the methods for diagnosing a person’s emotional state. In addition, these models did not take into account the characteristics of emotional states, determined by the degree of effectiveness / inefficiency of the subject-object interaction.

The circular scale we have proposed is intended both for quantitative measurement of the degree of emotional maladaptation, and for a qualitative assessment of the nature of emotions experienced by a person in the context of satisfying / dissatisfying such four basic human needs as the need for security, independence, achievement and self-realization; in attention and self-love.

In determining the degree of emotional maladaptation, we took the state of productive relaxation (emotional comfort) as the zero point of reference, while the transition to a state of productive stress, destructive stress, and destructive relaxation was correlated by us with an increase in the severity of mental maladaptation by one, two, or three levels, respectively.

Assessment of the conceptual validity of the proposed method was carried out by studying the correspondence of its results to the data obtained using other methods of diagnosing the degree of mental maladaptation. Along with this, a comparative analysis of the results of applying the proposed method in healthy individuals and patients with tension headaches, which are characterized by an increased level of emotional stress (D.A. Wittrock and T.C. Myers, 1998; Verma S., Gallagher R.M., 2000).

Checking the questionnaire for reliability (reproducibility of the results of the study) was not provided due to the high variability of the measured property itself.

The study involved 74 healthy individuals, 33 men and 41 women aged 22 to 51 years (mean age 33.7, standard deviation [Std.] 11.0 years) and 66 patients with tension headaches (GBN), 11 men and 55 women (mean age 41.6, standard deviation 13.1 years). The general criteria for inclusion in the study were the age from 18 to 59 years, voluntary consent to testing and the absence of gross intellectual and mnestic disorders that made it difficult to understand the questions used with the methods.

The nature of the cephalgic syndrome was established in accordance with the International Classification and diagnostic criteria for headache disorders, cranial neuralgias and facial pain // Cephalalgia. An International Journal of Headache. - 1988. - Vol.8., Suppl.7 . - P.9-96).

In 23 patients (mean age 27.3, st. Off. 8.0 years), primary GBN was developed, which developed as part of the psycho-vegetative syndrome (PVA). Headaches in these patients were one of the manifestations of polysystemic suprasegmental autonomic disorders that occurred in response to chronic psychophysiological stress and / or physiological hormonal changes in the pubertal period.

In 43 patients (mean age 49.3 years, st. Off. 7.7 years), a combination of tension headaches with vascular headaches developed against the background of hypertensive and atherosclerotic discirculatory encephalopathy (DE) stage 1 was diagnosed. Chronic GBN (the number of days with cephalalgia more than 15 per month or more than 180 per year) was observed in 43 people from all examined patients, episodic GBN - in 23 people.

Along with a clinical and neurological examination to all healthy and sick people, after explaining the purpose of the study and obtaining consent, psychological testing was carried out. It included the use of the claimed method for diagnosing an emotional state. Hospital Anxiety and Depression Scale (GSTD) and Fatigue Scale (SH) (Krupp L. B. et al., 1989). The fatigue scale consists of 9 statements, at the end of each of which the test subject is invited to choose one of seven numbers indicating the degree of agreement with this statement. The scale indicator is calculated as the sum of the numbers obtained for all statements, while higher values indicate a higher degree of chronic fatigue of the subject. Along with this, the emotional state of 22 healthy individuals and all patients was evaluated using the method of "Self-assessment of emotional states" (SES) A. Wessman and D. Ricks, adopted as a prototype of the proposed method.

In the mathematical processing of data, non-parametric methods of statistical analysis were used. The relationship of variables was studied by calculating the Spearman correlation coefficient. Comparison of the samples was carried out using the U Mann-Whitney test for unrelated groups.

Thus, a high degree of correlation was found between PSED and indicators of valid and reliable scales that are widely used in clinical practice to diagnose the severity of anxiety and depression.

Due to the fact that anxiety and depression are recognized as clinical correlates of the level of mental maladaptation, the obtained results support the conceptual validity of the claimed method, the application rate of which allows to diagnose the degree of emotional maladaptation. As might be expected, the correlation of PSED with the GSTD and the Fatigue Scale has a positive sign, since an increase in the values of the indicators of these scales serves as an indicator of an increase in the level of emotional maladaptation. The negative sign of the correlation coefficient of PSED with the indicator of the method “Self-assessment of emotional states” by A. Wessman and D. Ricks is explained by the fact that an increase in the latter corresponds to an increase in the level of emotional adaptation of the subject.

The existence of significant differences in PSED in patients with HDN and healthy individuals also confirms the validity of the claimed method for diagnosing the degree of emotional maladaptation.

Compared with the prototype, the claimed method has the advantage that it not only allows you to quantify the degree of emotional maladaptation of the subject, but also gives him the opportunity to realize the nature of the emotions he experiences, reflecting the degree of satisfaction of his basic biopsychosocial needs. Due to the fact that awareness of the emotions experienced by a person increases his ability for mental self-regulation, this method can be used for psychotherapeutic purposes in teaching patients self-control and self-regulation of their mental state.

Clinical example

B-va L.A., 51, a resident of the village, a pensioner, a disabled person of 3 groups.

Upon admission to the neurological department complained of daily headaches of a pressing nature in the frontal temporal and occipital areas, aggravated after mental and physical overload, lasting for 2-3 hours a day; noise and ringing in the ears; difficulty falling asleep; constant feeling of tiredness.

Headaches appeared for the first time at the age of 18 after suffering a mild traumatic brain injury (concussion). Repeatedly examined and treated by neurologists with a diagnosis of Autonomic Dystonia, without a significant effect. 10 years ago, she began to notice fluctuations in blood pressure, periodically increasing to 180/100 mm Hg. The therapist was diagnosed with Hypertension, for which he systematically takes antihypertensive drugs. During treatment, blood pressure figures returned to normal, but headaches persisted. Recently, tinnitus, a feeling of constant fatigue, sleep disturbance have joined them.

Concomitant diseases: - uterine adenomyosis, surgery to remove the uterus with appendages 2 years ago.

On examination: blood pressure 130/80 mm Hg, pulse 76 beats / min. Obesity of 1 degree.

In neurological status, there are microsymptoms of damage to the nervous system in the form of weakening convergence, uniform revitalization of tendon reflexes, mild instability in the Romberg position.

The results of laboratory tests did not reveal any deviations from the norm.

According to the ultrasound data of extra- and intracranial vessels, a decrease in elasticity, an increase in the tone of small vessels, a small spasm in the anterior carotid pool, and initial changes in the left internal carotid artery were found. The results of computed tomography of the brain - without pathology.

Anamnesis of life.

Born into a complete family, has two older brothers. Mother left her father for another man when L.A. was 9 years old. The children remained to live in the house with their father and grandmother, and went to their mother to visit another village. For many years L.A. She was very offended by her mother, and later forgave her, realizing "what a father is of a difficult nature."

She graduated from high school and college, began to work as an estimate engineer. She married a worker at the age of 19, and went with him to Vorkuta, where both had good work and earnings. However, due to the poor tolerance of climatic conditions, L.A. returned to the Nizhny Novgorod region, where for the past 13 years she has been living with her husband in his native village.

Has no children (was treated for infertility, without effect). There are no close friends - all the former remained in Vorkuta, and did not make new ones upon returning to the Nizhny Novgorod region.

Two years ago, she underwent a serious gynecological operation, after which she did not return to work, she retired. He devotes all his attention and strength to housework and caring for his father, who has been suffering from ankylosing spondylitis since his youth, and who recently need constant care. L.A. She admits that she doesn’t really like her father, but she brought him to her house and conscientiously cares for him, considering it her duty and partly focusing on the opinion of the villagers about her. The house is in perfect cleanliness. In addition, she travels 15 km to a neighboring village two to three times a week to her husband’s lonely and needy care father.

Relations of L.A. with her husband have worsened in recent years. According to L.A., her husband does not value her much and reproaches her for being too strict with her father, from whom she requires strict adherence to all hygiene rules.

Against the background of domestic overloads, recently I began to notice a constant decline in strength, the rush of which I felt only briefly one year ago, when I went to my friends of youth in Vorkuta.

During psychodiagnostic testing, the levels of anxiety and depression on the Hospital Anxiety and Depression Scale were elevated, amounting to 13 and 15 points, respectively.

The total indicator on the scale of “Self-assessment of Emotional States” by A. Wessman and D. Ricks was 13 points: I chose the following judgments to describe my condition: “I’m somewhat worried, I feel constrained, a little alarmed”; "Great fatigue, sluggish, meager energy resources"; “The mood is depressed and somewhat dull”; “A pressing feeling of weakness and futility of effort. I can’t do anything. ”

When conducting research on the proposed method (Figure 5), the patient in the first figure put a mark on the circle in her upper right quadrant, next to the group of words "alert, worried, worried."

In the second figure, she placed a mark in the upper left quadrant of the circle on her segment between such groups of words as “heated, indignant, angry” and “preoccupied, overloaded, overstrained”, bringing it closer to the second of the listed groups. The mark in the third figure was in the lower left quadrant of the circle directly in the area of the pointer of the group of words "emaciated, emptied, indifferent."

In the fourth figure, the patient put a mark on the circle in the region of her upper left quadrant in the area of the pointer of the group of words “frustrated, wounded, disappointed” (Figure 5).

Accordingly, the estimates for the first and fourth subscales of the declared "Method for diagnosing the degree of emotional maladaptation" amounted to "1", "2", "3" and "2" points.

The average score was 2.0 points, indicating a moderate psychophysiological maladaptation (state of pathological mental stress).

The application of the claimed method helped the patient to recognize the nature of the emotions experienced by her at the time of the examination and reflecting the degree of violation of her leading personal needs. This, in turn, attracted her attention to those situations that most often caused the corresponding emotions, and also allowed to start a discussion of the personal causes of her everyday stress.

Thus, the results of the examination indicated that when examining the spectrum of emotions characteristic of various degrees of satisfaction / dissatisfaction with the need for security, the patient at the time of the examination indicated feelings of alertness, concern, and excitement. Such feelings, according to the patient, prevailed in her throughout the last time and were associated largely with her illness and lack of treatment effect. These feelings indicated a minor violation of security needs.

From the whole spectrum of emotions arising in the framework of satisfying / dissatisfying the need for independence, the patient noted the predominance of feelings at the time of the examination, bordering between indignation and anger, on the one hand, and concern, depression, on the other (closer to the last). As it turned out, these emotions have prevailed in the patient all the past months. This indicated a mild violation of the need for independence. During the conversation, the patient noted that she was indignant and constantly irritated with her father and husband. He connects such feelings towards a sick father with the fact that his father has recently become extremely untidy (often washing his hands in the toilet, saying that he is “more comfortable”, urinating in his pants, lying in dirty clothes in bed, etc. .). This is the behavior of father L.A. explains it with a "bad character." She often makes comments to him, which, in turn, outrages her husband and gives him a reason to accuse L.A. of disrespectful attitude to his father. He is irritated in relation to her husband due to the fact that he helps her a little and, in addition, brings his reproaches. At the same time L.A. almost constantly experiences a feeling of congestion and concern, associated, in her opinion, with many daily duties that she is forced to perform due to circumstances.

Among the listed emotions, reflecting a varying degree of violation of the need for achievement and self-realization, the patient noted a feeling of exhaustion, emptying and indifference, which indicated a pronounced violation of this need. L.A. She said that her almost exhausted feeling of exhaustion is largely connected with her constant “struggle” for order and cleanliness in the apartment and clarification of relations with her father and husband. L.A. noted that in recent times her life has been practically devoid of any pleasant everyday activities and such tasks, the solution of which could bring joy.

Discussing the fourth subscale of the proposed method, L.A. She noted that lately she especially often feels offended, wounded, upset, and disappointed. Such emotions testified to a moderately expressed violation of the need for intimacy, love and unity with the outside world. The patient said that she feels disappointment and resentment towards her father and husband, who, in her opinion, value her care and constant care for them a little. He cannot forgive his father, who a few months ago expressed his desire to go to a nursing home, where, as he put it, "he will not be so bored." There is also an insult to fate as a whole when it thinks about its childlessness. This feeling worsened after retirement.

The patient’s awareness of the nature of the main emotions experienced by her, which serve as indicators of the degree of violation of the leading biopsychosocial needs of the person, and those situations in which these needs are most often violated, made it possible to identify the most significant problems for the patient, in the solution of which she needed psychotherapeutic help.

In the process of working out some of the situational problems most worrying the patient, the patient came to the realization that not only external factors, but also the features of her own perception, thinking and behavior play a role in the origin of her stress. In particular, one of such personal reasons for her everyday stress was a pronounced conflict between the patient’s need for independence from others and the need to receive attention and love from them. So, for example, L.A. at the same time she tightly controlled her father’s behavior, not noticing changes in his mental sphere and ignoring his real capabilities, and at the same time constantly expecting gratitude from him. Other personal reasons for everyday stress in the patient could include excessive fixation of attention on negative aspects of life, excessive rigidity of attitudes and strict adherence to certain behavioral stereotypes without taking into account the peculiarities of the situation.

The inclusion of psychotherapy in the complex course of treatment of the patient allowed to expand the range of her cognitive and behavioral reactions in stressful situations and reduce the level of her emotional maladaptation, which was accompanied by a decrease in cephalgic syndrome and an improvement in the patient's general well-being.

Claims (1)

A method of assessing a person’s emotional state, including presenting to a patient four groups of verbal characteristics that reflect different emotional states and their severity, analyzing a person’s verbal characteristics that reflect his condition using a score scale, characterized in that four groups of adjectives are presented to a person, reflecting different degrees of satisfaction of the following four basic personal needs: in safety, in independence, in achievement, in unity-close ty; to assess the degree of satisfaction of the basic personal need for security, the following system of adjectives and points is used: “calmed, peaceful, serene” - 0 points; “Guarded, worried, excited” - 1 point; “Alarmed, frightened, frightened” - 2 points; “Tormented, tormented, desperate” - 3 points; to assess the degree of satisfaction of the basic personal need for independence, the following system of adjectives and points is used: “facilitated, liberated, liberated” - 0 points; “Heated, indignant, angry” - 1 point; “Preoccupied, overloaded, overstrained” - 2 points; “Depressed, oppressed, shackled” - 3 points; to assess the degree of satisfaction of the basic personal need for achievement, use the following system of adjectives and points: “satisfied, joyful, proud” - 0 points; “Tuned, inspired, inspired” - 1 point; “Overexcited, frenzied, inflated” - 2 points; "Exhausted, devastated, indifferent" - 3 points; to assess the degree of satisfaction of the basic personal need for unity, use the following system of adjectives and points: “delighted, pleased, prosperous” - 0 points; “Interested, enthusiastic, admired” - 1 point; “Upset, wounded, disappointed” - 2 points; “Abandoned, lonely, yearning” - 3 points; to study each basic personality need, a circular scale is used, divided into four equal quadrants by two straight lines intersecting at its center at two degrees perpendicular and located at an angle of 45 ° to the horizontal, with three adjectives at each intersection point of these straight lines with a circle of a circular scale. reflecting a certain degree of satisfaction of the investigated basic personality needs; when the patient selects the words corresponding to his condition, they mark on the dial either at the point where the group of words is located, or when two different groups of words are selected - on a circle or a segment between two different groups of words; depending on the location of this mark, determine the number of points scored by a person for each of the four basic personal needs; in this case, if the mark is located on the border between the quadrants, the highest of the two values is assigned to it; if the mark is located in the very center of the circle, it is excluded from the analysis of the results, then the average score for all four basic personal needs is determined and the average grade is judged on the degree of emotional maladaptation as follows: 0 points - lack of emotional maladaptation, physiological relaxation; 1 point - mild emotional maladaptation, physiological stress; 2 - moderate emotional maladaptation, pathological stress; 3 - pronounced emotional maladaptation, pathological relaxation.

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