RU2681929C1 - Method of correction of self-regulation and psychoemotional state of extreme profile experts in conditions of stress load modeling - Google Patents

Abstract

FIELD: medicine.SUBSTANCE: invention relates to medicine and namely to the psycho-physiological correction of the functional state, and can be used to correct the psychological state of extreme profile employees, to prevent the somatic effects of stress reactions. It can be used at all stages of the professional tasks execution in all types of law enforcement agencies, including special forces. Perhaps in relation to the commanding staff of all types of armed forces and security forces. Correction of self-regulation and psychoemotional state is carried out by correcting the vegetative balance with the help of neurofeedback. Use vegetative balance indicators as controlled and simulate stress in the correction process. Method is carried out in sequential steps. At first, a baseline ECG is recorded with the definition of LF, HF and LF/HF index at stage 1. Against the background of relaxing music, a person trains a change in his psychoemotional state, focusing on objective changes in his functional state, namely, HF and LF vegetative balance indicators displayed on graphs on the screen in front of him and recorded from it in real time using ECG electrodes. When a person achieves an ability, taking into account the neurofeedback data, to arbitrarily control his functional state within the range of LF/HF values from 1.5 to 2.5 proceed to the second stage, in which the actions performed by the person in the first stage are added to the stress load in the form of pain electrostimulation or exposure to harsh, negatively perceived sounds. Arbitrary training is continued until a person achieves the ability, taking into account neurofeedback data, to arbitrarily control his functional state within the range of LF/HF values from 1.5 to 2.5. Sounds can be a woman's or children's cry or weeping, or the sound of breaking glass, falling things.EFFECT: method provides for the correction of the state of neuropsychic maladjustment among specialists of an extreme profile, including under conditions of increased stress load, taking into account the individual type of the vegetative nervous system, including the correction of the states of psychoemotional maladjustment among employees with an expressed predominance of the parasympathetic nervous system, as well as the correction of their stress reactions.3 cl, 2 ex

Description

The technical field of the invention:

The invention relates to medicine, namely to psychophysiological correction of a functional state, and can be used for medical and psychological correction of the psychological state of employees of extreme profile, as well as the prevention of somatic consequences of stress reactions. It can be used at all stages of performing professional tasks in all types of law enforcement agencies, including special forces. Perhaps in relation to the command staff of all types of armed forces and power formations.

The prior art of the invention:

It is known to use the biofeedback technique (BFB) to correct the functional state of specialists in dangerous professions. The biofeedback technique (otherwise called the adaptive or functional biocontrol technique, biorehabilitation, visceral training, operant conditioning method, etc.) is a set of procedures during which information is transmitted to a person through special technical devices (external feedback circuit) about the status of a particular function his own body. Based on the information received, a person, under the guidance of an instructor, using special techniques and equipment develops self-control and self-regulation skills, i.e. the ability to arbitrarily change the physiological function to correct one's own state.

A known method of correcting a functional state using the biofeedback method of Khankevich Yu.R. (10), which involves training submariners in the arbitrary control of heart rate (HR) using the appropriate protocol. The result of the application of this method is the normalization of the functional system of the cardiovascular activity of employees of extreme profile in the conditions of intense professional activity. The disadvantage of this method is the use of the same protocol of the method, regardless of the structure of functional disorders of the training participant.

A known method for the correction of neuropsychic maladaptation in EMERCOM employees using the biofeedback technique with audiovisual stimulation Kulakova DV (6). The method has shown high efficiency. The lack of information about the monitored parameters does not allow the use of this correction method, which is its drawback.

There is a known method for correcting the functional state of employees of the Police Department using the biofeedback method described by Weltman G (12), which involves the use of heart rate as a controlled parameter. The result of this method is the correction of heart rate variability, and, as a result, the normalization of the functional state of the police department. The disadvantage of this method is the use as a controlled parameter - an indirect parameter of heart rate variability, as well as the same correction protocol to different groups of maladaptive employees of an extreme profile.

The closest analogue to the proposed invention by its technical nature and the achieved result is non-pharmacological restorative correction of autonomic dysfunctions in persons of dangerous professions using the biological feedback method described by V. Matveeva (7). Common essential features are the use of biofeedback for correction, as well as the selectivity of applying various biofeedback protocols to various variants of autonomic disorders identified at the stage of preliminary diagnostics. High efficiency was shown in correcting the functional state of a group with excessive activation of the sympathetic nervous system. The disadvantages of the method is that this method is not intended for the correction of maladaptive individuals with an excess tone of the parasympathetic nervous system, characterized by an increase in the spectrum power in the fast frequency range (HF component), and also that indirect indicators of the vegetative balance are used as controlled parameters: peripheral temperature, heart rate, muscle tension.

The technical problem to be solved by the claimed invention is aimed at the need to create a method for the correction of the psychoemotional state of extreme specialists, taking into account the individual type of the autonomic nervous system, including the correction of the states of psychoemotional maladaptation in employees with a pronounced predominance of the parasympathetic nervous system, as well as the correction of their stressful reactions.

Disclosure of the invention:

This technical problem was solved by the developed method, which consists in conducting a course of individual training sessions using biological feedback in order to correct violations of self-regulation and psycho-emotional state, as well as increase stress resistance among employees of power structures, including under conditions of stress modeling. As controlled parameters, high- and low-frequency components of the electrocardiogram in absolute units of measurement (HF, LF) are used.

The developed method consists of two stages of training.

The first stage of the training includes several procedures aimed at creating a self-control skill without stress, and the second includes procedures aimed at consolidating the formed psycho-emotional state self-control skill under stress stimuli.

The developed method is as follows:

1) Preparatory work:

Before the start of the examination, the training participant is given time to adapt to the temperature and other conditions of the examination. Prior to registration, electrocardiogram electrodes (ECGs) and a neutral electrode are placed on the participant’s hands. The training participant must take a comfortable position in the chair, he is informed about the undesirability of physical activity during the procedure, as well as the details of the procedure. To demonstrate graphs with the values of the monitored parameters, a monitor installed opposite the training participant is used.

2) Instruction:

The instruction depends on the type of person's vegetative balance. For persons with a predominance of excess tone of the sympathetic nervous system, the instruction is aimed at reducing the absolute values of the parameter LF, as well as increasing the absolute values of the parameter HF. For a group with a predominance of excess tone of the parasympathetic nervous system, the instruction is focused on reducing the absolute values of the HF parameter, as well as increasing the absolute values of the LF parameter. The training participant is recommended to change their own state so that the values of the vegetative equilibrium index LF / HF correspond to the range from 1.5 to 2.5 (2) (for both groups). Prior to the trainings, the participants of the corrective measures are explained the significance of these indicators, their impact on subjective somatic and psychological well-being, and they also find out which conditions from the subjective experience of a person correspond to one or another change in these indicators. A high level of awareness of emotions and bodily sensations is a prognostic sign of the success of procedures using biological feedback.

3) After completion of the preparatory work and explanation of the instructions, a training procedure is started with an average duration of 20-25 minutes. The procedure consists of a “source background”, “managed periods”, as well as a “final background”.

a) The procedure begins with the period of "initial background", during which the parameters of the electrocardiogram (ECG), characteristic of the resting state, lasting 2 minutes or more, are recorded.

b) Next, spend controlled periods with instructions to arbitrarily adjust the activation power of the sympathetic and parasympathetic nervous systems, guided by the graphs of the values of LF and HF, as well as the LF / HF index. Due to the continuous recording of controlled parameters, the training participant forms the skill of arbitrary control of his own functional state, identifies that state of relaxation and sensation in the body that corresponds to the necessary changes, comparing the sensations in his own body with the change in the graphs of objective physiological parameters.

In the first stage, the control of controlled parameters with the help of graphs takes place against a background of neutral, relaxing music. The participant is introduced to the controlled parameters of the nervous system. During the first 3 procedures, a person confidently masters an arbitrary way of controlling the tone of both nervous systems. Achieving optimal values of the controlled parameters is accompanied by a subjective sensation of a decrease in anxiety, muscle relaxation, increased pain thresholds, leveling mood background. The first stage of trainings is completed after the appearance of awareness of the applied strategy of self-control of the nervous system. If necessary, an increase in the duration of the first stage is allowed.

In the second stage, the control of controlled parameters with the help of graphs occurs against the background of the application of stress load. The type of stressors is selected depending on the specifics of professional activity. If the main professional risk is psycho-emotional overload, loud sharp socially colored sounds are used (female or children's screaming or crying, the sounds of breaking glass, falling things, laughter; other unpleasant sounds are acceptable). Painful electrical stimulation can be used if a specialist is faced with a life threat or bodily harm. The second correction phase is completed with an objective change of state during the training (the value of the current controlled parameter should differ from the values of the “initial background” by at least 1 sigma (σ), as well as full awareness of the formed self-control strategy.

c) The final step is to register the "final background". A training participant rests and views neutral slides to relaxing music, ECG parameters are recorded to evaluate the automation of the created skill.

4) After the end of the procedure, the participant is instructed to use the generated skill between trainings in situations of excitement and emotional discomfort.

The average cycle time is 7-10 lessons.

The technical result achieved by the implementation of the proposed method consists in correcting the state of neuropsychic maladaptation among specialists of an extreme profile, including under conditions of increased stress, taking into account the individual type of autonomic nervous system, which includes correction of the states of psychoemotional maladaptation in employees with a pronounced predominance of parasympathetic nervous system, as well as the correction of their stress reactions.

The implementation of the invention:

A series of trainings using biofeedback (BFB) was conducted on a group of 100 people in dangerous professions. Each series of trainings consisted of an average of 7 lessons.

The purpose of the trainings was to develop the skills of voluntary control of one's own functional state, increase the level of stress resistance and the level of self-control, as well as the correction of states of neuropsychic maladaptation. At the level of operational tasks - normalization of the vegetative balance index LF / HF within the range of 1.5-2.5 (2).

As a result of the trainings, 90% of the training participants coped with instructions to change their own state. A success criterion for the training was considered to be a conscious change in one's own vegetative balance in accordance with the instruction by a value exceeding 1σ (the value is determined for each participant individually as a result of automatic processing by the BOS apparatus (for example, Medikom MTD software, Reakor apparatus). successfully coping with the instructions, consisted of equal-sized subgroups with excessive sympathetic and parasympathetic types of vegetative about the balance in the background recording (no load), as well as groups with a normotonic vegetative balance in the background sample, but an excessive sympathetic type of response when conducting a stress load.

The differences between the functional indicators of the psychoemotional state of the participants before undergoing psychophysiological correction of the functional state and after were evaluated using the method “Well-being-activity-mood” (SAN) (4). Influence

psychophysiological correction of the functional state on the features of decision-making, was diagnosed using the Melbourne Decision-Making Questionnaire (MOPR) (5). Method results were also measured before and after psychophysiological correction. To assess the dynamics of changes in functional indicators and decision-making features, we used the t-student test for dependent (paired) samples.

When analyzing the dynamics of functional indicators (SAN technique), participants who underwent psychophysiological correction of a functional state revealed a statistically significant increase in the values of “well-being”, “activity” and “mood”. An increase in the values of functional parameters indicates an improvement in the psychoemotional state after the psychophysiological correction of the functional state.

According to the MOPR, after the psychophysiological correction of the functional state, a significant decrease in the proportion of such unproductive decision strategies as “procrastination” associated with the postponement of decision-making and “over-vigilance” indicating indecision and difficulty in choosing between different alternatives was revealed. There was an increase in the indicator of the decision-making strategy “vigilance”, which is associated with tolerance to uncertainty, the consideration of alternatives, the search for information and rationality.

The results obtained indicate that after the psychophysiological correction of the functional state, a statistically significant improvement in the functional psycho-emotional state and the prevalence of a productive decision-making strategy associated with subjective rationality and willingness to act are observed.

According to the participants' self-reports, the achievement of a vegetative balance equal to the normative values in the range of 1.5-2.5 (2) was accompanied by a pronounced feeling of emotional and / or bodily relaxation. Participants who successfully changed their functional state during the first three classes also coped with additional instructions to increase their concentration while thinking (to themselves) about work tasks during emotional relaxation. Participants reported successful use of this skill in stressful situations.

Specific use cases:

1) Sergeant, assistant commandant S. Sh-ko. He is 24 years old, complete secondary education, 3 years of service, has no neurological, psychiatric and other diseases, no history of TBI. Complaints about a lowered mood background, exhaustion, an increased level of anxiety, an increased susceptibility to acute respiratory infections, constant daytime sleepiness. Psychological testing revealed: an increased tendency to take risky actions, as well as high rates of impulsiveness, egocentrism and preference for simple tasks (according to the self-control questionnaire G. Grasmic (3)); high rates of motivation to avoid failure / punishment, as well as moderately high motivation for receiving emotional encouragement and high activation aimed at obtaining pleasure (Questionnaire BIS / BAS (11)). Low ergicity indicators (characteristics of vitality, activity, working capacity, thirst for activity) in the psychomotor sphere and low values of the plasticity scale in the psychomotor and intellectual spheres (questionnaire of the formal and dynamic personality characteristics of V.M. Rusalov (9)) were also revealed. This psychological portrait is in good agreement with the parasympathicotonic types of autonomic response, as well as the subjective complaints of S. Sh-ko.

A psychodiagnostic examination using the biofeedback method before the start of correction procedures revealed an excess parasympathetic tone (HF = 9305, LF = 1147, LF / HF = 0.123). The instructions included a directional decrease in the absolute values of the HF parameter, as well as an increase in the LF / HF index. Already during the first training session, the subject reached averaged values for the controlled period HF = 2732, LF = 1724, LF / HF = 0.881. The achievement of this condition was accompanied by subjective feelings of relaxation, a decrease in anxiety and a feeling of "surge of strength."

Steady changes in the absolute indices of vegetative equilibrium were recorded towards their normalization even in the background without arbitrary control (HF = 520, LF = 863, LF / HF = 2.1), as well as during the controlled period with provoking socially colored stress stimuli (HF = 1352, LF = 2268, LF / HF = 2.0). A total of 7 remedial classes were conducted.

S. Sh-ko notes the following changes in well-being: the disappearance of headaches of overstrain, the normalization of night sleep, the decrease in daytime sleepiness, the increased mood background (“I feel like a happy person”), the reduction in the number of conflict situations with my wife and colleagues, the increase in physical and intellectual endurance , decreased exhaustion of higher mental functions, normalization of the level of attention, acceleration of cognitive processes ("it became easier to think, as if I had accelerated").

2) Officer E. K-s. Age 32 years, higher education, 10 years of service experience, has no neurological, psychiatric and other diseases, no history of TBI. Complaints of short temper, sleep problems, exhaustion, "tingling in the chest." Psychological testing revealed: an increased tendency to take risky acts, as well as high rates of impulsiveness and egocentrism according to the R. Grasmic self-control questionnaire); a high level of hostility (Bass-Perry aggressiveness level questionnaire (1)), as well as a low level of flexibility (“Behavior Self-regulation Style” questionnaire (8)), as well as high rates of emotional attitude to the result of one’s activity (questionnaire of formal and dynamic personality characteristics В .M. Rusalova).

Diagnostic examination using the biofeedback method before the start of corrective procedures revealed excessive sympathetic tone (HF = 62, LF = 619, LF / HF = 15). The instructions included a directed decrease in the absolute indices of the LF parameter, an increase in the HF index, as well as a decrease in the LF / HF index. During the second training session, the subject achieved averaged values for the controlled period HF = 148, LF = 600, LF / HF = 5.15. The achievement of this condition was accompanied by subjective feelings of relaxation. The first series of trainings ended with the third correction procedure, as E. K-s. Reduced the LF / HF index to 1.6.

By the time of the 8th corrective exercise, steady changes in the absolute indices of vegetative equilibrium were recorded towards their normalization even in the background without arbitrary control (HF = 320, LF = 663, LF / HF-2.07), as well as during the controlled period with provoking socially colored stress stimuli (HF = 615, LF = 1476, LF / HF = 2.4). In total, 8 remedial classes were conducted.

E. K-sov reports on the following changes in well-being: normalization of night sleep, increased mood background, decreased temper, a decrease in the number of conflict situations with colleagues, and a decrease in the exhaustion of higher mental functions.

The corrective procedure is accompanied by general neuromuscular relaxation, a decrease in situational anxiety, an increase in pain thresholds, and, as a result, the disappearance of chronic tension pains, normalization of mood background.

The developed method allows correction not only with a group characterized by excessive sympathetic activation, but also with a group characterized by excessive parasympathetic activation, the implementation of training for conscious self-monitoring of a functional state under conditions of modeling a professionally specific stress load.

The use of indicators of autonomic equilibrium as controlled parameters allows a person to learn to increase or decrease the tone of the sympathetic or parasympathetic nervous systems separately. Which increases the effectiveness of this method, and also makes the method effective for the correction of persons with excessive parasympathetic activation. Modeling of stressful situations using provocative samples allows you to use the proposed method to increase stress resistance of extreme specialists, as well as reduce personal anxiety. The normalization of autonomic homeostasis is accompanied by an increase in the adaptive reserves of the body, leading to an increase in the professional reliability of employees in hazardous professions, which in turn leads to an improvement in the level of self-control, a decrease in the risk of making wrong decisions, quick relief of stress, and a reduction in the duration of rehabilitation.

Information sources:

1. Bass A., M. Perry "Questionnaire of the level of aggressiveness of Bass-Perry." 1992.

2. Boyko A.I., Boyko I.M., Marunyak S.V. "The state of the vegetative balance among aviation specialists of the European North of Russia." Bulletin of SSMU. 2010. No2. S. 13-15.

3. Bulygina V.G. adapt. “G. Grasmika self-control questionnaire”, 2009.

4. Doskin V.A., Lavrentieva N.A., Miroshnikov M., test "Well-being-activity-mood", 1973.

5. Kornilova T.V. adapt. “Melbourne Decision Making Questionnaire”, 2013.

6. Kulakov D.V. “Correction of a maladaptive neuropsychiatric state in the staff of the State Fire Service of the Ministry of Emergencies of Russia on the basis of audiovisual exposure and biological feedback." Diss. Cand. psychol. sciences. St. Petersburg, 2011.

7. Matveeva V.V. "Non-drug reconstructive correction of autonomic dysfunctions in persons of dangerous professions using the method of hardware biofeedback." Diss. Cand. honey. sciences. Moscow 2013.

8. Morosanova V.I. "Questionnaire style of self-regulation of behavior." 1988.

9. Rusalov V.M. "Questionnaire of the formal-dynamic properties of personality." 1979.

10. Khankevich Yu.R., Bloshchinsky I.A., Vasiliev A.S., A.S. Kalmanov A.S. "Evaluation of the effectiveness of biofeedback training for correcting the functional state of submariners during a long voyage." Human Ecology, 2015, 10.

11. Carver C.S., White T.L. “Questionnaire BIS / BAS”, 1994. Standardization Knyazev GG, Slobodskaya ER. 2007.

12. Weltman G, Lamon J, Freedy E, Chartrand D. Police department personnel stress resili-ence training: an institutional case study. Glob Adv Health Med. 2014 Mar; 3 (2): 72-9. doi: 10.7453 / gahmj.2014.015.

Claims (5)

1. A method for correcting impaired self-regulation and psycho-emotional state in extreme specialists, including the correction of the autonomic balance using biological feedback (BFB), characterized in that the indicators of the autonomic balance are used as controlled ones and they model the stress load during the correction process, while this method carried out in sequential steps: during the first stage, initially, the initial - background ECG with the determination of LF, HF and LF / HF index is recorded, against the background of relaxing music, a person trains changing his psycho-emotional state, focusing on objective changes in his functional state, namely, indicators of the vegetative balance of HF and LF, displayed on graphs on the screen in front of him and recorded from him in real time using ECG electrodes; when a person achieves the ability to arbitrarily, taking into account the BFB data, control his functional state within the range of LF / HF values from 1.5 to 2.5, go to the second stage, where stress is added to the actions performed by the person at the first stage in the form of pain electrical stimulation or exposure to sharp negatively perceived sounds and continue voluntary training until a person achieves the ability to control his functional state within the range of LF / HF from 1.5 to 2.5. 2. The method according to p. 1, characterized in that the said sounds are a female or children's cry or cry. 3. The method according to p. 1, characterized in that the said sounds are sounds of breaking glass, falling things.