In medical psychology the following methods are used:

Subject, tasks and methods of investigation of psychical state of a person. Concept of mental health. Inner picture of disease. Condition of psychic functions and disease.

 

Psychology is a science about the origin, development and manifestations of mentality.

Mentality is a product of developing the living substance, subjective image of the objective world which serves for orientation in the surrounding world and controlling the behaviour. Mentality is the most perfect form of internal, subjective, ideal activities. At the expense of various ratios of the subjective categories (images of impressions, images of ideas, notions) it provides making adequate judgements and conclusions about an outer world, about the relations with the world not directly but rather indirectly, only abstractly without close contacts with the appropriate objects of the surrounding reality. The structure of the modern psychology is determined by the closely related forms of manifestation of mentality occurring in the process of active reflection of the objective world, mental processes, mental properties and conditions. The mental processes are the forms of the subjective reflection of the objective reality which help to perform cognition of the world, master knowledge, habits and skills. Some important processes are: cognitive (sensation, imagination) and emotional volitional (feeling, emotions, will). Mental properties are personally psychological features giving an opportunity to distinguish people, know their actions and motives of their activities. One can refer the person’s temper, character, abilities and ambitions to mental properties. The mental conditions characterize temporary dynamics of mental activity which has a considerable influence on the person’s behaviour and activity (e.g. anxiety, tension, stress, animation).

Mentality of the person is included in various connections and relations with the reality, that is cognition, study of reality, adaptation to the conditions, talking with other people. The development of the whole variety of the mental properties of the person cannot originate from one unified basis (e.g. only from biological or social basis) The systemic method supposes biopsychosocial unity of the personality and variety of sources and forces which promote mental development of the person. The functional systems of the brain are material, physiological substractum of the mental processes, therefore for their understanding it is necessary to know I.P.Pavlov’s theory about the ratio of the organism of the person with the surrounding environment, about general types of maximum nervous activity and also about P.K.Anohin’s studies about functional systems.

Table 1. Subfields of psychology

 

Psychology is directly connected with philosophy and other sciences about the man. It plays an important role in scientific cognition of regularities of developing the personality, his ideological, intellectual, ethical and aesthetic aims and values. General psychology is a science about regularities of development and practical realities of mental functions (perception, memory, attention, thinking, emotions, effect-will sphere, consciousness) separately in their interaction, which makes the personality. General psychology presents methods giving an opportunity to notice slight changes in the patients mental state, observe a course of disease step by step noticing positive and negative influence of methods of treatment.

Medical psychology is a field of psychology which studies regularities of developing and functioning mentality under conditions of the beginning and duration of the disease, treatment of the patients and using psychological factors in the process of treating, preventive and hygienic activities of the medical staff.

Medical psychology studies psychological aspects of activity of the doctor and behavior of the patients. In other words it focuses on the relationships of all participants of clinic process (relationships between doctor and patient, nurse and patient, doctor – nurse – patient, doctor and family of the patient). There are some areas in medical psychology. Neuropsychology studies the role of neurodynamic factors in the general picture of pathology of higher nervous activity and in the process of its restoration. The central problem of neuropsychology is “the brain as the substratum of mental processes”. Psychotherapy means a mental influence for patients treatment. Psychoprophylaxis measure on maintenance of mental health of the man. There are also such important areas of medical psychology as pathopsychology, psychophysiology.

Medical psychology is dealing with solving theoretical and practical problems connected with the restoration and maintenance of psychological health of the population, prevention of diseases, diagnosis of pathological conditions, psychocorrecting forms of influence the recovery with solving many problems of examinations, social and working rehabilitation of healthy and sick people and besides with study of psychological features of the professional activity of the medical worker. The place of medical psychology in clinical medicine is determined by the object of research of these sciences, e.g. by sick person who has changed mentality in any disease.

The basic points of contact of these sciences are the psychological peculiarities in doctor’s conduct, correction of mentality while treating the patient and psycholotherapeutic influence. Medical psychology is connected with all medical specialities (therapy, surgery, obstetrics, gynecology, paediatrics, hygiene and others). It has some specific methods and thus it plays an important role in doctor’s training in any speciality. Mental phenomena are determined by the factors of environment (mentality is a form of reflection of the objective reality). However, any outer influence produces one or another psychological effect under inner conditions such as the mood of the individual, his aims, needs and life experience. Due to activity the mentality fulfils the function of orientation of the person in a variety of surrounding events and phenomena (it is manifested in selectivity of the subject regarding outer influence) and the function of regulating behaviour (stimulation to the activity which meets needs and interests of the individual). In a definite situation the person’s behaviour depends on his interpretation and treatment of the situation. On the other hand, the character of treatment of the given situation, extent of knowledge about the situation will depend on interaction of the person with this situation.

Development of mentality is realized in different forms:

a)  phylogenesis is making structures of mentality in the process of biological evolution of species;

b)  ontogenesis is forming mental structures during the life of the individual;

c)   sociogenesis is developing processes of cognition of the personality, interpersonal relations which are conditioned by features of socialization in different cultures. Some differences of thinking of values, standards of conduct in representatives of various cultures are consequences of sociogenesis;

d)  microgenesis is forming and dynamics of images, concepts, notions and so on which are determined by the present situation and developed for a short time period.

Age psychology is based on the following classification of the age periods:

1.  New born – under 4 weeks.

2.  Infancy – under 1 year.

3.  Period of temporary teeth – from 1 up to б – 7 years: (pre-preschool) from 1 up to 3 years,

(preschool) from 3 up to 7 years.

4.  Prepubertal (primary school) – from 7 up to 12— 13 years.

5. Pubertal – 12 – 16 years for girls, 13—17 years for boys.

6.  Juvenile – 16 – 20 years for women, 17 – 21 for men.

7.  Mature – 21 -60years.

8.  Elderly – from 55 – 60 upto 75 years.

9.  Senile – above 75 years.

10.Long-livers – above 90 years.

Any stage of mental development has its own qualitative peculiarities and regularities. Thinking of the adult differs from that of a child not only because the adult has more knowledge but also because he operates other notions, other logical structures and bases on the other system of values.

For juvenile age it is typical to have turbulent physical and mental development with instability and sensitivity of mental functions, tendency to independence, mental development of the child depends on combined influence of two factors: biological nature of the organism and interaction with the environment.

Table 2.Classification of Parenting Styles

1.For mature age the highest development of individual physical and mental abilities is typical.

2.For elderly and senile it is typical to have gradual decrease of creative capability, acquisition of new information, increase of inertness of mental reactions, conservatism, hypochondriac anxiety about health.

Mental development of the person is directed to several lines simultaneously: intellectual development, moral-ethical, emotional-volitional development, etc. Development of different spheres of mentality takes place irregularly; on the one hand the development can go more intensively, on the other hand it goes more slowly. The irregularity of mental development results in the so-called crisis of the development. As an example we can say about a crisis of 1 year, crisis of 3 years or crisis of juvenile age which occur as a result of disharmony in development of intellectual and emotional spheres.

Positive significance of such crises is the fact that they stimulate development of «retarded» spheres and thus they are the moving force of development of the personality as a whole. The age peculiarities of person’s mentality in the period of the disease are interlaced and interacted with unhealthy changes and disturbances.

The doctor must know how to interpret and fix these interactions with the purpose of the adequate and opportune help to the patient.

Thus the basic tasks of medical psychology are as the follows:

1.Psychological evaluation of the specific features of the patient, changes of his mental and somatic diseases.

2.Analysis of the influence of different mental and somato-neurological diseases on the mentality of children and adults.

3.Analysis of the role of mental affects in causes, duration and prevention of psychosomatic diseases, their psychopathological complications.

4.        Analysis of personal and professional psychological peculiarities in doctor’s behaviour and work with patients.

Table 3. Tasks of Medical Psychology

 

A method is the way of activity organization directed to the achievement of the purpose. Before describing the methods used in medical psychology it is necessary to concentrate on the basic stages of experimental psychological examination.

On the preparatory stage the question (hypothesis) that should be answered is formulated. This question is mostly about differential diagnosis, the causes or factors which determine the specific character of one or other course of the disease, determination of individual psychological peculiarities of the patient’s personality.

 

Table 4.  Method of psychology

 

Experimental psychological examination includes the following stages:

♦  Preparatory (hypothesis formulation, selection of methods) ;

♦  Proper experimental;

♦  Quantitative processing of the findings;

♦  Interpretation of the received data and drawing the conclusion. After the problem is formulated it can be found out how and to what extent all possible phenomena influence the event that is of interest to the examiner. Such a preliminary answer to the question about the character of the connection of events is a hypothesis. The main demand to hypothesis is the possibility of its checking. Some various hypothesis may arise while planning the examination; in this case they are checked consequently.

Table 5. Experimental Method of Examination

 

In medical psychology the following methods are used:

1.Method of clinical interview.

2.Method of observation.

3.Experiment.

4.Psycho-diagnostic examination.

The methods of clinical interview and observation are the main methods used by doctors and medical psychologists in their everyday practice.

Method of clinical interview

The interview reveals the associations interesting to the examiner on the basis of the empiric data which were received at real two-way contact with the patient. This is the method of receiving information about the individual psychological peculiarities of the personality, psychological phenomena and psychopathological symptoms, inner picture of the disease and the structure of the patient’s problem. It is also the way of psychological influence of the person, which is worked out directly on the basis of a personal contact between the doctor, the psychologist and the patient.

The principles of clinical interview are unambiguity, exactness and simplicity of formulations, adequacy, sequence, flexibility and impartiality of interrogation, verity of the information received. The success of the interview depends on the examiner qualification that presupposes the capability to establish the contact with an examined person, to give him an opportunity to express himself as freely as it is possible.

In the process of clinical interview, the patient’s history and his complaints are taken. History taking permits to form an opinion about the character of the disease, its causes and development, peculiarities of its course and clinical manifestations. Taking a case history the doctor can reveal the neuropsychic state of the patient before the disease. He can also find out whether the patient was treated before and if so in what departments he was treated and how effective the treatment was. The case history allows the doctor to determine the attitude of the patient to his disease, the peculiarities of the psychological reactions to the disease. Interviewing the patient, the doctor both estimates the facts and has the opportunity to determine the psychological peculiarities of the patient. It is necessary to afford an opportunity for the patient to speak on his own about his life and disease. However, the interview with the patient should be guided by the doctor, It is very important to ask questions to the patient correctly and in the certain order and form. It is not recommended to inspire the patient these or other sensations asking him questions (for example, it is sometimes enough to ask the patient whether he has pains in the heart region and he begins to feel them). Intimate questions about the patient’s life should be asked with special delicacy. The doctor should take into account how attentively and thoughtfully the patient listens to his questions.

However, the patients who suffer from annoying sensations or pains can think that either a doctor did not examine them carefully or their disease is very serious and incurable. Besides, some of them try to stay sick after the recovery being afraid of reverting to their previous healthy mode of life. In this case, we can say that the patient is aimed at the disease. Sometimes patients underestimate the severity of their disease and either they don’t complain at all or alleviate the degree of its manifestations.

Clinical interview is an important method of examination of a patient and interaction between the doctor and the patient, doctor’s influence on the patient.

Method of observation

One of the most typical ways of examination is observation of an object (a person, a group of people) pending the phenomena interested by an examiner will show themselves to be recorded and described. By means of this method mental processes, states and properties of sick and healthy are studied. Mentality is studied under natural living conditions, and this study differs from an experiment because a doctor or a psychologist is a passive observer that has to wait for those phenomena he is interested in.

The advantage of this method is that during the observation the natural course of mental phenomena is not broken. The disadvantage of the observation is that it does not allow to determine the cause of a certain mental phenomenon precisely, because it is not possible to take into account all interrelations of a mental phenomenon in.the process of observation.

Observation is carried out under usual living conditions: in families, at work, game, during studies, in a hospital ward.

Independent activity, observation, reaction peculiarities of a patient, his relationship with other people are taken into consideration. Observation should be purposeful, that is follow some certain tasks. In medical practice it allows to estimate the patient’s sleep, appetite, mood, psychic activity, etc.

Experiment

An experiment differs from observation because it presupposes the arrangement of a clinical situation which allows to carry out a relatively absolute control of variables which is impossible at observation.

A variable is reality that can be changed in an experimental situation. One of the most important advantages of an experimenter over an observer is manipulation of variables.

An observer is interested in any interrelation of phenomena, but in an experiment under certain conditions it is possible to introduce a new element and to determine whether this or that change in the situation takes place. An examiner expects this situation as a consequence of the change made by him, but an observer has to wait for the change which may not take place.

An experiment can be divided into 4 types: laboratory, natural, establishing and forming.

The shortcoming of this method is that it is hard to arrange it in order an examined persoot to know what is going on. Thus, an examined person can reveal constraint, diffidence, conscious or unrealized anxiety, etc.

Psycho-diagnostic examination

On the basis of the psycho-diagnostic examination the hypotheses about the dependences between different psychological descriptions are checked. When their peculiarities are revealed in the sufficient number of the examined, it is possible to determine their interrelation on the basis of the proper mathematical Psycho-diagnosis is the science and practice of how to make the psychological diagnosis. The diagnosis as the main purpose of diagnostics can be made on various levels.

LEVEL 1 is symptomatic and empirical. On this level the diagnosis is limited by ascertaining of peculiarities or symptoms (signs).

LEVEL 2 is etiological. It takes into account not only the presence of descriptions but also the causes of their development.

LEVEL 3 is the level of the typological diagnosis which determines the place and the meaning of the revealed descriptions in the general picture of psychological human life.

Psycho-diagnosis methods

The main methods of psycho-diagnosis are testing and interviewing. Their systematic expression is tests and questionnaires which are also called methods. The methods make it possible to collect the diagnostic information in the relatively short time, they give the general information about the person, about these or those of his peculiarities in particular (his intellect, anxiety, etc.), they allow to make a quantitative and qualitative comparison of an individual with other people. The information received with the help of psycho-diagnostic methods is useful with regard to the selection of interference means, the prognosis of its efficiency, development, contact, effect of this or that individual activity.

Testing

A test is a try-out, a task or a task system which helps to estimate the mental state or maturity of the examined.

Psycho-diagnosis uses a number of experimental psychological methods or tests which help to estimate the functioning of both separate areas of mental activity and integrative formation such as temperament types, personality peculiarities, personal traits.

There are verbal (language) and non-verbal (picture) tests. Two groups of tests – standard and project – are usually distinguished. The test directed toward estimation is called a standard test (maturity, creativity, aptitude tests).

However, there are tests that are directed not toward the estimation indices, but toward the qualitative personality peculiarities. Project methods belong to this group of tests. They are based on the fact that the personality is realized through various manifestations of an individual including some hidden unconscious needs, conflicts, feelings. Thus the main thing is subjective contents and attitude that a test can cause in an examined person, and it allows to make conclusions about the personality peculiarities.

A number of psycho-diagnostic methods for the investigation of various areas of mental activity are given in the table.

 

Area of psycyhological activity	Psycho-diagnostic methods
Perception	Sensory excitability Aschaffenburg’s test Reichardt’s test Liepmann’s test
Memory	Ten words test Memorizing numbers Story reproduction
Attention	Schulte’s tables Proof test Anfimov’s tables Counting by Kraepelin
Thinking	Classification Exception of notions Syllogisms Analogies Generalization tests Association experiment Pictogram
Intellect	Raven’s matrices Wechsler’s test
Emotions	Spielberg’s test Luscher’s methods of colour choices
Personality	Rorschach’s test MMPI Topical apperceptive test (TAT)

 

Questionnaires are the methods containing a number of questions to be answered by an examined person in order to find out whether he agrees with them or not.

There are questionnaires of an “open” type (answers are given arbitrarily) and of a “closed” type (answers are chosen from the variants given in the questionnaire). Besides there are questionnaires-surveys and personality questionnaires.

Questionnaires-surveys give an opportunity to get such information about the examined person that doesn’t show directly his personality characteristics. They are biography, interests, aims questionnaires, for example.

 

Personality questionnaires used for the evaluation of personality characteristics are divided into several groups:

a)typological questionnaires worked out on the basis of personality type determination allow to refer the examined to this or that type which differs in its peculiar manifestations;

b)personality traits questionnaires which determine the expression of traits, i.e. stable personality signs;

c)motives questionnaires;

d)importance questionnaires;

e)aims questionnaires;

f) interests questionnaires.

 

The analysis of psychological examination methods shows that they are not isolated, i.e. they can be the components of one another.

The last stage of experimental psychological examination necessarily contains a written conclusion based on the received data.

1879, Wilhelm Wundt founded a psychological laboratory in Leipzig, Germany, Wundt and his student, Edward Titchener studied consciousness using a method of looking inward at one’s own experiences; this technique is called introspection. Wundt and his followers were interested in the elements and structures of the mind; they were called structuralists.

The first course on psychology was taught in 1875 by William James. He believed that the process of consciousness helps the human species to survive. His approach, which emphasized the purposes or functions of consciousness, is called functionalism.

In the 1890s, Russian psychologist Ivan Pavlov identified a simple form of learning called conditioning. Today this form of learning is called Pavlovian or classical conditioning. Pavlov’s ideas were popularized in the USA by John Watson, who believed, that only outward behavior could be scientifically understood. The school of psychology, based on the ideas of Pavlov and Watson is called behaviorism.

 In Germany, Hermann Ebbinghaus applied the experimental method to the study of human memory. Max Wertheimer and his associates studied perception. They believed that the mind could not be broken into raw elements because “the whole is different than the sum of its parts”. This approach is called Gestalt psychology.

In the 1890s, in France, Alfred Binet sought to measure the mind’s intellectual capacities.

 Sigmund Freud was an influential founder of psychology, who believed that conscious experiences were not as important as the unconscious mind. He believed the roots of psychological problems involved sexual and aggressive motives. The process Freud formulated to help people with psychological problems is called psychoanalysis.

The majority of new doctorates in psychology today are achieved by females, and the number of minority psychologists has greatly increased in the past 20 years. The early history of psychology includes sexual discrimination concerning women and prejudicial roadblocks against ethnic minorities.

Contemporary Perspectives.

Although not a single approach has emerged as the correct approach to psychology, two early approaches that still exist in contemporary psychology are behaviorism and psychoanalysis. Another contemporary perspective that can be traced to the founders of psychology is the cognitive perspective. Many contemporary behaviorists believe that mental processes such as cognition can be studied scientifically. This approach is referred to as social learning theory. A contemporary perspective that emphasizes cultural, gender and ethnic factors is called the socio-cultural perspective. A group of people who descended from a common group of ancestors is called an ethnic group. A person’s sense of belonging to a particular ethnic is referred to as ethnic identity. A person’s view of himself or herself as male or female is called gender identity. The socio-cultural perspective encourages the view of other cultures as being different rather than inferior; this view is called cultural relativity. The socio-cultural perspective also emphasizes individual differences among members of different ethnic groups, cultures, and genders. Modern psychoanalysts still believe that conflicts regarding unconscious sexual and aggressive motives are the chief source of psychological problems. Today, however, many psychoanalysts also stress the importance of other motives as well as cognitive process of the conscious mind.

Recently, there has been an increasing interest among psychologists in the intellectual processes of cognition, including perceiving, believing and thinking.

Abraham Maslow, Karl Rogers and Victor Frankl have popularized the humanistic approach, which holds that humans determine their own fates through the decisions they make.

Enormous progress has been made in unraveling the functions of nervous system, heredity and the hormonal system; these psychologists approach the field from a biological perspective.

The structure of modern psychology consists of 3 forms of mental displaying, which are intermixed with one another. They appear during the process of active reflection of objective reality.

So, the first: mental processes are the forms of subjective reflection of objective reality. The cognition of world is carried out thanks to them. We talk about 2 kinds of mental processes;

cognitive processes: sensation, perception, memory, thinking, attention, imagination, speech;

emotionally-willed processes: senses, emotions, will.

Mental qualities are individual peculiarities, which give the possibility to distinguish people, know their behavior, motives of their activity:

orientation of mental activity;

 temperament;

character;

intellectual facilities (talents).

States of psyches (mental states) – dynamics of mental activity, which have influence on the behavior and activity of a person. There are many different mental states, for example: anxiety; agitation; empathy; enthusiasm; tensity, etc.

Most psychologists would agree with the following statements:

Human beings are biological creatures, whose structure and physiology influence and limit behavior.

Although every human is unique, we have similar capacities to think, feel, etc. Therefore, every person is different, yet much the same.

As the socio-cultural perspective implies, people can be fully understood only by taking into account their culture, ethnic identity, and gender identity.

Our constant developmental changes and life experiences mean that human lives are in a contstant process of change, evolving from birth to death.

People do things for reasons; that is behavior is motivated, not random or aimless.

People need to have contact with each other; we are social animals working together in groups.

People are not passive; we play an active part in choosing our experiences and constructing perceptions.

Behavior can be influenced by many factors at once; it has multiple causes.

Although we are usually able to adjust to the challenges of life, sometimes we act in harmful ways; behavior can be either adaptive or indaptive.

Personality is a mask, which indicates uniqueness of every human being. To determine the word “personality” is very difficult. Alport in his monograph “Personality” gave 50 different authors’ definitions of this word, he even classified them. According to definite criteria he groups them into 5 categories. Eysenk defines personality as more or less stable and constant organization of character, intelligence, temperament and body. This organization is defined by its single and individual adaptation at the environment. Austrian psychologist T. Roraher combines characteristics of personality with character in interesting way. He strictly differentiated them, but at the same time he combines them as phenotype to genotype.

A character – is the personality’s originality of individuum. It is created with the help of dispositions, all inborn preconditions and inherited basis. It has all possibilities a person can possess in his life. Personality – is everything, which actually appear from this potential basis in this moment.

The main reason must surely be that human behavior is enormously complex, and is determined by not one factor or even one set of factors, but by a vast number of determinants at many different levels. With such a complex sphere of investigation, each different approach has emphasized different kinds of observations about people, which are inevitably reflected in different kinds of personality theories.

This complexity of subject is revealed by a glance at the different areas of personality which have been detailed (sometimes quite arbitrarily) by psychologists, such as personality development, personality dynamics, personality assessment, personality structure, personality change, personality adjustment and so on. It is rather as if ten blind men surrounding an elephant were reaching out and touching the nearest part, then theorizing about what it was. Each individual’s description and theorizing might be perfectly adequate, but would tell us little about the overall function and structure of the complete elephant.

Not only do personality theorists sample different aspects of human behavior, but they also use different tools to do so. Some theorists have used samples of unstructured speech as a major investigatory tool; others have used sophisticated mathematical analyses of responses to paper-and pencil questionnaires; some have simply counted items of behavior, and still others have used the size and shape of the body. There is, therefore, no such thing as a theory of personality, in the sense that a theory covers all aspects of human behavior, but there are many theories whose main area of interest lies within the domain of personality.

So, the branch of psychology that studies personality is called personology.

Typologiocal models of personality.

We often use the word “typical” to characterize a person: for example, “this is the typical teacher”, or “this is the typical German”, “the typical Englishman”, etc. in this case we mean definite traits of personality, which characterize definite group of people.

Personality is the most complicated psychic formation which unites numerous biological and social properties. The changes in one of these factors are reflected in the interrelation with the other factors and the personality as a whole. Therefore the approaches to personality study are various, different aspects of personality study originate from different concepts, they depend on the science which studied the personality.

Social sciences study personality as a special quality of the human being, which it acquires in the social cultural medium during joint activity and communication.

In a broad meaning, personality is an ensemble of psychic organization of the human being.

In a narrow meaning, this is a level of “integral individuality”, at which main vital choices and decision taking take place. It is an individual entity of human properties (intellectual, emotional, volition, moral, ethic), characteristics of its mental processes which create a stable unity and are mediated by the social environment.

Personality is a totality of congenital and developed mental features characteristic for the individuum, uniqueness of the individuum.

The fundamentals of the personality as a carrier of conscience and active social being are abilities, temper, and character, characteristics of their mental processes, totality of feelings and prevailing motives of the activity, attitude, etc.

The structure of the personality which was suggested by K.K. Platonov reflects the complexity of its forming (unity of biological and social mental properties) in the totality of different characteristics of the personality:

biologically mediated properties (inclinations, temper, pathological changes in the personality);

socially mediated properties (spiritual needs, trend, moral qualities);

the features of the personality mediated by the experience (knowledge, habits, skills);

the properties mediated by individual characteristics of mental processes (type of the memory, degree of emotional motor stability).

In the recent years both medical psychology and clinical psychiatry have demonstrated interest to investigation of personality characteristics in the patients. This is explained by a number of factors: a) the changes in the personality, which are caused by a specific disease can be used in differential diagnosis; b) the analysis of pre-morbid personality characteristics is useful when determining the causes of the disease; c) understanding personality changes during the disease enriches the knowledge of the pathogenetic mechanisms; d) the characteristics of the personality should be taken into account when working out the complex of preventive measures.

 

PERSONALITY STRUCTURE

The sphere of individual psychological characteristics of the personality includes abilities, temper, and character of the personality.

The success in acquiring knowledge, skills depends on the abilities of the person, but the abilities are not the presence of this knowledge and skills. Abilities are the possibility, not the real knowledge and skills, these are individual psychological characteristics of the personality, which can be the condition of successful performing the activity. Abilities manifest only in the activity which cannot be performed without the abilities. The abilities are seen in the process of gaining knowledge and skills. The highest degree of ability development is talent, which unites the abilities enabling the person to fulfill any job successfully, independently, originally. Biological grounds of abilities are inclinations. Inclinations are morphological and functional features of the brain, sense organs and motions, which are natural grounds of ability development.

Qualitative (organizational, musical, intellectual abilities) and quantitative (the level of the abilities to definite knowledge and skills) characteristics of the abilities can be distinguished. Depending on the activity there can be leading and auxiliary abilities. Abilities (intellectual, artistic, musical) are connected with the type of higher nervous activity, that is this or that signal system prevails (intellectual, artistic and median types). The obligatory condition of ability development is education and upbringing beginning from the early childhood. The abilities are not inherited, but without inclinations it is difficult to develop high abilities.

The temper is congenital individual characteristics of the personality, which determine the dynamics of mental activity and can be revealed in various activities irrespective of its content, purpose, motives. They remain constant in the older age.

 Tempers were first described by Galen and Hypocrates. They divided all tempers into four types: sanguine person, phlegmatic, choleric, melancholic, which are characterized by the following:

Sanguine person – extravert, vivid, active, frequently tries to change the impressions, quickly reacts to the events, easily survives the failures. Sanguine person is a very productive person but only when the work is interesting to him.

Phlegmatic – introvert, slow, quiet, with stable desires and mood, does not express his feelings externally, persistent, well regulated in the work. His slowness is compensated by the accuracy.

c) Choleric – extravert, quick, impetuous, is patiently devoted to the work, but he is unbalanced, can show stormy emotional fits, sharp changes in the mood. When they are involved in some work, they waste their strength and are quickly exhausted.

d) Melancholic – introvert, vulnerable, difficulty goes through even insignificant events, his sensitivity is increased, he is emotionally vulnerable.

Each type of temper has its advantages and disadvantages. Thus, a sanguine person is responsive but inconstant. Phlegmatic is self-possessed, restrained but dry and not sufficiently responsive. Choleric has a high potential of activity on the one hand, but is explosive, on the other hand. Melancholic is emotionally responsive, his feelings are deep, but he is reserved and shy.

I.P. Pavlov worked out physiological foundation of the tempers and distinguished the types of higher nervous activity according to such properties of maiervous processes (excitation and inhibition) as strength, balance, motility. According to him, a weak type is melancholic; strong, unrestrained – choleric, strong, balanced, motile – sanguine, strong, balanced, inert – phlegmatic.

Besides these common for people and animals types of higher nervous activity, I.P. Pavlov described three human types of signal systems. The people, in whom both signal systems take part in communication with the environment, are a mixed type. If first signal system prevails, this is an artistic type, if second one – intellectual. The so-called marginal types of higher nervous activity (weak, strong, unrestrained, intellectual, artistic) have problems with coping with psychological difficulties, they may develop various morbid manifestations in stress situations.

The temper determines the individual style of activity, that is individual scheme of means of action, which is characteristic of a definite person and individually reasonable. The character is a totality of individual psychological properties, which is revealed in typical for a definite personality means of action, they are revealed in typical circumstances and are determined by the attitude of the personality to these circumstances. This is an individual originality of the person’s attitude to him/herself and to the other, peculiarity of satisfying the needs, work. The character is the temper (type of higher nervous activity) plus life experience, intellect, will, emotions and other mental processes.

Each trait of the character expresses the attitude of the person to definite circumstances in the reality. Depending on prevailing influence of different mental processes (thinking, attention, will, emotional attitude, accuracy and skill) on the means of action, the following traits can be distinguished: intellectual, emotional, volitional. The traits can induce and decelerate actions. They are frequently revealed in difficult situations, form a complicated totality, which determines personality features. There are four systems of character traits, the traits manifest in:

attitude to the groups of people and separate people (kindness, sensitivity, exactingness, arrogance, etc.);

attitude to the work (diligence, laziness, conscientiousness, responsibility, etc.);

attitude to things (neatness, untidiness, careful or careless treatment);

attitude to himself (pride, ambition, vanity, self-esteem, arrogance, modesty, etc.).

Main personal needs:

 

Individual features of the character are the degree of deepness of its properties, activity and strength of the character, stability of beliefs, plasticity. The character is formed on the basis of the types of higher nervous activity (temper) under the influence of education, upbringing, especially in the family. This process takes place during the whole life, but main traits are formed by the age of 20 – 22 years. The most unfavorable consequences for the character formation appear, when the person’s education is neglected, he is treated cruelly or spoiled, educated in hypocritical, sanctimonious conditions. As a result, the following types can be formed: good-natured, hypocritical, ambitious, cowed, malicious, inhibited.

The sphere of the personality trend includes purposes, interests, world-outlook, the system of values, morals, ideology, labor and social activity. Together with the abilities, temper and character they make up the complete characteristics of the personality, which determines its social importance. Trend is the system of stimuli and value orientations, which determines selective attitude and auctive behaviour of the person, that is trend is a stable system of motives which orient life activity of the personality.

The structure of the personality trend:

Requirements are motive forces of personality development.

Motives are inducing force of the actions.

Interests are a form of cognitive abilities, they are expressed in a special attitude of the personality to definite objects and phenomena of the surrounding world and desire to know.

Interests are distinguished according to:

object – they are characterized by the objects to which they are directed (interest in music, physics, football, etc.);

deepness – deep interest frequently embraces the whole sphere of the personality and denotes the desire to learn something in detail, superficial interest is expressed only in general knowledge about the object or phenomenon;

stability

stable interests persist for a long time, they play an important role in the life of the person and are an important part of personality trend;

unstable interests develop and disappear quickly.

Worldoutlook is the system of generalized opinions about the objective world and the place of the person in it, this is a deep and substantiated belief in the principles and ideals which he is used in his life.

Belief is the system of realized needs of the personality which force the personality do everything according to his views, principles, world outlook.

Ideal is a model which is the standard in all fields of vital activity of the person and main stimulus of formation and self-perfection.

Together with normal (socially adapted) there are accentuated and abnormal personalities. Accentuated personalities are not pathological, but marginal variants of the norm, hidden or excessive emphasizing of some traits of the character, which creates increased sensitivity to definite psychic influences at relative stability to the other, which is frequently observed in extreme emotional situations.

 

 

K. Leonard (1981) distinguished the following variants of accentuated personalities:

♦ emotive – anxious, timid, compassionate, soft-hearted;

excitable – explosive, irritative, prone to impulse aggression but not bearing grudges;

epileptoid – excitable, vindictive, cruel;

demonstrative (with hysterical traits) – prone to self-appraisal and hysterical reactions, lying, trying to attract attention, demonstrative in communication, egoistic;

demonstrative sticking   (with hysterical and paranoid features) – lying,  self-confident, impudent, prone to slandering, ambitious, sensitive, hypocritical, vindictive, without ethic norms;

dysthimic (depressive) – constantly absorbed in their troubles, indecisive, prone to pessimism;

dysthimic sticking (paranoiac) – indecisive and preoccupied, they combine stinginess and suspicion;

pedantic (anancastic, psychasthenic) – timid, anxious, distrustful, conscientious;

sticking (paranoiac) – fanatic, non-flexible, vindictive, sure in their Tightness (“I am always right”);

hypertimic – active, cheerful, optimistic;

affective-labile – emotionally unstable, with quick changes in the mood;

affective-exalted – those who heavily react to everything in the form of delight of despair;

extraverted personalities (open, amiable) and introverted (restrained, experiencing everything inside). Various combinations of personality features (temper, character, intellect) are possible.

A.E. Lichko distinguished the following types of personality: hyperthimic, cycloid, astheno-neurotic, sensitive, psychasthenic, schizoid, epileptoid, unstable, conform, mixed (according to the names of mental diseases and neurosis, which we consider incorrect).

Abnormal pathologic forms of personality development are oligophrenia, psychopathies, psychopathic development and psychopathization of personality.

Psychopathies are marked character disturbances, which manifest by total pathology of the character causing social deadaptation (main sign of psychopathy).

Psychopathic development is determined by long-acting psychogenic factors.

Psychopathization of personality is deformation of the character due to some disease (drug or alcohol abuse, for example).

Personality reactions to difficult situations depend on the age. In young and medium-aged schoolchildren the following reactions are the most frequent: protest and opposition (active protest – disobedience, rudeness, aggressive behaviour, desire to do everything to spite somebody; passive protest – infantile communication, false loss of the habits to be neat, selective mutism, escape from school and home, autoaggressive behaviour); refusal (refusal from food, games, contacts, passiveness); simulation (long stable changes in the behaviour associated with mimicking the behaviour of the surrounding – scandal, alcoholozation, smoking, wearing some kind of dress, hair-do style); anxiety and diffidence.

The following reactions are characteristic of teen-agers: emancipation, (increased desire of independence, getting rid of guardianship and control of the parents, teachers, etc.); grouping with the persons of the same age – with formation of informal groups of pro-social (actively support and protect the ideals dominating in the society), asocial (neglect the ideals dominating in the society) and antisocial (actively come out against the ideals dominating in the society) types; hobby-reactions (excessive, exaggerated hobbies); due to libido formation (onanism, early sexual life, transitory juvenile homosexualism, petting, etc.).

In elderly persons (aged 60 – 74), the rate of mental working ability decreases, they lose the ability to rapid switching of the attention, the condition of health becomes worse, they become anxious, sensitive to offence, inattention).

In old persons (aged 75 – 90), considerable difficulties with acquiring new material develop. The character becomes egocentric, some traits of the character become more prominent. The mood is gloomy, they are unsatisfied with their relatives, require increased attention, they are frequently hypochondriac.

Individual psychological characteristics of the personality play a considerable role in development of various diseases, determine their course, development (prognosis) and success of therapeutic procedures. Patients with somatic diseases are different from healthy persons in changes in the mental state accompanying the changes in the function of the inner organs. Such changes of the personality characteristics are various: reduction of the memory and thinking (intellectual functions), abilities to perform some activities, some traits of the character become prominent, pathological traits may develop (psychopathization). This should be taken into account when working with patients in order to prevent unfavorable emotional reactions, which aggravate the course of the disease and development of psychopathological complications. In mental disorders, disturbances in the personality are connected with disturbances in the choice of the purpose and purposefulness of the actions, appearance of pathological needs and motives. The attitude to the world, the other people, himself also changes. The ability to control, regulate and think critically is damaged. Any disease changes the perception and attitude of the personality to the events, creates a special situation among the close persons.

Every personality is a unique constellation of traits, but on the other hand, type means common traits in the group of people. And every personality is unique by the way she/he differs from type, to which belongs. That’s why typology is very ancient.

 

Typological model of personality by K.Yung (1875-1961).

Yung divided all people on extraverts and introverts. Extraverts are characterized by orientation of mental activity outside, on other people and events. People of such type fall under influence of environment, adapt to socium easier, and feel confidently in wide diapason of situations. Introverts are characterized by orientation of mental processes inside, on inner world. These people are inclined to observation, introspection. They do not easy fall under influence of outer factors. They are not very confident in the relations of other people. Their ability to adopt is lower than in extraverted persons. These contrast traits co-exist in every person, but one is dominant, as a rule.

  The typological theory of Ernst Kretchmer (1888-1964) became the most known in psychological science. He was a psychiatrist and was interested in the correlation between the psychiatric diagnosis and somatic type. Kretchmer noticed, that people who have schizophrenia more often have asthenic frame, while people with affective psychosis (manic-depressive psychosis) often have picnic frame.

Later investigations showed that asthenic frame is characteristic for 66% of schizophrenics and picnic frame is observed in 67% of people with affective psychosis. So, the attempt of typological classification was the next:

Patient                     schizophrenia                        affective psychosis

On the border          schizoid                                 cycloid

Healthy                    schizotymic                           cyclotymic

The viscose type was added by Kretchmer to the main classification. This frame is athletic. As the scientist, Kretchmer understood that this classification is not differential, that’s why every type was divided into 3 modifications.

Cyclotymic type:

hypo-manic (merry, lively, enterprising, lot of plans, persistent, friendly);

practice (realistic, well developed sense of humor, active, the mood is between depression and mania);

depressive (groomy, slowcoach, careful, friendly with the necessity to be understood).

The constitution of these people is picnic – they are of middle weight, the head is round with constitutional bias towards bald spot, the body is short and stocky, thorax is well developed, hands and legs are weak and short, the muscles are more soft. The face is round, sometimes pentagonal, the skin is light, there is an inclination to corpulence.

Schyzotymic type:

hyper-aesthetic type (excessively sensible, delicate, tactful, he/she is characterized by subtle understanding of aesthetic forms, idealistic);

schyzotymic middle (coldly energetic, systematic, consistent, aristocratic);

unaesthetic (insensitive) (cold, pedantic, insensitive in relations to other people, indifferent, sometimes even dullish).

The constitution of these people is asthenic (leptosomic) – they are slender, lean, thin, have thin upper and lower extremities, the face is oblong, the head is not big, the profile is rather, acute, hair is thick, he/she has not inclination to growing bald and to corpulence, the muscles are weak, but the skeleton is comparatively strong.

Typological personality model of Sheldon is interesting, comparatively complicated but practically seldom used. It was created by very complicated empiric way. Sheldon analyzed photographs of 4000 students in three positions (full face, profile and from behind). By the complex estimation Sheldon received 3 morphological forms:

Endomorphic (organs of digestion are well developed, body structure is comparatively weak);

Mesomorphic (somatic structure is well developed, conjuctive tissue and all figure is hard, mighty, thickset, solidly);

Ektomorphic (slenderness, subtleness, gracefulness of the whole body, weakly developed internal organs and somatic structure).

Sheldon investigated components of temperament in the same (empiric) way. 50 traits were determined at the beginning, and these traits were analyzed in 33 students a week during 1 year. All these traits were estimated by 70 steps’ scale. Traits, determined in such way, then were correlated and three main kinds of temperament were picked out. These three types of temperament correspond to definite types of morphological structure. So, in dependence of somatic structure there are endomorphic, mesomorphic, ektomorphic types and in dependence of mental structure viscerotonic, somatotonic, cerebrotonic types.

In order for better understanding of this material let us recollect basic theses of embryology. Human embiro is a tube with three layers at the early stage of development. Internal layer then is turned into lungs and stomach, middle layer is turned into muscles, bones and conjuctive tissue, and external layer transforms into skin and nervous system. As a rule, these three layers are growing in the same rate. So, middle statistic human must be proportional combination of brain, muscles and internal organs. But often one of the layers grows more then others, and “when angels finish the assemblage of the child” (Eric Berne), there is find more internal organs than brain, or more brain then muscles. We can say, that middle statistic person is the combination of different traits, but at the same way some people have mainly “digestive purpose”, others have “muscle purpose”, and others – “brain purpose” and have correspondingly digestive, muscle or cerebral kind of the body. People with digestive kind of the body are looking plump and people with cerebral kind of the body – thin, with muscle kind – solidly. But it doesn’t mean, that the higher is the man the more clever he is. It means, that the man eveot high, looking more lean, than plump or solidly, will be often become interested in what is in his head than what is in his stomach. So, the more important factor is leanness than growth. On the other hand, the man looking like plump, than long or solidly, will be more often become interested in good chop than excellent idea or wonderful walk.

Internal layer of embrio (endoderm) forms internal organs (viscera), that’s why the endomorphic type will be turned to abdomen. The middle layer (mesoderm) forms the body tissues (soma), that’s why the mesomorphic type will be turned to muscles. And external layer (ectoderm) forms the brain (cerebrum), that’s why the ektomorphic type will be turned to the brain.

So, the model of personality.

Viscerotonic	Somatotonic	Cerebrotonic
Endomorphic	Mesomorphic	Ektomorphic
1. Freedom in carriage and movements.	The carriage and movements are resolute	Slow movements and uncertain carriage
2. Slow reaction	Energetness	Too fast reaction
3. Love to food	Love to physical culture	Love to solitude
4. Good deep sleep	Love to noise	Shortage of sleep

 

Factor (traits) models of personality.

A “trait” is a determining tendency or a predisposition to respond. (Hall and Lindzey, 1957. In some respects everyone is a trait theorist, in that we note consistencies in other people’s behavior and we label them accordingly as aggressive, lazy, shy or by one of the other 18000 words, which exist in English to describe human behavior. The number of trait-type descriptions available in ordinary language is too large to be employed in personality research and some method has to be found of reducing the number to more manageable proportions. The majority of investigators in recent years have used a specially designed mathematical method called factor analysis. 

Factor analysis is in the highest degree complicated (hard) mathematical procedure, but the logic in its basis is easy for understanding. This is the method of defining the degree of common differences in the large choice of psychological features.

The personality theories of Cattell and Eysenck both make extensive use of factor analytic techniques. The differences in emphasizes between the theories of Cattell and Eysenck result in part from theoretical differences in the methods of factor analyses used by two researchers. Factor analyses enables us to determine the minimum number of dimensions or factors which will summarize the data in the correlation matrix by noting the “grouping together” of correlations. It is often only necessary to extract two or three factors to account for most of the information contained in the matrix. How far a particular factor is related to a particular test can be determined by the correlation between them, and this relationship is known as the test “loading” on the factor. Usually, a test will load on a small number of different factors. The apparently precise mathematical nature of factor analysis, which is one of its chief attractions as a research tool, at the same time constitutes one of its major pitfalls. It is attractive because it enables complex data to be quantified and reduced to a more manageable form.

Cattell’s trait theory.

In formulating his theory of personality Cattell assumes that there are natural elements of personality, which can be discovered by the technique of multivariate analysis. In this procedure a large number of naturally occurring aspects of human behavior are sampled in an attempt to unravel complex interrelationships and uncover the basic building blocks of personality. Cattell believes, that we all have the same traits but to different degrees, and in this way no two individuals are exactly alike.

Cattell began his research by taking trait names used in everyday language to describe human behavior together with more technical descriptions drawn from psychology and psychiatry. He then rated individuals on the trait descriptions and inspection of the ratings suggested that about forty basic dimensions were involved. When individuals were rated on these dimensions and the ratings were factor-analyzed it was found that fifteen factors could account for all the terms used to describe people.

The sixteen first-order factors or “primary” factors, which make up the Sixteen Personality Factor Questionnaire (16PF) are the ones that have been most intensively investigated by Cattell and his associates. These factors are considered to represent “source traits” which are the most important units in Cattell’s theory. They are the basis of the enduring regularities observed in behavior, and it is through the interaction of these source traits that the more readily observed “surface traits” of an individual are determined. These surface traits correspond more closely to the ordinary personality descriptions, which the layman uses. Cattell’s preference for oblique factor analysis results in small correlations between the primary factors and if a further factor analysis is carried out on the primary factors then a number of second-order factors can be extracted.

The two most important second-order factors are given the names extra-invia and anxiety (cf. Eysenck’s extraversion-introversion and neuroticism). The second-order factors represent broad reaction tendencies, which, in Cattell’s view, only influence on the actual behavior through the intermediate primary factors, which are considered to be more accurate than the second-order factors in describing and predicting behavior.

Although he believes that general personality factors and abilities remain fairly stable over a long period, Cattell recognizes that motivational variables are likely to fluctuate from moment to moment, particularly under the influence of situational variables. The two main factors, which bring some regularity to this situational variability, are “states” and “roles” of the individual. The more enduring trait descriptions of an individual’s personality may have to be considerably modified when his behavior is influenced by a temporary state such as fatigue, happiness, fear or intoxication. A man who is tired, frightened or drunk may seem to “act out of character”; in other words, predictions of his behavior on the basis of trait factors alone are likely to be misleading. Cattell regards personality variables as one of a set of conditions, which influence on behavior: “Personality is what determines behavior in a defined situation and a defined mood” (Cattell, 1965).

In the description of Cattell’s basic theory we have not so far attempted to explain how individual differences in personality arise. It is generally accepted that environmental and hereditary influences determine behavior and that their affect are inextricably interwoven. However, the relative contributions of heredity and environment will differ with regard to different types of behavior. Cattell and his associates have developed a special research technique, called “Multiple Abstract Variance Analysis” in order to investigate the relative contributions of heredity and environment to different traits. The amount of variability contributed by environmental or hereditary influences varies considerably for different traits, for example, intelligence has been estimated to be largely determined by heredity (80%) by Cattell, whereas neuroticism or Ego Weakness has been estimated to be less influenced by hereditary factors (30-40%). However, Cattell recognizes that environmental and hereditary influences interact, in each factor, to a greater or lesser extent. The subjects’ responses are scored so that a score from one to ten is obtained on each of the sixteen trait dimensions.

Eysenck’s type theory.

The personality organization described by Eysenck has many similarities to that of Cattell. The chief difference concerns the level of organization which is considered to be most important, with Eysenck stressing the type or second-order factor level as opposed to the trait level. There are other major differences in the two approaches. Eysenck while sharing Cattell’s view that biological factors are involved in determining personality has gone much further in providing causal explanation. Eysenck’s theory has generated a large volume of experimental research.

 

Unlike Cattell much of Eysenck’s early work grew out of his interest in abnormal psychology and psychiatry. He acknowledges a debt to the writings of Galen, Kant, Wundt and Jung all of whom shared the view that individual temperaments could be described by a small number of different types. The inner circle represents the four classical temperaments described by Galen almost 2000 years ago.

Eysenck has supplemented his factor analytic work with the method of criterion analysis. The use of criterion analysis is intended to reduce the arbitrary nature of the process of naming factors. Having selected a dimension such as Extraversion-Introversion, along which individuals are assumed to vary, the next step is to collect test data from groups of individuals who are expected to differ widely on the dimension. Thus if certain diagnostic groups of psychiatric patients are presumed to be highly extraverted while others are considered to be highly introverted, then analysis of the test data should place them at different ends of the Extraversion-Introversion dimension.

In the original study of seven hundred neurotic soldiers Eysenck (1947) found that factor analysis of thirty-nine items of personal data, including personality ratings, resulted in the establishment of the two basic dimensions of Extraversion-Introversion and Neuroticism-Stability. These dimensions were supported by further research, with literally thousands of subjects. In a later investigation with psychiatric patients Eysenck (1952) established a third dimension, unrelated to Extraversion and Neuroticism, which he labelled “Psychoticism”.

Thus personality system of Eysenck is made up of four dimensions:

 Although intelligence is the only cognitive dimension in this structure it is not regarded as a pure dimension and the possibility of there being other important cognitive dimensions is not denied. Until recently the Psychoticism dimension received relatively little attention and most of Eysenck’s research and theory construction has been concerned with the Extraversion and Neuroticism dimensions.

Eysench used the terms “extravert” and “introvert” in ways, which resemble but are much wider than their use in everyday language.

“The typical extravert is sociable, likes parties, has many friends, needs to have people to talk to, and does not like reading or studying by himself. He craves excitement, takes chances, often sticks his neck out, acts on the spur of the moment, and is generally an impulsive individual. He is fond of practical jokes, always has a ready answer and generally like change; he is carefree, optimistic, and likes to laugh and be merry. He prefers to keep moving and doing things, tends to be aggressive, and loses his temper quickly. Altogether, his feelings are not kept under tight control, and he is not always a reliable person.

The typical introvert is a quiet, retiring sort of person, introspective, fond of books rather than people; he is reserved and distant except with intimate friends. He tends to plan ahead, “looks before he leaps”, and distrust any impulse of the moment. He does not like excitement, takes matters of everyday life with proper seriousness, and likes a well-ordered mode of life. He keeps his feelings under close control, seldom behaves in an aggressive manner, and does not lose his temper easily. He is reliable, somewhat pessimistic, and places great value on ethical standards.” (Eysenck, 1965).

These descriptions relate to the extreme ends of the dimensions and very few individuals would fit them completely. Most people fall somewhere in between and are neither strongly extraverted nor strongly introverted. The Extraversion dimension may be subdivided into two main components; sociability and impulsiveness, though most research has concentrated on the higher-level concept of Extraversion.

The Neuroticism dimension is similar to the notion of emotional instability. Those individuals who fall at the extreme neuroticism end of the dimension tend to be more prone to worries and anxieties and more easily upset. They are also likely to complain of headaches, and sleeping or eating difficulties. Although they may be more likely to develop neurotic disorders under stressful conditions, the frequency of such problems is low and most individuals function adequately in their work and in their family and social life.

The causal factors in Eysenck’s theory are firmly rooted in biology and are highly complex (Eysenck, 1967). Personality factors are not thought to be inherited directly but rather an individual inherits a particular type of nervous system, which predisposes him to develop in a particular direction. The final shape of the personality will be determined by the interaction between an individual’s biological predisposition and the environmental influences that he encounters during his life. The original form of Eysenck’s theory relies heavily on the work of Pavlov (1927) and Hull (1943). The ease and stability with which an individual forms conditioned responses is considered to be related to the balance between excitation (activation) and inhibition (dampening down) processes within the central nervous system. The learning of stimulus-response connections is favoured by a strong and rapid build-up of excitation in the nervous system and a tendency for inhibition to develop slowly and weakly. Introverts are considered to have inherited such a nervous system and are, therefore, capable of strong and rapid conditioning. Extraverts, on the other hand, are considered to form conditioned responses slowly and weakly.

The physiological basis for this difference in condition-ability has been related to the functions of the Reticular Activating System (RAS) in the brain. The main function of the RAS appears to be to maintain the individual in an optimum state of “arousal” or alertness. In addition to the activation role of the RAS it also has an inhibitory or dampening function. Claridge (1967) could find no simple relationship between levels of Extraversion and Neuroticism and psychological arousal: however, there did appear to be a complex interrelationship between arousal and an individual’s position on the two dimensions. Thus introverted neurotics appear to be more highly aroused than less introverted and less neurotic patients.

Emotionality or neuroticism is related to the reactivity of the autonomous nervous system. Individuals with more labile autonomous nervous system are liable to respond strongly to unpleasant or frightening experiences by increases in heart-rate, muscle tension, sweat-gland activity and so on. Individuals high oeuroticism will tend to have low threshold of emotional arousal. This will lead to the more frequent activation of their autonomous nervous system which in turn will trigger the RAS. Thus the RAS will be more often in a state of arousal for individuals with high scores of neuroticism. This means that such individuals will tend to resemble introverts who are generally more “aroused” than extraverts.

The biological aspects of the theory attempt to lay the basis for the assumed differences in conditionability of Introverts and Extraverts. However, not all studies of conditioning have found the expected differences between Introverts and Extraverts, viz. that Introverts condition more easily and stably than Extraverts. There are a number of important inconsistencies in the research findings and it has not always proved possible to replicate experiments. In addition, the theory cannot accommodate some of the established facts about conditioning without ad hoc assumptions. Brody (1972) concludes, that “it might be reasonable to suggest that the relationship between introversion and extraversion and conditioning is not clearly understood”.

This lack of clarity inevitably raises fundamental doubts about Eysenck’s subsequent theorizing on the socialization process and the development of neurosis, since it rests very largely on the assumed differences in conditionability of Introverts and Extraverts.

 

Theories of personality are different, that’s why it is practically impossible to use the word “personality” in conceptual meaning. Psychology has not a single meaning – there are so many meanings, as many psychologists and theories of personality, which decide such task.

Psychodynamic approach in the theory of personality.

The worked out by Z. Freud theory of personality shocked that time understanding, because it showed human being not as a homo sapiens, who understands his own behavior, but as a creature in conflict, the roots of which are in the sphere of unconsciousness. Freud was the first, who characterized mind as the field of battle between uncompromising instincts, reason and consciousness.

Psychoanalytic theory of Freud is a good example of psychodynamic approach. Dynamic means, that the human behavior is determined and unconscious psychological processes have big meaning in human behavior regulation.

Topographic model of conscious level.

First of all lets look through Freud’s opinion concerning psycho organization, that is topographic model. According to this model there are three levels of psychics: consciousness, pre-consciousness and unconsciousness.

The level of consciousness consists of sensations and experiences, which are realized at that moment. Consciousness has a little percentage of the whole information, which is in the brain, and which goes down to the field of pre-consciousness and unconsciousness according to switching of attention over to other signals. The field of pre-consciousness (the field available memory) includes the experience, which is not needed right now, but it is able to come back into consciousness spontaneously or without any efforts. Pre-consciousness is a bridge between a conscious and unconscious fields of psychics.

The deepest field of mind is unconsciousness. It is a treasure of primitive instinctive drives, emotions and memories, which were repressed out of consciousness because of many reasons. The field of unconsciousness defines our everyday functioning in many ways.

The structure of personality.

 

 

At the beginning of the 20^th Freud reviewed his conceptual model of psychic and introduced into the anatomy of personality 3 main structures: Id, Ego and Superego. It was called a structural model of personality. Freud considered them processes rather structures. He paid a great attention to its division: ”Psychoanalytic theory begins there”.

The term “Id” comes from Latin “id” and means primitive, instinctive and inherited aspects of personality (sleeping, eating, defecation, copulation). It also feels our behavior with energy. Id has its central significance for individual during all his life. If doesn’t have any limits, it is chaotic. As it is primary (initial) structure of psychics, id expresses primary principle of human life – immediate discharge of psychic energy, storage of which leads to the tension in personal functioning. This discharge was called the principle of pleasure. According to this principle, Id can be dangerous for individual and society. Id also plays a role of intermediary between somatic and psychic processes. Freud described two processes by which Id release the personality from tension: reflex actions (for example, the cough in response to breathing ways irritation) and initial processes (which form psychic images, which are connected with basic needs’ satisfaction). The initial processes are illogic, irrational form of human imagination. It is characterized by impossibility to suppress impulses and to differentiate real and unreal. Behavioral expression as the initial process can lead to the individuals’ death if outer source of satisfaction of needs are not available. For example, infants cannot store forward the initial needs satisfaction. And only after realizing of outer world existence the ability to put forward the satisfaction of these needs appears. After the appearance of this knowledge the next structure Ego comes into existence.

Ego (from Latin I) is a component of psychic apparatus, which is responsible for making the decision. With the aim of reorganization and realization of needs in a social context Ego takes from Id some energy, ensuring the security and self-protection of organism. It use the strategies of understanding and realizing to satisfy desires and needs of Id. Ego in its functioning is ruled by the principle of reality. The task of it is to save the organism integrity by putting forward satisfaction till the finding the possibility of its discharge or corresponding circumstances of environment. Ego was called by Freud the secondary process.

The appearance of the term “Superego” can be demonstrated by the words from the lecture about psychoanalysis, where Freud noted: ”I” can take itself as the object, to treat with itself like with other objects, observe itself. So, “I” can be parted, it can be parted in some of its functions, at least for the some period of time. It can be said, that the special instance, which I begin to identify in “I” is morality. But it will be more accurately to consider this instance independent. Morality can be one of the functions of “I” and self-observation is the other one.

So, Superego is the last component of developing personality, it means functional system of values, norms and ethics, which are co-existent with that, accepted in the individuals outer world. Superego, as the moral-ethic force of personality, is the result of the prolonged dependence from parents. The social environment (school, class-masters) takes the function of development of superego further.

 Superego is divided into some subsystems: morality and Ego-ideal. The morality is developed after parents’ penalty. It includes the ability to critical self-estimation, the existence of moral prohibitions and the appearing the sense of guilty in child. Encouraging aspect of Super-ego is Ego-ideal. It is based on the positive parents’ estimation and leads the individual to making high standards. Super-ego is considered to be fully formed in the case, when parents’ control is changed by self-control. It is important that the principle of self-control doesn’t serve the principle of reality: Super-ego leads the person to the improvement in his mind, words and actions, trying to make sure Ego that idealistic ideas are better than realistic ones.

 

 

The moving forces of behavior.

Instincts were called by Freud the moving forces of behavior: they are the psychic images of bodily needs, which were displayed as the desires. Giving for example the law of energy saving he formulated, that the neuro-physiological state of excitation is the source of psychic energy. Every person has limited quantity of such energy and the task of any form of behavior is to remove tension, which was caused by the accumulation of such energy at one place. Thus, the motivation of a person is based on the excitation energy, which was formed by bodily needs. The number of instincts is not limited. But Freud divided them into two groups: the instincts of life and instincts of death.

The first group of instincts (Eros) includes the forces, which serve to keeping on of vitally important processes and multiplication of species. It’s known, that Freud considered sexual instinct one of the most important; the energy of this instinct was called Libido (libido energy), the term is used for defining of vital instant energy in a whole. Libido may find discharge only in sexual behavior. But as sexual instincts are different, Freud supposed, that every instinct is connected with a definite part of the body: that is erogene zone. There are four such zones: the mouth, anus and genitalies.

The second group of instincts (the instinct of death) – Tanatos – is the base of destructive behavior: aggressiveness, cruelty, killings and suicide.   

 The every instinct has four features: the source, the aim, the object and stimulus.

The source is the state of organism, or the need, which courses this state.

The aim is in the removing and reduction of excitation.

The object means any person, object or thing in the environment or in the body of the individual, who has the aim of instinct.

The stimulus is a quantity of energy, which is necessary for the reaching of the aim, instinct satisfaction.

  For the understanding the instinct energy dynamics and its displaying during the choice of object is the term “activeness shifting”. According to this concept the releasing of energy takes place thanks to the behavioral activeness changing. The shifting activeness can be observed in the case, when the object choice is impossible because of some reason. Such shifting is in the base of creativity or home conflicts because of the professional problems. Freud suppose, that many social-psychological phenomena could be realized (understood) in the context of two primary instinct shifting: sexual and aggressive.

  Psychological stages of personality development.

   One of the ideas of psychodynamic theory is the following: a person comes to the world (is born) with a definite quantity of libido, which has in its own development a few stages, which are called psychosexual stages of development. Psychosexual development has its own unchangeable order; it is a characteristic feature of all people with different types of culture. Freud introduced hypothesis about four stages: oral, anal, phallic and genital. Analyzing these stages the following factors, introduced by Freud, should be mentioned: frustration, hyper-surveillance, regression, fixation. In the case of frustration psychosexual needs of the child are suppressed by the parents or teachers, that’s why they do not get optimal satisfaction. In the case of super-surveillance the child is not able to govern by his own inner functions, this can lead to “final” behavior, which is connected with the stage, where frustration or hyper-surveillance took place. Regression is returning to the earliest stage and the displaying of the child’ behavior, which is characteristic feature to this period. Finally, fixation is retardation of development at the definite stage.

   

 

Let’s look through the stages of psychosexual development in detail.

Oral stage lasts from the birth till 18 months. In this period the child depends from his parents and his mouth is the area of pleasant sensations and his biological needs satisfaction. Freud supposed, that the mouth is an important erogene zone during the whole life of the man. Oral stage is over after the finishing of breast feeding. Freud proposed two types of personality while fixating at this stage: oral-passive and oral-aggressive. Oral-passive is merry and optimistic, he/she expects maternal attitude to himself, he is characterized by passiveness, trusting, immaturity, extensive dependence. Oral-aggressive has the following features: he/she likes to argue, he is pessimistic and is characterized by cynic attitude to others. This type likes to use other people, to be dominant over them in order to satisfy his/her needs.

 Anal stage comes at the age of 18 months and lasts till 3 years old. During this period children get satisfaction from keeping or pushing out their faecales. During this stage of training to use child’s pot the child tries to differentiate the needs of Id (immediate defecation satisfaction) and social limits of their parents (self control of their needs). In Freud’s opinion all future forms of self control and self regulation begins at this stage. As the result of frustration at this period the formation of anal-retention personality type is possible (in mature age he/she is very methodical, punctual and obstinate and greedy. The second result of such anal fixation is anal-expulsive type (this type tends to destroying, agitation, impulsiveness, sometimes cruelty).

At the age of 3-6 years the interests, which are conditioned by libido, are shifted to the genital zone. During the phallic phase of psychosexual development children may investigate their genitals, masturbate and show their interest to the questions about birth or sexual intercourse.   

    In Freuds opinion, children doesn’t have distinct knowledge about sexual intercourse and accept it as aggressive action of their fathers to their mothers. The main conflict at this stage in boys is called Oedipus’s complex, in girls – Electra’s complex. The essence of these complexes is in unconscious desire of every child to possess one of the parents of the opposite sex and to remove one of the parents of the same sex.

  Such complexes are developing in boys and girls in different ways. As for the boys: from the moment of their birth the main source of satisfaction is their mother. A boy wants to posses his mother, to show his erotic feelings like adults. At the same time he percepts his father as a barrier to get of genital satisfaction. Because of the conflict with his father a boy understands that his father has negative reaction to the boys romantic feeling towards his mother, as a result may have the feeling of revenge and the fear of castration appears. It makes him get rid incest desire to his mother. Oedipus’s complex resolution begins about at the age of 5-7 years, a boy begins top suppress his sexual desire and begins to identify himself with his father. A child gets moral norms and models of sexual behavior. A boy may keep his mother by substitution because he has the same qualities as his father has. The main moment is in understanding of parents norms and taboo, which is in the base of the moral development (Super-ego).

  The same complex in girls is called Electra’s complex. At the beginning of the phallic stage a girl notices the absence of penis. It may symbolize the absence of strength, like in her brother or father. According to Freud, the girls have envy to penis, which is characterize iegative attitude to their mothers because she was born without penis. Some representatives of psychodynamic trend are not agree with such opinion, far example, Karen Horni. Yearning for their fathers is formed in the base of imagining him as the owner of such organ. Electra’s complex resolution in girls is like in boys – identification with the mother.

  Adult males with the fixation at the phallic stage are impudent, inclined to boasting, they are able to run a risk, to achieve success (symbolic victory aver parents), they have “don-huan” behavior. Phallic fixation in a woman leads to ability to flirt, seduce, to orderless sexual relationships, though they may seem naïve in sexual attitude.

  According to psychodynamic theory undecided complexes may lead to neurotic models of behavior.

  At the age of 6-7 years till the beginning of puberty period we have a stage of sexual still (latent period). According to Freud sexual instinct at this time is supposed to be in the “stage of sleeping”.

  The initial phase of genital stage (the period from adolescence till the death) is characterized by biochemical and physiological changes in organism. As the result the teenagers’ excitement and sexual activity are rather high. The beginning of genital stage is characterized by complete satisfaction of sexual instinct. Normal development leads to the choice of partner (wife or husband) and to the family formation.

  Genital character is an ideal type of personality in psychodynamic theory. The discharge of libido during the sexual intercourse gives the possibility of psychological control over impulses, which come from genitals. According to Freud, for formation of normal genital type of character a person should get rid from passiveness (which is characteristic for childhood, when al forms of satisfaction were easy to reach).

  The nature and types of anxiety.

Freud supposed, that anxiety was the function of Ego. Its task is in warning of the person about further danger in giving the possibility in dangerous situation to react properly. Psychodynamic theory has 3 types of anxiety, which depend on the source.

Realistic anxiety is an emotional response to the danger or understanding of outer world real danger. It has the function of self-preservation.

Neurotic anxiety is an emotional response to the danger of unacceptable impulses from Id will be conscious. Neurotic anxiety initially felt as realistic, but if Id can pass through the control of Ego, neurotic anxiety appears.

Moral anxiety is response to the danger from the punishment of Ego by Superego. Moral anxiety appears when Id tries to express actively unmoral minds or actions, Superego has the feeling of guilty and shy in response.

 Protective mechanisms of Ego.

The main function of anxiety is in avoiding of unpleasant instinctive impulses expressing and in encouragement of their satisfaction in an appropriative form and time. Protective mechanisms help to put this function into practice. In Freud’s opinion, Ego reacts on the thread Id’s impulse realize in two ways: 1) blocking of impulses expressing in conscious behavior; 2) distortion impulses in order to reduce or incline their intensity.

 

Here we have the following main protective strategies:

Repression is the initial Ego’s protection because it has the shortest way to avoid anxiety. It is also the basis to forming more complicated mechanisms. Repression or “motivated forgetting” is a process of removing of feelings and minds out of consciousness, which bring suffer.

Projection is the process, when an individual sticks his own unacceptable minds, feelings to another people, and such individual do not accept such feelings for themselves. Different social prejudices and phenomenon like “scapegoat” could be explained by projection because ethical and racial stereotypes are good target for its expression.

Replacing (substitution) takes place, when the expression of instinctive impulses comes from more dangerous object to the object, which is less dangerous.

Rationalization is the way to pass through frustration and anxiety by the distortion of reality. Rationalization is like false argumentation, thanks to which irrational behavior looks rational.

Reactive formation has two stages: 1) unacceptable impulse is suppressed, 2) then as the result we have an opposite impulse in consciousness. Freud suggested, that a lot of males, who made fun of homosexuals, were trying to protect themselves from their own homosexual impulses.

Regression is a process when adult people come back to their childhood models of behavior. This is the way to reduce anxiety by returning to the early period of life (not dangerous, pleasant).

Negation comes, when a person doesn’t want to accept the unpleasant fact, which happened to him. Negation is mostly typical for children and older individuals with not high intellectual level.

Sublimation as a mechanism of protection gives a possibility to change impulses with the aim of adaptation, in the way they could be expressed through socially adapted thoughts and actions. Sublimation is considered to be the only constructive strategy of unaccepted impulses restraining.

  All protective mechanisms of Ego distort the picture of our needs, that’s why Ego loses energy and flexibility. According to Freud genesis of serious psychological problems is in reality distortion.

  Conclusion.

So, psychoanalytic theory of Freud is a good example of psychodynamic approach to investigation of human behavior. According to this theory human behavior is determined, it depends on inner psychological conflicts. Such theory considers a person as a whole. Freud was attached to the idea of invariability, he believed, that the personality of adult person was formed from the childhood experience. To his mind, all changes in the behavior of an adult person are not deep, they do not touch the changes of personality structure. Human behavior is regulated by the aspiration for reducing unpleasant excitement, which appears on the level of organism with the appearing of outer irritator. Freud’s personality theory is fundamental for psychoanalytic therapy, which is popular nowadays.

 

 

The inner picture of the disease. The attitude of the patients to their disease.

 

Any illness in one way or another to change the vital functions of the body and therefore affects the physical and mental condition of man. In turn, changes the functioning of mind leads to modification of certain disease manifestations. That is clearly shown by the mutual influences and mental illness. Track major ones for each sphere of mental activity.

 

Illness and emotional-volitional sphere.

Any pathological condition affects appropriately with emotions, feelings and motivation sphere of the patient. Mostly cause serious disease in a patient state anxiety and fear, which can sometimes reach the level of despair and panic. Prolonged illness accompanied by depression, which can transform itself in apathy 

Typically, the listed types of emotional vidreahuvannya disease combined with the general phenomena astenizatsiyi. As a result, patients have the following main syndromes of mental vidreahuvannya the presence of somatic pathology. 

1. Astheno-depressive syndrome (on the background of the patient astenizatsiyi 
concerned about the decline of mood, longing, discontent with their condition, Perceptions that); 

2.Asteno-fobichnyy syndrome (a combination of events and astenizatsiyi clearly defined fears, such as kardiofobiyi);

3.Asteno-anxiety syndrome (astenizatsiyi phenomena connected to anxiety and unpleasant foreboding that do not have a clearly defined content);

4.Asteno-hypochondriac (sick in your mind exaggerating the severity of their disease, finds himself condemned or virtually incurable, carefully fixing his attention on painful feelings and hypertrophy of their value);

5.Asteno-neurotic (astenizatsiyi observed on the background of emotional lability-willed).

 

 

Psychology of the patient

 

Objectives. To study psychological aspects of the medical process, The inner picture of the disease. The attitude of the patients to their disease. Psychological peculiarities of patients with different diseases.

The plan

1.     The inner picture of the disease.

2.     The attitude of the patients to their disease.

– Normal.

– Scornful

– Denying

– Nosophobic

– Hypochondriac.

– Nosophilic.

–  Utilitarian

3.     Aggravation, simulation, dissimulation.

4.     Psychological types of doctors.Types of nurses.

5.     Medical deontology Iatrogenies, types of iatrogeny

6.     Psychological peculiarities of patients with different diseases.

 

The process of treatment of every disease is accompanied by a number of psychological phenomena closely connected with the personality of the patient and the doctor, as well as the applied therapeutic methods which produce both the positive and (sometimes) negative effects. Consideration of the psychological factors in the medical process makes it possible to obtain a more profound assessment for the efficacy of the therapy and prognosis. Assessment of the therapeutic dynamics in the somatic, psychological and social planes should be regarded as the most adequate one.

Organizing the medical process, it is important to take into account the attitude of each particular patient to his disease, this attitude being significantly dependent on the inner picture of the disease, i.e. a complex of feelings and sensations of the patient, his emotional and intellectual responses to the disease and its treatment. The inner picture of the disease does not consist only of the subjective complaints of the patient, but also includes his emotional and intellectual attitude dependent upon the personality peculiarities, the general cultural level, the social medium and upbringing. The attitude of the patients to their disease may be as follows.

1. Normal, i.e. corresponding to the patient’s state or the information given to him about the disease.

2. Scornful, when the patient underestimates the severity of his disease, is not treated and does not take any care of himself, as well as demonstrates ungrounded optimism with respect to the prognosis of the disease.

3. Denying, when the patient «does not pay attention to the disease», does not take medical advice, fights back any thoughts on his disease and reasonings about it; it also includes dissimulation.

4. Nosophobic, when the patient is disproportionately afraid of the disease, undergoes repeated examinations, changes his doctors; to a greater or less degree he understands that his fears are exaggerated but cannot fight them.

5. Hypochondriac, when the patient guesses or is sure that he suffers from a severe disease, or when he overestimates the severity of some less serious disease.

Nosophilic, connected with some calming and pleasant sensations during the disease; it proceeds from the fact that the patient should not perform his duties, the children can play and dream, the adults can read or be engaged in some of their hobbies; the family is attentive to the patient and takes more care of him.

7. Utilitarian, which is the highest manifestation of the nosophilic response. It can have a triple motivation:

a) receiving of sympathy, attention and a better examination;

b) finding a way out of some unpleasant situation, as, for instance, imprisonment, military service, hated work, obligation to pay alimony;

c)  receiving of material benefits: pension, vacation, free time which can be also used with some economic benefit.

The utilitarian response can be more or less deliberate; it may be based on some slight or severe disease, but sometimes is observed even in a healthy person.

The utilitarian response can be manifested with different forms of the patients’ behaviour: aggravation, simulation and dissimulation.

Aggravation is exaggeration of signs of the disease and subjective complaints. This exaggeration can be completely deliberate, but sometimes is rather caused by emotional motives of a deeper origin, e.g. fear, distrust, feeling of solitude, hopelessness, suspect that the doctor does not believe him. Transitions from the deliberate aggravation to a less deliberate one are sometimes rather unostentatious, and in some cases even hardly perceptible.

Simulation is a pretence with the help of which a person tries to create an impression that there is a disease and its signs. It occurs less frequently than aggravation. As a rule, it is used only by very primitive persons in whom its revealing can be relatively easy, or, on the contrary, by well-experienced, pushful and irresponsible persons. A great risk for the malingerer is incurred by the fact that he strives for a certain benefit, this aim being revealed sooner or later. If he does not reach his aim, e.g. receives a pension promising him a well-to-do life with a possibility to earn extra money, this circumstance cannot be concealed from surrounding people and revision of the case will put an end to the simulation. The doctor should not be in a hurry to make a conclusion about simulation until he absolutely makes sure that his suspicions are correct. In this case, a less experienced doctor must always consult his more experienced colleague. Substantiation and argumentation of simulation are particularly important in case of drawing a written conclusion about it. Substitution of the wording “a deliberate production of signs” or “an attempt of a deliberate affected representation of a disease” for the word “simulation” in a medical conclusion is more expedient.

Dissimulation means concealing of the disease and its signs. It often occurs in psychiatry in cases of psychoses. As far as other patients are concerned, it is mainly observed in the diseases resulting in some objective or subjective disadvantages for the patient, e.g.: in tuberculosis it is a prolonged staying at a sanatorium, syphilis is accompanied by notification about the disease and revealing of the focus of the infection, surgery is fraught with a possible operation. The greater is the extent of saving the patient from the fear of the forthcoming examination, treatment and consequences of the disease, the more successful is prevention of dissimulation.