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N.I. RASPOPOVA1, M. SH. JAMANTAYEVA2
S.D. Asfendiyarov Kazach National Medical University 1 - department of psychiatry, psychotherapy and narcology, 2 - department of internship and residency in psychiatry and narcology.
SOME ASPECTS OF AGGRESSION AND AGGRESSIVE BEHAVIOR
The paper presents problems of the theory, definition and classification of aggression. It describes pathopsychological aspects of formation and implementation of criminal aggressive behavior, as well as the impact of social and subjective factors. Keywords: aggression, aggressive criminal behavior, pathopsychological aspects.
The increase in acts of violence and aggression in different parts of the globe, a series of brutal, cynical terrorist acts that occurred in France in November 2015 are evidence of escalated of aggression in many different ways.
The problem of aggressive behavior of people attracted attention of scientists all over the world.
Today's world has become dangerous in many ways. Technology development of civilization has brought to revision human values and ideals, which used to serve limiting devise for aggressive excesses and promoting regulation of human relations. Now the restricting limits of ethics and spirituality have lost their former meaning. Only law- enforcement agencies hold in check their destructive impulses, though which is not always effectual. Aggressive manifestations bringing to publicly- dangerous acts committed by individuals with mental disorders are most important problems of general and forensic psychiatry, first of all concerning preventive measures of similar actions. It is necessary to analyze psychopathological, motivational aspects of individual's behavior in order to justify measures to prevent aggression. It is essential to evaluate the role of macro and micro social factors, influencing the individual's publicly dangerous acts.
Taking into account a rapid upward tendency in grave crimes against personality's life and health, studying the problem seems particularly topical.
Aggressiveness has been at all times an important social element of human existence, in fact, it has often been a serious problem for a person. Most human misfortunes are the suffering of the victims of aggression. People got inherited a penchant for aggressive, predatory behavior from the ancestors. Distant ancestors had been engaged in conquering new territory, getting free access to richer sources, controlling the greatest number of community members and disposing of food and drink. All this was more or less successfully carried out. People vary greatly in the degree of propensity to aggression. The strength, direction and duration of aggressive manifestations depend on a whole range of psychological, physiological and situational factors. But at the heart of any aggression there is conflict, conscious or unconscious, fleeting or protracted. Essentially, any aggression is nothing but a manifestation of active, energetic dissatisfaction of man with the conditions of life, with the relatives or man himself. Aggression is not always to be understood as something purely negative, destructive and opposing harmony of life. Aggression, along with the damaging phenomenon, has a positive constructive and creative aspect. Constructive aggression is characterized by active movement of psychobiological energy aimed at a particular type of activity. A person burdened with a definite charge of aggressive activity, invariably suffers from it himself, and to a large extent. Especially dangerous in today's world is the fact that aggressive behavior is often connected with the so-called deficit motivation, determined by the lack or absence of any desirable objects and states. Most often aggression comes to light when a person being unable to intellectually solve his problem, in fury seeks to destroy the obstacle instead of working around or any way overcoming the difficulty on his path.
Essential to understanding the problem of aggressive behavior is definition of the concepts. Aggressiveness should be singled out as a trait of character attributed to a personality, a feature of individual's disposition conditioned by biological constitutional particularities. It has important evolutionary significance for the survival of the species. Aggressiveness is under control of consciousness and moral and ethical norms. In addition,
aggressiveness is also a personality trait that is manifesting itself in the readiness to aggressive perception and corresponding interpretation of other individual's behavior, concerning only human relations.
On the other hand, there is aggression based on aggressiveness aimed at causing physical, moral or other damage to people or other objects of the surrounding world. This type of aggression is defined differently, but in general the definitions correspond to the above mentioned definition. It is referred to as motivated destructive behavior which contradicts the norms and rules of human existence in society, and which does harm to the objects of attack. This definition stresses the negative and often illegal side of aggression.
A broader definition of aggression was given by Shwab et al., 1976 [1]. The authors define aggression as specifically oriented behavior aimed at eliminating or overcoming all that threatens the physical and (or) mental integrity of the organism. It is obvious that this definition covers not only human behavior, but all living beings in general.
Erich Fromm distinguished between "benign aggression" i.e. determined by self-defense, a response to the threat and "malignant aggression", destructive, up to necrophilia, aimed at domination over other living beings and destruction [2]. Constructive, destructive and deficitary forms of aggression have been described by Günter Ammon. Under constructive aggression he understood social acceptability of aggression, the individual's ability to resist harmful influences. Destructive aggression is a violation of moral and ethical standards, fracture and deformation of relationships with others. Deficitary aggression is characterized by actions with flawed development of behavioral skills, which contribute to easy implementation of aggressive intentions.
Y.M.Antonian and W. W. Gulden, 1992, think that aggression as a psychological phenomenon is neutral; it can take a socially acceptable form, such as in sports; and a form which is socially disapproved of, including criminal, depending on the situation and public forms [3].
However, many problems of the theory of aggression have not been solved yet, diagnostic aspects of aggressiveness have not been sufficiently worked out. B. V. Zeigarnik (1980, 1982) has repeatedly emphasized that the study of disrupted mental processes allows one to discover things usually hidden in the norm from researchers [5, 6]. Thus, research work in the field of psychopathology can provide an insight into the mechanisms controlling the psyche, human behavior and in particular into the phenomena of his aggressiveness. From the perspective of psychopathology aggressive behavior is regarded as:
1) Targeted, though there are also many problems, such as aggressive acts can only be of a symbolic nature.
2) Contrary to the norms and rules of human coexistence in society.
3) Prejudicial to the objects of the attack. It is obvious that harm is an ethic category; consequently it is necessary to involve joint team approach of various disciplines.
4) Causing physical damage to people and causing them psychological discomfort.
Aggressive actions serve as: a) means of achieving significant goals (instrumental aggression); b) method of mental discharge, replacement of the blocked meet requirements and switching the activity; c) a way to meet the need in self-realization and self-affirmation [7].
Using various classifications, some authors identify the following types of aggression: intentional and unintentional. A. S. Feshbach,
Heckhausen H. divided intentional aggression into expressive, hostile and instrumental [8, 9]. Expressive aggression is an involuntary burst of rage and anger, focused and fast ending. The source of frustration is not necessarily being attacked. Hostile aggression is aimed at doing harm. Instrumental aggression is aimed at achieving neutral goal, while aggression is used as a tool.
A. Bass singles out direct aggression, always aimed directly against the person, and indirectly, causing harm by destroying the object of aggression related items or through other persons [10]. A. Bass suggests distinguishing between aggression and hostility. The latter is understood as a verbal reaction developing negative feelings and evaluation of people and events. Verbal aggressive reactions are divided in turn into 3 following types:
1) rejection (reaction of the type "go away"),
2) hostile comments ("I hate you"),
3) criticism that can be directed not just against individuals, but against the objects belonging to the individual, against the work carried out by the individual.
K. Izard (1980) defines hostility as a complex form of affective cognitive orientation, consisting of a set of emotions, instincts, cognitive structures [11]. Hostility, in his opinion, does not include verbal or physical activity. Aggression is a hostile action or behavior, i.e., a physical act. Therefore, animosity is motivational state, while aggression is behavior proceeding from hostility.
We believe that an undisputed manifestation of aggression, based on the above mentioned definition, is murder, an intentional killing of another person. Premeditated murder among the crimes against the person makes up 12-13%. The rate of growth of such crimes in the world in recent years has reached 17%, their character and structure have also changed. More murders (every 10th) were committed by women or with their participation. There increased the number of murders by "the order", for the purpose of taking possession of money and property, in clashes between criminal gangs and ethnic conflicts. There increased the number of murders as a result of terrorist acts. Many murders, including serial, were committed through sexual offences, with a great number of victims. The last circumstance is certain evidence that such dangerous crimes can hardly be prevented and disclosed.
The search for the causes of committing murders should focus primarily on identifying factors of subjective nature, or the so-called intrapersonal causes. Numerous studies of the personality, behavior and life of killers showed that their distinctive feature is constant, exhausting emotional tenseness, desperate anxiety passing into fear of death.
Anxiety is a subjective feeling of self-deprivation, which objectively cannot be. The alarm signal can come not only from the external environment, but also from one's own body and self. The signal warns of the danger and makes him search and specify the danger, actively study reality, including him in order to defect the source of the threat. Anxiety is very diffusive and indefinable, it paralyzes the mind and frustrates behavior. The threat to biological and social existence makes anxious individuals able to overcome any moral obstacles and fear of the severest punishment. One can say that a person, who constantly feels the need to defend himself, is ready for anything. Therefore, aggression, often fatal, is protection of the individual's status, and sometimes life when he feels the threat. Hence anxious people are vulnerable and sensitive, especially in the area of interpersonal and intimate relationships. Their emotiveness is connected with a tendency to frequent changes of mood. The emotive component of murders is mostly caused by rigidity, lack of agility, "stuck" emotions, affective experiences. Emotional memory of the killers keeps the previously received impression for a long period of time, although the actual events had remained in the past. Therefore, emotional experiences begin to paint some other events having nothing to do with the previous
event, as a result perception of reality is distorted, which is ascribed to unusual features and trends.
This can explain murders by persons who experienced psychological trauma in the distant past. Subjective meaning of such actions is psychological compensation for once caused personal damage in the achievement of self-awareness and self-affirmation. An extreme version of such acts is violence against children. Long-standing bitter resentment, a forgotten past for many years seemingly pressed back to the sphere of the unconsciousness now become effective. Connection of hypersensitivity with persistence and "stuck" emotions can serve as the basis for assumption that before the current situation, a serious threat had arisen to this person. A vague undefined and, of course, entirely unconscious anxiety or fear about situations with existence threatening character had already been formed by that time. Situations of this nature and significance can cause a destructive reaction. Rigid and affective painted experiences connected with the past make it reasonable to believe that deep anxiety appeared in the past. Such traits typical of killers as suspiciousness, hypochondria, rancor, and protective aggressiveness have become understandable. Suspiciousness of killers acts as a continual expectation of an attack from outside and readiness to resist it, although fears have no real grounds for it. Suspiciousness occurs to these people by the mechanism of projection, i.e. ascribing to the external environment features characteristic of you. Because heightened anxiety of killers is largely a consequence of feelings of threat to their existence, a real willingness occurs to defend it. Protective aggressiveness can be interpreted as protection in content and aggressiveness in form, importantly, it is in defense, of individual's existence, protection against anything which casts doubt on his existence, and threatens him.
This kind of diffuse anxiety, characteristic of killers is very much typical of persons with mental disabilities, starting with mental abnormalities and personality disorders to delusional phenomena, when the pressing thing is not a cause for alarm, but fear for his life ("the pursued pursuers").
There is most likely murder if a subject constantly experiences unsocialized fear of death, which should be considered as the highest point of anxiety. On the whole, high level of anxiety is observed among all violent offenders with mental abnormalities. Among the motives of killings can be the following:
6) revenge, including those related to ensuring perceptions of fairness or jealousy, and revenge as an attribute of culture;
7) establishment in the eyes of the immediate environment and in their own eyes, self-assertion securing;
8) destruction of the source of severe psychotrauma, including childhood and adolescent_experiences, with the protection of one's own biological and social status;
9) dominating the environment, usually determined by the need of reducing anxiety and removing fear of death;
10) necrophilous bent for death, murder for the sake of murder.
These are basic motives that can be found in various combinations and separately. They can express themselves when committing different types of crimes. For example, murder with robbery and burglary can be determined by the same motives of self-affirmation. Of course there are no specific criminal motives, i.e. motives that lead only to murders and other crimes, and not to any other forms of behavior.
Thus, aggressive behavior can occur in people both mentally healthy and those detecting mental disorders. Significant influence on the formation of aggressive behavior and implementation of aggression can have subjective factors, as well as mechanisms regulating psyche, human behavior, and in particular, one's aggressiveness.
Summary: The paper presents problems of the theory, definition and classification of aggression. It describes pathopsychological aspects of formation and implementation of criminal aggressive behavior, as well as the impact of social and subjective factors.
вестник™/^»
REFERENCES
1 Shwab J. et al. Цитируется по: Дмитриева Т.Б., Шостакович Б.В., Агрессивное поведение лиц с психическими расстройствами (диагностика, судебно-психиатрическая экспертиза, профилактика) - М.: 2000. - 28с.
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Н.И. РАСПОПОВА, М.Ш. ЖАМАНТАЕВА
АГРЕССИЯ ЖЭНЕ АГРЕССИВТ1 ЖYРIС-Т¥РЫСТЫH, КЕЙБ1Р АСПЕКТТЕР1
tywh: Аталмыш ецбекте агрессияныц теориялы; ,дефиниция жэне жштелушщ мэселелерi ;арастырылган.Кылмыстык; агрессивт журк-турыстыц тузшу1 жэне кке асуыныц патопсихологиялы; аспектерi суреттелген , жэнеде элеуметтiк жэне субъективт факторлардыц эсерi ;арастырылган.
ТYЙiндi сездер: агрессия, агрессивтi ;ылмысты; ЖYрiс-T¥рыс, патопсихологиялы; аспекттер.
Н.И. РАСПОПОВА, М.Ш. ДЖАМАНТАЕВА
НЕКОТОРЫЕ АСПЕКТЫ АГРЕССИИ И АГРЕССИВНОГО ПОВЕДЕНИЯ
Резюме: В работе изложены вопросы теории, дефиниции и классификации агрессии. Описаны патопсихологические аспекты формирования и реализации криминального агрессивного поведения, а также влияние социальных и субъективных факторов. Ключевые слова: агрессия, агрессивное криминальное поведение, патопсихологические аспекты.
УДК 616.133.33:616.12-008.331.1]-08
Ш.А. ТЕМИРКУЛОВА1, Г.Ж.САДЫРХАНОВА1,,С.К.СЕИЛЬХАНОВА2, М.Т.ДАЙРБЕКОВ2
1Международный казахско-турецкийуниверситет имениХА.Ясави. Кафедра терапии, 2ШГБСМП вр.ЭКГфункционалист, вр.невролог. г.Шымкент
ЭФФЕКТИВНОСТЬ КОМПЛЕКСНОЙ ЦИТОПРОТЕКТОРНОЙ ТЕРАПИИ У БОЛЬНЫХ С ЦЕРЕБРОВАСКУЛЯРНОЙ
БОЛЕЗНЬЮ И СОПУТСТВУЮЩЕЙ АГ
Эпидемиологическую и демографическую ситуацию в мире по цереброваскулярным заболеваниям (ЦВЗ) характеризует частая их распространенность среди населения и увеличение прогрессирующих форм, их «омоложение», в связи с ростом экстремальных факторов и воздействий [1,2]. Исследования достоверно подтверждают положительное влияние Цитофлавина на основные показатели суточного мониторирования артериального давления (СМАД), уменьшение вариабельности АД. Цитофлавин эффективен в комплексном лечении больных с ЦВЗ, ассоциированной с АГ[2,3].
Ключевые слова: цереброваскулярная болезнь, цитофлавин, нейропротекция, суточное мониторирование.
Цереброваскулярные изменения, приводящие к острым и хроническим формам недостаточности кровообращения в сосудах головного мозга со временем ложатся бременем не только в клинической практике, но и на общество в целом [1]. В связи с ростом экстремальных факторов и различных воздействий на человека растет количество хронической ишемии головного мозга, составляя не менее 700 на 100000 населения. Прогрессирующая хроническая ишемия мозга, приводящая к острым нарушениям мозгового кровообращения, являются в настоящее время ведущими причинами инвалидизации [1,2]. Эпидемиологическую и демографическую ситуацию в мире по цереброваскулярной патологии характеризует повсеместная распространенность этой патологии, «постарение» населения и увеличение прогрессирующих цереброваскулярных заболеваний, их «омоложение» [6].
Несмотря на многообразие причин, вызывающих ишемию сосудов головного мозга, в основе патогенеза поражения церебральных структур лежит нарушения регионарного церебрального и системного кровотока, приводящее к снижению оксигенации тканей мозга Эти процессы в свою очередь приводят к деструкции мембран нейронов и глиальных
элементов. В результате этих гипоксических и ишемических расстройств происходит развитие первичной и прогрессирование вторичной церебральной ишемии, формирование лакунарных инфарктов и увеличение зон ишемических полутеней с сосудистыми поражениями мозга [2,3].
«Цитофлавин» является комплексным цитопротективным и антиоксидантным препаратом, состоящим из естественных метаболитов организма и витаминов, в его состав входят янтарная кислота, инозин, никотинамид, рибофлавина мононуклеотид натрия. Цитофлавин оказывает положительное влияние на энергетические процессы в клетке, тем самым способствуя уменьшению выработки свободных радикалов и выбросу трансмиттеров в условиях ишемии мозга.
АГ является значимым модифицируемым фактором риска развития как острого, так и хронического нарушения мозгового кровообращения, повышая вероятность развития инсульта в 4 раза. Длительно существующая артериальная гипертония протекает с тоническим сужением просвета сосудов, в дальнейшем прогрессируют структурные изменения в виде утолщения мышечной оболочки, фиброза и пролиферации соединительнотканных элементов сосудов.
