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Study levels of emotional empathy patients with relapse of opioid dependence
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Tursunhodzhaeva Lyudmila Alexandrovna, Head of the Department of Addiction and adolescent psychopathology of the Tashkent Institute of Postgraduate Education, Republic of Uzbekistan Muzaffarova Lily Zhavdatovna, Assistant, Department of Addiction and adolescent psychopathology of the Tashkent Institute of Postgraduate Education, Republic of Uzbekistan E-mail: evovision@bk.ru
Study levels of emotional empathy patients with relapse of opioid dependence
Abstract: Use the "Scale of emotional response» (Balanced Emotional Empathy Scale — BEES) studied the effect of empathy on the emotional level of social adaptation of persons dependent on opioids. Research has shown that in all patients a low level of emotional empathy, which can be seen as a barrier to the successful restoration of family and environmental links between drug addicts in therapeutic remission and impedes their social reinsertion.
Keywords: emotional empathy, relapse, opioid dependence.
The relevance of research of drug addiction [1]. Exploring the personality traits that facilitate
Numerous scientific studies show that the level of social adapta- or hinder its harmonious existence in all spheres of interaction with tion of persons dependent on opioids, is one of the most important the environment, we can successfully meet the challenges of coping factors influencing the stabilization of remission after discontinua- and adaptation of patients with opioid addiction [2; 3; 4]. This, in tion of the drug [5; 7]. Achieving the goals of social rehabilitation, turn, can serve as an additional resource for stabilizing and prolong-re-socialization and reintegration of patients into society substan- ing remission.
tially reduces the risk of recurrent disease [6]. In this connection, The purpose of research: the study of the influence of emo-
great interest is the study of social conditions and personality traits tional empathy to the level of social adaptation of persons dependent that contribute to or hinder the full social rehabilitation of patients on opioids. after therapeutic intervention performed. Material and methods
We have attempted to study the quality of the personality of In terms of Republican Drug Treatment Center (Tashkent) clini-
drug addicts, as emotional empathy, that is, the ability to empathize cal and follow-up method examined 51 male patient with the syn-with another person, the capacity for emotional response to the ex- drome of dependence on opioid drugs series (code ICD-10 F11.2). perience of other people in their daily lives. Studies have shown All patients had repeated (at least three) attempts to treat with
that empathy reflects the level of development of skills of interac- the emergence of drug relapse after a short-term remissions. The tion with other people, so it is closely related to social adaptation average age ofpatients at the time of the survey was 34.2 ± 5.9 years.
Section 6. Medical science
In 76.4 % of patients with prescription drug abuse of opioid number did not exceed 10 years. At the time of the survey, all patients have abused heroin. The study excluded people with comorbid mental disorders, polizavisimostyu from two or more psychoactive substances (code ICD-10 F19), as well as to stop taking opioids, but switched to the vicarious other substance misuse. Follow-up data were obtained on all patients in the period from one month to 3 years from the date of discharge from hospital.
Detailed analysis of the factors contributing to the failure of remission and the development of drug addiction relapses, possible to distinguish two groups of patients for comparative study:
- 1 group consisted of23 (45.1 %) patients who had relapses all ever observed in the dynamics of opiate addiction, there were mainly influenced by endogenous factors that are closely associated with the exacerbation of symptoms of dependence. These included spontaneous actualization irresistible craving for the drug, and affective disorders dissomnicheskie have a significant effect on the occurrence ofrelapse remission. These factors predominated in the development of relapses in patients with group 1, exerting a significant influence on the occurrence of failures in the early (up to 6 months) periods of remission.
- 2 group consisted of28 (54.9 %) patients who had relapses occurred, usually under the influence ofexternal conditions. This group of factors, conventionally referred to the category of exogenous, including adverse mikrosotsial environment, first of all, contact with drug addicts, family or business conflicts, the lack of employment in the presence of material prosperity. These factors are particularly important in the later (more than 6 months) periods of remission.
To study the emotional empathy to use the "Scale of emotional response" (Balanced Emotional Empathy Scale — BEES), developed by A. Mehrabian and modified H. Epstein [8]. This technique allows analyzing the overall empathic tendencies, the level of expression of ability to emotional response to the experience of the other person and the degree of compliance or noncompliance with the sign of emotional experience of the object and the subject of empathy. The questionnaire consisted of 25 closed-end judgment test assesses the extent of their agreement or disagreement with each of them. Scale assumes 4 answers — "I agree (always)", "most agree (often)", "rather disagree (rare)", "disagree (never)", which gives an opportunity to express shades of relationships to each communication situation. For every answer is charged from 1 to 4 points. Processing of the results is carried out using a special key. Overall score is calculated by adding up the points. The severity of the individual's ability to emotional response to other people's feelings (empathy) is determined by the conversion table "raw" scores to standard scores. empathy level was estimated as follows: 82-90 points — very high, 63-81 points — the highest, 37-62 points — normal, 36-12 points — the lowest, 11 points or less — is very low.
High levels of capacity for empathy are in inverse relation to aggressiveness and a tendency toward violence have a direct correlation with a flexible, compliant, willing to forgive others (but not himself), to carry out routine work.
People with normal levels of empathy in interpersonal relationships are more likely to judge others by their actions than to trust their personal impressions. They are usually well controlled by their own emotional expressions, but often find it difficult to predict the development of relations between people.
People with low levels of empathy in interpersonal relationships have difficulty in establishing contacts with people often do not find mutual understanding with others.
Results
The analysis showed that at the time of the survey the average prescription opiate abuse in patients of Group 1, where relapses were associated with endogenous factors, was less significant — 7.6 ± 2.6 years than in patients 2 group — 9.8 ± 5.3 years (P < 0.01), where relapse occurs predominantly under the influence of external conditions. Thus the patients in group 1 opioid dynamics were observed for at least 3 remission (mean 3.2) and not less than 4 relapses (mean 4.2), while the two groups ofpatients in remission multiplicity averaged 2.8, relapse — 3.8 (P < 0.01).
Despite the relatively smaller prescription opioid abuse in patients of Group 1 at the time of the survey reached more severe signs of social maladjustment. The proportion ofpatients who discontinued career significantly exceeded similar index in group 2 (31.6 % of patients of group 1 and 10.2 % of Group 2 patients, P < 0.001). The number of patients preserving their marital status, was much smaller than in group 2 (42.1 % of patients of group 1 and 71.4 % of patients Group 2; p < 0.003). Dominated by patients consisted divorced (50.9 % of patients of group 1 and 24.5 % of Group 2 patients; P < 0.01) with a relatively small specific gravity of patients had never married (7.0 % of patients of group 1 and 4.1 % of group 2 patients; P > 0.05).
The number of persons who have been convicted of offenses ofvarious kinds, also was higher among patients of group 1 (45.6 % of patients of group 1 and 24.5 % of Group 2 patients; P < 0.045). This applies, above all, torts related to drug trafficking (42.1 % of patients of group 1 and 14.3 % of Group 2 patients, P < 0.001). The offenses that are not related to the drug (hooliganism), relatively frequently committed group 2 patients (3.5 % of patients of group 1 and 10.2 % of Group 2 patients; P > 0.05).
A comparative study of the ability of addicts emotionally respond to other people's experience has shown that patients in both groups predominantly characterized by low rates of "Scale of emotional response". In calculating the average it found that it is in group 1 was 30.8 points in Group 2 — 23.5 points, and the difference between groups did not have statistical significance (P > 0.05). This indicated that drug users do not understand the emotional manifestations and actions of other people feel uncomfortable in dealing with them, are not able to be sensitive and responsive to the loved ones. They give an emotional response to a partner state, experiencing at the same time on the opposite modality experiences. Neutral and negatively colored emotional states partner are treated patients with significant distortion. They lack emotional abilities, which are defined as «a system of competences and skills», affecting the ability to cope with the requirements and the ambient pressure. Individuals with low empathy, usually negatively perceived by others, but they do not realize it.
These personality traits led to the selection of patients ineffective behavioral strategies in relationship with others. This, in turn, could greatly impede their social rehabilitation therapy during remission and relapse of disease onset.
Thus, a low level of emotional empathy was detected in all patients, regardless of the predominance ofbiological and social influences in the mechanisms of opioid addiction relapse. This causes certain difficulties for restoring family links and environmental addicts with other people after treatment, and discontinuation of the drug. The results suggest the need to develop communication skills of drug addicts in treatment and rehabilitation process, the ability to listen and understand others, to describe and reflect their feelings and experiences in order to facilitate social adaptation in remission and prevent relapse of disease.
Aggregation activity of thrombocytes at patients with chronic generalized parodontitis.
Conclusions:
1. Low level of emotional empathy can be seen as a barrier to the successful restoration offamily and environmental links between drug addicts in therapeutic remission and impedes their social reinsertion.
2. Treatment and rehabilitation programs for patients with opioid dependence should include the development of empathie abilities, communication skills, ability to listen, reflect and understand the feelings of others.
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Usmanova Shaira Ravshanbekovna, Hadzhimetov Abdugaffur Ahatovich, The Tashkent State Dental Institute E-mail: sh.usmanova@yandex.ru
Aggregation activity of thrombocytes at patients with chronic generalized parodontitis in combination with an atherosclerosis syndrome
Abstract: To study the significance of functional activity of thrombocytes in pathogenesis of microcirculatory disturbances at patients with ChGP in combination with atherosclerosis syndrome.
Keywords: periodontitis, gingivitis, inflammation, endothelial cells, microcirculatory system, coagulation, hypertension, chronic ischemia of the brain, blood platelets.
Epidemiological researches of the population ofvarious regions of our country testify about high prevalence of inflammatory diseases of parodontitis (from 80 to 100 %) in various age groups [3; 4].
In structure of parodontal diseases gingivitis and periodontitis prevail. Diseases of parodontitis adversely act to functions of organs of system of digestion, leading to a sensibilization and infectioning of an organism, and also reduce its resistance. As damaging agents at an inflammation act not only microorganisms themselves, but also their endo- and exotoxins, various enzymes of pathogenicity of bacteria, components of a bacterial cellular wall (lypopolisaharidis, peptidoglicans, teychoid acids). The first visible stages of inflammatory process are haemodynamic changes — vessels in a place of an inflammation of risk are extended, it arises with gas of blood cells with the subsequent exit of leukocytes from a blood channel in a place of tissue damage of parodontitis. In process ofvicodiliatation there participate such endothelial factors, as thrombinis, hystaminis and leycotrinenum C4. In the present situation thrombinis appear at the expense of activation of vascular-thrombositis (microcirculatory) and coagulation links of system of a hemostasis [1].
The answer mechanism of endothelial cells on action of thrombinis is distinguished and it develops quickly. In the present situation endothelial cells produce endothelies — 1, thrombocytosis growth factor (GsFR) and the activation factor of thrombocytes (VEILS) which strengthen aggregation activity of thrombocytes.
In measure of generalization of pathological process of disturbances of microcirculation grow, and changes in vessels get generelized character both at patients with chronic parodontitis, and at patients with a chronic ischemia of a brain caused by an atherosclerosis. Damage of endotheliocytes at disturbances in microcirculation system is accompanied by development of sladge — a syndrome that in confirmed by the presence of significant amount of thrombocytes, settling down not only in a gleam of vessels, but also actually in a gum mucous membrane. However, now there are only unique works devoted to functional activity of thrombocytes at patients of ChGP in a combination with a syndrome of an atherosclerosis. However, it is necessary to notice that biomark-ers of coagulation activity and endothelial cellular activity, and also the subclinical atherosclerosis is improved from parodontal therapy [5]. Taking into account high prevalence of diseases of parodontitis, the given risk factor is considered important from the point ofview of public health.
The work purpose: to study the significance of functional activity of thrombocytes in pathogenesis of microcirculatory disturbances at patients with ChGP in combination with atherosclerosis syndrome.
Materials and methods
For object achievement under our supervision there were 52 patients with ChGP. From them 24 patients were without accompanying diseases; 28 patients — with ChGP in combination
