Affective and shock reactions
Affective and shock reactions (sharp jet tranzitorny psychoses) – the short-term psychotic states arising in the critical circumstances representing exclusively high importance for the subject. Develop at emergence of direct threat for life more often, however can be observed also in the situations causing sudden negative changes of social or private life of the patient. Are shown in the form of motive block, psychomotor excitement or an emotional stupor. Last from several minutes to several days. Come to the end with the expressed adynamy.
Affective and shock reactions
Affective and shock reactions – the sharp mental disorders arising at sudden threat physical are more rare to social existence of the patient. Are shown by consciousness narrowing, partial loss of contact with people around, affective, vegetative and somatic violations. The probability of development and expressiveness of frustration are caused by the importance of a situation, type of nervous system, the current physical and psychological state of the patient.
Affective and shock reactions are not a symptom of a chronic mental disease. They can arise at mentally normal people who suddenly experienced incredibly high psychological strain exceeding abilities of nervous system to adaptation by forming of psychological protection or by the analysis and processing of information. At the same time, the probability of development of such reactions increases at aktsentuation of the personality, borderlines, depressive frustration, subdepressions, neurosises etc. Treatment of affective and shock reactions is performed by experts in the field of psychiatry, psychology and psychotherapy.
Reasons of development of affective and shock reactions
Acute psychotic reactions on a stress arise in situations of extremely high importance. Indispensable conditions are suddenness and subjective perception of a situation as the patient menacing to further physical, social or psychological existence. Most often similar reactions develop in the circumstances connected with direct threat for life: during military operations, criminal incidents, technogenic and natural disasters, at the message on a serious illness.
Affective and shock reactions can also turn out to be consequence of the mental injuries connected with sudden, perhaps fatal change of social and private life of the patient. Sharp jet psychosis can provoke to become death close, dismissal, ruin, arrest, imprisonment and other similar events. In some cases shock reactions develop in the situations which are not representing the exclusive importance for people around, but being extremely significant for the most sick owing to features of his picture of the world, system of values, etc.
The probability of development of short-term jet psychosis depends on type of character and features of the identity of the patient. Frustration arises at emotionally labile, sensitive patients who are hard perceiving changes more often. Physical and psychological state of the patient at the time of a mental trauma matters. The previous sharp somatic diseases and exacerbations of chronic diseases, physical overfatigue, long mental and emotional pressure are among the contributing factors.
Children perceive the world "in the moment" and poorly see prospect, they strongly developed emotional and figurative perception, but still there are no abilities to the critical analysis therefore "threshold" of emergence of shock reactions at children's age is much lower. Affective and shock reactions at children can be provoked by any strong fright. At teenage age resistance to stressogenny factors increases, patients of pubertatny and postpubertatny age in critical circumstances show practically the same reactions, as adults.
Symptoms of affective and shock reactions
Acute reactions arise or during the injuring event, or right after its termination. Characteristic signs of similar reactions are the special narrowed condition of consciousness, partial violation of orientation in the place, time and the taking place events, ability loss to flexibly regulate the behavior taking into account the changing circumstances, disorder of behavior, existence of the expressed vegetative and somatic manifestations. The German psychiatrist Ernst Krechmer allocated two main types of such reactions: "imaginary death" and "a motive storm". In modern classifications of "imaginary death" corresponds hypokinetic, and "a motive storm" - hyperkinetic option of reaction.
The hypokinetic option is shown by catalepsy, an obezdvizhennost and loss of ability to productive contact with other people. Patients do not notice changes of a surrounding situation, do not try to undertake something, even to avoid danger of death, do not answer questions and do not let know in any way that they hear the speech turned to them. Skin is pale, cold, on a face expression of horror stiffened. It is noted . Involuntary defecation and an urination are possible. Duration of this state – of several minutes till several o'clock. At prolonged shock reaction patients lie in an embryo pose, without noticing anything around, accept water and food. In the subsequent full or almost full amnesia is observed – patients cannot remember the taken place events, own behavior during these events.
The hyperkinetic option is shown by excitement and senseless, not purposeful physical activity. Patients shout, rush about, sob, try to run (sometimes – towards danger). Heartbeat increase, reddening or a pobledneniye of integuments is observed . As well as in the previous case, involuntary defecation and an urination are possible. After getting out of a state of shock amnesia develops.
Hypokinetic and hyperkinetic option are the most primitive ways of response to incredibly severe acute stress. At children only these two types of affective and shock reactions develop. Teenagers and adults along with the listed ways of reaction can have a condition of an emotional stupor or emotional paralysis. This state can be also shown in two options.
At the first option, despite imminent danger, the patient becomes apathetic, shows indifference to surrounding, passively submits to any instructions and requirements, without estimating their rationality and own prospects in case of implementation of these requirements. At the second option of the patient difficult, flexible, purposeful, allowing to eliminate effectively danger both to itself, and to people around, but completely deprived of emotional coloring shows activity, his behavior. After an exit from this state the adynamy, apathy and partial amnesia is observed. Own actions rather accurately remain in memory, and circumstances in which they were made, forgotten or "washed away".
Diagnostics of affective and shock reactions
Diagnosis of sharp jet shock psychosis usually does not represent difficulties for the psychiatrist. Accurate communication with the previous sharp mental trauma comes to light. Experiences of the patient are aligned on a traumatic event. At the exit from this state at the mention of a traumatic event characteristic affective and vegetative reactions are observed: reddening or pobledneny skin, breath increase, change of a look, speed, loudness and contents of the speech.
At the long course of jet psychosis differential diagnostics with the schizophrenia, bipolar disorder and some other chronic mental diseases demonstrating under the influence of the injuring event and also with sharp hysterical psychosis is required. The diagnosis is specified by results of observations of the patient. Existence of a mental disease is demonstrated by lack of accurate connection of experiences with a traumatic event, the behavior and statements confirming existence of nonsense and hallucinations.
The forecast is favorable. After decrease in relevance of the injuring situation of display of jet psychosis completely disappear, being replaced by more or less expressed adynamy which recovery follows. Sometimes after shock reaction to a stress reactive depression develops, it is possible – with the expressed hysterical component. In rare instances the absolute recovery does not come, acute situational reactions are gradually succeeded by the character changes which are followed by a psikhopatization or violation of development of the personality.