Mpwa - Psychological diagnostics. Description of the psychodiagnostic methods used Questionnaire Zavyalova motivation for drinking alcohol

A questionnaire to identify the characteristics of the motivation for alcohol consumption was proposed by V.Yu. .

A certain advantage of the technique is the focus on the motivation of consumption - a less hidden factor than the amount and frequency of drinking. The questionnaire includes 9 scales with 5 statements each; answer but gives 3 points b- 2 points, in - 1, G- 0 points. Scales (the maximum possible number of points on each of the scales is 15, the minimum is 0; the more points scored on any scale, the more significant these motives are for the subject):

I. The first triad of scales forms a group "socio-psychological" motives for drinking alcohol:

1. Traditional, socially determined, culturally widespread motives (statements 1,10,19,28,37).

2. Submissive motives, reflecting submission to the pressure of other people or a reference group in terms of alcohol intake (2,11,20, 29,38).

3. Pseudo-cultural type of motives, indicating a person’s desire to adapt his personal experience to the "alcohol values" of the social microenvironment in which it functions (3,12,21,30,39).

II. The second triad forms a group personal, personal motives for alcohol consumption:

4. Hedonistic motives, reflecting the desire to obtain physical and psychological satisfaction from the effects of alcohol, as well as the experience of experiencing alcoholic euphoria (4,13,22,31,40).

5. Ataractic motives associated with the desire to neutralize negative emotional experiences - tension, anxiety, fear with the help of alcohol (5.14, 23.32.41).

6. Motives for hyperactivation of behavior (stimulating, disinhibitory effect) and saturation of the sensorium with the help of drinking, reflecting the desire to get out of the state of boredom, psychological "emptiness", mental inactivity, or the desire to increase the effectiveness of one's behavior (6,15,24, 33,42) .

III. The third triad forms actually pathological alcohol consumption motivation, morbid craving factor:

7. "Hangover" motivation - the desire with the help of alcohol to remove withdrawal symptoms, discomfort associated with the absence of alcohol, improve well-being (7,16,25,34,43).

8. Additive motives reflecting the fixation in the mind of a true craving for alcohol, "thirst" for alcohol (8,17,26,35,44).

9. Motives of self-harm - the desire to drink in spite of oneself and others as a protest, because of the loss, allegedly, of prospects for the future for oneself, the loss of the meaning of life (9,18,27,36,45).

Up to 35 points - no alcohol abuse, 35-50 points - manifestations of alcohol abuse, over 50 points - addiction, abuse (V.Yu. Zavyalov, 1986).

MPA

Instruction: for each proposed statement, give one of the most appropriate answers for you: a) a reason or condition for drinking alcohol occurs quite often; b) rarely, but not less than 2 times in a lifetime; c) doubt d) does not suit me at all.

Full name ________________________________ Age ______ Date ______________

question number	very often there is a cause or condition for alcohol intake; (Yes)	rarely, but not less than 2 times in a lifetime;	I doubt	doesn't suit me at all (no)
1. I drink because it is inconvenient to refuse to drink.
2. I think it's good to drink good wine with a meal.
3. I drink to enjoy.
4. I drink to get rid of inner tension and fear.
5. I drink out of boredom, I can’t have fun without drinking.
6. When I drink, I feel healthy.
7. I drink because the thought of drinking relentlessly haunts me.
8. I drink in spite of everyone who brings up and scolds me for drunkenness: my wife, bosses, relatives.
9. I drink on payday and on weekends.
10. I drink with colleagues, so as not to spoil the relationship with a refusal.
11. I think that a cultured person should understand the brands of wines, know the types of alcoholic beverages.
12. I drink because I like the pleasant sensations in a state of intoxication: warmth, relaxation, etc.
13. I drink because alcohol reduces timidity, makes me bolder.
14. I drink to change my condition, sharpen my feelings and interest in life.
15. I drink to relieve a hangover, not to get sick after a previous drink.
16. I drink against my own will because of a strong desire to get drunk.
17. I get drunk because I despise my life, I have not respected myself for a long time.
18. I drink on the occasion of meetings with friends, relatives, friends.
19. I do not refuse to drink, so that they would not make fun of me.
20. I pay for the services rendered to me with alcoholic drinks and I myself accept alcohol as a gift, as is customary.
21. I drink to experience a sense of well-being and happiness.
22. I drink to forget unpleasant events, grief, disappointment.
23. When I drink, time flies faster, more interesting, and without drinks it drags on long and tedious.
24. Until I drink, I feel bad, I don’t want to do anything.
25. I drink because I can’t overcome my cravings for alcohol, the desire to get drunk.
26. I drink because of the spirit of contradiction, I don’t want to be exemplary, a teetotaler.
27. I drink to make acquaintances - business and personal.

Until the beginning of the 19th century. alcoholism was seen as the result of bad upbringing, moral licentiousness or weak will. In other words, it was considered a product of the personal characteristics of the drinker, who does not find the will to refuse the bottle. The emergence of data on the complex nature of alcoholism, especially the mechanism of the formation of biological dependence, led to a change in the understanding of alcoholism, which since the middle of the 20th century. began to be treated as a disease. Gradually, the narrowness of the biological approach to alcoholism as a disease of the individual became apparent. Currently, researchers emphasize the social roots of this disease, associated with the characteristics of not the personality of an alcoholic, but his social environment.

The reasons for drinking alcohol are varied. Some see it as a kind of remedy, others - a means of facilitating communication with people, others - a way to relieve psychological stress.

It is believed that alcohol has a healing effect - stimulates appetite, helps with colds and other diseases. Doctors admit that small doses of alcohol really whet the appetite, its moderate consumption reduces the risk of cardiovascular disease for men over forty. All other "healing" functions of alcohol, in their opinion, are doubtful or false. In medical practice, the bacteriostatic properties of alcohol are used, using it for disinfection (with injections, etc.), preparation of medicines, but by no means for the treatment of Shakhanina I.L. Healthcare.- 1998.- No. 9.- P.169-172. .

The main motive for alcohol consumption is associated with the psychotropic effect of ethyl alcohol. The need for it exists in many categories of people - first of all, in people who are poorly adapted in society, working with emotional and physical overload. No wonder alcohol is taken “against fatigue”, with ailments and at almost all festivities. Since the degree social adaptation and the presence of overloads depend on the social environment of the individual, then the microclimate in the family, upbringing, traditions, and the presence of stress play an important role in the formation of addiction to alcohol.

Genetic factors can play a big role in the formation of addiction to alcohol. There is a hypothesis that a hereditary tendency to abuse alcohol, drugs, etc. about 10-15% of people have it. However, the presence of a hereditary predisposition in itself never leads to alcoholism, but is only a concomitant factor.

Although the reasons for the first initiation to alcohol are varied, their characteristic changes can be traced depending on age. In general, the motives for drinking alcohol are divided into two groups (Table 1) Ushakov A.A. Medical reference book.- M.: ANMI, 1996.-465s..

Table 1. MOTIVES FOR DRINKING

Until the age of 11, it is given “for appetite”, “treated” with wine, or the child himself tastes alcohol out of curiosity (a motive mainly inherent in boys). At an older age, the motives for the first use of alcohol become traditional occasions - "holiday", "family celebration", "guests", etc. From the age of 14-15, such reasons appear as “it was inconvenient to be left behind the guys”, “friends persuaded”, “for the company”, “for courage”, etc.

The second group of motives for alcohol consumption, typical of adults, deserves special attention. These motives form drunkenness as a type of behavior of a marginal person, a potential offender. If the drunkenness of young people is mainly associated with the incompleteness of their adaptation in the “adult” world, then the drinking of adults is caused by stressful situations in this world (poverty, overload at work, problems in family life).

Much is said about the causes of the spread of alcoholism by the fact that in modern Russia in federal cities and in the North Caucasus, the incidence is almost 2 times lower than the average. Two different "safety valves" operate here - the traditional way of life (in the Caucasus) and a more rational attitude towards one's health (among the townspeople). The most susceptible to alcoholism are those who are already free from traditions, but have not yet cultivated a culture of self-control.

The effect of alcohol on the human body. Accepted alcohol is quickly absorbed and enters the bloodstream. From the blood, alcohol enters the tissues, where it is distributed unevenly. Since it dissolves well in lipids - fat-like substances that are rich in nerve cells - its greatest accumulation occurs in the brain. These are the cells that die first.

Under the influence of alcohol, intensive gluing of erythrocytes occurs, providing the tissues of the body with oxygen. The diameter of some capillaries is so small that red blood cells literally "crawl" through them one by one; often pushing the walls of the capillaries apart. Therefore, a few sticky red blood cells clog the capillary, cutting off the supply of oxygen and nutrients to the cell that the capillary feeds. The nerve cell dies irrevocably. This process takes place throughout the body.

The number of dying cells depends on the amount of alconarcotic. In a systematically drinking person, over the years, a noticeable decrease in brain volume (shrunken brain) is observed. The loss of entire structures of the brain, as a result of the mass death of neurons, leads to the disorganization of its work. First of all, areas of the cerebral cortex that are responsible for the higher functions of a person suffer: morality, memory, and creative abilities. It has long been noted that a drunkard drinks first of all shame and conscience, as well as everything that is given to a person by culture and upbringing. The defeat of the subcortex of the brain is not so noticeable at first, so skilled workers who drink for a certain time can maintain their professional skills.

The severity of intoxication depends on the quantity and quality of alcohol consumed, individual sensitivity to alcohol and the psychophysical state of a person. There are three degrees of intoxication - light, medium and heavy.

Existing classifications of alcoholism can be divided into two types. In the first case, the basis is the clinic of an alcoholic disease, in the second - various social, psychological, even economic, and only partly clinical criteria. In Russia, the first type of classification has been adopted.

The entire period of development of alcoholism is divided into three stages, successively replacing one another:

I - initial (neurasthenic);

II - medium (addictive);

III - initial (encephalopathic).

In stage I of alcoholism, mental dependence on alcohol manifests itself in the form of an obsessive (compulsive) craving for alcoholic beverages, leading to the loss of quantitative control of alcohol consumed. There is a growing alcoholic addiction to alcoholic beverages, the transition from periodic drunkenness to systematic.

In stage II, there is a physical dependence on alcohol with a compulsive craving (irresistible attraction that occurs against the will, mind, feelings) to alcoholic beverages. The features of personality degradation, pathological changes in the internal organs are revealed.

In stage III, the attraction to alcohol acquires a compulsive-mastering character. Withdrawal syndrome (negative experience of abstinence) is aggravated. Situational control is lost. Quite often there are alcoholic psychoses (for example, delirium tremens).

It is noted that the stronger drinks are consumed, the higher the degree of development of alcoholism. For example, with the so-called wine alcoholism, the degree of its development is usually lower than with the abuse of stronger alcoholic beverages (vodka, moonshine).

The duration of the first stage of alcoholism varies, but most often from 1 to 6 years. The duration of stage II in approximately 60% of cases is less than 10 years, in the rest - from 10 to 15 years. Ed. AND ABOUT. Grigoriev. M.: UNITI-DANA, 2004. S. 121..

METHODOLOGY: The structure of alcohol motivation (1. Motivation for alcohol consumption) (2. Motivation for abstinence from alcohol) MPVA (Modified version of MPA by V.Yu. Zavyalov) (V.M. Alekhin). The technique is intended for diagnosing the structure of alcohol motivation, the motivation for abstinence from alcohol, as well as the general level of tension of these factors. The structure of alcohol consumption motivation proposed in this method differs from the classification of V. Yu. Zavyalov. 1. Socio-psychological motivation. Traditional, socially determined, culturally widespread motives - the desire to drink alcohol under the influence of existing alcohol traditions and customs. The desire to use alcohol as a means of entertainment, pastime. Conformal motives, the desire to comply with group norms in terms of alcohol intake. Communicative motives associated with the need to communicate with others. 2. Individual psychological motives. Hedonistic motives - the desire for psychosomatic comfort, euphoria, pleasure. Tranquilizing motives - the desire to neutralize negative emotional states. Psychostimulating motives - the desire to increase the psycho-emotional tone from the action of alcohol. The motives for relaxation are the desire for a state of psychological rest, the removal of neuropsychic tension. 3. Pathological motivation associated with the presence of withdrawal syndrome and pathological craving for alcohol: Addictive motives - the need for alcohol, fixation in the mind of the craving for drinking alcohol. Withdrawal motives - the desire to overcome psychophysical discomfort after previous alcohol consumption. Pathological motive not included in this technique : Motives of self-harm - the desire to use alcohol "in spite of oneself and others" in order to hasten the onset of social complications or somatic complications and even death, according to many researchers, are not the motives for alcohol consumption. Such a motivation is either characteristic of persons with a psychopathic radical personality, regardless of alcohol dependence, or it is a motivation (alcoholic "alibi") that justifies his dependence in the eyes of an alcoholic. The main characteristics of this technique. 1. MPVA - a computer method for studying alcohol motivation. 2. The program consists of three subtests: a) reliability scale, which measures the sincerity of the test-taker's answers; b) alcohol consumption motivation questionnaire; c) questionnaire of motivation for abstinence from alcohol consumption. 3. The wording of motives and the procedure for testing alcohol consumption are designed in such a way as to investigate this motivation, regardless of whether the tested person drinks alcohol during the survey period or not. Alcohol addicts may be motivated by alcohol during a period of remission (temporary abstinence from their consumption, for example, during or after treatment). Motivation to use and the very fact of using may not coincide. 4. The method has been developed for use in narcological dispensaries and hospitals for the purpose of differential diagnosis of narcologically healthy persons, persons with harmful consequences from alcohol consumption, and persons with dependence on alcohol consumption. 5. The possibilities of this method are limited by the diagnosis of motives presented in the mind of the subject or consciously declared by him. The final conclusion can only be made by a clinical psychologist who has experience working with people who abuse alcohol and who knows the specifics of the motivation for their consumption, depending on the severity of alcohol dependence. The questionnaire consists of 80 statements. Estimated testing time is 40 minutes. EXAMPLE OF TESTING: --- PSYCHOLOGICAL DIAGNOSIS. Methodology: Motivation to drink alcohol. Motivation for abstinence from drinking alcohol. Full name: __________________________________ Add. data: ____________________________ Scale of reliability of information. L ──────┼─────────────┼─────────────╢> Motivation to drink alcohol. * 12 11 ┼ 10 ┼ 9 ┼──────────── ──────────────▄▄──── 8 ┼ ██ ▄▄ 7 ┼ ██ ██ 6 4 ██ ██ ██ ██ ██ ██ ██ ██ ██ 2 ██ ██ ██ ██ ██ ██ ██ ██ ██ 1 ██ ██ ██ ██ ██ ██ ██ ██ ██ 0 ┼─+──+──+──+──+──+──+──+──+──+──* Tr Ps Gr Cm Pl Nt St Rl Ob Ab Motivation for abstinence from alcohol. 12 ██ ▄▄ ██ 9 █ ██ 7 ┼ ██ ██ ██ ▄▄ ██ ██ ██ 6 ┼─██────██─▄▄────██─██─██─███ ██ ██ ██ ██ ██ ██ ██ 4 ██ ██ ██ ██ ██ ██ ██ ██ ██ 3 ██ ██ ██ ██ ██ ██ ██ ██ ██ 2 ██ ██ ██ ██ ██ ██ ██ ██ ██ ██ 1 ██ ██ ██ ██ ██ ██ ██ ██ ██ ██ 0 ┼─+──+──+──+──+──+──+──+──+──+──* At In Bl Ht Sn Cs Sc Fm Pr Rn Index MPA=50 Index MBA=86 INTERPRETATION: Attitude towards testing: frankness, lack of conscious intention to embellish one's character, emphasize the "correctness" of one's behavior. MOTIVATION TO DRINK ALCOHOLIC DRINKS: The desire to drink alcohol is influenced by existing alcohol traditions and customs. Level of motivation: low. The desire to use alcohol as a means of entertainment, pastime. Level of motivation: low. Conformal motives, the desire to comply with group norms in terms of alcohol intake. Level of motivation: low. Communication motives associated with the need to communicate with others. Level of motivation: low. The desire for psychosomatic comfort, euphoria, pleasure. Level of motivation: medium. Striving to neutralize negative emotional states. Level of motivation: low. The desire to achieve a psycho-stimulating effect from the action of alcohol. Level of motivation: low. Striving for relaxation, removal of neuropsychic tension. Level of motivation: low. The need for alcohol, fixation in the mind of the attraction to the use of alcoholic beverages. Level of motivation: increased. The desire to overcome psychophysical discomfort, withdrawal symptoms after previous alcohol consumption. Level of motivation: increased. MOTIVATION FOR ABSTAINING FROM ALCOHOLIC DRINKS: Attitudinal motives, negative attitude to alcohol associated with upbringing, beliefs or life experience. Level of motivation: increased. Lack of any interest or need for drinking, indifference to alcohol. Level of motivation: low. Reduced biological tolerance of alcohol, deterioration in general well-being or mood in intoxication. Level of motivation: high. Worry about the state of one's physical health, the impossibility of drinking due to illness. Level of motivation: medium. Lack of appropriate conditions, sufficient occasion or suitable company for drinking. Level of motivation: low. The desire to implement the plans, to complete things, to be busy solving some personal problems. Level of motivation: high. The desire to avoid condemnation from others, the increased importance of public opinion. Level of motivation: medium. The desire to prevent conflicts with the family or relatives because of drinking, to maintain the respect and love of loved ones. Level of motivation: high. The desire to prevent trouble in professional (educational) activities. Level of motivation: high. The desire to completely or temporarily give up drinking, due to the presence of problems due to alcohol abuse. Level of motivation: high.

For each of the statements, give the answer that suits you:

1. “quite often there is a cause or condition for drinking alcohol”
2. "rarely, but not less than 2 times in a lifetime"
3. "doubt"
4. "doesn't suit me at all"

Statements:

I drink on holidays to enhance the feeling of joy.
I drink because it is inconvenient to refuse to drink.
I think it's good to drink good wine with a meal.
I drink to enjoy.
I drink to get rid of inner tension and fear.
I drink out of boredom, I can’t have fun without drinking.
When I drink, I feel healthy.
I drink because the thought of drinking relentlessly haunts me.
I drink to spite everyone who scolds me for drunkenness.
I drink on payday and on weekends.
I drink with colleagues, so as not to spoil the relationship with a refusal.
I think that a cultured person should understand the brands of wines, know the types of alcoholic beverages.
I drink because I like the pleasant sensations in a state of intoxication: warmth, relaxation, etc.
I drink because alcohol reduces timidity, makes me stronger.
I drink because to change my condition, to sharpen my feelings and interest in life.
I drink to relieve a hangover, not to get sick after a previous drink.
I drink against my own will because of a strong desire to get drunk.
I get drunk because I despise my life, I have not respected myself for a long time.
I drink on the occasion of meetings with friends.
I do not refuse to drink, so that they would not make fun of me.
I pay for the services rendered to me with alcoholic drinks and I myself accept alcohol as a gift, as is customary.
I drink to experience a sense of well-being and happiness.
I drink to forget unpleasant events, grief, disappointments.
When I drink, time flies faster, more interesting, and without drinks it drags on long and tedious.
Until I drink, I feel bad, I don’t want to do anything.
I drink because I can’t overcome my craving for alcohol, the desire to get drunk.
I drink because of the spirit of contradiction, I don’t want to be exemplary, a teetotaler.
I drink to make acquaintances - business, personal.
I am forced to drink by a company or a group of acquaintances with whom I am pleased to communicate.
I drink because the use of good wines and high-quality alcohol is a sign of well-being and culture.
I drink because drinking contributes to a pleasant pastime, communication, entertainment.
I drink to get rid of guilt and bad mood.
I drink because drinking adds strength and energy, excites me.
I drink in the morning for vivacity, to restore efficiency.
I drink for no reason or reason when I have something to drink.
I drink because I am considered a "lost man", a loser or an alcoholic.
I drink because it is customary to “wash” a purchase, a deal, a completed work, important events in life.
If not drinking friends I wouldn't drink as much as I drink.
I strive to drink culturally: moderately in an “aesthetic setting”, at a good table.
I drink because a good snack causes a joyful feeling and a desire to drink.
Drinking relieves me of anxiety and anxiety.
When I drink, I become bolder, I can take risks, I feel like a real man.
I drink to reduce trembling in my hands and improve my well-being.
I drink automatically as soon as I see alcohol.
I drink because I do not value my life at all.

Results processing:
1. “very often there is a reason or condition for taking alcohol” - 3 points;
2. "rarely, but not less than 2 times in a lifetime" - 2 points;
3. "I doubt" - 1 point;
4. "doesn't suit me at all" - 0 points.

Brief description of the scales:

First triad scales form a group "socio-psychological" motives for alcohol consumption:
1. Traditional, socially determined, culturally widespread motives (statements 1, 10, 19, 28, 37).
2. Motives reflecting submission to the pressure of other people or a reference group in terms of alcohol intake (2, 11,20, 29, 38).
3. Pseudo-cultural type of motives, indicating a person's desire to adapt his personal experience to the "alcohol values" of the social microenvironment in which he functions (3, 12, 21, 30, 39).

Second triad forms a group personal, personal motives for alcohol consumption:

4. Hedonistic motives, reflecting the desire to get physical and psychological pleasure from the effects of alcohol, as well as the experience of experiencing alcoholic euphoria (4, 13, 22, 31, 40).
5. Motives associated with the desire to neutralize negative emotional experiences - tension, anxiety, fear - with the help of alcohol (5, 14, 23, 32, 41).
6. Motives for hyperactivation of behavior (stimulating, disinhibitory effect and saturation of the sensorium with the help of drinking, reflecting the desire to get out of the state of boredom, "psychological emptiness", unemployment, mental inactivity, or the desire to increase the effectiveness of one's behavior (6, 15, 24, 33, 42 ).

Third triad actually forms pathological motivation alcohol use, a factor of painful craving for alcohol:

7. "Hangover" motivation - the desire to use alcohol to remove withdrawal symptoms, discomfort associated with the absence of alcohol, improve well-being (alcohol is like a medicine) (7, 16, 25, 34, 43).
8. Motives reflecting the fixation in the mind of a true craving for alcohol, “thirst for alcohol” (8, 17, 26, 35, 44).
9. The motives of self-harm are the desire to drink to spite oneself and others as a protest, because of the alleged loss of future prospects for oneself, the loss of the meaning of the former life (9, 18, 27, 36, 45).

The test result is a numerical expression (from 0 to 150 on each scale).

The maximum scores reveal the dominance of one or another type of alcohol consumption motives, and all the scales together reflect the structure (profile) of alcohol consumption motivation.

The total score on all scales gives a numerical expression of the overall motivational stress in the search for alcohol.

This method, of course, does not cover all aspects of alcohol consumption motivation, but only provides an approximate description and digital material for mathematical processing of the phenomenon under study.

In practice, the interval of 35-50 points can serve as a diagnostic criterion for alcohol dependence, it reveals a high level of motivation for alcohol consumption.

N	motives	Points
1.	Socio-psychological motives:
	1.1.Traditional, cultural	1.10,19,28,37
	1.2. Submissive, reflecting submission to the pressure of others, unwillingness to be responsible for their actions	2. 11,20.29,38


	1.3. Pseudo-cultural (the desire to attract the attention of others with refinement of taste, to feel belonging to high society)	3,12,21,30,39
2.	Personal, personally significant:
	2.1. Hedonistic (need for pleasure)	4,13,22,31,40
	2.2. Ataractic (desire to neutralize negative emotional experiences)	5,14,23,32,41
	2.Z.Psheractivation of behavior (the desire to disinhibit affect, impressions, experiences, improve performance)	6,15,24.33,42
3.	Pathological motives (at the clinical level):
	3.1. "Hangover" - removal of alcohol withdrawal syndrome	7,16,25,34,43
	3.2. "Addictive" - addiction to alcohol, thirst for intoxication	8.17,26.35,44
	3.3.Motives of self-punishment ("to spite" oneself and others)	9,18.27,36,45
Motivational stress index	sum 1.,2.,3.

Quite often - 3 b.

Rarely, but not less than 2 times in a lifetime - 2 b.

Doubt - 1 p.

Doesn't suit me at all - 0 p.

Motivational tension scale:

0 16.6 35 50 56.3

Appendix 11

Methodology

express diagnostics (screening) of chronic

Alcohol intoxication

The technique offers a way to expressly diagnose alcohol abuse, bypassing uncomfortable, alarming questions about the amount and frequency of alcohol consumption. The method is highly sensitive and specific, simple, economically available.

The methodology is based on Guidelines No. 99/174, developed by the Research Institute of Narcology of the Ministry of Health of Russia and the Peoples' Friendship University of Russia (group of authors: V.P. Nuzhny - Doctor of Medical Sciences, P.P. Ogurtsov - Candidate of Medical Sciences).

The method of express diagnostics of chronic alcohol intoxication is intended for specialists of psychological diagnostic centers, narcologists, psychiatrists of medical institutions of the Ministry of Internal Affairs, Central Internal Affairs Directorate, Internal Affairs Directorate of subjects Russian Federation for the purpose of timely detection of conditions of chronic alcohol intoxication among employees of internal affairs bodies during preventive (scheduled and targeted) examinations (surveys). The technique is designed for examination of persons limited by the age corridor of 30-65 years.

Introduction

Currently, the level of alcohol consumption in the Russian Federation per person per year is 13 liters, while the European average is 9.8 liters. Demographers believe that up to 80% of deaths among men are due to excessive alcohol consumption. At the same time, mortality from somatic morbidity accompanying alcoholism is taken into account.

Since the mid-1990s, after the outbreak of local armed conflicts on the territory of the Russian Federation, more and more law enforcement officers have been involved in the performance of combat missions in the North Caucasus region. At the same time, their activity is accompanied by the influence of known psychogenic factors, the nature of which is primarily associated with an experienced threat to health or life. Secondary, but no less significant psychogenic factors include: increased social and professional responsibility, unfavorable living conditions, often hostile attitude of the local population, prolonged separation from the family, insufficiently matched, in terms of psychological compatibility, service team, etc. With an increase in the period or frequency of stay in the emergency zone, chronification of stress occurs, the accumulation of negatively colored emotions, and an overstrain of the adaptive resources of the body of employees.

In this regard, the likelihood of employees turning to surrogate means and methods for relieving psychophysical overstrain, such as strong alcoholic beverages, increases. Regular use of this "method" of dealing with stress, often with toxic surrogate forms of alcohol, ultimately leads to chronic alcoholization of personnel with all the ensuing negative consequences.

Under these conditions, the psychologists of the units and doctors are faced with the task of identifying among the employees who returned after participating in the counter-terrorist operation, persons who are addicted to alcohol in order to provide timely specialized drug treatment.

In connection with the relevance of resolving the issue of timely diagnosis of chronic alcoholism, the following is a method developed by leading narcologists and recommended for use by the Russian Ministry of Health.

The method is based on a combination of three main tests. The first is the CEGE questionnaire, widely tested in the world and adapted for the Russian population; the second is the PAS questionnaire developed by V.P. Necessary, P.P. Ogurtsov, A.E. Uspensky, which allows assessing the severity of pathological reactions to alcohol (post-intoxication alcohol syndrome); the third is a modified Lego Mesh test based on the identification of objective physical signs of chronic alcohol intoxication (CHAI).

It should be taken into account that voluntary admission to excessive alcohol consumption is rare in the practice of doctors and psychologists, since employees fear not only public condemnation, but also medical and office measures of a repressive nature. Surveys on the amount and frequency of alcohol consumption due to the attitudes of employees do not provide an objective picture. According to the Ministry of Health of Russia, the amount drunk by respondents is no more than 40-60% of real consumption.

Despite the fact that the first experience of approbation of the methodology in the State Center for Internal Affairs of the Ministry of Internal Affairs of Russia confirmed the presence of attitudinal behavior among employees, we consider it possible to recommend it for practical application. The most informative technique may be when examining employees immediately after staying in long-term business trips in the emergency zone.

These recommendations are based on the fact that constant psychotraumatization in the conditions of performing service-combat and operational-service tasks leads to a restructuring of the hierarchy life values, to the emergence of other attitudes, to the formation of fundamentally new worldview positions, which, together, contributes to the development of an individual way of adapting to an extreme situation, in which alcohol consumption is considered as a natural form of behavior in extreme conditions. The prevailing uncritical attitude towards the recognition of the fact of immoderate alcohol intake will persist by inertia for a certain time in “normal” service conditions or during the readaptation period. Therefore, the sooner the research is carried out, the more likely it is to obtain objective results.

Below are the tests included in the methodology with criteria for evaluating the results, as well as a questionnaire.

In the section "Map of physical signs of CHAI" of the questionnaire filled out by the doctor, the following concepts and abbreviations:

No. 42. Trans. art. hyperten. – transient (labile) arterial hypertension;

№ 44. Polyneuropathy - diseases characterized by multiple lesions of the roots and peripheral nerves and is characterized by prolonged paresthesia, pulling pain along the nerve trunks and muscles, especially in the distal extremities ("stockings", "socks");

№ 45. Muscular atrophy - this refers not only to external manifestations - flabbiness and lack of relief of muscles, but, above all, a decrease in the level of physical development, in particular, studies using a dynamometer (strength of the hands) can be used to assess;

№ 46. Hyperhidrosis - excessive sweating;

№ 47. Gynecomastia - an increase in the fat layer of the chest according to the female type in men;

No. 48. Enlarged parotid glands - enlargement of the parotid glands;

No. 51. Dupuytren's contracture - Dupuytren's contracture;

No. 52. Ven. full-crown conjugation. - venous plethora of the conjunctiva;

No. 53. Hyp.face, extended capill. - hyperemia (redness) of the face with an expansion of the network of skin capillaries;

№ 54. Hepatomegaly - an increase in the size of the liver;

№ 55. Telangiectasia - the presence of spider veins on the skin;

No. 56. Palpation erythema - redness of the skin after pressing with a finger;

No. 57. Injuries, burns, death. - traces of injuries, bone fractures, burns, frostbite.

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