The use of biofeedback training in complex therapy of neurotic disorders and correction of negative psychological consequences of combat stress in combatants

Abstract

The parameters and effectiveness of biofeedback training in the complex treatment of neurotic disorders at the hospital stage and psychological correction at the sanatorium stages of rehabilitation of military personnel were assessed. We examined 40 mentally healthy military personnel who participated in combat operations and 36 military personnel who participated in combat operations and suffered from stress-associated neurotic disorders and who were undergoing inpatient treatment in the S.M. Kirov Military Medical Academy clinics. In identifying possible negative psychological consequences of combat stress in a group of mentally healthy military personnel, a medical and psychological examination was performed using the military version of the Mississippi scale for assessing post-traumatic reactions, Neurotic Disorders-Symptomatic Questionnaire, and Quality of Life Questionnaire-12. The military personnel underwent stress testing according to a specially developed scenario using a biofeedback hardware software complex to assess individual changes in physiological parameters in response to emotionally significant stimuli. In the military personnel who participated in combat operations and suffered from neurotic disorders, a medical and psychological examination was performed using the Neurotic Disorders-Symptomatic Questionnaire and Quality of Life Questionnaire-12 upon admission to the hospital and on the eve of discharge, and stress testing was conducted upon admission to the hospital. The therapeutic effectiveness of biofeedback training in the treatment of neurotic disorders was evaluated by comparing the results of treatment between two groups of 18 individuals each. One group received only drug therapy, whereas the other group, in addition to drug therapy, underwent biofeedback training on the amplitude of the systolic wave. The level of stress-associated psychogenic damage was found to be correlated with the amplitude of the systolic wave according to the digital photoplethysmogram. Moreover, the physiological indicators of the circulatory and respiratory systems, used in foreign studies for psychophysiological training in the treatment of post-stress disorders, were not associated with the level of psychogenic damage, indicating their lack of involvement in pathogenesis and the ineffectiveness of their use. The addition of biofeedback training on the amplitude of the systolic wave to the complex therapy of neurotic disorders leveled astheno-neurotic symptoms and improved quality of life. Therefore, when treating astheno-neurotic disorders in military personnel participating in combat operations, it is critical to include biofeedback training on the amplitude of the systolic wave; this reduces severity of neurotic symptoms, improves quality of life, and forms preventive skill of conscious control of excessive physiological reactions of combat stress. Furthermore, the correlation between the magnitude of the decrease in the amplitude of the systolic wave and level of mental damage in combatants, revealed during stress testing, indicates the importance of biofeedback training on the amplitude of the systolic wave in sanatorium-resort organizations and military clinical hospitals of the Russian Ministry of Defense for the medical and psychological rehabilitation of military personnel exhibiting negative symptoms and those suffering from psychological consequences of combat stress.