Vasileva A V, Karavaeva T A, Abdullaeva S M
Bekhterev National Research Medical Center for Psychiatry and Neurology, St. Petersburg, Russia.
Mechnikov North-Western Medical State University, St. Petersburg, Russia.
Zh Nevrol Psikhiatr Im S S Korsakova. 2020;120(9. Vyp. 2):40-45. doi: 10.17116/jnevro202012009240.
To evaluate an impact of perception of ones sexuality and autonomy on the level of insomnia in patients with neurotic/anxiety disorders.
A sample included 123 (93 women and 30 men) patients with neurotic/anxiety disorders (F40, F41, F43, F45) in the age from 25 to 50 years old, anxiety was the main syndrome in the clinical structure of the disorder. Test battery included Pittsburgh Sleep Quality index for the subjective sleep quality evaluation, Insomnia Severity index for stratification of patients into groups with different insomnia level. Anxiety was evaluated with the Hamilton Anxiety Rating Scale. Personality traits, sexuality and sovereignty of psychological space were assessed with the G. Ammon Ego-structure test and the Sovereignty of the individual psychological space questionnaire. Multiple regression analysis was used to study the interrelationship between insomnia severity and psychological characteristics. Insomnia severity index was chosen as the dependent variable.
An analysis of the regression model has shown the increase in insomnia index with the simultaneous augmentation of the following scales «Physical body sovereignty», «Sovereignty of objects», «Destructive aggression», «Deficient aggression», «Constructive narcissism», and decrease of the scales «Territory sovereignty», «Deficient narcissism», «Constructive sexuality». The study results imply the importance of the use of the level of sexual functioning and autonomy as the marker of identity maturity for psychotherapeutic targets in the treatment of neurotic/anxiety disorders. The use of anxiety and insomnia as the main complaints can be explained by its societal approval and need further active evaluation by the specialist for the successful psychotherapeutic treatment.
评估对自身性取向和自主性的认知对神经症/焦虑症患者失眠程度的影响。
样本包括123名年龄在25至50岁之间的神经症/焦虑症患者（93名女性和30名男性），诊断为（F40、F41、F43、F45），焦虑是该疾病临床结构中的主要症状。测试组合包括用于主观睡眠质量评估的匹兹堡睡眠质量指数，以及用于将患者分层为不同失眠程度组的失眠严重程度指数。使用汉密尔顿焦虑量表评估焦虑程度。通过G. 阿蒙自我结构测试和个体心理空间自主性问卷评估人格特质、性取向和心理空间的自主性。采用多元回归分析研究失眠严重程度与心理特征之间的相互关系。选择失眠严重程度指数作为因变量。
回归模型分析表明，随着以下量表“身体自主性”、“客体自主性”、“破坏性攻击”、“攻击性不足”、“建设性自恋”得分的同时增加，以及“领地自主性”、“自恋不足”、“建设性性取向”量表得分的降低，失眠指数升高。研究结果表明，在神经症/焦虑症治疗中，将性功能和自主性水平作为身份成熟度的标志用于心理治疗靶点具有重要意义。将焦虑和失眠作为主要诉求的现象可以通过其社会认可度来解释，并且专家需要进一步积极评估以实现成功的心理治疗。
