A unique approach to the treatment of posttraumatic stress disorder (PTSD) is difficult to support, because of the complexity and heterogeneity of this pathology. Multiple evidence-based guidelines for PTSD treatment exist, elaborated by prestigious institutions around the world, but a certain level of the inconsistency of their recommendations appears when these sources are compared with each other. Therefore, a review of current guidelines and extraction of the most supported by evidence recommendations is considered important for clinical practice, due to the need to approach such complex cases as PTSD-diagnosed patients in a stepwise manner. Structured monitoring of the clinical status during the treatment is also an important and rather neglected aspect of the case management in PTSD, and the necessity of follow-up visits for efficacy and tolerability should be taken into consideration. Psychotherapy (especially cognitive- behavioral oriented therapies and eye movement desensitization and reprocessing therapy) is supported by evidence as a first-line approach, as well as certain antidepressants, like the selective serotonin reuptake inhibitors and venlafaxine. Many second-line pharmacological agents and psychotherapies are also available, but there is an obvious need for more pragmatic trials with PTSD patients.
According to the results of the conducted study there were distinguished the peculiarities of perception of the image of a junior officer by servicemen who participated in hostilities and had various PTSD symptoms. The study included 233 male servicemen with combat experience. The age of the participants varied from 20 to 55 years. It was determined that the image perception of the direct commander by the servicemen who did not have any PTSD symptoms had been influenced by both the key features of the modern way of fighting and the way a protective mechanism of consciousness acted, which gave the possibility to maintain mental health under combat conditions. These servicemen considered the awareness, kindness, and physical strength of their commander to be not important. The first stage was occupied by his/her ability to adequately fulfill his/her leadership function and the power of his/her spirit – the courage and love of the Motherland, which formed his/her reliability. Servicemen who had PTSD symptoms were less satisfied with the role of a junior officer and considered him/her to be less capable of meeting their expectations. They were less interested in commanders who could involve them in situations that required quick, brave action and complete responsibility for the entrusted part of common affairs. The most important factors in the structure of the direct commander image in both studied groups were the power of personality (the ability of self-regulation); however, the servicemen with PTSD symptoms had a specific orientation of these factors – to help their subordinates. They were quite selfishly aimed at using their direct commanders as a way of getting help.
According to the results of the study, there were determined the peculiarities of military values of servicemen who participated in hostilities and had signs of PTSD and moral trauma. The study included 397 servicemen (aged 20 to 55 years) with combat experience. The study showed that PTSD and violation of moral normativity were closely related to unfavorable social conditions of performing combat tasks. Unlike PTSD, the moral normativity indicator was less tightly related to the immediate threat to life. The structure of values of the servicemen had no signs of PTSD as well as no violation of moral normativity consisted of factors that indicated the value of teamwork, responsibilities for decisions and actions made based on ideas related to loyalty to the oath and the Motherland, resistance, and professionalism. For the servicemen who participated in hostilities who had violations of moral normativity, it was more important to have the ability to act following their conscience, not to lose dignity, and to remain honest in the faces of their brothers than to have professionalism, loyalty to the oath and the Motherland.
The article shows the development of the method of psychological evaluation called “Evaluation of Negative Mental Reactions and States of Combatants”. In the study participated 1300 male servicemen (29.84% from junior lieutenant to colonel and servicemen under contract and demobilized, and 70.16% from private to senior warrant officer). The age of participants varied from 20 to 55 years. The system of evaluation developed consisted of 16 instruments that could help to determine the presence of negative psychological symptoms of servicemen related to their participation in hostilities. The results indicated that the evaluation method developed is a tool that allows determining the presence of negative psychological symptoms related to participation in combat. Likewise, it is a useful and fast method to assess the effectiveness of short-term psychological recovery programs. Unlike existing methods of diagnosing negative mental reactions and states of an individual, which arose after their participation in hostilities, the developed psychodiagnostic toolkit could consider the physical and mental fatigue of the respondents, their deterioration, and other cognitive dysfunctions.
