Medical Radiology and Radiation Safety. 2022. Vol. 67. № 2
Socio-Psychophysiological Assessment of Two Patients
with Local Radiation Injuries
N.A. Metlyaeva, A.Yu. Bushmanov, I.A. Galstyan, V.Yu. Nugis,
M.V. Konchalovsky, O.V. Shcherbatykh, F.S. Torubarov
A.I. Burnasyan Federal Medical Biophysical Center, Moscow, Russia
Contact person: N.A. Metlyaeva, e-mail: This email address is being protected from spambots. You need JavaScript enabled to view it.
ABSTRACT
Purpose: A socio-psychophysiological assessment of the adaptation of two patients with local radiation injuries (LRI) of the hands of severe and moderate severity and acute radiation sickness (ARS) of the 1st degree, according to the characteristics of their individual mental adaptation and the stages of the course of local radiation injuries (30 years of observation).
Material and methods: Psychophysiological examination was carried out on two patients, former border guards, who were injured on October 5, 1982 as a result of accidental contact with a source of gamma radiation (cesium – 137) while on duty while serving on the Iranian-Azerbaijani border in the ranks of the USSR army. They suffered grade I ARS with extremely uneven gamma irradiation in the form of local radiation injuries of the hands of varying severity. The assessment of the average dose to the whole body by the frequency of dicentrics in the cultures of peripheral blood lymphocytes in patient No. 1 and patient No. 2 is the same and amounts to 0.26 Gy. One of them, patient No. 1, had a local radiation injury of the left and right hand of the III degree of severity. In 1984 – 1985, he underwent amputation of the nail phalanges of the 1st and 2nd fingers of the left hand; in 2003, skin grafting was performed for late radiation ulcer of the 3rd fingers of the left hand. Patient No. 2 had grade III-IV LRI in both hands with severe and extremely severe sequelae of local radiation damage to both hands. Amputation stumps 1 – 5 fingers of the right and left hand. Rough cicatricial – atrophic changes in the skin of the left hand with a violation of its function. Condition after multiple surgical interventions, including autotransplantation of full-thickness flaps on vascular pedicles. Psychophysiological research was carried out in dynamics in 2001, 2003, 2008, 2009, 2011, 2013 using the automated software and methodological complex “Expert”, designed to study personal properties of a person, cognitive and intellectual characteristics of a person according to the MMPI method, the Cattell,s 16-Personality Factor Questionnaire (16PF), Raven’s Progressive Matrices test, sensorimotor reaction (SSR, СSR) and reaction to a moving object (RMO).
Results: According to MMPI data, both victims have a hyperthymic type of psychophysiological adaptation with varying degrees of severity. Patient No. 2 is a chronically hyperthymic personality with a significant increase in the profile on scale 9 and with a gradual increase in dynamics, which reflects the persistence of hyperthymic personality characteristics and causes an overstrain of mental adaptation, with an increase in the dynamics of the tendency to explain their difficulties and problems with somatic ill-being (1Hs). Characterological features were determined by high emotionality (factor A – 9.8 stan), sufficiently high intelligence (factor B – 7.3 stan), sufficient integration and sthenism of behavior, high dominance and freedom of behavior (factor F – 8.5 stan), due to a propensity for increased self-esteem, a high propensity to take risks (H – 9.3 stan), down-to-earth interests (factor M). Very high extroverted behavior (factor F2 –--- 9.9 stan). High rates of the Raven test and sensorimotor reactions. Thus, the personality profile of patient No. 2 has the form of a pronounced chronic hyperthymic personality, which determines the overstrain of mental adaptation, with manifestations of psychosomatic hypochondria.
Patient No. 1, according to the data of psychophysiological examination, revealed a hyperthymic personality type with a moderate increase in the dynamics of the profile on the ninth scale. The personality trait is also indicated by a high, growing in dynamics, indicator on the K scale, which determines behavior depending on social approval and concern for one’s social status. On the first three scales (1, 2, 3) there is a type of conversion V – this is a combination of unpleasant physical sensations with vegetative anxiety and with a predominance of demonstrative tendencies aimed at overcoming difficulties caused by the state of health (scales 1 and 3). The appearance in dynamics (2013) of a peak on scales 1 and 4 determines the insufficient ability to internalize the social norm, i.e. insufficient ability to perceive this norm as part of their own attitudes (combination of profile peaks on scales 4 and 9). The presence of profile peaks on the 7th scale and on the scales of the neurotic triad reflect the tendency towards various options for the implementation of asocial attitudes in a socially acceptable way, the desire to look in a favorable light (scale L). A sufficiently high intelligence and demonstrative behavior determine good adaptation to the environment with self-confidence, high social adaptability, and resilience in overcoming difficulties.
Conclusion: Psychophysiological assessment of personality and current mental state determined individual personality traits in two patients with hyperthymic type of psychophysiological adaptation of varying severity, who underwent ARS, severe and extremely severe local radiation injuries 30 years after the radiation incident, respectively.
A significant increase in the profile on the 9th scale in patient No. 2 was constantly detected, reflecting the persistence of the described personality traits characteristic of chronically hyperthymic individuals. A high level of hyperthymic activity causes him to overstrain his psychophysiological adaptation, with manifestations of psychosomatic hypochondria
A moderate increase in the profile on scale 9 and scale 3 characterized patient No. 1 as an optimistic, energetic and capable of high activity person, concerned about his social status (high values on the K scale). The appearance in the dynamics (2013) of a peak on the 1 (concern with the state of health) and 4 on the scale (emotional tension in direct behavior) determine the insufficient ability to internalize the social norm, i.e. insufficient ability to perceive this norm as part of one’s own attitudes (combination of profile peaks on scales 4
and 9). The presence of profile peaks on the 7th scale and the scales of the neurotic triad reflect the tendency for the implementation of asocial attitudes in a socially acceptable way.
Keywords: local radiation injuries, acute radiation sickness, criminal incident, military service, socio-psychophysiological assessment
For citation: Metlyaeva NA, Bushmanov AYu, Galstyan IA, Nugis VYu, Konchalovsky MV, Shcherbatykh OV, Torubarov FS. Socio-psychophysiological assessment of two patients with local radiation injuries to the hands. Medical Radiology and Radiation Safety. 2022;67(2):18-24. (In Russian) doi: 10.33266/1024-6177-2022-67-2-18-24
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Conflict of interest. The authors declare no conflict of interest.
Financing. The study had no sponsorship.
Contribution. Article was prepared with equal participation of the authors.
Article received: 30.11.2021. Accepted for publication: 30.03.2022.