Personal Characteristics of People with Hypertension

Smirnaya Anastasiya Andreevna PhD in Pedagogy Associate Professor, Department of Psychology and Pedagogy, Siberian State University of Science and Technology. M.F. Reshetnev. 82 Mira str., Krasnoyarsk, 660049, Russia mrostovtseva@sfu-kras.ru Other publications by this author     Potapova Ekaterina Vadimovna PhD in Psychology Associate Professor, Department of Developmental Psychology and Counseling, Siberian Federal University 79 Svobodny Prospekt str., Krasnoyarsk, 660028, Russia potapowa.catia2011@yandex.ru Smirnova Lyubov' Eduardovna PhD in Pedagogy Associate Professor, Department of Developmental Psychology and Counseling, Siberian Federal University 79 Prospect Svobodny str., Krasnoyarsk, 660028, Russia lubasmirnova1960@mail.ru Valitova Aliya Iskhakovna PhD in Psychology Associate Professor, Department of Developmental and Social Psychology, Bashkir State Pedagogical University. M. Akmulla 450076, Russia, Ufa, Pushkin str., 45, office 288 al_valitova@inbox.ru

Tkacheva Anna Vladimirovna Senior Lecturer, Department of Modern Educational Technologies, Siberian Federal University 79 Svobodny Prospekt str., Krasnoyarsk, 660028, Russia av.tkacheva@mail.ru

Introduction.  Hypertension today remains one of the most common diseases affecting the most able-bodied part of the population. Hypertension is in the first place among the causes of mortality. The prevalence of this pathology has been increasing in recent years in many countries and regions of the Russian Federation.

From the point of view of psychology, the basis of the occurrence of this disease are psychological factors and causes.

Even in the era of antiquity, when psychic phenomena and their destructive manifestations began to be described, ideas about the causes of many diseases arose in medical science and philosophy, as about the aspets lying in the plane of the doctor–patient relationship. Also at this time, the principle was formulated for the first time: "treat not the disease, but the patient" ^[1].

To date, scientists agree that many diseases, and hypertension in particular, are based on psychological causes, namely, a person's tendency to react painfully and emotionally to various stressful situations that arise in his life, which is largely determined by his personal characteristics ^{[3, 5]}.

A person's response to a negative situation is accompanied by a negative emotional state that causes physiological changes in human organs and tissues. It is not for nothing that research in the field of medical psychology has become widespread in recent years, where psychosomatic problems have a great weight among medical diagnoses.

The aim of the study is to study the personal characteristics of patients with mild and severe hypertension.

The subject of the study is the personal characteristics of people with hypertension.

Research methods: theoretical analysis of the literature devoted to the research problem; mathematical and statistical methods of processing the results;  methods aimed at identifying the features of the emotional sphere of patients with cardiovascular diseases:

1. Questionnaire for assessing neuropsychic stability (developed at LVMA named after S.M. Kirov).

2. Questionnaire for determining the level of neuroticism and psychopathization (developed at the Leningrad Institute named after V.M. Bekhterev, authors I. B. Lasko, B. I. Tonkonogy).

3. Beck's alarm scale. The scale is suitable for examining people with somatic pathology (cardiovascular diseases, diabetes mellitus, etc.), in whom anxiety can join the main disease, and then they are also shown the help of a psychiatrist.

Theoretical review. To date, there are a sufficient number of works in the scientific literature that are related to the study of the dynamics of the influence of mental states on the patient's illness.

Bokarev I.N. Borovkov N.N. ^{[1, 2]} in 2019, the influence of locus control on the occurrence of depression was studied. Foreign scientists P. Suzan (2019) ^[16], P.K. Luzano (2018) ^[15], investigating the correlation of the same characteristics, emphasize that for rehabilitation purposes it is more important to change the locus of control during psychotherapeutic measures.

Dudnichenko S.V. ^[9] studied the psychosomatics of bronchial asthma (2021). Denisova E.A. and co-authors investigated the influence of psychological disorders on the occurrence of diabetes mellitus ^[9].

As for hypertension, a number of domestic and foreign authors (Volkova E.V., Voronchikhina K.A., Maksimov N.I., Dimov A.S., Bronheim H. E., Brown A.D. ^[5,17,18]) note the influence of depressive, depressed states on the development of hypertension, which confirms the opinion that hypertension it is a psychosomatic disease, in the occurrence of which one of the main roles belongs to psychotraumatic factors ^{[13, 14, 15]}.

In particular, this is due to the fact that hypertension, as a disease of the cardiovascular system, primarily reacts to disturbing environmental factors, is quite "thin" and labile. There is also a reverse effect: diseases of this system entail disorders of cerebral circulation, which leads to the development of psycho-emotional disorders ^{[7, 9]}.

According to statistics, with the help of medications, only 30-40% of patients achieve normal blood pressure during treatment. These studies indicate the importance of diagnosing the personal characteristics of the emotional sphere of patients with hypertension, developing and carrying out appropriate non-drug preventive measures in relation to these individuals ^[6]. In this regard, it is necessary to purposefully organize research to study the personal characteristics of people suffering from hypertension ^{[8, 10, 11, 12]}.

In our research, we rely on the concept of E.V. Volkova, K.A. Voronchikhina, N.I. Maksimova, A.S. Dimova, who experimentally proved that the cause of many human diseases is associated with neuropsychiatric stress. The solution of these problems is primarily connected with the need for early diagnosis of subclinical manifestations of such conditions, in particular, neurotization, psychopathization and predisposition to them, as well as with anxiety as a personal acquired property of a person ^[5].

Research. The study was conducted on the basis of the cardiology department of the City Clinical Hospital No. 1 in Bratsk, Irkutsk region.

The study involved 74 respondents: 38 patients with mild hypertension and 36 patients with severe hypertension. Among patients with mild hypertension - 24 women and 14 men. Among the patients with severe course of the disease – 30 women and 6 men. All subjects aged 55 to 60 years.

The results of the questionnaire according to the methodology "Assessment of neuropsychic stability" (developed at the LVMA named after S.M. Kirov):

Figure 1 – results on the method of assessing neuropsychic stability

Figure 1. – The average level of neuropsychiatric stability in subjects with mild and severe hypertension

The average score of neuropsychiatric stability in the group of subjects with mild hypertension was 9.1. The average score in the group with severe hypertension was 9.3. Both results assess the neuropsychiatric stability of the subjects as average. Neuropsychiatric breakdowns are unlikely for participants of both groups.

The questionnaire for determining the level of neuroticism and psychopathization by the authors (I. B. Lasko, B. I. Tonkonogy) allowed us to obtain the following results:

Figure 2 – results on the method of determining the level of neuroticism and psychopathization

Figure 2. – The average level of neuroticism and psychopathization in subjects with mild and severe hypertension

In group c of patients with a mild course of the disease, the average level of neuroticism is higher (the average level with a tendency to high) than in the group of respondents with a severe stage of the disease. That is, in the first group, the majority of respondents have a pronounced emotional excitability, producing various negative experiences (anxiety, tension, anxiety, confusion, irritability). The lack of initiative of these persons forms the experiences associated with the dissatisfaction of desires. Their egocentric personality orientation is manifested both in a tendency to hypochondriac fixation on unpleasant somatic sensations, and in concentration on the experiences of their personal shortcomings. This, in turn, forms a sense of inferiority, difficulty in communication, social shyness and dependence.

The level of psychopathization in both groups is average. But in the group of patients with mild hypertension, it is slightly lower than in the group of patients with severe hypertension. Such a level may indicate prudence, compliance, focus on the opinions of others, commitment to strict compliance with generally accepted rules and norms of behavior. 

In the group with severe hypertension, the results tend to a greater extent to a high level of psychopathization, which indicates carelessness and frivolity, a cold attitude towards people, assertiveness, stubbornness in interpersonal interactions. These individuals tend to go beyond the generally accepted norms and morals, which can lead to unpredictability of their actions and the creation of conflict situations.

The following results were obtained using the Beck Scale method for assessing anxiety (Figure 3)

Figure 3. – The average level of anxiety in subjects with mild and severe hypertension

Thus, in two groups of subjects, the level of anxiety for the school used is approximately the same, and is an average value. This means that respondents are predisposed to perceive a wide range of situations as threatening their self-esteem, prestige, self-esteem or vital activity. The tendency to react to such situations with a state of anxiety. Sensitivity to those negative events or failures that are supposed to happen or occur.

Let's turn to mathematical data analysis to find reliable differences.

In order to study the reliability of differences between samples, a nonparametric method of comparing independent samples was used, the Mann-Whitney U-test. However, there were no significant differences in the results of the study of the groups. This indicates that the features of the emotional sphere in the studied sample of persons suffering from hypertension of mild and severe severity do not have a pronounced distinctive character relative to each other (U = 1.5 at p0.01 for the indicator of neuropsychiatric stability; U = 0.03 and U = 0.02 at p0.02 for indicators of psychotization and neurotization, U = 0.05 at p 0.01) on the alarm scale).

We have developed a number of general recommendations for the prevention of hypertension

A complex of autogenic training for falling asleep is useful. It is recommended, for example, repeated repetition (in slow motion on a long exhalation) of phrases like: "I'm getting more sleepy" (pause). "Eyelids are getting heavy" (pause). "I'm falling asleep" or "My blood pressure is normalizing" (pause). "The heart is working slowly" (pause). "The heart is working calmly," etc. The text of the phrases of autosuggestion is clarified by a psychologist; appropriate "hypnotic" tape recordings can be used.

At both stages of prevention, special attention should be paid to therapeutic physical culture, since it is a kind of measure of psychological protection, training the neurovascular apparatus, reducing the phenomena associated with neuropsychiatric disorders. Physical exercises allow you to stop the harmful effects of hypokinesia experienced by residents of economically developed countries.

To reduce the neuropsychiatric excitement, many resort to smoking or taking alcohol. These bad habits should be combated. Psychological training to relieve negative emotions and nervous excitement, also associated with the use of physical exercises in practice, helps to get rid of smoking. Metaphorically, it can be expressed like this: if you want to pick up a cigarette, you'd better do squats." In fact, after each stressful state, it is possible (if possible) to perform a set of exercises (squats, breathing exercises, movements with self-resistance, etc.) for utilization, excess adrenaline, glucose, carbon dioxide and other biologically active substances released into the blood during stress.

Conclusion.Thus, we conducted a study aimed at studying the personal characteristics of patients with mild and severe hypertension.

The following methods were used: a questionnaire for assessing neuropsychic stability (developed at the LVMA named after S.M.Kirov); a questionnaire for determining the level of neuroticism and psychopathization (developed at the Leningrad Institute named after V.M. Bekhterev), the Beck Anxiety Scale.

The average score of neuropsychiatric stability in the group of subjects with mild hypertension was 9.1. The average score in the group with severe hypertension was 9.3. Both results assess the neuropsychiatric stability of the subjects as average. Neuropsychiatric breakdowns are unlikely for participants of both groups.

In both groups, there is an average level of neuroticism with a tendency to a high level in the group with a mild degree of hypertension.

In both groups, there is an average level of psychopathization. In the group with a mild degree of GB, the results tend to a lower level of psychopathization to a greater extent. In the group with severe GB, the results tend to a high level of psychopathization to a greater extent.

In both groups of subjects, the level of anxiety is expressed at an average level. This means that respondents are predisposed to perceive a wide range of situations as threatening their self-esteem, prestige, self-esteem or vital activity. The tendency to react to such situations with a state of anxiety. Sensitivity to those negative events or failures that are supposed to happen or occur ^{[1, 2]}.

In order to study the reliability of differences between samples, a nonparametric method of comparing independent samples was used, the Mann-Whitney U-test. However, there were no significant differences in the results of the study of the groups. This indicates that the features of the emotional sphere in the studied sample of persons suffering from hypertension of mild and severe severity do not have a pronounced distinctive character relative to each other.

At the conclusion of this study, general recommendations were given for the prevention of the development of hypertension. One way or another, they are associated with a high role of physical activity and exercise in the prevention of this disease.