The concept of physiological and pathological affect. Murder committed in a state of passion. Diagnosis and treatment of pathological affect

According to modern concepts, this is a hyperkinetic form of an acute shock reaction, accompanied by psychomotor agitation and aggressive actions against the offender, at the height of which there is a violation of consciousness by the type of twilight stupefaction. Diagnostic signs: three-phase flow (accumulation, explosion, asthenia); unexpected occurrence; inadequacy to the occasion that caused it; sharp psychomotor agitation; twilight disorder of consciousness at the height of disorder; automatism of actions; violations of the motivation of behavior; severe asthenia after leaving this state. It should be noted that affectogenic exceptional states have much in common with physiological affect (causal relationship with a psychogenic factor, severity of onset, the same three-phase flow, similar vasovegetative and motor reactions). The main and cardinal difference is the symptoms of a psychopathological series in the second phase (explosion phase): phenomena of clouded consciousness, accompanied by subsequent amnesia. One of the essential signs in pathological psychogenic states is the disproportion of the cause to the strength of the psychogenic explosive reaction. The discharge occurs according to the principle of the "last drop", and although this "drop" is associated with the entire psychogenic situation, the occasion itself is often quite insignificant. And if the diagnosis of physiological affect is the competence of psychologists, then the diagnosis of pathological affect is the competence of psychiatrists, since this is a transient psychotic state.

The first phase (preparatory) includes the personal processing of psychogeny, the emergence and growth of the personality's readiness for affective discharge. A prolonged psycho-traumatic situation determines an increase in affective tension, against which a psychogenic occasion, by the mechanism of the “last drop”, can cause an acute affective reaction. In conditionally mentally healthy people, both acute and protracted psychogenies are equally important for the occurrence of a pathological reaction. As already mentioned, in "conditionally mentally healthy" one can almost always find signs of residual organic damage to the central nervous system and the presence of incoming asthenic factors, which also form pathological grounds.

With protracted psychogenies associated with a prolonged psycho-traumatic situation, persistent hostile relationships with the victim, prolonged systematic humiliation and bullying, an acute affective reaction occurs as a result of a gradual accumulation of affective experiences. The mental state of the subjects, prior to the occasion that caused the affective reaction, is characterized by low mood, neurasthenic symptoms, the appearance of dominant ideas, closely related to the psychogenic traumatic situation. Factors contributing to the facilitation of the occurrence of an affective reaction are overwork, forced insomnia, somatic weakness, etc. Under the influence of a psychogenic stimulus coming directly from the offender and outwardly seemingly insignificant, a reaction with aggressive actions directed against the victim may suddenly arise both for the person himself and for those around him. This mechanism is referred to as the "short circuit reaction".

This group is dominated by women with asthenic, inhibited character traits. These are timid, shy creatures who are in a psychogenic traumatic situation for many years, often in their own family. As a rule, these are bullying by an alcoholic husband who humiliates a woman, beats her and her children; bullying is often sadistic. For example, one subject's husband drove needles under her fingernails, another was forced to drink his own urine. Usually women do not tell anyone about this, and this situation lasts for years. Thus, the cumulation of affect occurs. It is important to note that such reactions usually occur in women against the background of long-term depressive states, i.e. it is natural to assume that in the conditions of such a long psychotraumatic situation, severe both objectively and subjectively, women have a painfully lowered mood. But these depressions are, as a rule, masked, larved, somatized in nature, i.e. somatovegetative manifestations come to the fore. In terms of clinical presentation, they are closest to P. Kielholz's "depressions of exhaustion", when the asthenic component of depression is pronounced and depression is accompanied by somatic masks. Usually in the cases of such subjects there is a somatic map - voluminous, all written over - for many years a woman has been examined by various specialists - internists, neuropathologists, endocrinologists, gynecologists. There is no complete objectification of these somatic complaints, but sometimes an observant doctor indicates that a woman's mood is lowered. In the broad sense of the word, this is reactive depression, a long-term reactive state. The affect cumulates, and by the time the offense is committed, a psychotic state occurs with the participation of a short circuit mechanism. So, with protracted psychogenies, there is a pathological ground: asthenia, depression, cumulation of affect. Moreover, for years these people endure bullying, and the last straw is always some minor event. It sometimes looks very strange that a woman endured beatings, humiliation, but on the day when everything happened, her husband, just passing by, said a swear word, which was the last straw.

There is an affective explosion, at the height of this state an affectively clouded consciousness is noted. The actions of the sub-experts, as it were, are finally directed, i.e. aimed at eliminating the offender, the cause of their experiences, which distinguishes these states from, say, pathological intoxication or a pathological sleepy state, where the victims are often accidental. Here, the actions are directed, which is the biggest difficulty in the forensic psychiatric evaluation of these cases. Sometimes experts say: "but they killed the one who offended them." However, if we analyze the entire history, then this is the case, as E. Kretschmer wrote, when "a rabbit turns into a tiger." That is, inhibited, timid, shy, insecure individuals commit the most serious offenses. The role of progredient asthenia in the occurrence of such conditions is also emphasized in foreign literature, and the fact that the actions are finally directed does not exclude the diagnosis of a disease state at all.

In the second phase of the pathological affect, a short-term psychotic state arises, the affective reaction acquires a qualitatively different character. Psychotic symptomatology, characteristic of pathological affect, is characterized by incompleteness, low severity, lack of connection between individual psychopathological phenomena. It is determined, as a rule, by short-term perceptual disorders in the form of hypoacusia (sounds move away), hyperacusis (sounds are perceived as very loud), illusory perceptions. Separate perceptual disorders can be qualified as affective functional hallucinations. The clinic of psychosensory disorders, violations of the body scheme (the head has become large, the arms are long), states of acute fear and confusion are presented much more holistically. Delusional experiences are unstable, and their content may reflect a real conflict situation.

The second group of symptoms includes expressive characteristics and vasovegetative reactions characteristic of affective tension and explosion, changes in motor skills in the form of motor stereotypes, post-affective asthenic phenomena with amnesia of the deed, as well as subjective suddenness of a change in state during the transition from the first to the second phase of an affective reaction, special cruelty of aggression , its inconsistency in content and strength with respect to the occurrence (with protracted psychogenies), as well as inconsistency with the leading motives, value orientations, attitudes of the personality.

Motor actions in pathological affect continue even after the victim ceases to show signs of resistance or life, without any feedback from the situation. These actions are in the nature of unmotivated automatic motor discharges with signs of motor stereotypes. An extremely sharp transition of intense motor excitation, characteristic of the second phase, into psychomotor retardation also testifies to the disturbance of consciousness and the pathological nature of the affect.

The third phase (final) is characterized by the absence of any reactions to what was done, the impossibility of contact, terminal sleep or painful prostration, which is one of the forms of stunning. In the differential diagnosis of pathological and physiological affects, it must be taken into account that, being qualitatively different states, they have a number of common features.

With pathological affect, insanity is determined only by the presence of signs of clouded consciousness at the time of the offense. This condition falls under the concept of a temporary disorder of mental activity of the medical criterion of insanity, since it excludes the possibility of a person realizing at the time of committing unlawful actions the actual nature and social danger of his actions.

The most adequate type of examination in assessing affective torts should be considered a comprehensive forensic psychological and psychiatric examination. The principle of joint consideration of the person, situation, state at the time of the tort is one of the main ones in assessing emotional states. Judicial complex psychological and psychiatric examination allows the most complete and comprehensive assessment of the affective delict in the process of joint psychological and psychiatric research at all stages of the examination. The competence of a psychiatrist extends to the disclosure and qualification of abnormal, pathological features of the personality of the subject, nosological diagnosis, delimitation of painful and non-painful forms of affective reaction, making a conclusion about the sanity-insanity or limited sanity of the accused. Within the competence of the psychologist is the determination of the structure of the personal characteristics of the subject, both within the limits of the norm and developing into a picture of personal disharmony, analysis of the current psychogenic situation, the motives of the behavior of its participants, determining the nature of a non-painful emotional reaction, the degree of its intensity and influence on the behavior of the subject when committing unlawful acts.

Pathological sleepy state- a fairly common mental pathology. But it can be assumed that it comes to the attention of psychiatrists only when subjects in this state commit serious offenses. Sleeping states aroused increased interest not only among clinicians, but also among the general public, therefore they were reflected in fiction. The pathological prosonic state is described in the story of A.P. Chekhov "I want to sleep." It took place with a girl who was a servant in the house and was subjected to humiliating bullying and beatings by the mistress. She was malnourished, sleep deprived (temporary soil), homesick. Thus, all factors are summed up and, rocking the child in the cradle, she suddenly begins to hallucinate. She sees the clouds, it seems to her that these clouds are laughing like children, she strangles the child and with a happy laugh lies on the floor next to the child and falls asleep. The time of writing this story coincides in time with the friendship of A.P. Chekhov with S.S. Korsakov. And it is quite possible that it was he who told the writer a similar case from practice. Despite the fact that A.P. Chekhov was a doctor, the accuracy of the description of psychopathology indicates that some real case formed the basis of the story. Then A. I. Solzhenitsyn recalled this story when describing morbid conditions in prisoners who were tortured by sleep deprivation.

A pathological sleep state is a hyperacute psychotic state that occurs during spontaneous or forced awakening from deep sleep. The main manifestation of this state is a violation of consciousness, which phenomenologically completely fits into the twilight clouding of consciousness. But just like other exceptional conditions, pathological sleepy states do not occur out of the blue. And in many cases, it is possible to identify an organic pathology of the brain of one or another genesis. Acute alcohol intoxication immediately before the development of a prosonic state is also a common occurrence. In many cases, the subjects drank alcohol before falling asleep, and when they woke up, being forcibly awakened, they committed serious offenses, and almost always after that the subjects went back to bed and slept. Then, upon awakening, in almost 100% of cases, they amnesize an acute psychotic episode. Such resleeping is characteristic of pathological prosonic states.

A very important point, which is noted in many German guidelines, is an indication of a history of sleep disturbances. These may include sleepwalking, sleepwalking, and individual characteristics such as delayed awakening, very deep sleep, and awakening orientation disorders. Great importance is attached to previous dreams - they can be nightmarish with a threat to life, and then the delict itself, the behavior of a person during a pathological sleepy state, is, as it were, a response to their threatening content in the form of the elimination of a life-threatening object. There may be dreams with a psychogenic coloring that reflect the previous psychogeny: quarrels, a showdown, a difficult conflict situation, and then, upon awakening, actions are performed in the vein of these dreams. It is important that in pathological prosonic states, unlike other exceptional conditions, not fragmentary amnesia is detected, but total. Previously, in the literature there were various terms for designating sleepy states: "drunk sleep", "slumbering delirium". Persons who have committed offenses in a state of pathological sleeplessness are recognized as insane.

Thus, an expert assessment of the so-called short-term mental disorders does not cause difficulties (Article 21 of the Criminal Code - “temporary mental disorder”).

The choice of medical measures in relation to persons who have undergone short-term mental disorders should be differentiated. The presence in the anamnesis of patients with organic insufficiency, alcohol abuse, taking into account the personality and socially dangerous actions, is the basis for the appointment of compulsory medical measures. Coercive measures against these persons may be carried out in general psychiatric hospitals. In cases where exceptional conditions occur in persons who have not previously abused alcohol, with a positive social status, with a mild pathology of the soil, outpatient compulsory observation and treatment by a psychiatrist can be recommended. If it is necessary to treat organic soil and psychogenic disorders, which are often observed in persons who have undergone short-term psychotic states, these patients may be recommended for examination and treatment in a psychiatric hospital outside the scope of compulsory medical measures.

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Affect is an emotional, strong experience that occurs when it is impossible to find a way out of critical, dangerous situations, associated with pronounced organic and motor manifestations. Translated from Latin, affect means passion, emotional excitement. This condition can lead to inhibition of other mental processes, as well as the implementation of appropriate behavioral reactions.

In a state of passion, strong emotional agitation narrows the consciousness and limits the will. After the experienced unrest, affective special complexes arise, which are triggered without awareness of the reasons that caused the reaction.

Causes of affect

The most important cause of affect are circumstances that threaten the existence of a person (indirect or direct threat to life). The reason can also be a conflict, a contradiction between a strong desire, attraction, desire for something and the inability to objectively satisfy the impulse. For the person himself there is an impossibility of understanding this situation. The conflict can also be expressed in the increased demands that are placed on a person at a given moment.

An affective reaction can be provoked by the actions of others that have affected a person’s self-esteem and thereby traumatized his personality. The presence of a conflict situation is mandatory, but not sufficient for the emergence of an affective situation. Of great importance are the stable individual psychological characteristics of the personality, as well as the temporary state of the subject who is in a conflict situation. In one person, circumstances will cause a violation of a coherent system of behavior, while in another they will not.

signs

The signs include external manifestations in the behavior of a person who is accused of a crime (motor activity, appearance, peculiarities of speech, facial expressions), as well as the sensations experienced by the accused. These feelings are often expressed by the words: “I vaguely remember what happened to me”, “something seemed to break in me”, “feelings like in a dream”.

Later, in the works of criminal law, the sudden emotional excitement began to be identified with the psychological concept of affect, which is characterized by the following features: explosive nature, suddenness of occurrence, deep and specific psychological changes that remain within the limits of sanity.

Affect refers to a sensual, emotionally excited state experienced by an individual in the process of all life activity. There are different signs by which emotions, feelings, affective reactions are distinguished. The modern use of the concept of affect, denoting emotional excitement, has three conceptual levels:

1) clinical manifestations of feelings associated with a spectrum of experiences of pleasure or displeasure;

2) associated neurobiological phenomena, which include secretory, hormonal, autonomic or somatic manifestations;

3) the third level is associated with psychic energy, instinctive drives and their discharge, signal affects without the discharge of drives.

Affect in psychology

The emotional sphere of a person represents special mental processes, as well as states that reflect the experiences of an individual in different situations. Emotions are the reaction of the subject to the acting stimulus, as well as to the result of actions. Emotions throughout life affect the human psyche, penetrating into all mental processes.

Affect in psychology is strong, as well as short-term emotions (experiences) that occur after certain stimuli. The state of affect and emotions are different from each other. Emotions are perceived by a person as an integral part of himself - "I", and affect is a state that appears beyond the will of a person. The affect occurs in unexpected stressful situations and is characterized by a narrowing of consciousness, the extreme degree of which is a pathological affective reaction.

Mental excitement performs an important adaptive function, preparing a person for an appropriate reaction to internal and external events, and is marked by a high severity of emotional experiences leading to the mobilization of psychological and physical resources of a person. One of the signs is a partial loss of memory, which is noted not in every reaction. In some cases, the individual does not remember the events that precede the affective reaction, as well as the events that occurred during the emotional excitement.

Psychological affect is marked by the excitation of mental activity, which reduces control over behavior. This circumstance leads to a crime and entails legal consequences. Persons in a state of mental agitation are limited in their ability to be aware of their actions. Psychological affect has a significant impact on a person, while disorganizing the psyche, affecting its higher mental functions.

Types of affect

There are such types of emotional excitement - physiological and pathological.

Physiological affect is an uncontrolled discharge that appears in an affective situation with emotional stress, but does not go beyond the norm. Physiological affect is a non-painful emotional state that represents a rapid and short-lived explosive reaction without a psychotic change in mental activity.

Pathological affect is a psychogenic painful condition that occurs in mentally healthy people. Psychiatrists perceive such excitement as an acute reaction to traumatic factors. The height of development has disturbances according to the type of twilight state. The affective reaction is characterized by sharpness, brightness, three-phase flow (preparatory, explosion phase, final). A tendency to pathological conditions indicates a violation of the balancing of the processes of inhibition and excitation in the central nervous system. For pathological affect, emotional manifestations are inherent, often in the form of aggression.

In psychology, the affect of inadequacy is also distinguished, which is understood as a stable negative experience provoked by the inability to succeed in any activity. Often, affects of inadequacy appear in young children when voluntary regulation of behavior is not formed. Any difficulty that caused dissatisfaction of the needs of the child, as well as any conflict, provokes the emergence of emotional unrest. With improper upbringing, the tendency to affective behavior is fixed. Under unfavorable conditions of upbringing, children show suspicion, constant resentment, a tendency to aggressive reactions and negativism, and irritability. The duration of such a state of inadequacy provokes the formation and consolidation of negative character traits.

Affect in criminal law

Signs of affect in criminal law are a loss of flexibility in thinking, a decrease in the quality of thought processes, leading to an awareness of the immediate goals of one's actions. A person's attention is focused on the source of irritation. For this reason, due to emotional stress, the individual loses the opportunity to choose a behavior model, which provokes a sharp decrease in control over his actions. Such affective behavior violates expediency, purposefulness, and also the sequence of actions.

Forensic psychiatry, as well as forensic psychology, relates the state of passion to the individual's limiting ability to realize the actual nature, as well as the social danger of his act and the inability to control it.

Psychological affect has minimal freedom. A crime committed in a state of passion is considered by the court as a mitigating circumstance, if certain conditions are met.

The concepts of affect in criminal law and in psychology do not coincide. In psychology, there is no specifics of negative stimuli that provoke a state of affective reaction. There is a clear position in the Criminal Code that speaks of the circumstances that can cause this condition: bullying, violence, insult on the part of the victim or a long-term psycho-traumatic situation, immoral and illegal actions of the victim.

In psychology, affect and strong emotional excitement that have arisen are not identical, and criminal law puts an equal sign between these concepts.

Affect as a strong short-term emotional excitement is formed in a person very quickly. This state occurs suddenly for others and the person himself. The proof of the presence of emotional excitement is the suddenness of its occurrence, which is an organic property. Strong emotional excitement can be caused by the actions of the victim and needs to establish a connection between the affective reaction and the act of the victim. This condition should suddenly appear. The suddenness of its appearance is closely related to the emergence of the motive. The following situations precede the sudden emotional strong excitement: bullying, violence, grave insult, immoral and illegal actions. In this case, an affective reaction arises under the influence of a one-time event, as well as a significant one for the most guilty event.

The state of passion and its examples

Affective reactions have a negative impact on human activity, lower the level of organization. In this state, a person commits unreasonable actions. Extremely strong excitation is replaced by inhibition and, as a result, ends with fatigue, loss of strength, and stupor. Disturbances of consciousness lead to partial or complete amnesia. Despite the suddenness, emotional excitement has its own stages of development. At the beginning of an affective state, one can stop emotional emotional excitement, and at the final stages, losing control, a person cannot stop on his own.

To postpone an affective state, huge volitional efforts are needed to restrain oneself. In some cases, the affect of rage is manifested in strong movements, violently and with cries, in a furious facial expression. In other cases, despair, confusion, delight are examples of an affective reaction. In practice, there are cases when physically weak people, experiencing strong emotional excitement, do things that they are incapable of in a calm environment.

Examples of the state of affect: the spouse unexpectedly returned from a business trip and personally discovered the fact of adultery; a frail man beats several professional boxers in a state of affective reaction, or knocks down an oak door with one blow, or inflicts many mortal wounds; a drunkard-husband commits constant scandals, fights, fights on the basis of drinking alcohol.

Treatment

Treatment of an affective state includes emergency measures, which include the establishment of supervision of a person and the mandatory referral to a psychiatrist. Depressed patients prone to suicide are shown hospitalization with enhanced supervision, and the transportation of such people is carried out under the supervision of medical staff. On an outpatient basis, patients with agitated depression, as well as depression with suicidal attempts, are shown injections of 5 ml of a 2.5% solution of Aminazine.

Treatment of affect with includes drug therapy that affects the manic and depressive phases of the disease. For depression, antidepressants of different groups are prescribed (Lerivol, Anafranil, Amitriprilin, Ludiomil). Depending on the type of affective reaction, atypical antidepressants are prescribed. Electroconvulsive therapy is used when it is impossible to carry out medical treatment. The state of mania is treated with such antipsychotics as Azaleptin, Clopixol, Tizercin. In the treatment, sodium salts have proven themselves well if the affective reaction takes a monopolar variant.

Manic patients are often hospitalized because their wrong and unethical actions can harm others and the patients themselves. In the treatment of manic states, neuroleptics are used - Propazine, Aminazin. Patients with euphoria also need hospitalization, since this condition means either the presence of intoxication or an organic disease of the brain.

Aggression in patients with epileptic is removed by hospitalization. If the depressive state acts as a phase of circular psychosis, then psychotropic drugs - antidepressants - are effective in the treatment. The presence of agitation in the structure requires complex therapy with antidepressants and neuroleptics. With psychogenic minor depression, hospitalization is not mandatory, since its course is regressive. Treatment includes antidepressants and sedatives.

Doctor of the Medical and Psychological Center "PsychoMed"

The information provided in this article is for informational purposes only and cannot replace professional advice and qualified medical assistance. At the slightest suspicion of the presence of an affect, be sure to consult a doctor!

The term "pathological affect" appeared in psychiatric literature in the second half of the 19th century. Prior to this, there were names "angry unconsciousness", "madness", the clinical content of which to a certain extent corresponded to pathological affect. In 1868, Krafft-Ebing (R. Krafft-Ebing) in the article "Painful moods of the soul" proposed to call the state of sharp emotional excitement "pathological affect." S. S. Korsakov emphasized the forensic psychiatric significance of the pathological affect, and V. P. Serbsky distinguished it from the physiological affect that arises on pathological grounds.

Clinical picture The development of pathological affect is usually divided into three stages. In the first (preparatory) stage, under the influence of a psychogenic traumatic effect and growing affect, consciousness concentrates on a narrow circle of traumatic experience.

In the second stage (the explosion stage), an affective discharge occurs, which manifests itself in violent motor excitation, a profound impairment of consciousness, a disorder of orientation and speech incoherence. All this is accompanied by a sharp reddening or blanching of the face, excessive gestures, unusual facial expressions.

The final stage is manifested in a pronounced mental and physical exhaustion. There comes a general relaxation, lethargy, indifference. Deep sleep often occurs. After awakening, partial or complete amnesia is detected for the duration of the pathological affect.

Studies of the etiology and pathogenesis of pathological affect were reduced to clarifying the question of its dependence on the soil on which it arises. S. S. Korsakov believed that pathological affect occurs more often in psychopathic personalities, but it can differ under certain circumstances in people without a psychopathic constitution.

V. P. Serbsky wrote that a pathological affect cannot occur in a completely healthy person.

It should be assumed that the reduced resistance of the brain to stress, which contributes to the occurrence

The affect is pathological, more often in people with non-covered deviations from the norm (psychopathy, traumatic brain damage, etc.). However, under the influence of a number of factors (exhaustion after illness, pregnancy, fatigue, insomnia, malnutrition, and others), a state of reduced brain resistance can also occur in normal people.

In the short-term period of the pathological affect, it is not possible to conduct pathophysiological, biochemical and other studies.

Differential diagnosis should be carried out with a physiological affect, with an affect arising on pathological soil, and with a reaction of the so-called short circuit [Kretschmer (E. Kretschmer)].

Unlike the pathological affect, the physiological affect is not accompanied by a change in consciousness, automatic actions and subsequent amnesia. With a physiological affect, there are no successive stages of its onset and cessation.

With physiological affect on pathological grounds, the affective state reaches a significant degree and has features characteristic of the affective reactions of persons who have suffered a skull injury, suffering from an organic lesion of the central nervous system, as well as psychopathy. However, these pronounced and vivid affective reactions are not accompanied by the described psychopathological phenomena (disorder of consciousness, automatism of actions, etc.) and their consistent development.

- a short-term mental disorder, an explosion of anger and rage, due to an unexpected psycho-traumatic situation. Accompanied by a clouding of consciousness and a distorted perception of the environment. It ends with autonomic disorders, prostration, deep indifference and prolonged sleep. Subsequently, partial or complete amnesia is observed for the period of pathological affect and previous traumatic events. The diagnosis is made on the basis of an anamnesis, a survey of the patient and witnesses of the incident. In the absence of other mental disorders, treatment is not required; if a mental pathology is detected, the underlying disease is treated.

General information

Pathological affect is a rather rare disorder, which is the basis for recognizing a patient as insane when committing criminal or administratively punishable actions. Physiological affect is much more common - a milder version of a strong emotional reaction to an external stimulus. Unlike pathological, physiological affect is not accompanied by a twilight state of consciousness and is not a basis for recognizing the patient as insane at the time of the offense. Diagnosis of pathological affect and treatment of the underlying disease (if any) is carried out by specialists in the field of psychiatry.

Causes and pathogenesis of pathological affect

The immediate cause of the development of a pathological affect is a sudden superstrong external stimulus (usually violence, verbal abuse, etc.). Panic fear caused by real danger, increased demands and self-doubt can also act as a triggering factor. The personal significance of an external stimulus depends on the character, beliefs and ethical standards of the patient. Many psychiatrists consider pathological affect as an "emergency" reaction to a situation that the patient considers hopeless and intolerable. In this case, the psychological constitution of the patient and the previous circumstances are of some importance.

The well-known Russian psychiatrist S. S. Korsakov believed that patients with psychopathic personality development were more prone to the occurrence of pathological affect. At the same time, both Korsakov and the founder of Russian forensic psychiatry, V.P. Serbsky, believed that pathological affect can be diagnosed not only in patients with a psychopathic constitution, but also in people who do not suffer from any mental disorders.

Modern Russian psychiatrists name a number of factors that increase the likelihood of pathological affect. These factors include psychopathy, neurotic disorders, a history of traumatic brain injury, alcoholism, drug addiction, and substance abuse. In addition, the risk of developing a pathological affect increases in people who do not suffer from the listed diseases, but who have a reduced resistance to stress due to exhaustion after a somatic or infectious disease, due to poor nutrition, insomnia, physical or mental overwork.

In some cases, the “accumulation effect”, a long-term accumulation of negative experiences caused by tensions, beatings, constant humiliation and bullying, is of great importance. The patient “accumulates” negative emotions for a long time, at a certain moment, patience ends, and feelings splash out in the form of a pathological affect. Usually, the patient's anger is directed at the person with whom he is in a conflict relationship, but sometimes (when getting into a situation resembling the circumstances of chronic psychological trauma), a pathological affect occurs when in contact with other people.

Affect is the most vivid manifestation of emotions, especially strong feelings. Pathological affect is an extreme degree of ordinary affect. The reason for the development of all types of affect is the excessive excitation of certain parts of the brain during inhibition of the departments responsible for other mental processes. This process is accompanied by one or another degree of narrowing of consciousness: with a physiological affect - the usual narrowing, with a pathological affect - twilight stupefaction.

As a result, the patient ceases to track information that is not related to the psychotraumatic situation, evaluates and controls worse (in case of pathological affect, does not evaluate and does not control) his own actions. Nerve cells in the area of ​​excitation work at their limit for some time, then protective inhibition occurs. Extremely strong emotional experiences are replaced by the same strong fatigue, loss of strength and indifference. In pathological affect, emotions are so strong that inhibition reaches the level of stupor and sleep.

Symptoms of pathological affect

There are three stages of pathological affect. The first stage is characterized by some narrowing of consciousness, the patient's concentration on experiences associated with a traumatic situation. Emotional stress increases, the ability to perceive the environment, assess the situation and realize one's own state decreases. Everything that is not related to the traumatic situation seems insignificant and is no longer perceived.

The first phase of the pathological affect smoothly passes into the second - the phase of the explosion. Anger and rage grow, at the peak of experiences there is a deep stupefaction of consciousness. Orientation in the surrounding world is disturbed, at the moment of climax, illusions, hallucinatory experiences and psychosensory disorders are possible (being in a state of pathological affect, the patient incorrectly assesses the size of objects, their remoteness and location relative to the horizontal and vertical axes). In the explosion phase, a violent motor excitation is observed. The patient shows severe aggression, performs destructive actions. At the same time, the ability to perform complex motor acts is preserved, the patient's behavior resembles the actions of a ruthless machine.

The explosion phase is accompanied by violent vegetative and mimic reactions. On the face of a person who is in a state of pathological affect, violent emotions are reflected in various combinations. Anger is mixed with despair, rage with bewilderment. The face turns red or pale. After a few minutes, the emotional outburst suddenly ends, it is replaced by the final phase of pathological affect - the phase of exhaustion. The patient sinks into a state of prostration, becomes lethargic, shows complete indifference to the environment and his own actions committed in the phase of the explosion. There is a long deep sleep. Upon awakening, partial or complete amnesia occurs. What happened is either erased from memory, or emerges in the form of scattered fragments.

A distinctive feature of the pathological affect in chronic mental trauma (constant humiliation and fear, prolonged physical or psychological abuse, the need to constantly restrain) is the discrepancy between the reaction and the stimulus that caused it. Pathological affect occurs in a situation that people who do not know all the circumstances would consider insignificant or of little importance. This reaction is called a "short circuit" reaction.

Diagnosis and treatment of pathological affect

The diagnosis is of particular medical and forensic significance, since the pathological affect is the basis for recognizing the patient as insane at the time of the crime or offense. To confirm the diagnosis, a forensic medical examination is carried out. In the process of diagnosis, a comprehensive study of the patient's life history and the study of the characteristics of his mental organization are carried out - only in this way can the personal significance of the traumatic situation be determined and the characteristics of the patient's psychological reactions be assessed. In the presence of witnesses, they take into account the testimony that testifies to the obvious senselessness of the actions of the patient, committed in a state of alleged passion.

The decision on the need for treatment is made individually. Pathological affect is a short-term mental disorder, after its completion the patient becomes fully sane, the intellect, emotional and volitional spheres do not suffer. In the absence of other mental disorders, treatment of pathological affect is not required, the prognosis is favorable. When psychopathy, neurotic disorder, drug addiction, alcoholism and other conditions are detected, appropriate therapeutic measures are taken, the prognosis is determined by the course of the underlying disease.

People's lives are filled with many states, which are often expressed by actions and behavior. A person's experiences are reflected by his emotions, which convey the body's reaction to certain stimuli. This applies both to changes in the surrounding reality and to people.

A person has a lot of emotions. They can be positive and negative, adequate and pathological. The latter are manifested in such a way that you can notice an increase in mood, and its decrease. It is pathological emotions that affect affect, which is also characterized by a pronounced reaction with its excessive manifestation of a non-verbal nature.

The concept of affect and description

Affect - strong feelings that are formed at the moment when a person is unable to find a way out of a critical situation.

Such a state provokes the inhibition of other processes at the mental level, and also implements behavioral reactions corresponding to such a manifestation.

Strong emotional experiences in such a state lead to the fact that consciousness is narrowed, and the will is limited. After the unrest experienced, one can observe special complexes, the launch of which occurs without realizing the reasons that caused such a reaction.

The term "state of affect" implies uncontrolled actions that can lead to rash acts. Behavior is usually formed against the will, a person is not able to consciously control it.

This concept can also be found in jurisprudence. A person in this state can represent a serious danger in society, and his actions are regarded as antisocial. From a medical point of view, the state of affect is defined as a loss of control over emotions at the time of psycho-emotional arousal.

For every person in a state of passion, in the company of other people, one could observe anger, tears or reddening of the face. And after a while, he thought about how to return time and change everything regarding his behavior. This can happen to anyone, and there is nothing to be ashamed of.

Causes and pathogenesis

A person experiences a state of affect in case of any traumatic situation, in an unpleasant conversation with an interlocutor, or as a result of negative emotions caused. Among the many factors that can provoke this behavior, psychologists distinguish the following most common reasons:

• a dangerous situation that threatens a person and can harm him (this includes direct and indirect threats);
• a conflict occurring between two or more personalities, as well as a situation caused by excessive emotions;
• lack of time, due to the need to respond quickly at critical moments;
• actions of other people that affect personal self-esteem and, thereby, traumatic feelings of a person;
• memories that negatively affect a comfortable existence;
• features of the individual in relation to his nervous system and psyche (stability, strength);
• increased emotions and impulsivity;
• regular repetition of events that traumatize the psyche;
• unexpected actions of an irritant when a person does not have a specific plan of action.

Condition symptoms

Affect, like many emotional reactions, accompanies a number of specific signs. In addition to the fact that in many respects their manifestation depends on the type of affect, there are also general ones, which are divided into two categories: mandatory and additional.

The first group of signs includes:

Additional symptoms of affect include:

• negative emotional disorders: disturbed sleep, fatigue, the occurrence of certain diseases;
• feeling of hopelessness;
• consciousness, speech and motor skills are partially disturbed;
• the sense of reality is lost, everything around is perceived in a distorted form.

In addition, the signs of affect are divided into:

1. Internal- a person is, as it were, cut off from reality; the sense of time and perception of space are lost; connection with consciousness is broken; there is fear and
2. External. This includes posture, facial expressions, timbre of voice, intonation and others.

Modern classification

Specialists divide affect into the following types:

1. Pathological. It is of a short-term nature, while consciousness becomes cloudy, control over behavior is completely lost.
2. Physiological. The state is quite sane, but is accompanied by serious limitations in consciousness. A person controls his actions and gives them an account.
3. Affect of inadequacy. The defensive reaction to failure is too violent. As a rule, there is anger, anger.

Pathological affect

This type of pathology belongs to the group of neurological disorders and is characterized by uncontrolled crying, laughter and other manifestations caused by an emotional background. Often such a state is secondary to or.

The patient exhibits an emotion that is beyond self-control for no reason. Also, it may be a reaction in response to something that is not comparable to the importance of the cause that can lead to such a disorder. As a rule, in this state, a person cannot stop for several minutes.

In addition, emotions may not correspond to the surrounding reality. For example, the patient is able to laugh at the moment when he is angry.

In addition, there are factors that can increase the likelihood of this type of affect:

• psychopathy;
• drug and alcohol addiction;
• substance abuse.

People without such pathologies, but having an increased reaction to, are also susceptible to the development of this condition. The consequence of this may be malnutrition, overwork, lack of sleep.

In many cases, the “accumulation effect” also plays an equally important role. Negative emotions accumulate for a long time, but at one moment they come out in the form of a pathological affect. Usually, they are directed towards the person with whom the conflict occurs.

According to doctors, this condition lasts only a few seconds. During this time, a person can show abnormal strength and behavior for him.

Specialists have divided pathological affect into 3 phases:

1. Preparatory. During this period, there is an increase in emotional stress, a change in the perception of reality and a violation of the ability to adequately assess the situation. Consciousness is focused only on the traumatic experience.
2. Explosive. This stage is characterized by aggressive actions. In addition, one can observe a sharp change in emotions - from rage to despair, from anger to bewilderment.
3. Final. There is an exhaustion of forces, both mental and physical. Suddenly, there may be a desire to sleep or a state of complete indifference to what is happening.

The diagnosis is of particular medical and forensic significance, since the pathological affect can act as a basis for recognizing the insanity of the patient at the moment when he committed a crime or violated other legal laws.

To confirm the diagnosis, a forensic medical examination is carried out. During the diagnostic process:

• carefully study the history of the patient's life, especially his psyche;
• if there are witnesses, their testimony is considered, confirming the manifestly inappropriate actions committed at the time of the alleged affect.

The decision to apply therapeutic measures in each case is taken individually. Since this state is short-term, after its termination the patient returns to his normal state.

In the absence of any mental disorders, treatment is not necessary. If abnormalities are identified, appropriate therapeutic procedures are carried out.

Physiological form of the disorder

This type of condition provides for the moment that a person is not recognized as insane. Such an action on an emotional background is not refers to a disease, and consists in an explosive reaction (positive or negative) to a stimulus. The occurrence occurs instantly, its course is rapid, and the manifestations are characterized by a change in the patient's mental balance and actions.

A person is able to control and realize everything that he does. There is no clouding of consciousness, the memory is in a normal state and there are no twilight effects.

Among the reasons are:

• conflict;
• a threat to the life of a person or his relatives;
• negative behavior towards a person, consisting in insult, which leads to a decrease in self-esteem.

Such states can be observed only in some annoying situations. However, it should be noted that such a reaction is often not comparable to a real threat, and may depend on factors such as:

• age;
• self-esteem;
• state of the nervous system;
• fatigue, menstrual period, insomnia.

Affective states are accompanied by the following characteristic features:

• transience;
• intensity;
• sharpness;
• aggression, unjustified cruelty;
• a state of exhaustion, at times partial.

As a rule, physiological affect does not require treatment, since it is a short-term reaction that does not cause psychotic changes in a person's activity.

The concept of affect in criminology

In the Criminal Code, crimes are divided into those committed with mitigating and aggravating circumstances. Taking this fact into account, we can say that killing or causing harm to health in a state of passion are mitigating factors.

Attributing an affect to a criminal law action is possible only when a sudden excitement arises against the background of violence, bullying, immoral behavior towards a person and other unlawful acts.

However, it is worth mentioning that the situation that provoked such a state must be real, and not imagined by the subject.

It must be remembered that certain forms of affect can be controlled. But here the training of consciousness and the education of self-control are important.

When a person is close to the state, but his mind is still able to think sensibly, you can try the following:

• try to find measures that contributed to a change in the situation;
• direct all thoughts to keeping your reaction as long as possible (counting or breathing exercises help well);
• try to focus on anything other than the object that provokes the affect.

In special cases, such training is unlikely to help. Here the help of a psychotherapist or even drug therapy is already needed.