Commentary.

The article is dedicated to problem in usage of main principals of syndrome neuropsychological analysis in psychiatry. Main requirements for realization of A.R. Luria’s syndrome approach are given: accountancy of psychopathology, conceptualization of brain functioning particularities, and special attention to the researched psychological reality. The prospects for further development of neuropsychology in psychiatry, including the assessment and theoretical perspectives, are observed.

Introduction.

Executive and unnecessary levels of the structure of mental processes in their defeat and the restoration are analyzed. Possible approaches to solving the problem of methods of restoration of higher mental functions are presented.

This article aims to acquaint the wide community of general and special education teachers, psychologists, speech and language therapists, including those who work in integrative and inclusive environments, with the outlines of child neuropsychology and neuropsychological approach to assessment, prevention, and remediation of learning disabilities. In the last 20 years the field of psychological theory and practice named school neuropsychology which bases itself upon Vygotsky’s and Luria’s ideas has been developing in Russia. It is actively penetrating the psychological and educational practices involving effective research based methods. Unfortunately, many professionals working in educational sphere and even school psychologists are not aware of the goals and methods of this approach to overcoming learning disabilities. This article aims to contribute in closing this gap. 

The article presents a case study of multiple visual agnosia (object agnosia, prosopagnosia, topographical agnosia, colour agonsia, alexia without agrafia) of a patient with bilateral lesions of the inferior areas of the temporal-parietal-occipital lobes. Clinical data are presented from the point of view of the patient, who struggle for surviving and her adaptation to the broken life. 

The article considers the role of different approaches to neuropsychological assessment, i.e. qualitative and quantitative analysis, from the point of view of those goals which can be put before neuropsychology in clinical practice. 

Based on the analysis of A.R. Luria’s works belonging to different periods of the formation and development of neuropsychology, the author highlights the main directions in the future development of the problem of neuropsychological factors. The author suggests possible aspects of the differential learning of the structural components of spatial factor, in accordance with its functional multiplicity in the systemic structure of the higher mental functions. 

Today the nature of neuropsychological syndromes in various corpus callosum (CC) pathology remains an open question. We have examined 30 subjects with cc pathology. All subjects performed the procedure of fixed set by D.N. Uznadze. The analysis of the results demonstrated connection between fixed set functioning and condition of left hemisphere and access to it. The most prominent impairment of set forming dynamics was demonstrated by the subjects with CC pathology. However these subjects have also demonstrated posterior right hemisphere deficit in standard neuropsychological examination. Thus, we can conclude the dissociative nature of the interhemispheric impairment syndrome. 

The paper aims to consider a syndrome-based approach in methodology adopted for psychological phenomena in application to corporeity psychology. We present a study case of 290 patients with mitral valve prolapse. We endeavor constructioning of a psychosomatic syndrome, employing techniques for a qualitative and statistical data analysis of longitudinal clinical-psychological study. We bring evidence that the syndrome is of multi-level character, and that its structure is determined by several factors: a motivational factor (with domination of the infavoidance motive and unsatisfied self-approval need), a factor of emotional regulation disorders, and a psychophysiological factor. We argue that it is feasible to use a psychosomatic syndrome as a key method in approaching not only diagnostic but also prognostic problems both in clinical psychology and in medicine. 

The paper determines and analyzes the term subject oriented neuropsychology, its relations to the cultural-historical theory, its conformity to the main features of Luria’s work and its value for efficient development of neuropsychology. 

The article is focused on the opportunities of further development of L.S. Vygotsky’s and A.R. Luria’s cultural-historical approach. Two of them are researched: 1) further analysis of symbolic mediation methods of psyche in the modern society and its social and cultural stratification and 2) cultural-historical analysis use in research of theories and conceptual apparat of clinical psychology. The necessity of understanding knowledge in clinical psychology in the context of its cultural-historical experience formation is proved. The importance of such analysis is shown for research of development conditions of such knowledge, its borders, functions and define historical sense, that contributes to the deeper understanding of psychological clinic and psychotherapy. 

In the article the problems of development of the level model of emotional regulation which are based on the synthesis of different approaches are examined. The concept of “a level of development of affective-behavioral complex” is introduced. This concept allows scrutinizing development of emotions and personality in children mostly in the frames of human ethology. The problem of development of mechanisms of “re-enciphering” of experience of realization of affective-behavioral complexes into movable symbolic images connected with dynamics of attachment behavior and into the basic structures of personality is set up.

In article the various questions connected with application in neuropsychological practice of a technique of definition of time on real and “mute” clock are discussed. The psychological structure of skill of definition of time with the clock, its communication with age, educational and gender factors is considered. The special attention is given to an estimation of possibilities of use of a technique at diagnostics of optic-spatial functions in a modern cultural situation. 

Actual problem of a modern neuropsychology is elaboration of batteries of tests combining advantages of qualitative and quantitative approaches. In this article we describe an important step of quantitative processing of neuropsychological data in “Method of neuropsychological assessment of children of 6—9 years” the formation of the generalized indices. The described procedure of the statistical analysis of neuropsychological results appreciably reproduces the logic of the expert who is carrying out the qualitative syndrome analysis of HMF-dysfunction. The formation of indices is considered on an example of neuropsychological assessment of 98 elementary school students with learning disabilities and 33 students with autistic disorders. 

The article analyzes certain socio-cultural and personal predispositions, which determine the modern diversity of displays of subjective uncertainty and ambiguity. The importance of understanding the relations between the resourceful and the psychopathological aspects of the ambiguity phenomenon and the cultural environment with its destructive ideals and mythologems, manipulative media-technologies and all-pervading idea of deconstruction is stressed for the creation of “realistic clinical psychology” (in terms of A.R. Luria). Methods for modeling the experiences of ambiguity in experimental settings, in pathopsychological examination and in projective psychological diagnostics are put in comparison. The arguments are adduced for the interpretation of deficient manifestations of subjective uncertainty and ambiguity as a criterion for diagnostics of the severity of personality disorder.

Psychoanalysis presents unique empirical material for the research of the dynamics of personality reflection in altered states of consciousness and its impact on different aspects of vital activity of the personality. Transference and countertransference altered states of consciousness were in focus of interest of the first part of the article. It was shown that as altered states of consciousness become deeper during the psychoanalytical process the reflexive processes of a personality enhance, become more active and change qualitatively, which is expressed in particular in the formation of the active «reflexive I». Reflexive activity of the personality in countertransference and combined transference-countertransference altered states of consciousness was analyzed in this second part of the article. 

Within a framework of a psychoanalytical concept it is not easy to define a single psychological mechanism of a pathological gambling addiction origin and development. Some psychoanalysts state that said addiction is one of manifestations of the risk predisposition attitude. They propose several hypotheses on certain psychological structures, which are involved in forming a pathological behavior and describe mechanisms which these structures are based on. But, visible controversies aside, current theories are not mutually exclusive, they rather supplement, augment and broaden one another. According to researchers, a pathological gambler is unconsciously driven not to win, but to lose. It is a case of autoaggression, differences lie in an interpretation of the guilt feeling origins. Psychological masochism and erotisation of pain are being shown as principal sources for an unconscious anxiety of a gambler.