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Pervichko E.I., Korsakova N.K., Darevskaya M.A. (2019) The role of motivation in the productivity of cognitive activity in patients with arterial hypertension in the middle age-movement practice as a method of self-knowledge and education a creative personality. National Psychological Journal, [Natsional’nyy psikhologicheskiy zhurnal], 12(4), 72–91.

Abstract

Background. One of the issues of modern health care the frequent arterial hypertension (AH) in people of the so-called middle age. There is a decrease in the productivity of mental activity accompanied by anxiety in the form of «cognitive dissatisfaction» with the corresponding experiences. Features and causes of cognitive dysfunctions in patients with hypertension require special study. Its results are important not only for understanding the central mechanisms of the disease, but also for the development of diagnostic and therapeutic procedures, preventive, correctional and rehabilitation programs. They are determined by the relevance of clinical and psychological studies of the syndromes of cognitive dysfunctions and factors that determine cognitive functioning in hypertension in the middle age.

The Objective is the assessing of motivational and emotional factors to the qualitative characteristics of cognitive activity in the middle-aged patients with AH who are unaware of the medical qualifications of their disease.

Design. The study and interpretation of its results was carried out in accordance with the principles of psychological syndrome analysis (school of L.S. Vygotsky - A.R. Luria - B.V. Zeigarnik). The research program included the diagnosis of emotional and personal characteristics using the Russian-language version of the 16-factor Cattell personality questionnaire (Cattell, Schuerger, 2003; Kapustina, 2006) and the Pictogram methodology (Zeygarnik, 1962; Rubinstein, 1970), diagnostics of general intelligence using the “Raven’s Progressive matrices” (Raven, et al., 2012; Davydov, Chmykhova 2016), and also the study of “qualitative” features of cognitive processes using pathopsychological examination (Zeigarnik, 1986). We examined 48 patients (52.3±6.6 years) with Stage 2 hypertension, Grade 1-2, unaware of the diagnosis and 54 almost healthy people, comparable to patients by gender, age and educational level.

Results. 84% of hypertensive patients with high and medium intelligence showed signs of a decrease in cognitive activity. A meaningful interpretation of the results of the study using the methodological principles of psychological syndrome analysis (the school of L.S. Vygotsky - A.R. Luria - B.V. Zeygarnik) showed that in the structure of disturbances of cognitive processes in hypertension, disturbances in the dynamics of mental processes expressed by labile mental activity and rapid exhaustion, based on a decrease in neurodynamic support of mental activity. Reduced cognitive functioning is also influenced by the emotional and personal characteristics of patients, especially the deficiency of harmony in their motivational sphere. The study of thinking showed the diversity of opinions in 43% of patients and signs of distortion of the generalization process in 24% of patients with hypertension. Correlation analysis data have confirmed the relationship between the frequency of occurrence of these phenomena and the frequency of decrease in the productivity of cognitive activity. Patients with hypertension in the middle age unaware of the presence of this diagnosis, differ from healthy individuals in the greater disharmony of personality traits. They are characterized by a tendency to restrain affect, personal rigidity, lack of flexibility of emotional manifestations, with persistence in achieving goals and overall dominance, and also increasing values on the scales of anxiety and depression. The levels of anxiety and depression are statistically related to the productivity of the cognitive functioning in patients with hypertension.

Conclusion. Using the methodological principles of psychological syndrome analysis showed that the cognitive processes in untreated middle-aged hypertensive patients can be described as cognitive dysfunction syndrome, where two syndrome factors can be considered significant: neurodynamic and motivational ones. The research results contribute to the solution of personal and «actually intellectual» processes correlation in solving problems in normal and pathological conditions. They expand the understanding of the etiology and pathogenesis of hypertension, and allow individualizing strategies for medical and psychological care for patients with hypertension.

Received: 11/30/2019
Accepted: 12/14/2019
Pages: 72-91
DOI: 10.11621/npj.2019.0408

By: ; ; Darevskaya M.A.;

Sections: Psychology and Medicine;

PDF: /pdf/npj-no36-2019/npj_no36_2019_072-091.pdf

Keywords: syndrome-based approach by L.S.Vygotsky-A.R.Luria-B.V.Zeigarnik; psychological syndrome analysis; syndromic factor; arterial hypertension (AH); cognitive processes; cognitive dysfunctions; cognitive functioning; cognitive disorders; emotional and personal characteristics; motivation;

Available Online 31.12.2019

Acknowledgments

This work was supported by the Russian Federal Property Fund, project 17-06-00954-OGN "Comprehensive topical diagnosis of cognitive disorders in essential arterial hypertension

Table 1. Patients with arterial hypertension (AH) and healthy individuals with signs of a decrease in cognitive activity (%)

Assessment Parameter

Group

Patients with AH

Healthy Individuals

Thinking

82**

20

Memory (direct memorising)

16*

12

Memory (indirect memorising)

84**

24

Attention

84**

36

NB: differences between groups are: * – р≤0,05; ** – р≤0,001. 


Fig. 1. The frequency of attention disorders in groups in patients with arterial hypertension (AH) and healthy individuals (%)

NB: differences between groups are: ** - p≤0.001.

Table 2. The frequency of occurrence of impaired natural auditory-speech memory (direct memory) in patients with arterial hypertension (AH) and in healthy individuals (%)

Assessment Parameter

Groups

Patients with AH

Healthy Individuals

Reduced memory (less than 4 items reproduced)

19**

8

Sawtooth Curve

32*

16

Plate Curve

8

0

Contamination

3

0

Decreased amount of delayed auditory-speech memory (Decreased memory productivity)

19**

4

Paraphases

31**

16

NB: differences between groups are: * – р≤0.05; ** – р≤0.001.


Fig. 2. Average values of the erroneous decisions according to the “Progressive Raven’s Matrices” in patients with arterial hypertension (AH) and healthy individuals

NB: differences between groups are: * – р≤0.05; ** – р≤0.001.

Table 3. Mean value of the emotional-personal sphere in patients with arterial hypertension (AH) and healthy individuals

Assessment Parameter

Group

Patients with AH

Healthy Individuals

A » Heartiness / Alienation (Cattel Test)

4.63*

5.59

F Expressiveness / Restraint (Cattel Test)

3.22*

4.36

Shock reaction (Pictogram)

4.93**

2.08

Hatching Pattern (Pictogram)

0.43**

0.01

Repeated Pinpointing (Pictogram)

4.54**

1.13

Anxiety (Hamilton Scale)

2.12**

0.05

Depression (Hamilton Scale)

0.96**

0,05

NB: differences between groups are: * – р≤0,05; ** – р≤0,01.


Fig. 3. Correlation relationship between the assessment parameters of cognitive activity and the emotional and personal characteristics of patients with arterial hypertension (AH)

Legend: dashed line – negative connection, solid line – positive connection, green – Cattel Test, purple – Pictogram, black – IQ (Raven’s Matrices), light-blue - error in each series of "Progressive Raven’s Matrices", red - severity of anxiety (Hamilton scale).


Fig. 4. Correlation between anxiety, depression and cognitive performance in patients with arterial hypertension (AH)

Legend: dashed line – negative connection, solid line – positive connection, green – Schulte table, orange – memory, 10 words technique, purple - Pictogram, black - severity of depression (Hamilton scale), light-blue - error in each series of "Progressive Raven’s Matrices", red - severity of anxiety (Hamilton scale).

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For citing this article:

Pervichko E.I., Korsakova N.K., Darevskaya M.A. (2019) The role of motivation in the productivity of cognitive activity in patients with arterial hypertension in the middle age-movement practice as a method of self-knowledge and education a creative personality. National Psychological Journal, [Natsional’nyy psikhologicheskiy zhurnal], 12(4), 72–91.

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