Murder committed in a state of passion. Causes of development and symptoms of pathological affect Pathological affect and depression

Pathological affect is considered short-term, an explosion of rage, anger. As a rule, it is provoked by a serious injury. In a state of passion, the perception of the environment is distorted, consciousness is clouded. Everything ends with prostration, vegetative disorder, indifferent attitude to everything, prolonged sleep. If a mental disorder is not treated in a timely manner, a person can pose a threat to others.

Description

It should be noted that pathological affect is a fairly rare disorder. If a person in a state of passion commits a murder or other crime, he is recognized as insane. Quite often you can meet the physiological type of affect, it is considered a milder version of the reaction to various stimuli.

When comparing the pathological and physiological affect, we can conclude that the latter is not a reason for the patient to be recognized as insane. More often you can find a physiological type of affect, in which consciousness is not clouded. Please note that physiological affect is not a reason to recognize a patient as insane when he committed an offense.

Causes

As a rule, a pathological affect develops due to a sudden superstrong external stimulus. The main factor of panic fear can be a real danger, self-doubt, increased demands.

Some psychiatrists consider affect to be a kind of reaction to an intolerable, hopeless situation. The famous psychiatrist S. S. Korsakov was sure: pathological affect is most often diagnosed not only in a patient with mental disorders, but also in those who previously had no mental problems.

Modern psychiatrists identify a number of factors that can cause pathological affect:

Traumatic brain injury.
neurotic disorder.
Substance abuse.
Addiction.
Alcoholism.

Also, a pathological affect can develop in those who cannot resist stress after exhaustion after an infection, somatic illness, insomnia, malnutrition, mental, physical overwork.

Sometimes the affect may be due to the accumulation of various negative experiences, beatings, constant humiliation, tension in relationships, bullying. A person for a long time accumulates all the negativity, emotions, and eventually splashes out all the feelings on others.

Often the patient directs anger at the one with whom he has a conflict, although in some situations the pathological affect may appear during contact with other people.

It is important to understand that affect is a vivid manifestation of one's emotions, strong feelings. As a rule, all types of affect are provoked by excessive excitation of the brain, which is responsible for the mental process. With a physiological affect, consciousness narrows, but with a pathological one, a slight cloudiness is observed.

Subsequently, the affect person does not track information, ceases to evaluate, control their actions. Nerve cells work beyond their capabilities, after which inhibition occurs. After strong emotions comes, severe fatigue, complete indifference. In the case of a pathological affect, the emotions are so strong that inhibition ends in sleep, in stupor.

Symptoms

At the first stage consciousness is significantly narrowed, the patient concentrates on various experiences that are associated with mental trauma. Then emotional tension begins to grow, a person ceases to perceive others, to realistically assess the situation, his own state.

At the second stage there is an explosion of emotions, accompanied by rage, anger, deep clouding of consciousness. In this case, a person ceases to navigate in the world around him, may appear:

Illusions.
Psychosensory disorders - the patient cannot correctly assess the distance, size, location of objects.
Stormy, motor actions. The patient behaves aggressively, destroys everything around him, while not thinking about it.
Peculiar mimic, vegetative reactions. Anger is mixed with rage, despair, bewilderment, while it turns very red, then the face turns pale.
A few minutes later, when the emotional explosion ends, the exhaustion phase begins. The patient begins to sink into a state of prostration, he is lethargic, indifferent to everything that surrounds him, after that he falls asleep.
After the patient wakes up, it comes - all information is erased from memory, or the person remembers it in fragments.

Pathological affect in chronic mental trauma due to constant humiliation, fear, prolonged physical, psychological violence appears abruptly, while the reactions do not correspond to the personality. The person seems to be "closing".

Methods of diagnosis and treatment

In some situations, it is extremely important that the doctor make a correct diagnosis, the punishment of the patient may depend on this - they will recognize him as insane or close him in a psychiatric clinic. If a pathological affect is not detected, a person will be arrested and put in jail.

When making a diagnosis, the patient's life history is comprehensively examined, his features, mental organization are studied. Only in this way can one learn about the traumatic situation that led to such a state. All evidence must be taken into account.

As for treatment, it takes place on an individual basis. Pathological affect is a short-term mental disorder, after which the patient becomes sane again, the volitional, emotional sphere does not suffer. If drug addiction, neurotic disorder, alcoholism, other unpleasant conditions are detected, specific treatment is prescribed.

So, pathological affect is not only a psychological problem, but also a social one. It is important to help the patient in a timely manner, until he has crossed the line of what is permitted!

For several decades, the question of whether the accused was in a state of strong mental agitation was decided by lawyers on their own, without the help of specialists, or attempts were made to submit it for resolution by a forensic psychiatric examination. At the same time, it was not taken into account that the possibilities of a forensic psychiatric examination in this regard are limited, since its competence includes resolving issues related to pathological states of the psyche, in particular, resolving the issue of the presence or absence of a state of pathological affect.

In general, in psychology affect” is considered as a strong short-term emotional state, accompanied by motor and visceral manifestations. There are physiological and pathological effects. Pathological affect- a short-term super-intense experience, reaching such a degree that complete clouding of consciousness and paralysis of the will occur. Pathological affect completely excludes sanity and, consequently, criminal liability for the committed act.

Physiological affect- such an emotional state in which the subject is sane, but his consciousness is significantly limited, and is subject to criminal liability. Physiological affect as an emotional state that does not go beyond the norm, characterized by sudden onset, great strength and short duration, is studied within the framework of psychology. Historically, the definition of “physiological” was introduced to emphasize the difference between a simple, normal affect and a pathological one, to show that its physiological basis is made up of neurodynamic processes natural for a healthy person. The above considerations allow us to consider that the diagnosis and study of the so-called physiological affect are within the competence of forensic psychological examination. To confirm the stated position, let us dwell in more detail on the description of the differences between the pathological and physiological affect.

In psychiatry pathological affect is considered as an acute short-term mental disorder that occurs suddenly and is characterized by such features as:

- deep stupefaction of consciousness, which according to “the structure should be attributed to twilight states”;
- violent motor excitation with automatic actions;
- complete (or almost complete) subsequent amnesia of committed actions.

The state of pathological affect is marked by extreme tension and intensity of experience, and actions committed in this state have great destructive power. In most cases, an outbreak of pathological affect ends with a more or less prolonged and deep sleep.

Thus, a pathological affect is a morbid state of mind and therefore can only be correctly assessed and investigated by a psychiatrist.

Physiological affect, as mentioned earlier, is considered in psychology as an emotional state that can occur in a mentally healthy person in a situation of conflict. An important feature of the physiological affect is that it is perceived as an unusual, paradoxical, form of response to a conflict situation alien to the personality of the subject. Often, the accused is characterized positively at work and at home, has high self-control of behavior and socially acceptable attitudes. However, the relationship of the accused with the victim, as a rule, is characterized by conflict, and a conflict that deeply affects the highly significant needs of the subject, threatens his self-esteem and system of life values, can arise both immediately before the tort situation, and long before it. The conflict situation seems to the expert to be hopeless, insoluble.

In practice, there are two types of physiological affect:

1) classic affect- this is a rapid, violently flowing emotional reaction of an explosive nature, which follows directly from the unlawful action of the victim and lasts an extremely short period of time, after which a recession occurs.
2) Cumulative affect- an affective outburst that can also occur on an insignificant (“real” or “conditional”) occasion, like the “last drop”, while the affective experiences of the subject are usually greatly extended in time - from several months to several years, during which a psychotraumatic situation develops, causing the cumulation (accumulation) of emotional stress.

The physiological affect consists of three outlined phases (according to V.V. Guldan):

1) Preparatory phase - processing by the subject of psychogenic experiences, the emergence and growth of affective tension.
2) Actually affective act - an explosive reaction, unexpected for the subject himself, which is characterized by three main features: affective narrowing of consciousness, behavioral and activity disturbance, pronounced vegetative and motor reactions as external signs of affect.
3) Stage of exhaustion - mental and physical asthenia.

AFFECT PATHOLOGICAL- a short-term mental disorder, expressed in a sudden attack of unusually strong anger or rage, which arose in response to a mental trauma. The pathological affect is accompanied by a deep stupefaction of consciousness, violent motor excitation with automatic actions and subsequent amnesia.

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 mental agitation "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.

Etiology and pathogenesis

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 develop 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 reduced brain resistance to stress, which contributes to the emergence of pathological affect, is more common in individuals with some 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, etc.), 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

The differential diagnosis should be carried out with a physiological affect, with an affect arising on pathological grounds, 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.

In the case of a “short circuit” reaction, an affective discharge occurs after a long-term mental traumatization (long-term insults, threats, humiliation, fear, the need to constantly restrain oneself). In these cases, affective impulses in patients pass directly into actions, expressed in sudden actions that were not previously characteristic of him.

Forecast

Since the pathological affect is expressed only in a short-term disorder of mental activity, which is an exceptional condition, its prognosis is favorable. Only persons in whom a pathological affect has developed on pathological grounds should be sent to a psychiatric hospital; they need to be treated for the underlying disease.

In forensic psychiatric practice, pathological affect is considered as a temporary disorder of mental activity, excluding responsibility for actions committed in this state. Persons who have committed pathologically dangerous acts in a state of passion are subject to Art. II of the Criminal Code of the RSFSR (or the corresponding articles of the Criminal Code of other Union republics).

Bibliography: Vvedensky IN The problem of exceptional conditions in the forensic psychiatric clinic, in the book: Probl. judicial psychiat., ed. Ts. M. Feinberg, v. 6, p. 331, M., 1947; Kalashnik Ya. M. Pathological affect, in the same place, century. 3, p. 249, M., 1941; Korsakov S. S. Course of psychiatry, t. 1, p. 239, M., 1901; Lunts D. R. Exceptional states, in the book: Sudebn. psychiat., ed. G. V. Morozova, p. 388, M., 1965; Serbian V. Forensic psychopathology, c. 1, M., 1895.

N. I. Felinskaya.

- 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.

Pathological affect is a mental disorder characterized by an over-intensive experience and an inadequate expression of anger and rage. Occurs in response to a sudden shock, lasts several minutes. The first mentions of a short-term mental disorder during the commission of crimes appeared in specialized literature as early as the beginning of the 17th century and were called "angry unconsciousness" or "insanity". For the first time, the term "pathological affect" to describe this condition was used by the German and Austrian psychiatrist and criminologist Richard von Kraft-Ebing in 1868.

Pathological affect is a rather rare disorder, which is the basis for recognizing a patient as insane when committing criminal or administratively punishable acts. 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 culmination, 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. After 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 violence, 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 one determine the personal significance of the traumatic situation and evaluate the characteristics of the patient's psychological reactions. 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.

Affect is the highest manifestation of strong emotional excitement. In forensic psychiatry, affect is classified into pathological, which excludes sanity, and physiological, - actions committed in a state of sudden strong emotional agitation (affect) caused by violence, bullying or grave insult or other illegal or immoral actions, as well as a prolonged psycho-traumatic situation. This gradation is based on the nature and extent of the influence of the mental state on the consciousness and will of the subject.

Physiological affect - this is an emotional state that does not go beyond the limits of the norm (i.e., not painful), which is a short-term, rapidly and violently flowing emotional reaction of an explosive nature, accompanied by a sharp, but not psychotic, change in mental activity, including consciousness, expressed by vegetative and motor manifestations.

The existing definitions of physiological affect make it possible to single out its characteristic features: a) the extreme nature of the reaction for the individual; b) the phase of the flow, close to the pathological affect; c) objective and subjectively felt suddenness of occurrence (surprise for the subject); d) disorganization of consciousness (narrowing) with a violation of the integrity of perception, the ability to regulate one's actions, their well-known automation; e) discrepancy between the nature and result of these actions to the cause, i.e. their inadequacy; f) the connection of actions and affective experiences with a traumatic factor; g) sudden exit through mental exhaustion; h) partial amnesia of what happened.

A pathological affect is a painful condition of a special psychogenic origin that occurs in an almost mentally healthy person. Pathological affect occurs suddenly in response to an unexpected psychogenic stimulus and is characterized by the inadequacy of the affective reaction to the occasion that caused it, sharp psychomotor agitation, twilight-type consciousness disorder, impaired motivation, automatic actions and staging of the course.

A thorough study of the clinic of pathological affect made it possible to distinguish various affective reactions from pathological affect, including physiological affect, which repeats the phases of pathological affect in its development. From this it follows that the isolation of the physiological affect proceeded through its delimitation from the pathological affect and, to a certain extent, as opposition to it.

Physiological affect should be distinguished from pathological affect - a painful neuropsychic overexcitation associated with complete clouding of consciousness and paralysis of the will (see Table No. 1). The main criterion for distinguishing between pathological and physiological affects is mainly the establishment of symptoms for a psychogenically caused special twilight state of consciousness in the case of a pathological affect or an affectively narrowed, however, not psychotic special state of consciousness in the case of a physiological affect.

Table No. 1

Distinguishing features of physiological and pathological affects