Cultural-historical methodology for the analysis of anamneses of adolescents with self-harm behaviours

Abstract

Background. Existing approaches to the analysis of anamneses are predominantly naturalistic and descriptive and rarely include cultural-historical analysis of mental development. Self-harm (suicidal) behaviour in adolescents is an acute clinical, medical and social problem. The obtained research data are often contradictory and mostly provide only medical perspective on the problem. Also, they are only rarely coordinated with organization of psychological development of adolescents and with designing preventive measures to aid adolescents and their families. The article examines social structures in the adolescents’ environment, which contribute to disorder development, in the framework of project-based approach developed in cultural-historical psychology. Objective. The scope of the article is to exemplify a study based on cultural-historical analysis of psychological anamneses and to show its stages in a case of a group of adolescents with self-destructive behaviours. Sample. The article data are based on the sample of 40 male adolescents aged 14–17 with self-destructive (suicidal) behavior hospitalized to the psychiatric facility. Methods. Analysis of anamnesis in its cultural-historical version, conversation, and observation were applied in the study. The study proceeded in the identification and analysis of the objective social structures that are significant for adolescents’ development, and then in understanding the process of their transformation within the internal phenomenological-clinical part of the adolescents’ experience. Results. The article describes the main stages and methods for conducting a study based on the psychological analysis of the anamnesis differing from other variations of work with the anamnesis. The two most significant factors contributing to the development of self-destructive behaviour in adolescents are identified: the position of the only child in the family (or its socio-psychological variations) and typical dysfunctions in the family history of such adolescents. Conclusion. The conducted analysis brings up the issue of developing hypotheses both about the social and psychological structure in the diagnostics of the corresponding disorders, and about those social and psychological mechanisms that underlie readiness for suicidal behavior in adolescents. According to the authors, psychological analytics organized in this way expands significantly the concept of the clinic, bringing it into wider social and cultural spaces, which in the future can be used in diagnosis and in the organization of prevention in relation to developmental deviations.