Anastasia V. Kotelnikova

Anxiety disorders are a widespread mental pathology, yet standard pharmacotherapy often fails to provide sustained remission. Adaptive biofeedback and mindfulness training are effective psychological correction methods, although the clinical and psychological profile of patients who are most responsive to these interventions remains understudied. This research aimed to predict the effectiveness of biofeedback training in cultivating mindfulness in patients with anxiety disorders. This prospective randomized controlled trial included 180 patients (coded F40 and F41 under ICD-10) divided into three groups: isolated biofeedback training (n = 76), combined therapy (biofeedback training plus pharmacotherapy, n = 58), and medication monotherapy (n = 46). The assessment tools included the Hamilton Anxiety Rating Scale, the Five Facet Mindfulness Questionnaire, the Toronto Alexithymia Scale, and functional diagnostics (EEG alpha-rhythm asymmetry and power). The statistical analysis employed analyses of variance (ANOVA). The predominating somatic component in the isolated biofeedback group was associated with a sustained increase in alpha rhythm at follow-up. In patients with predominantly psychic anxiety, the achieved increase was not maintained. Alexithymia emerged as a significant predictor. In the acute phase, the biofeedback training promoted the verbal component of mindfulness (the Describe subscale). At follow-up, it provided a higher overall level of mindfulness and stable anxiety reduction compared to isolated pharmacotherapy (p ≤ 0.05). The patients with low alexithymia demonstrated no significant differences between treatment modalities. Thus, the level of alexithymia and the structure of anxiety symptoms proved to be informative clinical and psychological predictors for tailoring biofeedback training. In this study, the patients with high or moderate alexithymia and somatic anxiety proved to be especially susceptible to the method.

Background. Posttraumatic stress disorder (PTSD) is one of the most prevalent and socially significant consequences of exposure to extreme stress. Its pathogenesis involves impairments in neuroplasticity, in which brain-derived neurotrophic factor (BDNF) plays a key role. In recent decades, the potential of using BDNF system components as biomarkers for objective diagnosis, disease prognosis, and personalized therapy in PTSD has been actively investigated; however, the data remain contradictory and require systematization. The goal was to systematize and summarize current evidence on the role of BDNF in the pathogenesis of PTSD, to examine the molecular, genetic, and epigenetic aspects of its dysfunction, and to evaluate the diag­nostic and prognostic potential of BDNF system components as possible biomarkers. Materials and methods. A systematic literature search was conducted in PubMed, Scopus, Web of Science, eLibrary, and Google Schol­ar databases for the period 2000-2025 in accordance with PRISMA guidelines, using keywords reflecting the relationship between BDNF and PTSD. Original clinical and experimental studies, meta-analyses, and systematic reviews in English and Russian were included. Results. A multi-layered nature of BDNF system dysfunction in PTSD was shown, ranging from region-specific changes in protein expression to genetic and epigenetic alterations. Controversies in peripheral BDNF levels were identified, attributable to differences in biomaterial type, protein form, and sample heterogeneity. Assessment of mature BDNF, the proBDNF/mBDNF ratio, BDNF gene promoter methylation, and regulatory microRNAs (miR-182-5p, miR-9-5p, miR-204-5p) demonstrated prognostic value, being associated with symptom severity, chronicity, and treatment response. The use of total BDNF as an independent diagnostic marker for PTSD is currently not justified. The most promising approach involves integrating a panel of BDNF-related measures (genotype, epigenetic marks, mature protein level, microRNAs) into multifactorial models for disease prognosis and personalized therapy.

Introduction. The active integration of personalised artificial intelligence (AI) systems into everyday and educational practices is transforming human-technology interaction, endowing it with qualities akin to interpersonal communication and stimulating users’ tendency towards anthropomorphism the attribution of human characteristics to AI. This issue is particularly pertinent among students, for whom digital agents are becoming not only learning tools but also potential sources of emotional dependency and educational risk. The question of which individual psychological traits (such as attachment style and aspects of self-concept) predispose individuals to profound anthropomorphism of AI and increase their vulnerability to developing dependent interaction patterns remains insufficiently explored. Aim. The present paper aims to identify the relationship between attachment style, self-concept characteristics specifically, the discrepancy between the actual self and the ideal self and the tendency to anthropomorphise personal AI among the student population. This will facilitate the identification of user profiles with varying risks of developing emotionally dependent interaction patterns and support the development of preventative strategies within the educational environment. Methodology and research methods. The study involved 629 students aged 18 to 24 years who were active users of AI services. The following instruments were employed: T. Leary’s Interpersonal Relationship Inventory (IRI) to assess the images of the “actual self”, “ideal self”, and “my virtual assistant (AI)”; and an adapted version of the Experiences in Close Relationships-Revised (ECR-R) questionnaire. Statistical analyses included cluster analysis (K-means method), analysis of variance (ANOVA), and the Mann–Whitney and Kruskal–Wallis tests. Results. Three profiles of AI perception were identified: instrumental-mechanistic (39.3%), selectively humanising (44.8%), and fully anthropomorphic (15.9%). Significant differences were observed between clusters in attachment styles ( p < 0.001) and the degree of intrapersonal conflict (actual self/ideal self discrepancy). A risk group, comprising 16% of the sample, was identified, characterised by a triad of anxious-ambivalent attachment, pronounced intrapersonal conflict, and a tendency towards full anthropomorphisation of AI. Scientific novelty. For the first time, the relationship between the anthropomorphisation of personal AI and deep-seated personality structures such as attachment style and self-concept has been empirically demonstrated within the context of educational risks. User profiles, differentiated by varying degrees of vulnerability to emotional dependency, have been identified. Practical significance. The research findings can be used to develop targeted preventative programmes and screening tools aimed at ensuring the psychological safety of the educational environment in the context of digitalisation.

Background/Objectives: Professional burnout is widespread among surgeons. Despite the abundance of research on organizational factors, little attention has been paid to the resources developed during training that may protect against burnout. The aim of this study was to examine the relationship between involvement in student research and prac-tical clubs (SRPCs) during training and burnout symptoms during surgical practice, as well as subjective assessments of career progression in surgical graduates. Methods: A cross-sectional survey of 96 surgeons (32 women, 64 men; mean age 33.1 ± 6.4 years) who participated in the SRPC over a 20-year period was conducted. Burnout was assessed us-ing the Maslach Burnout Inventory (MBI) questionnaire. Involvement indicators (duration, activity) were combined into an integrative activity index using the principal component analysis. Multiple linear regression analysis and Spearman's rank correlation analysis were used. Results: The sample was characterized by a favorable burnout profile: emo-tional exhaustion at a medium/high level was detected in 71.9%, depersonalization at a low level was detected in 62.5% (high level in only 7.3%), and there was no reduction in professional achievements. Regression analysis revealed a strong negative relationship between the integrative activity index and depersonalization (β = –0.740, p < 0.001, R² = 0.535, f² = 1.15): higher involvement in SRPC was associated with a lower level of deper-sonalization. No significant connections were found with emotional exhaustion and re-duction in achievements. Subjective assessment of the impact of SRPC on one’s career was negatively correlated with depersonalization (rₛ = –0.517, p < 0.001) and emotional ex-haustion (rₛ = –0.319, p = 0.002). Conclusions: Engagement in student research can act as a protective resource against depersonalization, a key component of burnout, by promoting meaningful professional interactions and strengthening professional identity. The find-ings support the need to support SRPC in medical schools not only as a means of training research personnel but also as a tool for preventing professional strain and burnout among actively working surgeons.

Background: Anxiety disorders are prevalent and debilitating. Given challenges in maintaining mindfulness at one-month remission, integrative approaches targeting anxiety and psychological resources (especially mindfulness) have gained interest. This study aimed to assess the effectiveness of adding biofeedback to the treatment of anxiety disorders. Methods: Inpatients with anxiety disorder (ICD10 F40/F41) were randomized to three groups: (1) biofeedback for enhancing mindfulness (BFB, n = 76); (2) medication therapy (MT, escitalopram 10 mg/day, n = 46); and (3) combined therapy (BFB + MT, CT, n = 66). Per-protocol analysis: 180 completers; ITT: all 188 randomized patients. The primary outcomes were changes in the Hamilton Anxiety Rating Scale (HAM-A) total score and the Five Facet Mindfulness Questionnaire total score, assessed at baseline, after 10 days of treatment, and at one-month follow-up. The HAM-A assessor was blinded to group allocation. Results: In the per-protocol analysis, the BFB and CT groups showed a significantly greater reduction in the HAM-A score than the MT group did. For example, post-treatment, the mean difference between BFB and MT groups was –6.30 points (95% CI: –9.12 to –3.48, p = 0.00046). The BFB and CT groups did not differ significantly. For mindfulness, the BFB and CT groups showed an increase, whereas the MT group showed a decrease (BFB vs. MT: mean difference 30.28 points, 95% CI: 23.54–37.02, p < 0.000001). Intention-to-treat (ITT) analysis (n = 188) confirmed the robustness of these findings. Conclusions: BFB appears to be a promising approach for reducing anxiety and fostering mindfulness skills; these findings suggest it may be worth exploring further as a potential component of comprehensive therapy for anxiety disorders. Clinical Trial Registration: ClinicalTrials.gov NCT07628153 (retrospectively registered). The trial was retrospectively registered, and the primary analysis was conducted on a per-protocol population.

Context and Relevance. The study of psychological determinants of treatment adherence in conditions characterized by a visible physical defect is of high importance, as therapeutic success directly depends on the patient's long-term, conscious, and personal engagement in the rehabilitation process. The insufficient exploration of the relationship between specific illness perceptions and selective non-adherence in patients with idiopathic scoliosis defines the relevance of this study. Objective. To investigate the contribution of illness perception to the formation of treatment and rehabilitation adherence in patients with idiopathic scoliosis. Hypothesis. Subjective illness perception determines the selective nature of treatment adherence: hypernosognosia is significantly associated with lower adherence to lifestyle modifications compared to normonosognosia. Methods and Materials. Using the semantic differential method (assessing the perception of the word «scoliosis»), 174 women (124 with idiopathic scoliosis, 50 conditionally healthy) were examined. Treatment adherence was investigated using the KOP-25 questionnaire. Results. Patients with idiopathic scoliosis perceived their illness as "noticeable," "severe," and impacting their autonomy. Three types of illness perception were identified: normonosognosia and two variants of hypernosognosia, the key difference between which was the experience of the illness as a limiting factor ("dependence"). The overall level of adherence was low, with differences between clusters found only for "adherence to lifestyle modifications" (p=0.03)—lowest in patients who experienced their illness as a restriction of freedom. Conclusions. Low treatment adherence primarily affects aspects requiring personal patient responsibility (lifestyle modifications). A hypernosognosic illness perception, accompanied by self-stigmatization and a perceived loss of autonomy, is a critical risk factor for impaired adherence. The targets for psychological intervention are the correction of stigmatizing attitudes and fostering an internal locus of control.

Background: This article presents an analysis of the use of immersive technologies in psychotherapy for patients with mood disorders. It examines the potential integration of virtual, augmented, and mixed reality into psychological interventions aimed at stabilizing emotional state and improving cognitive and social functioning. Aim: To analyze the potential use of immersive technologies in psychological interventions for patients with mood disorders. Methods: A systematic analysis of empirical clinical studies published between 2018 and 2025 and retrieved from the PubMed and eLIBRARY databases was conducted. The structure of the interventions was assessed, and the technical implementation and therapeutic content of psychological intervention programs were described. Data from clinical studies evaluating the effectiveness, acceptability, and therapeutic potential of immersive technologies in combination with traditional psychotherapeutic methods were summarized. Results: Virtual reality is most widely used as part of comprehensive psychotherapeutic interventions within cognitive behavioral therapy, cognitive rehabilitation, and psychoeducation for affective spectrum disorders. Studies indicate potential improvements in emotional stabilization, cognitive functioning, and social functioning. At the same time, the use of augmented and mixed reality, including mobile digital applications, remains understudied and requires further investigation. Conclusion: Immersive technologies have significant potential in the treatment of mood disorders, primarily as part of comprehensive programs combining traditional psychotherapeutic methods and digital interventions. Digital immersive programs based on mobile devices appear promising as a tool for expanding the accessibility and effectiveness of psychological support for patients with mood disorders.

The Unified State Exam is a powerful stressor that negatively impacts the psychosomatic health of high school students. However, assessment approaches usually rely solely on self-report data, which are often distorted by psychological defense mechanisms. This study bridges this methodological gap by employing an integrated analysis of both conscious (M. Yu. Chibisova’s Questionnaire of Psychological Readiness for State Exams) and unconscious (A. M. Etkind’s Color Relationship Test) components of psychological readiness. The typological profiles of readiness for the Unified State Exam were identified through cluster analysis, followed by resource provision evaluation. The sample included 232 high school students from Moscow. The research verified a threefactor questionnaire structure, explaining 67.3% of total variance: Anxiety Management Skills (45.3%), Perceived Importance of Success (13.1%), and Exam Procedure Knowledge (8.9%). The cluster analysis revealed four distinct profiles: balanced readiness (30.2%); highly motivated readiness with emotional regulation deficits (21.6%); readiness with overestimated resource capacity (34.1%); readiness with underestimated resource capacity (14.1%). Critically, significant discrepancies between self-reports and projective data emerged in 35.7% cases. Projective diagnostics revealed a pervasive emotional rejection of the Unified State Exam (69.8%), confirming high stress impact. Students with distorted self-assessment demonstrated instrumental resource deficits. Family support was crucial for the group with adaptive readiness profile. Traditional diagnostics should be supplemented with projective methods to develop targeted psychological support programs. Validation of this typology across regional populations represents a promising research direction.

Relevance. Anxiety disorders affect over 4 % of the global population, significantly impairing quality of life and creating a substantial burden on healthcare systems. The limited efficacy of existing treatment modalities necessitates the exploration of novel therapeutic approaches. Objective. To conduct a systematic analysis and integration of data regarding the potential of various psychotherapeutic approaches to develop mindfulness components in patients with anxiety disorders based on the Five-Facet Model. Methodology . A systematic literature review was conducted using PubMed, Google Scholar, CyberLeninka, and eLIBRARY databases for publications from 2000 to 2024. Comparative and systematic analysis methods were employed to identify mechanisms through which different therapeutic paradigms impact mindfulness components. Results and а nalysis . The study revealed distinct intervention profiles of different approaches: mindfulness-based cognitive therapy demonstrated efficacy in developing observation, conscious actions, and non-reactivity; dalectical behavior therapy was most effective for developing description and conscious actions; acceptance and commitment therapy proved effective for developing nonreactivity and absence of reactivity; psychoanalysis primarily fostered observation skills. Conclusion. The Five-Facet Mindfulness Model represents a practical tool for developing individualized psychotherapy protocols. The utilization of the Five-Facet Mindfulness Questionnaire (FFMQ) is recommended for diagnostic assessment and selection of relevant psychocorrection methods.

Background. The integration of immersive technologies into medical practice demonstrates, on the one hand, significant therapeutic potential; however, issues of methodological justification, associated risks, and limitations remain insufficiently studied. The impact of virtual reality (VR) technologies on pain reduction has been relatively well researched, whereas their effect on the motivational sphere has been underexplored, including in such a problematic area as the treatment of patients with chronic back pain. Objective: To identify the psychological mechanisms of motivational changes induced by VR intervention in patients with chronic back pain, with differentiation by the type of pain syndrome (nociceptive/mixed). Methods: In a randomized controlled trial (n=82), using psychodiagnostic tools, the effect of VR intervention on motivation and pain intensity was analyzed, differentiated by pain type (nociceptive/mixed), in comparison with the use of psychocorrective methods such as art therapy and the "Patient School". Results: A dual positive effect of VR was identified: an analgesic effect – a significant reduction in pain for both types; and a motivational effect – optimization of the motivational profile. In mixed pain, VR technologies reduced initially inflated indicators to a realistic level, while in nociceptive pain, they increased motivation, smoothing out intergroup differences after the intervention. VR technologies proved to be particularly significant for patients with mixed pain due to the specifics of intrapsychic processing of sensory information. Conclusions: A sequential (rather than parallel) inclusion of immersive technologies and structured methods ("Patient School") in rehabilitation is recommended.