ana yaraulaSvili daavadebaze reagirebisa da garemosTan ... · 1 iv. javaxiSvilis saxelobis Tbilisis saxelmwifo universiteti socialur da politikur mecnierebaTa fakulteti ana yaraulaSvili

1

iv. javaxiSvilis saxelobis Tbilisis saxelmwifo universiteti

socialur da politikur mecnierebaTa fakulteti

ana yaraulaSvili

daavadebaze reagirebisa da garemosTan urTierTobis

maxasiaTeblebi safeTqlis epilefsiis, rogorc qronikuli

daavadebis dros

fsiqologiaSi fisolofiis doqtoris akademiuri xarisxis mosapoveblad

warmodgenili disertacia

disertacia Sesrulebulia:

Tbilisis saxelmwifo universitetis socialur da politikur

mecnierebaTa fakultetze

samecniero xemZRvaneli:

fsiqologiis mecnierebaTa doqtori,

prof. Tamar gagoSiZe

Tbilisi

2009

2

sarCevi

Sesavali 4

Tavi 1. qronikuli daavadebis fsiqikuri

maxasiaTeblebi

1.1. qronikuli daavadebis cnebis gansazRvra 7

1.2. qronikuli daavadebis gavlena avadmyofis

pirovnebaze. daavadebaze reagirebis tipebi

12

1.3. “avadmyofis roli”. “daavadebasTan”

dakavSirebuli qceva

25

1.4. cxovrebis xarisxi qronikuli daavadebis dros 28

1.5. daavadebisadmi damokidebuleba da daZlevis

strategiebi

31

1.6. daavadebis “Sinagani suraTi” da masze moqmedi

faqtorebi

38

Tavi 2. epilefsia da misi fsiqologiuri

maxasiaTeblebi

46

2.1. epilefsiis gansazRvra 47

2.2. epilefsia, rogorc mastigmatizirebeli

daavadeba da masze damokidebuli cxovrebis

xarisxi

51

2.3. epilefsia da pirovneba 56

2.4. epilefsiis, rogorc qronikuli daavadebis

gavlena avadmyofis pirovnebaze

71

Tavi 3. kvlevis mizani da amocanebi 76

3.1. kvlevis meTodebi 79

3

3.2. kvlevSi monawile pirTa maxasiaTeblebi 87

Tavi 4. Sedegebis aRwera

4.1 safeTqlis epilefsiis mqone pirTa kvlevis

Sedegebi

90

4.2. gulis iSemiuri daavadebis mqone pirTa

kvlevis Sedegebi

103

4.3. janmrTel pirTa kvlevis Sedegebi 110

4.4. Sedegebis Sedareba 115

Tavi 5. monacemebis interpretacia 123

daskvnebi 150

danarTi 157

literatura 171

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Sesavali

kvlevis aqtualoba:

daavadebis subieqturi mxaris Sesawvlas xangrZlivi istoria

aqvs. Tumca mxolod uknasknel wlebSi aqtualurad dadga sakiTxi

am problemisadmi multidisciplinuri midgomis aucileblobis

Sesaxeb; kerZod, pacientis klinikuri, fsiqologiuri da

socialuri aspeqtebis kompleqsuri Seswavla da miRebuli

Sedegebis farTo gamoyeneba mkurnalobasa da reabilitaciaSi.

daavadebis Sinagani suraTi moicavs yvelafers, rasac

ganicdis adamiani daavadebis mimdinareobis dros, mis mier

daavadebis da misi Sedegebis subieqturi aRqma da am WrilSi misi

kognituri gadamuSavebis Sedegebi, rasac qceva mohyveba.

daavadebis Sinagani suraTi fenomenia, romelic moicavs, erTis

mxriv, sakuTari daavadebisadmi emociur damokidebulebas da

meores mxriv, ki garemosadmi, maT Soris mikrosociumisadmi

damokidebulebas. Cvenis azriT es fenomeni mniSvnelovanwilad

gansazRvravs qronikuli daavadebis mqone piris emociur

mdgomareobas, ”avadmyofobis qcevas”, damokidebulebas

mkurnalobisadmi da saboloo jamSi, pirovnebis cxovrebis xarisxs.

epilefsia erT-erTi yvelaze gavrcelebuli qronikuli

nevrologiuri daavadebaa. epilefsia multifaqtoruli daavadebaa;

misi diagnostika da mkurnaloba saWiroebs multidiciplinaluri

midgomas

epilefsia Tavis tvinis neironebis eleqtruli aqtivobis

darRvevis Sedegad aRmocenebuli daavadeba, romelsac klinikuri

Taviseburebebis gamo (uecari Setevebi, gulyrebi) gansakuTrebuli

adgili ukavia qronikul daavadebaTa rigSi. is ganixileba, rogorc

socialuri Sedegebis mqone daavadeba, romelic gavlenas axdens

pacientis socialur urTierTobebsa da socialur statusze.

epilefsiis klinikaSi mniSvnelovani adgili ukavia emociur

da pirovnul cvlilebebs, romlebic xSirad mwvave xasiaTs

atareben da romelTa gaTvaliswineba metad mniSvnelovania

mkurnalobis procesSi. daavadebis mimdinareobis dros

aRmocenebulma emociurma problemebma, miuxedavad warmatebuli

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antiepilefsiuri mkurnalobisa da gulyrebis remisiisa, SeiZleba

xeli SeuSalos pacientis gamojanmrTelebis process. amis gamo,

unda ganvasxvavoT erTmaneTisagan epilefsia, rogorc daavadeba,

gamowveuli Tavis tvinis disfunqciiT da epilefsia, rogorc

mdgomareoba, romelic daavadebul pirovnebas da mis garemos

moicavs.

mkurnalobis da reabilitaciis Sedegebis efeqturobis gazrda

SesaZlebelia mxolod im SemTxvevaSi, Tu gaTvaliswinebulia

epilefsiis mqone piris pirovnul-emociuri reaqciebi, misi

damokidebuleba garemosadmi da sakuTari daavadebisadmi.

mkurnalobis procesi da misi dadebiTi dinamika bevrad aris

ganpirobebuli imiT, Tu daavadebis ra Sinagani suraTi uyalibdeba

avadmyofs daavadebis mimdinareobis dros.

araadekvaturi emociuri mdgomareoba (araadekvaturi

daavadebis Sinagani suraTi) auaresebs pacientTa cxovrebis

xarisxs, xels uSlis maT pirovnul Tu profesiul realizacias

da arTulebs maT socialur adaptacias, rac gansakuTrebiT

aqtualuria Cvens sinamdvileSi.

am etapze epilefsiiT daavadebulTa sakuTari

daavadebisadmi emociuri damokidebulebis Seswavla erT-erT

uniSvnelovanes sakiTxs warmoadgens rogorc samedicino, aseve

fsiqologiuri TvalsazrisiT.

kvlevis mecnieruli siaxle:

miuxedavad imisa, rom epilefsia xSirad ipyrobda fsiqologTa

da klinicistTa yuradRebas _ qarTul sinamdvileSi mas pirvelad

ganvixilavT qronikuli daavadebis modelis WrilSi.

pirvelad, kompleqsuri gamokvlevis obieqtad iqca safeTqlis

epilefsiis, rogorc qronikuli daavadebis dros aRmocenebuli

daavadebis Sinagani suraTi, misi urTierTkavSiri daavadebis

cvladebTan da interpersonaluri urTierTobis tipTan. gamoiyo da

Sefasda am fenomenis ZiriTadi maxasiaTeblebi, misi klinikuri da

fsiqologiuri korelantebi. Seswavlil iqna pirovnuli da

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klinikuri maxasiaTeblebis urTierTgavlena daavadebis Sinaganis

suraTis formirebaze safeTqlis epilefsiis dros.

SemuSavda safeTqlis epilefsiis dros daavadebis Sinagani

suraTis modeli, romelic asaxavs misi Camoyalibebis process da

romelic daavadebis Sinagani suraTis sxva faqtorebTan erTad

(pirovnebis premorbiduli Taviseburebani, garemosTan urTiertobis

xasiaTi, daavadebis kliniluri maxasiaTeblebi)

urTierTzemoqmedebis xasiaTis analizis saSualebas iZleva.

zogadad, daavadebis qronikuloba (xangrZlivi drois

ganmavlobaSi mimdinareoba), klinikuri maxasiaTeblebi da misi

SesaZlo socialuri Sedegebi cal-calke ar warmoadgens daavadebis

Sinagani suraTis ganmapirobel da misi Camoyalibebis meqanizmebis

mTavar faqtorebs. es faqtorebi erToblivad ganapirobeben

daavadebis Sinagani suraTis xasiaTs.

kvlevis praqtikuli mniSvneloba:

klinikur fsiqologs koreqciuli muSaobis sworad warmarTvis

mizniT, unda hqondes informacia pacientis daavadebisadmi, misi

calkeuli sipmtomebisadmi, sakuTari SesaZleblobebisadmi

damokidebulebis Sesaxeb. daavadebis Sinagani suraTis zusti

gansazRvra xels Seuwyobs sareabilitacio miznebis efeqtur

ganxorcielebaSi, xolo adekvaturi Sinagani suraTis Camoyalibeba

xels Seuwyobs mkurnalobis warmatebas.

daavadebis Sinagan suraTze zemoqmedebiT SesaZlebelia

daavadebis mkurnalobis da prognozis nawilobrivi mainc

gansazRvra. daavadebis adekvaturi Sinagani suraTis Camoyalibeba –

sakuTar daavadebaze adekvaturi warmodgenis Seqmna _ xels uwyobs

mravali garTulebebis Tavidan acilebas. pirovneba ufro metad

aris epilefsiis, rogorc sakuTari daavadebis mimRebi; igi

zedmiwevniT icavs mkurnalobis strategiebs da eqimTan erTad

aqtiurad aris CarTuli gulyrebis kupirebis procesSi (reJimis

dacva, wamlebis miReba da sxva), rac Tavis mxriv, gansakuTrebiT ki

warmatebuli mkurnalobis SemTxvevaSi, zrdis mis rwmenas sakuTar

SesaZleblobebSi da aumjobesebs mis urTierTobas garemosTan.

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kvlevam garkveuli roli unda Seasrulos safeTqlis

epilefiis dros aRmocenebuli pacientis daavadebisadmi

damokidebulebis da misi garemosTan urTierTobis stilis

maxasiaTeblebis SeswavlaSi, rac Sesabamisi klinikuri da

fsiqologiuri mkurnalobis efeqturi taqtikis gamomuSavebis

winapirobas unda warmoadgendes.

kvlevis Sedegebi SeiZleba iyos gamoyenebuli diagnostikuri,

samkurnalo da reabilitaciuri muSaobis ganxorcielebis dros,

gansakuTrebiT daavadebis dawyebis adreul etapze. maT safuZvelze

SesaZlebeli iqneba safeTqlis epilefsiis mqone pirTa mimarT

individualuri koreqciuli programebis SemuSaveba.

kvlevis Sedegebi dRes warmatebiT gamoiyeneba epilefsiis

mqone pirebTan diagnostikuri, samkurnalo da reabilitaciuri

muSaobisas epilefsiis kontrolisa da prevenciis samecniero-

praqtikul centrSi.

kvlevaSi miRebuli Sedegebi iZlevian garkveuli pirovnul-

emociuri problemebis aRmocenebis winaswar ganWvretis

SesaZleblobas, rac qmnis safuZvels imisTvis, rom SemuSavdes

daxmarebis individualuri koreqciuli muSaobis sqemebi

safeTqlis epilefsiis mqone pacientisTvis. maT safuZvelze

SemuSavebuli rekomendaciebiT epileftologebi da fsiqologebi

exmarebian pacients sakuTari daavadebisa da mkurnalobis miRebaSi,

rac epilefsiis mqone pacientis gamojanmrTelebis aucilebeli

pirobaa.

Tavi 1. qronikuli daavadebis fsiqikuri maxasiaTeblebi

1.1 qronikuli daavadebis cnebis gansazRvra

adamians sicocxlis ganmavlobaSi sxvadasxva sirTulisa da

xangrZlivobis daavadeba SeiZleba Sexvdes.

ganvlilma avadmyofobam janmrTel adamianSi SeiZleba ar

datovos kvali, magram mZime daavadebis SemTxvevaSi adamiani didi

xniT tovebs Cveul cxovrebas, saavadmyofoSi moxvedris

SemTxvevaSi ki - Cveul garemos.Mmwvave daavadebisas pacientebi, maTi

ojaxis wevrebi, megobrebi da TanamSromlebi moelian avadmyofis

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socialuri aqtivobis mxolod xanmokle drois ganmavlobaSi

Sewyvetas an daqveiTebas. es molodinebi radikalurad icvleba,

rodesac pirovnebas qronikuli daavadebis diagnozs usvamen. aman

SeiZleba mTeli misi cxovreba Secvalos.

qronikuli mdgomareoba mniSvnelovan gavlenas axdens

adamianis cxovrebaze, rac dakavSirebulia xangrZliv da

SesaZlebelia Zvirad Rirebul mkurnalobasTan da sikvdilianobis

maRal riskTan. am dros mravali fsiqologiuri problema Cndeba,

romelTa aRmoceneba gamowveulia ara daavadebis dros moqmedi

gansakuTrebuli fsiqologiuri meqanizmebiT, aramed imiT, rom es

Cveuli meqanizmebi moqmedeben gansakuTrebul, avadmyofobiT

ganpirobebul da Secvlil pirobebSi. jer kidev 1880 wels,

cnobili rusi fsiqiatri v.x. kandinski miuTiTebda, rom

‘’avadmyofuri mdgomareoba - es igive cxovrebaa, magram Secvlil

pirobebSi.‘’ (Николаева, 1987).

ukanasknel wlebSi gaizarda interesi qronikuli daavadebis

socialuri Sedegebisadmi. es ganpirobebulia qronikuli daavadebis

farTo gavrcelebiT, qronikuli daavadebis mqone pirebis

samedicino da socialuri reabilitaciis sakiTxebisadmi

Tanamedrove midgomiT, jandacvis sadazRvevo sistemis

infrastruqturis ACamoyalibebiT.

qronikuli daavadebis cneba sakmaod farToa. erTmaneTisagan

unda ganvasxvavoT daavadeba, rogorc samedicino paTologia da

avadmyofoba, rogorc daavadebuli adamianis cxovrebis situacia.

ar arsebobs qronikuli daavadebis universaluri samedicino

gansazRvreba, radganac qronikuli mdgomareobani gansxvavdebian

erTmaneTisagan gamomwvevi mizezebiT, mimdinareobiT, cvalebadobiT

da SedegiT. qronikuli daavadebis damaxasiaTebel Tvisebas

warmoadgens misi garduvaloba, meordi defeqtebi, sirTuleebi,

arasrulfasovneba.

qronikuli davadebas ganixilaven rogorc mdgomareobas,

romelic xangrZlivi drois ganmavlobaSi mimdinareobs an romlis

simptomebis Semcirebas aseve xangZlivi dro esaWiroeba (Stanton,

Revenson & Tennen, 2007, Perrin, Bloom & Gortmaker, 2007). qronikul

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samedicino mdgomareobad miiCneven avadmyofobas, romelic

mimdinareobs da gavlenas axdens yovldRiur cxovrebaze weliwadSi

sam Tveze meti xnis ganmavlobaSi, an romelic regularulad,

weliwadSi erT Tves mainc moiTxovs hospitalizacias. maSasadame,

ganmartebis mixedviT, qronikuli daavadebis erT-erT niSans

warmoadgens misi xangrZlivi droiT mimdinareoba, e.w. drois

faqtori. Tumca, zog SemTxvevaSi, daavadebis simptomebi SeiZleba

ar iyos mkafiod gamoxatuli an saerTod ar iyos saxeze garkveuli

drois ganmavlobaSi; magram adamianis codna daavadebis arsebobisa

da simptomebis aRmocenebis saSiSroebis Sesaxeb, aseve ganapirobebs

mis qronikul xasiaTs. garda amisa, daavadeba yovelTvis aRiqmeba

warsuli gamocdilebis da momavali prognozebis wiaRSi.

gamoyofen qronikul daavadebaTa or did jgufs. pirvel

jgufs miekuTvneba xangrZlivi, xSirad, mTeli cxovrebis

ganmavlobaSi mimdinare daavadebebi, romlebsac axlavT mravalu

akrZalvaa da SezRudva, mag., dietis an reJimis dacva, fizikuri

aqtivobis SezRudva da sxva; esenia daavadebebi, romlebic ar arian

dakavSirebulni sicocxlis safrTxesTan. meore jgufs

miekuTvnebian mZime daavadebebi sasikvdilo SedegiT (Николаева,1987,

Radley, 1994). sxva klasifikaciebis mixedviT qronikuli daavadeba

iyofa funqciurad, rac ufro fsiqiatriis sagans warmoadgens da

organul daavadebad. gamoklevebSi ganasxvaveben qronikul

daavadebebs imis mixedvaTac, Tu sad mimdinareobs mkurnaloba:

saxlis pirobebSi Tu saavadmyofoSi (Волков, 1995).

zogierTi avtori saerTod eWvs qveS ayenebs qronikuli

daavadebis calke jgufad gamoyofis mcdelobas. maTi azriT

qronikuli da mwvave daavadebebis diferenciacia mcdaria da didi

msgavseba arsebobs ‘’mwvave“ avadmyofobasa da “qronikul“ daavadebas

Soris. mag., gamwvaveba, romelic xSirad axasiaTebs “qronikul”

daavadebas, emsgavseba mwvave daavadebis epizodebs, xolo iseTi

daavadeba, rogoricaa miokardiumis infarqti da romelic

oficialurad klasificirdeba rogorc mwvave, moiTxovs xangZliv

reabilitacias da am daavadebis gavlena individis momaval

cxovrebaze SeiZleba mudmiv, qronikul xasiaTs atarebdes

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(Schneiderman, 2001). garda amisa, qronikuli daavadebebi SeiZleba

gansxvavebodnen erTmaneTisagan fizikuri dazianebis tipis da misi

simZimis mixedviT; avadmyofobis TvalsaConoebis

mixedviT_ganasxvaveben ‘madiskreditebel” samedicino mdgomareobebs

(romelTa niSnebi TvalsaCinoa ucxo adamianebis TvalisaTvis) da

”aramadiskreditebel” samedicino mdgomareobas (romelTa niSnebi

ar aris TvalsaCino).

amrigad, qronikul daavadebaTa ricxvi sakmaod farToa. maT

miekuTvneba faqtiurad yvela gul-sisxZarRvovani daavadeba,

simsivneTa didi nawili, asTma da filtvebis qronikuli

daavadebani, diabeti, arTriti, kuW-nawlavis daavadebebi da sxva

(Gannon, Glover, O’Neill & Emberton, 2004). yvela es mdgomareoba

akmayofilebs farTo gavrcelebis, xangZlivi mimdinareobis

(xangZlivobis) da mkurnalobis didi danaxarjis kriteriumebs

(Maes, Leventhal & de Ridder, 1996), rac maT qronikul daavadebaTa jgufs

miakuTvnebs.

qronikuli daavadebiT cxovreba gulisxmobs: (1) cxovrebas

janmrTelobasTan dakavSirebuli siZneleebiT, fizikuri

gamofitviT, xSirad tkiviliT, rac gavlenas axdens pirovnul

miznebsa da ambiciebze; (2) organizmis gamokvlevis regularul

moTxovnas da yuradRebis gamaxvilebas mkurnalobis Sedegebze; (3)

is sakmaod xarjiania, rogorc finansuri TvalsazrisiT, aseve

emociuradac (mkurnaloba maRali xarjebiT an Zlieri tkiviliT

iwvevs damatebiT fsiqologiur stress, moiTxovs did dros (mag.,

vizitebi eqimebTan, saavadmyofoSi stacionireba, janmrTelobis

mdgomareobis regularuli Semowmeba, saxlSi darCena da

mkurnalobis reJimis dacva); (4) is gavlenas axdens yoveldRiur

aqtivobaze, profesiul unarebze, karieraze, urTierTobebze,

TviTSefasebaze; da bolos (5) mas Tan axlavs momavalSi kontrolis

dakargvisa da mowyvladobis SiSebi (Dobbie & Mellor, 2008). D

daavadebas kulturuli da personaluri mniSvneloba aqvs,

romlis safuZvelze xdeba pirovnebis mier misi aRqma. kulturuli

mniSvneloba gulisxmobs sazogadoebis mier daavadebisadmi an misi

calkeuli simptomebisadmi garkveuli mniSvnelobis miniWebas. es,

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Tavis mxriv, xSirad efuZneba im miTebsa da crurwmenebs, rac

sazogadoebaSia gavrcelebuli konkretul daavadebasTan

dakavSirebiT. arseboben ufro metad stigmatizebuli daavadebebi

(mag., tuberkulozi, epilefsia, veneriuli daavadebebi da sxva) da

naklebad stigmatizebuli daavadebebi (mag., gulis daavadebebi,

kuWis daavadebebi da sxva). asTma, tuberkulozi, epilefsia is

qronikuli mdgomareobebia, romlebsac kulturuli datvirTva aqvT;

epilefsiis mqone adamianze moqmedebs farTod gavrcelebuli miTi

imis Sesaxeb, rom epilefsia aucileblad iwvevs kognituri

unarebisa da zogadi funqcionirebis donis Secvlas (am miTis

arsebobas mravali gamokvleva adasturebs). daavadebis personaluri

mniSvneloba individualurad gansxvavdeba, magram ZiriTadi

yuradReba mainc kontrolis dakargvas, miznebis Secvlasa da

damoukideblobis SezRudvas eniWeba (Place,!993). amasTan dakavSirebiT

metad aqtualuria Radley-is (1994) mosazreba imis Sesaxeb, rom

qronikuli daavadebis mqone pirovnebis yvelaze did tragedias

sakuTar avadmyofobasTan erTad janmrTelTa samyaroSi cxovreba

warmoadgens.

qronikuli daavadebis pirobebSi avadmyofi pirovneba

kardinalurad icvleba, rac vlindeba ara mxolod mis

xasiaTobrivi cvlilebebSi, aramed garemosTan, sazogadoebasTan

urTierTobebSic. mZime qronikuli daavadeba arsebiTad cvlis,

upirveles yovlisa, adamianis ganviTarebis socialur situacias. is

cvlis moqmedebis ganxorcielebis fsiqikuri SesaZleblobebis

dones, iwvevs garSemomyof adamianebTan kontaqtebis SezRudvas, da

xSirad, obieqturi Tu subieqturi mizezebis gamo mTlianad misi

aqtivobis cvlilebas ganapirobebs. es ki TavisTavad iwvevs

pirovnebis interpersonaluri urTierTobis xasiaTis Secvlas da

axdens gavlenas avadmyofis mier sakuTari Tavis aRqmaze axal

cxovrebiseul situaciaSi interpersonaluri urTierTobebis

konteqstSi.

daavadebis, kerZod qronikuli daavadebis, da avadmyofi

pirovnebis urTierTzemoqmedebis xasiaTis mravalferovani aspeqtebis

UukeT gaazrebis mizniT, momdevno TavebSi Cven ganvixilavT ZiriTad

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Teoriebs da mimarTulebebs, aseve, modelebs, romlebic miznad

isaxaven pirovnebis rogorc cnobieri, aseve aracnobieri reaqciebis

aRweras sakuTari daavadebisadmi.

1.2 qronikuli daavadebis gavlena avadmyofis pirovnebaze.

daavadebaze reagirebis tipebi

rodesac pirovnebas daavadebis Sesaxeb eWvi uCndeba, is

akvirdeba mis organizmSi midinare procesebs. individi elodeba

swori diagnozis dasmas da Sesatyvisi mkurnalobis daniSvnas,

romelic daavadebis simptomebis Semcirebaze iqneba mimarTuli.

eqimebis mxridanac daavadeba ganixileba, rogorc organuli

simptomebis erToblioba, romelTa Semcirebas an romelTagan

ganTavisuflebas garkveul farmakologiuri an qirurgiuli

mkurnaloba esaWiroeba. aseT midgomas ”samedicino” an

”biosamedicino” midgomas uwodeben. mas daavadeba da misi

gamovlinebebi organul etiologiaze dahyavs da mkurnaloba

ZiriTadad mimarTulia mxolod organul darRvevebis

aRmosafxvrelad. amJamad farTo gavrcelebas hpovebs meore midgoma,

romelic yuradRebas amaxvilebs pirovnebaze, romelsac konkretuli

daavadebis simptomebi aqvs da daavadebulis qcevas ganixilavs

rogorc adamianis reagirebas avadmyofobis mimdinareobis rTul

procesze. daavadeba yovelTvis ufro metia, vidre ubralod

fizikuri simptomebis erToblioba da maTze reagireba.

rodesac pirovneba igebs sakuTari diagnozis Sesaxeb, mas

uCndeba survili gaarkvios, ra saxis daavadeba aqvs, rogori

mkurnaloba esaWiroeba da ra elodeba momavalSi. daavadebis

aRmocenebis Sedegad is SeiZleba aRmoCndes ucxo adgilas (mag.,

saavadmyofoSi), ucxo adamianebTan (samedicino personali). daavadeba

aiZulebs mas garkveulwilad uari Tqvas sakuTar avtonomiaze,

Secvalos samomavlo gegmebi. garda amisa, masze SeiZleba gavlenas

axdendes warsuli gamocdileba da sxvaTa azrebi.

Gr.Engel (1977) aRniSnavda, rom adamianis mier sakuTari

daavadebis aRqma ar SeiZleba iyos dayvanili mxolod ubralo

biologiur SegrZnebebze, daavadebis organuli simptomebis

13

erTobliobaze. igi aucileblad unda moicavdes fsiqosocialur

faqtorebsac (sqema #1) (Landau-Hurtig, 1994).

sqema#1 Gr.Engel-is (1977) avadmyofobis biofsiqologiuri modeli (Landau-

Hurtig, 1994).

organuli simptomebi

fsiqologiuri faqtorebi pacienti

kulturuli faqtorebi

socialuri faqtorebi

qronikuli daavadeba pirovnebis ganuyofeli nawili xdeba da

gavlenas axdens masze. CvenTvis mniSvnelovania somaturi

mdgomareobis paTogenuri gavlena adamianze. am gavlenis qveS

pirvel rigSi vgulisxmobT daavadebis adamianis fsiqikaze

zemoqmedebas, rac gamoixateba daavadebis dros aRmocenebul

fsiqologiur da pirovnul-emociur cvlilebebSi.

gamoyofen qronikuli daavadebis ori saxis paTogenur

gavlenas adamianis fsiqikaze: somatogenuri _ centralur nervul

sistemaze intoqsikaciuri zemoqmedeba da fsiqogenuri _ pirovnebis

mZafri reaqcia daavadebaze da mis Sedegebze (nikolaeva, 1987). am

ori tipis gavlenis gamoyofa aucilebelia, radganac maTi

gamovlinebis intensivoba gansxvavebulia sxvadasxva nozologiebSi.

ase, mag., somatogenuri gavlena gansakuTrebiT did rols TamaSobs

fsiqikuri darRvevebis aRmocenebaSi Tirkmlis daavadebebis, gulis

Tandayolili mankis dros (Березовский, Крайнова & Бондарь, 2005). unda

aRiniSnos, rom centralur nervul sistemaze intoqsikaciuri

zemoqmedeba aRmocendeba mxolod calkeuli somaturi daavadebebis

SemTxveveSi da ar axasiaTebs daavadebis umravlesobaTa klinikur

suraTs.

qronikuli somaturi daavadebis fsiqikaze gavlenis ZiriTad

formas warmoadgens fsiqogenuri gavlena - pirovnebis

fsiqologiuri reaqcia daavadebaze da mis Sedegebze.

fsiqikaze qronikuli daavadebis aseTi saxis gavlena didi

xania cnobilia. mraval SromaSi gvxvdeba fsiqikuri cvlilebebis

14

aRwera qronikuli somaturi daavadebis mqone pacientebSi da

fsiqikis am cvlilebebis speqtri sakmaod farToa.

xSiria sxvadasxva saxis negatiuri emociuri reaqcia, romelic

dakavSirebulia avadmyofis fizikuri mdgomareobis cvlilebebTan:

SiSi, depresia, SfoTva, gaRizianeba, rac aRmocendeba avadmyofobis

mimdinareobis da misi mkurnalobis sxvadasxva stadiebze (Blumenfield

& Thompson, 1989). literaturaSi aRwerilia nevrotuli da asTeniuri

mdgomareobani, romlebic viTardeba somaturi daavadebis fonze.

xSirad, gancdebi gamowveulia daavadebis SedegebiT,

Sromisunarianobis, ojaxuri mdgomareobisa da avadmyofi adamianis

socialuri statusis cvlilebebiT. �es emociuri cvlilebebi,

daavadebis xangrZlivad mimdinareobisa da araefeqturi

mkurnalobis pirobebSi, SeiZleba gadaizardos avadmyofis

pirovnebis myar, xSirad Rrma cvlilebebSi, romlebic gamoixateba

avadmyofis daavadebis pirobebSi anomaluri da egocentruli

ganwyobebis, dacviTi, kompensatoruli meqanizmebis formirebaSi da

xSirad misi TviTaRqmis da mTlianad cxovrebis mimarTulebis

cvlilebaSi (Blumenfield & Thompson, 1989, Mumford, 1989).

cnobili avstrieli fsiqoanalitikosi a. adleri Tavisi

Teoriis ZiriTadi cnebis - arasrulfasovnebis kompleqsis - erT-

erT gamomwvev mizezad (sxva mizezebs Soris, romleTa ganxilvaze

aq ar gavCerdebiT) Tvlis bavSvis garkveul fizikur nakls

(mxedvelobis, smenis deficiti da a. S.) an fizikur daavadebas, ris

gamoc bavSvi Tavs daCagrulad grZnobs, rasac a. adleri

‘’paTogenur bavSvur situacias uwodebs“. es iseTi pirovnebis

Camoyalibebis mizezia, rodesac “sakuTari sisustisa da sxvaze

damokidebulebis normaluri SegrZneba Rrmavdeba da gadaiqceva

arasrulfasovnebis mwvave gancdad“, rac Tavisebur gavlenas axdens

individis cxovrebaze da ganapirobebs misi qcevisa da garemosTan

urTieTobebis tips (adleri a., 1997).

v. kerbikovi (1971) miuTiTebs pirovnebis adaptaciis reaqciebze

arasrulfasovnebis gancdis, fizikuri da fsiqikuri

SesaZleblobebis SezRudvis gancdis, Secvlili guneba_ganwyobisa

da daavadebis sxvadasxva gamovlinebis gadasalaxavad. es reaqciebi,

15

misi azriT, SeiZleba iyos kompensatoruli, fsevdoautisturi

(kontaqtebis xelovnuri SezRudva, simptomebis qvecnobieri

maskireba, dRis reJimis cnobieri Secvla da sxva),

fsevdokompensatoruli xasiaTis reaqciebi (daavadebis uaryofa da

ignorireba mZime somaturi avadmyofobis SemTxvevaSi). sxva

sityvebiT rom vTqvaT, avadmyofi pirovneba daavadebis sakuTari

koncefciis safuZvelze garkveuli saxiT cvlis cxovrebis Cveul

wess. d. lakosinas da g. k. uSakovas avadmyofobaze reagirebis

tipologiaSi, gamoiyofa moTxovnilebebis kategoriebi, romlis

dakmayofileba yvelze metad ferxdeba daavadebiT, iqneba es

vitaluri moTxovnilebebi, sazogadoebriv _ profesiuli, eTikuri,

esTetikuri Tu intimur cxovrebasTan dakavSirebuli

moTxovnilebebi (Лакосина Д., Ушакова Г., 1984).�

Blumenfield-ma da Thompson-ma (1989) aRweres individis emociuri

reagirebis tipebi avadmyofobiT gamowveul stresze. Tavdapirvelad

Cndeba daavadebis uaryofa an zogadad, daavadebis saSiSroebis

Semcireba. Semdeg vlindeba daavadebasTan gamkvlavebis pirveladi

mcdeloba, romelsac xSirad Tan axlavs regresia, amis Semdeg ki

avadmyofi iwyebs daavadebaze da mis SesaZlo prognozze sakuTari,

Sesabamisi informaciis Ziebas da gamkvlavebis cnobieri

strategiebis SemuSavebas. amisTvis is sakuTari da sxva adamianebis

inteleqtualur resursebs iyenebs. ganvixiloT TiToeuli es

reaqcia ufro dawvrilebiT:

1.uaryofa _ aracnobieri dacviTi meqanizmia, romlis

saSualebiTac xdeba gare sinamdvilis arasasurveli movlenebis,

maT Soris arasasurveli da arasasiamovno sxeulebrivi

SegrZnebebis ukugdeba. uaryofa, erTis mxriv pirovnebas icavs gare

sinamdvilis metismetad Zlieri stimulaciisagan. amdenad is,

rogorc pirveladi reaqcia, sasargebloc SeiZleba iyos

avadmyofisaTvis. magram, meores mxriv, igi saxifaToc SeiZleba

aRmoCndes, vinaidan xels uSlis pirovnebas mdgomareobis realur

SefasebaSi. mag., Tu uaryofa Tan sdevs simsivnis dasawyiss, aman

SeiZleba savalalo Sedegic ki gamoiwvios, radganac xels SeuSlis

diagnozis droulad dasmas da mkurnalobas.

16

uaryofa xSirad aris is reaqcia, romelic uCndeba adamians

daavadebis pirveli simptomebis aRmocenebasTan erTad. mas ar

sjera, rom sxeulebrivi niSnebi SeiZleba iyos dakavSirebuli mZime

daavadebasTan, is fiqrobs, rom arsebuli simptomebi SemTxveviT

xasiaTs atareben, cdilobs maTi mizezebis cxovrebis pirobebSi

Ziebas (mag., gadaRla, stresi da sxva); amis gamo is ar asrulebs

eqimis daniSnulebas, araserioozulad aRiqvams mas. amis Sedegad

ikargeba dro, Rrmavdeba/mZimdeba paTologiuri procesi da

daavadeba arasaimedo mimdinareobas Rebulobs.

2.regresia _ aracnobieri dacviTi meqanizmia, romlis

saSualebiTac pirovneba ubrundeba qcevis da adaptaciis ufro

adreul etapebs. TiToeuliUpacienti, romelic seriozulad aris

avad da gansakuTrebiT is, vinc saavadmyofoSi imyofeba, sxvadasxva

xarisxiT amJRavnebs fsiqologiur regresias. is ubrundeba

fsiqologiur stresTan gamklavebis ganviTarebis adreul etapebze

gamocdil saSualebebs, xolo daavadeba, rogorc ukve avRniSneT,

fsiqologiuri stresis saxea. mag., erTi avadmyofi SeiZleba iyos

Seupovari, momTxovni da hqondes “cudi guneba _ ganwyoba“ (risxva,

gaRizianeba), maSin, rodesac meore Cumi da mtirala xdeba. garda

amisa, unda aRiniSnos, rom SfoTva aZlierebs regresias. arsebobs

sxva aracnobieri dacviTi meqanizmebic, romlebsac xSirad iyenebs

rogorc janmrTeli, aseve avadmyofi pirovneba da isini sxva

araferia Tu ara pirovnebis aracnobieri reaqcia mafrustrirebel

situaciaze da maT Soris daavadebazec.

3.codniT kontroli _ es reaqcia daavadebis uaryofis

sawinaaRmdegoa, radganac, am SemTxvevaSi, avadmyofs surs rac

SeiZleba meti gaigos sakuTari daavadebisa da misi mkurnalobis

Sesaxeb. is SeZenili codniT cdilobs situaciis anu daavadebis

kontrols; aseTma pacientma SeiZleba sakmaod farTo samedicino

codna daagrovos sakuTari daavadebis Sesaxeb. SfoTva da SiSi

mniSvnelovnad matulobs, rodesac subieqti ar flobs informacias

arsebuli mdgomareobis Sesaxeb. zogierT individs iseTi pirovnuli

stili gaaCnia, romelic aiZulebs situaciis kontrols (Dr. Simons,

1989). aseTi adamianebi Riziandebian rodesac yvelafers ver

17

gebuloben sakuTari daavadebis da misi mkurnalobis Sesaxeb. amis

gamo isini yovel Rones xmaroben imisaTvis, rom miiRon maTTvis

sasurveli informacia. am SemTxvevaSi mniSvnelovania maTTvis

daavadebis, misi prognozisa da mkurnalobis Sesaxeb amowuravi

informaciis miwodeba.

4.SfoTva _ avadmyofoba xSirad niSnavs funqciis dakargvas an

fizikuri Tu fsiqikuri Zalebis daqveiTebas, rac SfoTvas iwvevs.

SfoTva imdenad Zlieri SeiZleba iyos, rom avadmyofs eufleba

brZolis an gaqcevis moTxovnileba. SfoTviT Sepyrobilma erTma

avadmyofma SeiZleba yvelaferi gaakeTos sakuTari

gamojanmrTelebisaTvis, magram meore avadmyofi ki, romelic

daavadebis gamo fsiqologiurad Zlier daTrgunulia, SeiZleba

mowydes realobas, rac gaqcevis tolfasia.

5.risxva _ xSirad ganpirobebulia daavadebasTan

dakavSirebul SiSTan. avadmyofma SeiZleba uaryos, rom mas eSinia

da aracnobierad cvlis am arasasurvel da damamcirebel grZnobas

iseTiT, romelsac is ufro Tavisuflad gamoxatavs, kerZod, _

risxviT.

6.depresia _ garkveulma safrTxem, romelic xSirad Cndeba

daavadebis dros, SeiZleba gamoiwvios sxvadasxva simZimis

depresia, rac, umetes wilad, avadmyofobis mimdinareobis da mis

mier gamowveuli cvlilebebis xasiaTTan aris dakavSirebuli.

arsebobs kidev erTi reaqcia, romelic, avtorTa azriT,

zogjer gvxvdeba avadmyof pirebSi. es aris sxeulebrivi grZnobebis

gacnobierebis an daavadebasTan dakavSirebuli emociebis

gamoxatvis sirTule. am fenomenis aRsaniSnad Semotanili iyo

termini “aleqsiTimia“ (“alexithymia“), romelic berZnulad niSnavs

“grZnobebis aRweris SeuZleblobas“ an “grZnobebs sityvebis

gareSe“. Tavdapirvelad es cneba Semotanili iyo fsiqosomatur

medicinaSi da iTvleboda, rom is ZiriTadad mxolod

fsiqosomaturi avadmyofebisaTvis aris damaxasiaTebeli. magram

Semdgomma gamokvlevebis (Mendelson, 1982, Smith, 1983) mixedviT

aleqsiTimia gvxvdeba qronikuli daavadebis mqone TiTqmis yvela

avadmyofTan (M. Willmot, 1989).

18

aleqsiTimiis gansazRvrebaSi azrTa sxvaobaa. zogi fiqrobs, rom es

aris “emociebis aRwerisas sityvaTa SezRuduli maragi, erTi

emociis meorisagan gansxvavebis uunaroba da fantaziis gaRaribeba“

(Nemiah, 1973); zogi avtoris mixedviT (Lesser, 1985) ki aleqsiTimiis

mqone avadmyofi erTmaneTSi urevs emociebis Tanmxleb

fiziologiur da daavadebis fizikur niSnebs. aleqsiTimiis sxva

gansazRvreba (Rad et al., 1979) gulisxmobs socialuri damorCilebis

maRal xarisxs da azrovnebis “konkretul“ xasiaTs (M. Willmot, 1989).

maSasadame, SeiZleba aRiniSnos, rom “aleqsiTimiis“ koncefcia

dakavSirebulia emociuri grZnobebis gansazRvrasa da

SegrZnebebisgan maTi diferenciaciis individualur gansxvavebebTan

da igi sxvadasxva daavadebis SemTxvevaSi gvxdeba. jer _ jerobiT

gaugebaria Tu, ra meqanizmebi udevs safuZvlad am mdgomareobis

aRmocenebas.

Cven ukve avRniSneT, rom daavadebas TiTqmis yovelTvis Tan

axlavs SiSi, romelic dakavSirebulia mis SesaZlo SedegebTan da

mkurnalobasTan. Blumenfield-ma da Thompson-ma (1989) gaanalizes

aseTi SiSis Semdegi saxeebi:

a) pirovnuli mTlianobis dakargvis SiSi _ adamians sjera,

rom is damoukidebelia, sakuTari bedis patronia da rom misi

sxeulebrivi mTlianoba daurRvevelia. xolo, avadmyofobam da

hospitalizaciam SeiZleba uecrad Secvalon es universaluri,

magram iracionaluri da narcistuli rwmena;

b) ucxo adamianebis SiSi _ es aris SiSi imisa, rom sakuTari

cxovreba unda gadaabaro ucxo adamianebs, mag., saavadmyofoSi

moxvedris SemTxvevaSi. avadmyofebs ar gaaCniaT piradi kavSirebi

saavadmyofos personalTan da amitom eWvi SeaqvT maT

gulisxmierebasa da yuradRebaSi, imaSi Tu ramdenadaa personali

maTi gamojanmrTelebiT dainteresebuli.

g) sayvarel adamianebTan ganSorebis SiSi _ avadmyofobam

xSirad SeiZleba hospitalizacia gamoiwvios, rac, Tavis mxriv,

iwvevs ganSorebas axlobel adamianebTan da amasTan dakavSirebul

SfoTvas;

19

d) garSemomyofi adamianebis siyvarulis da keTilganwyobis

dakargvis SiSi _ avadmyofs SeiZleba eSinodes sakuTari

mimzidvelobis an aqtiuri movaleobebis Sesrulebis

SesaZleblobebis dakargvisa, ris gamoc, misi azriT, is dakargavs

misTvis mniSvnelovani adamianebis pativiscemas;

e) sxeulis sxvadasxva nawilebis dakargvis da dasaxiCrebis

SiSi _ es grZnoba Cndeba gansakuTrebiT maSin, rodesac avadmyofoba

Qqirurgiul Carevas moiTxovs da dakavSirebulia imasTan, Tu ra

mniSvnelobis matarebelia sxeulis esa Tu is nawili

pirovnebisaTvis;

v) danaSaulis grZnobis reaqtiulobis SiSi _ avadmyofs

SeiZleba gauCndes azri, rom misi avamyofoba dasjaa misi warsuli

codvebisaTvis;

z) organizmis romelime funqciuri sistemis moSlis SiSi -_

avadmyofis TviTpativiscemis grZnoba SeiZleba Selaxuli iyos kuW-

nawlavis, Sardis buStis da sxva funqciuri sistemebis moqmedebaze

kontrolis dakargviT.

Simons-s (1989) Tavis statiaSi qronikuli daavadebis mqone adamianis

qcevis Sesaxeb, mohyavs Ralph Kahama_is da Grete Bibring_is mosazreba

somatur avadmyofobaze fsiqologiuri reagirebis Svidi ZiriTadi

pirovnuli tipis Sesaxeb. TiToeuli pirovnuli tipi ganisazRvreba

pirovnebisTvis avadmyofobis fsiqologiuri mniSvnelobiTa da

masze reaqciiT. avtorebis azriT am individebs gaaCniaT

gamoxatulad fiqsirebuli pirovnuli stili, ris gamoc isini

Sesabamisad reagireben avadmyofobaze.

1) zedmetad momTxovni, damokidebuli tipi _ am avadmyofebs

eSiniaT ususurobisa da esaWiroebaTF personaluri zrunva.

avadmyofobisas es vlindeba ojaxis wevrebisa da megobrebisagan

yuradRebis, zrunvis usasrulo moTxovnebSi;

2) mSvidi, kompulsiuri tipi _ avadmyofoba safrTxis winaSe

ayenebs avadmyofis TviTmarTvis SesaZleblobas, romelic Zalian

mniSvnelovania misTvis. amis gamo is SeiZleba fsiqologiurad

rigiduli an zedmetad kontrolirebadi gaxdes;

20

3) isteriuli tipi _ am avadmyofebs eSiniaT mimzidvelobis

dakargvisa an imisa, rom maT naklebad daafaseben, amitom isini

zedmetad dramatulad reagireben da gazrdili emociuri

labilobiT gamoirCevian;

4) mazoxisturi tipi _ avadmyofebi aracnobierad cdiloben

avadmyofobis da sakuTar cxovrebaSi sxva stresuli SemTxvevebis

SenarCunebas yuradRebis miqcevisa da siyvarulis miRebis mizniT.

zogjer isini avadmyofobas ganixilaven, rogorc dasjas an

danaSaulis Rrma grZnobis gamosyidvas;

5) paranoialuri tipi _ am avadmyofebs gaaCniaT tendencia

daadanaSaulon sxvebi (gansakuTrebiT eqimebi) sakuTar daavadebebSi

an mkurnalobis warumateblobaSi. isini eWvis TvaliT uyureben

daxmarebis nebismier mcdelobas da zedmetad mgrZnobiareni arian

maT mimarT gamoCenili uyuradRebobis mimarT;

6) narcistuli tipi _ daavadeba safrTxis winaSe ayenebs

avadmyofis srulyofilebas da uvneblobis grZnobas. am tipis

avadmyofebs didi survili aqvT iyvnen mniSvnelovanebi,

gazviadebuli warmodgena aqvT sakuTar YTavze da

TviTdajerebulni arian;

7) Sizoiduri tipi _ isini ganmartoebuli da naklebad

socialurni arian; naklebad erevian yoveldRiur movlenebSi da

sxva adamianTa saqmeebSi. daavadeba emuqreba am avadmyofebis Sinagan,

fsiqologiur wonasworobas da is xSirad aZlierebs maT gaqcevas

Zlier SfoTvaSi.

Blumenfield_is da Thompson_is (1989) mixedviT, arseboben

avadmyofTa iseTi jgufebic, visac daavadebaze, hospitalizaciaze

da operaciaze mtruli fsiqologiuri reaqciebis ganviTarebis

maRali riski gaaCnia. am avadmyofebs aqvT fsiqoturi

dekompensaciis an sxva fsiqiatriuli darRvevebis istoria,

darRveuli kavSirebi axloblebTan da gaaCniaT mkurnalobis mimarT

ararealuri molodinebi.

iTvleba, rom ar arsebobs erTmniSvnelovani kavSiri somaturi

daavadebis xasiaTsa da daavadebaze pirovnuli reaqciis tips Soris

da rom es ukanaskneli gacilebiT metad damokidebulia daavadebis

21

xangZlivobaze, mis simZimeze da avadmyofis inteleqtualur

SesaZleblobebze. sakiTxis am saxiT dayeneba ar Sedis Cveni

gamokvlevis sferoSi, magram, mis sailustraciod sainteresoa

Barker_is et al. (1946) gamokvleva, romelic Seiswavlida fizikuri

naklis mqone qalebis jgufs _ da SemogvTavaza daavadebis

subieqturi mxaris Semdegi klasifikacia. man gamoyo 5 tipi:

a) diskomfortis Tavidan acileba, romelsac Tan axlavs

sakuTar TavSi CaRrmaveba, autizacia da romelic metwilad

damaxasiaTebelia interesebis viwro wris da dabali inteleqtis

mqone avadmyofebisaTvis; ufro xSirad gvxvdeba avadmyofobis

xangrZlivi mimdinareobis dros;

b) cxovrebiseuli Senacvleba, romlis dros avadmyofi

damoukideblad poulobs cxovrebiseuli miznebis miRwevis axal

saSualebebs; is cvlis daavadebis Sedegad dakargul

SesaZleblobebs sxva miznebiT. am tips avtorebi ukavSireben

inteleqtis maRal dones;

g) uaryofa, romlisTvis damaxasiaTebelia avadmyofis swrafva

gandevnos defeqtis aRiareba da daavadebasTan dakavSirebuli

SesaZleblobebis SezRudva. es tipi, R. Barker_is azriT, Gvlindeba

saSualo inteleqtis mqone individebTan.

d) kompensatoruli qceva _ gamoyofen mis 4 qvesaxes:

1) cikluri Segueba, romlisTvis damaxasiaTebelia

“aRmavlobis da vardnis“ periodebi;

2) fataluri damokidebuleba (ZiriTadad momavlisadmi);

3) paranoialuri Segueba, araadekvaturi gancdebi;

4) gamoxatuli agresiuli reaqciebi;

e) nevrotuli reaqciebi;

rogorc samarTlianad aRniSnaven Maes, Leventhal & de Ridder D.

(1996), Morse & Johnson (1991), yvela es gamokvleva atarebs calmxriv,

danawevrebul xasiaTs. maTSi yuradReba eqceva avadmyofi pirovnebis

SegrZnebebis gacnobierebas, grZnobebs an am SegrZnebebis da

warmodgenebis inteleqtualur gadamuSavebas, daavadebis mimarT

zogad emociur reagirebas. isini ar iZlevian daavadebis dros

aRmocenebuli emociuri da kognituri reagirebisa da maTi

22

garemosTan urTierTqmedebis Sedegebis suraTs. isini ganixilaven

calke avadmyof pirovnebas da ar exebian mis garSemo myof ”sxvebs”.

am naklis daZleva scades Morse-m da Johnson_ma (1991),

romlebmac Seqmnes daavadebaze reagirebis axali koncefcia, e. w.

“avadmyofobis konstelaciuri modeli“ anu daavadebis krebiTi

modeli, romlis saSualebiT cdilobdnen aexsnaT daavadebis dros

aRmocenebuli qcevebis xasiaTi.

aRniSnuli modeli daavadebas ganixilavs, rogorc zogad

gamocdilebas, romelic gavlenas axdens avadmyof pirovnebaze da

misTvis mniSvnelovan adamianebze, pirvel rigSi ojaxze.

Sesabamisad, igulisxmeba, rom avadmyofis gamojanmrTelebis

procesSi sxva adamianebic Rebuloben monawileobas.

am modelSi daavadebis individualuri gancda gavlenas

axdens adamianis cxovrebaSi manamde arsebul urTierTobebze,

rolebze da kavSirebze. mZime daavadebis SemTxvevaSic ki, am

modelis mixedviT, arsebobs kompensatoruli urTierTzemoqmedeba

avadmyofsa da mis ojaxs Soris.

am modelSi avadmyofobis gancda ganixileba oTx etapad, oTx

safexurad:

I _ daurwmuneblobis etapia. am etapze individi amCnevs

daavadebis niSnebs da cdilobs gaacnobieros simptomebi maTi

sirTulis da mniSvnelobis gansazRvriT. mas uCndeba eWvi

organizmSi raRac disbalansis arsebobis Sesaxeb, magram is jer

kidevs ar aris amaSi darwmunebuli. ojaxis wevrebma da axloblebma

aseve SeiZleba SeniSnon cvilebebi adamianSi da amis Semdeg

CaerTon aRmocenebuli eWvis ganxilvis procesSi. avadmyofi

adamiani da misi ojaxis wevrebi akvirdebian organizmis nebismier

cvlilebas, romelmac SeiZleba iCinos Tavi, axdenen am

cvlilebebis monitorings. magram maT am dros jer kidev ar

sjeraT, rom raime seriozulTan aqvT saqme.

II _ es rRvevis etapia, rodesac individi akeTebs daskvnas, rom

avadmyofoba realuri da seriozulia da iwyebs daxmarebis Ziebas.

es etapi SeiZleba iyos ganmtkicebuli samedicino diagnozis

dadasturebiT eqimis an sxva adamianis mier. es aris krizisis etapi,

23

rodesac individi xelidan uSvebs sakuTari cxovrebis kontrolis

sadaveebs. am momentidan is totalurad damokidebuli xdeba masze

mzrunvel adamianebze _ eqimebze, ojaxis wevrebze. mZime daavadebis

SemTxvevaSi, naTesavebi da megobrebi sakuTar Tavze iReben

avadmyofis yoveldRiur movaleobebs, an am movaleobebis nawils. am

safexurze adamians aRar aqvs gancda, rom is gaurkvevlobaSi

imyofeba, mas ZaluZs adekvaturad Seafasos realoba da ufro

aqtiurad CaerTos mkurnalobis procesSi. pacienti iRebs garkveul

pasuxismgeblobas sakuTar Tavze da am dros iwyeba

gamojanmrTelebis an e.w. ”TviTobis dabrunebis” safexurze

gadasvla.

III _ gamojanmrTelebis mcdelobis etapia. am stadiaze

avadmyofi cdilobs sakuTari daavadebis Semecnebas; is ikvlevs

warsuls, usvams mraval kiTxvas daavadebis Sesaxeb ojaxis wevrebs,

axloblebs, eqimebs imisaTvis, rom axsnas daavadebis mizezi da

cdilobs misi momavali Sedegebis prognozirebas. avadmyofi

adamiani acnobierebs da Rebulobs im faqts, rom misi cxovreba

Seuqcevedad Seicvala da miuxedavad imisi, rom zog SemTxvevaSi is

SeiZleba daubrundes yofil aqtivobas _ sakuTar Tavs sxvanairad

aRiqvams. am periodSi avadmyofi iwyebs brZolas da TandaTanobiT

anaxlebs sakuTari movaleobebis Sesrulebas; is iseT amocanebs

isaxavs, romelTa SesrulebiT Semdeg cdilobs daubrundes

cxovrebis Cveul wess.

am dros ojaxis wevrebi, axloblebi avadmyofTan erTad

iTviseben axal rolebs an Tmoben Zvel rolebs. isini mxarSi

udgebian pacients mis cxovrebis stilSi garkveuli cvlilebebis

SetaniT, pozitiuri ganwyobebis SemuSavebiT da maTi SenarCunebiT.

IV _ janmrTelobis dabrunebis etapi. am etapis ZiriTad

amocanebs warmoadgens: daavadebamde arsebuli urTierTobebis

aRdgena, sakuTar cxovrebaze kontrolis ganmtkiceba, sakuTari

sxeulisadmi ndobis swavla, avadmyofobis ukan mitoveba da

garkveul sferoebSi dakarguli poziciebis dabruneba. am dros

avadmyofi TviTon gansazRvravs Tu rodis grZnobs Tavs “kargad“ an

egueba da FRebulobs Tavisi organizmis funqcionirebis Secvlil

24

dones. avadmyofi adamiani swavlobs pasuxismgeblobis aRebas

sakuTari sxeulis mdgomareobaze, cdilobs gaakontrolos

simptomebi da icxovros daavadebiT Seqmnil axal situaciaSi. is

Rebulobs sakuTar daavadebas. ojaxTan da axloblebTan

urTierTobebi TandaTanobiT Cveul xasiaTs ubrundeba, qreba is

disbalansi, romelic gamowveuli iyo daavadebiT. rogorc ki

avadmyofi pirovneba iwyebs kontrolis dabrunebas, ojaxis wevrebma

da axloblebma unda daiwyon kontrolis daTmoba.

yvela zemoT aRniSnuli etapi moyvanilia cxrilSi #1.

es koncefcia gviCvenebs, rom avadmyofoba ar SeiZleba iyos

dayvanili mxolod fizikur darRvevebze, xolo misdami

damokidebuleba – mxolod sxvadsxva saxis reaqciebze.

cxrili #1 Morse-s da Johnson_is (1991) avadmyofobis konstelaciurimodelis ZiriTadi maxasiaTeblebi

me sxvebi1 safexuri: gaurkvevlobis

eWvi

sakuTar sxeulze dakvirveba

daTrgunva

eWvi

monitoringi, Sefaseba

daTgrunva

2 safexuri: rRvevis

kontrolis daTmoba

gaucxoveba

pasuxismgeblobis aReba

sifxizle, yuradReba3 safexuri: TviTobis dabrunebisaTvis brZola

avadmyofobis sazrisis Zieba

TviTobis SenarCuneba

rolebis gacvla

miznebis dasaxva

nugeSis da darwmunebulobis Zieba

brZolisaTvis Zalebis mokreba

buferireba, Semsubuqeba

rolebis gacvla

aqtivobebze zedamxedveloba

mxardaWera

4 safexuri: gamojansaReba

kontrolis dabruneba

gawafva, daostateba

dasasrulis Zieba

kontrolis daTmoba

daostatebaze Tvalyuris devneba

dasasrulis Zieba

pacientebi gansxvadebian erTmaneTisagan daavadebasTan

dakavSirebuli qcevebis mixedviT daavadebis mimdinareobis

25

sxvadasxva etapebze. am koncefciasac aqvs nakli. is ganixilavs

avadmyofis gancdebs mwvave daavadebis SemTxvevaSi da ar

iTvaliswinebs qronikuli daavadebis SemTxvevebs, romelic, xSirad,

wlobiT mimdinareobs da sakuTari specifika gaaCnia. garda amisa,

avtorebi aRweren ”avadmyofobiT gamowveuli qcevis” SesaZlebel

etapebs, magram ar iZlevian avadmyofobis subieqturi Sefasebis

mTlian suraTs, romelic SeZlebisdagvarad asaxavda mis sxvadsxva

komponentebs.

1.3. “avadmyofis roli”. “daavadebasTan dakavSirebuli qceva

daavadebis SedegebiT gamowveuli qcevebis SeswavlasTan

dakavSirebul koncefciebs Soris farTod aris gavrcelebuli e. w.

“avadmyofis rolis“ (sick role) koncefcia, romelic SemuSavebulia

sociolog Talcot Parsons-is mier (1951). misi azriT, TiToeuli individi

ganaxorcielebs erT an ramdenime rols (mag., deda, Svili, mama,

diasaxlisi da sxva). TiToeul rols gaaCnia Tavisi molodinebi da

valdebulebebi, rogorc pozitiuri, ise negatiuri. T.Parsons-i

sazogadoebas ganixilavs, rogorc dinamikuri wonasworobis

mdgomareobaSi myofs, rac ganisazRvreba damoukidebeli rolebis

arsebobiT. Cven aq ar SevCerdebiT T. Parsons-is Teoriis farTo

ganxilvaze, vinaidan is ufro sociologiis sferos miekuTvneba.

aRvniSnavT mxolod, rom misi azriT, sakuTari rolebi gaaCnia

agreTve eqims da avadmyofs.

eqimis roli funqcionaluri rolia, romlis mizani

mdgomareobs avadmyofi adamianebis disfunqciuri, usargeblo

rolebidan gamoyvanaSi da Cveul, funqcionalur rolebSi

dabrunebaSi.

“avadmyofis rolis“ ZiriTadi molodinebi da

valdebulebebi, T. Parsons-is azriT, SemdgomSi mdgomareobs:

1.“avadmyofi ganTavisuflebulia Tavisi “Cveuli socialuri

rolisa“ da valdebulebebisagan. ganTavisuflebis xarisxi

daavadebis simZimis proporciulia da xelisuflebisagan

legitimurobas moiTxovs, romlis warmomadgeneli eqimia da

romelic avadmyofis uflebis dacvis garantia.

26

2.“avadmyofi ar aris pasuxismgebeli sakuTar qcevaze.“

daavadeba ar ganixileba, rogorc avadmyofi adamianis brali da mas

unda gaewios daxmareba avadmyofuri mdgomareobidan gamosasvlelad.

daavadebis dros avadmyofi moiTxovs da elodeba zrunvas.

3.“avadmyofi gamojanmrTelebas unda cdilobdes.“ individma

unda gaigos, rom avadmyofis roli arasasurvelia da rom Cveul

socialur rolebze uaris Tqma SeiZleba droebiT xasiaTs

atarebdes.

4.“avadmyofma unda mimarTos kvalificirebul daxmarebas da

xeli Seuwyos mkurnalobas.“

eqimma unda Seafasos da umkurnalos avadmyofs am rolebis

specifikis gaTvaliswinebiT.

am koncefcias bevri nakli gaaCnia. pirvelia is, rom adamianTa

reaqciebi daavadebaze gacilebiT metia da xSirad dakavSirebulia

kulturasTan, asakTan da sqesTan. da meorec, eqimis da avadmyofis

rolebi ZiriTadad ganxilulia mwvave daavadebis konteqstSi da ar

aris gaTvaliswinebuli qronikuli daavadebebi an mwvave,

periodulad ganmeorebadi daavadebebi. avadmyofebisgan, romlebsac

MmZime daavadeba aqvT sasikvdilo SedegiT an daavadeba, romelic

dakavSirebulia moZraobebis SezRudvasTan, ar aris mosalodneli

zemoT xsenebuli yvela valdebulebebis Sesruleba. mesame, T.Parsons-

is modelis principebi ufro misaRebia sazogadoebrivi

mecnierebisaTvis da naklebad sasargebloa avadmyofis fsiqologiis

gasagebad. garda amisa, es koncefcia ar iTvaliswinebs imas, rom

�“avadmyofis rolSi“ yofna zogierTi pacientisTvis SeiZleba

cxovrebis damakmyofilebel stils warmoadgendes da garkveul

sargeblobasTan iyos dakavSirebuli.

“avadmyofis rolis“ (“sick role“) terminis nacvlad xSirad

iyeneben termins “avadmyofobasTan dakavSirebuli qceva“ (“illness

behaviour“) (e.g. Moss, 1986). “avadmyofobasTan dakavSirebuli qcevis“

koncefcia moicavs daavadebaze reagirebis mraval variants. Mechanic-

ma (1962) Semdegnairad gansazRvra es termini:“avadmyofobasTan

dakavSirebuli qceva es aris is gzebi, romelTa saSualebiTac

arsebuli simptomebi sxadasxvagvarad aRiqmeba, fasdeba da

27

xorcieldeba (an ar xorcieldeba) sxvadsxva admianebis mier“ (Willmot,

1989). mag., wamlis miReba/ar miReba, eqimTan viziti “avadmyofobasTan

dakavSirebuli qcevis“ gzebs warmoadgenen. koncefcia, motorul da

araverbalur qcevasTan erTad, moicavs agreTve, verbalur anu

metyvelebiT qcevasac, e. i. exeba yvela individualur gansxvavebas,

romliTac adamianebi aRweren da ganicdian sakuTar simptomebs.

aRniSnuli koncefcia gamoyenebuli iyo daavadebaze

reaqciebis cvlilebebis Sesafasebel kvlevebSi. “avadmyofobasTan

dakavSirebuli qceva“ gansxvavdeba iseTi maxasiaTeblebis mixedviT,

rogoric aris pirovnuli individualoba, asaki da sqesi,

kultururuli konteqsti. gansakuTrebiT mniSvnelovania is, rom

“avadmyofobasTan dakavSirebuli qceva“ icvleba daavadebis

individualuri istoriis da situaciis cvlilebis mixedviT.

aRmoCnda, rom individualuri istoriis sxva aspeqtebsac hqondaT

gavlena “avadmyofobasTan dakavSirebul qcevaze”. mag., ganaTleba,

Seguebis gansxvavebuli meqanizmi da a. S. garda amisa, aRniSnaven, rom

“avadmyofobasTan dakavSirebuli qcevis“ gagebisTvis, aucilebelia

individis daavadebaze kognituri reaqciisa da daavadebaze

socialuri reaqciis (atitudebi konkretuli daavadebisadmi da misi

Sedegebisadmi, codna daavadebis Sesaxeb) erToblivi analizi

(Kirchgaessler K.U., 1992).

“avadmyofobasTan dakavSirebuli qcevis“ koncefcia xels

uwyobs ufro specifikuri terminis gamoyenebas, mag., “tkivilis

qceva“ (“pain behaviour“) (Keefe, Block, 1982). es ukanaskneli moicavs

araverbaluri qcevis iseT magaliTebs, rogoricaa grimasa, oxvra-

kvnesa, saxis mimika da a. S. aRmoCnda am qcevebis sando kavSiri

daavadebis YTaviseburebebTan da eqimebi unda iTvaliswinebdnen am

araverbalur qceviT niSnebs fizikuri mdgomareobis Sefasebisas

(MacNab, 1977). Tavis mxriv, Pilowsky-im wamoayena �“avadmyofobasTan

dakavSirebuli araadekvatur qcevis“ koncefcia, romelic

gulisxmobs, daavadebiT gamowveuli obieqturi pirobebis miuxedavad,

sapirispiro qcevis ganxorcielebas. mag., simptomebis uaryofas an

piriqiT maT gazviadebas. magram vinaidan Pilowsky-im aqcenti gaakeTa

mxolod ipoqondriaze, isteriasa da simulaciaze da yuradRebis

28

gareSe datova daavadebasTan dakavSirebuli mravali sxva mxare,

misma koncefciam farTo gavrceleba ver hpova (Willmot M., 1989).

1.4. cxovrebis xarisxi qronikuli daavadebis dros

Devinsky da Cramer (1993,) aRniSnaven, rom “mxolod pacientma

icis Tu ras grZnobs, rogor moqmedebs darRveva pirovnebis yofaze,

mis pativmoyvareobaze, socializaciis unarze, dasaqmebaze da mis

ojaxur funqcionirebaze. ra Tqma unda, pacienti SeiZleba iyos

mikerZoebuli… . . . magram, pacienti pirovnebaa, romelmac unda

gansazRvros sakuTari cxovrebis xarisxi . . . mxolod pacientma

icis Tu ra disbalansia mis molodinebsa da realobas Soris . . .”

(Suurmeijer T.P. et al., 1998, pp.85)

bolo wlebSi medicinaSi da klinikur fsiqologiaSi farTod

gamoiyeneba daavadebasTan dakavSirebuli “cxovrebis xarisxis“

cneba (“quality of life “ - Q O L). am koncefciam gamoxatuleba hpova

ZiriTadad janmrTelobis dacvis sferoSi, rac ganpirobebulia,

erTis mxriv, qronikuli daavadebis mqone pacientebis raodenobis

zrdiT da meores mxriv, samedicino codnis ganviTarebiT.

farTod miRebulia “cxovrebis xarisxis Semdegi”

gansazRvreba _ “cxovrebis xarisxi fizikuri, fsiqikuri da

socialuri keTildReobis mdgomareobaa, romelic ar

Semoifargleba avadmyofobis ararsebobiT” (WHO, 1993). cxovrebis

xarisxi individis mier cxovrebaSi sakuTari poziciis aRqmaa

sakuTar miznebTan, molodinebTan mimarTebaSi, im kulturisa da

Rirebulebebis konteqstSi, romelSic mas uwevs cxovreba (Eiser C.,

2001).

“cxovrebis xarisxis“ cnebaSi Semavali faqtorebis gansazRvra

sakmaod problematuri sakiTxia. cxrilSi#2 moyvanilia sxvadasxva

avtorebis mier warmodgenili is mniSvnelovani sferoebi,

romlebic, maTi azriT, cxovrebis xarisxs ganapirobeben. TiToeul

am avtors gaaCnia sakuTari TvalTaxedva imaze, Tu ra aris

cxovrebis xarisxi da ras moicavs es cneba (Trimble & Dodson,1994).

29

cxrili # 2. sferoebi, romlibic ganapirobeben cxovrebis xarisxs (Trimble & Dodson,1994). Hornquist

(1982)Wenger et al. (1984).

W H O (1980)

Spitzer (1980)

Ware (1987)

Fallowfeild (1990)

Ffizikuri + + + + + +

*fsiqologiuri

+ + + + + +

socialuri + + + + + +profesionaluri

+ + + +

ekonomiuri statusi

+ + +

struqturuli

+

roluri funqcionireba

+

aRqma + +simptomebi +

*moicavs kognitur da emociur faqtorebs.

SeiZleba iTqvas, rom ZiriTadad gamoiyofa xuTi sfero,

romelTa mniSvneloba yvelaze metad arsebiTia “cxovrebis

xarisxisaTvis“ (Mc Guire et al., 1990): fizikuri funqcionireba,

kognituri SesaZleblobani, emociuri statusi, socialuri

funqcionireba da ekonomikuri/sazogadoebrivi statusi (WHO, 1993).

magram, aRniSnaven, rom am sferoebis SigniT specifikuri

maxasiaTeblebia, romlebic individualur xasiaTs atarebs da

individualurad icvleba. es cvlileba SeiZleba iyos

dakavSirebuli faqtorTa farTo speqtrTan, mag., asakTan, sqesTan,

daavadebasTan, pirovnebis TaviseburebebTan da sxva socio-

demografiul cvladebTan.

garda amisa, cxovrebis xarisxis cnebaSi gamoyofen or

faqtors, romelsac efuZneba es ukanaskneli. esenia _ cxovrebis

obieqturi pirobebi da cxovrebiT subieqturi dakmayofilebis

xarisxi, romlebic mWidrod urTierTqmedeben (Lingjiang Li, 1998).

cxovrebis obieqturi pirobebi mniSvnelovani faqtoria,

romelic gavlenas axdens cxovrebiT subieqtur kmayofilebaze. am

ukanasknelis xarisxi ki bevrad damokidebulia im gansxvavebaze,

romelic arsebobs pirovnebis moTxovnilebebsa da obieqtur

situacias Soris. Tuki cxovrebis xarisxis gansazRvra moxdeba

30

moTxovnilebebis gaTvaliswinebis gareSe, mxolod cxovrebiT

subieqturi kmayofilebisa da cxovrebis obieqturi mdgomareobis

SefasebiT, es am gansazRvrebas saeWvosD xdis. zogierTi mklevari

varaudobs, rom cxovrebis miznebi an moTxovnebi umniSvnelovanes

faqtorebs warmoadgenen cxovrebiT subieqturi kmayofilebis

xarisxis gansazRvraSi (Lingjiang Li, 1998). Sesabamisad, cxovrebis

xarisxi ganisazRvreba, rogorc Seusatyvisoba pirovnebis

moTxovnilebebsa, misi cxovrebis miznebsa da mis realur miRwevebs

Soris. amrigad, rac ufro naklebia es Seusatyvisoba, miT ufro

maRalia cxovrebis xarisxi.

mravali avtori Tvlis, rom “cxovrebis xarisxi“ molodinis

sxvadasxva doneebis funqciaa. is aris gansxvaveba mimdinare

cxovrebiseul situaciasa da arsebul molodinebs Soris. avtorebi

fiqroben, rom “cxovrebis xarisxi” ori gziT SeiZleba iyos

gaumjobesebuli: 1) aqtualuri unarebis gazrdiT da 2) molodinis

donis daqveiTebiT (Cambell et al., 1976; Cohen, 1982; McGuire, 1991).

unda aRiniSnos, agreTve, rom “cxovrebis xarisxi“ SedarebiTi

fenomenia. sakuTari cxovrebis xarisxis Sefasebisas individebi

axdenen sakuTari, arsebuli cxovrebiseuli situaciis Sedarebas

sxva dros arsebul situaciasTan da sxva adamianebis cxovrebasTan.

sainteresoa Cohen_is (1982) azri, romelic “cxovrebis

xarisxs“ ganixilavs, rogorc adamianis SesaZleblobas moaxdinos

sakuTari cxovrebiseuli gegmebis realizacia. misi Teoria

efuZneba amerikeli filosofosis Josiah Royce_is koncefcias,

romelic Tvlida, rom “yoveli individi cxovrobs garkveuli

gegmis mixedviT“. es is cxovrebiseuli gegmaa, romelic gvaniWebs

individualobas da gvaZlevs cxovrebis mizans. maSasadame, rodesac

Cven vsaubrobT imaze, Tu ras vakeTebdiT, ras vakeTebT an ris

gakeTebas vapirebT, sakuTar Tavs vabarebT angariSs. “cxovrebis

xarisxi“ ganixileba, rogorc adamianis SesaZlebloba moaxdinos

sakuTari cxovrebiseuli gegmebis da miznebis realizacia.

avadmyofoba, gansakuTrebiT qronikuli mdgomareoba ki,

gavlenas axdens cxovrebis xarisxze im TvalszrisiT, rom aferxebs

pirovnebis cxovrebiseuli gegmis ganxorcielebas. am dros

31

SeiZleba Seicvalos adamianis yvela perspeqtiva, misi momavalze

orientaciis xasiaTi. avadmyofisTvis momavali xSirad gaurkveveli

da bundovani xdeba da ar Seesatyviseba avadmyofobamde mis

molodinebs. amrigad, mZime somaturma daavadebam SeiZleba

Secvalos adamianis aqtivobis ara mxolod biologiuri pirobebi,

aramed cxovrebis obieqturi pirobebic da aseve cxovrebiT

subieqturi kmayofilebis donec. am SemTxvevaSi, SesaZlebelia ori

saxis gamosavali: pirovneba pasiurad emorCileba Seqmnil pirobebs

(am dros, cxovrebis xarisxis done sakmaod dabali iqneba) an

pirovneba iZulebuli xdeba Secvalos situacia sakuTari

moTxovnebis donis daqveiTebis an axali miznebis SemuSavebis gziT

(am dros cxovrebis xarisxi SeiZleba saSualo donesac aRwevdes).

1.5. daavadebisadmi damokidebuleba da DdaZlevis strategiebi

Cven ukve avRniSneT, rom avadmyofoba yovelTvis ufro metia

vidre ubralod fizikuri tanjva. avadmyofoba SeiZleba

ganvixiloT, rogorc krizisi. am krizisul situaciaSi yofnisas

individi reagirebs uCveulo mdgomareobaze Seguebis sakuTari

resursebis amoqmedebiT. Tu organizmis es dacviTi Zalebi

gamofitulia, irRveva pirovnebis Sinagani wonasworoba, da

aRmocendeba paTologiuri reaqciebi.

Tanamedrove medicinaSi pacientis problemaTa didi nawilis

gadaWra SesaZlebelia daZlevis strategiebsa da individis

janmrTelobas Soris kavSiris SeswavliT. qronikuli daavadebis

mqone adamians uxdeba sakuTar daavadebasTan Segueba. igi

SeZlebisdagvarad unda moergos garemos moTxovnebs da sakuTar

mdgomareobasac. zogadadaptaciur amocanas daZleva warmoadgens.

daZleva gulisxmobs qceviT an kognitiur strategiebs, romlebic

gamoiyeneba fizikur an emociur stresorebTan brZolaSi da is

dinamiur process warmoadgens (C.E. Schwartz, 1998, Stanton A. L. et.al.,

2007), fsiqologiuri an fizikuri saSiSroebidan da misi Tanmxlebi

negatiuri emociebidan Tavdacvis mizniT. daZlevas ori funqcia

aqvs: dacviTi da problemis gadaWris. daZlevis dacviTi funqcia

imaSi mdgomareobs, rom igi icavs individs saSiSroebisagan;

32

dacviTi meqanizmebi mowodebulia potenciurad usiamovno

situaciebis, fiqrebis da gancdebis Tavidan asacileblad, Tu

Sesamcireblad. problemis gadaWris daZlevis funqcia moicavs

moTxovnebisa da miznebis ganxorcielebisaTvis codnis, Cvevebis Tu

sxva saSualebebis gamoyenebas. qronikuli daavadebis dros

daZlevis es ori aspeqti SeiZleba erTmaneTs avsebdes.

zemoT Cven ukve visaubreT daZlevis ramdenime strategiis Sesaxeb.

daZlevis strategiebis gamoyenebis erT-erTi modeli aris

daavadebis prognozisa da mkurnalobis mosalodneli Sedegebis

modeli. daavadebis prognozis modelSi asaxulia avadmyofis

emociurad Seferili warmodgenebi sakuTari daavadebis SesaZlo

mimdinareobisa da Sedegis Sesaxeb. cxovrebiseuli gamocdilebidan,

misi inteleqtisa da pirovnebis emociuri sferodan gamomdinare

avadmyofebi gansxvavebulad axdenen droSi sakuTari daavadebis

mimdinareobis proeqcias (Березовский, 2005; Волков, 1995).

mkurnalobis mosalodneli Sedegebis modeli gulisxmobs

mkurnalobis Sedegebis Sesaxeb warmodgenis SemuSavebas, romelic

ganpirobebulia avadmyofis, eqimis an avadmyofis axloblebis

molodinebiT. daavadebis zogierT etapze mkurnalobis

mosalodneli Sedegebis modelma SeiZleba avadmyofis qceva

garkveul CarCoSi moaqcios. mkurnalobis mimdinareobis dros

avadmyofs uyalibdeba emociuri Seferilobis mqone warmodgenebi,

rac asaxavs mdgomareobis rogorc realur, aseve cru

(TviTSTagoneba, sxvaTa STagoneba) gaumjobesebas an gauaresebas.

pirovnul doneze mkurnalobis Sedegebis Sefaseba xorcieldeba

mkurnalobis mosalodneli Sedegebis SedarebiT mkurnalobis

realur SedegebTan. am warmodgenebis damTxveva iwvevs kmayofilebis

grZnobas, xolo gansvla ki _ uaryofiT emociebs,

daukmayofileblobis gancdas. am emociebis zemoqmedebis Sedegi

SeiZleba iyos uaris Tqma mkurnalobis garkveul meTodze, depresia

an saerTod, daavadebisadmi damokidebulebis Secvla.

erT-erTi yvelaze cnobili modeli, romelic daavadebasTan

Seguebas aRwers lazarusis da folkmanis stresis daZlevis

modelia (Lazarus and Folkman Stress-Coping Model) (1984). masSi daavadeba

33

ganxilulia, rogorc kulturuli, fsiqikuri da somaturi

stresori, romelic safrTxes uqmnis avadmyofis sxeulebriv

mTlianobas da arRvevs mis motivaciur qcevas. am modelis ZiriTadi

varaudi mdgomareobs imaSi, rom adamianebi stresis pirobebSi (am

SemTxvevaSi es aris qronikuli daavadebis sxvadasxva aspeqtebi da

Sedegebi) afaseben stresors da am Sefasebis safuZvelze

gansazRvraven sakuTar emociur an qceviT reaqciebs. Lazarus-i da

Folkman-i ganasxvaveben Sefasebis or saxes: pirvelads da meorads.

pirveladi Sefaseba mdgomareobs movlenebisaTvis individualuri

mniSvnelobis miniWebaSi da imis gansazRvraSi, Tu romeli movlena

an stresori atarebs individisTvis pozitiur, neitralur an

negatiur xasiaTs. pozitiuri xasiaTis Sefaseba warmoadgens

pozitiuri interpretaciis Sedegs (mag., rodesac stresori

ganixileba, rogorc cvlileba), negatiuri xasiaTis Sefaseba

warmoadgens stresors, rogorc saSiSroebas sakuTari fizikuri

da/an fsiqikuri usafrTxoebisTvis (rac gansakuTrebiT aqtualuria

qronikul daavadebis arsebobis dros). ganasxvaveben negatiuri

Sedegebis or klass: SfoTva, rodesac stresori aRiqmeba, rogorc

safrTxe da risxva da/an sevda, rodesac stresori aRiqmeba rogorc

pirovnuli rRveva an danakargi. negatiuri interpretaciebi da maTi

efeqtebi xSirad stresorTan Sexvedrisas sawyis stadiaze iCens

Tavs; amitom ar aris gasakviri, rom depresia, SfoTva da risxva is

pirveli reaqciebia, romlebic uCndeba adamians qronikuli

daavadebis moulodneli aRmocenebis Sedegad. mag., pacientebs

miokardiumis infarqtiT maRal SfoTva aqvT uSualod koronaluri

Setevis Semdeg, romelic mogvianebiT SeiZleba depresiaSi

gadaizardos. sxva stresorebi, romlebic dakavSirebulia gulis

miokardiumis infarqtTan (samsaxuris SesaZlo dakargva, problemebi

seqsualur sferoSi, daavadebis garTulebebi an SesaZlo kardio

operacia), aseve, warmoadgens maRali SfoTvis an depresiis mizezs.

Lazarus-i da Folkman-i aRniSnaven, rom afeqturi cvlilebebi

daavadebis mimdinareobis dros SeiZleba aseve iyos meoradi

Sefasebis Sedegi, rodesac pirovnebam pasuxi unda gasces kiTxvaze:

"ra unda gavakeTo?" pasuxi gulisxmobs individis mier sakuTari

34

unarebis Sefasebas raTa Seamciros daavadebiT gamowveuli

saSiSroeba an dazianeba. am unarebis gaaqtiurebaa swored daZleva.

igi ganisazRvreba, rogorc nebismieri mcdeloba, romelic

mimarTulia gare an Sida moTxovnebis marTvaze. eqsternaluri

moTxovnebi mimarTulia TavisTavad movlenebze, internaluri _ am

movlenebis emociur Sefasebaze/emociur reaqciebze. amis mixedviT

ganasxvaveben problemaze fokusirebul daZlevas (reaqciebi

mimarTulia garegan faqtorebze, pirovneba cdilobs raime

mouxerxos sirTuleebs da problemidan gamosavals eZebs) da

emociaze fokusirebul daZlevas (reaqciebi mimarTulia individis

emociur reaqciebze an mis Sinagan mdgomareobaze, rodesac

pirovneba cdilobs problemiT gamowveuli distresis Semsubuqebas,

stresTan dakavSirebuli emociuri mdgomareobebis regulacias).

rodesac stresuli situacia aRiqmeba rogorc kontrolirebadi,

maSin metia problemaze fokusirebuli daZlevis strategiis

aRZvris albaToba; xolo, rodesac stresuli situacia aRiqmeba

rogorc arakontrolirebadi, maSin ufro metia emociaze

fokusirebuli daZlevis strategiis aRZvris albaToba (Bradford R.,

1997).

daZlevis qceva SeiZleba Seicvalos droTa ganmavlobaSi da

individualuaradac. amiT SeiZleba aixsnas, Tu ratom adaptirdeba

qronikuli daavadebiT gamowveul stresorebze erTi pacienti ufro

swrafad, meores ki xangrZlivi dro esaWiroeba. ar iqneboda swori

imis aRniSvna, Tu romeli strategia aris ukeTesi da romeli

uaresi. Zalian xSirad xdeba orive maTganis erTdoulad gamoyeneba.

agreTve cnobilia Moos-is da Shaefer-is (1984) e.w. krizisis Teoria

(Bradford R., 1997). es Teoria exeba imas, Tu rogor reagireben da

umklavdebian adamianebi cxovrebiseul kriziss. avtorebi

varaudoben, rom daavadebis diagnozi aseve warmoadgens

cxovrebiseul kriziss, radganac is safrTxis winaSe ayenebs

adamianis pirovnul da socialur identifikacias. amis Sedegad

pirovneba cdilobs krizisis daZlevas problemis gadawyvetis

strategiebis gamoyenebiT. rodesac aRmoCndeba, rom es strategiebi

sakmarisi ar aris (an imis gamo, rom daZlevis individualuri

35

meqanizmebi araadekvaturia an imis gamo, rom krizisuli movlena

Zalian Zlieria), SesaZlebelia, rom individma dakargos Sinagani

wonasworoba. Moos-si da Shaefer-si fiqroben, rom am SemTxvevaSi,

pirovneba an gadalaxavs mis winaSe mdgar problemas, ris Sedegad

moxdeba misi «pirovnuli zrda» an Tavs iCenx «araadaptirebuli»

reaqciebi, romelTa Sedegad adamiani aRmoCndeba «fsiqologiuri

uZlurebis» mdgomareobaSi.

Moos-si da Shaefer-si aRniSnaven, rom arseboben faqtorebi,

romlebic gavlenas axdenen situaciis individualur Sefasebaze da

daZlevis strategiebis gamoyenebaze. esenia: demografiuli

cvladebi (mag., asaki, sqesi), pirovnuli cvladebi (mag., pirovnuli

maxasiaTeblebi), daavadebis cvladebi (mag., tkivili, TvalsaCinoeba)

da garemos cvladebi (mag., socialuri mxardaWera da sxva) (sqema#

2).

sqema # 2. Moos-is da Shaefer-is (1984) cxovrebis krizisis modeli (Bradford R., 1997)

Maes S., Leventhal H. da de Ridder T.D. (1996) mier SemoTavazebulia

qronikul daavadebis daZlevis udro farTo modeli. am modelis

Tanaxmad mniSvnelovani cxovrebiseuli movlenebi xels uwyoben

daavadebasTan dakavSirebuli Sedegebis Sefasebas. imisda mixedviT

Tu rogor cxovrebiseul pirobebSi imyofeba adamiani, aman

SeiZleba sxdasxvanairad Seafasebinos mas sakuTari daavadeba. mag.,

pirovnebam gaigo, rom mas Tirkmlis daavadeba aqvs, is mas Seafasebs

demografiulida pirovnuli faqtorebi

daavadebis

faqtorebi

fizikuri da

socialurigaremos

faqtorebi

kognituri

Sefaseba

(daavadebis

subieqturi

aRqma)

adapta-

ciuri

amocanebi

daZle-vis

Cvevebi

krizi-sis

gamosa-vali

36

gansxvavebulad imisda mixedviT Tu rogor situaciaSi imyofeba:

mag., axlo warsulSi mas daeRupa ojaxis wevri an dakarga

samsaxuri. am TvalsazrisiT, uaxloesi warsuli da awmyo gavlenas

axdens daavadebasTan dakavSirebuli Sedegebis Sefasebaze.

garda amisa, daavadebisa da mkurnalobis Taviseburebebma

SeiZleba gavlena moaxdinos Sefasebaze da daZlevis strategiebze.

mravali kvleva adasturebs, rom hospitalizacia, samedicino

gamokvleva, qirurgiuli Careva da mkurnalobis iseTi saSualeba,

rogoricaa qimioTerapia, gavlenas axdens pacientis mier daadebis

aRqmasa da Sefasebaze (Maes, Leventhal & deRidder, 1996).

aseve cnobilia, rom iseTi demografiuli cvladebi,

rogoricaa asaki, sqesi, erovneba da socialuri mdgomareoba bevrad

ganapirobebs qronikuli daavadebis Sefasebas da Sesabamisad

garkveulwilad gansazRvravs daZlevis strategiebs. mag., arsebobs

monacemebi, rom qalebi, dabali ganaTlebis mqone adamianebi da

xanSiSesuli pirebi iyeneben Eemociebze fokusirebul daZlevis

strategias (Maes, Leventhal & deRidder, 1996).

movlenebis Sefaseba xdeba ara mxolod situaciis

Taviseburebebis mixedviT, aramed im miznebisa da molodinebis

safuZvelze, rac qronikuli daavadebis mqone pirs gaaCnia. Tu

daavadebis SedegebTan dakavSirebuli molodinebi sasikeToa, maSin

pirovneba miiswrafis sakuTari miznebis misaRwevad, xolo Tu es

molodinebi ar aris sasikeTo _ pirovnebam SeiZleba xeli aiRos

yovelgvari mcdelobisagan miaRwios dasaxul mizans. maSasadame,

miznebis/moTxovnebis Sefasebam daavadebis Sedegebis molodinebTan

mimarTebaSi, SeiZleba daamZimos stresuli situacia. aqtualuri

daZlevis qceva mxolod miznebis Sefasebis Sedegi ar aris; is

damokidebulia agreTve situaciur, eqsternalur resursebze da

Sinagan, internalur resursebze. Hobfoll (1988)-i resursebs

ganmartavs, rogorc ”im obieqtebs, mdgomareobebs, pirovnul

Taviseburebebs, rasac afasebs individi da rac emsaxureba mas

miznebis miRwevaSi” (Maes, Leventhal & deRidder, 1996). eqstrenaluri,

situaciuri resursebis qveS igulisxmeba finansebi, dro,

profesiuli daxmarebis misawvdomoba, socialuri mxardaWera.

37

cnobilia, rom arsebobs kavSiri socialur mxardaWerasa da

qronikuli daavadebisadmi adaptacias Soris da ufro metic _

kavSiri socialur mxardaWerasa da qronikuli daavadebis

progresirebas Soris, Tumca es uknaskneli metwilad

ganpirobebulia daavadebis xasiaTiT.

internaluri, Sinagani resursebis qveS igulisxmeba energia an

fizikuri Zala, inteleqti, pirovnebis pirovnul-emociuri

maxasiaTeblebi. varaudoben rom maTi gavlena daZlevis

strategiebze ar atarebs gamokveTil xasiaTs da rom daZlevis

strategiebis arCeva xorcieldeba maTi pirdapiri zegavlenis

gareSe. Tumca, am faqtorebs gavlenis moxdena SeuZliaT

arapidapiri gziT, Sefasebis procesSi Tavisi wvlilis SetaniT

(Maes, Leventhal & deRidder , 1996).

rogorc vxedavT, mravali faqtori axdens gavlenas daZlevis

qcevaze. Krohne-s (1993) mier SemoTavazebuli daZlevis ierarqiuli

modeli, romelSic daZlevis ramdenime donea warmodgenili swored

am faqtorebis diferencirebis mizniTaa Seqmnili (Maes, Leventhal &

deRidder , 1996). umaRlesi donea _ daZlevis miznebi, dispoziciebi

(mag., riskis Tavidan acileba, energiis Senaxva, an yuradReba),

saSualo donea _ daZlevis strategiebi da dabali donea _

daZlevis specifikuri aqtebi da pasuxebi. qronikul daavadebasTan

dakavSirebuli daZleva yvela am dones moicavs.

da bolos arsebobs daZlevis moqmedebis sami ZiriTadi

Sedegi: fsiqologiuri, socialuri da fizikuri, romlebic

gamoxataven daZlevis gamoyenebuli strategiebis efeqturobas.

fsiqologiuri Sedegebis qveS igulisxmeba depresiis, SfoTvis

Semcireba; socialuri Sedegebi gulisxmoben pirovnebisTvis

misaRebi socialuri rolebis dabrunebas an maT miRwevas; xolo

fizikuri Sedegebis qveS ganixilaven fizikuri janmrTelobis

dabrunebas an mis gaubjobesebas.

amrigad, imas, Tu rogor umklavdebian adamianebi qronikul

daavadebas mniSvnelovani fsiqologiuri, socialuri da

biologiuri mniSvneloba aqvs. qronikuli daavadebis daZlevis

strategia, romlesac individi irCevs metad mniSvnelovania

38

mkurnalobis procesisaTvis, radganac araadekvaturma daZlevam

SeiZleba araefeqturi gaxados mkurnaloba da gaauaresos pacientis

mdgomareoba.

1.6 daavadebis “Sinagani suraTi” da masze moqmedi faqtorebi

am TavSi Cven ganvixilavT kvlevis ZiriTad sagans _ daavadebis

„Sinagan suraTs“ – mis ZiriTad niSnebs, aRmocenebis pirobebs da

meqanizmebs.

zemoT Cven visaubreT imis Sesaxeb, Tu ra saxis cvlilebebi

SeiZleba gamoiwvios qronikulma daavadebam pirovnebaSi da

ganvixileT am cvlilebebis Camoyalibebis ramdenime modeli. axla

ufro dawvrilebiT SevCerdebiT uSualod daavadebis ”Sinagani

suraTis” fenomenze, romelic Tavs iCens nebismieri daavadebis dros

da ramac SemdgomSi SeiZleba ganapirobos daavadebuli pirovnebis

qceva.

axal, avadmyofobiT gamowveul pirobebSi, metad mniSvnelovania

DTu rogor aisaxeba daavadeba adamianis cnobierebaSi,

mniSvnelovania, Tu ra damokidebuleba uyalibdeba pacients

sakuTari mdgomareobis mimarT. daavadebis Sesaxeb swori informacia,

sakuTar daavadebaze adekvaturi warmodgena _ xels uwyobs

qronikuli daavadebis pirobebSi xangrZlivi mkurnalobis

mimReblobas da mravali garTulebebis Tavidan acilebas. pirovneba,

romelic iRebs diagnozs da sakuTar mdgomareobas, zedmiwevniT

icavs mkurnalobis reJims da eqimTan erTad aqtiurad aris CarTuli

reabilitaciis procesSi (reJimis dacva, wamlebis miReba, varjiSebis

Sesruleba da sxva), rac zrdis mis rwmenas sakuTar

SesaZleblobebSi, momavalSi daavadebiT cxovrebis perspeqtivis

xedvas, aumjobesebs mis garemosTan urTierTobas.

avadmyofobis dros adamiani axdens sakuTari damokidebulebis

Camoyalibebas axali situaciis mimarT, am situaciaSi sakuTari

Tavisa da daavadebis mimarTac, e. i. iqmneba daavadebis subieqturi

suraTi (Николаева, 1987; Березовский, Крайнова & Бондарь, 2005). daavadebis

dros pirovnebas uyalibdeba garkveuli warmodgenebi sakuTari

daavadebis gamovlinebebis, misi mimdinareobis da mkurnalobis

39

Sesaxeb. Sedegad, formirdeba daavadebis subieqturi modeli,

romelic ori komponentisgan Sedgeba: sensorul-emociuri da

logikuri. sensorul-emociuri komponenti yalibdeba daavadebis

gamovlinebasTan da mis mimdinareobasTan dakavSirebuli uSualo

STabeWdilebebis da gancdebis zegavleniT. igive informacia udevs

safuZvlad logikuri komponentis Camoyalibebasac; magram am

SemTxvevaSi arsebiT rols TamaSobs is koncefciebi, romlebsac

adamiani iyenebs daavadebis mizezebis da meqanizmebis asaxsnelad.

orive komponentis sruli Tanxvedra iSviaTad gvxdeba. daavadebis

Sinagani suraTis sruli modeli Cndeba mxolod maSin, rodesac

yalibdeba, rogorc sensorul-emociuri, aseve logikuri

damokidebuleba daavadebisadmi.

r. luriac, umaRlesi fsiqikuri funqciebis darRvevebis dros

avadmyofis pirovnebas da mis emociuri sferos, kerZod, mis

damokidebulebas sakuTari daavadebisadmi ganixilavda, rogorc

efeqturi reabilitaciis erT _ erT mniSvnelovan faqtors. a.r.

luria xazs usvamda imas, rom am dros mniSvnelovania avadmyofis

subieqturi Civilebis, misi sakuTar Tavze da daavadebaze

warmodgenebis Sesatyvisoba avadmyofis obieqtur QqcevasTan, mis

reaqciebTan arsebul situaciaze (Николаева, 1987; Волкова, 1995).

samedicino da gansakuTrebiT, fsiqiatriul literaturaSi,

problemas “pirovneba da daavadeba” didi xnis istoria aqvs.

miuxedavad imisa, rom am sakiTxs sxvadasxva poziciebidan

ganixilaven, yvela Tanxmdeba imaSi, rom daavadebis subieqturi

suraTis SeqmnaSi monawileobs mTlianad pirovneba, xolo

mkurnalobis SedegebisaTvis sagulisxmoa is, Tu ra pirovnul

mniSvnelobas SeiZens daavadeba adamianisaTvis.

avadmyofobis subieqturi mxaris SeswavlasTan dakavSirebiT

fsiqologiaSi Semotanili iyo terminebis mTeli rigi, riTac

cdiloben aReweraT daavadebisadmi damokidebuleba. Cven ganvixilavT

mxolod ramdenime gansazRvrebas.

erT_erTi pirveli vinc miaqcia yuradReba daavadebis

subieqtur suraTs iyo Goldscheider-i (1926), romelsac ekuTvnis termini

“daavadebis autoplastikuri suraTi“. misi azriT, is avadmyofis mier

40

iqmneba fizikur mdgomareobasTan dakavSirebuli SegrZnebebis,

warmodgenebisa da gancdebis erTobliobis safuZvelze. Goldscheider

gamoyofs daavadebis suraTis or dones _ “senzitiurs“, romelsac

miekuTvneba paTologiuri procesiT uSualod ganpirobebuli

SegrZnebebi, da “inteleqtualurs“, romelic moicavs avadmyofis mier

sakuTari fizikuri mdgomareobis Sesaxeb warmodgenebs, mis

fsiqologiur reaqcias sakuTar daavadebaze.

am sqemas uaxlovdeba r. a. lurias (1944) cnebac “daavadebis

Sinagani suraTis“ Sesaxeb. es ukanaskneli, misi azriT, aris “is,

rasac ganicdis adamiani, misi SegrZnebebis speqtri, zogadi guneba _

ganwyoba, TviTdakvirveba, warmodgena sakuTar daavadebaze, mis

mizezebze _ avadmyofis uzarmazari samyaro, romelic warmoadgens

aRqmis da SegrZnebebis, emociebis, afeqtebis, konfliqtebis,

fsiqikuri gancdebisa da travmebis rTul erTobliobas.“ r. a.

luria, aseve gamoyofs daavadebis Sinagani suraTis or dones, magram

gansakuTrebul mniSvnelobas aniWebs mis inteleqtualur komponents,

romelsac didi gavlena aqvs paTologiuri procesis mimdinareobaze.

mis mier agreTve gamoyofili iyo avadmyofTa profilebi maTSi

daavadebis Sinagani suraTis ama Tu im komponentis siWarbis

mixedviT. r. a. luria Tvlis, rom avadmyofisaTvisac Zalian

mniSvnelovania daavadebis Sinagani suraTis es ori done: senzitiuri

da inteleqtualuri (Лурия А.Р., 1977).

sainteresoa g.v. kovaliovis (1972) mier Semotanili

“avadmyofobis gancdis“ cneba. mis qveS igulisxmeba zogadi

grZnobadi da emociuri foni, rac moicavs SegrZnebebs, warmodgenebs,

fsiqogenur reaqciebsa da daavadebasTan dakavSirebul sxva

fsiqikuri fenomenebs. Gg. v. kovaliovis mixedviT “avadmyofobis

gancdis“ cneba ar aris “avadmyofobis gacnobierebis“ cnebis

identuri, miuxedavad imisa, rom mWidrod aris masTan dakavSirebuli.

es ukanaskneli avadmyofobis gamomwvevi mizezebis, misi

mimdinareobisa da mkurnalobis Sesaxeb codnas gulisxmobs. es

avtori gamoyofs avadmyofobis gancdis 6 ZiriTad tips: depresiuls,

disTimiurs, ipoqondriuls, fobiurs, isteroiduls da eiforiul _

anozognozurs (Николаева, 1987).

41

r. koneCni da m. bouxali (1983) ZiriTadi cnebis saxiT iyeneben

“daavadebis autoplastikur suraTs“ da iZlevian misi tipebis Semdeg

klasifikacias:

normaluri _ Seesabameba avadmyofis obieqtur mdgomareobas;

anozognozuri _ avadmyofobis Ffaqtis ignorireba;

nozofoburi _ avadmyofs esmis, rom azviadebs daavadebis

saSiSroebas, magram mainc agrZelebs am tipis reaqciebis

ganviTarebas;

ipoqondriuli _ avadmyofobaSi CaRrmaveba;

uyuradRebo _ avadmyofobis simZimis arasaTanado Sefaseba;

nozofiluri _ avadmyofi Rebulobs dakmayofilebas imisgan, rom

avadmyofoba aTavisuflebs mas misTvis arasasurveli

movaleobebisagan;

utilitaluri _ gulisxmobs garkveuli sargeblobis miRebas

avadmyofobisagan _ materialuris Tu moraluris.

amave avtorebis azriT, daavadebis Sinagani suraTis cneba moicavs

daavadebis subieqturi mxaris gansxvavebul komponentebs da Seicavs

avadmyofi pirovnebis fsiqikaSi daavadebis gamovlenis oTx dones:

grZnobadi anu SegZnebis done;

emociuri done, romelic dakavSirebulia daavadebis calkeul

simptomebTan, mTlianad daavadebasTan da mis SedegebTan, masze

reagirebis tipTan;

inteleqtualuri done, romelic dakavSirebulia avadmyofis

warmodgenebTan da sakuTari daavadebis Sesaxeb codnasTan, mis

mosazrebebTan daavadebis mizezebisa da mosalodneli Sedegebis

Sesaxeb;

motivaciuri done, romelic dakavSirebulia avadmyofis garkveul

damokidebulebasTan sakuTari daavadebisadmi, daavadebis pirobebSi

cxovrebis stilisa da qcevis cvlilebebTan da im qcevebis

aqtualizaciasTan, rac mimarTulia janmrTelobis aRdgenaze.

maSasadame isini daavadebis Sinagani suraTis oTx Semdeg mxares

gamohyofen:

42

1. senzitiuri mxare _ lokaluri tkivilebi da darRvevebi,

fizikuri da fiziologiuri SegrZnebebi sxeulis sxvadasxva

nawilebidan da organoebidan;

2. emociuri mxare _ SiSi, SfoTva, imedi da sxva emociuri

gancdebi, romlebic dakavSirebuli an gamowveulia daavadebiT da

mis mier gamowveuli cvlilebebiT;

3. nebiTi mxare _ gamoixateba pacientis swrafvaSi ebrZolos

daavadebas, aqtiuri monawileoba miiRos gankurnebaSi;

4. racionaluri anu informaciuli mxare _ rac gulisxmobs

codnas daavadebis, misi mimdinareobis, mkurnaloibis da Sedegebis

Sesaxeb.

daavadeba (paTologiuri procesi organizmSi) ormag rols

asrulebs daavadebis Sinagani suraTis CamoyalibebaSi.

Tavdapirvelad es aris adgilobrivi da zogadi xasiaTis

sxeulebrivi SegrZnebebi, romlebic daavadebis Sinagani suraTis

sensorul dones ganapirobeben. biologiuri faqtoris monawileobis

xarisxi daavadebis Sinagani suraTis Camoyalibebis procesSi

ganisazRvreba klinikuli gamovlinebebis simZimiT. Semdeg ki,

daavadeba qmnis gansakuTrebiT rTul cxovrebiseul situacias,

romelic gavlenas axdens daavadebis subieqtur Sefasebaze.

daavadebis Sinaganis suraTis formirebaSi did rols TamaSobs

daavadebisadmi emociuri damokidebulebis tipi (Березовский, Крайнова

& Бондарь, 2005).

hiponozognostiuri tipi: aseTi avadmyofebi axdenen sakuTari

daavadebis ignorirebas da ugulvebelyofen mkurnalobas.

avadmyofma SeiZleba yvelaferi icodes sakuTari daavadebisa da misi

seriozulobis Sesaxeb, magram es ar iwvevs masSi SfoTvasa da

Sewuxebas. aseT avadmyofebs uyalibdebaT mkurnalobis mosalodneli

Sedegebisadmi araadekvaturi. damokidebuleba.

hipernozognosturi tipi: aseT avadmyofs uyalibdeba

daavadebis Sesaxeb zedmetad gadaWarbebuli emociuri Seferilobis

mqone warmodgenebi.

pragmatuli tipi: aseTi avadmyofi eqimTan mWidrod

TanamSromlobs, is cdilobs daavadebis da misi prognozis realur

43

Sefasebas, yuradRebas aqcevs mkurnalobis procedurebs, cdilobs

xeli Seuwyos mkurnalobis process (Березовский, Крайнова & Бондарь,

2005).

xSirad, daavadebis Sinagan suraTTan erTad iqmneba sxva,

sapirispiro modeli – janmrTelobis Sinagani suraTi, janmrTeli

adamianis an janmrTeli sxeulis Taviseburi etaloni. es etaloni

SeiZleba iyos sakmaod rTuli da SeiZleba moicavdes warmodgenebis

da logikuri daskvnebis gansxvavebul elementebs. pirovnebis am ori

komponentis aqtualizacia an inaqtualizacia gansazRvravs

daavadebis Sinagani suraTis xasiaTs da amiT gavlenas axdens

avadmyofis qcevaze. janmrTelobis ideali, aseve, warmoadgens

avadmyofis qcevis regulators da xSirad win uswrebs daavadebis

Sinagani suraTis Camoyalibebas.

arsebobs fsiqikuri da fizikuri janmrTelobis gansxvavebuli

etalonebi. magram etaloni, romelsac cxovrebis garkveul etapze

pirovneba miiCnevs normad, SeiZleba daingres an Seicvalos. mag.,

asakTan erTad bunebrivad xdeba janmrTelobis etalonis Secvla.

nevrozebis dros xSirad xdeba janmrTelobis idealis cnobieri an

aracnobieri gandevna. «daavadebaSi gaqceva» – janmrTelobis

idealis daTgrunvaa, rac garkveul cxovrebiseul situaciaSi

adaptaciur reaqcias warmoadgens. situaciis Secvlis SemTxvevaSi

janmrTelobis ideali SeiZleba isev aRdges; anozognoziis

SemTxvevaSi ki piriqiT, janmrTelobis xati mdgradi da rigiduli,

xolo daavadebis xati an ar yalibdeba an destruqcias ganicdis.

daavadebis Sinagani suraTi unda ganixilebodes, rogorc

erTiani funqciuri sistema, romlis Semadgeneli komponentebi

erTmaneTTan mWidro kavSirSi imyofebian da mudmivad

urTierTzemoqmedeben erTmaneTze. daavadebis Sinagani suraTis erT-

erTi Tvisebaa misi elementebis mravalsaxeoba da plastikuroba.

amitom misi analizis dros mniSvnelovania ara mxolod calkeuli

komponentebisa da elementebis gamoyofa, aramed maTi

urTierTqmedebis xasiaTis gansazRvrac.

daavadebis gansxvavebul etapebze daavadebis Sinagani suraTis

komponentebis wvlili SeiZleba dinamikurad icvlebodes. kerZod,

44

daavadebis dasawyisSi arsebuli daavadebis Sinagani suraTis

zogierTi grZnobadi elementi Semdeg qreba da misi adgili

SeiZleba daikavos avadmyofis mier daavadebis logikuri gaazrebis

Sedegad aRmocenebulma daavadebis emociurma Sefasebam (Березовский,

Крайнова & Бондарь, 2005).

zogierTi avtoris azriT, daavadebis Sinagani suraTi ar

Cndeba avadmyofobis dawyebisTanave; is TandaTanobiT yalibdeba.

avtorTa azriT, jer aRmocendeba zogadi da adgilobrivi xasiaTis

sxeulebrivi SegrZnebebi. avadmyofs gaaCnia sxvadasxva saxis Civilebi

arasasiamovno an uCveulo SegrZnebebis saxiT sxeulis sxvadasxva

nawilSi. Semdeg, avadmyofs uCndeba “gonebrivi codna“ anu

warmodgenebi mis mier gancdili SegrZnebebis SesaZlo

mniSvnelobaze, rogorc daavadebis simptomze. zogjer xdeba e.w.

”muSaoba” am codnis aqtualizaciaze: avadmyofi ixsenebs

informacias sxvadasxva daavadebebis Sesaxeb, romelic mas odesme

gaugia, waukiTxavs da a.S. avtorTa mixedviT, es gansakuTrebiT

damaxasiaTebelia ipoqondriuli avadmyofisaTvis. magram “gonebrivi

codnis“ arseboba ar aris sakmarisi daavadebis Sinagani suraTis

formirebisaTvis. is moklebulia emociur elfers, romlis gareSe

ver xerxdeba garkveuli damokidebulebebis Camoyalibeba.

Tavdapirvelad, Cndeba afeqti. magram, igi SedarebiT xanmokle

mdgomareobaa, romelic Seqmnil situaciaze sapasuxod aRmocendeba.

daavadebis Sinagani suraTis struqturaSi emociis aRmoceneba

dakavSirebulia Sesatyvisi motivis aqtualizaciasTan. daavadebis

SemTxvevaSi ki, avadmyofi adamianis moqmedebis erT_erT ZiriTad

motivs warmoadgens janmrTelobis SenarCunebis an aRdgenis motivi.

es aris daavadebis Sinagani suraTis formirebis erT_erTi SesaZlo

varianti (nikolaeva v.v., 1978).

TeoriaTa umravlesoba, romlebsac Cven aq ganvixilavT,

gamodis im mosazrebidan, rom individis mier sakuTari

mdgomareobis gacnobierebis done, misi interpretaciebi da rwmenebi,

warmoadgens daavadebisaTan/janmrTelobasTan dakavSirebuli qcevis

ZiriTad determinantebs da daswavlis socialuri Teoriidan

gamomdinare, efuZneba "molodini-Rirebulebis" models: rac niSnavs

45

imas, rom qceva damokidebulia individis molodinebze da

warmoadgens pozitiuri Sedegisa da am Sedegis pirovnebisTvis

Rirebulebis gamovlinebas.

amrigad, daavadebis Sinagani suraTis formirebaSi sxvadasxva

faqtori monawileobs. rogorc aRniSnaven r. koneCni da m. bouxali

(1983), daavadebis Sinagani suraTze Semdegi faqtorebi axdenen

gavlenas:

1.daavadebis xasiaTi _ mwvavea daavadeba Tu qronikuli, arsebobs

Tu ara tkivili, ra saxis mkurnalobas moiTxovs (ambulatoriuls

Tu stacionalurs, konservatuls Tu qirurgiuls), arsebobs Tu ara

aqtivobis SezRudva an raime kosmetikuri defeqti da sxva;

2.garemoebebi, romelSic mimdinareobs daavadeba _ problemebi,

romlebic Cndeba ojaxSi, samsaxurSi, uaxloes socialur garemoSi

da sxva;

3.pirovnebis premorbiduli Tvisebebi _ aRniSnaven ZiriTadad

Semdegs: asaks, zogadi mgrZnobelobis dones, emociuri reaqtiulobis

xasiaTs anu temperaments, Rirebulebebs da xasiaTs;

4.avadmyofis socialuri statusi.

daavadebis Sinagani suraTis Camoyalibebis procesSi monawile

TiToeuli faqtoris gavlena gansxvavebulia samkurnalo procesisa

da diagnostirebis gansxvavebul etapebze (Березовский, Крайнова &

Бондарь, 2005). didi mniSvneloba aqvs rogorc avadmyofis cxovrebis

obieqtur pirobebs (cxovrebis socialuri pirobebi, daavadebis

obieqturi simZime, misi obieqturi prognozi, vitaluri saSiSroebis

xarisxi da a. S.), aseve subieqtur faqtorebsac (avadmyofis zogadi

aqtivobis done da mimarTuleba, TviTSefasebis Taviseburebani,

pirovnebis premorbiduli Tvisebebis mTeli kompleqsi). aranakleb

mniSvnelovania avadmyofis cxovrebis situaciuri faqtori, romelic

monawileobs daavadebis Sinagani suraTis formirebaSi (v, nikolaeva,

1987). es TviT mkurnalobis situaciaa: samkurnali procedurebis

simZime da xangrZlivoba, avadmyofis samedicino aparaturasa da

medpersonalze damokidebulebis xarisxi, avadmyofis da eqimebis

urTierTobis stili da xasiaTi da sxva.

46

M. Blumenfield da T. L. Thompson (1989) Tvlian, rom daavadebis

Sinagani suraTis CamoyalibebaSi didi mniSvneloba aqvs, agreTve,

avadmyofis warsul gamocdilebas; yuradsaRebia ojaxis wevrebis da

megobrebis daavadebasTan dakavSirebuli piradi gamocdileba.

avtorebi aRniSnaven, rom daavadeba TiTqmis yovelTvis aRiqmeba,

rogorc saSiSi situacia da amitom mniSvnelovania avadmyofis

cxovrebiseuli gamocdileba da is saSualebebi, romliTac is

reagirebs saSiS situaciaze da umklavdeba mas. yovelive es gavlenas

axdens daavadebaze reaqciaze.

amrigad daavadebis Sinagani suraTi _ daavadebis meoradi,

fsiqologiuri simptomebis ZiriTadi kompleqsia, romelmac zog

SemTxvevaSi SeiZleba gaarTulos avadmyofobis mimdinareoba, xeli

SeuSalos mkurnalobis warmatebas da Seaferxos reabilitaciis

procesi; zogjer ki, piriqiT, xeli Seuwyos mas. daavadebis Sinagani

suraTis aseTi mniSvnelovani gavlena mkurnalobis Sedegebze

ganpirobebulia imiT, rom mJRavndeba pacientis damokidebulebebSi

daavadebis, sakuTari avadmyofobis Tu Secvlili situaciis mimarT.

es meoradi simptomokompleqsi TavisTavad SeiZleba iyos adamianis

invalidizaciis, an piriqiT, misi gamojanmrTelebis mizezi. amitom,

daavadebis Sinagani suraTi warmoadgens erT_erT centralur

fsiqologiur fenomens, romelic somaturi qronikuli daavadebis

dros fsiqokoreqciuli da fsiqoTerapiuli muSaobis samiznes unda

warmoadgendes. is gansakuTrebul mniSvnelobas iZens iseTi

daavadebebis SemTxvevaSi, romlebic Tavisi obieqturi (organuli)

simptomebisa Tu subieqturi damokidebulebebis (stigma) gamo,

xSirad, socialurad miuReblad aRiqmebian. swored aseTi

daavadebebis jgufs ganekuTvneba epilefsia.

Tavi 2. epilefsia da misi fsiqologiuri maxasiaTeblebi

epileftologiaSi dRemde yuradReba ar eqceva epilefsiis,

rogorc qronikuli daavadebis gavlenis efeqtebs avadmyofis

pirovnebaze da Sesabamisad, mkurnalobaze. avtorTa umravlesoba

arsebiT mniSvnelobas aniWebs epilefsiis dros aRmocenebul

pirovnul cvlilebebs, magram am cvlilebebis geneziss ganixilavs

47

rogorc paTologiuri organuli procesis Sedegs da TiTqmis ar

iTvaliswinebs socialuri, fsiqologiuri faqtorebis rols.

epilefsiac qronikuli daavadebaa da SeiZleba xasiaTdebodes

misi yvela TvisebiT. am dros pirovnuli cvlilebebis formirebis

procesSi arsebiTi mniSvneloba eniWeba iseT fsiqologiur

faqtorebs rogoricaa avadmyofis damokidebuleba sakuTari

daavadebisadmi, garemosadmi, agreTve garemos damokidebuleba

avadmyofisadmi.

2.1 epilefsiis gansazRvreba

berZnuli sityva “epilefsia” niSnavs “Sepyrobas”, rac

gamoxatavs gare ZalebiT Sepyrobil adamians. Zveli BberZnebi

epilefsiias ”RvTaebriv” daavadebadD miiCnevdnen. hipokrate iyo erT

_ erTi pirveli imaTgan, vinc gansazRvra epilefsia, rogorc Tavis

tvinis daavadeba.

epilefsiis arsebuli ganmartebebidan, Cvenis azriT, yvelaze

sruli a. gastosa da p. m. sarajiSvilisaa. a. gastos (1975) mixedviT,

“epilefsia _ Tavis tvinis gansxvavebuli etiologiis qronikuli

daavadebaa, romelic Zlieri neironuli ganmuxtvis Sedegad

xasiaTdeba ganmeorebadi SetevebiT, da maT Tan axlavT sxvadasxva

klinikuri da paraklinikuri simptomebi”. p. m. sarajiSvili da T. S.

gelaZe (1977) Tvlian, rom ”epilefsia Tavis tvinis qronikuli

polietiologiuri daavadebaa, romelic xasiaTdeba ganmeorebadi

krunCxviTi, arakrunCxviTi da (an) fsiqopaTologiuri paroqszmuri

gamovlinebebiT, rac aRmocendeba Zlieri neironuli ganmuxtvebis

Sedegad da dakavSirebulia paTologiuri keris lokalizaciasTan;

SeiZleba Tan axldes emociuri da fsiqikuri darRvevebi (ToiZe o.,

2003).

daavadebis etiologia erT-erTi yvelaze aqtualuri sakiTxia.

daavadebis mizezebs Soris mniSvnelovania memkvidreoba, intra-

, peri- , da postnataluri zemoqmedeba, cxovrebis wesi da sxva.

wamyvani faqtoris gamoyofa am mraval da xSirad mavne gavlenebs

Soris, rasac adamiani ganicdis muclad yofnis momentidan

daavadebis dawyebamde rTuli amocanaa, romelic umravles

48

SemTxvevaSi subieqturad wydeba. didi xnis ganmavlobaSi epilefsia

memkvidrul daavadebad miaCndaT. mecnierebis ganviTarebasTan da

axali meTodebis gamoyenebasTan erTad mividnen im daskvnamde, rom am

daavadebis genezisSi mniSvnelovan rols asrulebs egzogenuri mavne

gavlenebic (boldirevi, 1984)

Trimble_s (1989) mier warmodgenil cxrilSi Tavmoyrilia

yvela is SesaZlo mizezi, romelic SeiZleba safuZvlad edos

gulyris warmoqmnas (cxrilSi #3).

cxrili #3.epilefisuri gulyris gamomwvevi faqtorebi (Trimble, 1989)

Mmetabolozmi hipoglikemia, hipomagnemia (sisxlSi magniumis dabali done), eleqtrolituri cvlis darRveva/disbalansi (Ca,Na,Mg-ukmarisoba), mwvave porfiria (hemoglobinis sinTezis darRveva), aminomJavebis cvlis darRveva/disbalansi ukmarisoba

travma Tavis dazianeba, dabadebis travmebi, Tavis tvinis specifikuuri Sida Qwrilobebi

nevrologiuri tumorebi, cebro_vaskularuli SemTxvevebi, degenera tiuli darRvevebi, demieli nizaciis daavadebebi, Sturge- Weber _ is da ganviTarebis sxva mankebi, tuberuli sklerozi, infeqciebi (mag., citomegalovirusi, toqsoplazmozi, sifilisi, meningiti)

wamlebis moxsna gansakuTrebiT alkoholisda barbituratebis

vitaminebis nakleboba piridoqsinis (B1 vitamini) ukmarisoba

Sxamebi mag., striqnini

temperatura sicxe, cieb-cxeleba

mravali avtori aRniSnavs fsiqogenuri faqtorebis rols

rogorc gulyris ganviTarebaSi, aseve gulyraTa sixSiris zrdaSi.

iSviaT SemTxvevaSi, mZime fsiqogeniam SeiZleba wamyvani roli

iTamaSos Setevebis aRmocenebaSi da ganapirobos daavadebis mTeli

klinikuri suraTi. aseTi fsiqogenuri formebis ganviTarebaSi

mniSvnelovania agreTve rezidualuri xasiaTis xelSemwyobi

organuli safuZveli da organizmis maRali mgrZnobeloba

fsiqomatravmirebeli movlenebisadmi (ToiZe o., 2005). jer kidev E.

49

Gowers (1892) miuTiTebda, rom fsiqikuri travmebi, kerZod SiSi,

epilefsiis etiologiur faqtorTa ricxvs miekuTvneba. aRsaniSnavia,

rom ara ubralod SiSi, aramed Zlieri, mwvave fsiqogeniebi

SeiZleba CaiTvalos rogorc maprovocirebeli agenti. igulisxmeba

epilefsiis iseTi formebi, rodesac fsiqikuri travma ara mxolod

gamSvebi meqanizmis rols TamaSobs, aramed ZiriTadi rgolia

Setevebis da mTlianad epilefsiis ganviTarebaSi. epilefsiis aseTi

formebis mkurnalobaSi ar aris sakmarisi mxolod medikamenturi

antiepilefsiuri Terapia. kompleqsuri mkurnaloba aucileblad

unda Seicavdes specialur fsiqoTerapiul RonisZiebebs

(boldirevi, 1976, ToiZe, 2005).

Trimble (1985) aRniSnavs, rom pirdapiri kavSiri adamianis

garemoSi momxdar arasasiamovno, moulodnel, mZime movlenebsa da

epilefsiis aRmocenebas Soris ar dasturdeba. rogorc miuTiTebs I.

Grant (1989), mZime emociurma travmam an inteleqtualurma datvirTvam

SeiZleba epilefsiis mqone pirebSi epilefsiuri gulyrebi

gamoiwvios. socialurma stresma da emociurma daZabvam SeiZleba

gamoiwvios gulyra, mag., daRlis an Zilis darRvevis dros.

saerTod uZiloba erT - EerTi yvelaze gamoxatuli epileptogenuri

faqtoria da faqtiurad, diagnostikuri stresoria avadmyofis

eleqtrofiziologiur SefasebaSi. uZiloba SeiZleba amwvavebdes

qronikuli SfoTviTa da depresiiT gamowveul mdgomareobas. Trimble-

is da Wilson-Barnett_is (1982) epilefsias, stressa da Zils Soris

SesaZlebeli kavSiris modeli qvemoT aris moyvanili (sqema #3). am

modelidan Cans, rom stresis Sedegad gamowveuli Zilis darRveva

mniSvnelovan gavlenas axdens neironis aqtivaciis zRurblze da

axSirebs gulyrebs.

zogierTi gamokvlevis mixedviT Zlierma afeqtma SeiZleba

gamoiwvios gulyra. kerZod, zogierTi kvlevis mixedviT, epilefsiis

mqone piris emociuri agznebisas eleqtoencefalogramaze

registrirdeboda mniSvnelovani cvlilebebi (I. Grant, 1985).

50

sqema #3.kavSiri stressa da Setevebs Soris (Trimble & Willson – Barnett, 1982)

sxva avtorebi miuTiTeben mniSvnelovan kavSirze qronikuli

stressa da gulyris aqtivacias Soris (Friis, Lund, 1974; Mattson et al.,

1974). Aird (1983) Tvlis, rom qronikuli stresuli reaqciebi SeiZleba

garTulebuli iyos sxva Zlieri epileftogenuri movlenebiT, mag.,

alkoholis zedmeti miReba, Zilis darRvevebi. is miuTiTebda, rom

daswavlis SemTxvevaSi, romlis drosac arc erTi damamZinebeli

faqtori ar moqmedebda, avadmyofis moSoreba qronikuli stresuli

garemodan iwvevs daswavlis gaumjobesebas (Grant, 1985).

Trimble (1991) gvaZlevs neirofsiqiatriul daavadebasa da stress

Soris kavSiris kidev erT models, sadac TviT daavadebaa

ganxiluli rogorc stresogenuli faqtori, rac pirovnebas

uZlierebs SfoTvas da auaresebs misi mkurnalobis efeqturobas

(sqema #4).

amrigad, daavadebam SeiZleba TavisTavad gamoiwvios stresis

gaZliereba, ramac Tavis mxriv SeiZleba gaamwvavos pirveladi

daavadeba da meoradi sirTuleebi aRmoacenos.

stresi depresia Zilis darRveva Setevebis dabali

zRrubli

Secvlili

neirogadacema

hormonaluri

cvlilebebi

imunuri reaqciebis cvlileba,

metabolizmis

51

sqema #4. kavSirebi stressa da neirofsiqiatriul daavadebas Soris.

2.2. epilefsia, rogorc mastigmatizebeli daavadeba da masze

damokidebuli cxovrebis xarisxi.

aRiarebulia, rom epilefsiis mqone avadmyofebs mniSvnelovani

socialuri da emociuri problemebi gaaCniaT avadmyofTa sxva

jgufebTan SedarebiT. es aris ara mxolod cnobierebis dakargvisa

da dasaxiCrebis SiSi; arakontrolirebadi gulyris gamo ilaxeba

maTi sakuTari Rirsebis, pativiscemis grZnoba da Cndeba damatebiTi

emociuri da profesiuli sirTuleebi (Taveira et al., 1990; Wagner, Bungay,

Kosinsski, Bromfield & Ehrenberg, 1996). pacientebs gaurkvevlobis grZnoba

euflebaT gulyrebis bunebis dramatuli, usiamovno da xSirad

moulodneli xasiaTis gamo. gulyrebis garduvalobam da

moulodnelobam SeiZleba Seamciros individis motivacia

SeebrZolos cxovrebiseul cvlilebebs, rac iwvevs

daurwmuleblobis grZnobas da xSirad _ depresias (DeVills & DeVills,

1986).

es problemebi xSirad jer kidev bavSvobaSi iCens Tavs (Williams,

1981), rodesac bavSvi ver “grZnobs“ stress, magram is

“biologiurad arsebobs ojaxSi”. irRveva ojaxuri erTianobis

neirofsiqiatriu

li daavadeba

stresi gamkvlaveba

(coping)

SfoTva, depresia,

urCoba

gamkvlavebis

darRvevebi

sxva problemebi, mag., wamlebis gadametebuli miRebiT gamowveuli

darRveva, sxva somaturi

52

rwmena: Cndeba SfoTva, martoobis grZnoba ara mxolod daavadebul

pirovnebaSi, aramed ojaxis sxva wevrebSic. es grZeldeba

QWabukobaSi, zrdasruli adamianis cxovrebaSic da gavlenas axdens

TiTqmis yvela mniSvnelovan cxovrebiseul movlenaze. adamiani

“daRdasmuli”, stigmatizebuli xdeba sakuTari daavadebis gamo.

stigma aris daRi/damRa, romelsac sazogadoeba aniWebs

gansxvavebul adamianebs. es damRa ganpirobebulia im SexedulebebiT

da wrurwrmenebiT, romlebic arseboben sazogadoebaSi konkretuli

sakiTxis mimarT. xolo ojaxi sazogadoebis nawilia da aseve

eqvemdebareba masSi gavcelebul Sexedulebebis zegavlenas, rac

gavlenas axdens masSi mcxovreb TiToeul pirovnebaze.

“stigmis” aRqma, avtorTa azriT (Trimble, 1985), zomavs xarisxs,

romliTac epilefsiiT daavadebulni sakuTar Tavs crurwmenis

msxverplad miiCneven. xolo “stigma” miewereba adamianis im

nebismier Tvisebas, romelic Rrmad aris diskreditebuli

sazogadoebis TvalSi da damokidebulia am Tvisebis aRqmis

ganwyobebze (Goffman, 1963) (Morell, 2002; Baker, Brooks, Buck & Jacoby, 2000;

Jacoby, Snap & Baker, 2005).

Goldin & Margoin (1975) aRniSnaven, rom epilefsiiT daavadebuli

pirebi xSirad “izolirebulad cxovroben, gaucxovebis grZnobiT

Sepyrobilni arian, rac umeteswilad sazogadoebrivi azriT aris

gamowveuli.” (R. Ryan, K. Kemper, Ar.C. Emlen, 1980). Cven ukve avRniSneT,

rom epilefsia warmoadgens erT-erT yvelaze gavrcelebul

qronikuli xasiaTis nevrologiur daavadebas da misi

gamovlinebebis mravalsaxeoba da uCveulo mimdinareoba

gansazRvravs misdami gansakuTrebuli midgomis arsebobas.

Scambler-i (1989) ganasxvavebs erTmaneTisgan miRebul/dakanonebul

(Enacted) stigmas da subieqturi stigmis aRqmas. dakanonebuli

stigma gulisxmobs epilefsiis mqone pirTa mimarT sazogadoebis,

saxelmwifos mxridan diskriminaciis epizodebis arsebobas. stigmis

aRqmas ori damaxasiaTebeli niSani gaaCnia. pirveli es aris

epilefsiis arsebobiT gamowveuli sircxvili da meore _

miRebul/dakanonebul stigmasTan Sexvedris/Sejaxebis SiSi.

53

Cndeba kiTxva arsebobs Tu ara realurad stigma epilefsiiT

daavadebul pirTa Soris? amasTan dakavSirebiT azrTa

sxvadasxvaoba arsebobs. kvlevaTa nawili (Baskind R., Birbeck G.L., 2005)

adasturebs stigmis arsebobas epilefsiiT daavadebulTa Soris,

kvlevaTa nawili ki _ ara (Westbrook, Bauman & Shinnar., 1992).

epilefsiis diagnozi TavisTavad xSirad damRad aRiqmeba. yoveli

pirovneba gansxvavebulad reagirebs diagnozze, magram zogadi

kanonzomiereba mainc arsebobs. pacientebi epilefsiaze, rogorc

unarSemzRudav da sazogadoebisaTvis miuRebel mdgomareobaze

xSirad reagireben SfoTviT, daavadebis ignorirebiT, mkurnalobis

reJimisadmi daumorCelobiT an ipoqondriiT. aseTi reagirebis

mizezi, yvela SemTxvevaSi, daavadebis Sesaxeb subieqturi

warmodgenaa. epilefsia pirovnebis mier xSirad aRiqmeba rogorc

sasircxvilo, dasamali mdgomareoba, romlis xsenebac ki

usiamovnoa. pacientebi xSirad ver Rebuloben sakuTar daavadebas,

aRniSnaven, rom ezizRebaT is da misi saxeli (gagoSiZe, kasraZe,

2003).

epilefsiasTan dakavSirebuli stigma ar aris erTgvarovani da

bevrad damokidebulia individis premorbidul mdgomareobaze

sazogadoebaSi, e.w. mdgomareobis sazogadoebriv

konceptualizaciaze (gakicxvis/miRebis tendencia), daavadebis

klinikur mimdinareobaze, wamlebis gverdiT efeqtebze, asakze,

sqesze, ganaTlebasa da dasaqmebaze (Jacoby, Snape & Baker, 2005, Baskind &

Birbeck, 2005). Eepilefsiis klinikuli maCveneblebidan stigmis

aRqmasTan dakavSirebuli aRmoCnda gulyraTa tipi da maTi sixSire

(Ridsdale, Robins, Fitzgerald & Jeffery, 1996).

cxovrebis xarisxis Sefasebis mniSvneloba metwilad

ganpirobebulia informaciiT am qronikuli daavadebis gavlnis

Sesaxeb da mkurnalobis Sedegebis SefasebiT (Baker, 2000). qronikuli

daavadebis SemTxvevaSi pacientebi, maTi ojaxis wevrebi da eqimebi

pirvel rigSi dainteresebulni arian mdgomareobis funqcionaluri

efeqtiT da mkurnalobis SedegebiT. xolo epilrfiis dros

daavadeba ZiriTad gavlenas axdens Semdeg sferoebze: fizikuri,

socialuri, fsiqologiuri da neirofsiqologiuri.

54

epilefsiis mimdinareoba da misi mkurnaloba mniSvnelovan

gavlenas axdens pacientebis fizikur funqcionirebaze. epilefsiiT

daavadebul pirebs fizikuri dazianebis maRali riski aqvT, mag.,

xSiria motexilobebi, kbilebis dazianeba da Tavis travmebi. garda

amisa pacientebi ganicdian antikonvulsantebis gverdiTi efeqtebis

mniSvnelovan zemoqmedebas _ Tavis tkivili, Tavbrusxveva,

moTenTiloba, Zilianoba, wonis momateba, xSiria kognituri saxis

Civilebi (koncentraciis sirTuleebi, mexsierebis problemebi,

sirTuleebi azrovnebis sferoSi). gulyrebis simZime da maTi

sixSire aseve uaryofiTad moqmedebis epilefsiis mqone pirebze.

epilefsias, iseve rogorc mraval sxva qronikul daavadebas

axasiaTebs mimdinareobis cvalebadoba. misi prognozis da

gulyrebis simZimis winaswarmetyveleba xSirad gaZnelebulia.

umuSevrobis, martoobis, socialuri izolaciis maRali donis

gamo es mdgomareoba mastigmatizireblad aRiqmeba. garda amisa

zogierT qveyanaSi arsebobda/ an arsebobs kanoniT

gaTvaliswinebuli SezRudvebi epilefsiiT daavadebulTa mimarT,

mag.,: dasqmebis sferoSi, avtomobilis marTvaSi, qorwinebaSi da sxva.

garda amisa epilefsiis socialuri Sedegebis aRqmaze gavlenas

SeiZleba axdendes gulyrebis sixSire da maTi simZime, mkurnalobis

warmatebuloba/warumatebloba.

epilefsiasTan dakavSirebuli socialuri SezRudvebi gavlenas

axdens pacientis ojaxzec. ojaxis wevrebis reaqcia epilefsiis

diagnozze xSirad iwvevs hipermzurnvelobas an piriqiT uaryofas.

rogorc ukve avRniSneT, epilefsia xasiaTdeba sakuTar

Tavze/sakuTar sxeulze kontrolis dakargviT. gulyra SeiZleba

ganviTardes nebismier dros da nebismier adgilas. amitom ar aris

gasakviri, rom epilefsiiT daavadebulTa did nawils aqvs depresia,

dabali TviTSefaseba, gazrdili SfoTvis done. maTi emociuri

mdgomareoba SeiZleba aseve iyo ganpirobebuli epilefsiuri

fokusis klinikuri maxasiaTeblebiT (lokalizacia,

lateralizacia, neironuli kavSirebi xasiaTi da sxva). amas

SeiZleba axlavdes kognituri unarebis gauareseba da motoruli

SezRudvebi. epilefsiis dros cxovrebis garkveuli xarisxis

55

Camoyalibebaze gavlenas axdens faqtorTa erToblioba (Guberman &

Bruni, 1999). yvela zemoTxsenebuli faqtoris zemoqmedebiT xdeba

epilefsiis dros cxovrebis xarisxis Camoyalibeba (cxrili #4)

(Baker G., 2000).

arsebobs mravali kvleva, romelic cdilobs am sakiTxis ufro

dawvrilebiT Seswavlas. gamoyofilia faqtorTa rigi, romlebic

zogadad ganapirobeben cxovrebis dabal xarisxs epilefsiiT

daavadebulTa Soris, kerZod, romlebic gavlenas axdenen cxovrebis

xarisxis gansazRvraSi Semaval sferoebze (Devinsky et al.,1999). esenia

daavadebulTa asaki, sqesi, gulyrebis simZime da maTi sixSire,

sakuTari daavadebis aRqma, daavadebis aRqma (Robertson, 1991), garda

amisa daavadebis xangZlivoba da aRmocenebis asaki (Szaflarski, Meckler,

Privitera. & Szaflarski, 2006).

cxrili#4. epilefsiis dros cxovrebis xarisxze moqmedi ZiriTadi faqtorebi (Baker G., 2000).

globaluri janmrTeloba

fizikuri socialuri fsiqologiuri

done1 yovedRiuri funqcionireba

samsaxurisoc.&ojaxuri

kavSirebi

kognituri emociuri

done2 fizikuri funqcionireba

soc. funqcionireba kogniturifunqciebi

keTildReoba

gulyris simZimegulyris sixSire

wamlebis arasasikeToSedegebi

qowinebaojaxis mxardaWrasoc. mxardaWerastigma/gavlena

kogniturifunqciebiwamlebis efeqtebi

TviTSefasebakontroli

SfoTva/depresia

emociuri mdgomareoba

eplefsiisa da sxva daavadebebis dros cxovrebis xarisxis

SedarebiTi analizisas aRmoCnda, rom araerTxel wamoyenebuli

hipoTeza epilefsiis rogorc mastigmatizirebeli daavadebis dros

cxovrebis dabali xarisxis Sesaxeb ar Seesabameba sinamdviles.

aRmoCnda, rom sxva qrinikuli daavadebebis dros cxovrebis xarisxi

sandod ar gansxvavdeba epilefsiis dros arsebuli cxovrebis

xarisxisagan da zogjer ufro dabalic iyo (mag., gafantuli

sklerozi, diabeti) (Vickrey et al.,1994; Hermann et al.,1996). adgili aqvs

56

ara raodenobriv gansxvavebas, aramed _ Tvisobrivs. kerZod,

daavadebebi gansxvdebian cxovrebis xarisxis komponentebis

gansxvavebuli maCveneblebiT da maTi ganpirobebulobis mizezebiT.

es gansxvaveba TvalsaCinoa janmrTel adamianebTan Sedarebisas.

kerZod, Vickrey et al.(1994) kvlevaSi aRmoCnda, rom epilefsiis mqone

jgufSi, sakontrolo jgufebTan SedarebiT (gulis daavadebis da

diabetis mqone pacientebis jgufebi) ufro maRalia fizikuri

janmrTelobis, emociuri keTildReobisa da zogadi janmrTelobis

maCvenebeli. maSin, rodesac praqtikulad janmrTel pirebTan

SedarebiT, epilefsiis da sxva daavadebis mqone pirebs aqvT

mniSvnelovnad ufro dabali fizikuri janmrTelobis,

janmrTelobis aRqmis da cxovrebis xarisxis zogadi maCvenebeli.

2.3. epilefsia da pirovneba

sakiTxi epilefsiiT daavadebulTa pirovnuli cvlilebebis

Sesaxeb erT_erT yvelaze sakamaTo problemaTa ricxvs miekuTvneba.

epilefsiis mqone pirovnebis Sesaxeb Sexedulebebis

ganviTarebaSi SeiZleba ramdenime etapi gamoiyos:

epilefsiuri daRis, degeneciis periodi 1900 wlamde

epilefsiuri xasiaTis (”epileptoidis”) periodi 1900-1930 ww.

normalurobis aRiarebis periodi 1930 wlebis Semdeg

fsiqomotoruli Taviseburebebis periodi 1930 wlebis Semdeg

cnobilia, rom istoriulad zogierTi koncefcia uSualod

ukavSirebda epilefsias garkveuli tipis pirovnebas. me-19 saukunis

meore naxevarSi fsiqiatriaSi gabatonebuli iyo “fsiqikuri

degeneraciis Teoria”, romlis Tanaxmad epilefsia memkvidreobiTi

daavadebad iTvleboda da epilefsiis mqone pirebs gaaCniaT

saerTo ”degeneraciisaTvis damaxasiaTebeli” fizikuri da

fsiqikuri Tvisebebi. “epilefsiis” diagnozis dasma niSnavs

“fsiqikuri degeneraciis” konstantirebas. Bombardat (1896) pidapir

miuTiTebs, rom “epilefsia _ degeneracaa”. am Teoriis

ganviTarebas xeli Seuwyo morelis wignma “gadagvarebis Sesaxeb”,

romelic yvela fsiqikur darRvevebs degeneraciul memkvidreobas

57

miakuTvnebda. italieli anTropologi C. lombrozo ki Tvlida,

rom danaSauli da gadagvareba saerTo movlenebia da epilefsiiT

daavadebuls da damnaSaves saerTo pirovnuli niSnebi gaaCniaT.

maSasadame, Tu morels epilefsia degeneraciis Sedegad miaCnda,

lombrozo epilefsiis mqone pirebs damnaSaveTa ricxvs

miakuTnebda. am Sexedulebis Tanaxmad iTvleboda, rom avadmyofebs

axasiaTebT kriminaluri, agresiuli da anti-socialuri

tendenciebi. yvelaze mZime danaSaulebs, mag., mkvlelobebs,

epilefsiiT daavadebulebs miawerdnen. Tu krunCxviTi gulyrebi da

daavadebis sxva niSnebi ar vlindeboda, iTvleboda, rom maT aqvT

e. w. SeniRbuli epilefsia (boldirevi, 1984).

mogvianebiT, me-20 saukunis dasawyisSi, rodesac epilefsiis

etiologiaSi egzogenuri faqtorebic aRiares, fsiqikuri

degeneraciis koncefciam dakarga Tavisi mniSvneloba.

igi”konstituciuri da epilefsiuri xasiaTis” koncefciam Secvala.

am midgomis warmomdagenlebi ”epileptoiduri konstituciis”

arsebobas usvamdnen xazs (Trimble, 1989). ”epileptoiduri

konstiticiisaTvis” specifikurad iTvleboda sami ZiriTadi

maCvenebeli:

konstituciis memkvidruli gadacema;

fizikuri Tvisebebis Tavisebureba;

fsiqikuri Tvisebebis Tavisebureba.

am koncefciis mixedviT, epilefsiiT daavadebulni xasiaTdebian

garkveuli konstituciuri da fizikuri TaviseburebebiT, mag.,

saxis sworkuTxa konturebiT, aTleturi agebulebiT da ZiriTadad

ori ZiriTadi TvisebiT: erTis mxriv, Seneleba, webovaneba da

meores mxriv, feTqebadoba. garda amisa, iTvleboda, rom

memkvidreoba yvela SemTxvevaSi epilefsiis aRmocenebis mTavari

mizezia. ase mag., K. Fere (1890) Tvlida, rom garkveuli xasiaTobrivi

Tvisebebi da specifikuri qceva daavadebis eWvs iwvevs manamde,

sanam aRmocendeba pirveli paroqsizmebi (Trimble, 1989).

Teoriebi, romlebic miuTiTeben xasiaTobriv, Sinagan

predispoziciebze epilefsiis mqone avadmyofebTan, dRes

uaryofilia.

58

Lennox A. (1944) pirveli iyo vinc aRniSna, rom epilefsiiT

daavadebuli pirebi iseTive normalurebi arian, rogorc sxva

adamianebi; isini eqvemdebarebian iseTive zegavlenas, rogorc

sxvebi im gamonaklisiT, rom maT zogjer pirovnebis cvlilebebi

aReniSnebaT rac gamowveulia Tavis tvinis dazianebiT,

arakontrolirebadi SetevebiT, antikonvulsantebis regularuli

miRebiT da fsiqosocialuri problemebiT, romlebic epilefsiis

Sedegs warmoadgenen ( Trimble, 1989).

fsiqomotoruli specifikurobis periodis ZiriTadi debuleba

SeiZleba gamoixatos Gibbs da Stamps (1953) sityvebiT: ”pacientis

emociuri reaqcia daavadebaze, mis ojaxze da socialur

situaciaze fsiqikuri aSlilobisaTvis ufro naklebad

mniSvnelovani determinantia, vidre epilefsiuri gantvirTvis

mxareoba da tipi (gagoSiZe, kasraZe, 2003).

garda amisa, garkveuli mosazrebebi arsebobda

fsiqodinamikuri mimarTulebis wiaRSi, romlebic miuTiTebda

epilefsiisadmi garkveul Sinagan predispoziciaze. me-20 saukunis

daswyisSi evropaSi, gansakuTrebiT ki safrangeTSi, erTmaneTTan

mWidrod akavSirebdnen epilefsiasa da isterias. arsebobda kidec

termini, isteroepilefsia (hystero epilepsy). epilefsiuri gulyra

warmoadgens centraluri nervuli sistemis garkveul

mdgomareobas, romelic akavSirebs erTmaneTTan epilefsias,

isterias da fsiqasTenias (Trimble, 1985). f. dostoevskis cxovrebis

da xasiaTis fsiqologiur gamokvlevaSi S.Freud_i gamoyofda

organul da afeqtur epilefsias (Freud, 1929). igi Tvlida, rom

pirveli Tavis tvinis daavadebis Sedegia, xolo meore ki

avadmyofis nevrotizaciis Sedegi. “pirvel SemTxvevaSi, sulieri

cxovreba garedan zemoqmedebiT irRveva, meore SemTxvevaSi ki,

darRveva TviT sulieri cxovrebis gamovlenas warmoadgens.” (Freud,

1991). Stekel-i (1924) epilefsiur Setevas ganixilavda rogorc

autaneli, travmatuli situaciisagan gaqcevas. Pierce-Clark_ma (1929)

ganaviTara epilefsiis fsiqobiologiuri Teoria. is Tvlida, rom

garkveuli Sinagani predispoziciebi jer kidev daavadebis

dawyebamde aqvs pirovnebas. is aRniSnavda, rom Seteva emsaxureba

59

libidos aracnobier dakmayofilebas da rom “epilefsiuri reaqcia

nevrozis nairsaxeobaa, romlis arsi mdgomareobs somaturi

mdgomareobiT arasasiamovno stimulebisagan ganTavisuflebaSi.”

Lehrman (1925), agreTve, miuTiTebda, rom nevrozebis, fsiqozebisa da

fsiqogenuri epilefsiis simptomebi Seicaven ara mxolod

aracnobier daZabulobas, aramed moqmedebebis garduvalobas, da

realobisagan gaqcevas. misi azriT, nevrozebis SemTxvevaSi

nawilobrivi gaqcevaa, fsiqozebis SemTxvevaSi _ sruli, xolo

epilefsiis SemTxvevaSi _ moulodneli.

da bolos, Billings (1946) epilefsiur Setevas ganixilavda,

rogorc fsiqobiologiur reaqcias garkveuli predispoziciis

mqone adamianebTan; Jefliffe da White (1929) ™Tvlidnen, rom

epilefsiuri Seteva aris “aracnobieridan gaqceva gansakuTrebuli

stresis dros”.

zogierTi avtori cdilobda epilefsiis, rogorc

fsiqosomaturi daavadebis ganxilvas. kerZod, epilefsiuri

krunCxviTi Seteva ganixileboda, rogorc fsiqosomaturi reaqcia

(Gordin, 1953). am poziciaze mdgomi zogierTi avtoris azriT,

Zlieri risxva iwvevs zogad fsiqosomatur gauwonasworebulobas

da wonasworobis aRdgenisaTvis xorcieldeba masiuri motoruli

gantvirTva” (Aring et al. ,1947).

unda aRiniSnos, rom qarTul fsiqologiaSic iyo epilefsiiT

daavadebuli pirovnebis xasiaTobrivi Taviseburebebis axsnis

mcdeloba. d.UuznaZe (1949), i. bJalava (1944) ganwyobis Teoriis

poziciebidan gamomdinare cdilobdnen epilefsiis dros arsebuli

pirovnul-emociuri cvlilebebis gansazRvras. maTi azriT,

epilefsiiT daavadebuli pirovnebas aReniSneba advilad agznebadi,

tlanqi, lokaluri, stabiluri, mtkice ganwyobis tipi, rac

ganapirobebs avadmyofi adamianis qcevas da azrovnebis stils

(uznaZe, 2004).

AdRevandel epileftologiaSi da klinikur fsiqologiaSi am

Teoriebs mxolod istoriuli TvalsazrisiT ganixilaven.

dRes, epilefsiis dros aRmocenebuli pirovnuli cvlilebebis

amxsneli sruliad gansxvavebuli mravali koncefciaa.

60

zogadad miRebulia mosazreba, rom epilefsiis mqone

pacientebs aqvT fsiqopaTologiuri darvevebis aRmocenebis ufro

maRali albaToba, vidre Cveulebriv populaciaSi da rom xSirad

aRmocenebuli simptomebi SeumCneveli SeiZleba darCes (Barbieri, Lo

Ruso, Fracione, Scarone & Gambini, 2006). fsiqikis paTologiuri

darRvevebis formirebaSi reaqtiuli momentebis mniSvnelobaze

miuTiTeben Price, Kogan & Tompkins (1948), Bridge (1949), Pond (1952),

Groethnysen et al. (1957), Stores & Lwin (1981) da sxvebi. arsebiTi roli

eniWeba avadmyofis urTierTobas garSemomyofebTan da socialur

garemosTan. avtorTa TvalsazrisiT fsiqogenuri faqtorebi did

rols TamaSoben nevrotuli da fsiqiuri aSlilobebis

aRmocenebaSi epilefsiis dros (Dodrill & Batzel, 1993). epilefsiis

dros pirovnuli da emociuri cvlilebebis mizezad mecnierTa

nawili asaxelebs fsiqologiur da socialur faqtorebs, nawili ki

biologiurs. ukanasknel periodSi ki iTvleba, rom es

multifaqtoruli problemaa da pirovnuli Tu emociuri

cvlilebebis aRmocenebaSi Tavisi wvlili SeaqvT rogorc fsiqo-

socialur, aseve biologiur, daavadebisTvis damaxasiaTebel

faqtorebs (Goldstein, 2000, Baker, 1997). Herman, Seidenberg & Bell (2000)

ganixiles 36 kvleva da gamoyves faqtoraTa ZiriTadi jgufi,

romlebic gavlenas axdenen epilefsiis dros aRmocenebul

emociur-pirovnul cvlilebebze, kerZid depresiis, aRmocenebaze.

esenia: neirobiologiuri faqtorebi, socialur demografiuli (mag.,

asaki, sqesi, ojaxuri mdgomareoba, ganaTleba) da

fsiqologiur/socialuri faqtorebi.

cxrili #5. epilefsiaSi fsiqopaTologiis gamowvevis maRali risk faqtorebi (Hermann, Whitman, 1992)

Nneirobiologuri

Ffsiqosocialuri medikamentozuri

Ddaavadebis dawyebis asaki

Ggulyrebis SiSi monoTerapia/poliTerapia

Ggulyris kontroli

stigmis aRqma Sratis done

Ddaavadebis xangrZlivoba

Ddiskriminaciis aRqma wamlebis tipi

Ggulyris tipi Eepilefsiis regulireba

foliumis nakleboba

Ggulyris rTuli tipebi

Llokus kontroli wamlebis raodenoba

61

Eetiologia cvlilebebi cxovrebaSi

hormonaluri an endokrinuli efeqtebi

Aiqtaluri/interiqtaluri eeg-

s maxasiaTeblebi

socialuri mxardaWera

medikamentebis gavleniT monoaminebis metabolizmis

cvlileba

struqturuli dazianebis arseboba

socioekonomikuri statusi

medikamentebis gavleniT cerebruli metabolizmis

cvlilebacerebraluri metabolizmi

BbavSvobisasgaremocva

cvlilebebi neiotransmiterul sistemaSi.Nneirofsiqologiuri statusi

Hermann -ma da Whitman-ma (1990) ganixiles yvela risk faqtori,

romelic SeiZleba iyos dakavSirebuli pirovnul-emociuri

darRvevis aRmocenebasTan epilefsiis dros da gamoyves maTi sami

ZiriTadi kategoria: (1) Tavis tvinTan dakavSirebuli faqtorebi; (2)

araorganuli bunebis faqtorebi da (3) mkurnalobasTan

dakavSirebuli faqtorebi. maT ivaraudes, rom am kategoriebSi

Semavali yvela risk-faqtori SeiZleba iyos fsiqopaTologiis

aRmocnebis mizezi epilefsiis dros.

am avtorTa azriT yvela es cvladi/risk faqtori

erTmaneTisgan damoukidebeli ar aris. isini urTierTdakavSirebulia

da erT ZiriTad faqtors qmnis _ epilefsiuri mdgomareobis zogad

simZimes. epilefsiis simZime iseTi cvladebis urTierTqmedebis

Sedegia, rogoricaa gulyraTa tipis simravle, daavadebis dawyebis

adreuli asaki, gulyraTa susti kontroli da simptomaturi

etiologia.

Mmokled ganvixiloT TiToeuli es faqtori.

yvelaze gavrcelebulia Tavis tvinTan dakavSirebuli

cvladebis hipoTeza an e.w. neiroepilefsiuri hipoTeza, romlis

mixedviTac qceviTi darRveva epilefsiis dros, ZiriTadad,

gamowveulia centraluri nervuli sistemis disfunqciiT.

ukanaskneli 30 wlis ganmavlobaSi didi yuradReba eqceoda

fsiqopaTologiasa da gulyris specifikur tips Soris kavSirs (mag.,

fsiqomotoruli gulyra, safeTqlis an kompleqsuri parcialuri

62

epilefsia). Ees interesi Frederic Gibbs–is da misi kolegebis mier 1948

wels iyo stimulirebuli. epilefsiisas, fsiqopaTologiis

aRmocenebis sxva faqtorebic iyo gamoyofili. isini moicaven

epilefsiis etiologias, keris lateralizacias, daavadebis

xangrZlivobas, gulyris tips da gulyrebis kontrolis

SesaZleblobas.

interesi am faqtorebis mimarT klinikur da epileftologiur

kvlevebSi Zalian didi iyo. rogorc aRniSnaven Whitman & Hermann

(1990), ukanaskneli 20 wlis ganmavlobaSi epilefsiis dros

fsiqopaTologiis Sesaxeb literaturaSi, 79% exeba im potenciur

risk faqtorebs, rasac neiroepilefsiuri hipoTeza gamohyofs. magram

miuxedavad mravali kvlevisa, monacemebi urTierTgamomricxavi da

urTierTsawinaaRmdegoa. amis ramdenime mizezi arsebobs:

1. kvlevebSi gansxvavebuli neiroepilefsiuri cvladebi iyo

Sefasebuli gansxvavebuli qceviTi paternebis mixedviT;

2. sxvadasxva kvlevaSi monawileobda epilefsiis mqone

pacientebis gansxvavebuli jgufebi;

3.gamoiyeneboda gansxvavebuli Sefasebis meTodebi da

kriteriumebi;

4. zogierTi neiroepilefsiuri cvladebis zemoqmedeba

Seswavlili iyo gulyraTa mxolod ramdenime (an erTi romelime)

tipis safuZvelze da maTi efeqti zogadad epilefsiis mqone

pacientebze ucnobi rCeba (Hermann, Whitman, 1992) .

rogorc vxedavT, Zalian mniSvnelovania neiroepilefsiuri

modelis cvladebis ganxilva epilefsiis dros aRmocenebuli

fsiqopaTologiis mizezebis aRmocenebisas.

ganvixilavT zogierTi neiroepilefsiuri cvladis

mniSvnelobas fsiqopaTologiis aRmocenebaSi epilefsiis dros.

esenia:

daavadebis dawyebis asaki

gulyris kontroli

gulyris tipi (epilefsiuri keris lokalizaciis da

lateralizaciis gaTvaliswinebiT)

G

63

daavadebis dawyebis asaki

E daavadebis dawyebis asaki anu daavadebis xangrZlivoba, rogorc

fsiqopaTologiis aRmocenebis erT-erTi mizezi dRemde kvlevis

ZiriTadi obieqtia.Eepilefsiis xangrZlivobas xSirad akavSireben

epilefsiis dros arsebul fsiqopaTologiasTan da inteleqtualuri

funqcionirebis donesTan. mravali kvlevaSi aRiniSneba kavSiri

epilefsiis dros fsiqopaTologiis sxvadasxva maCveneblebsa da

epilefsiis dawyebis asaks Soris. Tumca, arsebobs azrTa

sxvadasxvaobac am sakiTxTan mimarTebaSi.

aRniSnavdnen, rom epilefsiis dawyebis adreuli asaki

dakavSirebulia fsiqopaTologiis maRal riskTan (Hermann, Whitman et

al., 1990), xolo safeTqlis epilefsiis dawyeba mozardobis

periodamde, avtoraTa azriT, dakavSirebulia iseT darRveveasTan

rogoric aris hiposeqsualoba, xolo gviani dawyeba ki SeiZleba

iyos dakavSirebuli impotenciasTan (Blumer, 1970; Saunders & Rawson,

1970). Serafetinides (1965) aRmoaCina, rom safeTqlis epilefsiis dawyeba

10 wlamde kavSirSia moWarbebul agresiasTan. safeTqlis epilefsiis

dawyeba pubertatis periodSi fsiqozebis aRmocenebis gazrdil

riskTan aris dakavSirebuli (Hermann, Schwartz, Karnes,& Vahdat, 1980).

gulyrebis kontroli

gulyrebis kontrolis qveS igulisxmeba gulyrebis sixSire

da maTi simZime.

mniSvnelovania sakiTxi gulyris sixSirisa da pirovnebis

cvlilebebis urTierTkavSiris Sesaxeb. gulyraTa sixSire orgvarad

SeiZleba gansazRvravdes fsiqikur aSlilobebs epilefsiis dros.

erTis mxriv, xSiri gulyrebi iwveven centraluri nervuli sistemis

cvlilebebs, meores mxvriv, _ isini xels uwyoben avadmyofi

adamianis pirovnul cvlilebebs, mag., interesTa sferos

Seviwroebis saxiT.

Llogikuri iqneboda gvefiqra, rom gulyraTa daqveiTebuli

kontroli kavSirSia qcevis sust regulirebasTan, rasac

64

adasturebs zogierTi klinikuli dakvirveba (Schachter, Shafer &

Murphy, 1993). magram, misi pirdapiri damadasturebeli empiriuli

faqtebi Zalze mcirea. zogierTi mkvlevari mxolod varaudobs, rom

mniSvnelovani kavSiria gulyrebis simZimesa (romelSic aseve

igulisxmeba gulyrebis kontroli, rogorc erT-erT cvladi) da

fsiqopaTologiis aRmocenebas Soris da aseTi kavSiri ar aris

SemTxveviTi (Arntson, Droge, Norton & Murray, 1986; Roth, Goode, Williams &

Faught, 1994).

MmiuTiTeben fsiqozebsa da gulyrebis simZimes Soris

mniSvnelovan kavSirze safeTqlis epilefsiis mqone pacientebTan.

safeTqlis epilefsiis mqone pacientebs naklebad kontrolirebadi

gulyrebiT agresiis, seqsualuri disfunqciis, da zogadad

fsiqopaTologiis ufro maRali maCveneblebi aqvT (Hermann & Whitman,

1984).

AzogierTi avtori miuTiTebs kavSiris arsebobaze gulyrebs,

gansakuTrebiT rTul parcialur an safeTqlis disfunqciasa da

fsiqozebs (Flor-Henry, 1969; Kristensen & Sindrup, 1979) da depresias (Betts, 1974;

Flor-Henry, 1969) Soris (Robertson, 1991).

agreTve, dgas sakiTxi gulyris simZimisa da avadmyofis mier

stigmis subieqturi aRqmis Sesaxeb am SemTxvevaSi gulyris simZimis

qveS igulisxmeba rogorc gulyris tipi, aseve gulyris sixSirec.

avtorebi aRniSnaven, rom TiToeuli cal_calke ver gamoxatavs

daavadebis simZimes da amitom aucilebelia am ori maCveneblis

erTobliobaSi ganxilva.

wamoyenebuli iyo ori alternatiuli modeli. pirveli _

samedicino midgoma, romelic gulisxmobs pirdapir kavSirs Setevis

simZimesa da individis mier sakuTari stigmatizaciis aRqmas Soris.

es modeli uSvebs, rom epilefsiiT gamowveuli stigma izrdeba

Setevis simZimesTan erTad. SemdgomSi, gamokvlevebis safuZvelze, es

modeli uaryofil iqna (Ryan, Kempner & Emler,1999).

meore modeli _ fsiqosocialuri midgomaa. mis mixedviT

gulyris simZimis zemoqmedeba stigmis aRqmaze gaSualebulia iseTi

individualuri maxasiaTeblebiT, rogorebic aris im diskriminaciis

aRqma, romelic xSirad arsebobs sazogadoebaSi epilefsiiT

65

daavadebulTa mimarT, epilefsiiT gamowveuli SezRudvebis aRqma,

ganaTlebis done, asaki da sqesi (Baskind & Birbeck, 2005). am hipoTezis

mixedviT epilefsiis mqone piri imyofeba unikaluri socialuri da

interpersonaluri stresis zemoqmedebis qveS da rom swored es

aris epilefsiis dros aRmocenebuli fsiqopaTologiis mizezi.

specifikuri risk faqtorebia stigma, diskriminacia, socialuri

izolacia, mxardaWeris uqonloba, gulyrebis SiSi da uimedobis,

ususurobis gancda da kontrolis dakargvis SiSi (Fenton, 1981),

gulyrebis kontrolis subieqturi aRqma (avadmyofis mier, aRqma

imisa, Tu rogor kontroldeba misi daavadeba) (Pedroso de Souza. &

Salgado, 2006).

mravali gamokvleva cdilobda aexsna kavSiri epilefsiis

dros unikalur socialur da interpersonalur stressa da

aRmocenebul fsiqopaTologias Soris - Fenton, 1981; Laidlaw & Laidlaw,

1982; Lennox & Lennox, 1960; Linnett, 1982; Williams, 1981. Mmagram, miuxedavad

amisa ar arsebobs sakmarisi empiriuli monacemi, romelic naTels

mohfenda am sakiTxs (Robertson, 1991).

miuxedavad mosalodneli kavSirisa, romelic SeiZleba

arsebobdes zogierT fsiqosocialur cvladsa (mag., epilefsiisadmi

Segueba) da fsiqopaTologias Soris, mizez-Sedegobrivi kavSiris

xasiaTi naTeli ar aris da moiTxovs ufro Rrma da zust

gamokvlevas (mag., longitiduri gamokvleva). Ggarda amisa, zogierTi

fsiqosocialuri cvladi SeiZleba uSualod iyos epilefsiasTan

dakavSirebuli (mag., gulyrebis SiSi), zogierTi ki SeiZleba iyos

epilefsiis, rogorc daavadebis Sedegi (mag., epilefsiis mqone pirs

SeiZleba hqondes dabali socialuri mxardaWera) da zogierTi

SeiZleba saerTod ar iyos ganpirobebuli epilefsiiT (mag.,

epilefsiis mqone adamians SeiZleba hqondes rTuli damokidebuleba

ojaxis wevrebTan).

A gulyris tipi

ukanasknel periodSi mkvlevrebi Tvlian, rom fsiqikisa da

qcevis darRvevebi, maT Soris, qronikuli darRveva da agreTve

fsiqikuri paroqsizmebis gansxvavebuli formebi, gamowveulia

66

mxolod epilefsiuri keris safeTqlis lokalizaciiT an rTuli

parcialuri gulyrebiT (Rodin, Katz & Lennox, 1976; Hashimoto, 1994).

safeTqlis epilefsia erT-erTi yvelaze gavrcelebuli formaa

adamianTa Soris da hipokampaluri sklerozi – erT-erTi yvelze

xSiri epileptogenuri dazianebaa adamianTa Soris. xolo, limburi

sistema, romelSiac Sedis hipokampi warmoadgens epilefsiaTan

dakavSirebul qceviTi daRvevebis aRmocenebis mTavar mizez (Engel,

Wilson & Lopez-Rodriguez, 2002).

avtorTa azriT, safeTqlis aris disfunqcia iwvevs fsiqikis

specifikur cvlilebebs: gaRizianebas, agresiulobas, ipulsurobas.

es avadmyofebi labiluri, advilad feTqebadi da guneba _

ganwyobis mZafri cvlilebebisadmi arian midrekilni (Gastaut, 1953).

avtorTa mier gamoyofilia TvisebaTa mTeli rigi, romlebic

damaxasiaTebelia safeTqlis epilefsiis mqone avadmyofebisaTvis

(Hashimoto K., 1994). safeTqlis epilefsiis mqone pacientebis

Sedarebisas fokaluri, magram Tavis tvinis sxva ubnebis

epilefsiuri fokusis mqone avadmyofebTan, aRmoCnda

fsiqopaTologiis ufro maRali sixSire safeTqlis epilefsiis

SemTxvevaSi (Dodrill C.B., Batzel L.W., 1993).

xSiria monacemebi obsesiur-kompulsiuri darRvevis arsebobis

Sesaxeb epilefsiis da kerZod safeTqlis epilefsiis dros (Barbieri

e.al., 2005). am avtorebis mier gaanalizebulia mravali MRI da fMRI

kvleva, romelic miuTiTebs safeTqlis wilis rolze obsesiur-

kompulsiuri darRvevebis aRmocenebaSi. cnobilia, rom es darRveva

naklebad eqvemdebareba fsiqoTerapiul strategiebs da misi

mkurnaloba ufro efeqturia farmakoTerapiiT, rac aZlierebs

hipoTezas zogadi paTofiziologiuri komponentebis arsebobis

Sesaxeb am darRvevis CamoyalibebaSi. Gray-is (1982) modelis

mixedviT, obsesiur-kompulsiuri darRvevebis dros saxezea

safeTqel-hipokampaluri sistemis disfunqcia (”qcevis damuxruWebis

sistema”). aRmoCnda, rom es sistema wamyvania Sinagani da garegani

informaciis monitoringSi, SfoTvis kontrolis dros, yuradRebis

gaZlierebisas potenciurad saSiSi an saxifaTo situaciebis dros.

obsesiur-kompulsiuri darRvevebis mqone pacientebTan, am sistemis

67

hiperaqtivobam SeiZleba gamoiwvios garegani da Sinagani situaciis

araswori interpretacia, rasac mosdevs obsesiuri azrebi (Engel,

Wilson & Lopez-Rodriguez, 2002).

lateralizaciis hipoTezis mixedviT, obsesiur-kompulsiuri

darRvevebi ufro ganpirobebulia marjvena hemisferos dazianebiT,

romelic pasuxismgebelia informaciis integraciaze da neitraluri

garegani stimulebis interpretaciaze (Barbieri et al., 2005). magram, Fedio

(1986) miuTiTebda marcxena hemisferos dainteresebaze obsesiuri

azrebis CamoyalibebaSi (Robertson, 1991).

unda aRiniSnos, rom safeTqlis epilefsiis dros obsesiur-

kompulsiuri darRvevebis armocenebis maRali riskis axsnis

hipoTezebi da empiriuli faqtebi, Semdgom kvlevebs moiTxovs.

safeTqlis epilefsiis, rogorc fsiqopaTologiis aRmocenebis

modelTan dakavSirebulia zogadi mosazreba imis Sesaxeb, rom

limburi sistema CarTulia emociuri qcevis regulaciaSi, xolo

safeTqlis wilebis medialuri nawili am sistemis erT-erTi

rgolia; amitom mosalodnelia, rom emociur-pirovnuli darRvevebis

didi nawili Tavs iCens safeTqlis epilefsiuri fokusis mqone

pacientebTan (Swinkels, Kuyk, van Dyck & Spinhoven, 2005; Koch-Stoecker, 2002).

magram ukanaskneli gamokvlevebi ar adastureben specifikuri

pirovnuli niSnebis arsebobas safeTqlis epilefsiis mqone yvela

pirTan. avtorebi Tvlian, rom safeTqlis wilis disfunqciis,

gansakuTrebiT ki medialuri struqturebis disfunqciis mqone

epilefsiiT daavadebuli pirebi ubralodD ufro mgrZnobiareni

arian fsiqiuri aSlilobis ganviTarebisadmi, romelTa Soris

SeiZleba iyos pirovnuli darRvevebi, SfoTva, depresia (Trimble,

1985). Rodin et al. (1976) gaakeTes mniSvnelovani dakvirveba; kerZod, maT

aRniSnes, rom safeTqlis epilefsiis mqone pacientebs xSirad aqvT

ramdenime tipis gulyra (safeTqlis gulyrebis klasifikacia

ixileT danarTSi #2). maT ivaraudes, rom gulyraTa tipis

raodenoba ufro relevanturia epilefsiaSi emociuri da fsiqiuri

aSlilobis aRmocenebisaTvis, vidre gulyris tipi. es dakvirveba

SemdgomSi daadastures Hermann et. al. (1982) da Dodrill (1984).

68

zogierTi avtori ki Tvlis, rom depresiisa da SfoTvisadmi

mgrZnobelobis gazrda specifikuri ar aris mxolod safeTqlis

wilis disfunqciisaTvis da ufro hemisferoTa dazianebis

mxareobasTan aris dakavSirebuli (DeVills & DeVills, 1986 , Altshuler,

1990).

Uukanasknel wlebSi gaizarda interesi safeTqlis

epilefsiuri fokusis mxareobis anu lateralizaciis mimarT,

gansakuTrebiT mas Semdeg, rac Flor-Henry-im (1969) Tavis cnobil

gamokvlevaSi miuTiTa safeTqlis epilefsiis dros marcxena

hemisferos rolze Sizofreniismagvari simptomebis aRmocenebaSi,

xolo marjvena hemisferos rolze afeqturi fsiqozebis

aRmocenebaSi (Leutmezer, Poreka, Asenbaum, Pietrzyk, Luncht & Back, 2003). am

avtoris gavleniT Catarebuli ramdenime gamokvleva, adasturebda

am kavSirebis arsebobas. garda amisa, arsebobs gamokvlevebi,

romlebic miuTiTeben safeTqlis epilefsiis dros marjvena

fokusis kavSirze depresiasTan, seqsualur disfunqciasTan.

aRmoCnda, rom eeg-ze bilateraluri fokusis mqone pacientebi,

gansakuTrebiT ki safeTqlis bilateraluri fokusisa, ufro metad

arian midrekilni hipergarfiisaken, pirovnuli da qceviTi

cvlilebebisaken, vidre unilateraluri fokusis mqone pacientebi

(Trimble. et al., 1989).

Tumca sxva gamokvlevebi, ar adastureben kavSirs

epilefsiuri fokusis safeTqlis lokalizaciasa, lateralizaciasa

da emociur-pirovnul darRvevebs Soris (Hermann B.P., Trenerry M.R.,

Colligan R.C., !996), pirovnul da qceviT darRvevebs Soris (Nielsen &

Kristensen, 1981).

emociuri cvlilebebi SeiZleba iyos dakavSirebuli gulyris

tipTan. kerZod, parcialuri epilefsiis mqone pirebSi

mniSvnelovnad ufro maRalia depresiis, fsiqasTeniis da zogjer

pirovnebis fsiqopaTologiuri niSnebis arseboba, vidre pacientebSi

generalizirebuli epilefsiiT (Akada, Kugoh, Fukuma, Mino, Suwaki &

Hosokawa, 1995). savaraudod es gamowveulia imiT, rom

fokaluri/parcialuri epilefsiebis dros SeiZleba adgili

hqondes Tavis tvinis lokalur struqturul dazianebas.

69

aq Cven ufro vrclad ganvixilavT zogierT specifikur

fsiqosocialur cvlads, rac SeiZleba kavSirSi iyos epilefsiis

dros aRmocenebul fsiqopaTologiasTan:

gulyris SiSi

kontrolis lokusi

stigmis aRqma.

Ggulyrebis SiSi

zogierTi mkvlevari epilefsiis dros aRmocenebul

fsiqopaTologiis gamomwvevi mizezebis ganxilvisas, miuTiTebs,

rom stresi warmoadgens pacientis mier sakuTari gulyrebis

araswori aRqmisa da amasTan dakavSirebuli SiSebis Sedegs (Mittan,

1983; Mittan & Locke, 1982). aRmoCnda, rom avadmyofTa daaxloebiT 70%

miuTiTebda gulyris dros sikvdilis SiSze; daaxloebiT 45%

aRniSnavda, rom isini cxovroben gulyrebis aRmocenebis mudmivi

SiSis pirobebSi da daaxloebiT 35%-s sjera, rom gulyrebis

Sedegad sikvdili sakmaod xSiri movlenaa; paciantTa or mesameds

eSiniaT gulyris Sedegad travmis miRebisa. mkvlevrebma daaskvnes,

rom gulyrebis da misi SesaZlo Sedegebis SiSi warmoadgens

epilefsiis dros SfoTvis, depresiisa da sxva fsiqopaTologiebis

aRmocenebisas erT-erT mTavar xelSemwyob faqtors (Mittan, 1983).

magram unda aRiniSnos, rom es hipoTeza dRemde Seumowmebeli

rCeba (Hermann, Whitman, 1986). arsebobs gulyris SiSis meore mxarec,

romelic gulyris gamovlinebebis socialur SedegebTan aris

dakavSirebuli. paciantma icis, rom gulyra SeiZleba aRmocendes

nebismier dros da nebismier SemTxvevaSi, misi winaswarmetyveleba

sakmaod rTulia (yvela gulyras ar axlavs winmswrebi aura). amis

gamo mas uCndeba SiSi, rom gulyris SemTxvevaSi ”arasasurvel”

mdgomareobaSi aRmoCndeba sazogadoebisa da mis garSemo myof

adamianebis TvalSi.

epilefsiis mqone pirebi xSirad uxerxulobas, grZnoben

gulyris gamo, sakuTar Tavs avadmyofad aRiqvamen moulodneli

70

Setevebis SesaZleblobis, an mxolod imis gamo, rom maT aqvT

epilefsia (Dodrill, Batzel, Queisser, & Temkin, 1980).

kontrolis lokusi

epilefsiis mqone individebs, romlebic gulyrebis gamo

kargaven kontrols sakuTari cxovrebis mniSvnelovan aspeqtebze,

uyalibdebaT kontrolis garegani lokusi, mag., maT mniSvnelovnad

maRali aqvT kontrolis garegani lokusi janmrTel adamianebTan

da diabetis mqone pacientebTan SedarebiT (DeVellis, DeVellis, 1982,

Herman et al., 1996). AamasTan erTad, kargad aris cnobili kavSiri

kontrolis lokussa da fsiqopaTologiisa da qcevis zogierT

maxasiaTebels Soris. zogierTi mklevari miuTiTebs kavSirze

kontrolis garegan lokussa da epilefsiis dros arsebul

fsiqopaTologias Soris (Gramstad, Iversen & Berna, 2001).

stigmis aRqma

sazogadoebis damokidebuleba epilefsiis mimarT xSirad

stigmis/damRis xasiaTs atarebs. stigmis komponentebia

ganmasxvavebeli niSnis gamoyofa da am niSnis matarebeli

pirovnebisTvis iarliyis miniWeba, am adamianisTvis arasasiamovno

niSnis miwera da misi rogorc ”gansxvavebulis” aRqma.

sazogadoebis damokidebuleba ki ganpirobebulia masSi

gabatonebuli crurwmenebiT da SexedulebebiT, romlebsac,

xSirad, mravlsaukunovani istoria aqvT da Tanamedrove

samedicino codnis miuwvdomlobiT.

garSemomyofi adamianebis TvalSi epilefsia da epilefsiis

mqone adamiani daRdasmulia, gansxvavebulia sxva qronikuli

daavadebis mqone pirebisagan. mas xSirad uyureben, rogorc

socialurad miuRebel pirovnebas da mraval akrZalvas uyeneben.

avadmyofi grZnobs amas, icis sazogadoebaSi arsebuli

Sexedulebebi da Tavis mxriv, Zalze mtkivneulad reagirebs aseT

damokidebulebaze. zogierTi avtoris mixedviT (Collings, 1990)

daavadebasTan dakavSirebuli cvladebi epilefsiis, rogorc

daavadebis prediqtoria, xolo sociodemografiuli cvladebi da

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avadmyofis mier sakuTari Tavisa da sakuTari daavadebis aRqma ki

epilefsiis mqone piris zogadi mdgomareobis prediqtoria (Hills &

Baker, 1992).

maSasadame, fsiqikuri darRvevebis mravalsaxeoba epilefsiis

dros ar SeiZleba avxsnaT wminda biologiuri poziciidan _

paTologiuri keris safeTqlis lokalizaciiT.

pirovnebis cvlilebebi epilefsiis dros gamowveulia

mravali faqtoris urTierTzemoqmedebiT. faqtorTa erTi jgufi

dakavSirebulia uSualod daavadebasTan. kerZod, Setevebis dawyebis

adreuli asaki, paroqsizmebis sixSire da tipi, maTi xangrZlivoba,

paTologiuri procesis simZime, misi lokalizacia. faqtorTa meore

jgufi, heterogenulia: asaki, mkurnalobis xarisxi, xasiaTi,

mkurnalobis gverdiTi efeqtebi, muSaobis, cxovrebis pirobebi.

garda amisa, Tavis tvinis funqcionaluri moqmedeba mWidrod aris

dakavSirebuli garemosTan da mniSvnelovnad aris ganpirobebuli am

garemos gavleniT. erTis mxriv daavadeba axdens gavlenas da cvlis

avadmyofis mdgomareobas sazogadoebaSi da, meores mxriv,

socialuri faqtorebi axdenen gavlenas daavadebis ganviTarebaze.

2.4. epilefsiis, rogorc qronikuli daavadebis gavlena

avadmyofis pirovnebaze

zemoxsenebuli yvela koncefcia cal-calke ver xsnis

epilefsiis dros pirovnul-emociuri cvlilebebis mTels speqtrs.

savaraudoa, rom mniSvneloba aqvs faqtorebis erTobliobas,

romelTa wona da kombinaciebi sxvadasxva SemTxvevebSi

gansxvavebulia. amasTan dakavSirebiT, WeSmaritebasTan yvelaze

axlos dganan avtorebi, romlebic pirovnebis cvlilebebs

ganixilaven rogorc ramdenime faqtoris erToblivi gavlenis

Sedegs. pirovnebis paTologiuri Tvisebebi epilefsiis dros

yvelaze kargad aixsneba, erTis mxriv, Tavis tvinis disfunqciiT,

meores mxriv _ avadmyofobasTan adaptaciis sirTuliT da

pirovnebis reaqciiT daavadebaze.

epilefsia qronikuli daavadebaa da epilefsiis diagnozma

mravali damatebiTi problema SeiZleba gamoiwvios, rogorc

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janmrTelobaStan dakavSirebuli, aseve – fsiqosocialur

funqcionirebasTan dakavSirebuli (Gilliam, Mendiratta, Pack & Bazil, 2005).

stigmatizacia, socialuri izolacia, fsiqologiuri problemebi,

interpersonaluri sirTuleebi xSirad gvxvdeba epilefsiiT

daavadebul pirebTan. sxdasxva samedicino. socialurma da

fsiqologiurma faqtorebma (Trimble,1988), SeiZleba garkveuli

gavlena moaxdinon epilefsiiT daavadebulis cxovrebis xarisxze.

kidev erTxel aRvniSnavT, rom epilefsiiT daavadebuli

piris sirTuleebi sxvadasxva mizezebiT SeiZleba iyos gamowveuli.

pirveli, TviT avadmyofurma procesma da Tavis tvinis nebismierma

disfunqciam SeiZleba gavlena moaxdinon individis unarebze. meore,

mkurnalobis xasiaTma aseve SeiZleba Seasrulos garkveuli roli

darRvevebis aRmocenebaSi, romlebic, Tavis mxriv, gavlenas axdens

pacientis cxovrebis xarisxze. mesame, socialurma ganwyobebma,

aseve, SeiZleba ganapirobon epilefsiiT daavadebulis cxovrebis

xarisxis xasiaTi. garemos mxridan epilefsiiT daavadebulis

diskriminacia, stigmatizacia, avadmyofi adamianis miuRebloba,

gavlenas axdens avadmyofis cxovrebis xarisxze. SeiZleba

vivaraudod, rom epilefsiis dros aRmocenebuli fsiqikuri

darRvevebi socialur adaptaciaSi arsebuli sirTuleebis Sedegs

warmoadgens, rac xSirad gamowveulia sazogadoebaSi arsebuli

negatiuri damokidebulebebis arsebobiT daavadebisadmi.

I. Wiley (1979) werda, rom “SiSi da sircxvili es is emociebia,

romlebsac iwvevs epilefsia xalxur mexsierebaSi” (Ryan et al., 1980).

daavadebul pirovnebas SiSi uCndeba mosalodneli gulyris

aRmocenebis gamo, gulyris SemTxvevaSi ki _ eSinia, rom misi

daavadebis gamovlinebebis momswreni SeiZleba gaxdnen sxva

adamianebi; SiSi uCndebaT sxva adamianebs, radganac maT, umravles

SemTxvevaSi, ar acian, Tu rogor moiqcnen gulyris dros; Semdeg

uCndebaT umweobis grZnoba imis gamo, rom ver SeZles adekvaturi

daxmarebis gaweva. meores mxriv, garSemomyofebs rcxveniaT, rom

gaxdnen sxva adamianis daavadebis gamovlinebis momswreni da ver

SeZles sakuTari emociebis damalva, ojaxis wevrebs ki rcxveniaT,

rom sxvam dainaxa maTi axloblis mdgomareoba. yovelive es

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gavlenas axdens rogorc pacientze, aseve, mis garSemo myof

adamianebze da bevrad ganapirobebs maT qcevas. aman SeiZleba

gaamwvavos epilefsiiT daavadebulis fsiqikuri regulaciis

problemebi (Hills & Baker,1992, Hayden, Penna & Buchanan, 1992)

pirovnebis reaqcia sakuTari daavadebisadmi bevrad

damokidebulia mis warmodgenaze epilefsiis Sesaxeb, imaze Tu,

rogor aisaxeba daavadeba avadmyofis cnobierebaSi. dasawyis

stadiaze aRiniSneba sakuTari mdgomareobis simZimis Seufasebloba.

pirvel Setevebs avadmyofebis umetesoba afasebs, rogorc

SemTxveviT movlenebs an akavSirebs gadaRlasTan da sxva garemo

zemoqmedebebTan. iol paroqsizmebs isini saerTod ar aniWeben

seriozul mniSvnelobas, yovelTvis ar asruleben eqimis

daniSnulebas, arRveven reJims manamde, sanam ar aRmocendeba xSiri

an mZime krunCxviTi Setevebi. sxvebi ki azviadeben sakuTar

mdgomareobas, epilefsias ganixilaven, rogorc ganukurnebel

daavadebas an ipoqondriuli simptomebi aqvT. maSasadame,

fsiqologiuri reagireba daavadebis sawyis stadiaze

gansxvavebulia sxvadasxva pirovnebisaTvis.

epilefsiis prognozi da mimdinareoba iseve, rogorc sxva

qronikuli daavadebis SemTxvevaSi, bevrad ganpirobebulia garemos

faqtorebiTac: cxovrebis, Sromisa da dasvenebis pirobebiT,

samkurnalo procesiT da a. S. damatebiTi faqtorebis (fsiqikuri da

fizikuri travma, infeqcia, intoqsikacia, gadaRla da sxva)

zemoqmedebiT daavadeba rTuldeba da zogjer wlebis ganmavlobaSi

Sewyvetili gulyrebi ganaxldeba. garemos faqtorebis mavne

zemoqmedebiT iSviaTi paroqsizmebi xSirdeba, xolo garemos

dadebiTi zemoqmedebiT _ gulyris sixSire da simZime mcirdeba da

xSirad saerTod qreba (ToiZe, 2005).

es kompensatoruli mdgomareoba gamoricxavs paroqsizmul

movlenebs, magram mainc gulisxmobs garkveuli ”deficitis”

arsebobas. “deficitis“ qveS igulisxmeba fsiqologiuri

cvlilebebi (kognituri funqciebis daqveiTeba, xasiaTobrivi

cvlilebebi), rasac ar gaaCnia progresirebis tendencia da agreTve

eeg_s cvlilebebi. avadmyofTa erT jgufSi es ”deficiti” orive

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maCvenebelSi vlindeba, sxvebSi ki Tavs mxolod mxolod

eleqtrofiziologiurad iCens.

epilefsiis prognozs zogjer ukavSireben Setevebis xasiaTs

da sixSires. rig SemTxvevaSi aseTi kavSiri arsebobs, magram

yovelTvis _ ara. zogjer avadmyofebs aqvT iSviaTi Setevebi, magram

gamoxatuli aqvT pirovnebis cvlilebebi da amitom daavadebis

mimdinareobisa da prognozis Taviseburebebis SefasebaSi didi

mniSvneloba eniWeba pirovnebis qronikul cvlilebebs. zustad

isini warmoadgenen Sromiunarianobis daqveiTebis, garemosTan

konfliqtebis safuZvels. isini arTuleben avadmyofis adaptaciis

unars. maSasadame, epilefsiis prognozis Sefasebisas unda

gaviTvaliswinoT ara mxolod paroqsizmebis sixSire da simZime,

Tavis tvinis dazianebis xasiaTi, inteleqtis done, aramed

daavadebis mTliani klinikuri da fsiqopaTologiuri suraTi.

rogorc samarTlianad aRniSnavda H.F. Spate, epilefsia ar

warmoadgens mxolod Tavis tvinis daavadebas, is mTlianad

pirovnebis daavadebaa (Trimble & Dodson,1994).

sakmaod mniSvnelovania kidev erTi faqtoris gaTvaliswineba,

romelic gavlenas axdens daavadebis mimdinareobaze, mkurnalobaze,

mis prognozze da epilefsiiT daavadebul pirovnebaze. es aris

daavadebis etiologiaze warmodgena avadmyofebsa da maT

axloblebSi. sazogadoebaSi gavrcelebulia azri imis Sesaxeb, rom

epilefsia memkvidruli daavadebaa. am Tvalsazrisidan gamomdinare,

avadmyofebis da maTi axloblebis mier epilefsia aRiqmeba,

rogorc raRac fataluri, garduvali, rogorc ganwirulis ganaCeni.

maTi azriT, adamiani sazogadoebis mier gankicxuli, daRdasmuli

xdeba. avadmyofs emsxvreva momavlis yvela perspeqtiva, amitom

pirovnebas uCndeba meoradi fsiqikuri da nevrotuli darRvevebi da

garkveuli sirTuleebi sxva adamianebTan urTierTobis procesSi

(Iivanainen, Uutela, Vilkkumaa, 1980). epilefsiaze swori warmodgenis

Seqmna xels uwyobs aseTi garTulebebis Tavidan acilebas. garda

amisa, ukanasknel periodamde codna epilefsiis Sesaxeb

yalibdeboda fsiqiatriul klinikebSi miRebuli masalis

safuZvelze; vinaidan maTi populacia Sedgeboda ZiriTadad mZime

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epilefsiuri avadmyofebisagan, epilefsia ganixilebida, rogorc

daavadeba, romelic iwvevs Rrma fsiqikur darRvevebs da

fsiqiatriul klinikaSi mkurnalobas saWiroebs. maSin, rodesac

mxolod pacientTa mcire jgufi moiTxovs amgvar mkurnalobas.

zogjer sakmarisia mxolod erTi Seteva imisaTvis, rom adamianma

“epileptikis” statusi miiRos da amas ki mosdevs garkveuli

problemebi, gansakiTrebiT socialur sferoSi (Dodrill & Batzel, 1991).

amitom epilefsia SeiZleba ganvixiloT, rogorc “socialurad

markirebuli” daavadeba (Jacoby, Snape & Baker, 2005).

rogorc vxedavT, literaturaSi winaaRmdegobrivi monacemebia

da dRemde ar arsebobs Tanxmoba epilefsiis dros pirovnul-

emociuri sferos cvlilebebis bunebisa da mizezebis Sesaxeb.

klinikuri dakvirvebebi da kvlevebi epilefsiis dros pirovnebis

da emociuri sferos cvlilebebis safuZvlad miiCneven an

biologiur, daavadebasTan dakavSirebul, an ki fsiqo-socialur

faqtorebs. mxolod ramdenime gamokvlevaa, sadac yuradReba

gamaxvilebulia epilefsiis dros pirovnebisa da emociuri sferos

cvlilebebis multifaqtorul bunebaze (Hermann &Whitman, 1992,

Mensah, Beavis, Thapar & Kerr, 2006).

literaturuli monacemebis safuZvelze, SeiZleba gavakeToT

daskvna, rom pirovnebis Tavisebureba epilefsiis dros savaraudod

Semdegi faqtorebiT aris ganpirobebuli:

avadmyofis premorbiduli pirovnuli TaviseburebebiT;

TviT avadmyofobis procesiT da Tavis tvinis sxvadasxva

saxis disfunqciiT, epilefsiuri keris lokalizaciiT, Setevebis

sixSiriTa da maTi simZimiT;

mkurnalobis xasiaTiTa da mimdinareobiT, romlis

warmateba/warumatebloba xSirad gavlenas axdens pacientis

cxovrebis xarisxze;

organizmis kompensatorul SesaZleblobebiT;

garemos gansxvavebuli faqtorebis zemoqmedebiT, maT Soris

aRzrdis stiliT, sazogadoebis damokidebulebiT daavadebulisa da

daavadebisadmi da a. S.

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socialuri ganwyobebiT, ramac SeiZleba ganapirobos

epilefsiiT daavadebulis cxovrebis stilis Secvla: diskriminacia,

stigmatizacia.

pirovnebis Sinagani resursebiT, kerZod misi stresis

daZlevis strategiiT;

daavadebis Sinagani suraTiT, romelic ganapirobebs

pirovnebis damokidebulebas sakuTari daavadebisadmi.

amrigad, epilefsiis prognozis Sefasebisas unda

gaviTvaliswinoT ara mxolod paroqsizmebis sixSire da simZime,

Tavis tvinis dazianebis xasiaTi, pirovnebis inteleqtis done,

aramed daavadebis mTliani klinikuri suraTi, romelSic daavadebis

Sinagan suraTs, Cvenis azriT, centraluri adgili ukavia. es is

fenomenia, romelic aerTianebs pirovnebis emociur

damokidebulebas daavadebis, sakuTari Tavisa da garSemomyofebis

mimarT daavadebiT Secvlil situaciaSi.

Tavi 3. kvlevis mizani da amocanebi

is, Tu ra saxis pirovnul-emociuri cvlilebebi Cndeba

qronikuli daavadebisas, bevrad gansazRvravs avadmyofis

mkurnalobis warmatebas. garda farmakologiuri mkurnalobisa,

mniSvnelovania fsiqologiuri da fsiqosocialuri Carevis

ganxorcieleba; amisTvis ki aucilebelia im pirovnul-emociuri

faqtorebis gansazRvra romlebic Tavs iCens qronikuli daavadebis

dros. epilefsiiT daavadebuli pirovnebis mkurnaloba mxolod

avadmyofobis mkurnalobas ar unda warmoadgendes da arcTu

meorexarisxovan rols asrulebs fsiqologiuri daxmarebac,

romlis mizania avadmyofis adekvaturi socialuri, SromiTi da

pirovnuli adaptaciisa da reabilitaciias miRweva. swored,

daavadebis Sinagani suraTis analizi daavadebaze pirovnebis

reagirebis tipis Seswavlis safuZvelze, iZleva adekvaturi

fsiqologiuri daxmarebis dagegmvisa da mkurnalobis pacientze

individualuri moargebis saSualebas, aseve, SesaZlo garTulebebis

droulad aRmoCenasa da aridebas.

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daavadebis Sinagani suraTis struqtura mravalfaqtoriania. mis

formirebaSi garkveul rols TamaSobs socialuri, fsiqologiuri

da biologiuri faqtorebi, romelTa gaTvaliswineba aucilebelia

yovel konkretul SemTxvevaSi.

amasTan dakavSirebiT, kvlevis mizania safeTqlis epilefsiis

dros daavadebis Sinagani suraTis Seswavla daavadebaze riagirebis

tipis gamovleniT da misi kavSiris kvleva pirovnebis

maxasiaTeblebTan da interpersonaluri urTierTobis stilTan.

kvlevis interess warmoadgens is faqtorebi, romlebic SeiZleba

gavlenas axdebs daavadebis Sinagan suraTze da Sesabamisad,

daavadebis reagirebis tipze: daavadebis biologiuri faqtorebi,

pirovnebis tipi, misi urTierToba uaxloes socialur garemosTan,

Tu maTi kombinacia. safeTqlis epilefsiis jgufis SerCeva

ganapiroba im faqtma, rom pirovnul-emociuri sferos cvlilebebi

yvelaze xSiria, xolo fsiqo-socialuri dezadaptaciis riski ki

maRalia epilefsiis am formis dros.

kvlevaSi safeTqlis epilefsiis, rogorc qronikuli daavadebis

Sinagani suraTis Seswavla da misi SedarebiTi analizi Catarda

iseT qronikul daavadebasTan mimarTebaSi, romelic ar iwvevs

stigmatizacias, magram msgavsi SezRudvebiTa da riskebiT

xasiaTdeba, kerZod, gulis iSemiur daavadebasTan.

epilefsia _ Tavis tvinis polietiologiuri qronikuli

daavadebaa, romelic xasiaTdeba ganmeorebadi krunCxviTi,

arakrunCxviTi SetevebiT, aRmocenebulia Tavis tvinSi Zlieri

neironuli ganmuxtvis Sedegad da maT Tan axlavT sxvdasxva

emociuri Tu fsiqikuri cvlilebebi. odnav dawvrilebiT

gavCerdebiT safeTqlis epilefsiis gansazRvraze. safeTqlis wilis

epilefsia aris sxvadasxva etiologiis fokaluri epilefsia

epileftogenuri dazianebis keriT safeTqlis wilSi. gulyrebi

SesaZloa gamovlindes ynosviTi, gemovnebiTi, epigastruli,

iSviaTad smeniTi SegrZnebebiT; afaziiT, dismnestiuri sipmtomebiT,

iluziebiT, halucinaciebiT: agreTve – fsiqomitoruli gulyrebiT

cnobierebis SecvliT, oraluri da rTuli avtomatizmebiT;

fokaluri sawyisis mqone generalizebuli tonur-klonuri

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krunCxvebiT (ToiZe o., 2005). es aris epilefsiuri sindromebis erT-

erTi yvelaze gavrcelebuli forma.

gulis koronaruli daavadeba dakavSirebulia gulis

sisxlZarRvebis sxvadasxva saxis disfunqciasTan. misi klinikuri

manifestacia gxvdeba zrdasrul asakSi da moicavs stenokardias,

miokardiumis infarqts, gulis ukmarisobas da sxva.

arsebuli gansxvavebis miuxedavad am or mdgomareobas aqvs

bevria saerTo. pirvel rigSi es aris maTi qronikuloba, daavadebiT

gamowveuli cxovrebis wesis radikaluri Secvla (reJimis mkacri

dacva, fizikuri aqtivobis garkveuli SezRudva, mravalwliani

mkurnalobis aucilebloba da sxva). orive mdgomareoba SeiZleba

garkveulwilad sicocxlisaTvis saSiSi iyos. orives Tan axlavs

fsiqosocialuri cxovrebis cvlileba. orive mdgomareoba SeiZleba

ganvixiloT, rogorc naklebad winaswarmetyvelebadi. orives Tan

axlavs depresiis garkveuli done.

kvlevis miznebia:

daavadebaze reagirebis tipisa da masze moqmedi faqtorebis

analizi safeTqlis epilefsiis dros;

daavadebaze reagirebis tipsa da interpersonaluri

urTierTobis tips Soris kavSiris dadgena safeTqlis epilefsiis

dros;

qronikuli daavadebis dros aRmocenebuli daavadebaze

reagirebis tipis maxasiaTeblebis, daavadebis Sinagani suraTis

daxasiaTeba safeTqlis epilefsiisa da gulis iSemiuri daavadebis

mqone jgufebis Sedarebis safuZvelze.

kvlevis amocanebia:

1. safeTqlis epilefsiisa da gulis iSemiuri daavadebis

mqone pacientebis daavadebaze reagirebis tipis kvleva da

maTi urTierTSedareba;

2. safeTqlis epilefsiis dros daavadebaze reagirebis tipis

kavSiris gansazRvra daavadebis cvladebTan da pirovnul

maxasiaTebelebTan.

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mqone pacientebis interpersonaluri urTierTobis kvleva

da maTi SedarebiTi analizi;


mqone pacientebTan daavadebis Sinagani suraTis

interpersonaluri urTierTobis tipTan kavSiris kvleva

da maTi SedarebiTi analizi.

3.1. kvlevis meTodebi

aRniSnuli amocanebis gadawyvetisaTvis gamoyenebuli iyo

kvlevis Semdegi instrumentebi:

daavadebaze reagirebis tipis gamosavlenad _ Cvens mier

modificirebuli bexterevis institutis pirovnuli kiTxvari (ЛОБИ),

rogorc daavadebis Sinagani suraTis aRweris saSualeba;

pirovnuli Taviseburebebis gamokvlevisaTvis _ aizenkis

pirovnuli kiTxvari (EPQ)

T. Leary-is interpersonaluri diagnostika (l.n. sobCakis mier

modificirebuli varianti);

depresiis arsebuli donis dadgenisaTvis _ bekis depresiis

skala (BDI)

meTodebis aRwera:

bexterevis institutis pirovnuli kiTxvari (ЛОБИ- Личностный

Опросник Бехтеревского Института) _ pirovnuli kiTxvaria, romelic

SemuSavebulia v. m. bexterevis saxelobis institutSi da gamoiyeneba

daavadebisadmi damokidebulebis tipis diagnostirebisaTvis

qronikuli somaturi daavadebis mqone pirebTan.

Cvens mier modificirebuli kiTxvari (kiTxvaris gadamuSavebaSi

monawileobas Rebulobda 40 eqsperti) Sedgeba, avadmyofobis mimarT

damokidebulebaTa amsaxveli msjelobebis 8 qvejgufisagan:

damokidebuleba mkurnalobisadmi, damokidebuleba eqimebisadmi,

damokidebuleba garSemomyofebisadmi, damokidebuleba sakuTari

momavlisadmi, damokidebuleba muSaobisadmi (swavlisadmi),

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damokidebuleba axlobel_naTesavebisadmi, sakuTari daavadebisadmi

da zogadi guneba_ganwyobileba.

avadmyofs vTxovT yuradRebiT waikiTxos TiToeuli msjeloba

da Semoxazos is msjeloba, romelic yvelaze zustad asaxavs mis

mdgomareobas. Tu arc erTi msjeloba mas ar exeba _ Semoxazos

simbolo “0”, xolo Tu ar surs pasuxis gaceba romelime qvejgufSi

Semaval kiTxvaze _ SeuZlia gamotovos is. avadmyofs vafrTxilebT,

rom uaryofiTi pasuxebis ricxvi da pasuxis gareSe darCenili

qvejgufis ricxvi ar unda aRematebodes sams. dro gansazRvruli ar

aris.

diagnostirdeba reagirebis mxolod is tipebi, romelTa mimarT

miRebulia e. w. “minimaluri sadiagnostiko maCvenebeli”, rac

empiriulad dgindeba; anu diagnostirdeba mxolod is tipebi,

romelTa qulebi aRwevs an aRemateba mocemuli tipisaTvis minimalur

diagnostikur maCvenebels. Tu minimaluri sadiagnostiko maCvenebeli

miiReba ramdenime tipis mixedviT, diagnostirdeba 2_3 tipi, sadac es

maCvenebeli yvelaze didia. am SemTxvevaSi laparakia Sereuli

tipebis Sesaxeb. reagirebis harmoniuli tipi diagnostirdeba

mxolod im SemTxvevaSi, Tu ar miiReba romelime sxva tipi. Sereul

tipebSi harmoniuli tipi ar diagnostirdeba.

daavadebaze reagirebis Semdegi cxra tipi vlindeba:

1. eiforiul_anozognozuri _ umizezod aweuli guneba_ganwyoba,

reJimis darRveva, daavadebis obieqturi gamovlinebebisa da misi

SesaZlo Sedegebis aqtiuri uaryofa, daavadebis simptomebis

miwera SemTxveviTi movlenebisadmi.

2. SfoTviT_ipoqondriuli _ mudmivi fiqri daavadebis saSiSroebis

da mkurnalobis araefeqturobis Sesaxeb; mkurnalobis axali

saSualebebis da daavadebaze damatebiTi informaciis mudmivi

Zieba, sakuTar subieqtur SegrZnebebze yurdRebis gamaxvileba,

realuri daavadebis gazviadeba;

3. senzitiur_obsesiur_fobiuri _ naTesavebsa da axloblebisTvis

Tavis mobezrebis da mZime tvirTad yofnis SiSi; avadmyofobis

gamo garSemomyofebis mier arasrulfasovnad aRqmis SiSi; ufro

metad aRelvebT warmosaxviTi sirTuleebi, vidre realuri,

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daavadebis saeWvo garTulebebi da SesaZlebeli, magram

usafuZvlo warumatebloba ojaSi da samsaxurSi;

4. melanqoliuri _ uimedobis gancda, daTrgunva avadmyofobiT,

gamojanmrTelebis rwmenis dagargva, pesimizmi, depresiuli,

zogjer suiciduri azrebic ki. ar sjeraT mkurnalobis

warmatebisa dadebiTi obieqturi Sedegebis SemTxvevaSic;

5. harmoniuli _ sakuTari mdgomareobis adekvaturi, obieqturi

Sefaseba, mkurnalobisadmi aqtiuri xelSewyoba, sakuTari

interesebisa da miznebis gardaqmna avadmyofobiT Secvlil, axal

cxovrebiseul situaciaSi;

6. apaTiuri _ sruli gulgriloba sakuTari momavlisadmi,

daavadebis mimdinareobisadmi, mkurnalobis Sedegebisadmi,

mkurnalobisadmi pasiuri damorCileba, interesebis sferos

Seviwroveba;

7. paranoialuri _ rwmena imisa, rom daavadeba sxvaTa zegavlenis

Sedegia; sxvebis dadanaSauleba (naTesavebi, TanamSromlebi,

eqimebi), braldebebi maT mimarT da dasjis moTxovna,

mkurnalobisadmi undobloba, avadmyofobis garTulebebis

eqimebis daudevrobisaTvis miwera.

8. ergopaTiuri _ “gaqceva samuSaoSi”, daavadebis simZimis

miuxedavad cdiloben muSaobis gagrZelebas, muSaoben ufro mets

da ufro meti intensivobiT, mkurnaloben mxolod im SemTxvevaSi,

Tu es samsaxuris (swavlis) gagrZelebas ar SeuSlis xels;

9. egocentruli _ “gaqceva avadmyofobaSi”; sakuTari gancdebis

saaSkaraoze gamotana garSemomyofTa yuradRebis mipyrobis

mizniT, gansakuTrebuli zrunvis moTxovnileba, sakuTari

pirovnebis mimarT gansakuTrebuli yuradRebis moTxovna

daavadebis pirobebSi.

aRsaniSnavia, rom daavadebaze reagirebis tipi SeiZleba mTlianad

ar Seesamabodes romelime am aRweril tips da am SemTxvevaSi,

saubaria reagirebis Sereul tipze, mag., ergopaTiur_SfoTviTi an

melanqoliur_ egocentruli da a. S. unda aRiniSnos, rom

daavadebaze reagirebis harmoniuli tipi dasturdeba mxolod sxva

82

tipebis gamoxatuli gamovlinebebis ararsebobis SemTxvevaSi. sxva

SemTxvevaSi Cven SegviZlia visaubrod mxolod tendenciis Sesaxeb.

A AT. Leary-is interpersonaluri diagnostika. meTodika

gamoiyeneba pirovnuli interpersonaluri urTierTobis stilisa da

struqturis Taviseburebebis SeswavlisaTvis da avlens pirovnebis

konfliqtis zonebs. is Seicavs pirovnuli

urTierTzemoqmedebisaTvis damaxasiaTebel lakonuri Tvisebebis 128

CamonaTvals. aqedan pirovnebam unda airCios is Tvisebebi, romlebic,

misi azriT, axasiaTeben mis “realur me-s” (“rogori var me

sinamdvileSi”, “aqtualuri me”). avadmyofs vTxovT yuradRebiT

waikiTxos TiToeuli maxasiaTebeli da Semoxazos im Tvisebis

Sesatyvisi nomeri, romelic yvelaze metad uaxlovdeba mis

warmodgenas sakuTar Tavze.

es meTodika iqna arCeuli, imis gamo, rom is, Cvenis azriT, iZleva

garemosTan urTierTobis srul suraTs.

kvlevaSi yurdadReba gamaxvilebulia “realuri-me”-s Sefasebaze.

gamoiyofa 8 tipi anu interpersonaluri qcevis 8 tendencia (e.w.

pirveladi faqtori an oqtanti), rac gamovlinebis intensivobis

mixedviT (adaptacia-dezadaptacia) raodenobrivad aris Sefasebuli

1-dan 16-mde. esenia:

1. Zalaufleba-liderobis (avtoritaruli) _ amJRavnebs sakuTar

Tavsa da SesaZleblobebSi rwmenas, xelmZRvanelis da

organizatoris Tvisebebs (8 qulamde). magram maRali qulebis

SemTxvevaSi aRiniSneba sakuTari SesaZleblobebis gadafaseba,

sxvaTa kritikis miuRebloba (12 qulamde), msjelobebis

avtoritaruli stili, sxvebze Zalauflebis survili, xSirad

despotizmis niSnebi (12-16).

2. damoukidebel-dominanturi _ amJRavnebs urTierTobis

damoukidebel, mebrZol tips, sakuTar TavSi darwmunebulobas

(8 qulamde), xolo maRali qulebis (12-16) SemTxvevaSi _

urTierTobebis TviTkmayofil, narcisistul tips sakuTari

upiratesobis gaZlierebuli grZnobiT da tendenciiT mudmivad

hqondes sakuTari, sxvebisagan gansxvavebuli azri;

83

3. sworxazovan-agresiuli _ miRebuli qulebis mixedviT es

oqtanti gamoavlens energiulobas, uSualobas,

mizandasaxulobas, an sijiutes, agresiulobas (maRali qulebi

12-16);

4. undobeli-skeptikuri _ msjelobebis da qcevebis realizmi,

skeptikuroba, arakonformizmi (qulebi 1-8), romelic SeiZleba

gadaizardos undoblobaSi, eWvianobaSi, garSemomyofebisadmi

gansakuTrebiT kritikul damokidebulebaSi, sakuTari negativizmis

xSirad verbalur agresiaSi gamovlenaSi;

5. morcxvi-damorCilebuli _ avlens iseT Tvisebebs, rogoricaa

simorcxve, TavSekavebuloba, sxvaTa valdebulebebis sakuTar Tavze

aRebis midrekileba. maRali qulebis (12-16) SemTxvevaSi _ sruli

damorCileba, pasiuroba, TviTgvemis gaZlierebuli grZnoba;

6. damokidebuli-damjeri _ sxvaTa mier aRiarebis, ndobis da

sxvebisagan daxmarebis miRebis moTxovnileba, ususuroba,

winaaRmdegobis gawevis SeuZlebloba. maRali qulebis (12-16)

SemTxvevaSi _ konformuloba, sruli damokidebuleba garSemomyofi

adamianebis azrze;

7. TanamSromlobiT-konvenciuri _ pirovnuli urTierTobis am

stilis mqone adamianebi iswrafvian garSemomyofebTan axlo,

megobruli urTierTobebis damyarebisaken. maRali qulebis (12-16)

SemTxvevaSi vlindeba kompromisuli qceva, garSemomyofTa yvela

moTxovnilebis dakmayofilebis mcdeloba realuri situaciis

miuxedavad;

8. pasuxismgebliani-gulisxmieri (altruistuli)_

pasuxismgeblobis ganviTarebuli grZnoba, garSemomyofsadmi

daxmarebis gawevis mzadyofna, gulisxmiereba, sxvebze zrunvis

survili, uangaroba. maRali qulebi (12-16) gulisxmobs Zlier

pasuxismgeblobas, hipersocialurobas, xSirad altruizms,

daxmarebis Zlier survils arsebuli situaciis miuxedavad.

TuUTvisebebis ricxobrivi maCvenebeli ar aRemateba 8 qulas,

maSin SeiZleba visaubroT harmoniuli pirovnebis Sesaxeb.

maCveneblebi, romlebic aRematebian 8 qulas, miuTiTeben mocemuli

Tvisebis aqcentuaciaze. maRali qulebi (12-16) socialuri adaptaciis

84

sirTuleebze miuTiTebs. yvela oqtantSi miRebuli dabali

maCvenebeli (0_3 qulamde) SeiZleba iyos pirovnebis

aragulaxdilobis Sedegi da maTi sandooba naklebad misaRebia.

urTierTobebis pirveli oTxi tipi _ 1, 2, 3 da 4 _ xasiaTdeba

arakonformuli da xSirad konfliqturi tendenciebis arsebobiT (3,

4 oqtanti), damoukideblobiT, mizandasaxulobiT da liderobisadmi

da dominirebisadmi tendenciiT (1, 2 oqtanti). meore oTxi tipi _ 5, 6,

7 da 8 _ sawinaaRmdego suraTs gviCvenebs:NG konformulobas,

kongruentobas garSemomyofebTan kontaqtebSi (7, 8 oqtanti), sakuTar

TavSi daurwmuneblobas, damorCilebas, midrekilebas

kompromisebisadmi (9, 5, 6 oqtanti).

garda pirveladi faqtorebisa, gamoyofilia e.w. meoradi

maCveneblebic:D dominireba-damorCilebisa da keTilmosurneoba-

mtrobis maCvenebeli, romlebic ganixileba, rogorc pirovnuli

urTierTzemoqmedebis ori ZiriTadi faqtori. maTi mniSvneloba

miiReba pirveladi faqtorebis maCveneblebis safuZvelze Semdegi

formulebis mixedviT:

D=(1 - 5) + 0,7 (3 + 2 - 4 - 6)

L=(7 - 3) + 0,7 (8 - 2 - 4 + 6)

D faqtoris dadebiTi mniSvneloba miuTiTebs dominirebaze,

uaryofiTi ki _ damorCilebaze: faqtoris dadebiTi mniSvneloba _

keTilmosurneobaze, uaryofiTi ki _ mtrobaze. ��

aizenkis kiTxvari (EPQ). avadmyofis pirovnuli Taviseburebebis

SeswavlisaTvis gamoyenebuli iyo aizenkis tipologiuri kiTxvari.

meTodika Seicavs oTx skalas: eqstraversia-intraversia,

neiroticizmi, fsiqotizmi da specifikuri skala, .e.w. ‘’sicruis

skala”, romelic zomavs adamianis gulwrfelobas kiTxvebze pasuxis

gacemisas. es meTodika arCeuli iyo aizenkis Teoriis

gaTvalisiWinebiT.

es meTodika arCeuli iyo pirovnebis konstituciuri

maxasiaTeblebis kvlevis mizniT. kerZod, aizenkis modelis mixedviT

Tavis tvinis qerqis agzneba-Sekavebis Taviseburebebi gansazRvravs

pirovnebis reagirebas garegan da Sinagan stimulebze da garemosTan

adaptaciis xasiaTze. Sesabamisad, safeTqlis epilefsiis, rogorc

85

qronikuli nevrologiuri daavadebisas konstituciuri pirovnuli

maxasiaTeblebis gamovlenis mizniT gamoyenebuli iyo EPQ.

Aaizenki Tvlis, rom adamianis emociur maCveneblebze gavlenas

axdens agzneba-Sekavebis biologiuri faqtorebi da limburi sistema

aris am procesis mniSvnelovani rgoli. magram aizenki aRniSnavs,

rom emociuri darRvevebi ar warmoadgenen mxolod genetikuri

ganwyobis Sedegs. “genetikurad gadaecema adamianis ganwyoba moiqces

da imoqmedos garkveuli saxiT konkretul situaciebSi moxvedris

dros “ (aizenki, 1982, p.29). amrigad aizenki Tvlis, rom garemos

faqtorebi garkveul wilad gavlenas axdenen am predispoziciaze.

agzneba-Sekaveba gansazRvras garkveul emociur maxasiatebelebs. misi

Secvla ar SeiZleba, magram SesaZlebelia im socialuri faqtorebze

zegavlena, romlebic ganapirobeben ama Tu im reaqciis gamovlenas

(Eysenck, 1 990).

safeTqlis epilefsia, rogorc wesi, limburi sistemis

abnormalur funqcionirebas gulisxmobs da am mxriv sainteresoa,

axdenen Tu ara predispoziciuri biologiuri faqtorebi gavlenas

daavadebis Sinagani suraTis Camoyalibebaze mxolo safeTqlis

epilefsiis dros, Tu sxva es Tavs iCens sxva samedicino daavadebis

drosac.

eqstraversia-introversia Semdeg maxasiaTeblebSi vlindeba:

a) tipiuri eqstraverti _ uyvars mxiaruleba, socialurad

Riaa,mimarTulia gareT, hyavs bevri megobari, yvelafers axals

advilad amCnevs da iTvisebs, optimistia, advilad gamoxatavs

sakuTar emociebs, xSirad impulsuria da moqmedebs momentis

gavleniT, urCevnia moZraoba da moqmedeba;

b) tipiuri introverti _ Tavis TavSi CaRrmavebuli pirovnebaa,

midrekilia TviTanalizisadmi, Hyavs erTi an ramdenime megobari,

sanam raimes gaakeTebs _ didxans fiqrobs, akontrolebs Tavis

emociebs, pesimistia, misi qceva sazogodoebriv normebzea agebuli.

intravertirebuli pirovnebis tipi SigniT mimarTuli pirovnebaa,

romelic gare samyaros gaurbis.

introversia-eqstraversiis, rogorc pirovnebis

ganzomilebasTan erTad, aizenkma Semoitana neirotizmis (emociuri

86

labiloba_stabiloba) ganzomilebac, romelsac ganixilavs, rogorc

pirovnebis savsebiT damoukidebel faqtors.

g) neirotizmi _ emociuri mdgradoba, aizenkis mixedviT,

axasiaTebs emociur mdgomareobas, rac zogierTi niSnebiT

dakavSirebulia nervuli sistemis labilurobasTan. emociuri

mdgradoba _ Tvisebaa, romelic gamoxatavs organizebul qcevas,

situaciur mizandasaxulobas, xasiaTdeba adaptaciis kargi unariT,

liderobisadmi ltolviT. emociurad mdgradi adamiani mSvidia,

TavSekavebuli, acnobierebs sakuTar qcevas, misi emociebi naklebi

siZlieriT vlindeba. neirotizmi anu emociuri labiluroba

gamoixateba Zlier emociur aramdgradobaSi, adaptaciis daqveiTebul

unarSi, maRal SfoTvaSi, depresiul reaqciebSi, yuradRebis

gafantulobaSi, hipermgrZnobelobaSi. aseTi adamiani ufro advilad

gamodis mwyobridan, mousvenaria, misi emociebis gamowveva advilad

xdeba, xSirad icvlis interesebs, ar aris darwmunebuli sakuTar

TavSi, xasiaTdeba araadekvaturad Zlieri reaqciebiT.

Dd) fsiqotizmis-super-ego skala miuTiTebs asocialur

qcevaze, emociuri reaqciebis araadekvaturobaze, maRal

konfliqturobaze, xSirad arakontaqturobaze da egocentrulobaze

(fsiqotizmis skala pirvelad Semotenili iyo 1968 wels).

aizenkis kiTxvaris Cvens mier gamoyenebuli forma Sedgeba 110

kiTxvisagan alternatiuli pasuxebiT “ki” an “ara”. 40 maTgani

ikvlevs pirovnebas eqstraversia_introversiis skalaze, 40 _

stabiloba_labilobis (neirotizmis) skalaze, 20 _ miekuTvneba e. w.

“sicruis skalas“ da 10 Tavisufali kiTxva.

eqstraversia-introversiis skalaze miRebuli maRali qulebi

Seesabameba pirovnebis eqstravertirebul tips, dabali ki _

introvertirebul tips. saSualo maCvenebelia _ 7-15 qula.

neirotizmis skalaze miRebuli maRali qula miuTiTebs maRal

fsiqikur aramdgradobaze. saSualo maCvenebelia _ 8-16 qula.

maRali qula fsiqotizmis skalaze gviCvenebs maRal

konfliqturobas. saSualo maCvenebeli _ 5-12 qula.

maRali qulebi neirotizmis skalaze jer kidev ar niSnavs imas,

rom saqme gvaqvs nevrozTan fsiqoanalitikuri gagebiT (aracnobieri

87

moTxovnilebebis safuZvelze aRmocenebuli pirveladi darRvevebi).

neirotizmi niSnavs mxolod garkveuli midrekilebis arsebobas

nevrotuli darRvevebis ganviTarebisaken.

Tu sicruis skalaze miRebuli qulebis raodenoba aRemateba 10-s,

Sedegebi arasaimedod iTvleba.

bekis depresiis skala (BDI). depresia xSirad Tan axlavs mZime somatur daavadebas. magram ar

iqneboda swori imis aRniSvna, rom yvela somaturi pacienti

depresiulia da rom es normaluri reaqciaa daavadebaze.

depresiis Sefasebis tradiciuri forma TviTSefasebaa. erT-erTi

aseTi meTodikaa Beck Depression Inventory ( BDI ).

BDI gamoiyeneba, rogorc TviTSefasebis saSualeba. is Sedgeba 21

kiTxvisgan, rac asaxavs depresiis specifikur simptomebs. am

simptomebis xarisxi Tanamimdevrulad Sefasebulia 0_dan 3 _mde.

punqtebi da Sefasebis qulebi miRebulia empiriulad. avadmyofma

unda aRniSnos, Tu romeli asaxavs mis arsebul mdgomareobas

yvelaze zustad.

BDI mTlianad moicavs depresiis simptomatologias, magram mas

aqvs aseve kognituri Sinaarsis aqcentuaciis tendencia. kiTxvebis 2

jgufi exeba afeqtebs, 11 _ kognicias, 2 _ farul qcevas, 5 _

somatur simptomebs da 1 _ interpersonalur maxasiaTeblebs.

gaTvaliswinebulia depresiis yvela ZiriTadi simptomi. BDI

mgrZnobiarea iseTi klinikuri cvlilebebisadmi, rogoric aris

medikamenturi da qceviTi Terapiuli zemoqmedeba.

3.2 kvlevaSi monawile pirTa maxasiaTeblebi

kvlevaSi monawileoba miiRo 155 respodentma. MmaT Soris aris

54 safeTqlis epilefsiiT daavadebuli, 31 gulis iSemiuri

daavadebis mqone piri da 70 praqtikulad janmrTeli piri.

gamokvlevebi Catarebuli iyo i. sarajiSvilis sax. klinikuri

da eqsperimentuli nevrologiis institutis epilefsiis

ganyofilebis bazaze. gamokvleuli iyo 54 safeTqlis epilefsiis

mqone avadmyofi, Setevebis sxvadasxva formebiT. maT Soris 28 qali

88

da 26 mamakaci, umaRlesi da saSualo ganaTlebiT. avadmyofTa

saSualo asaki iyo 36,4 weli. gamoiyo sami asakobrivi jgufi:

17-25 weli

26-37 weli

38 welze zeviT

avadmyofebi gansxvavebodnen erTmaneTisagan paTologiuri keris

ubnis mxareobiT, daavadebis dawyebis asakiT, gulyris tipis,

gulyrris sixSiris da mkurnalobis tipis (mono-poliTerapia)

mixedviT. daavadebis etiologiuri faqtorebs ZiriTadad

warmoadgenen: neiroinfqecia, maT Soris adreul asakSi miRebuli,

qala-tvinis travma, dabadebis travma da Tavis tvinis atrofiuli

procesebi. cxrilSi #7 moyvanilia jgufis zogierTi maxasiaTebeli.

cxrili #7. safeTqlis epilefsiis mqonejgufis monacemebi

Eepilefsiis jgufis cvladebi raodenobrivi maCveneblebi

sul epilefsiis mqone pirTa raodenoba

54

sqesi: MmdedrobiTi mamrobiTi

2826

saSualo asaki 36,4GganaTlebis done: saSualo umaRlesi

2428

Aasakobrivi jgufebi: 17-25 weli 26-37 weli 38< weli

91926

lateralizacia: upiratesad marcxena upiratesad marjvena

3222

daavadebis dawyebis asaki: 1-10 weli11-20 weli21< weli

182214

GgulyraTa sixSire: </weliwadSi </TveSi </kviraSi

142812

Mmkurnalobis tipi: MmonoTerapia poliTerapia

2826

89

epilefsiuri keris lateralizacia klinikuri da eeg-s

monacemebis safuZvelze dgindeboda. 54 avadmyofidan 32-s hqonda

paTologiuri keris aqtivoba upiratesad marcxena safeTqelSi da 22-

s _ upiratesad marjvena safeTqelSi. Setevebis sixSire varirirebda

1-2-dan weliwadSi 2-3-mde kviraSi. miRebulia daavadebis dasawyisis

sami kategoria (Herman et al., 1996): daavadebis dasawyisi bavSvobaSi _ 1-

12 w., dasawyisi ymawvilobis asakSi _ 13-18 w., da mozrdilobis asakSi

_ 19-42 w., sxva avtorebis mier miRebulia daavadebis dasawyisis

Semdegi kategoriebi : 1-10 w., 11-20 w., 11-30w., 30-ze meti.

Cvens mier daavadebis dawyebis asaki sam jgufad iyo dayofili:

1-10 weli;

11-20 weli;

21 welze zeviT.

mkurnalobis tipis gansazRvrisas miRebulia ori jgufi:

monoTerapia da poliTerapia.

gamokvleulTa ricxvSi ar Sediodnen avadmyofebi zogadi

inteleqtualuri donis daqveiTebiT, rac dgimdeboda

neirofsiqologiuri gamokvlevis safuZvelze da pacientebi

daavadebis statusuri mimdinareobiT.

gulis iSemiuri daavadebis mqone pacientebis gamokvlevebi

Catarda kardiologiis institutis bazaze. PpacientTa raodenoba

Seadgenda 31-s. MmaT Soris iyo 15 qali da 16 mamakaci, saSualo asaki

- 47 weli. Ggamoiyo erTi asakobrivi jgufi: 38 welze zeviT.

daavadebis dawyebis asaki aseve erT jgufad iyo warmodgenili: 21

welze zeviT.

sakontrolo jgufi Seadgenda praqtikulad janmrTel 70 cdis

pirs, saSualo asakiT 33 weli. maT Soris iyo 28 qali da 32 mamkaci.

Ggamoiyo sami asakobrivi jgufi:

17-25 weli – 16 cdis piri

26-37 weli _ 31 cdis piri

38 wels zeviT _ 23 cdis piri

kvlevis procedura: safeTqlis epilefsiis mqone pirebTan

procedura Sedgeboda ori etapisagan. pirvel etapze cdis pirebs

90

utardebodaT neirofsiqologiuri gamokvleva, romelic miznad

isaxavda pacientTa SesaZlo darRvevebis gamoricxvas. Tu

neirofsiqologiuri gamokvlevis safuZvelze dgindeboda garkveuli

problemebis arseboba (metyvelebaSi, mexsierebaSi, azrovnebaSi),

kvlevis Catareba am pacientTan mTavrdeboda. Tu pacientTan ar

vlindeboda umaRlesi fsiqikuri funqciebis darRveva, amave etapze

mas utardebida BDI, depresiis arsebuli donis gamosakvlevad.

meore etapze, pacientebs utardebodaT struqturuli

interviu, daavadebis aRmocenebis da misi mimdinareobis Sesaxeb,

raTa momxdariyo daavadebasTan dakavSirebuli cvladebis

diferenciacia. Semdeg maT utardebodaT daavadebaze reagirebis

kiTxvari (ЛОБИ), interpersonaluri urTierTobis Leary_is

diagnostikuri kiTxvari da aizenkis EPQ kiTxvari.

kvlevaSi miRebuli monacemebi damuSavebul iqna statistikuri

programis SPSS 12.0-is saSualebiT. gamoyenebuli iyo aRweriTi da

daskvniTi statistikis Semdegi sazomebi: saSualo ariTmetikuli,

standartuli gadaxra, jgufTaSorisi da jgufis Sida saSualoTa

Soris gansxvavebis sandooba Semowmda T-testis da kruskal-

uolisis koeficientis saSualebiT. gamoyenebul iqna dispersiuli

da regresiuli analizi, aseve, faqtoruli analizi (mTavari

komponentebis meTodi).

Tavi 4. Sedegebis aRwera

4.1. safeTqlis epilefsiis mqone pirTa Sedegebi

am TavSi mocemulia safeTqlis epilefsiis mqone pirTa

daavadebaze reagirebis tipis, interpersonaluri urTirTobis

stilis statistikuri monacemebi, depresiis maCvenebeli da EPQ

kiTxvarSi miRebuli Sedegebi, maTi kavSiri demografiul

cvladebTan da epilefsiis klinikur maxasiaTeblebTan.

daavadebaze reagirebis tipebidan safeTqlis epilefsiiT

daavadebul pirebTan, ZiriTadad, gamovlinda SfoTviT-

ipoqondriuli, senzitiur_obsesiur_fobiuri, harmoniuli da

ergopaTiuri tipebi (cxrili #8).

91

cxrili #8. daavadebaze reagirebis tipebis saSualo maCveneblebisafeTqlis epilefsiiT daavadebul pirebSi.

daavadebaze reagirebis tipi

Mean SD Max

1.eiforiul-anozognoziuri 2,54 1,978 82. SfoTviT- ipoqondriuli 5,56 2,799 133. senzitiur-obsesiur-fobiuri 5,09 2,601 10

4. melanqoliuri 1,69 1,911 65. harmoniuliH 6,22 2,938 136. apaTiuri 1,26 1,944 117. paranoialuri 0,44 0,883 48. ergopaTiuli 2,69 1,451 69. egocentruli 1,15 1,379 4

Cveni monacemebis mixedviT safeTqlis epilefsiiT

daavadebuli pirebi xasiaTdebian depresiis saSualo maCvenebliT,

M=17,28 (SD=11,416) (BDI). mas Tan axlavs maRali SfoTva, sevda,

sakuTar Tavsa da sakuTar ZalebSi daurwmunebloba, uimedoba da

sxva.

miRebuli monacemebis safuZvelze Cven ver vimsjelebT

safeTqlis epilefsiis mqone pirebSi interpersonaluri

urTierTobis ama Tu im tipis aqcentuaciaze. gamovlenili

maxasiaTeblebi miuTiTeben mxolod garkveuli interpersonaluri

urTierTobis tipis tendenciaze (cxrili #9).

cxrili #9. safeTqlis epilefsiiT daavadebuli pirebisinterpersonaluri urTierTobis tipebis saSualo maCveneblebiinterpersonaluri urTierTobis

tipebiMean SD Max

1.Zalaufleba-lideroba 6,39 3,779 152.damoukidebeli-dominanturoba

6,81 3,481 14

3.sworxazovan-agresiuli 6,80 2,506 124.undobeli-skeptikuri 5,85 2,688 135.morcxvi-damorCilebuli 7,70 3,374 166.damokidebuli-damjeri 6,48 3,020 147.TanamSromlobiT-konvenciuri 8,31 3,261 148.pasuxismgeblobis mqone-gulisxmieri

7,65 3,127 15

safeTqlis epilefsiiT daavadebul pirebs aReniSnebaT

interpersonaluri urTierTobis iseTi tendenciebi, rogoricaa,

pasuxismgeblobis mqone _ gulisxmieri (me-8 oqtanti),

TanamSromlobiT_konvenciuri (me-7 oqtanti), morcxvi-

92

damorCilebuli (me-5 oqtanti). safeTqlis epilefsiis mqone

pirebis interpersonalur urTierTobaSi aRiniSneba

konformulobis, damorCilebis, sakuTar TavSi daurwmuneblobis,

amave dros, garSemomyofebTan Tanxmobisa da kongruentobis

miRwevis moTxovnilebis tendenciebi.

interpersonaluri urTierTobebis kvlevis testSi miRebuli

maCveneblebi ar aRmoCnda sando korelaciaSi safeTqlis

epilefsiis iseT cvladebTan, rogoricaa: keris lokalizacia,

gulyris tipi, magram zogierTi misi maCvenebeli korelirebs

gulyraTa sixSiresTan, daavadebis dawyebis asakTan da

mkurnalobis tipTan. amaze ufro dawvrilebiT Semdeg SevCerdebiT.

safeTqlis epilefsiis mqone pacientebTan ar gamovlinda

romelime gamoxatuli pirovnuli maxasiaTebeli

(eqstraversia/introversia). Nxolo neirotizmis maCvenebeli

saSualoze maRalia da aRiniSneba emociuri labilurobis

tendencia.

cxrili#10. EPQ-s testis maCveneblebi safeTlisepilefsiis mqone pirebTan

M SD Maxfsiqotizmis maCvenebeli

4,08 1,774 9

eqstraversiis maCvenebeli 10,60 2,918 18neirotizmis maCvenebeli 12,00 4,489 19

sicruis maCvenebeli 8,43 2,316 16

sqesobrivi gansxvavebebi epilefsiis mqone pirTa Soris

safeTqlisGepilefsiiT daavadebul pirTa jgufSi qalebs

mniSvnelovnad ufro maRali depresiis maCvenebeli hqondaT

(M=21,08, SD=13,891), mamakacebTan SedarebiT (M=14,27, SD=7.012).

pirovnul maxasiaTeblebSi statistikurad sando sqesobrivi

sxvaobebi ar gamovlinda.

xazgasasmelia daavadebaze reagirebis tipebis mixedviT

sqesobrivi gansxvavebebi. daavadebaze reagirebis egocentruli

tipis maCvenebeli statistikurad sandod ufro maRalia

safeTqlis epilefsiiT daavadebul qalebTan, vidre mamakacebTan.

amave dros daavadebaze reagirebis harmoniuli tipis maCvenebeli

93

statistikurad sandod ufro maRalia safeTqlis epilefsiiT

daavadebul mamakacebTan (cxrili#11).

cxrili #11.daavadebaze reagirebis tipebi safeTqlisepilefsiiT daavadebul qalebsa da mamakacebSi

sqesi/daavadebaze

reagirebis tipi

mamakacebi qalebi df=52

M SD M SD t Sig(2-tailed)

harmoniuli 7,04 2,919 5,46 2,795 2,0624 ,048Eegocentruli 0,58 1,027 1,68 1,467 -3,174 ,003

interpersonaluri urTierTobebis tipis mixedviT

mamakacebSi sandod ufro maRali maCveneblebi gamovlinda

damoukidebel-dominantur, sworxazovan-agresiul da damokidebul-

damjer tipebSi. magram, amave dros qalebSi ufro maRalia

dominireba-damorCilebisa da keTilmosurneoba-mtrobis faqtoris

maCveneblebi.

cxrili #12 interpersonaluri urTierTobis tipis maCvenebeli safeTqlis epilefsiiT daavadebul qalebsa da mamakacebSi.

interpersonakluri urtierTobis

tipi

mamkacebi qalebis df=50M SD M SD T Sig (2-tailed)

damoukidebeli-dominanturoba

8,42 3,313 5,31 2,923 3,596 ,001

sworxazovan-agresiuli

8,04 1,685 5,65 2,622 3,901 ,000

damokidebuli-damjeri

5,5 2,657 7,39 3,095 -2,509 ,015

dominireba-damorCileba

3,854 6,25 -3,389 8,42 3,553 ,001

keTilmosurneoba-mtroba

-,188 8,295 5,514 8,15 -2,501 ,016

epilefsiis mqone pirTa Sedegebis asakobrivi gansxvavebebi

safeTqlis epilefsiis mqone pirebSi ar gamovlinda

statistikurad sando sxvaobebi asaakobriv jgufebs Soris

depresiis da daavadebaze reagirebis maCveneblebis mixedviT.

pirovnul maxasiaTeblebSi statistikurad sando asakobrivi

sxvaobebi ar gamovlinda.

94

interpersonaluri urTierTobis testSi statistikurad

mniSvnelovani sxvaobebi gamovlinda 1 da 2 asakobriv jgufebs

Soris Zalaufleba-liderobis, sworxazovan-agresiulobisa da

dominireba-damorCilebis faqtorebSi.

cxrili#13. interpersonaluri testis Sedegebis asakobrivisxvaobebis safeTqlis epilefsiis mqone jgufSi

interersonaluri urTierTobis

tipi

asakobrivi jgufebi

M SD df t Sig (2-tailed)

Zalaufleba-lideroba

17-25

26-38

8,675,11

4,3013,288 25 2,391 ,025

sworxazovan-agresiuli

17-25

26-38

8,566,33

2,2422,647 25 2,482 0,026

dominireba_damorCilebis faqtori

17-25

26-38

5,278-2,261

8,007,397 25 2,430 ,023

epilefsiis mqone pirTa monacemebi daavadebis klinikuri

maxasiaTeblebis mixedviT

epilefsiuri fokusis mxareoba (lateralizacia) ar aRmoCnda

kavSirSi gamokvlevaSi miRebuli testebis maCveneblebTan.

gamovlinda statistikurad sando gansxvaveba jgufebs Soris

gulyrebis sixSiresTan da daavadebis dawyebis asakTan

mimarTebaSi.

gulyrebis sixSire:

Cvens gamokvlevaSi depresiis done gansxvavdeba gulyraTa

sixSiris mixedviT. depresiis maCvenebeli bevrad ufro dabalia

pacientebTan iSviaTi gulyrebiT _ weliwadSi ramdenjerme (M=11,

SD=6,516), im pacientebTan SedarebiT, visac gulyra yovelTviurad

aqvs (M=21,50, SD=12,610).

cxrili#14. depresiis maCvenebeli da gulyraTa sixSiredepresiis maCvenebeli

gulyraTa sixSire M SD t df Sig (2-tailed)

/weliwadi 11 6,516-2,915 40 ,006

/Tve 21,50 12,610

95

gamovlinda statistikurad sando sxvaoba daavadebaze

reagirebis harmoniul da ergopaTiuli tipebis maCveneblebSi

gulyrebis sixSiris mixedviT. naklebi sixSiris gulyrebis mqone

jgufs mniSvnelovnad maRali aqvs reagirebis harmoniuli da

ergopaTiuli tipis maCveneblebi (cxrili #15).

cxrili#15. gulyraTa sixSire da daavadebaze reagirebis tipebidaavadebaze reagirebis

tipi

gulyraTa sixSire M SD df t Sig (2-tailed)

Hharmoniuli /weliwadSi

/TveSi

9,075,04

1,8592,502 40 5,332 ,000

Hharmoniuli /weliwadSi

/kviraSi

9,075,50

1,8592,991 24 3,613 ,000

ergopaTiuri /weliwadSi

/kviraSi

3,291,50

0,8251,269 24 4,186 ,012

ergopaTiuri /TveSi

/kviraSi

2,791,50

1,5721,269 38 2,324 ,026

rac ufro xSiria gulyra, miT naklebia daavadebaze reagirebis

harmoniuli da ergopaTiuli tipis maCveneblebi.

pasuxismgeblobis mqone-gulisxmieri interpesonalur

urTierTobaTa stilis mqone pacientebi gansxvavdebodnen gulyris

sixSiris mixedviT. pacientebs, romlebsac ufro iSviaTi gulyrebi

aqvT, axasiaTebT pasuxismgeblobis ganviTarebuli grZnoba da

garSemomyofisadmi daxmarebis gawevis mzadyofna (cxrili #16).

cxrili#16. gulyraTa sixSire da interpersonaluri urTierTobis tipiinterpersona

luri urTierTobis

stili

gulyraTa sixSire

M SD df t Sig (2-tailed)

pasuxismgeblobis mqone-gulisxmieri

/weliwadSi

/TveSi

8,866,86

2,6853,088 40 2,062 ,046

daavadebis dawyebis asaki:

miRebul iqna statistikurad sando sxvaoba daavadebaze

reagirebis senzitiur-obsesiur-fobiur da melanqoliuri tipebis

maCveneblebSi daavadebis dawyebis asakis mixedviT. rac ufro

96

adreul asakSia daavadebis debiuti, miT ufro maRalia masTan

dakavSirebuli daavadebaze reagirebis senzitiur-obsesiur-fobiuri

tipisa da daavadebaze reagirebis melanqoliuri tipis maCvenebeli

(cxrili#17).

cxrili#17. daavadebaze reagirebis senzitiuri da melanqoliuri tipebis saSualo maCveneblebi daavadebis dawyebis asakis mixedviT.

daavadebaze reagirebis

tipi

daavadebis dawyebis asaki M SD df t Sig (2-

tailed)

senzitiur-obsesiur-fobiuri

0-10 weli

11-20 weli

6,284,19

2,8032,4 37 2,506 ,017

melanqoliuri 0-10 weli

21 welze meti

2,780,92

1,8551,320 29 2,065 0.48

interpersonaluri urTierTobis damokidebuli-damjeri tipis

maCvenebeli ufro maRalia im pacientebTan, romlebTanac daavadeba

pirvelad gamovlinda gviandel asakSi (21 welze zeviT).

cxrili#18. interpersonaluri urTierTobis tipi dadaavadebis dawyebis asakiinterpersonaluri urTierTobis tipi

daavadebis dawyebis asaki M SD df t Sig (2-

tailed)


0-10 weli

21 welze meti

5,838,33

3,0342,863 29 -2,222 ,034


11-20 weli

21 welze meti

68,33

2,8112,862 32 -2,234 0,33

mkurnalobis tipi:

interpersonaluri urTierTobis morcxvi-damorCilebuli tipis

maCveneblebi statistikurad sandod gansxvavdebian mkurnalobis

gansxvavebuli tipis SemTxvevaSi. monoTerapiis SemTxvevaSi am tipis

maCvenebeli ufro dabalia, vidre poliTreapiis SemTxvevaSi.

97

cxrili#19. mkurnalobis xasiaTi da interpersonaluri urTierTobi tipiinterpersonaluriurTirTobis tipi

monoTerapia poliTerapia df=49M SD M SD t Sig(2-tailed)

morcxvi-damorCilebuli 6,40 2,784 9,10 3,476 -3,159 ,003

daavadebaze reagirebis tipis, interpersonaluri urTierTobis

stilis, depresiis maCveneblisa da pirovnebis maxasiaTeblebis

kavSiri safeTqlis epilefsiis mqone pirebTan

daavadebaze reagirebis eiforiul-anazognozuri tipi

mniSvnelovan 1kavSirSia interpersonaluri urTierTobis

Zalaufleba-liderobis (1 oqtanti) da damoukidebel-dominantur

(me-2 oqtanti) stilTan (1). rac ufro gamoxatulia sakuTari

daavadebis uaryofis, nivelirebis maCvenebli, eiforia, garemosTan

urTierTobis miT ufro dominantur tips gamoxataven avadmyofebi.

maT ar sjerad daavadebis arsebobisa da miiCneven, rom unda

daimkvidron tavisi adgili sociumSi.

sainteresoa, rom daavadebaze reagirebis SfoTviT-

ipoqondriuli, melanqoliuri da apaTiuri tipebi mniSvnelovan

kavSirSia interpersonaluri urTierTobis undobel-skeptikur (me-4

oqtanti) stilTan, depresiasTan da neirotizmis maCvenebelTan da

fsiqotizmTan. es adasturebs im faqts, rom SfoTviTi, depresiul

mdgomareobas axasiaTebs skeptikuroba garemosTan urTierTobaSi,

zogjer undobliba. adamianebs ar sjerad mkurnalobis

warmatebulobis, aqvT uimedoba, interesebis sferos Seviwroveba,

iqcevian impulsurad, sakuTar subieqtur SegrZnebebze dayrdnobiT.

daavadebaze reagirebis senzitiur-obsesiur-fobiuri tipi ki

kavSirSia depresiasTan – axloblebisTvis mZime tvirTan yofnis

SiSi, arasrulfasovnad aRqmis SiSi, daavadebis gamo sazogadoebaSi

arasasurveli adgilis dakavebis, izolaciis SiSi iwvevs depresias.

romlis arseboba, meores mxriv, amZafrebs arsebul simptomebs.

1 unda aRiniSnos, rom am da yvela danarCen SemTxvevaSi Cven vsaubrobT

interpersonaluri urTierTobis garkveul tendenciaze da ara gamoxatul tipze.

98

daavadebaze reagirebis harmoniuli tipi ki dadebiT kavSirSia

interpersonaluri urTierTobis Zalaufleba-liderobis (1

oqtanti), damoukidebel-dominantur (me-2 oqtanti), pasuxismgeblian-

gulisxmier (me-8 oqtanti) stilTan – sakuTari mdgomareobis

adekvaturi aRqma, sakuTari Zalebis rwmena, miuxedavad

avadmyofobisa, Tavis mxriv dakavSirebulia garemosTan

damoukidebel, pasuxilsmgeblian urtierTobis tendenciemTan. xolo

uaryofiT kavSirSia depresiasTan da fsiqotizmTan – rac ufro

maRalia adamianis sakuTari SesaZleblobebis da aqedan gamomdinare

daavadebis daZlevis rwmena, miT ufro naklebad gamoxatulia

depresiis simptomebi, emociuri aramdgradoba.

daavadebaze reagirebis paranoialuri da egocentruli tipis

kavSiri sxva testebis maCveneblebTan ar gamovlinda.

daavadebaze reagirebis ergopaTiuri tipi mniSvnelovan

kavSirSia interpersonaluri urTierTobis damoukidebel-

dominantur (me-2 oqtanti), sworxazovan-agresiul (me-3 oqtanti)

stilTan – avadmyofi muSaobis/swavlis gagrZelebiT amJRavnebs

urTierTobis mebrZol tips, energiulobas da miazndasaxulobas.

xolo uaryofiT kavSirSia depresiis maCvenebelTan da

neirotizmTan – MmuSaobis/swavlis survili ar aZlevs avadmyofs

saSualebas mudmivad ifiqros Tavisi mdgomareobis Sesaxeb da ayves

varaudebs daavadebis SesaZlo arasaimedo prognozis Sesaxeb

(cxrili #20, cxrili#21).

amrigad, safeTqlis epilefsiis mqone pacientebSi gamovlinda:

daavadebaze reagirebis SfoTviT-ipoqondriuli da

senzitiur-obsesiur-fobiuri tipis tendenciebi.

safeTqlis epilefsiis mqone pirebi upiratesad amJRavneben

morcxvi-damorCilebuli da TanamSromlobiT-konvenciuri

urTierTobis stilis tendencias.

safeTqlis epilefiis mqone pirebi xasiaTdebian depresiis

saSualo doniT, mas Tan axlavs maRali SfoTva, sevda, sakuTar

Tavsa da ZalebSi daurwmunebloba.

99

safeTqlis epilefsiis mqone pacientebTan ar gamovlinda

romelime gamoxatuli pirovnuli maxasiaTeblis tendencia

(eqstraversia/introversia). Nmagram neirotizmis maCvenebeli

saSualoze maRalia.

aRmoCnda kavSiri EPQ-s testis maCveneblebsa da sxva

testebis maCveneblebs Soris Soris, kerZod:

eqstraversia kavSirSia interpersonaluri urTierTobis

Zalaufleba-liderobis (1 oqtanti) tipTan.

fsiqotizmis maCvenebeli mniSvnelovan kavSirSia

interpersonaluri urTierTobis undobel-skeptikur (me-4 oqtanti)

tipTan da daavadebaze reagirebis melanqoliur tipTan, xolo

uaryofiT kavSirSia – daavadebaze reagirebis harmoniul tipTan.

neirotizmis maCvenebeli kavSirSia interpersonaluri

urTierTobis undobel-skeptikur tipTan da daavadebaze reagirebis

SfoTviT-ipoqondriul, melanqoliur, apaTiur da ergopaTiur

tipebTan.

100

cxrili#20. daavadereagirebis tipis, interpersonaluri urTierTobis stilis, depresiis maCveneblisa da daavadebazereagirebis

tipi

Spearmen’rho

Zalaufleba-liderobi(1 oqt.)

damoukidebel-

dominanturi(me-2 oqt.)

sworxazovan-agresiuli(me-3 oqt.)

undobeli-skeptikuri(me-4 oqt.)

morcxvi-damorCilebuli (me-5oqt.)


(me-6 oqt)

TanamSromlobiT-

konvenciuri (me-

7oqt.)

pasuxismgeblobis mqone-gulisxmieri (8oq.)

Ddepresia neirotizmi

fsiqotizmi

1.eiforiulanozognoziuri

Correlation CoefficientSig. (2-tailed)

.333**

.016

.441**

.0012. SfoTviT-ipoqondriuli


.511**

.000

.543**

.000

.556**.000

3. senzitiur-obsesiur-fobiuri


.528**

.000

4. melanqoliuri


.507**

.000

-.346*

.012

.560**

.000

.550**

.000

.322*

.027

5. harmoniuliH


.337*

.014

.417**

.002

.393**

.004

-.452**

.001

-.312*

.033

6. apaTiuri


.267*

.039

.283*

.042

.402**

.003

.334*

.022

8. ergopaTiuli


.468**

.000

.276*

.048

-.341*

.013

-.396**

.003

-.340*

.020

101

cxrili#21. daavadebaze reagirebis tipis, interpersonaluri urTierTobis stilis, depresiis maCveneblisa da pirovnebis maxasiaTeblebis kavSiri safeTqlis epilefsiis

daavadebazereagirebis

tipi

Spearmen’rho


damoukidebel-

dominanturi (me-2 oqt.)





(me-6 oqt)

TanamSromlobiT-

konvenciuri (me-

7oqt.)

pasuxismgeblobis mqonegulisxmieri (8oq.)



2. SfoTviT-ipoqondriuli




4. melanqoliuri


5. harmoniuliH


6. apaTiuri Correlation CoefficientSig. (2-tailed)

8. ergopaTiuli


neirotizmi Correlation CoefficientSig. (2-tailed)

.481**

.001

-.352*

.015

fsiqotizmi Correlation CoefficientSig. (2-tailed)

.327*

.025

-.407*

.004

eqstraversia


.364*

.012

.

102

daavadebaze reagirebis tipi mniSvnelovan kavSirSia

interpersonaluri urTierTobis stilTan. kerZod, daavadebaze

reagirebis iseTi tipebi, sadac Warbobs SfoTva, uimedoba,

pesimisturi damokidebuleba mkurnalobis SedegebTan, daavadebis

simptomebis gazviadebis tendencia (SfoTviT-ipoqondriuli),

arasrulfasovnebisa da garSemomyofebisTvis zedmet tvirTad

yofnis gancda (melanqoliuri), kavSirSia ZiriTadad

interpersonaluri urTierTobis undobel-skeptikuri stilis

tendenciasTan da amave dros TanamSromlobiT-konvenciur da

morcxvi-damorCilebuli stilis tendenciebTan. es miuTiTebs imaze,

rom epilefsiis mqone pirebi zedmetad damokidebulebi arian

uaxloes garemoze, xolo garSemomyofebis mxridan keTilganwyobis

mopovebisaTvis TanamSromlobiTi da konformuli urTierTobis

tendenciebi aqvT. daavadebaze reagirebis iseTi tipebi ki, sadac

Warbobs daavadebis ignorireba da akritikuli damokidebuleba

(eiforiul-anozognoziuri tipi) an piriqiT, daavadebaSi gaqceva da

daavadebaze fokusireba mniSvnelovan kavSirSia garemosTan ufro

konfliqtur da dominantur tendenciebTan, skeptikur da kritikul

damokidebulebasTan garSemomyofebis mimarT – skeptikur-

undobeli, Zalaufleba-liderobis, damoukidebel-dominantur

stilTan.

qalebSi mniSvnelovnad ufro maRalia depresiis maCvenebeli,

mamakacebTan SedarebiT.

daavadebaze reagirebis egocentruli tipis maCvenebeli

statistikurad sandod ufro maRalia safeTqlis epilefsiiT

daavadebul qalebTan, vidre mamakacebTan. amave dros daavadebaze

reagirebis harmoniuli tipis maCvenebeli statistikurad sandod

ufro maRalia safeTqlis epilefsiiT daavadebul mamakacebTan. es

imas niSnavs, rom qalebi ufro metad arian fokusirebuli

daavadebaze, metad aqvT daavadebaSi gaqcevis tendencia da

garemosgan ufro met yuradRebas iTxoven. azviadeben sakuTar

mdgomareobas da SeiZleba simptomebis agravaciac hqondeT.

103

interpersonaluri urTierTobebis tipis mixedviT mamakacebSi

sandod ufro maRali maCveneblebi gamovlinda damoukidebel-

dominantur, sworxazovan-agresiul da damokidebul-damjer tipebSi.

safeTqlis epilefsiis mqone jgufSi gulyris sixSire da

daavadebis dawyebis asaki mniSvnelovan gavlenas axdenda daavadebis

Sinagani suraTis zogierTi tipis Camoyalibebaze:

depresiis maCvenebeli bevrad ufro dabalia pacientebTan

iSviaTi gulyrebiT _ weliwadSi ramdenjerme, im pacientebTan

SedarebiT, visac gulyra yovelTviurad aqvs.

rac ufro naklebia gulyrebis sixSire, miT ufro maRalia

daavadebaze reagirebis harmoniuli da ergopaTiuli tipebis

maCvenebeli.

rac ufro naklebia gulyrebis sixSire, miT ufro maRalia

pasuxismgeblobis mqone-gulisxmieri interpersonaluri

urTierTobis stilis maCvenebeli.

rac ufro xangrZlivia daavadebis mimdinareoba, miT ufro

maRalia masTan dakavSirebuli daavadebaze reagirebis senzitiur-

obsesiur-fobiuri tipisa da daavadebaze reagirebis melanqoliuri

tipis maCvenebeli.

4.2 gulis iSemiuri daavdebis

mqone pirTa kvlevis Sedegebi

am TavSi Cven ganvixilavT daavadebaze reagirebis,

interpersonaluri urTierTobis tipis, depresiis maCveneblebis

statistikur Sedegebs gulis iSemiuri daavadebis mqone pirTa

jgufSi.

gulis iSemiuri daavadebis mqone pirebTan, daavadebaze

reagirebis tipebidan yvelaze ufro gamokveTilia daavadebaze

reagirebis harmoniuli da SfoTviT-ipoqondriuli tipi (cxrili#22).

ZiriTadad, vlindeba an SfoTva, simptomebis gaZlierebis tendencia,

pesimisturi damokidebuleba mkurnalobisadmi, momavlis SiSi, an

adekvaturi damokidebuleba sakuTari mdgomareobisadmi,

gamojanmrTelebis survili da mkurnalobis xelSewyoba.

104

cxrili #22. daavadebaze reagirebis tipebis saSualo maCveneblebidaavadebaze reagirebis tipi Mean SD Max1. eiforiul-anozognoziuri 1,87 2,391 82. SfoTviT- ipoqondriuli 6,68 3,187 12


3,06 1,7117

4. melanqoliuri 1,71 1,936 65. harmoniuliH 6,06 2,351 106. apaTiuri 0,57 0,81 37. paranoialuri 0,23 0,497 28. ergopaTiuli 2,30 1,140 49. egocentruli 1,23 1,117 3

interpersonalur urTierTobis stilSi tendencia

aqcentuaciisaken gamovlinda morcxvi-damorCilebuli (5 oqtanti),

TanamSromlobiT-konvenciuri (7 oqtanti) da pasuxismgeblobis

mqone-gulisxmier (8 oqtanti) stilebSi (cxrili#23).

cxrili #23. interpersonaluri urTierTobis tipebissaSualo maCveneblebiinterpersonaluri urTierTobis

tipebi Mean SD

1.Zalaufleba-lideroba 5,10 2,9822.damoukidebeli-dominanturoba 7,23 1,995

3.sworxazovan-agresiuli 7,81 2,2424.undobeli-skeptikuri 6,03 2,1685.morcxvi-damorCilebuli 8,16 2,3396.damokidebuli-damjeri 6,71 1,8657.TanamSromlobiT-konvenciuri 10,19 2,664

8.pasuxismgeblobis mqone-gulisxmieri

9,77 2,291

dominireba_damorCileba ,155 5,745keTilmosurneoba_mtroba 6,11 6,478

gulis iSemiuri daavadebis mqone pacientebSi

interpersonaluri urTierTobis stilSi Warbobs megobruloba,

TanamSromloba, konformulobisa da garemosTan kongruentobis

miRwevis survili.

depresiis maCvenebeli gulis iSemiuri daavadebis mqone

pirebTan saSualo simZimisaa M=15,45 (SD=6,617).

gulis iSemiuri daavadebis mqone pirebTan ar gamovlinda

gamoxatuli pirovnul-emociuri Taviseburebani EPQ-s mixedviT

(cxrili #24).

105

cxrili#24. EPQ-s testis maCveneblebi gulis iSemiuridaavadebis mqone pirebTan

EPQ M SD Max

fsiqotizmis maCvenebeli

2,97 1,426 7

eqstraversiis maCvenebeli

10,16 3,426 18

neiroticizmis maCvenebeli

9,97 3,647 17


sqesobrivi sxvaobebi testebis maCveneblebs Soris:

depresiis maCveneblebs Soris statistikurad sandod maRali

maCvenebeli aqvT qalebs.

cxrili #25. depresiis maCvenebeli gulis iSemiuridaavaebis mqone qalebsa da mamakacebSi

mamakacebi qalebiM SD M SD

depresiis maCvenebeli 12, 67 3,98 18,06 7,6

t=-2,451Sig.(2-tailed)=,021

interpersonaluri urTierTobis testSi sando sxvaobebi ar

gamovlinda.

daavadebaze reagirebis TvalsazrisiT, sando sqesobrivi

sxvaobebi gamovlinda eiforiul-anozognoziur, melanqoliur da

egocentrul tipebSi. eiforiul-anazognozuri tipis maCvenebeli

sandod ufro maRalia mamakacebTan, xolo melanqoliuri da

egocentruli tipebis maCvenebeli ki _ qalebTan.

cxrili #26. daavadebaze reagirebis tipebi gulis iSemiuri daavadebis mqone qalebsa da mamakacebSi


mamakacebi qalebiM SD M SD

eiforiul-anazognoziuri 2,8 2,43 1, 2,066

F=4,969Sig.=0,034

melanqoliuri 0,93 1,223 2,44 2,22F=5,354

Sig.=,028

egocentruli 0,67 0,9 1,75 1,064F=9,3

Sig.=,005miRebuli gansxvavebebi dasturdeba Kruskall-Wallis-is indeqsis gamoyenebiT.

106

asakobrivi sxvaobebi testebis maCveneblebs Soris:gulis iSemiuri daavadebulT jgufSi mxolod erTi asakobrivi

jgufia: 38 wels zeviT.

daavadebaze reagirebis tipis, interpersonaluri

urTierTobis stilis, depresiis maCveneblisa da pirovnebis

maxasiaTeblebis kavSiri.

aRmoCnda, rom daavadebis ignorireba da akritikuli

damokidebuleba sakuTari mdgomareobisadmi da aseve pesimisturi

damokidebuleba mkurnalobisa da momavlisadmi, uimedobis gancda,

anu daavadebaze reagirebis melanqoliuri tipi mniSvnelovan

uaryofiTi xasiaTis kavSirSia interpersonaluri urTierTobis

Zalaufleba-liderobis stilTan2 (1 oqtanti) – avadmyofs ara aqvs

sakuTari SesaZleblobebis rwmena da ver amJRavnebs garemosTan

urTierTobaSi liderobis tendenciebs.

sainteresoa, rom eiforiul-anozognoziuri reagirebis tipi

uaryofiT korelaciaSia depresiasa da neirotizmTan, xolo

melanqoliuri tipi piriqiT – mniSvnelovan dadebiT korelaciaSia

depresiisa da neirotizmis maCveneblebTan, rac am mdgomareobebis

gaTvaliswinebiT danarCen msjelobas ar saWiroebs (sapirispiro

mdgomareobani Tavisi gamoxatulebis mixedviT).

daavadebaze reagirebis SfoTviT-ipoqondriuli tipi

mniSvnelovan kavSirSia depresiasTan da neirotizmTan – SfoTvis

gazrda, mudmivi fiqri daavadebis SesaZlo garTulebebis Sesaxeb

iwvevs depresiuli simtomebis aRmocenebas, emociur aramdgradobas

da piriqiT.

xolo senzitiur-obsesiur-fobiuri tipi ki – FfsiqotizmTan

– daavadebis gamovlinebasTan dakavSirebuli SiSebi, xSirad

usafuZvlo SiSebi zogjer iwvevn arakontaqturobas da

egocentrulobas. daavadebaze reagirebis harmoniuli da

2 am da yvela danarCen SemTxvevaSi Cven vsaubrobT interpersonaluri

urTierTobis garkveul tendenciaze da ara gamoxatul tipze.

107

ergopaTiuri tipebi uaryofiT kavSirSia depresiasTan da

interpersonaluri urTierTobis undobel-skeptikur (me-4 oqtanti)

stilTan. xolo, daavadebaze reagirebis egocentruli tipi ki

kavSirSia depresiasTan.

108

cxrili #27. daavadebaze reagirebis tipis, interpersonaluri urTierTobis stilis, depresiis maCveneblisa da pirovnebis maxasiaTeblebis kavSiri.


tipi

Spearmen’rho


sworxazovan agresiuli(me-2 oqt.)




damokidebuli-

damjeri (me-6 oqt)

TanamSromlobiT-

konvenciuri (me-

7oqt.)

pasuxismgeblo

bis mqone-gulisxmieri (8oq.)

Ddepresia

neirotizmi

fsiqotizmi



.443*

.012

-.391*

.030

.361*

.046

-.759**

.000

-.420*

.021



.356*

.050

-.370*

.041

.481**

.006

.605**

.090



.506**

.004

4. melanqoliuri


-.497**

.004

.719**

.000

.384*

.036

5. harmoniuliH


-.420*

.0019


7. paranoialuri


8. ergopaTiuli


.374*

.038

-.501**

.004

-.497**

.004

-.367*

.046

9. egocentruli


.465**

.006

109

amrigad, gulis iSemiuri daavadebis mqone jgufis pacientebSi

gamovlinda:

gulis iSemiuri daavadebis mqone pirebSi ufro

gamokveTilia daavadebisa da sakuTari mdgomareobisadmi

damokidebulebis SfoTviTi da pesimisturi tendencia

(SfoTviT-ipoqondriuli), momavlis SiSi, daavadebis

gazviadeba, an ki adekvaturi damokidebuleba daavadebisadmi,

mkurnalobis reJimis dacvisa da cxovrebis axali

garemoebebisadmi Seguebis mcdeloba (harmoniuli tipi).

gulis iSemiuri daavadebis mqone pirebi amJRavneben

garemosTan urTierTobis morcxvi-damorCilebuli (5 oqtanti),

TanamSromlobiT-konvenciuri (7 oqtanti) da pasuxismgeblobis mqone-

gulisxmieri (8 oqtanti) stilis tendenciebs.

gulis iSemiuri daavadebis mqone pirebTan depresia

saSualo simZimisaa.

gulis iSemiuri daavadebis mqone pirebTan ar

gamovlinda gamoxatuli pirovnul-emociuri Taviseburebani

EPQ-s mixedviT.

gamovlinda EPQ-s testis maCveneblebis mniSvnelovani

kavSiri, daavadebaze reagirebis tipebsa da interpersonaluri

urTierTobis stilebs Soris, kerZod:

eqstraversiis maCvenebeli kavSirSia

interpersonaluri urTierTobis damoukidebel-

dominantur (me-2 oqtanti) stilTan.

fsiqotizmis maCvenebeli kavSirSia daavadebaze

reagirebis senzitiur-obsesiur-fobiur tipTan.

neirotizmis maCvenebeli kaSirSia daavadebaze

reagirebis eiforiul-anozognozur, SfoTviT-

ipoqondriul da melanqoliur tipebTan.

statistikurad sandod maRali depresiis maCvenebeli

aqvT qalebs.

gamovlinda Semdegi kavSirebis testebis maCveneblebs

Soris:

110

daavadebaze reagirebis eiforiul-anozognoziuri tipi

dakavSirebulia intrerpersonaluri urTierTobis

Zalaufleba-liderobis (avtoritarul) (1 oqtanti),

undobel-skeptikur (me-4 oqtanti), pasuxismgeblian-

gulisxmier (me-8 oqtanti) tipebTan, depresiasTan da

neirotizmTan.


dakavSirebulia dakavSirebulia depresiasTan da

neirotizmTan

daavadebaze reagirebis senzitiur-obseso-fobiuri tipi

dakavSirebulia fsiqotizmTan.

daavadebaze reagirebis melanqoliuri tipi

dakavSirebulia interpersonaluri urTierTobis

Zalaufleba-liderobis (avtoritarul) (1 oqtanti)

tipTan, depresiasTan da neirotizmTan

daavadebaze reagirebis apaTiuri tipi dakavSirebulia

inrterpersonaluri urTierTobis sworxazovan-

agresiuli (me-3 oqtanti) pasuxismgeblian-gulisxmier (me-8

oqtanti) tipebTan.

daavadebaze reagirebis ergopaTiuri tipi

dakavSirebulia interpersonaluri urTierTobis

undobel-skeptikur (me-4 oqtanti) tipTan da depresiasTan.

daavadebaze reagirebis egocentruli tipi

dakavSirebulia depresiis maCvenebelTan.

4.3. Nsakontrolo, janmrTel pirTa kvlevis Sedegebi

am TavSi mocemulia janmrTel pirTa statistikuri monacemebi

testebis Sedegebis mixedviT.

janmrTel cdis pirebTan daavadebaze reagirebis arc erTi

aqcentuirebuli tipi ar gamovlinda.

111

cxrili #28. daavadebaze reagirebis tipebissaSualo maCveneblebidaavadebaze

reagirebis tipiMean SD Max

1.eiforiul-anozognoziuri

2,85 1,836 9

2.SfoTviT-ipoqondriuli

1,87 1,903 7

3.senzitiur-obsesiur-fobiuri

2,39 1,928 8

4.melanqoliuri 0,60 0,75 25. harmoniuliH 3,96 2,866 106.apaTiuri 0,33 0,756 57. paranoialuri 0,23 0,543 38.ergopaTiuli 1,27 1,09 39.egocentruli 0,40 0,829 5

janmrTel cdis pirebTan iterpersonaluri urTierTobis

kvlevis testSi ar gamovlinda aqcentuirebuli tipebi. janmrTel

cdis pirebs aReniSnebaT interpersonaluri urTierTobis iseTi

tendenciebi, rogoricaa erTis mxriv Zalaufleba-lideroba (1

oqtanti) da damoukidebloba-dominantoba (me-2 oqtanti) da meores

mxriv TanamSromlobiT_konvenciuri (me_7 oqtanti) da

pasuxismgeblobis mqone (me_8 oqtanti).

cxrili #29. interpersonaluri urTierTobis tipebissaSualo maCveneblebi janmrTel cdis pirebSi.interpersonaluri urTierTobis tipebi Mean SD

Max1.Zalaufleba-lideroba

8.60 2.28 14

2.damoukidebeli-dominanturoba

8.3 2.24 14

3.sworxazovan-agresiuli

7,47 2.289 12

4.undobeli-skeptikuri

6,69 2.429 11

5.morcxvi-damorCilebuli

7.17 2.14 12

6.damokidebuli-damjeri

7.94 2.449 13

7.TanamSromlobiT-konvenciuri

8.41 1.952 13

8.pasuxismgeblobis mqone-gulisxmieri

8.89 2.417 14

dominireba_damorCileba

2.193 6,170 13

keTilmosurneoba_mtroba

2,181 5,64 16.7

112

depresiis zogadi maCvenebelia 10.81 (SD=8,491), rac msubuqi

depresiis donis arsebobaze miuTiTebs.

janmrTel pirTa jgufSi ar gamovlinda gamoxatuli pirovnul-emociuri Taviseburebani EPQ-s mixedviT.

cxrili#30. EPQ-s testis maCveneblebi

EPQ M SD Max


2,63 1,687 7


10,80 3,020 17


10,31 3,843 19


sqesobrivi sxvaobebi janmrTel cdis pirebSi

testebis maCveneblebs Soris:

depresiis maCveneblebis Soris statistikurad sando sxvaoba

qalebsa da mamakacebs Soris ar gamovlinda: mamakacebi=10,89

(SD=8,373), qalebi=10,76 (SD=8,670)

daavadebaze reagirebis tipebs Soris statistikurad sando

sxvaoba daavadebaze reagirebis arc erT tipSi ar gamovlinda.

interpersonaluri urTierTobis testebSi sando sqesobrivi

sxvaobebi gamovlinda undobel_skeptikur tipisa da

dominireba_damorCilebis faqtorSi. mamakacebSi ufro maRalia

undobel-skeptikuri tipis gamovlinebebi, rac gamoixateba

msjelobebis da qcevebis realizmSi, zogjer skeptikurobaSi da

meores mxriv, dominireba_damorCilebis faqtoris uaryofiTi

mniSvneloba, garkveuli morCilebisa konformulobis tendenciaze

miuTiTebs.

cxrili #31. interpersonaluri urTierTobis tipis maCvenebeli praqtikulad janmrTel qalebsa da mamakacebSiinterpersonaluri urTierTobis tipi

mamakacebi qalebi df=50M SD M SD

undobel-skeptikuri 7,46 2.134 6,17 2,498 t=2,253Sig. (2-

tailed)=,027dominireba-damorCileba

-,282 5,65 3,843 5,88 F=8,519Sig.=,005

113

miRebuli gansxvavebebi dasturdeba Kruskall-Wallis-is indeqsiT.

asakobrivi sxvaobebi testis maCveneblebs Soris janmrTel cdis

pirebSi:

depresiis maCveneblebs Soris statistikurad sando

asakobrivi sxvaobebi ar gamovlinda.

interpersonaluri urTierTobebis stilis gamosakvlev testSi

sando asakobrivi sxvaobebi gamovlinda 1 (17-25 weli) da 2 (26-37

weli) asakobrivi jgufebSi morcxvi-damorCilebuli urTierTobis

tipebSi, 1 (17-25 weli) da 3 (38 welze meti) asakobrivi jgufebSi

pasuxismgeblobis mqone-gulisxmieri urTierTobis stilSi da 2 (26-

37 weli) da 3 (38 wlis meti) asakobrivi jgufebSi - urTierTobis

stilSi. urTierTobis pasuxismgeblobis mqone-gulisxmieri da

TanamSromlobiT-konvenciuri stilis maCveneblebi ufro maRalia me-3

asakobriv jgufSi (38 wlis meti) _maT aqvT pasuxismgeblobis

ganviTarebuli grZnoba, garSemomyofisadmi daxmarebis gawevis

survili da gulisxmiereba, aseve axlo, megobruli urTierTobebis

damyarebis tendencia.

cxrili#32. interpersonaluri testis Sedegebis asakobrivi sxvaobebi praqtikulad janmrTel pirebTan

interpersonaluri urTierTobis tipi

asakobrivi jgufebi M SD df t

Sig (2-tailed)

morcxvi-morCilebuli 17-25 weli

26-37 weli

8,196,81

2,2871,99

45 2,143 ,038

pasuxismgeblobis mqone-gulisxmieri

17-25 weli

38<

7,889,48

2,2772,466 37 -2, 06 ,046

TanamSromlobiT-konvenciuri

26-37 weli

38<

8,109,48

1,4912,466

52 -2,081 ,042

daavadebaze reagirebis tipSi statistikurad sando asakobrivi

sxvaobebi gamovlinda 1 (17-25 weli) da 2 (26-37 weli) asakobriv

jgufebs Soris mxolod reagirebis egocentrul, 2 (26-37 weli) da 3

(38 welze meti) asakobriv jgufebs Soris ki - senzitiur-obsesir-

fobiuri da harmoniul tipebSi. reagirebis egocentruli tipis

maCvenebeli ufro maRalia axalgazrda cdis pirebTan – maTTvis

114

ufro damaxasiaTebelia sakuTari gancdebis saaSkaraoze

gamomJRavneba garSemomyofTa yuradRebis mipyrobis mizniT.

cxrili#33. daavadebaze reagirebis tipebis asakobrivi sxvaobebi praqtikulad janmrTel pirebTan


asakobrivi jgufebi M SD df t Sig (2-

tailed)

egocentruli 17-25 weli

26-37 weli0,750,29

0,6830,529

45 2,554 ,014

senzitiur-obsesiur-fobiuri

26-37 weli

38<3

1,741,881,63

52 2,576 ,013

harmoniuli 26-37 weli

38<4,812,74

2,7382,684

52 2,767 ,008

reagirebis senzitiur-obsesiur-fobiuri tipis maCvenebeli

ufro maRalia me-2 asakobrivi jgufisTvis _ masSi Semavali

adamianebi amJRavneben garkveuli saxis SiSebs da metad

mgrZnobiareni arian garSemomyofi adamianebis azris mimarT.

daavadebaze reagirebis harmoniuli tipis maCvenebeli, rodesac

adamiani adekvaturad afasebs sakuTar mdgomareobas, aseve ufro

maRalia 26-37 wlis adamianebSi.

daavadebaze reagirebis tipis, interpersonaluri urTierTobis

tipis, depresiis maCveneblisa da pirovnuli maxasiaTeblebis kavSiri.

gamovlinda kavSirebi daavadebaze reagirebis SfoTviT-

ipoqondriul, senzitiur-obsesiur-fobiur, melanqoliur tipebsa da

depresias Soris.

cxrili#34. daavadebaze reagirebis tipis, interpersonaluri urTierTobis tipis, depresiis maCveneblisa da pirovnebis maxasiaTeblebis kavSiri

daavadebaze reagirebis tipi Spearman`s rhoCorrelation Coefficient

Sig. (2-tailed)

N

SfoTviT-ipoqondriuli .412** .000 70

senzitiur-obseso-fobiuri .321* .007 70melanqoliuri .395** .001 70

sxva saxis kavSirebi ar gamovlinda.

115

amrigad, janmrTel pirTa jgufSi:

daavadebaze reagirebis arc erTi aqcentuirebuli tipi ar

aRiniSneba.

interpersonaluri urTierTobis kvlevis testSi ar gamovlinda

aqcentuirebuli tipebi.

depresiis zogadi maCvenebeli msubuqi depresiis donis

arsebobaze miuTiTebs.

ar gamovlinda gamoxatuli pirovnul-emociuri Taviseburebani

EPQ-s mixedviT

gamovlinda statistikurad sando sxvaobebi testis

maCveneblebs Soris da sqesisa da asakis mixedviT, kerZod:

mamakacebSi ufro maRalia undobel-skeptikuri urTierTobis

stilis tendencia;

urTierTobis pasuxismgeblobis mqone-gulisxmieri da

TanamSromlobiT-konvenciur tipis tendenciebis maCvenebeli

ufro maRalia 38 welze meti xnis pirebTan;

daavadebaze reagirebis senzitiur-obsesiur-fobiuri da

harmoniuli tipis maCveneblebi ufro maRalia 26-37 wlis mqone

pirebTan.

4.4 safeTqlis epilefsiis, gulis iSemiuri daavadebis mqone pirTa

da janmrTel pirTa jgufebis Sedareba.

depresiis maCvenebeli sandod ufro maRalia safeTqlis

epilefsiiT daavadebul da gulis iSemiuri daavadebis mqone pirTa

jgufSi janmrTel pirebTan SedarebiT (M=10,81).

safeTqlis epilefsiis mqone da gulis iSemiuri daavadebis

mqone pirebs ar gamouvlindaT statistikurad sando sxaoba

depresiis maCveneblebs Soris (cxrili #35).

amas adasturebs anovas araparametruli jgufTaSorisi

Sedarebis statistikuri monacemebi (danarTi #3).

116

cxrili#35. jgufebis Sedareba depresiis maCvenebelis mixedviTjgufi M SD df T Sig (2-tailed)

epilefsia

guli iS. daavadeba

17,6715,45

11,4246,617 81 ,987 ,327

epilefsia

janmrTeli c.p.

17,6710,81

11,4248,491

120 3,800 ,000

gulis iS. d-ba janmrTeli

c.p.

15,4510,81

6,6178,491 99 2,697 .008

interpersonaluri urTierTobis kvlevis testis mixedviT

janmrTel adamianebSi da safeTqlis epilefsiis mqone pirebSi

TiTqmis erTnairi tendenciebi vlindeba.

statistikurad sando sxvaobebi gamovlinda Zalaufleba-

liderobis (1 oqtanti), damoukidebel-dominanturi (2 oqtanti),

damokidebul-damjeri (6 oqtanti) da pasuxismgeblobis mqone-

gulisxmier (8 oqtanti). rogorc vxedavT janmrTel adamianebSi

yvela es maCvenebeli ufro maRalia (cxrili #36).

cxrili#36. interpersonaluri testis Sedegebis Sedareba safeTqlis epilefsiis mqone da praqtikulad janmrTel pirebTaninterpersonaluri urTierTobis

tipi

epilefsia norma df=120M SD M SD

Zalaufleba-liderobis

6,46 3.801 8,60 2,428 t=-3,784Sig (2-tailed)=,000

damoukidebeli-dominanturi

6,87 3,47 8,30 2,324 t=-2,733Sig (2-tailed)=,007

Adamokidebuli-damjeri

6,50 3,020 7,94 2,449 t=-2,912Sig (2-tailed)=,004

pasuxismgeblobis mqone-

gulisxmieri7,60 3,076 8,89 2,417 t=-2,593

Sig (2-tailed)=,011

amave dros, aRmoCnda, rom gulis iSemiuri daavadebis mqone

pirebs safeTqlis epilefsiis mqone pirebTan SedarebiT aqvT ufro

maRali maCvenebeli TanamSroblobiT-konvenciur da pasuxismgeblobis

mqone - gulisxmieri urTierTobebis stilSi. gulis iSemiuri

daavadebis mqone pirebi avlenen ufro met konformulobas da

kongruentobas garSemomyofebTan kontaqtis dros (cxrili #37).

117

cxrili#37. interpersonaluri testis Sedegebis Sedareba safeTqlis epilefsiis mqone da gulis iSemiuri daavadebis mqone pirebTaninterpersonaluri urTierTobis tipi

epilefsia Ggulis iS. d-ba df=81M SD M SD

TanamSroblobiT-konvencialuri

8,31 3,311 10,19 2,664 t=-2,692Sig (2-tailed)=,009

pasuxismgeblobis mqone-

gulisxmieri7,60 3,076 9,77 2,291 t=-3,415

Sig (2-tailed)=,001

amas adasturebs anovas araparametruli jgufebSorisi


ufro araerTgvarovania sxvaoba interpersonaluri

urTierTobebis stilSi janmrTel pirTa da gulis iSemiuri

daavadebis mqone pirebs Soris. janmrTel pirebSi ufro maRalia

garemosTan urTierTobis Zalaufleba-liderobis, damoukidebeli-

dominanturi tipebis maCveneblebi, rac imas niSnavs, rom isini ufro

metad amJRavnebs sakuTar Tavsa da SesaZleblobebSi rwmenas,

sakuTar TavSi darwmunebulobas, arian ufro damoukidebelni. xolo

iSemiuri daavadebis mqone pirebTan ufro maRalia morcxvi-

damorCilebuli, TanamSroblobiT-konvenciuri urTierTobis stilis

maCveneblebi – maTTvis damaxasiaTebelia simorcxve,

TavSekavebuloba, zogjer sxvaTa valdebulebebis sakuTar Tavze

aRebis midrekileba, isini iswrafvian garSemomyofebTan axlo,

megobruli urTierTobebis damyarebisaken3 (cxrili #38).

cxrili#38. interpersonaluri testis Sedegebis gulis iSemiuri daavadebis mqone da praqtikulad janmrTel pirebTaninterpersonaluri urTierTobis tipi

gulis iS. d-ba norma df=99M SD M SD

Zalaufleba-liderobis

5,10 2,982 8,60 2,428 t=6,22 Sig (2-tailed)=,000

damoukidebeli-dominanturi

7,23 1,995 8,30 2,324 t=2,233 Sig (2-tailed)=,028

morcxvi damorCilebuli

8,16 2,339 7,16 2,124 t=-2,124Sig (2-tailed)=,036


6,71 1,865 7,94 2,449 t=2,499Sig (2-tailed)=,014

3 saubaria interpersonaluri urTierTobis garkveul tendenciaze da ara gamoxatul tipze.

118

TanamSroblobiT-konvencialuri

10,19 2,664 8,41 1,952 t=-3,762Sig (2-tailed)=,000


6,110 6,47 2,180 5,64 t=-3,084Sig (2-tailed)

daavadebaze reagirebis testSi statistikurad sanda sxvaobebi

janmrTel pirebsa da safeTqlis epilefsiiT daavadebulebs Soris

gamovlinda Semdeg maCveneblebSi: SfoTviT-ipoqondriuli, senzitiur-

obsesiur-fobiuri, melanqoliuri, harmoniuli, ergopaTiuri da

egocentruli tipi. safeTqlis epilefsiis mqone pirebs yvela es

maCvenebeli mniSvnelovnad ufro maRali aqvT.

cxrili#39. daavadebaze reagirebis tipebis Sedareba safeTqlis epilefsiismqone da praqtikulad janmrTel pirebTan


epilefsia normadf=120

M SD M SDSfoTviT-

ipoqondriuli5,63 2,822 1,87 1,903 t=8,792

Sig(2-tailed)=,000senzitiur-

obsesiur- fobiuri5,08 2,648 2,39 1,928 t=6,497

Sig (2-tailed)=,000

melanqoliuri 1,75 1,919 0,60 0,750 t=4,572Sig (2-tailed)=,000

harmoniuli 6,21 2,979 3,96 2,866 t=4,225Sig (2-tailed)=,000

ergopaTiuri 2,67 1,465 1,17 1,090 t=6,495Sig (2-tailed)=,000

egocentruli 1,15 1,392 ,46 ,829 t=3,448Sig (2-tailed)=,001

daavadebaze reagirebis testSi statistikurad sando sxvaoba

safeTqlis epilefiis mqone pirTa da gulis iSemiuri daavadebis

mqone pirTa Soris gamovlinda mxolod senzitiur-obsesiur-fobiur

tipSi. ufro maRali maCvenebeli hqonda safeTqlis epilefsiis

jgufs.

cxrili#40. daavadebaze reagirebis tipebis dareba safeTqlis epilefsiis da gulis iSemiuri daavadebis mqone pirebTandaavadebaze reagirebis

tipi

epilefsia Ggulis iS. d-badf=81M SD M SD

senzitiuobseso-fobiuri 5,08 2,648 3,06 1,711 t= 3,781

Sig(2-tailed)=,000



119

#41-43 cxrilSi moyvanilia safeTqlis epilefsiis da gulis

iSemiuri daavadebis jgufebSi gamovlenili urTierTkavSirebis

daavadebaze reagirebis tipebs Soris. rogorc vxedavT, safeTqlis

epilefsiis mqone jgufSi arsebul SfoTvasTan kavSirSia gazrdili

mgrnobeloba garemosadmi, daavadebasTan dakavSirebuli SiSebi

(senzitiur-obseso-fobiuri tipi).

pirovnul-emociuri maxasiaTeblebis mixedviT statistikurad

sando sxvaobebi gamovlinda mxolod emociuri stabiloba-

labilobis maCvenebelSi. safeTqlis epilefsiis mqone jgufSi

mniSvnelovnad ufro maRalia neirotizmis maCvenebeli.

cxrili#41. neirotizmis maCveneblis statistikurad sandojgufuri sxvaobebi

EPQ epilefsia Ggulis iS. d-badf=81

M SD M SDNneirotizmi

12.19 4.675 9.93 3.704 t=2.234Sig (2-tailed)=,028



amrigad, SedarebiTi analizidan Cans, rom:

safeTqlis epilefsiisa da gulis iSemiuri daavadebis mqone

jgufSi depresiis maCvenebli statistikurad ufro maRalia

janmrTel pirebTan SedarebiT.

safeTqlis epilefsiis da gulis iSemiuri daavadebis mqone

pirebTan janmrTel individebTan SedarebiT mniSvnelovnad

gamokveTilia daavadebaze reagirebis SfoTviT-ipoqondriuli da

senzitiur-obsesiur-fobiuri tipebi. amave dros, epilefsiis mqone

pirebs aqvT statistikurad ufro maRali daavadebaze reagirebis

senzitiur-obsesiur-fobiuri tipis maCvenebeli gulis iSemiuri

daavadebis mqone pirebTan SedarebiT. es imas niSnavs, rom miuxedavad

msgavsi qronikulobisa da safrTxeebisa, epilefsiis mqone pirebs

ufro Zlierad aqvT gamoxatuli SiSi, eWvebi, wuxili sakuTari

mdgomareobis Sesaxeb, axloblebis damokidebulebis Sesaxeb da

sakuTari ususurobis gancda.

120

safeTqlis epilefsiis mqone pirebs mniSvnelovnad maRali

aqvT neirotizmis maCvenebeli gulis iSemiuri daavadebis mqone

pirebTan SedarebiT. es miuTiTebs safeTqlis epilefsiis mqone

pirebis ufro gamoxatul emociur aramdgradobaze, SfoTvaze,

interpersonalur urTierTobaSi mowyvaldobaze, depresiuli

reaqciebisadmi midrekilebasa da adaptaciis daqveiTebul unarze.

gulis iSemiuri daavadebis mqone pirebs safeTqlis

epilefsiis mqone pirebTan SedarebiT garemosTan urTierTobisas

axasiaTebT ufro meti swrafva socialurobisaken, garSemomyof

adamianebis mimarT megobruli urTierTobis damyarebisaken.

praqtikulad janmrTeli pirebi safeTqlis epilefsiis da

gulis iSemiuri daavadebis mqone pirebTan SedarebiT amJRavneben

garemosTan urTierTobis ufro dominantur tendenciebs, metad

arian sakuTar SesaZleblobebSi darwmunebuli.

121

cxrili #42. safeTqlis epilefsiis jgufbSi gamovlenili urTierTkavSirebis daavadebaze reagirebis tipebs Soris


tipi

Spearmen’rho


2. SfoTviT-ipoqondriul

i


4. melanqoliur

i

5. harmoniuliH

6. apaTiuri

7. paranoialuri

8. ergopaTiuli

9. egocentr

uli



.313*

.0242. SfoTviT-ipoqondriuli


.336*

.015

.604**

.000

.383**

.005

-.277*

.047

.448**

.001



.336*

.015

.352*

.010

.367**

.007

4. melanqoliuri


604**

.000

.352*

.010

.444*

.001

353*

.0105. harmoniuliH



519**

.0007. paranoialuri


8. ergopaTiuli


.313*

.024

-.277*

.0479. egocentruli


.448**

.001

.367**

.007

.353*

.010

.519**

.000

122

cxrili #43. gulis iSemiuri daavadebis jgufbSi gamovlenili urTierTkavSirebis daavadebaze reagirebis tipebsSoris


tipi

Spearmen’rho


2. SfoTviT-ipoqondriul

i


4. melanqoliur

i

5. harmoniuliH

6. apaTiuri

7. paranoialuri

8. ergopaTiuli

9. egocentr

uli



-.595**

.000

-.599**

.000

-.554**.001



-.595**

.000

.447*

.012

498**

.004



.413*

.021

4. melanqoliuri


-.599**

.000

.447*

.012

.406*

.024

-.426*

.017

367*

.042

5. harmoniuliH


.393*

.0296. apaTiuri Correlation

CoefficientSig. (2-tailed)

.406*

.0247. paranoialuri


8. ergopaTiuli


-.426*

.017

.393*

.0299. egocentruli


-.554**.001

.498**

.004.413*.021

.367*

.042

123

Tavi 5. monacemebis interpretacia da daskvnebidaavadebaze reagirebis tipi:

safeTqlis epilefsiiT daavadebul pirebs aqvT daavadebasTan

dakavSirebuli sxvadasxva saxis, xSirad, obieqtur safuZvels

moklebuli, dausabuTebeli SiSebi. mag., maT aqvT SiSi imisa, rom

garSemomyofebma (TanamSromlebma, megobrebma) SeiZleba gaigon maTi

daavadebis Sesaxeb da aman SeiZleba uaryofiTad imoqmedos maT

profesiul moRvaweobaze, karieraze, megobrul urTierTobebze.

amitom isini xSirad cdiloben damalon sakuTari avadmyofoba da ar

CamorCnen sxvebs sazogadoebriv cxovrebaSi. safeTqlis epilefsiiT

daavadebulebi zedmetad mgrZnobiareni xdebian sxvaTa azris da

Sefasebis mimarT (senzitiur-obsesiur-fobiuri tipi). pacientTa didi

nawili aRniSnavs, rom isini eridebian saubars daavadebis da

mkurnalobis Sesaxeb garSemomyof adamianebTan

(TanamSromlebTa/kurselebTan, mezoblebTan), amave dros isini

gamoxataven did ndobas ojaxis wevrebis mimarT da xSirad axlo

megobrebis mimarTac.

sxva avtorebic aRiareben aseTi saxis SiSebis arsebobas

epilefsiis da kerZod safeTqlis epilefsiis mqone pirebTan (Westbrook

L.E., Bauman L.J., Shinnar S., 1992). isini aRniSnaven, rom stigmis aRqma,

romelsac am SemTxvevaSi ganixilaven, rogorc subieqtur rwmenas, rom

epilefsiiT daavadeba negatiur gavlenas axdens socialur

urTirTobebze. miuxedavad imisa, rom am kvlevaSi pacientTa didi

nawili miuTiTebs, rom is ar grZnobs Tavs stigmatizirebulad

daavadebis gamo, maTgan 70% uars ambobs daavadebis Sesaxeb saubarze

sxvebTan urTierTobis dros.

magram ojaxis wevrebis mxardaWera amcirebs SfoTvas da

depresias: rac ufro Zlieri da adekvaturia es mxardaWera, miT ufro

dabalia daavadebasTan dakavSirebuli SfoTva da SiSebi. daavadebaze

regirebis senzitiur-obsesiur-fobiuri tipi dakavSirebulia

depresiis maCvenebelTan (cxrili#43). maT Soris dadebiTi

korelaciaa: SiSis da SfiTvis gaZliereba iwvevs depresiis donis

zrdas da piriqiT (Pearson Correl.=.458**, Sig (2-tailed)=.001). agreTve

daavadebaze reagirebis senzitiur-obsesiur-fobiuri tipi

124

dakavSirebulia daavadebaze reagirebis SfoTviT-ipoqondriul tipTan:

daavadebasTan dakavSirebuli interpersonaluri mgrZnobelobis

gazrda iwvevs SfoTvis gaZlierebas (Pearson Correl.=.321*, Sig (2-

tailed)=.020).

cxrili#44. daavadebis senzitiur-obseso-fobiuritipis da depresiis regresuli analizi

Model B Std. Error Beta t Sig.1 (Constant)

depresia3.201 .612 5.234 .000

.106 .029 .458 3.641 .001prediqtori: depresiadamokidebuli cvladi: daavadebaze reagirebis senzitiur-obsesofobiuri tipi

garda amisa, Cvens mier gamokvleul safeTqlis epilefsiiT

daavadebul pirebs aqvT sakuTari daavadebis gazviadebis tendencia,

axasiaTebT sakuTar SegrZnebebze yuradRebis gamaxvileba,

mkurnalobis Sedegebisadmi pesimisturi damokidebuleba, damatebiTi

informaciis Ziebis survili mkurnalobis axali saSualebebisa da

daavadebis Sesaxeb; maT maRali SfoTva aReniSnebaT daavadebis

mosalodnel garTulebebze, romlebic, maTi azriT, maT ojaxur Tu

samsaxureobriv urTierTobebze negatiuri gavlenis mizezia (SfoTviT-

ipoqondriuli tipi). SfoTva SeiZleba iyos Sedegi an SeiZleba iyos

gaZlierebuli im fsiqologiuri reaqciebiT, romlebic uCndeba

pacients gulyrebis araprognozirebad xasiaTze da organizmis

Cveuli funqcionirebis disfunqciis gamo (Vasquez B., Devinsky O., 2003).

safeTqlis epilefsiiT daavadebuli pirebi xSirad “muSaobaSi

gaqceviT” cdiloben Sinagani wonasworobis miRwevas _ daavadebis

simZimis miuxedavad ganagrZoben muSaobas, xSirad ufro

intensiuradac ki. zogjer mTel Tavisufal dros muSaobas andomeben,

Tumca mkurnalobas mainc ganagrZoben. samsaxuris dakargvis, an

umuSevrobis SemTxvevaSic cdiloben moZebnon raime saqmianoba, raTa

gaeqcnen azrebs daavadebis Sesaxeb, nawilobriv mainc

ganTavisufldnen misi gavlenisagan da moipovon sakuTari

Rirebulebis gancda (ergopaTiuri tipi). mozrdilebi cdiloben

TviTdamkvidreba muSaobaSi ipovon, axalgazrdebma ki megobrul

urTierTobebSi, ris gamoc, oreve SemTxvevaSi, xSiria mkurnalobis

125

reJimis darRveva (ergopaTiuli tipi SeiZleba ganvixiloT rogorc

adekvaturi damokidebulebis tipis maCvenebeli – muSaobis/swavlis

gagrZeleba miuxedavad daavadebisa, aseve rogorc daavadebisadmi

arakonstruqciuli damokidebulebis maCvenebeli - pacienti xSirad

arRvevs mkurnalobis reJims).

korelaciuri analizis Sedeged dadgenili kavSirebi

konstituciur fsiqologiur maxasiaTeblebsa da daavadebaze

reagirebis tipebs Soris gvaZleven safuZvels davsvaT kiTxva – ra

gavlenas axdens pirovnuli maxasiaTeblebi daavadebaze reagirebis

garkveuli tipis Camoyalibebaze. regresiuli analizis safuZvelze

dadginda, rom daavadebaze reagirebis ergopaTiuri tipis

Camoyalibebaze gavlenas neirotizmis maRali maxasiaTebelic (cxrili

#44). rac ufro naklebad aris gamoxatuli adamianSi neirotizmis

maCvenebli, e.s. rac ufro emociurad mdgradia adamiani, mSvidia da

acnobierebs sakuTar qcevas da mdgomareobas, miT ufro metad

cdilobs is adekvaturi adaptaciuri unarebis ganviTarebas. amis erT-

erTi maCvenebli aris survili gaagrZelos muSaoba/swavla miuxedavad

avadmyofobisa.

cxrili#45. daavadebis ergopaTiuri tipis da neirotizmis regresuli analizi (prediqtori: neirotizmi)

Model BStd. Error Beta t Sig.

1 (Constant)neirotizmidaavadebaze reagirebis ergopaTiuri tipi

4.014 .569 7.060 .000

-.104 .044 -.335 -2.388 .021

rac ufro naklebad aris gamoxatuli fsiqotizmis maCvenebeli,

miT ufro maRalia albaToba daavadebaze reagirebis harmoniuli

tipis Camoyalibebisa. avadmyofi adamiani am SemTxvevaSi ufro

adeqvaturad afasebs Seqmnil mdgomareobas da cdilobs misgan

gamosvlis konstrqciuli gzebis moZebnas – mkurnalobisadmi

xelSewyoba, rejimis dacva.

126

cxrili#46. daavadebis harmoniuli tipis da fsiqoTizmis regresuli analizi

Model B Std. Error Beta t Sig.1 (Constant)

fsiqotizmi8.999 1.051 8.185 .000.247 .229 -.351 -2.516 .016

prediqtori: fsiqotizmidamokidebuli cvladi: daavadebaze reagirebis harmoniuli tipi

Kkvlevis safuZvelze dadginda, rom daavadebaze reagirebis

garkveuli tipebze SeiZleba gavlena iqonios daavadebis iseTma

cvladebma, rogoricaa gulyrebis sixSire da daavadebis dawyebis

asaki. kerZod, rac ufro iSviaTia gulyrebi (/weliwadSi), miT ufro

maRalia daavadebaze reagirebis harmoniuli tipis Camoyalibebis

tendencia, romelic gulisxmobs “avadmyofis rolze” uaris Tqmas da

iseTi ganwyobebis Camoyalibebas, romlebic xels uwyoben fizikuri

mdgomareobis gaumjobesebas, mkurnalobisaTvis aqtiur xelSewyobas,

sakuTari mdgomareobis adekvatur Sefasebas, sakuTari interesebis da

miznebis Secvlas avadmyofobiT Secvlil, axal cxovrebiseul

situaciaSi; arasaimedo prognozis SemTxvevaSi ki _ interesebis

gadarTvas cxovrebis im sferoebze, romlebic jer kidev misawvdomia

avadmyofisaTvis.

iSviaTi gulyrebis SemTxvevaSi, aseve, ufro gamokveTilia

daavadebaze reagirebis ergopaTiuli tipi. iSviaTi gulyrebi

saSualebas aZleven pacientebs imuSaon/iswavlon srulyofilad,

daavadebis miuxedavad. xolo gulyrebis momatebasTan erTad,

matulobs sakuTar ZalebSi daurwmunebloba da pacientis qcevas

ufro metad, am SemTxvevaSi, gansazRvravs misi daavadeba.

miRebul monacemebTan dakavSirebiT, sainteresoa ramdenad

SesaZlebelia gulyris sixSiris mixedviT daavadebaze reagirebis

garkveuli tipebis winaswarmetyveleba. regresiuli analizi gvaZlevs

safuZvels vivaraudod, rom weliwadSi 2-3-jer gulyris sixSiris

SemTxvevaSi, SeiZleba Camoyalibdes daavadebaze reagirebis

harmoniuli (F=11.632, Sig=.001) da ergopaTiuli tipebi (F=7.985, Sig=.007).

amrigad rac ufro iSviaTia gulyrebi, miT ufro obieqturi da

adekvaturi damokidebuleba uyalibdeba avadmyofs sakuTari

daavadebisadmi, rasac mohyveba daavadebis pirobebSi sakuTari

127

Tavisadmi damokidebulebis Secvlac _ izrdeba TviTSefaseba,

mcirdeba SfoTva, avadmyofi socialurad ufro adaptirebuli xdeba.

cxrili #47. daavadebis harmoniuli tipis da gulyraTasixSiris moqmedebis regresuli analizi

B Std. Error Beta t Sig.(Constant) 9,746 1,096 8,893 ,000

harmoniuli tipi -1,796 .527 -,428 -3,411 ,001prediqtori: gulyraTa sixSiredamokidebuli cvladi: daavadebaze reagirebis harmoniuli tipi

cxrili #48. daavadebis ergopaTiuli tipis da gulyraTa sixSiris moqmedebis regresuli analizi

BStd. Error Beta t Sig.

(Constant) 4,171

,588 7,479 ,000

ergopaTiuri tipi -,757 ,268 -,365 -2,826 ,007

prediqtori: gulyraTa sixSiredamokidebuli cvladi: daavadebaze reagirebis ergopaTiuri tipi.

daavadebaze reagirebis senzitiur-obsesiur-fobiuri da

melanqoliuri tipebi dakavSirebulia daavadebis dawyebis asakTan.

rac ufro adreul asakSia daavadebis debiuti, miT ufro maRalia

maTi maCvenebeli.

daavadebis adreuli dasawyisi mis xangrZlivobas ukavSirdeba.

daavadebis didi xnis ganmavlobaSi mimdinareoba (wlobis

ganmavlobaSi) ki Seguebas da masTan dakavSirebuli SfoTvis

Semcirebas gulisxmobs . Cvens kvlevaSi es ar dasturdeba. safeTqlis

epilefsiis mqone pacientebTan vlindeba Semdegi tendencia:

daavadebaze reagirebis am tipis maCvenebelebi maRalia mxolod

daavadebis 10 wlamde dawyebis SemTxvevaSi. rac ufro adreul asakSia

daavadebis debiuti, miT ufro gamoxatulia daavadebasTan mimarTebaSi

aRmocenebuli uimedobis gancda, daTrgunva avadmyofobiT,

gamojanmrTelebis rwmenis dagargva, pesimizmi da naTesavebsa da

axloblebisTvis Tavis mobezrebisa da mZime tvirTad yofnis SiSi.

SeiZleba vivaraudoT, rom nawilobriv, es ganpirobebulia

mkurnalobis araefeqturobiT (Cvens mier gamokvleulTa ricxvSi

Sediodnen pacientebi, romlebsac, miuxedavad daavadebis

xangZlivobisa da mkurnalobisa, aReniSnebodaT gulyrebi da

128

anormaluri eeg-s maCveneblebi). regresiuli analizi aseve miuTiTebs

kavSirze daavadebis adreul asakSi dawyebisa da gazrdil

cvlilebebTan emociur-pirovnul sferoSi. garda amisa, wlobis

ganmavlobaSi mimdinare epilefsiurma aqtivobam SeiZleba gamoiwvios

sxvadasxva saxis neiroatonomiuri darRveva da, Tuki Cven

davubrundebiT mosazrebas safeTqlis epilefsiis dros aRmocenebuli

obsesiuri azrebis safuZvlad mdebare struqturuli darRvevebis

Sesaxeb, kerZod, E amigdalasa da safeTqel-limburi disfunqciis

Sesaxeb (Barbieri et al., 2005), am SemTxvevaSi miRebuli monacemebis axsna am

kuTxiTac aris SesaZlebeli.

rogorc kvlevidan Cans, mniSnvelovania sqesis faqtoris gavlena

daavadebaze reagirebis tipze. mamakacebTan Warbobs sakuTari

daavadebis ufro obieqturi aRqma (daavadebaze reagirebis harmoniuli

tipi), xolo qalebSi ufro gamoxatulia erTis mxriv, garkveuli

gulgriloba daavadebis mimdinareobisadmi, mkurnalobisadmi pasiuri

damorCileba, interesebis sferos gaRaribeba (daavadebaze reagirebis

apaTiuri tipi) da meores mxriv, “gaqceva avadmyofobaSi”, sakuTari

gancdebis saaSkaraoze gamotana garSemomyofTa yuradRebis mipyrobis

mizniT, gansakuTrebuli zrunvis moTxovnileba, sakuTari pirovnebis

mimarT gansakuTrebuli yuradRebis moTxovna daavadebis pirobebSi

(daavadebaze reagirebis egocentruli tipi). es nawilobriv SeiZleba

aixsnas imiTac, rom qalebSi ufro maRalia depresiis maCvenebeli.

regresiuli analizis meTodis saSualebiT SevamowmeT, Tu

ramdenad SesaZlebelia daavadebaze reagirebis am tipebis

Camoyalibebis winaswarmetyveleba avadmyofTa sqesis gaTvaliswinebiT.

aRmoCnda, rom daavadebaze reagirebis harmoniuli tipis Camoyalibebis

albaToba matulobs, Tuki pacienti mamkacia (F=11,632, Sig=.001)

(cxrili #49).

cxrili #49. daavadebis harmoniul tipze moqmedi faqtorebis moqmedebis regresiuli analizi

B Std. Beta t Sig.

129

Error

(Constant) 9,747 1,096 8,893 ,000harmoniuli

tipi-

1,796,527 -,428 -3,411 ,001

prediqtori: sqesidamokidebuli cvladi: daavadebaze reagirebis harmoniuli tipi

rodesac pacienti qalia da mas aqvs epilefsiuri fokusis

marjvena lateralizacia, SesaZlebelia mas Camouyalibdes

daavadebaze reagirebis apaTiuri tipi ((F=3,877, Sig=.027) (cxrili#49).

calke lateralizaciis faqtori araviTar gavlenas ar axdens

daavadebaze reagirebis tipze. aseve, rodesac pacienti aris

mdedrobiTi sqesis, maRalia albaToba daavadebaze reagirebis

egocentruli tipis Camoyalibebisa (F=10.623, Sig=.002), xolo Tu amas

emateba lateralizaciis faqtori – daavadebaze reagirebis aseTi

tipis albaToba kidev ufro matulobs (F=8.221, Sig.=.001) (cxrili#50).

cxrili #50. daavadebis apaTiur tipze moqmedi faqtorebis moqmedebis regresiuli analizi


(Constant) 31,474 8,340 3,774 ,000sqesi 7,735 3,707 ,274 2,087 ,042lateralizacia 7,747 3,769 ,270 2,055 ,045prediqtori: sqesi da lateralizaciadamokidebuli cvladi: daavadebaze reagirebis apaTiuri tipi

cxrili #51. daavadebis egocentruli tipze moqmedi faqtorebis moqmedebis regresiuli analizi


(Constant) 27,267 6,521 4,181 ,000sqesi 10,256 2,898 ,433 3,539 ,001

lateralizacia 6,910 2,947 ,287 2,344 ,023prediqtori: sqesi da lateralizaciadamokidebuli cvladi: daavadebaze reagirebis egocentruli tipi

amrigad, safeTqlis epilefsiis mqone mdedrobiTi sqesis

pacientebSi, epilefsiuri keris marjvenamxrivi lokalizaciis

SemTxvevaSi SesaZlebelia viwinaswarmetyveloT daavadebaze

reagirebis apaTiuri da egocentruli tipebis Camoyalibeba.

bevrad ufro gamokveTilia daavadebaze reagirebis tipis

ganpirobebuloba garemosTan urTierTobis tipiT.

130

sakuTar ZalebSi da SesaZleblobebSi gadaWarbebulma rwmenam

(Zalaufleba-liderobis tipi (1-oqtanti) SeiZleba gamoiwvios

daavadebisadmi eiforia-anozognozuri reagirebis tipis Camoyalibeba

– daavadebis simtomebis uaryofa/Semcireba, mkurnalobis

gauTvaliswinebloba da mxolod sakuTar Zalebze dayrdnoba (cxrili

#52).

cxrili#52. Zalaufleba-liderobis tipze moqmedi faqtorebis moqmedebis regresiuli analizi


(Constant) 1.447 .530 2.731 .009Zalaufleba-liderobis tipi (1-oqtanti)

.172 .071 .324 2.424 .019

damokidebuli cvladi: daavadebaze reagirebis eiforia-anozognozuri tipi

skeptikurobam, arakonformizmma, garemosadmi undoblobam

undobel-skeptikuri tipi (me-4 oqtanti) SeiZleba gamoiwvios

mkurnalobis sul mdam axali saSualebebis Ziebis survili, sakuTar

subieqtur SegrZnebebze yuradRebis gamaxvileba da adekvaturi

mkurnalobis uyuradReboD datoveba – daavadebaze reagirebis

SfoTviT-ipoqondriuli tipi (cxrili #53).

cxrili#53. undobel-skeptikuri tipi (me-4 oqtanti)tipze moqmedi faqtorebis moqmedebis regresiuli analizi


(Constant) 2.254 .838 2.690 .010undobel-skeptikuri tipi(me-4 oqtanti)

.565 .128 .528 4.402 .000

damokidebuli cvladi: daavadebaze reagirebis SfoTviT-ipoqondriuli tipi

xolo rwmena sakuTar SesaZleblobebSi, organizatoris unarebi

(zomierad gamoxatuli Zalaufleba-liderobis tipi (1-oqtanti)

xSirad iwveven situaciis obieqtur Sefasebas da Semdgom misgan

gamosvlis adekvaturi gzebis SemuSavebas, rac daavadebis pirobebSi

mdgomareobs avadmyofobis Sesaxeb informaciis analizSi, miRebaSi da

mkurnalobis rejimis mkacr dacvaSi(cxrili #54).

131

cxrili#54. Zalaufleba-liderobis tipze (1-oqtanti)moqmedi faqtorebis moqmedebis regresiuli analizi


(Constant) 4.388 .773 5.675 .000Zalaufleba-liderobis tipi (1-oqtanti)

.282 .103 .360 2.729 .009

damokidebuli cvladi: daavadebaze reagirebis harmoniuli tipi

am mosazrebas adasturebs is, rom garemosTan damoukidebel-

dominanturi tipis (me2-oqtanti) arsebobis pirobebSi – urTierTobis

damoukidebeli, merZoli, sakuTar TavSi darwmunebuli tipi da

pasuxismgeblobis ganviTarebuli grZnobis mqone avadmyof

adamianebTan (pasuxilsmgeblian-gulisxmioeri tipi (me-8 oqtanti),

aseve daavadebaze reagirebis harmoniuli tipis Camoyalibeba (cxrili

#55).

cxrili#55. garemosTaN urTierTobis tipebze faqtorebis moqmedebis regresiuli analizi


(Constant) 3.914 .859 4.599 .000damoukidebel-dominanturi tipi (me2-oqtanti)

.335 .112 .390 2.993 .004

(Constant) 2.914 1.002 2.908 .005pasuxilsmgeblian-gulisxmioeri tipi (me-8 oqtanti)

.434 .122 .448 3.545 .001

damokidebuli cvladi: daavadebaze reagirebis harmoniuli tipi

regresiulma analizma aCvena, rom energiulobam,

mizandasaxulobam (sworazrovan-agresiuli tipi (me-3-oqtanti) da

sxvaTa ndobis da sxvebisgan daxmarebis miRebis moTxovnilebam

(damokidebul-damjeri tipi (me-6-oqtanti) SeiZleba gamoiwvion

daavadebaze reagirebis ergopaTiuri tipis aRmoceneba – samsaxurSi

dabruneba da iq myofi adamianebis daxmarebis imedi (cxrili#56).

cxrili#56. garemosTaN urTierTobis tipebze moqmedi faqtorebis moqmedebis regresiuli analizi


132

(Constant) 1.541 .581 2.654 .011sworazrovan-agresiuli tipi (me-3-oqtanti)

.165 .080 .281 2.073 .043

(Constant) 3.840 .456 8.817 .000damokidebul-damjeri tipi (me6-oqtanti)

-.180 .064 -.370 -2.817 .007

damokidebuli cvladi: daavadebaze reagirebis ergopaTiuri tipi

agreTve gamovlinda, rom rac ufro damoukidebeli, merZoli da

sakuTar ZalebSi darwmunebulia (damoukidebel-dominanturi tipi (me2-

oqtanti)) avadmyofi adamiani, miT ufro naklebad aqvs mas gamoxatuli

e.w. “gaqceva avadmyofobaSi”, sakuTari gancdebis saaSkaraoze

gamotanis survili, garSemomyofTa yuradRebis mipyrobis mizniT

(daavadebaze reagirebis egocentruli tipi) (cxrili #57).

cxrili#57. garemosTaN urTierTobis tipebze moqmedi faqtorebis moqmedebis regresiuli analizi


(Constant) 2.114 .408 5.182 .000damoukidebel-

dominanturi tipi (me2-oqtanti)

-.140 .053 -.349 -2.632 .011

damokidebuli cvladi: daavadebaze reagirebis egocentruli tipi

is, rom epilefsiis mqone pirebs aRmoaCndaT maRali neirotizmi,

SeiZleba vivaraudoT, rom safeTqlis wilis aqtivobiT gamowveuli

SfoTvisa da emociuri labilobisken midrekileba ufro Zlieri aqvT

am pacientebs.

neirotizmi/emociuroba, aizenkis mixedviT, damokidebulia meore

fiziologiuri sistemis (limburi sistemis) aqtivobaze. gansvla

limburi sistemis aqtivobis zRrublSi, misi azriT, warmoadgens

fiziologiur safuZvels neirotizmis-emociuri stabilobis

maCveneblebisa – neirotizmi efuZneba limburi sistemis aqtivaciis

zRrubls. neirotcizmi es aris limburi sistremis aqtivobis

maCvenebeli. adamianebs neiroticizmis maRali maCvenebliT aqvT ufro

reaqtiuli simpaTikuri nervuli sistema da isini ufro senzitiurebi

arian garemo stimulebisadmi.

133

limburi sistema aris Tavis tvinis is nawili, romelic, zogadad

rom vTqvaT, pasuxismgebelia brZolis an gaqcevis reaqciis

ganxorcielebaze. is moicavs hipokamps, amigdalas, hipoTalamuss da

cingulum da aregulirebs iseT emociur mdgomareobebs, rogorebic aris

SiSi, agresia (Eysenck, 1990).

rogorc cnobili safeTqlis wils aqvs mWidro kavSirebi limbur

sistemasTan da misi agzneba/Sekavebis procesebi uSualo gavlenas

axdenen avadmyofi adamianis pirovnebaze. kerZod iwveven

neiroticizmis gazrdils maCvenebels. rac Cvens kvlevaSic

dasturdeba.

neirotizmis maRali donis mqone adamianebi, rogorc wesi

avadmyofur, uCveulo, SfoTvis gamomwvev stimulebze reagireben ufro

swrafad, vidre ufro stabiluri adamianebi. maT axasiaTebT agreTve

ufro xangZlivi reaqciebi, romlebic grZeldeba stimulis faqrobis

Semdegac.

gulis iSemiuri daavadebis mqone pirebs ufro metad axasiaTebT

daavadebaze reagirebis SfoTviT-ipoqondriuli tipi. maT axasiaTebT

mudmivi fiqri daavadebis saSiSroebis da mkurnalobis

araefeqturobis Sesaxeb, fiqri daavadebis savalalo SedegiT

dasrulebis Sesaxeb, sakuTar subieqtur SegrZnebebze yurdRebis

gamaxvileba, realuri daavadebis gazviadeba.

gulis iSemiuri daavadebis mqone pirebSi, iseve rogorc

safeTqlis epilefsiis jgufSi, gamovlinda sqesobrivi sxvaobebi

daavadebaze reagirebis tipebs Soris. mamakacebs ufro metad

axasiaTebT obieqtur safuZvels moklebuli aweuli guneba_ganwyoba,

ufro xSiria reJimis darRveva, mkurnalobis araregularuli

ganxorcileleba, daavadebis simptomebis miwera SemTxveviTi

movlenebisadmi (reagirebis eiforia-anazognozuri tipi). qalebSi,

iseve rogorc safeTqlis epilefsiis SemTxvevaSi ufro maRalia

uimedobis gancda, daTrgunva avadmyofobiT, pesimizmi, depresiuli

(daavadebaze reagirebis melanqoliuri tipi), aseve qalebs ufro metad

axasiaTebT sakuTar SegrZnebebze yuradrebis gamaxvileba, zogjer

134

maTi gazviadeba da amiT sakuTari TavisTvis yuradRebis miqceva

(egocentruli tipi).

gulis isemiuri daavadebis mqone pirebTan regresiulma analizma

gamoavlina, rom rac ufro meti aqvs avadmyof adamians ndoba

garSemomyofebisadmi da naklebia maT mimarT kritikuli

damokidebuleba, miT ufro gamoxatulia daavadebaze reagirebis

ergopaTiuri tipi – samsaxurSi/saswavlebelSi dabrunebis survili

(uaryoTi kavSiri korelaciuri analizis Sedegebis dadastureba)

(cxrili #58).

cxrili#58. garemosTanN urTierTobis tipebzemoqmedi faqtorebis moqmedebis regresiuli analizi


(Constant) 4.238 .669 6.330 .000undobel-

skeptikuri tipi (me-4-oqtanti)

-.328 .105 -.503 -3.136 .004

damokidebuli cvladi: daavadebaze reagirebis ergopaTiuri tipi

aseve uaryofiTi kavSiri arseboba (korelaciuri analizi)

dasturdeba daavadebaze reagirebis melanqoliur da garemosTan

urTierTobis pasuxilsmgeblian-gulisxmioer tipebs (1-oqtanti)

Soris – dauwmuneblobam sakuTar ZalebSi SeiZleba gamoiwvios

uimedobis gancda, daTrgunva avadmyofobiT, gamojanmrTelebis

rwmenis dakargva (cxrili #59).

cxrili#59. garemosTan urTierTobis tipebzemoqmedi faqtorebis moqmedebis regresiuli analizi


(Constant) 3.298 .622 5.304 .000

pasuxilsmgeblian-gulisxmioeri tipi (1-oqtanti)

-.313 .106 -.480 -2.948 .006

damokidebuli cvladi: daavadebaze reagirebis melanqoliuri tipi

regresiuli analizis meTodis saSualebiT SevamowmeT, Tu

ramdenad SesaZlebelia winaswarmetyveleba daavadebaze reagirebis am

tipebis Camoyalibebisa gulis iSemiuri daavadebis mqone pacientebTan.

135

SesaZlebelia viwinaswarmetyveloT, rom mamakacebs CamouyalibdebaT

daavadebaze reagirebis eiforiuli tipi (F=4,969, Sig=.034) (cxrili

#60).

cxrili #60. daavadebis eiforiul tipze moqmedi faqtorebis moqmedebis regresiuli analizi


(Constant) 60,124 6,361 9,452 ,000sqesi -8,883 3,985 -,382 -2,229 ,034

prediqtori: sqesi damokidebuli cvladi: daavadebaze reagirebis eiforiul-anazognozuri tipi

Tu pacienti mdedrobiTi sqesisaa, maRalia albaToba imisa, rom

mas Camouyalibdes daavadebaze reagirebis melanqoliuri (F=5.354,

Sig=.028) an egocentruli tipi (F=9.300, Sig=.005) (cxrili #61-62).

cxrili #61. daavadebis melanqoliur tipze moqmedi faqtorebis regresiuli analizi


(Constant) 38.884 6.514 5.969 .000sqesi 9.442 4.081 .395 2.314 .028

prediqtori: sqesi damokidebuli cvladi: daavadebaze reagirebis melanqoliuri tipi

cxrili #62. daavadebis egocentrul tipze moqmedi faqtorebis regresiuli analizi


(Constant) 39.023 4.908 7.951 .000sqesi 9.376 3.075 .493 3.050 .005prediqtori: sqesi damokidebuli cvladi: daavadebaze reagirebis egocentruli tipi

analogiurad safeTqlis epilefsiis jgufisa, am SemTxvevaSi

SeiZleba daisvas kiTxva - ganapirobeben Tu ara biologiuri

faqtorebi daavadebaze reagirebis garkveuli tipis Camoyalibebas.

regresiulma analizma aCvena, rom rac ufro maRalia gulis iSemiuri

daavadebis mqone avadmyofTan neirotizmis maCvenebeli, miT ufro

maRalia daavadebaze reagirebis eiforiul-anozognozuri tipi. mas

axasiaTebs gamoxatuli emociuri aramdgradoba, labiluriba,

mousvenroba, ris gamo mas uWirs mdgomareobis adekvaturi Sefaseba

da masTan vlindeba daavadebis da misi obieqturi gamovlinebebis

136

uaryofa, daavadebis sipmtomebis miwera SemTxveviTi movlenebisadbi,

rac iwvevs rejimis da mkurnalobis pirobebis daucvelobas (cxrili

#63).

cxrili#63. daavadebis eiforiul-anozognozuri tipis da neirotizmis regresuli analizi (prediqtori: neirotizmi)


(Constant) 4.638 1.179 3.932 .001neirotizmi -.282 .111 -.432 -2.533 .017

prediqtori: neirotizmi

epilefsiis mqone pacientebs, gulis iSemiuri daavadebis mqone

pacientebTan SedarebiT, ufro maRali aqvT daavadebaze reagirebis

senzitiur-obsesiur-fobiuri tipis maCvenebeli. safeTqlis epilefsiis

mqone pirebi ufro mgrZnobiareni arian garSemomyofi adamianebis

azrebis mimarT, maTTvis mniSvnelovania, Tu ras fiqroben maTze sxva

adamianebi, maTi SiSi ufro socialur xasiaTs atarebs, rac

epilefsiis mastigmatizirebeli bunebiT SeiZleba aixsnas.

sakontrolo jgufSi daavadebaze reagirebis arc erTi tipi ar

gamovlinda, rac bunebrivia obieqturi daavadebis ararsebobis

pirobebSi.

depresiis maCvenebeli:

depresia xSiria sxvadasxva daavadebis mqone pirebSi da

epilefiis mqone pacientebi am kuTxiT gamonakliss ar warmoadgenen.

Evans (2003), werda, rom ”depresia SeiZleba iyos zogierTi samedicino

mdgomareobis rogorc Sedegi, asve mizezi” (gv.177).

iTvleba, rom safeTqlis epilefsiiT daavadebul pirebs Soris

sakmaod maRalia depresiuli foni. miuTiTeben Tavis tvinis marcxena

hemisferos dainteresebaze depresiuli simptomatologiis

aRmocenebaSi. Cvens gamokvlevaSi depresiis maCvenebeli saSualo

simZimes aRwevs da is ar aRmoCnda ganpirobebuli epilefsiuri

fokusis lateralizaciiT, magram gamovlinda kavSiri gulyrebis

sixSiresTan. rac ufro xSiria gulyrebi, miT ufro maRalia

depresiis maCvenebeli. es sxva gamokvlevebSic dasturdeba (Robertson,

1991, Grabowska-Grzyb et al., 2006). gulyaraTa sixSire uSualod aris

dakavSirebuli depresiis zrdasTan: xSiri gulyrebi epilefsiuri

137

gulyrebis kupirebis (SeCerebis an Semcirebis) SeuZleblobaze

miuTiTebs, rac pacientisTvis mkurnalobis araefeqturobis

maCvenebelia. xSiri gulyrebis arseboba pacientis cxovrebaSi

aZlierebs daavadebiT gamowveul stress, rac dakavSirebulia

depresiis aRmocenebasTan. Hayden M. et al. (1992), Catarebul kvlevaSi

pacientTa didi nawili miuTiTebs kavSirze stressa da gulyraTa

kontrols Soris.

garda amisa, safeTqlis epilefsiis mqone jgufSi regresiuli

analizis safuZvelze aRmoCnda, rom dpresiis winaswametveleba didi

albaTobiTaa SesaZlebeli qalebSi, agreTve im pirebSi, visac maRali

aqvs fsiqotizmis maCvenebeli, gaaCnia interpersonaluri urTierTobis

undobel-skeptikuri tipi da daavadebaze reagirebis melanqoliuri

tipi. safeTqlis epilefsiis mqone qalebi ufro midrekilni arian

depresiis aRmocenebisaken. rac ufro pesimisturad afasebs pacienti

sakuTar mdgomareobas, miT ufro maRalia depresiis aRmocenebis

albaToba. sakuTari daavadebis mimarT pesimisturi ganwyobis kavSirze

depresiis aRmocenebasTan Soris miuTiTebdnen Tavis kvlevaSi Hermann,

Seindenberg & Bell, 2000.

amave dros, uaryofiTi korelaciaa depresiasa da daavadebaze

reagirebis harmoniul tips Soris; rac ufro sustad aris

ukanaskneli gamoxatuli miT ufro mniSvnelovania depresiis done

(cxrili #64).

garda amisa, rac ufro skeptikuria pacienti (urTierTobis

undobel-skeptikuri tipis maxasiaTebli), miT ufro maRalia depresiis

maCvenebeli.

cxrili #64. depresiis maCvenebelze moqmedi faqtorebis regresiuli analizi safeTqlis epilefsiis mqone jgufSi


(Constant) 52.698

12.858 4.098 .000

sqesi 3.949 2.319 .168 1.703 .096fsiqotizmi -.371 .123 -.316 -3.020 .004daavadebis melanqoliuri tipi .420 .118 .418 3.565 .001daavadebis harmoniuli tipi -.439 .125 -.369 -3.518 .001garemosTan urTirTobis undobel-skeptikuri tipi .338 .142 .286 2.384 .021

damokidebuli cvladi: depresiis maCvenebeli

138

epilefsiis dros depresiis aRmocenebis kvlevebis analizis

safuZvelze Cans, rom is ganpiriobebulia ramdenime faqtoris

urTierTzemoqmedebiT: (1) genetikuri anpirobebuloba, (2) garemos

movlenebi (gulyrebis aRmocenebiT gamowveuli maTi Secvla), (3)

fsiqosocialuri faqtorebi (mag., umuSevroba, stigma), (4)

fiziologiuri stresorebi (mag., gulyra) da (5) individualuri

Taviseburebani (Robertson, 1991).

Cvens gamokvlevaSi es mosazreba ar dasturdeba.

Cvens mier miRebuli Sedegebis regresiuli analiziz gvaZlevs

safuZvels vivaraudod, rom safeTqlis epilefsiis mqone pacientebSi

depresia ganpirobebulia ufro fsiqologiuri faqtorebiT, vidre

daavadebis organuli maxasiaTeblebiT. regresiuli analizma ar

gamoavlina daavadebis cvladebis pirdapiri, prediktoruli

mniSvneloba depresiiis aRmocenebaSi. Tumca depresia warmoadgens

daavadebiT gamowveuli cxovrebiseuli cvlilebebis Sedegs, rasac

biZgs gulyrebis maRali sixSire aZlev. Cvens gkvlevaSi regresiuli

analizi ar adasturebs am kavSiris prediktorul bunebas.

garkveuli gansxvavebebiT, analogiuri tendenciebi vlindeba

gulis iSemiuri daavadebis jgufSi. gamovlinda depresiasTan

dakavSirebuli Semdegi faqtorebi: interpersonaluri urTierTobis

garkeveuli tipi (Zalaufleba-liderobis da undobel-skeptikuri),

daavadebaze reagirebis melanqoliuri da harmoniuli tipebi.

qalebTan depresiis maCvenebeli, aseve, ufro maRalia. ufro maRalia

depresiis aRmocenebis albaToba, Tuki pacienti metismetad

skeptikurad afasebs mis garSemo momxdar movleneba (urTierTobis

undobel-skeptikuri tipi) da rac ufro naklebad aris pacienti

darwmunebuli sakuTar TavSi, miT ufro maRalia depresiis done

(urTierTobis Zalaufleba-liderobis tipis dabali maCveneblebis

SemTxvevaSi) (cxrili #65).

cxrili #65. depresiis maCvenebelze moqmedi faqtorebis regresiuli analizi gulis iSemiuri daavadebis mqone jgufSi

139


(Constant) 51.627

8.122 6.357 .000

garemosTan urTierTobis undobel-skeptikuri tipi .173 .060 .255 2.888

.008

garemosTan urTierTobis Zalaufleba-liderobis tipi -.174 .069 -.256 -2.526 .018

daavadebaze reagirebis harmoniuli tipi -.316 .075 -.365 -4.199 .000

daavadebaze reagirebismelanqoliuri tipi .256 .063 .458 4.101 .000

damokidebuli cvladi: depresiis maCvenebeli

janmrTel cdis pirebSi depresiis maCvenebeli aRmoCnda kavSirSi

daavadebaze reagirebis SfoTviT-ipoqondriul da melanqoliur

tipebTan da garemosTan urTierTobis morcxv-damorCilebul tipTan.

obieqturi daavadebis araarsebobis pirobebSi, Cven SegviZlia

vivaraudod, rom zogadad aweuli SfoTva, subieqtur SegrZnebebze

yuradRebis gamaxvilebis survili da dabali TviTSefaseba

dakavSirebulia depresiasTan.

garda amisa, SeiZleba gamovTqvaT varaudi, rom depresiis

saSualo maCvenebeli safeTqlis epilefiis mqone jgufSi

ganpirobebulia imiT, rom pacientebi ZiriTadad Rebulobdnen

karbamazepins, xolo, rogorc kvlevebi adastureben (Trimble M., 1989),

mas aqvs antidepresantis efeqti. Tumca Cvens kvlevaSi amis

damadasturebeli statistikurad sando monacemebi ver miviReT.

amrigad:

gamovlinda faqtorebis rigi, romlebic xels uwyoben depresiis

aRmocenebas. safeTqlis epilefsiis mqone da gulis iSemiuri

daavadebis mqne pirebTan es faqtorebi mniSvnelovnad ar

gansxvadebian erTmaneTisagan:


garemosTan urTierTobisas sakuTar

ZalebSi daurwmunebloba da skepticizmi

depresiis aRmocenebis mizezebi safeTqlis epilefsiis mqone

jgufSi da gulis iSemiuri daavadebis jgufSi fsiqologiuri xasiaTs

atareben.

140

interpersonaluri urTierTobis tipi:

safeTqlis epilefsiis mqone pirebi sxva adamianebTan

urTierTobisas iswrafvian axlo, megobruli urTierTobis

damyarebisaken, maT uWirT sakuTari GgrZobebis gamoxatva, Tumca amis

survili aqvT. isini pasiuri, dabali TviTSefasebis mqoneni arian,

aqvT pasuxismgeblobis maRali grZnoba (morcxvi-damorCilebuli).

meores mxriv, maT axasiaTebT (TanamSromlobiT-konvencialuri) maRali

mgrZnobeloba garemos zemoqmedebisadmi, isini cdiloben sxva

adamianebTan axlo urTierTobis damyarebas, eZeben maT mowonebas.

bevrad ufro gamoxatulia kavSiri garemosTan interpersonaluri

urTierTobebis tipsa da pirovnebis maxasiaTeblebs Soris. rac ufro

maRalia pacientebTan fsiqotizmis maCvenebli, miT ufro izrdeba

albaToba garemosTan urTierTobis undobel-skeptikuri tipis

Camoyalibebisa – rac ufro maRalia adamianSi konfliqturoba,

egocentrizmi, miT ufro undobeli, eWviani da konfliqturi SeiZleba

gaxdes is garSemomyofefTan urTierTobaSi (cxrili #66).

cxrili#66. garemosTan urTierTobis tipebzemoqmedi faqtorebis moqmedebis regresiuli analizi


(Constant) 3.838 .961 3.994 .000fsiqotizmi .493 .210 .331 2.352 .023

damokidebuli cvladi: garemosTan urTierTobis undobel-skeptikuri tipi

xolo, piriqiT, rac ufro naklebad aris gamoxatuli

fsiqotizmis maCvenebeli – adamiani xdeba ufro gaxsnili garemosadmi

da cdilobs sxvebTan axlo, megobruli urTirTobis damyarebas

(garemosTan urTierTobis TanamSromlobiT-konvenciuri tipi – me-7

oqtanti). analogiuri Sedegebi miviReT garemosTan urTierTobis am

tipis CamoyalibebaSi neiroticizmis rolis Sesaxeb – rac ufro

naklebad aris am ukanasknelis gamovlena, miT ufro maRalia

garemosTan keTili urTioerTobis damyarebis survili (cxrili #67).

cxrili#67. garemosTan urTierTobis tipebze moqmedi faqtorebis moqmedebis regresiuli analizi


(Constant) 11.09 1.109 9.999 .000

141

0fsiqotizmi -.673 .242 -.383 -2.782 .008

(Constant) 10.709

1.277 8.383 .000

neirotizmi -.201 .098 -.293 -2.054 .046damokidebuli cvladi: garemosTan urTierTobis TanamSromlobiT-konvenciuri tipi

Nneirotizmis gazrdili maCvenebli SeiZleba iyos winapiroba

garemosTan urTierTobis undobel-skeptikuri tipis Camoyalibebisa.

emociuri aramdgradoba, labiluroba, sakuTar TavSi daurwmunebloba

xSirad iwvevs msjelobebis da qcevebis SefasebaSi skeptikurobas, rac

ganapirobebs garemosadmi gansakuTrebiT kritikul damokidebulebas

(cxrili #68).

cxrili#68. garemosTan urTierTobis tipebze moqmedi faqtorebis moqmedebis regresiuli analizi


(Constant) 2.061 .952 2.165 .036neirotizmi .316 .073 .542 4.329 .000

damokidebuli cvladi: garemosTan urTierTobis undobel-skeptikuri tipi

gulis iSemiuri daavadebis mqone pirebTan aseve vlindeba

morcxvi-damorCilebuli urTierTbis tipi, isini sakuTar Tavs

axasiaTeben, rogorc morcxv, TavSekavebul adamianebad, amave dros

maT aqvT didi survili garSemomyofebTan axlo megobruli

urTierTobis damyarebisa (TanamSromlobiT-konvenciuri tipi), maT

axasiaTebT komunikabeloba, keTilmosurneoba (pasuxismgebliani-

gulisxmieri tipi).

janmrTel pirebSi sxva adamianebTan urTierTobisas aqvT

sxvaTa valdebulebebis sakuTar Tavze aRebis, megobruli

urTierTobebis damyarebis da TanamSromlobisaken swrafvis

tendencia. amave dros, maT aRiniSnebaT iseTi tendenciebi, rogoric

aris damoukideblobisaken swrafva, xSirad agresiuloba,

konfliqturoba, dominantobis moTxovnileba. isini cdiloben erTis

mxriv, daikavon dominirebuli, damoukidebeli mdgomareoba, Tavi

daicvan mosalodneli arakeTilmosurne damokidebulebisagan; meores

mxriv, ki cdiloben ar dakargon sxva adamianebis keTilganwyoba, rac

vlindeba urTierTobis gulisxmier da TanamSromlobiT tendenciebSi.

142

safeTqlis epilefsiis mqone pirebTan interpersonaluri

urTierTobebis tipSi mamakacebSi sandod ufro maRali maCveneblebi

gamovlinda damoukidebel-dominantur (F=12.931, Sig=.001), sworxazovan-

agresiul (F=15,200, Sig=.000) da damokidebul-damjer (F=6.295, Sig=.015)

tipebSi. mamakacebs axasiaTebT erTis mxriv, dominantobis survili

sxvebTan mimarTebaSi, mizanswrafuloba da meores mxriv, maTTvis

Zalze mniSvnelovania sxvaadamianebis aRiareba. qalebSi ufro maRali

dominireba-damorCilebis (F=12,627, Sig=.001) da keTilmosurneoba-

mtrobis (F=6.254, Sig=.016) meoradi faqtorebis faqtorebis maCveneblebi,

rac aseve dominirebaze da keTilmosuneobze miuTiTebs.

janmrTel cdis pirebSi mamakacebTan statistikurad sandod

maRali aqvT urTierTobis undobel-skeptikuri tipi (F=5.078, Sig=.027),

xolo qalebSi - dominireba-damorCilebis (F=8.519, Sig=.005) faqtori.

regresiuli analizi gvaZlevs safuZvels vivaraudoT, rom sqess

prediqtoruli Rirebuleba aqvs interpersonaluri urTierTobis am

tipebis CamoyalibebaSi rogorc safeTqlis epilefsiis mqone pirebSi,

aseve praqtikulad janmrTel cdis pirebSi.

metad mniSvnelovania safeTqlis epilefsiisa da sakontrolo

jgufSi asakobrivi sxvaobebi interpersonaluri urTierTobis

tipebSi.

safeTqlis epilefsiis mqone pirebTan axalgazrda asakSi (17-25

weli)Qinterpersonaluri urTierTobis stilSi Warbobs tendencia

Zalauflebisaken, dominirebisaken, ufro gamoxatulia orientacia

sakuTar azrze da sxvaTa azris minimaluri gaTvaliswineba. asakTan

erTad am maCveneblebis siZliere mcirdeba. janmrTel cdis pirebSi

igive tendenciebi iCenen Tavs, Tumca pirvel SemTxvevaSi is tendencia

ufro gamoxatul xasiaTs atarebs.

garda amisa, miRebuli masalidan gamomdinare aucilebeli xdeba

im faqtorebis/komponentebis gamoyofa, romlebic safuZvlad udevs

miRebul Taviseburebebs. am mizniT Cven gamoviyeneT faqtoruli

analizi (mTavari komponentebis meTodi).

faqtoruli analizis safuZvelze safeTqlis epilefsiis mqone

jgufSi gamoiyo 4 faqtori.

143

pirvel faqtorSi yvelaze maRali woniT gaerTiandnen Semdegi

maCveneblebi:

interpersonaluri urTirTobis undobeli-skeptikuri tipi (me-4

oqtanti)

depresiis maCvenebeli

neirotizmis naCvenebeli





meore faqtorSi gaerTiandnen Semdegi maCveneblebi:

interpersonaluri urTierTobis damoukidebeli-dominanturobis

tipi (me-2 oqtanti)

interpersonaluri urTierTobis Zalaufleba-liderobi tipi (1

oqtanti)

interpersonaluri urTierTobis sworxazovan-agresiuli tipi

(me-3 oqtanti)

dominireba-damorCilebis faqtori

keTilmosurneoba-mtrobis faqtori

daavadebaze reagirebis eiforia-anozognozuri tipi

mesame faqtori:

interpersonaluri urTierTobis morcxvi-damorCilebuli tipi

(me-5 oqtanti)

interpersonaluri urTierTobis pasuxismgeblobis mqone-

gulisxmieri (me-8 oqtanti)

interpersonaluri urTierTobis TanamSromlobiT-konvenciuri

(me-7 oqtanti)

interpersonaluri urTierTobis damokidebuli-damjeri (me-6

oqtanti)



daavadebaze reagirebis harmoniuli tipi

144

meoTxe faqtori:

eqtraversiis maCvenebeli

daavadebaze reagirebis apaTiuri tipi


pirvel faqtorSi gaerTianda iseTi maxasiaTeblebi romelTac

pirobiTad SeiZleba SfoTva-labilurobis maxasiaTeblebi vuwodoT;

meore faqtorSi ZiriTadad gaerTianda interpersonaluri

urTierTobis tipebi, romlebic dominirebisaken, damoukideblobisaken

da zogjer Zalauflebis survilisken arian mimarTulni,

daavadebisadmi da misi Sedegebis ugulvebelyofa da sqesis faqtori;

mesame faqtorSi _ gaerTianda interpersonaluri urTierTobis tipebi,

romlebic mimarTulia garemosTan kompromisuli urTierTobis

damyarebisaken, sakuTari daavadebis obieqturi aRqma da eqstraversiis

maCvenebeli; xolo meoTxe faqtorSi – gaerTiandenen daavadebis

klinikuri niSnebis, pirovnebis Taviseburebani da sakuTari daavadebis

erTmaneTis sawinaaRmdego aRqma, sruli gulgriloba sakuTari

daavadebisadmi, misi Sedegebisadmi da sakuTari daavadebis

saaSkaraoze gamotana da sakuTar pirovnebaze yuradRebis gamaxvileba.

pirvel da meoTxe faqtorebSi gaerTianebul yvela maCvenebels Soris

dadebiTi kavSiria. meore da mesame faqtorSi Tavmoyril maCveneblebs

Soris arsebuli kavSiri ar aris aseTi erTmniSvnelovani: iCens Tavs

sqesobrivi gansxvaveba interpersonaluri urTirTobebis stilSi da

fsiqotizmis donis Semcireba iwvevs garemosTan daqvemdebarebuli

urTierTobis stilis Camoyalibebas.

garda amisa arsebobs garkveuli kavSirebi faqtorebs Soris. ufro

metad is aris gamoxatuli meore da meoTxe fatorebs Soris. rac

safuZvels gavZlevs vivaraudod, rom daavadebis iseTi cvladebi

rogoric aris epilefsiuri keris lateralizacia, gulyraTa sixSire

da iseTi pirovnuli maxasiaTebelebi, rogoric aris sqesi da

eqstraversiis maCvenebeli, daavadebaze reagirebis apaTiuri da

egocentruli tipebi iwveven garemosTan dominirebuli stilis

Camoayalibebas (danarTi #7).

145

gulis iSemiuri daavadebis mqone jgufSi faqtoruli analizis

safuZvlad gamoiyo oTxi faqtori:

pirvel faqtorSi maRali woniT gaerTiandnen Semdegi maCveneblebi:



daavadebaze reagirebis eiforiul-anozognoziuri tipi


daavadebaze reagirebis ergopaTiuli tipi


interpersonaluri urTierTobis Zalaufleba-liderobis tipi

(1 oqtanti)

interpersonaluri urTierTobis undobel-skeptikuri tipi (me-

4 oqtanti)

interpersonaluri urTierTobois pasuxismgeblobis mqone-

gulisxmieri tipi (me-8 oqtanti)

neirotizmis maCvenebeli

meore faqtori:

interpersonaluri urTierTobis sworxazovan-agresiuli tipi (me-

3 oqtanti)

keTilmosurneoba_mtrobis faqtori

interpersonaluri urTierTobis damokidebul-damjeri tipi (me-6

oqtanti)

interpersonaluri urTierTobis TanamSromlobiT-konvencialuri

tipi (me-7 oqtanti)


mesame faqtori:

interpersonaluri urTierTobis Zalaufleba-liderobis tipi (1

oqtanti)

interpersonaluri urTirTobis morcxvi-damorCilebuli tipi (me-

5 oqtanti)


146



meoTxe faqtori:

interpersonaluri urTirtobis sworazrovan-agresiuli tipi (me-3

oqtanti)

daavadebaze reagirebis senzitiur-obseso-fobiuri tipi



neirotizmis maCvenebeli

gulis iSemiuri daavadebis mqone pirebTan dasturdeba depresiis

maCveneblis kavSiri daavadebaze reagirebis tipebTan: erTis mxriv,

depresiis maCveneblis gazrda iwvevs daavadebis mimarT SfoTvis

gazrdas, daavadebis arasasikeTod dasrulebis Sesaxeb azrebis

aRmocenebas da amis fonze pacientis mier sakuTar pirovnebaze

yuradRebis miqcevis survilis gazrdas da garemosTan mmarTveli

urTierTobis stilis nakleb gamoxatulebas da meore mxriv,

depresiis Semcireba iwvevs aweul guneba-ganwyobilebas da samuSaoSi

aqtiur CarTvas, rac xSirad reJimis darRvevasTan aris

dakavSirebuli. rac ufro gamoxatulia dominirebisken swrafva, miT

ufro gamoxatulia daavadebisadmi uyurdRebo damokidebuleba da

samuSaoSi gaqcevis survili. am faqtorSi wamyvania depresiis

maCvenebeli, masTan dakavSirebuli SfoTva da Zalauflebisken

swrafva. meore faqtorSi gaerTianebuli maCveneblebi asaxaven

garemosTan keTilganwyobili, kompromisuli urTierTobis stils da

daavadebasTan dakavSirebul gazrdil SfoTvas. mesame faqtorSi

arsebuli gaerTianebuli maxasiaTeblebi asaxaven garemosTan

urTierTobis stilis kavSirs eqstraversiis maCvenebelTan _ rac

ufro gamoxatulia es ukanaskneli, miT ufro maRalia sazogadoebaSi

dominirebuli poziciis dakavebis survili. meoTxe faqtorSi

ZiriTadad gaerTiandenen pacientis pirovnuli maxasiaTeblebi da

asaki da daavadebaze reagirebis SfoTviTi tipi (danarTi #8).

janmrTel pirTa jgufSi gamoiyo sami faqtori:

147

pirveli fatori: gaerTiandnen mxolod interpersonaluri

urTirtobis tipebi

meore faqtori:



daavadebaze reagirebis senzitiur-obsesofbiuri tipi

daavadebaze reagirebis melanqolirui tipi

daavadebaze reagirebis paranoialuri tipi


mesame faqtori:


daavadebaze reagirebis ergopaTiuri tipi

interpersonaluri urTierTobis damokidebuli_damjeri tipi (me-6

oqtanti)

interpersonaluri urTierTobis TanamSromlobiT-konvenciuri (me-

7 oqtanti)

interpersonaluri urTierTobis pasuxismgebliani-gulisxmieri

(altruistuli) (me-8 oqtanti) tipi


janmrTelTa jgufSi faqtorebi yvelaze ufro erTmniSvnelovan

xasiaTs atareben. pirvel faqtorSi gaerTiandenen garemosTan

interpersonaluri urTierTobis stilis gamomxatveli maCveneblebi.

maT Soris arsebuli kavSiri asaxavs testis maCveneblebs Soris

realurad miRebul suraTs. dasturdeba kavSiri sqesTan. meore

faqtorSi gaerTiandnen daavadebaze reagirebis testis maCveneblebi,

romlebic am SemTxvevaSi, obieqturi daavadebis ararsebobis

SemTxvevaSi, Cveni azriT ver iqneba sandod miRebuli, depresiis da

neoroticizmis maCvenebeli xolo mesame jgufSi gaerTiandnen

garemosTan urTierTobis megobruli stilis maxasiaTeblebis da

sakuTari daavadebis obieqturi aRqma (danarTi #9).

148

faqtorulma analizma gvaCvena, rom safeTqlis epilefsiis da

gulis iSemiuri daavadebis mqone jgufebSi avadmyofi adamianis

qcevas ZiriTadad erTi da igive faqtorebi gansazRvraven.

rogorc miRebuli Sedegebidan Cans dros aRmocenebuli

daavadebaze reagirebis tipi da garemosTan urTierTobis stili

mniSvnelovnad ar gansxvavdeba erTmaneTisagan. Tumca safeTqlis

epilefsiis mqone jgufSi miRebuli suraTi ufro gamoxatul,

aqcentualizirebul da socializebul xasiaTs atarebs.

safeTqlis epilefsiis mqone da gulis iSemiuri daavadebis mqone

jgufebSi ori ZiriTadi faqtori hgavs erTmaneTs (pirveli da meore

faqtorebi). orive SemTxvevaSi wamyvania daavadebaze reagirebis

zogadad SfoTviTi xasiaTis tipi da garemosTan urTierTobis

garkveuli ambivalenturoba. Tumca maT Soris aRiniSneba garkveuli

Tvisobrivi gansxvavebebi. gulis iSemiuri daavadebis mqone pirebs

megobrulobis faqtorebi garkveul konstruqciulobas mateben maT

qcevas, arbileben mas. xolo safeTqlis epilefsiis mqone pirebTan

qceva ufro mZafr xasiaTs Rebulobs, daavadebasTan da mis socialur

SedegebTan dakavSirebuli SiSebis gamo (daavadebaze reagirebis

senzitiur-obseso-fobiuri tipis gamoyofa safeTqlis epilefsiis

mqone pirTa jgufSi) (cxrili #69).

kardinaluri gansxvavebis araarseboba am or jgufSi dasturdeba

sxva kvlevebSic. kerZod Hermann & Whitman (1981) aRniSnaven, rom

epilefsiis mqone pacientebs da gulis daavadebis mqone pacientebs

Soris ar arsebobs mniSvnelovani sxvaobebi emociur-pirovnul

sferoSi. am or jgufs hqonda am cvlilebebis gacilebiT ufro

naklebad gamoxatuli intesivoba, vidre pacientebs sxva

nevrologiuri daavadebiT (mag., gafantuli sklerozi).

amave dros epilefsiis mqone pirebi AamJRavneben emociur-pirovnul

cvlilebaTa ufro farTo speqtrs, rac Cvens kvlevaSic gamoCnda.

cxrili#69. safeTqlis epilefsiis da gulis iSemiuri daavadebis mqone jgufebSi, faqtoruli analizis safuZvelze, gamovlenili faqtorebi*

faqtorebi epilefsia GULgulis iSemiuri1faqtori:

urToerTobis undobel-skeptikuri tipi

depresia

depresia neirotizmidaavadebaze reagirebis daavadebaze reagirebis SfoTviT-

149

SfoTviT-ipoqondriuli tipi ipoqondriuli tipidaavadebaze reagirebis senzitiur-obseso-fobiuri tipi



daavadebaze reagirebis apaTiuri tipi


daavadebaze reagirebis egocentuloi tipi

2 faqtori urToerTobis Zalaufleba-liderobis tipi

urToerTobis morcxvi-damorCilebuli tipi

urToerTobis damoukidebel-dominanturi tipi

urToerTobis damokidebul-damjeri tipi

urToerTobis sworazrovan-agresiuli tipi

urToerTobis pasuxismgebvlian-gulisxmieri tipi


keTilmosurneoba_mtrobis faqtori

3 faqtori urToerTobis morcxvi-damorCilebuli tipi

urToerTobis Zalaifleba-liderobis tipi

urToerTobis damokidebul-damjeri tipi

urToerTobis damoukidebel-dominanturi tipi

urToerTobis TanamSromlobiT-konvenciuri tipi

urToerTobis TanamSromlobiT-konvenciuri tipi

urToerTobis pasuxismgeblian-gulisxmieri tipi

dominireba_damorCilebis faqtori

KkeTilnmosurneoba-mtrobis faqtori

daavadebaze reagirebis paranoialuri tipi


4 faqtori eqstraversia fsiqotizmidaavadebaze reagirebis apaTiuri tipi

eqtraversia


daavadebaze reagirebis obseso-fobiuri tipi

sqesilateralizaciagulyraTa sixSire

*cxrilSi Seyvanilia mxolod dadebiTi niSnis matarebeli faqtorebi

daskvnebi:

1. safeTqlis epilefsiis mqone jgufSi daavadebis Sinagani

suraTis ZiriTadi damaxasiaTebeli niSani aris daavadebis socialur

SedegebTan dakavSirebuli SiSi, ris gamo pacientebi zedmetad

mgrZobiareni xdebian garSemomyof adamianebTan urTierTobis

procesSi da aqvT SiSi imisa, rom daavadebis klinikuri

Sedegebisadmi yuradRebis gamaxvilebam da maTze yuradRebis miqcevam

SeiZleba gamoiwvios maT mimarT negatiuri damokidebuleba

garSemomyofebis mxridan (senzitiur-obseso-fobiuri tipi). SfoTva

(SfoTviT-ipoqondriuli tipi), romelic daavadebis klinikuri

150

Sedegebisadmi yuradRebis gamaxvilebaSi da maTze yuradRebis

miqcevaSi iCens Tavs

2. gulis iSemiuri daavadebis jgufSi daavadebasTan dakavSirebuli

ZiriTadi niSania aseve SfoTvaa, romelic Tvisobrivad gansxvavebul

xasiaTs atarebs da gamomdinareobs sazogadoebaSi arsebuli rwmeniT

gulis daavadebis sicocxlisTvis saSiSroebis maRali riskis

Sesaxeb.

3. mniSvnelovania im klinikuri da konstituciuri faqtorebis

gamoyofa, romlebic safeTqlis epilefsiis dros daavadebaze

reagirebis tips gansazRvraven. esenia:

gulyraTa sixSire – rac ufro naklebia gulyraTa sixSire,

miT ufro maRali daavadebaze reagirebis harmoniuli da

ergopaTiuli tipebis Camoyalibeba – avadmyofi ufro

adekvaturad afasebs daavadebas, mis gamovlinebebs, eqimTan

erTad imuSavebs misi daZlevis saSualebebs da agrZelebs

cxovrebas daavadebiT Secvlil pirobebSi –

muSaobs/swavlobs.

daavadebis dawyebis asaki/misi xangZlivoba – rac ufro

adreul asakSi iCina Tavi daavadebam (rac ufro didia misi

xangZlivoba), miT ufro xSiria daavadebaze reagirebis

obseso-fobiuri tipis Camoyalibeba. avadmyofebs ukve

naklebad aqvT gamojanmrTelebis rwmena da maT uCndebaT SiSi

imisa, rom SeiZleba Tavi moaberzes garSemomyiofebs sakuTari

daavadebiT da ukve amdeni welia mZime tvirTan awvebian. maT

uCnddebaT arasrulfasovnebis gamoxatuli grZnoba da

saboloo warumateblobis SiSi (ojaxSi, samsaxurSi).

epilefsiuri keris lateralizacia (avadmyofTa sqestan

erTad) - calke lateralizaciis faqtori araviTar gavlenas

ar axdens daavadebaze reagirebis tipze. xolo sqesTan erTad

is gansazRvravs daavadebaze reagirebis garkveuli tipebis

151

Camoyalibebas - rodesac pacienti qalia da mas aqvs

epilefsiuri fokusis marjvena lateralizacia, SesaZlebelia

mas Camouyalibdes daavadebaze reagirebis apaTiuri tipi,

aseve, rodesac pacienti aris mdedrobiTi sqesis, maRalia

albaToba daavadebaze reagirebis egocentruli tipis

Camoyalibebisa, xolo Tu amas emateba lateralizaciis

faqtori – daavadebaze reagirebis aseTi tipis albaToba

kidev ufro matulobs.

neirotizmi/fsiqotizmi – avadmyofi adamianis es

konstiticiuri maCvenebelbi uaryofiT korelaciaSi

imyofebian daavadebaze reagirebis tipebTan. rac ufro

emociurad mdgradi da stabiluria avadmyofi adamiani, miT

ufro maRalia daavadebaze reagirebis adekvaturi

(harmoniuli) da samsaxurze orientirebuli (ergopaTiuri)

tipebis Camoyalibeba.

4. kvlevam aCvena, rom orive jgufSi yalibdebian garemosTan

urTierTobis morcxvi-damorCilebuli, TanamSroblobiT konvenciuri

da gulis iSemiuri daavadebis SemTxvevaSi pasuxismgeblian-

gulisxmieri tipebi. avadmyofi adamianebi erTis mxvriv, avlenen

TavSekavebulobas sxvebTan urTierTobisas, da meores mxriv,

iswrafian garSemomyofebTan axlo, megobruli urTierTobis

damyarebisken

5. amave dros, safeTqlis epilefsiis mqone pirebTan garemosTan

urTierTobis tipi xasiaTdeba gazrdili mgrZnobelobiT garemodan

wamosuli stimulebisadmi da gamoxatuli ambivalenturobiT _ maT

axasiaTebT, rogorc, survili adamianebTan axlo urTierTobis

damyarebisa da aseve, SiSi imisa, rom sxvebma SeiZleba uaryon isini

maTi daavadebis da misi gamovlinebebis gamo.

6. safeTqlis epilefsiis dros es ambivalenturoba mkafiod aris

gamoxatuli imis gamo, rom am jgufSi garemosTan urTierTobis

152

tipze gavlenas axdenen, rogorc daavadebis cvladebi, aseve

avadmyofi adamianis konstituciuri cvladebi:

neiroticizmi/fsiqotizmi, gulyraTa sixSire da daavadebis dawyebis

asaki.

7. praqtikulad janmrTelis cdis pirebi avlenen garemosTan

urTierTobis ufro metad dominantur tendeciebs.

8. safeTqlis epilefsiis mqone pirebTan, gulis iSemiuri

daavadebis mqone jgufTan SedarebiT aqvT depresiis ufro maRali

maCvenebeli.

9. safeTqlis epilefsiis mqone pirebi avlenen neirotizmis

gamovlinebis ufro maRal xarisxs, gulis iSemiuri daavadebis mqone

pirebTan SedarebiT. es nawilobriv xsnis im faqts, rom safeTqlis

epilefsiis mqone pirebi xasiaTdebian emociuri aramdgradobiT,

swrafviT interpersonaluri urTierTobisadmi, tendenciiT

depresiisadmi da adaptaciis dabal doniT.

10. safeTqlis epilefsiis mqone pirTa jgufSi ufro mkafiod aris

gamoxatuli kavSiri daavadebaze reagirebis da garemosTan

urTierTobis tipebs Soris, vidre gulis iSemiuri daavadebis mqone

pirTa jgufSi. avadmyof adamianebs, metwilad, garSemomyofebTan

urTierTobis xasiaTidan gamomdinare uyalibdebaT damokidebuleba

daavadebisadmi, am daavadebis pirobebSi sakuTari Tavisadmi.

11. rogorc Sedegebidan vlindeba, safeTqlis epilefsiis jgufSi

daavadebaze reagirebis zogadad FSfoTvare tipebi (SfoTviT-

ipoqondriuli, melanqoliuri, apaTiuri, egocentruli) ufro metad

dakavSirebulni arian garemosTan urTierTobis undobel-skeptikur

da morcx-damorCilebul tipebTan, romlebic erTis mxriv,

amJRavneben garSemomyoF adamianebTan undoblobas, zogjer

negativizms, da meores mxriv, maT axasiaTebT TavSekavebuloba,

pasiuroba, tendencia damorCilebisaken. aseTi araerTgvarovneba

153

iwvevs maTSi garkveul gaorebas, rac Tavs gaZlierebul SfoTvaSi

iCens. meores mxriv, daavadebaze reagirebis harmoniuli tipi

dakavSirebulia zomierad gamoxatul Zalaufleba-liderobis,

damoukidebel-dominantur da pasuxismgeblian-gulisxmier tipebTan.

sakuTari Zalebis, SesaZleblobebis rwmena, sakuTar TavSi

darwmunebuloba da pasuxismgeblobis ganviTarebuli grZnoba –

zrdian daavadebasTan gamklavebis adekvaturi gzebis Camoyalibebis

albaTobas. aseTi saxis kavSiri gulis iSemiuri daavadebis mqone

jgufSi ar vlindeba.

12. Cvens mier miRebuli Sedegebis Sefasebis da analizis

safuZvelze SemuSavda safeTqlis epilefsiis dros aRmocenebuli

daavadebis Sinagani suraTis Semdegi modeli: daavadebis Sinagani

suraTis Camoyalibebaze gavlenas axdens daavadebis klinikuri

maCveneblebi (1) (gulyraTa sixSire, daavadebis dawyebis asaki,

lateralizacia), safeTqlis epilefsiis, rogorc qronikuli

daavadebis maxasiaTebeli (2) (daavadebis socialur SedegebTan

dakavSirebuli SiSebi), da garemosTan urTierTobis tipi (3),

romelic Tavis mxriv damokidebulia pirovnebis konstituciur

Tvisebebze (4) da demografiuli cvladebi (sqesi,asaki).

13. gulis iSemiuri daavadebis SemTxvevaSi daavadebaze reagirebis

tips gansazrvravs: (1) avadmyofobis, rogorc qronikuli daavadebis

maxasiaTebeli (am SemTxvevaSi daavadebis sicocxlisaTvis maRali

saSioSroebasTan dakavSirebuli SiSebi), (2) garemosTan urTierTobis

tipi, (3) pirovnebis konstituciur Taviseburebebi da demografiuli

cvladebi (sqesi, asaki).

14. arsebuli gansxvaveba ganpirobebulia daavadebebiss subieqturi

da obieqturi simZimis gansxvavebuli gamovlinebebiT da maTi aRqmiT.

15. amrigad, monacamebi gvaZleven safuZvels vivaraudod, rom

daavadebis qronikuloba da masTan dakavSirebuli SezRudvebi da

154

saSiSroebebi mniSvnelovan rols asrulebs daavadebis Sinagani

suraTis Camoyalibebis prosesSi. magram, is ar warmoadgens

daavadebis Sinagani suraTis xasiaTis ganmapirobel erTadaTerT da

mTavar faqtors. daavadebis Sinagani suraTis xasiaTis

ganpirobebuloba ufro mravalfaqtoriani zegavlenis Sedegs

warmoadgens. masze gavlenas axdenen socialuri, fsiqologiuri da

biologiuri faqtorebi – garemosTan urTierTobis tipi, garkveuli

konstituciuri faqtorebi, daavadebis klinikuri maxasiaTeblebi.

daavadebis mimarT damokidebulebis suraTi konkretuli daavadebis

dros SeiZleba struqturulad msgavsi iyos, magram mas gamoxatuli

Tvisobrivad gansxvavebuli xasiaTi aqvs, rac daavadebis

mimdinareobiT, misi SesaZlo prognoziT da realuri da

mosalodneli socialuri SedegebiT aris ganpirobebuli.

daavadebis Sinagani suraTi aris erT-erTi umniSvnelovanesi

faqtori qronikuli daavadebis SemTxvevaSi. daavadebis dawyebisas

adekvaturi aRqmis Camoyalibeba bevrad ganapirobebs mkurnalobis

warmatebas da gansazRvras avadmyofi pirovnebis garemosTan

adaptaciis dones, rac saboloo jamSi mis cxovrebis xarisxze

aisaxeba. amitom, epilefsia unda ganixilebodes, rogorc mdgomareoba,

rodesac adre dawyebulma efeqturma mkurnalobam da

fsiqokoreqciulma muSaobam SeiZleba gamoiwvios pirovnebaze

epilefsiis qronikulobis zegavlenis efeqtis Semcireba.

16. kvlevaSi miRebuli Sedegebis analizis safuZvelze SemuSavda

reakomendaciebi, romelTa gaTvaliswineba fsiqokoreqciuli da

reabilitaciuri RonisZiebebis Catarebis dros bevrad gazrdis

mkurnalobis efeqturobas:

SfoTvis marTva gulyrebis aRmocenebis dros/Semdeg

daavadebis socialur SedegebTan dakavSirebuli SiSis

Semcireba

daavadebisadmi adekvaturi/obieqturi damokidebulebis

SemuSaveba

socialuri unarebis gaumjobesebis treningi

155

informaciis miwodeba daavadebis, misi mimdinareobis,

mkurnalobis da socialuri Sedegebis Sesaxeb

156

daavadebis Sinagani suraTis Camoyalibebis modeli

safeTqlis epilefsiis dros

safeTqlis epilefsia, rogorc qronikuli daavadeba

pirovnebis premorbiduli

Tvisebebi

daavadebis Sinagani suraTi

garemosTan interpersonaluri urTierTobis tipi

demogarfiuli cvladebi (sqesi,

asaki)

safeTqlis epilefsiis klinikuri niSnebi

157

danarTi #1

safeTqlis wilis epilefsiebi Seadgens mTeli epilefsiebis 30-

35%-s, am SemTxvevebis 2/3-di momdinareobs safeTqlis wilis mezialuri

wilidan, 1/3-di lateraluridan. neiroqirurgiuli gamokvlevebiT

yvelaze ufro xSiri eTiologiuri faqtori mezialuri sklerozia

(65%-i). kacebi da qalebi Tanabari sixSiriT avaddebian.

gulyrebis dasawyisi mniSvnelovnadaa ganpirobebuli

eTiologiuri faqtoriT.

safeTqlis wilis epilefsiuri gulyrebi SeiZleba warmodgenili

iyos

1) martivi fokaluri gulyrebiT.

2) rTuli fokaluri gulyrebiT.

3) meoradad generalizebuli t.kl. kr-Ti gulyrebiT

4) fokaluri arakrunCxviTi epistatusi

5) meorada generalizebuli krunCxviTi gulyrebis statusi.

158

danarTi#2

gulyrebis saerTaSoriso klasifikacia (ILAE 1981)

I fokaluri (parcialuri, lokalizebuli) gulyrebi

I.A martivi fokaluri gulyrebi (cnobiereba Senaxulia)

01. motoruli simptomebiT02. somatosensoruli an specifikuri sensoruli simptomebiT03. vegetatiuri simptomebiT04. fsiqikuri simptomebiT

I.B rTuli fokaluri gulyrebi (cnobierebis done daTrgunulia)

01. martivi fokaluri momdevno cnobierebis SecvliT02. dasawyisidanve cnobierebis SecvliT

a) mxolod cnobierebis SecvliTb) avtomatizmebiT

I.C fokaluri gulyra meoradi generalizaciiT

01. martivi fokaluri gulyra meoradi generalizaciiT02. rTuli fokaluri gulyra meoradi generalizaciiT03. martivi fokaluri gulyra gardamavali rTul fokalur gulyraSi da Semdgomi meoradi generalizaciiT

II generalizebuli gulyrebi (krunCxviTi da arakrunCxviTi)

II.A absansebi

tipiuri absansebi atipiuri absansebi

II.B. mioklonuri gulyrebi

II.C klonuri gulyrebi

II.D tonuri gulyrebi

II E. tonur-klonuri gulyrebi

II.F atonuri gulyrebi

III araklasificirebadi epilefsiuri gulyrebi

159

danarTi #3.

depresiis maCvenebeli. safeTqlis epilefsiis, gulis iSemiuri daavadebis mqone pirTa da janmrTel pirTa jgufebis Sedareba

Descriptives

Beek

52 17.67 11.424 1.584 14.49 20.85 0 50

31 15.45 6.617 1.189 13.02 17.88 4 37

70 10.81 8.491 1.015 8.79 12.84 0 41

153 14.08 9.740 .787 12.53 15.64 0 50

Epilephsia

Heart Disease

Norma

Total

N Mean Std. Deviation Std. Error Lower Bound Upper Bound

95% Confidence Interval forMean

Minimum Maximum

ANOVA

Beek

1476.190 2 738.095 8.554 .000

12943.705 150 86.291

14419.895 152

Between Groups

Within Groups

Total

Sum ofSquares df Mean Square F Sig.

Post Hoc Tests

Multiple Comparisons

Dependent Variable: Beek

Tukey HSD

2.221 2.108 .544 -2.77 7.21

6.859* 1.701 .000 2.83 10.88

-2.221 2.108 .544 -7.21 2.77

4.637 2.004 .057 -.11 9.38

-6.859* 1.701 .000 -10.88 -2.83

-4.637 2.004 .057 -9.38 .11

(J) GroupHeart Disease

Norma

Epilephsia

Norma

Epilephsia

Heart Disease

(I) GroupEpilephsia

Heart Disease

Norma

MeanDifference

(I-J) Std. Error Sig. Lower Bound Upper Bound

95% Confidence Interval

The mean difference is significant at the .05 level.*.

160

danarTi #4.

interpersonaluri urTierTobebis tipi. safeTqlis epilefsiis, gulis iSemiuri daavadebis mqone pirTa da janmrTel pirTa jgufebis

Sedareba

Descriptives

52 6.46 3.801 .527 5.40 7.52 0 15

31 5.10 2.982 .536 4.00 6.19 1 12

70 8.60 2.428 .290 8.02 9.18 3 14

153 7.16 3.357 .271 6.63 7.70 0 15

52 6.87 3.470 .481 5.90 7.83 0 14

31 7.23 1.995 .358 6.49 7.96 2 12

70 8.30 2.324 .278 7.75 8.85 3 14

153 7.59 2.778 .225 7.15 8.04 0 14

52 6.85 2.492 .346 6.15 7.54 0 12

31 7.81 2.242 .403 6.98 8.63 3 13

70 7.47 2.289 .274 6.93 8.02 3 12

153 7.33 2.364 .191 6.95 7.70 0 13

52 5.98 2.638 .366 5.25 6.72 1 13

31 6.03 2.168 .389 5.24 6.83 2 10

70 6.69 2.429 .290 6.11 7.26 0 11

153 6.31 2.461 .199 5.92 6.71 0 13

52 7.77 3.416 .474 6.82 8.72 0 16

31 8.16 2.339 .420 7.30 9.02 3 13

70 7.16 2.124 .254 6.65 7.66 3 12

153 7.57 2.685 .217 7.14 8.00 0 16

52 6.50 3.020 .419 5.66 7.34 1 14

31 6.71 1.865 .335 6.03 7.39 3 10

70 7.94 2.449 .293 7.36 8.53 2 13

153 7.20 2.634 .213 6.78 7.62 1 14

52 8.31 3.311 .459 7.39 9.23 2 14

31 10.19 2.664 .478 9.22 11.17 5 15

70 8.41 1.952 .233 7.95 8.88 4 13

153 8.74 2.712 .219 8.31 9.17 2 15

52 7.60 3.076 .427 6.74 8.45 0 15

31 9.77 2.291 .411 8.93 10.61 3 14

70 8.89 2.417 .289 8.31 9.46 4 14

153 8.63 2.743 .222 8.19 9.07 0 15

38 .332 8.3983 1.3624 -2.429 3.092 -20.5 14.8

30 .080 5.8277 1.0640 -2.096 2.256 -12.7 16.6

60 2.237 5.7587 .7434 .749 3.724 -10.9 13.0

128 1.166 6.6887 .5912 -.004 2.336 -20.5 16.6

38 1.766 8.8604 1.4373 -1.147 4.678 -19.6 16.4

30 6.063 6.5839 1.2021 3.605 8.522 -3.9 24.3

60 2.212 5.4779 .7072 .797 3.627 -13.4 16.7

128 2.982 7.0482 .6230 1.749 4.215 -19.6 24.3

Epilephsia

Heart Disease

Norma

Total

Epilephsia

Heart Disease

Norma

Total

Epilephsia

Heart Disease

Norma

Total

Epilephsia

Heart Disease

Norma

Total

Epilephsia

Heart Disease

Norma

Total

Epilephsia

Heart Disease

Norma

Total

Epilephsia

Heart Disease

Norma

Total

Epilephsia

Heart Disease

Norma

Total

Epilephsia

Heart Disease

Norma

Total

Epilephsia

Heart Disease

Norma

Total

leary I

Leary II

Leary III

Leary IV

Leary V

Leary VI

Leary VII

Leary VIII

Leary Agression

Leary Friendly



Minimum Maximum

161

danarTi #4.

interpersonaluri urTierTobebis tipi. safeTqlis epilefsiis, gulis iSemiuri daavadebis mqone pirTa da janmrTel pirTa jgufebis

Sedareba (gagrZeleba)

ANOVA

302.482 2 151.241 16.085 .000

1410.433 150 9.403

1712.915 152

66.699 2 33.349 4.522 .012

1106.177 150 7.375

1172.876 152

20.609 2 10.305 1.864 .159

829.051 150 5.527

849.660 152

17.907 2 8.953 1.487 .229

903.034 150 6.020

920.941 152

24.834 2 12.417 1.740 .179

1070.696 150 7.138

1095.529 152

71.560 2 35.780 5.459 .005

983.159 150 6.554

1054.719 152

82.641 2 41.321 5.989 .003

1034.901 150 6.899

1117.542 152

100.740 2 50.370 7.244 .001

1043.024 150 6.953

1143.765 152

130.619 2 65.310 1.471 .234

5551.149 125 44.409

5681.769 127

376.652 2 188.326 3.968 .021

5932.257 125 47.458

6308.909 127

Between Groups

Within Groups

Total

Between Groups

Within Groups

Total

Between Groups

Within Groups

Total

Between Groups

Within Groups

Total

Between Groups

Within Groups

Total

Between Groups

Within Groups

Total

Between Groups

Within Groups

Total

Between Groups

Within Groups

Total

Between Groups

Within Groups

Total

Between Groups

Within Groups

Total

Lyry I

Lyry II

Lyry III

Lyry IV

Lyry V

Lyry VI

Lyry VII

Lyry VIII

Lyry Agression

Lyry Friendly


162


Tukey HSD

1.365 .696 .125 -.28 3.01-2.138* .561 .001 -3.47 -.81-1.365 .696 .125 -3.01 .28-3.503* .662 .000 -5.07 -1.942.138* .561 .001 .81 3.473.503* .662 .000 1.94 5.07-.360 .616 .828 -1.82 1.10

-1.435* .497 .012 -2.61 -.26.360 .616 .828 -1.10 1.82

-1.074 .586 .162 -2.46 .311.435* .497 .012 .26 2.611.074 .586 .162 -.31 2.46-.960 .533 .173 -2.22 .30-.625 .430 .317 -1.64 .39.960 .533 .173 -.30 2.22.335 .507 .787 -.87 1.54.625 .430 .317 -.39 1.64

-.335 .507 .787 -1.54 .87-.051 .557 .995 -1.37 1.27-.705 .449 .262 -1.77 .36.051 .557 .995 -1.27 1.37

-.653 .529 .435 -1.91 .60.705 .449 .262 -.36 1.77.653 .529 .435 -.60 1.91

-.392 .606 .795 -1.83 1.04.612 .489 .425 -.55 1.77.392 .606 .795 -1.04 1.83

1.004 .576 .193 -.36 2.37-.612 .489 .425 -1.77 .55

-1.004 .576 .193 -2.37 .36-.210 .581 .931 -1.58 1.17

-1.443* .469 .007 -2.55 -.33.210 .581 .931 -1.17 1.58

-1.233 .552 .069 -2.54 .071.443* .469 .007 .33 2.551.233 .552 .069 -.07 2.54

-1.886* .596 .005 -3.30 -.47-.107 .481 .973 -1.24 1.031.886* .596 .005 .47 3.301.779* .567 .006 .44 3.12.107 .481 .973 -1.03 1.24

-1.779* .567 .006 -3.12 -.44-2.178* .598 .001 -3.59 -.76-1.290* .483 .023 -2.43 -.152.178* .598 .001 .76 3.59.888 .569 .265 -.46 2.24

1.290* .483 .023 .15 2.43-.888 .569 .265 -2.24 .46.2516 1.6276 .987 -3.609 4.112

-1.9051 1.3816 .355 -5.182 1.372-.2516 1.6276 .987 -4.112 3.609

-2.1567 1.4901 .320 -5.691 1.3781.9051 1.3816 .355 -1.372 5.1822.1567 1.4901 .320 -1.378 5.691

-4.2975* 1.6825 .032 -8.288 -.307-.4459 1.4282 .948 -3.834 2.9424.2975* 1.6825 .032 .307 8.2883.8517* 1.5404 .036 .198 7.505.4459 1.4282 .948 -2.942 3.834

-3.8517* 1.5404 .036 -7.505 -.198

(J) GroupHeart DiseaseNormaEpilephsiaNormaEpilephsiaHeart DiseaseHeart DiseaseNormaEpilephsiaNormaEpilephsiaHeart DiseaseHeart DiseaseNormaEpilephsiaNormaEpilephsiaHeart DiseaseHeart DiseaseNormaEpilephsiaNormaEpilephsiaHeart DiseaseHeart DiseaseNormaEpilephsiaNormaEpilephsiaHeart DiseaseHeart DiseaseNormaEpilephsiaNormaEpilephsiaHeart DiseaseHeart DiseaseNormaEpilephsiaNormaEpilephsiaHeart DiseaseHeart DiseaseNormaEpilephsiaNormaEpilephsiaHeart DiseaseHeart DiseaseNormaEpilephsiaNormaEpilephsiaHeart DiseaseHeart DiseaseNormaEpilephsiaNormaEpilephsiaHeart Disease

(I) GroupEpilephsia

Heart Disease

Norma

Epilephsia

Heart Disease

Norma

Epilephsia

Heart Disease

Norma

Epilephsia

Heart Disease

Norma

Epilephsia

Heart Disease

Norma

Epilephsia

Heart Disease

Norma

Epilephsia

Heart Disease

Norma

Epilephsia

Heart Disease

Norma

Epilephsia

Heart Disease

Norma

Epilephsia

Heart Disease

Norma

Dependent VariableLeary I

Leary II

Leary III

Leary IV

Leary V

Leary VI

Leary VII

Leary VIII

Leary Agression

Leary Friendly

MeanDifference

(I-J) Std. Error Sig. Lower Bound Upper Bound95% Confidence Interval


163

danarTi#5.

daavadebaze reagirebis tipi. safeTqlis epilefsiis, gulis iSemiuri daavadebis mqone pirTa da janmrTel pirTa jgufebis Sedareba

Descriptives

52 2.56 2.014 .279 2.00 3.12 0 831 1.87 2.391 .429 .99 2.75 0 8

70 2.86 1.836 .219 2.42 3.29 0 9153 2.56 2.039 .165 2.23 2.88 0 9

52 5.63 2.822 .391 4.85 6.42 1 1331 6.68 3.187 .572 5.51 7.85 0 12

70 1.87 1.903 .227 1.42 2.33 0 7153 4.12 3.281 .265 3.60 4.65 0 1352 5.08 2.648 .367 4.34 5.81 0 1031 3.06 1.711 .307 2.44 3.69 0 770 2.39 1.928 .230 1.93 2.85 0 8

153 3.44 2.465 .199 3.04 3.83 0 1052 1.75 1.919 .266 1.22 2.28 0 631 1.71 1.936 .348 1.00 2.42 0 670 .60 .750 .090 .42 .78 0 2

153 1.22 1.597 .129 .96 1.47 0 652 6.21 2.979 .413 5.38 7.04 1 1331 6.06 2.351 .422 5.20 6.93 2 1070 3.96 2.866 .343 3.27 4.64 0 10

153 5.15 3.002 .243 4.67 5.63 0 1352 1.31 1.966 .273 .76 1.85 0 1131 .55 .810 .145 .25 .85 0 370 .33 .756 .090 .15 .51 0 5

153 .71 1.371 .111 .49 .92 0 1152 .46 .896 .124 .21 .71 0 431 .23 .497 .089 .04 .41 0 270 .23 .543 .065 .10 .36 0 3

153 .31 .681 .055 .20 .42 0 452 2.67 1.465 .203 2.27 3.08 0 6

31 2.26 1.413 .254 1.74 2.78 0 470 1.17 1.090 .130 .91 1.43 0 3

153 1.90 1.459 .118 1.67 2.13 0 652 1.15 1.392 .193 .77 1.54 0 4

31 1.23 1.117 .201 .82 1.64 0 370 .46 .829 .099 .26 .65 0 5

153 .85 1.157 .094 .66 1.03 0 5

EpilephsiaHeart DiseaseNormaTotalEpilephsiaHeart DiseaseNormaTotalEpilephsiaHeart DiseaseNormaTotalEpilephsiaHeart DiseaseNorma

TotalEpilephsia

Heart DiseaseNorma

TotalEpilephsia

Heart DiseaseNormaTotalEpilephsiaHeart DiseaseNormaTotalEpilephsiaHeart DiseaseNormaTotalEpilephsiaHeart DiseaseNorma

Total

Loby I

Loby II

Loby III

Loby IV

Loby V

Loby VI

Loby VII

Loby VIII

Loby IX



Minimum Maximum

164

danarTi#5.

daavadebaze reagirebis tipi. safeTqlis epilefsiis, gulis iSemiuri daavadebis mqone pirTa da janmrTel pirTa jgufebis Sedareba

(gagrZeleba)

ANOVA

20.896 2 10.448 2.565 .080

610.882 150 4.073

631.778 152

675.966 2 337.983 52.773 .000

960.675 150 6.404

1636.641 152

221.511 2 110.756 23.661 .000

702.149 150 4.681

923.660 152

48.945 2 24.473 10.831 .000

338.937 150 2.260

387.882 152

184.127 2 92.064 11.650 .000

1185.415 150 7.903

1369.542 152

29.568 2 14.784 8.656 .000

256.197 150 1.708

285.765 152

1.877 2 .938 2.049 .132

68.685 150 .458

70.562 152

72.209 2 36.104 21.549 .000

251.321 150 1.675

323.529 152

19.982 2 9.991 8.165 .000

183.560 150 1.224

203.542 152

Between Groups

Within Groups

Total

Between Groups

Within Groups

Total

Between Groups

Within Groups

Total

Between Groups

Within Groups

Total

Between Groups

Within Groups

Total

Between Groups

Within Groups

Total

Between Groups

Within Groups

Total

Between Groups

Within Groups

Total

Between Groups

Within Groups

Total

Loby I

Loby II

Loby III

Loby IV

Loby V

Loby VI

Loby VII

Loby VIII

Loby IX


165


Tukey HSD

.687 .458 .294 -.40 1.77

-.299 .369 .697 -1.17 .58

-.687 .458 .294 -1.77 .40

-.986 .435 .064 -2.02 .04

.299 .369 .697 -.58 1.17

.986 .435 .064 -.04 2.02

-1.043 .574 .168 -2.40 .32

3.763* .463 .000 2.67 4.86

1.043 .574 .168 -.32 2.40

4.806* .546 .000 3.51 6.10

-3.763* .463 .000 -4.86 -2.67

-4.806* .546 .000 -6.10 -3.51

2.012* .491 .000 .85 3.17

2.691* .396 .000 1.75 3.63

-2.012* .491 .000 -3.17 -.85

.679 .467 .316 -.43 1.78

-2.691* .396 .000 -3.63 -1.75

-.679 .467 .316 -1.78 .43

.040 .341 .992 -.77 .85

1.150* .275 .000 .50 1.80

-.040 .341 .992 -.85 .77

1.110* .324 .002 .34 1.88

-1.150* .275 .000 -1.80 -.50

-1.110* .324 .002 -1.88 -.34

.147 .638 .971 -1.36 1.66

2.254* .515 .000 1.04 3.47

-.147 .638 .971 -1.66 1.36

2.107* .606 .002 .67 3.54

-2.254* .515 .000 -3.47 -1.04

-2.107* .606 .002 -3.54 -.67

.759* .297 .031 .06 1.46

.979* .239 .000 .41 1.55

-.759* .297 .031 -1.46 -.06

.220 .282 .716 -.45 .89

-.979* .239 .000 -1.55 -.41

-.220 .282 .716 -.89 .45

.236 .154 .277 -.13 .60

.233 .124 .148 -.06 .53

-.236 .154 .277 -.60 .13

-.003 .146 1.000 -.35 .34

-.233 .124 .148 -.53 .06

.003 .146 1.000 -.34 .35

.415 .294 .337 -.28 1.11

1.502* .237 .000 .94 2.06

-.415 .294 .337 -1.11 .28

1.087* .279 .000 .43 1.75

-1.502* .237 .000 -2.06 -.94

-1.087* .279 .000 -1.75 -.43

-.072 .251 .956 -.67 .52

.697* .203 .002 .22 1.18

.072 .251 .956 -.52 .67

.769* .239 .004 .20 1.33

-.697* .203 .002 -1.18 -.22

-.769* .239 .004 -1.33 -.20


Norma

Epilephsia

Norma

Epilephsia

Heart Disease

Heart Disease

Norma

Epilephsia

Norma

Epilephsia

Heart Disease

Heart Disease

Norma

Epilephsia

Norma

Epilephsia

Heart Disease

Heart Disease

Norma

Epilephsia

Norma

Epilephsia

Heart Disease

Heart Disease

Norma

Epilephsia

Norma

Epilephsia

Heart Disease

Heart Disease

Norma

Epilephsia

Norma

Epilephsia

Heart Disease

Heart Disease

Norma

Epilephsia

Norma

Epilephsia

Heart Disease

Heart Disease

Norma

Epilephsia

Norma

Epilephsia

Heart Disease

Heart Disease

Norma

Epilephsia

Norma

Epilephsia

Heart Disease

(I) GroupEpilephsia

Heart Disease

Norma

Epilephsia

Heart Disease

Norma

Epilephsia

Heart Disease

Norma

Epilephsia

Heart Disease

Norma

Epilephsia

Heart Disease

Norma

Epilephsia

Heart Disease

Norma

Epilephsia

Heart Disease

Norma

Epilephsia

Heart Disease

Norma

Epilephsia

Heart Disease

Norma

Dependent VariableLoby I

Loby II

Loby III

Loby IV

Loby V

Loby VI

Loby VII

Loby VIII

Loby IX

MeanDifference




166

danarTi#6.EPQ-s maCveneblebi. safeTqlis epilefsiis, gulis iSemiuri daavadebis

mqone pirTa da janmrTel pirTa jgufebis Sedareba

Descriptives

47 4.21 1.829 .267 3.68 4.75 0 9

30 2.93 1.437 .262 2.40 3.47 1 7

70 2.63 1.687 .202 2.23 3.03 0 7

147 3.20 1.819 .150 2.90 3.49 0 9

47 10.49 3.064 .447 9.59 11.39 5 18

30 10.20 3.478 .635 8.90 11.50 4 18

70 10.80 3.020 .361 10.08 11.52 5 17

147 10.58 3.118 .257 10.07 11.09 4 18

47 12.19 4.675 .682 10.82 13.56 2 19

30 9.93 3.704 .676 8.55 11.32 4 17

70 10.31 3.843 .459 9.40 11.23 3 19

147 10.84 4.181 .345 10.16 11.52 2 19

47 8.53 2.394 .349 7.83 9.23 4 16

30 9.53 2.063 .377 8.76 10.30 6 13

70 8.71 2.649 .317 8.08 9.35 3 18

147 8.82 2.471 .204 8.42 9.23 3 18

Epilephsia

Heart Disease

Norma

Total

Epilephsia

Heart Disease

Norma

Total

Epilephsia

Heart Disease

Norma

Total

Epilephsia

Heart Disease

Norma

Total

EPQ-Psychotism

EPQ-Extraversion

EPQ-Neurotism

EPQ-Lying



Minimum Maximum

ANOVA

73.197 2 36.599 12.852 .000

410.082 144 2.848

483.279 146

8.106 2 4.053 .413 .662

1411.745 144 9.804

1419.850 146

129.853 2 64.926 3.860 .023

2422.229 144 16.821

2552.082 146

19.947 2 9.973 1.648 .196

871.455 144 6.052

891.401 146

Between Groups

Within Groups

Total

Between Groups

Within Groups

Total

Between Groups

Within Groups

Total

Between Groups

Within Groups

Total

EPQ-Psychotism

EPQ-Extraversion

EPQ-Neurotism

EPQ-Lying


167


Tukey HSD

1.279* .394 .004 .35 2.21

1.584* .318 .000 .83 2.34

-1.279* .394 .004 -2.21 -.35

.305 .368 .687 -.57 1.18

-1.584* .318 .000 -2.34 -.83

-.305 .368 .687 -1.18 .57

.289 .732 .917 -1.44 2.02

-.311 .590 .859 -1.71 1.09

-.289 .732 .917 -2.02 1.44

-.600 .683 .655 -2.22 1.02

.311 .590 .859 -1.09 1.71

.600 .683 .655 -1.02 2.22

2.258 .958 .052 -.01 4.53

1.877* .773 .043 .05 3.71

-2.258 .958 .052 -4.53 .01

-.381 .895 .905 -2.50 1.74

-1.877* .773 .043 -3.71 -.05

.381 .895 .905 -1.74 2.50

-1.001 .575 .193 -2.36 .36

-.182 .464 .918 -1.28 .92

1.001 .575 .193 -.36 2.36

.819 .537 .282 -.45 2.09

.182 .464 .918 -.92 1.28

-.819 .537 .282 -2.09 .45


Norma

Epilephsia

Norma

Epilephsia

Heart Disease

Heart Disease

Norma

Epilephsia

Norma

Epilephsia

Heart Disease

Heart Disease

Norma

Epilephsia

Norma

Epilephsia

Heart Disease

Heart Disease

Norma

Epilephsia

Norma

Epilephsia

Heart Disease

(I) GroupEpilephsia

Heart Disease

Norma

Epilephsia

Heart Disease

Norma

Epilephsia

Heart Disease

Norma

Epilephsia

Heart Disease

Norma

Dependent VariableEPQ-Psychotism

EPQ-Extraversion

EPQ-Neurotism

EPQ-Lying

MeanDifference




168

danarTi #7

faqtoruli analizis Sedegebis safeTqlis epilefsiis jgufSi

safeTqlis epilefsiis jgufi 1 2 3 4Leary 1 4,662E-02 ,772 ,248 2,095E-02Leary 2 -1,069E-02 ,836 -6,575E-02 -,244Leary 3 ,290 ,740 1,719E-02 -,194Leary 4 ,740 ,135 -,134 -3,239E-02Leary 5 ,369 -,101 ,708 ,105Leary 6 8,855E-02 -7,031E-02 ,672 ,396Leary 7 -,338 -,142 ,748 3,439E-02Leary 8 -,139 3,319E-02 ,773 2,267E-02dominireba_damorCileba -,260 ,733 -,200 -,217keTilmosurneoba_mtroba -,399 -,497 ,644 ,220BDI ,812 -,140 3,219E-02 ,134EPQ-extraver. -,250 ,478 8,835E-02 ,513EPQ-psychot. ,143 -,185 -,638 ,213EPQ-neurot. ,766 ,131 -,124 4,314E-03EPQ-lying -,206 -,211 -,161 ,544ЛОБИ 1 -,103 ,441 -6,120E-03 -4,759E-03ЛОБИ 2 ,749 -1,126E-02 -5,337E-02 ,266ЛОБИ 3 ,497 -,114 -6,716E-02 -,101ЛОБИ 4 ,799 -1,815E-02 -,106 9,622E-02ЛОБИ 5 -,212 ,254 ,508 -,369ЛОБИ 6 ,200 1,336E-02 ,231 ,522ЛОБИ 7 ,229 -,182 -5,527E-02 ,318ЛОБИ 8 -,345 ,351 -,119 -,307ЛОБИ 9 ,540 -,259 ,120 ,513sqesi 4,126E-02 -,423 7,472E-03 ,539lateralizacia 9,284E-02 2,482E-02 7,664E-02 ,449sixSire ,107 -5,382E-02 -9,767E-02 ,549daavadebis dawyebis asaki -,280 -9,895E-02 ,305 2,488E-03mkurnalobis tipi ,243 ,248 ,296 -6,977E-02ojaxuri mdgomareoba ,320 -,149 -,119 -,413asakobrivi jgufi -5,737E-02 -,368 7,763E-02 -,259

Extraction Method: Principal Component Analysis. Rotation Method: Varimax with Kaiser Normalization.a Rotation converged in 7 iterations.

Component Transformation MatrixComponent 1 2 3 4

1 ,790 -,422 -,154 ,4172 -,459 -,635 ,473 ,4023 ,352 ,406 ,841 ,0544 -,201 ,503 -,211 ,813

Extraction Method: Principal Component Analysis. Rotation Method: Varimax with Kaiser Normalization.

169

danarTi #8

faqtoruli analizis saboloo Sedegebi gulis iSemiuri daavadebis mqone jgufSi

gulis iSemiuri daavadeba

1 2 3 4

Leary 1 -,524 -,312 ,492 ,289Leary 2 -9,420E-

024,834E-03 ,626 -,175

Leary 3 -7,953E-02

-,433 ,369 -,492

Leary 4 ,385 -,619 -,358 ,138Leary 5 -,229 ,718 -,148 -,126Leary 6 -,127 ,569 ,347 ,210Leary 7 ,198 ,375 ,602 ,176Leary 8 -,307 ,646 ,291 -,137

dominireba_damorCileba -,394 -,440 ,586 ,126


6,367E-02 ,867

-6,171E-02 ,187

BDI ,911 -8,685E-02 -,129 ,119EPQ-psychot. -,379 -,212 ,214 ,692EPQ-extraver. ,174 -6,426E-03 -,226 ,545EPQ-neurot. ,629 -,198

-9,237E-02

-,478

EPQ-lying ,128 ,291 ,646 ,231ЛОБИ 1 -,747 8,466E-03 ,288 2,655E-02ЛОБИ 2 ,644 -,173

-3,693E-02

-,147

ЛОБИ 3 ,192 6,813E-02 ,180 ,808ЛОБИ 4 ,815 4,457E-03 2,973E-02 7,431E-02ЛОБИ 5 -,390 -,200 2,039E-02 -,233ЛОБИ 6 ,526 -4,321E-02 ,219 ,333ЛОБИ 7 5,505E-

03-1,750E-02 ,534

-3,704E-02

ЛОБИ 8-,557 ,176 ,320

-3,308E-02

ЛОБИ 9 ,606 -,234 ,209 ,291sqesi ,472 -,257 ,185 ,180asaki -,471 4,264E-02 -,278 ,309


Component Transformation MatrixComponent 1 2 3 41 -,916 ,279 ,288 ,0042 ,336 ,680 ,403 ,5133 -,001 -,667 ,638 ,3844 ,219 ,122 ,589 -,768Extraction Method: Principal Component Analysis.Rotation Method: Varimax with Kaiser Normalization.

170

danarTi #9

faqtoruli analizis Sedegebi praqtikuladjanmrTel pirebTan

jamrTel pirTa jgufi 1 2 3

Leary 1 ,593 1,560E-02 8,880E-03Leary 2 ,662 6,194E-02 -5,955E-02Leary 3 ,514 8,878E-02 -6,288E-02Leary 4 -,287 ,172 3,822E-02Leary 5 -,527 4,029E-02 -5,663E-02Leary 6 -,337 -2,645E-02 ,662Leary 7 -,437 -,142 ,641Leary 8 -,355 -5,546E-02 ,544

dominireba_damorCileba ,911 -1,533E-02 -,230

keTilmosurneoba_mtroba -,629 -,179 ,618

BDI ,119 ,623 4,510E-02EPQ-psychot. ,127 ,119 ,204EPQ-extraver. 4,382E-02 ,199 ,198EPQ-neurot. -,111 -,433 ,228

EPQ-lying -3,240E-02 -4,170E-02 ,374ЛОБИ 1 ,107 -,394 -9,073E-02ЛОБИ 2 -7,020E-02 ,673 ,178ЛОБИ 3 ,204 ,603 ,257ЛОБИ 4 -,137 ,792 -7,733E-03ЛОБИ 5 ,386 ,142 ,653ЛОБИ 6 -,370 ,367 8,358E-02ЛОБИ 7 -4,833E-02 ,608 -6,146E-02ЛОБИ 8 ,261 ,166 ,573ЛОБИ 9 4,275E-02 ,449 -,186sqesi ,431 8,125E-03 ,102asaki -,135 2,883E-02 ,134


Component Transformation MatrixComponent 1 2 31 -,856 -,111 ,5052 ,040 ,960 ,2783 ,516 -,258 ,817Extraction Method: Principal Component Analysis.Rotation Method: Varimax with Kaiser Normalization.

171

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