We often hear about passion when it comes to any illegal action: “murder in the heat of passion.” However, this concept is not limited to criminal matters. Affect can both destroy and save a person.
1 Reaction to stress
Science perceives affect as a complex phenomenon - a set of mental, physiological, cognitive and emotional processes. This is a short-term peak state, or, in other words, the body’s reaction during which psychophysiological resources are thrown into the fight against stress that has arisen under the influence of the external environment.
Affect is usually a response to an event that has occurred, but it is already based on a state of internal conflict. Affect is provoked by a critical, most often unexpected, situation from which a person is unable to find an adequate way out.
Experts distinguish between ordinary and cumulative affect. In the first case, affect is caused by the direct impact of a stressor on a person; in the second, it is the result of the accumulation of relatively weak factors, each of which individually is not capable of causing a state of affect.
In addition to excitation of the body, affect can provoke inhibition and even blocking of its functions. In this case, a person is overcome by one emotion, for example, panic horror: in a state of asthenic affect, instead of active actions, a person watches in a daze the events unfolding around him.
2 How to recognize affect
Affect is sometimes not easy to distinguish from other mental states. For example, affect differs from ordinary feelings, emotions and moods in its intensity and short duration, as well as the obligatory presence of a provoking situation.
There are differences between affect and frustration. The latter is always a long-term motivational-emotional state that arises as a result of the inability to satisfy one or another need.
It is more difficult to identify the differences between affect and trance, since they have much in common. For example, in both states there are violations of the conscious volitional control of behavior. One of the main differences is that trance, unlike affect, is caused not by situational factors, but by painful changes in the psyche.
Experts also distinguish between the concepts of affect and insanity. Although the characteristics of an individual’s behavior in both conditions are very similar, in affect they are not random. Even in situations where a person is not able to control his impulses, he becomes their captive of his own free will.
3 Physiological changes during affect
Affect is always accompanied by physiological changes in the human body. The first thing that is observed is a powerful surge of adrenaline. Then comes the time of vegetative reactions - the pulse and breathing quicken, the arterial pressure, spasms occur peripheral vessels, coordination of movements is impaired. People who have experienced a state of passion experience physical exhaustion and exacerbation of chronic diseases.
4 Physiological affect
Affect is usually divided into physiological and pathological. Physiological affect is an intense emotion that completely takes over a person’s consciousness, as a result of which control over one’s own actions is reduced. In this case, deep clouding of consciousness does not occur, and the person usually maintains self-control.
5 Pathological affect
Pathological affect is a rapidly occurring psychophysiological reaction characterized by the suddenness of its occurrence, in which the intensity of the experience is much higher than with physiological affect, and the nature of the emotions is concentrated around such states as rage, anger, fear, despair. With pathological affect, the normal course of the most important mental processes - perception and thinking - is usually disrupted, a critical assessment of reality disappears, and volitional control over actions is sharply reduced.
German psychiatrist Richard Krafft-Ebing drew attention to the deep disorder of consciousness during pathological affect with the resulting fragmentation and confusion of memories of what happened. And the domestic psychiatrist Vladimir Serbsky attributed pathological affect to states of insanity and unconsciousness.
According to doctors, the state of pathological affect usually lasts a matter of seconds, during which a sharp mobilization of the body’s resources occurs - at this moment the person is able to demonstrate abnormal strength and reaction.
6 Phases of pathological affect
Despite its severity and short duration, psychiatrists distinguish three phases of pathological affect.
The preparatory phase is marked by an increase in emotional tension, a change in the perception of reality and a violation of the ability to adequately assess the situation. At this moment, consciousness is limited to the traumatic experience - everything else does not exist for it.
The explosion phase is directly aggressive actions, which, as described by Russian psychiatrist Sergei Korsakov, have “the nature of complex arbitrary acts committed with the cruelty of an automatic machine or machine.” In this phase, facial reactions are observed that demonstrate a sharp change in emotions - from anger and rage to despair and bewilderment.
The final phase is usually accompanied by a sudden depletion of physical and mental strength. After it, an irresistible desire to sleep or a state of prostration may arise, characterized by lethargy and complete indifference to what is happening.
7 Affect and criminal law
The Criminal Code of the Russian Federation distinguishes between crimes committed with mitigating and aggravating circumstances. Taking this into account, murder committed in a state of passion (Article 107 of the Criminal Code of the Russian Federation) and causing grievous or moderate harm to health in a state of passion (Article 113 of the Criminal Code of the Russian Federation) are classified as mitigating circumstances.
According to the Criminal Code, affect acquires criminal legal significance only in the case when “the state of sudden strong emotional excitement (affect) is caused by violence, mockery, grave insult on the part of the victim or other illegal or immoral actions (inaction) of the victim, as well as prolonged psychotraumatic situation arising in connection with systematic illegal or immoral behavior victim."
Lawyers emphasize that the situation provoking the emergence of affect must exist in reality, and not in the imagination of the subject. However, the same situation can be perceived differently by a person who has committed a crime in a state of passion - this depends on the characteristics of his personality, psycho-emotional state and other factors.
The severity and depth of an affective outburst is not always proportional to the strength of the provoking circumstance, which explains the paradoxical nature of some affective reactions. In such cases, only a comprehensive psychological and psychiatric examination can assess the mental functioning of a person in a state of passion.
PATHOLOGICAL AFFECT- short-term mental disorder, expressed in a sudden attack of unusually strong anger or rage that arose in response to mental trauma. Pathological affect is accompanied by deep stupefaction, violent motor excitement with automatic actions and subsequent amnesia.
The term "pathological affect" appeared in psychiatric literature in the second half of the 19th century. Before this, there were names “angry unconsciousness” and “insanity”, the clinical content of which to a certain extent corresponded to pathological affect. In 1868, R. Krafft-Ebing, in his article “Painful Moods of the Soul,” proposed calling the state of severe mental agitation “pathological affect.”
S. S. Korsakov emphasized the forensic psychiatric significance of pathological affect, and V. P. Serbsky distinguished it from physiological affect that arises on pathological grounds.
Clinical picture
The development of pathological affect is usually divided into three stages. In the first (preparatory) stage, under the influence of psychogenic-traumatic influence and growing affect, consciousness concentrates on a narrow circle of traumatic experiences.
In the second stage (explosion stage), an affective discharge occurs, manifested in violent motor excitement, deep violation consciousness, disorientation and speech incoherence. All this is accompanied by sudden redness or paleness of the face, excessive gesticulation, and unusual facial expressions.
The final stage manifests itself in pronounced mental and physical exhaustion. General relaxation, lethargy, and indifference sets in. Occurs frequently deep dream. After awakening, partial or complete amnesia is detected for the duration of the pathological affect.
Etiology and pathogenesis
Research into the etiology and pathogenesis of pathological affect has been reduced to clarifying the issue of its dependence on the soil on which it arises.
S.S. Korsakov believed that pathological affect occurs more often in psychopathic personalities, however, it can develop under certain circumstances and in persons without a psychopathic constitution.
V.P. Serbsky wrote that pathological affect cannot arise in completely healthy person.
It should be assumed that the brain's reduced resistance to stress exposure, which contributes to the emergence of pathological affect, more often occurs in individuals with certain deviations from the norm (psychopathy, traumatic brain damage, etc.). However, under the influence of a number of factors (exhaustion after illness, pregnancy, fatigue, insomnia, malnutrition, etc.), a state of reduced brain resistance can occur in normal people.
During the short-term period of pathological affect, it is not possible to conduct pathophysiological, biochemical and other studies.
Differential diagnosis
Differential diagnosis should be carried out with physiological affect, with affect arising on pathological grounds, and with the so-called short circuit reaction [Kretschmer (E. Kretschmer)].
Unlike pathological affect, physiological affect is not accompanied by a change in consciousness, automaticity of actions and subsequent amnesia. With physiological affect, there are no successive stages of its onset and cessation.
With physiological affect on pathological grounds affective state reaches a significant degree and has features characteristic of the affective reactions of persons who have suffered a skull injury, suffering from organic damage to the central nervous system, as well as psychopathy. However, these pronounced and vivid affective reactions are not accompanied by the described psychopathological phenomena (disorder of consciousness, automaticity of actions, etc.) and their consistent development.
In a “short circuit” reaction, an affective discharge occurs after prolonged mental trauma (prolonged insults, threats, humiliation, fear, the need to constantly restrain oneself). In these cases, affective impulses turn directly into actions in patients, expressed in sudden actions that were previously unusual for them.
Forecast
Since pathological affect is expressed only in short-term frustration mental activity, which is an exceptional condition, its prognosis is favorable. Only persons whose pathological affect has developed on pathological grounds should be sent to a psychiatric hospital; they need to be treated for their underlying disease.
In forensic psychiatric practice, pathological affect is considered as a temporary disorder of mental activity, excluding responsibility for actions committed in this state. Persons who have committed pathologically dangerous acts in a state of passion are subject to Art. II of the Criminal Code of the RSFSR (or the corresponding articles of the Criminal Code of other union republics).
Bibliography: Vvedensky I.N. The problem of exceptional states in the forensic psychiatric clinic, in the book: Probl. judicial psychiat., ed. Ts. M. Feinberg, V. 6, p. 331, M., 1947; Kalashnik Ya. M. Pathological affect, in the same place, in. 3, p. 249, M., 1941; Korsakov S.S. Course of psychiatry, vol. 1, p. 239, M., 1901; Lunts D.R. Exceptional states, in the book: Judicial. psychiat., ed. G. V. Morozova, p. 388, M., 1965; Serbsky V. Forensic psychopathology, in. 1, M., 1895.
N. I. Felinskaya.
– a short-term mental disorder, an explosion of anger and rage caused by an unexpected traumatic situation. Accompanied by clouding of consciousness and distorted perception of the environment. Ends with autonomic disorders, prostration, deep indifference and prolonged sleep. Subsequently, partial or complete amnesia is observed for the period of pathological affect and previous traumatic events. The diagnosis is made on the basis of anamnesis, interviews with the patient and witnesses to the incident. In the absence of other mental disorders, treatment is not required; if mental pathology is identified, the underlying disease is treated.
General information
a mental disorder characterized by hyper-intense experience and inappropriate expression of anger and rage. Occurs in response to a sudden shock and lasts several minutes. The first mentions of short-term mental disorder during the commission of crimes appeared in specialized literature at the beginning of the 17th century and were called “angry unconsciousness” or “insanity.” The term “pathological affect” was first used to describe this condition by the German and Austrian psychiatrist and criminologist Richard von Krafft-Ebing in 1868.Pathological affect is a fairly rare disorder, which is the basis for declaring the patient insane when committing criminal or administrative actions. Much more common is physiological affect - a milder version of a strong emotional reaction to an external stimulus. Unlike pathological, physiological affect is not accompanied by a twilight state of consciousness and is not a basis for declaring the patient insane at the time of the commission of the offense. Diagnosis of pathological affect and treatment of the underlying disease (if present) is carried out by specialists in the field of psychiatry.
Causes and pathogenesis of pathological affect
The immediate cause of the development of pathological affect is a sudden, super-strong external stimulus (usually violence, verbal abuse, etc.). Can also act as a triggering factor panic fear, due to real danger, increased demands and lack of self-confidence. The personal significance of the external stimulus depends on the character, beliefs and ethical standards of the patient. Many psychiatrists consider pathological affect as an “emergency” reaction to a situation that the patient considers hopeless and unbearable. In this case, the psychological constitution of the patient and previous circumstances are of a certain importance.
The famous Russian psychiatrist S.S. Korsakov believed that patients with psychopathic personality development are more prone to the emergence of pathological affect. At the same time, both Korsakov and the founder of Russian forensic psychiatry V.P. Serbsky believed that pathological affect can be diagnosed not only in patients with a psychopathic constitution, but also in people who do not suffer from any mental disorders.
Modern Russian psychiatrists name a number of factors that increase the likelihood of pathological affect. These factors include psychopathy, neurotic disorders, a history of traumatic brain injury, alcoholism, drug addiction and substance abuse. In addition, the risk of developing pathological affect increases in people who do not suffer from these diseases, but have reduced resistance to stress due to exhaustion after somatic or infectious disease, because of poor nutrition, insomnia, physical or mental fatigue.
In some cases, the “accumulation effect”, the long-term accumulation of negative experiences caused by tense relationships, beatings, constant humiliation and bullying, is of great importance. The patient “accumulates” negative emotions within himself for a long time; at a certain point, patience runs out and feelings spill out in the form of pathological affect. Usually the patient’s anger is directed at the person with whom he is in a conflict relationship, but sometimes (when he finds himself in a situation reminiscent of the circumstances of chronic psychological trauma) pathological affect occurs when in contact with other people.
Affect is the most vivid manifestation of emotions, especially strong feelings. Pathological affect is an extreme degree of ordinary affect. The reason for the development of all types of affect is excessive excitation of certain areas of the brain while inhibiting the departments responsible for others. mental processes. This process is accompanied by varying degrees of narrowing of consciousness: with physiological affect - ordinary narrowing, with pathological affect - twilight darkness.
As a result, the patient stops tracking information that is not related to the traumatic situation, and evaluates and controls worse (in the case of pathological affect, he does not evaluate and does not control) his own actions. Nerve cells in the excitation area they work at the limit of capabilities for some time, then a protective braking. Extremely strong emotional experiences are replaced by the same severe fatigue, loss of strength and indifference. With pathological affect, emotions are so strong that inhibition reaches the level of stupor and sleep.
Symptoms of pathological affect
There are three stages of pathological affect. The first stage is characterized by some narrowing of consciousness, the patient’s concentration on experiences associated with a traumatic situation. Emotional tension increases, the ability to perceive the environment, assess the situation and understand one’s own state decreases. Everything that is not related to the traumatic situation seems insignificant and ceases to be perceived.
The first phase of pathological affect smoothly transitions into the second - the explosion phase. Anger and rage grow, and at the peak of the experience, a deep clouding of consciousness occurs. Orientation in the surrounding world is disturbed; at the moment of climax, illusions, hallucinatory experiences and psychosensory disorders are possible (being in a state of pathological affect, the patient incorrectly assesses the size of objects, their distance and location relative to the horizontal and vertical axis). In the explosion phase, violent motor excitation is observed. The patient displays severe aggression and performs destructive actions. At the same time, the ability to perform complex motor acts is preserved; the patient’s behavior resembles the actions of a ruthless machine.
The explosion phase is accompanied by violent vegetative and facial reactions. The face of a person in a state of pathological affect reflects violent emotions in various combinations. Anger is mixed with despair, rage with bewilderment. The face turns red or pale. After a few minutes, the emotional explosion suddenly ends, and is replaced by the final phase of pathological affect - the phase of exhaustion. The patient plunges into a state of prostration, becomes lethargic, and shows complete indifference to the environment and his own actions committed in the explosion phase. A long deep sleep ensues. Upon awakening, partial or complete amnesia occurs. What happened is either erased from memory or emerges in the form of scattered fragments.
A distinctive feature of pathological affect in chronic mental trauma (constant humiliation and fear, prolonged physical or psychological violence, the need to constantly restrain) is the discrepancy between the reaction and the stimulus that caused it. Pathological affect occurs in a situation that people who do not know all the circumstances would consider insignificant or of little significance. This reaction is called a “short circuit” reaction.
Diagnosis and treatment of pathological affect
Making a diagnosis has a special medical and forensic significance, since pathological affect is the basis for declaring the patient insane at the time of the commission of a crime or offense. To confirm the diagnosis, a forensic medical examination is performed. During the diagnostic process, a comprehensive study of the patient’s life history and the study of its characteristics are carried out. mental organization– only in this way can one determine the personal significance of a traumatic situation and assess the characteristics of the patient’s psychological reactions. If there are witnesses, testimonies are taken into account indicating the obvious senselessness of the patient’s actions, committed in a state of alleged passion.
The decision about the need for treatment is made individually. Pathological affect is a short-term mental disorder, after its completion the patient becomes completely sane, intellectual, emotional and volitional sphere don't suffer. In the absence of others mental disorders Treatment of pathological affect is not required, the prognosis is favorable. When psychopathy, neurotic disorder, drug addiction, alcoholism and other conditions are identified, appropriate therapeutic measures are carried out, the prognosis is determined by the course of the underlying disease.
According to modern concepts, this is a hyperkinetic form of acute shock reaction, accompanied by psychomotor agitation and aggressive actions towards the offender, at the height of development of which there is a disturbance of consciousness of the type twilight darkness. Diagnostic signs: three-phase flow (accumulation, explosion, asthenia); unexpected occurrence; inadequacy to the occasion that caused it; sharp psychomotor agitation; twilight disorder consciousness at the height of disorder; automaticity of actions; violations of behavioral motivation; severe asthenia after recovery from this state. It should be noted that affectogenic exceptional states have much in common with physiological affect (causal connection with a psychogenic factor, severity of occurrence, the same three-phase course, similar vasovegetative and motor reactions). The main and cardinal difference is the symptoms of a psychopathological series in the second phase (explosion phase): phenomena of darkened consciousness, accompanied by subsequent amnesia. One of the significant signs in pathological psychogenic conditions is the disproportion of the occasion to the strength of the psychogenic explosive reaction. The discharge occurs according to the “last straw” principle, and although this “drop” is connected with the entire psychogenic situation, the reason itself is often quite insignificant. And if the diagnosis of physiological affect is the competence of psychologists, then the diagnosis of pathological affect is the competence of psychiatrists, since this is a transient psychotic state.
The first phase (preparatory) includes personal processing of psychogenicity, the emergence and increase in the individual’s readiness for affective release. A long-term psychotraumatic situation determines an increase in affective tension, against the background of which a psychogenic cause, through the “last straw” mechanism, can cause the onset of an acute affective reaction. In conditionally mentally healthy people, both acute and delayed psychogenies are equally important for the occurrence of a pathological reaction. As already mentioned, in “conditionally mentally healthy” patients one can almost always find signs of residual organic damage to the central nervous system and the presence of incoming asthenic factors that also form the pathological basis.
With protracted psychogenies associated with a long-term psychotraumatic situation, persistent hostile relationships with the victim, long-term systematic humiliation and bullying, an acute affective reaction arises as a result of the gradual accumulation of affective experiences. The mental state of the subjects, preceding the occasion that caused the affective reaction, is characterized by depressed mood, neurasthenic symptoms, and the emergence of dominant ideas that are closely related to the psychogenic-traumatic situation. Factors that help facilitate the occurrence of an affective reaction are overwork, forced insomnia, somatic weakness, etc. Under the influence of a psychogenic stimulus that comes directly from the offender and outwardly seems insignificant, a sudden reaction with aggressive actions directed against the victim may occur both for the person himself and for those around him. This mechanism is referred to as a “short circuit reaction”.
This group is dominated by women with asthenic, inhibited character traits. These are timid, shy creatures that long years are in a psychogenically traumatic situation, often in their own family. As a rule, this is the bullying of an alcoholic husband who humiliates a woman, beats her and children; bullying is often sadistic in nature. For example, one test subject’s husband pushed needles under her nails, another was forced to drink his urine. Usually women don’t tell anyone about this, and this situation lasts for years. In this way, the cumulation of affect occurs. It is important to note that such reactions usually occur in women during prolonged depressive states, i.e. It is natural to assume that in the conditions of such a long-term psychotraumatic situation, severe both objectively and subjectively, women have a painfully depressed mood. But these depressions are, as a rule, masked, larved, somatized in nature, i.e. Somatovegetative manifestations come to the fore. In terms of clinical design, they are closest to the “exhaustion depressions” of P. Kielholz, when the asthenic component of depression is pronounced and depression is accompanied somatic masks. Usually in the cases of such subjects there is a somatic map - voluminous, all covered with writing - for many years the woman is examined by various specialists - internists, neurologists, endocrinologists, gynecologists. There is no complete objectification of these somatic complaints, but sometimes an observant doctor indicates that a woman has a low mood. In the broad sense of the word, this is reactive depression, a long-term reactive state. The affect is cumulated, and by the time the offense is committed, a psychotic state arises with the participation of a short circuit mechanism. So, with protracted psychogenies, there is a pathological basis: asthenia, depression, cumulation of affect. Moreover, these individuals endure bullying for years, and the last straw is always some insignificant event. It sometimes looks very strange that a woman suffered beatings and humiliation, but on the day when everything happened, her husband, simply passing by, said expletive, which was the last straw.
An affective explosion occurs; at the height of this state, an affectively darkened consciousness is noted. The actions of the experts are, as it were, ultimately directed, i.e. are aimed at eliminating the offender, the causes of their experiences, which distinguishes these states from, say, pathological intoxication or a pathological drowsiness state, where victims are often accidental. Here the actions are directed, which is the biggest difficulty in the forensic psychiatric assessment of these cases. Sometimes experts say: “but they killed the one who offended them.” However, if we analyze the entire history, this is the case, as E. Kretschmer wrote, when “a rabbit turns into a tiger.” That is, inhibited, timid, shy, insecure individuals commit the most serious offenses. The role of progressive asthenia in the occurrence of such conditions is emphasized in foreign literature, and the fact that the actions are ultimately directed does not at all exclude the diagnosis of a painful condition.
In the second phase of pathological affect, a short-term psychotic state occurs, and the affective reaction takes on a qualitatively different character. Psychotic symptoms, characteristic of pathological affect, are characterized by incompleteness, low severity, and lack of connection between individual psychopathological phenomena. It is determined, as a rule, by short-term disturbances of perception in the form of hypoacusis (sounds move away), hyperacusis (sounds are perceived as very loud), and illusory perceptions. Certain perceptual disorders can be classified as affective functional hallucinations. The clinic of psychosensory disorders, disturbances in the body diagram (the head has become large, the arms are long), states of acute fear and confusion are presented much more holistically. Delusional experiences are unstable, and their content may reflect a real conflict situation.
The second group of symptoms includes expressive characteristics and vasovegetative reactions characteristic of affective tension and explosion, changes in motor skills in the form of motor stereotypies, post-affective asthenic phenomena with amnesia of the deed, as well as subjective suddenness of changes in state during the transition from the first to the second phase of the affective reaction, particular cruelty of aggression , its inconsistency in content and strength with respect to its occurrence (with affected psychogenies), as well as its inconsistency with leading motives, value orientations, and personal attitudes.
Motor actions during pathological affect continue even after the victim stops showing signs of resistance or life, without any feedback from the situation. These actions are in the nature of unmotivated automatic motor discharges with signs of motor stereotypies. The disturbance of consciousness and the pathological nature of affect is also evidenced by the extremely sharp transition of intense motor excitation, characteristic of the second phase, into psychomotor retardation.
The third phase (final) is characterized by the absence of any reactions to what has been done, the impossibility of contact, terminal sleep or painful prostration, which is a form of stunning. When differentially diagnosing pathological and physiological affects, it is necessary to take into account that, being qualitatively different conditions, they have a number of common features.
With pathological affect, insanity is determined only by the presence of signs of clouded consciousness at the time of the offense. This condition falls under the concept of a temporary disorder of mental activity of the medical criterion of insanity, since it excludes the possibility of a person being aware at the time of committing illegal actions of the actual nature and social danger of his actions.
The most adequate type of examination when assessing affective torts should be considered a comprehensive forensic psychological and psychiatric examination. The principle of joint consideration of the person, situation, and state at the time of the tort is one of the main ones when assessing emotional states. A forensic comprehensive psychological and psychiatric examination allows for the most complete and comprehensive assessment of an affective tort in the process of joint psychological and psychiatric research at all stages of the examination. The competence of a psychiatrist extends to the detection and qualification of abnormal, pathological features the personality of the subject, nosological diagnosis, delimitation of painful and non-painful forms of affective reaction, making a conclusion about the sanity-insanity or limited sanity of the accused. It is within the competence of the psychologist to determine the structure personal characteristics subject to the expert, both those that do not go beyond the norm, and those that add up to a picture of personal disharmony, analysis of the existing psychogenic situation, the motives of behavior of its participants, determining the nature of a non-painful emotional reaction, the degree of its intensity and influence on the behavior of the subject when committing illegal actions.
Pathological drowsy state- quite common mental pathology. But it can be assumed that it comes to the attention of psychiatrists only when subjects in this state commit serious offenses. Drowsy states aroused increased interest not only among clinicians, but also among the general public, and therefore were reflected in fiction. The pathological drowsy state is described in the story by A.P. Chekhov “I want to sleep.” It took place among a girl who was a servant in the house and was subjected to humiliating bullying and beatings from her mistress. She was malnourished, lacked sleep (temporary soil), and was homesick. Thus, all the factors add up and, rocking the baby in the cradle, she suddenly begins to hallucinate. She sees clouds, it seems to her that these clouds are laughing like children, she strangles the child and with a happy laugh lies down on the floor next to the child and falls asleep. The time of writing this story coincides with the friendship of A.P. Chekhov with S.S. Korsakov. And it is quite possible that it was he who told the writer a similar case from practice. Despite the fact that A.P. Chekhov was a doctor, the accuracy of the description of psychopathology indicates that the story was based on some kind of real case. Then A.I. Solzhenitsyn remembered this story when describing painful conditions in prisoners who were subjected to sleep deprivation torture.
A pathological prosleep state is a hyperacute psychotic state that occurs during spontaneous or forced awakening from deep sleep. The main manifestation of this state is a disturbance of consciousness, which phenomenologically fits completely into twilight stupefaction. But just like other exceptional conditions, pathological sleep states do not arise out of the blue. And in many cases, it is possible to identify organic pathology of the brain of one origin or another. Acute alcohol intoxication immediately before the development of a drowsy state is also a common occurrence. In many cases, the subjects drank alcohol before falling asleep, and upon waking up, being forcibly awakened, they committed serious offenses, and almost always after this the subjects went back to bed and took another nap. Then, upon awakening, in almost 100% of cases they are amnesic for the acute psychotic episode. This oversleeping is typical for pathological sleepy conditions.
Very important point, which is noted in many German guidelines, is an indication of a history of sleep disorders. This could be sleep-talking, sleepwalking, etc. individual characteristics, such as delayed awakening, very deep sleep and disorientation upon awakening. Great importance is attached to previous dreams - they can be nightmarish with a threat to life, and then the tort itself, the behavior of a person during a pathological waking state is, as it were, a response to their threatening content in the form of the elimination of an object, life-threatening. There may be dreams with a psychogenic overtones that reflect previous psychogeny: quarrels, a showdown, a serious conflict situation, and then upon awakening, actions are performed in the spirit of these dreams. It is important that in pathological sleep states, unlike other exceptional conditions, not fragmentary amnesia is detected, but total amnesia. Previously, various terms were found in the literature to denote drowsy states: “dream intoxication”, “drowsy delirium”. Persons who have committed offenses in a state of pathological drowsiness are declared insane.
Thus, the expert assessment of so-called short-term mental disorders does not cause difficulties (Article 21 of the Criminal Code - “temporary mental disorder”).
The choice of medical measures for persons who have suffered short-term mental disorders must be differentiated. The presence of a history of organic failure in patients, abuse of alcoholic beverages, taking into account the personality and socially dangerous actions, is the basis for prescribing compulsory medical measures. Compulsory measures against these persons may be carried out in psychiatric hospitals general type. In cases where exceptional conditions occur in persons who have not previously abused alcohol, with a positive social status, and with mildly expressed soil pathology, outpatient compulsory observation and treatment by a psychiatrist can be recommended. If necessary, treat organic soil and psychogenic disorders, often observed in persons who have suffered short-term psychotic states, these patients may be recommended examination and treatment in a psychiatric hospital outside the framework of the use of compulsory medical measures.
Pathological affect
It is necessary to distinguish pathological affect from physiological affect, which is one of the types of temporary mental disorder and excludes sanity (Article 21 of the Criminal Code of the Russian Federation: “A person who was in a state of insanity, that is, could not realize the actual nature and social danger of his actions, is not subject to criminal liability (inaction) or manage them due to a chronic mental disorder, temporary mental disorder, dementia, or other painful mental state”).
Pathological affect is a painful state of psychogenic origin that occurs in a practically healthy person. Pathological affect is understood by psychiatrists as acute reaction in response to a psychotraumatic influence, at the height of development of which there is a disturbance of consciousness similar to an affective twilight state.
An affective reaction of this type is characterized by acuteness and vividness of expression, and, despite its short duration, in the development of pathological affect, with a certain degree of convention, three phases can be distinguished - the preparatory phase, the explosion phase and the final one.
In the preparatory phase, under the influence of mental trauma (severe insult, unexpected insult, deeply shocking news, etc.), a sharp increase in affective tension occurs with the concentration of all ideas only on the traumatic moment. The most important condition contributing to the emergence of an affective reaction is the presence conflict situation, a feeling of physical or mental obstacles to the implementation of one’s plans and intentions. Factors that help facilitate the occurrence of an affective reaction are overwork, forced insomnia, somatic weakness, etc.
Under the influence of a psychogenic stimulus emanating from the immediate offender and outwardly seemingly insignificant, a reaction with aggressive actions directed against the victim may suddenly occur, both for himself and for those around him. The ability to observe and evaluate what is happening, to recognize and evaluate one’s own state is deeply impaired or simply impossible.
In the explosion phase, the intense affect of indignation, anger or frenzy that arises is combined with deep clouding of consciousness and frantic motor excitation, which is automatic and aimless or aggressive in nature. In the latter case, the actions have “the nature of complex arbitrary acts committed with the cruelty of an automaton or machine” (S.S. Korsakov). Motor actions during pathological affect continue even after the victim stops showing signs of resistance or life, without any feedback from the situation. The explosion phase is accompanied by a characteristic appearance- distortion of the features of a pale and reddened face, the presence of overly expressive movements, changes in the rhythm of breathing.
The disturbance of consciousness and the pathological nature of the affect are also evidenced by the extremely sharp transition of intense motor excitation, characteristic of the second phase, into psychomotor retardation.” .
The third phase (final) is manifested by a sharp depletion of mental and physical strength, which entails either sleep or a state close to prostration, with indifference and indifference to the environment and the deed. Memories of what happened are fragmentary, but more often than not they are not preserved.
In terms of the nature of their occurrence and course, exceptional states are similar to each other: they begin and end suddenly, occur against the background of altered twilight stupefaction, and are most often accompanied by violent motor agitation and aggression. The features of these conditions include the fact that people in this state are not available for contact with other people, these episodes last a short time (usually minutes, less often hours), after which they experience exhaustion of physical and mental strength (prostration), and more often sleep with subsequent restoration of mental health. Such persons report complete or less often partial amnesia about the act that occurred.
All these disorders are united by great similarities clinical picture and the main psychotic features of the course, as well as the reversibility of these disorders, determined by the community pathological mechanisms and the retrospective difficulties that arise in their diagnosis. Forensic psychiatric practice confirms the expediency and justification of identifying forms of exceptional conditions as a separate group.
Despite the fact that exceptional conditions can occur in practically healthy people, they are still more often observed in people with residual effects organic brain damage, in which psychiatrists note psychopathological abnormalities.
It is the latter that create one or another degree of mental instability, which, at the same time, is in no way a manifestation mental illness in the narrow sense of the word. But still, this mental instability is a predominant factor determining the development of exceptional states.
An example of pathological affect is the following observation. “Subject S., 29 years old, is accused of inflicting grievous bodily harm on his father, from which he died.
By nature, S. was impressionable, sensitive, and timid. He had a wife and child and lived with his parents. S.'s father abused alcohol. While intoxicated, he started quarrels with relatives. S. knew how to settle relationships. In the period preceding the offense. S, combining work with studies in his specialty, was preparing for exams. I studied in the evenings, stayed up late into the night, did not get enough sleep, and felt tired all the time. On the day of the crime, the father came drunk late in the evening. He made noise, woke everyone up, and then began to insult and beat his wife. S, lying behind the curtain that divided the room, listened intently. The scandal flared up. The father, grabbing a hammer, began to threaten S.’s mother with murder. She screamed; the awakened child cried. The son’s screams affected S. “like a siren.” He jumped out of bed and ran to his father. I saw only the face of my child approaching and receding, changing in size. I didn’t remember what happened next. Having regained consciousness, I experienced severe weakness and felt sleepy. Having learned about what had been done, he wanted to help his father, but he fell asleep very quickly.
From the case materials it is known that S. ran up to his father, snatched the hammer from him and hit him several times. When the father fell, S. continued to strike him numerous blows to the head. He was very pale and trembled all over. Didn't respond to his wife's requests. The gaze was fixed. When his wife snatched the hammer from him and called him by name, S. seemed to wake up and looked at his father in surprise; I was trying to go somewhere, then go to my father. He suddenly sank down, leaned sideways against the chair and instantly fell asleep. He did not wake up when they put him on the bed and made noise while helping his father. Subsequently, S. only retained in his memory the events up to the moment when he ran up to his father.
Transient psychosis arose in S. under the influence of acute intense mental trauma. In its development, three phases can be identified: the preparatory phase - a short period of affective tension with the concentration of all ideas on the current situation; an explosion phase with a darkening of consciousness of the twilight type, in the structure of which, in addition to motor excitation with stereotypical actions, individual visual hallucinations associated with the content of psychogenic trauma were initially noted, the final phase, during which at first there was a sharp mental and physical exhaustion, and then deep sleep. S. had complete memory of what he had done. Fragments of memories of the preparatory phase and the initial phase of the affective explosion (visual hallucinations) remained in his memory. During the explosion phase, S. had a clear vegetative reaction (pallor, trembling). .
Psychosis was preceded by a period of asthenia, in particular, lack of sleep.
The expert commission declared subject S. insane, as having committed an offense in a state of pathological affect. .
When committing an affective tort, insanity is determined only by the presence of signs of pathological affect at the time of the offense. This condition falls under the concept of a temporary disorder of mental activity of the medical criterion of insanity, since it excludes the possibility of such a person at the time of committing illegal actions to realize the actual nature and social danger of his actions.
Thus, the main criterion for distinguishing pathological and physiological affects is the establishment of symptoms of a psychogenically caused twilight state of consciousness in pathological affect or affectively-narrowed, but not mental state consciousness during physiological affect.
When discussing the issue of the conditions for the occurrence of strong emotional disturbance, it is necessary to take into account the state of mental health of the person who experienced strong emotional disturbance. A study of practice shows that investigators and judges, when determining the state of passion, focus on the provoking behavior of the victim and almost do not take into account the psychophysical properties of the perpetrator, other data about his personality that influence the decision to commit a crime. .
Meanwhile, special studies show that among those convicted under Article 104 of the Criminal Code of the RSFSR (Part 1 of Article 107 of the Criminal Code), 68 percent have mental anomalies. They are for the most part able to work, capable and sane, but their personality is characterized by such traits as irritability, aggressiveness, cruelty, and at the same time they have reduced volitional processes and weakened restraining control mechanisms.
Due to these qualities, persons with mental anomalies are more prone to affective actions than persons who do not have such anomalies. This circumstance must be taken into account when determining the conditions for the occurrence, as well as the presence or absence of a state of strong emotional disturbance when qualifying a crime under Part 1 of Article 107 of the Criminal Code of the Russian Federation.
The literature has addressed the issue of the need to conduct a forensic examination to determine sudden strong emotional disturbance. Various opinions were expressed. Some authors propose conducting a forensic psychological examination, others - a comprehensive psychological and psychiatric examination. . In practice, there are cases of ordering a forensic psychiatric examination.
As already noted, the state of sudden strong emotional excitement is a special emotional state of the psyche of a healthy person. On this basis, it seems to us that the opinion of those authors who advocate the appointment in such cases of a forensic psychological rather than a forensic psychiatric examination that examines a painful state of mind is correct.
As for the provision on the appointment of a comprehensive psychological and psychiatric examination, it is appropriate in cases where it is necessary to distinguish between physiological and pathological affects. However, there is no need to prescribe such an examination in all cases to determine physiological affect.
At the same time, it should be emphasized that the limits of competence of an expert psychologist are limited to identifying the presence or absence of a state of physiological affect. Research by psychologists confirms the fundamental possibility of a substantiated answer to this question. It has been established that traces of each experienced affect remain in the psyche for quite a long time. The fact is that during affect, a number of functional shifts occur in the body, most of which are beyond the control of consciousness. This is expressed in changes in biochemical, physiological and psychological processes.
The conclusion of a forensic psychological examination must be assessed taking into account all other evidence that reveals the picture. Tomsk Regional Court S. was convicted under Article 103 of the Criminal Code of the RSFSR (Part 1 of Article 105 of the Criminal Code) for the murder of A. Both of them were in A.’s apartment together with other persons drank alcoholic beverages. A. asked the younger S. to bring a watch from the bedroom and he himself went to fetch it. In the bedroom, A. began to force S. into sodomy, hugged him and tore off his clothes. These actions aroused the indignation of S, who grabbed the scissors lying on the bedside table and struck A. with them several times in the chest, from which he died on the spot.
A forensic psychological examination was carried out in the case, which recognized that S. was not in a state of strong emotional disturbance. One of the arguments was that S. was drunk at the time of the murder. The Judicial Collegium for Criminal Cases of the Armed Forces of the Russian Federation reclassified the actions of the perpetrator under Article 104 of the Criminal Code of the RSFSR (Part 1 of Article 107 of the Criminal Code), indicating that the court was obliged to evaluate the expert opinion in conjunction with all the circumstances of the murder, emphasizing that the state of intoxication does not exclude strong mental excitement caused by in this case cynical illegal actions.
Thus, pathological affect is a short mental disorder that occurs in response to intense unexpected mental trauma and turns out to be an affective discharge against the background of a confused state of consciousness, followed by general relaxation, indifference and, as a rule, deep sleep accompanied by complete or partial retrograde amnesia.
During a period of confusion, a person is not aware of his surroundings and does not control his actions.
For a crime committed in a state of pathological passion, a person does not bear criminal liability. To conduct a forensic psychiatric examination, the paramedic must collect an objective history in as much detail as possible and describe the person’s condition and behavior after recovering from the affect.
