Syndrome-factor method in historical and modern context: possibilities of studying social anxiety disorder

The aims of this article are: to analyze the methodological and empirical significance of this approach and the syndrome-factor method developed on its basis in the study of the patterns of syndromogenesis of disorders of mental activity and personality; to summarize the experience of using the method; to analyze the current trends in the development of this method in Russian clinical psychology; to provide a summary of the application of the method in the study of social anxiety / social anxiety disorder (hereinafter SA / SAD). The formation of this approach at the beginning of the 20th century is associated with the contradictions which are accumulated in science related to the disappointment of the classical and nonclassical idea about the human psyche, which could not be ignored. Currently the post-non-classical level of the scientific knowledge in clinical psychology is characterized by trends in reviewing the value of the cultural-activity approach. The syndrome factor method of the analysis in Russian clinical psychology allows us to consider the mental activity as an open, self-organizing and self-developing system, and to investigate system-dynamic components of the psyche. Based on the logic of syndrome analysis, it becomes possible to predict probabilistic trajectories of the development of the system, to create programs for the mental recovery. The most important consequence of applying the methodology of the post-non-classical model of scientific knowledge is the possibility of diagnosing not the symptoms, but the dynamics of the formation of the symptom complex and the basic laws of its development in unity with the solution of the theoretical and practical tasks of clinical psychology. According to the logic of the cultural-activity approach, which treats the psyche as a dynamic system, the syndrome-factor analysis method allows to define the leading and secondary / tertiary disorders, the conditions for occurring the leading (stable) factor. The generalization of the achievements and principles of the syndrome approach in medical psychology has made it possible to develop and experimentally confirm the pathopsycho-logical model of social anxiety (SA) and social anxiety disorder (SAD). The leading disorders in this nosology are manifested in the distortion of the arbitrary regulation of mental activity in the context of 'the perceived threat'. It is connected with the disorders in the organizational and target structure of the activity in the situations of evaluations (loss of target priority / multitasking, monitoring 'mistakes', negative evaluations by others); it also includes secondary motivational changes of the personality and distortions of attention. In the study of SAD in modern neurocognitive studies the peculiarities of monitoring 'inconsistencies' are studied, focusing on error (by analyzing the electrical activity of the brain ERN phenomenon (error-related negativity) is studied -- the negativity associated with an error or the potential associated with the processing of an error). In case of SAD a neural marker of anxiety is studied. Modern studies show that ERN is a stable neuropsychological correlate of SAD, and possibly representing endophenotypical features of SAD, resistant to therapy of symptoms, and acting as the central syndrome forming neuropsychological mechanism of SAD. ERN is a sharp negative peak of the wave activity in the frontal and central parts of the brain, and represents the result of an error in the activity. Its activity is aimed at the correction of behavior to improve the efficiency of activities. ERN acts as an indicator of sensitivity to the negative effects of the results of one's own behavior. A higher rate of ERN indicates the increased control over one's own behavior and greater sensitivity to the errors committed.

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