The Experience in Systematization of Autoaggressive Behavior Variants in Military Age Individuals with Personality Disorders

Background: auto-aggressive behavior in persons of military-age is due to personality disorders (PD) in 90%. The features of self-harm in people of military age with PD compared with mentally healthy conscripts in modern conditions have not been sufficiently studied. The aim of the work was to systematize the variants of auto-aggressive behavior in military-age people with PD in order to improve differential diagnostic measures. Patients and Methods: 504 young men of military age (average age 18.7 ± 1.7 years) were examined in a psychiatric hospital. The participants were examined with clinical method and using the character accents questionnaire by A.E. Lichko and the ISAS questionnaire by E. Klonsky et al. Statistical processing included a comparative analysis according to the Fisher criterion and factor analysis (p < 0.05). Results: autoaggressive behavior occurs in 10.9% of cases among people of military age who are referred for examination in a psychiatric hospital. Auto-aggressive behavior among conscripts was most often represented by self-cutting: 92.1% in cases of PD vs 88.2% in mentally healthy conscripts who were sent for inpatient examination due to auto-aggressive behavior (χ² 0.21, p = 0.50). Episodes of skin cauterization were less common: 15.8% and 11.8% (χ² 0.15, p = 0.53); impacts on hard surfaces: 13.2% and 0% (χ² 2.46, p = 0.14), respectively. It has been established that in PD, self-harm is more severe, first committed at an earlier age, and more often repeated. Specific clinical features and motives of auto-aggressive behavior have been identified for certain types of PD: emotionally unstable (anti-suicide motivation, skin cauterization), dependent (revenge and interpersonal influence motivation, attempt to hide self-harm, critical attitude towards auto-aggression), schizoid (anti-dissociation, toughness and self-care motivation, isolated self-cuts), dissocial (interpersonal boundaries motivation) and anxiety (suicidal intentions and autonomy motivation, blows on a hard object). Conclusion: the systematization of variants of auto-aggressive behavior in people of military age with PD in comparison with mentally healthy recruits can be used in psychiatric examination to identify hidden variants of PD, as well as differential diagnosis of PD recruits and evasive behavior with a negative attitude towards military service. Identifying and studying the features of auto-aggressive behavior as a marker of mental disorders in people of military age is important for improving the quality of military recruitment and ensuring national security.

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