Abstract
Введение. В научном обзоре представлены результаты анализа современной литературы, посвященной исследованию связи генетических, эпигенетических и психологических факторов с эффективностью психотерапии. Теоретическое обоснование.. Статистические данные свидетельствуют о том, что в Российской Федерации, с учетом социально-политических трансформаций последнего времени, ежегодно возрастает потребность населения в психологической и психотерапевтической помощи. Несмотря на это, психотерапевтическая помощь до сих по не включена в медицинскую страховку. Во многом на это влияет отсутствие достаточной доказательной базы, подтверждающей эффективность различных психологических и психотерапевтических подходов. Создание таковой возможно с опорой на фундаментальные биологические механизмы, лежащие в основе психических процессов. К ним относятся, среди прочих, генетические и эпигенетические предикторы. В статье рассмотрены базовые понятия генетики и эпигенетики, имеющие отношение к психологическим характеристикам и психотерапевтическому процессу. Описаны модели корреляции и взаимодействия между генами и окружающей средой. Представлены результаты анализа научной литературы, посвященной исследованию влияния носительства «аллелей пластичности», а также генов нейромедиаторных систем на эффективность
психотерапии. Обсуждены факторы социальной среды, оказывающие значительное влияние на нейробиологическое развитие. Описана связь выраженности процессов метилирования ДНК с психотравмирующим опытом с одной стороны и с эффектами психотерапевтической помощи – с другой. Изложены особенности связи профилей метилирования с психотерапевтическим эффектом. Проведен анализ связи генетических предикторов и психологических характеристик с применением методов когнитивно-поведенческой терапии, терапии посттравматического стрессового расстройства, пограничного расстройства личности, панических расстройств, депрессий. Обсуждение результатов. Проведенный анализ современной научной литературы по теме позволяет заключить, что показатель метилирования ДНК может быть использован в качестве биологического предиктора эффективности и индикатора ответа на психотерапию. В будущем это знание может быть использовано для разработки персонализированных программ, направленных на оказание психологической помощи.
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