Noopsychosomatic disorders in the light of empirical studies.
Heath psychology is a new area that has emerged within psychology only recently. It has involved drawing on findings in clinical psychology, psychosomatic medicine, behavioral medicine and medical psychology. In contrast to the earlier focus on pathological phenomena, i.e. illnesses or disorders, health psychology concentrates on health. The father of health psychology, Joseph Matarazzo, writes that "health psychology is the aggregate of the specific educational, scientific, and professional contributions of the discipline of psychology to the promotion and maintenance of health, the prevention and treatment of illness, the identification of etiological and diagnostic correlates of health, illness, and related dysfunction, and the improvement of the health care system and health policy formation" (Matarazzo, 1980, p.815). Indeed, health psychology draws on and embraces theories, findings and practices of both medical, natural and social sciences.
In the holistic-functional health model, health is defined as "the process of continuous dynamic balancing of the individual's needs and environmental requirements. What determines the level of health are the resources of man (both inner and accessible from the environment) and the needs, often called stressors. In the holistic-functional model, health is viewed as a process and a great role is assigned to the subject's aware activity" (Heszen 2002). The model views a human being as a wholeness, a view which dates back to antiquity. From this holistic concept of man, psychosomatic medicine was born, emphasizing the interdependence of psyche (mind) and body. Similarly, psychoneuroimmunlogy which examines relationships between psychic and immunological processes emerged (Ader, Felten, Cohen 1991). Both psychosomatic medicine and psychoneuroimmunology have produced a huge body of theoretical publications and have been positively verified in clinical practice. The only way for a human being to realize his biopsychosociospiritual potential is to enter the world of culture understood as the symbolic world of values (Rys, Mausch, 2007). It is worth noting that behavioral medicine, implementing the holistic-functional model, includes behaviors conductive to health or illness in its research area (Sek 2005).
Noetic dimension of psychosomatic disorders: noopsychosomatics
Traditional clinical and health psychologies treat psychosomatic disorders and illnesses as ailments resulting from personality disturbances and abnormalities in biological, psychological and social spheres. Psychosomatic disorders are interpreted in the context of great schools of psychology e.g.: Psychoanalysis, Behaviorism, Cognitive and Humanistic/ Existential Psychology. According to Kazimierz Popielski (1999) however, theoretical analyses and psychotherapeutic practice have not sufficiently emphasized the subjective-personal views on existence, i.e. the existential-intellectual, moral, or noetic dimension of personality. Ignoring the value dimension while studying personality and choosing psychological therapy, researchers and therapists fail to recognize basic values in an individual's subjective-personal life and experience. A person who creates oneself mainly in reference to the world of material values, deprives himself of realizing his own humanity (Rys, Mausch 2006; Mausch, Rys 2007). Values shape and guide existence and the world of values and sense guides man in his/her existential being and becoming. A failure to develop a system of values and the ability to appreciate value, or its underdevelopment, result in distorted existence, that is in existential frustration, the feeling of unfulfillment and not using one's potential. Consequences of such a condition are existential vacuum and noogenic neurosis, described by Victor Frankl. Popielski attributes noopsychosomatic disorders to noogenic neurosis. While investigating origins of existence-related disorders and ailments, too little attention is paid to nonbiological personality characteristics like human aspirations, longings and feelings that constitute the meta-need of the sense of life. The feeling of a sense of life guides one's life, gives motivation, helps establishing goals (short-term, long-term, and metaphysical), shapes needs and biopsychonoetic values. According to Frankl (1998), having an anthropological intention, gives a person a chance to achieve a biopsychonoetic balance and to recover and/or maintain the broadly understood health.
A functional-existential concept of personality reflects the multidimensional and multidirectional character of human needs, aspirations, development and evolution in the noetic, psychological and somatic spheres of existence. The above is the core of the biopsychonoetic model of personality proposed by Popielski. He writes: "The existential approach to the issue of the sense of life is rooted in a very general observation: in one's environment, man is the one who personally, through intentional actions, relates to values and systems of values, becomes aware of them, values and experiences the consequences of the above as the feeling of the sense of life" (Popielski, 1999, p.20).
Results of Popielski's analysis of noopsychosomatic symptoms, using the Noopsychosomatic Symptoms Scale, reveal that the following behaviors prevail in a noopsychosomatic crisis situation.
(i) The noetic dimension includes:
A deep feeling of boredom, unhappiness and resignation, depression, despondency, fading motivation to live and act. Experiencing helplessness, uncertainty and frustration. Lack of self-confidence, experiencing being lost in life (decreased noetic activity syndrome). Results of empirical studies reveal that there is a "high statistical correlation between the level of the felt sense of life and: 1) a feeling of freedom (Hellwig=0.501) and 2) an attitude to death (Hellwig=0.504)" (Rys, in print).
(ii) The psychological dimension includes:
Changing moods, a feeling of exhaustion, fear-reactivity, attention span and memory problems. A sense of weariness and fatigue, difficulties with relaxation and speech fluency, problems with sleeping (and dreams), suicidal thoughts, sexual problems. Various kinds of hyper anxiety and emotional hypersensitivity (psychological dysfunction syndrome).
(iii) The somatic dimension includes: A feeling of general nervous tension, heart rhythm disorders, stomachache, toothache, sore throat, oral or pharyngeal dryness, lack of appetite or excessive appetite (somatoform disorders) (ibid., p.34).
It follows that a noopsychosomatic interpretation of disorders and illnesses complements the traditional approach to psychosomatics. Health disorders and noopsychosomatic ailments can have noetic causes in addition to biopsychosocial ones.
Modern understanding of spirituality
What is spirituality? Emmons (2006) notes that until recently the most suitable adjective describing this notion was the adjective vague. Traditionally, the issue has been marginalized by scientific psychology. Owing to the difficulties in defining the problem, serious scientists had approached spirituality with reservation. That is completely understandable. For any scientific discipline to progress, it is fundamental to achieve consensus as far as terminology and measurement methods are concerned. Vague terms and definitions hamper the progress. It is difficult to reach agreement on what spirituality and religiosity are because the perception of religiosity in a wider cultural perspective and in psychology changes along the birth of new spirituality that frequently differs from traditional concepts of religion (Emmons 2006, after Hill 1999). Spirituality is variously understood and measured in different research projects.
Since 1990 the number of publications on the understanding of religion and spirituality has grown more than on any other issue in the psychology of religion. It has become fashionable--both in cultural and academic publications, to differentiate between religion and spirituality. The noun spirituality and the adjective spiritual generally refer to experience rather than to existence of incorporeal forces or persons. Spirituality derives from Latin spiritus meaning a breath or a reviving or vital element of a person. The concept of spirituality stems from Christian theology. Christian theology sees spirituality as the result of the working of the Holy Spirit in man that affects man's soul and activity (Emmons 2006, after Rican 2003). Since the domain of psychology is natural and not supernatural, the spirit has to be defined in terms used to describe and explain human actions. Therefore spirituality is defined as a deep feeling of belonging, fulfillment, connection and openness to the infinity (ibid. Kelly 1995). It addresses and refers to the highest values and personal truths (ibid., after Wong 1998). It is referred to as the journey of being and experiencing as well as the transcendence awareness. It embraces the self, others, nature, life and the Almighty (ibid., after Elkins 1998). Spirituality--as opposed to religion means something spontaneous, informal, creative, universal. This means spirituality includes an authentic inner experience, freedom of individual expression, freedom to seek and even to experiment with religion.
Some modern psychologists while using the term spirituality go even a step further. Instead of debating it as a theoretical concept, they describe in detail however pragmatically, how people can experience spirituality, what they say about it and how they act. In this approach, the spirit associated with spirituality is not the Holy Spirit but rather a human spirit, representing the highest human potential. Following Beck (ibid., after Beck 1986), a spiritual person must have 13 characteristics, including: understanding, context awareness and broad perspective, awareness of unity with things, seeing unity in diversity, optimism, and love that characterizes a fully spiritual person.
I. Heszen-Niejodek and E. Gruszczynska (2004, p.21) point out that from a psychological perspective, the spiritual dimension should be treated as man's attribute that is a theoretical construct on the ontological level and as such spirituality is not directly measurable. Thus spirituality as a psychological construct refers to a particular range of man's functioning that encompasses both observable activities and the inner experience.
It is disputable whether spirituality is something inherent to every human being or whether there can be people wholly deprived of spirituality. Heszen-Niejodek and Gruszczynska assume that spirituality, like other psychological constructs, is a disposition. It means that in a favorable environment the spiritual factor may develop, otherwise it remains a dormant potential disposition. Spiritual growth can progress continuously during the period of personality formation just like cognitive, emotional, motivational processes, self-knowledge, etc. "Man as a being aspiring (emotionally engaged) to find sense in his/her own life strives to understand themselves" (Rys, 2006, p.108).
A personality of a well developed spirituality characterizes a person capable of transcendence, sensitive and having well-developed sensibility (higher function). Such a person may experience special life events that are especially conducive to spiritual growth as epidemiologic research and clinical data indicate (Thoresen, Harris 2002). These include critical, dangerous and life-threatening situations. Spiritual development of patients suffering from cancer is characterized by a stronger feeling of closeness with other people, recapitulation of their life, strong self-reliance, affirmation of life and courage in the face of death (Heszen, Sek 2007).
Thoresen and Friedman (2002) write that a greater spiritual/religious involvement on the part of a patient results in:
* lower incidence of ischemic heart disease and suicide attempts
* lower blood pressure
* lower incidence of cardiac infarcts
* improvement of physical fitness, self-assessment and reduction of anxiety, worries about health in the year following a heart transplant
* reduction of pain sensation in people suffering from cancer
* better perception of one's own physical condition and less frequent use of medical services.
My research has been carried on a representative sample of 683 pedagogy students at the University of Szczecin. The research question was what relations there are between the felt level of sense of life (Rys) and noopsychosomatic disorders in the sample examined. The main hypothesis was that there is a valid statistical correlation between the level of sense of life and noopsychosomatic disorders, i.e. an increase in the felt sense of life results in reduced incidence of suffered psychosomatic ailments.
The following research methods were used:
1) Crumbaugh-Maholick's Purpose-in-Life Test (translated into Polish and extended by Pluzek).
2) Mausch's Questionnaire on Psychosomatic Ailments Psychosomatic Ailments Lists by K. Mausch (includes 38 kinds of psychosomatic ailments).
The test and questionnaire were filled in individually by each student. Noopsychosomatic disorders included in the questionnaire were: 1) dissociative disorders, 2) physical pain, 3) physical weakness, 4) sexual disorders, 5) neurotic depressive disorders, 6) digestive system disorders, 7) circulatory system disorders.
Research results (1)
The results demonstrate (fig.1) that persons with a low level of the felt sense of a purpose in life or the sense of meaning of life suffer 28% of noopsychosomatic disorders on a high level (acute), 70% on an average level and 2% on a low level. Persons with a very high level of the felt sense of life suffer 4% of noopsychosomatic disorders on a high level, 93% on an average level and 3% on a low level.
It follows that individuals with a generally high number of noopsychosomatic disorders suffer 77% of neurotic-depressive disorders on a high level(fig.2). In the case of the reported average number of noopsychosomatic ailments, neurotic depressive disorders constitute 21%. Persons with a low level of noopsychosomatic disorders suffered 1% of neurotic depressive disorders on a high level and 90% on a low level.
The results reveal that 48% of persons with a high level of neurotic depressive disorders experienced physical pain (fig.3). The same refers to 24% of persons with an average level of complaints and 6% with a reported low level of neurotic-depressive disorders.
Furthermore, a low level of neurotic depressive disorders corresponds to 11% of respondents experiencing physical weakness on a high level. A high level of neurotic depressive disorders has been found in 58% of persons complaining about physical weakness on a high level (fig.4)
Another relation revealed by the research is that persons with a very high and high level of the sense of a purpose in life (fig. 5-6) have very few noopsychosomatic disorders on a high level of intensity (from 3% to 17%, e.g. physical pain, physical weakness, neurotic-depressive disorders). Psychosomatic disorders prevailing in this group of people were of low (dissociative 85%) and average intensity (digestive system disorders 57%).
1. conversion disturbances, 2. physical pain , 3. physical weakness, 4. sexual disturbances, 5. neurotic--depressive disturbances, 6. disturbances of digestive system, 7. disturbances of blood circulation system.
Finally, the research results indicate that persons with a lowered and low level of the sense of purpose in life (fig.7-8) complain about a relatively large number of psychosomatic disorders of high intensity (from 6% to 46%). The prevailing disturbances found are: neurotic-depressive disorders (46%), physical weakness (43%), digestive system disorders (40%). Also a considerable number of psychosomatic disorders of average intensity (from 39% to 80%--physical pain) has been reported.
1. conversion disturbances, 2. physical pain , 3. physical weakness, 4. sexual disturbances, 5. neurotic--depressive disturbances, 6. disturbances of digestive system, 7. disturbances of blood circulation system.
The research results demonstrate that there is an important statistical correlation between the felt intensity of noopsychosomatic disorders and the felt level of the sense of a purpose in life, i.e. the higher the intensity of noopsychosomatic disorders, the lower the level of the sense of a meaning of life (98% of disturbances of a high or average level of intensity, Fig. 1). A high level of noopsychosomatic disorders is accompanied by:
* physical weakness (98%--high to average level, Fig. 4)
* neurotic depressive disorders (98%--high to average level, Fig. 2)
* physical pain (89%--high to average level, Fig. 3)
* digestive system disorders (56%)
A high level of neurotic-depressive disorders correlates with a high level of felt physical pain. An increase in the intensity of noopsychosomatic disorders correlates positively with higher incidence of digestive system disorders. There is a high correlation between neurotic-depressive disorders and physical weakness. A very high level of the sense of a purpose in life is characterized by: (i) a low intensity of psychosomatic disorders (from 3% to 17%), (ii) the least frequent being: dissociative disorders (3%) and digestive system disorders (3%), (iii) the most frequent ailments are physical weakness (17%) and physical pain (17%).
A low (pathological) level of the sense of life is accompanied by: (i) a high level of psychosomatic disorders (from 10% to 48%), (ii) the least frequent of which are circulatory system disorders (6%) and physical pain (6%), (iii) the most frequently occurring disturbances are neuroticdepressive disorders (46%), physical weakness (43%) and digestive system disorders (40%).
The results of empirical studies reveal an interdependence of the spiritual condition of an individual and noopsychosomatic disorders suffered. There is a significant statistical correlation between the felt level of the sense of life and noopsychosomatic disorders, i.e. an increase in the level of the sense of life results in a reduced number of suffered psychosomatic ailments. This phenomenon can be referred to as noopsychosomatic (spiritual-psychosomatic) suffering.
A most important finding is that 28% of respondents reporting a low level of the sense of life have experienced noopsychosomatic disturbances on a high level of intensity and 70% experienced an average level of disturbance intensity. Among respondents declaring a very high level of sense of purpose in life, 4% reported psychosomatic disorders on a very high level of intensity and 93% on an average level. Most disorders reported by respondents were neurotic-depressive disorders ("spiritual" in a sense) that resulted in somatic ailments such as physical pain. The intensity of pain increased with the escalation of neurotic depressive symptoms (48% of respondents). A low level of sense of purpose in life positively correlated also with an increase in the subjectively felt physical weakness (13% to 58% of respondents suffering from high intensity of psychosomatic disorders). Respondents declaring a high level of intensity of noopsychosomatic disturbances also suffered from more digestive system disorders than those who declared a low level of noopsychomatic disturbances.
In conclusion, 46% of pedagogy students at the University of Szczecin who participated in the research project felt a low or lowered level of sense of purpose in life (Rys, in print) and suffer from noopsychosomatic disorders. Therefore, it can be concluded that noetic disturbances (a decrease in the level of sense of purpose in life) are accompanied by somatic and psychological disorders. These results confirm the thesis of biopsychosociospiritual unity of human personality as advocated in the works of V. Frankl and K. Popielski.
Over last decades, the notions of health and well-being or wellness have been discussed not only in medicine but also in other sciences such as psychology, sociology, philosophy and pedagogy. What has changed is the approach to the concept of well-being, both in its subjective personal and objective dimensions. Recently theoretical and research approaches have changed their focus from pathogenetic, i.e. interested in illness only, to salutogenetic that focuses on factors contributing to health (Antonovsky 1984, 1995). Both health and illness perspectives complement each another and thus foster progress of knowledge about man, including investigating conditions necessary to lead a healthy and happy life in both biopsychosocial and spiritual dimensions. Absence of illness symptoms is not the only condition for one's well-being which encloses the capacity to fulfill one's potential, or to professional, family and social development. Also objective social factors (environment, socio-political system, economic situation, etc.), important as they are, are not sufficient to achieve a subjectively perceived state of well-being. The 21st century will probably be the time when science will start to also look for factors conducive to health in its many dimensions, including the subjective psychological and spiritual ones along objective factors conductive to illnesses.
In the light of the research results many questions arise, among them questions about the psychophysical condition of students, young generations, and more generally, about the well-being of modern humanity. How important are different factors affecting health (biological, social and spiritual) in the process of human development? What factors are underestimated and neglected in Poland, Europe and the world? Does the spiritual dimension, which is partly shaped in a planned way and partly develops spontaneously in family, various groups and the society, need special attention and care? How should humanity (regardless of country, socio-political system, religion or history) cooperate in creating comprehensive foundations for adequate shaping of personality and spirituality, health, sense of happiness and self-realization, not forgetting about the standards of humanism, freedom, respect for religious and cultural differences? (2)
These and other questions call for answers and should be discussed by interdisciplinary and multicultural teams, because each country and each culture have different experience in this area. Poland as a post-communist society now enrooting a democratic system, together with other post-soviet countries like the Czech Republic, Slovakia or the former East Germany undoubtedly have different experiences in the field of spiritual development than the former West Germany, the USA or Great Britain.
Ader, R., Felten, D.L., and Cohen, N. (1991). Psychoneuroimmunology, Academic Press, San Diego.
Antonovsky, A. (1984). A call for a new question--Salutogenesis--and a proposed answer. The sense of coherence. Journal of Preventive Psychiatry, 2, 973-994.
Antonovsky, A. (1995). "Rozwiklanie tajemnicy zdrowia. Jak radzic sobie ze stresem i nie zachorowac" [Unraveling the Mystery of Health--How People Manage Stress and Stay Well], Fundacja IPN, Warszawa.
Emmons, R.A. (2006). "Spirituality: Recent Progress", in M. Csikszentmihalyi, I.S. Csikszentmihalyi, 2006, A life worth living, University Press Oxford
Frankl V. (1998). Homo patiens, PAX Warszawa.
Heszen-Niejodek, I. (2002) "Psychologia zdrowia" [Psychology of Heath], in J. Strelau (ed.) Psychologia. Podrecznik akademicki, [Psychology. Student textbook], vol. 3, Gdanskie Wydawnictwo Psychologiczne, Gdansk.
Heszen I. and Sek, H. (2007). Psychologia zdrowia [Health Psychology], PWN, Warszawa.
Heszen-Niejodek, I. and Gruszczynska, E. (2004). "Wymiar duchowy czlowieka, jego znaczenie w psychologii zdrowia i jego pomiar" [Human's Spiritual Dimension, its Significance in Health Psychology and its Measurement], Przeglad Psychologiczny [Psychological Review], vol.47, no. 1, 15-32.
Matarazzo, J.D. (1980). "Behavioral Health and Behavioral Medicine: Frontiers for a New Health Psychology". American Psychologist, 35 (9), 807-917.
Popielski, K. (1999). "Noopsychosomatyka: propozycja nowego podejscia diagnostyczno--terapeutycznego" [Noopsychosomatics: Proposition of a New Diagnostic-Therapeutical Approach], Przeglad Psychologiczny [Psychological Review], vol.42, no. 4, 7-23.
Rys E. (2006). "Rozwoj emocjonalny studentow jako idea pedagogiki szkoly wyzszej"[Students' Emotional Development as a Higher Education Pedagogy Idea], in Pedagogika Szkoly Wyzszej [Higher Education Pedagogy], 2006, no. 28, 99 -110, Szczecin--Warszawa.
Rys E. and Mausch, K. (2006). "Sytuacja egzystencjalna czlowieka. Pomoc psychoterapeutyczna w zaburzeniach poczucia sensu zycia" [Existential Situation of Man. Psychotherapeutical Help in Sense of Purpose in Life Disorders], in Zeszyty Naukowe [Scientific Journals] no. 405, 169-185, Studia Pedagogica Universitatis Stetinensis 6, Szczecin
Rys, E. and Mausch, K. (2007). "Spoleczne konstruowanie emocji" [Social Construing of Emotions], in J. Leonski, U. Kozlowska (ed.), W kregu socjologii interpretatywnej. Badania jakosciowe nad tozsamoscia [In the Sphere of Interpretative Sociology. Qualitative Research into Identity], 255- 269, Szczecin
Rys, E. "Cierpienie duchowe. Studium empiryczne"[Spiritual Suffering. Empirical Study], in print.
Rys, E. The sense of life as a subjective spiritual human experience, typescript.
Rys, E. "Pracownik socjalny wobec duchowych problemow wspolczesnego czlowieka. Rozwazania w kontekscie wynikow empirycznych na temat poczucia sensu zycia" [Social Worker in the Face of Spiritual Problems of Modern Man. Reflections in the Light of Empirical Research on Sense of Purpose in Life], typescript.
Sek, H. (ed.) (2005). Psychologia kliniczna [Clinical Psychology], vol.1, PWN, Warszawa.
Thoresen, C.E. and Harris, H.S. (2002). "Spirituality and Health: What's Needed?", Annals of behavioral medicine, 24, 1, 3-13.
* E. Rys, K. Mausch, "Duchowo--afektywna kondycja studentow pedagogiki. Studium empiryczne pedagogiczno--psychologiczne" [Spiritual-affective Condition of Pedagogy Students. Pedagogicalpsychological Empirical Study], Funded by individual research grant No. N107 010 31/1712
(1) Programmes for statistical calculations were developed by B. Gebski, Ph.D. from the Institute of Sociological Research Methods and Techniques of the University of Szczecin. Programmes in C++ language were compiled with the aid of BORLAND compiler. The calculations were conducted using PC IBM Pentium IV 4.5.
(2) The results of empirical studies showed that 22% of teachers (382 persons) and 24% of students (683 persons) participating in the Polish research program felt a low level of sense of purpose in life. By contrast, only 2% of Swedish students exhibited a low level of sense of purpose in life. Cf. also: "Zaburzenia poczucia sensu zycia w sytuacji zmiany spolecznej. Studium empiryczne na przykladzie nauczycieli wojewodztwa zachodniopomorskiego"[Sense of Purpose in Life Disorders in Context of Social Change. Empirical Studies Involving Teachers from West Pomerania Voivodeship], in K. Mausch, E. Rys 2007, "Patologia spoleczna. Wybrane zagadnienia"[Social Pathology. Selected Issues], Szczecin; E. Rys, K. Mausch, "Duchowo--afektywna kondycja studentow pedagogiki. Studium empiryczne pedagogiczno--psychologiczne" [Spiritual-affective Condition of Pedagogy Students. Pedagogical-psychological Empirical Study], funded by grant no. N107010 31/1712
Prof. Karol Mausch, Ph.D. is a psychologist, psychotherapist, teacher and
scientist at Wyzsza Szkola Humanistyczna (Humanist College) and University of Szczecin, Poland. He is an expert witness, a consultant to government and educational organizations, and a trainer of Balint's groups. His interests include: existential neurosis, psychology of health, spirituality, and psychoneuroimmunology. He is the author/co-author of books and papers, including Psychological Qqualities in Rrelation to the Iimmune Ssystem; Social Pathology; Spirituality in Ssocial Wwork; Noopsychosomatic Ddimension of Ssuffering. He is a participant in international Polish--Slovak--German--Estonian research about sense of purpose in life, noopsychosomatic disorders, stress and burn out in samples of students from post-communist societies. Contact: email: Karol_Mausch@poczta.onet.pl Business address: Wyzsza Szkola Humanistyczna, Monte Cassino street 15, 70-466 Szczecin, Poland.
Fig. 1. Sense of meaning of life and noopsychosomatic disturbances Level of sense of meaning lack average high very high 3% 93% 4% high 0% 92% 8% lowered 1% 90% 9% low 2% 70% 28% Intensity of noopsychosomatic disturbances Note: Table made from bar graph. Fig. 2 Noopsychosomatic disturbances and neurotic-depressive disturbances Level of noopsychosomatic disturbance low average high high 1% 15% 77% average 9% 52% 21% low 90% 33% 2% Levels of neurotic-depressive disturbances Note: Table made from bar graph. Fig. 3. Neurotic-depressive disturbances and physical pain Level of neurotic-depressive disturbance lack average high high 11% 41% 48% average 24% 52% 24% low 52% 42% 6% Levels of physical high Note: Table made from bar graph. Fig. 4. Neurotic-depressive disturbances and physical weakness Level of neurotic-depressive disturbances low average high low 2% 40% 58% average 9% 60% 31% high 32% 57% 11% Levels of physical weakness Note: Table made from bar graph. Fig. 5. Very high level of sense of meaning of life and noopsychosomatic disturbances Noopsychosomatic disturbances lack average high 7 55% 33% 12% 6 40% 57% 3% 5 62% 27% 11% 4 54% 38% 8% 3 28% 55% 17% 2 40% 43% 17% 1 85% 12% 3% Intensity of noopsychosomatic disturbances Note: Table made from bar graph. Fig. 6. High level of sense of meaning of life and noopsychosomatic disturbances Noopsychosomatic disturbances lack average high 7 53% 38% 9% 6 30% 64% 6% 5 50% 39% 11% 4 45% 43% 12% 3 16% 60% 24% 2 33% 49% 18% 1 81% 15% 4% Intensity of noopsychosomatic disturbances Note: Table made from bar graph. Fig. 7. Lowered level of sense of meaning of life and noopsychosomatic disturbances Noopsychosomatic disturbances lack average high 7 44% 41% 15% 6 32% 62% 6% 5 36% 44% 20% 4 45% 45% 10% 3 14% 52% 34% 2 31% 40% 29% 1 72% 24% 4% Intensity of noopsychosomatic disturbances Note: Table made from bar graph. Fig. 8. Low level of sense of meaning of life and noopsychosomatic disturbances Noopsychosomatic disturbances lack average high 7 50% 44% 6% 6 21% 39% 40% 5 7% 47% 46% 4 34% 48% 18% 3 17% 40% 43% 2 14% 80% 6% 1 27% 43% 30% Intensity of noopsychosomatic disturbances Note: Table made from bar graph.
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