Nemi nazarin Yi amfani da al al., 2015 (wanda yake kira 87)
Binciken da aka yi amfani da EEG, wanda aka yi da Prause da abokan aiki, ya nuna cewa mutane da suke jin damuwarsu game da batuttukan da suka shafi batsa, idan aka kwatanta da ƙungiyar kulawa waɗanda ba su damu da yin amfani da batsa ba, na iya buƙatar ƙarin ƙarfin gani don ƙwaƙwalwar amsawar kwakwalwa [87]. Masu halartar 'yan luwadi-wadanda' suna fuskantar matsalolin da suke tsara yadda suke kallon hotunan jima'i '(M= 3.8 hours a mako daya) - cire izinin ƙananan ƙarancin ƙananan (wanda aka auna ta hanyar tasiri mai kyau a cikin siginar EEG) lokacin da aka nuna shi akan hotunan jima'i fiye da ƙungiyar kwatanta lokacin da aka nuna su a cikin hotuna guda. Dangane da fassarar jigilar jima'i a cikin wannan binciken (a matsayin sakamako ko sakamako, don ƙarin ganin Gola et al. [4]), binciken zai iya tallafawa sauran abubuwan da ke nuna alamun abubuwan da ke faruwa a cikin jita-jita [4]. A cikin 2015, Banca da abokan aiki sun lura cewa maza da CSB sun fi son matakan jima'i da kuma samo bayanan da suke nunawa game da al'ada a cikin dACC yayin da aka nuna su akai-akai a kan hotuna guda [88]. Sakamakon binciken da aka ambata da aka ambata ya nuna cewa yin amfani da batsa na yau da kullum zai iya rage ladabi, wanda zai iya haifar da haɓaka da haɓaka, don haka ya kara ƙarfafa buƙata don ƙarfafa sha'awar yin jima'i. Duk da haka, ana nazarin nazarin lokaci na nazarin wannan yiwuwar. Haɗuwa, binciken bincike na yau da kullum ya bayar da tallafi na farko don ra'ayin cewa CSB ya ba da alaƙa da maganin miyagun ƙwayoyi, caca, da kuma wasan kwaikwayon wasan kwaikwayo game da canza hanyoyin sadarwar kwakwalwa da kuma tafiyar matakai, ciki har da fahimtar juna da halayyar juna.
COMMENTS: Masu marubuta na wannan bita sun yarda da sauran takaddun da aka yi nazari a kansu - Binciken da aka yi wa matasa Yi amfani da al al., 2015: Bayanan EEG na ƙasa na nufin cewa batutuwa suna biyan hankali ga hotuna. An ba su raunuka Marubucin marubucin (Nicole Prause) ya ci gaba da cewa cewa wadannan sakamakon "jita-jita ne", amma wasu masu bincike basu yarda da ita ba. Dole ne ku tambayi kanku - "Abin da masanin kimiyyar halal za su yi iƙirarin cewa binciken da ba su yi ba ne kawai ya ƙetare da kyakkyawan tsari na binciken? ".
- Yi amfani da N, Steele VR, Staley C, Sabatinelli D, Proudfit GH. Canjin jigilar marigayi ta hanyar halayen jima'i a cikin masu amfani da matsala da kuma iko basu dace da "buri" ba. Biol Psychol. 2015; 109: 192-9.
Abstract
Manufar nazari: Binciken na yanzu yana taƙaita ƙaddarar da aka gano game da tsarin cututtukan kwayoyin cutar nakasa (CSBD) da kuma bayar da shawarwari game da bincike na gaba game da ƙaddamar da yanayin.
Sakamakon kwanan nan: A yau, yawancin binciken da ke tattare da halayen jima'i ya ba da hujjoji game da abubuwan da ke haifar da halayen jima'i da bautar jima'i. Harkokin jima'i mai haɗari yana haɗawa da gyaran aiki a cikin sassan kwakwalwa da kuma cibiyoyin sadarwa da aka sanya a cikin ƙwarewa, haɓakawa, dyscontrol, da ladabi a cikin dabi'u kamar abu, caca, da kuma wasan kwaikwayo na wasanni. Yankuna masu kwakwalwa da suka danganci abubuwan CSB sun haɗa da halayen gaba da na jiki, amygdala, da striatum, ciki har da accumbens.
Summary: Duk da yawancin binciken binciken da aka gano a tsakanin CSBD da abubuwa da halayen hali, Lafiya ta Duniya sun hada da CSBD a cikin ICD-11 a matsayin rikici-sarrafa cuta. Kodayake binciken da suka gabata ya taimakawa wajen nuna muhimmancin abubuwan da ke cikin yanayin, ana bukatar ƙarin bincike don fahimtar wannan lamari da warware matsalolin da aka tsara game da CSBD.
Gabatarwa
Halin halayen jima'i (CSB) wani batu ne wanda aka fi sani da jima'i da jima'i, jima'i, jituwa ta jima'i, jima'i mai rikicewa, nymphomania, ko jigilar jima'i [1-27]. Ko da yake ba daidai ba ne ƙididdigar ƙididdigar bincike ba, an ƙaddamar da CSB akan 3-6% na yawan balagagge kuma yafi kowa a cikin maza fiye da mata [28-32]. Dangane da matsalolin da ke tattare da mazauna mata da maza tare da CSB [4-6, 30, 33-38], Hukumar Lafiya ta Duniya (WHO) ta bayar da shawarar ciki har da Cutar Ƙarƙashin Ƙarƙwarar Jima'i (CSBD) a cikin ma'anar 11th mai zuwa. Kwayoyin Kayan Ƙasa na Duniya (6C72) [39]. Wannan hada ya kamata taimakawa wajen samun damar samun magani ga mutanen da ba a ba su ba, rage ƙyama da kunya da ke haɗaka da neman taimako, inganta ayyukan bincike, da kuma kara yawan kulawa da duniya akan wannan yanayin [40, 41] .Ya yarda cewa a cikin shekaru 20 na ƙarshe an sami sun kasance ma'anar bambancin da ake amfani dashi don bayyana halin kwaikwayon dysregulated yawancin halin da ake ciki da aikata kima akan ayyukan jima'i (misali, jima'i / jima'i ba tare da jimawa ba, amfani da rikici na batsa). Don dubawa na yanzu, zamu yi amfani da kalmar CSB a matsayin lokaci mai zuwa domin bayyana matsalar, yawan halayen jima'i.
An yi la'akari da CSB a matsayin mummunan cututtuka, cuta mai rikitarwa, ko rikitarwa [42, 43]. Kwayoyin cututtuka na CSBD suna kama da wadanda aka kawo a 2010forthe DSM-5 ganewar asali na rashin daidaituwa ta mazauni [44]. Cibiyar tabarbarewar mahaifa ta ƙare ne ta hanyar Ƙwararrun Ƙwararrun Ƙwararrun Amurka DSM-5 don dalilai masu yawa; rashin ilimin kwayoyin halittu da kwayoyin halitta ya kasance daga cikin dalilan da aka fi sani (45, 46). Kwanan nan, CSB ya karbi hankali a cikin al'adun gargajiya da zamantakewar zamantakewa, musamman ya ba da rarrabawar lafiyar jiki da ke haddasa haɗarin haɗari da ƙananan kungiyoyi. Duk da karuwa da yawa akan nazarin CSB (ciki har da wadanda ke nazarin "jima'i", "'yanci," "jima'i"), ƙananan bincike sun binciki rubutun hanyoyin CSB [4, 36]. Wannan talifin yayi nazarin hanyoyin da ke cikin kwayoyin halitta na CSB da kuma bayar da shawarwari don bincike na gaba, musamman kamar yadda aka danganta da ƙwarewar CSBD.
CSB a matsayin Cutar Guda
Yankuna na Brain da ke aiki a cikin kayan aiki suna da mahimmanci don fahimtar asalin, samuwar, da kuma kiyaye nau'ikan halayyar ha'inci (47). Tsarin gine-ginen da ake kira 'tsarin ladabi' ana kunna shi ta hanyar bunkasa matsalolin, irin su maganin ƙwayoyi a cikin ƙari. Babban mai ba da amfani ga aikin sarrafawa shine dopamine, musamman a cikin hanyar mesolimbic wanda ke ƙunshe da sashin jiki na jiki (VTA) da kuma haɗuwa da mahalartacci (NAc), da amygdala, hippocampus, da cortex na farko [48]. Ƙarin neurotransmitters da hanyoyi suna da hannu wajen yin aiki da ladabi, kuma waɗannan ka'idodin da aka ba da izini sunyi amfani da kwayoyin kwayoyin halitta zuwa kwayar cutar kwayoyi da kuma ciwon halayyar mutum a cikin mutane [49-51].
Bisa ga ka'idodin tayar da hankali, hanyoyi daban-daban na kwakwalwa suna haifar da dalili don samun lada ("son") da kuma ainihin sakamako na sakamako ('liking') [52]. Ganin cewa 'so' yana iya kasancewa da alaka sosai da dopaminergic neurotransmission a cikin ventral striatum (VStr) da kuma orbitofrontal cortex, cibiyoyin sadaukar da sadaukarwa don samar da dalili da ake bukata da kuma jin dadin zuciya sun fi rikitarwa [49, 53, 54].
Anyi nazarin sakamako mai alaƙa da sakamako na VStr a cikin rikicewar rikicewa kamar giya, hodar iblis, rikicewar amfani da opioid, da matsalar caca [55-58]. Volkow da abokan aiki sun bayyana mahimman abubuwa huɗu na jaraba: (1) wayar da kai da ke tattare da sake kunnawa da sha'awa, (2) lalacewa da ke tattare da yanayin rayuwa, (3) hypofrontality, da (4) rashin aiki da tsarin damuwa [59]. Har zuwa yanzu, bincike na CSB ya fi mayar da hankali kan haɓaka amsawa, sha'awar, da haɓakawa. Nazarin binciken neuroimaging na farko na CSB ya mai da hankali ne kan nazarin kamanceceniya tsakanin CSB da jaraba, tare da takamaiman mayar da hankali kan ka’idar jin daɗin haɓaka wanda ke dogara da ƙwarewar ƙarancin jijiyoyin jiki waɗanda ke da alaƙa da canje-canje a cikin tsarin kwazo mai alaƙa da dopamine [60]. A cikin wannan samfurin, sake bayyanawa ga magungunan ƙwayoyi masu maye na iya canza ƙwayoyin kwakwalwa da da'irorin da ke tsara sifa na jin daɗin motsawa zuwa motsa jiki, wanda shine tsarin halayyar halayyar mutum wanda ke cikin halayyar motsa jiki. Saboda wannan tasirin, kwakwalwar kwakwalwar na iya zama mai sanya hankali (ko a wayar da kai), don haka ta ba da gudummawa ga ci gaban matakan cututtukan cututtukan jin kai na karfafa gwiwa ga abubuwan hadafi da alamomin da ke hade da su. Arfafawar motsa jiki ('son') don ƙwayoyi na iya ɗaukar shekaru, koda kuwa an daina amfani da ƙwayoyi. Yana iya haɗawa da ɓoye (son sani) ko kuma bayyane (sha'awar hankali). An ƙaddamar da samfurin haɓaka don ba da gudummawa don haɓakawa da kiyaye CSB [1, 2].
Bayanai suna tallafawa samfurin maida hankali ga CSB. Alal misali, Voon da abokan aiki sunyi nazarin ayyukan da aka yi a cikin ƙananan haɗin gwanon (DACC) -Vstr -amygdala na aikin sadarwa [1] .Men da CSB idan aka kwatanta da waɗanda ba tare da nuna nuna ƙara VSTr, dACC, da amygdala ba. shirye-shiryen bidiyo Wadannan binciken a cikin mahallin wallafe-wallafe mafi girma sun nuna cewa jima'i da magungunan miyagun ƙwayoyi sun haɗa da yankuna da cibiyoyin sadarwa masu yawa [61, 62]. Maza tare da CSB idan aka kwatanta da wadanda ba tare da sun bada rahoton mafi girma da sha'awar (burin zinare) na batsawa da kuma ƙananan abin da ya dace da ka'idar tauhidi mai ban sha'awa (1). Hakazalika, Mechelmans da abokan aiki sun gano cewa mutanen da ke tare da CSB idan aka kwatanta da maza ba tare da nuna nuna jin dadin su ba game da jima'i ba tare da nuna bambanci ba [2]. Wadannan binciken sun nuna matakan da suka shafi kulawa da hankali akan nazarin magungunan miyagun ƙwayoyi a cikin jaraba.
A cikin 2015, Seok da Sohn sun gano cewa a tsakanin maza da CSB idan aka kwatanta da wadanda ba tare da ba, an lura da mafi yawan ayyuka a cikin ƙwayar dakin farko (dlPFC), caudate, gyrus supraarginal na launi, dACC, da thalamus a cikin amsa ga jima'i [63]. Har ila yau, sun gano cewa yawancin bayyanar CSB an hade shi tare da kunnawa dlPFC da thalamus. A cikin 2016, Brand da abokan aiki sun lura da yadda za a ci gaba da VSTr don zaɓin batutuwa na batsa idan aka kwatanta da abubuwan da ba a fi son batsa ba a tsakanin maza da CSB kuma sun gano cewa aikin VStr ya danganci halayen kamuwa da labarun yanar gizo Binciken Bincike na Intanit na Intanet wanda aka gyara domin cybersex (s-IATsex) [64, 65].
Klucken da abokan aiki kwanan nan sun lura cewa mahalarta tare da CSB idan aka kwatanta da mahalarta ba tare da nuna nunawa amygdala ba a lokacin gabatar da alamomi (masu launin launin fata) wanda yayi la'akari da hotuna (66). Wadannan sakamakon sun kama da wasu daga wasu nazarin nazarin amygdala kunnawa tsakanin mutane da maganin rashin amfani da kayan aiki da maza da CSB suna kallon bidiyon bidiyo na ainihi [1, 67] .Bayan da EEG, Steele da abokan aiki suka lura da girman P300 amplitude zuwa hotuna na jima'i (idan aka kwatanta da su tsauraran hotuna) tsakanin mutane da kansu da aka gano cewa suna da matsaloli tare da CSB, sun sake farawa tare da bincike na farko na yin aiki da maganin miyagun ƙwayoyi a fuskar maganin miyagun ƙwayoyi [68, 69].
A cikin 2017, Gola da abokan aiki sun wallafa sakamakon binciken ta yin amfani da hoton halayen magnetic resonance na aiki (fMRI) don nazarin hanyoyin Vstr don maganganu da kuma kudi tsakanin maza da ke neman magani ga CSB da maza ba tare da CSB [6] ba. Masu shiga sun shiga aikin jinkirta mai tayin (54, 70, 71) yayin da suke yin nazarin fMRI. A lokacin wannan aiki, sun sami ladabi ko lambobin kuɗi da aka riga sun gabata. Maza da CSB sun bambanta daga waɗanda ba tare da maganganun VStr ba game da labarun zane-zane, amma ba a cikin martani ga hotuna ba. Bugu da ƙari, mutanen da ke tare da CSB ba tare da CSB ba sun nuna mafi girma VStr kunnawa musamman domin alamun da ake tsammani hotunan hotunan kuma ba ga waɗanda suke bayarwa ba. Abubuwan da suka shafi halayen kuɗi da aka sani sune dangantaka da ƙara haɓaka hali don kallo hotuna masu ban sha'awa ('so'), tsanani na CSB, adadin batsa da ake amfani dasu a mako guda, da kuma masturbation na mako-mako. Wadannan binciken sun nuna alaƙa tsakanin CSB da ƙwarewa, muhimmiyar rawa ga ilmantarwa a cikin CSB, da kuma yiwuwar maganin magancewa, musamman abubuwan da suka shafi mayar da hankali kan ilimin koyarwa ga mutane don samun nasarar magance burge / neman [72]. Bugu da ƙari, za a iya nuna halayyar ta hanyar rage yawan ladaran da za a samu don samun ciwon jima'i kuma zai iya tasiri sakamakon amsawa ga matakan jima'i ciki har da kallon bidiyo da kuma jima'i [1, 68]. Har ila yau, an yi amfani da halayen a cikin abu da halayyar dabi'u [73-79].
A 2014, Kuhn da Gallinat sun lura da raguwar VTRr a mayar da martani ga hotuna masu ruɗi a cikin rukuni na mahalarta kallon batsa akai-akai, idan aka kwatanta da mahalarta kallon hotunan da wuya [80] .Bayan da aka haɓaka aiki a tsakanin dlPFC na hagu da kuma hakkin VStr. Rashin kuskure a cikin gefen gaba-gaba yana da alaka da rashin dacewa ko kuma rashin dacewar dabi'u ba tare da la'akari da sakamakon mummunar sakamako da ka'idojin rashin jin dadi ba (81, 82). Mutanen da ke tare da CSBmay sun rage ikon jagorancin lokacin da aka nuna su ga batsa [83, 84]. Kuhn da Gallinat sun gano cewa kararren launin toka na madaidaiciya (caudate nucleus), wanda aka sanya shi a cikin halayyar haɗin kai da kuma alaka da jihohin da suke da alaka da ƙauna mai ƙauna, an haɗu da halayen bidiyon finafinan yanar gizo [80, 85, 86]. Wadannan binciken sun haifar da yiwuwar yin amfani da batsa akai-akai na iya rage ƙarfin kwakwalwa ta hanyar mayar da martani ga jarabar jima'i da kuma kara yawan halaye zuwa jima'i ko da yake ana buƙatar nazari na tsawon lokaci don ware wasu hanyoyi.
Binciken da aka yi amfani da EEG, wanda aka yi da Prause da abokan aiki, ya nuna cewa mutane da suke jin damuwarsu game da batuttukan da suka shafi batsa, idan aka kwatanta da ƙungiyar kulawa waɗanda ba su damu da yin amfani da batsa ba, na iya buƙatar ƙarin ƙarfin gani don ƙwaƙwalwar amsawar kwakwalwa [87]. Masu halartar 'yan luwadi-wadanda' suna fuskantar matsalolin da suke tsara yadda suke kallon hotunan jima'i '(M= 3.8 hours a mako daya) - cire izinin ƙananan ƙarancin ƙananan (wanda aka auna ta hanyar tasiri mai kyau a cikin siginar EEG) lokacin da aka nuna shi akan hotunan jima'i fiye da ƙungiyar kwatanta lokacin da aka nuna su a cikin hotuna guda. Dangane da fassarar jigilar jima'i a cikin wannan binciken (a matsayin sakamako ko sakamako; don ƙarin bayani game da Gola et al. [4]), binciken zai iya tallafawa sauran abubuwan da ake nunawa na nuna halayen halaye a maganin cutar [4]. A 2015, Banca da abokan aiki ya lura cewa maza da CSB sun fi son matakan jima'i da kuma nuna sakamakon da suka nuna game da al'ada a cikin dACC lokacin da aka nuna su akai-akai a kan hotuna guda [88]. Sakamakon binciken da aka ambata da aka ambata ya nuna cewa yin amfani da batsa na yau da kullum zai iya rage ladabi, wanda zai iya haifar da haɓaka da haɓaka, don haka ya kara ƙarfafa buƙata don ƙarfafa sha'awar yin jima'i. Duk da haka, ana nazarin nazarin lokaci na nazarin wannan yiwuwar. Haɗuwa, binciken bincike na yau da kullum ya bayar da tallafi na farko don ra'ayin cewa CSB ya ba da alaƙa da maganin miyagun ƙwayoyi, caca, da kuma wasan kwaikwayon wasan kwaikwayo game da canza hanyoyin sadarwar kwakwalwa da kuma tafiyar matakai, ciki har da fahimtar juna da halayyar juna.
CSB a matsayin Cutar Tashin Ciki?
Nau'in "Kwayoyin cuta ba tare da sauran wurare" a cikin DSM-IV ba ne a cikin yanayi kuma ya haɗa da cututtuka masu yawa waɗanda suka sake kasancewa a matsayin abin kunya (matsalar caca) ko kuma abin da ya shafi damuwa (trichotillomania) a cikin DSM- 5 [89, 90]. Sakamakon yanzu a cikin DSM-5 na mayar da hankali ne ga rikicewa, rikice-rikice da rikici, ya zama kamuwa da juna a cikin mayar da hankali ta hanyar hada kleptomania, pyromania, rikice-rikice masu rikice-rikice, rikice-rikicen adawa, rikici, da rikici na zamantakewa (90). Kayan jigilar cuta-rikici a cikin ICD-11ya hada da wannan cuta ta farko da CSBD, yana kawo tambayoyin game da mafi dacewa. Da aka ba wannan mahallin, yadda CSBD ke danganta da aikin ƙwaƙwalwar ajiya na impulsivity na bada ƙarin ƙarin shawara don ƙayyadewa da kuma dalilan asibiti.
Ana iya bayyana impulsivity a matsayin, "predisposition zuwa gagarumin, halayen da ba shi da kyau a cikin ciki ko kuma na waje wanda ya rage game da mummunan sakamako ga mutum mai tsauri ko wasu" [91]. An haɗu da impulsivity tare da jima'i [92]. Impulsivity wani gini ne na multidimensional tare da nau'o'i daban-daban (misali, zabi, amsa) wanda zai iya samun dabi'un da halaye na jihar [93-97]. Ana iya tantance abubuwa daban-daban na impulsivity ta hanyar rahoton kai ko ta hanyar ayyuka. Suna iya haɓaka rauni ko a'a duka, ko da a cikin irin nau'in impulsivity; Muhimmanci, suna iya ba da labari daban-daban ga al'amuran asibiti da sakamakon [98]. Mai yiwuwa impulsivity mai yiwuwa ya iya auna ta hanyar yin aiki a kan ayyukan sarrafawa, irin su alamar tashoshi ko Go / No-Go, yayin da za a iya gwada zartar da zabi ta hanyar yin watsi da ayyuka [94, 95, 99].
Bayanai na bayar da bambance-bambance tsakanin mutane tare da ba tare da CSB ba akan rahoton kai da kuma matakan aiki na aikin impulsivity [100-103]. Bugu da ƙari, impulsivity da kuma sha'awar suna da alaka da tsananin da bayyanar cututtuka na amfani dysregulated batsa, kamar su asarar iko [64, 104]. Alal misali, binciken daya ya sami tasirin hulɗa da matakan matakan impulsivity auna ta rahoton kai da kuma ayyuka na hali game da tasiri masu tasiri a kan cutar ta CSB [104].
Daga cikin samfurori na neman magani, 48% zuwa 55% na mutane na iya nuna matakan girma na rashin kwaskwarima a kan Siffar Barratt Impulsiveness [105-107]. Ya bambanta, wasu bayanai sun nuna cewa wasu marasa lafiya da ke neman magani ga CSB ba su da wasu dabi'u masu ban sha'awa ko maganganu masu ƙyama ba tare da gwagwarmaya tare da halayyar jima'i wanda ya dace da binciken daga babban binciken kan layi na maza da mata da ke nuna rashin dangantaka da rashin ƙarfi tsakanin impulsivity da wasu sassan CSB (mawuyacin batsa) da kuma zurfafa dangantaka da wasu (haɗin kai) [108, 109]. Hakazalika, a cikin binciken da ke amfani da matakai daban-daban na masu amfani da batsa masu mahimmanci (lokacin da ake amfani da hotuna a cikin mako-mako = 287.87 mintina) da wadanda ba tare da (lokaci na yin amfani da hotuna bidiyo = 50.77 mintuna) ba su bambanta akan yadda aka ruwaito su ba (UPPS-P Scale) ko ɗawainiya na aiki (Tashar tashoshi) da matakan impulsivity [110] .Further, Reid da abokan aiki ba su lura da bambancin dake tsakanin mutane tare da CSB da kyawawan gwagwarmaya akan gwaje-gwajen neuropsychological na gudanarwa ba (watau maɓallin amsawa, gudun mota, zaɓi da hankali, lura da hankali, fahimtar sassaucin ra'ayi, ra'ayi da ra'ayi, saɓin saiti), ko da bayan daidaitawa don ƙarfin tunani a cikin nazarin [103]. Tare, binciken ya nuna cewa impulsivity iya danganta mafi karfi ga haɗin kai amma ba ga wasu siffofin CSB kamar matsala batsa amfani. Tana kawo tambayoyin game da yadda aka tsara CSBD a matsayin mai rikici-rikici a cikin ICD-11 kuma ya nuna muhimmancin buƙatar kimantawa na nau'o'in CSB. Wannan yana da mahimmanci tun lokacin da wasu bincike suka nuna cewa impulsivity da subdomains na rikitarwa mai rikitarwa ya bambanta a kan ka'idodin ka'ida da kuma tsarin pathophysiological [93, 98, 111].
CSB a matsayin Cutar Dama-Mai Rashin Jima'i?
Wani yanayin (trichotillomania) wanda aka kirkira a matsayin cuta mai rikitarwa a DSM-IV an sake dawo da shi tare da cuta mai rikitarwa (OCD) a matsayin cuta mai rikitarwa da rikici a cikin DSM-5 [90]. Sauran maganin rikici na DSM-IV kamar kamuwa da caca suna nuna manyan bambance-bambance daga OCD, suna tallafawa rarrabarsu a cikin wasu nau'o'i dabam dabam [112]. Ƙaddamarwa shine aikin gyaran ƙwaƙwalwa wanda ya ƙunshi, "aikin kwaikwayon da aiki da lalacewa ko ɓataccen hali ba tare da aikin daidaitaccen abu ba, wanda aka yi a cikin yanayin koyi ko al'ada, ko dai bisa ga dokoki maras kyau ko kuma hanya don kauce wa sakamakon" 93 ". OCD yana nuna babban matakan compulsivity; Duk da haka, sabili da haka kuyi abin da ya dace da rikitarwa da halayyar halin kirki kamar matsalar caca [98]. A al'ada, halayen da ke da mawuyacin hali da mawuyacin hali sun kasance kamar yadda suke kwance a kan iyakar ɗayan. Duk da haka, bayanan da aka bayar ya nuna cewa ƙaddarar suna kasancewa kothogonal tare da ƙwayoyin cuta masu yawa waɗanda suka yi tasiri a kan matakan da suka shafi impulsivity da compulsivity [93, 113]. Game da CSB, an bayyana ma'anar jima'i a matsayin cin lokaci da kuma tsangwama kuma zai iya ba da labari ga al'amuran OCD ko na al'amuran OCD [114].
Kwanan nan binciken nazarin abubuwa masu banƙyama da suke amfani da Inventory-Compressive Inventory -Dawancen (OCI-R) ba su nuna haɓaka tsakanin mutane tare da CSB [6, 37, 115] ba. Hakazalika, babban bincike kan layi ya gano wasu nau'o'in compulsivity kawai wanda ba shi da wata alaka da matsala masu amfani da batsa [109]. Tare, wadannan binciken ba su nuna goyon baya mai karfi wajen la'akari da CSB a matsayin rashin lafiyar da ke cikin rikici ba. Abubuwan da ke cikin jiki sun nuna mahimmancin halayen halayen da suka shafi mawuyacin hali [93]. Ƙarin karatu ta hanyar amfani da hanyoyin ƙwarewa ta hanyar kwakwalwa da kuma ƙwayoyin ƙwayoyin cuta don neman samfurori don buƙatar ƙarin yadda CSBD zai iya danganta ga compulsivity da OCD.
Zaɓuɓɓukan Gine-ginen Gine-gine tsakanin CSB Mutane
Ya zuwa yanzu, yawancin binciken da ba a yi amfani da shi ba sun mayar da hankali kan gyaran aikin a cikin mutane tare da CSB, kuma sakamakon ya nuna cewa alamun bayyanar CSB suna da alaƙa da ƙwayoyin hanyoyi na musamman [1, 63, 80]. Kodayake binciken da ake gudanarwa ya zurfafa saninmu game da haɓaka yankin da kuma haɗin aiki, ana bukatar amfani da ƙarin matakai.
An yi nazari a cikin CSB [102, 116]. A 2009, Miner da abokan aiki sun gano cewa mutanen da ke tare da CSB idan aka kwatanta da waɗanda ba tare da nuna alamar gaba mafi girma ba suna nuna bambanci kuma suna nuna rashin kulawa mara kyau. A cikin nazarin mutane tare da ba tare da CSB daga 2016 ba, an lura da ƙarar amygdala mafi girma a cikin kungiyar CSB kuma an yi la'akari da rage yawan haɗin gwiwar jihar tsakanin amygdala da dlPFC [116]. Rage yawan kwakwalwar kwakwalwa a cikin lobe, lobe, hippocampus, da amygdala da aka gano sunyi dangantaka da alamun alamun jima'i a cikin marasa lafiya da nakasa ko cutar Parkinson [117, 118]. Wadannan alamu masu tsayayya na ƙarar amygdala da suka shafi CSB sun nuna muhimmancin yin la'akari da rikici da ke tattare da rashin lafiya na neuropsychiatric a fahimtar kwayar halitta na CSB.
A cikin 2018, Seok da Sohn sunyi amfani da samfurin siffofi na voxel (VBM) da kuma nazarin haɗin gwiwa don nazarin ka'idojin launin toka da kuma hutu a CSB [119]. Maza tare da CSB sun nuna miki ƙwayar launin toka-ƙwayar jiki a cikin gyrusin baki. Hawan gyrus na kasa (STG) na hagu na da nasaba da ƙananan CSB (watau jarabawar maganin jima'i da nazarin [SAST] da Harkokin Ciniki na Hudu] [120, 121]. Bugu da ƙari, a canza hagu na STG-hagu da dama kuma ya bar ma'anar STG-dama caudate connectivities. A ƙarshe, sakamakon ya nuna babban haɓaka tsakanin ƙananan CSB da haɗin aikin aiki na STG na hagu zuwa tsakiya na tsakiya.
Duk da yake nazarin ne na CSB na haskakawa, kadan ana sani game da sauye-sauye a cikin tsarin kwakwalwa da kuma haɗin aiki tsakanin mutane CSB, musamman daga nazarin lura ko wasu abubuwan da aka tsara. Haɗuwa da binciken daga sauran yankuna (misali, kwayoyin halitta da jinsin halittar) zai zama mahimmanci a yi la'akari da nazarin gaba. Bugu da ƙari, binciken da ya dace da kwatanta ƙananan cututtuka da kuma haɗawa da matakan sakonni zai ba da dama ga tattara bayanai masu muhimmanci waɗanda za su iya sanar da ƙayyadewa da kuma cigaba da kokarin da ake ciki a halin yanzu.
Karshe kuma Yabo
Wannan labarin yayi nazarin ilimin kimiyya game da hanyoyin gina jiki na CSB daga abubuwa uku: jaraba, damuwa, da rikice-rikice. Yawancin nazarin ya ba da shawara tsakanin dangantaka tsakanin CSB da ƙwarewa ga sakamako ko ladaran da aka kwatanta da wadannan sakamako, wasu kuma sun nuna cewa CSB yana da alaka da ƙaddamar da yanayin kwalliya don ciwon kwari [1, 6, 36, 64, 66]. Nazarin kuma ya nuna cewa bayyanar cututtukan CSB suna haɗuwa da ƙananan damuwa [34, 37,122]. Kodayake gabobin sun kasance a cikin fahimtar CSB, yankunan kwakwalwa da yawa (ciki har da frontal, parietal da temporal cortices, amygdala, da striatum) an danganta su da CSB da sauran siffofin.
An hada CSBD a cikin halin yanzuICD-11a matsayin cuta mai rikitarwa [39]. Kamar yadda WHO ta bayyana, "Harkokin rikici-rikitarwa suna lalacewa ta sake ci gaba da tsayayya da motsa jiki, motsa jiki, ko kuma ya bukaci aikata wani aiki da yake ba wa mutumin sakamako, akalla a cikin gajeren lokaci, duk da sakamakon da ya fi tsayi -ma cutar da mutum ko kuma ga wasu, ya nuna damuwa game da halin halayyar, ko kuma rashin matsala a cikin sirri, iyali, zamantakewa, ilimi, sana'a, ko wasu muhimman wuraren da ke aiki '[39]. Binciken na yau da kullum yana tayar da tambayoyi masu muhimmanci game da rarraba CSBD. Yawancin cututtuka da aka lalata halayen motsa jiki sune aka ƙayyade sauran wurare a cikin ICD-11 (alal misali, caca, caca, da kuma maganin amfani da kayan aiki an kwatanta shi azabar kwari) [123].
A halin yanzu, CSBD ya zama mummunar cuta, da kuma sake tsaftace ka'idoji na CSBD ya kamata ya bambanta tsakanin ɗakoki daban-daban, wasu daga cikinsu na iya danganta da bambancin yanayin halin jima'i da matsala ga mutane [33, 108, 124]. Hakanan da ke cikin CSBD na iya zama wani ɓangare na bayyana sabanin rikice-rikicen da ake iya gani a fadin binciken. Kodayake binciken da ke tattare da nema a tsakanin CSB da abubuwan da aka saba da halayen mutum, kuma ana buƙatar ƙarin bincike don fahimtar yadda neurocognition ke danganta da al'amuran asibiti na CSB, musamman ma game da lalata siffofin jima'i. Ɗaukar karatu da yawa sun mayar da hankali kawai ga yin amfani da batsa masu amfani da batutuwan da zai iya rage iyakancewa ga sauran dabi'un jima'i. Bugu da ari, ƙaddamarwa / haɓaka ka'idodin masu bincike na CSB sun bambanta a ko'ina nazarin, har ila yau suna ɗana tambayoyi game da rashin daidaituwa da kuma daidaituwa a kowane nazarin.
Future Kwatance
Ya kamata a lura da yawancin ƙididdiga game da nazarin binciken da ke faruwa yanzu kuma za a yi la'akari da lokacin shiryawa na bincike na gaba (duba Table 1). Tsarin farko shine ƙananan samfurin samfurori da yawa sune fari, namiji, da namiji. Ana buƙatar ƙarin bincike don karɓar yawancin samari na maza da mata tare da CSB da kuma mutane daban-daban na jima'i da kuma fuskantarwa. Alal misali, babu nazarin kimiyyar kimiyya wanda ya yi nazari game da hanyoyin da CSB ke yi a cikin mata. Irin wannan nazari ana buƙatar da aka ba da bayanan da suka hada da jima'i da matsala a cikin mata idan aka kwatanta da maza da sauran bayanan da ke nuna bambancin jinsi tsakanin mazaunan da CSB [25, 30]. Yayinda mata da maza tare da ciwon haɗari na iya nuna irin kwarewa daban-daban (alal misali, suna da alaka da ƙyama da ƙarfafawa) don halartar halayyar haɗari da nuna bambancin damuwa da maganin maganin miyagun ƙwayoyi, nazarin neurobiological nan gaba ya kamata la'akari da tsarin jaraba da matakan da suka shafi alaka da jinsi bincike game da CSBD ya ba ta shiga cikin yanzu ICD-11 a matsayin rashin lafiyar lafiyar jiki (125, 126).
Hakazalika, akwai kuma bukatar gudanar da bincike na yau da kullum da ke mayar da hankalin kabilanci da jima'i don bayyana fahimtar fahimtar CSB tsakanin waɗannan rukuni. An yi wa jarrabawar jarrabawar CSB yawancin jarrabawa da kuma ingantawa a kan mutanen Turai. Bugu da ƙari, halin yanzu nazarin sun mayar da hankali yawanci a kan namiji maza. Ƙarin bincike kan nazarin halaye na asibiti na CSB tsakanin maza da mata da ake bukata. Binciken neurobiological na wasu kungiyoyi (transgender, polyamorous, kink, wasu) da kuma ayyukan (batsa kallon kallo, cin zarafi mai mahimmanci, jima'i mara jima'i, wasu) ana buƙata. Idan aka ba da wannan iyakance, sakamakon da aka samu zai kamata a fassara shi da hankali.
Ana buƙatar kwatancen CSBD tare da wasu cututtuka (misali, kayan amfani, caca, caca, da sauran cututtuka), kamar yadda ake haɗawa da wasu yanayin ba na samfurin (misali, kwayoyin, epigenetic) da kuma yin amfani da wasu hanyoyi na hoto. Hanyoyi kamar kamuwa da haɓakar iska mai kwakwalwa na iya samar da basira mai mahimmanci a cikin sashin layin na CSBD neurochemical.
Hakanan za'a iya fahimtar bambancin kwayoyin cutar ta CSB ta hanyar binciken da kyau game da siffofin asibiti wanda za'a iya samuwa a wani ɓangare na binciken bincike na ilimin likitanci kamar ƙididdigar ƙididdigar ƙirar ra'ayi na musamman [37]. Irin wannan bincike zai iya ba da hankali ga tambayoyi na tsawon lokaci kamar su batsa masu amfani da batsa na iya haifar da zubar da jima'i, da kuma haɓaka ƙididdigar lissafi a cikin irin waɗannan nazarin zai iya ba da hankali ga tsarin neurobiological. Bugu da ari, yayin da ake gudanar da ayyukan jarrabawa da maganin maganin maganin ƙwayoyin maganin maganin maganin maganin maganin maganin CSBD, haɗuwa da ƙididdigar tsararraki na iya taimakawa wajen gano magungunan jiyya na CSBD da masu cin gashin halitta. Wannan dalili na ƙarshe yana iya zama mai mahimmanci saboda hada CSBD a cikin ICD-11 zai iya ƙara yawan mutanen da ke neman magani don CSBD. Musamman, hada da CSBD a cikin ICD-11 ya kamata ya wayar da kan jama'a ga marasa lafiya, masu samar da wasu, da sauransu kuma zai iya cire wasu shingen (misali, sake biya daga masu samar da inshora) wanda zai iya kasancewa ga CSBD.
;