Neurobiological Mechanisms na Social Saduwa cuta (2001)

Ƙarƙashin Ƙarƙashin Ƙira

Kamar mutum, magunguna suna dogara ne akan dangantaka da zamantakewa, kuma za a iya gudanar da lura da labarun dabarun gwaje-gwaje. Shively (2) An gudanar da nazarin karatun da ba a san ba a rayuwar mutum ba tare da yin nazari ba a cikin jinsin mazauna cynomolgus. Abubuwan da ke nunawa a hankali sun bayyana cewa masu goyon baya sun ciyar da lokaci mafi yawa, suna kallon yanayin zamantakewa da tsoro, fiye da masu rinjaye. Nazarin halittu akan waɗannan ƙasƙanan sun nuna alamar aikin hypothalamic-pituitary-adrenal (HPA), da rashin lalata ayyukan da ke tattare da serotonergic, da kuma gurbin dopaminergic neurotransmission. A cikin kalubalen gwagwarmaya tare da ACTH, zamantakewar zamantakewa a cikin cortisol, suna nuna alamar HPA. Lokacin da masu binciken suka gudanar da gwajin gwagwarmayar gwagwarmaya (wanda ke haifar da saki na serotonin), cynomolgus macaques na dakin gwaje-gwaje sun nuna wani maganin prolactin maras kyau, wanda ya nuna rage yawan aikin serotonergic. Wadannan birai sun karu da karuwanci kuma sun rage lokaci a cikin kullun jikin jiki fiye da wadanda suka nuna karfin maganin prolactin (3). Lokacin da masu binciken suka gudanar da gwajin gwagwarmaya na haloperidol tare da dan damfara na dopamine wanda ke inganta labaran kwayar halitta ta hanyar hanyoyi na dopamin tubero-infundibular, rage maganganun prolactin a ƙarƙashin ƙasa (2). Wannan sakamakon ya ba da shawara wajen rage yawan karfin da masu sauraron kwayoyin halitta suka samu a cikin wannan hanya a cikin wadanda suke ƙarƙashin. Daidai da bayanai na neuroendocrin, nazarin rubutun kwaikwayo na positron (PET) (4) daga cikin wadanda suka nuna goyon baya sun nuna rageccen dop dopin D₂ mai karɓar mai karɓa, wanda ya nuna rashin lafiya na tsakiya na tsakiya wanda ke da mahimmanci, watau binciken da ke nuna sakamakon binciken ƙwararriyar ƙwayoyin lantarki na photon daya (SPECT) (5) a cikin mutane tare da zamantakewa tashin hankali cuta.

Nazarin ilimin zamantakewar al'umma a cikin daji sun saukar da wasu abubuwan da ba su dacewa da juna ba, wadanda ke nuna alamun bincike a wasu matsalolin mutane masu damu da kuma damuwa. Hypercortisolemia, da kuma juriya da ba da izini daga dexamethasone, ya ruwaitoshi daga Sapolsky et al. (6) a cikin baboons. Wani bincike mai ban sha'awa shi ne cewa 'yan kwando maza suna da ƙananan ci gaban insulin kamar yadda na fi girma fiye da masu rinjaye (7). Wannan binciken zai iya bayyana ƙungiyar da aka lura a tsakanin ɗan gajeren lokaci da rashin lafiyar zamantakewar da aka samu a binciken daya (8).

Akwai ƙananan ƙuntataccen tsari na wannan samfurin kamar yadda ya shafi marasa lafiya da rikici. Na farko, babu wata hujja game da rikice-rikicen HPA a cikin rikice-rikice na zamantakewar al'umma kamar yadda aka auna ta hanyar digiri na zubar da ciki na dexamethasone (9). Na biyu, maganin prolactin zuwa fenfluramine ya bambanta a cikin tsari da marasa lafiya tare da rikici da zamantakewa (10). Wani muhimmin iyakancewar wannan da sauran nau'ikan dabbobin shine mutane da ke da rikicewar rikice-rikice na zamantakewar al'umma suna iya zama "mai wahala" don yin kaucewa, mai ladabi, da damuwa a cikin tsarin zamantakewar jama'a, alhali kuwa wadanda ba na mutane ba, saboda magudin muhalli wajen mamayar da mika wuya, nunawa wani filastik don mayar da martani ga matsalolin muhalli. Misali, manyan birai masu tsananin girma suna da matakan serotonin na jini sama da na wadanda ke karkashinsu, amma matakan serotonin dinsu na raguwa sosai lokacin da aka cire su daga kungiyar (11). Saboda haka, yana nuna cewa babban mahimmanci da aka gano a tsarin jimawali na rikice-rikice na rikice-rikice tare da yanayin rikici na zamantakewar jiki shine lalacewar maganin dopaminergic. Ko wannan dysfunction shi ne wani tsari na damuwa ta zamantakewa ko wani ɓangaren zamantakewar zamantakewa ta hanyar ba shi da fili.

Alamar sauƙi-Foraging-Demand Model

Wani samfuri na amfani mai amfani shine samfurin ƙira-ƙirar-ƙira-ƙira a cikin wadanda ba a taɓa amfani da su ba. Rosenblum da Paully (12) sun kirkiro wannan samfurin don jin dadin zamantakewar al'umma da rashin nuna rashin amincewa ta hanyar yadawa iyayen mata ga yanayi marar tabbas da ake buƙatawa da kuma neman gwaji don haifar da alamar abin da aka haifa ga jarirai. Yawan dabbobin da aka haifa a ƙarƙashin yanayin da ake bukata don daidaitawa, idan aka kwatanta da abubuwan da aka kwatanta da su, sun nuna rashin daidaituwa a matakan zamantakewar zamantakewa-misali, rarrabawar zamantakewa, kauce wa matsalolin da ba'a taba fuskantar ba. kwatanta batutuwa (13). Daga bayanan nazarin halittu, batutuwa da aka samo a ƙarƙashin samfurori-samfurori-samfurori sun nuna yawancin karuwa a matakan CSF corticotropin-release factor (CRF) (14), da kwayoyin homobonillic dopamine (HVA), da kuma 5-hydroxyindoleacetic acid na serotonin (5-HIAA). Sai kawai a cikin batutuwa da aka samo a ƙarƙashin samfurori-samfuri-samfurin tsarin CRF sun daidaita daidai da matakan HVA da 5-HIAA, wanda ya nuna dangantakar haɗin tsakanin matakin CRF da duka tsarin dopaminergic da serotonergic (15). Bugu da ƙari, a cikin ƙungiyoyi masu tasowa mai sauƙi, haɓakar haɓaka a matakan CRF an haɗa su tare da raguwar zumunta a haɓakar hormone (GH) zuwa α₂ clonidine agonist adrenergic (16), kazalika da nuna juyayin juyayi ga yohimbine, α₂ antagonist (17).

Neurochemically, abin da ya fi dacewa ga rashin lafiyar zamantakewa ita ce binciken da ake samu na maganin maganin maganin ƙwayoyin cuta a cikin CSF a cikin ƙananan halittu waɗanda aka samo a ƙarƙashin yanayin da ake bukata, wanda yake da alaƙa da yawan abubuwan da ke fama da cutar rashin lafiya. A halin kirki, magungunan da suka samo asali a ƙarƙashin yanayin da suke da sauya-nau'in sunyi kama da abin da Kagan et al. (18) wanda aka bayyana a cikin ƙungiyar yara ƙanana waɗanda suka nuna halaye na “hana halaye ga waɗanda ba a sani ba.” Wadannan yara sun nuna saurin bugun zuciya don damuwa, matakan cortisol na yau da safe, da matakan hana halayyar da ke haɗuwa da babban aikin norepinephrine. Don haka, samfurin canzawa-neman tsari yana da amfani a cikin shawararta cewa damuwar farkon mahalli, musamman na yanayi mai tasiri, na iya canza ɗabi'a da kwayar halitta zuwa yanayin halayyar zamantakewar al'umma. A asibiti, duk da haka, binciken neuroendocrine na rarrabuwa tsakanin haɓaka matakan CRF da rage matakan cortisol sun yi kama da bayanan marasa lafiya tare da rikicewar damuwa na posttraumatic (PTSD) (19, 20).

Alamar haɗi na dabba

A tarihi, raguwa cikin halayen haɗin kai an haɗa su da haɗin kai tare da rikici da kuma cututtukan mutum. A gaskiya ma, bambanci na asibiti tsakanin marasa lafiya tare da rikici da zamantakewar al'umma da wadanda ke da autism da kuma halin mutuncin mutum na dabi'a ne a cikin nauyin sha'awar dangantaka da haɗewa ga wasu. Saboda marasa lafiya da zamantakewa na zamantakewa (da kuma alaka da alaka da shi na musamman II wanda ya bambanta matsala daga yanayin hali) an dauka a matsayin mutane da suke son haɗin kai da haɗewa tare da wasu amma suna jin tsoron sakamakon mummunan sakamakon wannan hulɗar, yayin da mutane masu tsinkaya da kuma marasa galibi ba sa so waɗannan haɗe-haɗe da rashin haɓaka da haɗin kai, wasu nau'un da aka haɗa ba su da mahimmanci a gane fahimtar rashin lafiyar al'umma. Duk da haka, fitowar kwayoyin halitta tsakanin autism da zamantakewa na zamantakewar al'umma sun ba da shawarar sake dubawa akan abin da ke tattare da kwayoyin halitta. Alal misali, Smalley et al. (21) ya gano cewa dangi na farko na autistic probands yana da karuwa a yanayin zamantakewa na zamantakewa dangane da batutuwan da aka kwatanta. Nazarin kwanan nan (22) ya nuna cewa iyayen 'yan kallo na autistic suna da karfin halayen zamantakewa fiye da iyayen Down's syndrome, kodayake babu wata hujja akan wata ƙungiya tsakanin mutane tsakanin rikice-rikice na zamantakewar jama'a da kuma mahimmanci na autism (wanda aka bayyana a matsayin bangarorin autism, ciki harda ƙuntatawar zamantakewar jama'a da sadarwa da kuma siffofi na maimaita hali). Wadannan nazarin suna nuna alamar halitta da aka haɗe, wanda ke haifar da kwayoyin halitta na abin da aka hade da dabba wanda yafi dacewa da rashin lafiyar jama'a fiye da yadda aka sani.

An gudanar da bincike sosai a cikin batutuwan da ke da autism kuma a cikin ka'idodin abin da aka haɗe da haɗin kai. Raleigh da abokan aiki (23) ya nuna cewa haɓakawa na aikin serotonergic ya haifar da ingantaccen haɗin gwiwa a cikin 'yan takara, yayin da matakan leƙunin ƙananan sifa sunyi nasara. A cikin bambanci amma aikin da aka ba shi, samfurori masu kyauta tare da ƙananan matakai na CSF 5-HIAA sun nuna rashin ƙarfin zamantakewar jama'a kuma sun fi sauƙi su yi hijira a cikin ƙuruciyar shekaru daga ƙungiyoyin zamantakewa fiye da mambobi masu girma da CSF 5-HIAA (24).

Kwayar kwakwalwa shine tsarin farko na neurochemical da za a sanya shi a matsayin mai kula da dabi'un halayyar da aka yi a cikin primates da wasu nau'in. A cikin nazarin daya daga cikin wadanda ba'a taba ba (25), 10 ƙananan yara da suke zaune a cikin ƙungiyoyin zamantakewa tare da iyayensu da sauran abubuwanda suka hada da abokiya sun kasance ana gudanar da naloxone, mai cin gashin kai. Maganin da suka karbi naloxone sunyi karin tambayoyi da yawa kuma sun karu da karuwa kuma suka kara da kusanci da iyayensu. Kalin et al. (26) nazarin haɗuwa da jarirai na wadanda ba na halitta ba bayan rabuwar mahaifiyarsu kuma sun nuna cewa duka jarirai da mahaifiyar da aka gudanar da morphine sun nuna raguwa mai yawa a cikin halayyar jingina, yayin da wadanda aka ba naltrexone sun karu da jingina. A ƙarshe, akwai alamun ƙaddara tsakanin haɗaka tsakanin aiki na opioid da sauran tsarin sakonni, kamar yadda aka nuna cewa aiki mai zurfi ya karu ta hanyar injections a cikin rat. (27). A cikin asibiti, akwai wasu shaidu da cewa masu cin zarafi suna da matakan da suka shafi zamantakewar al'umma da damuwa (28).

An kafa kafacin neurohormone oxytocin a farkon qaddamarwa amma ba kula da halayyar haifa da haɗin kai ba (29), kazalika a cikin hulɗar zamantakewar jama'a a cikin wadanda ba'a taba ba (30). Bayanin kwanan nan daga Insel da Winslow (29) ya nuna cewa linzamin da ke da kwayar halittar da ke fama da karancin iskar oxygen yana fitar da 'yan kiran kadaici kuma ya rage hulda da jama'a. Sun yi tunanin cewa ƙananan hanyoyin haɗin abin da aka haɗe sune "waɗancan hanyoyi waɗanda suke haɗuwa da fahimtar zamantakewar al'umma (ƙamshi, sauraro, da kuma motsawar gani) zuwa hanyoyin hanyoyin jijiyoyi don ƙarfafawa, kamar su tsinkayen mesolimbic daga ƙananan ƙananan yanki zuwa ƙananan ƙwayoyin cuta da kuma prefrontal cortex ”(shafi na 888). Sananne ne cewa kwayar cutar kwayar cutar dopaminergic tana cikin tsinkayar hanyar sakamako ta kwakwalwa. Rikicin tashin hankali, kamar Stein (31) da aka ba da shawara, saboda haka yana iya zama rashin lafiya "wanda ke nuna rashin aiki a cikin tsarin da ke kimanta (haɗarin) haɗari da fa'idodin alaƙar zamantakewar jama'a" (shafi na 1280) ta hanyar amfani da hanyoyin lada na ƙwaƙwalwa. Anatomically, da yawa daga cikin waɗannan hanyoyin haɗe-haɗen haɗe-haɗe suna ƙetare cingulate na baya, wani yanki da aka gabatar kwanan nan ta hanyar haɓakar haɓakar maganadisu na aiki (fMRI) a cikin wani ɓangare na haɗin ɗan adam-jariri na mahaifa: amsa ga kukan jariri (32). A taƙaice, nau'in dabba na dabba yana haifar da ƙananan oxytocin, amma bambancin serotonergic, opioid, da kuma hanyoyin dopaminergic.

Kodayake basu da cikakkiyar bayani game da bambancin ƙwarewar da aka lura da marasa lafiya tare da yanayin tashin hankali na zamantakewa, samfurori na ƙayyadaddun tsari na samar da kayan aiki mai amfani don fahimtar abokiyar zamantakewar zamantakewar al'umma da ke gani a cikin batutuwa masu fama da rikice-rikice na al'umma da kuma samar da jagororin binciken bincike na gaba game da kwayar cutar kwayar cutar. cuta. Abin takaici, yawan adadin bayanan da ke tattare da kwayar cutar kwayar halitta tana da ƙari, musamman a cikin neuroimaging. Saboda haka, yin amfani da wannan samfurin dabba a yanayin rashin lafiyar mutum yana da iyakance a wannan lokaci. (Duba t1 don taƙaitaccen tsari na musamman game da rikici na zamantakewa.)

Neuroplasticity, Neurogenesis, da kuma Social Dominance

Binciken binciken da aka yi a cikin neurodevelopment ya ba da zarafi na daukar wani samfurin dabba na damuwa, kamar wanda yake damuwa da rinjaye ko damuwa, kuma yayi nazarin kwayoyin halitta ta hanyar maganin neuroimaging ko samfurin samfurori na postmortem. Ɗaya daga cikin muhimman abubuwan da aka gano a cikin kwayar halitta ta mutum a cikin shekaru goma da suka gabata shine samar da hujjoji game da filayen filayen kwakwalwar da kwakwalwa da kuma ci gaban neurogenesis a cikin yankuna daban-daban na kwakwalwa, irin su cortex, hippocampus, cerebellum, da bulb (33). Gould et al. (34) ya nuna canzawa neuroplasticity a cikin itace shrews a cikin wani ci gaba mai rinjaye wanda ya samo asali daga zamantakewar zamantakewar al'umma (35). Musamman, ƙungiyar ta nuna yawan karuwar yawan sababbin kwayoyin halittar da aka samar a cikin gine-ginen katako na ƙananan bishiyoyi idan aka kwatanta da wadanda basu kasancewa ga wani kwarewa ba. (34). An gano wannan binciken a kwanan nan a cikin birane na marmoset ta hanyar yin amfani da matsala na mazaunin mazaunin, wani samfurin halayyar kwakwalwa na musamman da ya dace da abin da ya fi dacewa da ita don itace shrews (36). A wannan lokacin, ba mu san irin yanayin canji na gyaran ƙwayoyin ba a cikin kwakwalwa na jarirai na mutum tare da alamun farko da alamu na zamantakewar al'umma; Saboda haka, fassarar ma'anar danniya-ƙaddamar da raguwa a cikin samar da kwayoyin granules a cikin dabbobin dabba ba a sani ba. Duk da haka, binciken da aka yi a kwanan nan ya nuna cewa ƙananan ƙananan matuka suna iya shiga cikin ayyukan aikin ilimin hippocampal-dependent (37) da kuma ragewar da ake samu a yawan adadin ƙananan ƙwayoyin cuta zai iya canza tsofaffi na fararen hula (37). Ƙwarewar kwarewa, wanda ya kara yawan matakan da ke tattare da glucocorticoids da kuma motsa hippocampal glutamate saki (38), saboda haka zai hana kwayar cellular cell neurogenesis. A cikin yanayin jin dadin jama'a, muna tsammanin cewa zubar da jini mai yawa a cikin hippocampal da yankuna na cortical na iya kasancewa muhimmiyar magungunan dysfunctional, kuma jiyya mai nasara zai iya hana dakatar da neurogenesis yayin gyaggyarawa neurotransmission.

Kodayake yawancin nazarin dabba sun mayar da hankali akan samfurin hijirar, akwai shaida cewa damuwa yana shafi nau'in kwakwalwa (39). Canje-canje na gyare-gyare masu mahimmanci ma sun dogara ne akan matakan neurotrophins, irin su ci gaba da ƙwayar ƙwayar cuta, wanda aka sani da za a canza shi ta hanyar bambancewa (40). A gaskiya, magunguna irin su masu zanga-zangar da ke tattare da serotonin (SSRIs), masu amfani da zaluntar zamantakewar al'umma, suna da masaniya don ƙara yawan maganganun neurotrophy a cikin kwakwalwa a cikin hippocampus (41, 42).

Makarantar Harkokin Kasuwanci da Harkokin Kasuwanci

Idan aka ba da matukar cigaba da cigaba da hanyoyi masu mahimmanci, akwai babban sha'awa wajen kawar da tsoro da damuwa a fadin matakan cigaba (43, 44). Tsawon lokaci, aikin kwanan nan ya tabbatar da cewa adadi mai yawa na yara waɗanda aka sanya su a matsayin "masu hana" za su haɓaka ci gaban zamantakewar jama'a ta ƙuruciya (45, 46). Kagan (47) ya lura cewa jarirai 4 a watanni daya da ke da ƙananan ƙofa don samun damuwa da kuma motsa jiki zuwa matsalolin da ba a sani ba zasu iya jin tsoronsu kuma suyi nasara a lokacin yarinya. Hakazalika, 'ya'yan da aka gano a matsayin halaye a cikin watanni 21 wadanda aka hana su a lokacin da suka biyo baya a cikin shekaru 4, 5.5, da 7.5 shekaru, sun nuna yawan rashin lafiyar yara fiye da yara waɗanda ba su da hali ba (48), kodayake binciken bai kasance na musamman ba, game da tashin hankali. Duk da haka, binciken da ake yiwuwa a yanzu da Pine et al. (43) ya ba da shawara ga wasu ƙayyadaddun ƙungiyoyi tsakanin yara da ƙwararren labaran zamantakewar al'umma, binciken da ya dace da wadanda suke nazarin iyali a cikin manya (49).

Neman ganewar neurobiological ya danganta ga yanayin rashin jin dadin jama'a a cikin yara yana taimakawa wajen tabbatar da asibiti da kuma abubuwan da ke faruwa na annoba wanda ya haɗu da halin kirki ya hana yara da marasa lafiya (50). Mafi mahimmancin maganin neurobiological na maganin asibiti sun kasance kwakwalwa karatun karatun da ake gudanarwa a cikin halayen halayya da kuma hana yara (51, 52) da dabbobi (53). Davidson (52, 54) ya nuna a cikin jarirai da manya cewa abubuwan da suka shafi damuwa, irin su tashin hankali, sun kasance tare da kunna yankin gabas ta tsakiya, yayin da haɗin gwaninta na farko ya danganci kusantar da hankali. Magunguna marasa lafiya tare da rikitarwa na tashin hankali sun nuna yawan karuwa a cikin kunnawa a cikin yankuna na baya da na gefe a gefen gefe a lokacin da suke tsammani yin magana game da batutuwan da aka kwatanta da su. (52, 55). A cikin aikin ƙayyadaddun da suka shafi, rikodin EEG a cikin maƙallan rhesus macaques sun nuna aikin haɓaka na haɓaka na haƙiƙa, ƙananan cortisol da ƙaddarar CSF CRF, da kuma ƙara zurfin amsawar kare (53, 56). Kodayake wadannan binciken suna da ban sha'awa, suna iya kasancewa maras tabbas a cikin yanayin, a cikin Rauch et al. (57) ya nuna yawan ƙaruwa a cikin magungunan ƙananan na baya, a tsakanin sauran yankuna, a cikin dukkanin maganganu masu tayar da hankali (rashin lafiyar jiki) [OCD], PTSD, da sauƙi phobia) a cikin PET alama ce mai ban sha'awa. Sabili da haka, ko da yake haɗuwa da annoba tsakanin haɓaka da halayyar al'amuran zamantakewar jama'a sun kasance suna inganta ta hanyar sauye-gyaren yankuna na al'ada a cikin kwakwalwa, ƙungiyoyin halittu na iya zama marasa lafiya.

Ƙananan ƙayyadaddun tsarin kwayoyin halitta don rikice-rikice na zamantakewa a cikin ma'aurata guda biyu (62) sun nuna cewa jinsin suna taka muhimmiyar rawa a ci gaba. Kamar yadda muke nunawa ga rashin tsoro (1), abin da ke nuna gadon zama shine mai saukin kamuwa da tashin hankali, ba cutar kanta ba. Ko da yake babu wani tsarin nazarin haɗin gwiwar da aka yi amfani da kwayoyin halitta ko bincike tsakanin kwayoyin dan takarar da aka gudanar don magance rikici ta zamantakewa har yanzu, irin wannan nazari yana gudana don rashin tsoro (63) da OCD (64). Hakazalika, nazarin kwayoyin halitta na gwargwadon gwargwadon kwayoyin halitta na yawancin hanyoyin da ke tattare da kwakwalwa a cikin rikice-rikice, irin su mai ɗaukar serotonin da kuma dopomet receptor da ɗakunansu daban-daban, sun ba da dama ga ƙungiyoyi tsakanin wasu kwayoyin halitta da halaye na hali, irin su cutar da kaucewa da kuma neman sabon abu (65, 66)-I'idodin da ke dacewa da yanayin tashin hankali na zamantakewa. Saboda haka, nazarin halittu da iyali a yanayin rikice-rikicen har yanzu suna cikin ƙuruciya amma suna tallafawa bayanan asibiti mai zurfi wanda ke ba da shawara game da haɗi tsakanin yara da kuma bambance-bambancen girma na wannan cuta.

Kamfanin Pharmacological bincike

Cibiyoyin gwagwarmaya sun nuna matsala a monoamine (dopamine, norepinephrine) da kuma ƙananan ƙwayoyin cuta (serotonin) neurotransmission. Daga karatun serotonergic, Tancer et al. (10) ya ruwaito rahoton da ake yi na cortisol zuwa fenfluramine a cikin marasa lafiya da zamantakewar al'umma game da batutuwa da aka kwatanta da su, wani binciken da ya kama da wannan a cikin batutuwa masu rikici. Hollander et al. (67) ya ruwaito rahoton da ake damu da damuwa ga binciken serotonergic m-CPP, amma babu wani sabon gyare-gyaren neuroendocrine. A cikin nazarin aikin dopamin, ƙungiyar Tancer (10) ba su sami wata ƙarancin aikin dopaminergic lokacin amfani da su ba l-dopa a matsayin binciken kwayoyin halitta (duba F1 don taƙaita abubuwan da ke damun maganin damuwa da kwayoyin cutar da ke cikin rikice-rikice na al'umma [68-72]). Sauran binciken da aka saba amfani dashi a cikin nazarin yanayin rashin tsoro, irin su CO₂, lactate, pentagastrin, da epinephrine, sun haifar da wata matsala ta tsakiya, tsakanin marasa lafiya tare da rikice-rikice da matsala, a cikin marasa lafiya tare da yanayin rikici (73, 74). Wani rahoto na kwanan nan da Pine et al. (75) ya bayyana rashin hadin gwiwa tsakanin CO₂ fahimtar juna da kuma labarun zamantakewa na yara, wanda ya dace da nazarin binciken ba tare da wata dangantaka ba tsakanin ƙwayar tarbiyya da yara da kuma matsala masu girma (76). Mun ƙaddara daga waɗannan taƙaitaccen binciken cewa akwai wata kwayar halitta da ke tattare da rikice-rikice da tashin hankali.  

Norepinephrine a Social Phobia

Tun da yake mutum mai tsauri na jiki (wanda yake nuna ta hanyar flushing, tachycardia, da tremulousness) alamace ce ta marasa lafiya tare da tsoro da damuwa da jin dadin jiki a cikin halin da ake ciki, fahimtar fahimtar tsarin aiki mai kyau a cikin wadannan marasa lafiya na iya ba da haske ga yankunan da ba su da kyau. Stein et al. (77) yi wani gwajin kalubalantar gwaji a marasa lafiya tare da rikici, tashin hankali, da maganganu masu dacewa da kyau kuma sun gano cewa rukuni na farko sun sami matakan plasma mafi girma a gaban ko bayan ƙalubalen. Wannan binciken ba a maimaita shi a cikin nazarin da ya biyo bayan nazarin batutuwa tare da labarun zamantakewar al'umma tare da maganganun al'ada na al'ada, kuma a hakika an sami shawara na rashin aiki na nakasassu (rashin tausayi) a cikin rukuni tare da rashin daidaituwa ta zamantakewar al'umma dangane da batutuwan da aka kwatanta da su. (78).

Bayanai marasa iyaka sun nuna cewa α₂ mawuyacin halin da ake ciki da yarinya yohimbine yana kara yawan jin dadin jama'a a marasa lafiya tare da yanayin tashin hankali kuma yana haɗuwa da ƙananan ƙwayoyin cutar 3-methoxy-4-hydroxyphenylglycol (79). Ya bambanta, Papp et al. (80) ya sanya epinephrine intravenous a cikin marasa lafiya tare da rikici da zamantakewar al'umma kuma ya lura cewa daya daga cikin marasa lafiya na 11 sun ji damuwarsa, wanda ya nuna cewa karuwa a cikin matakan plasma epinephrine kadai bai dace ba don kawo damuwa da zamantakewa. Musamman, Tancer et al. (81) ya lura da ragewar GH zuwa ga intravenous, amma ba na bane, clonidine, α₂ agonist adrenergic. An mayar da martani na GH zuwa clonidine a cikin batutuwa da ke fama da damuwa, rashin ciwon zuciya mai tsanani, da kuma rikice-rikice masu rikice-rikice kuma ana tsammanin zai iya yin la'akari da ragowar mai karɓar sakonnin 2 mai ƙazantattun ƙwaƙwalwa saboda ƙananan ƙwaƙwalwa. A madadin, Coplan et al. (16) ya ɗauka cewa amsawar GH na Clonidine ko sauran sassan na GH na iya nuna wani ƙaramin aiki na tsakiya na CRF mai ba da tsoro. A takaitaccen bayani, kodayake akwai iyakanceccen bayanai game da rawar jiki na rashin tausayi a tsarin zamantakewar al'umma, mai karfin rai mai kwakwalwa yana lura da asibiti a cikin wasu marasa lafiya yana nuna wani dysregulation mai mahimmanci na tsarin jin dadin jiki.

Akwai tambayoyin da ba a amsa ba game da kwayoyin halitta na rikici. Bamu bada tabbacin cewa yanayin rashin jin daɗin zamantakewar jama'a ya kamata a fahimta a matsayin rashin lafiyar nakasar da ke ci gaba a lokacin yaro, batutuwan da dama na bukatar karin bincike. Na farko, ba mu da wani ilimin karatu game da yin amfani da farkon ganewa da kuma kula da rashin lafiyar zamantakewar jama'a da kuma rikice-rikicen da yake ciki da ƙananan yara. Ra'ayin rashin jin dadin jama'a na yara ya saba da rikicewar rikice-rikice na kowa ko rarrabuwa damuwa (91), kuma irin wadannan cututtuka na rashin lafiya suna da babbar ƙungiya da rashin tsoro (92). Gidaran gwaje-gwaje da kwayoyin halitta ba tare da magance marasa lafiya ba tare da yin amfani da su a lokacin balagagge zai zama mai ban sha'awa, kamar yadda za a yi nazari game da karɓar maganin kulawa a tsakanin bangarori na comorbid. Irin wannan nazarin rigakafi na biyu zai iya kasancewa faɗakarwa na nazarin nazari na yau da kullum game da halayyar halayyar yara.

Na biyu, fahimtar ci gaban daji na ciwon daji na kwakwalwa yana da mahimmanci a cikin rikici, irin su amygdala da striatum, da kuma haɗuwa da hade, haɗuwa da tsarin homoaminergic, da hippocampus, ya zama dole. Dangane da wannan ƙaddaraccen bincike na kwayoyin halitta, ya kamata mu yi ƙoƙari don ƙaddamar da kwayoyin halitta mai saukin kamuwa don cike da damuwa na zamantakewar al'umma. Muna da taƙaitaccen fahimtar hulɗar da ke tattare da yanayin halayyar kwayoyin halitta da kuma hangen nesa a cikin mutane masu jin tsoro. Shirye-shiryen kwalliya wanda aka sanya nau'ikan da aka kafa a ƙarƙashin yanayin da ake bukata-wanda ake buƙatarwa ga zuriya ko dai ɗayan jama'a da aka cire ko kuma iyayen mata masu iya taimakawa wajen amsa tambayoyin ko yaduwar wahalar yana da tasiri a kan mutane masu lalata.

Na uku, ana iya amfani da hoto na MRS don nazarin tsarin neurotransmitter wanda ba a sami kulawa mai yawa a cikin zamantakewar al'umma ba, kamar tsarin glutamatergic. Modelswararrun rodwararrun rodwararrun endwararru suna gwagwarmaya da waɗanda ke fama da cutar, ko dai kai tsaye ko kuma ta hanyar waɗanda suke aikatawa ta hanyar thalamic, suna amfani da tsarin glutamatergic a matsayin babban tushen tushen ƙarancin jijiyoyin ƙwayoyin cuta na "tsoron" neurocircuitry, wanda ya samo asali daga tsakiyar tsakiya na amygdala da gadon tsakiya na Terria terminalis (93, 94). Matsanancin yanayi da mutumin da ke fama da rikice-rikice na rayuwa zai iya haifar da saki a cikin hippocampal (38) da kuma sauran sassan kwakwalwa. A cikin wannan haske, wakilai da ke tattare da neurotransmission mai yatsawa ya kamata su rage matakan damuwa, kazalika da canje-canje na biochemical da suka hada da damuwa. Bincike na asibiti na masu tayar da hankali a cikin kullun zai iya zama garanti, tun lokacin da SSRI sun kasance cikin nasara a cikin maganin wannan cuta. MRS kuma ya ba masu binciken bincike don gano hulɗar neurotransmitter a vivo, irin su hulɗar dake tsakanin serotonin da glutamate, wanda kwanan nan Rosenberg et al. (95) a cikin OCD.

A ƙarshe, muhimmin mahimmancin fahimtarmu game da kwayar halitta na jin dadin jama'a shine wahalar yin rarrabuwa game da abin da aka gano shine amsawa ga damuwa ko damuwa kuma menene hakikanin abubuwan haɗari don ci gaban tashin hankali. Yana da mahimmanci cewa ƙwararren neuroendocrinology na zamantakewa na jiki yana nuna kyakkyawan matakin da aka biya a cikin girma, a cikin cewa babu wani gefe (watau HPA axis) pathology ya bayyana. A cikin wannan haske zai zama da sha'awar nazarin marasa lafiya tare da kwanan nan kwanan nan na rashin lafiyar zamantakewar al'umma tare da marasa lafiya tare da nesa da farko don ganewa abin da binciken binciken neuroendocrin ya ci gaba da kuma wace irin abin da ke canzawa a kan rashin lafiya. Wani muhimmin bambanci zai kasance ne don nazarin marasa lafiya tare da yanayin tashin hankali na zamantakewar al'umma tare da marasa lafiya a cikin gafara. Ƙarin fahimtar fahimtar wannan abin da zai iya haifar da kyawawan abubuwa ba kawai cikin yanayin tashin hankali ba amma a cikin wasu cututtuka na hankalinsu tare da ƙananan ƙananan halayen neuroendocrine.

An karɓa Yuli 13, 2000; bita ya karbi Jan. 10, 2001; karbar Jan. 18, 2001. Daga Cibiyar Harkokin Siyasa ta Jihar New York, Ƙungiyoyin Magunguna da Ciwon Lafiyar Harkokin Gudanarwa, Kolejin likitoci da likitoci, Jami'ar Columbia. Adireshin adireshin adireshin Dr. Mathew, Ma'aikatar Kimiyya, Kwalejin Kwararren Kwayoyi da Harkokin Siyasa, Jami'ar Columbia, 1051 Riverside Dokta, Akwatin 84, New York, NY 10032; [email kariya] (e-mail). Sakamakon kudi na NIH ya ba MH-00416 da Cibiyar Cibiyoyin Tsaro da Raɗaɗɗiya sun ba da MH-58911 da MH-00416 (ga Dr. Gorman), wani Kimiyya na Cibiyar Nazarin Kimiyya don Clinicians ya ba MH-01039 (zuwa Dr. Coplan) , da Cibiyar Nazarin Cibiyar Nazarin Harkokin Schizophrenia da Rashin Bincike da Masu Rarrabawa da Cibiyar Nazarin Harkokin Siyasa (Dokta Mathew). Masu marubuta sun gode wa Marc Laruelle, MD, don gudunmawarsa.