ABUBUWAN: Nazarin da karfi yana nuna cewa ciwon intanet zai iya haifar da ADHD kamar bayyanar cututtuka (maimakon ADHD da ke haifar da buri na intanet).
J Behav Addict. 2017 Agusta 8:1-9. doi: 10.1556/2006.6.2017.044.
Kim D 1,2 , Lee D 1,2 , Lee J 1,2 , Namkoong K 1,2 , Jung YC 1,2.
Abstract
Bayani da manufofin
Hanyar rashin lafiya ta rashin lafiya (ADHD) yana daya daga cikin maganganun ƙwaƙwalwar labaran Intanet (IA); duk da haka, hanyoyin da za su iya taimakawa wajen wannan babban halayen har yanzu suna cikin muhawara. Wannan binciken yana nufin bincika waɗannan hanyoyin da za a iya yin amfani da su ta hanyar kwatanta sakamako na rashin tausayi na ciki da kuma ADHD yara a kan rashin kulawa, tsinkaya, da kuma impulsivity ga matasa tare da IA. Mun yi tsammanin cewa ina iya samun ƙungiyoyi tare da ADHD-kamar ƙwaƙwalwar halayyar mutum da kuma bayyanar kwaikwayo na kamala tun daga yara ADHD.
Hanyar
Mahalarta matasa sun hada da 61 matasa. An gudanar da yin hira da masu halartar taron. Girman IA, yarinya da kuma halin yanzu na ADHD, da kuma alamun cututtuka na psychiatry sun samo asali ta hanyar ma'auni na ma'auni. Ƙungiyoyi tsakanin tsananin rashin lafiya na IA da ADHD an bincika ta hanyar nazarin ƙididdigar tsararraki.
results
Bincike na gyaran ƙwaƙwalwar sararin samaniya ya nuna cewa tsananin na IA yayi annabci mafi yawan siffofin cututtukan ADHD. Ya bambanta, yara ADHD annabta ne kawai daya girma.
tattaunawa
Babban halayen rashin kulawa da rashin tsinkayar cututtuka a IA ya kamata ba a lissafta shi kawai ta hanyar ADHD mai zaman kansa ba amma ya kamata la'akari da yiwuwar ganewa bayyanar cututtuka da suka shafi IA. Ayyukan aiki da halayen kwakwalwa da ke da alaƙa da kwarewar amfani da Intanet na iya zama masu dangantaka da wadannan alamun bayyanar ADHD. Ƙarshe Rashin kulawa da haɓakawa a cikin matasa tare da IA sun fi muhimmanci da dangantaka da tsananin ta NA fiye da yadda yaron yaron ADHD.
KALMOMI MAI MUHIMMANCI: jarabar intanet; matsalar rashin kulawa; rashin aiki; rashin kulawa
PMID: 28786707
Gabatarwa
Yayin da samun damar Intanet da masu amfani ke ƙaruwa, jarabar Intanet (IA) ta zama babban abin damuwa a fannoni da al'ummomi da yawa. Duk da cewa buga littafin Diagnostic and Statistical Manual of Mental Disorder , Fifth Edition (DSM-5) a cikin 2013 ya haifar da ƙarin rudani game da bayyana IA bayan an ɗauki matsalar caca ta Intanet ( Kuss, Griffiths, & Pontes, 2017 ), a cewar Young ( 1998b , 1999 ; Young & Rogers, 1998 ), ana iya bayyana IA a matsayin yawan amfani da Intanet, mai yawan damuwa, wanda ba za a iya sarrafawa ba, wanda ke haifar da haƙuri, wanda kuma ke haifar da babban damuwa da rauni a cikin ayyukan yau da kullun. Baya ga IA kanta, yawan kamuwa da cutar tabin hankali da yanayi tsakanin mutanen da ke da IA sun jawo hankali sosai. Ho et al. ( 2014 ) sun ba da rahoton cewa IA yana da alaƙa sosai da matsalar rashin hankali (ADHD), baƙin ciki, da damuwa. Musamman, Carli et al. ( 2013 ) sun nuna alaƙa mai ƙarfi tsakanin ADHD da amfani da intanet na cututtuka a cikin bitar da suka yi a tsarin, kuma Ho et al. ( 2014 ) sun kammala da cewa yawan ADHD a tsakanin marasa lafiya na IA shine 21.7%. Duk da wannan babban rashin lafiya, kuma wannan na iya nuna alaƙar da ke tsakanin dalilai ko asalin cutar da suka raba ( Mueser, Drake, & Wallach, 1998 ), har yanzu ana muhawara kan hanyoyin da za su iya taimakawa wajen haifar da wannan babban rashin lafiya.
ADHD yana daya daga cikin cututtuka na yau da kullum wanda yake faruwa a game da 5.3% na matasan ciki har da yara da matasa, kuma game da 4.4% na manya (Kessler et al., 2006; Polanczyk, de Lima, Horta, Biederman, & Rohde, 2007). ADHD tana da alamar ganewa da halayyar rashin lafiyar jiki, rashin jituwa, da impulsivity, waɗanda suke dangantaka da IA (Yen, Ko, Yen, Wu, & Yang, 2007; Yen, Yen, Chen, Tang, & Ko, 2009; Yoo et al., 2004). Bugu da ƙari, IA, yawancin marasa lafiya da ADHD sun kasance suna tare da ɗaya ko fiye da ƙwayoyin cuta na jiki wanda ya haɗa da yanayi, damuwa, da kuma amfani da kayan aiki, wanda ya haɗa da hoto na ADHD musamman ga balagagge. (Gillberg et al., 2004; Sobanski, 2006). Dangane da DSM-5, ADHD cuta ce ta ci gaban yara, kafin shekaru 12, saboda haka ADHD mai girma yana wakiltar ci gaba da yanayin yarinta. Koyaya, Moffitt et al. (2015) gabatar da sababbin bayanan da ke ƙalubalantar zaton cewa ADHD mai girma ya kasance ci gaba da yaron farko na ADHD, kuma wannan binciken ya nuna wani yiwuwar cewa samari biyu na farko da yara da suka fara haihuwa ADHD zai iya wanzu. Magana da ke bayarwa game da wanzuwar samari na farko ADHD ya nuna cewa mummunan matsala na kulawa ta jiki a lokacin yarinya zai iya haifar da ADHD-kamar bayyanar cututtuka a girma (Castellanos, 2015; Moffitt et al., 2015) kuma la'akari da IA yana hade da canje-canje a aiki da tsarin kwakwalwa (Hong et al., 2013a, 2013b; Kuss & Griffiths, 2012; Weng et al., 2013; Yuan et al., 2011; Zhou et al., 2011), wannan na iya bayyana babban haɓaka tsakanin IA da ADHD.
A cikin wannan binciken, mun kwatanta yiwuwar bincike guda biyu da za su iya bayyana babban haɓaka tsakanin IA da ADHD. Na farko, mutanen da ke ADHD masu yaro suna da wuya su ci gaba da cike da su da kuma yaduwar cutar ADHD su yara har sai sun girma. Na biyu, AI zai iya haɗuwa da ADHD mai girma AD-kamar ƙin bayyanar cututtuka banda tun daga yara ADHD da sauran yanayin ilimin hauka. Makasudin wannan binciken shi ne tabbatar da wadannan hanyoyi guda biyu; sabili da haka, mun kwatanta sakamakon mummunan rauni da ƙuruciya na ADHD akan tsofaffin cututtukan ADHD a cikin matasa tare da IA. Mun yi tsammanin cewa matakin NA zai kasance da dangantaka da tsananin karuwar tsofaffin cututtukan ADHD ko da bayan kulawa da ADHD karamin yara da kuma sauran al'amuran ƙwayoyi.
Hanyar
Masu shiga da kuma hanya
Mahalarta sun kasance maza 61 na shekaru daga 20 zuwa 29 shekara (yana nufin shekaru: 23.61 ± 2.34 shekara), waɗanda aka tattara daga tallan kan layi. An tambayi mahalarta ko suna da maganin tabin hankali akai-akai, ko suna da likita, cututtukan jijiyoyin jiki da ka iya shafar gwajin, kuma ko sun taɓa fuskantar raunin da ya faru a baya ko kamawa. An gudanar da mahalarta Tsararar Ganawar Clinical don DSM, Buga na Hudu da Siffar Hikimar Adult ta Siriya ta Wechsler, Buga na huɗu ta hanyar masanin halayyar ɗan adam don ware waɗanda suka haɗu da ƙa'idodi don rayuwarsu ta Axis I da tabin hankali da na rashin hankali, ban da ƙuruciya da girma ADHD. Ta hanyar wannan tsari, mahalarta masu fama da cututtukan ƙwaƙwalwa na yanzu ko na baya, raunin ƙwaƙwalwar ƙwaƙwalwa, likita, da cututtukan jijiyoyin an cire su.
An yi amfani da rahotanni masu zaman kansu don tantance yanayin halayyar 'yan jarida na Koriya ta Koriya (K-AIAS), Ƙarin Bincike na Beck (BDI), Binciken Ƙunƙarar Beck (BAI), Barratt Impulsiveness Scale-11 (BIS -11), da kuma Harshen Koriya na Abun Harshen Gurasar Maganin Dama (AUDIT-K). Mun kimanta yawancin yara da kuma girma ADHD bayyanar cututtuka ta hanyar Harshen Koriya Ƙananan fasalin Wender Utah ADHD Rating Scale (WURS-KS) da kuma Koriya Kayan Kayan Kwafin 'Adult ADHD Rating Scale (CAARS-KS).
Matakan
Tsananin jarabar intanet. Mun yi amfani da K-AIAS don tantance tsananin alamun IA. K-AIAS fassara ce ta Koriya ta Jarrabawar jarabar intanet ta Young's Internet (YIAT), sai dai wasu kalmomi kaɗan da suka dace da yanayin ɗaliban makarantar sakandare. Tsarin da abubuwan da ke cikin K-AIAS da YIAT iri ɗaya ne, ma'aunin Likert na mataki 6 zuwa tambayoyi 20. Jimlar maki 20-49 yana wakiltar matsakaicin mai amfani da intanet, kuma maki 50-79 yana wakiltar masu amfani waɗanda galibi ke fuskantar matsaloli tare da amfani da intanet. Maki 80-100 yana nuna cewa mahalarta suna fuskantar manyan matsaloli a rayuwa saboda amfani da Intanet. K-AIAS yana da aminci da inganci mai gamsarwa kuma α na Cronbach shine .91 ( Kim, Lee, & Oh, 2003 ; Young, 1998a ).
Baƙin ciki da damuwa. An kimanta alamun damuwa da damuwa ta amfani da BDI (sigar Koriya) da BAI (sigar Koriya), bi da bi. BDI da BAI sun ƙunshi abubuwa 21, kuma marasa lafiya suna kimanta kowace alama a kan sikelin Likert mai maki 4 a cikin tsananin ƙaruwa. A cikin BDI, ana ba da shawarar matakan tsanani masu zuwa: maki tsakanin 0 da 13 yana nuna ƙarancin, tsakanin 14 da 19 mai sauƙi, tsakanin 20 da 28 mai matsakaici, da kuma tsakanin 29 da 63 mai tsanani baƙin ciki. A cikin BAI, an ba da shawarar matakan tsanani masu zuwa: maki tsakanin 0 da 7 ba ya nuna rashin damuwa, tsakanin 8 da 15 mai sauƙi, tsakanin 16 da 25 mai matsakaici, da tsakanin 26 da 63 mai tsanani damuwa. An tabbatar da duka ma'auni biyu akan al'ummar Koriya. An samu α na Cronbach daga .78 zuwa .85 ga BDI da .91 ga BAI ( Beck & Steer, 1990 ; Beck, Steer, & Brown, 1996 ; Beck, Ward, Mendelson, Mock, & Erbaugh, 1961 ; Lee & Song, 1991 ; Yook & Kim, 1997 ).
Rashin Sha'awa. An kimanta alamar rashin sha'awa ta amfani da sigar Koriya ta BIS-11. BIS-11 yana ɗaya daga cikin kayan aikin da aka fi amfani da su don tantance rashin sha'awa. Asalin BIS-11 ya ƙunshi abubuwa 30 da aka ci a kan sikelin Likert mai maki 4 kuma ana auna matakin rashin sha'awa ta hanyar taƙaita maki ga kowane abu. Mafi girman maki yana nufin ƙarin rashin sha'awa. Yana kimanta manyan ma'auni uku na halayen rashin sha'awa: rashin sha'awa mai hankali (rashin mai da hankali kan aikin da ke gudana), rashin sha'awa mai motsi (yin aiki ba tare da tunani ba), da rashin shiri mai sha'awa (abubuwa, daidaitawa ga yanzu maimakon zuwa nan gaba). Sigar Koriya ta BIS-11 ta ƙunshi abubuwa 23, don haka adadin abubuwan da ke auna kowane girma ya bambanta, amma sauran iri ɗaya ne. Heo et al. sun tabbatar da inganci da ingancin sigar Koriya ta BIS-11 a cikin bincikensu, kuma α na Cronbach na sikelin shine .686 ( Heo, Oh, & Kim, 2012 ; Patton, Stanford, & Barratt, 1995 ).
Amfani da barasa da alamomin da suka shafi hakan. Mun yi amfani da AUDIT-K don tantance tsananin shan barasa da alamomin da suka shafi hakan. AUDIT-K ya ƙunshi abubuwa 10; kowace tambaya an yi mata maki daga 0 zuwa 4. Tambayoyi na 1-3 suna tantance shan barasar mahalarta, tambayoyi na 4-6 suna bincika halayen shan giya marasa kyau, tambayoyi na 7 da 8 suna tantance halayen rashin tausayi, kuma tambayoyi na 9 da 10 suna tantance matsalolin da suka shafi barasa. A cikin binciken da aka yi da ɗaliban kwaleji, Fleming da sauransu sun ba da shawarar ƙimar da aka rage ta 8. Lee da sauransu sun tabbatar da inganci da ingancin AUDIT-K a cikin bincikensu kuma α na Cronbach na sikelin shine .92 ( Babor, De La Fuente, Saunders, & Grant, 1992 ; Fleming, Barry, & MacDonald, 1991 ; Lee, Lee, Choi, & Namkoong, 2000 ).
Alamomin ADHD na Yara. Mun yi amfani da ɗan gajeren sigar WURS-KS, wanda Koo da abokan aikinsa suka fassara zuwa Yaren Koriya don tantance alamun ADHD na yara. WURS tambaya ce ta kai-tsaye don tantance alamun ADHD na yara a cikin manya don ADHD. Asalin WURS ya ƙunshi abubuwa 61, amma a cikin wannan binciken, an yi amfani da ɗan gajeren sigar da ya ƙunshi abubuwa 25. Asalin sigar WURS ta gano 86% na marasa lafiya da ADHD daidai, kuma ɗan gajeren sigar ta kuma ya nuna babban ƙwarewa da takamaiman bayani don samar da ganewar ADHD na yara lokacin da aka yi amfani da maki 36 a matsayin ƙimar yankewa. An yi nazarin inganci da aminci na gajeren sigar WURS na Koriya tare da manya na Koriya na yau da kullun kuma ya nuna gamsuwa da inganci. Cronbach's α shine .93 ( Koo et al., 2009 ; Ward, Wender, & Reimherr, 1993 ).
Alamomin ADHD na Manya. An yi amfani da CAARS-KS don tantance alamun ADHD na manya a cikin wannan binciken. CAARS yana ɗaya daga cikin ma'aunin tambayoyi na kai da aka fi amfani da shi wajen tantance alamun ADHD na manya, kuma mun yi amfani da ɗan gajeren sigarsa ta Koriya, wanda ya ƙunshi abubuwa 20 da ƙananan ma'auni guda huɗu: matsalolin rashin kulawa-tunani (IM), rashin aiki sosai-rashin natsuwa (HR), rashin iya motsa jiki/lalacewar motsin rai (IE), matsalolin da ke tattare da tunanin kai (SC). An san cewa maki T sama da 65 suna da mahimmanci a asibiti ga kowane ƙaramin ma'auni. An kafa aminci da ingancin CAARS-KS kuma α na Cronbach shine .92 ( Chang, 2008 ; Conners, Erhardt, & Sparrow, 1999 ; Erhardt, Epstein, Conners, Parker, & Sitarenios, 1999 ).
tattaunawa
A cikin wannan binciken, yawancin mahalarta, mahalarta 35 (57%), an rarraba su don samun IA lokacin amfani da ka'idojin Young waɗanda ke bayyana maki 50 a matsayin IA mai sauƙi ( Hardie & Tee, 2007 ; Young, 1998b ). Hakanan, matsakaicin maki na K-AIAS ya kasance mai girma (matsakaicin maki = 51.2, SD = 20.3), idan aka kwatanta da sauran cututtukan tabin hankali kamar BDI, BAI, BIS-11, AUDIT-K, da WURS-KS.
Daidai da binciken da aka yi a baya ( Dalbudak & Evren, 2014 ; Yen et al., 2009 , 2017 ; Yoo et al., 2004 ), mun sami alaƙa mai mahimmanci tsakanin tsananin IA da tsananin alamun ADHD. Hakazalika, wasu cututtukan tabin hankali kamar baƙin ciki, damuwa, da alamun da suka shafi barasa suma sun nuna alaƙa mai mahimmanci da alamun ADHD na manya daidai da binciken da ya gabata ( Fischer et al., 2007 ; Kessler et al., 2006 ; Ni & Gau, 2015 ; Sobanski et al., 2007 ).
Babban abin da aka gano a wannan binciken, wanda kuma ya yi daidai da hasashenmu, shi ne cewa tsananin IA yana da alaƙa sosai da matakin yawancin ma'aunin alamun ADHD na manya ko da bayan sarrafa alamun ADHD na yara da sauran yanayin tabin hankali. Ma'aunin SC kawai, wanda ke nuna ƙarancin girman kai da ƙarancin amincewa da kai, bai nuna muhimmiyar alaƙa da tsananin IA ba. Za a iya bayyana wannan sakamakon ta hanyar bincike da yawa da Chang ( 2008 ) da Kim, Lee, Cho, Lee, da Kim (2005 ) suka yi, wanda ya nuna girman alamun SC a cikin CAARS-KS a matsayin ƙarin sikelin da ke kimanta matsalolin sakandare da manyan alamun ADHD ke haifarwa kamar yawan aiki, rashin kulawa, da rashin himma. A cikin wannan binciken, tsananin alamun baƙin ciki kawai ya annabta matakin girman alamun SC. Idan aka yi la'akari da waɗannan binciken, za a iya kammala da cewa tsananin IA ya annabta duk ma'aunin alamun ADHD na manya.
Wani abin da aka gano mai ban sha'awa shi ne, ba kamar yadda aka saba ba, tsananin alamun ADHD na yara bai nuna alaƙa mai mahimmanci da yawancin ma'aunin alamun ADHD na manya ba. Girman IE kawai ya nuna alaƙa mai mahimmanci da alamar ADHD na yara a cikin samfurin nazarin koma-baya na 2 (duba Tebur 3 ). Duk da haka, wannan muhimmiyar alaƙar alamar ADHD na yara tare da IE ta ɓace bayan an haɗa tsananin IA cikin samfurin komawa, yana nuna cewa tsananin IA yana da alaƙa mai mahimmanci da IE fiye da ADHD na yara.
Binciken da aka yi a yanzu a cikin wannan binciken na iya haskaka alaƙar da ke tsakanin tsanani da ADHD. Ko dai hanyoyi biyu ne da ke bayyana babban haɗari tsakanin IA da ADHD, sakamakonmu ya goyi bayan hasashen da ke nuna wanzuwar alamun bayyanar ADHD na manya. Sabanin ra'ayin gargajiya na ADHD na manya dangane da ci gaba da yanayin ADHD na yara ( Halperin, Trampush, Miller, Marks, & Newcorn, 2008 ; Lara et al., 2009 ), binciken da aka yi kwanan nan ya nuna cewa farkon yara da farkon girma ADHD na iya wanzuwa kuma ADHD na manya ba ci gaba ne kawai na ADHD na yara ba ( Castellanos, 2015 ; Moffitt et al., 2015 ). Dangane da waɗannan binciken, wannan binciken ya nuna cewa alamun ADHD na yanzu sun nuna alaƙa mai mahimmanci da IA fiye da alamar ADHD na yara akan WURS. Bugu da ƙari, tsananin alamun ADHD na yara da kansa bai nuna muhimmiyar alaƙa da ainihin alamar ADHD na manya ba sai dai girman IE a cikin wannan binciken.
Nazarin da aka yi a baya sun nuna cewa matsayin ADHD na manya yana da alaƙa da yanayin ci gaban sassan cortical, da canje-canjen farin abubuwa na hanyoyin sadarwa da dama ( Cortese et al., 2013 ; Karama & Evans, 2013 ; Shaw et al., 2013 ). Hakazalika, binciken da aka yi kwanan nan ya nuna cewa IA na iya haifar da canje-canjen aiki, tsarin gini, da rashin daidaituwa a cikin kwakwalwa ( Hong et al., 2013a , 2013b ; Kuss & Griffiths, 2012 ; Lin et al., 2012 ; Weng et al., 2013 ; Yuan et al., 2011 ; Zhou et al., 2011 ). Dangane da waɗannan binciken, za mu iya yin hasashen cewa rashin daidaituwar kwakwalwa da tsarinta da ke da alaƙa da IA na iya kasancewa da alaƙa da alamun fahimta na manya kamar ADHD, wanda ya kamata a bambanta shi da rashin lafiyar ADHD mai zaman kanta. Babban rashin jituwa tsakanin IA da ADHD ( Ho et al., 2014 ) ana iya danganta shi da alamun fahimta da halayyar da suka shafi IA maimakon alamun rashin lafiyar ADHD mai zaman kanta.
Wannan binciken yana da wasu ƙuntatawa. Da farko, yin amfani da ma'aunin ma'auni don ƙididdige IA da sauran yanayin ƙwararrakin da za a iya ɗauka a matsayin iyakancewa. Na biyu, dukkan masu halartar taron balagagge ne ba tare da tarihin ilimin likita ba, waɗanda suka karɓa daga tallace-tallace na kan layi. Wannan irin wannan samfurin samfurin samfurin da aka zaɓa wanda ya zaɓa zai iya nuna rashin fahimtar binciken binciken. Bugu da ƙari, wannan ƙayyadaddun zaɓin ɗan takara ya ƙayyade yawanin binciken da aka samu a cikin binciken, ba shi yiwuwa ya bambanta ga mata, kungiyoyi daban-daban, da kuma marasa lafiya da suke buƙatar haɗin gwiwa. Musamman ma, tun da yake an gwada lafiyar mahalarta wadanda ba su da tarihin ilimin likita, an yi la'akari da cewa akwai iyaka don amfani da sakamakon wannan binciken ga marasa lafiya na asibiti. Don haɗu da sakamakon yanzu, muna buƙatar muyi nazarin samfurin wakilci mafi yawan jama'a da kuma marasa lafiya marasa lafiya. Na uku, kamar yadda wannan binciken ya dogara ne akan tunanin da aka yi la'akari da yarinya a yara, rahoton rahoto na mahalarta ba zai iya inganta ba kuma ba za mu iya kafa dangantaka tsakanin kawance ba tsakanin masu canji.