Bincike da Ƙididdigar Ƙididdiga Game da Cutar Gida: Yanayin Neurocognitive da Neurobiological (2019)

Ilimin Halayyar Dan Adam na Gaba . 2019; 10: 405.

An buga a yanar gizo 2019 Yuni 14. doi: 10.3389/fpsyt.2019.00405

PMCID: PMC6586738

PMID: 31258494

Anthony G. Vaccaro 1 , 2 da Marc N. Potenza 1 , 3 , 4 , 5 , 6 , *

Abstract

Wasannin bidiyo da amfani da intanet sun zama wani ɓangare na rayuwar yau da kullun na mutane da yawa, musamman a lokacin samartaka. Ganin damuwar lafiya da ke da alaƙa da halayen wasanni masu matsala, an haɗa matsalar caca (GD) a cikin sigar bugu na 11 na The International Rarraba Cututtuka (ICD-11) wanda sakatariyar Hukumar Lafiya ta Duniya ta amince da shi. Ganin waɗannan la'akari da wasu (gami da muhawara game da mafi kyawun rarrabuwar GD da kuma yadda mafi kyawun hanawa da magance matsalar), akwai buƙatar ƙarin bincike kan GD. Musamman, muna ba da shawarar cewa bincika yanayin tsaka-tsaki wanda ke mai da hankali kan aikin fahimta da na jijiyoyi na iya taimakawa wajen fayyace alaƙar GD da sauran cututtukan jaraba da kuma fayyace alaƙar su da ainihin fasalulluka na GD. Haɗuwa a cikin ayyukan jijiyoyi, aikin fahimta, da sauran fasalulluka suna nuna cewa GD yana da kamanceceniya da caca da cututtukan amfani da miyagun ƙwayoyi kuma ana iya rarraba shi azaman cuta mai jaraba. Mutanen da ke da GD sun bambanta da waɗanda ke da amfani da wasanni na yau da kullun (RGU) akan matakan neurocognitive. Duk da haka, an tayar da damuwa game da bambance-bambancen da ke tsakanin GD da cututtukan amfani da miyagun ƙwayoyi a cikin wasu fasalulluka masu girma, kamar haƙuri. Bugu da ƙari, an yi jayayya cewa bambance-bambancen da ke tsakanin GD da RGU ba za a iya kama su gaba ɗaya ta hanyar tsarin sunayen mutane kamar ICD-11 ba. Duk da haka, mutane suna neman magani don taimako tare da GD, duk da ƙarancin bayanai da ake da su don ingantattun magunguna. Yayin da ake tattara ƙarin bayanai daga binciken GD, ya kamata a fassara su zuwa ƙa'idodin tsaftacewa don GD da inganta hanyoyin shiga tsakani.

keywords: matsalar wasan kwaikwayon, wasan kwaikwayo na yanar gizo, wasan kwaikwayo na wasanni, fasalin hali, DSM-5, ICD-11

Yaya mafi kyau don ƙayyade cuta game da wasan kwaikwayon, ƙayyade yawan daidaito da la'akari da dangantaka tare da tsaka-tsakin tsaka-tsaki?

Yayin da duniya ke ƙara zama "mai amfani da fasahar zamani," yawan wasannin bidiyo ya ƙaru sosai. A shekarar 2016, kasuwar wasannin bidiyo ta kai dala biliyan 99.6 kuma an kiyasta cewa za ta kai biliyan 118 nan da shekarar 2019 ( ). Ya zuwa shekarar 2012, an kiyasta cewa mutane biliyan 1 ne ke buga wasannin kwamfuta, kuma bisa ga yanayin tattalin arziki, akwai yiwuwar wannan adadin ya ƙaru tun daga lokacin ( ). Wasanni sun fi yawa a tsakanin yara da matasa, inda aka kiyasta kashi 68% na yara 'yan shekara 8 zuwa 18 a Amurka suna yin wasanni aƙalla mako-mako ( ). Kamar wasu fannoni na fasaha da amfani da su, wasanni, a wasu lokutan, suna fuskantar bincike saboda alaƙar da aka tsara da ƙara yawan halayen tashin hankali a cikin yara, da yiwuwar mummunan tasirin da zai iya yi wa ci gaban ilimi, da kuma rashin ingantaccen aiki. Wasu masu bincike sun ruwaito cewa wasu suna da alaƙa da tashin hankali ko kuma ba su da ƙarfi kamar yadda wasu suka gabatar ( ), kuma yayin da aka ruwaito cewa wasan yana da alaƙa da ƙaruwar ƙwarewar fahimta a cikin fannoni na gani da hankali a wasu nazarce-nazarce ( ), wani bincike na meta na baya-bayan nan ya yi tambaya game da waɗannan binciken ( ). Duk da cewa yawancin mutane suna wasa ba tare da wata damuwa mai mahimmanci ba, akwai ƙarin shaida da ke nuna cewa wasu mutane na iya haɓaka halayen wasan caca masu matsala, wataƙila na jaraba. A cikin wannan labarin, za mu yi la'akari da yadda aka ayyana wasan caca mai matsala a cikin manyan tsarin sunaye, yadda ma'anoni daban-daban suka haifar da bambance-bambance a cikin kimanta yawan jama'a, da kuma yadda binciken abubuwan da ke haifar da ilimin jijiyoyi a matsayin abubuwan da za su iya haifar da tsaka-tsaki na iya taimakawa wajen haɓaka fahimtar ilimin jijiyoyi na asibiti na matsalar caca ko matsalar caca (GD).

Yaɗuwar "halayen wasan jaraba" na iya bambanta a cikin al'adu, tare da kimantawa ƙasa da kashi 1.16% na matasa a Jamus, zuwa sama da kashi 5.9% a Koriya ta Kudu ( , ), tare da ƙididdigar yawan kamuwa da cuta da aka lura a cikin binciken da ya gabata ( ). Kiyasi ya bambanta sosai, ya danganta da iyakokin "lamurra," tare da kimantawa a cikin matasa, misali, daga 0.3% a Jamus zuwa 50% a Koriya ta Kudu ( ). Bugu da ƙari, wasu nazarin sun haɗa nau'ikan nau'ikan amfani da Intanet daban-daban tare, wanda ya haifar da manyan ƙiyasi, kamar 2.1% a Jamus da 12.4% a Koriya ta Kudu ( , ). Saboda haka, kimanta yawan matsalolin caca yayin la'akari da bambance-bambancen al'adu/hukumomin iko da kuma bambance-bambancen yuwuwar da suka shafi kayan aikin tantance matsalolin caca yana da mahimmanci ( , ).

Yawancin kimantawa kan yawan matsalolin caca a wani ɓangare yana da alaƙa da ma'anoni daban-daban. A cikin nazarin, sunaye sun haɗa da "Matsalar Wasanni" (GD), "Matsalar Wasanni," "Matsalar Wasannin Intanet," da "Matsalar Wasannin Intanet" (IGD). Kodayake sunayen na iya bambanta, wasanni babban hali ne, kuma matsaloli babban fasali ne. Bugu da ƙari, kalmomin "Matsalar Jaraba ta Intanet" da sauran abubuwan da suka shafi hakan na iya haɗawa da GD. Misali, yayin da Koriya ta Kudu ta yi amfani da kalmar matsalar jarabar Intanet (IAD) a hukumance, wasannin kan layi sun ƙunshi kashi 67% na amfani da Intanet na nishaɗin yara maza na makarantar sakandare, ƙungiyar da ta fi yawan IAD ( ). Littafin Bincike da Ƙididdiga na Matsalolin Hankali, bugu na 5 (DSM-5), wanda aka buga a cikin 2013 kuma ya yi bincike kuma ya yi aiki a kai kimanin shekaru goma da suka gabata, ya nuna cewa shaidar IGD, a wani ɓangare da aka samo daga bayanan da ke akwai a lokacin akan IAD a cikin samari daga ƙasashen Asiya, ƙila ba za a haɗa su zuwa amfani da Intanet ba ( ). A duk faɗin masu bincike, ra'ayoyin da ke kan wannan matsalar sun fara ne daga GD da aka amince da shi a hukumance a matsayin cuta ta hukuma zuwa ganinsa a matsayin mai cutar da ɗabi'a ta al'ada wanda zai iya haifar da firgici na ɗabi'a ( , , , ). Wata muhawara ta ƙunshi ko ya kamata a ɗauki halayen wasa a matsayin jaraba, tare da wasu suna jayayya cewa yawan caca na iya haɗawa da ci gaba da shiga duk da mummunan sakamako wanda zai iya haɗawa da rashin ingantaccen sarrafa lokaci, wasanni don tserewa daga yanayin yanayi mara kyau ko damuwa, ko fasalulluka na jaraba na wasanni ( ). Kamar matsalar caca, IGD na iya raba manyan abubuwan da ke cikin jaraba, gami da ci gaba da shiga duk da mummunan sakamako, rashin iko ko tilastawa, da sha'awar sha'awa ko sha'awar da za ta iya gaba da shiga halayyar ( ). A cikin DSM-5, an haɗa IGD a ƙarƙashin "Sharuɗɗa don Ƙarin Nazari," yana nuna cewa a cikin mutanen da ke da IGD, wasanni na iya kunna irin waɗannan hanyoyin da suka shafi lada kamar yadda magunguna ke yi a cikin mutanen da ke da jarabar miyagun ƙwayoyi ( ). Irin waɗannan bayanai, tare da binciken da suka shafi janyewa da kuma babban raunin zamantakewa da fahimta da ke da alaƙa da yawan caca, suna kwaikwayon waɗanda ke da cututtukan amfani da miyagun ƙwayoyi; duk da haka, an lura da bambance-bambance. Wasu sharuɗɗa da aka haɗa a cikin DSM-5 na IGD, kamar haƙuri, ƙila ba su da mahimmanci ga IGD kamar matsalolin amfani da miyagun ƙwayoyi. Mutanen da ke da IGD na iya samun kwarin gwiwa musamman ta hanyar manufofi masu rikitarwa da takamaiman a cikin wasa, da kuma tsoron ɓacewa a wasannin 'yan wasa da yawa; wannan na iya bambanta da fannoni na haƙuri a cikin matsalolin amfani da miyagun ƙwayoyi ( ). Ana iya samun bambance-bambance masu yuwuwa tsakanin IGD da cututtukan amfani da miyagun ƙwayoyi don wasu sharuɗɗa yayin da ake gudanar da ƙarin bincike.

Tare da ƙirƙirar Tsarin Cututtuka na Duniya , bugu na 11 (ICD-11), an haɗa GD a matsayin cuta saboda halaye masu jaraba, inda wasu masu bincike ke jayayya game da haɗakarwa ( ) wasu kuma suna ambaton mahimmancin lafiyar mutum da ta jama'a ( ). Wasu daga cikin muhawarar sun mayar da hankali kan ko akwai isasshen shaida don a haɗa GD a cikin ICD-11, suna ambaton yuwuwar cutar da ɗabi'a ta al'ada. Duk da haka, wasu sun ba da rahoton cewa samun wata cuta da aka ayyana bai kamata ta tsoma baki ga yawancin mutanen da ke shiga cikin wasanni ba kuma zai zama mahimmanci don haɓaka samar da tsari don taimaka wa waɗanda za su iya fuskantar lahani da suka shafi wasanni. Bugu da ƙari, an yi muhawara game da haɗa wani abu mai haɗari na caca, kamar wannan don wasu halaye masu jaraba kamar shan barasa, amma yana iya zama mahimmanci musamman daga mahangar lafiyar jama'a ( ). Waɗannan muhawara game da GD suna raba fasaloli tare da wasu a cikin ilimin tabin hankali a tarihi (misali, dangane da cututtukan amfani da miyagun ƙwayoyi) dangane da yadda mafi kyawun bayyana da rarraba cututtuka ( ). Tare da tsarin rarrabuwa na yanzu kamar waɗanda ke cikin ICD-11 da DSM-5, an nuna damuwa cewa abubuwan da aka ayyana a matsayin waɗanda ba a rarrabe su ba a zahiri ba su bambanta da sauran ba ( ). Wannan la'akari na iya zama abin damuwa musamman lokacin da halaye ke wanzuwa a kan wani fanni daga al'ada zuwa mai cutarwa, kamar yadda yake a wasanni.

Hanyoyin da za a iya daidaitawa da sauran hanyoyin da ba su dace da juna kamar tsarin bincike ba (RDoC) ko wasu da ke mayar da hankali ga samfurori na tsaka-tsakin na iya zama da muhimmanci a yi la'akari da hanyoyin da za su iya yin la'akari da irin wannan hali ko tafiyar matakai. Wasu samfurori na tsaka-tsakin suna mayar da hankali akan tsarin tafiyar da hankali ko kuma abubuwan da suka danganci tsarin kwakwalwa da aiki. Saboda haka, yanzu za muyi la'akari da shaidar da ke da ita ga IGD ba wai kawai game da cututtuka masu amfani ba, amma kuma kamar yadda ya shafi wasan kwaikwayo na wasanni.

Neurochemical da kuma Functional Neural Circuitries a yanar-gizo Addiction da Cutar Gaming

An gabatar da tsarin samar da kwakwalwa don bayar da gudummawa ga aikin sarrafawa a cikin IGD, kuma a cikin ƙari-ƙari ya fi girma (), kodayake tsakiya na dopamine zuwa hali (, ) da abu () an tambayi jarabaci. Kowane mutum tare da jaraba da Intanit, idan aka kwatanta da waɗanda ba tare da shi ba, an ruwaito cewa suna da ƙananan samfurin DODNUMX kamar su masu karɓa a cikin striatum kuma suna da ƙananan ƙwayoyin fassarar kwayoyin dopamin (, ). Dodamine D2-like receptor kasancewa a cikin striatum ya kuma kasance inversely alaka da tsanani na yanar gizo buri da kuma rage glucose metabolism a cikin orbitofrontal cortex (). Dukkanin binciken uku sun haɗa da mutane biyar tare da farfado da Intanet don haka ana iya la'akari da binciken sosai. A wata hanyar da za ta iya haɗuwa da yanayin halayen kwayoyin halitta, Taq1A1 allele of DRD2, tsarin jigilar kwayoyin halitta ga mai karɓa na D2 dopamine, an bayar da rahoton cewa ya kasance mafi yawan mutane tare da wasan kwaikwayo mai matukar wuya da kuma matsalolin da suka danganci sakamako mai girma () Kamar yadda DRD2 yana cikin haɗin ƙwayar cuta tare da ankk1 da kuma duk wani bambanci a cikin yanki na ankk1 an danganta shi da haɗari (misali, rikitarwa na barasa) fiye da waɗanda suke cikin DRD2 ta hanyar (, ), tambayoyi suna kasancewa game da yadda binciken da aka lura zai iya danganta zuwa dopamine. Bupropion, mai maganin norepinephrine-dopamine reuptake, zai iya rage ƙyama da kuma shigarwa da dama daga cikin gwanon farko na gaba (DLPFC) a cikin mutane da IGD (). Yawanci mafi yawa akan labarun jarabar Intanit an samo su don hadewa tare da rage N-acetyl aspartate a cikin ƙananan haɗin gwiwar ƙananan yara tare da jita-jita na yanar-gizon Intanet ().

Nazarin hotunan aiki ya shafi yankunan kwakwalwa na cortical da striatal a cikin IGD, musamman a cikin maza. An ruwaito cewa ayyukan da aka haifar da wasan kwaikwayo a cikin striatum (ventral da dorsal) sun fi yawa a cikin mutanen da ke da IGD idan aka kwatanta da waɗanda ba su da su, kodayake kunnawa a cikin ventral striatum na hagu yana da alaƙa da mummunan alaƙa da ƙarfin sha'awar da aka haifar da cue ( ). Amsoshin ga alamun wasanni na iya canzawa bayan tilastawa nan take dainawa, kuma binciken ya nuna cewa canje-canje a cikin kunna DLPFC yayin tilastawa nan take hanawa na iya haifar da raunin maza ga IGD ( ). Bugu da ƙari, canje-canje a cikin haɗin aiki tsakanin yankuna da ke da alaƙa da sarrafa lada (misali, striatum) da sarrafa fahimta (misali, DLPFC) kafin wasa da kuma lokacin tilastawa nan take dainawa na iya bayyana ci gaban IGD ta hanyar da ta dace da jinsi ( ). An kuma ruwaito cewa haɗin aiki na yanayin hutu tsakanin yankin ventral tegmental da nucleus accumbens, yanki a cikin ventral striatum, yana da mummunan alaƙa da ƙarfin sha'awa, kuma tare da ƙarancin ƙarfi a cikin haɗin kai tsakanin waɗannan yankuna da aka lura a cikin mutanen da ke da IGD idan aka kwatanta da waɗanda ba su da ( ). An danganta insula da IGD tare da raguwar haɗin aiki na yanayin hutu da aka lura tsakanin yankuna na insula da waɗanda suka haɗa da yankunan ƙarin motsi, cingulate cortex, da kuma babban gyrus na gaba, wanda ke nuna raguwar sadarwa ta hutawa tsakanin yankuna da ke da alaƙa da aikin hulɗa, sha'awa, da sauran hanyoyin da waɗanda ke da alaƙa da halayen motsa jiki da ikon fahimta da halayya ( ). Sarrafa alamun wasanni da haɗin yanayin hutu suma na iya dangantawa da jiyya ga IGD. Misali, an lura da ƙaruwar ayyukan insula ga alamun wasanni bayan shiga tsakani na sha'awa a cikin IGD, tare da raguwar haɗin kai tsakanin insula (wanda ke da alaƙa da amsawar alama da sarrafa hulɗa) da yankunan da ke da alaƙa da sha'awar ƙwayoyi kamar precuneus ( ). Bayan shiga tsakani na sha'awa, haɗin aiki na yanayin hutawa ya ragu tsakanin cortex na orbitofrontal da hippocampus da tsakanin cingulate na baya da yankin ƙarin motsi ( ). Waɗannan binciken suna danganta canje-canje a cikin haɗin kai tsakanin yankuna da ke da alaƙa da sha'awar ga waɗanda ke da hannu a cikin tsarin ƙwaƙwalwa da tsarin motsa jiki, bi da bi, suna ba da shawarar hanyoyin neurobiological don maganin sha'awar IGD.

Nazarin MRI na aiki na iya bincika alaƙar jijiyoyi na hanyoyin fahimta, gami da waɗanda suka shafi sarrafawa da sarrafa lada/rashi, kamar yadda aka yi hasashen yana da mahimmanci a cikin IGD da sauran matsalolin amfani da Intanet ( , ). Mutanen da ke da IGD, idan aka kwatanta da waɗanda ba su da su, sun nuna ƙarancin haɗin kai a cikin yankunan kula da zartarwa, kuma an danganta wannan da ma'aunin halayen kula da fahimta ( ). Mutanen da ke da IGD suna nuna mafi girman kunna cortical na gaba yayin aikin kula da fahimta fiye da waɗanda ke amfani da wasan yau da kullun ko ƙarancin mita ( ). A kan aikin tsammani, ƙungiyar IGD ta nuna ƙarancin kunna cortical na gaba yayin sarrafa asarar da kuma ƙarancin kunna yankuna na cortico-striatal yayin sarrafa nasarori ( ). A lokacin aikin yanke shawara mai alaƙa da haɗari, a cikin mahalarta IGD akwai ƙarancin daidaitawa don haɗarin da aka fuskanta a yankunan cortical (DLPFC da yankunan parietal na ƙasa) da ƙaruwar kunna cortices na striatal da ventromedial da orbitofrontal yayin sakamako mai kyau ( ). An lura da alaƙa da tsananin IGD a cikin binciken biyu. Wani bincike daban ya gano cewa mutanen IGD sun nuna raguwar shigar gyri na gaba da na tsakiya yayin yin zaɓin yiwuwar ( ). An kuma lura da bambance-bambance a cikin sarrafa alamun motsin rai a cikin IGD, tare da kunna yankuna na cortico-striatal da aka lura da su a cikin martani ga alamun motsin rai marasa kyau da kuma yayin daidaita motsin rai a cikin striatum, insula, lateral prefrontal cortex, da anterior cingulate ( ). Wani bita na meta-analytic ya nuna cewa mutanen da ke da IGD idan aka kwatanta da waɗanda ba su nuna ƙaruwar aiki a cikin cortices na gaba da na baya, caudate, da gyrus na gaba na baya a lokacin lada da ayyukan zartarwa "sanyi", raguwar aiki a cikin gyrus na gaba na baya dangane da ayyukan zartarwa "masu zafi", da raguwar aiki a cikin cortices na baya, somatomotor, da somatosensory yayin sarrafa lada ( ). Tare, waɗannan binciken suna ba da shawarar hanyoyin jijiyoyi don yanke shawara mara kyau, rashin iko mai kyau, da sarrafa lada mara kyau a cikin IGD.

Nazarin neurochemical da nazarin kwayoyin halitta na IGD sun nuna alamun fasali tare da wasu cututtuka na addictive. Wadannan abubuwan da aka raba sun nuna cewa IGD yana da irin wannan ka'idar nazarin halittu tare da cikewar rikici.

Neurocognition of Internet Gaming Disorder Da aka kwatanta da Sauran ƙyama

Ko da yake ƙananan bincike ne suka kwatanta kai tsaye kuma suka bambanta alaƙar jijiyoyi a cikin IGD da na cututtukan amfani da miyagun ƙwayoyi kamar yadda aka yi wa matsalar caca [misali, duba Refs. ( , )], an lura da kamanceceniya tsakanin alaƙar jijiyoyi na IGD da cututtukan amfani da miyagun ƙwayoyi. An ruwaito cewa mutanen da ke da IGD suna nuna raguwar ayyukan jijiyoyi iri ɗaya don mayar da martani ga asara, da kuma ƙaruwar jin daɗin alamun, kamar yadda yake a cikin caca da matsalolin amfani da miyagun ƙwayoyi ( ). Amsoshin taba da alamun wasanni na iya haɗawa da kunnawa a cikin cingulate na gaba da parahippocampus tare da matsalar amfani da taba da IGD ( ). An ruwaito cewa rashin lafiyar IGD da barasa suna raba ƙarin daidaituwar yanki na hutu a cikin cortex na baya, tare da ƙungiyar IGD tana nuna raguwar daidaituwar yanki na hutu a cikin gyrus na lokaci mai girma idan aka kwatanta da rashin lafiyar amfani da barasa da ƙungiyoyin da ba su da abin ya shafa ( ). Duk da cewa ƙungiyoyin IGD da na rashin lafiyar amfani da barasa sun nuna alaƙar aiki mai kyau tsakanin DLPFC, cingulate, da cerebellum, ƙungiyar IGD ta nuna alaƙar aiki mara kyau tsakanin yankunan DLPFC, lobe na lokaci, da yankunan da ke fama da rashin lafiyar barasa kuma ƙungiyoyin da ke fama da rashin lafiyar barasa sun nuna alaƙar aiki mai kyau tsakanin waɗannan yankuna ( ).

Yadda kamanceceniya za ta iya nuna hanyoyin kwakwalwa na gama gari a cikin yanayi na iya dangantawa da takamaiman yanayin matsakaici [misali, sha'awar jima'i, kamar yadda aka nuna a cikin nazarin kwakwalwa a cikin jarabar miyagun ƙwayoyi ( )] kuma bambance-bambance na iya dangantawa da siffofi na musamman na yanayin (misali, tasirin sinadarai akan abubuwan da ke cikin kwakwalwa) yana buƙatar ƙarin bincike.

Matsala game da Gamal na yau da kullum

Binciken da aka yi kwanan nan ya fara haɗawa da ƙungiyoyi waɗanda membobinsu ke wasa akai-akai don nishaɗi, amma ba sa fuskantar mummunan sakamako (tsarin ɗabi'a da ake kira "amfani da wasa na yau da kullun" ko RGU). Amfani da ƙungiyar RGU wacce ke ba da rahoton adadin lokacin wasa iri ɗaya kamar ƙungiyar IGD amma ba tare da mummunan sakamako ba yana kawar da yiwuwar rikicewa da ke da alaƙa da ƙwarewar wasanni wanda za a iya cirewa akan nazarin ƙungiyoyin IGD da waɗanda ba na wasa ba. Wasu daga cikin binciken da aka kwatanta ƙungiyoyi tare da IGD da waɗanda ke da RGU suna kama da waɗanda aka lura a cikin mutanen da ke da matsalolin amfani da miyagun ƙwayoyi. Kamar yadda aka ambata a sama, mutanen da ke da IGD idan aka kwatanta da waɗanda ke da RGU sun nuna ƙarancin ikon fahimta wanda ke da alaƙa da ƙara yawan kunnawa na gaba da raunin kunnawa na yankuna na gaba da cortico-striatal yayin sarrafa asara da nasara ( ). An ruwaito cewa mutanen da ke da IGD idan aka kwatanta da waɗanda ke da RGU suna nuna ƙarancin kauri na cortical a cikin orbitofrontal cortex, inferior parietal lobule, cuneus, precentral gyrus, da dama temporal gyrus na tsakiya ( ). Hanyoyin Cortico-striatal kuma suna bambanta waɗanda ke da IGD daga waɗanda ke da RGU dangane da sha'awa, tare da mutanen IGD suna nuna babban haɗin kai tsakanin striatal-thalamic da raguwar haɗin gwiwa na gaba na DLPFC-mafi girma a lokacin da aka tilasta musu yin jima'i nan take, tare da tsarin haɗin kai guda biyu da ke da alaƙa da ƙarfin sha'awa ( ). An ruwaito cewa mutanen da ke da RGU waɗanda daga baya suka haɓaka IGD sun nuna ƙaruwar kunna lentiform zuwa alamun wasanni bayan wasanni ( ). Bugu da ƙari, an ba da rahoton binciken da ke nuna ingantaccen daidaiton farin abu a cikin mutanen da ke da IGD idan aka kwatanta da waɗanda ke da RGU, wanda ke haifar da sassan da ke da hannu wajen sarrafa lada da samar da kulawar ji da motsi da kuma haɗawa da ma'aunin tsananin jaraba ( ). Mutanen da ke da IGD idan aka kwatanta da waɗanda ke da ƙwararrun 'yan wasa sun rage yawan launin toka a cikin cingulate gyrus da ƙara yawan launin toka na thalamus, tare da ƙarin bambance-bambance da aka lura tsakanin ƙungiyoyi, gami da raguwar girma a cikin IGD da ƙungiyoyin wasanni na ƙwararru dangane da ƙungiyar kula da wasanni marasa wasa ( ). Abin lura ne cewa ƙungiyar IGD ta fi yin gaggawa kuma ta nuna kurakurai masu juriya dangane da ƙungiyar da ba ta yin wasa ba, daidai da ra'ayin cewa ɓangarorin rashin iko da tilastawa na iya zama mafi dacewa da IGD fiye da sauran ƙungiyoyin wasanni da waɗanda ba na wasa ba ( , ).

Bayan wuce lokacin wasan kwaikwayon, raunin aiki yana da muhimmanci a cikin IGD. Ma'aikata na zamani, irin su impulsivity da kuma arfafawa ko jihohin jihohi, suna da muhimmanci a IGD kamar yadda a cikin wasu ƙididdigar da aka yi wa masu ciwon hauka. Wadannan alamomi suna da alaka da matakan launin fata da fari a cikin batutuwa tare da IGD, kuma ana buƙatar karin bincike don sanin ko waɗannan binciken zasu iya jaddadawa ko kuma sakamakon sakamakon cinikayya.

Future Kwatance

IGD a cikin DSM-5 da GD a cikin ICD-11 wataƙila abubuwa ne daban-daban, kuma ingantaccen fahimtar bambance-bambancen da suka dace zai iya taimakawa wajen gano cuta, rarrabuwa, rigakafi, da ƙoƙarin magani. Ƙarin bincike kai tsaye na IGD idan aka kwatanta da sauran cututtukan jaraba ya zama dole. Ya kamata a gudanar da gwaje-gwajen da ke niyya ga tsarin jijiyoyi daban-daban da ke da alaƙa da jarabar ɗabi'a da ƙwayoyi, kamar glutamatergic, serotonergic, noradrenergic, GABAergic, da tsarin hormones na damuwa ( ), a cikin IGD. Tsarin tsaka-tsaki, gami da sha'awar motsa jiki, tilastawa, ma'aunin tsarin valen mai kyau da mara kyau, haɗin gwiwar zamantakewa, amsawar damuwa, sarrafa motsin rai, da sauransu, suna buƙatar ƙarin bincike game da mahimmancin su ga IGD ( 66-69 , musamman ganin cewa wasu daga cikin waɗannan fasalulluka an haɗa su da lafiyar kwakwalwa a cikin IGD ( . Sauran fasalulluka kamar tserewa da fannoni na musamman na wasanni (misali, amfani da avatars, bambance - bambance tsakanin manufa/kama-da-wane da ainihin kai) suma suna buƙatar la'akari ( . Ya kamata a faɗaɗa irin wannan binciken zuwa ga fannoni daban-daban na matsalolin amfani da intanet ( ), musamman ganin cewa wasanni suna da alaƙa da wasu halaye na amfani da intanet kamar kallon batsa ( ), kuma tallafin irin wannan binciken zai zama da mahimmanci ( ). Ya kamata a yi la'akari da nau'ikan wasanni (gami da kan layi da kuma a layi, da kuma nau'ikan/nau'ikan) ( , ), musamman ganin cewa nau'ikan wasannin da mutane suka fi wasa na iya shafar sakamakon magani ( ).

Gano mutanen da ke fama da IGD zai zama da muhimmanci, kuma aiwatar da kayan aikin tantancewa masu mahimmanci ga al'adu da ingantattun abubuwa zai taimaka a wannan tsari ( ). Ya kamata a faɗaɗa wannan tsari zuwa ƙarin iko kuma a yi ƙoƙari don samun gajerun kayan aiki, kuma irin waɗannan ƙoƙarin suna gudana tare da haɗin gwiwar Hukumar Lafiya ta Duniya. Wannan zai zama da mahimmanci musamman saboda yawancin mutanen da ke fama da matsalar caca ba sa karɓar magani ( ), kuma wannan wataƙila haka lamarin yake da IGD ( ). Ana buƙatar ƙarin bincike kan magunguna masu inganci (musamman gwaje-gwajen asibiti da aka sarrafa ta hanyar placebo, bazuwar) musamman tunda mutane da yawa da ke neman magani don IGD suna ci gaba da fuskantar matsaloli a bin diddigin shekaru 1 zuwa 5 ( ). Duk da cewa wasu bayanai suna tallafawa ingancin takamaiman hanyoyin shiga tsakani (misali, shiga tsakani na ɗabi'a wanda ya haɗa da abubuwan tunani da maganin halayyar fahimta), ana buƙatar gwaje-gwajen asibiti na bazuwar ( , ). Idan aka yi la'akari da amfani da hanyoyin halayya da na magani masu tasiri a cikin maganin jaraba ko wasu cututtuka waɗanda ke faruwa akai-akai tare da IGD (misali, baƙin ciki, rashin hankali da rashin aiki) na iya sauƙaƙe da hanzarta wannan tsari, kamar yadda aka gabatar ga matsalar caca inda aka ruwaito cewa rikice-rikicen da ke faruwa tare suna da amfani wajen zaɓar magungunan magunguna masu dacewa idan babu magunguna masu takamaiman alamomi don matsalar caca ( ). La'akari da yuwuwar tasirin ci gaba na wasanni da GD shima yana da mahimmanci ( ). Haɗa GD a cikin ICD-11 ya kamata ya taimaka wajen tabbatar da cewa akwai fahimtar abubuwan da suka shafi caca a cikin rukunin mutane ta hanyar da ba ta cutar da RGU ba ( ), musamman idan an yi la'akari da raunin aiki ( ), kuma haɗakar ya kamata ta taimaka wajen haɓaka rigakafi, magani, da ƙoƙarin lafiyar jama'a ( ).

Marubucin Mataimaki

AV ya rubuta rubutun farko da aka yi da shawara tare da MP, kuma MP ya tsara kuma ya sake fasalin fasalin. Dukansu mawallafa sun yarda da sashe na ƙarshe.

Fuskantarwa na Bayyana Shawarwari

AV da MP ba su da rikice-rikice game da abinda ke cikin rubutun. MP ya bayyana haka. MNP ya nemi shawara da shawarwari Shire, INSYS, HealthMend Health, Addiction Policy Forum, Data Game Day, Majalisar Dinkin Duniya a kan Matsalar Tambaya, Binciken / Lightlake Therapeutics, da Jazz Pharmaceuticals; ya karbi goyon bayan bincike mara kyau daga Mohegan Sun Casino kuma ya ba da goyon bayan daga Cibiyar Nazarin Kasa ta Duniya; kuma ya shawarci kuma ya shawarci hukumomin shari'a da caca akan al'amurra da suka shafi rikitarwa da rikici. Ya kuma shiga cikin kungiyoyin Lafiya ta Duniya game da IGD da GD. Marubucin da ya rage ya furta cewa an gudanar da binciken ne a cikin babu ciniki ko haɗin kai wanda za a iya ɗauka a matsayin rikici mai ban sha'awa.

kudade

MP ya karbi goyan baya daga Sashen Harkokin Kiwon Lafiyar Harkokin Kiwon Lafiyar Jama'a na Connecticut, Cibiyar Kiwon Lafiyar Lafiya ta Connecticut, Ƙungiyar Connecticut a kan Matsala Tafiya, da Cibiyar Ƙasa ta Duniya don Tambaya. Hukumomin bayar da tallafin ba su bayar da labari ko sharhi kan abubuwan da ke cikin labarin ba, kuma abubuwan da ke cikin labarin suna nuna gudunmawar da kuma tunanin masu marubuta kuma ba dole ba ne su kasance daidai da ra'ayi na hukumomin bayar da tallafi.

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