Harkokin Jirgin Intanit a Matasan Ado tare da Cutar Saduwa ta Yanki: Rahotanni Biyu Game Da Amfani da Ƙunƙasa Ci Gaban (2019)

Ilimin Halayyar Dan Adam na Gaba . 2019; 10: 336.

An buga a yanar gizo 2019 10 ga Mayu. doi: 10.3389/fpsyt.2019.00336

PMCID: PMC6524313

PMID: 31133904

Xavier Benarous , 1 , 2 , * Pierre Morales , 3 Hanna Mayer , 1 Cosmin Iancu , 1 Yves Edel , 3 da David Cohen 1 , 4

Abstract

Matsalar caca ta intanet (IGD) ta kasance wani abu mai rikitarwa wanda ke da ra'ayoyi daban-daban game da mahimmancin asibiti a matsayin matsalar kwakwalwa mai zaman kanta. Wannan muhawarar ta kuma haɗa da tattaunawa game da alaƙar da ke tsakanin wasannin caca masu matsala, cututtukan tabin hankali daban-daban, da halaye da girma. Wannan takarda ta bayyana wani tsari mai tushen ka'idar ci gaba na amfani da wasannin intanet wanda aka yi wahayi zuwa gare shi ta hanyar maganin matasa biyu da ke kwance a asibiti. Taswirorin asibiti guda biyu suna nuna hanyoyi daban-daban na ci gaba: "hanyar ciki" ta hanyar haɓaka damuwa ta zamantakewa, guje wa motsin rai da halayya; da kuma "hanyar waje" tare da ƙarancin matakan dabarun ƙa'idar motsin rai da sha'awa. A cikin shari'o'in asibiti guda biyu, batutuwan haɗe-haɗe sun taka muhimmiyar rawa don fahimtar takamaiman alaƙar haɗari da abubuwan da ke kiyaye IGD, kuma ana iya ɗaukar halayen wasanni a matsayin takamaiman nau'ikan dabarun kai na rashin daidaitawa ga waɗannan matasan biyu. Waɗannan lura na asibiti suna goyan bayan zato cewa ya kamata a kalli amfani da wasannin a cikin matasa masu matsala tare da hanyar ci gaba, gami da mahimman fannoni na ci gaban motsin rai waɗanda ke wakiltar manyan manufofi don hanyoyin magancewa.

keywords: Rashin caca ta yanar gizo, ɓarna cikin wasa, rikicewar motsa jiki, rikicewar cuta, rikicewar dabi'a, jaraba halayyar mutum, rashin damuwa, abin da aka makala, matasa

Tarihi

Cibiyar Tambaya ta Intanet

A shekarar 2013, Ƙungiyar Masu Ilimin Halayyar Dan Adam ta Amurka ta haɗa da matsalar caca ta intanet (IGD) a cikin ƙarin bayani na binciken da aka yi a cikin Littafin Bincike da Kididdiga , Bugu na Biyar (DSM-5) inda ta ba da shawarar a gudanar da ƙarin bincike ( ). Bayan shawarwarin DSM-5, an haɗa matsalar caca (GD) kwanan nan a matsayin wata ƙungiya ta bincike a cikin bugu na 11 na Rarraba Cututtuka ta Duniya ( ) tana nufin wasannin da ba na intanet ba da wasannin kan layi da kuma na kan layi da kuma bambance-bambance tsakanin GD da wasannin haɗari. An kiyasta yawan IGD/GD tsakanin 1.2% da 5.5% a cikin matasa, kuma amfani da wasanni mai matsala zai shafi matasa 1 cikin 10 da ke wasa wasannin bidiyo ( ).

An nuna damuwa da yawa game da gano DSM-5 IGD ko CIM-11 GD a matsayin wasu sassan asibiti daban-daban ( 4-6 Marubuta sun gano matsaloli da dama da suka mayar da hankali kan ka'idojin ganewar asali da kuma batutuwan da suka shafi tunani da kuma na zahiri. Waɗannan sun haɗa da ingancin ka'idojin ganewar asali na yanzu, faɗaɗa matsalar har ta haɗa da ayyukan da ba na wasanni ba na Intanet (misali, kafofin sada zumunta), da kuma haɗarin yin illa ga wani aiki na gama gari ( , , ). Duk da haka, nazarin gwaji ya nuna cewa ɗabi'ar wasanni mai ɗorewa ko maimaituwa tana da alaƙa da nau'ikan ilimin halayyar ɗan adam a cikin matasa kamar damuwa ta zamantakewa, rashin damuwa, rashin kulawa, rashin ɗabi'a, rashin jaraba da ke da alaƙa da sinadarai, da halayen halayen cuta ( , ). Waɗannan binciken sun yi daidai da binciken da aka gudanar a cikin samfuran al'umma ( ), matasa da aka ɗauka aiki a Intanet ( ), da kuma mutanen da ke neman taimako ( 14 .

Nazarin dogon lokaci ya goyi bayan alaƙar da ke tsakanin IGD da matsalolin lafiyar kwakwalwa a cikin matasa ( , misali, halayen psychopathological, kamar sha'awar jima'i , suna ƙara haɗarin kamuwa da IGD; bi da bi, lokacin fallasa wasanni yana annabta tsananin alamun damuwa shekaru 2 bayan haka a cikin matasa ( ).

Misalin Haɓaka Internetarfin Wasannin Yanar Gizo a cikin Matasa

Matasa suna wakiltar lokacin da ake fuskantar barazanar kamuwa da jaraba tare da kololuwar faruwar hakan a lokacin sauyawa zuwa samartaka ( ). A fannin ci gaba, matasa suna mai da hankali kan kafa 'yancin kai da asali ta hanyar tarin abubuwan da suka shafi zamantakewa a cikin ƙungiyoyin takwarorinsu. Bukatar haɗa buƙatu da yawa, da kuma waɗanda suka ɗan bambanta, da buƙatun ci gaba na iya haifar da rikice-rikice tsakanin mutane da damuwa ta motsin rai ( ). A wannan mahallin, halayen jaraba na iya bayyana a matsayin hanyar haɓaka sabuwar fahimtar asali a cikin ƙungiyar takwarorinsu da kuma rage damuwar motsin rai ( ). Duk da cewa farkon halayen jaraba galibi yana faruwa ne a lokacin samartaka, abubuwan da ke haifar da jaraba suna da tushe a cikin ƙuruciya, musamman abubuwan da suka shafi muhalli da kuma matsalolin fahimta da zamantakewa da motsin rai ( , , ).

Kamar yadda aka yi amfani da shi a cikin DSM-5, ma'anar IGD ba ta da wata mahangar ci gaba. Ta yaya mahimmancin asibiti, hanyar halitta, da dabarun magani na IGD suka bambanta a tsawon shekaru? Hakika, mutum zai iya tunanin cewa tasirin mummunan amfani da wasanni ba bisa ka'ida ba zai dogara ne akan yadda wannan halayyar ke tsoma baki ga canje-canjen ci gaba na yau da kullun da aka gani a yanayin halitta (misali, balaga ta kwakwalwa), fahimta (misali, daidaita motsin rai, hana motsi), tunanin mutum (misali, ƙirƙirar asali da gina ayyukan zamantakewa), da kuma matakan muhalli (misali, nasarar ilimi/ƙwararre, dangantakar takwarorinsu da iyali) a cikin takamaiman lokacin taga. Ra'ayin ci gaba ya fi mai da hankali kan lokacin da kuma yadda irin waɗannan abubuwan raunin ke tsoma baki kuma suna iya samar da hanyoyi daban-daban na kamuwa da cuta ga yin amfani da caca da/ko ilimin halayyar ɗan adam.

Matasa Tare da Rashin Lafiyar Jiki

Yawancin wallafe-wallafen da aka sadaukar don yin amfani da caca mai tsanani ga matasa sun fito ne daga nazarin da aka gudanar a cikin al'umma gabaɗaya, samfuran da aka ɗauka ta intanet, ko asibitoci na waje. Rahotanni ne kawai ke wanzuwa game da matasa masu fama da matsalolin tabin hankali masu tsanani ( , ). Duk da haka, a cikin wannan rukunin na ƙarshe, tarin matsalolin ilimi, janyewar zamantakewa, da tsananin alamun da aka samu a ciki yana sanya su cikin babban haɗarin kamuwa da rashin amfani da caca. Bugu da ƙari, idan amfani da caca ta intanet ya canza yanayin alamun tabin hankali a cikin matasa masu fama da matsalolin tabin hankali masu tsanani, gane da magance cututtuka biyu zai wakilci shawara mai dacewa a asibiti.

Bukatun

A cikin wannan takarda, mun yi nufin bayyana rahotannin shari'ar mutum biyu na IGD a cikin matasa masu fama da matsalar tabin hankali ta amfani da hanyar haɓaka. Mun nemi gabatar da jinkiri daban-daban tsakanin halayen wasa, psychopathology, da kuma muhalli. Hanyoyin haɓakawa na haifar da haɗarin haɗari da kuma ci gaba da abubuwanda ake tattaunawa game da kowane zane game da wallafe wallafen data kasance game da rashin amfani da wasan yanar gizo a cikin matasa.

Hanyar

Wannan binciken wani ɓangare ne na babban bincike kan alaƙar da ke tsakanin cututtukan jaraba da ilimin halayyar ɗan adam tsakanin matasa masu fama da matsalar tabin hankali mai tsanani ( ). Mahalarta sun kasance matasa (shekaru 12-18) a asibiti a Sashen Kula da Ilimin Halayyar Yara da Matasa a Asibitin Jami'ar Pitié-Salpêtrière da ke Paris. Ƙungiyar masu tabin hankali da kuma sashin kula da jarabar asibiti sun zaɓi hotunan batsa. A cikin sauran wannan labarin, mun yi amfani da rarrabuwar DSM-5 don komawa ga matsalolin GD da cututtukan tabin hankali. An sami izini a rubuce daga iyaye/masu kula da shari'a don buga waɗannan shari'o'in. Gabatar da rahotannin shari'ar ya biyo bayan Jagorar CARE ( ).

Gabatarwa na 1

Bayani na haƙuri da Binciken Clinical

Wani yaro ne dan shekara 13 wanda ake magana da shi zuwa ɓangaren inpatient don tsananin cirewar zamantakewa tare da rabuwa da makaranta tun shekara ɗaya da rabi. Ba shi da ilimin halin ƙwaƙwalwa ko tarihin likita. Ya zauna tare da 'yar uwar sa da mahaifiyarsa. Mahaifin ya mutu shekaru 2 da suka gabata daga cutar sankara. An haife tagwayen da farawa a makonni na 34, amma ba a jinkirta wani lokaci game da sayen psychomotor ba.

Bayan mutuwar mahaifinsa, A ya fara haɓaka warewa da ficewar jama'a. Kusan daidai lokacin, ya fara wasa a wasan gini a kwamfutarsa. Lokaci da aka shafe a cikin wannan aikin ya karu, kuma mai haƙuri ya bar makaranta da sauran ayyukan. A cikin shekarar da ta gabata, A ya kunna 10 zuwa 12 h kowace rana ba tare da wani lokacin kyauta na wasa fiye da kwana 1 ba. Lokacin da ba wasa ba, A yana da saurin fushi, mai rama, kuma yana magana da lafazi. Bugu da kari, wasan caca bai shafi kowane bangare na zamantakewa ba (misali, dandali ko gasar kan layi). A cikin watannin 6 da suka gabata, an tsare shi gaba ɗaya a cikin ɗakinsa (ban da tsabtar kansa) yana ɓatar da kusan yini yana wasa wasan bidiyo. Duk ƙoƙarin da dangin suka yi don taimaka masa rage wasan ya ci tura. Mai haƙuri bai yarda ya sadu da masu ilimin likita ba, kuma yayin ziyarar gida, ya kasance a kulle a cikin ɗakinsa.

Binciken Cutar Kwayar cuta da Ilimin Jima'i

A lokacin da aka kwantar da shi, majiyyacin ya bayyana a matsayin yaro mai hankali. Ya yi kama da mai baƙin ciki da kuma mai da hankali ba tare da wata tattaunawa ta baki ba. Jawabin ya kasance mai sauƙi kuma mai laushi sosai tare da tsayawa da yawa, musamman ma, yana ƙin yin magana game da tunaninsa. A ya yi taka tsantsan don zaɓar kalmar da ta dace don amsa tambayoyi. Ya bayyana jin daɗin rashin komai da rashin sha'awa a cikin mahallinsa. Yanayinsa na waje bai yi tasiri sosai ga yanayin ba. Ya bayyana jin daɗin a matsayin gurguwar motsin rai maimakon baƙin ciki. Babu wani tunani ko jin rashin bege; duk da haka, bai iya nuna kansa ga makomar ba kuma ba shi da wani kwarin gwiwa na yin wasu ayyuka banda wasanni. An kiyaye barci da sha'awar abinci kuma ba a bayar da rahoton ruɗani ba. An gano cutar rashin damuwa mai ɗorewa (F34.1) ( ).

Kafin farkon rikicewar damuwa na halin yanzu, Wani gogaggen zamantakewa-da tunanin mutum da matsaloli na rayuwa. Ya ba da labarin abubuwan da ya shafi tunanin mutum kawai a lokutan da ba a saba da su ba kuma ya miko neman tallafi don bukatun yau da kullun. Tun yana yaro an bayyana shi a matsayin abin kunya akai-akai a cikin sababbi da kuma wanda ba a sani ba, tare da fewan dabarun halayyar sarrafa halayyar sa. Restricuntatawa na fuska da murya sun shafi, wanda aka fassara da farko azaman alamar ɓacin rai, an ruwaito shi tun farkon ƙuruciyarsa.

A yayin tambayoyin likita, mahaifiyar mahaifiyar ta gabatar da rashin hankali mara kyau. Muryarta da fuskarta sun bayyana matukar bacin rai, amma ta kasance mai son tattauna yadda take ji. Tambayoyi game da alaƙar da ke tsakanin baƙin cikin iyali, raunin da ya shafi kowanne cikin iyali, da alamun cututtukan ƙwaƙwalwar ƙwaƙwalwar ƙwayar cuta ta A'a sun ragu. Ba ta taba ambaton yanayin amfani da yanayin rayuwarmu da muka gano ba da daɗewa bayan wannan asibiti. A zahiri, ya bayyana cewa alƙawarin mako-mako ga sabis na kulawa na mara ƙuruciya ita kaɗai ce tushen hanyar sadarwa. Game da caca, ta ji rashin taimako a cikin lura da amfani da caca. Ta amince da karɓar jagoranci na ɗabi'a amma ba ta taɓa yin amfani da wasu shawarwari ba. Tivationwarin gwiwarta na canza halin da ake ciki a gida kamar ƙarancinsu ne.

Shiga ciki, da sanya ido, da sakamako

A an bi da shi tare da antidepressant, mai zaɓar serotonin reuptake inhibitor (SSRI), sertraline har zuwa 75 mg / rana. A cikin kurkukun, ya kasance yana cikin ayyukan daban-daban tare da sauran masanan marasa lafiyan don inganta haɓaka ƙwarewa tare da manya da takwarorinsu. Ya zama kamar wanda ya buɗe da magana tare da ma'aikatan asibitin tare da sauran matasa fiye da lokacin tambayoyin likita. Yana da rukunin tallafi na mako-mako da rukuni don rikice-rikice na dabi'a da cutarwa. Mai haƙuri ya fara gyaran makaranta hoursan awanni ɗaya kowace rana.

Bayan makonni 4, mai haƙuri ya sami ci gaba sosai. Yayin izini a gida, ana bayyana A da cewa yana da kuzari da motsa jiki. Ya fara jin daɗin abubuwan yau da kullun tare da sauran dangin kuma ya nemi abokantaka cikin shirin abincin rana a ƙarshen mako tare da matasa waɗanda suka hadu a asibiti. Ci gaba, ya ɗan ɗauki lokaci yana wasa da wasannin bidiyo (kusan 2 h kowace rana) ba tare da damuwa lokacin da ba ya wasa ba.

Duk da ci gaba na asibiti da haɓaka aiki, duka A da mahaifiyarsa suna da alama sun kasa gano dalilan waje ko na ciki waɗanda suka ba da gudummawa ga rashin jin daɗin cuta da rashin amfani da wasa. Ba su bayyana wata damuwa game da yiwuwar komawar ba. Duk biyunsu, hangen nesa game da abin da ya gabata ko makomar kusan ba zai yiwu ba ko kuma ba na zahiri bane. Misali, duk da shekara guda da rabi ba tare da ya kasance a makaranta ba, A da mahaifiyarsa sun ƙi duk karbodin makarantar. Marasa lafiya na ganin maimaita aji a matsayin tushen ɓarke ​​da ƙin komawa makaranta. Bugu da kari, shawarwari na warkewa kamar su na kulawa da yau da kullun ko kuma maganin psychotherapy wanda mara lafiyan ya ki karba.

Bayan fitarwa, mai haƙuri yana da alƙawura na yau da kullun a cikin tsarin kulawa na marasa lafiya kuma ya fara a cikin sabuwar makaranta. Bayan makonni 10, mahaifiyar ta tuntube mu don bayyana cewa ɗanta ya ƙi bin kulawar marasa lafiya, ba ya zuwa makaranta, kuma ya sake komawa cikin zamantakewa tare da mummunar kuskuren wasan.

Clinical Relevance

Tattaunawa Tsakanin Rikicin Motsa Jiki da Rashin Amfani

A cikin wannan bidiyon, alamun damuwa/yanayi da rashin amfani da wasannin intanet suna da alaƙa sosai: raguwar tsananin alamun yanayi yana da alaƙa da ƙarancin halayen wasanni, kuma "komawa" zuwa mummunan wasanni ya faru tare da sake farfaɗo da damuwa ta motsin rai. An nuna irin wannan haɗin gwiwa sosai ( , , ). A cikin nazarin dogon lokaci, ana annabta amfani da wasannin bidiyo na cututtuka ta hanyar damuwa (gami da fargabar zamantakewa) da alamun damuwa ( , , ). Irin wannan hulɗar hanya biyu tsakanin rashin amfani da wasanni da alamun damuwa/yanayi na iya haifar da ci gaba da zagayowar alamun ciki ( ).

Haɗuwa da rashin tsaro a Matsayin Shahadar ularfin ularfin Shawara

A nan, mun gano matsalar haɗin kai mai alaƙa da amsawa (F94.1) ( ) dangane da wahalhalun A na fara da kuma mayar da martani ga yawancin hulɗar zamantakewa ta hanyar da aka saba gani tun yana ƙarami. Bugu da ƙari, yanayin rashin kulawa da motsin rai yana da yuwuwar la'akari da wahalhalun da uwa za ta iya fahimta da fahimtar motsin zuciyarta da na 'ya'yanta.

A tsakanin yaran da ke da salon soyayya mai rashin tsaro, an gano wani nau'in da ke guje wa damuwa da damuwa ( ). Waɗannan yaran ba sa nuna damuwa lokacin rabuwa kuma ko dai su yi watsi da mai kula da su ko kuma su juya musu baya lokacin da suka dawo. Main ( ) ya ba da shawarar cewa waɗannan yaran suna guje wa mai kula da su akai-akai saboda guje wa yanayin damuwa da kuma ci gaba da jin daɗin iko. Guje wa duk wani sabon yanayi na dangantaka a cikin yaran da ke da nau'in soyayya mai ban tsoro da ban tsoro na iya haifar da mummunan darajar kai da kuma haifar da alamun ciki ta hanyar rashin damar koyon ƙwarewar zamantakewa tare da mai kula da su ( ).

Matasa da matasa masu matsalar amfani da intanet suna da yuwuwar samun salon haɗewa mara tsaro ( . Wani bincike da aka yi a Italiya ya gano cewa salon haɗewa yana ba da gudummawa ga babban rabo (13%) ga bambancin halaye masu yawa na jaraba a cikin ɗaliban kwaleji ( ). Wasu halaye na tunani da aka ruwaito a cikin wannan hoton asibiti, kamar babban matakin taurin kai na psycho-, ikon tunani da hulɗa da mutane, da rashin sassaucin dangantaka, an kuma ruwaito su a matsayin abin da ke haifar da haɗarin farawa da kuma kula da amfani da caca a cikin matasa ( , ). Wani bincike ya goyi bayan wannan ra'ayin ci gaba, kamar yadda marubuta suka gano cewa halayen haɗewa/halayen mutum a cikin matasa suna daidaita tasirin dangantakar iyali mara kyau akan faruwar IGD ( ). A cikin Tattaunawar, mun yi cikakken bayani game da yadda gujewa da janyewa a matsayin martani mai dorewa na rashin daidaitawa a cikin majiyyaci tare da haɗin gwiwa mara tsaro mara damuwa suna taka muhimmiyar rawa a cikin fitowar da dagewar matsalar yanayi da matsalar caca.

Gabatarwa na 2

Bayani na haƙuri da Binciken Clinical

B wani yaro ne mai shekaru 15 da ake magana a kai zuwa sashin inpatient don mummunan halayen tashin hankali bayan an kore shi daga makarantarsa. Ya zauna tare da Xan uwan ​​ƙaramin 10 da -an uwan ​​biyu (shekaru 20 da 30 shekara). Iyayen sun rabu duk da cewa suna zaune tare. B sun saba fuskantar matsanancin jayayya da fada a tsakaninsu. Duk iyayen biyu ba su da aikin yi. Mahaifin yana da jarabar giya wacce ba a magani ba kuma mahaifiyar ba ta da takamaiman tarihin ilimin halin mahaukata. Iyalin sun bi ta hanyar zamantakewa tun lokacin da B ya kasance 3.

Mahaifiyar mai ciki ta sami rikitarwa ta cutar sankarar mahaifa da kuma giyar sha giya ta wani lokaci. B an haife shi da wuri a makonni na 35 na lokacin haihuwa. Ya kasance yana jinkirta fara magana (kalmomin farko a shekarun 2) da kuma kyakkyawan matsalolin motsa jiki. A farkon shigarsa, yana da wahalar fahimtar umarnin magana da yin ayyukan graphomotor. An kuma lura da rarrabuwa da kuma nutsuwa ta fuskar hankali. A shekaru 6, wani Makarantar Fasaha ta Wechsler da Scale of Intelligence (WPPSI-III) ta sami aiki mai yawa a cikin kewayon al'ada (Verbal IQ = 100, Performance IQ = 75). A shekaru 7, an yiwa mai haƙuri magana game da dangin kula da masu renon tare da cikakken haɗuwa a cikin ɗakunan ilimi don matasa waɗanda ke da matsalolin halayyar. An lura da haɓakawa a cikin kulawar tunani.

A shekaru 13, B ya fuskanci al'amuran rayuwa masu rikitarwa masu yawa (ɗaurin ɗan'uwan dan uwansa, ya bar kula da haɓaka don dawowa cikin gidan dangi, da kuma canji a cikin ƙungiyar tarbiya). Ya kasance mai zafin rai ga takwarorina da manya tare da yawan barkewar fushi kowace rana. An gwada magunguna daban-daban ba tare da wani ci gaba ko haɓaka ba: tiapridum (antipsychotic na ƙarni na farko) har zuwa 15 mg / day, carbamazepine har zuwa 200 mg / day, risperidone a hankali ya karu zuwa 4 mg / rana. An cire B daga aikinsa na ilimi sakamakon zaluntar wani memban ma’aikatan ilimi. Tun daga wannan lokacin, mara lafiya ya kwana a gida tsawon rana. An bayyana shi a matsayin mai tsananin damuwa da yawan fuskoki da yawa na fushin yau da kullun. Ya kasance mai magana da magana da tsoratarwa ga mahaifansa a cikin wani yanayi na takaici kuma ya yi ƙoƙarin murƙushe maƙwabcinsa bayan ambaton banal. A wannan lokacin, B ya ci gaba da sha'awar ayyukansa na yau da kullun, misali, kula da dabbobi ko dafa abinci.

Ya ƙara haɓaka lokaci a kan kwamfutarsa ​​bayan an kore shi daga makaranta. Yawanci ya yi Wasannin Wasanni da Wasan Shooter na Farko, tare da yanayin tashin hankali. Wasannin wasa na kullun ya kasance 2-6 h, lokaci-lokaci cikin dare. Zai iya tilasta kallon bidiyon kan layi a cikin awanni da yawa, ko dai zane-zanen yara ko bidiyo na tashin hankali. B yana da yawan shan barasa yau da kullum shi kaɗai na gilashin giya ɗaya ko kuma giyar giya tare da shan shan giya kusan kowane wata (watau, 10 g na giya kowace rana ko kuma 8.75 raka'a a mako a kan matsakaici). Ya bayyana cewa giya hanya ce ta “kwantar da hankali.” Bayanin kula, mai haƙuri ya kasance mai yawan sukar matsalar jarabar mahaifinsa, yana sukar rashin iyawar mahaifinsa lokacin da ya bugu don kulawa dashi. Hakanan ya kasance yana amfani da tabar wiwi a wasu lokuta (yana shan sigari ɗaya kowane wata 2).

Binciken Cutar Kwayar cuta da Ilimin Jima'i

Yayin tambayoyin mutum guda ɗaya, B ya kasance mai nutsuwa. Ya bayyana yadda ake ji da ƙiyayya, tsayayye fushi da jin damuwa a cikin manya ("damuwa, kunya da fushi a lokaci guda"). Ya ba da rahoton cewa ya fallasa rikice rikice a gida kuma akai-akai ya kula da mahaifinsa da ya bugu. A duniya, ya bayyana wani yanayi na sakaci na zahiri da tausaya a gida. B ya nuna damuwa game da sakamakon halayensa da makomar sa (yana fatan ya zama mai dafa abinci). Ya ji tsoron "yana fushi koyaushe" bayan ya bar asibiti ko kuma irin waɗannan matsalolin za su sake maimaita ɗan'uwansa. An kiyaye bacci da ci.

A rukunin rukunin, yana da abokan hulɗa kaɗan da wasu matasa. Ya kasance mai wahala ga shiga harkar wasanni kuma kungiyar ta saba dashi lokacin da yake wasa da wasannin allon. Ya samu kwanciyar hankali game da marassa lafiya tare da shi wanda ya yi amfani da shi don amfanin dabbobi. Lokacin da ya ji damuwa, mara lafiya ya nemi kulawa daga tsofaffi masu halayyar tashin hankali ko barazanar. Ba zato ba tsammani zai iya busa bango, ko ta taga, ko kuma wani kayan daki ba tare da wani bayani ba.

Kimantawar motsin rai ta nuna shaidar matsalar daidaituwar ci gaba (F82) ( ): sakamakon gwajin motsa jiki da daidaitawa gabaɗaya ya kasance a kashi 0.1 cikin ɗari, sakamakon gwajin haɗin kai na visuomotor ya yi ƙasa sosai, kuma yana da karkacewar −7 na daidaitattun ƙwarewar rubutu ( Tebur 1 ). Kimanta harshe ya nuna shaidar rashin daidaituwar dyslexia mai tsanani (Matsalar karatu, F315.0) tare da iyawa na yau da kullun zuwa rauni a cikin harshen baki amma ƙarancin iya karatu sosai ( Tebur 2 ). An shirya kuma an yi wa majiyyaci da iyayensa bayani game da gano cutar rashin daidaituwar yanayi mai rikitarwa (F34.8) kuma an yi masa bayani ga majiyyaci da iyayensa.

Table 1

An tantance ilimin halin ƙwaƙwalwa ne ta hanyar B.

Ɗawainiya kíɗàa
Girman Ilimin Motsa jiki: M-ABC-2
 Xarancin ragowar Manual 14 (1st % Ile)
 Kwarewar ƙwallon ƙafa 14 (16th % Ile)
 Matsakaici da tsayayyar ma'auni mai ƙima 9 (0.1st % Ile)
 Ƙididdiga duka 37 (0.1st % Ile)
Gnosopraxis: EMG
 Hannun motsi kwaikwayon 7.5 / 10 (−2.98 SD)
 Yatsun yatsu kwaikwayo 3 / 16 (+ 0.42 SD)
Hoton Bodily
 GHDT gwajin DA = Shekaru 7.25
 Berges somatognosia gwajin Ci nasara
Tsinkaye na gani da kuma kwarewar haɗin kai: DTPV-2
 Mahimmancin ragin motsi 36 (32nd % Ile)
 Kayayyakin-mota hadewa 27 (27th % Ile)
Graphism
 BHK-ado 37 (−7 SD)
 Bender gwajin-motar gwaji DA = Shekaru 6.0
Ayyukan ƙwanƙwasawa
 Ayyukan Auditory-Perceptual-motor (Soubiran) Ba a yi nasarar ba
 Auditory-visual-kinesthetic task (Soubiran) Ba a yi nasarar ba
 Taɓa (Stambak) Ba a yi nasarar ba

DA, shekarun ci gaba; SD, karkacewar misali; M-ABC, Batirin Kimanta Motsi ga Yara; EMG, Kimantawa ta Gnosopraxique; GHDT, Gwajin Zane na Goodenough–Harris; DTPV-2, Gwajin Ci gaba na Fahimtar Gani bugu na 2 ; BHK-ado, Gwajin Bender, Gwajin Gestalt na Bender.

Table 2

Bayanin kai, magana, da rubutu na kimar harshe na B.

Ɗawainiya kíɗàa
Wechsler sikelin hankali don yara-IV
 Bayanin fahimtar magana
 Indexididdigar tunani mai ma'ana
 Alamar ƙwaƙwalwar aiki
 Hanyar saurin aiki
Duniyar Fasaha
 Maimaitawa monosyllabic (EDA) DA = Shekaru 6
 Suppuntar da sautin ƙarshe (EDA) DA = Shekaru 9
Kalaman Soyayya
 Lissafin Lissafi (EDA) DA = Shekaru 9
 Sanya hoto (EVIP) DA = Shekaru 13
 Sunan hoto (EDA) DA = Shekaru 9
 Fahimtar yanayin jima'i (DEN 48) - 1.9 SD idan aka kwatanta da 8th samfurin saiti
Morphosyntax
 Fahimtar tsarin daidaituwa (EDA) DA = Shekaru 9
 Kammalallen jimla (EDA) DA = Shekaru 9
Reading
 Karatun kalmomi a cikin min 1 (LUM) - 1.6 SD idan aka kwatanta da 2nd samfurin saiti
 Karatun rubutu DA = Shekaru 6
Writing
 Kwafin hoto (L2MA2) - 1 ET idan aka kwatanta da 6th samfurin saiti
 Rubutun rubutu DA = Shekaru 6

EDA, Examen des Dyslexies Ya Samu; EVIP, Échelle de ƙamus na en hotunan Peabody; DEN 48, Epreuve de dénomination zuba enfants; LUM, Lakcar da Une Minute; L2MA2, yaren magana, yaren rubutu, ƙwaƙwalwa, kulawa.

Shiga ciki, da sanya ido, da sakamako

An daina shan maganin carbamazepine kuma an rage risperidone zuwa 2 mg/rana, wani magani da aka fi amfani da shi ga matasa masu halaye masu tayar da hankali ( ). An ƙara benzodiazepine, diazepam, saboda tasirinsa na tashin hankali. Majinyacin ya kuma fara gyaran motsin rai a cikin sabis (shakatawa ta rukuni na mako-mako da zaman mutum ɗaya). An bayyana wa iyaye buƙatar yin maganin magana mai zurfi. Haɗin gwiwa da ayyukan zamantakewa yana da matuƙar muhimmanci a wannan asibiti. An raka shi zuwa zaman kotun matasa inda aka yanke shawarar sanya shi. A makon ƙarshe na asibiti, ya ziyarci wani sabon wurin kula da marasa lafiya.

An lura da babban ci gaba a asibiti yayin asibiti tare da raguwar matsalolin halayen. A lokacin fitarwa, B bai gabatar da ka'idojin bincike ba ga IGD, kuma ba takamaiman aikin da ake bukata. Watanni shida bayan hakan, B baya gabatar da karawar asibiti ko raunin aiki.

Clinical Relevance

Tattaunawa Tsakanin Halayyar Ragewa da Rashin Cutar

Mun gano a cikin wannan hoton dangantaka tsakanin halayen da ke kawo cikas da kuma rashin amfani da wasanni ba bisa ka'ida ba daidai da wallafe-wallafen da suka riga suka wanzu a cikin matasa ( , , , , ). Wani bincike na Sipaniya ya nuna cewa matsalar halayyar da ke kawo cikas ita ce mafi yawan ganewar asali da ke da alaƙa da IGD a cikin samfurin asibiti na matasa ( ). Da alama IGD yana da alaƙa da nau'ikan halayen tashin hankali masu aiki da amsawa (mai motsa jiki) a cikin matasa. Wartberg et al. ( ) sun gano cewa a cikin babban samfurin matasa na al'umma, waɗanda suka ba da rahoton alamun IGD sun fi kamuwa da matsalolin sarrafa fushi, halayen rashin zamantakewa, da ƙananan matakan SDQ/rashin kulawa, a cikin nazarin bambance-bambance daban-daban.

Abin Da Aka Makala na Abin Da Aka Dora, Jigilar Motsin rai, da Tasiri

Bayanin yadda majiyyaci B ya saba magance matsalolin motsin rai tun yana ƙarami ya nuna tsananin wani nau'in ciwon haɗin kai mai jure damuwa (wanda kuma ake kira haɗin kai mai jure damuwa). Yara masu fama da ciwon haɗin kai mai jure damuwa suna nuna babban damuwa lokacin rabuwa kuma suna da yawan rashin daidaito lokacin da mai kula da su ya dawo ( ). A tsakiyar yara, waɗannan yaran sun fi son ɗaukar halin "iko" (watau, juyawa ga rawar da suke takawa) ga masu kula da su. Ana ɗaukar nuna fushi ko rashin taimako ga mai kula da su a lokacin haɗuwa a matsayin dabarar kiyaye kasancewar mai kula da su ta hanyar ɗaukar iko kan hulɗar da suka yi da juna ( ).

Rashin ci gaba da hasashen amsoshin mai kula da su, kamar yadda ake samu a cikin dangin B, bai bai wa yara damar samun ingantattun tsammanin game da halayen manya ba. Sakamakon haka, waɗannan yaran ba su sami isasshen jin daɗin amincewa da ikonsu na fassara duniyar zamantakewarsu ba: gabaɗaya, suna da ƙarin matsaloli wajen hango da fassara alamun motsin rai daidai (misali, yanayin fuska) da kuma fahimtar yanayin tunaninsu ( ).

Gaskiyar cewa waɗannan yaran sun nutse cikin duniyar zamantakewa da ba za su iya fahimta ba kuma suna fuskantar ƙarin matsaloli na "sauƙaƙe" yanayin motsin rai na wasu ya bayyana wahalhalun da ake fuskanta wajen haɓaka dabarun daidaita motsin rai mafi kyau da kuma tarin matsalolin ɗabi'u masu alaƙa da su (misali, ɗabi'ar adawa, rashin haƙuri ga takaici, fushi, ɗabi'un tashin hankali na gaggawa, ƙin amincewa da takwarorinsu) ( , ).

Ƙarancin ƙwarewar sarrafa motsin rai a lokacin ƙuruciya babban haɗari ne ga matsalolin jarabar ɗabi'a a cikin matasa, gami da matsalolin GD da Intanet ( , , , ). Matasa masu wahalar daidaita motsin zuciyarsu na iya shiga cikin irin waɗannan halaye masu maimaitawa don gujewa ko daidaita ji da motsin rai mara kyau ko kuma tsawaita yanayin motsin rai mai kyau ( ). A cikin Tattaunawar, mun bayyana yadda dabarun daidaita motsin rai marasa kyau za su iya wakiltar abubuwan da suka shafi rauni da kuma masu shiga tsakani na alaƙar da ke tsakanin ilimin halayyar ɗan adam da rashin amfani da wasanni a cikin majiyyaci.

tattaunawa

Hanyar shiga cikin toasari don Yin Amfani da Wasanni

Mun gabatar a cikin Hoto na 1 cikakken ra'ayi game da alaƙar da ke tsakanin haɗari da abubuwan da ke hana amfani da wasannin bidiyo ga mara lafiya A. Mun yi hasashen cewa a) salon haɗewa mara aminci da ke guje wa damuwa a matsayin jariri, b) alamun da aka gano a cikin ƙuruciya, da kuma c) rashin kwanciyar hankali mai ɗorewa a farkon ƙuruciya sun kasance halaye na halaye na hanyar ci gaba gama gari don ɗaukar alhakin matsalolin damuwa/yanayi. A cikin mahallin raunin mutum da yanayin da ba a daidaita shi ba, mara lafiyarmu ya sami dabarun magance damuwa mara kyau tun lokacin ƙuruciya. A lokacin samartaka, abubuwan da suka faru na rashin kyau na iyali (rashin tallafin uba, baƙin ciki na uwa) da wahalhalun da ke tattare da dangantakar takwarorinsa sun sa ya fi wahala a gare shi ya koma ga ƙungiyar takwarorinsa don kafa sabuwar fahimtar asali da kusanci.

Fayil ɗin waje wanda ke riƙe da hoto, hoto, da dai sauransu. Sunan makaman shine fpsyt-10-00336-g001.jpg

Hanya mai haɓakawa wacce ke haifar da mummunar amfani na wasa don haƙuri A.

Ana iya ɗaukar caca a nan a matsayin dabarar magance matsala don guje wa dangantakar mutane da ake gani a matsayin abin tsoro ko abin da ba a iya faɗi ba, yayin da majiyyacinmu ya fi son gamsuwar wasanni nan take a matsayin madadin alaƙa da dangantaka. Don fassara Flores ( ), wasanni suna aiki " a matsayin cikas ga kuma madadin dangantakar mutane ." A gefe guda kuma, sakamakon wasanni da ya wuce gona da iri da sakamakonsa na dangantaka suna ƙara ta'azzara darajar kai da kuma haifar da yanayi na baƙin ciki. Haɗin tsammanin da suka shafi wasanni da kuma guje wa ɗabi'a/jiki don ci gaban IGD da alama yana yiwuwa a wannan mahallin kamar yadda aka nuna a tsakanin manya ( ).

Hanyar Budewa zuwa Matsalar Ciniki

Mun gabatar a Hoto na 2 wata hanya ta ci gaba da ke haifar da rashin amfani da wasanni. Mun yi hasashen cewa a) matsalolin makaranta, musamman a cikin mahallin nakasa na koyo, da kuma b) wahalar muhalli, gami da rashin tallafin iyaye da kuma kulawar iyaye, suna da mahimmanci wajen haifar da haɗari ga halayen waje da kuma rashin amfani da wasanni. Duk da cewa matsalolin fahimta kamar jinkiri a cikin ci gaban ayyukan zartarwa sun wanzu tun lokacin makarantar yara, tasirinsa dangane da iyawar zamantakewa da motsin rai na iya ƙara muni tare da shekaru a cikin mahallin da ke ƙara tsammanin zamantakewa da ilimi. Yana da yuwuwar cewa matsalolin da ke cikin hana fahimta da motsa jiki don jinkirta lada nan take sun haifar da yanayi da yawa masu damuwa (misali, a makaranta, a cikin iyali) waɗanda suka haifar da jin damuwa, takaici, da ƙin yarda ga majiyyaci wanda ke haifar da "ƙaddamar ci gaba" ( ). A cikin wallafe-wallafen manya, irin waɗannan matsalolin suna da alaƙa da ayyukan farko marasa kyau a lokacin hutu ( ) da jinkirta ayyuka ( ).

Fayil ɗin waje wanda ke riƙe da hoto, hoto, da dai sauransu. Sunan makaman shine fpsyt-10-00336-g002.jpg

Hanyar haɓakawa wacce ke haifar da mummunar amfani na wasa don haƙuri B.

Abubuwan da suka shafi muhalli ko kwayoyin halitta na farko waɗanda ke shafar balaga ta jijiyoyi da fahimta na iya taka rawa wajen bayyanar ilimin halayyar ɗan adam da amfani da wasanni masu matsala a cikin wannan hoton. Da farko, ana iya nuna abubuwan kwayoyin halitta idan aka yi la'akari da cewa an gano mahaifin B da matsalar shan barasa da kuma haɗuwa tsakanin abubuwan kwayoyin halitta da ke da alaƙa da jarabar ɗabi'a da abubuwan da suka shafi sinadarai ( ). Na biyu, fallasa barasa ta tayi na iya tsoma baki ga ci gaban tsarin juyayi na tsakiya na B wanda ke haifar da ayyukan fahimta na gaba-gaba marasa kyau kuma don haka ga rashin kulawar hanawa. Na uku, abubuwan da suka faru na farko da kuma sakaci na motsin rai na iya taimakawa wajen kawo cikas ga balaga ta jijiyoyi da iyawar fahimta ( ).

A cikin wannan rahoton, za mu iya ɗauka cewa binciken B na tilasta wa wani abu na jin daɗi nan take ta hanyar wasanni na iya faruwa ne sakamakon dabarun daidaita kai da ba daidai ba a cikin mahallin da wasu nau'ikan dabarun daidaita kai na motsin rai (misali, kimanta fahimta, neman tallafi) ba su da tasiri. Ta amfani da ra'ayin psychodynamic, ana iya ɗaukar halayen wasanni a matsayin madadin wasu hanyoyin jin daɗi na gama gari a wannan shekarun a matakin abu (misali, dangantakar iyali da takwarorinsu) da kuma matakin narcissistic (ƙarancin gamsuwa da kai a cikin mahallin gazawa/rashin aikin ilimi ko ilimi) ( , ). Iyakar yankin B na sha'awa na iya bayyana wani ɓangare ta hanyar buƙatar iyakance hanyoyin jin daɗi/rashin jin daɗi ga abubuwan da aka iyakance kuma don haka ake iya faɗi a cikin muhallinsa. Dokokin wasan bidiyo wataƙila suna da sauƙin fahimta ga B kuma ana kallon su a matsayin "masu adalci" fiye da ƙa'idodin waje.

Clinical da Bincike

Wahalar da A ke fuskanta wajen gane ra'ayoyinsa da kuma bayyana ra'ayoyi masu karo da juna game da kulawa, wanda aka saba gani ga matasa masu matsalar alaƙa, tana da sarkakiya ga dangantakar magani da kuma tsarin mannewa ( ). Ana ɗaukar ƙarancin ƙarfin gwiwa na magani da kuma shirye-shiryen canzawa a matsayin manyan dalilan rashin ingancin ilimin halayyar ɗan adam ga matasa masu IGD ( , ). Ilimin halayyar ɗan adam mai hangen nesa na iya zama babban abin sha'awa ga matasa masu IGD kamar ilimin halayyar ɗan adam mai dogara da haɗe-haɗe ( ), ilimin halayyar ɗan adam mai dogara da tunani ( ), da kuma maganin halayyar ɗan adam mai alaƙa ( ). Irin waɗannan hanyoyin suna haɓaka fahimtar motsin rai da bayyana motsin rai na majiyyaci (misali, don A) ko samun jin daɗin amincewa da dangantaka (misali, don B) wanda ke ba da gudummawa ga ƙaruwar kamuwa da jaraba da yawa da ke faruwa tare ( ).

Menene rawar da A ke takawa a asibiti a wannan yanayi? Rabuwar A daga yanayin da ya saba da shi ya taimaka masa ya fita daga yanayin da ya saba da shi na yawan yin wasanni, amma sake dawowa ya faru jim kaɗan bayan an sallame shi daga asibiti. Asibiti ga matasa masu fama da jarabar ɗabi'a ba wai kawai dama ce ta dakatar da ɗabi'ar rashin daidaitawa ba, har ma da inganta ilimin matashi da iyalinsa game da abubuwan da ke haifar da haɗari na ciki da waje ( ). Kamar yadda aka nuna a nan, batun haɗe-haɗen galibi yana da alaƙa da abubuwan iyali na IGD waɗanda za su iya cancanci shiga tsakani: baƙin ciki na iyaye ( ), damuwa ta iyaye ( ), rashin isasshen matakin tallafin iyali da ake gani ( ), ko haɗin kai mara aminci na iyaye ( , ).

Wasu sun nuna cewa matsalolin iyali na iya zama babban abin da ke haifar da bayyanar IGD a cikin matasa. Matasa masu matsalar amfani da intanet sun fi ƙin amincewar iyalansu kuma sun fahimci cewa iyayensu ba su da goyon baya da kuma ɗumi idan aka kwatanta su da matasa marasa matsala ta amfani da intanet ( ). Xu et al. ( ) sun gano a cikin samfurin matasa 5,122 cewa ingancin dangantaka da sadarwa tsakanin iyaye da matasa yana da alaƙa da ci gaban jarabar intanet ta matasa. Ga Lam ( ), ana iya ɗaukar amfani da intanet a matsayin yunƙuri na rama hulɗar da ke da matsala da iyaye ɗaya, musamman idan aka yi la'akari da ilimin halayyar iyaye. A cikin yanayin sakaci mai tsanani na motsin rai, kamar yadda yake a cikin iyalin B, wasan bidiyo yana kama da ɗaya daga cikin hanyoyin jin daɗi kawai da ake iya faɗi a cikin iyali inda manya ba su da hannu sosai kuma suna samuwa ga 'ya'yansu.

A ƙarshe, kamar yadda aka nuna a cikin waɗannan shari'o'in guda biyu, ƙididdigar kulawa da kyau game da asalin muhalli da tarihin haɓaka yana da mahimmancin gaske don gano abubuwan da ke ci gaba da damuwa waɗanda ke haifar da ƙwaƙwalwar haƙuri da / ko dabarun tsarin kulawa na tunanin mutum. Matasa da ke da takamaiman nakasassu na ilmantarwa na iya wakiltar yawan jama'a masu haɗarin gaske ga IGD idan aka yi la’akari da dalilai masu haɗari don rashin amfani da caca, misali, gazawar ilimi, ƙarancin zamantakewar tunanin mutum, da kuma jinkiri ga ci gaban aikin zartarwa.

Kammalawa

Muna jaddada buƙatar yin la'akari da hanyoyin ci gaba da ke ƙarƙashin alaƙar da ke tsakanin ilimin halayyar ɗan adam da/ko rashin amfani da wasanni ga matasa masu fama da IGD. Hanya ta "ciki" da "waje" zuwa amfani da caca ta hanyar fara wasu cututtuka daban-daban, amma masu kama da juna, da abubuwan da suka shafi muhalli a cikin Hoto na 1 da 2. Ana iya ɗaukar halayen wasanni a matsayin takamaiman nau'ikan dabarun daidaita kai ga matasa masu matsalolin haɗin kai. Idan aka yi la'akari da abubuwan da ke haifar da rauni, kamar salon haɗin kai mara tsaro da rashin daidaituwar motsin rai, na iya wakiltar muhimmiyar dama ga matasa masu fama da cututtuka biyu.

Marubucin Mataimaki

XB da DC sun ba da gudummawa sosai ga ɗaukar ciki da ƙirar aikin. XB, PM, CI, da HM sun ba da gudummawa mai mahimmanci ga siye, bincike, ko fassarar bayanai. XB ne aka tsara aikin ko aka sake bita shi sosai don mahimmancin bayanan ilimi. XB, PM, YE, DC, CI, da HM sun ba da izini na ƙarshe na sigar da za a buga. XB, PM, YE, DC, CI, da HM sun yarda su zama masu ba da lissafi ga duk ɓangarorin aikin don tabbatar da cewa tambayoyin da suka shafi daidaito ko amincin kowane ɓangaren aikin an bincika su sosai kuma an warware su.

kudade

Muna matukar godewa cibiyoyin da suka tallafawa wannan aikin kudi: La Direction General de la Santé (DGS), La Caisse Nationale de l'Assurance Maladie des Travailleurs Salariés (CNAMTS), laminar ofishin jakadancin ta kasa da kuma ayyukan ta'azzara MILDECA), da l'Observatoire na ƙasa des Jeux (ODJ) ("IReSP-15-Rigakafin-11").

Fuskantarwa na Bayyana Shawarwari

An gudanar da binciken ne idan babu wata alaƙar kasuwanci ko ta kuɗi da za a iya ginawa a matsayin yiwuwar rikice-rikice na ban sha'awa.

References

1. American tabin hankali Association Bincike da rikice-rikice na ilimin rashin hankali. Buga na 5th. Psyungiyar Psywararrun Ilimin Hauka; (2013). 10.1176 / appi.books.9780890425596 [CrossRef] []
2. World Health Organization Classididdigar Internationalasashen Duniya na Cututtuka, Bita na 11 (ICD-11) - 6C51 Rikicin caca [Kan layi] (2018). Akwai: https://icd.who.int/browse11/l-m/en#/http://id.who.int/icd/entity/1448597234 [Shiga ciki].
3. Al'ummai DA, Bailey K, Bavelier D, Brockmyer JF, Cash H, Coyne SM, et al. Rashin caca na yanar gizo a cikin yara da matasa. ilimin aikin likita na yara (2017) 140:S81–S85. 10.1542/peds.2016-1758H [PubMed] [CrossRef] []
4. Király O, Griffiths MD, Demetrovics Z. Rashin caca ta yanar gizo da DSM-5: tsinkaye, tattaunawa, da jayayya. Curr Addictive Rep (2015) 2:254–62. 10.1007/s40429-015-0066-7 [CrossRef] []
5. Kardefelt-Buhayan D. Fahimtar rikice-rikicen amfani da yanar gizo: jaraba ko tsari na jimrewa? Psychiatry Clin Neurosci (2017) 71: 459-66. 10.1111 / pcn.12413 [PubMed] [CrossRef] []
6. Kuss DJ, Griffiths MD, Pontes HM. Hargitsi da rikice-rikice a cikin binciken DSM-5 na rikice-rikicen caca na Intanet: batutuwan, damuwa, da shawarwari don tsabta a cikin filin. J Behav shan tabarba (2017) 6: 103-9. 10.1556 / 2006.5.2016.062 [PMC free article] [PubMed] [CrossRef] []
7. Harshen T. Komawa gaba don ci gaba: dalilin da yasa IGD ke buƙatar ƙarawar muhawara maimakon yarjejeniya. J Behav shan tabarba (2017) 6: 121-3. 10.1556 / 2006.6.2017.014 [PMC free article] [PubMed] [CrossRef] []
8. Lemmens JS, Firayim Minista Valkenburg, Al'ummai DA. Rikicin caca na Intanet. Ƙaƙarin Cutar (2015) 27: 567 – 82. 10.1037 / pas0000062 [PubMed] [CrossRef] []
9. King DL, Delfabbro PH. The fahimi psychopathology na yanar gizo cuta cuta a lokacin balaga. J Abnorm Yara Psychol (2016) 44:1635–45. 10.1007/s10802-016-0135-y [PubMed] [CrossRef] []
10. Wartberg L, Brunner R, Kriston L, Durkee T, Parzer P, Fischer-Waldschmidt G, et al. Abubuwan ilimin halayyar dan adam wanda ke da alaƙa da barasa mai matsala da kuma amfani da Intanet na matsala a cikin samari na matasa a Jamus. Ciwon magunguna Res (2016) 240: 272-7. 10.1016 / j.psychres.2016.04.057 [PubMed] [CrossRef] []
11. Yu H, Cho J. Hanyoyin cinikayya na Intanet tsakanin 'yan yara da kuma ƙungiyoyi na Koriya tare da cututtuka na marasa lafiya da cututtuka, da tashin hankali na jiki. Am J Lafiya Behav (2016) 40: 705 – 16. 10.5993 / AJHB.40.6.3 [PubMed] [CrossRef] []
12. Yana nuna HM. Binciken bambance bambancen tasirin hanyar yanar gizan yanar gizo da rashin lafiyar caca na yanar gizo akan lafiyar hankalin mutum. J Behav shan tabarba (2017) 6: 601-10. 10.1556 / 2006.6.2017.075 [PMC free article] [PubMed] [CrossRef] []
13. Sioni SR, Burleson MH, Bekerian DA. Rashin wasan caca ta yanar gizo: cin amanar jama'a da kuma gano tare da kai mai amfani. Yi amfani da Hum Behav (2017) 71: 11-5. 10.1016 / j.chb.2017.01.044 [CrossRef] []
14. Bozkurt H, Coskun M, Ayaydin H, Adak I, Zoroglu SS. Rashin daidaituwa da tsarin cututtukan ƙwaƙwalwar ƙwaƙwalwa a cikin samari da aka ambata tare da jaraba na Intanet. Psychiatry Clin Neurosci (2013) 67: 352-9. 10.1111 / pcn.12065 [PubMed] [CrossRef] []
15. Martin-Fernandez M, Matali JL, Garcia-Sanchez S, Pardo M, Lleras M, Castellano-Tejedor C. Matasa tare da rashin lafiyar gidan caca ta yanar gizo (IGD): bayanan martaba da kuma amsawar magani. Adicciones (2016) 29: 125 – 33. 10.20882 / adicciones.890 [PubMed] [CrossRef] []
16. Al'ummai DA, Choo H, Liau A, Sim T, Li D, Fung D, et al. Yin amfani da bidiyon bidiyo ta hanyar matasa: binciken shekaru biyu. ilimin aikin likita na yara (2011) 127:e319–29. 10.1542/peds.2010-1353 [PubMed] [CrossRef] []
17. Brunborg GS, Mentzoni RA, Froyland LR. Shin wasan bidiyo ne, ko jarabar wasan bidiyo, hade da ɓacin rai, nasarar ilimi, shan giya mai zurfi, ko kuma matsalolin gudanarwa? J Behav shan tabarba (2014) 3: 27 – 32. 10.1556 / JBA.3.2014.002 [PMC free article] [PubMed] [CrossRef] []
18. Wartberg L, Kriston L, Zieglmeier M, Lincoln T, Kammerl R. Yin nazari mai zurfi a kan dalilai na psychosocial da kuma sakamakon rikice-rikicen caca na Intanet a cikin samartaka. Psychol Med (2018) 49(2): 1 – 8. 10.1017 / S003329171800082X [PubMed] [CrossRef] []
19. Davidson LL, Grigorenko EL, Boivin MJ, Rapa E, Stein A. Mayar da hankali kan samartaka don rage ƙwaƙwalwar ƙwaƙwalwa, ƙwaƙwalwa da rashin amfani na abubuwa. Nature (2015) 527: S161 – 6. 10.1038 / nature16030 [PubMed] [CrossRef] []
20. Padykula NL, Conklin P. Tsarin tsari na kai na lalata rauni da jaraba. Clin Social Work J (2010) 38:351–60. 10.1007/s10615-009-0204-6 [CrossRef] []
21. Schindler A, Thomasius R, Sack PM, Gemeinhardt B, Kustner U. Rashin tabbataccen tushe na dangi da cutar shayar da matasa: sabon tsarin kula da alaƙa na dangi. Haɗa Hum Dev (2007) 9: 111-26. 10.1080 / 14616730701349689 [PubMed] [CrossRef] []
22. Iacono WG, Malone SM, Mcgue M. Haramcin halayen halaye da ci gaba da jarabawar farko: na kowa da takamaiman tasirin. Annu Rev Clin Psychol (2008) 4: 325 – 48. 10.1146 / annurev.clinpsy.4.022007.141157 [PubMed] [CrossRef] []
23. Starcevic V, Khazaal Y. Dangantaka tsakanin jarabar halayyar da rashin hankalin ta kwakwalwa: abin da aka sani da abin da har yanzu za a koya? Shafin Farko (2017) 8: 53. 10.3389 / fpsyt.2017.00053 [PMC free article] [PubMed] [CrossRef] []
24. Gwynette MF, Sidhu SS, Ceranoglu TA. Ana amfani da kafofin watsa labarun allo na samari a cikin samari da ke fama da rashin daidaituwar bakan. Yaro matasa masu ilimin halin tabin hankali Clin N Am (2018) 27: 203 – 19. 10.1016 / j.chc.2017.11.013 [PubMed] [CrossRef] []
25. Benarous X, Edel Y, Consoli A, Brunelle J, Etter JF, Cohen D, et al. Binciko na ɗan lokaci da aikace-aikacen wayoyin hannu a cikin samari tare da amfani da sinadarai da kuma rikice rikicewar cututtukan ƙwaƙwalwa: nazarin binciken. Shafin Farko (2016) 7: 157. 10.3389 / fpsyt.2016.00157 [PMC free article] [PubMed] [CrossRef] []
26. Gagnier JJ, Kienle G, Altman DG, Moher D, Sox H, Riley D. Jagororin CARE: Jagorar jagora na tushen haɗaɗɗun ƙwayar cuta na asibiti. Duniyar Adv Lafiya ta Duniya Med (2013) 2: 38 – 43. 10.7453 / gahmj.2013.008 [PMC free article] [PubMed] [CrossRef] []
27. Ainsworth MD, Bell SM. Haɗawa, bincike, da rabuwa: wanda aka kwatanta shi da halayyar yaran shekara ɗaya a cikin wani yanayi mai ban mamaki. Child Dev (1970) 41:49–67. 10.1111/j.1467-8624.1970.tb00975.x [PubMed] [CrossRef] []
28. Babban M. Babban dalilin wasu alamomin abin da aka makala a gaba: ƙarin amsoshi, ƙarin abubuwan da suka faru, da ƙarin tambayoyi. Behav Brain Sci (1979) 2:640–3. 10.1017/S0140525X00064992 [CrossRef] []
29. Thompson RA. Haɗuwa da wuri da haɓakawa daga baya: tambayoyin da aka saba, sababbin amsoshi. A cikin: Cassidy J, Shaver PR, masu gyara. , masu gyara. Littafin Jagora da aka makala, 2nd ed Guilford; (2008). p 348 – 65. []
30. Schimmenti A, Passanisi A, Gervasi AM, Manzella S, Fama FI. M halayyar halayyar halayya yayin fara amfani da yanar gizo mai matsala a tsakanin matasa. Psyariyar Ilimin halin Human Adam Hum Dev (2014) 45:588–95. 10.1007/s10578-013-0428-0 [PubMed] [CrossRef] []
31. Schimmenti A, Bifulco A. Dangane da rashin kulawa a cikin ƙuruciya don rikicewar damuwa a cikin balagaggu: aikin jigon haɗe. Lafiyar Matan Yara (2015) 20: 41 – 8. 10.1111 / camh.12051 [CrossRef] []
32. Estevez A, Jauregui P, Sanchez-Marcos I, Lopez-Gonzalez H, Griffiths MD. Abin da aka haɗa da ƙa'idodin motsin rai a cikin abubuwan maye da jaraba na halayyar. J Behav shan tabarba (2017) 6: 534-44. 10.1556 / 2006.6.2017.086 [PMC free article] [PubMed] [CrossRef] []
33. Monacis L, De Palo V, Griffiths MD, Sinatra M. Binciko bambance-bambance na mutum a cikin jaraba na kan layi: rawar asali da haɗin kai. Int J Ment Lafiya tawo (2017) 15:853–68. 10.1007/s11469-017-9768-5 [PMC free article] [PubMed] [CrossRef] []
34. Cruuvala MA, Janikian M, Griffiths MD, Rennoldson M, Kuss DJ. Matsayin dangi da halaye na mutum a cikin matsalar caca ta yanar gizo: samfurin sulhu wanda ke hade da fahimta da ra'ayoyi haɗe. J Behav shan tabarba (2019) 8(1): 48 – 62. 10.1556 / 2006.8.2019.05 [PubMed] [CrossRef] []
35. Benarous X, Consoli A, Guile JM, Garny De La Riviere S, Cohen D, Olliac B. Tabbatarwa na tushen tabbaci ga matasa waɗanda ke da matsanancin halin dattreguled: tsarin gwaji na gwaji na gwaji don SMD da DMDD. Eur Child Adolesc Psychiatry (2017) 26:5–23. 10.1007/s00787-016-0907-5 [PubMed] [CrossRef] []
36. Solomon J, George C, De Jong A. Yaran da aka rarrabasu a matsayin sarrafawa tun yana da shekaru shida: shaidar nuna rashin tsari dabarun wakilci da tsokanar zalunci a gida da makaranta. Dev ƙwararru (1995) 7: 447-63. 10.1017 / S0954579400006623 [CrossRef] []
37. Sroufe LA, Egeland B, Kreutzer T. Makasudin ƙwarewar farko game da canji na haɓaka: tsarin kulawa na tsaye zuwa daidaituwa na mutum a cikin ƙuruciya. Child Dev (1990) 61:1363–73. 10.1111/j.1467-8624.1990.tb02867.x [PubMed] [CrossRef] []
38. Aldao A, Nolen-Hoeksema S, Schweizer S. Dabarun motsin zuciyar mutum a ƙasan psychopathology: nazarin meta-nazari. Clin Psychol Rev (2010) 30: 217 – 37. 10.1016 / j.cpr.2009.11.004 [PubMed] [CrossRef] []
39. Flores PJ. Rikici da gyara a cikin maganin jaraba. J Rukunin Rukunan Ruwa (2006) 1:5–26. 10.1300/J384v01n01_02 [CrossRef] []
40. Laier C, Wegmann E, Brand M. Haƙiƙa da gwaninta a cikin 'yan wasa: gujewa abubuwan tsammani suna haifar da dangantaka tsakanin halayen halayen mutum da alamu na rashin lafiyar gidan caca.. Shafin Farko (2018) 9: 304. 10.3389 / fpsyt.2018.00304 [PMC free article] [PubMed] [CrossRef] []
41. Masten AS, Roisman GI, Long JD, Burt KB, Obradovic J, Riley JR, et al. Cascades na haɓakawa: haɗu da cin nasarar ilimi da bayyanuwa da bayyanar cututtuka a cikin shekarun 20. Dev Psychol (2005) 41:733–46. 10.1037/0012-1649.41.5.733 [PubMed] [CrossRef] []
42. Kuss DJ, Pontes HM, Griffiths MD. Neurobiological daidaitawa a cikin matsalar caca yanar gizo: sake duba litattafan rubutu. Shafin Farko (2018) 9: 166. 10.3389 / fpsyt.2018.00166 [PMC free article] [PubMed] [CrossRef] []
43. Wang Y, Hu Y, Xu J, Zhou H, Lin X, Du X, et al. Darfin lalacewa na aiki yana da alaƙa da lalacewa a cikin mutane tare da rikice-rikicen caca na Intanet yayin jinkirin aikin ragi. Shafin Farko (2017) 8: 287. 10.3389 / fpsyt.2017.00287 [PMC free article] [PubMed] [CrossRef] []
44. Yau YH, Potenza MN. Cutar labaran da sauran halayyar halayya: fahimta da magani. Harv Rev Lafiya (2015) 23: 134 – 46. 10.1097 / HRP.0000000000000051 [PMC free article] [PubMed] [CrossRef] []
45. Malami AN. Sakamakon rauni mai dangantaka da wuri akan ci gaban kwakwalwa na dama, shafar tsari, da lafiyar hankalin jarirai. Lafiyar Mace ta Jariri J (2001) 22:201–69. 10.1002/1097-0355(200101/04)22:1<201::AID-IMHJ8>3.0.CO;2-9 [CrossRef] []
46. Erikson EH. Asali: Matasa da Rikici. New York: WW Norton & Kamfanin; (1994). []
47. Moccia L, Mazza M, Di Nicola M, Janiri L. Kwarewar jin daɗi: hangen nesa tsakanin neuroscience da psychoanalysis. Front Hum Neurosci (2018) 12: 359. 10.3389 / fnhum.2018.00359 [PMC free article] [PubMed] [CrossRef] []
48. Jaunay E, Consoli A, Greenfield B, Guile JM, Mazet P, Cohen D. Rashin yarda da samari tare da matsanancin rashin lafiya da raunin halayyar mutum. J Can Acad Yara masu ƙwaƙwalwar ƙwaƙwalwar yara (2006) 15: 135-42. [PMC free article] [PubMed] []
49. O'brien JE, Li W, Snyder SM, Howard MO. Matsalar Intanet ta amfani da halayyar ɗalibai a ɗaliban kwaleji: shirye-shiryen canji da karɓar magani. J Evid Inf Soc Aiki (2016) 13: 373-85. 10.1080 / 23761407.2015.1086713 [PubMed] [CrossRef] []
50. Lindenberg K, Szász-Janocha C, Schoenmaekers S, Wehrmann U, Vonderlin E. Binciken haɓakar kiwon lafiya don rikicewar amfani da Intanet a cikin samari da manya. J Behav shan tabarba (2017) 6: 579-92. 10.1556 / 2006.6.2017.065 [PMC free article] [PubMed] [CrossRef] []
51. Asen E, Fonagy P. Tunani-tushen maganin warkewa don iyalai. J Fam Kausar (2012) 34:347–70. 10.1111/j.1467-6427.2011.00552.x [CrossRef] []
52. Bernheim D, Gander M, Keller F, Becker M, Lischke A, Mentel R, et al. Matsayin halayen haɗe-haɗe a cikin ɗakunan harshe na harshe ga marasa lafiya da raunin halayyar mutum. Clin Clinic Psychother (2019). A latsa. 10.1002 / cpp.2355 [PubMed] [CrossRef] []
53. Di Nicola M, Ferri VR, Moccia L, Panaccione I, Strangio AM, Tedeschi D, et al. Banbancin jinsi da alamomin ilimin halayyar dan adam wadanda ke hade da halayen jaraba a cikin samari. Shafin Farko (2017) 8: 256 – 6. 10.3389 / fpsyt.2017.00256 [PMC free article] [PubMed] [CrossRef] []
54. Gioka S, Kefaliakos A, Ioannou A, Mechili A, Diomidous M. Asibitin da ake bayar da magani ga masu addinan yanar gizo. Bayanin Ilimin Kiwon Lafiya (2014) 202:279–82. 10.3233/978-1-61499-423-7-279 [PubMed] [CrossRef] []
55. Lam LT. Lafiyayyun tunani na iyaye da kuma jarabar Intanet a cikin samari. Addict Behav (2015) 42: 20-3. 10.1016 / j.addbeh.2014.10.033 [PubMed] [CrossRef] []
56. Schneider LA, King DL, Delfabbro PH. Abubuwan da suka shafi dangi a cikin wasan yanar gizo na samin matsala na Intanet: bita ta tsari. J Behav shan tabarba (2017) 6: 321-33. 10.1556 / 2006.6.2017.035 [PMC free article] [PubMed] [CrossRef] []
57. Li X, Li D, Newman J Halin iyaye da ikon kula da halayyar dan adam da kuma amfani da intanet mai matsala a tsakanin samari na kasar Sin: matsayin shawo kan sarrafa kai. Cyberpsychol Behav Soc Netw (2013) 16: 442 – 7. 10.1089 / cyber.2012.0293 [PubMed] [CrossRef] []
58. Xu J, Shen LX, Yan CH, Hu H, Yang F, Wang L, et al. Mu'amala tsakanin iyaye da yarinta da kuma haɗarin jarabar intanet na matasa: nazarin yawan jama'a a Shanghai. BMC Ciwon zuciya (2014) 14:112. 10.1186/1471-244X-14-112 [PMC free article] [PubMed] [CrossRef] []