COMMENTS: Binciken cikakken bayani game da wallafe-wallafen wallafe-wallafen da ke da alaƙa da ƙananan jarabar Intanet, tare da mai da hankali na musamman kan jarabar batsa ta yanar gizo. Binciken ya kuma yi suka game da karatun kwatancen kwanan nan da SPAN lab, wanda ke da'awar "lalata jita-jitar batsa." Wani bayani daga m:
“A cikin wannan nazarin, muna ba da taƙaitaccen ra'ayoyin da aka gabatar da jaraba ta asali kuma muna ba da bayyani game da nazarin ilimin kimiyya game da jarabar Intanet da matsalar caca ta Intanet. Bugu da ƙari, mun sake nazarin wallafe-wallafen wallafe-wallafen ilimin kimiyya game da jarabar batsa ta Intanet da haɗa sakamakon zuwa tsarin jaraba. Binciken ya kai ga ƙarshe cewa jarabar batsa ta Intanet ya dace da tsarin jaraba kuma ya ba da irin waɗannan hanyoyin na yau da kullun tare da jarabar abu. ”
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Taron rediyo tare da marubucin marubuci, yana magana akan wannan takarda
SANTA ZUWA GARANTI MAI TSARKI
Behav. Sci. 2015, 5(3), 388-433; doi:10.3390 / bs5030388
An buga: 18 Satumba 2015
Todd Love 1,†,*, Kirista Laier 2,†, Matthias Brand 2,3,†, Linda Hatch 4,† da Raju Hajela 5,6,†
1 {Ungiyar ta Ci gaba da Lafiya ta Jima'i, Ardmore, PA 19003, Amurka
2 Ma'aikatar Janar Kimiyya: Cognition, Jami'ar Duisburg-Essen, Duisburg 47057, Jamus; E-Mails: [email kariya] (CL); [email kariya] (MB)
3 Erwin L. Hahn Cibiyar Nazarin Hanya na Gaskiya, Essen 45141, Jamus +++
4 Kasuwanci na Kasuwanci, Santa Barbara, CA 93103, Amurka; E-Mail: [email kariya]
5 Lafiya Upwardly Mobile Inc., Calgary, AB T2S 0J2, Kanada; E-Mail: [email kariya]
6 Cibiyar Nazarin Harkokin Tsarin Harsoyi (DDTAG), Cibiyar Harkokin Addini ta Amurka (ASAM), Chevy Chase, MD 93101, Amurka
† Wadannan marubuta sun ba da gudummawa ga wannan aikin.
* Mawallafin wanda ya kamata a magance rubutu; E-Mail: [email kariya]; Tel .: + 1-706-383-7401.
Editan Editan: Andrew Doan
Abstract
Mutane da yawa sun gane cewa yawancin halayen da ke iya haifar da ladabi a cikin kwakwalwar mutum yana haifar da hasara da kuma sauran bayyanar cututtuka a akalla wasu mutane. Game da jarabawar Intanet, binciken bincike na kimiyya ba ya goyi bayan zaton cewa matakan da ke cikin kwakwalwa suna kama da maganin damuwa. Ƙungiyar Ƙwararrun Ƙwararrun Amurka (APA) ta gane cewa irin wannan halayen Intanet, cinikin Intanit, a matsayin wani mummunar cuta na ciwo da ke ba da damar yin nazari, a cikin nuni na 2013 da aka gano su Dattijai da Bayanan Lissafi. Sauran ayyukan halayyar Intanit, misali, amfani da batsa na Intanit, ba a rufe su ba. A cikin wannan bita, muna ba da taƙaitaccen ra'ayoyi da ake ba da jimawa da kuma ba da cikakken bayani game da ilimin lissafi akan ilimin yanar gizo da kuma labarun yanar gizo. Bugu da ƙari, mun sake nazarin wallafe-wallafe na labaran ilmin lissafin yanar gizo na intanet na Intanet da kuma haɗa sakamakon da aka samo asali. Binciken ya kai ga ƙarshe cewa jarabar batsa ta Intanit ya shiga cikin tsarin jaraba da kuma ba da ma'anar irin abubuwan da suka dace da maganin jaraba. Tare da karatu a kan jita-jita na intanit da Intanet Cibiyar Gamada mun ga shaidar da ta dace don yin la'akari da halin kirkiro na Intanit kamar yadda ake buri. Bincike na gaba ya bukaci magance ko a'a akwai bambancin bambanci tsakanin jaraba da halayyar hali
Ma'anar: jita-jitar hotuna na intanit; shafukan yanar gizo; Hadin yanar gizo; neuroscience; neuroimaging; DSM-5; ci gaba da hali; lalata hali; cybersex; halayyar jima'i na layi
1. Gabatarwa
Yunkuri na juyin juya hali yana faruwa a yanayin jaraba da ke da babban tasiri ga kima da magani. Yayin da "jaraba" ya haɗu da tarihi tare da matsala masu amfani da kwayoyi da / ko barasa [1], binciken binciken kimiyya a cikin wannan filin ya canza fahimtarmu a cikin 'yan shekarun da suka wuce. Yanzu ya bayyana cewa abubuwa daban-daban, waɗanda suke ƙarfafa lada, da motsa jiki da kuma ƙwaƙwalwar ajiya duk wani ɓangare na cuta na buri [2,3,4,5,6,7,8,9,10]. Hanyoyi na yau da kullum a cikin jaraba da ke tattare da abubuwa daban-daban irin su barasa, opioids da cocaine; da kuma dabi'un dabi'a irin su caca, ba da amfani da intanet, wasanni, batsa da kuma yin jima'i ba, an kuma fassara su.
A sakamakon binciken da ba'a samu ba, Ƙungiyar Amurkan Dandalin Addini (ASAM) ta haɓaka da ma'anar jaraba a cikin 2011 don hada da halayen da abubuwa:
Yau jaraba ne na farko, cuta na ciwon kwakwalwa, ladabi, ƙwaƙwalwar ajiya da kuma kewaye da shi. Rashin tsaiko a cikin wadannan hanyoyin yana haifar da halayen halitta, ruhaniya, zamantakewa da ruhaniya. Ana nuna wannan a cikin mutum wanda yake neman biyan bashi da / ko taimako ta hanyar amfani da kayan aiki da sauran dabi'un.
[11]
Ƙungiyar Ƙwararrun Ƙwararrun Amurka (APA) ta yarda da abin da ya faru na jarabawar hali, kamar yadda za'a iya gani a wurare masu yawa a cikin DSM-5. Alal misali, an sake ba da suna "Abubuwan Ruwa Mai Ruwa" da "Sake amfani da ƙwayoyin cuta", an ƙaddamar da wani ɓangaren ƙwayoyin "Abun da ba a Abubuwa" ba, kuma watakila mafi mahimmanci, Ƙungiyar Tambaya (wanda ake kira Pathological Gambling) ya koma cikin wannan sabon sashe na kundin tsarin mulki, saboda "shaidar da ke nunawa game da halayen caca da ke kunna ladaran tsarin da ya dace da wadanda aka yi amfani da kwayoyi masu cin zarafi da kuma samar da wasu alamun bayyanar cututtuka waɗanda suka bayyana kamar wadanda aka samo asali daga magunguna"12]. Bugu da ari, an gano wani asali na Cibiyar Tambaya ta Intanet (IGD) a ciki sashe 3-Disudin neman Karin Nazarin DSM-5. Don tallafawa wannan sabon ganewar asali, APA ta bayyana a cikin takarda sanarwa / takardun shaida akan IGD:
Nazarin ya nuna cewa lokacin da wadannan mutane ke shiga cikin wasanni na Intanet, wasu hanyoyi a cikin kwakwalwarsu suna haifar da su a hanya guda daya da zafin hanyar kwakwalwa na likitan magungunan magani yana shafar wani abu. Wannan wasan kwaikwayon ya haifar da amsawar da ke da tasiri da jin dadi, kuma sakamakon, a cikin matsanancin hali, an nuna shi azaman halin haɗari.
[13]
Wannan sanarwa yana goyan bayan bincike mai yawa na bincike neuroscientific, kamar yadda aka kwatanta cikin wannan bita. Abin takaicin shine, APA ya ci gaba da yin wannan bayani a cikin sashin binciken na daban na IGD:
Yin amfani da Intanet da yawa ba tare da kunna wasanni na wasanni na layi ba (misali, yin amfani da labarun zamantakewa, irin su Facebook; kallon batsa a kan layi) ba a yi la'akari da shi ba game da labarun labaran Intanet, kuma bincike na gaba akan sauran amfani da Intanet zai buƙaci bi hanyoyin kamar yadda aka nuna a nan.
[12]
Wannan yanke shawara bai saba da bayanan kimiyya da ke faruwa ba, kuma binciken da ake gudanarwa na nufin taimakawa wajen cigaba da tattaunawa akan jita-jita na Intanet (IPA) a cikin amsawar bukatar APA.
APA bai bayyana a fili dalilin da yasa aka gano mahimmancin ganewar asirin, Intanit na Intanit (IA) ba, an sake yin amfani da shi a cikin ƙarin ƙididdigar ƙwarewar IGD. Wannan matsayi ya dace da Davis's [14] ra'ayi na asali game da Amfani da Musamman na Intanet (SPIU), da Brand, Laier da Young's [15] sabuntaccen Ɗaukar Intanet na Intanit (SIA). Wannan kuma ya dace da Griffiths yana bayar da shawarar bambancin tsakanin tsangwama ga yanar-gizon intanet da tsinkaye a yanar gizo [16]. Zai zama mafi sauki kuma watakila ƙarin shawarar aiki, duk da haka, zai kasance don kula da samfurin da aka tsara na IA amma yana buƙatar takaddun shaida ko ƙayyadewa; wasan kwaikwayon, hotuna, sadarwar zamantakewa, cinikayya, da dai sauransu. Daidaita ka'idoji, nassoshi, da kuma mafi yawan kalmomin da aka lissafa a yanzu don IGD sun iya kiyaye, tare da kalmar "hali" kawai da aka yi amfani da ita a maimakon kalmar "wasan kwaikwayo". Tabbas, tsari na asali na IA da za a haɗa a cikin DSM-5 ya ƙaddamar da subtypes na saƙon nan take, yin amfani da batsa, da wasanni na bidiyo [17], a fadada daga baya don hada sadarwar zamantakewa [18]. Wannan zai hada da DSM-5 tare da abin da ya faru, a gaskiya, tun lokacin da aka buga shi, wato, ci gaba da bincike kan kimiyya a cikin tasirin matsalolin matsaloli masu amfani da yanar gizo. Wannan tsari mai mahimmanci an tsara shi sau da dama, duka tarihi [17] da kwanan nan [19,20].
Kuna tunanin IA a matsayin matsala ta kowacce tare da ƙayyadaddun ƙayyadaddun tsari cikakke ne don yin nazari. Akwai wani muhimmin mahimmanci da aka samo a duk abubuwan da suka shafi intanet: Gwargwadon iya kulawa ko haɓaka ƙuƙwalwa tare da danna wani linzamin kwamfuta ko swipe na yatsa. Hankali ga sabon abu (nazarin kallon kalma mai kyau a cikin yanayi) ya cigaba da rayuwa, kuma bincike ya nuna cewa yana kunna tsarin tsarin labarun kwakwalwa [21]. Saboda haka, aikin neman (wanda zai hada da hawan igiyar ruwa) yana haifar da tsarin sakamako [22]. Sabili da haka ne abubuwan da ke haifar da rashin tsammanin (tabbatacce ko korau) [23], wanda aka samo shi a yau da zane-zane da hotuna na intanet.
Wasu ayyukan yanar gizo, saboda ikon su na sadaukar da motsa jiki (da kunna tsarin tsarin kyauta), ana zaton su zama matsalolin supernormal [24], wanda ke taimakawa wajen bayyana dalilin da ya sa masu amfani da kwakwalwa suka nuna matakan da suka shafi addinan da suka shafi rikice-rikice suka kama su a cikin burinsu. Masanin kimiyya na lashe lambar Nobel Nikolaas Tinbergen [25] gabatar da ra'ayin "farfadowa mai mahimmanci", wani abu ne wanda za'a iya haifar da samfurori na wucin gadi wanda zai rinjaye juyin halittar juyin halitta. Don misalin wannan abin mamaki, Tinbergen ya halicci qwai tsuntsu wanda ya fi girma kuma ya fi launin tsuntsaye. Abin mamaki shine, tsuntsaye tsuntsaye sun zaɓi su zauna a kan ƙwayoyin ƙwayar wucin gadi kuma sun watsar da nasu da aka kafa a cikin halitta. Hakazalika, Tinbergen ya halicci butterflies artificial tare da fikafikan fuka-fukai da yawa, kuma ma'abuta butterflies akai-akai sunyi kokari suyi tare da wadannan falflies artificial a madadin ainihin budurwa mata. Masana juyin halitta Dierdre Barrett ya dauki wannan batu a cikin littafinsa na Supernormal na baya-bayan nan: Ta yaya Primal yake buƙatar kawar da manufar juyin halittar su [26]. "Dabbobi suna fuskantar matsalolin mahimmanci yayin da masu gwaji suka gina su. Mu mutane za su iya samar da namu. "[4] (shafi 4). Misalai na Barrett sun fito ne daga kyandir ga batsa da kuma saltsu mai kyau ko kuma abincin da ba'a daɗaɗɗen abinci don yin amfani da wasan kwaikwayo na wasan kwaikwayo. A takaice dai, jituwa ta yanar gizo mai zurfi na yau da kullum yana da matukar tasiri. Yana amfani da tsarin tsarin dabi'armu, amma mai yiwuwa ya kunna shi a matakan da ya fi girma fiye da matakan kunna kakanninmu da yawa sun hadu kamar yadda zuciyarmu ta samo asali, yana sa ya zama abin ƙyama don canzawa cikin yanayin jaraba [27].
A cikin nazarin da ya biyo baya zamu fara bayyane akan babban fahimtar fahimta ko samfurori na jaraba da ke dauke da abubuwa da kuma tushen tsarin aikin daji wanda ake aiwatarwa a cikin siga, ko akwai haɗuwa da abubuwa ko dabi'u. Bayan haka, zamu duba nazarin ilimin kimiyya na zamani wanda ya danganci al'amuran jaraba a gaba daya, sannan kuma matsalar da ta fi dacewa da matsalar Tambaya, sa'an nan kuma ci gaba da ambaliya na binciken kwanan nan a kan AI, da kuma ragowar wasanni da batsa. Yawancin nazarin da aka tattauna sunyi bayani game da batun jaraba da ke tattare da dabi'un ta hanyar binciken bincike-bincike, ciki har da nazarin bincike na aikin aiki da kuma nazarin tsarin gyare-gyare da gyare-gyare. Wadannan masu kai tsaye a kan kimiyyar da aka shafi kimiyya dangane da buri. A inda ya dace, mun tattauna batun binciken neuropsychology, wanda ya nuna cewa yanayin kwaikwayon ya dace da ilimin kwakwalwa irin su waɗanda suke da ƙwayar kwakwalwar ƙwaƙwalwar ƙwaƙwalwar ƙwaƙwalwar ƙwaƙwalwar tunani.
Mun zaɓa don ƙila mu mayar da hankalinmu ga binciken binciken bincike na kimiyya wanda ya shafi jaraba dangane da halayyar, duk da cewa akwai kuma babban bangare na binciken da suka danganci maganin su na asibitoci, annobar cutar, cututtukan kiwon lafiya, kiwon lafiya na jama'a, da dai sauransu. Yayinda wannan sashin bincike ya fi ƙarfin tallafawa jita-jita da hadarin da ke haɗuwa da jita-jita da Intanet da yanar gizo, yana da iyakacin wannan bita. Saboda haka mun yarda cewa yana da mahimmancin iyakance wannan bita na farko ga nazarin da ya dace da bukatun da ya fi dacewa, nazarin da ke magance ƙwayoyin neurobiochemical da na neurophysiological da aka sani da zazzage jaraba.
Muna fatan cewa abubuwan da aka bincika a nan za su bayyana a fili cewa yawancin karatu da ke goyon bayan AI (da kuma kowane ɓangare) suna kasancewa kamar ƙwayar maganin jiki kuma zai nuna cewa dukkanin halin da ake ciki na Intanet dole ne a dauki su a matsayin abin ƙyama a cikin wannan hanyar, kamar yadda bambancin ra'ayi kan jigo maimakon rarrabawar rashawa, kamar yadda nau'i-nau'i na caca (misali, casinos, caca-caca, da gyarawa-mawuyacin cin zarafi) na iya haifar da alamomi, alamun cututtuka, da kuma halin da ke nuna damuwa. Musamman ma za mu lura da nazarin binciken da ke faruwa a yayin bincike na IGD da IPA a matsayin manyan subtypes. A gaskiya ma haka shine mafi yawan ayyukan nazarin AI a duniya sunyi la'akari da irin abubuwan da ke cikin yanar gizo a cikin wannan haske.
2. Hanyar
Don gudanar da bincike, an gudanar da bincike mai yawa da kuma nazari ta hanyar amfani da mabambanta masu yawa: Ƙididdiga ta EBSCO (ciki har da ERIC, LISTA, PsychARTICLES, PsychEXTRA, PsychINFO, Psychology da Behavioral Sciences da SocINDEX), Google Scholar, PubMed da ƙididdiga masu yawa na ProQuest (ciki har da Central, Dissertations da Takardun, Psychology da Social Kimiyya). An wallafa wani ma'auni na ƙididdigar duniya a cikin wani mujallolin da aka yi nazari akan ɗan adam. Wani ma'auni na haɓaka na biyu ya dogara ne a kan kwanan wata kwanan wata, tare da bambancin lokuta da aka tsara dangane da ƙididdigar da aka ba da labarin (duba bayanan da ke ƙasa). Har ila yau, ana ci gaba da sake duba abubuwan da ke faruwa a hanyoyi (misali, shafukan yanar-gizon da ake danganta) a cikin ƙoƙari na ci gaba da kasancewa tare da ilimin ilimi. Saboda haka, ba a iya lissafin adadin sakamakon da aka ƙayyade ba a kan lissafin yayin da aka sake dawo da sakamakon da aka sake dubawa. An buƙatar wasu allo na takardun da ake kira rubutun takardu (wanda aka rubuta ta farko). Bugu da ƙari, an cire sharuɗɗa game da maganin, ilimin ilimin halitta, psychopathology, rashin tausayi, ko wasu matsalolin shawara / damuwa game da addinan da suka shafi yanar-gizon, kamar yadda aka rubuta game da abubuwan da ake amfani da yanar-gizon kamar yadda al'amuran al'umma ko zamantakewa suke. Ana amfani da Zotero kayan sarrafa kayan aiki don gina bayanai na duk abubuwan da aka duba.
2.1. Neurobiology na Addiction
Ƙididdigar wannan batu ya iyakance ne a cikin shekaru goma da suka wuce, tare da mayar da hankali na farko da aka ba da labarin da aka buga a cikin shekaru biyar da suka gabata. Yawan tsofaffin wallafe-wallafen da aka yi la'akari da abubuwan da ke faruwa a cikin ci gaban kimiyyar wannan filin sun hada da (Blum et al. 1990; Nestler, Barrot da Kai, 2001; Robinson da Berridge, 1993; Solomon da Corbit, 1974). An yi amfani da shafukan bincike da abubuwan da suka samo asali a cikin haɗuwa da yawa tare da labarun bayanai (*) kamar yadda ake buƙata: Addict * (don ba da izini ga magunguna, likita, da jaraba), DeltaFosB, kwayoyin *, epigenetic *, imaging, neurobiolog * (zuwa ba da izini ga dukkanin neurobiology da neurobiological), neuroscien * (don ba da izinin neuroscience da neuroscientific), "rashin ciwo rashin cancantar", da kuma "cin zarafi * *.
2.2. Neurobiology na Addictive Behaviors
Wannan jeri ba lokaci ba ne, don yana da matsala wanda akidun tarihi ya dace. Duk da haka, an ba da fifiko mai dubawa don duba wallafe-wallafen, da kuma rubutun da aka buga ta hanyar sabuwar hanyar zuwa mafi tsoho. Ana amfani da shafukan bincike da abubuwan da suka samo asali a cikin haɗuwa da yawa: Rubuce-rubucen *, hali * (don ba da izinin duka halayyar da halayyar), mai karfi, hoto, marasa magani, marasa amfani, da neurobiolog *.
2.3. Cutar Tambaya
Tambayar Tambaya / Tambaya ta Abun Tambaya ta kasance babban labarin da aka buga sosai na shekaru masu yawa, kuma yawancin lokaci na wannan batun shine mafi iyakance, saboda an riga an yarda da shi azaman halin haɗari, kuma haka aka hana shi zuwa binciken koyo da aka buga a cikin baya shekaru biyar. An yi amfani da haɗuwa da yawa daga cikin shafukan binciken da suka biyo baya da abubuwan da suka samo su a cikin gudanar da bincike: Ƙarfi, cuta, gambl * (don ba da izini ga caca da masu caca), "gambl * pathological", "matsala * (don bada izinin matsala da matsala ) gambl * ", da" neurobiolog * gambl * ".
2.4. Intanit yanar gizo
Kamar yadda wannan batun yake, babu wani lokaci da aka tsara don wannan batu, ko da yake an ba da fifiko ga nazarin da kuma sake dubawa a cikin shekaru biyar da suka gabata. An bukaci kulawa ta musamman ga nomenclature a nan, yayin da ake binciken matsalar a ƙarƙashin shafuka daban-daban. Alal misali, ban da lokacin farko na Addinin Intanit, ƙarin kalmomin sun hada da "Amfani da Intanit mai amfani" [28,29,30,31,32,33], Cibiyar Intanit ta Intanet [34], Amfani da Sadarwar Intanit [35], "Amfani da Intanit Tsarin Yanar Gizo" [14,36], da kuma "Amfani da Harshen Intanit" [37,38,39,40,41,42]. Kamar haka ne, ana amfani da shafukan da aka biyo baya da kuma abubuwan da suka samo su a cikin haɗuwa da yawa: Rikicin *, mai karfi, "intanet", yanar gizo, intanet, "Intanet", online, "intanet" da "matsala * Intanit" (don ba da damar don matsala da matsala).
2.5. Cibiyar Tambaya ta Intanet
Babu taƙaitaccen lokaci akan wannan batu, kuma ana amfani da waɗannan kalmomin bincike da abubuwan da suka samo asali a cikin haɗuwa masu yawa: Game, wasanni, yan wasa, wasan kwaikwayo, "wasan kwaikwayo / wasan kwaikwayo / wasan kwaikwayo", "wasan kwaikwayo na yanar gizo / es / ers / ing ", da" matsala * game / es / ers / ing ". Dukkan abubuwan da aka sanya IGD a cikin DSM-5 an sake nazari. An dauki tsarin zaɓin karshe na ƙarshe wanda ya fi dacewa da cewa APA ta rigaya ta yarda da IGD a matsayin bincike na gaskiya-bincike, kuma saboda haka ba a buƙatar cikakken ƙarar labarin a cikin wannan batu don tallafawa mu.
2.6. Intanit Intanit Intanet
Bincike a cikin yanayin wasan kwaikwayo na jima'i a yanar-gizon ya fara ne tare da bincike game da hanyoyi daban-daban kewaye da halayen jima'i. Babu wata takamaiman lokaci-bincike don wannan binciken, duk da haka, kamar yadda aka yi da maganin hali, an sanya fifiko a kan nazarin wallafe-wallafe da kuma rubutun da aka buga ta hanyar sabuwar hanyar zuwa mafi tsoho. Ana amfani da waɗannan kalmomin bincike da abubuwan da suka samo asali a cikin haɗuwa masu yawa: "Harkokin jima'i", cybersex, hypersexual, "rashin daidaituwa", hoton, "jima'i", neurobiolog *, "daga jima'i jima'i", "matsala * jima'i" , jima'i, "jima'i mai shan jima'i" *, "jima'i da zane-zane", da "jima'i na jima'i".
Babu wani lokaci da aka sanya a kan binciken a yankin IPA, ko da yake an buƙaci yawan bayanai game da labaru, kamar yadda sakamakon da yawa ke kasancewa game da batsa na Intanit (IP) amma an mayar da hankali ne a kan batutuwa wadanda basu da alaƙa da yin amfani da lalata / damuwa / matsala (misali, bincike na ciki, mata, 'yancin magana, halin kirki, tasiri na al'umma, da sauransu). Ana buƙatar ƙarin nuni don bambanta abubuwa game da IP (hada da) da ba IP (ba a haɗa su) ba. Ana amfani da haɗuwa da yawa na shafukan binciken da suka biyo baya da kuma abubuwan da suka samo: Porn * (don ba da izinin batsa, batsa, batsa), shan magani *, mai karfi, cyber, hoton, Intanet, neurobiol *, layi, matsala *.
3. Wallafe-wallafe
3.1. Neurobiology na Addiction
Dukkan kwayoyi na zalunci sun shafi hanyar kwayoyin mesolimbic dopamine (DA), wanda ya samo asali ne daga yanki na kwakwalwa (VTA) da kuma ayyukan shiga cikin mahaifa (ACC). Kullum ana kira cibiyar kyauta, NAcc yana da alaka da jin dadi, ƙarfafa ilmantarwa, neman sakamako, da impulsivity. Hanyar hanyar kwayoyin na mesolimbic ta haɗu tare da wasu manyan sassa uku don samar da tarin hanyoyin da aka hada da ake kira tsarin ladabi: Amygdala (ƙwaƙwalwar zuciya da mummunan zuciya, tunanin ƙwaƙwalwar ajiya), hippocampus (aiki da kuma dawo da tunanin tunawa da dogon lokaci), da kuma gurbaran gaba (hadewa da ƙayyade hali). Haɗuwa, tsarin ladabi da yankuna masu haɗuwa suna tsarawa, a tsakanin wasu abubuwa, jin dadi, sakamako, ƙwaƙwalwar ajiya, hankali, da kuma dalili [43].
Halin halin da ke faruwa a yanayi kamar cin abinci da jima'i, sun samo asali ne don su kunna tsarin ladabi saboda gaskiyar cewa suna ƙarfafa halin da ake ciki don rayuwa [20]. Shekaru goma da suka wuce sun haifar da ra'ayoyi masu yawa na jaraba, dukansu sun haɗa da tsarin ladabi da ƙwararrun ƙwaƙwalwar kwakwalwa da ƙananan rufi [44].
3.1.1. Sanya na Uku na Yara
Nora Volkow ya kwatanta jaraba a matsayin mai yuwuwar neurobiochemically daga aikin motsa jiki da aka koya ta hanyar tabbatar da ƙarfafawa ga ayyuka masu tilasta koya ta hanyar karfafa ƙarfafawa [43]. Hakanan ana ganin wannan a matsayin jagora zuwa tsarin cigaba wanda ya ci gaba da damuwa a tsawon lokaci. Volkow, Wang, Fowler, Tomasi da Telang [43] bayyana matakai uku na jigilar motsa jiki; (a) binge / inxication; (b) janyewa / mummunan tasiri; da (c) damuwa / jira.
Volkow, Wang, Fowler, Tomasi da Telang [43] koma zuwa mataki daya a matsayin "Binge / Intoxication" mataki. Daban-daban iri-iri na kwayoyi sun kunna tsarin kyauta ta hanyoyi daban-daban, duk da haka, sakamakon duniya shine ambaliya na dopamine a cikin NAcc (cibiyar kyauta). Wannan yana haifar da ƙarfin ƙarfafawa na halayyar da ta samo ambaliya. A cikin wannan matsala, wannan ƙarfafawa na ingantawa yana haifar da ƙungiyoyi masu ilmantarwa game da addinan [45]. Za'a iya canja canji na ƙananan ƙwayoyin cuta, duk da haka, kamar yadda ci gaba da cire dopamine a cikin NAcc ya kai ga karuwa a cikin matakan dynorphin. Dynorphin, ta biyo baya, yana rage yawan aikin da aka samu na tsarin ladabi, wanda hakan zai haifar da rage karbar sakamako da kuma karuwa a jurewa [43,45].
A mataki na biyu- "Juyewa / Kuskuren Cutar" - ruwan ambaliya ya gudana ta hanya, kuma an kunna amygdala mai zurfi, wani yanki da ke hade da aikin ciwo da damuwa da tsoro. Sakamakon mummunan halin da ake ciki yana haifar da kunnawa tsarin kwakwalwa na kwakwalwa da kuma dysregulation na tsarin magance matsalolin. Wannan yana haifar da ƙwarewar ragewa don samun lada da karuwa a cikin ƙoƙarin sakamako, wanda ake kira haƙuri. Wannan cigaba yana cigaba da ƙin ƙarfafawa yayin da mutum ya ci gaba da shiga cikin halin haɗari don kauce wa mummunar tasiri da aka haɗa da janyewa. Wannan, bi da bi, yana ƙarfafa sakewa da / ko ƙarfafa ayyukan haɗari. A nan, halin motsi yana canzawa zuwa halin halayya, ake kira a cikin samfurin kamar yadda ake ɗauka / neman [43,45]. Babban mahimmanci na wannan mataki shine cewa janyewar ba game da ilimin lissafi ba daga wani abu. Maimakon haka, wannan samfurin ya janye ta hanyar mummunan tasiri wanda ya haifar da tsari. Hanyoyin motsa jiki irin su tashin hankali, damuwa, dysphoria, da rashin tausayi suna nuna alamun karɓuwa a cikin wannan tsarin jaraba [43,45]. Masu bincike sun yi tsayayya da ra'ayi na halin da ake yin haɗari sukan saba shukawa ko rashin fahimtar wannan bambanci mai banbanci, raguwa da detoxification [46,47].
Sashe na biyu na tsarin ladabi ya zo cikin wasa a nan; da hanya ta hanyar dopamine. Kamar misolimbic DA hanya, da sakonni DA farawa a cikin VTA, duk da haka ya ƙare a frontal bawo. Yankunan da ya shafi yankunan da suka shafi abin da ke cikin kullun farko sun hada da magunguna na farko (DLPFC), wanda ke da alhakin ɓangarorin haɓakaccen halayen cognition da kuma aikin zartarwa, da kuma ƙwayar cuta na farko (VMPFC) wanda ke da alhakin gyarawa da kuma amsawar motsin. A haɗuwa, hanyar da ake amfani da shi na dopamine ta shafi rinjaye na aikin aiki [43,45].
Wannan yana haifar da mataki na uku- "Tsaro / tsammanin" -anan nan ake kira "craving". Hanyoyin da ke cikin jiki ba su daɗaɗɗa fiye da hanyar tafarkin dopamine a wasu yankuna na kodayake na farko wanda ke da alhakin motsawa, tsaftace kai / kai-kai, jinkirta ladabi da sakamako,43,45]. Goldstein da Volkow [48] ya haifar da samfurin Kariya da Sauran Sadir (I-RISA) don nuna muhimmancin wannan tsari. Hanyoyin I-RISA sun hada da ƙara karuwa da ilimin likitoci na ilimin likitoci (sakamakon sakamakon da ya dace da ingantaccen hali na haɗaka) tare da sababbin cibiyoyin da aka yi a cikin magunguna. Wannan ya bar mutumin da zai iya dawowa da halin, kuma an gano nau'o'i biyu; sabuntawa da sake dawowa da sake danniya -43,45]. Yawancin binciken neuroimaging da ke tabbatar da wannan samfurin [49,50], kuma waɗannan lalacewar sune tushen bayan "lalacewa na nakasawa" wanda ya shafi magungunan likita na jaraba [11,51].
3.1.2. Anti-sakamako
George Koob yayi nuni da fadadawa na mataki na biyu na buri. Koob [51] yana fadada Sulemanu da Corbit [52] matakan adawa-tsari tsarin motsi, wanda ya dace da irin abubuwan da ke ciki kamar yadda suke adawa da nau'i-nau'i, suna aiki da irin wannan hanya don tabbatar da ƙarfin hali na canzawa zuwa rashin ƙarfafawa da aka nuna a cikin matakai daya da biyu daga cikin matakai uku na sama. A cikin abokin hamayyar-tsari na dalili, tafiyar matakai suna nuna alamun sakamako mai kyau da kuma b-matakai suna nuna mummunar tasiri. Aikace-aikacen a cikin jaraba shi ne cewa matakan tafiyarwa sun fara faruwa kuma suna nuna haƙuri. Sabanin haka, b-matakai na tasowa bayan da tsarin ya kammala kuma ya nuna janyewa. Sulemanu da Corbit [52] amfani da sararin sama a matsayin misali na akasin haka, inda ma'abuta kullun sama suna jin tsoro sosai idan suka yi tsalle (b-tsari) da kuma wasu sauƙi lokacin da suka sauka (a-tsari). Yayin da suke sake yin halayyar, daidaituwa na canzawa irin wannan duniyar da ke da kwarewar samun kwarewa lokacin da suke tashi sai gagarumar sauƙi lokacin da suka sauka. Wannan samfurin ya kwanan nan an tsara shi don bayyana abin da ya faru na raunin kansa wanda ba shi da kansa ("yanke") [53].
Koob [51] ya ba da cikakkiyar samfurin nazarin halittu a kan ka'idar ka'idoji na kwakwalwa. Matakai guda biyu da uku na samfurin uku ya ƙunshi "canje-canje-canje-canje-canje-canje-canje", wanda aka nuna ta hanyar tsarin aikin sakamako, wanda ya kunshi wata hanyar samun sakamako mai karuwa da kuma rage tsarin kyautar dopamine zuwa sakamako wanda ba sawa. Koob yana fadada samfurin don haɗa "canje-canje tsakanin tsarin-tsarin", wanda ya fi mayar da hankali kan manufofin abokan adawa. Musamman ma, ka'idar "Anti-Reward" ta nuna cewa lokacin da tsarin ladabi ya shiga, akwai daidaitattun ka'idodi na kwakwalwar ƙwaƙwalwar ƙwaƙwalwar ƙwaƙwalwar ƙwaƙwalwar ƙwaƙwalwar ƙwaƙwalwar ƙwaƙwalwar ƙwaƙwalwar sakamako tare da kiyaye daidaitattun ƙaura tare da tsarin sakamako, sakamakon haka da kunnawa duka tsarin jiki na jiki (asalin hypothalamic-pituitary-adrenal axis), da kuma tsarin kwakwalwa na kwakwalwa (tsarin cisticotrophin-releasing factor (CRF). Wadannan matakan da aka dauka na dynorphin sun kara girman CRF, da kuma aiwatar da waɗannan tsarin yana haifar da mummunan tasirin da aka danganta da matakan cirewa. Dangane da matsala, tsarin kwakwalwar ƙwayar maganin ƙwayar cuta ya zama dysregulated, kamar yadda aka nuna ta hanyar ragewa a cikin neuropeptide Y (na halitta a cikin kwakwalwa). Cikakken kwakwalwa ya shiga wani "allostatic" lokacin da tsarin bashi bai iya komawa jiharsa ba (na al'ada). Sakamakon tsarin ladabi ya ƙaddamar da saitin canzawa, yana barin mutumin da zai iya komawa da kuma dogara. Wannan shine abin da Koob ya kira "duhu" na buri [51].
3.1.3. Koyon ilimin ilimin ilimin halitta, Habit, da Motsa jiki
Yayinda magungunan Anti-Reward da I-RISA sun haɗa da sassan ilmantarwa, wasu ra'ayoyin jaraba na mayar da hankali ne a kan ilmantarwa game da jaraba, da kuma tushen ilimin halitta. Hyman [54] tana nufin jaraba a matsayin "ilimin lissafi na hanyoyin ƙwayoyin hanyoyi na yau da kullum da ke ba da ilimin sakamako" [54] (shafi 565).
Everitt da Robbins [55,56] gabatar da samfurin jaraba azaman matsakaici na rikicewa daga ayyukan son rai zuwa ayyuka na yau da kullum zuwa ayyuka masu karfi. Misalin su ya haɗa da haɗuwa da kwarewar Pavlovian na gargajiya-amsawa da kuma kayan aiki na kayan aiki, kuma sun gabatar da hujjoji na nuna motsawa a cikin aikin kwakwalwa daga shinge mai kwakwalwa (wuri na NAcc) zuwa dorsal striatum (kwakwalwa yankin da aka kafa don halayen halayyar) ta hanyar hanya na cin gaban jaraba.
Robinson da Berridge [4,57] fadada samfurin ilmantarwa tare da "Sallar Incentive Sality" ka'idar jaraba. Ka'idar Shari'ar Sahihiyar Shari'ar ta biyo bayan tsarin hanyar hypersensitized mesocorticolimbic DA hanya, duk da haka, wannan ka'ida tana mayar da hankali kan abubuwan da aka haɗaka da halayen da aka haɗaka da halayen, maimakon jin dadi ko sakamako [58]. Wannan samfurin zai yiwu ya dace da tsarin juyin halitta na tsarin ladabi, inda "kwayoyi ke haifar da siginar ƙarya na amfanin jiki, wanda ke ɓatar da mafi yawan bayanai" ([59]. Wannan ka'idar ta bambanta "ƙauna" da "son" a cikin cewa cigaba da jaraba yana cigaba da tafiya tare da hanyar da ake so (darajar sakamako) don so (saɓin motsa jiki bisa tushen salience)60,61]. Wadannan masu bincike suna magana akan jaraba kamar "motsa jiki"4] yana haifar da ainihin halin bayyanar cututtuka. Wadannan marubuta sunyi zaton cewa "hujjoji da suka haɗu a cikin 'yan shekarun nan sun ƙarfafa mu, muna da tabbacin cewa a zuciyarta, jarabawar wani rikici ne na motsa jiki na motsa jiki saboda magungunan kwayoyin halitta wanda ke haifar da jin daɗi ga wasu matsaloli" [4]. Ko da yake ya fi mayar da hankali ga maganin jima'i, wadannan marubuta sun yanke shawarar cewa sakamakon ladabi yana da alaƙa da tsarin tsarin dopaminergic, saboda haka "mahimmancin haɓakawa na iya sau da yawa a cikin dabbobi ko mutane zuwa wasu manufofin, irin su abinci, jima'i, caca, da dai sauransu. . "[4].
Robinson da Berridge [61] kwanan nan sun sabunta samfurin su don kawar da wajibi ga bangaren abin da yake so, wanda yake nuna yadda ake son ƙaddamarwa ka'idar Sensitization. Sun yi haka ta hanyar tsoma baki daga ratsi daga "rushewa" (latsa dan iska mai ba da izinin gishiri mai haɗari) zuwa "son", ta hanyar saurin hanyar mesocorticolimbic nan da nan kafin a gabatar da wannan nauyin. Ta haka ne suke ba da shawara game da wannan sakamako kamar yadda aka saba da maganganun gargajiya na Pavlovian game da ilimin ilimin lissafi (wannan tilastawa da sha'awar sun dogara ne akan ƙungiyoyi masu koya), da kuma jaddada yadda ake son samun ladabi na "kwakwalwa"61] (shafi 282).
3.1.4. Genetics
Genetics, kamar yadda suke dacewa a nan, za a iya raba kashi uku; Halittar kwayoyin halitta, jaraba game da maganin kwayoyin halitta a cikin mutum, da kuma epigenetics dake rarraba biyu. Dangane da nazarin kwayoyin halitta, Swendsen da LeMoal [62] kiyasta dalilan kwayoyin da zasu taimaka wajen kimanin 40% na cutar shan taba. Mawallafa sun ci gaba da ba da lissafi na ainihi na ainihi game da wasu abubuwa kamar; 49% (m) da 64% (f) don shan giya, 44% (m) da 65% (f) don cocaine, 33% (m) da 79% (f) don marijuana, 43% (m) don masu amfani, da 53% (m) da 62% (f) don taba [62] (shafi 80). Volkow da Muenke [63] bayar da rahoton abubuwan da suka shafi kwayoyin halitta a bangarorin biyu na gwaji biyu; misali, ADHD da kuma zalunci abubuwa. Agrawal da colleauges [64] yi nazarin wallafe-wallafe da kuma gano jaraba dangane da kwayoyin halitta kamar yadda yake a cikin ɗayan biyu; kwayoyin da ke iya haifar da canje-canjen yanayi don mayar da martani ga wasu abubuwa, da kuma kwayoyin da ke tasiri ga sakamako-tsarin tsarin (kamar DRD2). Wadannan mawallafa sun gano cewa farkon matakan cigaba da jima'i sun fi dacewa da lambobin muhalli, yayin da matakai na baya sun fi dacewa da rashin daidaituwa.
Blum et al. [65] gano ainihin jigilar kwayoyin tsakanin A1 allele na Dopamine D2 gene receiver (DRD2) da kuma mai yaduwa don samar da giya. Musamman, sun lura cewa masu ɗaukar nauyin DRD2-A1 din suna da masu karɓa na D2 da yawa. Bayan 'yan shekaru baya, Blum, Cull, Braverman da Comings [66] ya ba da shawara cewa mutane tare da wannan jigilar kwayoyin halitta na iya haifar da rushewa cikin tsarin sakamako na mesolimbic, wanda ake kira su "Dopamine Reward Cascade". Wadannan cututtuka sun haifar da wani tsarin hypodopaminergic wanda ya haifar da tsinkaye ga dabi'un da ke cike da halayya, halayya, da halayya, da kuma rikice-rikice masu yawa. Blum et al. [66] ya sanya kalmar "Sakamakon rashin lafiya" (RDS) don wakiltar rashin daidaituwa da ƙwayar ƙwayar cuta wadda take bayarwa a matsayin daya ko fiye da nakasa hali. Yayinda suke ci gaba da bincike, Blum da tawagar sun gano cewa masu karɓar ragamar DRD2-A1 suna da 30% -40% kasa da masu karɓa na D2, kuma sun kasance game da 33% na yawan jama'ar {asar Amirka [67].
3.1.5. Ƙididdigar Lafiyar Halitta na Yara
Yawancin bincike kan kwayoyin bayani game da jaraba ya fito a cikin shekaru goma da suka wuce, sau da yawa akan mayar da hankali kan matsayin CREB, DeltaFosB da glutamate [2,68,69,70,71,72,73]. Jimlar wannan bincike ya nuna cewa ambaliya na dopamine a cikin tsarin kyauta yana haifar da karuwa a cikin samar da AMP na cyclic (CAMP), ƙananan kwayoyin sa'an nan kuma siginar sakin furotin amintattun sifa mai lamba (CREB). CREB wani furotin ne wanda yake sarrafa bayyanar wasu kwayoyin halitta. A wannan yanayin, sakamakon haka shine sakin dynorphin, wani sinadaran da ke jinkirta sakin dopamine kuma ya hana VTA, ta haka ne ya rage tsarin lada. Masu bincike sunyi imani cewa wannan shine tushen kwayar cutar, saboda yawancin miyagun ƙwayoyi (ko halayyar) ana buƙata don shawo kan ƙãra CREB. Wannan tsari yana da nasaba da dogara, kamar yadda tsarin ladabi ya hana mutum a cikin jihadiya lokacin da ya zama abstinent daga tushe na damuwa na dopamine. Lokacin da mai shan tabarbara ya zama abin ƙyama, matakan CREB da sauri sun sauke, rashin haƙuri ya ɓace, kuma abin da aka fara farawa ya fara. A wannan batu, DeltaFosB ya zama mahimmanci.
DeltaFosB shi ne ƙididdigeccen takardun shaida wanda ke aiki a wani ɓangare na hanyar CREB, saboda yana rufe dynorphin kuma yana ƙaruwa a cikin hanyar sakamako. Ganin cewa CREB ya haifar da ƙarfin hali na haɗari, DeltaFosB yana inganta ingantaccen halayyar haɗari. Kodayake CREB ya gina sauri a mayar da martani ga yin amfani da miyagun ƙwayoyi (ko kuma halayyar haɗari), DeltaFosB ya gina sannu a hankali. Bugu da ƙari, yayin da matakan CREB da aka haɓaka sun ɓace da sauri, ƙananan matakan DeltaFosB sun kasance na tsawon lokaci-mako ko watanni. Wannan yana inganta mayar da martani ga sakamako da ladaran sakamako, ya bar mutumin da ke damuwa da abin da ya shafi jaraba da damuwa ga halin halayya da sake dawowa. Wannan yaɗa tsayin daka da abubuwan da suka danganci shi ya haifar da batun DeltaFosB a matsayin "ƙwayoyin kwayoyin cutar don jaraba" [70].
Sashe na uku shi ne glutamate neurotransmitter. Masu bincike suna samun mafita don shiga cikin ilimin ilimin jaraba, da kuma ƙara yawan dopamine a cikin hanya ta mesocorticolimbic yana haifar da ƙara yawan hankali zuwa glutamate. Hakanan, ƙwarewar haɓakaccen gwaninta yana ƙarfafawa da kuma bunkasa hanyoyin ilmantarwa / ƙwaƙwalwar ƙwayar da ake danganta da jaraba da halin halayensa [74].
3.2. Neurobiology na Addictive Behaviors
Koob da Le Moal [5] ya sadaukar da sashe na karshe na cikakken nazari game da tsarin kwamfyutan da ke da alamun da aka ba da ita ga batun "Nondrug Addictions". Mawallafin sun hada da "marasa shan magani da miyagun ƙwayoyi", kuma sun kammala tare da sanarwa, "Ana iya gabatar da karar cewa yana da tasiri mai karfi tare da sakewa na jaraba da damuwa da damuwa (sha'awar), binge / intoxication, and withdrawal / negative shafi wurare na cinikin caca, cin kasuwa, cin abinci mai cin gashi, halayyar halayen jima'i, da motsa jiki mai karfi "[5] (shafi 46).
A cikin nazarin wallafe-wallafen da aka kwatanta da al'amuran ƙari da SUDs, Grant, Brewer da Potenza [6] takamaiman labarun caca, kleptomania, pyromania, sayen dan kasuwa, da halayyar halayyar jima'i a matsayin misalan halayyar haɗari, kuma ya kammala, "Biochemical, aikin neuroimaging, nazarin kwayoyin halitta, da bincike na maganin sun nuna wata dangantaka ta jiki mai karfi tsakanin haɓaka da kuma amfani da abu cuta "[6] (shafi 92). Grant, Potenza, Weinstein da Gorelick [7] ya samo al'amuran ƙwayoyi da SUD ya sake komawa a wurare masu yawa, ciki har da comorbidity, hanya (sake komawa baya), gudummawar kwayoyin halitta, neurobiology (kwakwalwa mai kwakwalwa, opioidergic, serotonergic, dopamine mesolimbic tsarin), phenomenology (sha'awar, maye, janye), haƙuri, da amsa maganin.
A cikin cikakken labarinsa, "Sakamakon halitta, neuroplasticity, da kuma wadanda ba miyagun ƙwayoyi ba", Olsen [8] ayyana, "akwai hujjoji na shaida cewa sakamakon ladabi na iya haifar da filasta cikin jarabawar alaka"8] (shafi 14). Olsen ya gabatar da karatun na FMRI da ke nuna caca, cin kasuwa, jima'i (kogasm), wasanni na bidiyo, da kuma ganin abincin da za a iya amfani da shi don kunna tsarin mesocorticolimbic kuma ya kara amygdala kamar yadda ake amfani da kwayoyi. Olsen ya kammala cewa "Mahimman bayanai sun nuna cewa cin abinci, cin kasuwa, caca, wasa wasanni na bidiyo, da kuma bayar da lokaci a kan intanet sune dabi'un da zasu iya bunkasa cikin dabi'un da ake ci gaba da ci gaba duk da mawuyacin sakamakon" [8] (shafi 14).
A cikin nazarin yadda ake iya haifar da halayen halin kirki, Lobo da Kennedy [75] ya ruwaito 'yan wasan wasan kwaikwayon da ba su da alamun da za su iya zama sau uku sau yiwuwa a sami iyayensu wanda ke da caca, kuma sau goma sha biyu suna da iyaye. Blum et al. [67] ya sami 'ya'yan shan giya don su zama 50% -60% mafi kusantar su zama giya, wani ƙididdiga wanda ya dace da Leeman da Potenza's [10] halin kuzari ga masu caca.
Blum ya kunshe da halayyar halayyar haɗari a cikin ƙungiyoyi na yankunan da RDS ke fuskanta. A cikin farkon takarda a kan sakamako cascade, Blum et al. [76] ya ce, "Saboda haka rashin masu karɓar D2 yana sa mutane su sami babban haɗari ga yawancin jaraba, da motsa jiki da halayyar halayyar halayya, gami da shaye-shaye, hodar iblis, tabar heroin, marijuana da amfani da nikotin, haɓakar glucose, caca da cuta, jarabar jima'i…". Jerin na gaba yana wakiltar takamaiman matsalolin halayya a halin yanzu an haɗa su da RDS (da fatan za a lura a nan cewa muna amfani da kalmomin asali, kodayake ba za mu rarraba Wasannin Intanet ko Abun Jima'i na erarfi a ƙarƙashin kalmar Halayyar ulsarfi ba):
- Abubuwa masu ladabi: Mai haɗari da ƙwayar cuta, Harshen Polysubstance, shan taba da kuma cin abinci-Kiba
- Abubuwa masu tasowa: Ciwon hankali na rashin lafiya Hanyoyin cututtuka, Tics da Ciwon ƙwayar cuta da Autism (ciki har da Asperger Syndrome)
- Abubuwan Bada Kwarewa: Abubuwa masu haɗaka da jima'i, Intanit na yanar gizo da rubutu mai lalata, Bambance-bambance na Matsaloli da Dubuguwa da Shopaholisnm
- Damaguwa na Mutum: Cutar Gudanar da Ƙwayar cuta, Matsayi na Musamman, Matsananciyar Zama, Tsarukar Laifi da Rikici [67].
A cewar Smith [77], ilimin kimiyyar kwakwalwa irin su wadannan da sauransu ya haifar da hada-hadar ASAM a matsayin yadda aka kwatanta shi. Bugu da ƙari, da aka ambata "Ƙananan Ma'anar Addini", ASAM ta wallafa "Tsawon Tsarin Addini", inda suke bayar da misalai na halin haɗari a cikin sakin layi na farko:
Addiction yana rinjayar neurotransmission da kuma hulɗar dake tsakanin tsattsauran ra'ayi da hippocampal da kwakwalwa, kamar yadda abincin, jima'i, barasa da wasu magunguna) ya kai ga mayar da martani da kuma halayyar halin da ake ciki a waje. jawo sha'awar da / ko haɗin kai a cikin halayen ƙari.
[11]
Don ƙarin goyan baya game da ra'ayin jaraba dangane da halayen, ASAM yana amfani da kalmar "Addictive behaviors" 13 sau da yawa a cikin Dogon Jima'i, kuma yayi magana a kan kalmar da ke cikin Magana mai zurfi 3:
A cikin wannan takardun, kalmar "dabi'a" yana nufin halin da suke da ladabi kuma suna da alamu a lokuta da yawa na jaraba. Bayyanawa ga waɗannan dabi'un, kamar dai yadda ya faru tare da daukan hotuna zuwa magungunan ladabi, yana da mahimmanci na tsarin jaraba da kwarewa da cin hanci. Jihar kwakwalwa ta jiki da kuma ilimin lissafin jiki shine mawuyacin hali wanda ya fi dacewa da cin zarafi. Saboda haka, a cikin wannan takardun, kalmar nan "dabi'un halayya" ba ta nufin halaye marasa cin hanci ko al'adun da ba a yarda da su ba, wanda zai iya bayyana a cikin wasu lokuta na jaraba. Hanyoyi, irin su rashin gaskiya, cin zarafin dabi'u ko dabi'u na wasu, aikata laifuka da dai sauransu. Wadannan sune mafi kyawun kallo kamar matsalolin da suka haifar da maimakon taimakawa wajen jaraba.
[11]
Bincike a kan kwayar halitta na "cin zarafin hali" ya ci gaba tun lokacin lokacin sabon bayanin ASAM. Alal misali, a cikin nazarin wallafe-wallafe game da annobar cutar, neurobiology, da kuma maganin maganin "halayyar dabi'a" [9], Karim da Chaudhri sun nuna rashin daidaituwa ga rashin lafiya, wanda suke maimaita halin halayya-halayya, da kuma aiwatar da karuwa. Wadannan mawallafa sun ba da labarin "caca, cin abinci, jima'i, cin kasuwa, yin amfani da Intanet ko kayan hotunan wasan kwaikwayo ko kuma yin amfani da su, yin aiki ko raguwar soyayya" [9] (shafi na 5) a matsayin misalai na jarabawan hali.
Leeman da Potenza [10] ya gudanar da nazarin wallafe-wallafe game da nazarin neurobiological akan al'amuran ƙwayar cuta, "Wani Binciken Tallafawar Neurobiology da Genetics of Behavioral Addictions: Wani Cibiyar Nazarin Bincike". Wannan labarin yana dauke da nassoshin 197, kuma ya kakkarya binciken a cikin sassa uku: Ayyukan ƙwararrun aiki da neuroimaging, tsarin neurotransmitter, da kwayoyin halitta. Masu marubuta sun taƙaita kowanne ɗayan a cikin teburinta na gaba, yana nuna "tsinkayen labaran" guda shida: Yin wasa, Intanet, wasanni, cin kasuwa, kleptomania, da jima'i. Harafin hagu na tebur ya ƙunshi taƙaitaccen binciken da ake ciki a kan ƙwarewar hali na musamman, kuma bangaren hagu ya bambanta da su tare da binciken da ya dace don cin zarafi. Mawallafa sun yanke shawarar cewa akwai iyakance amma bayanai masu tasowa suna haɗawa da jituwa daban-daban tare da binciken da ake ciki a kan cin zarafi.
Fineberg et al. [78] wallafa wani bita mai mahimmanci, "Sabbin abubuwan da ke faruwa a cikin neurocognition na mutum: Clinical, genetic, da kuma kwakwalwa tunanin yadda ya dace da impulsivity da kuma compulsivity". A cikin nazarin su, wadannan mawallafa mawallafi sun yarda da batun al'amuran ƙari, ciki har da su a cikin ƙoƙarin su "ganewa game da ilimin pathophysiology na rashin tausananci, rashin karfi, da kuma addictive cuta da kuma nuna sababbin hanyoyin neman bincike" [78] (shafi 2). Wadannan mawallafa sunyi amfani da Cutar Gambling a matsayin abin koyi don cin zarafin hali, ko da yake sunan gaba sun yarda da ciwon cin nama kamar yadda ake nuna neuropathophysiology tare da maganin ƙari. Ya hada da binciken su, waɗannan mawallafa rahoton,
Kamar yadda yake cikin maye gurbi, dangantakar da ke tsakanin rikice-rikice na kwakwalwa a yayin da ake sa ran sakamako da kuma yadda ake nuna damuwa a cikin kamfanoni masu kungiyoyi da caca da ke dauke da kwayar cutar suna nuna cewa wannan yanayin na kunna kwakwalwa a cikin ƙungiyoyi da kungiyoyi. ya danganta da irin wannan impulsivity.
[78] (shafi na 15)
Anyi nazari akan abincin da ake amfani da shi a cikin 'yan shekarun nan, ciki har da bincike mai zurfi a cikin kwayoyin halittun da ke tattare da cin nama da kiba [79,80,81,82,83,84,85,86,87,88,89,90].
3.2.1. Cutar Tambaya
Bugu da ƙari da binciken da aka ambata a cikin kwayoyin halitta na maganin cuta (SUDs) da kuma abin da ake ba da jaraba, akwai wani gwaji na bincike musamman a cikin kwayar cutar ta Gambling (GD) (wanda ake kira Pathological Gambling (PG)) kafin DSM-5). Lalle ne, kamar yadda aka ambata a cikin Fineberg et al. [78] nazarin, yawancin bincike game da al'amuran ƙwayoyi suna amfani da GD a matsayin samfurin.
Sauran nazarin da aka kwatanta da kai tsaye kuma ya bambanta kwayar cutar GD tare da kwayar cutar ta SUDs. Alal misali, Potenza [91,92] wallafa wallafe-wallafen wallafe-wallafe biyu game da kwayoyin halitta na GD. A cikin binciken farko na wallafe-wallafensa, bincike akan al'ada tsakanin GD da zalunci, Potenza [92] ya sami kamance da za a kara zuwa asibiti, kwayoyin halitta, annoba, halittu, da sauran wuraren nazarin halittu, kuma ya tada tambaya game da ko GD zai zama mafi dacewa a rarraba shi a matsayin "buri". Wadannan binciken ana karfafawa a bincikensa na biyu, inda ya sami yankuna masu kwakwalwa (kwakwalwa mai kwakwalwa, kwakwalwa na farko, insula, da sauransu), da kuma tsarin neurotransmitter (norepinephrine, serotonin, dopamine, opioid, da glutamate) da za a canza a cikin rikici yan wasan caca [91].
Gina kan irin wannan bincike, Leeman da Potenza [10] wallafa wani bita a kan "Mahimmanci da bambance-bambance a tsakanin caca-bambance-bambance da maganin cututtuka". Masu marubuta sun kwatanta yawan kamance tsakanin GD da SUDs game da aikin kwakwalwa (frontal cortices, striatum, da insula) da kuma binciken binciken bincike na neurotransmitter (dopamine, serotonin, opioids, glutamate, da norepinephrine). Hakazalika, El-Guebaly da abokan aiki sun wallafa wani binciken da yayi la'akari da dacewa da GD a matsayin mai rikici ko kuma ƙwayar cuta [93]. Bisa ga binciken da aka samu na masu amfani da neurotransmitters, neurocircuitry, da kuma kwayoyin da kuma amsa ga pharmacotherapies, waɗannan marubuta sun gano cewa GD da SUDs sun fi yawanta fiye da GD da rikitarwa na rikici. Hakazalika, Brevers da Noël [94] wallafa wallafen wallafe-wallafe a inda suka sami GD don su dace da I-RISA, Sakamakon Gwajiyya, Saukakawa Salula / Sensitization, da kuma dabi'u na jaraba. A matsayin misali na karshe, Gyollai et al. [95] wallafa wallafe-wallafen wallafe-wallafe game da jinsin GD kuma ya ƙare ta hanyar tabbatar da shigarsa a cikin rukunin RDS na hali.
Bisa ga wannan kuma yawancin wasu bincike, APA ta kaddamar da Kamfanin Tambaya na Pathological daga kasancewar Kwayoyin Tsaro na Jirgin Ƙungiyar zuwa wani "Cutar da ba a Cutar" ba a cikin DSM-5. Wannan sanarwa na GD a matsayin abin da ba shi da dangantaka da kwayoyin halitta (watau Addiction) ne a cikin DSM-5 na wakiltar ƙaddamar da tsayin dakawar cewa binciken kimiyya na jaraba da kuma ra'ayin jaraba a cikin kowa dole ne a iyakance ga da amfani da ilimin amfani da abubuwa masu kwakwalwa.
Tun daga wannan lokacin, nazarin neuroimaging da sake dubawa na ci gaba da fitowa. Alal misali, Singer et al. [96] sake nazarin karatun da suka danganci ka'idodin kwayoyin halitta na GD bisa ga ra'ayin cewa kaddarawar GD a kwanan baya kamar yadda ake yi a Addictive a cikin DSM-5 ya nuna cewa "irin wadannan abubuwan da suke da hankali da kuma motsa jiki na iya haifar da caca da kuma amfani da kayan abu"96] (shafi 1). Musamman ma sun bayyana wasu karatun da suka ba da tallafi ga ra'ayin cewa nunawa ga ladaran rashin daidaituwa zai iya haifar da amsawar aberrant a cikin tsarin dopamine, wanda hakan ya haifar da gamsuwa ga sassauci ga alamun sakamako. Har ila yau, masu nazarin sun shafi rubuce-rubucen da ke nuna cewa cortisol na taka muhimmiyar rawa wajen tsara motsawar motsa jiki a cikin harshe na kwakwalwa, wato, cewa matakan cortisol a cikin caca addicts ya dace da haɓakawa tare da maganganun ƙwararrakin da aka samu a cikin lambobin kuɗi.
A ƙarshe, nazarin kwanan nan ta Romanczuk-Seiferth et al. [97] ya fara daga gabatarwa cewa akwai tsohuwar wallafe-wallafen da ke nuna alamun kwayoyin halitta tsakanin GD da SUDs, da kuma cewa wannan karin tallafi ne ga gaskiyar cewa wasu jiyya na musamman ga SUDs na da mahimmanci wajen magance cigaba da caca. Sun yi nazari akan binciken da ba a yi ba ne a kwanan baya, binciken neurophysiological, da kuma nazarin ne na GD dangane da mahimman bayanai guda uku na ka'idojin bincike: Rashin iko, sha'awar / janyewa da kuma watsi da sauran wurare a rayuwa ". Sun kammala cewa hada rukuni na wadannan alamu a wannan hanyar ya ba da "tsari mai amfani don kwatanta tsarin da ke faruwa a GD da SUDs a nan gaba" [97] (shafi 95).
3.2.2. Intanit yanar gizo
Masu bincike sunyi nazarin IA har kusan shekaru biyu. Kimberly Young ya gabatar da bincike na farko game da IA a taron kungiyar ta Psychological Association na Amirka a 1996, kuma akwai daruruwan nazarin da kuma sake dubawa kan batun da aka gudanar tun lokacin. An samu akalla nauyin wallafe-wallafe na 20 da aka buga a cikin shekaru biyar da suka gabata a kan babban labarin IA, da kuma / ko takaddun takaddama na musamman [15,36,47,98,99,100,101,102,103,104,105,106,107,108,109,110,111,112,113]. Daga cikin wadannan nazarin, akalla 10 sun sake nazari, a cikin wani ɓangare ko cikin duka, bincike game da binciken neurobiological game da IA [15,104,105,111,114,115,116,117,118,119].
A cikin wallafe-wallafen su a kan labarun "Intanet da Gaming Addiction", da aka buga kafin a saki DSM-5, Kuss da Griffiths [105] lura;
Shawarwar yanar gizo ta ƙunshi nau'o'in ayyukan Intanet tare da ƙwarewar rashin lafiya, kamar cinikayya, cin kasuwa, caca, ko sadarwar zamantakewa. Wasan kwaikwayo na wakiltar wani ɓangare na gine-ginen Intanet wanda aka tsara, kuma cin abincin wasan kwaikwayon ya zama mafi yawan nazarin irin nau'in buri na Intanet har zuwa yau.
[105] (shafi na 348)
Duk da haka, akwai mummunan damuwa da matsalar matsalar "Intanit yanar gizo" da kuma "Cibiyar wasan kwaikwayo ta yanar gizo". Alal misali, APA ta bayyana abin da ya faru game da NI tare da ƙaddamar da IGD a cikin DSM-5 lokacin da suka bayyana "matsalar labarun Intanit (wanda aka fi sani da rashin amfani da Intanet, Intanit yanar gizo, ko cin gashin wasan kwaikwayon) ya cancanta a matsayin rashin zaman lafiya "([12], p. 796). APA ta ƙaddamar da wannan rikicewa ta hanyar ma'anar 14 na IGD da suka samar a cikin DSM-5 don tallafawa ganewar asali. Abubuwan sha uku daga cikin waɗannan nassoshin sun kasance a cikin mujallolin mujallolin da aka yi, wanda kuma wani abu ne da yake magana kan wani labarin mujallar pop-culture ("Wired") game da IA a kasar Sin. Daga cikin shafukan da aka bincika game da} aramin, wa] ansu abubuwa uku ne kawai aka mayar da hankali ga yanar-gizon Gaming [120,121,122]. Daga cikin abubuwan da ke cikin 10, dalibai hudu da ake magana da su a wasan kwaikwayon kamar ɗaya daga cikin kashi uku na IA [34,116,123,124], wani wasan kwaikwayon da aka yi la'akari da shi a matsayin daya daga cikin goma subtypes [125], uku aka yi amfani da kalmomin "wasan" da kuma "wasan kwaikwayo" tare da wasu shafukan yanar gizo kamar "caca" da "batsa" [126,127,128], kuma biyu suna magana akan "Amfani da Intanit" kullum ba tare da subtypes [129,130].
Duk da yadda APA ta sake fasalin, wasu masu binciken, ciki har da mai bincike na kwayoyin halitta Guangheng Dong, sun ci gaba da komawa ga IGD a matsayin mai tawali'u na IA [131,132,133,134,135]. A cikin sake nazarin kwanan nan, aka saki bayan da aka buga DSM-5, Brand, Young da Laier [15] ya bayyana:
APA yanzu ta maida hankali kan wasannin Intanet. Muna jayayya, duk da haka, cewa ana iya amfani da wasu aikace-aikacen cikin jaraba… Sabili da haka, muna taƙaita sakamakon binciken da ya gabata a kan jarabar Intanet ta hanya mafi fadi, kodayake yawancin karatun da aka buga har zuwa yanzu suna kan wasan Intanet.
[15] (shafi na 2)
Hakazalika, don manufar wannan bita, duk wani binciken da ke tattare da IGD a matsayin ƙaddara na IA an ƙaddara a matsayin nazarin IA don manufar wannan bita, kodayake mutane da yawa suna amfani da wasan kwaikwayon a matsayin misali na misali. Alal misali, Weinstein da Lejoyeux [116] nazarin abubuwan da suka shafi "Intanit yanar gizo" da "amfani da yanar-gizon mai matsala" da aka buga a Madline da PubMed tsakanin 2000-2009. Duk da yake wannan binciken ba shi da ƙayyadadden kwayoyin halitta ba, waɗannan mawallafa sunyi rahoton taƙaitaccen binciken akan wannan yanki, suna kammalawa:
Sakamakon ya nuna cewa ƙananan ginshiƙan abubuwan da ake dasu a cikin wasan kwaikwayon wasan kwaikwayon na yanar gizo sun kasance kama da abin da yake da sha'awa a cikin abin da ya dace. Saboda haka, sakamakon da ya nuna cewa wasan kwaikwayon wasan kwaikwayon na wasan kwaikwayon ta yanar gizo da kuma sha'awar abu mai karfi zai iya raba irin wannan tsarin neurobiological.
[116] (shafi na 279)
Kuss da Griffiths [105] wallafa wallafe-wallafen wallafe-wallafe game da kwayoyin halitta na "yanar-gizon Intanet da Gaming", inda suke gabatar da wani nau'i na nazarin da aka ba da takamaiman abubuwan da ke kan labarun intanet ko abubuwan da ke da labarun Intanet ba tare da wani mahimmin bayani ba. Hakazalika Weinstein da Lejoyeux ta nazarin [115] "Sabbin abubuwan da ke faruwa a kan abubuwan da ke tattare da kwayoyin halitta da kwayoyin maganin kwayoyin halittu da ke tattare da yanar-gizon yanar gizo da kuma labarun fim" sun hada da kalmar "Intanet da kuma cin zarafi" a cikin takardun su, duk da cewa ikon yin nazarin su na musamman ne ga wasanni. Ko da kuwa rashin daidaitattun yankuna, yana da mahimmanci a lura da cewa yawancin sakamakon binciken duka su ne kai tsaye tare da yawancin kwayoyin neurobiology da aka ambata a cikin abubuwan da ake ganowa [4,43,44,51,55,56,57,61]. A matsayin wani ɓangare na waɗannan binciken, ana gano tsarin sakamako na mesocorticolimbic da za a yi tasiri kamar yadda ake amfani da magungunan abu, kamar yadda abin mamaki ne wanda ya haifar.
Masu bincike daga Instituteungiyar ofwararrun Nationalwararrun inwararru a Meziko ma sun gudanar da bita kan batun IA. Wadannan masu binciken sun binciki rarrabuwa, rashin kamuwa da cuta, ganewar asali, ilimin kimiyyar lissafi, cututtukan cututtukan dabbobi, kwayar halittar kwayoyin, binciken kwayar halitta, da kuma magani (magani da mara magani) na rashin lafiyar. Dangane da binciken da suka yi, masu binciken sun yanke shawarar cewa "an gudanar da bincike na asibiti da na kwayar halitta kan batun… tare da binciken da ke zuba bayanai daga sassan duniya daban-daban"111] (shafi na 1, 7). Bugu da ƙari, a cikin nazarin su na mayar da hankali kan samfurin maganin IA, Winkler et al. [118] Har ila yau, ya ruwaito "farfado da gwagwarmaya tare da bayyanar cututtukan da ke hade da haɓaka da halayyar dabi'u da sauran ƙari [118] (shafi na 326) ".
Wata nazari na baya-bayan nan da aka mayar da hankali game da muhimmancin ayyukan kulawa na farko a IA kuma ya taƙaita nazarin neuropsychological da neuroimaging a kan wannan batu [15]. Masu marubutan sun ɗauka cewa ana iya rarraba IA a cikin Ƙasashen gaba ɗaya da kuma na musamman IAs, misali, IGD ko IPA. A cikin layi tare da samfurori da aka ambata a baya [4,43,44,51,55,56,57,61], kuma musamman bisa ga sakamakon da aka samu daga binciken nazarin ne a cikin yanar gizo na yanar gizo, wadanda marubutan sun ɗauka cewa ana ganin alaƙa ne da tsari, kuma ƙwararren kwakwalwar da aka fi sani da kwakwalwa ta canzawa (misali, ƙananan ƙafa da ƙananan haɓaka) da kuma ƙyama (misali , sassan basal ganglia) wuraren kwakwalwa. Wadannan kwakwalwa suna canje-canje na daukar nauyin ƙananan gida na ragewa a cikin shugabancin jagorancin, musamman ma a lokuta da alamun da ake magana da su game da jaraba. Brand et al. gabatar da samfurin halayen-halayen ƙwararru da ƙididdigewa ta musamman da ke jaddada ƙarfafawa da ƙwarewa ta hanyar amfani da Intanet, wanda zai haifar da haɓakawa da haɓakawa. Masu marubuta sun nuna cewa matakan da za a iya haifar da haɓaka da kuma sha'awar iya kara matsalolin matsalolin gudanarwa a cikin ayyukan gudanarwa [15].
Meng da abokan aiki [114] ya gudanar da nazarin littattafai na farko na nazarin littattafai / maganin bincike-bincike na FMRI akan IGD. Wadannan mawallafa sun fara ne da abubuwan 61, wanda suka karfafa su zuwa nazarin nazarin nazarin kwakwalwa na 10. Masu marubuta sun sami mahimmanci na yau da kullum na lalacewar lobe na gaba, kuma ta haka ne ya ce, "Idan muka la'akari da rawar da ake yi na lobe na farko a cikin sakamako da tsarin tsarin kai, sakamakonmu ya ba da shaida mai goyan baya don ƙaddamar da IGD a matsayin fasikanci hali" [114] (shafi 799).
A cikin wata nazarin wallafe-wallafen kwanan nan game da kwayoyin halitta na IA, Zhu, Zhang da Tian [119] musamman nazarin kwayoyin halitta ta hanyar binciken neuroimaging yin amfani da yanayin magnetic resonance imaging (fMRI), kwaikwayon watsi da kwayoyin halitta (PET) da kuma simintin photon watsi da aka kirkirar da kwaikwayo. Wadannan mawallafa sun gano cewa ana danganta AI da lalacewa a cikin kwakwalwar kwakwalwa kamar yadda jaraba da ke dauke da abubuwa; da kuma binciken MRI sun nuna canje-canje a cikin kwakwalwa a cikin sharuɗɗa na IA, tare da halayyar ƙwaƙwalwa da halayyar halin kirki waɗanda ke samuwa a cikin matasa na IGD musamman, kasancewa tare da tsarin kwakwalwa yana canzawa a cikin kututtukan da ke gaba da baya da kuma ɓoye wanda ke da halayyar jaraba.
Yawan nazarin karatu a kan jinsi na IA suna fitowa. Alal misali, Montag et al. [136] sun yi iƙirarin cewa sun iya samo wata alama ta kwayoyin NI ta hanyar jigilar kwayoyin halitta ga mai amfani da ƙwayar acetylcholine na nicotinic alpha alphaNNXX (CHRNA4). Wadannan masu bincike sun sami karuwa mai yawa a cikin wani takamaiman polymorphism a kan janin CHRNA4 a cikin shafukan yanar gizo na bidiyo. Bugu da ƙari, Lee et al. [137] ya sami shafukan yanar gizo da suka kamu da su don samun karin magunguna SS-5HTTLPR. Bugu da ƙari, Han et al. [138] sami shafukan yanar gizo masu amfani da yanar gizo don samun karin takalma Taq1A1 da yawa, dukkanin abubuwan da ke cikin COMT da kuma mafi girman sakamakon da suka shafi alaka.
Ayyukan da aka yi kwanan nan na IA sun mayar da hankali ne kawai kan nazarin neuroimaging yayin da yake watsar da binciken EEG mai dacewa. Bincikenmu yana ƙaddamar da binciken nazarin 15 IA EEG, hudu na musamman ga IGD. A cikin nazarin halin kwaikwayo, abin da za a iya amfani da su a cikin yanayin da aka yi a cikin tsarin EEG da kuma abubuwan da suka shafi abubuwan da suka shafi halayya. Abubuwan da suka shafi abubuwan da suka faru (ERPs) sune amsa tambayoyin lokaci ga ayyukan gwaji ko samfurori. Alal misali, Yu, Zhao, Li, Wang da Zhou [139] samfurori da aka gwada ta amfani da ayyuka na auditory oddball kuma sun sami ragewar P300 amplitudes da kuma ƙara PENDNUMX latencies a IA abubuwa idan aka kwatanta da kula da lafiya. Rage P300 da aka ruwaito a wasu abubuwa abusers [140], da kuma bayar da ƙananan ƙwaƙwalwa da ƙaddamar da hankali. Har ila yau mawallafa sun bayar da rahoto game da raunana karfin gamma, wanda aka nuna an danganta da matakan dopamine. Hakazalika, Duven, Müller, Beutel da Wölfling [141] gudanar da wani binciken da ya shafi wasan da wanda ya karbi ragamar. Ƙungiyar ta IGD ta ƙaddara P300 amplitudes da yawa a lokacin binciken sakamako, wanda ya jagoranci marubuta don kammala cewa P300 da aka ƙaddara ya nuna rashin raguwa a tsarin tsarin Gidaran IGD, wanda aka gano a cikin layi tare da abin da ya dace. Ge et al. [142] aiki na auditory oddball aiki da kuma gano muhimmancin ƙara PENDNUMX latencies. Wadannan mawallafa sun sami wadatawar P300 yana ƙarawa don komawa matakan al'ada bayan bayanan da aka kammala shirin CBT na watanni uku. Nazari na biyu na tsawon lokaci ya ruwaito rashin daidaituwa tare da magani ya inganta ƙwaƙwalwar ƙwaƙwalwar ƙwaƙwalwa da kuma daidaitawa na P300 amplitudes da latencies [143]. Wadannan binciken biyu na ƙarshe sun nuna cewa canje-canje na iyawa zai iya haifar da IN.
Zhou, Yuan, Yao, Li da Cheng [144] samfurori da aka gwada ta amfani da ayyukan Go / No-Go na gani kuma sun bada rahoton mafi girma da rashin ƙananan N2 amplitudes a cikin ayyukan IA idan aka kwatanta da kulawar lafiya. Ƙananan N2 amplitudes a neuropsychological gwaje-gwaje a layi daya binciken a cikin barasa amfani da cuta [145]. Wadannan masu binciken sun bayyana a karshen su, "Sakamakon wannan binciken ya nuna a sarari cewa mutane masu dauke da cutar PIU sun fi saurin nuna karfi fiye da sarrafawa da kuma musayar cututtukan kwakwalwa da na ERPs na wasu rikice-rikice, kamar caca da cuta, shan kwayoyi, ADHD ko shan giya…" [145] (shafi 233). Hakazalika, Dong, Zhou da Zhao [146] ya ruwaito cewa 'yan batutuwa NA wadanda suke da alaka da sarrafawa suna nuna ƙananan N2 amplitude da kuma ƙarar P300 da yawa. Bugu da kari, Yang, Yang, Zhao, Yin, Liu da An [147] ya gano cewa mabiya AI, irin su masu amfani da magungunan, sunyi aiki mafi girma a ayyukan NoGo. Shirin Go / Babu-Go wanda ya shafi '' 'yan wasa masu yawa' ya haifar da sakamako mai kamala [148]. A ƙarshe, Yu, Zhao, Wang, Li da Wang [149] ya yi amfani da nauyin sarrafa nauyin jigilar nau'in N400 a tsakanin masu amfani da Intanet da kima. N400 amplitude ya kasance ƙananan a cikin masu amfani da Intanet mai zurfi, yana nuna ƙwarewar ƙwarewa ta hanyar dawo da fahimtar ilimin. An gano irin wannan binciken ne game da masu shan barasa da masu yin amfani da cannabis masu nauyi [140].
Zhou, Li da Zhu [150] yayi amfani da aikin Erikson flanker da aka gyara, kuma ya ba da rahoton raguwar abin da ya shafi abin da ya faru (ERN's) a cikin batutuwa masu larurar Intanet idan aka kwatanta da sarrafawa. ERN's rukuni ne na ERP kuma suna nuna kuskuren kwakwalwa lokacin da batutuwa suka yi ƙoƙari don sarrafa hankali da impulsivity-ƙananan ƙarancin ERN, mafi girman dama cewa kwakwalwa ba za ta iya gyara kuskuren kuskuren kuskure ba. Mawallafa sun ambaci karatun da ke nuna ƙananan ERN a cikin ADHD da shan ƙwayoyi, suna kwatanta yadda marasa lafiya ke da wahalar kawar da yunƙurin karɓar lada na ɗan gajeren lokaci duk da mummunan sakamako na dogon lokaci. Dangane da rashin ƙarancin ERN ga gazawa a cikin aikin zartarwa, waɗannan masu binciken sun kammala, “Sakamakon wannan binciken a bayyane ya nuna mutane tare da jarabar Intanet sun fi saurin motsa jiki fiye da sarrafawa da kuma raba halayen neuropsychological da halayen ERN na wasu rikice-rikice, kamar caca-cuta, cin zarafin abu…” [150] (shafi 5). Yau, Potenza, Mayes da Crowley [151] ya yi amfani da Tasirin Abincin Rashin Analog na Balloon (BART), kuma ya bayar da rahoton ƙananan halayen (FRN) da kuma P300 amplitudes a cikin "masu amfani da matsala masu amfani" idan aka kwatanta da sarrafawa. Bisa ga waɗannan marubuta, rashin kulawa da karɓa a lokacin ɗaukar haɗari na iya taimakawa wajen ci gaba da amfani duk da sakamakon da ya faru. Dong, Zhou da Zhao [152] samfurori da aka gwada ta amfani da kalma-launi na Stroop, kuma sun bada rahoton ƙananan ƙananan haɗin gwiwar gabas (MFN) a cikin Ayyuka IA idan aka kwatanta da sarrafawa. Tare da ƙarin kurakuran da aka mayar da martani, waɗannan marubuta sun ruwaito cewa wannan binciken yana nuna rage aikin zartarwa, wani ɓangaren ɓangaren ƙari.
Wani binciken ERP daya ne kawai idan aka kwatanta da haɓakawa a cikin 'yan wasa masu kwarewa da yawa da kuma masu wasan kwaikwayo na kwamfuta. Cikin jituwa da ilimin maganin abubuwa, Thalemann, Wölfling da Grüsser [153] ya samo mafi girma daga cikin 'yan wasa masu yawa a cikin' yan takara masu yawa idan aka kwatanta da 'yan wasan da ba su damu ba. A ƙarshe, an buga wallafe-wallafen EEG guda biyu. Wadannan nazarin sun ruwaito rahoton da kungiyar IA ke da ita a kan iyakar sassan delta da beta idan aka kwatanta da sarrafawa. Dukkan karatu biyu sun nuna cewa waɗannan bambance-bambance na iya zama alamomin neurobiological na IA [154,155]. A haɗuwa, binciken na EEG ya ba da ƙarin shaida cewa waɗanda ke fama da ita suna da yawa a cikin waɗanda suke fama da rashin karfin jiki idan aka kwatanta da sarrafawa.
3.2.3. Cibiyar Tambaya ta Intanet
An shirya NASU gaba daya don shiga cikin DSM-5 sau biyu, sau ɗaya tare da wasan kwaikwayo kamar subtype, kuma sau daya ba tare da wani tsari ba [17,34]. Amma, IGD ba a ba da shawara ba ne don shiga cikin DSM-5, don haka ba ta hanyar hanyar yin sharhi ba. Duk da haka, a cikin sa'a na karshe, APA ya ba da damar shiga IGD sashe 3-Da'aƙai don Ci gaba Nazarin, yayin da aka sallami AI. Akwai wani jigon bincike game da batun "Intanit Intanit", kuma yana iya zama da wuya a rarraba ko karatu ne ainihin ƙayyadaddun ga IGD, ko rufe IA a gaba ɗaya tare da wasan kwaikwayon a matsayin subtype. Tabbatacce ne cewa yawancin batutuwan da aka fi sani da su ne mafi yawan lokuta suna nazarin digiri, kamar yadda yawancin binciken bincike na kimiyya akan abin da ke faruwa na kasar Sin ya fito ne daga Sin da Koriya ta Kudu, kasashen da IP ta kaddamar da ita, sabili da haka bincike kan IPA ya rasa [156].
Wannan bita ya bi ka'idodin asali, la'akari da wasan kwaikwayon a matsayin subtype na IA. Kamar yadda wannan takarda ya fi mayar da hankali kan wani nau'i na IA, IPA, an ba da hankali sosai ga IGD a matsayin mai ƙyama ko rashin lafiya. Kamar yadda irin wannan, an haɗu da rahoto na binciken binciken ne a kan duka IA da IGD. Duk da ikirarin da aka ƙayyade bincike akan batun [12,16,46,47,157,158,159], fashewar shekara ta kwalejin ƙwararrun kwakwalwa (ba tare da sake dubawa ba) a kan IAE da kuma IGD da ke ƙarƙashinsu ya nuna cewa kwakwalwar karatu a cikin goyon baya na IA a wannan filin suna hawa da sauri:
- Kafin nazarin 2009-6,
- Nazarin 2009-4,
- Nazarin 2010-8,
- Nazarin 2011-9,
- Nazarin 2012-14,
- Nazarin 2013-19,
- Nazarin 2014-23, kuma
- 2015 (ta Yuni) -16 binciken.
An tsara su ta hanyar fasaha, waɗannan nau'o'in kwakwalwa sun sami nazarin nazarin 44 fMRI [103,132,134,135,160,161,162,163,164,165,166,167,168,169,170,171,172,173,174,175,176,177,178,179,180,181,182,183,184,185,186,187,188,189,190,191,192,193,194,195,196,197,198,199], 23 tsarin binciken MRI [124,128,131,133,200,201,202,203,204,205,206,207,208,209,210,211,212,213,214,215,216,217,218], Nazarin halittun nukiliya 6 (PET / WAS) binciken [117,129,219,220,221,222], 15 EEG binciken [42,139,141,143,144,146,148,149,150,152,153,154,155,223,224], da kuma nazarin ilmin lissafi na 7 [121,138,225,226,227,228,229].
Wannan shaida mai zurfi na kimiyya ba ta bada goyon baya mai karfi don amincewa da tsangwama na intanet kamar rashin lafiya. Bugu da ari, bincike na ci gaba da fitowa a kan wani tsari da aka tsara na zamantakewar zamantakewar yanar gizo / facebook, duk da haka waɗannan ba su da nazari ne kawai don haka ba a cikin wannan takarda don sake dubawa ba [100,104,171,230,231,232,233,234,235,236,237,238,239,240,241].
3.2.4. Abun ciki mai haɗari da jima'i
Childress et al. [242] sun gudanar da wani binciken da suka dauki nauyin cutar ta CMRI na marasa lafiyar cututtukan cocaine da aka gabatar da sauri (33 millisecond), abubuwan da aka gani a hankali (siffofin da ake danganta da miyagun ƙwayoyi). Har ila yau, wadannan batutuwa sun nuna alamun abubuwan da ke tattare da jima'i (siffofi). Masu binciken sun sami damar yin amfani da wannan tsarin da ake amfani da su a madaidaiciya a cikin batutuwa da aka nuna alamun jima'i kamar yadda aka nuna da alamun da ake nunawa da miyagun ƙwayoyi. A cikin wallafe-wallafen su na nazarin nazarin binciken da aka yi game da sake juyayin jima'i, Georgiadis da Kringelbach [243] ya kammala, "ya bayyana a fili cewa cibiyoyin da ke tattare da halayyar jima'i na mutum sune kama da cibiyoyin sadarwa da ke aiki tare da sarrafa sauran lada" [243] (shafi 74).
Frascella, Potenza, Brown da Childress [244] gudanar da nazarin wallafe-wallafen nuna bambanci da halaye uku na halayen shan barasa, wasan caca, kiba, da kuma magunguna na jima'i. Mawallafa sun kara girman ikon Childress et al. [242] nazarin, kuma ya kammala aikin kwakwalwar hoto game da jima'i, soyayya da kuma haɗe-haɗe suna ba da cikakkun shaidu ga tsarin faɗaɗawa amma mai ganowa wanda ke tsakiyar yanayin halitta, hanyoyin ba da lada na kwayoyi da ayyukan rayuwa ƙauna da haɗe-haɗe sun cika (VTA, NAcc, amygdala, ventral pallidum, orbitofrontal cortex). Hasashe yana da hujja cewa yana danganta lada mai kyau ta rayuwa tare da jarabawar abubuwa, faɗaɗa tsarin kwakwalwa don magance ta, da haɓaka fahimtarmu game da wajabcin ƙarfin halaye [242] (shafi 15).
Kamar yadda aka fada a baya, samfurin RDS ya haɗa da halayen halin jima'i a cikin jerin matsaloli na RDS [245,246,247,248].
Kalmar "Rashin Ingancin Rashin wardimawa" an fara kirkirarta… a 1995, kuma yanzu kamfani na Microsoft Dictionary ya fassara ta da "brainwaƙwalwar ƙwaƙwalwa na ba da lada ga ƙoshin jini ko rashin lahani wanda ke haifar da halayyar neman yardar rai wanda ya haɗa da kwayoyi, yawan abinci, jima'i, caca / caca da sauran halaye ”.
[249] (shafi na 2)
Wataƙila mafi girman girma na karatun da ke nuna ainihin yanayin da ke tattare da halayen jima'i kamar yadda aka saba da shi ya ƙunshi mahimmanci na ɗan littafin transta DeltaFosB. An tabbatar da cewa magungunan magungunan ƙetare matakan da aka rubuta na DeltaFosB a cikin tsarin sakamako, wanda ya haifar da mayar da martani ga sakamako da ladabi da aka ba da ita, ya kara da hankali ga abubuwan da ake danganta da jita-jita, da kuma rashin haɓaka ga halin halayya da sake dawowa [2,73,250,251,252]. Yi la'akari da cewa wannan jerin bincike dole ne ya yi amfani da dabbobi marasa lafiyar jiki, irin su mice, berayen, da kuma hamsters, a matsayin wani bangare na binciken da ake buƙatar yin amfani da su don samun dama da kuma auna DeltaFosB intracranial. Alal misali, masu bincike sun yi amfani da ƙwayoyin ƙwayoyin halitta na hanyar sarrafawa DeltaFosB a cikin tsarin ladabtarwa a matakan da suka dace da wadanda ke shan magani. Lokacin da aka gabatar da cocaine a karo na farko, waɗannan ƙwayoyin sun nuna karin haske ga miyagun ƙwayoyi kuma sun amsa kuma suna nuna hali kamar irin na berayen da suka kamu da su ta hanyar amfani da ita [253]. Masarrafan da yawa da aka yi amfani da su da aka yi amfani da su a cikin Siriya sun yi amfani da su don ragewa DeltaFosB sunyi mayar da hankali akan tasirin jima'i, kuma sun sami fahimtar irin wannan yanayin don yin jima'i [254,255]. Wallace et al. [256] a hankali ya haifar da wannan ƙwarewa a cikin dakin gwaje-gwaje ta hanyar "halin jima'i na yau da kullum". Wadannan mawallafa sun sami maimaitawar jima'i da yawa sun kara yawan matakan DeltaFosB a cikin NAcc idan aka kwatanta da controls, kodayake yawan karuwar yawanci ya fi ƙasa da magunguna. Pitchers et al. [257] kamar yadda aka kwatanta da samar da manyan matakai na DeltaFosB a cikin NAcc, ya kara gano wannan tayin da za a yi amfani da shi wajen karfafa halayen jima'i. Bincike haɗin haɓaka na halitta da magani, Pitchers et al. samo mice don samun karin haske ga amphetamines bayan maimaita abubuwan jima'i [258]. Wadannan mawallafa sun kammala, "Harkokin jima'i yana haifar da canje-canjen aiki da na morphological a cikin tsarin mesolimbic kamar kamuwa da maimaitawa ga malaman mahaifa" [258] (shafi 1). Pitchers et al. [2] ya tabbatar da wadannan binciken, yana nuna cewa sakamakon lada (dabi'un jima'i) da magunguna na cin zarafi (amphetamines) suna aiki a kan hanyar da suke biye da hanyoyin, yayinda suka cigaba da goyon bayan jayayya don cin zarafi, ciki har da IPA.
3.2.5. Intanit Intanet
A cikin littafinsa mai karɓa akan neuroplasticity, The Brain That Changes itself [259] Norman Doidge ta taƙaita binciken da aka yi game da jaraba da tsarin ladabi, kuma ya bayyana cewa ci gaba da cire dopamine a cikin tsarin ladabi idan mutum yayi kallon batsa na Intanit tare da kallon lokaci ya motsa canje-canjen neuroplastic da ke ƙarfafa kwarewa. Doidge ya ci gaba da bayyana yadda wadannan canje-canjen neuroplastic sun gina taswirar kwakwalwa saboda tashin hankali. Ya gabatar da ƙarin haɗin haƙuri, a cikin taswirar ƙwaƙwalwar kwakwalwa ta yau da kullum don '' dabi'a '' '' 'ba za a iya kwatanta su da ci gaba da ingantaccen taswirar da aka gina ta hanyar ci gaba da kallon kallon batsa na Intanet ba, kuma haka ne mutum ya cigaba da cigaba da yin amfani da Intanet batsa don kiyaye matsayi mafi girma.
Neurosurgeons Hilton da Watts [260] wallafa wani sharhi a cikin Journal M Neurology International wanda suka wakilci "Addinan batsa: Bangaren da ba'a gani". Mawallafa sun bayar da taƙaitaccen wallafe-wallafen wallafe-wallafen sabunta gardamar cewa dukkanin bayyanuwar jarabawa sunyi aiki ta hanyar mahimman hanyoyin. Marubuta sun haɗa da yawancin binciken da aka ambata a baya; Rawar da DeltaFosB ke yi a cikin jaraba na al'ada, canje-canje neuroanatomical da ke haifar da halayen kisa, canje-canje a cikin karfin mai karɓa na dopamine, da kuma tasirin halayen halayya akan tsarin sakamako. A cikin jawabin da suka yi wa takardun su, Hilton da Watts sun bayyana muhimmancin samun ra'ayi mai zurfi game da binciken da ake ciki, inda ya kammala, "Majiyarmu ita ce za a iya ganin atrophy zaɓi na yankuna masu cortical da ke da alaƙa na hanyoyi a cikin wani haske neuromodulatory, an bayar da bincike na yanzu da ke tabbatar da neuroplasticity a overindulgence a cikin sakamako na halitta, musamman jima'i "[261] (shafi 6). Hilton wallafa wallafe-wallafe na biyu da kuma irin wa]24], kuma ya sake jaddada muhimmancin tasirin binciken DeltaFosB kamar yadda ya sanar da binciken da ba wai kawai jima'i ba, amma yawancin batutuwa na batsa.
An fara nazarin shirin na farko na FMRI wadda aka tsara a hankali a kan IPA a 2014, lokacin da farko a jerin jerin Jami'ar Cambridge sun sami irin wannan kwakwalwa kamar yadda aka gani a cikin magungunan miyagun ƙwayoyi da masu shan giya [262]. A cikin wannan bincike mai zurfi an gudanar da gwajin gwaje-gwaje don auna ma'aunin jigilar kwayoyin halitta da kuma haɓaka, idan akwai, a cikin batutuwa masu halayen halayen jima'i (CSB). Ka lura cewa wannan binciken ya ƙunshi jerin abubuwa biyu na bincike. Na farko, binciken ya bincika "bambanci" da bambanci ga CSB da kuma batutuwa na CSB. An nuna batutuwa da bidiyo da ciki da kuma waje na hotunan fMRI. Kowace lokaci, an tambayi batutuwa don yin la'akari da abubuwan da suka dace ta hanyoyi daban-daban ta hanyoyi guda biyu: "Yaya wannan ya karu da sha'awar jima'i?" Da kuma "Nawa kake son wannan bidiyon?" [262] (shafi 3). Wannan binciken ya haifar da sakamako guda biyu: (1) Idan aka kwatanta da batutuwa masu kula da lafiyar, batutuwa na CSB sun bada ra'ayi mafi girma ga bidiyo na bidiyo, amma ba ga shirye-shiryen bidiyo ba; (2) Idan aka kwatanta da kulawar lafiya, rubutun CSB sun bayar da rahoton mafi girman ra'ayi akan shirye-shiryen bidiyo, amma ba ga bayyane ba. Wadannan sakamakon ya nuna rashin haɓakawa tsakanin ƙauna da masu buƙata ta CSB a yayin kallon fina-finan bidiyo. Wadannan sakamakon sun sake haifar da sakamakon binciken da ya dace a kan ka'idar da ake damuwa game da jita-jita, inda addicts ke nuna matakan da suka fi girma amma suna ba da lada mai kyau.
Sashen na biyu na binciken da ke cikin wannan binciken ya nuna sakamakon lalatawa na al'ada (CSB), hotuna na intanet a musamman. Nazarin farko sun nuna lokuttan kwakwalwa na yau da kullum da ake aiki a lokacin jihohi da kuma maganin magungunan miyagun ƙwayoyi ga barasa, cocaine, da nicotine; a tsakanin wasu, amygdala, dACC, da ventral striatum [263]. Yayin da masu bincike a cikin binciken da aka yi a yanzu sun sami wadannan yankuna don a kunna su a cikin batutuwa CSB da wadanda ba na CSB ba a lokacin da aka nuna alamun jima'i, masu bincike sun sami karfin haɓaka a cikin batutuwa na CSB. Bisa ga waɗannan sakamakon, Voon et al. [262] kammala:
Binciken da ke faruwa yanzu da sauransu yana nuna cewa cibiyar sadarwar da ta keɓaɓɓe ta wanzu ne don karuwar jima'i da maganin magunguna a kungiyoyi tare da CSB da kuma maganin ƙwayoyi. Wadannan binciken sun nuna cewa ci gaba da rikici a cikin cibiyoyin sadarwa da ke tattare da amfani da kwayoyi da kuma sakamakon ladabi ".
[262] (shafi na 9)
Babu shakka, wadannan masu bincike sun bayar da rahoton cewa 60% na batutuwa (matsakaicin shekarun: 25 shekaru) yana da wuyar wahalar kayan aiki / haɗin kai tare da abokan hulɗa, duk da haka zai iya ci gaba da yin tasiri tare da batsa na intanet. Ka lura cewa wannan binciken yana cikin layi tare da ainihin sakamakon binciken da aka yi a kwanan nan don ɗaukar in ba haka ba [264].
Kühn da Gallinat [263] gudanar da nazarin MRI tare da shafukan maza maza da sittin da hudu (wadanda basu da CSB) da kuma lokuttan da suka shafi hulda na yanar gizo akan abubuwan da ke bayyane a cikin mako daya da kuma shekaru da amfani da tsarin dorsal da haɗin kai. An bayar da rahoton manyan sakamako uku. Na farko, tsawon lokaci da karin sa'o'i a kowane mako na yin amfani da shi tare da ƙarar ƙarar launin toka a cikin kyancin dama. Yayin da caudate ke aiki da ayyuka masu yawa masu yawa, canjin canji a cikin striatum suna haɗuwa da yawancin rikitarwa, yayin da jagorancin canji ba daidai ba ne. Na biyu, karin shekaru da karin sa'o'i a kowane mako na yin amfani da shi tare da aikin hagu na hagu don amsawa ga ɗan gajeren lokaci, har yanzu siffofin jima'i. Ayyukan FMRI sun tabbatar da cewa ana amfani da safan a lokacin yunkurin jima'i [265,266]. Mawallafa sun nuna wannan ƙananan ƙananan na iya kwatanta rashin haƙuri da aka samu ta hanyar rushewa: "Wannan ya dace da tsammanin cewa mummunar ɗaukar hotuna ga rikice-rikice na batsa ya haifar da rashin daidaituwa game da yanayin da ke tattare da ita akan yanayin jima'i" [236] (misali E6). Ba da amsa mai karfi ga 9-na biyu na bidiyon bidiyo na Voon et al. [262], yana iya kasancewa taƙaice (530 milliseconds) bayyane zuwa har yanzu hotuna ba su zama alamomi ga masu kallon bidiyo na yau da kullum ba, kuma suna da kyakkyawan hanya wajen auna rage yawan jima'i. A madadin haka, wadanda ba wadanda ba a taba yin amfani da su ba a nan suna iya amsawa daban-daban fiye da yadda addicts zasu yi. A ƙarshe, an gano batutuwa da suka cinye wasu batsa masu tsauraran ra'ayi don samun rashin haɗin kai a tsakanin kullun da ya dace kuma suka bar magungunan farko (DLPFC). Duk da yake DLPFC yana da damuwa da ayyukan gudanarwa, an haɗa shi da mayar da martani ga magungunan kwayoyi da wasanni na intanet. Rushewar da ke cikin wannan tafarki suna cikin kwayoyi da halayyar hali. Musamman, rashin haɗin aikin aiki a tsakanin DLPFC da caudate (kamar yadda aka samu a binciken yanzu) yana cikin jarabawar heroin [267].
Yawancin gabatarwa da ke nuna alamun da ake zuwa a kan ilmin kwayoyin halitta na IPA sun fito ne a taron 2015 2nd na Duniya game da Addictions a Budapest, Hungary. Yi la'akari da cewa waɗannan su ne duk taron tarurruka kuma ba a buga su ba a cikin mujallun mujallolin jarrabawa. Suna bayar da ƙarin tabbaci, game da gaskiyar cewa akwai hanyar bincike mai sauri. Alal misali, Gola, Wordecha, Sescousse, Kossowski da Marchewka [268] gabatar da su a kan binciken su na FMRI akan mutane da ke nuna hotuna a kan yanar gizo CSB. Wadannan masu bincike sun bi samfurin nazarin [269], inda masu bincike suka sami karfin karuwa a sakamakon maganin cigaba (wanda aka auna ta hanyar gajeren lokaci) da kuma mayar da martani a cikin sakonni na kwakwalwa lokacin da aka nuna alamomin da ba a jaraba ba. A cikin nazarin su, Gola et al. samo sakamakon sakamako kamar yadda ya kamata; Abubuwan da ke cikin CSB sun nuna karuwa sosai ga abin da ake kira addictive (erotica) idan aka kwatanta da sarrafawa, duk da haka ba su sami amsar damuwa ba game da abubuwan da ba a jaraba ba. A cikin irin wannan binciken na FMRI, Brand, Grabenhorst, Snagowski, Laier da Maderwald [270] ya sami mazaje maza da namiji sun sami karfin hali na kwakwalwa don amsawa ga abubuwan da suka fi son batsa. Bugu da ƙari, haɓakawa a cikin aikin da aka danganta da digiri na gunaguni na duniya saboda labarun Intanit. Wehrum-Osinsky, Klucken da Stark [271] ya ruwaito akan wani binciken da ake yi na fMRI mai kama da irin su da ake kira 20 da ke ba da rahoton yin amfani da hotuna na batsa da 20. Duk da yake ba a haɗa su da cikakkun bayanai game da nazarin su ba a cikin abin da aka wallafa a rubuce, waɗannan mawallafa sun bayar da rahoton gano "gyare-gyare na gyare-gyare na al'ada a cikin mai haƙuri idan aka kwatanta da ƙungiyar kulawa" [271] (shafi 42).
Ko da yake mafi yawan neuropsychological fiye da kwayoyin halittu, an gudanar da nazari da yawa akan tasirin hotunan intanet wanda ke kallo a kan ayyukan da ake da hankali. Wannan jigon bincike yana da nasaba da takarda na yanzu a cikin cewa hanyoyin da ke tattare da maganin neuropsychological suna da kyau. Alal misali, Fineberg et al. [272] wallafa wani labarin da suka yi nazari a cikin inda suka bincika haɗin tsakanin masu bincike da yawa a cikin neuroscience. A cikin aikin su, waɗannan marubuta sun ba da tebur wanda suka tsara ɗakunan yankuna ne (siffofin daban-daban na impulsivity da compulsivity) zuwa binciken neuroanatomical da neurochemical. Yin amfani da GD a matsayin samfurin, waɗannan mawallafa sun haɗa nauyin halayen sassa kamar su mabitofrontal cortex (OFC) da haɗin gwiwa da masu amfani da neurotransmitters irin su serotonin da serotonin / dopamine (bi da bi), kamar yadda ƙayyadaddun ayyuka suke aunawa kamar yadda yanke shawara da lokacin amsawa . Hakazalika, a cikin nazarin da suka gabata, Fineberg et al. [78] ya ruwaito cewa binciken da suka samu "ya kasance tare da wadanda ke dauke da kwayoyi masu amfani da caca da matsalolin shan barasa inda ƙungiyoyi biyu suka nuna rashin ƙarfi, amma ƙungiyar masu shan barasa sun nuna rashin lahani a kan tunanin aikin gudanarwa da ya shafi ƙaddamar da DLPFC" [78] (shafi 15). Saboda haka, mun yi imanin cewa bayar da rahoton waɗannan binciken neuropsychological binciken da ke tattare da tsangwama ga aiki da jima'i da haɗin gwiwar tare da ayyukan gudanarwa yana da amfani ga wannan nazarin binciken kimiyya na kwakwalwa da aka mayar da hankali game da matsalar IPA.
An tsara wasu darussan dabaru na gwaji don bayyanawa da bincika ayyukan gudanarwa [273]. Bugu da ƙari, aikin gudanarwa yana bayyana rikitarwa tsakanin wurare da dama don neman sauƙaƙa da halayen manufa, misali, mayar da hankalin hankali, ƙuntatawa (mahimmanci) bayanai, sauyawa tsakanin (dacewa) bayanai, tsarawa, saka idanu, da ƙayyade bayanai a ƙwaƙwalwar ajiyar aiki [274,275] wanda za a iya shafarwa da kuma tsangwama ta hanyar motsin rai [273]. Game da haɗin gine-gine na ayyuka na zartarwa an nuna cewa sun kasance sun kasance a cikin ƙwayar da ke gaba, amma sun bambanta tsakanin sassan guda ɗaya na ayyukan gudanarwa [276,277,278]. Nazarin neuropsychological da neuroimaging a kan maganin ƙwaƙwalwar da aka nuna sun nuna cewa lalacewa na farko da kuma zartarwar ayyuka suna da nakasa bayan amfani mai amfani [46,279]. An dauki wannan lamari ne don bayyana magungunan miyagun ƙwayoyi mai maimaitawa da kuma fifiko don ƙarfafawa na tsawon lokaci saboda miyagun ƙwayoyi duk da irin mummunan sakamako sakamakon amfani da miyagun ƙwayoyi [280].
A cikin ci gaba da halayyar halayyar jima'i a kan yanar-gizon an tsammanin cewa tsammanin sa ran samun karɓuwa yana taka muhimmiyar rawa [281], tun da tayin jima'i yana ƙarfafawa sosai [241,279]. A jarrabawar, an nuna cewa halayyar haɗari da jima'i zuwa Intanet sunyi dangantaka da bayyanar cututtuka na IPA a cikin maza da mata maza da kuma a cikin ɗan kishili maza [282,283,284,285] da kuma masu amfani da masu amfani na IP wadanda suke damuwa tare da ƙara yawan sha'awar sha'awa idan aka kwatanta da masu amfani da cybersex masu lafiya idan an fuskanta su da yanar-gizon intanet [286]. An kara nuna cewa ƙungiyoyi masu kyau waɗanda ba a haɗa su ba ta hanyar Taswirar Ƙungiya ta Ƙungiyar da aka gyara tare da hotuna batsa [287] kuma haka ma, kusanci da kauce wa halayen [288] suna da alaƙa da alamomi na IPA. Bisa ga waɗannan abubuwan da aka lura, samfurin ƙwaƙwalwar intanet wanda aka tsara ta Brand et al. [15] ya kwanan nan an ƙayyade don amfani da cybersex (ciki har da IP)289].
Reid, Karim, McCrory da Masassarar [290] ya sami mafi yawan kamfanoni masu kamuwa da kansu a cikin samfurin marasa lafiya na hypersexual, wani binciken bai gano wani ɓangare na al'amuran gudanarwa da aka gudanar ta yin amfani da gwajin neuropsychological [291]. Duk da haka, yawancin nazarin ya ruwaito rashin tsangwama ga aiki na jima'i da kuma jima'i tare da ayyukan gudanarwa. Raunin da aka yi a cikin aikin gani da aka haifar da hankali saboda damuwar jarabawar an nuna a cikin binciken ta amfani da lokacin zaɓaɓɓen lokacin aiki [292], hangen nesa mai zurfi [293], da kuma ɗawainiyar ganowa [294,295,296]. An nuna tsangwama tare da ikon hanawa a cikin binciken ta amfani da ayyukan Go / No-go tare da siffofi na jima'i da jima'i kuma ya nuna cewa mutanen da ke da halayen jima'i da rashin karfin hali sun nuna mummunan aiki [297].
A layi tare da sama, Laier, Pawlikowski da Brand [298] ya yi amfani da Taskar Yambayar Yammacin Iowa wanda aka gyara tare da hotuna batsa kuma ya gano cewa ƙuƙwalwar jima'i a cikin wani mataki na yanke shawara zai iya tsangwama tare da yin gyare-gyare da kuma kyakkyawan shawara. Hakazalika, jima'i da halayyar jima'i ta haifar da halayen jima'i ba zai iya yin aiki na ƙwaƙwalwar ajiya a cikin hoto na 4-baya ba.299] kazalika da sauyawa da kuma saka idanu a cikin wani zane mai mahimmanci [300]. Sakamakon binciken da aka yi da hankali game da labarun jima'i da aka nuna ya nuna cewa an bunkasa shi a cikin samfurin mahaukaci masu jima'i [301]. Wannan yana cikin layi tare da shawara mai ban sha'awa cewa ayyukan zartarwa ya kamata a shafe su a yanayin da mutane ke fuskanta da abubuwan da suka shafi jita-jita da ke tattare da halayen haɓaka [15]. Ɗaya daga cikin binciken da aka yi amfani da EEG yayin da masu halartar suka gudanar da Hasumiyar Hanoi da kuma Wisconsin Card Sorting Test kuma sun kalli bidiyo marasa tsaka-tsakin da bambance-bambance [302]. A sakamakon haka, babu wani bambanci a cikin aikin da aka yi a yayin da aka kwatanta yanayin bidiyo, amma an danganta daidaitattun gaba ɗaya a lokacin ayyuka biyu a cikin yanayin bidiyo. Mawallafin sun bayyana cewa jima'i da tsangwama ya dame shi tare da aiki mai kwakwalwa amma ba a rage wannan aikin ba saboda gyaran gyare-gyare na aiki a lokacin aikin aiki, wanda hakan zai iya hana shi cikin halin da ake ciki a cikin buri.
Nazarin EEG akan wadanda ke gunaguni na matsalolin da suke tsara yadda suke kallon hotunan batsa na intanit ya ruwaito yadda zazzafar karɓuwa ta jiki ta kasancewa ta hanyar jima'i [303]. An tsara binciken ne don bincika dangantaka tsakanin amfanonin ERP lokacin kallon hotunan tunanin rai da jima'i da matakan tambayoyi game da jima'i da jima'i. Mawallafa sun yanke shawarar cewa babu kuskuren tsakanin jigaba akan tambayoyin jima'i da ma'anar P300 amplitudes lokacin da kallon hotunan jima'i "kasa samar da tallafi ga samfurori na 'yanci"303] (shafi 10). Duk da haka, rashin daidaituwa na iya zama mafi mahimmancin bayani ta hanyar kuskuren hanya a cikin hanya. Alal misali, wannan binciken ya yi amfani da magunguna masu yawa (maza da mata, ciki har da 7 wadanda basu da namiji). Cue-reactivity karatu kwatanta da kwakwalwa mayar da martani ga addicts zuwa controls lafiya suna buƙatar bukatun homogenous (guda jima'i, shekaru masu kama) don samun sakamako mai kyau. Dangane da ilimin jita-jitar batsa, an tabbatar da cewa maza da mata sun bambanta da hankali a cikin kwakwalwa da kuma karfin kai ga irin abubuwan da ake gani na jima'i [304,305,306]. Bugu da ƙari, biyu daga cikin tambayoyin da aka nuna ba a tabbatar da su ga masu amfani da IP ba, kuma ba a kula da batutuwa ba don sauran bayyanuwar jaraba ko rashin lafiya.
Bugu da ƙari, ƙaddarar da aka ƙayyade a cikin abubuwar, "Abubuwan da ke tattare da fahimtar fahimtar jima'i kamar sha'awar sha'awa, maimakon rikici, an tattauna" [303] (shafi na 1) ba alama ba ne wajen la'akari da binciken binciken cewa P300 amplitude an haɗu da mummunar dangantaka da sha'awar jima'i da abokin tarayya. Kamar yadda aka bayyana a Hilton (2014), wannan binciken "ya saba daidai da fassarar P300 a matsayin babban sha'awa" [307]. Har ila yau, binciken na Hilton ya nuna cewa babu wata ƙungiya mai kula da rashin amfani da fasahar EEG don nuna bambanci tsakanin "jima'i da jima'i" da "jima'i" ya sa Steele et al. binciken da ba a iya fassara ba [307].
A ƙarshe, binciken da aka gano na takarda (mafi girman P300 amplitude zuwa hotuna jima'i, dangane da hotuna masu tsaka tsaki) an ba da hankali kadan a cikin sashin tattaunawa. Wannan ba zato ba tsammani, a matsayin bincike na yau da kullum tare da abu da kuma addinan yanar gizo an kara yawan karuwar P300 dangane da matsaloli masu tsaka-tsakin lokacin da aka nuna su ga abubuwan da ke gani da haɗarsu [308]. A gaskiya, Voon, et al. [262] sunyi wani ɓangare na zayyana su akan nazarin binciken binciken P300 na gaba kafin wannan binciken. Voon et al. ya ba da bayani game da muhimmancin P300 ba a cikin takardar Steele ba, musamman a gaisuwa ga samfurin jaraba,
Ta haka ne, duk aikin dACC a cikin binciken CSB na yanzu da kuma aikin P300 ya ruwaito a binciken da aka yi na CSB [303] na iya yin la'akari da irin wannan matakan da ake amfani dasu. Hakazalika, dukkanin karatun suna nuna daidaito tsakanin waɗannan matakan tare da sha'awar inganta. A nan mun bada shawara cewa aiki na DACC ya dace da sha'awar, wanda zai iya nuna alamar sha'awar, amma ba ya haɓaka da ƙaunar shawara game da samfurin haɓaka-haɓaka.
[262] (shafi na 7)
Saboda haka, yayin da waɗannan marubuta [303] sun yi iƙirarin cewa binciken su ya ƙi yin amfani da samfurin jaraba ga CSB, Voon et al. sun nuna cewa wadannan marubuta sun bayar da shaidar da ta dace da wannan samfurin.
Wani binciken nazarin EEG wanda ya shafi uku daga mawallafin guda daya an buga shi kwanan nan [309]. Abin takaici, wannan sabon binciken ya sha wahala daga yawancin batutuwan da suka shafi ka'idoji kamar yadda ya kamata [303]. Alal misali, ya yi amfani da tafkin shafe-shafe iri daban-daban, masu bincike sun yi amfani da tambayoyin tambayoyin da ba a tabbatar da su ba don masu amfani da batsa na intanet, kuma ba a kula da batutuwa ba don wasu bayyanuwar jaraba ko rashin lafiya.
A cikin sabon binciken, Prause et al. idan aka kwatanta da ayyukan EEG na masu kallo na batsa na Intanit tare da magunguna yayin da suke kallon hotunan mata da jima'i [309]. Kamar yadda ake tsammani, yawancin LPP da ya shafi hotuna masu tsaka-tsaki ya karu ga ƙungiyoyi biyu, kodayake karuwar amplitude ya karami don batutuwa na IPA. Da yake tsammanin yawan haske ga masu kallo na batsa na Intanit, marubuta sun ce, "Wannan tsari ya bambanta da tsarin jarabawar abu".
Duk da yake mafi girma daga cikin ƙididdigewa na ERP don amsawa game da jaraba game da jimillar hotuna an gani a cikin nazarin jarabaccen abu, binciken da ake ciki yanzu bai zama bace, kuma yayi daidai da binciken Kühn da Gallinat [263], wanda ya samo ƙarin amfani da dangantaka da ƙananan ƙwaƙwalwar kwakwalwa saboda amsawa ga hotunan jima'i. A cikin tattaunawar, marubuta sun ambaci Kühn da Gallinat kuma sun ba da halayyar aiki kamar bayani mai mahimmanci ga tsarin LPP mafi ƙanƙanci. Ƙarin bayani da Kühn da Gallinat ya bayar, duk da haka, wannan ƙin zafin zai iya haifar da canje-canjen neuroplastic. Musamman, mafi yawan batsalolin da ake amfani da ita suna haɗuwa da ƙananan ƙwayoyin launin toka a cikin dorsal striatum, wani yanki da ke haɗuwa da jima'i da motsa jiki [265].
Yana da muhimmanci a lura da cewa binciken Prause et al. kasance a cikin kishiyar shugabanci na abin da suke sa ran [309]. Mutum na iya sa ran masu kallo na batsa na Intanit da kuma iko suyi amfani da irin wannan labaran LPP don amsawa ga bayyanar ɗan lokaci zuwa hotuna masu jima'i idan amfani da batsa na Intanet ba shi da tasiri. Maimakon haka, binciken da ba'a gani na Prause et al. [309] yana nuna cewa masu kallo na bidiyo na Intanet sun sabawa al'amuransu har zuwa siffofi. Ɗaya yana iya daidaitawa daidai da wannan ga haƙuri. A cikin duniyar yau duniyar Intanet mai sauri, mai yiwuwa masu amfani da fina-finai na Intanit suna duban fina-finai da bidiyon jima'i a matsayin tsayayyar bidiyo. Jima'i na fina-finai na samar da karin ilimin lissafin jiki da na tunani fiye da jima'i [310] da kuma kallon fina-finai na fina-finan jima'i ya haifar da rashin amfani da jima'i ga jima'i [311]. Ɗauki tare, nazarin littattafai na Prause et al., Da kuma Kühn da Gallinat sun kai ga ƙaddara cewa masu sauraron batsa na intanet suna buƙatar karin haske na gani don yada kwakwalwar kwakwalwa kamar kamfanonin lafiya ko masu amfani da batsa.
Bugu da kari, sanarwa na Prause et al. [309] cewa, "Waɗannan su ne farkon aikin nazarin lissafi na mutanen da ke bayar da rahoton ka'idodin tsari na VSS" yana da matsala saboda yana shukawa bincike da aka buga a baya [262,263]. Bugu da ƙari, yana da muhimmanci a lura cewa ɗayan manyan matsalolin da ake fuskanta wajen magance ƙwaƙwalwar ƙwaƙwalwar ƙwaƙwalwar kwakwalwa a cikin labarun batsa ta Intanet shine cewa yin la'akari da halayen jima'i shine halin haɗari. Sabanin haka, nazarin haɗuwa da jigilar hawan gwiwar da ake amfani da su a cikin hawan cocaine suna amfani da hotuna game da amfani da hawan cocaine (launi tsararren a madubi), maimakon samun abubuwan da ke cikin cocaine. Tun da kallon hotunan jima'i da bidiyon shine yanayin haɗari, kwakwalwa ta gaba da ke gabatarwa a kan masu amfani da batsa ta Intanet dole ne su yi taka tsantsan a duka gwaji da fassarar sakamakon. Alal misali, da bambanci da zane na biyu zuwa har yanzu hotuna da amfani da Prause et al. [309], Voon et al. ya zaɓi zancen bidiyo na 9-bidiyo na biyu a cikin abin da suke nunawa na sake farfadowa ta hanyar yin amfani da layi na yanar-gizon intanet [262]. Sabanin bayyanar da na biyu da har yanzu hotunan (Yin amfani da al. [309]), daukan hotuna zuwa bidiyo na 9-na biyu sun haifar da ƙarawar kwakwalwa a cikin masu kallon batsa masu tsada fiye da yadda ba a nuna su ba na biyu a har yanzu hotuna. Har ila yau, game da cewa marubutan sun rubuta binciken Kühn da Gallinat, wanda aka saki a lokaci guda kamar yadda binciken [Voon]262], duk da haka basu fahimci Voon et al. nazarin ko'ina a cikin takarda duk da muhimmancin da ya dace.
4. Ƙarshe
Wannan bita ya binciki ilimin kimiyya na halin yanzu game da matakan hanzari na al'ada game da bangarorin biyu na abubuwa masu kwakwalwa da kuma dabi'u irin su caca, jima'i da intanet, da kuma binciken da ake samowa na taimakawa wajen halayen halayen halayen halayen su. Yawancin nazarin sunyi amfani da matakan neuroimaging, EEGs, ko matakan physiological, kodayake wasu bincike sunyi amfani da matakan neuropsychological. Hanya na kowa shine cewa duk sunyi amfani da bayanan nero don ƙulla jita-jita game da halin da aka shafi yanar-gizon na jaraba (da kuma subtypes) musamman, ga magungunan da aka yi akan "maganin zagi". Sakamakon sakamakon wannan bincike ya haifar da ƙididdiga masu yawa na nazarin binciken da ba su samo asali wanda ke goyon bayan aikace-aikacen ƙwayar da ake dasu ba game da halayyar Intanet.
ASAM ya bayyana a sarari cewa duk bayyanuwar jarabobi game da tasirin yau da kullun akan kwakwalwa, ba bambance-bambancen abubuwa ko abubuwan ciki ko halaye ba. Don haka, bisa ga wannan da binciken da aka duba a cikin wannan takarda, yana da wahala a ba da hujja ga APA ta ƙyamar wasu halaye na intanet da ke tilastawa (“Yin amfani da Intanet da yawa ba tare da yin wasannin kan layi ba (misali, yawan amfani da kafofin watsa labarun, kamar kamar yadda Facebook; kallon hotunan batsa ta yanar gizo)) ba a dauke shi a matsayin mai kama da matsalar caca ta Intanet ba… ”[12] (shafi 797). Ta wannan mahimmanci, kallo na IP da yawa kuma wasa cikin wasannin intanet da yawa ya bambanta, duk da cewa akwai matsala a cikin kunna tsarin tsarin kwakwalwa, kuma duk da yiwuwar nuna hoton irin halin da ake ciki na psychosocial and psychosocial results. Wannan shi ne, "ilimin halitta da halin rashin daidaituwa" [24] (shafi 5).
Rashin fahimtar ƙananan ƙwaƙwalwar ƙwayar cutar za a iya ƙara gani a cikin Sashen Hanyoyin Hanya na DSM-5 na IGD:
Muhimmin fasalin rikice-rikicen caca na Intanet yana ci gaba da kasancewa cikin wasannin kwamfuta, galibi wasannin rukuni, na awowi da yawa. Wadannan wasannin sun hada da gasa tsakanin kungiyoyin 'yan wasa… shiga cikin hadaddun ayyukan da suka hada da muhimmin bangare na mu'amalar jama'a yayin wasa. Aspectsungiyoyin ƙungiya sun zama babban maɓalli.
[12] (shafi na 797)
Bisa ga wannan mahimmanci, yin amfani da abubuwa a cikin wani mashaya ko a wata ƙungiya zai iya zama abin ƙi, amma yin amfani da abubuwa yayin da shi kadai ba shi da. Don yin fasalin ilimin intanet, wannan fassarar ta nuna cewa wani dan wasa na Duniya na Warcraft ya fi dacewa da shi, amma wanda ke wasa Candy Crush ba shi da yawa. Wannan bita ya nuna alamun bincike mai tsabta don duba abubuwan da ke da alaka da intanet, ciki har da amfani da IP, kamar yadda ya dace, abin da ya kamata a yi la'akari da shi lokacin da yake magana game da rarraba IPA.
Marubucin Mataimaki
Todd Love ya ɗauki aikin, ya gudanar da nazarin wallafe-wallafen, kuma ya rubuta takarda mai yawa. Kirista Laier da Matthias Brand sun ba da gudummawa ga rubuce-rubucen, sun rubuta wasu sashi na rubutun, kuma sun sake fasalin rubutun. Linda Hatch ta ba da gudummawar wajen tsarawa da kuma bayyana ainihin ra'ayoyin da aka gabatar, kuma sun taimaka wajen gyaran rubutun. Raju Hajela ta sake dubawa da kuma gyara ilimin kimiyya, ta ba da gudunmawa, kuma ta taimaka wajen gyara rubutun. Duk marubuta sun yarda da rubutun.
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