2021 Apr 2.
- PMID: 33822748
- DOI: 10.1556/2006.2021.00018
Abstract
Bayani da manufofin
Yin amfani da batsa, yayin da ba shi da matsala ga yawancin, zai iya haɓaka cikin dabi'un kama-ɗabi'a wanda a cikin mafi girman sigar an lakafta shi azaman halayyar halayyar halayyar tilastawa a cikin ICD-11 (WHO, 2018). Manufar wannan binciken shine bincika abubuwan da ke tattare da jita-jita game da maganganu don fahimtar hanyoyin da ke cikin ci gaban wannan cuta.
Hanyar
Mun yi amfani da ingantaccen layaukaka Sexaukaka Jima'i don yin nazarin aikin kwakwalwa a cikin lada masu alaƙa da ɓangarorin kwakwalwa yayin wani lokaci na jira (tare da alamun tsinkaye na bidiyo na batsa, sarrafa bidiyo ko babu bidiyo) da kuma dacewar isar da saƙo daidai a cikin maza masu lafiya. Abubuwan haɗin kai ga alamun alamun batsa masu matsala, lokacin da aka yi amfani da shi don yin amfani da batsa, da kuma bincika halayen jima'i.
results
Sakamakon mutane 74 ya nuna cewa yankuna masu kwakwalwa da suka shafi lada (amygdala, dorin cingulation cortex, orbitofrontal cortex, nucleus accumbens, thalamus, putamen, caudate nucleus, da insula) sun kasance sun fi kunnawa sosai ta hanyar bidiyon batsa da alamun batsa fiye da ta sarrafa bidiyo da alamun kulawa, bi da bi. Koyaya, ba mu sami wata alaƙa tsakanin waɗannan abubuwan kunnawa da alamomin amfani da batsa mai rikitarwa ba, lokacin da aka yi amfani da shi don amfani da batsa, ko tare da halayen jima'i.
Tattaunawa da kuma yanke shawara
Ayyuka a cikin yankunan kwakwalwa masu alaƙa da lamuran jima'i da na alamomi da alamu suna nuna cewa haɓaka aikin Tasirin Batun Jima'i ya yi nasara. Wataƙila, ƙungiyoyi tsakanin aikin ƙwaƙwalwar da ke da alaƙa da alamomi don matsala ko amfani da batsa na batsa na iya faruwa ne kawai a cikin samfuran tare da haɓaka matakan kuma ba a cikin ingantaccen samfurin da aka yi amfani da shi a cikin binciken na yanzu ba.
Gabatarwa
Amfani da batsa ta Intanet ɗabi'a ce mai tartsatsi a cikin yawancin jama'a (Blais-Lecours, Vaillancourt-Morel, Sabourin, & Godbout, 2016; Bőthe, Tóth-Király, Potenza, Orosz, & Demetrovics, 2020; Martyniuk, Okolski, & Dekker, 2019). Duk da yake mafi yawan suna nuna amfani da batsa mara amfani, a cikin wasu mutane kaɗan yana tare da wahala, ƙarancin kulawa, da rashin iya rage halayyar duk da mummunan sakamako (kusan 8%, dangane da ƙa'idodin da aka yi amfani da su; Cooper, Scherer, Boies, & Gordon, 1999; Gola, Lewczuk, & Skorko, 2016; Grubbs, Volk, Exline, & Pargament, 2015). Yin amfani da batsa tare da al'aura shine halin da yafi kowa rikicewa tsakanin mutane tare da halayen halayen jima'i (Kraus, Voon, & Potenza, 2016; Reid et al., 2012; Wordecha et al., 2018). A karo na farko, da Hukumar Lafiya ta Duniya (WHO) ya ƙayyade takamaiman ka'idojin bincike don waɗannan alamun a cikin bugu na 11th na Classasawar Cutar Kasa da Kasa (ICD-11) a ƙarƙashin kalmar Harkokin Cutar Jima'i mai tsanani (CSBD, Healthungiyar Lafiya ta Duniya, 2018). Don ƙarin fahimtar duka wasan nishaɗi da matsala masu amfani da batsa, dole ne a haɓaka abubuwan da ke tattare da kwayar cutar.
Kodayake daidaitaccen rarrabuwa na amfani da batsa batutuwa magana ce mai rikitarwa, binciken binciken kimiya yana nuna kusancinsa ga rikicewar jarabaAuna, Laier, Brand, Hatch, & Hajela, 2015; Stark, Klucken, Potenza, Nauyi, & Strahler, 2018). Robinson da Berridge sun bayyana a cikin Ka'idar Sensitization mai karfafa gwiwa don ci gaban jarabawa yadda sake shaye-shayen miyagun ƙwayoyi ke haifar da canje-canje a cikin lamuran lada (Robinson & Berridge, 1993, 2008). Yayin ci gaban jaraba, amsawa ga alamomi (“so”) yana ƙaruwa yayin da tasirin da ake buƙata na shan kwayoyi ("liking") na iya ma raguwa. Sabili da haka, haɓaka amsawa wanda ke tattare da motsin rai, halayya, ilimin lissafi da haɓaka dangane da abubuwan da suka shafi jaraba (Berridge & Robinson, 2016; Tiffany & Wray, 2012) muhimmin ra'ayi ne don bayyana sauyawa daga amfani da miyagun ƙwayoyi lokaci zuwa amfani da jaraba (Brand et al., 2019; Koob & Volkow, 2010; Volkow, Koob, & McLellan, 2016).
Nazarin kan marasa lafiya da cututtukan da ke da alaƙa da abubuwa daban-daban sun sami ƙarfin aiki a cikin ƙananan kwakwalwa, da dorsal striatum, da kututtukan cingulation na baya (ACC), kobitofrontal cortex (OFC), insula da amygdala zuwa alamomi masu alaƙa da abubuwa (Jasinska, Stein, Kaiser, Naumer, & Yalachkov, 2014; Kühn & Gallinat, 2011a; Stippekohl et al., 2010; Zilverstand, Huang, Alia-Klein, & Goldstein, 2018). Game da ƙwarewar ɗabi'a, akwai sake dubawa da yawa waɗanda ke nuna haɓaka aiki a cikin yankuna masu alaƙa da lamuran alamomi game da jita-jita (Antons, Brand, & Potenza, 2020; Fauth-Bühler, Mann, & Potenza, 2017; Starcke, Antons, Trotzke, & Alamar, 2018; Van Holst, van den Brink, Veltman, & Goudriaan, 2010). Ko dai hanyoyin da ke tattare da CSBD sun yi kama da na rikicewar amfani da abu da halayyar ɗabi'a har yanzu batun batun muhawarar kimiyya ne.
Yawancin bita da yawa sun nuna yawan ayyukan da ke cikin kwakwalwa da dorsal striatum, OFC, ACC, insula, caudate nucleus, putamen, amygdala, thalamus, da hypothalamus a cikin mahalarta masu lafiya yayin kallon abubuwan jima'i na gani (VSS) idan aka kwatanta da matsalolin tsaka tsaki (Georgiadis & Kringelbach, 2012; Poeppl, Langguth, Laird, & Eickhoff, 2014; Stoléru, Fonteille, Cornélis, Joyal, & Moulier, 2012). Bugu da kari, akwai karatuttukan akan martani na jijiyoyi wadanda suka hango VSS amma basu dauke da wani abun ciki na jima'i (misali, Banca et al., 2016: alamu masu launi; Klucken, Wehrum-Osinsky, Schweckendiek, Kruse, & Stark, 2016: murabba'i masu launi; Stark et al., 2019: sharuddan bayanin kwatancen). Amsar kwakwalwa ga waɗannan alamun da suka gabata VSS (Banca et al., 2016; Klucken et al., 2016; Stark et al., 2019) sunyi kama da martani ga VSS (ventral striatum, OFC, occipital cortex, insula, putamen, thalamus). Bugu da ƙari, mutanen da ke da matsala masu amfani da batsa (PPU) idan aka kwatanta da mahalarta masu iko sun nuna haɓaka amygdala ga siffofin geometric masu alaƙa da VSS (Klucken et al., 2016). Amfani da VSS azaman alamu, Voon et al. (2014) sami amsoshi mafi girma a cikin ƙuƙwalwar ƙofar baya, ventral striatum da amygdala na mutane tare da PPU. Wadannan binciken na karuwar amsawa game da alamun tsinkaya VSS a cikin mutane tare da PPU sunyi daidai da tsammanin da aka samo daga Ka'idar Sensitization.
Don nazarin ci gaban jaraba, Tasirin jinkiri na Tasirin Kuɗi (MIDT) kayan aiki ne da aka kafa don bincika musanya hanyoyin jijiyoyi da lamuran rayuwa (Balodis & Potenza, 2015). MIDT yana farawa tare da tsinkayen tsinkaye wanda alamomi ke nuna ko nasara ta kuɗi ko asara mai yuwuwa yayin lokacin isarwa mai nasara. Asali, ana amfani da wannan aikin don tantance yawan ladaran sakamako a cikin jaraba tare da, duk da haka, sakamakon da bai dace ba game da tsinkaye da lokacin isarwa (Balodis & Potenza, 2015; Beck et al., 2009; Bustamante et al., 2014; Jia et al., 2011; Nestor, Hester, & Garavan, 2010). Don bincika sake kunnawa a cikin PPU, ingantaccen sigar da aka kafa na MIDT (Knutson, Fong, Adams, Varner, & Hommer, 2001; Knutson, Westdorp, Kaiser, & Hommer, 2000) an gabatar da shi: Tasirin jinkirin Jima'i (SIDT) ta yin amfani da alamun jima'i da lada. Karatu uku sun yi amfani da ayyukan jinkiri na karfafa gwiwa tare da alamun jima'i da lada har yanzu (Gola et al., 2017; Sescousse, Li, & Dreher, 2015; Sescousse, Redouté, & Dreher, 2010). Sescousse da abokan aiki sun binciki tsarin ayyukan daban daban game da lada da lada a cikin tsofaffi masu lafiya kuma sun gano ɓangaren na baya na OFC da amygdala a matsayin yankuna da aka kunna ta musamman ta hanyar lada ()Sescousse et al., 2010). Gola da abokan aiki (2017) idan aka kwatanta maza da PPU da sarrafa maza game da aikin kwakwalwar su zuwa gauraye MIDT / SIDT. Ganin cewa mahalarta PPU sun nuna haɓaka aiki a cikin ƙananan maganganu don alamun tsinkayen ladan jima'i, ba su bambanta da sarrafawa game da aikin kwakwalwa zuwa ladan jima'i ba. Ya dace da Ka'idar Sensitization Mai Ingantawa, marubutan sun yi jayayya don ƙarin "son" lada na jima'i a cikin mahalarta PPU yayin da "son" abubuwan motsawar jima'i basu kasance ba.
Kodayake karatun da aka fara amfani da SIDT suna da matukar kwarin gwiwa dangane da binciken yadda ake maida martani game da batun jima'i da lada ga masu lafiya da kuma mutanen da ke tare da PPU, akwai wasu hanyoyin hanyoyin da za'a tattauna. Game da ingancin waje, karatun da suka gabata sunyi amfani da hotuna masu tsayayye maimakon bidiyo, kodayake na ƙarshen sune nau'in batsa da aka fi amfani dashi (Solano, Eaton, & O'Leary, 2020). Dangane da yanayin sarrafawa, tsoffin karatuttukan sunyi amfani da sifofin VSS wanda aka lalata kamar yanayin sarrafawa (Gola et al., 2017; Sescusse et al., 2010, 2015). Sakamakon haka, yanayin gwaji da yanayin sarrafawa ya banbanta game da halaye da yawa (saitunan yanayi da ƙananan zane, ƙudurin hoto, hoton mutum da wanda ba mutum ba). Abin tambaya ne idan waɗannan matsalolin sun wakilci ingantattun abubuwan kulawa. Bugu da ƙari, masu binciken sun yi amfani da hotunan mata tsirara a matsayin alamu. Ta wannan hanyar alamun ba za su iya samun darajar tsinkaya kawai ba, har ma suna wakiltar abubuwan jima'i. Bugu da ari, zai zama da taimako a bincika tasirin abubuwan haɗari don ci gaban CSBD, inda mai zuwa ya zama ya fi dacewa: matsalolin rahoton kai tsaye game da amfani da batsa (Alamar, Snagowski, Laier, & Maderwald, 2016; Laier, Pawlikowski, Pekal, Schulte, & Brand, 2013), lokacin ciyar kallon batsa (Kühn & Gallinat, 2014) da kuma sha'awar jima'i (Baranowski, Vogl, & Stark, 2019; Kagerer et al., 2014; Klucken et al., 2016; Stark et al., 2018; Strahler, Kruse, Wehrum-Osinsky, Klucken, & Stark, 2018).
Saboda haka, manufar binciken yanzu sune kamar haka: (1) Muna son kafa SIDT ingantacce ta amfani da shirye-shiryen bidiyo maimakon hotuna masu motsi. Munyi tsammanin yanayin ayyukan yayin lokacin jira da kuma isarwar bayarwa ya zama daidai da sakamako a cikin tsohon binciken da ke nuna shigar ACC, OFC, thalamus, insula, amygdala, nucleus accumbens (NAcc), caudate, da putamen. (2) Muna so mu bincika yadda abubuwan da ke tattare da haɗari ga CSBD (rahoton da aka ba da rahoton kansa na PPU, lokacin da aka yi amfani da shi don yin amfani da batsa, da kuma sha'awar jima'i) suna da alaƙa da aikin jijiyoyin jiki yayin lokacin tsammani da kuma isar da saƙo a cikin asibiti. samfurin. Dangane da Ka'idar Sensitization na Robinson da Berridge (1993), Mun yi tsammanin ayyukan jijiyoyin yankuna kwakwalwa da aka ambata a sama yayin lokacin tsammanin SIDT za a iya daidaita su da waɗannan abubuwan haɗarin. Dangane da nazarin Gola et al. (2017), Muna tsammanin ayyukan jijiyoyin yankuna da aka ambata a sama yayin lokacin isarwar bazai haɗu da waɗannan abubuwan haɗarin ba.
Hanyar
Wanda su ka Halarta
Maza da mata masu zaman lafiya tsakanin saba'in da takwas tsakanin shekaru 18 zuwa 45 an dauke su ta hanyar jerin sakonni, aikawa da kuma labaran manema labarai. Dole ne a cire mahalarta biyu saboda matsalolin fasaha, biyu saboda kayan adon hoto daya kuma saboda rashin lafiyar neuroanatomy. Samfurin ƙarshe ya ƙunshi maza 73 waɗanda shekarunsu ba su wuce 25.47 (SD = 4.44) ba. Yawancin mahalarta (n = 65; 89.04%) sun kasance ɗalibai. Talatin da uku (45.21%) mahalarta sun kasance marasa aure, 36 (49.32%) sun rayu cikin dangantaka ta soyayya kuma mahalarta huɗu (5.48%) sun yi aure. Mahalarta ashirin da huɗu (32.88%) mahalarta sun bayyana kansu a matsayin masu addini ("Shin kuna da'awar addini ko ɗarika?" "Ee" / "a'a"). An yi amfani da ka'idojin hadawa masu zuwa: rashin cututtukan cututtukan yau da kullun / halin tunani, babu magani na psychotherapeutic / magani na yau da kullun, babu amfani da giya / nicotine mai cutarwa, babu alamar nuna fMRI, da kuma iya magana cikin yaren Jamusanci.
hanya
A lokacin shigar da karatu, mahalarta sun rattaba hannu kan takardar izinin da aka sanar. Samfurin yanzu ya fito ne daga babban binciken da yayi binciken sakamakon tsananin damuwa akan aikin VSS ta hanyar kwatanta yanayin damuwa zuwa yanayin kulawa. Wani binciken da aka yi amfani da bayanai daga wannan aikin an buga shi ya zuwa yanzu. Klein et al. (2020) yayi nazarin tasirin fifiko na mutum akan tasirin ƙananan hanyoyi zuwa VSS. Analyididdigar sun nuna cewa yawancin ɓangarorin ƙwaƙwalwar da ke haɗuwa da lada suna haɓaka daidai da ƙimar mutum na VSS kuma wannan haɗin yana daidaita daidai da matakin PPU. Babu wani bayanan da aka ruwaito a ciki da aka buga a baya. Mahalarta daga binciken da aka yi yanzu an rarraba su bazuwar zuwa yanayin sarrafawa kuma sun sami siginar wuri mai wahala na Trier Social Stress Test (placebo TSST, 15 min, Het, Rohleder, Schoofs, Kirschbaum, & Wolf, 2009) kafin binciken MRI. Wannan gwajin ya ƙunshi ayyuka biyu masu sauƙi na ƙwaƙwalwa (magana kyauta da lissafi mai sauƙi) waɗanda ba sa haifar da wata damuwa ta hankali ko alamun canje-canje a cikin mahalarta, saboda haka ba a tsammanin tasiri a kan SIDT mai zuwa. Mai zuwa ga placebo TSST, mahalarta sun shiga cikin SIDT. Bayan barin na'urar daukar hotan takardu, mahalarta sun kimanta shirye-shiryen fim ɗin su kaɗai a cikin ɗaki daban don tabbatar da sirri da ingancin darajar. An riga an tattara wani ɓangare na bayanan zamantakewar zamantakewar al'umma da na tambayoyin jima'i kafin TSST ya fara (tsawon lokacin kimanin minti 45) ta amfani da dandamalin binciken SoSci na Intanet. Bayan binciken MRI, an ba wa mahalarta lokaci don kimanta shirye-shiryen fim ɗin kuma su cika ƙarin tambayoyin (kimanin minti 60).
Matakan
Tasirin jinkiri na Jima'i
Munyi amfani da SIDT wanda aka samo daga MIDT da aka kafa (Knutson et al., 2001). An maye gurbin ladan kuɗi a cikin wannan binciken ta shirye-shiryen bidiyo na tsawon dakika shida waɗanda aka gabatar ba tare da sauti ba kuma ko dai sun nuna VSS (Bidiyo na VSS), bidiyo mara jima'i ba (shirin bidiyo) ko allon baki (m). Yin amfani da bidiyon tausa ya tabbatar da daidaituwar abubuwan gani (hulɗar zamantakewar jama'a, nuna tsiraici, motsa jiki, da dai sauransu) zuwa shirye-shiryen bidiyo masu nuna VSS. A cikin binciken farko, duk fim ɗin fim an ƙididdige shi game da jin daɗi (daga "1" = "mara daɗi sosai" zuwa "9" = "mai daɗi sosai") da ƙyamar jima'i (daga "1" = "ba tada sha'awar jima'i ko kaɗan" zuwa "9" = "tashin hankali sosai") ta samfurin mai zaman kansa na maza 58 da ba yan luwadi ba. Interpreimomi sama da 5 an fassara su azaman babba. Shirye-shiryen bidiyo 21 VSS da aka yi amfani da su a cikin ainihin binciken sun sami matsakaicin matsayi na girman kai (M = 6.20, SD = 1.12) da haɓaka sha'awar jima'i (M = 6.29, SD = 1.34 a cikin pre-binciken, yayin da matsakaici zuwa babban maki don girman kai (M = 5.44, SD = 0.97) da ƙananan maki don sha'awar jima'i (M = 1.86, SD = 0.81) an ba da rahoton don shirye-shiryen sarrafa 21. Ana gabatar da kowane shirin fim sau ɗaya kawai yayin aikin. Gwajin ya kasance tare da kunshin software na Gabatarwa (Sigogi 17.0, Neurobehavioral Systems, Inc, USA) kuma ya dau kusan 20 min. SIDT ya haɗa da gwaji na 63 wanda ya ƙunshi lokacin jiran tsammani da lokacin isarwa tare da yanayi uku (21 × VSS, 21 × sarrafawa, 21 × m).
A yayin lokacin jiran tsammani, an gabatar da siffofi daban-daban na lissafi guda uku a matsayin alamun da ke sanar da ko dai shirin VSS (CueVSS), shirin sarrafawa (CueControl) ko allon allo (CueBabu, duba ma Siffa 1). Aikace-aikacen adadi na lissafi zuwa sakamako mai yuwuwa (shirin VSS, shirin sarrafawa, babu ɗayan) an rarraba shi tsakanin mahalarta. Munyi amfani da adadi na lissafi a matsayin alamu don tabbatar da cewa babu ƙungiyoyi da suka gabata tsakanin waɗannan alamun da VSS. An sanar da mahalarta game da ƙungiyoyi tsakanin alamomi da bidiyo kafin gwajin fMRI. Waɗannan ƙungiyoyin an horar da su a gwajin gwaji na 21 a waje da na'urar daukar hotan takardu. Bayan ɗayan alamun ya bayyane don 4 s, gicciyen gyarawa ya biyo don tazara tsakanin tazarar 1-3 s. Sannan an nuna maɓallin motsawa (farin murabba'i, 200 × 200 pixel) tsakanin 16 ms (m) da 750 ms (matsakaici). Ba tare da la'akari da alamun da aka gabatar a baya ba, umarnin ya kasance don amsawa ga manufa da sauri-wuri ta latsa maɓalli. Idan KayiVSS ko AlamarControl ya bayyana kuma mahalarta sun danna maɓallin yayin da ake ganin burbushin abin da aka sa gaba, mahalarta sun yi “cin nasara” da shirin fim. Maƙasudin ya biyo baya ta gabatar da wani gicciye mai gyara don tazarar tazarar tsaka-tsakin 0-2 s. Bayan haka, an nuna wa mahalarta shirin VSS, shirin sarrafawa ko allon baƙar fata na tsawon 6 s. Gwajin motsa jiki kafin binciken ya kuma yi aiki don ƙididdige lokutan matsakaicin mutum (ma'anaRT) da daidaitattun karkacewa (SDRT) don ƙayyade lokutan gabatarwa na ƙirar mai niyya (nasara: ma'anaRT+2 × SDRT; babu nasara: Ma'anaRT–2 × SDRT). An yi nasarar nasara kimanin kashi 71% na VSS da gwajin gwaji (15 daga gwaji 21), yayin da ba a taɓa haɗa gwajin da nasara ba. Gwajin farko na farko sun gabatar da CueControl, AlamarVSS, da CueBabu a cikin tsari bazuwar Wadannan AbubuwanControl da CueVSS gwaji koyaushe an tsara shi azaman gwaji masu nasara. Bayan gwaji uku na farko, an ƙirƙiri ƙananan abubuwan gwaji guda 6 kowane (CueGudanarwa, 2 × AlamaVSS da 2 × AlamaBabu). Tsakanin cin nasara gwaji (VSS nasara gwaji ko iko nasara gwaji) ba fiye da sauran gwaji 5 (sauran gwajin nasara ko babu gwaji) an yarda. Yanayi iri daya za'a iya gabatar dashi a kalla sau 2 a jere. Gabatarwar abin da aka sa a gaba an daidaita shi ta yanar gizo ta hanyar ragi ko kari na 20 ms kowane idan mahalarta suka yi nasara a gwajin da ba a shirya ba ko kuma basu yi nasara ba a gwajin da aka tsara don tabbatar da karfin karfafawa a cikin gwaji na gaba. Gwajin VSS da gwajin gwaji, wanda bai haifar da sakamako kamar yadda aka tsara ba, an maimaita shi a cikin gwajin da aka tsara tare da sabon tsawon lokacin gabatarwa.
Tasirin jinkiri na Jima'i. Yayin da ake jiran tsammani, mahalarta sun ga abin dubawa (adon yanayi). Bayan wani tazara na tazarar lokaci, an gabatar da makasudi na ɗan gajeren lokaci, wanda aka buƙaci mahalarta su mai da martani da sauri ta hanyar latsa maɓalli. Idan alama a cikin lokacin jiran tsammani ya kasance AlamaVSS ko AlamarControl, Ana iya samun bidiyo mai dacewa ta hanyar amsawa da sauri zuwa maƙirar (kalli kuma Klein et al., 2020)
Kira: Jaridar Behavioral Addictions JBA 2021. 10.1556/2006.2021.00018
Bincike na bayanan kwakwalwa
Bayan SIDT, mahalarta sun kimanta matsayinsu na yanzu na sha'awar jima'i a kan sikelin 9-Likert-sikelin yayin da suke cikin na'urar daukar hotan takardu. An tsara shirye-shiryen fim ta amfani da ma'auni na kai-Manikin (Bradley & Lang, 1994) don girman kai (daga 1 = mara daɗin gaske zuwa 9 = mai daɗi sosai) da kuma motsawar sha’awa (daga 1 = ba tayar da sha’awa zuwa 9 = tashin hankali sosai) bayan barin na'urar daukar hotan takardu a ɗaki daban.
An kimanta lokacin da aka kashe akan kallon VSS a cikin rayuwar yau da kullun tare da abun "Yaya yawan lokacin da kuka ɓatar akan cin hotunan batsa, kuna ba da amsar ku a watan da ya gabata?". Mahalarta sun sami damar zaɓar awanni da min “a kowane wata”, “a mako” ko “kowace rana” don tantance amsar su. Kafin nazari, nau'ikan amsar daban an canza su zuwa "sa'o'i a wata".
An auna PPU ta sifofin Jamusanci na gajeren Gwajin jarabar Intanet (s-IAT) (Pawlikowski, Altstötter-Gleich, & Alamar, 2013) an gyara shi don cybersex (s-IATjima'i; Laier et al., 2013) da kuma Inventory Behaviour Inventory (HBI; Reid, Garos, & Masassaƙa, 2011). An ƙididdige amincin ciki na bayanan tambayoyin da aka tattara don samfurin na yanzu. Kowane ɗayan abubuwa goma sha biyu na s-IATjima'i an ƙididdige shi akan sikelin 5 na Likert wanda ya fito daga 1 (faufau) zuwa 5 (sau da yawa). Jimlar jimla (s-IATjima'i jimla, Abubuwa 12, Cronbach's ɑ = 0.90) ya kasance daga 12 zuwa 60. Ana iya lissafa ƙananan ƙananan guda biyu bugu da :ari: asarar iko (abubuwa 6, na Cronbach's ɑ = 0.89) da sha'awar (abubuwa 6, na Cronbach's ɑ = 0.73). HBI ya ƙunshi abubuwa 19 waɗanda aka ƙididdige daga 1 (faufau) zuwa 5 (sau da yawa) tare da cikakken ci (HBIsuman, Abubuwa 19, Cronbach's ɑ = 0.89) daga 19 zuwa 95. Ana iya lissafin ƙananan lamura guda uku: sarrafawa (abubuwa 8, na Cronbach's ɑ = 0.89), jurewa (abubuwa 7, Cronbach's ɑ = 0.84) da sakamako (abubuwa 4, Cronbach's ɑ = 0.76). An daidaita daidaito na ciki zuwa jeri mai kyau a cikin binciken yanzu (duba bayanan da ke sama).
An auna ƙarfin motsawar jima'i ta hanyar Tambayar Motsa Jima'i na ualabi'a (TSMQ; Stark et al., 2015). Tsarin TSMQ ya ƙunshi abubuwa 35 da ke ɗorawa a kan ƙananan ƙananan 4: jima'i na ƙaura (abubuwa 10, Cronbach's ɑ = 0.77), mahimmancin jima'i (abubuwa 15, Cronbach's ɑ = 0.89), neman saduwar jima'i (abubuwan 4, Cronbach's ɑ = 0.92), da kwatanta tare da wasu (abubuwan 6, Cronbach's ɑ = 0.86). Bugu da ari, babban jituwa game da halayyar jima'i (TSMQma'ana) ana iya lasafta shi azaman ma'anar duk abubuwan 35 (Cronbach's ɑ = 0.91). Kowane abu an kimanta shi akan sikelin 6-Likert wanda ya fito daga 0 (ba komai ba) zuwa 5 (sosai). An umurci mahalarta su ba da labarin bayanansu zuwa shekaru biyar da suka gabata. Kalmar "motsawar jima'i" da aka yi amfani da ita a cikin wannan ma'aunin ya haɗa da ayyukan jima'i tare da abokin tarayya da kuma ayyukan jima'i kaɗaici. Valuesananan dabi'u suna nuna ƙimar halayen jima'i.
Bayanan halayya
An bayyana lokacin amsawa azaman lokaci tsakanin farawa da farawa. An bincika bayanan lokacin amsawa don fitarwa ta hanyar cire bayanan da ke ƙasa da 100 ms ko sama da ma'ana + 1.5 × SD ta kowane yanayi dangane da ƙididdigar ƙididdigar samfurin. A cewar wannan, akwai masu fita waje uku a cikin duka samfurin (ɗaya bisa sharaɗi). An ƙididdige ƙididdigar kwatancen ban da masu fita waje da ƙimar da ke ɓace a cikin bayanan. Abubuwan ɓacewa sun ƙunshi halayen latti ko babu martani ga gicciyen gyarawa. An bincika bambance-bambance a cikin tsaka-tsakin lokutan amsawa kan gwaji mai nasara ta amfani da gwajin Kruskal-Wallis da gwajin Dunn-Bonferroni. A ƙarshe, an ƙididdige haɗin Pearson tsakanin lokutan amsawa na yanayi uku da abubuwan haɗarin CSBD.
samo bayanai na fMRI da nazarin ilimin lissafi
An samo hotunan aiki da na anatomical ta amfani da 3 Tesla duka jikin MR tomograph (Siemens Prisma) tare da murfin kan mai tashar 64. Samun hoto mai tsari ya ƙunshi nauyin yanka mai nauyin 176 T1 (yanki kauri 0.9 mm; FoV = 240 mm; TR = 1.58 s; TE = 2.3 s). Don hotunan aiki, gabaɗaya hotunan 632 aka yi amfani da su ta amfani da jerin hoto mai ɗaukar nauyi na T2 mai nauyi (EPI) tare da yanka 36 da ke rufe dukkan ƙwaƙwalwar (girman ƙananan hoto = 3 × 3 × 3.5 mm; rata = 0.5 mm; sauko yanki saye; TR = 2 s; TE = 30 ms; juya kwana = 75; FoV = 192 × 192 mm2; girman matrix = 64 × 64; GRAPPA = 2). An sanya filin ra'ayi ta atomatik dangane da layin AC-PC tare da fuskantar -30 °. Ppingididdigar aramididdigar aramididdiga (SPM12, Wellcome Department of Cognitive Neurology, London, UK; 2014) wanda aka aiwatar a Matlab Mathworks Inc., Sherbourn, MA; 2012) an yi amfani dashi don ƙaddamar da ƙananan bayanai, da kuma matakin farko da na biyu.
Gabatar da ayyukan hotuna na EPI ya kunshi gudanar da aiki zuwa samfurin Montreal Neurological Institute (MNI), rabe-rabe, sake tsarawa da rashin tsari, gyaran lokaci, daidaita daidaito zuwa madaidaicin filin MNI tare da santsi tare da kwayar Gaussian a 6 mm FWHM. An bincika bayanan aiki don ƙididdiga masu yawa ta amfani da tsarin kyauta na rarrabawa don karkatattun bayanai (Schweckendiek et al., 2013). Kowane ɗayan girman ƙarar da aka samu daga baya an tsara shi a cikin tsarin linzamin kwamfuta na gaba ɗaya (GLM) azaman mai rikon kwarjin da ba shi da sha'awa. Kowane yanayi na gwaji (CueVSS, CueControl, CueBabu, bayarwaVSS, BayarwaVSS, IsarwaControl, BayarwaControl, BayarwaBabu da kuma manufa) an tsara shi azaman mai kula da sha'awa. Duk masu gyarawa sun haɗu tare da aikin amsawar hemodynamic. An shigar da sigogin motsi guda shida azaman masu haɓaka ban da masu rijista don matakan da aka gano. An tsara jerin lokaci tare da matattarar wucewa mai ƙarfi (tsayayyar lokaci = 128 s).
A matakin rukuni, an bincika bambance-bambancen guda biyu: CueVSS-KuyiControl da BayarwaVSS-BayyarwaControl. -Aya daga cikin samfurin t-gwaje-gwaje da kuma layin linzamin kwamfuta tare da masu canji masu zuwa kamar yadda aka yi hango nesa tare da bambancin: s-IATjima'i, HBI, lokacin da aka ɓata lokacin amfani da batsa (awanni a kowane wata), da TSMQ. Don TSMQ da na HBI, an sami sauye-sauye masu yawa waɗanda ke ƙunshe da duk ƙananan lambobin gaba ɗaya. Mun yi amfani da layin layi don adadin lokacin da aka yi amfani da shi don amfani da batsa da kuma s-IATjima'i.
An gudanar da nazarin ROI akan matakin voxel ta amfani da ƙaramin gyaran murya (SVC) tare da P <0.05 (an gyara kuskuren iyali-mai hikima: an gyara FWE). Caudate, NAcc, putamen, dorsal na baya cingulate cortex (dACC), amygdala, insula, OFC, da thalamus an zaba a matsayin ROIs saboda an gabatar da su a baya a cikin binciken da aka yi game da sakewa da kuma VSS aiki (Ruesink & Georgiadis, 2017; Stoléru et al., 2012). Createdirƙirar ROI na anatomical anatteical na OFC da dACC an halicce su a MARINA (Walter et al., 2003); duk sauran masks an ɗauke su daga Harvard Oxford Cortical Atlas (HOC). Hannun hagu da dama na ROI sun haɗu zuwa maski ɗaya. Don waɗannan ROI guda takwas, an gudanar da bincike akan matakin ƙananan sauti tare da P <0.05 FWE-gyara.
Mun ƙididdige jerin layin layi na yawan tambayoyin tambayoyin da amfani da batsa akan CueVSS- KuControl bambanci da BayarwaVSS-BayyanawaControl bambanci. Kawai muhimmi ne (SVC, FWE-gyara) voxels daga samfurin-samfurin t-zanga-zanga tsakanin ROIs inda aka yi amfani da SVC. Sabili da haka, an yi amfani da ƙaramin ROI don nazarin sake sakewa. Binciken kwakwalwa gaba daya (FWE-gyara) ya haɓaka nazarin ROI.
Ethics
Kwamitin da'a na yankin ne ya amince da binciken kuma an gudanar da shi ne daidai da sanarwar 1964 ta Helsinki da kuma kwaskwarimar da ta yi daga baya. Duk mahalarta sun ba da sanarwar izini kafin kowane kima. Akwai likitan jijiyoyin jiki don fayyace abubuwan rashin lafiyar neuroanatomical da ake zargi.
results
Ayyukan samfurori
Table 1 ya taƙaita bayanan ƙididdiga. Abubuwan haɗin kai tsakanin masu yin tambayoyin sun ba da haɗin kai mai ƙarfi wanda ke nuna duka abubuwan da ke ƙunshe da ƙarin hannun jarin ayyukan daban-daban (duba Siffa 2).
Table 1.Ididdigar ƙwaƙwalwar ƙwaƙwalwa da ƙimar jima'i da sarrafa bidiyo da aka yi amfani da su cikin aikin jinkirin haɓaka jima'i (N = 73)
| Ma'ana (SD) | range | ||
| s-IATjima'i | Rashin kulawa | 10.56 (4.66) | 6.00-30.00 |
| Craving | 9.60 (3.44) | 6.00-26.00 | |
| s-IATjima'i total score | 20.16 (7.74) | 12.00-56.00 | |
| HBI | Control | 14.86 (6.28) | 8.00-39.00 |
| Yin jimrewa | 17.92 (5.48) | 7.00-32.00 | |
| sakamako | 6.71 (2.81) | 4.00-20.00 | |
| HBIsuman | 39.49 (11.48) | 20.00-90.00 | |
| TimePU [h / watan] | 6.49 (7.21) | 0.00-42.00 | |
| Farashin TSMQ | Jima'i shi kaɗai | 3.74 (0.68) | 1.80-5,00 |
| Mahimmancin jima'i | 3.82 (0.74) | 1.27-5.00 | |
| Neman gamuwa da jima'i | 1.50 (1.40) | 0.00-4.75 | |
| Kwatantawa da wasu | 1.73 (1.10) | 0.00-4.33 | |
| Farashin TSMQma'ana | 2.70 (0.69) | 1.05-4.35 | |
| Ididdigar abubuwan jima'i | Valencia | 6.35 (1.17) | 2.14-8.67 |
| Jima'i ƙari | 6.63 (1.16) | 2.14-8.62 | |
| Atididdigar abubuwan kulawa | Valencia | 5.51 (1.27) | 2.95-8.86 |
| Jima'i ƙari | 2.01 (0.97) | 1.00-5.00 |
lura: s-IATjima'i = gajeren samfurin gwajin Intanet na Intanet da aka gyara don cybersex (Laier et al., 2013), HBI = Abubuwan Halayyar Haɗuwa da Abokan Hulɗa (Reid et al., 2011), LokaciPU = Lokaci da aka kashe akan amfani da batsa; TSMQ = Tambayar Tambayar Motsa Jima'i (Stark et al., 2015).
Haɗuwa da halayen haɗuwa da jaraba (N = 73): s-IATjima'i da HBI = jimlar jimla don matsalar amfani da batsa, LokaciPU = lokacin da aka kashe akan batsa a cikin h / watan; TSMQ = mahimmancin daraja don halayen jima'i
Kira: Jaridar Behavioral Addictions JBA 2021. 10.1556/2006.2021.00018
Gwajin Kruskal – Wallis ya nuna muhimmiyar bambance-bambance tsakanin lokutan median amsawa dangane da manufa a cikin yanayin ukuBabu, AlamarControl, AlamarVSS; Χ2(2) = 12.05, P <0.01). Table 2 ya taƙaita ƙididdigar kwatancen lokutan abubuwan da suka faru yayin SIDT. Gwaje-gwaje na baya-bayan nan (Dunn – Bonferroni gwaje-gwaje) ya bayyana cewa lokacin dauki zuwa manufa a cikin yanayin CueVSS ya kasance da sauri fiye da lokacin amsawa a cikin yanayin CueControl (z = 2.68, P <0.05, na Cohen's d = -0.65) kuma a cikin yanayin AlamarBabu (z = 3.35, P <0.01, na Cohen's d = -0.82). Ya bambanta, lokutan amsawa zuwa maƙasudin niyya a cikin yanayin CueControl kuma zuwa CueBabu bai bambanta da juna ba (z = 0.59, P = 0.56). Babu wani muhimmin alaƙa da aka samo tsakanin lokutan amsawa na yanayi uku da abubuwan haɗarin CSBD (duka r <0.1, P > 0.10). AlamaBabu ya biyo baya ta hanyar 75 (4.89%) da ba a amsa ba, CueControl ya biyo baya 51 (3.33%) ra'ayoyin da aka rasa, da CueVSS ya biyo baya ta hanyar 17 (1.11%) wanda aka rasa a cikin duka mahalarta.
Table 2.Statisticsididdigar ƙididdiga na lokutan amsawa a cikin aikin jinkirta haɓaka jima'i (N = 73)
| Matsakaici (SD) | |
| CueVSS | 235.11 (60.94) |
| CueControl | 296.63 (135.01) |
| CueBabu | 314.42 (158.64) |
lura: CueVss = nuna sanarwar bidiyon batsa, CueControl = alamar sanarwa bidiyo tausa, CueBabu = sanarwa ba sanarwa bidiyo.
Hemodynamic martani
Abubuwan da ke nuna alamun VSS kamar yadda aka kwatanta da shirye-shiryen kula da siginar sigina suna haifar da amsa mai ƙarfi-oxygenation-matakin (BOLD) a cikin NAcc, caudate, putamen, da insula (duka biyun), kazalika da dama dACC da thalamus. Hakanan an sami mafi girman BOLD amsa a hagu NAcc da OFC, a cikin caudate, putamen, dACC, insula, amygdala, da thalamus yayin isar da shirye-shiryen VSS idan aka kwatanta da shirye-shiryen bidiyo (duk sakamakon yana gani Table 3 da kuma Siffa 3).
Table 3.Sakamakon ROI don bambancin CueVSS- KuControl da BayarwaVSS-BayyanawaControl (Samaya daga cikin Samfura t-zanga-zanga) tare da girman tari (k) da kuma kididdiga (an gyara FWE; N = 73)
| bambanci | Structure | Side | x | y | z | k | Tmax | Pcorr |
| CueVSS- KuControl | NAcc | L | -6 | 8 | -4 | 77 | 8.71 | |
| R | 8 | 10 | -4 | 65 | 7.50 | |||
| caudate | L | -8 | 10 | 2 | 449 | 9.66 | ||
| R | 10 | 14 | 4 | 476 | 8.18 | |||
| safa | L | -16 | 8 | -2 | 774 | 6.72 | ||
| R | 24 | 2 | 4 | 766 | 7.42 | |||
| dACC | R | 12 | 16 | 36 | 1,697 | 10.77 | ||
| insula | L | -34 | 14 | 6 | 592 | 9.43 | ||
| R | 38 | 14 | 4 | 604 | 8.65 | |||
| thalamus | R | 8 | -2 | 0 | 2,164 | 8.91 | ||
| bayarwaVSS-BayyanawaControl | NAcc | L | -8 | 14 | -8 | 69 | 9.49 | |
| caudate | L | -12 | -6 | 18 | 56 | 4.24 | ||
| R | 16 | -16 | 22 | 71 | 5.32 | |||
| safa | L | -18 | 12 | -10 | 314 | 6.58 | ||
| R | 32 | -12 | -10 | 63 | 7.28 | |||
| dACC | L | -2 | 20 | 28 | 953 | 5.43 | ||
| R | 4 | 4 | 32 | 953 | 9.19 | |||
| amygdala | L | -22 | -4 | -16 | 232 | 10.71 | ||
| R | 20 | -4 | -14 | 280 | 12.20 | |||
| insula | L | -36 | -4 | 14 | 517 | 9.52 | ||
| R | 38 | 2 | -16 | 476 | 9.19 | |||
| OFC | L | -6 | 44 | -18 | 2,825 | 17.45 | ||
| thalamus | L | -20 | -30 | -2 | 1,747 | 25.67 | ||
| R | 20 | -28 | 0 | 1,747 | 24.08 |
Ayyukan ROI don bambancin CueVSS- KuControl (A) da IsarwaVSS-BayyanawaControl (B). Lines a kan yanki sagittal a gefen dama suna nuni da sassanin jijiyoyin da aka nuna a hannun hagu. Alamomin da ke nuna VSS (CueVSS) kamar yadda idan aka kwatanta da alamun alamun sigina masu nuna alamar (CueControl) ya nuna mafi girma BOLD amsa a cikin putamen, NAcc, caudate, da insula. Shirye-shiryen bidiyo na VSS (IsarwaVSS) idan aka kwatanta da shirye-shiryen tausa (IsarwaControl) ya nuna mafi girma BOLD amsa a cikin thalamus, insula, amygdala, putamen, da OFC. Nuni t-tsauran suna bakin kofa a t <5
Kira: Jaridar Behavioral Addictions JBA 2021. 10.1556/2006.2021.00018
Dukkanin kwakwalwar kwakwalwa ya bayyana amsoshin hemodynamic mafi girma a cikin tari mai ci gaba gami da manyan sassan kwakwalwa don bambancin CueVSS idan aka kwatanta da CueControl (Extentungiya mai yawa k = 174,054 voxel) kuma sake don bambancin IsarwaVSS idan aka kwatanta da IsarwaControl (k = 134,654)
Hanyoyin haɗari ga CSBD da martani na hemodynamic
Babu wani daga cikin rikice-rikicen da ya bincika kan hanyoyin tsakanin abubuwan haɗari don CSBD (rahoton da aka ba da rahoton kansa, lokacin da aka yi amfani da shi don yin amfani da batsa, da halayyar jima'i) da kuma nuna wariyar launin fata a cikin kowane ROI yayin lokacin tsammani (CueVSS- KuControl) ko lokacin isarwa (IsarwaVSS-BayyanawaControl) ya haifar da duk wani tasiri mai mahimmanci. Figure 4 yana gabatar da ƙungiyoyi tsakanin waɗannan abubuwan haɗarin da ƙananan hagu yana ƙaruwa 'mafi girman aikin voxel.
Daidaitawa a tsakanin hagu na hagu yana haɓaka 'mafi girman kwayar murya da s-IATsex, HBI, lokacin da aka ɓata lokacin amfani da batsa a cikin h / watan (LokaciPU) da kuma yawan adadin TSMQ yayin lokacin jiran tsammani (layi na sama, NAcc [-6 8 -4]) da kuma lokacin isarwa (layin da ke ƙasa, NAcc [-8 14 -8]) na Tasaukar Jinkirin centarfafa Jima'i (N = 73)
Kira: Jaridar Behavioral Addictions JBA 2021. 10.1556/2006.2021.00018
tattaunawa
Manufar farko ta wannan rahoto ita ce bincika aikin ƙwaƙwalwar da ke da alaƙa da lada yayin tsammani da lokacin isar da VSS a cikin babban samfurin marasa magani ta amfani da SIDT. Mun gano cewa gabatar da bidiyo na batsa da kuma gabatar da abubuwan da suka gabata na bidiyo na batsa suna da alaƙa da aikin ƙwaƙwalwa mafi girma a cikin ƙayyadaddun yanayin ƙwaƙwalwar da ke da alaƙa (NAcc, amygdala, OFC, putamen, caudate nucleus, insula, thalamus, and dACC) idan aka kwatanta da gabatar da bidiyon tausa ko alamun da suka gabata na tausa, a jere. Sakamakonmu yana cikin layi tare da binciken na Sescusse et al. (2015, 2010), wanda ya kwatanta amsawar jijiyoyin jiki ga VSS da abubuwan da ba na VSS ba (a nan kuɗi) a cikin samfurin maza masu ƙoshin lafiya yayin aikin jinkiri mai ƙarfafawa. Game da amsoshin kwakwalwa ga alamun VSS, sun sami aiki mafi girma a cikin kwamin ɗin tare da haɓaka ƙarfin sakamako mai tsammanin. Yayin bayarwa, sun sami takamaiman aikin kwakwalwa ga VSS a cikin wani ɓangare na OFC da kuma cikin amygdala na haɗin gwiwa. Bugu da ƙari, sun gano yankuna waɗanda ke da hannu wajen sarrafa nau'ikan lada biyu (ventral striatum, midbrain, ACC, insula na gaba).
Bayanan halayyar sun nuna cewa lokutan amsawa sun kasance da sauri da sauri don ƙaddamar da matsaloli a cikin yanayin gabatar da alamun batsa fiye da yanayin da ke da alamun kulawa ko alamun da ba a sanar da bidiyo ba kwata-kwata. Wannan yana nuna cewa tsammanin VSS yana kunna tsarin motar, wanda ke nuna ƙimar ƙimar VSS.
Manufa ta biyu ita ce gano alaƙar da ke tsakanin martani na jijiyoyi ga VSS da alamomi da abubuwan haɗarin CSBD. Abubuwan haɗarin haɗarin da aka auna sun nuna alaƙar haɗin kai na matsakaiciyar ƙarfi tsakanin juna, yana nuna kamanceceniya da ƙarin ɓangarorin haɓaka ginin. Babu tambayoyin da ke auna PPU (HBI da s-IATjima'i), ko yawan lokacin da aka kashe akan batsa, ko kuma halayyar jima'i (TSMQ) ya kasance yana da alaƙa da alaƙa da ayyukan kwakwalwa na ɓangarorin kwakwalwar da suka shafi lada yayin bayarwa da kuma tsammanin tasirin jima'i.
Don tattauna daidaitaccen ɓataccen haɗin tsakanin abubuwan haɗari don CSBD da martani na jijiyoyi zuwa VSS, yana da kyau a bincika littattafan karatun da ke akwai waɗanda ko dai kwatanta maganganun ƙananan ƙwayoyin cuta na CSBD tare da mahalarta masu kula (tsarin kwatancen ƙungiya) ko bincika dangantakar abubuwan haɗari don CSBD tare da maganganun NAcc ga VSS (tsarin daidaitawa). Bayan bin tsarin kwatancen ƙungiya, wasu nazarin sun sami mafi girman martani na jijiyoyin kai tsaye zuwa ga VSS a cikin kwamin ɗin da kuma sauran sassan kwakwalwar da ke hade da lada a cikin mahalarta tare da PPU idan aka kwatanta da mahalarta masu iko (Gola et al., 2017; Seok & Sohn, 2015; Voon et al., 2014). Wani muhimmin sakamako na binciken ta Gola et al. (2017) shi ne alamun da ke annabta VSS suna haɗuwa da babban aiki a cikin mahalarta CSBD fiye da batutuwa masu lafiya. Yayin Gola et al. (2017) bincika yanayin haɗuwa da jima'i da haɓaka kuɗi tare da hotunan mata tsirara kamar alamomi, Klucken et al. (2016) yayi nazarin yanayin kwalliyar kwalliya tare da alamun lissafi. A sakamakon haka, sun sami karuwar aikin amygdala yayin kwaskwarima don CS + (abin da ake tsammani VSS) da CS- (ba a tsinkayar komai) a cikin mahalarta tare da CSBD idan aka kwatanta da mahalarta masu iko, amma babu bambanci a cikin ventral striatum. Ya bambanta, a cikin yanayin yanayin ciye-ciye na Banca et al. (2016) babu wani tasiri na rukuni tsakanin mahalarta CSBD da masu halartar mahalarta game da martani na hanyoyi zuwa ra'ayoyi daban-daban (alamu masu launi masu tsinkaye VSS, ladan kuɗi ko komai).
Nazarin da ke bin hanyar daidaitawa ya nuna sakamakon da bai dace ba dangane da daidaituwa tsakanin abubuwan haɗari na CSBD da martani na jijiyoyi zuwa VSS: Duk da yake Kühn da Gallinat (2014) sami daidaituwa mara kyau tsakanin lokacin da aka ɓata akan batsa da aiki a cikin hagu na hagu, Brand et al. (2016) ya ba da rahoton babu wani muhimmin ma'anar ƙididdigar maganganun maganganu da lokacin da aka saba amfani dasu akan batsa. Koyaya, sun gano cewa aikin haɗin bakin yana da alaƙa da matakin PPU na kansa (wanda aka auna ta s-IATjima'i). Bugu da ƙari, a cikin ɗayan karatunmu na baya ba za mu iya samun tasirin tasirin lokaci a kan batsa ko halayen jima'i ba game da amsawar VSS (Stark et al., 2019). Saboda haka, bincike na yanzu game da aiki na VSS a cikin batutuwa da ke da nau'ikan digiri daban-daban na abubuwan haɗari ga CSBD ba su dace ba. Binciken binciken bai ɗaya wanda yake amfani da tsarin kwatancen ƙungiya amma sakamakon da bai dace ba daga nazarin alaƙa na iya ba da shawarar cewa tsarin aikin VSS a cikin CSBD ya sha bamban da na ƙananan samfuran. Wannan shawarar, duk da haka, tana da sha'awar hasken Ka'idar Sensitization na Robinson da Berridge (1993) wanda ke ba da shawarar haɓaka martani na jijiyoyi game da alamomi yayin haɓaka buri. Ya zuwa yanzu, har yanzu ba a san ko ka'idar ta shafi CSBD ba kuma idan haka ne, ko karuwar maganganun jijiyoyi zuwa VSS ya canza ta wani fanni ko kuma ya zama dole a wuce matsayin mawuyacin hali na jaraba.
Abin sha'awa, kuma a cikin abubuwan da suka shafi jarabawar abubuwan da suka shafi Ingantaccen Sensitization Theory basu dace ba. Yawancin bincike-bincike da yawa sun nuna ƙarfin haɓakawa a cikin tsarin sakamako (Chase, Eickhoff, Laird, & Hogarth, 2011; Kühn & Gallinat, 2011b; Schacht, Anton, & Myrick, 2012), amma wasu nazarin ba za su iya tabbatar da waɗannan binciken ba (Engelmann et al., 2012; Lin et al., 2020; Zilberman, Lavidor, Yadid, & Rassovsky, 2019). Hakanan don cin zarafin ɗabi'a mafi girman ma'amala a cikin hanyar sadarwar lada na batutuwa masu lahani idan aka kwatanta da batutuwa masu lafiya an samo su ne kawai a cikin ƙananan karatun kamar yadda aka taƙaita a cikin binciken da aka yi kwanan nan ta Antons et al. (2020). Daga wannan taƙaitaccen bayani, za a iya ƙaddamar da sakamakon da ke nunawa a cikin jaraba ta hanyar abubuwa da yawa kamar abubuwan mutum da ƙayyadaddun abubuwan nazari (Jasinska et al., 2014). Abubuwan bincikenmu na sifiri game da alaƙa tsakanin aiki tsakanin ƙasa da abubuwan haɗari na CSBD na iya zama saboda gaskiyar cewa koda tare da babban samfurinmu zamu iya la'akari da ƙaramin zaɓi na abubuwan tasiri masu tasiri. Ana buƙatar ci gaba da karatu mai girma don yin adalci ga yawancin jama'a. Dangane da ƙira, alal misali, yanayin jijiyar bayanai na alamomi ko keɓancewa da alamomi na iya zama mahimmanci (Jasinska et al., 2014).
Dangane da babban samfurinmu (ya bambanta da sauran karatu) yana da wuya cewa rashin ƙarfin ilimin lissafi ya haifar da binciken da bai dace ba dangane da haɗin abubuwan haɗari ga CSBD da martani na jijiyoyi ga VSS da alamun VSS. Probablyila mafi mahimmanci, haɓakar juyin halitta, ƙimar ƙarfin ƙarfin VSS tana kunna yankunan haɗin haɗin lada waɗanda ke barin ƙananan sarari kaɗan don bambancin mutum (tasirin rufin). Wannan tsinkayen yana tallafawa ta hanyar karatun da ke nuna cewa da wuya a sami bambancin jinsi dangane da aiki da VSS a cikin hanyar sadarwar lada (Poepl et al., 2016; Stark et al., 2019; Wehrum et al., 2013). Koyaya, dalilan rashin daidaito tsakanin karatun suna buƙatar ganowa ta hanyar ƙarin karatu.
Limuntatawa da shawarwari don ƙarin bincike
Ya kamata a yi la'akari da iyakokin da yawa. A cikin bincikenmu munyi nazarin al'adun yamma ne kawai, maza da mata. Sake yin nazarin tare da samfuran da suka bambanta game da jinsi, yanayin jima'i, da abubuwan zamantakewar al'umma suna da mahimmanci don tabbatar da ingancin muhalli. Bugu da ƙari, an samo bayanai daga samfurin marasa asibiti, karatun gaba zai zama dole yayi la'akari da samfuran tare da alamun cutar CSBD masu dacewa. Abubuwan da aka yi amfani da su a cikin wannan binciken an bayyana su a matsayin alamun tsaka-tsaki ba tare da wani daban-daban ƙwarewar da ta gabata ba. Koyaya, farashin wannan aikin tare da ingantaccen aiki na ciki na iya zama rashin ingancin waje tunda abubuwan batsa a cikin rayuwar yau da kullun suna da daidaikun mutane.
Wani iyakancewa shine tsarin mayar da martani mai sassauci (kowace rana / sati / wata) game da kimanta batsa. Bisa lafazin Schwarz da Oyserman (2001) Amsoshi ga tambaya guda ɗaya na iyakance kwatancen lokacin da tsarin amsawa ke nuni zuwa lokuta daban-daban. Babban dalilin zabar wannan tsarin amsawa shine cewa yawan batsa da ake amfani da shi a cikin samfuran na iya bambanta ƙwarai (daga hoursan awanni a shekara zuwa sa'o'i da yawa a rana). Bugu da ƙari, ya zama kamar mai dacewa cewa tsarin amsa mai ƙayyadadden zai iya sanya ƙa'idodi game da wane matakin amfani da batsa ya dace. Sabili da haka, mun yanke shawarar amfani da tsarin amsa sassauƙa don wannan tambayar ta kusanci, duk da sananniyar rauni.
Bugu da ƙari, dakin gwaje-gwaje yana wakiltar saiti na wucin gadi, tunda ana amfani da batsa a cikin rayuwar yau da kullun tare da al'aura. Sabili da haka, har yanzu bai tabbata ba ko sakamakon ya fito ne daga al'aura / inzali da / ko daga kayan batsa kanta. Gola et al. (2016) da tabbaci yayi jayayya cewa matsalolin jima'i na iya zama alamu da lada. Idan ana fassara fina-finan batsa a matsayin alamomi, karatu na gaba zai iya ba da izinin al'aura don fahimtar lokacin isarwa na gaskiya. Koyaya, matsalolin ɗabi'a da fasaha suna buƙatar yin la'akari don gudanar da irin wannan binciken. Don ƙarin fahimtar ci gaban CSBD, nazarin da ke tattare da dukkanin alamun bayyanar CSBD (lafiya, ƙwarewa, na asibiti) ya zama dole.
karshe
Nazarinmu ya bincika sarrafa alamomi da abubuwan VSS ta amfani da SIDT a cikin babban samfurin marasa asibiti. Bugu da ari, SIDT ɗinmu da aka gyara yana inganta SIDT ta baya ta amfani da shirye-shiryen bidiyo maimakon hotuna masu motsi, ta amfani da bidiyon tausa a matsayin yanayin sarrafawa maimakon hotan hotuna, da kuma amfani da alamun da ba su ƙunshi bayanin jima'i. Mun sami damar maimaita sakamakon da ke nuna shigar da tsarin lada yayin aiwatar da bayanai da na VSS. Sabanin tunaninmu, ba za mu iya gano tasirin halayen mutum wanda aka ɗauka azaman abubuwan haɗari don ci gaban CSBD a kan amsoshin jijiyoyi a cikin kowane ROI da aka haɗa da tsarin sakamako. Bincike na gaba yakamata ya binciki dukkanin samfuran alamun CSBD don ƙara fahimtar yadda amfani da batsa ke haɓaka cikin halayyar cuta kuma waɗanne dalilai zasu iya hango wannan ci gaban.
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