Nā hana moekolohe maikaʻi ʻole: ka wehewehe ʻana, nā pōʻaiapili maʻi, nā ʻikepili neurobiological a me nā mālama (2020)

Nā ʻāpana mai ka “ʻO ka hoʻohana ʻana i nā ponokala kiʻi i ka hoʻowalewale wahine ”ʻāpana ma lalo:

ʻO ka hana kolohe ʻana i ka porn, ʻoiai ʻo neurobiologically ʻokoʻa mai ka hoʻowalewale moekolohe, ʻo ia nō ke ʻano o ka lawena maʻa mau ...

ʻO ke kāpae koke ʻia ʻana o ka hoʻomana porn i nā hopena maikaʻi ʻole i ke ʻano, hauʻoli, a me ka pilina a me ka wahine.

ʻO ka hoʻohana nui ʻana o nā ponokala kiʻi i ka hoʻomaka o nā maʻi psychosocial a me nā pilikia pili….

Perrotta G (2020), Int J Sex Reprod Health Care 3 (1): 061-069.

DOI: 10.17352 / ijsrhc.000015

Hōʻuluʻulu Manaʻo

Kuhi kēia hana i ke kumumanaʻo o ka "hana moekolohe kīnā ʻole" a me ke kikoʻī e pili ana i ka clinical, psychopathological, a me nā anatomy physiological element, e hoʻomaopopo piha i nā papa like ʻole o ka lawena e noʻonoʻo ʻia nei: ka moekolohe, ka maʻi hoʻomau i ka moekolohe, a me ka hoʻāo wahine. Hoʻopau ka hana me ke kālailai ʻana i nā mea etiological a me nā lāʻau maikaʻi loa, e hoʻokū ana i ka nui o ka pono o ka hoʻohana ʻana i nā ponokala kiʻi i nā mea moekolohe.

Hoʻolauna, wehewehe a me nā pōʻaiapili

Hana moekolohe hewa he ala o ka hana a ke kanaka, i ka pilina a me ka launa pū ʻana me ke kaiapuni e pili ana, kahi e ʻike ai i kahi obsessive (a no laila pathological) pono e noʻonoʻo e pili ana i ka moekolohe, ke hoʻokō nei i nā ʻano psychological e pili ana i ka hana ʻana i ka moekolohe nui, ka nalowale ʻana o ka impulses a me kau palena ʻia e pili i nā pilikanaka. Ma ka laulaha, ʻo ka "addict" ʻo ia hoʻi ka nalo ʻana a ʻaʻole hiki ke loaʻa hou ka kaohi i ka lawena makemake, ʻo ia hoʻi, ka makemake e loaʻa a hoʻopau i kekahi mea. No laila, inā kū mai kahi kūlana hoʻomalu ke manaʻo ke kanaka i ke ʻano kahi e hoʻopau ai ʻo ia i kahi mea a hana paha i ka lawena, me ka nānā ʻole i ke ʻano o ka ikaika, ka hoʻomanawanui ʻana a i ʻole ka makaʻu paha o kēia komo ʻana, ua nalowale ke kaohi ke hana hou ʻia ka lawena me ka ʻoluʻolu ʻole ʻole. , a i ʻole ke ʻino i ke koena o ke ola o kēlā me kēia, kahi mea makemake ʻole ʻia iā ia. ʻAʻole ia ka lawena i pathological akā ka ʻole o ka kaohi i nā kumu o ka hōʻoluʻolu a ka mea e makemake ai e hoʻokō. ʻO ka lawena e māʻona hou ʻole ai ka maʻamau e make i waho, ʻoiai inā ʻoluʻolu ia ma mua, no ka mea ua pau ia. Inā kū ʻole kēia, a ʻaʻole hiki i ke kanaka ke hāʻule e noʻonoʻo e like me ka makana ma muli o ka hōʻino o ka inu, ua nalowale ke kāohi. Ma ke ala like, inā ʻaʻole hiki i ke kanaka ke hoʻonohonoho i kāna hana e hoʻokomo iā ia i loko o kona ola i ka wā a pehea e makemake ai (manuahi ia), hoʻopau ʻo ia i ka mōhai ʻana i ke koena o kona ola i ka makemake e hoʻokō i ka hana ke puka ia ( ʻo ia, lilo ʻo ia i kauā). Pēlā nō e lilo i paʻakikī paʻakikī e loaʻa nā kumuwaiwai e kākoʻo i ke ʻano ponoʻī (e laʻa me ke ʻano hoʻokele waiwai), a ʻoiai ke hoʻomau nei ka hoʻomaʻamaʻa ʻana i ka uku ʻaʻohe ʻoluʻolu maʻamau, a ʻoi aku ka paʻakikī o kēlā ʻoluʻolu ma muli o ka hiki ʻole ke hoʻokele i ka makemake. No laila, he mea hōʻino maoli ia e like me nā mea koi a i ʻole ʻaoʻao koʻikoʻi a loaʻa iā ia kahi papa kikoʻī, e pili ana i ka paʻakikī o ke ʻano pathological; ʻo ka ʻoiaʻiʻo, ʻokoʻa nā ʻano ʻekolu: ʻo ka moekolohe, ka maʻi hoʻomau i ka moekolohe a me ka moekolohe wahine [1].

I kēia mau lā wale nō, ua loaʻa ka maʻi hypersexuality i kahi papa ma waena o ka International Classification of Diseases for Mortality and Morbidity Statistics (ICD-11) [2] me ke code 6C72, ʻoiai ua hoʻokaʻawale ʻia ka mahele mai nā paraphilias i loko o ka impulse control. Wahi a ka wehewehe ʻana o ka World Health Organization (WHO) [3], ke ʻano o ka moekolohe moekolohe ke ʻano o ke ʻano hoʻomau ʻole o ka kaohi ʻole ʻana i nā impulses moekolohe pinepine a i ʻole nā ​​koi e hopena i ka hana moekolohe hou. Pākuʻi ʻia paha nā ʻōuli i nā hana moekolohe repetitive e lilo i kikowaena o ke ola o ke kanaka a hiki i ka launa ʻana i ke olakino a me ka mālama pilikino a i ʻole nā ​​makemake ʻē aʻe, nā hana, a me nā kuleana; nā hana nui i kūleʻa ʻole e hoʻoliʻiliʻi nui i ka moekolohe repetitive, a hoʻomau i ka moekolohe repetitive me nā hopena maikaʻi ʻole a i ʻole ka loaʻa ʻana o kahi ʻoluʻolu a ʻoluʻolu ʻole paha mai ia mea. ʻO ke kumu o ka kaohi ʻole i ka ikaika, ka moekolohe a me nā koi a me ka hopena o ka hana moekolohe pinepine i hōʻike ʻia i loko o kahi wā lōʻihi (e laʻa, 6 mau mahina a ʻoi paha), a kumu i ka pilikia a i ʻole ka hōʻino nui i ka pilikino, ka ʻohana, ka pilikanaka, ka hoʻonaʻauao, ka hana. aiʻole nā ​​wahi nui ʻē aʻe o ka hana. ʻO ke kaumaha e pili pono ana i nā hoʻokolokolo kūpono a me ka hōʻole e pili ana i nā impulses, nā koi, a me nā lawena e lawa ʻole e hoʻokō i kēia koi. Me nā hoʻāʻo pinepine ʻana e hōʻemi i ke alapine o ka hana moekolohe maikaʻi ʻole, ʻaʻole hiki i ke kanaka e ʻeha nei i ka moekolohe ke kāohi i kāna mau koi, a ma muli o ke koʻikoʻi o kāna maʻi, hiki iā ia ke hōʻike i nā ʻōuli hopohopo, ka loli o ka naʻau, ka huhū huhū ʻole, ka hypermanicity, ka obsessiveness a me ka compulsiveness [ 4].

ʻO ka lima o ka mana hou o ka Diagnostic and Statistics Manual of Mental Disorder i haku ʻia e ka American Psychiatric Association (Diagnostic Manual of Mental Disorder, DSM-5) [5] ʻaʻole naʻe i hoʻopili ʻia ka maʻi hypersexuality i ka hoʻohālikelike ʻana i nā maʻi noʻonoʻo, ʻoiai ʻelua. aia nā waeʻano no nā hana kolohe e pili ana i ka paʻakikī i ke kiʻi ʻana i ka orgasm a i ʻole ka huhū a me nā maʻi paraphilic [5]. Ua hoʻopaʻapaʻa nui ke kaiāulu ʻepekema i ka makaʻu o ka psychiatriizing nui loa o kēlā me kēia ʻano a me nā ʻano o nā kumuhana i ʻoi aku ka libido moekolohe ma mua o ka awelika, a i ʻole e noho ana i ka nohona kaiaulu a moʻomeheu kahi e ʻae ʻia ai kēlā ʻano hypersexualized. Pēlā nō, noho hoʻopaʻapaʻa ka hoʻopuka ʻana o ka diagnose ʻokoʻa, no laila ʻo ka maʻi moekolohe, e hōʻike pinepine nei iā ia iho me nā maʻi psychiatric e like me ka maʻi bipolar a me nā depressive syndrome, ʻaʻole pono e ʻike ʻia ma ke ʻano he kūʻokoʻa kūʻokoʻa, akā ma ke ʻano he hōʻailona lua o ke ʻano. maʻi ʻino. ʻO ka poʻe loea, i ka ʻaoʻao ʻē aʻe, koi mai aia he mea ia, wehewehe i ka moekolohe ma ke ʻano he mea hōʻona maikaʻi, e like me nā poʻe ʻē aʻe e like me ka waiʻona a me ka lāʻau ʻona. ʻO ka hana, i kēia hihia ʻo ka moekolohe, e hoʻohana ʻia ma ke ʻano he pathological modality wale nō e mālama i ke koʻikoʻi a i ʻole ke ʻano pilikino a me nā ʻano o ke ʻano [4].

Mai kahi manaʻo hōʻailona, ʻO ka wahine maoli, no laila, hōʻike iā ia iho i ke ʻano o ke kanaka e nalo ana i ka pāpā o ka mea i ʻae ʻia, makemake ʻole ʻia i kahi ʻano i hoʻonohonoho mau ʻia i nā hana hoʻowalewale, hoʻonāukiuki a me ka makemake no nā moe kolohe. He mea koʻikoʻi koʻikoʻi ia a me ka hoʻokiʻekiʻe ʻana i nā ʻano moekolohe a me nā impulses, ka mea e hoʻokau i ke kumuhana e hōʻike mau i ka hoihoi i ka pili kino a i ʻole ka hoʻokokoke ʻana. Eia nō naʻe, ʻaʻole kau kēia ʻano i ka loaʻa ʻana o ka moekolohe; hōʻike pinepine ia i kahi ala e huki ai i ka nānā a hāʻawi i ka vent i kēlā mau moe kolohe kūloko i ʻole e ʻike mākou i kahi ala e hoʻokuʻu ai iā mākou iho. He mea maʻamau no kēia mau kumuhana ke koi ikaika a hypermaniacally i ka hana masturbatory o kā lākou wahine wahine. Eia kekahi, ʻo ka masturbation kahi hihia kūikawā no ka mea ʻoi aku ka nui ma mua o ke keke e hōʻike ana i kahi hana pani, i hiki ke lawe i nā ʻano o ka hoʻōla ma o ke ala e hoʻomaikaʻi nui ai, ʻo ia ka ponokala kiʻi, a i ʻole ka voyeurism, ʻo ia hoʻi, nā kiʻi ʻoniʻoni. Live "hoʻomaʻamaʻa ʻia no kahi uku a i ʻole ma ka ʻike maka ʻana i nā pilina me nā poʻe ʻē aʻe, a i ʻole ka hūnā (kiu i ka poʻe e makemake ana i nā hana moekolohe). ʻO ke kanaka e hoʻomaʻamaʻa maʻamau i ka manawa maʻamau ke hoʻopilikia ʻia e ka hōʻoluʻolu o ka hiki ʻole ke loaʻa kahi mea o ka makemake kūpono, a me ka noho ʻana no ka masturbation. I kekahi manawa, ma ka ʻaoʻao ʻē, hoʻopau ke kanaka i ka hoʻokaʻawale ʻana iā lākou iho i ka pilikanaka a i ʻole ke hoʻomohala ʻana i kahi kīnā ʻole i nā pilina kaiaulu no ka mea ua lawe pio ʻia kā lākou moekolohe e ka masturbation Inā ʻole, lilo ka masturbation i pathological no ka mea ʻo ka hoʻonui ʻana o ke alapine e kūlike i ka ʻoluʻolu haʻahaʻa, ʻimi huhū a hopohopo ʻole ʻole me ka kūleʻa ʻole, a i ʻole pili i kahi kūlana hoʻohaʻahaʻa a hilahila hoʻi no ke kanaka. Kāhea ʻia ka masturbation pathological "compulsive" ʻoiai i ka ʻoiaʻiʻo e hana kēia i ka manaʻo kūpono ʻole e hōʻike ana i kahi ʻano o ka maʻi obsessive-compulsive. ʻOkoʻa ka moekolohe moekolohe mai ka pulakaumaka i ka mea i ʻimi ʻia, hana a hānai ʻia e like me ke ʻano o ka hōʻoluʻolu, a ʻaʻole hana ʻia ka hana masturbatory e kūʻē i ka makemake o kekahi i kēia manawa, akā inā kūʻē i ka manaʻo nui o kekahi. Ma kēia pae o ka hana ʻole, akā naʻe, hiki i nā paraphilic tendencies ke noho pū akā hōʻike i ke kumu o kēia ʻano. ʻO kahi laʻana, hiki i kahi kanaka me ka hyperactivity moekolohe ke koho i nā mea ponokala kiʻi āna i makemake ai a i ʻole nā ​​uku uku āna i makemake ai, ʻoiai ʻo ka limahana moekolohe e hoʻopau i kona manawa i kēia noiʻi a hiki i kahi e loaʻa hou ʻole ai (no ka mea ʻaʻole hiki iā ia ke hana a hoʻolaʻa iā ia iho i ka nohona kaiaulu) o nā kumuwaiwai nui, a no laila hiki ke hoʻololi i nā mea mua i ʻike ʻia, e ʻae pū nei i nā pilikia (hygienic and infectious, a i ʻole kaiapuni), e hoʻopau koke [1].

Ke lilo ka moekolohe i mea mau, e kamaʻilio ʻia kahi maʻi maoli, ka pae ʻelua e ka umekaumaha: ʻO ka maʻi hōʻeuʻeu i ka moekolohe mau (PSAD). ʻO ka pīhoihoi moekolohe mau e kipaku i ke kanaka e ʻimi koi i nā kūlana a me nā hanana i pili i ka moekolohe. no laila lilo ka moekolohe i wahi hoʻomaka o kēia maʻi. I mea e māʻona ai i kā mākou kalaiwa, hiki i ke kumuhana ke ʻimi i ka ʻimi ikaika loa no ka moekolohe e moekolohe a kekeʻe paha. No kēia kumu, pono e hoʻopili ʻia kēia mau hiʻohiʻona i kahi o ka psychological-psychiatric depression; Eia nō naʻe, hiki i ke kumuhana ke mālama i kahi ʻano like o ka maʻamau, ke nakinaki nei i kēia mau ʻano i ka ʻāpana o kāna ʻona ponoʻī a me ka moekolohe wale nō, ka palena ʻana i ka hōʻino ʻana o ka pilina kanaka a me ka stigma maʻamau a ke kāne e pili ana i ka moekolohe i ka hoʻopaʻa a i ʻole ka mea hōʻalo. . ʻO nā kumuhana i nīnau ʻia pinepine ʻia nā paraphilias, ka mea e pono ai e hōʻike a noho i ko lākou naʻau a me ka manaʻo sentimental [1].

I ka wā e pono ai ka manaʻo uninhibited a me ka moekolohe a lilo i koi mau a kaohi ʻole e hana i nā moekolohe, e lilo ka pīhoihoi mau i mea hōʻā maoli: ʻAno moekolohe. Hoʻohālikelike ia i ka pae hope loa e ka umekaumaha o ka hana moekolohe maikaʻi ʻole a hele pū me ka pono e hana i nā moekolohe me nā poʻe a i ʻole nā ​​mea e ka hana ʻana i hoʻokahi a i ʻole nā ​​paraphilias. ʻO ke kumu o ka ʻike ʻana i ka leʻaleʻa a me nā hopena pinepine o ka hana a kekahi, ʻoiai inā ʻike ʻia i ke kumuhana, e hoʻowahāwahā ʻia a i ʻole ʻole e noʻonoʻo pono ʻia, no ka mea ʻo ke kūpikipiki e hana ai lākou e hoʻonāukiuki i ka ikaika o ka moekolohe e mākaukau e haʻalele i ka mahu [ 6]. Hoʻohālikelike ka hana kolohe ʻana i kahi ʻano hoʻomau o ka ʻole e kaohi i nā impulses a i ʻole nā ​​koi ikaika, a i loaʻa i ka hana moekolohe hou no kahi manawa lōʻihi e hoʻopilikia ai a hōʻino ʻia paha i ka pilikino, ʻohana, ka nohona, ka hoʻonaʻauao, ka hana, a i ʻole nā ​​mea nui ʻē aʻe. o ka hana [7]. ʻO ka moekolohe, i ka wā ma mua, i ka lāʻau lapaʻau, ua ʻike ʻia me nā huaʻōlelo ʻo "Nymphomania" (e pili ana i nā wahine) a me "Satirism a i ʻole Satiriasis" (e pili ana i nā kāne), ʻoiai ma ka moʻomeheu Helene ua wehewehe ʻia nā Nymphs i ko lākou ʻano i loko ke ao o ka mana akua o Aidōs, no laila i ka pilikino a me ke kahaha i ka maka o ka mea immaculate a no laila hāmau a ua hōʻike ʻia lākou he mau kaikamahine ʻōpio mau loa, hiki ke kiʻi i nā kāne a me nā koa, ʻoiai ua hōʻike ʻia nā Satyrs ma ke ʻano he kanaka ʻumiʻumi. me nā kao a me nā pepeiao lio, nā pepeiaohao, ka huelo, a me nā wāwae, hoʻolaʻa ʻia no ka waina, e pāʻani a hulahula pū me nā Nymphs, i ka hui o kahi kūkulu moekolohe hoʻowahāwahā ʻia. I ka wā i hala iho nei, ua hōʻike ʻia ke ʻano me ka moekolohe, ka moekolohe, ka moekolohe a me ka moekolohe. ʻoi aku nei, ua noi ʻia ka moekolohe moekolohe e like me ke ʻano impulse control for inclusion in ICD-11, me nā hoʻokolohua kahua kahua pūnaewele a me nā noiʻi haukapila i hoʻolālā ʻia e hōʻoia i kona pono [7]. I kēia lā ua hāʻule kēia mau ʻōlelo ʻelua i ka hoʻohana. Aia ka hilinaʻi pathological i kekahi mau holomua, e hoʻonui nei i ka ikaika me ka hanana like o kahi ʻano o ka momona o ka moekolohe. Ma aneʻi hiki ʻole i ke kumuhana ke hoʻokaʻawale i nā palena i ʻae ʻia e ka nohona kanaka a me kāna hilinaʻi ʻana i nā kūlana piha iā ia, i nā wahi āpau o kona ola ʻana, mai ka pilikino a i ka ʻohana, mai ka hana a ka pilikanaka. Ua lilo ʻo Paraphilias i ala e ʻike ai i ka moekolohe e like me nā mea ʻē aʻe a ʻimi pū i ka leʻaleʻa me ka hoʻohana pū ʻana i nā kiʻi pono ʻole. Ma waena o nā hopena o kēia hōʻino hiki iā mākou ke ʻōlelo i nā ʻōuli maʻi i lalo: ke kaumaha o ke kino a me ka noʻonoʻo i hoʻokumu ʻia e ka frenetic, obsessive, compulsive a me obsessive no nā kumu pili i ka moekolohe. hōʻino o nā pilina pilikanaka; hoʻemi i ka hoʻomanaʻo wā pōkole a me ka synthes; opacity ʻike a hoʻemi i nā mākau ʻike e like me ka intuition, abstraction, synt synthes, noʻonoʻo a me ka noʻonoʻo; ʻimi i ka leʻaleʻa moekolohe ma kēlā me kēia pōʻaiapili me ka loiloi ʻole ʻole i nā hopena o kā kekahi hana (a me nā hopena hoʻokolokolo); hoʻemi i ka hana kino a me ka luhi mau loa; ua loli ka circadian rhythm o ka hiamoe; hoʻonui i nā mokuʻāina hopohopo; hoʻouka kaua pahū; hoʻomau i ka manaʻo hoʻohoka; hōʻoluʻolu paʻa mau; ke ʻano o ke aloha ʻole a me ka hoka ke hoʻopau ʻia ka hana moekolohe; hoʻolaʻa i ka ʻimi i kēlā me kēia lā no nā kūlana hoʻonāukiuki i ka moekolohe, no ka hapa nui o nā hola o ka lā; hoʻomaha ʻole; hoʻokaʻawale kaiaulu; uʻi a me ka affective saturation me ka paʻakikī hāʻule i ke aloha; ʻokoʻa o nā pilina moekolohe maʻamau e hoʻāʻo ai ke kumuhana e hana hou me kāna hoa (ʻoiai kekahi manawa) hoʻokahi a ʻoi paha nā ʻano pelapela, desubjecting poʻe.

No ka pōʻaiapili pōʻaiapili, eia nō naʻe, e hoʻomaka mau ana mai ka ʻokoʻa ma waena o ka moekolohe, ka maʻi hoʻomau i ka moekolohe a me ka hoʻowalewale wahine, ke ʻano o ke ʻano pathological ma muli o ke koʻikoʻi o nā ʻōuli i haʻi ʻia i ka anamnesis; no laila, ka moekolohe (ʻo ia ka wahi hoʻomaka o ke kūlana paʻalula, e pili ana i ka moekolohe) he hōʻailona kikoʻī paha ia o kekahi o kēia mau kuhiakau ʻehā [7].

1) "Hypersexualities" ma ke ʻano he kumu o ka pilikia psychosocial, ʻoiai ʻo ka hana i hana ʻia e ke kanaka, ʻoiai i manaʻo ʻia he maʻamau, ʻo ia ka mea i hōʻike ʻia ma ka awelika kiʻekiʻe ma mua o nā kūlana kaiāulu a me nā kaulike [7]. I loko o kēia pōʻaiapili, ʻo ka ʻimi no ka moekolohe i pili hou aku i ka pornographic a me ka pae paraphilic e hōʻike ana i kahi ala maʻalahi a me ka ʻokoʻa o ka ʻike ʻana i ka moekolohe, ʻoiai ma ke ʻano he kāne, me ka hoʻohoka ʻole i nā wahi kaiāulu o ke kanaka (ʻohana, manaʻo, manaʻo, hana), ʻoiai ke kumu o ka ego-dystonic kulana e hoʻonāukiuki i ke kanaka, e hoʻomaopopo iā ia i kāna hyperactivity moekolohe ma ke ʻano he hōʻailona pathological [8] e hoʻoulu i nā manaʻo o ka hewa a me ka hilahila [9];

2) "Hypersexuality" ma ke ʻano he hōʻailona o ke kūlana olakino o ka hoihoi olakino, ma mua i ka moe kolohe i manaʻo ʻia he maikaʻi ʻole (e laʻa me ke dementia a i ʻole ka tumo lolo) [7];

3) "Hypersexuality" ma ke ʻano he hōʻailona o ke ʻano psychic o ka hoihoi olakino, kū a i ʻole concomitant a ma hope paha o ka moekolohe ʻana i manaʻo ʻia he maikaʻi ʻole (e laʻa me ke ʻano ʻo obsessive-compulsive maʻi, maʻi manic, a pilikino pilikino) [7]. Hoʻohālikelike ʻia i nā ʻōuli i wehewehe ʻia i loko o ka anamnesis, hegosynthesis ka mea pili e pili ana i ka diagnostical mai kahi ʻano a me nā ʻano hana i kahi maʻi pilikino maoli (e laʻa me ka maʻi pilikino borderline) [1].

4) "Hypersexuality" ma ke ʻano he hōʻailona o kahi kūlana psychological kikoʻī e pili ana i ka eroticization (i kēia hihia, kuhikuhi ʻia i ka hypersexuality pono ʻole e mālama i ka hoʻomau ʻana, a hiki i ka hilinaʻi ʻana i ka lawena).

Nā moʻolelo Neurobiological

ʻO nā mea kākoʻo o ka "Manaʻo kolohe" e hoʻomaopopo i ka meaola o ka pathology i nā hoʻohālikelike physiological like o ka hoʻopili ʻana i ka piliwaiwai, no laila ʻo kahi hana nui ʻole o ka ʻōnaehana dopaminergic a me serotonergic ke kumu o ka hōʻoluʻolu wahine noiʻi koʻikoʻi a me ka kaohi ʻole. ʻO ka neurotransmitter dopamine i hoʻokuʻu ʻia e nā neurons aia i loko o ka ʻōnaehana limbic (nucleus accumbens a ma ka laulā ka ventral striatum) e hoʻokuʻu ʻia i kahi ʻano disregulated i nā kumuhana e ʻeha ana i ka maʻi. ʻO kēia neurotransmitter ka hana o ke koi ʻana i ka hoʻokō ʻana i nā lawena e pili ana i ka loaʻa ʻana o ka leʻaleʻa, a ʻo ia pū kekahi me kēlā mau ʻano e hōʻoia i ke ola i nā kānaka (ʻimi i ka meaʻai a me ka wai, nā hana hānau ...). ʻOiai ʻaʻole i hōʻoia ʻia e ka noiʻi ʻepekema nui, ua aʻo ʻia e ka poʻe ʻepekema ke komo i loko o ka etiology o ka moekolohe o ka neurotransmitter serotonergic, kahi neonaoneone e hōʻike iā ʻoe i ka manaʻo o ka hauʻoli, māʻona, a me ka ʻoluʻolu. Ke hoʻomaka nei mai nā neurons serotonergic aia i loko o ka prefrontal Cortex, ka papahana afferents serotonergic ma luna o ka nucleus accumbens ma o ka modulate ʻana i ka hana o ka dopamine a pēlā e hoʻoponopono ai i ka pāpāohi manawaleʻa a me ka mālama ʻana i ka lawena. I nā kumuhana e ʻeha nei i nā maʻi o ka impulse dysregulation a me ka maʻi obsessive-compulsive, e hoʻopili ʻia kēia hana [10,11].

ʻO kahi noiʻi hou a laila kuhiakau i nā hana moekolohe maikaʻi ʻole e like me kahi maʻi neuropsychiatric maoli: "ʻO ka moe kolohe e pili ana i ka hoʻonui ʻana a i ʻole ke komo loa ʻana i nā hana moekolohe. He paʻakikī kēia, hōʻike i nā trans-diagnostically a nui nā puke olakino e kamaʻilio ana i ka nosology, pathogenesis, a me nā neuropsychiatric i kēia maʻi maʻi maʻi. Hoʻohui ʻia ka hoʻopili ʻana me nā lawena hele hewa, nā mea ʻike diagnose e pili ana i ka impulsivity, a me nā phenomena obsessional ʻIke kekahi mau kauka lapaʻau i ka hoʻonui ʻana o ka makemake moekolohe ma ke ʻano he 'normal' ie psychodynamic theorists e manaʻo iā ia he pale pale ego i nā manawa e hōʻemi ana i ka hopohopo noʻonoʻo ʻole i hoʻokumu ʻia i nā hakakā intrapsychic. Hōʻike mākou i ka moekolohe ma ke ʻano he nui-dimensional e pili ana i ka hoʻonui ʻana o ka hana moekolohe e pili ana i ka pilikia a me ka hana pono ʻole. ʻO ka etiology o ka moekolohe he multi-factorial me nā diagnoses ʻokoʻa e pili pū me nā maʻi psychiatric nui (e like me ka maʻi bipolar), nā hopena maikaʻi ʻole o nā lāʻau lapaʻau (e like me ka mālama ʻana i ka levodopa), nā maʻi i hoʻokomo ʻia i loko o nā lāʻau (e like me ka hoʻohana ʻana o nā mea amphetamine), nā maʻi neuropathological (e like me ka maʻi maʻi o mua. ), me nā mea ʻē aʻe. Hoʻopili ʻia nā neurotransmitters he nui i loko o kāna pathogenesis, me ka dopamine a me noradrenaline e hoʻokani nui nei i nā ala uku neural a me nā ʻōnaehana neural-regulated limbic system neural circuit. Hoʻoholo ʻia ka mālama ʻana i ka moekolohe e ke kumumanaʻo o de causa effects evanescent, inā mālama ʻia nā kumu, nalowale paha ka hopena. Kūleʻa mākou e loiloi i ke kuleana o nā lāʻau lapaʻau e hana ai i ka moekolohe a me nā mea hana i waena e mālama ana i nā ʻano maʻi e pili ana. ʻO nā mea hoʻoholo bio-psycho-social ka mea nui i ka ʻapo ʻana i ka ʻike a me ke alakaʻi ʻana i kēia maʻi maʻi maʻi a me nā manaʻo hoʻoholo lehulehu.

ʻO ka mea hope loa, hōʻike ʻia kahi noiʻi ʻepekema ʻē aʻe i ka hiki ke komo i ka axis pituitary-hypothalamic-adrenal [13,14] a me ka nukleus frontostriatal [15], kahi noiʻi ʻē aʻe (ʻo ia hoʻi ka Palani), ma ka ʻaoʻao ʻē aʻe, ua kau i ka pilina ma waena o ka moekolohe maikaʻi ʻole. nā hana a me ka oxytocin [15-17], ʻoiai inā ʻaʻole i hoʻokūpaʻa ʻia ke kuhiakau hope loa me ka ʻoiaʻiʻo o ka intuition nui. ʻO kahi oxytocin-based therapy (me ka nasal spray) hiki i kēia kumu, inā hoʻopaʻa ʻia, kahi koho ʻē aʻe a me ke kōkua kōkua i nā loina maikaʻi loa e hoʻohana ʻia nei [18].

Nā kūlana ʻikepili a me nā diagnostical

ʻO nā kumu kumu o kēia mau kūlana ʻaʻole i ʻike piha ʻia, ʻoiai ka prevalent orientation i loko o nā puke he multifactorial: genetic, neurobiological, hormonal, psychological, environment [12]. Akā ʻo nā kūlana pathological kikoʻī hoʻi, e like me nā epilepsy [19,20], dementia [21,22], maʻi kūpilikiʻi-obsessive [23] ADHD [24], kaohi o ka impulse control [25] a me nā maʻi vascular [26].

Eia nō naʻe, e hoʻokaʻawale i nā kūlana hana ʻole mai ka hana moekolohe maʻamau (ʻoiai he ikaika a hoʻonui ʻia), pono e mālama ʻia kekahi ʻikepili i ka moʻolelo olakino o ka mea maʻi.

A) Hoʻohaunaele ka mea maʻi e kāna moekolohe a loaʻa iā ia kahi manaʻo maikaʻi ʻole;

B) Ke ʻimi mau nei ka mea hoʻomanawanui i nā kūlana a me nā kānaka me ka ʻike moekolohe kiʻekiʻe;

C) Hoʻolālā ka mea maʻi i mau hola i ka lā ma ka moekolohe;

D) Hōʻike ka mea maʻi i nā ʻano paraphiliac i kāna mōʻaukala olakino;

E) ʻAʻole hiki i ka mea maʻi ke hoʻomalie i ke ʻano moekolohe, i manaʻo ʻia he obsessive;

F) ʻO ka mea hoʻomanawanui, me kāna moekolohe, ua hoʻopili i nā ʻaoʻao ʻē aʻe o kona ola, e like me ka hana, pili a me ka nohona ʻohana;

G) Manaʻo ka mea hoʻomanawanui i ka naʻau ʻole ke hana ʻole ʻo ia i nā hana moekolohe;

H) Hoʻohilahi ka mea hoʻomanawanui i kāna pilina kanaka a me ka pilikanaka ma muli o kāna moekolohe.

I mea e hoʻomaʻalahi ai i kēia wehewehe ʻana, eia nō naʻe, ua hoʻomohala ʻia nā hoʻokolohua kaulike a me nā hoʻāʻo e like me SAST (United States of America) a me SESAMO (ʻItalia); ʻo ia hoʻi, ʻo ka pōkole hope e kū nei no ka nānā ʻana i ka hōʻike loiloi Sexrelation, kahi hōʻike psychodiagnostic i hana ʻia ma ʻItalia, i hōʻoia ʻia a kaulike ʻia ma ka heluna kanaka ʻItalia, i hoʻokumu ʻia i ka nīnau nīnau e hiki ai ke ʻike i ka moekolohe a me ka pilina, nā ʻano hoʻoponopono a me nā hana pono ʻole. , i nā kumuhana hoʻokahi a i ʻole me ke ola male. Aia nā hōʻike ʻelua i nā nīnau nīnau, kahi mana i manaʻo ʻia no nā wahine a hoʻokahi no nā kāne, ua mahele ʻia kēlā me kēia mea i ʻekolu mau ʻāpana: ʻo ka ʻāpana mua nā mea i ʻimi i nā wahi e pili ana i nā hiʻohiʻona o ka moekolohe mamao, ka nohona, ka nohona a me nā ʻano ʻokoʻa. o ke kumuhana, a me kahi moʻolelo olakino. Ua hōʻuluʻulu ʻia kēia ʻāpana e nā mea pane āpau e, ma ka hopena o kēia ʻāpana mua, e kuhikuhi ʻia i kekahi o nā ʻāpana ʻelua e pili ana i kā lākou kūlana pili i ka naʻau, i wehewehe ʻia ma ke ʻano he "kūlana hoʻokahi" a i ʻole "kūlana ʻelua"; hōʻiliʻili ka ʻāpana ʻelua i nā mea nona nā wahi o ka hoʻokolokolo e pili ana i ka moekolohe o kēia manawa a me nā ʻano hoʻoikaika. mālama ʻia kēia ʻāpana no ke kūlana o Single, ʻo ia hoʻi me ka ʻole o kahi pilina paʻa-pili aloha o ke kumuhana me kahi hoa; ʻo ka ʻāpana ʻekolu nā ʻāpana e nānā i ka moekolohe o kēia kumuhana a me nā ʻano pilina o ka wahine. Kuhi ʻia kēia ʻāpana i ke kūlana dyadic, i manaʻo ʻia e like me ke alo o kahi pilina pili aloha i hala no ʻeono mau mahina me kahi hoa. Ma hope o ka pau ʻana o ka hoʻokele, ʻaʻole hiki i nā hoʻololi ke hoʻololi i nā ʻike o ka nīnau nīnau a me ka hōʻike, kūpono kēia no nā kumu kūpono akā aia ma mua o nā mea āpau e pono ai ka pono o ka māla loea a me ka kānana. Aia i loko o ka hōʻike he 9 mau ʻāpana, e like me ka ʻikepili pilikino a me ka ʻohana, ka pakuhi, ka helu ʻana, nā ʻano koʻikoʻi, a me ka hōʻike haʻi moʻolelo, e hoʻopau me nā palena a me nā pane i ka nīnau nīnau [28].

Ka hoʻohana ʻana i nā ponokala kiʻi i nā mea moekolohe

Kaulana nui, ʻo nā kiʻi pono ʻole ka hōʻike mālamalama o nā kumuwaiwai erotic a me nā moekolohe i nā ʻano like ʻole, mai nā puke a i ka pena, i ka cinematography a me nā kiʻi paʻi kiʻi. No Greek kahi kumu, hōʻike kēia hana i kahi hana noʻeau, no ka mea, he mau moemoeā erotika kēlā me kēia kanaka, ʻo ia hoʻi, hoʻohana ʻo ia i ka manaʻo e hōʻike i nā hiʻohiʻona pīhoihoi, ʻaʻohe kumu ʻē aʻe ma mua o ka pīhoihoi iā ia iho: ʻo nā ponokala kiʻi ka concretization o kēia mau moemoeā i nā kiʻi, nā kiʻi, nā palapala, nā mea a i ʻole nā ​​hana ʻē aʻe. ʻOiai he nui nā poʻe e like me nā moemoeā erotic, ka mea maʻamau nā mea ponokala kiʻi i hana ʻia e hoʻokahi kanaka, me nā hiʻohiʻona o kona manaʻo erotic, hoihoi pū kekahi no nā mea ʻē aʻe ʻē aʻe. ʻOiai ua hoʻohana ʻia nā ponokala kiʻi ma ke ʻano he mea maʻalahi i nā hana noʻeau ʻoi aku ka paʻakikī, ʻo kāna kumu nui e hoʻokū i kahi kūlana o ka moekolohe. Ua hoʻopaʻapaʻa mau e pili ana i ka loli o ka palena ma waena o ka art, eroticism, a me nā ponokala kiʻi, i manaʻo ʻole ʻia he kū ʻole i nā ʻōnaehana loio komohana, akā i kekahi mau ʻano he mea ia (a i ʻole) pili i ka censorship a pāpā ʻia ka nānā ʻana (ʻo ia hoʻi ʻōpio). ʻO ka loaʻa nui o ka lehulehu a me ka waiwai o ke kumu kūʻai e hoʻolilo i ka pūnaewele i mea hoʻohana no ka hoʻolaha a me ka hoʻohana ʻana i nā mea ponokala kiʻi. I ka ʻoiaʻiʻo, me ka hiki ʻana mai o ka pūnaewele, ʻoi loa no ka hoʻolaha ʻana o nā ʻōnaehana e like me ka kaʻana like ʻana o ka faile (kaʻana like ʻana o ka faila) a me ke kaʻanalike wikiō ʻana (kaʻana like ʻana i nā wikiō), ua loaʻa koke ʻia nā kiʻi ʻoniʻoni ma nā wahi āpau a no kekahi. ʻO ka hopena hou loa o kēia hanana, ʻo ka mea mua, ua hoʻoliʻiliʻi i ka manaʻo laulā o ka hoʻohewa i mua o kēia ʻano o ka ʻōlelo, ʻoiai ma ka ʻaoʻao ʻē aʻe, ua kōkua ia i ka pahū a i ʻole ka hoʻolaha ākea o nā phenomena e like me ka "amateur" ʻano, i loko o ka hoʻokumu ʻia ʻana o nā kiʻi a me nā wikiō wikiō-erotic e hōʻike nei i ka poʻe maʻamau (pinepine nā mea kākau like me ka huahana). Ma waho aʻe o ka kaʻana like ʻana i ka faile, hōʻike ʻia kahi kahawai hoʻokaʻawale ʻē aʻe no ka ʻike ponokala pūnaewele e nā pūnaewele uku, kahi hana i hoʻonui nui ʻia no nā mea hana o nā mea ʻoihana e hoʻomaikaʻi nei i ka pūnaewele ma o nā kahawai hoʻolaha e like me nā nūhou, nā hale kūʻai wikiō a me nā hale kūʻai wahine. Mahalo i ka pūnaewele, ka mea a kekahi mau mea kākau i kapa aku ai ʻo neo-porn e ʻāpono mau nei, ʻoiai ke pāhola nei ka pāʻani uila no nā mākua, a i ʻole nā ​​pāʻani uila, nona nā kūlana (ʻoiai ke ʻano ʻē mai ka hoʻomākeʻaka a i ka moemoeā) e mālama i kahi ʻano ponokala i haʻi ʻia. Mahalo i ka hōʻike o nā hōʻike uku a uku ʻole ʻia, ma o ka hoʻolaha ʻana o ka webcam (makemake nui ʻia ma ka pūnaewele), ʻae ʻia e hele i nā hōʻike porn a me ke kamaʻilio ʻana ma o ke kamaʻilio pū ʻana me ka poʻe e hana nei i kēlā manawa [29].

Ua loaʻa i kahi noiʻi ʻepekema hou loa e pili ana i ka moekolohe a me nā kiʻi pono ʻole.

1. ʻO ka hoʻohana ʻana o nā kiʻi ʻoniʻoni i waena o ka poʻe ʻōpio, ka poʻe e hoʻohana nui ana iā ia ma ka pūnaewele, e pili ana i ka hōʻemi ʻana o ka makemake moekolohe a me ka ejaculation ma mua, a me kekahi mau hihia i nā maʻi pīhoihoi o ka nohona, kaumaha, DOC, a ADHD [30-32 .

2. Aia he ʻokoʻa neurobiological ʻokoʻa ma waena o nā "limahana moekolohe" a me nā "porn addicts": inā he hypoactivity ventral ka mea mua, ʻike ʻia ka hope e ka reactivity ventral ʻoi aku ka nui no nā hōʻailona erotic a me nā uku me ka ʻole hypoactivity o nā kaola uku. Hōʻike kēia i nā limahana i ka launa kino kino pilikino, ʻoiai ʻo ka mea hope e hana i ka hana mehameha [33,34]. Eia kekahi, hōʻike nā mea hoʻopili lāʻau i ka nui o ka disorganization o nā mea keʻokeʻo o ka prefrontal cortex [35].

3. ʻO ka hana kolohe ʻana i ka porn, ʻoiai ʻo neurobiologically ʻokoʻa mai ka hoʻowalewale moekolohe, ʻo ia nō kahi ʻano o ke kolohe lawena a makemake ʻia kēia hana pono ʻole i ka hōʻino ʻia o ke ʻano psychopathological o ke kanaka, pili pololei a pololei ʻole e pili ana i ka hoʻololi neurobiological i ka pae o ka desensitization i ka stimulus sex function, hypersensitization i hoʻonāukiuki i ka moe kolohe, kahi pae i ʻike ʻia o ke koʻikoʻi hiki ke hoʻopili i nā waiwai hormonal o ka pituitary-hypothalamic-adrenal axis a me hypofrontality o nā mua preircontal [36].

4. ʻO ke ahonui haʻahaʻa o nā kiʻi ponokala kiʻi i hōʻoia ʻia e kahi noiʻi fMRI i loaʻa kahi haʻahaʻa o ka mea hina i ka ʻōnaehana uku (dorsal striatum) e pili ana i ka nui o nā kiʻi pono ʻole i hoʻopau ʻia. Ua ʻike ʻo ia i ka hoʻonui ʻia o ka hoʻohana ʻana i nā ponokala kiʻi e hoʻopili ʻia me ka hoʻēmi liʻiliʻi o ka pōʻaiapuni makana ke nānā iki nei i nā kiʻi moekolohe. Manaʻo nā kānaka noiʻi ua hōʻike ʻia kā lākou hopena i ka desensitization a me ka hoʻomanawanui paha, ʻo ia ka pono no ka hoʻoulu hou ʻana e hoʻokō i ka pae like o ka hoʻoulu. Eia kekahi, ua loaʻa nā hōʻailona o ka hiki haʻahaʻa i Putamen i nā kumuhana pili i ka porn [37].

5. Kūlike ʻole i ka mea e noʻonoʻo ai, ʻaʻohe makemake nui o nā mea porn i ka wahine a ʻo ka hana masturbatory e pili ana i ka nānā ʻana i nā mea ponokala kiʻi e hoʻemi ana i ka makemake e makemake ana i ka ejaculation ma mua, no ka mea ʻoi aku ka ʻoluʻolu o ke kumuhana i ka hana solo. No laila makemake nā kānaka me ka reactivity ʻoi aku i ka porn e hana i nā hana moekolohe ma mua o ka kaʻana like ʻia me kahi kanaka maoli [38,39].

6. Ke kāpae koke ʻana o ka hoʻomana porn i nā hopena maikaʻi ʻole i ke ʻano, pīhoihoi, a me ka pilina a me ka leʻaleʻa wahine [40,41].

7. ʻO ka hoʻohana nui ʻana o nā ponokala kiʻi e kōkua i ka hoʻomaka ʻana o nā maʻi psychosocial a me nā pilikia pili.

8. ʻO nā pūnaewele neural e pili ana i ka moekolohe ke ʻano like me nā mea e pili ana i ka hana ʻana i nā uku ʻē aʻe, e like me nā mea maʻa. ʻO ka hoʻopili ʻia ʻana o nā ʻāpana lolo uku uku pānaʻi e pili ana i ka hoʻāla ʻana i ka moekolohe, ke aloha, a me ka hoʻopili ʻana i wehewehe ʻia me ka wahi tegmental ventral, ka nucleus accumbens, ka amygdala, ka ganglia basal, ka mua mua a me ka cortex orbitofrontal ʻo ia ka substrate maʻamau. Ua hoʻohālikelike ʻia kahi hiʻohiʻona i kapa ʻia ʻo "model deficit syndrome model" (RDS) i loko o nā kiʻi ponokala kiʻi a hōʻike ʻia kahi hauʻoli ʻole a me ka hōʻino ʻia o ka uku o ka lolo e hopena ai i kahi leʻaleʻa ʻimi i ka ʻimi ʻana i nā ʻano hana e komo pū me nā lāʻau, ʻai nui, nā pāʻani moekolohe, piliwaiwai, a nā hana ʻē aʻe. No laila, ua hoʻokūpaʻa ʻia ka hoʻokuʻu mau ʻana o ka dopamine i loko o ka ʻōnaehana uku i ka wā e nānā pono ai kekahi i nā ponokala kiʻi e hoʻonāukiuki i nā hoʻololi neuroplastic e hoʻoikaika i ka ʻike. Kūkulu kēia mau hoʻololi neuroplastic i nā palapala ʻāina no ka hoʻonāukiuki i ka moekolohe. ʻO nā ʻano āpau āpau e ʻike ʻia e pili ana i ke alapiʻi dopamine mesolimbic (DA), i hoʻomaka ʻia ma ka wahi tegmental ventral (VTA) a kuhi ʻia i loko o nā nucleus accumbens (NAcc) nāna e hoʻopuka i ke kaapuni makana ma ka hoʻōla. Ua hoʻopili ʻia kēia kaapuni i ka leʻaleʻa, ka mana, ke aʻo ʻana, ka uku ʻana, a me ka impulsiveness i ʻike ʻia i nā ʻano addicts. Hoʻopili ʻia ke ala mesolimbic o dopamine i ʻekolu ʻāpana lolo e hana i nā kaapuni makana i kapa ʻia he ʻōnaehana uku. ʻO nā hale e pili ana ka amygdala i nā code no ka maikaʻi a me ka maikaʻi ʻole o ka naʻau, ka makaʻu a me ka hoʻomanaʻo ʻana i ka naʻau, ka hippocampus e pili ana i ka hana a me ka hoʻihoʻi ʻana o nā mea hoʻomanaʻo no ka wā lōʻihi, a me ka ʻaoʻao mua e hoʻopili a hoʻoholo i ka lawena o ka hōʻalo. Hiki i nā papa like ʻole o nā lāʻau psychoactive ke hoʻoulu i ka ʻōnaehana uku ma nā ʻano like ʻole, akā naʻe, ʻo ka hopena o ke ao holoʻokoʻa ke kahe o ka dopamine i loko o nā nucleus accumbens (ke kikowaena uku). ʻO kēia ka hopena i kahi hoʻoikaika ikaika maikaʻi o ka lawena nāna i hoʻokumu i nā kaiāulu e pili ana i ke kai a Kahinaliʻi. Ke pau ka holo o ka wai dopamine, aia ka hoʻoulu ʻana o ka amygdala hoʻonui ʻia, kahi e pili ana i ka hana ʻeha a me ka hoʻoweliweli. ʻO kēia ke alakaʻi nei i ka hoʻoulu ʻana o nā ʻōnaehana koʻikoʻi o ka lolo a me ka disregulation o nā ʻōnaehana anti-stress me ka hoʻemi ʻana i ka ʻike i ka uku nui a me ka hoʻonui ʻana i ka paepae uku, i kapa ʻia he ahonui. No laila, aia kahi hana hou a me ka hoʻoikaika ʻana i nā ʻano mea addication. ʻO nā wahi kikoʻī i hoʻopili ʻia i loko o ka pale mua e komo pū ana me ka cortex prefrontal dorsolateral (DLPFC), kuleana no nā ʻāpana nui o ka cognition a me ka mana o ka mana (14) a me ka ventromedial prefrontal cortex (VMPFC) kuleana no nā ʻāpana o ka pāpā a me ka pane o ka naʻau, e pili ana i ka ʻikepili ʻike o ka hana uku. Komo ka lolo hilinaʻi i kahi mokuʻāina "allostatic" ke hiki ʻole i ka ʻōnaehana uku ke hoʻi i kona homeostatic (maʻamau). Hoʻomohala ka ʻōnaehana uku i kahi hoʻonohonoho hoʻonohonoho i hoʻololi ʻia, a waiho i ka mea nāwaliwali i ka hoʻi hou ʻana a me ka hoʻāla. ʻO kēia ka mea i kapa ʻia ʻo "ʻaoʻao pōuliuli" o ka hoʻohaʻahaʻa. I ka lolo o ka mea ʻaʻa porn, nā palapala ʻāina o ka lolo i hoʻokumu mua ʻia no ka moekolohe maʻamau ʻaʻole hiki ke hoʻohālikelike i nā palapala ʻāina hou i hoʻomohala ʻia a hoʻomau i hoʻoikaika ʻia e ka nānā ʻana i nā ponokala kiʻi, a ʻoi aku ka maopopo o ka mea hilinaʻi a me ka hoʻohana ʻana o nā kiʻi ponokala kiʻi e mālama i ka pae kiʻekiʻe ma mua o ka pīhoihoi. Ua hoʻopili ʻia nā loli i ka nui o ka receptor density i kēia ʻano me nā loli mau i ka ʻōnaehana uku. Ua hōʻike pinepine ʻia ka noiʻi ʻana i ka lōʻihi o ka lōʻihi o ka nānā ʻana i nā mea ponokala kiʻi, ʻo ka nui o nā mea hina i ka nucleus caudate pono e hōʻemi; Eia kekahi, ke emi nei ka pilina ma waena o ka caudate ʻākau a me ka cortex prefrontal dorsolateral hema (DLPFC), kekahi mea ʻē aʻe o ka pilina me nā mea e ʻeha nei i ka maʻi a me ka hilinaʻi hilinaʻi ʻole. ʻO ka hope loa, ua loaʻa nā noiʻi ʻē aʻe i ka hoʻololi ʻana o nā neural kūkulu e like me ka orbitofrontal cortex (OFC) a me nā subcortical hale e hoʻopili pololei ʻia i nā hoʻololi neurochemical o serotonin a ma waena o serotonin a me dopamine.

Nā lāʻau lapaʻau

ʻO ka maʻi, ka mea kūlohelohe i ka māla psychological, hana maʻamau ia me ka psychotherapy pākahi a i ʻole ka hui, kahi i hoʻohana ʻia ai kahi ala ʻokoʻa ʻē aʻe ma mua o ka mea i hoʻohana ʻia i ka abstinence: kahi hana e manaʻo e hoʻokuʻi i ke kumuhana e lanakila i ka ʻike obsessive o ka pono a hoʻi. i ka loaʻa ʻana o kahi pilina olakino me ka moekolohe. I nā hihia ʻoi aku ka paʻakikī, ma ka ʻaoʻao o ka psychotherapy-behavioral a i ʻole ka psychotherapy psychotherapy (e hōʻalo ana i ka mea ikaika, no nā kumu o ka lōʻihi), hiki ke hoʻohana ʻia nā lāʻau hoʻomāinoino a me nā lāʻau lapaʻau i hiki ke hoʻoliʻiliʻi i ka libido, inā ʻaʻohe mea e pono ai kahi lāʻau hoʻomāka lāʻau hoʻomāka ʻia me antidepressants, mood stabilizers, a me antipsychotics i ke alo o nā psychopathologies ʻē aʻe, i ka comorbidity [5,29,44].

ʻO ke kumumanaʻo a me ka noʻonoʻo-behavioral therapeutic tendencies, i ke kahua o ka moekolohe a me nā hana pono ʻole o ka moekolohe, e pili ana i nā hana kikoʻī [45].

a) E hoʻoliʻiliʻi i ka hoʻokele moekolohe a pale i ka pōʻaiapule orgasmic; ʻimi pinepine ʻia kēia pahuhopu me ka hoʻohana ʻana i nā antidepressants ka mea, inā ma ka lima hoʻokahi hiki iā lākou ke hōʻemi i ka makemake ikaika, ka wikiwiki, ka pīhoihoi a hoʻolōʻihi i ka manawa no ka orgasm, hiki iā lākou ke hoʻonui i ka impulsiveness a me nā manaʻo moekolohe, e hana ana i kahi ʻano hōʻino maikaʻi loa;

b) Hoʻoemi i ka impulsivity ākea ma o nā stabilizers a me nā antidepressants, e hoʻemi ana i ka lōʻihi, ka nui, a me ke koʻikoʻi o nā manic episodes;

c) Hoʻonui i ka ʻoluʻolu o loko, e hana i ka makemake e ʻimi hou aku i ka wikiwiki a me ka liʻiliʻi pinepine, ma ka liʻiliʻi i ka loaʻa ʻole o nā mea hoʻonāukiuki nui aʻe;

d) Hoʻopilikia me ka orgasm e hoʻoliʻiliʻi i ka leʻaleʻa i ka manawa nui i kāna hapa hope.

I ʻItalia, ʻo Cantelmi lāua ʻo Lambiase [46], i kau i ka lāʻau ma ka nīnauele hoʻoikaika a me ka hoʻihoʻi ʻana i nā hana metacognitive o ka mea maʻi. I ka ʻoiaʻiʻo, e like me kēia ʻano, ka nānā nui ʻana i ka mālama ʻana i nā ʻōuli a me nā mea nui loa o ka hoʻokō ʻana i nā ʻano moekolohe repetitive, compulsive a / a i ʻole moe kolohe, e nalowale ana ka ʻike ʻana i ka hiki ke hana i ka maʻi i kahi hoʻonui nui ʻia. ʻo ia hoʻi ka waiwai symbolic-kū i ke ʻano o ka moekolohe i kēlā manawa no ka mea hoʻomanawanui. No laila e hoʻopili ʻia ka maʻi hypersexuality i ka disorganization o nā ʻōnaehana hoʻoikaika i hoʻokumu ʻia ke kumuhana i ka makahiki ulu mai ka launa pū me kāna mau kahu mua. E pili ana i nā haʻawina e pili ana i nā ʻōnaehana hoʻoikaika i hana ʻia e Liotti, hoʻohui nā mea kākau i ke kumumanaʻo o ka hemahema o nā hana metacognitive na Antonio Semerari i loko o ke kumumanaʻo o nā hoʻolālā o nā ana hoʻohālikelike kūloko. Kūlike kēia mau hoʻolālā ʻike i nā mana hana kūloko i hōʻike mua ʻia e ka psychiatrist a me psychoanalyst ʻo John Bowlby, ka mea i ʻike i ka nui o kona ʻike i ka ʻae ʻana me nā noiʻi i mālama ʻia ma ʻItalia e Giovanni Liotti lāua ʻo Vittorio Guidano, ʻoiai ʻo ka hope kahi o ka noʻonoʻo ʻike. Hoʻokaʻawale ʻia nā kumu hoʻoikaika e Liotti i ʻekolu mau pae ulu a ke hānai nei, ka hanu ʻana, ka ʻimi ʻana, a me ka moe kolohe ʻana no ka mea pili i ka pae haʻahaʻa o ka evolution, kahi e hōʻoiaʻiʻo ai i ke ola. I ka pae ʻelua, ʻo ka mea e pili ana i ka pono o ka pilina kanaka, ʻano maʻamau o nā lāhui kanaka, ʻike ʻo Liotti i ka hoʻopili, ka launa pū ʻana ma waena o nā kaulike, ka hoʻopili ʻana i ka wahine e pili ana i ke ola o ka wahine, ke kūlana kaiāulu. ma ke kolu o ka pae, nā mea ʻoi aku ka holomua, ka ʻōlelo hōʻailona, ​​ka pono o ka ʻike, ka pono no ka hoʻoili ʻana i nā manaʻo, ka ʻimi ʻana i nā waiwai. Aia kēia mau hiʻohiʻona hoʻoikaika hoʻoikaika āpau i kēlā me kēia kanaka, a hiki ke hoʻoulu ʻia a i ʻole ʻaʻole e ka hanana kūwaho. Wahi a nā mea kākau ʻelua, pili nui ka ʻōnaehana hoʻopili i ka hoʻoulu ʻana o ka ʻōnaehana hoʻonāukiuki moekolohe i nā mea maʻi e loaʻa ana i ka maʻi hypersexuality. ʻO ka maʻamau, pono ka haʻalele ʻana o ka mea mua e kāpae i ka hoʻoulu ʻana o ka mea ʻē aʻe, ma ke ʻano he ʻelua kumu a me nā kumu ʻokoʻa. Eia nō naʻe, ua nānā nā kauka lapaʻau ʻelua i nā mea maʻi i hoʻopili i ka moekolohe, hana pinepine ʻia ka moekolohe i nā manawa o ka hopohopo, ka makaʻu, a me ka ukiuki paha ma ke ʻano he mea hana no ka mālama ʻana i nā manaʻo maikaʻi ʻole. ʻO kēia no ka mea ʻaʻole i loaʻa ka mea mālama mai nāna e loaʻa ka hōʻoluʻolu (naʻau), ua "aʻo" ʻole kēlā me kēia kanaka pehea e hoʻokō ai i nā manaʻo o ke olakino a me ka pīhoihoi maikaʻi ma o ka hana moekolohe a me ka orgasm. Hōʻoia kēia e nā noiʻi he nui e hoʻopili i ka maʻi hōʻino me ka hanana o nā hanana traumatic ikaika ma mua. Ma muli o ka ʻike ʻole o kēia ʻano hana i ka mea hoʻomanawanui, ʻaʻole hiki iā ia ke hoʻomaopopo a haki i ka automatism e alakaʻi iā ia e haʻi hou i ka moekolohe ma nā hanana kūpono ʻole. Ua manaʻo ʻo Cantelmi lāua ʻo Lambiase ʻo ka hemahema o ka elaboration ma kahi pae ʻike o ke kaʻina hana pathogenic ma muli o ka hemahema o nā hana metacognitive o ka mea hoʻomanawanui, ʻo ia hoʻi, i kona hiki ke noʻonoʻo iā ia iho, e hoʻomaopopo i kona mau naʻau, e hoʻololi mau iā lākou e hoʻokō i kāna mau pahuhopu. , kau i nā hoʻolālā e hoʻoponopono pono iā lākou. Kūkulu mau ʻia nā hana Metacognitive ma loko o ke ola o kēlā me kēia kanaka, e hoʻomaka ana mai kāna hana mua ʻana me ka mea mālama mua. Ma o ke kaʻina hana o ke aniani kilohi a ka hope i hana ai i ke keiki, aʻo ʻo ia e ʻike i kona mau manaʻo ponoʻī, a ma kahi pae primordial hoʻokaʻawale wale nō i nā "ʻoluʻolu" a i ʻole nā ​​"ʻoluʻolu" ʻole, a ʻike i ka poʻe ʻē aʻe. ʻO ka hoʻomanaʻo o kēia mau naʻau i ʻike ʻia i ka wā kamaliʻi i hoʻopaʻa ʻia i loko o ka hoʻomanaʻo implicit a preverbal o ke kumuhana; e hoʻonohonoho hou ʻia nā hoʻomanaʻo hoʻomanaʻo i mālama ʻia ma loko o nā ʻōnaehana hoʻoikaika, ka mea e alakaʻi i ka lawena o kēlā me kēia ke hoʻoulu ʻia kahi ʻōnaehana e ka hanana kūwaho. ʻO ka hōʻuluʻulu ʻana, e like me nā mea lapaʻau Italia ʻelua, ʻo ke ʻano o ka mālama ʻana i ka hana kolohe ʻo ka hana maoli ia o ka ʻōnaehana hoʻonāukiuki hewa e pili ana i ka noi o ke kaiapuni: ke koi ʻia ka hanana i ka hoʻoulu ʻana o ka ʻōnaehana hoʻopili. o nā ʻano e pili ana i ke kāhea ʻana i kahi kiʻi hōʻoluʻolu, e ʻimi nei i ke kōkua, a i ʻole ke hoʻokō ʻana i nā hoʻolālā ʻē aʻe e hoʻoliʻiliʻi kūʻokoʻa i ka makaʻu a me ka hopohopo, ua hoʻāla ʻia ka ʻōnaehana hoʻonāukiuki e hoʻouluulu i ke kumuhana e hoʻokō i ka moekolohe. ʻO ke kikoʻī o kēia kumumanaʻo, eia nō naʻe, ka pahuhopu kūpono e hoʻomāhuahua i ka ʻike o ka mea maʻi i ke kumu o kāna maʻi a me ke ala maikaʻi ʻole e hoʻāla ʻia ai ka moekolohe iā ia e uku no nā hana ʻē aʻe, e like me ka mālama ʻana i ka ʻeha, ka luhi, ka makaʻu. o ka haʻalele ʻia. ʻO ke kumu i ka hoʻokokoke ʻana o nā mea kākau ʻelua e kōkua i ka mea hoʻomanawanui e ʻike i nā ʻuhane a me nā ʻano e hoʻoulu ai i ka moekolohe iā ia, a laila e hiki ai iā lākou ke wehewehe pū i nā kaʻina hana ʻē aʻe.

hopena a

ʻO ka mahele lapaʻau o "nā hana moekolohe kīnā ʻole" e ʻapo i ke kaʻina o nā kuhiakau pathological i pili nui ʻia i ka simomatology i wehewehe ʻia i ka anamnesis. No laila, hiki i ka moekolohe ke hopena maʻalahi o kahi pae kiʻekiʻe o ka hoʻoulu ʻana a i ʻole, māka ʻana e like me nā ʻōuli, ke ʻano o ke ʻano pilikino a psychic paha: i ka hihia mua e kau mākou iā mākou iho i ka epileptic, vascular, dementia, tumoral nā maʻi, ʻōnaehana a neuroendocrine infectives paha; i ka lua o ka hihia, ma ka ʻaoʻao ʻē aʻe, e nānā mākou i nā pili psychopathological, a hiki i nā mea hōʻalo a me nā ʻano pilikino. Hoʻopaʻa pū kekahi nā noiʻi Neuros Scientific i ke kuhiakau ma hope o nā hana moekolohe maikaʻi ʻole aia kekahi ʻano like e mālama ai i ka lawena a me / a i ʻole nā ​​mea hoʻowaiwai, me ka nānā pono ʻana i ka wahi tegmental ventral, ka nucleus accumbens, ka amygdala, ka ganglia basal, ka mua mua a me ka orbitofrontal kino. Ma mua o ke kuhiakau e pili ana i ke komo ʻana o ka dopamine a me ka serotonin, ke kuhiakau o ke komo ʻana o ka oxytocin i ka uku a me ke kaʻina hana hōʻoluʻolu e like me ka hoihoi; Eia nō naʻe, ʻuʻuku nā haʻawina e pili ana i kēia kuhiakau a ʻaʻole hiki ke noʻonoʻo ʻia i ka ʻikepili he definitive. I ka wā e hiki mai ana, manaʻo nui ʻia i ka kuhiakau oxytocin e pili ana i ke kumuhana o ka hoʻāʻo i ka moekolohe, ka moekolohe a me nā kiʻi pono ʻole.

E hoʻomaopopo '

Hōʻike 2: Ka Hoʻololi ʻana i ka Pākēneka o nā ʻōpio e nā Lawelawe Puʻuwai Kumuwaiwai.

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