ʻEkolu hōʻikeʻike no ka Hypersexuality pilikia; ʻO nā koho hōʻike manaʻo kōkua ʻimi ʻimi hea? (2020)

Hōʻuluʻulu Manaʻo

1. Introduction

Hiki ke wehewehe ʻia ka moekolohe pili pilikia (PH) e like me ka ʻike o nā pilikia ma muli o ka moekolohe a me / a i ʻole pinepine pinepine i ka moekolohe, ka noʻonoʻo, nā manaʻo, nā manaʻo, a me nā moemoeā i waho o ka mana [1,2]. ʻO ka prevalence o PH ma kahi o 2% o ka heluna kānaka [3], me nā kuhi ma kekahi mau subpopulation i hiki ke kiʻekiʻe ma 28% [4,5]. Ua loaʻa he ʻelua a ʻekolu mau manawa ʻoi aku ka kiʻekiʻe o nā kāne ma mua o nā wahine i loaʻa.3,6]. ʻO ka noho ʻana o PH a me ka hiki ke ʻike pono iā PH e hoʻopaʻapaʻa ikaika ʻia [7,8,9,10]. ʻO ka mea kikoʻī, ua hoʻohewa ʻia ka hopena overpathologizing o kahi kuhi, a hōʻike kekahi i kahi hōʻailona maʻi no PH ma ke ʻano he wehewehe o ka moekolohe ʻole i hōʻole ʻia [11]. ʻOiai nā paʻakikī e ho'ākāka pono 'ana iā PH, kahi a nā diverging diagnostics e hōʻike ai [12,13,14,15], ua hōʻike nā kauka lapaʻau ua ʻike maopopo ʻia ke ʻano e kā lākou mea kūʻai aku [16,17,18], e ʻike diagnose paha ʻaʻole paha. Ma muli o ka hilahila manaʻo a me ka nele o ka noiʻi, hiki wawe paha ka wehewehe ʻana iā PH clinically. No laila, ʻo ka wehewehe ʻana o ka hana a PH a mākou i noi ai ma luna aʻe e pili hou ana i kahi ʻano lawena [12] ma mua o ka diagnose kūlana.

I nā makahiki i hala iho nei, ua hoʻomohala ʻia kekahi mau ʻano manaʻomanaʻo hakakā e hoʻokumu i PH ma ke ʻano he maʻi maʻi maʻi. Ua hoʻomohala ʻia nā pae hoʻohālikelike kikoʻī e pili ana i ʻekolu o kēia mau hiʻohiʻona. Nānā ʻia ʻo PH ma ke ʻano he (1) hōʻalo wahine [19,20,21,22,23,24], (2) maʻi ʻōlohelohe [25,26,27], a i ʻole (3) maʻi hōʻeuʻeu moekolohe.28,29]. ʻO ke ʻano o ka moekolohe ma ke ʻano he diagnostical clinical e nā ʻōuli generic generic, e like me ka preoccupation, hoʻopilikia maikaʻi ʻole i ka moekolohe me nā hana o kēlā me kēia lā, ka haʻalele ʻole ʻana, ka hoʻomau ʻana me nā hopena maikaʻi ʻole, ke ahonui, a me nā hōʻailona haʻalele.23,24]. Ua hāpai ʻia kahi maʻi hypersexual — a ma hope ua hōʻole ʻia - ma ke ʻano he diagnostic no ka DSM-5. Aia i loko o kāna ʻano diagnostical kekahi mau loina o ka hoʻohaʻahaʻa wahine, ʻaʻole naʻe ia o ka hoʻomanawanui a me ka haʻalele ʻana [25]. Ma muli o ka noiʻi koʻikoʻi [30], nā pae hoʻohālikelike no ka moekolohe i hoʻohana ʻia ma ke ʻano he coping [25] (ua hoʻokomo ʻia nā pae hoʻohālikelike A2 a me A3) ma ke ʻano he mahele o ka hōʻailona maʻi ʻo hypersexual. ʻOiai ʻo ka hōʻole ʻia o kēia kuhi no ka hoʻokomo ʻana i ka DSM-5 [31], kahi pālākiō me nā mea e kamaʻilio ana i ke kope ʻana i koe ka ʻāpana o ka Hypersexual Behaviour Inventory [32], kahi mea hana pinepine e loiloi iā PH. ʻO nā pākēneka kiʻekiʻe loa o ka poʻe moekolohe i loaʻa me kēia mea kani [4,33] manaʻo e pili pilikia paha nā hui ma waena o ke kāpae ʻana a me ka moekolohe ʻana no kekahi ʻāpana o ka heluna lehulehu i pilikia ʻole ʻia e PH. Ka hoʻohaunaele moekolohe koʻikoʻi, ka hōʻailona ICD-11 hou i ʻae ʻia [28], ʻokoʻa mai ka ʻike hoʻomāinoino wahine i ka hapanui o ka hoʻohui o hoʻokahi anakahi a me kahi papa kuhikuhi. Hoʻomaopopo ka mea hōʻike i ka hoʻomau ʻana o ka hana moekolohe repetitive me ka nalowale o ka leʻaleʻa [28]. Mālama nā alakaʻi i ka overpathologizing, keu hoʻi o ka preoccupation me ka wahine [28] a me ke kaumaha e pili ana i nā manaʻo o ka hewa a me ka hilahila [29].

ʻAʻole i aʻo pono ʻia kekahi mau pae hoʻohālikelike i hoʻohana ʻia i loko o ʻekolu mau ana hoʻohālike no PH. ʻO ka criterium o ka nalo o ka leʻaleʻa ʻaʻole i noi nui ʻia. kahi prevalence kiʻekiʻe o ke ahonui a me ka haʻalele ʻana i nā ʻōuli i loaʻa i waena o nā kauka i loko a me nā mea maʻi i mālama ʻia no ka hoʻāhewa wahine.23], akā i loko o hoʻokahi noiʻi e noiʻi ana i kēia prevalence, ʻaʻole hui ʻia kahi hui hoʻohālikelike i hoʻopili ʻia e PH. Hana ʻia kahi pilikia noiʻi noiʻi like i loko o kekahi mau noiʻi e pili ana i ka pinepine o ka moekolohe a me ka PH o nā hopena i hōʻike ʻia, e like me ka hoʻowalewale ʻana i ka lāʻau, ke wānana nei ke kiʻekiʻena wahine i ka hanana PH.34,35,36]. Eia nō naʻe, ke hoʻohui ʻia nā pūʻulu hoʻohālikelike pili i nā aʻo nui ana, ʻaʻole i hoʻokae ka nui o ka moekolohe ma waena o PH a me ka makemake moekolohe kiʻekiʻe me ka ʻole o ka pilikia37,38]. Hōʻike kēia mau hopena kūʻē e pili ana i ka pinepine o ka moekolohe (1) e loaʻa ka pākēneka kiʻekiʻe o PH i ka heluna lehulehu i waena o ka poʻe me ka nui o ka pinepine moekolohe.36,37,38] a ʻo kēlā (2) i waena o ka poʻe no lākou e pili pili i ka ʻike inā makaʻu lākou i ka PH, ʻaʻole paha ke alapine pinepine i kahi hōʻailona hoʻokaeʻike [39]. ʻAʻole pili kēia a kāpae ʻole i ke alapine wahine kiʻekiʻe ma ke ʻano he diagnost of PH, akā hōʻike ia ʻaʻole hiki ke hoʻohana ʻia ke alapine wahine kiʻekiʻe e hoʻokaeʻike iā PH mai nā kūlana ʻē aʻe, nonclinical, i ke ʻano o ka pinepine moekolohe me ka ʻole o ka pilikia.

I loko o kēia noiʻi noiʻi o kahi laʻana pūnaewele nui, lawe ʻia kahi hana mua e hoʻokumu i nā pae hoʻohālikelike o nā ʻano diagnostic ʻekolu he mau hōʻailona kūʻokoʻa e hoʻokaʻawale iā PH mai nā kūlana ʻē aʻe. E loaʻa i kēia mau hōʻailona nā mana hoʻokae kiʻekiʻe a alakaʻi i nā kuhi kūpono a hilinaʻi ʻia [40,41] e hoʻomaopopo a loiloi iā PH. No laila, ʻo ka pahuhopu nui o kēia noi ʻana e ʻimi a hoʻāʻo i kahi ʻano o nā ʻano a hoʻonui ʻia i hiki ke hoʻohana maikaʻi ʻia e loiloi iā PH. No kēia, hoʻohana mākou i kahi laʻana i hiki ke hoʻohālikelike ʻia i nā subgroups pili [42]. Eia kekahi, makemake mākou e noiʻi inā nui aʻe nā mea hōʻike kūpono e kū nei i kēlā me kēia mea e hoʻonui i ka manawa kūpono e ʻike lākou i ka pono no ke kōkua no PH. Inā ʻo kēia ka hihia, hōʻike ʻia hiki i kēia mau hōʻailona ke lilo i ʻāpana o kahi mea kani ʻaʻole wale i ka mana hoʻokae akā hiki ke ana i ka paʻakikī o PH. Me ke ana o ka paʻakikī, hiki ke hoʻokō ʻia nā loiloi o nā hana a hiki ke loiloi ʻia ka holomua therapeutic [43]. I kēia noi ʻana, e nānā nui ʻia i nā ʻokoʻa kāne no ka mea ʻaʻole hiki ke manaʻo ʻia he priori e ʻike ka wahine a me nā kāne iā PH ma ke ʻano like.

2. Nā Pono a me nā Una

3. Nā hualoaʻa

4. Kōkua

Hōʻike nā hopena nui o kēia noi ʻana ʻo ka hopena "Negative Effects", e ʻeono mau hōʻailona, ​​ka wānana nui loa o ka ʻike ʻana i ka pono no ke kōkua no PH. ʻO kēia kumu, makemake mākou kikoʻī e ʻōlelo "Withdrawal" (ke hopohopo a hoʻomaha ʻole) a me "Loss o ka leʻaleʻa". ʻO ka pili o kēia mau hōʻailona i ka hoʻokaʻawale ʻana iā PH mai nā kūlana ʻē aʻe i manaʻo ʻia [23,28] akā ʻaʻole i hoʻokumu mua ʻia e ka noiʻi empirical. ʻO nā hōʻailona ʻehā ʻē aʻe i ʻāpana o ka "Nā hopena maikaʻi", "ʻAʻole e haʻalele", "E hoʻomau me nā hopena maikaʻi ʻole", a me "Ka hopena o nā hopena maikaʻi ʻole" i hoʻokumu ʻia ma ke ʻano he wānana no PH [23,26,29] a no laila he ʻāpana o nā ʻānō diagnostic ʻekolu o PH. Ua ʻike ʻia ka mea nui o ka "Social pressure" i ka hui pū ʻana me PH [17] a malia paha ua pili kēia ʻano me ka ʻae ʻole (pono ʻole) [53]. I loko o nā kulekele diagnostical maʻi hōʻino Compulsive, ua ʻōlelo kikoʻī ʻia ʻo nā pilikia ma muli o ka hilahila a me ka lawehala ʻaʻole ia e hilinaʻi ʻia e hōʻike ana i ka maʻi maʻi [28]. Pono e nānā hou i ka ʻaoʻao o ka "Social pressure" e pono ai e hōʻike inā kuhikuhi ia i ka overpathologizing a i ʻole inā ma muli o ka hopena pili kaiaulu ka hopena o ka nohona maikaʻi (ka nalowale ʻana o ka launa aloha, haki54]). ʻAʻole i hoʻāʻo ʻia nā hui me nā manaʻo maikaʻi i kēia noi akā he kuleana nui paha ia i ka hoʻomaka a me ka hoʻomau ʻana o PH. Hāʻawi ʻia i ka mana hoʻokae o ka ʻaoʻao "Negative Effects", hiki ke hoʻohana ʻia kēia mea e loiloi iā PH i kahi subpopulation o ka poʻe e kānalua nei no ka hoʻopilikia ʻia e PH. Eia kekahi, ke loaʻa nā mea hōʻailona ʻoi aʻe o nā "hopena maikaʻi", piʻi ka manawa kūpono o ka ʻike ʻana i ka pono no ke kōkua. Hōʻike kēia i kahi ana o ka paʻakikī o PH hiki ke hoʻokumu ʻia i nā huahana o kēia kumu. Pono e ʻōlelo ʻia, hāʻawi ʻia i ke kūlike ʻole o loko, pono e hoʻomohala i kēia mea i mea hoʻohana pono kūpono e hoʻohana i kahi helu nui aʻe o nā mea like / kuhikuhi i mea e ana ai i nā kūkulu maikaʻi ʻole. Pono e noiʻi hou e hoʻokumu i nā mea hōʻailona i hiki ke hoʻohui ʻia i ka hopena Negative Effects e hoʻomaikaʻi ai i kāna kūloko kūloko.

Ua hōʻike hou nā hualoaʻa i kahi hui ʻana o ʻelima mau mea i lalo o ka helu "Coping". ʻO kēia mau mea i kuhikuhi kikoʻī ʻia i nā hopena ma hope o ka moekolohe (e laʻa, "E hiki iaʻu ke hoʻomanawanui i nā hassles o kēlā me kēia lā ma hope o ka moekolohe"). ʻAʻole i wānana nui ka mea "Coping" i ka ʻike ʻana i ka pono no ke kōkua no nā wahine a no nā kāne paha, e ʻōlelo ana ʻaʻole hiki ke hoʻohana ʻia ʻo "Coping" e hoʻokaʻawale i ka poʻe e loaʻa ana ka pono no ke kōkua mai nā poʻe makemake ʻole i ke kōkua. ʻAʻole koi kā mākou noiʻi noiʻi i kahi hopena paʻa e pili ana i nā hui o ka hana kope ʻana a me ka PH no ka mea ʻo nā mea e pili ana i ka "Coping" i kuhikuhi ʻia i nā hopena ma hope o ka moekolohe ʻana, a ʻo ka moekolohe i hoʻohana ʻia e like me ka hana kope ʻana i PH e lilo ia i mea nui i ka hoʻomaka ʻana i ka moekolohe.33]. Hōʻike mākou i ka mea, ʻo ka mea nui, ka noiʻi mua ma PH a me ke kāohi ʻana [33] hana hou ʻia a, ʻo ka lua, ʻo nā hui ʻē aʻe ma waena o ka moekolohe i hoʻohana ʻia e like me ka coping a me PH e aʻo ʻia ma mua o ka hoʻoholo ʻana e pili ana i ka coping a me PH. E wehewehe paha kā mākou hopena, akā, ka hapa nui o nā hopena wahaheʻe i loaʻa me ka Hypersexual Behaviour Inventory- [4,5], kahi mea hana e hōʻike pono ana i kahi pālākiō "Coping" [26] e nānā iā PH. Hōʻike ʻia kahi hana hoʻolaha e noiʻi i ka moekolohe i hoʻohana ʻia e like me ka hana kope ʻana i PH55], ʻo kēia ʻano ʻimi noiʻi e ʻae ai i ka hoʻāʻo ʻana i ka mana kūlohelohe o nā dynamics coping disfunctional o kēlā me kēia ʻeha e PH [56].

ʻO ke kumu ʻekolu i hoʻokumu ʻia i loko o kā mākou noi ʻana ʻo "Desire Sex", me nā ʻōuli e like me "Tolerance" a me "Need sex to function". Wanana maikaʻi ʻole ʻo "Desire Sex" i ka ʻike ʻana i ka pono no ke kōkua no nā wahine a me nā kāne. Kēia mea i ka wā e pono ai ka moekolohe ʻana (e hana), a i ʻole makemake i ka moekolohe ʻoi aku ka nui, e hoʻemi ana ka ʻike o ka pono no ke kōkua. No nā wahine, ʻo "Desire Sex" pū kekahi me "Preoccupation me ka wahine" a me "Orgasm frequency". No nā kāne, ua hoʻohui ʻia kēia mau hōʻailona ma ke ʻano he covariates i nā kālailai, a ua hōʻike ʻia nā hopena, no nā kāne, pili ka "Preoccupation with sex" me kahi kiʻekiʻe kiʻekiʻe e ʻike i ka pono no ke kōkua ʻoiai ʻo "Orgasm frequency" e pili ana me kahi haʻahaʻa haʻahaʻa. makemake kōkua. Kūlike kēia mau hopena me ka noiʻi mua e pili ana i ka makemake moekolohe [37,38], akā kūʻē i nā mea i manaʻo ʻia e pili ana i kahi kuanaʻike kolohe wahine. I ka hoʻohālikelike me ka hoʻohana ʻana i ka lāʻau, hiki ke manaʻo ʻia nā kānaka e "hoʻohana" ʻana i kekahi mau ʻano pinepine (e laʻa me ka piliwaiwai a i ʻole ka wahine) e ʻoi aku ka nui o ka makaʻu i ka hoʻomohala ʻana i kahi ʻano lawena.24,57]. I ka hāpana o kēia manawa, eia nō naʻe, ʻo ka poʻe i komo me ke alapine ʻoi aku ka kiʻekiʻe ma mua o ka makaʻu o ka ʻike ʻana i nā pilikia me ka moekolohe, kahi a mākou e hoʻoholo ai he ʻoki ma waena o ka pinepine a me ka pinepine ʻole o ka wahine.37,58] ʻaʻole hiki ke hoʻokūpaʻa. Pēlā nō, "Tolerance" (makemake i ka moekolohe a ʻoi aku) ʻaʻole hiki ke hoʻohana ʻia e loiloi iā PH; ma ke ʻano he mahele o ka "Sexual Desire", he wānana maikaʻi ʻole ia no PH. Hōʻike kēia noiʻi ʻo ia ka mea mua a me ka poʻokela "Nā hopena maikaʻi" e hōʻike inā ʻike ʻia ka moekolohe ma ke ʻano he pilikia. ʻO ka hoʻonui ʻana i ka moekolohe a me ke kiʻekiʻe o ka moekolohe ʻaʻole nā ​​hōʻailona maikaʻi o PH i kahi laʻana o ka poʻe kānalua e pili ana i kā lākou pae o PH.

ʻO ke kumu hope loa i hōʻike ʻia i loko o kā mākou ʻikepili, "Extreme", he ʻehā mau hōʻailona e kamaʻilio ana i nā "stimulus moe kolohe ʻole", "E hoʻohana i nā lāʻau i ka nānā ʻana i ka porn", "porn Extreme", a me "Time spent on porn". Kuhi kēia mau hōʻailona i kahi hiʻohiʻona piʻi e pili ana i ka nānā ʻana i nā porn a me nā ʻano paraphilic. No nā wahine a me nā kāne, wānana maikaʻi ʻo "Extreme" i ka pono o ke kōkua. Eia nō naʻe, liʻiliʻi ka mana hoʻokae o "Extreme", a i kona ʻano i kēia manawa ʻaʻole hiki ke noʻonoʻo ʻia kēia mea he hōʻailona maikaʻi o PH. Pono e mālama hou i nā noiʻi e loiloi i ka pilina ma waena o nā moekolohe nui a me PH.

I kēia laʻana, ʻo ka pākēneka o nā kāne i ʻike i ka pono no ke kōkua ma kahi o ʻelua manawa ka nui ma mua o ka pākēneka o nā wahine. Eia nō naʻe, ʻano like nā hiʻohiʻona pane no nā wahine a me nā kāne i kēia aʻo ʻana. Hoʻomaopopo mākou i nā ʻokoʻa kāne a me nā mea hoʻokaʻawale i koʻikoʻi nui ʻia no ka "Social pressure" a me nā hopena coping; ua hōʻike mua kēia mau hōʻailona i ka PH no nā wahine ma mua o nā kāne, a pono e noiʻi hou e ʻimi i kēia mau ʻokoʻa.

Makemake mākou e ʻōlelo i kekahi mau palena o kēia hoʻopaʻa ʻana: (1) ana ʻia ʻo PH e ka "ʻike ʻana i ka pono no ke kōkua no PH", kahi ana i hoʻokumu ʻia wale nō i ka loiloi ʻana iā ʻoe iho e hoʻohuli ʻia e nā lula kaiāulu a no laila ʻaʻole ia he hōʻailona no maʻi maʻi maʻi [28]. ʻO ka makaʻu o ka overpathologizing i ka hana moekolohe ponoʻī ma muli o nā kaiaulu.8,9,10,11,15] hiki ke hōʻalo ʻia e ka hoʻopili kaulike ʻana o ka poʻe komo e ka sexologist ʻike loea [16]; (2) ʻAʻole kiʻekiʻe ka hilinaʻi o nā subscales, ʻo ia hoʻi e mālama pono ʻia i ka wehewehe ʻana i nā hopena exploratory o kēia noi. pono ke nānā pono i ka noiʻi ʻana i ka hoʻomohala ʻana i nā subscales hoʻolōʻihi ʻia me nā mea i hoʻopili kaulike ʻia e hiki ai i ke kūlike kūloko maikaʻi aʻe. ʻo ka mea nui, ʻo ia mau noiʻi e hoʻomaikaʻi paha i ka mana hoʻokae o nā subscales (ʻoiai ua lawa ke kiʻekiʻe i ka hihia o "Negative Effects"); (3) Heterogeneity o ka hāpana e pili ana i ka moekolohe e pili ana iā PH (eg, ka hoʻowalewale ʻana i ka porn a me ka hoʻopunipuni koʻikoʻi) paha i hoʻohoka i nā hopena a pono e noʻonoʻo ʻia i kahi noiʻi hou; (4) ʻO ka laʻana, ʻoiai he nui, ʻo ia nā mea i koho ʻia i koho ʻia ʻaʻole i wehewehe i ko lākou mau kumu no ke komo ʻana. Eia nō naʻe, ka helu nui o nā wahine a me nā kāne i kēia noi ʻana e ʻike i ka pono no ke kōkua no PH, a me ka hoʻolauna ʻana i ka ana e hōʻike pono ana i ke kumu o ka hāʻawi ʻana i kahi loiloi mua o ka hoʻāo wahine, e hōʻike ana ua hōʻike ʻia nā pane i kēlā mau mea. kanalua i kā lākou pae o PH; (5) ʻAʻole i hoʻokaʻawale kēia noiʻi i ka wahine ma mua o ka wahine dichotomy; pono e noʻonoʻo pono i ka noiʻi ukali me ke ana ʻokoʻa loa o ka ʻike kāne kāne; a (6) ʻAʻole i noiʻi ʻia ʻo Comorbidity i kēia noiʻi ʻoiai, ma ka ʻaoʻao ʻē aʻe, ʻike ʻia ia he kumu maʻamau o PH (eg, i ka maʻi bipolar) [59] pono e noʻonoʻo ʻia i ka noiʻi ʻana.

ʻOiai nā palena i ʻōlelo ʻia, manaʻo mākou he mea kōkua kēia noiʻi i ke kahua o ka noiʻi PH a me ka ʻimi ʻana i nā kuanaʻike hou e pili ana i ka hana hypersexual (problematic) i ka nohona. Hoʻomaopopo mākou ua hōʻike kā mākou noiʻi i ka "Withdrawal" a me ka "Loss o ka leʻaleʻa", ma ke ʻāpana o ka "Negative Effects" factor, hiki ke lilo i mau hōʻailona nui o PH. Ma kekahi ʻaoʻao, ʻo "Orgasm frequency", ma ke ʻāpana o ka "Sexual Desire" factor (no nā wahine) a i ʻole ma ke ʻano he covariate (no nā kāne), ʻaʻole i hōʻike i ka mana hoʻokae e hoʻokaʻawale iā PH mai nā kūlana ʻē aʻe. Hōʻike kēia mau hopena no ka ʻike i nā pilikia me ka moekolohe, pono ka nānā nui ʻana i ka "Withdrawal", "Loss of ahuareka", a me nā "Negative Effects" o ka moekolohe, ʻaʻole nui ma ka pinepine o ka moekolohe a i ʻole ka "hoʻokele moekolohe nui" [60] no ka mea ʻo ia ka "Nā hopena maikaʻi" e pili ana me ka ʻike ʻana i ka moekolohe ma ke ʻano he pilikia. Ma muli o ka noiʻi i kēia manawa, paipai mākou e hoʻohui i nā mea i ka kamaʻilio ʻana i kēia mau ʻano i kahi mea ana no PH. ʻO kēia ka manaʻo e hoʻohui ʻia nā ʻano mai nā ʻano hoʻohālikelike like ʻole i hoʻokahi mea kani [14]. ʻO ke kumumanaʻo, e hōʻike ana kēia i ka hoʻohui piha ʻana o nā manaʻo i kēia manawa o PH he pono e lawe i ke ʻano kū hoʻokahi o ka moekolohe ma ka moekolohe e pili ana i nā loina kaiāulu a me ke olakino a me ke olakino noʻonoʻo.

5. Nā hopena

Hōʻike kēia ʻimi noiʻi noiʻi i ka mea ʻo "Negative Effects" e ʻoi aku ka maikaʻi loa i ka loiloi pololei ʻana iā PH a me ka hoʻokae ʻana iā PH mai nā kūlana ʻē aʻe. No kēia mea, i waena o nā mea ʻē aʻe, nā hōʻailona o ka "Withdrawal" a me "Loss o ka leʻaleʻa" i ka wā i hala i pili wale ʻia i kekahi o nā hiʻohiʻona diagnostics ʻekolu no PH. E pili ana i ke kumumanaʻo, hōʻike kēia ʻaʻole hiki ke hoʻokaʻawale ʻia ʻo PH ma lalo o nā manaʻo e kū nei ma ke ʻano he ʻano hoʻokamakama kolohe, moekolohe, a i ʻole koikoi ʻia ka moe kolohe akā e ʻoi aku paha ka maikaʻi ke nānā ʻia mai kahi kuanaʻike akea. E pili ana i ka hana haukapila, hōʻike nā hopena o kēia noi i nā ʻōkuhi pili empirically i hoʻohana ʻia i nā ʻano diagnostics ʻokoʻa e loiloi iā PH e hui maikaʻi ʻia e kūkulu i kahi mea kani e loiloi ai i ke alo a me ke koʻikoʻi o PH. ʻO ka noiʻi e hiki mai ana e hoʻomohala a hōʻoia i ia mea pono pono e hana pono ʻia i nā subpopulation pili like e like me kahi e noi ai ia, e hōʻalo i ka overpathologizing o ka moe kolohe nonproblematic. Pono e noʻonoʻo ʻia nā ʻokoʻa kāne a me nā kāne ma loko o ka PH, a me nā mea kani e loiloi ai iā PH ma ka liʻiliʻi e ʻokoʻa no nā wahine a me nā kāne.

Nā mea kōkua i kākau

Hoʻohālikelike, PvT, AT, G.-JM, a me JvL; ʻano hana, PvT, PV, a me RL; polokalamu, PvT; hōʻoia, PvT, PV a me RL; kālailai ʻana, PvT; hoʻokolokolo, AT; kumuwaiwai, AT; curation data, AT, PvT; kākau — hoʻomākaukau kope kumu, PvT; kākau — loiloi a hoʻoponopono ʻana, PvT, AT, G.-JM, PV, RL, a me JvL; ʻike kiʻi, PvT; luna hoʻomalu, JvL; hoʻomalu papahana, PvT; loaʻa kālā, NA. Ua heluhelu a ʻae nā mea kākau āpau i ka mana i paʻi ʻia o ka palapala.