Phunziro la Yunivesite ya Cambridge: Kugwiritsa ntchito mankhwala ozunguza bongo pa intaneti kumawonetsa mankhwala osokoneza bongo (Voon et al., 2014)

University of Cambridge

Zosintha:

YBOP COMMENTS (July, 2014)

Kafukufuku yemwe akhala akuyembekezeredwa kwa nthawi yayitali ku Valerie Voon adawonetsa mu zolembedwa ku UK "Porn pa ubongo”Watuluka. Monga zikuyembekezeredwa, ofufuza a University of Cambridge adapeza kuti ogwiritsa ntchito zolaula amachitiranso zolaula monga momwe anthu osokoneza bongo amachitira ndi mankhwala osokoneza bongo. Lumikizani ku kuphunzira kwathunthu - "Neural Correlates of Reactivity Cac Reactivity Mwa Anthu omwe ali ndi popanda popanda chilakolako chogonana (2014)"

Koma pali zambiri.

Ogwiritsa ntchito zolaula amangofuna zolaula (osowa kwambiri), koma analibe chilakolako chogonana choposa chilakolako. Kupeza uku kukugwirizana mwatsatanetsatane ndi kachitidwe kameneka kausokoneza, ndikutsutsa chiphunzitso chakuti “chilakolako chachikulu cha kugonana”Zimayambitsa zolaula. Omwe amamwa mankhwala osokoneza bongo amalingaliridwa kuti amayendetsedwa kufunafuna mankhwala awo chifukwa amafuna - m'malo mosangalala nawo. Izi zachilendo zimadziwika kuti zolimbikitsa, chomwe chimadziwika ndi matenda osokoneza bongo.

Zina mwazikuluzikulu (osanenedwa m'mawailesi) zinali zoposa 50% za maphunziro (okalamba a zaka: 25) anali ndi vuto lochita zinthu zolimbitsa thupi ndi enieni, komabe akhoza kukwaniritsa zolaula. Kuchokera pa phunzirolo (CSB akunena za ogwiritsa ntchito zolaula)

"Pazithunzi zosinthidwa za Arizona Sexual Experience Scale [43], Maphunziro a CSB poyerekeza ndi odzipereka omwe ali ndi thanzi labwino anali ndi zovuta kwambiri zokhudzana ndi kugonana ndikumva zovuta zambiri za erectile mu chibwenzi chogonana koma osati zogonana (Table S3 mu Lembani S1). "

Pomalizira pake, ofufuza adapeza kuti nkhani zazing'ono zidakulitsa mphoto yadera yoyendera dera podziwa zolaula. Mipikisano yapamwamba ya dopamine ndi mphamvu yaikulu yokhudzidwa ndizo zikuluzikulu pa achinyamata ovuta kwambiri kuledzera ndi kugonana.

Mu phunziro ili (Voon et al. Ofufuza a 2014) adapeza umboni wamphamvu kulimbikitsa mumagwiritsa ntchito zolaula. Kuyanjanitsa ndi njira yowonjezereka yomwe imatsogolera kulakalaka kugwiritsira ntchito, ndipo imaonedwa kuti ndiyo vuto lalikulu la ubongo wosinthika. A umboni waukulu akuwonetsa kuti zimayambitsidwa ndi Kuwonjezeka kwa DeltaFosB. Kulimbikitsa chidwi kumayesedwa pogwiritsa ntchito fMRIs kuyeza zochitika mu madera ena amdongosolo pomwe omvera awonetsedwa - pankhaniyi makanema ogonana. Monga wofufuza wotsogolera Valerie Voon Adati:

“Pali kusiyana kodziwikiratu pakachitidwe kaubongo pakati pa odwala omwe amachita zachiwerewere mokakamiza komanso odzipereka athanzi. Kusiyana kumeneku kumafanana ndi kwa anthu omwe amamwa mankhwala osokoneza bongo. ”

Chotsatira china chachikulu ndikuti ogwiritsa ntchito zolaula "sanakonde" zolaula monga gulu lolamulira. Izi zikugwirizana bwino ndi chitsanzo cha mankhwala osokoneza bongo monga ozolowera amakhala ndi zikhumbo zazikulu zogwiritsa ntchito (kufuna), koma osazikonda "izo" (zilizonse "zingakhale" mwamphamvu).

Ofufuzawa adafunsanso ophunzirawo kuti aone ngati ali ndi chilakolako chogonana chomwe amachiwona pamene akuonera mavidiyowa, komanso momwe amaonera mavidiyowo. Mankhwala osokoneza bongo akuganiza kuti amayendetsedwa kuti apeze mankhwala awo chifukwa amafuna osati kusangalala nawo. Njira yosazolowereka imadziwika ngati zolimbikitsa, chiphunzitso chokhwimitsa m'zovuta za mankhwala osokoneza bongo.

Monga momwe zinalili, odwala omwe anali ndi khalidwe lochita zachiwerewere anasonyeza kuti ali ndi chikhumbo chokhudzana ndi mavidiyo olaula, koma sanawoneke ngati akukwera kwambiri.

Zomwe tafotokoza pamwambazi zikutsutsana ndi kutsutsa kuti anthu omwe akuvutika kulamulira zolaula zawo amangokhala ndi ma libidos apamwamba komanso ngati kugonana kuposa anthu ena onse.

Maphunziro awiri a Cambridge amafika pafupi phunziro lachi German zomwe zimagwirizanitsa ubongo zingapo zimasintha nthawi ndi zaka zolaula zomwe zimagwiritsidwa ntchito. Maphunziro onsewa amangotsimikizira zomwe Maphunziro a ubongo a 110 pa intaneti awonetsa - kuti intaneti imatha kuyambitsa matenda opatsirana (osokoneza bongo), ndipo itha kubweretsa kusintha komweko monga momwe zimawonedwera ndi omwe amakonda kugwiritsa ntchito mankhwala osokoneza bongo.

M'munsimu muli zolemba zokhudzana ndi phunziroli, ndipo werengani zolemba ndi ndemanga.

NKHANI 1 - Kugonana Ndikakhala Weniweni Pambuyo Ponse

Mfundo zazikulu:

  • "Palibe funso [anthu awa] akuvutika," anatero wolemba mabuku wolemba Dr. Valerie Voon. "Makhalidwe awo ali ndi zotsatira zolakwika pamagulu angapo a ntchito, makamaka magulu othandizira, ndipo ... sangathe kulamulira makhalidwe awo."
  • "Ndikuganiza kuti [yathu ndi] kafukufuku yemwe angathandize anthu kumvetsetsa kuti ichi ndi matenda enieni, ichi ndi vuto lenileni, chifukwa chake anthu sangalekerere mchitidwe wogonana mokakamiza ngati chinthu chamakhalidwe," adatero Voon. "Izi sizosiyana ndi momwe kutchova njuga komanso kugwiritsa ntchito mankhwala osokoneza bongo kunkawonedwa zaka zingapo zapitazo."
  • Dr. Richard Krueger, pulofesa wa zachipatala ku Columbia University, adanena kuti akukhulupirira kuti kafukufukuyo adzakhala "maphunziro a seminal" m'munda.
  • Krueger, yemwe akuchokera ku 2008 kupita ku 2013, adatumizira komiti ya udokotala kuti iwononge matenda a hypersexual ku DSM-5. "[Phunziro] limagwirizana ndi lingaliro lakuti izi ndi matenda, mmaganizo anga, ndipo zidzakhudza akatswiri ndipo zimakhudza kwambiri tsopano mwa kufotokozera mwawailesi."

Ndi Tara Berman, MD. July 11, 2014

Zokambirana zokhudzana ndi kugonana komwe kulipo zikhoza kugonekedwa ndi phunziro latsopano lomwe limayang'ana mu ubongo wa iwo omwe ali ndi makhalidwe okhudzana ndi kugonana.

Ofufuza pa yunivesite ya Cambridge amagwiritsa ntchito ubongo wogwiritsa ntchito maginito opanga mafilimu (fMRI) pofuna kufanizitsa ntchito za ubongo za anthu a 19 ndi chizolowezi chogonana ndi chiwerengero chofanana cha machitidwe abwino pamene magulu awiriwo adawonerera zolaula.

Chimene iwo apeza chinali chakuti ubongo wa iwo omwe ali ndi chizolowezi chogonana "amatha" mwa njira yosiyana kwa omwe alibe makakamizo. N'zochititsa chidwi kuti machitidwe a ubongo mwa anthuwa amasonyeza zomwe zimawoneka mu ubongo wa anthu osokoneza bongo atakhala ndi mankhwala osokoneza bongo. Kuwonjezera apo, madera atatuwa omwe adayika kwambiri mu ubongo wokhudzana ndi kugonana - ndi ventral striatum, dorsal anterior cingulate ndi amygdala - ndi malo omwe amadziwika kuti akukhudzidwa ndi mphotho, chikhumbo ndi kukhumba.

Zomwe zapezazi zingabweretse kulemera kwa lingaliro la chizolowezi chogonana monga vuto lovomerezeka.

"Palibe funso [anthu awa] akuvutika," anatero wolemba mabuku wolemba Dr. Valerie Voon. "Makhalidwe awo ali ndi zotsatira zolakwika pamagulu angapo a ntchito, makamaka magulu othandizira, ndipo ... sangathe kulamulira makhalidwe awo."

Malingana ndi Voon, ambiri mwa anthu akuluakulu a 25 akhoza kukhudzidwa ndi khalidwe lachiwerewere - chosalamulirika ndi maganizo, kugonana kapena zochita. Omwe amawapeza nthawi zambiri amakumana ndi manyazi komanso kudziimba mlandu, ndipo zosankha za mankhwala ndizochepa.

Panopa palibe chidziwitso chovomerezeka cha chikhalidwe ichi. Iwo anali asanavomerezedwe mu DSM-5 - yomwe nthawi zambiri imatchedwa "bible" mkhalidwe wamaganizo. Mpaka chizolowezi chogonana chidziwika mwa njira iyi, zidzakhala zovuta kwa iwo omwe ali ndi vutoli kuti athandizidwe ndi chithandizo chimene chiwerengero chochulukira cha akatswiri a maganizo akusowa.

"Ndikuganiza kuti [athu] ndi phunziro lomwe lingathandize anthu kumvetsa kuti izi ndizovuta kwenikweni, ichi ndi matenda enieni, kotero kuti anthu sangawononge khalidwe lachiwerewere ngati chinthu china," adatero Voon. "Izi siziri zosiyana ndi momwe kutchova njuga ndi kugwiritsira ntchito mankhwala ozunguza bongo kunkawoneka zaka zingapo zapitazo.

"Anthu akuvutika ndi matenda omwe amafunikira chithandizo ndipo zothandizira ziyenera kuikidwa kuti zithandizire izi ndikuchiza ichi."

Akatswiri a zamaganizo omwe sagwirizane ndi kafukufukuyo anati phunziroli ndilofunika kwambiri pa chizoloŵezi chogonana chokhala ndi chiwerengero chofanana ndi zovomerezeka monga makhalidwe ena, monga kutchova njuga.

Dr. Richard Krueger, pulofesa wa zachipatala ku Columbia University, adanena kuti akukhulupirira kuti kafukufukuyo adzakhala "maphunziro a seminal" m'munda.

Krueger, yemwe akuchokera ku 2008 kupita ku 2013, adatumizira komiti ya udokotala kuti iwononge matenda a hypersexual ku DSM-5. "[Phunziro] limagwirizana ndi lingaliro lakuti izi ndi matenda, mmaganizo anga, ndipo zidzakhudza akatswiri ndipo zimakhudza kwambiri tsopano mwa kufotokozera mwawailesi."

Komabe, Dr. Reef Karim, yemwe ndi pulofesa wa zachipatala komanso wazelupale ku UCLA, adati zotsatira zake ziyenera kumasuliridwa mosamala. Mwachindunji, iye anati, zotsatira ziyenera kuwonetsedwa mu gulu lalikulu, losiyana kwambiri kuti liwonetseredwe.

"Kupatula kuwonjezeka kwa chiwerengero cha amuna kuchokera kwa amuna kapena akazi okhaokha kupita kwa amayi ndi omwe ali ndi zosiyana zogonana, muyenera kulemba zinthu zina zomwe zingayambitse anthu kugonana," anatero Karim, amenenso ali mkulu wa Control Center ku Beverly. Mapiri, Malo Amaganizo Aumoyo omwe amachitira nkhanza za kugonana, pakati pa mavuto ena ozunguza bongo. Ananenanso kuti nthawi zina pali zinthu zina monga matenda a bipolar, ADHD ndi OCD - omwe amachititsa odwala kuchita zogonana.

Tengani Dokotala

Ngakhale kuti izi zikhoza kukhala phunziro lofunika kwambiri lomwe limayang'ana m'maganizo mwa iwo omwe ali ndi chilakolako chogonana, kufufuza kwina kudzafunikanso kufotokozera kuwonjezera pa kugonana - komanso momwe angachitire.

N'zoonekeratu kuti pali anthu ambiri amene miyoyo yawo imakhudzidwa kwambiri ndi zovuta ndi zobakamizidwa. Ndipo ngakhale titayika motani, anthu awa amafunikira thandizo.

"Chofunika kwambiri n'chakuti izi zikudziwika kuti ndizo zopezeka m'masautso mwa anthu ndipo zikusowa zofunikira kuti apange chithandizo chabwino," adatero Krueger.

NKHANI 2 - Chikondi ndi mankhwala, asayansi amapeza

Ma Quotes Key:

  • Wasayansi wamkulu Dr Valerie Voon, wochokera ku Yunivesite ya Cambridge, adati: "Odwala pamilandu yathu anali anthu onse omwe anali ndi zovuta zowongolera machitidwe awo ogonana ndipo izi zinali ndi zotsatirapo zazikulu kwa iwo, zomwe zimakhudza miyoyo yawo komanso maubale awo.
  • ”Mwa njira zambiri, amawonetsa kufanana pamakhalidwe awo ndi odwala omwe amamwa mankhwala osokoneza bongo. Tidafunanso kuwona ngati kufanana kumeneku kumawonekeranso muzochita zamaubongo.
  • ”Pali kusiyana kosiyana pakati pa odwala omwe amakhala ndi chizolowezi chogonana komanso odzipereka athanzi. Kusiyana kumeneku kumafanana ndi kwa anthu omwe amamwa mankhwala osokoneza bongo. ”
  • Dr John Williams, wamkulu wa ma neuroscience komanso thanzi lam'mutu ku Wellcome Trust, yemwe adathandizira kafukufukuyu, adati: "Khalidwe lokakamiza, kuphatikiza kuwonera zolaula mopitirira muyeso, kudya kwambiri ndi kutchova juga, ndizofala kwambiri.
  • "Kafukufukuyu akutitsogolera kuti tipeze chifukwa chomwe timabwerezabwereza zomwe tikudziwa kuti zitha kutipweteka. Kaya tikulimbana ndi chizolowezi chogonana, kugwiritsa ntchito mankhwala osokoneza bongo kapena vuto la kudya, kudziwa njira yabwino, komanso liti, kulowererapo kuti tithetse vutoli ndicholinga chofunikira cha kafukufukuyu. ”

Akatswiri a sayansi ya yunivesite ya Cambridge amapeza kuti omwe ali ndi chizoloŵezi cha mankhwala osokoneza bongo komanso chizoloŵezi chogonana ali ndi mayankho ofanana

Ndi Mabungwe, BST 11 Jul 2014

Pamene nyenyezi ya Roxy Music Bryan Ferry adalengeza kuti "chikondi ndiye mankhwalawa" ayenera kuti anali kunena zoona.

Akatswiri a sayansi ya yunivesite ya Cambridge apeza kuti kugonana ndi mankhwala osokoneza bongo kungakhale mbali ziwiri za ndalama zomwezo.

Omwe akugonjetsa kugonana amatha kuona zithunzi zolaula, izo zinayambitsa ntchito za ubongo zofanana ndi zomwe zimawonedwa mwa anthu odalira mankhwala osokoneza bongo.

Koma ochita kafukufuku akuchenjeza kuti zimenezi sizikutanthauza kuti zolaula zimakonda kumwa mankhwala ozunguza bongo.

Wasayansi wamkulu Dr Valerie Voon, wochokera ku Yunivesite ya Cambridge, adati: "Odwala pamilandu yathu anali anthu onse omwe anali ndi zovuta zowongolera machitidwe awo ogonana ndipo izi zinali ndi zotsatirapo zazikulu kwa iwo, zomwe zimakhudza miyoyo yawo komanso maubale awo.

”Mwa njira zambiri, amawonetsa kufanana pamakhalidwe awo ndi odwala omwe amamwa mankhwala osokoneza bongo. Tidafunanso kuwona ngati kufanana kumeneku kumawonekeranso muzochita zamaubongo.

”Pali kusiyana kosiyana pakati pa odwala omwe amakhala ndi chizolowezi chogonana komanso odzipereka athanzi. Kusiyana kumeneku kumafanana ndi kwa anthu omwe amamwa mankhwala osokoneza bongo. ”

Kafukufuku wapitawo adanena kuti kwa akuluakulu akuluakulu a 25 akhoza kukhudzidwa ndi kukhudzidwa ndi malingaliro ogonana, malingaliro kapena makhalidwe omwe sangathe kuwongolera.

Chidziwitso cha anthu pankhani ya chizolowezi chogonana chatsutsidwa ndi anthu otchuka kufunafuna chithandizo, kuphatikizapo ojambula Michael Douglas ndi David Duchovny.

Akatswiri a sayansi ya Cambridge analembetsa anthu odzudzula amuna ndi akazi a 19 ndikuwamasewera mafilimu apamtima ophatikizapo zithunzi zolaula kapena anthu omwe amachita nawo masewera osangalatsa monga kusewera kwa skiing kapena skidiving.

Nthawi yomweyo, ntchito zaubongo za amuna zimayang'aniridwa pogwiritsa ntchito sikani yamagetsi yamagetsi (fMRI). Kuyesaku kunabwerezedwa ndi gulu lodzipereka lomwe silinakhudzidwe ndi vuto logonana.

Zigawo zitatu za ubongo zimapezeka kuti zimagwira ntchito kwambiri mu ubongo wa opatsirana pogonana kusiyana ndi odzipereka omwe ali ndi thanzi labwino, ventral striatum, kuthamanga kwapansi kumbali ndi amygdala.

Onse atatuwa amadziwikanso kuti amavomereza mankhwala osokoneza bongo omwe amachititsa chidwi kwambiri ndi kuona mankhwala osokoneza bongo.

The ventral striatum ndi zowonongeka zimagwiritsidwa ntchito pokonzekera ndi kuyembekezera mphotho, pomwe amygdala amathandiza kufunikira kwa zochitika ndi maganizo.

Ophunzirawo adafunsidwa kuti afotokoze chikhalidwe cha chilakolako cha kugonana chimene iwo anali nacho pamene akuwona mavidiyowa, ndi momwe iwo amawakondera.

Monga zikuyembekezeredwa, anthu omwe ali ndi vuto logonana adawonetsa kukhumbira kwambiri akamaonera zolaula, koma samatanthauza kuti makanema olaula amawaonetsa "m'mene amakonda".

Achinyamata omwe adakali aang'ono adasonyezeratu zochitika zina mu ventral striatum poyankha mavidiyo oonera zolaula.

Madera oyang'anira kutsogolo kwa ubongo omwe amakhala ngati "aswa" pamakhalidwe oyipa akupitilizabe kukula mpaka zaka makumi awiri, atero asayansi. Izi zitha kuyambitsa chidwi chachikulu ndikuyika pachiwopsezo achinyamata.

Dr Voon anawonjezera kuti: "Ngakhale kuti izi zapatsa chidwi, ndikofunikira kudziwa, komabe, sizingagwiritsidwe ntchito kuzindikira matendawa. Kafukufuku wathu samaperekanso umboni woti anthuwa amakonda kugwiritsa ntchito zolaula, kapena kuti zolaula ndizomwe zimakonda kukhala zosokoneza bongo. Pakufunika kuti tifufuze zochuluka kuti timvetsetse ubale womwe ulipo pakati pa chizolowezi chogonana komanso kugwiritsa ntchito mankhwala osokoneza bongo. ”

Dr John Williams, wamkulu wa ma neuroscience komanso thanzi lam'mutu ku Wellcome Trust, yemwe adathandizira kafukufukuyu, adati: "Khalidwe lokakamiza, kuphatikiza kuwonera zolaula mopitirira muyeso, kudya kwambiri ndi kutchova juga, ndizofala kwambiri.

"Kafukufukuyu akutitsogolera kuti tipeze chifukwa chomwe timabwerezabwereza zomwe tikudziwa kuti zitha kutipweteka. Kaya tikulimbana ndi chizolowezi chogonana, kugwiritsa ntchito mankhwala osokoneza bongo kapena vuto la kudya, kudziwa njira yabwino, komanso liti, kulowererapo kuti tithetse vutoli ndicholinga chofunikira cha kafukufukuyu. ”

Zomwe anapeza zikupezeka pa webusaiti ya Public Library ya Science ONE.

Phunziro LOPHUNZIRA: Neural Correlates of Reactivity Reactivity mwa Anthu omwe ali ndi popanda popanda kugonana kwaokha

PLoS One. 2014 Jul 11;9(7):e102419. doi: 10.1371 / journal.pone.0102419.

Onani V1, Mole TB2, Kusunga ndalama P3, Porter L3, Morris L4, Mitchell S2, Lapa TR3, Karr J5, Harrison NA6, Potenza MN7, Irvine M3.

Zambiri za wolemba

  • 1Dipatimenti ya Psychiatry, Chipatala cha Addenbrooke, University of Cambridge, Cambridge, United Kingdom; Khalidwe ndi Chipatala cha Neurosciences Institute, University of Cambridge, Cambridge, United Kingdom; Cambridgeshire ndi Peterborough Foundation Trust, Cambridge, United Kingdom.
  • 2Dipatimenti ya Psychiatry, Chipatala cha Addenbrooke, University of Cambridge, Cambridge, United Kingdom; Cambridgeshire ndi Peterborough Foundation Trust, Cambridge, United Kingdom.
  • 3Dipatimenti ya Psychiatry, Chipatala cha Addenbrooke, University of Cambridge, Cambridge, United Kingdom.
  • 4Dipatimenti ya Psychiatry, Chipatala cha Addenbrooke, University of Cambridge, Cambridge, United Kingdom; Khalidwe ndi Chipatala cha Neurosciences Institute, University of Cambridge, Cambridge, United Kingdom.
  • 5British Association for Counseling and Psychotherapy, London, United Kingdom.
  • 6Dipatimenti ya Psychiatry, Brighton ndi Sussex Medical School, Brighton, United Kingdom.
  • 7Dipatimenti ya Psychiatry, Neurobiology ndi Center Child Study, Yale University, New Haven, Connecticut, United States of America.

Veronique Sgambato-Faure, Mkonzi

Zolemba zochokera pa phunzirolo, ndi ndemanga za YBOP (CSB zikutanthauza zizoloŵezi zakugonana):

Kugwiritsa ntchito mankhwala osokoneza bongo-reactivity ndi chilakolako cha nikotini, cocaine ndi zakumwa zoledzeretsa zamagetsi kuphatikizapo ventral striatum, dACC ndi amygdala 13. Muzofukufuku wamakono, malowa adalandiridwa panthawi yowonera zida zolaula m'magulu omwe alibe ndi CSB. Kuwona kwa zochitika zowonjezereka za madera awa mu CSB ndi omwe ali ndi thanzi labwino odzipereka ndizofanana ndi zomwe zafukulidwa pazinthu zomwe zimagwiritsidwa ntchito mopitirira muyeso, zomwe zikuwonetseratu zofanana za matendawa.

Translation: Atadziwitsidwa, ogwiritsa ntchito zolaula amawonetsa osokoneza bongo omwe ali m'malo am'magazi omwe adayambitsidwa. Komabe, ogwiritsa ntchito zolaula analibe libido kapena "okonda" kwambiri. M'malo mwake, adasowa kapena kulakalaka kwambiri.

Chilakolako cha kugonana kapena kudzipangira zofuna zowoneka chinasokonezedwa kuchoka ku zokondweretsa, mogwirizana ndi zolimbikitsa zowononga 12 momwe kulipo kulimbikitsidwa kwakukulu koma osakondwera ndi mphoto zosavuta.

Poyerekeza ndi odzipereka omwe ali ndi thanzi labwino, maphunziro a CSB anali ndi chilakolako chachikulu chogonana kapena akufuna kufotokozera momveka bwino ndipo anali ndi chidwi chochulukirapo pazinthu zolimbitsa thupi, motero kusonyeza kusiyana pakati pa kufuna ndi kukonda. Zolinga za CSB zinakhalanso ndi zovuta zambiri zokhudzana ndi kugonana komanso zovuta za erectile mu maubwenzi apamtima koma osati ndi zida zogonana zomwe zikuwonetsa kuti chikhumbo chokhudzana ndi chilakolako chogonana chinali chodziwikiratu pazinthu zodziwika bwino ndipo sizinakwaniritse chilakolako cha kugonana.

Translation: Ogwiritsa ntchito zithunzi zolaula pa phunziro ili adagwirizana ndi chitsanzo chovomerezeka, chotchedwa zolimbikitsa or kulimbikitsana. Omwe ali ndi chizolowezi chowonera amakhala ndi zilakolako zamphamvu zogwiritsa ntchito "it" (akufuna), komatu iwo samatero ngati "Izo" kupatula osakhala osokoneza bongo. Kapena monga ena amanenera, "kufuna zambiri, kuzikonda pang'ono, komabe osakhutitsidwa."

Mitu ya CSB idatinso chifukwa chogwiritsa ntchito kwambiri zolaula ... .. odziwa kuchepa kwa libido kapena ntchito ya erectile makamaka mu ubale weniweni ndi akazi (ngakhale kuti siogwirizana ndi zolaula) (N = 11) ...

Masewera a CSB poyerekeza ndi odzipereka omwe ali ndi thanzi labwino anali ndi vuto lalikulu kwambiri ndi kugonana kwaukwati komanso kukhala ndi mavuto ochulukirapo erectile mu chibwenzi chogonana koma osati zogonana.

Translation: Avereji ya amuna omwe ali ndi CSB anali 25, komabe 11 mwa maphunziro a 19 adakumana ndi vuto la erectile / kuchepa kwa libido ndi anzawo, koma osati zolaula. Ofufuzawo akuti izi zikugwirizana ndi mtundu wa zosokoneza bongo komanso anthu omwe ali ndi mphotho yayikulu poyankha zolaula. Izi zikusokoneza malingaliro akuti ogwiritsa ntchito zolaula amangokhala ndi "chilakolako chogonana" kuposa omwe sachita zolaula.

Zomwe zilipo panopa komanso zowonjezereka zimasonyeza kuti anthu ambiri amagwiritsa ntchito makina okhudzana ndi kugonana komanso kugwiritsira ntchito mankhwala osokoneza bongo m'magulu omwe ali ndi kachilombo ka HIV ndi mankhwala osokoneza bongo. Zofukufukuzi zikusonyeza kuti zimayambanso kugwiritsidwa ntchito pazinthu zomwe zikuyambitsa matenda osokoneza bongo komanso madalitso achilengedwe.

Translation: Kuzindikira kusokoneza bongo ndi zolaula kumaphatikizapo ubongo womwewo umasintha mkati momwemo ubongo. Njira zamakono zolimbikitsa zimakhazikitsidwa bwino: kuwonjezeka kwa DeltaFosB mu malo opindulitsa

Timatsindikanso kuti zotsatirazi ndizofunikira makamaka kwa magulu a anthu omwe akukumana ndi mavuto ndi kugwiritsira ntchito zinthu zolaula pa intaneti ndikutheka kuti saganizire za anthu ambiri omwe amagwiritsira ntchito zidazo m'njira zosayenera. Zomwe anapezazi zikusonyeza mphamvu ya msinkhu wopititsa patsogolo kugwiritsidwa ntchito kwa kugonana, makamaka mu gulu la CSB. Chifukwa cha kuwonjezereka kwa posachedwapa kwa intaneti, kuphatikizapo achinyamata, komanso kukhala okonzeka kugwiritsira ntchito zinthu zogonana pa Intaneti, maphunziro omwe amadzapangitsa kuti adziŵe zomwe zimachititsa kuti anthu (makamaka achinyamata) athane ndi chiopsezo chotenga CSB ayenera kutero.

Translation: Ngakhale mitu yankhaniyi ikunena za "chizolowezi chogonana," kafukufukuyu anali kwenikweni okhudzana ndi zolaula za pa intaneti, mosamala za achinyamata omwe amagwiritsa ntchito zolaula pa intaneti.

ZOKHUDZA

Ngakhale khalidwe lachiwerewere lachiwerewere (CSB) ladzidzimutsa ngati "khalidwe lachizoloŵezi" komanso maulendo omwe amatha kugwiritsidwa ntchito kapena ophatikizana omwe amatha kugwiritsidwa ntchito poyang'anira zowonongeka ndi zakumwa za mankhwala, zomwe sizikudziwika ponena za mayankho okhudzana ndi kugonana kwa anthu omwe alibe ndi CSB. Pano, kugwiritsidwa ntchito kwazinthu zosiyana zogonana kunayesedwa kwa anthu omwe alibe ndi CSB, poyang'ana pa zigawo za neural zomwe zakhala zikuyambirira pa kafukufuku wa mankhwala osokoneza bongo. Ophunzira a 19 CSB ndi odzipereka a 19 anayesedwa pogwiritsira ntchito MRI yogwira ntchito poyerekezera mavidiyo owonetsa zithunzi ndi mavidiyo osangalatsa. Zotsatira za chilakolako cha kugonana ndi zokondweretsa zinapezeka. Pokhudzana ndi odzipereka omwe ali ndi thanzi labwino, maphunziro a CSB anali ndi chilakolako chochuluka koma zofanana zofanana poyang'ana mavidiyo owonetsera zakugonana. Kuwonetsera kwa zizindikiro zogonana mu CSB poyerekeza ndi zomwe sizinayake CSB zinagwirizanitsidwa ndi kuwonetseratu kwachinthu chodziwika bwino chodziwika bwino, cha ventral striatum ndi amygdala. Kugwirizanitsa ntchito kwachitsulo choyambirira cha cingulate-ventral striatum-amygdala network kunagwirizanitsidwa ndi chilakolako chogonana (koma osakondwera) kwambiri pa CSB yokhudzana ndi maphunziro omwe si a CSB. Kusiyana pakati pa chilakolako kapena chokhumba ndi chokhumba chiri chogwirizana ndi malingaliro a chilimbikitso chotsatira CSB monga mowa mankhwala osokoneza bongo. Kusiyana kwa Neural mu kugwiritsidwa ntchito kwa kugonana kwachidziwitso chodziwikiratu kunazindikiritsidwa mu maphunziro a CSB m'madera omwe kale anali okhudzana ndi maphunziro a mankhwala osokoneza bongo. Kuphatikizidwa kwakukulu kwa ma corticostriatal magalimoto oyendetsa mu CSB pambuyo poyang'anitsitsa kugonana kumasonyeza njira za neural zomwe zimayambitsa CSB komanso zomwe zingakhale zofunikira pazinthu zowonjezera.

Introduction

Kuphatikizika kwambiri kapena kugwirizana ndi zochitika zogonana, zomwe zatchulidwa kuti chilakolako chogonana (CSB), matenda okhudzana ndi kugonana ndi abambo kapena kugonana, ndimadokotala omwe amatha kukhala ndi thanzi labwino [1]. Ngakhale kuti mawerengero enieni omwe amapezeka m'maganizo sakudziwika bwino, sizinaphatikizepo njira za CSB, deta yomwe ilipo imasonyeza kuti chiwerengero cha CSB chikhoza kuchoka ku 2 kufika ku 4% m'midzi ndi achinyamata omwe ali ndi maphunziro omwe ali ndi zifukwa zomwezo m'magulu odwala matenda a maganizo [2]-[4], ngakhale kuti chiwerengero chapamwamba ndi chaching'ono chafotokozedwa malinga ndi momwe CSB ikufotokozera [5]. Chovuta kwambiri pakuzindikiritsa kuchuluka kwake ndi zotsatira za CSB kumaphatikizapo kusowa kwa tanthauzo lachidziwitso cha matendawa. Ngakhale zoyenera za matenda opatsirana pogonana zinaperekedwa kwa DSM-5 [6], matendawa sanaphatikizidwe mu DSM-5. Komabe, monga CSB ikhoza kugwirizanitsidwa ndi mavuto aakulu, kudzimva chisoni komanso kusokonezeka maganizo, zimapangitsa kuti pakhale kuyesedwa.

Zomwe zingakhale bwino kuganiza kuti CSB yatsutsana, ndi zomveka zokonzedwa kuti ziganizidwe ndi matenda monga vuto lodziletsa kapena lachizoloŵezi cha "khalidwe" [7]. Malinga ndi deta yomwe ilipo, kutchova juga (kapena kutchova njuga) posachedwapa analembedwanso ku DSM-5 pamodzi ndi mavuto ogwiritsa ntchito mankhwala monga khalidwe loletsa khalidwe [8]. Komabe, zovuta zina (mwachitsanzo, zomwe zimagwiritsidwa ntchito kwambiri pa intaneti, masewero a kanema kapena kugonana) sizidaphatikizidwenso gawo lalikulu la DSM-5, mbali imodzi chifukwa cha kuchepa kwa deta [9]. Choncho, kumvetsetsa bwino kwa CSB ndi momwe zingasonyezere zofananako kapena zosiyana ndi zovuta zogwiritsira ntchito mankhwala zingathandize pakuchita khama komanso kukhazikitsa ntchito zothandiza kupewa ndi kuchiza. Amaphatikizapo kufanana pakati pa kugwiritsa ntchito mankhwala, kutchova njuga ndi matenda opatsirana pogonana (mwachitsanzo, kutaya mphamvu pazinthu zosangalatsa kapena zopindulitsa), kufufuza za zinthu sizowonjezera kuledzeretsa (mwachitsanzo, cue reactivity) kulangizidwa mwachindunji mu CSB.

Cue reactivity imalongosola zofunikira kuzipatala zofunikira za vuto-kugwiritsa ntchito mankhwala. Mwachitsanzo, kuwonjezeka kwa cue reactivity kumagwirizana ndi kubwerera [10], [11]. Kafukufuku watsopano wamakono wofufuza zomwe zimachitika poyesa kugwiritsira ntchito mowa mwauchidakwa, kuphatikizapo mowa, nicotine ndi cocaine, zikuwonetseratu kuti akugwiritsira ntchito mankhwala osokoneza bongo mu ventral striatum, dorsal anterior cingulate (dACC) ndi amygdala, anachititsa chilakolako cha dACC, pallidum ndi ventral striatum [11]. Komabe, momwe maderawa angasonyezere kusiyana kosiyana pakati pa kugonana ndi anthu omwe alibe ndi CSB sanawerengedwepo.

Pali mitundu yosiyanasiyana yomwe imakonzedweratu kuti ifotokozere makhalidwe odzitayirira, ndi chitsanzo chimodzi chomwe chimawongolera kuti, "kufuna" kumasiyanitsidwa ndi "kukonda" pamene munthu amayamba kumwa mankhwala osokoneza bongo [12]. Komabe, zomwe zikukhumba ndi zofuna zimakhudzana ndi kugonana ndi reactivity ndi ma nerel correlates mu CSB sizinayang'anidwe mosamalitsa, ndipo kufufuza kuchokera ku maphunziro amenewa kungapereke deta kuti zithandize kutsogolera bwino kwa CSB ndikudziwitsani zolinga za neural mankhwala chitukuko.

Kafukufuku wambiri wakhala akugogomezera za kugonana kwa anthu odzipereka omwe amadziŵa malo omwe akuphatikizapo hypothalamus, thalamus, amygdala, chigoba chamtundu wa anterior, chigoba chamtundu wapansi, coryx yapamtunda, gyrus yoyambira, piretal cortex ndi pakatikati ya occipital cortex [13]-[19]. Zigawozi zikuphatikizidwa mu zokhudzana ndi zakuthupi ndi zamaganizo, chisamaliro komanso makamaka zowonetseratu zochitika, komanso zolimbikitsa. Pogwiritsa ntchito njira za penile tumescence, statum, anterior cingulate, insula, amygdala, occipital cortex, sensorimotor cortex ndi hypothalamus zasonyezedwa kuti zimathandiza penile erection [15], [20]. Kusiyanasiyana kwa amuna ndi akazi kwafotokozedwa ndi amuna omwe ali ndi zochitika zazikulu zowonjezera zamaganizo zokhudzana ndi kugonana zokhudzana ndi akazi, ndipo kusiyana kumeneku kungasonyeze mazunzo okhwima [21]. Kufufuza kwa meta kunatanthawuza malo ochezera a ubongo ku ndalama, zosokonekera komanso zotsatira za zakudya kuphatikizapo zowonongeka zamtundu wa correx, ventral striatum, amygdala, insula yamkati ndi thalamus [22]. Chakudya ndi mphotho zowonongeka zinagwirizanitsidwa makamaka ndi ntchito zowonjezera zowonjezera komanso zosangalatsa zowonjezera zomwe zimapindulitsa makamaka ndi ntchito ya amygdala. Kafukufuku waposachedwapa wasonyezeranso kuti nthawi yayitali yogwiritsira ntchito zipangizo zooneka bwino pa intaneti muzimuna zogonana zimagwirizanitsa ndi ntchito yochepetsetsa yowonongeka ndi kuchepetsa mavoti oyenerera kuti awonetsedwe mwachidule [23].

Maphunziro a Neurophysiological okhudza CSB mwa anthu ambiri m'malo mwa odzipereka omwe ali ndi thanzi labwino amakhala ochepa. Kuphunzira kwa MRI kufotokozera gulu laling'ono la zinthu za CSB (N = 8), poyerekeza ndi odzipereka odzipereka (N = 8). [24]. Ophunzira adatumizidwa kuchokera kuchipatala ndi 7 za maphunziro a 8 omwe ali ndi mbiri ya matenda osokoneza bongo, 4 ya 8 ndi mbiri ya mankhwala osokoneza bongo kapena kudalira komanso 1 ya 8 ndi mbiri ya vuto losautsa mtima. Mu kafukufuku wokhudza 52 nkhani za amuna ndi akazi a CSB ndi mavuto omwe amachititsa kuwonetsa zithunzi za kugonana kuchokera ku malonda a pa intaneti, kufanana ndi zithunzi zolimbana ndi kugonana poyerekeza ndi zojambula zandale zinali kugwirizana ndi amplitudes apamwamba a kuyankha kwa P300, [25]. Momwe muyesowu umalumikizana ndi chilakolako chogonana koma osakakamizidwa kuchita zachiwerewere, olembawo adalimbikitsa matalikidwe a P300 azolumikizana ndi chilakolako chogonana m'malo mokakamiza. Kugonana kwagonana kwatchulidwapo pankhani yamavuto amitsempha ndi mankhwala omwe amagwirizana nawo. Kugonana kwachiwerewere, komwe kumachitika mwa 3-4% ya odwala matenda a Parkinson komanso okhudzana ndi mankhwala a dopaminergic [26], [27], adawerengedwanso pogwiritsa ntchito mafanizo. Lipoti la nkhani pogwiritsira ntchito technetium-99 m-ethyl cysteinate dimer SPECT inasonyeza kuchulukitsidwa kwa magazi ku madera a m'madera ozungulira m'dera la CSB wodwalayo [28]. Kafukufuku wokulirapo wokhudza odwala a Parkinson omwe ali ndi vuto lachiwerewere adawonetsa magwiridwe antchito a MRI Magazi Oxygen Level Odalira pazithunzi zogonana zomwe zimakhudzana ndi chilakolako chogonana [29], zomwe olemba ankanena zikhoza kusonyeza malingaliro othandizira okhutira. Kufufuza kwa ma voxel-based-morphometry yokhudzana ndi kugonana kwachidziwikidwe kaŵirikaŵiri kawiri kawiri kawiri kawiri kawiri kawiri kawiri kawiri kawiri kawiri. [30]. Zindikirani, mwachitsanzo ichi, kugonana kwachiwerewere kunanenedwa ku 17% ndi makhalidwe ena ofunafuna mphotho kuphatikizapo kudya kwambiri mu 78% komanso mwatsopano kapena kuwonjezeka kwa mowa kapena mankhwala osokoneza bongo ku 26% mwa anthu omwe ali mu phunziro ili. Phunziroli laposachedwapa, timayang'ana pa maphunziro a CSB anthu ambiri.

Pano ife tinayeseranso kugwiritsidwa ntchito poyerekeza ndi zochitika zogonana zogonana ndi zosangalatsa zosagonana (monga mavidiyo a masewera) ndi kuyesa zofuna zokhudzana ndi kugonana kapena kufuna ndi kukonda nkhani ndi popanda CSB. Tinaganiza kuti anthu omwe ali ndi CSB poyerekeza ndi omwe alibe angasonyeze chilakolako chachikulu (kufuna) koma osakonda (ofanana ndi magulu) poyankha zogonana koma osati zogonana. Ngakhale kuti madera ambiri athandizidwa chifukwa chogonana ndi anthu odzipereka, monga momwe tinkawerengera odwala omwe ali ndi CSB, tinaganiza kuti padzakhala chidziwitso chowonjezereka pa zochitika zogonana poyerekeza ndi zosagwirizana ndi zachiwerewere m'madera okhudzana ndi mankhwala osokoneza bongo Maphunziro a reactivity kuphatikizapo ventral striatum, dACC ndi amygdala. Timagwiritsanso ntchito kuti ziwonetsero za m'deralo zingakhale zogwirizana ndi magulu osiyanasiyana koma makamaka mwa anthu omwe ali ndi CSB poyerekeza ndi omwe alibe, ndipo kuti chilakolako cha kugonana chidzakhudzidwa kwambiri ndi ntchito m'madera amenewa anthu omwe ali ndi CSB poyerekeza ndi omwe alibe. Chifukwa cha kusintha kwachitukuko m'zinthu zolimbikitsa zomwe zimayambitsa makhalidwe oopsa [31], tinaphunziranso ubale ndi zaka.

Njira

Mitu ya CSB inalembedwa kudzera pa malonda ochezera pa intaneti komanso kuchokera kwa otsogolera. Odzipereka odzipereka adatumizidwa kuchokera kumalonda a m'madera a East Anglia. Kwa gulu la CSB, kufufuza kunkachitika pogwiritsa ntchito Internet Sex Screening Test (ISST) [32] ndi kafukufuku wochuluka wopezera kafukufuku wotsatanetsatane, kuphatikizapo zaka zoyambira, kuchuluka kwa nthawi, nthawi, kuyesa kugwiritsa ntchito, kudziletsa, njira zogwiritsira ntchito, mankhwala ndi zotsatira zoipa. Ophunzira a CSB ayankhulana maso ndi maso ndi wodwala matenda a maganizo kuti atsimikizire kuti zizindikiro za CSB zatsimikiziridwa [6], [33], [34] (Table S1 mkati Lembani S1) poyang'ana kugwiritsira ntchito zovuta kugwiritsira ntchito zolaula pa Intaneti. Onse omwe adakumana nawo anakumana ndi njira zoyenera zoganizira za Hypersexual Disorder [6], [33] ndi zofunikira zokhudzana ndi kugonana [34] (Table S1 mkati Lembani S1).

Mwa kapangidwe kake ndikupatsidwa mawonekedwe ake, maphunziro onse a CSB ndi odzipereka athanzi anali amuna ndi akazi okhaokha. Amuna odzipereka athanzi anali ofanana (+/− azaka 5) ndi maphunziro a CSB. Odzipereka owonjezera azaka 25 azimuna ogonana amuna kapena akazi okhaokha adakumana ndi makanema kunja kwa sikani kuti awonetsetse mayankho amakanemawo moyenerera poyesedwa. Njira zoyeretsera zimaphatikizaponso kukhala osakwana zaka 18, kukhala ndi mbiri yazovuta zakugwiritsa ntchito mankhwala osokoneza bongo, kukhala wogwiritsa ntchito mankhwala osokoneza bongo (kuphatikiza nthendayi), komanso kukhala ndi vuto lalikulu lamaganizidwe amisala, kuphatikiza kukhumudwa kwakukulu kwaposachedwa (Beck Depression Inventory > 20) kapena matenda osokoneza bongo, kapena mbiri ya matenda a bipolar kapena schizophrenia (Mini International Neuropsychiatric Inventory) [35]. Zoledzeretsa zina kapena zosokoneza khalidwe ndizinso zofunikira. Ophunzira amamuyesa kafukufuku wogwiritsa ntchito masewera a pa Intaneti kapena masewera olimbitsa thupi, kutchova njuga kapenanso kugula zinthu zovuta, ubwana kapena akuluakulu odwala matenda osokoneza bongo, komanso matenda opatsirana pogonana. Zolinga zinawonetsedwanso kuti zikhale zofanana ndi chikhalidwe cha MRI.

Ophunzira anamaliza UPPS-P Impulsive Behavior Scale [36] kuti ayese kusaganizira, Beck Depression Inventory [37] ndi Mkhalidwe Wachikhalidwe Nkhaŵa Zofunikira [38] Kuchepetsa kuvutika maganizo ndi nkhawa, onani, Obsessive-Compulsive Inventory-R kuti aone zovuta zowonongeka ndi Kuyesedwa kwa Alcohol-Use Disorders Identification Test (AUDIT) [39]. Kugwiritsa ntchito intaneti pafupipafupi kunayesedwa pogwiritsa ntchito Young's Internet Addiction Test (YIAT) [40] ndi Compulsive Internet Use Scale (CIUS) [41]. Chiyeso cha Kuwerenga Pakati pa Akuluakulu [42] ankagwiritsidwa ntchito kupeza mndandanda wa IQ. Zithunzi zosinthidwa za Arizona Sexual Experiences Scale (ASES) [43] Anagwiritsidwa ntchito ndi mtundu umodzi wokhudzana ndi ubale wapamtima ndi zina zomwe zimagwiritsidwa ntchito pa intaneti zowonongeka.

Makhalidwe amtunduwu akufotokozedwa mu Table S1 Lembani S1. Masewera a CSB anali ndi kupanikizika kwakukulu ndi zovuta (Table S2 mu Lembani S1) koma palibe zochitika zamakono zokhudzidwa kwakukulu. Mitu iwiri ya 19 CSB inali kudwala matenda ovutika maganizo kapena anali ndi vuto lodziwika bwino la nkhaŵa komanso nthendayi (N = 2) kapena chikhalidwe cha anthu (N = 1) kapena mbiri yaunyamata ya ADHD (N = 1). Wodzipereka wa CSB ndi wodzipereka wathanzi la 1 amagwiritsira ntchito mankhwala osokoneza bongo.

Chiwerengero chovomerezedwa cholembedwa chinaperekedwa, ndipo phunzirolo linavomerezedwa ndi Komiti ya University of Cambridge Research Ethics. Ophunzira adalipidwa chifukwa chotenga mbali.

Ziwerengero za makhalidwe

Makhalidwe ndi ziwerengero zofunsidwa zinkafaniziridwa pogwiritsa ntchito mayeso odziimira okha kapena mayeso a Chi-square. Kufufuza kwa Multivariate kunagwiritsidwa ntchito pazithunzithunzi za ASES. Zowonongeka za kugonana kapena zofuna zokhudzana ndi kugonana, ANOVA zinagwiritsidwa ntchito kufanizitsa kufotokozera momveka bwino ndi zosiyana ndi gulu (CSB, osati CSB) monga chiwerengero pakati pa maphunziro, mtundu wa kanema (zofotokozera kapena zowonongeka), ndi chidziwitso chogonjera (chilakolako kapena kukonda) monga momwe mungayankhire.

Neuroimaging

Pogwiritsa ntchito mafano, maphunzirowa amawonetsedwa mafilimu opangidwa mosiyana ndi maonekedwe a 5: kufotokozera zakugonana, kugonana, osagonana, ndalama ndi ndale. Mavidiyowa adawonetsedwa kwa masekondi a 9, kenako ndi funso ngati kanema ili mkati kapena kunja. Ophunzira adagwiritsa ntchito makina a 2-piritsi ndi majiti awo achiwiri ndi atatu a dzanja lawo lamanja kuti atsimikizire kuti akuyang'anira. Funsoli linkachitika panthawi yopitilira pakati pa 2000 ndi 4000 milliseconds. Mavidiyo owonetsa amasonyeza kugonana pakati pa mwamuna ndi mkazi omwe adatengedwa kuchokera pa mavidiyo omwe amachotsedwa pa intaneti ndi malayisensi omwe amapezedwa ngati kuli kofunikira. Zitsanzo za mavidiyo okhudzana ndi zolaula zimaphatikizapo mkazi wovekedwa kuvina mozungulira kapena malo a mkazi akusuntha chiuno chake. Mavidiyo osangalatsa osagonana akuwonetsa mavidiyo a masewera omwe ali ofanana kwambiri ndi zithunzi zochititsa chidwi kwambiri kuchokera ku International Affective Picture System monga kusewera, kuthamanga, kukwera miyala, kapena kukwera njinga zamoto. Mavidiyo a ndalama amasonyeza zithunzi za ndalama kapena mapepala omwe amaperekedwa, kugwa kapena kufalikira. Mavidiyo osalowerera amasonyeza masewera. Zolingazo zinali zotsatiridwa ndi mayesero asanu ndi atatu pa chiwonetsero cha mavidiyo onse a 40. Mavidiyo asanu osiyana ndi omwe adawonetsedwa pazithunzi zonse za 25.

Mu ntchito yowerengera kanema kunja kwasintha, nkhaniyo inayang'ana mavidiyo omwewo ndipo inamaliza kupitirira malire a chilakolako cha kugonana ndi kukonda. Ofunsidwa anafunsidwa mafunso otsatirawa pa zithunzi zosiyana za 2: 'Kodi izi zawonjezera chikhumbo chotani chogonana?' ndipo 'Munakonda kanema iyi bwanji?' ndipo anasonyeza yankho pogwiritsa ntchito mbewa potsatira mzere wochokera ku 'Pang'ono' mpaka 'Kwambiri'. Owonjezera odzipereka aamuna a 25 anayesedwa pa ntchito yowerengera kanema. Ofunsidwa adafunsidwa ngati adawona mavidiyowa asanayambe kuphunzira. Ntchito zonse zinalembedwa pulogalamu ya Prime 2.0.

Kupeza data ndi kukonza

Zowonjezera magawo a maphunziro a fMRI akufotokozedwa Lembani S1. Makanema ojambula pamasekondi 9 komanso magawo oyeserera adayesedwa ngati ntchito yamagalimoto yama bokosi yosakanikirana ndi mayankho a hemodynamic. Kusanthula kunachitika pogwiritsa ntchito njira zowoneka bwino. Mavidiyo akuyerekezeredwa pogwiritsa ntchito ANOVA ndi gulu (CSB, osakhala CSB) ngati chinthu chapakati pamitu ndi mawonekedwe (mtundu wamakanema) monga chinthu chamkati mwa maphunziro. Zotsatira zazikulu za gululi pamikhalidwe yonse zidafanizidwa koyamba. Zotsatira zikhalidwe zimafaniziridwa mosiyana mosiyana ndi zochitika zolaula, zolaula komanso ndalama ndi zosangalatsa. Makanema osangalatsa a masewerawa adagwiritsidwa ntchito ngati chiwongolero chazinthu zowonekera komanso zolaula popeza onsewa amaphatikiza kusuntha anthu m'makanema. Zochita pamwambapa zolakwika m'banja lathunthu (FWE) zowongoleredwa P <0.05 zimawerengedwa kuti ndizofunikira pakufanizira kwakukulu. Gulu-ndi-mkhalidwe (mwachitsanzo CSB (zolaula - zosangalatsa) - Kudzipereka kwaumoyo (zowonekera - zosangalatsa)) a priori madera opatsa chidwi adachitidwa ngati kusiyanasiyana kwa momwe zinthu ziliri (mwachitsanzo zowoneka-zosangalatsa) madera omwe amadziwika pamlingo wonse wa ubongo FWE P <0.05 mulingo. Zaka zakukalamba ndi kukhumudwa zidagwiritsidwa ntchito ngati ma covariates. Zosiyanasiyana kuphatikiza malingaliro okhudzana ndi chilakolako chogonana komanso kukonda mayankho pazakanema, zambiri pa Young Internet Addiction Test, komanso masiku osadziletsa anaphatikizidwa ndi mitundu yazosangalatsa. Zaka zakubadwa zidafufuzidwanso, kuwongolera kukhumudwa ndi chidwi chofuna, m'magulu onse ndikugwiritsa ntchito masking.

The ventral striatum, amygdala ndi dorsal cingulate anali malo owonetserako chidwi. Kwa madera atatuwa amphamvu a priori malingaliro, tidaphatikiza ma ROI pogwiritsa ntchito pang'ono-kukonzanso-kocheperako (SVC) ndikukonzanso Kwabanja-Wanzeru-Kulakwitsa p <0.05 imawoneka yofunikira. Popeza zapezedwa zolumikiza kuyerekezera kwakanthawi kofunitsitsa kutsegulira kunja kwa kutsegulira kwina, kuwunika kwa psychophysiological kuyanjana kunachitika ndi dorsal cingate ngati gawo lambewu (imagwirizanitsa xyz = 0 8 38 mm, radius = 10 mm) makanema osangalatsa - osangalatsa. Popeza kutengapo gawo kwama mesolimbic ndi mesocortical circry, zochitika mu substantia nigra zinayesedwanso pamlingo wofufuza. Dera la ventral striatal anatomical region (ROI), lomwe limagwiritsidwapo ntchito m'maphunziro ena [44], anali atakokedwa ku MRIcro kutsatila tanthauzo la ventral striatum ndi Martinez et al. [45]. Mipando ya ROI yothandizidwa ndi amygdala inapezeka kuchokera ku maofesi a WFUPickAtlas SPM Toolbox [46]. Zithunzi ziwiri zosiyana siyana za nigra ROI zinagwiritsidwa ntchito kuphatikizapo template ya WFUPickAtlas ndi ROI yokhala ndi manja ku MRIcro pogwiritsa ntchito magnetization kuchoka ku 17 odzipereka wathanzi. Deta yonse yojambula idakonzedweratu ndi kuyesedwa pogwiritsa ntchito SPM 8 (Wellcome Trust Center ya NeuroImaging, London, UK).

Results

makhalidwe

Amuna khumi ndi asanu ndi anayi okwatirana amodzi ndi amuna omwe ali ndi HIV (zaka 25.61 (SD 4.77)) komanso zaka 19 (zaka 23.17 (SD 5.38) zaka zisanu ndi ziwiri (8) anadzipereka (Table S2 mu Lembani S1). Owonjezera a 25 omwe ali okalamba (25.33 (SD 5.94) zaka) amuna odzipereka ogonana ogonana amuna okhaokha amaimba mavidiyowo. Mitu ya CSB inanena kuti chifukwa cha kugwiritsira ntchito kwambiri zolaula, iwo adataya ntchito chifukwa cha ntchito (N = 2), maubwenzi apamtima owonongeka kapena osakhudzidwa ndi zochita zina (N = 16), libido yochepa kapena erectile zimagwiritsidwa ntchito makamaka pa ubale weniweni ndi akazi (ngakhale osagwirizana ndi zolaula) (N = 11), amagwiritsidwa ntchito mopitirira muyeso (N = 3), malingaliro odzipha odzipha (N = 2) ndi kugwiritsa ntchito ndalama zambiri (N = 3; kuchokera pa £ 7000 mpaka £ 15000). Nkhani khumi zinkakhala kapena zikulangiza uphungu wawo. Ophunzira onse amavomereza kuti kuseweretsa maliseche komanso kuyang'ana pazinthu zolaula pa Intaneti. Omwenso adawonetsa kuti ntchito zothandizira (N = 4) ndi cybersex (N = 5). Pazithunzi zosinthidwa za Arizona Sexual Experiences Scale [43], Maphunziro a CSB poyerekeza ndi odzipereka omwe ali ndi thanzi labwino anali ndi zovuta kwambiri zokhudzana ndi kugonana ndikumva zovuta zambiri za erectile mu chibwenzi chogonana koma osati zogonana (Table S3 mu Lembani S1).

Poyerekeza ndi odzipereka odzipereka, maphunziro a CSB poyamba ankawoneka pazinthu zowonongeka zogonana pazaka zoyambirira (HV: 17.15 (SD 4.74); CSB: 13.89 (SD 2.22) m'zaka) zokhudzana ndi msinkhu woyambira kugwiritsa ntchito intaneti ambiri (HV: 12.94 (SD 2.65); CSB: 12.00 (SD 2.45) m'zaka) (kugwirizana ndi gulu: F (1,36) = 4.13, p = 0.048). Ophunzira a CSB anali ndi ntchito yaikulu pa intaneti pogwiritsa ntchito odzipereka odzipereka (Table S3 in Lembani S1). Chofunika kwambiri, maphunziro a CSB akuti amagwiritsa ntchito intaneti powonera zolaula pa intaneti pa 25.49% yazomwe amagwiritsa ntchito pa intaneti (pafupifupi 8.72 (SD 3.56) zaka) poyerekeza ndi 4.49% mwa odzipereka athanzi (t = 5.311, p <0.0001) (CSB vs.HV: kugwiritsa ntchito zolaula: 13.21 (SD 9.85) vs. 1.75 (SD 3.36) maola pa sabata; kugwiritsa ntchito intaneti kwathunthu: 37.03 (SD 17.65) vs. 26.10 (18.40) maola pa sabata).

Cue reactivity

Zotsatira zoganizira za mafilimu ndi mafilimu omwe amawakonda zinasokonezeka mmenemo munali kugwirizana kwa gulu-ndi-rating-type-by-video-mtundu (F (1,30) = 4.794, p = 0.037): zikhumbo zofuna kumavidiyo owonetsera anali oposa CSB poyerekeza ndi odzipereka odzipereka (F = 5.088, p = 0.032) koma osati zolemba zowonongeka (F = 0.448, p = 0.509). 4.351) koma osati kufotokoza momveka bwino (F = 0.047, p = 3.332). Chikhumbo ndi kukonda chiwerengero kwa zizindikiro zozizwitsa zinali zogwirizana kwambiri (HV: R2 = 0.696, p <0.0001; CSB: R2  = 0.363, p = 0.017) ngakhale kusintha kwamizere sikunali kosiyana kwambiri pakati pamagulu (F = 2.513, p = 0.121). Panalibenso kusiyana pakati pamanambala owonera makanema pazokhumba komanso kukonda gawo lililonse pakati pa odzipereka omwe anali ndi thanzi labwino komanso ena 25 odzipereka athanzi omwe akuwonetsa kuti mavoti onsewa anali oimira (p's> 0.05). Ophunzira onse adanenapo kuti anali asanawonepo makanemawa asanaphunzire.

Kujambula kuganizira

Palibe kusiyana pakati pa magulu oyambitsa magwiridwe antchito a ubongo omwe adapulumuka pakuwongolera ubongo wonse. Kusiyanitsa kwa makanema osangalatsa - osangalatsa m'magulu amitu omwe adazindikira kuyambitsa kwa ventral striatum, dACC ndi amygdala pa FWE p <0.05 level yonse (Chithunzi 1, Matebulo S4 ndi S5 Lembani S1). Kusiyanaku kunazindikiranso kuyambika kwa magulu awiri a hypothalamus ndi substantia nigra (FWE p <0.05) wokonzedwa ndi ubongo wathunthu, zigawo zomwe zimakhudzidwa ndi chilakolako chogonana komanso ntchito ya dopaminergic, motsatana [13], [22]. Kusiyanitsa kwa zochitika zowoneka bwino komanso zosangalatsa - zosangalatsa zomwe zimadziwika mzigawo zapakati pa tempipito-temporal, parietal komanso malo otsika kutsogolo ndi caudate yolondola (FWE p <0.05) (Tebulo S4 mkati Lembani S1). Komabe, kusiyana kwa zachiwerewere - zosangalatsa sizinazindikire a priori madera oyerekeza. Momwemonso, kusiyanasiyana kosangalatsa kwa ndalama komwe kunadziwika parietal komanso kotsogola kwam'mbali (FWE p <0.05) koma osati a priori malo osokonezeka.

Chithunzi 1

Chikhalidwe chikusiyana.

Kenaka tinayang'ana kusiyana pakati pa magulu - kusiyana kosiyana-siyana komwe kunasonyeza zotsatira zogwira mtima m'magulu athu. Masewera a CSB amasonyeza ntchito yaikulu mu ventral striatum (pepala voxel xyz mm = 18 2 -2, Z = 3.47, FWE p = 0.032), dACC (0 8 38, Z = 3.88, FWE p = 0.020) ndi amygdala yolondola (32 -8 -12, Z = 3.38, FWE p = 0.018) (Chithunzi 2). Chifukwa cha dopaminergic circuitry mu cue reactivity, tinaphunziranso ntchito mu nigra. Masewera a CSB anali ndi ntchito yaikulu mu substantia nigra (10 -18 -10, Z = 3.01, FWE p = 0.045) mu zosiyana-siyana. Kufufuza kochepa kupatulapo nkhani ziwiri zomwe zinali ndi matenda opatsirana pogonana sizinasinthe zotsatira zofunikira.

Chithunzi 2

Zolondola ndi zochititsa chidwi.

Kuti tione mgwirizano pakati pa mayendedwe a neural ndi chiwerengero cha chikhumbo ndi chikhumbo, tinayambitsa zochitika zomwe zimakhudzana ndi machitidwe a ubongo. M'magulu onsewa, ziwerengero za zofuna zogonana zogwirizana ndi ntchito ya DACC (-4 18 32, Z = 3.51, p = 0.038), popanda kusiyana pakati pa magulu (Chithunzi 3). Panalibe mgwirizano wa neural ndi kukonda mwachidwi.

Chithunzi 3

Chilakolako cha kugonana.

Pazomwe zimafufuzira, ntchito ya neural inkafufuzidwa ngati kugwira ntchito kwa zaka. Zaka pazochitika zonse zinkasokonezeka kwambiri ndi ntchito mu ventral striatum (kumanja: 8 20 -8, Z = 3.13, FWE p = 0.022) ndi dACC (2 20 40, Z = 3.88, FWE p = 0.045). Ntchito yayikulu yogwiritsira ntchito zaka zakhala zikuwonetsedwa mu gulu la CSB poyerekezera ndi odzipereka omwe ali ndi moyo wathanzi m'mayiko awiri (kumanja: 4 18 -2, Z = 3.31, FWE p = 0.013; kumanzere -8 -18, X = , FWE p = 2) (Chithunzi 4).

Chifukwa cha mgwirizano pakati pa zizindikiro za kugonana ndi chilakolako chofuna kugonana ndi dACC, kusanthula maganizo pochita zinthu pogwiritsa ntchito dACC monga mbewu ikuyendetsedwa poyerekeza ndi zovuta zowoneka bwino. Pakati pa magulu onse awiriwa, kuwonjezeka kwagwira ntchito kwa dACC ndi ventral striatum yoyenera (8 20 -4, Z = 3.14, FWE p = 0.029) ndi amygdala yolondola (12 0 -18, Z = 3.38, FWE p = 0.009) . Panalibe kusiyana pakati pa magulu mu kugwirizanitsa ntchito. Pamene zokhumba zokhudzana ndi zofuna zawo zinkawerengedwa ngati covariate, panali mgwirizano wabwino pakati pa zikhumbo zokhumba ndi ntchito zowonjezera zogwira ntchito mu CSB nkhani pakati pa dACC ndi right ventral striatum (12 2 -2, Z = 3.51, FWE p = 0.041) ndi amygdala yolondola (30 -2 -12, Z = 3.15, FWE p = 0.048) (Chithunzi 3) ndipo, poyesa kufufuza, anasiya substantia nigra (-14 -20 -8, Z = 3.10, FWE p = 0.048) poyerekeza ndi odzipereka odzipereka. Panalibe zochitika zazikulu zokhudzana ndi mayeso okonda.

Kukambirana

Phunziro ili lofotokoza za kugonana, zolaula komanso zosagonana, anthu omwe ali ndi CSB ndi omwe alibe amasonyeza zofananako ndi zosiyana ndi zofanana ndi zomwe zimayendera chisamaliro cha neural ndi maubwenzi pakati pa mayankho ogonjera ndi oyenerera. Chilakolako cha kugonana kapena chikhumbo chogonana chinagwirizanitsidwa ndi dACC-ventral-amygdala functional network yomwe imawonekera m'magulu onsewa ndipo ikulimbikitsidwa kwambiri komanso yogwirizana ndi chikhumbo chogonana mu gulu la CSB. Chilakolako cha kugonana kapena kudzipangira zofuna zowoneka chinasokonezedwa kuchoka ku zokondweretsa, mogwirizana ndi zolimbikitsa zowononga [12] momwe kulipo kulimbikitsidwa kwakukulu koma osakondwera ndi mphoto zosavuta. Tinapitirizanso kuwona udindo wa msinkhu umene msinkhu, makamaka mu gulu la CSB, unagwirizanitsidwa ndi ntchito yaikulu mu ventral striatum.

Poyerekeza ndi odzipereka omwe ali ndi thanzi labwino, maphunziro a CSB anali ndi chilakolako chogonana kwambiri kapena amafuna kufotokoza momveka bwino ndipo ankakonda kwambiri zolaula, motero kuwonetsa kusiyana pakati pa kufuna ndi kukonda. Mitu ya CSB idalinso ndi zovuta zambiri pakukakamira kwakugonana komanso mavuto a erectile muubwenzi wapamtima koma osati ndi zida zolaula zomwe zikuwonetsa kuti zikhumbo zolimbikitsidwa zinali zodziwika bwino pazomwe zidafotokozedwazo osati kukweza chilakolako chogonana. M'maphunziro a CSB poyerekeza ndi odzipereka athanzi, zikhumbo zambiri zakugonana pofotokoza momveka bwino zimalumikizidwa ndi zochitika zazikulu za DACC ndikuwonjezera kulumikizana kwantchito pakati pa DACC, ventral striatum ndi amgydala (monga tafotokozera pansipa), ndikuwonetsa kuti netiweki yomwe ikukhudzidwa ndikukonzekera kwamalingaliro kufuna zokhudzana ndi kugonana. Kafukufuku wam'mbuyomu wokhudzana ndi chiwerewere chokhudzana ndi dopamine agonists mu matenda a Parkinson, omwe atha kuphatikizira zizolowezi monga kugwiritsa ntchito mokakamiza zolaula, adawonetsa zochitika zazikuluzikulu pazithunzi zogonana zomwe zimakhudzana ndi chilimbikitso chakugonana. [29]. Zomwe timapeza zokhudzana ndi CSB mwa anthu ambiri zimagwirizana ndi zolimbikitsa zomwe zimatsindika zokhudzana ndi chilakolako chofuna kugwiritsira ntchito mankhwala kapena kugonana, koma osati 'kukonda' kapena hedonic tone [12].

Kugwiritsa ntchito mankhwala osokoneza bongo-reactivity ndi chilakolako cha nikotini, cocaine ndi zakumwa zoledzeretsa zamagetsi kuphatikizapo ventral striatum, dACC ndi amygdala [13]. Muzofukufuku wamakono, malowa adalandiridwa panthawi yowonera zida zolaula m'magulu omwe alibe ndi CSB. Kuwona kwa zochitika zowonjezereka za madera awa mu CSB ndi omwe ali ndi thanzi labwino odzipereka ndizofanana ndi zomwe zafukulidwa pazinthu zomwe zimagwiritsidwa ntchito mopitirira muyeso, zomwe zikuwonetseratu zofanana za matendawa.

Phunziroli pakali pano poyankha zokhudzana ndi kugonana, chilakolako cha kugonana chinagwirizanitsidwa ndi ntchito yaikulu ya DACC, ndipo ntchito yaikulu ya DACC-ventral-amygdala ntchito yogwirizanitsa ntchito ikugwirizana ndi kukulitsa chikhumbo chachikulu kwambiri mu maphunziro a CSB kusiyana ndi maphunziro odzipereka . Masewera a CSB awonetsanso ntchito yaikulu ya nigra poyerekezera ndi odzipereka omwe ali ndi thanzi labwino, motero kugwirizanitsa zomwe zapeza ku ntchito ya dopaminergic. Kwa anthu ndi nyama zopanda anthu, dACC ndi cholinga chofunika kwambiri cha dopaminergic kuchokera kumbali ya nigra ndi ventral tegmental [47], kufufuza zolakwitsa zamatsenga ndi kutsindika. DACC imatumiza ziwonetsero zapadera kwa ventral ndi dorsomedial striatum, zomwe zimaphatikizapo kuwonetsera mtengo ndi zopereka zowonjezera komanso zolimbikitsana ndipo zimagwirizananso ndi phokoso lachidule la amygdala kotero kulandira chidziwitso pa zochitika zosautsa mtima [48], [49]. Derali lilinso ndi maulendo angapo okhudzana ndi malo oyendetsedwa ndi kanyumba kanyumba. DACC ikuphatikizidwa pakukonzekera kupweteka, kuwonongeka kolakwika komanso kudziletsa [48], ndi kafukufuku waposachedwapa omwe akuwonetsa udindo wa dACC mu kuwonetsera kolakwika ndikuwonetsa chiyembekezo [50], [51], makamaka kutsogolera ntchito-mphoto kuphunzira [52], [53]. Zomwe timagwirizanitsa ntchito zokhudzana ndi kugonana zimagwirizanitsa ndi gawo lothandizira kugwirizanitsa pa dACC pakukonzekera zopindulitsa za kugonana ndi kugwirizanitsa chiwerewere ndi kugwirizana kwake ndi chikhumbo monga chizindikiro cholimbikitsa.

Zomwe tapeza zikusonyeza kuti ntchito ya DACC imasonyeza mbali ya chilakolako cha kugonana, zomwe zingakhale zofanana ndi phunziro pa P300 mu CSB maphunziro okhudzana ndi chikhumbo [25]. Timasonyeza kusiyana pakati pa gulu la CSB ndi odzipereka wathanzi pomwe phunziro lapitayi silinakhale ndi gulu lolamulira. Kuyerekezera kafukufuku wamakono ndi zofalitsa zapitazo ku CSB zogwiritsa ntchito MRI yofalitsidwa ndi P300 n'zovuta kupatsidwa kusiyana kwa njira. Zofukufuku za P300, zomwe zingatheke kugwiritsidwa ntchito pophunzira zofuna zowonongeka pogwiritsa ntchito mankhwala, kusonyeza zowonjezereka zogwiritsa ntchito chikonga [54], mowa [55], ndi opiates [56], ndi njira zomwe zimagwirizanitsa ndi zikhumbo. P300 imaphunziranso ntchito zovuta kugwiritsira ntchito ntchito pogwiritsa ntchito ntchito zosamvetsetseka zomwe zimakhala zochepa kwambiri zomwe zimaphatikizidwa ndi zikuluzikulu zomwe sizingatheke. Kufufuza kwa meta kunasonyeza kuti nkhani zopanda kugwiritsa ntchito mankhwala ndi mabanja awo osakhudzidwa adachepetsa kukula kwa P300 poyerekeza ndi odzipereka odzipereka [57]. Zotsatira izi zikuwonetsa kuti zovuta zakugwiritsa ntchito mankhwala osokoneza bongo zitha kudziwika ndi kuchepa kwa magawidwe azinthu zodziwikiratu kuti zidziwike pazomwe zingachitike (zosagwiritsa ntchito mankhwala osokoneza bongo) zomwe zimapangitsa chidwi cha mankhwala osokoneza bongo. Kutsika kwa matalikidwe a P300 kumathanso kukhala chikhomo cha endophenotypic pamavuto ogwiritsa ntchito mankhwala osokoneza bongo. Kafukufuku wokhudzana ndi zochitika zomwe zikuyang'ana kufunikira kwakukhudzidwa ndi mankhwala a cocaine ndi heroin zimanenanso zovuta zina kumapeto kwa ma ERP (> 300 milliseconds; zomwe zingachitike mochedwa, LPP) kumadera akutsogolo, zomwe zitha kuwonetsanso kukhumba komanso kugawa chidwi [58]-[60]. LPP ikukhulupilira kuti ikuwonetseratu zochitika zoyambirira (400 kwa 1000 msec) ndipo pambuyo pake zakhala zikugwiritsidwa ntchito molimbikitsana. Anthu omwe ali ndi vuto la cocaine amagwiritsira ntchito mapepala oyambirira a LPP poyerekeza ndi odzipereka omwe ali ndi thanzi labwino omwe amachititsa chidwi kuti athandizidwe mofulumira pamodzi ndi mayankho okhudzidwa ndi zosangalatsa zabwino. Komabe, mochedwa LPP ndondomeko sizinali zosiyana kwambiri ndi anthu odzipereka odzipereka [61]. Jenereta ya zotsatira za P300 zokhudzana ndi zochitika zokhudzana ndi zokhudzana ndi zokhudzana ndi zokhudzana ndi zokhudzana ndi zokhudzana ndi zokhudzana ndi zokhudzana ndi zokhudzana ndi zokhudzidwa zimagwiridwa kuti ndizogwiritsiridwa ntchito kwa pirital cortex [62]. Choncho, ntchito yonse ya DACC mu maphunziro a CSB ndi ntchito ya P300 yomwe inafotokozedwa mu kafukufuku wa CSB yapitayo ikhoza kusonyeza njira zofanana zowonongeka. Mofananamo, maphunziro awiriwa amasonyeza mgwirizano pakati pa izi ndi chikhumbo chochuluka. Apa tikusonyeza kuti ntchito ya DACC ikugwirizana ndi chilakolako, chomwe chingasonyeze chiwerengero cha chilakolako, koma sichigwirizana ndi malingaliro okondweretsa omwe amachititsa kuti anthu azigwiritsa ntchito mankhwala osokoneza bongo.

Zomwe zikupezeka panopa zikusonyeza mphamvu zokhudzana ndi zaka zomwe zikuchitika pazokambirana za kugonana. Kukhazikika kwa fronto-cortical nkhani yamtundu wakuphatikizapo kulamulira akupitirirabe muunyamata pakatikati pa 20 s [63]. Zowonjezera mavuto omwe achinyamata amakumana nawo angasonyeze kuti chiyambi cha ziwalo zolimbikitsana ndi zolimbitsa thupi zowonjezera zowonjezereka zikugwirizana ndi kuwonjezereka kowonjezereka kwa kayendetsedwe ka kayendetsedwe ka kayendetsedwe ka kayendetsedwe ka kayendetsedwe ka kayendetsedwe ka kayendetsedwe kabwino ka HIV [31], [64], [65]. Mwachitsanzo, achinyamata akuwonetseratu zochitika zambiri zowonongeka pogwiritsa ntchito makina opanga opaleshoni panthawi yopindula poyerekeza ndi akuluakulu [65]. Pano tikuwona kuti maphunziro onse, msinkhu wachinyamata akugwirizanitsidwa ndi zochitika zazikulu zowonongeka ndi zochitika zogonana. Zotsatira za ntchito yowonongeka ikuwonekera kwambiri muzochitika za CSB, kutanthauza kuti nthawi yeniyeni yokhala ndi magawo okhudzana ndi kugonana kwa onse ndi CSB makamaka.

Mogwirizana ndi mabuku okhudza ubongo kwa anthu odzipereka omwe ali ndi thanzi labwino kuti afotokoze zochitika zogonana zogwiritsidwa ntchito, tisonyezera maukonde ofanana ndi a occipito-temporal and parietal cortices, insula, kulingalira ndi mapepala ozungulira omwe amatha kutsogolo, grey, mapiritsi, striatum, pallidum, amygdala, substantia nigra ndi hypothalamus [13]-[19]. Kuyambira nthawi yaitali kugwiritsa ntchito zipangizo zooneka bwino pazinthu zamwamuna wathanzi kumawonetsedwa kuti zigwirizane ndi ntchito ya kumanzere yomwe ili kumunsi kuti iwonetsenso zithunzi zojambulidwa zomwe zingatanthauzire zomwe zingatheke kuti zikhale zowonongeka. [23]. Mosiyana ndi zimenezi, kafukufukuyu akugwiritsidwa ntchito pa gulu lachibwana la CSB lomwe likudziwika ndi vuto ndi kugwiritsa ntchito ntchito yogwirizana ndi zotsatira zoipa. Kuwonjezera pamenepo, kufufuza kwaposachedwapa kumagwiritsa ntchito mavidiyo poyerekeza ndi zithunzi zochepa chabe. Odzipereka omwe ali ndi thanzi labwino, akuwona zithunzi zowonongeka zowonongeka poyerekeza ndi mavidiyo omwe ali ndi machitidwe ochepa omwe akuphatikizapo hippocampus, amygdala komanso ma cortical posterior and temparial cortices [20] kusonyeza kusiyana kwachisudzo pakati pazithunzi zochepa chabe ndi mavidiyo otalika omwe akugwiritsidwa ntchito mu phunziro lino. Kuwonjezera apo, kusokonezeka kwa mankhwala osokoneza bongo monga matenda a cocaine akuwonetsanso kuti akugwirizanitsa ndi chilakolako chodziwika bwino pamene ogwiritsa ntchito cocaine osangalala sakuwonetsedwa [66] kusonyeza kusiyana pakati pa osangalala ndi ogwiritsira ntchito ogwira ntchito. Kotero, kusiyana pakati pa maphunziro kungasonyeze kusiyana pakati pa anthu kapena ntchito. Kafukufuku wathu akusonyeza kuti ubongo amayankha pazinthu zojambulidwa pa intaneti zingakhale zosiyana pakati pa nkhani ndi CSB poyerekeza ndi anthu abwino omwe angakhale olemera kwambiri ogwiritsa ntchito zipangizo zojambulidwa pa intaneti koma popanda kutayidwa kapena kugwirizana ndi zotsatira zoipa.

Kafukufuku wamakono ali ndi malire ambiri. Choyamba, phunziroli linakhudza amuna okhaokha, ndipo maphunziro amtsogolo ayenera kufufuza anthu omwe ali ndi zosiyana zogonana ndi akazi, makamaka ngati atsikana omwe ali ndi matenda a maganizo angasonyeze kuti ali ndi CSB [67]. Chachiwiri, ngakhale maphunziro a CSB mu phunziroli adakumana ndi zofunikira zenizeni zogonana ndikuwonetsa kuwonongeka kwa ntchito zokhudzana ndi kugonana pogwiritsa ntchito miyeso yambiri yotsimikiziridwa, pakalipano palibe njira yeniyeni yogwiritsira ntchito CSB ndipo motero izi zikuyimira malire kuti amvetsetse zomwe apeza ndikuziyika pang'onopang'ono mabuku. Chachitatu, atapatsidwa chigawo chotsatira cha phunzirolo, zimatchula zazing'ono zomwe sizingapangidwe. Kafukufuku wamtsogolo ayenera kufufuza momwe kuchuluka kwa njira zogonana zogwiritsira ntchito zogonana zingasonyeze kuti zingakhale zoopsa zowonjezera zomwe zimapangitsa kuti chiwopsezo chiwonjezereke kapena ngati kubwereza mobwerezabwereza, chifukwa cha msinkhu komanso kufotokozera kwambiri zochitika zogonana, kungapangitse njira zowonongeka zogonana mu CSB. Maphunziro owonjezereka a chikhalidwe choyembekezera kapena omwe akuyang'ana achibale osakhudzidwa akuyenera. Zaka zopanda malire mu phunziroli zingathe kuchepetsa zomwe zingapezeke. Chachinayi, phunziro lathu makamaka limagwiritsa ntchito zipangizo zamakono zogwiritsa ntchito intaneti ndi maliseche okhudzana ndi kugonana komanso kugwiritsidwa ntchito mobwerezabwereza pa Intaneti kapena kugwiritsa ntchito maulendo operekeza. Pamene nkhanizi zidatumizidwa kuchokera ku malonda onse pa intaneti ndi makonzedwe ochiza chithandizo, kaya akuimira mokwanira nkhani zochiritsira sizikuwonekera bwino. Kafukufuku wa maphunziro a 207 ofuna chithandizo a CSB omwe akugwiritsidwa ntchito mu DSM-5 mayesero omwe amachititsa kuti azindikire kuti matendawa ndi omwe amachititsa kuti anthu aziona zolaula (81.1%), maliseche (78.3%), mauthenga a pa Intaneti (18.1%) ndi kugonana ndi akuluakulu ololera (44.9%) [33] kutanthauza kufanana pakati pa chiwerengero cha anthu ndi izi zokhudzana ndi anthu. Komabe, kafukufuku wokhudzana ndi kufunafuna chithandizo cha anthu angapangitse kukula kwakukulu kwa zizindikiro. Tinagwiritsa ntchito chigawo cha chidwi cha chidwi m'malo mochita ubongo wathunthu. Choncho, chitsanzo chaching'ono ndi kusowa kwa ubongo wonse kukonzedwa njira ndi malire. Komabe, tapatsidwa mphamvu zathu a priori malingaliro okhudzana ndi ma data omwe alipo omwe akupezekapo kuchokera ku maphunziro okhudzidwa, tawona kuti dera la chidwi chofuna chidwi cha banja lachidziwitso labwino labwino likuloledwa kuti lifanane ndi mayesero ambiri, njira yomwe imagwiritsidwa ntchito popanga masomphenya [68], anali njira yabwino.

Zomwe zilipo panopa komanso zowonjezereka zimasonyeza kuti anthu ambiri amagwiritsa ntchito makina okhudzana ndi kugonana komanso kugwiritsira ntchito mankhwala osokoneza bongo m'magulu omwe ali ndi kachilombo ka HIV ndi mankhwala osokoneza bongo. Zofukufukuzi zikusonyeza kuti zimayambanso kugwiritsidwa ntchito pazinthu zomwe zikuyambitsa matenda osokoneza bongo komanso madalitso achilengedwe. Ngakhale kuti phunziroli lingasonyeze kuti likugwedezeka ndi vuto la kugwiritsiridwa ntchito kwa mankhwala, zipangizo zamakono zowonjezera zimayenera kudziwa ngati CSB iyenera kugawidwa ngati magulu oletsa kugwiritsira ntchito, mwachinyengo kapena ngati chizolowezi chochita khalidwe. Maphunziro akuluakulu a magulu akuluakulu a m'midzi ndi maulendo a nthawi yaitali amayenera kufufuza kuchuluka kwa CSB ndi zotsatira zake za nthawi yaitali. Maphunziro a Epidemiological pa mgwirizano pakati pa CSB ndi zosokonezeka, kukhudzidwa ndi kuledzeretsa n'kofunika. Mofananamo, kuyerekezera kwakukulu pazidziwitso zokhudzana ndi ubongo ndi matenda okhudza ubongo ndi zovuta zokhudzana ndi matenda kungakhale zothandiza kumvetsetsa za thupi ndi maukonde a neural omwe akuyambitsa matendawa. Timatsindikanso kuti zotsatirazi ndizofunikira makamaka kwa magulu a anthu omwe akukumana ndi mavuto ndi kugwiritsira ntchito zinthu zolaula pa intaneti ndikutheka kuti saganizire za anthu ambiri omwe amagwiritsira ntchito zidazo m'njira zosayenera. Zomwe anapezazi zikusonyeza mphamvu ya msinkhu wopititsa patsogolo kugwiritsidwa ntchito kwa kugonana, makamaka mu gulu la CSB. Chifukwa cha kuwonjezereka kwa posachedwapa kwa intaneti, kuphatikizapo achinyamata, komanso kukhala okonzeka kugwiritsira ntchito zinthu zogonana pa Intaneti, maphunziro omwe amadzapangitsa kuti adziŵe zomwe zimachititsa kuti anthu (makamaka achinyamata) athane ndi chiopsezo chotenga CSB ayenera kutero.

Kuthandiza Information

Lembani S1

Kusamalitsa mfundo.

(DOCX)

Kuvomereza

Tikufuna kuthokoza onse omwe adagwira nawo phunziro ndi ogwira ntchito ku Wolfson Brain Imaging Center. Dr. Voon ndi mnzake wapamtima wa Wellcome Trust. Channel 4 inathandizidwa pakuthandizira ndi kuitanitsa poyika malonda okhudza intaneti pa phunzirolo.

Ndondomeko ya Zothandizira

Ndalama zoperekedwa ndi Grantcome Trust Intermediate Fellowship grant (093705 / Z / 10 / Z). Dr. Potenza anathandizidwa mwa magawo a ndalama za P20 DA027844 ndi R01 DA018647 kuchokera ku National Institutes of Health; Dipatimenti ya State Connecticut ya Mental Health ndi Addiction Services; chipatala cha matenda a maganizo a Connecticut; ndi malo ofunika kwambiri pa kafukufuku wotchova njuga ku National Center of Gaming Responsible. Ogulitsawo analibe gawo pa kupanga maphunzilo, kusonkhanitsa deta ndi kusanthula, chisankho chofalitsa, kapena kukonzekera malembawo.

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