NDEMANGA: Tanthauzo latsopano la ASAM la "kuledzera" (Ogasiti 2011) limathetsa mkangano wokhudza kukhalapo kwa zizolowezi zamakhalidwe, kuphatikizapo kugonana ndi chizolowezi chogonana. Tanthauzo latsopanoli la chizolowezi, lomwe limaphatikizapo zizolowezi zamakhalidwe, monga chakudya, kutchova juga ndi kugonana, ASAM imanena mosapita m'mbali kuti zizolowezi zamakhalidwe zimakhudza kusintha kwa ubongo ndi njira zamaubongo zofanana ndi zomwe zimachitika chifukwa cha chizolowezi chogwiritsa ntchito mankhwala osokoneza bongo. Timakhulupirira kuti chizolowezi chogwiritsa ntchito zolaula pa intaneti sichiyenera kukhala pansi pa ambulera ya chizolowezi chogonana. Amuna ambiri omwe amakhala ndi chizolowezi chogwiritsa ntchito zolaula sakanakhala chizolowezi chogonana akanakhala kuti anakhalapo nthawi isanafike intaneti. (Ndalemba mopendekera mawu okhudza zizolowezi zinazake zamakhalidwe.)
- ZOCHITIKA (2013) - National Institute of Mental Health (NIMH): DSM ndi yopanda pake komanso yosatha.
- ZOCHITIKA (2016) - Mapepala owunikiridwa ndi anzawo wolemba DSM-5 membala wa gulu la ntchito Richard Krueger MD: Kuzindikira za kugonana kapena kugonana kumagwiritsidwa ntchito pogwiritsa ntchito ICD-10 ndi DSM-5 ngakhale kukanidwa kwa matendawa ndi American Psychiatric Association
- ZOCHITIKA (2018) - Kodi munthu amadziwa bwanji? Mankhwala omwe amagwiritsidwa ntchito kwambiri padziko lonse, Mayiko Akumayiko Onse a Matenda (ICD-11), ali ndi matenda atsopano woyenera kuchita zolaula kapena kuledzera: "Kugonana Kwachiwerewere. ”(2018)
Lumikizani ku webusaiti ya ASAM
- Mafunso a ASAM pa tanthauzo: Tanthauzo la ASAM la Chizolowezi - Mafunso Ofunsidwa Kawirikawiri (2011)
- ASAM Press Release pa tanthauzo latsopano: ASAM Press Release (2011)
- Nkhani yabwino pa tanthauzo ndi ndondomeko ya ndondomeko: Akatswiri Opambana aku America (ASAM) Atulutsa Chidule Chatsopano Tanthauzo la Chizolowezi (2011)
Nkhani ziwiri ndi YBOP kuchokera ku 2011:
- Gwiritsani Ntchito Mabuku Athu: Ma Docs Amachepetsa Kugonjetsa Khalidwe lachiwerewere (2011). American Society of Addiction Medicine amavomereza kusagwirizana ndi DSM
- Kodi Mumakopeka ndi Zolaula? Funsani ASAM (2011). Ogwiritsira ntchito zithunzi akufotokoza zomwe zimakonda kuti azigwedezeka
Mapeto a mzere wa DSM :
Ndondomeko ya ndondomeko ya boma: Tanthauzo la Chizolowezi (Long Version)
Kuledzera ndi matenda oyamba komanso osatha a mphotho ya ubongo, chilimbikitso, kukumbukira ndi ma circuitry ogwirizana. Kuledzera kumakhudza kufalikira kwa mitsempha ndi kuyanjana mkati mwa mapangidwe a mphotho ya ubongo, kuphatikiza nucleus accumbens, anterior cingulate cortex, basal forebrain ndi amygdala, kotero kuti magawo olimbikitsira amasinthidwa ndipo machitidwe osokoneza bongo, omwe angaphatikizepo kapena osaphatikizapo kugwiritsa ntchito mowa ndi mankhwala ena osokoneza bongo, amalowa m'malo mwa makhalidwe abwino okhudzana ndi kudzisamalira. [Ndipo] kuledzera kumakhudzanso kufalikira kwa mitsempha ndi kuyanjana pakati pa ma circuits a cortical ndi hippocampal ndi mapangidwe a mphotho ya ubongo, kotero kuti kukumbukira zomwe zidachitika kale ku mphotho ( monga chakudya, kugonana, mowa ndi mankhwala ena osokoneza bongo) kumabweretsa yankho lachilengedwe ndi la khalidwe ku zizindikiro zakunja, zomwe zimayambitsa chilakolako ndi/kapena kuchita zinthu zosokoneza bongo.
Neurobiology ya chizolowezi chophatikizira imaphatikizapo zochulukirapo kuposa minyewa yamaubwino ya mphotho. (1) Khola lakumaso kwaubongo komanso kulumikizana kwazinthu zoyera pakati pa kotekisi yakutsogolo ndi madera amphotho, chilimbikitso ndi kukumbukira ndizofunikira pakuwonetsa kuwongolera kosintha, kuwongolera kosintha , komanso kufunafuna mphotho (zomwe nthawi zambiri zimachitikira munthu wokhudzidwayo ngati chikhumbo chokhala "wabwinobwino") kumawoneka pakumwa-ngakhale zovuta zoyipa zomwe zimadza chifukwa chogwiritsa ntchito mankhwala osokoneza bongo komanso machitidwe ena osokoneza bongo.
Kutsogolo kwa nkhokwe ndizofunikira popewa kulowerera komanso kuthandiza anthu kuti akuchedwa kuzengereza. Anthu omwe ali ndi vuto losokoneza bongo akaonetsa mavuto posintha kukhutira, pamakhala chiyembekezo chamanjazi. Frontal lobe morphology, kulumikizidwa ndi magwiridwe antchito adakali mu nyengo ya kusasamba paubwana ndi ukalamba, ndikuyamba kugwiritsa ntchito mankhwala osokoneza bongo ndichinthu chinanso chofunikira kwambiri pakulimbikitsa kusuta. Akatswiri ambiri a mitsempha amakhulupirira kuti kukula kwa morphology ndi komwe kumapangitsa kukhudzana ndi zinthu zofunikira kwambiri kukhala chinthu chofunikira kwambiri.
Zinthu zamtunduwu zimaphatikizapo pafupifupi theka la mwayi woti munthu akhoza kuyamba kuledzera. Zinthu zachilengedwe zimagwirizana ndi biology ya munthu ndipo zimakhudza momwe zimayambira. Zochita zomwe munthu amapeza (kupyolera mu kulera kapena zochitika zina zam'tsogolo) zingakhudze momwe maseŵero a chibadwa amathandizira ku makhalidwe ndi zina zowonongeka. Chikhalidwe chimathandizanso momwe chizoloŵezi chimayambira pa anthu omwe ali ndi chiopsezo cha chilengedwe kuti akule bwino.
Zina mwa zinthu zomwe zingapangitse maonekedwe a zizoloŵezi, zomwe zimatsogolere kuwonetseredwe kachipangizo-machitidwe-auzimu ndi uzimu, kuphatikizapo:
a. Kupezeka kwa vuto lalikulu lachilengedwe m'ntchito ya madera a mphotho, monga mankhwala ndi makhalidwe omwe amalimbikitsa mphoto ntchito ndizofunidwa monga zolimbikitsira;
b. Kubwereza mobwerezabwereza kugwiritsira ntchito mankhwala osokoneza bongo kapena makhalidwe ena oledzera, kuchititsa kuti munthu asagwiritsire ntchito mankhwala osokoneza bongo omwe amachititsa kuti asakhale ndi vuto loletsa kugwiritsa ntchito mankhwala osokoneza bongo kapena kuchita nawo zizoloŵezi zoipa;
c. Zosokoneza maganizo ndi zosokoneza, zomwe zimapangitsa kuti anthu asamvetsetse, komanso amalephera kuthetsa malingaliro awo, zomwe zimapangitsa kuti azidzipusitsa;
d. Kusokonezeka kwa chithandizo cha umoyo wabwino ndi mavuto mu maubwenzi apamtima omwe amakhudza chitukuko kapena zotsatira zokhutira;
e. Kuwonetsa zoopsa kapena zopanikizika zomwe zimapangitsa munthu kuthana ndi maluso;
f. Kusokonezeka mukutanthawuza, cholinga ndi zikhalidwe zomwe zimatsogolera maganizo, kuganiza ndi khalidwe;
g. Kusiyanitsa pakati pa munthu ndi kudzikonda, ndi ena komanso oposa (otchedwa Mulungu ndi ambiri, Mphamvu Zapamwamba ndi magulu a 12-, kapena chidziwitso cha ena); ndi
h. Kupezeka kwa matenda omwe amachititsa kuti anthu azigwiritsira ntchito mankhwala kapena makhalidwe ena oledzera.
Kuledzeretsa kumakhala ndi ABCDE (onani #2 pansipa):
a. Kulephera kusasintha nthawi zonse;
b. Kusokonezeka mu Kuchita Makhalidwe;
c. Kukonda; kapena kuwonjezeka kwa "njala" ya mankhwala kapena zochitika zowonjezera;
d. Kulepheretsa kuvomereza mavuto aakulu ndi maubwenzi ndi zochita zawo; ndi
e. Yankho losagwira ntchito pamtima.
Mphamvu zakunja zomwe zimapangitsa kuti chilakolako chofuna kugwiritsidwa ntchito komanso kugwiritsa ntchito mankhwala osokoneza bongo chikhalepo, komanso kuonjezera chizoloŵezi chochita nawo mwazizolowezi zina zomwe zingakhale zovuta, komanso chizoloŵezi choledzera, ndi hippocampus kukhala yofunika kukumbukira zochitika zam'mbuyomu kapena zam'tsogolo, komanso amygdala kukhala ofunika pokhala ndi cholinga chofuna kusankha makhalidwe okhudzana ndi zochitika zakale.
Ngakhale ena amakhulupirira kuti kusiyana pakati pa omwe ali ndi chizolowezi choledzera, ndi omwe alibe, ndi kuchuluka kapena kuchuluka kwa mowa/mankhwala osokoneza bongo, kuchita zinthu zoledzera (monga kutchova juga kapena kugwiritsa ntchito ndalama) (3), kapena kukumana ndi mphotho zina zakunja (monga chakudya kapena kugonana), mbali yodziwika bwino ya chizolowezi ndi njira yabwino yomwe munthuyo amayankhira ku zochitika zotere, zopsinjika maganizo ndi zizindikiro za chilengedwe. Mbali yodziwika bwino ya momwe anthu omwe ali ndi chizolowezi choledzera amatsatira kugwiritsa ntchito mankhwala osokoneza bongo kapena mphotho zakunja ndikuti kuganizira kwambiri, kukonda kwambiri ndi/kapena kufunafuna mphotho (monga kumwa mowa ndi kugwiritsa ntchito mankhwala ena osokoneza bongo) kumapitirirabe ngakhale zotsatirapo zake zikuchulukirachulukira. Zizindikirozi zimatha kuchitika mokakamiza kapena mosaganizira, monga kuwonetsa kulephera kudziletsa.
Chiopsezo chokhazikika ndi / kapena kubwereza kubwereranso, pambuyo pa nthawi ya kudziletsa, ndi chinthu china chofunika kwambiri cha kuledzera. Izi zingayambidwe chifukwa chokhala ndi zinthu zopindulitsa komanso makhalidwe abwino, poyang'ana zochitika zachilengedwe zomwe zingagwiritsidwe ntchito, komanso poyesedwa ndi maganizo oponderezedwa omwe amachititsa ntchito yowonjezereka m'madera ozungulira ubongo. (4)
Kuledzera kuli vuto lalikulu mu ntchito yogwira ntchito, yomwe imawonekera m'mavuto ndi malingaliro, kuphunzira, kutengeka, kukhudzidwa, ndi chiweruzo. Anthu omwe ali ndi chizoloŵezi chowongolera nthawi zambiri amawonetsa kukhala okonzeka kuchepetsa makhalidwe awo osayenerera ngakhale kulimbikitsa nkhawa zomwe zimafotokozedwa ndi ena ambiri m'miyoyo yawo; ndi kuwonetsa kuti akusowa kuyamikira kuchuluka kwa mavuto okhudzidwa ndi mavuto. Zomwe zimakhalapobe kuti zikhoza kukhala zovuta kwambiri, zimakhala zovuta kwambiri kuti zikhale zovuta kwambiri, zomwe zimachititsa kuti achinyamata azikhala ndi "chiopsezo chachikulu" kuphatikizapo kumwa mowa kapena kugwiritsa ntchito mankhwala osokoneza bongo. Kugwedeza kwakukulu kapena chikhumbo chogwiritsa ntchito zinthu kapena kukhala ndi makhalidwe opindulitsa, omwe amawonedwa kwa odwala ambiri omwe ali ndi chizolowezi choledzeretsa, amatsindika zochitika zovuta kapena zosavomerezeka za matendawa. Uku ndiko kugwirizanitsa ndi "kusowa mphamvu" pa kuledzeretsa ndi "kusalephereka" kwa moyo, monga momwe akufotokozera mu Step 1 ya mapulogalamu a 12 Steps.
Kuledzera sikungokhala vuto la khalidwe. Zizindikiro za chizoloŵezi zimaphatikizapo mbali za khalidwe la munthu, malingaliro, malingaliro, ndi kuyanjana ndi ena, kuphatikizapo kuthekera kwaumunthu kulumikizana ndi mamembala a banja lawo, kwa anthu ammudzi wawo, kudziko lawo laumaganizo, ndi zinthu zomwe zimadutsa tsiku ndi tsiku zochitika.
Ziwonetsero za zizoloŵezi ndi zovuta za vutoli, makamaka chifukwa cholephera kulamulira, zingaphatikizepo:
a. Kugwiritsira ntchito mopitirira muyeso komanso / kapena kuchita nawo zizoloŵezi zoipa, pafupipafupi komanso / kapena kuchulukirapo kuposa momwe munthuyo amafunira, nthawi zambiri kumagwirizana ndi chilakolako chopitirirabe cha kuyesayesa kayendetsedwe ka khalidwe;
b. Nthawi yambiri yawonongeka pogwiritsa ntchito mankhwala kapena kubwezeretsa zotsatira za kugwiritsiridwa ntchito kwa mankhwala ndi / kapena kuchita nawo zizoloŵezi zoledzera, zomwe zimakhudza kwambiri ntchito zokhudzana ndi chikhalidwe cha anthu komanso ntchito (mwachitsanzo chitukuko cha mavuto a chiyanjano kapena kunyalanyaza maudindo kunyumba, sukulu kapena ntchito );
c. Kupitiliza kugwiritsidwa ntchito ndi / kapena kuchita nawo malingaliro oledzera, ngakhale kukhalapo kwa mavuto kapena thupi lokhazikika kapena lobwerezabwereza lomwe likhoza kuchitidwa kapena kuwonjezeka ndi kugwiritsira ntchito mankhwala ndi / kapena makhalidwe ololedwa;
d. Kuwonetseratu zochitika zokhudzana ndi khalidwe labwino zoganizira za mphoto zomwe ziri mbali ya chizolowezi; ndi
e. Zikuwoneka kuti alibe luso komanso / kapena wokonzeka kutenga zochitika zodzikongoletsera, ngakhale kuvomereza mavuto.
Kusintha kwa chidziwitso kuledzera kungaphatikizepo:
a. Kutanganidwa ndi kugwiritsa ntchito mankhwala;
b. Kuwongolera kwazomwe zimapindula ndi zowonongeka zomwe zikugwirizana ndi mankhwala osokoneza bongo kapena opindulitsa; ndi
c. Chikhulupiriro chosagwirizana kuti mavuto omwe amakumana nawo m'moyo amakhala okhudzidwa ndi zifukwa zina osati kukhala zowonongeka zowonongeka.
Kusintha kwakumva kwauchidakwa kungaphatikizepo:
a. Kuwonjezeka kwa nkhawa, dysphoria ndi kupweteka mtima;
b. Kuchulukitsa mphamvu kwa opanikizana zomwe zimagwirizanitsidwa ndi kulembedwera kwa maganizo opanikizika a ubongo, kotero kuti "zinthu zimawoneka zolemetsa" chifukwa; ndi
c. Zovuta pozindikiritsa malingaliro, kusiyanitsa pakati pa kumverera ndi kumverera kwa thupi kumangirira, ndi kufotokoza malingaliro kwa anthu ena (nthawi zina amatchedwa alexithymia).
Zomwe zimachititsa kuti munthu aziledzera n'zovuta kwambiri. Anthu ena amamwa mowa kapena mankhwala osokoneza bongo kapena amatsata mphotho zina chifukwa amafuna "kulimbitsa bwino" kapena kukhala ndi maganizo abwino ("euphoria"). Ena amayesetsa kugwiritsira ntchito mankhwala kapena mphoto zina chifukwa adapeza mpumulo kuchokera kuzinthu zosokoneza maganizo ("dysphoria"), zomwe zimapangitsa kuti "kusamalidwa bwino." Pambuyo pa zoyamba za mphotho ndi mpumulo, pali vuto losagwirizana ndi vutoli zomwe zikugwirizana ndi kuumirira kwa chiyanjano ndi makhalidwe oledzera.
Mkhalidwe wa chizolowezi si wofanana ndi mkhalidwe wa kuledzera. Munthu akaledzera pang'ono pogwiritsa ntchito mowa kapena mankhwala ena osokoneza bongo, kapena akamachita zinthu zomwe zingakhale zovuta monga kutchova juga kapena kudya, munthu akhoza kukhala ndi "kuledzera", komwe kumamveka ngati mkhalidwe "wabwino" wamaganizo wokhudzana ndi kuchuluka kwa dopamine ndi opioid peptide m'magawo opereka mphotho. Pambuyo pa chochitika chotere, pamakhala kubwereranso kwa mitsempha, komwe ntchito ya mphotho simangobwerera ku chiyambi, koma nthawi zambiri imatsika pansi pa milingo yoyambirira. Izi nthawi zambiri sizimaonekera mwadala kwa munthuyo ndipo sizimakhudzana kwenikweni ndi zovuta za magwiridwe antchito.
Popita nthawi, zokumana nazo mobwerezabwereza ndi kugwiritsa ntchito mankhwala osokoneza bongo kapena zizolowezi zowonjezera thupi sizimagwirizanitsidwa ndi ntchito zomwe zikuchulukirachulukira zolandira mphoto ndipo sizabwino. Munthu akangosiya kugwiritsa ntchito mankhwala osokoneza bongo kapena machitidwe ofananirako, pamakhala nkhawa, kukwiya, kusowa kwa chidwi ndi zochitika zokhudzana ndi mtima, zokhudzana ndi mphotho yayitali komanso kufunsidwa kwa ubongo ndi kupsinjika kwamaganizidwe amakono, komwe kumalumikizidwa ndi kudzipatula ku magulu onse azachipatala a mankhwala osokoneza bongo. Ngakhale kulolerana kumakulirakulira kufikira “kumtunda,” kulolerako sikumakhazikika pamalingaliro “otsika” ogwirizana ndi kuzungulira kwa kuledzera ndi kudzipatula.
Chifukwa chake, pakukonda, anthu mobwerezabwereza amayesa kupanga "apamwamba" - koma zomwe zimawakhudza kwambiri ndizakuya komanso kuzama. Ngakhale aliyense "angafune" kukwera ", omwe ali ndi chizolowezi chomwa mowa mwauchidakwa amamva" chosowa "chogwiritsa ntchito mankhwala osokoneza bongo kapena chizolowezi choledzera kuti athe kuyesa kuthana ndi nkhawa zawo kapena zizindikiritso zakuthupi zakusuta. Anthu omwe ali ndi chizolowezi chomwa mowa mwauchidakwa amagwiritsira ntchito mankhwala osokoneza bongo ngakhale atha kuwapangitsa kuti asamve bwino, nthawi zina pambuyo pofunafuna "mphotho." (5) Ngakhale anthu azikhalidwe zilizonse angasankhe "kukwera" kuchokera kwa wina ndi mnzake ntchito, ndikofunikira kuzindikira kuti kuledzera si ntchito yokhayo yomwe munthu angasankhe. Mwachidule, kuledzera si vuto.
Monga chizoloŵezi ndi matenda aakulu, nthawi zobwereza, zomwe zingasokoneze mitsempha ya chikhululukiro, ndizofala zomwe zimachitika mowa. Ndifunikanso kuzindikira kuti kubwerera ku mankhwala osokoneza bongo kapena kupindula kwa mphotho sikungapeweke.
Njira zothandizira kuchipatala zingakhale zothandiza kuthetsa vutoli. Pewani kufufuza kwa makhalidwe omwe ali nawo payekha komanso nthawi zina, nthawi zina kuphatikizapo zotsatira za khalidwe la kubwezeretsa khalidwe, zingapangitse zotsatira zowonjezera. Kuchita nawo ntchito zotsitsimula zaumoyo zomwe zimalimbikitsa udindo wa munthu ndi udindo, kulumikizana ndi ena, ndi kukula kwaumwini kumathandizanso kuti ayambe kuchira. Ndikofunika kuzindikira kuti kuledzera kungayambitse kulemala kapena kufa msanga, makamaka ngati sanasamalidwe kapena kupatsidwa mankhwala osayenera.
Njira zamomwe ubongo ndi khalidwe zimayankhira ndi mankhwala osokoneza bongo komanso kukhala ndi chizoloŵezi chokhala ndi zizoloŵezi zoledzeretsa ndizosiyana pazigawo zam'tsogolo za chizolowezi choledzeretsa kusiyana ndi magawo oyambirira, kusonyeza kupita patsogolo, komwe sikungakhale koonekera kwambiri. Monga momwe zilili ndi matenda ena akuluakulu, chikhalidwechi chiyenera kuyang'aniridwa ndi kuyendetsedwa pakapita nthawi kuti:
a. Kuchepetsa mafupipafupi ndi mphamvu za kubwereranso;
b. Nthawi zolimbikitsa za kukhululukidwa; ndi
c. Konzekerani msinkhu wa ntchitoyo pa nthawi ya kukhululukidwa.
Nthawi zina kumwa mowa, mankhwala amatha kusintha zotsatira za mankhwala. Nthawi zambiri mowa, kuphatikizapo kukonzanso maganizo ndi chisamaliro chokhazikika ndi mankhwala opatsirana pogwiritsa ntchito umboni amapereka zotsatira zabwino. Kukonza matenda kwachilendo n'kofunika kuti kuchepetsedwa kwa zigawo za kubwereranso ndi zotsatira zake. Kuchiza kwauchidakwa kumapulumutsa miyoyo †
Oledzeretsa ogwira ntchito ndi anthu omwe akuchidziwitso amadziwa chiyembekezo chomwe chimapezeka. Kubwezeretsa kulipo ngakhale kwa anthu omwe poyamba sangathe kuzindikira chiyembekezo, makamaka pamene cholinga chake chikugwirizanitsa zotsatira za thanzi la matenda oledzeretsa. Monga momwe zimakhalire ndi thanzi labwino, kudziletsa nokha, ndi kuthandizana, ndikofunika kwambiri kuti muthe kuchipatala. Thandizo la anzanga monga limene likupezeka muzochita zosiyanasiyana "zothandizira" zimapindulitsa kukulitsa thanzi labwino ndi zotsatira zogwira ntchito. ‡
Kuchokera ku chizolowezi choledzeretsa kumapindula bwino pogwiritsa ntchito kudzigwirizanitsa, kuthandizana, komanso kusamalira akatswiri omwe amaphunzitsidwa ndi akatswiri odziwika bwino.
Mawu ofotokozera a ASAM:
1. Sayansi ya ubongo ya mphotho yakhala ikudziwika bwino kwa zaka zambiri, pomwe sayansi ya ubongo ya chizolowezi ikufufuzidwabe. Madokotala ambiri aphunzira za njira zopezera mphotho kuphatikizapo zoyerekeza kuchokera ku dera la ventral tegmental (VTA) la ubongo, kudzera mu median forebrain bundle (MFB), ndikutha mu nucleus accumbens (Nuc Acc), momwe ma dopamine neurons amaonekera. Sayansi ya ubongo yamakono imazindikira kuti neurocircuitry ya mphotho imaphatikizaponso ma circuitry olemera a bi-directional omwe amalumikiza nucleus accumbens ndi basal forebrain. Ndi malo opezera mphotho komwe mphotho imalembetsedwa, ndipo komwe mphotho zazikulu monga chakudya, madzi, kugonana, ndi chisamaliro zimakhala ndi mphamvu yolimba komanso yosunga moyo.
Mowa, nikotini, mankhwala ena osokoneza bongo ndi machitidwe a kutchova juga omwe amachititsa zotsatira zake zoyambirira pochita zinthu zomwezo zomwe zimawonekera muubongo kuti chakudya ndi kugonana zipangitse kuti chakudya chikhale cholimba, mwachitsanzo, zimalimbikitsa kwambiri. Zotsatira zina, monga kuledzera ndi chisangalalo chamaganizo kuchokera ku mphotho, zimachokera ku kuyatsa kwa mphotho. Ngakhale kuledzera ndi kusiya zinthu zimamveka bwino kudzera mu kuphunzira kwa mphotho, kumvetsetsa kuledzera kumafuna kumvetsetsa kulumikizana kwakukulu kwa mitsempha yokhudzana ndi ubongo wamtsogolo komanso kapangidwe ka ubongo wapakati. Kusankha mphotho zina, kuganizira kwambiri za mphotho zina, kuyankha kuzinthu zomwe zimayambitsa kutsata mphotho zina, ndi zolimbikitsa kugwiritsa ntchito mowa ndi mankhwala ena osokoneza bongo komanso/kapena kufunafuna mphotho zina mwachisawawa, zimakhudza madera angapo a ubongo kunja kwa neurocircuitry yokha.
2. Zinthu zisanuzi sizikuganiziridwa ndi ASAM kuti zigwiritsidwe ntchito ngati "njira zodziwira matenda" podziwa ngati chizolowezi chilipo kapena ayi. Ngakhale kuti zinthuzi zimapezeka kwambiri nthawi zambiri munthu akamamwa chizolowezi, mosasamala kanthu za mankhwala omwe amagwiritsidwa ntchito mu chizolowezi kapena mphotho yomwe imatsatiridwa ndi matenda, chizolowezi chilichonse sichingakhale chofanana nthawi zonse. Kuzindikira chizolowezi kumafuna kuwunika kwathunthu kwa zamoyo, zamaganizo, zachikhalidwe ndi zauzimu ndi katswiri wophunzitsidwa bwino komanso wovomerezeka.
3. M'chikalatachi, mawu oti "zizolowezi zosokoneza bongo" amatanthauza zizolowezi zomwe zimapindulitsa kwambiri ndipo zimakonda kupezeka nthawi zambiri. Kudziwonetsera pamakhalidwe amenewa, monganso momwe zimakhalira ndikupezeka ndi mankhwala opindulitsa, ndikuthandizira pakumwa mankhwala osokoneza bongo m'malo mochititsa kuti munthu akhale osokoneza bongo. Mkhalidwe wa anatomy yaubongo ndi physiology ndizomwe zimayambitsa zomwe zimayambitsa kusokoneza bongo. Chifukwa chake, mu chikalatachi, mawu oti "zizolowezi zosokoneza bongo" satanthauza zikhalidwe zosavomerezeka kapena zosavomerezeka pagulu, zomwe zimatha kupezeka nthawi zambiri. Makhalidwe, monga kusakhulupirika, kuphwanya mfundo zamakhalidwe abwino kapena zokomera ena, zachiwawa ndi zina zambiri, zitha kukhala gawo lazowonjezera; izi zimawoneka bwino ngati zovuta zomwe zimadza chifukwa chopewa kuledzera.
4. Matenda a ubongo (ozungulira ubongo omwe amagwira nawo ntchito) ndi physiology (omwe amachititsa kuti anthu asamangokhalira kugwiritsira ntchito mankhwalawa) mwa njira zitatu izi zomwe zimayambanso kubwezeretsedwa (kubwezeretsa mankhwala osokoneza bongo kapena kubwezeretsa mphoto) kufufuza.
- Kubwereranso komwe kumayambitsidwa chifukwa chogwiritsa ntchito mankhwala osokoneza bongo / opindulitsa, kuphatikiza mowa, zimakhudza ma nyukiliya omwe amapezeka ndi VTA-MFB-Nuc Acc neural axis (mesolimbic dopaminergic "incentive salience circry" - onani mawu am'munsi 2 pamwambapa). Kubwezeretsanso komwe kumabweretsa mphotho kumayambitsidwanso ndi ma circut a glutamatergic omwe amayang'ana ku ma nucleus omwe amapezeka kuchokera kumtunda wakutsogolo.
- Kubwereranso kumeneku kumayambidwa chifukwa chodziwika ndi chikhalidwe chochokera ku chilengedwe chimaphatikizapo maulendo a glutamate, omwe amachokera kutsogolo, kutsogolo, hippocampus ndi amygdala kukonzekera kuti zikhale zolimbikitsa zowonongeka.
- Kubwereranso kumeneku kumayambidwa chifukwa chokumana ndi zovuta zomwe zimachitika kumaphatikizapo maulendo opanikizika a ubongo kupitirira hypothalamic-pituitary-adrenal axis yomwe imadziwika bwino kwambiri kuti ndiyo maziko a dongosolo la maganizo la endocrine. Pali zinthu ziwiri zomwe zimayambitsa kubwezeretsa ubongo wa ubongo - imodzi imachokera ku noradrenergic nucleus A2 yomwe imayambira kumapeto kwa ubongo ndi mapulani ku hypothalamus, nucleus accumbens, frontal cortex, ndi pedi la bedi la stria terminalis, ndipo amagwiritsa ntchito norepinephrine monga neurotransmitter yake; Zina zimachokera pakatikati mwa amygdala, mapulani ku bedi la stria terminalalis ndipo amagwiritsa ntchito corticotrophin-release factor (CRF) monga neurotransmitter.
5. Mphoto yofunafuna mwanzeru (yotchulidwa mu Short Version ya tanthauzo la ASAM) motero ili ndi zigawo zingapo. Sikuti mulingo wokhudzidwa ndi mphothoyo (mwachitsanzo, kuchuluka kwa mankhwala) kapena kuchuluka kapena kufotokozera kwachidziwikire kumene kumachitika. Mwakuwonjeza, kufunafuna mphotho kumapitirirabe, ngakhale pali zovuta m'moyo zomwe zimadziunjikira chifukwa chamakhalidwe olowerera, ngakhale kuchita nawo zikhalidwe kumatha kusangalatsa. Momwemonso, m'magawo oyambirirawo, kapena ngakhale mawonekedwe akunja atawonekera, kugwiritsa ntchito mankhwala osokoneza bongo kapena kuchita zikhalidwe zosokoneza bongo zitha kukhala kuyesa kupeza mpumulo ku dysphoria; pomwe matendawa atadutsa, kudziwika kuti ali ndi zizolowezi zokhoza kupitilira apobe ngakhale zikhalidwe siziperekanso mpumulo.