Malingaliro Ophunzirira pa Zithunzi Zolaula Mavuto Omwe Amakhalapo Chifukwa Chosakhazikika Pamakhalidwe Ndi Njira Zogwiritsira Ntchito Zithunzi Zolaula: (Kufufuza kwa mtundu wa Grubbs wamakhalidwe osayenera)

Zilembedwa Zotsatira Zogonana

, Voliyumu 48, Nkhani 2, tsamba 417–423 |

https://link.springer.com/article/10.1007%2Fs10508-018-1293-5

Matthias Brand, Stephanie Antons, Elisa Wegmann, Marc N. Potenza

Introduction

Nkhani Yotchedwa Target yolembedwa ndi Grubbs, Perry, Wilt, ndi Reid ( 2018 ) ikufotokoza nkhani yofunika komanso yanthawi yake yokhudza mavuto omwe anthu angakumane nawo okhudzana ndi kugwiritsa ntchito zolaula. Grubbs et al. akunena kuti pali anthu omwe amadzizindikiritsa okha kuti ali ndi chizolowezi choonera zolaula popanda kugwiritsa ntchito molakwika. Grubbs et al. akupereka chitsanzo cha mavuto a zolaula chifukwa cha kusalingana kwa makhalidwe abwino (PPMI) omwe "angathandize kutanthauzira mabuku okhudzana ndi chizolowezi cha zolaula, makamaka momwe kusalingana kwa makhalidwe abwino—mwachidule, kuchita zinthu zomwe zimaswa mfundo za makhalidwe abwino zomwe munthu amakhala nazo—kungayambitse mavuto omwe munthu amadziona kuti ndi ofunikira chifukwa chogwiritsa ntchito zolaula."

Chitsanzo cha PPMI n'chofunika kuchiganizira. Chithunzi chomwe chikufotokoza mwachidule chitsanzochi (onani Chithunzi 1 mu Grubbs et al., 2018 ) chikuphatikizapo "mavuto" ngati chinthu chachikulu chodalira, kusiyanitsa magawo atatu osiyana: kuvutika maganizo pakati pa munthu ndi munthu, kuvutika maganizo pakati pa anthu/ubale, ndi kuvutika maganizo pachipembedzo/uzimu. Njira zomwe zaperekedwa zomwe zimayambitsa kuvutika zikuphatikizapo njira ziwiri zazikulu: Njira 1, yomwe imatchedwa "mavuto okhudzana ndi zolaula chifukwa cha kusokonezeka kwa malamulo" ndi Njira 2, yomwe imatchedwa "mavuto okhudzana ndi zolaula chifukwa cha kusagwirizana kwa makhalidwe." Grubbs et al. akunena kuti Njira 1, yomwe ikuwonetsa njira zopangira ndi kusunga kugwiritsa ntchito zolaula mopitirira muyeso, si cholinga chachikulu cha chitsanzo chomwe chayambitsidwa ndipo, m'malo mwake, amachiyerekeza ndi mitundu ina yeniyeni (monga chitsanzo cha I-PACE) (Brand, Young, Laier, Wölfling, & Potenza, 2016b ). Komabe, Grubbs et al. adaganiza zophatikiza Njira 1 iyi mu chitsanzo chawo, ndipo njira iyi ili ndi mbali zingapo za kugwiritsa ntchito zolaula mopitirira muyeso kapena mopitirira muyeso. Mbali zina za njira iyi zikugwirizana ndi njira za PPMI, mwachitsanzo, "kusokonezeka maganizo" ndi "kusalingana kwa makhalidwe" ziyenera kukhudza mwachindunji "mavuto okhudzana ndi zolaula omwe mumadziona nokha," zomwe zimabweretsa mavuto.

Tikunena kuti njira iyi—yophatikizapo njira yogwiritsira ntchito molakwika komanso kulumikiza njira iyi ndi njira ya PPMI—siyiganiziridwa mokwanira ndi Grubbs et al. ( 2018 ). Malinga ndi malingaliro athu, zikanakhala bwino kufotokoza zambiri za kulumikizana pakati pa zinthu zazikulu za njira ziwiri zomwe zingatheke ndikuganizira bwino zambiri, makamaka zokhudzana ndi zinthu zina zomwe sizinaganizidwe mokwanira m'nkhaniyi, ponena, mwachitsanzo, zifukwa zodziletsa komanso kulephera kudziletsa m'malo otere. Kuphatikiza apo, Grubbs et al. akhoza kuyika chitsanzocho mkati mwa machitidwe amakono owonera zolaula ndi machitidwe ena osokoneza bongo mkati mwa zochitika zachipembedzo.

Ndemanga za Pathway 1 ya Chitsanzo: Kuonongeka kwa Zithunzi Zolaula Gwiritsani Ntchito

Njira yoyamba mu chitsanzochi ndi chitsanzo chosavuta cha njira zomwe zimakhudzidwa pakupanga ndi kusunga zomwe Grubbs et al. amafotokoza kuti ndi zolaula zomwe zimasokoneza kapena kugwiritsa ntchito molakwika. Njirayi, momwe ilili pano, ikuphatikiza zitsanzo zochepa za kusiyana (monga, kulakalaka, kufunafuna malingaliro, kuthana ndi zofooka), monga zinthu zomwe zimayambitsa kugwiritsa ntchito zolaula kutsatiridwa ndi kusokonezeka. Chithunzichi chikuwonetsa kuti khalidwe losokonezeka limabweretsa mavuto, mwachindunji komanso mwanjira ina, kuposa mavuto okhudzana ndi zolaula omwe mumadziona nokha. Komabe, zinthu zazikulu zomwe zimagwirizanitsidwa ndi kusokonezeka kwa kugwiritsa ntchito zolaula zimangotchulidwa mopanda malire komanso mopanda pake ndi Grubbs et al. ( 2018 ). Ngakhale njira iyi si cholinga cha chitsanzochi, ikadapindula pophatikiza zambiri pakukula kwa kugwiritsa ntchito zolaula molakwika kuti athe kusiyanitsa bwino (kapena kulumikiza) njira ziwirizi.

Kafukufuku angapo agogomezera kale kuti pali zina zowonjezera zomwe zingalimbikitse kukula kwa zolaula kapena zolaula. Zitsanzo zazikulu ndizophatikizira kukondweretsedwa ndi chilimbikitso (Laier & Brand, 2014; Lu, Ma, Lee, Hou, ndi Liao, 2014; Stark et al., 2017), Kuzindikira pagulu (Whang, Lee, & Chang, 2003; Yoder, Virden, & Amin, 2005), ndi psychopathology (Kor et al., 2014; Schiebener, Laier, & Mtundu, 2015; Whang et al., 2003). Makhalidwewa sangakhudze kwambiri chizolowezi chogwiritsa ntchito zolaula, koma zoyeserera zimasinthidwa komanso / kapena zimayanjanitsidwa ndi machitidwe okhudzana ndi kuzindikira pazomwe zimayambitsa zakunja kapena zamkati ndi zoyang'anira (zoletsa) zomwe zimapangitsa chisankho chogwiritsa ntchito zolaula ( Allen, Kannis-Dymand, & Katsikitis, 2017; Antons & Brand, 2018; Brand et al., 2016b; Schiebener et al., 2015; Snagowski & Mtundu, 2015). Chimodzi mwazomwe zimapangitsa kuti munthu azigwiritsa ntchito zolaula ndi njira yodziwikiranso ndikuyambiranso mayankho (mwachitsanzo, Antons & Brand, 2018; Mtundu, Snagowski, Laier, & Maderwald, 2016a; Gola et al., 2017; Kraus, Meshberg-Cohen, Martino, Quinones, & Potenza, 2015; Laier, Pawlikowski, Pekal, Schulte, & Brand, 2013; Snagowski, Wegmann, Pekal, Laier, & Brand, 2015; Weinstein, Zolek, Babkin, Cohen, & Lejoyeux, 2015). Zakhala zikugogomezera kuti kukondwera komwe kunachitika pamene kugwiritsira ntchito zolaula kumalimbikitsa-chifukwa cha zikhalidwe (Banca et al., 2016; Klucken, Wehrum-Osinsky, Schweckendiek, Kruse, ndi Stark, 2016; Snagowski, Laier, Duka, & Brand, 2016) -Nkhani zomwe tatchulazi zokhudzana ndi zolaula, zomwe zimayambitsa kugwiritsa ntchito zolaula (onani Brand et al., 2016b). Kafukufuku wammbuyo amasonyeza kuti machitidwe oopsa a ubongo wa ubongo, makamaka omwe akuphatikizapo ventral striatum, amagwirizana ndi kuwonjezeka kwa chilakolako ndi zizindikiro zina zolaula zimagwiritsa ntchito (Brand et al., 2016a; Gola, Wordecha, Marchewka, & Sescousse, 2016; Gola et al., 2017).

Mu chitsanzo chawo, Grubbs et al. ( 2018 ) mwina amagwiritsa ntchito lingaliro lodziwika bwino la chilakolako pansi pa mawu akuti emotional dysregulation. Komabe, chilakolako sichinthu chongowonjezera kusokonezeka kwa malingaliro, chifukwa chimayimira mayankho amalingaliro, chilimbikitso, ndi thupi ku zoyambitsa zokhudzana ndi chizolowezi (Carter et al., 2009 ; Carter & Tiffany, 1999 ; Tiffany, Carter, & Singleton, 2000 ) zomwe zimapangitsa kuti pakhale njira zopewera komanso njira zopewera (Breiner, Stritzke, & Lang, 1999 ; Robinson & Berridge, 2000 ). Kufunika kophunzira njira zolakalaka zokhudzana ndi zomwe zapezeka mu Cyber ​​​​Pornography Use Inventory-9 (CPUI-9) (Grubbs, Volk, Exline, & Pargament, 2015b ) kwadziwika, makamaka popeza zomwe zapezeka zokhudzana ndi kugwiritsa ntchito zolaula mokakamiza (monga momwe zimagwiritsidwira ntchito ndi gawo la "kukakamizidwa kodziwika" la CPUI-9) zikuwoneka kuti zimakhudzidwa ndi zomwe zimapangitsa kuti munthu asamaone zolaula komanso kugwiritsa ntchito pafupipafupi poyesa kudziletsa (Fernandez, Tee, & Fernandez, 2017 ).

Gawo la "kudziletsa pang'ono" mu chitsanzo cha Grubbs et al. ( 2018 ) mwina limaphatikizapo kapena limatanthauza kuchepa kwa ntchito zoyang'anira ndi kuletsa kulamulira, monga zoletsa kuyankha kwa chilakolako (Bechara, 2005 ), zomwe zimapangitsanso kuchepetsa kulamulira kugwiritsa ntchito zolaula. Kusagwira ntchito bwino kwa njira zowongolera, monga kugwira ntchito kwa akuluakulu, mukakumana ndi zizindikiro zolaula komanso kuthana ndi nkhawa, kunapezeka kuti ndi koipa mwa anthu omwe ali ndi zizolowezi zogwiritsa ntchito zolaula molakwika (Laier & Brand, 2014 ; Laier, Pawlikowski, & Brand, 2014a ; Laier, Pekal, & Brand, 2014b ). Kulephera kugwiritsa ntchito zolaula kungachitike chifukwa cha kukhudzidwa kwambiri ndi zolaula komanso chilakolako komanso njira zochepetsera ulamuliro zomwe zimalimbikitsidwa ndi makhalidwe a munthu payekha monga chilakolako chachikulu chogonana, kusungulumwa, matenda amisala (Brand et al., 2016b ; Stark et al., 2017 ), komanso kusafuna kuchita zinthu mopitirira muyeso (Antons & Brand, 2018 ; Romer Thomsen et al., 2018 ; Wéry, Deleuze, Canale, & Billieux, 2018 ). Mu chitsanzo cha Grubbs et al., maubwenzi ovutawa ali ndi gawo limodzi lomwe limafotokoza mwachidule zina mwa izi. Komabe, kuwonetsa zovuta za Pathway 1 kungakhale kothandiza posiyanitsa bwino pakati pa zomwe zimayambitsa mavuto okhudzana ndi zolaula, kaya mwina chifukwa cha kusalingana kwa makhalidwe abwino ndi/kapena kugwiritsa ntchito mopitirira muyeso kapena molakwika.

Ndemanga za Pathway 2 ya Chitsanzo: Mavuto Odzidzidzidwa Okhudzana ndi Zithunzi Zolaula Gwiritsani Ntchito Zosokoneza Makhalidwe Abwino

Kutengera ndi maphunziro am'mbuyomu, Grubbs et al. ( 2018 ) akuwonetsa kuyanjana kwa malingaliro angapo omwe ali okhudzana ndi PPMI. Ngakhale kuti zomwe zapezekazo zimachokera ku kafukufuku wofalitsidwa kale, zimavutika ndi malingaliro okhudza "chizolowezi chodziwika" ndipo mwina zikupanga kusiyana kwabodza kutengera momwe zomangamanga ndi sikelo zimagwirira ntchito, komanso kutengera kafukufuku wochepa womwe ungakhale wochepa womwe wachitika mpaka pano.

Grubbs et al. ( 2018 ) akunena kuti kukhala wachipembedzo ndiye chinthu choyamba chomwe chikuwonetsa mavuto okhudzana ndi zolaula komanso kuvutika mu Pathway 2. Poganizira mivi, Grubbs et al. akuwoneka kuti akuwonetsa zotsatira (zochepa) kuchokera ku chipembedzo kupita ku mavuto omwe amadziona okha. Kuphatikiza apo, Grubbs et al. adaphatikizapo muvi wochokera ku chipembedzo kupita ku kukana makhalidwe abwino zolaula ndi kugwiritsa ntchito mopitirira muyeso zolaula kupita ku kusagwirizana kwa makhalidwe abwino kenako ku mavuto okhudzana ndi zolaula komanso kuvutika (onani Chithunzi 1 mu Grubbs et al., 2018 ). Izi zikuwoneka kuti zikusonyeza kusagwirizana pang'ono kuchokera ku chipembedzo kupita ku mavuto okhudzana ndi zolaula komanso kuvutika ndipo oyimira pakati akhoza kukhala kukana makhalidwe abwino, kugwiritsa ntchito zolaula, ndi kusagwirizana kwa makhalidwe abwino. Pankhaniyi, zingakhale zosangalatsa kwambiri kuwona zinthu zina zomwe zingathandize kugwiritsa ntchito zolaula popeza kupembedza ndi makhalidwe abwino zimachepetsa kugwiritsa ntchito kwake. Mwanjira ina: Nchifukwa chiyani anthu omwe ali ndi makhalidwe abwino ena amagwiritsa ntchito zolaula, ngakhale kuti kugwiritsa ntchito kumaphwanya makhalidwe awo abwino?

Chimodzi mwa zinthu zofunika kuzitchula ndichakuti maphunziro omwe adaphatikizidwa mu meta-analysis yomwe idafufuza makamaka amuna achikhristu. Mwachitsanzo, mu kafukufuku wopangidwa ndi Grubbs, Exline, Pargament, Hook, ndi Carlisle ( 2015a ), 59% ya omwe adatenga nawo mbali anali Akristu (36% Aprotestanti kapena Akatolika, 23% Akatolika), zomwe zimabweretsa funso ngati chitsanzochi chapangidwira makamaka gulu linalake la anthu achipembedzo. Kuphatikiza apo, pafupifupi gawo limodzi mwa magawo atatu (32%) a omwe adatenga nawo mbali mu chitsanzochi anali osagwirizana ndi chipembedzo kuphatikiza osakhulupirira Mulungu ndi osakhulupirira Mulungu. Izi zimabweretsa mafunso okhudza momwe Njira yachiwiri ya chitsanzo pa PPMI ingakhalire yovomerezeka kwa anthu omwe si achipembedzo pomwe kukhala wachipembedzo ndiye chinthu choyamba chomwe chimaneneratu. Palinso kuyanjana kwina komwe kungachitike pakati pa makhalidwe a anthu ndi kukhala wachipembedzo komwe kungakhale kokhudzana ndi mavuto okhudzana ndi kugwiritsa ntchito zolaula zomwe zingakhudze zomwe zili muzithunzi zolaula. Mwachitsanzo, mwa anthu omwe ali ndi chilakolako chosakhala cha amuna kapena akazi okhaokha (osachepera 10% ya omwe adatenga nawo mbali mu Grubbs et al., 2015a ), pakhoza kukhala mikangano pakati pa chipembedzo cha munthu ndi chilakolako chogonana/chokonda (chomwe chingaphwanye zikhulupiriro zachipembedzo), ndipo mikangano yotereyi ingakhudze malingaliro okhudzana ndi kugwiritsa ntchito zolaula zotere (monga, zomwe sizili za amuna kapena akazi okhaokha). Kuyanjana kotereku ndikofunikira kuganizira pofufuza zotsatira za chipembedzo pa PPMI. Mofananamo, ndi zolaula zomwe zilipo masiku ano zomwe zimawonetsa nkhanza kwa akazi komanso kukhala ndi mitu yotchuka yokhudza kugwiriridwa ndi kugonana kwachibale (Bridges, Wosnitzer, Scharrer, Sun, & Liberman, 2010 ; O'Neil, 2018 ), kodi zomwe zili munkhaniyi ziyenera kuganiziridwa poyesa kusagwirizana kwa makhalidwe abwino? Tsoka ilo, zinthu zokhudzana ndi zolimbikitsa ndi zolaula sizikuphatikizidwa momveka bwino mu njira/chitsanzo. Timatsutsa kuti zinthu zomwe zimayambitsa zolaula zimagwiritsidwa ntchito ngakhale kuti sizikugwirizana ndi makhalidwe abwino ndi/kapena chipembedzo mwina zimakhala zovuta komanso zosinthasintha kuposa zomwe zaperekedwa.

Zinthu zina zofunika kuziganizira zingaphatikizepo zinthu zokhudzana ndi nkhani ndi makhalidwe a munthu payekha. Zitsanzo za zinthu zokhudzana ndi nkhani, zomwe zafotokozedwa mwachidule ndi Grubbs et al. ( 2018 ), ndi kuthekera kogula zinthu, kusadziwika, ndi kupezeka mosavuta (injini ya A katatu) monga momwe Cooper ( 1998 adanenera ), komanso kuwona kuti zolaula za pa intaneti zimapereka mwayi wothawa zenizeni, monga momwe zanenedwera mu chitsanzo cha ACE cha Young ( 2008 ). Zinthu zomwe zimayambitsa kugwiritsa ntchito zolaula, ngakhale kuti kugwiritsa ntchito kumaphwanya makhalidwe abwino a munthu, zitha kukhalanso m'makhalidwe a munthu payekha, monga chilimbikitso cha kugonana (Stark et al., 2017 ). Zochitika zakale zokhudzana ndi kugwiritsa ntchito zolaula (monga, kukhutitsidwa ndi kugonana) (monga Brand et al., 2016b ), zithanso kuwonjezera mwayi wogwiritsa ntchito zolaula (nthawi zonse), popeza machitidwe ogonana amalimbikitsidwa mwachibadwa (monga Georgiadis & Kringelbach, 2012 ).

Mfundo yathu yaikulu ndi yakuti kulumikizana kwambiri pakati pa njira ziwirizi ndikofunikira kuganizira. Izi ndizofunikira kwambiri popeza Grubbs et al. ( 2018 ) akunena kuti cholinga chawo ndikuthandizira "kutanthauzira mabuku okhudzana ndi chizolowezi cha zolaula." Kuphatikiza apo, Grubbs et al. akuti: "Mwachidule, monga momwe tikuwunikira pansipa, chizolowezi chodziwika (monga momwe chawonedwera m'mabuku am'mbuyomu) nthawi zambiri chimagwira ntchito ngati choyimira malingaliro ambiri okhudza zolaula zomwe zimagwiritsidwa ntchito ngati zovuta chifukwa cha malingaliro osagwirizana ndi makhalidwe."

Tikugwirizana ndi mawu akuti "chizolowezi chodziwika" si mawu oyenera ndipo mwina angakhale ovuta kwambiri. Kugwiritsa ntchito chiŵerengero chonse cha CPUI-9 pofotokoza "chizolowezi chodziwika" sikukuwoneka koyenera chifukwa magawo atatuwa samayang'ana mokwanira mbali zosiyanasiyana za chizolowezi. Mwachitsanzo, chilakolako sichinaganizidwe mokwanira (onani pamwambapa), chizolowezi sichimafotokozedwa ndi miyeso ya kuchuluka/kawirikawiri (izi zitha kusiyana kwambiri pamavuto ogwiritsa ntchito mankhwala osokoneza bongo; onaninso kukambirana za miyeso ya kuchuluka/kawirikawiri yokhudzana ndi zigoli za CPUI-9 mu Fernandez et al., 2017 ), ndi zinthu zina zambiri zokhudzana ndi chizolowezi sizikuganiziridwa mokwanira (monga kusokoneza maubwenzi, ntchito, sukulu). Mafunso ambiri a CPUI-9, monga okhudzana ndi kupsinjika maganizo komanso ochokera ku miyeso yolumikizidwa ndi malingaliro a makhalidwe abwino/achipembedzo, sakugwirizana bwino ndi magawo awiri ofanana kwambiri a CPUI-9 okhudzana ndi kukakamizidwa ndi kupeza (Grubbs et al., 2015a ). Pachifukwa ichi, ofufuza ena (monga Fernandez et al., 2017 ) anena kuti, "zomwe tapeza zikukayikitsa ngati gawo la Emotional Distress liyenera kukhala gawo la CPUI-9," makamaka chifukwa ndi gawo la Emotional Distress lomwe nthawi zonse silisonyeza ubale ndi kuchuluka kwa anthu omwe amagwiritsa ntchito zolaula. Kuphatikiza apo, kuphatikizidwa kwa zinthuzi mu sikelo yomwe imafotokoza "chizolowezi chodziwika" kungasokoneze zomwe zapezeka zomwe zimachepetsa zomwe zimaperekedwa kuchokera ku kugwiritsidwa ntchito mokakamiza komanso kukulitsa zomwe zimaperekedwa chifukwa cha kusalingana kwa makhalidwe abwino (Grubbs et al., 2015a ). Ngakhale kuti deta iyi ingapereke chithandizo pakulekanitsa zinthuzi ndi zina zomwe zili mu sikelo (mwina pothandizira chitsanzo chomwe chaperekedwa), zinthuzi zimangoyang'ana kwambiri kumva kudwala, manyazi, kapena kukhumudwa mukaonera zolaula. Malingaliro oipa awa akuyimira zotsatira zoyipa zomwe zingachitike zokhudzana ndi kugwiritsa ntchito zolaula pa intaneti, ndi zomwe zingagwirizane ndi mbali zina za zikhulupiriro zachipembedzo. Kuti tithetse kugwiritsa ntchito mankhwala osokoneza bongo ndi PPMI, ndikofunikira kwambiri kuganizira osati mbali ya PPMI yokha, komanso momwe zinthu zingagwirizanire pakati pa njira zogwiritsira ntchito mankhwala osokoneza bongo kapena osokoneza bongo ndi zomwe zimapangitsa kuti PPMI ichitike kuti timvetse bwino zinthu ziwirizi komanso ngati zili zosiyana. Grubbs et al. ( 2018 ) akunena (mu gawo lakuti: "Nanga bwanji njira yachitatu?") kuti pakhoza kukhala njira yowonjezera ya mavuto okhudzana ndi kugwiritsa ntchito zolaula, zomwe zingakhale kuphatikiza kwa kukumana ndi "kusokonezeka kwa cholinga" ndi PPMI nthawi imodzi. Timanena kuti kuphatikiza kwa njira zonse ziwiri sikungakhale kwachitatu, koma mwina njira yomwe imayambitsa mavuto "onse awiri" ndi kugwiritsa ntchito zolaula. Mwanjira ina, tikunena kuti njira zina zokhudzana ndi chizolowezi ndi zinthu zolimbikitsa zitha kugwira ntchito pa PPMI ndi "kugwiritsa ntchito molakwika." Kufanana kumeneku kungakhalepo ngakhale nthawi yomwe mumagwiritsa ntchito poonera zolaula ingasiyane pankhani yobweretsa mavuto kapena kuwonongeka mu PPMI ndi "kugwiritsa ntchito molakwika." Mu "mikhalidwe yonseyi," zolaula zimagwiritsidwa ntchito kuposa momwe zimafunira, zomwe zingayambitse zotsatira zoyipa ndi kuvutika, ndipo kugwiritsa ntchito zolaula kumapitilira ngakhale zotsatira zoyipa. Njira zamaganizo zomwe zimayambitsa kugwiritsa ntchito mankhwalawa zitha kukhala zofanana, ndipo izi ziyenera kufufuzidwa mwatsatanetsatane.

Ndemanga pa Zowonjezera Zowonjezera Pakati pa Njira ziwiri M'malo Momwe Mungalankhulire Njira Yachitatu

Mafunso ambiri ofunikira akupitilizabe: Kodi PPMI ndi yotani pankhani ya njira zamaganizo? Kodi anthu omwe amanena kuti PPMI ali ndi mphamvu zochepa pa kugwiritsa ntchito kwawo zolaula (kochepa kapena kwapakatikati)? Kodi amaona kuti n'kovuta kukana kugwiritsa ntchito zolaula? Kodi amakumana ndi mkangano pakati pa chikhumbo chachikulu chogwiritsa ntchito zolaula kumbali imodzi ndi nthawi yomweyo kumverera kuti kugwiritsa ntchito zolaula ndikoletsedwa chifukwa cha makhalidwe abwino kumbali ina? Ndikofunikira kumvetsetsa bwino mtundu wa chikhumbo ndi chikhumbo chogwiritsa ntchito zolaula (Brand et al., 2011 ; Carpenter, Janssen, Graham, Vorst, & Wicherts, 2010 ; Stark et al., 2015 , 2017 ) mwa anthu omwe ali ndi PPMI. Chilakolako ndi chilimbikitso cha kugwiritsa ntchito zolaula, mphamvu ya zochita zokhudzana ndi malingaliro ndi kuzindikira pogwiritsa ntchito zolaula—monga, ponena za chiphunzitso cha kulimbikitsira ndi malingaliro awiri a chizolowezi (Everitt & Robbins, 2016 ; Robinson & Berridge, 2000 )—ndipo chifukwa chake mavuto omwe amakumana nawo polamulira kugwiritsa ntchito, akhoza kukhala ofanana mwa anthu omwe ali ndi PPMI komanso omwe ali ndi vuto logwiritsa ntchito mankhwala osokoneza bongo. Pankhaniyi, nkhani yofunika kwambiri ndi chilakolako (onani pamwambapa). Kodi anthu omwe akunena kuti PPMI amakumana ndi chilakolako ndi chilakolako chogwiritsa ntchito zolaula m'miyoyo yawo ya tsiku ndi tsiku? Kodi amatanganidwa ndi kugwiritsa ntchito zolaula? Kodi nthawi zambiri amaganiza za kugwiritsa ntchito zolaula kapena ngati akuphwanya mfundo zawo akamagwiritsa ntchito zolaula? Kodi amakhala ndi malingaliro oipa akapanda kugwiritsa ntchito zolaula? Mafunso awa ayenera kuyankhidwa m'maphunziro amtsogolo pa PPMI kuti amvetse bwino chifukwa chake izi zimachitika. Kuphatikiza apo, nkhani yosangalatsa yosiyanitsa pakati pa PPMI ndi kugwiritsa ntchito zolaula mopitirira muyeso ingakhale ziyembekezo zokhudzana ndi kugwiritsa ntchito zolaula, monga momwe zasonyezedwera pa mitundu ina ya matenda ogwiritsira ntchito intaneti, zizolowezi zamakhalidwe, ndi matenda ogwiritsira ntchito mankhwala osokoneza bongo (Borges, Lejuez, & Felton, 2018 ; Taymur et al., 2016 ; Wegmann, Oberst, Stodt, & Brand, 2017 ; Xu, Turel, & Yuan, 2012 ). Kodi anthu omwe ali ndi PPMI yomwe akuganiza kuti amagwiritsa ntchito zolaula amagwiritsa ntchito zolaula kuti apewe malingaliro oipa kapena kuthana ndi nkhawa za tsiku ndi tsiku? Kodi akuyembekezera kukhutira kwakukulu (Cooper, Delmonico, Griffin-Shelley, & Mathy, 2004 ) komwe sikungapezeke ndi ntchito ina? Kodi pali zochitika zina zomwe zimawapangitsa kuti asamavutike kuwongolera kugwiritsa ntchito zolaula zawo (Kraus, Rosenberg, Martino, Nich, & Potenza, 2017 ) ngakhale zitakhala kuphwanya mfundo zamakhalidwe abwino?

Kuyanjana pakati pa njira ziwiri kungakhale kokondweretsa ndipo kungalimbikitse kufufuza kobwerako. Ofufuzira angathe kusokoneza zochitika zomwe zimaonetsa anthu ena omwe amadziona kuti ali ndi chizoloŵezi choonera zolaula kapena kukhala ndi PPMI, motero, ngakhale kuti zingakhale zosiyana zolaula-amagwiritsira ntchito kuchuluka kapena kawirikawiri.

Zomwe zingakhalepo pakati pa njira ziwiri zingakhale:

  • Kusamvana pakati pa kukhumba ndi makhalidwe abwino pamene tikukumana ndi zolaula zokhudzana ndi zolaula

  • Kusamvana pakati pa njira zowonongeka zowonongeka ndi chikhumbo

  • Kusagwirizana pakati pa zofuna zolaula ndi makhalidwe abwino

  • Kusamvana pakati pa kayendedwe ka kapangidwe kake ndi njira zowonongeka

  • Kusagwirizana pakati pa kupanga chisankho chokhudzana ndi madalitso a nthawi yayitali (kukondweretsa chifukwa cha zolaula) ndi zotsatira za nthawi yaitali kuganizira makhalidwe abwino

  • Kuchita manyazi ndi kudziimba mlandu pambuyo poona zolaula, zomwe zingachititse kuti maganizo oipa asamveke ndipo zingakulepheretseni kugwiritsa ntchito zolaula kachiwiri pofuna kuthana ndi maganizo okhumudwa komanso kumverera kwachisoni

Timakayikira kuti ndi bwino kuganizira momwe mungagwiritsire ntchito njira zomwe mungathe kuzigwiritsira ntchito potsata zowonongeka zogwiritsidwa ntchito. Izi zingathandizenso kusokoneza njira zodziwika ndi zowonongeka m'machitidwe opangidwa. Kafukufuku wamtsogolo angapindule ndi lingaliro lachidziwitso koposa kutsata maulendo awiri ofanana omwe amasonyeza kuti orthogonality ya mavuto osiyanasiyana okhudzana ndi zolaula zimagwiritsidwa ntchito.

Ndemanga pa Clinical Implications

Grubbs et al. ( 2018 ) akunena kuti: “Kaya munthu akugwiritsa ntchito zolaula mopitirira muyeso (monga chizolowezi) kapena PPMI, tikuvomereza kuti mafotokozedwe onse awiri azachipatala akhoza kugwirizanitsidwa ndi ululu wamaganizo, kuvutika maganizo, komanso zotsatirapo zazikulu pakati pa anthu. Ndichifukwa chake tikupititsa patsogolo chitsanzo chathu cha PPMI ngati lingaliro lina lothandizira kuwunikira zomwe chisamaliro chachipatala chiyenera kukhala.” Tikugwirizana ndi lingaliro lakuti zochitika zonse ziwiri (ndi zina) ziyenera kusamalidwa ndi asing'anga ngati anthu omwe akufuna chithandizo akumana ndi vuto la magwiridwe antchito kapena kuvutika. Makamaka, monga taonera kale ndi ofufuza ena (Fernandez et al., 2017 ), ndikofunikira kuganizira zinthu zachipatala payekhapayekha kuphatikizapo zomwe zimakhudzana ndi kusalingana kwa makhalidwe. Komabe, kuti pakhale kusiyana pakati pa kugwiritsa ntchito zolaula ndi PPMI mopitirira muyeso, kumvetsetsa bwino njira zodziwika bwino komanso zosiyana za zochitika zonsezi ndikofunikira. Tikunenanso kuti kuphatikiza njira zomwe zimagwiritsidwa ntchito m'njira zosiyanasiyana zogwiritsira ntchito zolaula zovuta kungayambitse kuvutika maganizo, kugwiritsa ntchito mokakamiza, ndi zinthu zina zomwe anthu amakumana nazo ndipo motero ziyenera kuthandizidwa payekhapayekha.

Grubbs et al. ( 2018 ) akuti: "Mwachidule, tikunena kuti PPMI ndi mavuto enieni omwe ali ndi zotsatira zenizeni zamaganizo, koma kuti chifukwa cha mavuto amenewo ndi chosiyana ndi chizolowezi chenicheni. M'malo azachipatala, kutha kusiyanitsa mitundu iyi ya etiological mwina ndikofunikira." Monga tafotokozera pamwambapa, tikugwirizana ndi lingaliro lakuti mbali zonse ziwiri - PPMI ndi kugwiritsa ntchito molakwika - ziyenera kusamalidwa m'malo azachipatala. Tikufuna kutsindika mfundo iyi chifukwa tikukhulupirira kuti malingaliro omwe Grubbs et al. adapereka sayenera kutanthauziridwa ngati kuchepetsa mphamvu ya kugwiritsa ntchito zolaula pa anthu ndi magwiridwe antchito awo. Ndiye kuti, tikukhulupirira mwamphamvu kuti chitsanzo cha PPMI sichiyenera kugwiritsidwa ntchito kuchepetsa mphamvu yachipatala ya kugwiritsa ntchito zolaula zovuta m'maulaliki ake osiyanasiyana kapena kuti tipeze lingaliro lakuti kuonera zolaula kwa anthu omwe ali ndi PPMI yomwe ikuperekedwa ndi yopanda vuto, yogwira ntchito mopitirira muyeso, kapena yopanda phindu. Komabe, n'zotheka kuti njira zopangira ndi kusunga kugwiritsa ntchito mokakamiza/kosokoneza bongo ndi PPMI sizosiyana kwambiri ndi zomwe Grubbs et al adapereka. ndipo pakhoza kukhala njira zofanana kapena mwina zogwirizana m'malo motsatira njira zoyendetsera mavuto amisala. Tiyeneranso kudziwa kuti kuvutika maganizo kungasinthe malinga ndi magawo a zizolowezi ndipo chitsanzochi chiyenera kuyesedwa m'magulu osiyanasiyana azachipatala (monga, kufunafuna chithandizo mwachangu poyerekeza ndi kuchotsedwa), poganizira magawo osiyanasiyana a chidziwitso chokhudzana ndi kuvutika maganizo ndi zotsatira zake. Ndizotheka kuti zomwe zimayambitsa kugwiritsa ntchito mokakamiza/kusokoneza maganizo komanso kuvutika maganizo zimagawana njira zazikulu zolimbikitsira, zolimbikitsa, komanso zozindikira. Tikukhulupirira kuti pali mafunso otseguka okhudzana ndi chifukwa chake ndi chithandizo cha kugwiritsa ntchito zolaula mokakamiza/kusokoneza maganizo kapena movutitsa, ndipo kumvetsetsa zinthu zina zomwe zalembedwa ndi CPUI-9 ndi zomwe zaphunziridwa mpaka pano ndikofunikira kuti tipititse patsogolo kafukufuku ndi machitidwe azachipatala. Munjira iyi, kuganizira mbali zingapo za kuwonetsa ndikofunikira, kuphatikizapo zolinga zofunafuna chithandizo, momwe kuonera zolaula kumakhudzira, ndi zolinga za chithandizo. Nthawi zina, mwina ndizomveka kugwiritsa ntchito njira za Acceptance and Commitment Therapy, monga momwe Grubbs et al adanenera. Komabe, nthawi zina, kusintha khalidwe ndi njira zina zothandizira anthu kukhala ndi maganizo abwino zingakhale zothandiza ngati cholinga cha kasitomala ndi kuthana bwino ndi zilakolako zake ndi zilakolako zake zogwiritsa ntchito zolaula ndi malingaliro ake, kuletsa kuletsa, ndi ziyembekezo zokhudzana ndi zolaula (Potenza, Sofuoglu, Carroll, & Rounsaville, 2011 ). Zinthu zingapo ziyenera kuganiziridwa pamene anthu omwe akukumana ndi mavuto okhudzana ndi zolaula amagwiritsa ntchito njira yofunafuna chithandizo (Kraus, Martino, & Potenza, 2016 ). Chifukwa chake, zinthu zingapo—kusalingana kwa makhalidwe ndi njira zogwiritsira ntchito mankhwala osokoneza bongo, monga chilakolako, kuletsa kuletsa, kupanga zisankho—ziyenera kuganiziridwa mokwanira pofufuza mavuto a anthu okhudzana ndi zolaula kuti apereke chithandizo chabwino kwambiri.

zolemba

Kugwirizana ndi Makhalidwe Abwino

Kusamvana kwa chidwi

Olemba amanena kuti alibe kutsutsana kwa chidwi. Dr Brand walandira thandizo la (ku University of Duisburg-Essen) kuchokera ku German Research Foundation (DFG), Dipatimenti Yoyang'anira Zakafukufuku ndi Maphunziro ku Germany, Ministry of Health ya Germany, ndi European Union. Dr. Brand wapereka ndemanga zopereka kwa mabungwe angapo; yasintha magawo a makope ndi nkhani; wapereka mayankho pamaphunziro azachipatala kapena asayansi; ndipo wapanga mabuku kapena magawo a mabukhu kwa ofalitsa a matenda a maganizo. Dr. Potenza adafunsira ndi kulangiza Rivermend Health, Opiant / Lakelight Therapeutics, ndi Jazz Pharmaceuticals; analandira thandizo lofufuzira (ku Yale) kuchokera ku Mohegan Sun Casino ndi National Center for Gaming Responsible Gaming; anafunsidwa kapena akulangizitsa ziwalo zalamulo ndikutchova njuga pazinthu zokhudzana ndi kuyendetsa msanga ndi makhalidwe oledzera; Kupereka chithandizo chamankhwala chokhudzana ndi kuyendetsa msanga ndi makhalidwe oledzera; adachita ndemanga za ndalama; Magazini okonzedwa / magawo a magazini; anapatsidwa nkhani zamaphunziro pafupipafupi, zochitika za CME, ndi malo ena azachipatala / zasayansi; ndipo amapanga mabuku kapena mitu ya ofalitsa a zolemba zamaganizo.

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