MABWINO: Kafukufuku akuwonetsa kuti kukhudzidwa kwa intaneti kumatha kuyambitsa ADHD ngati zizindikiro (m'malo mwa ADHD yotsogolera ku kukhudzidwa kwa intaneti).
J Behav Addict. 2017 Aug 8: 1-9. pitani: 10.1556 / 2006.6.2017.044.
Kim D1,2, Lee D1,2, Lee J1,2, Namkoong K1,2, Jung YC1,2.
Kudalirika
Mbiri ndi zolinga
Kulabadira kuperewera kwa vuto la kugona (ADHD) ndi imodzi mwazomwe zimachitika kwambiri zamaukadaulo osokoneza bongo a Internet (IA); Komabe, njira zomwe zimathandizira kuti pakhale nyansi zambiri zili pakali pano. Kafukufukuyu akuyenera kupenda njira zamtunduwu poyerekeza ndi kuopsa kwa IA ndi kuopsa kwa ADHD paubwino, kusagwirizana, komanso kukakamiza achinyamata omwe ali ndi IA. Tidawerengetsa kuti IA ikhoza kukhala ndi mayanjano ndi ziwonetsero zokhudzana ndi ADHD komanso mawonekedwe amtundu pambali pa ADHD yaubwana.
Njira
Ophunzirawo anali ndi amuna akuluakulu a 61. Ophunzirawo adayankhidwa mokambirana. Kuwopsa kwa IA, ubwana ndi zizindikiro za ADHD zamakono, ndi zizindikiro za matenda opatsirana pogonana zinayesedwa kudzera muyeso. Mgwirizano pakati pa kukula kwa IA ndi ADHD zizindikiro zinayesedwa pogwiritsa ntchito machitidwe otsogolera olamulira.
Results
Kupenda kwa ma Harkarchical kuwunikira kunawonetsa kuti kuopsa kwa IA kunaneneratu kutalika kwa zizindikiro za ADHD. Mosiyana ndi izi, ana a ADHD adaneneratu gawo limodzi.
Kukambirana
Zizindikiro zapamwamba za kusasamala ndi kuchepa kwa ziwonetsero mu IA siziyenera kungowerengeredwa ndi vuto lodziyimira la ADHD koma ayenera kuganizira kuthekera kwa Zizindikiro Zokhudzana ndi IA. Ntchito zogwirira ntchito komanso zomangika muubongo zogwiritsidwa ntchito kwambiri ndi kugwiritsidwa ntchito kwa intaneti zingakhale zokhudzana ndi zizindikiro ngati za ADHD. Kutsiliza Kuzindikira komanso kuthana ndi vuto kwa achinyamata omwe ali ndi IA amakhudzana kwambiri ndi kuuma kwa IA kusiyana ndi ADHD yaubwana.
MAFUNSO: Mankhwala osokoneza bongo pa intaneti; chidwi kuchepa hyperactivity chisokonezo; Hyperacaction; kusakhazikika; kusasamala
PMID: 28786707
Introduction
Pamene kupezeka kwa intaneti komanso ogwiritsa ntchito akuwonjezeka, chizolowezi cha intaneti (IA) chakhala chodetsa nkhawa m'madera ambiri. Ngakhale kufalitsa kwa Kusanthula ndi Buku Lophatikiza la Mental Disorder, Fifth Edition (DSM-5) ku 2013 yadzetsa chisokonezo chambiri pakufotokozera IA pambuyo povomerezeka ndi vuto la masewera a pa intaneti (Kuss, Griffiths, & Pontes, 2017,, malinga ndi a Young (1998b, 1999; Achinyamata & Rogers, 1998), IA itha kutanthauzidwa kuti kugwiritsa ntchito intaneti mopitirira muyeso, kukakamira, kusalamulirika, kulekerera, komwe kumayambitsanso zovuta ndi zovuta zina pakugwira ntchito tsiku ndi tsiku. Kuphatikiza pa IA palokha, kusokonezeka kwa matenda amisala komanso mikhalidwe pakati pa anthu omwe ali ndi IA yakopa chidwi. Ho et al. (2014) adanenanso kuti IA imalumikizidwa kwambiri ndi vuto la kuchepa kwa chidwi (ADHD), kukhumudwa, ndi nkhawa. Makamaka, Carli et al. (2013) adawonetsa kulumikizana kwamphamvu pakati pa ADHD ndi kugwiritsidwa ntchito kwapaintaneti pa kafukufuku wawo, ndi Ho et al. (2014) adazindikira kuti kufalikira kwa ADHD pakati pa odwala IA anali 21.7%. Osatengera kukomoka kotereku, ndipo izi zitha kuwonetsa kulumikizana kwaupangiri kapena malingaliro wamba omwe adagawidwa nawo (Mueser, Drake, & Wallach, 1998), njira zomwe zimathandizira kuti izi zitheke zimatsutsanabe.
ADHD ndi imodzi mwazovuta zamisala zomwe zimachitika pafupifupi 5.3% ya achinyamata kuphatikiza ana ndi achinyamata, komanso pafupifupi 4.4% ya akuluakulu (Kessler et al., 2006; Polanczyk, de Lima, Horta, Biederman, & Rohde, 2007). ADHD imadziwika ndi chizindikiritso chazidziwitso komanso chakhalidwe chosasamala, kuchepa kwa chidwi, komanso kusakhazikika, komwe kumalumikizidwa ndi IA (Yen, Ko, Yen, Wu, & Yang, 2007; Yen, Yen, Chen, Tang, & Ko, 2009; Yoo et al., 2004). Kuphatikiza pa IA, odwala ochulukirapo omwe ali ndi ADHD amakhalanso ndi vuto limodzi kapena zingapo zamaganizidwe ophatikizidwa ndi comorbid kuphatikiza kusinthasintha, kuda nkhawa, komanso kugwiritsa ntchito zinthu, zomwe zimapangitsa chithunzi cha matenda a ADHD makamaka kwa achikulire. (Gillberg et al., 2004; Sobanski, 2006). Malinga ndi DSM-5, ADHD ndi vuto laubwana lomwe limayamba ndi neurodevelopmental disorder, asanakwanitse zaka 12, chifukwa chake wamkulu ADHD amayimira kupitiriza kwa mkhalidwe waubwana. Komabe, Moffitt et al. (2015) idapereka chidziwitso chatsopano chomwe chikutsutsa lingaliro loti ADHD wamkulu ndi kupitilira kwa nthawi yoyambirira ya ADHD, ndipo izi zidawonetsera kuthekera kwina koti matanthauzidwe osiyana aubwana ndi ukalamba wa ADHD ukhoza kukhalapo. Hypothesis yothandizira kukhalapo kwa ADHD yoyambirira ikusonyezeratu kuti kusasinthika kwakukhazikika kwa cortical control paunyamata kungayambitse zizindikiro ngati za ADHD mu ukalamba (Castellanos, 2015; Moffitt et al., 2015) ndikuyang'ana IA imakhudzana ndi kusintha kwa magwiridwe ndi ntchito ya ubongo (Hong et al., 2013a, 2013b; Kuss & Griffiths, 2012; Weng et al., 2013; Yuan et al., 2011; Zhou et al., 2011), izi zitha kufotokozera kukongola kwapakati pa IA ndi ADHD.
Mu phunziroli, tinayerekeza mwayi wofufuzidwa womwe ungafotokozere bwino za kuchepa kwapakati pa IA ndi ADHD. Choyamba, anthu omwe ali ndi vuto laubwana wa ADHD amakhala pachiwopsezo chachikulu chotenga matenda a IA ndipo zizindikiro za ADHD zaubwana zimapitilira mpaka atakula. Chachiwiri, IA ikhoza kukhala yolumikizidwa ndi zizindikiro zazikulu za kuzindikira za ADHD padera paubwana wa ADHD ndi zina zokhudzana ndi matenda amisala. Cholinga cha phunziroli chinali kutsimikizira izi; chifukwa chake, tinayerekezera momwe IA imakhudzidwira komanso kuzindikirika kwa makanda a ADHD pazizindikiro za ADHD za achikulire mwa achinyamata omwe ali ndi IA. Tidawerengera kuti mulingo wa IA ungakhale wogwirizana ndi kutha kwa zizindikiro za ADHD za akulu ngakhale utawongolera mwana wa ADHD ndi zina zokhudzana ndi matenda amisala.
Njira
Ophunzira ndi ndondomeko
Ophunzira nawo anali amuna azaka 61 azaka zapakati pa 20 mpaka 29 (zaka zakubadwa: 23.61 ± 2.34 wazaka), omwe adalembedwa kutsatsa pa intaneti. Ophunzirawo adafunsidwa ngati anali ndi mankhwala amisala pafupipafupi, kaya anali ndi zamankhwala, zamitsempha zomwe zingakhudze kuyesaku, komanso ngati adakumana ndi zowawa zam'mutu kapena kugwidwa. Ophunzirawo adayang'aniridwa ndi Structured Clinical Mafunso a DSM, Edition Wachinayi ndi Korea Wechsler Adult Intelligence Scale, Edition Wachinayi ndi katswiri wazamafukufuku wazachipatala kuti asatengere omwe akwaniritsa zofunikira zokhudzana ndi matenda a Axis I komanso kupunduka kwamaganizidwe, kupatula ADHD yaubwana ndi wamkulu. Kudzera mu njirayi, ophunzira omwe ali ndimatenda aposachedwa kapena am'mbuyomu amisala, kuvulala koopsa muubongo, zamankhwala, ndi matenda amitsempha sanatengeredwe.
Malipoti okhudzana ndi Psychometric adagwiritsidwa ntchito kuyesa momwe ochita nawoyo alili ndi machitidwe awo, kuphatikiza Korea Adolescent Internet Addiction Scale (K-AIAS), Beck Depression Inventory (BDI), Beck Anxiety Inventory (BAI), Barratt Impulsiveness Scale-11 (BIS -11), ndi mtundu waku Korea wa Alcohol Use Dis Display Idicationication Test (AUDIT-K). Tidawerengera zakuthwa kwaubwana ndi akulu akulu akakhala ndi vuto la ADHD kudzera mu Korea yaifupi ya Wender Utah ADHD Rating Scale (WURS-KS) ndi mtundu wa Korea Wachidule wa Conners 'Adult ADHD Rating Scale (CAARS-KS).
Njira
Zovuta zakugwiritsa ntchito pa intaneti. Tinagwiritsa ntchito K-AIAS kuwunika kuwuma kwa zizindikiro za IA. K-AIAS ndi kutanthauzira kwa Korea kwa Young's Internet Addiction Test (YIAT), kupatula mawu ochepa kuti agwirizane ndi zomwe ophunzira aku sekondale. Kapangidwe kazigawo ndi kapangidwe ka K-AIAS ndi YIAT ndizofanana, 6-level Likert sikelo kumafunso a 20. Chiwerengero chonse cha 20-49 mfundo chikuyimira ogwiritsa ntchito intaneti, ndipo chiwonetsero cha 50-79 mfundo chikuyimira ogwiritsa ntchito omwe amakhala akukumana ndi mavuto kugwiritsa ntchito intaneti. Kuchuluka kwa mfundo za 80-100 kukuwonetsa kuti ophunzirawo akukumana ndi zovuta zazikulu m'moyo chifukwa chogwiritsa ntchito intaneti. K-AIAS ili ndi kudalirika kovomerezeka komanso kovomerezeka ndipo Cronbach's α inali .91 (Kim, Lee, & Oh, 2003; Wamng'ono, 1998a).
Kukhumudwa ndi nkhawa. Zizindikiro zakukhumudwa ndi nkhawa zimayesedwa pogwiritsa ntchito BDI (mtundu wa ku Korea) ndi BAI (mtundu wa ku Korea), motsatana. BDI ndi BAI ndizopangidwa ndi zinthu za 21, ndipo odwalawo amawona chizindikiro chilichonse pamlingo wa Likert wa 4 pakuwonjezeka. Mu BDI, miyeso yotsatana ikusonyezedwa: kuchuluka pakati pa 0 ndi 13 kumawonetsa kuchepa, pakati pa 14 ndi 19 mofatsa, pakati pa 20 ndi 28 moderate, komanso pakati pa 29 ndi 63. Mu BAI, miyeso yolimba yotsimikizika: kuchuluka pakati pa 0 ndi 7 sikuwonetsa kuti palibe nkhawa, pakati pa 8 ndi 15 mofatsa, pakati pa 16 ndi 25 moderate, komanso pakati pa 26 ndi 63 nkhawa kwambiri. Masikelo onsewa ndi ovomerezeka pa anthu aku Korea. Cronbach's α idachokera ku .78 mpaka .85 ya BDI ndi .91 ya BAI (Beck & Steer, 1990; Beck, Steer, & Brown, 1996; Beck, Ward, Mendelson, Mock, & Erbaugh, 1961; Lee & Song, 1991; Yook & Kim, 1997).
Kukhazikika. Chizindikiro chosakhudzidwa adayesedwa pogwiritsa ntchito mtundu waku Korea wa BIS-11. BIS-11 ndi chimodzi mwazida zomwe zimagwiritsidwa ntchito kwambiri poyesa kusakhazikika. Choyambirira BIS-11 chimapangidwa ndi zinthu 30 zomwe zidapezedwa pamiyeso ya 4-Likert ndipo mulingo wosakakamizidwa umayezedwa powerengera mwachidule zambiri pachinthu chilichonse. Maphunziro apamwamba amatanthauza kukhudzidwa kwakukulu. Imayesa mbali zitatu zazikulu zamakhalidwe osakakamiza: chidwi cha chidwi (kusayang'ana kwambiri ntchito yomwe ikuchitika), kuyendetsa galimoto (kuchita mosalingalira), komanso kusakonzekereratu (zinthu, malingaliro apano pakadali pano mtsogolo). Mtundu waku Korea wa BIS-11 uli ndi zinthu 23, chifukwa chake kuchuluka kwa zinthu zomwe zimayeza gawo lililonse ndizosiyana, koma zina zonse ndizofanana. Heo neri Al. zatsimikizira kudalirika komanso kuvomerezeka kwa mtundu waku BIS-11 waku Korea pakuphunzira kwawo, ndipo C ya Cronbach ya sikeloyo inali .686 (Heo, O, & Kim, 2012; Patton, Stanford, & Barratt, 1995).
Kuledzera Tidagwiritsa ntchito AUDIT-K kuwunika kuopsa kwa omwe amamwa nawo mowa ndi zofananira. AUDIT-K ili ndi zinthu 10; funso lirilonse latengedwa kuchokera ku 0 mpaka 4. Mafunso 1-3 amayesa kumwa mowa mwa omwe atenga nawo mbali, mafunso 4-6 amawunika momwe amamwe mowa mopitirira muyeso, mafunso 7 ndi 8 amawunika zovuta zamaganizidwe, ndipo mafunso 9 ndi 10 amawunika mavuto okhudzana ndi mowa. Pakafukufuku ndi ophunzira aku koleji, Fleming et al. adapereka lingaliro lodula la 8. Lee et al. zatsimikizira kudalirika ndi kutsimikizika kwa AUDIT-K pakuphunzira kwawo ndipo α ya Cronbach ya sikeloyo inali .92 (Babor, De La Fuente, Saunders, & Grant, 1992; Fleming, Barry, & MacDonald, 1991; Lee, Lee, Lee, Choi, & Namkoong, 2000).
Zizindikiro zaubwana wa ADHD. Tidagwiritsa ntchito mtundu waifupi wa WURS-KS, womwe udamasuliridwa ku Korea ndi Koo et al. kuwunika zizindikiritso za ADHD zaubwana. WURS ndifunso lofunsira lokha pakuwunikiranso za zizindikiritso za ADHD zaubwana mwa akulu a ADHD. WURS yoyambirira idapangidwa ndi zinthu 61, koma mu phunziroli, mtundu waufupi wopangidwa ndi zinthu za 25 udagwiritsidwa ntchito. Mtundu woyambirira wa WURS udazindikira molondola 86% ya odwala omwe ali ndi ADHD, ndipo mtundu wake wafupipafupi udawonetseranso chidwi komanso kutanthauzira kwapadera kuti athe kuzindikira zaubwana wa ADHD pomwe mfundo 36 zidagwiritsidwa ntchito ngati mtengo wodula. Kutsimikizika ndi kudalirika kwa mtundu wachidule waku Korea wa WURS kunachitika ndi achikulire achikazi aku Korea ndikuwonetsa kudalirika kotsimikizika komanso kotsimikizika. Α ya Cronbach inali .93 (Koo et al., 2009; Ward, Wender, & Reimherr, 1993).
Zizindikiro za akulu akulu a ADHD. CAARS-KS idagwiritsidwa ntchito kuyesa zazikulupo za ADHD mu phunziroli. CAARS ndi amodzi mwa omwe amagwiritsidwa ntchito kwambiri podziyesa mafunso a ALHD, ndipo tidagwiritsa ntchito buku lake lalifupi la ku Korea, lomwe lili ndi zinthu za 20 ndi zolipira zinayi: kusazindikira-mavuto amakumbukidwe (IM), Hyperacaction-restless (HR), kunyengerera / kukhudzika kwa maganizidwe (IE), mavuto omwe amadzipangira okha (SC). Zimadziwika kuti zambiri za T pamwambapa 65 ndizofunikira kwambiri pamathandizo aliwonse. Kudalirika komanso kutsimikizika kwa CAARS-KS kudakhazikitsidwa ndipo Cronbach's α inali .92 (Chang, 2008; Misonkhano, Erhardt, & Sparrow, 1999; Erhardt, Epstein, Conners, Parker, & Sitarenios, 1999).
Kukambirana
Phunziroli, ambiri mwa omwe adachita nawo gawo, omwe ali ndi 35 (57%), adalembedwa kuti akhale ndi IA pakugwiritsa ntchito njira zachinyamata zomwe zimafotokoza za 50 ngati IA wofatsa (Hardie & Tee, 2007; Wamng'ono, 1998b). Komanso, kuchuluka kwapakati pa K-AIAS kunali kwakukulu (kumatanthauza mphaka = 51.2, SD = 20.3), poyerekeza ndi matenda ena amisala monga BDI, BAI, BIS-11, AUDIT-K, ndi WURS-KS.
Ogwirizana ndi maphunziro apitawa (Dalbudak & Evren, 2014; Yen et al., 2009, 2017; Yoo et al., 2004), tidapeza mayanjano ofunika kwambiri pakati pa kuwuma kwa IA ndi kuopsa kwa zizindikiro za ADHD. Momwemonso, mikhalidwe ina yama psychiatric comorbid monga kupsinjika, kuda nkhawa, komanso zizindikiro zokhudzana ndi mowa zidawonetsanso kulumikizana kwakukulu ndi zizindikiro za ADHD zachikulire motsatira maphunziro apitawa (Fischer et al., 2007; Kessler et al., 2006; Ni & Gau, 2015; Sobanski et al., 2007).
Kupeza kwakukulu kwa phunziroli, komwe kumagwirizananso ndi malingaliro athu, kunali kuti kuopsa kwa IA kunalumikizidwa kwambiri ndi kukula kwa mawonekedwe a akulu a ADHD ngakhale atawongolera chizindikiro cha ADHD chaubwana ndi zina zokhudzana ndi misala yama psychor. Kukula kwa SC kokha, komwe kumadziwonetsa kudzitsitsa komanso kufooka, sikunawonetse kuyanjana kofunikira ndi kuuma kwa IA. Zotsatira izi zitha kufotokozedwa ndi maphunziro angapo ndi Chang (2008) ndi Kim, Lee, Cho, Lee, ndi Kim (2005), yomwe idawonetsa kukula kwa chizindikiro cha SC mu CAARS-KS ngati njira yowonjezera yowunika mavuto achiwiri omwe amayamba chifukwa cha zizindikiro zoyambirira za ADHD monga hyperactivity, kusalemekeza, komanso kusakhazikika. Phunziroli, kuwopsa kwa chizindikiro cha kukhumudwa kunaneneratu kwambiri kukula kwa chizindikiro cha SC. Poganizira izi, titha kuona kuti kuopsa kwa IA kunaneneratu kukula kwa chizindikiro chachikulu cha ADHD yayikulu.
Chinanso chochititsa chidwi chinali chakuti, mosiyana ndi chikhulupiliro chofala, kuuma kwa ubwana zizindikiro za ADHD sizinasonyeze mgwirizano wapatali ndi kukula kwa zizindikiro za ADDD akuluakulu. Ndondomeko ya IE yokhayo inasonyeza kusonkhana kwakukulu ndi ubwana wa ADHD chizindikiro poyesa kutsindika chitsanzo 2 (onani Table 3). Komabe, mgwirizano waukulu uwu wa chibwana wa ADHD chizindikiro ndi IE unawonekera pambuyo pa kupirira kwa IA kunaphatikizidwa mu zovuta zowonongeka, kusonyeza kuti IA mwamphamvu anali ndi mgwirizano wofunika kwambiri ndi IE kuposa ubwana wa ADHD.
Zomwe zapezekazi mu kafukufukuyu zitha kuwunikira mgwirizano womwe ulipo pakati pa ADIVD. Pali njira ziwiri zomwe zingafotokozere kukomoka kwakukulu pakati pa IA ndi ADHD, zotsatira zathu zidathandizira kutsimikizira komwe kumakhalapo pakubwera kwa ziwonetsero ngati za ukalamba wa ADHD. Mosiyana ndi malingaliro wamba a ADHD wamkulu monga kupitiriza kwa mkhalidwe wa ADHDHalperin, Trampush, Miller, Marks, & Newcorn, 2008; Lara et al., 2009), zofukufuku zaposachedwapa zasonyeza kuti ADFD yoyamba ndi yokalamba yodalirika ingakhalepo ndipo ADHD wamkulu sikumangopitirira mosavuta mwana wa ADHD (Castellanos, 2015; Moffitt et al., 2015). Mogwirizana ndi zofukufukuzi, phunziroli linasonyeza kuti zizindikiro za ADHD zamakono zikuwonetsa maubwenzi ofunika kwambiri ndi IA kusiyana ndi ubwana wa ADHD chizindikiro pa WURS. Kuwonjezera apo, ubwana wa ADHD chizindikiro chowopsya sichimasonyeza kusagwirizana kwakukulu ndi chikhalidwe chachikulu cha ADHD chizindikiro kupatula IE gawo mu phunziro ili.
Kafukufuku wakale anawonetsa kuti chikhalidwe cha ADDD wamkulu chikugwirizana ndi njira zopititsa patsogolo za zigawo zamakono, ndi kusintha koyera kwa ma intaneti angapo (Cortese et al., 2013; Karama & Evans, 2013; Shaw et al., 2013). Mofananamo, kafukufuku waposachedwapa wasonyeza kuti IA ikhoza kuyambitsa kusintha, kusintha kwa kayendedwe kake, ndi zolakwika mu ubongo (Hong et al., 2013a, 2013b; Kuss & Griffiths, 2012; Lin et al., 2012; Weng et al., 2013; Yuan et al., 2011; Zhou et al., 2011). Malingana ndi zofukufukuzi, tikhoza kulingalira kuti zovuta zogwirira ntchito ndi ubongo zokhudzana ndi IA zingakhalenso zikhale zokhudzana kwa akuluakulu omwe ali ndi zizindikiro zozindikira, zomwe ziyenera kusiyanitsidwa ndi matenda a ADHD odziimira okhaokha. Kusokonezeka kwakukulu pakati pa IA ndi ADHD (Ho et al., 2014) akhoza kuwerengedwa ndi zizindikiro zamaganizo ndi zizindikiro zokhudzana ndi IA mmalo mwa zizindikiro za matenda a ADHD odziimira okhaokha.
Phunziroli linali ndi malire. Choyamba, kugwiritsa ntchito milingo yodziyesa pawokha kuti athe kuyesa IA ndi zina zamagetsi zitha kuwonedwa ngati malire. Chachiwiri, onse omwe anali nawo paudindo anali achichepere achichepere omwe alibe mbiri yamisala omwe adalandira zotsatsa pa intaneti. Njira zodzisankhira zamtunduwu zitha kukhala zosasangalatsa zomwe zapezeka mu kafukufukuyu. Kuphatikiza apo, kusankha kosaloledwa kumeneku kumapangitsa malire a zomwe zapezeka mu phunziroli, kupangitsa kuti sizingatheke kuphatikiza azimayi, magulu azaka zosiyanasiyana, komanso odwala omwe amafunikira chithandizo chamankhwala. Makamaka, popeza zomwe amisala omwe adakumana nawo omwe alibe mbiri yokhudza matenda amisala adayesedwa, zimaganiziridwa kuti pali malire ogwiritsira ntchito zotsatira za phunziroli kwa odwala matenda amisala. Pofupikitsa zotsatira zomwe zilipo, tiyenera kuphunzira zitsanzo zambiri zaanthu komanso odwala enieni amisala. Chachitatu, monga phunziroli lidakhazikitsidwa pakukumbukira mobwerezabwereza zizindikiro za ubwana, lipoti la omwe akutenga nawo mbali zokhudzana ndi ubwana silingakhale lovomerezeka ndipo sitingathe kukhazikitsa ubale wapakati pazomwe zimasiyanasiyana.
;