Kusokonezeka kwa kugwiritsidwa ntchito kwa intaneti komanso kusokonezeka kwa matenda osokoneza bongo: Maphunziro akulu awiri akuluakulu (2017)

J Behav Addict. 2017 Dec 1; 6 (4): 490-504. pitani: 10.1556 / 2006.6.2017.073.

Bielefeld M¹, Drews M², Putzig I³, Bottel L¹, Steinbüchel T¹, Dieris-Hirche J¹, Szycik GR⁴, Müller A⁵, Roy M⁶, Mafuta amp⁷, Theodor Te Wildt B¹.

Kudalirika

Zolinga

Pali umboni wabwino wa sayansi kuti vuto la kuchepa kwa matendawa (ADHD) ndilokulingalira komanso kusokonezeka kwa matenda osokoneza bongo ali wamkulu. Mabungwe awa amangoganizira za zoledzeretsa zokhudzana ndi mankhwala komanso zowonongeka monga khalidwe lakutchova njuga komanso vuto la kugwiritsa ntchito intaneti (IUD). Kwa IUD, ndemanga zowonongeka zazindikiritsa kuti ADHD ndi chimodzi mwa zovuta zomwe zimafala kwambiri pokhapokha kuvutika maganizo ndi kupsinjika maganizo. Komabe, pakufunika kuzindikiritsa mgwirizano pakati pa matenda onsewa kuti athandizidwe ndi chithandizo ndi kupewa. Izi ndizo makamaka kwa anthu achikulire omwe ali ndi matenda akuluakulu omwe sakudziwika bwino za maubwenzi amenewa mpaka pano. Phunziroli linali lopitiliza kufufuza nkhaniyi mwatsatanetsatane pogwirizana ndi lingaliro lalikulu lomwe liripo kuti pali njira yothetsera matenda a psychopathology ndi etiology pakati pa IUD ndi ADHD.

Njira

Zitsanzo ziwiri zoyang'anira milandu zinayesedwa ku chipatala cha yunivesite. Odwala ADHD ndi IUD odwala adadutsa mu chipatala chokwanira komanso zama psychograph.

Results

Tidapeza chothandizira pa hypothesis yomwe ADHD ndi IUD amagawana ma psychopathological. Mwa odwala a gulu lirilonse, tidapeza kuchuluka kwa mitundu yoopsa ya ADHD ku IUD komanso mosemphanitsa. Kuphatikiza apo, zizindikiro za ADHD zinali zogwirizana ndi nthawi yogwiritsira ntchito media komanso zizindikiro za chizolowezi cha intaneti m'masampweya onsewa.

Kukambirana

Odwala azachipatala akuyenera kudziwa za ubale wapakati pa zovuta ziwirizi pozindikira komanso pochiza. Zikafika pakubwezeretsanso momwe munthu angagwiritsire ntchito intaneti nthawi yonse yamankhwala ndi kukonzanso, kusintha kosokoneza bongo kuyenera kukumbukiridwa ndi akatswiri ndi odwala.

MAFUNSO:Kusagwiritsa ntchito intaneti; chidwi kuchepa hyperactivity chisokonezo; mankhwala osokoneza bongo

PMID: 29280392

DOI: 10.1556/2006.6.2017.073

Introduction

Pali umboni wamphamvu wasayansi wosonyeza kuti chidwi chosokoneza thupi (ADHD) onse ndi olosera (Biederman et al., 1995) ndi chikhalidwe chosangalatsa pamatenda ambiri osokoneza bongo (Gillberg et al., 2004). Mwa zitsanzo zambiri ku Europe za odwala omwe ali ndi vuto la kugwiritsa ntchito mankhwala osokoneza bongo, 13.9% idadziwika ndi ADHD wamkulu (van Emmerik-van Oortmerssen et al., 2014) mwakusiyana kwakukulu chifukwa chamtundu ndi zomwe zimagwiritsidwa ntchitovan de Glind et al., 2014). ADHD ndimatenda amisala omwe mwakhazikika amapita limodzi ndi zovuta kutchera khutu komanso kukhazikika, kuchita zinthu mopitilira muyeso, komanso mavuto pakuwongolera machitidwe, omwe sioyenera m'badwo wa munthu. Makamaka, koma osati pokhapokha, pamene ADHD ipitilira nthawi yonse yaunyamata ndi uchikulire, zomwe zimachitika pafupifupi 36.3% ya milandu (Kessler et al., 2005), chiwopsezo chokhala ndi vuto lomwa mowa mwauchidakwa (Biederman et al., 1995), chikonga (Wilens et al., 2008, kapenanso mankhwala osokoneza bongo monga cocaine (Carroll & Rounsaville, 1993) Kutalika. Popeza othandizira monga methylphenidate (MPH) amagwira ntchito ngati mankhwala othandiza (Van der Oord, Prins, Oosterlaan, & Emmelkamp, ​​2008), kugwiritsa ntchito mankhwala osokoneza bongo komanso nkhanza kwa odwala a ADHD adatanthauzidwanso kuti njira yodzithandizira nokha (Han et al., 2009). Kuphatikiza apo, kuchuluka kwakukulu kwa chidwi kumadziwika kwa onse omwe ali ndi ADHD (Winstanley, Mphungu, & Robbins, 2006) komanso ndimavuto ogwiritsa ntchito mankhwala osokoneza bongo (De Wit, 2009).

ADHD ndiwofanana comorbidity pa njuga zamatenda, malinga ndi ICD-10 (Bungwe la World Health, 1992) idayenera kuikidwa m'gulu la vuto losalamulira. Mosiyana ndi izi, mu 2013, mtundu wachisanu wa Kusanthula ndi Buku Lophatikiza la Mavuto a Mitsempha (DSM-5; Association of Psychiatric Association, 2013) adakhazikitsa malo omwe pakuchitika zovuta pazakudya ndi zosagwiritsa ntchito. Mu chaputala chakuti "Zokhudzana ndi Zidakwa komanso Zovuta Zowononga" zomwe tsopano zimatchedwa "Matenda a Kutchova Juga" ndizokhazokha zomwe zingakhale zovomerezeka. Komabe, mkati mwa Gawo III la DSM-5, vuto la masewera a pa intaneti (IGD) limayamba kutchulidwa ngati vuto lofufuzira zambiri zakuchipatala ndi zokumana nazo musanazindikiridwe bwino ngati vuto losiyana (Petry & O'Brien, 2013). IGD inde ndiye njira imodzi yolumikizirana bongo yomwe yaphunziridwa kwambiri (Achinyamata, 1996) ndikuwonetsa kutchuka kwambiri (Rehbein, Kliem, Baier, Mößle, & Petry, 2015). Kukula kumeneku sikubwera modabwitsa, makamaka chifukwa masewera a pa intaneti komanso kutchova juga pa intaneti zikugawana zambiri.

Podziyimira pawebusayiti, kuletsa zamasewera a video kulumikizidwa kale ndi psychopathology ya ADHD m'njira zingapo (Arfi & Bouvard, 2008; Yen et al., 2017). Ndemanga zadongosolo zazindikira ADHD ngati wolosera wamba (Weiss, Baer, ​​Allan, Saran, & Schibuk, 2011) ndi comorbidityWeinstein & Weizman, 2012) kwa IGD makamaka mu ana ndi achinyamata. Kuphatikiza apo, pa subclinical-level hyperacaction, impulsivity, hanya, kusowa kolingalira, ndikuyika chidwi pazinthu zodziwonetsa kwawonetsedwa kuti zikugwirizana ndi kugwiritsa ntchito kwambiri masewera a kanema, onse pakompyuta komanso pa intaneti (Swing, Amitundu, Anderson, & Walsh, 2010). Zotsatira zofananazi zapezeka m'mbuyomu kuti mugwiritse ntchito kwambiri TV (Miller et al., 2007), zomwe zimapangitsa kuti pakhale zokambirana zambiri zokhudzana ndi kugwiritsa ntchito kwambiri makanema pazenera komanso masewera a makanema makamaka sizingakhale chizindikiro of komanso chiopsezo chifukwa kukula kwa ADHD (Weiss et al., 2011).

Maubwenzi apakati pa kugwiritsa ntchito kwambiri mapulogalamu ena pa intaneti ndi ADHD samamveka bwino. Komabe, zikuyenera kuti zochitika zapaintaneti, monga kusewera masewera ena, zimapereka chikondwerero mosalekeza komanso mphoto zomwe zikubwera, zomwe, zimayamikiridwa kwambiri ndi anthu omwe ali ndi ADHD, omwe amakonda kutopa (Castellanos & Tannock, 2002) ndi kutsata njira zomwe zakuchedwaDiamond, 2005). Kafukufuku wina adatsimikiza kuti ulalowu ungathe kufotokozedwa ndi vuto la kukumbukira ntchito mu ADHD yomwe yadziwika kuti ndi endophenotype yofunika ya ADHD (Castellanos & Tannock, 2002). Potengera izi, mapulogalamu omwe amagwiritsidwa ntchito pa intaneti ngati masewera ochezera pa intaneti amapereka thandizo pakagwiritsidwe ntchito ka zolinga za mishoni kuti tithane ndikuwonongeka chifukwa chake kuthana ndi kukhumudwa komanso kusachita bwino m'moyo weniweni. Chifukwa chake, anthu omwe ali ndi ADHD atha kukonda mapulogalamu amtundu wa intaneti, omwe amawapangitsa kukhala pachiwopsezo chogwiritsa ntchito media (Yen, Yen, Chen, Tang, & Ko, 2008). Chosangalatsa ndichakuti, Koepp et al. (1998) adatinso kusewera makanema kumabweretsa kutuluka kwa dopamine komwe kumapangitsa kuti anthu azikhala ndi chidwi komanso azigwira bwino ntchito, zomwe zitha kuzindikirika ngati mpumulo wa anthu omwe luso lawo lazindikira silowona bwino m'moyo weniweni. Izi zikugwirizana ndi kugwiritsidwa ntchito kwa omwe anapangidwa mwapadera masewera aakulu zochizira paliponse odwala omwe ali ndi ADHD kuphatikiza ma neurofeedback application (Lau, Smit, Fleming, & Riper, 2017). Masiku ano, masewera a makanema amasewera kwambiri pazida za pa intaneti ndi mitundu ya pa intaneti. Kuphatikiza apo, masewera a pa intaneti amaphatikiza pang'onopang'ono magawo a njuga, kugula malo ochezera a pa Intaneti (Kupeza, Hing, Delfabbro, & King, 2014), yomwe ili ndi zina zowonjezera. Zizolowezi zokhudzana ndi chikhalidwe, monga vuto la kutchova njuga, kugula zam'magazi, ndi vuto la Hypersexual, lomwe lalumikizidwa ndi ADHD komanso (Blankenship & Laaser, 2004; Brook, Chenshu, Brook, & Leukefeld, 2016, adziwonetsa kwambiri pa intaneti ndipo muzipeza nzeru zamphamvu zatsopano (Dittmar, Long, & Bond, 2007; Achinyamata, 2008). Poganizira izi zomwe zikuchitika pang'onopang'ono malinga ndi kusamutsidwa kwa digito ndi kuphatikiza, ndikofunikira kuyang'ananso mitundu ina yazomwe mungagwiritse ntchito kwambiri kapena osokoneza bongo mopitilira IGD. Posachedwa, akatswiri amakonda kugwiritsa ntchito liwu loti kugwiritsa ntchito intaneti (IUD; Association of Psychiatric Association, 2013), zomwe zimatanthauza kugwiritsa ntchito intaneti kosalamulirika komwe kumasokoneza moyo watsiku ndi tsiku. M'malo mwake, IUD idalumikizidwa kale ndi ADHD. Pafupi ndi zovuta zamavuto ndi nkhawa, zapezeka kuti ndizochita ngati ma IUD mwazonse (Ko, Yen, Yen, Chen, & Chen, 2012). Kuphatikiza apo, odwala omwe ali ndi matenda onse a ADHD ndi IUD amawoneka kuti ali ndi chiwopsezo chachikulu chokhala ndi vuto lina. Muzochitika zamankhwala, izi ndizopeza bwino, popeza odwalawa amafunikira kuzindikira kofunikira pokhudzana ndi kusintha kosinthika kwa mankhwala osokoneza bongo nthawi yonse yobwerera ndi kukonza. Komabe, ndizochepa zomwe zimadziwika pazambiri komanso kulumikizana pakati pa IUD ndi ADHD makamaka m'magulu azachipatala akuluakulu. Chifukwa chake, ndizomveka kufufuza mopitilira ubale pakati pa ADHD ndi IUD kuchokera pamaonedwe azachipatala. Pakhala pali maphunziro angapo okhala ndi magulu akulu akulu omwe akumana ndi zovuta izi pamlingo wowerengeka (Yen et al., 2008). Komabe, ndi maphunziro ochepa okha omwe adachitidwa ndi zitsanzo zamankhwala zopangidwa ndi ADHD (Han et al., 2009) kapena odwala ovuta kugwiritsa ntchito intaneti (PIU) odwala (Bernardi & Pallanti, 2009). Pazidziwitso zathu, uwu ndi kafukufuku woyamba kufananitsa gulu la odwala akuluakulu a ADHD ndi gulu la achikulire a IUD odwala osati zowongolera komanso komanso wina ndi mzake kuti apitilizabe kufufuzana kwawo ndikufanana kwawo. Kafukufukuyu akuchokera ku lingaliro loti pali gawo lokhazikika la psychopathology lomwe liyenera kuthetsedwa mosiyanasiyana muzochita zochiritsira komanso zodzitetezera. Moyenera, tikuyembekeza kuti miyezo ya ADHD ingagwirizane ndi miyeso ya intaneti mpaka pamlingo wokulirapo.

Njira

Magulu awiri azachipatala (ADHD ndi IUD) ndi magulu awiri olamulira adalembedwa ku Hannover Medical School (MHH). Zokhala ndi ophunzira a 25 aliyense, njirayi idalola kuyerekeza gulu lililonse lazachipatala ndi gulu lawo loyang'anira komanso magulu onse azachipatala ndi amzake. Pakangokhala nthawi yoyamba, odwala omwe anali ndi cholinga chofuna kulandira chithandizo adayesedwa ndi mafunso othandizira anthu kudziwa ngati ali ndi matenda. Iwo omwe anakwaniritsa zomwe ADHD kapena IUD, adapemphedwa kuti achite nawo kafukufukuyu wochitikanso.

Gulu la ADHD ndi gulu lake lolamulira

Omwe nawo pagululi la ADHD adasankhidwa kuchokera ku chipatala cha MDHD cha achikulire. Odwala adalandira kuwunika kokwanira pofotokoza za zizindikiro zawo za ADHD ndi comorbidities. Mwa njira yofufuzira, aliyense adayitanidwa kuti adziwonetsere zida zazikuluzikulu zofufuzira, Mafunso a Adult ADHD Diagnostic Mafunso a DSM-IV (CAADID; Epstein, Johnson, & Conners, 2001). Apa, mawonekedwe a 18 DSM-IV a ADHD adagawika m'magawo awiri azachipatala osasamala (zinthu zisanu ndi zinayi) ndi hyperactivity / impulsivity (zinthu za 6 / 3) zokhudzana ndi ubwana ndi ukalamba zimayesedwa ndikuwunika mozama. ADHD idangopezedwa ngati njira za DSM-IV zikukwaniritsidwa, zikutanthauza kuti zosachepera zisanu ndi chimodzi mwa zizindikiro zisanu ndi zinayi zimayenera kupezeka mu gawo limodzi kapena onse aubwana ndi ukalamba. Kuyesaku kunakwaniritsidwa ndi mafunso odzichitira pawokha (onani pansipa). Kwa nthawi yayitali ya zaka za 1.5, zida za kafukufuku wa 50 zidagawidwa kwa odwala omwe adapezeka ndi ADHD, wazaka zapakati pa 18 ndi 65 zaka ndikuwonetsa kuchuluka kwa chizindikiritso cha mawu [zingapo zosankha mawu mayeso (MWT-B) IQ ya 100 ± 15]. Odwala onse a 25 abweza zomwe adaziwona, zomwe ndizofanana ndi kuyankha kwa 50%. Munthawi imodzimodziyo, gulu loyang'anira lidalembedwa kudzera pazidziwitso mkati mwa MHH molingana ndi kufalitsa kugonana, zaka, ndi maphunziro kusukulu. Njira zophatikizira gulu lolamulirazo zinali: kuchuluka kwa nzeru zamawu komanso kusakhalapo kwa mbiri yamatenda amisala. Maulamuliro adayang'aniridwa kwa ADHD ndi IUD.

Gulu la IUD ndi gulu loyendetsa

Gulu la IUD lidalembedwa mkati mwa chipatala cha MHH chomwe chimatuluka chifukwa chazovuta zokhudzana ndi media, amagwiritsa ntchito mankhwala osokoneza bongo pa intaneti. Njira zophatikizira zinali: kuzindikira za IUD molingana ndi zomwe Achinyamata (1996) ndi Beard (Ndevu & Wolf, 2001) (Tebulo 1) ndi cholinga chothandizira, zaka pakati pa 18 ndi 65, komanso kuchuluka kwa nzeru zamawu. Ngati njira zophatikizira zakwaniritsidwa, ophunzira adayitanidwa kukafunsidwa ku chipatala komwe kunali ndi chidziwitso chogwirizana ndi zamankhwala. Omwe anali nawo pagululi adalembedwa mu MHH ndipo adafananizidwa ndikugawa kofanana, zaka, komanso maphunziro apasukulu. Njira zophatikizira gulu lolamulirazo zinali: kuchuluka kwa nzeru zamawu komanso kusakhalapo kwa mbiri yamatenda amisala. Maulamuliro adayang'aniridwa kwa ADHD ndi IUD. Ponseponse, omwe ali ndi 25 omwe adawongolera IUD ndi 25 adalembedwa ndipo motero adaphatikizidwa mu phunziroli.

Gulu 1. Njira zoyenera zopezera kugwiritsa ntchito intaneti

Zindikirani. Osankhidwa kuchokera kwa Achichepere (1996) ndi Beard ndi Wolf (2001).

Ophunzira m'magulu anayi onsewo adauzidwa za kusungidwa mwachinsinsi kwa zosowa zawo komanso cholinga cha phunziroli. Gome 2 imapereka chithunzithunzi cha kuchuluka kwa anthu pamasamba.

Gulu 2. Njira zamankhwala. Mtengo wamtengo (SD)

Zindikirani. Zosankha zomwe zaphatikizidwa mkati mwa gulu la ADHD zifikira kuchokera n = 20-25 ndi gulu lolamulira kuchokera n = 24-25. Pakati pa gulu la IUD, kuphatikiza ma data amafikira kuchokera n = 20-25 komanso pagulu lake lolamulira kuyambira 24 mpaka 25. Madera okhala ndi imvi amaimira kuyerekezera kwa ziwerengero pakati pa gulu lazachipatala ndi gulu lowongolera. Gawo lomaliza likuyimira kufananitsa pakati pa magulu onse azachipatala. ADHD: kuchepa kwa chidwi cha kuchepa kwa chidwi; IUD: Vuto logwiritsa ntchito intaneti; ISS: Internetsuchtskala; WURS-k: Wender Utah Mulingo Wamlingo; CAARS: Masewero a Adult ADHD Rating Scales; BDI: Beck Kukhumudwa Kufufuza; SCL-90-R: Mndandanda wazizindikiro-90 - Wosinthidwa; GSI: Ndondomeko Yowona Padziko Lonse; PST: Chizindikiro Chokwanira; MWT-B: mayeso osankhidwa mwanzeru angapo; SD: kupatuka wamba; ns: zosafunikira.

*p <.01. **p <.001.

Mayankho

Mafunso ambiri

Mafunso ambiri anapangidwira maphunzirowo. Gawo loyamba linaphatikizapo mafunso okhudzana ndi zidziwitso zokhudzana ndi kuchuluka kwa anthu pazokhudza mgwirizano, maphunziro, ndi ntchito. Kuphatikiza apo, ophatikizidwa adafunsidwa kuti afotokoze za matenda aposachedwa ndi kale. Gawo lachiwiri linapangidwa kuti liwunike momwe ogwiritsira ntchito media amagwirira ntchito. Apa, ophunzira atha kufotokoza momwe amagwiritsidwira ntchito pawailesi mwakuthupi, pafupipafupi komanso nthawi yayitali. Kuphatikiza apo, adafunsidwa za zoyeserera komanso zosangalatsa za momwe amagwiritsira ntchito media komanso ngati pamapeto pake adazindikira kuti ali okhudzidwa ndi kugwiritsa ntchito media.

DSM-IV Zodzilemba pawokha pa ADHD

Mndandanda wazizindikiro za DSM-IV ndi chida chowunikira cha matenda a ADHD muubwana ndi unyamata. Kwenikweni, ndimasinthidwe a njira zakuzindikira za DSM-IV (Association of Psychiatric Association, 2000). Imakhala ndi zinthu za 18 zomwe zimagawika muzida zamankhwala osaganizira (zinthu zisanu ndi zinayi), hyperactivity (zinthu zisanu ndi chimodzi), komanso kusokonekera (zinthu zitatu). Chipangizocho chimalola kuti muzindikire zosakanikirana, makamaka zosafunikira kapena makamaka zopusa za ADHD. Kuti mupeze matenda a ADHD, osachepera zisanu ndi chimodzi mwa zizindikiro zisanu ndi zinayi zomwe zimakhalapo kwa miyezi ya 6 pazaka zaka 6-12. Pokhala momwe mungasinthire mwachindunji machitidwe a DSM-IV, chida ichi chikuwonetsa kuvomerezedwa kwapamwamba.

Wender Utah Rating Scale (WURS-k)

Kukula kwa Wender Utah Scale (WURS) ndichida chodziwika bwino pakuwunika kwa ADHD muubwana kwa akulu ndipo kwakhala kukugwiritsidwa ntchito pano. Retz-Junginger ndi al. (2002) adapanga mtundu waifupi wa Germany (WURS-k) wa WURS wokhala ndi zinthu za 25 zomwe zikuyimira kuyambiranso kwachuma kwa zizindikiro za ADHD ali mwana. Ophunzira alandila mndandanda wazomwe amauzidwa kuti aunikire kuchuluka kwa chikhalidwe, malingaliro, kapena vuto lomwe lidatchulidwa mkati mwazaka pakati pa 8 ndi 10 (mwachitsanzo, Ndikadali mwana pakati pa 8 ndi 10 ndinali ndi zovuta zokumbukira kapena zosavuta kuzisintha). Apa, mayankho akhoza kuperekedwa pamawonekedwe a 5-point Likert kuyambira [0] sakukhudzanso [4] yotchulidwa mwamphamvu. Pazotsatira zonse, kudula kwa mfundo za 30 kumawonetsa ADHD yoyipa ali mwana. Mtundu wofesawu unawonetsa zokwanira zama psychometrical malinga ndi kapangidwe kazinthu, kudalirika (gawo logawika: r12 = .85) komanso kusasintha kwamkati (α = 0.91) (Retz-Junginger et al., 2003).

Magulu a Convers 'Adult ADHD Mavoti (CAARS)

Yopangidwa mu 1999 ndi Conners [onani Macey (2003) pakuwunikira mwatsatanetsatane], ma CAARS akhala chida chodziwika bwino chodziwira ndi kuwunikira chizindikiro cha ADHD mu ukalamba. Apa, mu maphunziro omwe adawonetsedwa, mtundu wanthawi yayitali wa 66 walemba. Omwe amafunsidwa amafunsidwa kuti awunikire, kuchuluka kwake, kapena kaonedwe kangati (mwachitsanzo, Ndimakhumudwitsidwa mosavuta) imagwira ntchito pazomwe akumana nazo. Mayankho amaperekedwa pamiyeso 4 ya Likert kuyambira [0] ayi / ayi, [1] pang'ono / nthawi zina, [2] mwamphamvu / pafupipafupi, ndipo [3] mwamphamvu / pafupipafupi kwambiri. Kutulutsa kwakanthawi komweku kumalola kugawanika m'magawo asanu ndi atatu, mwachitsanzo, kusasamala, kusakhazikika / kusakhazikika, komanso chizindikiritso cha ADHD kutengera njira za DSM-IV za ADHD. Kusintha kwachijeremani kwa aChristianen, Hirsch, Abdel-Hamid, ndi Kis (2014) yawonetsa kudalirika komanso kuvomerezeka.

Makhalidwe a IUD

Monga IUD ndichinthu chatsopano komanso chifukwa chodikirira chomwe chikuyembekezeka pakadali pano monga vuto la kuwongolera kapena chizolowezi chamachitidwe, sichizindikirika kwathunthu ngati chipatala mu ICD-10 ndi / kapena DSM-IV. Komabe, kafukufuku yemwe akukula akuwonetsa kuti njira zamavuto okhudzana ndi zinthu zitha kugwiritsidwanso ntchito pakugwiritsa ntchito intaneti. Njira imodzi yogwirizana ndi kafukufukuyu ikuchokera kwa a Young (1996) amene adapanga njira zisanu ndi zitatu zomwe zikupangira osachepera asanu kuti adziwe zomwe zili ndi intaneti. Beard ndi Wolf (2001) idapereka kusintha kwa magwiritsidwe ntchito a njira zisanu ndi zitatuzi. Malinga ndi kutanthauzira kwawo, kukhalapo kwa zinthu zisanu zoyambirira, kuyang'ana kwambiri pamakhalidwe oyipa kwambiri, ndikofunikira kuti muzindikire kusuta kwa intaneti. Ndipo, chimodzi mwazinthu zitatu zomaliza ziyenera kukhalapo, zomwe zikulongosola zowonongeka pakugwira ntchito kwa tsiku ndi tsiku chifukwa chazinthu zomwe zimawonjezera. Mkati mwa phunziroli, njira zolimba monga momwe Beard ndi Wolf adagwiritsira ntchito zidagwiritsidwa ntchito (Gome 1).

Chikumbutso (ISS)

M'mayiko olankhula Chijeremani, ISS [kutanthauzira kwaulere: Internet Addiction Scale, kuti musakhale wolakwitsa ndi Internet Addiction Scale (IAS) of Griffiths (1998)] Wolemba Hahn ndi Yerusalemu (2003) ndi chida chovomerezeka bwino choyesa IUD. Zinthu makumi awiri zimakhudza mbali zisanu za IUD: kulephera kuwongolera (mwachitsanzo, Ndimagwiritsa ntchito nthawi yambiri pa intaneti monga momwe ndimafunira poyamba), Zizindikiro zakunyumba (mwachitsanzo, Pomwe sindingathe kukhala pa intaneti, ndimakhala wokwiya komanso wosakhutira), kukulitsa kulolerana (mwachitsanzo, Moyo wanga watsiku ndi tsiku umayamba kulamuliridwa ndi intaneti), zoyipa pakugwira ntchito (mwachitsanzo, Kuchita kwanga kusukulu kapena pantchito sikukhudzidwa ndi kugwiritsa ntchito kwanga intaneti,, komanso zoyipa pamaubwenzi (mwachitsanzo, Popeza ndinazindikira intaneti, sindimachita zinthu zochepa ndi ena). Subscale iliyonse ili ndi zinthu zinayi. Mayankho amapangidwa pamiyeso 4 ya Likert kuyambira [1] sikugwira ntchito, [2] sikugwira ntchito kwenikweni, [3] amangogwiritsa ntchito, ndipo [4] imagwiranso ntchito chimodzimodzi. Malingaliro odulidwa kuti adziwe IUD adakhazikitsidwa> 59 (kutanthauza kuyankha kwa 3), pomwe mphambu pakati pa 50 ndi 59 (kutanthauza kuyankha kwa 2, 5) kumawonetsa kugwiritsidwa ntchito molakwika komanso pachiwopsezo chotulutsa IUD. ISS idawonetsa kukhutira kwama psychometric okhutira malinga ndi kusasinthasintha kwamkati mwa α = 0.93 pamalipiro onse ndi α = 0.80 yama subscales asanu komanso kutsimikizika ndi njira zakunja, mwachitsanzo, kusakhazikika (pakuwunika, onani Hahn & Yerusalemu, 2010).

Beck Depression Inventory (BDI)

DSD yochokera BDI (Beck, Ward, Mendelson, Mock, & Erbaugh, 1961) ndi chimodzi mwazida zodziwika kwambiri zoyesera kukhumudwa mu kafukufuku wazachipatala ndi machitidwe. Makhalidwe ake abwino kwambiri olimbitsa thupi amalola kuyesa kovomerezeka komanso koyenera kovutika kwamavuto a nkhawa. Masinthidwe achijeremani (Hautzinger, Keller, & Kühner, 2006) ili ndi zinthu za 21 zololeza kuwerengetsa zowerengera zonse. Mayankho amapangidwa pamakwerero a 4-point Likert. Makhalidwe ochokera ku 0 mpaka 13 samayimira kutaya mtima, mfundo kuchokera ku 14 kupita ku 19 code kukhumudwa kofatsa, zomwe zimachokera ku 20 mpaka 28 zimawonetsa kukhumudwa kwakukulu, ndipo mfundo zomwe zili pamwamba pa 28 zimawonetsa kukhumudwa kwambiri. Kusintha kwachijeremani kwa BDI kwawonetsa kudalirika kwakukulu ndi kutsimikizika kovomerezeka (Kühner, Bürger, Keller, & Hautzinger, 2007).

Mndandanda-Zizindikiro-90 - Wokonzanso (SCL-90-R)

SCL-90-R (Derogatis, 1977) amayesa kufooka kwa kugonjera mwa zizindikilo zakuthupi ndi zamaganizidwe m'masiku 7 apitawa. Mafunsowa ali ndi zinthu za 90 pomwe zinthu za 83 zimafotokoza magawo asanu ndi anayi azizindikiro: kusasunthika, kukakamira - kukakamiza, kukhudzika pakati pa anthu, kukhumudwa, nkhawa, chidani, kuda nkhawa, malingaliro okhumudwitsa, komanso psychoticism. Zinthu zisanu ndi zinayi zonse zimaphatikiza ma indices angapo apadziko lonse lapansi (onani pansipa). Ofunsidwa akufunsidwa kuti afotokozere momwe adavutikira kwambiri chifukwa cha chizindikiro m'masiku 7 apitawa. Mayankho amapangidwa pamiyeso ya 5-Likert. Katunduyu amalola kupanga ziphaso zitatu zapadziko lonse lapansi: Global Severity Index, Positive Syndromeom Total, ndi Positive Symptom Distress Index. Kusintha kwa Germany ku Franke (2016) yawonetsa kukhudzika kwamkati pamtunda wapadziko lonse lapansi ndi zopumira zonse komanso zovomerezeka zakutanthauzira (Schmitz et al., 2000).

Mayeso osiyanasiyana owunika osiyanasiyana (MWT-B)

MWT-B yolembedwa ndi Lehrl, Triebig, ndi Fischer (1995) ndi mndandanda womwe umawunika kuchuluka kwa anzeru malinga ndi luntha lamakalata pakati pa akulu azaka zapakati pa 20 mpaka 64. Zili ndi zinthu 37 zomwe ofunsidwa amafunsidwa kuti apeze ndikulemba liwu lokhalo lachijeremani motsatira mawu asanu omwe alipodi . Ndi chida chachuma kwambiri popeza kumaliza kumatenga mphindi 5 zokha. Mapepala osaphika (kuchuluka kwa mayankho olondola) atha kusinthidwa kukhala phindu la IQ poganizira msinkhu wa munthuyo.

Kusanthula Deta

Kuti mufufuze ngati deta imalola njira za kusanthula, njira yosakanikirana idasankhidwa. Choyamba, mayeso ofunikira (mayeso a Kolmogorov-Smirnov ndi Shapiro-Wilk) adagwiritsidwa ntchito pofufuza momwe magawikidwe amagwiritsidwira ntchito. Kuphatikiza apo, zojambula (histograms, Q-Q ziwembu, ndi njira za P-P) komanso njira zowerengera, zomwe zimaphatikizapo kuwerengera kwa skew ndi kurtosis pazogawikazo, zimagwiritsidwa ntchito pofufuza momwe zimasinthidwira. Pakuwunika kwa njira zamankhwala, kuyerekezera njira zosavuta kunasankhidwa. Pomwe njira za parametric zinali zoyenera, zitsanzo zodziyimira pawokha t-Miyeso idachitika. Kwa njira zopanda parametric, Mann-Whitney U kuyesedwa kunachitika. Zosowa zomwe zapezeka zimawonetsedwa m'munsi am'matafura. Pazosintha zamagulu, χ² mayeso adakonzedwa. Chifukwa cha zitsanzo zazing'ono zazing'ono komanso kufananiza kambiri mkati mwa zitsanzozi, kufunika kwake kunayikidwa ku 0.01 (yamisala iwiri) kuti isanthule zonse. Chifukwa chake, ziwerengero zomwe zawerengedwa zikuyimira njira yowunikira mosamala.

Ethics

Ndondomekozi zidachitidwa molingana ndi Chidziwitso cha Helsinki komanso malinga ndi zofunikira zonse zoyenera kuzitsatira zakunja ndi mayiko. Komiti yoyang'anira zamakhalidwe [Hannover Medical School] ivomereza phunziroli. Maphunziro onse adauzidwa za phunziroli ndipo onse anapatsidwa chidziwitso chokwanira ndipo sanabwezeredwe chifukwa chotenga nawo mbali.

Results

Njira zamankhwala

Odwala onse a ADHD adapezeka pamaziko a CAADID omwe amachitidwa ndi akatswiri odziwa bwino zamankhwala. Kugwiritsa ntchito mafunso kunali chowonjezera china. Iyenera kuganiziridwa kuti kuzindikira komwe kumachitika makamaka pazofunsa mwachipatala sikutanthauza kuti anthu onse amafika pazodulidwazo pamapepala amafunsidwe (Tebulo 3).

Gulu 3. Zitsanzo za anthu

Zindikirani. Madera okhala ndi imvi amaimira kufananizidwa pakati pa magulu azachipatala ndi oyang'anira. Mzere womaliza ukuimira kuyerekeza kwa chiwerengero pakati pa magulu onse azachipatalachi. SD: kupatuka wamba; IUD: Kusagwiritsa ntchito intaneti; ADHD: chidwi chosowa hyperactivity; OCD: chisokonezo chokakamira; PTSD: kupsinjika kwa posttraumatic.

Zambiri zinayi zimasowa, idatha imodzi ikusowa, ma data atatu akusowa.

*p <.01. **p <.001.

DSM-IV Zodzilemba pawokha pa ADHD

Pafupifupi 18 ya odwala a 25 ADHD (72%) adafika pazomwe adadzichotsazo. Gululi makamaka limakwaniritsa njira za subtype (36%) yophatikizidwa mwachindunji ndi subtype (32%). Mwanthawi imodzi, a hyptyactive-imptyive subtype adapezeka (4%) ndipo atatu omwe sanatenge nawo gawo sanathe kudula (12%). Ma seti anayi okhudzana ndi zidziwitso za DSM zosowa (16%).

Pafupifupi 7 ya 25 IUD odwala (28%) anayesedwa ali ndi chiyembekezo cha ADHD mu njira za DSM. Apa, subtype yophatikizidwa inali yotchuka kwambiri (12%). Milandu iwiri idayesedwa yolondola ya subtype (8%) ndi hyperactive-impulsive subtype (8%). Mu milandu ya 15 (60%), kudula kwa psychometrical kwa ADHD sikunafikire ndipo ma seti atatu a data (12%) sanasoweke. Panalibe kusiyana kwakukulu pakati pa gulu la IUD ndi zowongolera zawo zokhudzana ndi njira za DSM. Pomaliza, magulu onse azachipatala anali osiyana kwambiri wina ndi mnzake pankhani yogawa zomwe zaphatikiza komanso zosasamala mokomera gulu la ADHD. Palibe kusiyana kwakukulu komwe kunapezeka pokhudzana ndi hyperactive-impulsive subtype.

ZINSINSI-k

Zotsatira pa WURS-k zikuwonetsa kukonzekera kwa ADHD kwa gulu la ADHD pamtunda wamagulu owerengera (M = 41.68, SD = 16.52). Pamodzi payekha, ophunzira 18 (72%) adawonetsa mtengo wofanana kapena kupitilira pa 30. Ponseponse, gulu la ADHD linali losiyana kwambiri ndi kuwongolera kwawo (U = 26.00, p <.001). Poganizira kuchuluka kwake, gulu la IUD lidawonetsa mtengo wapamwamba pa WURS-k kukhala pafupi ndi zomwe zadulidwazo zomwe zikuwonetsa chizindikiro chokwera cha ADHD muubwana (M = 27.29, SD = 17.30). Pamodzi payekha, milandu isanu ndi itatu ya IUD (32%) idafika pamtengo, womwe unali wofanana kapena pamwambapa. Magulu awiri azachipatala sanasiyane wina ndi mnzake pokhudzana ndi kudziwonetsa okha kwa ADHD chizindikiro chaubwana.

CAARS

Popeza ma CAARS sapereka njira yochepetsera pamwambo wamagulu owerengeka komanso amangoganiza zogonana. t-sukulu zambiri zolemba ndi Christianen et al. (2014) akuti amayesa miyeso ya ADHD dalili za masiku ano. Pano, t-scores ofanana kapena pamwambapa 65 adavoteredwa moyenera malinga ndi matenda. The t-maphunziro pakati pa 60 ndi 65 amatanthauza chisonyezo chapamwamba, chomwe chili pamwamba pamlingo wokhazikika komanso wolemba ngati mzere kumalire oyenera azachipatala. Gulu la ADHD lidawonetsa zambiri komanso zofunikira pamakina onse a CAARS ndipo zinali zosiyana kwambiri ndi zomwe amazilamulira. Pa gulu lililonse, anthu a 19 (76%) a gulu la ADHD adawonetsa zofunikira pamankhwala pa DSM-IV kutanthauza ADHD yomwe ikupezeka nthawi zambiri. Gulu la IUD lidawonetsa pang'ono kuti lizikweza kwambiri ma CAARS. Amasiyana kwambiri pakulamulira kwawo pamilingo ingapo kupatula ma subscales hyperacaction, kusakhazikika, DSM-IV hyperactive-impulsive, ndi zizindikiro za DSM-IV ADHD. Panthawi ya munthu aliyense, milandu isanu (20%) inakwaniritsa zomwe zili mu CAARS DSM-IV ADHD muyeso. Poyerekeza mwachindunji pakati pa magulu onse azachipatala, gulu la ADHD limasiyana kwambiri pazambiri za CAARS kupatula zovuta zodziyesa pawokha kuchokera ku gulu la IUD.

ISS

Ponseponse, odwala a ADHD adawonetsa kuchuluka kwambiri kwa ISS poyerekeza ndi zomwe amawongolera [(M = 36.36, SD = 17.45) motsutsana (M = 23.00, SD = 4.34)], pomwe matanthauzidwewo sanafike podula chifukwa chogwiritsa ntchito intaneti movutikira. Pa subscale level, gulu la ADHD lidawonetsa kwambiri kuchuluka kwakulephera kuwongolera (M = 9.68, SD = 4.09), zizindikiritso zakutha (M = 6.56, SD = 3.66), komanso zoyipa pamaubwenzi (M = 6.32, SD = 3.73) poyerekeza ndi kuwongolera kwawo. Pa mulingo wa aliyense, odwala asanu (20%) adawonetsa zambiri zofananira kapena kupitilira pakudula kuti akhale pachiwopsezo chogwiritsa ntchito intaneti. Odwala atatu (12%) adawonetsanso zikhalidwe zomwe zinali zofanana kapena kupitilira pakuchepetsa chizolowezi. Mgulu la IUD, ISS idawonetsa kugwiritsa ntchito zovuta kwa odwala anayi (16%) ndikugwiritsa ntchito intaneti kwa odwala 10 (40%). Pamlingo wotsika, gulu la IUD lidawonetsa kutaya kwakukulu kwamphamvu (M = 11.92, SD = 3.49), zizindikiritso zakutha (M = 10.12, SD = 3.27), kukulitsa kulolerana (M = 12.64, SD = 3.29), zoyipa pamaubwenzi (M = 10.28, SD = 3.61), ndi magwiridwe antchito (M = 8.32, SD = 4.40) poyerekeza ndi kuwongolera kwawo. Poyerekeza mwachindunji, gulu la IUD lidaposa gulu la ADHD kwambiri pamlingo uliwonse wa ISS kupatula kutaya ulamuliro subscale.

BDI ndi SCL-90-R

Ponseponse, odwala a ADHD adawonetsa zomwe zikuwonetsa kukhumudwa kwapang'onopang'ono (M = 16.96, SD = 9.91). Kuphatikiza apo, anali osiyana kwambiri ndi kuwongolera kwawo. Mwa odwala ADHD, 13 (52%) adayesedwa kuti ali ndi vuto lachipatala. Gulu la IUD lidawonetsa kukhumudwa koopsa pang'ono, komwe kunali kofatsa malinga ndi BDI (M = 18.54, SD = 8.40). Apa, odwala 15 (60%) adayesedwa kuti ali ndi vuto lachipatala. Apanso, gululi linali losiyana kwambiri ndi kuwongolera kwawo. Panalibe kusiyana kwakukulu pakati pamagulu onse azachipatala. Ponena za SCL-90-R, magulu onse azachipatala anali osiyana kwambiri ndi kuwongolera kwawo pazinthu zonse. Poyerekeza mwachindunji, magulu onse azachipatala sanawonetse kusiyana kwakukulu koma adawonetsa zambiri, zomwe zinali pamphepete kuti zikhale zofunikira pachipatala. Ponseponse, magulu onse azachipatala adawonetsa kuchuluka kwazizindikiro zosonyeza kuchuluka kwa zovuta.

Zosiyanasiyana za Sociodemographic

Pang'onopang'ono, kuwunikaku kunawonetsa kuti pazambiri, palibe kugawa mwazinthu zofananira komwe kungaganizidwe (onani Gome 4). Ndi zochepa zochepa zokha zomwe zimawonetsa kuti zimagawidwa bwino, koma ngati njira yopanda malire (mwachitsanzo, Mann-Whitney U zoyeserera) zitha kugwiritsidwanso ntchito pamilandu iyi, njira yopanda parametric idasankhidwa kuti ikhale yonse.

Gulu 4. Kugwiritsa ntchito media. Tanthauza (SD)

Zindikirani. Madera okhala ndi imvi amaimira kufananizidwa pakati pa magulu azachipatala ndi oyang'anira. Mzati womaliza ukuimira kuyerekezera kwa ziwerengero pakati pama magulu onse azachipatala. SD: kupatuka wamba; IUD: Kusagwiritsa ntchito intaneti; ADHD: chidwi chosowa hyperactivity; ns: zosafunikira.

^aIdatha imodzi yasowa, ma data anayi akusowa.

*p <.01. **p <.001.

Gulu la ADHD motsutsana ndi gulu

Kuwunikaku sikunawonetse kusiyana kofunikira pankhani yakugonana, zaka, maphunziro, udindo, komanso mgwirizano pakati pa gulu la ADHD ndi gulu lawolo. Makamaka, mogwirizana ndi njira zophatikizira, gulu la ADHD limasiyana ndi gulu lake loyang'anira malinga ndi matenda omwe apezeka preexisting. Apa, kukhumudwa ndi nkhawa zomwe zinali zovuta kwambiri. Pocheperapo pang'ono, zovuta za kudya ndi psychosomatic zidanenedwa mkati mwa gulu la ADHD.

Gulu la IUD motsutsana ndi gulu loyendetsa

Kuwunikaku sikunawonetse kusiyana kwakukulu pokhudzana ndi kuchuluka pakati pa IUD ndi gulu lawolo. Gulu la IUD linanenanso zodwala zomwe zikupangitsa kuti azikhala matenda. Apanso, kupsinjika ndi nkhawa zomwe zinali zovuta kwambiri.

ADHD motsutsana ndi IUD

Pazambiri zamitundu mitundu ya anthu, palibe kusiyana kwakukulu pakati pamagulu onse azachipatala omwe angapezeke. Monga zikuyembekezeredwa, gulu la ADHD lidanenanso zambiri za ADHD pafupipafupi.

Kugwiritsa ntchito media

Gulu la ADHD motsutsana ndi gulu

Panalibe kusiyana kwakukulu pakati pa kusiyanasiyana kwa kugwiritsidwa ntchito kwa intaneti pakati pa gulu la ADHD ndikuwongolera kwawo. Zomwezo pazomwe zimasinthidwa pamasewera akanema. Pankhani yakulimbikitsa kugwiritsa ntchito masewera a kanema, panali njira imodzi yabwino. Odwala a ADHD adanenedwa kuti amagwiritsa ntchito masewera a kanema kuti alimbikitse, kuthana ndi kusungulumwa, komanso / kapena pazosowa pazachikhalidwe, pomwe palibe omwe adalamulira. Cholinga china chachikulu chogwiritsa ntchito masewera a vidiyo pakati pa odwala a ADHD chinali kupumula. Cholinga chogwiritsa ntchito intaneti pakati pa anthu omwe ali mgulu la ADHD chinali makamaka chifukwa cha chidwi. Gulu la ADHD lidafotokozeratu pafupipafupi poyerekeza ndi zomwe amawongolera kuti adziwone ngati ali chidakwa kuchokera pamasewera a vidiyo [11 vs. 0, χ² (1) = 12.76, p <.001].

Gulu loyendetsa IUD motsutsana

Gulu la IUD lidagwiritsa ntchito masewera amuvidiyo pafupipafupi poyerekeza ndi omwe amawongolera [21 vs. 10, χ² (1) = 11.89, p <.001]. Panalinso kusiyana kwakukulu pokhudza maola omwe amathera tsiku ndi masewera amakanema mokomera gulu la IUD [(M = 6.47, SD = 5.41) motsutsana (M = 1.94, SD = 0.95), U = 18.00, p <.001]. Ponena za kugwiritsa ntchito intaneti, gulu la IUD limathera maola ochulukirapo patsiku pogwiritsa ntchito intaneti poyerekeza ndi zomwe amawongolera [(M = 6.47, SD = 4.07) motsutsana (M = 2.20, SD = 2.52), U = 66.0, p <.001]. Njira yosankhira kugwiritsa ntchito masewera apakanema omwe amapezeka pakati pa odwala ADHD inapezekanso pakati pa odwala a IUD. Zolinga zogwiritsa ntchito intaneti pakati pa anthu omwe ali ndi IUD zinali makamaka chifukwa cha chidwi. Odwala a IUD akuti amadzizindikira kuti ali osokoneza bongo pamasewera apakanema [12 vs. 1, χ² (1) = 7.60, p = .006] pafupipafupi kwambiri monga momwe amawongolera.

ADHD motsutsana ndi IUD

Omwe nawo pagululi la IUD adakhala masiku ambiri sabata iliyonse akusewera masewera a video [(M = 5.90, SD = 2.02) motsutsana (M = 4.61, SD = 2.34), U = 88.50, p <.05], ngakhale sanakhalepo maola ochulukirapo patsiku [[XNUMXM = 6.47, SD = 5.41) motsutsana (M = 3.69, SD = 3.12), U = 81.50, p > .05]. Zoyeserera zosewerera makanema mkati mwa gulu la IUD zidasiyana ndi gulu la ADHD potengera chizolowezi chopewa kunyong'onyeka. Kuphatikiza apo, zosowa pagulu ndizomwe zidawonekera kwambiri mgulu la IUD. Kugwiritsa ntchito masewera apakanema popumula kunadziwika kwambiri mgulu la ADHD. Poyerekeza mwachindunji magulu onse azachipatala, panalibe kusiyana kwakukulu pamasewera amakanema omwe amadziona okha. Gulu la IUD limagwiritsa ntchito intaneti kwa maola ochulukirapo patsiku [(M = 6.47, SD = 4.07) motsutsana (M = 2.5, SD = 2.43), U = 65.0, p <.001]. Zoyeserera zogwiritsa ntchito intaneti zimasiyana potengera kunyong'onyeka, kusungulumwa, zosangalatsa, komanso kupumula mokomera gulu la IUD.

Comorbidities

Kuti muwunikenso ndikuwunikira mzere wolumikizana ndi mayanjano omwe ali pakati pamavuto onsewa, odwala omwe adagwirizana ndi omwe amadulidwa pazotsatira za ADHD ndi IUD adawunika mosiyana. Pano, odwala omwe adawonetsa mtengo wapamwamba kapena wofanana ndi 50 pa ISS ndi T-mtengo wapamwamba kuposa kapena wofanana ndi 65 pa CAARS DSM-IV ADHD muyeso waphatikizidwa ndi gulu ili. Njirayi idapangitsa kuti odwala asanu ndi atatu achoke m'magulu onsewa m'magulu ofanana. Gululi linali la amuna asanu ndi akazi atatu omwe ali ndi zaka zapamwamba za 41.6 zaka (SD = 10.23). Pafupifupi 75% adalembedwa ntchito ndipo 62.5% anali ndi mnzake. Malinga ndi WURS-k, 87.5% idakwaniritsa zofunikira za ADHD muubwana (makamaka kuphatikiza pang'ono). Zotsatira zake, gululi lidawonetsa mtengo wapamwamba wa WURS-k (M = 49.88, SD = 16.19) ndikuwonetseranso kuti ADHD inali isanakwane muubwana. Ponena zakugwiritsa ntchito kwawo media, 62.5% ya gululi akuti amasewera makanema pafupifupi zaka 4.40 (SD = 2.07) masiku 6 / sabata (SD = 1.73) pafupifupi 4.60 hr (SD = 4.22) makamaka zosangalatsa (60%) ndi kupumula (60%). Intaneti imagwiritsidwa ntchito ndi odwala mgululi pafupifupi kuyambira zaka 7.75 (SD = 3.77). Kuphatikiza apo, akuti amagwiritsa ntchito intaneti potanthauza 6 hr / tsiku (SD = 5.90) ​​makamaka zosangalatsa (62.5%), chidwi (62.5%), ndi mayanjano (50%). Ponseponse, gululi lidapitilira gawo lomwe lidadulidwa pa ISS (M = 61.50, SD = 9.53). Zomwe zili pa CAARS DSM-IV: muyeso wa ADHD ukhoza kuonedwa kuti ndiwothandiza kwambiri kuchipatala (M = 81.75, SD = 7.72). Pomaliza, gululi lingafotokozeredwe kuti ndiopsinjika pang'ono (M = 17.13, SD = 7.10).

Zolumikizana

Pazonse, zida zomwe zidagwiritsidwa ntchito zinawonetsa kuyikika kwapakati mkati ndikugwira zopangidwazo m'njira yokhutiritsa (Tebulo 5). Pakati pagulu la ADHD, WURS-k ndi maola ogwiritsa ntchito intaneti adawonetsa ubale wamphamvu komanso wofunikira (r = .630, p <.01). Chosangalatsa ndichakuti, mgwirizanowu udangokhala wofooka mkati mwa zitsanzo za IUD ndipo walephera kuwonetsa tanthauzo (r = .264, ns). Chiyanjano pakati pa kugwiritsidwa ntchito kwamavidiyo mumaola ndi WURS-k mkati mwa zitsanzo za ADHD chinali chachikulu koma chosafunikira (r = .564, p = .056). Chosangalatsa ndichakuti, sizinali choncho mu zitsanzo za IUD (r = .297, ns). Munthawi ya ADHD, panali kulumikizana kwapakatikati koma kosafunikira pakati pa ISS ndi kugwiritsa ntchito intaneti m'maola (r = .472, ns), zomwe sizinali choncho mu zitsanzo za IUD (r = .171, ns). Munthawi ya IUD, muyeso wa CAARS wosakhazikika umalumikizidwa ndikugwiritsa ntchito intaneti kwamaola ochepa, osafunikira kwenikweni (r = .453, ns). Pakati pa gulu la odwala omwe amapezeka kuti ali ndi ADHD ndi IUD, panali kulumikizana kwamphamvu komanso kwakukulu pakati pa WURS-k ndi ISS (r = .884, p <.01) (sichikuwonetsedwa mu Table 5).

Gulu 5. Malumikizidwe a sikelo ndi magwiridwe amkati (kumanzere: ADHD ndi IUD wamanja) mu diagonal ya ADHD (pansipa ya diagonal) ndi chitsanzo cha IUD (pamwamba pa diagonal)

Zindikirani. Kuwongolera kwa Pearson, kuphatikiza ma seti a data kufikira kuchokera ku 12 mpaka 25 (gulu la ADHD) ndi 17 mpaka 24 (gulu la IUD). WURS-k: Wender Utah Rating Scale; ISS: Internetsuchtskala; IUD: Kusagwiritsa ntchito intaneti; ADHD: chidwi chosowa hyperactivity; CAARS: Convers 'Adult ADHD Masikelo Olinganiza; BDI: Beck Depression Inventory; SCL-90-R: Zizindikiro-zowonera-90; GSI: Global Severity Index.

*p <;; p mfundo zili mbali ziwiri.

Kukambirana

Gulu la IUD

Monga momwe zimayembekezeredwa, odwala omwe adapezeka ndi IUD adasiyana kwambiri pamiyeso yonse yokhudzana ndi zosokoneza pa intaneti kuchokera kuzowongolera zawo. Tidapezanso zomwezo pankhani yokhudza miyezo ya anthu achikulire a ADHD.

Kuzindikira kwa ADHD mkati mwa IUD

Mwa odwala omwe amapezeka ndi IUD, tinapeza kuchuluka kwa ADHD. Kuchuluka kwa kuchuluka kwa ana a ADHD mgulu la odwala a IUD kukuwonetsa kuti ADHD ikhoza kuyimira chiopsezo chachikulu poyambira ndi chitukuko cha IUD. Chithandizo cha lingaliro ili chimachokera, mwachitsanzo, kuchokera kudera la chikonga ndi kudalira mowa. Apa, Ohlmeier et al. (2007) adapeza kuti pafupifupi gawo limodzi mwa anayi mwa gulu la odwala omwe amadalira mowa amatha kupezeka ndi ADHD ali mwana. Thandizo lowonjezereka kuchokera kudera lazokonda intaneti limachokera ku Dalbudak ndi Evren (2014). Pofufuza kwawo kwa ophunzira aku koleji, adapeza kulumikizana mwamphamvu komanso kwakuya pakati pa muyeso wa WURS-25 ndi IAS. Phunziroli, 20% ya odwala IUD adadziwika ndi zizindikiro za ADHD wamkulu. Kutenga ziwerengerozi, tikuwona kuchirikiza lingaliro lathu la mgwirizano wamphamvu pakati pamavuto onse awiri. Popeza gulu lonse la mabuku pamutuwu, maka maka akulu akulu, lidakali laling'ono, Bernardi ndi Pallanti yekha (2009) lipereke zofanizira izi. Apa, adapeza kuti 20% ya makolo awo achikulire omwe adadziwika, omwe adadziwika kuti adawagwiritsa ntchito intaneti molingana ndi a Little's (1998) IAS, ndakwaniritsa njira za akuluakulu a ADHD. Zotsatira zawo zikufanana ndi zotsatira zathu, tili ndi chidaliro kuti data yathu ndi yovomerezeka. Zambiri zimachokera ku Ko, Yen, Chen, Chen, ndi Yen (2008) yemwe adafufuza zamaganizidwe amisala mu zitsanzo za ophunzira aku koleji akuluakulu omwe ali ndi intaneti. Apa, ophunzirawo adadutsa kuyankhulana kwapazachipatala ndipo 32.2% idadziwika kuti ili ndi ADHD. Ngakhale sizinali zachipatala, zotsatirazi zikuwonetsabe kuti ADHD ndi IUD zimawonetsa mayanjano.

IUD - Magawo olimbikitsira komanso kuwongolera

Ponena za zolinga zogwiritsira ntchito mapulogalamu ena pa intaneti, tinapeza njira yosangalatsa mkati mwa gulu la odwala omwe adapezeka ndi IUD. Monga akunenera, masewera a kanema adagwiritsidwa ntchito kuti alimbikitse, kuthana ndi kusungulumwa, komanso kucheza ndi ena mgulu la IUD, pomwe palibe omwe amawongolera omwe adanena izi. Kuphatikiza apo, kusungulumwa chinali cholinga chachikulu pakati pa odwala omwe amapezeka ndi IUD. Mu zitsanzo za ophunzira aku yunivesite, Skues, Williams, Oldmeadow, ndi Wise (2016) adadziwika kuti ali ndi vuto loyang'ana PIU. Kuphatikiza apo, kusungulumwa kunalumikizidwa ndi kusungulumwa komanso PIU koma sikunali kuwonetseratu kwakukulu pamutunduwu. Amaganiza kuti ophunzira aku yunivesite amakonda kukhala osungulumwa nthawi zambiri amagwiritsa ntchito intaneti kuti athe kukondweretsedwa komanso kukhutitsidwa ngati malipiro awo. Kutengera ndi zomwe tasamba, timagawana nawo malingaliro athu monga tidapeza kuti tangodzitukumula komanso zosangalatsa ndi cholinga chachikulu chochitira nawo zinthu pa intaneti, pamasewera apakanema komanso pa intaneti. Ponena za mayanjano othandizirana, tangopeza maubwenzi ofooka kapena opanda pake pakati pa njira zachipatala ndi zinthu zakunja monga nthawi yogwiritsira ntchito media. Apa, zikuyenera kunenedwa kuti maola ogwiritsira ntchito media sawonedwa ngati njira yoyenera yodziwira IUD. Njira zamankhwala monga za Young (1996) ndi Beard ndi Wolf (2001) ndizoyimira za golide kuphatikiza zovuta za IUD pazazinsinsi ndi akatswiri pamoyo. Izi zatsimikiziridwa ndi kufufuza kwa Hahn ndi Yerusalemu (2010) yemwe adafotokoza za kukhudzana kokha r = .40 pakati pa ISS ndi nthawi yogwiritsa ntchito media mkati mwa sabata. Komabe, ziyenera kunenedwa kuti kafukufukuyu adachitika mwa njira zosagwiritsa ntchito mankhwala.

Gulu la ADHD

Pokhudzana ndi zizindikiro za kusuta kwa intaneti, odwala a ADHD anali osiyana kwambiri ndi kuwongolera kwawo pamachitidwe ambiri.

Kuzindikira kwa IUD mkati mwa ADHD

Kuwunika kwa ISS kudawulula kuti 20% ya odwala omwe adapezeka ndi ADHD adawonetsa zikhalidwe, zomwe zinali pamwamba pazomwe zidadulidwa chifukwa chogwiritsa ntchito intaneti zovuta. Kudziwa kwathu, aka ndi kafukufuku woyamba yemwe amapereka zidziwitso zokhudzana ndi kugwiritsidwa ntchito kwa media mwa achikulire komanso azachipatala a ADHD. Chifukwa chake, kufananiza mwachindunji kwa zotsatirazi ndi kovuta. Han ndi al. (2009) adafufuza zitsanzo za ana omwe adapezeka ndi ADHD ndipo adapeza kuti 45% imawonetsedwa pa intaneti molingana ndi kuchuluka kwakukulu pa IAS. Ngakhale zitsanzo zathu ndizosiyana malinga ndi zaka komanso zida zogwiritsidwa ntchito, tikuwonabe kuthandizira pakuwona kwathu kuti IUD ndi nkhani yokhudza nkhawa osati kwa ana okha komanso kwa achikulire omwe ali ndi ADHD. Kafukufuku wamtsogolo wamagulu akuluakulu azachipatala amafunikira kuti apereke zambiri zokhudzana ndi kuchuluka. Ma ISS odulira pofotokozera vuto kapena kugwiritsa ntchito njira zofalitsa nkhani amadziwika kuti amakhazikika kwambiri chifukwa cha chikhalidwe. Chifukwa chake, zikuwoneka zomveka kuganiza kuti kuchuluka kwa IUD pakati pa achikulire omwe amapezeka ndi ADHD.

ADHD - Zinthu zoyeserera ndi kukonza

Pankhani yolimbikitsira yogwiritsidwa ntchito ndi atolankhani odwala omwe ali ndi ADHD, tidapeza mawonekedwe. Cholinga chachikulu mwa odwala a ADHD kusewera masewera a vidiyo chinali kupumula. Zachidziwikire, izi sizoyambira zokha, koma chidwi chake popeza cholinga ichi chinalipo kwambiri mkati mwa odwala omwe amapezeka ndi ADHD poyerekeza ndi magulu ena onse. Kuchokera pamalingaliro azachilengedwe, ndizodziwika bwino kuti ADHD imalumikizidwa ndi ntchito yochepa ya dopamine (Friedel et al., 2007; Golide, Blum, Oscar-Berman, & Braverman, 2014; Volkow et al., 2009). Monga kusewera masewera a video kwalumikizidwa ndi striatal dopamine kumasulidwa (Koepp et al., 1998) Masewera amatha kutanthauziridwa ngati njira yodzipulumutsira tokha pochepetsa mpumulo. Lingaliro lodziziritsa lokha lathandizidwanso kuti lifotokozere kuchuluka kwakukwera kwa vuto la kugwiritsa ntchito mankhwala pakati pa anthu omwe ali ndi ADHD (mwachidule, onani. Biederman et al., 1995). Chifukwa chake, apa, cholinga chomwe chanenedwa chogwiritsa ntchito masewera apakanema kuti mupumule chikhoza kutanthauziridwa ngati kukhudzidwa kwa kutulutsa kwa dopamine mukamasewera. Popeza mabuku owerengeka omwe ali m'magulu akuluakulu a ADHD odwala ndi ochepa, lingaliro ili limakhalabe lalingaliro. Pa mulingo wa kulumikizana, tapeza mayanjano ofunikira pakati pa WURS-k ndi nthawi yogwiritsira ntchito media. Kuphatikiza pakati pa WURS-k ndi kugwiritsa ntchito masewera a kanema mu maora sikunali kofunikira koma komabe. Apa, kukula kochepa pang'ono komanso kukula kwa kufunika komwe kukadatha kuteteza kufunika. Komabe, maubwenzi apamwamba awa ndiwokondweretsa popeza pali umboni wina wosonyeza kuti ziwonetsero za ADHD zomwe zimanenedweratu zimayenderana ndi zotsatira zenizeni za machitidwe osokoneza. Pa zitsanzo zazikulu, zachinyamata za achinyamata, Kollins, McClernon, ndi Fuemmeler (2005) adapeza chiyanjano chofunikira kwambiri pakati pa zomwe zidafotokozedwa kale za ADHD mkati mwa zaka 5-12 ndi kuchuluka kwa ndudu zomwe zimasuta tsiku lililonse. Mwatsatanetsatane, kuchuluka kwa zisonyezo zosatsatiridwa bwino komwe kumachitika ndi kuchuluka kwa ndudu patsiku. Apa, tikuwona mzere wina wotembenukira ku data yathu, yomwe ingalimbikitse lingaliro lakudzidzimutsa.

Kuzindikira kawiri - ADHD ndi IUD

Pakati pagulu laling'ono la odwala omwe adawonetsa zovuta ku ma pathological ku ISS ndi kuchuluka kwakuwoneka kwambiri pamiyeso ya CAARS ADHD, tidapeza kulumikizana mwamphamvu komanso kwakuya pakati pa WURS-k ndi ISS. Ubalewu unasiyanitsa gawo ili kuchokera kumagulu azachipatala omwe amapezeka ndi ADHD kapena IUD, pomwe ubale womwewo unali wofooka. Kupeza kumeneku kungalimbikitsenso kufunikira kwa ADHD yaubwana kukhala chiwonetsero cha kuyambika ndi kukula kwa IUD.

Mphamvu ndi malire

Izi ndizachidziwikire chathu, kafukufuku woyamba kuti apereke kafukufuku waposachedwa kuyerekeza zitsanzo za odwala omwe adapezeka ndi ADHD ndi IUD (ndi zowongolera zawo) ndikupereka umboni wina wothandizirana ndikuthandizira kufufuza kwina pankhaniyi. Kafukufukuyu adagwiritsa ntchito njira yokwanira yama psychometrical and clinical, yomwe idagwira ntchito zosiyanasiyana zosinthika komanso zida zokhazikitsidwa bwino zomwe zimalimbikitsa magulu angapo achidwi potipatsa mwayi wofufuza ndikuwunika mayanjano angapo. Popeza ili ndi gawo laling'ono, sitingapangire zonena za mabungwe omwe tidapeza. Monga ADHD nthawi zambiri imayamba pa 7, ikhoza kulingaliridwa ngati ena mwa mabungwe omwe amapezawa akukhudzana ndi zizindikiro za ADHD. Komabe, izi sizingasinthe mawonekedwe apakatikati, omwe ndi ofunikira pakufufuza ndikuwunika kusokoneza pakati pa ADHD ndi IUD. Chinanso chomwe chimalepheretsa kumasulira kwathu chinali zitsanzo zazing'ono pang'ono chifukwa cha kusowa kwa deta. Kuphatikiza apo, zovuta za matenda azachipatala za ADHD ndi odwala IUD sizinagwiritsidwe ntchito mosemphanitsa, zomwe zimakhala zovuta chifukwa zotsatira za mafunso omwe amadzidziwitsa sizikusonyeza kuti ali ndi vutoli. Chifukwa chake, zomwe tapeza zikuyenera kutanthauziridwa mosamala mpaka kukhala zobwerezedwanso m'mafanizo akulu. Pomaliza, gulu la ADHD linali lakale kuposa gulu la IUD, ngakhale kuti kusiyana kwamanambala kunali kopanda tanthauzo. Popeza kugwiritsa ntchito njira zamagetsi zikuchulukirachulukira pakati pa mibadwo ing'onoing'ono, gulu lakale la ADHD silingakhale loyimira molingana ndi kugwiritsa ntchito kwawo intaneti. Komabe, kafukufuku wathu akuwonetsa kuti kugwiritsa ntchito intaneti yamavuto komanso yamavuto kutha kupezeka pakati pa achikulire omwe sangathe kuwonetsedwa pa intaneti kuyambira zaka zawo zoyambira. Ngati kuwonekera kwakanthawi kofulumira kukuyenera kuyenderana ndi chitukuko cha ADHD, zotsatira zathu zitha kuwoneka ngati kuwunika kotsimikizika kagwiritsidwe kazomwe tili mu zitsanzo za ADHD.

Zokhudza matenda ndi zasayansi

Kuchokera pamawonedwe azachipatala komanso chifukwa chokwezeka kwamankhwala otsekemera, odwala omwe ali ndi IUD amayenera kuyesedwa kwa ADHD pamene zizindikiro zake zikuwoneka. Odwala omwe ali ndi ADHD amayenera kugwiritsa ntchito masewera ochezera a pa intaneti komanso mavidiyo ngati njira yodzitetezera. Monga njira yodziwira chithandizo, Park, Lee, ndi Han (2016) ikhoza kuwonetsa kuti mankhwala a 12-sabata omwe ali ndi atomoxetine kapena MPH atha kuchepetsa kuuma kwa IGD, yomwe idalumikizidwa ndikuchepetsa. Chifukwa chake, njira zamankhwala komanso zamaganizidwe othandizira kuchepetsa kusasamala, kuchepa kwa chidwi, ndi kusakhazikika mwina ndi njira yolimbikitsira kwambiri mpaka pano. Monga odwala omwe ali ndi ADHD nthawi zambiri amakhala ndi chiopsezo chambiri chokhala ndi zizolowezi zina, madokotala ayenera kudziwa kusinthika kwa chizolowezi chomwa mankhwalawa nthawi yonse yomwe amathandizidwira. Kumbali ina, sizingatheke kunena kuti kugwiritsa ntchito kwambiri media mwaubwana kungakhale chifukwa pakati pa ena, omwe angayambitse kapena kukulitsa chizindikiro cha ADHD.

Mawuwo

Tidapeza chithandiziro choganiza kuti kugwiritsa ntchito kwambiri kapena kugwiritsa ntchito media media pakati pa odwala omwe ali ndi ADHD ndi / kapena IUD alidi mbali yodziwika komanso yofunika kwambiri ya patological ndipo iyenera kuthandizidwa mokwanira pakukonzekera chithandizo. Mwa odwala, masewera a makanema akuwoneka ngati chida chothandiza kuthana ndi vuto la kusowa kwa malingaliro, pomwe intaneti imagwiritsidwa ntchito pazifukwa izi komanso pakati pa anthu athanzi. Izi ndizomwe zimachitika pakati pa odwala omwe ali ndi ADHD omwe amagwiritsa ntchito masewera apakanema kuti apumule pamlingo wamphamvu, womwe ungachitike chifukwa cha kuchepa kwawo pantchito ya dopamine. Popeza mitengo ya comorbidity ndiyodabwitsa, kafukufuku wamtsogolo akuyenera kuwunika momwe mavuto onse amakhudzidwira ndipo chifukwa chake akuyenera kugwiritsa ntchito mapangidwe azitali makamaka muzipatala ndi achikulire. Othandizira azachipatala ayenera kudziwa za ubale wapakati pa zovuta zonse ziwiri, pazozindikira komanso zithandizo. Mfundo zokhazikitsidwa bwino mu chithandizo cha ADHD zitha kugwiritsidwanso ntchito pochiza odwala a IUD. Komanso, zikafikanso pakawongolera ogwiritsa ntchito intaneti munthawi yonse ya chithandizo komanso kukonza, kusinthaku kwa chizolowezi kuyenera kukumbukiridwa kumbali ya akatswiri ndi odwala.

Zopereka za olemba

BTW: wofufuza wamkulu; MB: kusanthula deta ndi wolemba woyamba; MD ndi IP: mayeso pa odwala omwe ali ndi IUD; MR ndi MO: mayeso pa odwala omwe ali ndi ADHD; LB, TS, JD-H, GRS, ndi AM: coauthors ndiukadaulo pa IUD.

Kusamvana kwa chidwi

Olembawo amanena kuti palibe kutsutsana kwa chidwi.

Zothandizira