Kuyerekeza kwa Zizindikiro za Psychological ndi Serum Levels of Neurotransmitters ku Shanghai Adolescents ndi popanda Internet Addiction Disorder: A Case-Control Study (2013)

PLoS One. 2013 May 3; 8 (5): e63089. yani: 10.1371 / journal.pone.0063089.

Zhang HX, Jiang WQ, Lin ZG, Du YS, Vance A.

gwero

Dipatimenti ya Zamasamba Mankhwala, Chipatala cha Zhongshan, Yunivesite ya Fudan, Shanghai, China.

Kudalirika

Background

Vuto lolephera kugwiritsa ntchito intaneti, (IAD) tsopano ladziwika padziko lonse lapansi ndipo limadziwika kuti limagwirizanitsidwa ndi kusokonezeka kwamaphunziro komanso chikhalidwe. Mpaka pano, tikudziwa zochepa zokhudzana ndi chilengedwe. Kafukufukuyu cholinga chake chinali kuphatikiza gulu la achinyamata omwe ali ndi vuto la IAD komanso ausinkhu woyenera komanso amuna komanso akazi. Tidawerengera kuti achinyamata omwe ali ndi IAD adzakhala ndi nkhawa zodziwonetsa komanso zofooketsa, asintha kuchuluka kwa zotumphukira zamagazi dopamine, norepinephrine ndi serotonin. Kuphatikiza apo, ife tidaganizira nthawi yomwe maola omwe amagwiritsidwa ntchito pa intaneti amagwirizanitsidwa ndi kuwonongeka kwa nkhawa komanso nkhawa pakati pa achinyamata awa omwe ali ndi IAD.

Njira / Kupeza Kwambiri

Kafukufuku wophatikizidwa wa achinyamata a 20 omwe anakwaniritsa zomwe Beard amafunikira IAD ndi 15 zomwe zikukula bwino achinyamata (gulu lofananiza) zidachitika. Onse omwe adatenga nawo gawo adakwaniritsa gawo la Self Rating Depression Scale (SDS), Self Rating Anxcare Scale (SAS), ndi Screen for Ana Anxiety Related Emotional Dis shida (SCARED). Mwazi wamagazi dopamine, serotonin ndi norepinephrine anayesedwa. Norepinephrine yodalirika inali yochepa mu gulu la IAD kuposa momwe anthu ambiri omwe akulikulira, pamene dopamine ndi serotonin sizinali zosiyana. Masewera a SDS, SAS ndi SCARED anawonjezeka kwa achinyamata ndi IAD. Kafukufuku wodzitetezera mwachinsinsi umasonyeza kuti chiwerengero chapamwamba cha SAS ndi chiwerengero cha norepinephrine chochepa chinaneneratu kuti ndi gulu la IAD. Panalibe kusiyana kwakukulu pakati pa maola ogwiritsira ntchito pa intaneti ndi ma SAS / SDS ambiri mu gulu la IAD.

Mapeto / Kufunika

Kuchulukitsa kwakudzitcha kwanu komanso kuchepa kwa magazi kwa magazi norepinephrine kumalumikizidwa mosavomerezeka ndi IAD.

Ndemanga: Zhang HX, Jiang WQ, Lin ZG, Du YS, Vance A (2013) Kufananiza kwa Zizindikiro Za Psychological ndi Ma Serum Levels a Neurotransmitters ku Shanghai Adolescents omwe alibe komanso osokoneza bongo pa intaneti. PloS ONE 8 (5): e63089. doi: 10.1371 / journal.pone.0063089

Editor: Jerson Laks, Federal University ya Rio de Janeiro, Brazil

Zilandiridwa: December 31, 2012; Zavomerezedwa: March 27, 2013; Lofalitsidwa: Mwina 3, 2013

Copyright: © 2013 Zhang et al. Ichi ndi cholembera chotseguka chomwe chimaperekedwa pansi pa lamulo la Creative Commons Attribution License, chololeza kugwiritsa ntchito mosagwirizana, kufalitsa, komanso kubereka mwanjira ina iliyonse, kupatula wolemba woyambayo ndi komwe adadziwika.

Ngongole: Ntchitoyi idathandizidwa ndi zopereka kuchokera ku dziko la "11th zaka zisanu" zomwe zathandizira projekiti ndiukadaulo ku China, gulu (2007BAI17B03). Wothandizira ndalama alibe udindo wopanga zolemba, kusanjedza ndi kusanthula, kusankha kufalitsa, kapena kukonza zolembedwazo. Webusayiti ya Ministry of Science and Technology of the People's Republic of China ili motere: http://www.most.gov.cn/.

Zofuna zokakamiza: Olembawo adanena kuti palibe zotsutsana.

Introduction

Mavuto osokoneza bongo pa intaneti (IAD) abwera chifukwa cha kutchuka kwa intaneti: Zowonadi zake zikuwoneka kuti zikuwonjezeka m'mayiko otukuka ndi otukuka [1]-[3]. Zowonongeka pantchito m'maphunziro, chikhalidwe, mabanja ndintchito zalembedwa ndikugwirizanitsidwa ndi IAD [2], [4]. Zina zomwe zathandizidwa monga zaka zazing'ono zogwiritsira ntchito intaneti, nkhawa zowonjezereka komanso kuwonjezeka kwa zovuta ndi / kapena zovuta [5]-[7]: kuchuluka kwambiri pa Beck Depression Inventory (BDI) [6] kapena Center for Epidemiological Study Depression Scale (CES-D) [7] zimalumikizidwa ndi IAD. Kupitilira apo, zovuta zapamwamba zamagetsi zakhala zikuchitika pa Mafunso ndi Mphamvu Zovuta, kuchuluka kwa nkhawa komanso kuchuluka kwa malingaliro odzipha zanenedwapo mwa achinyamata omwe ali ndi IAD [8]-[10].

Pakadali pano, zinthu zazikulu zokhudzana ndi IAD sizikudziwika bwinobwino [6]. Lzinthu za ikely zimaphatikizira kusowa kwa magwiridwe antchito a dopamine (DA), serotonin (5-HT), ndi / kapena norepinephrine (NE), omwe amalumikizidwa ndi kuyambika kwa vuto la nkhawa komanso nkhawa monga momwe zilili ndi kusalinganika kwa serotonin ndi norepinephrine neuronal axon kusinthika [11]-[15]. Kupitilira apo, kuchepa kwapadera kwa ntchito ya serotonin kwalumikizidwa ndi vuto lalikulu la kukhumudwa ndipo kungakhale kovuta ku IAD [16]. Tidawerengera kuti achinyamata omwe ali ndi IAD angakhale ndi nkhawa zambiri zodzifotokoza komanso zosokoneza ndikusintha kwa zotumphukira zamagazi dopamine, norepinephrine ndi serotonin.

Tonioni et al. [17] tazindikira ubale pakati pa maola omwe amagwiritsidwa ntchito pa intaneti komanso kuchepa kwa nkhawa / nkhawa, omwe timawerengera nthawi yomwe timagwiritsa ntchito pa intaneti titha kuphatikizidwanso ndi kuchuluka kwa SAS / SDS pakati pa achinyamata omwe ali ndi IAD.

Zida ndi njira

ophunzira

Ophunzira a 20 achinyamata pa IAD, malinga ndi momwe Beard amafotokozera [17], adalembetsa kuchokera ku dipatimenti yopanga maofesi a Shanghai Mental Health Center ku Shanghai Jiao Tong University School of Medicine kuyambira Julayi 2008 mpaka Januwale 2010. Ophunzirawa anali kukhala pafupifupi maola pafupifupi 33.8 (16.8) pa sabata kugwiritsa ntchito intaneti. THei anali otanganidwa ndi intaneti (poganiza zomwe zachitika pa intaneti kapena kuyembekezera gawo lawo lotsatira la intaneti); Kufunika kugwiritsa ntchito intaneti poonjezera nthawi yayitali; osakhoza kudziletsa, kudula pang'ono, kapena kusiya kugwiritsa ntchito intaneti; osakhazikika, amiseche, okhumudwa, komanso / kapena kukwiyitsidwa pamene kugwiritsa ntchito intaneti kudadulidwa kapena kuyimitsidwa; ndi kukhala pa intaneti kwa nthawi yayitali kuposa momwe anafunira poyamba. inen Komanso, adawonetsera chimodzi mwazizindikiro zitatu zotsatirazi: adayika pachiwopsezo cha kutayika kwa ubale wofunikira, ntchito, maphunziro kapena mwayi pantchito chifukwa chogwiritsa ntchito intaneti; kunamizira anthu am'banja kapena ena kuti abise momwe amagwiritsira ntchito intaneti; komanso / kapena wogwiritsa ntchito intaneti ngati njira yothawira ku mavuto kapena kuthana ndi mavuto. Amawoneka ngati opunduka ngati adachita bwino maphunziro, kuwonetsa kukana kusukulu komanso / kapena kulangidwa ndi oyang'anira (aphunzitsi ndi / kapena makolo) chifukwa chogwiritsa ntchito kwambiri intaneti. Ophunzira adasiyidwa ngati ali ndi umboni wa matenda aliwonse a comorbid, matenda omwe adakhalapo amisala ndipo / kapena amamwa mankhwala aliwonse a psychoactive.

Kawirikawiri opanga achinyamata odzipereka, ofanana ndi zaka ndi jenda, ochokera kumudzi womwewo (sukulu yapakati ku Shanghai) popanda zovuta zamankhwala kapena zamisala, mowa ndi / kapena kugwiritsa ntchito mankhwala adalembedwa ngati ochita masewera olimbitsa thupi. Chilolezo chodziwikiratu chidapezeka kuchokera kwa onse omwe akutenga nawo mbali ndi omwe amawasamalira mwalamulo. Panali anyamata a 18 ndi atsikana a 2 (kutanthauza zaka za 16.8 ± 1.8 zaka) m'gulu la IAD ndi anyamata a 13 ndi atsikana a 2 (kutanthauza zaka za 18.1 ± 2.7 zaka) pagulu lomwe limakula.

Chikhalidwe

Phunziroli linali gawo la kafukufuku wamkulu yemwe amayang'ana kwambiri zovuta za machitidwe a achinyamata. Izi zidavomerezedwa ndi Institute Review Board of Shanghai Mental Health Center. Phunziroli linkachitika ku Shanghai kokha, osati kunja kwa China. Ophunzira ndi oteteza ovomerezeka adapita ku Shanghai Mental Health Center ku Shanghai Jiao Tong University School of Medicine mgawo la maola awiri popumira. Kuvomerezedwa kodziwitsa kunapezeka kumapeto kwa gawoli, atayesedwa mayeso momveka bwino kwa otenga nawo mbali ndi owasamalira mwalamulo.

Njira

Mafunso a Beard a Diagnostic Pazowonjezera pa Intaneti [18]: Zinthu za 8 zonse, zokhala ndi dichotomous (Inde / Ayi) sikelo. IAD imadziwika ngati zinthu zonse zoyambirira za 5 zikumana ndi chimodzi mwazinthu zingapo za 3 zomwe zidakumana.

Mulingo Wodzikhumudwitsa paokha (SDS) [19]: Zinthu za 20 zokhala ndi miyeso inayi ya Likert. Kulemba kwambiri kumawonetsa zizindikiro zowopsa. Kutsimikizika ndi kudalirika ndizokwanira ku People's Republic of China.

Mulingo Wodzidera Wodandaula [20]: Zinthu za 20 zokhala ndi miyeso inayi ya Likert. Kulemba kwambiri kumawonetsa zizindikiro zazikulu za kuda nkhawa. Kutsimikizika ndi kudalirika ndizokwanira ku People's Republic of China.

Zenera la nkhawa za ana zokhudzana ndi nkhawa (SCARED) [21], [22]: Zinthu za 41 zonse ndizogulitsa ma point atatu a Likert zothandizira zinthu zisanu izi: 'somatic / panic', 'generalized', 'kusiyanitsa nkhawa', 'nkhawa za pagulu' komanso 'sukulu nkhawa'. Akakwera bwino kwambiri, amakhala okwera nkhawa chifukwa chodera nkhawa mwana. Kutsimikizika ndi kudalirika ndizokwanira ku People's Republic of China.

Kuyesa Kwamizimu

Kwa aliyense yemwe akutenga nawo mbali, 5 ml ya magazi a venous adatulutsidwa pogwiritsa ntchito heparin anticoagulation vacuum chubu, osasungidwa nyengo yozizira komanso yopepuka. Miyezo ya DA ndi NE mu seramu imayezedwa pogwiritsa ntchito ELISA (enzyme inalumikiza immuno-sorbent assay), ndipo mulingo wa 5-HT m'mapulogalamu am'mbali am'madzi anayeza ndi HPLC (high performance fluid chromatography).

Kayendesedwe

Ophunzira ndi oteteza anzawo mwalamulo adapita ku Shanghai Mental Health Center ku Shanghai Jiao Tong University School of Medicine. Kuvomerezedwa kodziwitsa kunapezeka. Mayeso onse adayendetsedwa ndi akatswiri olembetsedwa ndipo zidziwitso zomwe zimachokera kwa iwo zidalowa mu database ya kompyuta.

Chiwerengero cha Kusanthula

Zambiri zidasinthidwa pogwiritsa ntchito Statistical Package for Social Sayansi (SPSS), mtundu 16.0 kuti mufanane ndi IAD komanso magulu omwe akutukuka kumene. Zosintha zomwe zimagawidwa nthawi zambiri, zomwe zimafotokozedwa ndi mayeso a Kolmogorov-Smirnov, kapena omwe angasinthidwe kukhala magawidwe wamba amafanizidwa pogwiritsa ntchito zitsanzo zosadziimira t mayeso. Zambiri zopanda parametric zinafanizidwa ndi Mann-Whitney U kuyesa. Ma coefficients a pearson apakanthawi kwakanthawi amawerengera zosintha zomwe zimasiyana pakati pa IAD komanso magulu omwe akutukuka kumene. Komanso, zosinthazi zidalowetsedwa mu kusanthula kwa zinthu zamabizinesi kuti mudziwe zomwe zimasintha molingana ndi gulu la IAD. Kuphatikiza pakati pa maola omwe amagwiritsidwa ntchito pa intaneti komanso kuchuluka kwa SAS / SDS mu gulu la IAD kunatsimikiziridwa ndi Pearson r.

Results

Mulingo wa Monoamine Neurotransmitters ku Plasma

Mulingo wofunika wa NE m'gulu la IAD anali wotsika kuposa omwe anali mu gulu lomwe likutukuka [(345 ± 68) pg / ml ndi (406 ± 76) pg / ml, motsatana, t = 2.515, p = 0.017]. Panalibe kusiyana kwakukulu pamigulu ya DA kapena 5-HT pakati pamagulu awiriwa (Gulu 1).

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Gulu 1. Mlingo wa 5-HT, NE ndi DA ku IAD ndi magulu owongolera.

onetsani: 10.1371 / journal.pone.0063089.t001

Kudzidziwitsa Wokha Zizindikiro

Zambiri za SDS, SAS ndi SCARED mu gulu la IAD zonse zinali zapamwamba kwambiri kuposa zomwe zinali m'gulu lomwe likupanga izi (Gulu 2).

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Gulu 2. Kuyerekezera kwa ambiri omwe adadziwonetsa eni ake adanena zokhudzana ndi IAD ndi magulu owongolera.

onetsani: 10.1371 / journal.pone.0063089.t002

Kuphatikiza kwa Zizindikiro Zamtundu Wathupi ndi NE Level

Makina a Pearson a product-mphindi yolumikizirana kwa IAD komanso magulu omwe akutukuka kumene amakhala pakati pa −0.26 mpaka −0.29 pamlingo wa NE komanso kuchuluka kwa SDS, SAS ndi SCARED (r = −0.263, −0.269 ndi −0.294, motsatana).

Kusanthula kwa Logistic

Zosintha zodziyimira payokha zomwe zidasungidwa pazoyang'anira zinali za NE level ndi SDS, SAS ndi SCARED scores. Age ndi jenda adazindikiranso ngati zosiyananso pawokha. Mitundu iwiri yosiyanasiyana idatsalira mu regression equation: SAS score (V1) ndi NE level (V2) (Gulu 3). Maperesenti olondola anali 80.0% (kuchuluka kwa malingaliro: malowo (P) = −14.729+0.475×V1−0.031×V2).

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Gulu 3. Zotsatira zakuwongolera kwatsatanetsatane kwa kuchuluka kwa NE komanso kuopsa kwa kudzidziwitsa komwe kumadziwika ndi matenda a IAD kapena ayi (achinyamata a 20 omwe ali ndi IAD ndi 15 yolamulira).

onetsani: 10.1371 / journal.pone.0063089.t003

Kusakanika kwa Maola Spent Online ndi Scores of SAS / SDS Pakati pa Achinyamata omwe ali ndi IAD

Pakati pa achinyamata a 20 omwe ali ndi IAD, kuchuluka kwa ma maola omwe amagwiritsidwa ntchito pa intaneti pa sabata sabata iliyonse kuti akwaniritse kuchuluka kwa SAS sikunali kopanda tanthauzo lililonse (r = 0.015, p = 0.955), sichinali chomwecho mpaka pakufika pa SDS (r = 0.015, p = 0.954).

Kukambirana

Kupeza kuti achinyamata omwe ali ndi IAD amakweza nkhawa komanso zizindikiro zofooketsa zimagwirizana ndi ntchito yapita: Bernardi et al. [23] adapeza kuti 30% ya achinyamata omwe ali ndi IAD anali ndi nkhawa yayikulu yamatenda. Kafukufuku wina adazindikira kuyanjana kwakukulu kwa mwayi kwa IAD wokhala ndi zovuta zokhumudwitsa [7], [9], [24], [25] komanso mwayi wokulirapo womwe achinyamata omwe ali ndi matenda ovutitsa amakhala nawo [26], [27]: Chofunika, mayesero athu oyeserera kale adapeza kuti achinyamata omwe ali ndi IAD adasintha nkhawa komanso kukhala ndi nkhawa pambuyo pochita zinthu mozindikira [28].

Chosangalatsa ndichakuti, ngakhale ntchito zosinthika za DA, NE ndi 5-HT zalumikizidwa ndi nkhawa zamatenda komanso zodandaula, tapeza kuti gawo la NE lokha ndi lotsika komanso kudziwonetsa kuti ali ndi nkhawa kwambiri pagulu la IAD poyerekeza ndi gulu lomwe likutukuka. Kupitilira apo, gawo lotsika la NE lidalumikizana pang'ono ndi nkhawa zowonjezereka komanso mawonekedwe okhumudwa.

Chifukwa chake zovuta zamavuto am'maganizo mu achinyamata omwe ali ndi IAD zitha kuphatikizidwa ndi ntchito yosinthika ya monoamine: Komabe, 5-HT ndi DA sizinakhudzidwe, ndikuwonetsa kuti pakhoza kukhala NE yachilengedwe yokhudzana ndi IAD muunyamata. Tanthauzo limodzi mwa izi zitha kukhala kuti dopamine yolimbikitsidwa yolimbitsa thupi siimayenderana ndi IAD, monga momwe mumakhalira mitundu ina [29]. Komabe, popeza NE ndi chipangizo cha metabolic cha DA, kufufuza kwina koyenera ndikofunikira. Zhu et al. [30] taona posachedwa kuti kusintha kwa magazi mu gawo la magazi a NE kungaphatikizidwe ndi chithandizo chokwanira cha IAD komanso zizindikiro zokhudzana ndi nkhawa komanso nkhawa. Apanso, ziyeso zoyesedwa zamtsogolo ndizofunikira.

Ngakhale maphunziro apitawa [17], [31] ndikuwonetsa ubale pakati pa maola omwe amagwiritsidwa ntchito pa intaneti ndi nkhawa / kuchuluka kwa nkhawa, sitinapeze ubale wabwino chotere mu kafukufukuyu. Pofotokozera kusiyana, pakhoza kukhala zinthu zina zoyenera kuphunzitsidwa kupatula malangizo osiyana owunika a malingaliro (SCL-90 m'maphunziro awiri apitawa ndi SAS, SDS pakuphunzira kwathu).

Pali zoperewera zingapo mu kafukufukuyu zomwe zimapangitsa kutanthauzira kwa zotsatira. Choyamba, kukula kwa zitsanzo zazing'ono kumatha kubweretsa kuchuluka kwa mtundu wa 1 ndi 2 zolakwika. Chachiwiri, kuchuluka kwa msambo komanso kugawa kwa akazi achisanzo kumatanthawuza kuti zomwe zachitika pa gawo lachitukuko ndi jenda sizingatheke. Chachitatu, kusowa kwa njira yakutali ikutanthauza kuti palibe cholakwika chilichonse chogwirizana ndi mayanjano ofunikawa. Zowonekeratu, zitsanzo zazitali zazitali za anyamata ndi atsikana, kuyambira paubwana, unyamata ndi uchikulire wachinyamata, wofotokozedwa mosamalitsa pamavuto a IAD ndi ma comorbid ofunikira, omwe amapezeka m'malo ambiri amatha kuthana ndi izi. Kuphatikiza apo, kuwunika kwamtsogolo kwa magulu a NE omwe ayesedwa pakuyesa koyesedwa kwamankhwala ndikofunikira.

Zopereka za Wolemba

Ndinazindikira ndikupanga zoyesazo: WQJ YSD. Adachita izi: WQJ YSD ZGL. Adasanthula data: HXZ AV YSD. Zopangira othandizira / zida / zida zowunikira: WQJ HXZ YSD. Wolemba pepala: HXZ AV.

Zothandizira

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