Aust NZJ Psychiatry. 2018 Apr 1: 4867418771189. pitani: 10.1177 / 0004867418771189.
Mfumu DL1, Delfabbro PH1, Potenza MN2, Demetrovics Z3, Billieux J4, Chizindikiro M5.
Posachedwa ANZJP pepala, Dullur ndi Starcevic (2018) Amanena kuti vuto la masewera a pa intaneti (IGD) sayenera kukhala vuto la kusokonezeka kwa malingaliro. Amayika izi pamalingaliro angapo, kuphatikiza lingaliro loti IGD siyigwirizana ndi vuto la kusokonezeka kwa malingaliro, kuti IGD ikhoza kufalitsa masewerawa abwinobwino, kuti mtundu wokondwerera wamasewera ndiwosocheretsa ndikuti kuwunika sikofunikira pazithandizo. Mu pepala ili, tikuwunika kofunikira pa zomwe olemba adalemba. Ngakhale pali mbali zina za malingaliro awo zomwe timachirikiza, pali zambiri zomwe sitimagwirizana nazo. Tikhulupirira kuti malingaliro awo angagwire ntchito pazikhalidwe zina ndipo atha kupeputsa kuvomerezeka kwawo, kuphatikiza pa vuto la kutchova juga.
Gulu la IGD limatengera umboni wa kafukufuku ndi zenizeni zamankhwala
Dullur ndi Starcevic (2018) Nenani kuti pali kusowa kwa mgwirizano pa zomwe zimapangitsa kuti masewerawa azikhala ovuta. Ngakhale zili zoona kuti akatswiri ena amatsutsana za kuvomerezeka kwa IGD, munthu sayenera kuyembekezera a mgwirizano wonse chifukwa izi ndizosatheka mu gawo lililonse la sayansi, ndipo motsutsa sizinapezeke chifukwa cha kusokonezeka kwa malingaliro kulikonse. Olembawo akuti IGD imatanthauzidwa ndi kuwonongeka kwa magwiridwe antchito ndipo amati chikhazikitso chokha sichingawonetse kusokonezeka kwa malingaliro. Komabe, izi zimanyalanyaza mfundo yakuti Kusanthula ndi Buku Lophatikiza la Mavuto a Mitsempha (5th ed.; DSM-5) ndi Mitundu Yonse ya Matenda, Makina a 11th Revision (ICD-11) yokhudza masewera a masewera (GD) onsewa amatanthauzanso lingaliro lofunika la 'kutayika kwa kuwongolera' kuwonjezera pazowunikira komanso kulingalira kwina. Olembawo akuti palibe tanthauzo 'logwirizana', koma IGD mu Gawo lachitatu la DSM-5 ndi GD ku ICD-11 amagawana zofotokozera za masewera osasunthika, kuwongolera kosawongolera komanso kusokonekera kwa magwiridwe ntchito m'malo ambiri amoyo.
Otsutsa a IGD nthawi zambiri amakopa chidwi pazomwe siziri zokomera ena komanso zopanda mayesero, poyerekeza ndi kukula kwa ntchito yolimba yomwe imathandizira kuvomerezeka kwa vutoli. Magulu azidziwitso a IGD ndi GD adapangidwa mosamala kuti agwire zowona zenizeni za anthu omwe akufuna chithandizo cha zovuta zawo zokhudzana ndi masewera. Kusankhidwa kulikonse kumawonetsa malingaliro ambiri othandizira pakati pa ofufuza komanso ochita zamatsenga ndi akatswiri amisala omwe amazindikira (1) zovuta zomwe zimagwirizanitsidwa ndi masewera kwambiri ndi (2) monga masewera osokoneza bongo.
IGD siziwonetsa kapena kusokoneza masewerawa abwinobwino
Dullur ndi Starcevic amatsimikizira kuti magulu a IGD / GD amakhala ndi chiwopsezo cha masewera olimbitsa thupi, ndipo amatanthauza mapindu osiyanasiyana amasewera. Ngakhale tikuvomereza kuti bala iyenera kukhala yokwezeka kwambiri kuti tisawonere zochitika zamasewera ngati zosangalatsa, tikukhulupirira kuti mapindu omwe adatsimikizidwa pamasewera samathandiza kwenikweni pa IGD. Choyamba, zina mwazabwino izi zitha kupitilizidwa Sala et al., 2018). Chachiwiri, ndi mfundo zomwezi, munthu akhoza kunena kuti vuto la kudya kapena nkhawa zam'mimba siziyenera kuganiziridwa kuti ndizoopa kusokoneza nkhawa zilizonse zomwe zimachitika kapena kudya. Monga momwe ziliri ndi kutchova juga, munthu sayenera kukana kukhalapo kwa vuto la kutchova njuga chifukwa anthu ambiri amatenga nawo mbali pazosangalatsa komanso zosavuta.
ICD-11 ndi DSM-5 sanena kuti kusewera masewera olimbitsa thupi ndivulidwe, komanso satero kuti masewera nthawi zambiri amakhala oopsa kapena osavulaza. Timagwirizana ndi Dullur ndi Starcevic kuti malire pakati pa 'kutanganidwa kwakukulu' ndi 'kugwiritsa ntchito zovuta' ndi 'osasangalatsa'. Pakhala pali maphunziro ena okayikira omwe amagwiritsa ntchito njira zosafunikira zowunikira (ndipo palinso zida zabwino kwambiri, monga Lemmens et al.'s (2015)Mulingo wa Kusokoneza Masewera pa intaneti), umboni woterewu suyenera kugwiritsidwa ntchito poyipitsa kuchuluka kwa umboni wosinthika womwe ukugwiritsidwa ntchito kuthandizira malangizo a DSM-5 kapena ICD-11 kapena zowonera za asing'anga omwe akumana ndi milandu yambiri ya IGD. Umboni wokhudza kukula komanso kuchuluka kwa mayendedwe nthawi zambiri kumawunikidwa molumikizana ndi kuwunika kwa zinthu zina zowonongeka ndi umboni wa kuwongolera kwamphamvu pamasewera, zomwe sizingafanane ndi masewera wamba. Kutengera ndi kuchuluka kwa umboni, wazachipatala wodziwa bwino ayenera kukhala wokhoza kusiyanitsa pakati pa masewera amtundu wa 'wamba' ndi IGD. Chiwopsezo chomwe sichingaganizidwe komanso chosatheka cha IGD misdiagnosis sichiyenera kuchitika pamwamba pa zosowa zowonekera za anthu omwe akufuna chithandizo cha zovuta zokhudzana ndi masewera.
Kuzindikira kwa IGD kumalimbikitsa kukula kumadera oyeserera ndi chithandizo
Tikugwirizana ndi Dullur ndi Starcevic kuti masewera amtunduwu ndiwopambana komanso kuti zina mwazomwe zimapangitsa kuti zisinthe (mwachitsanzo kuchotsedwa) sizingafanane bwino ndi zomwe akumana nazo pamasewera. Mwachitsanzo, ndizovuta, conceptualise 'kulolerana' pa ntchito pomwe sizikumveka kawirikawiri pazomwe wogwiritsa ntchito angaletse; Kodi osewera amafunikira nthawi yowonjezereka kapena china? (Mfumu ndi al., 2018). IGD ingafune kukonzanso, koma zingakhale zopanda pake kutsatira kutsatira kwa olemba kuti aleke gulu lonse mokomera kugwiritsa ntchito njira zotsimikizira kuti ali ndi vuto pamasewera olakwika. Izi zitha kubweretsa chisokonezo chochulukirapo, zopinga zina za mankhwala komanso cholepheretsa kafukufuku wosankha pofotokozera tanthauzo lomwe lingagwiritsidwe ntchito kuzikhalidwe ndi maphunziro onse.
Otsutsa IGD amalepheretsa mwayi wopezeka mu ntchito zamasewera ovuta
Ena otsutsa amaoneka ngati kutsutsa IGD pomwe akufalitsa kafukufukuyu zogwiriziza kufunikira kwamasewera pamasewera ovuta. Mwachitsanzo, wolemba woyamba wa pepala lomwe tidayankha posachedwapa wafalitsa kafukufuku wa malingaliro a 289 a psychiatrists pa IGD. Adanenanso kuti ambiri amathandizira IGD ngati vuto la thanzi lam'mutu ndipo amamva kuti sangathe kuthana ndi vutoli (Dullur ndi Hay, 2017). Zinatsimikizika kuti zida za IGD 'zowunikira ndi ma protocol ziyenera kupangidwa kuti zithandizire kuzindikira matenda oyamba ndi ntchito za mapulani' (p. 144). Malingaliro awiriwa akuwoneka kuti akutsutsana: Chifukwa chiyani muyenera kupanga chida chowunika ndi protocol ngati wina akutsutsa chisokonezo? Kodi IGD yotsutsa imapereka bwanji udindo wawo ndikuyang'ana patsogolo pa kafukufuku ndi ndalama, komanso zabwino za iwo omwe akufunika thandizo mwachangu?
Momwemo, sitimagwirizana ndi malingaliro akuti kudziwika kwa IGD sikofunikira 'kwa ochita masewera kufunafuna ndi kulandira thandizo. Ngakhale ena amatha kukhala ndi ntchito zapagulu za IGD, zosankha zotere sizingakhale zovuta kwa ambiri. M'mikhalidwe yambiri, kufikira kuchipatala wophunzitsidwa bwino mankhwala ochiritsira (mwachitsanzo, njira yayikulu yochitira umboni ya IGD) amafunika inshuwaransi yazaumoyo yomwe imafunikira matenda. Zachipatala zapadera kapena ntchito sizingakhalepo popanda gulu.
Maganizo otseka
Apa, tangolankhula mwachidule zina mwazinthu zathu zosagwirizana. Komabe, kuwunika kokwanira kukusonyeza kuti, monga momwe ziliri m'dera la juga, pali chidziwitso chothandizika komanso chachipatala chothandizira kusiyanitsa IGD kuchokera ku masewera olimbitsa thupi nthawi zonse. Zovuta zomwe zimadziwika ndikumasewera mopitirira muyeso zimaphatikizapo nkhawa komanso kukhumudwa, kudzipatula pagulu, kulumikizana kusukulu, kusowa ntchito komanso kusokonekera kwa ubale. Zotsatira za Epidemiological zikuwonetsa kuti pafupifupi 1% ya anthu akhoza kukwaniritsa njira zowunikira za IGD. Kuzungulira dziko lotukuka, kufunikira kwa ntchito za akatswiri ndikofunikira ndipo nthawi zambiri sikunakwaniritse. Zatsopano zamasewera zatsopano zikulowera mumsika mothandizidwa ndi makampani opanga madola mabiliyoni zana omwe sazindikira udindo wake wovomerezeka kapena kuvomereza kukhalapo kwa mavuto okhudzana ndi masewera, maboma ambiri chimodzimodzi samathandizira kufufuza, kupewa komanso chithandizo chamankhwala (Potenza et al., 2018). Ophunzira sayenera kunyalanyaza nawonso mavuto.
Zothandizira
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