Kudalirika
Kusokoneza ma circuits olipira ndikuchepetsa machitidwe akuwonetsedwa ngati matenda amiseche pa intaneti (IGD). Kugwira ntchito kwamabanja kumaganiziridwa kuti kumachita gawo lofunikira pakuwongolera zokhudzana ndi mphotho. Tidaganiza kuti achinyamata omwe ali ndi IGD amawonetsa zosokoneza ubale wamabanja, zomwe zimalumikizidwa ndi zochitika muubongo mkati mwa mphotho. Achinyamata a 42 omwe ali ndi IGD yopanda comorbidities ndi 41 zowongolera athanzi adayesedwa kuti agwire ntchito pabanja komanso mayiko azamaganizidwe pogwiritsa ntchito Korea Wechsler Intelligence Scale for Children (K-WISC), mtundu waku Korea waku DuPaul's deficit hyperactivity disorder (ADHD) Rating Scale (K-ARS) , Young Internet Addiction Scale (YIAS), Ana's Depression Inventory (CDI), Beck Anxcare Inventory (BAI), komanso gawo lolumikizana ndi Family Environmental Scale (FES-R). Zochita zamaubongo zimayesedwa kudzera pakupumula kwa boma fMRI. Achinyamata omwe ali ndi IGD adawonetsa kuchuluka kwa K-ARS, BAI, ndi YIAS, koma adachepetsa kuchuluka kwa FES-R ndi FES-cohesion subscale; Zambiri za YIAS zidalumikizidwa molakwika ndi zambiri za FES-R. Kulumikizana kwaubongo kuchokera ku cingate kupita ku striatum kunachepetsedwa, kulumikizidwa bwino ndi ziwerengero za FES-R, komanso zolumikizana molakwika ndi kuuma kwa IGD. Achinyamata omwe ali ndi IGD adawonetsa kusokoneza ubale wamabanja, womwe umalumikizidwa ndi kuopsa kwa vutoli, komanso kusalumikizana pakati pamalipiro.
Introduction
Kusokonezeka kwa Masewera pa intaneti komanso Dongosolo La Mphoto
Ngakhale pamakhala kutsutsana kosalekeza pazomwe zimapangitsa kuti munthu akhale wosuta, matenda, matenda, kapena vuto lodziletsa komanso kuzindikira kwambiri1, kusewera kwambiri pa intaneti tsopano akuti aphatikizidwe (kuvomereza kuti apitirize kuphunzira), monga "vuto la masewera a pa intaneti" (IGD), mu Gawo lachitatu la Diagnostic and Statistical Manual of Mental Disorder (DSM-5)2 komanso "vuto la masewera" (GD), mu International Classification of Diseases (ICD-11)3.
Kafukufuku wochuluka wanena kuti pathophysiology ya IGD imalumikizidwa ndi gawo losokoneza la mphotho ndikuchepetsa kuwongolera kwamakhalidwe4-6. Pakusanthula kwa meta pamaphunziro ogwiritsa ntchito ojambula kwa odwala omwe ali ndi IGD, Zheng Et al.4 adalangiza kuti mphotho ndi oyang'anira oyang'anira amatenga gawo lofunikira pakuwongolera kwa IGD. Wang Et al.5 adanenanso kuti kwa odwala omwe ali ndi IGD, chidwi pakulandila mphotho chimawonjezeka, pomwe kuthana ndi chidwi chochepa kumachepa. Lee Et al.6 adanenanso kuti maphunziro omwe ali mgulu la IGD anali ocheperako kumanja kwa anterior cingate (ACC) komanso kumayendedwe olondola a orbitofrontal (OFC) kuposa omwe amayang'anira bwino. Kuphatikiza apo, wowonda wakumanja wakumanja kwa OFC mgulu la IGD adalumikizidwa ndi chidwi chachikulu.
Kugwira Ntchito kwa Banja ndi Dongosolo La Mphoto
Kukonzekera mphotho kumatha kusinthidwa m'matenda osiyanasiyana amisala, kuphatikiza matenda osokoneza bongo komanso kuchepa kwa chidwi cha kuchepa kwa chidwi (ADHD)7,8. Dera la mphotho limakhala ndi striatum, yomwe imapangidwa ndi phata la lentiform ndi phata la caudate, ndi ma cortromedial pre mbeleal cortices kuphatikiza OFC ndi ACC9,10. Kusagwirizana pakati pa striatum ndi ventromedial preortal cortices kumalumikizidwa ndi ma psychopathologies osiyanasiyana11. Mwachitsanzo, mawonekedwe amachitidwe kusiyanasiyana mkati mwa striatum amatha kutengera gawo lakukonzekera mphotho, monga kusachita bwino pakulindirira mphotho komanso kusachita bwino pakubereka12.
Mgwirizano wabanja komanso kulumikizana kwa mayi ndi mwana monga cholumikizira kumatha kutenga gawo lofunikira pakulandirira mphotho13,14. Mitundu yolumikizana ndi ana yakhala ikugwirizanitsidwa kwambiri ndi mgwirizano wamabanja15. Kuznetsova16 mgwirizano wamabanja umatha kuletsa zovuta zoyipa zakupindulira pakunja, pomwe Holz Et al.13 adanenanso kuti chisamaliro choyambirira cha amayi chitha kuteteza mavuto m'banja pa psychopathology yolumikizidwa ndi oyendetsa mphotho, monga ADHD. Pauli-Pott Et al.14 adanenanso kuti kuyankha bwino kwa amayi ndi chidwi chawo zitha kuneneratu za kukula kwa kuwongolera kokhudzana ndi mphotho mwa ana.
Kugwiritsa Ntchito Banja Kusokonezeka Kwamasewera pa intaneti
Kugwira ntchito kwamabanja kumadziwika kuti ndi chimodzi mwazinthu zofunika kwambiri zomwe zimapangitsa kuti azichita masewera olimbitsa thupi komanso kuchitapo kanthu pazomwe zimachitika pa intaneti.17. Kafukufuku wochuluka wanena kuti kugwira ntchito kwa banja monga mgwirizano kungakhale chinthu chofunikira kwambiri pa chidziwitso cha IGD18,19. Powunikira mwatsatanetsatane zomwe zimachitika pabanja pamavuto azachinyamata pa intaneti, Schneider Et al.20 adanenanso kuti maubwenzi osavomerezeka a kholo ndi mwana amalumikizidwa ndi kuuma kwa IGD, ndikuti maubale abwino atha kuyimira china choteteza kufalikira kwa IGD. Chiu Et al.21 adapeza kuti mabanja abwino akugwira ntchito ngati chinthu choteteza pamasewera ovuta ku Taiwan. Liu Et al.22 amagwiritsa ntchito mankhwala am'magulu angapo kwa achinyamata omwe ali ndi vuto losokoneza bongo la intaneti (kuphatikiza IGD). Mayi Torres-Rodríguez Et al.23 adaphatikizanso gawo lolowererapo pabanja m'ndondomeko yawo yothandizira IGD, ndi zotsatira zoyendetsa bwino. Han Et al.24 adagwiritsa ntchito chidziwitso chazidziwitso (CBT) chothandizidwa ndi zinthu zochiritsira mabanja ku IGD ndikuwonetsa zotsatira zabwino. González-Bueso Et al.25 adanenanso kuti magulu a IGD omwe amalandila CBT popanda maphunziro a makolo adawonetsa kuchuluka kwa omwe amasiya kuchipatala kuposa omwe amalandira CBT ndi psychoeducation ya makolo.
Hypothesis
Tidaganiza kuti odwala omwe ali ndi IGD adawonetsa zosokoneza ubale wawo, poyerekeza ndi maphunziro olamulira bwino. Kuphatikiza apo, timayembekezera kuti machitidwe am'banja amtunduwu amatha kuphatikizidwa ndi zochitika muubongo mkati mwa mphotho ya odwala omwe ali ndi IGD.
Njira
ophunzira
Achinyamata omwe ali ndi IGD koma opanda zovuta zina zamagulu amisala adalembedwa kuchokera pagulu la achinyamata 215 omwe adapita ku Online Clinic and Research Center (OCRC) ku Chung Ang University Hospital pakati pa Januware 2015 ndi Disembala 2018. Mwa achinyamata onse 215 omwe ali ndi zovuta pamasewera pa intaneti, 106 Odwala omwe ali ndi IGD amapezeka kuti ali ndi ADHD ndi IGD, 15 ali ndi ADHD ndimatenda akulu okhumudwitsa (MDD) ndi IGD, 42 omwe ali ndi MDD ndi IGD, ndi 10 omwe ali ndi IGD ndi zovuta zina. Chiwerengero cha odwala omwe ali ndi IGD yokha (yoyera IGD) anali 42. Chifukwa onse odwala omwe adalembedwa anali amuna, tidalemba anyamata achikulire ofanana ndi zaka 41 ngati maphunziro owongolera, kudzera pazotsatsa ku dipatimenti yochira kunja kwa Chung Ang University Hospital.
Odwala onse ndi maphunziro owongolera athanzi omwe adayendera OCRC adayesedwa ndi Structured Clinical Interview ya DSM-5 Clinician Version26, buku lowongolera pamafunso amisala yayikulu komanso njira zodziwira za IGD zidakhazikitsidwa ndi DSM-52. Kuyesa konse kunachitika ndi olemba (DHH, JH), omwe ali akatswiri azamisala a ana ndi achinyamata omwe ali ndi zaka zopitilira 10 zachipatala pakati pawo. Njira zopatula zinali motere: 1) mbiri yakusokonekera kwamutu ndi matenda amisala kapena zamankhwala, 2) intelligence quotient (IQ) <70, kapena 3) claustrophobia.
Ndondomeko yofufuzira ya kafukufukuyu idavomerezedwa ndi bungwe lowunikirako la Chung Ang University Hospital. Njira zonse zidachitidwa molingana ndi Chidziwitso cha Helsinki. Chilolezo chodziwitsidwa chimatengedwa kuchokera kwa achinyamata onse komanso kuchokera kwa makolo awo kuti ana awo atenge nawo phunziroli.
Njira zophunzirira komanso ubale wapabanja
Onse omwe akutenga nawo gawo (achinyamata omwe ali ndi IGD ndikuwongolera athanzi) adafunsidwa kuti amalize kufunsa mafunso okhudzana ndi kuchuluka kwa anthu ndipo adapatsidwa masikelo owunikira momwe alili m'maganizo, kuopsa kwa matenda awo, komanso ubale wawo ndi mabanja. Mkhalidwe wamaganizidwe, IQ, ADHD, kuuma kwa IGD, MDD, ndi nkhawa zidayezedwa pogwiritsa ntchito Korea Wechsler Intelligence Scale for Children (K-WISC)27, Mtundu waku Korea wa DuPaul's ADHD Rating Scale (K-ARS)28,29, Achinyamata Achinyamata pa intaneti (YIAS)30, Ana Depression Inventory (CDI)31, ndi Beck Anxcare Inventory (BAI)32, motsatana. Maubwenzi apabanja adayesedwa pogwiritsa ntchito ubale wapakati pa Family Environmental Scale (FES-R)33 chomwe chimakhala ndi magawo atatu othandizira: mgwirizano wamabanja, kufotokoza, komanso mikangano18,33. Mgwirizano wapabanja umayesa kuchuluka kwa kuthandizana ndi kuthandizana ndi achibale wina ndi mnzake (mwachitsanzo, “Achibale amathandizanadi ndi kuthandizana”). Kufotokozera kumawunikira momwe anthu am'banja amaganizira kuti angathe kufotokozera zakukhosi kwawo (mwachitsanzo, "Achibale samakonda kunena zakukhosi kwawo"). Mikangano imachepetsa kukwiya komwe kumafotokozedwa poyera m'banja (mwachitsanzo, “Timamenya nkhondo kwambiri m banja lathu”). Chiyanjano cha FES chimayang'ana momwe mamembala am'banja amawonera momwe mabanja awo amagwirira ntchito; kuchuluka kwambiri nthawi zambiri kumatanthauza kuti munthuyo amawona kuti mabanja awo akugwiranso ntchito, komanso kuti ali ndi zovuta zochepa33-35.
Kupeza zithunzi za ubongo ndikukonzekera
Zambiri zopumula-state magnetic resonance imaging (rs-MRI) zinasonkhanitsidwa pa sikani ya 3.0 T Philips Achieva. Pakati pa kuyesa kwa Rs-MRI. Achinyamata onse adauzidwa kuti agone pansi ndikudikira maso atatsekedwa kwa masekondi 720 mpaka mavoliyumu 230 atapezeka. Pogwiritsa ntchito ma khushoni, mitu ya omwe akutenga nawo mbali idakhazikika kuti ipewe kuyenda kwa mutu. Zambiri za fMRI zidasonkhanitsidwa mozungulira ndi dongosolo la imaging-planar imaging (EPI) pogwiritsa ntchito magawo omwe ali pansipa: TR / TE = 3000/40 ms, magawo a 40, 64 × 64 matrix, 90 ° flip angle, 230-mm FOV, ndi 3- mm gawo makulidwe popanda chosowa. Mavoliyumu 10 oyamba adachotsedwa pamiyeso yolimba.
Kukonzekera kwazithunzi ndikukonzekera kunakonzedwa pogwiritsa ntchito Data Processing Assistant ya Rs-fMRI (bokosi la zida la DPARSFA)36, yomwe imagwira ntchito mu Statistical Parametric Mapping (SPM12; http://www.fil.ion.ucl.ac.uk/spm/software/spm12/) ndi Rs-fMRI Data Analysis Toolkit (REST)37. Zithunzi zamaubongo adazisonkhanitsa pakupeza kagawo, kusiyana kwa nthawi, kusinthidwa, kusinthidwa, kukonza malo ndi 6-mm Full-Width Half Maximum (FWHM) kernel, de-trended, and temporally band-pass sefa (0.01-0.08 Hz). Kutengera ndi zotsatira zakukonzanso kwamasinthidwe, maphunziro omwe adawonetsa kusuntha kwamutu kwakukulu (kumasulira kwakukulu kuposa 3 mm kapena kusuntha kozungulira kuposa madigiri 2 mbali iliyonse) sikuyenera kuphatikizidwa pakuwunika. Komabe, sitinapeze maphunziro aliwonse opita patsogolo kwambiri.
Kuti tipeze zochitika zamaubongo m'magawo achidwi (ROIS), matalikidwe am'magawo ochepa osinthasintha pafupipafupi (FALFF) adachotsedwa pogwiritsa ntchito REST software. Pakukonzekereratu kwa magwiridwe antchito, ma coefficients ophatikizika a Fisher m'magulu awiri a ROI komanso kusiyana kwa FALFF pakati pa ma ROI kudawerengeredwa pogwiritsa ntchito bokosi lolumikizira la CONN-fMRI (15)38. Coefficient ya Kendall ya concordance idasinthidwa kukhala z-zambiri pokonzekera kusanthula kwamagulu. Malumikizidwe apakati pa ziwerengero za FES ndi FALFF adagwiritsidwa ntchito kupeza zigawo za mbewu zomwe zinagwiritsidwa ntchito ngati kusanthula kochokera ku mbewu (FC).
Kusanthula kochokera ku mbewu kwa FC kunachitika pogwiritsa ntchito mbewu ya ROI yochotsedwa mu gawo lapitalo lofananitsa pakati pa FES ndi FALFF. Ma coefficients olumikizana a Pearson adasonkhanitsidwa kuchokera munthawi ya mbewa ya oxygen-oxygenation level (BOLD) mu voxel iliyonse. Ma coefficients ophatikizana adasinthidwa kukhala magawidwe z zofananira pogwiritsa ntchito Fisher's z-transform.
Statistics
Zambiri zokhudzana ndi kuchuluka kwa anthu ndikuyerekeza kwamaganizidwe zimafaniziridwa pakati pa achinyamata omwe ali ndi IGD ndikuwongolera koyenera pogwiritsa ntchito mayeso aokha. Maubwenzi apakati pa mamapu a FALFF ndi ziwerengero za FES adawerengedwa pogwiritsa ntchito pulogalamu ya SPM12. Makhalidwe a FALFF anafananizidwa pakati pa achinyamata omwe ali ndi IGD ndi kuwongolera koyenera pogwiritsa ntchito mayeso aodziyimira pawokha. FC pakati pa mbewu ndi madera ena idafanizidwanso pakati pa achinyamata omwe ali ndi IGD ndikuwongolera koyenera pogwiritsa ntchito mayeso aokha. Mamapu omwe amabwera chifukwa chake anali otsekereredwa ku a p-Mtengo wa <0.05, ndi malingaliro abodza (FDR) adagwiritsidwa ntchito poyerekeza zingapo ndi ma voxels opitilira 40.
Results
Chiwerengero cha anthu komanso zamankhwala
Panalibe kusiyana kwakukulu pazaka, maphunziro kusukulu, IQ, ndi ma CDI pakati pa achinyamata omwe ali ndi IGD ndi maphunziro owongolera athanzi (Table 1). Komabe, achinyamata omwe ali ndi IGD adawonetsa kuchuluka kwa K-ARS (t = 6.27, p <0.01), BAI (t = 2.39, p = 0.02), ndi YIAS (t = 18.58, p <0.01) ndikuchepetsa zambiri pa FES-R (t = -3.73, p <0.01). Kuyesa kwaposachedwa pamanambala a FES-R kunawonetsa kuti kuchuluka kwama cohesion subscale kwa FES-R kunali kotsika kwa achinyamata omwe ali ndi IGD kuposa kuwongolera athanzi (t = -8.76, p <0.01).
Gulu 1
Kuyerekeza kuchuluka kwa kuchuluka kwa anthu komanso mawonekedwe azachipatala pakati pa achinyamata omwe ali ndi IGD ndi maphunziro owongolera athanzi.
| Achinyamata omwe ali ndi IGD | Wachinyamata wathanzi | Statistics | |
|---|---|---|---|
| Zaka (zaka) | 14.6 ± 1.1 | 14.8 ± 2.0 | T = -0.67, p |
| Maphunziro a sukulu (zaka) | 7.5 ± 1.0 | 7.8 ± 1.9 | T = -0.92, p |
| IQ | 96.4 ± 10.3 | 96.3 ± 14.0 | t = 0.01, p = 0.99 |
| K-ARS | 13.6 ± 6.9 | 5.7 ± 4.3 | t = 6.27, p <0.01 * |
| CDI | 7.2 ± 5.2 | 5.8 ± 3.8 | t = 1.40, p = 0.16 |
| BAI | 8.1 ± 8.3 | 4.7 ± 3.4 | t = 2.39, p = 0.02 * |
| YIAS | 60.6 ± 8.2 | 30.1 ± 6.6 | t = 18.58, p <0.01 * |
| FES-R | 10.5 ± 4.4 | 14.6 ± 5.4 | T = -3.73, p <0.01 * |
| Kusamvana pang'ono | 3.5 ± 1.6 | 4.0 ± 2.7 | T = -1.09, p |
| Kufotokozera subscale | 3.5 ± 1.8 | 4.2 ± 2.1 | T = -1.68, p |
| Mgwirizano wocheperako | 3.4 ± 1.5 | 6.4 ± 1.6 | T = -8.76, p <0.01 * |
K-ARS: Mtundu waku Korea wa DuPaul's ADHD Scale Scale, CDI: Ana's Depression Inventory, BAI: Beck Anxcare Inventory, YIAS: Achinyamata Othandizira Kugwiritsa Ntchito Intaneti, FES-R: Dera Loyanjana ndi Mabanja.
Achinyamata onse ophatikizidwa (achinyamata omwe ali ndi IGD komanso maphunziro owongolera athanzi) adawonetsa kulumikizana koyipa pakati pa ziwerengero za YIAS ndi FES-R (r = -0.50, p <0.01); M'magulu ang'onoang'ono, zambiri za YIAS zidalumikizidwa molakwika ndi zambiri za FES-R mu achinyamata omwe ali ndi IGD (r = -0.67, p <0.01) koma osati pakuwongolera koyenera (r = -0.11, p = 0.46).
Mgwirizano wapakati pa ziwerengero za FES ndi malingaliro a FALFF
Mwa achinyamata onse ophatikizidwa, FALFF mkati mwazitsulo zakumanzere zamkati (x, y, z: -3, -18, 30, ke = 105, T = 6.30, FDRq = 0.002) idalumikizidwa ndi ziwerengero za FES-R (r = 0.66, p <0.01) (Chith. 1A). Kuwunika kwaposachedwa kunawonetsa kulumikizana kwabwino pakati pa mtengo wa FALFF mkati mwanyumba yamanzere yamkati ndi ma FES-R onse a IGD (r = 0.61, p <0.01) ndi magulu owongolera athanzi (r = 0.60, p <0.01) .
Mgwirizano wapakati pa zochitika zaubongo ndi maubale am'banja ndikuyerekeza kulumikizana magwiridwe antchito pakati pa achinyamata omwe ali ndi IGD ndi maphunziro owongolera athanzi. (AMgwirizano wapakati pa Family Environmental Scale-ubale domain (FES-R) zambiri ndi FALFF values (FALFF vs FES). Mitundu imawonetsa kulumikizana pakati pamitengo ya FALFF mkati mwazitsulo zamanzere zamkati (x, y, z: -3, -18, 30, ke = 105, T = 6.30, FDRq = 0.002) ndi ziwerengero za FES-R muunyamata wonse (r = 0.66 , p <0.01). (BKuyerekeza kolumikizana kwa magwiridwe antchito (FC) kuchokera kumanzere kubzala mbewu kupita kumadera ena pakati pa achinyamata omwe ali ndi vuto la masewera a pa intaneti (IGD) ndi maphunziro owongolera athanzi (Kusanthula Mbewu). FC kuyambira kumanzere kumanzere kwa mbewu zonse ziwiri (x, y, z: -21, -18, -3, ke = 446, T = 3.96, Pzopanda pake <0.001 ndi ke = 394, T = 3.49, pzopanda pake <0.001, 21, −15, 12) idachepetsedwa, poyerekeza ndikuwongolera koyenera.
Kuyerekeza kwa FC kuchokera kumanzere kumabzala mbewu kumadera ena pakati pa achinyamata omwe ali ndi IGD ndikuwongolera koyenera
FC kuyambira kumanzere kumanzere kwa mbewu zonse ziwiri (x, y, z: -21, -18, -3, ke = 446, T = 3.96, Pzopanda pake <0.001 ndi ke = 394, T = 3.49, pzopanda pake <0.001, 21, −15, 12) idachepetsedwa mwa achinyamata omwe ali ndi IGD poyerekeza ndi kuwongolera koyenera (mkuyu. 1B). Panalibe zigawo zomwe zimawonetsa kuwonjezeka kwakukulu kwa FC mu achinyamata omwe ali ndi IGD poyerekeza ndi kuwongolera koyenera.
Zolumikizana pakati pamitengo ya FC kuchokera kumanzere kumanzere mpaka pa mtima wa lentiform
Mwa achinyamata onse ophatikizidwa, mtengo wa FC kuchokera kumanzere kumanzere kupita kumutu wamanzere wa lentiform (r = 0.31, p <0.01) udalumikizidwa bwino ndi ziwerengero za FES-R. Mtengo wa FC kuchokera kumanzere kumanzere kumutu wamtundu wa lentiform udaphatikizidwanso bwino ndi ziwerengero za FES-R, koma kulumikizanaku sikunali kofunikira kwambiri (r = 0.27, p = 0.02) (mkuyu. 2A, B). Mwa achinyamata onse ophatikizidwa, mitengo ya FC kuyambira kumanzere kumanzere kumanzere (r = -0.35, p <0.01) ndi gawo lamanja la lentiform (r = -0.37, p <0.01) zidalumikizidwa molakwika ndi kuchuluka kwa YIAS (mkuyu. 2C, D). Mwa achinyamata onse ophatikizidwa, mitengo ya FC kuyambira kumanzere kumanzere kumanzere (r = -0.41, p <0.01) ndi gawo lamanja la lentiform (r = -0.31, p <0.01) zidalumikizidwa molakwika ndi kuchuluka kwa K-ARS ( Chith. XUMUMU, F).
Maubwenzi apakati pa FC kuchokera kumanzere kumanzere mpaka maukadaulo a lentiform m'mitu yonse (AKuphatikiza pakati pa magwiridwe antchito (FC) kuchokera kumanzere kumanzere kupita kumanzere a lentiform ndi dera la Family Environmental Scale-ubale domain (FES-R) m'maphunziro onse (r = 0.31, p <0.01). (BMgwirizano wapakati pamitengo ya FC kuchokera kumanzere kumanzere mpaka pachimake chakumaso kwa lentiform ndi dera la Family Environmental Scale-ubale domain (FES-R) m'maphunziro onse (r = 0.27, p = 0.02). (CKuphatikiza pakati pamikhalidwe ya FC kuchokera kumanzere kumanzere kupita kumalembedwe amtundu wa lentiform ndi kuchuluka kwa Young Internet Addiction wadogo (YIAS) m'maphunziro onse (r = -0.35, p <0.01). (DKuphatikiza pakati pamikhalidwe ya FC kuchokera kumanzere kumanzere kupita kumiyeso yakumanja ya lentiform ndi kuchuluka kwa Young Internet Addiction wadogo (YIAS) m'maphunziro onse (r = -0.37, p <0.01). (EKuphatikizana pakati pamiyeso ya FC kuchokera kumanzere kumanzere kupita kumalembedwe am'mbali am'munsi ndi mtundu waku Korea wa DuPaul's ADHD Rating Scale (K-ARS) m'maphunziro onse (r = -0.41, p <0.01). (FKuphatikizana pakati pamiyeso ya FC kuchokera kumanzere kumanzere mpaka pachimake chakumaso kwa lentiform ndi mtundu waku Korea wa DuPaul's ADHD Rating Scale (K-ARS) m'maphunziro onse (r = -0.31, p <0.01).
Achinyamata omwe ali ndi IGD, FC imayang'ana kuchokera kumanzere kumanzere (r = 0.56, p <0.01) ndi gawo lamanja la lentiform (r = 0.32, p = 0.04) zidalumikizidwa bwino ndi ziwerengero za FES-R (mkuyu. 3A, B), pomwe FC ikuyang'ana kuchokera kumanzere kumanzere kumanzere (r = -0.67, p <0.01) ndi gawo lamanja la lentiform (r = -0.41, p <0.01) zidalumikizidwa molakwika ndi kuchuluka kwa YIAS (mkuyu. 3C, D). Achinyamata omwe ali ndi IGD, FC imayang'ana kuchokera kumanzere kumanzere (r = -0.55, p <0.01) ndi gawo lamanja la lentiform (r = -0.31, p <0.01) silinaphatikizidwe molakwika ndi kuchuluka kwa K-ARS ( Chith. XUMUMU, F).
Maubwenzi apakati pa FC kuchokera kumanzere kumanzere mpaka maukadaulo onse a lentiform mwa achinyamata omwe ali ndi IGD (AKugwirizana pakati pa magwiridwe antchito (FC) kuchokera kumanzere kumanzere kupita kumutu wakumanzere wa lentiform ndi dera la Family Environmental Scale-ubale domain (FES-R) m'maphunziro omwe ali ndi vuto la masewera a intaneti (IGD) (r = 0.56, p <0.01 ). (BKuphatikiza pakati pamikhalidwe ya FC kuchokera kumanzere kumanzere kupita kumutu wakumanja kwa lentiform ndi dera la Family Environmental Scale-ubale domain (FES-R) mu achinyamata omwe ali ndi IGD (r = 0.32, p = 0.04). (CKuphatikiza pakati pamikhalidwe ya FC kuchokera kumanzere kumanzere kupita kumalembedwe am'munsi am'manja ndi mphotho ya Young Internet Addiction scale (YIAS) mwa achinyamata omwe ali ndi IGD (r = -0.67, p <0.01). (DKuphatikiza pakati pamikhalidwe ya FC kuchokera kumanzere kumanzere kupita kumiyeso yakumanja ya lentiform ndi ziwerengero za Young Internet Addiction scale (YIAS) mu achinyamata omwe ali ndi IGD (r = -0.41, p <0.01). (EKuphatikizana pakati pamiyeso ya FC kuchokera kumanzere kumanzere kupita kumutu wakumanzere wa lentiform ndi mtundu waku Korea wa ma DuPaul's ADHD Rating Scale (K-ARS) mu achinyamata omwe ali ndi IGD (r = -0.55, p <0.01). (FKuphatikizana pakati pamiyeso ya FC kuchokera kumanzere kumanzere mpaka pachimake chakumaso kwa lentiform ndi mtundu waku Korea wa ma DuPaul's ADHD Rating Scale (K-ARS) mu achinyamata omwe ali ndi IGD (r = -0.31, p <0.01).
Panalibe kulumikizana kwakukulu pakati pa ziwerengero za FES-R, zambiri za YIAS, ndi mfundo za FC kuyambira pazomwe zimapangidwa mpaka munthawi zonse za lentiform mu maphunziro oyendetsa bwino.
Kukambirana
Zotsatira zathu zidawonetsa kuchuluka kwa YIAS koma zidachepetsa kuchuluka kwa FES-R ndi FES-cohesion mu achinyamata omwe ali ndi IGD poyerekeza ndi kuwongolera koyenera. Zambiri za YIAS zidalumikizidwa molakwika ndi zambiri za FES-R mu achinyamata omwe ali ndi IGD, ndipo kulumikizidwa kwaubongo kuchokera ku cingate kupita ku striatum kunachepetsedwa. Kuphatikiza apo, kulumikizidwa kwaubongo kuchokera ku cingate kupita ku striatum kunalumikizidwa bwino ndi ziwerengero za FES-R komanso zolumikizana molakwika ndi kuuma kwa IGD mgulu la IGD.
Achinyamata omwe ali ndi IGD anali ndi ziwonetsero zambiri pa K-ARS ndi BAI kuposa zowongolera athanzi, ngakhale atapatula achinyamata omwe ali ndi IGD yokhala ndi zovuta zina zamaganizidwe, kutanthauza kuti achinyamata omwe ali ndi IGD atha kukhala ndi mavuto ambiri komanso nkhawa. Kuphatikiza apo, mitengo ya FC kuyambira kumanzere kumanzere mpaka maukadaulo onse a lentiform idalumikizidwa molakwika ndi kuuma kwa ziwerengero za ADHD mwa achinyamata onse, kuphatikiza omwe ali ndi IGD. Izi ndizogwirizana ndi maphunziro athu am'mbuyomu ogwiritsa ntchito fMRI kufananizira odwala omwe ali ndi ADHD ndi omwe ali ndi IGD; kuti kuphunzira anasonyeza kuchepa FC pakati pa gyrus kudzanja pakati mazunzo ndi caudate phata ndi pakati pa cingulate kumanzere ndi caudate phata odwala ndi IGD ndi anthu ADHD, kuonetsanso kuti magulu awiriwo kuuza ena pathophysiology wamba39. Kafukufuku wathu wakale wa EEG poyerekeza odwala omwe ali ndi ADHD ndi comorbid IGD ndipo omwe ali ndi ADHD yoyera adawonetsa beta yayikulu mgululi, ndikuwonetsa kuti odwala omwe ali ndi ADHD, omwe amavutika kuyang'ana, atha kugwiritsa ntchito masewera ngati njira yowathandizira40. Zolumikizana zofananazi zapezeka ndi ofufuza ena okhudzana ndi zovuta za odwala omwe ali ndi IGD41,42. Pazovuta zamavuto mwa odwala omwe ali ndi IGD, Wang Et al.43 adapeza kuti odwalawa amatha kukhala ndi nkhawa zambiri kuposa kuwongolera athanzi. Yen Et al.44 adawonetsa kuti odwala omwe ali ndi IGD amagwiritsa ntchito kupendekera pang'ono ndikuwonjezera kuponderezana, zomwe zidadzetsa zizindikilo zambiri zakukhala ndi nkhawa, poyerekeza ndi omwe akutenga nawo gawo pazaumoyo.
Tapeza kuchepa kwa mgwirizano wa FES-R ndi FES mu achinyamata omwe ali ndi IGD. Kuphatikiza apo, kuchuluka kwa FES-R kudalumikizidwa molakwika ndi kuchuluka kwa YIAS mwa achinyamata onse kuphatikiza, pomwe ndi okhawo omwe ali ndi IGD omwe adawonetsa kulumikizana komweko koyipa kwa FES-R-YIAS. Chiyanjano cha ubale wa FES chikuwunika momwe munthu angawone ubale wabwino wamabanja awo45. Izi zikutanthauza kuti achinyamata omwe ali ndi IGD amazindikira kuti ubale wamabanja awo ndiwosauka, ndikuti zovuta zamasewera omwe ali pamavuto komanso maubale m'mabanja omwe ali osauka amalumikizana. Ngakhale kapangidwe ka kafukufuku wathu wapano sakulola kuti zovuta ziziphunziridwa, ofufuza ena aganiza kuti malingaliro olakwika amachitidwe ogwirizana pabanja atha kukhala chimodzi mwazifukwa zomwe achinyamata amakonda kwambiri masewera46. Kafukufuku akuwonetsa kuti ochita masewera ovuta amatha kugwiritsa ntchito masewera ngati njira yothetsera mavuto awo, ndipo maubale osavomerezeka m'mabanja atha kukhala chifukwa chomwe achinyamata omwe ali ndi IGD akuwona kuti alibe njira ina kuposa kusewera masewera46,47. Kuphatikiza apo, zambiri zathu zimawonetsa zocheperako zocheperako m'mabwana omwe ali ndi IGD kuposa kuwongolera koyenera. Kulumikizana kwamgwirizano pakati pa ubale wa FES kumayesa kuchuluka kwa chithandizo ndikuthandizira aliyense m'banjamo33. Ndikulumikizana pang'ono m'banjamo, munthuyo atha kumva kuti sakukhudzidwa ndi banja ndipo amavutika kupeza chithandizo kuchokera kwa abale ake panthawi yamavuto, potero amayamba kusewera.
Mwa achinyamata onse ophatikizidwa, zambiri za FES-R zidalumikizidwa ndi FALFF mkati mwazitsulo zamanzere zamkati. Pofufuza mbewu, FC kuyambira kumanzere kumanzere kupita kumtunda wakumanzere wa lentiform idalumikizidwa bwino ndi zambiri za FES-R. Kuphatikiza apo, FC kuyambira kumanzere kumanzere mpaka maukadaulo onse a lentiform idalumikizidwa bwino ndi zambiri za YIAS. Mu gulu la IGD, zotsatira zofananira zidawonedwa, kuwonetsa kuti FC yotsika pakati pa cingate gyrus ndi nthenda ya lentiform idalumikizidwa ndi maubale oyipa am'banja komanso IGD yowopsa. Chosangalatsa ndichakuti, cingate cortex ndi lentiform nuclei amadziwika kuti ndi gawo la mphotho9,10. Kuphatikiza apo, dera lamalipiro limaganiziridwa kuti limalumikizidwa ndikuphatikizana kwamabanja komanso kulumikizana13,14,16. Zambiri zathu zikuwonetsa kuti maubale osavomerezeka am'banja amakhudzana ndi madera osapeza mphotho mwa munthu, omwe amatha kulumikizidwa ndi zizindikilo zapamwamba za IGD. Kafukufuku wam'mbuyomu adanenanso kuti chithandizo chamagulu atha kukhala ndi phindu pa IGD24.
Zotsatira zathu, zomwe zikuwonetsa kuti achinyamata a IGD asokoneza ubale wamabanja ndipo kusokonekera kumeneku kumalumikizidwa ndi dera lamalipiro, zikugwirizana ndi maphunziro am'mbuyomu omwe akuwonetsa ubale wa makolo ndi ana ndichinthu chofunikira ku IGD17-21. Kufotokozera za ubale wapakati paubale ndi IGD, Throuvala Et al. adanenanso kuti maubwenzi apabanja atha kubweretsa kusazindikira komwe kumatha kubweretsa kusewera kwambiri48. Kafukufuku wa nthawi yayitali adawonetsa kuti maubwenzi osagwirizana am'banja adakulitsa mwayi wamwana wokhala ndi zovuta zokhudzana ndi masewera49. Kafukufuku wina wazaka zazitali adawonanso zotsatira zofananira ndi ochita masewera ovuta, ngakhale kulumikizana kwakukulu kwamabanja pambuyo pake sikunapititse patsogolo chiopsezo cha IGD, chomwe chitha kuwonetsa kuti pangakhale zina zambiri zofunika kuziwona mu IGD kuposa mgwirizano wamabanja okha50. Phunziro lathu likuwonjezera kuunika kwatsopano pamutuwu, osati chifukwa cha zovuta, koma chifukwa timawonetsa kulumikizana kwa ubale wa IGD ndi banja kudzera pamawonekedwe amanjenje. Izi zitha kuchitidwa ngati umboni wazithandizo zamabanja zochokera ku IGD. Njira zambiri zochiritsira mabanja zakhala zikuwonetsa kuchita bwino pochiza IGD22,24,25. Chithandizo chochepa cha mabanja chamasabata atatu chawonetsa kusintha masewera okhudzana ndi masewerawa muubongo mwa odwala a IGD51 ndi chithandizo chamagetsi cholimbikitsa, mtundu wamankhwala am'banja omwe amagwiritsidwa ntchito pochiza matenda osokoneza bongo, awunikidwanso kuti akhale othandiza posinthidwa ku IGD52.
Kafukufuku wapano ali ndi zoperewera zingapo. Choyamba, kukula kwazitsanzo kunali kochepa; chifukwa chake, zotsatira zake sizingafanane. Chachiwiri, sitinagwiritse ntchito FES yonse, kuti tisunge nthawi, popeza achinyamata amakhala ndi chizolowezi chosiya kapena kuyankha molakwika komanso amakonda kukondera pagulu pomwe masikelo atenga nthawi yayitali18. Chisankhochi, ngakhale chidakwaniritsa kuchuluka kwa kuchuluka kwa sikelo, kutilepheretsa kuphatikiza magawo ena okhudzana ndi mabanja, monga kukula kwamunthu kapena kukonza makina, pakuwunika. Chachitatu, ngakhale YIAS, yomwe idagwiritsidwa ntchito ngati muyeso wama psychometric pakuphunzira kwathu, imagwiritsidwa ntchito kwambiri pakufufuza kofananako, idapangidwa ngati muyeso wazolowera intaneti osati makamaka ku IGD. Monga zakhala zikuchitika posachedwa mu IGD, yoyambitsidwa ndi American Psychiatric Association ndi World Health Organisation, maphunziro amtsogolo atha kusinthidwa pogwiritsa ntchito masikelo omwe akuphatikiza izi, monga Internet Gaming Disorder-20 Test53, Fomu Yaifupi Yosewerera Masewera pa intaneti54, Kukula Kwamasewera pa intaneti55, ndi Kuyesedwa Kwamasewera a Gaming56. Pomaliza, popeza uku kudali kuphunzira magawo awiri, sitinathe kupeza mayankho omveka pazokhudzana kwenikweni kwa maubwenzi apakati pa zisonyezo za IGD, madera olandirira mphotho, komanso ubale wosagwirizana m'mabanja. Owerenga ayenera kukhala osamala potanthauzira zotsatira za kafukufuku wapanoyu.
Pomaliza, achinyamata omwe ali ndi IGD adasokoneza ubale wawo, womwe umalumikizidwa ndi kuopsa kwa vutoli. Kuphatikiza apo, kusokoneza ubale wam'banja mwa achinyamata omwe ali ndi IGD kumalumikizidwa ndi kusalumikizidwa mkati mwa mphotho.
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