Makhalidwe ogonana osakwanira: tanthauzo, zochitika zamankhwala, mbiri ya neurobiological ndi chithandizo (2020)

Zolemba zochokera mu "Kugwiritsa ntchito zolaula pazokonda zakugonana "gawo ili m'munsiyi:

Zizolowezi zolaula, ngakhale ndizosiyana ndi zomwe zimachitika mokhudzana ndi chiwerewere, akadali mtundu wamakhalidwe ...

Kulekerera mwadzidzidzi zolaula kumayambitsa mavuto m'misewu, chisangalalo, komanso kukondana komanso kugonana….

Kugwiritsa ntchito zolaula mozama kumathandizira kuyambika kwamavuto amisala ndiubwenzi….

Perrotta G (2020), Int J Kugonana Kosokoneza Zaumoyo 3 (1): 061-069.

DOI: Onetsani: 10.17352 / ijsrhc.000015

Kudalirika

Ntchitoyi imayang'ana kwambiri pamutu woti "machitidwe osagonana osagwirizana" komanso makamaka zamankhwala, psychopathological, ndi anatomy zokhudza thupi, kuti timvetsetse magawo osiyanasiyana amachitidwe omwe akuwunikiridwa: chiwerewere, kupitilira kwazovuta zakugonana, komanso chizolowezi chogonana. Ntchitoyi yamalizidwa ndikuwunika zinthu zamatsenga ndi mankhwala abwino, kutsimikizira kufunikira kwakugwiritsa ntchito zolaula pazokonda zogonana.

Chiyambi, tanthauzo ndi zochitika zamankhwala

Khalidwe logonana ndiyo njira yochitira munthuyo, mu ubale ndi kulumikizana ndi malo oyandikana nawo, omwe amakumana ndi zovuta (chifukwa chodwala) amafunika kulingalira zakugonana, kukhazikitsa machitidwe azamalingaliro omwe cholinga chake ndi kuchita zachiwerewere, kulephera kuwongolera zomwe akufuna komanso amaletsa chikhalidwe chokhazikitsidwa ndi zochitika zenizeni. Mwambiri, "kuzolowera" kumatanthauza kutaya ndikulephera kuyambiranso chilakolako chofuna kudya, ndiye kuti, kufuna kukhala ndi kudya china chake. Chifukwa chake, ngati zinthu zikuwongolera pomwe munthu akuwona momwe akugwiritsira ntchito chinthu kapena akuchita, mosasamala kanthu momwe kulowerera kwake kuli koopsa, kopirira kapena koopsa, kuwonongeka kumatayika pamene khalidweli likubwerezedwa ngakhale kusakhutira konse , kapena ngakhale kuwonongeka kwa moyo wake wonse, zomwe zimamupangitsa kukhala wosayenera. Sikuti khalidweli limangokhala lamatenda okhaokha koma kulibe ulamuliro pazomwe munthu akufuna kukwaniritsa. Khalidwe lomwe silikukwaniritsa chizolowezi liyenera kutha, ngakhale linali losangalatsa m'mbuyomu, chifukwa lidasiya kukhala choncho. Ngati izi sizikuchitika, ndipo munthuyo angalephere kuziwona ngati zopindulitsa ngakhale atakhumudwitsidwa ndi chakumwa, kuwongolera kwatha. Momwemonso, ngati munthuyo sangakwanitse kupanga machitidwe ake kuti awaike m'moyo wake nthawi yomwe akufuna (ndi yaulere), pamapeto pake amadzipereka moyo wake wonse kulakalaka kuchita khalidweli likatuluka ( ndiye kuti, amakhala kapolo wake). Chifukwa chake zimakhalanso zovuta kupeza chuma chothandizira khalidweli (mwachitsanzo pazachuma), ndipo ngakhale khalidweli likadali lopindulitsa sipakhalanso kukhutira konse, ndipo kukhutitsidwa kotereku kumakhala kovuta kwambiri chifukwa cholephera kuthana ndi chikhumbocho. Chifukwa chake ndichizolowezi chenicheni monga chinthu china chilichonse chokakamiza kapena chikhalidwe ndipo chimakhala ndi magwiridwe antchito, kutengera kukula kwa matendawa; makamaka, mitundu itatu imasiyanitsidwa: chiwerewere, kupitirizabe kukakamiza kugonana ndi chizolowezi chogonana [1].

Posachedwapa, vuto lachiwerewere lidapeza gulu mkati mwa Gulu Lapadziko Lonse la Matenda a Kufa ndi Matenda Osautsa (ICD-11) [2] lokhala ndi nambala 6C72, monga gululi losiyanitsidwa ndi ma paraphilias omwe ali mkati mwamphamvu. Malinga ndi tanthauzo la World Health Organisation (WHO) [3], vuto lokakamira zachiwerewere limadziwika ndi chizolowezi cholephera kuwongolera zilakolako zakugonana, zobwerezabwereza kapena zolakalaka zomwe zimabweretsa chizolowezi chogonana mobwerezabwereza. Zizindikiro zimaphatikizaponso zochitika zogonana zobwerezabwereza zomwe zimakhala zofunikira kwambiri pamoyo wa munthu mpaka kunyalanyaza zaumoyo ndi chisamaliro chake kapena zofuna zina, zochita, ndi maudindo; zoyesayesa zingapo zakulephera zochepetsa kubwerezabwereza pakugonana, ndikupitilizabe kuchita zachiwerewere ngakhale zitakhala zovuta kapena kusakhutitsidwa pang'ono. Njira yakulephera kudziletsa pazolakalaka, zakugonana kapena zolakalaka zomwe zimapangitsa kubwerezabwereza kwa chiwonetsero chazaka zimawonetsedwa kwakanthawi (mwachitsanzo, miyezi 6 kapena kupitilira apo), ndipo zimayambitsa kukhumudwa kapena kuwonongeka kwakukulu pamunthu, banja, chikhalidwe, maphunziro, ntchito, kapena madera ena ofunikira. Zovuta zomwe zimakhudzana kwathunthu ndi ziweruzo zamakhalidwe osavomerezeka pazokhumba, zolimbikitsa, kapena machitidwe sizokwanira kukwaniritsa izi. Ngakhale kuyesayesa mobwerezabwereza kuti achepetse mchitidwe wogonana wosagwira ntchito, munthu amene ali ndi vuto lachiwerewere sangathe kuwongolera zomwe amakakamizidwa, ndipo kutengera kukula kwa matenda ake, amatha kuwonetsa zizindikiritso zowoneka bwino, kusinthasintha kwamalingaliro, kupsa mtima, kusadziletsa, kutengeka mtima komanso kukakamira [ [Chithunzi patsamba 4]

Mtundu wachisanu wosinthidwa wa Diagnostic and Statistical Manual of Mental Disorder lolembedwa ndi American Psychiatric Association (Diagnostic Manual of Mental Disorder, DSM-5) [5] komabe sikuphatikiza vuto la hypersexuality m'magulu amatenda amisala, ngakhale awiriwo Magawo amapezeka pokhudzana ndi zovuta zokhudzana ndi kugonana zokhudzana ndi zovuta kufikira chotupa kapena zovuta zogonana komanso zovuta za paraphilic [5]. Asayansi atsutsana kwambiri pankhani yangozi yakupititsa patsogolo machitidwe amisala ndi malingaliro amitu ya anthu omwe mwachilengedwe ali ndi zibwenzi zapamwamba kuposa anthu wamba, kapena omwe amakhala m'malo azikhalidwe zomwe machitidwe achiwerewere amavomerezedwa. Mofananamo, vuto la kusiyanitsa matenda limakhalabe lovuta, kotero kuti vuto lachiwerewere, lomwe limadziwonetsera nthawi zambiri molumikizana ndi matenda ena amisala monga bipolar kapena depress syndromes, sayenera kudziwika kuti ndi vuto lodziyimira palokha, koma ngati chisonyezo chachiwiri cha kusangalala chisokonezo. Akatswiri omwe, m'malo mwake, amati alipo, amafotokoza za chiwerewere ngati chizolowezi chomwa mankhwala osokoneza bongo, monga ena monga uchidakwa ndi mankhwala osokoneza bongo. Mchitidwewu, pankhaniyi wogonana, ungagwiritsidwe ntchito ngati njira yokhayo yothetsera kupsinjika kapena umunthu komanso zovuta zam'maganizo [4].

Kuchokera kuzizindikiro, Chiwerewere, motero, zimawonekera m'malingaliro amunthu kutaya choletsa chovomerezeka, mosasankha mwakufuna kwake komwe kumakhazikika pakuwonetsa zochitika zosokeretsa, zoyambitsa komanso zokhumba zogonana. Ndikulimbikitsa kwambiri komanso kukweza zilakolako zakugonana, zomwe zimakakamiza mutuwo kuti nthawi zonse azisonyeza chidwi chokhudzana ndi kugonana kapena kugonana. Komabe, malingaliro awa samangokhala ofuna kukwaniritsa zogonana nthawi zonse; nthawi zambiri zimayimira njira yokopa chidwi chathu komanso kupereka ziwonetsero zakugonana komwe tikapanda kupeza njira yodzimasulira tokha. Ndichizoloŵezi kuti nkhanizi zizichita mokakamiza komanso mokomera maliseche a maliseche awo. Makamaka, kuseweretsa maliseche ndichinthu china chifukwa kuposa kupotoza kumayimira zochitika zina, zomwe zitha kutenga zizolowezi zosokoneza mwa njira yomwe imapangitsa kukhala yopindulitsa kwambiri, yomwe nthawi zambiri imakhala zolaula, kapena voyeurism, ndiye kuti, zolaula " Khalani ndi moyo ”polipira ndalama kapena pochitira umboni maubwenzi ndi ena, kapena mobisa (kuzonda anthu omwe akufuna kuchita zogonana). Munthu amene amakonda kuseweretsa maliseche nthawi zambiri amakhala ndi nkhawa chifukwa cholephera kukhala ndi chinthu chomwe akufuna, komanso kukhazikika maliseche. Nthawi zina, munthuyo, amatha kudzipatula payekha kapena kukhala ndi chilema m'macheza chifukwa chakugonana kumatengedwa ndi maliseche. Kupanda kutero, maliseche amakhala amisala chifukwa kuwonjezeka kwafupipafupi kumafanana ndi kukhutira pang'ono, kufunidwa mokwiya kapena kuda nkhawa osapambana, kapena kumafanana ndi mkhalidwe wokhumudwitsa komanso wochititsa manyazi munthuyo. Kuchita maliseche kumatenda nthawi zambiri kumatchedwa "kukakamiza" ngakhale kwenikweni izi zimapanga lingaliro lolakwika lomwe limaimira kusiyanasiyana kwa kukakamira kwakukakamira. Malingaliro okhudzana ndi kugonana amasiyana ndi kutengeka chifukwa amafunidwa, kupangidwa ndi kudyetsedwa ngati njira yokhutiritsira, ndipo kuchita maliseche sikuchitika motsutsana ndi chifuniro cha munthu pakadali pano, koma ngati sichikutsutsana ndi zolinga zake. Pamsinkhu uwu wosagwira ntchito, komabe, zizolowezi zofananira zimatha kukhala limodzi koma kuyimira maziko a vutoli. Mwachitsanzo, munthu amene ali ndi vuto lachiwerewere amatha kusankha zolaula zomwe angafune kapena mnzake yemwe amamulipira, pomwe wogonana amatha kumaliza nthawi yake ndikufufuza mpaka kufika posapezeka (chifukwa sangathenso kugwira ntchito kapena kudzipereka kumakhalidwe abwino) pazinthu zazikulu, chifukwa chake mwina amasintha kuzinthu zoyambirira zomwe amapeza, kuvomerezanso zoopsa (zaukhondo komanso zopatsirana, kapena zachilengedwe), kuti awononge nthawi yomweyo [1].

Kugonana kwa amuna kapena akazi okhaokha kumakhala kwanthawi yayitali, pamakhala kukambirana za vuto lenileni, gawo lachiwiri ndi mphamvu yokoka: Kulimbikira Kugonana Kwachiwerewere (PSAD). Chisangalalo chosalekeza chakugonana chimamukakamiza munthuyo kufunafuna zinthu mokakamizidwa zomwe zingagwirizane ndi kugonana; chifukwa chake chiwerewere chimakhala chiyambi cha matendawa. Kuti munthu akwaniritse bwino zomwe akufuna kuyendetsa, atha kufunidwa kwambiri zogonana zomwe zimakhala zonyansa kapena zonyansa. Pachifukwa ichi, zinthuzi ziyenera kukhazikitsidwa m'malo opanikizika ndi malingaliro; Komabe, nkhaniyi imapitilizabe kukhala yofananira, kumangiriza zizolowezizi kumalingaliro ake ndi zogonana zokha, zochepetsera kuwonongeka kwa ubale wamunthu komanso manyazi omwe amuna amakhala okonda zachiwerewere kuti akhale okhazikika kapena osokoneza bongo . Omwe amafunsidwa nthawi zambiri amakhala ozunzidwa ndi paraphilias, omwe amayenera kuyimira ndikukhala mmoyo wawo wamaganizidwe ndi malingaliro [1].

Pomwe kufunika kokhala osatetezedwa komanso osagonana kumakhala chosowa chosalamulirika chakuchita zachiwerewere, chisangalalo chopitilira chimakhala chizolowezi: Kugonana. Zimayimira gawo lomaliza ndi mphamvu yokoka pakugonana ndipo nthawi zambiri imatsagana ndi kufunika kochita zogonana ndi anthu kapena zinthu popanga paraphilias imodzi kapena zingapo. Cholinga chake ndikuzindikira chisangalalo ndipo nthawi zambiri zotsatira zake, ngakhale zitadziwika ndi mutuwo, sizimaganiziridwa kapena sizingaganizidwe moyenera, chifukwa kumangika komwe angayambitse kukhumudwitsa mphamvu yakugonana yomwe yakonzeka kutulutsa nthunzi [ [Chithunzi patsamba 6] Khalidwe logonana limakhala chizolowezi cholephera kuwongolera zolakalaka [kapena] zobwerezabwereza zakugonana, zomwe zimapangitsa kubwerezabwereza kogonana kwakanthawi kotalikirapo komwe kumayambitsa mavuto akulu kapena kuwonongeka kwamunthu, banja, chikhalidwe, maphunziro, ntchito, kapena zina zofunika zantchito [7]. Kugonana, m'mbuyomu, pankhani zamankhwala, ankadziwika ndi mawu oti "Nymphomania" (kutanthauza akazi) ndi "Satirism kapena Satiriasis" (kutanthauza amuna), popeza kuti mu nthano zachi Greek ma Nymphs adafotokozedwanso mwa iwo gawo la mphamvu yaumulungu ya Aid therefores, chifukwa chake kukhala achinsinsi komanso kudabwitsidwa pamaso pazomwe zili zopanda cholakwika motero amakhala chete ndipo adayimilidwa ngati atsikana okongola kwamuyaya, okhoza kukopa amuna ndi ngwazi, pomwe ma Satyrs nthawi zambiri amawonetsedwa ngati anthu okhala ndi ndevu ndi makutu a mbuzi kapena kavalo, nyanga, mchira, ndi miyendo, yoperekedwa ku vinyo, kusewera ndi kuvina ndi a Nymphs, limodzi ndi chiwonetsero chazakugonana [1]. M'mbuyomu, vutoli limafotokozedwanso ngati chiwerewere, mchitidwe wogonana, kukakamira kugonana, komanso chizolowezi chogonana; ngakhale posachedwapa, zizolowezi zakugonana zakhala zikufotokozedwa ngati vuto lotha kupangika kuti liphatikizidwe mu ICD-11, ndimayeso oyeserera pa intaneti komanso maphunziro azachipatala omwe akukonzekera kuyesa kutsimikizika kwake [7]. Lero mawu awiriwa sanagwiritsidwe ntchito. Kudalira kwadongosolo nthawi zina kumapita patsogolo, kumakulirakulira mwamphamvu ndi mawonekedwe ophatikizika amtundu wina wokhudzana ndi kugonana. Apa nkhani sinathenso kusiyanitsa malire ovomerezeka pagulu ndipo kudalira kwake kumamukhazikika, munthawi zonse zakukhalapo kwake, kuchokera payekha mpaka kubanja, kuchokera kuntchito mpaka pagulu. Paraphilias amakhala njira yoonera zachiwerewere monga china chilichonse ndipo amasangalala mosagwirizana ndi zolaula. Zina mwazotsatira zakukulirakulira kumeneku titha kutchula zizindikiro zamankhwala zotsatirazi: kupsinjika kwakuthupi ndi kwamaganizidwe komwe kumachitika chifukwa chofunafuna, kusamala, kukakamiza komanso kuwonera anthu omwe ali ndi chidwi chofuna kugonana; kuwonongeka kwa maubwenzi; kuchepa kwa kukumbukira kwakanthawi kochepa ndi kaphatikizidwe; kuzindikira kwazindikiritso ndikuchepetsa maluso ozindikira monga kuzindikira, kubisa, kaphatikizidwe, luso komanso kusinkhasinkha; fufuzani zosangalatsa zakugonana munthawi iliyonse osawunika zotsatira za zomwe achita (komanso ndi ziweruzo); kuchepa kwa magwiridwe antchito ndi kutopa kosatha; anasintha kayendedwe ka kugona kozungulira; kuchuluka kwa nkhawa; kuphulika kwachiwawa; kulimbikira kukhumudwa; Kusakhutira kosatha; Kusasamala ndi kukhumudwa pamene kugonana kwatha; kudzipereka pakusaka tsiku ndi tsiku zochitika zolimbikitsa kugonana, kwa maola ambiri patsiku; kusakhazikika; kudzipatula pagulu; kukhutitsa kokongola komanso kovuta kuvutikira kukondana; kusiyanasiyana kwa machitidwe azogonana omwe mutuwo umayesa kubwerezanso ndi wokondedwa wake (ngakhale nthawi zina) njira imodzi kapena zingapo zonyansa, kutaya anthu.

Ponena za zochitika zamankhwala, komabe, kuyambira nthawi zonse kuyambira kusiyanasiyana pakati pa chiwerewere, matenda opatsirana pogonana komanso chizolowezi chogonana, vutoli limakhala lodziwika potengera kuopsa kwa zizindikilo zofotokozedwa mu anamnesis; choncho, chiwerewere (ndiye poyambira kusakhazikika, zokhudzana ndi chiwerewere) Chitha kukhala chizindikiro chachimodzi mwazinthu zinayi zodziwitsa matenda [7]

1) "Hypersexuality" ngati gwero lamavuto amisala, popeza zomwe zimachitika ndi munthuyo, ngakhale zimawoneka ngati zabwinobwino, zimayimiriridwa pamwambapa kuposa zikhalidwe ndi zachipatala [7]. Poterepa, kusaka zakugonana komwe kumalumikizidwa kwambiri ndi zolaula komanso zofananira kumayimira njira yosavuta komanso yosiyana yakugonana, ngakhale ngati banja, osasokoneza madera ena amunthuyo (banja, malingaliro, kutengeka mtima, kugwira ntchito), pomwe pali vuto linalake lomwe limasokoneza munthuyo, kumamupangitsa kuti azindikire kuti ali ndi vuto lachiwerewere ngati chizindikiro chamatenda [8] chomwe chimapangitsa kudzimva kuti ndi wolakwa komanso wamanyazi [9];

2) "Hypersexuality" ngati chizindikiritso chazovuta zakuchipatala, zomwe zidalipo kale pazogonana zomwe zimawoneka ngati zosagwira (mwachitsanzo, matenda amisala kapena chotupa chaubongo) [7];

3) "Hypersexuality" ngati chizindikiro cha mkhalidwe wazamisala wokonda zamankhwala, zomwe zidalipo kapena zofananira kapena pambuyo pazochita zogonana zimawoneka kuti ndizosavomerezeka (mwachitsanzo, kukakamira kwambiri, kusokonezeka kwa manic, kapena vuto la umunthu) [7]. Poyerekeza ndi zomwe zafotokozedwa mu anamnesis, hegosynthesis imayimira chinthu chofunikira chazachipatala chomwe chimayambitsa matendawa kuchokera pamakhalidwe ndi vuto lamakhalidwe mpaka vuto lenileni la umunthu (mwachitsanzo, malire amtundu wamalire) [1].

4) "Hypersexuality" ngati chizindikiro cha mkhalidwe wamaganizidwe womwe umakonda kukokomeza (pakadali pano, kutchulidwaku kukugonana kosakwanira komwe kumafikira pakumapezekanso, mpaka kudalira kogonana) [7].

Mbiri za Neurobiological

Ochirikiza "Chizolowezi chogonana" zindikirani zomwe zimayambitsa matendawa munjira zomwezo zomwe anthu amakonda kutchova juga, chifukwa chake kusokonekera kwa dopaminergic ndi serotonergic ndikomwe kungakhale maziko ofufuza mokakamiza komanso kosalamulirika pakukhutira ndi kugonana. Dopamine neurotransmitter yotulutsidwa ndi ma neuron omwe amapezeka mu limbic system (maukosi am'magulu komanso makamaka ventral striatum) amamasulidwa mosavomerezeka m'maphunziro omwe ali ndi vutoli. Nthenda yotereyi imagwira ntchito yolimbikitsa kukhazikitsidwa kwamakhalidwe omwe cholinga chake ndi kukwaniritsa chisangalalo, chomwe chimaphatikizaponso machitidwe omwe amatsimikizira kupulumuka mwa anthu (fufuzani chakudya ndi madzi, machitidwe oberekera…). Ngakhale sanatsimikizidwebe motsimikizika ndikufufuza kwakukulu kwasayansi, akatswiri aphunzitsanso kutengapo gawo kwa malingaliro okhudzana ndi chiwerewere cha neurotransmitter serotonergic, mahomoni amanjenje omwe amakupangitsani kuti mukhale osangalala, okhutira, komanso okhutira. Kuyambira pa ma serotonergic neurons omwe ali m'mbali mwa preortal cortex, ma serotonergic afferents projekitiyo amalowa mu maukosi ophatikizika potulutsa kupangidwa kwa dopamine ndikuwongolera kuletsa kodzifunira ndikuwongolera machitidwe. M'maphunziro omwe ali ndi matenda am'magazi osokonekera komanso kukakamizidwa kuchita izi, ntchitoyi imakhudzidwa [10,11].

Kafukufuku waposachedwa adawonetsa zikhalidwe zosagonana zogonana ngati vuto lenileni la mitsempha: "Hypersexual amatanthauza kuwonjezeka kwakukulu kapena kutengapo gawo pazogonana zilizonse. Ndizovuta kuchipatala, zimawonetsa kusanthula kwanthawi yayitali ndipo pali zolemba zambiri zamankhwala zomwe zimayankhula za nosology, pathogenesis, ndi ma neuropsychiatric munthawi yamatenda iyi. Kugawika kumaphatikizapo machitidwe osokonekera, zinthu zomwe zitha kuzindikirika zokhudzana ndi kusakhazikika, komanso zochitika zowoneka bwino. Madokotala ena amawona kuwonjezeka kwa chilakolako chogonana ngati 'chabwinobwino' mwachitsanzo, akatswiri azamisala amakuwona ngati kudzitchinjiriza nthawi zina kumachepetsa nkhawa zomwe zimayambitsidwa ndi mikangano ya intrapsychic. Tikuwonetsa za kugonana kwachiwerewere monga magawo angapo okhudzana ndi kuchuluka kwa zochitika zogonana zomwe zimakhudzana ndi kupsinjika ndi kuwonongeka kwa magwiridwe antchito. Zizindikiro zakugonana ndizophatikizira zambiri zomwe zimaphatikizira zovuta zamatenda amisala (mwachitsanzo matenda a bipolar), zovuta zoyipa zamankhwala (mwachitsanzo mankhwala a levodopa), zovuta zomwe zimayambitsa matenda (mwachitsanzo amphetamine kugwiritsa ntchito mankhwala osokoneza bongo), matenda amitsempha yam'mimba (mwachitsanzo, matenda am'mbali yam'maso ), Pakati pa ena. Ma neurotransmitters ambiri amatenga nawo mbali m'matenda ake, pomwe dopamine ndi noradrenaline amatenga gawo lofunikira pamiyeso ya mphotho ya neural ndi olamulira mwamphamvu a limbic system neural circuits. Kuwongolera kwa chiwerewere kumatsimikiziridwa ndi mfundo ya de causa zotsatira zomwe zimafalikira, ngati zoyambitsa zimathandizidwa, zotsatira zake zitha. Tikufuna kuwunikanso udindo wa omwe amagwiritsa ntchito mankhwala omwe amachititsa kuti amuna kapena akazi anzawo azigonana komanso azithandizira omwe achitapo kanthu pochiza omwe akudwala. Zomwe zimayambitsa zokhudzana ndi chikhalidwe cha anthu ndizofunikira kwambiri pakulandira kumvetsetsa ndikuwongolera kasamalidwe ka matendawa "[12].

Pomaliza, kafukufuku wina wasayansi akuwonetsa kuthekera kotenga gawo la pituitary-hypothalamic-adrenal axis [13,14] ndi nucleus frontostriatal [15], kafukufuku wina (makamaka French), mbali inayo, ikuyang'ana kulumikizana pakati pa kugonana kosagwira makhalidwe ndi oxytocin [15-17], ngakhale lingaliro lomalizirali silinatsimikiziridwebe motsimikizika ngakhale panali chidziwitso chofunikira. Mankhwala opangidwa ndi oxytocin (okhala ndi mphuno ya m'mphuno) atha pamaziko awa, ngati atatsimikiziridwa, njira ina komanso yothandizirana ndi mfundo zabwino kwambiri zomwe zikugwiritsidwa ntchito [18].

Etiological ndi matenda mbiri

Zomwe zimayambitsa zikhalidwezi sizikudziwika bwino, ngakhale kufalikira komwe kumapezeka m'mabukuwa kumakhala kosiyanasiyana: majini, ma neurobiological, mahomoni, malingaliro, chilengedwe [12]. Komanso zovuta zamatenda, monga khunyu [19,20], dementia [21,22], obsessive-compulsive disorder [23] ADHD [24], impulse control control [25] ndi matenda amitsempha [26].

Komabe, kusiyanitsa mikhalidwe yosavomerezeka ndi zochitika zachiwerewere (ngakhale zili zazikulu komanso zochulukirapo), zina ziyenera kuganiziridwa m'mbiri yazachipatala [27].

A) Wodwala amasokonezeka ndi machitidwe ake ogonana ndipo amadzidalira;

B) Wodwalayo amafufuzira mosalekeza zochitika ndi anthu omwe ali ndi zolaula zambiri;

C) Wodwala amakhala maola ambiri patsiku akugonana;

D) Wodwala amapereka zikhalidwe zofananira m'mbiri yake yamankhwala;

E) Wodwalayo amalephera kuthetsa chilakolako chogonana, chomwe chimaonedwa kuti ndi chonyansa;

F) Wodwalayo, ndimachitidwe ake ogonana, adakhudza magawo ena m'moyo wake, monga ntchito, zovuta komanso moyo wabanja;

G) Wodwala amamva kusakhazikika m'maganizo akapanda kuchita zachiwerewere;

H) Wodwalayo amasokoneza ubale wake wamunthu komanso mayanjano chifukwa cha mchitidwe wogonana.

Pofuna kutanthauzira izi, mayeso oyesedwa ndi mayeso apangidwanso monga SAST (United States of America) ndi SESAMO (Italy); makamaka, chidule chomalizachi chimayimira Kuwunika kwa Ntchito Zowunika Pamafunidwe a Sexrelation Evaluation Monitoring, mayeso ophunzirira zamaganizidwe opangidwa ku Italy, ovomerezeka ndi okhazikika pakati pa anthu aku Italiya, omwe amachokera pamafunso omwe amafunsidwa kuti athe kuwunika zogonana komanso zachibale, zowongolera komanso zosagwira , m'maphunziro amodzi kapena ndi banja. Kuyesaku kuli ndi mafunso awiri, omwe amafunsira azimayi ndi amodzi amuna, lirilonse limagawika magawo atatu: gawo loyamba lili ndi zinthu zomwe zimafufuza madera okhudzana ndi zakugonana, chikhalidwe, zachilengedwe komanso mawonekedwe osiyana. za nkhaniyi, komanso mbiri yazachipatala. Gawoli lidapangidwa ndi onse omwe adafunsidwa omwe, kumapeto kwa gawo loyambali, apita kudera limodzi mwamagawo awiri kutengera mkhalidwe wawo wamalingaliro, womwe umatchedwa "vuto limodzi" kapena "banja"; gawo lachiwiri limasonkhanitsa zinthu zomwe madera awo ofufuzira akukhudzana ndi kugonana pakadali pano komanso zolimbikitsa; gawoli limasungidwa kuti likhale la Osakwatira, kutanthauza kuti izi sizipangitsa kuti pakhale ubale wokhazikika wogonana ndi mnzake; gawo lachitatu likuphatikiza madera omwe amafufuza zakugonana pakadali pano komanso maubwenzi apabanja. Gawoli lanenedwa zakusokonekera, komwe kumakhalapo ngati ubale wogonana womwe wakhalako kwa miyezi isanu ndi umodzi ndi wokondedwa wanu. Utsogoleri ukamatha, palibe chomwe chingasinthidwe pazofunsidwa ndi lipotilo, izi ndizoyenera pazifukwa zamakhalidwe koma ndizoposa zonse zofunika kuti akatswiri azitsimikizika komanso kuwunika. Ripotilo lili ndi magawo a 9, kuphatikiza zidziwitso zaumwini komanso za banja, graph, kugoletsa, mawonekedwe ofunikira, ndi lipoti lofotokozera, kuti amalize ndi magawo ndi mayankho amafunso [28].

Kugwiritsa ntchito zolaula pazokonda zogonana

Chodziwikiratu kuti, zolaula ndizowonetseratu zolaula ndi zolaula m'njira zosiyanasiyana, kuyambira zolemba mpaka kujambula, makanema ojambula komanso kujambula. Zochokera ku Girisi, ntchitoyi ikuyimira luso, popeza munthu aliyense nthawi zambiri amakhala ndi malingaliro olakwika, ndiye kuti, amagwiritsa ntchito malingaliro kuyimira zochitika zosangalatsa, popanda cholinga china koma chisangalalo chokha: zolaula ndizokhazikitsanso malingaliro awa zithunzi, zojambula, zolemba, zinthu kapena zinthu zina. Popeza anthu ambiri ali ndi malingaliro ofanana okonda zachiwerewere, nthawi zambiri zolaula zomwe zimapangidwa ndi munthu m'modzi, zomwe zimawoneka ngati zolaula, zimasangalatsanso ena ambiri. Ngakhale zolaula zakhala zikugwiritsidwanso ntchito ngati chinthu chophweka pazinthu zovuta kwambiri, cholinga chake chachikulu ndikupangitsa kuti anthu azikhala ndi chilakolako chogonana. Pakhala pali kutsutsana pazakusintha kwa malire pakati pa zaluso, zolaula, komanso zolaula, zomwe nthawi zambiri zimawonedwa ngati zosaloledwa m'malamulo akumadzulo, koma m'malo ena zimakhala (kapena zakhala) zikuwunikidwa ndipo kuwonera ndikoletsedwa (makamaka Aang'ono). Kupezeka kwakukulu kwa anthu komanso kutsika mtengo kwa sing'anga kumapangitsa intaneti kukhala njira yogwiritsidwa ntchito kwambiri pakugawa ndikugwiritsa ntchito zolaula. M'malo mwake, pakubwera kwa intaneti, makamaka pakufalitsa machitidwe monga kugawana mafayilo (kugawana mafayilo) ndi kugawana makanema (kugawana makanema), zolaula zakhala zikupezeka kulikonse komanso kwa aliyense mosadziwika. Zotsatira zaposachedwa zodabwitsazi, zachepetsa, kumverera kodzudzulidwa pamaso pa mawonekedwe amtunduwu, komano, kwathandizira kuphulika kapena kufalikira kwakukulu kwa zochitika monga "amateur" mtundu, wopangidwa pakupanga zithunzi ndi makanema olaula omwe akuwonetsa anthu wamba (nthawi zambiri olemba omwewo monga malonda). Kuphatikiza pakugawana mafayilo, njira ina yayikulu yogawa zolaula zolaula pa intaneti imayimilidwa ndi masamba olipidwa, ntchito yopindulitsa kwambiri kwa omwe amapanga zinthu zamaluso omwe akupatsa ukonde njira zogawa zapamwamba monga malo ogulitsira manyuzipepala, malo ogulitsira makanema komanso malo ogulitsira ogonana. Chifukwa cha netiweki, zomwe olemba ena amazitcha kuti neo-porn zikuwonjezeka kwambiri, pomwe masewera achiwerewere a achikulire, kapena masewera apakompyuta, akufalikira, omwe mikhalidwe yawo (ngakhale imasiyanasiyana pakusekerera mpaka kuzosangalatsa) amakhalabe ndi zolaula. Tithokoze kuwululidwa kwa ziwonetsero zolipira komanso zomwe sizinalipidwe, kudzera pa tsamba la webukamu (lodziwika kwambiri pa intaneti), limalola kupita nawo kumawonetsero azolaula ndikulumikizana kudzera pa macheza ndi omwe akuchita nthawi imeneyo [29].

Kafukufuku waposachedwa pankhani zakugonana komanso zolaula zapeza kuti:

1. Kugwiritsa ntchito zolaula pakati pa achinyamata, omwe amawagwiritsa ntchito kwambiri pa intaneti, kumalumikizidwa ndi kuchepa kwa chilakolako chogonana komanso kutaya msanga msanga, komanso nthawi zina pamavuto azikhalidwe, kukhumudwa, DOC, ndi ADHD [30-32] .

2. Pali kusiyana kooneka bwino pakati pa "omwe amagonana ndi amuna anzawo" ndi "omwe amakonda kugwiritsa ntchito zolaula": ngati wakale ali ndi vuto lonyengerera, omalizirawa amadziwika ndi kuyambiranso kwazomwe zimachitika chifukwa cha zododometsa ndikupeza mphotho popanda kunyengerera kwa madera amalipiro. Izi zitha kutanthauza kuti ogwira ntchito amafunikira kulumikizana ndi anzawo, pomwe omalizawa amakhala akuchita zinthu zosungulumwa [33,34]. Komanso, ogwiritsa ntchito mankhwala osokoneza bongo amawonetsa kusokonekera kwakukulu kwa zinthu zoyera za preortal cortex [35].

3. Zizolowezi zolaula, ngakhale ndizosiyana ndi zomwe zimachitika chifukwa chogonana, zimakhalabe machitidwe ena osokoneza bongo ndipo kusokonekera kumeneku kumathandizira kukulira kwa matenda a psychopathological ya munthu, mwachindunji kapena mwanjira inayake yokhudzana ndi kusintha kwa ma neurobiological pamlingo wokhudzidwa kuti ukhale wolimbikitsa wogonana, hypersensitization to zolimbikitsa kukanika kugonana, kuchuluka kwa nkhawa zomwe zimatha kukhudza ma hormonal a pituitary-hypothalamic-adrenal axis komanso kusachita bwino kwa mabwalo oyambira [36].

4. Kulekerera kwakanthawi kogwiritsa ntchito zolaula kunatsimikiziridwa ndi kafukufuku wa fMRI womwe udapeza kupezeka kwa imvi pamalipiro (dorsal striatum) yokhudzana ndi kuchuluka kwa zolaula zomwe zidadyedwa. Anapezanso kuti kugwiritsa ntchito zolaula mopitilira muyeso kumalumikizidwa ndi kuchepa kwa gawo lamalipiro kwinaku mukuwonera mwachidule zithunzi zogonana. Ochita kafukufuku amakhulupirira kuti zotsatira zawo zikuwonetsa kukhumudwa komanso mwina kulolerana, zomwe ndizofunikira zolimbikitsanso zambiri kuti zikwaniritse zomwezo. Komanso, zizindikiro za kuthekera kochepa zapezeka mu Putamen m'mitu yodalira zolaula [37].

5. Mosiyana ndi zomwe munthu angaganize, anthu omwe amakonda kugwiritsa ntchito zolaula alibe chilakolako chogonana ndipo chizolowezi chogonana chomwe chimakhudzana ndikuwonera zolaula chimachepetsa chikhumbo chomwe chimakondweretsanso kukodzera msanga, popeza mutuwo umakhala womasuka mukamachita masewera olimbitsa thupi. Chifukwa chake anthu omwe ali ndi zolaula zambiri amakonda kuchita zogonana zokha kuposa momwe amachitira ndi munthu weniweni [38,39].

6. Kuyimitsidwa mwadzidzidzi kwa zolaula kumayambitsa zovuta mumisewu, chisangalalo, komanso kukondana komanso kugonana [40,41].

7. Kugwiritsa ntchito zolaula mozama kumathandizira kuyambika kwamavuto amisala ndi mavuto amgwirizano [42].

8. Ma network a neural omwe amachita zachiwerewere ndi ofanana ndi omwe amachita nawo mphotho zina, kuphatikiza zosokoneza. Kupezeka kwa madera am'magazi am'mbuyomu okhudzana ndi chilakolako chogonana, chikondi, ndi cholumikizira zafotokozedweratu ndi malo am'magawo amkati, ma nucleus accumbens, amygdala, basal ganglia, preortalal cortex ndi cortex orbitofrontal pokhala gawo wamba. Mtundu wotchedwa "mphoto ya vuto la matenda" (RDS) yakhala ikukhudzidwa ndi zolaula ndipo zimatanthauza kusakhutira chibadwa kapena kuwonongeka kwa mphotho yaubongo zomwe zimabweretsa chisangalalo chofunafuna machitidwe omwe amaphatikizapo mankhwala osokoneza bongo, kudya kwambiri, masewera achiwerewere, kutchova juga, ndi makhalidwe ena. Chifukwa chake, kutulutsidwa kosalekeza kwa dopamine m'dongosolo la mphotho kunatsimikiziridwa pomwe munthu amakakamira ndikuwonerera zolaula kumapangitsa kusintha kwamitsempha yamagetsi komwe kumalimbikitsa zomwe zidachitikazo. Kusintha kwamitsempha kwamtunduwu kumapanga mapu aubongo okhudzana ndi chilakolako chogonana. Mitundu yonse yamtunduwu imadziwika kuti imakhudza dopamine mesolimbic pathway (DA), yomwe imachokera ku ventral tegmental area (VTA) ndipo imawonekera mu nucleus accumbens (NAcc) yomwe imapanga dera lamalipiro osokoneza bongo. Dera ili lakhala likukhudzidwa ndi chisangalalo, kupatsidwa mphamvu, kuphunzira, kupindulitsa, komanso kupupuluma komwe kumawoneka pakukonda. Njira ya mesolimbic ya dopamine imalumikizidwa ndi zigawo zitatu zaubongo kuti ipange ma circuits owonjezera omwe amatchedwa mphotho yolowerera. Zomwe zimakhudzidwa ndi amygdala omwe amakhala ndi malingaliro abwino, oyipa komanso kukumbukira malingaliro, hippocampus yomwe imagwira ntchito pokonza ndikubwezeretsa kukumbukira kwakanthawi, ndi kotekisi yakutsogolo yomwe imagwirizanitsa ndikuwonetsa machitidwe osokoneza bongo. Magulu osiyanasiyana a mankhwala osokoneza bongo amatha kuyambitsa mphotho m'njira zosiyanasiyana, komabe, zotsatira zake zonse ndikutuluka kwa dopamine kulowa mu nucleus accumbens (malo opezera mphotho). Izi zimabweretsa kulimbikitsana kwabwino kwamakhalidwe omwe adayambitsa kusefukira kwamadzi ndi mayanjano okhudzana ndi zosokoneza bongo. Chigumula cha dopamine chikamaliza kumaliza, pamakhala kuyambitsa kwa amygdala, dera lomwe limakhudzana ndi kukonza ululu komanso mantha. Izi zimabweretsa kuyambitsa machitidwe opanikizika muubongo komanso kuchepa kwamankhwala ochepetsa kupsinjika komwe kumachepetsa chidwi chamaphunziro komanso kuchuluka kwa mphotho, komwe kumatchedwa kulolerana. Chifukwa chake, pali kubwereza ndi kulimbikitsa machitidwe osokoneza bongo. Madera ena omwe amakhudzidwa ndi preortal cortex amaphatikizira dorsolateral prefrontal cortex (DLPFC), yomwe imayang'anira zigawo zikuluzikulu zakuzindikira ndi ntchito yayikulu (14) ndi ventromedial prefrontal cortex (VMPFC) yomwe imayambitsa zigawo zoletsa kuthana ndi mayankho, zomwe zimakhudza chidziwitso chakukonzekera mphotho. Ubongo wodalira umalowa mu "allostatic" pomwe dongosolo lamalipiro silingathe kubwerera kwawo (kwachibadwa). Dongosolo la mphotho pambuyo pake limakhazikitsa mfundo zosinthidwa, kusiya munthuyo pachiwopsezo chobwereranso ndikuledzera. Ichi ndi chomwe chimatchedwa "mbali yakuda" yoledzera. Muubongo wogwiritsa ntchito zolaula, mamapu amaubongo omwe adakhazikitsidwa kale kuti azigonana sangafanane ndi mapu omwe apangidwa kumene komanso olimbikitsidwa mosalekeza opangidwa ndikuwonera zolaula, ndipo munthu wodalirayo amakhala wowonekera komanso kugwiritsa ntchito zithunzi zolaula kuti akhalebe wamkulu kuposa chisangalalo. Zosintha pakachulukidwe ka dopamine receptor zakhudzidwa pamtunduwu ndikusintha kwamuyaya mu dongosolo la mphotho. Kafukufuku waposachedwa akuwonetsa kuti nthawi yayitali pakuwonera zolaula, m'pamenenso kuchuluka kwa imvi pamiyeso yolondola ya caudate kumachepa; Kuphatikiza apo, kulumikizana pakati pa caudate yolondola ndi kumanzere kwa dorsolateral prefrontal cortex (DLPFC) kumachepa, chinthu china cholumikizana ndi iwo omwe ali ndi vuto lamakhalidwe kapena chizolowezi chodalira zinthu. Pomaliza, maphunziro ena apeza kuti kusinthidwa kwa mapangidwe a neural monga orbitofrontal cortex (OFC) ndi ma subcortical system amalumikizidwa mwachindunji ndikusintha kwa mitsempha ya serotonin komanso pakati pa serotonin ndi dopamine.

Zithandizo zamankhwala

Vutoli, lomwe limakhudza gawo lamaganizidwe, limagwiritsidwa ntchito ndi munthu kapena gulu la psychotherapy, momwe njira ina imagwiritsidwira ntchito pang'ono kuposa yomwe imagwiritsidwa ntchito podziletsa: njira yomwe cholinga chake ndi kukakamiza wophunzirayo kuthana ndi malingaliro owonera kufunikira ndikubwerera kukhala ndi ubale wabwino ndi kugonana. M'mavuto ovuta kwambiri, pambali pamaganizidwe amachitidwe kapena njira zamankhwala (kupewa zoyeserera, pazifukwa zazitali), mankhwala osokoneza bongo komanso mankhwala azamankhwala omwe amatha kuchepetsa libido atha kugwiritsidwa ntchito, nthawi zonse ngati palibe chifukwa chothandizira mankhwala osokoneza bongo antidepressants, mood stabilizers, ndi antipsychotic pamaso pa ma psychopathologies ena, mu comorbidity [5,29,44].

Zizolowezi zochiritsira zanzeru komanso zanzeru, pankhani yazakugonana komanso zikhalidwe zosagonana, zimayang'ana mbali zinayi zenizeni [45].

a) Kuchepetsa chilakolako chogonana ndikulepheretsa kusokoneza; Nthawi zambiri cholinga ichi chimafunidwa pogwiritsa ntchito mankhwala opondereza omwe, ngati angathe kuchepetsa chilakolako chogwira ntchito, changu, chisangalalo ndikuchulukitsa nthawi ya chiwonongeko, amathanso kukulitsa kukhudzika ndi malingaliro azakugonana, ndikupanga mkhalidwe woyipa kwambiri;

b) Kuchepetsa kukhudzika kwakukulu kudzera pazolimbitsa thupi komanso zopewetsa kupsinjika, kuchepetsa nthawi, kukula, komanso kuopsa kwa magawo amanjenje;

c) Kuchulukitsa kukhutira mkati, kuti chikhumbo chofunafuna mwachangu komanso pafupipafupi, osakhala ndi zoyambitsa zambiri;

d) Sokonezani ndi chiwonetsero chazomwe mungapangitse kuti chisangalalo chisakhale chowonjezera nthawi kumapeto kwake.

Ku Italy, Cantelmi ndi Lambiase [46], adayang'ana kwambiri chithandizo pakufunsidwa kwamphamvu komanso kuchira kwa zomwe wodwalayo akuchita. M'malo mwake, malinga ndi njirayi, kuyang'ana kwambiri pakuwunika kwa zodabwitsazi komanso zodetsa nkhawa pakukhazikitsa zikhalidwe zobwerezabwereza, zokakamiza komanso / kapena zonyansa, zimawopseza kuthekera koyambitsa matendawa kukulirakulira, zomwe zimaphatikizapo kufunikira kophiphiritsira komwe kugonana kumaimira nthawi imeneyo kwa wodwalayo. Vuto lachiwerewere lingagwirizane ndi kusakanikirana kwamachitidwe olimbikitsira omwe mutuwo udakonzedwa munthawi yachitukuko kuyambira polumikizana ndi omwe amamusamalira oyamba. Potengera kafukufuku wamachitidwe olimbikitsira omwe a Liotti adalemba, olembawo akuphatikiza lingaliro lakuchepa kwa ntchito zodziwikiratu zomwe a Antonio Semerari amapanga mu malingaliro amalingaliro amachitidwe ogwiritsira ntchito mkati. Njira zodziwikiratu izi zikufanana ndi mitundu yakachitidwe yomwe idafotokozedweratu ndi wamankhwala amisala komanso a psychoanalyst a John Bowlby, omwe adazindikira kuchuluka komwe amapezeka kuti akugwirizana ndi maphunziro omwe adachitidwa ku Italy ndi Giovanni Liotti ndi Vittorio Guidano, ngakhale omaliza anali ozindikira. Zoyeserera zomwe Liotti adagawana zidagawika m'magulu atatu azisinthiko ndipo akudyetsa, kupuma, kufufuza, kulumikizana mwakugonana pazomwe zikukhudzana kwambiri ndi chisinthiko, chomwe chimatsimikizira kupulumuka. Mu gawo lachiwiri, lomwe limakhudza kufunikira kwa mayanjano, mtundu wa anthu, Liotti amadziwika kuti kulumikizana, mgwirizano pakati pa ofanana, kuphatikiza zogonana komwe kumapangira moyo wapabanja, maudindo; pa mulingo wachitatu, otsogola kwambiri, chilankhulo chophiphiritsira, kufunikira kodziwa, kufunikira kofotokozera tanthauzo, kufunafuna mfundo. Mitundu yonse yoyendetsa yoyendetsa ilipo mwa munthu aliyense, ndipo imatha kuyatsidwa kapena ayi ndi zakunja. Malinga ndi olemba awiriwa, makina ophatikizira amatenga nawo mbali kwambiri pakukhazikitsa njira zolimbikitsira odwala omwe ali ndi vuto lachiwerewere. Nthawi zambiri, kutsegulira koyamba kuyenera kupatula kuyambitsa kwina, chifukwa cha zifukwa ziwiri zosiyana. Komabe, asing'anga awiriwo adawona kuti mwa odwala omwe ali ndi vuto logonana amuna kapena akazi okhaokha, machitidwe azakugonana nthawi zambiri amayambitsidwa munthawi yamavuto, mantha, kapena kukhumudwa ngati chida chothandizira kuthana ndi malingaliro osalimbikitsa. Izi ndichifukwa choti womusamalira yemwe samalandilidwa (mwamalingaliro) sapezeka, munthuyo "waphunzira" mosazindikira momwe angakhalire ndi moyo wabwino komanso chisangalalo kudzera munthawi yogonana. Izi zimatsimikiziridwa ndi kafukufuku wambiri yemwe amathandizira kusokonezeka kwa chizolowezi chomwe chimachitika chifukwa cha zovuta zomwe zidachitika kale. Popeza njirayi imachitika mwa wodwala mosazindikira, samatha kumvetsetsa ndikusokoneza zomwe zimamupangitsa kuti abwerezenso zikhalidwe zakugonana m'malo ovuta. Cantelmi ndi Lambiase amakhulupirira kuti kusoweka kolongosoka kwa msinkhu wa tizilombo toyambitsa matenda kumayambitsidwa ndi kuchepa kwa ntchito za wodwalayo, ndiko kuti, pakutha kudziganizira yekha, kuzindikira momwe akumvera, kuwongolera mosasintha kuti akwaniritse zolinga zake , ikani njira zokhazikitsira kuwongolera moyenera. Ntchito zama Metacognitive zimamangidwa mosalekeza ndikukonzanso m'moyo wa munthu aliyense, kuyambira pakuyanjana kwake koyamba ndi womusamalira woyamba. Kupyolera mukuwonetsera momwe mwanayo amachitira ndi mwanayo, amaphunzira kuzindikira momwe akumvera, zomwe pamlingo woyamba zimangosiyanitsa pakati pa "zosangalatsa" kapena "zosasangalatsa", ndikuzindikira za ena. Kukumbukira kwamomwe adakumana nawo ali mwana kumalembedwa pamutu wokumbukira komanso mosaganizira; zokumbukira zomwe zidasungidwa zidzakonzedwanso mkati mwa zoyeserera, zomwe ziziwongolera momwe munthuyo azikhalira ngati dongosolo lina litsegulidwa ndi zakunja. Mwachidule, malinga ndi azachipatala awiri aku Italiya, njira zomwe zimapangitsa kuti anthu azigonana ndizokhazikitsa njira zolakwika zokhudzana ndi pempho la chilengedwe: pomwe zinthu zingafune kuti pakhale njira yolumikizira, yomwe iyenera kuyambitsa mndandanda Makhalidwe omwe cholinga chake ndi kuyitana munthu wotonthoza, kufunafuna thandizo, kapena kugwiritsa ntchito njira zina kuti muchepetse mantha ndi nkhawa, machitidwe olimbikitsa kugonana amayambitsidwa, ndikupangitsa kuti mutuwo uzichita zachiwerewere. Mwachidziwitso cha chiphunzitsochi, komabe, mankhwala othandizawa cholinga chake ndikukulitsa chidziwitso cha wodwalayo za komwe kudwala kwake kumayambira komanso njira yovuta momwe kukondweretsedwa kwa kugonana kumayambitsidwira mwa iye kuti athe kulipirira ntchito zina, monga kusamalira zowawa, kunyong'onyeka, mantha za kusiyidwa. Chofunikira kwambiri mwa olemba awiriwa ndikuthandiza wodwala kuzindikira momwe akumvera komanso ndi zochitika ziti zomwe zimayambitsa chilakolako chogonana mwa iye, kuti athe kufotokoza njira zina zothetsera mavuto limodzi.

Mawuwo

Gulu lazachipatala la "machitidwe osagwirizana ndi zakugonana" limaphatikizapo malingaliro angapo am'magulu am'magazi makamaka olumikizidwa ndi zizindikiritso zomwe zafotokozedwa mu anamnesis. Chifukwa chake, chiwerewere chimatha kungokhala chifukwa cha kuyambitsa kwakukulu kapena, kuyika malingana ndi zizindikilo, chiwonetsero cha matenda am'magazi kapena zamatsenga: poyambirira tidzayenera kudzipangitsa kukhala ndi khunyu, mitsempha, matenda amisala, zotupa. kusokonezeka, matenda am'mimba kapena neuroendocrine; pankhani yachiwiri, mbali inayi, tiyenera kuganizira za mbiri ya psychopathological, mpaka zizolowezi ndi zovuta zamunthu. Kafukufuku wama Neurosciology amatsimikiziranso lingaliro loti kuseri kwamakhalidwe oyipa ogonana pali njira yomweyo yomwe imasunga machitidwe ndi / kapena zosokoneza bongo, makamaka ku dera la ventral tegmental, ma nucleus accumbens, amygdala, basal ganglia, preortal cortex ndi kotekisi orbitofrontal. Kupitilira pamaganizidwe okhudzana ndi kutenga nawo gawo kwa dopamine ndi serotonin, lingaliro la kukhudzidwa kwa oxytocin mu mphotho ndi njira yokhutira limawoneka losangalatsa; komabe, kafukufuku wokhudzana ndi malingaliro awa akadali ochepa ndipo zomwezo sizingaganiziridwe kukhala zotsimikizika. Mtsogolomu, chidwi chachikulu chikuyembekezeka pa lingaliro la oxytocin pankhani yokhudza chizolowezi chogonana, chiwerewere, komanso zolaula.

ZOKHUDZA

Chithunzi 2: Peresenti Kufalitsa kwa Achinyamata ndi Source Prevention Services.

1. Perrotta G (2019) Psicologia chipatala. Luxco mkonzi.
2. AA VV (2019) ICD-11, Washington.
3. World Health Organisation: WHO, Ginevra.
4. Kraus SW, Krueger RB, Briken P, MB Yoyamba, Stein DJ, et al. (2018) Matenda osokoneza bongo mu ICD-11. Padziko Lonse Lapansi Psychiatry 17: 109-110. Lumikizani: https://bit.ly/3iwIm35
5. APA, DSM-V, 2013.
6. Perrotta G (2019) Matenda a Paraphilic: tanthauzo, zochitika ndi njira zamankhwala. Onaninso nkhani, Author. Journal of Addiction Neuro Kafukufuku 1: 4. Lumikizani: https://bit.ly/34iqHHe
7. Walton MT, Bhullar N (2018) "Msychology" ya Hypersexuality: wazaka 40 wazogonana yemwe amagwiritsa ntchito macheza pa intaneti, zolaula, maliseche komanso kugonana kwachilendo. Zosungidwa Zokhudza Kugonana 47: 2185-2189. Lumikizani: https://bit.ly/34nP9Y2
8. Gwinn AM, Lambert NM, Fincham FD, Maner JK (2013) Zithunzi Zolaula, Ubale Njira Zina, ndi Makhalidwe Apamtima Owonjezera. Social Psychological and Personality Science 4. Lumikizani: https://bit.ly/36z2zCX
9. Brancato G (2014) Psicologia dinamica. Kutulutsa.
10. Kandel ER (2014) Principi di Neuroscienze, IV Mkonzi. IT, Casa Sinthani Ambrosiana. Lumikizani: https://bit.ly/36xF7Gv
11. Gola M, Zolemba M (2018) Ventral Striatal Reactivity mu Zokakamiza Zogonana. Front Psychiatry 9: 546. Ulalo: https://bit.ly/36vNwdh
12. Asiff M, Sidi H, Masiran R, Kumar J, Das S, ndi al. (2018) Hypersexuality ngati matenda a neuropsychiatric: njira za neurobiology ndi chithandizo. Zolinga za Mankhwala Osokoneza bongo 19: 1391-1401. Lumikizani: https://bit.ly/30ygN3q
13. De Sousa SMCWolemba Baranoff J, Rushworth LR, Butler J, Sorbello J, et al. (2020) Impulse Control Disorder mu Dopamine Agonist-Treated Hyperprolactinemia: Kukula ndi Zowopsa. J Clin Endocrinol Metab 105.pii: dgz076. https://bit.ly/36v5Lja
14. Wolemba Barake M., Klibanski A, Tritos NA (2018) kasamalidwe ka matenda a endocrine: Zovuta zakuwongolera kwa odwala omwe ali ndi hyperpolactinemia yothandizidwa ndi dopamine agonists: tiyenera kuda nkhawa zochuluka motani? Eur J Endocrinol 179: R287-R296. Lumikizani: https://bit.ly/33wMcoG
15. Amenya JWolemba Theis H, Giehl K, Hoenig MC, Greuel A, et al. (2019) Dopamine metabolism ya ma nucleus accumbens ndi kulumikizana kwa fronto-striatal kumayendetsa kuwongolera. Brain 142: 733-743. Lumikizani: https://bit.ly/33vUKfG
16. [Adasankhidwa] Mouly C., Wopanda Borson-Chazot F., Caron P Makhalidwe a L'hypophyse et ses: comment peuvent-ils influer sur le comportement?: Chithandizo ndi chithandizo chake: angakhudze bwanji machitidwe? Ann Endocrinol (Paris) 78: S41-S49. Lumikizani: https://bit.ly/30ADS5p
17. Guay DR (2019) Chithandizo cha mankhwala osokoneza bongo a paraphilic and nonparaphilic. Clin Ther 31: 1-31. Lumikizani: https://bit.ly/34tlHja
18. Bostrom AE, Chatzittofis A, Ciuculete DM, Flanagan JN, Krattinger R, et al (2020) Hypermethylation-yokhudzana ndi kuchepa kwa microRNA-4456 mu vuto la hypersexual lomwe limakhudza kuwonetsa kwa oxytocin: Kuwunika kwa methylation ya DNA ya majini a miRNA. Epigenetics 15: 145-160. Lumikizani: https://pubmed.ncbi.nlm.nih.gov/31542994/
19. Perrotta G (2020) Oxytocin ndi udindo wowongolera momwe akumvera: tanthauzo, zochitika zamankhwala am'magazi komanso zochitika zamankhwala, kugwiritsa ntchito moyenera ndi zotsutsana. Zosungidwa Zokhudza Kukhumudwa ndi Kuda Nkhawa 6: 001-005. Lumikizani: https://www.peertechz.com/articles/ADA-6-143.php
20. Gündüz N, Turan H, Polat A. (2019) Kugonana Kwakuwonetseredwa Monga Kugonana Kwambiri Kwa Wodwala Wachikazi Pambuyo Pa Opaleshoni Ya Khunyu Lobe Epileptic: Ripoti Lachilendo. Noro Psikiyatr Ars 56: 316-318. Lumikizani: https://bit.ly/3jxOHwu
21. Wachikhalidwe C, Kusintha OJ, Lufu G, Radhakrishnan K (2019) Kulephera kugonana kwa anthu omwe ali ndi khunyu. Khunyu Behav 100: 106495. Ulalo: https://bit.ly/3jzP3CT
22. Chapman KR, Spitznagel MB (2019) Muyeso wamankhwala opatsirana pogonana mu dementia: Kuwunika mwatsatanetsatane. Int J Geriatr Psychiatry 34: 1747-1757. Lumikizani: https://bit.ly/3izM77U
23. Nordvig AS, Goldberg DJ, (Adasankhidwa) Huey ED, Chithunzi ndi Miller BL (2019) Zazidziwitso zokhudzana ndi kugonana kwa odwala matenda amisala: kuwunika kwamitsempha. Neurocase 25: 66-74. Lumikizani: https://bit.ly/2Sudl5r
24. Fuss J, Briken P, Stein DJ, Lochner C (2019) Matenda okakamiza pakugonana pakukakamira-kukakamiza: Kukula ndi kuwonongeka kwake. J Behav Addict 8: 242-248. Lumikizani: https://bit.ly/3cXteL0
25. Bőthe B, Koos M, Tóth-Király I, Orosz G, Demetrovics Z (2019) Kufufuza Mayanjano Aakulu ADHD Zizindikiro, Hypersexuality, ndi Zovuta Zolaula Gwiritsani Ntchito Pakati pa Amuna ndi Akazi pa Largescale, Non-Clinical Sample. J Sex Med 16: 489-499. Lumikizani: https://bit.ly/2StOsqC
26. Garcia-Ruiz PJ (2018) Impulse Control Disorders ndi Kupanga Zinthu Zokhudzana ndi Dopamine: Pathogenesis ndi Mechanism, Short Review, ndi Hypothesis. Kutsogolo Neurol 9: 1041. Ulalo: https://bit.ly/2SpWOzc
27. Castellini G, Rellini AH, Appignanesi C, Pinucci I, Fattorini M, ndi al. (2018) Kupatuka kapena Zachilendo? Chiyanjano Pakati pa Maganizo a Paraphilic ndi Ma Behavi, Hypersexuality, ndi Psychopathology mu Zitsanzo za Ophunzira ku Yunivesite. J Sex Med 15: 1824-1825. Lumikizani: https://bit.ly/36yXPxk
28. Chithunzi cha KDS, Gulani M, Dutta P., Mukherjee KK, Bhansali A. (2018) Hypersexuality kutsatira kutulutsa kwamkati kwamitsempha yamitsempha. India India 66: 868-871. Lumikizani: https://bit.ly/3lbQrMr
29. Boccadoro L (1996) SESAMO: Kuwunika Ndondomeko Yowunika Zokhudza Kugonana, Approccio differentnziale al profilo idiografico psicosessuale e socioaffettivo. OS Organzazioni Speciali, Firenze.
30. Perrotta G (2019) Psicologia generale. Luxco mkonzi.
31. Sarkis SA (2014) ADHD ndi Kugonana: Mafunso ndi Ari Tuckman, su psychologytoday.com, Psychology Masiku Ano. Lumikizani: https://bit.ly/2HYlvB5
32. Paki ndi, Wilson G, Berger J, Christman M, Reina B, et al. (2016) Kodi Zithunzi Zolaula za pa Intaneti Zimayambitsa Mavuto Ogonana? Kubwereza ndi Malipoti Achipatala. Behav Sci (Basel); 6: 17. Lumikizani: https://bit.ly/3jwzgod
33. Porto R (2016) Zizolowezi zolimbitsa maliseche ndi ma dysfonctions sexuelles amuna. Kugonana 25: 160-165. Lumikizani: https://bit.ly/3daPXUd
34. Bzi B, Tóth-Király I, Potenza MN, Griffiths MD, Orosz G, ndi al. (2019) Kuyambiranso Udindo Wosakhudzidwa ndi Kukakamizidwa M'mavuto Ogonana. Zolemba pa Kafukufuku wakugonana 56: 166-179. Lumikizani: https://bit.ly/30wCZuC
35. Gola M, Draps M (2018) Ventral striatal reactivity pakuchita zachiwerewere. Malire a Psychiatry 9: 546. Lumikizani: https://bit.ly/33xFizI
36. Volkow ND, Koob GF, McLellan T (2016) Kupititsa patsogolo kwa Neurobiologic kuchokera ku matenda amtundu wa bongo. New England Journal of Medicine 374: 363-371. Lumikizani: https://bit.ly/3iwsf5J
37. Miner MH, Raymond N, Mueller BA, Lloyd M, Lim KO (2009) Kafukufuku woyambirira wazikhalidwe zosakakamiza komanso za neuroanatomical zokhudzana ndi chiwerewere. Psychiatry Res 174: 146-151 (Adasankhidwa) Lumikizani: https://bit.ly/34nPJFc
38. Kuhn S, Gallinat J (2014) Kapangidwe ka Ubongo ndi Kulumikizana Kogwira Ntchito Kogwirizana Ndi Kugwiritsa Ntchito Zolaula. Ubongo pa Porn JAMA Psychiatry 71: 827-834. Lumikizani: https://bit.ly/2GhtSaw
39. Vuto V, Mole TB, Banca P, Porter L, Morris L, et al. (2014) Zogwirizana ndi Neural zokhudzana ndi kugonana pakati pa anthu omwe ali ndi zizolowezi zogonana popanda. PLoS One 9: e102419. Lumikizani: https://bit.ly/36wUWwZ
40. Doran K, Price J (2014) Zolaula ndi Ukwati. Zolemba Pazabanja ndi Ecomomic Nkhani 35: 489-498. Lumikizani: https://bit.ly/3iwsOwn
41. Bergner RM, Bridges AJ (2002) Kufunika kokhudzana ndi zolaula zomwe zimakhudzidwa ndi omwe ali pachibwenzi nawo: Kafukufuku ndi zomwe zingachitike pamagulu azachipatala. J Kugonana Kwabanja Ther 28: 193-206. Lumikizani: https://bit.ly/2Srwm8v
42. Boies SC, Cooper A, Osborne CS (2014) Kusiyanasiyana kwamavuto okhudzana ndi intaneti komanso magwiridwe antchito pamaganizidwe ogonana pa intaneti: zomwe zimakhudza chitukuko cha achinyamata komanso kugonana. Cyberpsychol Behav 7: 207-230. Lumikizani: https://bit.ly/3jIOIO8
43. De Sousa A, Lodha P (2017) Neurobiology ya Zolaula Kuledzera - Ndemanga yachipatala. Telangana Journal of Psychiatry 3: 66-70. Lumikizani: https://www.tjponline.org/articles/Neurobiology-of-pornography-addiction-a-clinical-review/161
44. Perrotta G (2019) Psicologia dinamica. Luxco mkonzi.
45. Boncinelli V, Rossetto M, Veglia F (2018) Sessuologia clinica, Erickson, Ndinalemba.
46. Cantelmi T, Lambiase E (2016) Kuwunika kwa mlandu wa Borderline Personality Disorder wokhala ndi zonyansa zakukakamiza malinga ndi Interpersonal Motivational Systems ndi mitundu yogwira ntchito ya Metacognitive. Modelli della Mente.