Zolakolako zolaula: Kodi ndizosiyana? (2017)

Adnan Kadiani, Ekram Goyal, Spandana Devabhaktuni, Brig Daniel Saldanha, Bhushan Chaudhari
Dipatimenti ya Psychiatry, Dr DY Patil Medical College, Hospital ndi Research Research, Pune, Maharashtra, India

Mndandanda wa Mauthenga:
Brig Daniel Saldanha
Dipatimenti ya Psychiatry, Dr DY Patil Medical College, Pimpri, Pune - 411 018, Maharashtra
India

Gwero la Thandizo: Palibe, Kulimbana: palibe

DOI: 10.4103 / MJDRDYPU.MJDRDYPU_303_16

Pakati pa mitundu yonse ya machitidwe oledzeretsa, zomwe zokhudzana ndi kugonana ndizovuta kwambiri kuti tigwirizane pamene sitikukambirana zokambirana zokhudza kugonana. Kuyambira pa msinkhu woonera zolaula mwakuya, mnyamata wazaka 34 wokwatira kwa zaka 6 amakhala woledzera. Nkhaniyi ikuwunikira kufunika kozindikira zolaula monga vuto ndi mavuto omwe akukumana nawo.

Keywords: Njira yothetsera khalidwe lachidziwitso, khalidwe loonera zolaula, zolaula

Kukula kwakukulu kwa intaneti m'zaka zaposachedwa kukuwonetsa kuchuluka kwa anthu, omwe amaonera zolaula, mwachitsanzo, pali masamba opitilira zolaula oposa 4.2 miliyoni omwe amafunsidwa ndi injini zosaka zolaula za 68 miliyoni. Pafupifupi 42.7% owonera intaneti amaonera zolaula ndipo 72 miliyoni amawona masamba achikulire padziko lonse lapansi pamwezi. Pafupifupi 28% yazachuma ku China ndi South Korea imaposa $ 27.40 biliyoni iliyonse yokwanira kudyetsa 62% ya anthu omwe ali ndi njala yapadziko lonse chaka chonse.^[1] Chifukwa cha zovuta zomwe zili pamwambapa, kuwononga intaneti ngakhale kuti sizinalembedwe m'maganizo a Mayiko Osiyanasiyana a Matenda a 10 kapena Kufufuza ndi Masamba a Mental Disorder-5 (DSM-5), kupezeka kwake ndi nkhani yotsutsana ngakhale ambiri akudziyesa kuti ndi oledzera kuonera zolaula ndikufuna thandizo.^[2] Akatswiri ena ayesa kuyerekeza ndi zifukwa zina zolekerera monga kugwiritsa ntchito mankhwala osokoneza bongo.^[3] Kuzoloŵera kwazing'ono kwambiri zomwe zimatha kuyerekezera ndi "njuga" yomwe imatchulidwa ngati chidakwa popanda mankhwala. Zomwe zimaphatikizapo kutchova njuga monga matenda ozunguza bongo pamodzi ndi vuto la kugwiritsiridwa ntchito kwa mankhwala zimachokera ku umboni wochokera kuzipatala zomwe zimasonyeza kuti anthu otchova juga amagawana zolakwika za ubongo ndi zolakwika zomwe zimawonedwa mwa anthu omwe ali ndi vuto la kugwiritsira ntchito mankhwala.^[3],[4]

Kuphunzira zizoloŵezi zamakhalidwe monga kutchova njuga, kutsegula pa intaneti, masewera, kugula, chakudya, ntchito, kugonana, ndi zina zotero, zawonjezeka kwambiri m'zaka zaposachedwapa.^[4] Kugonana ndi khalidwe lachikhalire limakhala lopweteka ngakhale kuti limakhala zovuta kwambiri kwa iwo eni komanso kuvutika kwa ena. Kugonana kumakhala ndi mitundu yosiyana siyana: kugonana ndi chiwerewere, kugonana ndi achiwerewere, kugonana kosadziwika ndi anthu ambirimbiri, zochitika zambiri kunja kwa mgwirizano, chizoloŵezi chowonetsera, chizoloŵezi chochita chiwerewere, kugwirana kosayenera kwa kugonana, kubwerezabwereza kugonana kwa ana, ndi zochitika za kugwiriridwa. Nthawi zina, kuledzera sikungaphatikizepo kuchita zogonana pagulu, mmalo mwake, kungaphatikize maola owerengeka ndikuwonerera zolaula.^[5] 20% -60% amuna omwe amapita ku koleji amavomereza kuona zovuta zolaula malinga ndi malo omwe ali ndi chidwi. Pakhala pali zochepa zolemba za sayansi zolemba zolaula ndi zotsatira zake zoipa.^[2],[6] Ife tikupereka nkhani imodzi yotere yomwe inatikumbutsa.

Mwamuna wamwamuna wazaka 34 wokwatiwa kuyambira zaka 6 adabwera ku dipatimenti yachilendo ndi mkazi wake ndi cholinga chothana ndi mavuto am'banja makamaka okhudzana ndi chidwi chamwamuna pankhani yogonana komanso kutengeka kwake ndi zolaula pazaka 3 zapitazi. Vuto lomwe lidalipo lidawuka zaka 3 zapitazo mkazi wake ali ndi pakati, ndipo samatha kuchita zachiwerewere nthawi zambiri zomwe amkazolowera chifukwa choletsa kutenga mimba.

Mwamunayo adapereka mbiri yoonera zolaula kuyambira zaka za 16. Ngakhale kuti nthawi imeneyo sankatha, iye tsopano akugwiritsa ntchito nthawi zambiri akutsatira maliseche. Anavomereza kuti adayamba nthawi yowonera zolaula kuti akwaniritse zosangalatsa zake. Pa nthawi ya malipoti, anakhala ndi 4-5 h / tsiku kapena zina nthawi zina poonera zolaula. Anayang'anitsitsa mafilimu ngakhale atatha kumaliza maliseche komanso kuti adzalandira zokondweretsa pokhapokha atayang'ana mafilimuwo. Ngati nthawi yake idafupikitsidwa kapena iyeyo adasokonezedwa ndi munthu wina, adayamba kuvutika ndipo adakwiya. Kuntchito, iye anachenjezedwa chifukwa cha khalidwe loipa pambuyo pa kachilombo ka intaneti komwe kunayambitsa kusokonezeka kwa dongosolo ndipo kunatsatiridwa ku malo oonera zolaula omwe adawachezera. Pambuyo pake, atatha kuwona malo owonetsera zakugonana kuntchito, wodwalayo anatenga magazini oonera zolaula ndipo adathera nthawi yambiri akuwerenga. Zotsatirazi zinali zitachepetsedwa kwambiri kuti akwanitse kulingalira ndikugwira bwino ntchito. Anayamba kupatula nthawi yochepa ndi mwana wake wamkazi komanso nthawi yambiri yekha pa kompyuta kapena foni yake. Mkazi wake adawona kusintha kwa khalidwe lake ndikugwiritsa ntchito nthawi yambiri pa intaneti. Popeza mayankho osakhutiritsa a mafunso ake ndi zosakondweretsa iye ndi mwana wake wamkazi, iye adayankhula naye ndipo adadziŵa za vuto lake la kuwonetsa zolaula pa intaneti kuti akwaniritse zida zake. Anavomereza kuti sankatha kulamulira zofuna zake komanso chilakolako choonera zolaula ngakhale kuti ankakonda mkazi wake ndipo ankadziŵa kuti izi zamuika ukwati wake pangozi. Iye, komabe, anamuuza kuti sadzafuna thandizo la akatswiri monga momwe amamvera kuti amatha kusiya. Mkazi wake, komabe, sanakhulupirire, ndipo adamufikitsa kukamufunsa.

Kusanthula mkhalidwe wamaganizo kunasonyeza kuti munthu alibe maganizo komanso amamva chisoni. Ndondomeko yake yawonetsera kumverera kwa kusowa ntchito ndi kusowa chiyembekezo ponena za kusakhoza kuthetsa khalidwe lake. Pa Hamilton Depression Rating Scale (HAM-D) adapeza 9. Panalibe chinyengo kapena malingaliro. Chiweruzo chake ndi kuzindikira kwake zinali zogwirizana. Tinachita mantha, Obsessive Compulsive Disorder (OCD), kuvutika maganizo ndi umunthu kupyolera mu zokambirana zosiyana ndi zosiyana za wodwala ndi mkazi. Izi zinkachitidwa mwachipatala ndi azimayi awiri a maganizo, ndipo vuto lomaliza la kusokoneza ma intaneti linapangidwa pambuyo pochita khama kukumbukira njira zomwe zingagwiritsidwe ntchito pogwiritsa ntchito mankhwala osokoneza bongo. Panalibe mbiri yakale ya mtundu uliwonse wa mtundu uliwonse. Tinapanga chithandizo chamankhwala pakati pathu kuti tikwanitse kuthana ndi vuto lake ndikukambirana zinthu zitatu zovuta pamoyo wake, monga: (a) munthu, b) banja, ndi (c) ntchito.

Personal

Wodwalayo adafufuzidwa ndi zinthu zina zomwe zimagwirizana ndi chitukuko cha mankhwala osokoneza bongo. Wodwala akuganiza kuti kunyenga bwino kumatha kunena kuti, "Ndili ndi mphamvu pa zofuna zanga." Kutaya vutoli kunayenera kukhalapo. Iye anafotokozera kuti kuyambiranso kwathunthu kunkafuna kufufuza zowopsya zomwe zinayambitsa khalidwe ndi kuthetsa nkhaniyo mwabwino; Apo ayi, kubwereranso ndizochitika.

Anaphunzitsidwa momwe makhalidwe oterewa angathere kuchokera ku mavuto ena amalingaliro kapena maonekedwe monga kusokonezeka maganizo, nkhawa, nkhawa, mavuto a m'banja, mavuto a m'banja, ndi / kapena mavuto a ntchito. Anayesa khalidwe lake ponena kuti, "Sindikuvulaza aliyense pomuonera zolaula," "ndipo sindikunyenga mkazi wanga pocheza ndi wogonana naye." Chifukwa chodandaula kwambiri ndi zolaula, sadangotaya nthawi yofunikira yomwe amagwira ntchito koma anathera nthawi yayitali ndi banja lake.

Gawo loyambirira la mankhwala linali labwino, poyang'ana pa makhalidwe enaake ndi mkhalidwe momwe vuto lakuthamangitsidwa kwa msanga kunayambitsa vuto lalikulu. Thandizo lachikhalidwe linaganiziridwa zonse zomwe adokotala amapezako zolaula kuphatikizapo zamagetsi ndi zithunzi ngati magazini. Iye adafotokozedwanso kuti mafoni a m'manja ndi zipangizo zina zakhala zofunikira pamoyo wathu ndipo izi sizinatanthawuze kuti tiyenera kuledzera kwa iwo, koma tikhoza kuwonjezera njira zawo zabwino. Chimodzi mwa zolinga zoyambirira za chithandizo cha khalidwe ndi kuyamba kuyendetsa nthawi yogwiritsira ntchito zolaula ndikupanga pulojekiti yowonongeka bwino.

Pachifukwa ichi, chidziwitso cha khalidwe labwino (CBT) chinkagwiritsidwa ntchito kuti chichepetse zizindikiro, kuchepetsa kupanikizika, kusokoneza maganizo osokoneza maganizo, ndi kuthetsa zochitika zaumwini ndi zochitika zomwe zimagwirizana kwambiri ndi kugwiritsidwa ntchito kwa intaneti komanso kuthana ndi malingaliro oipa omwe nthawi zambiri amagwirizana nawo.

Kuvulaza mankhwala ochepetsa kuchepetsa ndi kusunga zolemba zokhudzana ndi tsiku ndi tsiku

Tsamba lolaula, nthawi inayake patsiku kapena momwe wodwalayo asanawonerere zimakhala zoyambitsa zomwe zitha kuyambitsa machitidwe osayenera komanso kuzunza. Pofuna kuthandizira kudziwa ndi zomwe zimayambitsa izi, adafunsidwa kuti azilemba zolemba tsiku lililonse kuti azidziwa nthawi ndi momwe amawonera komanso kulemba tsiku ndi nthawi ya chochitika chilichonse, zochitika zomwe zidatsala pang'ono kuwonera zolaula, ndi njira kupeza zomwe zili. Kenako, adapemphedwa kuti azisamalira kutalika kwa gawo lililonse, makamaka kujambula kuchuluka kwa mphindi kapena maola pa se ssion. Iye adalongosola zotsatira za gawo lirilonse ponena za zomwe adatsirizidwa, ntchito zomwe zinasokonezedwa poona zolaula, kapena momwe anamvera pambuyo pa gawo lililonse. Kusunga lolemba lotereli likugwiritsidwa ntchito monga maziko kuti azindikire mikhalidwe yoopsa yomwe imayambitsa kugwiritsa ntchito mopitirira muyeso. Izi zinatithandiza kukhazikitsa zolinga pa kukonza zachipatala.

Pa sitepe yotsatira, kasitomala akulangizidwa kuchotsa zizindikiro kapena mafayilo omwe mumawakonda pa kompyuta ndikusiya zowonjezera zomwe adazigwiritsa ntchito poyang'ana kapena kuwerenga zolaula.

Masewera ochepa chabe adangoganizira za kukonzanso koganizira za kasitomala. Kukonzekera kwa chidziwitso kunaphatikizapo kuzindikira mwachindunji njira zamaganizo zovuta zomwe zinapangitsa kuti ayambitse ndi kusamalira zovuta zowononga zolaula. Izi zathandizira kuti awonenso mkhalidwe wa khalidwe lake kwa mkazi wake ndi mwana wake.

M'kupita kwa nthaŵi, kutsutsa malingaliro oipa ndi olakwika a khalidwe lake ndi kugwirizana kwake kwa mkazi wake kunathandiza munthuyo kuti athetseretu kuonera zolaula pa intaneti. Wothandizirayo analimbikitsidwa kupereka mndandanda wa mavuto akulu omwe amabwera chifukwa cha kuledzera komanso kukhala ndi mapindu akuluakulu ochepetsera kapena kusiya zolaula. Wodwala anapatsidwa magawo a 12 a CBT pa nthawi ya miyezi 3 ya 45-60 min iliyonse. Ndipo kukhala ndi nkhawa, kuvutika, ndi kupsinjika maganizo kumakhudza ife tinayambira pa serotonine yabwino serotonin reuptake inhibitor (SSRI) piritsi la sertraline pa mlingo wa 50 mg poyamba patsiku ndipo pang'onopang'ono kuwonjezeka ku 150 mg tsiku.

Banja ndi ntchito

Pomwe wodwalayo anali ndi vuto laubwenzi ndi mkazi wake, upangiri wapabanja udalangizidwa m'malo motembenukira ku cybersex kuti athane ndi mavutowa. Komanso atagwidwa akuonera zolaula kuntchito, adaphunzitsidwa kupumula kwaminyewa komanso njira zosokoneza kuti athane ndi zovuta kuti zimuthandize kupumula m'malo modalira zolaula. Adalimbikitsidwa kuti azisokoneza nthawi iliyonse akafuna kuonera zolaula podutsa muofesi kapena kupita kukawona zomwe achibale akuchita m'chipinda chotsatira. Njira izi zidamuthandiza kuti adzichepetse ku zovuta ndikugwiritsa ntchito njira zosokoneza machitidwe akale azikhalidwe zosokoneza bongo. Kuphatikizidwa kwapang'onopang'ono kwa mkazi wake mgawoli, kulumikizana koyenera komanso njira zosinthana ndi machitidwe zalimbitsa ubale wawo. Pambuyo pa kuwunikiridwa kwapadera kwa odwala atapezeka kuti wathetsa mavuto ake okwatirana mpaka kufika pamlingo wa miyezi itatu. Wodwalayo adanenanso zakuchepa kwakanthawi kwakanthawi kakuonera zolaula ndikukhala paubwenzi wapamtima ndi mkazi wake. Pakuwunika komaliza, mayiyo adanenanso zakusintha kwamakhalidwe amwamuna wake komanso maubwenzi apabanja omwe adalipo pakati pao kumayambiriro kwaukwati.

Pali mipata yosawerengeka kuti aliyense athe kuwona zachiwerewere pa intaneti kuti akwaniritse zofuna zanu zamkati. Kafukufuku wazaka 1 wazaka zambiri pazogwiritsa ntchito intaneti ndi Meerkerk Et al. anaonetsa zolaula za pa Intaneti kuti zikhoza kukhala zovuta kwambiri.^[7] DSM mu 5 yake^th Kusindikizidwa kunali vuto lakutchova njuga monga matenda osokoneza bongo okhudzana ndi kusagwirizana. Njira zoyenera kutengera kutchova njuga zinali zofanana ndi zizoloŵezi za mankhwala osokoneza bongo, zomwe zimapangitsa kuti anthu azigwiritsa ntchito mankhwala osokoneza bongo, kuchotsa, kulekerera, osatha kuchepetsa ngakhale pambuyo pa kuchepa kwa anthu. Komabe, iwo sanafune kuwonjezera matenda okhudza kugonana chifukwa panalibe mabuku okwanira kuti apeze chidziwitso cha kugonana kwachiwerewere komanso kuwonetsa zithunzi zolaula kwambiri.^[8],[9] Phunziro la kujambula kwa maginito la maginito la masomphenya a amuna ofuna chithandizo cha zolaula (PPU) Gola Et al.^[10] anapeza kuwonjezereka kwa kuyambitsa mphotho ya ubongo (ventral striatum) makamaka kwa zithunzi zolaula kusiyana ndi kupeza ndalama. Kukonzekera kwa ubongo uku kunaphatikizidwa ndi kuwonjezeka kwa khalidwe kuti muwone zithunzi zolaula (zapamwamba "zofuna"). Kuchulukanso kwachisokonezo kwa Ventral kumakhudzana kwambiri ndi kukula kwa PPU, kuchuluka kwa zolaula zimagwiritsidwa ntchito pa sabata ndi chiwerengero cha maliseche. Izi zinali zofanana ndi mavuto ogwiritsira ntchito komanso kutchova njuga. Zomwe zapezazi zikusonyeza kuti PPU ikhoza kuwonetsa khalidwe lachizoloŵezi chosonyeza kuti njira zothandizira kuwongolera zizoloŵezi zamakhalidwe ndi zakuthupi zingathandize amuna omwe ali ndi PPU.^[11],[12] Kafukufuku akuwonetsanso kuti zomwe otchova juga amachita zomwe zimaika pachiwopsezo zimakhala ndi vuto lamanjenje, mwachitsanzo, kuchuluka kwa 3 methoxy-4 hydroxyphenylglycol (MHPG) mu plasma ndikuwonjezera kuchuluka kwa MHPG mu cerebrospinal fluid. Palinso umboni wosonyeza kuti kutayika kwa serotonergic pamachitidwe otchova njuga.^[13] Choncho, zothandiza za SSRI pazinthu monga kuledzera kwa intaneti zomwe zikugwirizana ndi vuto lakutchova njuga ndizothandiza, ndipo tidawona kuti n'zothandiza kwa ife kuti tipewe kukayikira koyamba kulandira thandizo la akatswiri.

Kukayikira kwa wodwalayo kulandira thandizo la akatswiri pachiyambi komanso kufunitsitsa pambuyo pake, kulowererapo kwa mkazi wake komanso kuthandizana nawo ponseponse zidathandizira nkhaniyi kukulitsa zizindikiritso zobwezeretsa moyo wabanja lake.

Njira yoyenera kutchula mulandu wathu monga zolaula zikuwoneka kuti ikukhudzana ndi chikhalidwe cha chizoloŵezi chochita chiwerewere. Chifukwa chake, anali ndi kulekerera, kutaya, kudziletsa, komanso kuwonongeka kwa chikhalidwe cha anthu ndi ntchito zake zolaula.

Kuzoloŵera zolaula kumakhala kovuta kusamalira wodwalayo komanso omwe akukhudzidwa. Ndili ndi milandu yowonjezereka ndipo ntchito yowonjezereka ingalimbikitse ngati momwe zingakhalire ngati matenda osokoneza bongo.

Chidziwitso cha chilolezo choleza mtima

Olemba amatsimikizira kuti adalandira mafomu onse ovomerezeka ovomereza. Mu mawonekedwe a wodwala atapereka / kuvomereza kwake / zithunzi zawo ndi zina zokhudza chidziwitso kuchipatala. Odwala amadziwa kuti mayina awo ndi oyambirira sadzafalitsidwa ndipo chifukwa cha kuyesayesa kudzapangidwira kuti adziwe, koma osadziwika kuti sangadziwitse.

Thandizo la ndalama ndi chithandizo

Nil.

Mikangano ya chidwi

Palibe mikangano ya chidwi.

1.	Ipezeka kuchokera: http://www.internet-filter-review.toptenreviews.com/internet-pornography-statistics.html. [Yotsiriza yapezeka pa 2017 Jan 25].
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3.	Leeman RF, Potenza MN. Zofanana ndi kusiyana pakati pa kutchova njuga ndi vuto la kugwiritsira ntchito mankhwala: Kuika maganizo pa kukhudzidwa ndi kukhudzidwa. Psychopharmacology (Berl) 2012; 219: 469-90.   [PUBMED]
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5.	Bancroft J, Vukadinovic Z. Kugonana, Kugonana, kugonana, kapena Chiyani? Kuchitsanzo Chongopeka. Journal of Sex Research 2004; 41: 225-34.   [PUBMED]
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9.	Association of Psychiatric Association. Kufufuza ndi Kusanthula Buku la Matenda a Mental (DSM-5®). Arlington, VA: Kusindikiza kwa Psychiatric American; 2013. p. 585-92.
10.	Gola M, Wordecha M, Masewero G, Starowicz ML, Kossowski B, Wypych M, Et al. Kodi zolaula zingayambe kumwa mankhwala osokoneza bongo? Kufufuza kwa fMRI kwa amuna ofuna chithandizo cha zolaula zimakhala zovuta. DOI: 10.1101 / 057083 http://dx.doi.org/10.1101/057083. [Kutsiriza kumapezeka pa 2017 Feb 22].
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