J Behav Wosuta. 2018 Jun 5: 1-12. doi: 10.1556 / 2006.7.2018.33.
Mawuecha M1, Wilk M1,2, Kowalewska E1,3, Skorko M1, Łapiński A4, Gola M1,5.
Kudalirika
Mbiri ndi zolinga
Khalidwe lokakamiza (CSBs) ndi vuto lofunikira lazachipatala komanso chikhalidwe. Ngakhale kuchuluka kwamaphunziro, zina mwazinthu za CSB sizinafufuzidwe. Apa, timasanthula mtundu wa CSB, monga kugwiritsa ntchito zolaula komanso kuseweretsa maliseche (PuM), ndikuwonetsetsa kulumikizana pakati pazinthu zomwe timazindikira zomwe zimapangitsa kuti azichita izi ndi zomwe adalemba muzolemba.
Njira
Kuyankhulana kwapadera ndi amuna asanu ndi anayi omwe amafunafuna chithandizo azaka za 22-37 (M = 31.7, SD = 4.85) adatsatiridwa ndifunso lazofunsidwa ndikuwunika masabata a 10-sabata, kutilola kuti tipeze zochitika zenizeni tsiku ndi tsiku za CSB .
Results
Maphunziro asanu ndi amodzi mwa asanu ndi anayi adakomoka kwambiri (maora angapo kapena kangapo patsiku) PuM. Maphunziro onse adapereka nkhawa yayikulu ndikuzindikira PuM ngati njira yowongolera kukhazikika ndi kupsinjika. Zomwe zasonkhanitsidwa pakuwunika kwa diary kunatulukira mitundu yayikulu yamakhalidwe (monga pafupipafupi a PuM) komanso zolumikizana. Binge PuM inali yokhudzana ndi kuchepa kwa mitsempha komanso / kapena kuchuluka kwa nkhawa kapena nkhawa. Ubale wapakati pa izi ulipobe mpaka pano.
Zokambirana ndi zolingalira
Binge PuM ikuwoneka kuti ndiimodzi mwamakhalidwe pakati pa amuna omwe akufuna chithandizo cha CSB ndipo imakhudzana ndikumverera kotaya mphamvu zakugonana. Anthu a CSB amawonetsa zovuta zingapo zomwe zimayambitsa kudya. Komanso, kuchuluka kwa ma diary kumawonetsa kuti ma correlates ena a PuM omwa mowa mwauchidakwa (kuchepa kwamaganizidwe, kupsinjika, komanso nkhawa) amasiyana pakati pa maphunziro. Ikuwonetsa kukhalapo kwa kusiyanasiyana kwakanthawi pamakhalidwe a PuM, komanso kufunika kophunzira kusiyanaku, chifukwa kumatha kuthandizira chithandizo chamunthu.
MAFUNSO: machitidwe okakamiza kugonana; kuwunika kwa diary; Hypersexourse; maliseche; zolaula
PMID: 29865868
Introduction
Kwa anthu ena, machitidwe okakamiza ogonana (CSB) ndi chifukwa chofunafuna chithandizo (Gola, Lewczuk, & Skorko, 2016; Lewczuk, Szmyd, Skorko, & Gola, 2017). Poganizira izi, chiwerengero cha kafukufuku pamutuwu chakwera kwambiri (Gola, Wordecha, Marchewka, & Sescousse, 2016; Kraus, Voon, & Potenza, 2016a), ndipo pali zokambirana zomwe zikupitilira kuphatikiza CSB mu buku lotsatira la International Classization of matenda (ICD; Gola & Potenza, 2018; Kraus et al., 2018; Potenza, Gola, Voon, Kor, & Kraus, 2017; Pembedzero, Janssen, Georgiadis, Finn, & Pfaus, 2017; World Health Organisation [WHO], 2018). Zizindikiro zomwe zimadziwika kwambiri zimagwiritsa ntchito nthawi yowonera zolaula (makamaka pa intaneti) komanso maliseche kwambiri (Gola, Lewczuk, et al., 2016; Kafka, 2010; Reid, Garos, & Carpenter, 2011; Stein, Wakuda, Shapira, & Spitzer, 2001). Zina zomwe zimalongosola khalidwe labwino zimaphatikizapo zoopsa za kugonana, kugonana kosadziwika, komanso kugwiritsa ntchito maubwino opatsirana pogonana (Kraus, Voon, & Potenza, 2016a).
Ngakhale pali mikangano yomwe ikupitilira pa momwe mungagwiritsire ntchito CSB (Kor, Fogel, Reid, & Potenza, 2013; Kraus, Voon, & Potenza, 2016b; Ley, Pembedzero, & Finn, 2014; Potenza et al., 2017), World Health Organisation idaphatikizapo CSB pakufunsira kwa ICD-11 yomwe ikubweraWHO, 2018) ngati vuto lotha kulimbana ndi zinthu (Kraus et al., 2018) ndi Symbomatology ofanana kwambiri ndi omwe Kafka adaganizira kale2010). Malinga ndi izi, titha kuzindikira CSB ngati (a) pakadutsa miyezi 6, osachepera anayi mwa asanu mwa zizindikiro zotsatirazi zikuwonetsedwa:
| 1. | Kugwiritsa ntchito nthawi yochulukirapo pazolakalaka zogonana, zolimbikitsa, kapena machitidwe mobwerezabwereza zimasokoneza zolinga zina (zosagonana), zochitika, ndi maudindo, mwachitsanzo, kuwonera zolaula kwakhala chinthu chofunikira kwambiri pamoyo wamunthu, kotero kuti ntchito zapabanja kapena ntchito ; |
| 2. | mutuwo umachita izi mobwerezabwereza pochita zachiwerewere poyankha machitidwe okhumudwitsa, mwachitsanzo, kugonana kwakhala njira yokhwima yosinthira kusinthasintha; |
| 3. | ndi / kapena kuyankha kuzinthu zovuta, mwachitsanzo, panthawi yamavuto kuntchito; |
| 4. | ngakhale adayesayesa mobwerezabwereza, nkhaniyi imalephera kuletsa kapena kuchepetsa kwambiri zachiwerewere, mwachitsanzo, mutuwo umayesetsa kangapo kuti muchepetse zovuta, koma nthawi zonse amalephera kuwalamulira pakatha masiku angapo; |
| 5. | Nkhaniyi imapitilizabe zogonana ngakhale atha kuvulazidwa kapena kuwonongera ena kapena ena, mwachitsanzo, kuchita zachiwerewere mosasamala kanthu zoyipa zomwe zingachitike chifukwa cha maubwenzi (mwachitsanzo, kutha kwa banja) kapena kuwopseza kuti achotsedwa ntchito. |
(b) Pafupipafupi komanso kukula kwa zochitika zogonazi zimabweretsa mavuto azachipatala kapena kukanika kuzinthu zofunikira pamoyo. (c) Zochita zogonana izi sizinali chifukwa chogwiritsa ntchito mankhwala osokoneza bongo (mwachitsanzo, kugwiritsa ntchito mankhwala osokoneza bongo kapena mankhwala).
Komabe, pamene a Kafka2010) tanthauzo la CSB ndilovomerezeka, silipereka lingaliro lililonse la CSB. Kafukufuku waposachedwa akusonyeza kuti ma CSB ndi okhudzana ndi kukhudzidwa kowonjezereka kwa mphotho zosamveka (Mtundu, Snagowski, Laier, & Maderwald, 2016; Kraus et al., 2016b; Voon et al., 2014) kapena malingaliro oneneratu za mphotho (Gola, Wordecha, et al., 2017). Zina zikuwonetsa kuti pamakhala zinthu zina zoyipa (Klucken, Wehrum-Osinsky, Schweckendiek, Kruse, & Stark, 2016) kapena kuchuluka kwa nkhawa (Gola, Miyakoshi, & Sescousse, 2015; Gola & Potenza, 2016) mwa anthu omwe ali ndi CSB. Reid adanenanso kuti odwala ochita masewera olimbitsa thupi nthawi zambiri amakhala ndi nkhawa komanso nkhawa, amakhala ndi manyazi kwambiri, komanso amakhala ndi mtima wotsika.Reid, Stein, & Carpenter, 2011; Reid, Temko, Moghaddam, & Fong, 2014).
Kuchulukana komanso kusiyanasiyana kwa zinthu zomwe tafotokozazi kumabweretsa mafunso ofunika osachepera atatu: (a) Kodi anthu omwe akufuna chithandizo amazindikira bwanji zinthu zomwe zimatsogolera ku CSB?, (B) Ndi ziti mwazinthu zomwe zimadziwika zomwe zimagwirizananso ndi zomwe zimayesedwa mu zochitika za moyo watsiku ndi tsiku?, ndi (c) Kodi zinthu izi ndizabwino bwanji mu CSB?
Mafunso oterewa akhoza kuyankhidwa ndi chidziwitso chokwanira (mwachitsanzo, chosonkhanitsidwa pamafunso azachipatala, monga Mmisili, Reid, Garos, & Najavits, 2013) ndi njira yochulukitsa, pogwiritsa ntchito njira ya mawerengedwe owerenga (Kashdan et al., 2013). Kuwunika kwa diary kumawerengedwa kuti ndi kotheka kwambiri kuyerekezera zochitika zatsiku ndi tsiku (mwachitsanzo, kuchuluka kwa nkhawa, malingaliro, ndi chilakolako chogonana) ndi zochitika (mwachitsanzo, machitidwe ogonana). Phunziroli, tidaganiza zophatikiza njira zonse zowunikira komanso zolemba kuti tiwone zomwe zikukhudzana ndi CSB m'mitu yomwe ikufuna chithandizo cha CSB.
Popeza palibe zikhalidwe zochulukirapo pazokhudza kugonana (Gola, Lewczuk, et al., 2016), Ma CSB nthawi zambiri amafotokozedwa ndi mafotokozedwe ofotokozera, kuwonetsa kuchepa kwapang'onopang'ono kwa chiwongolero pakugonana (Gola & Potenza, atolankhani; Kafka, 2010; Kraus et al., 2018). Titha kuyesa kupeza zina zomwe zimayambitsa izi, monga nthawi yochulukirapo yogonana (mwachitsanzo, kuseweretsa maliseche komanso zolaula zimasokoneza ntchito yanu) kapena malo olakwika omwe amachita zachiwerewere (mwachitsanzo, pagulu malo kapena zimbudzi). Njira imodzi yoyezera ya chizolowezi chomenyera ndi kubetcha - kubwerezabwereza, kupitilizabe, komanso machitidwe akulu - nthawi zambiri kumabweretsa kudzimva kwakulephera kuwongolera. Binges yafotokozedwa kwambiri pamavuto ogwiritsa ntchito mankhwala, monga vuto lakumwa mowa (Rolland & Naassila, 2017).
Odwala omwe akufuna kulandira chithandizo cha CSB amanenanso kuti azichita zachiwerewere (Gola, Wordecha, et al., 2017,, ndipo nthawi zambiri mumanena kuti iyi ndiye njira yolemekera kwambiri yakulephera kwamphamvu pazomwe munthu akuchita (Lewczuk et al., 2017). Nthawi zambiri, kuluma koteroko kumakhudza kuwonera kwakanema kwa nthawi yayitali (mosalekeza kapena kangapo patsiku), limodzi ndi maliseche ambiri. Kugwiritsira ntchito zolaula pakudya sikunatchulidwe mwatsatanetsatane m'mabuku asayansi. Chifukwa chake, tikuganiza zowunikiranso mbali iyi ya CSB ndikuwona momwe zimakhalira ndi vuto pakati pa anthu omwe akufuna chithandizo cha CSB. Chifukwa chake tikufuna (a) kuwunika momwe maphunziro omwe amafunikira chithandizo cha CSB amafotokozera zinthu zokhudzana ndi ma CSB awo, (b) kudziwa momwe zimafananirana ndi deta yomwe imasonkhanitsidwa pakuwunika kwa diary, ndi (c) kufufuza ngati zinthuzo sizili zothandiza kwa anthu onse CSB ndi iti mwa iwo omwe akukhudzana ndi zochitika zogonana komanso zosadetsa.
Njira
ophunzira
Gulu lathu linali ndi amuna asanu ndi anayi a CSB azaka 22-37 zaka (M = 31.7, SD = 4.85; Gome 1). Odwala onse adavutika ndimaganizo kapena zizolowezi zogonana ndipo amavomereza kuti mchitidwe wawo wogonana umapangitsa kuti azisinthana zochitika zofunika pamoyo. Odwala onse adazindikira kuwonjezeka pang'onopang'ono kwa vutoli ndipo adavomereza kugwiritsa ntchito zikhalidwe zakugonana (makamaka kuwonera zolaula zomwe zimachitika ndi kuseweretsa maliseche) kuthana ndi zovuta za pamoyo. Wodwala aliyense adatinso kuyesera kambiri kuchepetsa kapena kuthetsa CSB. Nthawi zambiri, zotsatira zake sizinali zabwino komanso zakanthawi, koma ena adanena kuti nthawi yayitali yodziletsa (miyezi ingapo mpaka 1 chaka) yotsatira. Pafupifupi maphunziro onse anali ndi mbiri ya chithandizo cham'mbuyomu cha CSB. Phunziroli, mutu umodzi (Mutu B) unali kudziletsa kwa PuM (anali ndi zogonana pafupifupi ndi tsiku ndi tsiku).
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Gulu 1. Chiwerengero cha odwala onse omwe akutenga nawo mbali phunziroli
wodwala | Age | Kugonana | Chikhalidwe cha ubale | Occupation | Kukhala ndi | Khalidwe lokakamiza pa zogonana (CSB) | Zithunzi zakugwiritsa ntchito zolaula (wazaka zakubadwa) | Zaka zambiri zogwiritsa ntchito zolaula | M'badwo wakudya koyamba | Mbiri ya chithandizo cham'mbuyomu |
|---|---|---|---|---|---|---|---|---|---|---|
| A | 36 | Amuna amodzi | Single | Wogwira ntchito muofesi | Friends | Kugwiritsa ntchito zolaula | 16 | 12 | 26 | Pakadali pano mu gulu la masitepe a 12 a CSB |
| B | 37 | Amuna amodzi | Wokwatiwa kwa zaka 18 | Wogulitsa ntchito | Banja (mkazi ndi ana) | Kugwiritsa ntchito zolaula (pakali pano pakudziletsa) komanso kuseweretsa maliseche mokakamiza | 11 | 10 | - | Pakadali pano mu psychotherapy yamtundu wa anthu omwe amamwa mowa kwambiri |
| C | 33 | Amuna amodzi | Mchibwenzi zaka 4 | Woyendetsa galimoto | chibwenzi | Kugwiritsa ntchito zolaula | 13 | 13 | - | M'mbuyomu mu gulu la 12 la CSB, pakadali pano gulu la CSB |
| D | 33 | Amuna amodzi | Wokwatiwa kwa zaka 4 | Wolemba mapulogalamu | Banja (mkazi ndi ana) | Kugwiritsa ntchito zolaula | 12 | 15 | ∼13 | palibe |
| E | 36 | Amuna amodzi | Single | Osagwira ntchito | yekha | Kugwiritsa ntchito zolaula, kuseweretsa maliseche mokakamiza, komanso kugonana amuna wamba osadziwika | - | 9 | 27 | M'mbuyomu payokha komanso gulu psychotherapy ya CSB |
| F | 25 | Amuna amodzi | Mchibwenzi cha 1 mwezi | Student | Friends | Kugwiritsa ntchito zolaula | 10 | 1 | 24 | Pakadali pano mu psychotherapy yaokha ya CSB |
| G | 30 | Amuna amodzi | Single | mphunzitsi | Banja (makolo) | Kugwiritsa ntchito zolaula | 10 | 14 | 20 | Pakadali pano mu psychotherapy yaokha ya CSB |
| H | 22 | Amuna okhaokha | Single | Marketer | Banja (makolo) | Kugwiritsa ntchito zolaula | 15 | 5 | 18 | Pakadali pano mu psychotherapy yamtundu wina yamavuto ena |
| I | 33 | Amuna amodzi | anakwatira | Sales | Mkazi | Kugwiritsa ntchito zolaula, kuseweretsa maliseche mokakamiza, komanso kugonana amuna wamba osadziwika | 8 | 13 | ∼13 | M'mbuyomu pobisalira zaumoyo, pakali pano pa chithandizo cha munthu wamkulu wa Adult Children of Alcoholics (ACoA) |
Njira zolembera anthu
Maphunziro onse adalembedwa pakati pa odwala omwe akufuna chithandizo cha CSB m'malo ochiritsira zakugonana ku Warsaw (Poland). Maphunziro onse anakumana ndi njira zinayi mwa zisanu za CSB malinga ndi Kafka (zofotokozedwera mu gawo la "Mawu Oyamba"). Komanso, onse adatenga magawo asanu ndi limodzi a chithandizo cha CSB atalembetsa nawo kafukufukuyu, zomwe zimawonetsa cholinga chawo chochepetsera kugwiritsa ntchito zolaula.
Njira
Tidachita mafunso okwanira maola angapo (Powonjezera Table S1) kuti tiwonetsetse zomwe zimadziwika kwambiri ku CSB (kuphatikiza kulumikizana ndi PuM), kudziwona komwe kumayambira pamaganizidwe ake, komanso zinthu zokhudzana ndi CSB. Pambuyo pa kuyankhulana uku, ophunzirawo adatenga nawo gawo pazowerengera zam'masiku osatha a 10 (masiku a 70), pogwiritsa ntchito pulogalamu yochokera pa intaneti yomwe ikupezeka kudzera pa ma foni a m'manja kapena makompyuta apayekha (Chithunzi 1). Kuwunika kwa diary kunadzaza pang'ono ndi kuyamba kwa mankhwala, chifukwa chake zomwe zalembedwa m'madina mwina zidakhudzidwa ndi mankhwalawo. Pogwiritsa ntchito masikelo a 10-point, tidayesa zochitika za tsiku ndi tsiku zokhudzana ndi kugonana, nkhawa, kupsinjika, komanso kusinthasintha. Tidawunikiranso zikhalidwe zakugonana, monga nthawi yatsiku ndi tsiku yoonera zolaula, kuchuluka kwa maliseche, kapena kuchuluka kwa zochitika zogonana. Omwe adapemphedwa amafunsidwa kuti adzaze tsikulo kamodzi patsiku, zomwe nthawi zambiri zimatenga mphindi 3-5. Komabe, asanu ndi awiri okha mwa asanu ndi anayi omwe adatenga nawo gawo ndi omwe adapereka chidziwitso chofunsidwa, ndipo nthawi yayitali pomwe magawo sanalembedwe anali masiku 2.75 ndi min = tsiku limodzi ndi max = masiku 1. Zambiri zimapezedwa mu Supplementary Table S32. Zolemba zomwe zidasowa sizinaphatikizidwe pakuwerengera kwamitengo yapakatikati komanso zolakwika zofananira za zomwe zikuwerengedwa. Nthawi zodalirika zomwe akuti akuti amagwiritsira ntchito njira yosunthira ya bootstrap yomwe ili ndi block size = 2, imagwiritsidwa ntchito kumaseti athunthu (kuphatikiza zosowa).
Chithunzi 1. Chiwonetsero chaukadaulo cha njira zakufufuzira. Maphunziro onse adafunsidwa koyamba ndi kuyankhulana kwapansipansi (Powonjezera Table S1), kenako adachita nawo mayeso amafunsidwe (Supplementary Table S3) ndi 10-sabata yayitali yolemba zolemba pabusayiti
Tinkasonkhananso miyezo yamafunso. Kukula kwa ma CSBs kunayesedwa ndi Mayeso a Kugonetsa Zakugonana - Revised (SAST-R; Nkhokwe, Green, & Carnes, 2010; Gola, Skorko, et al., 2017) ndi Chidule cha Zithunzi Zolaula (BPS; Kraus et al., 2017). Pulogalamu ya Mafunso ya BPS ndiwosiyanitsa zinthu zisanu, kuyeza kukula kwa vuto logwiritsa ntchito zolaula. Kukula kwa zizindikiro zowonera-zogwiritsa ntchito (OCD) zowunikira kunayesedwa ndi Obsessive-Compulsive Inventory - Revised (OCI-R; Foa et al., 2002). Mulingo wa nkhawa unayeza ndi State-Trait Anxcare Inventory - State (STAI-S; Sosnowski & Wrześniewski, 1983), yomwe idatilola kuyeza nkhawa monga boma (STAI-S) ndi mkhalidwe (STAI-T). Tidagwiritsanso ntchito Chipatala Chodetsa nkhawa komanso Kukhumudwa (Zigmond & Snaith, 1983) pakuwunikira nkhawa komanso kufooka. Impulivity idayesedwa ndi Ndalama Yofunsira Ndalama (Kirby & Maraković, 1996,, Zosankha za 27, zomwe otenga nawo mbali ayenera kuwonetsa ngati angakonde mphoto yaying'ono lero kapena yayikulu m'tsogolo (pambuyo masiku angapo).
Ethics
Phunziroli lidavomerezedwa ndi Ethics Committee of the Institute of Psychology, Polish Academy of Sciences (malinga ndi Chiyembekezo cha Helsinki) ndipo onse omwe adapereka adavomereza.
Results
Miyeso yamafunso
Odwala onse adachita zambiri mu SAST-R ndi BPS. Odwala ambiri adalandiranso zam'maphunziro a kukhumudwa ndi nkhawa za Chipatala cha Kuda nkhawa ndi Kukhumudwa (Zigmond & Snaith, 1983) ndi STAI (Sosnowski & Wrześniewski, 1983), monga zasonyezedwera ku Supplementary Table S3. Ndi maphunziro awiri okha omwe amapitilira malire a kukhudzika, omwe amayeza ndi OCI-R (Foa et al., 2002). Zambiri zafotokozedwa mu Gawo lowonjezera la S3.
Zodziwonetsa nokha komanso zolemba zamayendedwe a CSB
Maphunziro onse adanenanso PuM yokakamiza ngati chifukwa chachikulu chofunira chithandizo. Ndi anthu awiri okha omwe adanena zachiwerewere ngati njira yowonjezera yovutitsa. Wodwala m'modzi adafuna chithandizo, ngakhale anali ndi miyezi ingapo ya 6.5 asanachite kafukufukuyu. Kwa odwala asanu ndi atatu mwa asanu ndi anayi, awa sanali oyesera koyamba kuchitira CSB (Gome 1).
Ngakhale kuyesayesa kangapo kuti muchepetse kugwiritsa ntchito zolaula, nthawi yayitali yowonerera zolaula sabata iliyonse inali 2.96 hr, monga adalengezedwera ndi omwe amafunsidwa mafunso atafunsidwa. Malinga ndi zomwe adapeza pamasabata 10 pakuwunika tsikulo, zinali 1.57 hr (SD = 2.05 hr). Tidawona kusiyanasiyana kwakukulu kwa zithunzi zolaula (kuyambira 0.5 mpaka 8 hr sabata, monga tafotokozera pamafunso komanso kuyambira 0 mpaka 6.01 hr sabata, monga tafotokozera muzolemba; 2).
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Gulu 2. Njira zodzigonjera komanso zazitali zomwe zimawakakamiza kugonana (CSB)
wodwala | CSB | Kudziwonetsa nokha pazokambirana | Amayeza ndi kuyesa kwa dijiti ya 10-sabata yayitali | |||||
|---|---|---|---|---|---|---|---|---|
Kugwiritsa ntchito zolaula sabata iliyonse (hr) | Nthawi zambiri zithunzi zolaula zimagwiritsidwa ntchito | Chiwerengero cha maliseche sabata limodzi | Pafupipafupi kogwiritsa ntchito zolaula | Kugwiritsa ntchito zolaula sabata iliyonse (hr) [amatanthauza (SD)] | Chiwerengero cha maliseche pa sabata [amatanthauza (SD)] | Pafupipafupi kuluma [kumatanthauza (SD)] | ||
| A | Kugwiritsa ntchito zolaula | Pakati pa 4 ndi 8 | Pafupifupi tsiku lililonse | Pakati pa 4 ndi 8 | Pakadali pano kamodzi pa sabata, tsiku lililonse lisanachitike | 6.01 (7.11) | 7.43 (7.62) | 0.43 (0.50) |
| B | Kugwiritsa ntchito zolaula (tsopano kudziletsa) komanso kuseweretsa maliseche mokakamiza | 0.5 | 1-2 nthawi sabata | 1-2 nthawi sabata | palibe | 0.00 (0.00) | 0.00 (0.00) | 0.00 (0.00) |
| C | Kugwiritsa ntchito zolaula | 1-1.5 | 1-2 nthawi sabata | Nthawi za 2 kapena kupitilira apo | palibe | - | - | - |
| D | Kugwiritsa ntchito zolaula | 1-1.5 | Pafupifupi tsiku lililonse | Pafupifupi tsiku lililonse | Pakadali pano palibe (kale 1-2 nthawi pachaka) | 0.73 (0.86) | 4.67 (4.63) | 0.10 (0.31) |
| E | Kugwiritsa ntchito zolaula, kuseweretsa maliseche mokakamiza, komanso kugonana amuna okhaokha | 3 | 2 nthawi sabata | 4 nthawi sabata | Pakadali pano palibe (kale kangapo pachaka) | 0.81 (1.46) | 3.68 (4.19) | 0.05 (0.22) |
| F | Kugwiritsa ntchito zolaula | Pakati pa 4 ndi 6 | Tsiku lililonse | Pafupifupi tsiku lililonse | Pakadali pano 1-2 kawiri pa sabata, asanakhale tsiku lililonse | 1.70 (2.98) | 3.02 (5.29) | 0.16 (0.37) |
| G | Kugwiritsa ntchito zolaula | 1-1.5 | Pakati pa 2 ndi 5 nthawi | 5 kapena zambiri | Pakadali pano kawirikawiri pa sabata | 0.21 (0.48) | 4.67 (5.72) | 0.18 (0.39) |
| H | Kugwiritsa ntchito zolaula | 3.5-4 | Tsiku lililonse | 3 kapena zambiri | Maulendo angapo pamwezi | 1.54 (2.17) | 9.44 (11.32) | 0.33 (0.47) |
| I | Kugwiritsa ntchito zolaula, kuseweretsa maliseche mokakamiza, komanso kugonana amuna okhaokha | 1.5-3 | Pafupifupi tsiku lililonse | Pafupifupi tsiku lililonse | Kamodzi kapena kawiri m'moyo wake | - | - | - |
Zindikirani. SD: kutengeka kwakukulu.
Zambiri zomwe zasonkhanitsidwa pakuwunika kwa diary zidawonetsa kuti kuwonera zolaula kumayendetsedwa ndi kuseweretsa maliseche (Chithunzi 2), yomwe inali yogwirizana ndi kuwonongeka kwa data. Pamafunso, maphunziro asanu ndi limodzi adanena kuti kuwonera zolaula nthawi zonse kumayendetsedwa ndi kuseweretsa maliseche, ndipo maphunziro atatu adanenanso kuti kuseweretsa maliseche nthawi zambiri (koma osati nthawi zonse) kumayendetsedwa ndi kuwonera zolaula. Komabe, kuseweretsa maliseche popanda kuonera zolaula nthawi zambiri kumayenderana ndi kukumbukira zolaula zomwe zawonedwa kale kapena zolaula za anthu enieni. Wodwala wina adanena kuti kuseweretsa maliseche popanda zithunzi zolaula sikupangitsa kuti akhale pachimake pa iye.
Chithunzi 2. Kugawa kuphatikiza tsiku ndi tsiku kwa kuwonera zolaula ndi kuseweretsa maliseche muzinthu zomwe zasonkhanitsidwa pakuwunika kwa diary - Zambiri pazakulemba kwa diary (100% ndi zofanana ndi masiku onse akuzolemba zakale atasiyidwa deta yosowa)
Pakufunsidwa, odwala asanu ndi awiri mwa asanu ndi anayi adanenapo za kamodzi zolaula zomwe amawonera. Binges anali ndi mawonekedwe owonera zolaula mosalekeza limodzi ndi maliseche angapo kwa maola angapo motsatizana (nthawi zambiri> 6 hr osachepera 30 min break) kapena magawo angapo (> 4 patsiku, okhalitsa kwa 0.5-1 hr) zolaula Kuwona tsiku limodzi ndi maliseche. Mutu umodzi (Mutu B), yemwe adanenapo miyezi 6.5 yodziletsa, sananene chilichonse chakuwonera zolaula, pomwe Nkhani C idalemba magawo awiri owonera zolaula tsiku lililonse, zomwe sanaganize zakumwa mopitirira muyeso.
Pofuna kusanthula deta, tidatengera tanthauzo la "kulumwa", kutengera zomwe taphunzira m'maphunziro athu apitawo (Gola, Kowalewska, Wierzba, Wordecha, & Marchewka, 2015; Gola, Lewczuk, et al., 2016; Gola, Skorko, et al., 2017; Gola, Wordecha, et al., 2017; Lewczuk et al., 2017) kuwonetsa kuti pagulu lolamulira (osalandira chithandizo chamankhwala amuna aku Poland), kuchuluka kwa maliseche sabata iliyonse ndi 2.3-2.5 ndipo nthawi yayitali yogwiritsira ntchito zolaula ndi 50 min / sabata. Kuwongolera maphunziro m'maphunziro athu am'mbuyomu monga chiwonetsero chachikulu cha maliseche komanso kuwonera zolaula patsiku akuti pafupifupi 3.1 ndi 70 min. Zonsezi (magawo akulu kwambiri aziseweretsa maliseche ndikuwonera zolaula) amawonedwa ngati owongolera ngati zogonana. Pachifukwa cha kafukufukuyu kutengera zomwe tawonapo m'mbuyomu, tidakhazikitsa malire, poganiza kuti maliseche opitilira awiri patsiku komanso gawo limodzi lolaula lanthawi yayitali kuposa 1 hr limatha kukhala chizolowezi chomadzimana. Ngakhale malowa akuwoneka kuti akufanana ndi zomwe adadzinena pa nthawi yofunsidwa komanso zomwe zimawerengedwa ndi njira za diary (Table 2,, ziyenera kutsimikiziridwa mosamalitsa pakati pa anthu osiyanasiyana. Apa, timaphunzira za anthu omwe ali ofunitsitsa kuthetsa kuonera zolaula ndikuwonjezera zoyesayesa zambiri pa cholinga ichi.
Zinthu zokhudzana ndi PuM
Wodwala aliyense adanena kuyesera zingapo kuchepetsa kapena kuthetsa zolaula. Mwambiri, zotsatira zake zinali zochepa komanso zosakhalitsa, koma ena adanena nthawi yopewa zolaula kuyambira milungu ingapo mpaka 1 chaka, nthawi zonse chimatsatiridwa ndi kubwereranso. Kwa wodwala m'modzi, nthawi yopanda zolaula milungu ingapo inali yokhudzana ndi kuchuluka kwa ntchito; ndipo kwa wina, zidakulitsa zochitika zachikhalidwe. M'modzi mwa odwala adanenanso kuti kusinkhasinkha kukhala kothandiza kwakanthawi kochepetsa kugwiritsa ntchito zolaula.
Pakufunsidwa, odwala asanu ndi atatu mwa asanu ndi anayi adatha kuzindikira mawonekedwe awo a PuM, akuwonetsa malo ena, zochitika, malingaliro, ndi / kapena malingaliro. Malo omwe amagwiritsidwa ntchito kwambiri zolaula anali kunyumba ya wodwalayo. Ndipo vuto lomwe linali lofala kwambiri linali kukhala lokhalo. Maphunziro anayi adanenanso za kuonera zolaula pafupipafupi m'malo opezeka anthu ambiri, makamaka kuntchito. Odwala ena anayi adanena kuti nthawi zambiri amagwiritsa ntchito zolaula asanafike kapena atagwira ntchito.
Ambiri mwa odwala adanenanso zakusokonekera atatha kuyang'ana zolaula: kupsinjika (maphunziro asanu), mkwiyo (zitatu), nkhawa ndi kusokonezeka (zitatu), kusungulumwa (ziwiri), kudziona wotsika (mmodzi), malingaliro olephera (atatu) , ndi kutopa (ziwiri).
Ambiri mwa odwala anali ndi vuto lowonetsa zomwe zimayambitsa kuwonera zolaula. Wodwala m'modzi adazindikira kuwonjezeka kwa nkhawa ndikuganiza kuti atha kulephera ngati chinthu chodziwika chomwe chimapangitsa kuti achite zogonana. Wodwala wina adazindikira kukwiya koopsa monga zomwe zimayambitsa PuM. Mutu umodzi umasiyanitsa mitundu iwiri ya maliseche yomwe adachita: (a) yokhudzana ndi chilakolako chogonana komanso (b) pakuchepetsa nkhawa. Anaonanso kuti izi zinali zowonjezera kwa iye. Wodwala m'modzi yekha ndiye amene ananena kuti kuonerera zolaula ndi "mphotho" yabwino yomwe adadzipangira payekha.
Kuti tifufuze zomwe zimakhudzana ndi PuM, tinasanthula zomwe zimapezeka pazoyesa zakalemba, kuyerekezera malipoti kuchokera masiku omwe anali ndi maliseche ndikugwiritsa ntchito zolaula ndi malipoti kuyambira masiku osachita izi. Tidawunika kusiyana pakati pa magawo angapo a zinthu zingapo, zoyesedwa ndi diaries, monga, kutopa, kutopa, nkhawa, ndi nkhawa (zambiri zomwe zimafotokozedwa masiku onse zitha kupezeka pagome 3).
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Gulu 3. Zambiri pazakuyesa kwa dayosala ya 10-sabata yayitali (sikelo: 1-10)
wodwala | Zodandaula [zikutanthauza (SD)] | Kutopa [kumatanthauza (SD)] | Mulingo wamavuto [amatanthauza (SD)] | Mulingo wa nkhawa [zikutanthauza (SD)] | Wokonda kugonana [amatanthauza (SD)] |
|---|---|---|---|---|---|
| A | 4.92 (1.56) | 6.23 (1.63) | 5.86 (1.63) | 5.54 (1.91) | 2.42 (1.43) |
| B | 5.52 (1.99) | 6.43 (1.57) | 4.43 (2.06) | 4.14 (2.08) | 4.71 (1.82) |
| D | 5.3 (1.58) | 5.23 (1.74) | 4.5 (2.01) | 3.07 (2.26) | 3.7 (1.21) |
| E | 7.2 (0.69) | 4.9 (1.55) | 4.45 (1.08) | 3.35 (1.23) | 4.0 (0.88) |
| F | 6.35 (1.43) | 4.8 (1.81) | 3.1 (1.5) | 2.2 (1.04) | 5.1 (1.79) |
| G | 6.0 (1.6) | 6.47 (1.77) | 5.51 (1.87) | 4.76 (2.17) | 4.9 (2.04) |
| H | 4.3 (2.18) | 6.23 (1.76) | 4.74 (1.98) | 4.88 (2.2) | 3.88 (1.99) |
| gulu | 5.66 (0.96) | 5.76 (0.75) | 4.66 (0.89) | 3.99 (1.17) | 4.10 (0.92) |
Zindikirani. SD: kutengeka kwakukulu.
Tapeza kusiyana kwakukulu pakumala pakati pa masiku opanda ndi maliseche komanso kugwiritsa ntchito zolaula kokha kwa odwala atatu (D, F, ndi G; Table) 4). Zonsezi zinali ndi zotsika kwambiri pamasiku opita ndi maliseche komanso kugwiritsa ntchito zolaula. Kuphatikiza apo, wodwala D pa avareji ankakhala wotopa kwambiri, wopanikizika kwambiri, komanso anali ndi nkhawa yayikulu masiku omwe anali ndi maliseche komanso kugwiritsa ntchito zolaula poyerekeza ndi masiku opanda zolaula komanso maliseche.
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Gulu 4. Kusiyana pakati pa misinkhu, kutopa, kupsinjika, ndi nkhawa (zoyesedwa pa 10-day-diary test), kwa masiku omwe ali ndi "maliseche kapena zolaula" motsutsana ndi "masiku osonyeza maliseche kapena zolaula"
wodwala | Masiku okhala ndi maliseche kapena zolaula | Masiku popanda kuseweretsa maliseche kapena zolaula | Kusiyanitsa kwapakati | |||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
N | Zodandaula [zikutanthauza (SD)] | Kutopa [kumatanthauza (SD)] | Kupsinjika [kumatanthauza (SD)] | Kuda nkhawa [kumatanthauza (SD)] | N | Zodandaula [zikutanthauza (SD)] | Kutopa [kumatanthauza (SD)] | Kupsinjika [kumatanthauza (SD)] | Kuda nkhawa [kumatanthauza (SD)] | maganizo | kutopa | kupanikizika | nkhawa | |
| A | 45 | 4.87 (1.52) | 6.31 (1.43) | 5.98 (1.69) | 5.62 (1.89) | 20 | 5.05 (1.70) | 6.05 (2.04) | 5.60 (1.50) | 5.35 (2.01) | −0.18, 95% CI = [−0.99, 0.67] | 0.26, 95% CI = [−0.67, 1.27] | 0.38, 95% CI = [−0.56, 1.35] | 0.27, 95% CI = [−0.76, 1.19] |
| D | 17 | 4.88 (1.69) | 6.06 (1.56) | 5.53 (1.94) | 3.76 (2.56) | 13 | 5.85 (1.28) | 4.15 (1.34) | 3.15 (1.14) | 2.15 (1.41) | −0.96, 95% CI = [−1.79, −0.25] | 1.90, 95% CI = [1.26, 2.42] | 2.38, 95% CI = [1.46, 3.04] | 1.61, 95% CI = [0.00, 2.42] |
| E | 22 | 7.09 (0.75) | 5.18 (1.82) | 4.55 (1.22) | 3.45 (1.26) | 18 | 7.33 (0.59) | 4.56 (1.10) | 4.33 (0.91) | 3.22 (1.22) | −0.24, 95% CI = [−0.56, 0.18] | 0.63, 95% CI = [−0.27, 1.50] | 0.21, 95% CI = [−0.42, 0.59] | 0.23, 95% CI = [−0.51, 0.59] |
| F | 15 | 5.47 (0.99) | 5.47 (1.81) | 3.53 (1.55) | 2.40 (1.06) | 36 | 6.72 (1.43) | 4.53 (1.76) | 2.92 (1.46) | 2.11 (1.04) | −1.26, 95% CI = [−2.02, −0.58] | 0.94, 95% CI = [−0.33, 1.77] | 0.62, 95% CI = [−0.06, 1.42] | 0.29, 95% CI = [−0.13, 0.93] |
| G | 24 | 5.83 (1.71) | 6.17 (1.66) | 5.54 (1.91) | 4.79 (2.11) | 27 | 6.15 (1.51) | 6.74 (1.85) | 5.48 (1.87) | 4.74 (2.26) | −0.31, 95% CI = [−0.98, 0.39] | −0.57, 95% CI = [−1.54, 0.34] | 0.06, 95% CI = [−0.91, 0.82] | 0.05, 95% CI = [−1.13, 0.96] |
| H | 27 | 3.59 (1.89) | 6.15 (1.73) | 4.74 (2.01) | 5.07 (2.20) | 16 | 5.50 (2.16) | 6.38 (1.86) | 4.75 (1.98) | 4.56 (2.22) | −1.91, 95% CI = [−3.11, −0.66] | −0.23, 95% CI = [−0.79, 1.22] | −0.01, 95% CI = [−0.71, 1.54] | 0.51, 95% CI = [−0.35, 2.29] |
Zindikirani. SD: kupatuka wamba; CI: kudalirika kwakulimba.
Zinthu zokhudzana ndi kuluma
Mosiyana ndi kugwiritsa ntchito zolaula pafupipafupi, pomwe ambiri mwa ovutawa adavutika kuzindikira zovuta zomwe zimafunsidwa (pazoyankhulana zamankhwala) pazinthu zomwe zimayambitsa kugwiritsa ntchito zolaula, ambiri odwala adanena nkhawa, zovuta m'moyo wawo, komanso kuwopa kulephera pokumana ndi ziyembekezo zazikuluzikulu za anthu ena monga zinthu wamba. Munthu m'modzi adalumikizana ndi kudya kwambiri. Maphunziro atatu adawona kuti kulumwa kunali kokhudzana ndi kukwiya kapena kusungulumwa komanso kukanidwa.
Odwala onse adalengeza kuti panthawi yazolaula adayamba kukhala ndi malingaliro abwino (mwachitsanzo, chisangalalo ndi chisangalalo). Kenako, pakumwa mowa kwambiri, maphunziro ambiri alibe malingaliro enieni ("osadulidwa kuganiza") ndipo amasiyana ndi malingaliro awo. Atangomwa mowa mwauchidakwa, nthawi zambiri amamva chisoni ndi kuwonongera nthawi kapena kunyalanyaza ntchito yawo. Malingaliro oterewa amaphatikizidwa ndi malingaliro osalimbikitsa, monga manyazi, kusungulumwa, kunyansidwa, kudziimba mlandu, mkwiyo, chisoni, nkhawa, kusowa chiyembekezo, kusadzilemekeza, komanso kukhumudwa. Odwala amamva kukwiya komanso kukwiya. Amuna asanu adanena kuti ali ndi malingaliro olakwika okhudzana ndi iwo eni, mwachitsanzo, "Ndili wofooka," "Nditha kuthera nthawi yambiri ndikuchita zosangalatsa, malingaliro, misonkhano ndi anthu m'malo mowonera zolaula," ndipo "Ndalepheranso." Mitu itatu sinafotokoze malingaliro aliwonse atatha ma binges (Chithunzi 3).
Chithunzi 3. Kudzidziwitsa komanso malingaliro zakale, nthawi, komanso mutangolimbana ndi zolaula
Zambiri zakuwunika kwa bukulo zimayesedwa ngati panali kusiyana pakati pa miseru, kutopa, kupsinjika, ndi nkhawa m'masiku omwe anali ndi kulumala mosiyana ndi masiku opanda kuluma. Kufanizira uku kunafotokozera kusiyana kwakukuru kwambiri kuposa koyambirira, kokhudzana ndi kuonera zolaula komanso kuseweretsa maliseche (Gome 4). Kwa onse kupatula mutu umodzi (G), kulumikizidwa zolaula kumayambitsa kuchepa kwamtundu (odwala D, E, F, ndi H) kapena kupsinjika (odwala A, D, ndi E). Mukangotha kudya, nthawi zambiri amaganiza za kuwononga nthawi kapena ntchito zomwe ananyalanyaza. Malingaliro oterewa amayenda ndi malingaliro osalimbikitsa, monga manyazi, kusungulumwa, kunyansidwa, kukwiya, chisoni, nkhawa, kudzikayikira, kusadzilemekeza, komanso kupsinjika. ”
Pomaliza, tidasanthula kuthekera kwa kulumikizana pakati pa zosinthika zomwe zimayesedwa ndi diary (kutopa, kutopa, kupsinjika, ndi kuda nkhawa) ndi kuluma kwa PuM (Gome 5). Chifukwa chaichi, chofanana ndi kusanthula kwam'mbuyo (komwe kwawonetsedwa mu Gome 4), tidasankha masiku okhala ndi kuluma kwa PuM (monga momwe gawo la "Njira" limafotokozera) ndi masiku opanda kuluma. Kenako, tinawerengera kusiyana kwammwe, kutopa, kupsinjika, ndi kuda nkhawa masiku omwe analipo "tsiku lovuta" komanso masiku "opanda kuluma" (Supplementary Table S4) ndi masiku atatsata "tsiku lovuta" ndi masiku "osawuma konse" ”(Gawo lowonjezera la S5). Chithunzi 4 limapereka zosiyana zingapo zazikulu pakufananiza konseku. Kuchulukana kwakukulu kwamasiku am'mbuyomo kumapereka chidziwitso pamawu omwe amachepetsa nkhawa, kutopa kwambiri, kupsinjika, ndi nkhawa zitha kutenga gawo limodzi mukumenya kuluma kwa PuMs, pomwe kuchuluka kwakukulu pamasiku owerengetsa kudya. kuchepa kwa nkhawa, kutopa kochulukirapo, kupsinjika, ndi nkhawa zingakhale zotsatira za kulumidwa ndi PuM.
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Gulu 5. Kuyerekeza kwapakati kwamomwe timakhala, kutopa, kupsinjika, ndi nkhawa pakati pa "masiku omwe ali ndi kulumwa" ndi "popanda kulumwa", kuyesedwa pakafukufuku wamasiku ambiri a 10
wodwala | Masiku okhala ndi kulumwa | Masiku opanda kuluma | Kusiyanitsa kwapakati | |||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
N | Zodandaula [zikutanthauza (SD)] | Kutopa [kumatanthauza (SD)] | Kupsinjika [kumatanthauza (SD)] | Kuda nkhawa [kumatanthauza (SD)] | N | Zodandaula [zikutanthauza (SD)] | Kutopa [kumatanthauza (SD)] | Kupsinjika [kumatanthauza (SD)] | Kuda nkhawa [kumatanthauza (SD)] | maganizo | kutopa | kupanikizika | nkhawa | |
| A | 28 | 4.64 (1.37) | 6.25 (1.58) | 6.32 (1.56) | 5.54 (1.93) | 37 | 5.14 (1.69) | 6.22 (1.69) | 5.51 (1.61) | 5.54 (1.92) | −0.49, 95% CI = [−1.13, 0.15] | 0.03, 95% CI = [−0.79, 0.86] | 0.80, 95% CI = [0.04, 1.64] | 0.00, 95% CI = [−0.81, 0.60] |
| D | 3 | 2.67 (1.53) | 6.33 (1.15) | 7.67 (1.53) | 7.33 (1.53) | 27 | 5.59 (1.31) | 5.11 (1.76) | 4.15 (1.75) | 2.59 (1.78) | −2.93, 95% CI = [−3.34, −1.44] | 1.22, 95% CI = [−0.27, 2.05] | 3.52, 95% CI = [1.61, 4.00] | 4.74, 95% CI = [3.03, 5.15] |
| E | 2 | 6.50 (0.71) | 4.50 (0.71) | 5.00 (0.00) | 3.50 (2.12) | 38 | 7.24 (0.68) | 4.92 (1.58) | 4.42 (1.11) | 3.34 (1.21) | −0.74, 95% CI = [−1.28, −0.06] | −0.42, 95% CI = [−1.34, 0.28] | 0.58, 95% CI = [0.20, 0.85] | 0.16, 95% CI = [−1.70, 1.76] |
| F | 8 | 5.00 (0.93) | 5.38 (1.77) | 3.50 (1.69) | 2.50 (1.2) | 43 | 6.60 (1.37) | 4.70 (1.82) | 3.02 (1.47) | 2.14 (1.01) | −1.6, 95% CI = [−2.35, −0.74] | 0.68, 95% CI = [−0.51, 1.60] | 0.48, 95% CI = [−0.39, 1.39] | 0.36, 95% CI = [−0.24, 1.04] |
| G | 9 | 5.22 (2.44) | 6.44 (2.24) | 5.78 (2.17) | 5.11 (2.42) | 42 | 6.17 (1.34) | 6.48 (1.69) | 5.45 (1.82) | 4.69 (2.14) | −0.94, 95% CI = [−2.56, 0.37] | −0.03, 95% CI = [−1.40, 1.28] | 0.33, 95% CI = [−1.07, 1.76] | 0.42, 95% CI = [−0.95, 1.98] |
| H | 14 | 2.71 (1.38) | 5.79 (1.58) | 5.29 (1.94) | 5.71 (2.2) | 29 | 5.07 (2.09) | 6.45 (1.82) | 4.48 (1.98) | 4.48 (2.11) | −2.35, 95% CI = [−3.59, −1.27] | −0.66, 95% CI = [−1.95, 0.60] | 0.80, 95% CI = [−0.58, 2.39] | 1.23, 95% CI = [0.08, 2.50] |
Zindikirani. SD: kupatuka wamba; CI: kudalirika kwakulimba.
Chithunzi 4. Chiwerengero cha omwe tidawawona kusiyana kwakukulu pamasinthidwe, kutopa, kupsinjika, ndi nkhawa (zoyesedwa ndi zolemba) pakati pa masiku asanafike tsiku lomwe kulumwa kwambiri kapena tsiku lopanda zithunzi zolaula ndi maliseche (mbali yakumanzere ya chithunzicho; kuti mupeze kusiyana kwenikweni onani zowonjezera Gome S4). Mbali yakumanja, tikuwonetsa kuchuluka kwa maphunziro omwe kusiyanasiyana pakati pa masiku angapo tsiku limodzi kulumala motsutsana ndi PuM kunali kwakukulu (kusiyana kwenikweni, onani Powonjezera S5)
Panalibe kusiyana kwakukulu [χ2 = 2.64, p = .104; kuwerengedwa pakukula kwakusiyana / kosafunikira kwamasiku am'mbuyomu ma binges (Supplementary Table S4) ndi ma binges otsatirawa (Supplementary Table S5)] pakati pa kuchuluka kwa zotsatira zazikulu kuchokera pakusanthula masiku atatha kudya pang'ono ndikusanthula masiku omwe atsatira ndi mowa wambiri (Chithunzi 4).
Zokambirana ndi zolingalira
Phunziroli, tidayankhulana ndi odwala asanu ndi anayi omwe amafuna chithandizo cha PuM chovuta. Kenako tinatenga zofunsa mafunso ndikugwiritsa ntchito kuyang'ana kwatsiku kwa masiku angapo a 10 kuti tiwone momwe zolemba zimafotokozera zokhudzana ndi zovuta zawo zokhudzana ndi kugonana komanso momwe zimafananirana ndi deta yomwe imasonkhanitsidwa pakuwunika kwa diary.
Zotsatira zathu zonse komanso zolemba zakale zikuwonetsa kuti ngakhale panali chithandizo cham'mbuyomu, anthu onse adakumana ndi njira ya CSB (Kafka, 2010), ndikuti zovuta kwambiri zogonana zinali PuM (chimodzimodzi ndi kafukufuku wo Reid, Li, Gilliland, Stein, & Fong, 2011). Ambiri mwa iwo zimawavuta kuzindikira zomwe zimayambitsa zolaula; komabe, amatha kuzindikira zochitika zolaula zomwe zimabwerezedwa - monga malo ena (mwachitsanzo, kunyumba ndi kuntchito), nthawi, ndi zochitika (mwachitsanzo, kukhala nokha). Kutengera ndi kuwunika kwa ma diary (malingaliro, kutopa, kupsinjika, ndi nkhawa), maphunziro ambiri zimawavuta kuti apeze zolumikizana zilizonse zogonana. Mwinanso magawo ena a PuM amatenga gawo lazomwe zimachitika kuti muchepetse zachiwerewere kapena njira yothanirana ndi kusasangalala, kupsinjika, ndi nkhawa. Zomwe zimachitika pazaka makumi asanu ndi awiri za kuyesa kwa 70 zitha kukhala zoyambitsa zakusagwirizana kwenikweni ndi kusiyanasiyana kwa ma diary.
Chosangalatsa ndichakuti, maphunziro asanu ndi awiri mwa asanu ndi anayi adanena kuti, m'moyo wawo wonse, adakumana ndi PuM mowa kwambiri kwa maola angapo ndipo zimachitika kangapo patsiku. Pankhani ya ma binges otere, maphunziro ambiri adatha kuwonetsa zoyambitsa zingapo. Zina mwazomwe zatchulidwa kwambiri ndi kupsinjika, mavuto m'moyo wanu, kuwopa kulephera kukwaniritsa ziyembekezo zazikulu za ena, mkwiyo, ndikusungulumwa komanso kukanidwa. Zotsatira zofananazi zidanenedwa kale ndi Reid, Li, et al. (2011) yemwe adawonetsa kuti kugwiritsa ntchito zolaula kunali kokhudzana ndi zotsatira zingapo zoyipa, monga kusungulumwa komanso nkhawa. Izi zovuta kuzindikira komanso zomverera zimatha kukhala zokhudzana ndi mitundu yosavuta yoyezera m'madayilo. Tidawona izi, ndipo zowonadi, zowerengera zazakuwonetseratu zikuwonetsa kuyanjana kwakukulu pakati pa kulumikizidwa komanso kuchepetsedwa kwa mawonekedwe ndikuwonjezeka kwa nkhawa ndi nkhawa kwa anthu onse m'gulu lathu, kupatula m'modzi.
Malinga ndi odwalawo, kugwiritsa ntchito zolaula mopitirira muyeso kumawathandiza kuti azisangalala komanso kusangalala komanso kumathandiza "kutseka malingaliro awo." Zotsatira zoterezi zitha kuchitika ngati njira yothanirana ndi mavuto kwakanthawi kochepa. Tsoka ilo, atangomwa mowa mwauchidakwa, omvera onse adakumana ndi zovuta zina (monga manyazi, kusungulumwa, kunyansidwa, kudziimba mlandu, mkwiyo, chisoni, nkhawa, komanso kusowa chiyembekezo) komanso malingaliro olakwika okhudza iwo eni (mwachitsanzo, "Ndine wofooka, "" Ndikungowononga nthawi yanga, "komanso" Ndalepheranso "); ndipo malinga ndi odwala, zomwe zimachitika chifukwa chomwa mowa mwauchidakwa zimakhudzana ndikumverera kotayika pamachitidwe ako.
Kafukufuku wam'mbuyomu wasonyeza kuti kumverera kotayika kotereku kukhoza kukhala chinthu chofunikira kwambiri chotsogolera kukufuna chithandizo pakati pa amuna (Gola, Lewczuk, et al., 2016) ndi akazi (Lewczuk et al., 2017). Ngakhale kuti kudya mowa mwauchidakwa kwa PuM kumawoneka kofala pakati pa odwala a CSB, ndizochepa kwambiri zomwe zimadziwika pokhudzana ndi magwiridwe antchito amtunduwu, komanso njira zawo. Kukhalapo kwa zolaula zomwe zidagwiritsidwa ntchito kumatchulidwa pazowonera zambiri zamankhwala ndipo zidanenedwa mu kafukufuku wa Reid, Stein, et al. (2011), koma malinga ndi momwe tikudziwira, iyi ndi ripoti loyamba lomwe likuyesera kuyang'ana kwambiri kulumidwa ndikuwunika mawonekedwe a izi. Ngakhale tikudziwa zoyambirira za zomwe tasankha (zomwe takambirana mu gawo la "malire" komanso zofunikira pakufufuzidwa zochulukirapo, taphunzira zinthu zingapo zosangalatsa za kuluma kwa PuM.
Choyamba, kudya PuM kumatha kukhala ndi mitundu yosiyanasiyana. Malinga ndi zomwe adalemba, ma binges atha kukhala ndi mawonekedwe owonera zolaula omwe amaphatikizidwa ndi maliseche angapo kwa maola angapo motsatizana (nthawi zambiri> 6 hr zopuma zosakwana 30 min) kapena magawo angapo (opitilira anayi kangapo patsiku, kukhala ndi 0.5-1 hr iliyonse) ya zolaula zomwe zimawonetsedwa tsiku limodzi, limodzi ndi maliseche.
Chachiwiri, kulumidwa ndi PuM kumawoneka ngati yankho pamavuto ndipo sikumangokhala ntchito zongochepetsa kugonana, koma m'malo mwake kuchepetsa mavuto osakhalitsa, nkhawa, kapena nkhawa. Sizikudziwika chifukwa chomwe chochitika chimodzi cha PuM sichikwanira kuti zitsitsimutse motere koma chimakulirakulira. Tili ndi ma hypotheses ochepa osasankha komanso osaganizira ena, ofunika kufufuza kafukufuku wamtsogolo.
Kutanthauzira komwe kungakhalepo ndikuti malingaliro olakwika (mwachitsanzo, "Ndalephera kachiwiri") ndi momwe akumvera (mwachitsanzo, mkwiyo) gawo loyamba la PuM litabweretsa mavuto, omwe amafunika kuchepetsedwa mwa kubwereza zomwezo, chimodzimodzi ndi Khalidwe lokakamiza lochepetsa kupsinjika lomwe limawoneka chifukwa chazokonda mu OCD (Stein, 2002).
Kufotokozera kwachiwiri kukugwirizana ndi zomwe zapezedwa posachedwa (Gola, Wordecha, et al., 2017) kuti anthu omwe akufuna kulandira chithandizo chamavuto omwe ali ndi vuto la zolaula amakhala ndi chidwi chambiri mu mphoto muubongo (makamaka ma cyral striatum) poyankha machitidwe omwe amagwirizana ndi kugwiritsa ntchito zolaula. Mwina gawo limodzi la PuM lingathe kumveketsa kwakanthawi kachulukidwe kameneka, kukulitsa kukonzanso zinthu zomwe zikutsatira kenako ndikukumana ndi zilimbikitso zamphamvu, zomwe zingayambitse kuluma.
Mafotokozedwe achitatu akuwona imodzi mwazinthu zokhudzana ndi zovuta zomwe zimagwiritsidwa ntchito pokhudzana ndi kukhalamo. Mitundu yamavuto ogwiritsa ntchito mankhwala osokoneza bongo imayambitsa kuchepa kwa chisangalalo pakukonzekera zosokoneza bongo monga njira yodzipezera mphotho (Volkow et al., 2010). Izi zimabweretsa kuchuluka. Kumbali ya CSB, mphotho yomaliza ndiye chimake (Gola, Wordecha, Marchewka, et al., 2016); komanso machitidwe ogonana ambiri, zolaula zimapangitsa chidwi chodziseweretsa maliseche kuti zithetse (monga tikuonera Chithunzi) 2, zochulukirapo za zochitika zodziseweretsa maliseche zinatsatana ndi kugwiritsa ntchito zolaula. Ndizotheka kuti kwa anthu a CSB, zolaula zambiri sizokwanira pachimake ndipo zimatenga nthawi yambiri kuti mupeze buku, lomwe limapangitsa chidwi. Ndizothekanso kuti pachimake chimodzi chikadzakhala ndi mwayi waukulu wazomwe zachitika mtsogolo, ndikuwonera zolaula kwa nthawi yayitali ndikofunikira kuti mupeze chidwi chokwanira.
Chochitika chachinayi chikuganiza kuti pachimake palokha sichingakhale chinthu chosangalatsa kwambiri chogonana patokha kwa anthu ena omwe ali ndi CSB. Monga momwe zalembedwera (Gola, Wordecha, Marchewka, et al., 2016), zokopa zogonana zokhazokha zimatha kukhala zosangalatsa. Kuti tiwone, anthu ali ofunitsitsa kugwiritsira ntchito ndalama zofananira ndi zomwe zimafunikira kuti apeze phindu la ndalama (Sescousse, Caldú, Segura, & Dreher, 2013). Chosangalatsa ndichakuti, zolaula zomwe zimawonetsedwa zimadzutsa chilakolako chogonana chomwe chikukhudzana ndikuwonjezeka kwa chidwi chowayang'ana ndikuchita zachiwerewere, mpaka pachimake. Pambuyo pake, zonse zomwe zimakhudza kugonana komanso chidwi chowonera zolaula zimachepa. Timalingalira kuti ngati maphunziro a CSB amakumana pachimake ngati osasangalatsa kuposa anthu wamba (mwachitsanzo, chifukwa chazolowera), atha kuyang'ana kwambiri kuwonera zolaula - zomwe ndizosangalatsa - ndikuyesera kuchedwa pachimake, zomwe zimabweretsa magawo atali zolaula zimagwiritsa ntchito. Tikukhulupirira kuti njira zonse zinayi zitha kuthandizira kubwereketsa PuM, ndipo iliyonse ya iwo ndiyofunika kuphunzira zambiri.
Pomaliza, tidafunsa ngati kuchepa kwa nkhawa kapena kutopa kwambiri, kupsinjika, ndi nkhawa zoyesedwa pazomwe zikuwunikira zikuyambitsa kapena ndi chifukwa chogwiritsa ntchito zolaula. Popeza sitinapeze zotsatira zomveka, funso ili likufunika kufufuza mozama. Komabe, potengera deta yathu, timapereka malingaliro. Tinaona kuti kutsika konsekako kunayamba ndipo kutopa kwambiri kumawonekera tsiku limodzi zisanachitike komanso tsiku limodzi kuluma. Chifukwa chake, ndizotheka kuti kuchepa kwa nkhawa komanso kutopa kokwanira ndizomwe zimayambitsa komanso zotsatira. Ngati nkhawa zambiri ndi kupsinjika zikuchitika tsiku limodzi chitatha kulumikizidwa, ndipo makamaka zotsatira zake ndi (Chithunzi 4). Zofunikira, maphunziro adawonetsa kusiyana kwakukulu pakati pa anthu pazomwe zidalipo ndi kutsata kolumikizana. Chifukwa chake, tikuganiza kuti kulumikizana kumatha kutenga gawo lina mosiyana kwa aliyense payekhapayekha, kuthandizira wina kuthana ndi zochitika, wina ndi kutopa, ndipo zotsatira zake zimakhala zosiyana, kutengera zikhulupiriro za aliyense payekha. Kusintha kumeneku kukuwonetsa kufunikira kwakukoka kwakudya kwamankhwala.
Kufunika kwamankhwala
Kutengera ndi zotsatira zathu, tikupempha kuti tikambirane zochitika za kulumidwa kwa PuM pantchito yachipatala ndi odwala a CSB. Malinga ndi zomwe zapezeka mu kafukufukuyu, odwala ambiri a CSB amakumana ndi kuluma kotere. Chosangalatsa ndichakuti, mosiyana ndi anthu omwe amapeza zithunzi zolaula nthawi yayitali komanso magawo amodzi, ndipo amavutika kuzindikira malingaliro, malingaliro, ndi zochitika zomwe zimayambitsa kugwiritsa ntchito zolaula, anthu omwe amakhala ndi kulumala amatha kuzindikira malingaliro awo okhudzana ndi zomwe akumva kapena kuluma. Izi zitha kukhala nangula wabwino wazamankhwala komanso mwamakhalidwe. Komanso, zowerengera zazaka zazitali zazowonetseratu zikuwonetsa kulumikizidwa kwakakumbuyo kambiri, kutopa, kupsinjika, ndi kusintha kwa nkhawa, komwe kumathandizira kuwunika kwathu kuchokera ku deta yomwe yatengedwa pazokambirana.
Chowonjezera china chachikulu chokhudza kulumikizana ndizokhudzana ndi kusinthasintha kwakukulu kwa ntchito. Zikuwoneka kuti kulumikizana kotereku nthawi zonse kumakhala gawo limodzi lothandizira kuthana ndi machitidwe, m'malo mchitidwe womwe umachepetsa zovuta zogonana. Chifukwa chake, kuwunikira kofotokoza kumenyedwa (m'malo mopenda zolemba zilizonse zokhudzana ndi zolaula) kumatha kupereka njira yodziwikitsira malo omwe amafunikira kukulira njira zina, zomwe zimathandizira kupirira, komanso zomwe zingafunikire chisamaliro chambiri pakuchizidwa.
Pomaliza, wina atha kufunsa ngati kulumidwa kwa PuM kuyenera kuphatikizidwanso paziwonetsero za CSB zofunsidwa ku ICD-11 yomwe ikubweraWHO, 2018). Komabe, pomwe kafukufuku wathu wachidule akuwonetsa kuti ambiri mwa anthu omwe amakumana ndi a Kafka (2010) Njira za CSB zimakumana ndi kulumwa, si onse omwe amatero. Maphunziro awiri mwa asanu ndi anayi (B ndi C) sanakumane ndi kuluma kwa PuM, ndipo m'modzi (C) adakumana ndi kangapo m'moyo wake. Pachifukwa ichi, tikutsutsa kuphatikizidwa ndi kulumidwa kwa PuM monga chofunikira cha CSB, komanso tikuganiza kuti kusanthula mwatsatanetsatane kwa chizindikirochi kungakhale chidziwitso chofunikira kwa asing'anga.
Chowoneka china chosangalatsa ndi chachipatala chimakhudzana ndi wodwala B, yemwe adapewa PuM kwa miyezi yopitilira 6 (adafotokoza zamatsenga tsiku lililonse ndi mnzake), komabe amafunafuna chithandizo cha CSB, natchula kugwiritsa ntchito zolaula ngati chifukwa chachikulu. Anakumananso ndi zofunikira zonse za ICD-11, zomwe zikuwonetsa kuti ngakhale kusakhalapo kwakanthawi kokhala ndi zovuta zambiri, anthu ena akadatha kuyesedwa kuti adziwe ngati ali ndi vuto la CSB, popeza palibe chitsimikizo chofotokoza nthawi yayitali yomwe yatsala kuyambira gawo lomaliza la CSB. Tinaganiza zophatikiza Phunziro B mu lipoti lakafukufukuyu kuti tisonyeze zonsezo komanso kuwonetsa kuti anthu ena amafunafuna chithandizo chamankhwala ndikukumana ndi zidziwitso ngakhale tsopano kulibe zizindikiro.
sitingathe
Tikuwona kafukufukuyu ngati kafukufuku woyamba yemwe angalimbikitse ofufuza ena kuti adziwe chilengedwe, machitidwe, komanso udindo wa kulumidwa kwa PuM. Ili ndi zoperewera zingapo komanso zoyesereranso zomwe ziyenera kuchitika ziyenera kupangidwa (tidzakhala okondwa kugawana njira zathu ndi aliyense amene angafune kuzigwiritsa ntchito). Choyamba, tinaphunzira anthu asanu ndi anayi okha ndipo asanu ndi awiri okha ndi omwe amapereka zonse. Chachiwiri, anthuwa anali kufunafuna chithandizo cha CSB ndipo asanu ndi atatu a iwo adayesapo chithandizo cha CSB, chifukwa chake adalimbikitsidwa kuchepetsa kugwiritsa ntchito zolaula. Chachitatu, onsewa adayamba kulandira chithandizo pakuwunika kwathu kwa masiku angapo a 70 ndikutsiriza magawo asanu ndi limodzi (nthawi zambiri pamlungu). Izi zitha kukhudza ma data omwe adalemba, ndipo tikukayikira kuti zidapangitsa kuchuluka kwa ma CSB kuposa momwe timawonera kuchuluka kwa anthu a CSB omwe sanalandiridwepo. Zitha kuthandizanso kuti mudzidziwe kwambiri kuposa momwe anthu omwe sanalandire chithandizo.
Zowonjezera zina ndizokhudzana ndi mtundu wa kusanthula ndi kusanthula. Tidayesetsa kuti tisonkhanitse deta yapamwamba kwambiri polemba zamabuku, koma panali mipata yosagawika mu data (yowonjezera Table S2). Tikukayikira kuti zochitika zambiri zogonana zitha kukhala kuti zidachitika masiku omwe zolemba sizinachitike, ndipo zomwe zingabwezere m'mbuyo zitha kukhala zokhudzana ndi kuchepa kwa chilimbikitso chololera. Panalibe njira yoti titha kuwongolera izi phunziroli. Ngati izi zilidi zoona, ndiye kuti zomwe zachitika pakugonana zimayendetsedwa. Tidafunsa odwala kuti azilowetsa tsiku lililonse tsiku lililonse. Kusintha kwakanthawi kotereku kumawoneka ngati kosakwanira kudziwa kuyanjana pakati pa zosinthika, monga kusinthasintha, kuda nkhawa, kupsinjika, ndi zina, dzanja limodzi, ndi kuluma kwina. Pazotsatira zamtsogolo, tikuwonetsa kuyesa kwakanthawi kachilengedwe kangapo patsiku ngati njira yabwino yodziwira ubale wamtunduwu ndikupewa mipata muzolemba.
Chifukwa cha zoperewera zomwe tatchulazi (zomwe zingakhale zocheperako poyerekeza ndi zachiwerewere zokhudzana ndi chithandizo chamankhwala komanso kusowa kwa data), pofuna kusanthula deta, tidatanthauzira magawo opitilira muyeso kuposa 1 hr yolaula imagwiritsa ntchito / kapena 2 kapena maliseche ambiri patsiku. Tikudziwa kuchokera ku maphunziro ena kuti kutanthauzira kotereku kumatha kubwera pakati pa anthu omwe sagwirizana ndi CSB (Brand et al., 2016). Chifukwa chake, pamaphunziro amtsogolo a anthu opanda chithandizo komanso njira zopitilira muyeso (mwachitsanzo, kuwunika kwakanthawi kachilengedwe), komanso zithandizo zamankhwala, tikupangira kuti kumwa mowa kumatanthauza 2+ hr ya zolaula zomwe zimagwiritsidwa ntchito komanso / kapena 3+ maliseche magawo tsiku. Timalimbikitsanso ochita kafukufuku kuti adziwe izi mwa maphunziro opatsa chidwi.
Zopereka za olemba
MWo adathandizira pophunzira ndi njira zopangira, kufunafuna anthu, kufunsa mafunso, kusanthula deta, kutanthauzira, komanso kulemba pamanja. MWi anathandizira kusanthula kwa deta ndikumasulira komanso kukonzekera pamanja. EK idathandizira kukulitsa mafunso. MS ndi AŁ adathandizira kukulitsa pulogalamu yoyesa zam' diaries ndikuwongolera deta. MG idathandizanso pakuphunzira ndi kupanga mapangidwe, kutanthauzira kwa deta, kulemba pamanja, kupeza ndalama, ndi kuyang'anira maphunziro.
Kusamvana kwa chidwi
Olembawo akuti palibe kutsutsana kulikonse pazokhudza zomwe zalembedwa pamanja awa.
Zothandizira
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