Kukula kwa Mavuto Okhudzana ndi Kuvuta Kulamulira Kulimbikitsa Kugonana, Kumverera, ndi Zopindulitsa ku United States (2018)

Novembala 9, 2018

Janna A. Dickenson, PhD¹; Neil Gleason, MA¹; Eli Coleman, PhD¹; et al Michael H. Miner, PhD¹

Nkhani Yophunzira

JAMA Netw Open. 2018; 1 (7): e184468. doi: 10.1001 / jamanetworkopen.2018.4468

funso  Kodi pali kufala kotani pakati pa amuna ndi akazi aku US omwe ali pachiwonetsero chachikulu cha kukakamiza kugona mchitidwe wogonana, mavuto ndi zofooka zomwe zimakhudzana ndi zovuta kudziletsa pakumvera, zogonana, komanso machitidwe ake?

Zotsatira  Mu kafukufukuyu, tapeza kuti 8.6% ya akazi oyimira dziko (7.0% ya azimayi ndi 10.3% ya abambo) adalimbikitsa zamavuto azachipatala komanso / kapena kuwonongeka komwe kumalumikizidwa ndi zovuta kuthana ndi malingaliro ogonana, chilimbikitso, ndi machitidwe.

kutanthauza  Kukula kwambiri kwa zisonyezo zotere kumakhala kofunika kwambiri paumoyo wa anthu komanso vuto lachitukuko ndikuwonetsa vuto lalikulu lazachipatala lomwe liyenera kuzindikiridwa ndi akatswiri azaumoyo.

Importance  Zoona, maina, ndi malingaliro okhudzana ndi kugonana, khalidwe logonana, khalidwe lachiwerewere, ndi chilakolako chogonana ndizokangana. Mosasamala kanthu kosiyana kotereku mwa kulingalira, zitsanzo zonse zomwe zimagwirizana kwambiri ndi izi: Kusayendetsa kugonana ndi makhalidwe anu mwa njira yomwe imayambitsa kukhumudwa kwakukulu ndi / kapena kuwonongeka kwa ntchito. Komabe, kufalikira kwa nkhaniyi ku United States sikudziwika.

cholinga  Kuwonetsa kuchuluka kwa mavuto ndi kuwonongeka komwe kumakhudzana ndi vuto loletsa kugonana, zolimbikitsana, ndi makhalidwe pakati pa mayiko oimira dziko lonse la United States.

Kupanga, Kukhazikitsa, ndi Ophunzira  Kafukufukuyu adagwiritsa ntchito National Survey of Health Health ndi Behaviour kuwunika kuchuluka kwa zovuta ndi zovuta zomwe zimakhudzana ndi zovuta kuthana ndi malingaliro ogonana, chilimbikitso, komanso momwe zimakhalira ndikuwoneka momwe kufalikira kwakusiyana pakati pa kusiyanasiyana pakati pa chikhalidwe cha anthu. Ophunzira nawo azaka zapakati pa 18 ndi 50 adasinthidwa mwachisawawa kuchokera kumayiko onse a 50 US mu Novembala 2016.

Zotsatira zazikulu ndi Zotsatira  Kusokonezeka ndi kukhumudwa komwe kumakhudzana ndi vuto loletsa kugonana, zolimbikitsana, ndi khalidwe zinayesedwa pogwiritsira ntchito Compulsive Sexual Inventory-13. Chiwerengero cha 35 kapena chapamwamba pamlingo wa 0 mpaka 65 chikuwonetsa kuchuluka kwa zovuta komanso / kapena kuwonongeka.

Results  Amuna akuluakulu a 2325 (1174 [50.5%] azimayi; amatanthauza zaka [SD], zaka 34.0 [9.3], 201 [8.6%] anapeza mfundo zochepetsera zojambula za 35 kapena zapamwamba pa Compulsive Sexual Behavior Inventory. Kusiyana kwa kusiyana pakati pa amuna ndi akazi kunali kochepa kuposa momwe anthu ankayendera kale, ndi 10.3% mwa amuna ndi 7.0% a akazi omwe amavomereza zofunikira za kuchipatala ndi / kapena kuwonongeka komwe kumakhudzana ndi vuto loletsa kugonana, zofuna, ndi khalidwe.

Zotsatira ndi Kuyenera  Kukula kwambiri kwa chodziwikiratu chomwe chimakhudzana ndi kukakamizidwa kuchita zogonana kumabweretsa tanthauzo lalikulu kwa akatswiri azaumoyo ndi gulu. Ogwira ntchito zaumoyo ayenera kukhala atcheru ku chiwerengero chachikulu cha anthu omwe apsinjika ndi machitidwe awo ogonana, kuwunika mosamala mtundu wamvuto momwe akukhalira, ndikupeza chithandizo choyenera kwa amuna ndi akazi.

Kuchokera ku Tiger Woods kupita ku Harvey Weinstein, nkhani zankhani zatsimikizira kuti "chizoloŵezi cha kugonana" ndi "mliriwu" womwe ukukula komanso wamtunduwu womwe suukudziwika kale.¹ pomwe asayansi akutsutsana ngati vutoli limakhalapo. Ngakhale kuphatikiza zamisala zili ndi mbiri yayitali yoyesa kudziwika kuti ali ndi vuto laling'ono, ofufuza ndi asing'anga asiyanitsa malingaliro akuti ngati chikuyimira vuto lalikulu la matenda amisala kapena zikuwonetsa vuto lalikulu lazachikhalidwe (lotchedwa kuti machitidwe osagonana²). Komanso, pakhala kusagwirizana kwakukulu pamalingaliro apamwamba, malingaliro, komanso mayina (mwachitsanzo, chizolowezi chogonana [CSB],³Hypersexual matenda,⁴chilolezo chogonana,⁵ ndi machitidwe osagonana²).⁶ Chiwonetsero cha zizindikiro chimasiyananso pamakonzedwe, kupereka kuyerekezera koyenera kwa kufalikira kwa mayiko.⁷ Zotsatira zake, kuthekera kwa asayansi kupenda moona mtima za momwe chikhalidwe cha pop chimanenera kuti CSB ndi "mliri wakula"¹ amakhalabe ochepa.

Ngakhale kusowa kotereku pamagwiritsidwe ophatikizidwa ndi magwiridwe antchito, malingaliro onse amagawana gawo limodzi: kukhala ndi zovuta kwambiri pakulamulira malingaliro amtundu wa kugonana, chilimbikitso, ndi zomwe zimapangitsa kupsinjika kwakukulu komanso / kapena kukhumudwitsidwa. Chidule ichi chimapanga maziko a chikhalidwe chatsopano cha matenda osokoneza bongo (CSBD), omwe, kwa nthawi yoyamba, adadziwika ngati vuto lachiwerewere Kugawidwa Kwa Matenda Padziko Lonse, Kukonzanso kwa Gawo, pansi pa kalasi ya mavuto osokoneza maganizo.⁷ Mwachindunji, CSBD imadziwika ndi njira yosalekeza yolamulira, chilimbikitso chogonana, chomwe chimabweretsa kubwerezabwereza mchitidwe wogonana womwe umayambitsa kuwonongeka kapena kusokonezedwa pagulu. Kuvutika ndi kukhumudwa koteroku kumaphatikizapo kunyalanyaza zochitika za umoyo kapena thanzi laumwini, kuyesa mobwerezabwereza khalidwe la kugonana popanda kupambana, ndikupitirizabe kuchita zogonana ngakhale kuti zotsatira zake zimakhala zovuta kapena ngakhale munthuyo atapeza zosangalatsa zochepa zogonana.

Popeza kusasinthika kwa gulu la CSBD komanso kusowa kwa matanthauzidwe osinthika, tikudziwa kuti palibe kafukufuku wazotsatira zamatenda omwe adachitika ku United States. Ziwerengero zovuta za malingaliro a khalidwe la kugonana kukhala opanda mphamvu zapezeka m'mayiko ena,⁸ ndipo kufalikira kwa dziko lonse ku United States kwawerengedwa chifukwa cha zochepa zazing'ono.^4,7 Kafukufukuyu akuwonetsa kuti ndi anthu ochepa okha omwe amawona momwe amagonana ngati osaletseka ndipo amakumana ndi zovuta komanso / kapena kukhumudwa chifukwa cha machitidwe awo ogonana. Ku United States, kuchuluka kwakupezeka kwa 1% mpaka 6% kwa akuluakulu, ndi chiwerengero cha amuna ndi akazi choyembekezeka kuchokera ku 2: 1 mpaka 5: 1.^4,7 Poganizira kuchuluka kwakufunika kwamaphunziro ku miliri ku United States ndikutsutsana pamatanthauzidwe ozungulira ndikuwonetsa chizindikiro, kuwunika kuchuluka kwa kuvutikira komanso kuvutika komwe kumachitika chifukwa chovuta kudziletsa pakumverera kogonana, chilimbikitso, ndi machitidwe zimapereka chiwonetsero chapafupifupi cha kuchuluka kwa anthu kwa CSBD komwe kupezeka ku nthawiyi.

Kafukufuku wamakono akuwonetsa kuchuluka kwa chidule ichi ku United States mwa kupereka Compulsive Sexual Behavior Inventory-13 (CSBI-13) ku chitsanzo choimira dziko lonse (chithunzi). CSBI-13 idapangidwa ngati chida chowunika kuti iwononge kugona mwamphamvu komanso mokakamiza.^9,10 Zinthu za 13 zomwe zilipo zikufanana ndi njira zomwe CSBD ikuyang'anira ndikuwona kuyipa kwa malingaliro omwe munthu akuwona kuti ndi wovuta kuwongolera malingaliro amunthu wogonana, chilimbikitso, ndi chikhalidwe chake komanso kuchuluka kwa mavuto (kumva manyazi pazakugonana, kuchita zachiwerewere monga njira yodziwira) kuwonongeka kwa maganizo (chikhalidwe, chikhalidwe, ndi ntchito) chokhudzana ndi khalidweli.¹¹ Pakadali pano, CSBI-13 ndiyo chida chokhacho chowunika ndi malo omwe adakhazikitsidwa kuti azindikire moyenera omwe akukumana ndipo sakwaniritsa njira zomwe CSB syndrome 72% ndi 79% nthawiyo, motsatana.¹¹ Kutengera kuchuluka kwa kuchuluka kwa US komwe kumafala kwa CSBD, tidayesa kuti 1% mpaka 6% yaanthu akakumana ndi chipatala cha CSBI-13 ndi 20% mpaka 30% mwa omwe akumana ndi madokotala odula matendawa amakhala azimayi.

Zambiri adazisonkhanitsa kuti zikhale gawo la National Survey of Sexual Health and Behaeve (NSSHB) yotsatiridwa ndi American Association for Public Opinion Research (AAPOR) kuwunikira malangizo Kafukufuku wa NSSHB adapangidwa kuti ayang'anire zakugonana pakati pa anthu aku US pakati pa zaka za 18 ndi zaka za 50 (zikutanthauza kuti [SD] zaka zoyeserera, 34.0 [9.3]) ndikuphatikiza anthu ochokera m'maiko onse a 50 ndi District of Columbia. Ophunzirawo adalembedwa ntchito a KnowledgePanel (Kafukufuku wa GfK) patadutsa milungu ingapo ya 2 mu Novembala 2016 kuchokera pagulu la akulu omwe adamaliza 1 yamafunde am'mbuyomu kumaphunziro a NSSHB komanso kuchokera ku zitsanzo za anthu onse achikulire ku United States. Ophunzira ochokera m'magulu onse otsogolera analembedwanso mwachindunji kupyolera muzitsanzo zopezeka, ndipo mabanja anapatsidwa mwayi wopezeka pa intaneti ndi hardware ngati kuli kofunikira.¹² Njirayi imagwiritsa ntchito mawonekedwe akulu kwambiri amdziko lonse momwe zitsanzo zoyimira mokwanira zimatha kupangidwa kuti zithandizire anthu obwera kuphunzira. Mwa iwo omwe anali sampuli pa phunzirolo, 51% (2594) ankafuna chidwi pa phunzirolo poyendera webusaiti yomwe iwo angaphunzire za kuphunzira. Mwa anthu awa, 94% (2432) adapereka chidziwitso chidziwitso, ndipo 95.6% (2324) mwa omwe adapereka chidziwitso chokwanira adatsiriza CSBI-13. NSSHB idavomerezedwa ndi bungwe lowunika la Indiana University.

CSBI-13 ndi chida choyang'ana chomwe chimayang'ana chinthu chachikulu cha CSBD: kuwonongeka kwa ntchito komanso / kapena kuvutika komwe kumayenderana ndi kuvutika maganizo, kuganizira, ndi makhalidwe.¹⁰ CSBI-13 yawonetsedwa kuti ili ndi kudalirika kokwanira, kutsimikizika kotsimikizika kotsimikizika, komanso kusankhana komanso kusinthika kovomerezeka.¹¹ Mabaibulo akale a CSBI ayesedwa m'magulu osiyanasiyana a amuna ndi akazi akuluakulu ku United States^13-17 komanso m'mayiko ena.^17,18 Otsatira amawonetsa chilichonse cha zinthu 13 (chithunzi) pazithunzi za 5 zochokera ku 1 (ayi) mpaka 5 (kawirikawiri). Chiwerengero chonse cha chiwerengerocho chiwerengedwera powerengera pazinthu. Mapulogalamu a 35 kapena akuluakulu awonetsedwa kuti ndi ofunika kwambiri komanso odziwika bwino omwe amatha kusiyanitsa anthu omwe amakumana ndi zifukwa za matenda a CSB odwala, omwe amavomerezedwa ndi chiwerengero cha matenda a CSBD.¹¹ Chifukwa CSBI-13 ndi chida chodziwonetsera chokha chomwe chinalengedwa musanakhazikitsidwe mtundu watsopano wa CSBD, ziwerengero za 35 kapena zapamwamba zimapereka mwayi waukulu wokhudzana ndi matenda opatsirana pogwiritsira ntchito mankhwala oyenera kuti azindikire kuti matenda a CSBD ndi otani.

Zaka, mtundu, mtundu, maphunziro, ndi ndalama zapakhomo zinasonkhanitsidwa panthawi ya GfK yolemba ntchito. Ndalamayi inafotokozedwa mwachidule kuyambira pa $ 5000 mpaka $ 250 000 kapena apamwamba. Chifukwa cha chiwerengero cha magulu a ordinal, ndalama zowonongeka mwazinthu zotsatirazi: zosakwana $ 25 000, $ 25 000 ku $ 49 999, $ 50 000 ku $ 74 999, $ 75 000 ku $ 99 999, $ 100 000 mpaka $ 150 000, ndi zoposa $ 150 000. Mofananamo, maphunziro amasonkhanitsidwa mwachigawo ndipo adagwa m'magulu otsatirawa: osaphunzira sukulu ya sekondale, diploma ya sekondale kapena zofanana, dipatimenti ina ya koleji kapena adiresi, digiri ya bachelor, digiri ya digiri kapena apamwamba. Otsutsa anasankha mtundu wawo / mtundu wawo kuchokera kuzinthu zotsatirazi: zoyera, osali Aspania; wakuda, osali Aspania; Mitundu yambiri, osati ya ku Spain; ndi amwenye. Pafukufukuwo, ophunzira adanena za amuna awo monga abambo, amai, transman, kapena transwoman. Chifukwa chakuti anthu a 4 okha omwe amadziwika ngati transgender, anthu a transgender amagawidwa malinga ndi chikhalidwe chawo. Ophunzirawo adatchula zofuna zawo zokhudzana ndi kugonana monga amuna kapena akazi okhaokha, amuna kapena akazi okhaokha, amuna kapena akazi okhaokha, abambo amodzi, kapena ena. Anthu omwe amadziwika kuti ali asexual kapena chinthu chinanso adagwirizanitsidwa, kupatsidwa mafupipafupi a malemba awa.

Kufalikira kwa anthu omwe adalimbikitsa kuvutika maganizo ndi zovuta zomwe zimakhudzana ndi kuvutika kuganiza zokhudzana ndi kugonana, zokhumba, ndi makhalidwe adayesedwa poyesa chiwerengero cha 95% panthawi ya chidaliro cha anthu omwe adapeza 35 kapena apamwamba pa CSBI-13 pogwiritsa ntchito zofotokozera Zotsatira za SPSS zolemba mapulogalamu 22.0 (IBM). Makhalidwe pakati pa anthu omwe anakumana ndi osakwaniritsa mfundo yachitsulo ya CSBI-13 adaperekedwa monga magawo (magawo a magulu) kapena njira (zopitirira). Kufufuza kusiyana kwa chiwerengero cha anthu omwe anakumana ndi mfundo zachitsulo za CSBI-13 m'madera osiyanasiyana a anthu (mwachitsanzo, chikhalidwe, mtundu, mtundu, ndi kugonana), χ² ziwerengero zinawerengedwa. Zotsatira zofunikira (2-mbali P <.05) idawunikidwanso pogwiritsa ntchito kulumikizana kwamabina ndi logi yolumikizana kuti aganizire kusiyanasiyana kwamawonekedwe pazosiyanasiyana zamankhwala.

Kuti athetse mayankho a zitsanzo ndi zolakwika zolakwika, phunziroli linakonzedweratu ndi kusintha kwazomwekugwiritsiridwa ntchito posagwiritsa ntchito chiwerengero cha anthu kuchokera kuposachedwapa ya Survey Survey kuchokera ku US Census Bureau.¹⁹ Kusintha kumeneku kunayambitsa kulemera kwake kwapakati komwe kunagwiritsidwa ntchito mwinamwake kufanana ndi njira yosankhira yopangira chitsanzo cha phunziroli.¹² Deta yonse yomwe ili mu phunziro ili ikugwiritsa ntchito izi zolemera.

Otsatira (N = 2325) anali pakati pa zaka za 18 ndi zaka 50 (zaka [SD] zenizeni, zaka 34 [9.26], ndi nambala yofanana ya amuna ndi akazi omwe amadziwika (1174 [50.5%] akazi)Table). Dongosolo lofotokozera za maphunziro linasonyeza kuti 10.8% (Ophunzira a 251) sanamaliza sukulu ya sekondale, 26.8% (622) atamaliza sukulu ya sekondale, 30.7% (713) anamaliza maphunziro awo, 19.4% (450) adalandira digiri ya bachelor, ndipo 12.4% ( 289) adapeza digiri ya akatswiri. Ponena za ndalama, 19.7% (458) inalandira ndalama zochepa kuposa $ 25 000 ndipo 41.0% (953) adalandira ndalama zoposa $ 75 000. Ponena za mtundu ndi fuko, 19.8% (455) imadziwika ngati Apanishi; 58.4% (1358) ndi yoyera, osati Achifielaya; 12.7% (296) monga wakuda, osakhala Achipanishi; 1.6% (36) monga mafuko ambiri, osakhala Achipanishi; ndi 7.7% (179) monga ena, osakhala Achipanishi. Onse a 91.6% a ophunzira (2128) adadzifotokozera okha ngati amzake, 4.4% (101) monga amuna kapena akazi, 2.6% (60) monga amuna kapena akazi, ndipo 1.4% (33) ndi chinthu china. The Table amachititsa kuti anthu azikhala ndi makhalidwe osiyanasiyana pakati pa anthu omwe adasonyeze ndipo sanawonetsere mavuto omwe akukhudzana ndi chilakolako chawo chogonana komanso khalidwe lawo, komanso kusiyana kwa kusiyana kwa chiwerengero cha anthu.

Kuwonjezeka kwa chiwerengero cha kuvomerezana ndi mavuto okhudza kugonana, zofuna, ndi makhalidwe (chiwerengero cha CSBI-13 ≥35) chinali 8.6% (95% CI, 7.5% -9.8%) (olowa 201 ). Mwa amuna, 10.3% (119) omwe amavomerezedwa ndi odwala, osowa, komanso makhalidwe, poyerekeza ndi 7.0% ya akazi (olowa 82). Ngakhale kuti amuna anali 1.54 (95% CI, 1.15-2.06) nthawi zambiri amavomereza zovuta zazikulu zolimbana ndi zovuta kugonjetsa malingaliro a kugonana, zofuna, ndi makhalidwe (χ² = 8.32, P = .004), azimayi amawerengera pafupifupi theka (40.8%) la anthu omwe adakumana ndi malo ochezera azachipatala.

Kusiyanitsa kwakukulu pa mwayi wovomereza kuvutika komwe kumakhudzana ndi kuvutika kugonjetsa malingaliro ogonana, zolimbikitsana, ndi makhalidwe pazochitika zamtundu wina wa anthu zinayambanso kufufuzidwa ndi kulamulira kwachinsinsi. Ponena za ndalama, tapeza kuti anthu omwe ali ndi ndalama zosachepera $ 25 000 anali ndi zovuta kwambiri zothandizira kukhumudwa ndi kukhumudwa komwe kumakhudzana ndi vuto loletsa kugonana, zofuna, ndi khalidwe poyerekeza ndi omwe ali ndi ndalama za $ 25 000 ku $ 49 999 ( Chiwerengero [OR], 3.38; 95% CI, 2.06-5.55), $ 50 000 ku $ 74 999 (OR, 4.01; 95% CI, 2.37-6.81), $ 75 000 ku $ 99 999 (OR, 1.80; 95 % CI, 1.15-2.82), $ 100 000 ku $ 150 000 (OR, 4.08; 95% CI, 2.41-6.93), komanso zoposa $ 150 000 (OR, 1.67; 95% CI, 1.08-2.59). Kuwonjezera pamenepo, iwo omwe ali ndi ndalama pakati pa $ 75 000 ndi $ 100 000 anali ndi zovuta kwambiri zothandizira kukhumudwa ndi kuwonongeka komwe kumakhudzana ndi vuto loletsa kugonana, zofuna, ndi makhalidwe poyerekeza ndi omwe ali ndi ndalama pakati pa $ 25 000 ndi $ 50 000 (OR, 1.88; 95% CI, 1.12-3.16), $ 50 000 ku $ 75 000 (OR, 2.23; 95% CI, 1.29-3.88), ndi $ 100 000 ku $ 150 000 (OR, 2.27; 95% CI, 1.31-3.95 ). Mofananamo, iwo omwe ali ndi ndalama zoposa $ 150 000 anali osiyana kwambiri poyerekeza ndi omwe ali ndi ndalama pakati pa $ 25 000 ndi $ 50 000 (OR, 2.02; 95% CI, 1.22-3.36), $ 50 000 kwa $ 75 000 (OR, 2.40; 95% CI, 1.40-4.13), ndi $ 100 000 ku $ 150 000 (OR, 2.44; 95% CI, 1.42-4.20). Ponena za maphunziro, omwe ali ndi sukulu ya sekondale (OR, 0.48; 95% CI, 0.30-0.76), ena koleji (OR, 0.65; 95% CI, 0.42-0.99), digiri ya bachelor (OR, 0.45; 95% CI, 0.27 -0.74), kapena dipatimenti yapamwamba (OR, 0.47; 95% CI, 0.26-0.83) inali ndi zochepa zovomerezeka kuti zithetse mavuto okhudzana ndi kugonana, zofuna, ndi khalidwe kusiyana ndi anthu osaphunzira maphunziro.

Ponena za mtundu / mtundu, anthu omwe amawadziwitsa kuti ndi akuda, ena, ndi Aspanishi anali 2.50 (95% CI, 1.69-3.70), 2.02 (95% CI, 1.22-3.33), ndi 1.84 (95% CI, 1.27-2.65 ) nthawi zambiri, mosiyana, kuposa anthu oyera kuti athandizire maulendo okhudzidwa ndi matenda okhudzana ndi vuto la kugonana, zofuna, ndi makhalidwe. Pomalizira, anthu omwe amagonana ndi amuna kapena akazi okhaokha anali ndi vuto lochepa lothandizira kupititsa patsogolo zovuta komanso kukhumudwa komwe kumakhudzana ndi vuto la kugonana, zofuna, ndi khalidwe kusiyana ndi omwe amadziwika ngati amuna kapena akazi okhaokha, amuna kapena akazi okhaokha, kapena ena. Anthu ogonana amuna kapena akazi okhaokha, amuna kapena akazi okhaokha, anali 2.92 (95% CI, 1.51-5.66) nthawi zambiri, anthu amodzi ndi amuna kapena akazi okhaokha anali 3.02 (95% CI, 1.80-5.04) nthawi zambiri, ndipo anthu omwe amadziwika kuti 4.33 ( 95% CI, 1.95-9.61) nthawi zambiri zowonjezera kuvutika komwe kumayenderana ndi zovuta kugonjetsa malingaliro a kugonana, zokhumba, ndi makhalidwe. Palibe kusiyana kwakukulu komwe kunapezeka (P > .05 ya onse).

Kodi chikhalidwe cha pop chimazindikira kuti CSB ndi mliri? Zotsatira zimasonyeza kuti anthu ambiri (10.3% a amuna ndi azimayi a 7.0%) amazindikira kuti ali ndi vuto loletsa kugonana kwawo, zofuna zawo, ndi makhalidwe awo omwe amachititsa kukhumudwa ndi / kapena kukhumudwa mu ntchito zawo zamaganizo. Mfundo yowonjezereka ndi yakuti anthu omwe anakumana ndi mfundo yachinsinsi ya CSBI-13 akugwira lonse CSB, kuyambira kuvuto koma osagwirizana ndi kugonana kwa CSBD. Izi zikuwonetsa kuti magulu okhudzidwa ndi mavuto omwe ali nawo okhudzana ndi kugonana, zolimbikitsana, ndi makhalidwe angayimire mavuto onse a chikhalidwe cha anthu komanso matenda a matenda (ie, chiwonetsero cha mikangano ya chikhalidwe cha anthu komanso zachiwerewere zokhudzana ndi kugonana ndi matenda opatsirana pogonana wa CSBD). Choncho, akatswiri a zachipatala ayenera kukhala osamala kwa chiwerengero cha anthu omwe akuvutika maganizo chifukwa chosowa ulamuliro pazochita zawo zogonana ndikuonetsetsa kuti vutoli ndi lotani, ganizirani zomwe zingatheke, komanso kupeza chithandizo choyenera kwa amuna ndi akazi.

Zomwe timapeza zimasonyeza kuti kusiyana pakati pa amuna ndi akazi kumathandiza kuti pakhale mavuto okhudzidwa ndi mavuto okhudzana ndi kugonana ndi zofuna za kugonana, zokhumba, ndi makhalidwe omwe anali ochepa kwambiri kusiyana ndi kalembedwe.^20,21 Amuna amangooneka kuti ndi 54% ovuta kwambiri (OR, 1.54; 95% CI, 1.15-2.06) omwe amakumana ndi mfundo yochepetsedwa ndi amayi kuposa amayi, omwe amawerengera 41% ya chitsanzo chomwe anakumana ndi chithunzi chodula. Mafotokozedwe otsutsana ndi lingaliro lakuti CSBD ikhoza kukhala yofala kwambiri pakati pa amuna kusiyana ndi akazi omwe sakhala okayikitsa, ngakhale kuti ofufuza ena asonyeza kusiyana pakati pa kugonana kwa amuna pazokhudzana ndi kugonana kwachibadwa, kumangokhalira kukwatira, komanso maganizo okhudzana ndi kugonana.⁴ Kulongosola kotereku kumaphatikizapo chikhalidwe cha chikhalidwe cha amuna kapena akazi okhaokha chomwe chimagwirizana ndi malingaliro aumunthu (mwachitsanzo, kugonana amuna monga "osakhululukidwa"²²) ndikupatsanso kuti pamene amuna atha kupeza mwayi wambiri wogulitsa, "²² iwo akhoza kukhala ocheperapo kuti azikhala ndi chizoloŵezi chogonana. Izi zikusiyana ndi malingaliro achikazi omwe amasonyeza amayi ngati "ogwira ntchito zogonana,"²² omwe akuyembekezeredwa kuti azisunga zofuna za kugonana ndipo, motero, sangakhale ndi chizoloŵezi chogonana.

Chifukwa cha kusintha kwa chikhalidwe chaposachedwapa kuti chikhale chololera kuwonetsera kwa kugonana kwa amayi ndi kuwonjezeka kwa kugonana kwa zithunzi zachiwerewere ndi kugonana kosagonana kudzera pa intaneti, mapulogalamu a mapulogalamu, ndi mafilimu, chidziwitso chimodzi chokha cha kusiyana kwakukulu pakati pa amayi ndi akazi omwe amapezeka mu phunziro lathu ndi chakuti zovuta kulamulira makhalidwe achiwerewere pakati pa amayi akhoza kukula. Kulongosola kotereku kumafuna kuti pakhale ndondomeko yowonjezereka, chifukwa cha kusowa kwa chiwerengero cha mliri woyamba. Mwinanso, chifukwa cha njala ya deta pa CSBD pakati pa akazi, china chotheka ndi chakuti kusiyana pakati pa amuna ndi akazi kuli kochepa kwambiri kusiyana ndi kusokonezeka. Ochita kafukufuku ndi ogwira ntchito zachipatala sagwirizana ndi zokhudzana ndi chikhalidwe cha chikhalidwe komanso zachikhalidwe²³ ndipo mwina zingakhale zosafunika kunyalanyaza CSBD ya amayi kapena kuzilingalira ngati chiwonetsero cha vuto linalake (mwachitsanzo, vuto lachisokonezo, bipolar, kapena borderline personality disorder).²⁴ Kafukufuku wamtsogolo ayenera kufufuza mafunso ochulukirapo omwe apeza ndi kufufuza deta ya longitudinal, lingaliro lachiwerewere ndi kumatsatira miyambo ya amuna, komanso kugwirizanitsa maganizo.

Ponena za zikhalidwe za anthu, tawona kuti anthu omwe ali ndi maphunziro apansi, omwe ali ndi ndalama zapamwamba kapena zochepa kwambiri, amitundu / amitundu yochepa, ndi achichepere omwe amakhala ochepa kwambiri amakhala okhudzidwa kwambiri ndi anthu omwe adanena kuti ali ndi maphunziro apamwamba, ndalama, ndi zoyera komanso zachiwerewere. Zotsatirazi zikusonyeza kufunika kozindikira chikhalidwe cha chikhalidwe cha anthu momwe mavuto omwe amavutitsa kulamulira khalidwe la kugonana amapezeka. Komabe, tikudziwa zochepa chabe zomwe zikuchitika mpaka pano zomwe zasanthula chikhalidwe cha chikhalidwe cha CSBD, kupatulapo kugonana.^13,25 Ochita kafukufuku akhala akunena kuti amuna ochepa ogonana angakhale pachiopsezo chotenga chilakolako chogonana, kupatsidwa chiwerengero chawo chokwanira, kugonana kwachiwerewere, ndi kupeza malo osiyanasiyana ogonana.²⁵ Posachedwapa, kafukufuku wapeza kuti vuto lina laling'ono limawonjezera chiopsezo chogonana,²⁶ ndi zovuta zokhudzana ndi matenda (monga kupanikizika, nkhawa, kugonana kwa ana, kugwiritsira ntchito mowa mwauchidakwa, chiwawa chokwatirana, ndi chiopsezo cha kugonana) kuonjezera chiopsezo chotere pakati pa amuna ochepetseredwa pogonana.²⁷ Zotsatira zathu zimagwirizana ndi lingaliro lakuti zochepa zolemetsa zimawonjezera chiopsezo cha CSBD ndipo zimapereka zowonjezereka zowonjezera zaumoyo mu CSBD. Chifukwa chake, CSBD sayenera kuyesedwa kunja kwa chikhalidwe chake, komanso njira ya ukhondo yothandiza anthu kuthandizira kukwaniritsa CSB.

Maphunziro a tsopano anali ochepa ndi mtundu wa kafukufuku ndi njira zake. Choyamba, CSBI-13 ndi chida choyang'ana ndikuwonetseratu zolakwitsa molondola posiyanitsa matenda omwe ali ndi kachilombo ka HIV. Ngakhale titayesa zolakwika zochepa (zochokera ku 79% molondola wa CSBI-13), chiwerengero (8.6%) chiposa chiwerengero chapamwamba kwambiri kuposa cha matenda ena ammaganizo (mwachitsanzo, kufalikira kwa matenda alionse achisokonezo ndi 5.7%²⁸). Kuonjezerapo, bungwe la NHSSB silinayang'ane zowonjezera zomwe zimayambitsa mavuto chifukwa cha khalidwe la chiwerewere lomwe silingathe kulamulira, zomwe sizingathetse kutanthauzira tanthauzo la kuchuluka kwa chiwopsezo. Mikangano yokhudzana ndi chikhalidwe cha chikhalidwe cha chikhalidwe chokhudza kugonana ndi kugonana, mikangano yokhudzana ndi kugonana, ndi matenda ena (monga matenda a bipolar, mavuto osokoneza bongo, matenda osokoneza bongo) omwe agwirizanitsidwa ndi kugonana angayesetse kukhalapo kwa CSBD. Izi zikuyimira njira yofunikira yopenda kafukufuku wamtsogolo. Pomalizira, phunziro ili silingathetse ngati zikhalidwe za anthu zikusiyana chifukwa cha kusankhana. Komabe, kuthekera kwa kuyanjana kwakukulu kumachepetsedwa ndi malemba ambirimbiri a CSBI omwe atembenuzidwa, kutsimikiziridwa, ndi kuphunzira m'mitundu yosiyanasiyana mkati ndi kunja kwa United States.

Phunziroli ndilo loyamba lomwe tikudziŵa kulembera maiko a US kuvutika komwe kumakhudzana ndi vuto la kugonana, malingaliro, ndi makhalidwe - chinthu chofunika kwambiri cha CSBD. Kukula kwa chiwopsezo cha chiwerewerechi ndizofunikira kwambiri pa thanzi la anthu monga vuto la chikhalidwe cha anthu ndipo limasonyeza vuto lalikulu lomwe limapangitsa kuti odwala athandizidwe. Kuwonjezera apo, kugonana, kugonana, mtundu, komanso kusiyana kwa ndalama zimapangitsa kuti pakhale kusiyana kwa thanzi, kuwonetsa kufunika kwa chikhalidwe cha chikhalidwe cha CSBD, ndikutsutsa njira ya chithandizo chomwe chimakhudza thanzi laling'ono, malingaliro osiyana siyana, ndi zikhalidwe za chikhalidwe cha anthu kugonana komanso kugonana. Ophunzira zaumoyo ayenera kukhala tcheru ku chiwerengero chochuluka cha anthu omwe akuvutika maganizo ndi khalidwe lawo la kugonana, kufufuza mosamala mtundu wa vutoli, ndi kupeza chithandizo choyenera kwa amuna ndi akazi.

Chilandiridwa Kuti Chifalitsidwe: September 13, 2018.

Lofalitsidwa: November 9, 2018. do:10.1001 / jamanetworkopen.2018.4468

Kutsegula: Ichi ndi nkhani yotseguka yolumikizidwa pansi pa mawu a Chilolezo cha CC. © 2018 Dickenson JA et al. JAMA Network Open.

Wolemba Wolemba: Janna A. Dickenson, PhD, Ndondomeko ya Kugonana kwaumunthu, Dipatimenti ya Mankhwala a Banja ndi Zaumoyo Ammudzi, University of Minnesota, 1300 S 2nd St, Ste 180, Minneapolis, MN 55454 ([imelo ndiotetezedwa]).

Zopereka za Wolemba: Dokotala Coleman anali ndi mwayi wokhudzana ndi chidziwitso chonse pa phunziroli ndipo amatenga udindo wokhutiritsa deta komanso kulondola kwa kusanthula deta.

Kulingalira ndi kupanga: Dickenson, Coleman, Miner.

Kupeza, kusanthula, kapena kutanthauzira deta: Olemba onse.

Kukonzekera kwa zolembedwazo: Dickenson, Coleman.

Kusindikizidwa kovuta kwa zolembedwera kuti zikhale zofunikira zamaganizo: Olemba onse.

Kusanthula kusanthula: Dickenson, Gleason.

Thandizo, luso, kapena zakuthupi: Olemba onse.

Kuyang'anira: Coleman.

Kulankhulana Kwachidwi: Dr Coleman ndi m'modzi mwa aphungu a Church & Dwight Co, Inc, ndi Roman, Inc, ndipo adatinso ndalama za Church & Dwight Co, Inc, ndi Roman, Inc, kunja kwa ntchitoyi. Palibe zowulula zina zomwe zidanenedwa.

Ndalama / Thandizo: National Survey of Health Health and Behaeve imathandizidwa ndi thandizo lochokera ku Church & Dwight Co, Inc. Kafukufuku wapano anali chowonjezera chomwe sichinalandiridwe pantchito yofufuza.

Udindo wa Funder / Sponsor: Kufufuza kwa National Research on Health and Ethics kunalibe gawo pa kapangidwe ndi kachitidwe kafukufuku wamakono; kusonkhanitsa, kuyang'anira, kusanthula, ndi kumasulira kwa deta; kukonzekera, kubwereza, kapena kuvomereza zolembedwazo; ndi chisankho chopereka zolembazo kuti zifalitsidwe.

Zopereka Zowonjezera: Debra Herbenick, PhD, Director of the Center of Sexual Health Promotion ku Indiana University, adagwirizana pakuwonjezera Compulsive Sexual Behaeve Inventory – 13 ku National Survey of Health Health and Behaeve. Adalipidwa ndi thandizo lochokera ku Church & Dwight Co, Inc, lomwe lidathandizira kafukufukuyu.