Zofanana koma Zosiyana: Makhalidwe Okhudzidwa ndi Amuna Omwe Ali Ndi Hypersexual Disorder mu sex @ Brain Study (2019)

2019 Jan 30; 8 (2). pii: E157. yani: 10.3390 / jcm8020157.
Engel J1, Vuto M2, Sinke C3, Heitland I4, Kneer J5, Hillemacher T6,7, Hartmann U8, Kruger THC9.

Kudalirika

Mavuto omwe amabwera chifukwa cha khalidwe lachiwerewere amawoneka m'makonzedwe a chipatala. Tinayesetsa kufalitsa chidziwitso chokhudza zizindikiro za anthu omwe ali ndi matenda a hypersexual (HD). Gulu la anthu omwe adakwaniritsa zofuna za HD (amuna omwe ali ndi HD, n = 50) ankafanizidwa ndi gulu la machitidwe abwino (n = 40). Tinafufuza kusiyana pakati pa anthu, nthenda, komanso mabanja chifukwa chodzifunsa mafunso okhaokha. Amuna omwe ali ndi HD amafotokoza kuchuluka kwa malingaliro ogonana, kufotokozera, kugwiritsa ntchito mafano osokoneza ana, komanso khalidwe lolimbikitsana pogonana poyerekeza ndi kulamulira bwino. Komanso, malingaliro okhudza kugonana, zovuta zowonjezereka, zowonongeka, ndi njira zowonongeka zowonongeka zowonjezera zinali zazikulu mwa amuna omwe ali ndi HD. Amuna omwe ali ndi HD amawoneka kuti adakumana ndi zovuta zosiyanasiyana zovuta za ana, koma panalibe kusiyana komweko pakati pa anthu, zochitika za neurodevelopmental, ndi zinthu za m'banja. Kusanthula zochitika zowonongeka kunasonyeza kuti kupeŵa kugwirizanitsa zida zokhudzana ndi kugwirizanitsa ndi kumayambiriro koyambirira kwa maliseche kumasiyanitsa pakati pa amuna omwe ali ndi HD ndi machitidwe abwino. Pomalizira, amuna omwe ali ndi HD amawoneka kuti ali ndi chiwerengero chokhazikika m'maganizo, magulu a anzeru, chikhalidwe cha anthu, ndi zinthu za m'banja poyerekeza ndi kulamulira bwino, koma amafotokoza zosiyana ndi zovuta zomwe ali nazo ali mwana, zovuta zogonana, ndi mavuto a maganizo.

MAFUNSO: zovuta; chiwerewere; zochitika; kugonana; kugonana

PMID: 30704084
DOI: 10.3390 / jcm8020157

1. Introduction

Matenda opatsirana pogonana (HD) amadziwika ndi kuganiza mozama, kubwerezabwereza kugonana, zofuna, ndi makhalidwe omwe amachititsa kuvutika maganizo kwapadera [1,2,3]. Kafka [3] anaganiza kuti vuto la hypersexual liyenera kuphatikizidwa monga gawo mu Kufufuza ndi Statistical Manual ya Mental Disorders, kope la 5th (DSM-5) [4], koma pempholi linakanidwa. Chimodzi mwa zifukwa zomwe anapatsidwa chinali kusowa kwa kafukufuku woyesera pa matenda a hypersexual [5,6]. M'mbuyomu yomwe ikubwera ku International Classification of Diseases, ICD-11, matenda a hypersexual adzaikidwa ngati vuto loipa la chiwerewere [7].
Nambala zozizwitsa zikuwonetsedwa ndi kafukufuku watsopano wa amuna (n = 1151) ndi akazi (n = 1174) ku United States yomwe inapeza kuti 10.3% ya amuna ndi 7% ya amayi amasonyeza maulendo okhudzana ndi zovuta komanso / kapena kuwonongeka chifukwa cha zovuta zogonana, malingaliro, ndi makhalidwe [8]. Zisonyezero za khalidwe lachiwerewere lingaphatikizepo zochitika zenizeni zogonana zogonana ndi zochitika zogonana pa intaneti. Kugwiritsira ntchito pazinthu zogonana pogwirizanitsa ndi maliseche ndi khalidwe lofala kwambiri lomwe limapangitsa amuna kuti azindikire kuti ali ndi matenda a hypersexual malinga ndi njira za Kafka [3,9].
Cooper [10] adawonetsa kuti katatu kuti apeze, kukwanitsa, ndi kudziwika amathandiza anthu kupeza zinthu zilizonse zomwe amakonda mosadziwika, mosasamala kanthu za zovuta zachuma ndi zachikhalidwe. Inde, machitidwe a intaneti akusiyana kwambiri pakati pa anthu omwe ali ndi ena omwe amachita zovuta kwambiri pazochitika za kugonana pa intaneti [11] koma ena amagwiritsa ntchito masewera olimbana ndi zibwenzi pofuna kupeza zibwenzi zogonana [12]. Chifukwa chachikulu choyendetsa galimoto ndi kugwiritsira ntchito kwambiri kugonana pa Intaneti kungakhale kukondweretsedwa ndi kuyembekezera zokhudzana ndi chiwerewere ndi kugwiritsidwa ntchito kwa mitundu yonse ya kugonana kwabwino [13].
Zidziwika zochepa pokhudzana ndi matenda omwe ali ndi HD. Deta kuchokera ku phunziro popanda gulu lolamulira limasonyeza kuti maphunziro ambiri omwe ali ndi amuna omwe ali ndi HD ali mu ubale wapamtima, wophunzira, ndi wogwiritsidwa ntchito [14]; Komabe, ambiri amafotokozanso kuti anthu amatha kusokonezeka chifukwa chochotsedwa m'banja komanso mbiri ya kugonana,15]. Kugwiritsa ntchito kwambiri zolaula [16,17] ndi khalidwe lachiwerewere pamtundu uliwonse [18] adagwirizanitsidwa ndi khalidwe loopsa la kugonana. Kafukufuku amasonyeza kuti matenda okhudza matenda a maganizo, makamaka matenda a maganizo, amakhala ochuluka mu HD ndi mitengo kuchokera ku 72% -90% ngati vuto la maganizo [14,19,20,21], ndi 42% pa vuto la mankhwala osokoneza bongo [22]. Zomwe zimachitika pa mgwirizano pakati pa matenda opatsirana pogonana ndi kusakhudzidwa mtima ndi zosakaniza. Maphunziro awiri [23,24] a anthu ofuna chithandizo omwe akukwaniritsa zofunikira zokhudzana ndi matenda a hypersexual [3] anapeza kuti pakati pa 48% ndi 53.3% adawonetsa kutengeka kwakukulu mwazinthu zowonongeka. Reid, Berlin, ndi Kingston [25] analimbikitsa kuti mawonekedwe enieni a chilakolako cha kugonana, koma osati chidziwitso chochuluka, angakhale akufala mu matenda a hypersexual. Khalidwe lachiwerewere lasonyezedwa kuti limagwirizanitsidwa ndi zovuta za m'maganizo ndi kusintha kwa chisokonezo [26] ndi ulamuliro wamkulu [27,28].
Kuchokera ku chiwonetsero cha chilengedwe, testosterone imachita mbali yofunikira kwambiri pa chitukuko ndi kukonza chiwerewere [29]. Monga chizindikiro cha kutulukira kwa nayandrogeni, chiŵerengero cha kutalika kwa chiwiri ndi chachinayi (2D: 4D) chingagwiritsidwe ntchito, ndipo pali umboni wina wosonyeza kuti chiwerengero cha 2D: 4D chikhoza kugwirizanitsidwa ndi khalidwe la hypersexual [30], ngakhale kuti zotsatira zotsatizana zafotokozedwa. Kafukufuku wina wa anthu ambiri awonetsa kuti chiwerengero cha 2D chochepa: chiwerengero cha 4D (chiwerengero cha amuna ambiri) chimagwirizanitsidwa kukhala ndi chiwerengero cha anthu ogonana ndi ana ambiri [30,31,32], pamene ena asonyeza kuti chiwerengero chachikulu cha 2D: chiwerengero cha 4D chikugwirizana ndi chiwerewere mwa amuna [33].
Cholinga cha phunziro lino chinali kufufuza zachipatala ndi zina zomwe (neuro-) zomwe zimakhudza amuna omwe ali ndi vuto la hypersexual mu chitsanzo chachikulu cha anthu omwe amakwaniritsa njira zomwe akufunira [3] ndi kuwayerekeza ndi machitidwe abwino. Kuwonjezera apo, kufotokozera mwatsatanetsatane kuyenera kudziwa zowopsa zomwe zimayambitsa khalidwe lachiwerewere, monga zochitika zapadera, mwachitsanzo, zochitika zovuta zaunyamata ndi mavuto omwe angagwirizane nawo [34], komanso msinkhu wa kugonana [35]. Timapereka deta pazinthu zomwe sitinayesedwepo poyerekezera ndi zitsanzo zomwe timagwiritsa ntchito ndipo timakambirana za zotsatira zomwe tikudziwa zokhudza kugonana komweku.

2. Gawo Loyesera

2.1. Kulembera

2.1.1. Magulu Opatsirana Opatsirana pogonana

Amuna omwe ali ndi HD adatumizidwa pakati pa December 2016 ndi August 2017 kupyolera m'nkhani yosindikizidwa ndi Section of Clinical Psychology and Sexual Medicine, Dipatimenti ya Psychiatry, Social Psychiatry, ndi Psychotherapy ku Hannover Medical School, Germany. Nkhaniyi inatengedwa ndi nyuzipepala komanso zamanema (monga, Www.facebook.com, www.instagram.com) ndipo zinachititsa kuti 539 amuna odziwika okha omwe ali ndi HD akuwonetsa chidwi chochita nawo phunziroli (onani Chithunzi 1). Amuna awiri ndi makumi asanu ndi limodzi adayankha ku imelo akupempha nambala ya foni. Anthu makumi asanu ndi anayi mphambu asanu ndi anayi a 260 omwe adapereka nambala ya foni sakanakhoza kufikira pa telefoni, koma otsala a 201 adayesedwa kuti awonetsere matenda a hypersexual mu kafukufuku wa pakompyuta wofanana ndi a 45 maminiti opangidwa ndi katswiri wa zamaganizo pogwiritsa ntchito Kafka [3] zoyenera. Anthu adzalandira phunziro ngati akwaniritsa Kafka [3] zoyenera za matenda okhudza kugonana. Mayankho omwe anagwiritsidwa ntchito mu phunziro lino anatumizidwa ndi makalata kwa oyenerera. Otsatira atatu omwe mawerengedwe awo sanafike pamtanda (53) wa Hypersexual Behavior Inventory 19 [36] adatulutsidwa positi. Kafka [3] zizindikiro za matenda opatsirana pogonana zimakhala ndi zizindikiro zazikulu zomwe zimachokera ku zilakolako za kugonana, malingaliro kapena makhalidwe, ndipo zimatha nthawi yambiri ya miyezi 6 yomwe anthu amavutika kuyendetsa ndipo sichifukwa chokhalira ndi thupi lachilengedwe. Anthu makumi asanu ndi awiri mphambu atatu a 201 omwe adawonedwa anapeza izi ndikuwona kuti ndi oyenerera kuphunzira; 50 inaganiza zopanga nawo mbali ndipo idapanga gulu la matenda a hypersexual (gulu la HD, onani Chithunzi 1 chithunzi).
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Chithunzi 1. Kugwiritsa ntchito gulu lachisokonezo cha hypersexual.

2.1.2. Kudzetsa thanzi

Kulamulira kwabwino kunatumizidwa kudzera pa malonda pa Hanover Medical School, Germany, tsamba loyamba la intranet. Anthu makumi asanu ndi atatu kudza asanu adayankha ku malonda (onani Chithunzi 2) omwe 56 adayankha ku imelo akupempha nambala ya foni. Zina makumi awiri mphambu zisanu ndi zinayi za 56 sizingatheke kupyolera pa telefoni kuti ziwonetseredwe. Kulamulira kunkafanana ndi zaka (p = 0.587) ndi maphunziro (p = 0.503) ndi gulu la HD. Deta kuchokera ku maulamuliro awiri wathanzi pambuyo pake anachotsedwa ku kusanthula (wina adanena chovulaza chachikulu pamutu asanayambe kuphunzira, adafotokoza kugonana kwa amuna kapena akazi okhaokha, ndipo wina wothandizana nawo sanawonetsere kuunika).
Jcm 08 00157 g002 550
Chithunzi 2. Kugwiritsa ntchito mphamvu zowononga bwino.

2.1.3. Zotsatira Zopatula

Njira zochotsera onse omwe adatenga nawo gawo zinali: kulumala kwanzeru (monga kuyeza ndi Wechsler Adult Intelligent Scale-IV), vuto la psychotic (loyesedwa ndi Structured Clinical Interview for DSM-IV Axis 1 disorders, SCID-I), kuvulala kwambiri mutu, kugonana kwa amuna kapena akazi okhaokha pa mlingo wa Kinsey, ndi zokonda zogonana za ana aamuna (zoyesedwa muzoyankhulana zapakati). Mu pulojekiti yathu ya Sex@brain tidayang'ana kwambiri za omwe akutenga nawo mbali omwe amagonana ndi amuna kapena akazi okhaokha chifukwa cha zomwe zimalimbikitsa zomwe zikubwera. Onse omwe adatenga nawo gawo adalengeza kuti chidwi chawo chachikulu chogonana chinali mwa akazi ngakhale ena adanenanso za mbiri yogonana amuna kapena akazi okhaokha.
Ophunzira onse adapereka chidziwitso cholembedwa, chidziwitso chodziwitsidwa asanayambe kutenga nawo mbali ndi kulandira malipiro a ndalama kuti atenge mbali. Anauzidwa kuti akhoza kuchoka pa phunziro nthawi iliyonse. Phunzirolo linayendetsedwa molingana ndi Chidziwitso cha Helsinki ndipo linavomerezedwa ndi komiti ya machitidwe a Hannover Medical School, Germany. Zotsatira zomwe zafotokozedwa pano zinapezedwa ngati mbali ya kufufuza kwakukulu komwe kunaphatikizapo batri yoyesera yokhudzana ndi ubongo ndi maginito ogwiritsira ntchito maginito.

2.2. Njira

Zosinthazi zinagawidwa m'magulu atatu: (1) m'magulu a anthu, neurodevelopmental, ndi zinthu za m'banja, (2) makhalidwe a chiwerewere, ndi (3) makhalidwe omwe akuphatikizapo matenda olakwika. Kuti mumve tsatanetsatane wa zinthu chonde onani zolembazo Gulu 1, Gulu 2, Gulu 3 ndi Gulu 4.
Gulu 1. Sociodemographic, neurodevelopmental, ndi zinthu za m'banja.
Table
Gulu 2. Zogonana.
Table
Gulu 3. Zogonana.
Table
Gulu 4. Makhalidwe a maganizo ndi zovuta.
Table

2.2.1. Sociodemographic, Neurodevelopmental, ndi Zochitika za Banja

Pepala lofunsidwa linagwiritsidwa ntchito kusonkhanitsa deta ya anthu, yomwe ndi zaka, maphunziro apamwamba kwambiri, maphunziro a ntchito, mbiri yakale ya chiwawa, ndi chikhalidwe cha ubale. Panaliponso mafunso onena za neurodevelopmental perturbations, mchimwene wapachibale, umoyo wa makolo pa kubadwa, ndi zaka za amayi ndi abambo atabadwa. Zochitika zaunyamata zosasanthuka zinayankhidwa ndi mafunso a Childhood Trauma (CTQ) [37]. Zomwe zapangidwe ndi zowonjezereka zapadera zomwe adazifufuza zinali zovuta za kubadwa, kuchepa kwa nthawi yaitali, kuchedwa kuyenda, kuchepetsa kulankhula, ndi ngozi za ana zomwe zimapangitsa kuti asadziwe kanthu. Mankhwala adatsimikiziridwa kugwiritsa ntchito kusintha kwa chinthu cha 10 cha ku Edinburgh Handedness Inventory [38] ndi 2D: chiŵerengero cha 4D chiyenera kuti chikugwiritsidwa ntchito pogwiritsa ntchito zithunzi zomwe zimapezeka kuchokera kujambulidwa. Kutalika kwa chiwerengero cha dzanja lamanja kunalingaliridwa mothandizidwa ndi othandizira awiri ofufuza (pakati-kukonda kugwirizana: r = 0.83) ndi ziwerengero zinali zozikidwa pa njira za mawerengedwe awiriwo.
Nzeru zinayesedwa kuchokera kuzinthu zinayi zovomerezeka za Baibulo lachinayi la Wechsler Adult Intelligent Scale (WAIS-IV) [39] zomwe zimagwirizanitsidwa kwambiri ndi IQ yathunthu monga momwe anawerengedwera ndi WAIS-IV ya Germany. Zowonongeka zinayi izi ndi mawu (mawu omveka; r = 0.7), Pewani Kupanga (kulingalira kwabwino; r = 0.65), Masamu (ntchito memory; r = 0.73), ndi Coding (processing speed; r = 0.5).

2.2.2. Zogonana

Kukula ndi kugonana kwa chiwerewere kunayesedwa kudzera pa zokambirana zoyenerera ndi magawo a mafunso. Tinasonkhanitsa deta pa msinkhu woyamba, kutsegula maliseche sabata lisanayambe (kutalika ndi nthawi zambiri), kugonana kumapeto kwa sabata lisanayambe kuwonetseredwa, komanso nthawi zonse zogonana. Kuwonjezera apo, tinayesa kuchuluka kwa nthawi zolaula zolimbitsa thupi, kuchuluka kwa zinthu, kusagwirizana, khalidwe lachiwerewere, kugwiritsira ntchito mafano ogwiritsira ntchito chiwerewere, ndi zovuta zogonana. Zida zapadera zinagwiritsidwa ntchito poyesa chisangalalo cha kugonana ndi kulepheretsa kutchulidwa (Kugonana Kwachidwi, SES ndi Kugonana Kwachiwerewere, SIS) [40], zizindikiro za matenda a hypersexual (Hypersexual Beventvior Inventory-19, HBI-19) [36], zizindikiro za kugwiritsira ntchito Intaneti pa Intaneti.41] ndi chiwerewere (Kugonana Kwachilombo Kuyesa-Kukonzekera, SAST-R) [42].

2.2.3. Makhalidwe a Psychological and Comorbidities

Matenda a m'maganizo anapezeka kuti akugwiritsa ntchito German German SCID-I [43]. Mayankho a mafunso ena adagwiritsidwa ntchito kuti aone kusaganizira (Barrat Impulsiveness Scale-11, BIS-11) [44], kugwiritsa ntchito mankhwala osokoneza bongo (Fagerström Test Test for Nicotine Dependence, FTND) [45], njira zoopsa ndi zovulaza za mowa mowa (Kuyeza Kosokoneza Kosokonezeka kwa Mowa, AUDIT) [46], zizindikiro zowawa (Beck Depression Inventory-II, BDI-II) [47], kuyanjana (Zochitika mu Maubwenzi Ogwirizana-Revised, ECR-R) [48], alexithymia (Toronto Alexithymia Scale, TAS-26) [49], ndi malamulo othandizira (ERQ, Questionnaire Emotion Regulation Questionnaire [50]; Fragebogen zur Erhebung der Emotionsregulation, FEEL-E [51].
Matenda osokoneza bongo (ADHD) anapezeka pazifukwa zambiri ≥15 pa Wender Utah Rating Scale (WURS-K) [52] komanso ADHD kudziwerengera bwino (ADHS-SB) [53].

2.2.4. Kugonjetsa Kwachinsinsi Kufufuza

Kuti tipeze zovuta zowonongeka zokhudzana ndi matenda a hypersexual ife timachita kafukufuku wogwirizanitsa kugwirizanitsa ntchito ndi magulu a magulu omwe ali osiyana siyana omwe amadalira. Cholinga chathu chinali kuzindikira zinthu zomwe zimasiyanitsa pakati pa amuna ndi HD komanso machitidwe abwino. Chiwerengero cha zosinthika payekha chinasankhidwa pa ndondomeko za Agresti [54] (p. 138).

2.3. Kusanthula Deta

Kufufuza konse kunayesedwa ndi SPSS Statistics Version 24 (IBM® Corporation, Amonk, NY, USA). Kufufuza kunkachitika pogwiritsa ntchito t-Anatero, Mann-Whitney U mayesero kapena mayesero enieni a Fisher kuti asinthe mitundu yosiyanasiyana. Kuyesera kwa nsomba za tebulo zazikulu kuposa 2 × 2 zinagwiritsidwanso ntchito, chifukwa mitundu yonse ya polytomous inali ndi osachepera kamodzi kamene kanali kuyembekezera osachepera 5. Chifukwa ichi chinali chimodzi mwa zochitika zoyambirira zofufuza zomwe zinaphatikizapo amuna omwe ali ndi matenda a hypersexual ndi machitidwe abwino pa kufufuza kusiyana pakati pa magulu osiyana siyana pa zochitika zachipatala zomwe zinayesedwa pano, tinasankha njira yofufuzira ndikufotokozera zigawo ziwiri zofunikira popanda kuwongolera kwa kufanizira kochuluka (onse akufufuza p <0.05). Komabe, kwa owerenga chidwi tidaphatikizaponso Bonferroni kukonza kuwongolera kwa Gulu 1, Gulu 2, Gulu 3 ndi Gulu 4. Mavuto a zotsatira za mayesero a parametric adawonetsedwa ngati Cohen d, ndi d = 0.2 yosonyeza zotsatira zochepa, d = 0.5 yowonekera, ndipo d = 0.8 zotsatira yaikulu [55]. Pali kusiyana kwa kukula kwa magulu pa mayesero osiyanasiyana chifukwa mayankho a mafunso ndi ma data osasowa anachotsedwa pa kusanthula. Pofuna kuthana ndi zotsatira za matenda a maganizo kusiyana ndi matenda a hypersexual, kuyerekezera kwa magulu onse kunawerengedwanso pambuyo potsutsa anthu omwe ali nawo mbiri yakale ya SCID-ine matenda; ndondomekoyi inapereka N ya 45 (HD = 21; HC = 22). Zotsatira za zotsatirazi zikufotokozedwa Zida Zowonjezera.

3. Zotsatira

3.1. Sociodemographic, Neurodevelopmental, ndi Zochitika za Banja

Monga momwe zinalinganizidwira poyenderana ndi zomwe panalibe kusiyana pakati pa magulu pazochitika za anthu zokhudza zaka (t(83) = 0.55, p = 0.587) komanso maphunziro apamwamba kwambiri (mayeso enieni a Fisher (N = 85), p = 0.503; onani Gulu 1). Ndiponso, udindo wa ntchito (mayeso enieni a Fisher (N = 85), p = 0.458), mbiri yakale yowononga moyo (mayeso enieni a Fisher (N = 85), p = 0.368), ndi chikhalidwe cha ubale (mayeso enieni a Fisher (N = 85), p = 0.128) sizinali zosiyana pakati pa magulu. Panalibe kusiyana kwakukulu pazinthu zinai za WAIS-IV zomwe zikugwiritsidwa ntchito kuphatikizapo mau olakwika (t(82) = -1.28, p = 0.204), zojambula zojambula (t(82) = 0.92, p = 0.359), masamu (t(82) = 0.112, p = 0.911), ndi kulembetsa (t(82) = 1.66, p = 0.100), kusonyeza kuwerengera kwanzeru pakati pa magulu.
Zisonyezo za neurodevelopmental perturbations zinali zofanananso ndi amuna omwe ali ndi HD komanso mphamvu zowononga zomwe zimaphatikizapo zinthu zambiri zomwe zikukula panthaŵi ya ubwana (mayeso enieni a Fisher (N = 82), p = 1) kugawidwa kwa kuperekedwa (kuyesa kumene kwa Fisher (N = 85), p = 0.645) ndi 2D: chiŵerengero chautali cha 4D chaminwe (t(77) = 0.34, p = 0.738).
Deta yathu ikuwonetsa kuti amuna omwe ali ndi HD ndi machitidwe abwino amakula m'mabanja omwe ali ndi zofanana za banja monga chiwerengero cha ana omwe amakhala nawo m "t(78) = 0.01, p = 0.995); udindo mu dongosolo la kubadwa (w(78) = 718, z = -0.402, p = 0.687); udindo pakati pa ana m'nyumba (w(78) = 750, z = -0.464, p = 0.642); zaka za kubadwa pakubereka (t(79) = 0.88, p = 0.384); ndi zaka za makolo pa kubadwa (t(73) = 0.09, p = 0.93). Amuna omwe ali ndi HD amafalitsa mavuto ambiri a amayi omwe ali ndi matenda a maganizo aumunthu (mayeso enieni a Fisher (N = 62), p = 0.001), koma osati mavuto aumunthu a matenda aumoyo (mayeso enieni a Fisher (N = 68), p = 0.307) kuposa kulamulira bwino. Kuwonjezera apo, kukumbukira mwakuya kwa ana omwe ali ndi HD kumasiyana kwambiri ndi kulamulira bwino. Amuna omwe ali ndi HD amafotokoza kuchuluka kwa chiwerengero cha zovuta zomwe zimachitikira ana (CTQ; t(68) = 2.71, p = 0.009, d = 0.57), makamaka kuzunzika kwamtima (t(73) = 3.53, p <0.001, d = 0.73), kunyalanyaza maganizo (t(81) = 2.46, p = 0.016, d = 0.54), ndi nkhanza za kugonana (t(45) = 2.49, p = 0.017, d = 0.49) poyerekezera ndi kuyendetsa bwino. Komabe, kuchitiridwa nkhanza (t(80) = 1.60, p = 0.113) ndi kunyalanyaza thupi (t(83) = 1.49, p = 0.141) sinafike powerenga ziwerengero.

3.2. Zogonana

Mbiri ya kugonana kuchokera kwa amuna omwe ali ndi HD inasiyana kwambiri ndi kulamulira bwino (onani Gulu 2). Choyamba, amuna omwe ali ndi HD anali ndi zochitika zogonana kale kusiyana ndi kulamulira gulu. Amuna omwe ali ndi HD adanena kuti iwo anali oposa zaka chimodzi pamene anayamba kuchita maliseche (t(79) = 3.59, p <0.001, d = 0.80) ndipo pafupifupi chaka chimodzi atangoyamba kumene (t(77) = 2.79, p = 0.007, d = 0.63). Koma iwo sanali osiyana mu zaka zoyamba kugonana (t(83) = 1.868, p = 0.065). Amuna omwe ali ndi HD ndi machitidwe abwino amalembera nthawi yofanana ya mgwirizano wotsiriza / wamakono mu miyezi (t(42) = 0.14, p = 0.886), ndi chiwerengero cha ana (w(75) = 728, z = -0.081, p = 0.936). Komabe, amuna omwe ali ndi HD amasiyana mosiyana ndi kugonana kwawo kuchokera ku machitidwe abwino. Pafupifupi amuna omwe ali ndi HD amawauza amuna pafupifupi makumi asanu ndi atatu (100) ogonana nawo (w(79) = 470.5, p = 0.001) ndi abwenzi okwatirana nawo (w(81) = 443, p <0.000) kuposa zowongolera zathanzi. Kuphatikiza apo, ngakhale amakonda kwambiri amuna kapena akazi okhaokha, amuna omwe ali ndi HD adanenanso zakugonana ndi amuna omwe ali ndi zibwenzi zambiri zachimuna (w(83) = 567.5, p <0.000) ndi amuna ogonana nawo amuna (w(83) = 664, p = 0.002), pamene kulamulira kwabwino kwanena pafupifupi zochitika zogonana ndi amuna. Komanso, amuna omwe ali ndi HD amawoneka kuti ali ndi chiyanjano pachibwenzi chawo chotsiriza kapena chamakono (mayeso enieni a Fisher (N = 81), p <0.001), pomwe 67% amafotokoza zomwe zikuchitika poyerekeza ndi 19% yokha yoyang'anira bwino. Kuphatikiza apo, amuna omwe ali ndi HD amafotokoza zovuta zambiri zomwe amalandila kudzera pazogonana pa intaneti kuposa kuwongolera koyenera komwe kumawonetsedwa ndi gulu pagulu la sIATsex (t(80) = -11.70, p <0.001, d = 2.45). Choncho, adanena kuti amawononga zolaula nthawi zambiri sabata isanakwane (mayeso enieni a Fisher (N = 84), p <0.001), pafupifupi 85% ya amuna omwe ali ndi HD amafotokoza zosowa zolaula katatu pamlungu, poyerekeza ndi 40% yoyang'anira bwino. Kuphatikiza apo, amuna omwe ali ndi HD adawonera pafupifupi zolaula pafupifupi mphindi makumi asanu ndi awiri (t(47) = -3.61, p = 0.001, d = 0.73) kuposa kulamulira bwino. Nthawi yoonera zolaula imasiyanasiyana kwambiri pakati pa magulu, ndipo oposa theka la amuna omwe ali ndi HD akuwonerera ola limodzi pa sabata, poyerekeza ndi 9% yokhayo pazomwe akuyendetsa bwino. Pokhudzana ndi chilakolako cha kugonana ndi chilema, amuna omwe ali ndi HD analengeza zosangalatsa zambiri zogonana (SES: t(83) = 5.01, p <0.001, d = 1.09), chiopsezo chotere chogonana chifukwa choopseza zotsatira za ntchito (SIS2: t(83) = -3.75, p <0.001, d = 0.82). Komabe, amuna omwe ali ndi HD akuwonetsa mapepala apamwamba omwe amawoneka kuti akuopseza ntchito (SIS1; t(80) = 2.30, p = 0.024, d = 0.48). Chochititsa chidwi, kuti kufalitsa kwa kugonana komwe kunalumikizidwa kunali kofanana ndi amuna omwe ali ndi HD komanso machitidwe abwino (mayeso enieni a Fisher (N = 85), p = 0.765), makamaka panalibe kusiyana kwa matenda a erectile, matenda okhudzidwa ndi chilakolako chachisokonezo, kutayika msanga komanso kuchedwa.
Paraphilias monga mawonetsero, voyeurism, masochism, sadism, fetishism, frotteurism kapena transvestism anali ambiri mwa amuna omwe ali ndi HD (mayeso enieni a Fisher (N = 85), p <0.001) (onani Gulu 3). Amuna omwe ali ndi HD amakhalanso ndi chidziwitso chochita zokhudzana ndi kugonana (mayeso enieni a Fisher (N = 85), p <0.001) komanso kuchuluka kwakukhala ndi zithunzi zowonongera ana kamodzi kamodzi m'miyoyo yawo (mayeso enieni a Fisher (N = 82), p = 0.009); palibe mphamvu zowonongeka zowononga kuti zakhala zikuwononga zithunzi za kugwiririra ana.

3.3. Makhalidwe a Psychological and Comorbidities

Chofunika kwambiri ndi chakuti, amuna omwe ali ndi HD amaonetsa zizindikiro zambiri za maganizo monga matenda, kukhumudwa kapena zizindikiro za ADHD (onani Gulu 4). Kufufuza kwapadera kwa matenda omwe alipo tsopano a SCID-I m'magulu ang'onoang'ono adawulula kuchuluka kwa matenda opatsirana mu gulu la HD (mayeso enieni a Fisher (N = 85), p = 0.015). Kuwonjezeka kwa chiwerengero cha matendawa kunathandizidwa ndi kuunika kwa psychometric ya zizindikiro zachisoni ndi zizindikiro zazikulu mwa amuna omwe ali ndi HD (BDI-II; t(79) = 5.47, p <0.001, d = 1.13). Mawerengedwe atsopano a SCID-ine ndikudziwiratu za mankhwala osokoneza bongo ndi / kapena kudalira anali ofanana m'magulu awiri (mayeso enieni a Fisher (N = 85), p = 1.000), monga momwe kugwiritsira ntchito mankhwala osokoneza bongo (AUDIT; t(82) = -0.93, p = 0.354) ndi nkhanza zapompyuta (FTND; t(83) = 0.73, p = 0.471, d = 0.16). Komabe, kuchuluka kwa matenda omwe ali nawo tsopano (mayeso enieni a Fisher (N = 85), p = 0.690), zovuta zowonjezereka (zovuta zenizeni za Fisher (N = 85), p = 1.000), ndi zizindikiro zosautsa ndi zovuta za zakudya (mayeso enieni a Fisher (N = 85), p = 1.000) sizinali kusiyana pakati pa magulu. Kuphatikizidwa pamodzi, amuna omwe ali ndi HD komanso machitidwe abwino amachititsa kuti zikhale zofanana ndi za SCID-I zenizeni (mayeso enieni a Fisher (N = 80), p = 0.104) ndi moyo wanga SCID-ine matenda (mayeso enieni a Fisher (N = 85), p = 0.190). Komabe, amuna omwe ali ndi HD amakhala ndi zizindikiro zambiri za ADHD panthawi ya kuunika (ADHS / SB; t(73) = 6.31, p <0.001, d = 1.37) ndi kufotokoza zizindikiro za ubwana wa ADHD (WURS-K; t(82) = 3.76, p <0.001, d = 0.82), Komanso, amuna omwe ali ndi HD amaonetsa kukhudzidwa kwambiri kuposa kulamulira bwino (BIS-11; t(81) = 3.76, p <0.001, d = 0.83). Zotsatira zokhudzana ndi malamulo okhudza kutengeka maganizo zinasakanizidwa: Amuna omwe ali ndi HD anali otheka kugwiritsa ntchito njira zoletsa malingaliro a maladaptive (njira za malingaliro; t(81) = 3.54, p <0.001, d = 0.78) ndi "kubwereza" njira (ERQ: Kuyanjananso; t(83) = -2.477, p = .015, d = 0.545) koma kugwiritsira ntchito njira zowonongeka (njira zowonongeka za FEEL-E; t(81) = -1.26, p = 0.212) anali ofanana ndi momwe amagwiritsira ntchito njira "zodetsa" (ERQ: Kuchotsa; t(83) = 1.852, p = 0.068). Amuna omwe ali ndi HD amaonetsa zizindikiro zambiri za alexithymia (TAS-26; t(79) = 4.11, p <0.001, d = 0.92) zilembo zowonjezereka m'magulu onse, nkhawa yokhudzana ndi zojambulidwa (nkhawa ya ECR-R: t(78) = 5.413, p <0.000, d = 1.245) ndi kupeŵa zokhudzana ndi zojambulidwa (Kupewa kwa ECR-R: t(82) = 4.908, p <0.000, d = 1.064).

3.4. Kugonjetsa Kwachinsinsi Kufufuza

Zomwe zinasiyanitsa bwino pakati pa amuna omwe ali ndi HD komanso zowonongeka ndizofika zaka zakubadwa (OR = 0.55, 95% CI (0.35, 0.86)OR = 1.06, 95% CI (1.01,1.11)). Zosafunika zinali zovuta za mwana komanso zovuta zojambula. Mtundu wapadera wodula malamulo unali wabwino (ndi Nagelkerke R2 Mayeso a 0.55 ndi Hosmer-Lemeshow: χ2(7) = 11.76, df = 7, p = 0.11) ndipo adafotokozera za 55% za kusiyana pakati pa magulu awiriwa. Kutanthauzira kutanthawuza koyenera kunali 80.0% (78.1% yeniyeni, 81.4% yokhudzidwa).

4. Kukambirana

Phunziroli ndi limodzi mwa oyamba kufotokoza zochitika zowonongeka kuchokera kwa anthu ambiri omwe anakumana ndi zovuta zokhudzana ndi matenda a hypersexual [3] ndi kuwayerekeza ndi gulu la machitidwe abwino. Chiwerengero chochuluka cha anthu, chikhalidwe cha neurodevelopmental, ndi za m'banja, komanso chikhalidwe cha kugonana, zizindikiro za maganizo, ndi zovuta zinafukufuku.
Kupyolera mu kusanthula mndandanda wa masinthidwewa kafukufukuyu wasonyeza kusiyana kwakukulu pakati pa anthu omwe ali ndi matenda a hypersexual ndi machitidwe abwino.
Mwachidule, amuna omwe ali ndi HD amaoneka kuti akukumana ndi mavuto ambiri paunyamata kusiyana ndi kulamulira bwino, kukhala ndi amayi ambiri omwe ali ndi vuto la maganizo, kukhala ndi zovuta zosiyanasiyana pa nthawi ya ubwana komanso kusonyeza zizindikiro za ubwana wa ADHD. Kuwonjezera apo, zovuta zogwirizana ndi kupezeka kutetezedwa mu ubale wapamtima zinali zazikulu mwa amuna omwe ali ndi HD. Kuyamba kuseweretsa maliseche kunali pa msinkhu wakale mwa amuna omwe ali ndi HD ndipo adakhala ndi chilakolako chogonana komanso kuchepetsa kugonana chifukwa chodandaula za zotsatira zoipa, koma chiopsezo chogonana chifukwa cha kuopseza kwa ntchito. Kuwonjezera apo, amuna omwe ali ndi HD anali ndi mavuto omwe amabwera chifukwa cha kugwiritsira ntchito kwambiri pa kugonana pa Intaneti komanso kuwonetsa makhalidwe ena opatsirana pogonana, omwe ndi apamwamba kwambiri a khalidwe lachiwerewere, khalidwe lochita chiwerewere, komanso kugwiritsa ntchito zithunzi za kugwiririra ana. Kuzindikira matenda okhudzidwa ndi zizindikiro za matenda akuluakulu a maganizo monga chikoka, zizindikiro za ADHD wamkulu, alexithymia, ndi njira zowonongeka za malingaliro zina zawonjezeka kwa amuna omwe ali ndi HD.
Panali zizindikiro za kusiyana pakati pa ubwana wa amuna omwe ali ndi HD poyerekeza ndi kulamulira bwino. Mu chitsanzo chathu, njira zowonongeka zowonongeka za maganizo monga kuchepetsa kuyambiranso ndi njira zowonjezera zowonongeka zingathe kuwonedwa mwa amuna omwe ali ndi HD, komanso kuwonjezeka kwa alexithymia. Amuna omwe ali ndi HD amaonetsa chiŵerengero chapamwamba cha zovuta za ana; makamaka chiwerengero cha kugwiriridwa ndi kunyalanyazidwa, komanso kuchitidwa nkhanza zokhudzana ndi kugonana, zomwe zawonetsedwa kuti zimakhudzidwa ndi zovuta zowonongeka [57]. Komanso, njira zothetsera malingaliro okhudzidwa ndi amuna omwe ali ndi HD zingakhale zolimbikitsidwa ndi mavuto a maganizo a amayi a mwanayo [58] zomwe zinawonjezeka mwa amuna omwe ali ndi HD. Timakayikira kuti njira yopita ku HD imakhala kudzera m'mabuku ovuta komanso zochitika mu ubwana ndi unyamata zomwe zimayambitsa chitukuko cha njira zowonongeka za malingaliro [34]. Kuwonjezera pamenepo, njira zowonongeka za malingaliro osagwira ntchito zingagwirizane ndi mavuto omwe timakumana nawo m'mabambo omwe ali ndi HD, monga ana amasonyeza njira zowonongeka zokhudzidwa ndi maganizo awo pamene ali pachibwenzi chosatetezeka kwa amayi awo [59]. Pa kafukufuku woimira anthu a ku Germany, kugwiritsa ntchito njira zogonana pa intaneti kunagwirizanitsidwa kwambiri ndi anthu omwe amawadetsa nkhawa [60]. Kusanthula kwathu kuwonetsetsa kuti kupezeka mu maubwenzi apamtima akusiyana pakati pa amuna omwe ali ndi HD ndi machitidwe abwino, omwe ali ogwirizana ndi Katehakis [34] lingaliro lakuti odwala ena a HD angakhale atasokonezeka maganizo paunyamata. Izi zingachititse kuti thupi liziyenda bwino komanso ziwalo zina zapamtunda, chifukwa cha kusagwirizana pakati pa kayendedwe kabwino ka mitsempha, kayendedwe kabwino ka mitsempha, komanso hypothalamic-pituitary-adrenal axis [34].
Zomwe tapeza zikugwirizana ndi zomwe zikupeza kuti amuna omwe ali ndi vuto la HD amakhudzidwa ndi malamulo ndi zosokoneza ndipo angathe kugwiritsa ntchito khalidwe lachiwerewere ngati njira yothetsera mavuto [61]. Zoperewera za matendawa zimayamba kumayambiriro aunyamata ndipo zingasokoneze malingaliro ndi malingaliro [34]. Komabe, tinapeza kukhumudwa kokha ndipo palibe nzeru zofanana ndiyeso ya WAIS-IV [39] anawonetsedwa mu phunziro ili ndi mu phunziro ndi chitsanzo chaching'ono [62].
Chikhalidwe cha khalidwe lachiwerewere lingasonyeze posachedwapa kukula kwa kugonana, gulu lathu la HD likudziwika ndi chiyambi cha maliseche omwe adasiyanitsa kwambiri pakati pa amuna omwe ali ndi HD komanso kulamulira bwino mu kusanthula kwa kayendedwe ka kugonana. Komanso, khalidwe lachiwerewere limagwirizanitsa ndi chiyambi cha kugonana [35], ndi kuyamba koyambirira kwa chiwerewere chagwirizanitsidwa ndi chilakolako chofunafuna maganizo, kuvutika maganizo, ndi nkhawa [63]. Kuwonongera kwa nthawi yowerengera zithunzi zolaula kunali kwakukulu mwa amuna omwe ali ndi HD. Komabe, m'pofunika kuzindikira kuti kuchuluka kwa zolaula kumabweretsa mavuto koma kuti mgwirizano pakati pa nthawi ndi nthawi ndi zolaula zimagwiritsidwa ntchito, komanso kufunafuna mankhwala sizowoneka, koma zimatsutsana ndi kuuma kwa zizindikilo zolakwika zomwe zimagwiritsidwa ntchito zolaula [64]. Chilimbikitso cha chizolowezi choledzera [65,66], yomwe yagwiritsidwa ntchito ku HD [26,62], amavomereza kuti mwauchizoloŵezi chokhumba "chofuna" chimakhala chosiyana ndi zovuta "zokonda". Izi zikhoza kufotokoza chifukwa chake amuna omwe ali ndi HD akupitirizabe kukhala ndi vuto ngakhale kuti zowonongeka zimachitika. Ndipotu, amuna omwe ali ndi kachilombo ka HD mu zolemba zathu amafotokoza mavuto ambiri chifukwa cha kuchuluka kwa zolaula.
Ntchito yofunika yokhuza kugonana ndi chiletso cha khalidwe lachiwerewere yasonyezedwa mu kufufuza kwakukulu [35,67]. Gulu la HD mu chitsanzo chathu linanena zachisangalalo chogonana komanso kuchepa kwa kugonana chifukwa chowopsya kuti zotsatira zake zimakhala zovuta, ndipo izi zimapangitsa kuti anthu azigonana kwambiri. Timatsutsa kuti njira yeniyeni yokhudza kugonana ndi chiwopsezo chomwe, kuphatikizapo kugwiritsa ntchito chiwerewere monga njira yowonongeka yamaganizo, imapangitsa kuti pakhale vuto lachiwerewere. Kafukufuku wamakono akuluakulu a pa Intaneti omwe amagwiritsira ntchito chiwerengero cha ziwalo zogonana monga chiwonetsero cha kugonana akupeza kuti kukonda kwambiri kugonana kunayanjanitsika ndi kugwiritsidwa ntchito kudziwonetsera kwa zithunzi za kugwiriridwa kwa ana [68]. Ndipotu, mu chitsanzo chathu palibe mphamvu zowononga kuti zakhala zikuwonetsa zolaula za ana kusiyana ndi 80% ya amuna omwe ali ndi HD. Miyeso ya chilakolako chogonana yowonjezereka mwa amuna omwe ali ndi HD, kusonyeza kuwonjezeka kwa chiwerengero cha mafano osokoneza ana omwe ali ndi HD. Malingana ndi zotsatirazi pamodzi ndi meta-analyzes amene anapeza kugonana kwachisawawa ndi chithandizo chothandizira pa kugonana posachedwapa [69], timalimbikitsa madokotala kuti aone mbiri yachinyengo ndi momwe angagwiritsire ntchito chilakolako chogonana kwa odwala omwe ali ndi HD.
Komanso, tapeza chiwerengero chowonjezeka cha chidwi cha paraphilic kwa amuna omwe ali ndi HD. Pakadali pano, pali zovuta zogwirizana pa kusonkhana ndi zinthu za paraphilic ndi HD. Kafukufuku wina akusonyeza kuti kuchuluka kwa zigawo za paraphilic [14], pamene mukuyesedwa kumunda kwa zofunikira za HD [9] palibe kugwirizana komwe kunapezeka. Zomwe zingatheke chifukwa cha kusiyana kwa ndalama zingakhale zotseguka kufotokozera zofuna za paraphilic, chifukwa ku Germany chidziwitso ndi deta zomwe zasonkhanitsidwa pakapita kafukufuku ndi chithandizo cha mankhwala zimatetezedwa ndi chinsinsi, ngakhale ngati zikuphatikizapo malipoti a chidwi cha paraphilic, kugwiritsira ntchito zolaula za ana, khalidwe. Zofuna za Paraphilic zokha (ngati palibe zovulazidwa) sizikufuna kapena zifukwa zothandizira kuchipatala [4]; Komabe, zochitika za paraphili nthawi zambiri zimakhudzana ndi mavuto a ubale [70]. Kawirikawiri, vuto la maganizo lomwe limaimiridwa ndi HD ndi chimodzi mwazimene zimapezeka kuchokera ku phunziroli. Deta yathu ikuyimira zizindikiro za matenda ena opatsirana pogonana mu HD. Makamaka, zizindikiro za zizindikiro zamakono komanso zamoyo zonse za matenda opatsirana zikuwonjezeka mu gulu la HD. Mu phunziro lathu, zizindikiro za kuvutika maganizo monga momwe zinayesedwa ndi BDI-II zinali pafupifupi katatu kuposa amuna omwe ali ndi HD monga momwe akuyendetsera bwino. Mogwirizana ndi zomwe tinapeza, Weiss [71] anapeza kuti kuchuluka kwa kuvutika maganizo kunali pafupifupi nthawi 2.5 kuposa amuna omwe ali ndi HD kuposa anthu ambiri. Zotsatira zonse za kafukufuku wosiyanasiyana kufufuza zovuta zokhudzana ndi matenda a hypersexual zimasonyeza kuti kufalikira kuli pakati pa 28% ndi 42% [20,70,71]. Komanso, tikuganiza kuti kutengeka, makamaka chikhalidwe chofuna kugonana [25] ndi khalidwe la matenda a hypersexual, malinga ndi momwe timaonera kuwonjezereka kwa amuna omwe ali ndi HD komanso maphunziro amtsogolo ayenera kuyesa kufufuza izi. Kugwiritsira ntchito mankhwala osokoneza bongo nthawi zambiri kumagwirizanitsidwa ndi kuwonjezereka. Mu chitsanzo chathu tinapeza kuchuluka kwa kukhudzidwa ndi kukula kwakukulu, komabe chiwerengero cha mankhwala osokoneza bongo sichinali pakati pa magulu. Pali ziphunzitso zongopeka komanso zowona kuti kugwiritsira ntchito mowa mwauchidakwa kumakhudza khalidwe lachiwerewere [22,72,73], koma chithunzichi sichikudziwika bwino, chifukwa kafukufuku wosiyanasiyana akugwiritsa ntchito miyeso yosiyana ndi kukula kwake. Kuwonjezera pamenepo, kufufuza kwa m'tsogolomu kuyenera kufufuza njira zomwe zingakhale zoopsa zogonana pakati pa amuna ndi HD, zomwe zawonetsedwa kuti zikugwirizana ndi matenda osiyanasiyana a m'maganizo [74].
Malingana ndi malingaliro ovomerezeka ndi zotsatira zathu, ife tinapanga chitsanzo chothandizira kugonana kwa khalidwe lachiwerewere (Chithunzi 3). Ngakhale kulibe umboni wosonyeza kuti munthu ali ndi matenda opatsirana pogonana, chitsanzochi chimapereka zigawo zambiri zomwe zingachititse kuti munthu akhale ndi vuto la kugonana. Chitsanzo chogwira ntchitoyi chingakhale chothandiza popanga mafunso atsopano a kafufuzidwe ndi kusintha kwa mapulogalamu.
Jcm 08 00157 g003 550
Chithunzi 3. Kugwiritsa ntchito chitsanzo cha matenda osokoneza bongo. Timaganiza kuti pali zinthu zina zomwe zimayambitsa matenda a hypersexual. Kuphatikizapo zinthu zokhudzana ndi chilengedwe, mwachitsanzo, zochitika zapachibadwa ndi epigenetic ndi zochitika zovuta za ana zimapangitsa munthu kukhala ndi makhalidwe omwe amachititsa kuti azikhala ndi matenda oopsa a matenda a maganizo. Kuwukitsidwa kwakukulu kwa kugonana kungakhale kogwirizana ndi zibadwa zenizeni ndipo zingakhale zotsatizana ndi kuyambitsa kutsogolo koyambirira kwa zakugonana. Zizindikiro zosavomerezeka za munthu, zovuta zowonongeka, ndi kukwatulidwa kwakukulu kwa kugonana zingayambitse chitukuko cha matenda a hypersexual. Zinthu zomwe zidalembedwa ndi nyenyezi zimachokera kumbuyo kwa zotsatira zathu.
Deta yathu ili ndi zotsatira zambiri pa chithandizo. Timapereka kuti madokotala akufufuza momwe angathe kuchitiridwa nkhanza ndi kunyalanyazidwa, komanso kugwiriridwa ndi amuna omwe ali ndi HD. Kuwonjezera pamenepo, deta yathu imasonyeza kuti zizindikiro za ADHD akuluakulu owonjezeka awonjezeka mwa amuna omwe ali ndi HD ndipo zanenedwa kuti odwalawa akhoza kupindula ndi pharmacotherapy ndi mankhwala othandizira pamodzi [75]. Monga kuchepetsa kugwiritsira ntchito njira zowonongeka zozizwitsa zosawonongeka zinawonedwa mu chitsanzo chathu, chithandizo cha chidziwitso cha khalidwe chiyenera kuganiziranso zochitika zowonongeka zowonongeka komanso zochitika mwa amuna omwe ali ndi HD [76]. Njira yochiritsira yopanda chiweruzo ndi yofunika kuti imvetsere paraphilia, yomwe nthawi zambiri imakhala ndi amuna omwe ali ndi HD. Tapeza chiwerengero chowonjezereka cha khalidwe lachiwerewere komanso kugwiritsira ntchito zithunzi zopweteka kwa ana amuna omwe ali ndi HD, ndipo ngati sichiloledwa ndi malire a chinsinsi, timapereka kuti kuunika kwa odwala akulangizidwa kuti athe kupewa khalidwe loipa.

5. Kulepheretsa

Ndikofunika kuzindikira kuti zitsanzozi zinali ndi anthu omwe adadzipereka kuti athe kutenga nawo mbali pa phunziro lachipatala ndipo adagwirizana kulengeza zochitika zokhudzana ndi zochitika za moyo, zochitika zamkati, ndi chiwerewere. Choncho, zizindikiro za chitsanzochi sizingakhale zofanana ndi za anthu omwe ali ndi matenda a hypersexual omwe sakufuna kufotokozera zachinsinsi.
Zomwe zimachititsa kuti mafilimu a HD asamagwiritsidwe ntchito mosavuta, chifukwa-kupatulapo 2D: chiŵerengero cha 4D-tinadalira deta yodzipangira yekha komanso kuyankhulana kwachipatala m'maphunziro ndi magawo ena okhudzana ndi zochitika zokhudzana ndi chikhalidwe.
Zili zovuta kusinthitsa zomwe zaphunziroli ku zikhalidwe zina. Komanso, chitsanzo ichi chakumadzulo kwa Ulaya sichinayimire anthu a kumadzulo kwa Ulaya mwachitsanzo, zaka, zaka ndi maphunziro.

6. Zotsatira

Amuna omwe ali ndi HD amawoneka kuti ali ndi chikhalidwe chimodzimodzi, chiwerengero cha anzeru, chikhalidwe cha anthu, ndi zinthu za m'banja poyerekeza ndi kulamulira bwino. Komabe, amuna omwe ali ndi kachilombo ka HD amaonetsa kusiyana pakati pa zofunikira pamoyo wawo, monga zovuta zokhudzana ndi ubwana, khalidwe lachiwerewere, komanso mavuto okhudza maganizo.

Zida Zowonjezera

Zotsatirazi zikupezeka pa intaneti https://www.mdpi.com/2077-0383/8/2/157/s1, Zofufuza Zowonjezera.

Zopereka za Wolemba

Kulingalira, JE, TH, UH, THCK, JK; njira, JE, MV, CS, IH, THCK, kusanthula mwachidule, JE, MV, kulembera zolemba zoyambirira, JE, kulembera ndi kukonza, JE, IH, CS, MV, THCK, UH, kuyang'anira THCK, UH , CS, TH, kupeza ndalama, THCK, UH, TH, JK

ndalama

Maphunzirowa anathandizidwa ndi bungwe lofufuza za European Society for Sexual Medicine.

Kuvomereza

Olembawo ayamikira Marie-Jean Carstensen, Anna Spielvogel ndi Julia Liebnau kuti athandizidwe popanga zolembedwazo.

Mikangano ya Chidwi

Zolembazo ndizofukufuku wapachiyambi ndipo sizinayambe kufalitsidwa kwina kulikonse. Olembawo salengeza kuti palibe mpikisano wa ndalama.

Zothandizira

  1. Derbyshire, KL; Grant, JE Khalidwe lochita zachiwerewere: Kuwerengera mabuku. J. Behav. Kusokoneza. 2015, 4, 37-43. [Google Scholar] [CrossRef] [Adasankhidwa]
  2. Fong, TW; Reid, RC; Parhami, I. Kuledzeretsa. Kumene mungakoke mizere? Psychiatr. Kliniki. N. Am. 2012, 35, 279-296. [Google Scholar] [CrossRef] [Adasankhidwa]
  3. Kafka, MP Mphamvu ya Hypersexual Disorder: A Proposed Diagnosis kwa DSM-V. Mzere. Kugonana. Behav. 2010, 39, 377-400. [Google Scholar] [CrossRef] [Adasankhidwa]
  4. Association of Psychiatric Association. Kusanthula ndi Buku Lophatikiza la Mavuto a Mitsempha, 5th ed.; Association of Psychiatric Association: Washington, DC, USA, 2013; ISBN 089042554X. [Google Scholar]
  5. Kafka, MP Kodi chinachitika n'chiyani pa matenda a hypersexual? Mzere. Kugonana. Behav. 2014, 43, 1259-1261. [Google Scholar] [CrossRef] [Adasankhidwa]
  6. Piquet-Pessôa, M .; Ferreira, GM; Melca, IA; Fontenelle, LF DSM-5 ndi chisankho chosagwirizanitsa kugonana, kugula kapena kuba monga zizolowezi. Curr. Kusokoneza. Malipoti 2014, 1, 172-176. [Google Scholar] [CrossRef]
  7. Grant, JE; Atmaca, M ;; Fineberg, NA; Fontenelle, LF; Matsunaga, H .; Janardhan Reddy, YC; Simpson, HB; Thomsen, PH; Van Den Heuvel, OA; Veale, D .; et al. Kuwonetsa kusokoneza maganizo ndi "zizoloŵezi za khalidwe" mu ICD-11. World Psychiatry 2014, 13, 125-127. [Google Scholar] [CrossRef]
  8. Dickenson, JA; Gleason, N .; Coleman, E .; Miner, MH Kukula kwa Mavuto Okhudzana ndi Kuvuta Kulamulira Kulimbikitsa Kugonana, Kumverera, ndi Zopindulitsa ku United States. JAMA Netw. Tsegulani 2018, 1, e184468. [Google Scholar] [CrossRef]
  9. Reid, RC; Mmisiri wamatabwa, BN; Nkhumba, JN; Garos, S.; Manning, JC; Gilliland, R .; Cooper, EB; Mckittrick, H ;; Davtian, M .; Fong, T. Lipoti la zofukufuku mu dsm-5 mayesero pamunda chifukwa cha matenda a hypersexual. J. Kugonana. Med. 2012, 9, 2868-2877. [Google Scholar] [CrossRef]
  10. Cooper, A. Zogonana ndi intaneti: Kupitilira mu New Millennium. CyberPsychology Behav. 1998, 1, 187-193. [Google Scholar] [CrossRef]
  11. Cooper, A .; Delmonico, DL; Burg, R. Cybersex ogwiritsa ntchito, ozunza, ndi okakamiza: Zotsatira zatsopano ndi zofunikira. Kugonana. Kusokoneza. Kukhwimitsa J. Kuchitira. Choyamba. 2000, 7, 5-29. [Google Scholar] [CrossRef]
  12. Döring, NM Intaneti ikukhudzidwa pa kugonana: Kubwereza kwakukulu kwa zaka 15 zafukufuku. Tumizani. Hum. Behav. 2009, 25, 1089-1101. [Google Scholar] [CrossRef]
  13. Achinyamata, KS Internet Sex Addiction Risk Factors, Gawo la Kukula, ndi Chithandizo. Am. Behav. Sci. 2008, 52, 21-37. [Google Scholar] [CrossRef]
  14. Wéry, A .; Vogelaere, K .; Challet-Bouju, G ;; Poudat, F.-X.; Caillon, J ;; Wotsutsa, D .; Billieux, J ;; Grall-Bronnec, M. Makhalidwe a anthu omwe amadziwika ndi kugonana omwe ali ndi chizoloŵezi chogonana. J. Behav. Kusokoneza. 2016, 5, 623-630. [Google Scholar] [CrossRef]
  15. Carnes, PJ Kugonana ndi kukakamizidwa: Kuzindikira, kulandira chithandizo & kuchira. CNS Wopenya. 2000, 5, 63-72. [Google Scholar]
  16. Carroll, JS; Padilla-Walker, LM; Nelson, LJ; Olson, CD; Barry, CM; Madsen, SD Generation XXX: Kulaula Kuvomerezeka ndi Kugwiritsidwa Ntchito Pakati pa Achikulire Okalamba. J. Adolesc. Res. 2008, 23, 6-30. [Google Scholar] [CrossRef]
  17. Häggström-Nordin, E .; Hanson, U .; Tydén, T. Associations pakati pa zolaula ndi kugonana kwa achinyamata achinyamata ku Sweden. Int. J. STD AIDS 2005, 16, 102-107. [Google Scholar] [CrossRef]
  18. Kalichman, SC; Kaini, D. Ubale pakati pa zizindikiro zokhuza kugonana ndi zochitika zogonana zogonana kwambiri pakati pa abambo ndi amayi omwe alandira thandizo kuchokera kuchipatala cha matenda opatsirana pogonana. J Sex Res. 2004, 41, 235-241. [Google Scholar] [CrossRef]
  19. Mick, TM; Hollander, E. Impulsive-Kumangokhalira Kugonana. CNS Wopenya. 2006, 11, 944-955. [Google Scholar] [CrossRef]
  20. Raymond, NC; Coleman, E .; Miner, MH Psychiatric comorbidity ndi zizoloŵezi zofuna kugonana. Lowani. Psychiatry 2003, 44, 370-380. [Google Scholar] [CrossRef]
  21. de Tubino Scanavino, M .; Ventuneac, A .; Abdo, CHN; Tavares, H .; kodi Amaral, MLSA; Messina, B ;; dos Reis, SC; Martins, JPLB; Parsons, JT Makhalidwe okhudzana ndi kugonana ndi maganizo opatsirana pakati pa amuna ofunafuna mankhwala ku São Paulo, Brazil. Kupuma kwa maganizo. 2013, 209, 518-524. [Google Scholar] [CrossRef]
  22. Zojambula Musati Muzitchule Kukonda; Mabuku a Bantam: New York, NY, USA, 1991; ISBN 0-553-35138-9.
  23. Reid, RC; Cyders, MA; Moghaddam, JF; Fong, TW Mapangidwe a Barratt Impulsiveness Scale kwa odwala omwe ali ndi vuto la kutchova njuga, kugonana, kugonana ndi abambo a methamphetamine. Kusokoneza. Behav. 2014, 39, 1640-1645. [Google Scholar] [CrossRef] [Adasankhidwa]
  24. Reid, RC; Dhuffar, MK; Parhami, I .; Fong, TW Kufufuza mbali za umunthu mumsampha wodwala wa amayi okhudzana ndi chiwerewere poyerekeza ndi amuna omwe amagonana nawo. J. Psychiatry Pract. 2012, 18, 262-268. [Google Scholar] [CrossRef] [Adasankhidwa]
  25. Reid, RC; Berlin; HA; Kingston, DA kugonana ndi amuna okhaokha. Curr. Behav. Neurosci. Rep. 2015, 2, 1-8. [Google Scholar] [CrossRef]
  26. Mechelmans, DJ; Irvine, M .; Banca, P .; Porter, L .; Mitchell, S .; Mole, TB; Lapa, TR; Harrison, NA; Potenza, MN; Zoona, V. Kuwonetseratu chidwi cha kugonana kwa anthu omwe ali ndi makhalidwe osagonana. PLoS ONE 2014, 9, e105476. [Google Scholar] [CrossRef] [Adasankhidwa]
  27. Reid, RC; Karim, R .; McCrory, E ;; Mmisiri wamatabwa, BN Kudziwa zosiyana pazochitika za machitidwe apamwamba ndi khalidwe la hypersexual mu chitsanzo cha wodwala ndi chigawo cha amuna. Int. J. Neurosci. 2010, 120, 120-127. [Google Scholar] [CrossRef]
  28. Schiebener, J ;; Laier, C ;; Brand, M. Kodi mukutsatira zolaula? Kugwiritsa ntchito mosayenera kapena kunyalanyaza mauthenga a pa Intaneti pazinthu zambirimbiri zikugwirizana ndi zizindikiro za kugonana kwa pa Intaneti. J. Behav. Kusokoneza. 2015, 4, 14-21. [Google Scholar] [CrossRef]
  29. Baumeister, RF; Catanese, KR; Vohs, KD Kodi pali kusiyana kwa kusiyana pakati pa amuna ndi akazi pa mphamvu yogonana? Malingaliro aumulungu, malingaliro osiyanitsa, ndi kubwereza umboni wofunikira. Munthu. Soc. Psychol. Chiv. 2001, 5, 242-273. [Google Scholar] [CrossRef]
  30. Hönekopp, J ;; Bartholdt, L .; Beier, L .; Liebert, A. Chachiwiri mpaka kuchinayi chiwerengero cha chiwerengero cha chiwerengero (2D: 4D) ndi magulu akuluakulu a mahomoni okhudzana ndi kugonana: Deta yatsopano ndi kafukufuku wa meta. Psychoneuroendocrinology 2007, 32, 313-321. [Google Scholar] [CrossRef]
  31. Hönekopp, J ;; Voracek, M .; Manning, JT 2nd ku chiwerengero cha 4th chiwerengero (2D: 4D) ndi chiwerengero cha ogonana nawo: Umboni wa zotsatira za testosterone yobereka kwa amuna. Psychoneuroendocrinology 2006, 31, 30-37. [Google Scholar] [CrossRef]
  32. Klimek, M .; Andrzej, G ;; Nenko, I .; Alvarado, LC; Chiŵerengero cha Jasienska, G. Digit (2D: 4D) monga chizindikiro cha kukula kwa thupi, msinkhu wa testosterone ndi chiwerengero cha ana mwa amuna. Ann. Hum. Ubweya. 2014, 41, 518-523. [Google Scholar] [CrossRef]
  33. Varella, MAC; Valentova, JV; Pereira, KJ; Bussab, VSR Chiwerewere chikugwirizana ndi zikhalidwe za amuna ndi akazi mwa amuna ndi akazi: Umboni wochokera ku Brazil ndi Czech. Behav. Zotsatira 2014, 109, 34-39. [Google Scholar] [CrossRef] [Adasankhidwa]
  34. Katehakis, A. Katswiri wa sayansi ndi chithandizo cha kugonana. Kugonana. Kusokoneza. Kukhwima 2009, 16, 1-31. [Google Scholar] [CrossRef]
  35. Walton, MT; Bhullar, N. Kuchita Zogonana Mogwirizana ndi Kugonjetseratu Maganizo: Kuyembekezera Field Studies Data. Mzere. Kugonana. Behav. 2018, 47, 1327-1831. [Google Scholar] [CrossRef]
  36. Reid, RC; Garos, S.; Mmisiri wamatabwa, BN Wokhulupirika, chitsimikizo, ndi chithunzithunzi cha chitukuko cha khalidwe la hypersexual mndandanda muzitsanzo zapakati pa amuna. Kugonana. Kusokoneza. Kukhwima 2011, 18, 30-51. [Google Scholar] [CrossRef]
  37. Bernstein, D .; Fink, L. Buku la Mafunso Othandizira Ana Odwala (CTQ); The Psychological Corporation: New York, NY, USA, 1998. [Google Scholar]
  38. Oldfield, RC Kuwerengera ndi kusanthula zoperekedwa: Kufufuza kwa Edinburgh. Neuropsychologia 1971, 9, 97-113. [Google Scholar] [CrossRef]
  39. Wechsler, D. WAIS-IV Wechsler Adult Intelligence Scale Deutschsprachige Kusintha, 4th ed.; Petermann, F., Petermann, U., Eds ;; Hogrefe: Göttingen, Germany, 2013. [Google Scholar]
  40. Janssen, E ;; Vorst, H ;; Finn, P .; Bancroft, J. Kuletsa kugonana (SIS) ndi zikhumbo zokhuza kugonana (SES): Masiyeso: Kuyeza chiopsezo cha kugonana ndi kusangalatsa kwa amuna. J Sex Res. 2002, 39, 114-126. [Google Scholar] [CrossRef]
  41. Pawlikowski, M .; Altstötter-Gleich, C ;; Brand, M. Validation ndi psychometric katundu wa pang'ono ya Youth's Internet Matenda Test. Tumizani. Hum. Behav. 2013, 29, 1212-1223. [Google Scholar] [CrossRef]
  42. Zolemba, P .; Chomera, B .; Zolemba, S. Zofanana mosiyana: Kuganizira za Kugonana Kwachilombo Kuyezetsa (SAST) kuti uwonetsere chikhalidwe ndi kugonana. Kugonana. Kusokoneza. Kukhwima 2010, 17, 7-30. [Google Scholar] [CrossRef]
  43. Wittchen, HU; Wunderlich, U .; Gruschwitz, S .; Zaudig, M. SKID I. Strukturiertes Klinisches Kucheza kwa DSM-IV. Achse I: Psychische Störungen. Funsani ndi undurteilungsheft. Eine deutschsprachige, erweiterte Bearb. d. amerikanischen Originalversion des SKID I; Hogrefe: Göttingen, Germany, 1997. [Google Scholar]
  44. Patton, JH; Stanford, MS; Barratt, ES Barratt Impulsiveness Scale (BIS-11). J. Clin. Psychol. 1995, 51, 768-774. [Google Scholar] [CrossRef]
  45. Fagerström, OK; Schneider, NG Fagerström Kuyesedwa kwa Chikhulupiliro cha Nicotine. J Behav Med. 1989, 12, 159-181. [Google Scholar]
  46. Saunders, JB; Aasland, OG; Babor, TF; De la Fuente, JR; Grant, M. Kupititsa patsogolo zovuta zogwiritsira ntchito mowa (AUDIT): Ntchito yothandizana ndi WHO yofufuza anthu oyambirira mowa mwauchidakwa-II. Bongo 1993, 88, 791-804. [Google Scholar] [CrossRef] [Adasankhidwa]
  47. Hautzinger, M .; Keller, F .; Kühner, C. Beck Depressions-Inventar II. Deutsche Bearbeitung ndi Handbuch zum BDI II.; Mapulogalamu Oyesedwa a Harcourt: Frankfurt am Main, Germany, 2006. [Google Scholar]
  48. Fraley, RC; Waller, NG; Brennan, KA Kufufuza kwapadera kuyankhulidwa kwa kudzipangitsa malipoti okhudza kugwirizanitsa akuluakulu. J. Pers. Soc. Psychol. 2000, 78, 350-365. [Google Scholar] [CrossRef] [Adasankhidwa]
  49. Kupfer, J ;; Brosig, B ;; Brähler, E. TAS-26: Toronto-Alexithymie-Skala-26 (deutsche Version); Hogrefe: Göttingen, Germany, 2001. [Google Scholar]
  50. Gross, JJ; John, OP Osiyana Momwe Mulikumvera Mauthenga Awiri Njira: Zomwe Zimakhudza, Maubwenzi, ndi Ubwino. J. Pers. Soc. Psychol. 2003, 85, 348-362. [Google Scholar] [CrossRef] [Adasankhidwa]
  51. Petermann, F. Fragebogen ndi Erberung der Emotionsregulation bei Erwachsenen (FEEL-E). Zeitschrift fur Psychiatry Psychol. Sungani. 2015, 63, 67-68. [Google Scholar] [CrossRef]
  52. Retz-Junginger, P .; Retz, W .; Blocher, D .; Weijers, H.-G ;; Trott, G.-E.; Wender, PH; Rössler, M. Wender Utah Rating Scale (WURS-k) Imfa ya Deutsche Kurzform imapangidwanso ndi zovuta za hyperkinetischen syndroms bei erwachsenen. Nervenarzt 2002, 73, 830-838. [Google Scholar] [CrossRef] [Adasankhidwa]
  53. Rösler, M .; Retz, W .; Retz-Junginger, P .; Thome, J .; Supprian, T ;; Nissen, T .; Stieglitz, RD; Blocher, D .; Hengesch, G ;; Trott, GE Zida Zur Diagnostik der Aufmerksamkeitsdefizit- / Hyperaktivitätsstörung (ADHS) ndi Erwachsenenalter. Nervenarzt 2004, 75, 888-895. [Google Scholar] [CrossRef] [Adasankhidwa]
  54. Agresti, A. Chiyambi cha Categorical Data Analysis, 2nd ed.; Wiley: Hoboken, NJ, USA, 2018; ISBN 1119405262. [Google Scholar]
  55. Cohen, J. Kusanthula Mphamvu Zokwanira za Sayansi ya Zizolowezi, 2nd ed.; Erlbaum Associates: Hillsdale, NJ, USA, 1988; ISBN 9780805802832. [Google Scholar]
  56. Choyamba, MB; Spitzer, RL; Gibbon, M .; Williams, JB Funso la Clinical Interviews la DSM-IV Axis I Disorder; New York State Psychiatric Institute: New York, NY, USA, 1995. [Google Scholar]
  57. Carvalho Fernando, S .; Beblo, T .; Schlosser, N .; Terfehr, K ;; Otte, C ;; Löwe, B ;; Wolf, OT; Spitzer, C ;; Kuthamanga, M.; Wingenfeld, K. Mmene Zimakhudzidwira Mwana Wodzidzimutsa Wokhumudwitsidwa pa Mavuto a Kusokonezeka Maganizo M'dera Lomwe Anthu Akukumana ndi Matenda ndi Kuvutika Kwambiri Kwambiri. J. Trauma Dissociation 2014, 15, 384-401. [Google Scholar] [CrossRef]
  58. Goodman, SH; Gotlib, IH Risk ya Psychopathology kwa Ana a Amayi Opsinjika Maganizo: Chitsanzo Cholimbikitsidwa cha Kumvetsetsa Njira za Kutumiza. Psychol. Chiv. 1999, 106, 458-490. [Google Scholar] [CrossRef]
  59. Madzi, SF; Virmani, EA; Thompson, RA; Meyer, S .; Raikes, HA; Jochem, R. Kukonzekera maganizo ndi chiyanjano: Kutsegula makina awiri ndi mgwirizano wawo. J. Psychopathol. Behav. Yesani. 2010, 32, 37-47. [Google Scholar] [CrossRef]
  60. Beutel, ME; Giralt, S .; Wölfling, K .; Stöbel-Richter, Y .; Subic-Wrana, C ;; Wowonzanso, I .; Tibubos, AN; Brähler, E. Kukula ndi zizindikiro za kugwiritsira ntchito kugonana pa Intaneti pa chiwerengero cha anthu a ku Germany. PLoS ONE 2017, 12, 1-12. [Google Scholar] [CrossRef]
  61. Reid, RC; Mmisiri wamatabwa, BN; Spackman, M ;; Willes, DL Alexithymia, kusasinthasintha maganizo, komanso kusokonezeka maganizo kwa odwala omwe akuthandizira kuti azigonana. J. Kugonana kwa Ther. 2008, 34, 133-149. [Google Scholar] [CrossRef] [Adasankhidwa]
  62. Onani, V .; Mole, TB; Banca, P .; Porter, L .; Morris, L .; Mitchell, S .; Lapa, TR; Karr, J .; Harrison, NA; Potenza, MN; et al. Neural correlates of reactivity cac reactivity kwa anthu omwe ali ndi makhalidwe opanda kugonana. PLoS ONE 2014, 9, e102419. [Google Scholar] [CrossRef] [Adasankhidwa]
  63. Amabala, MD; Paglia, HA; Redden, SA; Grant, JE Age pachibwenzi choyamba: Amagulu achipatala ndi zamaganizo. Ann. Kliniki. Kupuma kwa Psychiatry. J. Am. Acad. Kliniki. Psychiatry 2018, 30, 102-112. [Google Scholar]
  64. Gola, M .; Lewczuk, K ;; Skorko, M. Zofunika: Kodi kuchuluka kwa zolaula kumagwiritsidwa ntchito bwanji? Zinthu zamaganizo ndi khalidwe la kufunafuna chithandizo cha zolaula zimagwiritsa ntchito. J. Kugonana. Med. 2016, 13, 815-824. [Google Scholar] [CrossRef] [Adasankhidwa]
  65. Robinson, TE; Berridge, KC Maziko a neural a chilakolako cha mankhwala: Chidziwitso cholimbikitsana cha kuledzera. Resin ya ubongo. Chiv. 1993, 18, 247-291. [Google Scholar] [CrossRef]
  66. Berridge, KC; Kringelbach, ML Mphamvu zokhudzana ndi chisangalalo cha zokondweretsa: Mphoto mwa anthu ndi zinyama. Psychopharmacology 2008, 199, 457-480. [Google Scholar] [CrossRef] [Adasankhidwa]
  67. Rettenberger, M .; Klein, V .; Briken, P. Ubale pakati pa khalidwe lachiwerewere, kugonana, chiwerewere, ndi makhalidwe. Mzere. Kugonana. Behav. 2016, 45, 219-233. [Google Scholar] [CrossRef] [Adasankhidwa]
  68. Klein, V .; Schmidt, AF; Turner, D .; Briken, P. Kodi kugonana ndi kugonana ndi kugonana komwe kumagwirizanitsa ndi chiwerewere ndi mwana wogwiriridwa pogonana pogonana? PLoS ONE 2015, 10, 1-11. [Google Scholar] [CrossRef]
  69. Mann, RE; Hanson, RK; Thornton, D. Kuwonetsa chiopsezo cha kubwezeretsa kugonana: Zina mwazinthu zokhudzana ndi zifukwa zomveka zowopsya. Kugonana. Kusokoneza J. Res. Tenga. 2010, 22, 191-217. [Google Scholar] [CrossRef]
  70. Kafka, MP; Hennen, J. A DSM-IV Pakati Phunziro la Kugonana kwa Amuna (n = 120) Ndili ndi Paraphilias ndi Matenda Okhudzana ndi Paraphilia. Kugonana. Nkhanza 2002, 14, 349-366. [Google Scholar] [CrossRef]
  71. Weiss, D. Kufala kwa kuvutika maganizo kwa amuna ogonana ndi amuna ogonana akukhala ku United States. Kugonana. Kusokoneza. Kukhwima 2004, 11, 57-69. [Google Scholar] [CrossRef]
  72. Hagedorn, WB Kuitana kwa Kufufuza Katsopano ndi Kowonjezera kwa Mavuto a Mental Disorders: Matenda a Addictive. J. Addict. Milandu Yamilandu. 2009, 29, 110-127. [Google Scholar] [CrossRef]
  73. Kaplan, MS; Krueger, RB Kuzindikira, kulingalira, ndi chithandizo cha chiwerewere. J Sex Res. 2010, 47, 181-198. [Google Scholar] [CrossRef] [Adasankhidwa]
  74. Maclean, JC; Xu, H ;; French, MT; Ettner, SL Kukhala ndi thanzi labwino ndi khalidwe loopsa la kugonana: Umboni wochokera ku matenda a DSM-IV Axis II. J. Ment. Zolinga za Umoyo Econ. 2013, 16, 187-208. [Google Scholar] [Adasankhidwa]
  75. Reid, RC; Davtian, M .; Lenartowicz, A .; Torrevillas, RM; Fong, TW Zochitika pa kufufuza ndi chithandizo cha anthu akuluakulu okhudzana ndi chiwerewere. Kulimbana ndi Neuropsychi 2013, 3, 295-308. [Google Scholar] [CrossRef]
  76. Hallberg, J .; Kaldo, V .; Arver, S .; Dhejne, C .; Öberg, KG Katswiri wokhudzana ndi khalidwe labwino lomwe limathandizira ku matenda a hypersexual: Kufufuza kotheka. J. Kugonana. Med. 2017, 14, 950-958. [Google Scholar] [CrossRef] [Adasankhidwa]