UPDATES pa chilengezo cha American Association of Addiction Medicine:
- Kodi munthu amadziwa bwanji? Mankhwala omwe amagwiritsidwa ntchito kwambiri padziko lonse, Mayiko Akumayiko Onse a Matenda (ICD-11), ali ndi matenda atsopano woyenera kuchita zachiwerewere: "Kugonana Kwachiwerewere. "
- Kugonana ndi kugonana / kugonana? Tsambali likulemba Zotsatira za 39 za sayansi (MRI, fMRI, EEG, matenda opatsirana pogonana, mahomoni). Amapereka chithandizo cholimba cha mtundu wa mankhwala osokoneza bongo pamene zofukufuku zawo zimagwirizanitsa zochitika za m'maganizo zomwe zimafotokozedwa mu maphunziro osokoneza bongo.
- Malingaliro enieni a akatswiri okhudzana ndi zolaula / kugonana? Mndandanda uwu uli Ndemanga za 16 zaposachedwa & ndemanga ndi ena mwa apamwamba a sayansi ya sayansi padziko lapansi. Zonse zothandizira mtundu wa mankhwala osokoneza bongo.
- Zizindikiro za kuledzera ndi kuchuluka kwa zinthu zoopsa kwambiri? Kupitilira maphunziro a 30 omwe amafotokoza zomwe zikugwirizana ndi kuchuluka kwa zolaula (kulolerana), chizolowezi choonera zolaula, komanso zisonyezo zosiya.
The American Society of Addiction Medicine imanena kuti zizolowezi za kugonana ndi zenizeni monga mankhwala osokoneza bongo
Chochitika chachikulu chachitika pankhani ya sayansi ndi chithandizo cha chizolowezi. Akatswiri apamwamba a chizolowezi ku America ku The American Society of Addiction Medicine (ASAM) angotulutsa tanthauzo lawo latsopano la chizolowezi . Tanthauzo latsopanoli likuthetsa mkangano wokhudza ngati chizolowezi chogonana ndi zolaula ndi "chizolowezi chenicheni." Ndizoonadi.
Kuchokera ku ASAM press release :
Kutanthauzira kwatsopano kumeneku kudabwera chifukwa cha ntchito yayikulu, yazaka zinayi yokhala ndi akatswiri opitilira 80 akugwira ntchito molimbika, kuphatikiza oyang'anira osokoneza bongo, asing'anga azachipatala komanso ofufuza otsogola mdziko lonselo. … Patadutsa zaka makumi awiri kupita patsogolo m'maganizo a sayansi kunatsimikizira ASAM kuti kusuta kumayenera kufotokozedwanso ndi zomwe zimachitika muubongo.
Mwina ASAM adachitapo kanthu, chifukwa madokotala amisala omwe akukonzanso DSM (American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders ) akhala akukoka mapazi awo pogwirizanitsa DSM-5 yomwe ikubwerayi ndi kupita patsogolo kwa kafukufuku wokhudza chizolowezi cha khalidwe. Mwachikhalidwe, DSM imapereka matenda ozikidwa osati pa matenda oyamba, koma pamndandanda wa makhalidwe. Popeza olemba DSM sangagwirizane pa mndandanda wa machitidwe ogonana omwe amapanga "Hypersexuality Disorder" (yomwe imakhudza kugwiritsa ntchito zolaula mokakamiza), ali ndi vuto. Ndipotu, akhoza kuchotsa vutoli ku appendix - pomwe kugwiritsa ntchito zolaula pa intaneti pakati pa anyamata achichepere kukukhala pafupifupi kulikonse . (ZINDIKIRANI: Izi zinalembedwa DSM-5 isanasankhe kupanga " gulu la chizolowezi chochita zinthu mopitirira muyeso ".)
Tanthauzo la ASAM
Mosiyana ndi zimenezi, tanthauzo la ASAM, “limayang’ana ntchito ya ubongo pa chifukwa cha chizolowezi—zomwe zikuchitika ndi kugwira ntchito kwa ubongo ndi machitidwe enaake a ubongo omwe angathe kufotokoza makhalidwe akunja omwe amaoneka mu chizolowezi.” Ndi kuvomereza kuti khalidwe logonana (monga kuonera zolaula pa intaneti tsiku lililonse) lingakhale umboni wa matenda mu ubongo wa munthu wina popanda kusonyeza matenda mu ubongo wa wina.
Kafukufuku akusonyeza kuti zizolowezi za khalidwe ndi mankhwala zimakhudza kusintha kwakukulu komweko mu kapangidwe ka ubongo ndi kagwiridwe ka ntchito ka thupi. Wolankhulira ASAM anafotokoza kuti :
Kutanthauzira kwatsopano kukusiya mosakayikira kuti zizolowezi zonse-kaya ndi mowa, heroin kapena kugonana, amati-ndizofanana. Dr Raju Haleja, Purezidenti wakale wa Canadian Society for Addiction Medicine komanso wapampando wa komiti ya ASAM yomwe idapanga tanthauzo latsopanoli, adauza The Fix, "Tikuyang'ana kuzolowera ngati matenda amodzi, mosiyana ndi omwe amawawona kuti ndi osiyana matenda. Kuledzera ndikoledzera. Zilibe kanthu kuti ubongo wanu ukugundana ndi njira yotani, ukasintha, umakhala pachiwopsezo chazovuta zonse. ” … Kugonana kapena kutchova juga kapena kuledzera [ndizomwe] ndizovomerezeka kuchipatala monga kumwa mowa kapena heroin kapena crystal meth.
Nayi chidule cha mfundo zazikulu za American Society of Addiction Medicine:
- Kuledzeretsa kumasonyeza ubongo womwewo umasintha kaya umachitika chifukwa cha mankhwala kapena makhalidwe.
- Kuledzera ndi matenda oyamba. Sikuti zimayambitsidwa ndimatenda amisala monga kusokonezeka kwa malingaliro kapena umunthu. Izi zikutsimikizira lingaliro lotchuka loti zizolowezi zosokoneza bongo nthawi zonse zimakhala mtundu wa "kudzichiritsa" kuti muchepetse zovuta zina.
- Zizoloŵezi zonse zokhudzana ndi khalidwe ndi mankhwala zimayambitsa kusintha kwakukulu komweku m'mabwalo oyendayenda ofanana: Hypofrontality, kulimbikitsa, kukhumudwitsa, kusintha maulendo opanikizika, ndi zina zotero.
- Kuchita nawo "zizolowezi zosokoneza" zomwe zikuwonetsa kuti kusintha kwam'mwambazi kwachitika. Zizolowezi zosokoneza bongo kenako amakhala osazindikira komanso ozolowera.
- Kutanthauzira kwatsopano kumathetsa kusiyanitsa kwakale ndi "kukakamiza motsutsana ndi kukakamiza", komwe nthawi zambiri kunkagwiritsidwa ntchito kutsutsa kukhalapo kwa zizolowezi zamakhalidwe, kuphatikiza zolaula pa intaneti.
Mosiyana ndi ubongo wa juga, chakudya, masewera a videogame, maubongo azakugonana / zolaula sadawunikidwebe. Komabe makina opanga bongo omwe ali ndi chizolowezi chamakhalidwe afotokozedwa kale bwino, momwe akatswiri amatha kunena motsimikiza kuti zizolowezi zakugonana nawonso zimatha kukhala zosokoneza. Mwanjira ina, si mawonekedwe kapena kuchuluka kwa cholimbikitsira, koma ubongo womwe umabweretsa umasintha, zomwe zili zofunika. Izi zochokera pamafunso a ASAM zimafotokozera za sayansi yomwe imakonda kuzolowera:
FUNSO: Nchiyani chosiyana ndi tanthauzo latsopanoli?
YANKHO: Kale kwambiri nthawi zambiri anthu ankaganizira kwambiri zinthu zokhudzana ndi chizolowezi choledzera, monga mowa, heroin, chamba, kapena cocaine. Tanthauzo latsopanoli likuwonetsa momveka bwino kuti chizolowezi sichokhudza mankhwala osokoneza bongo, koma ubongo . Si zinthu zomwe munthu amagwiritsa ntchito zomwe zimamupangitsa kukhala chizolowezi; si kuchuluka kapena kuchuluka kwa kugwiritsa ntchito. chizolowezi ndi zomwe zimachitika muubongo wa munthu akakumana ndi zinthu zabwino kapena makhalidwe abwino, ndipo chimachitika kwambiri ndi mayendedwe a mphotho muubongo ndi kapangidwe ka ubongo kogwirizana ndi izi osati za mankhwala akunja kapena khalidwe lomwe "limayambitsa" mayendedwe a mphotho. (Kugogomezera kwawonjezeredwa.)
Anthu omwe ali ndi zizolowezi zoledzera ali ndi kusintha kwa ubongo komwe kumachitika kawirikawiri, komwe kumawonekera m'makhalidwe monga kuyesa kosapambana kulamulira kugwiritsa ntchito, chilakolako panthawi yodziletsa, komanso zizindikiro zosiya kugwiritsa ntchito. Mpaka pano, kusintha kwa ubongo komwe kumawonedwa mwa anthu onse omwe ali ndi zizolowezi zoledzera (kusadziletsa, kusadziletsa, ndi kusadziletsa) kwawonedwa kale mu ubongo wa anthu omwe amatchova juga mopitirira muyeso, odya mopitirira muyeso, komanso osewera makanema. N'zotheka kuti kuliponso mwa ogwiritsa ntchito zolaula zomwe zimawavuta masiku ano. Ngati ikuyenda, kulankhula ndikuchita ngati bakha, ndi bakha. (Zosintha: Yunivesite ya Cambridge: Kusanthula ubongo kukupeza chizolowezi cha zolaula )
Chinthu china chomwe chimachokera ku mawu a ASAM ndichakuti munthu sangatanthauze "chizolowezi choonera zolaula" poganizira nthawi yomwe amathera akuonera kapena mitundu ya anthu omwe amaonera. Chizolowezi cha kugonana chimakhalapo pokhapokha ngati kusintha kwa ubongo komwe kwachitika kwachitika mwa wowonera . Popeza kusanthula ubongo sikungatheke, ASAM yapanga kuwunika kwa magawo 5 kuti ithandize anthu kudziwa ngati ubongo wawo wasintha. Izi zikufanana ndi kuwunika zizindikiro za matenda a shuga mwa odwala omwe akudandaula ndi zizindikiro zodziwika.
Mafunso otsatirawa otsatirawa kuchokera ku ASAM amalankhulana ndi kugonana ndi zakudya zowonongeka makamaka:
FUNSO: Kutanthauzira kwatsopano kumeneku kumatanthauza kuledzera kumatchova, chakudya, ndi chiwerewere. Kodi ASAM amakhulupiriradi kuti chakudya ndi kugonana ndizovuta?
YANKHO: Chizolowezi cha kutchova juga chafotokozedwa bwino m'mabuku asayansi kwa zaka zambiri. Ndipotu, kope laposachedwa la DSM (DSM-5) lidzalemba matenda a kutchova juga m'gawo lomwelo ndi matenda ogwiritsira ntchito mankhwala osokoneza bongo.
Tanthauzo latsopano la ASAM likusiyana ndi kuyerekeza chizolowezi ndi kudalira mankhwala osokoneza bongo, pofotokoza momwe chizolowezi chimagwirizanirananso ndi makhalidwe omwe amapindulitsa. Iyi ndi nthawi yoyamba kuti ASAM itenge udindo wovomerezeka kuti chizolowezi si "kudalira mankhwala osokoneza bongo" okha.
Tanthauzo ili limati kuledzera kumakhudza kugwira ntchito ndi kayendedwe ka ubongo komanso momwe kapangidwe ndi ntchito ya ubongo wa anthu omwe ali ndi chizolowezi zimasiyanirana ndi kapangidwe ndi ntchito ya ubongo wa anthu omwe alibe chizolowezi . Limalankhula za kayendedwe ka mphotho mu ubongo ndi kayendedwe kogwirizana, koma kutsindika sikuli pa mphotho zakunja zomwe zimagwira ntchito pa dongosolo la mphotho. Chakudya ndi machitidwe ogonana ndi machitidwe a juga zitha kugwirizanitsidwa ndi "kufunafuna mphotho" komwe kwafotokozedwa mu tanthauzo latsopanoli la chizolowezi. (Kugogomezera kwawonjezeredwa.)
FUNSO: Ndani ali ndi chizolowezi cha zakudya kapena chizolowezi chogonana?
YANKHO: Tonsefe tili ndi njira yopezera mphotho muubongo yomwe imapangitsa chakudya ndi kugonana kukhala kopindulitsa. Iyi ndi njira yopulumukira. Muubongo wathanzi, mphotho izi zimakhala ndi njira zoyankhira zomwe zimapangitsa munthu kukhuta kapena 'kukwanira.' Kwa munthu amene ali ndi chizolowezi choledzera, njira yopezera mphotho imakhala yosagwira ntchito kotero kuti uthenga kwa munthuyo umakhala 'wochulukirapo', zomwe zimapangitsa kuti munthu ayambe kufunafuna mphotho ndi/kapena mpumulo pogwiritsa ntchito zinthu ndi makhalidwe.
Mwachidule, chizolowezi chogonana chilipo, ndipo chimayamba chifukwa cha kusintha komweko kwa kapangidwe ka ubongo ndi kagwiridwe kake ka thupi monga chizolowezi chogwiritsa ntchito mankhwala osokoneza bongo. Izi ndizomveka bwino. Kupatula apo, mankhwala osokoneza bongo sachita chilichonse koma amawonjezera kapena kuchepetsa ntchito zachibadwa za thupi. Amalanda ma neural circuits kuti alandire mphotho zachilengedwe, kotero ziyenera kuonekeratu kuti mitundu yoopsa ya mphotho zachilengedwe (zakudya zopanda pake, zolaula za pa intaneti) zimathanso kulanda ma circuits amenewo.
Bwanji ponena za zolaula?
Opereka chithandizo chamankhwala amasiku ano ndi olemba nkhani zodziwika bwino nthawi zambiri amasocheretsedwa za zoopsa zogwiritsa ntchito zolaula pa intaneti—chifukwa chakuti amadziwa kuti kudziseweretsa maliseche (popanda zolaula) sikungoyambitsa chizolowezi. Vuto ndilakuti, zolaula pa intaneti si kungoseweretsa maliseche . Chikhulupiriro chakuti kudziseweretsa maliseche ndi zolaula pa intaneti ndizofanana chimasonyeza kusamvetsetsa zotsatira za ubongo zomwe zingachitike chifukwa cha zinthu zatsopano nthawi zonse. Nthawi zambiri, kudziseweretsa maliseche kumabweretsa kumva kukhuta. Mosiyana ndi zimenezi, zolaula pa intaneti zimatha kugonjetsa kukhuta kwachilengedwe. Mu ubongo wina, kupitirira kukhuta kwachilengedwe ndi kusonkhezera kwambiri ndiko kutsetsereka kwa kusintha kwa ubongo komwe kumabwera chifukwa cha chizolowezi. Kusamvetsetsana kumeneku kumabweretsa upangiri wosayenerera kwa odwala/makasitomala/owerenga.
Zovuta zakufufuza
Akatswiri ofufuza tsiku lina amafufuza za ubongo wa anthu ochita zolaula pa intaneti, ndithudi amawona kusintha komwe kumachitika kale m'mabungwe ena a intaneti. Tsoka, kufufuza zolaula kumayang'anizana ndi mavuto aakulu:
1. Magulu olamulira amuna, osagwiritsa ntchito intaneti sangapezekenso, ndipo ngakhale atakhala otheka, mabungwe owunikiranso sangavomereze malamulo omwe amawafuna kuti aziwonera zolaula kwa maola ambiri patsiku anyamata amasiku ano akuyang'ana.
2. Mafunso osamveka bwino (mosiyana ndi kusanthula kwaubongo) zimapangitsa kuti zikhale zovuta kwa ogwiritsa ntchito zolaula kulumikiza zovuta zakugonana (kapena nkhawa zamagulu, kukhumudwa kapena mavuto azithunzithunzi) pogwiritsa ntchito zolaula pa intaneti. Kupatula apo, zolaula zimawoneka ngati aphrodisiac yodalirika kwambiri padziko lonse lapansi, ndipo ogwiritsa ntchito amakhala akumva bwino akamagwiritsa ntchito. Zingayambitse bwanji mavuto omwe amachiritsa kwakanthawi?
Pokhapokha podziwa zambiri za kuledzera, zizindikiro zake, ndi chidziwitso chake, okhoza kufufuza ndi omvera awo akhoza kulumikizana molondola. Mawu a ASAM amathandiza ochita kafukufuku wofufuza zolaula pogwiritsa ntchito malingaliro a ubongo.
Achipatala ali ndi maudindo atsopano
Kulengeza kwa ASAM ndi gawo lopita patsogolo pothandiza kuphunzitsanso othandizira ndi makasitomala awo. Ambiri adaphunzitsidwa molakwika kuti zizolowezi zakugonana sizingachitike chifukwa chofunitsitsa ubongo kudzera pamachitidwe. M'malo mwake, adaphunzitsidwa kutsimikizira makasitomala kuti kuzolowera zogonana sikungakhale pachiwopsezo pokhapokha ngati kasitomala ali ndi zovuta zina (nthawi zambiri zamtundu).
Komabe olemba a ASAM akuti majini ndi omwe amapanga theka la zomwe zimayambitsa chizolowezi. Izi zikutanthauza kuti chizolowezichi chingayambike popanda matenda omwe alipo kale. Mwanjira ina, zizindikiro zokhudzana ndi zolaula monga kupsinjika maganizo, nkhawa, mavuto okhudzana ndi kugonana kwa achinyamata komanso mavuto okhudzana ndi kusamala ziyenera kuonedwa ngati zotsatira za chizolowezichi, m'malo moganiziridwa kuti nthawi zonse ndiye chifukwa chake.
Mfundo yatsopano yokhudza mankhwala osokoneza bongo chifukwa chake imapereka udindo kwa othandizira kuti athandizane pakugonana komanso ogula omwe ali ndi zolaula kuti asinthe momwe amakhalira. Pakadali pano, alangizi ambiri amangotengera makasitomala kwa dotolo kuti akwaniritse mankhwala opatsirana pogonana. Nthawi yomweyo akuwatsimikizira kuti machitidwe awo ogonana ndi achikhalidwe komanso osavulaza.
Mawu a ASAM ndi sitepe yayikulu yopita patsogolo. Mu positi iyi , tikuganizira zizindikiro zenizeni zomwe ogwiritsa ntchito zolaula amanena, zomwe zingasonyeze kusintha kwa ubongo komwe kumachitika chifukwa cha chizolowezi.
- Onani izi kuyambira Meyi, 2013 - National Institute of Mental Health (NIMH): DSM ndi yopanda pake komanso yosatha.