Online Addiction Addiction: O Le Mea Ua Tatou Iloa ma Le Mea Tatou te Leʻi-O se Iloiloga Faʻaletausaga (2019)

LINI I LE SUʻESUʻEGA SUʻESUʻEGA

Falemaʻi. Med. 2019, 8(1), 91; Tui:10.3390 / jcm8010091

Rubén de Alarcón 1 , Javier I. de la Iglesia 1 , Nerea M. Casado 1 ma Angel L. Montejo 1,2,*

1 Auaunaga Fomaʻi, Falemai Clínico Universitario de Salamanca, Institute of Biomedical Research of Salamanca (IBSAL), 37007 Salamanca, Sepania

2 University of Salamanca, EUEF, 37007 Salamanca, Sepania

lē faʻatino

I nai tausaga talu ai, sa i ai se galu o tusiga e fesootaʻi ma vaisu amioga; o nisi oi latou e taulai atu i vaisu i luga o le initaneti. Ae ui i lea, e ui i taumafaiga uma, tatou te le mafai ona faʻamalamalamaina pe a aafia i lenei amioga e faʻaleagaina. O faʻafitauli faʻapitoa e aofia ai: faʻataʻitaʻiga faʻapitoa, o le sailiga mo mea tau vailaʻau, faʻateteleina o le latalata i le mataupu, ma le mea moni e mafai ona aofia ai lenei vaega i totonu o se togafitiga sili atu (e pei o le tagofiaina o feusuaiga) lea e mafai ona faʻaalia i faʻamaoniga eseese. O vailaau faʻaleagaina e fausia ai se vaega tele o le suʻesuʻeina, ma e masani ona faʻaalia se faʻafitauli faʻafitauli faigata: le lava le pulea, faʻaletonu, ma le faʻaogaina le faʻaaoga. O le faʻasolosolo o le vaʻaia e tutusa lelei ma lenei faʻataʻitaʻiga ma atonu e aofia ai le tele o amioga tau feusuaʻiga, e pei o le faʻaaogaina o ponokalafi i le initaneti (POPU). O loʻo faʻagasolo le faʻaaogaina o ponokalafi i luga o le Initaneti, faatasi ai ma se gafatia mo le tagofia o mea ua fai ma vaisu e mafaufau ai i le "tolu tolu A" aafiaga (faʻaaogaina, gafatia, leai se igoa). O lenei faʻafitauli faʻafitauli e mafai ona i ai aʻafiaga leaga i le atinaʻeina o feusuaiga ma le gaioiga o feusuaiga, aemaise lava i le tupulaga talavou. Matou te faʻamoemoe e aoina faʻamatalaga o loʻo i ai i luga o faafitauli faʻaaogaina ponokalafi i luga o le initaneti e faʻaaogaina e avea o se vaega faʻaleaga. O iinei tatou te taumafai e tauaofai mea tatou te iloa e uiga i lenei vaega ma otootoina nisi vaega e talafeagai mo nisi suʻesuʻega.
Keywords: ponokalafi i luga o le initaneti; vaisu; cybersex; initaneti; amioga mataga tau feusuaiga; feusuaʻiga

1. faʻatomuaga

Faatasi ai ma le aofia ai o le "Taaloga Taaloga" i totonu o le "Faaaogaina o mea e faʻaaogaina ma faʻafitauli faʻapitoa" mataupu o le DSM-5 [1], na faʻaalia aloaia e le APA le tulaga o le tagofia o amioga. E le gata i lea, o le "Initaneti Telefoni Faʻatonu" na tuʻuina i totonu Fuaiupu 3-O faʻavae mo suʻesuʻega atili.
O lenei tulaga o le faʻaauau pea o suiga i le faʻalapotopotoga o mea ua fai ma vaisu lea e fesoʻotaʻi ma amioga ua fai ma vaisu, ma ua mafai ona maua ai le auala mo suesuega fou i le malamalama o suiga faaleaganuu ua mafua mai i tekonolosi fou.
E foliga mai o loʻo i ai le neurobiological masani masani [2] ma le siosiomaga [3] eleele i le va o suiga eseese o mea ua fai ma vaisu, e aofia ai le faʻaaogaina o fualaau faʻasaina ma amioga faʻafefete; e mafai ona faʻaalia e pei o se mea e sili atu i luga o nei mea e lua [4].
E masani lava ona faʻaalia e le tagata le faʻafitauli o le faʻafitauli faʻafitauli: faʻavaivaia le pulea (faʻataʻitaʻiga, manaʻoga, taumafaiga le manuia e faʻaitiitia le amio), faʻaletonu (faʻataʻitaʻiga, vavalalata o mea e fiafia i ai, tuulafoaia i isi vaega o le olaga), ma le faʻaaogaina le faʻaaogaina iloa o le faaleagaina o aafiaga o le mafaufau). Pe o nei amioga e ogatasi ma mataupu faavae o le physiological e faatatau i mea ua fai ma vaisu (faapalepale, tosoina) ua sili atu ona taugofie [4,5,6].
O le gasegase o le gasegase e masani ona manatu o se tasi o na mea ua fai ma vaisu. O loʻo faʻaaogaina e avea o se malu puipuia e aofia ai amio faʻalavelave faʻaletonu (televave tuinanau, telefoni feaveai, faʻaaogaina o ponokalafi, telefoni i luga o le telefoni, amioga feusuaʻi ma tagata matutua faʻatagaina, taʻaloga a le kalapu, ma isi) [7]. O lona fua faatatau masani e mai 3% i le 6%, e ui e faigata ona fuafua talu ai e leai se faʻamatalaga aloaia o le maʻi [8,9].
O le le lava o faʻamatalaga faʻasaienisi faʻamalosia e faʻataunuʻuina ana suʻesuʻega, faʻataʻitaʻiga, ma iloiloga, e taʻitaʻia ai le tele o fuafuaga e faʻamatalaina, ae masani ona fesoʻotaʻi ma le tele o mafatiaga, lagona o le maasiasi ma le faʻaletonu o le mafaufau [8], faapea foi ma isi amioga ua fai ma vaisu [10] ma e faʻamaonia le suʻeina saʻo.
I le tulaga tutusa, o le siitia o le tekinolosi fou ua tatalaina ai foi se vaitafe o faafitauli tau vaisu, aemaise lava o le Initaneti. O lenei vaisu atonu e taulaʻi i se faʻamatalaga patino i luga o le initaneti (faʻataʻaloga, fefaʻatauaʻiga, fefaʻatauaiga, cybersex ...) [11] faatasi ai ma le ono mafai ona iai ni amioga e ono lamatia ai-mausa; i lenei tulaga, o le a avea o se auala mo faʻamaoniga manino o lea amio [4,12]. O lona uiga o le faʻateleina o le faʻaleleia, saunia o ni mea fou mo faʻamaʻi faʻapitoa faʻapea foʻi ma tagata faʻaosoosoga (ona o le tele o le le faalauaiteleina, poʻo le avanoa) o le a le faia muamua i nei amioga.
Faaaogaina o ponokalafi i luga o le initaneti, e lauiloa foi o ponokalafi i luga o le Initaneti poʻo le telefoni feaveai, atonu o se tasi o na amioga patino ile Initaneti ma se lamatiaga mo vaisu. E fetaui ma le faʻaaogaina o le Initaneti e auai ai i le tele o galuega faamalieloto [13], o loo i ai le tulaga o le faaaogaina o ponokalafi [13,14] o le mea e sili ona lauiloa [15,16,17] faatasi ai ma se numera le mafaitaulia o mea tau feusuaiga e mafai ona maua [13,18,19,20]. O le faʻaauau pea ona faʻaaogaina i lenei faiga o nisi taimi e maua ai i tupe, faʻamaonia, galuega, ma mafutaga vavalalata [6,21] poʻo faʻafitauli patino, ma aʻafiaga le lelei. Le lagona o le leai o se puleaina ma le faʻaauau ona faʻaaogaina e ui lava i nei aʻafiaga leaga e aofia ai le "faʻamalosia o feusuaiga i le initaneti" [22] poʻo le Faʻafitauli Faʻainitaneti Faʻamatalaga Mataʻitusi (POPU). O lenei faʻafitauli faʻafitauli faʻaaogaina aoga mai le "Triple A" mea [23].
Ona o lenei faʻataʻitaʻiga, o le faʻafefeteina o ponokalafi e mafai ona sili atu ona masani ai i aso nei, ae e le o se faailoga lea o togafitiga [21]. Matou te iloa o se vaega tele o tamaʻitaʻi talavou e maua le Initaneti mo faʻataʻitaʻiga ponokalafi [24,25]; i le mea moni, o se tasi oa latou autu autu mo le soifua maloloina feusuaiga [26]. O nisi ua faaalia le atugaluga e uiga i lenei mea, e fetaui ma le vaelua taimi i le va o mea vevela ua faʻaaoga mo le taimi muamua lava, ma o se mea muamua na tupu i feusuaiga; aemaise lava, pe faʻapefea ona iai se aafiaga o le tagata muamua ile atinaʻeina o feusuaiga [27] e pei o le le maualalo o le manao i feusuaiga ao faʻaaogaina ponokalafi i le initoneti [28] ma le faʻaaogaina o le erectile, lea na faʻateleina i alii talavou i nai tausaga talu ai pe a faatusatusa i se ulugalii i le tele o tausaga talu ai [29,30,31,32,33].
Na matou iloiloina ma le faʻaleleia ia tusitusiga o loʻo i ai i luga o le mataupu o le POPU e taumafai e otooto faʻataʻitaʻiga lata mai na faia i faʻamatalaga o le epidemiology, faʻamaoniga faʻapitoa, neurobiological faʻamaoniga e lagolago ai lenei faiga o faʻafitauli faʻafitauli, lona faʻamalamalamaga o faʻamatalaga e fesoʻotaʻi ma le faʻafitauli o feusuaʻiga, o lana fuafuaga fuafuaina mea faigaluega ma togafitiga togafitiga.

2. Metotia

Na matou faia le iloiloga faʻaletolo e mulimuli i taiala a le PRISMA (Ata 1). Talu ai ona o le tino fou o molimau e uiga i lenei mataupu, sa matou faia la matou iloiloga e aunoa ma se taimi patino-faʻasalaga. O le faʻamuamua na tuʻuina i luga o iloiloga faʻalautelega ma tala na lolomiina e ala i se auala sili ona fou i le pito i sili ona tuai, sili ona fiafia i ai mo faʻamatalaga ua lolomiina i luga o le mataupu. PubMed ma Cochrane o faʻamaumauga autu ia na faʻaaogaina, e ui lava o nisi o tusiga na tuufaatasia e ala i faʻasalalauga.
Jcm 08 00091 g001 550
Ata 1. PRISMA faʻataʻitaʻi le ata.
Talu ai ona o le tatou taulaiga e masani lava i luga o luga o luga o luga o le initaneti ma amioga tau feusuaʻiga, na tatou vavaeese ai na tala na o se faʻalapotopotoga faʻapitoa i le tatou sailiga: oi latou o loʻo taulaʻi atu i vaisu i luga o le initaneti, o mea e faʻaoga i luga o le ponokalafi tutusa o fesuiaiga eseese, ma i latou faʻalatalata i le mataupu mai se vaʻaiga lautele.
O faʻamatalaga o loʻo mulimuli mai ma o latou mea na faʻaaogaina sa faʻaaogaina i le tele o faʻapotopotoga: cybersex, porn * (e mafai ai mo "ponokalafi" ma "ponokalafi"), o mea ua fai ma vaisu * (ia mafai ai ona "vaisu" ma "vaisu"), initaneti, internet , faʻafeusuaiga, faʻafeusuaiga, faʻafeusuaiga. O le mea e faʻaaogaina ai le faʻatautaia o Zotero na faʻaaogaina e fausia ai se faʻamaumauga o mataupu uma e talanoaina.

3. Iʻuga

3.1. Epidemiology

O faʻataʻitaʻiga o ponokalafi i le faitau aofaʻi o tagata ua faamaonia le faigata ona fuaina, aemaise lava talu mai le osofaʻiga o le Initaneti ma le "tolu tolu A" mafuaʻaga na mafai ona faʻaogaina e le gata i le tagata lava ia ae faigofie ona maua. O suʻesuʻega a Wright e uiga i le faʻaaogaina o ponokalafi i le faitau aofaʻi o tagata Amerika e faʻaaoga ai le Suʻesuʻega lautele lautele (GSS) [34], ma le suʻesuʻega a le Tau (lea e faʻalauteleina i luga o Wright e ala i le iloga o le matua, faʻapitoa, ma vaitaimi o aʻafiaga) [35] e aofia ai nisi, pe afai e le na o le pau, o punaoa o loo i ai nei e matamata i ponokalafi e faaaoga i le faitau aofai o tagata. Latou te faʻaalia le faateleina o le faʻaaogaina o ponokalafi i le tele o tausaga, aemaise lava i le tamaʻitaʻi o loʻo faʻatusatusa i tamaʻitaʻi. O lenei mea e sili ona taatele i le tupulaga talavou, ma o loʻo faʻaititia ma le matua.
O nisi mea taua e uiga i faanaunauga o taumafa ponokalafi e tu ese. O se tasi o ia mea, o le 1963 ma le 1972 male 'auʻaunaga na faʻaalia se laʻititi laʻititi i lo latou faʻaaogaina mai le tausaga 1999 i luga, ma fai mai o le faʻaaogaina o porn i nei vaega ua tumau pea ona tumau talu mai [35]. O le isi o le 1999 o le tausaga foi lea e tolu taimi e foliga mai ai o le 18 i le 26 mo le faʻaaogaina o ponokalafi e sili atu nai lo le 45 i le 53, nai lo le naʻo le lua taimi e foliga mai e masani ona oʻo i lena taimi [35]. O nei mea moni e lua e mafai ona fesoʻotai i suiga fesuisuiai i ponokalafi o taumafa na faaosofia e tekinolosi (suiga mai le tuusao i le initaneti o le taumafa), ae e le mafai ona iloa lelei talu mai le faʻamatalaga muamua e leʻo iai ni eseesega i offline ma online eseesega pe a faʻaaogaina ponokalafi faʻaaogaina.
Ae mo le POPU, e leai se faʻamatalaga manino ma le mautinoa i tusitusiga ua toe iloiloina ma e mafai ona ofoina atu se fua faʻatatau o lona faʻaogaina. Faʻaopoopo i faʻauiga ua uma ona taʻua ona o le le lava o faʻamaumauga i luga o faʻataʻitaʻiga o ponokalafi lautele, o se vaega e ono mafua mai i le natura le talafeagai o le autu i le taimi e mafai ai e tagata auai, le tele o meafaigaluega faʻaleaogaina e le au suʻesuʻe, ma le leai o se maliega i luga o le mea moni e aofia ai le faʻaleagaina o le faʻaaogaina o ponokalafi, lea o mataupu uma ua toe iloiloina atili i lenei pepa.

O le tele lava o suʻesuʻega e uiga i le POPU poʻo le faʻafeusuaiga faatauafafine e masani ona faʻaaogaina faʻataʻitaʻiga e fua ai, masani ona maua, e ui lava i eseesega o tagata, e toaitiiti lava tagata e manatu o lenei amioga o se vaisu, ma e tusa lava pe latou te faia, e itiiti lava e manatu e mafai ona leaga aoga i latou. O nisi faʻataʻitaʻiga:

(1) O se suʻesuʻega suʻesuʻega o vaisu amioga i totonu o tagata faʻaaoga, ua maua ai e na o le 9.80% mai i le 51 tagata na auai na latou manatu e iai a latou vaisu i feusuaiga poʻo ponokalafi [36].

(2) O se Suʻesuʻega Suetena na suʻeina se faʻataʻitaʻiga o le 1913 tagata auai e ala i se fesili i luga o le upega tafaʻilagi, 7.6% na lipotia mai nisi o feusuaiga i le Initaneti ma 4.5% ua faailoaina le lagona o le 'gauai' i le Initaneti mo le alofa ma le faʻafeusuaiga, ma o se 'faafitauli tele' [17].

(3) O se suʻesuʻega Sipaniolo faʻatasi ma se faʻataʻitaʻiga o tamaiti aʻoga kolisi o 1557 na latou iloaina o 8.6% na i ai se lamatiaga i le atinaʻeina o se faʻaleagaina o le faʻaaogaina o ponokalafi i luga o le initaneti, ae o le faʻaoga masani o le faʻaleagaina o tagata o 0.7% [37].

Naʻo le suʻesuʻega faʻatasi ma se faʻataʻitaʻiga faʻataʻitaʻiga i le aso o se tasi o Ausetalia, faʻatasi ai ma se faʻataʻitaʻiga o sui 20,094; 1.2% o fafine na suʻesuʻeina na latou manatu e fai ma vaisu, ae mo alii o 4.4% [38]. O sailiiliga tutusa e faatatau foi i amioga feusuai i fafo atu o ponokalafi [39].
Faigafaiva mo faafitauli o amioga tau feusuaʻiga ma ponokalafi e faʻaaoga, e aofia ai le faitau aofaʻi o tagata: o le tagata, talavou, lotu, faʻaaogaina i luga o le Initaneti, lagona le lelei, ma le masani ai i feusuaiga, ma le sailiili malosi [17,37,40,41]. O nisi o nei aʻafiaga faʻafitauli e faʻasoa foi e tagata gasegase o gaioiga [39,42].

3.2. Ethiopathogenical ma Diagnostic Faʻamatalaga

O faʻataʻitaʻiga amioga faʻaleagaga e faʻaauau pea ona avea ma luitau i aso nei. E ui ina tele ni taumafaiga na faia e uiga i amioga feusuaʻi, o le le lava o faamaumauga e pei o le taimi nei ua faamalamalama mai ai le mea moni e leai se maliega autasi i lenei mataupu [9]. O le POPU e aofia ai se vaega faapitoa o amio feusuaiga e aofia ai tekinolosi. Ona o le faʻaaogaina o tekonolosi (aemaise lava i luga o tekonolosi i luga o le initaneti) e le o toe mamao, e tatau ona tatou muamua talanoa e uiga i amioga feusuaʻi e le fesoʻotaʻi ma tekinolosi ina ia malamalama i le nofoaga o ponokalafi i luga o le initaneti.
O feusuaiga e pei o se amio e tele naua le eseesega, ma o lona itu e ono mafai ai ona suʻesuʻeina mo le tele o seneturi [43]. O le mea lea, o le a avea ma luitau i faʻataitaiga taumafai e faʻamalamalamaina lelei, talu ai e mafai ona faʻaaogaina faiga faʻavae mai le tuulafoaiina o mea taufaaleaga i feusuaiga mataga [21]. E faigata foi ona faʻamatalaina le mea o loʻo i ai se mea e faʻaleagaina ma pulea e aloese ai mai le faʻaaoga sese o lena faʻamalamalamaga e faʻaleagaina ma faʻamaonia ai tagata taitoatasi [44]. Mo se faʻataʻitaʻiga, o nisi e faʻatapulaʻa le va o amio masani ma amioga faʻafeusuai i le sili atu i le fitu orgasms i le vaiaso [43] (p. 381), ae o lenei auala e taulai atu i le tele e mafai ona matautia, aua o mea e aofia ai amio masani ma le faʻaleagaina e mafai ona matua fesuisuiaʻi i le va o tagata taʻitoʻatasi. O le leai o se laugatasia ma le tumau i lona faʻavasegaga e mafai ona taofia ai suʻesuʻega i le lumanaʻi e uiga i le suʻesuʻeina o amioga feusuaʻiga faʻafeusuaiga [45] ma le amanaia uiga taua e taulai atu i lagona le lelei e fesootai ma [46,47]. Ua i ai fuafuaga e toe faaola lenei lomiga e faʻaaoga ai nisi meafaigaluega, ua uma ona atiaʻe e avea o se vaega o le togafitiga o gasegase faʻafeusuaiga faʻaaogaina i le faamasinoga DSM-5 [43,47].
O le tauafafine e masani ona galue o se faamalu e fausia [7]. O lona igoa o le a avea pea ma mataupu o fefinauaiga seia oo mai i le aso, ma e masani ona fetaiai ma le tele o faaupuga e faatatau i le manatu lava lea e tasi: amio feusuaʻiga faatautala, vaisu o feusuaiga, feusuaʻiga i feusuaiga, amioga feusuaʻiga po o le feusuaʻi. O nisi tusitala, ao latou iloa le taua o le faaupuga "vaisu" ma le "faamalosi", e manao e tosina atu i le mataupu o le puleaina ma lona leiloa po o le maliega fetuutuunai e avea ma popolega muamua e uiga i lenei amioga, ma faapea ai o le "le pulea amioga feusuai "[45,48,49].
E ui o faʻauigaga e le tutusa, e masani ona latou taulai atu i le televave poʻo le malosi o faʻamaoniga [46] o isi tu masani ma masaniga, o le a mafua ai ona le afaina. O lenei mea e ese ai mai amioga faʻafeusuaiga faataʻitaʻi, e ui o le manaʻomia mo se faʻamalamalamaga sili atu o eseesega eseese, mea tutusa, ma le sologa lelei i le va o ituaiga e lua o loʻo tumau pea [45].
E masani ona aofia i amioga feusuaʻiga, o le faʻateleina o le faʻafeusuaiga ma le tele o amioga faʻafeusuaiga, e pei o le faʻalagolago atu i feusuaiga e le masani ai, faʻalapotopotoga faʻafeusuai, ponokalafi i luga o le initaneti, telefoni i luga o le telefoni,43,44,49,50,51]. Na manatu faapitoa Bancroft e faapea, i le faʻaaogaina o le Initaneti, e mafai ona faʻafefiloi e le tamaʻitaʻi ia mea uma e fai, ma faʻamatalaina o tagata e "faʻaaogaina e pei o le toeitiiti le faʻapulaaina o le latou amio mai le puleaina o amioga masturbatory".
E ui o le avanoa e iloa ai uiga feusuaʻiga e maua i taimi uma ma le "faʻafitauli o feusuaiga ae leʻo faʻamaonia" ile DSM [1], Kafka [43] taumafai e faʻaaogaina e avea o se vaega o suʻesuʻega mo le DSM-5. Na ia tuʻuina atu se seti o taʻiala mo ia, o se vaega o le feusuaʻiga mataupu. O nei faʻataʻitaʻiga na aofia ai amioga feusuaʻi e pei o le: (1) faʻafeusuaiga, (2) o se vailaʻau faʻatusa, (3) o se vaega o le maʻi o le spectrum-compulsive, (4) vaega o le impulsivity-spectrum disorders, ma (5) a " ese mai le pulea "le tele o amioga feusuai. O lenei talosaga na iu lava ina teena ona o mafuaaga; o le autu na fai mai o le leai o ni faʻamaoniga faʻamaʻi faʻamaʻi ma le faʻamalosia o faʻamaumauga e uiga i lenei amioga [52,53], ae faʻapea foi lona mafai mo le faʻaleagaina o mea faʻapitoa mo togafitiga, o se tulaga e le lava le maʻoti o faʻamaoniga, ma le malosi o le faʻapolokiki ma faʻalapotopotoga o le faʻamalosia o se vaega taua o le amio i le ola o le tagata [54]. E manaia le faatusatusa i le isi lua seti o mataupu muamua o loʻo tuʻuina atu i tusi na faʻasalalau, o Patrick Carnes ma Aviel Goodman [9]. O vaega uma e toatolu o loʻo faʻamatalaina le leai o se faʻataʻitaʻiga, le tele o le taimi na faʻaaluina i amioga feusuaʻi ma taunuuga le lelei ia te oe / isi, ae faʻasolo i isi elemene. E atagia mai ai i le lautele lautele le leai o se maliega i le faʻamalamalamaina o uiga feusuaʻi i le gasologa o tausaga. I le taimi nei, o filifiliga autu e aofia ai amioga feusuaʻiga e pei o se faʻafitauli o le manava o le manaʻo poʻo se vaisu amio [55].
Mai i se faʻaletonu o le le mautonu o le mafaufau, o uiga feusuaʻiga e masani lava ona taʻua o le mamafa o amioga faʻafeusuai (CSB). Coleman [56] o se lagolago i lenei manatu. E ui na ia aofia ai amioga faʻataʻitaʻi i lalo o lenei fuaitau [57], ma atonu latou te nonofo faʻatasi i nisi tulaga, na te vaʻaia manino mai i le CSB nonparaphilic, o le mea tatou te fia taulai i ai i lenei iloiloga. O le mea e mataʻina ai, o amioga faʻafeusuaiga e le masani ai ma le faʻamalosi e masani ona masani, pe a le sili atu, nai lo nisi o paraphilias [43,58].
E ui lava i lea, o faʻamatalaga lata mai nei o le CSB e masani lava ona taʻua le tele o amioga tau feusuaʻiga e mafai ona faʻamalosi: o le mea e masani ona lipotia o le faʻafefeteina, mulimuli mai i le faʻaaogaina o ponokalafi, ma le ola faʻatasi, ola malosi, ma le tele o mafutaga (22-76%) [9,59,60].
E ui lava o loʻo i ai ni faʻamatalaga manino i le va o le feusuaʻi ma tulaga e pei o le le mautonu-faʻamalosia o le maʻi (OCD) ma isi faʻafitauli o le pulea o le manaʻo [61], o loʻo i ai foi nisi eseesega iloga na faʻaalia: mo se faʻataʻitaʻiga, o amioga a le OCD e le aofia ai le taui, e le pei o amioga tau feusuaiga. E le gata i lea, a o le auai i faʻamalosi e mafai ona maua ai se fesoasoani tumau mo tagata maʻi OCD [62], o amioga feusuaʻi e masani lava ona fesootaʻi atu i le taʻusalaina ma le faanoanoa ina ua uma ona faia le mea [63]. E le gata i lea, o le le mautonu e mafai ona puleaina ai amioga a le tagata maʻi i nisi o taimi e le ogatasi ma le fuafuaina ma le faʻaeteete lea e manaʻomia i nisi taimi i le CSB (mo se faʻataʻitaʻiga, e tusa ai ma se feusuaʻiga)64]. E manatu le tagata lelei o le le atoatoa o mea ua fai ma vaisu e taoto i le vaeluaina o faamaʻi faamalosi (lea e aofia ai le faaitiitia o le popole) ma le le fiafia (lea e aofia ai le faamalieina), faatasi ai ma faailoga o lo o faavae e neurobiological mechanisms (serotoninergic, dopaminergic, noradrenergic, ma opioid systems)65]. Stein e ioe i se faʻataʻitaʻiga e faʻapipiʻiina ai le tele o metotiapathogenical mechanisms ma faʻatulagaina se faʻataʻitaʻiga ABC (faʻaleagaina o le dysregulation, vaisu amioga, ma le mafaufau faʻamalosi) e suʻesuʻe lenei faalapotopotoga [61].
Mai se amioga o mea tau vaisu, o le feusuaiga faataʻitaʻi e faalagolago i le faasoaina atu o vaega taua o mea ua fai ma vaisu. O nei tulaga, e tusa ai ma le DSM-5 [1], silasila i le faʻataʻitaʻiga o le faʻaaogaina o le faʻaaogaina o le faʻaaogaina o amioga faʻafeusuaiga, e le gata i le tuusao ma le initaneti6,66,67]. O faʻamaoniga o le faapalepale ma le alu ese mai i nei tagata gasegase masalo atonu o le a avea ma autu i le faʻamalamalamaina o lenei vaega o se maʻi o mea ua fai ma vaisu [45]. Faʻafitauli faʻapitoa o le cybersex e masani ona faʻatinoina faʻapitoa e fai ma vaisu amioga [13,68].
O le faaupuga "vaisu" o loʻo faʻaoga i lenei vaega e tumau pea i le finauga tele. Ua manatu Zitzman o le tetee i le faaaogaina o le faaupuga vaisu o le "sili atu ona atagia mai o le agaalofa masani faalefeusuai ma le gauai atu nai lo le le lava o faailoga ma le iloa o fesootaiga ma isi ituaiga vaisu" [69]. Ae ui i lea, o le faaupuga e tatau ona faʻaoga ma le faʻaeteete, talu ai e mafai ona faʻamatalaina o se faʻamaoniga mo se sailiga le talafeagai mo le faamalieina ma le fiafia, ma tuuaia ai le faʻaleagaina o taunuuga.
Ua leva ona i ai se finauga i le va o Patrick Carnes ma Eli Coleman i luga o suega o amioga feusuaʻi. O le manatu o Coleman o le feusuaʻiga e tatau ona tulituliloaina e le manaʻoga e faaitiitia nisi ituaiga o popolega, ae le o manaoga faalefeusuaiga [56] i le faʻasalalauina i vaega e fitu (o se tasi oi latou o loʻo faʻaaogaina ponokalafi i luga o le initaneti) [57], aʻo Carnes (o le faʻamalamalamaina o mea ua fai ma vaisu "o se sootaga faʻaleagaina ma se faʻavasegaga o le suia o lagona)" e maua ai faʻataʻitaʻiga i isi amioga faʻafeusuaiga e pei o taaloga petipeti, e taulai atu i le le lava o le pulea ma le amio faifai pea e ui i taunuuga le lelei [70].
O se iloiloga maeʻaeʻa o tusitusiga mai Kraus [71], na faʻauʻuina e ui lava i nei faʻatusa, o gaioiga iloga i le malamalamaga o le faʻamalamalamaga e aʻafia ai lona faʻavasegaga o se mea ua fai ma vaisu. O popolega autu e taulaʻi i le tele o le faʻateleina o faʻatelega, faʻamaumauga umi ma faʻamatalaga (faʻamalamalamaina faʻamaoniga autu ma ona faʻataʻitaʻiga), lagolagoina e neuropsychological, neurobiological, ma faʻamaumauga faʻasolo, ma nisi faʻamatalaga e uiga i togafitiga togafitiga ma puipuiga, ma e faasino atu i tekinolosi faʻainitaneti i amioga feusuaʻi e avea o se mea taua mo suʻesuʻega i le lumanaʻi.
O le siitia o le Initaneti e faateleina ai avanoa mo fesootaiga tau feusuaiga, ae le na o luga o ponokalafi i luga o le initaneti (webcamming, sosaiete feusuaiga). E tusa lava poʻo le faʻaaogaina o le Initaneti e fai ma sui o se alavai mo isi ituaiga o amioga faifai pea (faʻataʻitaʻiga, amioga tau feusuaiga poʻo taaloga faitupe) poʻo le avea o se isi itutino i lona lava aia tatau o loʻo finau pea [72]. Ae ui i lea, afai o le mataupu na muamua, o le faʻamaoniga muamua ma iloiloga e mafai ona faʻaoga lelei i luga ole laiga i le initaneti.
O loʻo i ai nei se manaʻoga mo ni faʻamaumauga faʻapitoa e mafua mai i mea taua e faʻaalia ai luga o luga o le initaneti (vavalalata) amioga feusuaʻi, talu ai o le toʻatele oi latou e leai se laina tuusaʻo e mafai ona faʻatusatusa i [73]. I le taimi nei, o loʻo i ai faʻamatalaga o mea fou fou pe a feagai ma amioga faʻafeusuaiga i luga o le initaneti, e pei o le i ai o le faʻaogaina o le initaneti [74], lea e mafua ai ona "taofia le mafaufau ma faalelagona pe a fai, faatasi ai ma taimi fetuutuunai ma le faalumaina". O lenei vavaeesega ua maea ona faamatalaina e faatatau i isi gaoioiga i le initaneti [75], lea e lagolago ai le manatu e mafai ona fesootaʻi le faafitauli o le cybersex i le initaneti ma le tagofia o feusuaiga [76].
Ma le mea mulimuli, e tatau ona tatou taʻua o se vaega o le mafaufau ua taua o le "le atoatoa o le amio feusuai" ua aofia ai i le lomiga o le ICD-11 i le lumanai o loo i luma, i le "faafitauli faaletonu o le mafaufau" mataupu [77]. O le faʻamatalaga e mafai ona faʻatalanoa i https://icd.who.int/dev11/l-m/en#/http%3a%2f%2fid.who.int%2ficd%2fentity%2f1630268048.
O le aofia ai o lenei vaega i le ICD-11 atonu o se tali i le talafeagai o lenei lomiga ma faʻamaonia i lona aoga aoga, ae o faʻamatalaga faʻatupulaia ae le aofia ai e taofia ai i tatou mai le vaʻaia lelei o le maʻi o le mafaufau [72]. E talitonuina le tuʻuina atu o se meafaigaluega sili atu (ae i le faʻaleleia o le faagasologa) mo le faʻatalanoaina o manaʻoga o togafitiga e sailia ai tagata gasegase ma le faʻasalaga e ono aʻafia ai [78], ma e mafai foi ona atagia ai felafolafoaiga faifai pea e faatatau i le tuʻufaʻatasia talafeagai o le CSB ma lona aofaʻiga o faʻamaumauga i nisi vaega [55,71] (Laulau 1). O lenei aofia ai e mafai ona avea ma laasaga muamua agai i le iloaina o lenei mataupu ma faʻalauteleina, o se tasi o autu autu o le masalosalo o ona ata tusi ata i luga o le initaneti.
Laulau 1. DSM-5 ma le ICD-11 faʻapitoa i le faʻavasegaina o amioga feusuaʻi.
laulau

3.3. Faʻailoga o Falemaʻi

O faʻamatalaga faʻapitoa o le POPU e mafai ona aoteleina i ni vaega taua se tolu:

  • Erectile le afaina: aʻo nisi suʻesuʻega na maua ni faʻamaoniga itiiti o le fegalegaleaiga i le va o ponokalafi faʻaaogaina ma le faʻaleagaina o feusuaiga [33], ua fautuaina e isi e faapea, o le siitia o ponokalafi e faʻaaogaina atonu o le vaega sili lea e faamatalaina ai le osofaʻi maualuga o le erectile i le va o tagata talavou [80]. I se suʻesuʻega se tasi, 60% o tagata na gasegase i feusuaiga ma se paaga moni, e leʻi iai se faʻafitauli i ponokalafi [8]. O nisi e finau faapea o le mafuaʻaga i le va o ponokalafi e faʻaoga ma le faʻafeusuaʻiga tau feusuaiga e faigata ona faʻatuina, talu ai e le masani ona maua [81] ma ua fuafua se mamanu suʻesuʻega i lenei itu.
  • O le le fiafia i le mafaufau ma le le fiafia: faʻaaogaina ponokalafi e fesoʻotaʻi ma le le fiafia ma feusuaiga, mo alii ma tamaitai [82], o le sili atu ona faitioina o le tino o le tagata po oa latou paga, faateleina le mamafa o le faatinoga ma le itiiti ifo o feusuaiga [83], i ai le tele o paaga feusuaiga ma auai i amioga tau feusuaʻiga totogi [34]. O lenei aafiaga e faapitoa le maitauina i mafutaga pe a tasi itu [84], i se auala talitutusa lava i le mariuana, faʻaaogaina mea taua e pei o le faalilolilo maualuga [85]. O nei suʻesuʻega e faʻavae i luga o faʻataʻitaʻiga e le faʻaleagaina ponokalafi faʻaaoga, ae o ponokalafi i luga o le initaneti atonu e leai ni aʻafiaga na o ia, pe a avea ma vaisu [24]. E mafai e lenei mea ona faʻamatalaina le sootaga i le va o le faʻaaogaina o ponokalafi faʻataʻitaʻi ma sili atu ona lelei mo tamaitai [86].
  • Comorbidities: amio feusuaʻiga e fesoʻotai ma le le mautonu o le popole, sosoo ai ma le le mautonu o le mafaufau, le faʻaaogaina o vailaʻau ma le faʻaleagaina o feusuaiga [87]. O nei suʻesuʻega e faʻaaoga foi i le POPU [88], faʻatasi ai ma le ulaula tapaa, inu ava malosi poʻo le kofe, vailaʻau faʻasaina [41] ma faʻafitauli faigata faʻaaoga taaloga vitio [89,90].
O le i ai o ni faʻamatalaga faapitoa a le ponokalafi e aofia ai ma se faʻaopoopoga i faafitauli ua lipotia [17]. Ua faʻatalanoa pe a faʻapea o nei faʻafitauli o le aʻafiaga o aʻafiaga o le faʻatautaia saʻo o le cybersex poʻo le mafuaʻaga o mataupu e iloa lelei lava e avea ma vaisu [91].

3.4. Neurobiological Evidence Supporting Addiction Model

O le aoina o faʻamatalaga e uiga i le POPU o se faʻafitauli faigata; faʻamatalaga autu i lenei mataupu ua faʻatapulaʻaina e nai laʻititi laʻitiiti, naʻo tamaʻitaʻi tamaʻitaʻi tamaʻitaʻi ma faʻataʻitaʻiga o fefaʻatauaʻiga [71], ma le le lava o le neuroimaging and neuropsychological studies [4], masalo ona o faʻamatalaga, faʻaletupe ma mea faʻaletonu. E le gata i lea, a o mafai ona mataʻituina ma faʻataʻitaʻiina vailaau vailaau i mea faʻataʻitaʻi, e le mafai ona tatou faia lenei mea ma se vailaau faʻataʻitaʻiga faʻaleagaina; o lenei mea e mafai ona faʻatapulaʻa ai a tatou suʻesuʻega o ona aʻafiaga o le neurobiological [72]. O gaps o le taimi nei e uiga i suʻesuʻega o amioga feusuaʻiga, faʻapea foi ma auala talafeagai mo le tautalagia, e faʻamalamalamaina ma faʻapitoa i le tusi a Kraus [71]. O le tele o suʻesuʻega o loʻo maua i totonu oa tatou suʻesuʻega e aofia ai uiga feusuaʻi, faʻatasi ai ma ponokalafi o se tasi lea o mea e maua mai ai mea faʻapitoa.
O lenei faʻamaoniga e faʻavae i luga o se malamalamaaga faʻalauteleina o le gaioiga faʻasolosolo i suiga ole neuroplasticity e aʻafia ai mea ua fai ma vaisu. O laʻasaga o le Dopamine e tāua tele i lenei faʻafeusuaiga o taui, e pei ona matauina muamua i le frontotemporal dementia ma le pro-dopaminergic medication i le maʻi o Parkinson e fesoʻotaʻi ma amioga tau feusuaiga [92,93].
O le faiga o mea ua fai ma vaisu i ponokalafi i luga o le initaneti e mafai ona faʻateleina e ala i le vave faʻavaveina ma le "supranormal stimulus" (o le taimi na faia e le Nobel winner Nikolaas Tinbergen) lea e aofia ai ponokalafi i le Initaneti [94]. O lenei mea matautia o le a avea ma mea e tupuga mai ai (i lenei tulaga, ponokalafi i le auala e masani ona faʻaumatia i le taimi nei, lona foliga i luga o le initaneti) na faʻaaogaina ai le faʻaalia o le gaosiga o le gaosiga. O le talitonuga e mafai ona faʻagaoioia la matou faiga faʻapitoa masani i faʻamanuiaga maualuga nai lo mea na masani ona maua e augatuaa aʻo tupu mai o matou mafaufau, ma faʻatagaina ai e sui i se faiga o mea ua fai ma vaisu [2]. Afai tatou te mafaufau i le initaneti mai lenei vaaiga, e mafai ona tatou amata vaaia mea e tutusa ma vaisu masani.

O le tele o suiga o le faiʻai na matauina i le vailaau oona e faataatia ai le eleele mo suʻesuʻega i le lumanaʻi o amioga ua fai ma vaisu [95], e aofia ai:

  • Sensitization [96]
  • Faanatinatiina [97]
  • Itu faʻasolosolo e le afaina (hypofrontality) [98]
  • Faʻaleagaina le faʻalavelave faʻalavelave [99]
O nei faiʻai ua suia i mea ua fai ma vaisu ua fesootaʻi ma tagata gasegase i amioga feusuaʻiga po o tagata ponokalafi e ala i suʻesuʻega 40 e uiga i ituaiga eseese: ata faʻasolosolo magnet, electroencephalography (EEG), neuroendocrine, ma neuropsychological.
Mo se faʻataʻitaʻiga, o loʻo i ai ni eseesega manino i le gaioiga i le va o tagata gasegase o loʻo i ai le malosi o feusuaʻiga ma pule, lea e foliga mai i vailaʻau o vailaau. Pe a faʻaalia i ata feusuaʻiga, o mataupu tau feusuaʻiga e faʻaalia ai le eseesega i le va o le manaʻoga (e tusa ai ma le pulea) ma le manaʻo (manaʻoga feusuaiga), e sili atu [8,100]. I se isi faaupuga, i nei mataupu o loʻo i ai le tele o manaʻoga mo na o le faʻaipoipo faapitoa, ae le o le faʻaipoipoina o manaʻoga tau feusuaiga. O le mea lea e faasino atu ai i tatou i le feusuaʻiga ona o ia o se taui [46].
O faʻamaoniga o lenei mea faʻaleaganuʻu e faʻaalia ai le manaʻoga e sili ona lauiloa i le pito i luma o le paʻu [101] ma le amygdala [102,103], o le faʻamaoniga o le faʻalauiloa. Faatoagaina mai i nei itulagi o faiʻai e faʻalauiloa ai le tau tupe [104] ma e mafai foi ona tauaveina se aafiaga talitutusa. E le gata i lea, o loʻo i ai le faitauga maualuga o le EEG i nei tagata faʻapitoa, faʻapea foi ma le faʻaitiitia o manaoga mo feusuaiga ma se paʻaga, ae le mo le faʻafefeina i ponokalafi [105], o se mea e atagia ai foi le eseesega o le lelei o le fausiaina [8]. E mafai ona manatu lenei mea o se faʻailoga o le faanatinati. Ae ui i lea, o suʻesuʻega a Steele e aofia ai le tele o mea faʻaletonu e mafaufau i ai (faʻaauau o le faʻalauteleina o mea, le leai o se suʻesuʻeina o le mafaufau poʻo le tagofia o mea ua fai ma vaisu, le leai o se vaega e pulea, ma le faʻaaogaina o fesili e leʻi faʻamaonia mo le faʻaaogaina o porn) [106]. O se suʻesuʻega a Prause [107], i le taimi lenei ma se kulupu e pulea, faʻapipiʻiina nei sailiga. O le matafaioi o le faaalia o le talileleia ma le naunau i le atinaʻeina o le gasegase i luga o le cybersex ua faʻataʻatia i tamaʻitaʻi o tamaʻitaʻi ma tamaitai [108] ma tamaʻitaʻi faʻafeusuaiga faatauafafine [109].
O lenei manatu faʻaituau i feusuaʻiga e sili ona taua i uluaʻi tagata feusuaʻi ma tagata [110], ae o se faʻasalaga faifaipea ia i latou e faʻaalia ai le faʻaleagaina [111,112]. O lona uiga o le faʻaitiitia o le faʻaogaina o faiga faʻapitoa, atonu o le a faʻafeiloaʻiina e le sili atu o le taʻaloga o le tino [107,113,114]. Talu ai ona o le faʻaaogaina o le taʻavale e aofia i le faʻamoemoeina o taui ma le tali atu i mea fou na tupu, o le faaitiitia o lona gaioiga pe a maeʻa ona faʻaalia o tatou faʻalavelave i le atinaʻeina o amioga masani i fuamauina muamua. O lenei mea e mafua ai ona sili atu le lelei o le fiafia i mea tau feusuaiga [115], lea e ono faʻaalia o ni taumafaiga e foia lea tulaga masani masani ma le faanatinatiina e ala i le sailiga mo nisi (fou) ponokalafi e avea o se auala o feusuaiga, filifilia lenei amioga nai lo le feusuaiga [20].
O nei taumafaiga i le sailia ma le naunautai e mafai ona faʻatalanoaina e ala i le faʻatinoga o le gaioiga o le tino [116] ma le amygdala [117]. Ua lauiloa o le matamataina o ponokalafi i tagata masani e masani ona fesootaʻi atu i gaoioiga sili ona maualuga [99], ae maise lava i le televise [116,118] lea e tele sona sao i le faʻamoemoeina o taui [119].
Ae ui i lea, o le fesoʻotaʻiga i le va o le telefoni ma le muamua o cortex ua faʻaitiitia [103,113]; o se faaitiitia o le fesootaiga i le va o le muamua ma le amygdala ua matauina foi [117]. E le gata i lea, o mataupu tau feusuaʻiga ua faʻaalia ai le faʻaitiitia o le fesoʻotaʻiga i le va o le paluga ma le cortex lobes, faʻapea foʻi ma le le maualalo o mea i nei vaega [120]. O nei suiga uma e mafai ona faamatalaina ai le le mafaia ona pulea amioga faʻafeusuaiga.
E le gata i lea, o mataupu tau feusuaʻiga na faaalia ai le faateleina o le tele o le amygdala [117], e ese mai i latou o loʻo faʻaalia i taimi uma i se vailaʻau, lea e faʻaalia ai le faʻaititia o le amygdala volume [121]; o lenei eseesega e ono mafai ona faamatalaina i le gasegase e ono tupu mai i le vailaʻau. I mataupu tau feusuaʻiga, faʻatupulaia le gaioiga ma le voluma e ono atagia mai ai le faʻafefeteina ma le faʻaaogaina o mea e fai ma vaisu (aemaise lava le lagolagoina o manatu faʻamalosiaga faaosofia) poʻo le aʻafiaga i faʻafitauli masani o le faʻalavelave faʻaleagafesootai,122].
O nei tagata faʻapitoa na faʻaalia foi se tali atu i le atuatuvale, e masani lava o le aufaasālalau e ala mai i le hypothalamus-pituitary-adrenal axis [122] i se auala e foliga tutusa ai na suiga na vaaia i vailaau oona. O nei fesuiaiga atonu o se taunuuga o suiga o le epigenetic i luga o le aufaasālalau faʻasalalau masani e faʻauluina mea ua fai ma vaisu, e pei o le corticotropin-releasing-factor (CRF) [123]. O lenei talitonuga o le epigenetic regulatory o loʻo manatu i le itu o le hedonic ma le anhedonic results behavioral o loʻo aʻafia i se vaega o aʻafiaga o dopaminergic, ma atonu foi isi polymorphisms e faʻafesoʻotaʻi le neurotransmitters [124]. O loʻo i ai foi faʻamaoniga o le maualuga o le necrosis factor (TNF) i mea faʻafeusuaiga, faʻatasi ai ma se faʻamalosiaga malosi i le va o le TNF ma le maualuga o sikuea i fua faʻatatau o feusuaʻiga [125].

3.5. Neuropsychological Testimony

E tusa ai ma faʻaaliga o nei suiga i amioga tau feusuaiga, o le tele o suʻesuʻega o le neuropsychology o loʻo faʻaalia ai nisi o itu le tuusao pe tuusaʻoina i galuega faatino [126,127], atonu o se taunuuga o suiga muamua o cortex [128]. A faʻaaogaina i luga o le initaneti, o le a fesoasoani i le atinaʻega ma le tausiga [129,130].
O faʻamatalaga patino o lenei galuega faʻaletonu e le aofia ai: impulsivity [131,132], malosi o le mafaufau lea e faʻalavelaveina ai aʻoaʻoga poʻo le gafatia e suia le mafaufau [120,133,134], le lelei o faaiuga ma le faia o faaiuga [130,135], le faʻalavelaveina o le mana galue manatuaina [130], le lava o tulafono faatonutonu o lagona, ma le popole tele i le feusuaiga [136]. O nei suʻesuʻega o loʻo faʻamanatuina ai isi mea ua fai ma vaisu faʻaleagaga (pei o le le fiafia i taaloga tau tupe) ma le amio i mea e faalagolago i ai [137]. O nisi suʻesuʻega e feteʻenaʻi ma nei suʻesuʻega [58], ae atonu ei ai ni tapulaa i auala (mo se faataitaiga, laʻititi laitiiti).
Faʻafeiloaʻi i mea e taua i le atinaʻeina o amioga feusuaʻiga ma feusuaʻiga, e iai nisi o latou. E mafai ona tatou mafaufau e uiga i le faʻasolosolo-toe talileleia, lelei le faʻamalosia ma aʻoaʻoga fegalegaleaiga [104,109,136,138,139] i le avea ai ma vaega autu o le tuputupu aʻe o vaisu i vaisu. Ae ui i lea, atonu e iai ni mafuaʻaga o le aʻafiaga autu [140], e pei o: (1) o le matafaioi o le fausiaina o feusuaiga ma le le fiafia e taulimaina i nisi o tagata na muaʻi filifilia [40,141,142,143] pe o se taunuuga o le le mautonu o le amio [144,145] poʻo le faʻasolosolo o le elemene [146], ma (2) faʻataʻitaʻi / aloese mai tuinanau [147,148,149].

3.6. Suʻega

O le tele lava o suʻesuʻega e faʻaaogaina ai mataupu e umi se taimi e faʻaalia ai i ponokalafi i le initaneti [34,81,113,114], o le mea lea o ana faʻaaliga i le falemaʻi ua foliga mai o se taunuuga tuusao ma talafeagai o le auai i lenei amioga faʻaleagaga. Matou te taʻua le faigata i le mauaina o pule e faʻavae ai le afaina, ae o nisi o lipoti o lipoti e taʻu mai ai o le faʻaitiitia poʻo le lafoaia o lenei amio e mafai ona faʻaleleia ai le faʻamalosia o feusuaiga mataga ma le le fiafia i le lotofuatiaifo [79,80] ma e oʻo lava i le toe malosi atoatoa; o lona uiga o le fesuiaiga o le faiai o loʻo taʻua muamua o se mea e mafai ona toe faʻaleleia.

3.7. Meafaigaluega Suesue

E i ai nisi mea e siakiina mo le laugaina o le CSB ma le POPU. Latou te faalagolago uma lava i le faamaoni o le tagata fai fai ma le amio saʻo; atonu e sili atu nai lo suʻesuʻega faʻapitoa o suʻesuʻega o le mafaufau, talu ai o faiga faʻafeusuaiga e aupito sili ona faʻalotomaualalo ona o lo latou tulaga patino.
Mo le feusuaʻiga, o loʻo i ai fesili ninii o le 20 ma suʻesuʻega a le falemaʻi. O nisi o mea e sili ona lauiloa e aofia ai le Suʻega o Suʻega Faʻafeusuaiga (SAST) na fuafuaina e Carnes [150], ma lona lomiga mulimuli ane SAST-R [151], le Inventory Sexual Behavior Inventory (CSBI) [152,153] ma le Faʻaipoipoina o le Faʻafitauli o le Toto i le Vaʻaia (HDSI) [154]. O le HDSI na muaʻi faʻaaogaina mo le suʻesuʻeina o le DSM-5 faʻasalaga o le togafitiga o feusuaʻiga. E ui lava e manaʻomia nisi suʻesuʻega o aʻafiaga faʻapitoa e faʻatatau i taʻiala ma toe teuteuga o togi o le faʻamaʻi, o loʻo umia nei le lagolago aupito sili ona malosi o le mafaufau ma o le meafaigaluega aupito sili lea ona lelei i le fuaina o le feusuaʻiga faʻafeusuaiga [151].
Ae mo ponokalafi i luga o le initaneti, o le meafaigaluega sili ona faʻaaogaina o le Initaneti suega suʻesuʻega ole feusuaiga (ISST) [155]. Iloiloina ni vaega se lima (feusuaiga i luga o le initoneti, amioga i luga o le initaneti-agafesootai, amioga i feusuaiga i luga o le initaneti-vavae ese, feusuaiga i luga o le initaneti ma le fiafia i amioga tau feusuaiga i luga o le initaneti) e ala i fesili 25 dichotomic (ioe / leai). Ae ui i lea, o ona uiga o le mafaufau, e na o le auiliiliina lelei, faatasi ai ma se malosi malosi i le Sipaniolo [156] lea na avea o se mamanu mo suesuega mulimuli [157].
O isi mea faʻapitoa faʻapitoa o faafitauli ia e faʻaaoga ai ponokalafi (PPUS) [158] e fa vaega o le POPU (e aofia ai: faʻalavelave faʻalavelave ma faʻafitauli, faʻaaoga tele, faʻafitauli faʻaletonu ma faʻaoga mo le sola ese / aloese mai lagona le lelei), o le poto masani i luga o le initaneti ua faʻafetaui i gaioiga i le initaneti (s-IAT-sex) [159], o se fesili a le 12-mea e fuaina ai le lua fausaga o le POPU, ma le initaneti o le faʻaaogaina o le initaneti (CPUI-9) [160].
O le CPUI-9 e iloiloina itu e tolu: (1) taumafaiga faʻafeiloaʻiga, (2) na iloa le faʻamalosi, ma (3) lagona faʻalavelave. I le taimi muamua na faʻamoemoe e i ai ni mea faʻapitoa o le mafaufau.9], o lenei suʻesuʻega e leʻi leva ona faʻamaonia e le mafai ona faʻatuatuaina: o le aofia ai o le "lagona lagona le fiafia" i tulaga maualuga o le maasiasi ma le taʻusalaina, lea e le oi ai i se iloiloga o mea ua fai ma vaisu, ma ua mafua ai ona togi i luga le maualuga [161]. O le faʻaaogaina o le suʻesuʻega e aunoa ma lenei itu e foliga mai e atagia tonu lava i nisi o faʻataʻitaʻiga ponokalafi faʻaaogaina.
O se tasi o mea sili ona lata mai o le faʻafefeina o le faʻalauiloaina o ponokalafi (PPCS) [162], e faʻavae i luga o le faʻataʻitaʻiga o le vailaʻau ono o le Griffith [163], e ui lava e le fuaina ai le tagofia o mea ua fai ma vaisu, ae na o le faʻafitauli faʻafitauli o ponokalafi ma mea malolosi o le mafaufau.
O isi fuataga o le POPU e le o fuafuaina e fuaina ai ponokalafi faʻainitaneti faʻaaogaina ae ua faʻamaonia e faʻaaoga ai le '9], aofia ai le Initaneti Consumption Consolidation (PCI) [164,165], o le Tauvaʻa Faʻamatalaga Mataʻutia Taumafa (CPCS) [166] ma le Ponokalafi Taumafa Fesili Fesili (PCQ) [167] lea e mafai ona iloilo ai faʻamatalaga faʻalagona i totonu o ituaiga eseese o ponokalafi.
O loʻo i ai foi meafaigaluega mo le suʻesuʻeina o le faʻaaogaina o ponokalafi tagata faaaoga e lafoai le amio e ala i fuafuaga a le tagata lava ia [168] ma se suʻesuʻega o togafitiga i le faia o lea mea [169], e iloa faapitoa ai ni mea e ono mafai ona toe faʻafoʻi mai: (a) faʻafeusuaiga / le fiafia / avanoa, (b) inisua / nofoaga / faigofie ona maua, ma (c) lagona le lelei.

3.8. Togafitiga

Ona o le tele o fesili e tumau pea e faatatau i le faʻataʻitaʻiga, iloiloga, ma mafuaʻaga o amioga feusuaʻiga ma le POPU, e itiiti lava ni taumafaiga e suʻeina ai togafitiga talafeagai. I suʻesuʻega faʻasalalau, o faʻataʻitaʻiga tetele e masani ona laʻititi ma e tutusa lelei, e leai ni faʻamalositino, ma o faʻamaumauga e faʻasalalauina, e le mafai ona faʻaalia,170].
O le masani lava, o le tuʻufaʻatasia o mafaufauga faʻapitoa, mafaufauga-amio, psychodynamic, ma le pharmacologic ua sili ona lelei i le togafitiga o le tagofiaina o feusuaiga, ae o lenei faiga e le faʻapitoa e atagia ai le leai o se malamalama e uiga i le mataupu [9].

3.8.1. Faʻataʻitaʻiga Faʻataʻitaʻi

O suʻesuʻega na faʻaogatotonu i paroxetine ma naltrexone e oʻo mai i le taimi nei. O se tasi o mataupu na aofia ai le paroxetine i luga o le POPU na fesoasoani e faaitiitia le maualuga o le popole, ae na iu ina le faaitiitia le amio na o ia lava [171]. E le gata i lea, o le faʻaaogaina o le SSRI e faia ai feusuaʻiga tau feusuaʻiga e ala i o latou aʻafiaga, e foliga mai e leai se aoga, ma e tusa ai ma le poto masani faʻapitoa e na o tagata maʻi e maua i le faʻafitauli o le mafaufau (psychiatric disorders)172].
E fa mataupu e aofia ai le naltrexone e togafitia ai le POPU ua faʻamatalaina. O sailiiliga talu ai ua fautua mai ai o le naltrexone e mafai ona avea ma togafitiga talafeagai mo vaisu amioga ma le faʻafeusuaiga o feusuaiga [173,174], faʻaitiitia le faʻaitiitia o manaʻoga ma faʻamalosia e ala i le taofia o le euphoria e fesootaʻi ma le amio. E ui lava e leʻi i ai se faamasinoga faʻasolosolo faʻatasi ma le naltrexone i nei mataupu, e fa mataupu o mataupu. O taunuʻuga na maua i le faʻaitiitia o ponokalafi faʻaaoga e fesuisuiai mai le lelei [175,176,177] ia amio pulea [178]; a itiiti mai i se tasi oi latou na maua foi e le tagata maʻi le sertraline, o lea e le manino ai le tele o le mea e mafai ona taʻua i le naltrexone [176].

3.8.2. Taunuuga o le Mafaufau

E le masalomia, o le mafaufau e mafai ona avea ma se meafaigaluega taua i le malamalama atoatoa ma suia se amioga. E ui lava o le mafaufau-amio-togafitiga (CBT) e mafaufauina e le tele o fomaʻi e aoga i le togafitia o maʻi feusuaʻiga [179], o se suʻesuʻega na aʻafia ai faafitauli i luga o luga o le initaneti faʻaaogaina le faʻaaogaina o faʻataʻitaʻiga e le ausia ai se faʻaititia o le amio [180], e tusa lava pe na faʻaleleia le malosi o le faʻavaivai o faʻamaoniga ma le lelei lautele o le olaga. O lenei mea e maua mai ai le manatu tului o le na o le faʻaitiitia o ponokalafi e faʻaaogaina e le o se mea e sili ona taua o le togafitiga [170]. O isi auala e faʻaaoga ai le CBT e togafitia ai le POPU ua faia, ae o le faʻafouina o faʻafitauli faʻapitoa i lenei vaega e taofia ai i tatou mai le aveesea o faaiuga faatuatuaina [181,182].
O togafitiga o le mafaufau ma isi e pei o togafitiga a aiga, o togafitiga o ulugalii, ma togafitiga o le mafaufau e pei o le 12 laasaga o polokalama e mafai ona taua tele pe a talanoaina autu o le maasiasi ma le tausalaina ma toe faafoisia le faatuatuaga i sootaga vavalalata a tagata [170,172]. E na o le toʻatasi le faʻatautaia o le faʻamasinoga o loʻo i ai faafitauli i luga o le 'aufaitautusi i luga o le initaneti e taulaʻi i le Taliaina ma le Tautinoina o le Tautinoga (ACT) [183], o se faʻaleleia atili mai la latou laʻasiga o le 2010 [184], o le uluai suesuega faataitai lea e faʻasino faapitoa ai le POPU. O le suʻesuʻega na maua ai taunuʻuga aoga ae e faigata ona faʻapipiʻi talu mai le laʻititi o le faʻataʻitaʻiga ma taulaʻi i luga o se faitau aofaʻi.
O le manuia o loʻo lipotia mai i le CBT, mafutaga faʻatasi ma ACT e mafai ona faalagolago i le mea moni e faʻavae i luga o le mafaufau ma le taliaina; e faʻalagolago i le faʻalapotopotoga, o le faʻateleina o ponokalafi faʻaaoga le taliaina atonu e tutusa pe sili atu ona taua nai lo le faʻaitiitia o lona faʻaaogaina [170].

4. Talanoaga

E foliga mai o le POPU e le gata na o le tasi le vaega o le gasegase feusuaʻiga, ae o le taimi nei e pito sili ona taatele ona e aofia ai foi i taimi uma le masturbation. E ui o lenei mea faigata e faʻamaonia lelei le tuʻuina atu o le le iloa ma le faʻaaogaina o mea e faʻaaogaina ai ponokalafi i aso nei, e mafai ona tatou faʻamaonia e faapea, o le pule o le taumafaina mo ponokalafi ua suia mo le sili atu i le sefulu tausaga talu ai. O le a le faʻavalevalea le maua o lona faʻaoga i luga o le initaneti na i ai se aafiaga taua i luga o ana tagata faʻatau, ma o le tolu tolu Faʻatonu e faʻaleleia ai le ono lamatiaina o le POPU ma isi amioga tau feusuaiga.
E pei ona matou taʻua, o le le amanaiaina o se tasi o mafuaaga sili ona lamatia mo lenei amioga feusuaiga e tupu ai se faafitauli. E tatau ona tatou manatua o fuainumera e faatatau i lenei faafitauli e manino lava le faatapulaaina i tagata o le matua o le matua e auai i feusuaiga, i luga o le initaneti pe leai foi; ae e le o ese mai ia i tatou o lena feusuaiga e seasea ona amataina i le maea ai o lenei faitotoa, ma o loo i ai se avanoa atonu o loo i ai pea le fanau i le faagasologa o le gaioiga o feusuaiga o se tagata e sili atu ona lamatia. O le mea moni, o se maliega sili atu ona malosi i luga o le amioga amio le mama a le tagata, e le gata i le tuusao ma le initaneti, e tatau ona lava le fuaina i se faiga faʻaalia ma faʻamaonia le tele o se faʻafitauli i le lalolagi nei.
E pei ona tatou iloa, o le tele o suʻesuʻega talu ai nei e lagolagoina ai lenei vaega e avea o se vaisu ma faʻamaoniga taua o le falemaʻi e pei o le feusuaiga ma le le fiafia i le mafaufau. O le tele o galuega i le taimi nei e faʻavaeina i luga o suʻesuʻega faʻapitoa na faia i vaisu, e faʻavae i luga o le talitonuga o ponokalafi i luga o le initaneti o se 'supranormal stimulus' i se mea moni lea, e ala i le faʻaauauina pea o le taumafa, e mafai ona osofia ai se mausa o le vaisu. Ae ui i lea, o mataupu e pei o le faapalepale ma le aloese e leʻo manino lelei ona faʻamautuina e talafeagai ai le faailogaina o mea ua fai ma vaisu, ma o lea ua avea ai ma vaega taua o suʻesuʻega i le lumanaʻi. Mo le taimi nei, o se vailaʻau faʻamaʻi e aofia ai le pulea o amio feusuaʻiga ua aofia i totonu o le ICD-11 ona o lona aoga i le taimi nei, ma o le a mautinoa lava e faʻaaogaina e faʻafesoʻotaʻi ai tagata maʻi i nei faʻaʻailoga e fesili ai i fomaʻi mo fesoasoani.
O le tele o meafaigaluega o suʻesuʻega e mafai ona fesoasoani i le avefeʻau o loʻo i ai togafitiga faʻapitoa, ae o le faʻamaoniaina o mea e le moni ma le saʻo, o se faafitauli faifai pea. I le taimi nei, o se vaega taua o vaega e tolu o taʻiala ua faʻatulagaina e Carnes, Goodman, ma Kafka e aofia ai manatu autu o le le lava o le pulea, le tele o taimi faʻaalu i amioga tau feusuaiga ma taunuuga le lelei ia te oe ma isi. I nisi auala poʻo isi, latou te iai foi i le tele o meafaigaluega suʻesuʻeina ua toe iloiloina.
Atonu latou te lava le fausaga e fausia ai i luga. O isi elemene, o loʻo faʻamoemoeina i eseesega eseese o le taua, atonu e taʻu mai ia i tatou e faʻaaoga manatu taʻitasi. O le fuafuaina o se meafaigaluega suʻesuʻe e tumau i le tulaga o le fetuutuunai ae o le taua foi mo le fuafuaina o le faafitauli o se tasi lea o luitau o loo feagai ma i tatou nei, ma o le a mafai ona tatou o gatasi ma nisi suʻesuʻega o le neurobiological lea e fesoasoani tatou te malamalama lelei ai pe a fua se vaega o le masani a tagata soifua e suia mai amioga masani i se maʻi.
E tusa ai ma togafitiga togafitiga, o le sini autū o loʻo taulaʻi nei i le faʻaitiitia o le faʻamalosia o ponokalafi poʻo le lafoaia uma lava, talu ai e foliga mai o le a mafai ona toe faʻamalosia. O le auala e ausia ai lenei mea e eseese e tusa ai ma le tagata gasegase ma atonu foi e manaʻomia ai nisi tulaga fetuʻutuʻunaʻi i taʻiala e faʻaaogaina, ma le mafaufau ma le taliaina o le psychotherapy e tutusa pe sili atu ona taua nai lo le faʻaaogaina o vailaʻau faʻatau i nisi tulaga.

faatupeina

O lenei suʻesuʻega e leai se tupe maua mai fafo.

Feeseeseaiga o Tului

Rubén de Alarcón, Javier I. de la Iglesia, ma Nerea M. Casado e leai se feteenaiga e fiafia i ai. AL Montejo ua maua totogifuapauina mo le faufautua poo le faʻamaonia / fesoasoani tau suʻesuʻega i le lima tausaga talu mai Boehringer Ingelheim, Forum Pharmaceuticals, Rovi, Servier, Lundbeck, Otsuka, Janssen Cilag, Pfizer, Roche, Instituto de Salud Carlos III, ma Junta de Castilla ma León .

mau faasino

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