Iyi seti yemibvunzo inowanzo bvunzwa inoperekedza ASAM tsananguro nyowani yekupindwa muropa. Mamwe mashoma eQ & A's kero kupindwa muropa pabonde. Zviri pachena kuti nyanzvi paASAM dzinoona bonde sekupindwa muropa chaiko. Isu tinoona kupindwa muropa kwepabonde (chaivo vadyidzani) zvakatosiyana zvakasiyana neinternet kupindwa muropa kwepabonde (skrini). Vazhinji vanogadzira Internet kupindwa muropa kwepabonde vangadai vasina kumbobvira vatanga kupindwa muropa nepabonde munguva yekutanga-internet.
- ZVINOKUDZIDZISWA NEZVO: MIBVUNZO INONYANYA KUBVUNZWA
- Unganidza kunotsanangurwa kweAASAM uye mutemo wemitemo: American Society yeAddiction Mishonga: Tsananguro yeAddiction - Long Version
- Batanidza kune ASAM Press Regedzera pane dudziro nyowani: ASAM Press Regedza
- Bata kune imwe nyaya yakanakisisa pamusoro peshoko uye chirevo chematongerwo enyika: Nyanzvi dzepamusoro dzeAmerica (ASAM) Vachangobva Kuburitsa Tsvairo Tsvairo Yekupindwa Muropa
Nyaya mbiri takanyora:
- Shandisai Mabhuku EpaMagwaro: Docs Dzochera Zvirwere Zvepabonde (2011). American Society of Addiction Medicine anobvumirana kusawirirana ne DSM
- Wakagumburwa paNotoni Here? Bvunza ASAM (2011). Vashandi veScott vanotsanangura kuti chii chakanaka kuti chigadzikane
Tsanangudzo yeAAMAM yeAiddiction: Mibvunzo Inowanzobvunzwa (August, 2011)
1. MUBVUNZO: Ndezvipi zvakasiyana nezvetsva iyi tsanangudzo?
MHINDURO:
Ikutarisa munguva yakapfuura yave iri pane zvinhu zvakabatana nekudhakwa, zvakadai sewaini, heroin, mbanje, kana cocaine. Iyi tsanangudzo itsva inojekesa kuti kusvuta hakusi nezvezvinodhaka, ndezvebongo. Haisi zvinhu izvo munhu anoshandisa izvo zvinoita kuti vashandise; hausi kunyange huwandu kana huwandu hwekushandiswa. Zvinodhaka ndezvezvinoitika muuropi hwomunhu pavanenge vachiwana zvinhu zvinokomborera kana zvipo zvinokomborera, uye zvinowedzera pamusoro pemakomborero ekufambisa muuropi nehutano hwehuropi hunobatana pane huri kunze kwemakemikari kana mufambiro "unotenderera" iyo mubairo circuitry. Takaziva basa rekuyeuka, kukurudzira uye sangano rakabatana mukuratidzwa nekufambira mberi kwechirwere ichi.
2. MUBVUNZO: Tsanangudzo iyi yekusagadzikana yakasiyana sei nezvitsanangudzo yapfuura zvakadai seDSM?
MHINDURO:
Iyo yakajairwa yekuongorora system yave iri Yekuongorora uye Statistical Manual yeMental Dambudziko (DSM), rakaburitswa neAmerican Psychiatric Association. Iri bhuku rinonyora mazana ekuongororwa kwemamiriro akasiyana, uye nzira iyo munhu anoongorora nayo. Iyo DSM inoshandisa izwi rekuti 'kutsamira kwezvinhu' panzvimbo pekupindwa muropa. Mukuita, tanga tichishandisa izwi rekuti 'kutsamira' mukusiyana nemishonga. Zvisinei, zvinovhiringidza. Iyo nzira iyo psychiatry yaivimba nayo kwave kuri kubvunzurudzwa kwevarwere uye nekunze maitiro anoonekwa. Izwi rinonyanya kushandiswa nderekuti 'kushandisa zvisizvo' - vamwe varapi vanoshandisa izwi iri vachichinjanisa ne 'kupindwa muropa' izvo zvinokonzeresa nyonganiso. Naizvozvo, ASAM yakasarudza kutsanangura kupindwa muropa nenzira yakajeka, nenzira inonyatsorondedzera maitiro echirwere anowedzera kupfuura maitiro akawandisa senge matambudziko ane chekuita nezvinhu.
Zvinyorwa zveDSM zvakabudiswa kubva ku1980 zvakanyatsojeka kuti nzira yeDMM ndiyo "asingatendi" - kuongororwa hazvibvi pane imwe pfungwa yekufunga nezvepfungwa kana kuti nheyo ye etiology (apo chirwere chinobva). Iyo DSM inongotarisa maitiro aunogona kuona kana zviratidzo kana zvakaitika kune murwere anorondedzera kuburikidza nemubvunzurudzo. Tsanangudzo yeAASAM yekudhakwa haisi kubvisa chikamu chezvakatipoteredza mune zvinodhaka - zvinhu zvakadai sevakidzani kana tsika kana chiyero chepfungwa mupfungwa iyo munhu akawana. Asi iyo inotarisa basa reropi muhutano hwekudhakwa - chii chiri kuitika neuropi kushanda uye humwe hutano hwehutano hunogona kutsanangura maitiro ekunze anowanikwa mukudhakwa.
3. MUBVUNZO: Sei tsanangudzo iyi inokosha?
MHINDURO:
Zvinodhaka, zvinenge zvichitsanangurwa, zvinosanganisira kukanganisa kwakanyanya mumunhu - basa ravo rinoshanda kumabasa avo, mumhuri yavo, kuchikoro, kana munharaunda yakazara, inoshandurwa. Vanhu vanogona kuita marudzi ose ezvinhu zvisina kukodzera kana vane dambudziko. Mimwe yemitemo iyi inonyatsopesana - kuita zvimwe zvinhu zvinogona kuputsa tsika dzevanhu uye kunyange mitemo yevanhu. Kana munhu achingotarisa mufambiro wemunhu ane zvinodhaka, munhu angaona munhu anoreva nhema, munhu anobiridzira, uye munhu anotyora mitemo uye anoita seasina tsika dzakanaka. Mhinduro yemasangano kazhinji yave iri kuranga maitiro evanhu vasingashamisi, uye kutenda kuti munhu ane chinodhaka, pamwoyo yavo, "munhu akaipa."
Apo iwe unonzwisisa zviri kuitika chaizvo nekudhakwa, iwe unoona kuti vanhu vakanaka vanogona kuita zvinhu zvakashata kwazvo, uye maitiro ekunyadzisa anonzwisisika mumamiriro ekuchinja kwehuropi basa. Kuita zvinodhaka hakusi, pachikamu chayo, kungova dambudziko revanhu kana chinetso chemitemo. Zvinodhaka ndezvehupfungwa, kwete kungoita maitiro.
4. MUBVUNZO: Nemhaka yokuti munhu ane chirwere chekudhakwa, anofanirwa here kusunungurwa kubva pamutoro wose wemafambiro avo?
MHINDURO:
Kwete. Kuzvimirira wega kwakakosha mumativi ese ehupenyu, kusanganisira nemabatirwo anoitwa munhu noutano hwake. Zvinowanzotaurwa munyika inodhakwa kuti, "Hausiwe unokonzeresa chirwere chako, asi ndiwe unokonzeresa kuti upore." Vanhu vane kupindwa muropa vanofanirwa kunzwisisa chirwere chavo uyezve, kana vapinda mukugadzirisa, kutora matanho anodiwa kudzikisira mukana wekudzokazve kune chinoshanda chirwere mamiriro. Vanhu vane chirwere cheshuga uye chirwere chemwoyo vanofanirwa kutora mutoro wega pamabatiro avanoita chirwere chavo - zvimwechetezvo kune vanhu vakapindwa muropa.
Sangano zvechokwadi rine kodzero yekuzvisarudzira kuti zvii zvinopesana zvakadzama zvehukama hwemagariro munharaunda yavanoonekwa sezvakaipa. Vanhu vane zvinodhaka vanogona kupara mhosva, uye vanogona kupiwa mhosva pamusoro pezviito izvo uye vanotarisana nemigumisiro ipi zvayo yakarongerwa yezviito izvozvo.
5. MUBVUNZO: Iyi tsanangudzo itsva yekudhakwa inoreva kukanganisa kunosanganisira kubhejera, zvokudya, uye zvepabonde. Ko ASAM anotenda chaizvo here kuti kudya uye zvepabonde zvinodhaka?
MHINDURO:
Kunyoresa kubhejera kwakanyatsotsanangurwa mumabhuku esayenzi kwemazana makumi emakore. Kutaura zvazviri, shanduro yakapedzisira ye DSM (DSM-V) inonyora urongwa hwekubhejera chirwere muchikamu chimwe chete nehutano hwekushandisa zvinodhaka.
Shanduro itsva yeAASAM inokonzera kuenzanisa kusagadzikana nemhando yekuzvidzivirira kwezvinhu, nekutsanangura kuti kusvuta kunobatanidza sei nemafambiro anopa mubayiro. Iyi ndiyo nguva yokutanga iyo ASAM yakatora nzvimbo yepamutemo kuti kukanganisa haisi kungoti "zvinhu zvinoderedza."
Iyi tsanangudzo inoti kudhakwa ndeyekushanda pamwe nehutano hwepfungwa uye kuti chimiro nekushanda kwehupi hwevanhu vane utsotsi zvakasiyana nehutano uye basa rehupi hwevanhu vasina kukanganisa. Inotaura pamusoro pemubairo wevachengeti muuropi uye nemakwikwi akafanana, asi kusimbiswa hakusi pamubairo wekunze unoshanda pane mubayiro wehutano. Zvokudya uye maitiro ekuita zvepabonde nekubhejera maitiro anogona kuenzaniswa ne "kutsvaga kutsvaga mibairo" inorondedzerwa mune iyi tsanangudzo itsva yekudhakwa.
6. MUBVUNZO: Ndiani ane zvinodhaka kana kudya zvepabonde? Vanhu vangani izvi? Unoziva sei?
MHINDURO:
Isu tose tine mupiro hwekupa mupiro mutsara unoita kuti zvokudya uye zvepabonde zvikomborerwe. Zvechokwadi, iyi ndiyo nzira yekupona. Muhutano hwakanaka, izvi zvikomborero zvine maitiro ezvakaitika zvekuita satiety kana kuti 'zvakakwana.' Kune mumwe munhu ane zvinodhaka, dunhu rinenge risingabatsiri zvakadai kuti shoko kune mumwe munhu rive 'rakawanda', izvo zvinotungamirira mukutsvaga kwemaitiro emararamiro uye / kana kubatsirwa kuburikidza nekushandiswa kwezvinhu uye maitiro. Saka, ani naani ane zvinodhaka anokanganisa kudya uye zvekuita zvepabonde.
Isu hatina zviyero zvakarurama zvekuti vanhu vangani vanobatwa nehutano hwekudya kana kutengesa zvepabonde, kunyanya. Tinotenda kuti zvingava zvakakosha kutsvaga tsvakurudzo pakuunganidza ruzivo urwu kuburikidza nekucherechedza zvinhu izvi zvekudhakwa, izvo zvingave zviripo kana pasina zvinetso zvine chokuita nezvinhu.
7. MUBVUNZO: Zvichida kuti kune hutano hwakagadziriswa hutano muhutano hweDMM, haasi iyo tsanangudzo ichinyadzisa here? Uyu haasi kukwikwidzana neDMM process?
MHINDURO:
Hapana kuedza kuno kukwikwidzana neDMM. Tsamba iyi haina zviratidzo zvekuongorora. Iyo tsanangudzo yehutano hwepfungwa. Zvose izvi zvinotsanangurwa tsanangudzo uye DSM inokosha. Iyo DSM inotarisa kubudiswa kwekunze kunogona kuonekwa uye kuvapo kwokuti kunogona kusimbiswa kuburikidza nehurukuro yekliniki kana mibvunzo yakagadziriswa pamusoro pehupenyu hwevanhu uye zviratidzo zvavo. Iyi tsanangudzo inotarisa zvakawanda pane zviri kuitika muuropi, kunyange iyo inotaura nezvekuratidzwa kwekunze kwekudhakwa uye kuti maitiro anowanikwa sei kune vanhu vane zvinodhaka zvinonzwisisika zvichibva pane izvo zvino zvinozivikanwa pamusoro pekuchinja kwehupfungwa muhupombwe kushanda.
Tinotarisira kuti tsanangudzo yedu itsva ichaita kuti tinzwisise zviri nani chirwere chetachiona, chepfungwa, zvepabonde uye zvemweya mukuratidzwa kwayo. Zvinenge zviri kuchenjera kuti unzwisise zviri nani maitiro ekurwisa mumamiriro ezvinhu akadaro, kunze kwekuongororwa kweStend Dependence kana kushandiswa kweShandisa Matambudziko.
8. MUBVUNZO: Chii chinoreva kurapwa, kwekubhadhara mari, kwehutano, yeAASAM?
MHINDURO:
Chirevo chikuru chekurapa ndechokuti hatigoni kuramba tichiisa pfungwa pane zvinhu. Zvakakosha kuisa pfungwa pahutano hwehutano hwehutano muhuropi hune hupenyu hwepanyama, hwepfungwa, hwemagariro evanhu uye hwekunamata. Shanduro yedu yakareba yerondedzero itsva inotsanangura izvi mune zvakawanda. Vagadziri vezvematongerwo enyika uye masangano ekubhadhara mari anofanira kucherechedza kuti kurapwa kunofanira kunge kwakakwana uye kuisa pfungwa pane zvose zvinokonzerwa nekupindwa muropa nekunyadzisa nekuzvibata panzvimbo yekunyatsotarisirwa, izvo zvingaguma nokuchinja kushandiswa kwemaitiro emararamiro uye / kana kubatsirwa nekushandisa zvimwe zvinhu uye / kana kubatanidzwa mune mamwe maitiro ekurwisa. Kunyatsotevedza kurapwa kunoda kuti tinyatsocherechedza zvinhu zvose zvinoshandiswa uye zvingangodaro uye maitiro anokwanisa kuiswa muropa kune munhu anenge aine zvinodhaka. Zvakajairika kuti mumwe munhu atsvake rubatsiro kune chimwe chinhu asi kuongororwa kwakajeka kunowanzobudisa zviratidzo zvakawanda zvinenge zvichange zviripo uye zvinowanzosvibiswa mumapurogiramu apo chinangwa chekurapa zvinhu chete kana zvimwe zvinhu zvakananga.
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