Zvidimbu zvinoratidza kudhakwa uye kushivirira ndizvo zvakakosha mukunetseka kwekushandisa zvinonyadzisira:
Kunyanya, iyo yakareba kwazvo yekuona zvinonyadzisira iyo yainge yaitwa nevanhu inogona kunge iine hukama nehunhu hwekuzvibata, inofungidzira zvichitsvaga kurapwa, kuomarara kwezviratidzo zvine ruzivo, uye nemanzwiro ekurasikirwa nekutonga pamusoro pemaitiro ebonde muboka rese revatori vechikamu. Izvozvowo zvainyanya kuitika kumakiriniki uye asiri emakiriniki mapoka kana achitariswa zvakasiyana.
… ..Izvi zvinogona kuratidza kuti kubatanidzwa mune inorema episodic maitiro inogona kuve iri nani chiratidzo chehunhu hwekushushikana pane yakakwira-frequency maitiro, iyo inogona kuve yakabatana zvakanyanya padanho remunhu chishuwo chebonde, maitiro epabonde, uye zvido.
… Misiyano yezvinhu zvinonyadzisira zvinodyiwa (zvinoshandiswa muchidzidzo chazvino sekushandisa mifananidzo yezvinonyadzisira zvinopesana nehukama hwepabonde - zvimiro zvine bonde revane ungochani, zvine mhirizhonga, zviitiko zvebonde, zviitiko zvebonde nevadiki) zvakanyanya kufanotaura danho rekutsvaga kurapwa uye kuomarara kwezviratidzo pakati pevatori vechidzidzo.…. Kunyangwe iyo yakatsanangurwa mhedzisiro pachayo isingareve zvakananga kuwedzera kushivirira kana kushushikana, sezvo hunyanzvi hwekushandisa zvinonyadzisira zvinhu zvine hunhu hunogona kuratidza hwakawanda, hwekutanga kufarira, zvinoita kunge zvingangoita zvinowirirana neanopindwa muropa nemhando dzematambudziko ezvinonyadzisira zvinoshandiswa
doi: 10.1016 / j.esxm.2020.10.004.
- PMID: 33302242
- DOI: 10.1016 / j.esxm.2020.10.004
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Mhedzisiro mikuru Mitezo
Results
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Mashoko Akakosha
ziviso
Iyo munda wekutsvaga pane dambudziko rekuona zvinonyadzisira shandisa irimo munguva yekukurumidza kukura uye shanduko.1,2 Izvi zvinoratidzwa zvishoma mukubatanidzwa kweCompulsive Sexual Behavior Disorder (CSBD) muInternational classification yezvirwere, 11th revision (ICD-11).3,4 Chiratidzo chekutanga cheCSBD chinonetsa kushandisa zvinonyadzisira, pamwe chete nekumanikidza kuita bonhora.5,6 Nekudaro, kumwe kutsvagurudza, kusanganisira munda data rekuyedza, zvichiri kudikanwa.1,7,8 Chikamu chakafanana chekuongorora, hypersexual kusagadzikana, chakarongedzwa asi hachina kuiswa mune yekupedzisira vhezheni yeDhignostic uye Statistical Manual yeMental Disorders, 5th Revision (DSM-5).5
Ongororo yapfuura yezvinetso zvekuona zvinonyadzisira zvinoshandiswa zvinoratidza kuti kune vamwe, asi kwete vese vashandisi, kuona zvinonyadzisira kunogona kuva nemhedzisiro. Izvi zvinosanganisira kurasikirwa kwekudzora, kunetsekana mukuita bonde, mhedzisiro yakaipa kuhukama hwepabonde nedzimwe nzvimbo dzehupenyu, kuita mune mamwe marudzi ehunhu hunhu, uye pamwe shanduko mukushanda kwehuropi. Iyi mhedzisiro inogona kuzobatsira mukutsvaga kurapwa.9,10,11,12,13,14
Nekudaro, kana uchiyedza kushandisa maitiro ekuona zvinonyadzisira, kutsvagisa kwakawanda kunotarisa kuhuwandu hwezviratidzo zvine chekuita nekushandiswa kwezviri pachena zvemukati: nguva yakatarwa yekushandisa zvinonyadzisira kana kuwanda kwekuona zvinonyadzisira kunoshandiswa.10,13,15,16 Isu tinopokana kuti izvi zvinoratidza mashoma uye akareruka maonero ekuona zvinonyadzisira anoshandisa maitiro. Kune zvimwe zviratidzo nezvitsananguro zvine chekuita nekushandisa zvirimo zvemukati zvinogona kutakura ruzivo rwakakosha nezve kuvandudzwa uye kuratidzwa kwekushandisa zvine matambudziko asi zvisina kuvharirwa muhuwandu kana nguva yekushandisa pachayo. Nekudaro, izvi zviratidzo zvinofanirwa kutariswa.
Zvinoenderana neiyi poindi, zvidzidzo zvakapfuura zvakapa humbowo hwekutanga hwekuti varaidzo nevashandisi vane dambudziko rekuona zvinonyadzisira vanogona kusiyaniswa kunyangwe ese ari maviri mapoka anoshandisa zvinonyadzisira nguva dzose.17 Uye zvakare, vaongorori vazhinji vakanongedzera kuchokwadi chekuti huwandu hwakawanda hwehuwandu kana nguva yakatarwa yekushandisa zvinonyadzisira - uye zvakanyanya, kuita zvepabonde - zvakaoma kutanga. Izvo zvinogona zvakare kuve zvinoshanduka zvakanyanya zvese kuyambuka-kutsika uye kudyidzana uye zvinogona kusabatsira sechiratidzo chakasimba chehunhu hunonetsa.10,12,18,19,20 Nekuda kweizvi, kuwanda kwepamusoro kana nguva yakapihwa yekuona zvinonyadzisira zvinoshandiswa zvakaonekwa kunge zvisina kukwana kuongorora CSBD sezvakakurudzirwa muICD-11,3 izvo zvinodikanwa kuti usapfuurire pamusoro pekuwedzera kwehuwandu hwehuwandu hwehuwandu, asi neimwe nzira hunodzorwa hunhu hwepabonde.
Kupfupisa, nguva uye kuwanda kwekuona zvinonyadzisira zvinoshandiswa hazviwanzo kuvimbika sezviratidzo zvekunetseka kwepabonde. Isu tinonyora kuti zvimwe zviratidzo, senge hunhu uye misiyano mune zvakadhakwa zvemukati zvemukati pamwe nekureba zvikamu zvekuona zvinonyadzisira, zviri pakati pekufarira mukutsvagisa kwezvino, zvinogona zvakare kutakura ruzivo rwakakosha. Izvi zvinongedzo zvinofanirwa kupihwa kutarisisa sezvinhu zvinopa kukiriniki yemufananidzo wekunetseka maitiro ehupombwe, uye nekumanikidza maitiro ehutano hwepabonde.4
Yakareba Zvinonyadzisira Kuona Zvikamu
Kushandisa episodic kwakanyanya kwechimwe chinhu (chezvinodhaka zvinodhaka) kana kuita episodic inorema kuita zvimwe zviito (zvehunhu hunodzvinyirira) izvo zvinogona kuperekedza "zvenguva dzose" maitiro ekurwisa akaratidzirwa kuve ane chinzvimbo mukudhakwa nedoro,21,22 kupindwa muropa nezvinodhaka,23,24 kubhejera kupindwa muropa,25,26,27 kunetsa vhidhiyo yemitambo,28,29 uye kunetsa kwevhidhiyo kutenderera.30 Iyi tsika yekuzvibata dzimwe nguva inonzi sehunhu hwekuita binge uye inoita kunge yakajairika munzvimbo mune vakapindwa muropa. Semuenzaniso, inoratidza mukati me50% kana kupfuura evashandisi vezvinodhaka.23,24 Nekudaro, kumwe kutsvagurudza kunodiwa kumisikidza kuwanda kweiyi maitiro maitiro zvichienderana, semuenzaniso, muropa mhando.
Kunyangwe bonde kana kupindwa muropa nezvinonyadzisira kwave kuzivikanwa seimwe yeakanyanya maitiro ekuzvibata31 uye nesainzi kutariswa kunoenderana nehunhu hwehunhu hwakakosha, tsvagurudzo inorema episodic zvinonyadzisira inoshandisa (sekusiyana neakanyanya-kazhinji kushandisa nguva dzose) pakati pevanonetsekana vanoona zvinonyadzisira vashoma. Mune 10-vhiki-refu diary kudzidza kunoenderana ne9 vanotsvaga kurapwa kwekumanikidza kuita zvepabonde, Wordecha et al32 yakaratidza kuti 2 yezvidzidzo zve3 zvakabatwa muzvinodhakwa nekuita bonhora. Kunyangwe chidzidzo ichi chaive pamusoro pesampuru diki yevanhu, chinopa humbowo hwepakutanga hwechinzvimbo chekubheja mukumanikidzira kuita bonde uye chinofanira kumutsa kutsvagisa kweramangwana pachinhu ichi.
Zvakare, kurasikirwa kwekudzora pamusoro pemaitiro epabonde inzira yekufungidzira ingangove irimo mune ese mafungiro ehunhu hwepabonde.3,5,33,34,35,36,37 Mukuona kwedu, zvinogona kupikiswa kuti kuremerwa kwepisodic kubatanidzwa mune zvine hunhu maitiro kunogona kutaridzirwa seakanaka, kana zvisiri - mune zvimwe zviitiko - mucherechedzo uri nani wekurasikirwa kwekudzora pamusoro pemaitiro epabonde pane kungoita zvepamusoro-frequency maitiro. Zvakare, zvakave zvichizivikanwa kuti akawanda asina kubudirira kuyedza kudzokorora kudzokorora maitiro ehupombwe ndeimwe yeakakosha maitiro eCSBD, 3,4 uye maitiro ekurega, kushaya kana kudzora kuedza zvinoita kunge kuri kugara kuchipindirana nezvikamu zvinotevera zvekuremerwa episodic kuita mune kunetsa maitiro. Mukuona kwekutsvaga kwakatsanangurwa uye nemaonero edzidziso, kukosha kwekuremerwa episodic kubatanidzwa mumatambudziko ezvinonyadzisira anoshandiswa mukuvandudza zviratidzo zvepfungwa uye kurapwa kuri kukodzera kukodzera kudzidza.
Musiyano weKunwa Zvinonyadzisira Zvemukati
Mhando dzakasiyana siyana dzezvinhu zvakajeka parizvino dzinowanikwa paInternet, uye zvikamu zvakasiyana zvakasiyana zvezvinhu zvinonyadzisa zvakadyiwa zvasiyana.38
Ichitevera chimiro chekupindwa muropa nezvinodhaka, yakamisikidzwa kuti yakawanda yekushandisa zvinonyadzisira inogona kutungamira mukutsungirira.33,34,39 Mukuenderana nemhando dzekupindwa muropa nehupombwe, shiviriro inogona kuratidzwa mu1 yenzira mbiri nzira: (i) yakakwira frequency kana nguva yakatarwa yekushandisa zvinonyadzisira, mukuyedza kuwana iwo iwo mwero wekumutsa, (ii) kutsvaga uye kupedza zvimwe zvinokurudzira. zvinonyadzisira, munhu paanozoora moyo nekutsvaga zvimwe zvinomutsa.33,34,40 Nepo kuratidzwa kwekutanga kwekushivirira kwakanyatso hukama nehurefu uye kuwanda kwekushandisa, yechipiri haina kudaro. Izvo zvirinani zvinoshandiswa nekushanduka kwezvinodyiwa zvemanyowa zvemukati, kunyanya kana uku kusiana kuchinongedzera mukushandisa zvechisimba, paraphilic kana kunyange zvakarambidzwa zviri pamutemo mhando dzezvinyadzo zvemukati (semuenzaniso, zvinyadzo zvinosanganisira vadiki). Zvisinei, kunyangwe paine zvirevo zvataurwa, zvine chekuita nezvinetso zvekuona zvinonyadzisira zvinoshandisa uye / kana kuita zvebonde, hunhu uye misiyano mune zvirimo zvezvinonyadzisa zvakapedzerwa hazvina kumbodzidzwa.
Kutora zvisiri zvekiriniki zvekufunga, mune ongororo ichangoburwa naBaranowski et al41 zvinoenderana neyakareruka, isiri-kiriniki sampuro yevakadzi veGerman, misiyano yezvinodyiwa zvemanyowa zvemukati zvakanyanyisa kufanotaura kunetsa kwekushandisa zvinonyadzisira. Mune kumwe kuongorora kuchangobva kuitwa kwakaitwa naDwulit naRzymski,42 46% yemuenzaniso wakareruka wevadzidzi vanotaura nezvezvinonyadzisira vanoshandisa (n = 4,260) vakazivisa kuchinjira kune imwe nyowani yezvinonyadzisira uye 32% yakaratidza kudiwa kwekushandisa zvakanyanya (zvechisimba) zvinhu zvinonyadzisira munguva yekuona zvinonyadzisira nguva. Kunyangwe mhedzisiro yetsananguro yekudzidza isingaenderane nekiriniki yekuratidzwa kwedambudziko rekuona zvinonyadzisira anoshandisa, vanoratidza kuti shanduko mune yakadyiwa yezvinonyadzisira zvirimo zvakajairika pakati pevashandisi vezvinonyadzisira uye zvinogona kuve zvishoma zvinokurudzirwa nechishuwo chekutsvaga zvimwe zvinomutsa zvirimo. .
Chidzidzo Chino
Zvinhu uye nzira
Iyo data seti iyo inoshandiswa mune yazvino basa yaive zvakare hwaro hweimwe remabasa apfuura10 iyo iine ongororo yakavakirwa pane imwecheteyo sampuro kunyangwe yakanangiswa kune zvimwe zvinangwa zvekutsvaga. Iyo yedzidziso uye yehuwandu hwehuwandu hwakagadzira a priori uye yakasimbiswa mune rakapfuura basa harina kusanganisira rinorema episodic zvinonyadzisira zvinoshandiswa kana kusiyanisa kwezvinodyiwa zve porno zvemukati uye izvozvi ongororo zvinowedzera zvakambotaurwa zvakatsvaga.
Kuwana Dhata, Muenzaniso, uye Maitiro Ekudzidza
Kurapa Kutsvaga Boka. Pakati pevane gumi nevaviri vanotsvaga kurapwa, 132 vakaendeswa kuburikidza neboka revane makumi maviri nevatatu vezvekurapa (iro raive nevane gumi nevaviri vezvepfungwa uye vezvepfungwa, vana vezvepfungwa vana pamwe neve 119 vezvepabonde). Kubatana varapi vakagovana chinongedzo kuongororo yepamhepo nevatengi vavo vakasangana nematanho ekudzidza. Nenzira iyi, vatori vechikamu vakave nemukana wekupedzisa seti yemibvunzo yepamhepo. Hapana muripo wakapihwa nekutora chikamu muchidzidzo. Pakati pevatori vechikamu 23, 17 vakaendeswa kuboka raitsvaga kurapwa panguva yekutora boka rekutonga, sezvavakataura kare vachitsvaga kurapwa kwekunetseka kushandisa zvinonyadzisira. Vese vatori vechikamu muboka iri vakazadzisa nzira dzekuongorora hutachiona hwehupombwe, izvo zvakafemerwa, asi pakupedzisira zvakarambwa kubva pakuiswa muDSM-4.5 Dambudziko rekuona zvinonyadzisira rinoshandiswa ndicho chikonzero chikuru chekutsvaga kurapwa kwevatori vechikamu muboka iri.
Kutora zvese kiriniki uye rinodzora boka kuverengera, izvo zvidzidzo zvaive pakati pe18 ne68 yemakore ekuberekwa. Avhareji zera revatori vechikamu yaive M = 28.71; SD = 6.36 (pakanga pasina mutsauko maererano nezera pakati pekiriniki uye rinodzora boka, maona Tafura 1).
shanduka | N | Zvinoreva | SD | η2 size saizi | ||||||
---|---|---|---|---|---|---|---|---|---|---|
zvose | Ehe | Aihwa | zvose | Ehe | Aihwa | zvose | Ehe | Aihwa | ||
1. Kuita zvepabonde zviratidzo | 561 | 129 | 432 | 7.28 | 13.55 | 5.41 | 5.25 | 3.96 | 3.99 | 0.353 |
2. Kunzwa kwekutadza kudzora | 569 | 132 | 437 | 1.81 | 3.30 | 1.37 | 1.45 | .90 | 1.28 | 0.306 |
3.Kureba kwekuona zvinonyadzisira chikamu (maminitsi) | 541 | 129 | 412 | 173.73 | 297.98 | 134.82 | 198.87 | 251.71 | 160.83 | 0.145 |
4. Misiyano yezvinodyiwa zvinonyadzisira | 561 | 132 | 429 | 1.78 | 2.17 | 1.65 | 1.23 | 1.37 | 1.16 | 0.026 |
5. Nguva yakatarwa yekuona zvinonyadzisira inoshandisa (maminitsi pavhiki) | 428 | 89 | 339 | 229.86 | 333.08 | 202.76 | 252.46 | 300.13 | 231.35 | 0.045 |
6. Zera (y) | 568 | 131 | 437 | 28.71 | 29.24 | 28.55 | 6.36 | 7.71 | 5.89 | 0.000 |
Tarira. Zvepabonde zvakayedzwa neKinsey Zvepabonde Zvingaitwa Scale, ChiPolish vhezheni.43 Vateereri vakawana akawanda e0 (chete heterosexual) kana 1 (kazhinji vanoita bonde, chete zvine hungochani) zve7 pachiyero ichi vakaverengerwa muchidzidzo.
Nzira
Kuomarara kwezviratidzo yakayerwa neKuita Zvepabonde Kuwedzeredza Kuongorora Bvunzo-Revised (SAST-R),44,45 ChiPolish vhezheni.46 Mubvunzo wemibvunzo unemibvunzo makumi maviri (hongu / kwete mhinduro yekuyera) uye inoongorora (20) kubatikana, (1) kukanganisa, uye (2) kukanganiswa kwehukama nezviito zvako zvepabonde pamwe ne (3) kushomeka kwekutonga pamusoro pebonde rako maitiro.
Kunzwa kwekurasikirwa kwekudzora pamusoro pemaitiro epabonde yakaongororwa kuburikidza nemubvunzo mumwe chete: Wakambonzwa here kuti hunhu hwako hwepabonde hauchadzoreke? Mhinduro dzekupindura dzakatangira pa0 (Hazvina kumboitika) kusvika pa4 (Kazhinji kazhinji). Kunyangwe iyo SAST-R chiyero chinosanganisira kurasikirwa kwekudzora subscale, mhinduro sarudzo yemubvunzo uyu inogumira (Hongu / Kwete). Sekurasikirwa kwekudzora maitiro emunhu pabonde ndeimwe yezvakanyanya kukosha, kana isiri iyo inonyanya kukosha uye inotsanangudza hunhu hwematambudziko ehupombwe,4,5,35 takafunga kuiongorora nemubvunzo wakasiyana wakatsanangurwa kare, zvichiita kuti vatori vechikamu varatidze kuwanda kwekurasikirwa kwekutonga.
Zvinonyadzisira Variability. Vatori vechikamu vakaratidza kana iwo ekuona zvinonyadzisira avakadya aisanganisira (i) zviono zveboka rebonde; (ii) zviono zvebonde reungochani (izvo zvinopesana nevechikamu zvevatambi); (iii) zviitiko zvepabonde zvinosanganisira vanhu vanoita zvepabonde; (iv) zviitiko zvine mhirizhonga; uye (v) zviitiko zvinosanganisira vadiki. Kana vatori vechikamu vakaratidza kuti vanodya imwe mhando yezvinyadzo zvemukati, zvakaratidzirwa na1; mune mhinduro inopesana - na 0. Nenzira iyi, chinongedzo chekusiyana kwezvinodyiwa zvemukati mezvinonyadzisira zvakatangira pakati pe0 ne5, nemitengo yepamusoro inoratidza kusiyanisa kwakakwirira kwezvakadyiwa zvemukati, zvichitora zvikamu zvambotaurwa. Chiyero chakashandiswa muchidzidzo chazvino chakafanana nematanho anoshandiswa nevamwe vaongorori muzvidzidzo zvekare47 kunyange hazvo isingasanganisiri ese ezvikamu zvezvinhu zvinonyadzisira zviripo (onawo "Zvikanganiso nenhungamiro dzeramangwana" chikamu).
Ethics
Results
Tafura 2 inoratidzira kuwirirana coefficients pakati pezvakasiyana zvinosanganisirwa mukuongorora. Yakareba chikamu chekuona zvinonyadzisira chete zvine mwero zvakabatana neavhareji vhiki nevhiki yakatsaurirwa kune zvinonyadzisira zvinoshandiswa (r = 0.40, P <.001). Uye zvakare, misiyano yezvinhu zvinodyiwa zviri pachena chete zvisina kusimba zvine hukama nenguva yakatarwa yekushandisa zvinonyadzisira (r = 0.10, P <.05).
shanduka | 1 | 2 | 3 | 4 | 5 | 6 |
---|---|---|---|---|---|---|
1. Kutsvaga kurapwa | 1 | |||||
2. Kuita zvepabonde zviratidzo | .65 | 1 | ||||
3. Kunzwa kwekutadza kudzora | .56 | .81 | 1 | |||
4. Yakarebesa kuona zvinonyadzisira chikamu | .35 | .45 | .39 | 1 | ||
5. Misiyano yezvinodyiwa zvinonyadzisira | .18 | .24 | .15 | .28 | 1 | |
6. Nguva yakatarwa yekuona zvinonyadzisira inoshandisa | .21 | .39 | .36 | .40 | .10 | 1 |
7. Age | 0.05 | 0.00 | 0.00 | .22 | 0.07 | 0.01 |
Tevere, isu takaitisa regression ongororo, umo nguva refu kwazvo yekuona zvinonyadzisira yakafanotaura (i) kutsvaga kurapwa, (ii) kuomarara kwezviratidzo, uye (iii) kunzwa kwekurasikirwa nehunhu pamusoro pemaitiro epabonde mune ese sampuro, pamwe ne - yezvikamu zviviri zvekupedzisira - zvevanotsvaga kurapwa uye neboka rinodzora zvakasiyana. Nguva yakatarwa yekuona zvinonyadzisira inoshandisa uye zera revatori vechikamu raidzorwa mune dzese modhi modhi. Ese mamodheru akagadzirwa anoenderana neanomira panguva imwechete yekumanikidza kupinda mukati (ona Tafura 3).
shanduka | Kurapa kutsvaga | Zvepabonde kupindwa muropa nezviratidzo | Kurasikirwa kwekutonga | ||||
---|---|---|---|---|---|---|---|
zvose | zvose | Ehe | Aihwa | zvose | Ehe | Aihwa | |
β | β | β | β | β | β | β | |
Yakarebesa kuona zvinonyadzisira chikamu | .32 | .36 | .18 | .26 | .29 | .26 | .15 |
Nguva yakatarwa yekuona zvinonyadzisira inoshandisa | .09 | .25 | .15 | .28 | .25 | .19 | .27 |
zera | -.08 | -.14 | -.27 | -.09 | -.11 | -.16 | -.08 |
F | 20.55 | 49.63 | 3.86 | 28.53 | 35.50 | 4.29 | 15.92 |
R2 | .130 | .267 | .125 | .209 | .205 | .136 | .127 |
Mune inotevera nhanho, isu takagadzira inoenderana yekudzora mamodheru ekusiyana kwezvakadyiwa zvinonyadzisira zvemukati. Mune aya mamodheru, musiyano wakataurwa wakaiswa muchinzvimbo chekufungidzira kwe (i) kutsvaga kurapwa, uyezve (ii) kuomarara kwezviratidzo uye (iii) manzwiro ekurasikirwa nekutonga pamusoro pehunhu hwepabonde mune yese sampuro, zvakare nezvevanotsvaga kurapwa uye neboka rinodzora zvakasiyana. Zvekare, nguva yakatarwa yekuona zvinonyadzisira inoshandisa uye zera revatori vechikamu rakadzorwa (Tafura 4).
shanduka | Kurapa kutsvaga | Zvepabonde kupindwa muropa nezviratidzo | Kurasikirwa kwekutonga | ||||
---|---|---|---|---|---|---|---|
zvose | zvose | Ehe | Aihwa | zvose | Ehe | Aihwa | |
β | β | β | β | β | β | β | |
Zvinonyadzisira zvinosiyana | 17 | .21 | .20 | .10 | .10 | .06 | .01 |
Nguva yekuona zvinonyadzisira inoshandisa | .20 | .37 | .20 | .38 | .36 | .25 | .33 |
zera | -.03 | -.10 | -.19 | -.06 | -.07 | -.12 | -.05 |
F | 11.51 | 35.87 | 4.68 | 21.68 | 24.33 | 2.65 | 13.83 |
R2 | .075 | .205 | .145 | .164 | .147 | .086 | .110 |
hurukuro
Kunyanya, iyo yekurebesa zvinonyadzisira yekutarisa chikamu iyo yainge yaitwa mairi inogona kunge iine hukama nehunhu hwekuzvibata, inofungidzira zvakanaka kurapwa kurapwa, kuomarara kwezviratidzo zvine ruzivo, uye nemanzwiro ekurasikirwa kwekudzora pamusoro pemaitiro ebonde muboka rese revatori vechikamu. Izvo zvakafanana zvainyanya kuitika kumakiriniki uye asiri emakiriniki mapoka kana achifungidzirwa zvakasiyana. Izvi zvinouya necaveat kuti hukama pakati peyakareba kwazvo kuona zvinonyadzisira chikamu uye kuomarara kwezviratidzo muboka rekiriniki - iro rakanga riri diki pane boka rekutonga - harina kusvika pakukosha (β = 0.18; P = .091). Mhedzisiro yakawanikwa inoratidzira yapfuura, humbowo hwekutanga hunoratidza kukosha kwekugara kwenguva refu kusinga misi yekuona zvinonyadzisira nguva dzekunetseka kwekushandisa zvinonyadzisira kwakawanikwa mukutsvaga kwekutanga.32 Uye zvakare, mhedzisiro yacho inoratidza kufanana nezvimwe zvinhu uye zvisina-zvinodhaka, izvo zvinorema kushandisa episodic ndechimwe chezvakakurumbira zviratidzo.21,22,23,25,26,27
Kunyangwe iyo yakatsanangurwa mhedzisiro pachayo isingareve zvakananga kuwedzera kushivirira kana kushushikana, sezvo hunyanzvi hwekushandisa zvinonyadzisira zvinhu zvine hunhu hunogona kuratidza hwakawanda, hwekutanga kufarira, zvinoita kunge zvingangoita zvinowirirana neanopindwa muropa nemhando dzematambudziko ezvinonyadzisira zvinoshandiswa .33,34 Kutsvagurudza mune ramangwana kunofanirwa kuongorora maratidziro ezvinonyadzisira anoshandiswa zvichienderana nehunhu hwezvakajeka zvemukati uye woongorora kana izvo zvido zvemamwe marudzi ezvinonyadzisira zvikawanikwa nekuda kwekufumurwa kune zvakajeka zvemukati mukati mehupenyu hwese kana zvinotsanangurwa zvirinani nezvaunofarira pakutanga. Iyi nyaya inoita kunge yakakosha pakiriniki uye inonakidza nesainzi uye inofanirwa kukwezva kwakawanda kutsvagiswa.
Zvinogumira uye Mafambiro enguva yemberi
Kutsvagurudza mune ramangwana kunozoda kuti vatsvagiridzi vatsanangurewo chaizvo kuti chii chinonzi "binge behaviour" zvine chekuita nekushandisa zvinonyadzisira. Inguva yakareba sei iyo yekuona zvinonyadzisira chikamu chekumisikidza sechidhakwa? Sezvambotaurwa, zviyero zveuwandu zvinogona kuve zvakaoma kumisikidza tsika kupindwa muropa pane, semuenzaniso, kushandiswa zvisiri pamutemo kwezvinhu,10,48 uye ichi chokwadi chinobata pachokwadi kana tsika dzakadai dzikashandiswa kune hunhu hwekuzvinyaradza Iyi, uye mimwe mibvunzo yakabatana, inofanirwa kupindurwa sekutsvagurudza nezvehunhu hwekuzvibata mukushushikana kwekuona zvinonyadzisira kushandisa uye kumanikidza kwehutano hwepabonde kunovapo.
Imwe imwe, inoenderana nhaurwa yekutsvagisa inoita senge inonakidza kwazvo panguva ino ndeipi chikamu chekuremerwa episodic kubatanidzwa mune kunetsa maitiro (kana binge maitiro) kunoitika mushure, kana kubudirira, nguva yekuwedzera kutonga pamusoro pemaitiro ehupombwe kana kuzvidzora? Izvo zvinokwanisika kuti maitiro akadaro ari iwo mhedzisiro yekuwedzeredza uye kusanzwisisika / kukonzeresa mhedzisiro yekudzora kwepfungwa, ayo akareba akafundwa neanonzwisisika masayendisiti epfungwa.12,49,50 Zvimwe zvidzidzo zvinodiwa kuti uongorore kuda uku.
Kana zvasvika pakusiyana kwezvinodyiwa zvemanyowani ezvinonyadzisira, chidzidzo chiripo chakaongorora kushandiswa kwemapoka mashanu chete ezvinonyadzisira (zvionekwe zvine hungochani, zvikamu zvebonde, zviitiko zvinosanganisira vanhu vanoita zvepabonde, zviitiko zvine mhirizhonga, zvinoitika pabonde nevadiki). Kushandiswa kwevamwe vacho chete (zvinonyadzisira zvinoratidzira bonde nevana vadiki uye mhirizhonga) inoonekwa sechirwere chega. Zvidzidzo zvenguva yemberi zvinofanirwa kukanda mambure akakura uye zvinosanganisira mamwe marudzi ezvinyorwa zvakajeka (kusanganisira zvikamu zvinowanzo kufadza kune varume vanoita zvepabonde, asi hazvibatanidzwe muchidzidzo chezvino, senge zviono zvevane mitezo yevanhurume nevanhukadzi, kana zvakanyanyisa. Mapoka38; onawo ongororo ichangobva kuitwa naBaranowski et al41). Zvinonyanya kuitika kuti kudyiwa kwevamwe, asi kwete mamwe marudzi ezvinyadzo, kunogona kuve kwakakosha mukusimudzira kwekuzviona-kwavo kwekupindwa muropa nekuona zvinonyadzisira nezvinetso vanoshandisa zviratidzo, semuenzaniso, chisimba, "hardcore" zvinonyadzisira kana paraphilic zvinonyadzisira. . Tsvagurudzo yapfuura yakapa humwe humbowo hwekuti chaiwo marudzi eanodyiwa ezvinonyadzisira anogona zvechokwadi kuva nemhedzisiro yemhedzisiro yekuita bonde pamwe nehukama hwepabonde uye husina-hukama-hunhu. Semuenzaniso, rimwe rebazi rakadai rekutsvaga rakaongorora hukama huripo pakati pekuona zvechisimba zvehupombwe nekushusha pabonde, kugamuchirwa kwenhema dzekubatwa chibharo, kubvumidzwa kuita zvechisimba pabonde, uye maitiro akafanana.51,52,53,54 Ongororo yeramangwana inofanirwa kuongorora kana chaiwo marudzi ezve pornographic zvemukati uye mashandisirwo ayo anogona kukanganisa maitiro ekutsvaga kurapwa uye kunetsa kwezvinonyadzisira zvinoshandisa zviratidzo kupfuura vamwe.
Imwe mhedzisiro yekudzidza ndeyeyakachinjika-chikamu chikamu dhizaini, iyo isiri yakanakisa kana mirayiridzo yekufungidzira ichiongororwa. Zvidzidzo zvenguva yemberi zvinofanirwa kuongorora mibvunzo yekutsvagisa yakatsanangurwa pano mumatanho ekureba. Iyo isingazivikanwe, yepamhepo maitiro echidzidzo anogona kunge akakonzera kuvimbika kwemhedzisiro. Mukuwedzera, chidzidzo chezvino chakaitwa CSBD isati yataridzirwa ICD-11,4 yaive yakavakirwa pane hypersexual kusagadzikana maitiro,5 uye SAST-R yaishandiswa sechiyero chekuomarara kwechiratidzo. Zvidzidzo zvenguva yemberi zvinofanirwa kushandisa nzira dzeCSBD4 uye matanho anoratidza izvi zvinotarisirwa, izvo zviri kuvandudzwa parizvino. Zvakare, zvakakosha kutsanangudza kuti iro kiriniki boka rakaonekwa neboka rakakura rakakura revarapi makumi maviri nevatatu, izvo zvinogona kukonzeresa imwe nhanho yekusiyana muhurongwa hwekuongorora. Mukupesana, boka rekutonga rakanyoreswa pamhepo uye harina kuongororwa nzira inoitwa nachiremba.
Iko kuongorora kwemazuva ano kunongoreva chete kune varume vanoita zvepabonde. Nhanho inotevera inofanirwa kuve yekuwedzera zviwanikwa zvakataurwa pano kuvakadzi nevatori vechingochani. Iwo iwo madiki madiki maR2 maitiro anowanikwa kune edu ekudzokorodza mamodheru anoratidza kuti zvimwe zvakakosha zvinhu zvinokonzeresa kurapwa kwekurapa uye kunetsekana maitiro ehupombwe zviratidzo hazvipo mukuwongorora kwedu. Izvi hazvishamise, sezvo ongororo yedu yaive yakanangana nemhando mbiri dzakasiyana uye kuyedza yakatarwa fungidziro. Izvo zvaive zvisina kuitirwa huwandu hwakawanda hwekufungidzira kana kuwedzera simba rekufungidzira remamodeli. Nekudaro, mhedzisiro yedu nenzira isina kunangana inoratidza kuti kune zvimwe zvakakosha zvinhu zvinokonzeresa kune zvinonetsa kushandisa zvinonyadzisira uye CSBD izvo zvakakosha kuti zviongororwe. Uyezve, mhedziso yekuti zvidzidzo zvinotsvaga kurapwa kwekunetseka kwezvinonyadzisira zvinoshandiswa zvinowanzoitika kupinda muchikamu chakareba chekuona zvinonyadzisira chinoshandisa uye kutarisa huwandu hwakawanda hwezvinyadzo zvemukati zvingaite sedzimwe tautological. Nekuda kwezvinhu izvi, kutsvagurudza mune ramangwana kunofanirwa kuongorora basa rezvimwe zvinokanganisa, kusanganisira mamwe matsananguriro ekuona zvinonyadzisira maitiro akasiyiwa muchidzidzo chezvino, semuenzaniso, zvinangwa zvekushandisa,55 pamwe nezvimwe zvekuziva uye zvepfungwa zvinhu9,56,57,58 zvinobatsira kumatambudziko epabonde, kusanganisira iwo anoratidzwa mumhando dzechimiro chechiitiko ichi.59,60,61 Izvo zvakare zvinoita kuti kubatanidzwa muzvikamu zvenguva refu zvekuona zvinonyadzisira kunogona kukanganiswa zvakanyanya nezvinhu zvisina kufungwa mukuwongorora kwazvino, senge basa kana hukama hwehukama, izvo zvinogona kukonzeresa kuti munhu apinde mukushandisa kwakanyanya episodic (binge shandisa), pachinzvimbo chekuwedzera kusarongeka, kushandisa kwakajairwa. Uye zvakare, zvinofanirwa kubvumwa kuti kune rakakura basa rekutsvagisa rinopokana nehutachiona hwehupombwe hwepamusoro-soro, huchokwadi hweiyo "yekuita zvepabonde" modhi kana kunongedzera kuzvinhu zvakaita sekukwirisa pabonde kana kusagadzikana pakati petsika dzetsika nehunhu kupa kune chinetso chimiro chezvepabonde.19,60,61,62 Nekuda kweizvi, zvidzidzo zvenguva yemberi zvinofanirwa kudzora zvinhu senge zvine hukasha pakuona zvinonyadzisira uye kusazvibata mutsika, kana uchiongorora zvinonetsa kushandisa.
Clinical Implications uye Mhedziso
Nyaya yekunyora
matafura
- Tafura 1Descriptive manhamba uye anoreva kuenzanisa kwematanho (Mann-Whitney U bvunzo, ine zvinoenderana nemagadzirirwo emasaizi) emisiyano inoshandiswa mukudzokorodza mamodheru, zvinoenderana nekutsvaga kwekurapa: Hongu (boka rinotsvaga kurapwa); Kwete (boka rekutonga)
- Tafura 2Correlation coefficients (Pearson's r) pakati pezvinhu zvese zvinosanganisirwa mukuongorora (zvichibva pane vese vatori vechikamu)
- Tafura 3Mhedzisiro yekudzokororwa kudzokorodza kunoongorora iyo yakarebesa isingamise chikamu chekuona zvinonyadzisira, avhareji vhiki vhiki yekutarisa zvinonyadzisira uye zera zvakafanotaura kurapwa kurapwa uye kuomarara kweanonetsa maitiro ehupombwe zviratidzo mune yese sampuro (Zvese) uye zvakare zvichienderana nekutsvaga kurapwa : Hongu (boka rinotsvaga kurapwa); Kwete (boka rekutonga)
- Tafura 4Mhedzisiro yekudzokororwa kudzokororwa kunoongorora umo kusiana kwekushandisa zvinonyadzisira, avhareji nguva yevhiki yakatarwa kuona zvinonyadzisira uye zera rakafanotaura kurapwa uye kunetseka kwehunhu hwepabonde mumuenzaniso wese (Zvese) uye zvakare zvichienderana nekutsvaga kurapwa: Hongu (kurapwa kunotsvaga boka) ; Kwete (boka rekutonga)