Behav Sci (Basel). SepNXX; 2016 (6): 3.
E hatisitsoe Inthaneteng 2016 Aug 5. doi: 10.3390 / bs6030017
Brian Y. Park,1 Gary Wilson,2 Jonathan Berger,3 Matthew Christman,3 Bryn Reina,4 Frank Bishop,5 Warren P. Klam,4 'me Andrew P. Doan4,5,*
inahaneloang
Lintho tsa setso tse kileng tsa hlalosa mathata a banna a thobalano li bonahala li sa lekana ho ikarabella bakeng sa ho phahama ho hoholo ha ho se sebetse ha erectile, ho lieha ho emisa, ho fokotsa khotsofalo ea thobalano, le ho fokotsa libido nakong ea thobalano e arohaneng ho banna ba ka tlase ho lilemo tse 40. Tlhatlhobo ena (1) e sheba lintlha tse tsoang libakeng tse ngata, mohlala. , kliniki, likokoana-hloko (ho lemalla / urology), kelello (boemo ba thobalano), bophelo ba batho; mme (2) e hlahisa letoto la litlaleho tsa bongaka, kaofela ka sepheo sa ho fana ka tataiso e ka bang teng bakeng sa lipatlisiso tse tlang tsa ketsahalo ena. Liphetoho tsamaisong e susumetsang ea boko li hlahlojoa e le mokhoa o ka bang teng oa etiology o bakang mathata a amanang le thobalano. Tlhahlobo ena e boetse e na le bopaki ba hore litšobotsi tse ikhethileng tsa litšoantšo tsa bootsoa tsa inthanete (bonohe bo se nang moeli, monyetla oa ho nyoloha habonolo ho thepa e fetelletseng, fomate ea video, jj.) E kanna ea ba matla ho lekana ho tsosa takatso ea thobalano ho likarolo tsa litšoantšo tsa bootsoa tsa inthanete tse sa fetoheng habonolo - balekane ba bophelo, joalo ka hore thobalano le balekane ba lakatsehang e kanna ea se ngolisoe joalo ka litebello tsa kopano le ho fokotseha ha tsoho. Litlaleho tsa bongaka li fana ka maikutlo a hore ho emisa ts'ebeliso ea litšoantšo tse manyala tse hlephisang boitšoaro Inthaneteng ka linako tse ling ho lekane ho etsolla litlamorao tse mpe, ho hatisa tlhoko ea lipatlisiso tse pharalletseng ho sebelisa mekhoa e nang le lihlooho tse tlosang tšebeliso e fapaneng ea litšoantšo tsa bootsoa tsa inthanete. Khabareng, ho hlahisoa mokhoa o bonolo oa ho hlahloba bakuli ba nang le ts'oaetso e amanang le thobalano.
Keywords: ho se sebetse hantle ka botona kapa botšehali, takatso e tlase ea thobalano, khotsofalo e tlase ea thobalano, ho lieha ho tsoha, litšoantšo tse litšila tse tsosang takatso, inthanete, litšoantšo tse tsosang takatso ea botona kapa botšehali, PIED
1. Selelekela
1.1. Mekhoa ea ho se sebetse ka thobalano-Lipotso tse sa arabelloang
Ho fihlela lilemong tse leshome tse fetileng, litekanyetso tsa ED li ne li le tlaase ho banna ba kopanelang liphate tlasa 40, 'me ha lia ka tsa qala ho ema ka matla ho fihlela ka mor'a moo [1,2]. Phuputso e kholo ea likarolo tsa 1999 e tlalehile ho se sebetse ha erectile ho 5%, le takatso e tlaase ea thobalano ho 5% ea banna ba kopanelang liphate, lilemo tse 18 ho 59 [3], 'me tlhahlobo ea 2002 ea lipatlisiso tsa erectile-dysfunction e tlalehile litefiso tse tsitsitseng tsa 2% ho banna ba tlas'a 40 (ntle le thuto e fetileng) [2]. Litlaleho tsena li ne li bokelloa ka pel'a "li-tube tsa bootsoa" tsa Inthanete li nolofalletsa batho ho fumana livideo tse hlalosang thobalano tse sa hlokahaleng. Ntho ea pele ho tsena "tube" e hlahile ka September 2006 [4].
Ka lehlakoreng le leng, lipatlisiso tsa morao-rao ka ED le takatso e tlaase ea ho kopanela liphate li ngotse ka ho eketseha ha sekhahla sa ts'oaetso e joalo ho banna ba tlas'a 40. Pontšo e hlakileng ea ts'ebetso ena e amana le ED, mme e bapisa litekanyetso tse kholo haholo, tseo kaofela li ileng tsa hlahlojoa li sebelisa potso e tšoanang (yebo / ha) ka ED joaloka karolo ea Thuto ea Lefatše ea Boikutlo ba Thobalano le Boits'oaro (GSSAB). Ka 2001-2002, e ne e fuoe banna ba 13,618 ba kopanelang liphate linaheng tsa 29 [5]. Lilemo tse leshome hamorao, ka 2011, potso e tšoanang (yebo / ha) ho GSSAB e ne e laoloa ho banna ba 2737 ba kopanelang liphate Croatia, Norway le Portugal [6]. Sehlopha sa pele, ho 2001-2002, se ne se le lilemo li 40-80. Sehlopha sa bobeli, ho 2011, se ne se le 40 le tlase. Ho itšetlehile ka liphuputso tsa lithuto tsa histori tse qotsitsoeng pejana, banna ba baholo ba ne ba tla lebelloa hore ba be le litekanyetso tse phahameng tsa ED ho feta litekanyetso tse sa lokelang tsa banna ba bacha [2,7]. Leha ho le joalo, ka lilemo tse leshome feela, lintho li ile tsa fetoha ka ho feletseng. Linomoro tsa 2001-2002 bakeng sa banna ba baholo 40-80 li ne li le ka 13% Europe [5]. Ka 2011, lipalo tsa ED ho bacha ba Europe, 18-40, ho tloha 14% -28% [6].
Lilemong tse 'maloa tse fetileng, patlisiso e sebelisa mefuta e fapaneng ea lisebelisoa e senoletse bopaki bo eketsehileng ba keketseho e sa lebelloang ea mathata a thobalano har'a bahlankana. Ka 2012, bafuputsi ba Switzerland ba fumane likhaello tsa ED tsa 30% sehlakaneng sa banna ba Switzerland ba lilemo li 18-24 ba sebelisang International Index of Erectile Function (IIEF-5) [8]. Phuputso ea Setsi sa 2013 e tlalehile e mong ho bakuli ba bane ba batlang thuso bakeng sa ts'ebetso e ncha ea ED e ne e le monyenyane ho feta 40, e nang le litekanyetso tsa ED e matla hoo e ka bang 10% e phahameng ho feta banna ho feta 40 [9]. Phuputso ea 2014 ho bacha ba Canada e tlalehile hore 53.5% ea banna ba lilemo li 16-21 e na le matšoao a bontšang bothata ba botona le botšehali [10]. Ho se sebetse ha Erectile ho ne ho tloaelehile ka ho fetisisa (26%), ho lateloa ke takatso ea ho kopanela liphate (24%), le mathata a nang le orgasm (11%). Litholoana li ile tsa makatsa baqolotsi, "Ha hoa utloahala hore na ke hobane'ng ha re fumane litekanyetso tse phahameng joalo ka kakaretso, empa haholo-holo litekanyetso tse phahameng har'a barupeluoa le basali ho e-na le barupeluoa ba bang feela, joalokaha ho tloaelehile lingoliloeng tsa batho ba baholo" [10] (p.638). Phuputso ea 2016 ea sehlopha sena se ile sa hlahloba mathata a ho kopanela liphate lilemong tsa bocha (16-21 lilemo) ka maqhubu a mahlano ka lilemo tse peli. Bakeng sa banna, mathata a sa khaotseng (bonyane leqhubu le le leng) e ne e le khotsofalo e tlaase ea thobalano (47.9%), takatso e tlase (46.2%), le mathata a erectile (45.3%). Bafuputsi ba hlokometse hore ha nako e ntse e feta mathata a thobalano a fokotsehile ho basali, empa eseng bakeng sa banna [11]. Phuputso ea 2014 ea ts'oaetso e ncha ea ED ka mosebetsi o sebetsang servicemen e tlalehile hore litefiso li bile le makhetlo a fetang a mabeli pakeng tsa 2004 le 2013 [12]. Matšeliso a ED ea kelello ea mafu a kelello a eketsehile ho feta ED e, ha litefiso tsa ED tse sa ratoang li lula li tsitsitse [12]. Phuputso ea karolo ea 2014 ea mosebetsi oa mafolofolo, e nang le bophelo bo botle, banna ba sesole ba lilemo li 21-40 ba sebelisang lintho tse hlano tsa IIEF-5 ba fumane karolo ea ED ea 33.2% [13], ka litekanyetso tse phahameng ho feta 15.7% ho batho ba se nang khatello ea kelello ea posttraumatic [14]. Bafuputsi ba boetse ba hlokometse hore likamano tsa botona le botšehali li na le litšitiso tse sa amaneng tse amanang le khethollo [14], le hore ke 1.64% feela ea ba nang le ED ba neng ba batla litokomane tsa phosphodiesterase-5 inhibitors ka sesole [13]. Tlhaloso ea bobeli ea lintlha tsa sefapano sa sesole e senotse hore mathata a ts'ebetso ea ho kopanela liphate a ne a amana le "matšoenyeho a thobalano" le "setšoantšo sa botona ba botona kapa botšehali" [14]. Tlhaloso e Khutšoanyane ea 2015 e tlalehile Palo ea ED ho feta 31% ho banna ba kopanelang liphate le litekanyetso tse tlase tsa thobalano ho feta 37% [6]. Qetellong, phuputso e 'ngoe ea 2015 ho banna (lilemo tse bolelang hore ke lilemo tse ka bang 36), e tlalehile hore ED e feletsoe ke takatso e tlase ea ho kopanela liphate le batho ba kopanetsoeng, hona joale e tloaelehile haholo ho banna ba batlang thuso ea boitšoaro bo feteletseng ba ho kopanela liphate, bao hangata ba "sebelisang litšoantšo tsa bootsoa le ho ipholla litho tsa botona kapa botšehali "[15].
Tloaelo, ED e bonoa e le bothata bo itšetlehileng ka lilemo [2], 'me lipatlisiso tsa maemo a kotsi a ED ho banna ba tlas'a 40 hangata li hlōlehile ho khetholla mabaka a atisang ho amahanngoa le ED ho banna ba hōlileng, tse kang ho tsuba, joala, botenya, bophelo ba bolulo, lefu la tsoekere, khatello ea kelello, lefu la pelo le hyperlipidemia [16]. ED e atisa ho hlalosoa e le ea psychogenic kapa ea manyolo. Maqheku a ED a amana le mabaka a kelello (mohlala, ho tepella maikutlong, khatello ea kelello, khatello ea kelello, kapa ho tšoenyeha ha ts'ebetso) ha tlhaho ea ED e 'nile ea bitsoa maemo a nama (mohlala, methapo ea pelo, li-hormone, li-anatomical kapa pharmacologic litla-morao) [[17]. Bakeng sa banna ba tlas'a 40, lefuba le tloaelehileng haholo ke ED, 'me bafuputsi ba hakanya hore ke 15% -20% feela ea linyeoe tse qalileng ka tlhaho [18].
Leha ho le joalo, ha ho tse ling tsa lintho tse tloaelehileng tse tsamaisanang le maikutlo a tlhahiso-pele bakeng sa ED ea maiketsetso li bonahala li loketse ho ikarabella bakeng sa keketseho e potlakileng hangata ea mathata a bocha ba thobalano. Ka mohlala, bafuputsi ba bang ba nahana hore mathata a bocha a ho kopanela liphate a lokela ho bakoa ke mekhoa e sa tloaelehang ea bophelo, e kang ho nona haholo, tšebeliso e mpe ea lithethefatsi le tsuba (mabaka a histori a amana le organic ED). Leha ho le joalo, mekhoa ena ea mekhoa ea bophelo e sa fetohe, kapa e fokotsehile, lilemong tsa ho qetela tsa 20: Botenya ba batho ba nang le 20-40 ba US bo phahame feela 4% pakeng tsa 1999 le 2008 [19]; mefuta ea ts'ebetsong ea lithethefatsi e seng molaong har'a baahi ba US ba nang le 12 kapa ba baholo ba se ba tsitsitse ka lilemo tse fetileng tsa 15 [20]; le litefello tsa batho ba baholo ba United States li fokotsehile ho tloha 25% ho 1993 ho 19% ho 2011 [21]. Bangoli ba bang ba fana ka mabaka a kelello. Leha ho le joalo, ho ka etsahala hore ebe ho tšoenyeha le ho tepella maikutlong ho na le mathata a ho kopanela liphate a bocha a fanoeng ke kamano e rarahaneng pakeng tsa takatso ea ho kopanela liphate le ho tepella maikutlong le ho tšoenyeha? Bakuli ba bang ba tepeletseng le ba tšoenyehileng ba tlaleha takatso e fokolang ea thobalano ha ba bang ba tlaleha takatso e eketsehileng ea thobalano [22,23,24,25]. Hase feela kamano pakeng tsa ho tepella maikutlong le ED e ka 'nang ea e-ba teng ka bobeli, e ka' na ea e-ba phello ea ho se sebetse ka thobalano, haholo-holo ho bahlankana [26]. Le hoja ho le thata ho lekanyetsa litekanyetso tsa maemo a mang a kelello a fetisetsoang ke tlaleho bakeng sa ho hōla ka bohale mathata a ho kopanela liphate, joaloka khatello ea kelello, likamano tse tepeletseng le thuto e sa lekaneng ea ho kopanela liphate, ke ho utloahalang hakaakang ho nahana hore lintlha tsena ke (1) le (2) li sebelisitse lihlahisoa tse lekaneng ho hlalosa keketseho e potlakileng ea mefuta-futa ea bothata ba botona le botšehali, joalo ka takatso ea ho kopanela liphate, bothata ba ho kopanela liphate le ED?
1.2. Na Litšoantšo Tsa Bootsoa Inthaneteng li Sebelisa Mathata a Kajeno a Thobalano?
Bafuputsi ba Kinsey Institute ba ne ba le har'a ba pele ba tlaleha litšoantšo tse manyala tse hlephisang boitšoaro-tse entsoeng ka erectile-dysfunction (PIED) le litšoantšo tsa bootsoa-li bakile libido tse sa tloaelehang, ka 2007 [27]. Karolo ea lihlooho tse fumanoang libakeng tsa bolulo le libaka tsa ho hlapela, moo litšoantšo tsa bootsoa li neng li le "hohle", li ne li sa khone ho finyella litlhahiso ho laborateng ho arabela litšoantšo tsa bootsoa. Ha bafuputsi ba bua ka litaba tsena, bafuputsi ba fumane hore ho shebella lipapali tse manyala tse hlephisang boitšoaro haholo ho bonahala ho entse hore ho be le boikarabelo bo fokolang le tlhokahalo e eketsehileng ea boitsebiso bo feteletseng, bo khethehileng kapa "kinky" ho tsoha. Bafuputsi ba hlile ba hlophisa thuto ea bona ho kenya likarolo tse fapaneng tse fapaneng 'me ba lumella ba bang ho ikhethela. Karolo ea kotara ea litho tsa 'mele tsa barupeluoa li ntse li sa arabe ka mokhoa o tloaelehileng [27].
Ho tloha ka nako eo, bopaki bo bontšitse hore litšoantšo tse manyala tse hlephisang boitšoaro tsa Inthanete e ka 'na ea e-ba sesosa sa ho eketseha ka potlako likaleng tsa ho se sebetse ka thobalano. Hoo e batlang e le batho ba tšeletseng ba 10 baeti ba 3962 ba batlang thuso ho "MedHelp.org ED Forum" e hlaheletseng, ba ileng ba bua ka lilemo tsa bona, ba ne ba le monyenyane ho feta 25. Phuputsong eo ea lilemo tse robeli tsa litlaleho le litlhaloso, har'a mantsoe a atisang ho amahanngoa le karolo ea kelello ea ED (e seng ea manyolo a ED), "litšoantšo tsa bootsoa" li ne li hlaha hangata ka ho fetisisa [28]. Phuputso ea 2015 ea batho ba hōlileng sekolong se phahameng e fumane hore litšoantšo tsa bootsoa tsa Inthanete li sebelisa hangata tse amanang le takatso e tlaase ea ho kopanela liphate [29]. Ho ba neng ba ja litšoantšo tsa bootsoa Inthaneteng hanngoe ka beke, 16% e ile ea tlaleha takatso ea thobalano e tlaase, ha e bapisoa le 0% ho bao e seng bareki (le 6% bakeng sa ba neng ba ja tlase ho hang ka beke). Tlhahlobo e 'ngoe ea 2015 ea banna (ba lilemo li ikhethang 41.5) ba batlang phekolo ea bong bo tšoanang le ba bosodoma, ba ikutloang litho tsa botona kapa botšehali ("ka tloaelo ba nang le litšoantšo tse manyala tse hlephisang boitšoaro hangata") lihora tse supileng kapa ho feta ka beke, ba fumane hore 71% e na le mathata a ho kopanela liphate, le 33% e tlaleha bothata ba ho kopanela liphate [30]. Ho tšoenyeha ka ho kopanela liphate ho ka etsa hore u itšetlehe haholo ka litšoantšo tsa bootsoa e le thobalano ea thobalano. Phuputsong ea XMUMX e sebetsang ka litšoantšo tse ts'oanang le litšoantšo tsa bootsoa (XMUMX), ba 2014 ba sebelisang litšoantšo tse manyala tse hlephisang boitšoaro tsa Inthanete tsa 11 (karolelano ea lilemo tsa 19), bao boko ba bona bo neng bo hlahlojoa bakeng sa bopaki ba ho lemala, bo tlalehile hore ka lebaka la tšebeliso e feteletseng ea litšoantšo tsa bootsoa ba Internet " ho fokotsa libido kapa mosebetsi oa erectile ka ho khetheha litabeng tsa kamano le basali (le hoja li sa tsamaisane le lintho tse hlalosang thobalano) "[31]. Lingaka li boetse li hlalositse likamano tsa botona le botšehali tse amanang le thobalano, ho kenyeletsa le PIED. Mohlala, bukeng ea hae The New Naked, moprofesa oa urology Harry Fisch o tlalehile hore litšoantšo tsa bootsoa tse feteletseng tsa inthanete li senya ts'ebetso ea thobalano ho bakuli ba hae [32], le moprofesa oa mafu a kelello Norman Doidge o tlaleha ka bukeng ea hae Boko bo Itšusumetsang hore tloso ea litšoantšo tsa bootsoa tsa inthanete e sebelisitse mathata le mathata a ho tsosa takatso ea thobalano ho bakuli ba hae [33]. Ka 2014, Bronner le Ben-Zion ba tlaleha hore motho ea sebelisang boitšoaro bo bobe ba ho sheba litšoantšo tsa bootsoa Inthaneteng, eo litakatso tsa hae tsa bootsoa li neng li se li le boemong bo feteletseng ba bootsoa, o ile a batla thuso bakeng sa takatso ea thobalano nakong ea thobalano. Likhoeli tse robeli ka mor'a ho khaotsa ho shebella litšoantšo tse manyala tse hlephisang boitšoaro, mokuli o tlaleha hore o atlehile ho ba le maikutlo a ts'oanang, 'me a atleha ho thabela likamano tse ntle tsa thobalano [34]. Ho fihlela joale, ha ho bafuputsi ba bang ba kileng ba botsa banna ba nang le mathata a ho kopanela liphate ho tlosa litšoantšo tse manyala tse hlephisang boitšoaro tsa Inthanete tse sebelisetsoang ho etsa lipatlisiso hore na li kenya letsoho litabeng tsa bona tsa thobalano.
Le hoja lithuto tse joalo tsa ho kenella li tla ba tse khanyang ka ho fetisisa, tlhahlobo ea rona ea lingoliloeng e fumana lithuto tse 'maloa tse amanang le litšoantšo tse tsosang takatso tse sebelisoang ka ho tsosoa, ho khahloa le mathata a ho kopanela liphate [27,31,35,36,37,38,39,40,41,42,43], ho akarelletsa le bothata ba li-orgasming, ho fokotseha libido kapa mosebetsi oa erectile [27,30,31,35,43,44], liphello tse mpe ho thobalano e kopanetsoeng [37], fokotseha thabo ea ho kopanela liphate [37,41,45], ho khotsofatsoa ke thobalano le kamano ea hau [38, 39, 40, 43, 44, 45, 46, 47], khetho ea ho sebelisa litšoantšo tse manyala tse hlephisang boitšoaro Inthaneteng ho finyella le ho lula u tsosoa takatso ea ho kopanela liphate le molekane [42], le ho matlafatsa bokhoni ba bokooa ho arabela litšoantšong tse manyala tse hlephisang boitšoaro ho ba tlaleha takatso e nyenyane ea thobalano le balekane [48]. Hape, litšoantšo tse manyala tse hlephisang boitšoaro tsa Inthanete li sebelisa khafetsa haholo le takatso e tlaase ea ho kopanela liphate sekolong se phahameng sa batho ba phahameng sekolong29]. Lithuto tse peli tsa 2016 li tšoanela ho hlahlojoa ka ho hlaka mona. Phuputso ea pele e boletse hore ke thuto ea pele ea sechaba ho banyalani ho hlahloba liphello tsa litšoantšo tse litšila tse tsosang takatso tse sebelisoang ka li-data-longitudinal data. E ile ea tlaleha hore ho sebelisa litšoantšo tse litšila tse tsosang takatso ho Wave 1 (2006) ho ne ho amana ka matla le hampe le litho tsa litho tsa lenyalo le khotsofalo le bophelo ba bona ba thobalano ho Wave 2 (2012). Lenyalo le amehileng ka ho fetisisa ke la banna ba neng ba sheba litšoantšo tsa bootsoa maemong a phahameng ka ho fetisisa (hang ka letsatsi kapa ho feta). Ho hlahloba mefuta e mengata ea litšoantšo tse ts'oanang, litšoantšo tse manyala tse hlephisang boitšoaro li sebelisoa ho 2006 e ne e le mokhoa oa bobeli o matla ka ho fetisisa oa boleng ba lenyalo bo sa lokelang ka 2012 [47]. Thuto ea bobeli e boletse hore ke eona feela thuto ea ho batlisisa ka ho toba likamano pakeng tsa ts'oaetso ea thobalano ho banna le ho ameha ka mathata ho li-OSA (liketso tsa thobalano). Phuputso ena ea banna ba 434 e tlaleha hore khotsofalo e tlase ea thobalano le mosebetsi o tlaase oa erectile li amana le litšoantšo tse litšila tse tsosang takatso tsa Inthanete li sebelisa [44]. Ho feta moo, 20.3% ea banna bao ba re sepheo se seng sa litšoantšo tsa bona tsa bootsoa ke "ho boloka ho tsosoa le molekane oa ka" [44]. Ha ho fumanoa hore ho ka 'na ha bontša hore litšoantšo tsa bootsoa lia sebelisoa, 49% e hlalositse ka nako e' ngoe "ho batla litaba tsa thobalano kapa ho ameha ho li-OSA tseo pele li neng li sa li thahasellise kapa hore li nka ho nyonyeha" [44] (p.260). Qetellong, karolo ea bohlokoa ea litho tsa sehlopha (27.6%) e ile ea itlhahloba ka ho sebelisoa ha bona ka li-OSA e le mathata. Le hoja tekanyo ena ea ho sheba litšoantšo tse litšila tse tsosang takatso e ka 'na ea bonahala e phahame, tlhahlobo e' ngoe ea 2016 ho banna ba 1298 ba neng ba shebile litšoantšo tse manyala tse hlephisang boitšoaro lilemong tse tšeletseng tse qetellang e tlalehile hore 28% ea barupeluoa ba ile ba fumana kapa ho feta taolo ea ho hlekahleka ka bongata [49].
Tlhaloso ea rona e boetse e kenyelletsa lipampiri tse peli tsa 2015 tse bolelang hore litšoantšo tse manyala tse hlephisang boitšoaro tsa Inthanete ha li amane le ho phahamisa mathata a thobalano ho banna ba bacha. Leha ho le joalo, litlaleho tse joalo li bonahala eka li sa tsoa qeta ho hlahloba lipampiri tsena ka hloko le ho nyatsuoa ka mokhoa o tšoanang. Pampiri ea pele e na le lintlha tse molemo mabapi le karolo ea bohlokoa ea boemo ba ho kopanela liphate ED ea bocha [50]. Leha ho le joalo, khatiso ena e tlile tlas'a ho nyatsoa ka ho se lumellane ho fapaneng, ho fokotsa lintho le mefokolo ea litsela. Ka mohlala, ha e fane ka liphetho tsa litekanyetso bakeng sa mokhoa oa erectile oa sephetho sa boemo bo amanang le litšoantšo tsa bootsoa tsa Inthanete tse sebelisoang. Ho feta moo, ha ngaka e etsang lipatlisiso e hlalositsoe ka mokhoa o hlophisitsoeng oa pampiri, bangoli ba lipampiri, "ha baa fana ka tlhahiso-leseling e lekaneng mabapi le baahi ba ithutoang kapa lipalo-palo li hlahlobisisa ho lumellana le qeto ea bona" [51]. Ho phaella moo, bafuputsi ba ile ba phenyekolla feela lihora tse ngata tsa bootsoa ba Inthanete ba sebelisa khoeli e fetileng. Leha ho le joalo, lipatlisiso tsa ho lemalla litšoantšo tse manyala tse hlephisang boitšoaro tsa Inthanete li fumane hore mefuta e sa tšoaneng ea litšoantšo tse manyala tse hlephisang boitšoaro tsa Inthanete e sebelisa ka boeona ha e amane haholo le "mathata a bophelo ba letsatsi le leng le le leng", tse ngata ho SAST-R (Sexual Addiction Screening Test), le lintlha tse hlahang IATsex (seletsa e lekanyang ho lemalla liketso tsa ho kopanela liphate ka inthaneteng) [52,53,54,55,56]. Moeletsi ea molemo ke boithabiso bo tsosang takatso ea ho kopanela liphate ho tsosoa takatso ha a ntse a shebella litšoantšo tse manyala tse hlephisang boitšoaro tsa Internet (cue reactivity), correlate e tsitsitseng ea boitšoaro bo hlephileng ba lithethefatsi tsohle [52,53,54]. Ho boetse ho na le bopaki bo ntseng bo eketseha ba hore nako e sebelisetsoang ho bapala lipapaling tsa Inthaneteng ha e bolele esale pele boitšoaro bo hlephileng. "Lithethefatsi li ka hlahlojoa feela haeba sepheo, liphello le likarolo tsa maemo a boitšoaro li boetse ke karolo ea tekanyetso" [57]. Lihlopha tse ling tse tharo tsa lipatlisiso, tse sebelisang mekhoa e fapa-fapaneng ea "bosodoma" (ntle le lihora tse ngata tsa tšebeliso), li e sebelisitse haholo le mathata a thobalano [15,30,31]. Ho hlophisitsoe, phuputso ena e bontša hore ho e-na le "lihora tse ngata tsa tšebeliso", mefuta e mengata e bohlokoa haholo tabeng ea ho lemalla ho lemalla litšoantšo tsa bootsoa / bosodoma, 'me mohlomong le eona e bohlokoa haholo ha ho hlahlojoa litlokotsi tsa thobalano tse amanang le thobalano.
Koranta ea bobeli e ile ea tlaleha phapang e nyenyane pakeng tsa palo ea litšoantšo tsa bootsoa tsa Inthanete selemong se fetileng le litekanyetso tsa ED ka banna ba kopanelang liphate ba Norway, Portugal le Croatia [6]. Bangoli bana, ho fapana le tse ling tsa pampiri e fetileng, ba lemoha ho ata ha ED ho banna ba 40 le ka tlase, 'me ka sebele ba fumane li-ED le tlase tsa takatso ea thobalano ho feta 31% le 37%, ka ho latellana. Ka lehlakoreng le leng, lipatlisiso pele ho phallo ea litšoantšo tsa bootsoa tsa Inthanete tse entsoeng ka 2004 ke e mong oa bangoli ba pampiri ba tlaleha likhakanyo tsa ED feela tsa 5.8% ho banna 35-39 [58]. Leha ho le joalo, ka lebaka la papiso ea lipalo, bangoli ba etsa qeto ea hore litšoantšo tse manyala tse hlephisang boitšoaro tsa Inthanete ha li bonahale li le kotsi haholo bakeng sa ED ea bocha. Ho bonahala eka banna ba Mapotoketsi bao ba ileng ba etsa lipatlisiso ba tlaleha litefiso tse tlaase ka ho fetisisa tsa ho kopanela liphate ho fapana le batho ba Norway le ba Croatia, 'me 40% feela ea Sepotoketsi e tlalehile ho sebelisa litšoantšo tsa bootsoa "Inthaneteng ka makhetlo a' maloa ka beke ho isa ho letsatsi", ha e bapisoa le MaNorway , 57%, le Croatians, 59%. Koranta ena e 'nile ea nyatsuoa ka molao ka ho se sebelise mehlala e pharaletseng e khonang ho kenyelletsa likamano tse tobileng le tse sa tsejoeng pakeng tsa mefuta e tsejoang kapa ea hypothesized hore e sebetse [59]. Ka mokhoa o ts'oanang, ka pampiri e amanang le bothata bo tebileng ba ho kopanela liphate bo etsoang ke barupeluoa ba bangata ba lipatlisiso ba tsoang Portugal, Croatia le Norway, banna bao ba botsoa hore na ke lintlha life tse ngata tseo ba lumelang hore li tlatsetsa bothateng ba bona ba ho se tsotelle. Har'a mabaka a mang, hoo e batlang e le 11% -22% e khethile "Ke sebelisa litšoantšo tsa bootsoa haholo" 'me 16% -26% e khethile "Ke ipholla litho tsa botona kapa botšehali"60].
Hape, lithuto tsa ho kenella li tla ba tse rutang ka ho fetisisa. Leha ho le joalo, mabapi le lithuto tsa correlation, ho ka 'na ha e-ba le setšoantšo se rarahaneng sa mefuta-futa se lokelang ho phenyekolloa e le ho hlokomelisa lisosa tsa likotsi tse sebetsang ka mathata a sa lebelloang a bocha a ho kopanela liphate. Taba ea pele, e ka 'na ea e-ba takatso e tebileng ea ho kopanela liphate, bothata ba ho kopanela liphate le molekane le mathata a erectile ke karolo e tšoanang ea liphello tse amanang le litšoantšo tse manyala tse hlephisang boitšoaro tsa Inthanete, le hore mathata ana kaofela a lokela ho kopanngoa ha ho batlisisoa ka likamano tse khanyang le litšoantšo tsa bootsoa tsa Inthanete.
Ea bobeli, le hoja ho sa tsejoe hantle hore na ke lintlha life tse ka 'nang tsa e-ba molemo ka ho fetisisa bakeng sa mathata a joalo, mekhoa e tšepisang ea ho batlisisa hammoho le palo ea litšoantšo tsa bootsoa tsa Inthanete e ka' na ea akarelletsa (1) lilemo tsa litšoantšo tsa bootsoa-tse thusitsoeng khahlanong le litšoantšo tse litšila tse tsosang takatso; (2) karolelano ea likarolo tse nang le molekane le li-ejaculations le litšoantšo tsa bootsoa tsa Inthanete; (3) boteng ba ho lemalla litšoantšo tsa bootsoa tsa Inthanete / bosodoma; (4) palo ea lilemo tsa ho shebella litšoantšo tsa bootsoa tsa Inthanete li sebelisa; (5) ka nako efe ka nako e tloaelehileng tšebeliso ea litšoantšo tsa bootsoa tsa Inthanete e qalile le hore na e qale pele ho kena bongoaneng; (6) mekhoa ea ho sheba litšoantšo tsa bootsoa Inthaneteng e ntse e eketseha; (7) ho ea ho mefuta e feteletseng ea litšoantšo tsa bootsoa Inthaneteng, joalo-joalo.
2. Litlaleho tsa Bongaka
Ha ho ntse ho le bonolo ho khanna lithuto tsa likamano, bothata ba ho arola mefuta e tobileng ea mosebetsi mosebetsing oa ho se sebetse ka ho kopanela liphate ho banna ba tlas'a 40 ho fana ka maikutlo a hore lithuto tsa ho kenella (moo lihlooho li ileng tsa tlosa litšoantšo tse manyala tse hlephisang boitšoaro tsa Inthanete) ho amana pakeng tsa tšebeliso ea eona le mathata a thobalano. Litlaleho tse latelang tsa bongaka li bontša kamoo ho botsa bakuli ba nang le mathata a sa tšoaneng le a sa hlalosoang ho felisa litšoantšo tse tsosang takatso ea Inthanete ho thusa ho arola liphello tsa bona litabeng tsa thobalano. Ka tlaase re tlaleha ka litoro tse tharo tse sebetsang tsa servicemen. Ba babeli ba ile ba bona ngaka bakeng sa ho se sebetse ha bona erectile e sa pheleng, takatso e tebileng ea ho kopanela liphate, le bothata bo sa hlaloseng ba ho finyella litho tsa botona le botšehali le balekane. Liphetoho tsa pele tse boletsoeng (1), (6) le (7), tse thathamisitsoeng serapeng se fetileng. Ea bobeli e boletsoeng (6) le (7). Ka bobeli ba ne ba se na boloetse bo botle ba kelello. Re boetse re tlaleha mohlankana oa boraro ea sebetsang ka thata mosebetsing ea ileng a bona ngaka ea mabaka a bophelo bo botle ba kelello. O buile ka phapang (6).
2.1. Tlhahlobo ea Pele ea Kakaretso
Mosebetsi oa ho sebetsa ka lilemo tse 20 o ile oa ngolla basebeletsi ba Caucasia ba nang le mathata a finyellang likamano tsa botona kapa botšehali nakong ea thobalano likhoeling tse tšeletseng tse fetileng. E ile ea qala ha a ntse a fetisetsoa mose ho maoatle. O ne a ipholla litho tsa botona kapa botšehali ka nako e ka etsang hora a se na palesa, 'me botona ba hae bo ne bo tsamaea hantle. Mathata a hae a ho ts'ehetsa le ho finyella li-orgasm a tsoelapele ho pholletsa le mosebetsi oa hae. Ho tloha ha a khutla, o ne a sa khone ho ejaculate nakong ea thobalano le mohlankana oa hae. O ne a ka finyella erection empa a sitoa ho etsa lipapali, mme ka mor'a 10-15 min o ne a tla lahleheloa ke ts'ebetso ea hae, e leng se neng se se joalo pele a e-na le litaba tsa ED. Sena se ne se baka bothata kamanong ea hae le molekane oa hae.
Mokuli ea mamellang ho ipholla litho tsa botona kapa botšehali hangata bakeng sa "lilemo", 'me hang kapa ka makhetlo a mabeli hoo e ka bang letsatsi le leng le le leng bakeng sa lilemo tse' maloa tse fetileng. O ile a lumella ho shebella litšoantšo tsa bootsoa tsa Inthanete bakeng sa ho tsosolosa. Kaha o ne a fumane Inthanete ka lebelo le leholo, o ne a itšetlehile feela ka litšoantšo tsa bootsoa tsa Inthanete. Qalong, "bootsoa bo bonolo", moo litaba li sa kenyelletsang ho kopanela liphate, "o ile a etsa mano". Leha ho le joalo, butle-butle o ne a hloka boitsebiso bo bongata bo hlakileng kapa bo fokolang. O ile a tlaleha livideo tse ngata tsa nako e le 'ngoe ka nako e le' ngoe le ho shebella likarolo tse susumetsang ka ho fetisisa. Ha a lokisetsa ho ngolisoa hoo e ka bang selemo se fetileng, o ne a tšoenyehile ka ho ba hōle le thobalano e kopanetsoeng. Kahoo, o ile a reka lipapali tsa thobalano, tseo a ileng a li hlalosa e le "botšehali ba leshano". Qalong sesebelisoa sena se ne se khothatsa hoo a fihletseng li-orgasm ka metsotsoana. Leha ho le joalo, joalokaha ho ne ho le joalo ka litšoantšo tse litšila tse tsosang takatso tsa Inthanete, ka tšebeliso e eketsehileng, o ne a hloka nako e teletsana ho feta nako e telele ho ejaculate, 'me qetellong o ne a sa khone ho itlosa bolutu. Ho tloha ha a khutla ho tloha moo, o ile a tlaleha hore o tsoela pele ho ikhotsofatsa ka ho ipholla litho tse ling ka makhetlo a mangata ka letsatsi ho sebelisa litšoantšo tsa bootsoa le Inthanete. Le hoja 'meleng le maikutlong a khahloa ke motlatsi oa hae, mokuli o ile a tlaleha hore o khethile mochine hore a etse thobalano ea sebele hobane o fumane e le e susumetsang haholoanyane. O ile a hana linyeoe tse ling tsa kamano. O ile a boela a latola leha e le efe ea botho le / kapa mosebetsi oa khatello ea mosebetsi. O ile a hlalosa maikutlo a hae ka "ho ameha" hobane o ne a tšoenyehile hore ho na le ho hong ho phoso ka litho tsa hae tsa botona le botšehali 'me o batla kamano ea hae le molekane oa hae hore a sebetse. O ne a qala ho nahana hore ha a sa khahloa ke eena.
Ka makhetlo a mangata, o ne a se na histori ea mafu a maholo, ho buuoa, kapa mafu a mafu a kelello. O ne a sa noe meriana leha e le efe kapa e tlatsetsa. O ile a latola ho sebelisa lihlahisoa tsa koae empa a noa lino tse seng kae ka makhetlo a mabeli kapa a mabeli ka khoeli. O ne a e-s'o ka a hlola a noa tahi. O ile a tlaleha likamano tse ngata tsa thobalano nakong e fetileng, empa ho tloha ha a ntse a kopanela selemo se fetileng molekane oa hae e ne e le molekane oa hae feela oa thobalano. O ile a hana histori ea mafu a tšoaetsanoang ka ho kopanela liphate. Ha ho hlahlojoa 'mele, lipontšo tsa hae tsa bohlokoa li ne li tloaelehile,' me tlhahlobo ea hae ea botona kapa botšehali e ne e bonahala e se na liso kapa masapo.
Qetellong ea ketelo, o ile a mo hlalosetsa hore tšebeliso ea lipapali tsa ho kopanela liphate e ne e ka 'na ea hlokomoloha methapo ea hae ea penile le ho sheba litšoantšo tse manyala tse hlephisang boitšoaro tsa Internet li fetotse monyako oa ho tsosoa ha thobalano. O ile a eletsoa hore a khaotse ho sebelisa lipapali tsa ho bapala le ho sheba litšoantšo tse manyala tse hlephisang boitšoaro tsa Internet. O ne a bitsoa urology bakeng sa tlhahlobo e eketsehileng. Nakong eo a ileng a bonoa ke setsebi sa 'mele sa libeke tse' maloa hamorao, o ile a khaola litšoantšo tse manyala tse hlephisang boitšoaro Inthaneteng a sebelisa haholo, le hoja a itse a ke ke a khaotsa ka ho feletseng. O ile a khaotsa ho sebelisa papali eo. O ne a boetse a e-na le likamano tsa botona le botšehali ka thobalano le molekane oa hae, 'me kamano ea bona e ile ea ntlafala. Tlhahlobo ea bo-urologist e ne e tloaelehile.
2.2. Second Clinical Report
Motho ea lilemo li 40 ea African American o ile a ngolisa basebetsi ba nang le lilemo tse 17 tsa mosebetsi o tsoelang pele o mafolofolo o hlahisitsoeng ke bothata ba ho finyella litlhoko tsa likhoeli tse tharo tse fetileng. O ile a tlaleha hore ha a leka ho kopanela liphate le mosali oa hae, o ne a thatafalloa ho finyella ho tsosoa le ho thatafalloa ke ho e boloka nako e telele ho fihlela e le bosiu. Ho tloha ha ngoana oa bona e monyenyane a tloha kolecheng, likhoeli tse tšeletseng pejana, o ne a iphumana a ipholla litho tsa botona kapa botšehali hangata ka lebaka la ho ba le boinotšing bo eketsehileng. O ne a tloaetse ho ipholla litho tsohle ka beke ka karolelano, empa e ile ea eketseha ho isa ho tse peli ho tse tharo ka beke. O ne a atisa ho sebelisa litšoantšo tsa bootsoa Inthaneteng, empa hangata o ne a li sebelisa, nako e telele e ne e nkoa e le li-orgasm ka boitsebiso ba hae bo tloaelehileng. Sena se ile sa etsa hore a sebelise boitsebiso bo bongata bo hlakileng. Nakoana ka mor'a moo, ho kopanela liphate le mosali oa hae "ho ne ho sa susumetsa" joaloka pele le ka linako tse ling o fumane mosali oa hae "a sa rate". O ile a hana ho ba le mathata ana pele ho lilemo tse supileng tsa lenyalo la bona. O ne a e-na le mathata a lenyalo hobane mosali oa hae o ne a belaella hore o na le taba, e leng seo a ileng a se hana.
Histori ea hae ea bongaka e ne e le ea bohlokoa feela bakeng sa khatello ea meriana, e ileng ea fumanoa e le lilemo tse peli pele ho moo 'me e ne e laoloa hantle ka diuretic: 25mg ea chlorthalidone letsatsi le leng le le leng. Ha aa ka a noa meriana e meng kapa a e tlatsa. Opereishene ea hae feela e ne e le appendectomy e ileng ea etsoa lilemo tse tharo pele ho moo. O ne a se na mafu a tšoaetsanoang ka thobalano kapa mafu a kelello. O ile a lumella ho tsuba lipakete tse tharo tsa lisakerete ka beke ka lilemo tse fetang leshome 'me a noa lino tse peli ka beke. Ho hlahlojoa ha 'mele ho ile ha senola matšoao a bohlokoa ka har'a maemo a tloaelehileng, tlhahlobo e tloaelehileng ea lefu la pelo, le liphatsa tsa lefutso tse tloaelehileng ntle le liso kapa masapo.
Qetellong ea tlhahlobo eo, litaba tsa hae li ne li boleloa hore ho tsosoa takatso ea ho kopanela liphate ho fokolloa ke ho shebella litšoantšo tse manyala tse hlephisang boitšoaro tsa Internet le ho ipholla litho tsa botona kapa botšehali khafetsa. O ile a eletsoa hore a khaotse ho shebella litšoantšo tse manyala tse hlephisang boitšoaro tsa Internet le ho fokotsa makhetlo a ho ikhotsofatsa. Likhoeli tse tharo hamorao, mokuli o ile a tlaleha hore o ile a leka "ka thata" ho qoba litšoantšo tse manyala tse hlephisang boitšoaro tsa Internet le ho ipholla litho tse seng kae, empa "o sitoa ho e etsa". O ile a re neng kapa neng ha a le mong a le mong, o ile a iphumana a shebile litšoantšo tse manyala tse hlephisang boitšoaro tsa Inthanete, tse qetellang li lebisa ho ho ipholla litho. Ho se shebehe ho ile ha etsa hore a ikutloe eka o "lahleheloa", e leng se ileng sa etsa hore a halefe 'me a etsa hore a batle ho e etsa le ho feta, ho fihlela a lebeletse hore mosali oa hae a tsoe ka tlung. O ile a fanoa ka ho fetisetsoa phekolo ea ho kopanela liphate, empa o ile a hana. O ne a batla ho leka ho sebetsa boitšoarong ba hae a le mong.
2.3. Tlaleho ea Boraro ea Bongaka
Ngoana ea lilemo li 18 ea bitsoang SNC o ile a kenngoa setsing sa bophelo bo botle ba kelello se sa foleng ka mor'a lefu la ho ipolaea. Nakong ea tlhahlobo ea hae le kalafo o ile a lumela ho noa joala le hoja a ne a eletsoa hore a se ke a noa joala ha a ntse a tšoaroa ka meriana e loantšang maikutlo. Histori ea hae le ho mamellana ho eketsehileng li ne li lumellana le ho noa ha Alcohol Use Disorder ka lebaka la tšebeliso ea hae ha a ntse a e-na le bothata ba ho tepella maikutlo. E le karolo ea karolo ea lithethefatsi ea histori ea hae o ile a botsoa ka ho becha, ho bapala Inthanete le ho lemalla litšoantšo tsa bootsoa. O ile a senola hore o amehile haholo ka tšebeliso ea hae ea litšoantšo tsa bootsoa, a qeta nako e ngata (24 + ha ha letsatsi) a sheba litšoantšo tsa bootsoa inthaneteng ka likhoeli tse tšeletseng. O ile a boela a hlokomela hore o fokolitse thahasello ea ho kopanela liphate ho mosali oa hae, a bontšoa ke ho se khone ho boloka lintho tse tsitsitseng, a khetha ho sheba litšoantšo tsa bootsoa moo a neng a se na mathata a erectile. Ha a hlokomela hore o sheba litšoantšo tsa bootsoa ka tsela e feteletseng, o ile a khaotsa ho e shebella ka ho feletseng, a bolella motho ea botsang lipotso hore o ne a tšaba hore haeba a ka e sheba ka tsela leha e le efe o tla iphumana a le hlokolosi hape. O ile a tlaleha hore ka mor'a hore a khaotse ho sebelisa litšoantšo tse litšila tse tsosang takatso ea hae erectile e ile ea nyamela.
Ka bokhutšoanyane, lithuto tsa ho kenella ho etsoa ho senola ts'oaetso ka ho tlosa mefuta-futa ea litšoantšo tse manyala tse hlephisang boitšoaro Inthaneteng li sebelisoa haholo ho hlahloba mathata a sa hlalosoang ka thobalano ho basebelisi ba litšoantšo tsa bootsoa ba Internet tlas'a 40. Joalokaha ho hlalositsoe litlaleho tsa rona tsa bongaka, hammoho le katleho ea lingaka Doidge [33] le Bronner le Ben-Zion [34] ka holimo, lipatlisiso tse joalo li ka 'na tsa botsa barupeluoa ba ithutoang hore ba na le PIED, bothata ba ho finyella setho sa botona le molekane, le / kapa takatso ea ho kopanela liphate / khotsofalo ea ho felisa litšoantšo tsa bootsoa ba Inthaneteng.
3. Puisano
3.1. Karabelo ea Male ho Botsoa
Le ha karabelo ea botona le botšehali e rarahane, likarolo tse 'maloa tsa bohlokoa tsa boko li bohlokoa bakeng sa ho fihlela le ho boloka liqabang [61]. Hypothalamic nuclei e bapala karolo ea bohlokoa ho laoleng boits'oaro ba thobalano le li-erections ka ho sebetsa e le setsi sa kopanyo bakeng sa tlatsetso ea kelello le pherekano [62]. Nete ea hypothalamic e tataisang li-erections e fumana tsela ea pro-erectile ho tsoa tseleng ea mesolimbic dopamine, e nang le sebaka sa "ventral tegmental tegmental" (VTA) le nucleus accumbens (NAc) [62]. Potoloho ea VTA-NAc ke senotlolo sa bohlokoa sa mehopolo e putsang, 'me e ba konopo ea lipotoloho tse akaretsang, tse rarahaneng ho feta tse kopaneng tse bitsoang "tsamaiso ea moputso" [63]. Karabelo ea motho ka mong meputsong ea tlhaho, joalo ka thobalano, e laoloa haholo ke tsela ea mesolimbic dopamine, e fumanang karabo e thabisang le e thibelang ho tsoa metsong e meng ea methapo le cortex ea pele.64]. Mehato e itšetlehile ka ts'ebetso ea li-neuron tsa dopaminergic ho VTA le li-receptor tsa dopamine ho NAc [65,66]. Menyetla ea glutamate e khahlisang e tsoang metsong e meng ea li-limbic (amygdala, hippocampus) le preortalal cortex e nolofalletsa mosebetsi oa dopaminergic ho VTA le NAc [62]. Meputso e amohelang li-dopamine neurons e boetse e kenella ka har'a dorsal striatum, e leng sebaka se hlahisoang nakong ea takatso ea thobalano le penile tumescence [67]. Dopamine agonists, joalo ka apomorphine, e bonts'itsoe ho kenyelletsa erection ho banna ba nang le ts'ebetso ea erectile e tloaelehileng le e holofetseng.68]. Kahoo, dopamine ho supa tsamaisong ea moputso le hypothalamus li bapala karolo ea mantlha lithutong tsa botona le botšehali, tse susumetsang ka thobalano le li-penile erections [65,66,69].
Re fana ka tlhahiso ea hore tšebeliso e mpe ea ts'ebeliso ea thobalano marang-rang e felle ka hore ho se sebetse hantle 'me ho liehise kemolo ho mosebetsi oa rona o tlalehiloeng kaholimo. Re fetisa thuto ea boitšoaro e hlahisoang ke ho fetoha ha litšoantšo tse tsosang takatso ea boitšoaro bo bobe tsa inthanete liserekising tse laolang takatso ea thobalano le likamano tse litšila. Bobeli boithuto ba maikutlo a marang-rang a litšoantšo tse manyala tse hlephisang boitšoaro tsa inthanete ka ho kenella ka mokhoa o batsi le ho nyarosoa ha karabelo ea tsamaiso ea moputso meputsong e tloaelehileng ho ka ameha. Liphetoho tsena tse peli tsa boko li tsamaellana le ho fetoloa ho sa feleng hoa meputso ea tlhaho le lithethefatsi tsa tlhekefetso, hape li hokahanngoe ke dopamine surges tsamaisong ea moputso [70,71,72].
3.2. Litšoantšo Tsa Bootsoa Tsa Inthanete ke Tšusumetso e Feteletseng
Ha ho pelaelo hore tsoelo-pele ea bohlokoa ka ho fetisisa tšimong ea boitšoaro bo hlephileng ba ho kopanela liphate ke tsela eo inthanete e susumetsang le ho tsamaisa boitšoaro bo hlephileng ba ho kopanela liphate [73]. Maemo a sa lekanyetsoang a phahameng a ho kopanela liphate a phalleloang ka "tube" hona joale a fumaneha mahala le a fumanehang haholo, letsatsi la 24 ka ho sebelisa lik'homphieutha, matlapa le li-smartphone, 'me ho' nile ha boleloa hore litšoantšo tse manyala tse hlephisang boitšoaro Inthaneteng ke tšusumetso e sa tloaelehang, ho phehella ka lebaka la matla a eona a ho iphetola ha lintho [74,75]. Boitsebiso bo bong bo bontšang thobalano bo 'nile ba e-ba teng ka nako e telele, empa litšoantšo tsa bootsoa tsa video (1) li tsosa takatso ea ho kopanela liphate ho feta mefuta e meng ea litšoantšo tsa bootsoa [76,77] kapa fantšo [78]; (2) litšoantšiso tsa thobalano li bontšitsoe ho etsa hore motho a tsohe haholoanyane, ho phalla ka potlako, le ho etsa lintho tse ling tse ngata ho feta le tse ling tse tloaelehileng, mohlomong kahobane ho ela hloko molekane ea ka mocha le ho tsosoa ha hae ho ile ha e-ba le boiphihlelo ba ho ikatisa [75,79,80,81,82,83,84]; le (3) bokhoni ba ho ikhethela boitsebiso ka boiketlo bo etsa hore litšoantšo tse manyala tse hlephisang boitšoaro tsa Inthanete li tsohe haholo ho feta likhetho tse khethiloeng [79]. Setšoantšo sa litšoantšo tse manyala tse hlephisang boitšoaro se ka boloka kapa sa phahamisa tsoho ea ho kopanela liphate ka ho panya-panya hang-hang ho boemo ba libuka, video e ncha kapa ho se mohla u kileng ua kopana le mofuta. Phuputso ea 2015 ea ho sheba litšoantšo tsa bootsoa tsa Inthaneteng ka ho lieha ho fokotsa (ho khetha ho khotsofatsoa hang-hang ka meputso e liehang ea bohlokoa bo boholo) e re, "Mokhoa o sa khaotseng oa ho kopanela liphate le litlhohonolofatso tsa tlhaho ka ho khetheha ho etsa hore litšoantšo tse manyala tse hlephisang boitšoaro tsa inthanete e be moetsi o ikhethileng oa moputso oa boko. ... Ka hona ke habohlokoa ho tšoara litšoantšo tse tsosang takatso e le tšusumetso e ikhethang ea ho ba le moputso, ho ba le tšusumetso ea maikutlo le lithuto tsa lithethefatsi "[75] (maqephe a 1, 10).
Ntho e ncha e ngolisa e le ea bohlokoa, e eketsa bohlokoa ba moputso, ebile e na le liphello tse tšoarellang ho susumetsa, ho ithuta le ho hopola [85]. Joaloka tšusumetso ea thobalano le litšobotsi tse khotsofatsang tsa ho kopanela liphate, mokhoa o tsosolositsoeng o qobella hobane o baka ho phatloha ha dopamine libakeng tsa boko ho amana haholo le moputso le sepheo-boitšoaro bo laoloang [66]. Le hoja litšoantšo tse manyala tse hlephisang boitšoaro tsa Inthanete li qobella batho ho rata litšoantšo tsa thobalano ho feta ho laola bophelo bo botle, dACC (dorsal anterior cingulate cortex) e boetse e bontša mokhoa o potlakileng oa ho etsa litšoantšo ho feta ho laola bophelo bo botle [86], ho etsa hore ho batloe litšoantšo tse ling tsa thobalano. Joaloka mongoli-co-author Voon o hlalositse ka phuputso ea 2015 ea sehlopha sa hae ka mokhoa o sa tloaelehang le ho tloaela batho ba ts'oanang le litšoantšo tsa bootsoa ba Inthaneteng, "Thepa e bonahalang e sa feleng ea litšoantšo tsa thobalano e fumanehang Inthaneteng [e ka fepa] ho lemalla, e leng se etsang hore ho be thata ho baleha"87]. Mesolimbic dopamine ts'ebetsong e ka boela ea ntlafatsoa ke lisebelisoa tse eketsehileng tseo hangata li amanang le litšoantšo tsa bootsoa tsa Inthanete li sebelisa tse kang, tlōlo ea litebello, tebello ea moputso, le ketso ea ho batla / ho etsa lipapali (ho sheba litšoantšo tsa bootsoa Inthaneteng) [88,89,90,91,92,93]. Matšoenyeho, a bontšitsoeng ho eketsa tsoho ea ho kopanela liphate [89,94], e ka boela ea tsamaea le litšoantšo tsa bootsoa tsa Inthanete. Ka bokhutšoanyane, litšoantšo tse litšila tse tsosang takatso tsa Inthaneteng li fana ka litšobotsi tsena kaofela, tse ngolisang e le tsa bohlokoa, li etsa hore ho be le li-dopamine tse phatlohang le ho ntlafatsa tsoho ea ho kopanela liphate.
3.3. Litšoantšo Tsa Bootsoa Inthaneteng Sebelisa Joaloka Mosebetsi oa Boithaopo
Ha tsamaiso ea moputso e khothalletsa likokoana-hloko hore li hopole le ho pheta mekhoa e nyonyehang, e kang ho kopanela liphate, ho ja le ho kopanela liphate, litšoantšo tsa bootsoa tse sa tloaelehang tsa Inthanete li sebelisa e ka ba mosebetsi oa boithati [95]. Mokhoa oa moputso o kotsing ea thuto ea mafu a maholo [96], haholo-holo lichabeng, tse kang kotsi e khōlō ea ho lemala [97,98] le tšebeliso e khōloanyane ea "litšoantšo tse manyala tse hlephisang boitšoaro" (ho robala le ho kopanela liphate le bana)99]. Litsela tse 'maloa tsa lipatlisiso li qalile ho lemoha ho kopana ha li-substrate tsa neural tsa ho ithuta ka thobalano le lithethefatsi [100,101]. Ka mohlala, boitšoaro bo bobe ba ho kopanela liphate le lithethefatsi tse lemaletseng lithethefatsi li etsa lihlahisoa tse tšoanang tsa neurone ka har'a mehaho e tšoanang ea meputso ea tsamaiso (NAc, basolateral amygdala, sebakeng se ka pele sa sebaka sa maiketsetso) [102]. Ka lehlakoreng le leng, ho na le karolo e fokolang e teng pakeng tsa meputso e meng ea tlhaho (lijo, metsi) le lithethefatsi tse lemalang, tse kang cocaine le methamphetamine [102]. Ka hona, tšebeliso ea methamphetamine e sebelisa mekhoa e tšoanang le li-substrate tsa neural joalokaha e le moputso oa tlhaho oa ho tsosoa ha thobalano [103]. Phuputsong e 'ngoe, lithethefatsi tsa cocaine li ne li batla li tšoana hantle le bokooa ha li sheba litšoantšo tse manyala tse hlephisang boitšoaro tse amanang le lithethefatsi tsa tsona, empa mekhoa ea boikoetliso ba boko ha ho shebella litšoantšo tsa tlhaho li fapane haholo [104].
Ho feta moo, boitšoaro bo bobeli ba ho kopanela liphate le ts'ebetso ea phekolo ea psychostimulant e pheta-pheta ho hlahisa taolo ea Delta FosB, ntho e ngotsoeng e khothalletsang liphetoho tse 'maloa tsa phekolo ea meriana e matlafatsang tsamaiso ea dopamine ea mesolimbic ho etsa mosebetsi [103]. Tšebelisong ea lithethefatsi ka bobeli le litefello tsa ho kopanela liphate, molao-motheo ona ho NAC neurons e le 'ngoe o kopanngoa ka dopamine receptors [103]. Ts'ebetso ena e etsa hore motho e mong le e mong a susumelletsehe ho susumelletseha ho kopana le ts'ebetso ena (matla a tsosolositsoeng a khothatsang) [105]. Ho ipapisa le likamano tse amanang le hona ho etsa hore batho ba lakatse ho kopanela boitšoarong (ho "eketseha" ho eketsehileng), 'me ho ka lebisa tlhobelisong ea ho qobella [106]. Ha ba bapisa Pitchers et al. o ile a etsa qeto ea hore, "Meputso ea tlhaho le lithethefatsi ha e fetohe ka tsela e le 'ngoe feela ea li-molecule, e fetola li-molecule tse tšoanang, mme e ka' na ea e-ba li-neurons tse tšoanang NAC, ho susumetsa matla a khothatsang le" ho batla "mefuta e 'meli ea moputso "[103]. Ka mokhoa o tšoanang, tlhahlobo ea 2016 ea Kraus, Voon le Potenza e tiisitse hore, "Ts'ebetso e tloaelehileng ea methapo ea meriana e ka tlatsetsa ho [boitšoaro bo hlephileng ba ho kopanela liphate] le mathata a ho sebelisoa ha lithethefatsi, le lipatlisiso tsa morao-rao tsa bokooa li bontša phapang e amanang le takatso le litakatso"107].
Ho fihlela joale, likotsi tse ka 'nang tsa e-ba teng bophelong ba litšoantšo tse manyala tse hlephisang boitšoaro tsa Inthanete ha lia utloisisoe hantle joaloka tsa joala le tšebeliso ea koae, le litšoantšo tse litšila tse tsosang takatso tsa Inthanete li sebelisoa ka mokhoa o tloaelehileng joaloka boitšoaro bo tloaelehileng'108,109]. Mohlomong ke ka lebaka lena banna ba liehang ho kopanya litšoantšo tsa bona tsa bootsoa ka mathata a bona a thobalano. Ha e le hantle, "Ke mang ea sa shebelleng litšoantšo tsa bootsoa matsatsing ana?" E mong oa bahlanka ba rona ba servicemen o ile a botsa ngaka ea hae. O ne a nka hore tsoelo-pele ea hae e thata ke ntho e tloaelehileng, mohlomong le bopaki ba libido tse phahameng [110]. Leha ho le joalo, ho na le bopaki bo ntseng bo eketseha ba hore e ne e le pontšo ea mekhoa e amanang le lithethefatsi [31,52,54,73,86,107,111,112,113,114,115,116,117,118,119,120,121,122]. Bafuputsi ba Mafinnishe ba fumane "boithabiso ba batho ba baholo" e le eona lebaka le tloaelehileng la ho sebelisa li-intanete ho sebelisa Inthanete [123], le ho ithuta ka nako e telele lik'homphieutheng tse bontšang hore litšoantšo tse litšila tse tsosang takatso tsa Inthanete li ka 'na tsa e-ba le bokhoni bo phahameng ba ho lemala [124], ka ho bapala Inthaneteng ka motsotsoana oa bobeli lithutong tseo ka bobeli. Ho fihlela joale, bothata ba ho bapala lipapali tsa Inthanete (IGD) bo reretsoe ho tsoela pele ho ithuta Buka ea ho hlahloba le ea Statistical ea Mathata a kelello (DSM-5) [125], ha ts'oaetso ea lithethefatsi ea ho lemalla lithethefatsi e sa le joalo. Leha ho le joalo, ho latela mofuputsi oa UK, Griffiths, "motheo oa ho lemalla ho kopanela liphate ka tsela e ts'oanelang ho na le IGD" [73]. Ha e le hantle, litsebi tse fapa-fapaneng tsa ho lemalla lithethefatsi li batla hore lithethefatsi tsa Inthanete li nkoe e le bothata bo akaretsang ka lihlopha tse ling tse khethehileng tse kang ho bapala le litšoantšo tsa bootsoa [118,126,127,128]. Tlhahlobo ea 2015 e ile ea boela ea etsa qeto ea hore ho lemalla boitšoaro bo hlephileng ba litšoantšo tsa bootsoa ho Internet ho lokela ho nkoa e le karolo e nyenyane ea lithethefatsi tsa Inthanete, e leng DSM [118].
Hoa thahasellisa hore ebe serisi sa rona sa bobeli se kopana le mekhoa e mengata e hlahisoang bakeng sa IGD ho DSM-5, e fetotsoeng bakeng sa litšoantšo tsa bootsoa tsa Inthanete tse sebelisoang. O ile a bontša tse latelang: (1) ho ameha ka litšoantšo tsa bootsoa tsa Inthanete; (2) tahlehelo ea thahasello tabeng ea ho kopanela liphate le molekane oa hae oa sebele-joalo ka phello; (3) matšoao a ho itokolla ho kang ho halefa le ho hlonama; (4) ho batla litšoantšo tse manyala tse hlephisang boitšoaro ho lokisa maikutlo a hae a mebe; (5) ho sitoa ho tlohela ho sa tsotellehe mathata a maholo; le (6) ho nyolohela ho boitsebiso bo bong bo hlakileng.
3.4. Matšoao a kotsi a amanang le Internet Pornography-Mathata a ho Kopanela Liphate
Re nahana hore litšoantšo tse litšila tse tsosang takatso-tse susumelitseng mathata a ho kopanela liphate li akarelletsa ho se tsitsisehe le ho hloka boikemisetso tsamaisong ea ho susumetsa bokong [72,129] le li-neural correlates tsa e 'ngoe le e' ngoe, kapa tse peli, li fumanoe liphuputsong tsa morao-rao ho basebelisi ba litšoantšo tsa bootsoa ba Internet [31,48,52,53,54,86,113,114,115,120,121,130,131,132,133,134]. Re robile karolo ena ea puisano ea rona ka likarolo tse tharo tse amanang.
3.4.1. Matšoenyeho a Eketsehileng a ho Susumetsa Litšoantšo Tsa Litšoantšo Tsa Bootsoa Inthaneteng (ho se nahane)
Ho se sebetse ho bua ka karabo e matlafatsang, e sebetsanang le maemo a amanang le tšebeliso. Thuto e matlafatsang e kenyeletsa ho ntlafatsa mokhoa oa ho arabela ka matla oa methapo ea meriana e etsang hore ho be le mekhoa e ka 'nang ea e-ba le tšusumetso e matla ea ho phekola lithethefatsi le meputso ea tlhaho [135,136,137]. Masolimbic dopamine tsamaiso e fumana litho tsa glutamate libakeng tse sa tšoaneng tsa cortical le limbic. Tlhahiso ea morao-rao e bontša hore li-synapses tsa glutamaterg tse amanang le ho batla le ho fumana moputso o itseng li fetoha liphetoho, tse matlafatsang karabo ea tsamaiso ea mesolimbic dopamine ho fihlela moputso oo [100,138]. Mekhatlo ena e matla e ithutang e matlafatsa "khothatso-ts'oaetso" (kapa "khothatso ea khothatso") khopolo ea ho lemala.
Mabapi le ho ikopanya ha basebeletsi ba rona le balekane ba rona, ho ka etsahala hore ha ba ntse ba hlohlelletsa tsoalo ea bona ea thobalano ho litšoantšo tsa bootsoa tsa Inthanete, thobalano e arohaneng ha e sa hlola e finyella litebello tsa tsona tse behiloeng 'me ha e sa etsa hore ho lokolloe dopamine e lekaneng bakeng sa ho hlahisa le ho boloka likheo [50,62,139]. Joaloka Prause le Pfaus, "Mathata a Erectile a ka 'na a etsahala ha ho hlile ho e-na le maikutlo a ho kopanela liphate a sa lumellaneng le litaba tse pharaletseng [tse fumanehang Inthaneteng]" [50]. Thuto ea batho le liphoofolo e bontša hore ha litebello li sa finyellehe (phoso e boletsoeng esale pele), mosebetsi o bobebe oa dopamine o thibeloa [140,141,142,143]. Liphuputso tsa lithethefatsi li tlalehile hore lintlha tse hlalositsoeng ka ho toba le ho ba sieo ha moputso oa lithethefatsi li ka ba le liphello tse thibelang ho tlosoa ha dopamine [72]. Tumellanong le phoso e boletsoeng esale pele, Banca et al. ho tlalehile ho fokotseha ha tšebetsong ea ho itšehla thajana ka lebaka la ho se lumelle setšoantšo sa ho kopanela liphate (ho latela sekheo sa ho kopanela liphate) [86]. Banca et al. o ile a boela a tlaleha hore, ha ho bapisoa le ho laola bophelo bo botle, basebelisi ba litšoantšo tse manyala tse hlephisang boitšoaro ba Inthaneteng ba ne ba ntlafalitse ho khetha maemo a tloaelehileng (a sa hlakang mekhoa) e amanang le litšoantšo tsa thobalano [86]. Tlhahiso ena e fana ka maikutlo a hore basebelisi ba litšoantšo tsa bootsoa ba Inthaneteng ba ka khothatsoa hore ba se ke ba amana le litaba tsa thobalano, mekhatlo e ka ba phephetso e kholo ho tima [87].
Thuto ea 2014 ea fMRI ea Voon et al. e fana ka ts'ehetso bakeng sa mohlala oa ho susumetsa (ho hlokomelisa) mohlala mabapi le ho qobella basebelisi ba litšoantšo tsa bootsoa Inthaneteng [31]. Ha ho bapisoa le ho laola bophelo bo botle, basebelisi ba litšoantšo tsa bootsoa ba Inthaneteng ba qobelletse ho etsa lipapali tsa ho kopanela liphate ka sekhahla sa ventral, amygdala le dorsal anterior cingulate cortex. Ts'ebetso ena ea mantlha e ts'oaroa nakong ea ts'ebetso ea reactivity le litakatso tsa lithethefatsi tse sebelisang lithethefatsi hampe [144]. Voon et al. o ile a boela a tlaleha hore, "Ha ho bapisoa le baithaopi ba phetseng hantle, [basebelisi ba litšoantšo tse manyala tse hlephisang boitšoaro ba Inthanete] ba ne ba e-na le takatso e matla ea ho kopanela liphate kapa ba batlang ho bua ka mokhoa o totobetseng 'me ba ne ba rata likarolo tse ngata ka ho fetisisa ha ba batla"31] (leq. 2). Mohlala oa ho khothaletsa batho ho lemalla, ho khetholla pakeng tsa "ho batla" le "ho rata" ho nkoa e le pontšo ea thuto ea mafu.106]. Joalokaha ho lemalla litšoantšo tsa bootsoa tse hlakileng tsa Inthanete ho tsoela pele, ho susumetsoa ke litakatso le litakatso tsa ho "sebelisa" ("ho batla"), athe thabo e tsoang ho eona ("ho rata") e fokotseha. Mona, baetsi ba litšoantšo tsa bootsoa ba Inthaneteng "ba ratile" tšusumetso ea litakatso tsa tlhaho, empa ba "batla" litlhaloso tse hlakileng. Ho tšoana le servicemen ea rona, boholo ba lihlooho tsa Voon et al. (Lilemo tse bolelang 25) "li ne li e-na le mathata a mangata a ho kopanela liphate le mathata a erectile kamanong e haufi-ufi empa eseng ka lihlahisoa tse hlakileng tsa ho kopanela liphate tse hlalosang hore takatso e matlafatsang e ne e totobetse ho hlakile litlhahiso le tse sa tloaelehang li phahamiselitse takatso ea thobalano "[31] (leq. 5). Phuputso e amanang le litaba tse ngata tse tšoanang le tse ling tse fumanoang li le boima ba ho shebella litšoantšo tse litšila tse tsosang takatso Inthaneteng li sebelisoa ho latela tse fumanoang liphuputsong tsa lithethefatsi litabeng tsa ho lemalla lithethefatsi [111]. Sehlopha se etsang lipatlisiso se ile sa etsa qeto ea hore, "Ts'ebetso ena e kopane e fana ka ts'ehetso ea khothatso ea khothatso ea ho lemalla ho lemalla ho kopanela liphate ho CSB [boitšoaro bo bobe ba ho kopanela liphate]" [111].
Phuputso ea 2015 ea fMRI ho batho ba bong bo tšoanang le ba Seok le Sohn e hlalositsoe mme e atolosoa holim'a liphuputso tsa Voon et al. [31] le Mechelmans et al. [111], feela e hlalositsoe [120]. Seok le Sohn ba tlaleha hore ha ho bapisoa le ts'oaetso ea bosodoma ho ne ho e-na le ts'ebetso e matla haholo ea boko ha e pepese litšoantšo tsa thobalano bakeng sa 5. Ha Voon et al [31] a hlahloba tšebetso e entsoeng ka mahlakoreng a metsoako ea DACC-ventral striy-amygdala functional network, Seok le Sohn ba ile ba hlahloba liketsahalo ka mokhathala oa li-prefrontal cortex (DLPFC), motsoako o fokolang, poroetal lobe, tlase ea pele ea cingulate gyrus le thalamus. Seok le Sohn ba phaella ka hore boima ba ho lemalla ho kopanela liphate ka kotloloho bo amana le ts'ebetso e bakoang ke ts'oaetso ea DLPFC le thalamus. Ntho ea boraro e fumanoeng ke hore ho bapisoa le ts'ebetso ea bosodoma ho ne ho e-na le ts'ebetso ea DLPFC e kholo ho feta thobalano, leha ho le joalo ho fokolloa haholo ke DLPFC ho se nke lehlakore. Liipone tsena tse sa tloaelehang tsa li-cortex tse sebetsanang le batho ba nang le bothata ba ho lemalla ho lemalla lithethefatsi tse amanang le lithethefatsi li kopantsoe le phaello e fokolang mesebetsing e tloaelehileng e putsang [145]. Tlhaloso ena e lumellana le maikutlo a rona a hore phekolo e tsitsitseng le boikutlo ba boikaketsi ba tsamaiso ea boko bo susumelletsehang bo sebelisoa, 'me e ka' na ea amana le litlokotsi tsa ho kopanela liphate tse tsosang takatso ea thobalano.
Tlhahlobo ea 2016 ea fMRI-reactivity ho banna ba bong bo fapaneng ba bootsoa ba sebelisang eketseha lilemong tse fetileng [54]. Brand et al. ba tlaleha hore mosebetsi oa li-ventral striatum o ne o le moholo bakeng sa boitsebiso ba bootsoa bo khethiloeng ha bo bapisoa le boitsebiso bo bong bo hlephileng ba bootsoa. Ho phaella moo, ts'ebetso e matla ea li-ventral bakeng sa boitsebiso bo bobebe ba bootsoa e amana le matšoao a boithati ba ho sebelisa lithethefatsi tsa bootsoa Inthaneteng. Ha e le hantle, matšoao a ho lemalla litšoantšo tse manyala tse hlephisang boitšoaro ho Internet (e le ho hlahlojoa ke s-IATsex) e ne e le eona feela ea bohlokoa ea karabo ea ventral striatum ho litšoantšo tsa bootsoa tse sa khethiloeng. Liphetoho tse ling, tse kang libeke tsa beke le beke tsa inthanete, boithabiso ba ho kopanela liphate, boitšoaro bo hlephileng ba ho kopanela liphate ka kakaretso, matšoao a ho tepella maikutlo le kutloisiso ea batho ba bang, le lits'ebetso tsa matla a boitšoaro ba ho kopanela liphate, ha lia ka tsa amana le ketsahalo ea ventral striatum. Ka mantsoe a bonolo, e ne e le ho lemosa se molemo ka ho fetisisa se boletseng matšoao a ho lemalla litšoantšo tsa bootsoa ba Inthaneteng. Brand et al. o ile a etsa qeto ea hore, "Liphuputso li hatisa phapang pakeng tsa IPA [lithethefatsi tse tsosang takatso ea boitšoaro bo bobe] le mekhoa e meng ea ho itšoara hampe le mathata a amanang le lithethefatsi" [54].
Thuto ea XMUMX fMRI (Klucken et al.) [121] bapisa lihlopha tse peli tsa banna ba bong bo fapaneng: batho ba nang le boitšoaro bo bobe ba ho kopanela liphate (CSB) le ho laola bophelo bo botle. Nako e bolelang e sebelisoang ka tloaelo ho shebella boitsebiso bo hlalosang thobalano beke le beke e ne e le 1187 min bakeng sa sehlopha sa CSB le 29 min bakeng sa sehlopha sa taolo. Bafuputsi ba pepesa litaba tsohle ho latela mokhoa oa ho etsa liphallelo tseo ho tsona lipolotiki tse neng li sa nke lehlakore li ne li bolela esale pele ho hlahisa setšoantšo se tsosang takatso. Ha ho bapisoa le ho laola lihlooho ka CSB ho bonts'itsoe ho eketsa ts'ebetso ea amygdala nakong ea ho bonts'oa ha boemo bo hlalosang setšoantšo se tsosang takatso. Tlhaloso ena e lumellanang le litlaleho tsa liphuputso tsa tlaleho e eketsehile ts'ebeliso ea amygdala ha lithethefatsi tsa lithethefatsi li pepesehela litlhahiso tse amanang le tšebeliso ea lithethefatsi146]. Voon et al. o ile a boela a tlaleha hore livideo tse hlakileng li entse hore ho be le ts'ebetso e kholo ea amygdala ka litaba tsa CSB ho feta ho laola bophelo bo botle. Patlisiso ena e fetoha le lipatlisiso tsa liphoofolo tse kopanyang amygdala ho boemo bo matlafatsang. Ka mohlala, ho hlohlelletsa ho potoloha ha li-opioid ka amygdala ho matlafatsa matla a ho susumetsa mohopolo o lebisitseng tlhokomelong e tiisitsoeng, hammoho le ho fokotseha ha nako e le 'ngoe ea ho khahloa ha sepheo se seng sa bohlokoa [147]. Ha sehlopha sa CSB se Klucken et al. [121] ba ne ba e-na le ts'ebetso e kholo ea ho etsa qeto ea ho etsa setšoantšo sa thobalano, tsoho ea bona ea ho kopanela liphate e ne e se ea bohlokoa ho feta taolo. Ho thahasellisang ke hore lihlooho tse mashome a mabeli tsa CSB li tlalehile "bothata ba" orgasmic-erection "ha ho buisanoa ho ea ho hlahloba mafu a Axis I le Axis II, athe ha ho le tse ling tsa litaba tse laolang mathata a thobalano. Tlhaloso ena e hopola Voon et al., Moo lihlooho tsa CSB li neng li e-na le li-amygdala-ventral striatum-activation-dACC tse hlahisang lipapali tsa thobalano, empa 11 ea 19 e tlalehile mathata a erectile kapa a tsosang takatso le balekane ba thobalano. Klucken et al. e boetse e fumane ho kopana ho fokolang pakeng tsa ventral striatum le prefrontal cortex litabeng tse nang le CSB ha li bapisoa le litsamaiso. Ho fokotseha ho fokolang ha li-ventral-PFC ho 'nile ha tlalehoa hore ho na le mathata a mangata' me ho lumeloa hore ho amana le ho laola maikutlo a ho laola maikutlo [145].
Thuto ea 2013 EEG ea Steele et al. e tlalehile hore P300 e phahame litšoantšong tsa thobalano, ha e bapisoa le litšoantšo tse sa jeleng paate, batho ba ipelaetsang ka mathata a ho shebella litšoantšo tsa bootsoa ba Inthanete ba sebelisa [48]. Batho ba hlekefetsang ba bang ba boetse ba bontša bophahamo bo boholo ba P300 ha ba pepesehela litšoantšo tse amanang le tahi ea bona [148]. Ho feta moo, Steele et al. ho tlalehile ho se lumellane ho fapaneng pakeng tsa P300 bophahamo le takatso ea thobalano le molekane [48]. Tlhaloso e kholo ea ho shebella litšoantšo tse manyala tse hlephisang boitšoaro Inthaneteng tse nang le takatso e fokolang ea thobalano ea thobalano e kopanetsoeng, joalo ka tlaleho ea Steele et al., E lumellana le Voon et al. ho fumanoa ka "ho fokotsa libido kapa mosebetsi oa erectile ka ho khetheha likamanong tsa rona le basali" ka ho qobella batho ho sheba litšoantšo tsa bootsoa Inthaneteng [31]. Ho tšehetsa lithuto tsena, lipatlisiso tse peli tsa ho hlahloba takatso ea thobalano le mosebetsi oa erectile ho "ho kopanela liphate" le ho qobella batho ho sheba litšoantšo tse manyala tse hlephisang boitšoaro Inthaneteng li ile tsa tlaleha mekhatlo pakeng tsa litekanyetso tsa bosodoma le ho fokotsa takatso ea likamano tsa botona le botšehali le likamano tsa botona le botšehali [15,30]. Ho phaella moo, phuputso ea 2016 ea banna ba 434 ba neng ba sheba litšoantšo tsa bootsoa Inthaneteng bonyane hanngoe likhoeling tse tharo tse fetileng ba ile ba bolela hore bothata bo sebelisitsoeng bo amahanngoa le maemo a phahameng a ho tsosoa, empa ho fokotsa khotsofalo ea ho kopanela liphate le mosebetsi o bobebe oa erectile [44]. Liphello tsena li lokela ho nkoa ho latela lipatlisiso tse ngata tsa lefu la kelello tse fumanoeng hore ho kopanela liphate ho tsosa litšoantšo tse manyala tse hlephisang boitšoaro tsa Inthanete le litakatso tsa ho shebella litšoantšo tsa bootsoa li amana le bothata ba matšoao a ho lemalla li-cybersex le mathata a boithati bophelong ba letsatsi le leng le le leng ka lebaka la litšoantšo tse manyala tse hlephisang boitšoaro tsa Internet li sebelisa [52,53,54,113,115,149,150]. Ho kopanngoa, lithuto tse ngata le tse fapa-fapaneng tse sebelisang litšoantšo tsa bootsoa ba Inthaneteng li lumellana le khopolo ea ho tsuba, eo liphetoho tsa bohlokoa ba ho khothatsa li lumellana le liphetoho ho ts'ebetso ea libaka tsa boko bo kenyelletsoeng ts'ebetsong [31,106]. Ho akaretsa, tumellanong le maikutlo a rona, lipatlisiso tse fapa-fapaneng li tlaleha hore ho ts'oanela ho ts'oanela ho shebella litšoantšo tsa bootsoa, litakatso tsa ho sheba le ho qobella litšoantšo tse manyala tse hlephisang boitšoaro ho sebelisoa ho amana le mathata a thobalano le ho fokotsa takatso ea thobalano ho balekane.
3.4.2. Ho Fokotseha Moputso oa ho Utloisisa Boikutlo (Boikaketsi)
Ho fapana le karabo e fokolang ea ho sheba litšoantšo tse manyala tse hlephisang boitšoaro Inthaneteng ho hlalositsoe, ho se tšepahale ke ho fokotseha ha maikutlo ho fokolang ha moputso ho tloaelehileng ka mokhoa o sa tloaelehang [70,151,152,153], tse kang thobalano e kopanetsoeng [31,48]. Ho fokotseha hona ho boetse ho etsa hore motho a mamelle [70], 'me e' nile ea e-ba le maikutlo a mabeli le boitšoaro bo hlephileng [153,154,155,156], ho akarelletsa le mefuta e meng ea lithethefatsi tsa Inthanete [157,158,159] Mamello ea rona ea servicemen ea litšoantšo tse manyala tse hlephisang boitšoaro tsa Inthanete e ile ea eketseha ka potlako, e leng se lebisang ho bonang boitsebiso bo feteletseng. Taba ea hore livideo tse manyala tse hlephisang boitšoaro tse ikhethang e phahamisa haholo ho feta kamoo litšoantšo tse litšila tse tsosang takatso li ka tlatsetsang kateng ho tloaela batho kapa ho mamellana [27,75,79,81,160]. Ka mohlala, banna ba neng ba shebella filimi ea thobalano ho e-na le filimi e sa nke lehlakore hamorao ba ile ba bontša hore ha ba na likarabo tse fokolang litšoantšong tsa thobalano,161]. Nakoana ka mor'a hore libaesekopo tsa video tse hlephisang boitšoaro li fumanehe, bafuputsi ba ile ba boela ba fumana hore ha bashebelli ba fuoa litšoantšo tsa litšoantšo tsa bootsoa libitum tsa lihlooho tse fapa-fapaneng ba ile ba eketseha ka potlako ho ea bootsoa bo feteletseng bo feteletseng [162]. Ha litšoantšo tse manyala tse hlephisang boitšoaro li shebahala haholoanyane, ho na le takatso e matla ea lihlooho tse thata [27,43,162], e bontšang ho fokotsa boikarabelo ba ho kopanela liphate. (Hape, halofo ea lihlooho tsa Kinsey Institute tse neng li tloaetse ho shebella litšoantšo tse tsosang takatso ea boitsebiso bo bontšang litšoantšo tse manyala tse hlephisang boitšoaro li bontšitse ho se tsotelle ha erectile ho laborateng, '27], le halofo ea basebelisi ba litšoantšo tse tsosang takatso ea ho sheba litšoantšo tse manyala tse hlephisang boitšoaro ba sa tsoa hlahlojoa, le bona ba ile ba fallela linthong tse sa kang tsa ba thahasella nakong e fetileng44(leq. 260).) Phuputsong e 'ngoe, khotsofalo ea thobalano le balekane, e lekanngoa ka lerato, ponahalo ea' mele, thahasello ea ho kopanela liphate, le ts'ebetso ea thobalano, e ne e amana le litšoantšo tse manyala tse hlephisang boitšoaro [43]. Likokoana-hloko tse peli tse khomarelang ka ho feteletseng li susumetsoa ka matla le amphetamine tse fokolang ka bobeli-ho kopanya ka ho sebelisoa ha li-receptor tsa mahlaseli a maholo [163], mme ho ka etsahala hore litšoantšo tse manyala tse hlephisang boitšoaro tsa inthanete tse matlafatsang kajeno li tlise phello e ts'oanang ho basebelisi ba bang.
Tumellanong le tlhahiso ea hore litšebeletso tsa litšoantšo tsa bootsoa tsa basebelisi ba Inthaneteng li ka 'na tsa e-ba le boikaketsi ha li arabela likamano tsa botona le botšehali (hammoho le phekolo ea ho sheba litšoantšo tsa bootsoa Inthaneteng), tlhahlobo ea XMUMX ea fMRI ea basebelisi ba litšoantšo tse manyala tse hlephisang boitšoaro tsa Inthanete ka Kühn le Gallinat o ile a fumana hore ho hlajoa ha molumo o nepahetseng oa striatum ho ne ho le nyenyane haholo ka lihora tse ngata le lilemo tse ngata tsa ho sheba litšoantšo tsa bootsoa tsa Inthanete [134]. Ho bonahala eka ho na le mekhoa e metle ea ho itšoara ka mokhoa oa ho atamela 'me e na le maikutlo a matla ka ho susumetsa maikutlo a amanang le lerato la lerato [164,165]. Hape, lihlooho tse kholo tsa 'litšoantšo tsa bootsoa tsa Inthanete li sebelisa, theolela ho kenya letsoho ka letsohong le letšehali ha u shebile litšoantšo tsa thobalano e sa ntse e le lifoto (0.530 s exposure). Ho kenyelletsa setamen ho amahanngoa le ho tsosoa ha thobalano le penile tumescence [67,166]. Bangoli ba ile ba fana ka maikutlo a hore liphuputso tsena li "lumellana le khopolo ea hore ho pepeseha ho hoholo ha litšoantšo tsa bootsoa ho fella ka ho fokotseha ha karabo ea tlhaho ea mekhoa ea boipheliso litabeng tsa thobalano" [134]. Ho thahasellisang ke hore banna ba "thahasellang haholo litšoantšong tse litšila tse tsosang takatso kapa tse feteletseng" ba tlaleha hore ba amehile haholo ka liketso tsa bona tsa ho kopanela liphate, boholo ba pona, le bokhoni ba ho boloka likhetho ho feta basebelisi ba bang ba bootsoa ba Internet [42]. Ha motho a nahana hore ho shebella litšoantšo tse manyala tse hlephisang boitšoaro ho feteletseng ho ka fokotsa boikarabelo ba ho kopanela liphate ho basebelisi ba bang, ka hona ho khanna tlhokahalo e matla ea lintlha tse feteletseng kapa tsa morao ho etsa [27]. Hape, phuputso ea 2016 e tlalehile hore halofo ea banna bao ho buisanoeng le bona e ne e falletse linthong tse bonahalang "tseo pele li neng li sa li thahasellise kapa li nahana hore li nyonyeha" [44].
Thuto ea 2015 EEG ea Prause et al. o bapisa ba shebelang litšoantšo tse manyala tse hlephisang boitšoaro tsa Inthanete (e bolelang 3.8 h / beke) ba neng ba tšoenyehile ka maikutlo a bona a ho laola (e bolelang 0.6 h / beke) ha ba ntse ba sheba litšoantšo tsa thobalano (tlhahiso ea 1.0) [130]. Ha ho fumanoa hore ho tšoana le Kühn le Gallinat, ba shebellang litšoantšo tsa bootsoa hangata ba Inthaneteng ba bonts'a matla a ho etsa li-neural activation (LPP) ho litšoantšo tsa thobalano ho feta taolo [130]. Liphello tsa lipatlisiso tsena tse peli li bontša hore hangata ba shebellang litšoantšo tse manyala tse hlephisang boitšoaro Inthaneteng ba hloka boikutlo bo eketsehileng ba ho hlahisa maikutlo a boko ha ba bapisoa le ho laola bophelo bo botle kapa basebelisi ba litšoantšo tsa bootsoa ba Inthaneteng [167,168]. Ho phaella moo, Kühn le Gallinat ba tlaleha hore litšoantšo tse litšila tse tsosang takatso tsa Inthanete li sebelisana le ho kopana ho tlaase ho pakeng tsa striatum le prefrontal cortex. Ho se sebetse ho potolohileng hona ho amana le khetho e sa lokelang ea boitšoaro ho sa tsotellehe hore na ho ka ba le liphello tse mpe hakae [169]. Tumellanong le Kühn le Gallinat, lipatlisiso tsa kelello li tlaleha hore litaba tse nang le tšekamelo e phahameng ea ho lemalla ho kopanela liphate Inthaneteng li fokolitse taolo ea bolaoli ba tsamaiso ha li tobane le litšoantšo tsa bootsoa [53,114].
Thuto ea 2015 ea fMRI ea Banca et al. li tlalehile hore, ha li bapisoa le ho laola bophelo bo botle, litaba tse manyala tse hlephisang boitšoaro tsa Inthaneteng li ne li e-na le khetho e kholo ea ho rata litšoantšo tsa thobalano [86]. Le hoja ho batla lits'oants'o le ho batla lits'ebeletso ho amana le kotsi e kholo bakeng sa mefuta e mengata ea lithethefatsi [170], Banca et al. ha a fumane phapang pakeng tsa ho batla lintho tse ngata pakeng tsa basebelisi ba bootsoa ba Inthanete le ho laola bophelo bo botle. Bangoli ba fana ka maikutlo a hore khetho bakeng sa mokhoa o sa tloaelehang o ne o totobetse ho sheba litšoantšo tse manyala tse hlephisang boitšoaro Inthaneteng,86]. Liphetho tsena li lumellana le Brand et al. (2011), e fumanoeng hore "palo ea litšebeliso tsa thobalano" e ne e le ts'ebetso ea bohlokoa ea ho lemala ho sebelisa lipotso tsa IATsex, ha litšobotsi tsa botho li sa amane le ho lemalla ho kopanela liphate ka litaba tsa thobalano [53]. Banca et al. o ile a boela a tlaleha hore basebelisi ba litšoantšo tse manyala tse hlephisang boitšoaro ba Inthanete ba bontšitse tloaelo e khōlō ho feta moo ho bonang litšoantšo tse tšoanang tsa thobalano [86]. Ka kakaretso, tekanyo ea dACC tloaelo ea litšoantšo tsa thobalano e ne e amahanngoa le khetho e kholo bakeng sa mokhoa oa ho kopanela liphate o mong le o mong [86]. DACC e kenyelelitsoe ts'ebetsong ea lithethefatsi reactivity le takatso, hammoho le tekanyetso ea litlhohonolofatso tse lebeletsoeng le tse sa lebelloang [144,171]. Voon et al. e tlalehile hore mosebetsi oa DACC o ntlafetse haholo litabeng tsa bootsoa tsa Inthaneteng ho qobella lipapali tsa ho kopanela liphate [31]. Liphuputso tsa Banca et al. Li fana ka maikutlo a hore batho ba bangata ba ts'oanang le litšoantšo tse manyala tse hlephisang boitšoaro ba Inthaneteng ba susumelletseha haholoanyane ka mokhoa o potlakileng oa ho kopanela liphate. Bafuputsi ba ile ba phetha ka ho re, "Re bontša liteko tsa lithethefatsi tse bontšang hore litšoantšo tse manyala tse hlephileng tsa boitšoaro bo bobe li sebelisoa] ke ho batla maemo, maemo a tloaelehileng le tloaelo ea ho kopanela liphate ho banna" [86]. Thupong e amanang le eona, tse ngata tsa lihlooho tse tšoanang li ne li boetse li tlalehile mathata a tsosang takatso ea ho kopanela liphate le erectile ka likamano tse kopanetsoeng tsa thobalano, empa eseng nakong ea litšoantšo tsa bootsoa tsa Inthanete li sebelisa [31]. Sena se bolela hore litšoantšo tse manyala tse hlephisang boitšoaro tsa Inthanete-tse bakang mathata a ho kopanela liphate li ka 'na tsa e-ba karolo e itseng ka lebaka la litebello tsa ts'ebetso tse sa tšoaneng le liketso tsa thobalano. Ba kopantsoe hammoho, Kühn le Gallinat [134] Prause le al. [130] le Banca et al. [86] ba bontšitse hore basebelisi ba litšoantšo tse manyala tse hlephisang boitšoaro ba Inthanete ba bontša (1) ho se sebetse ha boko ba maikutlo ka lebaka la ho pepesehela litšoantšo tsa thobalano; (2) e kholo ka ho fetisisa litabeng tsa thobalano; (3) ka potlako DACC tloaelo ea litabatso tsa thobalano; le (4) ho se na bohlooho bo bobebe bo bongata. Liphuputso tsena li tšehetsa khopolo-taba ea hore litšoantšo tsa bootsoa tsa Inthanete li ka 'na tsa fokotsa ts'oaetso ea mohloli, e lebisang ho tloaelehileng le ho mamellana hammoho le tlhokahalo e kholo ea ho tsosoa ka thobalano.
Liphuputso tsa ho etsa lipatlisiso ka ED ea AIDS li fana ka ts'ehetso e eketsehileng bakeng sa karolo ea moputso oa boipheliso ho se sebetse ka ho se sebetse ha erectile le tlaase ea libido. Dopamine agonist apomorphine e kenyelletsa penile erections ho banna ba nang le psychogenic ED [172]. Ha tlhahlobo ea XMUMX ea fMRI e ne e hlahloba boitsebiso ba bokooa ha banna ba nang le ED ea kelello le litsamaiso tse matla ba ne ba shebella lifilimi tsa thobalano, ba nang le ED ea kelello ea matsoho ba fapane haholo le ho laoloa ke matla ka tekanyo ea ho ts'oara libaka tsa cortical le subcortical. Ha dopamine agonist apomorphine e ne e fuoa banna ba nang le maikutlo a kelello ea ED, e hlahisa mekhoa ea bokooa e tšoanang le e bonngoeng ka matla a ho laola: haholo-holo ho eketsa ts'ebetso e hlaselang le ea ho itšireletsa habonolo [173]. Ho feta moo, phuputso ea 2012 MRI e fumane kopano e matla pakeng tsa ho fokotseha ha taba ea bohlooho ba lefuba le ea maikutlo a bohlooho ba ED-ED [174]. Phuputso ea 2008 e ile ea tlaleha banna ba nang le ED ea kelello ea maikutlo e bontšitsoeng liketso tse fokolang tsa tlhaho ea ho kopanela liphate [175].
3.4.3. Litšoantšo Tsa Bootsoa Inthaneteng le ho Kopanela Liphate
Kaha basebeletsi ba rona ba tlaleha hore ba ile ba ts'oaroa le ho tsosoa ke litšoantšo tsa bootsoa tsa inthanete, empa eseng ntle le tsona, lipatlisiso lia hlokahala ho thibela maemo a thobalano a sa lebelloang e le sesosa sa keketseho ea likhathatso tsa ts'ebetso ea thobalano le takatso e tlase ea thobalano ho banna ba ka tlase ho 40. Prause le Pfaus ba nahanne hore ho tsosa takatso ea thobalano ho ka fetoha likarolo tsa litšoantšo tsa bootsoa tsa inthanete tse sa fetoheng habonolo maemong a balekane ba nnete. "Ho nahanoa hore ho ba le litakatso tse ngata tsa thobalano ho latela maemo a VSS [tšusumetso ea thobalano] ho ka baka karabelo e fokotsehileng ea erectile nakong ea likamano tsa thobalano tse arohaneng ... Ha litebello tse matla tsa ts'usumetso li sa fihlelloe, ts'usumetso e kopanetsoeng ea thobalano ha e sebetse" [50]. Boemo bo joalo bo sa tloaelehang ba ho kopanela liphate bo lumellana le mokhoa oa ho khothatsa. Litsela tse 'maloa tsa lipatlisiso tse hlakileng li ile tsa eketsa mesolambic dopamine ho matlafatsa lithethefatsi tse peli tsa tlhekefetso le moputso oa thobalano [100,103]. Ho sebetsana le li-receptor tsa dopamine tsa D1, boiphihlelo ba ho kopanela liphate le tlhahiso ea kelello ea psychosotimulant ho baka liphetoho tse ngata tsa nako e telele tsa neuroplastic ho NAc e le bohlokoa bakeng sa ntlafatso ea ho batla litlhohonolofatso tse peli [103].
Motho ea sebelisang litšoantšo tse manyala tse hlephisang boitšoaro tsa Inthanete kajeno a ka lula a tsositse takatso ea ho kopanela liphate, 'me a haelloa ke dopamine e phahameng, ka nako e telele ka lebaka la litaba tse sa lekanyetsoang tsa romana. Linaha tse phahameng tsa dopamine li 'nile tsa ameha tabeng ea ho beha boitšoaro bo bobe ba likamano tsa botona le botšehali ka litsela tse sa lebelloang ho bobeli ba liphoofolo [176,177] le batho. Ho batho, ha bakuli ba Parkinson ba ne ba laetsoe hore li-agonists li fuoe dopamine, ba bang ba tlaleha hore batho ba sa lumellaneng le litšoantšo tse litšila tse tsosang takatso, ba sebelisa 'me ba bonahatsa mesebetsi e mengata ea litšoantšo tsa thobalano, e amanang le takatso ea ho kopanela liphate [178]. Liphuputso tse peli tsa morao-rao tsa FMRI li tlalehile hore litaba tse nang le boitšoaro bo bobe ba likamano tsa botona le botšehali li atisa ho theha mekhatlo e nang le maemo a pakeng tsa maqheka a sa nke lehlakore le likhang tse hlakileng tsa ho kopanela liphate ho feta taolo [86,121]. Ka ho sheba litšoantšo tse manyala tse hlephisang boitšoaro tsa Inthaneteng, "ho batla" ho ka 'na ha eketseha bakeng sa litšoantšo tsa bootsoa tsa Inthaneteng tse sa lebelloang le tse fapa-fapaneng, tseo ho leng thata ho li boloka nakong ea thobalano. Tumellanong le khopolo ea hore litšoantšo tsa bootsoa tsa Inthanete li ka sebelisa maemo a ho kopanela liphate, Seok le Sohn ba fumane hore ho bapisoa le taolo ea bosodoma ho ne ho e-na le ts'ebetso e kholo ea DLPFC likamano tsa botona le botšehali, leha ho le joalo ts'ebetso ea DLPFC e se ke ea etsoa khahlanong le thobalano [120]. Hape ho bonahala eka litšoantšo tse manyala tse hlephisang boitšoaro tsa Inthanete li ka etsa hore motho a ka lebella kapa a "batle" mokhoa o sa tloaelehang. Banca et al. ba tlaleha hore litaba tse nang le mekhoa ea ho kopanela liphate e qobelloang li ne li e-na le khetho e kholo ea litšoantšo tsa ho kopanela liphate le ho bontša mekhoa e meholo ka holimo ho ho sheba litšoantšo tse tšoanang tsa thobalano [86]. Bakeng sa basebelisi ba bang, khetho ea tlhaho e hlahisoa ke tlhoko ea ho hlōla ho fokotseha ha libido le mosebetsi oa erectile, e leng se ka lebisang ho litakatso tse ncha tsa bootsoa [27].
Ha mosebelisi a tsosa takatso ea hae ea thobalano litšoantšong tsa bootsoa tsa inthanete, thobalano le balekane ba nnete ba ka ngolisoang e le "ba sa fihlelleng litebello" (ponelopele e mpe ea moputso) e lebisang ho fokotseheng ho ts'oanang ha dopamine. E kopantsoe le ho se khone ho tobetsa ho hlasimolla ho feta, polelo ena e sa reroang e ka matlafatsa maikutlo a hore thobalano e arohaneng ha e na thuso ho feta litšoantšo tsa bootsoa tsa inthanete. Litšoantšo tse manyala tse hlephisang boitšoaro tsa Inthanete li boetse li fana ka pono ea motho eo a atisang ho ba le eona ha a sa kopanele liphate. Ho ka etsahala hore haeba mosebelisi ea sebelisang litšoantšo tse manyala tse hlephisang boitšoaro Inthaneteng a matlafatsa kamano pakeng tsa ho tsoha le ho shebella batho ba bang ba etsa thobalano lipapaling ha a ntse a tsohile haholo, botsoalle ba hae lipakeng tsa likamano tsa botona le botšehali tse tsoileng tseleng bo ka fokola.
Lipatlisiso mabapi le maemo a ho kopanela liphate ho batho ha li lekane, empa li bontša hore tsoho ea ho kopanela liphate ke boemo bo botle [179,180,181], haholo-holo pele e e-ba motho e moholo [182]. Ho banna, ho tsosoa ho ka fetisetsoa ho lifilimi tse khethehileng [183], hammoho le litšoantšo [184]. Ho sebetsana le thobalano le ho khahloa ke liphoofolo tsa banna (eseng batho) ho ka ba le maemo a mangata ao ka tloaelo a sa lokelang ho kopanela liphate ho tsona, ho akarelletsa litholoana tsa litholoana, linotlolo tse kang a cadaverine, balekane ba bong bo tšoanang, le ba apereng ea liaparo tse nang le litoeba [177,185,186,187]. Mohlala, likhoto tse neng li ithutile thobalano le jekete ha ea ka ea sebetsa ka tloaelo ntle jekete tsa bona [187].
Tumellanong le lipatlisiso tsena tsa boemo bo botle, nako e khutšoanyane eo banna ba qalileng ho sebelisa litšoantšo tsa bootsoa ba Inthanete ka eona kamehla, 'me ba e rata haholoanyane ka thobalano e kopanetsoeng, ho se thabise ha bona ho tlaleha ka thobalano e arohaneng, le ho phahamisa tšebeliso ea litšoantšo tsa bootsoa ba Inthanete hona joale. [37]. Ka tsela e tsoanang, banna ba tlaleha ho sebelisoa ho eketsehileng ha litšoantšo tse manyala tse hlephisang boitšoaro tse se nang letho (tseo batšoantšisi ba sa li kenyeng likhohlopo) le tšebeliso ea eona lilemong tsa pele ho moo, ba kopanela liphate tse ling tse sa sireletsang tsa thobalano ka bobona [188,189]. Ho sebelisa litšoantšo tse manyala tse hlephisang boitšoaro pele ho nako ho ka boela ha amahanngoa le litakatso tsa maemo a ho feteletseng haholo [99,190].
Tlhahlobo ea Pfaus e supa hore boemo ba pele bo bohlokoa haholo bakeng sa litšoantšo tse tsosang takatso ea thobalano: "Ho ntse ho hlaka hore ho na le nako ea bohlokoa ea tsoelo-pele ea boitšoaro bo hlephileng ea ho kopanela liphate e ikarabellang ho liphihlelo tsa pele tsa thobalano le takatso, ho ipholla litho tsa botona kapa botšehali le ho kopanela liphate ho kopanela liphate ka boeona "[191] (leq. 32). Tlhahiso ea nako ea bohlokoa ea tsoelo-pele e lumellana le tlaleho ea Voon et al. hore litšoantšo tse manyala tse hlephisang boitšoaro tsa Inthanete tse qobelloang ka ho fetisisa li bontša hore ho na le mosebetsi o moholo oa ho etsa lipapali tse hlakileng [31]. Sepheo sa ventral ke sebaka se ka sehloohong se amehang ho matlafatsa moputso oa tlhaho le lithethefatsi [103]. Voon et al. o ile a boela a tlaleha hore litšoantšo tse manyala tse hlephisang boitšoaro tsa Inthaneteng lihlooho li ile tsa qala ho sheba litšoantšo tse manyala tse hlephisang boitšoaro tsa Inthanete nakoana pele (lilemo tse bolelang 13.9)31]. Phuputso ea 2014 e fumane hore hoo e batlang e le halofo ea banna ba lilemo li kolecheng ba tlaleha hore ba pepesehetse litšoantšo tsa bootsoa tsa Inthanete pele ba le lilemo li 13, ha li bapisoa le 14% feela ka 2008 [37]. Na litšoantšo tse litšila tse tsosang takatso tsa Inthanete tse sebelisoang nakong ea boemo bo boima ba ho hōla li eketsa kotsi ea mathata a amanang le litšoantšo tsa bootsoa ba Internet E ka thusa ho hlalosa tlhaloso ea 2015 ea hore 16% ea banna ba bacha ba Mataliana ba neng ba sebelisa litšoantšo tse manyala tse hlephisang boitšoaro Inthaneteng hanngoe ka beke ba tlaleha takatso e tebileng ea ho kopanela liphate, ha bapisoa le 0% ho bao e seng bareki [29]? Mohlanka oa rona oa pele e ne e le 20 feela mme o ne a ntse a sebelisa litšoantšo tse manyala tse hlephisang boitšoaro Inthaneteng kaha o ile a fumana Inthanete e phahameng.
Banna ba ka atleha ho etsa qeto ea ho kopanela liphate ho laboratori ka tlaleho ea thuto, empa ntle le ho matlafatsoa, maemo a joalo a laboratori a nyamela litekong tsa morao [176]. Ts'ebetso ena ea tlhaho ea mali e ka 'na ea fana ka maikutlo a hore na tse peli tsa servicemen tsa rona li tsosolosoa joang le ho kopanela liphate le balekane ba bona ka mor'a ho tlohela lipapali tsa thobalano le / kapa ho khaola litšoantšo tsa bootsoa tsa Inthaneteng. Ho fokotsa kapa ho tima likarabo tsa boemo bo hlaselang ho etsoang ka maiketsetso e ka 'nang ea khahloa hape le liketso tsa thobalano le balekane ba bona.
4. Liphello le Litlhahiso
Lintho tsa setso tse kileng tsa hlalosa mathata a thobalano ho banna li bonahala li sa lekana ho ikarabella bakeng sa keketseho e matla ea likamano tsa thobalano le takatso e tlase ea thobalano ho banna ba ka tlase ho lilemo tse 40. Lingoliloeng le litlaleho tsa rona tsa bongaka li hatisa tlhoko ea lipatlisiso tse batsi tsa litlamorao tsa bootsoa ba inthanete ho basebelisi, hantle ka ho ba le lihlooho ho tlosa mefuta e fapaneng ea litšoantšo tsa bootsoa inthaneteng molemong oa ho bonts'a litlamorao tse ka bang teng tsa phetoho ea boits'oaro. Ka mohlala, phuputso ea 2015 e fumane hore litefiso tsa ho lieha ho theola (ho khetha ho ikhotsofatsa hanghang ho feta meputso e liehang ea boleng bo holimo) e fokotsehile ha barupeluoa ba phetseng hantle ba leka ho tlohela litšoantšo tse manyala tse hlephisang boitšoaro Inthaneteng libeke tse tharo feela (ha li bapisoa le sehlopha se laolang se lekileng ho tela lijo tseo ba li ratang ka nako e tšoanang) [75]. Boits'oaro bo bobeli le mofuta oa sepheo se fanoeng ke mekhoa e ka sehloohong.
Le ha mathata a sa amaneng le thobalano a nkuoa e le a kelello, ka hona profinse ea litsebi tsa bophelo bo botle ba kelello, mathata a sa hlalosoang a thobalano a ntseng a hola haholo ho bahlankana (ED, bothata ba bothata ba botona le botšehali, takatso e tlase ea thobalano), ho fihlela moo a ka fetohelang ka ho tlohela litšoantšo tse manyala tse hlephisang boitšoaro tsa marang-rang, eseng ka lebaka la "ho tšoenyeha ka tšebetso" (ke hore, ho se sebetse ka thobalano, ICD-9 khoutu 302.7), leha ts'ebetso ea matšoenyeho e ka tsamaea le bona. Bafuputsi ba nakong e tlang ba tla hloka ho ela hloko litšobotsi tse ikhethang le litlamorao tsa ho tsamaisa litšoantšo tsa bootsoa inthaneteng kajeno. Ntle le moo, ts'ebeliso ea litšoantšo tse manyala tse hlephisang boitšoaro inthaneteng nakong ea bocha ba pele, kapa pele ho moo, e ka ba phapang ea bohlokoa.
Tlhaloso ea rona le litlaleho tsa meriana li boetse li totobatsa tlhoko ea lisebelisoa tsa ho hlahloba ho bona hore na ho ka ba le bothata ba bothata ba ho kopanela liphate, eseng le mathata a amanang le litšoantšo tse manyala tse hlephisang boitšoaro ho banna ba phelang hantle. Hangata ho qetella ho ka tsosolosoa feela ka ho fetola boitšoaro. Hobane mathata a ho kopanela liphate a amanang le litšoantšo tsa bootsoa ha a e-s'o ka a kenngoa ka ho khetheha ho hlahlojoa ka molao, bahlokomeli ba tlhokomelo ea bophelo bo botle ha ba ba hlophise kamehla, ba siea bakuli ba kotsing. Tabeng ena, e le ho hlahloba bakuli ka tsela e nepahetseng, ho ka 'na ha e-ba thata ho khetholla litšoantšo tsa bootsoa-ntle le litšoantšo tsa bootsoa-li thusitse ho ikhotsofatsa litho tsa botona kapa botšehali. Ka tloaelo, haeba bakuli ba ne ba se na bothata ba ho etsa lintho tse ts'oanang, ba tsosoa le ho qetella ha ba ntse ba ipholla litho tsa botona kapa botšehali, empa ba tlalehile mathata nakong ea thobalano, ba ne ba nahana hore ba na le mathata a kelello, eseng manyolo, mathata. Leha ho le joalo, bakuli ba bacha ba botsa hore na bokhoni ba bona bo ka 'na ba nahana hore "ho ipholla litho tsa botona kapa botšehali" ho bolela "ho ipholla litho tsa botona kapa botšehali" ka hona, ho hlahlojoa hore ke "ho tšoenyeha ha mosebetsi", ha mathata a bona a ho kopanela liphate a amana le litšoantšo tsa bootsoa. Mokhoa o mong o bonolo oa bahlokomeli ba tlhokomelo ea bophelo bo botle ba ka 'na ba sebelisa ke ho botsa, "ebang mokuli a ka finyella le ho boloka erection e khotsofatsang (le ho qetella ka tsela eo ae ratang) ha a ipholla litho ntle le ho sebelisa litšoantšo tsa bootsoa tsa Inthanete". Haeba a sa khone, empa a ka finyella lipakane tsena habonolo ka litšoantšo tsa bootsoa tsa Inthanete, joale ho se sebetse ha hae ka thobalano ho ka amahanngoa le tšebeliso ea eona. Ntle le ho sebelisa teko e joalo, ho na le kotsi ea ho hlahlojoa ka bohata ka "ho tšoenyeha ha ts'ebetso", le kotsi ea ho beha meriana e sa hlokahaleng ea meriana le (qetellong mohlomong ha e sebetse) phosphodiesterase-5 inhibitors. Lintho tse ling tse bontšang hore litšebelisano tse hlephisang boitšoaro tse amanang le litšoantšo tse manyala tse hlephisang boitšoaro Inthaneteng li ka 'na tsa e-ba ho lahleheloa ke likarolo tsa mantsiboea le / Phuputso e eketsehileng sebakeng sena e tiisitsoe.
Ho phaella moo, le hoja bafani ba tlhokomelo ea bophelo ba tlameha ho hlahloba mathata a kamano, ho itšepa ho tlaase, ho tepella maikutlong, ho tšoenyeha, PTSD, khatello ea kelello le mathata a mang a bophelo ba kelello, ba lokela ho ba hlokolosi ho nahana hore bophelo bo botle ba kelello ke sesosa sa ho se sebetse ka thobalano ho banna tlas'a 40. Kamano pakeng tsa lintlha tsena le ho se sebetse ka thobalano ho banna bahlankana ba ka 'na ba e-na le likamano tse peli tsa likamano tsa botona le botšehali, kapa li ka ba le phello ea ho se sebetse ka thobalano [26].
khutsufalitsoeng
Likarolo tse latelang li sebelisitsoe bukeng e ngotsoeng ka letsoho.
| CSB | Boitšoaro bo qobelloang ba thobalano |
| DLPFC | dorsolateral prefrontal cortex |
| DSM | Buka ea ho hlahloba le ea Statistical ea Mathata a kelello |
| ED | Ho se sebetse ha erectile |
| fMRI | litšoantšo tse sebetsang ka matla a motlakase |
| IIEF | Index ea Machaba ea Mosebetsi oa Erectile |
| MRI | papiso ea mahlaseli a motlakase |
| NAc | nucleus accumbens |
| Li-OSA | liketso tsa thobalano tsa inthaneteng |
| PTSD | posttraumatic khatello ea kelello |
| PIED | litšoantšo tse litšila tse tsosang takatso ea boitšoaro bo bobe |
| VTA | sebaka sa ventral tegmental |
Menehelo ea Mongoli
Brian Y. Park le Warren P. Klam ba bokelletse data ea bakuli; bangoli bohle ba kentse letsoho ho ngola sengoloa.
Likhohlano tsa Thahasello
Bangoli ha ba phatlalatse hore ha ho likhohlano tsa phaello. Maikutlo le lintlha tse hlahisitsoeng ke tsa lingoli 'me ha li hlile ha li supe boemo ba semolao kapa maano a US NAVY kapa Lefapha la Ts'ireletso.
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