Ke eng e lokelang ho kenyelletsoa maemong a tlhekefetso ea boits'oaro ba thobalano? (2020)

Bothata ba boitšoaro bo hlephileng ba ho kopanela liphate (CSBD) ho ICD-11

Boloetse ba boitšoaro bo hlephileng ba ho kopanela liphate (CSBD) hajoale bo hlalositsoe ntlafatsong ea leshome le motso o mong ea Lenaneo la Machabeng la Maloetse (ICD-11; WHO, 2020; Kraus et al., 2018) joalo ka bothata ba taolo ea maikutlo le "bo tšoauoang ke mokhoa o phehellang oa ho hloleha ho laola litabatabelo tse matla, tse pheta-phetoang tsa thobalano le boits'oaro" moo motho (1) a fanang ka nako e fetelletseng liketsong tsa thobalano ho isa ntlheng ea ho se tsotelle bophelo bo botle, tlhokomelo ea botho, lithahasello le boikarabello, (2) liphihlelo tse fokolitseng taolo e bonts'itsoeng ke boiteko bo bongata bo sa atleheng ba ho fokotsa boits'oaro ba thobalano, (3) e tsoelapele ho etsa thobalano leha ho na le litlamorao, (4) e tsoelapele ho etsa thobalano le ha e sa khotsofala hanyane kapa hofeta, le (5) liphihlelo khatello e kholo ea mmele kapa bofokoli libakeng tsohle tsa bophelo kapa libaka tsa bohlokoa tsa tšebetso. Mokhahlelo ona o boetse oa hlokomelisa, "Matšoenyeho a amanang ka ho felletseng le melao ea boitšoaro le ho se amohele litakatso tsa thobalano, litakatso kapa boits'oaro ha a lekana ho fihlela tlhoko ena." Ntle le moo, mathata a paraphilic aa khetholla. Tlhaloso ea ICD-11 e arolelana ho ts'oana le litekanyetso tse reriloeng tsa lefu la hypersexual (HD) le neng le nkuoa, empa qetellong la khelosoa ho DSM-5 (Mokhatlo oa American Psychiatric Association, 2013; Kafka, 2010, 2014), ka liphapang tse 'maloa tse hlokomelehang tse amanang le (1) maikutlo le / kapa likarolo tse amanang le taolo ea khatello ea maikutlo, (2) boits'oaro bo hlephileng bo amanang le boitšoaro ba thobalano, (3) mathata a boitšoaro bo bobe ba thobalano a amanang le ts'ebeliso ea lithethefatsi, le (4) khotsofalo e nyane ho tsoa ho liketso tsa thobalano (Lethathamo 1).

Ho senyeha ha maikutlo le ho sebetsana ka katleho le mathata

Matšoao a amanang le maikutlo a amanang le maikutlo ha a kenyellelitsoe maemong a CSBD ho ICD-11 leha data e bonts'a CSB hangata e amahanngoa le ho sebelisa thobalano ho sebetsana ka katleho le maikutlo a thata (mohlala, ho hlonama, ho hlabisoa lihlong, ho jeoa ke bolutu, ho teneha kapa ho halefa), khatello ea maikutlo kapa liphihlelo tse bohloko (Lew-Starowicz, Lewczuk, Nowakowska, Kraus, & Gola, 2020; Reid, 'Metli oa mapolanka, Spackman, & Willes, 2008; Reid, Stein, & Carpenter, 2011). Khopolong ea maikutlo ea HD e hlahisitsoeng ke Khafetsa (2010) bakeng sa DSM-5, litekanyetso tse peli ho tse hlano li sebetsana ka kotloloho ts'ebeliso ea liketso tsa thobalano ho laola maikutlo kapa ho fokotsa khatello ea maikutlo (A2 le A3, Lethathamo 1).

Ho senyeha ha maikutlo ho amana le bosodoma maemong a kliniki le mehopolo ea mohopolo le thuto (Metsoana, 2001; Kingston & Firestone, 2008; Wéry le Billieux, 2017). Moetso oa Goodman o ne o na le likarolo tse kholo tsa 3: ho holofala ho amang taolo, ho sitisa boits'oaro, le liphapano ts'ebetsong ea litsamaiso tsa moputso tse susumetsang (Goodman, 1997). Ho nahanang ka bosodoma le ho nts'etsapele Hypersexual Behavior Inventory (Reid, Garos, & Carpenter, 2011), Reid le Woolley (2006) lintlha tse totobetseng tse amanang le khatello ea maikutlo (Reid & Woolley, 2006). Ha u hlahloba likhopolo tse fapaneng tsa etiological tsa CSB, Bancroft le Vukadinovic (2004) e boletse, "Re nka karolo ea li-affect e le ea bohlokoa maemong a mangata, haeba e se kaofela, maemong a sa laoleheng boitšoaro ba thobalano" (leq. 231). Ba khothalelitse litsela tse 3 tseo ka tsona ts'oaetso e mpe, e mpe e ka kenyang letsoho ho CSB: ho tsosa takatso ea thobalano le thobalano e qobelloang e ka bonts'ang liteko tsa ho fihlela lipheo tsa taolo nakong ea maikutlo a mabe a maikutlo; tšusumetso ea thobalano e ka sebelisoang e le tšitiso linthong tse susumetsang kapa maemong a bakang maikutlo a mabe; hape, tsoho ea thobalano e ka bang karabelo e maemong a ho tsosa maikutlo a mabe haholo. Mefuta ea morao-rao, ea mefuta-futa, e kopanyang e shebaneng le mofuta le etiology ea CSB le eona e supa bohlokoa ba khatello ea maikutlo (Grubbs, Perry, Wilt, & Reid, 2018; Walton, Cantor, Bhullar, & Lykins, 2017).

Ka kakaretso, lipatlisiso tse boletsoeng ka holimo li totobatsa bohlokoa ba mekhatlo pakeng tsa taolo ea maikutlo kapa botumo ba khatello ea maikutlo le CSB. Karolo e hlahelletseng bakeng sa taolo ea maikutlo le eona e hlalositsoe ka bothata ba papali ea chelete, boemo boo pele bo neng bo khetholloa e le bothata ba taolo ea tšusumetso mme joale e le bokhoba ba boitšoaro. Haholo-holo, taolo ea maikutlo e sebelisoang e le litšusumetso tse matlafatsang e hlalositsoe e le tsela e kholo ea ho nts'etsapele le ho boloka bothata ba papali ea chelete (Blaszczynski & Nower, 2002). Hoa utloahala hore maemo a mabe a mabe a ka baka lisosa tsa likotsi tsa CSB. Ho khahlisang ke hore, litekanyetso tsa DSM-5 tsa bothata ba papali ea chelete li kenyelletsa moelelo o amanang le maikutlo le melaoana empa litekanyetso tsa ICD-11 ha li joalo. Kahoo, liphapang tse boletsoeng kaholimo li ka bontša liphapang tse sa fetoheng ka litsela tseo makhotla a busang, Mokhatlo oa Lefatše oa Bophelo le Mokhatlo oa Maiketsetso oa Amerika, a nahanang ka tsona litekanyetso tsa mantlha tsa mathata ana. Mefuta ea phokotso ea tsitsipano kapa maikutlo a hau a ho iphekola a baka hore boits'oaro bo ka etsang hore motho a be le boiphihlelo bo ka fetohang bo ka sebetsa ka mekhoa e matlafatsang ea ho matlafatsa linaha tse mpe kapa ho fokotsa khatello ea maikutlo (Gola & Potenza, 2016; Kasten, 1999; Khantzian, 1987; Lentsoeecha et al., 2018), 'me tsena li lokela ho tsotelloa ha ho hlahisoa likarolo tsa bakuli ba batlang kalafo ea CSBD. Le ha ts'ebetso ena e ka tsamaisoa ke ho kenyeletsoa ha likarolo tsena ka har'a maemo, lingaka esale li lekola likarolo tse amehang tsa bongaka le ha li sa kenyelletsoa e le litekanyetso tse bohareng (mohlala, litabatabelo tsa papali ea chelete bothateng ba papali ea chelete).

Hajoale, ha ho hlake ka ho felletseng hore na hobaneng litekanyetso tse amanang le melao ea taolo ea maikutlo kapa khatello ea maikutlo li sa kenyeletsoe ho latela litekanyetso tsa ICD-11 tsa CSBD. Re khothaletsa le ho buella puisano e bulehileng ka taba ena e le sesosa sa hore na likarolo tsa mantlha tsa CSBD li nahanoa joang le hore na boiteko bo amanang le CSBD bo atamela joang lipatlisisong le maemong a bongaka. Ha o hlalosa litekanyetso tsa CSBD, ho kanna ha ba bohlokoa ho nahana hore na matšoao a mantlha a ka khetholloa joang ho tsoa lits'ebetsong tsa kelello, joalo ka ha ho sa tsoa hlalosoa bakeng sa boloetse ba papali le boits'oaro bo bong bo lemalloangMoetso, Rumpf, Morena, Potenza, & Wegmann, 2020).

Thabo e fokotsehileng

Lipuisano tse ling mabapi le ho tšoana le phapang lipakeng tsa litekanyetso tsa HD le CSBD lia hlokahala. Ha li bapisoa le HD, litekanyetso tsa CSBD li fapana ka hore li kenyelletsa ka mokhoa o hlakileng tsoelo-pele ea boits'oaro ba thobalano ha u sa natefeloe ke letho (WHO, 2020). Sena se bonahala se bonts'a metheo ea "qobello" ea "boloetse" e fanang ka maikutlo a hore boitšoaro ba thobalano har'a batho ba fumanoeng bo ka tsamaisoa ke mabaka a sa amaneng le menyaka; lintlha tse joalo li ka kenyelletsa thobalano joalo ka tloaelo kapa boits'oaro kapa liteko tsa ho fokotsa menahano e mebe le / kapa litlamorao tse mpe tse amanang le tsona (Barth & Kinder, 1987; Stein, 2008; Walton et al., 2017). Thabo e fokotsehileng e tsoang boitšoarong ba botona le botšehali e ka bonts'a mamello e amanang le ho pheta-pheta le ho pepesehela maikutlo a feteletseng a thobalano, a kenyellelitsoeng mefuteng ea lithethefatsi ea CSBD (Kraus, Voon, & Potenza, 2016) mme e ts'ehetsoa ke liphuputso tsa methapoKe Tla Tseba Joang 2018). Karolo ea bohlokoa bakeng sa mamello e amanang le ts'ebeliso e mpe ea litšoantšo tse manyala tse hlephisang boitšoaro e boetse e khothalelitsoe sechabeng le mehlala e meng e menyenyane (Chen le al., 2021). Ho nahanisisa ka liketsahalo tse joalo joalo ka ha li amana le litekanyetso tsa CSBD ho ka thusa ho khetholla pakeng tsa batho ba nang le matšoao a CSBD le ba kenang khafetsa liketsong tsa thobalano ka lebaka la litakatso tse phahameng tsa thobalano kapa ho khanna (Carvalho, Štulhofer, Vieira, le Jurin, 2015), eo e neng e le ntlha ea pele ea nyatso ea mahlale ea HD le CSBD (Thapelo, 2017).

Ho nahanoa ka litekanyetso tse kenyelletsang

Ntle le moo, hore na hantle-ntle mokhoa oa ho nahana ka moelelo o mong le o mong oa CSBD ha o etsa tlhahlobo ea lefu lena ha o hlalosoe ka ho hlaka. Hajoale, ho na le tlhaloso ea matšoao a ka amanang le ts'oaetso, le tataiso e sa nepahalang mabapi le hore na ke lintlha life tse kae tse hlokahalang khahlanong le boikhethelo bakeng sa ho etsa tlhahlobo ea mafu (WHO, 2020). Tlhahlobo ea HD e hloka litekanyetso tsa kopano B le tse 3 ho tse 5 tsa mofuta oa mofuta oa A (bona Lethathamo 1). Hajoale, tlhaiso-leseling e tsamaellanang ha e hlahisoe bakeng sa CSBD. Sehlooho sena se fana ka tumello ea tlhatlhobo e eketsehileng lipatlisisong tse tlang le mesebetsing ea bongaka le litlatsetso tse ling ho ICD-11.

Boitšoaro bo sa tsitsang

Tlhaloso ea hajoale ea CSBD e boetse e kenyelletsa polelo ea hore tlhahlobo ea CSBD ha ea lokela ho etsoa haeba khatello ea maikutlo e amana ka botlalo le ho se amoheloe ke boitšoaro kapa likahlolo. Polelo ena e bonts'a lipatlisiso tsa haufinyane mabapi le litšusumetso tse ka bang teng tsa litumelo tsa bolumeli le tsa boits'oaro mabapi le ho batla kalafo ea CSB (Grubbs et al., 2018; Grubbs, Kraus, Perry, Lewczuk, & Gola, 2020; Lewczuk, Szmyd, Skorko, & Gola, 2017; Lewczuk, Glica, Nowakowska, Gola, & Grubbs, 2020), data e neng e sa fumanehe ha HD e ne e hlahisoa bakeng sa DSM-5. Leha ho le joalo, maikutlo a boits'oaro bo sa lokang ha aa lokela ho etsa hore motho a se ke a tšoaneleha hore a se ke a fumana tlhahlobo ea CSBD. Mohlala, ho shebella lintho tse amanang le thobalano tse sa tsamaellaneng le litumelo tsa hau tsa boitšoaro (mohlala, litšoantšo tse manyala tse hlephisang boitšoaro tse kenyeletsang pefo khahlanong le basali (Bridges et al., 2010khethollo ea morabe (Fritz, Malic, Paul, & Zhou, 2020), lihlooho tsa peto le ho nyalana ka thobalano (Bőthe et al., 2021; Rothman, Kaczmarsky, Burke, Jansen, le Baughman, 2015) e ka tlalehoa e le boitšoaro bo sa lokang, 'me ho shebella lintho tse joalo ka mokhoa o fetelletseng ho ka baka tšenyo libakeng tse ngata (mohlala, tsa molao, tsa mosebetsi, tsa motho ka mong le tsa lelapa). Hape, motho a ka ikutloa a sa itšoare hantle mabapi le boits'oaro bo bong (mohlala, ho becha bothateng ba papali ea chelete kapa ts'ebeliso ea lithethefatsi mathateng a ts'ebeliso ea lithethefatsi), empa boits'oaro ba boits'oaro ha bo nkuoe maemong a maemo a amanang le boits'oaro bona, leha e ka fana ka tumello nakong ea kalafo (Lewczuk, Nowakowska, Lewandowska, Potenza, & Gola, 2020). Ho kanna ha ba le liphapang tsa bohlokoa tsa setso le setso tse amanang le tumelo e ka bang le tšusumetso ea boitšoaro bo sa bonahalengLewczuk et al., 2020). Ho feta moo, bafuputsi ba hlahisitse lipotso mabapi le hore na mefuta ea CSB e kenyelletsang boteng kapa ho ba sieo ha boits'oaro ba boits'oaro e fapane joalo ka ha ho sisintsoe (Moetso, Antons, Wegmann, & Potenza, 2019). Kahoo, leha boits'oaro bo hlephileng bo ka ba le bohlokoa ba bongaka ho se susumelletsang batho ho batla kalafo ea CSB (Kraus le Sweeney, 2019), Karolo ea eona ho etiology le tlhaloso ea CSBD e fana ka kutloisiso e eketsehileng.

Ts'ebeliso ea lithethefatsi le matšoao a ho ferekana kelellong

Mekhoa ea CSBD ha e nahane ka ho hlaka lintlha tse ling tse ka bang bohlokoa ho fumanoeng ho kenyeletsoa tšebeliso ea lithethefatsi (Kafka, 2010; Reid & Meyer, 2016). Boitšoaro bo ikhethileng bo kopaneng (mohlala, CSB e lekantsoeng makhetlo a ts'ebeliso ea cocaine ts'ebetsong ea ts'ebeliso ea koae kapa kalafo ea phetolo ea dopamine ho lefu la Parkinson) e amana joang le litumello tsa CSBD. Ka mokhoa o ts'oanang, CSB e lekanyelitsoeng liketsahalong tsa manic e lokela ho tsotelloa, joalo ka ha ho le joalo bakeng sa papali ea chelete e amanang le mania mabapi le bothata ba papali ea chelete.

tlhophiso

Sehlopha sa CSBD e le bothata ba ho laola maikutlo le sona se hloka hore ho nahanoe. HD e ne e nkuoa ke sehlopha sa basebetsi sa DSM-5 sa Thobalano le Bong.Kafka, 2014), Le data e fana ka maikutlo a ts'oanang lipakeng tsa CSBD le mathata a lemalloangGola & Draps, 2018; Kraus, Martino, & Potenza, 2016; Stark, Klucken, Potenza, Brand, & Strahler, 2018). Liphuputso tse ling li ka thusa ho ntlafatsa tlhophiso e nepahetseng ka ho fetesisa ea CSBD joalo ka ha ho etsahetse ka bothata ba papali ea chelete, e hlophisitsoeng bocha ho tsoa sehlopheng sa mathata a taolo ea tšusumetso ho litlamorao tse seng tsa lithethefatsi kapa tsa boitšoaro ho DSM-5 le ICD-11. Tumellanong le mohopolo ona, lipatlisiso tse ling li fumane ho se tsotelle e le karolo e amanang le bakuli ba ka tlase ho halofo ea bakuli ba batlang thuso bakeng sa CSB (Reid, Cyders, Moghaddam, & Fong, 2014) le hore ho se ts'oenyehe ho kanna ha se tlatsetse ka matla ho sebeliseng mathata a litšoantšo tsa bootsoa joalo ka ha ba bang ba hlahisitse (Bőthe et al., 2019).

Mefuta ea boitšoaro ba thobalano

Matšoao a boits'oaro a ts'oanang le a oelang tlasa taolo ea CSBD le ona a ithutiloe ka har'a moralo o mosesane oa ts'ebeliso e nang le bothata ba litšoantšo tsa bootsoa (de Alarcón, la Iglesia, Casado, & Montejo, 2019). Ho fanoa ka bothata ba ho shebella litšoantšo tse manyala tse hlephisang boitšoaro le ho qobella ho ipholla litho tsa botona kapa botšehali hangata e le lits'oants'o tse hlahelletseng tsa boitšoaro tsa CSBDGola, Kowalewska et al., 2018; Reid et al., 2011), Motho a ka hlahisa hore ts'ebeliso e thata ea litšoantšo tse manyala tse hlephisang boitšoaro e lokela ho nkuoa e le karoloana ea CSBD, leha lintlha tse ling li hlalositsoe (Brand et al., 2020). Mekhoa e reriloeng ea HD (Kafka, 2010) e kenyelelitse litlatsetso tse supileng tsa boits'oaro (ke hore, ho ipholla litho tsa botona kapa botšehali, Litšoantšo tse manyala tse hlephisang boitšoaro, boitšoaro ba thobalano le batho ba baholo ba lumellanang, Cybersex, Telephone Sex, Strip Clubs, tse ling) tse neng li reretsoe ho thusa ho khetholla lipontšo tse fapaneng tsa lefu lena. Ho ICD-11, ha ho na likaroloana tsa CSBD tse hlalositsoeng hajoale, e kanna ea ba mosebetsi oa lipatlisiso tsa nako e tlang. Ts'ehetso ea tlhaiso-leseling e ka ba le mekhoa le linehelano tse nang le mathata a boits'oaro ba thobalano (Carvalho et al., 2015; Knight & Graham, 2017; Kingston, 2018a, 2018b), e ka fuputsoang ho ea pele ka mekhoa ea CSBD ka kelellong. Mabapi le lipatlisiso tsa mahlale, ho tsebahala ha CSBD ho ICD-11 ho ka thusa ho bokella lipatlisiso tse amanang empa ka linako tse ling li sa sebetse (ts'ebeliso e nang le bothata ba litšoantšo tse manyala tse hlephisang boitšoaro, ho sheba litšoantšo tse manyala tse hlephisang boitšoaro le ho lemalla ho kopanela liphate, mathata a cybersex, bosodoma), e leng se ka hlahisang tlhakisetso e kholo ea mahlale le potlakisa lipatlisiso le tsoelo-pele ea bongaka.

Tlhahlobo

Ho hatela pele ho fihlela sepheo sa lipatlisiso tse kopaneng, mehato ea ho lekola matšoao a CSBD a bonts'ang ka botlalo litekanyetso tsohle tsa CSBD le bohlokoa ba eona bo lekantsoeng li lokela ho ntlafatsoa le ho netefatsoa. Mosebetsi ona, leha o ne o le bohlokoa, o ne o ipakile o le thata nakong e fetileng bakeng sa HD, joalo ka ha mehato ea ho lekola HD e ne e nyatsuoa ka ho hlahloba batho ba bangata ka kakaretso, bonyane mehlala e meng (mohlala, Walton et al., 2017). Boiteko ba mantlha bo kenyelelitse nts'etsopele ea sekala sa lintho tse 19 se netefalitsoeng lipuong tse tharo (Bőthe et al., 2020). Liphuputso tse ling lia hlokahala ho lekola bonnete le ts'epahalo ea eona libakeng tse ling tse ka bang le litso tse fapaneng tsa setso ka thobalano (hara liphapang tse ling) le ho fuputsa lipatlisiso tsa eona le lits'ebeletso tsa bongaka.

Litlhahiso tsa meriana

Ho sa tsotelehe tlhoko ea tlhakiso e eketsehileng joalo ka ha ho boletsoe pampiring ena, ho kenyeletsoa CSBD ho ICD-11 e lokela ho thusa batho ba batlang kalafo le bafani ba tlhokomelo ea bophelo. Hoo e ka bang monna a le mong ho ba supileng ba shebileng litšoantšo tse manyala tse hlephisang boitšoaro o tlalehile thahasello ea ho batla kalafo bakeng sa ts'ebeliso ea bona ea litšoantšo tsa bootsoa, ​​mme ba nang le thahasello ea kalafo ba na le monyetla o moholo oa ho fihlella monyako oa bongaka oa bosodoma (Kraus, Martino, & Potenza, 2016). Kahoo, ho kenyelletsoa ha CSBD ho ICD-11 ke kenyelletso e amoheloang e lokelang ho ba le tšusumetso e kholo ho kliniki. Bafuputsi ba lokela ho tseba ho haha ​​motheong oa litekanyetso tsa CSBD ho fana ka leseli le maikutlo a eketsehileng mabapi le lefu lena le likarolo tse amanang le lona le ho thusa ho khothaletsa tsoelo-pele ea bongaka.

Mehloli ea lichelete

Mosebetsi ona o ne o sa tšehetsoe ke lichelete.

Menehelo ea bangoli

MG, KL, le RCR li hlahisitse mohopolo oa pele oa sengoloa sa pele, MNP, JBG, DAK, le RS li fane ka liphetoho tse kholo le mehopolo e meng bakeng sa mefuta e latelang. Bangoli bohle ba buile ka litaba tse hlahisitsoeng mme ba lumellane ka mofuta oa hoqetela.

Khohlano ea thahasello

Bangoli ba tlaleha hore ha ho na khohlano ea lithahasello.

Ho ananela

Ha ho letho.