Uphando loPhando. I-2014 Oct; 11 (4)I-387-93. doi: 10.4306 / pi.2014.11.4.387. I-Epub 2014 Oct 20.
Lee JY1, Ipaki EJ2, Kwon M3, I-Choi JH3, UJeong JE3, I-Choi JS4, I-Choi SW5, Lee CU3, U-Kim DJ3.
Abstract
INJONGO:
Olu phononongo luvavanye umahluko kwiimpawu zengqondo zengqondo kunye neendlela zokuziphatha ngokungqinelana nobukrwada bokulutha kwe-Intanethi kulutsha olungamadoda.
IINDLELA:
Ikhulu elinamanci mabini anesihlanu abafikisayo abavela kwizikolo ezine eziphakathi neziphakamileyo eSeoul babhaliswa kolu phando. Izifundo zahlulwe zangamaqela angenabukhoboka bokuphatha gadalala, gadalala, kunye nokuxhomekeka ngokodliwanondlebe lokuqonda isifo ngoochwephesha bezengqondo. Iimpawu zengqondo kunye nokuziphatha kwezifundo kuvavanywe ngodliwanondlebe lweklinikhi yengqondo esekwe kwiDiagnostic kunye neStatistical Manual yeNgqondo yokuPhazamiseka (uhlelo lwe-4), i-Inventory yoxinzelelo lwabantwana, i-State-Trait Anxcare Inventory, uVavanyo lwe-Intanethi lweziyobisi, kunye nokuzenzela uxele iphepha lemibuzo malunga nokuziphatha.
IINKCUKACHA:
Ukusasazwa kwengqondo yokuhanjiswa kwengqondo kwahluke kakhulu kuxhatshazo kunye nokuxhomekeka kumaqela, ngakumbi ngokubhekisele kukuchaphazeleka kwengxaki yokuphazamiseka kwengqondo kunye nezinto zokuphazamiseka kwemood. Uluhlu lweZintlu zoxinzelelo lwaBantwana, i-State-Trait Anxcare Inventory, kunye ne-Intanethi yokuvavanywa kwamanqaku ovavanyo kwi-Intanethi nazo zahluke kakhulu kula maqela mathathu. Kwakukho umahluko obonakalayo kwizinto ezili-10 zezingama-20 zovavanyo lweziyobisi kwi-Intanethi phakathi kwamaqela angenabukhoboka bokuphathwa gadalala, kunye nokuxhomekeka. Kwakukho umahluko obonakalayo kwizinto ezisixhenxe phakathi kwamaqela angenabukhoboka bokuxhaphaza, kodwa akukho mahluko phakathi kwezifundo kuxhatshazo kunye namaqela abaxhomekekileyo. Umahluko obonakalayo waqwalaselwa kwizinto ezintathu phakathi kokuphathwa gadalala kunye namaqela okuxhomekeka, kodwa kwakungekho mahluko ubalulekileyo phakathi kwamaqela angenabukhoboka bokuxhaphaza. Ngokwezinto zokuziphatha, amanqaku okuhlukumeza, ezesondo, kunye nokwehla kokuziphatha komdla wokuziphatha babephezulu kwiqela lokuxhomekeka, kwaye bephantsi kwiqela elingengomlutha. Nangona kunjalo, indlela yokuziphatha yokuncipha kobudlelwane phakathi kwabantu ayibonisanga mahluko phakathi kwamaqela.
UKUQINISWA:
Olu phononongo lubonisa ukuba kukho umahluko kwimigqaliselo yengqondo kunye neendlela zokuziphatha phakathi kwamadoda akwishumi elivisayo aneempawu zokuxhatshazwa kwi-Intanethi kunye nokuxhomekeka kwi-Intanethi.
IINKCUKACHA:
Imiba yokuziphatha Ukunyibilika; Ukuxhomekeka; Ukuphathwa gadalala kwi-Intanethi
INTSHAYELELO
Ukuza kuthi ga ngoku, akukho zinkcazo zichanekileyo zokusetyenziswa gwenxa kwe-Intanethi, kwaye ukubhengeza kwi-Intanethi njengento ehlukileyo ngaphakathi kwesihloko sokuphazamiseka okuqhubekayo kuya kuba yinto yokuxoxwa. Nangona kukho iikhrayitheriya ezahlukeneyo kunye novavanyo lokufumana iziyobisi kwi-Intanethi, uvavanyo lwe-Intanethi lweOnline (IAT) luphuhliswa nguLutsha1 Esona sixhobo sokuvavanya sisetyenziswa kakhulu. I-IAT isekwe kwimilinganiselo yokungcola kwe-pathological echazwe kwiDiagnostic kunye ne-Statistical Manual yeNgqondo yokuPhazamiseka kwengqondo, uhlelo lwe-4th (DSM-IV),2 Ukucebisa ukuba iziyobisi kwi-Intanethi ziindlela zokuziphatha kakubi.
Izifundo ezininzi zibonise ukuba imiba yokuziphatha kunye neziyobisi zinokufana kwizinto ezahlukeneyo.3 Ukuvavanya umlutha we-Intanethi, u-Anderson no-Fortson basebenzise iikhrayitheriya eziguqulweyo kwisifundo esenziwe imodeli emva konxunguphalo olunxulumene neziyobisi kwi-DSM-IV, kuvavanyo lwe-Intanethi.4,5 Usebenzisa ezi ndlela, umlutha we-Intanethi uchazwa ngokuba kukungasebenzi kakuhle kweziyobisi ngokuchaphazela iziyobisi. Uphando lwabo lubonisa ukuba, kwiimeko zokusetyenziswa gwenxa kweziyobisi, ikhoboka le-Intanethi linokuchongwa ngokwahlukeneyo njengokuxhatshazwa okanye ukuxhomekeka, kwiimpawu zekliniki ezizodwa. Nangona kunjalo, kuba olo phononongo aluzange luqhube udliwanondlebe lwesigulana, kodwa endaweni yoko kwenziwa uvavanyo ngokusekwe kuphando lwephepha, ababhali abakwazanga ukumisela ngokuqinisekileyo isigulo sengqondo sengqondo kwisigulana ngasinye.
Ubutyebi bophando malunga nokulutha kwi-Intanethi lujolise kwiimpawu zengqondo kunye nonyango lwengqondo lwale meko.6,7,8 Kukho iziphumo ezifumanekayo malunga nobudlelwane phakathi kweempawu ezixinzisayo kunye nokulutha kwi-Intanethi,8,9,10,11 kwaye abaphandi abaninzi baye baxela ukuba uluhlu lwezifo zengqondo ezihambelana nokulutha kwe-Intanethi.12,13 Uvavanyo oluchanekileyo lwe-comorbidity yinxalenye ebalulekileyo yokuqonda i-etiology yeziyobisi ze-Intanethi, kuba kuyacaca ukuba ukulutha kwe-Intanethi kunye ne-psychor yengqondo zichaphazela omnye komnye nangona ubudlelwane babo be-causal buhlala bungacacanga. Kwiklinikhi, uvavanyo oluchanekileyo lwe-comorbidity lubalulekile kunyango olufanelekileyo, kunye nokuxela kwangaphambili ukuqhubela phambili kweziyobisi. Izifundo zamva nje zibonakalise ukuba ikhoboka le-Intanethi linamanqaku aphezulu kwimo yengqondo yengqondo kunye nemikhwa yokuziphatha ngokwesini, iminyaka, kunye nobukrakra bolukuko.9,14 Nangona kunjalo, ezi ibizizifundo ezincinci ezincinci okanye izifundo ezisebenzisa kuphela amaphepha emibuzo azixelayo ngaphandle kodliwano-ndlebe noxilongo lwezonyango. Ukuba kuyacaca ukuba iqela loxinzelelo kunye neqela lokuxhomekeka libonisa umahluko ngokwezigqondo zengqondo ngokusekwe kuxilongo oluchanekileyo ngoogqirha bezengqondo, siya kuba nakho ukucwangcisa indlela yophando kunye nonyango lokulutha ngokuqinisekileyo i-intanethi.
Ngokusekwe kwiikhrayitheriya ezibonelelwe yiFortson,4 Uphononongo lwangoku lujolise ukwahlula impatho-gadalala kwi-Intanethi kunye nokuxhomekeka ngokwenza udliwanondlebe lokuqonda, kunye nokumisela umahluko phakathi kwala maqela mabini ngokwengqondo kunye neendlela zokuziphatha. Ababhali bavavanya ukuba kukho umahluko kwizinto zengqondo kunye neendlela zokuziphatha phakathi kolutsha olungamadoda olunotyekelo lokuxhatshazwa kwi-Intanethi kunye nokuxhomekeka.
IINDLELA
nxaxheba
Idatha yafunyanwa kwizikolo ezine eziphakathi nendawo eziphakamileyo. Okubandakanyiweyo kolu phando yayizizifundo ezichongiweyo njengezamachiza kwi-Intanethi kokubini ngamanqaku e-IAT ngaphezulu kwe-401,15,16 kunye nokuchongwa kwengqondo. Izifundo ezenzelwe ubudala nobudala obuhambelana nesini ezachongwa njengezona zingangabikho makhoboka zabandakanywa njengeqela lolawulo. Kwiqela elingengomlutha, udliwanondlebe oluchongiweyo malunga nokulutha kwi-Intanethi kunye namaphepha emibuzo aqhutywa, kodwa imeko yengqondo yezifundo ayikhange ivavanywe kweli qela. Izifundo kunye nabazali bazo banike imvume ebhaliweyo ebhaliweyo emva kokufumana inkcazo epheleleyo yesifundo, ngokuhambelana neenkqubo ezivunywe yiBhodi yokuPhononongwa kweZiko leSibhedlele iSeoul St.
izinto
Ukusetyenziswa kwe-Intanethi
Umgangatho wokusetyenziswa kwe-Intanethi wavavanywa ngeendlela ezimbini. Okokuqala, bonke abathathi-nxaxheba bathatha i-IAT. I-IAT sisikali senqaku le-5-point Likert equka izinto ze-20, nganye nganye ibala ubungakanani bokugxila, ukusetyenziswa okunyanzelekileyo, iingxaki zokuziphatha, ukutshintsha kwemvakalelo, kunye nefuthe lokusebenza ngokubanzi okuhambelana nokusetyenziswa kwe-Intanethi.1 Amanqaku aphezulu abonakalisa ukuba likhoboka le-Intanethi. Okwesibini (kunye nenxalenye ebaluleke kakhulu kolu phononongo), iingcali zengqondo ezintlanu zaqhuba udliwanondlebe kusetyenziswa inguqulelo eguqulweyo yokusetyenziswa gwenxa kweziyobisi kunye nenqobo yokuxhomekeka kwi-DSM-IV. Iikhrayitheriya zethu zokuxhatshazwa kwi-Intanethi kunye nokuxhomekeka kuboniswe kwi 1 Table.
Iimpawu zengqondo zengqondo
Oogqirha bengqondo bavavanye imeko yengqondo yezifundo kunye noDliwanondlebe noKwakhiwa kweKlinikhi yokuChonga kunye neNgcaciso yeNcwadi yeNgxaki yeMpilo yeNgqondo-IV (SCID). Ukongeza, zonke izifundo zenziwe ngohlobo lwaseKorea loLuhlu lweZinto zoXinzelelo lwaBantwana (CDI)17 kunye ne-State-Trait Anxonomy Inventory (STAI)18 kuvavanyo lweinjongo zokujongwa kobunzima be comorbidities.
Umbuzo onike ingxelo ngokwakho
Uphando olusebenzisa i-Intanethi lusebenzisa iphepha lemibuzo le-40-elizixele ngokwakho malunga nokusetyenziswa kwe-Intanethi.19 Kolu phononongo, izinto ezine ezinxulumene nokuziphatha zongezwa kwiphepha lemibuzo lohlalutyo olongezelelweyo: I-1) Ngaba usiba ngumsindo ngakumbi kwihlabathi le-cyber? (ehlukumeza), 2) Ngaba iingxoxo zakho kwihlabathi le-cyber ngakumbi ngesondo kwindalo? (ngokwesondo), 3) Ngaba unomdla kubomi bakho besikolo? (kunciphise umdla wentlalontle), 4) Luthini ulwalamano lwakho nabahlobo? (unciphise ubudlelwane phakathi kwabantu)
Zonke izinto ezine zathelekiswa kwinqanaba le-5-point Likert.
Uhlalutyo lwedatha
Izinto eziqhubekayo eziqhubekayo zahlaziywa kusetyenziswa isampulu ezimeleyo yohlalutyo lokwahluka (ANOVA) ngeposi hoc uthelekiso oluninzi kunye nohlengahlengiso lweBonferroni. Idatha yoluhlu yahlalutywa kusetyenziswa iimvavanyo ngqo zikaFisher.
IINKCUKACHA
Ukuxhatshazwa kwi-Intanethi kunye nokuxhomekeka
2 Table Uluhlu lwedatha ebonisa inani labantu ngezifundo. Kwiqela lomlutha, izifundo ze-21 kunye ne-41 zachongwa njengezona qela lokuxhaphaza i-Intanethi kunye neqela lokuxhomekeka kwi-Intanethi, ngokulandelanayo.
Iimpawu zengqondo zengqondo
Iimpawu ezininzi zengqondo zengqondo zichongiwe kubantu abasebenzisa iziyobisi kwi-Intanethi. Kwiqela lilonke elinomlutha, eyona nto yayixhaphakileyo kwi-comorbidity yayikukudakumba kwengqondo (38.7%), ilandelwe yingxaki yokujongana nesi sifo (i-35.5%), ukuphazamiseka kwemood ngaphandle kokudakumba (12.9%), uxinzelelo lwexhala (8.1%), ukusetyenziswa kweziyobisi Ukuphazamiseka (i-4.8%), ukuphazamiseka kolawulo lwempembelelo (i-4.8%), kunye nokunye (14.5%). Xa iqela labakhoyo lithe lahlulwa kubunini beqela lokuphathwa gadalala kunye nokuxhomekeka, kwabakho umahluko okhoyo kubukho bokuzonwabisa phakathi kwala maqela mabini (3 Table). Iqondo elipheleleyo le-comorbidity laliphezulu kwiqela lokuxhomekeka (i-82.9%) kunakwiqela lokuphathwa gadalala (81.0%), kodwa umahluko wawungabalulekanga ngokwamanani. Owona mahluko ubalulekileyo phakathi kwala maqela mabini wawukukungqubuzana koxinzelelo lwe-hyperactivity. Indibaniselwano yesifo sokudakumba kunye nokunye ukuphazamiseka kwemood kudidi olunye lwe "ukuphazamiseka kwemood", kutyhile umahluko obonakalayo phakathi kwala maqela mabini njengokuphazamiseka kwengqondo kokuphazamiseka (Umzobo 1).
Umahluko kwi-IAT, CDI, kunye ne-STAI amanqaku phakathi kweqela ngalinye
Umzobo 2 ibonisa umahluko kwi-CDI, uxinzelelo lomkhondo, unxunguphalo lwaseburhulumenteni, kunye nenqaku le-IAT phakathi kwamaqela. I-CDI, uxinzelelo lomkhondo, kunye nenqanaba le-IAT lenyuke ngokulandelelana kwabantu abangabikho makhoboka, ukuphathwa gadalala, kunye nokuxhomekeka kwamaqela, kodwa amanqanaba oxinzelelo lwaseburhulumenteni akazange akwenze oko. Kwakukho umahluko obalulekileyo phakathi kweqela ngalinye lezinto ze-CDI ngokubhekisele kwiingcinga ezimbi zokuzithemba kunye nekamva, ukuzithemba okuphantsi, umbono wokuzibulala, ukulala, ukuphulukana nomdla, ukuphulukana nomdla kwimisebenzi, kunye nobunzima ubudlelwane boontanga. Ngokukodwa, kukho umahluko obalulekileyo wokuzithemba okuphantsi, iingcinga ezimbi ngekamva, kunye nembono yokuzibulala phakathi kwamaqela okuphathwa gadalala kunye nokuxhomekeka.
Umahluko kwizinto ze-IAT
Iimpendulo kwi-10 yezinto ze-IAT ze-20 zibonise umohluko obonakalayo phakathi kwabangenisi-mlutha, ukuxhatshazwa, kunye namaqela axhomekeke kuwe. Izinto ezisixhenxe zahluke kakhulu phakathi kwamaqela angenabukhoboka kunye neqela lokuphathwa gadalala, kodwa hayi phakathi kweqela lokuxhatshazwa kunye nokuxhomekeka. Kwelinye icala, kwizinto ezintathu, bekukho umahluko obonakalayo kwizimpendulo zempatho gadalala kunye nokuxhomekeka kumaqela, kodwa hayi phakathi kwamaqela angenabukhoboka nabaxhaphazi (4 Table).
Umahluko kwiinkalo zokuziphatha
Izinto ezintathu malunga nokuxhaphaza, ngokwesondo, kunye nokunciphisa umdla wentlalontle zazahluke kakhulu phakathi kwamaqela amathathu. Nangona kunjalo, iimpendulo malunga nokuncipha kobudlelwane phakathi kwabantu bezingahlukile (5 Table).
UKUQALA
Iziphumo zophononongo lwangoku zibonisa ukuba kukho umahluko kwi-psychor yengqondo comorbidities phakathi kwezifundo kwi-Internet gadalala kunye namaqela okuxhomekeka. Kwiqela lokuxhomekeka, ukuphazamiseka kwemood, ngakumbi uxinzelelo lweengxaki, yayiyeyona nto iqhelekileyo comorbidity kune-hyperactivity disc. Kwelinye icala, kwiqela lokuphathwa gadalala, isifo esosulelayo sokujongana nengqondo yayisesona sifo siphambili esiqhelekileyo. Iimpawu eziphambili zokungakwazi ukunxibelelana nokungabikho kwengqondo kwi-hyperactivity "ziyadika ngokulula" kwaye "ziyakuthintela ukulibaziseka kwembuyekezo."20,21 Ukuziphatha kwe-Intanethi kuphawulwa ngempendulo ekhawulezileyo kunye nemivuzo ekhawulezileyo, enokubangela ukuba unciphise imvakalelo yokuba nesithukuthezi okanye ukubonelela kwangoko kunye nemivuzo kwizifundo ezinesithintelo sokungakhathali. I-Intanethi ikwabonelela ngenkxaso yoluntu, impumelelo enokubakho, uyolo lokulawula, kunye nelizwe elinokuthi lifikise kulo ulutsha olunobunzima ngokweemvakalelo kwilizwe lokwenyani.22,23,24 Ngokuhambelana noku, kubonakala kusengqiqweni ukuba ulutsha olunxinzayo lusengozini yokusebenzisa i-Intanethi ukunciphisa uxinzelelo, kwaye banokuba neziphumo ezibi kakhulu zokusebenzisa okunzima kwi-Intanethi. Oku kudala umjikelo ombi okunokukhokelela kwisimo sokuxhomekeka kwi-Intanethi ukuwela ngaphakathi kubukhoboka be-Intanethi.25
Umahluko obonakalayo kwi-CDI kunye ne-STAI amanqaku phakathi kwezingabikho, iziyobisi, kunye nokuxhomekeka kumaqela kucacisa ukuba izifundo kula maqela mathathu zinamanqanaba ohlukeneyo oxinzelelo kunye noxinzelelo. Nangona kunjalo, ukubakho phakathi kokudakumba, ixhala, kunye nokulutha kwi-Intanethi akuchongiwe kolu phando.
Izinto ze-20 ze-IAT zinokwahlulahlula zibe ngamaqela amathathu, ngokwahluka kumanqaku okungabikho makhoboka, ukuxhatshazwa, kunye nokuxhomekeka. Amacandelwana amathathu e-IAT abonisa ukuba ezinye izinto ziyakwazi ukubona inqanaba ngalinye lokulutha (nangona ezinye izinto zinokuba luncedo ekuchongeni izifundo eziqhelekileyo okanye iziyobisi), kanti ezinye izinto ziyakwazi ukubona inqanaba lokuxhomekeka kwizifundo. Kolu phononongo, ukuphazamiseka kokulala, ukutshintsha kwemvakalelo, kunye nokuzibandakanya kwakuqaqambile kwiqela lokuxhomekeka, kodwa kwakungekho mahluko mkhulu kwezi zinto phakathi kwamaqela angenanto yakwenza nokuluxhaphaza.
Ukuziphatha okungafunekiyo, indlela yokuziphatha ngokwesondo, kunye nokuhla komdla kwezoluntu bekukho kakhulu kwiqela lokuphathwa gadalala kunakwiqela elinganabugwenxa, kwaye babekubi kakhulu kwiqela lokuxhomekeka. Ezi ziphumo ziyahambelana neziphumo zezifundo zangaphambili.26,27,28 Unxibelelwano olwehlileyo phakathi kwabantu, nangona kunjalo, alukhange lubonise imodeli efanayo nezinye izinto zokuziphatha. Kubonakala ngathi izifundo kwiqela lokuxhatshazwa zinobudlelwane obungcono nabanye kunakwizifundo kwiqela elingengomakhoboka. Oku kunokuchazwa ngeendlela ezimbini. Okokuqala, uphononongo alukhange lwahlule amagama athi 'on-line' abahlobo kunye 'nabahlobo abangaphandle' kwaye oku kukhokelele ekwandisweni kwekota. Ukucacisa oku, kuya kufuneka silicacise gca igama, 'abahlobo abangaphandle' kubahlobo 'kwi-intanethi' ngaphambi kovavanyo. Okwesibini, oku kunokuchazwa ziingxelo zangaphambili ezibonisa ukuba i-Intanethi ithambekele ekubuyiseleni ubunzima kunxibelelwano lwabantu abazisiweyo nabarhoxisiweyo.29 Ulwazi malunga nenqanaba lomntu lobudlelwane phakathi kwabantu phambi kokuba umntu abonise iimpawu zokuxhatshazwa kwi-Intanethi okanye ukuxhomekeka kufuneka lifunyenwe kuvavanye ngokuchanekileyo isiphumo se-Intanethi kubudlelwane phakathi kwabantu.
Olu phononongo lunezithintelo ezithile. Umda wokuqala kukuba iimeko zengqondo zezifundo kwiqela elingengomlutha zange zivavanywe. Ngenxa yoku kusikelwa umda, iziphumo zethu azibonisi mahluko kwi-psychiatric comorbidities phakathi kwamaqela angenakho umlutha kunye nomlutha. Le ngongoma, nangona kunjalo, ayiphazamisi kwinjongo eziphambili zokuthelekisa i-comorbidities yengqondo phakathi kokuxhatshazwa kwi-Intanethi kunye namaqela okuxhomekeka. Umda wesibini kukuba olu phononongo lwaluqhutywa njengesifundo esiphambili. Isifundo esimalunga nokuthatha ixesha elide siyafuneka ukubonisa ubukho besiyobisi se-Intanethi kunye neengqondo zengqondo.
Ukuqukumbela, kukho umahluko kwimigqaliselo yengqondo kunye neendlela zokuziphatha phakathi kolutsha olungamadoda olunotyekelo lokuxhatshazwa kwi-Intanethi kunye nokuxhomekeka. Ezi ziphumo zibonisa ukuba uxinzelelo lwe-Intanethi kunye nokuxhomekeka kunesiseko seengqondo kwengqondo eyahlukileyo. Ngokusekelwe kwezi ziphumo, kuphando lwexesha elizayo, siya kuba nakho ukuqhuba isifundo esikhulu malunga neendlela zebhayoloji nezengqondo zokuxhatshazwa kwe-intanethi kunye nokuxhomekeka. Kwaye, ngokwembono yendawo yokujonga, ukuba ukubangelwa kokunyanga kwengqondo kufunyenwe kuxinzelelo lwe-intanethi kunye neqela lokuxhomekeka, liya kuba nakho ukunceda ukuthintela ukuphindaphindiweyo okanye ukuba mandundu kwalo.
Imibulelo
Uphononongo luxhaswe sisibonelelo esivela kwiProjekthi ye-R & D yeTekhnoloji yezeMpilo yaseKorea, Icandelo loMphathiswa Wezempilo kunye neNtlalontle, kwiRiphabhlikhi yaseKorea (HI12 C0113 (A120157)).
Ucaphulo