Ukuxhatshazwa kobuxhatshazo kunye nokuLawula: i-Phenomenology, i-Neurogenetics ne-Epigenetics (i-2015)

Ngokuqinisekileyo, ukuziphatha kwe-hypersexual kubhalwe ngaphakathi kweklinikhi kunye noseto lophando kule minyaka ilishumi idlulileyo [1]. UBenjamin Rush, ugqirha ongomnye woyena tata waseUnited States ubhale ngokwezonyango ukuziphatha okugqithisileyo ngokwesondo [2] URichard von Krafft-Ebing, uvulindlela wenkulungwane ye-19 osisazi ngesondo eNtshona Yurophu, noHirshfeld ngowe-1948 baqhubeka nomsebenzi. [3-4]. Umqeshi osisiseko waba baphandi ucebise ukuba ubulili obugqithisileyo bubandakanya ukuziphatha okuthe gqolo kokuphambuka kwezesondo kumadoda kunye nabasetyhini abanomdla ogqithileyo wesondo wokuba maladaptive. Ngowe-1975, uStroller wachaza imeko njengoDon Juanism [5]. Ngo-1969, u-Allen wacebisa i-satyriasis yamadoda kunye ne-nymphomania kwabasetyhini exhaswa ngu-Ellis noSagarin. [6-7]. Nangona i-hypersexuality ingabandakanywa njengokuxilongwa kwengqondo kwi-DSM, umsebenzi wabaphandi abaninzi bexesha elibandakanya i-Kafka, i-Reid, i-Bancroft, oogxa babo kunye nokuthambekela kombutho wezeMpilo weHlabathi kunokukhokelela ekufakweni kwale meko njengento ehlukeneyo yokuxilonga. [8-11].

Indlela yokusebenza yoncwadi

I-database ye-Medline, ukususela nge-12 kaJulayi 2015, yasetyenziselwa ukwenza uphando olusekelwe kwi-intanethi. La magama alandelayo afakiwe: i-hypersexual (170), i-hypersexuality (479), umlutha wesondo (1,652), ikhoboka lezesondo (1,842), inkanuko yesini (989), isinyanzelo sesondo (946), isinyanzelo sesondo (1,512), isinyanzelo ngokwesondo (782) ), i-paraphilia-related disorder (234), kunye nesondo esigqithisileyo (857). Ekubeni eli nqaku luphononongo olufutshane kunokuba luhlalutye i-meta-analysis, lusekelwe kummeli okhethiweyo wezi zifundo ezinokubaluleka kwi-subtopics ehlanganisiweyo. Ukungabandakanywa kwalo naluphi na uphononongo oluthile akukuchasanga ukubaluleka kwalo kwintsimi. Kuyaqondakala ukuba, kukho ezo zingavumelaniyo nombono wokuba ukuba likhoboka lesondo ngenene sisiphithiphithi sokwenyani kwaye zinokuba nobungqina obubonisa ukuba zikwindawo eqinileyo. Nangona kunjalo, siphikisa ukuba kukho ubungqina obuninzi bokucebisa ukuba umlutha wesondo ukhona kunye nezifundo ezibandakanya i-neuroimaging, neurogenetics kunye ne-epigenetics zixhasa uluvo lokuba ukunyanzeliswa kwesondo kunye nokulalana ngokwesini kunokubonwa njengengxaki ekhobokisayo. Ngelixa sikuqonda oku kungangqinelani sihambisa ngokulandelelana imbono yethu ukuvelisa uphononongo lwezenzululwazi ngakumbi kwaye singagxothi iintetho zenzululwazi ngalo mbandela ubalulekileyo. Ukuze sikhanyise ngakumbi ngalo mbandela siye saphanda uncwadi ukuze sifumane imvumelwano ethile. Ngomhla we-17 ka-Agasti, i-2015 siphendle i-PUBMED Central sisebenzisa eli gama lilandelayo - "Ngaba isondo likhoboka lokwenyani?" kwaye yafumana amanqaku angama-46.

Inkcazo yokukhotyokiswa ngokwesondo

Ukukhotyokiswa ngokwesondo kuchazwa njengako nakuphi na ukuziphatha okunyanzelekileyo kwezesondo okuphazamisana nokuphila okuqhelekileyo kwaye kubangela uxinzelelo olumandla kusapho, abahlobo, abantu obathandayo kunye nendawo yomsebenzi. Ukukhotyokiswa ngokwesondo kuye kwabizwa ngokuba kukuxhomekeka ngokwesondo, ubuni obugqithisileyo, kunye nokunyanzeliswa ngokwesondo. Ngalo naliphi na igama, kukuziphatha okunyanzelekileyo okulawula ngokupheleleyo ubomi bekhoboka. Amakhoboka ngokwesondo enza ukuba iintlobano zesini zibe yeyona nto ibalulekileyo kunentsapho, abahlobo kunye nomsebenzi. Ukwabelana ngesondo kuba ngumgaqo oququzelelayo wobomi bomlutha. Bakulungele ukuncama oko bakuxabisa kakhulu ukuze balondoloze kwaye baqhubeke nokuziphatha kwabo okungafanelekanga [12]. Umnqweno we-Hypersexual uchazwe njengomnqweno osekwe kuvavanyo lobomi lokuphindaphinda ukuziphatha ngokwesondo kunye nexesha elichithwe kwiingcamango zesini ezinxulumeneyo. Kumadoda, uvavanyo lomnqweno wesini esine-hypersexual wachazwa nguKafka kunye noHannen njengelona xesha liphakamileyo (ubuncinci beenyanga ezintandathu ubude bexesha) lokuziphatha okuzingileyo kwezesondo (indawo yonke yesondo / iVeki emva kweminyaka eyi-15). Ngapha koko, imbali yexesha elide yomnqweno we-hypersexual, echazwe ngokusebenza ngasentla, ichongiwe kwi-72-80% yamadoda afuna unyango lwe-paraphilias kunye nokuphazamiseka okunxulumene ne-paraphilia. [13].

Hypersexuality kunye neeyantlukwano zesini

Kusekwe kakuhle ukuba kuluntu lwezesondo kunye noncwadi umnqweno wesini uthathwa njengobukho beengcinga zesini, imisebenzi okanye izibongozo, kunye nenkuthazo yomntu ukuba aziphathe ngokwesondo. Kukho zombini iimpawu ezifanelekileyo zangaphakathi nangaphandle [14]. Abaxhasi bethiyori ye-Evolution baye baphikisana ukuba amadoda nabasetyhini banee-ajenda ezahlukeneyo xa kuziwa kumsebenzi wesondo. [15]. Izifundo ezininzi zityhila umahluko ocacileyo phakathi kwamadoda nabasetyhini. Amadoda aye anda ukucinga ngesondo [16], ukwanda rhoqo kokuphulula amalungu esini [17], ukwanda kokuthambekela kokuvuswa kwezesondo okwenziwe ngaphandle [18] isimo sengqondo esivumelayo ngokuphathelele ukuba neentlobano zesini nomntu ongathandani naye [19], ukukhululeka kokuvuka [20], kunye nenkuthazo yangaphakathi [21]. Ngokwahlukileyo koko, abasetyhini babonisa imeko yezesondo eyahlukileyo enenkuthazo yesondo, ukuvuseleleka ngokwesondo, kunye nokuziphatha ngokwesondo okubunjwa zizinto zokuzivelela. [22] kunye notyalo-mali olukhulu lwebhayoloji, lweemvakalelo, nolwexeshana ekuveliseni nasekukhuliseni abantwana [23]. Abasetyhini abasengozini kakhulu kwi-hypersexuality [24] kwaye ilungelelaniswe ukukhuthaza ubudlelwane bobudlelwane kunye nokuzibophelela kweqabane lexesha elide [25]. Ngelixa umlutha wesondo kuqikelelwa ukuba uchaphazele ukuya kuthi ga kwi-3% ukuya kwi-6% yabemi, ukuqonda okucacileyo kwe-neurobiological antecedents kulinganiselwe. [26] kunye novavanyo lweklinikhi [27]. Sikhuthaza ukufunda ngakumbi ngokunyanzeliswa ngokwesondo, ukuzincama kunye nokuziqhelanisa nesondo [28], kunye nokwahlukana ngokwesini kwiimpendulo kwi-stimuli yesondo [29-30].

Kuyaphawuleka ukuba uKafka noHennen [13], yafumanisa ukuba iminyaka yobudala bokuqala kokuziphatha kwe-hypersexual eqhubekayo yayiyi-18.7 ± 7.2 iminyaka kumadoda abelana ngesondo kunye noluhlu lweminyaka yokuqala yokuziphatha kwe-hypersexual yayineminyaka eyi-7-46. Ubude bexesha eliqhelekileyo lokuhlala lihlala lihlala lihlala linqwenela ukuziphatha okubi ngokwesondo kwakuyi-12.3±10.1 iminyaka. Nangona kunjalo, iminyaka yobudala yala madoda asebenzayo ngokwesondo ayefuna unyango yayiyi-37 ±9 iminyaka. Hanson, kunye nabanye. iphinde yavavanya ubulili obugqithisileyo kubaphuli-mthetho kwaye yafumanisa ukuba aboni abaphantsi banamazinga asezantsi okuphinda abuyele kunabo basemngciphekweni omkhulu. [31].

Hypersexuality kunye nokusetyenziswa kakubi kweziyobisi ngokudibeneyo

Kukho i-co-morbidity ephezulu phakathi kokuphazamiseka kwe-hypersexual kunye nezinye iziyobisi, ezifana nokuphazamiseka kokusetyenziswa kweziyobisi [32-33]. Ngokukodwa, uGarcia kunye noThibaut bacebise ukuba i-phenomenology ye-non-paraphilic disorder yesondo kufuneka ihlelwe njengokuziphatha okukhobokisayo, endaweni yokunyanzeliswa, okanye ukuphazamiseka kokulawula impembelelo. [34]. Bachaza ngokuchanekileyo ukuba iinqobo zokugweba zisondele kakhulu kwezo zokuphazamiseka kokukhobokisa njengoko zicetywa ngabanye [35]. Aba baphandi baye banikezela ukuqhubela phambili kophando oluqhubekayo kule ndawo kunye nokufakwa kwexesha elizayo kwi-hypersexual disorder kwi-DSM-6. Iziyobisi zokuxhatshazwa, i-rock 'n' roll, kunye nokwabelana ngesondo kwenzeka ngokubambisana, kwaye yonke iminyhadala iye yakhiwe malunga nale ndibaniselwano ukusuka eWoodstock ukuza kuthi ga ngoku.

Uncwadi lutyhila ukuba abasebenzisi be-methamphetamine baxela ukuba eli chiza livuselelayo liyawunyusa umnqweno wesini, ngakumbi ukuziphatha okuyingozi. Nangona kunjalo, i-amphetamine ibonakaliswe ukunciphisa umsebenzi wesondo weempuku zabasetyhini. Unale nto engqondweni, uHolder, et al. ivavanye indima yemethamphetamine kwiimpuku zabasetyhini [36]. Baye bafumanisa ukuba, ngokuchaseneyo, i-methamphetamine iququzelele indlela yokuziphatha ngokwesondo kwabasetyhini, kwaye esi siphumo sibangelwa kukwandiswa kosulelo lwe-dopaminergic kunye nokusasazeka kwe-neurotransmission ngenxa yokudityaniswa kweehomoni ze-ovarian kunye ne-methamphetamine. Ngokukodwa, bafumene ukongezwa kwenkuthazo yesondo edityaniswa nokusebenza kwe-neuronal kwi-amygdala ephakathi kunye ne-ventromedial nucleus ye-hypothalamus.

Ngapha koko, izazinzulu zaseNetherlands ziye zafunda ukuhlangana kokusetyenziswa gwenxa kweziyobisi kwii-swinger ezichongiweyo. [37]. Kolu phononongo, uSpauwen, et al. ugqibe kwelokuba i-79% yeeswinger ichaze ukusetyenziswa kweziyobisi zokuzonwabisa (kubandakanya utywala kunye nokusetyenziswa kweziyobisi ezingasebenzi kakuhle); I-46% yabo ichaze ukusetyenziswa kweziyobisi ezininzi. Enyanisweni, ukusetyenziswa kweziyobisi zokuzonwabisa (ngaphandle kotywala kunye neziyobisi ze-erectile dysfunction) kwakudityaniswe kakhulu kunye nokuziphatha okusemngciphekweni omkhulu wesondo kumadoda nabasetyhini. Kwakhona, ukusetyenziswa kweziyobisi kwakudityaniswa ngokuzimeleyo nosulelo oludluliselwa ngokwabelana ngesondo (STI) kwii-swingers zabasetyhini, ngakumbi abo bathatha inxaxheba kwisini seqela.

Castelo-Branco, et al. ingxelo yokuba abasetyhini abancinci abadala babona ukuba ukwabelana ngesondo yinxalenye ebalulekileyo yobomi babo kodwa hayi eyona nto ibaxhalabisayo (77.6%). [38]. Baphinde baxela ukuba utywala bususa imiqobo yokulala ngesondo (62.3%). Okubalulekileyo, baye bafumanisa ukuba ukusetyenziswa kakubi kotywala kwakuyinguqu eqikelelwayo ekuphuculeni indlela yokuziphatha enobungozi ngaphandle kweminyaka yabasetyhini.

Kuyaphawuleka ukuba uJia, et al. kuxelwe ngokuziphatha okuyingozi ngokwesondo phakathi kwabaxhaphazi be-psychostimulant kunye ne-heroin, kubandakanywa neentlobano zesini ezininzi, amaqabane okwabelana ngesondo, abantu abathandana besini esifanayo, kwaye bangaze okanye ngamanye amaxesha baziqhelise ngesondo ngokukhuselekileyo. [39].

Umqeshi wethu ophambili kukuba iziyobisi, ezifana ne-methamphetamine, i-cocaine, i-heroin, kunye notywala, zinokuvuselela umnqweno wesini kubantu abangengawo amakhoboka. Kubantu abakhotyokisiweyo, yahluke kakhulu; iziyobisi ezifanayo zinokubangela i-anhedonia kwisiseko esingapheliyo. Nangona kunjalo, i-post-addiction ngexesha lesigaba sokubuyisela kwiimeko ezininzi zokuziphatha ezifana ne-aphrodisiac ziye zabonwa.

Hypersexuality kunye nokurhoxa

Ukukhangela kwe-PubMed (7-19-15) kusetyenziswa igama elithi "hypersexuality kunye neempawu zokurhoxisa" kubangele amanqaku amahlanu kuphela, akukho nalinye elichaza "impawu zokurhoxisa." Nangona kunjalo, olunye uphando olusebenzisa amagama athi "iimpawu zokuhoxiswa kwezesondo eziphezulu" zibangele amanqaku adwelisiweyo angama-25.

Umlutha kwingxelo yokubuyisela ukwanda kokutya kunye nomnqweno wokutya ukutya okuthile kunye nokusetyenziswa kakubi kwecuba ngexesha lokuziyeka ixesha elide. Ukuzuza ubunzima kuye kwaboniswa kwaye kwabhalwa kwizilwanyana kunye nabantu abaye bayeka ixesha elide [39]. UBruijnzeel wenze umbono onomdla wokuba ukurhoxiswa kwe-opiate kunokubangela i-orgasms ezenzekelayo. [40]. Okubalulekileyo, kwinqaku, uBruijnzeel ucebise ukuba i-symptomatology yokurhoxisa kwiziyobisi kunye nomsebenzi wesondo ongapheliyo unokubangelwa ngumsebenzi ongachaswanga we-kappa opioid receptor signing ethintela ukukhutshwa kwe-dopamine ngelixa inyusa i-norepinephrine kwiisekethe zomvuzo wobuchopho.

Amaphepha kuncwadi ahlupheke ngenxa yokungabikho kokungqongqo malunga nokurhoxiswa okukrakra kunye nexesha elide kunye nokuyeka ukuqinisekiswa ngokuvavanywa komchamo. Iinkqubo zonyango lweklinikhi ziye zanyuka ukusuka kunyango lwesini ukuya kwahlula izini ezibini, ukubonelela ngeenkqubo zonyango ezikhethekileyo zesini. Bakwanikezela ngemfundo yokujongana nokunyuka kwangoko kunye nexesha elide kumdla wesondo kunye nomsebenzi, kunye nobudlelwane bokubuyisela ekutyeni nasekutyeni kakhulu.

Iimpawu zokurhoxa ezibangelwa kukuthandana kwabantu besini esinye ziye zaxelwa ngabaphandi abanamanqanaba ahlukeneyo obunzima kunye nokusetyenziswa kakubi kweziyobisi ngokudibeneyo. [41-45]. Ngenxa yolu phendlo, asizange sifumane iphepha elinye elichaza iimpawu zangempela zokurhoxisa ezinxulumene nokuyeka ukudibana ngokwesondo okusebenzayo. Uninzi lwamaphepha akhankanyiweyo abandakanya imiphumo yokuyeka ukusebenzisa iziyobisi, njenge-opioids, inikotine, i-amphetamines, kunye ne-cocaine, enokuthi iphazamise ukuziphatha ngokwesondo.

Hypersexuality kunye neurogenetics

Uphendlo lwe-PubMed (7-19-15) luveze amaphepha amathandathu kuphela adwelisiweyo asebenzisa igama elithi "imfuza kunye ne-hypersexuality" ikakhulu egxile kumanqaku anxulumene nesifo se-Kleine-Levin (KLS), isifo esinqabileyo kakhulu apho ubungqingili bunokuhlala ukuya kuthi ga kwiminyaka engama-27. Kolunye uphononongo, kwafunyaniswa ukuba i-HLA-DQBl esabela kwi-immune, i-DQBl *0602 yafunyanwa ngobuninzi obubalulekileyo kwizigulana ezine-KLS kwaye inokunyusa umngcipheko we-KLS. [46-47].

Nangona kunjalo, xa sisebenzisa amagama athi "umsebenzi wesondo kunye nofuzo," amanqaku angama-2,826 adweliswe, kwaye sinika isishwankathelo esifutshane semiba embalwa ebalulekileyo ye-neurogenetic. Yingcinga yethu yokuba ukuziphatha kwe-hedonic kunye ne-anhedonic ziziphumo kwinxalenye ye-alleles yomngcipheko womntu kwezi ziphatha kwaye unyango lubandakanya ukujoliswa ngokufanelekileyo kwezi polymorphisms ezichongiweyo. Ngaphezu koko, impendulo yonyango ixhomekeke kule mingcipheko ye-alleles kwaye inika ingqiqo ebalulekileyo yovavanyo lwe-pharmacogenetic kunye ne-pharmacogenomic / nutrigenomic solutions.

Ukulandela impikiswano yokuqala efunyenwe nguBlum, et al. kwi-1990 yobungqina bokuqala bobudlelwane phakathi kwe-DRD2 Al allele kunye notywala obunzima, kukho amanqaku angama-3,938 kwi-PubMed (7-19-15) [48]. Izifundo zibandakanya i-polymorphism yengqondo yengqondo, i-DRD2 Al allele, kunye nokuziphatha okuhambelanayo kunye ne-physiology. Kukho, nangona kunjalo, ukunqongophala kwedatha edibanisa izenzo zesondo kule nto kunye nezinye izakhi zofuzo ezinxulumene noko ngaphandle kobungqina obuninzi bokusebenza kwe-mesolimbic, ngakumbi kwiindlela ze-dopaminergic kunye ne-neuronal loci ehambelana nokuvuselela ngokwesondo kunye nomsebenzi. Kuyaphawuleka ukuba uBlum kunye noNoble bahlele ngokuchanekileyo uhlobo lwe-DRD2 njengohlobo lomvuzo oqhelekileyo onoxanduva lokuziphatha kokusilela komvuzo (RDS). Ngapha koko, ukusebenzisa abathwali bethiyori ye-Bayesian yohlalutyo lwe-Taq Al allele baya kuthi, kubomi babo bonke, babe nethuba elingama-74%, lokuba badibane nokuziphatha omnye okanye ngaphezulu kokusilela komvuzo (RDS) [49].

Umbutho wokuqala wayo nayiphi na i-polymorphism ye-gene kunye nokusebenza ngokwesondo akuzange kwenzeke kude kube yi-1999 xa uMiller, et al. ivavanye ezinye iijini ze-dopaminergic [50]. Ukufunyaniswa okusisiseko kukuba inkqubo ye-dopaminergic kwingqondo ibonakala idlala indima enkulu kulawulo lokuziphatha ngokwesondo. Ubudlelwane phakathi kofuzo lwe-Dl, i-D2, kunye ne-D4 i-dopamine receptors kunye nobudala kwi-experience yokuqala yesondo (AFSI) yavavanywa kwisampuli ye-414 engeyiyo i-Hispanic, amadoda nabasetyhini baseYurophu-Amerika. Umbutho obalulekileyo wabonwa phakathi kwe-DRD2 allele kunye ne-AFSI kunye nombutho onamandla ngakumbi xa i-DRD2 allele idityaniswa ne-DRDl allele. Imodeli yokubuyisela enyanzelweyo yakhiwe ixela kwangaphambili i-AFSI isebenzisa isondo kunye neqela lezinto ezisithoba eziguquguqukayo zengqondo njengezibikezelo. Ukongeza i-DRD2 kunye ne-DRD2-by-DRD1 izibikezelo kulo mzekelo kwandisa ukuhluka okuchazwe ngu-23% kunye ne-55%, ngokulandelanayo. Inyani yokuba ezi zinto zifunyanisiweyo zibonisa umanyano olomeleleyo phakathi kwamadoda kunaphakathi kwabasetyhini luvumelana nomsebenzi wamva nje wabanye obonisa impendulo ephezulu yokuvuselela ngokwesondo emadodeni kunakwabasetyhini. [51]. Ke mhlawumbi "amadoda avela kuMars kunye nabafazi abavela eVenus" kwaye oku kunokuba yinyani ekusebenziseni kakubi icocaine [52].

Ngokukodwa, zombini izifundo zangaphambi kweklinikhi kunye nekliniki zibonise iipatheni ze-dimorphic ngokwesondo kwiimpendulo zokuziphatha kwi-cocaine kuzo zonke izigaba zenkqubo yokulutha kwe-cocaine (ukwenziwa, ukugcinwa, kunye nokubuyela umva). Ke, kuvela umfanekiso ocacileyo ocebisa ukuba kukho isiseko sebhayoloji sokwahluka ngokwesondo ngokuthe ngqo kumlutha wecocaine. Lo mahluko ubangelwa kulawulo olwahlukileyo lwe-CNS ngamahomoni angamadoda nabasetyhini kwaye unokuqikelelwa bubukho be-DRD2 gene polymorphisms. [53]. Ngaphezu koko, kuyaziwa ukuba imibutho yofuzo phakathi kwe-COMT kunye neephenotypes ezahlukeneyo zengqondo zihlala zibonisa ukungafani phakathi kwamadoda nabasetyhini. Ezi ziquka i-Val esebenzayo (158)Met polymorphism kwi-COMT inxulunyaniswa ne-obsessive-compulsive disorder kumadoda kunye ne-phenotypes yokukhathazeka kwabasetyhini. Ukongeza, i-Val (158)Met polymorphism kwi-COMT inempembelelo enkulu ekusebenzeni kwengqondo kumakhwenkwe kunamantombazana. [54].

Miller, kunye nabanye. akazange afumane umbutho weepolymorphisms ezidityaniswe ne-DRD4 gene kunye nobudala bokuqala bokulala ngesondo [50]. Noko ke, abanye baye bafumana unxulumano oluphawulekayo kumaqela athile ezizwe. Ngokukodwa, uhlalutyo lwabo lweepolymorphisms kwi-DRD4 lubonisa ukuba abo banayo nayiphi na i-genotype ye-3R bafumana umngcipheko wesondo sokuqala esiphakamileyo kunezinye (okanye nayiphi na i-4R) i-genotype kuzo zonke iintlanga (n = 2,552). Okubangel 'umdla kukuba, umngcipheko wesondo sokuqala awohlukanga phakathi kwee-genotypes ezimbini kwisampulu yase-Afrika-yaseMelika, iphakamisa umbuzo wokukhuliswa kwenkcubeko. [55].

Amava ngokwesondo, njengokusetyenziswa kweziyobisi ngokuphindaphindiweyo, kuvelisa utshintsho oluhlala ixesha elide, kubandakanywa uvakalelo kwi-nucleus accumbens (NAc) kunye ne-dorsal striatum. Bradley, et al. usebenzisa uhlalutyo lwe-microarray ukufunda i-hamsters efunyenwe okokuqala ukuba amava ngokwesondo kwisilwanyana esiyindoda okanye esetyhini ngokwahlukileyo phezulu okanye ezantsi ilawula ukubonakaliswa kwe-mRNA yothotho lwemfuza kwi-NAc. [56]. Baye bafumanisa ukuba xa kuthelekiswa nezilwanyana ezingenangqondo ngokwesondo, i-hamster enamava ngesondo efumana i-stimulus indoda kwiVeki ye-7 ibonise ukwanda kwenani elikhulu leemfuza. Ngokwahlukileyo koko, i-hamster yabasetyhini abanamava ngokwesondo abangafumani i-stimulus indoda kwiVeki ye-7 ibonise ukunciphisa ukubonakaliswa kwemfuza emininzi. Ngokutsho kwababhali, le mvelaphi yokuqala yofuzo kwi-hamster yabasetyhini inokubonelela ngengqiqo kwiindlela zokuziphatha (isondo) kunye neziyobisi zokuxhatshazwa zikhuthaza utshintsho lwexesha elide kwindlela ye-mesolimbic kunye ne-nigrostriatal dopamine.

Ii-electrode ze-bipolar, ezifakwe ngokudibeneyo kwi-hypothalamus esecaleni kunye ne-substantia nigraventral tegmental area, i-stereotaxically yayisetyenziselwa ukubonelela ngamava okuzihlaziya angapheliyo afana nokuziphatha ngokwesondo. Olu hlobo lokuvuselela lufunyenwe lubangela ukwanda okukhulu kwenani le-synapses kummandla we-CA3 we-hippocampus kunye ne-molecular layer ye-motor cortex kwiigundane. Ngokwenyani, ukuvuselela kwengqondo okungapheliyo kubangele amandla exesha elide (LTP), eyaziwayo ngokwandisa unxibelelwano olutsha lwe-synaptic. [57]. Ukuvezwa okukodwa kwi-cocaine kwizilwanyana ezingenangqondo kwanele ukuba kubangele utshintsho oluqhubekayo kwindawo ye-ventral tegmental (VTA) i-glutamatergic synapses efana ne-LTP exhomekeke kumsebenzi kweminye imimandla yobuchopho. Le LTP eyenziwe nge-cocaine ibonakala ngathi ifakwe kwi-dopamine D5 receptor activation ye-N-methyl-D-aspartate (NMDA) receptors kwaye ifuna iprotein synthesis. [58], kwakhona ukuxhasa isiseko sethu esicetywayo apha ukuba iziyobisi kunye nesondo zinokuba ne-neurochemical substrates eziqhelekileyo.

Uphando lobungqina luveze ubudlelwane obuhle phakathi kwenani lamaqabane ngesondo kunye nokubandakanyeka kwindlela yokuziphatha engathandekiyo [59]. Uninzi lwemizamo yokucacisa lo mbutho uthathe imbono yendaleko. Ukusuka kwimbono yendaleko, iimpawu ezifanayo, umzekelo, ukungxama, ukungaboni kakuhle, kunye nobudlova, ezihambelana nenani elikhulu labalingani bezesondo nazo zihambelana nokubandakanyeka kolwaphulo-mthetho. Nangona kunjalo, kukho isizathu sokukholelwa ukuba ukwahlukana phakathi kwamaqabane ngesondo kunye nokuziphatha kolwaphulo-mthetho kunokuchazwa ngokuyinxenye yindlela eqhelekileyo yofuzo, apho imfuzo enxulumene namanani amaqabane ngesondo nayo inxulumene nokuziphatha okuchasene noluntu. Ukusebenzisa ingqiqo echazwe ngasentla, uBeaver et al. Ufumene umanyano olomeleleyo phakathi kwamaqabane ngesondo kunye nokuziphatha okungathandekiyo kunye neepolymorphisms ze-dopamine transporter gene (DAT1) icacisa umahluko kuwo omabini amanani amaqabane ngesondo kunye nokuziphatha kolwaphulo-mthetho kumadoda. [59]. Impembelelo ye-polymorphic ye-DAT l gene kunye nenani labalingani bezesondo banokubangelwa umbutho ofunyenwe phakathi kweepolymorphisms ezithile kunye ne-penile ejaculation yamadoda ngaphambi kwexesha. Abathwali be-1OR / 1OR genotype babenamanqaku abonisa umda ophantsi wokukhupha i-ejaculate kwisibonisi ngasinye xa kuthelekiswa ne-9R9R / 9R10R edibeneyo (i-9R ephezulu umsebenzi ophantsi ukufumaneka kwe-dopamine) iqela labathwali [60]. Iipolymorphisms zofuzo lwe-DATl, ngokukodwa i-10R/10R genotype, ifunyenwe kubantwana abagwenxa abafunda kwiSikolo saseBrown (eSan Marcos, eTexas) ngenxa yokuziphatha ndlongondlongo, kuquka ukuziphatha okuchasene noluntu. [61]. Ulungelelwaniso oluhle lwe-DRD2 kunye neepolymorphisms ze-DATl zabonwa ngobundlobongela be-pathological kulutsha olufikisayo kulingo lwezonyango olumfamekileyo. Ngaphaya koko, nangona bekucingelwa ekuqaleni ngenxa yokulinganisa koontanga ekuqalekeni komntwana okanye kwikhondo lobomi-butsha obuzingisileyo, kukho ubungqina obandayo obuvela kwizifundo ezingamawele bokuba ukuqala kokufikisa okanye ukuziphatha okungathandekiyo kokufikisa kusenokuchaphazeleka ngokwemfuza. UBurt noMikolajewski abaqinisekisanga nje ezi zinto zifunyanisiweyo nge-DATl gene kodwa bandise ezi ziphumo ukubandakanya ukwahluka kwe-His452Tyr ye-encoding ye-5-HT2A receptor ngokunjalo. [62], Kutshanje, Jozkow et al. ixele unxulumano phakathi kwemilinganiselo yezesondo yeempawu zamadoda akhulileyo (AMS) kunye nokwahluka kofuzo lwe-5-HTRlB G861C [63]. Ngaphezu koko, ukuthengisa, et al. ifunyenwe ngohlalutyo oluguquguqukayo lokubuyela umva, intsebenziswano phakathi kokuxhatshazwa kunye neqela le-5-HTTLPR apho bekukho unxulumano olubalulekileyo kunye nesimo esingaguqukiyo, kunye namanqaku onxibelelwano lomlingane ekulandeleni. [64] Ukuba nembali yokuxhatshazwa kwakunxulunyaniswa kakhulu namathuba amakhulu okungabikho utshintsho ekusebenziseni ikhondom emva kokungenelela kuphela kwabo bane-s allele.

Kuyaziwa ukuba iipolymorphisms kwimimandla engafakwanga kwikhowudi ye-vasopressin la receptor gene (Avpr la) inxulunyaniswe neempawu zentlalo neemvakalelo ebantwini, iichimpanzi, kunye nee-voles, kwaye zinokubakho ngenxa yokwahluka okuthe ngqo kwisiza kwimbonakalo yemfuza. NgokukaBarrett, et al., I-socially monogamous prairie vole inika ithuba elikhethekileyo lokufunda i-neurobiology ye-monogamy. [65]. Enyanisweni, i-vasopressin la receptor (VlaR) ibonakaliso iyimfuneko ekubunjweni kwesibini sesibini kumadoda. Okubangela umdla kukuba, i-social prairie voles ibonisa ukubophelela okukhulu kwe-VlaR kumvuzo wokusetyenzwa kwe-ventral pallidum kune-asocial voles yohlobo olufanayo. Barrett, kunye nabanye. Ufumanise ukuba ukulawulwa okuphantsi kwe-pallidal VlaR density kubangele ukuchaphazeleka okubalulekileyo ekukhetheni iqabane elitshatileyo kunye nokuncipha kokuziphatha okufana nexhala xa umntu emdala. [65]. Omnye umsebenzi kaGarcia, et al. ibonise ukuba abantu abanobuncinci be-7-repeat allele (7R +) ye-DRD4 babika izinga eliphezulu lokuziphatha okuvakalala ngokwesondo, kubandakanywa nokuba "ubusuku obunye," kwaye baxela ukwanda okungaphezulu kwe-50% kwiimeko ukungathembeki ngokwesini [66].

Okubalulekileyo, uDaw noGuo banike ingxelo yokuba abantu abaphethe i-genotypes DRD2* Al/A2, DRD2*A2/A2, DATl *9R/10R, kunye ne-MAOA*2R/ banxulunyaniswa namathuba aphezulu okwabelana ngesondo okungakhuselekanga kunezinye iigenotypes kwezi loci. [67]. Imibutho yeDRD2 isebenza kumadoda nabasetyhini, ngelixa amanye amakhonkco esebenza kwabasetyhini kuphela. Ekugqibeleni, uEmanuele, et al. ibike unxulumano olubalulekileyo phakathi kweDRD2 TaqI A genotypes kunye ne "Eros· (isitayela sothando esibonakaliswe ngokutyekela ekuphuhliseni amava anzima ngokweemvakalelo ngokusekelwe kumtsalane womzimba kwiqabane), kunye naphakathi kwe-C516T 5HT2A polymorphism kunye ne "mania" (i-mania) uthando olunobunini noluxhomekeke, oluphawulwa ziimvakalelo zokuzoyisa) [68].

I-Epigenetics kunye nomsebenzi wesondo

Uphononongo loncwadi lubonisa ukuba amanqaku amaninzi akutshanje abonisa ukubaluleka kwemiphumo ye-epigenetic kwimisebenzi yesondo. Umzekelo, uMatsuda uphonononge utshintsho lwe-epigenetic lwe-estrogen receptor a (ERalpha) kunye nefuthe ekuziphatheni ngokwesini. [69]. Ngapha koko, ukuguqulwa komsebenzi wofuzo we-ER alpha olawulwa ziindlela ze-epigenetic, ezinje ngokuguqulwa kwe-histone kunye ne-DNA methylation, iguqula indlela yokuziphatha komntu ngokwesondo. Ngokuphathelele ubufanasini, iRice, et al. iphuhlise imodeli enokuthi ichaze ukuphuhliswa (ukuguqulwa) kobufanasini [70]. Bachaza ukuba le modeli isekelwe kumanqaku epigenetic abekwe phantsi ekuphenduleni i-XX vs. XY karyotype kwiiseli ze-embryonic stem. Ngokufanelekileyo, la manqaku akhulisa ubuntununtunu kwi-testosterone kwi-XY fetus kwaye ayithobe kwi-XX fetus, ngaloo ndlela ikhulisa ukukhula ngokwesondo. Kuye kwachazwa ukuba iseti engaphantsi yala manqaku aguqulayo epigenetic ngokobungakanani inokuthwala i-trans-genetically, kwaye inokukhokelela kwi-mosaicism yophuhliso lwezesondo kwinzala yesini esahlukileyo-i-phenotype yobufanasini.

Kwi-social monogamous prairie vole (Microtus ochrogaster), ukukhwelana kubangela ukuba kubekho iibhondi ezimbini ezihlala zihleli eziqalwa kukubunjwa okuthandwa ngumlingani kwaye zilawulwe ziindidi ze-neurotransmitters, kubandakanya i-oxytocin, i-vasopressin, kunye ne-dopamine. Umsebenzi kaGundersen [71], kunye noWang, et al. [72] icebisa ukuba i-histone deacetylase inokuququzelela ukwakheka kweqabane kwi-female prairie voles enokuthi inokubaluleka ebantwini. Ngokukodwa, uWang, et al. yafumanisa ukuba i-histonedeacetylase-inhibitors-sodium butyrate kunye ne-trichostatin A (TSA) yokuphucula ukwakheka kweqabane elithandwayo kwi-female prairie voles. [72]. Olu qulunqo olukhethiweyo lweqabane ludibaniswe nokulawulwa kwe-oxytocin receptor (OTR, oxtr) kunye ne-vasopressin V la receptor (VlaR, avprla) kwi-NAc, ngokunyuka kwe-histone acetylation kubagqugquzeli babo.

Kukho ubungqina obukhulayo bomdla obubonisa ukuba amabhinqa azibandakanya ngenkuthalo kwi-polyandry mhlawumbi ukunqanda ukungahambelani kwemfuza okanye ukuthambekela kobutata ekuthandeni amadoda aphezulu ngokwemfuzo. Kukho ithuba lokuba ukhetho lokufaneleka okuphezulu kwamadoda lunokuba ngenxa yeziphumo ze-epigenetic. NgokukaZeh noZeh, ngokungafaniyo ne-DNA esekelwe ngokulandelelana, ukwahluka kwe-epigenetic kunokuphenjelelwa kakhulu yimeko engqongileyo kunye neziphumo zestochastic ezifunyanwa ngexesha lokuphila komntu. [73]. Bacebisa ukuba ukuhluka kwe-epigenetic kunokubaluleka ekukhethweni kwezesondo emva kokukopa kwaye kunokuthi kuphendule ngeziphumo ezidibanisa amandla okukhuphisana kwesidoda kwinzala.

I-Genetic kunye ne-meme evolution: Ukuzala komntu

U-Eysenck ucebise ulungelelwaniso oluhle phakathi kokugqithiswa kunye nokuqina kokuziphatha ngokwesondo kunye naphakathi kwe-neuroticism kunye neengxaki zokuziphatha ngokwesondo (ukuziphatha okuchasene noluntu). Uphononongo lwangaphambili nabantu abatshatileyo aluzange lubonise naluphi na olu nxulumano. Kwakucingelwa ukuba olu nxibelelwano lukhona kuphela kubantu abangatshatanga abangabandakanyekanga kubudlelwane obuhlala ixesha elide kuba umgangatho wobudlelwane umisela intsebenziswano yezesondo. Kwisampulu yamadoda aselula angatshatanga, bekukho ulungelelwaniso oluhle phakathi kokugqithiswa kunye nezinto apho umntu achaze isenzo sesondo sangaphambili nabantu abaninzi kunye namaxesha amaninzi. Akukho lunxulumano lufunyenweyo kunye neuroticism. Kwakukho unxulumano oluncinci kunye nezinye izikali zobuntu kunye nentlalo. Ngenxa yonxulumano nesikali sobuntu obudlalayo, iziphumo zatolikwa ngokwembono yentlalo-yengqondo. Kwibutho lanamhlanje, inkwenkwe eselula ilindeleke ukuba ithabathe inyathelo lokuqala lokwabelana ngesondo okunokuthi umfana osemncinane osele ekhulile aqonde ngcono kunalowo ungenwayo. [74]. Le mbono ivumelana ngokuthe ngqo nombono kaRichard Brodie malunga nemfuza yengqondo yokuzingca [75]. Ngokwembono ye-DNA, kambe ke, izazi ngendalo ziyavuma ukuba “siselapha ngesizathu esinye kuphela; ukuphuma, ande. Ngoxa inkqubela yendaleko icotha, inyathelo elinye rhoqo emva kweminyaka engama-20 nangaphezulu, xa lithelekiswa “nendaleko yembali, ingcamango iyatshintsha kwixesha elifunekayo ukufunda isivakalisi.” Ubuchopho bethu abunanto yakwenza nendaleko yemfuza ngaphandle nje kokuba inxulumene nabantu abakrelekrele abaneentsana ezimbalwa. Enyanisweni, ukuba kukho imizila yemfuza eyenza abantu batyekele ekuthabatheni ii<em>memes ezinciphisa inani labo lenzala, baya kufa kwizizukulwana ezimbalwa bekhetha imizila yemfuza enika abantu utyekelo lokufumana abantwana. Nangona kukho impikiswano, ngelishwa, inani lezifundo libonisa ukuba iHomo sapiens kule minyaka ingama-42,000 idlulileyo ziye zehlisa ii-IQ zazo ngenxa yokukhetha ukukhwelana. [76].

Ngokungaqhelekanga, kuvele ukuba ekubeni i-extraversion inxulumene nokwanda komsebenzi wesondo ngokukodwa kumadoda, i-quantitative geneticist iqikelela ukuba i-heritability yobuntu obugqithisiweyo ibe malunga ne-40-60%. U-Smillie kunye noogxa bafunda kwaye bafumanisa ukuba enye ikopi ye-DRD2 gene Al allele yayinxulunyaniswa ne-extraversion ephezulu kakhulu. [77]. Lo mbutho uphakamisa umbuzo onomdla malunga nokuzala komntu. Ukuza kucebise ukuba ngenxa yempembelelo yabo ephawulekayo ekuziphatheni kokuzala, ukuphazamiseka kokufunda kunye nezinye izinto ezingxamisekileyo, ezinyanzelekileyo, ezinobundlobongela, kunye nokuphazamiseka kokulutha abo bathwali be-DRD2 Al banakho ukubangela utshintsho oluqhubela phambili kunye nolusisigxina kubuninzi be-DRD2Al allele "ekhokelela ekubeni ukunyibilika kwemizila yemfuza” [78].

Kwincwadi yakhe, i-Comings ibonelela ngobungqina bokuba abantu abanemikhwa ephazamisayo banabantwana ngaphambili, kwaye oku kunempembelelo ekukhetheni uhlobo lwemfuza efana ne-DRD2 Allele. [79]. Ucebisa ukuba abantu abathwele le allele ephazamisayo baya kuba nabantwana masithi kwiminyaka engama-20 ubudala kwaye abantu abangenayo le allele baya kuba nabantwana kwiminyaka engama-25. Ngenxa yoko, umzila wemfuza uya kuzala ngokukhawuleza, oko kukuthi, rhoqo emva kweminyaka engama-20 ngoxa uhlobo oluqhelekileyo lomzila wemfuza luya kuzala rhoqo emva kweminyaka engama-25. Umlinganiselo we-25/20 ngu-1.25. Ngaloo ndlela, izinga apho i-gene ene-1.25-fold-fold selective advantage iya kwanda ngokuphindaphindiweyo ukusuka kwisizukulwana ukuya kwisizukulwana. Umahluko weminyaka emihlanu yobudala boomama okanye ootata xa benabantwana babo bokuqala wanele ukukhokelela kukhetho olubalulekileyo nolukhawulezayo lwemizila yemfuza ethwalwa liqela eliqalisa ukuzala kwasebudala. Ukunyuka kwezinye iindlela zokuziphatha ze-RDS zibhalwe ukusuka kwi-1955 ukuza kuthi ga ngoku. Olu lwando luquka i-adolescent behaviour syndrome (iziyobisi, isini, ukukhulelwa kwabakwishumi elivisayo, nokuziphatha kakubi, ukutshaya), ukuziphatha kakubi, ulwaphulo-mthetho, ukusebenzisa kakubi iziyobisi, ukukhotyokiswa butywala, ukuziphatha kakubi ngokwesini, oomama abangatshatanga, intlalontle, ukugxothwa esikolweni, nokuyeka isikolo, kwakunye ukuhla okuhambelana ne-IQ [80]. Ezi ziphumo zisekwe kuPhononongo lweBerkeley olusebenzisa idatha yelongitudinal evela kwiMpilo yoMntwana kunye neSifundo soPhuhliso kunye noPhando lweSizwe loLutsha okanye i-NLYS. [81]. Ukusebenzisa olu lwazi, i-Comings iqikelele ukuba ukusuka kwi-1955 ukuya kwi-2015 kuya kubakho ukuphindaphinda okuphindaphindiweyo, umzekelo, i-DRD2 Al allele, ngoko ke ukwandisa ukuxhaphaka kokuziphatha kwe-RDS, kubandakanywa ukwabelana ngesondo kwangaphambili. [50]. Sikhuthaza ukulandelelwa kwale ngqikelelo inika umdla.

Ngaphandle kokungavisisani okuthile, sicebisa ukuphazamiseka kokuziphatha ngokwesini njengenxalenye yeempawu zokwabelana nge-RDS ezinento ethile kunye nokuziphatha okungeyonto ekhobokisayo kunye nenkcazo yeklinikhi echatshazelwa ngokuyinxenye zezofuzo kunye ne-epigenetics. Nangona singavavanywanga ngeli xesha, sikwacebisa unyango lwexesha elifutshane oluvunyiweyo lwe-FDA-oluncediswa ngamayeza (MAT) luthanda ukuthintela ukusebenza kwe-dopamine kulandelwa kukuvuselelwa ngobunono beendlela ze-dopaminergic ezikhokelela kwi-dopamine homeostasis yexesha elide. Le yokugqibela inokufezwa ngeendlela ezithile ezinokunceda ukuchacha.

Nangona i-bias enokubakho, ibandakanya i-dopamine agonist therapy-nutraceuticals (KB220), inkqubo ye-12 yeNyathelo kunye nesiko, unyango olupheleleyo, unyango lokuziphatha kwengqondo (CBT), kunye nonyango lokunceda umonzakalo (TRT) kunye nemisebenzi ye-dopamine-boosting kunye nokutya (Figure 1) [82].

Ingxabano

Ngelixa sikholelwa ngokuqinileyo ukuba ukuphazamiseka kwe-hypersexuality kufuneka kuqukwe kuhlelo oluzayo lwe-DSM, siyaxakwa kukuba kuncinci okwaziwayo malunga nesi sifo ngokwe-neurogenetics kunye ne-epigenetics kunye neempawu zokurhoxa kunye ne-phenomenology yonke. [83]. Umyalezo ophambili wokuthatha ekhaya kukuba ngoku sikhuthaza uluntu lwezenzululwazi ukuba lwenze imifuniselo, ngakumbi kwindawo ye-neuroimaging kunye ne-neurogenetics, kubandakanywa i-epigenetics ethe ngqo kwijene, efana ne-oxytocin-vasopressin-orexin-dopamine kunye nolunye uhlobo lomvuzo. Mhlawumbi le meko inokuxhamla kunyango olujolise kumvuzo we-polymorphisms yemfuza ukuncedisa ekukhuthazeni i-dopamine homeostasis. [84-89]. Inani lokuphononongwa nguJoranby, et al. kunye neEdge kunye neGolide zixhasa amathuba onyango aqhelekileyo anxulumene neendlela ekwabelwana ngazo ze-neurochemical kumjikelezo womvuzo wengqondo njengoko bekutshiwo ngaphambili kwingqikelelo ye-RDS. [90-91].

Ngokwembali "umlutha wesondo" wawubandakanyiwe kwi-DSM-III, nangona kunjalo, yasuswa kwi-DSM-1V kuba ukuvumelana kwababhali be-DSM-1V bakholelwa ukuba akukho bungqina obaneleyo bokufaneleka kwayo. Esi sigqibo sasizaliswe luvakalelo olukhulu lweenkokeli ebaleni. Ukulandela esi siganeko, uninzi lwezazinzulu ezibandakanya uKafka, uReid, uPrause, kunye nabanye bagqibe kwelokuba baqulunqe “ubuNgxaki besondo” hayi njengekhoboka lezesondo kodwa kukuphazamiseka kwengqondo okuzimeleyo kwaye hayi njengokukhotyokiswa ngomnye umntu. Ngelixa umsebenzi wabo wangaphambili ngo-2010 ucetyiswe njengoko kukhankanyiwe apha ukuba "ubulili obufanayo" babufana nokukhotyokiswa ngokwesondo kwaye mhlawumbi nezinye iziyobisi, kubandakanya nokusetyenziswa gwenxa kweziyobisi, umsebenzi wabo wamva nje ubuyile kule ngxabano. Umsebenzi wamva nje kulo mmandla utyhila impikiswano eqhubekayo. Kukho inani lezifundo ezisekwe kwi-electrophysiological, liqela likaPrause elibonelela ngobungqina bokuba umnqweno wesini, hayi ubulili obugqithileyo, uxela kwangaphambili ukuzilawula kwenkanuko yesini. [92]. Aba baphandi bacetyisa komnye umsebenzi ukuba izifundo ezibika iingxaki ezilawula ukujonga kwabo i-visual stimuli (VSS) ekwachaza umnqweno wesondo ophezulu wabonisa amandla aphantsi kade (LPP) ekuphenduleni i-VSS. Ababhali bacebisa ukuba le pateni ibonakala yahlukile kwiimodeli zokusebenzisa iziyobisi [93]. Nangona kunjalo, ngelixa lingabandakanyi izifundo ezine-hypersexual disorder, umsebenzi weqela likaVoon ubonise ukuba kwizifundo ezinyanzelekileyo-zokuziphatha ngokwesondo, ezivezwe kwiividiyo ezicacileyo ngesondo, umsebenzi omkhulu kwinethiwekhi ye-neural efana naleyo ibonwa kwizifundo ze-drug-cue-reactivity. [94]. Umnqweno omkhulu okanye ukufuna kunokuthanda kwayanyaniswa ngakumbi nomsebenzi kule nethiwekhi ye-neural. Lo msebenzi udibana neethiyori zenkuthazo [95].

Thina, ababhali benqaku langoku, siyavuma ukuba asizange sibe yimfihlo kuyo yonke intsebenziswano ebalulekileyo eyenzeka phakathi kwabacebisi be-"Hypersexuality Disorder" kunye nenjongo yabo enyanisekileyo yokuba le ngxaki ifakwe kwi-DSM-5 yangoku. Nangona ayiphumelelanga into ebizwa ngokuba yi "acid-test", kukho isizathu sokukholelwa ukuba iya kufakwa kuhlelo oluzayo lwe-DSM. Kuyaphawuleka ukuba uSteven Hyman, umlawuli we-NIH wangoku, ngokuchanekileyo waxoxa ukuba "i-DSM isibuko esibi sezonyango kunye neemeko zebhayoloji; eyona ndlela intsha yolwahlulo lokuxilonga iyafuneka njengoko abaphandi befumanisa iindlela ezintsha zokufunda nokuqonda ukugula ngengqondo” [96]. Ngaphezu koko, uCasey, et al. licebise ukuba ngelixa i-DSM ithatha ukuphazamiseka okuhlukeneyo njengento eyahlukileyo, "imida phakathi kokuphazamiseka ihlala ingekho ngqongqo njengoko i-DSM icebisa" [97].

Kwi-2014, uKarila, et al. ucebise ukuba ukukhotyokiswa ngokwesondo, okwakwaziwa ngokuba yi-hypersexual disorder, akuhoywanga ngoogqirha bengqondo, nangona imeko ibangela iingxaki ezinzulu zengqondo. Ngokwaba babhali, bacebisa ukuba umlutha wesondo okanye ukuphazamiseka kwe-hypersexual umele amagama ahlukeneyo kwingxaki efanayo. Babonisa ukuba amazinga okuxhaphaka kweengxaki ezinxulumene nokulutha ngokwesondo ukusuka kwi-3% ukuya kwi-6%. Ngokufanelekileyo, ulwakhiwo lwe-Sexual Addiction/Hypersexual Disorder lubonisa isimilo esinengxaki kubandakanya: ukuphulula amalungu esini ngokugqithisileyo, i-cybersex, ukusebenzisa iphonografi, ukuziphatha kakubi ngokwesondo nabantu abadala abavumayo, isini ngefowuni, ukutyelelwa kweklabhu, kunye nezinye iindlela zokuziphatha eziluthayo. [98]. Ngokuqinisekileyo siyavuma ukuba kunokubakho iyantlukwano eyahlukileyo phakathi kokukhotyokiswa ngokwesondo kunye nokwabelana ngesondo okugqithisileyo njengoko kuphawulwe nguCarvalho, et al. [99], Rettenberger, et al. [100], Kor, et al. [1], Reid, et al. [9], Kafka kunye noHennen [13], kunye noPrause, et al. [93-94] phakathi kwabanye.

Isishwankathelo, sicebise ukuba, ngelixa kukho umahluko phakathi kokuziphatha ngokwesini kunye nokukhotyokiswa ngokwesondo, uphando olongezelelweyo luyafuneka ukuze uhlele ngokufanelekileyo ezi meko zibaluleke kakhulu. Siyavumelana nomsebenzi kaWalters, et al. [101] oko kucebise ukuba iyantlukwano yomntu kwi-hypersexuality ininzi kunokuba ibe semgangathweni kwindalo. Bacebisa kwakhona ukuba i-hypersexuality ilungelelaniswe kunye ne-continuum ewela ekupheleni okuphezulu kokuqhubekayo (Figure 1).

Umzobo 1: Imephu echazayo ye-Hypersexuality Disorder njenge-subtype ye-RDS

Umzobo ubonisa impembelelo ye-neurogenetic kunye ne-epigenetic esebenzayo. Zombini uthintelo lwexesha elifutshane lwe-dopamine kunye nexesha elide "i-dopaminergic-homeostasis" yonyango olusekwe kunyango kunye nonyango lokunyusa i-dopamine kunye nemisebenzi yemihla ngemihla zidweliswe. Izangqa zibonisa iimpawu ze-RDS kunye neebhokisi zibonisa ukuziphatha kwe-RDS.

  Khuphela ubungakanani obupheleleyo

 

Ngelixa siqaphela impikiswano, sicebisa ukuba umahluko onokwenzeka kunye nokufana phakathi kokuphazamiseka kokulala ngokwesini kunye nokulutha ngokwesondo kufuneka kuphandwe ngokwaneleyo kusetyenziswa i-neuroimaging (fMRI, PET, SPECT), i-optogenetics, uhlalutyo lomgqatswa kunye ne-microarray, kunye nobuchule be-epigenetic. Sikholelwa ukuba olu phando luya kubonelela ngesiseko sokubandakanywa kwe-hypersexuality njengokuphazamiseka kuhlelo oluzayo lwe-DSM.