I-neuroscience ye-Inthanethi ye-Pornography Umlutha: Ukubukeza nokuvuselelwa (2015)

IZIMPENDULO: Ukubuyekezwa okuphelele nokuphoqelelayo kwezincwadi ze-neuroscience ezihlobene nama-subtypes wokulutha kwe-Intanethi, ngokugxila ngokukhethekile ekuluthweni kocansi lwe-inthanethi. Isibuyekezo siphinde sigxeke izifundo ezisanda kwenziwa ezithathwa yibhodi le-SPAN, okukholakala ukuthi “zenze umlutha wobulili obubi”. Ingcaphuno evela kokungabonakali:

"Kulesi sibuyekezo, sinikeza isifinyezo semiqondo ehlongozwayo yokuba umlutha futhi sinikeze ukubuka konke mayelana nezifundo ze-neuroscience mayelana nokulutha kwe-Intanethi kanye nokuphazamiseka kwemidlalo ye-Intanethi. Ngaphezu kwalokho, sibuyekeze izincwadi ezitholakalayo ze-neurosciology mayelana nokulutha kwezithombe zocansi ze-Intanethi bese sixhuma imiphumela kwimodeli yokulutha. Lokhu kubuyekezwa kuholela esiphethweni sokuthi umlutha wezithombe zocansi we-Intanethi ungena ohlakeni lokulutha futhi wabelane ngezindlela ezifanayo eziyisisekelo nokulutha kwezidakamizwa. ”

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Ukuxoxa nge-radio nomlobi oholayo, ekhuluma ngaleli phepha

LINK UKUBUYEKEZA OKUQHELELE

Behav. Sci. 2015, 5(3), i-388-433; doi:10.3390 / bs5030388

Ishicilelwe: 18 September 2015

Love Todd ^1,^†,*, Christian Laier ^2,^†, I-Matthias Brand ^2,^3,^†, ULinda Hatch ^4,^† noRaju Hajela ^5,^6,^†

¹ Society for the Promotion of Health and Health, Ardmore, PA 19003, eU.SA

² UMnyango Wezobuchwepheshe Bokuzivocavoca: Ukuqonda, i-University of Duisburg-Essen, iDuisburg 47057, eJalimane; Ama-imeyili: [i-imeyili ivikelwe] (CL); [i-imeyili ivikelwe] (MB)

³ I-Erwin L. Hahn Institute for Imagination Magnetic Resonance, Essen 45141, eJalimane +++

⁴ I-Private Practice, eSanta Barbara, CA 93103, eU.SA; Imeyili: [i-imeyili ivikelwe]

⁵ Health Upwardly Mobile Inc., Calgary, AB T2S 0J2, Canada; Imeyili: [i-imeyili ivikelwe]

⁶ I-Group of Action Addiction (DDTAG), i-American Society of Addiction Medicine (ASAM), i-American Society of Addiction Medicine (i-ASAM), i-Chevy Chase, i-MD 93101, e-USA

^† Lababhali banikele ngokulinganayo kulo msebenzi.

* Umbhali ozoxhumana naye kufanele aqondiswe; Imeyili: [i-imeyili ivikelwe]; Ucingo: + 1-706-383-7401.

Umhleli Wezemfundo: Andrew Doan

abstract

Abaningi bayaqaphela ukuthi ukuziphatha eziningana okungase kuthinte umjikelezo wokujikeleza kubuningi bomuntu kubangela ukulahlekelwa ukulawulwa kanye nezinye izimpawu zokulutha umlutha okungenani abanye abantu. Mayelana nokulutha kwe-intanethi, ucwaningo lwe-neuroscience lusekela ukuthi izinqubo ze-neural ezisemqoka zifana nokulutha ngokweqile. I-American Psychiatric Association (APA) ibone ukuziphatha okunjalo okuhlobene ne-intanethi, ukudlala kwe-intanethi, njengengozi yokulutha yomlutha okuqinisekisa ukuqhubeka nokutadisha, ku-2013 ukubuyekezwa koMqulu wabo wokuThola nokuThathaniswa. Okunye ukuziphatha okuhlobene ne-intanethi, isib. Ukusetshenziswa kocansi lwe-Inthanethi, akuzange kuhlanganiswe. Ngaphakathi kwalokhu kubuyekezwa, sinikeza isifingqo semiqondo ehlongozwayo yokulutha umlutha futhi unikeze umbono wokuhlola mayelana neuroscience ucwaningo on Internet inselele kanye ne-inthanethi yokudlala disorder. Ngaphezu kwalokho, sibuyekeze izincwadi ezitholakalayo ze-neuroscientific on ukulutha kobulili ezingcolile kuyi-intanethi futhi sixhuma imiphumela emfanekisweni wokulutha. Ukubuyekezwa kuholela esiphethweni sokuthi umlutha wezithombe zobulili ezingcolile we-intanethi ufinyelela ohlelweni lokulutha umlutha futhi uhlanganyela ngezindlela ezifanayo eziyisisekelo nokulutha ngokweqile. Kanye nezifundo zokulutha kwe-intanethi ne-Internet Gaming Disorder sibona ubufakazi obuqinile bokucabangela ukuziphatha kwe-Inthanethi kokulutha njengokulutha kokuziphatha. Ucwaningo lwesikhathi esizayo luzodinga ukubhekana nokuthi ngabe kukhona yini umehluko ocacile phakathi kwezinto ezidakamizwa nokuziphatha ngokweqile

Amagama angukhiye: ukulutha kwezidakamizwa ze-inthanethi; umlutha we-intanethi; ingozi yokudlala i-intanethi; i-neuroscience; i-neuroimaging; I-DSM-5; ukulutha ukuziphatha; ukuziphatha komlutha; i-inthanethi yocansi; ukuziphatha ngokocansi oku-inthanethi

1. Isingeniso

Ukuguquguquka kokuguquguquka kweparadigm kwenzeka emkhakheni wokulutha umlutha onomthelela omkhulu wokuhlola nokuphathwa. Ngenkathi "ukulutha umlutha" uye wahlotshaniswa nokuhlukunyezwa kwezidakamizwa kanye / noma utshwala [1], ukucwaninga kwemiphumela ye-neuroscience kule nkambu kushintshe ukuqonda kwethu emashumini eminyaka edlule. Manje sekusobala ukuthi ukuziphatha okuhlukahlukene, okuyinto eqinisa ngokuphindaphindiwe umvuzo, ukugqugquzela kanye nenkumbulo abajikelezayo konke okuyingxenye yesifo sokulutha [2,3,4,5,6,7,8,9,10]. Izindlela ezivamile phakathi kokulutha umlutha okubandakanya izinto ezihlukahlukene ezingokwengqondo ezifana ne-alcohol, i-opioids ne-cocaine; kanye nokuziphatha okuphazamisayo njengokugembula okungalawulwa, ukusetshenziswa kwe-intanethi, imidlalo, izithombe zobulili ezingcolile kanye nokuzibandakanya ngokobulili nakho kwachazwa.

Ngenxa yobufakazi obunamazinyo obukhulayo, i-American Society of Addiction Medicine (ASAM) yandisa ngokucacile incazelo yabo yokulutha ku-2011 ukufaka kokubili ukuziphatha nezinto:

Isiyaluyalu yisifo esiyisisekelo, esingapheli somvuzo womqondo, isisusa, inkumbulo kanye nezifunda ezihlobene. Ukungasebenzi kulezi zifunda kuholela ekuboniseni izinto eziphilayo, ezengqondo, ezenhlalakahle nezingokomoya. Lokhu kukhonjiswe kumuntu ngamunye wokuphishekela umvuzo kanye / noma ukusiza ngokusetshenziswa kwezidakamizwa kanye nezinye izinto zokuziphatha.
[11]

I-American Psychiatric Association (APA) nayo yavuma ukuthi isilingo sokuziphatha ngokweqile, njengoba singabonakala emaqenjini amaningi ngaphakathi kwe-DSM-5. Isibonelo, isahluko se-"Izinto Ezihlobene Nezifo Ezihlobene Nezimo" saqanjwa ngokuthi "Ukusetshenziswa Kwezinto Nokuhlukunyezwa Kwemithi", isithwathwa se-"Non-Sub--Related-Disorders" esakhiwe, futhi mhlawumbe ikakhulukazi, Ukugembula Kokungcebeleka (okwakuthiwa yi-Pathological Gambling) kuhanjiswe kulokhu i-subchapter esanda kusungulwa, ngenxa yokuthi "ubufakazi bayo bokuthi ukugembula ukuziphatha kwenza kusebenze izinhlelo zokuvuza ezifana nezizosetshenziswa izidakamizwa zokuhlukunyezwa futhi zenze ezinye izimpawu zokuziphatha ezibonakala zifana nalabo abakhiqizwa izidakamizwa zokusetshenziswa kwezidakamizwa" [12]. Ngaphezu kwalokho, ukuxilongwa kwe-Gaming Disorder (IGD) kwafakwa ngaphakathi Isigaba 3-Izifundo Zokufunda Okuqhubekayo kwe-DSM-5. Ekusekeleni lokhu kutholakala okusha, i-APA yathi ku-release release / fact sheet kwi-IGD:

Ucwaningo lubonisa ukuthi uma laba bantu bexhunyiwe emidlalweni ye-inthanethi, izindlela ezithile ezibuchosheni babo zibangelwa ngendlela efanayo futhi eqondile ukuthi ubuchopho bomlutha wezidakamizwa kuthinteka ngento ethile. Ukudlala kudala impendulo yezinzwa ezithonya imizwa yenjabulo nomvuzo, futhi umphumela, ngokweqile, ubonakala njengokuziphatha komlutha.
[13]

Lesi sitatimende sisekelwa yinani elikhulu locwaningo lwe-neuroscience, njengoba kuboniswe kulokhu kubuyekezwa. Ngeshwa, i-APA yaqhubeka yenza isitatimende esilandelayo esigabeni sokuhlukana okuhlukile se-IGD:

Ukusetshenziswa ngokweqile kwe-Intanethi kungabandakanyeli ukudlala imidlalo ye-intanethi (isib. Ukusetshenziswa ngokweqile kwezindaba zenhlalo, njenge-Facebook; ukubukela izithombe zobulili ezingcolile kuyi-intanethi) akubhekwa njengokufana ne-inthanethi yokudlala i-disorder, nokucwaninga kwesikhathi esizayo kwezinye izinto ezisetshenziswa ngokweqile ze-intanethi kuzodingeka landela imihlahlandlela efanayo ephakanyisiwe lapha.
[12]

Lesi sinqumo asihambisani nobufakazi besayensi obukhona nabusakhulayo, kanti ukubuyekezwa okuhlosiwe kuhlose ukufaka ingxoxo kwingxoxo eqhubekayo yokulutha ukuhlaselwa kobulili ezingcolile kuyi-Internet (IPA) ngokuphendula isicelo se-APA.

I-APA ayizange ichaze ngokucacile ukuthi kungani ukuxilongwa okukhulu, i-Internet Addiction (IA), kuphinde kusetshenziselwe ukuxilongwa okungaphezulu kokuqukethwe kwe-IGD. Lesi sikhundla sihambisana noDavis [14] Umqondo wangempela we-Inthanethi ye-Intanethi ngokuqondile ye-Internet (SPIU), kanye neBrith, i-Laier ne-Young [15] ulwazi olusha olusha lwe-Inthanethi Ye-Addiction Inthanethi (i-SIA). Lokhu kufana neGriffiths ehlongozwa ukuhlukaniswa phakathi kwezilutha kwi-intanethi kanye nezidakamizwa kwi-intanethi [16]. Isiqunto esilula futhi mhlawumbe esisebenza kahle, noma kunjalo, bekuyobe siwukulondoloza ukuhlonza okuhlongozwayo kwe-IA kodwa nje sidinga i-subtype noma i-specifier; ukudlala, izithombe zobulili ezingcolile, ukuxhumana nabantu, ukuthenga, njll. Indlela efanayo, izinkomba, kanye namagama amaningi okwamanje abhalwe i-IGD kungenzeka ukuthi agcinwe, kuphela igama elithi "ukuziphatha" elisetshenziswe esikhundleni segama elithi "imidlalo". Ngempela, isiphakamiso sokuqala se-IA sokufakwa ku-DSM-5 sihlanganisa ama-subtypes omyalezo osheshayo, ukusetshenziswa kocansi, nemidlalo yevidiyo [17], wanda kamuva ukuthi kufaka ukuxhumana nabantu [18]. Lokhu kuzobe kuhambisane ne-DSM-5 ngalokho okwenziwe enkundleni kusukela ekushicilelwe kwayo, okungukuthi, uphenyo oluqhubekayo lwesayensi olwenziwe ububanzi obuningi bokuziphatha okuyinkimbinkimbi okubandakanya ukusetshenziswa kwe-inthanethi. Le ndlela esebenzayo iphakanyisiwe izikhathi eziningi, kokubili ngokomlando [17] futhi kamuva nje [19,20].

Ukucabangela i-IA njengenkinga ejwayelekile kanye ne-subtypes ecacile ivuthiwe ukuhlolwa kabusha ngokusemthethweni. Kukhona into ebalulekile etholakala kuyo yonke imininingwane ephathelene ne-intanethi: Ikhono lokugcina noma ukuphakamisa ukuvusa ngokuchofoza kwegundane noma uswayipha ngomunwe. Ukunakekelwa kwezinto ezintsha (ukuskena izici eziqinile emvelweni) kuqhubeka nokuphila, futhi ucwaningo lubonisa ukuthi luvuselela uhlelo lomvuzo wobuchopho [21]. Ngakho-ke, isenzo sokufuna (okuzofaka phakathi ukufakwe kwi-surfing) kususa isimiso somvuzo [22]. Ngakho-ke yenza ama-stimuli ephula ukulindela (okulungile noma okungalungile) [23], okuvame ukutholakala kumavidiyo womculo wanamuhla nezithombe zobulili ezingcolile ze-intanethi.

Eminye imisebenzi ye-intanethi, ngenxa yamandla abo okuletha ukuvuselela okungahleliwe (nokusebenza komshini wokuvuza), kucatshangwa ukuthi yakha isimiso esingavamile [24], okusiza ukuchaza ukuthi kungani abasebenzisi abanobuchopho babo obonakalisa izinguquko ezihlobene nokulutha izidakamizwa babanjwa ekuphishekeleni kwabo. Usosayensi weNobel owathola umklomelo uNikolaas Tinbergen [25] wenza umqondo wokuthi "into engavamile", into ekhona lapho kungenziwa khona izinto ezingenziwayo ezizobe zithinta ukuphendulwa kwemvelo ngokoqobo. Ukufanekisa lesi simo, i-Tinbergen yakha amaqanda amazinyo ayenziwe amakhulu futhi ayenemibala kunamaqanda wangempela ezinyoni. Ngokumangazayo, izinyoni zenyoni zakhetha ukuhlala emaqanda aqhamukayo futhi zilahla amaqanda azo ngokwawo ngokwemvelo. Ngokufanayo, i-Tinbergen yakha izimvemvane ezibonakalayo ezinamaphiko amakhulu nezinamabalabala, futhi izivunguvungu zamadoda zizama ngokuphindaphindiwe ukushada nalezi zimvemvane ezenziwe esikhundleni sezimvemvane zangempela zesifazane. Isazi sokusebenza kwengqondo uDierdre Barrett wathatha lo mqondo encwadini yakhe yakamuva i-Supernormal Stimuli: Ukuthi U-Primal Urges Over Overan Inhloso Yabo Yokuguquguquka [26]. "Izilwane zihlangabezana nokulimala okungavamile uma izivivinyo zakha. Thina bantu singakwazi ukukhiqiza eyethu. "[4] (iphe. 4). Izibonelo zikaBarrett zivela ku-candy kuya ezingcolile zobulili ezingcolile kanye nokudla okungenamsoco okunamanzi noma okungawunakho okunamnandi okudliwayo kumdlalo wevidiyo we-video ohlanganyele kakhulu. Ngamafuphi, ukusetshenziswa ngokweqile kwe-intanethi okungavamile kuvuselela kakhulu. Isebenzisa isimiso sethu somvuzo wemvelo, kodwa singase siyivuselele emazingeni aphezulu kunamazinga okusebenza okhokho bethu ababhekana nawo njengoba ubuchopho bethu beguquka, okwenza ukuba bakwazi ukushintshela kwimodi yokulutha [27].

Ekubukeni okulandelayo okulandelayo sizohlinzeka ngokubheka ngokucacile ukuqonda okuyinhloko noma imodeli yokulutha umfutho okubandakanya izinto kanye nesisekelo sezinzwa lapho izinqubo zokulutha zisebenza, kungakhathaliseki ukuthi ukubandakanya izinto noma ukuziphatha. Sizobe sesibukeza izifundo ezikhona ze-neuroscientific eziphathelene nezici zokuziphatha zokulutha ngokweqile, ngakho-ke inkinga ecacile kakhulu yokuGembula Disorder, bese uqhubekela phambili ekukhuleni kwezifundo zamuva ku-IA, kanye nama-subtypes ayo okudlala kanye nezithombe zobulili ezingcolile. Iningi lezifundo zaxoxisana ngokuhlola izici eziyinhloko zokulutha ukuziphatha okubandakanya ukuziphatha ngokuphenywa kwebholabhuthi, kufaka phakathi izifundo zokusebenza nge-neuroimaging kanye nezifundo zesakhiwo kanye nokuphumula kwesimo sezinkanyezi. Lezi zithwala ngesayensi esungulwe ngokuphathelene nokulutha ngokweqile ngokujwayelekile. Uma kudingekile, siphinde saxoxa ngezifundo ze-neuropsychological, ezikhomba ukuziphatha kwe-laboratory ukufana nokuhlola kobuchopho njengalezo ezingqondweni ezingavamile ezicatshangwa ukuthi ziwumphumela wokulutha.

Sinqume ukugxila ekugxilweni kwethu ngokuyinhloko ekutholeni ucwaningo lwe-neuroscience oluhlobene nokulutha ukuziphatha okubandakanya ukuziphatha, naphezu kokuthi kukhona futhi ucwaningo olukhulu olukhulayo oluphathelene nokukhulumisana kwabo emtholampilo, izifo ze-epidemiology, imiphumela yezempilo, ukutholakala kwempilo yomphakathi, njll. Nakuba lolo chungechunge locwaningo lusiza kakhulu ukusabalala nezingozi ezihlobene nokulutha okuhlobene ne-intanethi nokuxhumeka kwe-Intanethi, kungaphandle kokubukeza kwalokhu kubuyekezwa okugxilwe nge-neuroscience. Ngakho-ke siyakholelwa ukuthi kunengqondo ukukhawulela lokhu kubuyekezwa ikakhulukazi ezifundweni ezihlangabezana nezidingo eziqine kakhulu, izifundo ezibhekene nezinqubo ze-neurobiochemical neurourosiological eziyaziwa ngokucindezeleka ngokujwayelekile.

Sithemba ukuthi lezi zihloko zizobuyekezwa lapha zizocacisa ukuthi iningi lezifundo ezisekela i-IA (futhi ngayinye ye-subtypes yayo) njenge-neuroscience efana nokulutha kabi kwezidakamizwa futhi izobonisa ukuthi zonke izindlela zokuziphatha ze-intanethi kufanele zithathwe njengomlutha ngendlela efanayo, njengokuhluka kwetheksthi kunezinkinga ezihlukene, njengoba nje izinhlobo zokugembula ezihlukahlukene (isib. amakhasino, ukugembula nge-electronic, kanye nokubheja okungahleliwe) kungenza ngamunye enze izimpawu, izimpawu, nezimpawu ezibonakalayo ezibonisa ukulutha. Ngokuyinhloko sizoqokomisa izifundo ezivela phambili eziphenya i-IGD ne-IPA njengama-subtypes amakhulu. Eqinisweni kunjalo ukuthi iningi le-IA izifundo emhlabeni wonke liye lacubungula ukuziphatha okuhlukahlukene kwe-Inthanethi kulokhu kukhanya.

I-2. Indlela

Ukuqhuba ucwaningo, ukufundwa kwezincwadi eziningi nokubuyekezwa kwenziwa ngokusebenzisa imithombo ehlukahlukene: Amaqoqo amaningi e-EBSCO (kufaka phakathi i-ERIC, i-LISTA, i-PsychARTICLES, i-PsychEXTRA, i-PsychINFO, i-Psychology ne-Behavioral Sciences ne-SocINDEX), iqoqo le-Google Scholar, i-PubMed ne-ProQuest eminingi (kufaka phakathi iCentral, Dissertations and Thesis, Psychology and Social Science). I-criterion yokufaka yonke indawo ishicilelwa kumagazini obuyekezwe ngontanga. Isimiso sokuqala sokufakwa sisekelwe ngosuku lokushicilela, ngezikhathi ezithile-ukudilizwa kusethelwe ngokususelwa kusihloko esithize / isigaba esiphenywe (bona imininingwane ngezansi). Ukunciphisa okuqhubekayo kwezizinda eziphuthuma ngokushesha (isib., Izidakamizwa ezihlobene ne-Intanethi) zenziwa ngomzamo wokuhlala njengamanje ngolwazi olwandayo lwolwazi. Ngakho-ke, inani eliqondile lemiphumela elibuyekezwayo alikwazanga ukubala njengoba ukubuyiselwa kwemiphumela ngokuvamile kubuyiselwe imiphumela. Esinye isikhombimsebenzisi sezincwadi zamaphepha aqoshiwe kwakudingeka (kwenziwa ngumlobi wokuqala). Ukwengeza, izihloko zokwelapha, i-etiology, ukuphathwa kwengqondo, ukucabangela, noma ezinye ukukhathazeka ngokwengqondo / ukukhathazeka kwengqondo mayelana nokulutha okuhlobene ne-Inthanethi kwaqedwa, njengama-athikili aphathelene nokulutha okuhlobene ne-Intanethi njengenkinga yomphakathi noma yenhlalo. Ithuluzi lokuphatha i-Zotero lisetshenziselwe ukwakha i-database yazo zonke izihloko ezicutshangwayo.

I-2.1. I-Neurobiology Yezokwelapha

Ububanzi belesi sihloko bukhawulelwe eminyakeni eyishumi eyedlule, ngokugxila okuyinhloko okunikezwe ezihlokweni ezishicilelwe eminyakeni emihlanu eyedlule. Izincwadi ezindala zazibheke phambili ngentuthuko eyinhloko ekuthuthukiseni insimu yale nsimu yayihlanganisiwe (isibonelo, i-Blum et al. 1990; i-Nestler, i-Barrot ne-Self, i- 2001; i-Robinson ne-Berridge, i- 1993; uSolomon no-Corbit, i-1974). Amagama alandelayo okucinga kanye nezinzuzo zawo ezisetshenziselwa ukuhlanganiswa okuningi nezinqolobane ze-database (*) njengoba kudingeka: Umlutha * (ukuvumela kokubili umlutha, umlutha, nokulutha), i-DeltaFosB, i-genetic *, i-epigenetic *, i-imaging, i-neurobiolog * (kuya ku- vumela kokubili i-neurobiology neurobiological), i-neuroscien * (ukuvumela i-neuroscience neuroscientific), "umvuzo wokulahlekelwa kwesifo", nokusetshenziswa kabi kwezinto * *.

I-2.2. I-Neurobiology Yezintandokazi Zokulutha

Lesi sikhundla sasingeyona isikhathi-sikhululwe, njengoba sihloko esivela phambili esikulo lonke ulwazi lomlando olufanele. Okubalulekile kokuhlaziya, nokho, kunikezwe ukubuyekezwa kwezincwadi, nama-athikili ashicilelwe ngendlela entsha kunazo zonke izindlela zakudala. Amagama alandelayo okucinga kanye nezinzuzo zawo ezisetshenziselwa ukuhlanganiswa okuningi: Umlutha *, ukuziphatha * (ukuvumela kokubili ukuziphatha nokuziphatha), ukuphoqa, ukucabanga, okungewona izidakamizwa, okungewona imithi, kanye neurobiolog *.

I-2.3. UkuGembula Disorder

Ukugembula kwezokuGembula / Ukugembula Kwezemvelo bekuyisihloko eshicilelwe kakhulu iminyaka eminingi, futhi isikhathi saleso sihloko sasilinganiselwe kakhulu, njengoba sesivele samukelwa njengendlela yokuziphatha kabi, futhi ngaleyo ndlela kuvinjelwe ukuhlolwa kwe-neuroimaging noma ukubuyekezwa okushicilelwe eminyakeni emihlanu eyedlule. Inhlanganisela eminingi yale mibandela yokucinga elandelayo kanye neziqephu zayo ezisetshenziselwa ukuqhuba ucwaningo: Compulsive, disorder, gambl * (ukuvumela kokugembula kanye nabagembula), "i-gambl * ye-pathological *", "inkinga * (ukuvumela kokubili inkinga nezinkinga ) gambl * ", futhi" neurobiolog * gambl * ".

I-2.4. Isiyaluyalu se-inthanethi

Njengoba lokhu kungenye isihloko esiphuthumayo, kwakungekho isikhathi esisekelwe kulokhu sihloko, nakuba kuqala kunikezwa izifundo nezibuyekezo ezishicilelwe eminyakeni emihlanu eyedlule. Ukuqaphela okukhethekile ukuphakanyiswa kwamagama kwakudingeka lapha, njengoba isifo sifundwa ngaphansi kwezihloko ezahlukene. Isibonelo, ngaphezu kwesikhathi esiyinhloko se-Inthanethi ye-Inthanethi, imigomo eyengeziwe ifaka phakathi "Ukusebenzisa i-intanethi ye-Compulsive" [28,29,30,31,32,33], I-Internet Addiction Disorder [34], Ukusebenzisa i-Internet Disorder [35], "Ukusebenzisa i-intanethi ye-Pathological" [14,36], futhi "Ukusebenzisa i-Intanethi ye-Problem" [37,38,39,40,41,42]. Ngakho-ke, la magama alandelayo okuseshwayo kanye neziqephu zawo ezisetshenziselwa ukusetshenziselwa izinhlanganisela eziningi: I-Addict *, iphoqelela, "i-intanethi ye-intanethi", i-cyber, i-intanethi, "ukusetshenziswa kwe-intanethi", inthanethi, "i-intanethi ye-pathological" kanye "nenkinga * ye-intanethi" (ukuvumela ngenkinga nangenkinga).

I-2.5. I-Internet Gaming Disorder

Akukho ukukhawulelwa kwesikhathi okubekwe kulokhu okukhulunywa ngakho, futhi amagama alandelayo okusesha kanye neziqephu zawo ezisetshenziselwa ukuhlanganiswa okuningi: Igeyimu, imidlalo, amageyimu, imidlalo, "imidlalweni / imidlalo / imishini", "imidlalane / imidlalo / inthanethi" / ing ", futhi" inkinga * yegeyimu / is / / ing ". Zonke izinkomba ze-IGD ku-DSM-5 zibuyekezwe. Inqubo yokukhetha yokugcina engapheli kunayo yonke ithathwe ngokuya ngokuthi i-APA isivele ivume i-IGD njengesifo sokuxilongwa esifanele ukucwaninga, ngakho-ke iningi eligcwele lezihloko kulolu daba akudingeki ukusekela isisekelo sethu.

I-2.6. Umlutha Wezithombe Zobulili Ezingxenyeni

Ucwaningo olwenziwe endaweni yokuziphatha kabi ngokobulili kwi-intanethi lwaqala ngokucwaninga ngezakhiwo ezihlukahlukene ezizungeze ukuziphatha kocansi ngokucindezela. Kubekho isikhathi esithile-ukukhipha ukukhishwa kwalokhu kusesha, noma kunjalo, njengokubheja kokuziphatha, ukubeka phambili kokuhlaziywa kwafakwa ekubukeni kwezincwadi nezincwadi ezishicilelwe ngendlela entsha kunazo zonke izindlela zakudala. Amagama alandelayo okucinga kanye nezinzuzo zawo ezisetshenziselwa ukuhlanganiswa okuningi: "Ubulili obunqunyiwe", ucansi lwe-intanethi, u-hypersexual, "ukuhlukumeza ngokocansi", ukucabanga, "ukuhlukunyezwa ngokobulili", i-neurobiolog *, "ngaphandle kokulawula ucansi", "ubulili obuyinkinga" , ubulili, "umlutha wobulili *", "izinto ezicacile ngokocansi", kanye "nesenzo socansi".

Kwakungekho isikhathi esinikezwe ucwaningo endaweni ye-IPA, nakuba kuningi okudingeka kwenziwe ukuhlolwa kwe-manual, imiphumela eminingi ibe yizihloko eziphathelene nezithombe zobulili ezingcolile ze-intanethi (i-IP) kodwa zigxile ezihlokweni ezincane ezingahlobene nokusetshenziswa okuluthayo / okuphoqelela / okuyinkimbinkimbi (isib. ukuhlaziywa kokuqukethwe, ubufazi, inkululeko yokukhuluma, ukukhathazeka kokuziphatha, umthelela womphakathi, njll). Ukuhlolwa okungeziwe kwakudingeka ukuhlukanisa izihloko mayelana ne-IP (kufakiwe) futhi okungewona i-IP (engabandakanyi). Inhlanganisela eminingi yale mibandela yokusesha elandelayo kanye neziqephu zayo ezisetshenzisiwe: I-Porn * (ukuvumela i-porn, izithombe zobulili ezingcolile, nezithombe zobulili ezingcolile), umlutha *, ukucindezela, i-cyber, i-imaging, i-intanethi, i-neurobiol *, inthanethi, inkinga *.

I-3. Ukubuyekeza incwadi

I-3.1. I-Neurobiology Yezokwelapha

Zonke izidakamizwa zokuhlukunyezwa zithinta indlela ye-mesolimbic dopamine (DA), evela endaweni ye-ventral tegmental (VTA) kanye namaphrojekthi ku-nucleus accumbens (NAcc). Ngokuvamile ibizwa ngokuthi isikhungo sokuvuza, i-NAcc ixhunyaniswe kakhulu nenjabulo, ukuqiniswa kokufunda, ukufuna umvuzo, nokungafisi. I-elelimbic dopamine indlela iyaxhuma nezinye izifunda ezintathu eziyinhloko ukwenza iqoqo lama-circuits ahlanganisiwe ngokuvamile okuthiwa uhlelo lokuvuza: I-amygdala (imizwa emihle neyibiyo, inkumbulo ngokomzwelo), i-hippocampus (ukucubungula nokubuyiswa kwezinkumbulo zesikhathi eside), ne-cortex yangaphambili (izixhumanisi futhi inquma ukuziphatha). Kuthathwa ndawonye, uhlelo lokuvuza kanye nezizinda zalo ezixhumayo, luhlonza phakathi kwezinye izinto, injabulo, umvuzo, inkumbulo, ukunakwa, nokugqugquzela [43].

Ukuziphatha okwenzeka ngokwemvelo njengokudla nokucansi, kuye kwavela ukuthi kusebenze uhlelo lokuvuza ngenxa yokuthi baqinisa ukuziphatha okudingekayo ukuze basinde [20]. Le minyaka eyishumi eyedlule iye yaveza imibono eminingi yokulutha, okubandakanya uhlelo lokuvuza kanye nezifunda eziphathelene nobuchopho kanye nezinsizakalo [44].

I-3.1.1. Isibonelo Esithathu Sokulutha Umlutha

U-Nora Volkow uchaza ukulutha umlutha njengendlela yokuguquka kwesifo se-neurobiochemically esivela esenzweni esingenasisindo esifundwe ngokuqiniswa okunamandla ezenzweni zokuphoqelela ezifundwe ngokuqiniswa okungalungile [43]. Lokhu kubonakala kubonakala ekuholeni kumjikelezo wokulutha okuqhubekayo ngokuqhubekayo ngokuhamba kwesikhathi. UVolkow, Wang, Fowler, uTomasi noTelang [43] chaza izigaba ezintathu zomjikelezo wokulutha; (a) ukudakwa / ukudakwa; (b) ukuhoxiswa / ukungathinteki; futhi (c) ukukhathazeka / ukulindela.

UVolkow, Wang, Fowler, uTomasi noTelang [43] ubheke esiteji esisodwa njengesigaba sokuthi "Ukubheja / Ukudakwa". Amakilasi ahlukene wezidakamizwa asebenze uhlelo lokuvuza ngezindlela ezahlukene, noma kunjalo, umphumela wendawo yonke yi-flood of dopamine ku-NAcc (isikhungo sokuvuza). Lokhu kubangela ukuqiniswa okunamandla kokuziphatha okwaqala ukukhukhula. Kulesi sigaba esiphuthumayo, lokhu kuqiniswa okuphumelelayo kubangelwa izinhlangano zokufunda eziphathelene nokulutha [45]. Izinguquko ze-neuroplastiki ziqala ukuvela, noma kunjalo, njengoba ukuqhutshwa okuqhubekayo kwe-dopamine ku-NAcc kuholela ekwandeni kwamazinga e-dynorphin. I-Dynorphin nayo iyanciphisa umsebenzi we-dopaminergic wesistimu yokuvuza, okuholela ekunciphiseni kwemingcele yomvuzo kanye nokwanda kokubekezela [43,45].

Esikhathini sesigaba ezimbili- "Ukuhoxiswa / Ukuthinteka Okungathintiyo" -sisimkhukhula se-dopamine siphelile, futhi kukhona ukuvuselelwa kwe-amygdala enwetshiwe, indawo ehlotshaniswa nokucubungula ubuhlungu nokwesaba isimo. Isimo esibuhlungu esingokomzwelo esiholela ekusebenziseni izinhlelo zokucindezeleka kobuchopho kanye nokuhlukunyezwa kwezinhlelo zokulwa nokucindezeleka. Lokhu kubangela ukuzwela kwehla ukuvuza kanye nokwanda emkhawulweni womvuzo, okubizwa ngokuthi ukubekezela. Lokhu kuqhubekela phambili ekuqiniseni okungalungile njengoba lo muntu eqhubeka ehlanganyela ekuziphatheni okuluthayo ukugwema ukuphazamiseka okubi okuhambisana nokuhoxiswa. Lokhu, futhi, kukhuthaza ukubuyiselwa kanye / noma ukuqiniswa kwezimo zokulutha. Lapha, ukuziphatha okuguquguqukayo kushintshela ekuziphatheni okuphoqelekile, okubhekiswe kulo modeli njengokuthatha okungapheli / okufunayo [43,45]. Iphuzu elibalulekile laleli qembu ukuthi ukuhoxiswa akukhona ngemiphumela yomzimba evela emthonjeni othile. Esikhundleni salokho, lo modeli ulungisa ukuhoxiswa ngethonya elibi elibangelwa inqubo engenhla. Imizwelo ephazamisayo njengokukhathazeka, ukucindezeleka, i-dysphoria, nokucasula yizibonakaliso zokuhoxiswa kule ndlela yokulutha [43,45]. Abacwaningi abaphikisana nomqondo wokuziphatha okuba umlutha ngokuvamile bawubheki noma bangaqondi kahle lo mbono obucayi, ukudida ukuxoshwa ngokuxoshwa [46,47].

Ingxenye yesibili yesistimu yokuvuza idlala lapha; umzila we-mesocortical dopamine. Njengendlela ye-DA ye-mesolimbic, i-DA ye-mesocortical iqala ku-VTA, kepha iphela ku-cortex yangaphambili. Izindawo eziphathekayo ezikhungethwe yi-prefrontal cortex zihlanganisa i-dorsolateral prefrontal cortex (DLPFC), ephethe izingxenye eziyinhloko zokuqashelwa nokusebenza okuphezulu, kanye ne-ventromedial prefrontal cortex (i-VMPFC) ephethe izinto zokuvimbela kanye nokuphendula ngokomzwelo. Ukuhlanganiswa ndawonye, indlela ye-mesocortical dopamine ithinta ingxenye engqondweni yokucubungula umvuzo [43,45].

Lokhu kuholela esiteji ezintathu- "Ukukhathazeka / Ukulindela" -kubizwa ngokuthi ukulangazelela. Ukukhubazeka kwe-neuroplastic kwandisa ngaphesheya kwe-mesocortical dopamine endleleni eya kwezinye izifunda ze-prefrontal cortex ezinesizathu sokugqugquzela, ukuzithiba / ukuzithiba, ukunciphisa umvuzo wokunciphisa, kanye neminye imisebenzi yokucabangela kanye nokusebenza [43,45]. I-Goldstein noVolkow [48] ikhulise imodeli Yokukhubazeka Yokuphendula Ngezimpikiswano kanye ne-Salience Attribution (I-RISA) ukugcizelela ukubaluleka kwale nqubo. I-I-RISA imodeli ihlanganisa ukukhula okwedlulele kwezihloko ezihlobene nezidakamizwa ezibangelwa izidakamizwa (okubangelwa ukuqiniswa okuhle nokubi kokuziphatha okuluthayo) ngokulahla okusha okwakusanda kuthuthukiswa ekulawuleni okuphezulu okungenakuvimbela. Lokhu kushiya umuntu obhekene nengozini yokubuyisela ukuziphatha, futhi izindlela ezimbili eziyinhloko zikhonjwe; ukubuyiswa kabusha okubangelwa ukukhunjulwa nokuvuselelwa kokucindezelwa [43,45]. Ucwaningo oluningi lwe-neuroimaging lufakazela lesi simodeli [49,50], futhi lezi zinkinga ziwumthombo we-"disorder relapsing disorder" element ye incazelo yezokwelapha yokulutha [11,51].

I-3.1.2. Anti-Umvuzo

UGeorge Koob uphakamise ukukhuliswa kwesigaba sesibili sokulutha. I-Koob [51] landisa uSolomoni noCorbit [52] imodeli yendlela yokugqugquzela yokuphikisa, eyenza okuhlangenwe nakho ngokomzwelo njengamaqembu aphikisanayo, asebenza ngokufanayo ekuqinisekiseni okuhle ukuguqulwa kokungalungi okuboniswe ngezigaba eyodwa kanye nambili emodeli yesigaba esilandelayo ngenhla. Esikhathini sendlela yokuphikisana nesisusa, izinqubo-zikhombisa imiphumela emihle ye-hedonic kanye nezinqubo ze-b ezibonisa imiphumela engafanele ye-hedonic. Isicelo sokulutha umuthi ukuthi i-izinqubo zenzeka kuqala futhi zibonisa ukubekezelelana. Ngokuphambene nalokho, i-b-izinqubo ziphakama ngemuva kokuthi inqubo iphelile futhi ibonisa ukuhoxiswa. USolomon noCorbit [52] asetshenziselwa isibhakabhaka njengesibonelo sokuphambene, lapho ama-skydivers amancane asabela ukwesaba okukhulu lapho eqa (b-inqubo) nokunye ukuphumula lapho befika (inqubo). Njengoba bephinda ukuziphatha, ibhalansi ishintshela lokho okuhlangenwe nakho kwama-skydivers okuhlangenwe nakho kwesaba lapho beqa kodwa bekhululekile lapho befika. Lo mfanekiso usanda kuhlongozwa ukuthi uchaze ukuthi kwenzekani ngokuzilimaza okungezona ukuzibulala ("ukusika") [53].

I-Koob [51] unyakazela imodeli eningiliziwe ye-biologic engxenyeni yengqondo yokuphikisa kwengqondo. Inyathelo elilodwa nelinye lamamodeli amathathu wesigaba libandakanya "izinguquko zangaphakathi-ohlelweni", elibhekiswe ekunciphiseni umsebenzi wesistimu yomvuzo, ohlanganisa umkhawulo womvuzo okhuphukile kanye nokunciphisa ukukhululwa kwemvelo kwe-dopamine kumvuzo ongewona umlutha. I-Koob ikhulisa lo modeli ukufaka "izinguquko eziphakathi kwe-system", ngokusekelwe ngokuyinhloko emcimbini wokuphikisa-izinqubo. Ngokuqondile, inkolelo ethi "Anti-Reward" ichaza ukuthi lapho ubuchopho buvuza uhlelo, kukhona ukubandakanya okufanayo kwezinhlelo zokucindezeleka kobuchopho ngenjongo yokunciphisa impendulo yomvuzo nokugcinwa kwesilinganiso se-homeostatic nge-system reward, okuholela ekutheni ukuvuselelwa kokubili uhlelo lokucindezeleka komzimba (i-hypothalamic-pituitary-adrenal axis), kanye nesistimu yokucindezeleka kwengqondo (i-corticotrophin-releasing factor (CRF) system. Amazinga aphezulu okukhulunywe ngenhla e-dynorphin akhuthaza ukuphakamisa i-CRF, futhi ukuzibandakanya kwalezi zinhlelo kubangele okuningi okuthinta okubi okuxhunyaniswe nesiteji sokuhoxiswa. Ukwandisa inkinga, uhlelo lobuchopho bokuqeda ukucindezeleka lubuye lube nomthelela, njengoba kuboniswa ukunciphisa i-neuropeptide Y (i-anxiolytic yemvelo ebuchosheni). Ubuchopho obumluthayo bufaka isimo se "allostatic" lapho uhlelo lokuvuza lungakwazi ukubuyela esimweni sayo sasekhaya sasekhaya (esivamile). Uhlelo lomvuzo luyaqhubeka lube ne-point adjusted point, okushiye umuntu obhekene nengozini yokuphindaphinda nokuthembela. Yilokho uKoob abiza ngokuthi "uhlangothi olumnyama" lokulutha [51].

I-3.1.3. I-Neurobiology Yokufunda, Indlela Yokuphila, Nokugqugquzela

Nakuba kokubili ama-Anti-Reward ne-I-RISA amamodeli afaka izingxenye zokufunda, ezinye izinkolelo zokulutha ukubheja zigxila ngokuyinhloko kwizici zokufunda ukulutha, kanye nezici eziphathelene nokulutha. Hyman [54] ubhekisela ekuluthweni komlutha ngokuthi "ukuguqulwa kwamathambo kwezinqubo ze-neural ezivame ukusiza ukufunda okuhlobene nomvuzo" [54] (iphe. 565).

Everitt noRobbins [55,56] ukuphakamisa imodeli yokulutha umlutha njengenguqu eguquguqukayo evela ezenzweni zokuzithandela kuya ezenzweni ezenzelwe ezenzweni zokucindezela. Imodeli yabo ihlanganisa inhlanganisela ye-classic-stimulus-response conditioning and learning tool, futhi banikeze ubufakazi obubonisa ukushintshwa komsebenzi wobuchopho kusukela kwi-ventral striatum (indawo ye-NAcc) kuya kwi-dorsaal striatum (isifunda somqondo esibekelwe ukuziphatha okucindezelayo) inkambo yokuthuthukiswa komlutha.

I-Robinson ne-Berridge [4,57] ukwandisa imodeli yokufunda ne-"Incentive Salience" inkolelo yokulutha. I-Theory Intelligence Salience ilandela uhlaka lomgwaqo we-mesocorticolimbic we-DA ophethwe yi-hypersensitized, Nokho, le ncazelo igxile emisebenzini yokugqugquzela ehambisana nokuziphatha, kunokuba injabulo noma umvuzo [58]. Le modeli mhlawumbe ilandela kahle umsebenzi wokuziphendulela we-system reward, lapho "izidakamizwa zenza isignali yamanga yenzuzo yokufaneleka, okufakela ukucutshungulwa kolwazi oluphakeme" [59]. Le ncazelo ihlukanisa ngokucacile "ukuthanda" nokuthi "ukufuna" ngokuthi ukuthuthukiswa komlutha kuqhubekela phambili endleleni yokuthanda (hedonic umvuzo value) ekufuneni (ukulungiswa kokugqugquzela ngokusekelwe ebukhali) [60,61]. Ngakho-ke, abacwaningi babhekisela ekubhekaniseni umlutha ngokuthi "isisusa sokucindezeleka" [4] okuholela ekuboniseni izimpawu zokuziphatha zokulutha. Laba babhali bathi "ukuqinisekiswa kobufakazi obuningi eminyakeni yamuva nje, sihlala siqiniseka ekuphetheni ukuthi enhliziyweni yayo, ukulimala kuyisifo esiyingozi ekugqugquzeleni izidakamizwa ngenxa yokwehliswa kwezidakamizwa zezinhlelo ze-neural ezibonisa ukuthi ubuwula buyizinto ezithile" [4]. Nakuba okuyinhloko kugxile ekuluthweni kwamakhemikhali, laba abalobi baphetha ngokuthi imivuzo yemvelo ixhunyaniswe ohlelweni lwesibonelelo se-dopaminergic, futhi ngaleyo ndlela "ukukhuthaza ukugqugquzela futhi ngezinye izikhathi kungadlulela ezilwaneni noma kubantu kwezinye izinto, njengokudla, ubulili, ukugembula, njll. . "[4].

I-Robinson ne-Berridge [61] kusanda kubuyekezwa imodeli yabo ukususa isidingo senkampani yokuthanda, okubonisa ukufunwa njengento eyodwa kuphela ye-Incentive Sensitization theory. Benza kanjalo ngokuguqula ama-rats kusukela "ekuvukeleni" (ukucindezela i-lever okunikezwa kasawoti olwandle olumunyu) ukuze "bafune", ngokusungula indlela ye-mesocorticolimbic ngokushesha ngaphambi kokusakaza kwe-lever efanayo. Ngakho-ke baphakamisa le miphumela njengokungqubuzana nezingxabano ezisekelwe esimisweni sePavlovian ngokuphathelene nokufunda kokulutha (lokho ukuphoqeleka nokufisa kusekelwe ezinhlanganweni zangaphambi kokufunda), futhi kugcizelele ukuthi ukuthanda "ukugijima" kwimijikelezo yobuchopho yomvuzo [61] (iphe. 282).

I-3.1.4. I-Genetics

I-Genetics, njengoba ikhona lapha, ingahlukaniswa zibe izindlela ezintathu; Ukwehla kwesifo sofuzo, inkulumo ephathelene nezokwelapha eziphathelene nomlutha kumuntu ngamunye, kanye ne-epigenetics ehlukanisa le mibini. Ngokuqondene nezifundo zokuthi i-genetic heritability, i-Swendsen neLeMoal [62] kucatshangwa ukuthi izakhi zofuzo zifaka isandla cishe ku-40% yesifo sokulutha. Abalobi baqhubeka nokuhlinzeka ngezilinganiso eziphathelene nokulingana ngokobulili ngezinto ezithile ezifana nokuthi; I-49% (m) ne-64% (f) yotshwala, i-44% (m) ne-65% (f) ye-cocaine, i-33% (m) ne-79% (f) yamanoni, i-43% (m) yama-opiate, futhi i-53% (m) ne-62% (f) yegwayi [62] (iphe. 80). U-Volkow noMuenke [63] kubika izici zofuzo ezivamile ezihlangothini zombili zokuxilongwa okubili; isibonelo, i-ADHD nokusetshenziswa kabi kwezidakamizwa. I-Agrawal namaqoqo [64] wenza ukubuyekezwa kwezincwadi futhi wahlonipha izakhi zofuzo ezihlobene nomlutha njengomunye wezigaba ezimbili; izakhi zofuzo ezingase zenze ushintsho lwemigomo ekuphenduleni izinto ezithile, kanye nezakhi zofuzo ezithonya ukuziphatha-uhlelo lokuziphatha (njenge-DRD2). Laba balobi bathole nokuthi izinyathelo zokuqala zokulutha zihambisana kakhulu nezimo zemvelo, kuyilapho izigaba kamuva zibophezelekile ekuzimele.

Blum et al. [65] uhlonze ukuxhumeka kofuzo phakathi kwe-A1 allele ye-Dopamine D2 i-gene receptor (DRD2) nokukwazi ukuthuthukisa utshwala. Ngokuqondile, babambe ukuthi abathwali begciwane le-DRD2-A1 banezamukeli ezimbalwa ze-D2. Eminyakeni embalwa kamuva, i-Blum, Cull, i-Braverman ne-Comings [66] kuhlongozwa ukuthi abantu abanezici eziphathelene nezakhi zofuzo kungenzeka ukuthi babe nokuphazamiseka ohlelweni lokuvuza lomvuzo, olubizwa ngokuthi "i-Dopamine Reward Cascade". Lezi ziphazamiso ziholela esimweni se-hypodopaminergic esenza ukuba kube nokuziphatha okuluthayo, okucindezelayo, nokuziphendulela, kanye nezinkinga eziningana zobuntu. Blum et al. [66] wahlanganisa igama elithi "Imbuyiselo Ye-Reward Deficiency Syndrome" (i-RDS) ukumele ukungalingani kwamakhemikhali okungakazalwa okuveza njengenkinga eyodwa noma ngaphezulu yokuziphatha. Njengoba beqhubeka nokucwaninga, i-Blum neqembu lakhe bathole ukuthi abathwali begciwane le-DRD2-A1 bane-30% -40% engaphansi kwe-receptors ye-D2, futhi bakha mayelana ne-33% yabantu base-US [67].

I-3.1.5. I-Underpinnings ye-Molecular of Addiction

Inani elikhulu locwaningo oluchazwe ngencazelo yamangqamuzana yokulutha umlutha liye lavela eminyakeni eyishumi edlule, evame ukugxila emisebenzini ye-CREB, i-DeltaFosB ne-glutamate [2,68,69,70,71,72,73]. Isibalo salolu cwaningo lubonisa ukuthi ukukhukhula kwe-dopamine ohlelweni lomvuzo kubangele ukwanda komkhiqizo we-AMP (cAMP) we-cyclic, i-molecule encane ekhombisa ukukhululwa kwamaprotheni okuhlanganisa izici ze-cAMP (CREB). I-CREB iyiprotheni elawula ukushiwo kwezakhi zofuzo ezithile. Kulesi simo, umphumela ukukhululwa kwe-dynorphin, iphrotheni elinciphisa ukukhululwa kwe-dopamine futhi ivimbela i-VTA, ngaleyo ndlela inciphisa uhlelo lokuvuza. Abacwaningi bakholelwa ukuthi lokhu kuyi-molecular of tolerance, njengoba inani eliphakeme lemithi (noma ukuziphatha) kudingeka ukuba linqobe inani elengeziwe le-CREB. Le nqubo ihileleke ekuthembekeni, njengoba uhlelo lokuvuza olungavinjelwe lushiya umuntu esifundeni se-anhedonia uma engavumi emkhathini wokukhishwa kwe-dopamine eyinkinga. Uma umlutha weqile, amazinga e-CREB awela phansi ngokushesha, ukubekezelelana kufinyeleleka, futhi ukuzwa ukuqala kuqala. Ngalesi sikhathi, i-DeltaFosB iba yinto ebaluleke kakhulu.

I-DeltaFosB iyinhlangano ye-transcription esebenza ngandlela-thile ngendlela ehlukile ku-CREB, ngoba idonsa i-dynorphin futhi ikhulise ukuzwela endleleni yokuvuza. Nakuba i-CREB iholela ekuqiniseni okungalungile kokuziphatha okuluthayo, i-DeltaFosB ikhuthaza ukuqiniswa okuhle kokuziphatha okuluthayo. Nakuba i-CREB ikwakha masinyane ekuphenduleni ukusetshenziswa kwezidakamizwa (noma ukuziphatha okuluthayo), i-DeltaFosB iyakha kancane kancane. Ukwengeza, kanti amazinga aphezulu e-CREB ahlakazeka ngokushesha, amazinga aphakanyisiwe e-DeltaFosB ahlala isikhathi eside-amasonto noma izinyanga. Lokhu kuphakamisa impendulo ekuzuzeni imivuzo kanye nokuvuza, okushiya lowo muntu ozwela ekubhekiseni izidakamizwa futhi obhekene nokuziphatha okuphoqelekile futhi abuyele emuva. Lokhu kuqhubeka okuqhubekayo kanye nemiphumela ehambisana nayo kuye kwaholela ekubhekiseni kukaDeltaFosB ngokuthi "ukushintshwa kwamakhemikhali okulutha umlutha" [70].

Ingxenye yesithathu yi-glutamate ye-neurotransmitter. Abacwaningi bathola i-glutamate ukuba bahlanganyele ngokujulile nengxenye yokufunda yokulutha, futhi inani elengeziwe le-dopamine emgwaqweni we-mesocorticolimbic liholela ekuzweleni okwenyukayo ekugubheni. Kanti, ukuzwela kwe-glutamate okuqinisayo kuqinisa futhi kuphazamise izindlela zokufunda / imemori ezihlobene nokulutha nokuziphatha okuzungezile [74].

I-3.2. I-Neurobiology Yezintandokazi Zokulutha

U-Koob noLe Moal [5] bazinikezele ingxenye yokugcina yokubuyekezwa kwabo okuningiliziwe kohlelo lobuchopho lobuhle / uhlelo lokulwa nomvuzo ngokuphathelene nethi "Izidakamizwa zeNondrug". Abalobi bahlukanisa "izidakamizwa ezingekho izidakamizwa nezidakamizwa", futhi baphetha ngesitatimende esithi, "Icala lingenziwa ukuthi kukhona ukuqina okuqinile kombuso nomjikelezo wokulutha umxhwele wokukhathazeka / ukulindela, ukuzitika ngokweqile / ukudakwa, nokuhoxiswa / ukungalungi kuthinta izigaba zokugembula okuphoqelela, ukuthenga okuphoqelekile, ukudla okuphoqelekile, ukuziphatha ngokucindezela ngokobulili nokuzivocavoca "5] (iphe. 46).

Ekubuyekezeni kwezincwadi ngokuqhathanisa ukuziphatha okuluthayo kanye nama-SUDs, Grant, Brewer kanye nePotenza [6] ukugembula okuphathelene nokulandelana kwemvelo, i-kleptomania, i-pyromania, ukuthenga okuphoqelekile, nokuziphatha okucindezelayo ngokobulili njengezibonelo zokuziphatha okuluthayo, futhi waphetha ngokuthi, "Ukuhlolwa kwezinto eziphilayo, ukuhlolwa kwezinto eziphilayo, ukuhlolwa kofuzo, nokucwaninga ukwelashwa kuye kwaphakamisa isixhumanisi esinamandla se-neurobiological phakathi kwezidakamizwa zokuziphatha nokusetshenziswa kwezidakamizwa ukuphazamiseka "[6] (iphe. 92). Grant, Potenza, Weinstein no Gorelick [7] wathola ukuziphatha okuluthayo nokuziphatha kwe-SUD ukuze kuqhubekele ezindaweni eziningi, kufaka phakathi ukuguqulwa, inkambo (ukuphindaphinda okungapheliyo), umnikelo wezakhi zofuzo, i-neurobiology (i-brain glutamatergic, i-opioidergic, i-serotonergic, i-dopamine mesolimbic systems), i-phenomenology (ukuthanda, ukudakwa, ukuhoxiswa), ukubekezela impendulo yokwelashwa.

Encwadini yakhe eningiliziwe, "Imivuzo yemvelo, i-neuroplasticity, kanye nezidakamizwa ezingekho izidakamizwa", u-Olsen [8] wabikezela, "kukhona glut of ubufakazi ukuthi imivuzo yemvelo ingakwazi ukunciphisa ipulasitiki eziphathelene nezidakamizwa ezihlobene nomlutha" [8] (iphe. 14). U-Olsen ucaphune izifundo ze-FMRI ezibonisa ukugembula, ezothengisa, ezocansi (i-orgasm), imidlalo yevidiyo, nokubona ukudla okuthakazelisayo ukuze kusebenze uhlelo lwe-mesocorticolimbic kanye ne-amygdala enwetshiwe ngendlela efanayo nokusebenzisa izidakamizwa zokuhlukunyezwa. U-Olsen waphetha ngokuthi "Idatha eyengeziwe ibonisa ukuthi ukudla, ukuthenga, ukugembula, ukudlala imidlalo yevidiyo, nokuchitha isikhathi kwi-intanethi yizimo zokuziphatha ezingakhula zibe ukuziphatha okucindezelayo okuqhubekayo naphezu kwemiphumela ebuhlungu" [8] (iphe. 14).

Ekubuyekezeni kwabo ubuhle bokuzalwa komzimba, uLobo noKennedy [75] babike ukuthi abagembula abadlali abanomdlavuza baba kathathu amathuba okuba nomzali ongumgijimi wezemvelo, futhi cishe amathuba okuba nomkhulu ugogo. Blum et al. [67] bathole izingane zezidakamizwa ukuba zibe yi-50% -60% amathuba okuba izidakamizwa, isibalo esifana neLeeman noPotenza [10] ukulinganisa izinga labagijimi bezemidlalo.

I-Blum ihlale ihlanganisa ukuziphatha okuluthayo ekuqanjeni kwayo kwezizinda ezithintekile yi-RDS. Emaphepheni okuqala ngomvuzo owehlayo, Blum et al. [76] kusho, "Ngakho-ke ukungabi khona kwama-receptors e-D2 kubanga abantu babe nengozi enkulu yokuziphatha okuluthayo, okungacabangi nokuziphoqelela, kubandakanya ukuphuza ngokweqile, i-cocaine, i-heroin, insangu nokusetshenziswa kwe-nicotine, ukuzitika ngoshukela, ukugembula kwezifo, ukulutha ngokocansi ...". Uhlu olulandelayo lumele izinkinga ezithile zokuziphatha okwamanje eziboshelwe kwi-RDS (sicela wazi lapha ukuthi sisebenzisa amagama okuqala, yize singeke sihlukanise ukugembula kwe-Intanethi noma i-Aberrant Sexual Behavior ngaphansi kwegama elithi Compulsive Behaviors):

Izithako zokulutha: Ukuphuza ngokweqile, ukuhlukunyezwa kwe-Polysubstance Abuse, Ukubhema nokudliwa ngokweqile
Izithandwa Zomkhuhlane: Ukunakekelwa-Ukuphulukiswa Kwezifo Ukungaziphathi kahle, Ama-Tics no-Tourette Syndrome ne-Autism (kuhlanganise ne-Asperger Syndrome)
Izithandwa Zomshwalense: I-Aberrant Sexual Behavior, Amageyimu We-Intanethi Nokubhala Nge-Obsessive, Ukugembula Kwemvelo Nokusebenza Kwe-Workaholism no-Shopaholisnm
Ukukhathazeka Komuntu: Ukuziphatha Okuphazamisayo, Ubuntu Bokuziphatha, Ukuziphatha Okucindezelayo, Ukuhlukunyezwa Kwemvelo Nokuhlukunyezwa [67].

Ngokusho kukaSmith [77], izifundo zesayensi yobuchopho ezifana nalezi nabanye ziholele ekufakweni kwe-ASAM yokuziphatha ngendlela ehlelekile yokulutha. Ngaphezu kwalokho okushiwo ngaphambilini "Incazelo Efushane Yomlutha", i-ASAM yashicilela i- "Long Definition of Addiction", lapho inikeza izibonelo ezithile zokuziphatha okuluthayo esigabeni sokuqala:

Ukubheja kwezidakamizwa nakho kuthinta i-neurotransmission kanye nokuxhumana phakathi kwezifunda ze-cortical kanye ne-hippocampal nezakhiwo zomvuzo wobuchopho, njengokuthi ukukhumbula kokudlulela kwangaphambilini kokuvuza (njengokudla, ubulili, utshwala nezinye izidakamizwa) kuholela ekuphenduleni kwezinto eziphilayo kanye nezokuziphatha emaceleni angaphandle, futhi kubangela ukuthanda kanye / noma ukubandakanya ekuziphatheni okuluthayo.
[11]

Ekusekelweni okuqhubekayo komqondo wokulutha okubandakanya ukuziphatha, i-ASAM isebenzisa inkulumo ethi "Ukuziphatha okuluthayo" izikhathi ezingu-13 ku-Definition Long of Addiction, futhi ichaza inkulumo echazwe embhalweni ochazwe nge-3:

Kulo dokhumenti, igama elithi "ukuziphatha okuluthayo" libhekisela ekuziphatheni okuvame ukuvuza futhi kuyisici ezimweni eziningi zokulutha. Ukuboniswa kulezi zindlela zokuziphatha, njengoba kwenzeka nakwehliswa kwezidakamizwa ezivuzayo, kuhlinzekela inqubo yokulutha esikhundleni sokulimala. Isimo se-anatomy yobuchopho kanye ne-physiology yizinto eziguquguqukayo ezibangelwa ukubheja ngokweqile ngqo. Ngakho-ke, kulo mbhalo, igama elithi "ukuziphatha okuluthayo" alibhekiseli ekuziphatheni okungafaneleki noma okungahloniphi emphakathini, okungabonakala ezimweni eziningi zokulutha. Ukuzikhandla, njengokungathembeki, ukwephulwa kwamanani omuntu noma amanani abanye, izenzo zobugebengu njl. Kungaba ingxenye yokulutha; lezi zibhekwa kangcono njengezinkinga ezitholakala kunokuba zenze umthelela wokulutha.
[11]

Ukucwaninga nge-neurobiology ye "izidakamizwa zokuziphatha" kuqhubeke kusukela esikhathini sencazelo entsha ye-ASAM. Isibonelo, ekubukeni kwezincwadi zabo ze-epidemiology, neurobiology, kanye nokhetho lwezokwelapha "zokulutha ukuziphatha" [9], UKarim noChaudhri babonise ukunyuka kwezimfucuza, okwakubhekisela ekuziphatheni okucindezelayo, nasekusebenzeni izidakamizwa. Laba balobi babhekisela ngokuqondile "ukugembula, ukudla, ucansi, ukuthenga, ukusebenzisa i-intanethi noma amavidiyo wevidiyo noma ngisho nokusebenzisa, ukusebenza noma ukuwa othandweni" [9] (i-5) njengezibonelo zokulutha ukuziphatha.

ULeeman noPotenza [10] wahlola ngokugcwele izincwadi zezifundo ze-neurobiological ekuziphatheni okuluthayo, "Ukubukezwa Okuhlosiwe kwe-Neurobiology ne-Genetics yeziLawu zokuziphatha: Indawo Evelayo Yokucwaninga". Lesi sihloko siqukethe izinkomba ze-197, futhi siphumelela okufunyenwe phansi kube yizigaba ezintathu: Ukusebenza kobuchopho nemiphumela ye-neuroimaging, izinhlelo ze-neurotransmitter, ne-genetics. Abalobi bafingqa isigaba ngasinye etafuleni lakhe eligcwele lekhasi eligcwele, bachaza "izilingo zokuziphatha" eziyisithupha: Ukugembula, i-Inthanethi, imidlalo, ezitolo, kleptomania, kanye nobulili. Ikholomu lesokunxele letafula kufaka isifingqo socwaningo olukhona mayelana nokulutha kokuziphatha okuqondile, kanti ikholomu lesokudla libahlukanisa ngokuthola okuhambisanayo kokusebenzisa kabi izidakamizwa. Abalobi baphetha ngokuthi kukhona idatha elinganiselwe kepha evelayo ehlanganisa izidakamizwa ezahlukene zokuziphatha nocwaningo olukhona mayelana nokusetshenziswa kabi kwezidakamizwa.

Fineberg et al. [78] ushicilele ukubuyekezwa okubanzi, "Ukuthuthukiswa okusha kwe-neurocognition yabantu: imitholampilo, izakhi zofuzo, nobuchopho be-imaging correlates yokungafuni nokucindezela". Ekubuyekezeni kwabo, laba abalobi abakhulu abahlonishwayo bavuma umqondo wokuziphatha okuluthayo, kuhlanganise nabo ekuzameni kwabo "ukuqonda (ing) ye-pathophysiology yokuphazamiseka okungaqondakali, okucindezelayo, kanye nokulutha umlutha futhi bakhombise izinkombandlela ezintsha zocwaningo" [78] (iphe. 2). Laba abalobi basebenzise ukuGembula Disorder njengendlela yokubhekisela yokulutha kwezidakamizwa, nakuba bavuma ukuthi ukugula okunomdlavuza kubonisa i-neuropathophysiology evamile ngezidakamizwa ezidakamizwa. Kuhlanganisiwe ekutholeni kwabo, laba babhali babika,

Njengokuxhomeka kotshwala, ubudlelwane obuphambene phakathi kokuvuselelwa kwe-ventral striater ngesikhathi sokulindela umvuzo nokuziphendulela komuntu siqu kubikwa kokubili emaceleni okugembula nokugembula kanye nokuphuza utshwala okubonisa ukuthi lesi sici sokuqalisa ukusebenza kwe-ventral ngokweqile kwamanye amaqembu wokuziphatha ngokweqile ulandisa ngendlela efanayo nokungahambi kahle.
[78] (iphe. 15)

Umqondo wokudla njengoba umlutha uhlolwe ikakhulukazi eminyakeni yamuva, kufaka phakathi ucwaningo olunzima ezingxenyeni ze-neurobiological zokudla ngokweqile nokukhuluphala [79,80,81,82,83,84,85,86,87,88,89,90].

I-3.2.1. UkuGembula Disorder

Ngaphezu kokucwaninga okukhulunywe ngenhla ku-neurobiology kokubili izifo zokusebenzisa izidakamizwa (ama-SUDs) kanye nokuziphatha okuluthayo, kunomzimba ocwaningayo ocwaningweni ngokuqondile kwi-neurobiology yeGambling Disorder (GD) (eyaziwa ngokuthi i-Pathological Gambling (PG)) ngaphambi I-DSM-5). Ngempela, njengoba kushiwo ku-Fineberg et al. [78] ukutadisha, izifundo eziningi zokuziphatha okuluthayo zisebenzisa i-GD njengesibonakaliso.

Ezinye izifundo ziqhathanisa ngokuqondile futhi zahlukana neurobiology ye-GD ne-neurobiology yama-SUDs. Isibonelo, uPotenza [91,92] washicilela ukubuyekezwa kwezincwadi ezimbili eziqondene ngqo neurobiology ye-GD. Ekubuyekezeni kwakhe kokuqala kwezincwadi, ukuphenya okufanayo phakathi kwe-GD nokusetshenziswa kabi kwezidakamizwa, Potenza [92] bathola ukufana nokwandisa emitholampilo, ezakhiweni zofuzo, epidemiological, phenomenological, nakwezinye izindawo eziphilayo, futhi baphakamisa umbuzo wokuthi ngabe i-GD ingabekwa ngokufanelekile ngokuthi "ukulutha ukuziphatha". Lezi zithole ziqiniswa esifundweni sakhe sesibili, lapho athola khona izindawo eziningi zobuchopho (ventral striatum, ventromedial prefrontal cortex, insula, phakathi kwabanye), kanye nezinhlelo ze-neurotransmitter (i-norepinephrine, i-serotonin, i-dopamine, i-opioid, ne-glutamate) ukuze iguquke ngokuphazamiseka abagembula [91].

Ukwakha kulolu cwaningo, uLeeman noPotenza [10] ushicilele isibuyekezo "" Ukufana nokuhlukana phakathi kokugembula kwezemvelo nokuphazamiseka kokusetshenziswa kwezidakamizwa ". Abalobi babonisa ukufana okungafani phakathi kwe-GD ne-SUD mayelana nokusebenza kobuchopho (i-cortices yangaphambili, i-striatum, ne-insula) kanye nokuthola imiphumela yocwaningo lwe-neurotransmitter (i-dopamine, i-serotonin, i-opioids, i-glutamate, ne-norepinephrin). Ngokufanayo, u-el-Guebaly kanye nozakwethu bashicilele isibuyekezo sokuphenya ngokufaneleka kwe-GD njengesiyaluyalu sokulawula umfutho noma njengesifo sokungeza [93]. Ngokususelwa ekufuneni kwezinzwa ze-neurotransmitters esebenzayo, i-neurocircuitry, ne-genetics kanye nokuphendula kuma-pharmacotherapies, laba abalobi bathole ukuthi i-GD ne-SUDs yayivame kakhulu kune-GD kanye nokuphazamiseka kokulawula umfutho. Ngokufanayo, uBrevers noNoël [94] ushicilele ukubuyekezwa kwezincwadi lapho bathola ukuthi i-GD ifanele ngaphakathi kwe-I-RISA, Anti-Reward, Incentive Salience / Senensisation, kanye nemikhuba yokujwayela. Njengesibonelo sokugcina, uGyollai et al. [95] ushicilele ukubuyekezwa kwezincwadi kwizakhi zofuzo zeGD futhi uphetha ngokuthi uqinisekisa ukufakwa kwawo ekwakheni kwe-RDS yokuziphatha.

Ngokusekelwe kulokhu kanye nezixuku zocwaningo oluthile, i-APA ivuselele ukuGembula kwePathological ekubeni yi-Impulse Control Disorder kwi "Disorder Related Disorder" ku-DSM-5. Ukuqashelwa kwe-GD njengesifo esingahlobene nemithi (okungukuthi, Ukulimala kokuziphatha) ku-DSM-5 kubonisa ukwehluleka kokucabanga okude isikhathi eside ukuthi izifundo zesayensi zokulutha umlutha nomqondo wokulutha ngokweqile kumele zikhawulelwe ukusetshenziswa kwezinto ezinengqondo ezisebenzayo.

Kusukela ngaleso sikhathi, ukuhlolwa kwe-neuroimaging nokubuyekezwa kuyaqhubeka kuvela. Isibonelo, i-Singer et al. [96] ubuyekeze izifundo eziphathelene ne-neurobiological underpinnings ye-GD ngokusekelwe emcabangweni wokuthi ukuhlelwa kabusha kwe-GD njengoMlutha Wokuziphatha Ngokwe-DSM-5 kusiphakamise ukuthi "ama-phenotypes afanayo okucabangela nokugqugquzela anganciphisa kokubili ukugembula nokuphazamiseka kokusetshenziswa kwezidakamizwa" [96] (iphe. 1). Ngokukhethekile bachaza izifundo eziningi ezibolekisa umqondo wokuthi ukuchayeka ukuvuza ukungalindeleki kungabangela izimpendulo ezingezangezimo ohlelweni lwe-dopamine, okuzokwenza kube nomphumela wokubamba iqhaza ekukhuthazeni izinkomba ezihlobene nomvuzo. Ababuyekezi baphinde baphendule ekucwaningeni okuphakamisa ukuthi i-cortisol idlala indima ekwenzeni ukugqugquzela ukugqugquzela ukugqugquzelwa kwe-ventral striatum, okungukuthi, amazinga e-cortisol ekugembula ukugembula ahambisana ngokuqondile nezimpendulo ezithintekayo ezibhekene nezindleko zemali.

Okokugcina, ukubuyekezwa kwamuva kukaRomanczuk-Seiferth et al. [97] waqala ngokuqaphela ukuthi kwakunezinhlangano ezikhulayo zezincwadi ezibonisa ukufana kwe-neurobiological phakathi kwe-GD ne-SUDs, nokuthi lokhu kusekelwa ngokusobala ukuthi ukwelashwa okhethekile kuma-SUDs nakho kuyasebenza ekuphatheni ukugembula ukulutha. Bahlolisisa izifundo zamuva ze-neuropsychological, neurophysiological, ne-neuroimaging ye-GD ngokusekelwe ezinhlokweni ezintathu eziyinhloko zesimo sokuxilonga: Ukulahlekelwa kokulawula, ukufisa / ukuhoxiswa nokungahoxiswa kwezinye izindawo ekuphileni ". Baphetha ngokuthi ukuqoqa lezi ziqoqo zezibonakaliso ngale ndlela kwanikeza "uhlaka oluwusizo lokuqhathaniswa okuhlelekile kobufakazi obusha ku-GD ne-SUDs esikhathini esizayo" [97] (iphe. 95).

I-3.2.2. Isiyaluyalu se-inthanethi

Abacwaningi bebelokhu befunda i-IA cishe iminyaka engamashumi amabili. UKimberly Young ushicilele ucwaningo lokuqala lwe-IA emhlanganweni wonyaka we-American Psychological Association ku-1996, futhi kuye kwaba namakhulu ezinfundo nezibuyekezo esihlokweni esenziwe kusukela ngaleso sikhathi. Kube okungenani izibuyekezo zezincwadi ze-20 ezishicilelwe eminyakeni emihlanu edlule ngesihloko esibanzi se-IA, kanye / noma ama-subtypes akhethekile [15,36,47,98,99,100,101,102,103,104,105,106,107,108,109,110,111,112,113]. Phakathi kwalezi zibuyekezo, okungenani i-10 ibuyekezwe, ingxenye noma yonke, ucwaningo olutholakala nge-neurobiological mayelana ne-IA [15,104,105,111,114,115,116,117,118,119].

Ekubuyekezweni kwabo kwezincwadi kwi-neurobiology ye-"Inthanethi nokulutha komlutha", eshicilelwe ngaphambi kokukhululwa kwe-DSM-5, i-Kuss ne-Griffiths [105] waphawula;

Ukulutha kwezidakamizwa ku-Intanethi kunezinhlobonhlobo zemisebenzi ye-Intanethi enezinto ezibonakalayo zokugula, njengokudlala, ukuthenga, ukugembula, noma ukuxhumana nabantu. Ukugembula kumelela ingxenye yokwakhiwa kwe-Inthanethi yokulutha, futhi ukulutha komlutha kubonakala sengathi kuyindlela ekhethekile kakhulu yokutadisha inthanethi kuze kube yimanje.
[105] (iphe. 348)

Noma kunjalo, kukhona inkinga yokushayisana yenkinga yenkinga yenkinga ye-"Inthanethi yokulutha" kanye ne "Inthanethi yokudlala i-disorder". Isibonelo, i-APA ididekile ngokucacile umqondo we-IA ne-subtype yayo ye-IGD ku-DSM-5 lapho bethi "I-inthanethi yokudlala i-intanethi (futhi evame ukubhekwa njengesiyaluyalu sokusebenzisa i-Inthanethi, ukulutha kwe-intanethi, noma ukubheja ngokweqile) kuwufanele njengesiyaluyalu esizimele "([12], iphe. I-796). I-APA yenze lokhu kuhlanganiswa ngezikhombandlela ze-14 ze-IGD zanikeza i-DSM-5 ukusekela ukuxilongwa. Okuyishumi nesishiyagalolunye kulezi zikhombo kwakuyizincwadi ezibukezwa ngontanga, kanti enye ibhekisela ku-athikili yomagazini we-pop-culture ("Wired") mayelana ne-IA eChina. Phakathi kwezihloko ezibuyekezwa ngontanga, izihloko ezintathu kuphela empeleni zigxile ngqo kumageyimu we-inthanethi [120,121,122]. Kwama-athikili e-10 asele, izifundo ezine ezibhekiswe kumageyimu njengenye yezingxenye ezintathu ze-IA [34,116,123,124], umdlalo owodwa ochazwe njengenye yezinhlamvu eziyishumi [125], abathathu basebenzisa amagama athi "umdlalo" kanye "nokudlala" okuhlangene namanye ama-intanethi afana nokuthi "ukugembula" kanye "nezithombe zobulili ezingcolile" [126,127,128], futhi ababili babhekiselwa "ekusetshenzisweni kwe-intanethi" ngokuvamile okungenayo i-subtypes [129,130].

Naphezu kokuguqulwa kwe-APA, iningi labacwaningi, kuhlanganise nomcwaningi omkhulu we-neurobiology Guangng Dong, baye baqhubeka bebhekisela ku-IGD njengesigatshana se-IA [131,132,133,134,135]. Kubuyekezwe kamuva, okukhishwe ngemuva kokushicilelwa kwe-DSM-5, Brand, Young neLaer [15] wathi:

I-APA manje seyigxile ekudlaleni nge-Intanethi. Siyaphikisana, nokho, ukuthi nezinye izinhlelo zingasetshenziswa ngokulutha… Ngakho-ke, sifingqa imiphumela yezifundo zangaphambilini zokulutha kwe-Intanethi ngendlela ebanzi, yize ingxenye enkulu yezifundo ezishicilelwe kuze kube manje zigxile ekudlaleni nge-Intanethi.
[15] (iphe. 2)

Ngokufanayo, ngenhloso yalokhu kubuyekezwa, noma yisiphi isifundo esicabanga i-IGD njengesigatshana se-IA sibhekwa njengesifundo se-IA ngenhloso yalokhu kubuyekezwa, nakuba abaningi basebenzisa ukudlala njengesibonelo esibonisa ukuthi siyasibonelo. Ngokwesibonelo, u-Weinstein noLejoyeux [116] izihloko ezibuyekezwe ngokukhethekile "kokulutha kwe-intanethi" nethi "ukusetshenziswa kwe-intanethi okunenkinga" okushicilelwe ku-Medline no-PubMed phakathi kwe-2000-2009. Ngenkathi lesi sifundo sasingaqondile kwi-neurobiology, laba abalobi babika ngokufushane okutholakele kule ndawo, baphetha ngokuthi:

Imiphumela yabonisa ukuthi ama-neural substrates wokugqugquzela ukudlala / ukuthanda ukugembula ku-intanethi ukulingana nokugembula kwakufana nokwenqatshelwe ukukhwabanisa ekuxhasweni kwezidakamizwa. Ngakho-ke, imiphumela iphakamisa ukuthi ukunxusa / ukufisa ukugembula ku-inthanethi yokulutha nokulwela ukuxhaswa ngokwezinto ezibonakalayo kungase kuhlanganyele ngendlela efanayo neurobiological.
[116] (iphe. 279)

Kuss noGriffiths [105] ushicilele ukubuyekezwa kwezincwadi kwi-neurobiology ye-"Inthanethi nokulutha kweMidlalo", lapho ekhuluma ngokuxubana kwezifundo ezibhekene nezihloko ezinomlutha wokudlala i-intanethi noma izihloko ezingumlutha we-intanethi ngaphandle kwesihlonzi esithile esincane. Ngokufanayo nokubuyekezwa kukaTeinstein noLejoyeux [115] "Ukuthuthukiswa okusha kwezinqubo ze-neurobiological kanye ne-pharmaco-genetic ezithinta i-intanethi nokulutha kwevidiyo" kuqukethe inkulumo ethi "Inthanethi nokulutha kwevidiyo" njalo kulo lonke iphepha labo, nakuba ububanzi bokubukeza kwabo buqondile ngokudlala. Kungakhathaliseki ukuthi ukungahambisani nomphakathi okungahambisani nomthetho, kubalulekile ukuphawula ukuthi okuningi kwemiphumela kokubili ukubuyekezwa kuhambelana ngqo ne-neurobiology eminingi eshiwo ngenhla yokuthola izidakamizwa [4,43,44,51,55,56,57,61]. Njengengxenye yalezi zitholakele, uhlelo lwe-mesocorticolimbic lokuthola umvuzo litholakala ukuthi luthinteka ngendlela efanayo nokusebenzisa kabi izidakamizwa, njengoba kwakunjalo ukukhathazeka okubangelwa ukukhwabanisa.

Abaphenyi abavela eNational Institute of Psychiatry eMexico nabo benze ukubuyekeza ngesihloko se-IA. Laba bacwaningi baphenye ukuhlukaniswa, comorbidity, ukuxilongwa, i-electrophysiology, i-epidemiology, i-genetics yamangqamuzana, i-neuroimaging, kanye nokwelashwa (okwenziwa kwemithi kanye nokungeyona ekhemisi) kwalesi sifo. Ngokuya ngokutholakele kwabo, abacwaningi baphethe ngokuthi “kwenziwe ucwaningo oluningi ngemitholampilo nange-neurobiological ngale ndaba… ngocwaningo oluthumela imininingwane evela ezingxenyeni ezahlukene zomhlaba” [111] (iphe. 1, 7). Ngokufanayo, ekubuyekezweni kwabo kugxile ikakhulukazi kumamodeli wokwelashwa we-IA, Winkler et al. [118] futhi wabika "ukuhlangana okukhulu nezimpawu ezivame ukuhambisana nezidakamizwa zokuziphatha kanye nokufana kwezinzwa nezinye izidakamizwa [118] (iphe. 326) ".

Okunye ukubuyekezwa kwamuva kugxile ekubambeni imisebenzi yokulawula i-prefrontal ku-IA futhi kufingqa izifundo ze-neuropsychological and neuroimaging kule ndaba [15]. Abalobi bacabanga ukuthi i-IA ingahlukaniswa ku-IA jikelele kanye ne-IAs ethile, isib. IGD noma i-IPA. Ngokuvumelana nalokho okushiwo ngenhla yemilutha [4,43,44,51,55,56,57,61], ikakhulukazi ngokusekelwe emiphumeleni yakamuva yocwaningo lwezinkanyezi kubantu abasebenzisa izidakamizwa ze-intanethi, abalobi baphetha ngokuthi i-IA ibonakala ihlobene nokuhlelwa kwesakhiwo, futhi ubuciko obuvelele, obusebenzayo buyashintsha ekolishi (isb., i-prefrontal cortex nezakhiwo ze-limbic) kanye ne-subcortical (isib. , izingxenye ze-basal ganglia) izindawo zengqondo. Lezi zinguquko zobuchopho zibhekwa njenge-neural correlates yokunciphisa ekulawuleni okuphezulu, ikakhulukazi ezimweni lapho kutholakala khona izici ezihlobene nokulutha izidakamizwa. I-Brand et al. wafaka imodeli yokuziphatha-yokuziphatha ye-generalized kanye ne-IA ethize egcizelela ukuqiniswa okuhle nokubi ngenxa yokusetshenziswa kwe-inthanethi, okuholela ekuqapheleni-ekusebenziseni nasekusebenziseni ukulangazelela. Abalobi babethi ukuthi izinqubo zokuqaphela-ukusebenzisana nokulangazelela kungase kuphuthumise izinkinga emisebenzini yokulawula ephezulu [15].

U-Meng nozakwethu [114] waqhuba ukuhlaziywa kokuqala kwezincwadi / ukuhlaziywa kwemeta kokuhlolwa kwe-FMRI ye-IGD. Laba balobi baqala ngezihloko ze-61, ezizihlanganisela izifundo ze-10 ezihlakaniphile zokuhlaziya ngobuchopho. Abalobi bathola okujwayelekile okubalulekile kwe-prefrontal lobe ukungasebenzi kahle, ngakho-ke baphetha ngokuthi, "Ngokubhekisisa indima ethintekayo ye-prefrontal lobe emkhakheni wezokuzilawula, imiphumela yethu inikeze ubufakazi obusekelayo bokuhlelwa kabusha kwe-IGD njengomlutha wokuziphatha" [114] (iphe. 799).

Kwenye ukubuyekezwa kwezincwadi zakamuva ku-neurobiology ye-IA, Zhu, Zhang noTan [119] ngokucophelela ubuyekeze izindlela ze-molecular ngokusebenzisa izifundo ze-neuroimaging ngokusebenzisa i-imagination resonance imaging esebenzayo (fMRI), positron emission tomography (PET) kanye nokukhishwa kwesinye se-photon kubhalwe tomography (SPECT). Laba balobi bathole ukuthi i-IA ihlotshaniswa nokungasebenzi emisebenzini yezobuchopho ze-dopaminergic njengomlutha ohlanganisa izinto; Izifundo ze-MRI zibonise izinguquko zesakhiwo ebuchosheni ezifundweni ze-IA, nge-cognition engenakukhubazeka nokulawulwa kokuziphatha okutholakala kumantombazane e-IGD ngokuqondile, okuhambisana nokushintsha kobuchopho kwesakhiwo se-cortex ngaphambili nangaphambili futhi okuyisici sokulutha.

Inombolo ehlukumezayo yezifundo ezakhiweni ze-IA zivela. Isibonelo, i-Montag et al. [136] bathi kungenzeka ukuthi bathole inkomba ye-molecule ye-IA ngegijimi ekhokhelwe i-nicotinic acetylcholine receptor subunit alpha 4 (CHRNA4). Laba baphandi bathola ukunyuka okukhulu kwipolymorphism ethize kulesi sifo se-CHRNA4 ezindabeni ze-Internet eziluthayo. Ngaphezu kwalokho, uLee et al. [137] wathola izihloko ze-addicted ze-intanethi ukuze zibe namazinga aphezulu we-SS-5HTTLPR. Ngaphezu kwalokho, Han et al. [138] bathole izidakamizwa ze-intanethi ukuthi zibe nezindlalelo zikaTaq1A1 ezivame kakhulu, imisebenzi ephansi ye-COMT alleles kanye nezibalo eziphezulu zokuxhaswa kwemivuzo ezihlobene nezilawuli.

Ukubuyekezwa kwe-IA yakamuva kakhulu kugxile kwizifundo ze-neuroimaging ngenkathi ushiya izifundo ezifanele ze-EEG. Usesho lwethu luye lwafakazela ngezifundo ze-15 IA EEG, ezine eziqondene ne-IGD. Ekucwaningweni kokuziphatha okuluthayo, kokubili ukuphumula i-EEG yombuso kanye namathuba okuhlobene nomcimbi kungase kusetshenziswe. Amandla okuhlobene nomcimbi (ERPs) izimpendulo ezivalelwe isikhathi ngesikhathi semisebenzi yokuhlola noma isenzo. Isibonelo, Yu, Zhao, Li, Wang noZhou [139] izihloko ezivivinyelwe zisebenzise imisebenzi ye-oddball yokuhlola futhi zithole ama-amplitudes we-P300 anciphise futhi zanda ama-P300 latencies kwizihloko ze-IA uma kuqhathaniswa nokulawula okunempilo. Ukuncipha kwe-P300 kuye kwabikwa kwezinye izidakamizwa ezidakamizwa [140], futhi ukhombise inkumbulo empofu kanye nokwabiwa kokunakekelwa. Abalobi nabo babike ukuthi ukwehlisa amandla kwe-gamma oscillation, okuye kwaboniswa kuhlobene nokunciphisa amazinga e-dopamine. Ngokufanayo, Duven, Müller, Beutel noWölfling [141] wenza ucwaningo oluhilela umdlalo lapho abahlanganyeli bethola khona imivuzo. Iqembu le-IGD lalingamaphesenti angu-P300 aphansi kakhulu ekutholeni imivuzo, eholela abalobi ukuphetha ngokuthi i-P300 ephikisiwe yabonakala ekulahlekelweni kwezimo ze-IGD izimpendulo zezifundo, okutholakele ngokuhambisana nezidakamizwa zezidakamizwa. Ge et al. [142] waqashwa umsebenzi we-auditory oddball futhi wathola kakhulu ukukhula kwe-P300 latencies. Laba balobi bathole ukukhula kwe-P300 latency ukubuyela emazingeni avamile ngemuva kokufunda iziqu zezinhlelo ezintathu ze-CBT. Ucwaningo lwesibili lwesikhathi eside lubika ukuzigcina kanye nokwelashwa kwandisa inkumbulo yesikhashana kanye nokujwayelekile kwe-P300 amplitudes kanye namasalense [143]. Lezi zifundo ezimbili zokugcina zisho ukuthi izinguquko zengqondo zingaba nomphumela we-IA.

U-Zhou, Yuan, Yao, Li no-Cheng [144] izihloko ezivivinyelwe zisebenzisa imisebenzi ebonakalayo ye-Go / No-Go futhi zibike ukungafuneki okukhulu kanye nama-ampludu aphansi e-N2 kuzihloko ze-IA uma kuqhathaniswa nokulawula okunempilo. Ama-amplitudes aphansi e-N2 ekuhlolweni kwe-neuropsychological okufanayo okutholakala ekudleni kokusetshenziswa kotshwala [145]. Laba bacwaningi basho esiphethweni sabo ukuthi, "Imiphumela yalolu cwaningo ikhombisa ngokusobala ukuthi abantu abane-PIU bebenamawala kakhulu kunokulawula futhi babelana ngezimpawu ze-neuropsychological kanye ne-ERP zezinkinga ezithile, njengokugembula kwezifo, ukulutha izidakamizwa, i-ADHD noma ukusetshenziswa kabi kotshwala…" [145] (iphe. 233). Ngokufanayo, u-Dong, uZhou noZhao [146] kubike ukuthi izihloko ze-IA ezihlobene nezilawuli zibonise ubukhulu be-NoGo N2 nobude be-P300 obude. Ngaphezu kwalokho, uYang, Yang, Zhao, Yin, Liu no-An [147] bathole ukuthi izihloko ze-IA, ezifana nabahlukumezi bezidakamizwa, zenze imisebenzi eminingi ephezulu kwimisebenzi ye-NoGo. I-Godi-No-Iya i-paradigm ehilela "amageyimu amaningi kakhulu" akhiqizwe imiphumela efana nayo [148]. Ekugcineni, Yu, Zhao, Wang, Li no Wang [149] basebenze umsebenzi wokungahambisani nomsebenzi wokuqeda ukusekela ukuhlukana kwe-N400 phakathi kwabasebenzisi abakhulu be-intanethi nezilawuli. Ukuphakama kwe-N400 kwakungaphansi kwabasebenzisi abakhulu be-intanethi, okubonisa ubunzima obunokwenzeka bokuthola ulwazi olunembile. Okutholakele okufanayo kuye kwabikwa abahlukumezi bokuphuza utshwala kanye nabasebenzisi abanobunzima be-cannabis [140].

UZhou, Li noZhu [150] usebenzise umsebenzi we-Erikson flanker oguquliwe, futhi wabika ukwehla kokunganaki okuhle okuhlobene nomcimbi (ama-ERN's) ezifundweni eziluthwe yi-Intanethi uma kuqhathaniswa nezilawuli. Ama-ERN ayisiqeshana sama-ERP futhi abonisa iphutha lobuchopho lapho izifundo zizama ukulawula ukunakwa nokungafisi — uma kwehla ama-ERN, kunethuba elikhulu lokuthi ubuchopho abuzukuqondisa ngokuzenzakalela ukuqonda okuyiphutha. Ababhali bacaphune izifundo ezibonisa ama-ERN aphansi ku-ADHD nokusetshenziswa kabi kwezidakamizwa, okukhombisa ukuthi iziguli zikuthola kanjani kunzima ukucindezela isifiso sokwamukela imivuzo yesikhashana naphezu kwemiphumela emibi yesikhathi eside. Ukunikela ngama-ERN aphansi ekushodeni ekusebenzeni okuphezulu, laba bacwaningi baphetha ngokuthi, "Imiphumela yalolu cwaningo ikhombisa ngokusobala ukuthi abantu abanomlutha we-Intanethi babephuthuma ukwedlula izilawuli futhi babelana ngezimpawu ze-neuropsychological ne-ERN zezinye izinkinga, njengokugembula kwe-pathological, ukusetshenziswa kwezidakamizwa…" [150] (iphe. 5). Yau, Potenza, Maye noCrowley [151] wasebenzisa i-Balloon Analogue Risk Task (BART), futhi wabika ukunganaki okuhlobene nokuphendula okungezansi (FRN) kanye ne-P300 amplitudes "kubasebenzisi be-intanethi abanobunzima" uma kuqhathaniswa nezilawuli. Ngokusho kwalaba bhali, ukuzwela okuncane ukuphendula ngesikhathi sokuthatha ingozi kungaholela ekusetshenzisweni okuqhubekayo naphezu kwemiphumela emibi. U-Dong, uZhou noZhao [152] izihloko ezihlolwe besebenzisa umbala we-Stroop umsebenzi, futhi zibike ukungabi nalutho okungezansi okungezansi (MFN) ezifundweni ze-IA uma kuqhathaniswa nezilawuli. Kanye neziphambeko eziningi zokuphendula, laba abalobi babike ukuthi lokhu kutholakala kusikisela umsebenzi owenziwe wehlisiwe, isici esabiwe sokulutha.

Ucwaningo olulodwa lwe-ERP luqhathanise ukucubungula-ukucubungula kwamageyimu wekhompiyutha ngokweqile kanye namageyimu wekhompiyutha engavamile. Ngokuhambisana nokufundiswa kwezidakamizwa, uThalemann, Wölfling noGrssss [153] wathola i-ERP ekhuphuke kakhulu-abadlali be-pathological excessive uma kuqhathaniswa nabadlali abavamile. Okokugcina, izifundo ezimbili zokuphumula ze-EEG zishicilelwe. Lezi zifundo zibike ukuthi izihloko ze-IA zinegunya elingaphansi kwamagatsha e-delta ne-beta uma kuqhathaniswa nezilawuli. Zombili izifundo zibonisa ukuthi lokhu kungezwani kungaba uphawu lwe-neurobiological ye-IA [154,155]. Ukuhlanganiswa ndawonye, izifundo ze-EEG zinikeza ubufakazi obengeziwe bokuthi labo ababhekana ne-IA bafana kakhulu nalabo ababhekene nezidakamizwa ngokweqhathaniswa nezilawuli.

I-3.2.3. I-Internet Gaming Disorder

IA ihlongozwa ngokomthetho ukuba ifakwe ku-DSM-5 izikhathi ezimbili, kanye kanye nokudlala njengenhlawulo, futhi kanye ngaphandle kwama-subtypes [17,34]. I-IGD, kodwa, ayizange ihlongozwe ngokomthetho ukuze ifakwe ku-DSM-5, ngakho ayizange ihambe ngenqubo yokubeka amazwana. Noma kunjalo, ngesikhathi sokugcina, i-APA inikeze ukufinyelela kwe-IGD Isigaba 3-Izifundo Zokuqhubeka Nokufundwa, ngenkathi IA ixoshwa. Kunomzimba ocwaningayo wophando mayelana nesihloko esithi "Inselele Yenthanethi", futhi kungase kube nzima ukukhipha ukuthi ngabe izifundo empeleni ziqondene ne-IGD, noma zimboze i-IA ngokujwayelekile ngokudlala njenge-subtype. Kuyaqondakala ukuthi izifundo zokudlala ziyi-subtype evame ukutadisha, iningi lokucwaninga nge-neuroscientific in the phenomenon of IA livela e-China naseNingizimu Korea, amazwe lapho i-IP igxiliwe khona, ngakho-ke ucwaningo nge-IPA alukho [156].

Lokhu kubuyekezwa kulandela iziphakamiso zokuqala, ngokucabangela ukugembula njenge-subtype ye-IA. Njengoba leli phepha ligxile kakhulu kwelinye i-subApe, i-IPA, ukunakwa okulinganiselwe kunikezwa i-IGD njenge-subtype noma i-disorder emele. Ngenxa yalokho, ukubika kwezifundo ze-neuroscience kokubili i-IA ne-IGD kuhlangene. Naphezu kwezimangalo zokucwaninga okulinganiselwe ngesihloko [12,16,46,47,157,158,159], ukuphazamiseka konyaka kobuchopho obuyisisekelo (ngaphandle kwezibuyekezo) ku-IA kanye ne-subtype yayo IGD kwenza kube sobala ukuthi izifundo zobuchopho ekusekeleni i-IA kule nsimu zikhula ngokushesha:

Ngaphambi kokuhlola kwe-2009-6,
Ucwaningo lwe-2009-4,
Ucwaningo lwe-2010-8,
Ucwaningo lwe-2011-9,
Ucwaningo lwe-2012-14,
Ucwaningo lwe-2013-19,
Ucwaningo lwe-2014-23, futhi
I-2015 (ngoJuni) -Izifundo ze-16.

Ihlukaniswe ngobuchwepheshe, lezi zifundo zobuchopho zihlanganisa izifundo ze-44 fMRI [103,132,134,135,160,161,162,163,164,165,166,167,168,169,170,171,172,173,174,175,176,177,178,179,180,181,182,183,184,185,186,187,188,189,190,191,192,193,194,195,196,197,198,199], Izifundo ze-MRI ze-23 [124,128,131,133,200,201,202,203,204,205,206,207,208,209,210,211,212,213,214,215,216,217,218], Izifundo ze-6 ze-nuclear (PET / SPECT) [117,129,219,220,221,222], Izifundo ze-15 ze-EEG [42,139,141,143,144,146,148,149,150,152,153,154,155,223,224], nezifundo zezinto eziphilayo ze-7 [121,138,225,226,227,228,229].

Lobufakazi obuningi be-neuroscience buhlinzeka ukwesekwa okuphoqelela ukuvuma izidakamizwa ezihlobene ne-intanethi njengezinkinga ezivumelekile. Ngaphezu kwalokho, ucwaningo luyaqhubeka luvela kwenye i-subtype ehlongozwayo yokuxilongwa kwezokuxhumana / i-facebook, kodwa lokhu ngokuvamile akusiyo izifundo ze-neuroscience ngakho-ke hhayi ngaphakathi kwalesi sihloko ukuze kubuyekezwe okuqhubekayo [100,104,171,230,231,232,233,234,235,236,237,238,239,240,241].

I-3.2.4. Ukuziphatha Ngokwemvelo Ngokucindezelayo

Childress et al. [242] baqhuba ucwaningo lapho bathatha khona ukuhlolwa kwe-fMRI yeziguli eziluthayo ze-cocaine ezinikezwe ngokushesha (i-33 millisecond), iziqephu ezibonakalayo ezingabonakali (izithombe ezihlobene nezidakamizwa). Izifundo ezifanayo kamuva zaboniswa izici ezibonakalayo zobulili ezihlotshisiwe (imifanekiso engabonakali). Abacwaningi bathola ukusetshenziselwa uhlelo olufanayo lwe-limbic system / umvuzo ezifundweni eziboniswe ngokobulili njengalapho kuboniswe izici ezihlobene nezidakamizwa. Ekubuyekezeni kwabo izincwadi zezinhlolo ze-neuroimaging zomjikelezo womuntu wobulili, uGeorgiadis noKrankelbach [243] kuphelile, "kucacile ukuthi amanethiwekhi ahileleke ekuziphatheni kocansi kwabantu afana ngokuphawulekayo namanethiwekhi ahilelekile ekusetshenziseni ezinye imivuzo" [243] (iphe. 74).

UFrascella, uPotenza, uBrown no-Childress [244] waqhuba ukubuyekezwa kwezincwadi ngokungafani nokuziphatha okuyisithathu okuqondene nokudakwa ngokweqile, ukugembula okufuze umzimba, ukukhuluphala ngokweqile, kanye nomshini wobulili. Abalobi banda ububanzi be-Childress et al. [242] ukutadisha, futhi waphetha izifundo zokucabanga zobuchopho ezisebenzayo zocansi, uthando lwezothando nokunamathiselwa kunikeza ubufakazi obanele bohlelo olwandisiwe kodwa olukhombekayo oluphakathi kwezinqubo zemivuzo zemvelo, ezingezona izidakamizwa nemisebenzi yokusinda… Ukugqagqana kwezindawo zomvuzo zakudala ezibandakanya ubulili, uthando nokunamathiselwa kuphelele (i-VTA, i-NAcc, i-amygdala, i-ventral pallidum, i-orbitofrontal cortex). Ukuqagela kuyafaneleka ukuthi kuhlobanisa imivuzo yemvelo esezingeni lokusinda nezidakamizwa ezidakayo, ukwandisa izindlela zobuchopho ezizobhekelelwa ekwelashweni, futhi kwandise ukuqonda kwethu ukuqina okudingekayo kokuziphatha [242] (iphe. 15).

Njengoba kushiwo ngaphambilini, imodeli ye-RDS ihlanganisa ukuziphatha okubi kobulili ohlwini lwezinkinga ezihlobene ne-RDS [245,246,247,248].

Igama elithi “Reward Deficiency Syndrome” laqanjwa okokuqala… ngo-1995, manje selichazwa yi-Microsoft Dictionary ngokuthi “Ubuchopho buklomelisa ukunganeliseki kwezakhi zofuzo noma ukukhubazeka okuholela ekuziphatheni okujabulisa injabulo okubandakanya izidakamizwa, ukudla okweqile, ucansi, ukugembula / ukugembula nezinye izindlela zokuziphatha ”.
[249] (iphe. 2)

Mhlawumbe umthamo omkhulu wezifundo ezibonisa ukuthi i-neurobiological isisekelo sokuziphatha ngokweqile ngokocansi njengoba kuhambisana nesimo somlutha kuhlanganisa i-factor factor DeltaFosB. Kuye kwasungulwa ukuthi izidakamizwa zokuhlukumeza iziphakamiso eziphezulu ze-factor factor DeltaFosB ohlelweni lokuvuza, okuholela ekuphenduleni okuthuthukisiwe ukuvuza nemivuzo ehambisanayo, ukuvuthwa okwenyuka ekubhekiseni izidakamizwa, nokukhubazeka okukhulu ekuziphatheni okucindezelayo futhi kubuya [2,73,250,251,252]. Qaphela ukuthi lo mkhakha wocwaningo kufanele usebenzise izilwane ezincelisayo ezingezona abantu, njengezinja, amagundane nama-hamsters, njengengxenye edingekayo yocwaningo kudinga ukuvuselela izihloko ukuze kufinyelele futhi kulinganiswe i-DeltaFosB engenawo amandla. Isibonelo, abacwaningi banezigundane eziguqulwa ngokwezakhi zofuzo ukuze bavuselele kakhulu i-DeltaFosB ohlelweni lokuvuza emazingeni afanayo kulabo abasebenzisa izidakamizwa ezidakamizwa. Uma ihanjiswa i-cocaine okokuqala, lezi zinja zibonisa ukuzwela komuthi futhi ziphendule futhi ziziphathe emikhuba efana naleyo yamagundane ayekade engumlutha ngokusebenzisa ukusetshenziswa okungapheli [253]. Ukuhlolwa okuningi okusebenzisa ama-Hamster aseSyria okuphathwe ukukhiqiza ngokweqile i-DeltaFosB igxile emiphumeleni yokuziphatha ngokobulili, futhi wathola ukuzwela okuthuthukisiwe okufanayo kumsebenzi wezocansi [254,255]. Wallace et al. [256] ngokwemvelo kwenza lokhu kuzwela emakhakheni we laboratory nge "ukuziphatha okungavamile ngokobulili". Laba balobi bathole isipiliyoni esiphindwe ngokocansi kakhulu kwandisa amazinga e-DeltaFosB ku-NAcc uma kuqhathaniswa nokulawula, nakuba amazinga okukhuphuka ayengaphansi kunezidakamizwa zokuhlukunyezwa. Pitchers et al. [257] ngokufanayo kufanekisela ukukhiqizwa kwamazinga aphezulu eDeltaFosB ku-NAcc, futhi ekutholeni lokhu kuphakama ukuthi kuhileleke ngokujulile emiphakathini yokuqinisa umvuzo wezocansi. Ukuhlola ukuhlanganiswa kwemiklomelo yemvelo nemithi, Pitchers et al. wathola amagundane ukuthi abe nokweluleka kwamamttamines ngemuva kokuhlangenwe nakho okuphindaphindiwe ngokocansi [258]. Laba balobi baphetha ngokuthi, "Okuhlangenwe nakho ngokocansi kudala ukuguqulwa okusebenzayo nokuziphatha okusemthethweni ohlelweni lwe-mesolimbic olufana nokuvezwa okuphindaphindiwe kuma-psychostimulants" [258] (iphe. 1). Pitchers et al. [2] ukuqinisekisile lokhu okutholakele, okubonisa ukuthi imivuzo yemvelo (ukuziphatha ngokocansi) kanye nezidakamizwa zokuhlukumeza (amphetamines) zenza ngendlela efanayo yokuhlelwa kwemivuzo, ngokuqhubekayo isekela ukuphikisana kwezidakamizwa zokuziphatha, kuhlanganise ne-IPA.

I-3.2.5. Izithombe ezingcolile ze-intanethi

Encwadini yakhe ehlonishwa kakhulu nge-neuroplasticity, I-Brain Eyaziguqula [259] UNorman Doidge wasifingqa ucwaningo olumayelana nokulutha umlutha kanye nesistimu yokuvuza, futhi wathi ukukhululwa kwe-dopamine ohlelweni lokuvuza uma umuntu ebuka ngokucophelela futhi engapheliyo izithombe zobulili ezingcolile ze-intanethi kuvuselela izinguquko ze-neuroplastiki ezenza kube lula. U-Doidge waqhubeka ukuchaza ukuthi lezi zinguquko ze-neuroplastic zakha kanjani amabalazwe obuchopho bokuzijabulisa ngokobulili. Wethula ingxenye eyengeziwe yokubekezelelana, lapho amabalazwe obuchopho obusungulwe ngaphambilini obuningi bokuthi ubulili "bemvelo" awakwazi ukuqhathaniswa namamephu asekusanda kuthuthukiswa futhi aqinisekisiwe aphethwe ukubuka okuphoqelekile ukubuka izithombe zobulili ezingcolile ze-intanethi, ngakho-ke umlutha uyathuthukela kwi-intanethi ecacile nangokomfanekiso izithombe zobulili ezingcolile ukuze kugcinwe izinga eliphezulu.

I-Neurosurgeons Hilton ne-Watts [260] washicilela ukuhlaziywa kwe-Journal Surgical Neurology International abayibamba ngokuthi "Ukulutha kobulili Ezingcolile: Umbono we-neuroscience". Ababhali banikeze ukubuyekezwa kwezincwadi ezincane okuvuselela ukuphikisana ukuthi konke ukubonakaliswa kokulutha komzimba kusebenza ngendlela efanayo. Abalobi babehlanganisa izifundo eziningi ezikhulunywe ngaphambili; indima yeDeltaFosB emilutha yemvelo, izinguquko ze-neuroanatomical ezibangelwa ukuziphatha ngokweqile, izinguquko ku-dopamine receptor mass, kanye nomthelela wokuziphatha ngokweqile ohlelweni lokuvuza. Ekuphenduleni kwabo ekuxhaseni ephepheni labo, i-Hilton ne-Watts echazwe ngokubaluleka kokuthatha umbono obanzi wezocwaningo ezikhona, ephetha ngokuthi, "Isizathu sethu ukuthi i-atrophy ekhethiwe yezindawo ezinama-cortical ehambisana nemikhuba yokuvuza ingabhekwa ekukhanyeni kwe-neuromodulatory, esinikezwe ucwaningo lwamanje oluqinisekisa ukungasebenzi kwezidakamizwa ngokweqile ngokwemvelo, ikakhulukazi ngokobulili "[261] (iphe. 6). U-Hilton ushicilele isibuyekezo sesibili nesinye esifanayo sezincwadi [24], futhi kugcizelele indima ebalulekile yocwaningo lweDeltaFosB njengoba kwazisa ukutadisha hhayi ngokobulili kuphela ngokujwayelekile kepha ububanzi obuningi bokusetshenziswa kwezithombe zobulili ezingcolile ze-intanethi.

Ucwaningo lokuqala lwe-FMRI olugxile ngokucacile ku-IPA lushicilelwe ku-2014, lapho kuqala uchungechunge lwezifundo zeCambridge University athola umsebenzi ofanayo wobuchopho njengoba kuboniswa izidakamizwa nezidakamizwa [262]. Kulolu cwaningo oluphawulekayo ukuhlolwa kwenziwa ukuhlolelwa ukulinganisa isipiliyoni esiphezulu se-cue-reactivity, kanye nabakaki be-neurobiological kanye nama-correlates, uma ekhona, atholakala kwizihloko ezinokuziphatha okucindezelayo ngokocansi (CSB). Qaphela ukuthi lolu cwaningo luhlanganisa imigqa emibili yokuphenya. Okokuqala, isifundo siphumelele ukuhlukana "okuthandayo nokufuna" kwe-CSB nezifundo ezingezona ze-CSB. Izihloko zaboniswa amavidiyo ngaphakathi nangaphandle kwesithwebuli se-fMRI. Isikhathi ngasinye, izihloko zacelwa ukuba zilinganise okuhlangenwe nakho kwazo okuzithobayo ngezinyathelo ezimbili eziqondile: "Lokhu kwanda kangakanani isifiso sakho sobulili?" Nokuthi "Uthanda kangakanani le vidiyo?" [262] (iphe. 3). Lo mkhakha wokutadisha unikeze imiphumela emibili ehlukile: (1) Uma kuqhathaniswa nezihloko zokulawula okunempilo, izihloko ze-CSB zibike izilinganiso eziphakeme ezifisweni kumavidiyo acacisayo ngokobulili, kodwa hhayi emaceleni omculo; (2) Uma kuqhathaniswa nokulawula okunempilo, izihloko ze-CSB zibike ukulinganisa okuphakeme kokulinganisa kumavidyo ahlukumezayo, kodwa hhayi ezichazweni ezicacile. Le miphumela ikhombise ukuhlukaniswa phakathi kokuthanda nokufunwa yizihloko ze-CSB uma ubukela amavidiyo acacile ngocansi. Le miphumela yabe yichaza imiphumela yezifundo ezisekelwe kahle embonweni wokukhuthaza ukulimala, lapho izidakamizwa zibika amazinga aphezulu okufunayo kepha hhayi ngokufanisa imivuzo yabo ephawulekayo.

Indawo yesibili eyinhloko yophenyo equkethwe kulolu cwaningo libhekisela emiphumeleni yokuzicabangela kokuziphatha ngokobulili (CSB), ikakhulukazi izithombe zobulili ezingcolile ze-intanethi. Ucwaningo olwandulelayo luye lwabonisa ukuthi izifunda ezibucayi ezivame ukuvuthwa ngesikhathi sokudinga nokusebenzisa izidakamizwa-ukuvuselela utshwala, i-cocaine ne-nicotine; phakathi kwabanye, i-amygdala, i-DACC, ne-ventral striatum [263]. Ngesikhathi abacwaningi esifundweni samanje bethola ukuthi lezi zifunda ezifanayo zizosetshenzwa ngaphakathi kokubili izifundo ze-CSB nezinsizakalo ezingekho CSB uma kuboniswa izinto ezicacile zobulili, abacwaningi bathole ukusebenza okuphezulu kulezi zihloko ze-CSB. Ngokusekelwe kule miphumela, i-Voon et al. [262] waphetha:

Ukuthola okukhona kwamanje futhi okukhona kuphakamisa ukuthi inethiwekhi evamile ikhona ekusebenzeni ngokocansi nokuqaphela izidakamizwa ngamaqembu nge-CSB nezidakamizwa zezidakamizwa, ngokulandelana. Lokhu kutholakala kubonisa ukuthi kudlulela kumanethiwekhi athola ukuphazamiseka kokusetshenziswa kwezidakamizwa zezidakamizwa kanye nemivuzo yemvelo ".
[262] (iphe. 9)

Ngokusobala, laba baphandi baphinde bathi i-60% yezifundo (iminyaka yobudala: iminyaka engu-25) inzima ekufezeni ukulungiswa / ukuvuswa nabalingani bangempela, kodwa okwamanje kungafinyeleleka ukulungiswa kwezithombe zobulili ezingcolile ze-intanethi. Qaphela ukuthi lokhu okutholayo kuvumelana nemiphumela yangempela yocwaningo lwamuva olutshela ukuthola okunye [264].

UKühn noGallinat [263] uqhube isifundo se-MRI ngezifundo zesilisa ezingamashumi ayisithupha nane ezinezempilo (non-CSB) kanye namahora afanayo wokubukwa kwe-intanethi kwezinto ezicacile ngesonto kanye neminyaka yokusebenzisa ngokuhlelwa kwesakhiwo nokuxhuma. Imiphumela emithathu eyinhloko yabika. Okokuqala, ubude obude kanye namahora amaningi ngesonto lokusetshenziswa elihambisana nomthamo we-grey ophansi ku-caudate efanele. Ngenkathi i-caudate ikhonza imisebenzi eminingi eyinkimbinkimbi, izinguquko zomsindo ku-striatum zihlotshaniswa nezilingo eziningana, kanti ukuqondiswa kokushintsha akuhambisani. Okwesibili, iminyaka engaphezulu namahora amaningi ngesonto lokusetshenziswa lihambisana nomsebenzi we-putaminal ongakwesokunxele ekuphenduleni izithombe ezincane, ezisezocansi. Ucwaningo lwe-FMRI luqinisekisile ukuthi i-putamen ivuliwe ngesikhathi sokuvuswa kocansi [265,266]. Abalobi basikisela ukuthi leli volumu elingaphansi lingabonisa ukubekezelelana okulethwe ngokungafuni ukuhlaziya: "Lokhu kuvumelana nalokho okushiwo ukuthi ukuvezwa okukhulu kwezithombe zobulili ezingcolile kubangela ukwehliswa kwempendulo yemvelo ye-neural kwisenzo socansi" [236] (iphe. E6). Unikezwe impendulo enamandla kumavidiyo wevidiyo we-9-second ecacile ku-Voon et al. [262], kungenzeka ukuthi lokho okufutshane (i-530 milliseconds) ukuvezwa kwezithombe ezinamanje akuyona into ebheka ababukeli bevidiyo ye-porno yanamuhla, futhi esikhundleni salokho kuyindlela enhle yokukala ukusabela kokuya ocansini. Ngaphandle kwalokho, abangewona umlutha lapha abahlolwayo bangase baphendule ngokuhlukile kunokuba abayilutha babe nayo. Okokugcina, izihloko ezazithengisa izinto ezingcolile zobulili zitholakala ukuthi zinokuxhumana okuncane phakathi kwe-caudate efanele ne-left dorsolateral prefrontal cortex (DLPFC). Ngenkathi i-DLPFC ibhekene nemisebenzi ephezulu, ibuye ihlotshaniswe nokucutshungulwa kwezidakamizwa nokudlala kwe-intanethi. Ukuphazamiseka kulesi sigaba kubandakanya izidakamizwa nezidakamizwa. Ngokuqondile, ukuxhumana okungasebenzi okuphakathi kwe-DLPFC ne-caudate (njengoba kutholakala esifundweni samanje) kufakwa ku-heroin ukulutha [267].

Izintshumayelo eziningi ezibonisa amakhophi angase azayo ku-neurobiology ye-IPA zanikezwa kwi-2015 2nd International Conference mayelana nokuziphatha kwezidakamizwa eBudapest, eHungary. Qaphela ukuthi konke lokhu kuyinkambinkimbi yenkomfa futhi ayingakashicilelwa kumaphephandaba abuyekezwa kontanga. Banikeza ubufakazi obengeziwe, noma kunjalo, ukuthi kukhona ucwaningo olukhula ngokushesha. Isibonelo, i-Gola, i-Wordecha, i-Sescousse, i-Kossowski ne-Marchewka [268] okwethulwe ekutadisheni kwabo kwe-FMRI yabantu abane-pornography e-intanethi eqondile ye-CSB. Laba baphandi balandela isibonelo sokutadisha [269], lapho abacwaningi bathola ukuzwela okwedlulele ekuphenduleni izikhala zomlutha (kulinganiswa ngezikhathi ezithinta ukusabela) nokuphendula okungenangqondo emgodini we-ventral lapho kuboniswa amagama angewona umlutha. Esifundweni sabo, Gola et al. uthole imiphumela efanayo efana; Izihloko ze-CSB zibonise kakhulu ukuzwela emaceleni okulutha (i-eerotic) uma kuqhathaniswa nezilawuli, kodwa azitholanga impendulo engafanele emaceleni angewona umlutha. Esifundweni esifanayo se-fMRI, uBrith, iGrabenhorst, Snagowski, Laier noMaderwald [270] wathola abesilisa abesilisa abesilisa nabesifazane ukuba babe nokwanda komsebenzi wokuhlaselwa kwezemvelo ngokuphendula imifanekiso yezithombe zobulili ezingcolile. Ngaphezu kwalokho, ukwanda komsebenzi okuhambisana nezinga lezikhalazo ezizithobayo ngenxa yokulutha kwezidakamizwa ze-Internet. I-Wehrum-Osinsky, i-Klucken ne-Stark [271] kubike ucwaningo olufanayo lwe-fMRI olwenziwe ngezihloko ze-20 ezibika ukusetshenziswa kakhulu kwe-pornography ukusetshenziswa kwe-20 nezihloko zokulawula. Nakuba imininingwane ecacile yokutadisha kwabo ayifakiwe kwi-abstract yabo eyashicilelwe, laba abalobi babike ukuthi "ukuguqulwa kwesiguli sezocansi esigulini uma kuqhathaniswa neqembu lokulawula" [271] (iphe. 42).

Nakuba kunezinzwa eziningi ze-neuropsychological kune-neurobiological, ucwaningo oluningi luye lwaphenywa ngemithelela ye-inthanethi yezithombe zobulili ezingcolile ekubukeni kwemisebenzi yokucabangela. Leli chungechunge lokuphenywa lihambisana nephepha lamanje ngoba izindlela zokuhlinzeka nge-neurobiological ezisemsebenzini we-neuropsychological ziye zasungulwa kahle. Isibonelo, Fineberg et al. [272] yanyathelisa ukubuyekezwa okulandayo lapho behlola ukusebenzisana phakathi kokuthola okutholakala nge-neuroscience. Emisebenzini yabo, laba abalobi banikeze itafula lapho bebeka khona imephu yezizinda ezingenayo i-neurocognitive (izinhlobo ezahlukene zokungafuni nokucindezela) ezifunyenweni ze-neuroanatomical neurochemical. Ukusebenzisa i-GD njengesibonelo, laba abalobi bahlanganisa izakhiwo ze-neural ezifana ne-orbitofrontal cortex (OFC) nokuxhumeka kwe-subcortical nge-neurotransmitters efana ne-serotonin ne-serotonin / i-dopamine (ngokulandelana), njengoba kunqunywe yimisebenzi elinganisa imisebenzi yokucabangela njengokuthatha izinqumo kanye nesikhathi sokuphendula . Ngokufanayo, ekubuyekezweni kwabo okubalulwe ngenhla, Fineberg et al. [78] babike ukuthi ukutholakala kwabo "kuhlangene nalabo abavela ekuhloleni okungenangqondo kwabantu ababhekene nokugembula nokusetshenziswa kotshwala lapho izinkampani zombili zibonisa ukungathandeki okukhulu, kodwa iqembu elixhomeke kuleso siphuzo liye labonisa ukukhubazeka ekucabangeni okusebenzayo okubandakanya ukubandakanya okukhulu kwe-DLPFC" [78] (iphe. 15). Njengalokhu, sikholelwa ukuthi ukubika okulandelayo ukuhlolwa kwezinzwa zokuhlola ukuphazanyiswa kokucubungula amacansi ocansi kanye nokuvuswa kocansi nemisebenzi yokuphatha kusebenza ngokuqondile kulokhu kuhlolwa kwezifundo zesayensi yobuchopho kugxile inkinga ye-IPA.

Izinkambiso eziningana nama-paradigms okuhlola asetshenziselwe ukuchaza nokuphenya imisebenzi ephezulu [273]. Ngokuvamile, ukuphatha okusebenzayo kuchaza ukusebenzisana okuyinkimbinkimbi phakathi kwezizinda eziningana ezicatshangelwayo ukuze kuqondiswe ukuziphatha okuqondiswe umgomo, isib. Ukugxila, ukwaziswa okuvimbela (okungafaneleki), ukuguqula ulwazi olufanele (olufanele), ukuhlela, ukuqapha, kanye nokwaziswa kwenkomba kwimemori yokusebenza [274,275] okungathinteka futhi kuphazanyiswe izinqubo ezingokomzwelo [273]. Ngokuqondene nama-neural correlates wemisebenzi ephezulu yaboniswa ukuthi ngokuvamile babesendaweni ye-prefrontal cortex, kodwa bahluka phakathi kwezici ezilodwa zemisebenzi ephezulu [276,277,278]. Ucwaningo lwe-Neuropsychological and neuroimaging ngezidakamizwa ezidakamizwa lubonise ukuthi i-prefrontal cortex nemisebenzi ephezulu ayiphumelelanga ngemuva kokusetshenziswa kwezidakamizwa [46,279]. Lokhu kwacatshangelwa ukuchaza ukuphathwa kwezidakamizwa eziphindaphindiwe kanye nokuthandwa okwesikhathi esifushane ngenxa yesidakamizwa naphezu kwemiphumela emibi elandela ukusetshenziswa kwezidakamizwa [280].

Phakathi nokuthuthukiswa kwezimo zobulili eziluthayo kwi-intanethi kwakucatshangwa ukuthi ukulindela nokwamukela ukuzithokozisa kudlala indima ebalulekile [281], ngoba ukuvusa ngocansi kuqinisa kakhulu [241,279]. Ngokweqile, kuboniswe ukuthi ukusabela kocansi ekuphenduleni izithombe zobulili ezingcolile ku-intanethi kwakuhlobene nokuqina kwesifo se-IPA kubantu abesilisa nabesifazane abesilisa nabesilisa kanye nabesilisa abangqingili [282,283,284,285] futhi abasebenzisi be-IP abanezinkinga baphendule ngokukhanga okukhulu okuzithobayo uma kuqhathaniswa nabasebenzisi abasebenzisa i-cyber bephilile lapho bebhekene nendaba ye-pornography e-intanethi [286]. Kuye kwaboniswa ngokuqhubekayo ukuthi izinhlangano ezinobungozi obuhle njengoba zilinganiswa yi-Implicit Association Task eshintshwe ngezithombe zobulili ezingcolile [287] futhi ngaphezu kwalokho, ukuthambekela kokugwema nokugwema [288] zixhunyaniswa nezimpawu ze-IPA. Ngokusekelwe kulokhu okubonwayo, imodeli yezokwelapha eziqondile ze-inthanethi ehlongozwa nguBrand et al. [15] kusanda kubalulwe ukusetshenziswa kokusebenzisa i-inthanethi (kufaka phakathi i-IP) [289].

Reid, Karim, McCrory noMbazi [290] wathola ukuhlukumeza okuphezulu okubikiwe okukhulunywe ngawo kwisampuli yeziguli ezingcolile, esinye isifundo asifumananga ukukhubazeka okujwayelekile kwemisebenzi ephezulu esetshenziswa ngokuhlolwa kwezivivinyo [i-neuropsychological [291]. Kodwa-ke, izifundo eziningana zibike ukuphazanyiswa kokucubungula izici zocansi kanye nokuvuswa kocansi nemisebenzi ephezulu. Ukulahlekelwa ekubonweni okubukwayo okubangelwa ukuboshwa okubangelwa ukukhwabanisa okubonakalayo kuboniswe kwizifundo besebenzisa umsebenzi wokwenza isikhathi sokuphendula [292], umbono wokuqondisa ngokushesha [293], nomsebenzi wokuthola ichashazi [294,295,296]. Ukuphazamiseka kwamandla wokuvimbela kuboniswe ekutadisheni ngokusebenzisa imisebenzi ye-Go / No-go ngezithombe ezingahambisani nezocansi futhi kubonise ukuthi abantu abanezizathu eziphakeme zokuzibandakanya ngokocansi nokuzikhandla okukhulu babonisa ukusebenza okubi kakhulu komsebenzi [297].

Ngokuvumelana nalokhu ngenhla, i-Laier, i-Pawlikowski ne-Brand [298] wasebenzisa i-Iowa Yokugembula Umsebenzi oshintshiwe ngezithombe zobulili ezingcolile futhi wathola ukuthi ukuvota ngokocansi esimweni sokwenza izinqumo kungaphazamisa ukucubungula impendulo nokuthatha izinqumo eziwusizo. Ngokufanayo, ukuvuvukala ngokocansi okubangelwa izithombe ezingcolile zobulili ezingasebenzi kahle embukisweni we-4-back [299] kanye nokushintsha nokuqapha ukusebenza kwipharadimm ephezulu yokuphatha okuningi [300]. Ukutholakala kokukhathazeka okubhekiswe kulokho okukhulunywe ngakho ngokobulili kwakucacisiwe futhi kuboniswe ukuthi kuthuthukiswe kwisampula yabantu abenza ucansi [301]. Lokhu kuvumelana nesiphakamiso semfundiso yokuthi imisebenzi ephezulu kufanele ithinteke ezimweni lapho abantu abhekene neziqu ezihlobene nokulutha umlutha ezikhuthaza ukufuna ukuthanda [15]. Ucwaningo olulodwa lwalusebenzisa i-EEG ngenkathi abahlanganyeli benza umbhoshongo we-Tower of Hanoi kanye neWisconsin Card Sorting Test futhi babheka amavidiyo angathathi hlangothi nongenangqondo [302]. Emiphumeleni, akukho umehluko ekusebenzeni komsebenzi okwakucatshangwa uma kuqhathaniswa nezimo zevidiyo, kepha ukuhlukaniswa kwe-prefrontal yokuhlukanisa kubonwe phakathi kwemisebenzi emibili esimweni sevidiyo esibucayi. Abalobi bachaza ukuthi ukuvota kocansi kwaphazamisa ukusebenza komqondo kodwa umsebenzi wokusebenza awuzange wehle ngenxa yokuzivumelanisa nokusebenza ngesikhathi sokusebenza, okungahle kuphazamiseke ekukhulekeleni izimo ezitholakalayo ekulweni.

Ucwaningo lwe-EEG kulabo abakhononda ngezinkinga eziqondisa ukubuka kwabo kwezithombe zobulili ezingcolile ze-intanethi kubike ukubuyiswa kwe-neural kwisenzo socansi [303]. Ucwaningo lwenzelwe ukuhlola ubuhlobo phakathi kwe-ERP amplitudes uma ubuka izithombe ezingokomzwelo nezomzimba kanye nezinyathelo zombuzo wobulili obucansi kanye nesifiso socansi. Abalobi baphetha ngokuthi ukungabikho kwemibono phakathi kwezibalo eziphathelene nemibuzo ye-hypersexual futhi kusho ama-amplitudes e-P300 uma ubuka izithombe zobulili "ukwehluleka ukuhlinzeka ngokusekelwa kwama-hypersexual pathological"303] (iphe. 10). Kodwa-ke, ukungabi khona kwemibono kungachazwa kangcono yiziphambeko eziphikisanayo endleleni. Isibonelo, lolu cwaningo lusetshenziselwa izidakamizwa eziphathekayo (abesilisa nabesifazane, kuhlanganise no-7 abangewona abesilisa nabesifazane). Ucwaningo lwe-Cue-reactivity ngokuqhathanisa ukuphendula komqondo kwezidakamizwa ekulawuleni okunempilo kudinga izifundo ezizimele (ubulili obufanayo, ubudala obufanayo) ukuze kube nemiphumela evumelekile. Ngokucacile ekufundiseni izidakamizwa ze-porn, kusungulwe kahle ukuthi abesilisa nabesifazane bahluke ngokujulile ebuchosheni nasezimpindeni ezizimele ezifanisayo zobulili ezibukwayo [304,305,306]. Ukwengeza, imibuzo emibili yokuhlola ayiqinisekisiwe kubasebenzisi abasebenzisa i-IP abanomlutha, futhi izihloko azange zihlolwe ezinye izibonakaliso zokudakwa noma ukukhathazeka kwemizwa.

Ngaphezu kwalokho, isiphetho esichazwe ku-abstract, "Impikiswano yokuqonda ubulili obufanayo njengesifiso esikhulu, kunokukhathazeka, kucatshangelwa" [303] (i-1) kubonakala kungekho lapho kucatshangelwa ukuthi isifundo sithola ukuthi ukuphakama kwe-P300 kwakungavumelani kabi nesifiso sobulili nomlingani. Njengoba kuchaziwe ku-Hilton (2014), lokhu okuthola "ngokuphambene ngokuqondile nokuchazwa kwe-P300 njengesifiso esiphakeme" [307]. Ukuhlaziywa kukaHilton kuveza ukuthi ukungabikho kweqembu lokulawulwa nokuhluleka kobuchwepheshe be-EEG ukubandlulula phakathi "nesifiso sobulili obuphezulu" nokuthi "ukuphoqeleka ngokobulili" kwenza uSteele et al. okutholakele okungenakuqondakala [307].

Okokugcina, ukutholakala okuphawulekayo kwephepha (ukuphakama okuphezulu kwe-P300 ezithombeni zobulili, ngokuphathelene nezithombe ezingathathi hlangothi) kunikezwa ukunakwa okuncane engxenyeni yengxoxo. Lokhu kungalindelekile, njengoba ukutholakala okuvamile ngezidakamizwa nezidakamizwa ze-intanethi ukuphakama kwe-P300 okuhlobene nokungahambisani nokungathathi hlangothi lapho kuvezwa emibonweni ebonakalayo ehambisana nokulutha kwayo [308]. Eqinisweni, Voon, et al. [262] banikeze ingxenye yengxoxo yabo ehlaziya lokhu okutholwe ukufundwa kwe-P300. Voon et al. uma kunikezwa incazelo yokubaluleka kwe-P300 enganikezwa ephepheni le-Steele, ikakhulukazi ngokuqondene namamodeli wokulutha, okuphetha,

Ngakho-ke, kokubili umsebenzi we-DACC ocwaningweni lwe-CSB wamanje nomsebenzi we-P300 abike kusifundo se-CSB sangaphambilini [303] kungabonisa izinqubo ezifanayo zokubamba iqhaza. Ngokufanayo, kokubili izifundo zibonisa ukuhlangana phakathi kwalezi zinyathelo ngesifiso esithuthukisiwe. Lapha siphakamisa ukuthi umsebenzi we-DACC uhambelana nesifiso, okungase kubonise inkomba yokulangazelela, kodwa akuhambisani nokuthanda okusikisela ekutheni umthamo wokulutha umfutho we-incentive-salience.
[262] (iphe. 7)

Ngakho ngenkathi laba balobi [303] bathi ukutadisha kwabo kuphikisana nokusetshenziswa kwesimiso sokulutha kwezidakamizwa ku-CSB, Voon et al. kwafakazela ukuthi laba abalobi banikeze ubufakazi obusekela lo mfanekiso.

Olunye ucwaningo lwe-EEG olubandakanya abalobi abathathu abafanayo olusanda kushicilelwa [309]. Ngeshwa, lolu cwaningo olusha lubhekene nezinkinga eziningi ezifanayo zendlela yokwenza ngendlela efanayo ngaphambili [303]. Isibonelo, sisetshenziselwe i-pool ephathekayo yezihloko, abacwaningi basebenzisa ama-questionnaires angahlolwayo angazange avunyelwe abasebenzisi be-pornography abasebenzisa i-intanethi ye-intanethi, futhi lezi zihloko azizange zihlolwe ezinye izibonakaliso zokudakwa noma ukukhathazeka kwemizwa.

Esifundweni esisha, uPrause et al. kuqhathanisa umsebenzi we-EEG wababukeli abaningi bezithombe zobulili ezingcolile ze-intanethi kanye nokulawula njengoba bebheka kokubili izithombe zocansi nezingathathi hlangothi [309]. Njengoba kulindeleke, ukuphakama kwe-LPP ngokuphathelene nezithombe ezingathathi hlangothi kwandiswe kuwo wonke amaqembu, nakuba ukukhuphuka kwe-amplitude kwaba mncane kwizihloko ze-IPA. Ukulindele ukuphakama okukhulu kwababukeli abaningi bezithombe zobulili ezingcolile ze-intanethi, abalobi bathi, "Leli phethini libonakala lihlukile emifanekisweni yokulutha izidakamizwa".

Ngenkathi ama-amplitudes amakhulu e-ERP ekuphenduleni izigwegwe zokulutha izidakamizwa ezihlobene nezithombe ezingathathi hlangothi kubonakala ekufundiseni izidakamizwa, ukutholakala kwamanje akulindelekile, futhi kuhambelana nokufundwa kukaKühn noGallinat [263], othole ukusetshenziswa okuningi okuhlobene nokusebenza kakhudlwana kobuchopho ekuphenduleni izithombe zobulili. Engxenyeni engxoxweni, abalobi bakhulume uKühn noGallinat futhi banikeza ukujwayela njengenkcazelo evumelekile yephethini elingaphansi le-LPP. Okunye okushiwo nguKühn noGallinat, noma kunjalo, ukuthi ukugqugquzela okukhulu kungase kubangele izinguquko ze-neuroplastic. Ngokucacile, izithombe ezingcolile zobulili ezingcolile zisebenza ngokuhambisana nomthamo wezinga eliphansi e-dorsal striatum, ukuvuvukala ngokocansi okuhambisana nesisusa [265].

Kubalulekile ukuqaphela ukuthi okutholakala kuPrause et al. babekwehlukile kulokho ababekulindele [309]. Omunye angalindela ababukeli abavamile bezithombe zobulili ezingcolile zobulili ze-intanethi ukuba babe nama-amplitudes afanayo e-LPP ekuphenduleni ukufinyeleleka okufutshane ezithombeni zocansi uma ukusetshenziswa kwezingane ezingcolile zobulili ezingcolile kuyi-Internet akuzange kube nomphumela. Kunalokho, ukuthola okungalindelwe kukaPrause et al. [309] ukusikisela ukuthi ababukeli abaningi bezithombe zobulili ezingcolile ze-intanethi bajwayele ukujwayela izithombe. Omunye angase afane ngokulinganayo nalokhu ekubekezeleni. Ezweni lanamuhla lokufinyeleleka kwe-Inthanethi ngokusheshisa, kungenzeka ukuthi abathengi abaningi abasebenzisi be-pornography be-intanethi babheka amafilimu namavidiyo ocansi ngokuphambene namacici okwamanje. Amafilimu ezocansi akhiqiza ukuvusa okungokwenyama nokuzicabangela kunezithombe zocansi [310] nokubuka amafilimu ezocansi kubangela inzalo encane nokuphendula ngokocansi kwezithombe zocansi [311]. Ukuhlanganiswa ndawonye, i-Prause ne-al., No-Kühn no-Gallinat ziholela ekuphethweni okunengqondo ukuthi ababukeli abaningi bezithombe zobulili ezingcolile ze-intanethi badinga ukuvuselelwa okubukeka okukhulu ukuze baphendule izimpendulo zobuchopho ezifana nokulawulwa okunempilo noma abasebenzisi be-porn abalinganiselayo.

Ngaphezu kwalokho, isitatimende sikaPrause et al. [309] ukuthi, "Lezi yizibalo zokuqala zokusebenza zomuntu ezibika izinkinga zomthethonqubo we-VSS" kunenkinga ngoba ibheka uphenyo olushicilelwe ekuqaleni [262,263]. Ngaphezu kwalokho, kubalulekile ukuphawula ukuthi enye yezinselelo ezinkulu ekuhloleni izimpendulo zobuchopho ekubhekeni kwezidakamizwa ezingcolile kuyi-Internet ukuthi ukubuka isenzo socansi kuyindlela yokulutha. Ngokuphambene nalokho, izifundo zokucubungula-ukucubungula ezidakamizwa ze-cocaine zisebenzisa izithombe ezihlobene nokusetshenziswa kwe-cocaine (imigqa emhlophe esibukweni), kunokuba izihloko empeleni zisebenzise i-cocaine. Njengoba ukubukwa kwezithombe zobulili namavidiyo kungukuziphatha okuluthayo, izifundo zokuvuselelwa kobuchopho esikhathini esizayo kubasebenzisi bezithombe zobulili ezingcolile ku-Inthanethi kumele ziqaphe kokubili ukuklama nokuhlola kwemiphumela. Isibonelo, ngokuphambene nokuvezwa okwesibili kwemifanekiso esasetshenziswa yi Prause et al. [309], Voon et al. wakhetha amavidyo kliphu we-9-sesibili ekuqalisweni kwawo kwe-reactivity paradigm ukuze afane ngokulingana ne-Internet porn stimuli [262]. Ngokungafani nokuvezwa okwesibili kwemifanekiso emanje (Prause et al. [309]), ukuvezwa kwevidiyo ye-9-yesibili kwaholela ekusebenzeni okukhulu kobuchopho kubabukeli abanobucayi bezithombe zobulili ezingcolile kuyi-internet kunokuba ukuvezwa kwe-one-second imifanekiso yamanje. Ngokuqondene nokuthi abalobi babhekisela ekutadisheni kukaKühn noGallinat, bakhululwa ngesikhathi esifanayo nesifundo seVoon [262], nokho abazange bavume iVoon et al. funda noma yikuphi ephepheni labo naphezu kokubaluleka okubalulekile.

I-4. Iziphetho

Lesi sibuyekezo siphenya ngomzimba wamanje wolwazi lwesayensi mayelana nezinqubo ze-neural zokulutha ngokweqile ngokuphathelene nezindawo ezibanzi zezinto eziphathekayo nokuziphatha njengokubheja, ubulili kanye nokusetshenziswa kwe-intanethi, kanye nocwaningo olutholakalayo lusekela izici ezithile zokuziphatha kanye nama-subtypes. Iningi lezifundo zasebenzisa izinyathelo ze-neuroimaging, ama-EEG, noma izilinganiso zomzimba, nakuba ezinye izifundo zasebenzisa izinyathelo ze-neuropsychological. Intambo evamile yukuthi bonke basebenzise idatha ye-neural yokubopha umlutha wokuziphatha okubandakanya ukuziphatha okubonakalayo okuhlobene ne-intanethi yokulutha (kanye ne-subtypes) ngokukhethekile, kwi-neuroscience eqinisiwe kahle "ekusebenziseni kabi izidakamizwa". Umphumela wenhlawulo wale mphenyo wanikeza inqwaba enkulu yezifundo ze-neuroscience ezisekelwe ekusetshenzisweni kwesimiso sokulutha umlutha ekuziphatheni okuphathelene nomlutha we-Inthanethi.

I-ASAM isho ngokusobala ukuthi konke ukubonakaliswa kokulutha kungokwemiphumela ejwayelekile ebuchosheni, hhayi umehluko ezintweni noma kokuqukethwe noma ekuziphatheni. Ngakho-ke, ngokuya ngalokhu kanye nokutholakele okubuyekeziwe ngaphakathi kwaleli phepha, kunzima ukufakazela ukungavumi okucacile kwe-APA kokunye ukuziphatha kwe-intanethi okuphoqelelwe (“Ukusetshenziswa ngokweqile kwe-Intanethi kungabandakanyi ukudlala imidlalo ye-inthanethi (isb. Ukusetshenziswa ngokweqile kwezokuxhumana, njenge-Facebook; ukubuka izithombe zocansi ku-inthanethi)) akubhekwa njengokufana nenkinga yokudlala i-inthanethi… ”[12] (iphe. 797). Ngalesi sici, ukubuka i-IP ngokweqile nokudlala imidlalo ye-intanethi ngokweqile kuyahluka kakhulu, naphezu kokweqa okukhulu ekusebenziseni uhlelo lomvuzo lobuchopho, futhi naphezu kokubonakala kombukiso wezimo ezifanayo zokuziphatha kwengqondo nemiphumela yengqondo. Lokhu, "okungahambisani nokuziphatha okungahambisani" [24] (iphe. 5).

Ukungaboni kahle kokulutha kwemithi ngokweqile kungabonwa nakakhulu esigabeni se-DSM-5 sika Diagnostic Izici se-IGD:

Isici esibalulekile sokuphazamiseka kwemidlalo ye-Intanethi ukubamba iqhaza okuphikelelayo nokuphindaphindayo emidlalweni yamakhompiyutha, imidlalo yamaqembu, amahora amaningi. Le midlalo ifaka ukuncintisana phakathi kwamaqembu wabadlali… ukubamba iqhaza emisebenzini eyakhiwe eyinkimbinkimbi efaka isici esibalulekile sokuxhumana komphakathi ngesikhathi sokudlala. Izici zethimba zibonakala ziyisisusa esiyinhloko.
[12] (iphe. 797)

Ngokusekelwe kulolu logic, ukusebenzisa kabi izinto ebhasini noma emcimbini kungabangela ukuhlukumeza izidakamizwa, kodwa ukuxhaphaza izinto ngesikhathi esisodwa kungenjalo. Ukuze wenze ukufaniswa okuhlobene ne-intanethi, le logic ibonisa ukuthi umuntu odlala iWorld of Warcraft ngokweqile uyadakwa, kepha othile odlala i-Candy Crush ngokweqile akuyona. Lokhu kubuyekezwa kubonisa ubufakazi obunamandla obuphathelene ne-neuroscience ngokubuka ukuziphatha okuhlobene ne-intanethi, kuhlanganise nokusetshenziswa kwe-IP, njengokungalimaza, okufanele kucatshangelwe lapho kuxoxwa ngezigaba ze-IPA.

Iminikelo Yomlobi

Uthando luka-Todd lwakha lo msebenzi, lwaqhuba ukubuyekezwa kwezincwadi, futhi lwabhala ipheshana eliyinhloko. UChristian Laier noMatthias Brand babenezela ngokuyinhloko kulo mbhalo wesandla, babhala izingxenye zombhalo wesandla, futhi bahlaziya umbhalo wesandla. U-Linda Hatch unikeze isandla ekwakheni futhi echaza imibono jikelele evezwe, futhi yasize ngokuhlelwa kombhalo. URaju Hajela ubuyekeze futhi wahlela isayensi yezokwelapha, wanikela ngokweqile, futhi wasiza ngokuhlela umbhalo. Bonke abalobi bavumile umbhalo wesandla.

Abalobi bathi akukho mpikiswano yenzuzo.

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