I-PATHOS: Isicelo esifingqiwe sokuhlola ukulutha kocansi (2012)

J Addict Med. Umbhalo wesandla; kutholakala ku-PMC 2013 Mashi 1.

Ishicilelwe efomini lokugcina ehleliwe njenge: J Addict Med. I-2012 Mashi; 6(1): 29-34.

doi:  10.1097/ADM.0b013e3182251a28

UPatrick J. Carnes, Ph.D.,1 UBradley A. Luhlaza, Ph.D.,2 Lisa J. Merlo, Ph.D., MPE,3,4 I-Alexis Polles, MD,5 Stefanie Carnes, Ph.D.,6 futhi UMark S. Igolide, MD3

abstract

Ukuluthwa ngokocansi kulinganiselwa ukuthi kufinyelela kubantu abangu-3-6%. Kodwa-ke, odokotela abaningi abanazo izindlela ezicacile zokuthola amacala angaba khona.

Izinhloso

Ucwaningo olwalukhona lwenziwa ukuhlola ukusebenza ngempumelelo kwensiza yokuhlola umlutha ngokocansi (isb., Imibuzo yePATHOS) ukuhlukanisa iziguli ezilashelwa umlutha wobulili kanye namavolontiya anempilo.

izindlela

Ku-Study One, kwahlolisiswa imibuzo enezinto eziyisithupha esebenzisa i-mnemonic "PATHOS" maqondana nokuzwela kanye nokucacisa kusetshenziswa isampula elihlanganisa iziguli ezilashelwa umlutha wobulili namavolontiya anempilo (iziguli ze-970 / 80.2%; i-938 abesifazane / i-63.8% iziguli). Ku-Study Second, isampula yokuqinisekisa ukusebenza kwe-672 men (iziguli ze-93%) kanye nabesifazane be-241 (iziguli ze-35.3%) bagcwalise isikrini se-PATHOS.

Imiphumela

Imiphumela yokuhlaziywa kwe-ROC eSifundweni sokuqala ikhombise ukuthi abakwaPATHOS babamba i-92.6% yendawo engaphansi kwekhola, futhi bathola ukuzwela kwe-88.3% kanye nokucaciswa kwe-81.6% yokuhlukanisa isampula yabesilisa (n = 963) njengeziguli nezifundo ezinempilo zisebenzisa ukusikwa isikolo se3. Ngokufanayo, abakwa-PATHOS babamba i-90.2% yendawo engaphansi kwekhola futhi, ngokunqanyulwa kwe-3, bathola ukuzwela kwe-80.9% kanye nokucaciswa kwe-87.2% kwesampula yabesifazane (n = 808). Ku-Study Second, imiphumela yokuhlaziywa kwe-ROC iveze ukuthi ama-PATHOS athumba i-85.1% yendawo ngaphansi kwjika, ngokuzwela kwe-70.7% kanye nokucaciswa kwe-86.9% yamadoda (ukunqunywa kwe-3). Kwabesifazane, abakwaPATHOS babamba i-80.9% yendawo ngaphansi kwekhola futhi bathola ukuzwela kwe-69.7% kanye nokucaciswa kwe-85.1% ngokusikwa kwe-3.

iziphetho

Lezi zifundo zinikezela ngokusekelwa kokusetshenziswa kwe-PATHOS njengethuluzi lokuhlonza ukuthola amacala angaba umlutha wobulili ezilungiselelweni zomtholampilo.

Amagama angukhiye: Umlutha Wezocansi, Ukuxineka Ngocansi, Ukuhlola, Ukuhlola, Izimo Zengqondo

Ama-Pathos: ukuvusa umzwelo, ikakhulukazi usizi noma ububele

- Kusuka esiGrekini Ama-pathos "ukuhlupheka"

Umlutha wezocansi (obizwa nangokuthi Ukuncipha Kobulili, I-Hypersexourse, i-Compulsive Sexual Disorder, Paraphilia-Disorder Disorder, Impulsivity Sexual, Nymphomania, kanye ne-Out of Control Behaviour) ubukeka ungukuphazamiseka okuvamile. Kulinganiselwa ukuthi kuthinte kuze kufike ku-3-6% yabantu base-US [Amakhadi, i-1991], futhi ucwaningo lwakamuva oluvela eNew Zealand lukhombisile ukuthi amazinga angaphansi wokuziphatha lokhu angaphezulu kakhulu [Skegg et al 2009]. Umlutha wokuya ocansini uchazwe ngokuthi "Ukuba khona kwemibono evamile, eqinile, evusa inkanuko ngokobulili, izinkanuko zocansi, noma isimilo esiqhubeka isikhathi esingangezinyanga eziyisithupha futhi esingangeni ngaphansi kwencazelo ye-paraphilia," futhi kubangela ukukhathazeka okukhulu nokukhubazeka okukhulu kubantu abahluphekayo [I-Stein, Emnyama, iPienaar, i-2000]. Ngaphandle kwemiphumela emibi yomuntu siqu neyenhlalo ehlobene nokuluthwa ngokocansi, kubhekwe okuncane kule nkinga enkulu. Ukuntuleka ukunakwa kungenzeka, ingxenye enkulu, ukudideka mayelana etiology yayo kanye nosology. Eqinisweni, umlutha wobulili awufakwa ngisho naku-Diagnostic and Statistical Manual of Mental Disriers [I-APA, i-2000], noma i- "hypersexual disorder" icubungulwa nge-edition elandelayo [I-Kafka, i-2010].

Ngenhlanhla, iqembu elikhulayo lolwazi liyavela ukubhala nokuchaza inkinga. Isibonelo, iphephabhuku, i-Sexual Addiction kanye neCompulsivity: I-Journal of Treatment and Prevention, isemnyakeni wamashumi amabili wokushicilelwa. Ngokufanayo, amaSadock noSadock's (2005), I-Comprehensive Textbook of Psychiatry kufaka hlangana isahluko sokuluthwa umlutha wocansi nokwelashwa kwawo [Amakhadi, i-2005]. Kodwa-ke, ukuhlanganiswa komzimba kokuziphatha njengamanje okubizwa ngokuthi "umlutha wobulili" kwaqala kwakhonjwa ngu-Orford [I-Orford, 1978 & 1985]. Lo msebenzi ulandelwe yizincazelo eziningiliziwe ezijulile nguCarnes [1983, 1988, 1991a], I-Goodman [1992], Futhi I-Earle [1995]. Abaphenyi abahlukahlukene basebenzise izindlela zokuxilonga ezifanisa lezo zenzelwe ukuhlukunyezwa kwezidakamizwa kanye nokugembula kwe-pathological kubantu ababonisa izimpawu zokuluthwa ngokocansi [Amakhadi, i-1983, 1988, 1991a, kanye Schneider, 1991], nabanye basebenzise izindlela ezizimele zokuxilonga kulaba bantu [Okumnyama, i-2000].

Ucwaningo olubonakalayo luhlole i-etiology yokuluthwa umlutha wezocansi futhi luveze abanikeli abajwayelekile, kufaka nomlando wokuhlukumezeka [I-Earle ne-Earle, i-1995], izinto zomndeni [I-Sussman, 2007], kanye nokuchayeka okwengeziwe okuvuselelayo njenge "cybersex" [UHunt noKraus, 2009]. Ngaphezu kwalokho, ukunakwa okuningi kugxilwe ekwenzekeni kokuhlangana komlutha wobulili nezinye izindlela zokuziphatha umlutha [I-Carnes, Murray neCharpentier, i-2005]. Ukuqagela kokuqala kwe-neuroscience yokuluthwa ngokocansi kwavela kuma-1980's [IMilkman neSunderwirth, 1987], futhi njengoba isisekelo sokucwaninga se-neuroscience sithuthukile, izindlela zebhayoloji ezingaphansi komlutha wezocansi zikhonjisiwe [I-Berlin, i-2008; I-Cozolino, i-2006; I-Kafka, i-2008; UKrueger noKaplan, 2000; UStein et al., 2000]. Imizamo ebonakalayo yokufingqa ucwaningo lwamanje ivele kumaphephabhuku wezokwelapha ajwayelekile [Coleman, 1990, Coleman-Kennedy 2002]. Ngokufanayo, izindlela zokwelashwa ziye zachazwa futhi kwafundwa abantu abahlukahlukene [AmaCarnes nama-Adams, 2002].

Noma kunjalo, kunokuntuleka okuncane kokuqwashisa mayelana nokuluthwa umkhuba wokuya ocansini phakathi kwabahlinzeki bezokunakekelwa kwempilo. Ngaphezu kwalokho, kukhona ukuntuleka kwezindlela zokuhlola / ukuhlolwa okusekelwa kobufakazi ukusiza abahlinzeki bezempilo ukuthola abantu abahlushwa yilesi simo. Ngokubambisana, lezi zinto ziye zaphazamisa ukufinyelela kweziguli ekwelashweni okusebenzayo. Ngakho-ke, kunesidingo sokukhiqiza uhlelo lokusebenza lokuhlola okulula olufana ne-CAGE Questionnaire [I-ewing, i-1984], okuyisikrini esiseduze sokutholwa kotshwala (ie, C = Wake wakuzwa ukuthi kufanele unciphise ukuphuza kwakho? unecala ngokuphuza kwakho?, = = Wake wakwazi ukuphuza into yokuqala ekuseni ukuze uqinise izinzwa zakho noma ukhiphe i-hangover [eyevula amehlo]. I-CAGE isebenze njengophawu olusebenzayo lodokotela abasebenza zombili impilo yezengqondo nezilungiselelo ezijwayelekile zezokwelapha.

Kuvele inani lokuhlola umlutha wokuya ocansini futhi liqhathaniswa ezincwadini ezengeziwe [Ama-Carnes, aluhlaza okotshani no-Carnes, 2010; I-Delmonico noMiller, i-2003; UHook et al., 2010; UKalichman noRompa, 2001]. Enye yezinto ezisetshenziswa kakhulu yi-Sex Addiction Screening Test (SAST), esetshenziswe okungenani eziyisishiyagalombili ezishicilelwe, izifundo ezibukezwe ontanga, futhi isetshenziswa kaningi ekuziphatheni ezikhungweni zokwelapha ezihlalwa lapho ezingapheli, kanye nokulutha okuqinisekisiwe kocansi. abelaphi (CSATS) kulo lonke elaseMelika, nakwamanye amazwe. Kuvele okokuqala e1989 [Amakhadi, i-1989] futhi ngemuva kwalokho kubuyekezwe (SAST-R) [I-Carnes et al., I-2010]. Kokubili i-SAST ne-SAST-R kwakususelwa emashumini eminyaka okuhlangenwe nakho kwezifo. Noma kunjalo, i-SAST-R yinde (ie, izinto ze-45), ikwenza kungabonakali ukusetshenziswa kwezilungiselelo ezijwayelekile zomtholampilo (isib. Ihhovisi likadokotela noma igumbi lezimo eziphuthumayo). Njengoba kunikezwe ukudideka okuhambisana nokuhlonza abantu abanenkinga yokungakwazi ukuqonda okuqondile, ukuqonda, noma izindlela zokuxilonga, kanye nesidingo sedivaysi yokuhlola emfushane, inhloso yalolu cwaningo kwakungukuthuthukisa ama-PATHOS, ithuluzi lokuhlola elifushane lokusiza abahlengikazi ngokukhonjwa kwabantu abangaba nemilutha yezocansi. Kwenziwa uchungechunge lwezifundo ezimbili ukuze kuthuthukiswe isilinganiso futhi kuqinisekiswe kusampula elihlukile. I-PATHOS iqukethe izinto eziyisithupha ezitholakala kuzo zombili i-SAST ne-SAST-R.

Indlela: Isifundo sokuqala

Izindlela

Ukuxilonga Ingxoxo Yomtholampilo

Njengoba kunikezwe ukuthi izindlela zokuxilonga zokulutha ngokocansi azingafakwa kwi-Diagnostic and Statistical Manual of Mental Disorders, iziguli ezithunyelwe ukwelashwa zitholwe zinomlutha wezocansi ngokususelwa kwinhlolokhono yomtholampilo, zisebenzisa izindlela ezisungulwe I-Carnes (2001). Lezi zinqubo zokuxilonga zibhalwe ku Ithebula 1.

Ithebula 1 

Izindlela Zokuhlonza Iziguli Zomlutha Wezocansi

Uhlolo lwe-Screening Addiction Screening (SAST)

Izinto ze-PATHOS zikhishwe ku-SAST yasekuqaleni kulolu cwaningo. I-SAST yisilinganiselo sento ye-25 esivivinya izimpawu zokulutha ngokocansi [Amakhadi, i-1989]. Zonke izinto zinamaphutha ngokudanisa (yebo / cha). Izinto eziyisampula zifaka phakathi, "Ngabe uzizwa ulawulwa isifiso sakho sobulili?" Nokuthi "Ngabe ufihla ezinye zezindlela zakho zokuziphatha zocansi kwabanye?" Ucwaningo lwangaphambilini luveze ukuthi i-SAST iyabandlululwa kahle nangendlela efanelekile phakathi kokuluthwa umkhuba wokuya ocansini nabangadingi umthetho. Isebenzisa i-13 njengomphumela we-cutoff, i-96.5% yabaphendulayo yahlukaniswa ngokufanele njengabantu abayimilutha yezocansi, kuyilapho i-3.5% kuphela yokushaya i-13 noma ngaphezulu eyayingavunyelwe, futhi ngenxa yalokho yabekwa kabi, kusetshenziswa i-SAST. Kulesi sampula, ukuvumelana kwangaphakathi kwe-SAST bekuhle kakhulu (KR-20 = .94) [UGeorge noMagineti, 2003].

Abahlanganyeli

Isampula lokutadisha (N = 1,908) laliqukethe amasampula amabili amancane abantu. Imininingwane evela ezigulini ze-1,118 (i-30.4% yowesifazane, n = 340) abelashwa esikhungweni sokwelapha i-inpatient institution for umlutha wezocansi phakathi kwe-1996 ne-2004 babhaliswa kulolu cwaningo. Ukuze uvikele ukungaziwa, idatha yabantu ayizange iqoqwe kusampula yeziguli. Ngaphezu kwalokho, amavolontiya angama-790 anempilo (i-75.7% abesifazane, n = 598) aqashwa eyunivesithi enkulu yaseningizimu esikhathini esingangonyaka. Isampula yomfundi ibekwe eminyakeni yobudala kusukela eminyakeni engu-18-58 (M = 20.60, SD = 3.88) futhi ngokuyinhloko azibike njengeCaucasian (59.6%, n = 471), kulandele iBlack / African American (37.1%, n = 293) kanye no- "Okunye" (1.4%, n = 11). Bekukhona nabasishiyagalombili be-Hispanic (1.0%), abayisithupha base-Asia (0.8%), nomuntu oyedwa weNative American (0.1%) ngamunye ofakiwe kusampula. Ukungafani okusobala kokulingana ngokobulili phakathi kwalezi amasampula amabili kukhombisa iqiniso lokuthi amadoda amaningi afuna ukwelashwa kokuluthwa ngokocansi kunabesifazane, nokuthi abesifazane abaningi babamba iqhaza ocwaningweni kunabesilisa baseyunivesithi lapho kwaqashwa khona abahlanganyeli abanempilo.

Izinqubo

Abantu abathile kusampula yeziguli baphathwe ngemibuzo ebuzwa ngo-SAST ngesikhathi sokudla kwabo komtholampilo. Izimpendulo ezhlonziwe zakhishwa kumarekhodi ezokwelapha alolu cwaningo. Ukuze kuhlolwe ubuqiniso bokubandlululwa kwama-PATHOS, isampulu yamavolontiya anempilo aqashwa ukuba asisebenzise njengesampula yokuqhathanisa. Ngemvume yeBhodi Yesikhungo Sokuhlola (i-IRB), abafundi basekolishi batshelwa ngalolu cwaningo ngokuya ezifundweni ezethulelayo zengqondo futhi banikezwa ithuba lokubamba iqhaza ocwaningweni olukhona njengamanje noma kolunye uhlobo lwezifundo njengengxenye yezidingo zabo zezifundo. Ngemuva kokuthola imvume enolwazi, ababambiqhaza bacelwa ukuba bagcwalise uhlu lwemibuzo olufushane lwabantu kanye ne-SAST.

Izinto ze-SAST zikhethiwe ukufakwa ku-PATHOS ngokususelwa emiphumeleni yokuhlaziywa kwezakhi eziyinhloko ze-SAST ne-W-SAST1, ophakamise ukwakheka kwezinto ezine zokulutha ngobulili [ngemininingwane yalokhu kuhlaziya bheka: Ama-Carnes, aluhlaza okotshani no-Carnes, 2010]. Kwakhethwa izinto ezine ze-PATHOS ukuthinta izinto ezine ze-SAST (Ukugxila, Ukulahleka Kokulawula, Ukuphazamiseka Kwebudlelwano, kanye ne-Affective Disgency) ngokususelwa kulokho okuphezulu kakhulu kokulayisha kwabesilisa nabesifazane ngenxa yokuluthwa ngokocansi. Kwakhethwa izinto ezimbili ezingeziwe ukumela ezinye izici ezibalulekile zomtholampilo ezihlobene nokuluthwa kocansi (ihlazo nokufuna ukwelashwa), ezingahanjiswa ngqo yizinto ezine zokuqala. Uhlobo lokugcina lwaqanjwa igama elithi PATHOS Questionnaire, ngokususelwa ku-mnemonic eyenziwe ngezinto zayo. Izinto zePATHOS zemibuzo ezihlelwe ku Ithebula 2.

Ithebula 2 

Izinto ze-PATHOS zemibuzo

Izibalo

Imiphumela yayiqhathaniswa nokuhlola umehluko weqembu. Ukuvumelana okungaphakathi kwahlolwa amasampula owesilisa nowesifazane ngokwahlukana, kusetshenziswa ukuhlaziya kwe-KR-20. Izibalo ezichazayo nezingenamikhawulo nazo zabhalwa ngokwahlukile kwabesilisa nabesifazane. Kusetshenziswe ukuhlolwa kwe-T ukuhlaziya ukubaluleka kokungafani phakathi kwamasampula eziguli namavolontiya anempilo. Ukuhlaziywa kwezimpawu zokusebenza kwe-Receiver (ROC) kusetshenziselwa ukunquma izikolo ezijwayelekile zokusikwa emtholampilo.

Imiphumela: Isifundo sokuqala

Isamba samadoda e-970 abambe iqhaza kulolu cwaningo. Isilinganiselo se-PATHOS sesikrini sesikrini samadoda kwisampula yeziguli (n = 778) sasiyi-4.53 (SD = 1.48); kanti, umaki wokuqukethwe wesampula lesifundo esinempilo (n = 192) kwakuyi-1.52 (SD = 1.19). Lo mehluko wawubalulekile ngokwezibalo (t(968) = 29.8, p <.001; M umehluko = 3.01, 95% CI = 2.81 to 3.21). Imiphumela yabahlanganyeli besifazane be-808 yayifana. Amaphuzu abesifazane besampula yeziguli (n = 340) yi-3.82 (SD = 1.50); kanti, umaki wokuqukethwe wesampula lesifundo esinempilo (n = 598) kwakuyi-1.16 (SD = 1.12). Futhi, kube nomehluko obalulekile ngokwezibalo phakathi kwamaqembu womabili (t(936) = 28.5, p <.001; M umehluko = 2.66, 95% CI = 2.48 to 2.84).

Kuzo zombili amasampula owesilisa nowesifazane, ukuvumelana kwangaphakathi kwe-PATHOS kwakukuhle ku-KR-20 = .94 ne-KR-20 = .92, ngokulandelana. Imiphumela yokuhlaziya kwe-ROC yesampula yabesilisa iveze ukuthi ama-PATHOS athumba i-92.4% yendawo ngaphansi kwekhola (p <.001). Kusetshenziswa amaphuzu anqunyiwe ka-3, i-PATHOS ikhombe ngokufanele i-88.3% yesampula yesiguli sesilisa (ukuzwela) kanye ne-79.7% yesampula lesilisa elinempilo (imininingwane ethile). Kusetshenziswa ukunqunywa okufanayo, i-PATHOS ikhombe ngokufanele i-80.9% yesampula yesiguli sesifazane kanye ne-88.1% yesampula yabesifazane enempilo, okuthola i-90.6% yendawo engaphansi kwejika (p <.001).

Ingxoxo: Isifundo sokuqala

Uhlu lwemibuzo lwePATHOS lwakhiwa njengesikrini esisheshayo sokulutha ngokocansi. Imiphumela yokuTadisha kokuqala iveze ukuthi le nsimbi emfushane kakhulu (ie, izinto eziyisithupha), engaqashwa ngaphansi komzuzu owodwa, ingasetshenziswa ukuthola kahle abantu abanomlutha wezocansi. Ukuzwela nokucaciswa kwezilinganiso ze-PATHOS kukhombise ukunemba okuhle kakhulu, ikakhulukazi kucatshangelwa ubuncane bephepha lemibuzo. Impela, ucwaningo lwakamuva lukhombise imiphumela efanayo kwekhasi lemibuzo le-CAGE ekuboneni abesilisa abanokuxhomekeka kotshwala (ukuzwela kwe-91.0%; ukucaciswa kwe-87.8%) kanye nokusebenzisa kabi utshwala (ukuzwela kwe-87.5%; ukucaca kwe-80.9%)do Amaral and Malbergier, 2008].

Yize imiphumela iyathembisa, ukuqinisekiswa kwesiphambano kusampula ehlukile kwakudingeka ukuqinisekisa imiphumela etholakele. Ngenxa yalokhu, kwenziwa isifundo sesibili sokuqinisekisa ukuqina kwemiphumela.

Indlela: Isifundo Sesibili

Izindlela

Uhlu lwemibuzo lwePATHOS

Abahlanganyeli kulolu cwaningo lwesibili baphathwe i-SAST-R, ukubuyekezwa kwento ye-45 ye-SAST yasekuqaleni, equkethe izinto ezifanayo ze-PATHOS njenge-SAST yasekuqaleni. Izinto zePATHOS zemibuzo zakhishwa kwa-SAST-R (njengoba kuchaziwe kuSifundo sokuqala). Ama-PATHOS aqukethe izinto eziyisithupha, futhi athuthukiswa njengethuluzi lokuhlola okusheshayo lokutholwa komlutha wobulili ongaba khona. Izinto zibhalwe ku Ithebula 2 futhi beshaywa ngefomethi ka-yebo / cha.

Abahlanganyeli

Abantu kwisampula lesibili lesifundo (i-N = 913) baqashwa kubantu abathathu: ababephuma lapho bathola ukwelashwa kokuluthwa ngokocansi (n = 646, 86.8% besilisa), abantu abathola ukwelashwa okuhlala endaweni yokulutha ngokocansi (n = 64, 100% male), kanye nezitshudeni zasekolishi ezingaphansi kweziqu (n = 203, 23.2% male). Njengoba kunikezwe ukuthi umlutha wobulili uvame kakhulu phakathi kweziguli zesilisa [I-Goodman, i-1992], ukungalingani okukhulu kwenani lababambiqhaza besilisa nabesifazane ababelindelwe kwakulindelwe. Amasampula ezinsizakalo zeSifundo sesibili afakiwe Ithebula 3.

Ithebula 3 

Idatha Yobuningi Besampula Ye-2 yeSifundo

Izinqubo

Zonke izinqubo zenziwa ngokuhambisana namazinga wokuziphatha afanele futhi zavunywa ngamabhodi afanelekile wokubuyekezwa kwesikhungo. Ukuze kuqinisekiswe iphepha lemibuzo lePATHOS njengethuluzi elifanele lokuhlonza umlutha wezocansi, iziguli ezinomlutha wezocansi zaqashwa esikhungweni sezokwelapha ezikhethekile zokwenza umlutha wezocansi kanye nokuphuma kweziguli zabelaphi bezempilo eziphuma phambili ezigxila ekwelapheni umlutha wezocansi kusuka kuzungeze lokho Iziwe Ezihlangene. Abantu abethula ukwelashwa okungekuhle kwendawo yokuhlala noma engaphandle kokulutha ngokocansi baziswe ngocwaningo oluhlola iziguli ezinomlutha wezocansi futhi bacelwa ukuba babambe iqhaza. Ngemuva kokuhlinzeka ngemvume enolwazi, banikezwe i-SAST-R (okukhishwe kuyo izinto ze-PATHOS) ngesikhathi sokuhlolwa kwabo kokudla ngokomtholampilo. Amavolontiya anempilo aqashwa kwizitshudeni ezinabafundi abathola iziqu futhi aphathwa lelo zinga ngemuva kokuhlinzeka ngemvume enolwazi yokubamba iqhaza ocwaningweni lokucwaninga.

Izibalo

Ukuvumelana okungaphakathi kuhlolwe amasampula amadala ahlanganisiwe owesilisa nowesifazane asebenzisa ukuqina kweKuder-Richardson-20 (KR-20). Amanani okuvama abalwa izimpendulo ezinhle zento ngayinye kwizimo zangaphandle, ukwelashwa kokuhlala, namasampula wokuzithandela anempilo. Ukuhlaziywa kwe-ANOVA ye-Univariate kwahlanganiswa ukuze kuhlolwe ukubaluleka kokuhluka phakathi kwamasampula eziguli kanye nesampula yabafundi ngaphakathi kobulili ngamunye. Ukuze i-ROC ihlaziye ukwelashwa kokuhlala kanye namaqembu aphuma ngaphandle ahlanganiswe ukuze kwakheke iqembu leziguli eziyinhlanganisela. Iqembu lokuzithandela elinempilo lalinabafundi kuphela. Kwakusetshenziswa izivivinyo zamasampula azimele ukuqhathanisa izikolo ze-PATHOS zeziguli namasampula wokuzithandela anempilo. Ukuhlaziywa kwe-ROC kwakusetshenziselwa ukuhlola ukweneleka kwenqaku lokunqunywa komtholampilo elinqunywe ngaphambili (ie, inani eliphelele = 3).

Imiphumela: Isifundo Sesibili

Ngokucabanga ngesimo esifushane sesilinganiso, ukuvumelana kwangaphakathi kwamasampula akhona kwamukelekile (abesilisa: KR-20 = .77; abesifazane: KR-20 = .81) [UGeorge noMagineti, 2003]. I-ANOVA engavunyelwe ukuqhathanisa amasampula wesilisa ibalulekile (F(2,669) = 53.71, p <.001; isi-adj. R2 = 0.14; amandla = 1.00). Ukuhlaziywa kwe-hoc hoc, kusetshenziswa uTamhane ngenxa yokungafani kweqembu, kutholakale ukuthi wonke amaqembu amathathu ayehluke kakhulu komunye nomunye (ukuphathwa ngendawo yokuhlala, M = 4.78, SD = 1.46; Izikhathi eziphumayo, M = 3.41, SD = 1.87; Bafundi, M = 1.21, SD = 1.232). Ngenxa yokuthi kwakukhona amaqembu amabili kuphela abesifazane, kwenziwa ama-t-test ukuqhathanisa izindlela. Ukuhlolwa kwe-t kwabesifazane kwakubalulekile (t(239) = 9.75, p <.001; d = 1.51; amandla = 1 · 00). Umehluko osho ukuthi lokhu kufana nalokhu kwabesilisa abangaphandle kwabafundi kanye nezabafundi (abesifazane abangaphandle: M = 3.26, SD = 2.11; abesifazane abafunda: M = 0.88, SD = 1.04; M umehluko = 2.38, 95% CI = 1.90 to 2.86).

Ekuhlaziyeni kwe-ROC, ama-PATHOS ahlukaniswe ngokufanele abantu kusampula yeziguli zesilisa (n = 625; ukwelashwa kokuhlala kanye namasampula aphuma ngaphandle ahlanganiswe) kanye nesampula yokuzinikela enempilo (n = 47) 83.3% yesikhathi. Kusetshenziswa umugqa osikiwe we-3, ama-PATHOS akhombe kahle i-69.6% yesampula yesiguli (imizwa) ne-80.9% yesampula lamavolontiya anempilo (ukucaciswa). Ku-ROC ihlaziya isampula yabesifazane (i-outpatient n = 85; ekolishi n = 156) ama-PATHOS ahlukaniswe kahle i-81.4% yesampula iyonke. Kusetshenziswa umaki we-3, ama-PATHOS akhombe kahle i-65.9% yesampula yesiguli (uzwela) kanye ne-91.0% yesampula enempilo (ukucaciswa).

Ingxoxo: Isifundo Sesibili

Imiphumela yeSifundo Sesibili ihlinzeka ukwesekwa okwengeziwe kokusebenziseka kwekhasi lemibuzo le-PATHOS njengesikrini esifushane sokulutha ngokocansi. Ukulinganiselwa kokungalingani kwangaphakathi kwamasampula owesilisa nowesifazane kuphakanyiswe ukuthembeka okwanele. Ukuhlaziywa kwe-ANOVA kwamaqembu abesilisa eSifundweni Sesibili kukhombise ukusebenza okuhlaba umxhwele kwe-PATHOS ngokuhlukanisa ngokucacile phakathi kwawo wonke amaqembu amathathu. Lokhu kuthola ukuthi iphepha lemibuzo le-PATHOS lingaba yithuluzi eliwusizo kodokotela ukuthola abantu abazosizakala ekuhlolweni okwengeziwe kwezimpawu zabo zokulutha ngocansi, futhi futhi bangasebenza njengezinkomba ezinzima zecala lobunzima. Imiphumela ye-t-test yesampula yabesifazane iveze ukuthi ama-PATHOS ahlukanisa kahle abesifazane abangaphandle kweqembu elijwayelekile lokuqhathanisa abafundi basekolishi. Izigaba ekuhlaziyweni kwe-ROC bezinganembile njengaseSifundo 1, kodwa nokho zibonisa ukusebenza kahle kwe-PATHOS. Ukunemba okuphansi ku-Study 2 kungenzeka kungenxa yengxenye yesampula encane yabesilisa enempilo, njengoba umehluko omkhulu kumanani asisekelo uvame ukunciphisa ukunqunywa kokuhlukaniswa ngezigaba. Ngemininingwane evela kwabesifazane kukhona ukungalingani ngamanani wesisekelo. Noma incane ngokwendlela futhi iqonde ngaphesheya, lokhu kungalingani kungenzeka futhi kukubonile ukunemba. Kuyo yonke idatha yowesilisa nowesifazane, ukufakwa kwedatha engaphandle nakho kungenzeka ukuthi kwehlise ukunemba, njengoba ukuphuma kwesikhathi kuvame ukubika i-pathology engathí sina (njengoba kubonakala ngokuqhathanisa izindlela zeziguli zesilisa).

Yize imiphumela iyiphoqelela, eminye imikhawulo yocwaningo kufanele iphawulwe. Okokuqala, kunokungalingani okukhulu kokumelwa kobulili kumasampula eziguli nawabafundi. Isampula yeziguli inamadoda amaningi kunabesifazane (cishe abayisikhombisa kuya koyedwa), kanti isampula labafundi alilingani kolunye uhlangothi (cishe abesifazane abathathu endodeni ngayinye). Ngaphezu kwalokho, kuyaphawuleka ukuthi bekukhona umehluko obalulekile wobudala phakathi kwamasampula eziguli nawabafundi. Ngakho-ke, ucwaningo lwesikhathi esizayo kufanele lufake isampula yesihloko esidala esinempilo ukuze sinciphise imiphumela yobudala njengosongo ekuqinisekisweni kokuqhathaniswa phakathi kwala maqembu womabili, nokulinganisa ukumelwa kobulili.

iziphetho

Imiphumela yocwaningo lwamanje ikhombisile ubufakazi bokuthi i-PATHOS Questionnaire iyasebenziseka njengesilinganiselo sokuhlola umlutha wezocansi. Ngaphandle kokusebenzisa amasampula ahlukene, i-Study One neBili bakhombise imiphumela efanayo. Ngokuvamile, iphepha lemibuzo le-PATHOS, elingahunyushwa ngaphansi komzuzu owodwa, likhombise ukuzwela okuhloniphekayo kanye nokulinganisa okuqondile lapho kuhlukaniswa phakathi kwamasampula ezihloko eziguli nezinempilo. Lokhu kuphakamisa ukuthi kungasiza odokotela ekuhlonzeni abantu abazosizakala ekuhlolweni okuningana futhi / noma kudluliselwe ekwelapheni le nkinga eyaziwa futhi engaphathwa kahle.

Umkhawulo omkhulu wezo zifundo zombili bekungukuhlukahluka kobudala kanye nobulili phakathi kwamasampula wokuzinikela ocansini anempilo (okwaziwa nge-Study 2 futhi kucatshangelwe eSifundweni 1). Ukuqhathanisa kwesikhathi esizayo kwezidakamizwa ezihambisanayo zocansi ezifakiwe nezinamasampula anempilo kungaba wusizo. Ucwaningo lwesikhathi esizayo kufanele futhi lwenziwe ukuze kuqinisekiswe ukusetshenziswa kwePhepha Lezimpendulo le-PATHOS ngamasampula amadala ezifundo ezindala, kanye namasampula emitholampilo ngaphandle kokuluthwa ngokocansi, ukuhlinzeka ukwesekwa okwengeziwe ukusetshenziswa kwayo. Ngaphezu kwalokho, amasampula ethu awazange anikeze ukumelwa okwanele kwezinhlanga ezahlukahlukene zokuvumela ukuqhathanisa kuwo wonke amaqembu anjalo. Ukuthola amasampula eziguli ezanele zobuthakathaka bobuhlanga ngokuluthwa kwezocansi kufanele futhi kubhekwe ngocwaningo lwesikhathi esizayo ukuvumela ukuhlolwa okungcono nokwelashwa kwalawo maqembu. Okokugcina, imininingwane ye-PATHOS ehlaziyelwe lezi zifundo ayizange iqoqwe ngokuphatha imininingwane yezinhlu eziyisithupha zePATHOS, kodwa kunalokho ngokukhipha idatha yento ye-PATHOS ekuphatheni kwe-SAST ne-SAST-R. Ngakho-ke, kunethuba elithile lokuthi imiphumela yoku-oda imibuzo ingaba nomthelela kwimiphumela yethu, yize kubonakala kungathandeki kunikezwe ukuvumelana phakathi kwezifundo ezimbili, kusetshenziswa imibuzo yemibuzo ehlukene yabazali namasampula angahlobene.

Phambilini, akukho sibuko esifushane esivele saziswa ukuthi sikhombe amacala okungenzeka ukuthi anomlutha wezocansi. Ngempela, abantu abaningi abazosizakala ekwelashweni bahlala bengaziwa. Uhlu lwemibuzo lwePATHOS lwenzelwe ukugcwalisa lesi sidingo nokusiza odokotela ekuhlonzeni abantu abangaba nezimpawu zokuluthwa ngokocansi. Imiphumela yamanje ihlinzeka ngokusekelwa kokusetshenziswa kwayo njengesikrini esifushane sokulutha ngokocansi ekusebenzeni okuvamile noma kwezinye izilungiselelo zomtholampilo.

Kuvuma

Umbhali wesithathu wasekelwa ingxenye yengxenye yeNational Institute of Drug Abuse (NIDA) yesibonelelo sokuqeqeshwa iT32-DA-07313-10 (PI: Linda B. Cottler). I-NIDA yayingenayo enye indima ekuklanyweni kokutadisha; ekuqoqweni, ekuhlaziyeni nasekuhumusheni imininingwane; ekubhalweni kombiko; noma esinqumweni sokuhambisa iphepha ukuze lishicilelwe.

Imibhalo yaphansi

1I-W-SAST iyindlela yokuqala esetshenzisiwe ye-25-nto SAST yasekuqaleni, okuhloswe ngayo ukuthola umlutha wobulili kwabesifazane. I-W-SAST yayifana ne-SAST yasekuqaleni, iguqula izinto eziyisithupha kuphela futhi ibopha abanye abathathu ngokuqondile. Zonke izinto eziyisithupha zePATHOS nazo zaziyizinto ze- W- SAST. Ababili babo baphinde baqanjwa kabusha ku-W-SAST.

2Izikhathi zokuqhathanisa zokuqiniseka zokuqhathanisa ze-ANOVA zitholakala ngesicelo sababhali.

Akunaziphikiso zokuthakaselwayo ongazibika.

Leli fayili le-PDF yesandla esingenakubalwa esamukelwe ukuze sishicilelwe. Njengenkonzo kumakhasimende ethu sinikeza le nguqulo yokuqala yombhalo wesandla. Umbhalo wesandla uzothola ukukopisha, ukufaka izinhlobo, nokubukeza ubufakazi obulandelayo ngaphambi kokuba ushicilelwe efomini layo lokugcina. Uyacelwa ukuthi uqaphele ukuthi ngesikhathi sezinqubo zokukhiqiza kungenzeka ukuthi zitholakale ezingahle zithinte okuqukethwe, nazo zonke izinqamulajuqu ezisemthethweni ezisebenza kulo magazini.

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