1Laboratory Clinic Neuroscience, Institute of Psychology, IsiPolish Academy of Sciences, Warsaw, Poland
2Isikhungo se-Swartz se-Computational Neuroscience, Institute for Neural Computations, University of California San Diego, eSan Diego, CA, eU.SA
* Umbhali ofanayo: Mateusz Gola, PhD; Isikhungo se-Swartz se-Computational Neuroscience, Institute for Neural Computations, University of California San Diego, 9500 Gilman Drive, San Diego, CA 92093 0559, USA; Ifoni: + 1 858 500 2554; Ifoni yehhovisi: + 1 858 822 7543; Imeyili: mgola@ucsd.
3Iminyango ye-Psychiatry ne-Neurobiology, i-Child Study Centre ne-CASAColumbia, i-Yale School of Medicine, eNew Haven, CT, eU.SA
4Isikhungo sezempilo se-Connecticut, eNew Haven, CT, eU.SA
abstract
Incwadi kaKraus et al. (2018) eshicilelwe muva nje ku- I-World Psychiatry unikeza izindlela zokuxilonga zokuziphatha okuphoqeleka ngokocansi (CSBs). Lapha, sixoxisana nomthelela ongase ube nawo wokufaka ukuphazamiseka kwe-CSB ku-ICD-11 ezindaweni ezine: imizamo yokufundisa ehlobene ne-CSB (kokubili odokotela kanye neziguli), uphenyo lwezinqubo ezingezansi kanye nezinhlayiya, ukuthuthukiswa kwezinhlaka zokwelashwa ezizimele, nokuphendula imibuzo ebalulekile emphakathini futhi uthuthukise imizamo ebalulekile yokuvimbela kanye nezinqubomgomo eziphumelelayo. Ngayinye yalezi zine ezine inezinselelo zazo okufanele zibhekiswe kuzo, futhi sizichaza kafushane futhi sixoxe ngazo. Sithemba ukuthi lolu lwazi luzosiza ukuqhubeka nengxoxo bese inikeza uhlaka lokuqhubekela phambili kule ndawo.
Ngenkathi yokungena kwe-intanethi engapheli kumadivaysi eselula, ukuziphatha okunjengokusetshenziswa kwezithombe zobulili ezingcolile, ukufuna izinsizakalo zobulili ezikhokhelwayo, kanye nokuhlangana kocansi okungajwayelekile (kubonakala sengathi yi-hook-ups) kubonakala sengathi sekuvame kakhulu. Ukubuka okuvamile kwansuku zonke kanye nemitholampilo kubonisa ukuthi kwabanye abantu, lezi zindlela ezintsha zokuziphatha ngokobulili ziye zaba nezinkinga futhi zenza ukufuna ukwelashwa (IGola, iLeccukuk, neSkorko, 2016). Njengoba kunikezwe amacala anjalo, imigomo enjengokuthi "ukulutha ngokocansi" ikhona emithonjeni yemidiya kanye nengxoxo yomphakathi. Kodwa-ke, naphezu kokubaluleka okukhulu kwezenhlalakahle kanye nesithakazelo kulezi zenzakalo, ukuziphatha okucindezelayo ngokocansi (CSBs) iminyaka kuye kwahlala iminyaka eminingana ekuphenyweni kwesayensi okuhleliwe kanye nokuhlukaniswa kwengqondo (I-Kafka, i-2014; IKraus, Voon, & Potenza, 2016; Potenza, Gola, Voon, Kor, & Kraus, 2017).
Iminyaka eyizinkulungwane zezingxoxo zesayensi nezomtholampilo mayelana nama-CSB, ukuxhaswa ngokobulili, nokulutha kocansi kuye kwadala imibono eminingi, kodwa uma kuqhathaniswa nezinye izimo zengqondo nokukhathazeka, kukhona idatha encane yokuzihlola (IGola & Potenza, 2018). Ngakolunye uhlangothi, idatha enganele kungenzeka ukuthi yavimbela ukufakwa kwe-CSB disorder noma ukwakheka okuhlobene [okusho, i-hypersexual disorder (I-Kafka, i-2010)] kumagazini wesihlanu we Incwadi Yokuhlola Nezibalo Zezinkinga Zengqondo (DSM-5; I-American Psychiatric Association, i-2013), naphezu kwemiphumela yesilingo se-DSM-5 ehlobene nenkinga ye-hypersexual (Reid et al., 2012). Ngakolunye uhlangothi, ukungabi khona kwesinye isikhungo sokuxilonga okusemthethweni okungaqondile kungase kubangele ucwaningo, ukuqoqwa kwedatha, nemizamo yemfundo ephathelene nama-CSB. Ngenhlanhla, ukuthuthuka okubalulekile kwamuva nje ekuqondeni izici ezibalulekile ze-CSB kuye kwenzeka.
UKraus et al. (2018) ichaze izidingo ze-CSB disorder njengoba kuhlongozwa ukuba kufakwe ku-ICD-11. Ngokombono wethu, isinqumo se-World Health Organization sokuphakamisa ukukhathazeka kwe-CSB sokufakwa kwi-ICD-11 ezayo kuyisinyathelo esibaluleke kakhulu ngokubheka abantu abafuna ukwelashwa kwama-CSB; odokotela banikeza ukwelashwa okunjalo; abacwaningi banentshisekelo yokutadisha lesi sihloko; futhi umphakathi uphakamisa imibuzo futhi uthola izimpendulo, okumele ekugcineni ubike imizamo yenqubomgomo. Sithanda ukuveza kafushane imibono kulezi zindawo ezine kanye nezindaba ezibaluleke kakhulu zezwi esikholelwa ukuthi zifanele ukuphenywa esikhathini esizayo.
Kubantu abaningi abahlangabezana namaphethini aqhubekayo obunzima noma okwehluleka ukulawula izifiso ezinamandla, eziphindaphindwayo zocansi noma izifiso eziholela ekuziphatheni ngokocansi okuhambisana nokucindezeleka noma ukukhubazeka okuphawuleka komuntu siqu, komndeni, kwezenhlalo, kwezemfundo, emsebenzini, noma kwezinye izindawo ezibalulekile zokusebenza, kubaluleke kakhulu ukukwazi ukuqamba nokukhomba inkinga yabo. Kubalulekile futhi ukuthi abahlinzeki bokunakekelwa (okungukuthi, odokotela nabeluleki) abantu abangafuna kubo usizo bazi ama-CSB. Phakathi nezifundo zethu ezibandakanya izihloko ze-3,000 ezifuna ukwelashwa kwe-CSB, siye sazwa ukuthi abantu ababhekana ne-CSB bahlangana nezivimbela eziningi ngesikhathi befuna usizo noma bexhumana nabahlengikazi (UDhuffar & Griffiths, 2016). Iziguli zibika ukuthi odokotela bangazigwema isihloko, bathi izinkinga ezinjalo azikho, noma ziphakamise ukuthi umuntu unesidingo esikhulu sezocansi, futhi kufanele amukele esikhundleni sokuphatha (naphezu kwalokho kulabo bantu, ama-CSB angase azizwe e-dystonic futhi eholele kwimiphumela emibi eminingi). Sikholelwa ukuthi izindlela ezichazwe kahle ze-CSB disorder zizogqugquzela imizamo yezemfundo kuhlanganise nokuthuthukiswa kwezinhlelo zokuqeqesha ngendlela yokuhlola nokuphatha abantu abanezimpawu ze-CSB disorder. Sithemba ukuthi izinhlelo ezinjalo zizoba yingxenye yokuqeqeshwa komtholampilo kwabangokwengqondo, abagula ngengqondo, kanye nabanye abahlinzeka ngezinsizakalo zokunakekelwa kwezempilo yengqondo, kanye nabanye abahlinzeki bokunakekelwa kubandakanya abahlinzeki bokunakekelwa okuyinhloko, njengabadokotela jikelele. (ugcizelelwe wengezwe)
Imibuzo eyisisekelo mayelana nendlela engcono yokucabanga ngayo i-CSB disorder futhi inikeze ukwelashwa okuphumelelayo kufanele iqondiswe. Isiphakamiso samanje sokuhlukanisa izifo ze-CSB njengengcindezi yokulawula ukucindezela ingxabano njengamanye amamodeli aphakanyisiwe (Kor, Fogel, Reid, & Potenza, 2013). Kukhona idatha ebonisa ukuthi i-CSB yabelana ngezici eziningi ngezidakamizwa (UKraus et al., 2016), kufaka phakathi idatha yakamuva ebonisa ukukhishwa kwemisebenzi ephakeme yokwaziswa kwemivuzo ekuphenduleni imibono ehambisana nokukhohliswa okungahambi kahle (Umkhiqizo, uSnagowski, uLaier, noMaderwald, 2016; IGola, i-Wordecha, iMarchewka, neSescousse, ngo-2016; UGola et al., 2017; IKlucken, Wehrum-Osinsky, Schweckendiek, Kruse, & Stark, 2016; IVoon et al., 2014). Ngaphezu kwalokho, idatha yokuqala inikeza ukuthi i-naltrexone, imithi enezinkomba zokuphuza utshwala-nokusetshenziswa kwe-opioid, ingaba usizo ekuphatheni ama-CSB (IKraus, Meshberg-Cohen, Martino, Quinones, & Potenza, 2015; URaymond, uGrant, noColeman, 2010). Ngokuphathelene nesigaba se-CSB esihlongozwayo se-disorder njengengcindezi yokulawula ukucindezela, kunedatha ebonisa ukuthi abantu abafuna ukwelashwa ngesimo esisodwa se-CSB disorder, izithombe zobulili ezingcolile eziyinkimbinkimbi zisebenzisa, azifani ngokungahambisani nomphakathi. Kunalokho kunikezwa ukukhathazeka okwenyuka (IGola, iMiyakoshi, neSescousse, 2015; UGola et al., 2017), futhi ukwelashwa kwemithi okubhekise ekuboniseni ukukhathazeka kungase kube usizo ekunciphiseni ezinye izimpawu ze-CSB (IGola & Potenza, 2016). Nakuba kungase kungakakwenzeka ukudweba iziphetho ezicacile mayelana nokuhlukaniswa, idatha eminingi ibonakala isekela ukuhlukaniswa njengesiyaluyalu somlutha uma kuqhathaniswa nesifo sokulawula umfutho (UKraus et al., 2016), futhi ucwaningo olwengeziwe luyadingeka ukuhlola ubuhlobo nezinye izimo zengqondo (UPotenza et al., 2017).
Njengezinye izimo zengqondo, i-CSB disorder kungenzeka ihambisane nezindlela eziningi zokunikela. Ifomu le-CSB lingamela into ebalulekile okufanele icatshangwe maqondana nokuphazamiseka kokungafani. Isibonelo, umehluko ungahle ube khona maqondana nokubamba iqhaza ikakhulu ekuziphatheni kocansi phakathi kwabantu (isb., Ucansi oluyingozi lokuzibandakanya nabanye abantu noma izinsizakalo zocansi ezikhokhelwayo) uma kuqhathaniswa nokuziphatha wedwa (isb. Ukusebenzisa kabi izithombe zocansi nokushaya indlwabu; Efrati & Mikulincer, 2017). Kungenzeka ukuthi owokuqala angase ahlobanise namazinga aphezulu okungafuneki nokufuna ukuzwa, futhi lokhu kungase kuhlobanise namazinga aphezulu okukhathazeka, ngamunye abe ne-correlates ehlukile ye-neural njengoba ehlongozwayo ngokuziphatha okuyingozi kokusebenzisa utshwala (Coleman, 1991, 2015; UGola et al., 2015; IStark & Klucken, 2017); Nokho, lokhu kungenzeka ukuthi kuhlolwe ukuhlolwa okuqondile.
Izindlela zokwelapha ezempilo nezengqondo ze-CSB disorder kanye ne-subtypes engenzeka kufanele ihlolwe. Njengamanje, zimbalwa izifundo ezihlelekile zesifo se-CSB, ikakhulukazi ngokucatshangelwa kwezinto ezincane ezingasetshenziswa njengezinkinga zokusebenzisa izithombe zobulili ezingcolile. Izifundo ezinjalo zizodinga ukusekelwa ezivela e-finance agencies (IPotenza, iHiguchi, neBrand, i-2018). Ukutadisha okungeyona imithi noma izidakamizwa zokuziphatha njengokungcakaza ngogesi akutholakeli ukwesekwa kukahulumeni ngendlela ephazamiseka ngayo imizwa, ukukhathazeka, ukusetshenziswa kwezidakamizwa, kanye nezinye izinkinga zempilo yengqondo (Ukuhlela, i-2018). Ukukhathazeka komuntu ngamunye kanye nokwezempilo komphakathi okuhlobene nama-CSB, sithemba ukuthi ama-ejensi kahulumeni nabanye abathintekayo (kufaka phakathi kodwa abangagcini kubakhiqizi nabasabalalisi bezithombe zobulili ezingcolile, abahlinzeki be-intanethi kanye nabakhiqizi bedivaysi yedijithali) bazosekela ucwaningo ngemibandela emikhulu ehlobene nokusabalala kwe-CSB ukuphazamiseka kanye nezinsizakalo zayo, ukuthuthukiswa kwezinsimbi zokuhlola nokuziphatha okuqinisekisiwe ngokwezemvelo nokuqondiswa kwengqondo, impikiswano engaba khona yezithombe zobulili ezingcolile ze-intanethi (ikakhulukazi ngokuchazwa kwentsha kanye nezinyathelo zokuthuthukiswa), kanye nokuhlonza izici ezithintekayo ezingafaka abantu engozini yokubhekana nezinkinga nama-CSB. Le mibuzo kanye neminye imibuzo igxila ekuthuthukiseni imizamo yokuvimbela, yokwelashwa, kanye nenqubomgomo ukuze kukhuthazwe impilo yezocansi emazingeni ahlukene ngabanye kanye nakumphakathi. (ugcizelelwe wengezwe)
Ngokombono wethu, indlela ecacile yokuxilonga ye-CSB disorder njengoba ehlongozwayo ukufakwa ku-ICD-11 ibeka isisekelo esibalulekile sohambo olude lokuxazulula imibuzo ebalulekile emphakathini. Ukuphendula nokuphendula imibuzo enjalo kufanele kuhlinzeke ukuqonda okuthuthukisiwe kwabantu abahlukunyezwayo nalabo abanenkinga ye-CSB futhi baholele ekuthuthukiseni impilo yezocansi emphakathini jikelele.
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