Okufanayo kodwa Okuhlukile: Ukufaniswa Kwemitholampilo Yabesilisa abane-Hypersexual Disorder ku-Sex @ Brain Study (2019)

2019 Jan 30; 8 (2). i-pii: E157. i-doi: 10.3390 / jcm8020157.
Engel J1, Veit M2, Sinke C3, I-Heitland I4, Kneer J5, Hillemacher T6,7, Hartmann U8, I-Kruger ye-THC9.

abstract

Izinkinga ezivela ekuziphatheni okuphathelene nokucanshangelwa zivame ukubonakala kuzilungiselelo zomtholampilo. Sihlose ukwandisa ulwazi mayelana nezici zomtholampilo zabantu abane-hypersexual disorder (HD). Iqembu labantu abafezile indlela yokuhlonza ehlongozwayo ye-HD (amadoda ane-HD, n = I-50) yayiqhathaniswa neqembu lezilawuli ezinempilo (n = 40). Siphenya ukungezwani kwezenhlalo zomphakathi, izinkinga ze-neurodevelopmental, kanye nemindeni esekelwe emibhalweni yokuzibika kanye nokuxoxwa kwemithi. Amadoda ane-HD abike amanani aphakanyisiwe okusebenza ngokocansi, ama-paraphilias, ukusetshenziswa kwezithombe ezihlukumeza izingane, nokuziphatha kocansi ngokuqhathaniswa nokulawula okunempilo. Ngaphezu kwalokho, izinkinga zokuhlukunyezwa kwe-affective, izinkinga zokunamathisela, ukungafisi, kanye namasu okulawulwa kwemizwelo engasebenzi aphezulu kumadoda ane-HD. Amadoda anesifo se-HD abonakala ahlangene namafomu ahlukahlukene okuhlangenwe nakho okubuhlungu ebuntwaneni, kodwa kwakungekho ukungafani nakakhulu emphakathini, izici ze-neurodevelopmental, kanye nezici zomndeni. Ukuhlaziywa kobudlova kuboniswe ukuthi ukugwema okuhlobene nokunamathiselwa okuhambisana nokunamathiswa okuhambisana nokunamathiswa okuhambisana nokunamathiswa komuntu ngokushaya indlwabu kuqhathaniswa phakathi kwabantu abane-HD nokulawula okunempilo. Ekuphetheni, amadoda anesifo se-HD abonakala enesimo esifanayo se-neurovelopmentment, amazinga e-intelligence, isizinda sezenhlalo, kanye nezici zomndeni uma kuqhathaniswa nokulawula okunempilo, kodwa babika okuhlangenwe nakho okuhlukile nokubi ebuntwaneni, ukuziphatha kobulili okunenkinga, nokubunzima kwengqondo.

AMAKHOSI: ama-comorbidities; ubulili obufanayo; i-phenomenology; umlutha wezocansi; ukuphoqeleka ngokocansi

I-PMID: 30704084
I-DOI: 10.3390 / jcm8020157

1. Isingeniso

I-hypersexual disorder (HD) ibhekene nokucabanga okuphindaphindiwe okuphindaphindiwe ngokobulili, izikhalo, nokuziphatha okuholela ekukhubaleleni okungokwengqondo okuphawulekayo ngokomzimba [1,2,3]. Kafka [3] uhlongoze ukuthi ukugula ngengqondo ocansini kufanele kufakwe njengesigaba kwiNcwadi yokuHlola neStatistical of Disorders Mental, edition 5th (DSM-5) [4], kodwa isiphakamiso sagcinwa ekugcineni. Esinye sezizathu ezinikezwe yikuntuleka kocwaningo lokuhlola ngengozi ye-hypersexual [5,6]. Esikhathini esilandelayo se-International Classification of Diseases, i-ICD-11, ukuphazamiseka kwe-hypersexuality kuyobekwa ngokuthi iyinkimbinkimbi yokuziphatha kocansi [7].
Izinombolo zokuhlonza ziboniswa isifundo samadoda esanda kuvele samanje (n = 1151) nabesifazane (n = 1174) e-United States ethola ukuthi i-10.3% yamadoda nabesifazane abangu-7% babonisa amazinga afanelekile okucindezeleka kanye / noma ukukhubazeka ngenxa yobunzima bokulawula izifiso zobulili, imizwa, nokuziphatha [8]. Ukubonakaliswa kokuziphatha kocansi kungabandakanya kokubili othintana nabo ngokobulili kanye nemisebenzi yezocansi e-intanethi. Ukusetshenziswa kwe-inthanethi kokuqukethwe ngokocansi kuhlanganise nokushaya indlwabu kungukuziphatha okuvame kakhulu okuholela emadodeni ekutholeni ukuthi banesifo sokuxilonga ngokobulili ngokwemigomo ye-Kafka [3,9].
Cooper [10] ukhombise ukuthi intukuthelo yokufinyelela, ukukwazi ukukwazi ukukwazi, ukukwazi ukukwazi nokukwazi ukungaziwa, yenza abantu bakwazi ukufinyelela noma yikuphi okuqukethwe abakuthandayo ngokungabonakali, kungakhathaliseki ukuthi kunemithintelo yezomnotho nezenhlalo. Yiqiniso, amaphethini wokusebenzisa i-intanethi ahluka kakhulu phakathi kwabantu ngabanye abanomsebenzi owedlula kakhulu emisebenzini yezocansi e-intanethi [11] kanti abanye basebenzisa amapulatifomu okuthandana ukuze bathole abalingani bokuhlangana kocansi [12]. Amandla amakhulu okushayela umsebenzi ocansini ngokweqile ku-intanethi kungase kube ukuzithokozisa okulindelwe nokuhlangenwe nakho okuhlobene nokuvuswa kocansi nokufinyeleleka cishe kuzo zonke izinhlobo zesisusa socansi [13].
Okuncane okuyaziwa ngezici zomtholampilo zabantu abane-HD. Idatha evela ocwaningweni ngaphandle kweqembu lokulawula iphakamisa ukuthi izifundo eziningi ngamadoda ane-HD zisebudlelwano obuseduze, ezifundisiwe futhi eziqashiwe [14]; Kodwa-ke, iningi libika nokulahlekelwa ukusondelana ngenxa yokwehlukaniswa komndeni kanye nomlando wokuhlukunyezwa ngokobulili, ngokomzimba, nangokomzwelo [15]. Ukusebenzisa kakhulu izithombe zobulili ezingcolile [16,17] nokuziphatha kocansi ocansini ngokuvamile [18] ziye zaxhunyaniswa nezindlela zokuziphatha zobulili eziyingozi. Ucwaningo lubonisa ukuthi izidakamizwa ezingokwemvelo, ikakhulukazi izinkinga zemizwelo, zivame kakhulu kwi-HD ngamanani avela ku-72% -90% uma kwenzeka izinkinga zemizwa [14,19,20,21], no-42% uma kwenzeka izidakamizwa zokusetshenziswa kwezidakamizwa [22]. Okutholakele ebuhlotsheni obukhona phakathi kwezifo zocansi kanye nokungaziphathi kahle kuhlanganisiwe. Izifundo ezimbili [23,24] abantu abafuna ukwelashwa abafeza uhlelo oluhlongozwayo lwe-hypersexual disorder [3] bathole ukuthi phakathi kwe-48% no-53.3% babonise ukungabi nesimo esiphakeme ekuziphenduleleni komuntu siqu. Reid, Berlin, ne-Kingston [25] uphakamise ukuthi ifomu eliqondene nesimo sengqondo lokungacabangi ngokocansi, kodwa hhayi ukungafisi komuntu jikelele, kungenzeka kube yinto evamile ekungcolweni kwe-hypersexual. Ukuziphatha kobulili obucatshangelwayo kuboniswe ukuthi kuhlotshaniswa nokukhubazeka kwe-neuropsychological kanye nezinguquko ekuqapheliseni [26] nokulawula okuphezulu [27,28].
Ngokombono wezinto eziphilayo, uhlelo lwe testosterone ludlala indima ebalulekile ekuthuthukiseni nasekulondolozeni ukuziphatha ngokocansi [29]. Njengombonakaliso wokuvulwa kwe-androgen ngaphambi kokubeletha, isilinganiso sobude bezinombolo eziyisibili nesine (2D: 4D) singasetshenziswa, futhi kukhona ubufakazi bokuthi isilinganiso se-2D: 4D esingaphansi singase sixhunywe ekuziphatheni okungezansi ngokocansi [30], nakuba ukutholakala okuhlanganisiwe kuye kwabikwa. Ezinye izifundo zabantu abaningi ziye zabonisa ukuthi i-2D ephansi: isilinganiso se-4D (i-pattern more masculine) ixhunywe nokuba nenani eliphakeme labalingani bobulili kanye nenzalo eningi [30,31,32], kanti abanye bakhombise ukuthi i-2D ephezulu: isilinganiso se-4D sixhunyaniswa nokuziphatha kabi kumadoda [33].
Inhloso yalolu cwaningo kwakuwukuphenya izici zokuthuthukiswa komtholampilo kanye nezinye (neuro-) eziqondene nokuthuthukiswa kwezidakamizwa ezingenasifo esibucayi esiteshini esikhulu sabantu abafeza uhlelo lokuhlonza oluhlongozwayo [3] bese uziqhathanisa nezilawuli ezinempilo. Ngaphezu kwalokho, ukuhlaziywa okuningiliziwe kumele kubonakale ukuthi kunezici ezingabangela ingozi ekubambeni kokuziphatha ngokobulili, njengezici zobuntu, okungukuthi, izenzakalo ezimbi ezinganeni kanye nezinkinga zokunamathisela [34], kanye nesikhathi sokusondelana ngokocansi [35]. Sethula idatha kwimingcele engakaze ibekwe ngaphambilini kuma-sampuli afanelanayo futhi sixoxa ngemiphumela ekukhanyeni kokuqonda kwamanje ngokocansi.

I-2. Isigaba sokuhlola

I-2.1. Ukuqashwa

I-2.1.1. I-Hypersexual Disorder Group

Amadoda ane-HD aqashwe phakathi kukaDisemba 2016 no-Agasti 2017 ngokushicilelwa yi-Section of Clinical Psychology and Medicine Medicine, uMnyango Wezokwelapha, I-Social Psychiatry, ne-Psychotherapy eHannover Medical School, eJalimane. Ukukhululwa kwezindaba kwenziwa ngamaphephandaba wendawo kanye nabezindaba zenhlalo (isib. www.facebook.com, www.instagram.com) futhi kuholele amadoda e-539 aziwayo ayenayo i-HD ebonisa isithakazelo ekuhlanganyeleni esifundweni (bheka Umfanekiso we-1). Amadoda amabili namakhulu ayisithupha aphendule ku-imeyili ecela inombolo yocingo. Abantu abangamashumi ayisishiyagalolunye nesishiyagalolunye kwabakwa-260 abahlinzeka ngenombolo yocingo babengenakufinyelelwa ngocingo, kodwa i-201 esele yahlolwa ngengxabano e-hypersexual inkulumo ehambelanisiwe yocingo mayelana nemizuzu ye-45 eyenziwa ngumqondo wezokwelapha oqeqeshiwe osebenzisa uKafka [3] izindlela eziphakanyisiwe. Abantu babefanelekile ukutadisha uma begcwalisa i-3] iziphakamiso ezihlongozwayo zokungaboni kahle ngokocansi. Imibuzo esetshenziswe kulolu cwaningo ithunyelwe ngeposi kubahlanganyeli abafanelekile. Abathathu abahlanganyeli abangakafinyelelanga ukuvalwa (53) ye-Hypersexual Behavior Inventory 19 [36] bekunqatshelwe ukuthunyelwa kweposi. Kafka sika [3] izimo zokuhlukunyezwa kwe-hypersexual ziqukethe izimpawu ezibalulekile zomzimba ezivela ezifisweni zobulili, amafantasi noma ukuziphatha, futhi zibuyele esikhathini sezinyanga ze-6 abantu abahlukumezayo ukuzolawula futhi hhayi ngenxa yomphumela oqondile wokusebenza ngokomzimba wezinto ezidakayo. Abantu abangamashumi ayisishiyagalombili nantathu kwabakwa-201 abahlolwayo bahlangabezana nalezi zinqubo futhi babhekwa njengelungelo lokutadisha; I-50 yanquma ukubamba iqhaza futhi yakha iqembu le-hypersexual disorder (iqembu le-HD, niyabo Umfanekiso we-1 ishadi).
I-Jcm 08 00157 g001 550
Umfanekiso we-1. Ukuqasha iqembu le-hypersexual disorder.

I-2.1.2. Ukulawulwa Kwezempilo

Izilawuli ezempilo zaqashwa ngezikhangiso kwi-Hannover Medical School, eJalimane, ikhasi lasekhaya le-intranet. Abantu abangamashumi ayisishiyagalombili nanhlanu bavumelana nezikhangiso (bheka Umfanekiso we-2) u-56 uphendule ku-imeyili ecela inombolo yocingo. Amashumi amabili nesishiyagalolunye kulawa ma-56 awakwazi ukufinyelelwa ngocingo ukuze ahlolwe. Izilawuli zazifanelwe iminyaka yobudala (p = 0.587) nemfundo (p = 0.503) neqembu le-HD. Idatha evela kokubili ukulawula okunempilo kade ingabandakanywa ekuhlaziyweni (okubikiwe ukulimala okukhulu kwekhanda ngaphambi kokubamba iqhaza kokufunda, omunye wabika ubuhlobo bobulili obufanayo, kanti omunye umuntu obambe iqhaza akazange abonise ukuhlolwa).
I-Jcm 08 00157 g002 550
Umfanekiso we-2. Ukuqashwa kwezilawuli ezinempilo.

I-2.1.3. Izinyathelo Zokungabikho

Imibandela yokungafakwa yabo bonke ababambiqhaza kwakuyilezi: ukukhubazeka kwengqondo (njengoba kukalwe i-Wechsler Adult Intelligent Scale-IV), ukuphazamiseka kwengqondo (okuhlolwe nge-Structured Clinical Interview yezinkinga ze-DSM-IV Axis 1, SCID-I), ukulimala okukhulu ekhanda, ukuthambekela kobungqingili isikali se-Kinsey, kanye nokuthandwa ngokocansi kwe-pedophilic (kuhlolwe kunhlolokhono ehlelwe kancane). Kuphrojekthi yethu ethi Ubulili@ubuchopho sigxile kubahlanganyeli abathandana nobulili obuhlukile ngenxa yesimo socansi esivusa amadlingozi ekuhlolweni okuzayo. Bonke ababambiqhaza bamemezele ukuthi isithakazelo sabo esiyinhloko socansi kwakukwabesifazane nakuba abanye babike umlando wokuthintana nobulili obufanayo.
Bonke ababambiqhaza banikeze imvume ebhaliwe, enolwazi ngaphambi kokuba bahlanganyele futhi bathole isinxephezelo semali ngokubamba iqhaza. Batshelwa ukuthi bangakwazi ukuhoxisa esifundweni nganoma yisiphi isikhathi. Ucwaningo lwaluqhutshwa ngokuhambisana neSimemezelo seHelsinki futhi lwavunyelwa yikhomishini yokuziphatha yeHannover Medical School, eJalimane. Imiphumela ebikwe lapha itholakale njengengxenye yokuhlola okukhudlwana okubandakanya ibhethri yokuhlola ye-neuropsychological kanye nokufaneka kwe-imagination yamagnetic resonance.

I-2.2. Izindlela

Iziguquguquko zahlukaniswa ngezigaba ezintathu: (1) sociodemographic, neurodevelopmental, kanye nezici zomndeni, (2) izici zocansi, kanye (3) izici zengqondo ezihlanganisa izidakamizwa ezingqondweni. Ukuze uthole incazelo ecacile yezinto sicela ubone amanothi Ithebula 1, Ithebula 2, Ithebula 3 futhi Ithebula 4.
Ithebula 1. I-Sociodemographic, i-neurodevelopmental, nezici zomndeni.
Ithebula
Ithebula 2. Izici zobulili.
Ithebula
Ithebula 3. Izici zobulili.
Ithebula
Ithebula 4. Izici zengqondo kanye nokuncintisana.
Ithebula

I-2.2.1. I-Sociodemographic, i-Neurodevelopmental, ne-Fact Factors

Uhlu lwemibuzo lusetshenziselwa ukuqoqa idatha ye-sociodemographic, okungukuthi ubudala, imfundo ephakeme kunazo zonke, isimo somsebenzi, umlando wesiphambeko sokuphila, nesimo sobuhlobo. Kwakukhona neminye imibuzo mayelana ne-neurodevelopmental perturbations, isikhundla somntakwethu, impilo yabazali ngesikhathi sokuzalwa, neminyaka yobudala nengane ekuzalweni. Okuhlangenwe nakho okuhlangane nakho kokubuntwana kwahlolwa nge-Childhood Trauma Questionnaire (CTQ) [37]. Ukuhlukumeza nokuthuthukiswa kwe-neurodevelopmental kucwaningo kwakuyizixazululo zokuzalwa, ukulala isikhathi eside, ukuhamba okulibazisekile, ukuthuthukiswa kwenkulumo okulibazisekile, kanye nezingozi zezingane eziholela ekutheni zingenasici. Isandla sinqunyelwe ukusebenzisa isimo se-10-Into yokuPhathwa kwe-Edinburgh Inventory [38] no-2D: isilinganiso se-4D kulinganiselwa ukuthi sisebenzisa izithombe ezitholakale kusuka kwisithwebuli esiphathekayo. Ubude bamadijithi wesandla sokunene babalwa ngokuzimela ngababili abasizi bezocwaningo (ukuthembela phakathi kokubambisana: r = 0.83) kanye nokubala kusekelwe ezindleleni zokulinganisa ezimbili.
Ukucwaninga kwakucatshangwa kusukela emagumbini amane okushicilelwa kohlelo lwesine lwe-Wechsler Adult Intelligent Scale (WAIS-IV) [39] ezihambisana kakhulu ne-IQ egcwele ngokulinganisa nge-German WAIS-IV. Lezi zinhlamvu ezine ziyiSilulumagama (ukuqonda ngokuzwakalayo; r = 0.7), Block Design (ukucabanga okuzwakalayo; r = 0.65), i-Arithmetic (ukusebenza inkumbulo; r = 0.73), ne-Coding (isivinini sokucubungula; r = 0.5).

I-2.2.2. Ukwabelana ngokocansi

Ukuthuthukiswa ngokobulili nokuziphatha kuhlolwe nge-interview ehleliwe kanye nesethi yemibuzo. Siqoqa idatha ngeminyaka ekuqaliseni kokuqala, ukushaya indlwabu ngesonto ngaphambi kokuhlolwa (ubude nemvamisa), ubulili ngesonto ngaphambi kokuhlolwa, kanye nabalingani bobulili. Ngaphezu kwalokho, sihlolisise isikhathi nobude bokusebenzisa izithombe zobulili ezingcolile, inamba yezindaba, i-paraphilias, ukuziphatha kocansi, ukusetshenziswa kwezithombe zokuhlukumeza izingane, kanye nokuhlukunyezwa ngokocansi. Izinsimbi ezicacisiwe zisetshenziselwa ukulinganisa ukukhushulwa ngokobulili nokuvimbela ukuvimbela (Ukuxhaswa Ngokobulili, Isigaba SES kanye Nesisindo Sokuvinjelwa Ngokobulili, SIS) [40], izimpawu zokuphazamiseka kocansi (i-Hypersexual Bearing Performance Inventory-19, i-HBI-19) [36], izimpawu zokulutha kocansi lwe-inthanethi (Ukuvivinya Umlutha We-intanethi kwemisebenzi yocansi e-inthanethi-inguqulo emfushane, i-sIATsex; [41] nokulutha ngokobulili (Ukuvivinya Ngokweqile NgokweSandulela Ngculazi-Kubuyekezwe, SAST-R) [42].

I-2.2.3. Izimo Zengqondo Nezinkinga

I-comorbidities yezifo zatholakala ukuthi zisebenzisa inguqulo yesiJalimane ye-SCID-I [43]. Imibuzo eyengeziwe eyasetshenziselwa ukuhlola ukungacabangi (i-Barrat Impulsiveness Scale-11, BIS-11) [44], ukusebenzisa kabi izidakamizwa (Fagerström Test for Nicotine Dependence, FTND) [45], amaphethini enobungozi nokulimaza okusetshenziswa kotshwala (Ukuhlolwa Kokuqapha Ukusetshenziswa Kokusetshenziswa Kokuphuza Utshwala, i-AUDIT) [46], izimpawu zokucindezeleka (Beck Depression Inventory-II, BDI-II) [47], ukuhlanganiswa (Okuhlangenwe nakho kobudlelwane obuseduze-i-Revised, ECR-R) [48], i-alexithymia (i-Toronto Alexithymia Scale, i-TAS-26) [49], nesimiso somqondo (i-ERQ, i-Emotion Regulation Regulation Questionnaire [50]; I-Fragebogen zur Erhebung der Emotionsregulation, I-FEEL-E [51].
Ukunakekelwa kokulahlekelwa kwe-hyperactivity disorder (ADHD) kutholakala ngesisekelo sezinombolo ≥15 kokubili kwe-Wender Utah Rating Scale (WURS-K) [52] kanye ne-ADHD yokuzihlola kokulinganisa (ADHS-SB) [53].

I-2.2.4. Ukuhlaziywa kohlelo lokuHlola

Ukuze ubone ukuthi kungenzeka yini izibikezelo zokuhlukunyezwa kwe-hypersexual senza ukuhlaziywa kokuguqulwa kokubambisana kokubambisana ngokuhlukaniswa kwamacembu njengezinguquko ezixhomeke ezinhlobonhlobo. Inhloso yethu kwakuwukukhomba izici ezahlukanisa phakathi kwabantu abane-HD nokulawula okunempilo. Inombolo yeziguquko ezizimele zikhethiwe ezinconyweni zika-Agresti [54] (iphe. 138).

I-2.3. Ukuhlaziywa kwedatha

Konke ukuhlaziywa kwenziwa nge-SPSS Statistics Version 24 (IBM® Corporation, Amonk, NY, USA). Ukuhlaziya kwenziwa ngokusetshenziswa okuzimele t-abasebenzi, uMann-Whitney U ukuvivinywa noma ukuhlolwa okuqondile kukaFisher kwezinguquko eziguquguqukayo. Ukuhlolwa kwe-Fisher kwamatafula amakhulu kunama-2 × 2 nawo asetshenzisiwe, njengoba zonke iziguquguquko zezinhlobo ze-polytomous zazingenani okungenani elilodwa lemvamisa yeselula engaphansi kwe-5. Njengoba lokhu kwakungenye yezinhlelo zokuqala ezenzakalelayo ezifaka phakathi kokubili amadoda ane-disorder sex and controls enempilo ekufuneni umehluko weqembu mayelana neqoqo elithathwe yizinhlobo zemikhakha ehlolwe lapha, sakhetha indlela yokuhlola futhi sibika amazinga okubaluleka okubili amabili ngaphandle kokulungiswa kokufaniswa okuningi (konke kuhlaziya p <0.05). Kodwa-ke, kubafundi abanentshisekelo sifake neBonferroni elungiswe ukubaluleka ku- Ithebula 1, Ithebula 2, Ithebula 3 futhi Ithebula 4. Ubukhulu bezinkinga zokuhlolwa kwe-parametric kuboniswe njengo-Cohen d, Nge d = I-0.2 ebonisa umphumela omncane, d = 0.5 umphumela ophakathi, futhi d = 0.8 umphumela omkhulu [55]. Kukhona ukuhlukahluka kwamasayizi wezinhlu ezivivinyweni ezihlukahlukene ngoba imibuzo ye-data ne-data elahlekile ayikhishwe ekuhlaziyweni. Ukuze ulawule imiphumela yezifo zengqondo ngaphandle kwesifo socansi, zonke iziqhathaniso zeqembu nazo zibalwa emva kokukhipha abahlanganyeli abanomlando we-SCID-I; le nqubo yanikeza i N ye-45 (HD = 21; HC = 22). Imiphumela yalezihlaziyi zenziwa ku- Izinto zokwengeza.

I-3. Imiphumela

I-3.1. I-Sociodemographic, i-Neurodevelopmental, ne-Fact Factors

Njengoba kuhloswe yizihloko ezihambisanayo azikho ukuhlukana kweqembu emiphakathini yezenhlalo mayelana nobudala (t(83) = 0.55, p = 0.587) kanye neziqu zemfundo eziphakeme kakhulu (ukuhlolwa okuqondile kukaFisher (N = 85), p = 0.503; bheka Ithebula 1). Futhi, isimo somsebenzi (ukuhlolwa okuqondile kukaFisher (N = 85), p = 0.458), umlando wezobugebengu wesikhathi eside (ukuhlolwa okuqondile kukaFisher (N = 85), p = 0.368), nesimo sobuhlobo (ukuhlolwa okuqondile kukaFisher (N = 85), p = 0.128) awafani neze phakathi kwamaqembu. Kwakungekho nokungafani ezikoleni kuma-subscales amane we-WAIS-IV asetshenziswayo kufaka phakathi isilulumagama esilawulayo (t(82) = -1.28, p = 0.204), i-block design (t(82) = 0.92, p = 0.359), izibalo (t(82) = 0.112, p = 0.911), nokubhala ikhodi (t(82) = 1.66, p = 0.100), ebonisa amazinga afanayo ohlakaniphile phakathi kwamaqembu.
Izinkomba ze-neurodevelopmental perturbations zazifana namadoda ane-HD nokulawulwa okunempilo kuhlanganise nezici zokuthuthukisa jikelele ngesikhathi sobuntwana (ukuhlolwa okuqondile kukaFisher (N = 82), p = Ukusabalalisa kwe-1) (ukuhlolwa okuqondile kukaFisher (N = 85), p = 0.645) no-2D: isilinganiso sobude bomunwe we-4D (t(77) = 0.34, p = 0.738).
Idatha yethu ibonisa ukuthi amadoda ane-HD nezilawuli ezinempilo akhulele emindenini enezici zomndeni ezifanayo ezifana nenani lezingane ekhaya lapho umhlanganyeli akhule khona (t(78) = 0.01, p = 0.995); isikhundla esimweni sokuzalwa (w(78) = 718, z = -0.402, p = 0.687); isikhundla phakathi kwabantwana ekhaya (w(78) = 750, z = -0.464, p = 0.642); Ukuzalwa komama ngesikhathi sokuzalwa (t(79) = 0.88, p = 0.384); futhi iminyaka yobudala ekuzalweni (t(73) = 0.09, p = 0.93). Amadoda anesifo se-HD abike kaningi izinkinga zempilo yengane (ukuhlolwa okuqondile kukaFisher (N = 62), p = 0.001), kodwa hhayi izinkinga zengqondo zezingane (ukuhlolwa okuqondile kukaFisher (N = 68), p = 0.307) kunokulawulwa okunempilo. Ngaphezu kwalokho, izinkumbulo ezincane ezingqondweni zabantu abancane abane-HD zihluke kakhulu ekulawuleni okunempilo. Amadoda ane-HD abike amanani aphakanyisiwe okuhlangenwe nakho okubuhlungu kwezingane (CTQ; t(68) = 2.71, p = 0.009, d = 0.57), ikakhulukazi ukuxhashazwa ngokomzwelo (t(73) = 3.53, p <0.001, d = 0.73), ukunganakwa ngokomzwelo (t(81) = 2.46, p = 0.016, d = 0.54), nokuhlukumeza ngokocansi (t(45) = 2.49, p = 0.017, d = 0.49) kuqhathaniswa nokulawula okunempilo. Nokho, ukuxhashazwa ngokomzimba (t(80) = 1.60, p = 0.113) nokunganakwa ngokomzimba (t(83) = 1.49, p = 0.141) ayifinyelelanga ukubaluleka kwezibalo.

I-3.2. Ukwabelana ngokocansi

Umlando wezocansi ovela kubantu abane-HD uhluke kakhulu kusuka ekulawuleni okunempilo (bheka Ithebula 2). Okokuqala, amadoda ane-HD abe nakho kwangaphambili kobulili kunokulawula iqembu. Amadoda ane-HD abike ukuthi bebancane kunangonyaka uma beqala ukushaya indlwabu (t(79) = 3.59, p <0.001, d = 0.80) futhi cishe unyaka omncane lapho beqala ukukhishwa (t(77) = 2.79, p = 0.007, d = 0.63). Kodwa ahluke eminyakeni yobudala bokuqala (t(83) = 1.868, p = 0.065). Amadoda ane-HD nezilawuli ezinempilo abike ubude obunjalo bobudlelwane bokugcina / bamanje ezinyangeni (t(42) = 0.14, p = 0.886), nenani lezingane (w(75) = 728, z = -0.081, p = 0.936). Kodwa-ke, amadoda ane-HD ahluke ebuhlotsheni babo bocansi kusukela ekulawuleni okunempilo. Amadoda afanayo ne-HD abike mayelana nabalingani bobulili besifazane abangamashumi ayisishiyagalombili (w(79) = 470.5, p = 0.001) nabalingani bomlingani besifazane (w(81) = 443, p <0.000) kunezilawuli ezinempilo. Ngaphezu kwalokho, ngaphandle kokuthambekela kwabo ekuthandeni abesilisa nabesifazane, abesilisa abane-HD babike imisebenzi yezocansi nabesilisa abanabalingani abaningi besilisa abesilisa (w(83) = 567.5, p <0.000) nabalingani bomlingani wesilisa (w(83) = 664, p = 0.002), kanti ukulawula okunempilo kubike cishe akukho imisebenzi yezocansi namadoda. Ngaphezu kwalokho, amadoda anesifo se-HD angase abike ukuthi abe nomcimbi phakathi kobudlelwane bawo bokugcina noma bamanje (ukuhlolwa okuqondile kukaFisher (N = 81), p <0.001), ngama-67% abika indaba uma kuqhathaniswa ne-19% kuphela ekulawuleni okunempilo. Ngaphezu kwalokho, amadoda ane-HD abika izinkinga eziningi ezitholwe ngemisebenzi yezocansi eku-inthanethi kunezilawuli ezinempilo ezikhonjiswe ngomehluko weqembu kumaphuzu we-sIATsex (t(80) = -11.70, p <0.001, d = 2.45). Ngakho-ke, babika ukuthi badla izithombe zobulili ezingcolile kaningi ngesonto ngaphambi kokuhlolwa (ukuhlolwa okuqondile kukaFisher (N = 84), p <0.001), cishe ama-85% wamadoda ane-HD abike okungenani kathathu ukusetshenziswa kwezithombe zocansi ngesonto, uma kuqhathaniswa no-40% wezilawuli ezinempilo. Ngaphezu kwalokho, amadoda ane-HD abukele ngokwesilinganiso cishe imizuzu engamashumi ayisikhombisa ngaphezulu yezithombe zocansi (t(47) = -3.61, p = 0.001, d = 0.73) kunokulawulwa okunempilo. Ubude bezinhlelo zobulili ezingcolile zihluka kakhulu phakathi kwamaqembu, nangaphezu kwesigamu samadoda ane-HD ebukela ihora ngeliviki, uma kuqhathaniswa ne-9% kuphela ekulawuleni okunempilo. Ngokuphathelene nokuzijabulisa ngokocansi nokuvinjelwa, amadoda anesifo se-HD abike ukukhushulwa kobulili okwedlulele (SES: t(83) = 5.01, p <0.001, d = 1.09), ukuvimbela ngokobulili okuphansi ngenxa yengozi yemiphumela yokusebenza (SIS2: t(83) = -3.75, p <0.001, d = 0.82). Noma kunjalo, amadoda ane-HD abonise amaphuzu aphakeme ngokusongelwa kokusebenza kokuhluleka (SIS1; t(80) = 2.30, p = 0.024, d = 0.48). Ngokuthakazelisayo, ukusabalala kokungasebenzi komzimba ngokobulili kwakufana namadoda ane-HD nokulawulwa okunempilo (ukuhlolwa okuqondile kukaFisher (N = 85), p = I-0.765), ikakhulukazi kwakungekho ukungafani e-erectile disorder, disorder disorder disorder, ejaculation ngaphambi kwesikhathi futhi ephuzile.
I-paraphilias njengemiboniso, i-voyeurism, i-masochism, i-sadism, i-fetishism, i-frotteurism noma i-transvestism yayivame kakhulu kubantu abane-HD (ukuhlolwa okuqondile kukaFisher (N = 85), p <0.001) (bheka Ithebula 3). Amadoda anama-HD ayengase akwazi ukubika ukuziphatha kocansi (ukuhlolwa okuqondile kukaFisher (N = 85), p <0.001) kanye nezinga eliphakeme lokusebenzisa izithombe zokuhlukunyezwa kwezingane okungenani kanye ezimpilweni zabo (isivivinyo esiqondile sikaFisher (N = 82), p = 0.009); akukho nokulawula okuphilile okubike ukuthi sekuqedile izithombe zokuhlukumeza izingane.

I-3.3. Izimo Zengqondo Nezinkinga

Okubaluleke kakhulu, amadoda ane-HD abonakaliswe izimpawu zokugula ngengqondo ezinjengokucindezeleka, ukungabi nesifiso noma izimpawu ze-ADHD (bheka Ithebula 4). Ukuhlaziywa okwehlukile kwezifo zokuxilonga zamanje ze-SCID-I ezingaphansi kwamatshana ezimbulwe izinga eliphakeme lezinkinga zokuphazamiseka eqenjini le-HD (ukuhlolwa okuqondile kukaFisher (N = 85), p = 0.015). Ukukhula okwenyuka kwezifo kwaxhaswa ngokuhlolwa kwengqondo kwezimpawu zokucindezeleka ezinemikhawulo ephakeme kumadoda ane-HD (BDI-II; t(79) = 5.47, p <0.001, d = 1.13). Amanani we-SCID-I amanje okuxilongwa ngokusebenzisa kabi izidakamizwa kanye / noma ukuthembela kwakufana namaqembu amabili (ukuhlolwa okuqondile kukaFisher (N = 85), p = I-1.000), njengokuhlola kwengqondo kokusetshenziswa kotshwala (i-AUDIT; t(82) = -0.93, p = 0.354) nokuhlukunyezwa kwe-nicotine (FTND; t(83) = 0.73, p = 0.471, d = 0.16). Kodwa-ke, amanani wezinkinga zokukhathazeka zamanje (ukuhlolwa okuqondile kukaFisher (N = 85), p = 0.690), ukuphazamiseka okucindezelayo (ukuhlolwa okuqondile kukaFisher (N = 85), p = I-1.000), nezimpawu ezibuhlungu kanye nokuphazamiseka kokudla (ukuhlolwa okuqondile kukaFisher (N = 85), p = 1.000) awazange ahluke phakathi kwamaqembu. Kuthathwa ndawonye, ​​amadoda ane-HD nokulawula okunempilo akhombisa ukufana okufanayo kwe-SCID-I yamanje (ukuhlolwa okuqondile kukaFisher (N = 80), p = 0.104) kanye nokuhlolwa kwe-SCID-I yokuphila (ukuhlolwa okuqondile kukaFisher (N = 85), p = 0.190). Kodwa-ke, amadoda anesifo se-HD angase abonise izimpawu ze-ADHD ngesikhathi sokuhlolwa (ADHS / SB; t(73) = 6.31, p <0.001, d = 1.37) nokubika izimpawu zobuntwana ze-ADHD (WURS-K; t(82) = 3.76, p <0.001, d = 0.82), Ngaphezu kwalokho, amadoda ane-HD abonisa ukungabi nesisindo esikhulu kunezindlela zokulawula okunempilo (BIS-11; t(81) = 3.76, p <0.001, d = 0.83). Imiphumela ephathelene nomthethonqubo wemizwe yahlanganiswa: amadoda ane-HD ayengase asebenzise amasu omthethonqubo womzwelo we-maladaptive (amasu angama-FEEL-E-maladaptive; t(81) = 3.54, p <0.001, d = 0.78) kanye namaqhinga "okubukeza kabusha" (ERQ: Ukuhlolwa kabusha; t(83) = -2.477, p = .015, d = 0.545) kodwa ukusebenzisa amasu afanelekayo (amasu e-FEEL-E-adaptive; t(81) = -1.26, p = I-0.212) yayifana nokusetshenziswa kwamasu okuxhaswa (ERQ: Ukususwa; t(83) = 1.852, p = 0.068). Amadoda ane-HD abike izimpawu eziningi ze-alexithymia (TAS-26; t(79) = 4.11, p <0.001, d = 0.92) izikolo eziphakanyisiwe kokubili, ukukhathazeka okuhlobene nokunamathisela (ukukhathazeka kwe-ECR-R: t(78) = 5.413, p <0.000, d = 1.245) nokugwema okuhlobene nokunamathiselwe (ukugwema kwe-ECR-R: t(82) = 4.908, p <0.000, d = 1.064).

I-3.4. Ukuhlaziywa kohlelo lokuHlola

Izinguquko ezahlukanisa kangcono phakathi kwamadoda ane-HD nokulawulwa okunempilo kwakuyiminyaka ekuqaleni kokushaya indlwabu (OR = 0.55, 95% CI (0.35, 0.86)) nesitayela sokunamathisela (OR = 1.06, 95% CI (1.01,1.11)). Okungekho okuphawulekayo kwakuyi-traumata yengane kanye nesitayela sokunamathisela okukhathazayo. Imodeli yokubuyisela ecacisiwe yayinempilo efanele (ene Nagelkerke R2 = 0.55 nokuhlolwa kwe-Hosmer-Lemeshow: χ2(7) = 11.76, df = 7, p = 0.11) futhi kuchazwe mayelana ne-55% yokuhluka phakathi kwamaqembu amabili. Ukucaciswa okucacile okushiwo yi-80.0% (i-78.1% ethize, 81.4% ukuzwela).

I-4. Ingxoxo

Lolu cwaningo luyingxenye yokuqala yokuhlaziya idatha yesimo esivela kwisampula enkulu yabantu abahlangabezane ne-criteria ehlongozwayo yokuhlukunyezwa kwe-hypersexual [3] bese uwaqhathanisa neqembu lezilawuli ezinempilo. Inamba enkulu yezenhlalakahle, izinkinga ze-neurodevelopmental, kanye nezomndeni, kanye nezici zobulili, izici zengqondo, kanye nokungahambisani nokucutshungulwa kwaphenywa.
Ngokuhlaziywa kweqoqo elibanzi lezinguquko lolu cwaningo luveze umehluko obalulekile phakathi kwabantu abatholwe benenkinga yokuxhumene nocansi kanye nokulawula okunempilo.
Ngamafuphi, amadoda anesifo se-HD abonakale ebhekene nobunzima obuningi ebuntwaneni kunokulawulwa okunempilo, cishe babe nomama ngezinkinga zempilo yengqondo, ukuba babe namafomu ahlukahlukene okuhlangenwe nakho okubi ngesikhathi sebuntwana futhi bebonise izimpawu zobungane bezingane. Ngaphezu kwalokho, izinkinga zokunamathisela ngokuzigwema okukhulunywe ngazo ekuhlotsheni obuseduze zaphezulu kumadoda ane-HD. Ukuqala kokushaya indlwabu kwakuneminyaka yobudala emadodeni abane-HD futhi bahlangabezana nokukhathazeka okuphezulu kobulili nokunciphisa ubuncane bezocansi ngenxa yokukhathazeka ngemiphumela emibi, kodwa ukuvimbela kocansi okuphakeme ngenxa yokwesaba kokuhluleka ukusebenza. Ngaphezu kwalokho, amadoda anesifo se-HD abhekene nezinkinga ezivela ngezikhalazo ezizimele ngokusetshenziswa kwawo okuphezulu emisebenzini yezocansi e-intanethi futhi kubika ukuziphatha okubi ngokobulili, okungukuthi amazinga aphezulu e-paraphilia, ukuziphatha ngokucindezela ngokocansi, nokusetshenziswa kwezithombe zokuhlukumeza izingane. Ukuthola izifo eziphazamisayo nezibonakaliso zezinkinga eziningi zempilo ezifana nokungahambisani nokuzikhandla, izimpawu ze-ADHD yabantu abadala, i-alexithymia, kanye namasu okulawulwa kwemizwelo ye-maladaptive yanyuswa kubantu abane-HD.
Kwakukhona izinkomba zokungafani ebuntwaneni besilisa abane-HD uma kuqhathaniswa nokulawula okunempilo. Esikhathini sethu sesampula, amasu omthethonqubo wezimzwelo ezingasebenzi, njengokuhlaziya okunciphisayo nokwandisa amasu angenawo ama-maladaptive angabonakala kumadoda ane-HD, kanye nokukhula kwe-alexithymia. Amadoda ane-HD abike izinga eliphezulu lokuhlangenwe nakho kwezingane; ikakhulukazi amazinga okuhlukunyezwa ngokomzwelo nokunganakiwe, kanye nokuhlukumeza ngokocansi okwenyuka, okuye kwaboniswa ukuthi kuhlotshaniswa nezinkinga zokulawulwa komzwelo [57]. Ngaphezu kwalokho, amasu omthetho wokulawulwa kwemizwelo engathandabuzeki emadodeni anesifo se-HD angase akhuthazwe ubunzima bokugula ngengqondo obhekana nonina wengane [58] okwandisiwe kumadoda ane-HD. Siphikisa ukuthi indlela engena kuyo i-HD ingokuthi uchungechunge lwezinto eziphikisanayo kanye nokuhlangenwe nakho ekubuntwaneni nasekukhuleni okugqugquzela ukuthuthukiswa kwezinhlelo zokulawulwa kwemizwelo ye-maladaptive [34]. Ngaphezu kwalokho, amasu omthethonqubo wezinzwa ezingasebenziyo angahlotshaniswa nobunzima bokunamathisela esibubonayo kumadoda ane-HD, njengoba izingane zibonisa amasu omthethonqubo wezimzwelo ezingasebenzi uma zisendaweni engaqinisekisiwe kumama [59]. Esikhathini sokuhlola okumelelekile kwesibalo saseJalimane, ukusetshenziswa kwemisebenzi yezocansi e-intanethi kwakuxhunyaniswe kakhulu kubantu abathinteka ngokukhathazeka [60]. Ukuhlaziywa kwethu kokubonisa ukubonisa ukuthi ukugwema ebuhlotsheni obuseduze buhlukanisa phakathi kwabantu abane-HD nokulawula okunempilo, okuhambisana nokaKathakis [34] isiphakamiso sokuthi ezinye iziguli ze-HD zingase zibe nokucindezeleka ngokomzwelo ebuntwaneni. Lokhu kungaholela ekuthuthukiseni ukukhubazeka kwesimiso somzimba kanye nezingxenye ze-prefrontal cortex, ngenxa yokuxhumana okungahambi kahle okubandakanya isimiso semisipha esiyinhloko, isimiso sezinzwa esibucayi se-autonomic, kanye ne-hypothalamic-pituitary-adrenal axis [34].
Izinto esizifunayo zihambisana nokuthola okuphakamisa ukuthi amadoda anenkinga ye-HD eyiphutha ayithinta umthethonqubo kanye nomthelela omubi futhi angasebenzisa ukuziphatha okuphathelene nokuxilongwa ngokobulili njengeqhinga lokubhekana ne-maladaptive [61]. Lezi zinsalela ze-neurobiological zingase zithuthuke ebuntwaneni basencane futhi zingadala amandla amakhono nangokwengqondo [34]. Kodwa-ke, sithole ukukhubazeka ngokomzwelo futhi akukho ukungafani ekuhlakanipheni njengoba kulinganiswa yi-WAIS-IV yokuzonda [39] kukhonjiswe kulolu cwaningo nasesifundweni ngesampula encane [62].
Isimo sengqondo sokuziphatha okuphathelene nokuxubana ngokobulili kungabonakalisa ekuthuthukiseni ngokocansi, iqembu lethu le-HD libhekene nokuqala kokushaya indlwabu okwahlukanisa kakhulu phakathi kwamadoda ane-HD nokulawulwa okunempilo ekuhlaziyweni kokuguqulwa kwemvelo. Ngaphezu kwalokho, ukuziphatha kobulili obucanshangelwayo kuhlotshaniswa nokuqala kwesithakazelo socansi [35], nokuqala kokuziphatha ngokobulili kuye kwaxhunyaniswa nokuziphatha okufuna ukuzwa, ukucindezeleka nokukhathazeka [63]. Ukuvama nokuhamba kwesikhathi kokusetshenziswa kwezithombe zobulili ezingcolile kwakungaphezulu kwamadoda ane-HD. Noma kunjalo, kubalulekile ukuqaphela ukuthi hhayi kuphela inani lokusebenzisa izithombe zobulili ezingcolile kuholela ezinkingeni kodwa ukuthi ubuhlobo phakathi kobuningi nobude bezithombe zobulili ezingcolile akusetshenzisiwe futhi ukufuna ukwelashwa akuyona into eqondile, kodwa kunqunywe ubukhulu bezimpawu ezimbi ezibonakalayo ezihlobene nokusetshenziswa izithombe zobulili ezingcolile [64]. Intshisekelo yokukhuthaza umlutha [65,66], okusetshenzisiwe ku-HD [26,62], ukufakazela ukuthi ekugqilazweni "okufunayo" ukukhishwa kwesimo kuyahlukaniswa "okuthandayo". Lokhu kungachaza ukuthi kungani amadoda ane-HD aqhubeka nokuziphatha okunzima naphezu kwemiphumela emibi ebonakalayo. Eqinisweni, amadoda ane-HD esampula sethu abika izinkinga eziningi ngenxa yokusetshenziswa kwawo kwezithombe zobulili ezingcolile.
Indima ebalulekile yokuzijabulisa ngokobulili nokuvimbela ekuziphatheni okungezansi ngokobulili kuboniswe ekuhloleni okukhulu [35,67]. Iqembu le-HD esampula sethu libike ukukhathazeka okuphezulu kobulili nokunciphisa okuncane ngokobulili ngenxa yokusongelwa kwemiphumela yokusebenza, futhi kanjalo nokuvusa okuphezulu kocansi. Siphikisa ukuthi le nqubo ethize yokuvusa ucansi iyisici sokungcupheni, okuhlangene nokusebenzisa ukuziphatha ngokobulili njengendlela yokulawulwa kwemizwelo engasebenzi, kwandisa amathuba okuthuthukisa ukungezwani kocansi. Ukutadisha isampula enkulu ye-intanethi esetshenzisiwe isibalo esiphelele semikhiqizo yezocansi njengendlela yokukhombisa ucansi ngesifo socansi ithola ukuthi isithakazelo esikhulu sezocansi sihlotshaniswa nokusetshenziswa okuzenzekelayo kwezithombe zokuhlukumeza izingane [68]. Eqinisweni, kusibonelo sethu asikho ukulawulwa okunempilo okubikwe ukuthi sekuke kwadlula izithombe zobulili ezingcolile zezingane ngokuphambene no-80% wamadoda ane-HD. Amanani okuziphatha okucindezela ngokocansi avunyelwe kumadoda ane-HD, ekhombisa izinga eliphezulu lokusetshenziswa kwezithombe ezihlukumeza izingane kumadoda ane-HD. Ngokusekelwe kule miphumela kuhlangene nokuhlaziywa kwe-meta okutholakala ukuthi ukuxhumene kobulili obufanayo kuyisici esiyingozi esisekelwe ekubuyiseleni ngokocansi [69], sikhuthaza odokotela ukuba bahlole umlando wesigebengu kanye nokuziphatha okungenzeka kube nokucindezeleka ngokocansi kwiziguli ezine-HD.
Ngaphezu kwalokho, sithole amanani akhula we-interest paraphilic kumadoda ane-HD. Kuze kube manje, kunokutholwa okungahambisani nokuhlangana kwezintshisekelo ze-paraphilic ne-HD. Ucwaningo oluthile lubonisa ukuthi izinga lezintandokazi ze-paraphilic14], kuyilapho kuvivinywa kwensimu ngenqubo ehlongozwayo ye-HD [9] akukho ukuxhumana okutholiwe. Incazelo engaba khona yamanani ahlukeneyo kungaba ukuvuleka ukubika izithakazelo ze-paraphilic, ngoba eJalimane ulwazi nolwazi oluqoqwe ngesikhathi sezocwaningo kanye nezimo zokwelapha zivikelwe yimfihlo, ngisho nalapho zifaka imibiko nge-paraphilic inzalo, ukusetshenziswa kwezingane ezingcolile, nokucindezela ngokocansi ukuziphatha. Inzalo kaParaphilic ngokwayo (uma engekho abanye abalimala) ayidingi noma ayilungele ukungenelela emtholampilo [4]; Kodwa-ke, izithakazelo ze-paraphilic zivame ukuhlotshaniswa nobunzima bomshado [70]. Ngokuvamile, umthwalo wengqondo omelelwa i-HD ungenye yezinto ezitholakalayo ezivela kulolu cwaningo. Idatha yethu igcizelela izimpawu zezinye izidakamizwa ze-psychiatric e-HD. Ikakhulukazi, ukuhlonza kokubili izimpawu zamanje nezesikhathi sokuphila kwezinkinga zokucindezeleka kwanda eqenjini le-HD. Esifundweni sethu, amaphuzu wezimpawu zokucindezeleka njengoba alinganiswa yi-BDI-II cishe aphindwe kathathu emadodeni ane HD anezilawuli ezinempilo. Ngokuvumelana nokuthola kwethu, Weiss [71] bathole ukuthi ukusabalala kokucindezeleka kwaba cishe izikhathi ezingu-2.5 eziphakeme kumadoda ane-HD kunabantu abaningi. Ngokubonke imiphumela yezinhlobo zezifundo eziphenyayo izifo ezibangelwa yi-comorbid affective ku-hypersexual disorder zikhomba ukuthi ukusabalala kuphakathi kwe-28% no-42% [20,70,71]. Ngaphezu kwalokho, sisola ukuthi ukungabi nomusa, ikakhulukazi ukungacabangi ngokobulili ngokoqobo [25] isici se-hypersexual disorder, esekelwe ekuboneni kwethu kokunyuka komfutho kwamadoda ane-HD nezifundo zesikhathi esizayo kufanele azame ukuphenya lokhu. Ukuxhashazwa kwezidakamizwa kuvame ukuxhunyaniswa nokunyuka komfutho. Esikhathini sesampula sethu sithole ukunyuka komfutho okwedlula ubungako obukhulu, kodwa amazinga okusebenzisa kabi izidakamizwa awahlukanga phakathi kwamaqembu. Kunezinhlolovo zemfundiso nezombhalo ezibonisa ukuthi ukuphathwa kabi kwezidakamizwa kuthatha indima ekuziphatheni okuxilisayo [22,72,73], kodwa isithombe asihlali ngokucacile, ngoba izifundo ezahlukene ziye zasebenzisa izinyathelo ezahlukene nezayizi zesampula. Ngaphezu kwalokho, izifundo zesikhathi esizayo kufanele ziphenye izindlela zokuziphatha zobulili ezingaba yingozi emadodeni ane-HD, okuye kwaboniswa ukuthi ihlotshaniswa nezinkinga ezihlukahlukene ezingqondweni [74].
Ngokusekelwe ekucabangeni kwemibono kanye nemiphumela yethu, sakha imodeli yokusebenza ye-etiology yokuziphatha okungcolile (Umfanekiso we-3). Nakuba kungekho bufakazi bokuthi i-etiology eyingqayizivele ye-hypersexual disorder, i-model iveza izingxenye eziningi ezingase zandisa amathuba okuthuthukisa ukugula ngengqondo yobulili obufanayo. Lo mzekelo osebenzayo ungasiza ekukhiqizeni imibuzo emisha yocwaningo kanye nezilinganiso zezinhlelo zokwelashwa.
I-Jcm 08 00157 g003 550
Umfanekiso we-3. Imodeli yokusebenza ye-hypersexual disorder. Sithatha inhlanganisela eyinhloko yezakhi zofuzo nezimo ezingokwemvelo ezingase zenze amathuba okuthuthukisa ukugula ngengculazi. Inhlanganisela yezici ze-biopsychosocial, isib. Izici zezofuzo kanye ne-epigenetic kanye nezenzakalo ezingathandeki zobuntwana zithinta izici ezithile futhi zandisa amathuba okuthuthukisa izifo ze-comorbid psychiatric. Ukuvuvukala okuphezulu kocansi kungaxhunyaniswa nezici zofuzo futhi kungenzeka kokubili kuthonywe futhi kuthinte ukuqala kokuqala kocansi. Izici ezingafaneleki zomuntu ngamunye, izifo ezibangelwa yi-comorbid, nokuvusa okuphezulu kocansi kungaholela ekuthuthukiseni ukuphazamiseka kwe-hypersexual. Izici ezikhonjiswe nge-asterisk zitholwe i-posteriori evela emiphumeleni yethu.
Idatha yethu inezimbalwa eziningi zokwelapha. Siphakamisa ukuthi odokotela bahlolisise ukuhlukunyezwa ngokomzwelo nokunganakiwe, kanye nokuxhashazwa ngokocansi kumadoda ane-HD. Ngaphezu kwalokho, idatha yethu ibonisa ukuthi izimpawu ze-ADHD yabantu abadala be-comorbid zanda ngamadoda ane-HD futhi kuye kwaphakanyiswa ukuthi lezi ziguli cishe zizozuza ku-pharmacotherapy kanye nokwelashwa kokuziphatha kuhlangene [75]. Njengoba ukunciphisa ukusetshenziswa kwamasu okulawulwa kwemizwelo engasebenzi kahle kuboniswe kwisampuli sethu, ukwelapha okuphathelene nokuziphatha kufanele kugxile nasezintweni zokukhathazeka komzimba kanye nokungafisi emadodeni ane HD [76]. Indlela yokwelapha engekho yokwahlulela iyadingeka ukubhekana ne-paraphilia, evame kakhulu kumadoda ane-HD. Sithole amanani okwandisa ukuziphatha kocansi nokusetshenziswa kwezithombe ezihlukumeza izingane kumadoda ane-HD, futhi uma kungenqatshelwe ngemingcele yemfihlo, siphakamisa ukuthi ukuhlolwa kwabahlengikazi kunconywa ngokuqinile ukuvimbela ukuziphatha okulimazayo.

I-5. Ukunciphisa

Kubalulekile ukuthi uqaphele ukuthi lesi sampula senziwa ngabanye abazinikele ekutadisheni emtholampilo futhi bavuma ukubika imininingwane eseduze yemicimbi yokuphila, okuhlangenwe nakho kwangaphakathi nokuziphatha ngokobulili. Ngakho-ke, izici zalesi sampula kungenzeka zingalingani nalabo bantu abanenkinga yokuxhumene nocansi abangenayo ukwabelana ngolwazi oluyimfihlo.
Izincazelo ze-etiology ze-HD zilukhuni ukudweba, ngoba-ngaphandle kwe-2D: isilinganiso se-4D-sithembele ku-self-umbiko we-data kanye nezingxoxo zomtholampilo ekutadisheni kwesigaba esiphezulu kanye nezimpendulo kungenzeka ukuthi zithintekile ukuthanda izinto zomphakathi.
Kunzima ukudlulisela iziphetho zalolu cwaningo kwamanye amasiko. Ngaphezu kwalokho, lesi sampuli saseNtshonalanga YaseYurophu yayingabonisi abantu baseNtshonalanga Yurophu ngokwemibandela, ngokwesibonelo, iminyaka yobudala nezinga lemfundo.

I-6. Iziphetho

Amadoda ane-HD abonakala enesimo esifanayo se-neurovelopmentment, amazinga ezobuhlakani, isizinda somphakathi, nezici zomndeni kuqhathaniswa nokulawula okunempilo. Kodwa-ke, amadoda ane-HD abika umehluko ezindaweni ezibalulekile zokuphila, njengokuhlangenwe nakho okubi ebuntwaneni, ukuziphatha kocansi okunenkinga, nokunyuka kwengqondo kwengqondo.

Izinto zokwengeza

Okulandelayo kuyatholakala ku-inthanethi https://www.mdpi.com/2077-0383/8/2/157/s1, Ukuhlaziya okungeziwe.

Iminikelo Yomlobi

Ukucabangela, IJ, TH, UH, THCK, JK; Indlela, i-MV, i-CS, i-H, i-THCK, ukuhlaziywa okusemthethweni, I-JE, i-MV, ukubhalwa kwe-original draft draft, JE, ukubuyekezwa nokubuyekezwa, I-JE, i-IH, i-CS, i-THCK, i-UH, i-supervision, i-THCK, UH , CS, TH, ukuthola imali, THCK, UH, TH, JK

Izimali

Ucwaningo lwasekelwa isibonelelo socwaningo esivela e-European Society for Medicine Medicine.

Ukuvuma

Abalobi babonga uMarie-Jean Carstensen, u-Anna Spielvogel noJulia Liebnau ngosizo lwabo ekudaleni lo mbhalo.

Izingxabano Zesithakazelo

Okubalulekile ukucwaninga kwasekuqaleni futhi akushicilelwe ngaphambilini kwenye indawo. Abalobi basho ukuthi akukho okuthintana nezimali.

Okubhekwayo

  1. I-Derbyshire, KL; U-Grant, JE Ukuziphatha kocansi ngokucindezela: Ukubuyekezwa kwezincwadi. J. Behav. Umlutha. 2015, 4, I-37-43. [-Google Scholar] [I-CrossRef] [I-PubMed]
  2. I-Fong, TW; Reid, RC; I-Parhami, I. Izidakamizwa zokuziphatha. Kuphi ukudweba imigqa? I-Psychiatr. Umtholampilo. N. Am. 2012, 35, I-279-296. [-Google Scholar] [I-CrossRef] [I-PubMed]
  3. Kafka, MP MP Hypersexual Disorder: A Ukuhlonza Okuhlongozwayo for DSM-V. I-Arch. Ubulili. Behav. 2010, 39, I-377-400. [-Google Scholar] [I-CrossRef] [I-PubMed]
  4. I-American Psychiatric Association. Incwadi Yokuhlola Nezibalo Zezinkinga Zengqondo, I-5th ed.; I-American Psychiatric Association: Washington, DC, USA, 2013; I-ISBN 089042554X. [-Google Scholar]
  5. Kafka, MP Yini okwenzekile enkingeni ye-hypersexual? I-Arch. Ubulili. Behav. 2014, 43, I-1259-1261. [-Google Scholar] [I-CrossRef] [I-PubMed]
  6. Piquet-Pessôa, M .; Ferreira, GM; UMelca, IA; I-Fontenelle, i-LF DSM-5 nesinqumo sokungafaki ucansi, ukuthenga noma ukweba njengemilutha. I-Curr. Umlutha. Imibiko 2014, 1, I-172-176. [-Google Scholar] [I-CrossRef]
  7. Grant, JE; I-Atmaca, M .; I-Fineberg, i-NA; I-Fontenelle, i-LF; Matsunaga, H .; UJanardhan Reddy, YC; I-Simpson, i-HB; Thomsen, PH; UVan Den Heuvel, i-OA; I-Veale, D .; et al. Ukuphazamiseka kokulawula ukucindezeleka kanye "nokulutha ukuziphatha" ku-ICD-11. I-World Psychiatry 2014, 13, I-125-127. [-Google Scholar] [I-CrossRef]
  8. Dickenson, JA; Gleason, N .; Coleman, E .; Umncinci, MH Ukuqwashisa kokucindezeleka okuhambisana nobunzima ekulawuleni ukugqugquzela ngokobulili, imizwelo, kanye nezinzuzo e-United States. I-JAMA Netw. Vula 2018, 1, e184468. [-Google Scholar] [I-CrossRef]
  9. Reid, RC; Umbazi, BN; I-hook, i-JN; I-Garos, iS .; I-Manning, i-JC; Gilliland, R .; Cooper, EB; Mckittrick, H .; Davtian, M .; I-Fong, T. Umbiko wezinto ezitholwe kusivivinyo sezinsizakalo ze-dsm-5 se-hypersexual disorder. J. Sex. I-Med. 2012, 9, I-2868-2877. [-Google Scholar] [I-CrossRef]
  10. Cooper, A. Ukuziphatha ngokocansi kanye ne-intanethi: Ukungena kwiNew Millennium. I-CyberPsychology Behav. 1998, 1, I-187-193. [-Google Scholar] [I-CrossRef]
  11. Cooper, A .; I-Delmonico, i-DL; Burg, abasebenzisi be-R. Cybersex, abahlukumezi, kanye nabacindezeli: Ukuthola okusha kanye nemiphumela. Ubulili. Umlutha. Ukunyanzeliswa J. Ukuphatha. Ngaphambi. 2000, 7, I-5-29. [-Google Scholar] [I-CrossRef]
  12. Döring, NM Umthelela we-Inthanethi kwezocansi: Ukubuyekezwa okubucayi kweminyaka engu-15 yocwaningo. I-comput. I-Hum. Behav. 2009, 25, I-1089-1101. [-Google Scholar] [I-CrossRef]
  13. I-Young, KS I-Internet Sex Addiction Risk Factors, Izinyathelo Zokuthuthukiswa, Nokunakekelwa. Am. Behav. Sci. 2008, 52, I-21-37. [-Google Scholar] [I-CrossRef]
  14. I-Wéry, A .; I-Vogelaere, K .; I-Challet-Bouju, i-G.; I-Poudat, i-F.-X .; Caillon, J .; I-Lever, i-D .; Billieux, J .; I-Grall-Bronnec, M. Ukufaniswa kwezidakamizwa ezithintekayo ngokobulili emtholampilo wokulahla ukukhubazeka. J. Behav. Umlutha. 2016, 5, I-623-630. [-Google Scholar] [I-CrossRef]
  15. Ama-Carnes, i-PJ ukulutha ngokocansi nokuphoqelelwa: Ukwamukelwa, ukwelashwa nokubuyiselwa. I-CNS Spectr. 2000, 5, I-63-72. [-Google Scholar]
  16. UCarroll, JS; I-Padilla-Walker, i-LM; UNelson, uLJ; Olson, CD; I-Barry, i-CM; Madsen, SD Generation XXX: Ukwamukela Izithombe Zobulili Ezingcolile kanye Nokusetshenziswa Phakathi Kwabantu Abakhulayo. J. Adolesc. Res. 2008, 23, I-6-30. [-Google Scholar] [I-CrossRef]
  17. I-Häggström-Nordin, E .; UHanon, U .; UTydén, T. Associations phakathi kokusetshenziswa kwezithombe zobulili ezingcolile kanye nemikhuba yobulili phakathi kwentsha eSweden. Int. J. STD AIDS 2005, 16, I-102-107. [-Google Scholar] [I-CrossRef]
  18. Kalichman, SC; UKhayini, D. Ubuhlobo phakathi kwezinkomba zokuphoqeleka ngokobulili kanye nemikhuba emibi yokuziphatha ngokocansi phakathi kwamadoda nabesifazane abathola izinsizakalo ezivela emtholampilo wokutheleleka ngokocansi. J. Sex Res. 2004, 41, I-235-241. [-Google Scholar] [I-CrossRef]
  19. Mick, TM; Hollander, E. Impulsive-Compulsive Sexual behavior. I-CNS Spectr. 2006, 11, I-944-955. [-Google Scholar] [I-CrossRef]
  20. Raymond, NC; Coleman, E .; I-Miner, MH I-Psychiatric comorbidity kanye nezici eziphoqelekile / eziphambene nokucindezela ukuziphatha kocansi. I-Compr. I-Psychiatry 2003, 44, I-370-380. [-Google Scholar] [I-CrossRef]
  21. de Tubino Scanavino, M .; I-Ventuneac, A .; I-Abdo, i-CHN; I-Tavares, i-H .; do Amaral, MLSA; I-Messina, B .; dos Reis, SC; UMartins, JPLB; I-Parsons, i-JT Ukuziphatha ngokweqile ngokobulili nokusebenza kwengqondo phakathi kwamadoda afuna ukwelashwa eSão Paulo, eBrazil. I-Psychiatry Res. 2013, 209, I-518-524. [-Google Scholar] [I-CrossRef]
  22. Amakhadi Ungabizi Ngothando; Amabhuku e-Bantam: eNew York, e-NY, e-USA, e-1991; I-ISBN 0-553-35138-9.
  23. Reid, RC; Cyders, MA; Moghaddam, JF; I-Fong, i-TW Izakhiwo ze-Psychometric ze-Barratt Impulsiveness Scale kuziguli ezinezinkinga zokugembula, ukuxhumene kocansi, nokuxhomekeka kwe-methamphetamine. Umlutha. Behav. 2014, 39, I-1640-1645. [-Google Scholar] [I-CrossRef] [I-PubMed]
  24. Reid, RC; Dhuffar, MK; I-Parhami, I .; Fong, TW Ukuhlola izici zobuntu ngesampula sesiguli samakhosi abesilisa ocansini obuqhathaniswa nabantu abathandanayo. J. Psychiatry Pract. 2012, 18, I-262-268. [-Google Scholar] [I-CrossRef] [I-PubMed]
  25. Reid, RC; I-Berlin, HA; Kingston, i-DA ukungathandani ngokobulili kumadoda angcolile. I-Curr. Behav. I-Neurosci. I-Rep. 2015, 2, I-1-8. [-Google Scholar] [I-CrossRef]
  26. Mechelmans, DJ; Irvine, M .; I-Banca, i-P .; Porter, L .; UMitchell, uS .; I-Mole, i-TB; I-Lapa, TR; Harrison, NA; Potenza, MN; I-Voon, V. Ukukhathalela okubhekiswe ekubhekiseni imibono ecacile ngokobulili kubantu abanezinkinga zokuziphatha ngokocansi. PLoS ONE 2014, 9, e105476. [-Google Scholar] [I-CrossRef] [I-PubMed]
  27. Reid, RC; I-Karim, R .; McCrory, E .; Umbazi, BN Ukungafani okubikwayo ngokuzikhandla kwezinyathelo zokusebenza okuphezulu nokuziphatha kocansi phakathi kwesimuli nesiguli samadoda. Int. J. Neurosci. 2010, 120, I-120-127. [-Google Scholar] [I-CrossRef]
  28. I-Schiebener, i-J .; Laier, C .; Brand, M. Ukubambelela ngezithombe zobulili ezingcolile? Ukusebenzisa ngokweqile noma ukunganakwa kwezimo zocansi ze-inthanethi esimweni esiningi sezihlobene nezibonakaliso zokulutha kocansi lwe-inthanethi. J. Behav. Umlutha. 2015, 4, I-14-21. [-Google Scholar] [I-CrossRef]
  29. I-Baumeister, i-RF; I-Catanese, i-KR; Vohs, KD Ingabe kukhona umehluko wobulili emandleni okushayela ucansi? Imibono yezinkolelo, ukuhlukaniswa kwemicabango, nokubukeza ubufakazi obufanele. Umuntu siqu. I-Soc. I-Psychol. IsAm. 2001, 5, I-242-273. [-Google Scholar] [I-CrossRef]
  30. Hönekopp, J .; Bartholdt, L .; Beier, L .; Liebert, A. Okwesibili kuya kwesine ubude bedijithali isilinganiso (2D: 4D) namazinga omuntu wesilisa omdala we-hormone: Idatha entsha kanye nokubuyekezwa kwe-meta-analytical. I-Psychoneuroendocrinology 2007, 32, I-313-321. [-Google Scholar] [I-CrossRef]
  31. Hönekopp, J .; Voracek, M .; Manning, JT 2nd kuya ku-4th digit ratio (2D: 4D) kanye nenani labalingani bobulili: Ubufakazi ngemiphumela ye-testosterone ngaphambi kokubeletha emadodeni. I-Psychoneuroendocrinology 2006, 31, I-30-37. [-Google Scholar] [I-CrossRef]
  32. I-Klimek, M .; U-Andrzej, G .; Nenko, I .; I-Alvarado, i-LC; I-Jasienska, i-G. Digit ratio (i-2D: i-4D) njengombonakaliso wesayizi womzimba, ukuhlushwa kwe-testosterone nenani lezingane kumadoda wesilisa. U-Ann. I-Hum. I-Biol. 2014, 41, I-518-523. [-Google Scholar] [I-CrossRef]
  33. I-Varella, i-MAC; I-Valentova, i-JV; Pereira, KJ; I-Bussab, i-VSR Ukunyanyiswa komzimba kuhlotshaniswa nezici zomzimba zesilisa nabesifazane kokubili amadoda nabesifazane: Ubufakazi obuvela kumasampuli aseBrazil naseCzech. Behav. Izinqubo 2014, 109, I-34-39. [-Google Scholar] [I-CrossRef] [I-PubMed]
  34. Katehakis, A. Impact Neuroscience kanye nokwelashwa koMlutha Wezocansi. Ubulili. Umlutha. Ukuphoqeleka 2009, 16, I-1-31. [-Google Scholar] [I-CrossRef]
  35. I-Walton, MT; I-Bhullar, N. Ukuziphatha kocansi okuphoqelekile njenge-Impulse Control Disorder: Ukwaziswa Kwemininingwane Yesizinda Sekulinda. I-Arch. Ubulili. Behav. 2018, 47, I-1327-1831. [-Google Scholar] [I-CrossRef]
  36. Reid, RC; I-Garos, iS .; Umbazi, uBN Ukuthembeka, ukuqinisekiswa, nokuthuthukiswa kwengqondo ye-hypersexual yokusungula ukuziphatha kwesampula esiphelelwe yisifo samadoda. Ubulili. Umlutha. Ukuphoqeleka 2011, 18, I-30-51. [-Google Scholar] [I-CrossRef]
  37. UBernstein, uD .; Fink, L. Incwadi Yemibuzo Yezinkinga Zokuhlukunyezwa Kwabantwana (CTQ); I-Psychological Corporation: eNew York, NY, e-USA, i-1998. [-Google Scholar]
  38. Oldfield, RC Ukuhlolwa nokuhlaziywa kokunikezwa: Inqolobane yase-Edinburgh. I-Neuropsychologia 1971, 9, I-97-113. [-Google Scholar] [I-CrossRef]
  39. Wechsler, D. U-WAIS-IV Wechsler Adult Intelligence Scale Deutschsprachige Adaption, I-4th ed.; Petermann, F., Petermann, U., Eds ;; UHogrefe: Göttingen, eJalimane, i-2013. [-Google Scholar]
  40. Janssen, E .; I-Vorst, i-H .; Finn, P .; I-Bancroft, J. Ukuvimbela ngokocansi (SIS) nokuzijabulisa kocansi (SES) izilinganiso: I. Ukulinganisa ukuvimbela ngokobulili nokuvusa abantu. J. Sex Res. 2002, 39, I-114-126. [-Google Scholar] [I-CrossRef]
  41. I-Pawlikowski, M .; I-Altstötter-Gleich, iC .; I-Brand, M. Ukuqinisekiswa kanye nezakhiwo ze-psychometric zenguqulo emfushane yokuhlolwa kwe-Young's Insemination Inthanethi. I-comput. I-Hum. Behav. 2013, 29, I-1212-1223. [-Google Scholar] [I-CrossRef]
  42. Amakhadi, P .; Okuhlaza, B .; Amaketanga, S. Okufanayo okuhlukile: Ukuphinda uhlaziye ukuhlolwa kocansi ukuhlola ukuhlukumeza ngokocansi (SAST) ukukhombisa ukuqondisa kanye nobulili. Ubulili. Umlutha. Ukuphoqeleka 2010, 17, I-7-30. [-Google Scholar] [I-CrossRef]
  43. I-Wittchen, i-HU; I-Wunderlich, U .; Gruschwitz, S .; Zaudig, M. I-SKID I. I-Strukturiertes Klinisches Ingxoxo ye-DSM-IV. I-Achse I: I-Psychische Störungen. Interviewheft und Beurteilungsheft. Eine deutschsprachige, erweiterte Bearb. d. Amerikanischen Originalversion des SKID I; UHogrefe: Göttingen, eJalimane, i-1997. [-Google Scholar]
  44. UPatton, JH; Stanford, MS; Barratt, ES Barratt Impulsiveness Scale (BIS-11). J. Clin. I-Psychol. 1995, 51, I-768-774. [-Google Scholar] [I-CrossRef]
  45. Fagerström, Kulungile; Schneider, NG Fagerström Ukuhlolwa kweNyotine Dependence. J Behav Med. 1989, 12, I-159-181. [-Google Scholar]
  46. Saunders, JB; Aasland, OG; I-Babor, i-TF; De la Fuente, JR; Grant, M. Ukuthuthukiswa kohlelo lokuhlonza ukuhlukunyezwa kokusetshenziswa kotshwala (i-AUDIT): Iprojekthi ehlangene ye-WHO ekutholeni ngokushesha abantu abanokuphuza utshwala-II. Addiction 1993, 88, I-791-804. [-Google Scholar] [I-CrossRef] [I-PubMed]
  47. I-Hautzinger, M .; UKeller, F .; Kühner, C. I-Beck Depressions-Inventar II. Deutsche Bearbeitung und Handbuch zum BDI II.; Izinsizakalo zokuhlolwa kwe-Harcourt: iFrankfurt am Main, eJalimane, i-2006. [-Google Scholar]
  48. Fraley, RC; I-Waller, NG; Brennan, KA Ukuhlaziywa kwezinto ezithinta izinyathelo zokuziphendulela kwezinto ezizimele zokunamathiswa kwabantu abadala. J. Pers. I-Soc. I-Psychol. 2000, 78, I-350-365. [-Google Scholar] [I-CrossRef] [I-PubMed]
  49. Kupfer, J .; I-Brosig, B .; Brähler, E. I-TAS-26: I-Toronto-Alexithymie-Skala-26 (deutsche Version); UHogrefe: Göttingen, eJalimane, i-2001. [-Google Scholar]
  50. Gross, JJ; Uhlu lwezifiso zami Sebenzisa Thenga ikhadi lesipho Thenga isikweletu se-Google Play Izinhlobo Ekhaya Amashadi aphezulu Ukukhishwa okusha Ama-oda wami Izilungiselelo ISiphathi Sedivayisi ye-Android J. Pers. I-Soc. I-Psychol. 2003, 85, I-348-362. [-Google Scholar] [I-CrossRef] [I-PubMed]
  51. Petermann, F. Fragebogen zakwa Erhebung der Emotionsregulation bei Erwachsenen (FEEL-E). Zeitschrift fur Psychiatry Psychol. I-Psychother. 2015, 63, I-67-68. [-Google Scholar] [I-CrossRef]
  52. I-Retz-Junginger, i-P .; I-Retz, i-W .; I-Blocher, D .; Weijers, H.-G .; I-Trott, G.-E.; Wender, PH; Rössler, M. Wender Utah Isilinganiso Scale (WURS-k) I-Deutsche Kurzform i-retrospektiven erfassung ye-hyperkinetischen syndroms bei erwachsenen. Nervenarzt 2002, 73, I-830-838. [-Google Scholar] [I-CrossRef] [I-PubMed]
  53. Rösler, M .; I-Retz, i-W .; I-Retz-Junginger, i-P .; Thome, J .; U-Supprian, T .; I-Nissen, T .; I-Stieglitz, i-RD; I-Blocher, D .; I-Hengesch, G .; I-Trott, i-GE Instrumente zur Diagnostik der Aufmerksamkeitsdefizit- / Hyperaktivitätsstörung (ADHS) i-Erwachsenenalter. Nervenarzt 2004, 75, I-888-895. [-Google Scholar] [I-CrossRef] [I-PubMed]
  54. Agresti, A. Isingeniso se-Categorical Data Analysis, I-2nd ed.; UWiley: Hoboken, NJ, USA, i-2018; I-ISBN 1119405262. [-Google Scholar]
  55. Cohen, J. Ukuhlaziywa kwamandla eStatistical for the Sciences Behavioral, I-2nd ed.; Erlbaum Associates: Hillsdale, NJ, USA, 1988; I-ISBN 9780805802832. [-Google Scholar]
  56. Okokuqala, MB; I-spitzer, i-RL; Gibbon, M .; Williams, JB Inkhulumomphendvulwano Yokwelashwa Ehlelekile Ye-DSM-IV I-Axis I Disorder; I-New York State Psychiatric Institute: eNew York, NY, e-USA, i-1995. [-Google Scholar]
  57. UCarvalho Fernando, uS .; I-Beblo, T .; Schlosser, N .; I-Terfehr, K .; Otte, C .; Löwe, B .; Wolf, OT; I-Spitzer, iC .; I-Driessen, M .; I-Wingenfeld, K. Impembezo Yokuzilimaza Kwezingane Ezizimele Ngokwemiso Yomzwelo ku-Borderline Personality Disorder kanye Nokucindezeleka Okukhulu. J. Disuma Dissociation 2014, 15, I-384-401. [-Google Scholar] [I-CrossRef]
  58. Goodman, SH; I-Gotlib, IH Risk ye-Psychopathology Ezinganeni Zomama Ocindezelekile: Isibonelo Esithuthukayo Sendlela Yokuqonda Ukudluliswa. I-Psychol. IsAm. 1999, 106, I-458-490. [-Google Scholar] [I-CrossRef]
  59. Amanzi, i-SF; UVirmani, EA; Thompson, RA; Ummeli, uS .; I-Raikes, HA; UJochem, R. Ukulawulwa kwemizwelo nokunamathiselwe: Ukukhipha izakhi ezimbili kanye nokuhlangana kwabo. J. Psychopathol. Behav. Hlola. 2010, 32, I-37-47. [-Google Scholar] [I-CrossRef]
  60. Beutel, ME; Giralt, S .; I-Wölfling, K .; I-Stöbel-Richter, Y .; I-Subic-Wrana, C ;; I-Reiner, I .; I-Tibubos, i-AN; I-Brähler, E. Ukuvama nokunquma kokusetshenziswa kobulili ngokobulili kubantu baseJalimane. PLoS ONE 2017, 12, I-1-12. [-Google Scholar] [I-CrossRef]
  61. Reid, RC; Umbazi, BN; U-Spackman, M .; Willes, DL Alexithymia, ukungazinzi ngokomzwelo, kanye nokuhlukunyezwa kokucindezeleka iziguli ezifuna usizo lokuziphatha kocansi. J. Sex Sex Ther. 2008, 34, I-133-149. [-Google Scholar] [I-CrossRef] [I-PubMed]
  62. I-voon, i-V .; I-Mole, i-TB; I-Banca, i-P .; Porter, L .; UMorris, uL .; UMitchell, uS .; I-Lapa, TR; I-Karr, J .; Harrison, NA; Potenza, MN; et al. Ama-Neural correlates ekuziphatheni ngokobulili ekusebenziseni abantu abanezinkinga zokuziphatha ngokocansi. PLoS ONE 2014, 9, e102419. [-Google Scholar] [I-CrossRef] [I-PubMed]
  63. AmaHarries, MD; I-Paglia, HA; Redden, SA; U-Grant, UJ Age esikhathini sokuqala kocansi: Izinhlangano zomtholampilo kanye nokuqonda. U-Ann. Umtholampilo. I-Psychiatry Off. J. Am. I-Acad. Umtholampilo. I-Psychiatry 2018, 30, I-102-112. [-Google Scholar]
  64. I-Gola, M .; I-Lewczuk, K .; I-Skorko, M. Yiziphi izinto ezidingekayo: Ukulingana noma izinga lokusebenzisa izithombe zobulili ezingcolile? Izici zengqondo nezokuziphatha zokufuna ukwelashwa kwezithombe zobulili ezingcolile ezinenkinga. J. Sex. I-Med. 2016, 13, I-815-824. [-Google Scholar] [I-CrossRef] [I-PubMed]
  65. Robinson, TE; I-Berridge, KC Isisekelo se-neural sesifiso sezidakamizwa: I-incentive-senitization theory of addiction. I-Brain Res. IsAm. 1993, 18, I-247-291. [-Google Scholar] [I-CrossRef]
  66. I-Berridge, i-KC; Kringelbach, ML Okuthandana neuroscience yenjabulo: Umvuzo kubantu nasezilwaneni. I-Psychopharmacology 2008, 199, I-457-480. [-Google Scholar] [I-CrossRef] [I-PubMed]
  67. I-Rettenberger, M .; Klein, V .; UBriken, P. Ubudlelwano Phakathi Kwendlela Yokuziphatha Ngama-Hypersexual, Ukuxhaswa Ngokocansi, Ukuvimbela Ngokwecansi, kanye Nezici zobuntu. I-Arch. Ubulili. Behav. 2016, 45, I-219-233. [-Google Scholar] [I-CrossRef] [I-PubMed]
  68. Klein, V .; Schmidt, AF; I-Turner, D .; UBriken, P. Ingabe ucansi nokuxhumene kobulili obuhlobene nomdlandla wezingane kanye nokuhlukunyezwa kwezingane ngokocansi kwisampula yomphakathi wesilisa? PLoS ONE 2015, 10, I-1-11. [-Google Scholar] [I-CrossRef]
  69. Mann, RE; UHanon, uRK; Thornton, D. Ukuhlola ingozi yokubuyiselwa ngokocansi: Ezinye iziphakamiso ezinhlobonhlobo zengozi ezithinta ingozi. Ubulili. Ukuhlukunyezwa J. Res. Phatha. 2010, 22, I-191-217. [-Google Scholar] [I-CrossRef]
  70. I-Kafka, i-MP; UHennen, J. A DSM-IV I-Axis I Ukuxilongwa Kwamadoda Amadoda (n = 120) Nge-Paraphilias ne-Paraphilia-Related Related Disorders. Ubulili. Ukuhlukunyezwa 2002, 14, I-349-366. [-Google Scholar] [I-CrossRef]
  71. Weiss, D. Ukusabalala kokucindezeleka kubantu abahlukunyezwa ngokobulili besilisa abahlala e-United States. Ubulili. Umlutha. Ukuphoqeleka 2004, 11, I-57-69. [-Google Scholar] [I-CrossRef]
  72. I-Hagedorn, i-WB Ikholi yokuthola i-Manual Yokuhlola kanye neSitatimende esisha Sokuhlukunyezwa Kwemental: Ukuphazamiseka kwezidakamizwa. J. Umlutha. Ama-Counsel Couns. 2009, 29, I-110-127. [-Google Scholar] [I-CrossRef]
  73. I-Kaplan, MS; UKrueger, RB Ukuxilongwa, ukuhlolwa, kanye nokwelashwa kocansi. J. Sex Res. 2010, 47, I-181-198. [-Google Scholar] [I-CrossRef] [I-PubMed]
  74. I-Maclean, i-JC; Xu, H .; IsiFulentshi, MT; Ettner, SL Impilo yengqondo kanye nokuziphatha kocansi okunobungozi: Ubufakazi obuvela ku-DSM-IV ukuphazamiseka kwe-Axis II. J. Ment. Inqubomgomo Yempilo Econ. 2013, 16, I-187-208. [-Google Scholar] [I-PubMed]
  75. Reid, RC; Davtian, M .; Lenartowicz, A .; I-Torrevillas, RM; Fong, TW Izimpendulo ekuhlolweni kanye nokwelashwa kwe-ADHD omdala kumadoda angcolile. I-Neuropsychiatry 2013, 3, I-295-308. [-Google Scholar] [I-CrossRef]
  76. Hallberg, J .; I-Kaldo, i-V .; I-Arver, i-S .; Dhejne, C .; U-Öberg, KG I-intervention-therapy ye-therapy ithimba lokungenelela kwe-hypersexual disorder: Ukutadisha ukufezeka. J. Sex. I-Med. 2017, 14, I-950-958. [-Google Scholar] [I-CrossRef] [I-PubMed]