Ukulutha okuthe xaxa esimweni sobhadane lwe-COVID-19 (2020)

Isingeniso

Ukusabalala komhlaba wonke kwe-COVID-19, izidingo ezilandelayo zokuhlala ekhaya, ukuhlukaniswa isikhathi eside, nezinyathelo zokuhlukaniswa kwendawo ziletha izinselelo ezengeziwe kubantu abasimeme (UMarsden et al., 2020). ENingizimu Afrika, okuyisisekelo sesifo esiwumshayabhuqe e-Afrika, imithethonqubo ebekiwe ibandakanya ukuvinjelwa kokudayiswa nokuthengwa kotshwala (okusungulwe ngomhlaka 27 Mashi, kwasuswa ngomhlaka 1 Juni, kwabuyiselwa ngo-12 kuJulayi kwaphakanyiswa ngomhlaka 17 Agasti 2020) nogwayi ( kusukela ngomhlaka 27 Mashi kuya kumhla ziyi-17 kuNcwaba 2020). Phakathi kokugunyazwa nguhulumeni, ukuziyeka ngenkani (isb ICastro-Calvo, iBallester-Arnal, iPotenza, iKing, neBillieux, 2018), kube nemibiko yokwanda kokuhweba okungekho emthethweni nokwebiwa kukagwayi notshwala (ULuthuli, 2020; UMokone, 2020) nokukhiqizwa futhi (kwesinye isikhathi) ukuphuza utshwala okwenziwa ekhaya (ngezinye izikhathi)IPyatt, 2020). Ngenkathi kulindelwe ukwehla okuphawulekayo emazingeni okuphuza utshwala (UMarsden et al., 2020), izibonelo zomlando ziphakamisa ukuthi kulabo abanemilutha ye-nicotine noma yotshwala, imilutha engena esikhundleni / yokuwela ingavela ngokulandela ukuhambisana nemithetho noma ukuzibophezela kwesikhathi eside ekuziqedeni. Lokho wukuthi, izimpendulo zokuyeka ngenkani zingafaka ukuhambisana nokuzithiba, kepha futhi nokufuna ezinye izindlela zokulutha kanye nokufakwa esikhundleni. Sisebenzisa icala elibonisayo elivela eNingizimu Afrika, sixoxa ngokusetshenziswa kwezithombe zocansi ezihlobene ne-COVID-19 ngokusebenzisa i-lens yokuphindaphinda nokufaka ezinye izidakamizwa.

Izidakamizwa ezithatha indawo zimelela ukushintshwa kokuziphatha okuluthayo ngenye (I-Sussman, 2017). Ukushintshwa kungagcwalisa ukungabi nalutho kokuziphatha okuyekisiwe kokulutha, okwesikhashana noma esikhathini eside, kunikeze imiphumela efanayo yokunciphisa. Ukushintshwa kwesikhashana kungenzeka ngesikhathi sokuyeka ukuzibandakanya ngenkani, kuphele uma umuntu obambele engasebenzi imisebenzi elindelekile noma lapho umsebenzi / into yokuqala yokulutha iphinda itholakala (USinclair et al., 2020). Ukufaka esikhundleni / ukufaka esikhundleni kungaxhunyaniswa nomlando wokulutha komuntu futhi akuhlobene kuphela nokuziphatha okungavunyelwe (isb., Njengokuziphatha okunxephezelayo; UCastro-Calvo et al., 2018); kuncike ekutholakaleni nasekutholakaleni, izinga lapho kuveza khona izimpawu zokubekezela ezibekezelelekayo, nezimo ezibandakanyeka kuzo (isb. kwezenhlalo noma kukodwa, Sussman et al., 2011). Ngokuya ngezifundo ezitholakalayo, ukufaka okunye okuningi kufaka ukushintshaniswa kwezinto. Isibonelo, izimpendulo ku-Operation Intercept, inqubomgomo yomphakathi yase-US ephoqelelwe phakathi kuka-21 Septhemba - 2 Okthoba 1969 ukulawula ukungeniswa kwensangu nezinye izinto emngceleni we-US-Mexico, kufaka phakathi ukungavunyelwa, ukunciphisa ukusetshenziswa nokufakwa esikhundleni (Gooberman, ngo-1974). Ukufakwa esikhundleni, kufaka phakathi i-hashish, utshwala, ama-barbiturate, ama-amphetamines, i-cocaine ne-heroin, kuzanywe ngesikhathi sokushoda noma bekuke kwasetshenziswa phambilini (Gooberman, ngo-1974). Ngokufanayo, izimpendulo zesomiso se-heroin sase-Australia sango-2000/2001 esasibonakala ngokwenyuka kwezindleko, izinga eliphansi kanye nokushoda ekutholakaleni kwe-heroin kwaba: ukuncipha kokusetshenziswa, ukweqisa ngokweqile, ukufaka i-cocaine, insangu, ama-amphetamine kanye ne-benzodiazepines (UDegenhardt, uSuku, iGilmour, neHholo, ngo-2006; Isimo sezulu, uJones, uFreeman, noMakkai, 2003) kanye nokwakhiwa kwemakethe ye-methamphetamine ekhuliswe ekhaya. Izinto nazo zifakwe endaweni yokuziphatha okucindezelayo njengokubuka izithombe zocansi (I-Tadpatrikar & Sharma, 2018).

Ukwanda okuphawulekayo kokusetshenziswa kwezithombe zobulili ezingcolile kuye kwabonwa phakathi nobhadane lwe-COVID-19 (IMestre-Bach, iBlycker, nePotenza, 2020), njengoba imisebenzi eku-inthanethi neyedwa ingasetshenziselwa ukunxephezela ukuxhumana nabantu okulinganiselwe okubandakanya ubulili obuhlanganyelwe (Lehmiller, Garcia, Gesselman, & Mark, 2020) kanye / noma ukubhekana nezimo zemizwa ezihlobene nobhubhaneI-Grubbs, 2020). Kodwa-ke, akwaziwa ukuthi lezi zimilo zinqunyelwe isikhathi noma zilandelana ngokulandelana kwalo bhubhane.UMestre-Bach et al., 2020). Yize ukusetshenziswa kwemvamisa ephezulu kukodwa kungakhombisi ukuthi ukusetshenziswa kwezithombe zocansi okunenkinga (PPU) kunenkinga, iPPU isebenza kaningi (IBőthe, iTóth-Király, iPotenza, et al., 2020). Abanye abantu abane-PPU bazokhombisa ukusetshenziswa okuphazamisekile noma okuluthayo, okuzoholela ekucindezelekeni kwengqondo (I-Király et al., I-2020), izinkinga ebudlelwaneni bezothando (USzymanski noStewart-Richardson, 2014) nokusebenza kocansi (IBőthe, iTóth-Király, iGriffiths, et al., 2020). Abantu abakhombisa i-PPU njengomlutha ongena esikhundleni, noma kunjalo, bangaba sengozini enkulu yokubuyela emuva. Izici ezinobungozi zokuphindaphinda zibandakanya ukunqanyulwa esakhiweni, ubunikazi bezenhlalo kanye nokuhlinzekwa okunikezwa ngamanethiwekhi wokusekelwa kokuthola kabusha (Ama-Dekkers, i-Vos, ne-Vanderplasschen, i-2020), ngizizwa ngingenamandla (UMestre-Bach et al., 2020) futhi ihlukanisiwe lapho kuvela izifiso zokusebenzisa (Volkow, 2020). Ngesikhathi sokuziyeka okuphoqelelwe, lapho umuntu evinjelwa ukuthi ahlanganyele emsebenzini owunikiwe, kungahle kwenzeke ukubuyela emuva lapho ukuziphatha okungavunyelwe kubusa imicabango nezenzo futhi kube okubaluleke kakhulu (Griffiths, i-2005).

I-Compulsive Sexual Behaeve Disorder (CSBD) ichazwa ngokuthi “iphethini eqhubekayo yokwehluleka ukulawula izifiso ezinamandla, eziphindaphindayo zocansi noma izifiso, okuholela ekuziphatheni okuphindayo kwezocansi esikhathini eside (isb., Izinyanga eziyisithupha noma ngaphezulu) okubangela ukucindezeleka noma ukukhubazeka okuphawulekayo ezomuntu siqu, ezomndeni, ezenhlalo, ezemfundo, ezomsebenzi noma ezinye izindawo ezibalulekile zokusebenza ”(I-Kraus et al., I-2018, ikhasi. 109). I-CSBD ivame kakhulu emadodeni (I-Kraus et al., I-2018). Ngaphakathi IBőthe, Potenza nozakwabo '(2020) Ucwaningo lwamuva nje, i-CSBD-19 Scale yanikezwa abantu abadala abayi-9,325 eJalimane, e-US naseHungary, kwaveza ukulinganiselwa kokutholakala kwama-4.2-7% no-0-5.5% engcupheni enkulu ye-CSBD phakathi kwabesilisa nabesifazane ngokulandelana. Ocwaningweni lwangaphambili olwenziwe ngu UDickenson, Gleason, Coleman, and Miner (2018) e-United States, i-8.6% (i-7% yabesifazane ne-10.3% yamadoda) yesampula emele abantu abadala (N = 2,325) ivumile isici esichazayo se-CSBD, leso sokucindezeleka okukhulu ngokomzwelo kanye / noma ukukhubazeka ngenxa yokulahlekelwa ukulawula izinkanuko zocansi, imizwa nokuziphatha.

I-CSBD ine-comorbidity ephezulu ene-Substance Use Disorder (SUDs) (I-Kraus et al., I-2018). Isibonelo, ocwaningweni lwaseNingizimu Afrika, ama-54% abantu abathola ukwelashwa okukhethekile kwe-SUD bahlolwe ukuthi bangaba nokugembula noma ukulutha ngokocansi, noma bobabili (UKeen, uSathiparsad, noTaylor, 2015). I-CSBD iphinde ihlotshaniswe nomlando wokuphila wokuhlukunyezwa ngokocansi, ikakhulukazi phakathi kwamadoda (USlavin, uBlycker, et al., 2020; ISlavin, iSoglio, iBlycker, iPotenza, neKraus, 2020). Ukuhlukumezeka kwengane okungalungisiwe kuyisici esivame ukungaziwa se-etiological ekwakhiweni kokuziphatha okuluthayo (okuxhunyiwe)Lim, Cheung, Kho, & Tang, 2020; ISundin neLilja, 2019; Intsha, i-1990).

Ngezansi, sethula icala elibonisa i-JP lokucacisa izindlela zokulutha okufakwa esikhundleni futhi, ikakhulukazi, ziphinde zibuyele emuva ngesikhathi sokuvalwa eNingizimu Afrika. Lapho kusebenza khona ukutakula kuma-SUD njengokuphila okulondolozwa ngokuzithandela kwansuku zonke kokuzola, ukuba yisakhamuzi kanye nempilo yomuntu siqu (I-Betty Ford Institute Consensus Panel, ngo-2007), Inqubo yokubuyela emuva ye-JP ingalandelwa ngokulandelana kwezinqumo ezincane: ukunqamula ekusekelweni kokutakula; ukuzama ukuthumelelana imiyalezo yocansi nowesifazane nokuxoxisana naye ngokubuka izithombe zocansi. Yize zingabalulekanga kangako, lezi zinqumo - ngokuhlanganyela - zenze ukubuyela emuva (UMarlatt noGeorge, ngo-1984). Ukuxoxisana ngokuthi yiziphi izimo, izikhathi nezinto zokulutha "ezivumelekile" ekuzibandakanyeni kukhombisa ukubuyela emuva ngokomzimba okuseduze lapho engekho amakhono okubhekana ngokuphumelelayo (UKalema et al., 2019; UMelemis, 2015).

Umbiko wecala

UJP yindoda eneminyaka engu-50 eselulama enkingeni yokusebenzisa utshwala futhi eyilungu le-Alcoholics Anonymous (AA) iminyaka engama-25. Uqale ukuzwa utshwala eneminyaka yobudala eyi-7, ngenkathi "umsebenzi wakhe wokuphuza" waqala eneminyaka engu-15. UJP ukholelwa ukuthi utshwala buguqula ubuntu bakhe, bumenza angabi namahloni kakhulu, kumenze akwazi ukuxhumana nokucindezela intshisekelo yakhe ebudlelwaneni bezothando, abesaba ngaleso sikhathi. lapho kusangulukile. Ngaphambi kokuba aqale ukubuka izithombe zobulili ezingcolile, ukulingisa kusenesikhathi kwakuhilela ukucabanga; ukufunda omagazini besifazane, nokweba amanoveli othando nokubuka ngeso lengqondo okuqukethwe kwezocansi. Uhoxile empilweni yomndeni ebibonakala ngodlame kanye nokusetshenziswa kwezidakamizwa kukanina. Kusukela eminyakeni engu-16 kuya kwengu-20, wayenukubezwa ngokocansi owesilisa osekhulile. Futhi manje useyabona "ukuthandana" nabazala abadala njengokuhlukumeza izingane. Lapho eneminyaka engama-24 ubudala, lapho ubaba wakhe emeluleka ukuba "enze okuthile mayelana" nokuziphatha kwakhe kotshwala, waxhumana ne-AA futhi ezinsukwini ezimbili wayesethamele umhlangano wakhe wokuqala. Kepha, ngokubheka emuva, ukhomba ukuthi iminyaka engama-20 wayeziphatha "njengesidakwa esomile" nokuthi "kwavela izingqinamba".

Lapho esangulukile, wayefisa ukuthandana, ikakhulukazi ukuze aphile ngemicabango yocansi. Kodwa-ke, lokhu kwakuphikisana nokubizwa kwakhe ukuba abe ngumfundisi wamaKatolika futhi, lapho eneminyaka engama-25, wangena esikoleni sobufundisi. Ngesikhathi sokuqeqeshwa kwakhe, ukuqhubeka nokushaya indlwabu kwaqhubeka. Uhlanganyele ebudlelwaneni obubili: obunye nomuntu wesifazane ohlangane nowesifazane oshadile futhi obunye obamkhuthaza ukuthi aqede ukuqeqeshwa kwakhe. Waba ngumsizi wokululama ngo-2008, esebenzisa umsebenzi wakhe wokuba umlutha nokululama ukuze asekele ukwelashwa nokunakekelwa ngemuva.

Ngemuva kokuhlangabezana nezilonda zocansi nothando (SLAA) ngomsebenzi, uJP waqala ukuya emihlanganweni ngo-2019. Ukubamba iqhaza kwaholela kolunye "uvuko ngokomoya" kanye nokwamukelwa kokuziphatha kwesikhathi eside njengokulutha kocansi nothando (kunzima ebudlelwaneni; ukukhetha abesifazane abangatholakali ; ukubuka izithombe zocansi nokushaya indlwabu ngokweqile). UJP ukholelwa ukuthi (umlutha wezithombe zocansi) wakhe "ubelokhu ekhona," kepha wanda ngokuyeka utshwala; ukulinganisa “nokuthatha leso siphuzo sokuqala.” Lokho wukuthi, wayebheka ukulutha kwakhe ngokocansi njengengxenye yokulutha kwakhe utshwala. Kanjani wafinyelela izithombe zobulili ezingcolile zashintsha ngokuhamba kwesikhathi: kusuka ekubukeni ama-DVD, ukuya ekukhetheni ku-flash drive; Izithombe ezihambayo nokubuka amawebhusayithi kusuka ocingweni lakhe. Wenqaba ukuthola i-smartphone kuze kube yiminyaka engu-40 ngokwesaba ukukhulisa ukubuka kwakhe izithombe zocansi. Ukusebenzisa ifoni yakhe kumenza akwazi ukubuka izithombe zobulili ezingcolile noma nini lapho ethanda khona nalapho etholakala khona. Yize "esaba" ekuqaleni, manje usebenzisa ifoni yakhe ukuthola okuqukethwe okwenzelwe "ukufeza" imicabango yakhe yezocansi. Intombi yakhe yamanje (ethandana nomuntu ongekho emshadweni noJP) ibheka ukusetshenziswa kwakhe kwezithombe zocansi njengokukhaphela. Kodwa-ke, lapho ebuka izithombe zobulili ezingcolile, “unamathela” efonini yakhe; "Akakwazi ukuthola okwanele" futhi "ukhathazeka ngokweqile" oku "kusabisayo" kuye. Uyeke ukubuka izithombe zocansi "emasontweni ambalwa ngaphambi kokuvalwa".

Ukumenyezelwa kokuvalwa kweNingizimu Afrika ngoMashi 23, 2020 kwaqondana nomhlangano wakhe wokugcina we-AA. Ngemuva kwamasonto amabili kuvaliwe, uJP wabamba iqhaza emhlanganweni wakhe wokuqala we-inthanethi we-AA futhi kamuva waba ngumhlangano weSLAA. Kodwa-ke, ekhathazekile ngokungaziwa kanye nezindleko eziphezulu zedatha yeselula, wayeka ukubamba iqhaza emihlanganweni ye-SLAA. Izinqubomgomo zokuhlukaniswa kwabantu zivimbela ukuxhumana nentombi yakhe kanti uJP uzwakalise ukuzizwa ekhungathekile ngokocansi, enesizungu futhi "elangazelela ukusondelana." Uhlangabezane "nokushelela" ngemuva kwesicelo sakhe sokushintshana ngemibhalo yezocansi nowesifazane ayekade ebathumelela imiyalezo enqatshelwe, futhi waqala ukuxoxisana naye ngokubuka izithombe zocansi. Manje, ebuka izithombe zobulili ezingcolile eziningi kunalokho obekuhleliwe kwasekuqaleni futhi eshaya indlwabu ngokucindezela, uchaza "ukuzizwa ungenalutho, ucasukile, ucabalele, ukhathele, ungakwazi ukusebenza, ukungalali ebusuku" futhi ulahlekelwe isikhathi sokuhlangana ngenxa yalokho. Ukusungula ukuzithiba okuhlala njalo, uveza isidingo sokuhlela impilo yakhe ekhaya kangcono ngesikhathi sokuvalwa, nokuhlola ukuhlukunyezwa kwengane yakhe kanye nokuxhumana kwayo nemicabango yakhe yezocansi.

Ingxoxo neziphetho

Leli cala ligcizelela ukuthi kungahle kube khona ukuthambekela kokufaka ezinye izidakamizwa ngenxa yomuntu ngamunye (isib. Ukucindezeleka; amakhono okubhekana nezinkinga; izimpendulo zokuqonda nezingathinteki), ezemvelo (isib. Ukwesekwa kokuthola kabusha, ukufinyelela ezintweni nasekuziphatheni) kanye nezici ezihlobene nokuziphatha komlutha (isb. Umlando kanye iphethini yemiphumela yokunciphisa). Ngenkathi abangena esikhundleni bengenzi ngempela ukuveza ukubuyela emuva, okuhambisana nokuhlukaniswa, ukunciphisa ukwesekwa kokutakula kanye nezimpendulo (ezingezinhle) zokuqonda kanye nezempumelelo ekuphelelweni (okusho umphumela wokwephula ukuzithiba; UCollins noWitkiewitz, 2013), Bangakwazi ukubuyela ekuziphatheni kwangaphambilini noma "okusha". Okungukuthi, indima enikezwe ubhadane maqondana nokuphela (nokufakwa esikhundleni) nokuthi ukubuyela emuva kubunjwe kanjani uma kwenzeka, kunomthelela ekulondolozweni nasekusungulweni kabusha kokululama. Ukuziphatha okuluthayo okungakhulunywanga kusethi yokulutha kungavimbela ukululama okuzinzile noma kuholele ekubuyeleni ekuziphatheni okungavunyelwe. Ngakho-ke, inqubo yokutakula impilo yakho yonke kufanele ibhekele yonke imisebenzi ekhulisa ubungozi bokubuyela emuva (ISchneider, Sealy, Montgomery, ne-Irons, 2005). Ukuhlukunyezwa ngokocansi okungaxazululiwe kungadlala indima ethile ekuluthweni kotshwala nocansi futhi kungabeka umuntu emuva ekubuyeleni emuva; kungadingeka ukuxazululwa kokuhlukumezeka (Intsha, i-1990).

Izidakamizwa ezithathelwe indawo kungenzeka zivele ngesikhathi sobhadane zinikezwe ukufinyelela okulinganiselwe nokutholakala kwezinto ezithile kanye nokuziphatha, kanti ezinye (isib. Lezo ezenziwa lula yi-intanethi) zingatholakala futhi zikhuthazelele ngesikhathi nangemva kwalo bhubhane. Akuzona zonke izindlela zokuziphatha ezizobanjelwa imilutha yangempela. Kodwa-ke, yikho kanye lokhu kuhlukahluka kwezindlela zokulutha izidakamizwa okumele ochwepheshe bezidakamizwa bazi ngazo ngesikhathi nangemva kobhadane lwe-COVID-19, kanye namandla alo okwenyuka kwezidakamizwa uma kungekho ukusekelwa kokutakula (kanye nokuqhubeka okungaba khona kwezinkinga ezenzeka ngokubambisana ezifana ukuhlukumezeka). Ngenxa yalokho, izinsizakalo ze-SUD kufanele zenze ukuhlolwa okuphelele (kwezinto ezingezona ezomuthi), kubhekane nezimilo ezizongena esikhundleni sohlaka lwezokwelapha futhi zifake lolu lwazi ekuhlelweni nasekusekelweni kokunakekelwa kabusha. Ukuqinisa isizungu, abantu abangaphakathi noma abafuna ukululama kufanele bakhuthazwe ukuthi bagcine ukuxhumana nokuxhumana nabantu ngokusebenzisa izinkundla ze-inthanethi noma ucingo futhi bafune usizo lochwepheshe ngesikhathi sokuphelelwa amandla noma ukucindezeleka (I-Király et al., I-2020). Ucwaningo lwesikhathi esizayo kufanele luhlolisise ukuthi izinqubo ezithinta ingqondo nezisebenza engqondweni ngokulandela ukuphelelwa yisikhathi ziyahluka yini lapho kubhekene nobhadane, kanye nemiphumela engaba khona yokulawula imilutha yezidakamizwa nokukhuthaza ukululama.

Ethics

Lolu cwaningo lwamukelwa yiKomidi Lezimilo Zabantu kanye Nesocwaningo Lwezenhlalakahle eNyuvesi yaseWestern Cape (eKapa, ​​eNingizimu Afrika) kanti lwenziwa ngokuhambisana neSimemezelo saseHelsinki. Isihloko sazisiwe ngocwaningo futhi sanikezwa nemvume yocwaningo lwamacala.

Imithombo yokuxhasa ngezimali

Lo msebenzi ubusekelwa yiNational Research Foundation yaseNingizimu Afrika (izibonelelo 107586 no-121068) kanye neGhent University's Special Research Fund (BOF) Yabafundi Abavela Emazweni Athuthukayo.

Umnikelo wabalobi

I-DS yabhala uhlaka lokuqala locwaningo lwamacala, olabuyekezwa ngokujulile yi-WV, SYS, DB, SS ne-MF. Bonke ababhali bavume inguqulo yokugcina yombhalo wesandla ukuze ithunyelwe.

Ukungqubuzana kwesithakazelo

Abalobi bathi akukho mpikiswano yenzuzo.