I-UPDATES ngalesi simemezelo se-American Association of Addiction Medicine:
- Ukuxilongwa okusemthethweni? Umbhalo wezokwelapha wezokwelapha osetshenziswa kakhulu emhlabeni, I-International Classification of Diseases (ICD-11), iqukethe ukuxilongwa okusha efanelekile ukulutha izidakamizwa: "Ukucindezeleka Ngokuziphatha Ngokwemvelo. "
- Ukulutha kobulili / ucansi? Leli khasi libala Ucwaningo lwe-39 lwe-neuroscience (I-MRI, i-FMRI, i-EEG, i-neuropsychological, i-hormonal). Banikeza ukusekela okuqinile ngesimodeli sokulutha kwezidakamizwa njengoba iziphumo zabo zibuyisa ukutholakala kwezinzwa ezibikiwe ezifundweni zokulutha izidakamizwa.
- Imibono yangempela yezobuchwepheshe ekubhekaneni nocansi / ucansi? Lolu hlu luqukethe Ukubuyekezwa kwezincwadi ezingama-16 zakamuva nezincazelo ngezinye zezazi eziphezulu zezinzwa emhlabeni. Bonke basekela imodeli yokulutha.
- Izimpawu zokulutha umlutha nokukhula kwezinto ezimbi kakhulu? Ngaphezulu kwezifundo ze-30 zokubika okutholakele okuhambisana nokwanda kokusetshenziswa kocansi (ukubekezelelana), ukujwayela i-porn, kanye nezimpawu zokuhoxa.
I-American Society of Addiction Medicine ithi ukukhwabanisa ngokobulili kungokoqobo njengemilutha yezidakamizwa
Umcimbi omkhulu wenzekile endaweni yesayensi yokwelashwa nokulashwa. Ochwepheshe abaphezulu bezidakamizwa baseMelika e-The American Society of Addiction Medicine (ASAM) basanda kukhipha ukushanela kwabo incazelo entsha yokulutha umlutha. Le ncazelo entsha iqeda impikiswano yokuthi ucansi nezidakamizwa zocansi “kuyizidakamizwa ezingokoqobo” yini. Kunjalo.
Ukusuka Ukusakaza kwe-ASAM:
Incazelo entsha ibangelwe inqubo eqinile, yeminyaka emine enezingcweti ezingaphezu kuka-80 ezisebenza kuyo, kufaka phakathi iziphathimandla eziphezulu zokulutha izidakamizwa, odokotela bezokwelapha izidakamizwa kanye nabacwaningi abahamba phambili be-neuroscience ezweni lonke. … Iminyaka engamashumi amabili yentuthuko kwezobuchwephesha bezinzwa yaqinisekisa i-ASAM ukuthi ukulutheka kumele kuchazwe kabusha ngokwenzeka ebuchosheni.
Kungenzeka ukuthi i-ASAM isebenze, ngokwengxenye, ngoba odokotela bengqondo ababukeza i-DSM (iAmerican Psychiatric Association's Incwadi Yokuhlola Nezibalo Ukuphazamiseka Kwengqondo) kuye kwaba behudula izinyawo zabo ekuletheni i-DSM-5 ezayo ihambisane nentuthuko ocwaningweni lokulutha isimilo. Ngokwesiko, i-DSM inikeza ukuxilongwa okungasekelwe kwizifo eziyimbangela, kepha kuhlu lokuziphatha. Njengoba ababhali be-DSM bengavumelani ohlwini lwezenzo zokuziphatha zocansi ezakha i- "Hypersexuality Disorder" (ekhuluma ngokusetshenziswa kocansi okucindezelayo), bashunqekile. Eqinisweni, bangasusa lesi sifo kusihlomelo-Kufana nokusetshenziswa kocansi kwe-intanethi phakathi kwabafana abasha abafana cishe jikelele. (QAPHELA: Lokhu kwabhalwa ngaphambi kokuthi i-DSM-5 ezayo inqume ukudala i- "behaisigaba sokulutha umlutha".)
Ukuchazwa kwe-ASAMU
Ngokungqubuzanayo, incazelo ye-ASAM, “Ibheka indima ebuchosheni ekufundisweni kokulutha — okwenzekayo ngokusebenza kobuchopho kanye nokujikeleza okuthile kobuchopho okungachaza ukuziphatha kwangaphandle okubonwa ukulutheka.” Kuwukuvuma ukuthi ukuziphatha ngokobulili (isib. Ukubuka i-Internet nsuku zonke) kungaba ubufakazi bokuthi isifo somuntu sisebenza kanjani ebuchosheni bomuntu ngaphandle kokubonisa ukukhubazeka komunye.
Ukucwaninga kubonisa ukuthi kokubili ukulutha kwezimo zokuziphatha kanye namakhemikhali kubandakanya ukuguqulwa okukhulu okufanayo ekutheni ubuchopho be-anatomy ne-physiology. An Okhulumela i-ASAM wachaza:
Incazelo entsha ishiya ngaphandle kokungabaza ukuthi zonke izidakamizwa - kungaba utshwala, i-heroin noma ucansi, zithi-ziyafana ngokuyisisekelo. UDkt Raju Haleja, owayengumongameli weCanada Society for Addiction Medicine nosihlalo wekomidi le-ASAM elenza le ncazelo entsha, utshele iThe Fix ukuthi, “Sibheke ukuba umlutha njengesifo esisodwa, ngokungafani nalabo ababona behlukene izifo. Umlutha umlutha. Akukhathalekile ukuthi yini ebucisha ubuchopho bakho kulolo hlangothi, uma selushintshile, usengcupheni yakho konke ukulutheka. ” … Ucansi noma ukugembula noma ukulutha kokudla [konke] kusebenza ngokomthetho njengokulutha kotshwala noma i-heroin noma i-crystal meth.
Nasi isifinyezo esifushane samaphuzu amakhulu e-American Society of Addiction Medicine:
- Ukulimala kubonisa ukuthi ubuchopho obufanayo bushintsha ukuthi buvela ekuphenduleni amakhemikhali noma ukuziphatha.
- Umlutha yisifo esiyinhloko. Akudingekile ukuthi kubangelwe yizinkinga zempilo yengqondo ezinjengokuphazamiseka kwemizwelo noma ubuntu. Lokhu kubeka emcabangweni odumile wokuthi ukuziphatha okuluthayo kuhlala kuyindlela “yokuzelapha” ukudambisa ezinye izifo.
- Zombili izidakamizwa zokuziphatha nezidakamizwa zenza izinguquko ezinkulu ezifanayo ezijikelezweni ezifanayo ze-neural: I-hypofrontality, ukuzwela, ukuhlenga izinkinga, ukushintsha izijikelezo zokucindezeleka, njll.
- Ukuzibandakanya "ekuziphatheni okuluthayo" okungapheli kubonisa ukuthi izinguquko zobuchopho ezingenhla zenzekile. Ukuziphatha okuluthayo bese kuba ukungazi nokujwayela.
- Incazelo entsha iqeda umehluko wakudala "wokulutha ngokweqile nokucindezela", obejwayele ukusetshenziselwa ukwenqaba ukuba khona kwezidakamizwa zokuziphatha, kubandakanya nokulutha kwezocansi kwe-Intanethi.
Ngokungafani nobuchopho bokugembula, ukudla, imilutha yevidiyo, ubuchopho bezocansi / imilutha yezocansi abukaskena. Kodwa-ke imishini yobuchopho yokulutha kokuziphatha isivele ichazwe kahle, ukuthi ochwepheshe bangasho ngokuzethemba ukuthi indlela yokuziphatha ngokocansi nayo ingalutha. Ngamanye amagama, akuyona ifomu noma ubungako besikhuthazi, kepha kunalokho ubuchopho obumphumela buyashintsha, okubalulekile. Lezi zingcaphuno ezivela kuma-FAQ we-ASAM zichaza isayensi ejwayelekile kuyo yonke imilutha:
UMBUZO: Yini ehlukile ngale ncazelo entsha?
IMPENDULO: Ukugxila esikhathini esedlule kuye kwaba izinto eziningi ezihlobene nokulutha, njengokudakwa, i-heroin, i-marijuana noma i-cocaine. Le ncazelo entsha ikwenza kucace ukuthi ukulutheka akulona olwezidakamizwa, kumayelana nobuchopho. Akuzona izinto umuntu azisebenzisayo ezenza zibe umlutha; akulona ngisho ubuningi noma imvamisa yokusetshenziswa. Umlutha umayelana nokwenzeka ebuchosheni bomuntu lapho echayeka ezintweni ezinomvuzo noma ekuziphatheni okuvuza, futhi kumayelana nemivuzo yokujikeleza ebuchosheni nasezakhiweni zobuchopho ezihlobene kunokuba kumayelana namakhemikhali angaphandle noma isimilo "esivula" esiklomelisa izifunda. (Kugcizelelwe.)
Ukuhlukunyezwa kubelana nezinguquko ezivamile zengqondo, ezibonisa ukuziphatha njengemizamo engaphumelelanga yokulawula ukusetshenziswa, izifiso ngesikhathi sokuziqeda, nezimpawu zokuhoxiswa. Kuze kube manje, ukuguqulwa kobuchopho obuseduze kubonakala kuzo zonke izilingo (ukungafuni, ukuzwela, nobuzenzisi) sekuvele kuphawulwe ebuchosheni babadlali abagembayo, abadla ngokweqile, abadlali bevidiyo. Kungenzeka ukuthi bakhona nakubasebenzisi banamuhla be-porn abacindezelayo. Uma ihamba, ikhuluma futhi yenza njengedada, idada. (Ukuvuselelwa: I-Cambridge University: Ukuhlola kwe-Brain thola ukulutha kwe-porn)
Okunye okushiwo isitatimende se-ASAM ukuthi umuntu akakwazi ukuchaza "umlutha wezocansi" ngesikhathi esichithwa kubukwa noma izinhlobo ezibukelwe. PUkubhebhetheka komuthi okukhona kukhona kuphela uma izinguquko zobuchopho ezifanele zenzeke kumbukeli. Njengoba ukuskena kobuchopho kungenakwenzeka, i-ASAM idale ukuhlolwa okuyingxenye emi-5 ukusiza abantu ukuthola ukuthi ubuhlakani babo sebushintshile. Lokhu kufana nokuhlola amamaki kashukela ezigulini ezikhononda ngezimpawu ze-telltale.
Le mibuzo emibili elandelayo esuka ku-ASAM ikhuluma ngezocansi kanye nezidakamizwa zokudla ngokuqondile:
UMBUZO: Le ncazelo entsha yokulutha umlutha ibhekisela ekuluthweni okubandakanya ukugembula, ukudla nokuziphatha kocansi. Ingabe i-ASAM ikholelwa ngempela ukuthi ukudla nokulala ngokobulili kungumlutha?
IMPENDULO: Ukubheja ukugembula kuye kwachazwa kahle ezincwadini zesayensi emashumini ambalwa eminyaka. Eqinisweni, uhlelo olusha lwe-DSM (DSM-5) luzobeka uhlu lwengozi yokugembula esigabeni esifanayo ngezifo zokusebenzisa izidakamizwa.
Incazelo entsha ye-ASAM yenza ukuhlukanisa ukulingana nokulondeka ngokwezinto ezibonakalayo, ngokuchaza ukuthi ukubheja kuhlobene kanjani nokuziphatha okuvuzayo. Lesi yisikhathi sokuqala ukuthi i-ASAM ithathe isikhundla esisemthethweni sokuthi ukulutheka akulona kuphela "ukuncika kwento."
Le ncazelo ithi ukulimala ngokuphathelene nokusebenza nokucubungula ubuchopho nokuthi isakhiwo kanye nomsebenzi wezinhliziyo zabantu abanomlutha uhlukile kanjani kwisakhiwo kanye nomsebenzi wezinhliziyo zabantu abangenalo umlutha. Ikhuluma ngomvuzo wesifundazwe ebuchosheni nasezindaweni ezihambelana nazo, kodwa ukugcizelela akukona emivuzo yangaphandle eyenza uhlelo lokuvuza. Ukudla nokuziphatha kocansi nokuziphatha kokugembula kungahlotshaniswa "nokuphishekela imivuzo ngokweqile" okuchazwe kule ncazelo entsha yokulutha. (Ukugcizelelwa kwengezwe.)
UMBUZO: Ubani onomlutha wokudla noma umlutha wezocansi?
IMPENDULO: Sonke sinemijikelezo yomvuzo wobuchopho eyenza ukudla nezocansi kuzuzise. Le yindlela yokusinda. Ebuchosheni obuphilile, le mivuzo inezindlela zokuphendula ngokusutha noma 'ngokwanele.' Kumuntu onomlutha, izifunda azisebenzi kahle kangangokuba umyalezo oya kulowo muntu ube 'ngaphezulu', okuholela ekuphishekeleni ngokweqile imivuzo kanye / noma ukukhululeka ngokusebenzisa izinto nokuziphatha.
Ngamafuphi, kukhona umlutha wezocansi okhona, futhi kubangelwa ukuguqulwa okuyisisekelo esifanayo kwisakhiwo sobuchopho kanye ne-physiology njengemilutha yezidakamizwa. Lokhu kwenza kahle. Phela, izidakamizwa eziluthayo azikwenzi lutho kodwa zanda noma zinciphisa imisebenzi evamile yemvelo. Bashaya izifunda ze-neural ukuze bazuze imivuzo yemvelo, ngakho kufanele kubonakale ukuthi izinguqulo ezimbi kakhulu zemikhiqizo yemvelo (ukudla okungenamsoco, i-porn inthanethi) nakho ukuphanga lezo zifunda.
Kuthiwani mayelana nezilutha ezingcolile?
Abahlinzeki bezempilo banamuhla nabahleli bezeluleko abadumile bavame ukukhohliswa ngobungozi bokusetshenziswa kocansi lwe-Intanethi-ngokwengxenye ngoba bayazi ukuthi ukushaya indlwabu (ngaphandle kocansi) akuvamisile ukugqilaza. Inkinga, i-porn ye-Intanethi iyi hhayi nje ukushaya indlwabu. Inkolelo yokuthi ukushaya indlwabu kanye ne-porn ye-intanethi kufana nokubonisa ukungabi nokuqonda kwemiphumela engaba khona ebuchosheni obunjalo. Ngokuvamile, ukushaya indlwabu kuholela ekuzizweni kwemizwa. Ngokuphambene, izithombe ze-intanethi zingakwazi yenzeke ngaphezulu satiety yemvelo. Kwezinye ubuchopho, ephethe isifo satiety yemvelo ngokugqugquzela ngokweqile yi-slope ephuzayo ekushintsheni kobuchopho obuhlobene nokulutha umlutha. Lokhu ukungaboni kahle kubangela iseluleko esingalungile kubaguli / amaklayenti / abafundi.
Izinselelo zokucwaninga
Lapho abacwaningi ngelinye ilanga babheka ubuchopho bezilonda ze-inthanethi ze-Internet, bayaqiniseka ukubona izinguquko ezivele zikhona kwezinye izinhlobo zezilutha ze-intanethi. Maye, ucwaningo lwezokwelapha ngocansi lubhekene nezinselele ezibucayi:
1. Ukulawulwa kwamaqembu wabasebenzisi bezithombe zocansi besilisa, okungebona abaku-inthanethi abasakwazi ukutholakala, futhi noma bengakwazi, amabhodi wokubuyekeza ngeke avume imigomo ebabiza ukuthi babuke izinhlobo zezithombe zocansi amahora amaningi ngosuku izinsizwa zanamuhla zibhekile.
2. Imibuzo engacacile (ngokungafani nokuskena kobuchopho) yenza kube nzima kubasebenzisi be-porn ukuxhuma izinkinga zokusebenza kocansi (noma ukukhathazeka komphakathi, ukucindezeleka noma izinkinga zokuhlushwa) nokusetshenziswa kocansi lwe-intanethi. Ngemuva kwakho konke, i-porn ibukeka njenge-aphrodisiac ethembeke kakhulu emhlabeni, futhi abasebenzisi bahlala bezizwa bengcono ngenkathi besebenzisa. Kungenzeka kanjani ukuthi kubangele zona kanye izinkinga ezelapha okwesikhashana?
Kuphela ngolwazi olubanzi lokulutha, izimbonakaliso zalo, kanye ne-etiology yayo ingabacwaningi nezikhonzi zabo baxhumane ngokunembile imbangela ngokusebenza. Isitatimende se-ASAM sisekela abacwaningi ekuphenyweni kokusetshenziswa kocansi ngokusebenzisa i-lens yokushintsha kwengqondo.
Abahlinzeki banemithwalo yemfanelo emisha
Isimemezelo se-ASAM yisinyathelo esiya phambili ekusizeni ekufundiseni kabusha abelaphi namakhasimende abo. Abaningi bafundiswe ngephutha ukuthi ukulutha kokuziphatha ngokocansi akukwazi ukuvela ekukhuliseni ubuchopho ngokuziphatha. Esikhundleni salokho, baqeqeshelwa ukuqinisekisa amaklayenti ukuthi ukulutheka ekuziphatheni ngokocansi akukaze kube yingozi — ngaphandle kwalapho iklayenti linezinye izifo (ezivamile zofuzo).
Kodwa abalobi be-ASAM balinganisela ukuthi izakhi zofuzo zenza cishe isigamu imbangela yokulutha. Lokhu kusho ukuthi ukulimala kungathuthuka ngokungabikho kwezimo ezandulele. Ngamanye amazwi, izimpawu ezihlobene nezocansi ezifana nokucindezeleka, ukukhathazeka komphakathi, izinkinga ezisencane zocansi kanye nezinkinga zokuhlushwa kudingeka zibhekwe njengokusemandleni imiphumela wokulutha, kunokuba kuthathwa njengabo njalo imbangela.
Isitatimende esisha somuthi wokulutha sibeka umthwalo wemfanelo kwabelaphi ukuze basize abathengi bezocansi futhi abawumlutha wokwenza izinguquko eziyisisekelo ekuziphatheni kwabo. Okwamanje, abeluleki abaningi bamane badlulisela amakhasimende kudokotela wezidakamizwa ezithuthukisa ngokobulili. Ngasikhathi sinye futhi bayabaqinisekisa ukuthi ukuziphatha kwabo kocansi kuyinto ejwayelekile futhi ayinangozi.
Isitatimende se-ASAM sisinyathelo esikhulu ekuqondiseni umsindo. Ngaphakathi lokhu okuthunyelwe, sibheka izimpawu ezithile ezibonisa abasebenzisi be-porn, okungabonisa izinguquko zobuchopho ezihlobene nokulutha.
- Bona lokhu kusuka ngoMeyi, 2013 - I-National Institute of Health Mental (NIMH): I-DSM iphutha futhi iphelelwe yisikhathi.
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