Ukukhutshwa kwesikrini soTyhubhu kwifowuni

'Ukuziphatha ngokunyanzelekileyo ngokwesondo' okuchazwe njengengxaki yezempilo yengqondo nguMbutho wezeMpilo weHlabathi

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Ngezantsi kunamaphepha amanqaku asemthethweni kubathetheli kunye noluntu jikelele malunga nesigaba esitsha sokuxilonga. Nantsi isishwankathelo esheshayo kwi blog.

Ngomhla we-18 kaJuni 2018, ababhali boMbutho wezeMpilo weHlabathi kuHlelo lweZifo, i-11th Uhlaziyo, beka uxwebhu lweendaba olubhengeza ukuba ingxelo yokuphunyezwa kwe-ICD-11 ezayo iyafumaneka kwi-Intanethi. Yayibandakanya ukungahambi kakuhle ngokwesondo (CSBD) okokuqala ngqa. Ngaphandle kwamahemuhemu ambalwa alahlekisayo ngokuchaseneyo, ayonyani into yokuba i-WHO iyalile "umlutha we-porn" okanye "umlutha wesini".

Ukuziphatha ngokwesondo okunyanzelekileyo kuye kwabizwa ngamagama ahlukeneyo kule minyaka idlulileyo: "Ukuxhatshazwa ngokwesini", "ukubakho kweziyobisi ezingamanyala", "ukulutha ngokwesondo", "indlela yokuziphatha ngokwesondo ngaphandle kolawulo" njalo njalo. Kwikhathalogu yayo yamva nje yezifo i-WHO ithatha inyathelo lokuqinisekisa ukuba esi sifo siphantsi ngokuvuma ukuba "kukunyanzelwa ukuba uziphathe kakubi ngokwesondo" (CSBD) njengesigulo sengqondo. Ngokutsho kwengcali ye-WHO uGeoffrey Reed, ukuxilongwa kwe-CSBD "kwazisa abantu ukuba" banemeko yokwenene "kwaye banokufuna unyango."

  • Ukukhutshwa kogcino kungabonwa kwisayithi le-WHO Apha. Ukulungelelanisa, siye sazizalisa ngokupheleleyo ngezantsi.
  • Ukushicilelwa kwe-ICD-11 kukhankanya ukongezwa kwezemidlalo njengengxaki yempilo yengqondo, kwaye indlela yokuziphatha ngokubhekisana ngesini ngoku i-categorization.
  • Iya ngathethi esinye isifo esitsha: "Inkinga yokuziphatha ngokwesondo"Ebonakala" kwiingxaki zokulawula umfutho ".
  • "IAmanqaku okukhululwa”Phantsi kwesifo ngasinye kubandakanya le ngxelo: Isakhiwo somgaqo we-ICD-11 MMS sizinzile. "
  • Nantsi umbhalo wokugqibela we "Ukunyanzeliswa kwesifo sokuziphatha ngokwesondo" ukuxilongwa:

Inkqubo Yokuziphatha Ngokwemvakalelo Yokuziphatha ngokwesondo

Ukuqondwa

Ingxaki yokuziphatha ngokwezesondo (6C72], ekugqibeleni inikezela ootitshala bezempilo ukuba bafumane ukuxilongwa ngokusemthethweni, ukukwazi ukulawula ukuziphatha ngokwesondo nangemiba emibi. Ukuphunyezwa kwangempela kweekhowudi ezintsha kuyahluka yonke indawo, kodwa into ebalulekileyo kukuba iingcali zezempilo zehlabathi ziye zavuma ukuba ukuziphatha ngokunyanzelekileyo ngokwesondo kuyafaneleka ukuxilongwa. Ixesha elibanzi lekhefu elingasetyenziselwa umntu ohlangabezana neemfuno zayo. "Ukuziphatha ngokunyanisekileyo ngokwesondo" kwakhona "kubhekiswe kwisilingo sokuxhatshazwa ngokwesondo okanye ukuxhatshazwa kwabantu ngokobuxhakaxhaka" ngokweengcali zonyango uJon E. Grant, JD, MD, MPH Psychiatry yangoku (NgoFebruwari 2018: p.3). Uvavanyo olutsha lwe-CSBD lungasetyenziselwa ukuxilonga abo banesifo esininzi se-intanethi esisetyenziswayo.

Ngaphezu kwe-80% yabantu abaneenkanuko zokuziphatha ngokwesini buchaza ngokugqithiseleyo okanye ukusetyenziswa koonobumba obugqithisileyo.

"Ukusetyenziswa kweengxaki zoonografi kunokubonakalisa ukubonakaliswa koxhatshazo ngokwesini (okubizwa ngokuba kukunyanzeliswa ngokwesondo, ukuxhatshazwa ngokwesondo okanye ukuziphatha kakubi ngokwesondo kwiincwadi-Kafka, 2010; Karila et al., 2014; Wry & Billieux, 2017) kuba kwizifundo ezininzi ngaphezulu kwe-80% yabantu abane-hypersexuality baxele ukusetyenziswa gwenxa / ingxaki yokusebenzisa iphonografi (Kafka, 2010; Reid et al., 2012) ”. (Bőthe et al. 2018: 2)

Iincwadi zokuxilonga njenge-WHO Ulwahlulo lwaMazwe ngamazwe (ICD-11) kunye ne-American Psychiatry Association I-Diagnostic and Statistical Manual yeMpilo yengqondo (DSM-5) suku ilebula iimeko zempilo yengqondo njengezi “Ziyobisi” nganye. Bakhetha ukusebenzisa igama elithi “Disorder.”

"Ukuziphatha kakubi ngokwesini" ukuxilongwa kuvela kumzekelo wokungakwazi ukulawula ukunyanzelisa, ukuziphatha ngokwesini okanye ukukhuthaza, okubangele ukuziphatha ngokuphindaphindiweyo ngokwesini (ixesha, iinyanga ze-6 okanye ngaphezulu).

Ukwenza ukuxilongwa kweengxaki zokuziphatha ngesondo

Abagxeki bokuqala babekhathazekile ukuba nakuphi na ukuxilongwa ngokusesikweni kuya kusetyenziswa ekufumaneni isifo ngokwesini kunye nezinye iindlela zokuziphatha ngokwesondo. Nangona kunjalo, ukufezekisa iikhrayitheriya zokuchonga i-CSBD, indlela yokuziphatha enengxaki kufuneka ibangele uxinzelelo oluqhubekayo oluphawulweyo okanye ukuphazamiseka okubonakalayo kubuntu, usapho, intlalontle, imfundo, umsebenzi, okanye ezinye iindawo ezibalulekileyo zokusebenza. Ngamanye amagama, isifo esitsha asichongi izigulana ngokusekwe Intoni Indlela yokuziphatha ngokwesondo abayifumene ngokuzikhethela ngayo. Ixilonga izigulane ezisekelwe kukuphazamiseka okuqhubekayo kunye noxinzelelo. Ukuba ukuziphatha ngokwesondo, nayiphi na indlela ethathayo, akuyi kubakho, i-diagnostic entsha ayiyi kusebenza.

Abanye abagxeki baxwayisa ukuba ukuxilongwa kwe-CSBD kungabangela ukuxilongwa ngephutha kwezigulane eziziphatha kakubi, eqinisweni, zinyanzeliso, kwaye uxinzelelo lwazo lwalubangelwa isigwebo sokuziphatha ngesigulane okanye kwizakhono. Ukuthintela iziphumo ezinjalo, ukuxilongwa okutsha kukuthi, "Ukuxhatshazwa okuhambelana nokugwetywa kokuziphatha kunye nokungafuni ukucinga ngesini, ukukhuthaza, okanye ukuziphatha akufaneleki." Ngamanye amazwi, isiguli kufuneka singakwazi ukulawula iimpembelelo kwaye ukubandakanya ukuziphatha okuphindaphindiweyo ngokwesondo okwenzekile.

Iingxoxo zeNcwadi yokuChonga

Kukho ingxoxo enkulu ekukhokheni ukupapashwa kolwahlulo olutsha kwi-ICD-11. Ingxaki yokuziphatha ngokwezesondo (okubhekiselwe kwintsebenziswano njengengxaki yokuxhatshazwa koxhatshazo) yaqwalaselwa ukuba ifakwe kwi-DSM-5 kodwa ekugqibeleni ingabandakanywa. Ngokutsho kweengcali zenzululwazi ezikhokelayo, "Ukukhutshwa oku kuye kwaphazamisa ukukhusela, ukuphanda, kunye nokunyanga, kunye noogqirha abashiyekileyo ngaphandle kokufumana isigxina ngokusesikweni sokuziphatha okubi ngokwesini." (Potenza et al. 2017)

Okwangoku, udidi lomzali lwesifo esitsha se-CSBD kukuPhazamiseka koLawulo lweMpembelelo, okubandakanya ukuxilongwa okunje ngePyromania [6C70], Kleptomania [6C71] and Intermittent Explosive Disorder [6C73]. Ukanti ukuthandabuza kusahleli malunga nodidi olufanelekileyo. Njengoko ugqirha we-Yale neuroscientist uMarc Potenza MD PhD kunye noMateusz Gola PhD, umphandi kwiPolish Academy yezeNzululwazi kunye neYunivesithi yaseCalifornia San Diego esithi, "Isindululo sangoku sokuchaza isifo se-CSB njengesiphazamiso solawulo lokungqubana siyimpikiswano njengokuba eminye imodeli ibikho ndicetywayo… Kukho idatha ethi i-CSB yabelana ngeempawu ezininzi kunye neziyobisi. ”(Kraus et al 2018)

Kungakuhle ukuba uqaphele ukuba i-ICD-11 ibandakanya ukuxilongwa kweNgcakazo yokuNgcakaza phantsi kwazo zombini ezi ngxaki ngenxa yeziyobisi kunye naphantsi kwempembelelo yokuLawulwa kokuPhazamiseka. Ke ngoko, ukwahlulahlulahlulahlulahlulahlulahlulahlulahlulahlulahlulahlulahlulahlulahlula iimeko eziphambeneyo kunokubangela ukuba kungabi njalo (Bőthe et al. 2018: 2). Ukwahlulahlulwa kwakhona kunokuhamba kunye nexesha. Ingxaki yokungcakaza yayihlelwe njengesixhobo sokuphazamiseka kwi-DSM-IV nakwi-ICD-10, kodwa ngokusekwe kwinkqubela phambili yokuqonda okuqinisekileyo, ukuphazamiseka ekuNgcakazeni kuye kwafakwa kwakhona njenge- "Izinto ezinxulumene neziyobisi kunye neNgxaki yeziyobisi" (DSM-5) kunye "Ukuphazamiseka ngenxa yokuziphatha kakubi" (ICD-11). Kuyenzeka ukuba olu hlolisiso lutsha lwe-CSBD lulandele ikhosi efanayo yophuhliso njengoko ukungcakaza kungcungcutheka.

Kungakhathaliseki ukuba le ngxoxo iguqukela njani ixesha, ukufakwa kwangoku kwe-CSBD kwi-ICD-11 kubonelela ngokuqinisekileyo kwaye kuyimfuneko yokuba kukho abantu abanesidingo sokungenelela kwekliniki eyiyo ukuze bancede baxoxe ngokuziphatha kwabo ngokwesondo kunye nemiphumo. Kuya kuququzelela uphando olunzulu oluzayo malunga nokuziphatha okubi ngokwesini.

“Iya kuba yinto efanelekileyo ukuqaphela ukuba iDSM kunye nokuHanjiswa kweZifo (ICD) kusebenza njani ngokubhekisele kwinkcazo nakwinkqubo yokuhlelwa. Ngokwenza njalo, sicinga ukuba kufanelekile ukugxila kungxaki yokungcakaza (ekwabizwa ngokuba kukungcakaza okungapheliyo) kunye nendlela eyaqwalaselwa ngayo kwi-DSM-IV nakwiDSM-5 (nakwi-ICD-10 nakwi-ICD-11 ezayo). Kwi-DSM-IV, ukungcakaza okubangelwa ziintsholongwane kwahlulwa kwahlulwa njenge- “Impulse-Control Disorder Not Other Else Classified.” Kwi-DSM-5, yahlelwa kwakhona “njengengxaki yeziyobisi nengxaki yokulutha.”…. "Indlela efanayo kufuneka isetyenziswe kwi-CSB, ngoku iqwalaselwa ukuba ifakwe njengengxaki yokulawula ukunyanzeliswa kwe-ICD-11 (Grant et al., 2014; Kraus et al., 2018) ". Ezi zicaphuno zithathwe Gola kunye nePotenza 2018.

impatho

Ekuvukeni kwe World Health Organization (I-WHO) echaza ukukhathazeka kwezemidlalo kunye ne-CSBD njengeemeko zempilo yengqondo, a ingxelo kwi Guardian phe phandaba wathi isibhedlele saseLondon silungiselela ukuqalisa isikhulu sokuqala seNational Health-finance addiction center kubantu abatsha nabantu abadala. Iingcali zezocansi kwenye indawo zibone ukwanda kwabathengi abancinci abenza ngokunyanisekileyo izicelo zokusebenza zokuthandana kunye namagumbi okuxoxa e-intanethi, kunye neengxaki zempilo yengqondo ngenxa yoko.

Ngokwe-Mateusz Gola PhD, umphandi kwi-Polish Academy yeSayensi naseYunivesithi yaseCalifornia San Diego, i-diagnostic entsha ye-CSBD inezinye iinzuzo ngokunjalo. "Yenza inkcazo ecacileyo yokuxilongwa. Ukongezelela, iikliniki zeengqondo kunye neengqondo zengqeqesho ziya kufundisisa le ngxaki. Ngaphandle koxilongo olusesikweni lwe-CSBD, abaninzi beekliniki babengenalwazi malunga nemiba yokuziphatha ngokwezesondo. Ekugqibeleni, olu xilongo lunokunika izigulane ezininzi ukufikelela kwonyango efunyenwe ngomshuwalense. "UGolla wongezelela ukuba, ukuxilongwa ngokutsha," ayicombululi ingxaki yokuphatha i-CSBD ngempumelelo, kodwa ivumela ukuba kuphinde kuqhutywe izifundo eziqhubekayo, ezinokubangela ukuba iindlela ezifanelekileyo, ezinokuthenjwa. "

Ufikeleleko olwandisiweyo lwabaguli

UShane W. Kraus, Ph.D. UNjingalwazi oNcedisayo woNyango lwezeMpilo kunye noMlawuli weKlinikhi yokuLungisa iZenzo kwi-Edith Nourse Rogers Memorial Veterans Hospital, kwiYunivesithi yaseMassachusetts Medical School uthe ngokubhekisele kwicandelo elitsha lokuqonda isifo: “Eli linyathelo lokuqala elifanelekileyo. Ukufakwa kwe-CSBD kwi-ICD-11 kunokunyusa ukufikelela kukhathalelo lwezigulana (kwilizwe jikelele nase-US). Ukongeza, ukubandakanywa kuya kunyusa inkxaso-mali yophando egxile ekuchongeni ukuphazamiseka kwezempilo yengqondo. Ukongeza, ndicinga ukuba inganciphisa ukubekwa ibala kwabantu abachaphazelekayo kwaye inyuse imfundo yababoneleli ngalo mba. ”

Abaqeqeshi bezeMpilo

Isizathu esivakalayo sokukhutshwa kwe-ICD-11 kutsha nje kukuvumela amazwe ukuba aqeqeshe iingcali zempilo kwisifo esichongiweyo. Bacebisile ke ukuba abagqirha kunye nabacebisi bafumane uqeqesho kwaye baqonde ngcono isimilo sesinyanzeliso:

Kukwabalulekile ukuba ababoneleli ngenkathalo (okt, oogqirha kunye nabacebisi) apho abantu banokufuna uncedo kubo baziqhelile ii-CSB. Ngexesha lezifundo zethu ezibandakanya ngaphezulu kwezifundo ze-3,000 ezifuna unyango lwe-CSB, sihlala sisiva ukuba abantu abaphethwe yi-CSB badibana nemithintelo emininzi ngexesha lokufuna kwabo uncedo okanye ukunxibelelana nabezonyango (UDhuffar kunye noGriffiths, ngo-2016). Izigulane zibika ukuba oogqirha banokuphepha isigxina, bathi iingxaki ezinjalo azikho, okanye ziphakamise ukuba umntu unesigxina esiphambili sezesondo, kwaye kufuneka amkele endaweni yokuphatha (nangona kunjalo kulaba bantu, ii-CSB zivakalelwa zi-ego-dystonic kwaye zikhokelela kwimiphumo emibi). Sikholelwa ukuba iimpawu ezichazwe kakuhle kwi-CSB ziza kukhuthaza imizamo yezemfundo kuquka ukuphuhliswa kweenkqubo zoqeqesho malunga nendlela yokuvavanya nokuphatha abantu abaneempawu ze-CSB. Siyathemba ukuba iinkqubo ezinjalo ziya kuba yingxenye yoqeqesho lwezonyango zeengqondo zengqondo, izazi zengqondo, kunye nabanye ababoneleli ngeenkonzo zonyango lwempilo yengqondo, kunye nabanye ababoneleli ngononophelo kuquka nabanikezeli bokunakekela abantwana, njengabagqirha abaqhelekileyo. "(Kraus et al 2018)

I-Foundation Foundation

The Umvuzo weZiseko sisibonelelo semfundo esiphayona esenza ukuba isayensi yesondo kunye nothando lufikeleleke kubaphulaphuli abaninzi. Ukugxila kwethu kwimpembelelo ye-intanethi kwi-intanethi nakwishumi elivisayo. Siye samkelwa yiKholeji yaseRoyal of General Practitioners eLondon ukuqhuba ii-workshops zeentsuku ze-1 zeengcali kwiimpembelelo ze-intanethi kwimpilo yengqondo nangokwenyama. Oku kuyazixhasa iinjongo zoMbutho wezeMpilo weHlabathi osasazo lwawo kumaphephandaba olungezantsi ligxininisa isidingo soqeqesho phakathi kwabaqeqeshiweyo. Sikwasifundisa ezikolweni kwaye siya kubonelela ngezicwangciso zezifundo kunye noqeqesho lootitshala ngasekupheleni konyaka. Sinikezela ngeenkonzo zonxibelelwano kwimibutho enqwenela ukwenza iinkqubo zokwazisa ngeengozi ezingamanyala.

Ukuba udliwano-ndlebe okanye olunye ulwazi oluquka iikopi ezipheleleyo zemithombo ecatshulweyo, nceda qha ga mshelana info@rewardfoundation.org.

FOOTNOTE

Umbhalo opheleleyo we ICD-11 Press Release.

Ngubani okhupha iHlabathi lokuHlaba kwiZizwe eziMnyama (ICD 11) 18 Juni 2018 News Release Release

I-World Health Organisation (i-WHO) namhlanje ikhulula iCandelo loLutsha lweZifo zoLuntu (ICD-11).

I-ICD sisiseko sokuchonga imeko yezempilo kunye neenkcukacha manani kwihlabathi liphela, kwaye iqulethe iikhowudi ezizodwa ezingama-55 000 zokulimala, izifo kunye nezizathu zokufa. Inika ulwimi oluqhelekileyo oluvumela abaqeqeshi bezempilo ukuba babelane ngolwazi lwempilo kwihlabathi lonke.

"I-ICD yimveliso ubani azingca ngayo," utshilo uGqr Tedros Adhanom Ghebreyesus, UMlawuli-Jikelele we-WHO. "Sisenza ukuba siqonde kakhulu malunga nokuba yintoni egulisa abantu kwaye bafe, kwaye sithathe amanyathelo ukuthintela ukubandezeleka nokusindisa ubomi."

I-ICD-11, ebingaphaya kweminyaka elishumi isenziwa, ibonelela ngophuculo olubonakalayo kwiinguqulelo zangaphambili. Ngethuba lokuqala, i-elektroniki ngokupheleleyo kwaye inefomathi enobuntu ngakumbi. Kwaye kwabakho ukubandakanyeka okungathethekiyo kwabasebenzi bokhathalelo lwempilo abaye bazimanya neentlanganiso zokusebenzisana kwaye bathumela izindululo. Iqela le-ICD kwikomkhulu le-WHO lifumene ngaphezulu kwezindululo ezingama-10 000 zohlaziyo.

I-ICD-11 iya kuboniswa kwiNdibano yezeMpilo yoMhlaba ngo-Meyi 2019 ukuba yenziwe ngamanye amazwe aseLungu, kwaye iza kusebenza ngo-1 Januwari 2022. Olu khuphazo luyi-preview yangaphambili eya kuvumela amazwe ukuba acwangcise indlela yokusebenzisa le nguqulo entsha, ulungiselele iziguqulelo, kunye qeqesha abaqeqeshi bezempilo kulo lonke ilizwe.

I-ICD iphinda isetyenziswe ngabaqinisekisi bempilo ababuyiselwayo kwi-ICD; abaphathi beprogram yesizwe; iingcali zokuqokelela idatha; kunye nabanye abatyelela inkqubela phambili kwimpilo yehlabathi jikelele kwaye banqume ukwabiwa kwezibonelelo zezempilo.

I-ICD-11 entsha ikwabonisa inkqubela kwezamayeza kunye nokuqhubela phambili kokuqonda kwesayensi. Umzekelo, iikhowudi ezinxulumene nokuchasana ne-antimicrobial zihambelana ngokusondeleyo ne-Global Antimicrobial Resistance Surveillance System (i-GLASS). I-ICD-11 ikwazile ukubamba idatha ngakumbi ngokubhekisele kukhuseleko kwezempilo, okuthetha ukuba iziganeko ezingeyomfuneko ezinokuba yingozi kwezempilo- njengokuhamba okungakhuselekanga kwezibhedlele- zinokuchongwa zincitshiswe.

I-ICD entsha iquka izahluko ezintsha, enye kwiyeza zendabuko: nangona izigidi zabantu zisebenzisa amayeza emveli emhlabeni jikelele, akakaze ahlelwe kule nkqubo. Esinye isahluko esitsha malunga nempilo yentsondo ihlanganisa imiqathango ebekwe ngaphambili ngezinye iindlela (umzekelo, ukungabikho kwesini kwintlupheko yesini kubhalwe phantsi kweemeko zempilo yengqondo) okanye kuchazwe ngokwahlukileyo. Ukuphazamiseka kwemidlalo kuye kwongezwa kwicandelo kwiintlungu zokulutha.

"Umgaqo obalulekileyo kule nguqulelo ukuwenza kube lula ukwakhiwa kwekhowudi kunye nokusetyenziswa kwezixhobo zekhompyutha-oku kuya kubangela ukuba ootitshala bezempilo babe lula ukurekhoda iimeko," utshilo uDkt. Robert Jakob, iNkokeli yeQela, uLawulo lweeNkcazo kunye neMigangatho, i-WHO.

UDkt Lubna Alansari, uMcebisi-Jikelele weMpilo weeMpilo neMilinganiselo ye-WHO, uthi: "I-ICD iyinxalenye yenkcazelo yempilo kunye ne-ICD-11 iya kubonelela ngethuba lokujonga izifo zesifo."

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