Ubaluleka bokubuyiswa kwesisindo kunye nokubuyiswa koMzimba
I-Anorexia nervosa (AN) isifo esichazwe ngumda wokutya, ngokuqhelekileyo kubangele ukungondleki. Ukungondleki kusithintela yonke inkqubo yomzimba, kwaye ingqondo ingabikho ncipheko yempembelelo yokungondleki.
Iinguqu zeBrain kwi-Anorexia Nervosa
I-AN ihambelana neenguqu kwiimeko kunye nokucinga. Izigulane zihlala zibonakalisa iimpawu zokuxhalaba kunye nokudandatheka okungekho ngaphambili kwesifo sokutya okanye sikhatyiswe yi-AN.
I-Ancel Keys yaseMinnesota Study yachaza ukuba ukuxhalaba nokudakumba kwakuphakathi kweempawu eziboniswe kumadoda aphilileyo zibeka ukutya okukulo-njala. Ukongezelela, abantu abane-AN bahlala bexosha inhlalakahle, bazinze ngakumbi kwaye bazilungiselele ekucingeni kwabo, kwaye kaninzi banokuqonda ukugula kwabo. Omnye umzali wachaza intombi yakhe, "Njengokuba ukuhla kwezinto ezibonakalayo kwakungekho ukwesaba ngokwaneleyo, waba ngumntu ohlukile kunye noyikayo. Wayeza kuxoka aze asebenze ukuze aphume ekudleni aze asebenze. Wayeqamba amanga aze asebenze ukuze achaze ukukhupha okukhulayo kubangane. Xa ndizama ukuba 'ndiyidle,' ingxelo yam kumyeni wam malunga nendlela eya kuhamba ngayo, 'Intloko yakhe yajikeleza ngokuphindwe kathathu i-Exorcist-style kunye nesifo saqala ukuphuma emlonyeni wakhe.' "
Uphando ngeBrain kwi-Anorexia Nervosa
Kukho isivumelwano esiqhelekileyo sokuba ukubuyiswa kwe-AN kufuna ukubuyiswa kwesisindo kunye nokulungiswa kwesondlo.
Oku kufuneka kubekwe phambili kwi-job-focal work. Uphando oluthathu lwakutshanje olusengqondweni lubonisa ukuba kutheni oku kubaluleke kangaka.
Uphononongo olwenziwa nguRoberto kunye noogxa (2010) basebenzise iindlela zobuciko be-MRI ukuze bafunde ubuchopho besifazane abangama-32 abadala kunye ne-AN ngaphambi nangemva kokubuyiswa kwesisindo (ukuya kuma-90 ekhulwini wabo ubunzima bomzimba obuhle) kwaye bawafanisa nobuchopho babesetyhini abangama-21 unayo i-AN.
Iziphumo zibonise:
- Abantu abangaphantsi kwamandla omzimba abane-AN babenokwehla okukhulu kwiqondo lobuGrey ingqondo xa kuthelekiswa nokulawula okunempilo.
- Ezi zintlupheko kumbono wegrey zikhuphuke ngokuphuculwa kwexesha elifutshane kodwa azizange zilungele ngokupheleleyo kwikhosi yesifundo seveki ezingama-51.
- Abaphengululi baphetha ngokuthi: "Ulungelelaniso phakathi kwe-BMI kunye nokuguqulwa kwamanzi lubonisa ukuba indlala idlala indima ebalulekileyo ekukhungeni kwengqondo phakathi kwezigulane ezine-AN, nangona indlela yokubulawa yindlala yempembelelo yengqondo ihlale ingacacile."
Uhlolisiso lukaWagner kunye noogxa (2005) lwenza i-MRI isicatshulwa sengqondo kuma-40 amabhinqa ekuphumeni kwexesha elide kwiintlungu zokutya (izifundo ziquka izigulane ezine-AN kunye ne-bulimia nervosa). Ubude babo bobudala babuya kwiinyanga ezingama-29 ukuya kwii-40 (ixesha elide kunomxholo weRoberto). Iziphumo zabonisa:
- Zonke izakhiwo zobuchopho kumabhinqa afunyanwe ziqhelekileyo ngokuvakalayo kwaye zifana nezifundo zolawulo.
- Olu pho nonongo lubonisa ukuba iingqondo ezingaqhelekanga ziguqulwa ngokuphindwa kwexesha elide .
Uphononongo olwenziwa yiChui kunye noogxa (2008) lwavandlakanya abafazi abadala abadala abangama-66 abanembali yokuqalisa i-AN kunye nokuqhathanisa nabo abangama-42 abasetyhini abasetyhini. Abathathi-nxaxheba bafumana i-MRI kunye nokuhlolwa kwengqiqo.
Iziphumo zibonise:
- Abathathi-nxaxheba abane-AN abahlala besisindweni esiphantsi babenomdla wokungaqhelekanga kwe-MRI.
- Ukunyameka kwezigulane ezifumanekayo kwakunemiqulu evamile yengqondo.
- Abathathi-nxaxheba abaye balahlekelwa yimizila yabo yokuya esikhathini okanye abanamaqondo angabonakaliyo babonisa ukungaphumeleli okukhulu kwiindawo ezininzi ezininzi ezibandakanya ukukwazi ukuthetha, ukuqonda kakuhle, ukufunda, izibalo, nokukhumbula ukuthetha (nangona ukuba inguqu yesimo ishintsho).
Ukubuyiswa kweBrain ku-Anorexia Nervosa
Kuthatyathwe ndawonye, ezi zifundo zibonisa ukusebenzisana okunzima phakathi kwesimo sobunzima, isakhiwo sobuchopho kunye nokusebenza kwengqondo ephezulu.
Ingxaki yobunzima iyancipha ngexesha le-AN, kwaye ithatha ixesha lokubuyela. Kwiinyanga ezintandathu emva kokubuyiswa kwesisindo esipheleleyo ingqondo isoloko ingekahleleki kwakhona. Sekunjalo nexesha elaneleyo kwisisindo esifanelekileyo, ubuchopho bubonakala buyifumana ngokupheleleyo . Uphando lubonisa ukuba emva kweminyaka emithathu emva kokufumana ukubuyiswa kwesisindo, ubuninzi bobuchopho bomntu buya kubonakala buqhelekileyo ngokwenyama.
Nangona kunjalo, nangona ubuchopho bokubuyiswa kwesisindo somzimba bubukeka buqhelekileyo, ukusebenza kobuchopho obuqhelekileyo kungenzeka ukuba abuyi kubuya. Kubonakala ukuba umsebenzi wokuya esikhathini unokuba ngumlamli kunye nokulungelelanisa okungcono ukuphucula ingqondo kunokwesisindo (kubafazi) kwaye ukusebenza ngokugcwele kwengqondo kungabuyeli kude kube sekupheleni kweenyanga ukuya kweenyanga ezintandathu. Esi sizathu esenza ukuba ukubuyela kwexesha kwaye kuqhubekele phambili kwimihlaba ebalulekileyo yokumakisha.
Abazali bezigulane abane-anorexia baxela ixesha elide, ukususela kwiinyanga ezintandathu ukuya kwiibini ezimbini kunye no-full "ukuphulukiswa kwengqondo" ukuba kwenzeke. Ngako oko abazali bathetha ukuthini xa bexela ukuphulukiswa kwengqondo kukuba baqaphela imeko ephucukileyo, "njengokuba isigulane siphumela kwintambo." Ngaphezu koko, abazali baxela ukuba ukuphulukiswa kwengqondo kubangela ukutshintsha kwimiqondo kunye nokuziphatha okufana nezigulane zibonakala zizinzile ngakumbi ukubuyiselwa kwabo kunye "nokubuyela kwabo ngaphambili (ngaphambi kokugula)." Enye incwadi kubazali inelungelo lokuba, "Inyana yam ibuyele."
Kubalulekile ukuqaphela i-catch-22 ye-AN. Abantu abane-AN banokukhubazeka kakhulu kwaye bafuna ixesha elizinzileyo kwisisindo esifanelekileyo sokunqongophala kwengqondo ukuphucula ngokupheleleyo. Nangona kunjalo, ngokuyinxalenye zibonakaliso zengqondo ze-AN ezenza ukuba abagulayo bakholelwe ukuba "akukho nto iphosakeleyo" kunye nabo kwaye bayayilahla unyango, yimeko ebizwa ngokuthi "anosognosia."
Impembelelo kwizigulane kunye neentsapho
Uphando lwale phando, ngokutsho kukaDkt. Ovidio Bermudez, MD, iGosa eliKhulu lezeMpilo kunye noMlawuli wezeMpilo weeNkonzo zeNtsapho kunye neNtsholongwane kwiZiko lokuFumana iZiko eDenver, kukuba ngabazali nabaqeqeshi bonyango abanako ukukwazi ukuphazamisa ukufumana ubunzima (ukuhlaziywa Ukufezekiswa kweZenzo zoLutsha kunye ne-Anorexia kwisiCwangciso soPhulo lweZifo, Ukutya okuPhuculo lweZiko loPhuhliso loLwazi). Izifundo zikaDkt. Bermudez ezigulayo izigulane eziphantsi kokugula zifuna "ukukhululwa kwengqondo" ukwenzela ukuba "ukuguqulwa kwengqondo kunye nokuguquka kwimizimba kungenza umehluko."
Esi sizathu esinye isizathu sokuba unyango olusekelwe kwintsapho (FBT) luvame ukuphumelela ngaphezu kweyonyango elithile kwizigulane ezincinci. Abazali bahlala befuna ukwenza ukunyusa okukhulu kwabo bantwana abangenasondlo. Kwakhona kubonisa umceli wonyango kwizigulane ezindala ezine-anorexia ezinokuba zizama ukufumana ukuphulukana kunye nengqondo elambileyo. Uphando luxhasa ukuba kuphela ukubuyiswa kwesisindo esipheleleyo kunye nabantu abanokukwazi ukugcina ukubuyiswa kwabo.
Imithombo:
IChui H, Christensen B, Zipursky R, Richards B, Hanratty M, Kabain No, et al. Umsebenzi wokuqonda kunye nesakhiwo sengqondo kubasetyhini abanembali yabantwana abaselula-i-anorexia nervosa. Pediatrics. 2008; e426-e437.
URoberto C, uMeyili L, uBrickman A, uMuraskin J, uYeung L, uSteffener J, et al. Iinguqu zebhanki zengqondo zitshintsha emva kokufumana ubunzima kubantu abadala abane-anorexia nervosa. I-International Journal Yokudliwayo Kwokutya. 2011; 44 , 406-411.
Wagner A, Greer P, Bailer UF, Frank GK, Henry SE, Putnam K, et al. Iimvo zengqondo zomzimba eziqhelekileyo emva kokuphulukana kwexesha elide kwi-anorexia kunye ne-bulimia nervosa. Psychiatry . 2006; 59 (3): 291-3.