Xa abantu abaninzi becinga ngokugula okunyanzelekileyo, bajolise kwiimpawu ezibonakalayo eziqhelekileyo zizibonakaliso zengxaki ezifana nokuhlamba izandla, ukucoca rhoqo, ukuhlola rhoqo, okanye imfuno yokulinganisa. Nangona ezi zinto zingaba ziimpawu ezibonakalayo ze-OCD, kubalulekile ukuqonda ukuba akuzona zonke iimeko zengxaki ezifanayo.
Ukunyanzeliswa yinto eyodwa kuphela yolu daba, kwaye liyinxalenye yokugqithisa okuqhelekanga. Kwezinye iimeko, abantu bafumana ezi zinto ngokuzibandakanya ngaphandle kokubandakanyeka ekunyanzelweni kokuziphatha abadla ngokuba yi-OCD. Le ntetho yeengxaki ngezinye izihlandlo ibizwa ngokuba yi-O ecocekileyo, eyaziwa nje ngokuba yi-OCD okanye i-dispersive disulsive disorder.
Yintoni Eyinyani?
Ucoceko O luhlobo lwe-OCD olubhekiselele kwiingcamango eziphindaphindiweyo, ezingenakunyanzelwanga, ezingenakulawulwa (okanye ukugqithiswa) okuqhelekileyo kungekuhambelani nokunyanzeliswa kokuziphatha kwangaphandle. Nangona umntu ojongene no-O ococekileyo akanako ukubandakanya eziphatheni ezibonakalayo eziphathekayo ezinxulumene neengcamango zabo, ezifana nokubala, ukulungiselela okanye ukuhlamba izandla, ingxaki leyo ihamba kunye neendlela ezifihlakeleyo ezingqondweni.
I-dispersive-compulsive disorder (OCD) ngokwayo iquka ukufumana iingcamango ezingapheliyo nezingalawulekiyo (ukuphosa) kunye nokuziphatha (ukunyanzeliswa).
Ngokomzekelo, umntu ophethe i-OCD unokufumana iingcamango ezingalawulekiyo malunga neentsholongwane kunye nokuhlanzeka okubangela ukuba unqwenela ukuhlamba izandla zakhe ngokuphindaphinda.
Ngamanye amaxesha i-O yeyona nto ingaboniswa ngephutha njengowomzimba "ophantsi kakhulu" we-OCD, kodwa abo bafumana iimpawu zesi sifo bafumanisa ukuba iingcamango ezingathandekiyo zingabaphazamisa kwaye ziphazamise.
Nangona abantu abangabika ingxelo yokunyanzeliswa ngamanye amaxesha batyathwa ngokuba "ococekileyo O" okanye "ukukhubazeka ngokugqithiseleyo," le nto ayifumanekanga njenge-diagnostic eyahlukileyo kwi- DSM-5 , incwadana yokuxilonga esetyenziswa ngabagqirha abaninzi. , kunye neengqondo.
Iimpawu eziqhelekileyo ze-OCD
Abantu abafumana "uhlobo olusisigxina" lwalo mkhuhlane bafumana uluhlu lweempawu ze-OCD, nangona ukunyanzeliswa okusoloko kungekho. Ngokutsho kwe-DSM-5, i-OCD ibonakala ngokugqithiswa kunye / okanye ukunyanzeliswa.
Ukuqwalasela kubandakanya:
- Ukuphinda kuhlaziywe imifanekiso, iingcamango, kunye neempembelelo ezidala ukukhathazeka okukhulu
- Iingcinga ezingahambelani nokukhathazeka okungaphezulu kunye noxinzelelo kubomi boqobo
- Ukuqonda ukuba ezi zinto zivela ngaphakathi kwengqondo yomntu
- Ukwenza iinzame zokungahoywa, ukucima, okanye ukuzincipha iingcamango eziphosakeleyo
Ukuqwalasela kunokubakho kwiingcamango zesiganeko, zesondo, zonqulo, okanye iingcamango ezinobungqina kunye nokukhathazeka ngezinto ezinjenge-hoarding, ukuhlola, ukulinganisa, ukucoceka nokulungiselela.
Izigqibo zibandakanya:
- Izenzo eziphindaphindiweyo, okanye ukuziphatha okanye ingqondo, ukuba umntu uzive eyanyanzelekile ukuba enze ngenxa yeengcamango ezingapheliyo
- Ukubandakanya kwizenzo ezijoliswe ekunciphiseni uxinzelelo olunxulumene neengxaki
Ukongezelela ekufumaneni i-obsessions kunye / okanye ukunyanzeliswa, i-DSM-5 i-criteria yokuxilonga nayo ichaza ukuba:
- Iimpawu eziphosakeleyo zokunyanzeliswa akufanele zibangelwe ngenxa yemiphumo yomzimba yendalo, njengomphumo wecala lomzimba okanye iziyobisi ezingekho mthethweni. Iimpawu akumele zenzeke ngenxa yobukho bezinye izifo zonyango.
- Ukunyanzeliswa kunye nokunyanzeliswa kufuneka kuthathe ixesha elide, ngokuqhelekileyo kuthatha ixesha elingaphezulu kweyure nganye ngosuku, okanye kufuneka bakha ukukhathazeka okukhulu okanye ukuphazamiseka emsebenzini, kwintlalo, okanye kwezinye izinto ezibalulekileyo zokusebenza komsebenzi.
- Iimpawu akufanele zibhekiselele kwizinto ezinengqondo ezifana nokukhathazeka ngokubanzi, ukuphazamiseka komzimba, ukuphazamiseka kwengxaki, ukuphazamiseka kwezidakamizwa, okanye ingxaki enkulu yokudandatheka.
Iimpawu ze-O
Ngoko yintoni malunga nokuhluka okugqithisileyo kweempawu ezibangela ukuba abanye abantu babhekisele kule nxalenye yeempawu njenge-O ecocekileyo?
Izimbonakaliso ezimbini ezibonakaliswe ngamanye amaxesha ukuhlula ococekileyo O ziquka ezi zilandelayo:
Ubukho beemfundiso zengqondo ezenzelwe ukunciphisa uxinzelelo. Iimfundiso ezinjalo zingabandakanya ukukhumbula iingcinga okanye ulwazi, ukuphinda ngokuphindaphindiweyo amagama athile, ukungenzi ngokwengqondo okanye ukwenza izinto ezithile.
Ukuphinda ufune ukuqinisekiswa. Ukufuna ukuqinisekiswa kunokuba yingxaki kuba izigulane ezininzi azikwazi ukuyiqonda njengento enyanzelekileyo. Ukufuna ukuqinisekiswa okunjalo kunokubandakanya ukukhangela ukuzithemba, ukuphanda i-intanethi, ukuphepha izinto ezinokukhathaza okanye imeko, nokucela abanye ukuba baqinisekise. Inkxalabo eyongeziweyo yale mpawu kukuba intsapho kunye nabahlobo banokukhathazeka okanye baxoliswe yizicelo eziqhubekayo zokuqinisekiswa, ezinokuthi zibonwe ngabanye njengezinto ezifunekayo.
Izifundo zangaphambili zicebise ukuba kukho ubuninzi beempawu ezihlukeneyo ze-OCD ezintathu ukuya kweyesithandathu, kubandakanywa nolu hlobo olubizwa ngokuba "luhlobo olusulungekileyo" lwe-disorder. Okokuqala echazwe nguBaer kwinqaku le-1994 kwi- Journal of Clinical Psychiatry , i-O ecocekileyo yayichazwa ngokuba yinto yokwabelana ngesondo, enobudlova kunye neenkolo ezingazange zihambisane nokunyanzeliswa.
Uphando olutshanje lucetyisa ukuba ukugqithisa ngokugqithiseleyo kungahlukana ngokwengeziwe ngenxa yokwenzakalisa ingozi kunye nokulimala okungenakuzenzela. Lezo ngcamango zijoliswe kukulimala ngokukhawuleza zihlala ziko lento edlalwa ngamanye amaxesha ngokuthi "iingcamango zesondo" ezinxulumene nesondo, inkolo kunye nobudlova.
Ngophando luka-2011, abaphandi bafumanisa ukuba abantu abafumana "ukungcola okucokisekileyo" ngamanye amaxesha bachazwa ngokuthi "iingcamango zengqondo" okanye "iingcamango ezingavumelekanga" nazo zibandakanya kwiimfundiso zengqondo okanye ukuqinisekiswa okufunwa njengendlela yokulawula uxinzelelo lwabo. Izikhalazo zikhoyo kwi-O ecocekileyo, kodwa azincinci ngokucacileyo kuba ziphantse ziqikelele kwindalo.
Iingonyango eziqhelekileyo ze-O
Ulwaphulo lwe-OCD, oluquka ucocekileyo O, luhlala luquka ukusetyenziswa kwamachiza kunye nentsebenziswano ye- psychotherapy , enokubandakanya ulwaphulo lokuziphatha , amaqela ezenkxaso kunye nemfundo yengqondo.
Ulwaphulo lweZenzo zoLungiso kwi-O
Uphando lubonisa ukuba unyango lwe-cognitive-behavioral (CBT) lunokuba luncedo kakhulu ekuphatheni i-OCD ecocekileyo. Nangona kunjalo, kubalulekile ukuba oogqirha kunye nezinye iingcali zempilo yengqondo ziqonde ukuba kufuneka ukujongana neendlela ezisemgangathweni ezisemgangathweni ezibonakalisa le nxalenye yeempawu. Ukuba umgqirha ukholelwa ukuba isigulane sineenkathazo kuphela kwaye ayiphathi imigaqo yengqondo ehamba kunye nale ngcamango, unyango aluyi kuzaliseka okanye lusebenza.
Amachiza Ococekileyo O
Amayeza anokuquka i-serotonin e-reuptake inhibitors (SSRIs) okanye i-tricyclic anti-depressant clomipramine. Ezinye iziphumo ezichaphazelekayo ezinxulumene nokusetyenziswa kwe-SSRI zibandakanya ukulala, ukuxhalaba, ukunyanyiswa kwesisu kunye nokulala. Olunye uphononongo lophando luye lwaphakamisa ukuba malunga nama-40 ukuya kuma-60 ekhulwini kwizigulane ziphendula unyango nge-SRIs kunye nokunciphisa i-OCD iimpawu ze-OCD ezingama-20 ukuya kuma-40.
Ulwaphulo oluthile olusetyenziswayo, nokuba imithi yodwa, i-psychotherapy yedwa, okanye ukuhlanganiswa kwezi zibini, kuxhomekeke kwiimfuno ngamnye zesigulane ngasinye. Ngokomzekelo, i-CBT ingasetyenziselwa yodwa kwizigulane ezithintela ukuthatha imithi okanye abo abakhulelweyo okanye abanesi. Amachiza angasetyelwa yedwa kwizigulane ezinesifo esichukumisayo sokunakekelwa kwengqondo okanye abangenakho ukufikelela kwiingcali zempilo yengqondo e-CBT.
ERP ye-O
Kuphononongo olulodwa, abaphandi babhekisisa kwizifundo zangaphambili ukuze babone ukuba iimpawu ezithile ze-OCD ziphendule ngakumbi kwiindlela ezithile zonyango. Bafumanisa ukuba kwiinkoliso ezininzi, i-OCD ibonakalisa ukunyanzelwa kwezenzo zesondo kunye nokungabikho koxinzelelo (oko kukuthi, i-o ecocekileyo) yabandakanyeka impendulo engalunganga kwizonyango usebenzisa i-SRIs kunye nokuchasana nokukhusela impendulo.
Ukukhuselwa kunye nokukhusela impendulo, eyaziwa nangokuthi i-ERP yonyango, yindlela yokwazi ukuziphatha kwengqondo nokuziphatha. Kubandakanye ogqirha oqeqeshiwe ekuncedeni umxhasi ukuba athathe into enkwantya ngaphandle kokubandakanyeka nasiphi na isenzo sokunyanzelisa.
Abaxhasi bazibeka ngokuzithandela kwizinto, imifanekiso, imeko, okanye iingcamango ezibenza bazixhalabele okanye zezifundo zabo, kodwa banqandwa ukuba bangene ekuziphatheni okunyanzelisayo oku kulandela ezi ziganeko. Injongo yonyango elinjalo kukunceda izigulane zifunde indlela yokuphatha kakuhle iimpawu zabo ngaphandle kokuba zenze iindawo zokunyanzelisa ukuba zenze ukukhululeka kwengqondo.
Ucocekileyo O: Uhluke njani kwi-OCD?
Ngaba ucocekile O ohlobo olukhethekileyo lwe-OCD? Yintoni eyenza ihluke kwi-diagnostic yendabuko yengxaki yokunyanzela? Nangona ezinye iingcaphephe zicebise ukuba kukho iimpawu ezahlukeneyo zengxaki, olunye uphando luye lwacebisa ukuba i-term ecocekileyo i-O ibe yinto engafanelekanga. Ngelixa abantu bafumana ezi zinto zingenakuphi na ukunyanzeliswa kokuziphatha, baqhubeka bebandakanya kwizithethe ezingabonakaliyo.
Kutheni kubalulekile ukuba uqaphele ukuba ezi ziko zengqondo zikhona, nangona kungekho masiko okuziphatha? "Ukuqwalaselwa kweengcinezelo ezenziwa ngabantu abaye bacatshangelwa njengento engafanelekanga kunokuncedisa ukuxilongwa nokuphuculwa kwabantu abane-OCD," kuchaza umphandi kunye nesigqirha sengqondo sezonyango uMonnica T. Williams kunye nabo asebenza nabo kwinqaku yabo ethi "Inkolelo-mbumbulu yohlobo olugqibeleleyo lwe-Obsessional in Obsessive -Compulsive Disorder. "
Ngokuqonda ukuba ezo ziko zengqondo zikhona, oogqirha kunye nezinye iingcali zempilo yengqondo zingabuza izigulane malunga nale mpawu. Ngaphandle kokubuza imibuzo kunye nokunyusa, izigulana zingenakho ukuzithemba ukuchaza iimpawu abazifumanayo okanye zingenakuqonda ukuba kufuneka zixubushe ngezi zimpawu.
ILizwi
I-O yeyona nto ingabandakanyi iziphatho zangaphandle ezivame ukuza engqondweni xa abantu bacinga nge-OCD. Nangona kunjalo, izithethe zengqondo ezifihliweyo ezibonakalisa uhlobo oluthile lwe-obsessional ye-disorder zihlobo lokunyanzeliswa, nangona zingabonakali.
Ukuba ufumana ufumana ukukhathazeka okukhathazayo kunye / okanye ukunyanzeliswa kwengqondo okuphazamisana nobomi bakho kunye nokusebenza kwansuku zonke, cinga ukuthetha nodokotela wakho okanye uchwepheshe wezempilo yengqondo. Nangona ezi ngcamango zingabonakala ziphazamisa ngamanye amaxesha, ingcali eqeqeshiwe ingakunceda ukuba uqonde ngakumbi iimpawu zakho kunye neendlela zokwenza unyango onokuzifumana. Ukuthetha ngeengcamango zakho akusoloko kulula, kodwa ukuthatha eli nyathelo elibalulekileyo yincinci yokuqala yokufumana uncedo onokuyidingayo ukuze ufumane uncedo.
> Imithombo:
> Abramowitz, JS, Deacon, BJ, & Whiteside, SPH. Ulwaphulo lwe-Exposure Treatment for Concerning: Principles and Practice. INew York: I-Press Guilford; 2011.
> Starcevic, V & Brakoulias, V. Ii-subtypes ze-distypes ezixinzelelekileyo: Ingaba zifanelekile unyango? Aust NZJ Psychiatry. 2008; 42 (8): 651-661. i-doi: 10.1080 / 00048670802203442.
> Stewart SE Obsessive-Compulsive Disorder. Ku: Camprodon J., Rauch S., Greenberg B., Dougherty D. (eds) I-Psychiatric Neurotherapeutics. I-Psychiatry yangoku. ENew York: Humana Press; 2016.
> Williams, MT, et al. Ingqungquthela yoluhlobo olusenyulu olusisigxina kwi-disorder-disulsive disorder. Ukuxinezeleka Okuxhalabileyo. 2011; 28 (6): 495-500. i-doi: 10.1002 / da.20820