Nā hana no ka hoʻowalewale pūnaewele, hoʻoweliweli wahine a me ka kūʻai koi ʻana: A meta-analysis (2020)

Ka Palapala Moʻolelo o nā'Apena'Auhavioral

Volume / Nūpepa: Helu 9: Nūpepa 1

Authors: ʻO Martina Goslar¹, He Leibetseder Max Leibetseder¹, Hana M. Muench², Stefan G. Hofmann³ a ʻO Anton-Rupert Laireiter^{1 , 4}

DOI: https://doi.org/10.1556/2006.2020.00005

Hōʻuluʻulu Manaʻo

Ke kumu a me nā manaʻo

Hoʻopili i ka Pūnaewele, ke hoʻoili ʻana a me ke kūʻai ʻana. Akā, liʻiliʻi liʻiliʻi e pili ana i ka hopena o kā lākou mālama. ʻO ka pahuhopu o kēia meta-analysis ʻo ia nō ka ʻike ʻana i ka hopena o nā ʻano o nā ʻano pilikia, a e huki hoʻi i nā leʻaleʻa i ka pili ʻana i ka pelu a me ka hoʻohana ʻana i nā maʻi pili i nā hua o ka pane ʻana o ka mālama.

Nā Papahana

Ua loaʻa i ka ʻimi noiʻi ʻana i nā haʻawina 91 me ka huina o nā poʻe 3,531 e hāʻawi i kahi loiloi piha o ka hopena pōkole a me ka lōʻihi o ka noʻonoʻo ʻana i ka noʻonoʻo, pharmacological a me nā hui i hoʻohui ʻia no ka pili ʻana i ka pūnaewele, ka hoʻohui male ʻana, a me nā mea e pono ai ke kūʻai.

Results

Ua hoʻopili ʻia nā hana psychological, pharmacological, a hui pū ʻia me nā hoʻomaikaʻi mua ma hope o ka nui o ka hoʻoweliweli pūnaewele (Hedges's g: 1.51, 1.13, a me 2.51, a me ka moe kolohe (Hedges's g: 1.09, 1.21, a me 1.91, ). No ke kūʻai ikaika ʻana, ua pili pū kekahi me nā lāʻau lapaʻau a me nā lāʻau lapaʻau me kahi hōʻemi nui ma mua o ka hopena ma mua o ke koʻikoʻi o ka honua (Hedges's g: 1.00 a me 1.52). ʻO ka nui o ka hopena ma mua o ka hopena a ma loko o ka pūʻulu ma mua o ka hopena o ka hopena ma ka pae like, me nā ʻokoʻa ʻē aʻe. Hōʻike nā loiloi moderator i ka maikaʻi o nā hana psychological no ka hōʻemi ʻana i nā hana koʻikoʻi, keu hoʻi ke hāʻawi ʻia he alo a he alo a mālama ʻia i loko o nā manawa lōʻihi. ʻO ka hui pū ʻana o nā ʻano noʻonoʻo-behavioral me nā lāʻau i hōʻike i kahi maikaʻi ma mua o nā monotherapies.

Kūkākūkā a me nā ʻĀina

Hōʻike nā hopena i mālama ʻia ka mālama ʻia ʻana o nā maʻi maʻamau i ka wā pōkole, ka mea like me nā mea i hoʻokō ʻia no ka pili ʻana i ka pili i ka palaka a me nā pilikia hoʻonaninani.

Ua ʻike ʻia nā noiʻi hou i nā mea like ma waena o nā hana hoʻohana kino (SUDs) a me nā mea e pili ana i ka hana (BAs; eg; Grant, Potenza, Weinstein, & Gorelick, 2010). Ma muli, ua pili nā mea pili e pili ana i ka hana pili i ke ʻano o ka hoʻohana ʻana i nā waiwai i hoʻohālikelike ʻia i ka Diagnostic and Statistical Manual of Mental Disorders (DSM IV; AhahuiʻApelika Psychiatric Association, 1994) e komo pū me ka hana kūpono, ka nele o ka mana o ka ʻohi, ka ʻae ʻana, ka hoʻihoʻi ʻana, a me ka hoʻomau ʻana ma ke ʻano o nā hopena maikaʻi ʻole. Grant a me., 2010). I kēia manawa, ka maʻi ʻaumea āpau (GD), i helu ʻia ma lalo o ka "Impulse-Control Disriers Not Elseither Classified" ma DSM IV (AhahuiʻApelika Psychiatric Association, 1994), kākuhi ʻia ma lalo o ka ʻāpana hou "ʻO nā mea pili e pili ana a me nā hoʻohui i mea hoʻohui ʻole"O ka DSM-5 (AhahuiʻApelika Psychiatric Association, 2013). Ua hoʻāla ka hana hou ʻana i kēia hoʻopaʻapaʻa nui inā paha i nā ʻano ʻē aʻe me ka emi ʻana o ka mana hoʻomake e pono ke kūkākūkā i nā poʻe koho no ka BA (eg, Grant a me., 2010; Mueller et al., 2019).

Ma waho aʻe o GD, ʻo ka punahele pāʻani pūnaewele (IGD) ke kūlana wale nō i kau i ka DSM-5 ma lalo o ka Pauku III me ka ʻōlelo no ka noiʻi hou aʻe (AhahuiʻApelika Psychiatric Association, 2013). Kākoʻo ʻia e nā poʻe loea mai nā ʻĀina a me nā kikowaena olakino olakino (ʻo ia hoʻi, Rumpf et al., 2018; Saunders et al., 2017), ke nānā pū nei ka maʻi pāʻani i ka hana o ka ICD-11 (ʻOihana Ola Lahui, 2018). He mea nui e pono e hoʻokaʻawale ʻia ka IGD mai ka hoʻolālā honua honua addiction (IA), ma ke ʻano he ʻano nane ʻelua. ʻO Griffiths & Pontes, 2014; Kiraly et al., 2014). Akā, ʻo ka mea he nui nā puke e pili ana i ka honua IA, ua hoʻokaʻina ʻia kēia huaʻōlelo i kēia pepa. Eia nō naʻe, he ʻokoʻa ka ʻokoʻa ma waena o ka "pāʻani" a me ka "pā". Ma ka "pāʻani ke kuhi ʻia nei e ka launa ʻana, me ke ʻano pāʻani, a me nā ʻike e pili ana i ka holomua a me ka kūleʻa. ka nui o nā hopena i koho ʻia, a me nā hiʻohiʻona monetization e pili ana i ka hopena a me ka uku no ka mea pāʻani. " ((King, Gainsbury, Delfabbro, Hing, & Abarbanel, 2015, p. 216).

ʻOiai ke komo ʻana o ka IGD i nā puke diagnostic ua kūkākūkā nui ʻia i ka ʻepekema ʻepekema (King & al., 2019; Petry, Rehbein, Ko, & O'Brien, 2015; Rumpf et al., 2018; Saunders et al., 2017), nui ka noiʻi ʻana i hana ma ka IA a me IGD, e pili ana i nā hana neʻe e pili ana i nā mea e like me nā SUDs (no nā loiloi ʻike Fauth-Buhler & Mann, 2017; ʻO Kuss, Pontes, & Griffiths, 2018). Ma waho aʻe o nā mea like ma waena o ka SUDs a me nā BA i nā ʻano o ka phenomenological a me nā kūlana kulekele, comorbidity a me ka mōʻaukala, ʻoiai nā ʻike mai nā loiloi neuroscience mea pono no ka hōʻike ʻana i nā hōʻailona o nā ʻano hoʻohālikelike (e hoʻohālikelike ai. Grant a me., 2010; Potenza, Sofuoglu, Carroll, & Rounsaville, 2011).

I ka laina me kēia noʻonoʻo, ua loaʻa i kahi holomua i ka nānā ʻana i nā mea maʻamau neurobiological me SUDs i ʻoi hou aku i loko o nā kāʻei o nā kaomi ʻekikena (SA) a me ke kūʻai ʻikepili (CB) ma ka nānā ʻana i nā mea i noiʻi ʻia i nā SUD e like me ke kaʻina hana hoʻomehana (e laʻa. ʻO Hoffmann, Goodrich, Wilson, & Janssen, 2014; Snagowski, Laier, Duka, & Brand, 2016), cue ka hoʻohui ʻana, ka hopena a me nā hana neural pili ʻana (ka hoʻohālikelike, Brand, Snagowski, Laier, & Maderwald, 2016; Gola et al., 2017; Jiang, Zhao, & Li, 2017; Laier, Pawlikowski, & Brand, 2014; Laier, Schulte, & Brand, 2013; Lawrence, Ciorciari, & Kyrios, 2014; Mechelmans et al., 2014; Pekal, Laier, Snagowski, Stark, & Brand, 2018; Schmidt et al., 2017; Seok & Sohn, 2015; Starcke, Schlereth, Domass, Schöler, & Brand, 2012; ʻO Trotzke, Starcke, Pedersen, & Brand, 2014; ʻO Trotzke, Starcke, Pedersen, Müller, & Brand, 2015; Voon et al., 2014), ai ʻole lawelawe hana (ʻO Derbyshire, Chamberlain, Odlaug, Schreiber, & Grant, 2014; Messina, Fuentes, Tavares, Abdo, & Scanavino, 2017; Raab, Elger, Neuner, & Weber, 2011; Trotzke et al., 2015). Ua hōʻike ʻia kēia mau haʻawina ma waena o kēlā mau kūlana i ʻike ʻole ʻia ma ka DSM-5 me he mau BA, ʻo kēia ka mea i ʻike ʻia i kēia manawa e pili ana i nā hōʻailona neurobiological no nā mea like ma waena o nā mea pili e pili ana i ka pili a me ka pili ʻole o nā mea pili i ke ʻano ma nā wahi o IA, SA a CB, ʻo ia ke kumu o ka pepa o kēia manawa. Ma muli o kēia mau pilikia e pili ana i ka pili pono o ka haukapila, a pili pinepine i nā hopena maikaʻi loa no ka poʻe i hoʻopilikia ʻia ʻO Pontes, Kuss, & Griffiths, 2015), pono e koho ʻia nā koho mālama maʻi (e hoʻohālike, Grant a me., 2010). I kēia manawa, ua mālama mua ʻia ka meta-analts me ka mahalo i ka IA e hōʻike nei i ka pono o nā ʻano hoʻokala like ʻole (Chun, Shim, & Kim, 2017; Liu, Liao, & Smith, 2012; ʻO Winkler, ʻO Doersing, Rief, Shen, & Glombiewski, 2013). ʻElua o nā meta-loiloi i hōʻike i ka ʻimiʻepekema, pharmacological a me nā hoʻohui o nā pālua ʻelua, akā ʻo ka mea hōʻike i palena ʻia i nā haʻalulu hopena hopena ma China (Liu et al., 2012), a me Korea (ʻO Chun et al., 2017). ʻO ke loiloi meta-analiti ākea ākea i kākoʻo i nā mea hōʻike no ka hopena o ka noʻonoʻo psychotherapy a me nā lāʻau lapaʻau e hōʻemi i nā hōʻailona o IA me nā hoʻokolohua mai nā poʻe ʻAsia a me nā ʻaoʻao komohana.Winkler et al., 2013). ʻO nā hui hui ʻia, ʻaʻole naʻe i noʻonoʻo ʻia. Eia hou, ʻo ka meta-analysis o Winkler et al. (2013) ʻaʻole ia i komo i ka noiʻi hou aku.

Loaʻa nā hopena maikaʻi no nā pale olakino a me ka pālapa lāʻau i ka hōʻemi ʻana i ka nui o ka honua o CB.Hague, Hall, & Kellett, 2016). Eia naʻe, ʻaʻole nānā ʻia ka hopena o ka maikaʻi o ke aʻo ʻana a me nā mea hoʻohālikelike ʻē aʻe i nā hopena lapaʻau. No laila, ke kali nei kahi noiʻi ākea o nā koho lapaʻau no IA a me CB. ʻOiai SA i manaʻo ʻia i ka ICD-11 me ka huaʻōlelo ʻo "ke ʻano moekolohe moekolohe" (ʻOihana Ola Lahui, 2018), a "ʻaʻole maopopo ka manaʻo i ka hōʻike ʻana i nā kiʻi i hoʻohālikelike ʻia i nā ponokala" (Grubbs, Kraus, & Perry, 2019, p. 93), nā loina no SA SA ʻuʻuku ʻole ʻia e nā metotia meta-analytic. Eia kekahi, ʻaʻohe mea i hoʻohālikelike ʻia ma waena o IA, a i ʻole IGD — kahi moho no ka ʻāpana "ʻO nā mea pili e pili ana a me nā hoʻohui i mea hoʻohui ʻole"O ka DSM-a me nā mea hoʻohuli ʻē aʻe paha, e like me SA me CB, e pili ana i ka pane ʻana o ka mālama ʻana, ka mea i manaʻo ʻia he kuhikuhi nui no nā mea e like ma waena o ka SUDs a me nā BA (e like me, Grant a me., 2010).

ʻO ka pahuhopu mua o ka meta-analysis o kēia manawa, no ka noiʻi ʻana i ka hopena o ka noʻonoʻo pono, ʻona hoʻokūkū a me ka hoʻohui naʻau a me nā ʻano hoʻokolohua ʻenekia no IA, SA, a me CB no ka hoʻemi ʻana (a) i ka hōʻino honua a me (b) ka neʻe o ka koi nā helehelena ma hope o ka pau ʻana o ka mālama ʻana (nā hopena pōkole) a ma ka manawa hope i hōʻike ʻia ma hope loa (nā hopena lōʻihi). Koho ʻia ma nā ʻike i nā loiloi hope loa (Hague et al., 2016; Winkler et al., 2013), ua manaʻo mākou i nā hana lapaʻau a me nā lāʻau lapaʻau e like me ka hana pono ma waena o nā māhele hoʻohui ʻekolu. Ua manaʻo hou hou mākou ua like nā hopena hana e like me nā mea i hōʻike ʻia no ka hoʻohana ʻana i nā mea a pau a me nā pāʻani.Grant a me., 2010; ʻO Potenza et al., 2011). Eia kekahi, ʻo kā mākou pahuhopu ʻo ia iho e ʻike i nā mea loli o ka nui o ka hopena i loko o kēlā me kēia māhele hoʻohui. Ua hana ʻia ka meta-anal e like me nā ʻōlelo a ka ʻōlelo ʻo PRISMA.Moher, Liberati, Tetzlaff, & Altman, 2009).

Nā Papahana

Nā koho koho

Ua noʻonoʻo ʻia nā haʻawina no ka hoʻokomo ʻana me lākou (1) hana i kekahi ʻano o ka noʻonoʻo, ka pharmacological a i ʻole kekahi ʻano hui i hui pū ʻia (e like me, ʻekepili a me nā ʻano lāʻau lapaʻau i noi ʻia i ka manawa like); (2) i hoʻohana ʻia i loko o nā pūʻulu, hoʻopaʻa 'ia, a i ʻole nā quasi-randomized design ʻokoʻa hoʻopaʻa ʻana me ka mana o ka papa inoa waitohu, nā poʻe komo ʻaʻole i mālama i ka hoʻomaʻamaʻa, nā ʻano maʻi hoʻōla hou ʻole, a i ʻole interlay pletebo; (3) mālama i nā poʻe hui me ka maʻi o ka IA, SA, a i ʻole CB; (4) ana i ka liʻiliʻi o kekahi o nā hualoaʻa hopena (ʻo ia hoʻi, ka hōʻino a i ʻole ka leʻa honua); a (5) hōʻike pono i ka helu helu helu helu no ka helu helu nui. Ua hoʻokaʻawale ʻia nā haʻawina inā (1) ke ʻano noiʻi hoʻokahi hōʻike; (2) i hoʻopaʻa pono ʻia i ka papa noiʻi me ka hoʻohālike o kekahi haʻawina ʻē aʻe i komo pū me ka meta-analysis; (3) ʻaʻole i hōʻike ʻia ka lāʻau lapaʻau, a i ʻole (4) i loaʻa i ka abstract a i ʻole ka piha palapala o ka hoʻopaʻa ʻana. Me ka mahalo o SA, ua komo wale mākou i nā noiʻi e noiʻi ana i nā ʻano lawaiʻa e pili ana i ka hoʻohālikelike ʻia ʻana e ka manaʻo Kafka (2010), a wehe ʻia nā haʻawina e pili ana i nā mālama ʻana i nā paraphilias ʻokoʻa i ka SA ma nā ʻōlelo o ka "socially anomalous a 'deviant' form of sexual sex"Kafka, 2010, p. 392).

ʻO nā ʻikepili ʻike a me ka huli ʻana i ka palapala

Ua hana mākou i kahi hulina literatur multilevel me ka hoʻohana ʻana i ka ʻikepili PsycInfo, Medline, PubMed, Psyndex, a me ka Pūnaewele Pūnaewele ʻo ISI. Ua uhi ʻia ka hulina i nā paʻi pili āpau mai ka makahiki mua a hiki i Iune 30, 2019 me ka hoʻohana ʻana i nā huaʻōlelo pili e pili ana i ka maʻi hanana: Ka hoʻohui pūnaewele ʻana, ka mea hoʻokaumaka pūnaewele ∗, ka hana pāʻani pāʻani pūnaewele, ka mea hoʻokau pāʻani pūnaewele ict, ka mea hoʻokani wikiō ∗, ka addict videogame ∗, addict computer, hana addict computer, addict smartphone, addict phone, Addict ∗, Hoʻoponopono ∗, pilikia ∗ kelepona; sex ∗ addict ∗, sex ∗ compuls ∗, sex ∗ impuls ∗, hypersex ∗, nonparaphilic sex ∗, paraphilia-related disorder ∗; kūʻai kūwaha, paʻa i kūʻai ∗, oniomania, shopaholic ∗, overshopping hui pū me nā hua'ōlelo pili kīwīwīwīwīwīwīwīwīwī i ke alapine, hoʻoweliweli, ʻehaʻeha, psychotherapy. Ua hoʻohana ʻia nā huaʻōlelo like ʻole e nānā iā ProQuest Digital Dissertations no nā puke paʻi ʻole i paʻi ʻia. Ma hope aku, ua hana mākou i ka noiʻi ʻokoʻa loa i nā papa inoa o nā loiloi o nā loiloi, meta-analysis, a me nā haʻawina mua i loaʻa mai i ka ʻikepili. Eia kekahi, ua hoʻopili ʻia nā mea kākau o nā ʻatikala e noi ai no ka nalo data a / a i ʻole i paʻi ʻia nā pepa i hoʻopaʻa ʻia no ka hoʻopili ʻana i ka meta-analysis. Ua unuhi ʻia nā paʻi Kaina e nā ʻōlelo ʻōlelo ʻelua me kahi pae kula haʻawina.

Nā mea i loaʻa

Ma hope o nā hopena hopena i hōʻike ʻia i nā kumu ma nā kumu mua, ua kuhikuhi mākou i ʻelua mau hopena o ka hopena e wehewehe i ka hōʻemi o nā hōʻailona pathological: (1) ka hōʻino honua, i ʻike ʻia e ka hoʻohana pono ʻana i nā mea loiloi kūpono, a (2) i ke alapine (e,. Ka helu o nā hola i hala ma ke pūnaewele, nānā ʻia ke nānā aku a me ka helu o ke kūʻai ʻana i nā episekole i ka hebedoma i hala a i ka mahina paha), helu ʻia e nā kāleka diary a i ʻole hōʻike.

Ke kohoʻana

Ua hana ʻia ke koho noiʻi e ʻelua mau loiloi kūʻokoʻa (ka mea mua a me ka lua o ka kākau, ʻo MG a me ML) a mālama ʻia e ka mea kākau hope o kēia pepa (AL). Ua hoʻoholo ʻia nā hoʻopaʻapaʻa ma waena o nā mea kākau ma o ke kūkākūkā ʻana.

ʻO ka hōʻiliʻili o ka ʻikepili a me ka lawe ʻana i ka hōʻike

Ua hana mākou i kahi palapala hoʻoweliweli hoʻoweliweli i hoʻoponopono ʻia a hoʻololi ʻia ma hope o ka hoʻohālikelike ʻana ma ke ʻano he 10 mau haʻawina. No ka helu ʻana i ka palena mua a me ka nānā mua i ka nui o ka hopena o ka hopena, ua lawe ʻia ka ʻike helu no kēlā me kēia kūlana lapaʻau a hopena i ka hopena. Inā i nānā ʻia nā ʻano loiloi a i ʻole nā lāʻau lapaʻau ʻē aʻe i loko o hoʻokahi noiʻi, ua hoʻopaʻa ʻokoʻa ka hōʻike no kēlā me kēia kūlana a i komo i loko o nā helu hopena o loko no nā helu hoʻohālike. No ka helu ʻana i ka nui o ka pākuʻi ʻana i ka nui o ka hopena, nā data mai ka papa inoa no ka papa inoa ʻana, ʻaʻohe mea mālama, a me nā pūʻulu hoʻomalu placebo i hoʻohui ʻia. Hoʻohui ʻia, ua lawe mākou i ka ʻikepili helu a me ka helu kumumanaʻo mai kēlā me kēia haʻawina e hana ai i nā huli kūmole. ʻO ka kiʻi ʻikepili i hana ʻia e ka mea kākau mua (MG), a i hōʻoia ʻia e ka lua o ka mea kākau (ML). ʻO nā loiloi o nā coders kūʻokoʻa ʻelua i kau ʻia ma nā ʻano o nā lāʻau lapaʻau, ka hoʻohālikelike ʻana o nā hopena hopena, a me ka hilinaʻi a me ka hōʻoia o nā hopena maʻi me ka hopena maʻi. Ma nā noiʻi, akā, ua hoʻohana ʻia nā mea like me ka loiloi o ka maʻi maʻi a me ka ʻike ʻana i ka hopena o ka hopena "hōʻino honua" i ka wā mālama. No ka mea ʻo ka loiloi o ka hilinaʻi a me ka hōʻoia pono o nā mea i hoʻohana ʻia no ka ana o ka loli ʻana o nā hopena hopena he hapa kekahi o ka helu o ka hopena o ka ʻēʻī o nā kino ma nā haʻawina pilikino (e ʻike i lalo), ʻo ka hilinaʻi interrater i helu ʻia e ka kappa statistic i hana wale ia no nā ʻano lāʻau lapaʻau.

Loaʻa i ka paʻakikī o nā haʻawina pilikino

Ua loiloi mākou i ka mana kūloko o kēlā me kēia haʻawina e hoʻohana ana i ke ʻano loiloi loiloi maikaʻi no nā loiloi kūloko, i hoʻomohala ʻia e ka Effective Public Health Pract Project (EPHPP) (ʻO Thomas, Ciliska, Dobbins, & Micucci, 2004). Ua hōʻike i kēia mea hana a me ka kūkulu ʻana i ka pono (ʻO Thomas et al., 2004) a ua ʻōlelo ʻia no nā loiloi ʻōnaehana a me nā meta-analel (Deeks et al., 2003). Kahi ʻia kēlā me kēia haʻawina i hoʻohālikelike ʻia i ʻeono mau kikowaena: ke koho koho, ka hoʻolālā noiʻi, ka ʻike ʻana a me ka kāohi ʻana o nā mea hūnā, ka makapō, ke hilinaʻi a me ka pono o nā ʻikepili o ka hōʻiliʻili data, a me ka hōʻike ʻana a me ka pākē o ka hoʻihoʻi ʻana a me nā haʻahaʻa. Ua loiloi kēlā me kēia pākahi me ka ikaika, pākahi, a palupalu paha. ʻO ka helu honua ua helu ʻia ma hope o ka loiloi o nā kikowaena ʻeono. Ua kuhi kū hoʻokahi nā mea kākau ʻelua (MG a me ML) i kēlā me kēia haʻawina a hoʻoholo i ka helu honua o kēlā me kēia hoʻokolohua. Ua helu ʻia ka hilinaʻi o Interrater me ka hoʻohana ʻana i ka statist kappa. Ua hoʻoholo ʻia nā hoʻopaʻapaʻa ma waena o nā mea kākau ma o ka kūkā ʻana a hiki i ke ʻano ʻana i ka ʻae ʻana.

ʻO ka kiko helu helu a me ka helu helu helu synthesis

Ua hana ka helu helu helu helu ʻana me ka hoʻohana ʻana i ka polokalamu polokalamu Comprehensive Meta-Analysis (CMA) version 2.2.064 (Borenstein, Hedges, Higgins, & Rothstein, 2005). Ma loko o kēlā me kēia maʻa, ua helu mākou i nā nui o ka hopena no nā loli hopena i hōʻike ʻia i loko o ka psychological, pharmacological, a me nā noiʻi i hoʻokaʻawale ʻia no loko o ka pūʻulu a me nā hoʻolālā hoʻopaʻa naʻau (e nānā i ka Pepa Hoʻohui no nā kūmole). Ma muli o nā liʻiliʻi liʻiliʻi, ua hoʻoponopono ʻia nā nui o ka hopena no ka bias e hoʻohana ana iā Hedges g me nā palena hilinaʻi 95% kūpono ʻole (CI; ʻO Hedges & Olkin, 1984). Inā ʻaʻole i loaʻa nā ala a me nā hana pākahi maʻamau, helu ʻia ka nui o ka hopena ma ke kumu hoʻohālike e like me ka hoʻohālikelike (e hoʻohālike, t waiwai, aiʻole pae kūpono pae pae kiʻekiʻe). Inā ana paha ke ʻano o ka hopena iʻoi aku ma mua o ka mea hoʻokahi, ua hoʻokomo ka ʻikepili mai kēia mau mea hana a hoʻokaʻawale ʻia no ka pūlima hopena hopena (Lipsey & Wilson, 2000). No nā haʻawina e hōʻike nei i ka ʻikepili ma muli o nā mea hoʻopihapiha a me nā anamanaʻo manaʻo-e-mālama (ITT), lawe ʻia ka ʻikepili ITT. ʻO ke kuhikuhi o ka hopena i hoʻoponopono ʻia e like me ka "kūleʻa": maikaʻi ka hopena inā ua ʻoi aku ka maikaʻi o ka hui i mālama ʻia ma mua o ka pūʻulu kaohi. Wahi a nā ʻōlelo a Cohen (1977), hiki i nā hua kiko o 0.20 a i 0.30 hiki ke helu ʻia ma ka liʻiliʻi, ʻo ka poʻe kokoke i 0.50 e like me ka nui, a ʻo nā mea ma luna o 0.80 e like me ka nui.

Ke manaʻo nei i ka heterogeneity ma waena o nā mea noiʻi, ua hoʻoholo mākou e hoʻohana i nā hiʻohiʻona ʻai pākihi no ka hoʻopili ʻana i ka nui o ka hopena. Ua nānā ʻia ka Heterogeneity o ka nui o ka hopena me ka hoʻohana ʻana i ka statist Q me ka mea pili p waiwai, a me ka I² ke hōʻike, e hōʻike ana i ke ʻano o nāʻokoʻa maoli i ka nui o ka hopena i hōʻike ʻia e ka hapa ʻana o ka loliBorenstein, Hedges, Higgins, & Rothstein, 2009; Higgins, Thompson, Deeks, & Altman, 2003); I² mau waiwai o 25%, 50%, a me 75% i helu ʻia he mau haʻahaʻa, maʻalahi, a kiʻekiʻe.Higgins et al., 2003).

ʻO ka hopena o ke keʻa i nā haʻawina

No ka kaohi ʻana no ka hoʻopilikia paʻi ʻana, ua alakaʻi mākou i kahi hulina moʻokalaleo maikaʻi loa a ua helu ʻia ka palekana ʻole o Rosenthal N (Rosenthal, 1979) a ua nānā ʻia me nā plough funnel (ʻO Duval & Tweedie, 2000). Wahi a ʻO Rosenthal (1991), ke ʻano he nui nā hopena i makemake ʻia inā he nui ka nui o nā haʻawina e kiʻi ai i kahi hopena nonsignificant ma mua o 5k + 10, ma hea k kūlike o ka helu o nā haʻawina. Hoʻopili ia, ua hoʻohana mākou i ke ala kuhi-a-piha (ʻO Duval & Tweedie, 2000) ke kuhi ʻo nā haʻawina nalo a me ko lākou hopena i ka nui o ka hopena hopena. Kahi ʻia kēia ʻano ma ka loiloi o ka pāʻauʻau ʻōpala me ke kālai ʻana i ka symmetrical hopena o ka nui o ka hopena no ka hopena o ka hopena i ka pāpā ʻana. Ma ka hōʻike o ka māhele asymmetrical, ua hoʻoponopono ka kime a me ka hoʻopiha i ka nui o nā hopena (Borenstein et al., 2009); ua hoʻohana wale mākou i kēia ʻano inā loaʻa nā haʻawina 10 no ke kaana ʻana (ʻO Sterne, Egger, & Moher, 2011). Loiloi ʻia ka asymmetry o Funnel ma ka hoʻohana ʻana i ka hōʻike a EggerʻO Egger, Smith, Schneider, & Minder, 1997). E like me ka hopena nui o ka nui o nā waiwai nui e hoʻopili hewa i ka wehewehe ʻana i nā hopena hopena (Lipsey & Wilson, 2000), ua hoʻohana mākou i ka hana “hoʻokahi-hoʻopaʻa-neʻe” i hāʻawi ʻia e CMA e nānā i ka hopena o ka nui o ka hopena o kēlā me kēia haʻawina i ka hopena holoʻokoʻa.Borenstein et al., 2005). Inā ʻaʻole i hopena nui ka hopena i ka nui o ka hopena a noho i loko o ka 95% CI, paʻa nā haʻawina i nā loiloi.

Hoʻolālā kumu

I mea e wehewehe ai i ka heterogeneity ma waena o nā nui o ka hopena, ua nānā mākou i ke ʻano o ka nānā 'ana i ka ʻikepili (ITT vs completer analysis), a me ka ʻano o nā haʻawina (ʻĀpana pae honua EPHPP) e like me nā mea e hiki ai nā mea hoʻokolohua. No ka mea, ua loaʻa ka manaʻo kaumaha a me nā hopohopo e pili pū ana me BAs (e like me, ʻO González-Bueso et al., 2018; Starcevic & Khazaal, 2017), ua nānā mākou inā i loli ka nui o ka hopena ma ke ʻano he hana o kēia mau hanana i hōʻea ʻia (komo pū ʻia me ka wehe ʻana i ke kaumaha a / a i ʻole ka hopohopo). ʻOiai ʻo nā pilikia pū kekahi, ʻoi loa ka kaumaha a me ke kaumaha, he maʻamau i waena o nā mea i hoʻopilikia ʻia e nā BAs (Starcevic & Khazaal, 2017), nā loiloi i hōʻole ʻole e hōʻike i ka ʻike i nā kūlana comorbid i kuhi ʻia e komo pū me nā mea i hui pū ʻia me ke kaumaha a me ka hopohopo pū. No nā noiʻi noʻonoʻo, ua noiʻi hou ʻia mākou i ke ʻano o ke ʻano lapaʻau (hoʻonohonoho ʻana i nā poʻe ma ke ʻano he ʻōlelo aʻo kūʻokoʻa a me kekahi mau ʻano ʻē aʻe [e laʻa, kū hoʻokahi a me ka hoʻonohonoho hoʻonohonoho pilikino, ka hoʻonohonoho ʻana o ka ʻohana)), ke ʻano o ke kaukau ʻana (maka-ka-alo [FTFT] vs. kau iho i nā maʻi lapaʻau kūʻokoʻa [SGTs]), a me ke ʻano o ke komo ʻana o ka noʻonoʻo noʻonoʻo. Kuhi ʻia ke ʻano o ka noʻonoʻo naʻauao ʻana ma ka hoʻokaʻawale ʻana i nā hoʻolālā ʻepekema i loko o kēia ʻano: (1) CBT, e uhi ana i nā hana cognitive a / a i ʻole nā hanana kūpono; (2) lawelawe hoʻohui hoʻohui e pili ana i nā ʻano hana like ʻole, a me (3) mau maʻi lapaʻau e pili ana i nā kumuhana ʻē aʻe, e like me ka ʻohana ʻohana, ka lāʻau maoli ʻana i ka pono, ʻae a me nā loiloi, a i ʻole ʻano lāʻau lapaʻau. ʻO ka manaʻo ʻana he nui nā haʻawina i hana ʻia ma nā ʻāina hema, ʻaʻole hoʻi no IA, ua ukali mākou i ka hana loiloi mua (Winkler et al., 2013) a kāhea aku inā ʻo ka moʻomeheu moʻomeheu (ʻĀsia ma mua o nā ʻāina ʻē) i hōʻoia ʻia i ke kamaʻilio. Mai ka honua a me ka IGD e hōʻike i nā ʻano hana like ʻole (e hoʻohālike, ʻO Griffiths & Pontes, 2014), ua nānā pū mākou i nā ʻokoʻa ma waena o nā haʻawina e pili ana i ka honua IA a me kēlā, i noiʻi ʻia ʻo IGD a me nā hana ʻē aʻe i hoʻohana ʻia e ka pūnaewele (e like me, smartphone addiction, videogame addiction).

No nā lāʻau lapaʻau lāʻau, ua ninaninau mākou inā hana nā antidepressants i ʻoi aku i nā ʻano lāʻau lapaʻau ʻē aʻe a i ʻole i ke ʻano ʻana i nā lāʻau lapaʻau (like, antidepressants i hui pū me ka methylphenidate). No nā ʻatikala i hoʻohui ʻia, ua nānā mākou i nā hopena ʻelua o nā ʻano o nā ʻano noʻonoʻo a me nā kikowaena pharmacological. Hoʻopohopo, ua noiʻi mākou inā ʻo kekahi o nā ʻano lapaʻau (psychological vs pharmacological vs. hoʻohui interventions) i loko o kēlā me kēia māhele addiction i hōʻike i kahi maikaʻi ma luna o nā mea'ē aʻe. ʻO ka mea hope, hoʻohālikelike mākou i ka nui o nā hopena o ka noʻonoʻo a me nā kikowaena pharmacological o nā ʻokoʻa like ʻole o nā ʻatikala. Ke hōʻike nei i ke ʻano o ka "ʻoihana pūnaewele he channel wale nō ia e hiki ai i kekahi ke komo i nā manaʻo a lākou e makemake ai (e laʻa, ʻoihana.ʻO Griffiths & Pontes, 2014, p. 2), ua hoʻomau mākou i nā haʻawina i komo pū ai nā mea me ka wahine e pili ana i ke ʻano o ka wahine ma ke ʻano he "addiction male" a me "compulsive Buy", i ka pūnaewele i hoʻohana ʻole ʻia a i ʻole.

Ua hoʻopaʻa ʻia ka Lunahooponopono no nā loli like ʻole i hoʻohana ʻia ka hoʻohana ʻana i nā hopena like ʻole me nā mea hoʻohālikelike like ʻole T² a me ka Q-hoʻokolohua e pili ana i ka nānā ʻana o ka ʻano like me ka mea like p waiwai no ka ho'ākāka 'ana o nā ʻokoʻa ma waena o nā hui.Borenstein et al., 2009). Ma kahi o ka liʻiliʻi he 10 mau haʻawina loaʻa (Deeks, Higgins, & Altman, 2011), hana hou mākou i nā loiloi meta-regression me ka hoʻohana ʻana i ka makahiki o ka paʻi a me ka lōʻihi o ka mālama ʻana (i loiloi me ka huina o nā hola i hoʻokaʻina i nā hoʻokolohua hopohopo, a i ʻole me ka helu o nā hebedoma i nā hoʻokolohua pharmacological). Inā ʻaʻole i lawa ka helu o nā haʻawina noʻonoʻo e hōʻike ana i ka nui o nā hola i mālama ʻia, ʻo ka nui o nā hebedoma i hoʻohana ʻia no ke ana ʻana i ka lōʻihi o ka mālama ʻana. Ua hōʻike ʻo Meta-regression i ke ʻano o ka makahiki a me ka pākēneka o nā kāne male i hana ʻia no ka mea he ʻokoʻa ka makahiki a me ka wahine ma waena o nā haʻawina ma waena o nā haʻawina e hōʻole ana i ka wehewehe pono (ʻO Thompson & Higgins, 2002).

Results

Ke kohoʻana

Hōʻike ʻia ka kaila o ke kaʻina hana noiʻi i loko Laau. 1. ^ E Ha yM. ʻAʻohe ʻano hakakā ʻole e pili ana i nā ʻano o nā ʻano lāʻau.

Nā ʻano o nā haʻawina, mālama, a me nā mea komo

Ma kahi o nā helu addiction āpau, ʻokoʻa ka ʻano o nā haʻawina i kēia manawa i ke ʻano o ka mana o ka mana: ʻAi ka hapalua o lākou i ʻole he hui pūpū (50%) a me kekahi mau haʻawina i hoʻohana ʻia i ka papa inoa waitiki, ʻaʻohe mālama lāʻau, ka mālama kino, a i ʻole nā hui pleta plasebo (30%), a i ʻole nā hoʻohālikelike hoʻomaʻamaʻa ʻano ʻē aʻe (20%). Kūkū ʻia nā hopena ma nā pahuhopu (80%). Hāʻawi ʻia ka ʻike pili ʻana e 32 mau noiʻi noʻonoʻo (IA: k = 16 mau haʻawina me nā wā manawa mai 1 a 6 mau mahina; M = 3.53, SD = 2.13; SA: k = 11 mau haʻawina me nā wā manawa mai 1.5 a 6 mau mahina; M = 4.27, SD = 1.88; CB: k = 5 mau haʻawina me nā wā manawa mai 3 a 6 mau mahina; M = 5.4, SD = 1.34), e hoʻokahi noiʻi lāʻau lapaʻau ma ka māhele CB me 12 mau mālamalama mau, a ma ʻelua mau haʻawina i ka māhele IA i hoʻohana i nā ʻano hui pū kekahi, ʻo kēlā me ka hōʻiliʻili i ka ʻikepili ma hoʻokahi lā iho.

ʻO ka hapa nui o nā noiʻi noʻonoʻo e nānā ana iā CBT (58%), hāʻawi i ka mālama ʻana ma o nā pūʻulu pūʻulu (71%), a me ka hoʻohālikelike ʻana i nā maka (92%). ʻO ka huina o nā hola i hala i loko o nā manawa noʻonoʻo mai ka 15 min a i ka 54 h (M = 12.55 hola, SD = 10.49), mai hoʻokahi pule mai 26 pule (M = 10.44, SD = 6.12), a mai 8 wiki i 20 mau pule (M = 11.71, SD = 3.90) no ka mālama ʻana mai i IA, SA, a me CB. ʻO ka hapa nui o nā noiʻi lāʻau lapaʻau e nānā i nā antidepressants (85%); ka hapa nui o nā hoʻokolohua hui pū i hoʻohana ʻia ʻo CBT i hui pū me nā antidepressants (71%). ʻO nā lōʻihi lōʻihi o nā lāʻau lapaʻau e hoʻomaka ana mai 6 a 52 mau pule (M = 15.67, SD = 17.95), mai 12 a 72 mau pule (M = 24.83, SD = 23.58), a mai ka 7 a he 12 mau pule (M = 9.50, SD = 2.20) no ka mālama ʻana mai o IA, SA, a me CB.

Ma waena o nā helu hoʻohui āpau, he 3,531 mau mea i komo i hoʻopaʻa ʻia (IA: n = 2,427; SA: n = 771; CB: n = 333). ʻO ka hapa nui o nā haʻawina e komo i nā poʻe i hui pū ʻia me ke kaumaha a me ke kaumaha (77%). Ua mālama nui ʻia nā hoʻokolohua e nānā ana i ka ʻĀina ma nā ʻāina ʻĀina (75%). ʻO ka helu kime he nui nā kāne i nā haʻawina e ʻike ana i ka IA (76%) me ka awelika makahiki 21, a me SA (98%) me ka makahiki he 37, akā ʻo ka wahine ma nā haʻawina e ʻike nei iā CB (92.45%) me ka makahiki maʻamau o 42 Ua hōʻike ʻia ka ʻike kikoʻī e pili ana i nā ʻano o nā noi Nā ʻ 1lelo 3–XNUMX.

1 Pūnaewele.Nā hiʻohiʻona o nā noi no ka pili ʻana i ka pūnaewele

ʻIke / Makahiki	N^a	Mahele ʻaia (N) / Kaʻina o ka lāʻau / mode o ka hāʻawi ʻana^b	Kāpena hui (N) / Kaʻina o ka lāʻau / mode o ka hāʻawi ʻana^b	Ka moʻomeheu / D / A (+/−) / IA ʻano	Duration t / c^c	Nā Leo (mahina)	Nā hopena (loiloi)	ʻIkeʻikepili	EPHPP
Nā mālama naʻau
ʻO Anuradha lāua ʻo Singh (2018)	28	CBT (28) / I / FTFT	None	Asia / - / IA	NA	None	GS (IADQ)	CO	3
Bai and Fan (2007)	48	IT (CBT; kāohi pilikino; hoʻokūkū kūloko) (24) / G / FTFT	NT (24)	Asia / + / IA	16	1.5	GS (CIAS-R)	CO	3
ʻO Cao et al. (2007)	57	CBT (26) / G / FTFT	NT (31)	Asia / + / IA	10	None	GS (YDQ, CIAS)	CO	2
Celik (2016)	30	EDU (15) / G / FTFT	NT (15)	Turkey / + / IA	10	6	GS (PIUS) FR (% pāʻani o ka pāʻani pūnaewele ma waena o ka hoʻohana pūnaewele / w)^d	NA	3
ʻO Deng et al. (2017)	63	CBI (44) / G / FTFT	WL (19)	Asia / + / IGD	18	6	GS (CIAS)	CO	2
Du et al. (2010)	56	IT (CBT; aʻo makua; EDU no nā kumu) (32) / G / FTFT	NT (24)	Asia / + / IA	14	6	GS (IOSRS)	CO	2
ʻO González-Bueso et al. (2018)	30	1) CBT (15) / I / FTFT 2) IT (CBT + EDU no nā mākua) (15) / I / FTFT	HC (30)^e	Sepania / - / IGD	1) 9 2) 9	None	GS (DQVMIA)	CO	3
Guo et al. (2008)	28	1) CBT (14) / G / FTFT	2) SUPP (e like me, ka hoʻolaha ʻana i ka ʻike i ka IA; ka hoʻolaha ʻana i ka manaʻo o ka naʻau pono a me nā kumu waiwai) (14) / G / FTFT^f	Asia / + / IA	1) 8 2) NA	None	GS (CIAS)	CO	2
Han et al. (2012)	14	FT (14) / F / FTFT	None	Asia / - / IGD	NA	None	GS (YIAS) FR (h / w)	CO	3
Han et al. (2018)	26	CBT (26) / G / FTFT	None	Asia / - / IGD	24	None	GS (CIAS) FR (h / w)	CO	3
Hui et al. (2017)	73	1) CBT (37) / G / FTFT	2) IT (CBT + EA) (36) / I + G / FTFT^f	Asia / - / IGD	1) 5 2) 10	None	GS (IAD)	CO	2
Ke a me Wong (2018)	157	CBT (157) G / FTFT	None	Asia / + / IA	12	1	GS (PIUQ)	CO	3
Khazaei et al. (2017)	48	PI (24) / G / FTFT	WL (24)	Iran / + / IA	NA	None	GS (IAT) FR (h / w)	NA	3
Kim (2008)	25	RT (13) / G / FTFT	NT (12)	Asia / + / IA	12.5	None	GS (K-IAS)	NA	3
King et al. (2017)^g		CBT (84 h abstinence) (9) / I / NA	None	Australia / + / IGD	NA	1	Kākau inoa GS (IGD) FR (h / w)	CO	3
ʻO Lan et al. (2018)	54	1) CBT (27) / G / FTFT	2) EDU (27) / G / FTFT^f	Asia / + / SMA	1) 8 2) 1	3	GS (MPIAS) FR (h / w)	CO	2
Lee et al. (2016)	46	ʻO CBT (kahi kākau i kēlā lā i kēia lā) (46) / FTFT / I	None	Asia / + / SMA	NA	None	GS (KSAPS)	CO
Li a me Dai (2009)	76	CBT (38) / I / FTFT	WL (38)	Asia / + / IA	14	None	GS (CIAS)	CO	3
Li, Garland et al. (2017)	30	1) MEA (15) / G / FTFT	2) SUPP (15) / G / FTFT^f	USA / - / IGD	1) 16 2) 16	3	GS (mau koho (DSM-5)	ITT	2
Li, Jin et al. (2017)	73	1) CBT (36) / G / FTFT	2) CBT + EA (37) / I + G / FTFT^f	Asia / + / IGD	1) 5 2) 10	None	GS (IAT)	CO	3
Liu et al. (2013)	31	1) CBT (16) / G / FTFT	2) SM (e nānā i nā nūpepa i kākau ʻia no ka hoʻāliʻi ʻana i ka hoʻokaʻawale o nā ʻano hana hoʻokau) (15) / G / SGT^f	Asia / - / IA	1) 54 2) 24	None	GS (IAT) FR (h / d)	CO	3
Liu et al. (2015)	46	FT (21) / G / FTFT	WL (25)	Asia / - / IA	12	3	GS (APIUS) FR (h / w)	CO	2
Pallesen et al. (2015)	12	IT (CBT; FT; SFT; MI) (12) / G / FTFT	None	Kahiki / + / VGA	NA	None	GS (GASA; PVP)	CO	3
Pāka, Kim et al. (2016)	24	1) CBT (12) / G / FTFT	2) VRT (12) / G / SGT^f	Asia / - / IGD	1) 16 2) 4	None	GS (YIAS)	CO	3
ʻO Pornnoppadol et al. (2018)	54	1) IT (CBT + mākaukau + haʻuki) (24) / G / FTFT	2) EDU (30) / G / FTFT^f	Asia / - / IGD	NA 2) 1	6	GS (GAST)	CO	2
Sakuma et al. (2017)^g	10	IT (SDiC komo me CBT; ka ʻai kī ʻana; hele huakaʻi; hele wāwae; hana like ʻana) (10) G / FTFT	None	Asia / - / IGD	NA	3	FR (ke pāʻani h / d; h / w; d / w)	CO	3
Shek et al. (2009)	22	IT (ʻōlelo aʻo a ka poʻe ʻokoʻa a me ka ʻohana; kōkua kākoʻo) (22) / I / FTFT	None	Asia / + / IA	NA	None	GS (CIA-Y; CIA-G)	CO	3
ʻO Sei et al. (2018)	46	MII (PFB) (46) / I / SGT	None	Asia / + / IA	NA	None	GS (IAT)	CO	3
Su et al. (2011)	59	CBT (polokalamu mālama pūnaewele) 1) LE (17) / I / SGT 2) NE (12) / I / SGT 3) NI (14) / I / SGT	NT (16)	Asia / + / IA	1) 0.48 2) 0.48 3) 0.26	None	GS (YDQ) FR (h / w)	CO	2
van Rooij et al. (2012)	7	CBT (7) / I / FTFT	None	Netherlands / + / IA	7.5	None	GS (CIUS) FR (d / w; h / d)	CO	3
Wartberg ma. (2014)	18	CBT (18) / G / FTFT	None	Kelemānia / + / IA	12	None	GS (CIUS) FR (h / lā pule; h / pule)	CO	3
Woelfling ma. (2014)	42	CBT (42) / G + I / FTFT	None	Kelemānia / - / IA	32	None	GS (AICA-S) FR (h / lā pule)	ITT	3
ʻO lāua ʻo Hao (2005)	52	IT (SFBT; FT; CT) (52) / I / FTFT	None	Asia / + / IA	NA	None	GS (YDQ)	CO	3
ʻO Yang et al. (2017)	14	1) CBT (14) / G + I / FTFT 2) EA (16)^h	HC (16)^e	Asia / - / IA	20	None	GS (IAT)	CO	2
Yao a al. (2017)	37	IT (RT; MFM) (18) G / FTFT	NT (19)	Asia / + / IGD	12	None	GS (CIAS)	CO	3
Nā Young (2007)	114	CBT (114) / I / FTFT	None	USA / + / IA	NA	6	GS (APA; CCU; MSA; SF) FR (OA)	CO	3
Nā Young (2013)	128	Hoʻololi ʻia ʻo CBT (128) / I / FTFT	None	USA / + / IA	NA	6	GS (IADQ)	CO	3
Zhang (2009)	70	IT (CBT; pāʻani) (35) / G / FTFT	NT (35)	Asia / + / IA	24	None	GS (IAT)	CO	3
Zhang et al. (2009)	11	CBT (11) / G / FTFT	None	Asia / + / IA	NA	None	GS (IAT)	CO	2
Zhang et al. (2016)	36	IT (CBI + MFTR) (20) / G / FTFT	NT (16)	Asia / + / IGD	17	None	GS (CIAS) FR (h / w)	CO	2
ʻO Zhong et al. (2011)	57	1) FT (28) / G / FTFT	2) IT (aʻo ka pūʻali koa; hoʻokūkū; ke kaukaʻi ʻana i nā hana hoʻohālikelike) (29) / G / FTFT^f	Asia / - / IA	24.5 2) NA	3	GS (OCS)	CO	2
ʻO Zhu et al. (2009)	45	1) CBT (22) / G / FTFT	2) IT (CBT + EA) (23) / I + G / FTFT^f	Asia / + / IA	5 2) 10	None	GS (ISS)	CO	2
ʻO Zhu et al. (2012)	73	1) CBT (36) / G / FTFT	2) IT (CBT + EA) (37) / I + G / FTFT^f	Asia / + / IA	5 2) 10	None	GS (IAT)	CO	2
Nā lāʻau lapaʻau lāʻau
Bipeta mā. (2015)	11	Nā antidepresants (ma hope o clonazepam ua pipi ʻia i 3 wiki) (11) (nā poʻe komo pū me IA a me OCD)	2) Nā mea kū'ē (antidepressants) (ma hope o clonazepam ua ʻoki ʻia i 3 mau pule) (27) (nā mea komo pū me OCD wale nō)^e	ʻĀina / - / IA	52	None	GS (YBOCS; IAT)	NA	3
DellʻOsso et al. (2008)	17	Kaumakaiwa (17)	None	USA / + / IA	10	None	GS (IC-IUD-YBOCS) FR (h / w)	CO	3
Han et al. (2009)	21	Hōʻailona (21) (Koncerta)	None	Asia / - / IGD	8	None	GS (YIAS-K) FR (h / d)	CO	3
Han et al. (2010)	11	Naana Bupropion SR (11)	None	Asia / - / IGD	6	None	GS (YIAS) FR (h / d)	CO	3
Pāka, Lee ma. (2016)	86	1) Methylphenidate (44)	2) Atomoxetine (42)^f 10 mg / d	Asia / - / IGD	12	None	GS (YIAS)	CO	3
Mele a me al. (2016)	119	1) ʻO Bupropion SR (44) 2) Escitalopram (42)	NT (33)	Asia / - / IGD	6	None	GS (YIAS)	CO	2
ʻO nā lāʻau hoʻohui
ʻO Han me Renshaw (2012)	25	1) Bupropion + 8 mau papa EDU (25)	2) Placebo + 8 mau papa EDU (25)^e	Asia / + / IGD	8	1	GS (YIAS) FR (h / w)	CO	2
Kim et al. (2012)	32	1) Bupropion + 8 mau hola CBT (32)	2) Bupropion + 10 min. nā nīnau no nā pule (33)^e	Asia / + / IGD	8	1	GS (YIAS) FR (h / w)	CO	2
Li et al. (2008)	48	Nā pale kū'ē + CBT + FT (48)	None	Asia / + / IA	4	None	GS (IRQ)	CO	3
Nam et al. (2017)	30	1) Bupropion + EDU (15)	2) Escitalopram + EDU (15)^f	Asia / + / IGD	12	None	GS (YIAS)	CO	2
Santos et al. (2016)	39	Nā lāʻau lapaʻau + hoʻohui ʻia he 10 mau haʻawina hoʻohuli CBT (39)	None	Kahiki / + / IA	10	None	GS (IAT)	CO	3
ʻO Yang et al. (2005)	18	CBT + aʻoi aku ka makua + Fluoxetine (18)	None	Asia / + / IA	10.5	None	GS (CIUS)	CO	3

palapala aie.

^aKa helu o nā kumuhana i hoʻokomo ʻia i ka loiloi.

^bʻO ke ʻano "mode of therapy" a me "mode of delivery" ua noi ʻia no nā lāʻau lapaʻau wale nō.

^cNo nā noiʻi noʻonoʻo, ua ana ʻia ka lōʻihi o ka mālama ʻana me ka helu o ka nui o nā hola i hoʻokaʻawale no ka mālama ʻana (t) a me nā pūʻali mana (c). No nā lāʻau lapaʻau a me nā mea hoʻohui like, ʻike ʻia ka lōʻihi o ka hoʻohana ʻana i ka helu o nā hebedoma.

^dLoaʻa nā ʻikepili no ka loli hua “frequency” wale nō no ka hui o ka mālama ʻana.

^eHoʻokuʻu ʻia ka kūlana kaohi mai nā loiloi ma muli o ka hoʻohui ʻole ʻia me nā pae koho.

^fUa manaʻo ʻia ke ʻano hoʻokele me he lima kaawale.

^gUa hōʻike ʻia ka noiʻi ʻana i ka ʻikepili mai ka pretreatment e hahai ma hope.

^hʻAʻole i haʻalele ʻia ke kūlana no nā loiloi ma muli o ka hoʻohui ʻole ʻia me nā koho koho.

2 Pūnaewele.ʻO nā hiʻohiʻona o nā noiʻi no ka hoʻohui wahine

ʻIke / Makahiki	Ka huina N^a	Mahele ʻaia (N) / Kaʻina o ka lāʻau / mode o ka hāʻawi ʻana^b	Kāpena hui (N) Hoʻolālā / ʻoihana o ke kauā ʻana^b	Duration t / c^c/ D / A (+/−)	Nā Leo (mahina)	Nā hopena (loiloi)	ʻIkeʻikepili	EPHPP
Nā mālama naʻau
ʻO Crosby (2012)	27	Ke kaʻina (14) / I / FTFT	WL (13)	12 / +	5^d	GS (SCS) FR (ʻike wikiō nānā i nā hola / w; loli hou o ka DDQ)	CO	2
ʻO Hallberg et al. (2017)	10	CBT (10) / G / FTFT	None	8 / -	6	GS (HD: CAS; HDSI)	ITT	3
ʻO Hallberg et al. (2019)	137	CBT (70) / G / FTFT	WL (67)	8 / -	6	GS (HD: CAS; SCS)	ITT	2
ʻO Hardy et al. (2010)	138	CBT (Polenika pūnaewele papahana) (138) / I / SGT	None	26 / +	None	GS (PDR) FR (hoʻohana i nā kiʻi porno / m; masturbation / m)	CO	3
ʻO Hart et al. (2016)	49	MIKI (49) / G / FTFT	None	7 / +	3	GS (SCS)	CO	3
Hartman ma. (2012)^e	57	IT (papahana no SA ma SA-SUD) / I + G / FTFT (57)	None	13 / +	6	GS (CSBI)	CO	3
Klontz et al. (2005)	38	1) IT (EXPT; CBT; EDU; M-Medit.), Nā kāne (28) / G / FTFT 2) IT (EXPT; CBT; EDU; M-Medit.), Nā wahine (10) / G / FTFT	None	1) 1 / + 2) 1 / +	6	GS (GSBI; CGI)	CO	3
ʻO Levin et al. (2017)	11	Keʻano (SHWB) (11) / I / SGT	None	8 / +	1.5	GS (CPUI) FR (kiʻi nānā aku iā h / w)	CO	3
Minarcik (2016)	12	CBT (12) / I / FTFT	None	12 / +	None	GS (CLAPS; HBI; SCS) FR (kiʻi ʻikepili e nānā iā min./w)	CO	3
ʻO Orzack et al. (2006)	35	IT (RtC; CBT; MI) (35) / G / FTFT	None	16 / +	None	FR (ʻike wikiō / w; OTIS)	CO	3
Pachankis et al. (2015)	63	ʻO CBT (ESTEEM-SC e pili ana i ka UP) (32) / I / FTFT	WL (31)	12 / +	3	GS (SCS)	ITT	2
Nā Parsons a me nā al. (2017)	11	ʻO CBT (ESTEEM-SC e pili ana i ka UP) (11) / I / FTFT	None	12 / +	None	GS (SCS)	CO	3
ʻO Quadland (1985)^e	15	1) GPT / G / FTFT (15)	2) PT no nā poʻe komo e pilikia i nā pilikia ʻē aʻe / I / FTFT (14)^f	20 / +	6	FR (n o nā kāne like ʻole o nā kāne kolohe / 3 mau mahina i hala;% o ka launa wahine i ʻike hoʻokahi wale;% o ke kāne me ka hoa;	CO	3
ʻO Sadiza et al. (2011)	10	CBT (10) / G / FTFT	None	12 / +	None	GS (SCS)	CO	3
ʻO Twohig a me Crosby (2010)	6	Ke kaʻina (6) / I / FTFT	None	8 / +	3	FR (kiʻi nānā aku iā h / d)	CO	3
Wilson (2010)	54	1) Ke hoʻomaʻamaʻa Art (27) / G / FTFT	2) loli CBT (TCA) (27) / G / FTFT^g	1) 6 / + 2) 6 / +	1.5	GS (HBI-19)	CO	2
Nā lāʻau lapaʻau lāʻau
Kafka (1991)	10	Nā pale kū'ē + Lithium (10)	None	12 / +	None	GS (SOI)	CO	3
Kafka lāua ʻo Prentky (1992)	16	Kapuki (16)	None	12 / +	None	GS (SOI)	CO	3
Kafka (1994)	11^h	Kahaunu (11)	None	17 / +	None	GS (SOI) FR (ka manaʻo hoʻohālikelike, koi aku, nā hana pilikino min./d)	CO	3
Kafka lāua ʻo Hennen (2000)	26	Nā huakaʻi huakaʻi + methylphenidate (26)	None	72 / +	None	GS (TSO) FR (ka manaʻo hoʻohālikelike, koi aku, nā hana pilikino min./w)	ITT	3
Wainberg ma. (2006)	28	Citalopram (13)	PLA (15)	12 / -	None	GS (YBOCS-CSB; CSBI; CGI-CSB) FR (masturbation, hoʻohana pūnaewele, hoʻohana hoʻohana kino ʻana i ka h / w)	ITT	2
ʻO nā lāʻau hoʻohui
Gola a me Potenza (2016)	3	CBT + Paroxetine (3)	None	10 / +	None	FR (hoʻohana porno / w)	CO	3
ʻO Scanavino et al. (2013)	4	STPGP + mau lāʻau lapaʻau (4)	None	16 / +	None	GS (SCS)	CO	3

palapala aie. ^ E Ha yM. A = hopohopo; ACT = ʻae a hoʻokō a hoʻōla; BSI = Ka Hoʻohui Hapa Pūnaewele; CBT = mālama mālama-cognitive therapy; CGI-CSB = Scale Global Impression Scale i hoʻopaʻa ʻia no ka hoʻopiʻi ʻana i ka moekolohe; CLAPS = Hoʻomaʻemaʻe i ka hoʻohui ʻana i ka loko o ka palaualelo; CO = hoʻopau wale nō; ʻO CPUI = Hoʻohana ka Cyber-Pornography i ka Inventory; CSBI = Hoʻopilikia i kahi hana kūpono kūpono i ka kāne; D = luuluu; d = lā; DDQ = Kahi nīnau inu inu ka lā. EDU = ʻĀkau; EPHPP = Polokalamu Hoʻōkua Hana Pono Kūʻai (1 = ikaika, 2 = maʻalahi, 3 = hōʻemi haʻahaʻa); ESTEEM = E hoʻomaʻamaʻa pono i nā hoʻomaʻamaʻa maikaʻi i ke kāne ikaika; EXPT = hana hoʻokolohua hoʻāʻo; FR = miki; FTFT = hana ma ka maka; FU = hahai-hana; Pūnaewele G =; GPT = hui psychotherapy; GS = ikaika o ka honua; GSBI = Garos Sexual Toventory Inventory; h = hola; HBI = Kūʻai Hypersexual ʻAilana; HD: CAS = Kaumaka Hypersexual: Nā Palena Helu Helu ʻĀina; HDSI = Hoʻopiʻi Hypersexual Disorder Screening Inventory; ʻO = ka ʻōlelo aʻo pākahi; IT = pili hoʻohui; ITT = kāʻili-pono-e mālama; m = malama; M-Medit. = noʻonoʻo noʻonoʻo; MI = Uiui Kauoha; ʻAʻole i loaʻa NA =; OTIS = ʻO Orzack Time Intensity Survey; PDR = ʻekekema hoʻomehana o ka hoʻihoʻi (ʻoluʻolu i ka manaʻo noʻonoʻo, hana hoʻonaninani i ka hoʻōla, hopena maikaʻi, hōʻino kino, ʻike ʻana i ke kikowaena ma luna o ka addiction, ʻano hoʻohālikelike i ka kuleana no ka hoʻohui, ʻokoʻa ma ke ola, pili i nā poʻe ʻē aʻe, nā kala kala ʻia. ka ʻike ʻana i nā manaʻo a me nā kūlana hoʻowalewale, nā hōʻola leʻaleʻa olakino); PLA = pletena; PT = psychotherapy; RtC = Mākaukau e hoʻololi; SA = hoʻohui wahine; SA-SUD = hoʻohui melemele a me ka hoʻohui waiwai; SC = koi i ka hana; SCS = Palena kōkuhi Pelekikena; SGT = mālama alakaʻi ponoʻi; SHWB = kōkōlaha-kōkua pilikino; SOI = Hoʻopuka a Pilikino; STPGP = ka pōkole psychodynamic pōkole pōkole; TCA = Hoʻomaka pili paha ʻo Task; TSO = Hōʻulu ʻia ka wahine i waho; UP = Unified Protocol no ka Hoʻolālā Transdiagnostic o nā Hoʻolālā Kūleo; W = papa inoa; w = wiki; YBOCS-CSB = ʻO ke poʻo nui o Yale-Brown Obsessive Compulsive Scale i hoʻololi ʻia no ka hoʻokau ʻana i ka moekolohe.

^aKa helu o nā kumuhana i hoʻokomo ʻia i ka loiloi.

^bʻO "moderators o ke kuʻina" a "mode no ka lawe ʻana" i noi no nā hana noʻonoʻo.

^cHoʻohālikelike ʻia ka lōʻihi o ka mālama ʻana ma ka hoʻohana ʻana i ka helu o nā hebedoma.

^dLoaʻa nā ʻikepili mai ka haʻa ʻana aku e pili ana i ka hopena no ka hoʻololi “hopena”.

^eUa hōʻike ʻia ka noiʻi ʻana i ka ʻikepili mai ka pretreatment e hahai ma hope.

^fHoʻokuʻu ʻia ka kūlana kaohi mai nā loiloi ma muli o ka hoʻohui ʻole ʻia me nā pae koho.

^gUa manaʻo ʻia ke ʻano hoʻokele me kahi lima i mālama ʻia.

^hʻO nā mea wale nō i hōʻike ʻia me ka maʻi pā o ka paraphilia i hoʻopili ʻia i loko o nā loiloi.

3 Pūnaewele.ʻO nā hiʻohiʻona o nā haʻawina no ke kūʻai ʻana

ʻIke / Makahiki	Ka huina N^a	Mahele ʻaia (N) / Kaʻina o ka lāʻau / mode o ka hāʻawi ʻana^b	Kāpena hui (N)	Duration t / c^c/ D / A (+/−)	Nā Leo (mahina)	Nā hopena (loiloi)	ʻIkeʻikepili	EPHPP
Nā mālama naʻau
Armstrong (2012)	10	MBSR (4) / G / FTFT	NT (6)	8 / +	3	GS (CBS; YBOCS-SV; IBS)	CO	2
ʻO Benson et al. (2014)	11	IT (CBT, PSYDYN, PSYEDU, MI, Hoʻolālā, nā manaʻo noʻonoʻo noʻonoʻo (6) / G / FTFT	WL (5)	12 / +	6	GS (mod. VCBS; RCBS; CBS; YBOCS-SV) Hoʻohana ʻo FR (min./w i ke kūʻai ʻana; kūʻai ʻana i nā manawa / w)^d	CO	2
Filomensky & Tavares (2009)	9	CBT (9) / G / FTFT	None	20 / +	None	GS (YBOCS-SV)	CO	3
Mitchell ma. (2006)	35	CBT (28) / G / FTFT	WL (7)	10 / +	6^e	GS (YBOCS-SV; CBS) FR (kūʻai aku i nā manawa / w; h lilo i kūʻai / w)	ITT	2
Mueller et al. (2008)	60	CBT (31) / G / FTFT	WL (29)	12 / +	6^e	GS (CBS; YBOCS-SV; G-CBS)	ITT	2
Mueller et al. (2013)	56	1) CBT (22) / G / FTFT 2) GSH-papahana (CBT WB + 5 mau kelepona kelepona) (20) / I / SGT	WL (14)	1) 10 / + 2) 10 / +	6	GS (CBS; YBOCS-SV)	ITT	2
Nā lāʻau lapaʻau lāʻau
ʻEleʻele al. (1997)	10	Fluvoxamine (10)	None	9 / -	None	GS (YBOCS-SV)	CO	2
ʻEleʻele al. (2000)	23	Fluvoxamine (12)	PLA (11)	9 / -	None	GS (YBOCS-SV)	ITT	2
Hāʻawi iā al. (2012)	9	Memantine (9)	None	8 / -	None	GS (YBOCS-SV; mod. CB-SAS)	CO	2
Koran et al. (2002)	24	Citalopram (24)	None	12 / +	None	GS (YBOCS-SV)	ITT	2
Koran et al. (2003)	23	Citalopram (23)	None	7 / +	None	GS (YBOCS-SV; CBS; IBTS)	ITT	2
Koran et al. (2007)	26	Kaumakaiwa (26)	None	7 / +	None	GS (YBOCS-SV)	ITT	3
Ninan et al. (2000)	37	Fluvoxamine (20)	PLA (17)	12 / +	None	GS (YBOCS-SV)	ITT	3

palapala aie. ^ E Ha yM. A = hopohopo; ACT = ʻae a hoʻokō a hoʻōla; CBS = Kūʻai kūʻai kūleʻa; CB-SAS = Palapala Hoʻoikaika Koi ʻĀpelika Hoʻomaka (laʻana o ka Palani Helu ʻĀmaʻomaʻo Kani Pūnaewele; CBT = ʻomaʻomaʻomaʻo-e pili ana i ka hanana; CO = hoʻokō wale; , 1 = nāwaliwali nāwaliwali); FTFT = hana alo-o-maka; FR = frequency; FU = hana i luna; G = hoʻonohonoho ʻ ;lelo; G-CBS = Kanaka Hoʻomoe Kūʻai Ke Kīwila, Kēia Kelemania; GS = hōʻino honua; GSH = kōkua pono-kōkua; h = hola; I = ʻōlelo aʻoi aku; IBS = Impulsive Buy Buy Scale; IBTS = Impulse Buying Tendency Scale; ITT = manaʻo e mālama i ka nānā ʻana; MBSR = noʻonoʻo noʻonoʻo e hoʻonaninani ana i ka manaʻo; MI = Motivational Uiui; NA = ʻaʻole i ʻike; NT = ʻaʻohe lapaʻau; PLA = pūʻulu mana o ka plasebo; PSYDYN = psychodynamic; PSYEDU = psycho-hoʻonaʻauao; RCBS = Richmond Compulsive Buying Scale; SGT = hana alakaʻi alakaʻi ;; VCBS = Palapala Pāʻani Hoʻololi; WB = workbook; WL = papa inoa; w = wiki; YBOCS-SV = Yale-Brown Obsessive Com Pulewive Scale-Shopping Version.

^aKa helu o nā kumuhana i hoʻokomo ʻia i ka loiloi.

^bʻO "moderators o ke kuʻina" a "mode no ka lawe ʻana" i noi no nā hana noʻonoʻo.

^cHoʻohālikelike ʻia ka lōʻihi o ka mālama ʻana ma ka hoʻohana ʻana i ka helu o nā hebedoma.

^dLoaʻa nā ʻikepili no ka loli hua “frequency” wale nō no ka hui o ka mālama ʻana.

^eʻAʻole i haʻalele ʻia nā haʻawina mai ka hoʻopili ʻana ʻo FU, no ka mea, ʻo ka ʻike wale nō mai ka posttreatment i FU.

ʻO ka pilikia o ke koi i nā haʻawina

Ka nui o nā helu EPHPP o ka honua no nā haʻawina i komo i loko o nā māhele hoʻohui like ʻole Nā ʻ 1lelo 3–XNUMX. ^ E Ha yM. Ua hana ʻia kahi loiloi pono ʻole e ʻelua mau ʻōiwi kūʻokoʻa e hoʻohua ana i kahi hilinaʻi interrater o κ = 0.73 no nā haʻawina ma nā helu IA a me SA, a κ = 0.75 no nā haʻawina ma ka māhele CB.

Synthesis o nā hopena a me ka pilikia o ke kaulike ma waena o nā haʻawina

ʻO nā nui hopena i kūpono no nā ʻano lāʻau āpau a me nā hoʻokaʻawale ʻana no nā mahele pūʻulu a me nā hoʻolālā aʻo i hoʻopaʻa ʻia i nā hopena āpau ma ka posttreatment a me ka hana ʻana, ka 95% CI, a me nā hōʻike koʻikoʻi i hōʻike ʻia i loko 4 Pūnaewele. ^ E Ha yM. Hōʻalo ka ululāʻau nahele i nā wahi hopena i loko o kēlā me kēia kūlana, mālama, a me ka hopena ma ka posttreatment i hōʻike ʻia ma loko Laau. 2.

4 Pūnaewele.Loaʻa nā nui no nā ʻano kaupaona, nā hualoaʻa a me nā hoʻolālā aʻo ʻana ma ka posttreatment a me ke ʻano hana

Hualoaʻa	Kahi hopena	k	g	95% CI	z	p	I²	FS N
ʻAno Pūnaewele
Nā mālama naʻau
Hoʻoohao honua	loko i ka pūʻulu (post)	54	1.51	[1.29, 1.72]	13.79		93.66	18,317
	kāhea	15	1.84	[1.37, 2.31]	7.268		83.56	1,254
	loko (hui)	17	1.48	[1.11, 1.85]	7.92		94.61	4,221
'O ka pinepine	loko i ka pūʻulu (post)	17	1.09	[0.73, 1.49]	6.02		92.54	1,801
	kāhea	6	1.12	[0.41, 1.83]	3.08		78.05	69
	loko (hui)	6	1.06	[0.12, 2.00]	2.21		97.30	259
Hoʻolaha lāʻau
Hoʻoohao honua	loko i ka pūʻulu (post)	8	1.13	[0.85, 1.42]	7.78		78.76	564
	kāhea	2	1.28	[0.85, 1.71]	5.85		0.00	-^a
	loko (hui)	NA
'O ka pinepine	loko i ka pūʻulu (post)	3	0.72	[0.49, 0.96]	6.01		0.00	27
	kāhea	NA
	loko (hui)	NA
Nā Hoʻohui hui
Hoʻoohao honua	loko i ka pūʻulu (post)	7	2.51	[1.70, 3.33]	6.03		92.99	756
	kāhea	NA
	loko (hui)	2	2.15	[0.66, 3.65]	2.82		93.55	-^a
'O ka pinepine	loko i ka pūʻulu (post)	2	2.77	[2.29, 3.24]	11.39		14.43	-^a
	kāhea	NA
	loko (hui)	2	2.69	[2.06, 3.32]	8.43		49.72	-^a
Ka HanaʻAi
Hoʻolaha noʻonoʻo
Hoʻoohao honua	loko i ka pūʻulu (post)	14	1.09	[0.74, 1.45]	6.03		92.54	1,311
	kāhea	3	0.70	[0.42, 0.99]	4.87		7.02	19
	loko (hui)	10	1.00	[0.67, 1.32]	6.02		90.02	760
'O ka pinepine	loko i ka pūʻulu (post)	6	0.75	[0.46, 1.03]	5.10		70.96	177
	kāhea	1	1.67	[0.82, 2.53]	3.83		0.00	-^a
	loko (hui)	4	0.83	[0.37, 1.29]	3.57		71.59	45
Nā lāʻau lapaʻau lāʻau
Hoʻoohao honua	loko i ka pūʻulu (post)	5	1.21	[0.88, 1.54]	7.12		50.42	134
	kāhea	1	0.14	[-0.58, 0.87]	0.38	0.70	0.00	-^a
	loko (hui)	NA
'O ka pinepine	loko i ka pūʻulu (post)	3	0.87	[0.63, 1.12]	6.92		0.00	33
	kāhea	1	0.79	[0.04, 1.55]	2.06		0.00	-^a
	loko (hui)	NA
ʻO nā lāʻau hoʻohui
Hoʻoohao honua	loko i ka pūʻulu (post)	1	1.91	[0.75, 3.08]	3.22		0.00	-^a
	kāhea	NA
	loko (hui)	NA
'O ka pinepine	loko i ka pūʻulu (post)	1	1.04	[0.22,1.85]	2.49		0.00	-^a
	kāhea	NA
	loko (hui)	NA
Kūʻai kūʻai
Nā mālama naʻau
Hoʻoohao honua	loko i ka pūʻulu (post)	7	1.00	[0.75, 1.25]	7.88		46.43	210
	kāhea	6	0.75	[0.42, 1.08]	4.45		0.00	27
	loko (hui)	4	1.36	[0.88, 1.84]	5.57		53.65	66
'O ka pinepine	loko i ka pūʻulu (post)	2	0.97	[0.68; 1.26]	6.55		0.00	-^a
	kāhea	1	2.48	[1.46, 3.49]	4.76		0.00	-^a
	loko (hui)	1	1.01	[0.47, 1.55]	3.68		0.00	-^a
Nā lāʻau lapaʻau lāʻau
Hoʻoohao honua	loko i ka pūʻulu (post)	7	1.52	[1.18, 1.86]	8.84		63.17	386
	kāhea	2	-0.13	[-0.82, 0.57]	-0.35	0.724	0.00	-^a
	loko (hui)	1	-0.49	[-1.00, 0.03]	-1.86	0.063	0.00	-^a
'O ka pinepine	loko i ka pūʻulu (post)	NA
	kāhea	NA
	loko (hui)	NA

Hoʻomaopopo. k; = helu o nā kūlana mālama; g = ʻO Hedges's g; CI = wā hilinaʻi; I² = ka nui o ka nui o ka loli ʻana i loko o nā noi; FS N = Paʻa-palekana N (ka helu o nā haʻawina i loaʻa ai ke hopena lapaʻau nonsignificant); ʻAʻohe = NA ʻole.

^aKahu ʻole N ʻaʻole i helu ʻia no ka mea ua liʻiliʻi ʻia ma 3 mau haʻawina i loaʻa.

ʻO nā hopena kūpono no ka mālama noʻonoʻo ʻana i ka posttreatment a me ka hana ʻana

Nā hana lapaʻau ma waena o nā mea pili i ke ʻano ua hana i nā nui o ka hopena pōkole e hoʻomaka ana mai ka nui a i ka nui i nā papa hana ʻelua. ʻO ka nui o ka hopena hopena i loko o nā pauka āpau i hōʻike ʻia no ka mālama ʻia o nā hopena lapaʻau. E like me ka mea e hōʻike ʻia ma loko 4 Pūnaewele, ua ʻike nui ʻia ka heterogeneity kiʻekiʻe ma nā haʻawina i ʻike ʻia no nā ʻano hopena i loko o nā māhele IA a SA, a me ka ʻano heterogeneity a i ʻole homogeneity i ʻike ʻia ma ke ʻano CB.

Ma loko o ka māhele IA, ua hōʻike ka ʻano hana a ka hoʻopiha piha ʻana i nā 17 mau haʻawina i hoʻolāʻau ʻia ai ka wahi neʻe ʻana o ka funnel no ka hōʻemi o ka hōʻino nui o ka honua a me ke aʻo hoʻokahi no ka hoʻohaʻahaʻa ʻana i ka ʻike i loko o nā papa noiʻi o ka pūʻulu. Kuhi ʻia nā ʻikepili me kēia mau noiʻi piha i hōʻike ʻia i nā loli liʻiliʻi (global grabity: g = 0.87; 95% CI [0.82, 0.92]; Hōʻike a Egger p <0.001; alapine (frequency): g = 0.93; 95% CI [0.84, 1.03]; Hōʻike a Egger p = 0.282) e hōʻike nei i kahi hopena kūpono ʻole o ka laha hoʻolaha. ʻAʻole i loaʻa kahi hōʻailona no ka hoʻopuka hoʻolaha ʻana no ka hōʻemi ʻana o ke koʻikoʻi o ka honua e pili ana i nā hoʻolālā hoʻopaʻa naʻau (hōʻoia ʻo Egger p = 0.067). Ma loko o ka māhele SA, ua hōʻike ka ʻano hana a ka hoʻopiha ʻana i kahi haʻawina e hoʻokō nei i ka hoʻolōʻihi ʻia o ka funnel no ka hōʻemi ʻana o ka nui o ka honua i alakaʻi i ka liʻiliʻi o ka hopena o kēia hopena hopena (g = 0.88; 95% CI [0.79; 0.97], hōʻike a Egger p = 0.318). Inā ʻaʻole palekana i palekana N ua mālama ʻia nā loiloi, ʻo ka nui o ka hopena ma nā māhele āpau āpau i manaʻo ʻia he ikaika no nā ʻano hopena, koe wale nō ka nui o ka hopena e pili ana i ka hōʻemi o ka hakakā honua i ka māhele SA a me CB, ʻaʻole i paʻa.

ʻO nā hopena kūpono o nā lāʻau lapaʻau lapaʻau ma ka posttreatment a me ka hana ʻana

Ma ka posttreatment, ʻo ka nui o ka hopena i loko o ka pūʻulu i waena o nā māhele āpau āpau he nui a me ka nui. ʻO ka nui o nā hopena hopena i kau ʻia ma luna o nā hoʻokolohua hoʻokahi i hoʻokumu ʻia mai ka nui o ka ʻAle IA a liʻi a liʻiliʻi hoʻi i nā kā SA a me CB. ʻO ka nele o nā hōʻaiʻē ʻimi kaohi i ka hoʻākāka ʻana o nā nui hopena o ka hopena lōʻihi. Heterogeneity kiʻekiʻe a me ke kaulike i waena o nā noi i ʻike ʻia no nā loli hopena i loko o nā māhele hoʻohui. ʻO ka palekana-palekana N nā loiloi i hana ʻia no ka ʻike ʻike e hōʻike ana i ka ikaika o ka nui o ka hopena.

ʻO nā hopena kūpono e pili ana i ka hoʻokaʻawale ʻana i ka posttreatment a me ka hana ʻana

Ua hoʻokō ʻia nā ʻano hui hui ʻole no ka mālama ʻana o IA a me SA i hoʻokumu ʻia ʻana i ka papa noiʻi i loko o ka pūʻulu hoʻopaʻa ʻana i ka nui o ka hopena pōkole. Loaʻa nā ʻikepili i ka pili ʻana i ka ʻāpana IA me ka nui o nā hopena like. ʻO ka heterogeneity kiʻekiʻe ma nā haʻawina ua ʻike ʻia no ka hōʻemi o ka hōʻeha nui o ka honua i ka māhele IA; akā naʻe loaʻa ʻole ka palekana N hōʻike i ka hana paʻa o ka nui o ka hopena.

Ua hōʻike ʻia ka hōʻike waho loa ʻana ma o ke kaʻina hana hoʻokahi i hōʻike ʻia i nā hopena maʻamau no ka hopena o ka psychological, pharmacological, a me nā hui hoʻohui.

Hoʻoponopono ke kumu

Ua hana ʻia nā noiʻi ʻo Luna no ka nui o ka hopena hua. Hōʻike ʻia nā hualoaʻa no nā loli ʻano i ka posttreatment ma 5 Pūnaewele.

5 Pūnaewele.Hana a Luna Hoʻonohonoho no nā loli like ʻole o nā ʻano āpau, a me nā hopena

		IA		SA		CB
Moderator	Ka hualoaʻa hopena	Qbet	p (Q)	Qbet	p (Q)	Qbet	p (Q)
Nā mālama naʻau
Ke ʻano o ka noʻonoʻo noʻonoʻo (CBT vs. IT me nā mea'ē aʻe)
	GS	4.24	0.120	4.50	0.105	0.34	0.945
	FR	0.11	0.947	15.67	^a	-	-
ʻAno Hoʻomaʻamaʻa (ʻo ka hui ma kahi o kēlā me kēia)
	GS	0.47	0.792	0.11	0.741^b	0.44	0.508^b
	FR	0.55	0.761	14.55	^b
Ke ʻano o ka hoʻokele (FTFT vs. SGT)
	GS	9.15		0.56	0.453	0.44	0.508
	FR	2.03	0.154	0.76	0.384	-	-
Comorbidity (D / A komo hui me haʻalele)
	GS	0.02	0.898	0.84	0.360	0.00	1.00
	FR	1.13	0.289	0.00	1.00	-	-
Ka ikepili ikepili (completer vs. ITT)^c
	GS	0.30	0.586	0.99	0.320	0.007	0.933
	FR	0.09	0.771	0.00	1.00	-	-
EPHPP (1 = ikaika vs. 2 = hōʻemi hou ʻia 3^d
	GS	1.14	0.285	2.24	0.134	0.02	0.903
	FR	1.94	0.164	0.53	0.466	-	-
ʻLelo moʻomeheu (ʻĀsia ma nā ʻāina Komohana)
	GS	0.54	0.461	-	-	-	-
	FR	0.58	0.447	-	-	-	-
ʻAnoʻino IA (honua IA vs. IGD a me kekahi)
	GS	1.63	0.653	-	-	-	-
	FR	4.21	0.122	-	-	-	-
Nā lāʻau lapaʻau lāʻau^e
Ke ʻano o ka lapaʻau lāʻau lapaʻau (AD meā a i ʻole nā mea ʻē aʻe)
	GS	5.62	^f	0.09	0.765	0.65	0.421^g
Comorbidity (D / A komo hui me haʻalele)
	GS	0.73	0.392	-^h	-^h	0.22	0.642
Ka ikepili ikepili (completer vs. ITT)
	GS	0.00	1.00	0.76	0.383	4.89
EPHPP (1 = ikaika vs. 2 = hōʻemi hou ʻia 3^d
	GS	0.47	0.493	-^h	-^h	2.52	0.112
ʻLelo moʻomeheu (ʻĀsia ma nā ʻāina Komohana)
	GS	7.32		-	-	-	-
ʻAnoʻino IA (honua IA vs. IGD a me kekahi)
	GS	7.32	ⁱ	-	-	-	-
ʻO nā lāʻau hoʻohui^e
Ke ʻano o ka lapaʻau lāʻau lapaʻau (AD meā a i ʻole nā mea ʻē aʻe)
	GS	0.83	0.362^j	-	-	-	-
Ke ʻano o ka noʻonoʻo noʻonoʻo (CBT vs. IT me nā mea'ē aʻe)
	GS	20.81	^k	-	-	-	-
ʻAno hana o ka noʻonoʻo noʻonoʻo (hui ma kahi o kēlā me kēia)
	GS	0.29	0.592^b	-	-	-	-
Comorbidity (D / A komo hui me haʻalele)
	GS	0.00	1.00	-	-	-	-
Ka ikepili ikepili (completer vs. ITT)
	GS	0.00	1.00	-	-	-	-
EPHPP (1 = ikaika vs. 2 = hōʻemi hou ʻia 3^d
	GS	6.06		-	-	-	-
ʻLelo moʻomeheu (ʻĀsia ma nā ʻāina Komohana)
	GS	0.83	0.362	-	-	-	-
ʻAnoʻino IA (honua IA vs. IGD a me kekahi)
	GS	6.06	ⁱ	-	-	-	-

palapala aie. ^ E Ha yM. A = hopohopo; AD = antidepressants; CB = koi i ke kūʻai mai; CBT = hana e pili ana i ka hana pono cognitive therapy; D = luuluu; EPHPP = Polokalamu Hoʻolālā Kahi Hana Pono Kūʻai (ʻoi aku ka maikaʻi o ka loiloi loiloi no nā noi kuʻuna); GS = ikaika o ka honua; FR = miki; FTFT = hana ma ka maka; IA = piliona i loko o ka pūnaewele; IGD = hoʻonāukiuki pāʻani pūnaewele; IT = pili hoʻohui; ʻO ITT = manaʻo e mālama i ka nānā ʻana; Qbet = helu homogeneity no nā ʻokoʻa ma waena o nā hui; SA = hoʻohui wahine; SGT = mālama mālama pono ʻia.

^aCBT: g = 0.98; 95% CI [0.83, 1.13]; p ≤ 0.001; IL g = 0.25; 95% CI [−0.08, 0.58]; p = 0.132; ʻO nā hana ʻē aʻe (ʻo ia hoʻi, ʻae a me ka mālama ʻana i nā lāʻau lapaʻau): g = 0.80; 95% CI [0.51, 1.10]; p ≤ 0.001.

^bHoʻokomo ʻia ʻo ka loiloi unuhi ʻōlelo ʻelua wale nō i hui ʻia (hui pū kekahi me kahi kanaka hoʻokahi).

^cʻO nā noi wale nō ka mea i hōʻike i ke ʻano o nā kaʻikepili ʻike i hoʻokomo ʻia i loko o nā noiʻi (ʻike 1 Pūnaewele).

^dHoʻokomo ʻia nā loiloi unuhi ʻōlelo ʻelua wale nō hui (2 = ʻano; 3 = nāwaliwali).

^eUa hoʻopaʻa ʻia ka Lunahooponopono i ka hopena o ke ʻano "frequency" ʻaʻole i mālama ʻia ma muli o ka nui o ka hoʻopaʻa ʻana.

^fHoʻokomo wale nō ka loiloi ʻo Lunahanu i ʻelua mau pūʻulu hui (AD me nā lāʻau ʻē aʻe [i ʻole, methylphenidate, atomoxetine]).

^gHoʻokomo wale nō ka loiloi ʻo Luna Hoʻomaopopo i ʻelua mau pūʻulu puke (AD me nā lāʻau ʻē aʻe [i laila, memantine]).

^hʻAʻole i unuhi ʻia nā hopena o nā unuhi hope, no ka mea hoʻokahi wale nō aʻo ʻana i noho i kekahi o nā papa ʻelua.

ⁱHoʻokomo wale nō ka loiloi unuhi ʻōlelo ʻelua wale nō hui (IA vs. IGD).

^jHoʻokomo wale nō ka loiloi unuhi ʻōlelo ʻelua wale nō hui (AD me mix).

^kHoʻokomo wale nō ka loiloi ʻo Luna Hoʻohui wale nō ʻelua mau pūʻulu hui (CBT vs nā lāʻau ʻē aʻe [ʻo ia hoʻi, ka papahana aʻo]).

Pākuʻi ʻia ka nui o nā ʻano mea i hoʻohui ʻia a me ka hoʻoweliweli ʻana me ka maikaʻi o nā haʻawina, nā lā a me ke kaumaha a me ka hopohopo, a me ka makahiki paʻi (IA: hōʻino honua; β = −0.02; SE = 0.03; p = 0.417; : alapilua: β = −0.09; SE = 0.05; p = 0.075; SA: ʻokoʻa ʻole ka honua: β = −0.03; SE = 0.04; p = 0.519).

I ka mea pili i ka IA, ʻike nui ʻia nā nui like me nā FTFT e hoʻohālikelike ʻia i nā SGT, a no nā kikowaena me ka nui o nā hola ma ka mālama ʻana i ka hōʻemi o ka puni honua.β = 0.04; SE = 0.01; p <0.01) a me ke alapine (β = 0.03; SE = 0.009; p <0.01). No ka hōʻemi ʻana o ka nui o ka honua ma nā noiʻi lāʻau lapaʻau, ua puka aʻe ka nui o nā hopena nui aʻe no nā antidepressants i hoʻohālikelike ʻia me nā ʻākena kemika ʻē aʻe (ie, methylphenidate, atomoxetine), no kēlā mau mea i hoʻokō ʻia i nā ʻāina ʻē aʻe i hoʻohālikelike ʻia i nā ʻāina ʻAsia, a me ka nānā ʻana iā IA honua i hoʻohālikelike ʻia me ka IGD a me ke kelepona akamai. ʻōpala.

Ma ka mahalo i ka SA, ʻo CBT a me nā ʻano lāʻau ʻē aʻe (ʻo ia hoʻi, ʻae a me ke kūpaʻa ʻana) e hōʻike i kahi pono ma luna o ke kikowaena integrative a me nā ʻōlelo aʻoi aku kūʻokoʻa ma luna o nā pae hoʻonohonoho no ka hōʻemi o ka ʻike maʻamau. I loko o ka māhele CB, ʻo nā hoʻokolohua hoʻokolohua ma ka hoʻohana ʻana i nā mea hoʻopihapiha hoʻopihapiha ua hana i nā nui o ka hopena nui ma mua o nā mea e pili ana i ka loiloi ʻo ITT e pili ana i ka hōʻemi o ka hōʻeha honua.

Ua hoʻopaʻa ʻia ka Lunahoʻo loiloi i nā ʻano hui hui ʻana no ke kāʻei IA. Hōʻike nā hopena i pili i ka nui o ka hopena nui e pili ana me CBT-hoʻohui, nā hoʻohaʻahaʻa haʻahaʻa haʻahaʻa, a me kēlā poʻe e nānā nei i ka honua IA.

Psychological vs pharmacological vs. hui pū

E pili ana i ka IA, ʻo nā hui like i hana ʻia i nā nui like loa me ka hoʻohālikelike ʻana i ka naʻau o ka naʻau a me ka hōʻiliʻili lāʻau no ka hōʻemi o ka ʻāʻī honua (psychological vs._{waena o} = 7.80, p <0.01; Hoʻohui vs. Q_{waena o} = 14.69, p <0.001), a me ke alapine (psychological vs. hui pū ʻia: Q_{waena o} = 8.73, p <0.01; Hoʻohui vs. Q_{waena o} = 63.02, p <0.001). Ua loaʻa nā hualoaʻa ʻole ma waena o nā hopena o ka nui o ka hoʻomaʻamaʻa psychological a me nā lāʻau lapaʻau (koʻikoʻi honua: p = 0.173; : alapilua: p = 0.492). Ke noʻonoʻo nei i ka CB, nā lāʻau lapaʻau i hōʻike i kekahi pono ma luna o nā wahi noʻonoʻo no ka hoʻohaʻahaʻa ʻana i ka hoʻomehana o ka honua (Q_{waena o} = 5.45, p <0.05). ʻAʻohe mea ʻokoʻa ʻē aʻe i waena o nā ʻano o nā ʻano mālama.

ʻO nā ʻokoʻa ma waena o nā māhele hoʻohui

ʻO nā hoʻohālikelike o nā nui hopena e pili ana i nā māhele hoʻohui i hāʻawi ʻia i nā hopena nonsignificant e pili ana i ka paleʻana i ka noʻonoʻo (koʻikoʻi o ka honua: p = 0.174; : alapilua: p = 0.559) a me nā interaction pharmacological (hōʻeha honua: p = 0.203; : alapilua: p = 0.389).

kūkākūkā

ʻO ka pahuhopu o kēia pepa ka noiʻi ʻana i ka pono o nā noʻonoʻo noʻonoʻo, a me ka lāʻau lapaʻau a me nā ʻano hoʻohui no IA, SA a me CB a e ʻike i nā mea wānana o ka hopena o ka mālama ʻana. Eia nō naʻe, ua hana ʻia nā hoʻohālikelike ʻana ma waena o nā ʻano ʻekolu o nā BA i ka nui o nā hopena no ka mālama ʻana i ka noʻonoʻo a me ka lāʻau lapaʻau i hana ʻia no ka manawa mua, me ka pahuhopu hou ʻana o ka hoʻohālikelike ʻana i ka pāʻani a me nā SUD e pili ana i ka pane ʻana i ka mālama ʻana.

Ua ʻike mākou i ka hoʻōla kūpono ʻana o ka mālama ʻana i ka honua i ka nui o ka honua a me ka pinepine o ka IA a me SA me ka mālama ʻana o ka mālama ʻana i ka mālama ʻana i nā manawa lōʻihi. No CB, ua hoʻopili pū kekahi i nā hana noʻonoʻo me ka nui o ka nui a me ka hoʻolauna ma mua o ka hōʻemi. ʻO nā lanakila nui a me ka hōʻemi pōkole ma nā hua ʻelua o nā hopena ʻelua i hoʻopaʻa ʻia ma nā papa hana loiloi, hoʻomāuʻi ʻia e pili ana i ka IA a me nā haʻawina pilikino i nā ʻano SA a me CB. Aia kēia mau hopena i ka pae like like me ka poʻe i loaʻa i loko o ka meta-analyses e nānā ana i nā maʻi psychological no ka hoʻokaʻawale pāʻani.Cowlishaw et al., 2012; Gooding & Tarrier, 2009; ʻO Goslar, Leibetseder, Muench, Hofmann, & Laireiter, 2017; Leibetseder, Laireiter, Vierhauser, & Hittenberger, 2011; Pallesen, Mitsem, Kvale, Johnsen, & Moulde, 2005) a me SUD (Dutra et al., 2008; ʻO Tripodi, Bender, Litschge, & Vaughn, 2010).

ʻOiai ka hoʻohana pinepine ʻana o CBT ma waena o nā kolikina ʻekolu, ua hōʻike ʻia ke ʻano like ʻole o ka hoʻonaninani ʻana i nā ʻano pilikia e pili ana i ke ʻano o ka mālama ʻana a me ka pili ʻana o IA i ka moʻomeheu moʻomeheu. ʻIke ʻia kēia mau ʻike i ka mea i hōʻike ʻia i loko o kahi loiloi meta hou, ka mea i loaʻa he maikaʻi o CBT ma luna o nā hana noʻonoʻo ʻē aʻe no ka hōʻemi o ka manawa i hoʻolilo ʻia ma ka pūnaewele, ke aʻo pilikino, a no nā haʻawina i hana ʻia ma US (Winkler et al., 2013). ʻO nā ʻokoʻa, ʻaʻole naʻe ma muli o ka hana a nā mea noiʻi i hana ʻia ma nā pūʻulu o loko a me nā nui o ka hopena o ka hopena a me ka hoʻohui ʻana i nā hopena noiʻi hou i kā mākou loiloi meta. Ma waena o kēia mau mea, ʻo nā ala pinepine e pili ana i ka ʻohana ʻohana, i ka ʻike ʻana i nā ʻano ʻohana ʻohana dysfunctional ʻohana like ʻole. Schneider, King, & Delfabbro, 2017) ke kaola aku nei ʻaʻole wale no nā mea pāʻani loea ʻikepili opio (ʻoi aku, Han, Kim, Lee, & Renshaw, 2012), akā no nā ʻōpio me SUDs (no ka ʻike loiloi Nā faila, Andersen, & Jørgensen, 2018). Pēlā nō, noʻonoʻo maikaʻi nā papahana noʻonoʻo e pili ana i ka ameliorating hōʻailona o IA (Li, Garland, et al., 2017) a me CB (ʻO Armstrong, 2012), a me ka ʻae a me ka hoʻokau ʻana i hoʻokō ʻia e mālama ʻia no ka mālama ʻana i ka SA (k. ʻO Crosby, 2012) ua hōʻike i ka waiwai nui e hōʻemi i nā hōʻailona o ka pāʻani pāʻani a me nā SUDs (A-tjak et al., 2015; Li, Howard, Garland, McGovern, & Lazar, 2017; Maynard, Wilson, Labuzienski, & Whiting, 2018). ʻO nā papahana hoʻohui, ka hapanui o nā mea like o CBT, i hana i nā nui like i nui ma nā hāmeʻa ʻekolu, koe wale nō ka hoʻēmi ʻana o ka lōʻihi o ka hana moekolohe. Akā, ua kau ʻia kēia hopena ma kahi hoʻāʻo hoʻokahi i kūʻokoʻa mai nā mea ʻē aʻe ma o ka hoʻohana ʻana i ka Orzack Time Inventory Survey (OTIS; ʻO Orzack, 1999) i hōʻike ʻia "ʻaʻole kūpono"ʻO Orzack, Voluse, Wolf, & Hennen, 2006, p. 354) e ana i ke kahe o ka hoʻohana kamepiula kamepiula. No ka mea ʻO Orzack et al. (2006) ka lawe ʻia ʻana o ka mālama ʻana i nā hoʻonohonoho hoʻonohonoho, i ka nui o ka hopena o kēia haʻawina no ka hōʻino ʻana o ka hoʻonohonoho hoʻonohonoho ʻana i ka manaʻo o ka loiloi pilikino e hoʻomālamalama ana i ka ʻike o ka hoʻohana ʻana i nā mea hana kūpono kūpono a ʻike ʻia (e nānā pū kekahi ʻO Hook, Reid, Penberthy, Davis, & Jennings, 2014). Eia kekahi, ʻike ʻia ka kūʻokoʻa o ke kūleʻa ʻana mai ke ʻano o ka lawe ʻana, me ke ʻano hoʻokahi: ʻo ka mea i hoʻopilikia ʻia e IA i loaʻa nā FTFT e ʻoi aku ka maikaʻi o ka ʻoihana ma mua o ka loaʻa ʻana o nā SGT. Hoʻokomo ʻia nā SGT no ka mālama ʻana o IA, akā, i kahi helu haʻahaʻa loa o nā papa ma mua o FTFT. No laila, ʻo ka lōʻihi ma mua o ka ʻano o ka hoʻokaho e manaʻo ai no kēia mau ʻokoʻa ma waena o nā pūʻulu, e kākoʻo ana i nā hopena o kahi meta-analysis hou (ʻO Goslar et al., 2017) e hōʻike ana i nā SGT pōkole e hana i nā haʻahaʻa haʻahaʻa o ka hoʻomaikaʻi ma mua o nā paʻahana kiʻekiʻe, ka hana kōkua kōkua ponoʻī. Hāʻawi ʻia nā ʻike no kēia loaʻa ʻana e nā SGT e paʻa loa no ka mālama ʻana iā SA (Hardy, Ruchty, Hull, & Hyde, 2010; ʻO Levin, Heninger, Pierce, & Twohig, 2017) a me CB (Mueller, Arikian, de Zwaan, & Mitchell, 2013), e hāʻawi ana i nā nui hopena e hoʻohālikelike ʻia i nā mea i loaʻa no FTFT. Ka mea, hana ulu kūleʻa o ka mālama ʻana me ka lōʻihi o ka psychotherapy, pili me ka hoʻohaʻahaʻa ʻana i ka nui o ka honua a me ka pinepine o IA. ʻO nā hopena like like, akā ʻaʻole ia i nānā ʻia no ka hoʻēmi ʻana o ka paʻakikī o ke ao holoʻokoʻa o SA. He kūpono kēia mau ʻike i ka ʻimi ʻĀina IA.ʻO Chun et al., 2017), a me nā mea i loaʻa mai ka pāʻani hakakā ʻōpio (ʻO Goslar et al., 2017; Leibetseder et al., 2011; Pallesen et al., 2005), e kuhikuhi ana i ka hōʻike ʻana o nā mea hoʻohālikelike i ke kino e koi aku i ka hana ʻoi aku ka holomua e hiki ke hoʻonui.

E like me nā pilikia kūlohelohe, hōʻike nā lāʻau lapaʻau i hōʻike i nā hōʻemi nui i mua o ka post-post i nā hōʻailona pathological i waena o nā hāmeʻa makaʻāina ʻekolu. ʻAʻole he mau hopena, hiki ke hali ʻia e pili ana i ka hoʻomakeʻa o ka pane ʻana i ka mālama ʻana a me nā manawa pōkole o nā lāʻau lapaʻau me ka manawa pōkole ma luna o ka pletebo ma muli o ka hapa o ka ʻike. Eia kekahi, nā hoʻokele e hoʻomalu ʻia e ka pletebo i mālama ʻia no ka mālama ʻana i ka SA me CB e hoʻopili ʻia e ke kākoʻo hou e like me nā hui lapaʻau maʻamau me ka noʻonoʻo pono ʻana i nā ʻano pilikia.ʻEleʻele, Gabel, Hansen, & Schlosser, 2000; Wainberg et al., 2006) a i ʻole nā hoʻopiha ʻana e like me nā hana e like me ka mālama ʻana i nā hale kūʻai kūʻai (e hoʻohālike, Black a me.., 2000; Ninan et al., 2000) ka hāʻawi ʻana i nā ʻokoʻa liʻiliʻi ma waena o nā hui liʻiliʻi, a hūnā i ka hopena o nā mea kemika (Black a me.., 2000; Ninan et al., 2000; Wainberg et al., 2006). No ka hoʻohālikelike, loaʻa nā pōkole pōkole o nā lāʻau lapaʻau ma luna o ka plasebo no ka maʻi hoʻonaninani aia i ka waena waena (ʻO Goslar, Leibetseder, Muench, Hofmann, & Laireiter, 2018), e like me nā mea i hōʻike ʻia no ka inu ʻana i ka wai ʻona, a no nā maʻi maʻi molo a me nā maʻi olakino. ʻO Jonas et al., 2014; Leucht, Hierl, Kissling, Dold, & Davis, 2012).

ʻAʻole hōʻike i ka mana o ka loiloi ma waena o nā papa o ka lāʻau lapaʻau, ʻoiai ke loaʻa nei ka loaʻa ʻana o ka lāʻau lapaʻau no ka hoʻemi ʻana o ka hōʻemi nui o ka honua no CB.ʻEleʻele, Monahan, & Gabel, 1997; Grant, Odlaug, Mooney, O'Brien, & Kim, 2012) ua hoʻohālikelike ʻia i nā mea i loaʻa mai ʻikepili ITT. Ua hoʻoholo pū kekahi mau ho'āʻo ʻana i ka ʻoi o ka lāʻau lapaʻau ma luna o nā maʻi noʻonoʻo no ka hōʻemi o ka hoʻomehana honua e kākoʻo ana i ka hoʻohana ʻana o ITT loiloi, kahi e hōʻike nei i kahi ʻano hana pragmatic e hōʻike ana i nā kūlana ʻoiaʻiʻo loa o ka wā o nā maʻi. ʻO Sedgwick, 2015). Ma loko wale nō o ka ʻāpana IA, ua ʻike ʻia nā antidepressants ma mua o nā lāʻau lapaʻau ʻē aʻe. ʻIke ʻia kahi hōʻike e pili ana i ka ʻike, hōʻike ʻia ka subgroup me ka ʻoi aku ka ʻoi aku ka ʻoi aku i ka poʻe maʻi ma waena o ke kanaka makua me ka hōʻeha ʻana o ke kanikau, a me nā maʻi e nānā me ka antidepressants, a hoʻopili i ka hōʻike me ka nui o ka hopena hopena (g = 2.54; DellʻOsso et al., 2008). ʻO ka haʻawina me ka loaʻa o ka hoʻohaʻemi ʻana i ka hoʻōla ʻana, ma ka huli ʻana, i hoʻohui ʻia nā ʻōpio me ka comorbid attention deficit hyperactivity disorder (ADHD) i mālama ʻia me ka psychostimulants (methylphenidate), a loaʻa i ka hoʻokolokolo me ka hopena haʻahaʻa haʻahaʻa loa e nānā ana i nā poʻe me ka luuluu haʻahaʻa o IA (g = 0.57; Han et al., 2009). Ua hoʻopili ʻia kēia mau ʻokoʻa ʻole e like me ka "moʻomeheu" a me ka ʻano 'IA. Me nā noiʻi ʻelua i hoʻoiho ʻia mai ka hope o nā mea noiʻi, ʻo ka pono o antidepressants, a me nā hopena nui loa no ka "moʻomeheu" maʻalahi, a ua nalowale ke ʻano "IA type". ʻOiai ʻo ka mālama ʻana i nā ʻāpana ʻelua i hoʻohua i nā hopena pōmaikaʻi, ʻike ʻia nā ʻokoʻa ʻē a holo i ka hoʻokau hoʻokahi. No laila, ʻo nā pilina ma waena o ka ADHD e neʻe nei, me ka mālama ʻana i ka lāʻau lapaʻau, ʻokoʻa, a me ka moʻomeheu e pono ai nā hoʻokolokolo inā loaʻa kahi kiʻekiʻe o nā haʻawina e loaʻa. Ma waho aʻe o ka comorbid ADHD, ʻoiai, ua kūʻokoʻa ka holomua-maʻi kūʻokoʻa mai ke comorbid kaumaha a me ka hopohopo, e kākoʻo ana i nā ʻike mai ka IA mua (ʻo ia hoʻi, Han & Renshaw, 2012) a hūnā ʻia i ka noiʻi pili pāʻani (no kahi ʻike e ʻike Dowling, Merkouris, & Lorains, 2016).

Ma kahi o nā helu addiction ʻekolu, ka nui o ka serotonin selective reuptake inhibitors (SSRIs) ua loiloi e pili ana i nā kiʻekiʻe kiʻekiʻe o nā maʻi ʻeha comorbid (e hoʻohālike, Kafka, 1991) a me ka pili o SA me ka waiwai o ka serotonin e pili ana i ka moekolohe. Kafka & Prentky, 1992). ʻO nā maʻi opioid opioid (e laʻa, naltrexone) a me nā lāʻau lapaʻau glutamatergic (e like me, topiramate) i manaʻo ʻia i nā hana ʻona no ka mālama ʻana i ka SA (. Grant & Kim, 2001; Khazaal & Zullino, 2006) a me CB (ke kumu, Hāʻawi, 2003; ʻO Guzman, Filomensky, & Tavares, 2007ke hōʻike nei i nā hopena pono. No ka mea nā opioid antagonist a me nā mākia glutamatergic i hōʻoia i nā koho kūpono e mālama ai no SUDs (ʻO Guglielmo et al., 2015; ʻO Jonas et al., 2014; Minarini et al., 2017) a hōʻahewa keʻa (ʻO Bartley & Bloch, 2013; ʻO Goslar et al., 2018), i kēia mau ʻano o nā lāʻau lapaʻau ke hoʻohiki nei no ka hoʻokolokolo ʻana i nā hoʻolālā noiʻi nui-i hoʻopaʻa ʻia a hoʻokipa ʻia, e like me ka hoʻokaʻina o nā kiʻekiʻe SUD e comorbid i nānā ʻia ma BAs (e like me, Grant a me., 2010).

Hoʻohui ʻia nā lāʻau lapaʻau no IA, ka lāʻau lapaʻau pū kekahi me CBT, i hoʻopiʻi ʻia i nā hopena hoʻomaʻamaʻa hoʻohālikelike ʻia e like me ke kūlohelohe noʻonoʻo pono a me nā ʻano hoʻokolohua hoʻāliʻi e kākoʻo ana i ka loiloi hou ʻana i nā loiloi hopena hopena IA (Przepiorka, Blachnio, Miziak, & Czuczwar, 2014). Ua ʻoi aku ka nui o nā hui a CBT ma luna o nā mea i hui pū ʻia me nā hoʻolālā noʻonoʻo ʻē aʻe ma luna o ka hoʻokolokolo hoʻokahi e loaʻa ana i ka nui hopena (nui loa).g = 5.31; Yang, Shao, & Zheng, 2005), hoʻopili i ka mea hoʻoponopono "ʻano" a me ke ʻano "IA". Me kēia noiʻi i neʻe ʻia mai nā loiloi subgroup, ʻoiai, ʻo ka pono wale o nā hui CBT i noho nui.

ʻOiai ka hapanui o ka ʻike i hāʻawi ʻia e nā loiloi hopena hopena o IA, a ua palena wale nō ka ʻikepili mai nā hoʻokele hoʻomalu, ʻike ʻia nā hoʻokele noʻonoʻo a me ka lāʻau lapaʻau i nā hopena pōkole ma waena o nā kūlana ʻekolu, i hoʻohālikelike ʻia i ka poʻe i noi no ke hoʻohana waiwai a me nā papa hoʻokele waiwai (eg. ʻO Goslar et al., 2017; Grant a me., 2010) kākoʻo i kā mākou hypotheses. ʻAʻole lawa kēia mau ʻike no ka hoʻomaʻamaʻa ʻana i ka helu helu ʻana o IA, SA a me CB i loko o ka kiko o nā maʻi psychiatric ma muli o ka nalowale o ka hōʻoia o nā kuleana diagnostic, a me nā palena epidemiological, genetic a me ka neurobiological data (eg. Grant a me., 2010). Eia nō naʻe, manaʻo lākou, e pane maikaʻi ka poʻe like i ka lāʻau lapaʻau me ka manaʻo ʻole o ke ʻano pili. Kūkū maikaʻi kēia mau hopena i nā hiʻohiʻona ʻo ka maʻi addictive e hoʻopau ana i nā mana lalo i lalo o nā maʻi a me nā BA.Griffiths, 2005; Jacobs, 1986; Orford, 2001; Shaffer et al., 2004), hiki ke hoʻololiʻia ma ka hoʻopili ʻana i nā noʻonoʻo lapaʻau a me nā lāʻau lapaʻau.ʻO Potenza et al., 2011). I ka hoʻomakaʻana o ka hana prefrontal lēwa a me ka uku o ka pōʻaiapuni i ka wā o ka hoʻohana 'ana i ka lāʻau lapaʻau a me nā ʻano hana. Nestler, 2005), nā hana lapaʻau, ʻoi aku nā koho e pili ana i ka CBT, i hiki ke hoʻololi i nā cognitions disfunctional a me nā ʻano hana maladaptive (Kim & Hodgins, 2018), a hoʻoikaika i nā kaohi-mana lāʻau ponoʻī ma o ke kuhikuhi ʻana i nā wahi lolo prefrontal (ʻO Potenza et al., 2011). ʻO ka mālama ʻana i nā lāʻau lapaʻau, e huli ana i ka hōʻemi i ka nānā ʻana a me ke kaila ʻana i nā hōʻailona ma ka huli ʻana i nā ala uku a me nā ʻōnaehana neurotransmitter (ʻO Potenza et al., 2011). Eia kekahi, e like me ka nānā ʻana no ka mālama ʻana o IA, ʻo ka hui pū ʻana o CBT a me nā lāʻau lapaʻau hiki ke loaʻa i kahi hopena hoʻohui, ʻoiai ʻo ia nā pilina ma waena o ka ʻelua o ka maopopo ʻole.ʻO Potenza et al., 2011).

Eia nā mea e pono ke hoʻomaopopo ʻia: ʻO ka mea mua, no ka mea pono no ka hapa nui o ka loiloi meta-analytic, ʻokoʻa nā haʻawina i hoʻohui ʻia i ko lākou ʻano methodological, ʻoiai inā ʻike ʻia ka heluʻelika, ʻaʻole mākou i ʻike i ka hana ʻōnaehana ma o nā hopena hopena e like me nā ʻokoʻa i ka maikaʻi. o na noi. ʻAʻole i loaʻa kekahi o nā haʻawina i ke kiʻekiʻe kiʻekiʻe e hōʻike ana i ka nui o ka hōʻike no ka hōʻike hoʻoliʻi a me - ma muli o ka hoʻomākaukau ʻana o nā hoʻolālā aʻo ʻana i loko o ka hui - i ka ʻike a me ka kāohi o nā mea hoʻopiʻi, a me ka makapō. No laila, pono e hoʻolālā pono i ka RCTs, me ka nānā ʻana o ke kākoʻo psychosocial a me ka data huli ʻana. Eia nō naʻe, ʻo ka hapa nui o nā haʻawina IA i komo i nā ʻano hana like ʻole ma luna o ka pūnaewele (e laʻa, ke pāʻani pūnaewele, ke nānā ʻana i ka ponokona), ʻoiai ua hōʻike nā noiʻi i nā ʻokoʻa ma waena o ka manaʻo ākea o ka IA a me nā ʻano kikoʻī o nā ʻano hana hoʻohālikelike ʻia e ka pūnaewele.Montag et al., 2015). Eia nō naʻe, ua hoʻāʻo mākou e hoʻokele i kēia pilikia ma o ka helu ʻana i nā haʻawina e like me kēlā Ma ka pili ʻana i nā pilikia hui, ua kaupalena mākou i ka hoʻoponopono ʻana i ke kaumaha a me ke kaumaha i ʻole ka manaʻo wale nō ma muli o ko lākou kiʻekiʻe i waena o nā mea pili i hoʻohālikelike ʻia. Starcevic & Khazaal, 2017), akā no ka mea, i ka ʻikepili o kēia mau kikoʻī i loaʻa ʻia mai nā palena o nā kumu mua. ʻO ka hele pinepine ʻana nā kūlana ʻē aʻe me BAs (e like me, Grant a me., 2010), a ke ʻano ka hopena o ka mālama ʻana i ke ʻano o ka comorbidity (Dowling et al., 2016), ua paipai ʻia nā haʻawina e hoʻomaʻamaʻa i ka ʻōnaehana ʻano o nā ʻano a me nā helu o nā maʻi i hui ʻia i mea e loiloi ai i kēia ʻike i ka meta-analyse e hiki mai ana. Ua haki ʻole ka hapa nui o nā haʻawina e pili ana i ke ala i loaʻa ai nā maʻi. ʻO ke ʻano o ka hoʻoholo ʻana i nā maʻi, eia nō ke hāpai i ko lākou mana (Carlbring et al., 2002; e nānā hoʻi Andersson & Titov, 2014). No laila, e hōʻike e pili ana nā haʻawina o ka wā i loaʻa i nā maʻi nā lapaʻau, hōʻike pilikino, ka maka a he maka, a i ʻole ma ka pūnaewele. Hoʻohui hou ʻia nā haʻawina o hope e hoʻohālikelike i ka hopena o nā mea lapaʻau no nā poʻe me nā BAs a me nā SUD i mea e nānā ai i nā mea like a me nā ʻokoʻa ma waena o nā mea pili i ka waiwai a me ka mea ʻole i nā mea pili i ka hopena o ka mālama ʻana.

ʻOiai ʻo kēia mau palena, ua ʻōlelo nā hopena o ka meta-analysis o kēia manawa i ka ʻano o ka hōʻuluʻulu ʻana o ka noʻonoʻo ʻana i ka hopena o ka hōʻemi ʻana i nā hōʻailona o IA, ʻoi aku ka pae a maka ʻia i mua o ke alo a nānā ʻia i kahi manawa lōʻihi. ʻOiai ʻo antidepressants a me psychostimulants no nā poʻe me ka ADHD i hoʻonui i nā hōʻailona IA, ʻo CBT i hui pū me ka antidepressants e hōʻike i kahi pono ma luna o nā monotherapies. E pili ana i ke kūlana noiʻi o kēia manawa, ʻike nui ʻia ka CBT a me nā antidepresan e pono ai no ka mālama ʻana i ka SA me CB. Hāʻawi i ke noi no ka mālama ʻana, e hoʻomau ka noiʻi neurobiological i nā mea e ʻike i nā mea i waena o nā maʻi a me nā mea e pili ana i ka lawena, a e hoʻomaikaʻi hou i ka mālama ʻana i kēia mau kūlana.Grant a me., 2010; ʻO Potenza et al., 2011).

ʻO nā kumuwaiwai kālā

ʻAʻole loaʻa kēia noiʻi kālā i ke kākoʻo kālā mai kekahi mau hui kālā i ka lehulehu, ʻoihana, ʻona a ʻaʻohe waiwai paha.

Hoʻomaka a ka mea kākau

Ua alakaʻi ʻo Martina Goslar i ka ʻimi noiʻi, ua hoʻopili i ka hōʻike a hana i nā ʻano hōʻike. Hoʻokomo ʻia nā pepa no ka hoʻokomo ʻana i ka meta-analysis e Martina Goslar a me Max Leibetseder nāna i hōʻoia i ka ʻikepili i ka ʻike. Na Anton-Rupert Laireiter i kiaʻi ma kēia mau kaʻina. Ua loiloi ʻo Martina Goslar a me Max Leibetseder i ka hōʻoia o nā haʻawina. Ua kākoʻo ʻo Hana M. Muench i ka hoʻonohonoho o ka ʻikepili a hāʻawi i nā ʻōlelo statistic. Ua kākau ʻia ka ʻōlelo kākau ʻia e Martina Goslar me nā ʻōlelo a Hana M. Muench, Anton-Rupert Laireiter, a me Stefan G. Hofmann. Ua kōkua nā mea kākau a pau a apono ʻia ka palapala hope.

Kōkua hihia

Hōʻike ʻo Martina Goslar ʻaʻole āna kūlike me ka makemake. Hōʻike ʻo Max Leibetseder ʻaʻole ia e kūlike i ka hoihoi. Ua hōʻike ʻo Hana M. Muench ʻaʻole ia e kūlike ʻole ka hoihoi. Loaʻa iā Dr. Hofmann ka kākoʻo kālā mai ka Alexander von Humboldt Foundation (ma ke ʻano o ka makana Humboldt), NIH / NCCIH (R01AT007257), NIH / NIMH (R01MH099021, U01MH108168), a me ka James S. McDonnell Foundation 21^st Kenekulia ʻEnekema Initiative i ka hoʻomaopopo ʻana i ka ʻike kanaka - Initiative kūikawā. Loaʻa iā ia ka uku no kāna hana ma ke ʻano hoʻoponopono mai Springer Nature a me ka Association for Psychological Science, a ma ke ʻano he kākāʻōlelo mai ka Palo Alto Health Science a no kāna hana ma ke ʻano he Matter Expert Expert mai John Wiley & Sons, Inc. a me SilverCloud Health, Inc. . Loaʻa iā ia nā uku aliʻi a me nā uku no kāna hana hoʻoponopono mai nā mea paʻi puke like ʻole. Ua haʻi ʻo Anton-Rupert Laireiter ʻaʻohe ona ʻaʻe hoihoi.

mau hoomaikai ana

Makemake nā mea kākau e mahalo iā Mrs Xuan Wang und Mrs Yang Zhang i unuhi i nā paʻi Haina.

PākuʻiNā ʻōmole no ka helu pākēpē o ka pāpaʻi ʻana

I ka hōʻuluʻulu ʻana i nā nui like i loko o ka pūʻulu i hoʻohana ʻia, ua hoʻohana ʻia nā ʻōmole hana (kahi)ʻO Borenstein et al, 2005, 2009):

d = (Y ʻ¯ 1 - Y ʻ¯ 2 S D i f f e r e n c e) 2 (1 - r) ------- \sqrt,

pela Yʻ¯1 hoʻākāka i ke kumu kolohe, Yʻ¯2 hōʻike i ke ʻano o ka mālama ʻana i ke ʻano, S_{koena unuhi} e hōʻike ana i ka kūlike pilikino o ka hoʻokaʻawale, a r hōʻike i ka hoʻopili ma waena o nā helu helu pretreatment a me posttreatment. Ma muli o nā liʻiliʻi liʻiliʻi, ua hoʻoponopono ʻia nā nui o ka hopena no ka bias e hoʻohana ana iā Hedges g i hoʻohālikelike ʻia e ka hoʻonui ʻana d me ka mea hoʻoponopono

J (d f) = 1 - 3 4 d f - 1,

pela df ʻoi ke kumu o ke kūʻokoʻa e hoʻohālikelike i ka pānaʻina kūlike o ka hui. Ua noi ʻia kēia mau palapala no ka hoʻopili ʻana o ka nui o ka hopena mai ka pretreatment a me ke ʻano hou loa. Ua hoʻohālikelike ʻia ka nui o ka hopena e hoʻohana ana i kēia ʻano iho.

g = ( Δ ʻ¯ PONO - Δ ʻ¯ ALOHA ) ( n PONO - 1 ) S D 2 PONO + ( n ALOHA - 1 ) S D 2 ALOHA n Ka huina - 2 ------------------------- \sqrt \times (1 - 3 4 ( n Ka huina - 9 )),

pela Δ ʻ¯ ʻo ia ka mea pre-to post-treatment change, SD ka kūlike maʻamau o nā hōʻailona no ka mālama ʻana, n ʻO ka nui o ka hoʻohālike, e pili ana ʻo TREAT i ke ʻano lapaʻau ikaika, a pili ʻo CONT i ke kūlana mana. Mamuli ʻO Rosenthal (1991), mākou i manaʻo no ka pre-post hoʻoponopono r = 0.70.

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ʻO nā mea mālama no ka hoʻohui pūnaewele, ka hoʻomauʻana i ka wahine a me ke kūʻai kūʻē: A meta-analysis (2020)

Hōʻuluʻulu Manaʻo

Ke kumu a me nā manaʻo

Nā Papahana

Results

Kūkākūkā a me nā ʻĀina

Nā Papahana

Nā koho koho

ʻO nā ʻikepili ʻike a me ka huli ʻana i ka palapala

Nā mea i loaʻa

Ke kohoʻana

ʻO ka hōʻiliʻili o ka ʻikepili a me ka lawe ʻana i ka hōʻike

Loaʻa i ka paʻakikī o nā haʻawina pilikino

ʻO ka kiko helu helu a me ka helu helu helu synthesis

ʻO ka hopena o ke keʻa i nā haʻawina

Hoʻolālā kumu

Results

Ke kohoʻana

Nā ʻano o nā haʻawina, mālama, a me nā mea komo

ʻO ka pilikia o ke koi i nā haʻawina

Synthesis o nā hopena a me ka pilikia o ke kaulike ma waena o nā haʻawina

ʻO nā hopena kūpono no ka mālama noʻonoʻo ʻana i ka posttreatment a me ka hana ʻana

ʻO nā hopena kūpono o nā lāʻau lapaʻau lapaʻau ma ka posttreatment a me ka hana ʻana

ʻO nā hopena kūpono e pili ana i ka hoʻokaʻawale ʻana i ka posttreatment a me ka hana ʻana

Hoʻoponopono ke kumu

Psychological vs pharmacological vs. hui pū

ʻO nā ʻokoʻa ma waena o nā māhele hoʻohui

kūkākūkā

ʻO nā kumuwaiwai kālā

Hoʻomaka a ka mea kākau

Kōkua hihia

mau hoomaikai ana

E hoʻomaopopo '

Nā Palapala Loaʻa i loko o ka Meta-Analysis

hoopoina koke ana Loulou