Kuchepetsa chilakolako chogonana pa scanner: Kugonana ndi kukonzanso mphotho, komanso kulumikizana ndi zovuta zolaula komanso zolimbikitsa (2021)

2021 Apr 2.

do: 10.1556 / 2006.2021.00018. 

Charlotte Markert  1   2   3 , Sanja Klein  1   2   3 , Jana Strahler  1   2 , Pano Kruse  1   2   4 , Rudolf Stark  1   2   3

Kudalirika

Mbiri ndi zolinga

Kugwiritsa ntchito zolaula, ngakhale kuli kovuta kwa ambiri, kumatha kukhala chizolowezi chomangokhala chizolowezi chomangokhala chizolowezi chomwe chimadziwika kuti ndi chizolowezi chogonana mu ICD-11 (WHO, 2018). Cholinga cha phunziroli chinali kufufuzanso zokhudzana ndi zosokoneza bongo kuti zidziwike bwino zomwe zimayambitsa vutoli.

Njira

Takhala tikugwiritsa ntchito ntchito yothandiza pakuchepetsa chilimbikitso kuti tiwone zochitika muubongo mu mphotho zomwe zimakhudzana ndi ubongo munthawi yoyembekezera (ndikulosera zamakanema olaula, kuwongolera makanema kapena makanema opanda pake) komanso gawo lofananira la amuna athanzi. Zolumikizana ndi zisonyezo zamavuto ogwiritsa ntchito, nthawi yomwe amawonongera zolaula, ndikuwunika pazomwe amagonana.

Results

Zotsatira za amuna 74 zidawonetsa kuti magawo amubongo okhudzana ndi mphotho (amygdala, dorsal cingate cortex, orbitofrontal cortex, nucleus accumbens, thalamus, putamen, caudate nucleus, and insula) adalimbikitsidwa kwambiri ndi makanema olaula ndi zolaula kuposa onetsani makanema ndikuwongolera, motsatana. Komabe, sitinapeze ubale pakati pazoyambitsa izi ndi zisonyezo zamavuto ogwiritsa ntchito, nthawi yomwe timagwiritsa ntchito zolaula, kapena tili ndi zikhalidwe zogonana.

Zokambirana ndi zolingalira

Zochitikazo m'magulu okhudzana ndi mphotho pazowonera zolaula komanso zowonetsa zikuwonetsa kuti kukhathamiritsa kwa Ntchito Yochepetsa Kugonana kunali kopambana. Mwinamwake, mayanjano pakati pa zochitika zokhudzana ndi mphotho zokhudzana ndi mphotho ndi zisonyezo zogwiritsa ntchito zolaula zimatha kuchitika muzitsanzo zomwe zikuwonjezeka osati muzitsanzo zabwino zomwe zikugwiritsidwa ntchito phunziroli.

Chiyambi

Zithunzi zolaula pa intaneti ndizofala kwambiri pakati pa anthu (Blais-Lecours, Vaillancourt-Morel, Sabourin, & Mulungu, 2016; Bőthe, Tóth-Király, Potenza, Orosz, & Demetrovics, 2020; Martyniuk, Okolski, & Dekker, 2019). Ngakhale ambiri akuwonetsa zolaula zopanda vuto, mwa anthu ochepa zimaphatikizidwa ndi zowawa, kuwoneka kuti alibe mphamvu, komanso kulephera kuchepetsa khalidweli ngakhale zitakhala zovuta (pafupifupi 8%, kutengera momwe agwiritsidwira ntchito; Cooper, Scherer, Boies, & Gordon, 1999; Gola, Lewczuk, & Skorko, 2016; Grubbs, Volk, Exline, & Pargament, 2015). Zithunzi zolaula zomwe zimagwirizana ndi maliseche ndizovuta kwambiri pakati pa anthu omwe ali ndi chizolowezi chogonana (Kraus, Voon, & Potenza, 2016; Reid et al., 2012; Masewera a Wordecha et al., 2018). Kwa nthawi yoyamba, Bungwe la World Health Organization (WHO) yatanthauzira njira zodziwira za matendawa mu kope la 11 la International Classification of Disways (ICD-11) pansi pa mawuwa Kusokoneza Magwiridwe Ogonana (CSBD, World Health Organisation, 2018). Kuti mumvetsetse bwino zolaula komanso zovuta kugwiritsa ntchito zolaula, zomwe zimafunikira muubongo wake ziyenera kufotokozedwa.

Ngakhale kufotokozedwa koyenera kwamavuto ogwiritsa ntchito zolaula ndi nkhani yotsutsana, zomwe asayansi amapeza zimayandikira pafupi ndi zovuta zamankhwala osokoneza bongo (Chikondi, Laier, Brand, Hatch, & Hajela, 2015; Stark, Klucken, Potenza, Brand, & Strahler, 2018). Robinson ndi Berridge adalongosola mu Chiphunzitso Chawo Chotsitsimutsa Pakukweza zizolowezi momwe kugwiritsa ntchito mankhwala osokoneza bongo mobwerezabwereza kumabweretsa kusintha kwamitsempha mkati mwa mabwalo amphoto (Robinson & Berridge, 1993, 2008). Pakukula kwa chizolowezi, kuyankha kuzinthu ("kufuna") kumachulukirachulukira pomwe kufunafuna kwakumwa mankhwala osokoneza bongo ("kukonda") kumatha kuchepa. Chifukwa chake, yang'anani kuyambiranso komwe kumakhudza kutengeka mtima, machitidwe, thupi komanso kuzindikira pazomwe zimakhudzana ndi zosokoneza bongo (Berridge & Robinson, 2016; Tiffany & Wray, 2012) ndi lingaliro lofunikira kufotokoza kusinthaku kuyambira pomwe nthawi zina ndimagwiritsa ntchito mankhwala osokoneza bongo ndikugwiritsa ntchito mankhwala osokoneza bongo (Mtundu et al., 2019; Koob & Volkow, 2010; Volkow, Koob, & McLellan, 2016).

Kafukufuku wa odwala omwe ali ndi zovuta zosiyanasiyana zokhudzana ndi mankhwala apeza kuyambiranso mu ventral striatum, dorsal striatum, anterior cingulate cortex (ACC), orbitofrontal cortex (OFC), insula ndi amygdala ku zokhudzana ndi zinthu (Jasinska, Stein, Kaiser, Naumer, & Yalachkov, 2014; Kühn & Gallinat, 2011a; Stippekohl et al., 2010; Zilverstand, Huang, Alia-Klein, & Goldstein, 2018). Ponena za zizolowezi zamakhalidwe, pali ndemanga zingapo zomwe zikuwonetsa kuwonjezeka kwa ntchito m'magawo olumikizidwa ndi mphotho kuzinthu zokhudzana ndi zosokoneza bongo (Antons, Brand, & Potenza, 2020; Fauth-Bühler, Mann, & Potenza, 2017; Starcke, Antons, Trotzke, & Brand, 2018; Van Holst, van den Brink, Veltman, & Goudriaan, 2010). Kaya zomwe zimachitika mu CSBD zikufanana ndi zovuta zakugwiritsa ntchito mankhwala osokoneza bongo komanso zizolowezi zamakhalidwe akadali nkhani yotsutsana ndi asayansi.

Ndemanga zingapo zikuwonetsa zochitika zowonjezereka za ventral ndi dorsal striatum, OFC, ACC, insula, caudate nucleus, putamen, amygdala, thalamus, ndi hypothalamus mwa omwe amatenga nawo mbali pazaumoyo wowonera zolaula (VSS) poyerekeza ndi zoyambitsa ndale (Georgiadis & Kringelbach, 2012; Poeppl, Langguth, Laird, & Eickhoff, 2014; Stoléru, Fonteille, Cornélis, Joyal, & Moulier, 2012). Kuphatikiza apo, pali maphunziro pamayankho amanjenje pazinthu zomwe zimaneneratu VSS koma mulibe chilichonse chogonana (mwachitsanzo, Banca et al., 2016: mitundu yamitundu; Klucken, Wehrum-Osinsky, Schweckendiek, Kruse, & Stark, 2016: mabwalo achikuda; Stark et al., 2019: mawu ofotokozera gulu). Ubongo umayankha pazinthu izi zisanachitike VSS (Banca et al., 2016; Klucken et al., 2016; Stark et al., 2019) anali ofanana ndi mayankho ku VSS (ventral striatum, OFC, occipital cortex, insula, putamen, thalamus). Kuphatikiza apo, anthu omwe ali ndi vuto logwiritsa ntchito zolaula (PPU) poyerekeza ndi omwe akuwongolera omwe akuchita nawo ziwonetsero akuwonetsa kuchuluka kwa amygdala kuyambiranso kwa ziwerengero za VSS (Klucken et al., 2016). Pogwiritsa ntchito VSS monga cues, Voon et al. (2014) adapeza mayankho apamwamba mu dorsal anterior cingate, ventral striatum ndi amygdala a anthu omwe ali ndi PPU. Zotsatirazi zakuchulukirachulukira pazinthu zomwe zikuneneratu za VSS mwa anthu omwe ali ndi PPU zikugwirizana ndi ziyembekezo zomwe zachokera ku Incentive Sensitization Theory.

Kuti muphunzire kukula kwa chizolowezi, Monetary Incentive Delay Task (MIDT) ndichida chokhazikitsidwa chofufuzira mayankho osinthika amtundu wazomwe zimayambitsa ndi zoyambitsa (Balodis & Potenza, 2015). MIDT imayamba ndi gawo loyembekezera momwe ziwonetsero zimatsimikizira ngati kupambana kapena kutaya ndalama ndikotheka munthawi yotsatira yobereka. Poyambirira, ntchitoyi idagwiritsidwa ntchito kuwunika kukhudzika kwa mphotho pazokonda, komabe, zotsatira zosagwirizana zokhudzana ndi gawo lakuyembekezera komanso gawo lobereka (Balodis & Potenza, 2015; Beck et al., 2009; Bustamante et al., 2014; Jia et al., 2011; Nestor, Hester, & Garavan, 2010). Kuti muwone kuyambiranso kwa PPU, mtundu wosinthidwa wa MIDT (Knutson, Fong, Adams, Varner, & Hommer, 2001; Knutson, Westdorp, Kaiser, & Hommer, 2000) adakonzedwa: Ntchito Yochepetsa Kuchepetsa Kugonana (SIDT) pogwiritsa ntchito zachiwerewere ndi mphotho. Kafukufuku atatu agwiritsa ntchito zolimbikitsa kuchedwetsa ntchito ndi zachiwerewere ndi mphotho mpaka pano (Gola et al., 2017; Sescousse, Li, & Dreher, 2015; Sescousse, Redouté, & Dreher, 2010). Sescousse ndi anzawo adasanthula zochitika zosiyanasiyana zokhudzana ndi mphotho zandalama komanso ndalama kwa achikulire athanzi ndikuzindikira gawo lotsalira la OFC ndi amygdala ngati zigawo zomwe zimayendetsedwa ndi mphotho zonyansa (Sescousse et al., 2010). Gola ndi anzawo (2017) poyerekeza amuna omwe ali ndi PPU ndikuwongolera amuna pokhudzana ndi ubongo wawo ndi MIDT / SIDT yosakanikirana. Pomwe omwe amatenga nawo gawo la PPU adawonetsa zochulukirapo mu ventral striatum ya zomwe zimaneneratu za mphotho zakugonana, sizinasiyane ndi kuwongolera kokhudzana ndi zomwe ubongo umachita ndi mphotho yakugonana. Mogwirizana ndi Chiphunzitso Chotsitsimutsa, olembawo adanenanso zakuchulukirachulukira kwa "zofuna" zakugonana mwa omwe akutenga nawo gawo pa PPU pomwe "kukonda" zachiwerewere sikukhudzidwa.

Ngakhale maphunziro am'mbuyomu omwe amagwiritsidwa ntchito ndi SIDT ali odalirika kwambiri pakuwunika kwa zomwe zingachitike pokhudzana ndi kugonana ndi mphotho mwa anthu athanzi komanso anthu omwe ali ndi PPU, pali njira zina zomwe ziyenera kukambidwa. Ponena za kutsimikizika kwakunja, kafukufuku wakale adagwiritsa ntchito zithunzi zosasintha m'malo mwa makanema, ngakhale zithunzizi ndizomwe zimagwiritsidwa ntchito kwambiri zolaula (Solano, Eaton, & O'Leary, 2020). Ponena za momwe zinthu zikuyendera, kafukufuku wakale amagwiritsa ntchito mitundu ya VSS yoyeserera ngati njira zowongolera (Gola et al., 2017; Sescousse et al., 2010, 2015). Zotsatira zake, zoyeserera ndikuwongolera zimasiyana pamitundu ingapo (zachilengedwe motsutsana ndi njira zosamveka, kusanja kwazithunzi, kuwonetsa anthu motsutsana ndi ziwonetsero zosakhala za anthu). Ndizokayikitsa ngati zoyeserera izi zikuyimira kulamulira koyenera. Kuphatikiza apo, ofufuzawa adagwiritsa ntchito zithunzi za akazi amaliseche ngati cue. Mwanjira imeneyi zidziwitso sizimangokhala ndi tanthauzo lenileni, komanso zimaimira zachiwerewere. Kuphatikiza apo, zingakhale zothandiza kufufuza zomwe zingayambitse chiopsezo cha CSBD, pomwe zotsatirazi zikuwoneka kuti ndizofunikira kwambiri: mavuto omwe adziwonetsa okha okhudzana ndi zolaula (Mtundu, Snagowski, Laier, & Maderwald, 2016; Laier, Pawlikowski, Pekal, Schulte, & Brand, 2013), nthawi yogwiritsira ntchito zolaula (Kühn & Gallinat, 2014) ndikuchita zachiwerewere (Baranowski, Vogl, & Stark, 2019; Kagerer et al., 2014; Klucken et al., 2016; Stark et al., 2018; Strahler, Kruse, Wehrum-Osinsky, Klucken, & Stark, 2018).

Chifukwa chake, zolinga za phunziroli zinali izi: (1) Tikufuna kukhazikitsa SIDT yogwiritsa ntchito makanema m'malo mwa zithunzi zosasintha. Tinkayembekezera kuti magwiridwe antchito munthawi yoyembekezera komanso gawo loperekera likhale lofanana ndi zotsatira zamaphunziro akale omwe akuwonetsa kutenga nawo mbali kwa ACC, OFC, thalamus, insula, amygdala, nucleus accumbens (NAcc), caudate, ndi putamen. (2) Tidafuna kufufuza momwe ziwopsezo za CSBD (yodzinenera PPU, nthawi yomwe amagwiritsira ntchito zolaula, ndikuchita zachiwerewere) yolumikizidwa ndi zochitika za neural munthawi yoyembekezera komanso nthawi yobereka kuchipatala chitsanzo. Malinga ndi Chiphunzitso cha Incentive Sensitization of Robinson ndi Berridge (1993), timayembekezera kuti zochitika za neural m'magawo omwe atchulidwa pamwambapa panthawi yakuyembekezeredwa kwa SIDT zitha kulumikizidwa bwino ndi izi. Malinga ndi kafukufuku wa Gola et al. (2017), timayembekezera kuti zochitika za neural za madera omwe atchulidwa pamwambapa panthawi yobereka sizikugwirizana ndi zoopsa izi.

Njira

ophunzira

Amuna makumi asanu ndi awiri mphambu asanu ndi atatu athanzi pakati pa zaka 18 ndi 45 adalembedwa pamndandanda wamakalata, zolemba komanso zofalitsa nkhani. Ophunzira awiri adayenera kutulutsidwa chifukwa chazovuta, awiri chifukwa cha zojambulajambula ndipo m'modzi chifukwa cha neuroanatomy. Chitsanzo chomaliza chinali amuna 73 omwe ali ndi zaka zapakati pa 25.47 (SD = 4.44) zaka. Ambiri mwa omwe akutenga nawo mbali (n = 65; 89.04%) anali ophunzira. Ophunzira makumi atatu ndi atatu (45.21%) anali osakwatira, 36 (49.32%) amakhala pachibwenzi ndipo anayi (5.48%) omwe adatenga nawo mbali anali okwatirana. Ophunzira makumi awiri mphambu anayi (32.88%) adadzinena kuti ndi achipembedzo ("Kodi mumadzinenera kuti ndinu achipembedzo kapena chipembedzo?" "Inde" / "ayi"). Njira zotsatirazi zikugwiritsidwa ntchito: kusapezeka kwamatenda amisala / matenda amisala, kulibe mankhwala opatsirana pogwiritsa ntchito mankhwala osokoneza bongo, mankhwala osokoneza bongo / chikonga, palibe chotsutsana ndi fMRI, komanso kuzindikira bwino Chijeremani.

Kayendesedwe

Pakulowa kuphunzira, ophunzirawo adasaina chikalata chovomerezeka. Zitsanzo zomwe zilipo pano zimachokera pakufufuza kwakukulu komwe kumafufuza zomwe zimachitika chifukwa cha kupsinjika kwa VSS pakufanizira kupsinjika ndi chiwongolero. Kafukufuku wina wogwiritsa ntchito zomwe zafotokozedwazi wafalitsidwa mpaka pano. Klein ndi al. (2020) adasanthula zomwe amakonda pazokonzanso kwa neural ku VSS. Kuwunikaku kunawonetsa kuti magawo angapo aubongo omwe amalumikizana ndi mphotho amalumikizana bwino ndi kuchuluka kwa VSS ndikuti kulumikizaku kumalumikizana bwino ndi mulingo wa PPU. Palibe chidziwitso chofotokozedwa pano chomwe chidasindikizidwa kale. Ophunzira nawo pakuwunikaku adapatsidwa mwayi wowongolera ndipo adakumana ndi mayesero a Trier Social Stress Test (placebo TSST, 15 min, Het, Rohleder, Schoofs, Kirschbaum, & Wolf, 2009) isanakwane sikani ya MRI. Kuyesaku kuli ndi ntchito ziwiri zosavuta zamaganizidwe (kuyankhula momasuka komanso kuwerengera kwamaganizidwe osavuta) zomwe sizimapangitsa kuti munthu asamavutike kwambiri kapena kusintha kusintha kwa thupi mwa omwe atenga nawo mbali, zomwe zimapangitsa SIDT yotsatira sikuyembekezeredwa. Pambuyo pa placebo TSST, ophunzirawo adatenga nawo gawo mu SIDT. Atachoka pa sikani, omwe adatenga nawo mbali adavotera zojambulazo zokha m'chipinda chapadera kuti zitsimikizire zachinsinsi komanso zowona. Gawo la mafunso okhudzana ndi chikhalidwe cha anthu komanso osagonana adasonkhanitsidwa kale TSST isanayambike (kutalika kwa mphindi 45) pogwiritsa ntchito nsanja ya SoSci Survey pa intaneti. Pambuyo pakuwunika kwa MRI, ophunzirawo adapatsidwa nthawi kuti aone kanema ndikulemba mafunso enanso (pafupifupi 60 min).

Njira

Ntchito Yochedwetsa Kugonana

Tidagwiritsa ntchito SIDT yochokera ku MIDT yokhazikitsidwa (Knutson et al., 2001). Mphoto zandalama zidasinthidwa phunziroli ndi makanema amfilimu yamasekondi asanu ndi limodzi omwe adawonetsedwa popanda mawu ndipo mwina adawonetsa VSS (VSS kopanira), makanema osagonana osagonana (lowetsani kopanira) kapena chophimba chakuda (palibe). Kugwiritsa ntchito makanema otikita minofu kumatsimikizira kufanana kwa mawonekedwe (kucheza, kucheza pang'ono, maliseche, mayendedwe, etc.) ndi makanema akuwonetsa VSS. Pakafukufuku woyambirira, makanema onse adavoteledwa pokhudzana ndi chisangalalo (kuyambira "1" = "chosasangalatsa kwambiri" mpaka "9" = "chosangalatsa kwambiri") komanso kukakamiza kugonana (kuchokera ku "1" = "osagonana konse" to "9" = "kudzutsa chilakolako chogonana") ndi zitsanzo zodziyimira pawokha za amuna 58 omwe si amuna kapena akazi okhaokha. Makhalidwe pamwambapa 5 adamasuliridwa kukhala okwera. Zithunzi za 21 VSS zomwe zagwiritsidwa ntchito pofufuza zenizeni zidakwaniritsa kuchuluka kwa valence (M = 6.20, SD = 1.12) ndikukweza chilakolako chogonana (M = 6.29, SD = 1.34 musanaphunzire, pomwe masikelo apakatikati mpaka okwera a valence (M = 5.44, SD = 0.97) ndi zambiri zotsika pakukakamiza kugonana (M = 1.86, SD = 0.81) adanenedwa pazowongolera 21. Kanema aliyense wamakanema amangoperekedwa kamodzi pantchitoyi. Kuyesaku kunakwaniritsidwa ndi pulogalamu ya Presentation (Version 17.0, Neurobehavioral Systems, Inc, USA) ndipo idatenga pafupifupi 20 min. SIDT idaphatikizapo mayesero 63 omwe amakhala ndi gawo lakuyembekezera komanso gawo loperekera ndi zinthu zitatu (21 × vesi21 × ulamuliro, 21 × palibe).

Munthawi yoyembekezera, ziwerengero zitatu za geometric, zidaperekedwa ngati zomwe zikulengeza za VSS clip (Cuevesi), clip clip (CueControl) kapena chophimba chakuda (Cuepalibe, onani Chith. 1). Kutumizidwa kwa ziwerengero zamagetsi pazotsatira zomwe zingachitike (VSS clip, clip clip, palibe) zidasinthidwa mwa omwe atenga nawo mbali. Tidagwiritsa ntchito ziwerengero zamagetsi ngati njira zowonetsetsa kuti kulibe mabungwe am'mbuyomu pakati pa izi ndi VSS. Ophunzirawo adadziwitsidwa za mayanjano omwe ali pakati pazinthu ndi makanema asanayese fMRI. Mabungwewa adaphunzitsidwa pamayeso 21 olimbitsa thupi kunja kwa sikani. Chimodzi mwazinthu zomwe zidawonekera pa 4 s, mtanda wokonzekera udatsata mosiyanasiyana wa interstimulus wa 1-3 s. Kenako cholimbikitsira chandamale (yoyera yoyera, 200 × 200 pixel) idawonetsedwa pakati pa 16 ms (osachepera) ndi 750 ms (maximum). Mosasamala kanthu za zomwe zidaperekedwa kale, malangizowo anali oti ayankhe chandamale mwachangu podina batani. Ngati Cuevesi kapena CueControl adawonekera ndipo ophunzira adakanikiza batani pomwe cholimbikitsacho chimawoneka, ophunzirawo "adapambana" kanema. Chotsatiracho chinatsatiridwa ndikuwonetsedwa kwa mtanda wina wokonzekera kwakanthawi kosiyanasiyana kwa 0-2 s. Pambuyo pake, ophunzirawo adawonetsedwa VSS clip, clip clip kapena screen yakuda kwakanthawi kwa 6 s. Mayeso olimbitsa thupi asanajambulidwe adathandiziranso kuwerengera kuchuluka kwakanthawi komwe amatanthauza (kutanthauzaRT) ndi zolakwika zofananira (SDRT) kudziwa nthawi yowonetsera yolimbikitsayo (win: meanRT+2 × SdRT; osapambana: KutanthauzaRT-2 × SdRT). Zopambana zidakonzedwa pafupifupi 71% ya VSS ndikuwongolera mayesero (mayesero 15 mwa 21), pomwe mayesero palibe omwe adaphatikizidwa ndi kupambana. Mayesero atatu oyamba adapereka CueControl, kuvesi, ndi Cuepalibe mwadongosolo. Izi CueControl ndi Cuevesi mayesero amakonzedwa nthawi zonse ngati mayesero opambana. Pambuyo pazoyesa zitatu zoyambirira, zoletsa zoyeserera za 6 zidapangidwa (2 × CueLamulira, 2 × Kuzindikiravesi ndi 2 × Cuepalibe). Pakati pa mayesero opambana (mayesero opambana a VSS kapena mayesero opambana) osaposa mayesero ena 5 (mayesero ena opambana kapena osayesedwa) adaloledwa. Chikhalidwe chomwecho chitha kuperekedwa nthawi zopitilira 2 motsatizana. Kuwonetsedwa kwa zomwe adalimbikitsazo kunasinthidwa pa intaneti pochotsa kapena kuwonjezera pa 20 ms aliyense ngati ophunzira atapambana mayesero omwe sanakonzekere kapena sanapambane pamayeso omwe akonzedwa kuti awonetsetse kulimbikitsidwa m'mayeso amtsogolo. Mayesero a VSS ndi mayesero olamulira, omwe sanabweretse zotsatira monga momwe anakonzera, anabwerezedwa m'mayesero omwe anakonzedwa ndi nthawi yatsopano yowonetsera.

Fanizo la 1.
Fanizo la 1.

Ntchito Yochedwetsa Kugonana. Pakati pa gawo lakuyembekezera, ophunzirawo adawona cue (jiometric chithunzi). Kutsatira nthawi yosinthasintha, chandamale chidaperekedwa kwakanthawi kochepa, pomwe ophunzirawo adapemphedwa kuti achitepo kanthu mwachangu podina batani. Ngati chidziwitso m'gawo lakuyembekezera chinali Cuevesi kapena CueControl, kanema wofananira atha kupezedwa poyankha mwachangu pazolinga (onaninso Klein et al., 2020)

Ndemanga: Zolemba Pazikhalidwe Zosokoneza JBA 2021; 10.1556/2006.2021.00018

Kuunika kwa psychometric data

Pambuyo pa SIDT, omwe adatenga nawo mbali adavotera kuchuluka kwawo pakukondweretsedwa pamiyeso ya 9-Likert-wadogo akadali mkati mwa sikani. Zithunzi zojambula zidavoteledwa pogwiritsa ntchito sikelo Yodziyesa-Manikin (Bradley & Lang, 1994valence (kuchokera 1 = yosasangalatsa kwambiri mpaka 9 = yosangalatsa kwambiri) komanso kukakamiza kugonana (kuchokera ku 1 = osagonana mpaka 9 = kukondweretsa kwambiri) mutasiya sikani m'chipinda chapadera.

Nthawi yomwe mumawonera VSS m'moyo watsiku ndi tsiku idawunikidwa ndi "Mudagwiritsa ntchito nthawi yayitali bwanji mukuwonera zolaula, kuyankha kwanu mwezi watha?". Ophunzira adatha kusankha maola ndi mphindi "pamwezi", "sabata" kapena "patsiku" kuti anene yankho lawo. Zisanachitike kusanthula, mitundu yosiyanasiyana yamayankho idasinthidwa kukhala "maola pamwezi".

PPU inayesedwa ndi mitundu yaku Germany ya Short Internet Addiction Test (s-IAT) (Pawlikowski, Altstötter-Gleich, & Brand, 2013) yosinthidwa pa cybersex (s-IATkugonana; Laier et al., 2013) ndi Hypersexual Behaeve Inventory (HBI; Reid, Garos, & Carpenter, 2011). Kudalirika kwamkati pazosankhidwa zamafunso omwe adawerengedwa adawerengedwa pazitsanzo zamakono. Chimodzi mwazinthu khumi ndi ziwiri za s-IATkugonana idavotera pamiyeso ya 5-Likert kuyambira 1 (konse) kwa 5 (nthawi zambiri). Chiwerengero chonse (s-IATkugonana chiwerengero, Zinthu 12, Cronbach's ɑ = 0.90) amakhala pakati pa 12 mpaka 60. Zowonjezera ziwiri zitha kuwerengedwanso: kutaya mphamvu (zinthu 6, Cronbach's ɑ = 0.89) ndi kulakalaka (zinthu 6, Cronbach's ɑ = 0.73). HBI ili ndi zinthu 19 zochokera pa 1 (konse) kwa 5 (nthawi zambiri) ndi mphambu yonse (HBIchiwerengero, Zinthu 19, Cronbach's ɑ = 0.89) kuyambira 19 mpaka 95. Zothandizira zitatu zitha kuwerengedwa: kuwongolera (zinthu 8, Cronbach's ɑ = 0.89), kulimbana (zinthu 7, Cronbach's ɑ = 0.84) ndi zotsatira (zinthu 4, Cronbach's ɑ = 0.76). Kusintha kwamkati kunali kovomerezeka pamitundu yabwino mu kafukufuku wapano (onani zambiri pamwambapa).

Khalidwe logonana linayezedwa ndi Mafunso Othandizira Kugonana (TSMQ; Stark et al., 2015). TSMQ ili ndi zinthu 35 zotsitsa pazowonjezera 4: kugonana nokha (zinthu 10, Cronbach's ɑ = 0.77), kufunikira kwakugonana (zinthu 15, Cronbach's ɑ = 0.89), kufuna zogonana (zinthu 4, Cronbach's ɑ = 0.92), ndikuyerekeza ndi zina (zinthu 6, Cronbach's ɑ = 0.86). Kuphatikiza apo, chiwonetsero chazonse zakukakamiza zogonana (TSMQmukutanthauza) itha kuwerengedwa ngati tanthauzo la zinthu zonse 35 (Cronbach's ɑ = 0.91). Chilichonse chimavotera pamiyeso ya Likert ya 6-point kuyambira 0 (ayi konse) kwa 5 (kwambiri). Ophunzirawo alangizidwa kuti afotokozere zomwe anena zaka zisanu zapitazi. Mawu oti "chilimbikitso chogonana" omwe amagwiritsidwa ntchito pamlingo uwu akuphatikizapo zochitika zogonana ndi wokondedwa wanu komanso zochitika zogonana zokha. Makhalidwe apamwamba amawonetsa kutengera zakugonana.

Zotsatira zamakhalidwe

Nthawi yoyankha idatanthauzidwa ngati nthawi yapakati pazoyambira ndi poyambira. Zambiri zakusintha kwakanthawi zidawunikidwa kwa ogulitsa kunja osachotsa zomwe zili pansipa 100 ms kapena pamwambapa + 1.5 × SD pachikhalidwe chilichonse kutengera zitsanzo zowerengera. Malinga ndi izi, panali ogulitsa atatu mwa zitsanzo zonse (m'modzi pachikhalidwe). Ziwerengero zofotokozera zinawerengedwa kupatula ogulitsa kunja ndi zosowa zomwe zidasungidwa. Makhalidwe omwe anali akusowa anali ndi kuchitapo mochedwa kwambiri kapena kusachitapo kanthu pamtanda wokonzekera. Kusiyana kwamankhwala amkati mwazomwe adachita poyesedwa bwino kudawunikidwa pogwiritsa ntchito mayeso a Kruskal-Wallis ndi mayeso a Dunn-Bonferroni. Pomaliza, kulumikizana kwa Pearson pakati pazomwe zimachitika munthawi zitatuzi ndi zomwe zimaika pachiwopsezo cha CSBD zinawerengedwa.

Kupeza deta kwa fMRI ndikuwunika manambala

Zithunzi zogwira ntchito ndi anatomical zidapezeka pogwiritsa ntchito 3 Tesla thupi lonse MR tomograph (Siemens Prisma) yokhala ndi mutu wa 64-channel. Kapangidwe kazithunzi kameneka kamakhala ndi magawo a sagittal a 176 T1 (makulidwe a kagawo 0.9 mm; FoV = 240 mm; TR = 1.58 s; TE = 2.3 s). Pazithunzi zogwira ntchito, zithunzi zonse 632 zinajambulidwa pogwiritsa ntchito T2 yolemera gradient echo-planar imaging (EPI) motsatizana ndi magawo 36 okuta ubongo wonse (voxel size = 3 × 3 × 3.5 mm; gap = 0.5 mm; kutsika kagawo kupeza; TR = 2 s; TE = 30 ms; pepala lozungulira = 75; FoV = 192 × 192 mm2; kukula kwa matrix = 64 × 64; GRAPPA = 2). Munda wowonera udakhala m'malo molingana ndi mzere wa AC-PC wokhala ndi -30 °. Statistical Parametrical Mapping (SPM12, Wellcome department of Cognitive Neurology, London, UK; 2014) yakhazikitsidwa ku Matlab Mathworks Inc., Sherbourn, MA; 2012) idagwiritsidwa ntchito pokonzekereratu zaiwisi, komanso kusanthula gawo loyamba ndi lachiwiri.

Kukonzekereratu kwa zithunzi za EPI zomwe zidalembetsa ku Montreal Neurological Institute (MNI) template, magawo, kusintha ndi kusasunthika, kukonza nthawi, kukonza malo a MNI komanso kuwongola ndi kernel ya Gaussian pa 6 mm FWHM. Zambiri zantchito zidawunikiridwa ngati kuchuluka kwakutali pogwiritsa ntchito njira yaulere yogawa zinthu zosokonekera (Schweckenndiek et al., 2013). Voliyumu iliyonse yomwe idatuluka pambuyo pake idasinthidwa pambuyo pake modabwitsa (GLM) ngati regressor yopanda chidwi. Chimodzi mwazoyeserera (Cuevesi, CueControl, Cuepalibe, Kutumizavesi, Palibe Chidziwitsovesi, KutumizaControl, Palibe ChidziwitsoControl, Palibe Chidziwitsopalibe ndi chandamale) adayesedwa ngati regressor of interest. Ma regressor onse adakwaniritsidwa ndi mayankho a canonical hemodynamic reaction. Magawo asanu ndi limodzi osunthika adalowetsedwa ngati ma covariate kuphatikiza pa ma regressor a mavoliyumu omwe adapezeka. Nthawiyo idasefedwa ndi fyuluta yayikulu (nthawi zonse = 128 s).

Pa gulu, panali kusiyanasiyana kawiri: Cuevesi-KutiControl ndi Kutumizavesi-KuperekaControl. Chitsanzo chimodzi t-mayesero komanso kuphatikizika kwa mzere ndi zosintha zotsatirazi monga olosera zam'mbuyo adachitidwa ndi zotsutsana: s-IATkugonana, HBI, nthawi yogwiritsidwa ntchito zolaula (maola pamwezi), ndi TSMQ. Kwa TSMQ ndi HBI, kusunthika kambiri komwe kumakhala ndi zopezera nthawi imodzi kumachitika. Tidagwiritsa ntchito njira zowerengera nthawi yomwe timagwiritsa ntchito zolaula komanso s-IATkugonana.

Kusanthula kwa ROI pamlingo wa voxel kunachitika pogwiritsa ntchito kukonzanso kwakanthawi kochepa (SVC) ndi P <0.05 (cholakwika mwanzeru pabanja) chakonzedwa: FWE-chokonzedwa). Caudate, NAcc, putamen, dorsal anterior cingate cortex (dACC), amygdala, insula, OFC, ndi thalamus adasankhidwa kukhala ma ROI chifukwa adanenedwa kale m'maphunziro a cue reactivity ndi VSS processing (Ruesink & Georgiadis, 2017; Stoléru et al., 2012). Masks am'magawo amtundu wa ROI a OFC ndi DACC adapangidwa ku MARINA (Walter et al., 2003); Maski ena onse adatengedwa ku Harvard Oxford Cortical Atlas (HOC). Mitundu yakumanzere ndi kumanja ya ROI idalumikizidwa ku chigoba chimodzi. Kwa ma ROI asanu ndi atatuwa, kuwunika kwa voxel kunachitika ndi P <0.05 yokonzedwa ndi FWE.

Tinawerengera momwe mizere yamafunso komanso zolaula zimagwiritsidwira ntchito ku Cuevesi-CueControl Mosiyana ndi Kutumizavesi-KutumizaControl kusiyana. Ma voxels ofunikira (SVC, FWE-corrected) ma voxels ochokera pachitsanzo chimodzi t-Mayeso mkati mwa ma ROI omwe amagwiritsidwa ntchito ku SVC. Chifukwa chake, ma ROI ang'onoang'ono adagwiritsidwa ntchito poyesa kusanthula. Kafukufuku wathunthu wamaubongo (FWE-corrected) adawonjezera kuwunika kwa ROI.

Ethics

Kafukufukuyu adavomerezedwa ndi komiti yamakhalidwe abwino yakomweko ndipo idachitika malinga ndi chidziwitso cha 1964 cha Helsinki ndi zomwe zidasinthidwa pambuyo pake. Onse omwe atenga nawo mbali adapereka chidziwitso chodziwitsidwa asanawunikidwe. Dokotala wamaubongo analipo kuti afotokozere zovuta zomwe amakayikira za neuroanatomical.

Results

Zitsanzo za chitsanzo

Gulu 1 afotokozera mwachidule ziwerengero zofotokozera. Malumikizidwe amitundu iwiri pakati pamafunso omwe adafunsidwa adapereka kulumikizana kwamphamvu komwe kumawonetsa zonse zomwe zidakwaniritsidwa komanso magawo owonjezera amitundu yosiyanasiyana (onani Chith. 2).

Gulu 1.Kuyeza kwa ma psychometric ndi mavoti azakugonana ndikuwongolera makanema omwe amagwiritsidwa ntchito pantchito yochedwetsa kugonana (N = 73)

Kutanthauza (SD)zosiyanasiyana
s-IATkugonanaKutaya ulamuliro10.56 (4.66)6.00-30.00
Kukonda9.60 (3.44)6.00-26.00
s-IATkugonana malipiro onse20.16 (7.74)12.00-56.00
HBIControl14.86 (6.28)8.00-39.00
Kupirira17.92 (5.48)7.00-32.00
Zotsatira6.71 (2.81)4.00-20.00
HBIchiwerengero39.49 (11.48)20.00-90.00
TimePU [h / mwezi]6.49 (7.21)0.00-42.00
Mtengo wa magawo TSMQKugonana payekha3.74 (0.68)1.80-5,00
Kufunika kwa kugonana3.82 (0.74)1.27-5.00
Kufufuza zogonana1.50 (1.40)0.00-4.75
Poyerekeza ndi ena1.73 (1.10)0.00-4.33
Mtengo wa magawo TSMQmukutanthauza2.70 (0.69)1.05-4.35
Mavoti azokakamiza pakugonanaValence dzina loyamba6.35 (1.17)2.14-8.67
Kugonana6.63 (1.16)2.14-8.62
Mavoti azolamulira zoyesereraValence dzina loyamba5.51 (1.27)2.95-8.86
Kugonana2.01 (0.97)1.00-5.00

Zindikirani: s-IATkugonana = mtundu wafupipafupi wa Internet Addiction Test womwe udasinthidwa kukhala ma cybersex (Laier et al., 2013), HBI = Hypersexual Khalidwe Inventory (Reid et al., 2011), NthawiPU = Nthawi yogwiritsira ntchito zolaula; TSMQ = Mafunso Olimbikitsa Kugonana (Stark et al., 2015).

Fanizo la 2.
Fanizo la 2.

Kuphatikizika kwa mawonekedwe okhudzana ndi zosokoneza bongo (N = 73): s-IATkugonana ndi HBI = ziwerengero zonse zogwiritsa ntchito zolaula, TimePU = nthawi yogwiritsira ntchito zolaula mu h / mwezi; TSMQ = tanthauzo lofunikira pakulimbikitsa kugonana

Ndemanga: Zolemba Pazikhalidwe Zosokoneza JBA 2021; 10.1556/2006.2021.00018

Kuyesa kwa Kruskal-Wallis kunawonetsa kusiyana kwakukulu pakati pa nthawi yapakatikati poyankha poyang'ana pazomwe zachitika (Cuepalibe, kuControl, kuvesi; Χ2(2) = 12.05, P <0.01). Gulu 2 inafotokozera mwachidule ziwerengero zofotokozera zamachitidwe omwe adachitika munthawi ya SIDT. Mayeso omwe adachitika pambuyo pake (mayeso a Dunn-Bonferroni) adawulula kuti nthawi yakusintha kwa chandamale mu mkhalidwe wa Cuevesi idali mwachangu kwambiri kuposa momwe zimachitikira mu CueControl (z = 2.68, P <0.05, a Cohen d = -0.65) ndipo mkhalidwewo Cuepalibe (z = 3.35, P <0.01, a Cohen d = -0.82). Mosiyana ndi izi, nthawi zomwe zimachitika pazomwe zimalimbikitsidwa ndi zomwe Cue idachitaControl ndi ku Cuepalibe sizinasiyane kwambiri wina ndi mnzake (z = 0.59, P = 0.56). Palibe kulumikizana kwakukulu komwe kwapezeka pakati pazomwe zimachitika munthawi zitatuzi ndi zomwe zimaika pachiwopsezo cha CSBD (onse r <0.1, P > 0.10). Dziwanipalibe inatsatiridwa ndi mayankho 75 (4.89%) akusowa, CueControl inatsatiridwa ndi mayankho osowa a 51 (3.33%), ndi Cuevesi inatsatiridwa ndi 17 (1.11%) yomwe idasowa mayankho mwa onse omwe atenga nawo mbali.

Gulu 2.Ziwerengero zofotokozera zamomwe zimachitikira munthawi yakuchepetsa chilimbikitso pantchito (N = 73)

Mediya (SD)
Cuevesi235.11 (60.94)
CueControl296.63 (135.01)
Cuepalibe314.42 (158.64)

Zindikirani: CueNdime = kudziwa kulengeza kanema zolaula, CueControl = mukulengeza kanema wa massage, Cuepalibe = sakudziwitsa kanema.

Mayankho a Hemodynamic

Zizindikiro zosonyeza VSS poyerekeza ndi zikwangwani zosonyeza ziwonetsero zolimbitsa thupi zidapangitsa kuti magazi azikhala ndi mpweya wabwino (BOLD) ku NAcc, caudate, putamen, ndi insula (onse awiri), komanso ku DACC ndi thalamus yolondola. Kuyankha kwapamwamba kwa BOLD kunapezekanso kumanzere kwa NAcc ndi OFC, mgawo lamayiko awiri, putamen, DACC, insula, amygdala, ndi thalamus popereka ma VSS clip poyerekeza ndi zowongolera (zotsatira zonse onani Gulu 3 ndi Chith. 3).

Gulu 3.Zotsatira za ROI zotsutsana ndi Cuevesi-CueControl ndi Kutumizavesi-KutumizaControl (Chitsanzo chimodzi t-mayeso) ndi kukula kwa masango (k) ndi ziwerengero (kukonzedwa FWE; N = 73)

siyanitsanikapangidwembalixyzkTMaxPcorr
Cuevesi-CueControlNAccL-68-4778.71
R810-4657.50
zovutaL-81024499.66
R101444768.18
putamenL-168-27746.72
R24247667.42
dACCR1216361,69710.77
insulaL-341465929.43
R381446048.65
thalamusR8-202,1648.91
Kutumizavesi-KutumizaControlNAccL-814-8699.49
zovutaL-12-618564.24
R16-1622715.32
putamenL-1812-103146.58
R32-12-10637.28
dACCL-220289535.43
R44329539.19
amygdalaL-22-4-1623210.71
R20-4-1428012.20
insulaL-36-4145179.52
R382-164769.19
OFCL-644-182,82517.45
thalamusL-20-30-21,74725.67
R20-2801,74724.08
Fanizo la 3.
Fanizo la 3.

Zochita za ROI zotsutsana ndi Cuevesi-CueControl (A) ndi Kutumizavesi-KutumizaControl (B). Mizere pagawo la sagittal kumanja kumawonetsera magawo a coronal omwe amawonetsedwa kumanzere. Zomwe zikusonyeza VSS (Cuevesi) poyerekeza ndi zomwe zimawonetsa kutikita minofu (CueControl) idapangitsa kuti yankho LABWINO lapamwamba mu putamen, NAcc, caudate, ndi insula. Zithunzi za VSS (Kutumizavesi) poyerekeza ndi tatifupi la kutikita (KutumizaControl) idalimbikitsa kuyankha KWABWINO kwakukulu mu thalamus, insula, amygdala, putamen, ndi OFC. Zowonetsedwa t-miyeso yazunguliridwa t <5

Ndemanga: Zolemba Pazikhalidwe Zosokoneza JBA 2021; 10.1556/2006.2021.00018

Kusanthula konse kwa ubongo kudawulula mayankho apamwamba a hemodynamic mugulu lopitilira kuphatikiza magawo akulu aubongo wa Cue wosiyanayovesi poyerekeza ndi CueControl (Masango ochuluka k = 174,054 voxel) komanso kwa Kutumiza kosiyanakovesi poyerekeza ndi KutumizaControl (k = 134,654)

Zowopsa za CSBD ndi mayankho a hemodynamic

Palibe chilichonse chomwe chimawunikira kulumikizana komwe kulipo pakati pa zoopsa za CSBD (yodzinenera PPU, nthawi yomwe amagwiritsira ntchito zolaula, ndikuchita zachiwerewere) ndi zochitika zosankha za neural mu ROI iliyonse panthawi yomwe akuyembekeza (Cuevesi-CueControl) kapena gawo lotumiza (Kutumizavesi-KutumizaControl) zidabweretsa zovuta zilizonse. Chithunzi 4 imapereka mayanjano pakati pazifukwa zowopsa izi ndikumanzere kwa ma nucleus accumbens 'pachimake voxel.

Fanizo la 4.
Fanizo la 4.

Mgwirizano wapakati pa gawo lakumanzere la voxel ndi s-IATsex, HBI, nthawi yomwe mumagwiritsa ntchito zolaula mu h / mwezi (NthawiPU) ndi ziwerengero zonse za TSMQ panthawi yoyembekezera (mzere wapamwamba, NAcc [-6 8 -4]) ndi gawo lotumiza (mzere wapansi, NAcc [-8 14 -8]) wa Ntchito Yochepetsa Kuchepetsa Kugonana (N = 73)

Ndemanga: Zolemba Pazikhalidwe Zosokoneza JBA 2021; 10.1556/2006.2021.00018

Kukambirana

Cholinga choyamba cha lipotili chinali kufufuza momwe ubongo umagwirira ntchito panthawi yoyembekezera komanso gawo lotumiza VSS pachitsanzo chachikulu chosagwiritsa ntchito SIDT. Tidapeza kuti kuwonetsa makanema olaula komanso kuwonetsa zomwe zachitika makanema olaula zidayanjanitsidwa ndi zochitika zapamwamba zamaubongo m'malo omwe adakonzedweratu okhudzana ndi mphotho (NAcc, amygdala, OFC, putamen, caudate nucleus, insula, thalamus, ndi dACC) poyerekeza ndikuwonetsedwa kwamavidiyo osisita kapena mavidiyo am'mbuyomu, kutengera. Zotsatira zathu zikugwirizana ndi zomwe zapezedwa mu Sescousse neri Al. (2015, 2010), yemwe anayerekezera kuyankha kwa neural ku VSS komanso non-VSS stimuli (pano ndalama) zoyeserera mwa zitsanzo za amuna athanzi panthawi yolimbikitsanso ntchito. Ponena za kuyankha kwaubongo pazinthu za VSS, adapeza zochitika zapamwamba mu ventral striatum ndikuwonjezera kwamphamvu kwa mphotho. Pakubereka, adapezanso zochitika muubongo ku VSS gawo lina la OFC komanso amygdala amgwirizano. Kuphatikiza apo, adazindikira madera omwe amatenga nawo gawo pakupanga mitundu yonse yamalipiro (ventral striatum, midbrain, ACC, anterior insula).

Zotsatira zamakhalidwezi zidawonetsa kuti nthawi zomwe zidachitikazo zinali zofulumira kwambiri kuti zikwaniritse zomwe zimachitika pakakhala zolaula. Izi zikuwonetsa kuti chiyembekezo cha VSS chimayendetsa magalimoto, zomwe zimatsimikizira kufunikira kwakukulu kwa VSS.

Cholinga chachiwiri chinali kuwunika ubale womwe ulipo pakati pa mayankho a neural ku VSS komanso zomwe zikuwonetsa ku CSBD. Zomwe zimayikidwa pachiwopsezo zikuwonetsa kulumikizana kwamphamvu yapakati pakati pawo, kuwonetsa kufanana komanso magawo owonjezera a omwe akupanga. Palibe mafunso omwe amayesa PPU (HBI ndi s-IATkugonana), kapena kuchuluka kwa nthawi yomwe mumathera pa zolaula, kapena chilakolako chogonana (TSMQ) sizinagwirizane kwambiri ndi zochitika zamaubongo m'malo amubongo okhudzana ndi mphotho panthawi yobereka komanso kuyembekezera zachiwerewere.

Kuti mukambirane moyenera za kulumikizana komwe kulipo pakati pazifukwa zowopsa za CSBD ndi mayankho amitsempha ku VSS, ndikofunikira kufunsa zolemba zomwe zilipo kale zamaphunziro zomwe zimafanizira mayankho a neural a CSBD ndi omwe akutenga nawo mbali (njira yofanizira yamagulu) kapena kuwunika kulumikizana kwa zoopsa ya CSBD yokhala ndi mayankho a NAcc ku VSS (njira yolumikizirana). Kutsatira njira yofananizira pagulu, kafukufuku wina adapeza mayankho akulu ku VSS mu ventral striatum komanso madera ena olumikizidwa ndi mphotho mwa omwe ali ndi PPU poyerekeza ndi omwe akutenga nawo mbali (Gola et al., 2017; Seok & Sohn, 2015; Voon et al., 2014). Zotsatira zofunika za phunziroli mwa Gola et al. (2017) zinali zomwe zimaneneratu kuti VSS imalumikizidwa ndi zochitika zapamwamba kwambiri mwa omwe akutenga nawo gawo pa CSBD kuposa maphunziro athanzi. Pomwe Gola et al. (2017) adafufuza zakugonana zosakanikirana komanso zolimbikitsa kuchedwetsa paradigm ndi zithunzi za azimayi amaliseche monga zomwe zili, Klucken et al. (2016) adasanthula paradigm yokonda kukhathamiritsa yokhala ndi njira zowonekera. Zotsatira zake, adapeza zochulukirapo zochitika za amygdala panthawi ya CS + (onani kulosera za VSS) motsutsana ndi CS- (sananene chilichonse) mwa omwe ali nawo CSBD poyerekeza ndi omwe akutenga nawo mbali, koma palibe kusiyana mu ventral striatum. Mosiyana ndi izi, pakukondweretsedwa kwa paradigm ya Banca et al. (2016) Panalibe zovuta zamagulu pakati pa omwe akutenga nawo gawo pa CSBD ndikuwongolera omwe akutenga nawo gawo pazokhudza mayankho amitundu yosiyanasiyana (mitundu yakulosera zamtsogolo za VSS, mphotho zandalama kapena chilichonse).

Kafukufuku wotsatira njira yolumikizirana adawulula zotsatira zosagwirizana zokhudzana ndi kulumikizana pakati pazoyambitsa za CSBD ndi mayankho a neural ku VSS: Ngakhale Kühn ndi Gallinat (2014) adapeza kulumikizana kolakwika pakati pa nthawi yomwe amawononga zolaula ndi zochitika kumanzere putamen, Brand et al. (2016) sananene kuti pali kulumikizana kwakukulu kwamayankho a ventral striatum komanso nthawi yomwe amathera pa zolaula. Komabe, adapeza kuti ntchito ya ventral striatum idalumikizidwa bwino ndi mulingo wa PPU wodziyesa (woyesedwa ndi s-IATkugonana). Kuphatikiza apo, m'modzi mwamaphunziro athu am'mbuyomu sitinapeze chilichonse chofunikira chogwiritsa ntchito nthawi zolaula kapena kuchita zachiwerewere poyankha kwa VSS (Stark et al., 2019). Chifukwa chake, kafukufuku waposachedwa wokhudzana ndi kukonza kwa VSS m'mitu yomwe ili ndi zoopsa zingapo za CSBD zikuwoneka zosagwirizana. M'malo mopeza yunifolomu yamaphunziro ogwiritsa ntchito njira yofananirana kwamagulu koma zotsatira zosagwirizana kuchokera m'maphunziro olumikizana zitha kunena kuti kusintha kwa neural kwa VSS mu CSBD kumasiyana kwambiri ndi komwe kumakhala koyeserera. Lingaliro ili, komabe, ndilofunika kutengera Malingaliro Olimbikitsa Olimbikitsira a Robinson ndi Berridge (1993) zomwe zikusonyeza kuwonjezeka kwamayankho amanjenje pazinthu zomwe zimachitika pakukula kwa mankhwala osokoneza bongo. Pakadali pano, sizikudziwika ngati lingaliroli likugwira ntchito kwa CSBD ndipo ngati ndi choncho, ngati mayankho omwe akuwonjezeka ku VSS asintha pang'ono kapena ngati mkhalidwe wovuta kwambiri uyenera kupitilizidwa.

Chosangalatsa ndichakuti, komanso pazokhudzana ndi zosokoneza bongo zotsatira zakukhudzana ndi Chiphunzitso Cholimbikitsana sizikugwirizana. Kufufuza kwa meta zingapo kunawonetsa kuwonjezeka kwa cue reactivity mu mphotho ya mphotho (Kuthamanga, Eickhoff, Laird, & Hogarth, 2011; Kühn & Gallinat, 2011b; Schacht, Anton, & Myrick, 2012), koma kafukufuku wina sanatsimikizire izi (Engelmann et al., 2012; Lin ndi al., 2020; Zilberman, Lavidor, Yadid, & Rassovsky, 2019). Komanso pakukonda zamakhalidwe oyipa pamachitidwe opatsirana poyerekeza ndi maphunziro athanzi adangopezeka m'maphunziro ochepa monga afotokozedwera mwachidule pakuwunika kwaposachedwa ndi Antons, et al. (2020). Kuchokera pachidule ichi, mawu omaliza akuti kuzindikira kuti kuyambiranso kusokoneza bongo kumayendetsedwa ndi zinthu zingapo monga zinthu zina ndi zina pazaphunziro (Jasinska et al., 2014). Zomwe tapezapo pazokhudzana ndi kulumikizana pakati pa zochitika za striatal ndi zoopsa za CSBD zitha kukhalanso chifukwa chakuti ngakhale ndi zitsanzo zathu zazikulu titha kungoganizira zazing'ono zomwe zingakhudze. Maphunziro owonjezera akulu amafunikira kuti chilungamo chidziwike pazambiri. Potengera kapangidwe, mwachitsanzo, kusintha kwa malingaliro pazinthu zina kapena kudzisankhira pamalingaliro kungakhale kofunikira (Jasinska et al., 2014).

Malinga ndi kukula kwathu kwazitsanzo (mosiyana ndi maphunziro ena) sizokayikitsa kuti kusowa kwa mphamvu zowerengera kudapangitsa zomwe zapezeka pokhudzana ndi kulumikizana kwa zoopsa za CSBD ndi mayankho a neural ku VSS ndi ma VSS. Zowonjezerapo, kusunthika komwe kumachitika chifukwa cha kusinthika, komwe kumalimbikitsa kwambiri VSS kumathandizira magawo am'magulu okhudzana ndi mphotho mofananamo kusiya malo ochepa okha pazakusiyana (kutentha kwake). Lingaliro ili limathandizidwa ndi kafukufuku wosonyeza kuti palibe kusiyana kulikonse kwakugonana pakukonzekera kwa VSS mu netiweki yamalipiro (Poppl et al., 2016; Stark et al., 2019; Wehrum et al., 2013). Komabe, zifukwa zosagwirizana pakati pa maphunzirowa zimayenera kuwululidwa ndi maphunziro ena.

Zoperewera ndi malingaliro pakufufuza kwina

Zoyipa zingapo zimayenera kuganiziridwa. Pakafukufuku wathu tidangoyang'ana chikhalidwe chakumadzulo, amuna ogonana amuna kapena akazi okhaokha. Kubwereza kwa phunziroli ndi zitsanzo zosiyanasiyana pankhani ya jenda, malingaliro azakugonana, komanso zikhalidwe zina zimawoneka ngati zofunikira kuti zitsimikizire kutsimikizika kwachilengedwe. Kuphatikiza apo, zambiri zidachokera kuzitsanzo zosagwiritsa ntchito zamankhwala, maphunziro amtsogolo amayeneranso kulingalira za zitsanzo zomwe zimakhala ndi zisonyezo za CSBD. Zomwe zimagwiritsidwa ntchito phunziroli zidafotokozedwa ngati njira zopanda mbali popanda chilichonse chosiyana nacho m'mbuyomu. Komabe, mtengo wa njirayi ndi kutsimikizika kwamkati mwamphamvu ukhoza kukhala kusowa kwa zowona zakunja popeza zolaula zomwe zimachitika m'moyo watsiku ndi tsiku ndizopambana.

Cholepheretsa china ndi mayankho osinthika (patsiku / sabata / pamwezi) pokhudzana ndi kuwunika kwa zolaula. Malinga ndi Schwarz ndi Oyserman (2001) mayankho amafunso omwewo ndi ochepa poyerekeza pomwe mayankho amatanthauza nthawi zosiyanasiyana. Chifukwa chachikulu chosankhira mayankhidwewa chinali chakuti kuchuluka kwa zolaula zomwe zimagwiritsidwa ntchito mu zitsanzo zimatha kusiyanasiyana (kuyambira maola ochepa pachaka mpaka maola angapo patsiku). Kuphatikiza apo, zimawoneka kuti ndizofunikira kuti mayankho okhazikika atha kukhazikitsa chizolowezi chazomwe zolaula zimagwiritsidwa ntchito moyenera. Chifukwa chake, tidaganiza zogwiritsa ntchito mayankho osinthika pamafunso apamtimawa, ngakhale anali ofooka.

Kuphatikiza apo, labotale imayimira malo opangira, popeza zolaula zimagwiritsidwa ntchito tsiku ndi tsiku nthawi zambiri zimaphatikizana ndi maliseche. Chifukwa chake, sizikudziwika ngati mphothoyo imachokera ku maliseche / maliseche komanso / kapena zolaula. Gola et al. (2016) adatsimikiza motsimikiza kuti zachiwerewere zitha kukhala zopindulitsa komanso zabwino. Ngati makanema olaula amamasuliridwanso kuti ndi malingaliro, maphunziro amtsogolo atha kuloleza kuseweretsa maliseche kuti chizindikiritse gawo loyenera. Komabe, zovuta zamakhalidwe ndi ukadaulo ziyenera kuganiziridwa pochita kafukufukuyu. Kuti mumvetsetse bwino kukula kwa CSBD, maphunziro omwe amafotokoza za CSBD (zathanzi, zamankhwala, zamankhwala) ndizofunikira.

Mawuwo

Kafukufuku wathu adasanthula momwe ma cue ndi ma VSS amagwiritsira ntchito SIDT muzitsanzo zazikulu zosagwiritsa ntchito mankhwala. Kuphatikiza apo, SIDT yathu yosinthidwa imathandizira SIDT yapitayi pogwiritsa ntchito makanema m'malo mwa zithunzi zosasunthika, pogwiritsa ntchito makanema otikita ngati olamulira m'malo mwazithunzi, komanso pogwiritsa ntchito zomwe sizikhala ndi chidziwitso chogonana. Tidatha kubwereza zomwe zikuwonetsa kutengapo gawo kwa mphothozo pakupanga kwa cues ndi VSS. Mosiyana ndi malingaliro athu, sitinathe kuzindikira zovuta zamakhalidwe athu omwe amaganiziridwa ngati zoopsa pakukula kwa CSBD pamayankho amitsempha mu ROI iliyonse yolumikizidwa ndi dongosolo la mphotho. Kafukufuku wamtsogolo akuyenera kuwunika zizindikilo zonse za CSBD kuti amvetsetse bwino momwe zolaula zimagwiritsidwira ntchito m'makhalidwe oyipa komanso zomwe zitha kuneneratu za izi.