Togafitiga mo vaisu i luga o le initaneti, vaisu i feusuaiga ma le faatauanau faatau: O se meta-auiliiliga (2020)

Volume / Mataupu: Volume 9: Mataupu 1

tusitala: Martina Goslar¹, Max Leibetseder¹, Hana M. Muench², Stefan G. Hofmann³ ma Anton-Rupert Laireiter^{1 , 4}

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

lē faʻatino

Faʻamatalaga ma sini

O mea ua fai ma vaʻaiga i luga ole initaneti, o fai ma vaʻaiga tau feusuaiga ma le faʻatau faamalosi o ni masani masani o amioga, e tutusa o latou uiga i le taʻaloga ma le tele o mea faʻaaoga. Peitaʻi, e leʻo iloa tele e uiga i le aoga oa latou togafitiga. O le mafuaʻaga o lenei meta-auiliiliga o le suʻesuʻeina o le aoga o togafitiga o ia faʻafitauli amioga, ma le tutusa o le taʻaloga faʻafitauli ma vailaau faʻaaoga i tulaga o togafitiga tali atu.

Metotia

O le suʻesuʻega o tusitusiga na maua ai 91 suʻesuʻega atoa 3,531 tagata auai e faia ai se aotelega o le lelei o le vaʻai ma taimi uʻumi o le aoga o le mafaufau, faʻafomai ma tuʻufaʻatasiga mo togafitiga o vaʻaiga i luga o le initaneti, vaisu o feusuaiga, ma faʻatau faamalosi.

i'uga

Togafitiga o le mafaufau, vailaʻau, ma togafitiga tuʻufaʻatasia na fesoʻotaʻi ma le faʻamalosia o le muaʻi maeʻa faʻaleleia i le lalolagi atoa ogaoga o vaisu i luga o le initaneti (Hedges's g: 1.51, 1.13, ma le 2.51, faʻatulagaina) ma vaisu i feusuaiga (Hedges's g: 1.09, 1.21, ma le 1.91. ). Mo faʻatauga faʻatauga, mafaufau ma vailaʻau faʻafomaʻi togafitiga na fesoʻotaʻi foʻi ma le tele-tele muamua-meli faʻaititia o le lalolagi faigata (Hedges's g: 1.00 ma 1.52, faʻatulagaina). O le puleaina muamua-meli ma totonu-kulupu muamua-tulitatao aafiaga tele sa i le tutusa laina, ma ni nai tuusaunoaina. O faʻataʻitaʻiga a le au suʻesuʻe e faʻapea e aoga le faʻagaioia o le mafaufau mo le faʻaititia o amioga mataga, ae maise pe a faʻafesagaʻi ma faʻatautaia i taimi uumi. O le tuʻufaʻatasia o mafaufauga-amioga faʻatino auala ma vailaʻau faʻaalia le sili atu nai lo monotherapies.

Talanoaga ma Faaiuga

O iʻuga ua faʻailoa mai o togafitiga mo masani masani mausa e aoga i se taimi puʻupuʻu, faʻapena foʻi ma togafitiga mo gaioiga o faʻafitauli ma vailaʻau o loʻo faʻaaogaina, ae manaʻomia ni faʻataʻitaʻiga faigata tele.

O ni suʻesuʻega sa faia lata mai ua iloa ai ni mea tutusa i le va o vailaʻau faʻaaoga (SUDs) ma amioga e fai ma vaisu (BAs; faʻataʻitaʻiga, Grant, Potenza, Weinstein, & Gorelick, 2010). O le mea lea, o mea e le faʻatatau i amioga ua fai ma vaisu ua uma ona faʻamatalaina e faʻavae i luga o tulaga mo mea e faʻaaogaina ua faʻamaoti mai i le Diagnostic and Statistics Manual of Mental Disorders (DSM IV; American Psychiatric Association, 1994) e aofia ai le popolevale i amioga faʻapitoa, le le mafai ona pulea le amio, faʻapalepale, aveese, ma le faia pea o amioga e ui lava i mea le lelei (e pei o, Grant et al., 2010). Ile taimi nei, naʻo taaloga faitino (GD), na saofaʻi i lalo o le "Impulse-Control Disorders Not Not Another Classified" i le DSM IV (American Psychiatric Association, 1994), ua faʻavasegaina i lalo o le vaega fou “O vailaau faʻatatau i mea ua fai ma vaisu”O le DSM-5 (American Psychiatric Association, 2013). O lenei toe faʻatulagaina ua faʻaosofia ai le tele o felafolafoaʻiga e tusa pe sili atu amioga ma le faʻaititia o lagona puleaina e tatau ona mafaufauina o ni sui talafeagai mo BA (eg, Grant et al., 2010; Mueller et al., 2019).

E ese mai le GD, internet gaming disorder (IGD) e na o le pau lea o le tulaga o loʻo tuʻuina i le DSM-5 i lalo o le Vaega III ma le fautuaga mo nisi suʻesuʻega (American Psychiatric Association, 2013). Lagolagoina e tagata atamamai mai eseese fomai ma lautele soifua maloloina vaega (eg, Rumpf et al., 2018; Saunders et al., 2017), taʻaloga faʻaletonu ua mafaufauina foi i le ata tusia o le ICD-11 (Faalapotopotoga o le Soifua Maloloina a le Lalolagi, 2018). E taua le maitauina o IGD e tatau ona faʻaeseese mai le tulaga o le initaneti ua fai ma vaisu i luga ole initaneti (IA), ona o loʻo avea uma ma sui eseʻese fale. Griffiths & Pontes, 2014; Kiraly et al., 2014). Peitai, talu ai tele lomiga e faasino i le lalolagi IA, o lenei vaitaimi na vaetamaina mai foi i lenei pepa. E le gata i lea, e tatau ona faia se eseʻesega i le va o "taʻaloga" ma le "taaloga faitupe": E ui lava o le "taʻaloga taʻutaʻua ua faʻamatalaina e lona fegalegaleaiga, o le mea e masani ona faʻatatau i le tomai, taʻaloga, ma le faʻailoga i tulaga o le alualu i luma ma le manuia, ... taʻaloga ua faamatala mai e ala i le betting ma wagering mechanics, sili atu avanoa fuafuaina-taunuʻuga, ma faʻamanuiaga faʻapitoa aofia ai aʻafia ma totogi atu i le tagata taalo. " ((Tupu, Gainsbury, Delfabbro, Hing, & Abarbanel, 2015, i. 216).

E ui o le aofia ai o le IGD i tusi lesona faʻamaʻi e soalaupuleina finauga i le faasaienisi tusi (Tupu et al., 2019; Petry, Rehbein, Ko, & O'Brien, 2015; Rumpf et al., 2018; Saunders et al., 2017), tele suʻesuʻega ua uma ona faia i luga o le IA ma le IGD, ae maise i neurobiologics faiga e faʻatatau ai le tutusa i le SUDs (mo iloiloga vaʻai Fauth-Buhler & Mann, 2017; Kuss, Pontes, & Griffiths, 2018). E ese mai mea tutusa i le va SUDs ma BA i tulaga o uiga faʻamaonia ma uiga masani, faʻamalositino ma talaʻaga o aiga, aemaise sailiiliga mai le neuroscience suʻesuʻega foliga taua mo le faailoaina o faʻailoga o amioga fai ma vaisu (eg, Grant et al., 2010; Potenza, Sofuoglu, Carroll, & Rounsaville, 2011).

E tusa ai ma lenei iloiloga, o nisi o alualu i luma i le suʻesuʻega o mea masani o le neurobiologic ma SUDs ua ausia talu ai nei i totonu o le itupa o feusuaʻiga vaisu (SA) ma le faʻatau faamalosi (CB) e ala i le auiliiliga o mea masani na suʻesuʻeina masani i le SUD pei o faʻatonutonu gaioiga (e pei o, Hoffmann, Goodrich, Wilson, & Janssen, 2014; Snagowski, Laier, Duka, & Brand, 2016), fai se mea e faʻaalia ai, faʻaalia le faʻaaloalo ma fesoʻotaʻiga faʻailogaina neural (eg, 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; Trotzke, Starcke, Pedersen, & Brand, 2014; Trotzke, Starcke, Pedersen, Müller, & Brand, 2015; Voon et al., 2014), poʻo galuega faʻatino (Derbyshire, Chamberlain, Odlaug, Schreiber, & Grant, 2014; Messina, Fuentes, Tavares, Abdo, & Scanavino, 2017; Raab, Elger, Neuner, & Weber, 2011; Trotzke et al., 2015). O nei suʻesuʻega na faʻaalia ai o loʻo i ai na tulaga e leʻi aloaʻia aloaia i le DSM-5 o ni BA, o loʻo iai nei faʻamaoniga e faatatau i faʻailoga o le neurobiologis mo mea e tutusa ai amioga i le va o mea e fesoʻotaʻi ma mea e leai ni vailaʻau. ma CB, o loʻo avea ma manulauti o le pepa lea ua i ai nei. Talu ai o nei faʻafitauli e fomaʻi taua, ma e tele lava ina fesoʻotaʻi ma iʻuga leaga e aʻafia mo tagata aʻafia (eg, Pontes, Kuss, & Griffiths, 2015), manaʻomia togafitiga suʻesuʻe (e iai, Grant et al., 2010). I le taimi nei, lomia meta-auiliiliga muamua faia e tusa ai ma IA faʻamaonia le aoga o le tele o togafitiga togafitiga (Chun, Shim, & Kim, 2017; Liu, Liao, & Smith, 2012; Winkler, Doersing, Rief, Shen, & Glombiewski, 2013). Lua o meta-auiliiliga na iloiloina le mafaufau, pharmacological ma tuʻufaʻatasiga o gaioiga uma e lua, ae o le faʻamaoniga na faʻatapulaʻaina i togafitiga o taunuʻuga o suʻesuʻega i Saina (Liu et al., 2012), ma Korea (Chun et al., 2017). O le suʻesuʻega sili o le meta-analytic na lagolagoina le faʻamaoniga o le aoga o le psychotherapy ma togafitiga faʻafomai e faʻaititia ai faʻailoga o le IA e aofia ai faʻafitauli mai Asia ma sisifo atunuu (Winkler et al., 2013). O gaioiga faʻatasia, e ui i lea, sa le iloiloina. Ma le isi, o le meta-iloiloga o Winkler et al. (2013) e leʻi aofia ai ni suʻesuʻega talu ai nei.

O iʻuga lelei mo faʻalavelave ole mafaufau ma vailaʻau i le faʻaititia o le ogaoga o le CB o loʻo maua foi i se isi faʻataʻitaʻiga lata mai nei (Hague, Hall, & Kellett, 2016). Ae ui i lea, o le aʻafiaga o suʻesuʻega lelei ma isi faʻataʻitaʻiga i iʻuga o togafitiga e leʻi suʻesuʻeina. O le mea lea, o loʻo faʻatali pea se suʻesuʻega maeʻaeʻa o togafitiga mo IA ma CB. E ui lava o SA o loʻo mafaufauina ile ICD-11 ma le faaupuga "faʻamalosia amioga faʻafeusuaiga faʻaletonu" (Faalapotopotoga o le Soifua Maloloina a le Lalolagi, 2018), ma "lagona faʻaalia maia o vaisu i vaisu i ponokalafi e le masani ai" (Grubbs, Kraus, & Perry, 2019, itu. 93), togafitiga mo SA e leʻi faʻataʻitaʻia e metotia-auiliili metotia. Ma le isi, e leai ni faatusatusaga na faia i le va IA, poʻo IGD - o se sui tauva mo le vaega "O vailaau faʻatatau i mea ua fai ma vaisu”O le DSM - ma isi atonu e fai ma vaisu amioga, pei o le SA ma le CB, faʻatatau i le tali atu i togafitiga, lea e manatu o se faʻailoga taua mo le tutusa i le va SUDs ma BAs (eg, Grant et al., 2010).

O le mea muamua na faʻataua nei meta-suʻesuʻega, o le mea lea o le suʻesuʻeina o le aoga o mea faʻafomaʻi, vailaʻau faʻafesoʻotaʻi ma tuʻufaʻatasiga o aʻafiaga mo le IA, SA, ma le CB mo le faʻaititia (a) o le tulaga faigata o le lalolagi ma le amio na faʻatino ina ua maeʻa togafitiga (aʻafiaga mo taimi pupuʻu) ma i le taimi mulimuli na lipotia o le toe tulitatao (taimi uumi o aʻafiaga). Faʻavae i mea na maua i iloiloga lata mai (Hague et al., 2016; Winkler et al., 2013), matou faʻamoemoe o le mafaufau ma faʻafomai togafitiga e tutusa lelei i isi vaega o vaisu e tolu. Sa matou faʻamoemoe foʻi o taunuʻuga togafitiga e tutusa ma tulaga ua lipotia mo vailaʻau faʻaaoga ma taaloga faitupe (Grant et al., 2010; Potenza et al., 2011). I se faʻaopopoga, o la matou sini o le faʻailoa lea o tagata gafatia faʻatonutonu o auga tele i totonu o vaisu taʻitasi. O le faʻatautaia-iloiloga na faia e tusa ai ma fautuaga a le PRISMA Statement (Moher, Liberati, Tetzlaff, & Altman, 2009).

Metotia

Tulaga e agavaa ai

Suesuega na iloiloina mo le aofia ai pe a latou (1) faʻaaogaina soʻo se ituaiga o mafaufau, faʻafomai, poʻo tuʻufaʻatasiga (faʻataʻitaʻiga, fesoasoani faʻalemafaufau ma pharmacological faʻaaogaina i le taimi e tasi); (2) faʻaaogaina i totonu o le kulupu, faʻataʻapeʻapeina, poʻo le tele-faʻapitoa faʻataʻitaʻiga suʻesuʻega o suʻesuʻega e aofia ai faʻatali lisi-lisi, tagata auai le mauaina togafitiga, isi togafitiga malosi, poʻo se placebo faʻamasinoga; (3) togafitia tagata auai i le suʻesuʻeina o IA, SA, poʻo le CB; (4) fuaina a itiiti mai se tasi o le taunuʻuga taunuʻuga (ie, globality mamafa poʻo taimi); ma (5) lipotia lava fuainumera faʻamaumauga mo taunuʻuga tele aofaʻiga. Na le aofia suʻesuʻega pe a fai (1) o le suʻesuʻega e tasi le suʻesuʻega o mataupu; (2) o le suʻesuʻega o le faʻataʻitaʻiga na faʻaalu uma i le faʻataʻitaʻiga o se isi suʻesuʻega na aofia i le meta-iloiloga; (3) e le i faamatalaina le togafitiga, poʻo (4) e leai se faʻamatalaga poʻo atoa tusitusiga o le suʻesuʻega na maua. Ile faʻaaloalo ia SA, matou na aofia ai suʻesuʻega o loʻo suʻesuʻeina ni amioga tau feusuaiga mulimuli mai le faʻamatalaga na fuafuaina e KIFKA (2010), ma faʻateʻaina suʻesuʻega e faʻataʻitaʻia togafitiga o paraphilias e ese mai i le SA i le tulaga o "sosaiete faʻaalia poʻo 'eseʻesega' ituaiga o feusuaiga faʻatagaina" (Kafka, 2010, i. 392).

Faʻamatalaga faʻamatalaga ma tusitusiga suʻesuʻe

Na matou faia le suʻesuʻega tusi e tele mai le faʻamatalaga e faʻaaoga ai faʻamaumauga o PsycInfo, Medline, PubMed, Psyndex, ma ISI Web of Knowledge. O le suʻesuʻega na aofia uma ai faʻamatalaga talafeagai mai le muamua avanoa i le tausaga nei ia Iuni 30, 2019 faʻaaogaina ai mea nei e uiga i faʻalavelave e fesoʻotaʻi: Upega tafaʻilagi i totonu o le initaneti, fai ma vaisu i luga o le initaneti ∗, faʻafitauli i luga o le initaneti, taʻaloga taʻavale i luga ole laiga ∗, mea fai meaʻai vaisu ∗, vaʻavaʻai vaisu ∗, mea fai meaʻai i mea tau komipiuta ∗, tagata fai meaʻai mea fai ma vaisu ∗, telefoni feaveaʻi social, sosaiete faʻasalalauga vaisu ∗, facebook fai ma vaisu ∗, faʻafitauli ∗ telefoni feaveaʻi; feusuaiga ∗ fai ma vaisu ∗, feusuaiga ∗ faamalosi ∗, feusuaiga ∗ le faʻamalosia ∗, hypersex ∗, nonparaphilic sex ∗, paraphilia-fesoʻotaʻi faʻalavelave ∗; faʻatau faamalosi, faʻatau le fiafia ∗, oniomania, shopaholic ∗, overshopping faʻatasi ma le fesoʻotaʻiga-fesoʻotaʻi 'upu taua togafitiga, faʻalavelave, togafitiga, psychotherapy. O upu saʻo na faʻaaogaina ai e suʻe ai le ProQuest Digital Dissertations mo faʻasalalau e leʻi faʻasalalauina, lanu efuefu. Mulimuli ane, sa matou faia se auiliiliga o le faasinomaga lisi o toe iloilo tusitusiga, meta-auiliiliga, ma uluai suesuega maua mai i le nofoaga autu o faamatalaga. E le gata i lea, o tusitala o tala talafeagai na faʻafesoʻotaʻi e fesili mo le leiloa o faʻamatalaga ma / poʻo pepa e leʻi faʻasalalauina e talafeagai mo le aofia i totonu o le faʻataʻitaʻiga. O lomiga a Saina na faaliliuina e le au gagana moni e toalua ma le aʻoaʻoga.

Fua faʻatatau

I le maeʻa ai o tulaga masani na lipotia fua faatatau i uluaʻi suʻesuʻega, sa matou faamaʻotiina tulaga eseese e lua e iloa ai le faʻaititia o faʻailoga masani: fuainumera o itula faʻaalu i luga ole lugalaina, ponokalafi matamata, poʻo le numera o le faʻatauina o mea na tupu i le vaiaso mulimuli poʻo le masina)

Filifiliga suʻesuʻe

Suesueina filifiliga na faia e ni tutoatasi tutoatasi (o le muamua ma le lona lua tusitala, MG ma ML), ma vaʻavaʻaia e le tusitala mulimuli o lenei pepa (AL). O feeseeseaiga i le va o tusitala na foia e ala i talanoaga.

Faʻamaumauga o faʻatatauga ma le puʻeina o faʻamatalaga

Sa matou fausiaina se faʻatulagaina o faʻamatalaga faʻasaʻoina le laupepa matou te toe faʻaleleia ma suia ina ua uma ona faʻataʻitaʻi le pailate i se faʻataʻitaʻiga o 10 suʻesuʻega. Ina ia fuafuaina muamua-meli ma muamua-mulimuli-i totonu-vaega vaega aafiaga tele, fuainumera faamatalaga na aumaia mo tulaga togafitiga ma taunuuga ese. Afai eseese suʻesuʻega mataupu tau le mafaufau poʻo le pharmacological suʻesuʻeina i totonu o se tasi suʻesuʻega, faʻamaumauga mo tulaga taʻitasi na tusia eseese ma aofia ai i totonu o le-vaega aafiaga fua mo fuainumera auiliiliga. Ina ia fuafuaina mea na muamua faʻatonutonu le faʻaaogaina tele, faʻamatalaga mai le lisi faʻatalitali, leai ni togafitiga, ma le vaega pule faʻapipiʻi sa aofia ai. E le gata i lea, matou te aumaia le numera ma faʻavasegaina faʻamatalaga mai i suʻesuʻega uma ina ia mafai ona faia ni auiliiliga auiliiliga. O faamatalaga na aveeseina na faia e le tusitala muamua (MG), ma na faamaonia e le tusitala lona lua (ML). Le faʻatulagaina o le tutoatasi tutoatasi lua taulai atu i le ituaiga o togafitiga, le fuaina o taunuʻuga suiga, ma le faʻamoemoeina ma le faʻamaoniaina o le faʻaletonu-faʻapitoa suʻesuʻega. Peitai, i suʻesuʻega, o mea lava ia e tasi sa faʻaaogaina e le gata i le suʻesuʻeina o faʻaletonu e faʻatatau i suʻesuʻega faʻapea foi le fuaina o le fesuiaʻiga o le mea e tupu i le taimi o togafitiga. Talu ai o le tulaga o le talitonuina ma faʻamaoni ai mea faigaluega na faʻaaogaina mo le fuaina o taunuʻuga o fesuiaʻiga sa avea foi o se vaega o le faʻatulagaina o le tulaga lamatia o faʻaituau i suʻesuʻe taʻitoʻatasi (vaʻai i lalo), o le faʻatatauina faʻatatauina aofaʻi i le fuainumera kappa na faia naʻo le ituaiga o togafitiga.

Auga o le faʻaituau i suʻesuʻe taʻitoʻatasi

Sa matou iloiloina le moni o totonu o suʻesuʻega uma le faʻaaogaina o le Quality Assessment Tool mo Quantitative Studies, atiae e le Effective Public Health Practice Project (EPHPP) (Tomasi, Ciliska, Dobbins, & Micucci, 2004). O lenei meafaigaluega ua faʻaalia ai mea ma fausia lelei (Thomas et al., 2004) ma ua fautuaina mo iloiloga faʻapitoa ma meta-auiliiliga (Deeks et al., 2003). O suʻesuʻega taʻitasi sa fuaina i se tulaga faʻapitoa i luga o itulagi ono: filifiliga faʻaituau, suʻesuʻega filifiliga, faʻailoaina ma le faʻatonutonuina o faʻafitauli, faʻasoasoaina, faʻatuatuaina ma le faʻamaoniaina o aoina mea faigaluega meafaigaluega, ma le lipotia ma pasene o le aveeseina ma ua lafoai. O vaega taʻitasi sa iloiloina e malosi, feololo, pe vaivai. Ole tulaga ole lalolagi na faʻatulagaina pe a maeʻa iloiloga o itulagi e ono. O tusitala muamua e lua (MG ma ML) tutoatasi iloilo suʻesuʻega taʻitasi ma fuafuaina le tulaga lautele o taʻitasi o faamasinoga. Na faʻamatalaina le faʻatatauina a le Interrater i le faʻaaogaina o le kappa statistic. O feeseeseaiga i le va o tusitala na foia e ala i talanoaga seia oo ina maua se maliega.

Aafiaga tele o faʻatusatusaga ma fuainumera faʻamatalaga tuufaatasia

Faʻamatalaga fuainumera faʻatino na faʻaaogaina le polokalama polokalama Comprehensive Meta-Analysis (CMA) version 2.2.064 (Borenstein, Hedges, Higgins, & Rothstein, 2005). I totonu o vaega taʻitasi o mea ua fai ma vaisu, na matou fuafuaina ai le tele o faʻatonuga mo fesuiaʻiga o taunuuga na lipotia mai i le mafaufau, vailaʻau, ma le tuʻufaʻatasia o suʻesuʻega eseese mo totonu-vaega ma faʻatonutonuina suʻesuʻega (vaʻai Faʻaopopoga mo metotia). Ona o laʻititi faʻataʻitaʻiga, na faʻasaʻoina ai le lapopoʻa o mea na tutupu mo le faʻaituau i le faʻaaogaina o Pa g faʻatasi ai ma le 95% mautinoa vaitaimi (CI; Hedges & Olkin, 1984). Afai e le avanoa ni auala ma ni faʻavae eseʻese, e fua aofaʻi o fua faatatau e faʻavae i luga o tuutuuga faʻatatau metotia (eg, t faʻatauga, poʻo le saʻo tulaga e ono tupu). Afai o se fesuiaʻiga o taunuʻuga na fuaina e sili atu ma le tasi mea fai mea, o faʻamatalaga mai i nei mea faigaluega na tuʻu faʻatasi ma tuʻufaʻatasia faʻatasi mo le fesuiaʻiga o le taunuʻuga (Lipsey & Wilson, 2000). Mo suʻesuʻega lipotia faʻamatalaga faʻavae i luga o uma maeʻaeʻa ma faʻamoemoe-e-togafiti (ITT) auiliiliga, o le ITT faʻamaumauga na amanaʻia. O le faʻatonuga o le aʻafiaga na toe fetuʻunaʻi e tusa ma le "manuia": o le aoga tele na lelei pe a fai o le vaega togafitia faia sili atu nai lo le kulupu pulea. E tusa ai ma fautuaga a Cohen (1977), aofaʻi 0.20 i le 0.30 e mafai ona faavasegaina laʻititi, oi latou e latalata i le 0.50 e ogatotonu, ma i latou o loʻo i luga o le 0.80 tele.

I le le talitonuina o le eseese o nei suʻesuʻega, na matou filifili ai e faʻaaoga le faʻataʻitaʻiga o mea e masani ai mo le tuʻufaʻatasia o le tele o auga. O le eseese o le aʻafiaga sa suʻesuʻeina faʻaaogaina le fuainumera Q ma le tutusa p aoga, ma le I² faʻamaumauga, faʻaalia ai pe o le a le tulaga moni eseʻesega i aafiaga tele na atagia mai i le fua faatatau o le eseese (Borenstein, Hedges, Higgins, & Rothstein, 2009; Higgins, Thompson, Deeks, & Altman, 2003); I² 25%, 50%, ma 75% faʻatulagaina e maualalo, feololo ma maualuga maualuga.Higgins et al., 2003).

Auga o le faʻaituau i suʻesuʻega

Ina ia faʻatonutonu le lolomiga faʻasalalau, na matou faia se suʻesuʻega maeʻaeʻa ma faʻamaonia le le saogalemu a Rosenthal N (Rosenthal, 1979) ma sa suʻesuʻe foi poloka faʻataʻitaʻiga (Duval & Tweedie, 2000). Ae faimai foi Rosenthal (1991), aofaʻiga fua e faʻapea e malosi pe a fai o le numera o suʻesuʻega manaʻomia e maua ai se leai taua taua atoa sili atu nai lo 5k + 10, i le mea k faatusa i le numera o suesuega. Ma le isi, matou faʻaaoga le trim-and-fill metotia (Duval & Tweedie, 2000) faatatauina o loʻo misi suʻesuʻega ma a latou aʻafiaga ile fua faatatau o taunuʻuga. O lenei auala e faʻavae i luga o le mafuaʻaga o le faʻasologa agavaʻa ma faʻapea o se tuʻufaʻatasia o tufatufaina o le tele fua mo faʻaiuga suia i le leai o faʻasalalauga faʻaituau. I le tulaga o asymmetrical tufatufaina, o le teuteu-ma-faʻatumu metotia fetuunai ma faʻasaʻoina le tele fua (Borenstein et al., 2009); naʻo matou faʻaaogaina lenei metotia peʻafai e 10 suʻesuʻega na avanoa mo le saʻiliʻiliga (Sterne, Egger, & Moher, 2011). Funnel plot asymmetry na iloiloina e ala i le faʻaaogaina o le Egger's test (Egger, Smith, Schneider, & Minder, 1997). A o se tasi tulaga ogaoga aafiaga tele fua faatatau faʻasesega faʻauiga o togafitiga togafitiga (Lipsey & Wilson, 2000), na matou faʻaaogaina le metotia “tasi-suʻesuʻega-aveʻese” na ofoina mai e CMA e suʻesuʻe ai le aʻafiaga o suʻesuʻega o le tele o le aʻafiaga o le aotelega o aʻafiagaBorenstein et al., 2005). Afai e leʻi aʻafia tele fua faʻaiuga na aʻafia ai le fua o le aafiaga ma nofo ai pea i le 95% CI, o loʻo taofia suesuega i suʻesuʻega.

Moderator auiliiliga

Ina ia faʻamatalaina le le mautonu i le va o mea tetele, na matou suʻesuʻeina le ituaiga faʻamaumauga o faʻamaumauga (ITT vs. faʻataʻitaʻiga faʻataʻitaʻiga), ma le tulaga lelei o suʻesuʻega (EPHPP lalolagi faʻailoga) o ni soʻo se pule. Talu ai o le atuatuvale ma le atuatuvale na maua e iai ma BAs (eg, González-Bueso et al., 2018; Starcevic & Khazaal, 2017), sa matou suʻesuʻe pe o le tele o auga e fesuiaʻi o se galuega a nei mea na tutupu-faʻaletonu (aofia ai ma le le aofia ai o le atuatuvale ma / pe popole). Talu mai le tulai mai o faʻafitauli, aemaise o le faʻanoanoa ma le popole, e sili ona taatele i tagata tagata aʻafia i le BAs (Starcevic & Khazaal, 2017), suesuega na le mafai ona lipotia faʻamatalaga i tulaga o le comorbid na manatu e aofia ai tagata auai ma le oʻo mai o le atuatuvale ma popolega. Mo suʻesuʻega o le mafaufau, matou te suʻesuʻeina le auala o togafitiga (faʻavasegaina o vaega ma faʻatatau i tagata taʻitoʻatasi ma isi ituaiga o faʻatulagaga [faʻataʻitaʻiga, tagata ma le faʻavasegaina o seti, aiga faʻatulagaina]), le faiga o faʻaoʻo atu (faafesagaʻi ma foliga [FTFTs] vs. au lava-faʻataʻitaʻi togafitiga [SGTs]), ma le ituaiga o faʻalavelave ole mafaufau. O le ituaiga o faʻafitauli o le mafaufau e faʻatinoina e ala i le vaevaeina o mafaufauga o le mafaufau i vaega nei: (1) CBT, e aofia ai le malamalamaaga ma / poʻo amioga faʻatautaia; (2) fesoʻotaʻiga tuʻufaʻatasia e aofia ai le tele o eseʻesega o togafitiga, ma le (3) togafitiga o le mafaufau lea e faʻatatau i isi vaega, pei o aiga, faʻataʻitaʻiga moni, talia o le taliaina ma le taofiofia togafitiga, poʻo le fofo togafitiga. I le manatu faapea o le tele o suʻesuʻega na faia i atunuu e le i sisifo, aemaise lava mo IA, sa matou mulimulitaʻi i se muamua meta-faʻataʻitaʻiga (Winkler et al., 2013) ma suʻesuʻe pe o le aganuu pito i tua (Asia ma isi atunuʻu) na faʻamaonia ose tulaga faʻapitoa. Talu mai le lalolagi IA ma IGD fai ma sui eseese o fausaga (eg, Griffiths & Pontes, 2014), matou suʻesuʻe foʻi eseʻesega i le va o suʻesuʻega e faʻavae i luga o le lalolagi IA ma i latou, na suʻesuʻe le IGD ma isi gaioiga i luga o le initaneti (e pei o mea ua fai ma vaisu o le telefoni, vaisu videogame).

Mo togafitiga faʻafomai, matou suʻesuʻe pe na sili le lelei o antidepressants sili atu i isi ituaiga o vailaʻau pe tuʻufaʻatasi vailaʻau (eg, antidepressants tuʻufaʻatasi ma methylphenidate). Mo suesuega tuʻufaʻatasia, sa matou suʻesuʻeina uma le aʻafiaga o ituaiga o faʻatalanoaga o le mafaufau ma pharmacological. Ma le isi mea, sa matou suʻesuʻe pe o se tasi o ituaiga o togafitiga (faʻalemafaufau ma pharmacological vs. faʻatasia tuʻufaʻatasia) i totonu o vaega taʻitasi tagofia vaʻaia maua ai se aoga i lo isi. I le mea mulimuli, matou faʻatusatusaina le aoga tele o le mafaufau ma faʻafomai tuʻufaʻatasiga o vaega eseese o vaisu. Teugatupe mo le mea moni "o le initaneti ua na o se auala e mafai ai e tagata taitoatasi ona mauaina soʻo se mea latou te manaʻo (faʻataʻitaʻiga, taʻaloga, faʻatau, talatalanoaga, feusuaiga)" (Griffiths & Pontes, 2014, itu. 2), na matou oʻo mai suʻesuʻega e aofia ai tagata o loʻo tele ni feusuaiga pe faʻatauina amioga i lalo o vaega "feusuaʻiga itupa" ma le "faʻatau faamalosi", tusa lava pe faʻaaoga le initaneti pe leai.

Na faʻatautaia le auiliiliga a le au faʻataʻitaʻi mo fesuiaʻiga o vaega ma faʻaogaina le faʻafefiloiina o aʻafiaga ma tuʻufaʻatasia o tau T² ma le Q-suʻega faʻavae i luga o auiliiliga o eseese ma le tutusa p aoga mo le faʻauiga o eseesega i le va o kulupu laiti (Borenstein et al., 2009). I le tulaga o le a itiiti ifo 10 avanoa suesuega (Deeks, Higgins, & Altman, 2011), na matou toe faia foi meta-regression auiliiliga faʻaaoga ai le tausaga o faʻasalalauga ma le umi o togafitiga (iloiloina ma le aofaʻi o itula na faʻaalu i togafitiga i faʻafitauli o le mafaufau, poʻo le aofaʻi o vaiaso i faʻataʻitaʻiga pharmacological). Afai e le lava le numera o suʻesuʻega o le mafaufau faʻamaonia faʻailoa le numera o itula faʻaalu i togafitiga, o le numera o vaiaso sa faʻaogaina e fuaina le umi togafitiga. Meta-regression auiliiliga i le uiga o tausaga ma pasene o tane / fafine tagata auai na le faia ona o tausaga ma feusuaiga i suʻesuʻega eseʻese mai le i totonu o suesuega taofia ai le faʻamatalaina faʻamatalaina (Thompson & Higgins, 2002).

i'uga

Filifiliga suʻesuʻe

O le ata o le suʻesuʻega o le filifilia filifiliga e faʻaalia i totonu Mati. 1. E leai ni faʻalavelave na faʻasino i ituaiga o togafitiga.

Uiga o suesuega, togafitiga, ma auai

I tuʻufaʻatasiga uma o vaisu, o le taimi nei o suʻesuʻega o suʻesuʻega eseese ituaiga tulaga o tulaga pulea: O le afa o latou faia le leai se vaega faʻatonutonu (50%) ma le tele o suʻesuʻega faʻaaogaina le lisi faatali, leai ni togafitiga, puleaina maloloina, poʻo ni vaega o le placebo control (30%), poʻo isi togafitiga malosi faʻatusatusaga (20%). O iʻuga na mafua fua i tagata faʻaiʻuga (80%). Toe siakiina faʻamatalaga na saunia e 32 psychoa suʻesuʻega (IA: k = 16 suʻesuʻega ma vaitaimi e mai le 1 i le 6 masina; M = 3.53, SD = 2.13; SA: k = 11 suʻesuʻega ma vaitaimi e mai le 1.5 i le 6 masina; M = 4.27, SD = 1.88; CB: k = 5 suʻesuʻega ma vaitaimi e mai le 3 i le 6 masina; M = 5.4, SD = 1.34), e le tasi suʻesuʻega vailaʻau i le vaega CB ma le 12 masina tulitatao, ma e lua suʻesuʻega i le vaega IA na faʻaaogaina tuʻufaʻatasiga, o le aoina uma o faʻamaumauga i le tasi masina mulimuli.

O le tele o suʻesuʻega o le mafaufau na suʻesuʻe CBT (58%), faia togafitiga e ala i vaega (71%), ma faʻafesagaʻi ma foliga (92%). Ole numera o itula na faʻaalu ile mafaufau fesoasoani mai le 15 mini i le 54 h (M = 12.55 itula, SD = 10.49), mai le tasi vaiaso i le 26 vaiaso (M = 10.44, SD = 6.12), ma mai le 8 vaiaso i le 20 vaiaso (M = 11.71, SD = 3.90) mo le togafitiga o IA, SA, ma CB, faʻatasi. Tele suesuega pharmacological suesueina antidepressants (85%); o le tele o tuʻufaʻatasiga faʻataʻitaʻiga faʻaaogaina CBT faʻatasi ma antidepressants (71%). O le umi o togafitiga faʻafomai mai le 6 i le 52 vaiaso (M = 15.67, SD = 17.95), mai le 12 i le 72 vaiaso (M = 24.83, SD = 23.58), ma mai le 7 i le 12 vaiaso (M = 9.50, SD = 2.20) mo le togafitia o le IA, SA, ma le CB, faʻatasi.

I le tuʻufaʻatasiga o vaisu, o se aofai o 3,531 tagata auai na auiliiliina (IA: n = 2,427; SA: n = 771; CB: n = 333). O le tele o suʻesuʻega na aofia ai i latou na auai ile o faatasi atu ole atuatuvale male popole (77%). Tofotofoga e taulai atu i IA masani na faia i atunuu Asia (75%). O le aofaʻi o faʻataʻitaʻiga na tele lava aliʻi i suʻesuʻega na suʻesuʻeina ai le IA (76%) ma le averesi o le matua o le 21, ma le SA (98%) ma le averesi o tausaga o le 37, ae o le tamaʻitaʻi i suʻesuʻega na suʻesuʻeina le CB (92.45%) ma le averesi o le 42 tausaga. O faʻamatalaga auiliili e faatatau i uiga o suʻesuʻega o loʻo tauaʻaoina atu i Laulau 1–3.

Laulau 1.Uiga o suʻesuʻega mo vaisu i luga ole initaneti

Suesue / Tausaga	N^a	Togafitiga vaega (NFaiga o togafitiga / Faiga o le tilivaina^b	Vaega faʻafoe (NFaiga o togafitiga / Faiga o le tilivaina^b	Aganuu / D / A (+/−) / IA ituaiga	umi t / c^c	FU (masina)	Iʻuga (iloiloga)	Faʻamatalaga faʻamatalaga	EPHPP
Togafitiga mafaufau
Anuradha ma Singh (2018)	28	CBT (28) / I / FTFT	leai se isi	Asia / - / IA	NA	leai se isi	GS (IADQ).	CO	3
Bai ma Fan (2007)	48	IT (CBT; amio pulea; agavaʻa lautele) (24) / G / FTFT	NT (24)	Asia / + / IA	16	1.5	GS (CIAS-R)	CO	3
Cao et al. (2007)	57	CBT (26) / G / FTFT	NT (31)	Asia / + / IA	10	leai se isi	GS (YDQ, CIAS)	CO	2
Celik (2016)	30	EDU (15) / G / FTFT	NT (15)	Turkey / + / IA	10	6	GS (PIUS) FR (% o taʻaloga Initaneti e taʻalo i le Initaneti / w)^d	NA	3
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; matua aʻoaʻo; EDU mo faiaoga) (32) / G / FTFT	NT (24)	Asia / + / IA	14	6	GS (IOSRS)	CO	2
González-Bueso et al. (2018)	30	1) CBT (15) / I / FTFT 2) IT (CBT + EDU mo matua) (15) / I / FTFT	HC (30)^e	Sepania / - / IGD	1) 9 2) 9	leai se isi	GS (DQVMIA).	CO	3
Guo et al. (2008)	28	1) CBT (14) / G / FTFT	2) SUPP (eg, faʻasoaina o faʻamatalaga i IA; faʻalauiloaina o le tagata lava ia ma mea taua) (14) / G / FTFT^f	Asia / + / IA	1) 8 2) LE	leai se isi	GS (CIAS)	CO	2
Han et al. (2012)	14	FT (14) / F / FTFT	leai se isi	Asia / - / IGD	NA	leai se isi	GS (YIAS) FR (h / w)	CO	3
Han et al. (2018)	26	CBT (26) / G / FTFT	leai se isi	Asia / - / IGD	24	leai se isi	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	leai se isi	GS (IAD)	CO	2
Ke ma Wong (2018)	157	CBT (157) G / FTFT	leai se isi	Asia / + / IA	12	1	GS (PIUQ)	CO	3
Khazaei et al. (2017)	48	PI (24) / G / FTFT	WL (24)	Iran / + / IA	NA	leai se isi	GS (IAT) FR (h / w)	NA	3
Kim (2008)	25	RT (13) / G / FTFT	NT (12)	Asia / + / IA	12.5	leai se isi	GS (K-IAS)	NA	3
King et al. (2017)^g		CBT (84 h le faʻamama) (9) / I / NA	leai se isi	Ausetalia / + / IGD	NA	1	GS (IGD siaki lisi) FR (h / w)	CO	3
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	CBT (tusitusiga i fale-aso aso) (46) / FTFT / I	leai se isi	Asia / + / SMA	NA	leai se isi	GS (KSAPS)	CO
Li ma Dai (2009)	76	CBT (38) / I / FTFT	WL (38)	Asia / + / IA	14	leai se isi	GS (CIAS)	CO	3
Li, Garland et al. (2017)	30	1) ATILI (15) / G / FTFT	2) SUPP (15) / G / FTFT^f	ISA / - / IGD	1) 16 2) 16	3	GS (DSM-5 tulaga)	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	leai se isi	GS (IAT)	CO	3
Liu et al. (2013)	31	1) CBT (16) / G / FTFT	2) SM^f	Asia / - / IA	1) 54 2) 24	leai se isi	GS (IAT) FR (h / aso)	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	leai se isi	Nouei / + / VGA	NA	leai se isi	GS (GASA; PVP)	CO	3
Paka, Kim et al. (2016)	24	1) CBT (12) / G / FTFT	2) VRT (12) / G / SGT^f	Asia / - / IGD	1) 16 2) 4	leai se isi	GS (YIAS)	CO	3
Pornnoppadol et al. (2018)	54	1) IT (CBT + tomai + taʻaloga) (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 aofia CBT; kuka i fafo; savali savali; savaliga; Woodworking) (10) G / FTFT	leai se isi	Asia / - / IGD	NA	3	FR (taʻaloga h / d; h / w; d / w)	CO	3
Shek et al. (2009)	22	IT (tagata taʻitoʻatasi ma aiga faufautua; lagolago o tupulaga) (22) / I / FTFT	leai se isi	Asia / + / IA	NA	leai se isi	GS (CIA-Y; CIA-G)	CO	3
Sei et al. (2018)	46	MI (PFB) (46) / I / SGT	leai se isi	Asia / + / IA	NA	leai se isi	GS (IAT)	CO	3
Su et al. (2011)	59	CBT (polokalame i luga ole laiga) 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	leai se isi	GS (YDQ) FR (h / w)	CO	2
van Rooij et al. (2012)	7	CBT (7) / I / FTFT	leai se isi	Netherlands / + / IA	7.5	leai se isi	GS (CIUS) MAI (d / w; h / d)	CO	3
Wartberg et al. (2014)	18	CBT (18) / G / FTFT	leai se isi	Siamani / + / IA	12	leai se isi	GS (CIUS) FR (h / vaiaso aso; h / faaiuga vaiaso)	CO	3
Woelfling et al. (2014)	42	CBT (42) / G + I / FTFT	leai se isi	Siamani / - / IA	32	leai se isi	GS (AICA-S) FR (h / faaiuga ole aso)	ITT	3
Yang ma Hao (2005)	52	IT (SFBT; FT; CT) (52) / I / FTFT	leai se isi	Asia / + / IA	NA	leai se isi	GS (YDQ)	CO	3
Yang et al. (2017)	14	1) CBT (14) / G + I / FTFT 2) EA (16)^h	HC (16)^e	Asia / - / IA	20	leai se isi	GS (IAT)	CO	2
Yao et al. (2017)	37	ITU (RT; MFM) (18) G / FTFT	NT (19)	Asia / + / IGD	12	leai se isi	GS (CIAS)	CO	3
Young (2007)	114	CBT (114) / I / FTFT	leai se isi	ISA / + / IA	NA	6	GS (APA; CCU; MSA; SF) FR (OA)	CO	3
Young (2013)	128	CBT suia (128) / I / FTFT	leai se isi	ISA / + / IA	NA	6	GS (IADQ).	CO	3
Zhang (2009)	70	IT (CBT; taʻaloga) (35) / G / FTFT	NT (35)	Asia / + / IA	24	leai se isi	GS (IAT)	CO	3
Zhang et al. (2009)	11	CBT (11) / G / FTFT	leai se isi	Asia / + / IA	NA	leai se isi	GS (IAT)	CO	2
Zhang et al. (2016)	36	ITU (CBI + MFTR) (20) / G / FTFT	NT (16)	Asia / + / IGD	17	leai se isi	GS (CIAS) FR (h / w)	CO	2
Zhong et al. (2011)	57	1) FT (28) / G / FTFT	2) IT (aʻoaʻoga militeri; taʻaloga; fofo faʻatatau agavaʻa fai ma vaʻaia) (29) / G / FTFT^f	Asia / - / IA	24.5 2) LE	3	GS (OCS)	CO	2
Zhu et al. (2009)	45	1) CBT (22) / G / FTFT	2) IT (CBT + EA) (23) / I + G / FTFT^f	Asia / + / IA	5 2) 10	leai se isi	GS (ISS)	CO	2
Zhu et al. (2012)	73	1) CBT (36) / G / FTFT	2) IT (CBT + EA) (37) / I + G / FTFT^f	Asia / + / IA	5 2) 10	leai se isi	GS (IAT)	CO	2
Togafitiga vailaau
Bipeta et al. (2015)	11	Eseese vailaʻau oona (ina ua maeʻa le talepe i lalo ile 3 vaiaso) (11) (tagata auai ma IA ma OCD)	2) Eseese vailaʻau 'eseʻese (ina ua maeʻa le talepe i lalo ile 3 vaiaso) (27) (tagata auai ma OCD na)^e	Initia / - / IA	52	leai se isi	GS (YBOCS; IAT)	NA	3
DellʻOsso et al. (2008)	17	Escitalopram (17)	leai se isi	ISA / + / IA	10	leai se isi	GS (IC-IUD-YBOCS) FR (h / w)	CO	3
Han et al. (2009)	21	Methylphenidate (21) (Faʻatasi)	leai se isi	Asia / - / IGD	8	leai se isi	GS (YIAS-K) FR (h / aso)	CO	3
Han et al. (2010)	11	Bupropion SR (11)	leai se isi	Asia / - / IGD	6	leai se isi	GS (YIAS) FR (h / aso)	CO	3
Park, Lee et al. (2016)	86	1) Methylphenidate (44)	2) Atomoxetine (42)^f 10–60 mg / aso	Asia / - / IGD	12	leai se isi	GS (YIAS)	CO	3
Pese et al. (2016)	119	1) Bupropion SR (44) 2) Escitalopram (42)	NT (33)	Asia / - / IGD	6	leai se isi	GS (YIAS)	CO	2
Togafitiga tuufaatasi
Han ma Renshaw (2012)	25	1) Bupropion + 8 sauniga EDU (25)	2) Placebo + 8 sauniga EDU (25)^e	Asia / + / IGD	8	1	GS (YIAS) FR (h / w)	CO	2
Kim et al. (2012)	32	1) Bupropion + 8 sauniga CBT (32)	2) Bupropion + 10 min. vaiaso talanoaga (33)^e	Asia / + / IGD	8	1	GS (YIAS) FR (h / w)	CO	2
Li et al. (2008)	48	Eseese vailaʻau 'eseʻese + CBT + FT (48)	leai se isi	Asia / + / IA	4	leai se isi	GS (IRQ)	CO	3
Nam et al. (2017)	30	1) Bupropion + EDU (15)	2) Escitalopram + EDU (15)^f	Asia / + / IGD	12	leai se isi	GS (YIAS)	CO	2
Santos et al. (2016)	39	Fofoʻaga fefiloi + 10 sauniga suia CBT (39)	leai se isi	Pasila / + / IA	10	leai se isi	GS (IAT)	CO	3
Yang et al. (2005)	18	CBT + matua toleniga + Fluoxetine (18)	leai se isi	Asia / + / IA	10.5	leai se isi	GS (CIUS)	CO	3

tusi.

^aAofai o mataupu aofia ai i le auiliiliga.

^bO tagata faʻatonutonu o le "auala o togafitiga" ma le "auala o le faʻaavanoaina" na faʻatino i naʻo togafitiga tau mafaufau.

^cMo suesuega o le mafaufau, o le umi o togafitiga na fuaina e faʻaaoga ai le aofaʻi o numera o itula na faʻaalu i le togafitiga mo togafitiga (t) ma le puleaina vaega (c). Mo suesuega pharmacological ma tuʻufaʻatasia, o le umi o togafitiga na fuaina e faʻaaoga ai le numera o vaiaso.

^dFaʻamatalaga mo le taunuʻuga taunuʻuga "faʻafiafiaga" na o avanoa mo le vaega togafitiga.

^eE leʻi aofia i suʻesuʻega le tulaga ole pule ona o le le talafeagai ma le filifiliga filifilia.

^fO le tulaga na faʻatonutonuina o se vaega o togafitiga.

^gO le suʻesuʻega na lipotia faʻamatalaga mai le faʻataʻitaʻiga e naʻo le siakiina.

^hO le togafitiga togafitiga na vavaeeseina mai le auiliiliga ona o le le talafeagai ma le filifiliga filifilia.

Laulau 2.Uiga o suʻesuʻega mo vaisu feusuaiga

Suesue / Tausaga	Aofai N^a	Togafitiga vaega (NFaiga o togafitiga / Faiga o le tilivaina^b	Vaega faʻafoe (N) Faiga o togafitiga / Faiga o tilivaina^b	umi t / c^c/ Aso / A (+/−)	FU (masina)	Iʻuga (iloiloga)	Faʻamatalaga faʻamatalaga	EPHPP
Togafitiga mafaufau
Crosby (2012)	27	GALUEGA (14) / I / FTFT	WL (13)	12 / +	5^d	GS (SCS) FR (ponokalafi matamata itula / w; fesuiaiga lomiga o le DDQ)	CO	2
Hallberg et al. (2017)	10	CBT (10) / G / FTFT	leai se isi	8 / -	6	GS (HD: CAS; HDSI)	ITT	3
Hallberg et al. (2019)	137	CBT (70) / G / FTFT	WL (67)	8 / -	6	GS (HD: CAS; SCS)	ITT	2
Hardy et al. (2010)	138	CBT (Candeo polokalame i luga ole laiga) (138) / I / SGT	leai se isi	26 / +	leai se isi	GS (PDR) FR (ponokalafi faʻaaoga / m; masturbation / m)	CO	3
Hart ma isi. (2016)	49	MI (49) / G / FTFT	leai se isi	7 / +	3	GS (SCS)	CO	3
Hartman et al. (2012)^e	57	IT (polokalame mo SA ma SA-SUD) / I + G / FTFT (57)	leai se isi	13 / +	6	GS (CSBI)	CO	3
Klontz et al. (2005)	38	1) IT (TUPE; CBT; EDU; M-Medit.), Male (28) / G / FTFT 2) IT (FUA; CBT; EDU; M-Medit.), Fafine (10) / G / FTFT	leai se isi	1) Le / 1 2) Le / 1	6	GS (GSBI; CGI)	CO	3
Levin et al. (2017)	11	GALUEGA (SHWB) (11) / I / SGT	leai se isi	8 / +	1.5	GS (CPUI) FR (ponokalafi matamata h / w)	CO	3
Minarcik (2016)	12	CBT (12) / I / FTFT	leai se isi	12 / +	leai se isi	GS (patipati; HBI; SCS) FR (ponokalafi matamata min./w)	CO	3
Orzack et al. (2006)	35	IT (RtC; CBT; MI) (35) / G / FTFT	leai se isi	16 / +	leai se isi	FR (ponokalafi matamata / w; OTIS)	CO	3
Pachankis et al. (2015)	63	CBT (ESTEEM-SC faʻavae i luga o le UP) (32) / I / FTFT	WL (31)	12 / +	3	GS (SCS)	ITT	2
Parsons ma isi. (2017)	11	CBT (ESTEEM-SC faʻavae i luga o le UP) (11) / I / FTFT	leai se isi	12 / +	leai se isi	GS (SCS)	CO	3
Quadland (1985)^e	15	1) GPT / G / FTFT (15)	2) PT mo tagata auai na aʻafia i isi faʻafitauli / I / FTFT (14)^f	20 / +	6	FR (n o feusuaʻiga faʻapitoa eseese / masina mulimuli 3;% o feusuaʻiga paʻaga na o le tasi le taimi;% o feusuaiga ma le tasi paaga;% o feusuaiga i tulaga lautele)	CO	3
Sadiza et al. (2011)	10	CBT (10) / G / FTFT	leai se isi	12 / +	leai se isi	GS (SCS)	CO	3
Twohig ma Crosby (2010)	6	GALUEGA (6) / I / FTFT	leai se isi	8 / +	3	FR (ponokalafi matamata h / d)	CO	3
Wilson (2010)	54	1) Faʻataʻitaʻiga o togafiti (27) / G / FTFT	2) faʻafouina CBT (TCA) (27) / G / FTFT^g	1) Le / 6 2) Le / 6	1.5	GS (HBI-19)	CO	2
Togafitiga vailaau
KIFKA (1991)	10	Eseese vailaʻau 'eseʻese + Lithium (10)	leai se isi	12 / +	leai se isi	GS (SOI)	CO	3
Kafka ma Prentky (1992)	16	Fluoxetine (16)	leai se isi	12 / +	leai se isi	GS (SOI)	CO	3
KIFKA (1994)	11^h	Sertraline (11)	leai se isi	17 / +	leai se isi	GS (SOI) FR (fantasizing, urges, feusuaiga gaioiga min./d)	CO	3
Kafka ma Hennen (2000)	26	Eseese antidepressants + methylphenidate (26)	leai se isi	72 / +	leai se isi	GS (TSO) FR (fantasizing, urges, feusuaiga gaioiga min./w)	ITT	3
Wainberg et al. (2006)	28	Citalopram (13)	PLA (15)	12 / -	leai se isi	GS (YBOCS-CSB; CSBI; CGI-CSB) FR (masturbation, internet use, ponokalafi faʻaaoga h / w)	ITT	2
Togafitiga tuufaatasi
Gola ma Potenza (2016)	3	CBT + Paroxetine (3)	leai se isi	10 / +	leai se isi	FR (ponokalafi faʻaaoga / w)	CO	3
Scanavino et al. (2013)	4	STPGP + eseese vailaʻau (4)	leai se isi	16 / +	leai se isi	GS (SCS)	CO	3

tusi. A = popolega; ACT = Taliaina ma Tautino Suiga; BSI = Vaʻaiga Faʻailoga otoʻoto; CBT = togafitiga-amio-mafaufau; CGI-CSB = Faʻamau Faʻailoga Faʻapitoa i le Lalolagi Faʻaaogaina mo amioga faʻamalosia feusuaiga; FESOASOANI = Faʻamagaloga Vaitele Vaisua i Ponokalafi Fua; CO = na faʻauma; CPUI = Cyber-Ponokalafi Taumafa Faʻaaoga Faletupe; CSBI = Faʻatautaiga Faʻataʻitaʻiga Amio Feusuaʻiga; D = atuatuvale; d = aso; DDQ = Fesili Taʻitasi e inu ai; EDU = psychoeducation; EPHPP = Polokalame Faʻataʻitaʻi Soifua Maloloina a le Soifua Maloloina (1 = malosi, 2 = faʻalelei, 3 = faʻatupuina vaivai); ESTEEM = Tomai Faʻamalolosi e Faʻamalosia Tamaloloa Faʻamaoni; TUPE = togafitiga togafitiga; FR = taimi masani; FTFT = togafiti faafesagai; FU = tulitatao; G = vaega faʻatulaga; GPT = vaega a le psychotherapy; GS = lalolagi atoa; GSBI = Garos Feusuaiga Amio Faʻamaumauga; h = itula; HBI = Faʻataʻitaʻiga Taualoa aʻiʻi; HD: CAS = Faʻataʻamilomilo faʻaletonu: Lenei Suʻesuʻega Fua; HDSI = Faʻataʻitaʻiga Faʻailoaina o le Hypersexual; I = tasi tagata faufautua; IT = togafitiga tuʻufaʻatasi; ITT = faʻamoemoe-ia-togafiti; m = masina; M-Medit. = mafaufau loloto mafaufau loloto; MI = Motivational Faʻatalanoaga; NA = le maua; OTIS = Orzack Time Intensity Survey; PDR = mafaufauga loloto itu o le toe faʻaleleia o le tino (mafaufau loloto i lagona feusuaʻi, faʻafouina aga i le toe faaleleia, lelei le afaina, leaga le mafaufauina, lagona o le saolotoga i luga o le vaisu, o le aga e teena le tali atu mo le vaisu, uiga i le olaga, fesoʻotaʻiga i isi, lagona o le faamagaloina, malamalama i mafaufauga ma faʻaosoosoga tulaga, maloloina fiafiaga faleoloa); PLA = placebo; PT = soifua maloloina; RtC = Tapenaga e Suia; SA = vaisu fai tino; SA-SUD = comorbid feusuaiga ma vailaau fai ma vaisu; SC = feusuaiga faʻamalosia; SCS = Feusuaiga Faʻamalosi Faʻatatau; SGT = lava-faʻataʻitaʻiga togafitiga; SHWB = self-help tusi tusi; SOI = Faʻafeiloaʻiga oloa i fafo; STPGP = faʻatupuʻuga vaega o le psychodynamic psychotherapy; TCA = Auala e faʻatulagaina ai se auala; TSO = Aofai o feusuaiga i fafo; UP = Unified Protocol mo le Transdiagnostic Togafitiga o lagona faʻalavelave; W = lisi faʻatalitali; w = vaiaso; YBOCS-CSB = Yale-Brown Obsessive Compulsive Scale teuteuina mo amioga faʻamalosia feusuaiga.

^aAofai o mataupu aofia ai i le auiliiliga.

^bO tagata faʻatonutonu i le "auala o togafitiga" ma le "auala o le faʻaavanoaina" na faʻatoa faʻatino i togafitiga tau mafaufau.

^cO le umi ole togafitiga na fuaina ile faʻaaogaina ole numera o vaiaso.

^dFaʻamatalaga mai le faʻataʻitaʻiga e toe siakiina na o loʻo avanoa mo le taunuʻuga taunuʻuga "faʻafia taimi".

^eO le suʻesuʻega na lipotia faʻamatalaga mai le faʻataʻitaʻiga e naʻo le siakiina.

^fE leʻi aofia i suʻesuʻega le tulaga ole pule ona o le le talafeagai ma le filifiliga filifilia.

^gO le tulaga na puleaina sa manatu o se lima togafitiga.

^hNaʻo tagata auai na aʻafia i faʻalavelave e fesoʻotaʻi ma paraphilia sa aofia ai i le auiliiliga.

Laulau 3.Uiga o suʻesuʻega mo faʻatau faamalosi

Suesue / Tausaga	Aofai N^a	Togafitiga vaega (NFaiga o togafitiga / Faiga o le tilivaina^b	Vaega faʻafoe (N)	umi t / c^c/ Aso / A (+/−)	FU (masina)	Iʻuga (iloiloga)	Faʻamatalaga faʻamatalaga	EPHPP
Togafitiga mafaufau
Armstrong (2012)	10	MBSR (4) / G / FTFT	NT (6)	8 / +	3	GS (CBS; YBOCS-SV; IBS)	CO	2
Benson ma isi. (2014)	11	IT (CBT, PSYDYN, PSYEDU, MI, ACT, mafaufau mafaufau elemene) (6) / G / FTFT	WL (5)	12 / +	6	GS (mod. VCBS; RCBS; CBS; YBOCS-SV) FR (min./w faʻaalu i le faʻatauina; faʻatau mai episodes / w)^d	CO	2
Filomensky & Tavares (2009)	9	CBT (9) / G / FTFT	leai se isi	20 / +	leai se isi	GS (YBOCS-SV)	CO	3
Mitchell et al. (2006)	35	CBT (28) / G / FTFT	WL (7)	10 / +	6^e	GS (YBOCS-SV; CBS) FR (faʻatau faʻapitoa / w; h faʻaalu faʻatau / 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-polokalame (CBT WB + 5 telefoni sauniga) (20) / I / SGT	WL (14)	1) Le / 10 2) Le / 10	6	GS (CBS; YBOCS-SV)	ITT	2
Togafitiga vailaau
Black et al. (1997)	10	Fluvoxamine (10)	leai se isi	9 / -	leai se isi	GS (YBOCS-SV)	CO	2
Black et al. (2000)	23	Fluvoxamine (12)	PLA (11)	9 / -	leai se isi	GS (YBOCS-SV)	ITT	2
Grant et al. (2012)	9	Manatua (9)	leai se isi	8 / -	leai se isi	GS (YBOCS-SV; mod. CB-SAS)	CO	2
Koran et al. (2002)	24	Citalopram (24)	leai se isi	12 / +	leai se isi	GS (YBOCS-SV)	ITT	2
Koran et al. (2003)	23	Citalopram (23)	leai se isi	7 / +	leai se isi	GS (YBOCS-SV; CBS; IBTS)	ITT	2
Koran et al. (2007)	26	Escitalopram (26)	leai se isi	7 / +	leai se isi	GS (YBOCS-SV)	ITT	3
Ninan et al. (2000)	37	Fluvoxamine (20)	PLA (17)	12 / +	leai se isi	GS (YBOCS-SV)	ITT	3

tusi. A = popolega; ACT = Taliaina ma Tautino Suiga; CBS = Faʻamalosi faʻatau Fua; CB-SAS = Faʻatau Faʻatau Faʻapitoa Suʻega Fua (faʻafouina vaega o le Gambling Symptom Assessment Scale; CBT = faʻamaoniga-amio-amio; CO = na o tagata atoatoa; D = atuatuvale; EPHPP = Lelei tele Polokalame Faʻataʻitaʻi Soifua Maloloina (1 = malosi, 2 = feololo , 3 = vaivai faʻatulagaina); FTFT = faʻasaga ile mata; FR = taimi; FU = tulituliloa; G = faʻatulagaina o vaega; G-CBS = Kanata Faʻatau Faʻatau Faʻapitoa Fua, Suiga Siamani; GS = tulaga faʻavaomalo; GSH = taiala fesoasoani i le tagata lava ia; h = itula; I = faufautua tagata taʻitoʻatasi; IBS = Fuafuaina faʻatau faʻatau; IBTS = Fuafuaga Faʻatau Fuafuaina Faʻatau; ITT = faʻamoemoe e togafitia le auiliiliga; MBSR = faʻaititia o le mafaufau-faʻavae manatu; MI = Motivational Interviewing; NA = le maua; NT = leai se togafitiga; PLA = placebo control group; PSYDYN = psychodynamic; PSYEDU = psycho-educational; RCBS = Richmond Compulsive Buying Scale; SGT = self-guide treatment; VCBS = Valence Compulsive Buying Scale; WB = workbook; WL = lisi faatalitali; w = vaiaso; YBOCS-SV = Yale-Brown Obsessive Com Pulsive Fuataga-Faʻatau Lomiga.

^aAofai o mataupu aofia ai i le auiliiliga.

^bO tagata faʻatonutonu i le "auala o togafitiga" ma le "auala o le faʻaavanoaina" na faʻatoa faʻatino i togafitiga tau mafaufau.

^cO le umi ole togafitiga na fuaina ile faʻaaogaina ole numera o vaiaso.

^dFaʻamatalaga mo le taunuʻuga taunuʻuga "faʻafiafiaga" na o avanoa mo le vaega togafitiga.

^eO suesuega na le aofia mai FU auiliiliga, ona naʻo faʻamatalaga mai le pasia togafitiga i FU na lipotia.

Aafiaga o faʻaituau i totonu o suesuega

O faʻailoga a le lalolagi EPHPP mo suʻesuʻega na aofia i vaega eseese o vaisu ua otootoina i le Laulau 1–3. Iloilo iloiloga sa faia e ni tutoatasi tutoʻatasi maua ai se interrater faatuatuaina o κ = 0.73 mo suesuega ile vaega IA ma le SA, ma κ = 0.75 mo suʻesuʻega ile vaega CB.

Tuufaʻatasiga o iʻuga ma le lamatiaga o le faʻaituau i isi suʻesuʻega

Le faʻapipiʻiina le tele o tulaga mo soʻo se ituaiga o mea ua fai ma vaisu ma togafitiga eseese mo le i totonu o le kulupu ma faʻatautaia suʻesuʻega mamanu i luga o taunuʻuga uma pe a maeʻa togafitiga ma mulimulitaʻi, le 95% CI, ma le taua o suʻega o loʻo faʻataoto mai i Laulau 4. O loʻo faʻailoa atu i totonu le togavao i luga o le kulupu ni lapoʻa fua mo tulaga, togafitiga, ma iʻuga i le faʻaiuga o togafitiga Mati. 2.

Laulau 4.Aafiaga tele mo soʻo se ituaiga o vaisu, taunuʻuga ma suʻesuʻega mamanu i le tuʻuga ma le toe siakiina

Taunuʻuga	Ituaiga o aafiaga	k	g	95% CI	z	p	I²	FS N
Initaneti i vaisu
Togafitiga mafaufau
Lalolagi faigata	totonu-kulupu (pou)	54	1.51	[1.29, 1.72]	13.79		93.66	18,317
	pulea (pou)	15	1.84	[1.37, 2.31]	7.268		83.56	1,254
	totonu o le kulupu (FU)	17	1.48	[1.11, 1.85]	7.92		94.61	4,221
faisoʻoga	totonu-kulupu (pou)	17	1.09	[0.73, 1.49]	6.02		92.54	1,801
	pulea (pou)	6	1.12	[0.41, 1.83]	3.08		78.05	69
	totonu o le kulupu (FU)	6	1.06	[0.12, 2.00]	2.21		97.30	259
Togafitiga Pharmacological
Lalolagi faigata	totonu-kulupu (pou)	8	1.13	[0.85, 1.42]	7.78		78.76	564
	pulea (pou)	2	1.28	[0.85, 1.71]	5.85		0.00	-^a
	totonu o le kulupu (FU)	NA
faisoʻoga	totonu-kulupu (pou)	3	0.72	[0.49, 0.96]	6.01		0.00	27
	pulea (pou)	NA
	totonu o le kulupu (FU)	NA
Togafitiga Tuufaatasi
Lalolagi faigata	totonu-kulupu (pou)	7	2.51	[1.70, 3.33]	6.03		92.99	756
	pulea (pou)	NA
	totonu o le kulupu (FU)	2	2.15	[0.66, 3.65]	2.82		93.55	-^a
faisoʻoga	totonu-kulupu (pou)	2	2.77	[2.29, 3.24]	11.39		14.43	-^a
	pulea (pou)	NA
	totonu o le kulupu (FU)	2	2.69	[2.06, 3.32]	8.43		49.72	-^a
Togafitiga o Feusuaiga
Lelei togafitiga
Lalolagi faigata	totonu-kulupu (pou)	14	1.09	[0.74, 1.45]	6.03		92.54	1,311
	pulea (pou)	3	0.70	[0.42, 0.99]	4.87		7.02	19
	totonu o le kulupu (FU)	10	1.00	[0.67, 1.32]	6.02		90.02	760
faisoʻoga	totonu-kulupu (pou)	6	0.75	[0.46, 1.03]	5.10		70.96	177
	pulea (pou)	1	1.67	[0.82, 2.53]	3.83		0.00	-^a
	totonu o le kulupu (FU)	4	0.83	[0.37, 1.29]	3.57		71.59	45
Togafitiga vailaau
Lalolagi faigata	totonu-kulupu (pou)	5	1.21	[0.88, 1.54]	7.12		50.42	134
	pulea (pou)	1	0.14	[-0.58, 0.87]	0.38	0.70	0.00	-^a
	totonu o le kulupu (FU)	NA
faisoʻoga	totonu-kulupu (pou)	3	0.87	[0.63, 1.12]	6.92		0.00	33
	pulea (pou)	1	0.79	[0.04, 1.55]	2.06		0.00	-^a
	totonu o le kulupu (FU)	NA
Togafitiga tuufaatasi
Lalolagi faigata	totonu-kulupu (pou)	1	1.91	[0.75, 3.08]	3.22		0.00	-^a
	pulea (pou)	NA
	totonu o le kulupu (FU)	NA
faisoʻoga	totonu-kulupu (pou)	1	1.04	[0.22,1.85]	2.49		0.00	-^a
	pulea (pou)	NA
	totonu o le kulupu (FU)	NA
Faʻamalosia malosi
Togafitiga mafaufau
Lalolagi faigata	totonu-kulupu (pou)	7	1.00	[0.75, 1.25]	7.88		46.43	210
	pulea (pou)	6	0.75	[0.42, 1.08]	4.45		0.00	27
	totonu o le kulupu (FU)	4	1.36	[0.88, 1.84]	5.57		53.65	66
faisoʻoga	totonu-kulupu (pou)	2	0.97	[0.68; 1.26]	6.55		0.00	-^a
	pulea (pou)	1	2.48	[1.46, 3.49]	4.76		0.00	-^a
	totonu o le kulupu (FU)	1	1.01	[0.47, 1.55]	3.68		0.00	-^a
Togafitiga vailaau
Lalolagi faigata	totonu-kulupu (pou)	7	1.52	[1.18, 1.86]	8.84		63.17	386
	pulea (pou)	2	-0.13	[-0.82, 0.57]	-0.35	0.724	0.00	-^a
	totonu o le kulupu (FU)	1	-0.49	[-1.00, 0.03]	-1.86	0.063	0.00	-^a
faisoʻoga	totonu-kulupu (pou)	NA
	pulea (pou)	NA
	totonu o le kulupu (FU)	NA

Manatua. l = numera o togafitiga tuutuuga; g = Hedges's g; CI = vaitaimi faʻatalitali I² = pasene o le aofaʻi faʻavasegaina i suʻesuʻega; FS N = Leaga-sefe N (numera o suʻesuʻega e manaʻomia e maua ai se taua o togafitiga); NA = le maua.

^aLe manuia-saogalemu N e le i fuafuaina ona sili atu 3 suʻesuʻega na maua.

Aafiaga tele mo togafitiga o le mafaufau ile posttreatment ma toe siaki

O togafitiga faʻafomaʻi i vaega o mea ua fai ma vaisu na fua mai ai ni taimi puʻupuʻu e tele mai le auala e oʻo atu i le tele i le tele o suʻesuʻega. Ole fua ile umi ole taimi ile vaega o vaisu uma na faʻaalia ai na faatumauina togafitiga. E pei ona faʻaalia i Laulau 4, ma le maualuga tele o le tulaga eseese i luga o suʻesuʻega na maitauina mo iʻuga suiga i vaega o le IA ma SA, ma sa maitauina le felanulanuaʻi o mea eseese poʻo le homogenity i le vaega CB.

I totonu o le vaega IA, o le teuina-ma-faʻatumu metotia faʻamaonia 17 suʻesuʻega mafua ai le faʻafiafiaga faanatinati mo le faʻaititia o le mamafa o le lalolagi ma se tasi suʻesuʻega mo le faʻaititia o le faʻafiafia i totonu o-vaega suʻesuʻega mamanu. O le auiliiliga ma nei suʻesuʻega na fautuaina ua faʻaitiitia tele le paʻu i lalo fua (mamafa i le lalolagi: g = 0.87; 95% CI [0.82, 0.92]; O le suʻega a Egger p <0.001; taimi masani: g = 0.93; 95% CI [0.84, 1.03]; O le suʻega a Egger p = 0.282) o loʻo fautua mai ai le le taua o aʻafiaga o le lolomiga faʻasalalau. Leai se faʻailoga mo le lolomiina faʻailoga na maua mo le faʻaititia o le lalolagi ogaoga faʻavae i luga o pulea pulea suʻesuʻega (Egger's suʻega p = 0.067). I totonu o le vaega SA, o le teuina-ma-faʻatumu metotia faʻamaonia se tasi suʻesuʻega mafua ai faʻataʻitaʻiga faanatinati mo le faʻaititia o le mamafa o le lalolagi ma tau atu i se laititi laʻititi faʻaititia tele mo lenei taunuʻu suiga (g = 0.88; 95% CI [0.79; 0.97], Egger's suʻega p = 0.318). Soo se taimi e toilalo ai-sefe N na faia le auiliiliga, o le tele o ituaiga o mea ua fai ma vaisu ua manatu malosi mo le iʻuga, vagana ai le faʻatonutonuina le tele o fua faatatau i le faʻaititia o le mamafa o le lalolagi i le SA ma CB vaega, e le malolosi.

Aafiaga tele o talavai togafitiga ile posttreatment ma toe siaki

I le maeʻa ai o togafitiga, o le totonu o le kulupu aafiaga tele i vaega uma o vaisu na feololo ma tele. O le tele o aʻafiaga na faʻavae i luga o faʻataʻitaʻiga e tasi mai le tele i le vasega IA e oʻo lava i mea laiti ma leaga i vaega o le SA ma le CB. Le leai o se toe siakiina faʻamaumauga taofia ai le faʻauigaina o umi-umi aafiaga tele. Maualuga ma feololo le tulaga eseese i le va o suʻesuʻega na maitauina mo taunuʻuga suiga i totonu o vaisu vaisu. O le le-sefe N auiliiliga na faʻatinoina mo faʻamatalaga ua faʻaalia mai o le malosi tele o le faʻaogaina.

Aafiaga tele o tuʻufaʻatasiga o togafitiga ile posttreatment ma toe siaki

Ole fesoʻotaʻiga tuʻufaʻatasi na faʻatino mo naʻo le togafitiga o le IA ma le SA e faʻavae i luga o le vaega o suʻesuʻega e maua mai ai le tele o auga taimi. O faʻamatalaga tulitatao na maua naʻo le vaega i IA e maua ai tele le tele o aʻafiaga. O le maualuga o le tulaga maualuga i aʻoga na maitauina mo le faʻaititia o le mamafa o le lalolagi i le vaega IA; ae ui i lea-le-saogalemu N faʻaalia le malosi o le aʻafiaga tele.

O faʻailoaga i fafo atu e ala i le tasi-suʻesuʻe-faʻasolosolo faiga e leai se aʻafiaga o soʻo se suʻesuʻega e tasi i luga o le aotelega o aʻafiaga mo le mafaufau, faʻafomai, ma togafitiga tuʻufaʻatasi.

Moderator faʻatautaia

Na faia suʻesuʻega a le au faʻataʻitaʻi mo ituaiga o auga i totonu o le kulupu. O iʻuga mo suiga eseese pe a maeʻa le togafitiga ua tuuina atu Laulau 5.

Laulau 5.Moderator auiliiliga mo faʻavasega suiga mo ituaiga uma o vaisu, ma taunuʻuga

		IA		SA		CB
taitai o	Taunuʻuga taunuʻuga	Qbet	p (Q)	Qbet	p (Q)	Qbet	p (Q)
Togafitiga mafaufau
Ituʻaiga ole mafaufau mafaufau (CBT vs. IT vs. isi)
	GS	4.24	0.120	4.50	0.105	0.34	0.945
	FR	0.11	0.947	15.67	^a	-	-
Faiga o togafitiga (kulupu vs. tagata faʻatasi ma isi)
	GS	0.47	0.792	0.11	0.741^b	0.44	0.508^b
	FR	0.55	0.761	14.55	^b
Auala e momoli ai (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 aofia vs. aofia ai)
	GS	0.02	0.898	0.84	0.360	0.00	1.00
	FR	1.13	0.289	0.00	1.00	-	-
Faʻamatalaga auiliiliga (faʻataʻitaʻi ma 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 = malosi vs. 2 = feololo vs. 3 = vaivai i totonu o le aoga)^d
	GS	1.14	0.285	2.24	0.134	0.02	0.903
	FR	1.94	0.164	0.53	0.466	-	-
Aganuu (Asia vs. atunuu i Sisifo)
	GS	0.54	0.461	-	-	-	-
	FR	0.58	0.447	-	-	-	-
IA ituaiga (lalolagi IA vs. IGD vs. isi)
	GS	1.63	0.653	-	-	-	-
	FR	4.21	0.122	-	-	-	-
Togafitiga vailaau^e
Ituʻaiga togafitiga o vailaʻau (AD vs. fefiloi poʻo isi)
	GS	5.62	^f	0.09	0.765	0.65	0.421^g
Comorbidity (D / A aofia vs. aofia ai)
	GS	0.73	0.392	-^h	-^h	0.22	0.642
Faʻamatalaga auiliiliga (faʻataʻitaʻi ma ITT)
	GS	0.00	1.00	0.76	0.383	4.89
EPHPP (1 = malosi vs. 2 = feololo vs. 3 = vaivai i totonu o le aoga)^d
	GS	0.47	0.493	-^h	-^h	2.52	0.112
Aganuu (Asia vs. atunuu i Sisifo)
	GS	7.32		-	-	-	-
IA ituaiga (lalolagi IA vs. IGD vs. isi)
	GS	7.32	ⁱ	-	-	-	-
Togafitiga tuufaatasi^e
Ituʻaiga togafitiga o vailaʻau (AD vs. fefiloi poʻo isi)
	GS	0.83	0.362^j	-	-	-	-
Ituʻaiga ole mafaufau mafaufau (CBT vs. IT vs. isi)
	GS	20.81	^k	-	-	-	-
Faiga o mafaufau mafaufau togafitiga (vaega vs. tagata taitoatasi ma isi)
	GS	0.29	0.592^b	-	-	-	-
Comorbidity (D / A aofia vs. aofia ai)
	GS	0.00	1.00	-	-	-	-
Faʻamatalaga auiliiliga (faʻataʻitaʻi ma ITT)
	GS	0.00	1.00	-	-	-	-
EPHPP (1 = malosi vs. 2 = feololo vs. 3 = vaivai i totonu o le aoga)^d
	GS	6.06		-	-	-	-
Aganuu (Asia vs. atunuu i Sisifo)
	GS	0.83	0.362	-	-	-	-
IA ituaiga (lalolagi IA vs. IGD vs. isi)
	GS	6.06	ⁱ	-	-	-	-

tusi. A = popolega; AD = fofoʻiloloa; CB = faʻatau faamalosi; CBT = faʻalauiloaina amioga mataala; D = atuatuvale; EPHPP = Polokalame Faʻataʻitaʻi mo le Soifua Maloloina Masani (mea faigaluega aoga lelei mo le aofaʻi o suʻesuʻega); GS = lalolagi atoa; FR = taimi masani; FTFT = togafiti faafesagai; IA = vaʻai i luga ole initaneti; IGD = initaneti o taʻaloga faaletonu; IT = togafitiga tuʻufaʻatasi; ITT = faʻamoemoe e togafitia iloiloga; Qbet = homogeneity faʻamaumauga mo eseesega i le va o kulupu laiti; SA = vaisu faifeʻau; SGT = lava-faʻataʻitaʻi togafitiga.

^aCBT: g = 0.98; 95% CI [0.83, 1.13]; p ≤ 0.001; IT: g = 0.25; 95% CI [−0.08, 0.58]; p = 0.132; Isi togafitiga (ie, taliaina ma tautinoga togafitiga): g = 0.80; 95% CI [0.51, 1.10]; p ≤ 0.001.

^bSuʻesuʻega a le Moderator e aofia ai naʻo le lua vaega faʻavasega (group vs. individual).

^cNaʻo suʻesuʻega na faʻailoa mai ai le ituaiga o faʻamatalaga auiliiliina na aofia ai i auiliiliga (vaʻai Laulau 1).

^dSuʻesuʻega a le Moderator e aofia ai naʻo le lua kulupu (2 = faʻaititia; 3 = vaivai).

^eFaʻatautaia le auiliiliga i le iʻuga fesuiaʻi "faʻaavanoa" ona le faia ona o le le lava numera o suesuega.

^fO le auiliiliga auiliiliga na aofia ai naʻo le lua vaega (AD ma isi vailaʻau [ie, methylphenidate, atomoxetine]).

^gSuʻesuʻega a le Moderator e aofia ai naʻo le lua kulupu (AD ma isi vailaʻau [ie, memantine]).

^hO faʻaiuga o le au faʻataʻitaʻi auiliiliga e leʻi faʻauigaina, ona e naʻo le tasi le suʻesuʻega na tumau i le tasi o le lua vaega.

ⁱModerator auiliiliga na o ni vaega se lua (IA vs. IGD).

^jSuʻesuʻega a le Moderator e naʻo le lua kulupu (AD vs. faʻafefiloi).

^kSuʻesuʻega a le Moderator e aofia ai naʻo le lua kulupu (CBT faʻatasi ma isi togafitiga [ie, aʻoaʻoga polokalame]).

Aafiaga tele i ituaiga uma o vaisu ma fesoasoani na le afaina i le tulaga lelei o suʻesuʻega, o loʻo tupu faʻafitauli ma le popole, ma le tausaga faʻasalalau (IA: globality: β = −0.02; SE = 0.03; p = 0.417; taimi: β = −0.09; SE = 0.05; p = 0.075; SA: tulaga faigata a le lalolagi: β = −0.03; SE = 0.04; p = 0.519).

E tusa ai ma le IA, e matua tele lava le tele o aʻafiaga na maua mo FTFT pe a faʻatusatusa i SGT, ma mo faʻalavelave e aofia ai le sili atu numera o itula i togafitiga mo le faʻaititia o le mamafa o le lalolagi (β = 0.04; SE = 0.01; p <0.01) ma taimi masani (β = 0.03; SE = 0.009; p <0.01). Mo le faʻaititia o le ogaoga o le lalolagi i falemaʻi falemaʻi, lapoʻa tele lapoʻa na aliaʻe mai mo vailaʻau antidepressants faʻatusatusa i isi vailaʻau vailaʻau (ie, methylphenidate, atomoxetine), mo na faʻatinoina i isi atunuʻu faʻatusatusa i Asia atunuʻu, ma suʻesuʻe lalolagi IA faʻatusatusa i IGD ma poto telefoni fai ma vaisu

E tusa ai ma le SA, CBT ma isi faʻafitauli o le mafaufau (o lea, talia ma aʻoaʻo fofo) faʻaalia se avanoa i luga o faʻatasiga tuʻufaʻatasia ma o faʻutua a tagata taʻitoʻatasi i vaega faʻatulagaina mo le faʻaititia o taimi. I totonu o le CB vaega, faʻafetauʻega faʻataʻitaʻiga faʻaaogaina suʻesuʻe faʻapitoa faʻatupuina sili atu lona tele aʻafiaga nai lo i latou e faʻavae i luga o auiliiliga ITT faatatau i le faʻaititia o le lalolagi tulaga faigata.

Faʻataʻitaʻitele faʻataʻitaʻiga i togafitiga tuʻufaʻatasi na faia mo le vasega IA. O iʻuga na faʻaalia ai o le tele o aʻafiaga o loʻo fesoʻotaʻi ma CBT-faʻatasiga, o maualalo faʻataʻitaʻiga, ma i latou na suʻesuʻeina le IA lautele.

Faalauiloa mafaufau faʻafefiloi vs pharmacological vs. tuʻufaʻatasia togafitiga

E tusa ai ma IA, o tuʻufaʻatasiga togafitiga na maua ai le tele o faʻatusatusaga o faʻatusatusaga pe a faʻatusatusa i le mafaufau ma vailaʻau faʻafitauli i le faʻaititia o le mamafa o le lalolagi (faʻalemafaufau ma tuʻufaʻatasia: Q_{i le va o} = 7.80, p <0.01; fale vailaʻau faʻatasi vs. Q_{i le va o} = 14.69, p <0.001), ma taimi (mafaufau faʻatasi vs. Q_{i le va o} = 8.73, p <0.01; fale vailaʻau faʻatasi vs. Q_{i le va o} = 63.02, p <0.001). E leʻi taua ni iʻuga na maua i le va o le tele o togafitiga o le mafaufau ma togafitiga faʻafomaʻi (ogaoga le lalolagi: p = 0.173; taimi: p = 0.492). Mafaufauina CB, togafitiga faʻafomai na faʻaalia se aoga i luga o faʻafitauli tau mafaufau mo le faʻaititia o le lalolagi tulaga faigata (Q_{i le va o} = 5.45, p <0.05). E leai seisi eseesega taua i le va o ituaiga o togafitiga na maitauina.

Eseesega i le va o vaisu vaisu

O faʻatusatusaga o aʻafiaga i vaega eseese o vaisu ua maua ai ni faʻaiʻuga taua e tusa ai ma faʻafitauli tau le mafaufau (globality شدت: p = 0.174; taimi: p = 0.559) ma vailaʻau togafitiga (fesoasoani i le lalolagi atoa: p = 0.203; taimi: p = 0.389).

Talanoaga

O le mafuaʻaga o lenei pepa o le suʻesuʻeina lea o le aoga o togafitiga faʻafomaʻi, vailaʻau faʻafomaʻi ma tuʻufaʻatasia o togafitiga mo IA, SA ma CB ma faʻailoa mai ai le ono aʻafia ai togafitiga o taunuʻuga. E le gata i lea, faʻatusatusaga i le va o ituaiga e tolu o le BA e faʻavae i luga o le tele o aʻafiaga mo togafitiga faʻafomaʻi ma vailaau faʻatino na faia mo le taimi muamua, ma le faʻamoemoe atili o le faʻatusatusaina o le taʻaloga ma le SUDs faʻaletonu i le tali atu o togafitiga.

Na matou mauaina o togafitiga faʻafomaʻi na faʻaititia lelei le tulaga o le lalolagi ma le taimi masani o le IA ma le SA faʻatasi le tali togafitiga o loʻo tausia i taimi uumi o taimi. Mo CB, togafitiga faʻafomaʻi na fesoʻotaʻi foʻi ma se muamua tele-muamua ma muamua-mulimuli-faʻaitiitia pa'ū i le lalolagi faigata. O faʻamaumauga tetele ma feololo o taimi faʻatatau i taunuʻuga na faʻamaonia i le puleaina o suʻesuʻega, aemaise lava i le IA ma suʻesuʻega a tagata i vaega SA ma CB. O iʻuga nei o loʻo tutusa lelei ma suʻesuʻega na maua i meta-auiliiliga na suʻesuʻeina faʻafomaʻi o togafitiga mo le le mautinoa o taʻaloga (Cowlishaw et al., 2012; Gooding & Tarrier, 2009; Goslar, Leibetseder, Muench, Hofmann, & Laireiter, 2017; Leibetseder, Laireiter, Vierhauser, & Hittenberger, 2011; Pallesen, Mitsem, Kvale, Johnsen, & Moulde, 2005) ma SUDs (Dutra et al., 2008; Tripodi, Bender, Litschge, & Vaughn, 2010).

E ui lava o le CBT sa sili ona masani faʻaaogaina i vaega e tolu o vaisu, o le tele o isi auala faʻafitauli o le faʻamaonia e tutusa lava le aoga mo le faʻaititia o faʻafitauli amioga tusa lava pe o le a le auala o togafitiga ma - aemaise lava e faatatau i IA - aganuu. O nei suʻesuʻega e 'eseʻese ma mea na lipotia i se meta-faʻataʻitaʻiga lata mai, lea na iloa ai le aoga o CBT nai lo isi togafitiga o le mafaufau mo le faʻaititia o le taimi e faʻaaluina i luga o le initaneti, fautua taʻitoʻatasi, ma mo suʻesuʻega na faia i le US (Winkler et al., 2013). Ae peitai, feeseeseaiga, atonu e mafua mai i le mea moni o loʻo faia ni auiliiliga auiliiliga i faʻatasia i totonu o le kulupu ma faʻatonutonu laʻasaga tele ma i le faʻaopopoga o le lata mai o faʻamaumauga suʻesuʻega i la matou meta-auiliiliga. I totonu o nei, o le masani masani faʻaaoga metotia aofia ai togafitiga aiga, lea i le vaʻai i le tele o faʻalavelave tulaga aiga (eg, Schneider, Tupu, & Delfabbro, 2017foliga mai e aoga e le gata mo talavou faʻafitauli i luga ole initaneti internet gamers (eg, Han, Kim, Lee, & Renshaw, 2012), ae faʻapea foʻi mo talavou ma le SUDs (mo se iloiloga vaʻai Faila, Andersen, & Jørgensen, 2018). I se tulaga faʻapitoa, mafaufau-faʻavae polokalame faʻaogaina manuia mo le faʻaleleia o faʻailoga o le IA (Li, Garland, et al., 2017) ma CB (Armstrong, 2012), ma taliaina ma tautinoga togafitiga faʻatinoina mo le togafitiga SA (e pei, Crosby, 2012Ua faamaonia le taua tele e faʻaititia ai faʻailoga o le le fiafia i taaloga faitupe ma SUDs (A-tjak et al., 2015; Li, Howard, Garland, McGovern, & Lazar, 2017; Maynard, Wilson, Labuzienski, & Whiting, 2018). Polokalame tuʻufaʻatasia, e tele na i ai CBT elemene, ma gaosia faʻateleina lava auga tele i vaega e tolu o vaisu, vagana ai mo le faʻaititia o le tele o le faʻamalosia o amioga feusuai. Peitai, o lenei iʻuga, sa faʻavae i luga o le suʻega e tasi na ese mai isi mai le faʻaaogaina o le Orzack Time Inventory Survey (OTIS; Orzack, 1999) na aliali mai “a le lava le aofia ai” (Orzack, Voluse, Wolf, & Hennen, 2006, itu. 354) e fuaina ai le taimi o le leaga o le komepiuta faʻaaogaina. Talu ai Orzack et al. (2006) tuuina atu le togafitiga i vaega faʻatulagaina, o le maualalo laʻasaga o lenei suʻesuʻega na faʻamatalaina foi le leaga o le faʻatulagaina o vaega pe a faʻatusatusa i faufautua faufautua faʻailo taua le taua o le faʻaaogaina o mea faʻatuatuaina ma faʻamaonia meafaigaluega (vaʻai foi Matau, Reid, Penberthy, Davis, & Jennings, 2014). I se faʻaopopoga, o tali a togafitiga na foliga mai e tutoʻatasi mai le ituaiga o faʻalauiloa, ae tasi le faʻatagaga: IA na aʻafia tagata na mauaina FTFTs foliga mai e tele atu ana aoga mai togafitiga na i lo o aofia i SGT. SGT faʻatinoina mo le togafitia o IA, peitaʻi, e aofia ai le matua maualalo le numera o vasega nai lo FTFT. O le mea lea, o le umi nai lo le ituaiga faʻalauiloa e ono faʻaalia nei eseesega i le va o-kulupu, e lagolagoina le iʻuga o se faʻafouga lata mai-auiliiliga (Goslar et al., 2017) lea na faʻaalia mai e ono puʻeina SGT e ono maua ai maualalo tulaga o le faʻaleleia nai lo maualuga-malosi, faʻataʻitaʻia polokalama lava-fesoasoani. Faʻamaoniga mo lenei sailiga na maua mai i ni sili atu SGT faʻatinoina mo le togafitiga o le SA (Hardy, Ruchty, Hull, & Hyde, 2010; Levin, Heninger, Pierce, & Twohig, 2017) ma CB (Mueller, Arikian, de Zwaan, & Mitchell, 2013), maua mai se aofaʻiga fua faʻatusatusa i na maua mo FTFT. Lenei, togafitiga manuia faʻateleina ma le umi o psychotherapy, aemaise lava e faʻatatau i le faʻaititia o le lalolagi tulaga faigata ma le taimi o le IA. I se vaʻaiga tutusa, ae leai se taua na matauina foi mo le faʻaititia o le ogaoga o le lalolagi o le SA. O nei sailiiliga e ogatasi ma mea mai Asia IA suʻesuʻega (Chun et al., 2017), ma i latou e mauaina mai le le fiafia i taaloga faitupe (Goslar et al., 2017; Leibetseder et al., 2011; Pallesen et al., 2005fautua mai e faapea o le faʻaaliga o vaisu vaʻaia e manaʻomia ai le sili atu togafitiga malosi ina ia maua le alualu i luma.

E pei foʻi o togafitiga faʻalenatura, o togafitiga faʻafomaʻi na faʻaalia le tele ma malosi o faʻaitiitia muamua i le tuʻufaʻatasiga o faʻailoga i isi vaega o vaisu e tolu. E leai ni faʻaiuga, ae ui i lea, e mafai ona tosina mai e faʻatatau i le umi o le tali atu i togafitiga ma le puʻeina o taimi o vailaʻau i luga o le placebo ona o le utiuti o le tele o faʻamaumauga. E le gata i lea, o placebo-faʻatonutonu faʻataʻitaʻi na faʻatautaia mo le togafitiga o le SA ma le CB na faʻaletonu i ni lagolago faʻaopopo e pei o fesoʻotaʻiga fomaʻi masani e aofia ai ma le mafaufau loloto i amioga faʻafitauli (Black, Gabel, Hansen, & Schlosser, 2000; Wainberg et al., 2006) poʻo se isi metotia faʻapitoa pei o le tausia o tusi o faʻatau (eg, Black & al., 2000; Ninan et al., 2000) saofaga i laiti i le va o-vaega eseesega, ma nana le aafiaga o vailaau sooupu (Black & al., 2000; Ninan et al., 2000; Wainberg et al., 2006). Mo faʻatusatusaga, o taimi puʻupuʻu na maua ai togafitiga o vailaʻau i luga o le placebo mo faʻafitauli o le olaGoslar, Leibetseder, Muench, Hofmann, & Laireiter, 2018, faʻapena foʻi ma i latou na lipotia mo le faʻaaogaina o le 'ava, ma le tele o faʻamaʻi fomaʻi ma faʻaletonu o le mafaufau. Jonas et al., 2014; Leucht, Hierl, Kissling, Dold, & Davis, 2012).

Na faʻaalia e le au faʻataʻitaʻi le leai o se suiga taua i le va o vasega o vailaʻau, e ui lava o togafitiga mo le faʻaititia o le tulaga faigata o le CB e foliga mai ua sili atu ona soʻona maualuga ona o le tele o auga tele faʻatatau i le faʻatonuina na maitauina i tofotofoga e lua (Uliuli, Monahan, & Gabel, 1997; Grant, Odlaug, Mooney, O'Brien, & Kim, 2012) faʻatusatusa i mea na maua mai ITT auiliiliga. O nei tofotofoga na latou iloa ai foi le tulaga maualuga o le pharmacological i le mafaufau togafitiga mo le faʻaititia o le mamafa o le lalolagi lagolagoina le faʻaaogaina o auiliiliga ITT, lea e faʻaalia ai se auala faʻataʻitaʻia faʻataʻitaʻia e atagia mai ai sili moni tulaga i le tulaga o togafitiga (eg, Sedgwick, 2015). Naʻo totonu o le IA vasega, o antidepressants foliga sili atu i isi vailaʻau. Peitaʻi, o le suʻesuʻeina auiliili o faʻamaumauga, na faʻaalia mai ai, o le kulupu ma le maualuga o togafitiga na ufiufi ai tagata matutua ma le faʻafitauli o le mafaufau, ma faʻafitauli e tele na togafitia i le fomaʻi, ma e aofia ai le faʻataʻitaʻiga ma le tele o auga tele (g = 2.54; DellʻOsso et al., 2008). Le subgroup ma le faʻaititia togafitiga maua, i le isi itu, aofia talavou ma le faʻamalosiʻauʻuga defact hyperactivity faʻafitauli (ADHD) togafitia ma psychostimulants (methylphenidate), ma o loʻo aofia ai le faʻataʻitaʻiga ma le maualalo ifo le tele o tulaga suʻesuʻe tagata taʻitoʻatasi ma maualalo le malosi o le IA (g = 0.57; Han et al., 2009). O nei eseʻesega ua afaina ai foʻi le au faʻatonutonu “aganuu” ma le “ituaiga IA”. Faʻatasi ai ma suʻesuʻega e lua na aveʻese mai le au faʻataʻitaʻi auiliiliga, o le lelei o antidepressants, ma faʻaiuga taua mo le faʻatautaia "aganuu", ma "IA ituaiga" mou. E ui o togafitiga i vaega uma e lua e maua ai faʻamanuiaga iuga, o feeseeseaiga foliga mai na avea ma taʻitaʻia e tasi tofotofoga. O lea, fegalegaleaiga i le va o soʻosoʻotau ADHD, vailaʻau togafitiga, tausaga, ma aganuu manaʻomia suʻesuʻega pe a sili atu le numera o suʻesuʻega o le a maua. E ese mai le comorbid ADHD, ae ui i lea, o le faʻaletonu-faʻalelei alualu i luma sa tutoʻatasi mai comorbid atuatuvale ma popolega, lagolago i sailiiliga mai le IA muamua (eg, Han & Renshaw, 2012) ma le faʻaletonu suʻesuʻega taʻaloga Dowling, Merkouris, & Lorains, 2016).

I le isi itu o vaega e tolu o vaisu, e masani lava o serotonin selective reuptake inhibitors (SSRIs) na suesueina faʻavae i luga o maualuga maualuga o comorbid lagona faaletonu (eg, Kafka, 1991) ma - aemaise faʻaaloalo i le SA - mea faʻalavelave a le serotonin i amioga faʻafeusuaiga (eg, Kafka & Prentky, 1992). Opioid antagonists (eg, naltrexone) ma glutamatergic vailaau (eg, topiramate) na iloiloina na o mataupu suʻesuʻe mo le togafitia SA (eg, Grant & Kim, 2001; Khazaal & Zullino, 2006) ma CB (eg, Grant, 2003; Guzman, Filomensky, & Tavares, 2007) faʻaalia ni mea aoga Talu ai o opioid antagonists ma le glutamatergic sui na faʻamaonia tulaga lelei togafitiga mo SUDs (Guglielmo et al., 2015; Jonas et al., 2014; Minarini et al., 2017) ma le le mautonu i taaloga faitupe (Bartley & Bloch, 2013; Goslar et al., 2018), o nei ituaiga vailaʻau foliga foliga mai o suʻesuʻega mo suʻesuʻega i totonu o lapisi-tele ma le puleaina o suʻesuʻega, aemaise lava i le malamalama o le maualuga o le tau o le comorbid SUDs matauina i BAs (eg, Grant et al., 2010).

O le tuʻufaʻatasia o togafitiga mo IA, ae maise vailaʻau faʻatasi ma CBT, e maua ai faʻaleleia atili o aʻoaʻoga pe a faʻatusatusa i le mama mafaufau ma faʻaletonu vailaʻau e lagolagoina le fautuaga o se toe iloiloga lata mai i le IA togafitiga suʻesuʻega iuga (Przepiorka, Blachnio, Miziak, & Czuczwar, 2014). O le maualuga o CBT tuʻufaʻatasiga o tuʻufaʻatasia ma isi metotia faʻafomaʻi na faʻamoemoeina e faʻavae i luga o se faʻamasinoga e tasi e maua ai se tele tele o aafiaga tele (g = 5.31; Yang, Shao, & Zheng, 2005,) aʻafia ai foi le au faʻafesoʻotaʻi "lelei" ma le "ituaiga IA". Ma i lenei suʻesuʻega aveesea mai vaega auiliiliga, peitaʻi, naʻo le lelei o tuʻufaʻatasiga CBT tumau taua.

E ui o le tele o faʻamatalaga na maua mai i le IA togafitiga suʻesuʻega iuga, ma o faʻamaumauga mai faʻataʻitaʻiga pulea e faʻatapulaʻaina, ae faʻaalia manatu faʻapitoa faʻafomaʻi ma vailaʻau vailaʻau i luga o tulaga e tolu, e faʻatusatusa i le faʻaaogaina mo vailaau faʻaaoga ma le le mautonu taaloga taʻalo (eg, Goslar et al., 2017; Grant et al., 2010lagolagoina o tatou talitonuga. O nei sailiiliga e le lava mo le faʻamaninoina o le faʻavasegaga o IA, SA ma CB i totonu o le siosiomaga o le mafaufau faʻaletonu o mafaufau ona o le leiloa le faʻamaonia o faʻailoga faʻamaonia, ma le faʻatapulaʻa o faʻamaʻi epidemiologis, kenera ma neurobiologis (eg, Grant et al., 2010). Peitai, latou fautua mai, o tagata taitoatasi e tali tutusa lelei i togafitiga tusa lava po o le a le ituaiga o vaisu. O nei iʻuga fetaui lelei i faʻataʻitaʻiga faʻataʻitaʻiga o faʻafitauli ua fai ma vaisu e faʻataʻotoina masani ai faiga faavae mo uma vailaʻau-faʻaletonu faaletonu ma BAs (Griffiths, 2005; Jacobs, 1986; Orford, 2001; Shaffer et al., 2004), lea e mafai ona faʻaleleia e ala i le faʻaaogaina o mafaufau ma faʻafomai togafitiga (Potenza et al., 2011). I le malamalama o le faʻaletonu prefrontal galue ma faʻamanuiaina taʻamilosaga i le taimi faʻaaogaina masani o vailaʻau ma amioga (eg, Nestler, 2005), faʻafitauli o le mafaufau, ae maise CBT-faʻavae filifiliga, i ai le agavaʻa e suia ai le le iloa mafaufau ma amioga le lelei (Kim & Hodgins, 2018), ma ia faʻamalosia le amio pulea e ala i le faʻatauaina o vaega muamua o faiʻai (Potenza et al., 2011). Togafitiga vailaau, i le isi itu, faʻamoemoe i le faʻaititia o le manaʻo ma le aveeseina o faʻailoga i le faʻatauaina o le auala auala ma le neurotransmitter polokalama (Potenza et al., 2011). E le gata i lea, e pei ona matauina mo le togafiti IA, o tuʻufaʻatasiga o CBT ma faʻafomai togafitiga e ono i ai se faʻaopoopoga aafiaga, e ui lava i fegalegaleaiga i le va o le lua e leʻo manino (Potenza et al., 2011).

O tapulaʻa nei e tatau ona maitauina: Muamua, e pei ona saʻo i le tele o iloiloga meta-analytic, o suʻesuʻega aofia e eseese i la latou metotia lelei, e ui lava pe a talanoaina fuainumera, matou te le i matauina se faʻaogaina faʻatulafonoina i le tele o tulaga ona o eseesega i le tulaga lelei o suʻesuʻega. Leai se tasi o suʻesuʻega, ae ui i lea, na mauaina le maualuga maualuga faʻailoga atagia ai le faʻatapulaʻaina lelei o faʻamaoniga e faʻatatau i le filifilia faʻaituau ma - ona o le sili ona lelei o totonu-vaega suʻesuʻega suʻesuʻega - i le faʻailoaina ma le faʻatonutonu o le feteenaiga, ma faʻasoasoaina. Ole mea lea, e manaʻomia le fuafuaina RCT e aofia ai le mataʻitūina o faʻamatalaga faʻaopoopo ma lagolago i faʻamaumauga, ae maise lava ile faʻataʻitaʻiga o vailaʻau. E le gata i lea, o le tele o IA suʻesuʻega aofia ai amioga eseese faia i luga o le initaneti (e pei o, taʻaloga i luga ole laiga, vaʻaiga ponokalafi), e ui lava suʻesuʻega faʻaalia le eseesega i le va o le sili atu manatu lautele o le IA ma faʻapitoa ituaiga ituaiga o amioga faʻatupuina taʻavale e le initanetiMontag et al., 2015). Peitai, sa matou taumafai e foia lenei faʻafitauli e ala i le faavasegaina o suʻesuʻega e tusa ma le uiga, tusa lava poʻo le a le faʻaaogaina. E tusa ai ma co-tutupu mai faʻalavelave, matou faʻatapulaʻa moderator auiliiliga i le atuatuvale ma popolega e le gata ona o lo latou maualuga tele i le va o amioga fai mausa (eg, Starcevic & Khazaal, 2017), ae ma faʻapea foʻi, o nei faʻamaumauga na matua manino lelei mai le faʻatapulaʻaina o tulaga o aʻoga muamua. Talu ai o isi tulaga e masani ona soʻofaʻatasi ma BA (faʻataʻitaʻiga, Grant et al., 2010), ma togafitiga tali atu e ono aʻafia i le natura o le faʻamalositino (Dowling et al., 2016), o loʻo faʻamalosia nisi suʻesuʻega e lipotia faʻataʻitaʻiga ituaiga ma tau o loʻo tutupu ai faʻafitauli ina ia iloiloina ai nei faʻamatalaga i le lumanaʻi meta-auiliiliga. Ole tele o suʻesuʻega na le mafai foʻi ona tuʻuina atu faʻamatalaga i faʻamatalaga na maua ai. O le auala e faʻamautu ai suʻesuʻega, peitaʻi, e ono afaina ai lo latou aoga (Carlbring et al., 2002; Vaʻai foi Andersson & Titov, 2014). Lenei suʻesuʻega lumanaʻi tatau ona lipotia pe o faʻailoga na maua e fomaʻi, o ia lava-lipoti, faʻafesagaʻi, poʻo luga o le initaneti. E le gata i lea, o aʻoaʻoga i le lumanaʻi o loʻo faʻamalosia e faʻatusatusa tuusaʻo le aʻafiaga o togafitiga mo tagata taʻitoʻatasi ma le BA ma le SUD ina ia suʻesuʻe ai tutusa ma eseʻesega i le va o mea faʻatatau i le vailaʻau ma mea e le faʻatatau i vailaau.

E ui lava i ia faʻatapulaʻaina, o faʻaiʻuga o le taimi nei o le faʻataʻitaʻiga-manatu e faʻaalia ai o se tele o faʻalavelave o le mafaufau e aoga mo le faʻaititia o faʻailoga o le IA, aemaise lava pe a momoli faafesagaʻi ma faia i luga o se taimi umi. E ui lava antidepressants ma psychostimulants mo tagata ma faatasi co-ADHD faaleleia a IA faʻailoga, CBT faʻatasi ma antidepressants faʻaalia se manuia i luga o monotherapies. Faʻavae i luga o le tulaga o loʻo iai nei suʻesuʻega, CBT ma antidepressants foliga lelei mo le togafitia o le SA ma le CB. Tuʻuina atu le manaʻoga mo togafitiga, e tatau ona faʻaauau pea suʻesuʻega o le neurobiologis, ina ia mafai ona faʻaalia mea e tutusa ai faʻalavelave e fesoʻotaʻi ma mea e ono fai ma vaisu, ma ia faʻaleleia atili le togafitiga mo nei tulaga faigata (Grant et al., 2010; Potenza et al., 2011).

Faatupeina o punaoa

O lenei suʻesuʻega sa le mauaina saʻo se fesoasoani tautupe mai soʻo se faʻatupega i soʻo se itu lautele, pisinisi, pe leai foi.

Fesoasoani a le tusitala

Na faʻatino e Martina Goslar suʻesuʻega tusitusiga, ma puʻeina faʻamatalaga ma na faia le auiliiliga. Pepa mo le aofia ai i le meta-auiliiliga na faʻailoaina e Martina Goslar ma Max Leibetseder oe na faʻamaonia foi faʻamatalaga mai fafo. Anton-Rupert Laireiter vaʻavaʻaia nei gaioiga. Na faʻamauina e Martina Goslar ma Max Leibetseder le aoga o nei suʻesuʻega. Sa lagolagoina e Hannah M. Muench le faʻatulagaina o faʻamaumauga ma tuʻuina atu faʻamatalaga faʻamaumauga. O le tusitusiga na tusia e Martina Goslar ma manatu faaalia e Hannah M. Muench, Anton-Rupert Laireiter, ma Stefan G. Hofmann. O tusitala uma na saofagā i ma faʻamaonia le tusi mulimuli.

Feeseeseaiga o tului

Na faailoa mai e Martina Goslar, e leai se feeseeseaiga o aia. Na faʻailoa mai e Max Leibetseder e leai sona feteenaiga o aia. Na faalauiloa mai e Hannah M. Muench e leai se feteenaiga o aia. Ua maua e Dr. Hofmann le fesoasoani tau tupe mai le Alexander von Humboldt Foundation (o se vaega o le Humboldt Prize), NIH / NCCIH (R01AT007257), NIH / NIMH (R01MH099021, U01MH108168), ma le James S. McDonnell Foundation 21^st Century Science Initiative i le Malamalama i le Faʻalauiloaina o Tagata - Polokalama Faʻapitoa. Na ia mauaina le taui mo lana galuega o le faatonu mai le Springer Natura ma le Asosi mo Saienitisi Faʻafomai, ma o se faufautua mai le Palo Alto Health Science ma mo lana galuega o se Matai Matter Expert mai John Wiley & Sons, Inc. ma SilverCloud Health, Inc. Na ia mauaina foi totogi ma totogi mo ana galuega faʻatonu mai nisi o tagata lolomitusi. Ua folafola e Anton-Rupert Laireiter e leai se feteenaiga o aia.

tautinoga

E fia faʻafetai atu le tusitala i le Mrs Xuan Wang ma Mrs Yang Zhang o le na faaliliuina lomiga Saina.

faʻaopoopogaFuafuaga mo le Aafiaga Tele Fua

Ina ia fuafua le lapoʻa i totonu o le kulupu, na faʻaaogaina ai fua nei:Borenstein et al, 2005, 2009):

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

ia faapena Y¯ ¯ ¯1 atagia ai le muaʻi faiga, Y¯ ¯ ¯2 atagia mai ai le post-treatment uiga, S_eseʻesega atagia ai le tulaga masani o le suiga o le eseesega, ma r faʻaalia ai le faʻafesoʻotaʻiga i le va o le faʻataʻitaʻiga ma togi posttreatment. Ona o laʻititi faʻataʻitaʻiga, o faʻatonuga uma na faʻasaʻoina mo le faʻaituau i le faʻaaogaina o Hedges's g lea na faʻamatalaina i le faʻateleina d faʻatasi ai ma faʻasaʻoga

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

ia faapena df e fai ma sui o tikeri o le saolotoga e fuafua ai le eseese o lau vasega. O nei faiga na faʻaaogaina foi mo le fuafuaina o alualu i luma mai i le muamua togafitiga ia latou toe siakiina. O le puleaina o le tele faʻatusatusaga na fuafua e faʻaaoga le fuaitau lea:

g = ( Δ ¯ ¯ ¯ TREAT - Δ ¯ ¯ ¯ FAAOFI ) ( n TREAT - 1 ) S D 2 TREAT + ( n FAAOFI - 1 ) S D 2 FAAOFI n Aofai - 2 ------------------------- \sqrt \times (1 - 3 4 ( n Aofai - 9 )),

ia faapena Δ ¯ ¯ ¯ ¯ o le leaga i luma atu-ina ua mavae-togafitiga suiga, SD o le tulaga masani ese o le post-togafitiga faʻailoga, n O le faʻataʻitaʻiga tele, o le TREAT e faʻasino i le gaioiga o togafitiga, ma le CONT e faʻasino i le tulaga pule. Mulimuli mai Rosenthal (1991), matou faʻatatauina aʻo leʻi maeʻa le faʻaaogaina e avea r = 0.70.

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Togafitiga mo initaneti vaisu, feusuaiga fai ma vaisu ma faamalosia faʻatau: O se faʻamatalaga-iloiloga (2020)

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