Daaweynta balwadaha internetka, qabatinka galmada iyo iibsashada khasabka ah: Falanqaynta meta (2020)

aan la taaban karin

Taariikhda iyo ujeeddooyinka

Qabatinka internetka, qabatinka galmada iyo iibsashada khasabka ah waa dhibaatooyin dabeecad oo caadi ah, kuwaas oo la wadaaga wax la mid ah ciladda khamaarka iyo dhibaatooyinka isticmaalka maandooriyaha. Si kastaba ha noqotee, wax yar baa laga ogyahay wax ku oolnimada daaweyntooda. Ujeeddada falanqaynta meta-daani waxay ahayd in la baaro wax ku oolnimada daaweynta daaweynta dabeecadaha dhibaatada noocaas ah, iyo in la sawiro is barbardhiga ciladda khamaarka iyo ciladaha isticmaalka maandooriyaha marka loo eego jawaabta daaweynta.

Dariiqooyinka

Raadinta suugaanta waxay dhalisay 91 daraasadood oo wadarta 3,531 kaqeybgaleyaal ah si ay u bixiyaan qiimeyn dhammaystiran oo ku saabsan muddada-dheer iyo waxtarka muddada-dheer ee cilmu-nafsiga, daawooyinka iyo isku-darka daaweynta ee balwadda internet-ka, qabatinka galmada, iyo iibsashada khasabka ah.

Natiijooyinka

Cilmi-nafsiyeed, dawooyin, iyo daaweyn isku dhafan ayaa lala xiriiriyay hagaajinta hore ee boostada ee darnaanta adduunka ee qabatinka internetka (Hedges's g: 1.51, 1.13, iyo 2.51, siday u kala horreeyaan) iyo qabatinka galmada (Hedges's g: 1.09, 1.21, iyo 1.91, siday u kala horreeyaan) ). Iibsashada qasabka ah, daaweynta nafsaaniga ah iyo daaweynta dawooyinka ayaa sidoo kale lala xiriiriyay hoos u dhac weyn oo horay loo sameeyay oo ku saabsan darnaanta adduunka (Hedges's g: 1.00 iyo 1.52, siday u kala horreeyaan). Qiyaasta saameynta hore ee dabagalka ah ee kooxda la xakameeyey iyo koox-kooxeeduba waxay ahaayeen kuwo isku mid ah, marka laga reebo in yar oo ka reeban. Falanqaynta dhexdhexaadiyaha ayaa soo jeedinaysa in waxqabadyada nafsaaniga ah ay wax ku ool u yihiin yareynta dabeecadaha qasabka ah, gaar ahaan marka la geeyo fool-ka-fool iyo in lagu qabto waqti dheer. Isku-darka habab garashada-habdhaqanka leh ee daawooyinka ayaa muujiyey faa'iido ka badan monotherapies.

Dood iyo Gunaanad

Natiijooyinka waxay soo jeedinayaan in daaweynta loogu talagalay balwadaha dabeecadda caanka ah ay wax ku oolka yihiin muddada gaaban, oo la mid ah kuwa loo hirgaliyay cilad-khamaarka iyo ciladaha isticmaalka maandooriyaha, laakiin loo baahan yahay tijaabooyin caafimaad oo adag.

Daraasad dhowaan la sameeyay waxay ogaatay isku ekaanshaha u dhexeeya ciladaha isticmaalka maandooriyaha (SUDs) iyo qabatinka dabeecadda (BAs; tusaale ahaan, Grant, Potenza, Weinstein, & Gorelick, 2010). Sidaas awgeed, waxyaabaha maandooriyaha ah ee la xiriira maandooriyaha ayaa lagu qeexay iyada oo lagu saleynayo aasaaska isticmaalka maandooriyaha oo lagu qeexay Buugga Baadhista iyo Buugga Tirakoobka ee Cilladaha Maskaxda (DSM IV); Ururka cilmi-nafsiga ee Mareykanka, 1994) oo ay kujirto ku mashquulida dabeecada gaarka ah, xakameyn la'aanta dabeecadda, dulqaadka, ka bixitaanka, iyo dabeecadda sii socota in kasta oo cawaaqib xumo (tusaale ahaan, Grant et al., 2010). Waqtigaan la joogo, kaliya khamaarka khamaarka (GD), oo hoos loogu dhigay "Dhibaatooyinka Xakamaynta-Kartida Aan Meel Kale Lagu Aasin" ee DSM IV (Ururka cilmi-nafsiga ee Mareykanka, 1994), waxaa lagu qeexay qaybta cusub “Dhibaatooyinka Maandooriyaha iyo Dhibaatooyinka Maandooriyaha”Ee DSM-5Ururka cilmi-nafsiga ee Mareykanka, 2013). Dib-u-habeyntaani waxay kicisay doodo badan oo ku saabsan in dabeecadaha kale ee xakamaynta yar ay tahay in loo tixgeliyo sida ugu macquulsan ee musharraxiinta BAs ah (tusaale ahaan, Grant et al., 2010; Mueller et al., 2019).

Marka laga reebo GD, qalalaasaha khamaarka internetka (IGD) waa xaaladda kaliya ee lagu meeleeyo DSM-5 ee hoos timaada Qeybta III iyadoo la soo jeedineysa cilmi-baaris dheeri ah (Ururka cilmi-nafsiga ee Mareykanka, 2013). Waxa taageera khubaro ka kala socota aagag caafimaad oo kala duwan iyo dawladeed (tus., Rumpf et al., 2018; Saunders et al., 2017), cilad-darrada ciyaarta ayaa sidoo kale loo tixgeliyaa qabyo-qoraalka ICD-11 (Ururka Caafimaadka Adduunka, 2018). Waxaa muhiim ah in la ogaado in IGD lagu kala sooco nashqadeynta internetka ee balwadaha adduunka (IA), maadaama labaduba matalaan dhismayaal kala duwan (tusaale ahaan, Griffiths & Pontes, 2014; Kiraly et al., 2014). Si kastaba ha noqotee, maadaama qoraallo badan ay tixraacaan IA adduunka, ereygan sidoo kale waa lagu qaatay warqaddan. Waxaa intaa dheer, farqiga waa in lagu sameeyaa "khamaarka" iyo "khamaarka": Halka "Ciyaarta guud ahaan lagu qeexo is dhex galkeeda, ciyaarta inta badan ku saleysan xirfada, iyo tilmaamayaasha guud ee horumarka iyo guusha, ... khamaarka waxaa lagu qeexaa sharadka iyo farsamada gacanta, natiijooyinka inta badan go'aan ka go'an, iyo qaababka monetures ee ku lug leh halista iyo bixinta lacagta ciyaaryahanka. ” (King, Gainsbury, Delfabbro, Hing, & Abarbanel, 2015, p. 216).

In kasta oo ku darista "IGD" ee buugaagta baaritaanka lagu ogalaan karo si muran leh looga hadlay suugaanta sayniska (King et al., 2019; Petry, Rehbein, Ko, & O'Brien, 2015; Rumpf et al., 2018; Saunders et al., 2017), baaritaan badan ayaa horay loogu sameeyay IA iyo IGD, gaar ahaan tillaabooyinka neerfaha ee soo jeedinaya isbarbar dhiga SUDs Fauth-Buhler & Mann, 2017; Kuss, Pontes, & Griffiths, 2018). Ka fogow isku ekaanshaha u dhexeeya SUDs iyo BAs marka loo eego astaamaha naxdinta leh iyo kuwa caafimaad, sumcadda iyo taariikhda qoyska, gaar ahaan natiijooyinka baaritaanka cilmi-nafsiga waxay u muuqdaan kuwo muhiim u ah aqoonsashada astaamaha dabeecadaha balwadda leh (tusaale ahaan, Grant et al., 2010; Potenza, Sofuoglu, Carroll, & Rounsaville, 2011).

Iyada oo la tixgalinaayo tixgalintaan, xoogaa horumar ah oo ku saabsan baaritaanka caabuqyada neerfayaasha la wadaaga ee loo yaqaan 'SUDs' ayaa dhowaanahan lagu gaadhay astaamaha qabatinka jinsiga (SA) iyo iibsashada khasabka ah (CB) iyadoo la falanqeynayo ifafaalaha caado ahaan lagu baaray SUDs sida habraacyada xaaladaha (tusaale ahaan, Hoffmann, Goodrich, Wilson, & Janssen, 2014; Snagowski, Laier, Duka, & Brand, 2016), firfircoonida dareenka, eexashada feejignaanta iyo dhaqdhaqaaqa shabakada neural ee la xiriira (tusaale ahaan, Sumadda, Snagowski, Laier, & Maderwald, 2016; Gola iyo 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 vd, 2014), ama hawl qabad fulin (Derbyshire, Chamberlain, Odlaug, Schreiber, & Grant, 2014; Messina, Fuentes, Tavares, Abdo, & Scanavino, 2017; Raab, Elger, Neuner, & Weber, 2011; Trotzke et al., 2015). Daraasadahaani waxay muujiyeen in shuruudahaas oo aan weli si rasmi ah loogu aqoonsan karin DSM-5 sida BAs, caddeynta hadda jirta ee ku saabsan tilmaamayaasha neerfaha ee isbarbardhiga u dhexeeya dabeecadaha la xiriira iyo dabeecadaha aan la xiriirin waxyaabaha inta badan ka yimaadda aagagga IA, SA. iyo CB, kuwaas oo ah udub dhexaadka warqadda hadda jirta. Maaddaama dhibaatooyinkaani yihiin kuwo ku habboonaanta kiliinikada, oo inta badan la xidhiidha cawaaqib xumada loogu talagalay shakhsiyaadka ay dhibaatadu saameysey (tusaale ahaan, Pontes, Kuss, & Griffiths, 2015), xulashooyinka daaweynta ee waxtarka leh waxay u baahan yihiin in la baaro (tusaale ahaan, Grant et al., 2010). Ilaa hada, la daabacay-falanqaynta metalaad ayaa ugu horreyntii la sameeyay iyadoo la tixraacayo IA oo caddaynaysa hufnaanta dariiqooyinka daaweynta kala duwan (Chun, Shim, & Kim, 2017; Liu, Liao, & Smith, 2012; Winkler, Doersing, Rief, Shen, & Glombiewski, 2013). Laba ka mid ah tijaabooyinka meta-falanqaynta ayaa baaray cilmi nafsi ahaan, dawooyinka iyo isku darka labadaba waxqabadka, laakiin caddaynta ayaa ku koobnayd daraasadaha natiijooyinka daweynta ee Shiinaha (Liu et al., 2012), iyo Kuuriya (Chun iyo al., 2017). Dib-u-eegistii ugu sarreeysay ee metelo-falanqeyntu waxay taageertay caddeynta ku habboonaanta cilmu-nafsiga iyo daweynta caafimaad si loo yareeyo astaamaha IA oo ay ku jiraan tijaabooyin ka socda waddamada Aasiya iyo galbeedka (Winkler et al., 2013). Waxqabadyada isku-dhafan, hase yeeshe, looma tixgelin. Waxaa intaa dheer, meta-falanqaynta Winkler et al. (2013) kuma soo dirin cilmi baaris dhawayd.

Natiijooyin wanaagsan oo loogu talagalay waxqabadyada cilmi-nafsiga iyo dawooyinka ee yaraynta darnaanta caalamiga ah ee CB ayaa sidoo kale laga helay falanqayn yar-yar oo dhowaan la soo saaray (Hague, Hall, & Kellett, 2016). Si kastaba ha noqotee, saameynta tayada daraasadda iyo dhexdhexaadiyeyaasha kale ee natiijooyinka daaweynta lama baarin. Sidaa awgeed, baaritaan dhammaystiran oo ku saabsan xulashooyinka daaweynta ee IA iyo CB wali waa la sugayaa. In kasta oo SA loo tixgeliyo ICD-11 oo leh ereyga "khalkhalka dabeecadda galmada ee qasabka ah" (Ururka Caafimaadka Adduunka, 2018), iyo "dareenka is-sheegashada ee la qabatinka sinada maahan wax aan caadi ahayn" (Grubbs, Kraus, & Perry, 2019, p. 93), daaweynta loogu talagalay SA wali laguma baarin hababka meta-analytic. Intaa waxaa sii dheer, isbarbardhigyo wali lama samayn inta u dhaxaysa IA, ama IGD — murashax qaybta “Dhibaatooyinka Maandooriyaha iyo Dhibaatooyinka Maandooriyaha"DSM-iyo dabeecadaha kale ee balwada leh, sida SA iyo CB, oo ku saleysan jawaabta daaweynta, oo loo arko inay tahay tilmaame muhiim u ah isbarbardhiga u dhexeeya SUDs iyo BAs (tusaale ahaan, Grant et al., 2010).

Ujeedada ugu weyn ee falanqaynta meta-hada, sidaa darteed, waxay ahayd in la baaro wax ku oolnimada cilmu-nafsiga, dawooyinka iyo isku-darka wax-ka-qabashada cilmi-nafsi iyo dawooyinka ee IA, SA, iyo CB ee yareynta (a) darnaanta adduunka iyo (b) inta jeer ee khasabka ah Dabeecadaha ka dib joojinta daaweynta (saamaynta muddada-gaaban) iyo muddadii ugu dambeysay ee la soo sheegay ee la socoshada (saamaynta muddada-dheer). Iyada oo ku saleysan natiijooyinka dib u eegisyadii ugu dambeeyay (Hague iyo al., 2016; Winkler et al., 2013), waxaan fileynay in daaweynta cilminafsiyeed iyo dawooyinka cilminafsiyeed ay si isku mid ah waxtar ugu yeelan doonaan saddexda qaybood ee balwadaha. Waxaan sidoo kale fileynay in natiijooyinka daaweynta inay la mid yihiin kuwa loo soo sheegay isticmaalka maandooriyaha iyo khamaarka (Grant et al., 2010; Potenza et al., 2011). Intaa waxaa sii dheer, yoolkeennu wuxuu ahaa in la aqoonsado dhexdhexaadiyeyaasha suurtagalka ah ee cabirrada saamaynta ee qayb kasta oo balwadaha ah. Falanqaynta meta-meta waxaa loo qabtay iyadoo la raacayo talo soojeedinta Bayaanka PRISMA (Moher, Liberati, Tetzlaff, & Altman, 2009).

Dariiqooyinka

Shuruudaha xaq u yeelashada

Daraasadaha waxaa loo qaddariyo ka mid noqoshada haddii (1) ay shaqaaleeyaan nooc kasta oo cilmi nafsi ah, daawo-gacmeed, ama faragelin isku-dhafan (tusaale, wax-ka-qabashada cilmi-nafsi ahaan iyo dawooyinka dawooyinka isla waqtigaas la adeegsaday); (2) loo isticmaalay koox-kooxeed, kala-sooc, ama naqshadeynta daraasadaha daraasadaha la-kantaroolay ee ay kujiraan kontaroolada liiska sugitaanka, ka-qeyb-galayaasha oo aan helin daaweyn, daaweyn kale oo firfircoon, ama wax-ka-qabasho placebo; (3) kaqaybgalayaasha daaweynta leh ee lagu garto cudurka IA, SA, ama CB; (4) cabbir ugu yaraan mid ka mid ah doorsoomayaasha natiijada (ie, darnaanta adduunka ama soo noqnoqoshada); iyo (5) waxay soo sheegeen xog tirakoob ku filan oo loogu talagalay xisaabinta cabirka saamaynta. Daraasadaha waa laga saaray haddii (1) daraasaddu ay ahayd daraasad keliya; (2) muunadda daraasadda lagu soo lifaaqay oo gebi ahaanba ku xidhan shaybaarka daraasad kale oo lagu soo daray falanqaynta meta-meta; (3) daaweynta lama sharixin, ama (4) ma jirin wax nuqul ah ama qoraal buuxa ee daraasadda la heli karo. Marka laga hadlayo SA, kaliya waxaan ku soo darnay daraasado baaritaano kusaabsan akhlaaq xumada galmada kadib qeexida ay soojeedisay Kafka (2010), oo laga saaray daraasadaha diiradda saaraya daweynta cudurka 'paraphilias' ee ka duwan tan SA marka loo eego "qaab nololeed bulsheed ama 'qalloocsan' qaababka galmada.Kafka, 2010, p. 392).

Ilaha macluumaadka iyo raadinta suugaanta

Waxaan ku sameynay raadinta buugaag badan oo buugaag ah anaga oo isticmaaleyna kaydadka macluumaadka 'PsycInfo, Medline, PubMed, Psyndex, iyo' ISI Websaydhka Aqoonta '. Baaritaanku wuxuu daboolay dhammaan daabacadihii la xiriiray laga soo bilaabo sanadkii ugu horreeyay ee la heli karo illaa Juun 30, 2019 iyadoo la adeegsanayo shuruudaha raadinta ee la xiriira cilad-darrada: qabatinka internetka, qabatinka internetka ', ciladda ciyaarta internetka', qabatinka ciyaarta fiidiyowga game, cayaaraha fiidiyowga ciyaarta ', qabatinka fiidiyowga', qabatinka ciyaarta kombiyuutarka ∗, qabatinka taleefanka gacanta add, qabatinka taleefanka gacanta, qabatinka warbaahinta bulshada ∗, qabatinka facebook ∗, dhibaatada phone taleefanka gacanta; galmada ict balwad sex, galmo ∗ qasab ∗, galmo "kicin", hyperex ∗, galmada nonparaphilic ∗, cilad la xiriirta paraphilia ∗; dukaamaysiga khasabka ah, iibsashada firfircoon ∗, oniomania, shopaholic ∗, overshopping marka lagu daro faragelinta ereyada la xiriira faragelinta, wax ka qabashada, daaweynta, teraabiyada cilmu-nafsiga. Shuruudo isku mid ah ayaa loo adeegsaday in lagu baaro barnaamijka Proquuest Digital Dissertations ee loogu talagalay kuwa aan la daabicin, suugaanta cawlan. Marka xigta, waxaan sameynay baaritaan qoto dheer oo liisaska tixraaca ee maqaallada dib-u-eegista, falanqaynta meta, iyo daraasadihii asalka ahaa ee laga soo qaatay keydka macluumaadka. Intaa waxaa sii dheer, qorayaasha maqaallada ay quseyso ayaa lala xiriiray si ay u weydiistaan ​​xog la waayey iyo / ama waraaqo aan la shaacin oo ku habboon ka mid noqoshada falanqaynta. Daabacaadaha Shiinaha ayaa waxaa tarjumay laba ku hadla oo asal ahaan aqoon u leh.

Tallaabooyinka natiijada

Iyada oo la raaco tallaabooyinka natiijada inta badan la soo sheego ee daraasadihii asalka ahaa, waxaan cayimnay laba isbadal oo natiijada ah si loo go'aamiyo yareynta astaamaha cudurka: (1) darnaanta adduunka, oo ay ku xaddidan yihiin adeegsiga aaladaha qiimeynta, iyo (2) inta jeer ee (tusaale ahaan, Tirada saacadaha lagu qaatay internetka, daawashada qaawan, ama tirada iibsashada usbuucii la soo dhaafay ama bishii), oo ay kuxiran yihiin kaararka xusuus qorka ama warbixin-shaqsiyeed.

Xulashada Daraasada

Xulashada daraasadda waxaa sameeyay laba muraayadood oo madax-bannaan (qorayaasha koowaad iyo kan labaad, MG iyo ML), waxaana kormeeraya qoraaga ugu dambeeya ee warqaddan (AL). Khilaafka u dhexeeya qorayaasha waxaa lagu xalliyay dood.

Habka aruurinta macluumaadka iyo soo saarista xogta

Waxaan soo saarnay foomka soo saarista xogta qaabeysan oo aan dib u habeyn ku sameynay isla markaana aan wax ka beddelnay ka dib markii tijaabada tijaabada lagu sameeyay muunad ah 10 daraasadood. Si loo xisaabiyo pre-post iyo dabagal ku samaynta cabirka saamaynta kooxda, xogta tirooyinka ayaa laga soo saaray xaalad kasta oo daweyn ah iyo natiijada ka soo baxda. Haddii daaweyn kaladuwan oo cilmi nafsi ama dawooyin ah lagu baaray hal daraasad, xogta xaalad kasta ha loo qoro si gooni gooni ah waxaana lagu soo daray cabirka saamaynta kooxda dhexdeeda ee falanqaynta tirakoobka. Si loo xisaabiyo cabirka saameynta hore ee post-post, xogta liiska sugitaanka, daweyn, iyo kooxaha xakameynta booska ayaa lagu soo daray. Intaa waxaa sii dheer, waxaan ka soo saarnay xog tiro iyo qayb qaybba daraasad kasto ah si aan u sameeyno falanqeyn ku saabsan qaabaynta. Soo saarista xogta waxaa sameeyay qoraa koowaad (MG), waxaana ansaxiyay qoraa labaad (ML). Qiimaynta labada coders madax-bannaan ayaa diiradda saareysa noocyada daaweynta, cabirka natiijada doorsoomayaasha natiijada, iyo isku hallaynta iyo ansaxnimada baaritaanka cudurrada-gaarka ah. Daraasadaha, si kastaba ha noqotee, isla agabkii ayaa lagu dabaqay labadaba qiimaynta cudurada-gaarka ah iyo cabiraada natiijada kaladuwan “darnaanta guud” inta daaweyntu socoto. Sababtoo ah qiimeynta kalsoonida iyo ansaxnimada aaladaha loo adeegsaday cabbiraadda natiijada doorsoomayaasha ayaa sidoo kale qeyb ka ahaa qiimeynta halista eexda ee daraasadaha shaqsiga ah (hoos ka eeg), isku hallaynta dhex-dhexaadka ah ee laga soo qaatay tirakoobka kappa ayaa la sameeyay oo keliya noocyada daaweynta.

Halista eexda ee daraasadaha shaqsiga ah

Waxaan qiimeynay ansaxnimada gudaha ee daraasad kasta iyadoo la adeegsanayo Aaladda Qiimeynta Tayada ee Daraasadaha Tirada, oo ay soo saartey Mashruuca Dhaqanka Caafimaadka Dadweynaha ee wax ku oolka ah (EPHPP)Thomas, Ciliska, Dobbins, & Micucci, 2004). Qalabkani wuxuu muujiyey tusmada iyo dhisida ansaxnimada (Thomas et al., 2004) waxaana lagula talinayaa dib u eegis habaysan iyo falanqayn-metaDeeq et al., 2003). Daraasad kasta waxaa lagu qiimeeyay qaab ahaan jaangooyooyin lix qaybood ah: eexda xulashada, qaabeynta daraasadda, aqoonsashada iyo xakamaynta walxaha isku-buuqa, indho-la’aanta, isku-halaynta iyo ansaxnimada aaladaha xog aruurinta, iyo warbixinta iyo boqolkiiba ka bixidda iyo ka-tagidda. Qayb kasta waxaa loo qiimeeyay mid xoogan, dhexdhexaad ah, ama daciif ah. Qiimaynta caalamiga ah ayaa la xisaabiyey ka dib markii la qiimeeyay lixda qaybood. Labada qoraa ee ugu horreeyay (MG iyo ML) waxay si iskood ah u qiimeeyeen daraasad kasta waxayna go'aamisay natiijada adduunka ee tijaabo kasta. Ku tiirsanaanta Dhex-dhexaadiyaha ayaa la soo koobay iyadoo la isticmaalayo tirakoobka kappa. Khilaafaadka ka dhex jira qorayaasha ayaa lagu xalliyay wadahadal ilaa laga gaaro heshiis.

Xisaabinta cabirka saamaynta iyo isugeynta xogta tirooyinka

Falanqaynta tirakoobka waxaa lagu sameeyay iyadoo la adeegsanayo barnaamijka software Comprehensive Meta-Analysis (CMA) nooca 2.2.064 (Borenstein, Hedges, Higgins, & Rothstein, 2005). Qeyb kasta oo mukhaadaraad ah, waxaan u xisaabinay saamiyada saamaynta natiijooyinka doorsoomayaasha ee lagu soo warramey cilmi-nafsi, daaweyn, iyo daraasado isku dhafan oo si gooni ah loogu talagalay koox-kooxeed iyo naqshadeynta daraasadda la xakameeyey (eeg Lifaaqa qaabeynta). Saamiyada yar yar awgood, cabirka saamaynta waxaa lagu saxay eexasho iyadoo la adeegsanayo Hedges's g oo u dhigma 95% isku xirnaanta kalsoonida (CI; Xeryaha & Olkin, 1984). Haddii habka iyo weecinta caadiga ah aan la helin, cabirrada saamaynta waxaa lagu xisaabiyay iyadoo lagu saleynayo habraaca u dhigma (tusaale ahaan, t qiyamka, ama heerarka itimaalka saxda ah). Haddii doorsoome natiijada lagu cabbiro wax ka badan hal aalad, xogta aaladahaan waxaa loo galinayaa si gooni gooni ah waxaana iskugu keenaya isbadalka natiijada gaar ahaaneed (Lipsey & Wilson, 2000). Daraasadaha ka warbixinaya xogta ku saleysan labadaba dhammaystirka iyo falanqaynta ujeedka-daaweynta (ITT), xogta ITT waa la tixgeliyey. Jihada saameynta ayaa lagu hagaajiyay iyadoo loo eegayo "guusha": cabirka saameyntu wuxuu ahaa mid hagaagsan haddii kooxda la daweeyay ay ka sarreeyaan kooxda xakamaynta. Marka loo eego talooyinka Cohen (1977), cabirka saamaynta 0.20 ilaa 0.30 waxaa loo kala saari karaa mid yar, kuwa ku dhow 0.50 dhexdhexaad ah, iyo kuwa ka sarreeya 0.80 sida weyn.

Adoo ka soo qaadanaya heterogeneity ka mid ah daraasadaha, waxaan go'aansanay inaan u isticmaalno moodalka saameynta aan tooska aheyn ee loogu talagalay is dhexgalka cabirrada saameynta Heterogeneity ee cabirrada saameynta ayaa la baaray iyadoo la adeegsanayo tirakoobka Q oo u dhigma p qiimaha, iyo I2 tiro ahaan, oo muujinaya illaa heerka kala duwanaanshaha dhabta ah ee cabirrada saameynta ay ka muuqatay saamiga kala-duwanaanta (Borenstein, Hedges, Higgins, & Rothstein, 2009; Higgins, Thompson, Deeks, & Altman, 2003); I2 qiimayaasha 25%, 50%, iyo 75% waxaa lagu kala saaraa hoose, dhexdhexaad, iyo sare, siday u kala horreeyaan (Higgins iyo al., 2003).

Halista eexda ee dhammaan daraasadaha

Si loo xakameeyo eexda daabacaadda, waxaan sameynay raadinta suugaanta oo qoto dheer oo aan xisaabinay Rosenthal's guuldaro-badbaado N (Rosenthal, 1979) iyo sidoo kale la baadhay shirqooladaha funnel (Duval & Tweedie, 2000). Sida laga soo xigtay Rosenthal (1991), cabirrada saamaynta waxaa loo tixgeliyaa inay xoog badan yihiin haddii tirada daraasadaha loo baahan yahay si loo helo saameyn aan la taaban karin guud ahaan ka badan tahay 5k + 10, xaggee k wuxuu matalaa tirada daraasadaha. Intaa waxaa sii dheer, waxaan adeegsannay habka jar-iyo-buuxin (Duval & Tweedie, 2000) in la qiyaaso daraasadaha ka maqnaanaya iyo raadka ay ku leeyihiin cabirka saamaynta la xaqiijiyay. Qaabkani wuxuu ku saleysan yahay macquulnimada qolka jiifka wuxuuna soo qaataa qaybinta sumadda ee cabbirrada saamaynta ee doorsoomayaasha natiijada marka maqnaanshaha daabacaadda la daabacay. Arrinta qaybinta asymmetrical-ka, habka loo yaqaan 'trim-and-buuxintu' wuxuu isku hagaajiyaa oo saxayaa cabirka saamaynta (Borenstein et al., 2009); waxaan ku dalbanay qaabkan haddii 10 daraasadood loo heli lahaa falanqaynta (Sterne, Egger, & Moher, 2011). Nidaamka asymmetry Funnel waxaa lagu qiimeeyay iyadoo la adeegsanayo tijaabada Egger (Egger, Smith, Schneider, & Minder, 1997). Iyada oo qiyamka qiyaasta saamaynta aan caadiga ahayn ay soosaartay tafsiir marin habaabin ah oo ku saabsan saamaynta daaweynta (Lipsey & Wilson, 2000), Waxaan adeegsanay habka "hal-daraasad-laga saaray" oo ay bixiso CMA si loo baaro saameynta daraasad kasta saameynteeda ay ku leedahay guud ahaan saameynta (Borenstein et al., 2005). Haddii natiijooyinka dib loo xisaabiyo aysan si muuqata saameyn ugu yeelan cabirka saamaynta oo ay ku nagaadaan 95% CI, daraasadaha ayaa lagu hayey falanqaynta.

Falanqaynta Moderater

Si aan u sharraxno heterogeneity ee cabirrada saameynta, waxaan baarnay nooca falanqaynta xogta (ITT iyo lafagurista dhammaystirka), iyo tayada daraasadaha (EPHPP dhibcaha adduunka) sida dhexdhexaadka ah. Sababta oo ah niyad jab iyo walwal ayaa la ogaaday inay xidhiidh la leeyihiin BAs (tus., González-Bueso iyo al., 2018; Starcevic & Khazaal, 2017), waxaan baarnay bal in cabirrada saameyntu ay kaladuwan tahay sida shaqada shaqaalahan isku dhaca ah (ku darida iyo ka saarida niyad jab iyo / ama walwal). Tan iyo markii cilado isku dhaca, gaar ahaan niyad jabka iyo walaaca, ay ku badan yihiin shaqsiyaadka ay saameeyeen BAs.Starcevic & Khazaal, 2017), daraasado ku fashilmay inay soo sheegaan xogta ku saabsan xaaladaha cudurka 'comorbid' ayaa loo qaatay inay ka mid yihiin kaqeyb galayaasha murugada iyo walaaca sidoo kale. Daraasadaha cilmu-nafsiga, waxaan sii baadhnay habka daaweynta (koox dejinta iyo la-talinta shaqsiyadeed iyo noocyada kale ee meeleyn ah [tusaale ahaan, goob shaqsi iyo kooxeed, dejinta qoyska]), habka gaarsiinta (waji ka waji [FTFTs] vs. daaweynta is-hagista [SGTs]), iyo nooca faragelinta nafsaaniga ah. Nooca wax ka qabashada nafsaaniga ah waxaa lagu falanqeeyay iyadoo loo qeybinayo istiraatiijiyadda cilmi nafsi qeyb hoosaadyada soosocda: (1) CBT, oo dabooleysa garashada iyo / ama daaweynta dabeecadda; (2) daaweyn isku-dhafan oo ku lug leh habab daaweyn kala duwan, iyo (3) daaweyn nafsi ah oo la xiriirta qeybaha kale, sida daaweynta qoyska, daaweynta dhabta ah, aqbalida iyo daaweynta ka go'naanta, ama daaweynta farshaxanka. Adoo ka soo qaadanaya in tiro daraasado ah laga sameeyey waddammada aan reer galbeedka ahayn, gaar ahaan IA, waxaan raacnay falanqayn yar oo hore ah (Winkler et al., 2013) iyo sahamiyay in asalka dhaqanku (Aasiya iyo dalal kale) ay muujiyeen inuu yahay dhex-dheraad. Maaddaama caalamiga ah IA iyo IGD ay u taagan yihiin dhismayaal kala duwan (tusaale ahaan, Griffiths & Pontes, 2014), waxaan sidoo kale baarnay farqiga u dhexeeya daraasadaha ku saleysan IA adduunka iyo kuwa, ee baaray IGD iyo howlaha kale ee internet-ka awood u leh (tusaale ahaan, qabatinka taleefanka gacanta, qabatinka fiidiyowga).

Daaweynta daweynta, waxaan baarnay in dawooyinka lidka ku ah dawooyinka lidka ku ah ay ka sarreeyaan noocyada kale ee dawooyinka ama dawooyin isku dhafan (tusaale, dawooyinka lidka ku ah methylphenidate). Daraasadaha la isku daray, waxaan baarnay labadaba saamaynta noocyada waxqabadyada cilmi nafsi ahaan iyo kuwa dawooyinka. Intaa waxaa sii dheer, waxaan baarnay in mid ka mid ah noocyada daaweynta (cilmi nafsiga vs. dawooyinka iyo waxqabadyada la isku daray) ee qayb kasta oo balwadda ah ay muujineyso faa'iido ka badan kuwa kale Ugu dambeyntii, waxaan isbarbar dhig ku sameynay cabbirrada saamaynta ee wax-ka-qabashada cilmi-nafsi ahaan iyo dawooyinka ee qaybaha kala duwan ee balwadaha La xisaabtanka xaqiiqada ah "internetku waa khad ay dadku shaqsiyaadku ka heli karaan waxkastoo ay jecel yihiin (tusaale ahaan, khamaar, adeegan, sheekeysi, galmo")Griffiths & Pontes, 2014, p. 2), waxaan yareynay daraasado ay kujireen shakhsiyaad leh galmo xad dhaaf ah ama dabeecado iibsasho iyadoo la raacayo qeybaha "qabatinka galmada" iyo "iibsashada khasabka ah", iyadoo aan loo eegin in internetka la adeegsaday iyo in kale.

Falanqaynta Moderaterka ee doorsoomayaasha u kala qaybsan ayaa la qabtay iyada oo la adeegsanayo hannaanka saamaynta isku-dhafan ee leh qiyaasta liidata ee T2 iyo Q-test ku saleysan falanqaynta kala duwanaanta u dhigma p qiimaha turjumaadda farqiga u dhexeeya koox hoosaadka (Borenstein et al., 2009). Marka loo eego ugu yaraan 10 daraasadood oo la heli karo (Deeks, Higgins, & Altman, 2011), waxaan sii sameynay falanqaynta meta-regression iyadoo la adeegsanayo sanadka daabacaadda iyo muddada daaweynta (lagu qiimeeyay wadarta tirada saacadaha lagu qaatay daaweynta tijaabooyinka nafsiyan, ama tirada toddobaadyada tijaabooyinka dawooyinka). Haddii tiro ku filan oo daraasad cilmi-nafsi ah ay muujisay tirada saacadaha lagu qaatay daaweynta, tirada toddobaadyada ayaa loo isticmaalay in lagu cabbiro muddada daaweynta. Falanqaynta Meta-regression on celceliska da'da iyo boqolkiiba kaqeybgalayaasha ragga / haweenka lama sameynin maxaa yeelay da'da iyo galmada ee daraasadaha oo dhan way ka duwan yihiin tan daraasadaha gudahooda oo carqaladeynaya tarjumaada la isku halleyn karo (Thompson & Higgins, 2002).

Natiijooyinka

Xulashada Daraasada

Jaantuska qulqulka hannaanka xulashada daraasadda ayaa lagu muujiyey gudaha Berdihii. 1. Ma jirin khilaaf soo-dhex-gala oo ku saabsan noocyada daaweynta.

Jaantus 1.
Jaantus 1.

Jaantuska qulqulaya ee habka xulashada daraasadda

Sharax: Saxafiga balwadaha akhlaaq J Behav Addict 9, 1; 10.1556/2006.2020.00005

Astaamaha cilmiga, daaweynta, iyo kaqeyb galayaasha

Dhamaan noocyada balwadaha, muunada hada ah ee daraasada ayaa ku kala duwan nooca xaalada xakamaynta: Kalabar badhkood ma hirgalin koox xakameyn ah (50%) iyo dhowr daraasadood oo la adeegsaday liiska sugitaanka, ma daweynayaan, kontoroolka caafimaadka qaba, ama kooxaha xakamaynta placebo (30%), ama isbarbardhiga kale ee daaweynta firfircoon (20%). Natiijooyinka badanaa waxay ku saleysan yihiin dhammeystir (80%). Xogta dabagalka waxaa bixiyay 32 daraasadood oo cilmi nafsi ah (IA: k = 16 daraasadood oo leh caadooyin u dhexeeya 1 illaa 6 bilood; M = 3.53, SD = 2.13; SA: k = 11 daraasadood oo leh waqtiyo u dhexeeya 1.5 illaa 6 bilood; M = 4.27, SD = 1.88; CB: k = 5 daraasadood oo leh caadooyin u dhexeeya 3 illaa 6 bilood; M = 5.4, SD = 1.34), hal daraasad cilminafsiyeed oo ku saabsan qaybta CB oo leh 12 bilood oo dabagal ah, iyo laba daraasadood oo ku saabsan qaybta IA oo adeegsaday waxqabadyo isku dhafan, mid kasta oo xog aruurin ah hal bil ka-dabgal ah.

Inta badan daraasadaha cilmi nafsiga waxay baarteen CBT (58%), waxay ku bixiyeen daaweyn koox koox ah (71%), iyo qaab waji ka waji (92%). Wadarta tirada saacadaha lagu qaatay wax-ka-qabashada nafsaaniga ah waxay u dhexeysay 15 min illaa 54 saac (M = 12.55 saac, SD = 10.49), min hal toddobaad ilaa 26 toddobaad (M = 10.44, SD = 6.12), iyo 8 toddobaad illaa 20 toddobaad (M = 11.71, SD = 3.90) daweynta IA, SA, iyo CB, siday u kala horreeyaan. Inta badan daraasadaha cilminafsiga ayaa baaray dawooyinka lidka diiqadda (85%); inta badan tijaabooyinka isku dhafka ah waxay adeegsadeen CBT marka lagu daro dawooyinka lidka ku ah diiqadda (71%). Muddada daaweynta dawooyinka cilmiyada leh waxay u dhexaysay 6 illaa 52 toddobaad (M = 15.67, SD = 17.95), min 12 illaa 72 toddobaad (M = 24.83, SD = 23.58), iyo 7 ilaa 12 toddobaad (M = 9.50, SD = 2.20) daaweynta IA, SA, iyo CB, siday u kala horreeyaan.

Dhamaan qaybaha balwadaha, guud ahaan 3,531 kaqeybgale ayaa la falanqeeyay (IA: n = 2,427; SA: n = 771; CB: n = 333). Daraasadaha badankood waxaa ka mid ahaa kaqeybgalayaasha murugada iyo walaaca (77%). Tijaabooyinka ku wajahan IA waxaa inta badan lagu qabtay wadamada Aasiya (75%). Tirada guud ahaan saamiga ayaa ahayd inta badan rag ku jiray daraasadaha baaraya IA (76%) celcelis ahaan da'da 21, iyo SA (98%) oo celcelis ahaan jirta 37, laakiin haweeneyda dhigta daraasadaha baaraysa CB (92.45%) oo celcelis ahaan jira 42 Macluumaad faahfaahsan oo ku saabsan astaamaha waxbarashada ayaa lagu soo bandhigay Shaxda 1-3.

Jadwalka 1.Astaamaha daraasadaha ee balwadda internetka

Daraasad / SannadNaKooxda daaweynta (N) / Qaabka daaweynta / Qaabka dhalmadabKooxda xakamaynta (N) / Qaabka daaweynta / Qaabka dhalmadabDhaqanka / D / A (+/−) / nooca IADuration t / ccFU (bilooyin)Natiijooyinka (qiimaynta)Falanqaynta xogtaEPHPP
Daaweynta cilmu-nafsiga
Anuradha iyo Singh (2018)28CBT (28) / I / FTFTNoneAasiya / - / IANANoneGS (IADQ)CO3
Bai iyo Fan (2007)48IT (CBT; is-xakameyn, karti bulsheed) (24) / G / FTFTAxdiga Cusub (24)Aasiya / + / IA161.5GS (CIAS-R)CO3
Cao iyo al. (2007)57CBT (26) / G / FTFTAxdiga Cusub (31)Aasiya / + / IA10NoneGS (YDQ, CIAS)CO2
Celik (2016)30EDU (15) / G / FTFTAxdiga Cusub (15)Turkiga / + / IA106GS (PIUS)

FR (% Ciyaarta internetka ee dhexmara isticmaalka Internetka / w)d

NA3
Deng iyo al. (2017)63CBI (44) / G / FTFTWL (19)Aasiya / + / IGD186GS (CIAS)CO2
Du et al. (2010)56IT (CBT; tababarka waalidiinta; EDU ee macallimiinta) (32) / G / FTFTAxdiga Cusub (24)Aasiya / + / IA146GS (IOSRS)CO2
González-Bueso iyo al. (2018)301) CBT (15) / I / FTFT

2) IT (CBT + EDU oo loogu talagalay waalidiinta) (15) / I / FTFT

HC (30)eIsbaanish / - / IGD1) 9

2) 9

NoneGS (DQVMIA)CO3
Guo et al. (2008)281) CBT (14) / G / FTFT2) SUPP (tusaale ahaan, wadaagida macluumaadka IA; kor u qaadida isku kalsoonida iyo ilaha) (14) / G / FTFTfAasiya / + / IA1) 8

2) NA

NoneGS (CIAS)CO2
Han et al. (2012)14FT (14) / F / FTFTNoneAasiya / - / IGDNANoneGS (YIAS)

FR (h / w)

CO3
Han et al. (2018)26CBT (26) / G / FTFTNoneAasiya / - / IGD24NoneGS (CIAS)

FR (h / w)

CO3
Hui iyo al. (2017)731) CBT (37) / G / FTFT2) IT (CBT + EA) (36) / I + G / FTFTfAasiya / - / IGD1) 5

2) 10

NoneGS (IAD)CO2
Ke iyo Wong (2018)157CBT (157) G / FTFTNoneAasiya / + / IA121GS (PIUQ)CO3
Khazaei iyo al. (2017)48PI (24) / G / FTFTWL (24)Iran / + / IANANoneGS (IAT)

FR (h / w)

NA3
Kim (2008)25RT (13) / G / FTFTAxdiga Cusub (12)Aasiya / + / IA12.5NoneGS (K-IAS)NA3
King et al. (2017)gCBT (84 h ka fogaansho) (9) / I / NANoneAustralia / + / IGDNA1GS (Liiska hubinta ee IGD)

FR (h / w)

CO3
Lan iyo al. (2018)541) CBT (27) / G / FTFT2) EDU (27) / G / FTFTfAasiya / + / SMA1) 8

2) 1

3GS (MPIAS)

FR (h / w)

CO2
Lee et al. (2016)46CBT (qoraalka maalinlaha ah ee guriga ku saleysan) (46) / FTFT / INoneAasiya / + / SMANANoneGS (KSAPS)CO
Li iyo Dai (2009)76CBT (38) / I / FTFTWL (38)Aasiya / + / IA14NoneGS (CIAS)CO3
Li, Garland iyo al. (2017)301) DHAQAN (15) / G / FTFT2) SUPP (15) / G / FTFTfUSA / - / IGD1) 16

2) 16

3GS (shuruudaha DSM-5)HALKAN2
Li, Jin iyo al. (2017)731) CBT (36) / G / FTFT2) CBT + EA (37) / I + G / FTFTfAasiya / + / IGD1) 5

2) 10

NoneGS (IAT)CO3
Liu et al. (2013)311) CBT (16) / G / FTFT2) SM (tus., Diiwaanada qoran ee soo noqnoqoshada khamaarka; go'aan ka gaarista dabeecadaha hadafka ah) (15) / G / SGTfAasiya / - / IA1) 54

2) 24

NoneGS (IAT)

FR (h / d)

CO3
Liu et al. (2015)46FT (21) / G / FTFTWL (25)Aasiya / - / IA123GS (APIUS)

FR (h / w)

CO2
Pallesen et al. (2015)12IT (CBT; FT; SFT; MI) (12) / G / FTFTNoneNorway / + / VGANANoneGS (GASA; PVP)CO3
Park, Kim iyo al. (2016)241) CBT (12) / G / FTFT2) VRT (12) / G / SGTfAasiya / - / IGD1) 16

2) 4

NoneGS (YIAS)CO3
Pornoppadol iyo al. (2018)541) IT (CBT + xirfadaha + isboorti) (24) / G / FTFT2) EDU (30) / G / FTFTfAasiya / - / IGDNA

2) 1

6GS (GAST)CO2
Sakuma iyo al. (2017)g10IT (SDiC oo ay kujirto CBT; karinta dibedda; isu socodka socodka; socodsiinta, alwaax ku shaqeynta) (10) G / FTFTNoneAasiya / - / IGDNA3FR (ciyaarta h / d; h / w; d / w)CO3
Shek et al. (2009)22IT (la-talin shakhsi iyo qoys ahaaneed; taageero facooda) (22) / I / FTFTNoneAasiya / + / IANANoneGS (CIA-Y; CIA-G)CO3
Sei iyo al. (2018)46MI (PFB) (46) / I / SGTNoneAasiya / + / IANANoneGS (IAT)CO3
Su et al. (2011)59CBT (barnaamijka daaweynta khadka tooska ah)

1) LE (17) / I / SGT

2) NE (12) / I / SGT

3) NI (14) / I / SGT

Axdiga Cusub (16)Aasiya / + / IA1) 0.48

2) 0.48

3) 0.26

NoneGS (YDQ)

FR (h / w)

CO2
van Rooij et al. (2012)7CBT (7) / I / FTFTNoneNederland / + / IA7.5NoneGS (CIUS)

FR (d / w; h / d)

CO3
Wartberg iyo al. (2014)18CBT (18) / G / FTFTNoneJarmalka / + / IA12NoneGS (CIUS)

FR (h / maalmaha shaqada; h / maalmaha fasaxa ah)

CO3
Wolfling iyo al. (2014)42CBT (42) / G + I / FTFTNoneJarmalka / - / IA32NoneGS (AICA-S)

FR (h / maalinta Sabtida)

HALKAN3
Yang iyo Hao (2005)52IT (SFBT; FT; CT) (52) / I / FTFTNoneAasiya / + / IANANoneGS (YDQ)CO3
Yang iyo al. (2017)141) CBT (14) / G + I / FTFT

2) EA (16)h

HC (16)eAasiya / - / IA20NoneGS (IAT)CO2
Yao et al. (2017)37IT (RT; MFM) (18) G / FTFTAxdiga Cusub (19)Aasiya / + / IGD12NoneGS (CIAS)CO3
Dhalinyarada (2007)114CBT (114) / I / FTFTNoneUSA / + / IANA6GS (APA; CCU; MSA; SF)

FR (OA)

CO3
Dhalinyarada (2013)128CBT wax laga beddelay (128) / I / FTFTNoneUSA / + / IANA6GS (IADQ)CO3
Zhang (2009)70IT (CBT; isboorti) (35) / G / FTFTAxdiga Cusub (35)Aasiya / + / IA24NoneGS (IAT)CO3
Zhang et al. (2009)11CBT (11) / G / FTFTNoneAasiya / + / IANANoneGS (IAT)CO2
Zhang et al. (2016)36IT (CBI + MFTR) (20) / G / FTFTAxdiga Cusub (16)Aasiya / + / IGD17NoneGS (CIAS)

FR (h / w)

CO2
Zhong iyo al. (2011)571) FT (28) / G / FTFT2) IT (tababbarka milatariga; isboorti; daaweynta daweynta dabeecadaha balwadda leh) (29) / G / FTFTfAasiya / - / IA24.5

2) NA

3GS (OCS)CO2
Zhu iyo al. (2009)451) CBT (22) / G / FTFT2) IT (CBT + EA) (23) / I + G / FTFTfAasiya / + / IA5

2) 10

NoneGS (ISS)CO2
Zhu iyo al. (2012)731) CBT (36) / G / FTFT2) IT (CBT + EA) (37) / I + G / FTFTfAasiya / + / IA5

2) 10

NoneGS (IAT)CO2
Daaweynta Farmashiyaha
Bipeta iyo al. (2015)11Ka hortagga dawooyinka kala duwan (ka dib markii clonazepam laga duubey 3 toddobaad gudahood) (11)

(kaqeyb galayaasha IA iyo OCD)

2) Daawooyinka dawooyinka lidka ku ah (ka dib markii clonazepam la duubey 3 toddobaad gudahood) (27)

(kaqeyb galayaasha OCD kaliya)e

Hindiya / - / IA52NoneGS (YBOCS; IAT)NA3
Dell'Osso et al. (2008)17Qorno (17)NoneUSA / + / IA10NoneGS (IC-IUD-YBOCS)

FR (h / w)

CO3
Han et al. (2009)21Methylphenidate (21)

(Riwaayad)

NoneAasiya / - / IGD8NoneGS (YIAS-K)

FR (h / d)

CO3
Han et al. (2010)11Bupropion SR (11)NoneAasiya / - / IGD6NoneGS (YIAS)

FR (h / d)

CO3
Beeraha, Lee et al. (2016)861) Methylphenidate (44)2) Atomoxetine (42)f

10 mg / d

Aasiya / - / IGD12NoneGS (YIAS)CO3
Heesta et al. (2016)1191) Bupropion SR (44)

2) Escitalopram (42)

Axdiga Cusub (33)Aasiya / - / IGD6NoneGS (YIAS)CO2
Isugeynta daaweynta
Han iyo Renshaw (2012)251) Bupropion + 8 kalfadhi EDU (25)2) placebo + 8 kalfadhi EDU (25)eAasiya / + / IGD81GS (YIAS)

FR (h / w)

CO2
Kim et al. (2012)321) Bupropion + 8 kal fadhi CBT (32)2) Buro-weyne + 10 daq. wareysiyada toddobaadlaha ah (33)eAasiya / + / IGD81GS (YIAS)

FR (h / w)

CO2
Li et al. (2008)48Kala duwanaanta dawooyinka lidka diiqadda

+ CBT + FT (48)

NoneAasiya / + / IA4NoneGS (IRQ)CO3
Nam et al. (2017)301) Bupropion + EDU (15)2) Escitalopram + EDU (15)fAasiya / + / IGD12NoneGS (YIAS)CO2
Santos iyo al. (2016)39Daawooyinka isku qasan + 10 fadhi oo wax laga beddelay CBT (39)NoneBraziil / + / IA10NoneGS (IAT)CO3
Yang iyo al. (2005)18CBT + tababarka waalidka + Fluoxetine (18)NoneAasiya / + / IA10.5NoneGS (CIUS)CO3

note.

aTirada maadooyinka ku jira falanqaynta.

bDhexdhexaadiyaha “qaabka daaweynta” iyo “qaabka gudbinta” ayaa loo dalbaday daweynta nafsiga ah oo keliya.

cDaraasadaha cilmu-nafsiga, muddada daaweynta ayaa lagu cabiray iyadoo la adeegsanayo wadarta tirada saacadaha lagu qaatay daaweynta daaweynta (t) iyo kooxaha xakamaynta (c). Daraasadaha dawooyinka iyo isugeynta, muddada daaweynta ayaa lagu cabiray iyadoo la adeegsanayo tirada toddobaadyada.

dXogta ku saabsan natiijooyinka 'isdaba-joogga natiijada' ayaa loo heli karay kooxda daaweynta oo keliya.

eXaaladda kontaroolada ayaa laga saaray falanqaynta sababta oo ah ka-hor-imaad la'aanta shuruudaha xulashada.

fXaaladda xakamaynta ayaa loo tixgeliyey inay tahay cudud daaweyn oo gooni ah.

gDaraasaddu waxay ku warrantay xog laga keenay iska-hor-imaad ilaa dabagal keliya.

hXaaladda daweynta ayaa laga saaray falanqaynta iyadoo ay ugu wacan tahay ka-dheellitir la'aanta shuruudaha xulashada.

Jadwalka 2.Astaamaha daraasadaha ee balwadda galmada

Daraasad / SannadWadarta Guud NaKooxda daaweynta (N) / Qaabka daaweynta / Qaabka dhalmadabKooxda xakamaynta (N)

Qaabka daaweynta / Habka dhalmadab

Duration t / cc/ D / A (+/−)FU (bilooyin)Natiijooyinka (qiimaynta)Falanqaynta xogtaEPHPP
Daaweynta cilmu-nafsiga
Crosby (2012)27ACT (14) / I / FTFTWL (13)12 / +5dGS (SCS)

FR (Saacadaha daawashada qaawan ee sawirka / w; nooca wax laga beddelay ee DDQ)

CO2
Hallberg iyo al. (2017)10CBT (10) / G / FTFTNone8 / -6GS (HD: CAS; HDSI)HALKAN3
Hallberg iyo al. (2019)137CBT (70) / G / FTFTWL (67)8 / -6GS (HD: CAS; SCS)HALKAN2
Hardy iyo al. (2010)138CBT (barnaamijka khadka tooska ah ee Candeo) (138) / I / SGTNone26 / +NoneGS (PDR)

FR (adeegsiga sawirka qaawan / m; damis / m)

CO3
Hart iyo al. (2016)49MI (49) / G / FTFTNone7 / +3GS (SCS)CO3
Hartman iyo al. (2012)e57IT (barnaamijyada SA iyo SA-SUD) / I + G / FTFT (57)None13 / +6GS (CSBI)CO3
Klontz iyo al. (2005)381) IT (EXPT; CBT; EDU; M-Medit.), Lab (28) / G / FTFT

2) IT (EXPT; CBT; EDU; M-Medit.), Dheddigga (10) / G / FTFT

None1) 1 / +

2) 1 / +

6GS (GSBI; CGI)CO3
Levin iyo al. (2017)11ACT (SHWB) (11) / I / SGTNone8 / +1.5GS (CPUI)

FR (sawirka qaawan ee h / w)

CO3
Minarcik (2016)12CBT (12) / I / FTFTNone12 / +NoneGS (CLAPS; HBI; SCS)

FR (daawashada qaawan ee min./w)

CO3
Orzack iyo al. (2006)35IT (RtC; CBT; MI) (35) / G / FTFTNone16 / +NoneFR (muuqaallo qaawanCO3
Pachankis iyo al. (2015)63CBT (ESTEEM-SC oo ku saleysan UP) (32) / I / FTFTWL (31)12 / +3GS (SCS)HALKAN2
Parsons iyo al. (2017)11CBT (ESTEEM-SC oo ku saleysan UP) (11) / I / FTFTNone12 / +NoneGS (SCS)CO3
Quadland (1985)e151) GPT / G / FTFT (15)2) PT ka qaybgalayaasha ay saameeyeen dhibaatooyin kale / I / FTFT (14)f20 / +6FR (n ee lammaaneyaasha galmada ee kala duwan / 3dii bilood ee la soo dhaafay;% rafiiqaha galmada la arkay hal jeer;% galmo hal lammaane;% galmo goobaha bulshada)CO3
Sadiza iyo al. (2011)10CBT (10) / G / FTFTNone12 / +NoneGS (SCS)CO3
Secondhig iyo Crosby (2010)6ACT (6) / I / FTFTNone8 / +3FR (daawashada qaawan ee h / d)CO3
Wilson (2010)541) Farsamada gacanta (27) / G / FTFT2) wax laga beddelay CBT (TCA) (27) / G / FTFTg1) 6 / +

2) 6 / +

1.5GS (HBI-19)CO2
Daaweynta Farmashiyaha
Kafka (1991)10Kala duwanaanta dawooyinka lidka diiqadda

+ Lithium (10)

None12 / +NoneGS (SOI)CO3
Kafka iyo Prentky (1992)16Fluoxetine (16)None12 / +NoneGS (SOI)CO3
Kafka (1994)11hSertraline (11)None17 / +NoneGS (SOI)

FR (khayaal, damac, howlo galmo min./d)

CO3
Kafka iyo Hennen (2000)26Kala duwanaanta murugada + methylphenidate (26)None72 / +NoneGS (TSO)

FR (khayaal, damac, howlo galmo min./w)

HALKAN3
Wainberg iyo al. (2006)28Citalopram (13)Uur (15)12 / -NoneGS (YBOCS-CSB; CSBI; CGI-CSB)

FR (niyadda, isticmaalka internetka, iyo adeegsiga sawirada h / w)

HALKAN2
Isugeynta daaweynta
Gola iyo Potenza (2016)3CBT + Paroxetine (3)None10 / +NoneFR (adeegsiga sawirka qaawan / w)CO3
Scanavino iyo al. (2013)4STPGP + daawooyin kaladuwan (4)None16 / +NoneGS (SCS)CO3

note. A = walwal; ACT = Daaweynta iyo Ballan Qaadka; BSI = Calaamadaha Gaarka ah ee Calaamadaha; CBT = daaweynta cilmiga dabeecadda; CGI-CSB = Qiyaasta Clinical Global Impression Scale oo loo qaatay dhaqan galmo khasab ah; SHAQADA = Cadaynta Balwadda Layaab Leh ee Iskeelka Saamiyada Filimka; CO = dhameystiraysaa oo keliya; CPUI = Adeegsiga sawir-sameeye internetka CSBI = Liiska Dhaqanka Ku Xadgudubka Galmo; D = niyad jab; d = maalin; DDQ = Su'aalaha cabitaanka maalinlaha ah; EDU = cilmu-nafsiga; EPHPP = Mashruuca Dhaqanka Caafimaadka Dadweynaha ee Wax ku oolka ah (1 = xoog, 2 = dhexdhexaad ah, 3 = qiimeyn daciif ah); ESTEEM = Xirfadaha wax ku oolka ah ee lagu xoojinayo ragga waxtarka leh; EXPT = daweyn khibrad leh; FR = inta jeer; FTFT = daaweyn fool ka-fool ah; FU = dabagal; G = dejinta kooxda; GPT = teraabiyada cilminafsiga ee kooxda; GS = darnaanta caalamiga ah; GSBI = Garos Dhaqanka Galmoodka Garos; h = saacadaha; HBI = Dhaqanka dabeecadda liita; HD: CAS = Khilaafaadka Hyperexual: Qiyaasta Qiimaynta Hadda; HDSI = Qalabka Baaritaanka Maskaxda ee Xiinka; I = latalin shaqsiyeed; IT = daaweynta isku-dhafan; ITT = ujeedka-daaweynta; m = bishii; M-Medit. = miyir-qabka maskaxda; MI = Wareysiga Dhiirrigelinta; NA = lama heli karo; OTIS = Sahanka Halista ah ee Waqtiga Orzack; PDR = cabirrada nafsi ahaaneed ee soo kabashada (fikradaha galmada ee kacsan, falcelinta waxtarka leh ee soo kabashada, saameynta wanaagsan, saameynta xun, aragtida hay'adda ee balwadda, u janjeeridda dafirashada mas'uuliyadda balwadda, macnaha nolosha, xiriirinta dadka kale, dareennada la cafiyo, ka warqabka fikradaha iyo xaaladaha tijaabada ah, meelaha caafimaadka laga helo); PLA = placebo; PT = teraabiyada cilmu-nafsiga; RtC = Diyaar u Noqoshada; SA = qabatinka galmada; SA-SUD = galmada maandooriyaha iyo maandooriyaha; SC = galmo galmo; SCS = Iskeelka Miisaanka Galmoodka; SGT = daaweynta is-hagidda; SHWB = Buugga shaqada ee iskaa wax u qabso ah; SOI = Istaraatijiyadda Galmo ee Jinsiga; STPGP = teraabiyada cilmu-nafsiga ee muddada-gaaban; TCA = Habka Xarun Xarun; TSO = Isugeynta galmada; UP = Borotokool mideysan oo loogu talagalay Daaweynta Transdagnostic of Ciladaha Maskaxda; W = liiska sugida; w = toddobaad; YBOCS-CSB = Iskeelka qasabka ah ee 'Yale-Brown' waxaa laga beddelay hab dhaqan galmo oo khasab ah.

aTirada maadooyinka ku jira falanqaynta.

bDhex dhexaadiyaha “qaabka daaweynta” iyo “qaabka gudbinta” ayaa kaliya loo adeegsaday daweynta nafsiga ah.

cMuddada daaweynta waxaa lagu cabiray iyadoo la adeegsanayo tirada toddobaadyada.

dXogta ka timid iska-hor imaad ilaa iyo dabagal ayaa loo heli karay oo keliya isugeynta natiijada “soo noqnoqda”.

eDaraasaddu waxay ku warrantay xog laga keenay iska-hor-imaad ilaa dabagal keliya.

fXaaladda kontaroolada ayaa laga saaray falanqaynta sababta oo ah ka-hor-imaad la'aanta shuruudaha xulashada.

gXaaladda xakamaynta ayaa loo tixgeliyey inay tahay gacanta daaweynta.

hKaliya kaqeyb galayaasha lagu soo arkay ciladaha laxiriira cudurka paraphilia ayaa lagu soo daray falanqeynta.

Jadwalka 3.Astaamaha waxbarasho ee iibsashada khasabka ah

Daraasad / SannadWadarta Guud NaKooxda daaweynta (N) / Qaabka daaweynta / Qaabka dhalmadabKooxda xakamaynta (N)Duration t / cc/ D / A (+/−)FU (bilooyin)Natiijooyinka (qiimaynta)Falanqaynta xogtaEPHPP
Daaweynta cilmu-nafsiga
Armstrong (2012)10MBSR (4) / G / FTFTAxdiga Cusub (6)8 / +3GS (CBS; YBOCS-SV; IBS)CO2
Benson iyo al. (2014)11IT (CBT, PSYDYN, PSYEDU, MI,

ACT, walxaha maanka dooriya (6) / G / FTFT

WL (5)12 / +6GS (hab. VCBS; RCBS; CBS;

YBOCS-SV)

FR (min./w ku kharash gareeyay iibsashada; iibsashada marxaladaha / w)d

CO2
Filomensky & Tavares (2009)9CBT (9) / G / FTFTNone20 / +NoneGS (YBOCS-SV)CO3
Mitchell et al. (2006)35CBT (28) / G / FTFTWL (7)10 / +6eGS (YBOCS-SV; CBS)

FR (iibsashada marxaladaha / w; h ku iibsaday / w)

HALKAN2
Mueller iyo al. (2008)60CBT (31) / G / FTFTWL (29)12 / +6eGS (CBS; YBOCS-SV; G-CBS)HALKAN2
Mueller iyo al. (2013)561) CBT (22) / G / FTFT

2) GSH-program (CBT WB + 5 kalfadhi taleefan) (20) / I / SGT

WL (14)1) 10 / +

2) 10 / +

6GS (CBS; YBOCS-SV)HALKAN2
Daaweynta Farmashiyaha
Black et al. (1997)10Fluvoxamine (10)None9 / -NoneGS (YBOCS-SV)CO2
Black et al. (2000)23Fluvoxamine (12)Uur (11)9 / -NoneGS (YBOCS-SV)HALKAN2
Grant et al. (2012)9Xusuusin (9)None8 / -NoneGS (YBOCS-SV; qaab. CB-SAS)CO2
Koran iyo al. (2002)24Citalopram (24)None12 / +NoneGS (YBOCS-SV)HALKAN2
Koran iyo al. (2003)23Citalopram (23)None7 / +NoneGS (YBOCS-SV; CBS; IBTS)HALKAN2
Koran iyo al. (2007)26Qorno (26)None7 / +NoneGS (YBOCS-SV)HALKAN3
Ninan iyo al. (2000)37Fluvoxamine (20)Uur (17)12 / +NoneGS (YBOCS-SV)HALKAN3

note. A = walwal; ACT = Daaweynta iyo Ballan Qaadka; CBS = Qiimaynta Iibsiga khasabka ah; CB-SAS = Qiyaasta Qiimaynta Qiimaynta Calaamadaha Astaanta (nooca la beddelay ee Qiyaasta Qiimaynta Khamaarka; CBT = daaweynta cilmiga dabeecadda; CO = buuxiye oo keliya; D = niyad jab; EPHPP = Mashruuca Xirfadda Caafimaadka Dadweynaha ee Dhaqanka ah (1 = xoog, 2 = dhexdhexaad ah , 3 = qiimeyn daciif ah); FTFT = daaweyn waji ka waji; FR = inta jeer; FU = dabagal; G = koox; G-CBS = Kanadinta qasabka ah ee Iibsiga Cabbiraadda, Nooca Jarmalka; GS = darnaanta guud; GSH = Iscaawinta iscaawinta; h = saacadaha; I = latalinta shaqsiyadeed; IBS = Istaraatiijiyada Iibsiga; IBT = Qulqulka Iibsiga Istaatiijiyada; ITT = ujeedka loo daweeyo falanqaynta; lama heli karo; NT = ma daaweyn; PLA = kooxda xakamaynta meelaynta; PSYDYN = psychodynamic; PSYEDU = cilmi-nafsi; RCBS = Richmond khasab ku ah Soo iibsashada Miisaanka; SGT = daaweynta is-hage; VCBS = Valence Compulsive iibsashada Miisaan; = liiska sugida; w = toddobaad; YBOCS-SV = Yale-Brown Obserive Com Noocyo Isdabamarin leh oo Soojiidasho leh.

aTirada maadooyinka ku jira falanqaynta.

bDhex dhexaadiyaha “qaabka daaweynta” iyo “qaabka gudbinta” ayaa kaliya loo adeegsaday daweynta nafsiga ah.

cMuddada daaweynta waxaa lagu cabiray iyadoo la adeegsanayo tirada toddobaadyada.

dXogta ku saabsan natiijooyinka 'isdaba-joogga natiijada' ayaa loo heli karay kooxda daaweynta oo keliya.

eDaraasadaha waxaa laga saaray falanqaynta FU, sababtoo ah kaliya xogta ka timid dib-u-dhigga illaa FU ayaa la soo sheegey.

Halista eexda ee ka dhex jirta daraasadaha

Dhibcaha caalamiga ah ee loo yaqaan 'EPHPP' ee daraasadaha lagu soo daray qaybaha maandooriyaha ee kaladuwan ayaa lagu sharraxay Shaxda 1-3. Qiimaynta ku habboonaanta waxaa qabtay laba raadiye madaxbanaan oo soosaaraya isku halaynta dhexdhexaadka ah κ = 0.73 oo loogu talagalay daraasadaha qaybaha IA iyo SA, iyo κ = 0.75 oo loogu talagalay daraasadaha qeybta CB.

Soosaarista natiijooyinka iyo halista eexda ee dhammaan daraasadaha

Cabbirka saameynta liidata ee dhammaan noocyada balwadaha iyo daaweynta si gooni gooni ah kooxda gudaheeda iyo naqshadaha daraasadaha la xakameeyay ee natiijooyinka dib-u-dhaca iyo dabagalka, 95% CI, iyo muhiimada tijaabooyinka ayaa lagu qeexay Shaxda 4. Shirqoollada kaynta ee cabbiraadda saameynta kooxda dhexdeeda xaalad kasta, daaweyn, iyo natiijooyinka dib-u-dhigga ayaa lagu soo bandhigay Berdihii. 2.

Jadwalka 4.Cabbiryada saamaynta ee dhammaan noocyada balwadaha, natiijooyinka iyo naqshadaha daraasadda ee dib-u-dhigga iyo dabagalka

NatiijadaNooca saamayntakg95% CIzpI2FS N
Qabsashada internetka
Daaweynta cilmu-nafsiga
Darnaanta Caalamkakoox-koox (dhejin)541.51[1.29, 1.72]13.7993.6618,317
la xakameeyay (boostada)151.84[1.37, 2.31]7.26883.561,254
koox-koox (FU)171.48[1.11, 1.85]7.9294.614,221
Frequencykoox-koox (dhejin)171.09[0.73, 1.49]6.0292.541,801
la xakameeyay (boostada)61.12[0.41, 1.83]3.0878.0569
koox-koox (FU)61.06[0.12, 2.00]2.2197.30259
Daweynta Farmashiyaha
Darnaanta Caalamkakoox-koox (dhejin)81.13[0.85, 1.42]7.7878.76564
la xakameeyay (boostada)21.28[0.85, 1.71]5.850.00-a
koox-koox (FU)NA
Frequencykoox-koox (dhejin)30.72[0.49, 0.96]6.010.0027
la xakameeyay (boostada)NA
koox-koox (FU)NA
Dawooyinka iskujira
Darnaanta Caalamkakoox-koox (dhejin)72.51[1.70, 3.33]6.0392.99756
la xakameeyay (boostada)NA
koox-koox (FU)22.15[0.66, 3.65]2.8293.55-a
Frequencykoox-koox (dhejin)22.77[2.29, 3.24]11.3914.43-a
la xakameeyay (boostada)NA
koox-koox (FU)22.69[2.06, 3.32]8.4349.72-a
Cudurka galmada
Daaweynta cilmu-nafsiga
Darnaanta Caalamkakoox-koox (dhejin)141.09[0.74, 1.45]6.0392.541,311
la xakameeyay (boostada)30.70[0.42, 0.99]4.877.0219
koox-koox (FU)101.00[0.67, 1.32]6.0290.02760
Frequencykoox-koox (dhejin)60.75[0.46, 1.03]5.1070.96177
la xakameeyay (boostada)11.67[0.82, 2.53]3.830.00-a
koox-koox (FU)40.83[0.37, 1.29]3.5771.5945
Daaweynta Farmashiyaha
Darnaanta Caalamkakoox-koox (dhejin)51.21[0.88, 1.54]7.1250.42134
la xakameeyay (boostada)10.14[−0.58, 0.87]0.380.700.00-a
koox-koox (FU)NA
Frequencykoox-koox (dhejin)30.87[0.63, 1.12]6.920.0033
la xakameeyay (boostada)10.79[0.04, 1.55]2.060.00-a
koox-koox (FU)NA
Isugeynta daaweynta
Darnaanta Caalamkakoox-koox (dhejin)11.91[0.75, 3.08]3.220.00-a
la xakameeyay (boostada)NA
koox-koox (FU)NA
Frequencykoox-koox (dhejin)11.04[0.22,1.85]2.490.00-a
la xakameeyay (boostada)NA
koox-koox (FU)NA
Iibsashada qasabka ah
Daaweynta cilmu-nafsiga
Darnaanta Caalamkakoox-koox (dhejin)71.00[0.75, 1.25]7.8846.43210
la xakameeyay (boostada)60.75[0.42, 1.08]4.450.0027
koox-koox (FU)41.36[0.88, 1.84]5.5753.6566
Frequencykoox-koox (dhejin)20.97[0.68; 1.26]6.550.00-a
la xakameeyay (boostada)12.48[1.46, 3.49]4.760.00-a
koox-koox (FU)11.01[0.47, 1.55]3.680.00-a
Daaweynta Farmashiyaha
Darnaanta Caalamkakoox-koox (dhejin)71.52[1.18, 1.86]8.8463.17386
la xakameeyay (boostada)2-0.13[−0.82, 0.57]-0.350.7240.00-a
koox-koox (FU)1-0.49[−1.00, 0.03]-1.860.0630.00-a
Frequencykoox-koox (dhejin)NA
la xakameeyay (boostada)NA
koox-koox (FU)NA

Ogeysiis. k = tirada xaaladaha daaweynta; g = Geedaha g; CI = isku kalsoonaanta; I2 = boqolkiiba wadarta kala duwanaanta guud ee daraasadaha; FS N = Guul-la’aan N (tirada daraasadaha loo baahan yahay si loo helo saameyn daaweyn aan micno lahayn); NA = lama heli karo.

aGuul-darro N looma xisaabin sababta oo ah wax ka yar 3 daraasadood ayaa la helay.

Jaantus 2.
Jaantus 2.Jaantus 2.Jaantus 2.

Guud ahaan cabir saameyn kooxeed ah xaalad kasta, daaweyn, iyo natiijooyinka dib-u-dhigga. ACT = aqbalida iyo daaweynta go aanka; AD = dawada ka hortagga cudurka; ArtTh = farsamada gacanta; ATO = atomoxetine; BUP = bupropion; CBI = faragalinta dabeecada; CBT = daaweynta cilmiga dabeecadda; CIT = citalopram; EDU = barnaamijka waxbarashada; ESC = escitalopram; FLU = fluvoxamine; FT = daaweynta qoyska; GSH = is-caawin iskaa ah; IT = faragelinta dhexgalka; LE = jawiga sheybaarka; MBRS = dhimista walwalka walwalka; MEM = memantine; METH = methylphenidate; MI = wareysiga dhiiranaanta leh; DHAMMAAN = xoojinta maskaxda ku haysa soo-kabashada; NE = deegaanka dabiiciga ah; NI = Xaaladda daaweynta is-dhexgalka; PFB = jawaab celin shaqsiyeed; PI = faragelinta cilmi nafsiga ee togan; PTr = tababarka waalidka; RT = daaweynta dhabta ah; RW = miisaanka qaraabada; SER = sertraline; SH = iskaa wax u qabso; SUPP = daaweyn taageero; UP = hab maamuus mideysan oo loogu talagalay daaweynta transdiagnostic-ka ee ciladaha shucuurta; VRT = daaweynta dhabta ah ee dhabta ah

Sharax: Saxafiga balwadaha akhlaaq J Behav Addict 9, 1; 10.1556/2006.2020.00005

Cabbir wax ku ool ah oo loogu talagalay daweynta cilmi nafsiga ee dib-u-dhigga iyo dabagalka

Daaweynta cilmu-nafsiga ee dhammaan noocyada balwadaha waxay soo saareen qiyaaso saameyn muddada-gaaban ah oo u dhexeysa dhexdhexaad ilaa weyn labadaba naqshadeynta daraasadda. Cabbirka saamaynta muddada-dheer ee dhammaan qaybaha balwadaha waxay muujiyeen in saamaynta daaweynta la sii waday. Sida ku cad Shaxda 4, heterogeneity sare inta badan daraasadaha ayaa lagu arkay isbeddelada natiijada ee qaybaha IA iyo SA, iyo heterogeneity dhexdhexaad ah ama isku-dhafan ayaa lagu arkay qaybta CB.

Qaybta IA gudaheeda, habka loo yaqaan 'trim-and-buuxinta' ayaa lagu gartay 17 daraasadood oo sababa isku-duubnaan u horseed u ah yareynta darnaanta adduunka iyo hal daraasad oo lagu yareynayo inta jeer ee qaabaynta daraasadda koox-koox. Falanqaynta daraasadahaan buuxiyey waxay soo jeediyeen cabbirada saamaynta waxoogaa hoos loo dhigay (darnaanta adduunka: g = 0.87; 95% CI [0.82, 0.92]; Imtixaanka Egger p <0.001; inta jeer: g = 0.93; 95% CI [0.84, 1.03]; Imtixaanka Egger p = 0.282) oo soo jeedinaysa saameyn aan qiimo lahayn oo ku saabsan daabacaadda daabacaadda. Looma helin tilmaam daabacaadda daabacaadda ee hoos u dhigista darnaanta adduunka ee ku saleysan naqshadaha daraasadda la xakameeyey (Imtixaanka Egger p = 0.067). Qaybta SA gudaheeda, habka loo yaqaan 'trim-and-buuxinta' ayaa lagu gartaa hal daraasad oo horseedaya gogol-xaarid murugo leh yareynta darnaanta adduunka taas oo horseedaysa in la yareeyo saamaynta saamaynta natiijadan isbedelka ah (g = 0.88; 95% CI [0.79; 0.97], baaritaanka Egger p = 0.318) .Maal kasta oo lagu guul-darreysto N falanqaynta ayaa la sameeyay, cabirka saamaynta dhammaan qaybaha balwadaha waxaa loo tixgeliyay inay ku adag yihiin isbeddelada natiijada, marka laga reebo cabirka saamaynta la xakameynayo ee ku saabsan yareynta darnaanta adduunka ee qaybaha SA iyo CB, kuwaas oo aan ahayn kuwa xoogan.

Cabbir wax ku ool ah oo daaweynta dawooyinka kimikalka ah ee dib-u-dhigga iyo dabagalka

Dib-u-dhigga, cabirka saameynta kooxda dhexdeeda dhammaan qeybaha balwadaha waa dhexdhexaad iyo weyna. Xaddiga saameynta la xakameeyay waxay badanaa ku saleysan yihiin hal tijaabo oo u dhexeeya ballaaran oo ka mid ah qaybta IA illaa yar iyo taban ee qaybaha SA iyo CB. La'aanta xogta dabagalka ayaa horjoogsatay tarjumaadda cabirrada saameynta muddada-dheer. Heterogeneity sare iyo dhexdhexaad ah oo ku saabsan daraasadaha ayaa loo arkay natiijada doorsoomayaasha natiijada ee qaybaha balwadaha. Amni-darrada N falanqayn lagu sameeyay xogta la hayo waxay soo jeediyeen adkaynta cabirka saamaynta.

Cabbir wax ku ool ah oo isugu jira daweyn isku dhafan oo ah dib-u-dhig iyo dabagal

Waxqabadyada isku-dhafan ayaa la hirgaliyay oo keliya daaweynta IA iyo SA iyadoo lagu saleynayo naqshadeynta koox-koox ee naqshadaha soosaara cabbir weyn ee muddada-gaaban. Xogta dabagalka ayaa laga heli karay kaliya qeybta IA ee soo saarta cabir saameyn weyn oo isla eg. Heterogeneity sare guud ahaan daraasadaha waxaa lagu arkay yareynta darnaanta adduunka ee qeybta IA; si kastaba ha noqotee waa nabad-galyo N wuxuu muujiyey adkeynta cabirka saamaynta.

Aqoonsiga soo-saaraha iyada oo loo marayo habka-hal-daraasadda looga saaray ma muujiso wax saamayn ah oo ah daraasad hal nooc ah oo ku saabsan saamaynta guud ee xagga nafsadda, dawooyinka, iyo daaweynta la isku daray.

Falanqaynta Moderater

Falanqaynta dhex-dhexaadaha waxaa lagu sameeyay cabbiraad saamayn kooxeed dhexdeeda ah. Natiijooyinka doorsoomayaasha noocyada kaladuwan ee dib-u-dhigga ayaa lagu soo bandhigay gudaha Shaxda 5.

Jadwalka 5.Qiimeeyaha ayaa falanqeynaya doorsoomayaasha noocyada kala duwan ee balwadaha iyo natiijooyinka

IASACB
ModeratorNatiijooyinka doorsoomayaashaQbetp (Q)Qbetp (Q)Qbetp (Q)
Daaweynta cilmu-nafsiga
Nooca daaweynta maskaxda (CBT iyo IT kale iyo kuwa kale)
GS4.240.1204.500.1050.340.945
FR0.110.94715.67a--
Qaabka daaweynta (koox vs. shaqsi ahaan iyo kuwa kaleba)
GS0.470.7920.110.741b0.440.508b
FR0.550.76114.55b
Qaabka gaarsiinta (FTFT iyo SGT)
GS9.150.560.4530.440.508
FR2.030.1540.760.384--
Cudur-barar (D / A waxaa ka mid ah iyo kuwa laga saaray)
GS0.020.8980.840.3600.001.00
FR1.130.2890.001.00--
Falanqaynta xogta (dhameystir vs. ITT)c
GS0.300.5860.990.3200.0070.933
FR0.090.7710.001.00--
EPHPP (1 = vs. adag 2 = dhexdhexaad ah vs. 3 = ansax gudaha ah daciif ah)d
GS1.140.2852.240.1340.020.903
FR1.940.1640.530.466--
Dhaqanka (Aasiya iyo wadamada reer galbeedka)
GS0.540.461----
FR0.580.447----
Nooca IA (caalami ahaan IA iyo IGD iyo kuwa kale)
GS1.630.653----
FR4.210.122----
Daaweynta Farmashiyahae
Nooca daaweynta kemoolajiga (AD ama kuwa kale ama kuwa kale)
GS5.62f0.090.7650.650.421g
Cudur-barar (D / A waxaa ka mid ah iyo kuwa laga saaray)
GS0.730.392-h-h0.220.642
Falanqaynta xogta (dhameystir vs. ITT)
GS0.001.000.760.3834.89
EPHPP (1 = vs. adag 2 = dhexdhexaad ah vs. 3 = ansax gudaha ah daciif ah)d
GS0.470.493-h-h2.520.112
Dhaqanka (Aasiya iyo wadamada reer galbeedka)
GS7.32----
Nooca IA (caalami ahaan IA iyo IGD iyo kuwa kale)
GS7.32i----
Isugeynta daaweyntae
Nooca daaweynta kemoolajiga (AD ama kuwa kale ama kuwa kale)
GS0.830.362j----
Nooca daaweynta maskaxda (CBT iyo IT kale iyo kuwa kale)
GS20.81k----
Qaabka daaweynta cilmi nafsiga (koox vs. shaqsi ahaan iyo kuwa kale)
GS0.290.592b----
Cudur-barar (D / A waxaa ka mid ah iyo kuwa laga saaray)
GS0.001.00----
Falanqaynta xogta (dhameystir vs. ITT)
GS0.001.00----
EPHPP (1 = vs. adag 2 = dhexdhexaad ah vs. 3 = ansax gudaha ah daciif ah)d
GS6.06----
Dhaqanka (Aasiya iyo wadamada reer galbeedka)
GS0.830.362----
Nooca IA (caalami ahaan IA iyo IGD iyo kuwa kale)
GS6.06i----

note. A = walwal; AD = dawooyinka lidka diiqadda; CB = iibsashada khasabka ah; CBT = daaweynta dabeecadda garashada; D = niyad jab; EPHPP = Mashruuca Ku-dhaqanka Caafimaadka Dadweynaha ee Wax-ku-oolka ah (qalab qiimeyn tayo leh oo loogu talagalay daraasadaha tirada); GS = darnaanta caalamiga ah; FR = inta jeer; FTFT = daaweyn fool ka-fool ah; IA = qabatinka internetka; IGD = jahwareerka ciyaaraha internetka; IT = daaweynta isku-dhafan; ITT = ujeedka lagu daaweynayo falanqaynta; Qbet = tirakoobka isku mid ahaanshaha ee farqiga u dhexeeya koox hoosaadka; SA = qabatinka galmada; SGT = daaweynta is-hagidda.

aCBT: g = 0.98; 95% CI [0.83, 1.13]; p .0.001 XNUMX; IT: g = 0.25; 95% CI [-0.08, 0.58]; p = 0.132; Daaweynta kale (tusaale, aqbalida iyo daaweynta go aanka): g = 0.80; 95% CI [0.51, 1.10]; p ≤ 0.001.

bFalanqaynta dhexdhexaadiyaha waxaa ka mid ah laba koox hoosaad (koox ahaan iyo shaqsi ahaanba).

cKaliya daraasadihii muujiyey nooca falanqaynta xogta ayaa lagu soo daray falanqaynta (eeg Shaxda 1).

dFalanqaynta dhexdhexaadiyaha waxaa ku jira laba qaybood kaliya (2 = dhexdhexaad; 3 = daciif ah).

eFalanqaynta dhex-dhexaadka ah ee ku saabsan natiijada 'soo noqnoqda' looma sameynin tirada daraasadaha oo aan ku filnayn.

fFalanqaynta dhexdhexaadiyaha waxaa ka mid ah oo keliya laba koox hoosaad (AD iyo daawooyinka kale [yac, methylphenidate, atomoxetine]).

gFalanqaynta dhexdhexaadiyaha waxaa ka mid ah oo keliya laba koox hoosaad (AD iyo dawooyinka kale [yac, memantine]).

hNatiijooyinka baaritaanka falanqaynta ee dhexdhexaadiyaha looma tarjumin, sababtoo ah hal daraasad ayaa ku hadhay mid ka mid ah labada koox hoosaad.

iFalanqaynta dhexdhexaadiyaha waxaa ka mid ah laba koox hoosaad oo keliya (IA vs. IGD).

jFalanqaynta dhexdhexaadiyaha waxaa ka mid ah laba koox hoosaad (AD iyo kuwa isku dhafan).

kFalanqaynta dhexdhexaadiyaha waxaa ka mid ah oo keliya laba koox hoosaadyo (CBT iyo daaweyno kale (tusaale, barnaamijka waxbarashada]).

Cabbiryada saamaynta ee dhammaan noocyada balwadaha iyo wax ka qabadyada ayaan wali laga helin tayada daraasadaha, isku-buuqa murugada iyo walaaca, iyo sanadka la daabacay (IA: darnaanta caalamiga ah: β = -0.02; SE = 0.03; p = 0.417; soo noqnoqota: β = -0.09; SE = 0.05; p = 0.075; SA: darnaanta adduunka: β = -0.03; SE = 0.04; p = 0.519).

Marka laga hadlayo IA, cabir saameyn weyn oo aad u weyn ayaa loo helay FTFT marka loo eego SGTs, iyo waxqabadyada oo ay ku jiraan tiro ka badan saacado daawaynta yareynta darnaanta adduunka (β = 0.04; SE = 0.01; p <0.01) iyo soo noqnoqoshada (β = 0.03; SE = 0.009; p <0.01). Yaraynta darnaanta adduunka ee daraasadaha dawooyinka, cabirro saameyn ballaaran ayaa u soo baxay daawada lidka diiqadda marka loo barbardhigo wakiillada kale ee kiimikada (ie, methylphenidate, atomoxetine), kuwa laga fuliyo dalal kale marka la barbardhigo waddamada Aasiya, iyo baaritaanka IA adduunka marka loo eego IGD iyo taleefanka casriga ah. qabatinka.

Iyada oo la tixraacayo SA, CBT iyo daweynta kale ee nafsaaniga ah (tusaale ahaan, aqbalaada iyo daaweynta ka go'naanta) waxay muujiyeen faa iido ku saabsan waxqabadyada is dhexgalka iyo la-talinta shaqsiyeed ee goobaha kooxda ee yareynta soo noqnoqoshada. Marka loo eego qaybta CB, tijaabooyinka dawooyinka iyadoo la adeegsanayo falanqayn dhameystiran ayaa laga soo saaray cabbir saameyn weyn marka loo eego kuwa ku saleysan falanqaynta ITT ee la xiriira yaraynta darnaanta adduunka.

Falanqaynta moderaterka ee daaweynta la isku daray ayaa loo sameeyay kaliya qaybta IA. Natiijooyinka waxay muujiyeen in cabbiraadda saamaynta weyn ay la xiriirtay isku darka CBT, tijaabooyin tayo hooseeya, iyo kuwa baarayay IA adduunka.

Cilmi nafsi ahaan iyo dawooyinka cilminafsiyeedka iyo daaweynta la isku daray

Marka la eego IA, daaweynta la isku daray waxay soo saartey cabbir saameyn weyn marka la barbar dhigo waxqabadyada cilmi nafsiga iyo dawooyinka ee yaraynta darnaanta adduunka (cilmi nafsiga iyo iskudarka: Qinta u dhaxaysa = 7.80, p <0.01; farmasiga iyo iskudarka: Qinta u dhaxaysa = 14.69, p <0.001), iyo soo noqnoqoshada (cilmi-nafsi ahaan iyo isku-dar ah: Qinta u dhaxaysa = 8.73, p <0.01; farmasiga iyo iskudarka: Qinta u dhaxaysa = 63.02, p <0.001). Natiijooyin aan qiimo lahayn ayaa laga helay inta udhaxeysa cabirka saameynta daaweynta daaweysan ee nafsaani ah iyo kuwa dawooyinka leh (darnaanta adduunka p = 0.173; soo noqnoqota: p = 0.492). Iyadoo la tixgelinayo CB, daaweynta dawooyinka ayaa muujisay faa iido weyn oo ku saabsan daaweynta nafsi ahaaneed ee yareynta darnaanta adduunka (Qinta u dhaxaysa = 5.45, p <0.05). Ma jiro faraqyo kale oo muhiim ah oo u dhexeeya noocyada daweynta.

Farqiga u dhexeeya qaybaha balwadaha

Isbarbar dhig ku saabsan cabbiraadda saamaynta dhammaan qaybaha balwadaha waxay soo saareen natiijooyin aan muhiim ahayn marka laga hadlayo faragelinta nafsaaniga ah (darnaanta caalamiga ah: p = 0.174; soo noqnoqota: p = 0.559) iyo wax ka qabashada dawooyinka (darnaanta caalamiga ah: p = 0.203; soo noqnoqota: p = 0.389).

Dood

Ujeeddada warqaddani waxay ahayd in la baaro wax ku oolnimada cilmu-nafsiga, dawooyinka iyo daawaynta isku dhafan ee loogu talagalay IA, SA iyo CB iyo in la aqoonsado saadaasha suurtagalka ah ee natiijada daweynta. Waxaa intaa dheer, isbarbardhiga u dhexeeya saddexda nooc ee BAs oo ku saleysan cabirrada saamaynta ee daaweynta nafsi ahaaneed iyo dawooyinka ayaa la sameeyay markii ugu horreysay, iyada oo ujeeddada dambe ee lagu sawirayo isbarbardhiga khamaarka iyo SUDs marka loo eego jawaabta daaweynta.

Waxaan ogaanay in daaweynta daaweyntu ay si wax ku ool ah u yareysay darnaanta adduunka iyo soo noqnoqoshada IA ​​iyo SA iyadoo jawaabta daaweyntu ay sii socoto muddo dheer. CB, daweynta nafsi ahaanta waxaa sidoo kale lala xiriiriyay pre-post-pre-post-ka-hor iyo ka-hor-dabagalka darnaanta adduunka. Faa'iidooyin waaweyn oo dhexdhexaad ah muddada-gaaban marka loo eego labada doorsoomeyaasha natiijooyinka waxaa lagu xaqiijiyay qaab dhismeedka daraasadda gacanta lagu hayo, gaar ahaan quseeya IA iyo daraasadaha shaqsiyadeed ee qaybaha SA iyo CB. Natiijooyinkaani waxay la mid yihiin kuwa laga helay sahan-meta-falanqeyn oo baaray daaweynta daaweynta nafsiyeed ee khamaarka murugada leh (Cowlishaw iyo al., 2012; Gooding & Tarrier, 2009; Goslar, Leibetseder, Muench, Hofmann, & Laireiter, 2017; Leibetseder, Laireiter, Vierhauser, & Hittenberger, 2011; Pallesen, Mitsem, Kvale, Johnsen, & Molde, 2005) iyo SUDs (Dutra iyo al., 2008; Tripodi, Bender, Litschge, & Vaughn, 2010).

In kasta oo CBT inta badan lagu isticmaalay saddexda qaybood ee balwadaha, haddana habab kala duwan oo kale oo cilmi nafsi ah ayaa la caddeeyey inay si isku mid ah waxtar ugu leeyihiin yaraynta dabeecadaha dhibaatada leh iyada oo aan loo eegin qaabka daaweynta iyo gaar ahaan marka loo eego IA — asalka dhaqanka. Natiijooyinkaani waxay ka duwan yihiin kuwii lagu soo sheegay falanqayn-meta-kii dhawaa, ee lagu ogaaday faa iidada CBT marka loo eego daweynta kale ee nafsi ahaaneed ee yareynta waqtiga lagu qaatay internetka, la-talinta shaqsiga, iyo daraasadaha lagu sameeyay Mareykanka (Winkler et al., 2013). Kala-soociddu, si kastaba ha noqotee, waxaa laga yaabaa inay sabab u tahay xaqiiqda ah in falanqaynta dhexdhexaadiyaha lagu sameeyay liidashada kooxda gudaheeda iyo cabirka saamaynta la xakameeyay iyo isku-darka natiijooyinka cilmi-baarista ee ugu dambeeyay ee ku saabsan falanqaynta-meta. Kuwaas dhexdooda, dariiqooyinka sida caadiga ah loo adeegsado waxaa ka mid ahaa daaweynta qoyska, taas oo ay u aragto xaalado qoys oo kaladuwan oo aan kala go 'lahayn (tusaale ahaan, Schneider, King, & Delfabbro, 2017) u muuqataa mid faa'iido u leh kaliya ciyaartooyda internetka dhibaatada leh (tusaale ahaan, Han, Kim, Lee, & Renshaw, 2012), laakiin sidoo kale dhalinyarada qaangaarka ah ee qaba SUDs (dib u eegis eeg Filges, Andersen, & Jørgensen, 2018). Sidoo kale, barnaamijyada ku saleysan miyir-qabka ayaa si guul leh loogu dalbaday calaamadaha lagu garto cudurka AA (Li, Garland, iyo al., 2017) iyo CB (Armstrong, 2012), iyo aqbalaadda iyo daaweynta ka go'naanta ee loo hirgaliyay daaweynta SA (tusaale ahaan, Crosby, 2012) waxay cadeeyeen inay qiimo leeyihiin si loo yareeyo astaamaha khamaarka xumaaday iyo SUDs (A-tjak iyo al., 2015; Li, Howard, Garland, McGovern, & Lazar, 2017; Maynard, Wilson, Labuzienski, & Whiting, 2018). Barnaamijyada isdhaxgalka ah, oo inta badan kujiraan walxaha CBT, waxay soo saareen qiyaaso saameyn isku mid ah seddexda nooc ee balwadaha, marka laga reebo yareynta inta jeer ee dabeecadaha galmada qasabka ah. Natiijadan, si kastaba ha noqotee, waxay ku saleysan tahay hal tijaabo oo ka duwan kuwa kale iyadoo la adeegsanayo Sahanka Halista ah ee Orzack Waqtiga Kala-baxa (OTIS); Orzack, 1999) u muuqday "si ku filan oo loo dhan yahay" ()Orzack, Voluse, Wolf, & Hennen, 2006, p. 354) si loo cabbiro inta jeer ee isticmaalka kumbuyuutarka maladarect. Sababta oo ah Orzack iyo al. (2006) lagu bixiyo daaweyn kooxeed, saamaynta yar ee daraasaddan ayaa sidoo kale lagu tiriyay faa'iido darrada koox koox marka la barbar dhigo la-talinta shaqsiga ee hoosta ka xariiqday muhiimadda ay leedahay adeegsiga aalado cabbir lagu kalsoonaan karo oo ansax ah (eeg sidoo kale Hook, Reid, Penberthy, Davis, & Jennings, 2014). Intaa waxaa sii dheer, jawaabta daaweyntu waxay u muuqatay inay ka madax banaantahay nooca dhalmada, marka laga reebo hal: IA saameysay shaqsiyaadka helay FTFTs waxay u muuqdeen inay ka faa iidayaan daweynta marka loo eego kuwa ku jira SGTs. SGTs loo hirgaliyay daaweynta IA, si kastaba ha noqotee, waxaa ku jiray tiro aad u tiro yar oo fadhiyada ka badan FTFTs. Sidaa darteed, muddada aan la adeegsan karin nooca gudbintu waxay la xisaabtami kartaa kala-duwanaanshaha u dhexeeya koox-kooxeed, isagoo taageeraya natiijooyinka falanqaynta metalaad ee dhowaan la sameeyay (Goslar iyo al., 2017) taas oo tilmaamtay in SGTs gaagaaban ay soo saari karaan heerar hoose oo horumar ah marka loo barbar dhigo xoogga sare, barnaamijyada is-caawinta ee habaysan. Caddaynta helitaankan waxaa bixiyay SGTs oo deg-deg ah oo loo fuliyey daaweynta SA (Hardy, Ruchty, Hull, & Hyde, 2010; Levin, Heninger, Pierce, & Twohig, 2017) iyo CB (Mueller, Arikian, de Zwaan, & Mitchell, 2013), soosaarid cabir saameyn leh oo la mid ah kuwa loo helay FTFTs. Marka loo eego, guusha daaweynta ayaa kordhay muddadii teraabiyada cilminafsiga, gaar ahaan marka la eego yareynta darnaanta adduunka iyo soo noqnoqda IA. Natiijo la mid ah, laakiin natiijooyin aan muhiim ahayn ayaa sidoo kale loo arkay dhimista darnaanta adduunka ee SA. Natiijooyinkaani waxay la jaan qaada yihiin kuwa ka soo baxay cilmi baaris Aasiyaanka AA (Chun iyo al., 2017), iyo kuwa ku kasbaday khamaarka foosha xun (Goslar iyo al., 2017; Leibetseder iyo al., 2011; Pallesen et al., 2005), soo jeedinta muujinta dabeecadaha balwadda leh ee u baahan daaweyn degdeg ah si loo gaaro horumar.

Sida daawaynta cilminafsiyeedka, dawooyinka cilminafsiyeedka waxay muujiyeen hoos u dhac weyn oo hordhac ah oo ku yimid calaamadaha cudurka ee seddexda nooc ee balwadaha. Ma jiraan wax gunaanad ah, hase yeeshe, looma sameyn karo qaddarin ku saabsan jiritaanka jawaabta daaweynta iyo faa'iidooyinka muddada-gaaban ee daawooyinka meelaynta sababta oo ah xaddidan xogta. Waxaa intaa dheer, tijaabooyin lagu xakameynayay placebo oo lagu daaweynayo SA iyo CB waxaa lagu muujiyey taageero dheeri ah sida xiriirada daaweeyaha joogtada ah oo ay ka mid tahay ka fikirida dabeecadaha dhibaatada leh (Madow, Gabel, Hansen, & Schlosser, 2000; Wainberg iyo al., 2006) ama istiraatiijiyadaha iskudhacyada sida xafidida xusuus qorista dukaameeysiga (tusaale ahaan, Black et al., 2000; Ninan iyo al., 2000) ku biirinta yar yar oo ka dhexeeysa kooxaha, iyo qarinta saameynta wakiilada kiimikada (Black et al., 2000; Ninan iyo al., 2000; Wainberg iyo al., 2006). Isbarbardhig ahaan, faa'iidooyinka muddada-gaaban ee daaweynta daaweynta dawooyinka loo yaqaan 'placebo' ee khamaarka khaladaadka ku jiray waxay ahaayeen kuwa dhexdhexaad ah (Goslar, Leibetseder, Muench, Hofmann, & Laireiter, 2018), oo la mid ah kuwa loo soo sheegay cilad-darrada isticmaalka aalkolada, iyo cuduro kala duwan oo caafimaad iyo cilado caafimaad maskaxda ah (tusaale ahaan, Jonas iyo al., 2014; Leucht, Hierl, Kissling, Dold, & Davis, 2012).

Falanqaynta moderaterna ma muujineynin kala duwanaansho muhiim ah oo u dhexeeya fasallada dawooyinka, in kasta oo faa'iidada daaweynta ee yaraynta darnaanta adduunka ee CB ay u muuqatay in si xad dhaaf ah loo eegayo cabirrada saamaynta weyn ee ku saleysan dhammaystirka lagu arkay laba tijaabo (Madow, Monahan, & Gabel, 1997; Grant, Odlaug, Mooney, O'Brien, & Kim, 2012) marka la barbar dhigo kuwa laga helay falanqaynta ITT. Tijaabooyinkan waxay sidoo kale go’aamiyeen in ay ka sarreeyaan dawooyinka cilminafsiyeed ee daaweynta nafsi ahaaneed ee dhimista darnaanta adduunka ee taageeraysa adeegsiga falanqaynta ITT, oo mataleysa qaab xisaabeed heer sare ah oo ka tarjumaya xaalado macquul ah oo macquul ah marka loo eego daweynta (tusaale ahaan, Sedgwick, 2015). Kaliya qaybta IA, dawooyinka lidka ku ah sunta ayaa ka sare maray dawooyinka kale. Baadhitaan dhaw oo xog ah, hase yeeshe, waxay daahfurtay in koox hoosaadka leh daaweynta sare ay kasbatay kaqeybgaleyaasha qaangaarka ee qaba niyad jabka, iyo ciladaha walaxda-qasabka ah ee lagu daaweeyo dawooyinka lidka diiqadda, waxayna ku dartay tijaabada saamaynta ugu weyn (g = 2.54; Dell'Osso et al., 2008). Qeybta hoose ee faa'iidada daaweynta oo yaraatay, ayaa iyana, waxaa ku jira dhallinta qaan-gaarka ah ee qaba feejignaanta khafiifinta hyperactivity disorder (ADHD) oo lagu daaweeyey cilmu-nafsiga (methylphenidate), waxaana ku jira tijaabada saamiga ugu yar ee sahaminta shakhsiyaadka leh heerka hoose ee IA (g = 0.57; Han et al., 2009). Kala duwanaanshahaani wuxuu sidoo kale saameyn ku yeeshay dhexdhexaadiyaha “dhaqan” iyo “Nooca IA”. Iyada oo labada daraasadood laga saaray gorfaynta moderaterka, faa iidada dawooyinka lidka diiqadda, iyo natiijooyinka wax ku oolka ah ee dhex dhexaadiyayaasha "dhaqanka" iyo "Nooca" IA "ayaa la waayey. In kasta oo daaweynta labada qayboodba ay soo saareen natiijooyin faa'iido leh, haddana kala duwanaanshaha ayaa u muuqday in ay kicinayaan tijaabooyin keliya. Sidaa daraadeed, isdhaxgalka ka dhexeeya iskaashiga ADHD, daaweynta daaweynta, da'da, iyo dhaqanka waxay u baahan yihiin baaritaan haddii tiro ka badan oo daraasado ah la heli doono. Ka sokow comorbid-ka ADHD, hase yeeshe, horumarin gaar ah ayaa ka madax bannaan niyad-jabka iyo walaaca, iyadoo la taageerayo natiijooyinka kasoo baxay IA (tusaale ahaan, Han & Renshaw, 2012) iyo cilmi-baaris qamaar khaldan (dib u eegis eeg Dowling, Merkouris, & Lorains, 2016).

Inta lagu jiro seddexda nooc ee balwadaha, gaar ahaan serotonin xulista reuptake inhibitors (SSRIs) ayaa la baaray iyadoo lagu saleynayo qeybaha sare ee ciladaha niyadda (tusaale,, Kafka, 1991) iyo - qaasatan marka loo eego SA - astaamaha xakamaynta serotonin ee dabeecadaha galmada (tusaale ahaan, Kafka & Prentky, 1992). Mucaaradka Opioid (tusaale ahaan, naltrexone) iyo dawooyinka 'glutamatergic' (tusaale ahaan, topiramate) waxaa loo tixgeliyay kaliya daraasadaha xaaladaha daaweynta ee daaweynta (tusaale ahaan, Grant & Kim, 2001; Khazaal & Zullino, 2006) iyo CB (tus., Grant, 2003; Guzman, Filomensky, & Tavares, 2007) muujinta natiijooyinka waxtarka leh. Sababtoo ah opioid antagonists iyo wakiilada glutamatergic waxay cadeeyeen ikhtiyaarada daaweynta wanaagsan ee SUDs (Guglielmo iyo al., 2015; Jonas iyo al., 2014; Minarini iyo al., 2017) iyo khamaarka xumaaday (Bartley & Bloch, 2013; Goslar iyo al., 2018), daroogooyinka noocan ahi waxay umuuqdaan kuwa ballanqaad u leh baadhitaanka qaababka darajooyinka-cabirka culus ee la xakameeyay, gaar ahaan marka loo eego heerarka sare ee SUD-yada caadiga ah ee lagu arkay BAs (tus. Grant et al., 2010).

Daaweynta isku-darka ah ee loogu talagalay IA, gaar ahaan daawooyinka marka lagu daro CBT, waxay soo saarteen saameyn tababareed oo la xoojiyay marka la barbar dhigo waxqabadyada cilmi nafsiyeed ee saafiga ah iyo dawooyinka taageeraya tallada dib-u-eegista dhowaan ee daraasadaha natiijada daaweynta IA (Przepiorka, Blachnio, Miziak, & Czuczwar, 2014). Ka sarreynta isku-darka CBT marka loo eego kuwa lagu daro istiraatiijiyadda kale ee cilmi-nafsi waxaa loo qaatay inay ku saleysan tahay hal tijaabo oo soosaarid cabbir aad u weyn (g = 5.31; Yang, Shao, & Zheng, 2005), saamaynaya sidoo kale dhexdhexaadiyayaashu "tayo" iyo "Nooca IA". Iyada oo daraasaddan laga saaray falanqaynta koox hoosaadka, si kastaba ha noqotee, kaliya faa'iidada isugeynta CBT ayaa weli ah mid weyn.

In kasta oo macluumaadka badankood ay bixiyeen daraasadaha natiijada daaweynta IA, iyo xogta laga helo tijaabooyinka la xakameeyay ay wali xaddidan yihiin, hababka cilmi-nafsi ahaan iyo dawooyinka ayaa muujiyey saameyn muddo gaaban ah saddexda xaaladood, kuwaas oo u dhigma kuwa loo adeegsado maandooriyaha iyo khamaarka xumaaday (tusaale ahaan, Goslar iyo al., 2017; Grant et al., 2010) taageerida fikradaheena. Natiijooyinkaas kuma filna in lagu caddeeyo kala soocidda IA, SA iyo CB marka loo eego noocyada cudurada dhimirka sababo la xiriira ansaxinta shuruudaha baaritaanka, iyo xaddidan ee cudurrada faafa, hiddo-wadaha iyo xogta neerfaha. Grant et al., 2010). Si kastaba ha noqotee, waxay soo jeedinayaan, in shakhsiyaadka si isku mid ah ay uga jawaabaan daaweynta si kasta oo aan loo eegin nooca qabatinka. Natiijooyinkaani waxay si fiican ugu habboon yihiin moodooyinka fikirka ah ee cilladaha qabatinka balwadaha ee qeexaya qaababka guud ee salka u ah labadaba dhibaatooyinka la xiriira walaxda iyo BAs (Griffiths, 2005; Jacobs, 1986; Orford, 2001; Shaffer et al., 2004), kaas oo lagu beddeli karo iyadoo la adeegsanaayo daweynta cilmi-nafsi ahaan iyo dawooyinkaPotenza et al., 2011). Iyada oo laga duulayo waxqabadka hore ee daciifka ah iyo abaalmarinta wareegga inta lagu gudajiro isticmaalka daroogada iyo dabeecadaha aan joogtada ahayn (tusaale ahaan, Nestler, 2005), daaweynta daaweynta cilmi nafsiga, gaar ahaan xulashooyinka ku saleysan CBT, ayaa leh karti ay wax kaga badali karaan is fahamka iyo dabeecadaha qalafsanaanta (Kim & Hodgins, 2018), iyo in la xoojiyo farsamooyinka is-xakameynta iyadoo lala beegsanayo aagagga hore ee maskaxda (Potenza et al., 2011). Daaweynta Farmashiyada, ayaa taa badalkeed, looga golleeyahay yareynta damaca iyo ka bixitaanka astaamaha iyadoo la bar-tilmaameedsanayo marinnada abaalmarinta iyo nidaamyada neurotransmitter (Potenza et al., 2011). Intaa waxaa dheer, sida loo daaweeyay daaweynta IA, iskudhafka CBT iyo daaweynta daawooyinka ayaa laga yaabaa inay yeeshaan saameyn dheeri ah, in kasta oo xiriirka ka dhexeeya labada wali uusan caddeyn (Potenza et al., 2011).

Xuduudaha soo socda waa in la ogaadaa: Marka hore, sida ay run u tahay inta badan dib-u-eegis-falanqaynta, daraasadaha lagu soo daray ayaa ku kala duwanaa tayadooda hab-dhismeedka, in kasta oo markii si taxaddar leh wax looga qabto, aynaan u fiirsaneynin eex nidaamsan cabirka saamaynta ay sabab u tahay kala duwanaanshaha tayada ee daraasadaha. Daraasadaha midkoodna, si kastaba ha ahaatee, ma gaadhin heerka ugu sarreeya ee ka tarjumaya tayada caddaynta xadidan ee laxiriirta xulashada iyo iyo sababtuna tahay saadaalinta nashqadaha daraasadda koox-koox ahaanta iyo aqoonsashada iyo xakameynta walxaha isku-buuqa, iyo indho-la'aanta. Sidaa daraadeed, RCTs si adag loo naqshadeeyay ayaa lagama maarmaan ah, oo ay ku jiraan la socoshada taageerada dheeraadka ah ee nafsaani-bulsho iyo xog-raac, gaar ahaan marka la eego tijaabooyinka dawooyinka. Intaa waxaa dheer, inta badan daraasadaha IA waxaa ka mid ah dabeecado kaladuwan oo laga sameeyay internetka (tusaale ahaan, ciyaaraha tooska ah ee internetka, daawashada filimmo), in kasta oo cilmi baaristu muujisay kala duwanaansho u dhexeeya fikradda guud ee IA iyo noocyada gaarka ah ee dabeecadaha balwadaha ee internetku wado (Montag et al., 2015). Si kastaba ha noqotee, waxaan isku daynay inaan ka adkaano dhibaatadan anagoo koox koox u sameynayna daraasadaha iyadoo loo eegayo hab dhaqankeena, iyadoo aan loo eegin qaabka loo isticmaalo. Marka la eego dhibaatooyinka la xiriira isku-dhaca, waxaan ku xadidanay falanqaynta qun-socod-eegtada niyad-jabka iyo walwalka keliya sababtuna tahay baahidooda sare ee balwadaha dabeecadda (tusaale ahaan, Starcevic & Khazaal, 2017), laakiin sidoo kale maxaa yeelay xogtan ayaa si muuqata loogu cadeeyay shuruudaha ka saarista ee daraasadaha aasaasiga ah. Maaddaama xaalado kale oo badanaa lala kulmo BAs (tusaale ahaan, Grant et al., 2010), iyo jawaabta daaweyntu waxaa saameyn kara dabeecadda cawrada (Dowling et al., 2016), daraasado dheeri ah ayaa lagu dhiirigelinayaa inay si nidaamsan uga warbixiyaan noocyada iyo qiimayaasha dhibaatooyinka isku-dhaca ah si loo qiimeeyo macluumaadkan falanqaynta metalayaasha mustaqbalka. Daraasadaha badankood waxay sidoo kale ku guuldareysteen inay bixiyaan macluumaad ku saabsan sida cudurka loo helay. Qaabka go'aaminta cudurrada, si kastaba ha noqotee, waxay saameyn ku yeelan kartaa ansaxnimadooda (Carlbring iyo al., 2002; eeg sidoo kale Andersson & Titov, 2014). Daraasadaha mustaqbalka waa inay sidaas darteed soo sheegaan haddii cudurka lagu helay ay heleen dhakhaatiirta, is-warbixin, waji ka-waji, ama internetka. Waxaa intaa dheer, daraasadaha mustaqbalka waxaa lagu dhiirigelinayaa inay si toos ah u barbar dhigaan saameynta daaweynta ee shakhsiyaadka leh BAs iyo SUDs si loo baaro waxyaabaha u dhigma iyo farqiga u dhexeeya waxyaabaha aan la xiriirin iyo waxyaabaha aan la xiriirin BA ee la xiriira jawaabta daaweynta.

In kasta oo ay xadidan yihiin, natiijooyinka falanqaynta metalaadlaha ah ee hadda jira waxay muujinayaan in faragelinno kala duwan oo nafsaani ah ay wax ku ool u yihiin yaraynta astaamaha IA, gaar ahaan marka lagu bixiyo waji-ka-waji oo la sameeyo muddo dheer. In kasta oo dawooyinka lidka ku ah cudurka nafsiga ah iyo cilmi nafsiga ee shakhsiyaadka isku dhaca ADHD ay soo fiicnaadeen astaamaha IA, CBT oo ay weheliso dawooyinka lidka ku ah dawooyinka lidka ku ah sunta dawooyinka. Iyada oo ku saleysan xaaladda cilmi-baarista ee hadda jirta, CBT iyo dawooyinka lidka ku ah sunta waxay u muuqdaan inay waxtar u leeyihiin daaweynta SA iyo CB. Marka la eego baahida loo qabo daaweynta, cilmi-baarista neurobiologiska waa in la sii wadaa si loo caddeeyo isbarbardhiga u dhexeeya ciladaha la xiriira walaxda iyo dabeecadaha la qabatinka leh, iyo in la sii wanaajiyo daaweynta daaweynta xaaladdan curyaaminta ah (Grant et al., 2010; Potenza et al., 2011).

Ilaha maalgelinta

Daraasaddan kama helin taageero maaliyadeed oo toos ah hay'adaha maaliyaddeed eek u yaal dadweynaha, ganacsiga, ama kuwa aan macaash doonka ahayn.

Ku biirinta qoraaga

Martina Goslar waxay sameysay raadinta suugaanta, waxay soosaartay xogta waxayna ku sameysay falanqaynta. Waraaqaha ku darista falanqaynta 'meta-falanqaynta' waxaa la baarey Martina Goslar iyo Max Leibetseder oo iyaguna xaqiijiyey soo saarista xogta. Anton-Rupert Laireiter ayaa kormeeray howshan. Martina Goslar iyo Max Leibetseder ayaa ku qiimeeyay ansaxnimada daraasadaha. Hannah M. Muench waxay taageertay ururinta xogta waxayna siisay talo ku saabsan tirakoobka. Buug-gacmeedkan waxaa qoray Martina Goslar oo leh faallooyin ay bixiyeen Hannah M. Muench, Anton-Rupert Laireiter, iyo Stefan G. Hofmann. Dhammaan qoraayaashu waxay gacan ka geysteen oo ay oggolaadeen qoraalkii ugu dambeeyay.

Isku dhaca xiisaha

Martina Goslar waxay cadeyneysaa inaysan laheyn wax khilaaf ah oo dan ah. Max Leibetseder wuxuu cadeeyay inuusan lahayn wax dan ah oo dano ah. Hannah M. Muench waxay cadeyneysaa inaysan laheyn wax dan ah oo dano ah. Dr. Hofmann wuxuu taageero dhaqaale ka helaa Alexander von Humboldt Foundation (oo qayb ka ah abaalmarinta Humboldt), NIH / NCCIH (R01AT007257), NIH / NIMH (R01MH099021, U01MH108168), iyo James S. McDonnell Foundation 21st Hindisaha Sayniska Qarniga ee Fahamka Garashada Aadanaha - Hindisaha Gaarka ah. Wuxuu magdhow ka helaa shaqadiisa tifaftiraha ee Springer Nature iyo Ururka Sayniska Cilmu-nafsiga, iyo lataliye ka socda Palo Alto Health Sciences iyo shaqadiisa oo ah Khabiir Mawduuca Mawduuca ah oo ka socda John Wiley & Sons, Inc. iyo SilverCloud Health, Inc Wuxuu sidoo kale ka helayaa lacag-bixinno iyo lacag-bixinnada shaqadiisa tifaftirka daabacadaha kala duwan. Anton-Rupert Laireiter wuxuu cadeynayaa inuusan laheyn khilaaf dano gaar ah leh.

Mahadnaq

Qoraayaashu waxay jecel yihiin inay u mahadceliyaan Mrs Xuan Wang iyo Mrs Yang Zhang oo turjumay qoraalada Shiinaha.

Foormulada loogu talagalay Xisaabinta Cabbirka Saameynta

Si loo xisaabiyo cabirka saameynta kooxda dhexdeeda, qaacidooyinka soosocda ayaa la isticmaalay (Borenstein iyo al, 2005, 2009):

d=(Yan1-Yan2SDifference)2(1-r),

sidaas oo kale Yan1 Waxay ka tarjumaysaa isu-ekaanshaha Yan2 waxay ka tarjumaysaa dawada kadib, Sfarqiga Muujinaya heerka toosan ee kala duwanaanshaha, iyo r waxay ka tarjumaysaa isku xirnaanta udhaxeysa daaweynta iyo dhibcaha daaweynta kadib. Sababtoo ah cabirrada tusaalooyinka yar yar, dhammaan cabirka saamaynta waxaa lagu saxay eexasho iyadoo la adeegsanayo Hedges's g kaas oo lagu xisaabiyay isugeyn d oo leh qodobka sixitaanka

J(df)=1-34df-1,

sidaas oo kale df waxay matalaysaa heerarka xorriyadda si loo qiyaaso kala-soocidda heerka kooxeed. Qaacidooyinkaan waxaa sidoo kale loo adeegsaday xisaabinta cabirrada saamaynta laga soo bilaabo mooshin illaa iyo dabagalkii ugu dambeeyay. Cabbirka saameynta la xakameynayay waxaa lagu xisaabiyay iyadoo la isticmaalayo qaaciddada soo socota:

g=(ΔanTREAT-ΔanXIDHIIDHKA)(nTREAT-1)SD2TREAT+(nXIDHIIDHKA-1)SD2XIDHIIDHKAnWadarta Guud-2×(1-34(nWadarta Guud-9)),

sidaas oo kale Δ Akpa waa celceliska ka hor isbedelka daaweynta ka dib, SD waa weecashada caadiga ah ee dhibcaha daaweynta ka dib, n waa cabirka muunadda, TREAT waxaa loola jeedaa xaaladda daaweynta firfircoon, iyo CONT waxaa loola jeedaa xaaladda xakameynta. Soo socda Rosenthal (1991), waxaan ku qiyaasnay ​​xiriirinta ka horeeya post-ka inuu noqon doono r = 0.70.

tixraacyada

Tixraacyada ayaa lagu soo daray Falanqaynta Meta-Falanqaynta