LIKETSO tsa menyetla ea ACT ho sebetsana le ho lemalla lijo (2015)

PMCID: PMC4391226

Roberto Cattivelli,1, * Giada Pietrabissa,1,2 Martina Ceccarini,1,3 Chiara AM Spatola,1,2 Valentina villa,1 Annalisa Caretti,1 Arianna Gatti,4 Gian Mauro Manzoni,1 'me Gianluca Castelnuovo1,2

Boitsebiso ba Mongoli ► Sehlooho sa Article ► Tlhahisoleseding ea Copyright le License ►

Ho nona ho feta tekano ke bothata bo ntseng bo hola lefatšeng ka bophara, 'me bo fetoha seoa sa Europe le United States. Litlaleho tsa morao-rao li bonts'a hore 64% ea batho ba baholo ba US ba na le boima ba 'mele haholo,' me sena se ntse se eketseha (Lifshitz le Lifshitz, 2014). United States, moroalo oa moruo ho sistimi ea bophelo bo botle e amanang le bothata bona ke lidolara tse limilione tse likete tsa 100 (Cawley et al., 2014; Specchia et al., 2015). Meroalo ea moruo Europe e tšoana le ea United States (Pietrabissa et al., 2012; Lehnert et al., 2014).

Kotsi ea bophelo bo botle e amanang le ho ba le boima ba 'mele hangata e kenyelletsa mathata a kelello, a joalo ka khatello ea maikutlo le sekhobo, le ho senyeha hoa mmele, joalo ka pelo le pelo, lefu la metabolic kapa lefu la masapo a manonyeletso (Deitel, 2002; Foromo le Bulwer, 2006; Castelnuovo et al., 2014; Knäuper et al., 2014). Phephetso e kholo ea ho tobana le botenya le mafu a amanang le eona a hlobaetsang le a sa foleng ke ho nts'etsapele nts'etsopele le ts'ebetso ea mananeo a felletseng a taolo ea boima ba 'mele, a atisang ho kenyelletsa motsoako oa ho ikoetlisa' meleng, ho ja le ho kena lipakeng kelellong (Kramer et al., 2011, 2014). Leha ho le joalo, litlamorao tsa mananeo ana hangata ha li tšoarelle nako e telele (Castelnuovo le Simpson, 2011). Ho latela liphumano tsa morao-rao, tlhokomelo ea ho theola boima ba 'mele e fumanehang nakoana e telele feela (Gifford le Lillis, 2009; Cooper et al., 2010; Knäuper et al., 2014).

Ka kakaretso, ho fumaneha, litšenyehelo, ho latela kalafo, le ho sebetsa ka nako e telele ke meeli ea bohlokoa ea mekhoa ena ea mekhoa (Byrne et al., 2003; Manzoni et al., 2009; Cesa et al., 2013; Castelnuovo et al., 2014). Khafetsa, bakuli ba batenya haholo ba fumana chelete e ka bang 30% ea boima bo lahlehileng nakong ea kalafo nakong ea selemo sa 1 mme ka tloaelo ba khutlela boima ba bona ba mantlha nakong ea lilemo tsa 3-4 (Castelnuovo et al., 2011). Litšusumetso tsa setso le boits'oaro bo botle bo kenyelelitsoeng ho kenelletseng lithutong tse fapaneng, tse sa sebelisoeng joalo ka mananeo a emeng a le mong, hangata li nkuoa e le mokhoa oa khauta oa ho tobana le "Globalbesity" (Lifshitz le Lifshitz, 2014), e bolelang tlokotsi ea lefats'e ea batho ba nonneng haholo (Deitel, 2002; Avena et al., 2012b; Pietrabissa et al., 2012; Castelnuovo et al., 2014). Leha ho le joalo, liphetho tsa nako e telele hangata li mpe (Cooper et al., 2010).

Mananeo a thehiloeng ho CBT a bonts'a sephetho se setle ho bongata ba batho ba batenya, kaha ba khothaletsa maano a taolo, joalo ka ho ja lijo tse sa laoleheng, litaelo tsa ho ikoetlisa le ho hatella mohopolo kapa ho hlophisa bocha kelello (Forom et al., 2007, 2013; Cooper et al., 2010). Leha ho le joalo, ho latela lipatlisiso, liphetho tsa mananeo ana hangata ha li tšoarelle nako e telele (Foreter and Poston, 1998; Byrne et al., 2004; Cooper et al., 2010). Mefuta e hlahlamang ea ho lekola botenya hona joale e supa karolo ea mantlha ea ts'ebeliso ea lijo (FA) ho etsa conceptualize botenya eseng feela joalo ka phello ea bophelo bo seng kotsi empa hape le sephetho sa karolo ea lintho tse ka tlasa kelello tsa kelello (Riva et al., 2006; Gearhardt le Corbin, 2011; Gearhardt et al., 2011a,b; Avena et al., 2012a; Boggiano et al., 2014; García-García et al., 2014).

Ho latela mefuta ena, tšebeliso e ngata ea lijo e ts'oana le bokhoba ba lithethefatsi (Gearhardt et al., 2012). Boitšoaro bo tlatsetsang bo hlaha ka mefuta e fapaneng, ho kenyelletsa ho ja ho feta tekano (Shaffer et al., 2004). Ho batho ba bang ba batenya haholo, matšoao a ho pepeta ka ho feteletseng a seipone a amanang le boits'oaro bo bong bo qobelloang, bo kang bo bonoang ke lithethefatsi (James et al., 2004; Volkow le Wise, 2005; Volkow le O'Brien, 2007; Gearhardt et al., 2011a). Bopaki bo fana ka maikutlo a hore palo e itseng ea batho ba batenya haholo ntle le ts'oaetso ea metabolic e futsitsoeng e kopana le mathata a tebileng a ho fokotsa boima ba 'mele le matšoao a FA (Gearhardt et al., 2009, 2012;; Davis et al., 2011).

Leha ho ila lintho tse nooang le joala le ho theha mekhoa e metle ea ho sebetsana ka katleho ho khothaletsoa ba nang le ts'ebeliso ea lithethefatsi, ho thata ho hana ho fepa. Ntle le moo, tšebeliso ea lijo tse ling li amana le phetoho ea mmele le kelello tse amanang le tšebeliso ea lithethefatsi, joalo ka ho tlosa, ho mamella, tahlehelo ea taolo, litakatso, le ho ts'oaroa (Volkow le Wise, 2005). Lijo tse nang le phepo e ntle li ka kenya tšebetsong tsamaiso ea moputso oa boko ka li-sensor tse kenang ka potlako le liphetho tsa morao-rao tse lebisang maemong a phahameng a tsoekere bokong le maling (Garber le Lustig, 2011). Potoloho ea moputso e hlahisoang ke takatso ea lijo le eona e ka hlahisoa ka kotlolloho ke lintho tsa kelello (Di Leone et al., 2012).

Boholo ba bakuli ba batenya haholo ba na le "litakatso tsa lijo," tseo e leng matšoao a kang a bokhoba ba lijo. Bakuli bana ha ba arabele hantle ho kenelletseng ha ho fokotsa boima ba 'mele (Avena et al., 2011). Boemo bona bo lebisa takatsong e ntseng e eketseha ea ho ja ho laola maikutlo a sa phutholoheng le maemo a mabe a maikutlo. Tekanyo le mofuta oa lijo tse jeoang le tsela eo lijo tse se nang phepo tse joalo li fumanehang ka tsona li fapana ho ea ka batho (Hill et al., 2014).

Leha ho na le tlhaiso-leseling e nepahetseng mabapi le ho ata ha FA bathong ba batenya, ho kenella ho reretsoeng ho tobana le boima ba 'mele ka ho feteletseng le FA, ho kenyeletsoa likarolo tsa kalafo tse joalo tsa bokhoba, li ka bonts'a liphetho tse ntle ha li bapisoa le kalafo e tloaelehileng ea ho fokotsa boima ba' mele (Avena et al., 2012a). Ho latela lipatlisiso tsena tsa pele, empa tse ts'episang, liphatlalatso tse ncha tsa kalafo ea ho fokotsa boima ba 'mele li lokela ho nka karolo ea FA e le sesosa sa kelello sa maemo a tlase a tlas'a maemo a thata a taolo ea boima (Gearhardt le Brownell, 2013; Gearhardt et al., 2014;; Hebebrand et al., 2014; Innamorati et al., 2015), le ho khothaletsa ho kenella ka mokhoa o nepahetseng oa boits'ebetso (Ceccarini et al., 2014).

Mefuta e fapaneng ea lipatlisiso e fuputse likarolo tse amanang le taolo e atlehileng le e sa atleheng ea boima ba 'mele mme li hlophisitse mananeo a shebileng lintlha tsena (Gifford le Lillis, 2009; Lillis et al., 2009; Barnes le Tantleff-Dunn, 2010b; Schuck et al., 2014). Batho ba ileng ba fokotsa boima ba 'mele ba nakong e fetileng ba fana ka bokhoni ba ho sebetsana le boemo bona ka katleho. Ebile, batho bana ba tloaetse ho qoba, ho se qobellehe, mme maemong a mangata, ba ja maikutlong (Avena et al., 2011; Schag et al., 2013). Ka lehlakoreng le leng, liphetho tse ntle li bonoa har'a batho ba nang le maemo a phahameng, ba amohelang, le boitlamo bo eketsehileng litloaelong tsa bophelo bo botle (Gifford le Lillis, 2009).

Mosebetsing oa bona oa seminal, Lillis et al. (2009) o khothalelitse ho sebetsana le kalafo le lisebelisoa tse sa ameng litakatso ka kotloloho kapa bokhoni ba ho sebetsana le maemo kapa tse shebang feela taolo ea boima ba mmele, empa o amohela mokhoa o amoheloang le o kelello oa ho phekola botena le botenya. Ho ba le tsebo ea ho ruta le ho ikoetlisa ho amohela ho se khotsofale maikutlong le menahano e thata, ho fokotsa ho qoba boiphihlelo, le ho khothaletsa ho phehella ka boits'oaro bo nang le boleng bo nang le boleng, o lokela ho emela tsoelo-pele ea bohlokoa bakeng sa phetolo ea boitšoaro ba nako e telele libakeng tse fapaneng (Lillis et al. , 2011; Weineland et al., 2012).

Phekolo ea kamohelo le boitlamo, e bitsoang ACT, e sebelisoa haholo ho khothaletsa mekhoa e metle ea bophelo bo botle le bophelo bo botle ba kelello maemong a mangata, ho kenyelletsa litheko, mafu a pelo le mathata a ho ja (Prevedini et al., 2011; Weineland et al., 2012; Spatola et al., 2014a,b; A-Tjak et al., 2015). Mohlala, ho kenella ho thehiloeng ho Molao ho ile ha sebelisoa ka sepheo sa ho ts'episa ho ntlafatsa mamello ho basali ba mafolofolo (Ivanova et al., 2014). Moetso oa phetoho ea kelello, o thehiloeng maemong a sebetsang mme o thehiloe ka kotloloho mohopolong oa setsoalle, e leng tlaleho ea puo le kelello, o tobane le phephetso ea boemo ba motho ea ho khothaletsa maemo a bophelo bo fapaneng. Ts'ebeliso ea tliliniki ea mohlala ona ke theknoloji, ACT, e tlasa ntlafatso e tsoelang pele ebile e tšoaetsoe maemo a mangata a feto-fetohang, lits'ebetso tse ngata tsa kliniki le tse ka tlase, le sehokelo se matla saenseng ea motheo (Gifford le Lillis, 2009; Barnes le Tantleff-Dunn, 2010a).

Act, e thehiloe ho liteknoloji tsa boitshwaro le mahlale, e ka hokahanya mekgwa ya maemo a gauta ho ntlafatsa ho latelwa, ho kgothaletsa boits'oaro ba boitšoaro, le ho khothaletsa tlhaiso e tsoelang pele ea boits'oaro bo lebisitsoeng. Ntle le moo, ts'ebetso, eseng feela ea sebopeho, ho fetoloa hoa Molao ho bohlokoa ho ntlafatsa phetoho ea boits'oaro ho ikarabela bakeng sa maemo a fapaneng a sechaba le maemo a ntlafalitsoeng le ho ntlafatsa ts'ebetso ea ho kena lipakeng maemong a fapaneng (Cattivelli et al., 2012a,b; Drossel et al., 2014). Sepheo sa ho amohela le ho amohela kalafo e thehiloeng ho kelello ke ho eketsa maemo, eseng ka ho khutlisetsa mehopolo e sa sebetseng kapa ho hlahisa maano a matla a taolo (mohlala, tlhahlobo ea kelello), empa ka ho ruta mokuli ho ba teng le ho tsamaisana le litekanyetso tse khethiloeng ka bolokolohi ( Barnes le Tantleff-Dunn, 2010b).

Ho ruta le ho amohela ho sebetsana le maikutlo a thata le menahano ho ka ba molemo haholo ho ba sa fetoheng le ba tloaetseng ho qoba khatello ea maikutlo (Lillis et al., 2009). ACT e fana ka mefuta e mengata ea likopo tse sebetsang bakeng sa botenya le taolo ea boima ba 'mele, ho tloha kalafong e le' ngoe ho isa ho li-setting tsa sehlopha, ka bobeli le ka ntle ho nako. Ntle le moo, ACT e fana ka mekhoa e fapaneng ea ho fana ka kalafo, ho kenyelletsa tlhahlobo ea mohala le ts'ebetso e thehiloeng marang-rang, ka kabo e nepahetseng ea lisebelisoa, liphetho tsa bohlokoa le katleho. Liphumano tsa morao-rao li bonts'a litholoana tse ntle sebakeng sena (Bricker et al., 2013; Schuck et al., 2014). Monyetla oa ho hlahisa li-protocol tse thehiloeng ho web tsa ACT ho lebisa botenya ke mokhoa o nepahetseng o ka sebelisoang mefuteng ea kalafo bakeng sa ho nona haholo mabapi le ts'ebeliso ea lisebelisoa tsa theko. Lingoliloeng tsa morao-rao tse mabapi le ho khaotsa ho tsuba ka ho sebelisa mokhoa oa ACT li hlahisitse litholoana tsa bohlokoa le ntlafatso ho hlahiseng litaba (Schuck et al., 2011). Phapanyetsano ea litaba tsa ho arolelanoa ka bolokolohi le maemo maemong a ntlafatso kamora lenaneo le itseng kapa kalafo e emeng e le 'ngoe e ka ba tšibollo e kholo saenseng ea taolo ea boima mme e ka fihlela palo e fapaneng ea batho ho eketsa ts'usumetso ea sechaba ea mananeo a amoheloang ntlafatsong ea bophelo bo botle. .

Ho fetola mohopolo ho tloha ho topography ho sebetsa, ntle le ho shebisa ka kotloloho ho tsieleha kelellong empa ho rarolla maikutlo ho laola kapa ho qoba maikutlo le menahano e thata, ke tšobotsi ea bohlokoa ea ACT. ACT e kanna ea sebetsa ho phekoleng botenya le botenya haholo ka lebaka la bofokoli ba nako e telele ba mekhoa e mengata ea setso (Prevedini et al., 2011). Mohopolo ona o tsamaellana le lingoliloeng tse mabapi le ho lemalla lithethefatsi le tšebeliso e mpe ea lithethefatsi, tse fanang ka maikutlo a hore mokhoa oa mantlha oa ho ithiba ke ho eketsa bolokolohi ba motho ho mathata a kelello kapa lintho tse a bakang; lingoliloeng tsa bohloko li bonts'a liphetho tse tšoanang (Gifford le Lillis, 2009; Lillis et al., 2011; García-García et al., 2014). Ka hona, kalafo bakeng sa batho ba batenya haholo ba nang le maemo a phahameng a FA e lokela ho kenyelletsa ho ruta mamello e kholo ea khatello ea maikutlo, ho eketsa bokhoni ba ho etsa liketso tse nang le boleng, le ho fokotsa ntoa ea ho laola maikutlo le menahano e thata le ho nts'etsapele taolo e ntle ea ho ja maikutlong. khothaletsa phetoho ea boits'oaro ba nako e telele.

Foran et al. (2007), ha ho bapisoa maano a taolo a sebelisang mokhoa oa ho amohela le ho ela lintho hloko, 'me a fumana hore, ho na le litekanyetso tse phahameng tsa litakatso tsa lijo, barupeluoa ba fumane sephetho se betere maemong a LITLHOKOMELISO. Liphumano tsena tsa pele li ts'ehetsa ts'ebetso ea kamohelo le kamohelo e thehiloeng mohopolong maemong a tloaelo ea ho fana ka khalemelo e mengata bakeng sa botenya, haholoholo ha ho lebisoa batho ba sa arabeng le ba qobang haholo (Forman et al., 2007). Ho kenyelletsoa ka mokhoa o hlakileng oa mekhoa ea ho qoba 'nete ea FA le boiphihlelo, haholo bakeng sa batho ba sa arabeng mekhoa e tloaelehileng ea kalafo, ho ka emela mohato oa pele ho kenelletseng liphatlalatso bakeng sa batho ba hlahisang litekanyetso tse phahameng tsa boits'oaro le boits'oaro.

Kahoo, ho kenyeletsoa ha ACT ho kenelletseng lithutong tse fapaneng tsa khalemelo tse fapaneng bakeng sa ho nka sebaka kapa ho li sebelisa hammoho le CBT ho ka khothaletsa liphetoho tse amanang le mekhoa ea bophelo bo botle, haholo-holo ho bakuli ba thibelang haholo (Lillis et al., 2011; Foran et al., 2013; Hawkes et al., 2014). Boleng bo ekelitsoeng ba ho amohela le kalafo e thehiloeng kelellong hase phetoho ea nako e khuts'oane; empa, e fana ka sephetho sa nako e telele. Lipampiri tsa morao-rao tse tsamaisang ntlheng ena, li bonts'a litlamorao tse ts'oanang le CBT ea setso qetellong ea kalafo le liphetho tse ntle tsa nako e telele kamora ho latela (Weineland et al., 2012; Foran et al., 2013). Ts'oaetso ea lintlha tsa kelello, haholo-holo FA, e ka thusa ho khetha batho ba hlokang ts'ebetso e reretsoeng ho fokotsa tšireletso le boiphihlelo ba ho etsa ts'ebetso ea boleng, ka hona, e lumella keketseho ea ts'ebetso le ts'ebetso ea kalafo e teng ka nako hammoho le Molao. Ha ho na tumellano e hlakileng mabapi le boteng ba litekanyetso tse hlalositsoeng hantle eseng bakeng sa FA kapa, joalo ka ha ho boletsoe ke lingoliloeng tsa morao-rao (Hebebrand et al., 2014), bakeng sa ho ja Joala. Le ha ho le joalo, DSM5 e bonahala e buleha litlhaloso tse pharaletseng tsa boits'oaro bo lemaletseng, ho kenyelletsa le mathata a amanang le lintho tse sa amaneng le mali (Hone-Blanchet le Fecteau, 2014; Meule le Gearhardt, 2014; Potenza, 2014). Kahoo, khang e ntse e bulehile, joalo ka litataiso tsa morao-rao tse tsoang ho Australia PA (Hay et al., 2014) bontša tlhokahalo ea ho fana ka bopaki bo eketsehileng bo tšehetsang ts'ebeliso ea MESO, kapa liphekolo tse ling tse ntseng li hola tsa ho ja. Ntle le sena, tšepiso e hlahisa litholoana tsa botona bo amanang le boits'oaro bo joalo ba ho lemalla lijo (Forman et al., 2013) fana ka tlhahiso ea ho nts'etsapele lipatlisiso tse ling le Molao oa batho ba sa tsebeng ho araba, ba nang le maemo a mangata a thibelo ea lijo tse fumanehang habonolo. Ka ts'epo, morao tjena lipatlisiso li tla supa lintlha tsa bohlokoa tsa ho lemalla khafetsa tšimong ea ho ja le ho se sebetse ka lijo, le merero e tla sebetsana le bona haholoanyane ho sebetsana le bona.

Eya ho:

Khohlano ea polelo ea thahasello

Bangoli ba bolela hore lipatlisiso li ne li etsoa ka ho se be le likamano leha e le life tsa khoebo kapa tsa lichelete tse ka nkoang e le khohlano e ka 'nang ea e-ba le thahasello.

Eya ho:

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