Litlhahlobo tsa Neuroscience le Biobehaisheral
Volume 84, Pherekhong 2018, maqephe 204-217
- Tim van Timmerena, b,,, ,
- Joost G. Daamsc,
- Ruth J. van Holsta, b, d, 1,
- Anna E. Goudriaana, b, e, 1
https://doi.org/10.1016/j.neubiorev.2017.11.022
Lintlha-khōlō Tsa
• Ho qobelloa ho nahanoa hore ke mohopolo o ka sehloohong oa ho putlama ha papali ea chelete.
• Leha ho le joalo, ha ho hlake haeba sena se bonahatsoa ke ts'ebetso e amanang le ts'ebetso ea methapo e amanang le khatello ea kelello.
• Ho kopanya bopaki ba lipatlisiso, re entse tlhahlobo e hlophisitsoeng le tlhahlobo ea meta.
• Re lemohile lithuto tsa 30 tse lekolang ts'ebetso ea amanang le ts'ebetso ea neuropsychological.
• Liteko tsa Meta-tlhahlobo li senola khaello ea ts'ebetso ho batho ba nang le bothata ba ho becha le taolo e phetseng hantle.
inahaneloang
Ho qobelloa ke tšobotsi ea mantlha ea mathata a lemalloang, ho kenyeletsoa le bothata ba papali ea chelete. Leha ho le joalo, ha ho hlake hore na boitšoaro bona bo qobelloang ba bothata ba papali ea chelete bo amana hakae le tšebetso e sa tloaelehang ea khatello ea kelello e amanang le ho qobelloa. Mona, re akaretsa le ho hlophisa bopaki ba boits'oaro bo qobelloang, joalo ka ha bo lekantsoe ke mesebetsi e amanang le khatello ea kelello, ho batho ba nang le bothata ba papali ea chelete ha ba bapisoa le taolo e nepahetseng (HCs). Kakaretso ea lithuto tsa 29, tse nang le liphetho tsa mosebetsi tsa 41, li kenyelelitsoe tlhahlobisong e hlophisehileng; Li-database tsa 32 (n = Batho ba 1072 ba nang le bothata ba papali ea chelete; n = 1312 HCs) le bona ba kenyellelitsoe litlhahlobong tsa meta, tse etselitsoeng mosebetsi o mong le o mong oa kutloisiso ka thoko. Litlhahlobo tsa rona tsa meta li bonts'a likhaello tse kholo ho batho ba nang le bothata ba papali ea chelete ho fetoheng ha maemo, ho tsepamisa maikutlo le ho ba leeme. Ka kakaretso, liphuputso tsena li tšehetsa mohopolo oa hore likhaello tse amanang le ts'ebetso ea ho qobelloa ho sebetsa li khetholla bothata ba papali ea chelete. Mokhatlo ona o ka fana ka khokahano e ka bang teng lipakeng tsa bofokoli mesebetsing ea phethahatso e amanang le ketso e qobelloang. Re tšohla bohlokoa ba liphetho tsena, moelelo oa tsona kutloisisong ea rona ea bothata ba papali ea chelete le kamoo li amanang le mabaka a neurobiological le "mathata a mang a ho qobelloa".
Keywords
- Ho becha ka tsela ea tlhaho;
- Tlatsetso;
- Ho feto-fetoha le maemo ha kelello;
- Mesebetsi ea phethahatso;
- Ho ithuta hape
- Mosebetsi oa Stroop;
- Mosebetsi oa ho khetha karete ea Wisconsin;
- Intra-e eketsehileng sebopeho-feto-fetolehang;
- Mosebetsi oa ho etsa literene;
- Dimensional psychiatry;
- Ho ithuta ka maemo a tšohanyetso;
- Ho fetoha hoa kelello
1. Selelekela
1.1. Rationale
Mokhoa oa papali ea chelete ea theknoloji ea morao-rao o sa tsoa hlalosoa e le lemallo la boitšoaro mme o rehiloe hape ka hore ke Ts'ebetso ea Papali ea Chelete (DSM-5; Mokhatlo oa Mahlale oa Amerika, 2013). Qeto ena e ne e thehiloe haholo litabeng tsa bongaka le tsa neurobiological tse nang le mathata a ts'ebeliso ea lithethefatsi (Fauth-Bühler et al a., 2017 ; Romanczuk-Seiferth et al a., 2014). E ts'oanang le ts'ebeliso ea lithethefatsi, matšoao a bothata ba papali ea chelete ea ho becha a kenyelletsa boiteko bo sa atleheng ba ho khaotsa ho becha, ho ikutloa u sa phomole kapa o sa tenehe ha o leka ho emisa le ho fokotsa bokhoni ba ho emisa ho becha le ha ho bile le litlamorao tse mpe tsa papali ea papali ea chelete. Boloetse ba papali ea chelete ea papali ea chelete bo ne bo khetholloa e le bothata ba taolo ea tšusumetso 'me ke nako e telele bo amanang le tšusumetso e phahameng (Verdejo-García et al., 2008). Kaha hona joale papali ea chelete e boetse e sebelisoa e le tšibollo ea boitšoaro, ho na le tlhoko e ntseng e eketseha ea ho shebisisa likarolo tse qobelloang tsa boitšoaro, tse ka bang motheo oa ho utloisisa methapo ea mafu a ho becha (mohlala. El-Guebaly et al., 2012; Leeman le Potenza, 2012), le bokhoba ka kakaretso.
Ho lemalla ho ka bonoa e le qetello letotong la liphetoho: ho tloha sepheo sa mantlha-se tataisoang ho tloaela tloaelo ho ea ho boits'oaro bo hatelletseng ba ho fetolela (Everitt le Robbins, 2005). Mefuta ea Phenomenological ea ho lemalla e boetse e totobatsa phetoho e susumetsang ea ho tloha ho ts'oaroa ho isa ho ho qobelloa (El-Guebaly et al., 2012). Liphetho tsa lipotso tse itlhatlhobisang tse nang le litekanyetso tse itseng tse qobelloang ha li hlile li bontša boteng ba boitšoaro bo qobelloang bathong ba lemalloang (Anton et al a., 1995; Blaszczynski, 1999; Bottesi et al a., 2014 ; Vollstädt-Klein et al a., 2015). Ntle le moo, ho tlatselletsoa ts'ebetsong ea tšebeliso e mpe ea tšebeliso ea lithethefatsi, ho sitisoa ha mesebetsi e meng e amanang le ho qobelloa ka kakaretso, joalo ka boits'oaro bo mamellehang kapa ho ba le ts'oaetso ea kelello, e kanna ea amana le ho lemalla (Fineberg et al., 2014). Hobane bothata ba ho becha bo ka fana ka mohlala oa bokhoba ba lithethefatsi ntle le lithethefatsi, bo fana ka monyetla oa ho etsa lipatlisiso mabapi le ho qobella motho hore a lemalle. Boitšoaro bo bong, bo joalo ka lijo, thobalano le bokhoba ba marang-rang bo ka u qobella haholo (Morris le Voon, 2016). Leha ho le joalo, boits'oaro bona bo ne bo le kantle ho boiphihlelo ba tlhahlobo ea hajoale, kaha ha bo kenyelletsoe tlasa karolo ea 'Lits'ebeletso tse amanang le tlhekefetso le tlhekefetso ho DSM-5 ka lebaka la lipatlisiso tse sa lekanang.
Boithuto bo batlisisang ho qobelloa, ke ho re, ts'ebetso ea liketso tse pheta-phetoang leha ho bile le litlamorao tse mpe, bathong ba nang le bothata ba ho becha ba haelloa. Sena se kanna sa bakoa ke mofuta o rarahaneng oa sebopeho. Ehlile, ho qobelloa ho ka hlalosoa ka mekhoa e fapaneng, e shebahalang e fapana lipakeng tsa litlhaloso le litlhaloso (Yücel le Fontenelle, 2012). Habohlokoa, 'me ho fapana le ho ts'oaroa, palo ea lisebelisoa tsa ho etsa lipatlisiso ho lekanyetsoa e lekantsoe. Ka hona ho fanoe ka maikutlo a hore, leha e le bohlokoa joalo ka mohopolo bakeng sa baoki, ho qobelloa "ho makatsa haholo hape ho ferekanya lithuto tsa boithuto ba sehlooho" (Yücel le Fontenelle, 2012). Ka lehlakoreng le leng ho hlalositsoe litlhaloso tse ncha tsa ho qobelloa tse ikarabellang bakeng sa boholo ba tsona tse fapaneng le ho fana ka menyetla ea ho ithuta ka mokhoa o hlophisehileng mekhoa e kenyang letsoho boits'oarong (mohlala, Fineberg et al a., 2010 ; Dalley et al a., 2011).
Boitšoaro bo qobellehang bo ka bakoa ke pherekano mekhoeng e fapaneng ea kelello, ho kenyeletsoa tlhokomelo, temoho, le taolo ea likarabo tsa makoloi kapa tsa kelello. Tlhahlobo ea morao-rao ea maikutlo mabapi le ho qobelloa ke litsebi lefapheng lena e hlahisitse moralo oo ka oona khatello e arotsoeng likarolo tse 'ne tse arohaneng, tsa khatello ea kelello: ho feto-fetoha le maemo ha maemo a amanang le maemo a tšohanyetso, ho feto-fetoha ha kelello, ho se tsotelle le ho se tsotelle, le ho ithuta ka tloaelo (Fineberg et al., 2014). E 'ngoe le e' ngoe ea libaka tsena e kenyelletsa karolo e fapaneng ea qobello le potoloho e fapaneng ea neural (Fineberg et al., 2014) mme e ka sebetsoa ka mesebetsi e ikhethileng ea li-neurocognitive (bona Lethathamo 1). Karolo e 'ngoe ea bohlokoa ea boits'ebetso bo qobelloang, bo amanang haholo le bo pheta-pheta boitshwaro, ke ho se khone ho ikamahanya le maemo habonolo. Mesebetsi e sa hlokeng ho hlahloba maemo (c) a fetohang (i) ho laola maemo a tšohanyetso, a ipapisitse le ho ithuta / ho se sebelisoe (maemo a amanang le maemo a tšohanyetso a amanang le maemo a tšohanyetso), (ii) ho laola mekhoa ea karabelo ea maikutlo (mosebetsi / phetoho e lebisang tlhokomelo) kapa (iii) ) leka bokhoni ba ho thibela pelehi, ho itlhahlobe ka boiketsetso (tlhokomeliso e lebisang / khethollo) (Fineberg et al., 2014). Karolo e 'ngoe e ka fanang ka ts'usumetso ea (iv) ho itšepa ho tlola ho ithuta ka tloaelo: tloaelo ea ketso eo khafetsa e phetoang ho fetoha ka boiketsetso le ho se tsotelle lipheo. Bakeng sa ho ba le matla, re ile ra khetha ho sebelisa libaka tsena tse 'ne e le moralo oa ho hlophisa le ho fuputsa bopaki bakeng sa tšusumetso bothateng ba papali ea chelete.
Tafole 1.
Mekha e mene ea ho qobelloa.
Sebaka sa Neurocognitivea | Tlhaloso | Mosebetsi | Sephetho (lithuto tsa # tse tlalehang sephetho sena) | lithuto tsa # ka GD |
|---|---|---|---|---|
| Ho fetoha ha maemo ho amanang le maemo a tšohanyetso ho amanang le maemo a tšohanyetso | Tloaelo e fosahetseng ea boitšoaro kamora karabelo e mpe | Mosebetsi oa ho Ithuta oa Reversal | Palo ea liphapang (1); chelete e hapileng (1); liphoso tsa mamello (1); litšenyehelo tse fetohileng (1) | 4 |
| Mosebetsi oa ho bapala ka karete | Palo ea likarete tse bapalitsoeng (1); boemo ba mamello (mekhahlelo) (2) | 3 | ||
| Mosebetsi oa ho Ithuta oa Reversal | Sekhahla sa phoso (1) | 1 | ||
| Mosebetsi oa ho Ithuta oa maemo a tšohanyetso | Liphoso tsa khomishene / tiisetso (1) | 1 | ||
| Mosebetsi / phetoho e lebisang tlhokomelo | Phetoho e sa khahliseng ea tlhokomelo lipakeng tsa maikutlo | Mosebetsi oa ho hlophisa karete ea Wisconsin | Liphoso tsa mamello (8); liteko tsohle (1) | 9 |
| Intra-Extra Dimensional Set Shift | Liphoso tsohle (4) | 4 | ||
| Fetolela mosebetsi | Ho nepahala (1) | 1 | ||
| Boikemisetso bo ikhethileng / khethollo | Ho feto-fetoha ha maikutlo ho sa fetoheng kelellong | Mosebetsi oa Stroop | Lenane la ho kenella (8); RT /% e fosahetse (4) | 12 |
| Mosebetsi oa Terene (B) | Nako ea ho qeta (4) | 4 | ||
| Ho ithuta tloaelo | Ho hloka kutloelo-bohloko lipakaneng kapa liphelong tsa liketso | Mehato e 'meli ea qeto | Likhetho tse entsoeng ka mohlala le tse se nang mohlala | 0 |
| Papali e Ntle ea Litholoana | Liphoso tsa liketso | 0 | ||
| Mosebetsi oa ho lekanya | Karolelano ea khetho e lekantsoeng le e lekantsoeng | 0 |
GD = Bothata ba ho becha; RT = Nako ea Liketso.
a
Mebuso e tsoang Fineberg et al. (2014).
1.2. Sepheo
Morero o ka sehloohong oa tlhahlobo ena e hlophisehileng le tlhahlobo ea meta ke ho akaretsa le ho kopanya, ka lekhetlo la pele, bopaki bo matla ba liphokotso mesebetsing e amanang le ts'oaetso ea ts'ebetso ea ts'ebetso ea ts'ebetso ea ts'ebetso ea ts'ebetso ea ts'ebeliso ea papali ea papali ea chelete. Ka hona, re ikemiselitse ho araba potso e latelang (tse latelang tsa PICO): ho batho ba nang le bothata ba ho becha, na ho na le bopaki ba boitšoaro bo qobelloang, ha bo bapisoa le ba li-HC, joalo ka ha bo lekotsoa ka mehato ea methapo ea kutlo? Ho fihlela sena, re ile ra lekola lingoliloeng ka botlalo mabapi le bothata ba ho becha ho kenyelletsa lithuto tsohle tsa liteko tse lekang e 'ngoe ea likarolo tse' ne tsa ho qobelloa (Lethathamo 1). Ntle le moo, ho ile ha etsoa tlhahlobo ea meta bakeng sa mesebetsi eohle e arohaneng kahara 'muso o mong le o mong (ka bonyane lithuto tsa 3 ka mosebetsi o mong le o mong) ho akaretsa tsebo e fumanehang. Re ile ra nahana hore ts'ebetso ea ts'ebetso e amanang le "neuropsychological" e kenelletse ho batho ba nang le bothata ba ho becha ha bo bapisoa le li-HC.
2. Mekhoa
Tlhahlobo ena e hlophisehileng le tlhahlobo ea meta e ile ea etsoa mme ea tlaleheloa ho latela lintlha tse Tlalehang tsa ho Tlaleha bakeng sa litlhahlobo tse hlophisitsoeng le Meta-Analyses bakeng sa Protocol ea 2015 (PRISMA-P 2015)Moher et al., 2015) hape e ngolisitsoe ho PROSPERO Rejista ea Tlhahlobo ea Machabeng ea Tlhahlobo ea Tsamaiso (crd.york.ac.uk/prospero, nomoro ea ngoliso: CRD42016050530). Lenane la tlhahlobo ea PRISMA ea li-Protocol (PRISMA-P) bakeng sa tlhahlobo le lona le kenyellelitsoe ho File 1 ea Tlatsetso.
2.1. Mehloli ea tlhaiso-leseling
Re qalile ka ho batla setsi sa WHO sa Clinical Trials Registry Platform (WHO ICTRP) le ClinicalTrials.gov bakeng sa liteko tse ka tsoelang pele tse loketseng. Lingoloa tsa mantlha li ile tsa batloa ho sebelisoa Ovid MEDLINE, Embase le PsycINFO. Patlo eo e entsoe ka Phato 2016 mme ea ntlafatsoa ka Pherekhong 2017.
Patlisiso ea scoping e bontšitse mohopolo o latelang oa bohlokoa [] [motsoako: Kamora nako, likhopolo tsena tsa bohlokoa li ile tsa fetoloa sebakeng se seng le se seng sa polokelo ea libuka tsa libuka tse sebelisang mantsoe a nepahetseng (a laoloang), libaka tsa tlhahlobo tse ikhethileng tsa database le li-syntaxes. Bona Sehlomathiso A (Tlhahisoleseling ea tlatsetso) bakeng sa leano le hlakileng la ho batla.
Re lokela ho hlokomela hore mesebetsi e neng e lekola khethollo e mabapi le khethollo e ne e sa nkuoe, hobane litloaelo tsa boits'oaro lipakeng tsa batho ba nang le bothata ba ho becha le li-HC ha li (e hlile) ha li amane le temoho ea kelello ea motho ka mong, empa ho fapana le seo, empa ha se ea bohlokoa. bakeng sa sefapano sa tlhahlobo ea tlhahlobo ea lefutso. Ho feta moo, leeme le tobileng le amanang le ho se sebetse hantle le ka bonts'a mekhoa e mengata e thellisang (Masimong le Cox, 2008). Bakeng sa mabaka ana, ha re a ka ra nka ho kenyelletsa mesebetsi e kang mosebetsi oa papali e tobileng ea Stroop kapa Dot-Probe Task.
2.2. Mekhoa ea ho tšoaneleha
Lithuto tse khethiloeng li tlameha ho phethahatsa mekhoa e latelang ea ho kenyelletsa: thuto e kenyelelitse lithuto tsa batho ba lilemo tse 18-65; thupelo e kenyelelitse bakuli ba DSM-5 Gossip Disorder, DSM-III, DSM-III-R kapa DSM-IV Pathological Gambler kapa ba bechang ba nang le lintlha tsa SOGS tse kholo ho feta 5; thuto e ne e kenyelletsa sehlopha sa taolo e phetseng hantle; mme thuto e ne e na le bonyane lithuto tsa 10 ka sehlopha ka seng. Ntle le moo, lithuto li tlameha ho kenyelletsa mosebetsi oa ho leka kapa paradigm ho leka karolo ea ho qobelloa, joalo ka ha ho hlalositsoe ke likarolo tse 'ne (Lethathamo 1). Lingoloa tsa mantlha li ne li kenyelitsoe ho sa tsotelloe puo, selemo sa phatlalatso, mofuta oa khatiso, kapa boemo ba phatlalatso. Lenane le felletseng la litšupiso le ile la romeloa ho EndNote X7 ho tlosa likopi tse peli mme ka mor'a moo la romeloa ho Rayyan (Elmagarmid et al., 2014) bakeng sa sehlooho le ho hlahlojoa ho seng thata.
2.3. Khetho ea ho ithuta
Litlotla le likhetho tsa lithuto tsohle tse khethiloeng li ile tsa hlahlojoa ka boikemelo bakeng sa ho tšoaneleha ke bangoli ba babeli (TvT le RJvH). Liphapang tse teng lipakeng tsa liqeto tsa mohlahlobi li rarollotsoe ka puisano ho fihlela tumellano e fihletsoe (<1% ea lingoloa). Lingoloa tse khethiloeng li ile tsa balloa ka botlalo ho bona hore na litekanyetso tsohle tsa kenyelletso li fihletsoe. Re hlahlobile ka mafolofolo lingoliloeng tse kopitsoang kapa ts'ebeliso e ncha ea dataset e tšoanang, mme ha re kopana le eona, ho sebelisitsoe dataset ea morao-rao kapa e felletseng ka ho fetesisa.
2.4. Tlhahiso ea lintlha le boleng ba ho ithuta
Lintlha tse latelang li nkuoe lithutong tse khethiloeng: sebopeho sa batho le maemo a bongaka a sebopeho sa thuto (boholo, bong, lilemo, tlhahlobo ea bongaka, ho teba ha papali ea chelete); mofuta oa tlhahlobo ea methapo ea kutlo e sebelisitsoeng; tekanyo ea sephetho se tlalehiloeng; sephetho sa mantlha sa thuto; litekanyetso tsa teko ea mantlha, mokhoa le ho kheloha ho tloaelehileng hammoho le tlhaiso-leseling e bohlokoa ea lipalopalo moo boholo ba lipalo bo ka hlahisoang (bona Lethathamo 2, Lethathamo 3 ; Lethathamo 4). Haeba li-parameter tsa liteko tsa mantlha li ne li fapane le lithuto tse ling li sebelisa mosebetsi o tšoanang oa tlhahlobo-leseling, re ne re ikopanya le bangoli ba lumellanang. Lithuto tse peli li ile tsa qheleloa ka thoko ho tlhahlobo e hlophisehileng le tlhahlobo ea meta hobane tlhaloso ea litekanyetso tsa sephetho se tlalehiloeng e ne e sa hlaka ebile e ka se hlakisoe.
Tafole 2.
Kakaretso e kenyellelitse lithuto kahare ho maemo a amanang le maemo a tšohanyetso a amanang le Contingency.
Tsa Sehlooho se Ithutoang | Baahi (♀ / ♂) | Age | Ka kalafo | Tekanyo ea bongaka | Mosebetsi | Phello | GD vs HC | Phello |
|---|---|---|---|---|---|---|---|---|
| Boog et al. (2014) | 19 GD (5♀), 19 HC (3♀) | GD = 42.1, HC = 38.8 | e | DSM-IV; LITLHAKU = 8.3 | PRLT | palo ea likhahla | GD <HC | Li-GD li entse liphetoho tse fokolang |
| de Ruiter et al. (2009) | 19 GD, 19 ND, 19 HC (♂) | GD = 34.3, HC = 34.1 | e | DSM-IV; LITLHAKU = 8.9 | PRLT | chelete e hapiloe | GD <HC | Li-GD li hapile chelete e tlase ho feta ho tsubang le HCs |
| Torres et al. (2013) | 21 GD (2♀), 20 CD (♂), 23 HC (2♀) | GD = 31.4, HC = 30.1 | e | DSM-IV | PRLT | kakaretso ea likhetho tse nepahetseng | EA-XNUMX-GD | |
| Verdejo-García et al. (2015) | 18 GD (2♀), 18 CD (1♀), 18 HC (1♀) | GD = 33.5, HC = 31.1 | e | DSM-IV | PRLT | litefiso tsa hit & phoso | EA-XNUMX-GD | |
| Ba qhekellang et al. (2012) | 65 GD (15♀), 35 HC (6♀) | GD = 38.9, HC = 43.2 | Che | DSM-IV; LITLHAKU = 7.1 | CPT | # Likarete tse bapaloang (mekhahlelo) | GD <HC | Li-GD tse ling li sebelisitse leano le khethang haholo la khetho ea likarete; mamello e kopantsoe le lintlha tsa SOGS |
| Goudriaan et al. (2005) | 48 GD (8♀), 46 AD (10♀), 47 TS (15♀), 49 HC (15♀) | GD = 39.0, HC = 35.8 | e | DSM-IV; LITLHAKU = 13.9 | CPT | # Likarete tse bapaloang (mekhahlelo) | GD <HC | Li-GD tse ling li sebelisitse leqheka la ho khetha likarete |
| Thompson et al. (2013) | 42 GD (2♀), 39 HC (20♀) | GD = 25.0, HC = 24.8 | Che | LITLHAKU = 9.1 | CPT | chelete eohle e hapiloeng; #Likarata li bapiloe | GD <HC | Li-GD li ne li bapala likarete tse ngata 'me li hapile chelete e nyane, ho bontša mamello |
| Vanes et al. (2014) | 28 GD, 33 AD, 19 HC (♂) | GD = 36.6, HC = 39.1 | e | DSM-IV; LITLHAKU = 10.6 | TLOTL | liphoso tsa mamello | EA-XNUMX-GD | Li-GD li bontšitse letšoao la mamello karolong ea pele |
| Janssen et al. (2015) | 18 GD, 22 HC (♂) | GD = 35.2, HC = 32.2 | kopanya | DSM-IV; LITLHAKU = 12.3 | DRLT | litekanyetso tsa liphoso litekong tse khutlang; sekhahla sa phoso | EA-XNUMX-GD |
khutsufalitsoeng: Baahi: GD = Ho becha bakuli ba nang le mathata; HC = Taolo e phetseng hantle; ND = Bakuli ba itšetlehileng ka Nicotine; CD = Bakuli ba itšetlehileng ka Cocaine; AD = Bakuli ba itšetlehileng ka joala; TS = bakuli ba Tourette Syndrome; BN = bakuli ba Bulimia Nervosa; OCD = Boloetse ba Obsessive-Compulsive Disorder; IAD = bakuli ba nang le bothata ba ho lemalla Internet; IGD = Bakuli ba Mathata a ho bapala ka Inthanete; PrGs = Mathata a Papali ea chelete; Male = Monna; Female = Mosali;? = bong ha bo tlalehoe. Methati ea Kliniki: DSM = Tlhatlhobo le Buka ea Lipalopalo ea Mathata a Kelello; SOGS = Screen ea Oaks ea Papali ea Boroa ea Oaks; PGSI = Bothata ba ho becha ho thata; SCID = Puisano ea Kliniki e hlophisitsoeng bakeng sa DSM; NODS = Screen Screen Diagnostic ea Mathata a Ho becha. Mesebetsi: PRLT = Mosebetsi oa ho ithuta o feto-fetohang oa mohlomong; CPT = Mosebetsi oa ho Bapala karete; DRLT = Ho ikemisetsa ho khutlisa mesebetsi ea ho ithuta; CLT = Mosebetsi oa ho Ithuta o sa Lebelloang; WCST = Mosebetsi oa ho Hlopha Karete ea Wisconsin; IED = Intra-Extra Dimensional Set Shift; TMT = Mosebetsi oa ho Etsa Litsela. Mehato ea sephetho: RT = Nako ea Reaction; * = sitiso e ile ea sebetsoa e le: [#items lenane la boraro - ((#Words × #Colors) / (# Words + #Colors))]; TMT_B = Karolo ea teko ea ho etsa liteko B. GD vs HC: GD <HC e bonts'a bakuli ba GD ba sebetsang hampe ho feta li-HC.
Li-raters tse peli (NMS le JMK) ka bolokolohi li ile tsa lekanya thuto e 'ngoe le e' ngoe bakeng sa boleng ba mokhoa ho boleng ba 8-elemental tekolo ea tlhahlobo ea mekhoa, khetho le khetho ea leeme. Lethathamo le kileng la sebelisoa pele (Thompson et al., 2016), e neng e ipapisitse le lintho tse tsoang litekanyetsong tsa Cochrane Collaboration, likhothaletso tsa PRISMA, le litataiso tsa PEDro, e ile ea fetoloa ka ho tlosa lintho tse lekolang tšebeliso ea lihlopha le lits'ebetso tsa bofofu, kaha tsena li ne li sa sebetse lithutong tse hlahlojoang tlhahlobisong ea hajoale (Lintho tsa 5). Maemo a boleng ba bopaki a ne a hlalosoa e le a phahameng (lintlha tsa 6-8), tse mahareng (lintlha tsa 3-5) kapa tse tlase (lintlha tsa 0-2).
2.5. Tlhahlobo le tlhaiso-leseling
Hobane lithuto tse fapaneng li sebelisitse liteko le litekanyetso tsa liteko, maemo a tšoanang a bolela phapano (li-SMD) ka boholo bo fapaneng (Hedge's g) li baliloe ho lekola phapang lipakeng tsa batho ba nang le bothata ba papali ea chelete le li-HC lipatlisisong tsohle. Ena ke tekanyo e ts'oanang le ea Cohen d empa ka khalemelo bakeng sa leeme le lenyenyane la sampole, 'me liphetho li ka tolokoa e le tse bonts'ang e nyane (g = 0.2-0.5), e mahareng (g = 0.5-0.8) kapa phello e kholo (g> 0.8). Marako ' g e ne e ngotsoe ka mokhoa oa boleng e le boleng bo bonts'ang ts'ebetso e ntlafalitsoeng ho li-HC ha e bapisoa le batho ba nang le bothata ba ho becha. Mefuta ea boholo ba sephetho e ne e kopantsoe le tšebeliso ea maemo a mantlha (a sa fetoloang); haeba ho hlokahala, liphoso tse tloaelehileng li ile tsa fetoloa hore li khelohe ka mokhoa o tloaelehileng (o bontšoa litafoleng tse lumellanang).
Ha ts'ebetso e 'ngoe le e' ngoe ea methapo ea kutlo e leka karolo e fapaneng ea 'ho qobelloa' le kaha ho na le phapang e kholo litekanyetsong tsa bona tsa liteko, litlhahlobo tsa meta li ile tsa etsoa bakeng sa mosebetsi o mong le o mong ka thoko. Ho kenyeletsoa lipatlisisong tsa meta, ho ne ho hlokahala bonyane lithuto tse 3 molemong oa mosebetsi o mong le o mong. Ka lebaka la ho se lumellane ho lebelletsoeng lipakeng tsa mehlala ea ho ithuta le ho fapana hoa mekhoa, mefuta ea litlamorao e ile ea sebelisoa bakeng sa tlhahlobo ea sehlopha. Ho sebelisitsoe boemo ba bohlokoa ba p <0.05 (li-tailed tse peli). Boteng ba heterogeneity bo ile ba lekoa ho sebelisoa Q ea Cochran mme boholo ba eona bo hakantsoe ho sebelisa I2, e ka hlalosoang e le karolo ea boholo ba phello ka lebaka la heterogeneity. Bakeng sa mesebetsi e kenyelletsang lithuto tse hlano kapa ho feta, tlhahlobo ea meta-regression e entsoe ka lilemo, bong, IQ le boima ba papali ea chelete ea ho becha. Re sebelisitse phapang pakeng tsa lilemo, bong le IQ (e baloang ho sebelisoa Cohen's) d) e le setsi sa boithuto ba meta-regression. Litlhatlhobo tsohle li entsoe ka ho sebelisa Vetae-Meta-Analysis V2 (CMA, Bio-Englewood, New Jersey, US).
3. Liphetho
3.1. Lithuto tse khethiloeng
Patlo ea pele e bonts'a lithuto tse ikhethang tsa 5521, tseo 29 e ka kenyellelitsoeng ho tsona. Feie. 1 e bonts'a Setšoantšo sa Phallo sa PRISMA se bonts'a ts'ebetso ea khetho ea boithuto. Palo ea lithuto tse khelositsoeng kamora ho skrine se felletseng ka lebaka la "Mosebetsi o fosahetseng oa ho tseba" e batla e le kholo hobane lithuto tse sebelisang Iowa Gask Task (n = 20) li ne li e-so qheleloe ka thoko nakong ea tlhahlobo e sa bonahaleng. Tsena li ile tsa qheleloa ka thoko nakong ea tlhaiso-leseling e felletseng, leha ho le joalo, hobane li ne li sa lumellane le efe kapa efe ea libaka tse nne tsa ho qobelloa. Ho feta moo, qalong re ne re batla ho kenyelletsa lipotso tsa khatello ea maikutlo, ka hona li ne li kenyellelitsoe ho polelo ea ho batla le ho khethoa nakong ea sehlooho le tlhaiso-leseling. Leha ho le joalo, qetellong re ile ra qoba ho kenyelletsa lipotso tsa rona tsa ho itlaleha peisong ea hoqetela: lipotso ha se hangata e leng sephetho sa mantlha mme lithuto hangata ha li tlalehe ts'ebeliso ea lipotso tse joalo. Ka hona, monyetla oa lithuto tse sieo tse kenyelletsang lipotso li ne li le holimo, ho etsa hore ho be thata ho li kenyelletsa ka tatellano le ka mokhoa o hlakileng.
Setšoantšo sa 1.
Flowchart e bonts'a palo ea lingoloa tse tšoailoeng le tse kenyelelitsoeng le tse sa khetholloang mohato ka mong oa lipatlisiso. Lithutong tse ling ho ile ha tlalehoa mesebetsi e mengata ea tlhahlobo-leseling e ka kenyelletsoang tlhaisong ea meta. Ka hona, palo ea sephetho le datha e holimo ho feta palo ea lithuto.
Ba 29 ba kenyelelitse lithuto tse nang le kakaretso ea n = Batho ba 1072 ba nang le bothata ba papali ea chelete le n = 1312 HCs. Leha e se liphuputso tsohle tse ileng tsa leka batho ba bechang ba neng ba le kalafong kapa ba fumanoeng ba na le bothata ba papali ea chelete (bo boletsoeng ho Tafole ea 3-5), ha rea ka ra kenyelletsa lithuto tse ileng tsa leka batho ba bechang ba fumaneng lintlha tse phahameng ho feta tsa kalafo ea lipotso tsa papali ea chelete. Ka hona, re tla bua ka bona e le batho ba nang le bothata ba papali ea chelete hohle bukeng e ngotsoeng ka letsoho. Lintlha tsa boleng li ne li le "mahareng" bakeng sa lithuto tse tharo le "holimo" bakeng sa lithuto tsa 26 (Tlatsetso Lethathamo 1). Likarolong tse latelang, tse arotsoeng ka libaka tse 'ne, re hlalosa mosebetsi ka mong le mekhahlelo ea liteko tse atileng haholo; fana ka kakaretso ea boleng ba se fumanoeng; 'me u hlahise liphetho tsa tlhahlobo ea litlhahlobo. Lethathamo 2, Lethathamo 3 ; Lethathamo 4 fana ka kakaretso e akaretsang ea lithuto tse kenyelelitsoeng bakeng sa domain e 'ngoe le e' ngoe. Bakeng sa mesebetsi eo ea methapo ea kutlo e amanang le 3 kapa lithuto tse eketsehileng, ho ile ha etsoa lipatlisiso tsa meta; merero ea motho ka mong e bonts'itsoe Feie. 2, Feie. 3 ; Feie. 4.
Tafole 3.
Kakaretso e kenyelletsa lithuto ka hare ho Task / tlhokomeliso ea setache e fetolang tlhokomelo.
Tsa Sehlooho se Ithutoang | Baahi (♀ / ♂) | Age | Ka kalafo | Tekanyo ea bongaka | Mosebetsi | Phello | GD vs HC | Liphetho (p <0.05) |
|---|---|---|---|---|---|---|---|---|
| Álvarez-Moya et al. (2010) | 15 GD, 15 HC, 15 BN (♀) | GD = 44.4, HC = 35.5 | e | DSM-IV; LITLHAKU = 11.2 | WCST | liphoso tsa mamello | GD <HC | Li-GD li entse liphoso tse mamellang ho feta tsa HCs |
| Fekete et al. (2013) | 54 GD (35♀), 65 HC (38♀) | GD = 45.3, HC = 47.5 | kopanya | DSM-IV; MELAO = 13.7 | WCST | likarabo tsa mamello | GD <HC | Li-GD li entse liphoso tse mamellang ho feta tsa HCs |
| Boog et al. (2014) | 19 GD (5♀), 19 HC (3♀) | GD = 42.1, HC = 38.8 | e | DSM-IV; LITLHAKU = 8.3 | WCST | liphoso tsa mamello | EA-XNUMX-GD | |
| Cavedini et al. (2002) | 20 GD (1♀), 40 HC (22♀) | GD = 38.5, HC = 30.3 | e | DSM-IV; LITLHAKU = 15.8 | WCST | liphoso tsa mamello; mekhahlelo | EA-XNUMX-GD | |
| Goudriaan et al. (2006) | 49 GD (9♀), 48 AD (11♀), 46 TS (14♀), 50 HC (15♀) | GD = 37.3, HC = 35.6 | e | DSM-IV; LITLHAKU = 11.6 | WCST | likarabo tse mamellang; #karolo | GD = HC; GD <HC | Li-GD ha lia ka tsa etsa likarabo tse eketsehileng tsa mamello ha li bapisoa le li-HC, empa li qetile mekhahlelo e fokolang |
| Hur et al. (2012) | 16 GD (♂), 31 OCD (8♀), 52 HC (16♀) | GD = 28.3, HC = 25.1 | e | DSM-IV; LITLHAKU = 15.8 | WCST | liphoso tsa mamello; liphoso tse sa mamelleheng | GD = HC; GD <HC | Li-GD ha lia ka tsa etsa likarabo tse ngata tsa ho mamella ha li bapisoa le li-HC, empa li bontsitse liphoso tse sa hlokeng mamello ho feta |
| Ledgerwood et al. (2012) | 45 GD (21♀), 45 HC (23♀) | GD = 46.1, HC = 45.8 | kopanya | DSM-IV | WCST | likarabo tse mamellang; mekhahlelo | GD = HC; GD <HC | Li-GD ha lia ka tsa etsa likarabo tse eketsehileng tsa mamello ha li bapisoa le li-HC, empa li felletse likarolo tse fokolang |
| Rugle and Melamed (1993) | 33 GD, 33 HC (♂) | GD = 41.3, HC = 40.8 | e | LITLHAKU = 17.9 | WCST | liteko tse felletseng | GD <HC | Li-GD li sebelisitse liteko tse ngata ho qeta lits'ebetso tse tšeletseng tse nepahetseng, tse bontšang mamello e mpe le ho feta |
| Zhou et al. (2016) | 23 GD (5♀), 23 IAD (6♀), 23 HC (7♀) | GD = 29, HC = 28 | e | DSM-IV | WCST | liphoso tsa mamello; mekhahlelo | GD <HC; GD <HC | Li-GD li entse liphoso tse ngata tsa ho mamella ha li bapisoa le li-HC mme li qetile mekhahlelo e fokolang |
| Choi et al. (2014) | 15 GD, 15 IGD, 15 ADs, 15 HC (♂) | GD = 27.5, HC = 25.3 | e | DSM-5; PGSI = 19.9 | IED | liphoso tse felletseng | GD <HC | Li-PG li entse liphoso tse ngata ho feta tsa li-HC |
| Manning et al. (2013) | 30 GD, 30 HC (♂) | GD = 37.1, HC = 37.2 | e | DSM-IV; LITLHAKU = 13.4 | IED | liphoso tse felletseng | EA-XNUMX-GD | |
| Odlaug et al. (2011) | 46 GD (23♀), 69 PrGs (16♀), 135 HC (55♀) | GD = 45.4, HC = 23.4 | Che | DSM-IV; SCID = 7.5 | IED | liphoso tse felletseng | GD <HC | Li-PG li entse liphoso tse ngata ho feta tsa li-HC |
| Patterson et al. (2006) | 18 GD, 20 HC (?) | GD = 45, HC = 41 | e | DSM-IV; LITLHAKU = 14.3 | IED-joalo ka | likarabo tse felletseng | GD <HC | Li-GD li qetile liteko tse fokolang ho feta tsa li-HC |
| van Timmeren et al. (2016) | 26 GD, 26 HC (♂) | GD = 37.1, HC = 37.9 | e | DSM-IV; LITLHAKU = 11.1 | Fetolela mosebetsi | chencha litšenyehelo; % liphetoho tse nepahetseng | EA-XNUMX-GD |
Bakeng sa lenane le felletseng la likhahla: bona Lethathamo 2.
Tafole 4.
Kakaretso e kenyellelitse lithuto kahare ho Attentional bias / disengagement domain.
Tsa Sehlooho se Ithutoang | Baahi (♀ / ♂) | Age | Ka kalafo | Tekanyo ea bongaka | Mosebetsi | Phello | GD vs HC | Phello |
|---|---|---|---|---|---|---|---|---|
| Albein-Urios et al. (2012) | 23 GD, 29 CD, 20 HC (?) | GD = 35.6, HC = 28.6 | e | DSM-IV | Stroop | index ea ho kena-kenana | GD <HC | Li-GD li bonts'itse mathata a thibelo ha a bapisoa le li-HC |
| Álvarez-Moya et al. (2010) | 15 GD, 15 BN, 15 HC (♀) | GD = 44.4, HC = 35.5 | e | DSM-IV; LITLHAKU = 11.2 | Stroop | lintlha tse kenelletseng | GD <HC | Li-GD li ne li e-na le sekhahla se phahameng sa tšitiso ho feta li-HC |
| Fekete et al. (2013) | 54 GD (35♀), 65 HC (38♀) | GD = 45.3, HC = 47.5 | kopanya | DSM-IV; MELAO = 13.7 | Stroop | index ea ho kena-kenana | EA-XNUMX-GD | |
| De Wilde et al. (2013) | 22 GD (2♀), 31 HC (4♀) | GD = 33,5, HC = 28.1 | e | DSM-IV; LITLHAKU = 11.1 | Stroop | RT | GD <HC | Li-GD e ne e le mosebetsi o liehang haholo ho feta li-HC |
| Goudriaan et al. (2006) | 49 GD (9♀), 48 AD (11♀), 46 TS (14♀), 50 HC (15♀) | GD = 37.3, HC = 35.6 | e | DSM-IV; LITLHAKU = 11.6 | Stroop | index ea ho kena-kenana | GD <HC | Li-GD li bonts'itse mathata a thibelo ha a bapisoa le li-HC |
| Hur et al. (2012) | 16 GD (♂), 31 OCD (8♀), 52 HC (16♀) | GD = 28.3, HC = 25.1 | e | DSM-IV; LITLHAKU = 15.8 | Stroop | index ea ho kena-kenana | EA-XNUMX-GD | |
| Lai et al. (2011) | 37 GD, 40 HC (♂) | EA-36.4, HC = 35.6 | e | DSM-IV; LITLHAKU = 14.3 | Stroop | index ea ho kena-kenana | EA-XNUMX-GD | |
| Ledgerwood et al. (2012) | 45 GD (21♀), 45 HC (23♀) | GD = 46.1, HC = 45.8 | kopanya | DSM-IV | Stroop | index ea ho kena-kenana | EA-XNUMX-GD | |
| McCusker le Gettings (1997) | 15 GD, 15 HC (♂) | EA-33.6-GD | e | - | Stroop | RT | EA-XNUMX-GD | |
| Kertzman et al. (2006) | 62 GD (20♀), 83 HC (25♀) | GD = 40.6, HC = 40.4 | e | DSM-IV; LITLHAKU> 5 | Stroop | index ea ho kena-kenana | GD <HC | Li-GD li bonts'itse mathata a thibelo ha a bapisoa le li-HC |
| Potenza et al. (2003) | 13 GD, 11 HC (♂) | GD = 35.2, HC = 29.0 | e | DSM-IV; LITLHAKU = 12.6 | Stroop | % e fosahetse; RT e fosahetse | EA-XNUMX-GD | |
| About et al. (2003) | 21 GD (1♀), 19 HC (1♀) | GD = 33.6, HC = 34.4 | e | DSM-III | Stroop | RT; palo ea liphoso | GD = HC; GD <HC | Li-GD li ne li sa liehe empa li ile tsa etsa liphoso tse ngata mosebetsing oa Stroop ho feta li-HC |
| Fekete et al. (2013) | 54 GD (35♀), 65 HC (38♀) | GD = 45.3, HC = 47.5 | kopanya | DSM-IV; MELAO = 13.7 | TMT | TMT_B (sec) | EA-XNUMX-GD | |
| Choi et al. (2014) | 15 GD, 15 IGD, 15 ADs, 15 HC (♂) | GD = 27.5, HC = 25.3 | e | DSM-5; PGSI = 19.9 | TMT | TMT_B (sec) | EA-XNUMX-GD | |
| Hur et al. (2012) | 16 GD (♂), 31 OCD (8♀), 52 HC (16♀) | GD = 28.3, HC = 25.1 | e | DSM-IV; LITLHAKU = 15.8 | TMT | TMT_B (sec) | EA-XNUMX-GD | |
| Rugle and Melamed (1993) | 33 GD, 33 HC (♂) | GD = 41.3, HC = 40.8 | e | LITLHAKU = 17.9 | TMT | TMT_B (sec) | EA-XNUMX-GD |
Bakeng sa lenane le felletseng la likhahla: bona Lethathamo 2.
Setšoantšo sa 2.
Moralo oa moru bakeng sa kakaretso ea phello ea phapang ho (A) Mosebetsi oa ho Ithuta oa ho feto-fetoha ha Probabilistic le (B) Card Tekeletso ea Mosebetsi lipakeng tsa bakuli ba GD le HCs. * Ha ho tlhaolohelo e tloaelehileng e tlalehiloeng thutong ena, empa e kopantsoe ka lebaka la Phoso e tloaelehileng. Boholo ba mabala a supa boima bo lekanyelitsoeng ba lithuto bakeng sa tekanyo ea poo. Taemane e bontša boholo ba phello.
Setšoantšo sa 3.
Moralo oa moru bakeng sa kakaretso ea phello ea phapang ho (A) Mosebetsi oa ho Hlophisa Karata ea Cardconsin (B) Intra Extra Dimensional Set Shift pakeng tsa bakuli ba GD le HCs. Boholo ba mabala a supa boima bo lekanyelitsoeng ba lithuto bakeng sa tekanyo ea poo. Taemane e bontša boholo ba phello.
Setšoantšo sa 4.
Moralo oa moru bakeng sa kakaretso ea phello ea phapang ho (A) Mosebetsi oa Stroop le (B) Teko ea ho etsa liteko pakeng tsa bakuli ba GD le HCs. * Ha ho tlhaolohelo e tloaelehileng e tlalehiloeng thutong ena, empa e kopantsoe ka lebaka la Phoso e tloaelehileng. Boholo ba mabala a supa boima bo lekanyelitsoeng ba lithuto bakeng sa tekanyo ea poo. Taemane e bontša boholo ba phello.
3.2. Ho fetoha ha maemo ho amanang le maemo a tšohanyetso ho amanang le maemo a tšohanyetso
Ho feto-fetoha ha maemo ho amanang le maemo a tšohanyetso ho kenyelletsa ho ithuta molao le boitshwaro bo latelang kamora phetoho ea molao o sebelisang karabo ea teko ka teko. Kahoo, thuto e hloka ho ithuta le ho ithuta maemong a sa tsitsang habonolo. Lithutong tse kenyellelitsoeng, ho ile ha bonoa mesebetsi e mene e ileng ea kopana le tlhaloso ena: Tlhokahalo ea Reitabilistic Reversal Study Task, Card Playing Task, Deterministic Reversal Task Task le Task ea ho ithuta e tsoelang pele.
3.2.1. Mosebetsi o mong oa ho feto-fetoha oa ho ithuta o kopanyang
Mosebetsing oa Tlhaho ea ho Ithuta oa Probabilistic (PRLT; Cools et al., 2002), lithuto li khetha pakeng tsa (hangata) tse susumetsang tse peli 'me u ithute hore e' ngoe ea likhetho tse peli li "ntle" ha e 'ngoe e le' mpe '. Khothatso ke karolo e itseng ea sephetho (joalo ka ha probabilistic), mohlala, 70% ea nako eo karabo e nepahetseng le 30% ea nako eo maikutlo a fosahetseng ka eona. Kamora ho ithuta ka katleho ho khetholla lipakeng tsa khetho e ntle le e mpe, molao oa fetoha (e leng phetoho) mme ea nkang karolo o hloka ho ikamahanya le molao o mocha. Ho sebelisoa mefuta e fapaneng ea mosebetsi ona, 'me ho etsoa liphetoho tse etsahalang ka palo ea liteko kapa kamora likarabo tse fapaneng tse nepahetseng. Ho ipapisitse le motsotso oa ho fetoha, tiisetso e ka bonts'oa ke palo ea likhetho tse nepahetseng kamora phetoho ea molao, palo eohle ea litefiso tse felisitsoeng kapa kakaretso ea chelete e fumanoeng (ka mehato eohle, lintlha tse tlase li bonts'a mamello e kholo).
Ho ile ha fumanoa lithuto tse 'ne tse sebelisang PRLT lihlopheng tse arohaneng tsa papali ea chelete. Lithutong tse peli (Boog et al a., 2014 ; de Ruiter et al a., 2009) batho ba nang le bothata ba ho becha ba bontšitse tiisetso, athe lithutong tse ling tse peli (Torres et al a., 2013 ; Verdejo-García et al a., 2015) ha ho mathata a bohlokoa a boitšoaro a ileng a bonoa mosebetsing ona. Leha lithuto tse fapaneng tsa PRLT li ne li sebelisoa thutong e ngoe le e ngoe (bona Lethathamo 2), li ne li bapisoa le teko ea 'mamello' 'me ka hona, lithuto tsohle li kenyelelitsoe tlhahlobisong ea meta.
Lintlha tsa lithuto tsohle tse 'ne, ho kenyeletsoa kakaretso ea batho ba 77 ba nang le bothata ba papali ea chelete le li-HC tse 79, li ile tsa bokelloa' me tsa senola ho senyeha ho hoholo ho PRLT lipakeng tsa batho ba nang le bothata ba papali ea chelete le li-HCs (size size = 0.479; Z-value = 1.452; p = 0.144) (Feie. 2A). Leha ho le joalo, bakeng sa mosebetsi ona, boholo ba bong bo fapaneng bo ile ba pakoa (Q = 11.7, p <0.01, I2 = 74%) (Letlapa la Tlatsetso 2). Boikarabello bona ha boa ka ba hlalosoa haholo ke lintlha life kapa life tse nkuoeng meta-regression (bong, lilemo, IQ le ho tiea ha papali ea chelete, tseo ka nnete li neng li ka bapisoa le lithuto tsohle), empa li ka bonts'a taba ea hore sephetho se fapaneng sa PRLT se tlalehiloe ho thuto ka 'ngoe.
3.2.2. Mosebetsi oa ho bapala ka karete
Mosebetsing oa Card Playing (kapa Perseveration) (CPT; Newman et al., 1987), monka karolo o fuoa mokato oa likarete mme o bolelloa hore karete ea sefahleho e hapa chelete mme karete ea linomoro e lahleheloa ke chelete. Morupeluoa o lokela ho etsa qeto, tekong ka mokhoa oa teko, hore na o tsoelapele ho bapala kapa ho tlohela mosebetsi. Ha ho tsoelapele, ho phetoa karete e lebisang ho hlolang (ke hore, ha karete ea sefahleho e buloa) kapa e lahleha (ke hore, ha karete ea linomoro e buloa) chelete e itseng. Qalong, karolelano ea win-to-loss e phahame (mohlala, 90%), empa karolelano ena e fokotseha ka 10% kamora 'ngoe le e' ngoe ea liteko tse 10, ho fihlela e le 0%. Kahoo ho nepahetse ho tsoela pele ho bapala liteko tsa 40-60 ebe o tlohela ho bapala. Tekanyo ea sephetho sa mosebetsi ona ke palo ea likarete tse fetotsoeng; ho tsoelapele ho bapala ha karolelano ea win-to-loss e se e se ntle (> liteko tse 60) e bontša mamello.
Re fumane lithuto tse tharo tse sebelisang CPT lihlopheng tsa bothateng ba papali ea chelete. Boithuto bohle bo fumane phapang e kholo lipakeng tsa batho ba nang le bothata ba ho becha le li-HC, le batho ba nang le bothata ba papali ea chelete ba sebelisang leano la ho khetha likarete (Maqhubu et al a., 2012; Goudriaan et al a., 2005 ; Thompson le Corr, 2013). Lintlha tsa lithuto tsohle tse tharo, ho kenyeletsoa kakaretso ea batho ba 155 ba nang le bothata ba papali ea chelete le li-HC tse 123, li ile tsa bokelloa ho senola phello e kholo ea batho ba nang le bothata ba papali ea chelete ba mamellang ho feta li-HC (boholo ba phello = 0.569; Z = 3.776, p <0.001 ) (Feie. 2B). Heterogeneity e ne e le tlase haholo (Q = 1.0, p = 0.60, I2 = 0%) (Letlapa la Tlatsetso 2).
3.2.3. Mesebetsi e meng
Mesebetsi e meng e 'meli e hlahlobang maemo a amanang le maemo a tšohanyetso a amanang le maemo a tšohanyetso ho batho ba nang le bothata ba ho becha khahlanong le HC e bontšitsoe: Teko ea ho Ithuta ea Deterministic Reversal (DRLT; Janssen et al., 2015) le mosebetsi oa ho ithuta oa Contingency (CLT; Vanes et al., 2014).
DRLT e ts'oana le PRLT empa e otlolohile haholoanyane, kaha ts'usumetso e reretse sephetho ka botlalo (ke hore moputso kapa kotlo) eseng ts'ebetso. Tekanyetso ea sephetho sa mantlha ke sekhahla sa phoso kamora ho fetoha, le liphoso tse ngata kamora ho feto-fetoha ho bontšang karabelo. Janssen et al. (2015) ha e tlalehe ho senola liphoso tsa ts'ebetso ho batho ba nang le bothata ba ho becha khahlanong le HC mosebetsing ona.
CLT e tsamaisana le DRLT empa e kenyelletsa likonteraka tse 'ne, karolo e le' ngoe ea ho fetola maemo, le karolo e 'ngoe ea ho timela. Liphoso tsa mamello nakong ea phetoho tse ling li hlalosoa e le ho bonts'a ho rarahana. Vanes et al. (2014) ha a fumana phapang e kholo palong ea liphoso tsa mamello pakeng tsa batho ba nang le bothata ba ho becha le li-HC.
3.3. Mosebetsi / phetoho e lebisang tlhokomelo
Mosebetsi kapa phetoho e lebisang tlhokomelo e hloka bokhoni ba ho feto-fetoha khafetsa har'a mofuta oa mesebetsi kapa mekhoa ea ho araba. Ho kenyelletsa khethollo ea pono le tlhokomelo e hlokolosi le ho fetoha ha linako. Athe mesebetsi e amanang le maemo a tšohanyetso e amanang le maemo a tšohanyetso e na le liphetoho tse teng ka har'a sete e le 'ngoe, mesebetsi e lebisang tlhokomelo e lebisang tlhokomelo e kenyelletsa li-sete tse ngata (mohlala,' mala, palo kapa sebopeho). Sena se hloka hore motho a ele hloko mefuta e fapaneng ea tšusumetso. Mesebetsi e meraro e felletseng e thathamisitsoe kahara sebaka sena sa marang-rang: mosebetsi oa ho khetha likarete tsa Wisconsin, Intra-Extra Dimensional Set-Shift le Turnch Task.
3.3.1. Teko ea ho hlophisa karete ea Wisconsin
Teko ea ho Lekanya ea Cardconsin Card (WCST; Heaton et al., 1981) ke mosebetsi oa ho feto-fetoha o atisang ho sebelisoa ho batho. Morupeluoa o kopuoa ho hlophisa likarete tsa likarabo ho latela e 'ngoe ea mekhoa e meraro ea ho khetholla (' mala, sebopeho le nomoro). Molao o fumanoa ho sebelisoa maikutlo a fanoeng kamora karabo e 'ngoe le e' ngoe. Kamora palo e lekantsoeng ea lipapatso tse nepahetseng, molao o tla fetoloa ebe motšehetsi o tlameha ho fetohela mokhoeng o mocha oa sehlopha. Litekanyetso tsa liteko li kenyelletsa palo ea mekhahlelo e finyeletsoeng, palo e felletseng ea liphoso le - e nepahetseng haholo bakeng sa ho qobelloa - palo ea liphoso tsa mamello (ke hore, liphoso ka mor'a phetoho ea molao).
Kakaretso ea lithuto tse robong ho batho ba nang le bothata ba papali ea chelete ba sebelisang mosebetsi ona e fumanoe, eo lithuto tse robeli li tlalehileng ts'ebetso e mpe haholo ho batho ba nang le bothata ba papali ea chelete le li-HC bonyane paramethara e le 'ngoe ea liteko (eseng liphoso tsa mamello). Ho kopanya lithuto tsohle le ho kenyelletsa kakaretso ea batho ba 274 ba nang le bothata ba papali ea chelete le 342 HCs, ho fumanoe phello e kholo, ka batho ba nang le bothata ba papali ea chelete ba etsang liphoso tse ngata ho feta HCs (size size = 0.518; Z = 5.895, p <0.001) (Feie. 3A). Heterogeneity e ne e le tlase (Q = 10.9, p = 0.28, I2 = 17%) (Letlapa la Tlatsetso 2).
3.3.2. Sekhahla se fetisisang sa sebopeho se fetisisang (IED)
Mosebetsing oa Intra-Extra Dimensional Set-Shift (IED) (Robbins et al., 1998), ho hlahisoa lintlha tse peli tse susumetsang. E 'ngoe e nepahetse, e' ngoe e fosahetse. Sebelisa sekirini se ts'oaroang, motho ea nkang karolo o ama e le 'ngoe ea lintho tse peli tse susumetsang' me a fuoa maikutlo. Kamora liteko tse ts'eletseng tse tšeletseng, sepheo le / kapa phetoho lia fetoha: qalong, li susumetsoa li entsoe ka sebopeho se le seng (ke hore, meetso e tlatsitsoeng ka mebala) 'me liphetoho li ts'oaroang (ke hore, ho tloha sebopeho se seng se tlatsitsoeng ka' mala o mong) sebopeho). Hamorao, li-stimuli li entsoe ka "likarolo" tse peli (ke hore, libopeho tse tlatsitsoeng ka mebala le mela e tšoeu), 'me mohatong oa ho qetela, liphetoho li sekhahla (ke hore, ho tloha mefuteng e tlatsitsoeng ka mebala ho ea ho mela e tšoeu). Litekanyetso tsa liteko li kenyelletsa palo ea methati e phethiloeng, palo ea liphoso tse shebiloeng ka hare, palo ea liphoso tse fapaneng haholo, mme tse tlalehiloeng khafetsa lithutong mona le lipontšo tsa karabelo e mamellang, palo eohle ea liphoso.
Lithutong tse 'ne tse sebelisang IED, ba bararo ba fumane hore batho ba nang le bothata ba ho becha ba entse liphoso tse kholo ho feta tsa li-HC (Khetho et al a., 2014; Odlaug et al a., 2011 ; Patterson et al a., 2006) 'me thuto e le' ngoe ha ea fumana liphapang tsa sehlopha (Manning et al., 2013). Phuputso e le 'ngoe e sebelisang mofuta oa pejana oa IED (Patterson et al., 2006) ha ea kenyelletsoa tlhahlobisong ea meta hobane ho tlalehiloe paramente e fapaneng ea liteko. Ho kopanya lithuto tse ling tse tharo le kakaretso ea batho ba 91 ba nang le bothata ba papali ea chelete le li-HC tse 180 ho bonts'itse kholofalo e kholo ho batho ba nang le bothata ba papali ea chelete ho IED (size size = 0.412, Z = 2.046, p = 0.041) (Feie. 3B). Heterogeneity e ne e batla e le tlase (Q = 3.71, p = 0.16, I2 = 46%) (Letlapa la Tlatsetso 2).
3.3.3. Fetolela mosebetsi
Mosebetsing oa switch (Sohn et al., 2000), lengolo le digit di bonts'oa nako e ts'oanang ho khubelu kapa boputsoa. Ho ipapisitse le 'mala oa matšoao ana, motho ea nkang karolo o laetsoe ho sheba tlhaku (e khubelu) kapa digit (putsoa). Ho ipapisitse le hore na lengolo / nomoro ke mohokahanyi / ho sa tloaelehang kapa seluma / leha ho le joalo, mosireletsi o hloka ho tobetsa ka ho le letšehali / ka ho le letona. Ho feto-fetoha le maemo ha kelello ho lekanngoa ka ho bapisa ho nepahala le nako ea karabelo ea liteko tse latelang phetoho ea mmala le eo kamora ho pheta-pheta ha mmala. Ke thuto feela e sebelisang mosebetsi ona (van Timmeren et al., 2016) ha baa fumana phapang ea bohlokoa pakeng tsa tšebetso ea mosebetsi pakeng tsa batho ba nang le bothata ba ho becha le li-HC.
3.4. Boikemisetso bo ikhethileng / khethollo
Ho shebella ka leeme kapa ho se amoheloe ho kenyelletsa bokhoni ba ho arabela ts'usumetso e itseng ea tikoloho ha u ntse u hlokomoloha ba bang. Ho fetoha ha temoho mona, ho hlalosoa ke bokhoni ba thuto ba ho thibela karabo e itlhahelang pele, le boits'oaro. Ho sitoa ho thibela karabelo e itjarileng joalo ho ka lebisa ho boits'oarong bo bobebe. Khokahano pakeng tsa leeme la ho tsepamisa mohopolo le ho fetoha habonolo ha kutloisiso e kanna ea hlaka ho feta ka libaka tse fetileng mme ke taba ea ho se lumellane ho lingolo (Izquierdo et al., 2017), joalo ka ha leeme le mamello le lona le ka latela mesebetsi e meng ea bolaoli. Liphetho tse ka har'a domain ena li amana le qobello ka kotloloho. Mesebetsi e kenyellelitsoeng sebakeng sena sa marang-rang ke Tlhahlobo ea Stroop (Colour-Word Interaction) le Teko ea ho Etsa Trail.
3.4.1. Mosebetsi oa Stroop
Mosebetsi oa Stroop (Stroop, 1935) ke mosebetsi oa mantlha oa neuropsychological o hlokang ho khethoa ka hloko, ho fetoha le maemo ha kelello le taolo ea thibelo. Mosebetsing ona, morupeluoa o hlahisoa ka mantsoe a mmala (mohlala, bofubelu), a hatisitsoeng ka 'mala o le mong (o kopaneng) kapa' mala o fapaneng. Morupeluoa o tla kopuoa hore a bolele 'mala oa enke oa mantsoe ana. Morero oa ho kena-kenana le maemo hangata o sebelisoa e le mokhoa oa tlhahlobo bakeng sa mosebetsi oa Stroop mme o supa keketseho ea nako ea karabelo e bakoang ke ho bona lentsoe le sa nepahalang ha le bapisoa le lentsoe le kopaneng. Morero ona oa ho kena-kenana le (bonyane ka karolo e itseng) o its'etleha ho thibelo ea karabo e itlhahang ho bala lentsoe. Ho sitoa ho thibela tloaelo ena e iketsahallang ho ka lebisa ho boits'oarong bo bobe mme lintlha tsena li ka bonoa e le mokhoa o mong oa ho feto-fetoha le maemo ha kelello. Leha ho le joalo, lintlha tsa tšitiso li itšetlehile ka lits'ebetso tse ling tsa kelello hape, joalo ka ho tsepamisa maikutlo le ho se arabele. Ka 'nete, ts'ebetso ea mosebetsi oa Stroop e boetse e nahanoa ho bonts'a ho hloka matla (motor).
Ho lingoliloeng tsa 12 tse sebelisitseng mosebetsi oa Stroop, tse supileng li fumane likotsi tse kholo ho batho ba nang le bothata ba ho becha ha ba bapisoa le li-HC, athe tse hlano li ne li sa etse joalo. Bakeng sa tlhahlobo ea meta, lithuto tse tharo ha lia ka tsa kenyelletsoa hobane ho tlalehiloe feela linako tsa karabelo mme ha ho na index ea ho kena-kenana e ka fumanoang (De Wilde et al a., 2013; McCusker le Gettings, 1997 ; Potenza et al a., 2003). Bakeng sa thuto e le 'ngoe, index ea ho kena-kenana e ka baloa ho latela linako tse tlalehiloeng tsa karabelo (tse sa sebetseng hantle - tse kopaneng; Lai et al., 2011). Har'a lithuto tsena tse 'ne tse sa kenyellelloang, tse peli li tlalehile ts'ebetso e mpe haholo ho batho ba nang le bothata ba papali ea chelete, athe ba bang ba babeli ha ba tlalehe phapang e kholo ea sehlopha. Lintlha tsa lithuto tse robong tse setseng, ho kenyeletsoa batho ba 337 ba nang le bothata ba papali ea chelete le li-HC tse 404, li ile tsa bokelloa 'me tsa senola phello e kholo ho batho ba nang le bothata ba papali ea chelete ba bonts'ang mathata a mangata a ho kena-kenana le mosebetsi oa Stroop ha a bapisoa le HCs (size size = 0.331, Z = 2.575, p = 0.01) (Feie. 4A). Leha ho le joalo, ho ne ho e-na le heterogeneity ea bohlokoa e emeloang ke li-Q-scores tsa bohlokoa (Q = 19.5, p <0.01) le I e itekanetseng2 (59%) (Lethathamo la Tlatsetso 2). Sephetho sena ha sea hlalosoa ke mefuta efe kapa efe eo re e nahanneng ho meta-regression (tsohle p> 0.05), empa hape e kanna ea bonts'a tlaleho e sa lumellaneng ea mehato ea sephetho, kaha ho ne ho sa tlaleheloe kamehla hore na likhakanyo tsa litšitiso li ne li baloa joang lipatlisisong.
3.4.2. Teko ea ho etsa liteko
Teko ea Ho Etsa Trail (TMT; Reitan, 1992) ke mosebetsi oa pampiri le pentšele, eo morupeluoa a laetsoeng ho hokahanya tatelano ea lipehelo tse latellanang kapele kamoo ho ka khonehang ha a ntse a boloka ho nepahala. E na le likarolo tse peli: nakong ea karolo ea pele (A) lipolao tsohle ke linomoro (1, 2, 3, jj) 'me morupeluoa o hloka ho hokela linomoro ka tatellano; nakong ea karolo ea bobeli (B) sepheo ke litlhaku le lipalo mme morupeluoa o laetsoe ho hokahanya tse latellanang (1, A, 2, B, jj.). Sena se hloka taba hore e sitise tšekamelo ea ho ikenya ea ho hokahanya linomoro kapa litlhaku ka tatellano (1, 2, 3, kapa A, B, C, jj) ho fapana le ho fapanyetsana lipakeng tsa tse peli. Nako e hlokahalang ho phethela karolo ea bobeli ea tlhahlobo (TMT-B) e bonts'a ho rarahana ha kelello le mathata a memori a sebetsang. Leha phapang ea BA e le sesupo se hlakileng sa ho fetoha ha maemo ho hlakileng (Sanchez-Cubillo et al., 2009), TMT-B e ne e le palo e tlalehiloeng khafetsa ho feta lithuto tsohle tse kenyellelitsoeng, ka hona, ke tekanyo ea sephetho eo re e sebelisitseng tlhahlobo ea meta. Hlokomela hore re kenyelletse TMT-B sebakeng sa Attentional bias / disengagement domain hobane ho rarolla mosebetsi ona ho hloka thibelo e sa khaotseng ea karabelo ea pele. Leha ho le joalo, ho falla ha tlhokomelo ho boetse ho hlokahala hore o phethe mosebetsi ona ka hona o ka beoa tlasa Task / Attentional Set-Shifting domain.
Ke thuto e le 'ngoe feela ho tse' ne tse sebelisitseng TMT-B e fumaneng phapang e kholo lipakeng tsa batho ba nang le bothata ba papali ea chelete le li-HC, ka batho ba papali ea chelete ba ntseng ba mpefala. Ha re kopanya lithuto tsena tse nne tlhahlobisong ea meta, le batho ba 118 ba nang le bothata ba papali ea chelete le li-HC tse 165, re fumane hore batho ba nang le bothata ba papali ea chelete ba sebetsa hampe ho TMT-B ho feta li-HCs (size size = 0.270, Z-score = 2.175, p = 0.030) (Feie. 4B). Heterogeneity e ne e le tlase (Q = 6.26, p <0.18, I2 = 36%) (Letlapa la Tlatsetso 2).
3.5. Ho ithuta tloaelo
Ho ithuta ka mokhoa oa tloaelo ho bolela tloaelo ea liketso hore e iketsehale ha e phetoa khafetsa. Ho ea ka likhopolo tsa ho ithuta tse amanang, ho ithuta ka sistimi ho ka tšehetsoa ke litsamaiso tse laoloang ke sepheo le tloaelo (Balleine le Dickinson, 1998). Khale, liketso li etsoa le ho nchafatsoa ho latela sephetho. Kamora nako, mokhoa oa tloaelo o qala ho fana ka boitšoaro ka boiketsetso mme liketso li se ke tsa tsotella sephetho, ho fapana le moo li its'etleha maemong a tšusumetso ea khothatso. Boitšoaro bo qobelloang e ka ba litholoana tsa taolo e tataisitsoeng e lebisitsoeng ho sepheo kapa mokhoa o tloahang ho itloaetsa tloaelo. Liteko tsa ho ithuta ka tloaelo li lokela ho kenyelletsa ho hlaka hore na ke litsamaiso life tse peli tse laolang boitšoaro. Mamello ho paradig-ho ithuta ka morao-rao, mohlala, e boetse e kenyelletsa thuto ea moputso e thehiloeng ho mekhatlo ea sephetho sa khothaletso, empa e ka ba litholoana tsa litsamaiso ka bobeli (Izquierdo et al., 2017). Mehlala ea mesebetsi e khothalletsoang hore e leke ho ithuta ka mokhoa o khethehileng ke papali e ntle ea litholoana (de Wit et al., 2009) le mosebetsi oa mehato e 'meli (Daw et al., 2011).
Leha thuto ea tloaelo e sebelisoa ho bapala karolo ea bohlokoa phetohong ho tloha sepheo se lebisitsoeng ho sepheo se qobelloang, ha ho lithuto tse fumanoeng tse lekang ho ithuta ka tloaelo ea ho becha.
4. Puisano
4.1. Puisano ka kakaretso
Re lekola lingoliloeng ka mokhoa o hlophisehileng 'me ra etsa liteko tsa meta tsa lithuto tse lekang ts'ebetso ea ts'ebetso ea ts'ebetso ea ts'ebetso ea ts'ebetso ea ts'ebetso ea botona le botšehali khahlanong le HCs. Compulsivity e arotsoe likarolo tse 'ne tse arohaneng tse emelang likarolo tse fapaneng tsa boitšoaro bo qobelloang bo hlahlojoang ka mesebetsi e fapa-fapaneng ea neuropsychological (Lethathamo 1). Re fumane hore batho ba nang le bothata ba ho becha, ha ba bapisoa le li-HC, ba bonts'a bofokoli ba ts'ebetso ho mefuta e mengata e fapaneng ea ts'ebetso e amanang le ts'ebetso ea neuropsychological. Leha ho e-na le phapang e itseng lipakeng tsa mesebetsi ka bonngoe, bopaki bo fumanehang khafetsa bo supa bofokoli ba ts'ebetso kahare ho libaka tsohle tse khothalletsoang ho batho ba nang le bothata ba ho becha ha bo bapisoa le li-HC. Liphetho tsena li tla buisanoa pele bakeng sa sebaka se seng le se seng sa khatello pele u buisana ka sona ka botlalo.
Sebakeng sa maemo a tšohanyetso a amanang le maemo a tšohanyetso a amanang le maemo a tšohanyetso, mesebetsi e 'ngoe le e' ngoe e bonts'a sephetho se kopaneng (Feie. 2). Liphetho tse tsoang liphuputsong tse sebelisang PRLT ha lia ka tsa senola boitšoaro bo botle ho batho ba nang le bothata ba ho becha; leha ho le joalo, sena se ka ba teng ka lebaka la sampole e nyane haholo. Ntho e 'ngoe e ka' nang ea pata sephetho sena ke phapang ea litekanyetso le litekanyetso tsa liphetho lipakeng tsa lithuto, tse ileng tsa bonts'oa hape ke boemo ba bohlokoa ba heterogeneity e fumanoeng. Ho CPT, phokotso ea bohlokoa le tekanyo ea mahareng a boholo bo fumanoe ho batho ba nang le bothata ba ho becha khahlanong le HC. Sephetho sena e ka ba se loketseng haholo tleliniking, kaha ts'ebetso e sa sebetseng hantle mosebetsing ona e bontšitse ho rerela ho khutla hape ho batho ba nang le bothata ba ho becha (Goudriaan et al., 2008) 'me ho tlalehiloe liphoso tsa ts'ebetso e tšoanang litsietsing tsa tšebeliso ea lithethefatsi (Martin et al., 2000). Ho khahlisang, ho araba ka mamello mosebetsing ona ho bonahala ho tloaelehile ha ho eketsoa khefu ea karabelo ea 5 (Thompson le Corr, 2013). Tlhaloso e 'ngoe e ka ba hore ho araba ka mokhoa o qobelloang ho na le karolo e arabeloang ke ho arabela ka potlako. Phuputso e 'ngoe e fumane hore le ha li-HC li lieha ho potlaka ho arabela ka mor'a tahlehelo, batho ba nang le bothata ba ho becha ha ba (Goudriaan et al., 2005). Sena, hape, se ka hlalosoa ke karabelo e potlakileng ea ho arabela, joalo ka ha ho tlalehiloe khafetsa bothateng ba papali ea chelete (Verdejo-García et al., 2008). Tšebelisano lipakeng tsa boits'oaro bo susumetsang le bo hatellang ke taba eo re tla khutlela ho eona hamorao puisanong.
Mosebetsi o fumanehang oa ho etsa liteko oa liteko o bonts'a mokhoa o ts'oanang: lithutong tsohle, batho ba nang le bothata ba ho becha ba etsa lintho tse mpe ho feta taolo (Feie. 3). Liphetho tse tsoang tlhahlobisong ea meta li bonts'a bofokoli bo bohlokoa ba ts'ebetso bo nang le boholo bo lekaneng ba tšebeliso ho batho ba nang le bothata ba ho becha khahlanong le HC ho WCST le IED ka bobeli. Litekanyetso tsa liteko tse tlalehiloeng ka mesebetsi ena li lumellana haholo, tse bonts'itsoeng hape ke boemo bo tlase ba heterogeneity kahara domain ena. Ha li kopantsoe hammoho, liphetho tsena li fana ka bopaki bo bongata ba bofokoli ba tšebetso ho feto-fetoha le maemo hoa kelello ho batho ba nang le bothata ba ho becha. Sena se tiisa le ho feta ke phuputso ea morao-rao e sebelisang sampole e kholo eo e seng ea bongaka ea barekisi ba tloaelehileng ba bonts'ang kamano e nepahetseng lipakeng tsa liphoso tsa IED le likala tse fapaneng tsa botebo ba papali ea chelete, ho kenyeletsoa mekhoa ea DSM-5 (Leppink et al., 2016). Leha ho le joalo, lithuto tse lekang ho noha sephetho sa kalafo li ipapisitse le ts'ebetso ho WCST ho batho ba nang le bothata ba ho becha (Rossini-Dib et al., 2015kapa mathata a tšebeliso ea lithethefatsi (Aharonovich et al., 2006) ha lia atleha.
Mesebetsing eo ka bobeli e kenyellelitsoe ka har'a lehlohlo la taolo ea ho khetholla / ho lahla thepa, liphoso tse kholo tsa ts'ebetso li fumanoe ho batho ba nang le bothata ba ho becha, ba nang le boholo bo bonyenyane ho isa bohareng (Feie. 4). Liphetho mabapi le mosebetsi oa Stroop, leha ho le joalo, li lokela ho hlalosoa ka mokhoa o hlakileng kaha heterogeneity e ne e phahame. Sena se ka se hlalosoe ke accounting ea lilemo, thobalano, IQ kapa boima ba papali ea chelete papaling ea meta-regression.
Ka kakaretso, liphetho tsena li fana ka maikutlo a tloaelo ea batho ba nang le bothata ba ho becha ho bonts'a litloaelo tse qobelloang tse sa amaneng ka kotloloho le boits'oaro ba papali ea chelete. Lits'oaetso tsena tsa ts'ebetso li kanna tsa amahanngoa le ntlafatso le tlhokomelo ea matšoao a ho becha. Mohlala, ho se khone ho fetola tlhokomelo, kapa tšekamelo ea ho mamella boitšoaro hang ha ho ithutile, ho ka fana ka monyetla oa ho eketsa kotsi ea ho ts'oara boitšoaro ba papali ea chelete. Ho feta moo, mefokolo ea ts'ebetso ena e ka ba litholoana tsa papali ea chelete e sa pheleng. Maemong ana ka bobeli, sena se ka amana le mathata a eketsehileng a ho tlohela mokhoa oa ho becha, kaha lithuto tse ngata li ile tsa leka batho ba nang le bothata ba ho becha ba neng ba le kalafong. Kamano e teng lipakeng tsa sephetho sa kalafo le ts'ebetso ho mesebetsi eo e tlameha ho ithutoa haholo (Goudriaan et al., 2008) kaha sena se ka fana ka menyetla ea ho kenella ka thibelo le kalafo. Ho khahlisang, mokhoa o ts'oanang oa bofokoli ba ts'ebetso mabapi le mesebetsi ea methapo e teng ho bakuli ba OCD, bothata ba prototypical ba boitšoaro bo qobelloang: tlhahlobo ea meta haufinyane e fumane bofokoli ba bohlokoa ho WCST, IED, mosebetsi oa Stroop le TMT-B (Shin et al., 2014). Ho se sebetse hantle mesebetsing eo ho bonahala ho akaretsa le mathata a mang a qobelloang.
Mekhoa e amanang le "urouro "e sebelisitsoe ho etsa lipatlisiso mabapi le ho feto-fetoha ha methapo ea kutlo, ho feto-fetoha ha linako le ho hlokomela lintho tse sa hlokeng tlhokomelo lithutong tsa taolo e phetseng hantle. Libaka tse amanang khafetsa le libaka tsena li kenyelletsa orbitofrontal cortex (OFC), ventrolateral (vlPFC), ventromedial (vmPFC) le dorsolateral prefrontal cortex (dlPFC) le basal ganglia (Fineberg et al a., 2010 ; Izquierdo et al a., 2017). Ka mokhoa o makatsang, likarabo tse sa tloaelehang tsa boko libakeng tse tšoanang li ile tsa bonoa bothateng ba papali ea chelete ha ho botsoa ka mesebetsi e lekolang lits'oants'o tsa methapo ena (e sa tsoa hlahlojoa ke Moccia et al., 2017). Lithuto tse hlano tse kenyelitsoeng tlhahlobisong ena li boetse tsa etsa lipatlisiso tsa ts'ebetso ea boko ho batho ba nang le bothata ba ho becha le li-HC ha lithuto li ntse li etsa mesebetsi e amanang le ho qhekella. Nakong ea mosebetsi oa Stroop, batho ba nang le bothata ba ho becha ba bontšitse ho fokotseha ha mosebetsi oa vmPFC (Potenza et al., 2003), ha ts'ebetso ea vlPFC e fokotsehileng e tlalehiloe nakong ea PRLT (de Ruiter et al a., 2009 ; Verdejo-García et al a., 2015). Phuputso e entsoeng ka EEG e fumane tšebetso e sa tloaelehang e hlahisitseng maikutlo a batho ba nang le bothata ba ho becha nakong ea PRLT (Torres et al., 2013). Ho tšepahala hoa makunutu a taba e tšoeu pakeng tsa dlPFC le basal ganglia, e leng pampitšana e bohlokoa bakeng sa ho fetoha le maemo, e bonoe ho batho ba nang le bothata ba ho becha (van Timmeren et al., 2016), leha sena se ne se sa amane ka kotloloho le ts'ebetso ea mosebetsi o mong oa tlhokomelo. Bopaki bo fumanehang bo bobe ba ho hlahloba ts'ebetso ea papali ea papali ea chelete, bo fetolela ho batho ba nang le bothata ba ho becha bo bontšang ho fokotseha ha ts'ebetso ea sebopeho le sebopeho libakeng tse bohlokoa bakeng sa ho fetoha habonolo ha kelello, ho feto-fetoha ha maikutlo le ho se mameloe ka hloko.
Mekhatlo ea methapo e kenyang matla a ho qobella ha e utloisisoe hantle, leha ho nahanoa hore dopamine le serotonin li bapala karolo ea bohlokoa (Fineberg et al., 2010). Boithuto bo fetileng ho batho le liphoofolo bo bontšitse ka mokhoa o kholisang hore ho tenyetseha hoa kelello ho amang ka ho hlaka le ka mokhoa o sa amaneng ke dopamine le serotonin ka bobeli. Mohlala, matla a mantlha a dopamine synthesis ka har'a striatum ea motho a bolela esale pele ts'ebetso ea ho khutlela morao ea ho ithuta, ha litlamorao tsa taolo ea lithethefatsi tsa dopaminergic le tsona li ipapisitse le maemo ana a motheo (Cools et al., 2009). Pele ho moo dopamine e felisoa ke litšoene, ka lehlakoreng le leng, ha e ame thuto ea morao-rao, athe ho akheha ha serotonin ho sitisa ho sekama le ho se shebe ho fetolelang.Clarke et al a., 2007 ; Clarke et al a., 2005). Glutamate e bile le tšusumetso lithutong tse feto-fetohang tsa ho ithuta le mefuta e meng ea ho feto-fetoha le maemo ha kelello, empa liphetho li 'nile tsa hanyetsana (Izquierdo et al., 2017) Mathateng a papali ea chelete, liphuputso tse ling li tlalehile maemo a dopamine a fetohileng, leha liphuputso li sa lumellane (Boileau et al a., 2013 ; van Holst et al a., 2017) mme hanyane ho tsejoa ka ts'ebetso ea neurotransmitter mabapi le mesebetsi ea methapo ea kutlo. Ho fihlela joale, ke phuputso e le 'ngoe feela e entseng lipatlisiso tsa dopamine ka kotloloho le kamano ea eona ea ho feto-fetoha ho ithuteng (DRLT) ho batho ba nang le bothata ba ho becha. Janssen et al. (2015) e fumane hore, joalo ka ha ho ne ho lebeletsoe, ts'ebetso ea ts'ebetso ea sulpride (moemeli oa D2-receptor antagonist) e lebisitse ho thuto e sa sebetseng e bapisoang le taolo ea kotlo ho taolo e phetseng hantle. Ho batho ba nang le bothata ba ho becha, leha ho le joalo, sulpride ha e na phello ea ts'ebetso ha e bapisoa le boemo ba placebo. Ntle le moo, phuputso ea sefofane e fumane hore tsamaiso ea memantine, mohanyetsi oa NMDA-receptor ea fokotsang thabo ea glutamate, e ntlafatsa maemo a kelello (joalo ka ha e lekantsoe le IED) mme ea fella ka hore papali ea chelete e fokotsehe (Grant et al., 2010). Ha ho nahanoa le khaello ea lithuto tse etsang lipatlisiso tsa methapo ea methapo e tlatsetsang ho qobelloeng bothateng ba papali ea chelete, ho hlokahala lipatlisiso tse eketsehileng.
4.2. Meeli le litlhahiso bakeng sa lipatlisiso tsa nako e tlang
Morero o ka sehloohong oa tlhahlobo ena e hlophisitsoeng le tlhahlobo ea meta e ne e le ho akaretsa le ho kopanya bopaki ba bofokoli ba ts'ebetso ea neuropsychological bothateng ba papali ea chelete bo ka amanang le boits'oaro bo hatellang. Leha ho le joalo, ho qobelloa ke mokhoa o rarahaneng oa ho theha multidimensional ebile boitšoaro bo qobelloang bo ka hlaha ka mabaka a mang a neng a sa hlahlojoa tlhahlobisong ena. Lintho tse tsebahalang tse bakang likarolo tse qobelloang tsa bokhoba ba tahi ke matšoenyeho le khatello ea maikutlo (Koob le Le Moal, 2008); qalong, boits'oaro bo ka sebetsa e le mokhoa oa ho sebetsana le maemo, ebe ho mamella ho fana ka moputso ho ka tsoela pele empa boits'oaro bo ka tsitlallela e le mokhoa oa ho fokotsa ho hloka thabo. Tlas'a tšusumetso ea lintho tse susumetsang tse susumetsang, boitšoaro bo joalo bo ka qetella bo lebisitse ho qobelloang ka boiketsetso, bo sa tsebeng letho le tahlehelo ea taolo. Hape ha rea ka ra lekola kamano le tšebelisano lipakeng tsa ho qobelloa le ho se kenelle, ke ho re tloaelo ea ho etsa lintho pele ho nako ntle le ponelo-pele. Ho susumetsa ke mokhoa o kopanetsoeng, hangata o amanang le ho batla kotsi le ho batla moputso, athe ho qobelloa ho etsoa ka mokhoa o fokolang ebile ho tsamaisana le ho qoba kotsi (Fineberg et al., 2010). Leha ho le joalo, likhopolo tsena ka bobeli li arolelana maikutlo a ho hloka taolo, 'me ka bobeli li ka hlaha ka lebaka la ho sitoa ha taolo ea "holimo-tlase"Dalley et al., 2011). Mabaka ka bobeli a ka boela a sebelisana: boits'oaro bo qobelloang bo ka khethoa ke karabelo e eketsehang e potlakileng, e hlahisoang ke tšusumetso e phahameng ea litheko ho likhoto tse bolelang ho ts'oanela ho batla lithethefatsi (Belin et al., 2008). Kahoo, ho se kenelle ho ka fetoha tšusumetso 'me litšebelisanong tsena ke menyetla ea ho etsa lipatlisiso tsa nako e tlang.
Leha meetso e lekantsoeng hangata e nkuoa e le litšobotsi, ho ka ba le litšitiso tse itšetlehileng ka mmuso ha li bapaloa, li bakoa ke matšoao a sithabetsang, mathata a tlhokomelo, kapa mathata a mang a ka bakang pherekano ea ho becha. Ntle le moo, ho qobelloa ka bohona ho ka itšetleha ka 'muso (ke hore, ho amana le boemo ba bokuli kapa sethala) ka hona ho khothalelitsoe hore ke' sepheo se sa tsitsang 'se ke keng sa ba mofuta oa endophenot (Yücel le Fontenelle, 2012). Ka lehlakoreng le leng, ho qobelloa ho 'nile ha talingoa e le tšekamelo ea ho nahana ka tšohanyetso e nang le mofuta o tloaelehileng oa tlhaho oa popophenotype (Robbins et al., 2012). Ho hlokahala lithuto tse telele bakeng sa ho rarolla mathata ana.
Kaha ho qobelloa e ne e le sebaka sa rona sa mantlha sa lithahasello, ha rea ka ra hlahloba liphoso tse ling, tse sa qobelloang tsa neuropsychological bothateng ba papali ea chelete. Ka hona, ha re na ho etsa liqoso mabapi le hore na litlamorao tsa litlamorao tsa rona li ama eng ha ho bapisoa le lintho tse sa qobelloeng. Ntle le moo, mesebetsi ena e amanang le botsitso e boetse e itšetleha ka lits'ebetso tse ling tsa (non-) tsa taolo e phahameng: mohlala, ho fetohela mosebetsing oa IED lipakeng tsa mebala le sebopeho le hona ho hloka ts'ebetso ea pono (Miyake et al., 2000).
Leha e na le karolo ea bohlokoa eo e ka bang karolo ea bohlokoa ea ho ba mohloli oa boitšoaro bo khothalletsoang bo amanang le tšebeliso ea litheko (Everitt le Robbins, 2015), ho na le khaello e felletseng ea lithuto tsa boithuto ba ho ithuta ho ithuta ka tloaelo ea ho becha. Kahoo, hore na bothata ba ho becha bo tsebahala ka ho ithuta tloaelo e sa tloaelehang e ntse e le potso e bulehileng. Leha boholo ba mosebetsi o amanang le ho ithuta ka tloaelo le bokhoba ba batho bo tsoa lithutong tsa liphoofolo, liphuputso tse 'maloa haufinyane li tlalehile liphokotso molemong oa tloaelo ea tšebeliso ea lithethefatsi bathong ba seng lihlong. Boithuto bo fetileng bo bontšitse kholo e fetelletseng ea ho ithuta ka tloaelo ka mohlala joala (Sjoerds et al., 2013) le bakuli ba itšetlehileng ka koaeErsche et al., 2016). Taolo e fokotsehileng e tataisoang ke sepheo (e etselitsoeng mohlala) e 'nile ea amahanngoa le' mathata a ho qobelloa '(ho kenyeletsa le bothata ba ho ja ho ja, khatello ea kelello le khatello ea tšebeliso ea lithethefatsi; Voon et al., 2014); ts'ebeliso ea joala (Sebold et al., 2014, empa bona Sebold et al., 2017); le matšoao a nang le boits'oaro bo kenyelletsang boits'oaro bo khothalletsang le mohopolo o makatsang mohlaleng o moholo oa lithuto tse phetseng hantle (Gillan et al., 2016).
Mokhoa oa rona oa ho fana o fana ka mokhoa oa ho etsa lipatlisiso le ho khetholla mohopolo oa ho qobelloa trans-diagnostically, e leng eona e ka thusang ho bolela ho ba kotsing ea ho hlaseloa le ho tšoaea mekhoa ea kalafo ea boits'oaro le ea meriana ka mokhoa o atlehileng haholoanyane ( Robbins et al., 2012). Lithuto tsa nako e tlang li khothaletsoa ho etsa papiso lipakeng tsa taolo ea papali ea chelete le "mathata a ho qobelloa". CPT, WCST, le IED li bonahala e le tsona tse amehang ka ho fetesisa ho khetha bofokoli ba ts'ebetso, bonyane ho batho ba nang le bothata ba ho becha. Leha e ne e se molemong oa rona ho hlahloba sena ka mokhoa o hlophisehileng, tse ling tsa lithuto tse kenyelelitsoeng tlhahlobisong ena li bapisitse batho ba nang le bothata ba ho becha le mathata a tšebeliso ea lithethefatsi ( Albein-Urios et al a., 2012; Khetho et al a., 2014; de Ruiter et al a., 2009; Goudriaan et al a., 2006; Goudriaan et al a., 2005; Torres et al a., 2013; Vanes et al a., 2014 ; Verdejo-García et al a., 2015), bokhoba ba boitšoaro ( Khetho et al a., 2014 ; Zhou et al a., 2016) kapa lefu le thibang kelello (le lematsang)Hur et al., 2012). Ka kakaretso, lithuto tsena li bonts'a bofokoli ba ts'ebetso lihlopheng tseo tse tšoanang le ( Albein-Urios et al a., 2012; Goudriaan et al a., 2006; Goudriaan et al a., 2005; Utloisa bohloko et al a., 2012; Vanes et al a., 2014 ; Zhou et al a., 2016kapa ho hobe (Choi et al., 2014) ho feta ho batho ba nang le bothata ba ho becha.
Tlas'a bothata ba papali ea chelete ea ho becha, ba bechang le bona ba ka aroloa likarolo tse ling. Lithuto tse fetileng li entse sena ka mekhoa e mengata: ho ipapisitse le papali eo ba e ratang ka ho becha (mohlala, metjeko ea li-slot- kapa li-kasinoque; Goudriaan et al., 2005), e ipapisitse le mekhoa ea ho hlonama kapa ea botho (mohlala: ho tepella maikutlo, ho batla maikutlo kapa ho hohela; Valvarez-Moya et al., 2010), kapa ho ipapisitse le tšusumetso ea bona ea papali ea papali ea chelete (mohlala, ho sebetsana le khatello ea maikutlo kapa maikutlo a fosahetseng; Stewart et al., 2008). Mabapi le ho feto-fetoha le maemo ha kelello, phuputso e 'ngoe e fumane hore bashebelli ba casino ba ne ba mamelletse haholo ho CPT, athe barekisi ba marang-rang ba marang-rang ba sebelisa mokhoa o hlokolosi hape ((hape o mpe)Goudriaan et al., 2005). Boithuto ba nako e tlang bo ka supa ts'ebelisano e nang le mathata a bongaka (a kahare le pakeng tsa mafu a kelello) ka ho etsa lipatlisiso mabapi le tšebelisano ea likarolo tse joalo tsa ts'ebetso le ts'ebetso ea motho ka mong. Mokhoa o mong oa ho ntlafatsa karohano ea bakuli le kutloisiso ea methapo e bakang bofokoli ba tšebetso ke ka ho sebelisa mohlala oa boikhakanyo, ke ho re 'computational psychiatry' (Tse ngata et al a., 2016 ; Maia le Frank, 2011). Ho qolla likarolo tse ngata tsa ts'ebetso ea kelello e amanang le qobello e ke keng ea nkuoa ho sebelisoa mekhoa ea khale, ho ka ba molemo ho (re) ho sekaseka datha tse teng u sebelisa mefuta ea likhomphutha (Lesage et al., 2017).
4.3. Qetello
Tlhahlobisong ena e hlophisehileng le ho shebella meta, re fuputse likarolo tse 'ne tsa tsamaiso ea methapo tse nkoang li le bohlokoa haholo ho litloaelo tse hatellang bothateng ba papali ea chelete. Ho fihlela sena, re ile ra khetha mesebetsi ea boitšoaro e lekanyang ts'ebetso ea maemo e bonts'a efe kapa efe ea likarolo tsena. Liphetho tse loketseng le tse nyane li fana ka maikutlo a hore batho ba nang le bothata ba ho becha, ka kakaretso, ba bonts'a bofokoli ba tšebetso, ho feto-fetoha ha maikutlo le takatso ea ho shebella, ha ho sa fumanoe lithuto tse etsang lipatlisiso tsa ho ithuta ka bothata ba ho becha. Ka kakaretso, liphumano tsena li ts'ehetsa mohopolo oa hore ts'ebeliso ea papali ea chelete ea ho becha e tšoauoa ka litšitiso tse amanang le ts'oaetso ea ts'ebetso ea methapo, joalo ka mohlala ho tiisetso le ho se sebetsehe hoa kelello. Leha ho le joalo, joalo ka ha ho boletsoe pejana, 'mapa oa mesebetsi ea neuropsychological libakeng tse ikhethileng ha se kamehla o hlakileng. Ka hona, tlhoko e sala e le ho ntlafatsa le ho ntlafatsa moelelo oa khopolo le tlhahlobo ea boikemisetso, tse tla thusa ho nts'etsapele lipatlisiso lefapheng lena.
Ntle le hore ke tsa bohlokoa bakeng sa bothata ba ho becha ka bohona, liphetho tsena li ka ba le litlamorao tse pharaletseng. Ka ho talima bothata ba ho becha e le tšebeliso ea boitšoaro bo tšoanang le mathata a ts'ebeliso ea lithethefatsi ntle le litlamorao tse tlisoang ke taolo ea lithethefatsi, liphetho tsena li ts'ehetsa maikutlo a hore ts'usumetso ea ho qobella ho etsa lintho esale pele a ka ba le boitšoaro bo bobe.Leeman le Potenza, 2012). Kahoo, li fana ka khokahano lipakeng tsa ho senyeha mesebetsing ea botsamaisi e amanang le ts'ebetso e qobelloang le ho ba kotsing ea ho lemalla ebile e ka kenya letsoho ho theheng mofuta oa endophenotype bakeng sa mathata a amanang le ho qobelloa (Gottesman le Gould, 2003).
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Ha ho letho.
Liteboho
Re leboha haholo prof. Dr. Wim van den Brink bakeng sa tlhahiso ea hae ea bohlokoa. Re leboha José C. Perales, Kelsie T. Forbush le Lieneke K. Janssen ka likarabo tsa bona tse ntle mabapi le likopo tsa data; le Jente M. Klok le Nikki M. Spaan bakeng sa ho fana ka litekanyetso tsa boleng ba lithuto tse kenyelelitsoeng.
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