Ho kopanya Mekhoa ea Theoretical le Therapy e Atamela ka Motheo oa Internet Gaming Disorder: A Personal Perspective (2017)

 Ka pele. Psychol., 20 Mphalane 2017 | https://doi.org/10.3389/fpsyg.2017.01853

Kimberly S. Young¹ 'me Matthias Brand^2,3*

• ¹Setsi sa Tebello ea Marang-rang, Russell J. Jandoli Sekolo sa Botsoa le Khokahano ea Mass, Univesithi ea St. Bonaventure, Olean, NY, United States
• ²Psychology ea Kakaretso: Tlhalohanyo le Setsi sa Patlisiso ea Ho Etsa Lintho Tse Ntle, Univesithing ea Duisburg-Essen, Essen, Jeremane
• ³Erwin L. Hahn Setsi sa Magnetic Resonance Imaging, Essen, Jeremane

Leha, ha e e-so tsebisoe semolao e le mokhatlo oa bongaka o ka fumanoang, Internet Gaming Disorder (IGD) e kentsoe karolong ea III bakeng sa ho tsoela pele ho ithuta ho DSM-5 ke Mokhatlo oa Amerika oa Psychiatric Association (APA, 2013). Sena ke sa bohlokoa hobane ho na le bopaki bo ntseng bo eketseha ba hore batho ba lilemo tsohle, haholo bacha le batho ba baholo ba tobane le litlamorao tse mpe haholo bophelong ba letsatsi le letsatsi ka lebaka la tšebeliso e mpe ea lipapali tsa inthanete. Sengoloa sena se akaretsa lintlha tse akaretsang tsa IGD ho kenyelletsa mekhoa ea tlhahlobo le mabaka a khethollo e le bothata bo kenyelletsang ho kenyelletsa bopaki bo tsoang lithutong tsa neurobiological. E ipapisitse le likakanyo tse fumanoeng tsa theoretical le lipatlisiso tse matlafatsang, pampiri ena e lekola tšebeliso ea mofuta o le mong o sa tsoa khethoa, mokhoa oa Interaction of Motho-Afimate-Cognition-Execution (I-PACE), bakeng sa ho khothaletsa lipatlisiso tsa nako e tlang le ho nts'etsapele protocol ea kalafo e ncha ea IGD. Moetso oa I-PACE ke sebopeho sa mohopolo se hlalosang matšoao a bokhoba ba marang-rang ka ho sheba tšebelisano lipakeng tsa lintho tse rerang esale pele, motsamaisi, le babuelli hammoho le ho fokotsa tšebetso. Kamora nako, pampiri e tšohla hore na li-protocol tsa kalafo tsa morao-rao tse lebisang ho Cognitive-Behaeveal Therapy tsa ho lemalla lithethefatsi tsa inthanete (CBT-IA) li tsamaisana joang le lits'ebetso tse qotsitsoeng mohlaleng oa I-PACE.

Selelekela

Bokhoba ba marang-rang bo ile ba khetholloa ka lekhetlo la pele ho 1995 ho latela lithuto tsa linyeoe tsa 600 tse kenyelletsang batho ba nang le mathata a thuto, thuto, lichelete kapa kamano kapa ba lahlehetsoe ke mosebetsi hobane ba ile ba lahleheloa ke taolo holim'a tšebeliso ea bona ea inthanete (E monyenyane, 1996, 1998a,b). Lilemong tse mashome a mabeli tse fetileng, lipatlisiso tsa bokhoba ba marang-rang li ile tsa hola ka potlako ho ba karolo ea thuto e fetohang ka potlako. Bo-pula-maliboho ba bang tšimong ba kenyelletsa litsebi tsa kelello tse kang Drs. David Greenfield le Marissa Hecht Orzack (Greenfield, 1999; Orzack, 1999) le Ngaka Mark Griffiths (mohlala, Griffiths le Hunt, 1998; Griffiths, 1999). Lithuto tse matlafalitsoeng li qalile ho hlaha ka ho shebana le litekanyetso tsa ho ata ha batho ba bangata le litekanyetso tsa psychopathological ka disampole tse ikhethileng, lithuto tse ngata tsa linyeoe, le ho hlahlojoa ha lintlha tse 'maloa tsa psychosocial tsa tlhekefetso ea inthanete, joalo ka botho le likarolo tsa sechaba (mohlala, Armstrong et al., 2000; Morahan-Martin le Schumacher, 2000; Shapira et al., 2000; Chou, 2001; Kubey et al., 2001; Caplan, 2002). Le ha ho ne ho phehisanoa khang ka matla, lilemong tsena tsa pele tsa lipatlisiso tsa mahlale (1995-2005) li thehile mefuta e mecha ea theoretical le lefats'e ka taba eo (mohlala, Griffiths, 1995, 2005; Davis, 2001), e ikemiselitseng ho akaretsa matšoao a sehlooho le lits'ebetso tse ka bang teng tlasa ts'ebetso e fetelletseng ea inthanete.

Litsong tsa Asia, mathata a ho sebetsana le ts'ebeliso ea Marang-rang a bonahala a le bohlokoa haholo ha a bapisoa le setso se seng (mabaka a ka bang teng a tšohloa ka mohlala ho Montag et al., 2016). Leha ho le joalo, ho 2006, US e fumane ka phuputso ea pele ea naha hore batho ba fetang 10% ba Maamerika ba kopana le sesupo se le seng sa tšebeliso ea mathata a Marang-rang (Aboujaoude et al., 2006). Lebaka le leng la sena e ka ba hore lilemong tse 15 tse fetileng, lits'ebetso tse ncha tsa Marang-rang li ile tsa fetoha, mohlala, Facebook, Twitter le WhatsApp, tse etsang hore theknoloji e be karolo ea bohlokoa bophelong ba batho ba letsatsi le letsatsi (Montag et al., 2015) le ho fifatsa phapang lipakeng tsa tšebeliso ea inthanete e lemalloang le e sebetsang.

Pejana 2008, litsebi li ile tsa buisana ka tšebeliso ea bokhoba ba marang-rang ka mofuta o mocha oa Diagnostic and Statistical Manual (DSM; Thibela, 2008). Ka tlhokomelo e eketsehileng, lipuisano, le lipatlisiso, American Psychiatric Association (APA) haufinyane e kentse Internet Gaming Disorder (IGD) karolong ea III bakeng sa thuto e tsoelang pele ho DSM-5 (APA, 2013). Sena se na le litlamorao tse kholo lefapheng la lipatlisiso hobane ka ho ngola lenane la IGD ho DSM-5 bakeng sa boithuto bo tsoelang pele, APA e ne e tšepile ho khothaletsa lithuto ho IGD ho fumana hore na boemo bona bo nepahetse tleleniking mme ka hona e lokela ho kenyelletsoa e le bokuli bo tšoaelitsoeng mefuteng e tlang DSM. Tsoelo-pele ena e ne e le bohlokoa ebile e bohlokoa hobane ho na le bopaki bo ntseng bo eketseha ba hore batho ba lilemo tsohle, haholo bacha le ba baholo, ba tobana le litlamorao tse mpe haholo ka linako tse ling tsa bophelo ba letsatsi le letsatsi ka lebaka la tšebeliso e mpe ea lipapali tsa marang-rang (E monyenyane, 2004, 2015). Litekanyetso tsa DSM-5 li kenyelletsa tšebeliso e sa feleng ea lipapali tsa marang-rang, hangata le libapali tse ling, tse bakang khatello ea maikutlo kapa khatello ea maikutlo joalo ka lits'upiso tse hlano (kapa ho feta) tsa maemo a latelang nakong ea khoeli ea 12:

• Ho ameha haholo ka lipapali tsa inthanete.

• Matšoao a ho tlohela ha lipapali tsa inthanete li tlosoa.

• Ho tiisetsa e le tlhoko ea ho qeta nako e eketsehileng u le lipapaling tsa inthanete.

• Liteko tse sa atleheng tsa ho laola ho nka karolo lipapaling tsa inthanete.

• Ho lahleheloa ke lithahasello tsa boithabiso bo fetileng le boithabiso ka lebaka la lipapali tsa marang-rang.

• Ts'ebetso e tsoetseng pele ea lipapali tsa marang-rang le ha ho e-na le tsebo ea mathata a kelello.

• Motho eo o thetsitse litho tsa lelapa, litsebi tsa bongaka, kapa ba bang mabapi le bongata ba lipapali tsa inthanete.

• Tšebeliso ea lipapali tsa inthanete ho baleha kapa ho imolla mohopolo o mobe (mohlala, maikutlo a ho hloka thuso, letsoalo, matšoenyeho).

• Motho o sentse kapa o lahlehetsoe ke kamano ea bohlokoa, mosebetsi, kapa monyetla oa thuto kapa mosebetsi ka lebaka la ho nka karolo lipapaling tsa inthanete.

DSM-5 e hlokometse hore lipapali tsa inthanete feela tse se nang litšobotsi tsa papali ea chelete li amehile bothateng bona bo khothalletsoang hobane papali ea chelete ea inthaneteng e kenyelelitsoe le litekanyetso tsa DSM-5 tsa bosholu ba papali ea chelete. Ho sebelisa marang-rang bakeng sa mesebetsi e hlokahalang maemong a thuto, thuto kapa maemo a khoebo ha ho kenyeletsoe ho litekanyetso tsa DSM-5 tsa IGD. Ntle le moo, IGD ha e kenyeletse ts'ebeliso e meng ea boithabiso kapa ea marang-rang ea sechaba. Ka mokhoa o ts'oanang, ts'ebeliso e fetelletseng ea lits'ebetso tsa inthanete tse nang le litaba tsa thobalano ha e qheleloe ka thoko. Ka bothata bo tsamaeang ba papali ea chelete ea ho becha sehlopheng sa mathata a amanang le lithethefatsi le lithethefatsi, DSM-5 e totobatsa ho tšoana lipakeng tsa mathata a tšebeliso ea lithethefatsi le bokhoba ba boitšoaro. Mabapi le bokhoba ba marang-rang, leha ho le joalo, ho ntse ho buisanoa ka khang ea hore na mohopolo oa ho lemalla o nepahetse ho hlalosa ketsahalo eo. Bangoli ba 'maloa ba pheha khang ea hore polelo e sa jeleng paate, e sa bolele hore motho ea lemaletseng boitšoaro, e ka ba molemo ha a bua ka boitšoaro bo sa laoloang le bo feteletseng ba inthanete (Kardefelt-Winther, 2014, 2017). Ka lehlakoreng le leng, ho na le lithuto tse ngata, haholo-holo tse tsoang ho pono ea methapo ea kutlo, e fumanang ho tšoana lipakeng tsa mathata a tšebeliso ea lithethefatsi le IGD (le mefuta e meng ea mathata a tšebeliso ea marang-rang) mme ka lebaka leo e lokafatsa khethollo e le tlhekefetso (Weinstein et al., 2017). Boemong ba boitšoaro bo sebelisang lipotso tsa lipotso, liphuputso tse ling, leha ho le joalo, li bonts'a hore mefuta e fapaneng ea bokhoba ba boits'oaro (ke hore, bothata ba papali ea chelete ea ho becha le mefuta e fapaneng ea ts'ebeliso ea ts'ebeliso ea marang-rang) e na le phapang e kholo har'a bona ha e bapisoa le ho ata ha litletlebo tsa boits'oaro le tšebeliso ea lithethefatsi (Sigerson et al., 2017), ho buella sehlopha se ikhethileng sa lithethefatsi tsa boits'oaro. Motho o tlameha ho elelloa, hore ho boetse ho na le phapang e kholo ho mefuta e fapaneng ea mathata a ts'ebeliso ea lithethefatsi (Shmulewitz et al., 2015), mme leha ho le joalo li khethollotsoe hammoho ka har'a sehlopha se le seng ho DSM-5. Ha re kene lipuisanong tse tebileng tsa sehlooho sena mona, empa ho latela pono ea rona, hoa utloahala ho sebelisa mohopolo oa tšebeliso e le moralo o le mong oa ho ithuta IGD le mathata a mang a tšebeliso ea tšebeliso ea Interne. Ka tlholeho, ho bohlokoa ho eketsa tlhahlobo mefuta e meng ea mohlala, mohlala, mehopolo ea mathata a taolo a susumetsang kapa mathata a ts'usumetso e matla, ho utloisisa sebopeho sa 'nete sa IGD. Ho sebelisa mekhoa e fapaneng ea thupelo ho ithuta IGD ho bohlokoa hobane bangoli ba bang ba pheha khang ea hore bothata bo bong ba lefapha lena la lipatlisiso ke ho hloka semelo sa thuto lithutong tse ngata (Billieux et al., 2015; Kardefelt-Winther et al., 2017). Re lumellana le polelo ea hore ho bohlokoa ho etsa lithuto tse susumetsoang ke khopolo-taba ho kenya letsoho kutloisisong e ntle ea metheo ea kelello e thehileng boitšoaro bo fetelletseng ba inthanete, mme re nahana hore mohopolo oa tlatsetso ke sebopeho se le seng se bohlokoa, se ka khothatsang maikutlo lithuto. Mohopolo oa bokhoba ba taolo o boetse o na le thuso ho theheng liprotheine tse khethehileng tsa kalafo tse ipapisitseng le liphihlelo tse kahara lefapha la mathata a ts'ebeliso ea lithethefatsi. Re boetse re pheha khang ea hore mefuta e meng ea tlhahlobo ea tšebeliso ea marang-rang e se e ntse e le teng (sheba karolo e ka tlase), empa e tlameha ho sebelisoa ka matla haholo lithutong tse matla tsa tlhahlobo ea maikutlo le ho eketsa bonnete ba mefuta ena. Ha re le temana ea ho qetela mabapi le polelo ea mantsoe re ka rata ho bua ka phapang ea bohlokoa pakeng tsa "ho lemalla Internet" le "ho lemalla inthanete," e boletsoeng ke Starcevic (Starcevic, 2013; Starcevic le Billieux, 2017). Re lumellana le maikutlo a hore inthanete ke mahareng feela a fanang ka menyetla e mengata ea boits'oaro bo fumanehang marang-rang mme ho bohlokoa ho utloisisa mekhoa e ikhethileng ea mefuta e fapaneng ea boits'oaro ho inthanete. Leha ho le joalo, ha re nahana hore tšebeliso ea bokhoba ba marang-rang e sebelisoa haholo ke bangoli ba bangata lebaleng, re ntse re sebelisa polelo ena ha re bua ka boitšoaro bo feteletseng ba inthanete. E lumellana le polelo ea DSM-5, re boetse re sebelisa poleloana ea tšebeliso ea marang-rang, e lokelang ho hlalosoa mabapi le boitšoaro bo ikhethileng ba inthanete (mohlala, ho sebelisa libaka tsa mabenkele, tšebeliso ea litšoantšo tse litšila tse tsosang takatso.).

Neurobiology ea Ts'oaetso ea Lipapali tsa Inthanete: Kakaretso e Khutšoanyane

Ha lipatlisiso tsa saense mabapi le bokhoba ba marang-rang ka kakaretso le IGD ka ho khetheha li eketsehile ka potlako lilemong tse fetileng tsa 20, ho se ho tloaelehile haholo ho sebetsana le li-amanang tsa neurobiological tsa ketsahalo ena ea bongaka. Tsebo e mabapi le mekhoa ea methapo ea IGD e na le bopaki ba tlatsetso ea liphatsa tsa lefutso, liphetoho tsa methapo ea kutlo, le li-link tsa ubongo tsa sebopeho le tšebetso tsa IGD (Weinstein et al., 2017).

Menehelo e ka bang teng ea liphatsa tsa lefutso le bokhoba ba marang-rang le IGD li amana le dopamine (Han et al., 2007), serotonin (Lee le al., 2008), le tsamaiso ea cholinergic (Montag et al., 2012). Boithuto bo senotse hore phapang ea matšoao a bokhoba ba marang-rang a ka hokahanngoa le menehelo ea liphatsa tsa lefutso ka ho fihla ho 48%, leha ho boetse ho na le phapang e utloahala lithutong tsohle (Deryakulu le Ursavas, 2014; Li et al., 2014; Vink et al., 2016; Hahn et al., 2017). Liphetho ha li bapisoa le se tsebahalang ka tlatsetso ea lefutso ho mafu a mang a kelello ho kenyeletsa le mathata a tšebeliso ea lithethefatsi (Egervari et al., 2017) le bokuli ba ho becha (Nautiyal et al., 2017). Menehelo ea liphatsa tsa lefutso ho lithethefatsi tsa inthanete e ka amana haholo le litšobotsi tse ling tsa kelello, joalo ka botho, joalo ka ha ho bonts'itsoe, ka mohlala, bakeng sa ho itaola (Hahn et al., 2017). Ho itaola ke e 'ngoe ea litšobotsi tse nepahetseng tsa botho bo mabapi le mathata a tšebeliso ea marang-rang (Sariyska et al., 2014; Gervasi et al., 2017).

Mabapi le lintho tse amanang le ts'ebetso ea IGD, boholo ba liphetho bo bonts'a libaka tse tšoanang ho IGD le ho lemalla lintho tse ling (mohlala, bothata ba ho becha) le mathata a ts'ebeliso ea lithethefatsi. Tlhahlobo e morao-rao e felletseng mabapi le liphetho tsa neuroimaging ho IGD ka Weinstein et al. (2017) e totobatsa hore lithuto tsa hajoale ka mekhoa ea neuroimaging e tšoana le liphetho tsa lithuto tseo mabapi le tšebeliso ea lithethefatsi (mohlala, ho nka karolo ha li-ventral striatum joalo ka mokhoa o hlophisitsoeng oa neural oa ho lakatsa le ho se sebetse libakeng tse ka pele tsa bokong tse emelang bofokoli ba taolo ea thibelo). Mona re akaretsa mehlala e meng ea liphetho tsa neuroimaging, feela. Sekhahla sa litaba tsa Grey e ne e le mohlala Yuan et al. (2011). Ba tlalehiloe ba fokotsehile ka taba ea bohlooho libakeng tse tlang pele ho nako ho kenyeletsa le dorsolateral preortal cortex le orbitofrontal cortex mohlala oa bacha ba nang le bothata ba ho lemalla inthanete. Phokotso ena ea pele e ne e hokahane le nako ea bokhoba ba tahi, e bonts'a hore liphetoho tsena tsa boko li ka bonts'a phokotso ea taolo ea thibelo. Mathata a taolo a taolo ea thibelo le ts'ebeliso ea kelello a tlalehiloe lithutong tse nang le ts'oaetso ea IGD / Internet, tse ka bapisoang le tse fumanoeng litsietsing tsa tšebeliso ea lithethefatsi (sheba tlhaiso ho Brand et al., 2014b). Phokotso ea litaba tsa pele-pele ea bohlooho le eona e tlalehiloe ke Weng et al. (2013)tse neng li hokahane le matšoao a ho teba ha litekanyetso ka tlhahlobo ea Tlhatlhobo ea Phallo ea Inthanete (Monyane, 1998a). Ka lehlakoreng le leng, ho boetse ho na le bopaki ba bophahamo ba litaba tsa bohlooho ho libapali tse fetelletseng, ka mohlala ho "ventral striatum"Kühn et al., 2011). Bophahamo bo phahameng ba "ventral striatum" bo ka bonts'a maikutlo a meputso e phahameng, e boetse e bontšitsoe ho batho ba nang le bothata ba tšebeliso ea lithethefatsi (cf. Goldstein le Volkow, 2002; Volkow et al., 2012). Leha ho le joalo, liphumano tse fapaneng le litheko tse tlase tsa "grey" ea litaba tsa ventral li tlalehiloe haufinyane maemong a ts'ebeliso e feteletseng ea Facebook (Montag et al., 2017a). Kaha lithuto tse ka sebetsoang tšimong ha li bapisoe ka ho toba le mohlala oa mohlala, moralo oa ho ithuta le ho sekaseka, lipatlisiso tse hlophisitsoeng haholoanyane ho bapisa mefuta e fapaneng ea mathata a ts'ebeliso ea marang-rang lia hlokahala.

Ho ata ha mathata a tšebeliso ea lithethefatsi, bokuli ba papali ea chelete, le IGD hoa totobala le ho feta ha ho nahanoa ka likarolo tsa tšebetso tsa boko. Mohlala o mong oa bohlokoa ke ts'ebetso e kholo ea "ventral striatum" ha e kopana le lintlha tse amanang le papali (Thalemann et al., 2007; Ko et al., 2009; Ahn et al., 2015; Liu et al., 2016). Phumano ena e bapisoa le e bonoang ho bakuli ba nang le bothata ba tšebeliso ea joala ha ba tobane le mekhoa e amanang le joala (mohlala, Braus et al., 2001; Grüsser et al., 2004). Mohlala o mong ke ts'ebetso ea pele ea cortex ha lithuto tse nang le IGD li etsa mesebetsi e sebetsang. Ho bonts'oa mosebetsi oa pele-ho ipapisitse le mosebetsi le libaka tsa pele tse kenyellelitsoeng ho lipatlisiso - ho eketsoa le ho fokotsoa ha ho bapisoa le lithuto tse phetseng hantle (mohlala, Dong et al., 2012, 2013, 2015; Brand et al., 2014b).

Ka kakaretso, ho na le bopaki bo bong ba ho kenyelletsa likarolo tsa boko ba pele le ba maiketsetso bokong ba IGD ka ho khetheha le tšebeliso ea lithethefatsi tsa inthanete ka kakaretso (cf. Kuss le Griffiths, 2012; Meng et al., 2015; Sepede et al., 2016), le - joalo ka ha ho bonts'itsoe morao tjena — ts'ebelisong e matla ea Liwebsaete tsa ho Etsa Metsoalle (He et al., 2017). Ts'ebetso ena ea boko e tsamaisana le ts'ebetso ea neuropsychological ho IGD, haholoholo ka ts'ebetso e fokotsehileng mesebetsing ea taolo e kholo le ea kelello (cf. Brand et al., 2014b, 2016), tseo le tsona li bapisoang le tse tlalehiloeng litsietsing tsa tšebeliso ea lithethefatsi, ho etsa mohlala ho bakuli ba nang le bothata ba tšebeliso e mpe ea joala (Zhou et al., 2014). Liphetho tsa neuropsychological li lumellana le likhopolo tse peli tsa ts'ebetso ea tahi (cf. Bechara, 2005; Everitt le Robbins, 2016), tse sa tsoa hlalosoa bakeng sa IGD (Schiebener le Brand, 2017) le bakeng sa ts'ebeliso e lemalloang ea libaka tsa marang-rang tsa bathoTurel le Qahri-Saremi, 2016). Boholo ba lipatlisiso tsa methapo ea kutlo bo tšehetsa pono ea ho nka IGD e le bothata ba ho lemalla, bo khothalletsang karohano mokhatlong oa DSM-5 oa mathata a amanang le lithethefatsi le bokhoba ba lithethefatsi (Weinstein et al., 2017).

Phephetso bakeng sa lilemo tse latelang tsa patlisiso ea methapo lefapheng la IGD ke ho bonts'a hore na liphetoho tsena tsa boko li tsamaellana le katleho ea kalafo, ho latela phetolo, empa hape le mabapi le hore na tlhekefetso ea boko e ka bolela katleho ea kalafo.

Mehlala ea Khopolo-taba

Ho tloha ha nyeoe ea pele-e tlaleha lilemo tsa 20 tse fetileng, liphuputso tse ngata li fuputse mohopolo oa bongaka ba mathata a ts'ebeliso ea marang-rang, o shebile haholo IGD. Joalokaha ho boletsoe ka holimo, bangoli ba bang ba bolela hore lipatlisiso tse ngata tsa bongaka mabapi le IGD le litekanyetso tse ling tsa boits'oaro ha li na semolao se hlakileng sa (Billieux et al., 2015; Kardefelt-Winther et al., 2017). Joalokaha ho hlalositsoe kaholimo, re lumellana le maikutlo a hore lithuto tse ngata tse neng li sheba ts'ebelisano 'meleng ea mafu a kelello kapa litšobotsi tsa botho tsa IGD ha lia ka tsa nahana ka semelo se hlakileng. Leha ho le joalo, re boetse re pheha khang ea hore likhopolo le lithuto tsa kelello tsa bokhoba ba marang-rang li se li ntse li le teng, tse ka bang molemo ho khothatsang mehopolo e hlakileng mekhoeng e tlatselletsang ts'ebetso ea bongaka ea IGD. Mefuta ea pele e ne e bua haholo ka likarolo tsa bokhoba ba marang-rang, mohlala mohlala oa karolo ea Griffiths (2005), e bileng le tšusumetso haholo, mohlala ka ho khothaletsa nts'etsopele e thehiloeng ke theolelo ea lisebelisoa tsa tlhahlobo (Kuss et al., 2013). Leha ho le joalo, likarolo tsa sebopeho li mpa li akaretsa matšoao eseng lits'ebetso tsa kelello tse amehang mathateng a ts'ebeliso ea marang-rang. Lilemo tse 'maloa hamorao, ho kile ha buelloa ka mefuta e' meli ea IGD kapa bokhoba ba marang-rang ka kakaretso. Mohlala ka Dong le Potenza (2014) e shebana le mekhoa ea boits'oaro ea IGD hape e kenyelletsa litlhahiso tse ling tsa kalafo. Ba pheha khang ea hore ho batla moputso kapele le ha ho na le litlamorao tse mpe tsa nako e telele ho bapala karolo ea mantlha ho IGD. Mokhoa ona oa ho etsa liqeto o nkuoa o tsamaisana le takatso ea ho susumetsa (ho lakatsa), ho bolelang hore o tlameha ho natefeloa ke thabo le sepheo sa ho fokotsa linaha tse mpe. Ho batla ho susumetsa ho nkoa ho laoloa ke ho lekola le mesebetsi e meng ea bolaoli 'me ho na le lithuto tse bontšang hore taolo ea thibelo e fokola ho batho ba nang le IGD (Argyriou et al., 2017). Ka mohlala oa bona, Dong le Potenza (2014) e kenyelletsa le likhetho tsa menyetla ea kalafo. Phekolo ea ntlafatso ea kelello le kalafo ea boits'oaro ea kelello li nkuoa li le bohlokoa bakeng sa ho fetola mokhoa oa ho etsa liqeto tse sa sebetseng le bakeng sa ho matlafatsa taolo ea thibelo ho se batlang. Ho fokotsa khatello ea kelello e thehiloeng kelellong ho nkuoa ho kenyelletsa phokotso ea ho batla-ho susumetsa ka ho fokotsa tšusumetso ea ho imoloha matšoenyehong le liphatlalatsong tse fosahetseng. Ho feto-fetoha ha leeme ka leihlo la kelello ho ka susumetsa maikutlo a moputso, le ona o kenyang sepheo sa ho batla. Ka kakaretso, mohlala ka Dong le Potenza (2014) e kenyelletsa ho sebelisana ha likarolo tsa bonohe (botsamaisi), mokhoa oa ho etsa liqeto, le likarolo tse khothatsang ho hlalosa IGD, eo ka kotloloho e ka rarolloang ka ho kopanngoa ha lipallo tsa kalafo tse fapaneng.

Moetso o mong oa IGD le ts'ebeliso ea lithethefatsi tsa inthanete ka kakaretso li hlahisitsoe ke Brand et al. (2014b). Mohlala ona o na le likarolo tse tharo tse fapaneng (kapa esita le mefuta e meraro e fapaneng): Ea pele e hlalosa ts'ebeliso e ntle ea ts'ebeliso ea Marang-rang, mohlala oa bobeli o ikemiselitse ho hlalosa nts'etsopele le ho boloka ts'ebeliso ea ts'ebeliso e mpe ea tšebeliso ea inthanete le ea boraro Karolo e hlalosa mekhoa e ka amehang mofuteng o itseng oa pherekano ea tšebeliso ea methapo, ho etsa mohlala, IGD. Mohlala oa ts'ebeliso ea ts'ebeliso ea marang-rang e totobatsa hore likopo tse ngata li ka sebelisoa bakeng sa boithabiso, ho baleha se etsahetseng le ho sebetsana ka katleho le maemo a khelohileng bophelong ba letsatsi le letsatsi. Leha ho le joalo, ho phehisanoa hore ts'ebeliso e sebetsang / e phetseng hantle e tsebahala ka hore marang-rang a sebelisetsoa ho khotsofatsa litlhoko le lipheo tse itseng mme a emisoa hang ha merero ena e phethahala. Karolo ea bobeli, mohlala oa tšebeliso ea tšebeliso ea marang-rang e sa reroang / kakaretso, o boetse o nka mekhoa ea ho sebetsana ka katleho e le ea bohlokoa. Leha ho le joalo, ho nahanoa hore ho ba kotsing ea ho ba le ts'ebetso ea kelello (tlhaselo ea maikutlo, khatello ea maikutlo, ho tšoenyeha ka setjhaba) ha ho sebetsanoa le mokhoa oa ho sebetsana le ts'ebeliso e mpe ea ts'ebeliso ea ts'ebetso le ts'ebeliso e itseng ea ts'ebeliso ea marang-rang e hlalosa phetoho ho tloha ts'ebetsong / ts'ebeliso e ntle ea ts'ebeliso ea ts'ebeliso ea ts'ebeliso ea marang-rang e sa laoloang, ntle le ho ba le ts'ebeliso e mpe ea taolo ea marang-rang kopo e hlakileng ea khetho. Maikutlo ana a lumellana le monahano oa bafuputsi ba bang ka tšebeliso e mpe ea marang-rang kapa mecha e meng ea litaba e shebaneng le karolo ea ho sebelisa media ka sepheo sa ho sebetsana le mathata le ho baleha taba ea nnete (Kardefelt-Winther, 2014, 2017). Tšebelisano 'moho ea lintho tse rerang esale pele (khatello ea maikutlo, ho tšoenyeha ka setjhaba) le bo-ramatsete ba sebetsanang le bothata ba tšebeliso ea ts'ebeliso ea marang-rang le ho sebelisa matšoao a hlalositseng matšoao a ts'ebeliso ea ts'ebeliso ea marang-rang a sa hlalosoang / a fumanehang ka bongata bo fumanoe ka sampole e kholo eo e seng ea bongaka le sebopeho sa tikoloho.Brand et al., 2014a). Karolo ea boraro mosebetsing ka Brand et al. (2014b) e ikemiselitse ho hlalosa bothata bo itseng ba tšebeliso ea marang-rang, mohlala, IGD. Ntle le lintlha tse boletsoeng esale pele tsa ho ba kotsing le ho sebetsana ka katleho le ho se sebetse hantle, mohlala o fana ka maikutlo a hore sepheo se ikhethileng sa ho sebelisa lits'ebetso tse khethehileng li kenya letsoho bothateng bo itseng ba tšebeliso ea marang-rang. Re boetse re pheha khang ea hore ts'ebetsong ea bokhoba, ho fokotsa taolo ea inhibitory ho thusa ho etsa liqeto tse sa rateheng bakeng sa likhetho tsa meputso ea nako e khuts'oane, e lebisang ho ts'ebeliso e fetelletseng ea ts'ebeliso e itseng (bona temoso bakeng sa lithuto mabapi le ho etsa liqeto le mesebetsi e phahameng. e boletsoeng ka holimo).

Lilemo tse peli hamorao, ho khothalelitsoe mokhoa o ntlafalitsoeng oa mathata a itseng a ts'ebeliso ea Marang-rang. Ho ipapisitsoe le likhopolo tse ncha tsa theoretical le liphetho tse matlafatsang tsa morao-rao, ho ile ha hlahisoa mokhoa oa ho sebelisana le motho oa motho ea amanang le ts'oaetso (I-PACE) oa mathata a itseng a ts'ebeliso ea marang-rang (Brand et al., 2016). Moetso oa I-PACE ke moralo oa thuto bakeng sa lits'ebetso tse inahaneloang, tse thehang nts'etsopele le tlhokomelo ea ts'ebeliso e lemalloang ea lits'ebetso tse ling tsa inthanete, joalo ka lipapali, papali ea chelete, ts'ebeliso ea litšoantšo tsa bootsoa, ​​mabenkeleng le puisano. Moetso oa I-PACE o qapiloe e le mofuta oa ts'ebetso, ho kenyeletsoa mefuta e reriloeng esale pele hammoho le mefuta ea motsamaisi le mokena-lipakeng. Ho utloisisa karolo ea (e fetohang) ea ho lekanyetsa le ho tsekela mefuta e fapaneng hamolemo ho ka khothatsa kalafo ka kotloloho (bona karolo e latelang mabapi le litlamorao tsa kalafo). Mathata a ikhethileng a ts'ebeliso ea Marang-rang a nkuoa a le teng ka lebaka la litšebelisano lipakeng tsa melaoana ea methapo ea kutlo le ea kelello (mefuta e sa lebelloang) le maemo a ho lekola, joalo ka setaele sa ho sebetsana le maemo le ts'ekamelo e amanang le inthanete, hammoho le lipakeng tse fapaneng, joalo ka tse amang maikutlo le liphetoho tsa kutloisiso ho lisosa tsa maemo li kopane le taolo e fokotsehileng ea thibelo. Ka lebaka la lits'ebetso tsa maemo, mekhatlo ena e ba matla le ho feta nakong ea ts'ebeliso ea lithethefatsi. Likamano tse kholo tsa litšobotsi tsa mantlha tsa motho (mohlala, botho, psychopathology) le likarolo tse itseng (mohlala, takatso, tšusumetso ea ho natefeloa, kapa ho fokotsa maikutlo a mabe), likarolo tsa kutloisiso (mohlala, mokhoa oa ho sebetsana ka katleho, litloaelano tse ntle), mesebetsi ea phethahatso , le ho nka liqeto nakong ea nts'etsopele le tlhokomelo ea bothata bo itseng ba ts'ebeliso ea Marang-rang, joalo ka ha ho akaretsoe ka mofuta oa I-PACE, ho bontšoa ho Setšoantšo. 1.

 

Setšoantšo sa 1. Mofuta oa mofuta oa I-PACE o fokotsehileBrand et al., 2016).

Moetso oa I-PACE o ikemiselitse ho akaretsa mekhoa eo e amanang le mefuta eohle ea mathata a itseng a ts'ebeliso ea inthanete. Ka lebaka leo, ha ho lintlha tse ikhethang tsa lipapali tse kentsoeng. Le ha ho le joalo, ha se taba ea mantlha ea sengoloa sena, re pheha khang ea hore lipapali li tlisa meputso e mengata, e tlatsetsang ho nts'etsopele ea IGD motheong oa ts'ebetso le menyetla ea maemo a tlase ea meputso. Lipapali tse ngata li etselitsoe hore e be tse rarahaneng ho ba phephetso le ho lumella libapali ho fihlella tseo li li etsang, tse etsang hore li lule li bapala. Likarolo ka bobeli tsa botho, tse kang ho fihlela lipheo, le ho sebetsana le sechaba, joalo ka ho buisana le libapali tse ling, ke likarolo tsa mantlha tsa lipapali tse ngata mme li kenya letsoho ho "boiphihlelo bo nepahetseng" kapa maikutlo a ho phalla ha o ntse o bapala (Choi le Kim, 2004). Monyetla oa ho fumana lintlha tse phahameng ke e 'ngoe ea li-hook tse bonojoang habonolo, kaha libapali li lula li leka ho otla lintlha tse phahameng mme sena se ka etsoa ka ho sa feleng lipapaling tse ngata. Lipapaling tsa papali tse bapalang karolo ea inthanete, libapali li leka ho fihlela boemo bo holimo (“ho nyoloha”), matla a eketsehileng le ho ananeloa ke libapali tse ling. Katleho, kapa ka mokhoa o qaqileng haholoanyane litekheniki e le sekhahla sa katleho, hammoho le ho baleha e ne e hlile e le baqapi ba hlakileng ba mathata a amanang le papali thutong e felletseng ke Kuss et al. (2012). Khohlano e 'ngoe ea lipapali tsa inthanete ke hore libapali tse ngata li rata ho ikamahanya le libapali tsa bona tsa papali (E monyenyane, 2015). Ntle le sena, karolo ea bohlokoa ea lipapali tse ngata e qala kapa e boloka likamano tsa sechaba (Cole le Griffiths, 2007). Hangata libapali li etsa setsoalle le libapali tse ling, 'me ke metsoalle ena eo e kanna ea kopa libapali ho tsoelapele ho bapala kapa ho eketsa nako e sebelisoang ho bapala. Ha e le hantle, esita le lipapaling tsa likhukhuni, libapali tse ngata li tlaleha ho bapala ka lihlopha. Mohlala, thutong e mabapi le botho ba libapali tsa lithunya ka Montag et al. (2011), 90% ea litho tsa 610 e tlaleha ho bapala khafetsa e le sebapali sa sehlopha. Kameho ea litšebelisano tsa sechaba bakeng sa libapali tse ngata le eona e fuputsoe lithutong tse telele ka Billieux et al. (2013). Ba fumane hore tse sibolotsoeng hammoho le tšebelisano ke tsona tse boletsoeng esale pele ka ho fetisisa tsoelo-peleng ea lipapali tsa inthanete. Liphetho tsena li tsamaisana le mohlala oa lintlha tse tharo (ho kenyeletsa le lintlha tse ka tlase tsa 10) tse reriloeng ke Yee (2006). Moetso ona o fana ka maikutlo a hore katleho, likarolo tsa kahisano le ho qoelisoa ke tsona likarolo tsa mantlha tsa tšusumetso ea libapali. Moetso ona o se o hlahlobiloe liphuputsong tse ngata mme menahano ea mantlha e netefalitsoe maemong a mangata. E ipapisitse le khopolo-taba ea boits'oaro ba sechaba, phuputso ea morao tjena (De Grove et al., 2016) o thehile sekala se lekanyang sepheo sa ho bapala lipapali tsa marang-rang (kapa ka tsela e batsi lipapali tsa dijithale). Ba boetse ba fumane lintho tse kopaneng ho kenyelletsa ts'ebetso, likarolo tsa sechaba, le seo ba se bitsang qaqiso (e bapisoang le sebaka sa ho sibolla) hammoho le lintlha tse ling (mohlala, escapism, tloaelo) ho ba lisosa tse kholo tsa ho bapala lipapali tsa marang-rang (bona hape Demetrovics et al., 2011). Ka kakaretso, sepheo se nepahetseng sa ho bapala lipapali ke katleho (kapa ts'ebetso), litšebelisano tsa sechaba, le ho baleha / ho sibolla. Le ha ho le joalo, sepheo sena se ikhethileng ha se kenyelelitsoe ka mokhoa o hlakileng oa mofuta oa I-PACE, li emela sepheo sa ho sebelisa ts'ebeliso e itseng, e emeloang ke "ho sebelisa sepheo" mohlaleng ona mme mohlomong o ka hlalosang hore na ke hobaneng batho ba bang ba theha IGD. Hape, sepheo se ka hlalosa lebaka leo batho ba bang ba nang le matšoao a boloi ba tšebeliso ea litšoantšo tse litšila tse tsosang takatso inthaneteng, mohlomong hobane ba na le thabo e phahameng ea thobalano kapa tšusumetso e phahameng ea thobalano (Laier et al., 2013; Laier le Brand, 2014; Stark et al., 2015). Ts'ebetso ena ea ho sebelisa e nkuoa e le litšobotsi tsa mantlha tsa motho ka hona ke tsa bohlokoa esale pele tsa nts'etsopele le tlhokomelo ea IGD kapa mathata a mang a ts'ebeliso ea inthanete. Leha ho le joalo, re pheha khang ea hore mabaka ana ha a susumetse ka kotloloho nts'etsopele ea IGD. Le ha ho le joalo, ho na le monyetla oa hore IGD e hlahe ho batho ba nang le sepheo se phahameng haholo se amanang le papali, ho khotsofatsa kapa ho matlafatsoa hampe ho nang le boiphihlelo ha ba ntse ba bapala le ho tsamaellanang le sepheo sa ts'ebeliso ho potlakisa nts'etsopele ea litlatsetso tse amanang le papali (mohlala, leeme, tlhokomelo e totobetseng le lipapali) le litebello tse ikhethang tsa tšebeliso ea papali. Lintlha tsena tsa kutloisiso li etsa hore ho be le monyetla o moholo oa ho hlahisa boithaopo le ho lakatsa maemong ao ho ona motho a tobanang le tšusumetso e amanang le papali, kapa maemong a maikutlo a mabe kapa khatello ea maikutlo bophelong ba letsatsi le letsatsi. Likamano tsena tsa sepheo, ho fana ka maikutlo a khotsofalo ha o bapala, le liphetoho tsa kutloisiso e hlakileng le e hlakileng le likamano tse matla maemong a amanang le papali li nkuoa e le lits'ebetso tsa mantlha tse tlisang nts'etsopele le tlhokomelo ea IGD (bona Setšoantšo. 1).

Le ha ho le joalo, mofuta oa I-PACE ke oa kelello ebile menahano e mabapi le mekhoa e ka fokotsang nts'etsopele le ho boloka mafu a itseng a ts'ebeliso ea marang-rang e lokela ho hlahlojoa ka botlalo, meelelo ea kalafo e ka khethoa. Karolong e latelang, re akaretsa mekhoa e meng ea kalafo ea morao-rao ebe re e hokahanya le menahano ea khopolo-taba e akaretsoang mohlaleng oa I-PACE. Leha ho le joalo, mohlala oa I-PACE o ikemiselitse feela ho hlalosa nts'etsopele le tlhokomelo ea matšoao a IGD le mathata a mang a ts'ebeliso ea inthanete. Ho bohlokoa ho hlokomela hore IGD (kapa e bapalang lipapali tsa khomphutha le livideo, bonyane ha lipapali li bapaloa ntle le ho tloha lapeng kapa ntle le boikoetliso ba 'mele) hangata li hokahantsoe le litlamorao tse ling tsa' mele (physiological), joalo ka botenya ho bana le ho bacha. tse amanang le phokotso ea boleng ba ho robala le ho noa lino tse tahang haholo (Turel et al., 2017). Mathata a joalo a eketsehileng ha aa lokela ho hlokomolohuoa kalafong ea IGD. Leha ho le joalo, lihlooho tsena tse ling ha li kenyelletsoe mohlaleng oa I-PACE ka hona ha li rarolloe ka karolo ea liphetho tsa kalafo.

Liphello tsa kalafo

Le ha ho le joalo, sebopeho sa IGD le mekhoa ea kelello e ka tlase e ntse e tsekisanoa (bona puisano e khutšoane kenyelletsong), bohlokoa ba kliniki ea ketsahalo ena bo hlakile. Ka lebaka leo, ho hlokahala hore ho fanoe ka lipheo tsa kalafo tse loketseng ho thusa bareki ho tlohela lipapali kapa ho fokotsa boitšoaro ba papali. Sengoliloeng sena, ha re na sepheo sa ho fana ka tlhahlobo e hlophisehileng ea ho kenella ha kliniki ho IGD, ho kenyelletsa ts'ebetso ea psychotherapy le ea lipilisi, e ka fumanoang libakeng tse ling (Kuss le Lopez-Fernandez, 2016; King et al., 2017; Nakayama et al., 2017).

Boholo ba lithuto li hlahlobe ts'ebeliso ea Cognitive-Behahlangual Therapy (CBT) bakeng sa kalafo ea ho lemalla lithethefatsi tsa inthanete ka kakaretso kapa IGD ka ho khetheha (Dong le Potenza, 2014; King le Delfabbro, 2014), le tlhahlobo ea pele ea meta e fumane hore CBT e ntlafalitse mekhoa e meng ea kalafo ea kelello ha e bua ka nako e sebelisitsoeng ho boits'oaro ba inthanete (Winkler et al., 2013).

Mona re tsepamisa mohopolo mofuteng o le mong oa ho kenella, CBT bakeng sa ts'ebeliso ea lithethefatsi tsa inthanete (CBT-IA), le hore na mokhoa ona oa kalafo o amana joang le mofuta oa I-PACE. CBT-IA e hlophisitsoe ka ho khetheha bakeng sa ho phekola bokhoba ba marang-rang ka ho kopanya likarolo tsa khale tsa CBT le litaba tse ikhethileng tse amanang le inthanete (E monyenyane, 2011). CBT-IA e na le mekhahlelo e meraro: (1) Behaeve modified, (2) phumano ea kutloisiso ea kelello, le (3) phetoho e mpe. Mekhahlelo ena e meraro e hlalositsoe ka botlalo ho litemana tse latelang. Thutong ea sephetho le bakuli ba 128 ba lemaletseng Inthanete (E monyenyane, 2013), CBT-IA e fumanoe e sebetsa hantle ho fokotsa matšoao, ho fetola likhopolo tse sa nepahalang, le ho sebetsana le mabaka a mantlha a botho le a amanang le matšoao a bokhoba ba marang-rang. Haufinyane tjena, mofuta oa CBT-IA o ka sebelisoa maemong a IGD. Maemong ana, likarolo tse amanang le inthanete tsa CBT-IA (mohlala, likhopolo tse fosahetseng mabapi le ts'ebeliso ea inthanete) li ka hlalosoa mabapi le lipapali tsa inthanete (E monyenyane, 2013).

Khafetsa, kalafo e lokela ho qala ho lekola tšebeliso ea hajoale ea moreki ea li-skrini tsohle le mahlale a morao-rao. Le ha ho le joalo, litlhahlobo tsa ho noa hangata li akaretsa ebile li koahela matšoao a nepahetseng a mafu a kelello ho kenyelletsa boits'oaro bo lemalloang, matšoao a IGD, kapa mefuta e meng ea mathata a ts'ebeliso ea inthanete hangata a hlokomolohuoa lipuisanong tsa tloaelo ea bongaka ka lebaka la bocha ba eona. Lingaka tse ling ha li tloaelane le IGD le mefuta e meng ea lithethefatsi tsa inthanete mme ka hona ba ka hlokomoloha matšoao a teng a lefu lena. Re pheha khang ea hore ho bohlokoa hore baoki ba tloaetse ho lekola matšoao a teng a ts'ebeliso e fetelletseng le e sa laoleheng ea inthanete ka kakaretso le IGD ka ho khetheha.

Ka ho ba teng hoa lits'ebetso tsohle tsa inthanete ho bohlokoa hore ka bomong ho nts'etsopele lenaneo le hlakileng la ho hlaphoheloa le moreki e mong le e mong mabapi le ts'ebeliso ea inthanete le tšebeliso ea mecha e meng ea phatlalatso kapa theknoloji ea skrine (ho kenyeletsoa lipapali tsa video). Batho ba nang le temallo ea lijo kapa litloaelo tsa ho ja ho tlola ba lekola karolo ea katleho ea bona ka ho supa matšoao a joalo ka tekanyo ea ho ja lijo tse matla le ho theola boima ba 'mele. Ka papiso ena, kalafo ea bakuli ba nang le IGD e lokela ho lekanya karolo ea katleho ea ho fola ka ho fokotseha lihora tsa inthanete, ho ja lijo tsa dijithale le ho se ikopanye le ts'ebeliso efe kapa efe ea ts'ebeliso e mpe ea marang-rang, eo IGP ke papali e ikhethileng ea inthanete. Sena ke seo bangoli ba bang ba reng ke phepo ea dijithale, mohopolo o hlahisitsoeng ke Jocelyn Brewer ho 2013 (http://www.digitalnutrition.com.au/). Leha ho le joalo, phepo ea dijithale ha e bolele ho itšunya-tšunya ho botlalo ho lisebelisoa tsohle tsa skrineng kapa lits'ebetso tsa inthanete, empa mokhoa o phetseng hantle o sebetsang, o sebetsang oa ho sebelisa marang-rang le lisebelisoa tsa media.

Phepo ea dijithale ke mofuta oa leano la thibelo ea ho theha ts'ebeliso e ntle le e sebetsang ea mahlale. Ha batho ka bomong ba e-na le bothata ba setšoantšo sohle sa matšoao a IGD, kalafo e lokela ho thusa bakuli ho ithiba ho bapala le ho sebelisa marang-rang bakeng sa merero e meng ka mokhoa o itekanetseng. Ona ke mohato o thata ka ho fetesisa, e leng mohato oa 1 oa CBT-IA o bitsoang phetoho ea boits'oaro. Lingaka li hloka ho lekola ts'ebeliso ea bareki le marang-rang ea bareki le ho thusa bareki ho lokisa puisano le mahlale a media le skrineng. Sena se boetse se bolela tšusumetso le taolo ea maemo, ho kenyeletsoa le ho tataisa bareki ho fetola maemo lapeng kahoo ho tla ba bonolo hore ba se sebelise papali. Ka mohlala sena se ka kenyelletsa ntlafatso ea likhomphutha. Boitšoaro bo latelang bo fetoha lipheo tse ling tsa kalafo, mohlala ho khona ho phethela mesebetsi ea letsatsi le letsatsi, ho boloka tloaelo e tloaelehileng bophelong ba letsatsi le letsatsi, le ho qeta nako kantle ho Marang-rang le batho ba bang (mohlala, lipapaling kapa mekhatlong) kapa tsepamisa maikutlo ho tse ling tsa boithabiso. Batho ba nang le IGD ba hloka ho ts'oaroa hape ke lintho tseo ba li ratang pele ho papali kapa ba fumane mesebetsi e mecha eo ba ka ithutang ho e rata e le karolo ea ho ithiba lipapaling. Ha o kopanya mofuta oa I-PACE le CBT-IA, karolo ea 1 ea CBT-IA (phetoho ea boits'oaro) e shebana haholo le maemo a boemo le qeto ea ho sebelisa ts'ebeliso e itseng (bona Setšoantšo. 2).

 

Setšoantšo sa 2. Ho kopanngoa ha likarolo tsa CBT-IA le mekhoa e meng ea kalafo e tsoelang pele ho mofuta oa I-PACE (Brand et al., 2016).

Haholo-holo, ho sebelisa mofuta oa I-PACE le mofuta oa CBT-IA, ho bohlokoa ho lekola mekhoa ea boits'oaro ba moreki le leeme le amanang le inthanete hammoho le likarabo tse matla le tsa kelello papaling. Ena ke sehlooho sa sehlooho sa karolo ea 2 ea CBT-IA: Ho hlophisoa bocha ha kelello. Batho ba nang le IGD ba na le mathata a kelello a ba bolokang ba kenella papaling eo. Mohlala, ba kanna ba ikutloa ba jeoa ke bolutu, ba hloka phomolo, kapa ba bile ba sithabetse maikutlo empa ha ba ntse ba bapala papali ea inthanete, sebapali sa inthanete ke mohlabani ea matla ea itšepang ebile a ratoa haholo. Moreki ea nang le boitšepo bo tlase a ka inka a sa ratehale empa a na le maikutlo a hore papali ke mokhoa oa ho eketsa boitlhompho ba hae. CBT-IA e sebelisa ntlafatso ea kelello ho roba paterone ena ea likhakanyo tse mpe le ts'ebeliso ea marang-rang (E monyenyane, 2013). "Ts'ebetsong ea ts'ebeliso ea kelello e thusa ho beha maikutlo le maikutlo a mofani" tlas'a microscope "ka ho mo phephetsa 'me, maemong a mangata, ho ngola hape menahano e fosahetseng e ka morao ho eena" (E monyenyane, 2013, leq. 210). CBT-IA e ka thusa bakuli ba nang le IGD ho utloisisa hore ba sebelisa papali ea marang-rang ho qoba maikutlo a fosahetseng kapa ho baleha ho tsoa ho nnete le hore ba nahana hore ba fumana maikutlo a nepahetseng ha ba bapala papali ha ba bapisoa le ketsahalo efe kapa efe ea letsatsi le letsatsi. Sena ka linako tse ling se thatafalloa ke bareki, empa ho bohlokoa hore katleho ea kalafo e utloisise le ho fetola menahano ena e fosahetseng. Hape, mohopolo oa bobeli ba I-PACE le CBT-IA ke ho hlahloba mekhoa ea ho khotsofala ka ho bapala papali le litlhoko tse sa khotsofatseng bophelong ba 'nete le tse fanang ka tefo ka ho bapala ka mokhoa o fetisisang (E monyenyane, 2013; Brand et al., 2016).

Ho hlophisoa bocha ba kelello le bareki ho bohlokoa hape ho thusa bareki ka IGD ho lekola botjha hore na litlhaloso tsa hae le maikutlo a hae li nepahetse hakae ebile li nepahetse. Mohlala, moreki ea sebelisang lipapali tsa marang-rang e le tsela ea ho ikutloa a le betere ka bophelo ba hae le ho ikutloa a le matla, a le matla hape a tsebahala o tla qala ho hlokomela hore o sebelisa papali ea inthanete ho khotsofatsa litlhoko tse sa khotsofatseng bophelo ba hae ba nnete. Moelelong ona, CBT-IA e thusa moreki ho theha maano a ho sebetsana le khatello ea bophelo bo botle le maikutlo a fosahetseng le ho fumana mekhoa e metle ea ho itšepa le ho etsa boiketlo le ho theha likamano tse tsitsitseng tsa batho.

Joalo ka litumelong tse ngata, karabelo e atileng haholo bathong ba bonang ba na le bothata ka papali ea marang-rang ke “ho itlosa molato le ho itlhatsoa.” Ho hlaphoheloa ha 'nete, bonyane ho libapali tse ngata, ho kenyelletsa ho sheba sepheo le litebello tse lebelo ho tse boletsoeng. tloaelo ea papali. Phekolo e boetse e tlameha ho thusa bareki ho lemoha, ho rarolla le ho alafa mathata a hlahang hammoho le IGD, e leng eona taba ea mantlha ea CBT-IA phase 3: Phokotso ea kotsi. Haholo-holo, khatello ea maikutlo le khatello ea maikutlo ea sechaba li lokela ho phekoloa.

CBT-IA e ka tlatsana le boikoetliso ba morao-rao bo khothalelitsoeng, bo hlahlojoang hantle maemong a tšebeliso ea lithethefatsi. Mohlala o mong ke ho khopamisa likhopolo tse ling tse sa bonahaleng, tse ka bakang tšireletso ho e-na le ho tloaela ho tloaela mekhoa ea ha motho a lakatsa (Wiers et al., 2011; Eberl et al., 2013a,b). Mananeo a thibelang motho kelello (mohlala, Schoenmaker et al., 2010; Christianen et al., 2015) e ka ba molemo ho eketsa taolo ea thibelo ea bareki (mohlala, Houben le Jansen, 2011; Houben et al., 2011; Bowley et al., 2013). Sena se ka etsoa ka mohlala ka ho sebelisa mesebetsi ea Go / No-Go le ts'usumetso e amanang le bokhoba. Leha ho le joalo, lithuto tsa nakong e tlang li tlameha ho bonts'a hore mekhoa ena e na le thuso bakeng sa ho eketsa taolo ea thibelo maemong a IGD. Phekolo ea maqhubu a CuePark et al., 2015) e ka ba molemo ho fokotseng botebo ba litakatso tse nang le boiphihlelo (Pericot-Valverde et al., 2015), e lumellanang le liphumano tsa morao-rao tsa neuroimaging ho IGD (Zhang et al., 2016).

Ts'ebetso ea mehopolo ea mantlha ea I-PACE mabapi le lits'ebetso tse ka bang teng ho nts'etsopele le tlhokomelo ea IGD le mathata a mang a ts'ebeliso ea marang-rang le tse ling tsa mekhoa ea kalafo e sebetsang ka ho fetesisa (CBT-IA le mekhoa e meng ea tlatsetso) e bontšoa ho Setšoantšo. 2. Le ha ho le joalo, palo ena e tsepamisitse mohopolo oa I-PACE, e fapana haholo le likhopolo tse hlahisitsoeng ke bangoli ba bang (Dong le Potenza, 2014). Joalokaha ho hlalositsoe kaholimo mohlaleng oa bona, Dong le Potenza (2014) o re pheko ea boits'oaro ba boits'oaro le kalafo ea ntlafatso ea kelello e bohlokoa bakeng sa ho fetola mokhoa oa ho etsa liqeto le ho eketsa taolo e thibelang ts'usumetso ea ho sebelisa lipapali tsa inthanete. Phetoho ea khethollo ea kelello, e ka bapisoang le se bitsoang ntlafatso ea kelello ho CBT-IA, e thusa ho susumetsa litebello tsa bareki ho fumana moputso ha ba bapala papali eo (Zhou et al., 2012). Lithuto tsa nako e tlang le tsona li lokela ho batlisisa hore na marang-rang a marang-rang ka boeona a na le thuso e kae ho thusa bareki. Liphuputso tse ling tsa morao-rao li shebile Lisebelisoa tse tataisang bareki bophelong ba letsatsi le letsatsi le tse ba thusang ho fokotsa khatello ea maikutlo (mohlala, ka phokotso ea khatello ea kelello) kapa ho sebetsana hamolemo le maikutlo a mabe, empa Lisebelisoa tse joalo li ka shebella nako ea moreki e sebelisitsoeng marang-rang, eo hape e ka bang molemo bakeng sa kalafo. Kakaretso ea morao-rao ea menehelo ea li-psychoinformatics ho phekola bokhoba ba inthanete e ka fumanoa ho Montag et al. (2017b).

Hobaneng ho thusa ho hokahanya mehlala ea maikutlo a mathata a tšebeliso ea marang-rang (joalo ka I-PACE) le mekhoa e teng ea kalafo (joalo ka CBT-IA) bakeng sa lipatlisiso le boikoetliso ba bongaka? Re pheha khang ea hore mehlala ea maikutlo e na le sepheo sa ho akaretsa mekhoa e meholo e tlatselletsang nts'etsopele le ho boloka moferefere. Mefuta ena e bohlokoa molemong oa ho hlakisa li-hypotheses tsa ts'ebetso lits'ebetsong tse nahanoang. Haeba re utloisisa hofihlella lits'ebetso tsa mantlha tse kenyelletsoang tlhahisong ea bokhopo, re ka hlahloba hore na lits'ebetso tsena li rarollotsoe ka mekhoa e teng ea kalafo, mme haeba ho se joalo, hore na li-protocol tsa kalafo li ka tlatsana joang le mekhoa e meng e ikhethileng. Ka lehlakoreng le leng, lithuto mabapi le katleho ea mekhoa ea kalafo li ka khothatsa le mehlala ea maikutlo a lefu lena. Haeba re bona ka mohlala hore ntlafatso ea kelello e thusa haholo ho bareki, ho hlakile hore mekhoa ea ho lemoha (mohlala, litebello) e bohlokoa haholo polokelong ea mafu, mme mehlala e teng e ka hlahlojoa haeba ba nahanne lits'ebetso tsena ka nepo. Ka bokhutšoanyane, kamano pakeng tsa mehlala ea maikutlo le kalafo e hloka maikutlo. Kamano ena e akaretsoa ka Setšoantšo 3.

 

Setšoantšo sa 3. Kamano ea bidirectional pakeng tsa mehlala ea lithuto le lithuto tsa bongaka.

Ha re kopanya mofuta oa I-PACE le mofuta oa CBT-IA, rea bona hore likarolo tse tharo tse kholo tsa aterese ea CBT-IA ka ho khetheha mefuta eo e nkoang e le maemong a phetisetso le phehisano molemong oa I-PACE. Rea bona, leha ho le joalo hore boholo ba CBT-IA bo ka tlatsana le mahlale a tlatsetso (likhalase tse nyane ho Setšoantšo. 2). Ka bobeli mofuta oa I-PACE le oa CBT-IA o boetse o na le thuso ho ntlafatseng lisebelisoa tse ncha tsa tlhahlobo bakeng sa tloaelo ea bongaka. Mohlala, haeba re bona lithutong tse susumetsang hore litebello tse sebelisoang Inthaneteng li kenella haholo ho hlalosa matšoao a mathata a tšebeliso ea marang-rang (Brand et al., 2014a) mme rea bona hore ntlafatso ea kelello e bohlokoa ho fetoleng litebello tsena (E monyenyane, 2013), ho ka ba molemo ho ba le lisebelisoa tse netefalitsoeng tse lekanyang ts'ebeliso ea ts'ebeliso ea inthanete bakeng sa tloaelo ea bongaka. Ho ka ba molemo hape ho kenyelletsa bothata bona mananeong a thibelo. Setšoantšo 3 e ikemiseditse ho akaretsa likamano tse tlatselletsang lipakeng tsa likhopolo (le lithuto tse matlafatsang mabapi le lits'ebetso) le ts'ebetso ea bongaka e kenyelletsang ho hlahloba, thibelo le kalafo. Kaha melao ea theoretical le mekhoa ea kalafo (le tlhahlobo le thibelo) ha e tsoe e le tsa ho qetela kapa tse phethahetseng, ho bohlokoa ho ela hloko hore na libaka tsena tse peli li ka sebelisana joang ka katleho le ho susumetsa e mong le e mong ho eketsa ts'ebeliso e nepahetseng.

Nahanisisa

Pampiri ena e lekola lithuto tse tšoanelehang tsa neurobiological tse amanang le nts'etsopele ea IGD, mehlala e meng ea khopolo ea ntlafatso le tlhokomelo ea IGD le mathata a mang a ts'ebeliso ea marang-rang, le litlamorao tsa kalafo ho bareki ba lemaletseng ba sebelisa meetso ea I-PACE le CBT-IA.

Boithuto ba morao-rao ba morao-rao bo bonts'a hore IGD le litekanyetso tse ling tsa boits'oaro (mohlala, bothata ba papali ea papali ea chelete) hammoho le mathata a ts'ebeliso ea lithethefatsi li arolelana lintho tse ngata tse tšoanang. Lintho tse ts'oanang li ka bonoa ho limolek'hule (mohlala, tlatsetso ea liphatsa tsa lefutso), li-neurocircuitry (mohlala, dopamine fronto-striatal loops ho kenyelletsa le ventral striatum le likarolo tse 'maloa tsa preortalal cortex), le litekanyetso tsa boits'oaro ho kenyelletsa tse sa bonahaleng (mohlala, leeme ka hloko) le ho hlaka. maikutlo le mehopolo (Brand et al., 2016). Ha re ntse re fetela pele, tlhahlobo ea IGD e na le litlamorao tse ngata ho tsoa maemong a kliniki, a thuto le a setso.

Ka karolelano, tlhokomelo le koetliso tse ngata li lokela ho sebelisoa koetlisong ea tlhabollo, likolo le litsi. Ka lebaka la bocha ba eona, matšoao a IGD a ntse a hlokomolohuoa ke lingaka tse ling. Ka hona, ho bohlokoa hore baoki ba koetlisoe lits'ebetsong tsa tlhahlobo le ho hlahloba khafetsa hore na ho na le ts'ebeliso e ngata e sa laoleheng ea inthanete mekhoeng ea bona. Ntle le moo, baoki ba lokela ho koetlisoa kalafo ea IGD le mefuta e meng ea ts'ebeliso ea ts'ebeliso ea marang-rang. Liprotheine tsa kalafo li tlameha ho ithutoa le ho ntlafatsoa. Ehlile, le ha data ea sephetho sa pejana e bonts'a CBT-IA e fana ka mokhoa o sebetsang oa ho thusa bareki ho boloka mokhoa o motle oa inthanete, lithuto tse tsoelang pele li lokela ho hlahloba mekhoa e meng ea kalafo e kang kalafo ea sehlopha, kalafo ea lelapa, le Ka vivo tlhabollo ho shebella katleho ea bona e kopaneng ea kalafo.

Haeba kannete IGD e nkuoa e le pherekano ena e ka ba le litlamorao ho litsamaiso tsa sekolo ho nts'etsapele melaoana e bohlale e sireletsang bana le bacha ho tsoa mathateng a IGD Ho ka ba molemo ho thusa matichere ho fumana koetliso ea ho khetholla liithuti tse kotsing e kholo ea ho holisa IGD. Ho ka ba molemo ho batsamaisi ba likolo ho theha maano a tšebeliso ea mahlale a baithuti ka litlelase ho thibela IGD hore e se ke ea etsahala, maano a ka kenyelletsa tšebeliso ea skrineng ka phapusing, melaoana ea lipapali, le khothatso ea lihlopha tsa sechaba sekolong.

Ka lehlakoreng le leng, hoa utloahala ho hlokomela hore ho na le meeli e 'maloa ea boemo ba morao-rao lipatlisisong tsa IGD. Ho na le ngangisano e tsoelang pele mabapi le ho khetholla batho, mekhoa ea ho khetholla lintho le lisebelisoa, ho nahana ka mokhoa oa tlatsetso kapa mofuta o mong oa bothata, le mathata a mang a mangata a sa rarolloeng kapa mathata a lipatlisiso tse reretsoeng ho utloisisa mofuta oa IGD le mathata a mang a ts'ebeliso ea marang-rang. Ka lebaka leo, ho tlamehile hore o se sebelise ho fetisa ts'ebeliso e nepahetseng ea inthanete ka kakaretso kapa lipapali, ha feela ts'ebeliso e kopantsoe bophelong ba letsatsi le letsatsi ntle le ho ba le litlamorao tse mpe.

Mehlala ea thuto ea morao-rao e ka khothatsa lithuto tse matla tse batlisisang mofuta oa IGD le mathata a mang a ts'ebeliso ea inthanete. Ho bohlokoa ho sebelisa mehlala ena ho qolla mantsoe a hlakileng a lipatlisiso lithutong tse tlang. Litaba tse nepahetseng le tse fapaneng li lokela ho rarolloa ka mokhoa o hlakileng lithutong tse tlang. Leha, semelo sa theoretical sa mofuta oa I-PACE ke sebopeho sa bokhoba, re boetse re tlameha ho nahana ka mekhoa e meng ea thuto lithutong tse matla ho kenya letsoho kutloisisong e ntle ea metheo e teng. Boithuto ba nako e tlang bo tla bonts'a likarolo life tsa sebopeho sa bokhoba le hore na likarolo life tsa likhopolo tse ling li nepahetse ho hlalosa IGD. Mefuta ea theoretical holima mofets'e e ka susumetsa mekhoa ea kalafo, empa ha feela mehlala ena e le e nepahetseng mme e lekoa ka matla. E 'ngoe ea liqholotso tsa bohlokoa lipatlisisong tsa IGD tsa morao-rao ke ho kopanya likhopolo tsa kelello tse mabapi le mekhoa ea kelello ea tlokotsi ka mekhoa ea phekolo le ea thibelo. Khothatso ea mohopolo le kalafo e lokela ho ba tsa maikutlo le maemong a matle, lipatlisiso mabapi le mekhoa ea kelello le lipatlisiso tsa kalafo li sebelisana mo khonsateng.

Menehelo ea Mongoli

Bangoli bohle ba thathamisitsoeng ba entse tlatsetso e kholo, e tobileng le e nang le kelello mosebetsing, 'me ba e amohetse bakeng sa ho hatisoa.

Tlhōlisano ea Tlhaloso

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.

References

Mantsoe a bohlokoa: bokuli ba marang-rang, ho lemalla marang-rang, mohlala oa I-PACE, kalafo ea IGD

Caring: Young KS le Brand M (2017) Ho kopanya li-Models tsa Theoretical le Litsela tsa Therapy Litabeng tsa Tlokotsi ea Lipapali tsa Inthanete: Khopolo ea Motho. Ka pele. Psychol. 8: 1853. Doi: 10.3389 / fpsyg.2017.01853

E amohetse: 23 June 2017; E amohetsoe: 04 Mphalane 2017;
E phatlalalitsoe: 20 Mphalane 2017.

Copyright © 2017 e Ncha le ea Brand. Ena ke sengoloa se bulehileng se fihletsoeng ka tlase ho License ea Boikarabelo ba Creative Commons (CC BY). Ho sebelisoa, ho abeloa kapa ho hlahisa liforomo tse ling ho lumelloa, hafeela bangoli ba pele kapa ba le lengolo la tumello ba tlotlisoa le hore sengoliloeng sa pele sa makasine ena se boleloa, ho latela mokhoa o amohelehang oa thuto. Ha ho sebelisoe, ho abeloa kapa ho hlahisa ho lumelloa ho sa lumellaneng le melao ena.

* Litaba: Sengoloa sa Matthias, [imeile e sirelelitsoe]