Biomed Res Int. 2014; 2014: 425924. Doi: 10.1155 / 2014 / 425924. Epub 2014 Jul 1.
Wölfling K, Beutel ME, Dreier M, Müller KW.
inahaneloang
Bokhoba ba marang-rang bo nkuoa e le taba ea bophelo bo ntseng bo hola libakeng tse ngata tsa lefats'e ka bongata ba 1-2% Europe le ho fihla ho 7% linaheng tse ling tsa Asia. Patlisiso ea bongaka e bonts'itse hore temallo ea inthanete e tsamaisana le tahlehelo ea lithahasello, e fokotsehile ts'ebetso ea kelello, boiketlo ba sechaba, le khatello ea kelello le kelello. Mananeo a khethehileng a kalafo a hlokahala ho tobana le bothata bona bo sa tsoa eketsoa sehlomathisong sa DSM-5. Le ha ho na le lithuto tse ngata tse hlahlobang litšobotsi tsa bakuli ba nang le ts'oaetso ea inthanete, tsebo ka katleho ea mananeo a kalafo e haelloa. Leha tlhahlobo ea morao-rao ea meta e bonts'a hore mananeo ao a bonts'a litlamorao, lithuto tse ngata tsa kliniki li hlokahala mona. Ho eketsa tsebo, re ile ra etsa phuputso ea sefofane ka litlamorao tsa lenaneo le hlakileng la kalafo ea boikoetliso bakeng sa IA. Litekanyetso tsa banna ba baholo ba 42 tsa ho kopana le lithethefatsi tsa inthanete li ile tsa ngolisoa. Boemo ba bona ba IA, matšoao a psychopathological, le tebello ea ho sebetsa hantle li ile tsa hlahlojoa pele le ka mor'a kalafo. Liphetho li bonts'a hore bakuli ba 70.3% ba qetile kalafo khafetsa. Kamora hore kalafo matšoao a IA a fokotsehe haholo. Matšoao a Psychopathological a ile a fokotsoa hammoho le mathata a amanang le kelello. Liphetho tsa boithuto bona ba lifofane li totobatsa se fumanoeng ho tsoa ho tlhahlobo-leseling ea meta ho fihlela joale.
1. Selelekela
Boithuto bo bongata ba lilemo tse leshome tse fetileng bo supa boits'oarong ba inthanete e le bothata bo ntseng bo hola ba bophelo libakeng tse fapaneng tsa sechaba. Likhakanyo tsa esale pele li fihla ho 6.7% ka har'a bacha le batho ba baholo ba Asia e Boroa-bochabela [1], 0.6% United States [2], le lipakeng tsa 1 le 2.1% linaheng tsa Europe [3, 4] tse nang le bacha ba bontšang ho eketseha ha maemo (mohlala, [4]). Motheong oa lipatlisiso tsena, APA e nkile qeto ea ho kenyelletsa bothata ba lipapali tsa marang-rang - mofuta o le mong oa ts'ebeliso ea litheko tsa inthanete (IA) - karolo ea III ea DSM-5 "e le maemo a lumellang lipatlisiso tsa bongaka le boiphihlelo pele ho ka nahanoa hore li kenyeletsoe. bukeng e ka sehloohong e le bokuli bo hlophisehileng ”[5].
Batho ba anngoeng ke matšoao a tlaleho ea IA ba ts'oana le a tsejoang ke lithethefatsi tse amanang le lithethefatsi le lintho tse ling tse amanang le ho se sebetse hantle (mohlala, bothata ba ho becha). Ba bontša ho ameha ka botebo ka mesebetsi ea inthanete, ba ikutloa ba le takatso e ke keng ea hanyetsoa ea ho ea inthaneteng, ba bonts'a lihora tse ngata tse sebelisoang marang-rang (mamello), ba ikutloa ba khopisitsoe le ho se sebetse hantle ha phihlello ea bona inthaneteng e thibetsoe kapa ba haneloa (ho tlosoa), ba tsoelapele ho ea marang-rang leha ho na le litlamorao tse mpe ho likarolo tse fapaneng tsa bophelo (mohlala, likhohlano le litho tsa lelapa le katleho e fokotsehileng sekolong, koleche, kapa mosebetsi), 'me ha ba khone ho fokotsa boitšoaro ba bona (tahlehelo ea taolo). Kaha ho tšoanang ho tlalehiloe ho tšoana ho mabapi le likarolo tse arolelanoang tsa neurobiological (mohlala, [6]; bakeng sa tlhahlobo ea bona [7]) le ho ts'oana ho joalo ka litšobotsi tsa botho (mohlala, [8, 9]), ho bile le tlhahiso ea ho bona IA joalo ka e ngoe mofuta oa tlhekefetso e amanang le bokhoba ba tlholeho. Ho feta moo, litekanyetso tse eketsehang tsa comorbid IA ka har'a bakuli ba nang le mefuta e meng ea lithethefatsi tse tlalehiloeng li tiisa mohopolo ona [6, 10].
Lithuto tsa kliniki tse sebetsanang le lipatlisiso tsa kalafo li ile tsa eketsa matšoao a psychopathological le litekanyetso tse fokotsehang tsa ho sebetsa ho bakuli [11], boleng bo ntseng bo mpefala ba bophelo [12], boiketlo ba sechaba, le ho itšehla thajana, ka tatellano [13], hammoho le maemo a phahameng a khatello ea kelello le psychopathological [14, 15 ]. Mohlala, Morrison le Gore [16] ba tlaile maemo a phahameng a khatello ea maikutlo ka har'a mehlala ea barupeluoa ba 1319. Ka mokhoa o ts'oanang, Jang le basebetsi-'moho le eena [17] ba tlalehileng ba eketsehile khatello ea kelello, haholo malebana le matšoao a bonts'a maikutlo le a nyahamisang ho bacha ba nang le IA.
Kaha IA e tsejoa hape e le bothata bo tebileng ba kelello bo bakang khatello ea maikutlo le ho fokola ha maemo a ts'ebetso ho ba anngoeng ke seo, ho eketseha boiteko ba ho nts'etsapele le ho ngola mekhoa e fapaneng ea kalafo, ho kenyelletsoa le ho kenella ha psychotherapeutic le psychopharmacological bakeng sa IA [18]. Leha motho a tlameha ho amohela hore lipatlisiso tsa hajoale tsa bongaka li haelloa ke boleng ba mokhoa kapa li thehiloe sampole tse nyane tsa mokuli (bakeng sa tlhahlobo ea lithuto tsa sephetho sa kalafo ho IA bona King et al. [18]), liphetho tsa pele mabapi le karabelo le tšoarelo kamora kalafo ho IA ea tšepisa.
Phuputso e le 'ngoe e ileng ea kopana le litekanyetso tse ngata tsa boleng ba lithuto tsa sephetho sa kliniki ho latela tlhahlobo ea tlhahlobo ea King et al. [18] e batlisisitse litlamorao tsa lenaneo la boitsoaro bo bongata ba tlhaho ho bacha ba nang le IA [19]. Bakuli ba 32 ba ileng ba phekoloa ka lebaka la IA ba ne ba bapisoa ka lipalo le sehlopha sa taolo ea lenane la ho leta se sa amohela kalafo (lithuto tsa 24). Liphetho tsa mantlha tsa thuto ena li kenyeletsa tekanyetso ea ho itlaleha bakeng sa IA (Internet overuse self-Rating Scale ka Cao le Su [20]) le mehato ea ho itlaleha e lekolang bokhoni ba taolo ea nako le matšoao a kelello. Liphetoho mehatong ena ea sephetho li ile tsa hlahlojoa pele, hang kamora moo, le qetellong ea kalafo. Ho latela ho ile ha etsoa likhoeli tse tšeletseng kamora kalafo. Liphetho li bonts'itse hore, ka lihlopha tsena ka bobeli, ho fokotseha ho hoholo hoa matšoao a IA ho ne ho bonahala ebile ho bile ho tsitsitse nakong ea likhoeli tse tšeletseng. Leha ho le joalo, ke sehlopha sa phekolo feela se neng se bonts'a ntlafatso e kholo lithutong tsa taolo ea nako le ho fokotsa mathata a kelello le a amanang le matšoenyeho a tlase le mathata a sechaba.
Ka mokhoa o ts'oanang, lithuto tse sebelisang kalafo ea psychopharmacological li bonts'itse liphetho tse ts'episang tse bonts'ang hore bakuli ba nang le IA ba rua molemo ho SSRI le methylphenidate [21, 22], e lumellanang le lipatlisiso tsa bopaki ba kliniki kalafong ea bakuli ba nang le bothata ba ho becha [23].
Ho feta moo, phuputso ea morao-rao e phatlalalitsoeng ea meta-analytic ke Winkler le basebetsi mmoho le [24] e kenyelitseng liteko tsa tleliniki ea 16 ka mekhoa e fapaneng ea kalafo e thehiloeng ho bakuli ba 670 e bonts'a katleho e kholo ea kalafo ea IA: liphetho tse qaqileng li fana ka maikutlo a hore ho bile le phapang e kholo ho latela mofuta oa kalafo ea kalafo ka mananeo a kelello-boits'oaro a bonts'a litekanyo tse phahameng () mabapi le matšoao a fokotsehileng a IA ho feta mekhoa e meng ea psychotherapeutic (). Leha ho le joalo, liphetho tse akaretsang li bonts'a hore mokhoa o mong le o mong oa kalafo o hlahlobiloeng o hlahisitse litlamorao tse kholo.
Leha ho le joalo, lingoliloeng tse mabapi le sephetho sa kalafo ho IA li ntse li tsoetse-pele ebile li le ngata ka litsela tse ngata, joalo ka ha ho boletsoe ke bangoli ba tlhahlobisiso e boletsoeng ka holimo ea meta [24, leqephe la 327]: “Leha ho le joalo thuto ena e bontša ho haella ha lithuto tsa kalafo ea kalafo ea mahlale, e fana ka leseli mabapi le boemo ba hajoale ba lipatlisiso tsa kalafo ea marang-rang, li thibela lipatlisiso ho tsoa "Bochabela" le "Bophirima" mme ke bohato ba pele ho nts'etsopele ea khothaletso ea kalafo e thehiloeng holim'a bopaki. " liteko tse ling tsa kliniki tse itšetlehileng ka mekhoa e hlalositsoeng hantle ea kalafo. Ka lebaka la maemo ana, re tla kenya lenaneo la nakoana la kalafo ea kelello bakeng sa IA mme re fane ka datha ea pele ho tsoa ho thuto ea sefofane mabapi le bohlokoa ba eona le litlamorao tsa eona. Leha thuto ena e ka ipapisa le sampole e nyane ka ho lekana mme ha e na sehlopha sa taolo ea lethathamo, re ho nka e le thuso ho phatlalatsa lintlha tsena tsa pele.
1.1. Phekolo ea nako e khuts'oanyane ea ho lemalla taolo ea marang-rang le likhomphutha (STICA)
Ho tloha 2008, sehlopha sa basebetsi sa Outpatient Clinic for Behaisheral Addiction Jeremane se ile sa fana ka tlhabollo ho bakuli ba nang le mefuta e fapaneng ea IA. Khabareng, bakuli ba 650 - boholo ba banna ba pakeng tsa 16 le 35 lilemo tse - ba itsebisitse e le ba batlang kalafo. Ka leseli la ho hokahana le bakuli, ho thehiloe lenaneo le emeng la psychotherapeutic bakeng sa IA mme ho ile ha hlahisoa bukana ea kalafo (STICA) [25] e ipapisitseng le mekhoa ea boits'oaro e tsejoang ho tsoa ho mananeo a kalafo a mefuta e meng ea boitšoaro bo lematsang. STICA e etselitsoe ho sebelisoa bakeng sa kalafo ea ka ntle 'me e na le lihlopha tsa sehlopha sa 15 hammoho le linako tse robeli tsa phekolo e le' ngoe.
Ha lithuto li ntse li sebetsana le litaba tsa motho ka mong, likarolo tsa sehlopha li latela moralo o hlakileng oa taba. Karolo ea boraro ea lenaneo, lihlooho tsa sehlooho li leba ho nts'etsopele ea sepheo sa phekolo, ho tsebahatsa ts'ebeliso ea inthanete e amanang le matšoao a IA, le boits'oaro ba tlhahlobo e akaretsang ea matšoao a psychopathological matšoao, bofokoli, lisebelisoa, le mathata a comorbid. Mekhoa ea ho susumetsa e boetse e sebelisoa ho ntlafatsa sepheo sa bakuli sa ho fokotsa boitšoaro bo sa sebetseng. Karolong ea bobeli, ho hlahisoa lintho tsa kelello tse amanang le tšebeliso ea marang-rang, ho tsepamisa mohopolo linthong tseo a li etsang le menahanong ea mokuli maemong a tšohanyetso (SORKC-scheme, [18]) , li etsoa. Morero o mong oa bohlokoa mohatong ona ke ntlafatso ea mohlala oa IA bakeng sa mokuli ka mong, ho ipapisitse le tšebelisano ea ts'ebeliso ea inthanete e sebelisitsoeng, ho rera esale pele le ho boloka maemo a mokuli (mohlala, botho ba hae) le tikoloho ea bakuli. Boemong ba ho qetela ba kalafo, maemo a nang le takatso e matla ea ho kena inthaneteng a hlalositsoe ka ho hlaka le maano a ho thibela ho oela hape. Tlhatlhobo e qaqileng ka sebopeho sa STICA e hlahisoa ho Tafole 1.
tab1
Lethathamo la 1: Mekhoa ea phekolo ea lenaneo la kalafo "Pheko ea nakoana bakeng sa ts'ebeliso ea taolo ea marang-rang le marang-rang" (STICA).
1.2. Lipotso tsa lipatlisiso
Thutong ena, re ikemiselitse ho bokella lintlha tsa pele mabapi le katleho ea STICA. Re boetse re ikemiselitse ho supa bakuli ba kenyelelitsoeng mabapi le matšoao a psychosocial, comorbidity, le litšobotsi tsa botho tse ka bapalang karolo ea kalafo ea kalafo mabapi le ho aha tumellano ea kalafo le phapang ea karabelo ea kalafo [13]. Ho ekelletsa moo, ho tlalehiloe litlamorao tsa khatello ea kelello le boits'oaro qalong ea kalafo. Qetellong, re batla ho fana ka papiso lipakeng tsa bakuli ba qetang kalafo (ba tlatselletsang) le ba tlohelang lenaneo.
2. Lisebelisoa le mekhoa
2.1. Tlhahiso ea data le moralo oa tlhahlobo ea Statistical
Teko ena, datha li ile tsa bokelloa ho tsoa ho bakuli ba 42 ka tatellano ba ntse ba itlhahisa ho Clinical Clinic bakeng sa Boitšoaro ba Boitšoaro Jeremane ka lebaka la IA (sampole ea bonolo ea kliniki). Bakuli bana ba kenyelelitsoe ka ntle ho sampole ea mantlha ea bongaka ea ba batlang kalafo ea 218. Ho tsena, 74 (33.9%) e ile ea tlameha ho qheleloa ka thoko ka lebaka la ho se lumellane le litekanyetso tsa IA. Lithuto tse ling tsa 29 (13.3%) li ile tsa tlameha ho qheleloa ka thoko ka lebaka la ho ba ka tlase ho lilemo tsa 17. Phapang e eketsehileng ea 73 (33.5%) e ne e le ka lebaka la mathata a tebileng a komorbid, a hanang ho fumana kalafo ea kelello, kapa ho teba ha IA e etsang kalafo e hlokang tlhokomelo. Bakuli ba ile ba kopuoa ho fana ka datha ea hau bakeng sa ts'ebetso ea mahlale mme ba fana ka tumello e ngotsoeng e nang le tsebo. Patlisiso e ne e tsamaisana le phatlalatso ea Helsinki. Ka lebaka la tlhaiso-leseling e sa fumaneng ho liphetho tsa mantlha tsa T1, lithuto tsa 5 li ile tsa tlameha ho qheleloa ka thoko tlhahlobisong ea data.
Mekhoa ea ho kenyelletsoa e ne e le ho ba teng ha IA ho ea ka AICA-S (Sekala sa Tlhahlobo ea Tlatsetso ea Inthanete le K'homphieutha ea K'homphieutha, AICA-S [26]; bona serapa sa 2.2) le tlhahlobo ea tlhahlobo ea maemo a bophelo ea IA (AICA-C, lethathamo la tlhahlobo bakeng sa Tlhahlobo ea Bokhoba ba Papali ea Inthanete le Khomphutha, [15]. Ho feta moo, bong ba monna le lilemo tse kaholimo ho lilemo tsa 16 e ne e le litlhoko tse ling.
Litekanyetso tsa ho kenyelletsa li bua ka mathata a tebileng a komorbid (mathata a mang a ho lemalla, mathata a kelello, khatello e kholo ea maikutlo, khatello ea botho ba moeli le ho se sebetse hantle bathong). Hape, bakuli ba tlalehang meriana ea hajoale ka lebaka la mafu a kelello le ba tlalehang ba le kalafong ea kelello ba ne ba sa kengoe tlhahlobisong ea data.
E le sephetho sa mantlha, ho hlakoloa ha IA ho ea ka tlhaiso e iketselitsoeng ea tlaleho ea boits'oaro (AICA-S) ho hlalositsoe. Joalo ka ha ho phethoa lintlha tsa bobeli, ho ile ha hlahlojoa liphetoho mefuteng e latelang e latelang: botebo ba matšoao a kelello, nako e sebelisitsoeng marang-rang, litlamorao tse mpe ka lebaka la tšebeliso ea inthanete, le tebello ea ho atleha.
Lintlha li ile tsa hlahlojoa qalong ea kalafo (T0) mme hang hoba a felise kalafo (T1). Litlhahlobo tsa data li tlalehiloe ka maemo ana ka bobeli, tse ikemiselitseng ho phekola (ho kenyeletsa bakuli ba tlohelang kalafo) le bathusi. Bakeng sa tlhahlobo e ikemiselitseng ho phekola, ho sebelisitsoe mokhoa oa ho shebella oa ho qetela (LOCF). LOCF e eletsa ho sebelisa lintlha tsa ho qetela tse fumanehang lithutong tseo tse sa feliseng boemo ba kalafo khafetsa. Thutong ea hona joale, datha e tsoang ho T0 e ne e sebelisoa bakeng sa lithuto tseo tse ileng tsa tsoa lenaneong la kalafo pele T1 e hlahlojoa.
Bakeng sa litlhahlobo tsa lipalo, liteko tsa chi-mraba li ne li sebelisoa ho bapisa mefuta e fapaneng ea dichotomous le cramer-v e le tekanyo ea boholo ba phello. Liphetoho mokhoabong oa pele le oa bobeli li ile tsa lekanngoa ho sebelisoa lipara tse peli tsa pele le tsa postcomparison bakeng sa sampole e le 'ngoe. Ho latela tlhahiso eo Dunlap et al. [27], e fetotsoeng e ne e baloa haeba khokahano lipakeng tsa li-pre- le li-postcores tsa mefuta-futa e itšetlehileng li le kholo ho feta 0.50. Litlhahlobo tsohle li entsoe ka sebelisa SPSS 21.
2.2. Liletsa
Bakeng sa karohano ea IA, ho sebelisitsoe mehato e 'meli ho T0. Bakeng sa Sekala sa Tlhahlobo ea Tlatsetso ea Papali ea Inthanete le Khomphutha (AICA-S, [26]), ho ile ha sebelisoa tekanyetso ea ho itlaleha ea litekolo ho hlahloba IA ho latela maemo a ikhethileng a bosholu ba papali ea chelete le mafu a amanang le lithethefatsi (mohlala, ho tsepamisa maikutlo, ho mamella , ho tlosa, le tahlehelo ea taolo). Boitšoaro bo bong le bo bong bo bonts'ang IA bo hlahlojoa mohlomong ka tekanyo ea likert-point tse hlano (ho se khafe kapa hangata) kapa ka sebopeho sa dichotomous (e / che) le lintlha tse akaretsang li ka hlahisoa ho bokelleng lintho tsa tlhahlobo. Ho khaola ha lintlha tsa 7 (e tsamaellanang le lintlha tse felletseng tsa 4 tse fihletsoeng) ho fumanoe hore li na le tlhaiso-leseling e ntle ka ho fetisisa ea ho lemoha IA (sensitivity = 80.5%; specificity = 82.4%) lipatlisisong tsa bakuli ba kenang lipetlele tsa rona tleliniki. Ho latela lipatlisiso tse fetileng, AICA-S e ka nkuoa e le ho bonts'a thepa e ntle ea psychometric (Cronbach's), ho aha nnete, le sensitivity ea bongaka [11]. Kaha AICA-S le eona e ne e le qetello ea mantlha, e boetse e hlahlojoa ho T1.
Ho netefatsa ho tsebahatsa lefu la IA, le tekanyetso ea setsebi sa kliniki le eona e ile ea fanoa. Lenane la tlhahlobo ea Inthanete le K'homphieutha ea K'homphieutha ea K'homphieutha (AICA-C, [15]) le ile la sebelisetsoa morero oo. AICA-C e kenyelletsa litekanyetso tse tšeletseng tsa mantlha tsa IA (ho tsepamisa maikutlo, taolo ea taolo, ho tlohela, litlamorao tse mpe, mamello, le ho lakatsa) tse lokelang ho lekanngoa ke setsebi se koetlisitsoeng ka tekanyo ea lintlha tse tšeletseng ho tloha 0 = tlhahlobo e sa kopaneng le 5 = sesupo se kopane ka botlalo. Ho latela tlhahlobo mabapi le ho nepahala ha eona ea ho sibolla, ho khaola ha lintlha tsa 13 ho hlahisitse boleng bo holimo (sensitivity = 85.1%; specificity = 87.5%). E hlahlojoe ka katleho bakeng sa thepa ea eona ea psychometric (Cronbach's) le ho nepahala ha eona ea bongaka [15].
Kakaretso ea Boitšoaro bo Akaretsang (GSE; [28]) e sebelisitsoe ho lekola kaho ea tebello e akaretsang ea ho sebetsa ka lintho tse leshome. GES e utloisisoa e le palo ea likahlolo tse ikhethileng tsa palo ea bokhoni ba hau ba ho hlola mathata le liphephetso tsa letsatsi le letsatsi. Liphuputso tse ngata li tlalehile hore GSE e tlameha ho nkoa e le sesosa sa bohlokoa sa ho iphelisa, ka GSE e phahameng e boletseng liphetoho tsa ts'ebetso ea boits'oaro le ho khothaletsa batho ka bomong ho tobana le maemo a kenellang [29]. GSE e ne e tsamaisoa ho T0 le T1.
NEO Tano-Factor Inventory [30] e ile ea hlalosoa e le hore e ka lekanya libaka tse hlano tsa Model ea Metso e Mehlano. E na le lintho tsa 60 tse arabiloeng ho sekala sa 5-point Likert mme ke e 'ngoe ea mehato e sebelisoang ka ho fetisisa ea ho itlaleha lithutong tsa botho. Lithuto tse ngata li hatisitse boleng ba eona bo botle ba psychometric le ho nepahala [4]. NEO-FFI e ne e sebelisoa feela ho T0 ho hlahloba matla a ho hakanya lintho tse hlano tse mabapi le sephetho sa kalafo le ho latela melao.
Libakeng tsa litekanyo, T0 le T1, matšoao a psychopathological a ile a hlahlojoa a sebelisa Syndromeom Checklist 90R [31], lipotso tse sebelisitsoeng haholo tsa kliniki tse nang le thepa e ntle ea psychometric [32]. Matšoenyeho a Psychopathological a hlahlojoa ke lintho tsa 90 (0 = ha ho na matšoao ho 4 = matšoao a matla) ho kenya liphallelo tse robong. SCL-90R e bua ka tekanyo eo sehlooho se fumaneng matšoao ho eona bekeng e fetileng. Lenane la bokhopo ba lefatše lohle (GSI) - palo ea lefatše ka bophara ho lits'ebetso tse robong - e emela mahlomola ka kakaretso.
3. Liphetho
3.1. Tlhaloso ea Mohlala
Lipalo-palo tsa sechaba tsa batho ba batlang kalafo li ka fumanoa ho Tafole 2.
tab2
Lethathamo la 2: Lintlha tsa Sociodemographic tsa batho ba batlang kalafo ba kenyelelitsoeng tekong ena.
Joalokaha ho ka hlahisoa ho tafole ea 2, bakuli ba bangata ba ne ba sena ts'ebelisano 'moho le halofo ea bona ba neng ba ntse ba lula hae le batsoali ba bona. Boholo ba batho ba batlang kalafo ba ne ba sa sebetsoa empa ba e-na le thuto ea sekolo se phahameng.
Boholo ba bakuli ba ne ba bonts'a tšebeliso e lemalloang ea lipapali tsa marang-rang tse fumanehang marang-rang (78.4%). 10.8% e ne e sebelisa lits'ebetso tse fapaneng tsa inthanete haholo, 8.1% e sebelisa liwebosaete tsa marang-rang, 'me 2.7% e ne e etsa lipatlisiso tse feteletseng litsing tsa data tsa tlhahisoleseling.
Mabapi le likarolo tse ikhethileng, lintlha tse latelang li fumanoe bakeng sa NEO-FFI: () bakeng sa neuroticism, () bakeng sa ho fetoloa haholo, () bakeng sa ho buleha, () bakeng sa ho amoheloa, le () bakeng sa letsoalo.
3.2. Liphetoho lithutong tsa mathomo le tse mahareng
70.3% (26) e qetile kalafo khafetsa (bathusi), bakuli ba 29.7% (11) ba ile ba akheha nakong ea thupelo (ba nyahlileng). Liphetho li bonts'a hore bahlophisi ba bile le ntlafatso ea bohlokoa mananeong a mantlha le a mantlha. Lintho tsa pele le tsa morao-rao tsa li-complements li ka tsoa ho
Lethathamo la 3: Liphetoho maemong a mantlha le a mahlonoko a ho qetela.
Joalokaha ho ka bonoa ho tafole ea 3, ho fokotseha ho hoholo hoa palo ea AICA-S hoa bonahala kamora kalafo. Ho feta moo, ho fokotseha ho hoholo ha lihora tse sebelisitsoeng marang-rang ka letsatsi la beke le beke le ho fokotseha ha likhohlano ka lebaka la tšebeliso ea inthanete libakeng tse hlano ho tse tšeletseng tse hlahlobiloeng li ne li bonahala. Ka mokhoa o ts'oanang, ho fokotsehile ho hoholo ho GSI ho fumanoe, mme bapalami ba bonts'a lintlha tse fokotsehileng haholo kamora kalafo ho tse supileng tsa subscales tse supileng tsa SCL-90R.
Joalo ka ha ho lebelletsoe, litlamorao tsa kalafo li ne li le nyane ka tsela e nyane ha li eketsa lihlahlobo tlhahlobisong. Leha ho le joalo, tlhahlobo e ikemiselitseng ho phekola e boetse e senola hore kamora kalafo, palo ho AICA-S e fokotsehile haholo (,;). Ho ts'oanang ho ile ha bonoa ka kakaretso ea nako e sebelisitsoeng marang-rang ka letsatsi le le leng la beke (,;) le litlamorao tse mpe tse tsamaisanang le ts'ebeliso ea inthanete (,;). Hape, matšoao a psychopathological, litla-morao tsa bohlokoa le tsa morao-rao li ne li bonoa, mabapi le GSI (,;) le SCL-subscales obsessive-activive (,;), ho se sireletsehe ha sechaba (,;), khatello ea maikutlo,,;, ho tšoenyeha (,; ), mabifi (,;), matšoenyeho a phobic (,;), le psychoticism (,;). Hape, tebello ea ho ikatisa e ile ea eketseha haholo ka mor'a kalafo (,;).
3.3. Tšusumetso ho Karabo ea Phekolo
Tlhahlobo ea liphapang tsa sechaba ka bongata pakeng tsa bapalami le batho ba tlohelang mosebetsi ha e bontše litholoana tsa bohlokoa mabapi le lilemo, tšebelisano, boemo ba lelapa, maemo a bophelo, kapa boemo ba mosebetsi. Phapang feela e bonts'ang bohlokoa ba tloaelo (;; cramer-v = .438) e fumanoe thutong e nang le bapalami ba bonts'ang thuto e phahameng ea sekolo (76.9%) ho feta ba tlohelang sekolo (63.7%).
Mabapi le tšusumetso ea litšobotsi tsa botho ho feliseng kalafo, ha ho liphapang tse kholo tsa sehlopha tse fumanoeng, ntle le mabaka a bulehileng. Bohlokoa ba tšitiso bo hlahile bo bonts'a hore li-complement (;) li ne li bonts'a likhahla tse phahameng ho feta li-dropout (;; ;,,). Ka mokhoa o ts'oanang, ha ho liphapang tsa sehlopha tse fumanoeng mabapi le matšoao a psychosocial ho T0 (SCL-90R) kapa tekanyo ea tebello ea ho sebetsa hantle (GSE). Hape, botebo ba matšoao a IA a ne a sa khetholle lipakeng tsa bathusi le ba tlohelang thepa le bona ha baa ka ba qeta lihora tse ngata inthaneteng (tse lekiloeng ke AICA-S).
4. Puisano
Phuputsong ena ea sefofane, re fuputse litlamorao tsa psychotherapy e khuts'oanyane ea nakoana ho sampole ea bareki ba sa tsubeng ba nang le lefu la IA. Bakeng sa sepheo seo, bakuli ba mantlha ba 42 ba ile ba phekoloa ho latela lenaneo la kalafo ka boemo ba bona ba bophelo bo botle ba kelello bo neng bo hlahlojoa ha ba kenella kalafo le hang ka mor'a ho felisoa. Joaloka sepheo sa mantlha, re ile ra hlahloba matšoao a IA ho ea ka tekanyo e tšepahalang ea ho itlaleha ea tlaleho (AICA-S; [26]). Ntle le moo, nako e sebelisitsoeng marang-rang, litlamorao tse mpe tse hlahisoang ke mesebetsi ea inthaneteng, tebello ea ho sebetsa ka katleho, le matšoao a kelello a hlalositsoe e le sephetho sa bobeli.
Hoo e batlang e le 70% ea ba batlang kalafo ba fetisitse lenaneo le felletseng la kalafo (bathusi), mme hoo e ka bang karolo ea boraro e ile ea akheha nakong ea kalafo. Kahoo, sekhahla sa ho tloheloa se sebetsa hantle se ntse se le maemong a kantle a tlhokomelo ea bophelo bo botle ba kelello (bona [33]; 19-51%) empa se feta se tlalehiloeng ke Winkler le basebetsi mmoho (bona [24]; 18.6%). Liphetho tse ling li bontša hore lenaneo la kalafo le na le litlamorao tse matla. Kamora kalafo, ho ile ha bonoa phokotso e kholo ea matšoao a IA. Liphetho tse fumanoang mona li ne li lekana bahlophisi ba tlatsetso le sampole e felletseng Ho latela litlhaloso tsa Cohen [34], sena se ka nkuoa e le sesupo sa litlamorao tse kholo. Ntle le moo, e lumellana le boholo ba phello ho boemo ba IA-kamora ho ba le psychotherapy (;; ka kholiseho pakeng tsa .84 le 2.13) tse tlalehiloeng meta-analysis ke Winkler et al. [24]. Ka mokhoa o ts'oanang, nako e sebelisitsoeng marang-rang ka mafelo-beke e fokotsehile haholo kamora kalafo ka boholo bo boholo bo lekanang () empa e nyane haholo ha e bapisoa le data e fanoeng ke tlhahlobo ea morao-rao ea meta ka taba eo (bona [24];).
Ho bohlokoa ho hlalosa hore sepheo sa mokhoa ona oa kalafo ha se ho thibela bakuli hole le ts'ebeliso efe kapa efe ea Marang-rang. Sebakeng seo, merero ea phekolo e khethehileng e ntlafatsoa ho latela sephetho sa sebatli se pharaletseng moo mekhoa ea ts'ebeliso ea marang-rang ea mokuli e hlakisoang mme ho fumanoe litaba tsa inthanete tse sebetsanang le bothata. Phekolo ena e ikemiselitse ho susumetsa mokuli ho qala ho ithiba mosebetsing oa inthanete o nkoang o amana le matšoao a mantlha a IA, joalo ka tahlehelo ea taolo le takatso. Kahoo, boleng ba zero ba lihora tse sebelisitsoeng marang-rang bo ne bo sa lebelloa. Ho joalo, nako ea inthanete ea lihora tsa 2.6 ka letsatsi e lekana le karolelano ea baahi ba Jeremane. Thutong ea boemeli mabapi le lithuto tse ka bang 2500 tsa Jeremane, Müller et al. [35] e tlalehile hore nako e tloaelehileng e sebelisoang marang-rang ka letsatsi la beke e ne e le lihora tsa 2.2 ka har'a basebelisi ba tloaelehileng ba inthanete.
Ho feta moo, le boholo ba lipono tsa bobeli li fetohile haholo nakong ea phekolo. Pele ho tsohle, mathata a hlahang ka lebaka la tšebeliso e mpe ea tšebeliso ea inthanete a ile a fokotseha libakeng tse 'maloa, mabapi le khafetsa likhohlano tsa malapa, ho hana mesebetsi e meng ea boithabiso, khafetsa mathata a bophelo bo botle, ho qabana le metsoalle le litlamorao tse mpe sekolong kapa mosebetsing. Tebello ea boits'ebetso e ile ea eketseha ka boholo ba phello ea bohareng le palo ea boleng ho GSE kamora kalafo e ka bapisoa le e nkiloeng ho baahi ba Jeremane ka kakaretso [28]. Sena se bontša hore tebello ea tšepo ea bokhoni ba motho ea ho hlola mathata le mathata a fihla maemong a amohelehang kamora kalafo. Haeba liphapang tsa ho lebella ho sebetsa hantle ho bakuli ka mor'a kalafo li ka nkuoa e le selelekela bakeng sa kalafo ea nako e telele le ea nako e telele, litlamorao li lokela ho hlahlojoa lithutong tse latelang.
Qetellong, matšoao a kelello le a amanang le IA a fokotsehile haholo kamora kalafo. Ho bile joalo bakeng sa index ea botebo ba lefatše hammoho le lits'ebeletso tse supileng tsa subscales tse supileng ho tse robeli tsa SCL-90R. Mefuta e meholo ea litlamorao e fihletsoe bakeng sa bokhopo ba lefatše lohle ba Index le matšoao a ho qobella ho sithabela le a sithabetsang, hammoho le ts'ireletso ea sechaba.
Ho makatsang ke hore ha rea ka ra fumana phapang efe kapa efe e khethollang pakeng tsa bakuli ba fetang kalafo e felletseng le ba tlohelang lenaneo leo ba ka beng ba sebelitse e le matšoao a bohlokoa bakeng sa katleho ea kalafo. Ho bile le tloaelo ea lipalo e bonts'ang hore bakuli ba nang le maemo a phahameng a thuto ba na le monyetla oa ho qeta kalafo khafetsa. Hape, re fumane hape — joalo ka tloaelo — hore bakuli ba qetang kalafo ba bontša maemo a holimo popehong ea botho bo bulehileng. Libukeng tsa botho, ho bula maemo a phahameng ho hlalosoa e le ho khahloa ke mefuta e meng ea menahano ea setso le ho etsa lintho le ho bonts'a maikutlo a menahanong le menahano e mecha ea ho nahana [36]. Motho a ka fihlela qeto ea hore bakuli ba ipatileng ka lebaka lena ba ka ba le maikutlo a matle mabapi le kalafo ea kelello 'me ka lebaka leo ba khona ho fetoha liphetoho tsa psychotherapy. Leha ho le joalo, likamano tse tlalehiloeng mona li ne li bohlokoa haholo ka tsela e makatsang. Sena se ka hlalosoa ke mohlala o monyane oa sampole, haholo-holo mabapi le bakuli ba tlohelang kalafo. Ka ho hlakileng, ho hlokahala lipatlisiso tse eketsehileng ho tsebahatsa baphethahatsi ba phetheho ea kalafo ho bakuli ba IA.
Phuputso ena e na le meeli e 'maloa e hlokang ho sebetsoa. Phokotso e kholo e tlameha ho bonoa ho hlokeng sehlopha sa taolo, ekaba taolo ea lenane la ho leta (WLC) kapa kalafo joalo ka sehlopha se tloaelehileng (TAU). Kaha ho ne ho e-na le boemo bo le bong feela ba sehlopha sa kalafo, lipalo (ka papiso e lekanang) le meeli ea ho toloka li totobetse. Ho ke ke ha khoneha hore qetellong u tsebe hore na litlamorao tsa matšoao a fokotsehang a IA le khatello ea kelello li bakoa ke ho kenella hoa kelello kapa tšimoloho ho tsoa mefuteng e sa laoloang bakeng sa. Taba ea bobeli, mohlala o bonolo oa ba batlang kalafo o ile oa hlahlojoa ntle le ts'ebetso ea ho se sebetse hantle. Sena se hlahisa potso haeba barupeluoa ba thuto ena ba tlameha ho nkuoa e le ba ikhethileng. Ho feta moo, sampole ea bongaka e neng e le tlasa lipatlisiso e entsoe ke bakuli ba banna ba 42 feela. Ona ke mohlala o fokolang o fokolang o sa kang oa lumella tlhahlobo efe kapa efe ea lipalo tse tebileng (mohlala, tšusumetso ea mefuta e fapaneng ea IA sephethong sa kalafo). Kaha sampole e ne e le bakuli ba banna feela, liphetho li ke ke tsa akaretsoa ho bakuli ba basali. Qetellong, moralo oa lipatlisiso o ne o sa kenyeletse tlhahlobo, ka hona ha ho khonehe ho fihlela liqeto mabapi le botsitso ba litlamorao tsa kalafo tse ileng tsa bonoa hang ka mor'a kalafo. Ho lokisa mefokolo ena, bangoli ba etsa tlhahlobo ea bongaka ea ho latela hona joale [17]. Morero ona o shebileng ho kenyelletsoa ha bakuli ba 193 ba nang le IA o na le liteko tse ngata tse laoletsoeng le tse laoloang ka tlhahlobo ea ho latela 12 likhoeli tse ngata kamora ho felisoa ha kalafo.
5. Qetello
Ho latela lintlha tse fanoeng thutong ena ea sefofane, hoa utloahala ho nahana hore kalafo ea kelello ea bakuli ba nang le lefu la IA ea sebetsa. Kamora ts'ebeliso ea kalafo e ts'oanang ea boits'oaro ea kelello, re fumane liphetoho tse kholo matšoao a IA, nako e sebelisitsoeng marang-rang, liphihlelo tse mpe tse latelang ts'ebeliso ea marang-rang, le matšoao a amanang le psychopathological, ka litlamorao tse kholo ho matšoao a sithabetsang le a hlokofatsang. Boithuto bona ba lifofane, bo ileng ba etsoa ho tsebisa ho qala ha teko ea tleliniki e kholo, e sa reroang, le e laoloang, e tiisa sephetho sa hore Winkler le basebetsi-'moho le eena [24] ba tlohetse datha ea tlhahlobo ea bona ea meta: IA e bonahala e le bothata ba kelello. e ka alafshoa ka katleho ke maano a psychotherapeutic-bonyane ha o bua ka litlamorao tsa kalafo e tlang.
Khohlano ea Lithahasello
Bangoli ba phatlalatsa hore ha ho na likhohlano tsa lithahasello mabapi le phatlalatso ea pampiri ena.
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