Boitšoaro bo sa sebetseng ba thobalano: Tlhaloso, maemo a kliniki, profiles ea neurobiological le kalafo (2020)

Tse qotsitsoeng ho “Tšebeliso ea litšoantšo tse manyala tse hlephisang boitšoaro litlamong tsa thobalano "ka tlase:

Ho lemalla lit soant so tsa bootsoa, ​​leha e le mokhoa o fapaneng oa ho lemalla thobalano, e ntse e le mofuta oa boits'oaro bo hlephileng….

Ho emisoa ka tšohanyetso ha lithethefatsi tse hlephisang boitšoaro ho baka litlamorao tse mpe maikutlong, nyakallo le khotsofalo ea likamano tsa botona le botšehali….

Ts'ebeliso e kholo ea litšoantšo tse manyala tse hlephisang boitšoaro e thusa ho qala ha mathata a kelello le mathata a likamano….

Perrotta G (2020), Int J Tlhokomelo ea Bophelo bo Botle ba Botona le Botšehali 3 (1): 061-069.

DOI: 10.17352 / ijsrhc.000015

inahaneloang

Mosebetsi ona o shebana le sehlooho sa "boits'oaro bo sa sebetseng ba thobalano" mme haholoholo ho tsa bongaka, psychopathological, le anatomy likarolo tsa mmele, ho utloisisa ka botlalo limaraka tse fapaneng tsa boits'oaro bo shebiloeng: bosodoma, ho phehella ho tsosa takatso ea thobalano, le bokhoba ba thobalano. Mosebetsi o phethetsoe ka ho hlahloba likarolo tsa kalafo le kalafo e ntle ka ho fetisisa, ho hatisa bohlokoa ba kliniki ea ts'ebeliso ea litšoantšo tsa bootsoa litlamong tsa thobalano.

Selelekela, tlhaloso le maemo a bongaka

Boitšoaro bo bobe ba thobalano Ke mokhoa oa ho etsa lintho oa motho, kamanong le ts'ebelisanong le tikoloho e haufi, e nang le maikutlo a feteletseng (mme ka hona a kulang) a hloka ho nahana ka thobalano, ho kenya tšebetsong boits'oaro ba kelello bo reretsoeng ho etsa thobalano e matla, ho lahleheloa ke taolo holim'a litakatso le meeli e behiloeng sechabeng ke maemo a nnete. Ka kakaretso, "ho lemalla" ho bolela ho lahleha le ho se khone ho fumana taolo hape holim'a boits'oaro ba takatso, ke hore, takatso ea ho ba le ho hong. Ka hona, haeba maemo a taolo a etsahala ha motho a nka boemo boo a jang ntho kapa a itšoara ka bona, ho sa tsotelehe hore na ho nka karolo ho matla hakae, ho mamella kapa ho kotsi hakae, taolo e ea lahleha ha boits'oaro bo phetoa le ha ho sa khotsofala ka kakaretso , kapa ho sa tsotelehe tšenyo bophelong bohle ba motho, e leng se etsang hore a se ratehe. Hase boitšoaro bo bobe haholo empa ke ho ba sieo ha taolo holim'a sepheo sa ho ikhotsofatsa seo motho a batlang ho se fihlela. Boitšoaro bo seng bo sa khotsofatse tloaelo bo lokela ho shoa, leha e ne e le bo khahlisang pele, hobane bo emisitse ho ba joalo. Haeba sena se sa etsahale, mme motho a ke ke a hloleha ho nahana hore se tla putsa leha a nyahamisitsoe ke seno, taolo e lahlehile. Ka mokhoa o ts'oanang, haeba motho a sa khone ho hlophisa boits'oaro ba hae ho bo kenya bophelong ba hae hore na o batla neng le joang (hoo ke mahala), o qetella a tetse bophelo bohle ba hae ho takatso ea ho kenya tšebetsong boitšoaro neng kapa neng ha bo tsoa ( ke hore, o fetoha lekhoba la hae). Kahoo ho ba thata le ho feta ho fumana lisebelisoa tsa ho ts'ehetsa boits'oaro ka bo bona (mohlala moruo), mme leha boits'oaro ka bo bona bo lula bo putsa ha ho sa na khotsofalo ka kakaretso, 'me khotsofalo e ntse e thatafala le ho feta ka lebaka la ho se khone ho laola takatso. Ka hona ke tahi ea 'nete joalo ka ntho efe kapa efe e tlamang kapa boitšoaro bo qobelloang mme e na le maemo a eona a ikhethang, ho ipapisitse le ho teba ha boemo ba lefu; haele hantle, mefuta ena e meraro ea khetholleha: bosodoma, ho phehella ho tsosoa takatso ea ho kopanela liphate le ho lemalla ho kopanela liphate [1].

Haufinyane tjena, ts'oaetso ea bosodoma e fumane karohano ka har'a Classification ea Machabeng ea Mafu a Ho shoa ha Batho le Lipalo-palo tsa Mafu (ICD-11) [2] e nang le khoutu ea 6C72, e le sehlopha se arohaneng le paraphilias ka har'a taolo ea tšusumetso. Ho ea ka tlhaloso ea Mokhatlo oa Lefatše oa Bophelo (WHO) [3], bothata ba boitšoaro bo hlephileng ba ho kopanela liphate bo khetholloa ka mokhoa o sa khaotseng oa ho hloleha ho laola litabatabelo tse matla, tse pheta-phetoang tsa thobalano kapa litakatso tse hlahisang boits'oaro bo pheta-phetoang ba thobalano. Matšoao a ka kenyelletsa ho pheta-pheta liketso tsa thobalano ho ba ntho ea mantlha bophelong ba motho ho isa ntlheng ea ho se tsotelle bophelo bo botle le tlhokomelo ea motho kapa lithahasello tse ling, mesebetsi le boikarabello; boiteko bo bongata bo sa atleheng ba ho fokotsa boits'oaro bo pheta-phetoang ba thobalano, le ho ts'oara boits'oaro bo pheta-phetoang ba thobalano leha ho bile le litlamorao tse mpe kapa ho fumana khotsofalo e nyane kapa ho hang. Mohlala oa ho hloleha ho laola litabatabelo tse matla, tsa thobalano kapa litakatso tse hlahisang boits'oaro bo pheta-phetoang ba thobalano o bonahala nakong e telele (mohlala, likhoeli tse 6 kapa ho feta), mme o baka khatello ea maikutlo kapa ho holofala ho hoholo bathong, lelapeng, sechabeng, thutong, mosebetsing. kapa likarolo tse ling tsa bohlokoa tsa tšebetso. Matšoenyeho a amanang ka ho felletseng le likahlolo tsa boitšoaro le ho se amohele litakatso tsa thobalano, litakatso, kapa boits'oaro ha a lekana ho fihlela tlhoko ena. Leha a lekile khafetsa ho fokotsa khafetsa boits'oaro bo sa sebetseng ba thobalano, motho ea nang le ts'oaetso ea botona kapa botšehali a ke ke a laola likhatello tsa hae, mme a ipapisitse le bohale ba lefu la hae, a ka hlahisa matšoao a hlakileng a ho tšoenyeha, ho feto-fetoha ha maikutlo, ho ba mabifi a sa sisinyeheng, ho itšepa ho feteletseng, ho itšoara hampe le ho qobella [ 4].

Mofuta oa bohlano o ntlafalitsoeng oa Diagnostic and Statistical Manual of Mental Disorders o hlophisitsoeng ke American Psychiatric Association (Diagnostic Manual of Mental Disorder, DSM-5) [5] leha ho le joalo ha e kenyeletse ts'oaetso ea bosodoma ka karohano ea mafu a kelello, leha bobeli bona ho na le mekhahlelo bakeng sa likotsi tsa thobalano tse amanang le bothata ba ho fihlela mokhelo kapa ho tsosa takatso ea thobalano le mathata a paraphilic [5]. Sechaba sa mahlale se phehile khang haholo ka kotsi ea ho fetisa kelello le boits'oaro ba batho ba bang bao ka tlhaho ba nang le libido tsa mantlha tsa thobalano ho feta karolelano, kapa ba lulang maemong a setso le setso moo boitšoaro bo hlephileng joalo bo amoheloang hangata. Ka mokhoa o ts'oanang, taba ea tšoaetso ea phapang e lula e le likhang, e le hore bothata ba bosodoma, bo iponahatsang khafetsa hammoho le mathata a mang a kelello a joalo ka lefu la ho ferekana kelellong kapa syndromes e tepelletsang, ha ea lokela ho fumanoa e le lefu le ikemetseng, empa e le sesupo sa bobeli sa maikutlo ho hloka taolo. Litsebi tseo, ho fapana le hoo, li bolelang hore li teng, li hlalosa bosodoma e le bokhoba bo sebetsang, joalo ka ba bang ba joalo ka bokhoba ba tahi le bokhoba ba lithethefatsi. Ketso ena, tabeng ena ea thobalano, e ne e tla sebelisoa e le eona feela mokhoa o fapaneng oa ho sebetsana le khatello ea maikutlo kapa botho le mathata a maikutlo [4].

Ho tloha ponong ea matšoao, BosodomaKa hona, e iponahatsa boikutlong ba motho ba ho lahleheloa ke tšitiso e amoheloang hangata, ka boikhethelo a khetha boits'oaro bo shebaneng le ponahatso e tsoelang pele ea liketso tse hohelang, tse tsosang takatso le tse labalabelang mekhoa ea thobalano. Ke ho matlafatsa le ho phahamisa maikutlo le litakatso tsa thobalano, tse susumelletsang motho hore a bontše thahasello litabeng tsa thobalano. Leha ho le joalo, maikutlo ana ha se kamehla a reretsoeng ho fihlela thobalano; hangata e emela mokhoa oa ho hohela tlhokomelo le ho fana ka maikutlo ho litakatso tsa kahare tsa thobalano tseo ho seng joalo re ke keng ra fumana mokhoa oa ho itokolla. Ho tloaelehile hore lithuto tsena li qobelle batho ho etsa thobalano le botona kapa botšehali. Haholo-holo, ho ipholla litho tsa botona kapa botšehali ke boemo bo itseng hobane ho feta boitšoaro bo litšila bo emela ntho e nkeloang sebaka, e ka nkang litšobotsi tsa bokhoba ka ho e etsa hore e be e putsang ka ho khetheha, eo hangata e leng litšoantšo tsa bootsoa, ​​kapa voyeurism, ke hore, litšoantšo tsa bootsoa “ Phela "tloaela ho etsa tefo kapa ka ho paka likamano le ba bang, kapa ka lekunutu (ho hloela batho ba ikemiselitseng ho etsa thobalano). Motho ea tloaetseng ho ipholla litho tsa botona kapa botšehali hangata o apareloa ke bothata ba ho se khone ho ba le sepheo se lakatsehang, le ho tlameha ho khotsofatsa ho ipholla litho tsa botona kapa botšehali. Ka nako e 'ngoe, ka lehlakoreng le leng, motho o qetella a itšehla thajana kapa ho holofala likamanong tsa sechaba hobane thobalano ea hae e nkuoa e le sehloho ka ho ipholla litho tsa botona kapa botšehali. Ho seng joalo, ho ipholla litho tsa botona kapa botšehali ho fetoha ho kula hobane ho eketseha ha makhetlo ho lekana le khotsofalo e tlase, ho batloa ka bohale kapa ka ho tšoenyeha ntle le katleho, kapa ho tsamaellana le maemo a nyahamisang le a hlabisang motho lihlong. Ho ipholla litho tsa botona kapa botšehali hangata ho bitsoa "ho qobella" le ha e le hantle sena se baka mohopolo o fosahetseng o emelang phapang ea bokhoetsana bo sa laoleheng. Khopolo-taba ea thobalano e fapane le takatso e fetelletseng ka hore ea batloa, ea hlahisoa le ho fepuoa e le mokhoa oa ho ikhotsofatsa, 'me liketso tsa ho ipholla litho tsa botona kapa botšehali ha li etsoe khahlanong le thato ea motho hajoale, empa ha li etsoa khahlano le merero ea motho ka kakaretso. Boemong bona ba ho se sebetse, leha ho le joalo, litloaelo tsa papiso li ka lula hammoho empa tsa emela semelo sa boemo bona. Mohlala, motho ea nang le ts'ebeliso e mpe ea thobalano a ka khetha litaba tsa bootsoa tseo a li ratang kapa balekane ba lefuoang bao a ba ratang, athe mohiruoa oa thobalano o qetella a sebelisitse nako ea hae lipatlisisong tsena ho fihlela a se a sa fumanehe (hobane ha a sa khona ho sebetsa kapa a inehele bophelong ba sechaba) ka lisebelisoa tse kholo, ka hona mohlomong a ikamahanya le lintho tsa pele tseo a li fumanang, hape a amohela likotsi (bohloeki le tšoaetso, kapa tikoloho), ho li sebelisa hang hang [1].

Ha bosodoma bo lula bo sa fole, ho tla ba le puo ea lefu la 'nete, boemo ba bobeli ka matla a khoheli: Ho phehella ho tsosoa ka thobalano (PSAD). Thabo e tsoelang pele ea thobalano e sutumetsa motho hore a qobelle ho batla maemo le liketsahalo tse amanang le thobalano; ka hona, bosodoma e ba qalo ea lefu lena. Ho khotsofatsa koloi ea motho, motho eo a buang le eena a ka 'na a ba le takatso e matla ea ho kopanela liphate e ka' nang ea e-ba e nyonyehang kapa e fosahetseng. Ka lebaka lena, lintlha tsena li lokela ho hlophisoa maemong a khatello ea kelello le kelello; leha ho le joalo, taba ena e ntse e khona ho boloka sebopeho sa tloaelo, e tlama boits'oaro bona feela mohatong oa maikutlo le thobalano, ho fokotsa ho senyeha ha likamano tsa batho le sekhobo se tloaelehileng sa monna ea sekametseng ho tsa thobalano ho ikemisetsa kapa tahi. . Litaba tseo ho buuoang ka tsona hangata ke bahlaseluoa ba paraphilias, ba tlamehang ho emela le ho phela maphelong a bona a maikutlo le maikutlo [1].

Ha tlhoko ea ho ikutloa u sa thibeloa ebile o lokolohile ka thobalano e fetoha tlhoko ea kamehla le e sa laoleheng ea ho etsa liketso tsa thobalano, thabo e tsoelang pele e fetoha lemalla la 'nete: Ho lemalla thobalano. E emela boemo ba hoqetela ka khoheli ea boits'oaro bo sa sebetseng ba thobalano mme hangata e tsamaea le tlhoko ea ho etsa liketso tsa thobalano le batho kapa lintho ka ho theha paraphilias e le 'ngoe kapa ho feta. Morero ke ho phethahala ha monyaka 'me hangata litlamorao tsa liketso tsa motho, leha a ka tsejoa ke motho eo a li buang, li khelloa fatše kapa ha li nkuoe ka nepo, hobane tsitsipano eo ba ka e bakang e ka nyahamisa matla a thobalano a seng a le malala-a-laotsoe ho tuka [ 6]. Ho lemalla thobalano ho tšoaea mokhoa o phehellang oa ho hloleha ho laola litabatabelo tse matla [le] tse pheta-phetoang tsa thobalano, ho fella ka boits'oaro bo pheta-phetoang ba thobalano ka nako e telele e bakang khatello e kholo kapa ho holofala bathong, lelapeng, sechabeng, thutong, mosebetsing kapa libakeng tse ling tsa bohlokoa. ea tšebetso [7]. Ho lemalla thobalano, nakong e fetileng, lefapheng la bongaka, ho ne ho tsejoa ka mantsoe "Nymphomania" (ho bua ka basali) le "Satirism kapa Satiriasis" (ho bua ka banna), kaha lithutong tsa Bagerike ba Nymph ba ne ba hlalosoa ka sebopeho sa bona kahare Lekala la matla a bomolimo a Aidòs, ka hona ho ba boinotšing le ho makatsoa ke sefahleho sa se se nang molato 'me ka hona ba thotse' me ba emeloa e le banana ba batle ba sa feleng, ba khonang ho hohela banna le bahale, ha ba Satyrs ka kakaretso ba ne ba bontšoa e le batho ba litelu ka litsebe tsa pōli kapa tsa pere, manaka, mohatla, le maoto, a inehetseng ho veine, ho bapala le ho tants'a le ba Nymphs, ba le kopanong ea boithabiso ba thobalano [1]. Nakong e sa tsoa feta, boemo bona bo boetse bo hlalosoa e le bosodoma, boitšoaro ba bosodoma, ho ts'oaroa ke thobalano le boits'oaro bo qobelloang ba thobalano; le haufinyane tjena, boitšoaro bo hlephileng ba thobalano bo hlahisitsoe e le bothata ba taolo ea tšusumetso ea ho kenyeletsoa ICD-11, ka liteko tsa inthanete le lithuto tsa bongaka tse reretsoeng ho leka bonnete ba eona [7]. Kajeno mantsoe ana a mabeli ha a sa sebelisoa. Ho itšetleha ka mafu ke maemong a mang ho tsoela pele, ho eketseha ka matla le ketsahalo e lumellanang ea mofuta oa ho khotsofatsa thobalano. Mona taba ena ha e sa khona ho khetholla meeli e amoheloang sechabeng mme ho itšetleha ha hae ho mo beha maemong a felletseng, maemong ohle a bophelo ba hae, ho tloha ho motho ka mong ho ea ho lelapa, ho tloha mosebetsing ho ea sechabeng. Paraphilias e fetoha mokhoa oa ho ba le thobalano joalo ka eng kapa eng mme o batla menyaka ka nako e le ngoe le ts'ebeliso ea litšoantšo tsa bootsoa. Har'a litlamorao tsa keketseho ena re ka bolela matšoao a latelang a kliniki: khatello ea 'mele le ea kelello e bakoang ke ho batla lintho tse sa tsitsang, tse feteletseng, tse qobelloang le tse fetelletseng; ho senyeha ha likamano tsa sechaba; fokotseha mohopolong oa nakoana le mohopolong; ho fifala ha kutloisiso le phokotso ea boiphihlelo ba ho tseba lintho tse kang intuition, abstraction, synthesis, creativity le concentration; batla menyaka ea thobalano maemong afe kapa afe ntle le ho lekola litlamorao tsa liketso tsa motho (hape le litlamorao tsa boahloli); ho fokotsa ts'ebetso ea 'mele le mokhathala o sa foleng; fetotsoe morethetho oa circadian oa boroko; lipalo tse ntseng li eketseha tsa matšoenyeho; pefo e phatlohang; ho phehella ho ferekana maikutlo; ho se khotsofale ho sa feleng; maikutlo a ho se tsotelle le ho soetseha ha thobalano e phethetsoe; boinehelo ba letsatsi le leng le le leng bakeng sa ho batla maemo a tsosang takatso ea thobalano, boholo ba lihora tsa letsatsi; ho hloka botsitso; ho behellwa thoko ha batho; ho khotsofatsa le ho khahlisa ka thata ho oela leratong; phapano ea likamano tse tloaelehileng tsa thobalano moo moqoqo a lekang ho pheta le molekane oa hae (leha e le ka linako tse ling) mokhoa o le mong kapa tse 'maloa tse nyonyehang, a nyatsa batho.

Mabapi le maemo a kliniki, leha ho le joalo, kamehla ho qala ka phapang lipakeng tsa bosodoma, ho phehella ho tsosa takatso ea thobalano le bokhoba ba thobalano, boemo ba lefu lena bo tloaetse ho khetholloa ho ipapisitsoe le ho tiea ha matšoao a tlalehiloeng nalaneng; ka hona, Hypersexourse (e leng qalo ea boemo bo sa sebetseng, ka boitšoaro ba thobalano) e kanna ea ba sesupo se ikhethileng sa e 'ngoe ea likhopolo tsena tse' ne tsa tlhahlobo ea kelello [7].

1) "Thobalano ea botona le botšehali" e le sesosa sa khatello ea maikutlo le kelello, hobane ts'ebetso e etsoang ke motho, leha e nkuoa e le ntho e tloaelehileng, e emetsoe ka karolelano e phahameng ho feta maemo a bophelo le litleleniki [7]. Moelelong ona, patlo ea botona le botšehali e hokahantsoeng le karolo ea litšoantšo tsa bootsoa le paraphilic e emela tsela e bonolo le e fapaneng ea ho ba le thobalano, leha le le banyalani, ntle le ho sekisetsa likarolo tse ling tsa sechaba tsa motho (lelapa, maikutlo, maikutlo, ho sebetsa), ha ho ntse ho e-na le boemo ba "ego-dystonic" bo tebileng bo tšoenyang motho, bo mo etsa hore a lemohe boits'oaro ba hae ba thobalano joalo ka sesupo sa mafu [8] e hlahisang maikutlo a molato le lihlong [9];

2) "Bosodoma" e le sesupo sa boemo ba 'mele bo khahlisang bongaka, bo neng bo le teng pele ho thobalano bo nkoang bo sa sebetse (mohlala,' dementia 'kapa hlahala ea boko) [7];

3) "Bosodoma" e le sesupo sa boemo ba kelello bo khahlisang bongaka, bo teng kapa bo lumellanang kapa kamora boitšoaro ba thobalano bo nkoang bo sa sebetse (mohlala, boloetse bo fetelletseng-bo qobelloang, bothata ba manic, kapa bothata ba botho) [7]. Ha li bapisoa le matšoao a hlalositsoeng ho anamnesis, hegosynthesis e emela karolo e amehang ea bongaka e lebisang ho fumanoeng ho tsoa ho sebapali le bothata ba boits'oaro ho isa bothateng ba 'nete ba motho (mohlala, borderline personality disorder) [1].

4) "Bosodoma" e le lets'oao la boemo bo ikhethileng ba kelello bo atisang ho tsosa takatso ea maikutlo.

Litlaleho tsa Neurobiological

Baloaneli ba "Khopolo ea ho lemalla thobalano" khetholla karolo ea 'mele ea bokuli ka mekhoa e ts'oanang ea' mele ea ho lemalla papali ea chelete, ka hona ts'oaetso ea bohlokoa ea sisteme ea dopaminergic le serotonergic e ka ba motheo oa lipatlisiso tse qobelloang le tse sa laoleheng tsa thobalano. Dopamine neurotransmitter e ntšitsoeng ke li-neuron tse fumanehang tsamaisong ea limbic (nucleus accumbens mme ka kakaretso ventral striatum) e ne e tla lokolloa ka mokhoa o laoloang ke lithuto tse nang le bothata bona. Ts'ebetso ena ea methapo ea kutlo e na le mosebetsi oa ho khothaletsa ts'ebetsong ea boits'oaro bo reretsoeng ho fihlela thabo, e kenyeletsang boits'oaro bo netefatsang ho phela bathong (batla lijo le metsi, boits'oaro ba ho ikatisa…). Le ha e so ka e netefatsoa ka ho hlaka ke patlisiso e kholo ea mahlale, litsebi li boetse li boletse hore ho nka karolo ho etiology ea bosodoma ea serotonergic ea neurotransmitter, hormone ea neuronal e etsang hore u utloe thabo, khotsofalo le khotsofalo. Ho qala ho tsoa ho li-neuron tsa serotonergic tse karolong e ka pele ea cortex, projeke ea serotonergic e kenella ho li-nucleus accumbens ka ho hlophisa tlhahiso ea dopamine mme ka hona e laola taolo ea boithaopo le taolo ea boits'oaro. Lithutong tse nang le mafu a ts'oaetso ea khatello ea maikutlo le khatello e feteletseng ea maikutlo, mosebetsi ona o tla ameha [10,11].

Phuputso e sa tsoa etsoa e ile ea hatisa boits'oaro bo sa sebetseng ba thobalano e le lefu la 'nete la methapo ea pelo: "Ho ts'oaroa ka thobalano ho bolela ho eketseha ka mokhoa o sa tloaelehang kapa ho nka karolo ka mokhoa o fetelletseng liketsong life kapa life tsa thobalano. Ke phephetso ea bongaka, e fana ka tlhahlobo ea bongaka mme ho na le lingoliloeng tse pharaletseng tsa bongaka tse sebetsanang le lintlha tsa nosology, pathogenesis, le neuropsychiatric ho lefu lena la bongaka. Kemiso e kenyelletsa boits'oaro bo khelohileng, likarolo tse ka hlahlojoang tse amanang le ho se ts'oenyehe, le liketsahalo tse sa bonahaleng. Lingaka tse ling li nka keketseho ea takatso ea thobalano e le 'ntho e tloaelehileng' ke hore litsebi tsa kelello li nka hore ke boits'ireletso ka linako tse ling ho fokotsa ho tšoenyeha ho sa tsebe letho ho bakoang ke likhohlano tsa kelello. Re totobatsa bosodoma e le mekhahlelo e mengata e amanang le keketseho ea thobalano e amanang le khatello ea maikutlo le ts'ebetso ea ts'ebetso. Boitšoaro ba bosodoma bo na le lintlha tse ngata tse nang le phapang e fapaneng e kenyeletsang mathata a maholo a kelello (mohlala, lefu la ho ferekana kelellong), litlamorao tse mpe tsa kalafo (mohlala, kalafo ea levodopa), mathata a bakoang ke lithethefatsi (mohlala, tšebeliso ea lithethefatsi tsa amphetamine), mathata a neuropathological (mohlala, lobe syndrome e ka pele. ), hara tse ling. Li-neurotransmitters tse ngata li amehile ho pathogenesis ea eona, ka dopamine le noradrenaline e bapala karolo ea bohlokoa litseleng tsa moputso oa neural le lipusong tsa limbic system tse laoloang maikutlong. Tsamaiso ea bosodoma e khethoa ke molao-motheo oa litlamorao tsa de causa, haeba lisosa li phekoloa, litlamorao li ka nyamela. Re ikemiselitse ho lekola karolo ea baemeli ba litlhare tsa meriana ba bakang bosodoma le baemeli ba maemong a bohareng ba phekolang maemo a amanang le bongaka. Lintho tse khethollang bio-psycho-social li bohlokoa ho amohela kutloisiso le tataiso ea taolo ea lefu lena la bongaka le rarahaneng le le ikemiselitseng ho fapana ”[12]

Kamora nako, lipatlisiso tse ling tsa mahlale li fana ka maikutlo a ho ameha ho ka bang teng ha pituitary-hypothalamic-adrenal axis [13,14] le nucleus frontostriatal [15], lipatlisiso tse ling (haholo-holo Sefora), ka lehlakoreng le leng, li shebile lehokela lipakeng tsa thobalano e sa sebetseng. boits'oaro le oxytocin [15-17], leha mohopolo oa morao o e-so tiisoe ka bonnete le ha e le bohlale ba kelello. Phekolo e thehiloeng ho oxytocin (e nang le spray ea nko) e ka ba motheong ona, haeba e netefalitsoe, kalafo e 'ngoe hape e tlatsetsang ho li-protocols tse ntle tse sebelisoang hajoale [18].

Litlaleho tsa Etiological le diagnostic

Lisosa tsa maemo ana ha li so tsejoe ka botlalo, leha ts'ebetso e atileng lingoliloeng ka sebele e le lintho tse ngata: liphatsa tsa lefutso, methapo ea kutlo, lihormone, kelello, tikoloho [12]. Empa hape le maemo a ikhethileng a mafu, joalo ka lefu la sethoathoa [19,20], 'dementia' [21,22], boloetse bo feteletseng bo qobelloang [23] ADHD [24], khatello ea taolo ea tšusumetso [25] le maloetse a methapo [26].

Leha ho le joalo, ho khetholla maemo a sa sebetseng le thobalano e tloaelehileng (leha e le matla ebile e le kholo), lintlha tse ling li lokela ho tsotelloa nalaneng ea bongaka ea mokuli [27].

A) Mokuli o tšoenngoa ke boits'oaro ba hae mme o itšepa hampe;

B) Mokuli o lula a batla maemo le batho ba nang le litaba tse phahameng tsa thobalano;

C) Mokuli o qeta lihora tse ngata ka letsatsi a etsa thobalano;

D) Mokuli o hlahisa boits'oaro ba paraphiliac nalaneng ea hae ea bongaka;

E) Mokuli ha a khone ho khutsisa tšusumetso ea thobalano, e nkoang e le ntho e fetelletseng;

F) Mokuli, ka boitšoaro ba hae ba thobalano, o amme likarolo tse ling tsa bophelo ba hae, joalo ka mosebetsi, bophelo bo botle le bophelo ba lelapa;

G) Mokuli o ikutloa a sa tsitsa maikutlong ha a sa etse thobalano;

H) Mokuli o sekisetsa likamano tsa hae tsa botho le tsa sechaba ka lebaka la boitšoaro ba hae ba thobalano.

Ho tsamaisa tlhaloso ena, leha ho le joalo, litlhahlobo le liteko tse hlophisitsoeng le tsona li hlahisitsoe joalo ka SAST (United States of America) le SESAMO (Italy); ka ho khetheha, khutsufatso ea morao-rao e emetse Tekano ea Tekolo ea Tekano ea Tlhatlhobo ea Botona le Botšehali, teko ea kelello ea tlhahlobo ea kelello e entsoeng Italy, e netefalitsoeng le ho emisoa ho baahi ba Italy, e ipapisitseng le lipotso tseo ho tsona ho ka etsahalang ho lekola litaba tsa thobalano le likamano, melao ea tsamaiso le ho se sebetse. , ka lihlooho tse le 'ngoe kapa ka bophelo ba banyalani. Teko e na le lipotso tse peli tsa lipotso, mofuta o etselitsoeng basali le e le 'ngoe bakeng sa banna, e' ngoe le e 'ngoe ea eona e arotsoe likarolo tse tharo: karolo ea pele e na le lintho tse hlahlobang libaka tse mabapi le likarolo tsa thobalano e hole, boits'oaro, tikoloho le litšobotsi tse khethollang. ea taba, hammoho le nalane ea bongaka. Karolo ena e hlophisitsoe ke bohle ba arabelitsoeng bao qetellong ea karolo ena ea pele, e tla lebisoa ho e 'ngoe ea likarolo tse peli tse ipapisitseng le boemo ba bona ba maikutlo, bo hlalosoang e le "boemo bo le bong" kapa "boemo ba banyalani"; karolo ea bobeli e bokella lintho tseo libaka tsa tsona tsa lipatlisiso li amanang le thobalano le lintlha tse susumetsang; karolo ena e boloketsoe boemo ba Bosoha, ho bolelang hore ho se be teng ha kamano e tsitsitseng ea thobalano ea motho eo le molekane oa hae; karolo ea boraro e kenyelletsa libaka tse fuputsang thobalano ea hajoale ea taba le kamano ea banyalani. Karolo ena e lebisitsoe ho maemo a mabe, a reretsoeng ho ba teng ha kamano e amanang le thobalano e nkileng bonyane likhoeli tse tšeletseng le molekane. Kamora ho fela ha tsamaiso, ha ho liphetoho tse ka etsoang ka har'a litaba tsa lipotso le tlaleho, sena se nepahetse ka mabaka a boits'oaro empa ka holim'a tsohle ho hlokahala bakeng sa bonnete ba lefapha la litsebi le tlhaiso-leseling. Tlaleho e na le likarolo tse 9, ho kenyeletsoa lintlha tsa botho le tsa lelapa, graph, lintlha, litšoaneleho tse mahlonoko, le tlaleho ea tlaleho, ho phethela ka mekhahlelo le likarabo tsa lipotso tsa lipotso [28].

Tšebeliso ea litšoantšo tse manyala tse hlephisang boitšoaro litlamong tsa thobalano

Ho tsebahala hore litšoantšo tse manyala tse hlephisang boitšoaro ke setšoantšo se hlakileng sa litaba tse tsosang takatso le tsa thobalano ka mefuta e fapaneng, ho tloha lingoliloeng ho isa ho penta, ho shebella lifilimi le ho nka lifoto. Ka tšimoloho ea Segerike, ketsahalo ena e emetse mofuta oa bonono, hobane motho e mong le e mong o na le litoro tse litšila, ke hore, o sebelisa mohopolo ho emela liketsahalo tse khahlisang, ntle le lebaka le leng ntle le thabo ka boeona: Litšoantšo tsa bootsoa ke ho tiisa likhopolo tsena litšoantšo, litšoantšo, lingoloa, lintho kapa lihlahisoa tse ling. Kaha batho ba bangata ba na le likhopolo tse ts'oanang le tsa thobalano, hangata litšoantšo tse manyala tse hlephisang boitšoaro tse hlahisoang ke motho a le mong, tse nang le litšoantšo tsa maikutlo a hae a tsosang takatso, li boetse li thabisa ba bang ba bangata. Leha litšoantšo tse manyala tse hlephisang boitšoaro li boetse li sebelisoa e le sesebelisoa se bonolo mesebetsing e rarahaneng ea bonono, sepheo sa eona se seholo ke ho tsosa takatso ea thobalano. Kamehla ho 'nile ha phehisana khang ka moeli o fetohang lipakeng tsa bonono, litšoantšo tsa bootsoa le litšoantšo tse manyala tse hlephisang boitšoaro, tseo hangata li nkoang li se molaong litsamaisong tsa molao tsa bophirima, empa maemong a mang e (kapa e bile) tlasa thibelo mme ho e shebella ho thibetsoe (haholoholo ho ba banyenyane). Ho fumaneha ho hoholo ha sechaba le theko e tlase ea seaplane ho etsa hore inthanete e be sesebelisoa se sebelisoang haholo ho abeng le ts'ebeliso ea lisebelisoa tsa litaba tsa bootsoa. Ebile, ka ho qaleha ha marang-rang, haholoholo ts'ebetsong ea lits'ebetso tse joalo ka ho arolelana faele (ho arolelana faele) le ho arolelana livideo (ho arolelana livideo), litšoantšo tsa bootsoa li se li fumaneha hanghang le ho sa tsejoe hohle le ho mang kapa mang. Litholoana tsa morao-rao tsa ketsahalo ena, pele ho tsohle, li fokolitse maikutlo a akaretsang a ho nyatsuoa ha a tobane le mofuta ona oa polelo, ha ka lehlakoreng le leng, e thusitse ho phatloha kapa ho hasana ho pharalletseng haholo ha liketsahalo tse kang "Amateur" mofutakwalo, o bopang lifoto le livideo tse amanang le litšoantšo tse litšila tse bontšang batho ba tloaelehileng (hangata e le bangoli ba tšoanang le sehlahisoa). Ntle le ho arolelana lifaele, mocha o mong o moholo oa kabo ea litšoantšo tsa bootsoa inthaneteng o emeloa ke libaka tsa marang-rang tse lefelloang, e leng mosebetsi o kenyang chelete e ngata ho bahlahisi ba thepa ea profeshenale ba fang sebaka sa marang-rang monyetla oa liteishene tsa khale tsa kabo joalo ka mabenkele a litaba, mabenkele a livideo le mabenkele a thobalano. Ka lebaka la marang-rang, seo bangoli ba bang ba se bitsang neo-porn se ntse se tiisa le ho feta, ha papali ea batho ba baholo, kapa lipapali tsa elektroniki, e ntse e hasana, eo maemo a eona (leha a fapana ho ea ka metlae ho ea ho litoro) a ipolokang e le motho oa bootsoa. Ka lebaka la ho senoloa ha lipontšo tse lefuoang le tse sa lefelloeng, ka khaso ea webcam (e tsebahalang hohle webong), e lumella ho ea lipapaling tsa bootsoa le ho buisana ka puisano le ba etsang ka nako eo [29].

Phuputso ea morao-rao ea mahlale mabapi le bokhoba ba thobalano le litšoantšo tsa bootsoa e fumane hore:

1. Ts'ebeliso ea litšoantšo tse manyala tse hlephisang boitšoaro har'a bacha, ba e sebelisang haholo inthaneteng, e hokahane le ho fokotseha ha takatso ea thobalano le ho ntsha peo pele ho nako, hape maemong a mang le mathata a khatello ea maikutlo sechabeng, khatello ea maikutlo, DOC le ADHD [30-32] .

2. Ho na le phapang e hlakileng ea "neurobiological" lipakeng tsa "basebetsi ba thobalano" le "makhoba a litšoantšo tsa bootsoa": haeba motho oa pele a na le hypoactivity ea ventral, ba qetellang ba khetholloa ke ts'ebetso e kholo ea ts'ebetsong bakeng sa lipontšo tsa thobalano le meputso ntle le boikaketsi ba lipotoloho tsa moputso. Sena se ka fana ka maikutlo a hore basebetsi ba hloka ho ikopanya le batho ba bang, ha ba morao ba tloaetse ho etsa boinotšing [33,34]. Hape, ba lemaletseng lithethefatsi ba bonts'a ho se hlophisehe ho hoholo ha taba e tšoeu ea prefrontal cortex [35].

3. Ho lemalla lit soant so tsa bootsoa, ​​leha e le mokhoa o fapaneng oa ho lemalla ho kopanela liphate, e ntse e le mofuta oa boitšoaro bo hlephileng mme ho se sebetse hantle hona ho thusa ho mpefatsa boemo ba motho ba psychopathological, ka kotloloho le ka tsela e sa tobang e amanang le phetoho ea methapo ea kutlo boemong ba ho hloka ts'ebeliso ea ts'ebeliso ea thobalano, hypersensitization ho ho hlohlelletsa ho se sebetse ka thobalano, boemo bo totobetseng ba khatello ea maikutlo bo ka amang boleng ba lihormone tsa axis ea pituitary-hypothalamic-adrenal le boikaketsi ba lipotoloho tsa pele [36].

4. Mamello e tlase ea ts'ebeliso ea litšoantšo tsa bootsoa e netefalitsoe ke phuputso ea fMRI e fumaneng boteng bo tlase ba taba e putsoa tsamaisong ea moputso (dorsal striatum) e amanang le bongata ba litšoantšo tse manyala tse hlephisang boitšoaro tse jeoang. O boetse a fumana hore ts'ebeliso e ntseng e eketseha ea litšoantšo tse manyala tse hlephisang boitšoaro e tsamaellana le ts'ebeliso e nyane ea potoloho ea moputso ha o ntse o shebile lifoto tsa thobalano hakhutšoane. Bafuputsi ba lumela hore liphetho tsa bona li bonts'itse ho hloka boithati le ho mamellana, e leng tlhoko ea ho hlasimoloha ho feta ho fihlela boemo bo ts'oanang ba tsoho. Ho feta moo, lipontšo tsa bokhoni bo tlase li fumanoe ho Putamen lithutong tse itšetlehileng ka litšoantšo tsa bootsoa [37].

5. Ho fapana le seo motho a ka se nahanang, makhoba a litšoantšo tsa bootsoa ha a na takatso e matla ea thobalano mme tloaelo ea ho ipholla litho tsa botona kapa botšehali e amanang le ho shebella litšoantšo tsa bootsoa e fokotsa takatso hape e lumella ho tsoa peo pele ho nako, kaha taba e ikutloa e phutholohile haholo mesebetsing ea motho a le mong. Ka hona batho ba nang le ts'ebeliso e kholo ea litšoantšo tsa bootsoa ba khetha ho etsa thobalano ba le bang ho fapana le motho oa nnete [38,39].

6. Ho emisoa ka tšohanyetso ha lithethefatsi tse hlephisang boitšoaro ho baka litlamorao tse mpe maikutlong, nyakallo, le khotsofalo ea likamano tsa botona le botšehali [40,41].

7. Tšebeliso e kholo ea litšoantšo tsa bootsoa e thusa ho qala ha mathata a kelello le mathata a kamano [42].

8. Marang-rang a amanang le boits'oaro ba thobalano a ts'oana le a amehang ho sebetsaneng le meputso e meng, ho kenyeletsoa le lithethefatsi. Ho kopana ha likarolo tsa khale tsa boko tse amehang ka ho tsosa takatso ea thobalano, lerato, le ho hokelloa ho hlakisitsoe ka sebaka sa karoloana ea karoloana, li-nucleus accumbens, amygdala, basal ganglia, preortal cortex le cortex orbitofrontal ho ba substrate e tloaelehileng. Moetso o bitsoang "model deficit syndrome model" (RDS) o kentsoe letsoho litlamong tsa bootsoa mme o fana ka maikutlo a ho se khotsofale kapa liphatsa tsa lefutso tsa moputso oa boko o hlahisang thabo e kholo ea ho batla boits'oaro bo kenyelletsang lithethefatsi, ho ja ho tlōla, lipapali tsa thobalano, papali ea chelete le maitshwaro a mang. Ka hona, tokollo e tsoelang pele ea dopamine tsamaisong ea moputso e netefalitsoe ha motho a shebella litšoantšo tse manyala tse hlephisang boitšoaro ka mokhoa o qobelloang le o sa feleng o tsosa liphetoho tsa methapo ea pelo tse matlafatsang boiphihlelo. Liphetoho tsena tsa methapo ea pelo li aha limmapa tsa boko bakeng sa tsoho ea thobalano. Mefuta eohle ea tahi e tsejoa e kenyelletsa dopamine mesolimbic pathway (DA), e tsoang sebakeng sa ventral tegmental (VTA) mme e hlahisoa ho nucleus accumbens (NAcc) e etsang potoloho ea moputso ka ho lemalla. Potoloho ena e kentsoe letsoho thabong, matlafatsong, ho ithuteng, ho putsoeng le ho se ts'oenyehe ho bonoang ke ho lemalla. Tsela ea mesolimbic ea dopamine e hokahane le libaka tse tharo tsa boko ho theha lipotoloho tse atolositsoeng tse bitsoang lits'oants'o tsa moputso. Meaho e amehang ke amygdala e bonts'ang maikutlo a matle le a mabe, tšabo le mohopolo oa maikutlo, hippocampus e sebetsanang le ho sebetsana le ho hlaphoheloa ha mehopolo ea nako e telele, le cortex e ka pele e hokahanyang le ho khetholla boits'oaro. Lihlopha tse fapaneng tsa lithethefatsi tse sebelisang kelello li ka kenya tšebetsong sistimi ea moputso ka litsela tse fapaneng, leha ho le joalo, sephetho sa bokahohle ke phallo ea dopamine ho li-nucleus accumbens (setsi sa moputso). Sena se baka ts'ehetso e matla ea boits'oaro e qalileng likhohola le mekhatlo e amanang le ho lemalla lithethefatsi. Hang ha moroallo oa dopamine o qetile tsela ea ona, ho na le ts'ebetso ea amygdala e atolositsoeng, sebaka se amanang le ho sebetsana le bohloko le boemo ba tšabo. Sena se lebisa ts'ebetsong ea litsamaiso tsa khatello ea kelello le phokotso ea lits'ebetso tse khahlano le khatello ea maikutlo tse nang le kutloisiso e fokotsehileng ea li-premium le keketseho ea moeli oa moputso, o bitsoang mamello. Ka hona, ho na le pheta-pheto le matlafatso ea boits'oaro bo lemalloang. Libaka tse ikhethileng tse anngoeng kahare ho preortal cortex li kenyelletsa dorsolateral prefrontal cortex (DLPFC), e ikarabellang bakeng sa likarolo tsa bohlokoa tsa ts'ebeliso ea ts'ebetso le phethahatso (14) le ventromedial prefrontal cortex (VMPFC) e ikarabellang bakeng sa likarolo tsa thibelo le karabelo ea maikutlo, e amang karolo ea ts'ebetso ea ts'ebetso ea moputso. Boko bo itšetlehileng ka bona bo kena boemong ba "allostatic" ha sistimi ea moputso e sa khone ho khutlela maemong a eona a homeostatic (tloaelehileng). Sistimi ea moputso e ntan'o ba le set-point e ntlafalitsoeng, e siee motho eo a le tlokotsing ea ho khutlela mokhoeng hape le bokhoba ba tahi. Sena ke se bitsoang "lehlakore le lefifi" la tahi. Bokong ba motho ea lemaletseng bootsoa, ​​limmapa tsa boko tse neng li thehiloe bakeng sa thobalano e tloaelehileng li ke ke tsa tšoana le limmapa tse sa tsoa ntlafatsoa le ho matlafatsoa khafetsa tse hlahisoang ke ho shebella litšoantšo tse manyala tse hlephisang boitšoaro, 'me motho ea itšetlehileng ka eena o hlaka haholoanyane le ts'ebeliso ea litšoantšo tse manyala tse hlephisang boitšoaro ho boloka boemo bo phahame ho feta thabo. Liphetoho ho segokanyipalo sa dopamine receptor li kentsoe boemong bona ka liphetoho tse sa feleng tsamaisong ea moputso. Phuputso ea morao-rao e bontšitse hore nako e telele ea ho shebella litšoantšo tse manyala tse hlephisang boitšoaro e tla fokotseha le ho feta; Ntle le moo, khokahano lipakeng tsa caudate le letona le ka morao ea dorsolateral prefrontal cortex (DLPFC) ea fokotseha, e leng karolo e 'ngoe ea khokahano le ba nang le bothata ba boits'oaro kapa boits'oaro ba lithethefatsi. Kamora nako, lithuto tse ling li fumane hore phetoho ea meaho ea methapo e kang orbitofrontal cortex (OFC) le li-subcortical li hokahane ka kotloloho le liphetoho tsa methapo ea methapo ea serotonin le lipakeng tsa serotonin le dopamine.

Kalafo ea bongaka

Boloetse bona, ka tlhaho bo amang tšimo ea kelello, hangata bo sebetsoa ka kalafo ea kelello ea motho ka mong kapa ea sehlopha, eo ho eona ho sebelisoang mokhoa o fapaneng hanyane ho feta o sebelisitsoeng ho ithiba: mokhoa o ikemiselitseng ho sutumetsa sehlooho ho hlola maikutlo a fetelletseng a tlhoko le ho khutla ho ba le kamano e ntle le thobalano. Maemong a rarahaneng haholo, hammoho le kalafo ea kelello ea boits'oaro kapa boits'oaro (ho qoba e matla, ka mabaka a bolelele ba nako), lithethefatsi tsa khatello ea maikutlo le kalafo ea litlhare tse ka felisang libido li ka sebelisoa, kamehla haeba ho se na tlhoko ea kalafo ea lithethefatsi e shebiloeng. li-anti-depressing, li-stabilizers tsa maikutlo le li-antipsychotic ka pel'a li-psychopathologies tse ling, ka comorbidity [5,29,44].

Mekhoa ea kalafo ea boits'oaro le ts'ebetso ea boits'oaro, lebaleng la bokhoba ba thobalano le boits'oaro bo sa sebetseng ka thobalano, e shebile liketsong tse 'ne tse ikhethileng [45].

a) Fokotsa takatso ea thobalano le ho sitisa potoloho ea mokhelo; khafetsa sepheo sena se batloa ka ts'ebeliso ea li-anti-depressing tseo, ka lehlakoreng le leng li ka fokotsang takatso e mafolofolo, ho potlaka, ho hlasimoloha le ho lelefatsa nako ea botona kapa botšehali, hape li ka eketsa ho se ts'oenyehe le menahano ea thobalano, tsa baka boemo bo bobe ka ho fetesisa;

b) Fokotsa ho tsilatsila ka kakaretso ka li-stabilizers le li-anti-depressing, ho fokotsa nako, boholo le ho tiea ha linako tsa manic;

c) Eketsa khotsofalo ea kahare, ho etsa takatso ea ho batla ho potlaka le ho feta khafetsa, bonyane ha ho se na tšusumetso e kholo;

d) Ho itšunya-tšunya le setotsoana ho etsa hore monyaka o se ke oa ba matla haholo ho feta nako ea bona ea ho qetela.

Naheng ea Italy, Cantelmi le Lambiase [46], ba shebile kalafo lipuisanong tse khothatsang le ho hlaphoheloeng ha mesebetsi ea mokuli ea ts'ebeliso ea maikutlo. Ebile, ho latela mokhoa ona, ho tsepamisa maikutlo ho fetelletseng taolong ea matšoao a makatsang le a sa sebetseng a ts'ebetsong ea boits'oaro bo pheta-phetoang, bo qobelloang le / kapa bo nyonyehang, bo kotsing ea ho lahleheloa ke pono ea monyetla oa ho theha bothata ka mokhoa o holisitsoeng haholoanyane, e kenyeletsang boleng ba tšoantšetso bo teng boo thobalano e bo emelang motsotsong oo ho mokuli. Boloetse ba bosodoma bo ka amahanngoa le ho se hlophisehe hoa litsamaiso tse susumetsang tseo moetsi a li hlophisitseng lilemong tsa kholo ho tloha ts'ebelisanong le bahlokomeli ba hae ba pele. Ha ba bua ka lithuto tsa lits'ebetso tse susumetsang tse entsoeng ke Liotti, bangoli ba kenyelletsa mohopolo oa khaello ea mesebetsi ea boits'oaro ke Antonio Semerari khopolong ea merero ea mechini e sebetsang ea kahare. Merero ena ea kutloisiso e tsamaellana le mefuta ea ts'ebetso e ka hare e seng e hlalositsoe ke ngaka ea mafu a kelello le psychoanalyst John Bowlby, ea ileng a hlokomela hore na o iphumane a lumellana hakae le lithuto tse entsoeng Italy ke Giovanni Liotti le Vittorio Guidano, leha tse morao li ne li le mabapi le boits'oaro. Mekhoa ea tšusumetso e khethiloeng ke Liotti e arotsoe ka mekhahlelo e meraro ea ho iphetola ha lintho 'me e fepa, e phefumoloha, e fuputsa, e hlekefetsa thobalano ka mabaka a amanang le maemo a tlase ka ho fetesisa a netefatsang ho phela. Boemong ba bobeli, e mabapi le tlhoko ea tšebelisano ea sechaba, e tloaelehileng ea mefuta ea batho, Liotti e supa kamano, tšebelisano lipakeng tsa ba lekanang, ho kopanya thobalano e etselitsoeng bophelo ba banyalani, maemo a sechaba; Boemong ba boraro, tse tsoetseng pele haholo, puo ea tšoantšetso, tlhoko ea tsebo, tlhoko ea ho fana ka litlhaloso, ho batla litekanyetso. Mefuta ena eohle ea likoloi tse susumetsang e teng ho motho ka mong, 'me e ka kengoa tšebetsong kapa che ke maemo a kantle. Ho ea ka bangoli ba babeli, sistimi ea likhokahano e amehile haholo ts'ebetsong ea sistimi ea ts'usumetso ea thobalano ho bakuli ba nang le ts'oaetso ea bosodoma. Ka tloaelo, ts'ebetsong ea ea pele ha ea lokela ho kenyelletsa ts'ebetso ea e 'ngoe, hobane e le mabaka le mabaka a mabeli a fapaneng. Leha ho le joalo, lingaka tse peli li hlokometse hore ho bakuli ba lemaletseng bosodoma, boitšoaro ba thobalano hangata bo ne bo ts'oaroa nakong ea matšoenyeho, tšabo kapa pherekano e le sesebelisoa sa ho sebetsana le maikutlo a mabe. Lebaka ke hobane mohlokomeli eo a ka fumanang matšeliso ho eena (moeeng) a le sieo, motho eo "o ithutile" a sa tsebe hore na a ka fihlela maikutlo a boiketlo le thabo e ntle joang ka ketso ea thobalano le likamano tsa botona le botšehali. Sena se netefatsoa ke lithuto tse ngata tse hokahanyang bothata ba bokhoba ba tahi le ketsahalo ea liphihlelo tse matla tse fetileng. Kaha mochini ona o hlaha ho mokuli a sa tsebe letho, a ke ke a utloisisa le ho roba mochini o iketsang o mo lebisang ho pheta boitšoaro ba thobalano maemong a sa thabiseng. Cantelmi le Lambiase ba lumela hore khaello ea ho hlaka maemong a ts'oaetso ea ts'oaetso e bakoa ke khaello mesebetsing ea metacognitive ea mokuli, ke hore, ho khona ho itlhahloba, ho amohela maikutlo a hae, ho a lekanyetsa ka linako tsohle ho fihlela sepheo sa hae. , beha maano a teng ho li laola ka nepo. Mesebetsi ea ts'ebetso ea ts'ebetso e ntse e hahuoa le ho hlophisoa bocha ho pholletsa le bophelo ba motho ka mong, ho qala ka litšebelisano tsa hae tsa pele le mohlokomeli oa mantlha. Ka ts'ebetso ea ho iponahatsa maikutlong eo ngoana a e etsang ho ngoana, o ithuta ho amohela maikutlo a hae, ao boemong ba pele a khethollang feela maikutlo a "monate" kapa "a sa thabiseng" le ho amohela a ba bang. Khopotso ea maikutlo ana a bileng teng bongoaneng e tlalehiloe mohopolong o hlakileng le oa pele ho taba; mohopolo oa mohopolo o bolokiloeng o tla hlophisoa bocha ka har'a sistimi ea ts'usumetso, e tla tataisa boits'oaro ba motho ha sistimi e itseng e ts'oaroa ke boemo ba kantle. Ho akaretsa, ho ea ka lingaka tse peli tsa Mataliana, mochini o ts'ehetsang bokhoba ba thobalano ke ts'ebeliso ea sistimi e fosahetseng e mabapi le kopo ea tikoloho: ha boemo bo ka hloka ts'ebetsong ea sistimi e hoketsoeng, e lokelang ho kenya tšebetsong letoto ea boits'oaro bo reretsoeng ho letsetsa motho ea tšelisang, ho batla thuso, kapa ho kenya tšebetsong maano a mang ho ikemela a ho fokotsa tšabo le matšoenyeho, sistimi ea ts'usumetso ea thobalano ea ts'oaroa, e susumelletsang motho ho etsa boits'oaro bo qobelloang ba thobalano. Haholo-holo ka khopolo ena, leha ho le joalo, kalafo e sebetsang e ikemiselitse ho eketsa kutloisiso ea mokuli ka tšimoloho ea bokuli ba hae le tsela e sa sebetseng eo ts'usumetso ea thobalano e kenngoang ho eena ho lefella mesebetsi e meng, joalo ka taolo ea bohloko, ho teneha, tšabo ea ho lahloa. Taba ea mantlha katlisisong ea bangoli ba babeli ke ho thusa mokuli ho tseba hore na ke maikutlo afe le hore na ke maemo afe a ka etsang hore a tsose takatso ea thobalano ho eena, hore a tsebe ho hlakisa maano a mang a ho sebetsana ka katleho mmoho.

Nahanisisa

Mokhahlelo oa bongaka oa "boits'oaro bo sa sebetseng ba thobalano" o kenyelletsa letoto la likhopolo tsa mafu tse amanang haholo le matšoao a hlalositsoeng ho anamnesis. Ka hona, bosodoma e ka ba feela phello ea ts'ebetso e phahameng kapa, ho ea ka matšoao, ponahalo ea boemo ba mmele kapa ba kelello: maemong a pele re tla tlameha ho itlhahisa ka lefu la sethoathoa, methapo ea mali, 'dementia,' mala. Mathata, tšoaetso ea systemic kapa neuroendocrine; ketsahalong ea bobeli, ka lehlakoreng le leng, re tla tlameha ho shebana le lifaele tsa psychopathological, ho fihlela litlatsong le bothateng ba botho. Liphuputso tsa Neurosciology li boetse li tiisa khopolo ea hore ka mora boits'oaro bo sa sebetseng ho na le mochini o ts'oanang o bolokang boits'oaro le / kapa lithethefatsi, o shebile haholo-holo sebaka sa ventral tegmental, nucleus accumbens, amygdala, basal ganglia, preortal cortex le cortex orbitofrontal. Ntle le likhopolo-taba tse amanang le ho nka karolo ha dopamine le serotonin, khopolo-taba ea ho nka karolo ha oxytocin molemong oa moputso le khotsofalo e bonahala e khahlisa; leha ho le joalo, lithuto tsa khopolo-taba ena li ntse li fokola 'me lintlha li ke ke tsa nkuoa e le tse hlakileng. Nakong e tlang, ho lebelletsoe tlhokomelo e kholo khopolong ea oxytocin ka taba ea bokhoba ba thobalano, bosodoma le litšoantšo tsa bootsoa.

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Setšoantšo sa 2: Palo ea liperesente tsa Bacha ke Lits'ebeletso tsa Thibelo ea Mehloli.

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