Likhokahano tsa Neural le tsa boits'oaro tsa tebello ea ts'usumetso ea thobalano li supa mekhoa e kang ea bokhoba ba boits'oaro bo qobelloang ba boitšoaro ba thobalano (2022)

koranteng ea bokhoba ba boitšoaro
Maikutlo a YBOP: Tumellanong le lithuto tse fetileng, phuputso ena ea boko e fumane hore batho ba lemaletseng bootsoa / thobalano (bakuli ba CSBD) ba na le boitšoaro bo sa tloaelehang le mosebetsi oa boko nakong ea ho lebella ho shebella litšoantšo tsa bootsoa, ​​​​haholo-holo ho ventral striatum. Lihlooho tse ileng tsa tlaleha matšoao a matla a CSBD li bontšitse boitšoaro bo sa tloaelehang ka ho lebella ho shebella litšoantšo tsa bootsoa. Ho feta moo, thuto e boetse e fumane batho ba lemaletseng bootsoa / thobalano "batla" porn ho feta, empa ha ho joalo "joaloka" e feta taolo e phetseng hantle. Sena se tsamaisana le Khothatso ea Khothatso mohlala oa bokhoba. 
 
Hlokomela: Bafuputsi ba bontšitse liphuputso tsena li tsamaellana le mohlala oa bokhoba, 'me ba fana ka maikutlo a hore ho aroloa ha CSBD e le bokhoba ba boitšoaro ho nepahetse ho feta sehlopha sa hona joale sa "impulse-control disorder". Ho tsoa boithutong:
 
Habohlokoa, liphapang tsena tsa boitšoaro li fana ka maikutlo a hore lits'ebetso tse kenyelletsang tebello ea ts'usumetso e tsosang takatso le e seng e tsosang takatso li ka fetoloa ho CSBD le ho tšehetsa mohopolo oa hore. mekhoa e amanang le tebello e amanang le tebello e ts'oanang le ea mathata a ts'ebeliso ea lithethefatsi le bokhoba ba boitšoaro e ka bapala karolo ea bohlokoa ho CSBD., joalo ka ha ho boletsoe pejana (Chatzittofis et al., 2016; Gola et al., 2018; Jokinen et al., 2017; Kowalewska et al., 2018; Mechelmans et al., 2014; Politis et al., 2013; Schmidt et al., 2017; Sinke et al., 2020; Voon et al., 2014). Sena se ile sa tšehetsoa hape ke taba ea hore ha rea ​​ka ra bona liphapang mesebetsing e meng ea kelello e lekanyang ho nka kotsi le taolo ea tšusumetso, ho hanyetsana le maikutlo a hore mekhoa e akaretsang e amanang le khatello e teng.
 
Ho tloha pheletsong:
 
Liphuputso tsa rona li fana ka maikutlo a hore CSBD e amahanngoa le mekhoa e fetotsoeng ea boitšoaro ea tebello, e amanang le ts'ebetso ea VS nakong ea tebello ea maikutlo a tsosang takatso. The liphuputso li tšehetsa mohopolo oa hore mekhoa e ts'oanang le ea bokhoba ba ntho le boitšoaro e bapala karolo ho CSBD le ho fana ka maikutlo a hore ho aroloa ha CSBD e le bothata ba ho laola maikutlo ho ka 'na ha phehisana khang ho latela liphuputso tsa neurobiological.

 

inahaneloang

Ka morao le sepheo

Compulsive Sexual Behavior Disorder (CSBD) e tšoauoa ka mekhoa e phehellang ea ho hloleha ho laola maikutlo a ho kopanela liphate ho fellang ka ho pheta-pheta boitšoaro ba thobalano, bo lateloang ho sa tsotellehe liphello tse bohloko. Leha ho na le matšoao a nakong e fetileng a mekhoa e kang ea bokhoba ba tahi le sehlopha sa morao-rao sa taolo ea khatello ea maikutlo ho Sehlopha sa Machaba sa Mafu (ICD-11), lits'ebetso tsa neurobiological tse tlasa CSBD ha li tsejoe.

mekhoa

Re thehile le ho sebelisa paradigm ea boitšoaro e reretsoeng ho arola mekhoa e amanang le tebello le ho shebella lintho tse tsosang takatso. Ho bakuli ba 22 ba banna ba CSBD (lilemo: M = 38.7, SD = 11.7) le taolo ea banna ba 20 ba phetseng hantle (HC, lilemo: M = 37.6, SD = 8.5), re ile ra lekanya likarabo tsa boitšoaro le ts'ebetso ea methapo nakong ea litšoantšo tse sebetsang tsa magnetic resonance (fMRI). Liphetho tsa mantlha e ne e le liphapang tsa nako ea karabelo lipakeng tsa liteko tse tsosang takatso le tse seng tse tsosang takatso le ts'ebetso ea ventral striatum (VS) nakong ea tebello ea ts'usumetso ea pono. Re ile ra amahanya liphetho tsena hammoho, ho hlahlojoa ke CSBD, le ho teba ha matšoao.

Results

Re fumane liphapang tse matla tsa taolo ea linyeoe maemong a boitšoaro, moo bakuli ba CSBD ba bonts'itseng liphapang tse kholo tsa nako ea karabelo lipakeng tsa liteko tse tsosang takatso le tse seng tse tsosang takatso ho feta HC. Mosebetsi o ile oa etsa hore ho be le liketso tse ka tšeptjoang ka har'a sehlopha ka seng. Le hoja re sa ka ra bona phapang e kholo ea lihlopha mosebetsing oa VS, ketsahalo ea VS nakong ea tebello e amanang le liphapang tsa nako ea ho arabela le ho itlhahloba bakeng sa ho lebella lintho tse tsosang takatso.

Puisano le Liphetho

Liphetho tsa rona li ts'ehetsa bonnete le ts'ebetso ea mosebetsi o ntlafalitsoeng mme li fana ka maikutlo a hore CSBD e amahanngoa le mekhoa e fetotsoeng e amanang le tebello, e neng e amahanngoa le ts'ebetso ea ventral striatum nakong ea tebello ea lintho tse tsosang takatso. Sena se tšehetsa mohopolo oa hore mekhoa e kang bokhoba ba tahi e bapala karolo ho CSBD.

Selelekela

Compulsive sexual behaviour disorder (CSBD) e kenyelelitsoe ho Sehlopha sa Machaba sa Lipalopalo tsa Mafu le Mathata a Amanang le Bophelo bo Botle (ICD-11) (Mokhatlo oa Lefatše oa Bophelo, 2019), e thathamisitsoeng karolong e nyenyane ea mathata a ho laola maikutlo. Ho ea ka ICD-11, CSBD e khetholloa ka mokhoa o tsitsitseng oa ho hlōleha ho laola maikutlo a matla a ho kopanela liphate kapa litakatso tse hlahisang boitšoaro ba ho kopanela liphate bo pheta-phetoang, bo phehelloang ho sa tsotellehe liphello tse mpe tsa bongaka, tsa kelello le tsa sechaba. Ho ata ha matšoao a CSBD ho hakanngoa ho 3-10% ea batho ka kakaretso (Blum, Badgaiyan, & Gold, 2015; Litholoana le al., 2012; Derbyshire et al., 2015; Dickenson, Gleason, Coleman, & Miner, 2018; Estellon et al., 2012; Kafka, 2010; Kingston et al., 2013; Kor, Fogel, Reid, & Potenza, 2013; Kuhn et al., 2016; Weinstein, Katz, Eberhardt, Cohen, & Lejoyeux, 2015). Le hoja mekhoa e meng ea phekolo e teng (Briken, 2020; Hallberg et al., 2019; 2020; Savard et al., 2020), ba ntse ba hloka ntlafatso ho netefatsa liphetho tse ntle tsa nako e telele ka katleho e phahameng.

Leha CSBD e kenyelelitsoe ho ICD-11, mekhoa ea neurobiological e thehiloeng ho CSBD e ntse e sa tsejoe.Derbyshire et al., 2015). Ho na le likhang tse tsoelang pele mabapi le sehlopha sa ICD-11 sa CSBD se ipapisitseng le liphuputso tse fokolang tsa neurobiological (Fuss et al., 2019). Patlisiso e fetileng e fana ka maikutlo a hore mekhoa e ts'oanang e fumanoang bothateng ba khatello ea maikutlo, mathata a tšebeliso ea lithethefatsi, le bokhoba ba boitšoaro bo ka bapala karolo ho CSBD. Ho senyehetsoe ha libaka tsa boko tse laolang takatso ea thobalano le ho tsosoa ha maikutlo le tsona li hlahisitsoe (Blum et al., 2015; Litholoana le al., 2012; Derbyshire et al., 2015; Estellon et al., 2012; Kafka, 2010; Kingston et al., 2013; Kor et al., 2013; Kraus, Voon, & Potenza, 2016; Kuhn et al., 2016Weinstein et al., 2015). Lithuto tsa morao-rao tsa neuroimaging li senoletse hore CSBD e amahanngoa le ts'ebetso e fetotsoeng ea tšusumetso ea thobalano (Stark, Klucken, Potenza, Brand, & Strahler, 2018). Tlhahlobo ea morao-rao e etsa qeto ea hore CSBD e amahanngoa le ho sebetsa ka mokhoa o sa laoleheng libakeng tsa boko tse amehang ho itloaetsang, ho laola maikutlo le ho sebetsana le meputso (Kowalewska et al., 2018). Libaka tsa boko tse amehang li kenyelletsa li-prefrontal le temporal cortices, amygdala, le ventral striatum (VS) (Gola et al., 2018; Kowalewska et al., 2018; Voon et al., 2014). Kahoo, tsamaiso ea moputso oa boko e bonahala e phetha karolo ea bohlokoa ho CSBD (Kowalewska et al., 2018; Politis et al., 2013; Schmidt et al., 2017; Voon et al., 2014), 'me ho na le bopaki bo ntseng bo eketseha ba hore mekhoa ea bohlokoa e kopana le batho ba lemaletseng lintho le boitšoaro (Gola et al., 2018; Kowalewska et al., 2018; Mechelmans et al., 2014). Ka hona, ho ntse ho na le khang ea hore na CSBD e ka khetholloa hamolemo e le boitšoaro bo lemalloang.

Karolo e ka sehloohong ea bokhoba ba tahi ke ho senyeha ha tsamaiso ea moputso oa boko e lebisang "ho ba le ts'usumetso e feteletseng", kapa ka mantsoe a mang "ho batla" ho feteletseng kapa takatso ea ho fumana moputso. Sena se lebisa takatsong e matla ea ho batla moputso, mohlala, ho sebelisa sethethefatsi. Tumellanong le sena, batho ba nang le mathata a ts'ebeliso ea lithethefatsi ba bonts'a ts'ebetso e sa tloaelehang ea boko molemong oa tebello ea moputso (Balodis et al., 2015), hangata ho VS, e leng sebaka sa nako e telele sa bohlokoa sa ho lebella meputso (Jauhar et al., 2021; Oldham et al., 2018). Leha ho le joalo, liphuputso tse sebetsang tsa magnetic resonance imaging (fMRI) tse lebisitseng lits'ebetso tsa tebello ho CSBD lia fokola (Gola et al., 2018), 'me liqeto tse ngata mabapi le mekhoa e ka' nang ea e-ba teng li nkiloe liphuputsong tse ileng tsa batlisisa karabelo ea neural ho pono e bonolo ea tšusumetso ea thobalano, ho tlohela lipatlisiso tsa tebello ea ts'usumetso.

Mefokolo e meng ea lithuto tse fetileng tsa fMRI e kenyelletsa hore litšoantšo tsa taolo ha li laole ka ho lekaneng bakeng sa ts'ebetso ea likarolo tsa 'mele oa motho le likamano tsa sechaba. Ho feta moo, ts'ebetso ea boko e bonoang nakong ea ts'ebetso ea ts'usumetso ea thobalano e ka ferekanngoa ke ho tsosoa ha maikutlo ka kakaretso haeba e sa laoloe bakeng sa (Walter et al., 2008). Maikutlo a ho hlajoa ke lihlong le ho ba molato kapa ho leka ho laola takatso ea thobalano nakong ea teko ho ka ferekanya. Linako tse telele tsa ts'usumetso le ts'ebeliso ea meralo ea li-block kapa livideo li etsa hore ho be thata ho tseba hore na ke mekhahlelo efe ea potoloho ea karabelo ea thobalano e lekantsoeng (Georgiadis et al., 2012; Markert, Klein, Strahler, Kruse, & Stark, 2021), ho sitisa tlhaloso ea data. Habohlokoa ka ho fetisisa, lithuto tsa pele li ne li sitoa ho khetholla pakeng tsa ts'ebetso ea boko e amanang le tebello le ho shebella maikutlo a ho kopanela liphate. Phapang ena e bohlokoa ho etsa likopo mabapi le liketsahalo tsa 'ho lemalla' ho CSBD (Gola, Wordecha, Marchewka, & Sescousse, 2016).

Mosebetsi o sebelisoang khafetsa ho lekanya ts'ebetso ea boko e amanang le tebello ea moputso ke ts'ebetso e netefalitsoeng ea ts'usumetso ea chelete, e sitisang tebello ea moputso ho tsoa lits'ebetsong tsa ho amohela moputso.Balodis et al., 2015; Knutson, Westdorp, Kaiser, & Hommer, 2000; Lutz et al., 2014). Sena se etsoa ka lipontšo tse bontšang esale pele mofuta oa moputso o tlang. Phuputso e 'ngoe e sebelisitse ts'ebetso ea ts'usumetso ea ho lieha ho kopana le ts'usumetso ea thobalano (Sescousse, Redouté, & Dreher, 2010), le ho sebelisa bafuputsi ba mosebetsi ona ba bontšitse hore bothata ba ho sebelisa litšoantšo tse manyala tse hlephisang boitšoaro bo amahanngoa le ts'ebetso e fetotsoeng ea ts'ebetso ea VS ka lebaka la litlhahiso tse bolelang litšoantšo tse tsosang takatso, empa eseng bakeng sa ho bolela esale pele meputso ea chelete (Gola et al., 2017). Ho ea ka tsebo ea rona, ena e bile thuto ea pele e lekanyang ts'ebetso ea boko e amanang le tebello ea tšusumetso ea thobalano ho batho ba nang le matšoao a amanang le CSBD. Leha ho le joalo, meputso ea chelete e ne e sebelisoa e le liteko tsa taolo, ho e-na le litšoantšo tse sa kopaneleng tsa thobalano (maikutlo). Lits'oants'o tsa tebello e ne e le tse susumetsang ebile li le teng - le hoja li ngotsoe - litaba tsa thobalano, tse ka 'nang tsa se li ntse li kenya tšebetsong marang-rang a amehang ts'ebetsong ea ts'usumetso ea thobalano (Gola et al., 2017). Hantle-ntle, liphapang leha e le life tsa tšoantšetso tsa matšoao a tebello, ho kenyelletsa le 'mala le sebōpeho, li ka ferekanya. Ho feta moo, tekanyo ea setšoantšo e entsoeng ka mor'a tlhahiso ea ntho e 'ngoe le e' ngoe e susumetsang e le karolo ea mosebetsi e ka hlahisa mekhoa ea kelello e amanang le kahlolo le ho ama ts'ebetso ea neural nakong ea tlhahiso ea tšusumetso (Walter et al., 2008).

Sepheo sa thuto ea joale e ne e le habeli. Taba ea pele, re ne re ikemiselitse ho hlola meeli ea moralo oa mosebetsi oa li-paradigms tse fetileng. Ka hona, re thehile mosebetsi oa ho lieha ho ts'oanela, moo ts'usumetso ea thobalano le litšoantšo tsa taolo ea 'mele li neng li tsamaellana ka hloko le litšobotsi tse fapaneng tsa setšoantšo. Ts'ebetso le lits'ebetso tsa pokello ea data li ne li etselitsoe ho qoba litlamorao tsa tatellano, maemo le matšoao a tebello ea tebello. Taba ea bobeli, re ne re ikemiselitse ho sebelisa mosebetsi tekong ea fMRI ho leka hore na CSBD e amahanngoa le karabelo e fetotsoeng ea boitšoaro le ts'ebetso e fetotsoeng ea ventral striatum (VS) e amanang le tebello ea tšusumetso ea thobalano.

Re sebelisitse paradigm ea fMRI ho bakuli ba 22 CSBD le li-control tse phetseng hantle tsa 20 (HC) mme ra leka mehopolo e 'meli: 1) re ne re lebelletse hore bakuli ba CSBD ba bonts'e tšusumetso e phahameng e susumetsoang ke tebello ea ho sheba litšoantšo tse tsosang takatso ho fapana le tseo e seng tse tsosang takatso, tse bonts'itsoeng liphapanong tsa nako ea karabo. , ka mor'a ho lokisa bakeng sa lilemo. 2): Le hoja re ne re lebeletse ho kenya letsoho ho phahameng ha VS nakong ea tebello ea litšoantšo tse tsosang takatso ha li bapisoa le litšoantšo tse sa tsitsang (e tsosang takatso> e seng e tsosang takatso) lihlopheng tsena ka bobeli, re ile ra boela ra leka hore na bakuli ba CSBD ba bontšitse karabo e khōloanyane ea VS ho feta HC. Boemong bona, re ne re boetse re lebelletse kamano e fapaneng lipakeng tsa mehato ea boitšoaro le ts'ebetso ea VS nakong ea tebello.

Litekong tsa bobeli, re sebelisa tlhahlobo ea neurocognitive, re ile ra lekola mehato ea sepheo sa ho nka kotsi, taolo ea thibelo, le bohlale bo sa bueng, tse amanang le tlhahlobo ea CSBD, boitšoaro le liphetho tsa fMRI. Hape re ile ra etsa liteko bakeng sa litlamorao tse ka ferekanyang ka palo ea batho, mefuta e fapaneng ea bongaka, le litekanyetso tsa maikutlo nakong ea mosebetsi. Qetellong, re ile ra hlahloba hore na takatso, ho rata, le lintlha tse tsosang takatso li amana joang le liphetho tsa thuto.

mekhoa

barupeluoa ba

Thuto e ile ea etsoa Karolinska Institutet le ANOVA, Karolinska University Hospital, Stockholm, Sweden. Bakuli ba CSBD ba ile ba hiroa ka mohala oa thuso oa mohala oa Sweden PrevenTell (Adebahr, Söderström, Arver, Jokinen, & Öberg, 2021). Lintlha tse ling tsa ho hira, mekhoa ea ho kenya le ho qheleloa ka thoko e fanoe ho Supplemental Materials le libakeng tse ling (Hallberg et al., 2020; Savard et al., 2020). Ka bokhutšoanyane, bakuli ba banna ba ileng ba finyella litekanyetso tsa CSBD ho latela ICD-11 ba ile ba memeloa ho kenya letsoho. Litaolo tse tsamaellanang le lilemo le thobalano tse tsoang sebakeng sa Stockholm li ile tsa hiroa ka lipapatso tsa sechaba le tsa mecha ea litaba. Litaolo ha lia ka tsa bontša hore ho na le CSBD.

Re ngolisitse 20 HC le bakuli ba 23 CSBD, bao bakuli ba 22 ba faneng ka lintlha tsa MRI. Lintlha tsohle li bokelloa lipakeng tsa Mots'eanong 2018 le Tšitoe 2020.

Litšobotsi tsa bongaka le lipotso tsa lipotso

Ka lipotso tsa inthaneteng, re ile ra hlahloba maemo a matšoao a khatello ea maikutlo (Montgomery Asberg Depression Rating Scale (MADRS-S) (Montgomery et al., 1979; Svanborg et al., 2001)), maemo a khaello ea tlhokomelo (Sekala sa Boithaopo ba Batho ba baholo ba ADHD (ASRS) (Kessler et al., 2005), tšebeliso ea joala le lithethefatsi (Teko ea Boitsebiso ba Mathata a Tšebeliso ea Joala (AUDIT) (Bergman et al., 2002); Teko ea Boitsebiso ba Mathata a Tšebeliso ea Lithethefatsi (DUDIT) (Berman, Bergman, Palmstierna, & Schlyter, 2005)), matšoao a hypersexual (Hypersxual Disorder Screening Inventory (HDSI) (Parsons et al., 2013), Hypersexual Behavior Inventory (HBI) (Reid, Garos, & Carpenter, 2011)), tlamallo ea thobalano (Sekhahla sa Tlamello ea Thobalano (SCS) (Kalichman et al., 1995)), thibelo ea thobalano / likhahla tse tsosang takatso (SIS/SES) (Mmetli, Janssen, Graham, Vorst, & Wicherts, 2008), maemo a ho tšoenyeha (State-Trait Anxiety Inventory - State (STAI-S) (Tluczek, Henriques, & Brown, 2009)), matšoao a autism spectrum disorder (Ritvo Autism Asperger Diagnostic Scale (RAADS-14) (Eriksson, Andersen, & Bejerot, 2013)), takatso ea thobalano (Sexual Desire Inventory (SDI) (Spector, Carey, & Steinberg, 1996)), tšusumetso e akaretsang (Barratt Impulsiveness Scale (BIS-11) (Stanford et al., 2009)), le thibelo ea boitšoaro (Behavioral Inhibition/Activation System (BIS/BAS) (Carver et al., 1994)). Re ile ra lekola khafetsa tšebeliso ea litšoantšo tse manyala tse hlephisang boitšoaro inthaneteng le likamano tsa thobalano nakong ea likhoeli tse 6 tse fetileng, hammoho le maikutlo a thobalano (7-point Kinsey scale) (Kinsey, Pomeroy, & Martin, 1948). Ea morao-rao e ne e tloha ho 0-6 'me 0 e hlalosoa e le' batho ba ratanang le batho ba bong bo fapaneng feela 'me 6 ba rata batho ba bong bo fapaneng feela'.

Teko ea Neurocognitive

Re ile ra etsa liteko tsa neuropsychological ho fumana likhakanyo tsa sepheo sa ts'usumetso/ho nka kotsi (Balloon Analogue Risk Task, BART (Lejuez et al., 2002)), taolo ea inhibitory/impulse (Stop Signal Task, STOP-IT (Verbruggen, Logan, & Stevens, 2008)), le bohlale bo sa bueng (Ravens Standard Progressive Matrices, SPM (Raven et al., 2000)). SPM e arola tšebetso ea motho ho sehlopha sa I (tlaase) ho isa ho V (holimo ka ho fetisisa). Nako e Phahameng ea Stop-Signal Reaction (SSRT) e fumanoeng ho STOP-IT e bontša taolo e tlase ea thibelo. Mehato ea ho nka kotsi e fumanoeng ho BART e ne e le palo e fetotsoeng ea libalune le palo ea ho phatloha (Lejuez et al., 2002), moo lintlha tse phahameng li bontšang boitšoaro bo kotsi haholoanyane.

fMRI paradigm le tšusumetso

Tlhaloso e qaqileng ea paradigm ea fMRI e hlahisoa ho Lisebelisoa tsa Tlatsetso. Setšoantšo sa 1 e bontsha leano la paradigm. Ka bokhuts'oane, moralo oa mosebetsi o ne o ipapisitse le ts'ebetso e sebelisoang khafetsa ea monetary incentive delay (MID) mosebetsi (Knutson et al., 2000) le mosebetsi oa tieho ea khothatso o sebelisoang ke Gola le basebetsi-’moho (Gola et al., 2017). Palo eohle ea liteko e bile n = 80 (40 Ho nyonya 'me 40 e hlokang thobalano liteko). Lits'oants'o tsa litšoantšo li fumanoe ho International Affective Picture System (IAPS) (Lang, Bradley, & Cuthbert, 2008) le Nencki Affective Picture System (NAPS) (Marchewka, Zurawski, Jednorog, & Grabowska, 2014; Wierzba et al., 2015). Lintho tse susumetsang tse tsoang litsing tse peli tsa marang-rang li netefalitsoe mme li bonts'itsoe ho susumetsa maemo a bohlokoa a ho tsosoa ha thobalano lithutong tse fapaneng tse fetileng (Gola et al., 2016; Marchewka et al., 2014; Politis et al., 2013; Walter et al., 2008; Wierzba et al., 2015). Tšusumetso e tsosang takatso le e seng e tsosang takatso e ne e tsamaellana ka hloko mabapi le litekanyetso tsa valence le tse tsosang takatso, le likarolo tse ling tsa setšoantšo. Kaha barupeluoa ba ne ba kenyelelitsoe ho sa tsotelehe maikutlo a bona a bong, re thehile mefuta e 'meli ea maikutlo a hore maikutlo a tsosang takatso a ka bapisoa le khetho ea barupeluoa. Lintlha tse ling mabapi le litšobotsi tsa stimuli li fanoe ho Lisebelisoa tsa Tlatsetso.

Setšoantšo sa 1.
 
Setšoantšo sa 1.

Kemiso ea moralo oa ts'usumetso ea thobalano e liehisa mosebetsi oa fMRI. Mehlala e 'meli ea liteko tsa taolo e sa chesehang (holimo) le liteko tse tsosang takatso (ka tlase) li bonts'itsoe. Palo eohle ea liteko e bile n = 80 (40 bakeng sa mofuta o mong le o mong oa teko) e fumanoeng ka linako tse peli. Seboka se seng le se seng se ne se na le 20 Ho nyonya 'me 20 e hlokang thobalano laola liteko. Kakaretso ea nako ea mosebetsi e ne e ka ba metsotso e 24. Taelo ea nyeoe e ne e sa reroe. Linako tsa liketsahalo li bonts'itsoe. Ketsahalo ea 1 skrine e grey (e khethiloe nako ea nako ea teko): nako e sa reroang lipakeng tsa 4 le 7 s. Ketsahalo ea 2 e ne e le mohato oa tebello o hlahisang lets'oao le bonts'ang mofuta oa teko, ke hore, nehelano ea kamoso ea setšoantšo se "hlokang maikutlo" kapa "se sa tsosang takatso" (ketsahalo e kholo ea thahasello). Se boleloang ke letšoao le leng le le leng se ile sa hlalosetsoa barupeluoa ba ka ntle ho scanner, ba ileng ba boela ba etsa nako e khutšoanyane ea boikoetliso pele ho teko. Ketsahalo ea 3 (fixation cross) e bontšitse tokisetso ea mosebetsi. Ketsahalo ea 4 target square: mosebetsi o hloka ho tobetsa konopo. Barupeluoa ba ile ba laeloa ho tobetsa konopo kapele kamoo ho ka khonehang ha lisekoere li hlaha 'me haeba ba ka arabela kapele ho lekana setšoantšo se tla hlahisoa. Mosebetsi oa ho tobetsa konopo o kenyelelitsoe ho boloka barupeluoa ba falimehile le ho lekola linako tsa karabelo e le mokhoa oa ho ba moemeli oa 'tšusumetso ea ho hlola'. Sekhahla sa ho hloleha se behiloe ho 20%, moo setšoantšo sa lerata se hlahisitsoeng e le tšusumetso ea pono (sheba Lisebelisoa tsa Tlatsetso bakeng sa lintlha tse ling mabapi le moralo oa mosebetsi). Ketsahalo ea 5 skrine ea bohlooho: nako ea ho leta (nako e sa reroang). Ketsahalong ea 6, ho ile ha hlahisoa setšoantšo se tsamaellanang le mofuta oa teko, ke hore, e ka ba ntho e tsosang takatso kapa e seng e tsosang takatso ea pono (ketsahalo ea bobeli ea thahasello). Mokhoa oa ho fumana o ne o etselitsoe ho qoba litlamorao tse ka bang teng tsa taelo, litlamorao tse hlahisoang ke ho potoloha ha matšoao, le litlamorao tsa tloaelo/conditioning (bona Supplemental Materials). Jittering (linako tsa nehelano tse sa reroang) tsa nako ea li-inter-stimuli li ile tsa sebelisoa ho arola tebello ea moputso ho tsoa ho rasiti kapa ts'ebetso ea boko e amanang le konopo.

Liphapang tse peli li ile tsa bapisoa pakeng tsa bakuli le litsamaiso tsa CSBD: Phapang ea 1 (ka sehloohong): Phapang ea ts'ebetso ea boko pakeng tsa liteko tse tsosang takatso le tse sa tsitsang nakong ea tebello (ketsahalo ea 2). Phapang 2 (ea bobeli): Phapang ea ts'ebetso ea boko lipakeng tsa liteko tse tsosang takatso le tse seng tse tsosang takatso nakong ea tlhahiso ea litšoantšo (ketsahalo ea 6).

Tlhaloso: Journal of Behavioral Addictions 2022; 10.1556/2006.2022.00035

Lipotso tse amanang le liteko tsa fMRI

Pele le ka mor'a ho hlahlojoa ha MRI, barupeluoa ba ile ba botsoa ho lekanya litakatso / litakatso tsa bona bakeng sa lintho tse fapaneng (ho kenyeletsoa takatso ea thobalano). Pele ho teko, barupeluoa ba ile ba botsoa hore na ba lebelletse hakae ho boha litšoantšo tse sa tsosang takatso le tse tsosang takatso. Ena e ne e le eona ntlha ea mantlha ea thahasello, kaha e amana ka kotloloho le tebello. Ka mor'a teko, barupeluoa ba ile ba botsoa ho fana ka litekanyetso tsa valence le ho tsosoa ha maikutlo ho bakoang ke ts'usumetso ea pono. Lipotso tse ling li ne li shebane le lintlha tse ka bang le litlamorao tse ferekanyang tšebetsong ea boko nakong ea teko, joalo ka maikutlo a nang le boiphihlelo a lihlong, molato, le hore na monkakarolo o lekile hakae ho laola takatso ea thobalano. Sheba Lisebelisoa tsa Tlatsetso bakeng sa tlhaiso-leseling e batsi mabapi le lipotso tse amanang le fMRI.

Setšoantšo sa mahlaseli a resonance

fumana

Litlhahlobo tsa MRI li ile tsa etsoa ho 3T GE scanner (Discovery MR750) e nang le coil ea lihlooho tse robeli. Lintlha tsa fMRI li ile tsa fumanoa ka tatellano ea 2D gradient-echo EPI le litšoantšo tse boima ba T1 li ile tsa fumanoa ka tatellano ea 3D-BRAVO. Ntle le tlhahlobo ea fMRI, ho ile ha etsoa skena se boima ba T1 mme sa sebelisoa bakeng sa ngoliso e kopanetsoeng ea data ea fMRI. Mekhahlelo ea ho etsa litšoantšo e fanoe ho Lisebelisoa tsa Tlatsetso.

Processing

Lintlha mabapi le ts'ebetso le litlhahlobo tsa fMRI li fanoe ho Lisebelisoa tsa Tlatsetso. Ka bokhutšoanyane, ho sebelisa software ea FSL 6.0.1, boko bohle bo bolela limmapa tsa ts'ebetso (Contrast Of Parameter Estimates: COPE) bakeng sa phello ea thahasello (liketsahalo tse tsosang takatso> tse sa thabiseng) li ile tsa balloa bakeng sa tebello ka bobeli (phapang e kholo 1, Setšoantšo sa 1) le mohato oa ho shebella (phapang 2). Tsena li ne li sebelisetsoa ho batlisisa ts'ebetso e amanang le mosebetsi ka hare ho lihlopha le lipakeng tsa lihlopha (phapang ea thahasello: CSBD> HC).

Le hoja papiso ea sehlopha sa boko bohle e ne e le lipatlisiso, sepheo sa rona se seholo e ne e le ho hlahloba phapang ea lihlopha mosebetsing oa VS nakong ea tebello. Ka hona, re ntšitse litekanyetso tsa COPE tse bolelang nakong ea mohato oa tebello (le mohato oa ho shebella e le taolo) ho tloha ho VS (Figure S7) (Tziortzi et al., 2011). Mehato ena e ile ea hlahlobjoa ho SPSS mabapi le liphapang tsa taolo ea linyeoe, litlhahlobo tsa kutlo bakeng sa pherekano e ka bang teng, le khokahano le sephetho sa boitšoaro (ΔRT) le matšoao a CSBD (sheba ka tlase).

Lipatlisiso tsa sethathamo

Litšobotsi tsa sehlopha (data ea palo ea batho, ea bongaka, le ea kelello)

Litšobotsi tsa sehlopha ho mefuta ea batho le ea kliniki e thathamisitsoeng ho Tafole 1 li ne li bapisoa ho sebelisoa t-liteko kapa tsa Fisher's exact/Chi2. Lipapiso tsa sehlopha ho nka kotsi le SSRT li ile tsa etsoa ho sebelisoa tlhahlobo e sa tloaelehang ea covariance (ANCOVA), ha e ntse e lokisa lilemo, ho SPSS v26.

Tafole 1.

Palo ea batho le litšobotsi tsa kliniki

HlakolaHC (n = 20)CSBD (n = 23)HC khahlano le CSBD (P-sotho)
Age, ho bolela (SD)37.6 (8.5)38.7 (11.7)0.741
BMI, e bolelang (SD)23.1 (2.8)25.8 (4.5)0.026
tšebeliso ea nikotine (e / che / ka linako tse ling), n
Senefi se mongobo3/16/0*7/13/0*0.157
tsuba0/16/40/21/0*0.048
Matsoho (R/L/M), n16/4/016/1/1*0.822
Boikutlo ba thobalano
Self-identified homosexual, n110.919
Kinsey scale, bolela (SD)0.6 (1.1)0.71 (1.3)0.778
HDSI, moelelo (SD)1.9 (2.2)20.2 (3.8)
HBI, moelelo (SD)22.5 (4.1)69.4 (13.4)
SDI, bolela (SD)55.2 (12.6)80.6 (17.1)
SCS, moelelo (SD)11.2 (0.9)29.4 (6.3)
Tšebeliso ea litšoantšo tsa bootsoa   
linako ka beke, ho bolela (SD)2.2 (2.3)13.0 (20.7)0.033
lihora ka beke, ho bolela (SD)0.7 (0.7)9.2 (8.0)
lilemo tsa tšebeliso ea pele, ho bolela (SD)14.2 (3.4)13.2 (4.9)0.424
MADRS, moelelo (SD)3.9 (4.9)18.3 (7.8)
AUDIT, ho bolela (SD)4.1 (3.8)6.3 (3.8)0.059
DUDIT, e bolelang (SD)2.7 (4.5)2.1 (3.0)0.582
RAADS, e bolelang (SD)6.1 (6.0)11.1 (7.7)0.025
ASRS, moelelo (SD)14.7 (10.6)34.2 (11.7)
BIS-11, bolela (SD)53.1 (7.3)66.7 (10.8)
BIS / BAS   
BAS drive, e bolelang (SD)7.4 (2.3)9.0 (2.7)0.048
BAS ho batla monate, ho bolela (SD)10.5 (2.5)11.9 (1.7)0.037
Karabelo ea moputso oa BAS, e bolelang (SD)16.3 (2.1)16.5 (1.6)0.726
BIS, moelelo (SD)17.9 (5.1)20.7 (3.1)0.033
STAI-S, bolela (SD)9.3 (2.0)12.6 (2.5)

Litšobotsi tsa palo ea batho le tsa bongaka (ho bolela (SD) kapa palo ea bankakarolo n) tsa lihlopha ka bobeli le liphetho tse lumellanang (P-values) ea papiso ea sehlopha e hlahisoa. Hlokomela, lintlha tse tlalehiloeng bakeng sa bakuli bohle ba ngolisitsoeng. Boikutlo ba ho kopanela liphate bo ne bo lekanyetsoa ka ho itsebahatsa le ka tekanyo ea 7-point Kinsey. * e bonts'a lintho tse fapaneng tse nang le data e sieo.

Khothatso ea nako ea karabelo ea ho lieha ho tsoa mosebetsing oa fMRI

Phapang lipakeng tsa linako tsa karabelo e bolelang nakong ea erotic (RTE) le liteko tse seng tsa thobalano (RTN) - boitšoaro bo lekanang le phapang ea fMRI - ho ne ho lebeletsoe hore e fapane pakeng tsa bakuli ba CSBD le litsamaiso, ha re ntse re nahana ka potlako RTE ho bakuli ba CSBD. Re sebelisa mehato e pheta-phetoang ea ANCOVA, re ile ra etsa liteko bakeng sa mofuta oa teko ea liphello (e tsosang takatso vs. non-erotic), sehlopha (CSBD vs HC), le tšebelisano ea mofuta oa liteko ka RT, ha re ntse re lokisa lilemo. Tokiso ea lilemo e ile ea etsoa ho ikarabella bakeng sa phapang e amanang le lilemo ho data ho latela hore nako ea karabo ea batho ba baholo e lieha ho ea ka lilemo. Re ile ra latela ka ho sebelisa komporo ΔRT = RTE– RTN bakeng sa morupeluoa e mong le e mong le ho bapisa ΔRT pakeng tsa lihlopha tse sebelisang ANCOVA, ha li ntse li lokisa lilemo. Re ile ra tsoela pele ho hlahloba hore na ΔRT e amana le lintlha tsa matšoao a CSBD, ho kenyelletsa le mehato ea ho sebelisa litšoantšo tsa bootsoa. Ka lebaka la boholo ba lisampole tse nyane le taba ea hore matšoao a atisa ho sothoa, re ile ra kopanya likhokahano tsa boemo ba Spearman tseo e seng tsa parametric.

Litlhahlobo tsa ts'ebetso ea VS

VS e bolela ts'ebetso nakong ea tebello e bapisoa pakeng tsa lihlopha tse sebelisang ANCOVA, ha li ntse li lokisa lilemo (SPSS). Re ile ra tsoela pele ho hlahloba hore na ts'ebetso ea VS nakong ea tebello e amana le boitšoaro ba eona ba ΔRT, 'me ra hlahloba kamano ea eona le matšoao a CSBD le mekhoa ea tšebeliso ea litšoantšo tsa bootsoa (Spearman correlations) sehlopheng se kopantsoeng. Sepheo e ne e le ho khetholla likamano tsa 'nete lipakeng tsa VS le matšoao a ΔRT/CSBD ho sa tsotelehe lengolo la tlhahlobo ea maemo le ho eketsa phapang ea lintlha le matla a lipalo. Ts'ebetso ea VS bakeng sa phapang 2 e ile ea hlahlojoa ka mokhoa o ts'oanang molemong oa ho hlalosa. Litlhahlobong tse ling tsa morao-rao, re ile ra batlisisa kamano pakeng tsa ts'ebetso ea VS nakong ea tebello le tekanyo ea thahasello ea pele ho fMRI. 'ke labalabela ho shebella litšoantšo tse tsosang takatso' lintlha tsa lintlha (Supplemental Materials).

Sensitivity analysis

Bakeng sa bobeli, ts'ebetso ea VS le ΔRT re pheta lipapiso tsa sehlopha ho leka ho ferekanngoa ke palo ea batho, bongaka, takatso / setšoantšo, le mefuta e fapaneng ea kelello. Mokhoa o qaqileng, lethathamo la mefuta e lekiloeng, le liphetho tsa liteko tsena li fanoe ho Lisebelisoa tsa Tlatsetso (Letlapa la S8).

Ethics

Mekhoa ea boithuto e entsoe ho latela Phatlalatso ea Helsinki. Boithuto bona bo amohetsoe ke Boto ea Lebatooa ea Tlhahlobo ea Boitšoaro, Stockholm, Sweden. Barupeluoa bohle ba fane ka tumello e ngotsoeng e nang le tsebo.

Results

barupeluoa ba

Litšobotsi tsa sehlopha li hlahisoa ho Tafole 1. Lihlopha tse tsamaellanang ka lilemo (CSBD: M = 38.7, SD = 11.7, HC: M = 37.6, SD = 8.5) le maikutlo a ho kopanela liphate (mosodoma a le mong ea itsebahatsang sehlopheng ka seng). Bakuli ba CSBD ba ne ba e-na le BMI e phahameng ho feta HC (CSBD: M = 25.8, SD = 4.5, HC: M = 23.1, SD = 2.8), le hoja e ntse e le sebakeng se tloaelehileng. HC e ne e na le batho ba bane ba tsubang ka linako tse ling. Ho ne ho se na liphapang tsa lihlopha tsa tšebeliso ea meriana kapa lefu la kelello (Letlapa la S1). Ha ho bapisoa le HC, bakuli ba CSBD ba ile ba fumana lintlha tse phahameng haholo ka likala tse hlahlobang matšoao a hypersexuality, khatello ea thobalano le takatso (HDSI, HBI, SDI, SCS), maemo a khatello ea maikutlo (MADRS), likhaello tsa tlhokomelo (ASRS), matšoao a autism (RAADS), matšoenyeho (STAI). -S), ts'ebetso le ho thibela boitšoaro (BIS-11, BIS), empa eseng karabelo ea moputso (BAS). Bakuli ba CSBD ba ne ba sebelisa litšoantšo tsa bootsoa ho feta HC. Ho ne ho se na liphapang tsa lihlopha tsa tšebeliso ea lithethefatsi le joala kapa palo ea batho ba kopanelang liphate kapa balekane (Letlapa la S2).

Linako tsa karabelo ea tieho ea khothatso e fumanoeng mosebetsing oa fMRI

Mehato e phetoang ANCOVA e senotse phello e kholo ea mofuta oa teko (P = 0.005, F 1, 39 = 9.0) le tšebelisano ea liteko ka sehlopha (P = 0.009, F 1, 39 = 7.5). Litlamorao tse kholo tsa lilemo le sehlopha li ne li se bohlokoa, (P = 0.737 le P = 0.867). Liteko tse latelang tsa phello e ka sehloohong ea mofuta oa liteko li senoletse hore sehlopheng se kopantsoeng barupeluoa ba ile ba itšoara ka potlako haholo nakong ea maikutlo a tsosang takatso ha ba bapisoa le liteko tse seng tse tsosang takatso (RT).E <RTN). E ngotsoe t-teko ho bapisa RTE le RTN ka har'a sehlopha ka seng ho bontšitse hore ho ne ho le joalo ho bakuli ka bobeli (P <0.001) le ditaolo (P = 0.004). RT (RTE– RTN) e ne e le mpe lihlopheng ka bobeli 'me e fapane haholo pakeng tsa CSDB le HC (P = 0.009, d= 0.84), moo bakuli ba CSBD ba bonts'itseng ΔRT e kholoanyane, e netefatsang tšebelisano ea sehlopha ka sehlopha (e bonts'itsoeng ho Setšoantšo sa 2). Phapano ena e kanna ea tsamaisoa ke RT e tlase hanyaneE le RT e kholoanyaneN e bolela ho CSBD ha e bapisoa le HC (Setšoantšo sa 2, Tafole 2).

Setšoantšo sa 2.
 
Setšoantšo sa 2.

Liphetho tsa boitšoaro tse tsoang mosebetsing oa ho lieha ho etsa thobalano o entsoeng nakong ea fMRI. Morero o bonts'itse tšebelisano ea liteko le sehlopha le liphapang tse tsamaellanang tsa ΔRT. Kakaretso ea nako ea karabelo bakeng sa mofuta o mong le o mong oa teko (e tsosang takatso khahlano le e seng e tsosang takatso) le sehlopha (HC vs. CSBD) lia bontšoa. ΔRT bakeng sa sehlopha ka seng e bontšitsoe (metsu e otlolohileng). Maemo a linomoro a thathamisitsoe ho Tafole 2

Tlhaloso: Journal of Behavioral Addictions 2022; 10.1556/2006.2022.00035

Tafole 2.

Liphetho tsa tlhahlobo ea Neurocognitive

Liteko tsa KelelloHC (n = 20)CSBD (n = 23)HC khahlano le CSBD; P
Mosebetsi oa ho lieha ho etsa thobalano (fMRI) ho ms* 
RTE, bolela (SD)281 (65)270 (46)0.544
RTN, bolela (SD)297 (72)314 (68)0.434
ΔRT, moelelo (SD)-15 (22)-43 (42)0.009
SSRT ho ms, bolela (SD)285 (30)300 (59)0.324
BONTA
Adj. lipompo, bolela (SD)10.1 (5)11.1 (4.8)0.486
Nr. ho phatloha, ho bolela (SD)13.6 (4.8)14.3 (4.4)0.664
Raven SPM
E bolelang (SD)2.3 (1.0)2.9 (0.8)0.041
Sehlopha sa I, n410.042
Sehlopha sa II, n96
Sehlopha sa III (karolelano), n411
Sehlopha sa IV, n15
Sehlopha sa V, n10

Liphetho tse fumanoeng tlhahlobong ea kelello lia bontšoa. Mekhoa le liphapang tse tloaelehileng (SD) tsa sehlopha ka seng li thathamisitsoe. Liphetho tsa papiso ea lihlopha (P-values) li fanoe. BART: Mosebetsi oa Kotsi oa Balloon Analogue, SSRT: Nako ea ho Stop-Signal Reaction (thibelo/taolo ea tšusumetso), Raven SPM: Matrices a tsoelang pele a tloaelehileng (bohlale bo sa bueng). Mehato ea sephetho e tsoang mosebetsing oa ho lieha ho etsa thobalano nakong ea fMRI e thathamisitsoe hape: RTE: karolelano ea nako ea karabelo nakong ea liteko tse tsosang takatso, RTN: karolelano ea nako ea karabelo nakong ea liteko tseo e seng tse tsosang takatso. ΔRT = RTE−RTN. * mokuli a le mong oa CSBD ha a ka a etsa mosebetsi oa fMRI.

ΔRT e amana hampe le matšoao a hypersexuality le khatello ea thobalano (HDSI, HBI, SCS) (Letlapa la S9), le ka drive 'me karabelo ya moputso lintho tsa BIS/BAS (Lethathamo la S14).

Liteko tsa lipatlisiso li senoletse hore sehlopha sa CSBD se bonts'itse phapang e kholoanyane ea RT (ho kheloha ho tloaelehileng) nakong ea liteko tse seng tsa thobalano (SD)N) ho feta litekong tse tsosang takatso (SDE), e neng e sa hlokomeloe ho HC (Lisebelisoa tsa Tlatsetso; Letlapa la S3), e bontšang hore phapang ea lihlopha ho ΔRT e ka 'na ea susumetsoa ke bakuli ba CSBD ba sebetsang hampe (kapa ba sa tsitsang) nakong ea liteko tse sa tsitsang ho feta HC, ho e-na le ho sebetsa hantle nakong ea thobalano. liteko.

Teko ea Neurocognitive

Ho ne ho se na liphapang tsa sehlopha ts'ebetsong ho BART (ho nka kotsi) kapa STOP-IT (SSRT, inhibitory / impulse control). HC e sebelitse betere tekong ea Raven SPM (bohlale bo sa bueng) ho feta bakuli ba CSBD. Leha ho le joalo, bakuli ba CSBD ba bontšitse ts'ebetso e tloaelehileng, ha HC e sebetsa ka holimo ho karolelano (Tafole 2).

Mosebetsi o amanang le mosebetsi (fMRI)

Ka har'a sehlopha se amanang le ts'ebetso e amanang le ts'ebetso nakong ea tebello e bontšoa ho Setšoantšo sa 3. Liphetho tsa mohato oa ho shebella li bonts'oa ho Lisebelisoa tsa Tlatsetso (Figures S4–S5). Ts'ebetso e ts'oanang e na le libaka tse tlalehiloeng pele nakong ea tebello le ts'ebetso ea ts'usumetso ea thobalano, ka ho latellana, ho kenyelletsa VS, anterior cingulate cortex, orbitofrontal cortex, insula, (pele) motor, pono le libaka tsa occipitotemporal (Georgiadis et al., 2012; Jauhar et al., 2021; Oldham et al., 2018). Boemong ba boko bo feletseng (ho hlahloba), ha ho liphapang tsa lihlopha tse ileng tsa hlokomeloa ka mor'a ho lokisoa. Sheba Figure S3 le S6 bakeng sa liphetho tse sa lokisoang.

Setšoantšo sa 3.
 
Setšoantšo sa 3.

Ka har'a sehlopha se amanang le mosebetsi oa fMRI e bolela ts'ebetso. COPE e lokisitsoeng e bolela ts'ebetso (e tsosang takatso> e seng e tsosang takatso) bakeng sa phapang ea 1 (tebello) e bonts'oa bakeng sa taolo e phetseng hantle (HC, holimo) le bakuli ba CSBD (ka tlase). Litefiso tsa Z li bonts'oa ka 'mala ('mapa oa mocheso). Leha ho na le liphapang tse bonoang tsa tikoloho lipakeng tsa ts'ebetso lipakeng tsa HC le CSBD, lipapiso tsa sehlopha ka kotloloho li ne li se bohlokoa ka mor'a tokiso (e tšoanang e sebetsa ho phapano e fetotsoeng HC> CSBD). Hlokomela hore litlhahlobo tsohle tsa boko e ne e le boithuto. Liphetho tsa phapang 2 (mohato oa ho shebella) le papiso e sa lokisoang ea lihlopha moeling oa P = 0.01 e bontšoa ho Lisebelisoa tsa Tlatsetso (Setšoantšo sa S3-S6). Lipalopalo tsa Cluster, likhokahano tsa MNI tsa maxima a activation, le lileibole tsa libaka li fanoe ho Supplemental Materials Table S10 le S12.

Tlhaloso: Journal of Behavioral Addictions 2022; 10.1556/2006.2022.00035

Ts'ebetso ea VS le likamano le matšoao a ΔRT le CSBD

Ho ne ho se na liphapang tsa bohlokoa tsa sehlopha ho ts'ebetsong ea VS nakong ea tebello (kapa karolo ea ho shebella, Tafole 3). Leha ho le joalo, ts'ebetso ea VS nakong ea tebello e ne e amana hampe le ΔRT (r = -0.33, P = 0.031), athe ΔRT ha e amane le ts'ebetso ea VS nakong ea karolo ea ho shebella (r = 0.18, P = 0.250). Ho ne ho e-na le setšoantšo se le seng sa pono se nang le ΔRT e tlase le ts'ebetso e phahameng ea VS nakong ea tebello (Setšoantšo sa 4). Likamano lipakeng tsa ts'ebetso ea ΔRT le VS nakong ea tebello e ne e ntse e fana ka maikutlo (P = 0.072) ka mor'a ho tlosa sehlahisoa sena (Setšoantšo sa S2, Letlapa la S10), 'me tataiso le matla a matla a ntse a le teng (r = -0.28). Hlokomela hore ha rea ​​khona ho tseba mabaka a entseng hore ho tlosoe motho ea kantle ho litlhahlobo (ha ho na data e fosahetseng). Har'a barupeluoa bohle, sehlooho sena se ile sa fumana lintlha tse phahameng ka ho fetisisa ho matšoao ohle a CSBD (a bontšitsoeng ke litlhahlobo tse ngata tse fapaneng; Lisebelisoa tsa Tlatsetso). Ho feta moo, ho ile ha sebelisoa khokahano ea boemo ba Spearman e seng ea parametric, e leng, ha e bapisoa le khokahano e tloaelehileng ea Pearson, e sa tsotelleng ba tsoang kantle ho naha. Kahoo, liteko tsohle tse entsoeng li nka liphetho ho kenyelletsa le tse kantle li ka tšeptjoa.

Tafole 3.

Lipapiso tsa sehlopha ho VS li bolela ts'ebetso

 HC (n = 20)CSBD (n = 22)HC khahlano le CSBD; PCohen oa d
Ketsahalo ea VS (bapisa 1: tebello)173 (471)329 (819)0.4570.20
Ketsahalo ea VS (bapisa 2: ho shebella)181 (481)69 (700)0.540.19

Mean (SD) ea ts'ebetso ea COPE e ntšitsoeng bakeng sa VS nakong ea phapang ea 1 (tebello) le 2 (mohato oa ho shebella) li thathamisitsoe bakeng sa sehlopha ka seng. Liphetho (P-values) le boholo ba phello (Cohen's d) ea lipapiso tsa sehlopha li fanoa (HC vs. CSBD).

Setšoantšo sa 4.
 
Setšoantšo sa 4.

A: Kamano lipakeng tsa ts'ebetso ea VS nakong ea tebello le ΔRT. Lintlha tsa mokuli li reriloe ka bofubelu, data ea HC e putsoa. Setšoantšo sa Tlatsetso S2 se bonts'a morero oa ho fokotsa maemo ha ho sa kenyelelitsoe kantle ho VS le ΔRT e tlase ka ho fetesisa. Hlokomela hore re nka liphetho ho kenyeletsoa le tse ling tse ka tšeptjoang (sheba mongolo oa sehlooho le Lisebelisuoa tsa Tlatsetso bakeng sa ho beha mabaka). B: Kamano lipakeng tsa ts'ebetso ea VS nakong ea tebello le tekanyo ea hore na bakuli ba CSBD ba tlalehile hakae ho lebella ho shebella litšoantšo tse tsosang takatso (tse botsoang pele ho liteko tsa fMRI) (r = 0.61, P = 0.002). Khokahano e joalo e ne e sa bonoa litaolong (r = -0.221, P = 0.362; bona Supplemental Materials bakeng sa lintlha tse ling)

Tlhaloso: Journal of Behavioral Addictions 2022; 10.1556/2006.2022.00035

Qetellong, ts'ebetso ea VS nakong ea tebello, empa eseng ts'ebetso ea VS nakong ea ho shebella, e amanang le mehato ea tšebeliso ea litšoantšo tsa bootsoa (Letlapa la S9), empa eseng ka lintlha tse ling tsa matšoao a CSBD.

Takatso, ho rata, le likarabo tse ling tsa maikutlo nakong ea mosebetsi oa fMRI

Liphetho tse qaqileng tsa lipotso tse amanang le liteko tsa fMRI li ka fumanoa ho Supplemental Materials (Letlapa la S4-S6). Ka bokhutšoanyane, bakuli ba CSBD ba ne ba lakatsa ho kopanela liphate ho feta HC, 'me takatso ena e ile ea eketseha ka mor'a teko ea lihlopha ka bobeli. Le hoja ho ne ho se na liphapang tsa lihlopha mabapi le hore na barupeluoa ba ratile tšusumetso e kae, bakuli ba CSBD ba ne ba labalabela ho shebella litšoantšo tse tsosang takatso ho feta litšoantšo tse sa thabiseng. Sena ha sea ka sa bonoa ho HC. Ho bakuli ba CSBD, eseng ho HC, VS ts'ebetso nakong ea tebello e amanang hantle le 'ke lebeletse litšoantšo tse tsosang takatso' lintlha (r = 0.61, P = 0.002; Setšoantšo sa 4). Likamano tse joalo le ΔRT li ne li fana ka maikutlo (Lisebelisoa tsa Tlatsetso).

Sensitivity analysis

Liphetho li ile tsa lula li le matla ha li laola batho ba ka 'nang ba ferekanya (Letlapa la S8) ntle le hore phapang ea lihlopha ho ΔRT e ne e se ea bohlokoa ha ho laoloa litekanyetso tsa ho tepella maikutlong (MDRS). Leha ho le joalo, sephetho sena se lokela ho hlalosoa ka hloko, kaha khatello ea maikutlo e amana le CSBD, phenotype ea thahasello (Ballester-Arnal, Castro-Calvo, Giménez-García, Gil-Juliá, & Gil-Llario, 2020; Hyatt et al., 2020).

Puisano

Thutong ena, re sebelisitse paradigm e ncha ea liteko ea fMRI e reretsoeng ho arola lits'ebetso tse amanang le tebello ho tse amanang le ts'ebetso ea ts'usumetso ea thobalano. Mosebetsi o ne o sebelisetsoa ho batlisisa mekhoa ea boitšoaro le methapo ea methapo ea CSBD e tsepamisitse maikutlo mosebetsing oa VS nakong ea tebello. Re ile ra tsoela pele ho lekola hore na matšoao a CSBD le mehato ea sepheo sa ho ipeha kotsing, taolo ea thibelo, le bohlale bo sa bueng bo amanang le liphetho tsa rona joang.

Phapang ea boitšoaro lipakeng tsa HC le CSBD

Tumellanong le maikutlo a rona, bakuli ba CSDB ba bonts'itse phapang e kholo lipakeng tsa linako tsa karabelo tse lekantsoeng nakong ea liteko tse tsosang takatso le tse seng tse tsosang takatso (ΔRT) ho feta HC. Boholo ba phello bo ne bo le boholo (d = 0.84). Liphetho li ile tsa lula li le matla ha ho lokisoa lintho tse ka ferekanyang 'me li bontša phapang e ka bang teng ka har'a koloi e susumetsang - le takatso e ka bang teng - ho sheba litšoantšo tse tsosang takatso kapa tse sa tsosang takatso. Phapang e ne e bonahala eka e khannoa ke bakuli ba CSBD ba bontšang linako tse fokolang tsa ho arabela le ho fetoha ho hoholo ha ts'ebetso nakong ea liteko tse sa thabiseng, tse bontšang tšusumetso e fokolang / takatso ea ho sheba litšoantšo tse sa tsitsang ha li bapisoa le HC. Hlokomela hore sena ha se qhelele ka thoko monyetla oa ho khanna kapa takatso e phahameng ho bakuli ba CSBD mabapi le ho shebella litšoantšo tse tsosang takatso (tse bonts'itsoeng ke RT e tlase.E) ho bapisoa le HC, kaha ho na le mefokolo ea 'mele ho lebelo la karabo ea koloi. Habohlokoa, liphapang tsena tsa boitšoaro li fana ka maikutlo a hore lits'ebetso tse amanang le tebello ea ts'usumetso e tsosang takatso le e seng e tsosang takatso e ka fetoloa ho CSBD mme e ts'ehetsa mohopolo oa hore meputso e amanang le tebello e ts'oanang le ea mathata a ts'ebeliso ea lithethefatsi le bokhoba ba boitšoaro e ka bapala karolo ea bohlokoa ho CSBD. , joalo ka ha ho boletsoe pejana (Chatzittofis et al., 2016; Gola et al., 2018; Jokinen et al., 2017; Kowalewska et al., 2018; Mechelmans et al., 2014; Politis et al., 2013; Schmidt et al., 2017; Sinke et al., 2020; Voon et al., 2014). Sena se ile sa tšehetsoa ka ho eketsehileng ke taba ea hore ha rea ​​ka ra bona phapang mesebetsing e meng ea kelello e lekanyang ho nka kotsi le ho laola maikutlo, ho hanyetsa khopolo ea hore mekhoa e tloaelehileng e amanang le khatello ea kelello e sebetsa (Norman et al., 2019; Mar, Townes, Pechlivanoglou, Arnold, & Schachar, 2022). Hoa thahasellisa hore tekanyo ea boitšoaro ΔRT e amana hampe le matšoao a hypersexuality le khatello ea thobalano, e bontšang hore liphetoho tse amanang le tebello ea boitšoaro li eketseha hammoho le matšoao a CSBD a matla.

Tšusumetso ea thobalano e liehisa tšebetso e amanang le boko

Ka har'a sehlopha ka seng, mosebetsi o hlahisitse ts'ebetso e hlakileng ea sebaka ka nako ea tebello le ea ho shebella (Setšoantšo sa 3). Lits'ebetso tse bolelang li na le libaka tse tlalehiloeng nakong ea tebello le ts'ebetso ea ts'usumetso ea thobalano, ho kenyeletsoa ts'ebetso ho VS, anterior cingulate cortex, orbitofrontal cortex, insula, (pre) motor, visual, le occipitotemporal regions.Georgiadis et al., 2012; Jauhar et al., 2021; Oldham et al., 2018), e tšehetsang bonnete, bonnete, le ho sebetsa ha mosebetsi. Sena se ile sa tšehetsoa ka ho eketsehileng ke taba ea hore ho etsa mosebetsi ho ekelitse takatso ea thobalano, ha litakatso tsa lintho tse ling tse hlahlobiloeng ha lia ka tsa eketseha ka mor'a teko, e leng se bontšang hore mosebetsi oo o ne o lebisitse ka ho khetheha takatso ea thobalano.

Leha liphapang tse hlakileng tsa ts'ebetso ea libaka li ile tsa bonoa ho bakuli ba HC le CSBD nakong ea mohato oa tebello (Setšoantšo sa 3), moo, ha ho bapisoa le HC, bakuli ba CSBD ba bonts'itseng ts'ebetso e hlakileng haholoanyane libakeng tsa prefrontal cortex le subcortical, ho kenyeletsoa le VS, ha rea ​​ka ra fumana liphapang tse kholo tsa sehlopha boemong ba boko bohle. Hlokomela hore litlhahlobo tsa boko bo felletseng e ne e le tsa boithuto, 'me ho ka hlokahala lisampole tse kholo ho supa litlamorao tse nyane. Kahoo, ho tsoa liphuputsong tsena ha hoa lokela ho etsoa qeto ea hore CSBD ha e amane le bokooa bo sa tloaelehang nakong ea tebello, haholo-holo, kaha litlhahlobo tsa correlational joalokaha ho tšohloa ka tlase li supa ho fapaneng.

Tlhahlobo ea mantlha mabapi le ts'ebetso ea VS nakong ea tebello

Le hoja liphapang tsa lipalo li ne li lebeletsoe (CSBD> HC), boholo ba phello bo ne bo le bonyenyane 'me ho ne ho se na liphapang tsa bohlokoa tsa lihlopha ho VS ho bolela ts'ebetso nakong ea tebello. Hape mona, lisampole tse kholoanyane li ka hlokoa ho hapa phapang ea taolo ea linyeoe ho ts'ebetsong ea VS. Leha ho le joalo, ts'ebetso ea VS nakong ea tebello e ne e hokahane hampe le ΔRT (kamano e itekanetseng), athe ΔRT ha e amane le ts'ebetso ea VS nakong ea karolo ea ho shebella. Ka hona, phapang e kholo ea boitšoaro pakeng tsa liteko tse tsosang takatso le tse seng tse tsosang takatso, e kholoanyane ea VS e bolela mosebetsi nakong ea tebello (hlokomela hore le mona liteko tse tsosang takatso le tse seng tse tsosang takatso li ne li bapisoa). Kaha karabelo ea boits'oaro e ka amahanngoa ka kotloloho le ts'ebetso ea VS nakong ea tebello, empa e sa shebelle, ea litšoantšo, re fana ka maikutlo a hore likarabelo tse fapaneng tsa methapo tse amanang le tebello li kanna tsa hlalosa ho se tloaelehe ha boitšoaro ho bonoang ho CSBD. Tumellanong le maikutlo ana, ha a bapisoa le HC, bakuli ba CSBD ba ne ba labalabela ho shebella litšoantšo tse tsosang takatso ho feta tse sa thabiseng, le ts'ebetso ea VS nakong ea tebello e amanang le litekanyetso tsa hore na bakuli ba ne ba lebelletse hakae ho shebella litšoantšo tse tsosang takatso pele ho teko. .

Ka kakaretso, liphapang tsa sehlopha sa boits'oaro le taba ea hore ts'ebetso ea VS nakong ea tebello e amanang le sepheo ka bobeli (ΔRT) le mehato ea boinotšing ea tebello e ne e tsamaellana le maikutlo a rona a hore ts'usumetso e feteletseng le lits'ebetso tse amanang le neural tsa tebello ea moputso li phetha karolo. ho CSBD.

sheba mefokolo ea

Taba ea pele, ho ke ke ha etsoa liqeto mabapi le sesosa, kaha thuto ena e ne e fapane. Taba ea bobeli, kaha liphapang tsa sehlopha ts'ebetsong ea methapo nakong ea tebello e kanna ea ba ea boholo bo nyane (mona d = 0.2), kapa mohlomong ha e eo, lisampole tse kholoanyane tsa boithuto li ka hlokahala ho lemoha sena. Ntlha ea boraro, ho na le likhang tsa saense mabapi le hore na matšoao a CSBD a ka bakoa ke mekhoa ea ho sebetsana le maemo e lefellang maemo a sa thabiseng a maikutlo (mohlala, ho tepella maikutlong) kapa haeba maikutlo a tepeletseng a bakoa ke mahlomola a bakoang ke CSBD. Leha mekhoa ka bobeli e ka kenya letsoho, e ke ke ea aroloa thutong ena. Leha ho le joalo, hoa tsebahala hore khatello ea maikutlo le CSBD li amana haholo.Antons et al., 2021), ka hona, sehlopha sa rona sa thuto se ne se emela mohlala oa kliniki o sebetsang hantle oa tikoloho oa bakuli ba nang le CSBD. Ea bone, makhetlo a ho kopanela liphate ha aa ka a fapana pakeng tsa lihlopha. Bakuli ba CSBD, leha ho le joalo, ba bontšitse tšebeliso ea litšoantšo tse manyala tse hlephisang boitšoaro hangata e bonoang ho CSBD (Antons et al., 2021). Ho phaella moo, re fumane kamano pakeng tsa mosebetsi oa VS nakong ea tebello le mekhoa ea ho sebelisa litšoantšo tsa bootsoa. Le hoja thuto e fetileng ea Markert et al. ha baa ka ba fumana likamano tse joalo ho batho ba phetseng hantle, bangoli ba boletse hore litloaelano tse joalo li ka bonoa ka mehlala e nang le litekanyetso tse eketsehileng tsa tšebeliso ea litšoantšo tsa bootsoa (Markert et al., 2021), e ka hlalosang hore na ke hobane'ng ha re khonne ho lemoha likamano tsena thutong ea hona joale. Kahoo, liphuputso tsa rona li lumellana le liphuputso tse bontšang hore bothata ba ho sebelisa litšoantšo tse manyala tse hlephisang boitšoaro bo amana le ts'ebetso e fetotsoeng ea VS nakong ea litšoantšo tse bontšang litšoantšo tse tsosang takatso.Gola et al., 2017). Leha liphetho tsa boitšoaro ba thobalano li kanna tsa fapana haeba barupeluoa ba bang ba ka be ba sa ka ba ngolisoa nakong ea seoa sa COVID-19, ho sa ntse ho tla hlahlojoa hore na liphetho tsa rona li fumaneha ho lihlopha tse nyane tsa CSBD tse nang le ts'ebeliso ea litšoantšo tsa bootsoa hangata. Hantle-ntle, ho tsebahatsa lihlopha tse nyenyane tsa bongaka e ne e se sepheo sa thuto ea hona joale, empa re fana ka maikutlo a hore e lokela ho nkoa lipatlisisong tse tlang. Qetellong, re sebelisitse sekhahla se tlase le se tsitsitseng sa ho hloleha mosebetsing oa fMRI ho eketsa litlamorao tse lebelletsoeng le ho ntlafatsa homogeneity ea data. Le hoja re fane ka litlhaloso bakeng sa liphello tse sa lebelloang 'me ho ne ho se pontšo ea hore barupeluoa ba belaelloang esale pele ba hlōlehile, ho ntse ho sa tsejoe hore na barupeluoa ba ka be ba sebelitse joang ba sebelisa paradigm e ikamahanyang le maemo.

fihlela qeto e

Paradigm e ntlafalitsoeng ea fMRI e hlola meeli e mengata ea li-paradigms tse fetileng, 'me liphetho tsa rona li ts'ehetsa ts'ebetso ea eona ho batho ba phetseng hantle le ho lihlopha tsa bongaka. Liphuputso tsa rona li fana ka maikutlo a hore CSBD e amahanngoa le mekhoa e fetotsoeng ea boitšoaro ea tebello, e amanang le ts'ebetso ea VS nakong ea tebello ea maikutlo a tsosang takatso. Liphuputso li tšehetsa khopolo ea hore mekhoa e ts'oanang le ea ho lemalla lithethefatsi le boitšoaro e bapala karolo ea CSBD 'me e fana ka maikutlo a hore ho hlophisoa ha CSBD e le bothata ba ho laola maikutlo ho ka phehisana khang ho latela liphuputso tsa neurobiological.

Mehloli ea lichelete

Mosebetsi ona o ile oa tšehetsoa ke Karolinska Institutet's Research Foundation Grants (2016 le 2017; CA) le Swedish Research Council (Dnr: 2020-01183; JJ, CA).

Menehelo ea bangoli

CA e ne e le mofuputsi ea ka sehloohong, ea qapileng thuto le ho nts'etsapele paradigm ea fMRI. CA e ile ea bokella lintlha tsa fMRI le tsa boitšoaro, ea etsa litlhahlobo tsa boitšoaro le ho ngola moralo oa pele oa buka e ngotsoeng ka letsoho. BL e entse tlhahlobo ea fMRI le tlhahlobo ea fMRI. KJÖ, SA, CD, le MI li kentse letsoho moralong oa thuto le ka likeletso tsa bongaka. BL, KJÖ, JJ, JS, le JF li fane ka boitsebiso ba bohlokoa ba bohlale 'me tsa kenya letsoho ho ngoleng ha libuka tse ngotsoeng ka letsoho. JS e ile ea hira le ho hlahloba bakuli bakeng sa ho tšoaneleha le ho kenya letsoho ho bokelleng lintlha. Bangoli bohle ba ne ba e-na le phihlelo e feletseng ea boitsebiso bohle thutong 'me ba nka boikarabelo ba botšepehi ba lintlha le ho nepahala ha tlhahlobo ea lintlha. Bangoli bohle ba hlahlobile buka e ngotsoeng ka letsoho, ba fana ka tlhahiso ea bohlale, 'me ba lumella ho hlahisoa ha buka e ngotsoeng ka letsoho.

Khohlano ea thahasello

CA e hiriloe ke Quantify Research (mosebetsi oa boeletsi o sa amaneng le mosebetsi oa hajoale). Bangoli ha ba tlalehe likamano tsa lichelete kapa tse ling tse amanang le sehlooho sa sengoloa sena.

Liteboho

Re leboha baoki ba thuto-thuto, basebetsi ba tsa bongaka, le ba tsamaiso ho ANOVA bakeng sa tšehetso ea bona mabapi le pokello ea lintlha le mokhatlo oa boithuto, Christoffer Rahm bakeng sa lipuisano nakong ea moralo oa thuto, le Christian Mannfolk bakeng sa thuso ea hae ho thaoeng ha bankakarolo ba HC.

polelo ea ho fumaneha ha mosebetsi oa fMRI

Mosebetsi oa fMRI o ka fumaneha ka kopo e utloahalang.

Lisebelisoa tse tlatselletsang

Lintlha tse tlatsetsang ntlheng ena li ka fumaneha inthaneteng ho https://doi.org/10.1556/2006.2022.00035.