E Tšoanang empa e fapane: Tšobotsi ea Kliniki ea Banna ba nang le Hypersexual Disorder Thutong ea Botsoa le Brain (2019)

2019 Jan 30; 8 (2). pii: E157. Doi: 10.3390 / jcm8020157.
Engel J1, Veit M2, Sinke C3, Heitland I4, Kneer J5, Hlemlemacher T6,7, Hartmann U8, Kruger THC9.

inahaneloang

Mathata a hlahang ka lebaka la boitšoaro bo amanang le hypersexual hangata a bonoa maemong a kliniki. Re ikemiselitse ho holisa tsebo mabapi le litšobotsi tsa bongaka tsa batho ba nang le lefu la hypersexual (HD). Sehlopha sa batho ba ileng ba phethahatsa mekhoa ea tlhahlobo ea mafu bakeng sa HD (banna ba nang le HD, n = 50) e ne e bapisoa le sehlopha sa taolo e phetseng hantle (n = 40). Re fuputse phapang litabeng tsa socialodemographic, neurodevelopmental, le tsa malapa re ipapisitse le lipotso tsa tlhahlobo le tlhahlobo ea lipotso tsa bongaka. Banna ba nang le HD ba tlalehile litekanyetso tse phahameng tsa thobalano, paraphilias, tšebeliso ea litšoantšo tse hlekefetsang tsa bana, le boitšoaro bo hatellang ba thobalano ha bo bapisoa le taolo e ntle. Ho feta moo, litekanyetso tsa mathata a amanang le mathata, mathata a khokahano, ho se tsitse, le ho se sebetse maano a ho laola maikutlo a ne a phahame ho banna ba nang le HD. Banna ba nang le HD ho bonahala ba kile ba ba le mefuta e fapaneng ea boiphihlelo bo bohloko ba bongoana, empa ho ne ho se na phapang e fapaneng litabeng tsa sechaba, litaba tsa tšebetso ea methapo ea kutlo, le lintlha tsa lelapa. Tlhahlobo ea khatello ea maikutlo e bontšitse hore thibelo e amanang le khokahano le ho qaleha ha thobalano li aroloa pakeng tsa banna ba nang le HD le taolo e phetseng hantle. Qetellong, banna ba nang le HD ba bonahala ba e-na le li-neurodevelopment, maemo a bohlale, semelo sa sechaba le litaba tsa lelapa ha li bapisoa le taolo e ntle, empa ba tlaleha liphihlelo tse fapaneng le tse mpe tsa bongoana, boits'oaro bo bobe ba thobalano le mathata a kelello.

LITLHAKISO TSE KHOLO: li-comorbidities; Hypersexourse; phenomenology; tlhekefetso ea thobalano; qobello ya thobalano

PMID: 30704084
DOI: 10.3390 / jcm8020157

1. Selelekela

Hypersexual disorder (HD) e tšoauoa ka litoro tse matla, tse pheta-phetoang tsa thobalano, litakatso, le boits'oaro bo lebisang ho senyeha ho hoholo kelellong ho hoholo kelellong [1,2,3]. Kafka [3] e khothalelitse hore tlhaselo ea hypersexual e lokela ho kenyelletsoa e le karolo ho Diagnostic and Statistical Manual of Mental Dis shida, 5th edition (DSM-5) [4], empa tlhahiso eo qetellong e ile ea hana. Le leng la mabaka a ileng a fanoa e ne e le ho haella ha lipatlisiso tsa liteko mabapi le lefu la hypersexual [5,6]. Khatisong e tlang ea Classified ea Mafu a Machaba, ICD-11, lefu la hypersexual le tla khetholloa e le tlhekefetso ea boitšoaro bo amanang le thobalano.7].
Linomoro tse tšosang li bonts'oa ke tlhahlobo ea morao-rao ea baemeli ba banna (n = 1151) le basali (n = 1174) United States e fumaneng 10.3% ea banna le 7% ea basali e bontšitse maemo a amanang le khatello ea maikutlo le / kapa ho senyeha ka lebaka la mathata a ho laola takatso ea thobalano, maikutlo le boits'oaro [8]. Liponahatso tsa boitšoaro bo nyarosang li ka kenyelletsa likhokahano tsa thobalano tsa 'nete tsa lefats'e le liketso tsa thobalano tse fumanehang marang-rang. Ts'ebeliso ea marang-rang ea litaba tsa thobalano hammoho le ho ipholla litho tsa botona kapa botšehali ke boitšoaro bo atileng haholo bo lebisang ho banna ho fumanoa ba e-na le lefu la ho hleka-hlekoa ho latela maemo a Kafka [3,9].
Cooper [10] o bontšitse hore phallo ea phihlello, phihlello le ho se tsejoe e thusa batho hore ba fihlelle eng kapa eng eo ba e ratang ntle le mathata a moruo le a sechaba. Ho joalo, mekhoa ea ts'ebeliso ea marang-rang e fapana haholo pakeng tsa batho ba etsang liketso tse ngata tsa thobalano marang-rang [11] athe ba bang ba sebelisa libaka tsa ho intša ho fumana balekane bakeng sa likamano tsa botona le botšehali [12]. Lisosa tse ka sehloohong tsa ts'ebetso ea thobalano e feteletseng ea inthanete e kanna ea ba boitšepo bo lebelletsoeng le boiphihlelo bo amanang le ho tsosa takatso ea botona kapa botšehali le ho fihlella hoa mefuta eohle ea ts'usumetso ea thobalano [13].
Hanyane hanyane hoa tsebahala ka litšobotsi tsa batho ba nang le HD. Lintlha tse tsoang thutong ntle le sehlopha se laolang li bontša hore lithuto tse ngata le banna ba nang le HD li kamanong e haufi, ba rutehileng ebile ba hiriloe [14]; leha ho le joalo, ba bangata ba boetse ba tlaleha bofokoli bo atamelaneng ka lebaka la ho khesoa ho tsoa lelapeng le nalane ea tlhekefetso ea thobalano, mmele le / kapa maikutlo [15]. Tšebeliso e mpe ea litšoantšo tsa bootsoa [16,17] le boitšoaro bo feteletseng ka kakaretso [18] li hokahantsoe le boitšoaro bo kotsi ba thobalano. Boithuto bo bonts'a hore li-comorbidities tsa kelello, haholo-holo mathata a ho feto-fetoha ha maikutlo, li atile ho HD ka litekanyetso tse tsoang ho 72% –90% maemong a khatello ea maikutlo [14,19,20,21], le 42% maemong a tšebeliso ea litheko tsa tšebeliso ea lithethefatsi [22]. Liphumano mabapi le kamano pakeng tsa khatello ea maikutlo le ho se tsube li kopantsoe. Lithuto tse peli [23,24] ea batho ba batlang kalafo ba phethahatsang litekanyetso tse hlokoang tsa ho ferekanya kelello [hypersexual disc [3] e fumane hore pakeng tsa 48% le 53.3% e bonts'itse pherekano e phahameng maemong a ho itlaleha. Reid, Berlin, le Kingston [25] e khothalelitse hore mokhoa o ikhethileng oa ho ts'oaroa ke thobalano, empa eseng ho nkeha maikutlo ka kakaretso, o ka atile haholo moferefereng oa hypersexual. Boitšoaro ba Hypersexual bo bontšitsoe hore bo amana le ho senyeha ha methapo ea methapo ea kutlo le liphetoho tse amanang le leeme [26le taolo e phahameng [27,28].
Ho latela pono ea tlhaho, Sisteme ea testosterone e bapala karolo ea bohlokoa ntlafatsong le tlhokomelong ea boitšoaro ba thobalano [29]. Ha e le letšoao la tlhahiso ea prenatal androgen, tekanyo ea bolelele ba linomoro tsa bobeli le tsa bone (2D: 4D) e ka sebelisoa, mme ho na le bopaki bo bong ba hore tekanyo ea 2D e tlaase: tekanyo ea 4D e kanna ea hokahanngoa le boitšoaro bo amanang le hypersexual [30], leha ho fumanoe liphetho tse tsoakaneng. Boithuto bo bong ba sechaba ka kakaretso bo bonts'itse hore tekanyo e tlase ea 2D: 4D (tekanyetso ea monna) e hokahane le ho ba le palo e phahameng ea balekane ba thobalano le bana ba eketsehileng [30,31,32], athe ba bang ba bonts'itse hore tekanyo e phahameng ea 2D: 4D e hokahane le boitšoaro bo bobe ho banna [33].
Morero oa thuto ena e ne e le ho etsa lipatlisiso tsa litšobotsi tsa ntlafatso ea bongaka le tse itseng tsa banna ba nang le lefu la tsoekere ho sampole e kholo ea batho ba phethisang litekanyetso tsa tlhahlobo ea tlhahlobo [3] mme o bapise le taolo e phetseng hantle. Ntle le moo, tlhahlobo e qaqileng e lokela ho supa maemo a ka behang kotsing a kenya letsoho ts'ebetsong ea hypersexual, joalo ka lintlha tsa biographical, ke hore, liketsahalo tse bohloko tsa bongoana le mathata a khokahano [34], hammoho le lilemo tsa pele tsa takatso ea thobalano [35]. Re hlahisa tlhahisoleseling ka liparamente tse neng li sa lekanyetsoe mehlala e tšoanang le ena 'me re buisana ka liphetho ka leseli la kutloisiso ea hona joale ea khatello ea maikutlo.

2. Karolo ea liteko

2.1. Ho hira

2.1.1. Sehlopha sa Ts'oaetso ea Hypersexual

Banna ba nang le HD ba ile ba hapuoa pakeng tsa Pherekhong 2016 le Pherekhong 2017 ka phatlalatso e phatlalalitsoeng ke Karolo ea Clinical Psychology le Bongaka ba Bong, Lefapha la Psychiatry, Social Psychiatry, le Psychotherapy Sekolong sa Bongaka sa Hannover, Jeremane. Phatlalatso ea boralitaba e nkiloe ke likoranta tsa lehae le mecha ea litaba ea sechaba (mohlala, Www.facebook.com, www.instagram.com) mme ea fella ka banna ba ipitsitseng ba 539 ba nang le HD ba bonts'a thahasello ea ho nka karolo thutong (bona Setšoantšo sa 1). Banna ba makholo a mabeli a metso e tšeletseng ba ile ba araba lengolo-tsoibila le kopang linomoro tsa mohala. Ba mashome a mahlano a metso e robong ba batho ba 260 ba faneng ka linomoro tsa mohala ba ne ba ke ke ba fihlella ka mohala, empa 201 e setseng e ile ea hlahlojoa bakeng sa khatello ea methapo moqoqong o hlalositsoeng oa mohala o lekanang oa metsotso e ka bang 45 o ileng oa etsoa ke setsebi sa kelello se koetlisitsoeng se sebelisang Kafka [3] mekhoa e khothalletsoang. Batho ka bomong ba ne ba tšoaneleha bakeng sa thuto haeba ba ne ba phethela Kafka [3] mekhoa e khothalletsoang ea phallo ea hypersexual. Lintlha tsa lipotso tse sebelisitsoeng thutong ena li rometsoe ka poso ho ba nkang karolo ba tšoanelehang. Barupeluoa ba bararo bao lintlha tsa bona li sa kang tsa fihla keletsong (53) ea Hypersexual Behaeve Inventory 19 [36] li ne li sa kenyeletsoe hoc ea hoc. Kafka's [3] litekanyetso tsa lefu la ho ferekanya kelello li na le matšoao a bohlokoa a tlisoang ke takatso ea thobalano, litoro kapa boits'oaro, 'me li ipheta ka likhoeli tse 6 tseo batho ka bomong ba loanelang ho li laola ebile li sa bakoe ke phello e tobileng ea' mele ea ntho e tsoang kantle. Linoko tse mashome a supileng a metso e meraro tsa batho ba 201 ba neng ba hlahlobiloe ba ile ba fumana lintlha tsena mme ba nkuoa ba tšoaneleha bakeng sa thuto; 50 e nkile qeto ea ho nka karolo 'me ba theha sehlopha sa hypersexual disorder (sehlopha sa HD, bona Setšoantšo sa 1 chate).
Jcm 08 00157 g001 550
Setšoantšo sa 1. Ho amoheloa ha sehlopha sa khatello ea kelello.

2.1.2. Litaolo tse Phelang hantle

Litaolo tse phetseng hantle li ile tsa hiroa ka lipapatso ho Sekolo sa Bongaka sa Hannover, Jeremane, leqephe la intranet. Batho ba mashome a robeli a metso e mehlano ba arabile lipapatso (bona Setšoantšo sa 2) eo 56 e ileng ea mo araba ka lengolo tsoibila le kopang nomoro ea mohala. Mashome a mabeli a metso e robong ea 56 ena ha a ka a fihlella ka mohala bakeng sa ho hlahlojoa. Litaolo li ne li tsamaellana le lilemo (p = 0.587) le thuto (p = 0.503) le sehlopha sa HD. Boitsebiso bo tsoang ho taolo e 'meli e phetseng hantle bo ile ba aroloa kamora tlhahlobo (e mong o tlaleha kotsi e mpe ea hlooho pele ho karolo ea thuto, e mong a tlaleha mokhoa oa bosodoma,' me karolo ea motho a le mong ea sa keneleng tlhahlobo).
Jcm 08 00157 g002 550
Setšoantšo sa 2. Ho amoheloa hoa taolo e phetseng hantle.

2.1.3. Litekanyetso tsa Khethollo

Mekhoa ea ho qheleloa ka thoko bakeng sa barupeluoa bohle e ne e le: bokooa ba kelello (joalo ka ha bo lekantsoe ke Wechsler Adult Intelligent Scale-IV), lefu la kelello (le hlahlobiloeng ka Structured Clinical Interview bakeng sa mathata a DSM-IV Axis 1, SCID-I), kotsi e mpe ea hlooho, maikutlo a bosodoma. sekala sa Kinsey, le khetho ea thobalano ea pedophilic (e hlahlobiloeng ka lipuisano tse hlophisitsoeng hantle). Morerong oa rona oa thobalano @ boko re tsepamisitse maikutlo ho bankakarolo ba bong bo fapaneng ka lebaka la mofuta o fapaneng oa tšusumetso litekong tse tlang. Barupeluoa bohle ba phatlalalitse hore thahasello ea bona ea mantlha ea thobalano e ne e le ho basali le hoja ba bang ba tlaleha histori ea thobalano ea batho ba bong bo tšoanang.
Barupeluoa bohle ba fane ka tumello e ngotsoeng, e nang le tsebo pele ba nka karolo 'me ba fumana matšeliso bakeng sa ho nka karolo. Ba ile ba tsebisoa hore ba ka itokolla thutong ka nako efe kapa efe. Boithuto bona bo ile ba etsoa ho latela Phatlalatso ea Helsinki mme ba amoheloa ke khomishene ea melao ea boitšoaro ea Sekolo sa Bongaka sa Hannover, Jeremane. Liphetho tse tlalehiloeng mona li fumanoe e le karolo ea tlhahlobo e kholo e kenyelletsang betri ea tlhahlobo ea neuropsychological le imaging e sebetsang ea matla a matla a kelello.

2.2. Mehato

Lintho tse fetotsoeng li arotsoe ka mekhahlelo e meraro: (1) sociodemographic, neurodevelopmental, le lintlha tsa lelapa, (2) litšobotsi tsa thobalano, le (3) litšobotsi tsa kelello tse kenyeletsang likotsi tsa kelello. Bakeng sa litlhaloso hantle tsa lintho ka kopo bona lintlha ho Lethathamo 1, Lethathamo 2, Lethathamo 3 'me Lethathamo 4.
Tafole 1. Bochaba, li-neurodevelopmental le lelapa.
Lethathamo
Tafole 2. Litšobotsi tsa thobalano.
Lethathamo
Tafole 3. Litšobotsi tsa thobalano.
Lethathamo
Tafole 4. Litšobotsi tsa kelello le li-comorbidities.
Lethathamo

2.2.1. Litaba tsa Sociodemographic, Neurodevelopmental, le Lintlha tsa Lelapa

Ho ne ho sebelisoa lipotso ho bokella lintlha tsa sechaba, e leng lilemo, thuto e phahameng ka ho fetisisa, boemo ba mosebetsi, nalane ea botlokotsebe bophelong le boemo ba kamano. Ho ne ho boetse ho e-na le lipotso mabapi le litšebelisano tsa methapo ea methapo, boemo ba ngoan'eno, bophelo bo botle ba botsoali ha a hlaha, le lilemo tsa bo-mme le ba ntate ha a hlaha. Liphihlelo tse feto-fetohang tsa bongoana li ile tsa hlahlojoa le Childhood Trauma Questionnaire (CTQ) [37]. Mathata a nts'etsopele a nts'etsopele le "neurodevelopmental" a fuputsitsoeng ke mathata a ho tsoala, ho robala nako e telele, ho lieha ho tsamaea, ho lieha ho bua, le likotsi tsa bongoana tse lebisang ho se tsebe letho. Handsness e ne e ikemiselitse ho sebelisa mokhoa oa 10 oa ntho ea Edinburgh Handedness Inventory [38] le 2D: Karolelano ea 4D e ile ea hakangoa ho sebelisoa litšoantšo tse fumanoeng ho tsoa ho sehatisi se nkehang. Bolelele ba linomoro tsa letsoho le letona bo ne bo hakantsoe ka boithatelo ke bathusi ba babeli ba lipatlisiso (ho ts'epahala pakeng tsa rato: r = 0.83) le lipalo li ne li ipapisitse le mekhoa ea litekanyetso tse peli.
Bohlale bo ne bo hakanngoa ho tsoa likhethong tse 'ne tsa khatiso ea bone ea Wechsler Adult Intelligent Scale (WAIS-IV) [39] tse amanang haholo le IQ ea boholo bo felletseng joalo ka ha e lekantsoe ke WAIS-IV ea Jeremane. Maele ana a mane ke Vocabulary (Kutloisiso ea mantsoe; r = 0.7), Design ea block (mabaka a bonoang; r = 0.65), Arithmetic (memori e sebetsang; r = 0.73), le Coding (lebelo la ho sebetsa; r = 0.5).

2.2.2. Litšobotsi tsa Thobalano

Nts'etsopele ea thobalano le boits'oaro li ile tsa hlahlojoa ka puisano e hlophisitsoeng hanyane ka hanyane le letoto la lipotso. Re ile ra bokella lintlha mabapi le lilemo qalong ea kemolo, ho ipholla litho ka beke pele ho tlhahlobo (nako le khafetsa), thobalano bekeng e tlang pele ho tlhahlobo, le nako ea bophelo bohle ba baratuoa. Ntle le moo, re ile ra hlahloba nako le tšebeliso ea litšoantšo tse litšila tse tsosang takatso ea ho sheba litšoantšo tse litšila tse tsosang takatso, litaba tse ngata, likamano tsa botona le botšehali, tšebeliso ea litšoantšo tsa tlhekefetso ea bana le mathata a thobalano. Ho ile ha sebelisoa lisebelisoa tse khethehileng ho lekanya boits'oaro ba thobalano le tšibollo ea lebitso (Sekala sa Thabollo ea Thobalano, SES le Scale Inhibition Scale, SIS) [40], matšoao a ho ferekana kelellong (Hypersexual Behaeve Inventory-19, HBI-19) [36], matšoao a bokhoba ba cybersex (Teko ea tlatsetso ea Inthanete bakeng sa thobalano e fumanehang marang-rang), sIATsex;41] le temallo ea thobalano (Teko ea Tlhatlhobo ea Thobalano ka Thobalano, SAST-R) [42].

2.2.3. Litšobotsi tsa Psychological le Comorbidities

Li-comorchiidric psychorbidities li fumanoe li sebelisa mofuta oa Sejeremane oa SCID-I [43]. Lipotso tse ling tsa lipotso li ile tsa sebelisoa ho lekola ho ts'oenyeha (Barrat Impulsiveness Scale-11, BIS-11) [44], tlhekefetso ea lithethefatsi (Teko ea Fagerström bakeng sa Depotence ea Nikotine, FTND [45], mekhoa e kotsi le e kotsi ea ts'ebeliso ea joala (The Alcohol Use Disorder Idicationication Test, AUDIT) [46], matšoao a sithabetsang (Beck Depression Inventory-II, BDI-II) [47], bonding (Liphihlelo tsa Haufi le Kamano ea Tsamaiso-Revised, ECR-R) [48], alexithymia (Toronto Alexithymia Scale, TAS-26) [49], le taolo ea maikutlo (ERQ, Potso ea Molao oa Emotion [50]; Fragebogen zur Erhebung der Emotionsregulation, FEEL-E [51].
Attention deficit hyperactivity disorder (ADHD) e fumanoe motheong oa manane ≥15 ka bobeli ho Wender Utah Rating Scale (WURS-K) [52] le tekanyo ea boits'oaro ea ADHD (ADHS-SB) [53].

2.2.4. Tlhatlhobo ea Logistic ea Logistic

Ho khetholla mabaka a ka 'nang a hlaha bakeng sa bothateng bo feteletseng re ile ra etsa tlhahlobo ea maikutlo a marang-rang ka sehlopha sa mefuta e le li-dichotomous tse itšetlehileng ka tsona. Morero oa rona e ne e le ho fumana lintlha tse khethollang pakeng tsa banna ba nang le HD le taolo e phetseng hantle. Palo ea liphapang tse ikemetseng e khethiloe ho likhothaletso ke Agresti [54] (leq. 138).

2.3. Tlhahlobo ea data

Litlhahlobo tsohle li entsoe ka SPSS Statistics Version 24 (IBM® Corporation, Amonk, NY, USA). Litlhahlobo li ile tsa etsoa ho sebelisoa boipuso tLiteko, Mann-Whitney U liteko kapa liteko tsa Fisher tse tobileng tsa li-dichotomous variables. Liteko tsa Fisher bakeng sa litafole tse kholo ho feta 2 × 2 le tsona li ile tsa sebelisoa, joalo ka ha li-polyte tse fapaneng kaofela tsa mekhahlelo li ne li na le bonyane lebelo le le leng le lebelletsoeng la nako e ka tlase ho 5. Kaha ena e ne e le e 'ngoe ea lithuto tsa pele tse makatsang tse kenyelletsang banna ba nang le lefu la ho ferekana kelellong le taolo e phetseng hantle ha ba batla liphapang tsa sehlopha mabapi le tlhahlobo e thehiloeng lithutong tsa bongaka tse lekiloeng mona, re ile ra khetha mokhoa oa ho hlahloba le ho tlaleha mekhahlelo ea bohlokoa bo habeli ntle le khalemelo bakeng sa papiso e ngata (liphatlalatso tsohle p <0.05). Leha ho le joalo, bakeng sa babali ba nang le thahasello re kenyelelitse Bonferroni ho lokisa bohlokoa ho Lethathamo 1, Lethathamo 2, Lethathamo 3 'me Lethathamo 4. Meetso ea boholo ba liteko tsa parametric e bontšitsoe e le ea Cohen d, le d = 0.2 e bontšang phello e nyane, d = 0.5 phello e mahareng, le d = 0.8 phello e kholo [55]. Ho na le phapang lipapaling tsa boholo ba sehlopha litlhahlobong tse fapaneng hobane lipotso tse nang le tlhaiso-leseling li ne li sa kengoe tlhahlobisong. Ho laola litlamorao tsa mafu a kelello ntle le ho ferekana kelellong, lipapiso tsohle tsa sehlopha le tsona li ile tsa qaptjoa kamora ho qolla barupeluoa ba nang le nalane ea tlhahlobo ea SCID-I efe kapa efe; Ts'ebetso ena e hlahisitse N ea 45 (HD = 21; HC = 22). Liphetho tsa litlhahlobo tsena li hlahisoa ho Lisebelisoa tse tlatsetsang.

3. Liphetho

3.1. Litaba tsa Sociodemographic, Neurodevelopmental, le Lintlha tsa Lelapa

Joalokaha ho reriloe ke sehlooho se tsamaellanang ho ne ho se na liphapang tsa lihlopha tsa batho ka mekhoa ea sechaba e amanang le lilemo.t(83) = 0.55, p = 0.587) le lengolo la thuto e phahameng ka ho fetisisa (Tlhahlobo e tobileng ea Fisher (N = 85), p = 0.503; bona Lethathamo 1). Hape, boemo ba mosebetsi (Tlhahlobo e tobileng ea Fisher (N = 85), p = 0.458), nalane ea bophelo ba botlokotsebe (Teko e tobileng ea Fisher (N = 85), p = 0.368), le boemo ba likamano (Tlhahlobo e tobileng ea Fisher (N = 85), p = 0.128) li ne li sa tšoane lipakeng tsa lihlopha. Hape ha ho na phapang ea lintlha mananeng a mane a WAIS-IV a sebelisitsoeng ho kenyeletsa mantsoe a subtest (t(82) = −1.28, p = 0.204), moralo oa block (t(82) = 0.92, p = 0.359), arithmetic (t(82) = 0.112, p = 0.911), le ho kh'outa (t(82) = 1.66, p = 0.100), e bonts'a maemo a bohlale a tšoanang hara lihlopha.
Matšoao a litšebeliso tsa methapo ea methapo ea methapo ea methapo e ne e tšoana ho banna ba nang le HD le taolo e phetseng hantle e kenyeletsang lintlha tse akaretsang tsa ntlafatso nakong ea bongoana (tlhahlobo e tobileng ea Fisher (N = 82), p = 1) kabo ea phetisetso (Tlhahlobo e tobileng ea Fisher (N = 85), p = 0.645) le 2D: Karolelano ea menoana ea 4Dt(77) = 0.34, p = 0.738).
Lintlha tsa rona li bonts'a hore banna ba nang le HD le taolo e phetseng hantle ba hōletse malapeng a nang le lintlha tse tšoanang tsa malapa tse kang palo ea bana ka tlung eo morupeluoa a hōtseng ho eona (t(78) = 0.01, p = 0.995); boemo ka tatellano ea tlhaho ea tsoalow(78) = 718, z = -0.402, p = 0.687); boemo ba bana ka lapeng (w(78) = 750, z = -0.464, p = 0.642); lilemo tsa bo-'mè ha a hlahat(79) = 0.88, p = 0.384); le lilemo tsa ntate ha a hlaha (t(73) = 0.09, p = 0.93). Banna ba nang le HD ba tlaleha mathata a kelello a bo-mme hangata (tlhahlobo e tobileng ea Fisher (N = 62), p = 0.001), empa eseng mathata a kelello a ntate oa hae (Tlhahlobo e tobileng ea Fisher (N = 68), p = 0.307) ho feta taolo e ntle. Ntle le moo, litebello tsa bongoaneng tsa bongoana tsa banna ba nang le HD li ne li fapane haholo le taolo e ntle. Banna ba nang le HD ba tlaleha litheko tse phahameng tsa liphihlelo tse bohloko tsa bongoana (CTQ; t(68) = 2.71, p = 0.009, d = 0.57), haholo ho hlekefetsoa maikutlong (t(73) = 3.53, p <0.001, d = 0.73), ho nyahama maikutlong (t(81) = 2.46, p = 0.016, d = 0.54), le tlhekefetso ea thobalano (t(45) = 2.49, p = 0.017, d = 0.49) ha e bapisoa le taolo e ntle. Leha ho le joalo, tlhekefetso ea 'mele (t(80) = 1.60, p = 0.113) le ho se tsotellet(83) = 1.49, p = 0.141) ha ea ka ea fihlela bohlokoa ba lipalo.

3.2. Litšobotsi tsa Thobalano

Nalane ea thobalano e tsoang ho banna ba nang le HD e ne e fapane haholo le taolo e phetseng hantle (bona Lethathamo 2). Pele ho tsohle, banna ba nang le HD ba ne ba bile le liphihlelo tsa thobalano pele ho sehlopha se laoloang. Banna ba nang le HD ba tlaleha hore ba ne ba le ka tlase ho selemo ha ba qala ho ipholla litho (t(79) = 3.59, p <0.001, d = 0.80) le nako e ka etsang selemo ha ba emisoa (t(77) = 2.79, p = 0.007, d = 0.63). Empa ba ne ba sa tšoane ka lilemo tsa thobalano ea pele (t(83) = 1.868, p = 0.065). Banna ba nang le HD le taolo e phetseng hantle ba tlalehile nako e ts'oanang ea kamano ea ho qetela / ea hona joale ka likhoeli (t(42) = 0.14, p = 0.886), le palo ea bana (w(75) = 728, z = -0.081, p = 0.936). Leha ho le joalo, banna ba nang le HD ba ne ba fapane likamanong tsa bona tsa thobalano le taolo e phetseng hantle. Ka karolelano banna ba nang le HD ba tlalehiloe ka basali ba bang ba mashome a robeli ba nang le thobalano (w(79) = 470.5, p = 0.001) le balekane ba kopaneng ba basali (w(81) = 443, p <0.000) ho feta taolo e nepahetseng. Ho feta moo, leha ba na le tloaelo ea ho ratana le batho ba bong bo fapaneng, banna ba nang le HD ba tlalehile liketso tsa thobalano le banna ba nang le balekane ba batona ba bangata ba thobalano (w(83) = 567.5, p <0.000) le balekane ba banna ba kopanetsoeng (w(83) = 664, p = 0.002), athe taolo e phetseng hantle e tlalehiloe hoo e batlang e se liketso tsa thobalano le banna. Ho feta moo, banna ba nang le HD ba ne ba na le monyetla oa ho tlaleha hore ba ratana nakong ea kamano ea bona ea ho qetela kapa ea hona joale (tlhahlobo e tobileng ea Fisher (N = 81), p <0.001), ha 67% e tlaleha taba e bapisoa le 19% feela ea taolo e nepahetseng. Ho feta moo, banna ba nang le HD ba tlaleha mathata a mangata a fumanoeng ka ho etsa thobalano inthaneteng ho feta taolo e nepahetseng e bonts'itsoeng ke phapang ea sehlopha lipapaling tsa sATAT (t(80) = −11.70, p <0.001, d = 2.45). Ka hona, ba tlaleha hore ba sebelisa litšoantšo tsa bootsoa hangata bekeng pele ho tlhahlobo (tlhahlobo e tobileng ea Fisher (N = 84), p <0.001), banna ba ka bang 85% ba nang le HD ba tlalehile bonyane makhetlo a mararo a ts'ebeliso ea litšoantšo tsa bootsoa ka beke, ha ba bapisoa le 40% ea taolo e nepahetseng. Ho feta moo, banna ba nang le HD ba shebelletse litšoantšo tse manyala tse hlephisang boitšoaro ka karolelano ea metsotso e mashome a supileng (t(47) = −3.61, p = 0.001, d = 0.73) ho feta taolo e ntle. Nako ea tšebeliso ea litšoantšo tsa bootsoa e fapane haholo lipakeng tsa lihlopha, ha banna ba fetang halofo ba nang le HD ba shebelletse nako e fetang hora ka beke, ha ba bapisoa le 9% feela taolong e phetseng hantle. Mabapi le ho rata thobalano le thibelo ea thobalano, banna ba nang le HD ba tlaleha ho nyatsa ho eketsehileng ka thobalano (SES: t(83) = 5.01, p <0.001, d = 1.09), thibelo e tlase ea thobalano ka lebaka la ts'okelo ea litlamorao tsa ts'ebetso (SIS2: t(83) = −3.75, p <0.001, d = 0.82). Leha ho le joalo, banna ba nang le HD ba bontšitse sekoli se phahameng bakeng sa tšokelo ea ts'ebetso ea ho se sebetse hantle (SIS1; t(80) = 2.30, p = 0.024, d = 0.48). Ho khahlisang, ho ata ha khatello ea thobalano e tlalehiloeng ho ne ho tšoana ho banna ba nang le HD le taolo e phetseng hantle (tlhahlobo e tobileng ea Fisher (tlhahlobo e tobileng ea Fisher (N = 85), p = 0.765), ka kotloloho ho ne ho se na phapang lipuisanong tsa erectile, takatso ea litakatso tsa hypoactive, pele ho nako le ho lieha hoa kemolo.
Litšoantšo tse tšoanang le tsa ponelopele, ho hlopha mahlo, ho hlonama, bosholu, ho fetella kapa ho li fetisa li ne li atile haholo ho banna ba nang le HD (tlhahlobo e tobileng ea Fisher (N = 85), p <0.001) (bona Lethathamo 3). Banna ba nang le HD le bona ba ne ba na le menyetla ea ho tlaleha boitšoaro bo matla ba thobalano (Tlhahlobo e tobileng ea Fisher (N = 85), p <0.001) le sekhahla se phahameng sa ho sebelisa litšoantšo tsa tlhekefetso ea bana bonyane hanngoe bophelong ba bona (Teko e nepahetseng ea Fisher (N = 82), p = 0.009); ha ho le e 'ngoe ea taolo e phetseng hantle e tlalehileng hore e sebelisitse litšoantšo tsa tlhekefetso ea bana.

3.3. Litšobotsi tsa Psychological le Comorbidities

Habohlokoa le ho feta, banna ba nang le HD ba ile ba senola matšoao a kelello a mangata a joalo ka khatello ea maikutlo, ho akheha kapa matšoao a ADHD (bona Lethathamo 4). Tlhahlobo e arohaneng ea tlhahlobo ea hajoale ea mekhahlelo ea SCID-I e bonts'a sekhahla se phahameng sa mathata a amanang le sehlopha sa HD (tlhahlobo e tobileng ea Fisher (N = 85), p = 0.015). Tekanyo ena e ntseng e eketseha ea tlhahlobo e ile ea tšehetsoa ke tlhahlobo ea psychometric ea matšoao a sithabetsang a nang le matšoao a phahameng ho banna ba nang le HD (BDI-II; t(79) = 5.47, p <0.001, d = 1.13). Liphetho tsa tlhahlobo ea hona joale ea SCID-I ea ts'ebeliso e mpe ea lithethefatsi le / kapa ho itšepa ho ne ho tšoana lihlopheng tsena tse peli (Tlhahlobo e tobileng ea Fisher (N = 85), p = 1.000), feela tlhahlobo ea psychometric ea tšebeliso ea joala (AUDIT; t(82) = −0.93, p = 0.354) le tlhekefetso ea nicotine (FTND; t(83) = 0.73, p = 0.471, d = 0.16). Leha ho le joalo, litekanyetso tsa mathata a hona joale a matšoenyeho (Tlhahlobo e tobileng ea Fisher (N = 85), p = 0.690), likhatello tse potellehang tse lekang (tlhahlobo e tobileng ea Fisher (N = 85), p = 1.000), le matšoao a somatic le mathata a ho ja (Teko e tobileng ea Fisher (N = 85), p = 1.000) e ne e sa fapana lipakeng tsa lihlopha. Ha ba kopantsoe hammoho, banna ba nang le HD le taolo e phetseng hantle ba bontšitse tekanyo e tšoanang ea tlhahlobo ea hajoale ea SCID-I (tlhahlobo e tobileng ea Fisher (N = 80), p = 0.104) le tlhahlobo ea bophelo ea SCID-I ea bophelo bohle (Tlhahlobo e tobileng ea Fisher (N = 85), p = 0.190). Leha ho le joalo, banna ba nang le HD ba ne ba na le monyetla oa ho bonts'a matšoao a ADHD ka nako ea tlhahlobo (ADHS / SB; t(73) = 6.31, p <0.001, d = 1.37) le ho tlaleha matšoao a bongoana a ADHD (WURS-K; t(82) = 3.76, p <0.001, d = 0.82) Ho feta moo, banna ba nang le HD ba ile ba senola ho susumetsoa ho hoholo ho feta taolo e phetseng hantle (BIS-11; t(81) = 3.76, p <0.001, d = 0.83). Liphetho tse amanang le taolo ea maikutlo li ne li kopantsoe: banna ba nang le HD ba ne ba le monyetla oa ho sebelisa maano a ho laola maikutlo a fosahetseng (maano a FEEL-E-maladaptive; t(81) = 3.54, p <0.001, d = 0.78) le maano a ho “reappraisal” (ERQ: Reappraisal; t(83) = −2.477, p = .015, d = 0.545) empa ts'ebeliso ea maano a ho feto-fetoha le maemo (maano a sebetsang a FEEL-E-adapter; t(81) = −1.26, p = 0.212) e ne e ts'oana le ts'ebeliso ea maano a "hatello" (ERQ: Khatello; t(83) = 1.852, p = 0.068). Banna ba nang le HD ba boletse matšoao a eketsehileng a alexithymia (TAS-26; t(79) = 4.11, p <0.001, d = 0.92) lintlha tse phahameng maemong a mabeli, matšoenyeho a amanang le khokelo (ECR-R matšoenyeho): t(78) = 5.413, p <0.000, d = 1.245) le ho qoba ho amanang le sehokelo (Qobello ea ECR-R: t(82) = 4.908, p <0.000, d = 1.064).

3.4. Tlhatlhobo ea Logistic ea Logistic

Mefuta e fapaneng e fapaneng hantle pakeng tsa banna ba nang le HD le taolo e phetseng hantle e ne e le lilemo tsa ho qala ho ipholla litho tsa botona kapa botšehali (OR = 0.55, 95% CI (0.35, 0.86))OR = 1.06, 95% CI (1.01,1.11). Lintho tseo eseng tsa bohlokoa e ne e le likotsi tsa bana le mokhoa oa ho ikamahanya le ho tšoenyeha. Mohlala oa "regression" o boletsoeng o ne o le hantle (le Nagelkerke R2 = 0.55 le tlhahlobo ea Hosmer-Lemeshow: χ2(7) = 11.76, df = 7, p = 0.11) mme a hlalosa ka 55% ea phapang lipakeng tsa lihlopha tsena tse peli. Ho nepahala ha khethollo e ne e le 80.0% (tlhaiso ea 78.1%, kutloisiso ea 81.4%).

4. Puisano

Phuputso ena ke e 'ngoe ea pele ea ho sekaseka tlhaiso-leseling e ikhethang ho tsoa ho sampole e kholo ea batho ba ileng ba fihlela mekhoa e boletsoeng bakeng sa phallo ea hypersexual [3'me u li bapise le sehlopha sa taolo e phetseng hantle. Palo e kholo ea lintlha tsa sechaba, sebopeho sa litaba tsa bophelo, le litaba tsa lelapa, hammoho le litšobotsi tsa thobalano, litšobotsi tsa kelello, le li-comorbidities li ile tsa hlahlojoa.
Ka tlhahlobo ea mefuta-futa ea lipatlisiso tsena, thuto ena e senotse liphapang tsa bohlokoa lipakeng tsa batho ba fumanoeng ba na le phallo ea maikutlo le taolo e phetseng hantle.
Ka kakaretso, banna ba nang le HD ho bonahala ba bile le mathata a mangata nakong ea bongoana ho feta taolo e phetseng hantle, ho na le monyetla oa ho ba le mme ea nang le mathata a kelello, ho ba le mefuta e fapaneng ea liphihlelo tse bohloko nakong ea bongoana le ho ba le matšoao a AdHD ea bongoaneng. Ho feta moo, mathata a khokahano le ho qojoa ho boletsoeng kamanong e haufi a ne a phahame ho banna ba nang le HD. Ts'ebetso ea ho ipholla litho e ne e sa le lilemong tsa pele ho banna ba nang le HD mme ba ile ba ba le thobalano e phahameng ea thobalano le thibelo e fokolang ea thobalano ka lebaka la ho ameha ka litlamorao tse mpe, empa thibelo e phahameng ea thobalano ka lebaka la ts'okelo ea ho hloleha ho sebetsa. Ntle le moo, banna ba nang le HD ba ne ba tšoauoa ka mathata a hlahisoang ke litletlebo tse bobebe ka lebaka la ts'ebeliso e phahameng ea thobalano e teng inthaneteng mme ba tlaleha boitšoaro bo khelohileng ba ho kopanela likobo, e leng litekanyetso tse phahameng tsa paraphilia, boits'oaro bo bobe ba thobalano, le tšebeliso ea litšoantšo tsa tlhekefetso ea bana. Matšoao a tšoaetso ea mafu a amanang le matšoao le matšoao a mefuta e mengata ea li-comorbidities tsa kelello joalo ka ho se tsitse, matšoao a ADHD ea batho ba baholo, alexithymia, le maano a taolo ea maikutlo a fosahetseng a ile a eketseha ho banna ba nang le HD.
Ho ne ho e-na le matšoao a phapang bongoaneng ba banna ba nang le HD ha ba bapisoa le taolo e phetseng hantle. Mohlaleng oa rona oa mohlala, maano a ho se sebetse hantle maikutlong a kang ts'ebetso e fokotsoang le mokhoa o nyane oa ts'ebetso e mpe o ka bonoa ho banna ba nang le HD, hammoho le alexithymia e eketsehileng. Banna ba nang le HD ba tlaleha maemo a mabe a boiphihlelo ba bongoana; haholoholo litefiso tsa tlhekefetso ea maikutlo le ho se tsotelle, hammoho le tlhekefetso ea thobalano li ile tsa eketsoa, ​​tse bonts'itsoeng li amana le mathata a taolo ea maikutlo [57]. Ho feta moo, maano a ho laola maikutlo a fosahetseng ho banna ba nang le HD a ka hlohlelletsoa ke mathata a kelello ao 'm'a ngoana a nang le ona [58] tse ileng tsa eketsoa ho banna ba nang le HD. Re pheha khang ea hore tsela e ka khonehang ea ho ea HD ke ka lipapatso tsa boithuto le boiphihlelo bongoaneng le bocha bo re thusang ho nts'etsapele maano a taolo a maikutlo a fosahetseng [34]. Ho feta moo, maano a ho se sebetse hantle maikutlong a ka sebetsanang le mathata a khokahano ao re a boneng ho banna ba nang le HD, joalo ka ha bana ba bonts'a maano a ho se sebetse hantle maikutlong ha ba le kamanong e sa bolokeheng le bo-mme ba bona.59]. Thutong ea baemeli ea baahi ba Majeremane, tšebeliso ea liketso tsa thobalano marang-rang e ne e amahanngoa haholo le batho ba khothetseng ba tšoenyehileng [60]. Tlhahlobo ea rona ea regression e bontšitse hore ho qoba likamano tse atamelaneng pakeng tsa banna ba nang le HD le taolo e phetseng hantle, e tsamaellanang le Katehakis's [34] tlhahiso ea hore bakuli ba bang ba HD ba kanna ba hlonepha maikutlo nakong ea bongoana. Sena se ka lebisa nts'etsong e mpe ea tsamaiso ea limbic le likarolo tsa "cortex ea pele", ka lebaka la ts'ebelisano e mpe e amanang le tsamaiso ea methapo ea methapo, tsamaiso ea methapo ea methapo ea kutlo le hypothalamic-pituitary-adrenal axis [34].
Liphetho tsa rona li tsamaellana le liphumano tse fanang ka maikutlo a hore banna ba nang le boiphihlelo ba HD ba nang le bofokoli ba melaoana bo ama melaoana mme bo ama hampe mme ba ka sebelisa boits'oaro bo matla e le leqheka le phoso la ho sebetsana le bona [61]. Liphoso tsena tsa methapo ea kutlo li ka hlaha bongoaneng mme li ka fokolisa bokhoni ba maikutlo le ba kelello [34]. Leha ho le joalo, re fumane feela mathata a maikutlo mme ho se na phapang ea bohlale joalo ka ha bo lekantsoe ke likarolo tse tlase tsa WAIS-IV [39] li hlokometsoe thutong ena le lithutong tse nang le sampole e nyane [62].
Boikutlo bo mabapi le boitšoaro bo nyarosang bo ka bonts'oa pejana kholong ea thobalano, sehlopha sa rona sa HD se ile sa bonts'oa ke tšimoloho ea pele ea ho ipholla litho e ileng ea khetholla haholo lipakeng tsa banna ba nang le HD le taolo e phetseng hantle tlhahlobisong ea maikutlo. Ho feta moo, boitšoaro bo feteletseng bo amanang le ho qaleha ha litakatso tsa thobalano [35], le ho qaleha ha thobalano ho hokahane le ts'ebetso ea ho batla maikutlo, khatello ea maikutlo le matšoenyeho [63]. Khafetsa le nako ea ts'ebeliso ea litšoantšo tsa bootsoa li ne li phahame ho banna ba nang le HD. Leha ho le joalo, ho bohlokoa ho hlokomela hore ha se palo ea tšebeliso ea litšoantšo tse litšila tse tsosang takatso e bakang mathata empa kamano ea lipakeng tsa khafetsa le nako ea tšebeliso ea litšoantšo tse litšila tse tsosang takatso ha e tsamaisane, empa e kopantsoe le botebo ba matšoao a bonoang a amanang le ts'ebeliso ea litšoantšo tsa bootsoa [64]. Tlhahiso ea tšusumetso ea bokhoba ba tahi [65,66], e sebelisitsoeng ho HD [26,62], e fana ka maikutlo a hore ka ho lemalla "ho batla" ho susumetsoa ho ikarohanya le "ho rata" ho susumetsa. Sena se ka hlalosa hore na hobaneng banna ba nang le HD ba ntse ba tsoela pele ka mathata ha ba na le litlamorao tse mpe. Ebile, banna ba nang le HD mohlaleng oa rona ba tlaleha mathata a mangata ka lebaka la ts'ebeliso ea bona ea litšoantšo tsa bootsoa.
Karolo ea bohlokoa ea thobalano ea thobalano le tšitiso ho boitšoaro bo nyarosang e bontšitsoe lipatlisisong tse kholo [35,67]. Sehlopha sa HD mohlaleng oa rona o tlalehile likamano tse phahameng tsa thobalano le tšitiso e fokolang ea thobalano ka lebaka la ts'oso e lemohuang ea litlamorao tsa ts'ebetso, mme ka hona e ne e le mohopolo o phahameng oa thobalano. Re pheha khang ea hore mokhoa ona o hlasimolohileng oa thobalano ke ntho e ka bang tlokotsing eo, hammoho le ho sebelisa boitšoaro ba thobalano e le leqheka la taolo la maikutlo le sa hlokeng ho eketsa monyetla oa ho ba le khatello ea maikutlo. Phuputso ea sampole e kholo ea inthanete e sebelisitseng palo eohle ea mabenkele a thobalano e le sesupo sa ho khanna thobalano e bontšitse hore lithahasello tse phahameng tsa thobalano li ne li amana le tšebeliso ea litlaleho tsa tlhekefetso ea bana [68]. Ebile, mohlaleng oa rona ha ho na taolo e phetseng hantle e tlalehiloeng e kileng ea qeta ho sheba litšoantšo tsa bootsoa tsa bana ho fapana le 80% ea banna ba nang le HD. Litefiso tsa boitšoaro bo kopaneng ba ho ba le thobalano li ile tsa eketseha ho banna ba nang le HD, ho bonts'a litekanyetso tse ngata tsa tšebeliso ea litšoantšo tsa tlhekefetso ea bana ho banna ba nang le HD. Ho ipapisitsoe le liphetho tsena tse kopantsoeng le litlhahlobo tsa "meta" tse fumanoeng hypersexuality e le karolo ea ts'ehetso ea ts'usumetso ea matla ho boits'oaro ba thobalano [69], re khothaletsa baoki hore ba hlahlobe nalane ea botlokotsebe le boitšoaro bo ka bang teng ho tsa thobalano ho bakuli ba nang le HD.
Ntle le moo, re fumane litheko tse eketsehileng tsa banna ba nang le HD paraphilic. Ho fihla joale, ho na le liphumano tse sa lumellaneng mokheng oa lithahasello tsa paraphilic le HD. Boithuto bo bong bo fana ka maikutlo a ho nyoloha ha lithahasello tsa paraphilic [14], athe tekong ea tšimo bakeng sa mekhoa e ntlafalitsoeng ea HD [9] ha ho kamano e fumanoeng. Tlhaloso e ka bang ea litheko tse khelohileng e tla ba ho buleha ho tlaleha litabatabelo, hobane Jeremane leseli le tlhaiso-leseling e bokelletsoeng nakong ea lipatlisiso le maemo a kalafo e sirelelitsoe ke lekunutu, leha e kenyelletsa litlaleho tsa phaello ea papiso, tšebeliso ea litšoantšo tsa bootsoa tsa bana le ho ts'oaroa ka thobalano. boits'oaro. Thahasello ea Paraphil ka boeona (haeba ho se na ba bang ba utloisitsoeng bohloko) ha e hloke kapa ho lokafatsa ho kenella ha kliniki [4]; leha ho le joalo, lithahasello tsa paraphara hangata li amahanngoa le mathata a kamano [70]. Ka kakaretso, moroalo oa kelello o emeloang ke HD ke e 'ngoe ea liphetho tsa mantlha tsa ho tsoa thutong ena. Lintlha tsa rona li totobatsa matšoao a ntlafatsang a li-comorbidities tsa mafu a kelello ho HD. Haholo-holo, ho fumanoa ha matšoao a hona joale le a bophelo ba mathata a amanang le bophelo ho eketseha sehlopheng sa HD. Thutong ea rona, palo ea matšoao a khatello ea maikutlo joalo ka ha e lekantsoe ke BDI-II e ne e batla e le makhetlo a mararo ho banna ba nang le HD joalo ka taolo e phetseng hantle. Tumellanong le liphetho tsa rona, Weiss [71] e fumane hore ho ata ha khatello ea maikutlo ho ne ho batla ho le makhetlo a 2.5 ho banna ba nang le HD ho feta ho bongata ka kakaretso. Ka bobeli sephetho sa liphuputso tse ngata tse batlisisang mathata a amanang le comorbid bothateng ba hypersexual li bontša hore ho ata ho teng lipakeng tsa 28% le 42% [20,70,71]. Ho feta moo, re belaela hore ho nkeha maikutlo, haholo thobello e ikhethileng ea thobalano [25] ke lets'oao la khatello ea maikutlo, ho ipapisitse le maikutlo a rona a eketsehang a banna ba nang le HD mme lithuto tsa nako e tlang li lokela ho leka ho etsa lipatlisiso ka sena. Ho sebelisa tlhekefetso ea lithethefatsi khafetsa ho hokahana le ho nkeha maikutlo ho hoholo. Mohlaleng oa rona re fumane keketseho e nyane ka boholo bo boholo ba phello, empa litekanyetso tsa tlhekefetso ea lithethefatsi li ne li sa fapana lipakeng tsa lihlopha. Ho na le lithuto tsa kelello le tsa maikutlo tse fanang ka maikutlo a hore tlhekefetso ea lithethefatsi e bapala karolo ea boitšoaro bo feteletseng [22,72,73], empa setšoantšo se ntse se sa hlaka, kaha lithuto tse fapaneng li sebelisitse mehato e fapaneng le mehlala ea mehlala. Ntle le moo, lithuto tsa nako e tlang li lokela ho etsa lipatlisiso tsa boits'oaro bo kotsi ba ho ba le thobalano ho banna ba nang le HD, ba bontšitsoeng hore ba amana le mefuta e mengata e mengata ea likoluoa ​​tsa kelello [74].
Ho ipapisitse le likhopolo tsa theoretical le liphetho tsa rona, re thehile mohlala oa ts'ebetso bakeng sa etiology ea boitšoaro bo amanang le hypersexual (Setšoantšo sa 3). Le ha ho se na bopaki ba hore ho na le ts'oaetso e le 'ngoe ea ho hlaseloa ke lefu la khatello ea methapo, mohlala o supa likarolo tse ngata tse ka eketsang monyetla oa ho ba le lefu la hypersexual. Moetso ona o sebetsang o ka ba molemo ho hlahiseng lipotso tse ncha tsa lipatlisiso le liphetoho tsa mananeo a kalafo.
Jcm 08 00157 g003 550
Setšoantšo sa 3. Mohlala oa ho sebetsa oa hypersexual disc. Re nahana ka motsoako o ka sehloohong oa liphatsa tsa lefutso le tikoloho tse ka eketsang monyetla oa ho ba le lefu la hypersexual. Motsoako oa lintho tse amanang le biopsychosocial, mohlala, liphatsa tsa lefutso le epigenetic le liketsahalo tse bohloko tsa bongoana li ama litšobotsi tsa motho ka mong le ho eketsa monyetla oa ho ba le mathata a kelello a kelello. Motho ea nang le takatso e phahameng ea thobalano a ka hokahana le liphatsa tsa lefutso mme a ka susumetsoa ke le ts'usumetso ea ho qala liphihlelo tsa thobalano pele ho nako. Litšobotsi tsa ho se sebetse hantle tsa motho ka mong, mathata a comorbid, le takatso e phahameng ea thobalano li ka lebisa nts'etsopele ea khatello ea maikutlo. Mabaka a tšoailoeng ka asterisk a nkuoe posterori lipatsong tsa rona.
Lintlha tsa rona li na le litlamorao tse 'maloa tsa kalafo. Re khothaletsa hore baoki ba hlahlobe ho hlekefetsoa maikutlong le ho se tsotelle, le tlhekefetso ea thobalano ho banna ba nang le HD. Ho feta moo, datha ea rona e bonts'a hore matšoao a motho ea moholo oa comorbid ADHD a ile a eketseha ho banna ba nang le HD mme ho fanoe ka tlhahiso ea hore bakuli bana ba kanna ba rua molemo kalafing ea kalafi le ea boits'oaro bo kopaneng [75]. Ha phokotso ea tšebeliso ea maano a ho se sebetse hantle maikutlong a sa bonahaleng a bonoa mehlala ea rona, kalafo ea boits'oaro bo botle e lokela ho shebana le maemo a dysphoric mood and impulsivity ho banna ba nang le HD [76]. Mokhoa oa phekolo o sa ahloleng o oa hlokahala ho sebetsana le paraphilia, e atisang ho etsahala ho banna ba nang le HD. Re fumane litekanyetso tse eketsehang tsa boits'oaro bo bobe ba thobalano le tšebeliso ea litšoantšo tsa tlhekefetso ea bana ho banna ba nang le HD, mme haeba e sa thibeloe ke meeli ea ho boloka lekunutu, re fana ka maikutlo a hore tlhahlobo ea lingaka e eletsoa ka matla ho thibela boitšoaro bo ka bang kotsi.

5. Meeli

Ho bohlokoa ho hlokomela hore mohlala ona o ne o kenyelletsa batho ba ithaopileng ho nka karolo ho ithuteng bongaka mme ba lumela ho tlaleha lintlha tse hlakileng tsa liketsahalo tsa bophelo, boiphihlelo ba kahare le boitšoaro ba thobalano. Kahoo, litšobotsi tsa sampole ena li kanna tsa se bapisoe le tsa batho ba nang le bothata ba khatello ea maikutlo bo tsilatsila ho arolelana tlhahisoleseling.
Litlhaloso tsa mabaka mabapi le etiology ea HD li thata ho hula, hobane - ntle le 2D: tekanyo ea 4D-re ne re itšetleha ka tlhaiso-leseling ea tlhaiso-leseling le tlhahlobo ea bongaka lithutong tse bohareng le likarabo li kanna tsa angoa ke khethollo ea kahisano ea sechaba.
Ho thata ho fetisetsa sephetho sa thuto ena litsong tse ling. Ntle le moo, mohlala ona oa Europe Bophirimela e ne e se moemeli oa baahi ba Europe Bophirima ho latela mohlala, lilemo le thuto.

6. Liphello

Banna ba nang le HD ba bonahala ba na le li-neurodevelopment tse tšoanang, maemo a bohlale, semelo sa sechaba le litaba tsa lelapa ha li bapisoa le taolo e ntle. Leha ho le joalo, banna ba nang le HD ba tlaleha liphapang likarolong tsa bohlokoa tsa bophelo, tse kang liphihlelo tse bohloko bongoaneng, boitšoaro bo bobe ba ho kopanela liphate, le mathata a kelello a eketsehang.

Lisebelisoa tse tlatsetsang

Tse latelang li fumaneha inthaneteng ho https://www.mdpi.com/2077-0383/8/2/157/s1, Litlhahlobo tse ling.

Menehelo ea Mongoli

Conceptualization, JE, TH, UH, THCK, JK; mokhoa, JE, MV, CS, IH, THCK, tlhahlobo e hlophisitsoeng, JE, MV, ho ngola-ho ngola litlhaku tsa pele, JE, ho ngola-lekola le ho hlophisa, JE, IH, CS, MV, THCK, UH, tlhokomelo, THCK, UH , CS, TH, ho fumana chelete, THCK, UH, TH, JK

dithuso tsa ditjhelete

Boithuto bona bo tšehelitsoe ke chelete ea ho etsa lipatlisiso e tsoang ho European Society bakeng sa Bongaka ba Thobalano.

lumela hore baa fokola

Bangoli ba leboha Marie-Jean Carstensen, Anna Spielvogel le Julia Liebnau ka thuso ea bona ea ho etsa sengoloang.

Likhohlano tsa Thahasello

Lingoloa ke lipatlisiso tsa mantlha ebile ha li e-so phatlalatsoe kae kae. Bangoli ha ba phatlalatse lithahasello tsa lichelete tse ka tlholisano.

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